On the Case: Installment 3

(A note of clarification before we begin: these tutorials are for anyone looking to use homeopathy at home. They are not geared towards practitioners. Jump in any time - you get access to the complete archive!)

The best way to learn your way around this stuff is to practice. Homeopathic remedies are gentle and, given in the way described in these posts, you are not going to hurt anyone if you get it wrong. Below I have prepared an interview with a client.

.

How can I help you today?

Client: My seven year old had a cold last week and it seems stuck; she’s not getting any better. she’s coughing and congested and not sleeping well.

Okay, we can work with that. (In the interest of editorial clarity, I am going to list the types of questions I usually ask. In a consultation, I typically take it one thing at a time.)

What is her cough like? Is it wet/loose or dry? What brings it on? It is worse any particular time of day or body position? Is she in pain? Is she coughing anything up? What color is it?

What is her congestion like? Is her nose running or just stuffed up? If running, any color? Is it both sides or just one? Does it change at night or lying down?

How’s her energy, mood, color? How is she treating other members of the family? What is she asking for? Does she feel hot or cold to the touch? Is she complaining of hot or cold? Does she want blankets, fresh air, a fan on, etc? Give me a complete picture of what is going on with her.

Anything happening digestively; nausea, vomiting, diarrhea, etc? Is she thirsty? Does she want drinks any particular temperature? Is she craving any foods?

Anything else you can tell me that might help me make a decision?

Client:

The cough is loose; it sounds like something is stuck in her throat, but she doesn’t bring anything up. It’s worse at night, especially when she lies down. She cries for one of us to come sit with her.

Her nose is running, mostly it’s yellow or green, and she says it’s really stuffy on both sides – when she stands up it all drains and she says it’s yucky and makes her cough more.

She said her head hurt around the temples yesterday, but today she hasn’t complained about that as much. She wanted me to open all the windows and she threw the blankets on the floor. She even wanted to go outside despite saying she felt cold; she said the house made her feel fidgety. I’ve been trying to get her to drink water. She says her tummy feels fine.

(Note: as often as possible, try to speak with the child or make sure the child is in the room to answer; if you can actually see her, on video or in person, you will get a better sense of the mood and energy and color. I will sometimes ask for a picture if we’ve been on the phone. Ask as many open-ended questions as you need to in order to get complete information – there is no such thing in the early stages of study as too much information!)

Analysis Time!

The first thing we need to do is read over the notes and pull out what are called “characteristic” symptoms. This is more of what I was talking about in the previous post regarding matching the remedy to the client versus matching a pharmaceutical drug to a named disease. And this is also why I hesitate when asked, “Can homeopathy treat [shingles, colds, diabetes, cancer, fill in the blank]? ” Every single disease that has a name has a set of symptoms that are typical to most cases, and then also has a unique presentation in each patient. Doctors tend to look at the common symptoms, and ignore the unusual ones, because those don’t fit neatly in the system. Homeopaths are MUCH more interested in the unique stuff. Where we care about common symptoms is when someone doesn’t have them. For instance, a cold where the child isn’t bothered by the symptoms, plays happily and color is good, nothing too disruptive, but the cold doesn’t resolve – that’s unusual (and can be indicative of Ferrum phosphoricum, but we haven’t talked about that yet:)

Let’s pull out the symptoms:

·      loose cough, worse at night, worse lying down, no expectoration, sounds stuck in her throat

·      Weeping and wants company at night

·      yellow or green nasal discharge

·      stuffy until she stands up

·      wants the windows open, to play outside; throws off blankets

·      restless inside

·      Thirst? Here’s where your discernment is important! Most people who are considering homeopathy know that you want to stay hydrated when you are sick. So, when you ask them, they will tell you they are trying to drink lots of water. That’s terrific, BUT, it is not the same as thirst. In this situation, the mom says she is trying to give the child water, rather than that the child is requesting it. We don’t know that she is thirstless, but we can’t say she is thirsty.

For this one, I will do the differential and explain it. For the next round, I’ll wait before posting the prescription so you can have a whack at it on your own.

We’re limited to three remedies, so I’ve made this easy. If you have a kit, and you can’t get the best remedy, give something that’s close. Remedies are harmonic resonances of substances; one that is similar may overlap sufficiently to move the case along, even if it doesn’t bring it to a close.

Let’s look at what we have for indications for our three remedies; below, we’ll pull out the ones that match.

Pulsatilla

·      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.

Arsenicum

·      Anxiety and extreme fear, especially at night, with a need for company; this person does not want to be left alone, but is restless and antsy.

·      The anxiety can show up as irritability and criticism.

·      Burning pains and heat, with internal chill, or icy cold skin with feelings of great internal heat. The pains can be like hot wires.

·      Desire to be wrapped warmly; everything is worse with cold.

·      Thin discharges, generally clear, which can be excoriating (burning) and can smell bad, even corpse-like.

·      Night aggravates - all symptoms seem worse at night.

·      Can be great prostration and weakness, and nausea.

·      Extremely thirsty but wants small sips; asks for icy drinks but then feels nauseated.

·      Can be short of breath.

·      Can be extremely tidy, even OCD, or totally disorganized and made anxious by the chaos. Afraid of financial loss and theft.

Kali bi

·      Kali bichy is always sticky. "Gluey" might even be a better term. The discharges and sensations when Kali-bi is indicated are thick and stagnant.

·      The person needing this remedy can also have a gluey, stick-in-the-mud energy, with rigidity and conformity.

·      Long-winded lists of complaints with a need to dominate someone's attention; irritability and self-pitying energy if this attention is not paid.

·      Chilly and cold or cold damp makes it worse.

·      Symptoms can be localized to a spot, especially on the head or at the top of the nose.

·      Pains can alternate and move around, including in the joints.

·      There can be a sensation of hair on the tongue.

Now, let’s take our symptoms.

·      Loose cough without expectoration, sounds stuck in her throat.

o   Puls – we know that Puls can have thick heavy mucus, and she says that, when she stands up, her sinuses drain and it makes her cough

o   Ars – we don’t have any indications in our list that match

o   Kali-bi – also sticky and thick; we could see this symptom in Kali-bi

·      Worse (in homeopathy, that is written <) at night, <lying down

o   The closest remedy from our list for symptoms <night is Ars. That doesn’t mean that the other remedies can’t be aggravated at night, it just means that those aren’t strong keynotes.

·      Weepy and wants company at night

o   Pulsatilla is weepy and needy

o   Arsenicum is fearful of being alone at night

·      Yellow or green nasal discharge

o   Pulsatilla has thick yellow or green discharge

o   Kali-bi is characterized by thick green discharges

·      Wants the windows open, to play outside in the cold, is restless indoors

o   Pulsatilla wants fresh, moving air

o   Arsenicum is restless and anxious

·      Not thirsty

o   Pulsatilla is not thirsty

o   Arsenicum IS thirsty, but can’t drink much at one time

Now we try to decide, which of these remedies is the most closely indicated? You can see that, even with these abbreviated materia medica profiles, there is a lot of overlap and a case can look like several different possibilities. Therefore, we need to take a step back and look at the overall picture. Which remedy shows up in the most categories?

Definitely Pulsatilla. When we look at the whole picture, and refer back to our remedy descriptions, we see that Pulsatilla has the discharges, the weepiness, and the desire for cool, moving air, while Kali-bi is likely to show a greater degree of irritability, and the energy of the Arsenicum client will have more fear.

Let’s give our client Pulsatilla, and have her mom check in with us by the end of the day, before bedtime.

As noted in my prior posts, I start all acutes, and even some chronic cases, with a water dose.

·      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. (Can also use sips – getting the remedy into the person is more important than getting the dosing perfect)

o   Wait 15 min, give another tsp.

o   Wait 15 min, give another tsp.

o   WAIT.

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!)

I always ask to be updated by bedtime – I give my clients my business cell phone so they can text me. If it’s not business hours, I might not respond, but when I am following an acute, I want to know what’s happening, and I will respond if I have instructed the person to contact me. My chronic clients receive acute care as part of their work with me, even when they aren’t active at the moment, as long as we’re within a year of our work and there haven’t been any dramatic changes.

.

My brain is full – how about yours? I’ll drop the footnotes below, and look forward to sending the follow up within a week (since I have to work on my real, live cases, too!)

FOOTNOTES

*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!

On The Case Installment 4