Case Quizes Clinical Cases

Revisiting: Severe Backache (Thanks to Nat-mur!)

Revisiting: Severe Backache (Thanks to Nat-mur!). Did you guess the right remedy?

To read last month’s full case quiz. Visit – Severe Backache (Thanks to Nat-mur!)



Nat-mur 30C

Nux vomica 30C

Nat-mur 200C in water


Well, geez, this was certainly an unpopular quiz!  Even the twins from Slovakia didn’t show up!

Mom, they’re not twins!

Well, anyway, hey look everybody, Vamsi’s in the house!!!

Hi Elaine, I read “The Aggravation Zapper” and it was terrific.

You would have to read “The Aggravation Zapper” to understand this quiz.

I have not tried it yet, but definitely will if the opportunity arises.  Coming over to the quiz, Joe was given Nat-mur 200 for 2 months.  This sounds like a case of overdosing.  The person has been overdosed and must have started proving the remedy.


He started showing the drug qualities of Nat-mur.  That’s when he wanted to antidote or “zap” it.  He antidoted with Nat-mur 200C 24th cup, and was ameliorated of the symptoms. The aggravation had been antidoted.  But later, the symptoms relapsed.  This is what is tricky here.  It could be the 24th cup effect had been lost…

Yes, it clearly was lost.

or – as seen from one of your articles, “a return of old symptoms is possible when a remedy works and we can be tricked that we are relapsing.”

But Vamsi, the backache was not an old symptom; so, it surely was a Nat-mur proving.  So let me just quickly explain that to make up the “aggravation zapper”, what Joe did was drop a 200C pellet of Nat-mur into a disposable cup of water, stood at the sink, and dumped and refilled the cup 24 times and then took a sip.

But then Joe went up to 36th cup after the case relapsed, and then the 60th cup, and then to Nat-mur 1M, which only aggravated that much further, and he became a drug prover.  I think Joe should have taken the 24th cup again.

YES! You’re absolutely right!  Joe should have gone back to what worked the first time!

It had given him an amelioration before.

Exactly! He should not have changed the number of cups.  If something works, you can’t do any better than that!  Always stick with what works!

To antidote this Elaine, he must have been given Nat mur 200C in water to reduce the aggravation as this was the main drug he was administered and this is what gave him the aggravation.  I am really not sure about this, as I have not tried this before, but it’s a hunch.

So you’re saying one pellet of Nat-mur 200C in a cup of water, one sip. We would call this “Nat-mur 200C in the first cup”.  Well, it’s a thought, and maybe it would have worked, but I didn’t do that.

Here was the situation; to recap:

  1. Joe aggravated on Nat-mur 200C, dry pellets, taken 3 times in 2 months.
  2. He successfully antidoted the aggravation by dropping a pellet of Nat-mur 200 into a cup of water and dumped out and refilled the cup with water 24 times (Nat-mur 200C in the 24th cup) and took a sip.  This cure lasted for one week.
  3. After a week, he relapsed.  Instead of repeating Nat-mur 200C in the 24th cup, he instead went to 36 cups!  As he is so hypersensitive, this change in cups caused an immediate aggravation; so….
  4. He tried antidoting in the 60th cup!  This caused an even greater aggravation; so….
  5. He went to Nat-mur 1M.  This caused an even greater aggravation still; so….
  6. He decided to antidote the 1M in the 24th cup but he got worse again!

As you can see, this case is spiraling out of control!  It doesn’t matter what he does now, he’s getting worse.  There appears to be nothing he can do!  What do you do in a situation like this????

Well, you know what our motto is in homeopathy, right?  “Whatever something can cause, it can cure in small doses.”  With that in mind, I told him to take a dose of Nat-mur 6C, one pellet in a large bottle of water, one small sip.  And it worked!!!!!

So I hope we’ve all learned something here today:

  1. If you’re going to start every case with 200C, the sensitive people in your practice are probably going to aggravate, so, beware of that!
  2. Don’t repeat a remedy if a patient tells you he’s aggravating!  Do the “Aggravation Zapper” instead!  It’s on my website but you can also google “The Aggravation Zapper”.
  3. When you take a dose of a remedy and it works, but later you relapse… repeat what worked before!  Don’t try something new.  If that doesn’t work, then you’re justified in going to a higher potency, and if that fails, retake the case and find a different remedy; but, your first thought should be repeating what worked!
  4. When going up higher and higher in potency becomes less and less effective, drop down to 6C.  I’ve seen it happen many times that a remedy gets less and less effective the higher up in potency you go until finally it’s not working at all.  This remedy may still work at 6C.

Elaine, that was a wonderful explanation and a great learning. Thank you so much. Regarding the Point 4, (when going higher and higher), I do understand what you have said but, just wanted to know, do we have this point mentioned anywhere in the Organon, and which aphorism is it?  If its not in Organon, could you kindly suggest me the book where this point has been elaborated.

Vamsi, everywhere in the 6th ed. of the Organon, Hahnemann is warning us to start the chronic case off with the lowest appropriate potency or dose.  In Aph. 249, he says we wouldn’t be scrambling around looking for antidotes if only we had started the case with the lowest possible dose in the first place.  How often have you seen a case arbitrarily started with LM3, for example?  I always ask, “What happened to LM1?”  Well, the practitioner just didn’t think it was necessary, I guess!

Hahnemann doesn’t say, specifically, “Here’s what you should do if you started with 30C and the higher you went, the less and less effective the remedy got,” because he is saying, in numerous places in The Organon, start the case with the lowest potency and go to the next potency as needed.

It was from Robin Murphy that I learned that if you’re going higher and higher and getting poorer and poorer results, drop down to 6C and the remedy will work again.  He says, “I have a trick. When I get a referral from another homeopath who is stuck in a case, I ask him, ‘What remedy worked?’ He tells me. Then I give that same remedy in 6C and it works again.”

Thanks a ton Elaine. That was real good information.

Thanks for a wonderful quiz again.




I think we might have time for one more contestant.  Maria from Greece!  Come on down!

Hi Elaine and Shana!

Hi, Maria!

I have to say that I am a HUGE FAN of “The X-files” too!

Oh boy, here we go….

I never missed an episode, saw the movies too, and I also watched the first 2 new episodes. We should make a quiz about Scully and Mulder, right Shana?!

I forwarded this to Shana, I’m sure she’ll be thrilled and is probably working on the Mulder/Scully quiz now!

Now for the quiz. The doctor I think gave high potency with unnecessary repetitions.

Yes, exactly!

He should have started lower.  A 30th potency or a 12C maybe.

Yes, 12C would have been a lot safer, but, this hypersensitive patient should have gotten a 6C in a very large bottle of water and told to take just one dose/sip, wait 24 hours, and report back.

After the relapse, the patient maybe should have also stepped to a lower potency, like 30c.  I think it is clear that 200c and 1M were too big for him.  My vote is for Nat-mur 30C.

Maria, he successfully zapped the 200C in the 24th cup and then relapsed a week later, all the proving symptoms (the back pain) came back.  He tried zapping again and failed.  What did he do wrong?  OK, I will tell you.  Instead of repeating what worked initially (zapping in the 24th cup), he went to the 36th cup!  Moral of the story: Always stay with what worked!  That is the message here.  Either stay with what worked, or be very close to it. For instance, maybe if he had tried zapping in the 25th cup, it would have still been OK.  But going to the 36th cup was a radical change.  What works, works!  The 24th cup worked, so that should have been his first thought when he relapsed.

So OK, I guess this was a very hard quiz and scared away just about everyone, but hey, what are you going to do for these hyper-sensitive patients, they’re out there!  So I want to thank all the courageous people who voted: Maria, Vamsi, and Dr. Salma Afroz from Bangladesh who thought Nux vomica would be a good idea, and she could be right!  Thank you again everybody!  See you next time for another fabulous and exciting Hpathy Quiz!

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

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

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About the author

Shana Lewis

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"!

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: and


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