Originally, in taking this case, I saw a clear picture of Sepia. Let me explain. Originally, I did NOT spend too much time other than looking up an odd symptom or two to confirm my prejudged knowledge of Sepia. It started to work positively, however within a week all action had ceased and her symptoms all returned as described.
What did I learn from that? I learned that knowledge of the remedy is essential, but in writing a prescription for the remedy, it had better match the symptoms of the patient.
I hate paper cases. Its a fine balance between presenting the case and in giving the case away. This case took me out of my comfort zone. Sepia did not work for an obviously Sepia menopausal woman! Only, that was my assessment of the case and not the reality. Yes she was 'hormonal' but it was not the symptoms that required Sepia.
In analyzing any case, it is a matter of balance. It is a matter of completing symptoms and a matter of synthesizing all the information.
Generally, a physician would outline a complete picture of the diseased state, by noting the areas of disorder. In this case we have a woman who has had a hysterectomy in her late 20s. She is receiving and has received hormone treatment since then.
The results of the hysterectomy, even WITH hormone treatment is frequent urination, it is controlled by medication. So here we see, REGARDLESS of the cause, she is troubled with this problem. This is a symptom that exists and is always present.
P&W Therapeutic Pocket Book
Rubric number 477: Urination, frequency, too often. 90 remedies.
If we combine this with the direct action of the hysterectomy, the resultant state is one of suppressed menses.
P&W Therapeutic Pocket Book
Rubric number 2529. Menses suppression of. 68 remedies.
So now, we have a direct correlation to the present cause and genesis of one presenting symptom which has narrowed the remedy search down to 68 medicines.
We now note that the patient suffers from pain in the back, neck and shoulder blades.
P&W Therapeutic Pocket Book
Rubric number 686: Back 122 remedies
Rubric number 685: Shoulder Blades: 112 remedies.
Not very helpful as most medicines can produce areas of discomfort in this location.
She has a modality of a pain in the neck when turning the head. So we add that because it’s a constant.
P&W Therapeutic Pocket Book
Rubric number 2483: aggravation head turning: 60 remedies.
In looking at the chart, we can see Calc and Kali Carb are represented quite evenly in grades, with Kali Carb being even across the board. Grades in themselves mean NOTHING except to represent a value of consistency of appearance/presence in a symptom. It has no affinity to intensity of a symptom. A grade value of 1 can be of a higher intensity of pain but not seen so often as a grade of 3 or 4.
At this point, I looked in the Materia Medica and chose Kali Carb for the patient. I noted these other symptoms expressed by the patient as well.
As we can see, the headache, the sleepiness from riding in a car and the lack of perspiration, all symptoms noted in the patient but NOT chosen as prescribing symptoms were present.
Also, as I read Kali Carb, I noted an affinity for fibroids and uterus disfunction which was the main cause for the hysterectomy.
There are many ways to arrive at a prescription. Im just giving an oultline of my thinking in this case.