final will be harder than midterm
extra credit: 6 points for one mini-case, send by email
he hopes we read the handouts
CASES
7yo girl cough thin tired run down 101 fever intermittent
thirsty for cold (phos, nat mur, sulph, merc)
fear of alone (phos, ars, lyc, puls, kali carb)
worse sunset (puls, phos)
looks nice, expresses well (phos)
painful cough (phos, caust)
craves sweets (lyc, sulph, phos usu, kali carb, calc carb, puls)
craves salt (nat mur, calc carb, phos, sulph)
craves ice cream (phos, puls, calc carb)
26 yo med student recurring fevers in childhood
AF grief (ign, nat mur, aur, caust, carc)
sympathetic (caust, phos, carc)
emotional keeps lots inside
consolation agg (sepia, nat mur, ign, carc, thuja)
loves outside in sun (carc)
sensitive to injustice (caust, ign, carc)
probs falling asleep
constip
craves choc (sepia, carc)
craves egg (calc carb, puls, carc)
craves fat (sulph, ars, tub, nux, carc)
soup (carc)
moles (thuja, carc, med, all sycotic incl staph, sep)
48 yo man pro photog
worse wet
worse first mot, better ctd mot (rhus tox, calc carb, lyc, kali carb, med)
red circumscribed cheeks (tub)
alopecia since 30's (lyc, sil, tub)
milk allergy (tub, sil, calc carb)
bronchitis (confirms tub)
arthritis
worse before storm or change in weather (tub)
compulsive, ritualistic (OCD is syphilitic but tub has syph in it)
extramarital affairs (lach, med, lyc, tub)
craves meat, fat, pork, ham, smoked
craves smoked (caust, tub)
52 emot swings menopause
craves sweest
sleeps on abd (puls, med)
jealous (lach, puls, apis)
worse sun (nat mur, puls if hot sun)
craves open air (puls, tub)
worse twilight, sunset (phos, puls)
digestive upset rich food (puls, nux)
hardboiled eggs (puls)
AF grief, no hope, anger, betrayed but tells no one
silent grief
insomnia, endless agony nights
works harder (mind occup amel)
sinus headache (aur, sil)
fate, prays for release
music amel (aur)
alc (aur)
47 yo man foggy poor concentration and memory
disorganized, creative, artistic (sulph
paints at night, goes to bed at sunrise (med, sulph)
vital, charismatic (med, some sulph but mb more in head)
pushes self (med)
craves spicey (med, sulph, carc, nux)
alc (sulph, med ...)
craves grapefruit (med)
averse beans, eggplant (med)
painful arthritis
unhappy in work, silent brooding
love affair with boss ended abruptly
weeps alone in room
can't stand contradiction (nux #1, ign, aur)
upper back pain-->h/a (nux, ign)
sensitive to coffee, tobacco, perfume (may use anyway)
coffee (nux, ign)
how know ign? because silent brooding
nux is in your face
PMS, hemorrhoids, constip, depress
hormonal remedies (sep, puls, kali carb, lach)
indigest with nausea (sep, good confirmatory)
chilly but doesn't like stuffy (sep, ars)
(puls runs warm)
better exercise (sep)
evening amel (sycotic, sep, med)
12yo boy asthma
tense and inhibited, reserved
fastidious (ars, thuja, carc, nux, ign, nat mur)
sebaceous cysts (all sycotic remedies)
worse wet weather (sycotic and psoric)
3am (thuja, kali carb, nux)
dreams of falling (thuja)
sweats on uncovered parts (thuja) and groin
honeylike or oniony sweat
aversion to onions (thuj)
26 yo man joint pain
hoarseness (caust, phos)
cough raw in chest (caust, phos)
bells palsy hx (caust, poss phos)
worse cold windy or draft (caust)
better wet (caust, nux but not if cold)
craves salt
33yo woman severe PMS (lach, sep)
headaches
ailments start in sleep (lach)
irrit
jealous
craves alc (lach)
PMS resolves w/ menses (lach)
cravings: coffee, alc, farinaceous
strong sex drive
competitive and intense (lach, nux, aur)
passionate
dominates conversat
sun headache
hard to connect (syphilitic)
suspicious
comes on at night (syph)
offensive discharge
chronically swollen LNs cerv
bad odor (merc)
worse sweat (merc)
averse sweets (merc, caust, sulph, phos)
thirsty cold
bread and butter (merc)
10yo serious sad boy
divorce-->insomnia, depress, suicidal
religious
loves church music (aurum)
keeps probs to self
heart dz
48yo woman asthma and peptic ulcer (syph)
worse night 11pm-2am (worse midnight: ars)
*burning stomach better warm drinks (ars)
ulcer pains better warm milk (ars)
anxious, restless, fears death
anxious (ars, calc, phos, lyc, kali carb)
chilly but wants window open (tub, ars)
fears robbers (nat mur, ars, puls, lyc)
fear alone
fear cancer (carc, ars, all anxious)
fear poverty (calc, ars, sep)
critical/censorious (sep, nux, ars, sulph)
(ars was answer)
62 yo man recurrent bronch, pleurisy, allergies, asthma
face swells (kali carb)
2-3am agg (kali)
stitching sharp pain (kali, bry)
averse touch (kali carb, thuja, some nat murs and sepias)
fear of ghosts (kali, sep, phos)
craves sweets
conscientious, hardworking, careful (calc carb, kali carb, nux vomica, ignacia)
29yo woman with digestive probs
worse overeating
worse rich food (puls)
craves milk, icecream
low thirst (puls)
runs warm (puls, sulph, nat mur, lach)
better cold applications (puls)
uncovers feet in bed (sulph, med, puls)
(calc takes sox off in night)
sad before menses (all hormonal remedies)
fear dark (same as fear alone)
fear men (puls)
fear insanity (calc, puls)
easy to talk with, likes company, people person (phos, puls)
difficulty deciding (puls doesn't know own mind, ign dt perfectionism)
likes consol (puls, phos)
24 yo woman hx of URIs
persistent swollen LNs
thin and chilly
loves open air even in winter
night sweats
irrit on waking (lyc, tub, carc)
restless and bored with relat (tub)
loves mtns (tub)
craves milk (tub)
bacon (tub, caust)
doesn't like dogs/cats (tub)
29yo man w/ frequent sore throats and back pain
likes warm weather
sweats a lot (calc)
back pain (calc carb)
sweats when cold (calc)
fears heights (calc, aur, thuja, nat mur, sulph)
fears spiders (calc, nat mur)
anxious re health, fears dz (ars, kali carb, lyc, phos, nat mur)
hard worker, gets along
constip (calc, sil-bashful, nux-straining, sep, ign, lyc-alt w/ d)
allergy to aspirin (calc)
tub bowel: loose stool
7yo ADD boy
exhuberant, bright, restless
connects well, likeable, curious, alert (phos, sulph)
gets in trouble for talking
interactive (phos)
craves salt sweet bread
averse fish (phos, mb crave)
thirst cold (phos)
fears alone, dark, kidnap, cancer
seeks consol
chilly
epistaxis (phos)
29yo woman oral and vaginal herpes
outbreaks sev times/yr
physically fit, works out up to 2 hrs several times a week
amenorrhea (all hormonals but esp sep, nat mur)
(puls irreg menses, leukorrhea bland)
leukorrhea irrit and acrid (sep)
irritable and weepy before menses
no romantic relationship in years
sex too animalistic, wants to focus on spirit
hates consol
likes sun
herpetic probs (sep, nat)
9yo boy bad cold sore throat
R tonsil to L (lyc)
better warm drinks (ars, lyc*, nux)
demanding esp when ill, dictatorial (lyc, nux)
fearful child, worried about health even with mild illness (lyc)
fears alone, kidnappers, dark, meeting new kids
wakes hungry has to eat right away (lyc, sulph, phos) "blood sugar remedies"
gas bloating
h/a on R temple
worse late afternoon 4-8 (lyc)
37 yo man BPH (sycotic, enlargement)
difficulty standing up for self (staph, sil)
weak boundaries (staph, carc)
*psoriasis after grief (staph)
masturbates to sleep (staph)
*sleepy in afternoon, worse after siesta (staph)
74yo man chronic GI probs
offensive gas
tends to D (sulph, tub)
red ruddy complexion (sulph)
intelligent, bright, curious, independent
warm to hot, uncovers in bed
tinker and fix things
loves praise
craves sweets fat beer cola
thirst for cold
itchy rectum (sulph)
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exam retake is Jan 9 costs $$$
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multiple choice section:
questions on kali carb and carcinosin, only 1 correct answer of four
if on followup remedy pic not clear: wait
several Q's on aggravation handout
agg is increase or intensification of sx
are aggs safe?
when should agg begin? (how long after remedy) right away
how long do aggs last? typically a few days
return of old sx/unwinding is not an agg
bigger agg with more vitality
give high potency-->more intense agg
if wrong remedy get proving, higher potency-->longer to recover
week after remedy severe pain, best strategy?: see pt again
hierarchy of sx
mental illness, give remedy, mental better but get physical prob: good
give remedy mind clears but turns irritable: good
see list in agg handout re: things that cause sx after remedy
bad food, go off drugs, right remedy (therapeutic agg), placebo agg (elmore)
best time to give remedy: when pt sx are strongest
give remedy-->worse pain but positive mental: good
chart of time vs intensity: three levels: mental, energy, physical
if mental agg-->improve, energy improve, physical same: wait or repeat, no new remedy
how late can agg occur? 3 weeks later poss if sluggish vital force
during acutes, expect agg? no
"nontherapeutic agg" = not right remedy
if remedy suppresses (against Hering's law): don't try to antidote with another remedy
camphor is best antidote, rub it around nose, on body
or instead restudy case, re-prescribe
give remedy and pt gets better but has brand new symptom of remedy that was given
(lump in rectum, sepia) called "partial proving" and remedy is correct
wait
cases of extremes
sleeps 2-3 hours night give remedy-->sleeps 8 hours/nt
pt complains of "ruined energy level"
you were excessively pushing yourself, vital force says you need sleep
beyond avogadros number: 12C
(20X is not, 24x is)
arsenicum
syphilitic miasm mainly, then psora (fearful)
aurum
syphilitic and some sycotic (excess)
goes counter to Herring's law: suppression
new layer known by:
1) new mental emotional sx,
2) intensity,
3) new or changed physical generals
MIASMS
genitalia : sycosis
syphilitic : ulcers, bones, destructive
high fever : sycosis
weakness, poor assim : psora
worse night : syph
fears : psora
cancer : all other miasms: psor, tub, syc, syph
fun loving : sycotic, tub
psoric : functional probs, itching
foul smell : syphilitic
fears povery : psora
violent : syph
lung prbs, restless, night sweats : tub
deep cracks : syph
bleeding tendency : syph
pt responds to med --> eventually need psoric remedy
excessive discharge : sycotic, med
lives longest suffers most : psora
most fun : sycotic