Case Quizes Clinical Cases

Revisiting: Lump in Throat

Written by Elaine Lewis

Our patient thinks she has a lump in her throat. Do you know what the remedy is? Scroll down for the answer.

Time for another quiz, Mom.  Unfortunately there are some bad things that I have to report on this month.  Do you want the good or the bad news first?

Might as well get the bad news over with.

Our favorite restaurant at 910 Christian Street in South Philly, Sabrina’s Cafe, closed its doors permanently.

Oh no!!!!!  Where are we going to hang out now????

They were temporarily closed for the past year due to the pandemic.  They’ve been around for 20 years and it’s hard to believe that it just won’t be there anymore.  Didn’t you and Shirley go there that time she visited us?

Yes.  I had pictures somewhere!  Oh!  OK, here’s Shirley Reischman (left) and me eating al fresco at Sabrina’s in 2003 and below, you and Shirley in our living room and I think I see Mousey there:

Or am I thinking of Shobi from Sri Lanka?

Shobi met us there too.

I miss her.

I miss her too!!!!  Here you are with Shobi at Sabrina’s.  Shobi’s a homeopath too.

OMG, where will you and Shobi meet now if she ever visits Philly again?

Sabrina’s is supposed to relocate, and hopefully they will do it soon.  Shirley, by the way, is famous for the article she wrote on Nux vomica:

Nux vomica: The Pre-eminent Remedy for Modern Day Life

If Lorenzo’s closes, we’re officially doomed!

George (owner of Lorenzo’s), Shirley and me outside Lorenzo’s:

It’s just when you consider that, 1. we’ve lost the fruit stand, 2. we lost Golden Donuts, 3. The Butcher’s Cafe and 4. now Sabrina’s… what’s next?  The only thing left in our old neighborhood is Lorenzo’s Pizza and Molly’s Book Store.  Do you remember what Daddy used to order from Lorenzo’s?

A cheesesteak with fried onions and ketchup.  He also ordered the Italian Hoagie.  Remember when you would order a hoagie and eat it at Sabrina’s?  You’d take everything out of it and just eat the roll! What a ridiculous waste of money.  I would get stuck eating the ham, cheese, onions and lettuce! What a mess!  Remember I would order a pancake from Sabrina’s and you would eat the center and I would eat the edges?

And the other half of the hoagie we always gave to a homeless person.

I know, we’d drive around and around until we found one!  Those were the good ol’ days!  The pandemic has ruined everything.

Here you are at Sabrina’s in 2012:

You don’t have anymore bad news, do you?

Well, you might want to sit down for this, Mom.  We lost “Mr. Personality”, Lloyd Price.

No way!!!!!  We just saw him at the Kimmel Center!

He was 88 years old and it was crazy how I found out!  I ended up on Youtube because we were talking about his #1 hit, “Stagger Lee”, which has the distinction of being the first 1950s record to be censored.


Dick Clark, the host of “Bandstand”,

Did I mention that I was on Bandstand 3 times?


You were saying?

I was saying…. Dick Clark wanted him to rewrite “Stagger Lee” and take out all the references to gambling, bar rooms, shooting, etc., as he didn’t think it was appropriate content for an afternoon TV dance show for teens.  So, Lloyd had to turn his song about “Stagger Lee and Billy, 2 men who gamble late” into a song about two guys arguing over a girl and in the end, coming to an amicable resolution over who she belonged to.  Lloyd thought it sounded ridiculous!!!!

It did.

Anyway, I ended up on the Youtube page for the Rock N Roll Hall of Fame, and found a video from the 1998 ceremony where Lloyd is performing with John Fogerty of Credence Clearwater Revival.  I guess that was his induction year?  There was a comment at the bottom saying “RIP” and I was, like, “What?????”  That’s how I found out he was no longer with us!  The really insane thing is that he’s the same age as Daddy (born 1933) and also went to fight in Korea.  You’d think they would’ve known each other.

Daddy was transferred out of Korea to Germany.  Remember?

We saw Lloyd Price 7 years ago at a Kimmel Center show.  It was one of those things hosted by Jerry Blavat.  We got an autographed picture of him.  I believe you told him that one of his songs (that I’ve never heard) was one of your favorites.

Yes, I did tell him.  I said, “My favorite song by you is ‘Never Let Me Go’.”  So, that’s how he signed his picture: “Lloyd Price Never Let Me Go”.  I also told him he was GREAT!

I know, you said it over and over!

You don’t think I made a pest out of myself, do you?

Oh nooooo, not at all!!!!!!!!


Shana and Lloyd Price:

As long as we’re honoring Lloyd Price, I guess I should share this hilarious story.

If you can, Puh-leeze do!

I once had a music teacher at school who thought that “Rock Around the Clock” by Bill Haley was the first rock and roll record.  Ha!  So naturally we had to show her how wrong she was!

Yeah, I don’t think she’ll make that mistake again!

We made her a cassette tape with all the songs that came out before “Rock Around The Clock”, one of which was, naturally, “Lawdy Miss Clawdy” by Lloyd Price.

Shana, I could play the record, but, I just found a live performance of Lloyd Price and Little Richard singing it together!


Wow! You can’t beat that, you just cannot beat it!  What else was on that tape we made for your music teacher?

Um… “He Treats Your Daughter Mean” by Ruth Brown, “Tutti Frutti” by Little Richard, “Shake Rattle and Roll” by Big Joe Turner….

Get outta that bed, wash your face and hands…


Get outta that bed, wash your face and hands…


Get into that kitchen make some noise with the pots and pans…

Mom, you have to stop singing now…

I said Shake, rattle and roll!  Shake rattle and roll…

MOM!  Get a hold of yourself!  We have more deaths to announce!!!!

We do?

Joe Long of The 4 Seasons died of covid.


Clockwise from the top: Tommy DeVito, Joe Long (b. Joe LaBracio), Frankie Valli and Bob Gaudio.

Here are Frankie Valli and the 4 Seasons singing “Hang On To What We Got”, Joe is playing the black and white bass and he is left-handed:

Since this got so long, a quick run down of the good news to outweigh the bad.

I’m glad to hear there is good news!

  1. May 17th, 2021 is the 30th Anniversary of “What About Bob?”  Readers should direct themselves immediately to Mom’s article with Mati Fuller about the two main characters, Bob Wiley and Dr. Leo Marvin:

Elaine Lewis and Mati Fuller Sort out Arsenicum alb. and Argent-nit.


I wonder if Bill Murray and Richard Dreyfuss will acknowledge it, but I’ve heard that for some crazy reason they don’t get along in real life.

No way!  Of course, they didn’t get along in the movie either!

Also, in one of our quizzes (“Child Has Scary Virus, Hears Voices”) I proposed an idea for a sequel to “What About Bob” but I guess it just wasn’t meant to be.

Wait a minute.  You proposed an idea for a sequel, and nobody listened?


I can’t believe that!

Bob Wiley and Dr. Leo Marvin


  1. I’m excited for The Rugrats revival…

Oh for heaven’s sake!!!

…on Paramount+ (a streaming service) May 27th.  Yes, I know you think I need to grow up.

Well, if it wouldn’t be too much trouble… I know how busy you are!!!!

They’ve recast the adults though, so I’m not really sure what to think.  I mean, Stu and Grandpa Lou I can understand, since their original voice actors died, but, they also literally recast all the adults in the show!

No way!  Somebody call the police!  Can we start the Quiz now?

Who’s in it this time?

Remember Rosetta Stone?  I think she’s got a lump in her throat.


Elaine, for the last five days i find myself clutching my throat like there is a lump in it.

I wonder if its enlarged thyroid?

When I look at it in the mirror it doesn’t seem enlarged but when I swallow or just when I’m sitting it feels enlarged and with a lump.

Last night I felt it was getting bigger.

I’m going to take thymuline today after I get home from the beach at sunrise which I go to every morning.

I went to an ear nose and throat doctor a few months ago and they put camera down my throat to see if I had that thing that causes u to have shortness of breath while coughing but they couldn’t find anything.

I found myself grabbing at my throat many times this week.  It seems to be lower Adam’s apple area.

When I swallow it feels like lump in throat.

It also scares me that it could be my esophagus because for years now when I over-eat, I eat a bite then spit out the rest so i don’t gain more weight and I’ve been doing it for years.  I read an article saying you must eat some bites of it and swallow it so as not to hurt your esophagus.

I do that but in the back of my mind I’m scared thinking I’m doing harm to my esophagus throat area.

I’m addicted to food.

Rosetta, I think you should take a dose of __________________.

Elaine, the _____________ HELPED THE LUMP IN THROAT!!!!  It’s all gone now!!!  Thank you.


Well, that’s it, everybody!  If you think you know the remedy, write to me at [email protected].  The answer will be in the June ezine.







Well, we’re back!!!!  How did we do with last month’s quiz?

Hi Elaine,

Hey, it’s Lori D from NYC!

My guess for this month’s quiz is Lachesis.

I expected a lot of votes for Lachesis.  It’s a common remedy for “lump in the throat”.

This is what I came up with but not sure what to do with the ENT visit.  Did she have the concomitants of dyspnea and coughing in the past?

What I did with the ENT visit was to take the rubric “Hypochondriasis”, as the doctor couldn’t find anything wrong with her.

Sensation of lump in throat–pit.

I wouldn’t go there.  For “location”, “throat” is enough!  If we insist on narrowing it down to “throat-pit”, we’re going to lose a lot of remedies that fall under “throat”; including the one that cured!  There’s just not that much difference between “throat” and “throat-pit” to justify disqualifying dozens of remedies.

Sensation of lump on swallowing

But here’s the problem with taking that rubric; she also had the lump sensation when not swallowing.  So, think about it.  If you’ve got a lump in your throat when not swallowing, it’s gonna be there when you swallow too, don’t you think?  

Swollen sensation, no swelling visible, throat

No.  Did she say she had a “swollen” sensation?  No, she didn’t.  I can’t even find that rubric.  I see “swollen sensation, tonsils”.  Let’s just stick with “lump sensation” since those were her words.

Excessive hunger (bulimia, ravenous, voracious)

Well, whoa, wait a minute!  You picked “ravenous hunger”, “voracious hunger”, “excessive hunger”…and bulimia!  Let’s simplify this list.  The rubric for her appetite is “Food: appetite, ravenous”, and even though we can take that rubric if we want to, with so many remedies in it (235), it’s basically showing us that every remedy, for all intents and purposes, has ravenous hunger!!!!!  Just look at what’s in Bold in this rubric: Calc-carb, Arsenicum, Argent-nit, China, Graphites, Nat-mur, Lycopodium, Sulphur, Phosphorus, Pulsatilla, Nux vomica, Veratrum alb….and more!  How is this going to help us if all our polychrests are there in bold????

The rubric I took for her food addiction was “Obsessive, compulsive disorder (OCD)” because it better depicts “addiction”, to use her words, than ravenous appetite.

But, I am impressed that you picked out Bulimia!  Do you think she’s bulimic?  I thought so too!  I wrote back to her and said, “How is spitting out food going to hurt your esophagus?  Are you bulimic?”  She never answered!!!!!  I took the rubric “secretive” because she was not forthcoming about what she was really doing.  I am pretty sure you can’t injure your esophagus by spitting out food; but, vomiting can most assuredly put your esophagus at risk!  Unfortunately, I guess we will never know the whole story.

Desires open air

Where does it say that?  Do you mean her trips to the beach to watch the sunrise?  I took the rubric “romantic” for that.  We really have to be more careful with the assumptions we’re making.  A lot of assumptions were made about this case.

It is also known for hormonal disturbances…is that why she is taking thymuline?

I think Thymuline is homeopathic thymus.  The point is, it’s another example of hypochondriasis—a preoccupation with health matters, taking “treatments”, seeing doctors/healers, etc.

Ok, if I’m wrong, then I will try try again.

You’re wrong, but, here’s the case:  We have two striking symptoms here: 1) lump sensation in the throat and 2) what I am perceiving as bulimia.  You could say, “We need a lump in the throat/bulimia remedy that’s also secretive, hypochondriacal, obsessive/compulsive and romantic.”

Who else wants to try?


Hi Elaine,

I’ll go with Ignatia.  If not Ignatia, then Nat Mur.


Mary K. Makoski

Mary, I totally agree!  And it’s funny that they’re complementary remedies, meaning one usually follows the other.  How did you figure out it was Ignatia?

Here is how I figured it out.  After reading the case, I went to Murphy’s Repertory and looked up Throat, Lump, sensation of.

That’s what I did too!

Five remedies were in caps, and bold:  ASAF, IGN, LACH, NAT-M, and PSOR.

OK, but, be careful.  There’s no reason why the correct remedy HAS to be in Bold.

I didn’t think it was Lachesis because the client kept clutching and grabbing at her throat and Lachesis doesn’t like touch especially around the throat.

OK; though I agree with that, we’re not sure, however, that that includes her own hand; though surely Lachesis would not want anyone else’s hand near her throat.

Still, I looked at each of those 5 remedies in Muphy’s Materia Medica, as well as in Morrison’s Desktop Guide.

I checked Morrison’s Desktop Guide too.

Ignatia and Nat Mur stood out.  There were many similarities between them.  It was hard to decide.  One intriguing thing was that she went to the beach at sunrise every morning – that could have indicated Nat Mur, because even though Nat-murs avoid the beach and the sun, they can also be drawn to the beach.  And at sunrise, the sun is not that strong and hot.

But, here’s what we don’t know: is it a desire to watch the sunrise?  Or an amelioration from being at the beach and breathing in the sea air?  I took it as a desire to watch the sunrise since that was her stated goal; hence, an expression of “romantic feelings”, I thought, which is actually in the Repertory.

Three things helped me decide on Ignatia:

1) The Desktop Guide lists “Lump in the throat” as a keynote symptom for Ignatia.

Yes, it is.

2) In the Clinical section for Ignatia in both Murphy’s Materia Medica, and Morrison’s Desktop Guide, “Bulimia” is listed.

Aha!  There ya go!!!!!  Ding!  Ding!  Ding!  Ding!  Ding!!!!!  Very good!  You spotted it!!!!!  I wondered if anyone would spot it!

The client reports “when I overeat, I eat a bit then spit out the rest so I don’t gain more weight”.  That struck me as bulimic behavior.

You are absolutely right!  Totally spot-on!  Great observation!

3) In Dr. Smith’s “The Home Prescriber”, he states under Natrum Muriaticum, “Natrum Mur. is the chronic of Ignatia.”  Right!  I ask myself – in this instance, are we looking at a case that is chronic (Nat Mur) or acute (Ignatia)?  Since the client’s first sentence states that she has had the lump sensation for five days – I go with acute.

This points to Ignatia.  Then if Ignatia doesn’t clear up the case, try Nat Mur.

Dr. Smith’s Home Prescriber was my handy dandy little go-to materia medica when I started in homeopathy in 1974.

You did a great job!


Mary K.


Thanks, Mary K.  I think I see our friend Maria from Greece!

Hi Elaine and Shana! Loved your pictures in the article!

Thanks, Maria!

For this month’s quiz I am not really sure. I am between two remedies. I’ll vote for Ignatia but if I am wrong I will try again.

You’re not wrong, so don’t try again!  But how did you know?

Well, Ign. is famous for the lump sensation and the hysterical nature of symptoms.

Good, that’s what I thought too!

As I read the case, I gave weight in that she didn’t have anything physical in her throat, she was examined.

So it must be hysterical in nature.

Let me just point out that when she went to the doctor to have the camera put down her throat?  It was for a different complaint, shortness of breath with a cough, I think.  But, again, the doctor couldn’t find anything.

I wasn’t sure though because Lachesis was also a 3 under lump sensation in throat and hysterical in 2 grade.

She also said that she felt it was getting bigger in night (another keynote of lachesis, night agg.)

But I searched in Time chapter (Murphy’s repertory) and Ign. was also there in 2nd grade under night aggravation.

Then I thought about her food addiction and the way she is eating.  But I couldn’t come up with something except that it reminds me of a kind of perfectionism to stay thin.

OMG!  Brilliant!  That is so brilliant!  Perfectionism, yes!  Very good, Maria!  This is the kind of deep thinking that I like to see!!!  I didn’t even think of that!  Excellent!!!!

And Ign is a perfectionist.

Yes, you’re right!

Maybe I interpreted it wrong, I am not sure.  I wouldn’t be surprised if Ign. had an effect on her way of eating, though it is a long shot.

So,I went for my initial hunch that it must be Ign.  I am very interested to learn how you solved the case!  I am sure you saw things I missed.

Well, OK, I picked up on a kind of “obsession” to see doctors and take “medicine” and therefore picked the rubric, “Hypochondriasis”; plus, “I’m going to take Thymuline later” was a part of that too; then, the addiction to food was another example of “obsession”, I thought; so, I took “Obsessive, compulsive disorder”.  The big one, though?  She said she was afraid of damaging her esophagus by “spitting out food”–chewing it but not swallowing it.  I wrote back and said, “How can you damage your esophagus by spitting out food?”  She never answered, almost as if I was getting too close to a  “secret”; so, on a hunch, I took the rubric “Bulimia” and “Secretive”.  Of course, bulimia is done in secret, by definition!  No one’s supposed to know!  I thought her trips to watch the sunrise were suggestive of “Romantic feelings” so I took that.  Now, if I add “Perfectionism” to this list—(thank you!)— it will be an Ignatia grand-slam; in fact, it will be the only remedy that covers the whole case!


Elaine, you could add “artistic” as well.

Yes, that also explains the visits to watch the sunrise at the beach.

As I see it, the sunrise and the sunset are the ultimate masterpieces of painting.

Well said!!!!!  “Picture-Perfect”!!!!

It is not in Murphy’s repertory under artistic.

Yet another mistake/omission in the Repertory!

But it is in Radar’s Keynotes under Ignatia:

– Emotional sensitivity. Refined, artistic.

– Romantic. Idealistic.

– Close themselves off.  Mistrustful.  (she never confirmed your suspicion about bulimia).


Roger Morrison clearly mentions “Bulimia” in his Desktop Guide under Ignatia.  That’s a very important element of this case!  He also says, “The Ignatia type is romantic and idealistic in all her dealings with the world.”  Clearly, we see that here—especially in her trips to the beach to watch the sunrise.  She has a concept of the “ideal weight”, another way of seeming Perfectionistic.  Ignatia is a remedy for “spasms” which can be perceived as a “lump” or “knot”.  A spasm on the mental plane can look like an “obsession”, as in an obsession with food.  All things considered, this case fits Ignatia perfectly.  Thanks, Maria, great job!


Hey everybody, Vamsi’s in the house!!!!!


Dearest Elaine,

Back Again !!!  An Ice-breaker quiz from you !!!

Elaine this is a clear case of LACHESIS and what else should we look for, the most prominent symptoms…

From the quiz:

>>> When I swallow it feels like a lump in throat.

But Vamsi, she says it’s there when she doesn’t swallow too.

>>>>I find myself clutching my throat like there is a lump in it.

This reminded me of your Clinical Case:

Lachesis Out Of Nowhere!


Wow, I had forgotten all about that case!  Well, Vamsi, Lachesis does look like a good choice.  It certainly covers the sensation as if a lump in the throat; but, here’s the problem:  There are 181 remedies in that rubric!  Five in BOLD and many in italics, including Pulsatilla, Nux vomica, Kali carb, Kali bich, Gelsemium, Hepar sulph, Argent-nit, Sepia, Sulphur and many more.  Now, what does that mean?  It means we need at least two other symptoms if we want to find a remedy.  Do you see anything else in this case that we could add to “throat, lump sensation”?

Yes Elaine, the next in the race would be Hepar Sulph.  But in all cases, yes we need 2 more symptoms if we want a remedy

One could be that she had shortness of breath while coughing.

But that was an old complaint.  It’s gone now.

She has been hurting her esophagus too….

No, she said she was afraid she was going to hurt her esophagus if she kept on “spitting out food”.

And also says “Pain on swallowing” which is typical of Hepar Sulph.

But, she also had the lump sensation when not swallowing as well.  And I believe the sensation of Hepar sulph. is “as if a fishbone or splinter” in the throat.

Elaine, Now you please explain, if i go wrong ??

What is peculiar about this case?  Didn’t you think it was odd that she starting talking about food addiction and not swallowing food, but it was important to swallow one bite to protect your esophagus and she had a fear that she was going to damage it?  What does that sound like to you?  And previously she had been to a doctor so he could put a camera down her throat?  Doesn’t that sound odd?  She goes to the beach every morning to watch the sun come up, what does that make you think of, what kind of person would be inclined to do that?

Okay now let me not lose your hints…those were great !!!

Yeah !!  Anorexia nervosa, right? …. and associated with ANXIETY !!

YESSSS !!!  Is it the remedy ….serious anxiety associated with fear of gaining weight ??


Vamsi, what kind of person obsesses over maintaining the “ideal” weight, who also goes to the beach every morning to watch the sun come up?  An “Idealist”!  She’s an idealist!  Look up “Idealist” in the Repertory.

Oh ! Elaine…..I know its IGNATIA…(thought of it too in the first place)

Yes, it’s Ignatia!

They too have throat Symptoms and are “Idealists”

AND, they’re perfectionists!  Look up “perfectionist” in the Repertory.  You’ll see Ignatia beats out Nat-mur. which is there only as a 1.  I can remember Robin Murphy, in his course, describing Ignatia as the kind of student who, if they find one mistake in their homework, will tear up the whole thing and start over again–that’s how perfectionistic they are!

Think about people with eating disorders.  They think their weight has to be perfect!  They try so hard to be perfect about losing weight that they don’t know when to stop trying, they have to be “perfect” at losing weight!  Now, in Murphy’s Repertory, under “Anorexia”, Ignatia isn’t there.  That’s a mistake, because it’s in the “Bulimia” rubric which is essentially the same thing!!!!!  And, in fact, when “Rosetta” remarked that she was scared she was damaging her esophagus by “spitting out food” to lose weight, I said, “Are you bulimic?”  She didn’t answer.  Because of that, I picked the rubric “Secretive”. Ignatia is there too, scoring higher than Nat-mur.

But then do they go and want to see the sun rise everyday ?

Definitely!  They’re artists!  Once again, missing from Murphy’s Repertory, but present in Radar.  What could be more artistic than a sunrise at the beach?  What could be more ideal?  More perfect?

Wow Elaine !! did not know about the “Bulimia” rubric.  Looked at Anorexia and did not find Ignatia in it.

But yes this is a new learning for me…and now I know !!

And yes Ignatia is very emotional too and they are artistic, because emotions drive us to get to artistry.

That suits well and she goes to the beach for a sunrise.

And being secretive , I did not know that …guess it was not mentioned in the quiz…..

Vamsi, it’s a subtlety.  It’s one of those things you have to pick up on.  She’s describing bulimia but not calling it that, which to me represented a kind of “secrecy”.  You can’t hurt your esophagus by “spitting out food”.  Am I right?

Altogether, really thank you from the bottom of my heart, trying to learn your deep way of thinking for a case.  For sure it would take time, but, I’m trying my best !!

Thanks for your patience and your explanations, you make us learn in this process.

You are amazing…

Well, if you say so…..  I think I see the gang from Slovakia here!


Hello Elaine and Shana,

Hello, Miroslav and Jitka!

here are our solutions of the Quiz, “Lump in the Throat”

Miroslav votes: Lachesis

I looked at the new case and I have come up with this:

Breathing, difficult, shortness of breath with

She had that months ago.  She said she went to the doctor and they put a camera down her throat because she had coughing with shortness of breath.  The doctor couldn’t find anything wrong.  What is this starting to look like to you?

Breathing, difficult, cough with

Again, that was months ago.  But it does suggest that since the doctor could find nothing wrong, that maybe she’s a hypochondriac.  Just a thought!  And since she now “thinks” there is something in her throat?  It tends to lend credence to that theory.

Food, appetite, increased

No, don’t look at it as “appetite increased” because it hasn’t really “increased”.  She’s always like this.  She’s addicted to food, to use her own words.  What’s another way of saying “addicted to food”?  She’s got an eating disorder!  You completely missed that, it was the most peculiar, most striking, thing in the case!  According to her, she eats only but so much, and then spits out her food!  What does that sound like to you?

Food, appetite, voracious

Throat, lump, foreign body/matter

No, we don’t have any information on foreign body, and, in fact, there was nothing there.

Throat, chest, foreign body/matter, swallowing on

I wouldn’t take “on swallowing” because she had the same “lump” when she wasn’t swallowing.

Throat, foreign body, sensation

Whoa!  Wait a minute!  Look at all the rubrics you picked that mean basically the same thing!  What can we do in these cases, where many rubrics can be picked for the same symptom?  We can COMBINE them into One Grand Rubric–which we can do if we have homeopathic software.  But what you can’t do is keep them all separate.  Can you imagine, three rubrics, all meaning the same thing, all with Lachesis in Bold?  It’s going to look like, Wow!  Look how high Lachesis is scoring!  It’s way out in front!  No, by all rights, those 3 rubrics should have been ONE rubric!  That way, Lachesis gets 3 points, not 9 points!  Do you see the difference?

The rubrics regarding her ravenous hunger? They’re not really the issue.  The issue is that she’s bulimic!  She’s “spitting out food” so she won’t gain weight!  She said so!  So the rubric you need to take isn’t in the “food” chapter, it’s in the Mind chapter.  It’s “Mind: bulimia”.

Throat, foreign body, feeling, swallowing does not improve: Lachesis.  I was still thinking about Ignatia, but Lachesis came out more markedly.

Lachesis came out more markedly because you zeroed-in on “lump sensation” and “voracious appetite”, ignoring the other elements of the case.  At best, that’s only 2 symptoms in 2 very large rubrics, which clearly can’t possibly narrow us down to a single remedy.  What are the elements of the case?

  1. Lump sensation in throat
  1. Bulimia (eating disorder/addicted to food)
  1. Possible hypochondriasis, as we discussed in the beginning.
  1. Romantic (She goes to the beach every morning to watch the sun come up.  Isn’t that romantic?  Or idealistic?  Either one?  Either way, we now have a clear picture of Ignatia.

So to summarize: You picked a whole bunch of rubrics and sub-rubrics that all meant the same thing, namely, lump in the throat.  Here’s what you picked:

  1. Throat, lump, foreign body
  1. Throat, foreign body, swallowing, on
  1. Throat, foreign body sensation
  1. Throat, foreign body, swallowing does not improve

All those rubrics, if repertorized, would only have brought confusion, not clarity, to the case.  Listen, when you take a small rubric, like “Throat, foreign body, swallowing does not amel,” and there are only 7 remedies there, but the main rubric has 79 remedies, you have to ask, Are they saying that those other 72 remedies ARE better after swallowing?  I seriously doubt that!  72 of the 79 remedies in this rubric are all better for swallowing?  What’s the likelihood of that?  You know, if swallowing could make a “lump sensation” go away?  Imagine!  You feel a lump in your throat, you swallow.  It’s gone!  What the heck??!!!  I mean, that’s not even a symptom!  I would be willing to bet you that none of these remedies are better after swallowing!  Look at Ignatia, Ignatia’s in the main rubric; was our patient better after swallowing?  No!  So this sub-rubric, “lump, not better after swallowing”, is practically worthless.  Remember, the Repertory is capricious!  It’s very inconsistent, incomplete, and what’s in one Repertory isn’t in another; what should be in a rubric–because it’s in the materia medica–isn’t there.  Sub-rubrics with only a handful of remedies in them should be viewed with great suspicion.  Give them all a good deal of scrutiny.

You misidentified the eating disorder as “hunger” or having a “big appetite”.  You missed her romantic/idealistic nature.  So, you missed Ignatia.

Jitka votes: Lachesis

While reading the title of your case “Lump in throat”,  two remedies came up to my mind  known for this symptom – Ignatia and Lachesis.  Both remedies  among many others, can be found in the chapter Throat: Lump, foreign body, but  Lachesis in bold is also in the rubric “Lump, throat socket” (lower adams apple area???)

The rubric isn’t “Lump, foreign body, sensation of” because there are only 79 remedies in that rubric and it’s practically identical in meaning to another rubric, “Throat, lump sensation”, which lists 181 remedies; so, if we have 2 identical rubrics, we’re going to want to take the one with the most remedies in it so we don’t lose, possibly, the winning remedy by accident.  The rubric, then, is, “Throat, lump sensation” with 181 remedies.  If we instead take the sub-rubric, “Throat, lump sensation, throat-pit”, as you’re suggesting, with only 10 remedies in it, we’re tossing out 171 remedies!  Are we prepared to disqualify 171 remedies based on a difference in location of maybe half an inch????  So, I would want to take just the main rubric and move on to determine what the other elements of the case are, to help narrow down the remedy choice.

And Lachesis in bold can also be found in rubric “Lump, swallowing, not ameliorate.

Yeah, I just discussed that with Miroslav.

In the rubric “Lump, foreign body, painful – is the only big remedy Lachesis, but since the patient did not complain of pain, I can not take this into account.

Jitka, see my comments to Miroslav.

I think it’s time for us to congratulate our two winners: Mary K and Maria!  Nice going, ladies!  Oh wait!  Ram Saini just wrote in with another vote for Ignatia; so, congrats to all 3 of you!

See you back here in July!



Elaine Lewis, DHom, CHom

Elaine takes online cases. Write to her at [email protected]

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About the author

Elaine Lewis

Elaine Lewis, D.Hom., C.Hom.
Elaine is a passionate homeopath, helping people offline as well as online. Contact her at [email protected]
Elaine is a graduate of Robin Murphy's Hahnemann Academy of North America and author of many articles on homeopathy including her monthly feature in the Hpathy ezine, "The Quiz". Visit her website at: and

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