- Sample Case Page 1
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Working Up a Sample CaseThe Case of "Fluffy the Cat" In our sample case, the client calls up and you do an intake on her cat, "Fluffy". She tells you that her cat is normally happy and playful. The cat has been hiding in the closet which is unusual since this is a cat that normally is very curious and outgoing. Fluffy also cannot seem to get comfortable. She'll come out of the closet and try to sleep on the computer monitor (desiring warmth) and then go to the litter box and have diarrhea. Whenever she has diarrhea she also vomits up a small amount. She does not want to be held or petted and goes to the water dish for one or two laps of water and then back to the closet. She did notice that Fluffy's ears and skin have a yellowish tinge. We go to the repertory (in this case one called the Complete 4.5 in the MacRepertory© computer program) and find the following rubrics that seem to match Fluffy at this point in time. Next
Sample Case Page 2
Note *The ALLCAPS, Bold, italics and underline indicate symptom frequency in the provings
1. GENERALITIES; WARMTH; desires
2. MIND; TOUCHED; aversion of being
3. SKIN; DISCOLORATION; yellow, jaundice, icterus, etc
4. STOMACH; VOMITING; General; diarrhea; during
5. STOMACH; THIRST; small quantities, for; often
6. MIND; HIDE, desire to
Sample Case Page 3Once we have accumulated our rubrics (and this is a very simple scenario to demonstrate principles) we list all the remedies in each of the rubrics and chart their frequency. In other words, we try to find a common theme running through the case.
Fortunately we can do this by computer but many homeopaths still do it by hand. Here is the computer repertorization of these six rubrics.
As you can see, Ars. (Arsenicum-album) and Bell (Belladonna) come up as the top two remedies in this chart. The others in the top group should also be considered since this chart is only a starting place to finding the appropriate remedy.
Since the Ars and the Bell are so strong we decide that the correct remedy is one of these two but which one?
Sample Case Page 4Going to the Materia Medicas. we read about each remedy and see that Arsenicum patients tend to be chilly and restless and thirsty for sips of water. They also do not usually have the intensity one usually finds in the patient requiring Belladonna. The level of fear is less intense (more of an anxiety and less terror or panic).
Also the Belladonna patient tends to be thirstless rather than thirsty and tends more to a constipation than to a diarrhea.
There is one other remedy that came to my mind while creating this sample. It was Nux-Vomica. The Nux patient also tends to be chilly, averse to company, has stomach upsets and is very sensitive to being touched. I was curious as to why Nux did not seem to show up in the top ten or so remedies in the chart
I looked further and found that the thirst and the vomiting DURING diarrhea, both of which are very strong symptoms in the case, are NOT usual Nux-vomica symptoms and that is why it was far down on the list. This also demonstrates that each time we look at a remedy we can learn another aspect of that remedy.
Sample Case Page 5I digressed to show you how the process of repertorization is a dynamic one and your knowledge of the remedies themselves is so very important. Repertory analysis is only a jumping off point. It is the Materia Medicas. and the study of the nuances of the remedies that shines the true light on the appropriate remedy for that patient's state.
Back on track, we decide that the Arsenicum fits the picture of case most closely and administer one dose of Arsenicum. The potency we use would be determined by our evaluation of the patient's Vital Force and other factors and that is a much deeper subject and not important to this example.
Sample Case Page 6The following day the client calls and reports that her cat is feeling much better. Fluffy came out of the closet to greet a visitor and she seemed much calmer. She still has not eaten but there were two episodes of diarrhea without vomiting. In fact, there has been no vomiting at all! Fluffy allowed herself to be petted and brushed and slept on the bed last night and not in the closet.
We decide that the remedy appears to be helping and (even though she has not yet started to eat) we want to wait and watch for another day. On day two post-remedy, Fluffy started to eat again and was almost back to her normal self but the diarrhea had been more frequent and little blood was seen at the end of two movements. This concerned her mom since it was something Fluffy had been "treated" for (by conventional medication) in the past - she decided, since Fluffy was feeling better on many levels, to be patient.
Since Fluffy is feeling better, eating some and there is a general improvement on both the physical (she has not vomited, is more active and is eating) and emotional level (not hiding, more social and less restless) we decide that the slight increase in the diarrhea and the return of an older symptom picture was encouraging (as long as it does not bother her or persist)and her improved emotional state suggests we continue to wait and watch.
Sample Case Page 7By day five post remedy the diarrhea is gone and she is essentially back to her old self but she has started with some sneezing and a runny nose. Fluffy's mom wants to run out and get her some antibiotics since they have "cured" this the last six times Fluffy has had this upper respiratory "infection". Obviously she had not read through the Primer as well as she could and she does not realize that these colds were never really cured, only suppressing and the Return of Old Symptoms can indicate an excellent response to the remedy. The Vital Force now feels strong enough to deal with this old problem.
She trusts us enough (and since Fluffy is acting great) she waits and the symptoms of the cold subside in two days and Fluffy continues to improve. A month later we look at her case and find that there are still signs of the underlying chronic disease. These signs include a dry hair coat, inflamed gums and vomiting hairballs. We then look to determine the next remedy as the process of healing Fluffy's deeper chronic disease continues. Since her symptom picture is now different, her remedy picture is also different. We might feel there is adequate reason to repeat the Arsenicum but it may be a completely different remedy is now indicated. This stresses the importance of being patient, observant and keeping a journal so we can chart the progress and refer back to the effect of a certain remedy in the years to come.
Sample Case Page 8This case was hypothetical but demonstrated the fundamental process in case taking, remedy selection and evaluating the remedy response. These are some of the skills and training required by a homeopath