Case Quizes Clinical Cases

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

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

Mom, it’s time for the quiz.

I can’t believe it’s 2016 already.  I have a few announcements about the things I’m looking forward to this year.

Before your announcements, we have to say good-bye to all the people we lost in 2015.

Is this going to take long?  Oh, and speaking of deaths, Robert Stigwood died.

Shana, believe it or not, no one knows who Robert Stigwood is!

Are you kidding?  He was the manager of the Bee Gees and the manager of Cream, and he produced “Saturday Night Fever” and, I think, “Grease”.

No one cares, Shana!

Hey, it was your idea to talk about people who died, I have more important announcements!  Though it is sad and all, and by the way, if it weren’t for Cream we wouldn’t have Eric Clapton!

More minutia no one cares about!  Can we possibly get on with saying good-bye to the people we lost in 2015, not the least of which was Natalie Cole, and just a few days ago, David Bowie?

Doesn’t Dr. B complain when our articles go on and on with too many pictures and videos and stuff?

Are you finished finding fake reasons to stop me from talking?  Because I would like for us to say good-bye to the 21 talented people we lost in 2015, if you don’t mind!  Thank you.  Ahem!

Natalie Cole

Ben E. King

Allen Toussaint

B.B. King

Louis Johnson (The Brothers Johnson)

Julian Bond (civil rights leader)

Leslie Gore

Ben Cauley (The Bar-kays)

Haleema Alkhatib (The Majors)

Cynthia Robinson (Sly and the Family Stone)

William Guest (Gladys Knight and the Pips)

Larry Johnson (The Artistics)

Wally Roker (The Heartbeats)

Lenny Coco (The Chimes)

Ken Kelly (The Manhattans)

Ronnie Bright (The Coasters and the bass voice on “Mr. Bass Man”)

Don Covay

Dave Somerville (The Diamonds)

William Brown (The Mad Lads)

Percy Sledge

Curtis Lee

Rest in peace, everybody! And thanks for the great music!

Can I make my announcements now?

Dear God, are you still here?  Yeah, go ahead, and hopefully this will have been worth waiting for.

Fox is bringing back the X-Files!

Its not a show I thought I would ever watch but for some reason when I watch it I feel closer to Daddy.

I’m sure he watches with you.

It’s only going to run for 6 episodes.  I guess David Duchovny and Gillian Anderson are getting older.

If I am, I’m guessing they are too.


Next, Netflix is bringing back “Gilmore Girls”.

Yay!!!!  (Is this going to cost me money?)

Mom, I already explained this to you but explaining anything to you is a complete waste of time!  Anyway, “Full House” is coming back in February.

I don’t know when “Gilmore Girls” starts but I want to see it and I know you do too.  I want to see how the writers deal with Edward Hermann’s death.  Its unfortunate we don’t have Netflix because I really want to see these.  I heard one of today’s pop singers remade the “Full House” theme song.

No one cares, Shana!  It was a dumb song to begin with!

It’s not “Full House” without the theme song, just like it’s not “The Fresh Prince” without the theme song!

I hate the “Fresh Prince” theme song!

It’s an iconic theme song!

It’s stupid!

I’m afraid I won’t like “Full House” without the original theme song–which is here:

I love the old theme song so much that I’m worried the new version might ruin it for me.  Also Michelle won’t even be in it.

OMG!  Michelle won’t be in it?  Someone call the Television Police!

Yeah but Bob Saget, Dave Coulier and John Stamos will be in it so I guess it more than makes up for it.

If you say so.  By the way, Bob Saget looks terrible!

Its because he’s older than he was in 1987.  I’m curious about what Danny Tanner and his family have been up to since the original show ended in 1995.

Nothing, Shana, they haven’t been up to anything, just like when the show was airing!

I want to see DJ and Stephanie all grown up.  Another thing is Elton John is coming out with a new album sometime this year.  That’s all of my announcements.

That’s all your announcements?  You didn’t think to announce the show you’re going to be on?  January 27th on the Fuse Network?  11 pm?

Mom!  Our readers from India and Pakistan probably don’t even get the Fuse network!  I’m embarrassed to be on a dance show when I don’t even know how to dance; and besides, you know how I feel about today’s “music”–ugh!  And the fact that a minute ago we were talking about Elton John should prove my point.  Now that I’m completely embarrassed…

We can start the quiz!

So what’s this month’s quiz all about?

This month we’re having a case-management quiz, featuring the ever-popular, Joe Schmo!

Joe Schmo again?  You’ve given up trying to find names, haven’t you!

It’s a different Joe Schmo!  “Joe Schmo” is a hypersensitive, allergic patient.  Normal doses of remedies aggravate him, his symptoms can easily spiral out of control, and that’s what happened here.  Tell me what mistake the homeopath made, what mistake Joe Schmo made, and how you would correct it.


Dear Elaine,

How are you? I am contacting you after a gap of more than 3 years. I hope you remember me.

Presently I am in India for the last 4 years.

I was advised by my Homeopath to take Nat Mur 200C continuously: 3 doses over a period of 2 months. Since then I have developed a severe backache. So, I did your Aggravation Zapper, I diluted a Nat Mur 200C pellet in water, dumped out and refilled with water 24 times, and took a sip. I felt better within 3 hours, but there was a relapse after a week and the backache returned. Then I zapped again in the 36th cup this time but it didn’t help. Then went to the 60th cup but that also didn’t help. Both 36th cup & 60th cup only brought aggravation!

Next I took Nat Mur 1M after a month but backache came back with greater ferocity. I zapped Nat Mur 1M to the 24th cup & took a sip but that aggravated the condition further! What am I going to do?

I have experienced that normally 24th cup zapping after an aggravation brings lot of relief. But this time, it failed.


“Joe Schmo”


Dear Joe,

Drop one pellet of ____________________C in a large bottle of spring water, take a sip, and let me know what happens.


Dear Elaine,

I took __________________C yesterday morning (Indian time) and feel much better today morning. Backache reduced, phlegm coming out with cough. Slight aggravation in headache, though. Overall I feel better. Improvement noticed within 2 hours. I am much better. ___________________C has done wonders for me. Back pain has literally gone. Will wait now. The dose seems to be still working and bringing improvement.


So, everybody, Joe Schmo had really painted himself into a corner where everything he tried made him worse!  How to rescue him?  Let me know.  I want to know what the homeopath did wrong.  I want to know what Joe Schmo should have done when he relapsed after his successful zapping of Nat-mur in the 24th cup.  I want to know what finally ended the severe backache aggravation.  Write to me at [email protected].  The answer will be in next month’s ezine.

Now my dilemma is, what song to play us out?  I want to honor one of the many great entertainers we lost in 2015 but with so many truly talented artists to choose from, I find it next to impossible!  I am literally going to have to pull a name out of a hat!  So, hold on.

OK, we used a deck of cards and gave each artist a number.  Shana picked the card and the winner was…(drum roll please)…Ken Kelley of The Manhattans!  Shana is insisting on picking the song.

Mom!!!!  That is not how you spell Ken Kelly!

Well excuuuuse meeeee, I am not an encyclopedia of music–as some of us apparently are!  Have you picked a song yet?  (I saw the Manhattans at the Uptown Theater in 1967, in case anybody cares.)

I’m sure everyone cares!!!!!

Mom, I know I should probably play “Kiss And Say Good-Bye” but, as far as I’m concerned, you can’t beat the early Manhattans when George Smith was singing lead.  Here is “Can I”.

Can I kiss my bride, now preacher…..



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]

Visit her website:

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"!

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


  • Very helpful ! Learned alot with these details of case management. Clapton is God! ( well, for a short while when with Cream and the Bluesbreakers.) X files was great.Hope it comes back next season.

  • hi Elaine.
    thanks a lot for this quiz as this is frequent encounters in practice.

    but im confused as first you said that nat mur200 24th cup is the right choise for this case but then you said that you gave nat mur 6c.
    pls clarify my dilema….

    • Have you read the Aggravation Zapper? Because if you haven’t, you’re going to be confused. You should start by reading that. Then try to read the quiz answer again, and maybe you won’t be so confused this time.

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