Case Quizes Clinical Cases

Revisiting: Mystery Illness?

Elaine Lewis
Written by Elaine Lewis

I have no idea what was wrong with this patient! Did you guess the right remedy? Scroll down for the answer.

Hi Mom, before we start the quiz… don’t you have something to say?

No. I’m pretty sure I don’t.

Maybe something that starts with happy and ends with… Well, actually, I think we need Paul McCartney for this.

No, no, Shana, actually, we don’t…. Shana?  Oh crap!

By the way, I think I saw Linda in the video.

Yes, you did. I really miss Linda McCartney.  You know, Paul put her in the band so that he’d never have to be away from her.  Isn’t that sweet?  Kind of like you and me, always together; only what a shame you’re wasted on me, I’m so boring, and you’re so beautiful!

Mom, it’s hard to meet people in a pandemic.

You are so right.  Oh well, Happy Birthday!  You might want to stop aging.  It’s enough already!

If we can possibly move on to the Death Report?

Well, if we have to….

We lost Morris “B.B.” Dickerson (seated below), bass player and co-founder of the funk band, War.

Maybe you’ve heard of Eric Burdon from the Animals?

Heard of him!  Don’t you remember?  I sang “House of the Rising Sun” in assembly in the 10th grade!  Wasn’t that an Eric Burdon song?

Well, I don’t “remember” it, per se, but, it was when Eric Burdon sang with The Animals.

How was I supposed to know it was about a house of prostitution?!  I was only 16!

OK, Mom, it’s over now, you really need to put it behind you.  I seriously doubt that anybody remembers it.

It had good chords!  Do you want to hear me play it?

No! I mean, maybe some other time, we should really be talking about War now and B.B. Dickerson.

In the early days, the group was called Eric Burdon and War and that’s when “Spill the Wine” came out.  Eric was only, apparently, on three albums.

Who knew?

That’s Eric Burdon front and center

He should really do something with his hair.

and I think B.B Dickerson is in there somewhere.

Second row, 2nd from the left.

War (after Eric Burdon left) is best known for the following: “Low Rider”–which used to be the theme song of the George Lopez Show…

No one cares, Shana!

“Cisco Kid”, “Slippin’ Into Darkness”, “The World is a Ghetto” and “Why Can’t We Be Friends?”.

Great songs, all.  Here’s my favorite, “Slippin’ Into Darkness”.  B.B.’s the one in the glasses, playing bass guitar:

 

 

I like “Cisco Kid” and the “World is a Ghetto”.  I never thought I would say I’m sick of a song, but… “Low Rider” is really getting on my nerves!  It got a lot of mileage as theme for the George Lopez Show.

Did I mention that no one cares?

“Why Can’t We Be Friends” is good too.

One more thing I have to point out is that this April marks the 50th anniversary of James Taylor’s

Aaaaaaaah!!!!!!!!!!!!

second album, (I knew you were going to do that!) “Mudslide Slim and the Blue Horizon”.

It’s an important album because it spawned his own cover of Carole King’s “You’ve Got A Friend”, which he has frequently performed in concert.  It has other good ones though; “Mud Slide Slim”, “Hey Mister That’s Me Up on the Jukebox” and I would like to point out that “Highway Song” from Mudslide Slim was apparently first released by James’ brother, Alex Taylor, on another album from the same year.  James then ended up putting it on Mudslide Slim, so it’s kind of funny that the same song was released twice.  I’m not familiar with Alex’s version though.

Well, here it is; and I hate to say it, Shana, but, it’s not very good. James’ version is much better:

I know and I can say that without listening to it, because I’ve heard his brother’s and it’s great!

Poor Alex Taylor died in a plane crash.  You know, it was his kid, Alex’s son, James, that James Taylor wrote “Sweet Baby James” for.

I know that. I also know…

Oh boy, here it comes!  More useless trivia no one cares about!  (Except for, you know, Linda Santini!)

As I was saying…. I also know that “Enough To Be On Your Way” from “Hourglass” was all about Alex’s death but he used the name “Alice” instead.

Thank you very much, Miss Pedia!  Maybe we should play “Highway Song” by James Taylor now.  And then we can go out with “Mudslide Slim” at the end.

Shana, we really have to start the quiz now.

Who’s in the quiz this time?

Miss Toni Tortilini.

Who????

Toni Tortilini

What kind of a name is that?

It’s Italian.

Well, it sounds ridiculous.

It’s a perfectly good name!  This patient has big problems!

What’s wrong with her?

I have no idea!!!!!!

***

Hi Elaine –

Hi Toni, great hearing from you again.

I don’t know if you keep files,

Maybe….

but I have worked with you in the past

I know.

– once with my daughter (hemorrhage case remedied with Lachesis),

Yes, I remember that; great case!

But today I am asking for acute help.

Please fill out the acute case questionnaire:

Questionnaire

Name: “Toni Tortilini”

Age:50

Male or Female: Female

Weight: 155

Height: 5’4’’

Date: 4/8/2021

Email Address: ****@icloud.com

  1. Describe the complaint.

Loss of taste and smell – this happened on April 5th or 6th. Around the last week of March I had what I thought were tree allergies – itchy eyes developing into eye pressure after a few days, itchy throat, sneezing, and extra fatigue. By Easter Sunday, I felt like I had a fever although my temp was only 98.9, but I had to be in bed all day. Only slight stuffy/runny nose. Same thing on Monday, April 5th.

Leg pain – started around 4am on Tuesday April 6th. It happens in bed at night and off and on during the day. I cannot lay down when it flares up, walking brings some relief, but then fatigue sets in.

  1. Etiology–

Possibly due to stress from arguing with my husband combined with traveling — family trip (including the dog), a 5 ½ hour drive to see our oldest daughter and her husband. A good visit but the stress was probably too much on top of the “allergies” that I thought I had. I could have been exposed to Covid, but I am not aware of anyone who has it.

  1. Sensation–

This is hard to describe, but the leg pain is like a tightening of the leg muscles – front and back of thighs, calves, butt. But it swirls around and comes and goes. Again, walking is usually necessary to alleviate the sensation.

The loss of taste and smell I think speaks for itself. I think this has been going on for three days now.

  1. Appearance–

My eyes are droopy, especially after being up and about. Color of skin is normal.

  1. Location–where on the body is your complaint located?

Tongue (taste buds), nose, legs

  1. Modalities– This is a fancy word that simply means, “What makes your complaint better or worse”?

My first instinct is to stop breathing and grit through the leg pain. Tossing and turning in bed does NOT help. But breathing deeply and walking around helps. On Sunday, when I felt sick, I needed warmth and hot tea. Now, warm drink in the morning, and cold drink (lemon, baobab, Vit C in water and mineral water) is better in the afternoon. Back to hot drinks before bed. Not very thirsty though.

During the first day of intense leg pain (Tuesday, I think), I found relief in a warm bath. But as soon as I got out, pain returned.

  1. Concomitants

Fatigue and foggy brain are the main ones. Today, I felt slight plugging of ears. Sneezing is occasional. Crying accompanies intense leg pain. A scratchy throat and swollen gland on right side of neck show up in the evening.

  1. Discharges–color, odor, consistency and sensation.

I have a slight runny nose that is clear and watery. My nose burns a little on the inside.

  1. Generals–these are all the symptoms that begin with the word “I”:

I am worried about how long loss of smell will go on. I am very tired. I’m weak. I’m sad and irritable. I want to be left alone, but feel lonely if alone. I want quiet. I am quiet.

  1. The mentals: Is the complaint changing you mentally and emotionally?

It is probably adding more anxiety and depression on top of the usual. I don’t really want to talk.

  1. What have you been saying?

I am quiet. But I am THINKING “ Turn off the music. I want to be at home! I want to sit in the recliner chair.”

  1. What are you doing?

In bed at night, I sleep until the leg pains start. Then I toss and turn, moan and groan until I have to get up and walk around. Sometimes I am able to stay in bed. I am trying to read during the day, but hard to keep eyes open. I called a friend for support today. Managed to help my daughter with her school today at the table. Had to lay down and rest after an hour.

  1. Describe your thirst and appetite–

I am less thirsty than normal. I have to have my normal hot Lemon Ginger Green Tea with ½ teaspoon of honey in the morning. I have been skipping the coffee after breakfast since I’m not sure how it will taste anyway. I have to have my cold drink after breakfast which is fresh lemon juice, stevia (although I forgot to put it in today and barely noticed!) baobab powder, Vit C, water, and mineral water. I will make some hot “Throat Coat Tea” in the evening when the scratchy throat comes on. I have a quart of room temp water sitting on the counter all day. I might drink half of it.

  1. Fever?

Not much of a fever. The highest I detected was 98.9

  1. Sweating?

Sweating around 4 or 5am is not new to this illness. That has been going on for 6 months or so, but not very often. I take Dr. Schulze Female+ which helps reduce the night sweats. I’m still having regular periods. I can’t smell anything to detect an odor.

  1. Odors? Are odors an issue in the case?

At the Easter Vigil service, Saturday, April 3rd, at about 10pm, I started smelling smoke and my nose felt irritated. No one else around me smelled it. That continued until we left the church at 11pm and for the short car ride back to the house we were staying. I didn’t notice it on Sunday, just woke up feeling very weak and tired.

  1. What is most striking, peculiar or identifying about your condition?

Both the strange leg pains and the loss of smell are very odd.

  1. Is there a diagnosis?

No.

  1. Describe your energy–

Quiet but restless. Sleepy but cannot sleep during the day. Generally down and discouraged. Just typing this email requires great effort.

  1. What does your tongue look like? (color/coating/pattern, crack/s, shape, etc.)

Ummmm it looks like a mixture of red, pink, and white? I don’t see any cracks.

  1. If you have a cough, please tell what it sounds like.

Little or no cough. Dry if anything.

  1. If you haven’t already said if you’re hotter or colder than usual, say it now.

I am usually cold, but I might be a bit colder than usual.

__________________

Toni, I read your case, and I think you need __________ 30C, 3 times a day, in water, with five succussions before each dose.

Hi, Elaine; I am just getting up this morning. I feel pretty tired and weak, like I worked hard during the night. Maybe all that tossing and turning!

I took one dose of _____________ at 11:15pm right before I went to bed, stirring vigorously. It seems like it is helping a little. I have a slight improvment in smell.

Stay with ____________ and tell me what tomorrow brings.

OK, so I woke up feeling better. No leg pain. Clear nose, but some congestion in head. After being up and about for a couple hours, though, my nose started getting drippy and I got weak. I am needing to be on the couch, resting. Should I go back to the ________ 30C three times today?

Yes, don’t hesitate once you relapse, don’t wait around to hear from me; strike back fast with another dose of _________ 30C. Yes, 3 or 4 times a day. Take less often as you get better, but take more often if you get worse.

OK, thanks! I always forget how this works, since I don’t use it that often. I took a dose at 1:30pm and had some good food.

Write to me tomorrow and give me an update.

OK, whew! I am feeling well enough to get back to the busy routine of homeschooling and evening activities, at a slower pace with lots of resting, but was able to go to my daughter’s softball game today and my book club tonight.

Woo-hoo!

The gland in my neck (right side) is just a tiny bit swollen now. My smell is still at about 10% and taste is up to 50%.

I took 3 doses of ___________ today.

I forgot to ask. The scratchy throat–do you still have it?

No, my throat is no longer scratchy.

Your thirst, is it still less than usual?

Oh, yeah, I forgot to mention! Monday and Tuesday I was very thirsty. Thirsty this morning too.

Are you still sad, weak and irritable?

Not it an acute way.

Nose still burning?

Off and on.

Still sneezing?

Just a couple times a day.

Itchy eyes?

Sort of.

Itchy throat?

No, not itchy.

Fatigue?

Yesterday, I was able to function pretty well with minimal resting periods, so I think the acute fatigue is better.

__________________________

OK, everybody, that’s it!  Do you know the remedy?  Write to me at [email protected] and tell me what you think.  The answer will be in next month’s ezine.

And now, as promised, “Mudslide Slim”.  In 2019 all of his albums released on Warner Brothers were remastered, which I think is really cool.

 

 

Happy Birthday, Shana–April 22nd!

————————————

Votes:

Arsenicum-5

Rhus tox-2

Nat-mur-2

Pulsatilla

Gelsemium

_________________

OK, how did we do this month?  Does anybody want to go first?

Hi Elaine,

Hi Rohini, welcome to the Hpathy Quiz!

I think the remedy was Arsenicum.  Keynotes being burning and itching sensation, fatigue, restless leg, worse night time, chilly, better hot bath, melancholy and sad disposition.  Arsenicum is also a good hayfever remedy.

It’s hard not to think of Arsenicum when you hear that a patient is restless, cold and better for warmth.  However… we have another remedy famous for restlessness too, do you know what it is?

Rhus tox?  Better continued motion.

Yes, exactly, it is Rhus tox!  Since they look so much alike (both are restless, both better for warmth), how do we distinguish between Arsenicum and Rhus tox?

Very interesting!  The restless legs and fatigue from continued motion pointed towards Rhus tox but the hayfever symptoms were leaning towards Arsenicum.

The hayfever symptoms seemed like common allergy symptoms to me: itchy eyes, itchy throat, nose burns “a little” ….  But, her leg symptoms were a clear picture of Rhus tox!  Practically everything we needed to know was right there in her Questionnaire under “Sensation” and again under “Modalities” (I’ll put the key words in red for you):

Sensation–

 This is hard to describe, but the leg pain is like a tightening of the leg muscles – front and back of thighs, calves, butt.  But it swirls around and comes and goes.  Again, walking is usually necessary to alleviate the sensation.

 Modalities–

 My first instinct is to stop breathing and grit through the leg pain.  Tossing and turning in bed does NOT help.  But breathing deeply and walking around helps.  On Sunday, when I felt sick, I needed warmth and hot tea.  Now, warm drink in the morning, and cold drink (lemon, baobab, Vit C in water and mineral water) is better in the afternoon.  Back to hot drinks before bed.  Not very thirsty though.

During the first day of intense leg pain (Tuesday, I think), I found relief in a warm bath.  But as soon as I got out, pain returned.

***

There it is!  That’s the whole case!  “Tight” is a Rhus tox word!  Try and remember that!  It’s in “Generals: constriction sensation”.  She says she feels a “tightening” of the leg muscles.  She MUST walk and is better for it.  And finally, if you can find a case where the patient says the complaint goes away in a hot bath or shower?  Even if just temporarily?  Look no further than Rhus tox!

Now, what about Arsenicum, aren’t they restless too?  Yes, but there’s a big difference!  Arsenicum is NOT better for motion!  They are NOT better for walking, even if they feel that they MUST walk or MUST move, they are not better for it!  Rhus tox is BETTER for walking!  Arsenicum’s desire for movement is only due to anxiety.  Rhus tox moves because their sensation of tightness and stiffness can be alleviated that way.

What’s another difference?  Arsenicum’s aggravation time is around midnight.  Rhus tox is worse after midnight.  So, there might be some over-lap there, but, our patient was worse at 4 a.m., which is way past Arsenicum’s aggravation time of midnight–2 a.m.

The only thing that didn’t add up for Arsenicum was thirstlessness of the patient.  Arsenicum is a thirsty remedy and patients like to take small sips but rhus tox is thirstless.

No, Rhus tox is listed only as a 1 under “Thirstless”.  Moreover, we can’t really say for sure that our patient was thirstless because we were only told she had less thirst than usual, not that she was thirstless, per se; so, her thirst symptoms probably weren’t going to help us.

Thank you!

Kind regards,

Rohini

___________________

Is anybody else here today?  Oh look!  It’s Dr. Ketan Kumar Singh!

Elaine, I am guessing its Arsenicum alb…. since the patient had restlessness and warm drinks amel.

Arsenicum is getting very popular around here!  But, what’s our other famous remedy for restlessness?

Rhus tox?

Yes!

____________________

Who else wants to try?  I think I see Dr. Abhishek Choudhary!

Elaine, I think the answer is Rhus tox.

You are right!!!!

______________________

Hi Elaine,

It’s Krista from Nebraska!

Thank you for another fun quiz.  I love learning!

That’s the spirit!  Some people don’t answer the quiz because they’re afraid they’re going to be wrong.  But, the more wrong answers we get, the more we learn!

I can’t wait to find out the answer because I have a couple remedies I am going back and forth about.  I think I could make a case for both…and maybe there is one I haven’t even considered yet.

I am going to have to dismiss or overlook something in each of them.  Hoping I get It right the first time, but you know what they say-

If you don’t get what you want … you get experience !

So true!

Let me know if I got it right the first time or need to keep trying – thank you!

I am going to go with Rhus Tox because it seems like this leg pain is very painful for her, and her not sleeping well is a drain on her whole system,

and it seems like these modalities are so strong.

Rhus tox has-

-Leg pain- Worse at night/ sleeping/ lying, Better Heat / bath and Motion/ Walking

– Loss of Smell

– Mind and senses become cloudy

OH, WAIT!  I am having second thoughts!!!!

What????

I am being haunted by the hierarchy of symptoms – Etiology!!  It could have been the car ride, but I really think it was the cold symptoms, which pushes me to Pulsatilla.  Pulsatilla is great for wrapping up a cold.

– It is much stronger in regard to loss of taste and smell which is the primary complaint she had.

OMG!  Krista, you totally went off the rails!

– Legs- it does have leg pain worse at night, restlessness and better for walking.

– Thirstless

– Emotional

Too general!  I would have to know what you mean by “emotional”.  Emotional is a word that can mean almost anything!!!  You don’t mean the crying because of leg pain, do you?  Because that’s not “emotional”.  That’s a normal reaction to pain.

– Symptoms come and go.

Not all of them.  The leg pain comes and goes but not the loss of smell and taste, that’s constant.

Ok I am ready for your feedback.

When you said it was Rhus tox, and all your reasoning for why it was Rhus tox, you were spot-on!  All the clarity in the case was with Rhus tox.  Rhus tox was highly recognizable, even the Rhus tox mentals were there as you actually pointed out:  “Mind: cloudy” or, as she said, “foggy brain”.  We didn’t see the Pulsatilla mentals here (weepy, clingy, wanting company).  The Rhus tox symptoms were also “the worst thing” in the case (the leg pain caused her to cry), and hence, the most striking symptom, and as you pointed out, also caused her to lose sleep at night due to having to get up and walk to stop the pain; so, the leg pain was very serious and demanded immediate attention.  You could also say it was the “Concomitant” in the case (common cold or allergies with concomitant leg pain) and you’ve probably noticed that when there’s a concomitant?  The case becomes all about that!  Observe how the remedy changes every time the concomitant is different:

Headache with nausea and vomiting–Ipecac

Headache with with craving for sweets–Lycopodium

Headache with lachrymation–Eurphrasia

Headache with thirst for cold drinks–Phosphorus

Headache with desire for lemons–Belladonna

 

So, we could view the leg pain as:

  1. The worst thing in the case, demanding our immediate attention. (We’re always looking for the “worst thing” because the remedy has to cover that.)
  2. Having a clear remedy picture matching Rhus tox.
  3. The mentals of the case were, in fact, Rhus tox mentals.
  4. You could classify the leg pain as the “peculiar”.  The leg pain was pretty bizarre, as in, Where did that come from?!  So, as a “peculiar”, it’s right at, or near, the top of the Hierarchy Of Symptoms, it would over-rule everything that came underneath it, like her so-called thirstlessness or a bunch of common allergy or cold symptoms like scratchy throat.  Another thing about Pulsatilla?  It wouldn’t be better for hot baths.

So, to sum up, the leg pain was the Concomitant, the leg pain was the “Peculiar” and the leg pain was the Worst Thing.  It also had a clear remedy picture–including, and we haven’t mentioned this up until now–the Sensation, which was “tightening”–a Rhus tox word!

So, all things considered, there was really overwhelming evidence for Rhus tox!

Thanks so much!  I will try not to overthink or second guess myself so much in the future.:)

Just one more thing.  I noticed that you said the cold symptoms were the Etiology?  See below:

“WAIT! – I am having second thoughts.  I am being haunted by the hierarchy – Etiology!!  It could have been the car ride, but I really think it was the cold symptoms”

I think you might have the wrong idea about what etiology is.  Maybe you’re confusing etiology with the name of the complaint.  Etiology is the cause of the complaint, the predisposing factor.  But, she said she wasn’t sure about what it was.  There was a stressful, exceedingly long car ride that included a husband, a dog and I assume children.  That’s enough to kill anybody!

But then she thought that it could also be her allergies (to some sort of tree).  Maybe you were thinking that her “cold” was the cause of her leg pain?  But, that’s not the way to look at it.  The leg pain should be construed as the concomitant in a case of either “common cold” or “tree allergy”.  And what happens when we have a concomitant in the case?  The case becomes all about the concomitant!

Therefore, we shift our attention to the leg pain and its characteristics: worse after midnight, tightness sensation, must walk, better hot bath.  A perfect picture of Rhus tox!  Yes, you saw a picture of Rhus tox, then you “over-thought” and said, “Wait a minute… Pulsatilla actually scores higher for loss of taste and smell,” and you’re right!  It does!  But you know what?  Loss of taste and smell isn’t that uncommon in a cold, I’ve actually had it myself!  Unquestionably, what was, in fact, peculiar about this case was the leg pain!  What does leg pain have to do with a cold?  How did that get there?  It boggles the mind!

Thank you for explaining the shift with concomitants.  Understanding that would have sealed it for me in an obvious case like this instead of over- thinking.

Yes, these are things people have to know.  There’s a reason we always ask about the concomitant!  So, if you look at it as, “Common cold…” or “Tree allergy… with concomitant leg pain…” that’s the way to phrase the complaint.  And she even said that the leg pain was the most peculiar part of the case, that and the loss of smell.  But there was no way we could have discerned a remedy from “loss of smell”!  There’s no “sensation” associated with loss of smell, there are no “modalities” that go with loss of smell…so how does loss of smell help us pick a remedy?  But the leg pain was like a gift, in terms of being sooo Rhus toxy: better for movement, better hot bath, sensation of tightness….  What more could we ask for?

_______________________

Hi Elaine, it’s Lori D from NYC!

Yo…

I have been looking for a place to live and moving my belongings into storage so I was MIA for a bit.

Hmm…..finding a place to live in NY can’t be easy!  Let me rephrase that.  Finding a decent place to live in NY can’t be easy!

I am not sure if I am too late to guess for the mystery illness quiz.

No, you’re right on time!

I am in between living spaces and quite literally living out of a suitcase and a friend’s couch.  But just in case I’m on time to guess, I would like to say Arsenicum album for the remedy.

Why did you guess Arsenicum?

As I was thinking more about this I realized that Arsenicum does not have loss of taste and smell but Pulsatilla does along with the brain fog, the restlessness, more chilly than usual, and leg pain with the constriction shifting rapidly.

I too was thinking it might be Pulsatilla; but, I didn’t think Pulsatilla would be ameliorated by anything warm, like a hot bath.  I know you suspected Arsenicum because of the restlessness; but here’s the thing:  Although Arsenicum can’t keep still and must move, it is not better for it!  Arsenicum is walking or pacing out of anxiety and worry.  However, our patient is actually better for walking!  And here’s another clue.  She says the sensation in her leg is one of “tightness”.  Do you know what the remedy is now?

Ok, so three’s a charm.  Rhus Tox.

Yes!!!

I know Rhus Tox is ameliorated by anything warm and motion, and changes positions a lot which she does while she is in bed.  It also has an inner tightness theme, anxiety and restlessness and exhausts quickly.  But I don’t think it has loss of taste and smell?

Actually, it does, Lori.  It’s a 2 under “Nose: smell, loss of” and a 1 under “Taste: loss of” (Murphy’s Repertory has its own “Taste” chapter) but, here again, we see the inconsistencies of the Repertory.  If Rhus tox is a 2 under loss of smell, and if loss of smell leads to loss of taste, shouldn’t Rhus tox be a 2 under loss of taste?  But that’s the Repertory for you!

Let’s just say this, for the sake of argument, that Rhus tox didn’t appear under “loss of taste and smell” as you suspected, how should that change our opinion of Rhus tox?

  1. Loss of smell is a relatively common symptom in the common cold, and because of that, we can’t really use it as a symptom anyway (meaning, it’s not “characteristic”).
  2. Since we have shifted our attention over to the “Concomitant” (the leg pain), loss of smell is not connected with that! In case I haven’t already mentioned, many people don’t know that when a case has a concomitant, finding the remedy becomes all about that. In other words, the remedy changes depending on what the concomitant is:

Examples

Headache with nausea and vomiting—Ipecac.

Headache with lachrymation—Euphrasia.

Headache with gas and bloating—Lycopodium.

Headache with irritability—Nux vomica.

Do you see what I mean?  So, in our Mystery Illness, we’ve switched our attention over to the Concomitant: the leg pain!  We would phrase it like this: “Common cold or allergy with concomitant leg pain/tightness, better walking, better hot bath, worse after midnight, worse on waking.”  And that, of course, would lead us to consider Rhus tox; and therefore, “loss of taste and smell” would drop out of the picture.  Do you see that?

  1. Lastly, we know that the Repertory is an imperfect, inconsistent instrument.  We know that not all the rubrics that could be in the Repertory are there; we know that not all the remedies that belong under a certain rubric are actually there. We know that some remedies, like Sulphur, are over-represented in the Repertory, while others are not in all the places that they should be (like Calc-carb, for example, not being in the “Procrastinates” rubric—which is big mistake!!!!)  So… taking a remedy like Rhus tox, with so many uses, especially in the common cold, there is every reason to suspect that if Rhus tox were missing from “loss of smell”, it would probably be a mistake and shouldn’t be used against Rhus tox if there were many other confirmations for it!

When using the Repertory, we always have to THINK!  For example, “Is there maybe some other rubric, phrased differently, that means the same thing?”  Because there are a lot of examples of that, like, Calc-carb not being under “Procrastinates”, but IS under “Late, always”!  And “Slowness”.  So, this is how you have to think when using the Repertory.

Another point is, if you’re looking at a small rubric, and you can see that obvious remedies are missing, you’re better off asking yourself, “Is there a larger rubric I could be using?”  For example, “Mind: absent-minded, studying, while”.  The only remedy listed is Helleborus!  Now, how likely is that?  Doesn’t that seem odd?  Absent-minded while studying?  Shouldn’t Phosphorus be there?  Shouldn’t Baryta carb be there?  What about Cannabis indica?  Now, go to “Mind: concentration, difficult, studying, while” and there are 52 remedies!  52!!!!  Holy cow, what a difference!

When using the Repertory, we must be discerning, suspicious, calculating, and more like detectives than obedient court stenographers.

Wow, fantastic information!!!  Thank you so much for the teaching.  I love how you explained it… easy to understand.  I did not know that about the concomitant.

You’re not alone!

I would like to be a better homeopathic detective… rubrics are daunting to me.

Before Murphy’s Repertory?  In which everything is in alphabetical order?  Rubrics were even more daunting–and impossible to find!

Ok, that’s all I got at this time.  I have to hit the pavement in the quest for YES, the decent affordable place to live in NYC…if that exists…

Oh, it exists, alright–for millionaires.

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Oh look, it’s Maria from Greece!

Hi Elaine and Shana!

Hi Maria!!!!!

For this month I vote for Rhus tox.

If I am wrong I will try again!

You’re not wrong so don’t try again!!!

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Hey, it’s the gang from Slovakia!

Hello, Elaine and Shana,

Hi, Miroslav and Jitka!

We send our solutions for the April quiz.

OK, let’s hear it!

Miroslav’s answer is as follows:

I think Toni Tortellini is a prime example of Gelsemium …

Key symptoms: great fatigue,

Actually, she doesn’t use the word “great”, she just says “fatigue”.  Keep in mind, Toni is not bed-ridden as Gelsemium so often is.  Because all Gelsemium wants to do is sleep!  They are very wobbly and might need help getting around if they decide to get out of bed.

heavy eyelids,

Yes, but, did you know there are over 100 remedies in that rubric?  4 of them are in Bold, and one of those four is the one I gave.

muscle pain,

Yes, but, this is not a “complete symptom”, Miroslav.  What is a “complete symptom”?  It’s the symptom + its sensation, location and modalities.  So when you say “muscle pain”, I assume you’re referring to her leg pain?  And what does she say about her leg pain?  What’s the sensation?  “Tightness”, she says.  And what are the modalities?  Better walking and better hot bath.  Doctors say “muscle pain” because any other information is meaningless to them, they’re going to give Ibuprofen anyway!  Homeopaths say, “Leg, tightness, better hot bath, better walking.”  That’s how a homeopath talks!  And why is this distinction important?  Because when you say “Leg, tightness, better walking, better hot bath”, you know what the remedy is, right?  It’s Rhus tox!  “Tight” is a Rhus tox word, I’ve said that many times.  So is “Stiff”.  Tight and Stiff are almost the same thing.  Rhus tox stiffens up UNLESS they keep moving!!!!  Or UNLESS they’re in a warm bath or shower.  So, by learning to talk in “Complete Symptoms”, we can clearly see what the remedy is.  But if we say, “Muscle pain”, do we know what the remedy is then?  No, we have no idea!  And then, once we know it’s Rhus tox, all we have to do is look back at the case and say, “Does Rhus tox have heavy eyelids?”  Yes!  “Does Rhus tox have a scratchy throat?”  Yes!  “Does Rhus tox have loss of smell?”  Yes!  “Does Rhus tox have ‘brain fog’?”  Yes!  In fact, you can go through the whole case and find that Rhus tox is everywhere you look!

absence of thirst,

She says, “Less thirsty than normal”; so, I don’t know if we can call that “absence” of thirst.

she wants to be alone, rest …

Do you know why?  She’s sleep-deprived!  She’s not getting any sleep at night, walking around because of leg pain.  What did I say last month?  “Don’t just write things down; think!”  So this isn’t even a symptom (wants to be alone, rest) because it makes sense!  It makes sense because she’s not sleeping at night!  And if it makes sense, it’s not a symptom.

Jitka’s answer is as follows:

You called this case “Mystery Illness” but I think the remedy is also a mystery to me.  I thought I won´t answer this difficult quiz, but in the end I realized that I answer wrongly most often, so I´m going to try it.

Good.  But why is this quiz difficult?  She says the most peculiar thing in the case is her leg pain!  So right away, that’s all we need to know!  What does Hahnemann say?  The most striking, strange, rare and peculiar (characteristic) symptoms, above all else, must match the chosen remedy.  The leg pain is not simply peculiar but also the most striking!  Why do I say that?  Because she cries from the pain!  Anything that’s so bad it makes the patient cry, you can’t place anything above that!  So, it just so happens that the leg pain is like a gift because it is so clearly Rhus tox, as I explained above, we needn’t look any further.  So, was this really a hard case?

Although Toni did not have a confirmed diagnosis, her symptoms were very similar to Covid, because some people in my surrounding area had it. Symptoms such as weakness, heavy eyelids, fatigue, thirstlessness indicated a picture of Gelsemium.

But what goes against Gelsemium here?  When asked, “Describe your energy”, she says “Restless”.  Is Gelsemium restless?  No.  They just want to sleep.  They’re practically comatose, besotted, toxic, unresponsive.  Also, as I think I pointed out to Miroslav, Toni is still up and around.  She’s doing home-schooling, she’s going to church…. It’s hard to imagine Gelsemium doing that.   And the “fatigue” she has?  Do you know why she’s fatigued?  She’s not getting any sleep at night on account of leg pain!  It forces her to walk in the middle of the night!  So, let’s take a closer look at your list.  “Weakness and Fatigue”: since we now know why she has it (not sleeping at night) we have to cross those 2 off the list.  “Thirstlessness”?  She just says she’s “less” thirsty than usual, not completely thirstless.  So, that’s another symptom we have to take off.  What are we left with?  “Heavy eyelids”?  Maybe she has heavy eyelids because she’s not getting any sleep!  Did anything on your list survive discernment?  No.

But since there in the case was also a slightly strange symptom of “loss of taste and smell,” I looked for it in Murphy’s repertory in the chapter “Nose” smell ; worsened; taste, and;  there are two highlighted remedies natrum mur. and pulsatila.  They are also found in the rubric “Smell; lost” – in bold, and in the chapter Tongue there is the rubric Taste, loss of taste -also among the six bold remedies are also Natrum mur. and Pulsatila.  From these two remedies, the case seems more like Natrum mur.  Nat-m. symptoms follow intense emotions, Natrum Muriaticum would be the most appropriate choice among  remedies for itchy eyes, pain in eyes, especially on looking down, the eyelids may feel heavy.  This remedy also has watery discharges in colds or allergies.  Leg pain, especially at fever, may also occur.  BUT there’s one snag, Natrum mur. is a thirsty remedy.  Unfortunately, I could not find such a remedy that would correspond to all important symptoms, so my solution is Natrum mur.

Do you know what the problem is with Nat-mur?  It doesn’t cover the worst thing in the case—the leg pain—which is so bad, it makes her cry!  And it’s spinning off to create further symptoms, which you observed yourself: the fatigue, the weakness, the heavy eyelids, etc.  So, clearly, we have to aim our prescription at the leg pain.

Kind regards    Jitka

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

Elaine,

I am not sure about the remedy, so I’ll take this quiz as a learning curve.

My understanding is that The Most Striking and Peculiar have to be taken into consideration.  Here she says that the following are most peculiar:

1) Leg pain

2) Loss of smell

I go to Repertory and check Nose: smell, loss of and I find the following under Bold:

Bell, Calc Carb, Calc Sulph, Hepar  Merc, Natrum Mur, Phos, Plumbum, Puls , Sep and Silicea.

Here’s your first mistake: only considering the remedies in Bold?  Why?  Knowing how imperfect the Repertory is?  (which we’ve talked about before…)  And I think it’s too early in our assessment to say, “This is the rubric I’m going to hang my hat on, it’s gotta be here, and it’s gotta be a remedy in Bold!”  There are over 100 remedies in this rubric and there must be 50 in italics, how can you disqualify all of them?

And here’s the other thing: just because a patient says something?  That doesn’t mean we’re obligated to take it and run with it.  We’re supposed to think!  Our patient believes “loss of taste and smell” is peculiar, probably because she’s never had it before; but I have!  Have you?  I think this is a somewhat common symptom of the common cold.  I can remember one time having a bad cold when I was away in Boston, and every restaurant I ate at struck me as being horrible because the food had no taste!  I lamented, “What is wrong with these people, the food has no taste here!”  Then, when I got home, and the food still had no taste, I said, “OK, wait a minute, maybe it’s not the food, maybe it’s me!”

So, my first thought would be to cross this symptom off the list of “strange/rare/and peculiars” because I would have to question whether this is a “peculiar” symptom at all.

Now going to Etiology –

But wait!  You skipped over the other peculiar symptom completely, even though you wrote it down!  The leg pain!  Why did you blow past that?  It is now our only legitimate peculiar symptom!  And believe me, it’s peculiar alright!  What does leg pain have to do with the common cold, or even an allergy to trees?  Nothing!  It’s downright peculiar!  Plus, it makes her cry and she has to get up at night to walk because of it!  The loss of sleep is making her exhausted.  So, this leg pain now is at the center of our case!

Stating this symptom as “leg pain” is another mistake, because homeopaths don’t talk that way!  That’s how allopaths talk (ordinary doctors).  They say a person has “leg pain” because they’re going to give a pain-killer anyway, regardless of the “kind of pain”, etc, so, end of story.  But “leg pain” is a symptom we homeopaths can’t do anything with!

To us, a symptom is the symptom, plus its sensation, location and modalities.  That’s what we call a “complete symptom”.  It’s never “leg pain”, or “headache”, or “cold”…we can’t find remedies for that!  The leg pain is actually properly phrased as follows:

“Leg, tightness sensation, worse night, better walking, better hot bath.”  That’s the real symptom.  So…without even opening the Repertory, you should know what the remedy is now.    “Leg pain” is not a complete symptom, it doesn’t help us, that’s why you were sure you wouldn’t be able to solve this case!

Back to etiology: She says it’s stress after arguing with her husband….

OK, first of all, we don’t have an etiology.  She couldn’t pin it down.  She said it might be allergy to trees.  She said maybe she was exposed to covid.  She said maybe it was an especially long car drive with husband, kids and a dog, which could easily kill anybody!  So, we’ve got nothing specific to go on.

Elaine, another important pointer is:  She says “Turn off the music.”

No.  Again, are we going to elevate everything a person says without putting it in context?  Why does she want the music off?  She’s tired!  She wants quiet so that she can go to sleep; heaven knows she doesn’t sleep at night!  Any of us would say the same thing in her condition.

Stress remedy is NATRUM MUR…and they hate music.

Again, does she “hate music”?  Or does she just want quiet because she’s exhausted?  Context, people, context!  Put things in context!  Don’t just take words uttered by a patient and repertorize them as though they stand alone.  Plus, I don’t think it’s Nat-mur that’s aggravated by music, it’s more likely to be Nat-carb or Nat-sulph.  Go to Mind: music, agg.  Nat-carb is a 4, Nat-sulph is a 2, Nat-mur only a 1.  And I don’t think you can call Nat-mur the “stress remedy”.  If you go to Mind: stress, overwhelmed by, there are 9 remedies, no Natrums.

So i go for Nat-mur…

Elaine this is really a mystery quiz…and not sure if my understanding is correct

Please explain….

I think I just did.  How did I do?

That was an awesome explanation.  How on earth I missed the Leg pain….
It looks so easy when You explain it, by placing the exact jigsaw puzzle pieces.
Need to learn the art of solving a case from you….a long journey, but it’s okay
and we learn from our mistakes.
Yes !! The leg pains should not be left out.
>>> From your write up..
“Leg, tightness sensation, worse night, better walking, better hot bath.”  That’s the real symptom.  Now…without even opening the Repertory, you should know what the remedy is.  “Leg pain” is not a complete symptom, it doesn’t help us, that’s why you were sure you wouldn’t be able to solve this case! 

Seeing this, it reminds me of our famous RHUS TOX and nothing else!  

Yes, exactly!  I knew you would know it!

Thanks Elaine !!  I sincerely feel I owe you a lot.

Do let me know when you come over to India, would fly to
meet you, wherever u are…
I’m in Philadelphia!
Thanks feels short many times.

cheers

Vamsi.

You know what?  It’s past my bed time!  I’m not even sure what I’m saying anymore!  Who are our winners?  Maria and Dr. Abhishek Choudhary, come on down!  You’re our big winners of the April Quiz!  Your prize is this elephant.

Unfortunately, you’ll have to share him.

See you again next time for another breath-taking Hpathy Quiz!


Elaine Lewis, DHom, CHom

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

Visit her website: https://ElaineLewis.hpathy.com

About the author

Elaine Lewis

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:
https://elainelewis.hpathy.com/ and TheSilhouettes.org

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