On The Case
Today I am going to start a short series where we look at three remedies (what is called “materia medica,” the profile of an individual remedy) and then I will present an imaginary case. We’ll walk through what is called a “differential diagnosis,” wherein we analyze the case, identify possible remedies (which will be the next three we discuss so you will be familiar with them), and then compare and contrast them and select the best one. Then I will present the imaginary follow ups and discuss case management in an acute – this involves understanding the remedy reaction and identifying next steps. We will also talk about when, and how, to change the remedy.
The three remedies we are going to study are Pulsatilla, Kali bichromicum, and Arsenicum. These are basic remedies called “polychrests;” in homeopathy, that means that they have been widely used and extensively “proved,” which is what we call the process of studying the medicinal effects in blind trials.
(A little aside about provings. These are at the heart of the homeopathic materia medica; when homeopathy was discovered by Samuel Hahnemann, he determined the therapeutic effects of medicines by giving them to healthy people who didn’t know what the substance was, and having them record their symptoms. Then, when used in practice, he was also able to observe what symptoms they cured in sick people. Putting those two data sets together, he got the profile of a remedy. It’s not as simple as it sounds because human beings are complex and there’s no such thing as a truly identical cohort, but it has shown itself to be an effective way to understand and apply medicinal substances.)
These three remedies are available at most stores that carry homeopathic substances, and in most household kits, so they are important ones to have some facility with. When you are dealing with common acute illnesses, it is likely that you will sometimes need to differentiate between these three.
We begin with Pulsatilla.
Pulsatilla is yielding and changeable. The wind flower, it clings to its anchor and is blown around in the breeze. The way this shows up in a case is:
· weepy attachment to a parent or companion
· symptoms may move from side to side or part to part
· lack of thirst
· chilly BUT wants open air, to be outside, to have a fan on, to have the covers off – uncomfortable if the space is stuffy and closed, especially at night
· green or yellow mucus and discharges which tend to be thick and heavy
· symptoms may come on after some sort of emotional or physical suppression
What kind of symptoms can indicate that Pulsatilla is worth consideration?
· For general colds and flus, this is a top choice. Many people with Covid-like symptoms, including severe ones, have experienced benefit from Pulsatilla.
· Nasal discharge is thick and green or yellow, the nose feels congested and is worse lying down at night; there can be loss of smell.
· Ear aches – this is considered THE top ear ache remedy (although it is not the only one), when ears feels stopped up and are worse at night.
· Menses can be late and light – think of this remedy in adolescent girls who have delayed periods.
When I work up a case, I use repertory software that allows me to select symptoms called “rubrics” and cross reference them with other symptoms. In the software I use most often, Pulsatilla comes up with over 23,000 symptoms. In studying remedies, especially large polychrests, it is important to recognize that there is a huge range of symptoms that might be covered by the remedy, but the remedy might not be the right one for the case. We will get into this more when we work up our mock case. The subtlety of homeopathic prescribing involves understanding both keynote symptoms and the overall gist of the remedy so that you can match the remedy to the client. There’s never one single remedy for any type of issue. It’s always a whole picture.
In Pulsatilla, the important keynotes are the green discharges, the desire for moving air, the clingy-ness and the changeability. You don’t have to see all of these, but you should expect to see some, and if you see any, you definitely want to consider this remedy.
That’s a good place to stop for today; there’s a lot to absorb in learning materia medica. If you follow this link you can read James Tyler Kent’s materia medica on Pulsatilla, and it will help you understand why some translation is needed when learning to apply these tools to everyday circumstances! It’s because you have to understand what he means with sentences like these: “In many nervous women the attack comes on with sneezing and watery discharge and then a copious, thick, yellowish-green discharge.” (Hint: it doesn’t have to be nervous women!)
As always, I’ll leave this at the bottom of the post because it is an excellent reminder, and I’ll be following up soon with the other two remedies and then our mock case, and we’ll talk about potency and dosing. Feel free to ask questions in the comments.
The last piece of housekeeping is how to dose remedies in an acute. Less is more with homeopathy. Here’s how I always start:
· I do a water dose in the following way:
o One pellet of the 30c potency dissolved in four ounces of pure water. I will use bottled or well water, but not chemically-treated water. Don’t touch the pellet with your fingers.
o Once dissolved, swirl or stir gently with a non-metallic spoon.
o Give one tsp.
o Wait 15 min, give another tsp.
o Wait 15 min, give another tsp.
o If symptoms do not improve, repeat the three doses after an hour.
o If symptoms DO improve, wait until they relapse or stop improving to redose.
o Always wait a couple hours between rounds and don’t do more than 3-4 rounds
in 24 hours unless the situation is emergent, in which case it is wise to get a professional on the phone to offer some support (that’s me!)
*Homeopathic remedies are made by extracting, through tincture or grinding, the crude properties of the substance and then putting that extract through a series of dilutions and hard impacts which isolate the healing properties while eliminating any toxicity.
**All homeopathic remedies have both acute and chronic applications. An acute ailment is something self-limiting (that means short term that’s going to run a course to recovery or death). A chronic condition can drag on for years.
In both acute and chronic illness, the remedy is there to reflect and assist in the process of the healing through the unwinding dynamic. It’s never intended as a quick fix or a suppressive measure. In truly acute situations, when the vital force is strong, the response can be so rapid to a well-chosen remedy that it can feel magical. Often, though, it can take multiple doses, mild temporary intensification, patience, and even additional remedies to get all the way to the other side. So when you are learning to manage acutes at home, remember:
Slow is always good, patience is always part of healing. Don’t panic if you aren’t getting immediate results.
Home prescribing should be used for acutes, not chronics. Homeopathic remedies are safe, but the vital response is complex and chronic prescribing relies on extensive study of case-taking and analysis, remedy selection, posology (what potency and in what dose), materia medica (the medicinal properties of the remedy), and remedy reactions. It is possible to mess it up in a way that can make it difficult for the person to heal fully. Don’t be afraid, but do ask for help!