Case Quizes Clinical Cases

Revisiting: Post-Partum Blow-out!

Written by Elaine Lewis

Elaine reveals the answer to the February Quiz.

Hi Everybody!  It is now time to revisit our quiz from February, “Post-Partum Blow-out!”: There’s been too much stress in a certain California girl’s new life as a mom!  Now she’s got a doozy of a headache!  What’s a mother to do?  Shana, get ready to rewind the tape…. Here it is again, and….Action!


Hello!!!  MOM!  Isn’t it time for the February Quiz?

Well, Shana, for your information, if I had a little help around here, like with cooking?  And doing the laundry?  Maybe I’d have more time for the ezine and solving cases!

Well, Mom, as you can see, I’m busy!

Oh yes, I can clearly see that.  Isn’t that you on facebook?

I’m not ON Facebook, Mom; I’m getting on Facebook, there’s a difference; and shouldn’t you be starting dinner?

Shana, here’s an idea, maybe I can put you up for adoption.  (Needed: Good home for 19-year-old; must have internet and cable.)

Aren’t there laws against child abuse?  By the way, do we have a case for this month?

Yes, can you come up with a fictitious name for our patient?

Um…OK, “Lehigh”.

Isn’t that the name of your dorm?

It was the best I could come up with on short notice.

(sigh!)  OK, so this is the case of “Lehigh” (pronounced Lee-High) and Lehigh has just given birth a week ago.  She’s been under a lot of stress with relatives visiting the new baby, friends dropping by, not getting enough sleep, the baby, it seems, can’t get enough milk, nursing is painful, there are pains from the delivery still and not surprisingly, Lehigh has a great big HEADACHE!  Her husband filled out the questionnaire because Lehigh has gone to bed.  Here it goes:


1. Describe the complaint

“Lehigh” is having a constant and deep headache.  She suffers from migraines once in a while (maybe 3-4 times a year).  She is having migraine type headaches for the last 2-3 days.

She is also constipated.  She has an anal fissure that got reactivated during delivery.  So, when she does pass stool it hurts really bad.

She has joint pains.

She has sore nipples when the baby feeds.  One of her breasts also bled two days ago.

2. Etiology–this means the CAUSE

“Lehigh” delivered a baby boy 10 days ago.  It was a long labor (almost 48 hours) and it was vaginal delivery.  It was long because she was having the labor pains but her cervix had not dilated.  We went to the hospital thrice because of the contractions but were sent back home twice because there was no dilation at all.  The third time they took pity on her and admitted her to the hospital because the pains were severe.  Then they gave her Fentanyl because the pains were severe and the cervix was not dilated.  While Fentanyl took the edge of the pain she could still feel it.  Within 45 minutes of giving Fentanyl her cervix went from 0cm to 9cm dilatation.  Then they gave her an urgent epidural.  The baby was delivered 3 hours later.

She developed an anal fissure during her first pregnancy that got reactivated during this pregnancy.  She also had 2nd degree tears due to vaginal delivery.

Because it was hurting soon after delivery I gave her Arnica 200C, followed by Arnica 1M.  It did not help with the pain.  Then I gave Staphysagria 200C (again not much help).  She was also taking Motrin for her pain.  But her tears healed more or less.

In her first pregnancy she was severely constipated.  So this time she made sure to drink a lot of water and also ate fiber rich food.  She was not constipated for the first few days after delivery.  But constipation started 3-4 days ago.

3. Sensation–

Headache is deep (migraine).  All her joints hurt.

4. Appearance– anything remarkable? Red skin, droopy eyes, etc.?


5. Location

Head, back and anal fissure (hemorrhoid).

6. Modalities

When she has the headaches she feels like sleeping and all sounds and lights are turned off.

7. Concomitants

She has a neck sprain that she developed yesterday.

8. Discharges


9. Generals

When she has a headache, she wants to be left alone.  It seems like eating chicken has increased her headache, but she can’t say for sure.

10. The Mentals

She is making an attempt to keep her spirits high even with the pain, because she fears that it might impact her ability to lactate.  As it is, the breast milk she is producing is not sufficient for this baby.  So we are having to supplement the baby with formula (i.e., topping off the breast milk with formula, if baby is still crying for milk). Avoid formula if the baby is not crying for more.

11. What have you been saying?

She wants to drink cold water.

12. What are you doing?

Don’t know how to answer this question.

13. Describe your thirst and appetite.

She is drinking plenty of water to keep herself hydrated. She prefers cold water.

14. Fever?


15. Sweating?


16. Odors?  Are odors an issue, such as bad breath, foul or unusual odors of any sort?  Any identifiable odors–like sulphur, onions, fish, etc.?


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

Headache and joint aches.

18. Is there a diagnosis?


19. Describe your energy

Frustrated because of the constant headache.


Well, gang, what do you think it could be?  If you know the remedy, write to me at [email protected] and let me know!  See you back here in March for the answer.





Actea Racemosa


Nux v.


So, the consensus for this quiz seems to be Bryonia.  Let’s see who’s here to talk to us….it looks like it’s you, Maria:

Hi Elaine! My vote for this month’s quiz is Bryonia;

Constant Headache with constipation
Thirsty for cold water

You know, I’m not sure that she was “thirsty”, per se.  Her husband said she’s drinking water to avoid dehydration.

better sleeping, with lights and noise turned off, wants to be left alone when she has the headache.

Also bryonia is a major joint remedy.  Though the husband didn’t fill in the modalities of the joints pain in the questionnaire, I may say it looks typical bryonia.  But cocculus crossed my mind too at first, anyway…

Fingers crossed 😛

Well, Maria, the problem with Bryonia is, it actually isn’t sensitive to light!  Why does Bryonia have a headache?  It’s often because of a virus like the flu.  This lady has a headache…why?  That is the question!!!!!  Why does “Lehigh” have a headache?  Well, she’s been under an amazing amount of stress!  Having a baby would have been enough, but, she got sent home from the hospital two times before finally being admitted; when they did accept her at long last, powerful drugs were needed, she developed hemorrhoids after delivery, constipation; nursing has been painful, visitors are in and out, her sleep cycle is off; in fact, “off” is a good word for her, nothing is working right; in short, she’s really been under stress and experiencing a lot of pain from all quarters.  What remedy do you think of now?

That is why I told you Cocculus at first email.  It seemed she is off from all this caretaking.

Yes, there is caretaking.  I think if it were just caretaking and nothing else, Cocculus would have been a good choice.

Lot of pain and stress makes me think of Aconite.

There’s no fear, anxiety nor fright, though.

The stress and some modalities makes me think of Gelsemium.

There’s no virus, no ailments from bad news, no stage fright….

I thought of Nux-v. too, many symptoms agree.

Ding Ding Ding Ding Ding!!!!

Yes, it is Nux vomica!!!!! Think of ailments from stress, ailments from drugs, and then think of the sensitivity to light and noise and constipation as a concomitant and there you have it!  Here’s an article for you on Nux v. by Shirley Reischman:

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

Thank you for enlightening me in this!  The article was very helpful.  The fact that I didn’t see the typical irritability of a nux v. confused me…

Remember the husband said that she was trying to remain calm for the sake of maintaining the breast milk?

Oh yes you are right!  He mentioned it in the questionnaire!

So, we don’t really know what her actual mental state might have been if she weren’t making some sort of effort there.

Here is what I thought when I eliminated Nux v. from my first choices; I would expect from Nux to tell all the annoying guests etc. to go home or to refuse them the visit in the first place… From reading Shirley’s article, I think I had the wrong impression of Nux until now.

The guests may not have been annoying, per se; but, she may have felt obligated to entertain and be cheerful which would have been another added stress!  Thanks, Maria, as always…

Who else is here?


Hi Elaine! How are you?  It’s Maryam from Pakistan.

Well, it’s about time!  And where is Little Elaine Lewis?  Has she started pre-school yet?

Little Elaine Lewis is not as little now as you might think; she has become a mature cat; she wants a partner.

D’oh!  Maryam, we cannot have Little Elaine Lewis gallivanting about, sacrificing her academic career for some cool cat on the prowl!  Look at this picture, doesn’t it take you back?

Here she is, soaking in the Repertory….

Those were the days, now she’s a teenager.  Meanwhile, I am so sad that I am participating in the Quiz after a long absence (and people, in spite of participating, post their answers in the comment box!!)

I know, I know!

They decrease my excitement because I also guessed for Bryonia!

That seems to be the popular choice!

I did not gain much knowledge from the case, means did not get many symptoms so I am not sure about Bryonia.

I collected only one key symptom “thirst for much water, wants to drink plenty of water to be hydrated” but she prefers cold.  Does Bryonia want cold water?  I don’t know about this. I also found underlined bryonia under the rubric “migraine” in Murphy’s repertory.  Bryonia also has constipation, joint pains, pain in the nape but symptoms are not so characteristic.

Yes, exactly, we’re not hearing the usual Bryonia confimatories and in answer to your question, yes, Bryonia does want cold water.

It also does not want company but gain only one point.  I also don’t know which remedies are excellent for post-partum complaints.

I saw this as a stress headache and a toxic headache; toxic in the sense of all the drugs she’s been given, narcotics.  If you go to “Headaches: drugs”, in the Repertory, you see only one likely candidate and that is Nux vomica.  So, already, I’m thinking of Nux vomica as my first choice, but then I have to ask myself, “Can I confirm Nux vomica?” and lo and behold, she’s worse for light and noise!  Now, is that a gift or what?  Plus she’s constipated!  What more could you ask for?  Did you know that Bryonia actually isn’t listed under “Sensitive to light”?  And the thirst is very “iffy” because the husband says, “She’s trying to keep hydrated.”  So is she REALLY thirsty?  I don’t know.

Stress and Nux vomica go hand-in-hand!  Think of all the stress she’s been under–she got sent home from the hospital twice before they actually admitted her!  She’s got a lot of pain–I don’t know why her joints hurt (drug side-effects?) but there was pain from that, plus hemorrhoids, plus the baby is apparently nursing constantly and painfully and not giving her a break AND she’s got sleep loss and visitors!  Is this stressful or what?  I’m telling everyone to read Shirley Reischman’s article on Nux vomica as linked to above.

As the article says:

“It’s a great remedy for stress and overdoing things, insomnia and for general calming of the nervous system.”

Amazing!!!  An excellent choice.  This is called case observation.  My mind did not move towards this essence. Anyway, I learn much more about that type of case after your explanation.  I again tell you that you are a very good teacher!


Maryam from Pakistan


Well, Dr. B, I am sorry to report that we don’t have a winner this time; but, Maria did have Nux v. under consideration; so, I think we can give her half a star.  Where do we keep our half-stars, Dr. B?  Oh, wait a minute, hold the phone, this just in at the 11th hour, I think we’ve finally got a WINNER!

Hi Elaine,

Here is my answer to Feb’s quiz:


pain in joints (3)
fissures (2)
constipation pregnancy (3)
head pain while constipated (2)
thirst (2)
cold drinks, desires (1)



Well, there you have it; at the last minute, Diderik Finne rides in on a white horse!  Let’s hear it for Diderik Finne!!!


And now, to sing us out…. on a sad note, a devastating note, especially for me, the lead singer of The Trammps passed away last week–Jimmy Ellis.  Their big record, “Disco Inferno”, came out at a time when popular music was devolving into some kind of toxic sludge!  I could hardly stand to listen to the radio at all with for but a few exceptions: Al Green, The O’Jays, The Spinners and a few others, and then this song came along in 1976 and was like a breath of fresh air.  Here are the Trammps from 1976, featuring the unmistakable voice of Jimmy Ellis on lead: “Disco Inferno”:

Jimmy Ellis, 2005

See you back here in April (Shana’s birthday month)!  Bye-bye!

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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