How to pick rubrics in a homeopathic case

Maria, once again, has asked me to walk her (and my readers in general) through a homeopathic case and explain what I’m thinking as I go.  I’ll give it a try.  Here we have the case of a long-time friend of the hpathy ezine, Gabi from Canada, who recently sent me the following email (and also gave me permission to use her case in “Tidbits”).  Gabi’s answers to the Questionnaire are in red, my comments are in blue):


Hi Elaine,

Here is my questionnaire. I had to ask for help after the third time this has happened!

Let me know your fees at the moment.  Sending you a hug along with the questionnaire and I hope you can help me…

Gabi xx

Acute Case Questionnaire

  1. Describe the complaint or complaints in your own words.

This is the second or third time it happened. I have severe vertigo (the room moves all over)

So the first thing I’m thinking here is that I have to read the entire Vertigo Chapter!  Do you know why?  Because I know that “room moves all over” is NOT in the Repertory!  I need to ask Gabi what she means by it, but I need it in the form of a rubric or it’s not going to help me!  So my goal is to find all the rubrics in Vertigo that can possibly mean “room moves all over” and then tell her to pick one, which I did, and guess what it turned out to be?  It was under “Objects”!  Yes, OBJECTS!  (See why I had to read the whole chapter?)  “Vertigo: Objects, general, seem to turn in a circle, room whirls”.  That’s the rubric!  I mean, the room is spinning and we’re supposed to know to look under “objects”!  I’m shaking my head.

…and nausea so bad that I am about to throw up.

OK, so, we’ve now got our second rubric:  “Vertigo, nausea, with”.

This time it happened after I was lying down on the floor trying to stretch my left shoulder that has been giving me pain.

I took this to mean that lying down aggravates.  Later in the questionnaire she says she must sit up, so, that would tend to confirm it.  So I took the rubric, “Vertigo: lying, while, agg.”

I’ve been sick with this and that, especially EAR ACHE, the loud ringing persists and the pain is on the left side, inside sometimes it gets worse than outside.

“Generals: air, open air, outside, amel.”  I decided to find out if the ear symptoms are true concomitants or if they’re chronic complaints.  If they’re chronic complaints, we have to dismiss them as not being part of the case.  Well, as it turns out, they are chronic; so, we will ignore them for now.  Kent says don’t mix up chronic symptoms with the ones in your acute case.

I have tried a number of remedies. ACONITE right after it happened and lately BRYONIA but with limited success. I want to get rid of this it’s debilitating…

Do we have to make an issue out of the last sentence?  No.  Anyone with this problem would want to get rid of it and anyone would find it debilitating.

  1. Etiology–

I don’t know how it started the first time, I simply woke up and the room was moving all around me it was awful, I stumbled to the bathroom as I can’t walk straight when it happens.  It also makes me incredibly sad to be like this.  Right now it might have to do with what happened when ______ was here (she just left) there was a lot fighting with my kids, old issues came up, awful stuff.

Am I going to take “ailments from emotions”?  I could but, Gabi’s not really sure about this, so, I’m moving on.

  1. Sensation–

Like I’m falling.

“Vertigo: falling sensation”.

  1. Appearance–

Deep black rings around my eyes (I have tried PHOSPHORUS too but it doesn’t work)

5. Location–

The head and the ear but also the left kidney it is painful, better by warmth I have a hot water bottle, the shoulder, it’s all on the left side.  Stomach–bloating after eating.

I took “Stomach: distention, eating, after”.  I asked again and the ear, kidney pain and shoulder all pre-date the vertigo; so, they’re not part of our case.

6. Modalities– This is a fancy word that means, “What makes your complaint better or worse”?

I have to sit up or it all moves around me, knees are up, warmth, lemon water, not eating, silence, sleep, worse closing my eyes, worse motion, turning my head, better fresh air

I already have “worse lying” so I passed on taking “better sitting”.  I took “Vertigo: eyes, closing, on, agg.”, “Vertigo: turning, on, moving the head”, “Vertigo: motion agg.”

7. Concomitants (symptoms that came with the complaint, “along for the ride”, so to speak)

I have a stiff neck.  I have a headache, like pressure in my forehead.  There is a headache together with this at the top of the head, last night it was at the back; the kidney pain, the shoulder (collar bone).

I took “Headaches: pressing pain, forehead”.  So, because there is no “Headache: vertex” rubric, there’s nothing I can do with that symptom.  Vertex, of course, means the top of the head.  I know you’re finding it hard to believe that there’s no “Headache: vertex” rubric, but, in the Repertory, the first word listed is the “Sensation”–not the Location!!!!  So, the headache chapter will have, for example, “Pressing pain, vertex”, not “Vertex, pressing pain”.  See what I mean?  So, to be able to use this symptom, I would have to say to Gabi, “What does the headache pain on the vertex feel like?”  This is why you should tell your patients, “If you’re going to give me symptoms without sensations and modalities, then don’t even bother, because I won’t be able to find your remedy!”

  1. Discharges–color, odor, consistency and sensation.

No discharges

  1. Generals–these are all the symptoms that begin with the word “I”.

I do get rushes of heat out of the blue (I tried Mercury), I’m never hungry, I’m embarrassed, nauseous, I’m weak

I took “Generals: heat, flushes of”.  There’s no subrubric for “sudden”.  We’ve already taken a rubric for nausea; as for embarrassment, anyone would be embarrassed if they couldn’t walk normally, and “weakness” would be common given that she is not eating due to having no appetite.

  1. The mentals:

Confusion would be the most pressing; dullness, sometimes feel like crying but mostly indifference

We could take “confusion”; but, with over 300 remedies under it, it appears that just about every remedy is confused!  We could also take “indifference”; but again, at almost 250 remedies, such a large rubric won’t be of much help to us.

  1. What have you been saying?

I want to be alone and quiet

Once again, we are met with the inscrutability of the Repertory!  There’s “Mind: noise, aversion to”, and that would seem to be our rubric, right?  But, I was struck by how few remedies were in it!  Just 14, and no spider remedies!  And the most famous one of all–Theridion–is not there!  I said to myself, this can’t be right; there’s gotta be a better rubric for this, but where?  So I looked and looked, and you know where it is?  It’s under “Sensitive”!  Mind: sensitive, mental, oversensitive, emotional, noise, to”.  Good heavens!  Should “oversensitive” really have come before “noise”?  And why is “mental” in there?  We already know we’re in the Mind chapter!  You know, you really have to wonder about who wrote this stuff and what they were thinking.  The rubric should be “Mind: noise, sensitive to, oversensitive”.  Am I right?  I almost took that rubric but in the end, I felt that under the circumstances, wanting quiet wasn’t so unusual.  I didn’t bother with the “wanting to be alone” symptom either because I know that no one’s there but Gabi’s 2 kids and they’re not very helpful, so, in fact, we don’t really know if Gabi would have appreciated helpful company; so, I’m just going to ignore that for now.

12. What are you doing?

I have been sick for quite a while now so I feel bad I am not doing anything except the daily things…

Nothing significant here.

13. Describe your thirst and appetite–

I am quite thirsty, want ice on the drinks, sips, I ate an orange yesterday and it made me very sick it was right after the onset of the nausea/vertigo etc.

So this is a very important question for us–thirst–and to a lesser extent, appetite.  If a person is thirsty, we can eliminate all of our thirstless remedies, like Pulsatilla (which is a big vertigo remedy, by the way).  When a person says they want ice, that’s a gift!  It really narrows down the selection!  Never be satisfied with your case until you’ve heard about your patient’s thirst.  But be careful to establish that this is a true concomitant and not just the way they normally are.  Needless to say, I took “desires cold drinks” and “desires ice”.  What about “ailments from citrus”?  No.  She was sick, THEN ate an orange.  For all we know, ANYTHING she might have eaten would have made her worse.  We have no way of knowing, so, we’ll pass on that.

  1. Fever?

I have been taking hot baths in the evenings. There was a fever the first time it happened now it would be low grade

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 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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  • Great article Elaine! Thank you so much. The rubric selection procedure was very very helpful.
    Like the movie “Inside Elaine’s head” 🙂

    PS: I would try the remedy from lake water too for the ear.

  • Elaine, Very good presentation, Your style of case analysis and selection of rubrics is really amazing & an easy learning tool. Please keep it up.

  • Elaine thank you so very very much for your informative information on hypertension. Your article is the very best online and I have read almost every article and forum I could find with information on high blood pressure. After refusing to take blood pressure drugs my doctor labeled me defiant. Instead I chose to change my lifestyle which includes losing weight and to date in four months I have lost 40 pounds. I juice every day and fill my body with an abundance of fruits and vegetables. I also walk 10,000 steps every day. I supplement with coq10, hawthorne berry, vitamin d, nattokinase, Proteolytic Enzynes and several other supplements. Although my numbers aren’t down as much as I would like I so great and the turnaround to waking up and feeling good is proof positive that I am on the right path. Thank you so much Elaine wish you wer on the West Coast so I could have you speak to a club that I co chair.

  • Very nice case ! Presentation is also fantastic .Very helpful for me as I am a practitioner.Many thanks Elaine.