Elaine, hi, it’s Kelly here! My daughter had swine flu! I wish I could write it up for you but I wasn’t able to help her much. I tried maybe 8 different remedies during the course of the illness but nothing really helped.
You should have emailed me!
You’re probably right, I should have. My sister had the same symptoms when she stayed with me the month before. Poor thing was sooo sick- she’s still talking about it! I tried many remedies to no avail.
After she left, I bought 2 more remedies; but, none of them helped my daughter.
I wondered what others have found helpful for this flu because:
and a bunch of others did nothing!
The symptoms were as follows: sore throat, high (104 F.) fever, severe body aches, severe chilliness and pounding headache.
How sad. Kelly, as you know, none of the symptoms you just mentioned mean anything to a homeopath!
What? What do you mean they don’t mean anything? I just told you what was wrong!
The Repertory rubrics (headings) for these symptoms (fever, sore throat, etc.) are so large, so HUGE, so general, that virtually every homeopathic remedy has them!!!
What’s peculiar about your fever? What’s strange or characteristic about your sore throat? That’s what we have to know! So, towards that end….
The Big 4!
The Big 4?
Yes, the Big 4. Repeat after me:
Sensation, Location, Modalities, Concomitants
Sensation, Location, Modalities, Concomitants!
It sounds like one of my most favorite songs from the ’50’s: “Every Day Of The Week” by the Students!
Substitute “Sensation, Location, Modalities, Concomitants” for “Sunday to Monday, Tuesday to Wednesday, Thursday to Friday, Saturday to Sunday….” go ahead, try it!
Elaine, you’re just finding excuses to play your favorite songs! Again!!!!!!!
But it’s a classic!
What does “sensation” mean?
“Sensation” is self-explanatory. What does the pain, etc. feel like? It can be sharp, dull, achy, burning, raw, scratchy–there’s no limit to what the sensation might be, you just have to think about it! Don’t tell the homeopath you have a “pain” or something “hurts”, that’s not going to lead anywhere!
“Location” matters because some of our remedies are “right-sided” and others are “left-sided”.
What about “modalities”?
They are REALLY important to us! If we don’t get the “modalities”, God help us! Modalities are all the things that have an influence on the complaint, for better or for worse! For example, if you have the flu, believe it or not, there will be factors that make you feel either better or worse: some people with the flu are better for sips of water or tea, but worse for cold air, or showering; or better from hand-holding and sympathy, or worse for all company and conversation and better for lying perfectly still in the dark or better lying on the side that hurts.
These little details (“better this” and “worse that”) are called the modalities! TRY AND THINK OF EVERYTHING that makes your complaint better or worse! And if your child, or whoever, can’t express himself? Simply observe what he’s doing, what he’s avoiding, what he’s asking for, what he’s saying “no” to, how he’s lying, moving…all these things will give you clues for the modalities.
And what about “concomitants”, what are they?
Concomitant means “associated with” or “along with”. In other words, what symptoms came “along with” your complaint? They are highly valued because they are often the striking, strange, rare and peculiar symptoms we need to find the right remedy. Take for example…. OK, here’s one that will be familiar to everyone– a headache with nausea. Many people have this, right? Nausea is the concomitant. Or…I just recently met someone who had a cough with a rash on the right side of her face! Tell me that isn’t peculiar! But what if she had just told me, “I have a cough”? Would I have had a complete picture of her illness? I don’t think so!
Sometimes body language tells us what we need to know. Bryonia patients are lying perfectly still. Any movement makes them worse, even answering questions makes them worse! Colocynthis and Mag-phos. patients are bent over double. Shana recently got Mag-phos. for menstrual cramps just because I found her bent over double! Gelsemium patients tend to answer every question with the word, “Huh…?” because they’re stuporous; or, they start to answer and don’t finish their sentence. Nux vomica patients are rudely barking orders at people (“I’m still waiting for that glass of water I asked for two seconds ago!”). Arsenicum patients are begging you not to leave because they’re so afraid to be alone! (“Can’t you just stay for one more minute?”)
Do you need to know anything else besides the Big 4?
Which, again, are?
Sensation-Location, Modalities-Concomitants/Sensation-location, modalities-concomitants!
That was very good Kelly! Good singing, too! Yes, yes it would help to know three more things:
1. Is there a time issue? Is the patient worse in the evening? Worse at 9 p.m.? Worse at midnight, etc.? Think of this as the Time Modality. I once literally had a cough that came on at 11:30 every night without fail!
2. Did the complaint come on suddenly or gradually? Complaints that come on suddenly are often covered by just two remedies: Aconite and Belladonna! (Or Baptisia if the complaint is more septic.)
Really? And what does septic mean?
Sepsis is characterized by bad odors, stupor, muscle aches and confusion. If a septic condition comes on suddenly, think of Baptisia. Baptisia is thought of as a thirsty Gelsemium with stupor, apathy and an inclination to sleep. Now for # 3. I’m leaving the best for last.
Etiology means the cause. Am I right?
Yes, it means “what caused your complaint?” It’s so important to know this! The remedy must cover it! Unless the etiology is something really vague, like, “germs”, it alone could be so valuable as to solve the case for you! How often has this happened? You’ve taken the case and it looks really good for a certain remedy, like Belladonna: the patient is red, full of heat, burning; you’re just about to give Belladonna when you ask, “What caused this, what happened?” And the patient says, “I have a Peanut allergy, I ate peanuts!” What???? Allergy???? That’s not Belladonna! That’s Apis! See, when you know the cause, it changes everything!
So, people, take note:
Etiology Over-rules Symptomatology!
Or stated simply, etiology over-rules the totality of symptoms. Consider the following (remember that etiology is expressed through our “Ailments From” rubrics in the Repertory):
Ailments from cold/dry winds–Aconite
Ailments from acute grief–Ignatia
Ailments from eating fatty, rich food–Pulsatilla
Ailments from over-excitement–Coffea
Ailments from cold/damp weather–Rhus tox.
Ailments from blunt trauma–Arnica
We scarcely need to know anything else, such is the importance of etiology.
So, getting back to your daughter’s flu, when you say “sore throat”, we would have to ask:
What was the sensation of the sore throat?
What made it better or worse (the modalities)?
Where in the throat is it, right side? left side? (location)
What’s associated with it, what came along with it? (the concomitants)
We need to do this for every symptom in the case. A properly delivered symptom should sound like this:
I have constipation. There’s frequent ineffectual urging (sensation). It’s chronic and causes much abdominal pain (concomitant) which causes me to bend over double (modalities–better bending double), the abdominal pain is better for rubbing (modalities); it’s a sharp pain that shoots downward (sensation); a hot water bottle helps (modalities–better hot applications); plus, I also have burping (concomitant) with this and my stomach makes gurgling noises (concomitant).
That is a “complete symptom”!
“I have constipation” is a one-dimensional, meaningless, worthless statement to a homeopath. Is this how you plan to report your symptoms? Then forget about ever getting well!
You have no hope of finding the remedy unless you learn to speak in “complete symptoms”!
Right, I got that: sensation, location, modalities, concomitants. And etiology. What else does the homeopath have to know?
The “Generals”! Kelly, think about it. If you’re sick “in general”, you’re a lot worse off than if you just have a local complaint, like a sprained ankle. You can still get on with your life even if you have a sprained ankle; but, let something effect you “in general” and your life comes to a screeching halt! So, that means if you had a choice between the remedy that matched the “generals” or the remedy matching the “particulars”, the “generals” would win every time! “General” symptoms start with the word “I”; “local/particular” symptoms start with the word “my”. Examples of “General symptoms”:
“I’m scared, I need someone sitting next to me!”
“I need to have a fan blowing on me!”
“I need a cup of ice.”
“I’m cold but I don’t want a blanket!”
We want to make sure the remedy we pick matches the Generals!
Now, let’s say you’ve done all this fancy questioning, you’ve taken a proper case, and no remedy covers the picture really well or all you’ve got are common symptoms like “runny nose” and “cough”. Then look for the “concomitant” in the case because that might be your salvation! For instance, maybe you can’t figure out the patient’s fever remedy but you notice he’s very irritable, impatient and rude–that’s the concomitant! It’s probably Nux vomica! If there are no concomitants, no modalities, no definable sensations, or etiology, a “nosode” should be tried. Nosode means a “disease” remedy. A remedy made from disease. For example, one of our flu remedies is called “Influenzinum”, it’s a remedy made from the flu virus. You can also make a remedy out of one of your own discharges. I’ve written an article called “How To Make Your Own Remedy” which you can search for; plus, it’s on my website, you can find it there: ElaineLewis.hpathy.com
Anything else you need to know in taking an acute case?
Since you mention it, you should know what you have! I mean, is it the flu or is it food poisoning or what? Knowing what you have gives you some direction. Which chapter of the Repertory are you supposed to look in if you don’t know what you have?
Should we recap before succumbing to information-overload?
Good idea! You’ve got a sick patient. The first thing you want to know is….
WHAT’S WRONG with this person!? What happened? And when did it happen?
DID IT COME ON SUDDENLY or GRADUALLY? And then….
DO YOU KNOW WHAT CAUSED IT (if not already stated)?
(Don’t forget to observe the patient; what’s he doing, what’s he saying, what does he look like?)
Sensation. We’ve already described that. What does the pain, etc., feel like?
Location–Where is it?
WHAT MAKES YOU BETTER OR WORSE (the modalities–including the time of day when the person is better or worse). This is a question most patients don’t get the point of and they will generally say, “Nothing. Nothing makes me better or worse.” Or they will say, “Aspirin.” So you have to give them examples. Consider: the weather, the temperature, drafts, hot or cold applications, food, drink, odor of certain things, presence of people, motion, position of body, light, noise, sympathy, touch, pressure, etc.
THE LOCAL SYMPTOMS (they start with the word “my”) The local symptoms must include THE BIG 4:
sensation, location, modalities, concomitants
You need to know this for each local symptom! Don’t tell your homeopath, “My leg hurts! My scalp itches!” Say, “My leg hurts in the calf area, I got it from over-stretching, it’s better from rubbing, hot applications and walking around, it’s worse the longer I sit. My scalp itches along the hairline. Scratching makes it worse–burns! A very hot shower makes it better. I don’t know what caused it.”
Remember that Concomitants are any symptoms that came along for the ride. They may be “normal” but out of place, or in excess, or less than what you’d expect like lack of thirst during a fever.
IF THE CASE HAS A NOTICEABLE MENTAL/EMOTIONAL CONCOMITANT, THE REMEDY MUST MATCH THAT above all else! I would imagine that only a compelling etiology could trump the mental/emotional concomitant.
By the way, your homeopath is going to ask you to describe your symptoms anew each time you get the same complaint because she — or he — knows that just because you’ve had a headache before, doesn’t mean that this headache is the same as the last one! Don’t say, “I’ve got a headache again!” Talk in complete symptoms!!!! Say, “I have a headache on the right side (location) that came on suddenly (onset) after being out in the sun (etiology) and it feels like a throbbing in my head (sensation) and it’s worse lying flat, better sitting up, worse in bright light (modalities), I’m also nauseous (concomitant) and I’m thirstless (concomitant).” What remedy is this? Belladonna, of course! Can you come up with Belladonna just by hearing that someone has a headache? No! As you can see, Belladonna has a certain KIND of headache.
Is there a hierarchy of symptoms?
Funny you should ask! It just so happens there is! We’ve already said that etiology overrules symptomatology, and that Generals are more important than Particulars and that the mental/emotional concomitant is more important than the physical generals in terms of selecting a remedy; so, here it goes, The Hierarchy of Symptoms:
Etiology (the cause)
Diagnosis/name of the condition–aka, “The Chief Complaint” (ask patient to describe it in his own words)
Onset–When did it start? Was it sudden or gradual?
Appearance–what does the patient look like? What does he “say” and “do”? (He may say things like, “I’m doomed!” or “Bring me some ice!” all clues to the remedy; he may be tossing and turning or lying perfectly still; all important information.)
Generals (“I’m hot”, “I’m cold”, “I’m anxiety-ridden”, “I’m sleepless”, etc.)
Locals (the big 4, which are, again?)
Sensation, Location, Modalities, Concomitants; Sensation, Location, Modalities, Concomitants!
Very good! Let’s move on to discharges. If there are discharges, you’ll need to know their color, odor and consistency. (Yellow and stringy, etc.) You’ll also want to know if they create a sensation–like burning, irritation or itching, etc.
Plus, for heaven’s sake, don’t mix up acute and chronic symptoms! Don’t tell the homeopath you’re thirsty if you’re ALWAYS thirsty! Don’t tell him you’re irritable if you’re ALWAYS irritable. What we want to know is how this complaint has changed you, what’s different about you now that you’re sick?
OK! Enough! I’m starting to get irritable and thirsty!
Me too! This would be a good time to stop (mainly because I’ve got a sink full of dirty dishes!) Did you know, Kelly, that Acute Prescribing and Emergency Prescribing are the highest form of homoepathy?
No, I had no idea.
By knowing how to solve acute cases, you can stop a complaint from going chronic! You can save a person’s life! You can stop a person’s suffering! Even people with chronic disease develop acutes of one kind or another and we have to be able to step in and stop the suffering!
Good point! I’m leaving.
Will I see you in the Quiz section, Kelly?
Mom, it’s me, Shana! Kelly just left. She was singing “Every Day Of The Week” by the Students.
Then my work here is done!
Elaine Lewis, DHom, CHom
Elaine takes online cases. Write to her at [email protected]