Case Quizes Clinical Cases

Revisiting: Paula McCartney Has Breast Problems!

Did you guess the right answer to last month’s quiz!

Mom, it’s time for our case quiz!

But first, my important announcement.  On April 6th, I went to see Bernie Sanders at Temple University.

Yay!!!!  Bernie! Bernie! Bernie!

Mom!!!  OK, enough already!  The rally was held at Temple University’s Liacouras Center.  The line to get in was HUGE!  Also it was freezing, very bad standing-in-line weather.  My old roommate, Messina, was also at the rally but we missed each other.  Apparently she and her friend drove two hours just to see Bernie Sanders.  Can you believe that?!!  I may not have been able to see too well since the seats we got were behind the stage.  Still it was an awesome experience.  Of course I’ve seen Bernie on tv before but I’ve never heard him speak in person.  Also I’ve never been to a political rally before either.

Shana, have you forgotten the anti-war march we went to in Washington, against the invasion of Iraq?

Well excuuuuse meeee for not remembering things!  Do we possibly have a quiz this month?

As a matter of fact, we do!  It’s the case of ….

Wait!  Let me give you a name!

Um, well……

How about Paula McCartney?

It sounds stupid, but fine!  So here is the case of “Paula McCartney”!  Paula wrote to me complaining of a painful breast, and here is her story:

In a message dated 4/15/2016 4:39:34 P.M. Eastern Daylight Time, ***** writes:

Hi Elaine,

Can you take my case?  My left breast is as hard as a rock.  I took Mercurius last night, it helped…the Asterias rubens doesn’t seem to be working anymore.  It’s like a muscle pain…worse on movement, it’s warmer than the other breast…

I went to a drop-in clinic.  The doctor is sending me to do an ultrasound and then to a specialist.

He noticed how much bigger left breast was and it is red (er) I feel it larger under my arm and much heavier than the other one.  When I lean forward it also looks much bigger.  I’ll fill out the questionnaire:

  1. Describe the complaint:

Swelling of left breast started after a high fever, came on gradually…I also went for a run the day before this happened (don’t know if it’s related)

  1. Etiology–

I’m not sure.  Breast implants?

  1. Sensation–

It feels like a lump on the side of the breast that is hot and hard; when I lift my arm it hurts more and the muscle aches as well as the shoulder, pain extends to the back on the left, my tonsils are swollen, but, I had a cold or flu preceding all this; so, it’s hard to know where one stops and the other begins.

  1. Appearance–

I have bags under my eyes. The skin is red on the bottom of the breast all around it. The headache is now on the top of the head and sinus…

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

breast, although there is pain at the back like a muscular pain and on the neck on the left side and shoulder. Breast feels so enlarged it touches the arm when I sit.

  1. Modalities–

better warmth, company, music, dried dates, warm drinks, being still, darkness, not thinking about it…lying on that side makes it worse, actually being in bed is terrible because I sleep on my side; worse pressure, worse heat

  1. Concomitants

headache in the front of the head, and top, face, sinus, although it feels “all over” the back too, pulsating, bloated stomach, ringing in ears (ongoing)

  1. Discharges

(no answer)

  1. Generals–

(no answer)

  1. The mentals:

irritability, I want company but I don’t, the pain is in stings, then it subsides, I am pessimistic

  1. What have you been saying?

I’m irritable, I have an ear ache, my head hurts, I hate my breasts, I’m embarrassed, I’m angry, I’m blaming others…

  1. What are you doing?

Right now I am sitting under the covers giving orders to the kids to do stuff…I didn’t eat much today only a banana and some dates…

  1. Describe your thirst and appetite–

I was very thirsty this morning for cold drinks but had lemon water and it subsided, now I would like grapefruit juice

  1. Fever?

this morning I was sweating, now it stopped, I have like a sniffle, I have occassional bouts of dry cough and feel like choking, my eyes start watering and when I eat it feels like phlegm comes up.

  1. Sweating? Describe.

sweating is acrid

  1. Odors?

(no answer)

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

It hurts as a muscle pain cause it is on the shoulder as well, the implants are located underneath the muscle

  1. Is there a diagnosis?

could be that the silicone is leaking…I don’t know.

  1. Describe your energy–

depressed, anxious, nervous (woke up screaming) fearful, scared

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

Tongue is pink now but it’s white in the morning.

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

Cough is dry but there is nothing coming up

  1. If you haven’t already said if you’re hotter or colder than usual, or if there’s an issue with your body temperature, like hot feet or cold feet, cold hands, shivering, etc., say it now.

Warmer than usual


Here is Paula’s update after I prescribed _________.

In a message dated 4/16/2016 4:29:32 A.M. Eastern Daylight Time, ***** writes:

I took the ______________________ 200c…feeling calm… I took it last night and I took it this morning. The hardness is subsiding but best of all is the improvement on the mental sphere.


Well, folks, you know that that’s what we want to hear after a remedy is given, right?  That the “mentals” have improved?  That’s golden to us!  It means the remedy is correct and that all will be well soon!  The mentals change first, it’s just the opposite of “regular” medicine which makes the local complaint “better” (if you’re lucky) but the mentals, emotions and energy often go bad!

So what remedy is this?  Write to me at [email protected] and let me know.  






OK, so first of all, I asked Paula for an update and she wrote:

Sorry I haven’t written.  No relapses. Breasts are back to normal. The constant fear and worry is gone. That is the best part.   Thanks Elaine!

So first of all, we didn’t get too many answers, did we?  No one seemed to know what to do.  Well, let me begin by saying that whenever you hear that the tumor or breast lump is “hard as a rock”, your first thought should be that the patient has cancer and the remedy is ConiumBut we have an etiology here that we have to consider.  Who wants to come up first and solve the case?

Hi Elaine

Hi Adriana!

…greetings from Slovakia! The first remedy that crossed my mind was Phytolacca so I am going to stick with it for now. Am I right?

Well, Phytolacca often comes up as a breast cancer remedy!  But Paula gives us a clue, she says her silicon breast implants might be leaking….

So you gave her Silica?

Yes!  But P.S., Silica is a breast cancer remedy too!  It covers both contingencies.  And it so happened that in repertorizing, Silica actually covered everything in the case–all symptoms in bold: breast swelling, hard lumps, worse pressure, etc.  Here is the Repertorization chart:

That’s quite a confirmation, you have to agree!  Oh look!  The rest of the Slovakia Gang is here!

Hello, Elaine and Shana,

Hello Miroslav and Jitka!!!

I have been pretty busy when I have found that it is a high time to send our responses to the April quiz.

Everyone is late this month!  (Or maybe just confused.)

Miroslav votes for Belladona:

The dynamics of the whole case, symptoms and modalities point to Belladonna.

Well, I can understand that you saw redness in the case and thought of belladonna.

Jitka votes for Belladona:

Modalities – worse, touch, jar,

noise, draught, after noon, lying down.

Mastitis – pain, throbbing, redness, breasts feel heavy; are hard and red.

pain worse lying down. Belladonna, desires lemonade.

We are quite sure that this time our answers are right. ..:)

You are?  Well, look; what does our remedy HAVE to have in order for it to be the right remedy?  Which is another way of asking, What is striking about this case?  The remedy has to have swelling of the breast, it must have hardness, hard like a rock, hard tumors or lumps or nodules.  We must have worse motion and worse pressure and the sensation she mentioned was ‘stinging pain’.  Belladonna is only a 1 for stinging pain, and it is absent completely under hard lumps/tumors; so, because of that, we don’t like Belladonna; “hardness” was an important part of this case!!!

Also, your rubrics: you’re too free with your choices; like, for example, she says she’s worse lying on the breast so you picked “worse lying down”.  No, she’s not worse lying down.  She’s worse lying on the painful side; or, “worse pressure” would be another way of saying that.  And does she actually say she’s worse touch or worse being jarred?  No.  Does she say she has mastitis?  No.  Does she say anywhere that she’s worse for a draft of air, worse noise, worse afternoon?  Does she say the breast is throbbing?  No, she says the headache is throbbing.  You have to be much more careful about choosing rubrics (Repertory headings).

All we know is this: her breast is swollen, it’s hard, and she has a hard lump which is worse pressure, worse motion; plus, there’s a stinging pain in her breast which she mentions under the question about “mentals”:

  1. The mentals:
    irritability, I want company but I don’t, the pain is in stings, then it subsides, I am pessimistic

That’s all we know about the pathology.  Oh, and one other thing, there’s a presumption that the cause of her problem is her silicone breast implants.  So, what’s the remedy?  Silica!  And by the way, Silica covers everything in the case–hard breasts, hard tumors, swollen breasts, worse pressure, worse motion.  And stinging pains.

Thanks, Elaine– Jitka

So, here’s the deal.  I actually had to “repertorize” to come up with the answer.  I thought of Conium right away!  But Conium wasn’t worse pressure, and that bothered me.  So I decided to take the trouble to repertorize–which means open up the Homeopathic Repertory, our book of symptoms, and look for the rubrics in the case and see which remedy covered all of them.  And when it came up resoundingly for Silica, I said, “OMG!  Those silicone breast implants!!!!!”  So, it’s like Robin Murphy always says: Etiology–it really matters, it can tell you all by itself what the remedy is.  OK, see ya next time! 

Elaine Lewis, D.Hom., C.Hom.

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

About the author

Shana Lewis

Shana spices up the Hpathy Quiz with her timely announcements and reviews on the latest in pop culture. Her vast knowledge of music before her time has inspired the nickname: "Shanapedia"!

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