Case Quizes Clinical Cases

Revisiting: The Weirdest Cough Ever!

Maria has a suffocating cough; did you guess the right remedy?

Happy Mother’s Day, Mom! 

I got you a present.

 I know, Shana!  Thanks for the apron!

 Now you won’t have to get all wet when you’re washing dishes!

 If only I had a baby who could do the dishes for me….

 Mom, we can talk about that later!  Right now we have a very important Death Report to get to!  Sadly, at the beginning of May, singer-songwriter Gordon Lightfoot died at age 84. 

Natural causes, apparently, and it seems his health had been declining to the point where he had to cancel the rest of his 2023 tour in mid-April. 

But anyway, it’s kind of ironic to me that Gordon Lightfoot died the same year as another person connected to his song.  Guess who plays drums on “Sundown”?

 I have to guess?????  Um…. Don’t tell me… don’t tell me….  Tell me!

 A session drummer who was in Derek and the Dominos.

 That was going to be my next guess.

 He played on tons of famous albums.  His name is Jim Gordon and he died in March.  In prison.

 Egads!

 The story of how he ended up there is a sad one too.  Declining mental  health but he will always be remembered for his contribution to music.  Jim played on the Soundtrack version of the Muppet Movie. 

 Oh good grief, I should have known!

 I thought that was really interesting since I didn’t have the album and thus never would’ve read the liner notes.  But “Rainbow Connection” is famously known as the song associated with Kermit The Frog when not on Sesame Street. 

 Oy vey!

 It’s even in the National Recording Registry and in case you didn’t know, that’s where songs deemed “culturally, historically or aesthetically significant” by the Library of Congress are preserved.

 Dear God.  Rick!!!!!!!!!

 But anyway, look at how cute Kermit is with his banjo!

Shana!!!!!  We’re losing half our audience!!!  You know, the half that doesn’t watch The Muppets?  (By the way, I didn’t realize that Kermit was left-handed.)

As you know, Mom, Derek and the Dominos are most famous for “Layla.”

 Aha!  Yes, what a great song!  Are you saying WhatsHisName played drums on “Layla”?

Yes, Jim was in the band and wrote the song with Eric Clapton.  Derek and the Dominos only lasted 2 years (1970-1971) so once they broke up, that’s basically how Jim became a session drummer where ever he could find work, but he ended up on some great stuff.  He plays the on-going piano part on “Layla” as well.

 You mean the part I don’t like?

 It apparently belonged to his ex-girlfriend, Rita Coolidge.  He never gave her credit for it.

 So he stole it from her?  Well that’s just great!  No wonder he’s in jail!

However, one year before “Layla”, he played drums on “Marrakesh Express” for Crosby, Stills, and Nash’s debut album.

Then there’s the Summer Breeze Album by Seals and Crofts.

 He played on that too?

 Yes.  Two albums by Hall and Oates and the bass player (Leland Sklar) on the second album is also worth mentioning.

 Why?

 Because he’s from James Taylor’s backing band.

 I knew it!!!!   Shana!!!!  Have you noticed that James Taylor is in every issue of the Hpathy Ezine???

Is that a problem? 

Well, it’s just a bit odd, given that this is a medical journal!!!!

And just to round out the list, Jim Gordon played on two George Harrison albums, plus John Lennon’s “Power to the People” which was also Bernie Sanders’ campaign song when he ran for President in 2020.

 OK, I think we’ve established that an unknown session drummer has left his mark on music — sort of.  Do you have anything else to report before we start the Quiz?

 It seems we lost the last surviving member of The Coasters at 92:  Leon Hughes. 

Bottom Row (l-r): Leon Hughes and Billy Guy

Top Row: (l-r): Bobby Nunn and Carl Gardner

 He was with the group for only three years.  (1955-1957)  Apparently he was the tenor and according to his daughter, the reason why Leon left the Coasters in 1957 was due to an illness that affected his singing voice.  Given the timeline, he’d likely be on songs such as “Down in Mexico”, “Young Blood”, and “Searchin'”.

 I believe “Searchin'” went to #1.  I was lucky enough to find a live version of “Searchin'” from The Dick Clark Show; it’s not easy to find any live footage on the Coasters, or any black group from the ’50’s and ’60’s for that matter, and often, if you do, it’s of poor quality, the lighting’s bad, the audio is out of synch with the video… and, you know, for all the hits the Coasters had?  To have so few live performances on tape?  It’s just jaw-dropping!  If I had to count all their hits….

You could start with “Along Came Jones”, “What About Us”, “Charlie Brown”, “Yakety Yak”, “Wake Me, Shake Me”…

“Shopping For Clothes”, “Girls Girls Girls”, “T’aint Nothin’ To Me”, “Run Red Run”, “Wait A Minute”…  You know, they called them the “Clown Princes of Rock ‘n’ Roll” for their eccentric, whimsical lyrics.

 Let’s not forget “Poison Ivy”, which I think should be declared the Rhus Tox theme song!

 

Also, in school, we had to read The Watsons Go to Birmingham 1963, it took place during the Civil Rights Movement and “Yakety Yak” was mentioned in the story.  (I’m sure by now Governor DeSantis of Florida has banned it!)

 Oh, for sure!  DeSantis is on a book-banning tour; anything that puts white people in a bad light should not be allowed to be taught in the schools, according to him (he thinks it will help get him elected president in 2024), and apparently, he can’t tolerate anything positive written about gays either.  OK, OK, we’ll change the subject, we wouldn’t want to offend any Nazis or members of the Ku Klux Klan who might be reading the Hpathy ezine!

Exactly!  So, getting back on track….while we’re talking about the Coasters,  I bet some people didn’t know that “Smokey Joe’s Cafe” by The Robins was an earlier version of the group.

 The link between The Robins and The Coasters is Bobby Nunn and Carl Gardner.  

 Just like The Exceptions, who did “Down by the Ocean”, later became The Trammps.

 The link between The Exceptions and The Trammps is Earl Young and Jimmy Ellis. 

Earl Young, 2nd from left, Jimmy Ellis, far right.

 

Jimmy Ellis 10 years later:

THE TRAMMPS-hold back the night - YouTube

 But wow, you know what?  What a great doo-wop song “Down By The Ocean” is!  Let’s play it and we’ll see if anybody can recognize the great Jimmy Ellis—famed for his distinctive lead voice on “Disco Inferno” ten years later:

 You know what Mom?  We’ve gotten so far off-track, we never even played “Searchin'”, the song Leon Hughes’ voice is on!

 Right!  The Dearly Departed, the last surviving member of The Coasters.  OK, now listen people, pay attention:  We’re lucky to have this video of The Coasters even though Leon Hughes isn’t in it; but his VOICE is!  See, this video is from 1960 and “Searchin'” came out in 1957 and apparently, even though this song went to #1 in ’57, no one bothered to film it.

 What’s so distinctive about “Searchin'” is that whimsical “plinking” piano running all the way through, which is being played by Mike Stoller, the co-writer of this and all the Coasters’ songs; and, you can hardly mention The Coasters without giving a shout-out to Jerry Lieber and Mike Stoller, the 2 geniuses behind the group:

 Lieber and Stoller

 We could spend all day talking about The Coasters; but, sadly, we have to move on; in February, we also lost one of The Exciters—Lillian Walker-Moss—famous for “Tell Him” from 1964.  Lillian is on the left.

  They opened for The Beatles on their ’64 tour—how exciting for them! 

 

 And now, ladies and gentlemen, it is showtime!  Time for the Hpathy Quiz!!!!!

We are fortunate to have a guest presenter with us today!  Welcome please, if you will, to the Hpathy Quiz, the one and only…

Maria from Greece!!!!!

Hooray!!!!!

Elaine….

Why did we have to meet at the Hanging Gardens of Babylon?

Maria, Hpathy just bought it!  It was on sale, they were practically giving it away!!!!

That’s because no one can find it!!!!

Didn’t you use Google Maps?

I’d like to start my case if you don’t mind, I have a taxi waiting and the meter’s running!

Oh.  So you won’t be taking the tour?

No, I don’t think so!  OK, so, this is all about my cough.  It was the weirdest cough ever!  I filled out the Questionnaire:

Questionnaire

  1. Describe the complaint

It came on gradually.  A stupid cough for almost 10 days.  It started very mild with very little cough 3-4 times per day producing very thick and hard phlegm easy to expel.  But for the last 6 days I have been coughing so often because of tickling in the low throat pit/larynx and I can’t raise the phlegm easily.

I noticed this tickling occurs when phlegm needs to come up. When I spit it out, the cough stops until more phlegm needs to come up and so on. When I am awake the phlegm is clear, but after sleeping in the night it is usually pale yellow.  I don’t hear any sound in my chest at all.  Even the doc said it is a dry cough, but it isn’t.  I can feel phlegm in lower throat pit and he heard it too with the stethoscope.

I went to the doc to hear my chest and he said that my lungs are clear and only hears something near the larynx/trachea.  He said there is an infection going on around here and that it is nerve- breaking because it is going away very slowly.  He prescribed me antibiotics, cortisone, codeine and ephedrine syrup, which I didn’t buy, of course.

When I enter a closed stuffy room, a paroxysmal cough starts, ending in sneezing and tears from my eyes, my nose starts to run clear mucus.  The phlegm tries to exit from every opening of my head.  It is suffocative when it is occuring, I can’t even speak or breathe properly.  It resolves only if I expel sufficient mucus.  Today I went to the library and they had the heater on.  Very dry atmosphere in there and as I was talking the coughing attack came.  I had to go to open air and use tissues to clear the mucus.

  1. Etiology–

No idea.  Generally it is a stressful period with the garden, my father’s health etc.  Before the cough I had an injury in my back.  I was stooping to get some leaves from the garden and I felt a tearing pain in my lower back.  Or I strained it at the gym, the day before.  It is still hurting when I stoop and have to walk very carefully.  Seems like sciatica.

  1. Sensation–

I feel that the phlegm is never ending.  I have used over 5 rolls of tissue paper.  I feel a tickling in lower throat when I have to try to raise phlegm.

  1. Appearance–

Nothing to report.

  1. Location–

Throat pit, lungs.

  1. Modalities–

Moist atmosphere is good for the cough, fresh air.  I have windows open all day and all night.  Outside temperature is 15 degrees C. Better sleeping with 2 pillows.

Worse in closed spaces, warm rooms, without fresh air.  Worse talking.  Worse lying in right side, I may never stop coughing.  Worse on waking, all the phlegm gathered at night needs to be expelled I think.  Worse dust.

  1. Concomitants

Frequent urging to stool (3 times a day) and urinate, though I drink very little water.  Irritability, I use bad words for the cough (this f-ing cough).

Whimpering in my sleep for some nights, it has stopped now.  It happened every two minutes and it was waking me up.  Like a puppy.

Very dry lips, I apply liposan.  Today for the first time I woke up from my afternoon nap with very dry nose and mouth (inspite of rainy weather outside, it is quite humid).

  1. Discharges–color, odor, consistency and sensation

In early days the phlegm tasted salty.  Now it tastes like sunflower seeds.  It is a little stringy, though.  Also I feel I am salivating more than usual.

  1. Generals–

I am f-ing tired of this cough!  Also irritable, I don’t want to talk.  I want my life back.  All I do is cough and spit, grrrrrrr!

  1. The mentals:

I was feeling fear of coughing, that it won’t stop ever, but I took Aconitum and it is ok now.  The cough is still there, so I am mostly irritable.

  1. What have you been saying?

I am saying, “don’t make me talk” or showing my throat to people, to understand that talking can trigger cough trouble.  Also I am thinking constantly “f-ing cough!”  I miss the gym and to workout.

  1. What are you doing?

Reading materia medica, repertory trying to find out what the remedy is.  Avoiding conversations, because of cough.  Watching Chinese series with fairies and dragons 🙂

  1. Describe your thirst and appetite–

Thirstless.  When I drink water it is always at room temperature, usually sipping.  I also drink warm bitter cocoa, no sugar.  I crave salty and spicy, for example yesterday I ate some salty chips. Normal appetite.

  1. Fever?

No.

  1. Sweating?

No.

  1. Odors?

No.

  1. What is most striking

Cough suffocative violent attacks, never ending creation of mucus, my inability to expel them naturally without these cough attacks.

Also the urging to stool and urinate.  I don’t drink that much so where on earth this urine is coming from!  Also the stool, it seems that I expel more than I eat.

  1. Is there a diagnosis?

Seasonal virus or infection, circulating the neighborhood.

  1. Describe your energy–

I am quiet, after Aconitum, I even smiled 😛  Also I sleep more deeply, because the cough is exhausting.

  1. I need to know what you eat, drink and “take”.

I usually do 16 hours fasting.  I eat lots of salads and fruits, cooked vegetables, soups. I take vitamin D3, C and E every day.  Also propolis.

***

Hi Elaine, before you reply to me about a remedy, I had already tried Allium cepa just minutes before to test until you answered and it worked!  I slept even on the right side with no cough at all!  I still have traces of minor cough 2 times per day to expel some clear mucus, but overall it is going very well.  Tickling is gone, paroxysms are gone, I even sat for an hour in a very warm room with no cough attack.

Talking is easier now, but I am still careful, yet no cough came during talking.  If it stops working I will let you know.

Also the All-c I took was from an empty vessel with no pellets in it, it’s been empty for three years!  I just added some water and sipped it!  Literally homeopathy is magic!

This is what I try to tell people, you can’t run out of your remedy, just fill your empty bottle up with water and the remedy is back!!!  Also, this is why I warn people, don’t use the good glassware for remedies!  The remedy never goes away!  You can’t wash it away with soap and water!  As soon as you fill the glass back up with water?  The remedy is back!  Use paper cups or plastic cups, etc. for remedies.

Anyway if things don’t go well I will let you know, but so far things seem going towards cure 😀

This is the weirdest cough ever!

***

Hi again, Elaine, I guess I spoke too soon; need your help again.  Allium cepa seems to have stopped helping.  I tried the 200C also.

I am without a cough during the day, I even went to the gym today.  I am totally normal until I lay down to sleep either at night or for an afternoon nap.

When I go to sleep I start to cough again as soon as I lay my head to the pillow – both left and right side.

So I start to cough and raise phlegm from my mouth and nose which is transparent, clear.

Cough won’t stop until I clear all the mucus raised up.  But after maybe 2-3 hours I start to cough again.

Last night I managed to get to sleep on my abdomen, apparently the cough doesn’t start in this position.

If you have an idea I will gladly try it.  I tried lachesis yesterday during the cough attack in the middle of the night but it did nothing.

Thank you 🙂

 

Maria, take a dose of _______________30C in water and let me know what happens.

****

Maria, any coughing news yet?

Elaine, it worked like a charm!  I used the 30ch potency, just one dose, and slept undisturbed!

Thank you Miss Sherlock!!

OK, everybody, that’s it!  If you know the remedy, write to me at [email protected].  The answer will be in next month’s ezine.

Bye-bye!


VOTES

Antimonium tart

Pulsatilla-3

Drosera

Arsenicum

Medorrhinum

Kali sulph.

Coccus cacti

 

Hello everybody!  How did we do this time?  Who wants to be first?  OK, looks like it’s Kalyanee!

Hi Elaine.

Firstly, Congratulations on the 100th case solved and Belated mother’s day wishes.

Thank you!  I have to clarify; it was my 100th case—again!  About 7 years ago, roughly, we got our first 100, and now we’ve done it again.  So it’s 200 now!  And actually, since I got up to the year 2020 with our 2nd count, we’re 3 years, already, into our next 100 cases!  OK, go ahead with your Quiz Answer! 

Here is my attempt to solve the Weirdest Cough Ever case posted in May.

Well, good luck because this is a very tricky case!

Hard to expel phlegm/mucus

Tickling cough, aggravation from talking and lying down seems to be very strong in the case.

True but so is “worse inside, better outside”.  That was very clear also.

Irritability

Fear of coughing – seemed striking to me

That’s why Aconite helped her.  But it didn’t cure the cough.

Whimpering in sleep – could not find a rubric, but checked sleep, interrupted or disturbed to check if the remedy choices were there.

She said the whimpering had stopped; so, we should probably not make an issue out of it and move on.

Murphy, III – M; Mind; irritability, general (366)

Murphy, III – M; Mind; fears, phobias, general; coughing, of (3)

You would be afraid of coughing too if it kept you from breathing.  This is why Aconite worked so well, but it didn’t cure.  If a symptom makes sense, it’s not a “symptom”.  So, we can’t use “fear of coughing”.

Murphy III – C; Coughing; lying, down, general; agg.(100)

Murphy III – C; Coughing; suffocative, cough(107)

Murphy III – C; Coughing; exhausting, coughs(115)

Murphy III – S; Stool; frequent, stool(153)

Murphy III – U; Urine; profuse, increased, urine(325)

Murphy III – C; Coughing; talking, from(92)

Murphy III – C; Coughing; tickling, cough; larynx, in, from(152)

Murphy III – L; Lungs; expectoration, lungs, discharges; difficult (126)

At this point it was Antimonium tartaricum

I thought that too.

When I add

Murphy III – C; Coughing; paroxysmal, cough, attacks; mucus, followed by copious(9) or an equivalent in Complete Repertory as well,  Coccus cacti seems to be strongly indicated over Antimonium Tartaricum.

Yes, Coccus cacti is another good choice.

Good news is, I am not so hung up on any one remedy. Hoping it is at least one of these two.

My first choice would be Ant-t 30C.  This remedy has helped many of my coughing friends struggling to bring out the phlegm.

Second choice would be Coc-c 30C.  I had used this remedy once when one of my friends described the sensation of hair in her sternum to me 🙂 with all other modalities of Coc-c.

Here’s the thing with Antimonium tart.  We don’t have the rattling it’s so famous for; as in, it sounds like phlegm would come out easily but doesn’t.  Here’s what Allen’s Keynotes says about Antimonium tart:

“There appears to be a large collection of mucus in the bronchi; it seems as if much would be expectorated, but nothing comes up.”

***

Here’s the other thing about Antimonium tart, they’re drowsy, stuporous, with inclination to sleep, like Gelsemium.  The patient is cold, blue, pale with cold sweat; seems a lot sicker than Maria.  Here’s what Murphy’s MM says under Ant-t.:

“Prostrated in mind and body. … Patient becomes  increasingly weak, sweats, becomes drowsy and relaxed with lack of reaction.

***

So, if I repertorized this case, here’s what it would look like:

A very unspectacular showing!  Why?  Sulphur is the supposed “winner” but numerous remedies actually score higher!  What do you do in a situation like this?

Well, fortunately, I didn’t have to make such an arduous decision because Maria, very happily, took Allium cepa on her own and it worked!  And why would that be true?  Because Allium cepa is very strong for “worse inside, better outside”, which was a big part of this case! 

But then, you know what happens sometimes when you give a close remedy?  It clarifies the picture of the remedy you SHOULD have given!  It shows you a keynote to prescribe on!  So when Maria came back and said, “It looks like I spoke too soon!  Here’s what the cough is like now…”

Here is what she said:  She said she is totally fine during the day!  Then, at night, as soon as her head hits the pillow?  Wham!  The cough is back! 

I said, “OMG!  That’s a keynote of a remedy!”  Do you know what it is?

I did not remember any remedy with that keynote.

Murphy’s repertory for this symptom only has 3 remedies: DROSERA, Conium and capsicum!

I remember that Drosera is a great whooping cough remedy, paroxysmal cough remedy, however the gagging and vomiting is missing. No hemoptysis either.

Is that essential to have?  Do we have to have EVERYTHING that’s listed under a remedy?  Does the cough have to end in vomiting?  Here’s what Murphy’s MM says:

“Whooping cough.  Spasmodic, dry irritative cough like whooping cough, the  paroxysms following each other very rapidly , can scarcely breathe, chokes.”

Doesn’t that sound familiar?

Similar rubric in Complete Repertory has 10 remedies.

CR21 – Cough; lying; agg.; down; head touches pillow, as soon as (10) : bell., caps., 3 con., 3 croto-t., 4 dros., hyos., puls., 3 rumx., sabad., sil.

Given your clue that Allium cepa is a close remedy, I am going with Sabadilla, as it is in the Lily family as well.

Hope I got close to the remedy this time.  Besides, I have learned 10 remedies with this keynote!!

In fact, it was Drosera.  And I think if you’ll look at that list you made after “CR21”, Drosera was the only 4!  And by “4”, we mean “Bold/underlined“; whereas, the Sabadilla you picked is only a 1.  So, your thought about families…plant families?  Maybe that’s not as helpful in choosing a remedy as one might think.

Does anybody else want to try?

 

Hi Elaine,

Hi, Edina!

This sounds like pulsatilla again.

You know, if a case has mentals, the remedy has to match them.  Pulsatilla doesn’t match the mentals of this case.  Maria is irritable, angry.  She’s going, “f-ing cough!” over and over again!  Pulsatilla’s mentals are in no way like this!  They are piteous, crying, wanting sympathy and cuddles.

Strong keynotes of: Worse in warm stuffy room, needs air/open windows…

But you know what?  Allium cepa has these exact same modalities.  That’s why it worked so well!

…better from cold air, changeable (mucus, and mood), no thirst, worse lying down, better sitting up, must sit up.

Was her mood changeable?  I thought she was consistently angry and irritable.

Difficult expectoration, tickling in larynx and the list goes on.  Hope I got it right!  Causticum and Sulphur were also considered for the chief complaints but I feel like the modalities overpowered the other options.

Here’s what I saw: that Allium cepa had pushed her into a new remedy state that clarified the picture of the real remedy she needed.  That’s what a close remedy will do sometimes.  There was an especially glaring keynote of the new remedy which tipped me off as soon as I saw it.  Do you want to try to guess what it was?

I thought it didn’t work.

What, Allium cepa?

Only partially.  Was not the similimum, right?

It worked, then stopped, the cough came back; BUT, in a new way!

Brainstorming…

  1. Strange peculiar: increased urine without drinking,
  1. Mental, irritability, cursing
  1. Worse for warmth, room, heater
  1. Worse lying on back
  1. Thirstless
  1. Difficult expectoration, only at night

Almost nux vomica except it’s very chilly.

So is causticum…(1 of 2 in rubric coughing only at night)

Maybe sulphur?

Irritable 4, profuse urine 3, worse from heat, lying down, at night… only 1 in thirstless though.

I repertorized and Sulphur did come up in the #1 position.  But…I see you’re not familiar with this new keynote that Maria mentions.  Here are Maria’s exact words:

“I start to cough again as soon as I lay my head to the pillow.”

Here is the rubric:

“Coughing: lying down, as soon as head touches pillow.”

Wow!  That’s a word-for-word match!  And there are only 3 remedies, with only one in BOLD, and that remedy is… Drosera!

And then look at this, from Allen’s Keynotes:

DROSERA ROTUNDIFOLIA

Sundew, Drosceraceae.

 …cough with violent paroxysms which follow each other rapidly, is scarcely able to get a breath … and does not cease coughing until a large quantity of tenacious mucus is raised.

Here are Maria’s exact words:

“Cough won’t stop until I clear all the mucus raised.”

OMG!!!  Again, it is practically a word-for-word match!

And then, if you continue reading the Drosera MM, you find almost all of Maria’s symptoms there, including “worse warmth” (Allen), worse talking, better open air and easily angered (Murphy).  Murphy states:

<LUNGS>

  …Spasmodic, dry irritative cough like whooping cough, the  paroxysms following each other very rapidly , can scarcely breathe, chokes. Cough worse singing, talking. Cough very deep and hoarse, worse after midnight.  …  Harassing and titillating [tickling?] … not at all through the day, but commences as soon as the head touches the pillow at night.

***

OMG!!!!  Good heavens!!!!  Well, there it is, folks, an incredible match!  And as I said, I think Allium cepa pushed her into this more clearly identifiable remedy state.

Gotta get me the Murphy MM!

Yes, you do!

I did see drosera for cough, but I was looking for the mentals.

Alas……  The Repertory is not, as they say, “complete”.  In Murphy’s MM, the first thing it says under “Mentals” is “easily angered”, but, is it in the Repertory under “Mind: anger, easily”?  Nooooo!  It’s not there!!! 

I only have Allen’s keynotes. I didn’t read anything that matches on drosera besides the chief complaints, which should be last?  I’m confused which “drawers” we are talking about.

In terms of my “Repertory Round-Up part 4” article

https://hpathy.com/homeopathy-papers/tidbits-50-repertory-round-part-4/

the top “drawer” (hierarchy of symptoms) is “Etiology”.  Next drawer, “Diagnosis”.  Third drawer, “Sudden onset”.  Fourth drawer, “Strange, Rare, Peculiar (characteristic)”—notice, we haven’t even gotten to the “Mentals” yet!!! 

What is “Cough starts as soon as head hits the pillow”?  It’s a characteristic symptom!  A keynote of a remedy is a characteristic symptom!  (Go back and read the article again.)

So, “No cough all day, then, as soon as head hits pillow at night, cough starts”, actually over-rules the mentals!!!!  That is exactly what Maria said, “No cough all day!  Then, as soon as my head touches the pillow, the cough starts!”  That statement is so rare and peculiar, so characteristic, it takes precedence over the mentals, it’s higher than the mentals and therefore, over-rules them.

So let me get this straight. Was drosera the similinum all along?

YES.  Here’s the repertorization before Allium Cepa changed everything:

It’s a very crowded field!  It looks like Sulphur wins, but it’s a very weak showing, lots of “1’s” compared to Drosera which has only three “1’s” and lots of “3’s”, especially a 3 for “worse talking”, whereas Sulphur only scores a 1 for that.

But, Maria takes Allium Cepa, which clears almost all the symptoms away, except for 1 thing—a keynote of a remedy!!!  Wow!  It was so easy after that!  I said, “That’s a keynote of a remedy!”  I used my repertory software (so valuable—expensive but we can’t do without it!) and I went to the “Coughing” chapter and just typed in the word, “pillow”, and guess what, there it was!  Three remedies, Drosera only one in Bold!  And then, if you go to Drosera in the MM, you find the whole case:  Worse warm rooms, better fresh air, worse talking…and then there was another unusual symptom: has to cough out all the mucus before the cough will stop!  That went for Drosera too!  That was very specific!

Did Allium cepa change the picture so that now we needed a remedy for a new kind of pathology, ignoring the pre-Allium cepa picture?  I was reading Hahnemann Revisited about Similimum vs. Simile.

And, did he say that a close remedy can clarify the remedy picture for you?

Yes, he did say that.

So where I made the mistake was that I thought coughing only at night in bed was common.

Yes, I’m sure; but, what isn’t common is “no cough at all during the day but at night, as soon as the head touches the pillow, coughing starts.”  That is actually a rubric.  And then the other odd thing is, “coughing won’t stop until all the mucus is coughed out.”  That’s what Maria said—her exact words—and that’s what’s in the Materia Medica under Drosera.  And yet, under “Coughing, expectoration amel”?  Is Drosera there?  Nooooo!!!!!  This is what you’re up against with the Repertory!  It is not “complete”!  Maybe this is one reason we rely on keynotes so much! 

Depends on the wording.  Sometimes when you try to get too specific like that, it can be misleading. That rubric was not easy to find — about the head touching the pillow — I had to look twice.  And where is the increased urination?  Drosera is only 1 for that and the same for Mind, irritable.

And yet the MM says that Drosera “angers easily”!

I thought the strange peculiar was the urination without drinking, because unless you’re on Lasix, it is very weird.  Allium cepa is only in italics, and not at all mentioned in the rubric that says more than is drunk.  Maria mentioned it at least once, or twice.  So I went astray chasing the wrong rubric.  Anyway, I see the logic now.  And yes I did read about a simile clarifying the picture.

Well, that’s what happened here.

Thank you for your detailed explanation.  Always appreciated.

Edina

 

I couldn’t help noticing that Wayne Butcher is here! 

Hi Elaine

I think this month’s remedy is Arsenicum.

It has:

coughing tickling in the larynx and pharynx,

desires spicy foods

has frequent stool,

walking aggravates cough

dust aggravates

has dryness of mouth and lips

thirst for small quantities of water

mucus discharges taste salty

air passages constricted

better open air

better lying with head elevated

cursing

Regards Wayne Butcher

Wayne, I think you’ve missed some of the essential features of the case.  She has coughing fits (paroxysms).  She can’t get a breath in.  It’s violent.  What disease does this sound like to you?

I noted the paroxysms, suggesting this was not a hacking cough or other specific cough.  I noted the doctor examined her and found a chest infection.

He actually found nothing—failing to make a diagnosis.  He had nothing to say except that there was something “going around”.  He prescribed for her everything he could think of—antibiotics, of course; cortisone, codeine, cough syrup…all irrelevant.  By and large, a complete waste of time.

I presumed it was a cough caused by a virus.

Yes, for sure.  If it’s “going around”, it would almost have to be a virus.

I felt if it was a serious disease,  (not being able to breathe is serious) he would have given it a name –

She can breathe, Wayne; just not while she’s coughing; hence, the “suffocative” cough.

it is a wet productive cough – some of these diseases are bronchitis, whooping cough, pneumonia, tuberculosis, bronchiectasis, etc.

Sometimes you can give a remedy based on a specific number of repeated paroxysms, but no clue was given here as to repetition.  I am interested in your response.

When I think of coughing attacks that don’t allow a person to breathe, I think of whooping cough.  What’s our main remedy for that?

I would prescribe Drosera for whooping cough or else the nosode Pertussin.

And Drosera was it!

If I had the clue “Whoop” I would have  known.

A whoop is a gasp for air, and you would almost have to gasp for air if you had coughing attacks that wouldn’t allow you to breathe.  I just asked Maria if she gasped for air and she said, “Yes, exactly.”  But if you look up Drosera, you’ll note that it says:

“…does not cease coughing until a large quantity of tenacious mucus is raised.”  (Allen’s Keynotes)

Now, look at what Maria says,

” It is suffocative when it is occurring, I can’t even speak or breathe properly.  It resolves only if I expel sufficient mucus.”

How do you like that?  It’s a match!  Cough only stops when mucus is raised and expectorated.

My son when a child, would have a “whoop” dead on midnight, which would be stopped by Drosera.

I find Drosera generally good for children who accumulate mucous, especially at night.

Lesson learned – for people with coughing attacks who find difficulty breathing…Drosera.

Remember, it’s not that she has trouble breathing, it’s that the cough comes in attacks making breathing impossible.  Is anybody else here? 

 

Hi Elaine

Hi Dr. Nishana!

The remedy is MEDORRHINUM.

INDICATIONS:

Cough better lying on stomach.

Incessant, dry night cough.

Chronic pharyngeal and nasal catarrh.

Dr. Nishana,

Although coughing > lying on abdomen is very peculiar, and Medorrhinum would fit that very well, Medorrhinum doesn’t fit the BIG picture, which, in my opinion, is either Whooping Cough or a Whooping Cough-like illness. 

With Maria describing her cough as “suffocating”, I had to wonder if she didn’t have to gasp for air at the end of the paroxysms.  So I asked her, “Did you have to gasp for air?”  She said, “Yes, exactly.”  Unfortunately, she didn’t volunteer this when filling out her questionnaire—BUT, if a cough is SUFFOCATING, you can easily infer it! 

Now, I hasten to add, I based my remedy selection on another keynote in the case, and it was “Cough starts as soon as head touches the pillow.”  And the remedy for that is, coincidentally, our main Whooping Cough remedy: Drosera!

If I repertorize her case, here is what the “Expert” analysis comes up with:

You’ll see that Drosera is #1 while Medorrhinum shows up only at #7.

This time it was a tricky one I guess…

Sorry I got it wrong…while I was going through the case, the first medicine that popped up in my mind was Drosera.

Oh, OK!

Unfortunately I got diverted to MEDORRHINUM by seeing the symptom lying on belly gives amelioration….

A lot of people saw “peculiars” in the case that made them pick questionable remedies.  For example, someone hung their hat on, “urinates more than one drinks”.  “Cursing” could also make you want to choose a certain remedy.  The angry, irritable disposition might lead someone to pick Nux vomica.

Here’s what we have to be careful of.  Sometimes you can reject a remedy because it’s not in the rubric you’ve defined as “peculiar”; for instance, it’s not listed under, “Coughing: warm, room, entering, from open air”.  But, in the Materia Medica, under Drosera, it says, “Cough worse warmth”.  That fact should have entitled it to be listed under “cough on entering warm room from open air”, especially since it’s also listed under Cough > open air!  If that’s true, then we can conclude that a lot of remedies are left out of rubrics they ought to be in! 

So maybe, just maybe… Drosera should be listed under “urinates more than he drinks” as it’s a 2 under “Bladder: urging, frequent”.  But to me, what Drosera DOES cover in this case obliterates all of its absences from rubrics deemed “peculiar”.  For instance, look at what Drosera has that matches this case.  Kent says:

“The cough is brought on from tickling from accumulation of mucus in the larynx.”

That’s exactly what Maria said!  She says that the cough doesn’t stop until all the mucus is coughed out.  Here’s what Allen’s Keynotes says:

“[Cough] does not cease until a large quantity of tenacious mucus is raised.”

How’s that for a match?!  And then, biggest one of all, after taking Allium cepa, which was a very close remedy (known for coughing on entering a warm room from the outside) she’s left with only one symptom: “no cough all day until the head touches the pillow”.  That’s a Drosera keynote!  It’s actually in Bold for that:

“Coughing: lying down, night, as soon as head touches pillow”.  They say that a “close” remedy amplifies the picture of the remedy that’s actually needed and maybe that’s what Allium cepa did for this case.

Keep up the good work Elaine…it has always been my favourite part in the journal.

Really??????  Well, Shana will take heart for that.  People really DO want to hear about The Rolling Stones’ tour schedule and the Muppets!  Thank you!!!!!

I think the gang from Slovakia is here: 

 

Hello Elaine and Shana,

Hello Miroslav and Jitka!!!

our answers for the cough case are as follows:

Miroslav’s answer is: Coccus cacti

I was thinking about a remedy in this quiz a lot, I also repertorized a bit and I would probably try Coccus cacti.

Cough, air impact, fresh outside, ameliorates

Cough, irritation, cough from, larynx, in , coughing

This remedy has a large amount of clear, stringy mucus in its picture (Phatak).  Also aggravation in a warm room, by warming up and especially at night, which was shown especially in the final, after using All-c., Lach…

Jitka surmises: Kali sulph.

Maria always has difficult homeworks for us, but I will try to guess the remedy you prescribed for her. The first remedies that came to my mind were Antimonum tart. and Rumex. Both of them have a lot of mucus in their pictures, but I exluded them out because Antimonum tart has more mucus in the bronchi than in the larynx.

You are so right!

Rumex  has tickling in throat-pit which causes cough, copious  discharge from nose and trachea but it is aggravated  by inspiring cool air and your patient were worse in closed spaces, warm rooms, without fresh air, she needed have windows open all day and night. It reminded me of Pulsatilla, but the patient said she was irritated, so I remembered the mineral Pulsatilla, which is Kali sulph,  there is also a lot of irritation in  its picture.

That’s a good thought, Jitka.  Yes, the irritability and cursing does not sound like Pulsatilla.  Well, this case got very easy for me after Maria took it upon herself to take Allium cepa, and actually, Allium cepa is very well indicated for coughs that come on as soon as you enter a warm room from outside! 

So, Allium cepa wiped away almost the entire case except for one thing:  No cough at all until she lies down.  Then, as soon as her head touches the pillow… Wham!  The cough is back!  Now, incredibly, that’s a keynote of a remedy!  And, thank God for Repertory Software, because I went to the Coughing chapter and I typed in “Pillow”, and there it was!  Drosera!  In Bold!!!  And doesn’t it sound like she has whooping cough?  Coughing paroxysms (attacks) that take her breath away?  Drosera is our main whooping cough remedy.  It’s Bold/Underlined!  Even the mentals, if you check the MM, say, “Easily angered”.  I guess that’s another way of saying “irritable”.  It’s also under > open air and worse talking.  So, it fits the case really well.  Thanks for voting! 

I think I see Neil from England!

 

Hi Elaine

Hi, Neil!

The answer to the quiz i think is Pulsatilla.

Tickling cough in larynx, worse lying down, better from fresh air, worse indoors, lots of bland phlegm

Did also think of Rumex as this has tickling cough and phlegm but think worse going into cold air.

Also Kali bich also springs to mind when lots of mucus if stringy but Pulsatilla seems best

UK Neil

Pulsatilla also came up #1 for me in the “weighted” analysis; but, the mentals don’t match!!!  And as I always say, if a case has “mentals”, the remedy has to match them!  Pulsatilla is a pathetic remedy that cries and wants sympathy.  Maria was angry and cursing.  No match there. 

So, Neil, there’s a keynote of a remedy in this case: coughing as soon as the head hits the pillow—Drosera.  And if you look back over the symptoms, and say, Does Drosera have this?  Does Drosera have that?  The answer is yes!  Does it have paroxysms of coughing, better open air?  Does it have cough worse talking?  Does it have suffocative cough?  Is it worse for warmth?  Yes, yes and yes!  Oh, and it’s also “easily angered” but sadly, not listed in the Repertory but it’s in the MM.  So, there you have it!

 

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

Dear Elaine,

Miss Sherlock 🙂  A perfect one for you.

Maria seems to be going on a roller coaster ride with her cough.

You solved it in one go…Amazing and surely Interesting.

Vamsi, Maria did me a tremendous favor by taking Allium cepa on her own and wiping out most of the case!  It looked like I was going to have nothing to do until she wrote back and said, “I guess I spoke too soon.”  But the case had changed.  Now she was fine all day, no cough at all; UNTIL… she laid down to go to sleep at night.  AS SOON AS HER HEAD TOUCHED THE PILLOW… the cough started again!  Well, guess what?  That’s a keynote of a remedy!  You know, they say a close remedy helps to clarify the remedy you were were supposed to give!  And I guess it’s true!  I went to the Coughing chapter and — thank goodness for homeopathic software — typed in the word “pillow”, and there it was!

Ok, let me see if I can crack this quiz..

Lots of Cough remedies, but looking at the peculiar symptoms of the case.

1) Worse Closed stuffy room  ( closed stuffy room, a paroxysmal cough starts )

2) Worse Warm rooms ( went to the library where the heater was on )

Vamsi, your #2 was the same as #1.

3) Wants open air

4) Thirstless….

5) Loose cough with lot of Phlegm

I would go for PULSATILLA ..

Please do write your invaluable comments, which is what I always await for.

I know it looks good for that remedy, but, why can’t it be Pulsatilla?  When a case has mentals, the remedy has to match them (unless some compelling etiology is over-ruling them).  Did you see any Pulsatilla mentals in this case?  She was angry and cursing, right?  BUT, if you remember, in the Hierarchy Of Symptoms (see Repertory Round-Up, part 4), the “characteristic symptoms” over-rule the mentals!  Remember my list of “characteristic symptoms”?  One of them was:

“A keynote of a remedy”. 

And it’s not hard to see why!  If Maria’s mentals were “anger” and “irritability”, look at all the remedies in those rubrics, it’s impossible to choose!  But, how many remedies are in the rubric “Coughing: lying down, night, as soon as head touches pillow”?  3!  And only 1 in Bold–Drosera!  (Source: Murphy’s, 3rd ed.)  So, can you see why “Characteristic Symptoms” over-rule the mentals?  Maybe this is the important lesson we can learn from this case.

But, I hasten to add:  What over-rules the characteristic symptoms?  Diagnosis!  I had to add that because I’m recalling a quiz where people found characteristic symptoms that matched remedies that weren’t listed for the diagnosis!  But, for our case, is Drosera a cough remedy?  Yes!  So, no problem there!

Cheers

Vamsi

 

Hello Elaine,

I think the remedy is Drosera.

Noreen Sumey

Noreen, don’t look now, but, you’re our winner!  You get the Gold Star!

That’s it, everybody, I’m supposed to be cooking dinner now!

See you again next time….

_____________________________

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, 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

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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