Urinary Pain and a Peculiar Symptom Can a Definite Result in an Acute Case Confirm the Similitude of a Chronic Case?

Joseph Kellerstein, DC, ND

I first made the acquaintance of Chelsea about 2 years ago. We worked through a homeopathic initial exam during a college clinic I was doing for the graduating class. Chelsea is about 25 years old, tall and lean, and unconventional.

Her parents are both professors. She had some parental pressure to pursue an academic career, but instead has chosen to be a performing musician. It is rare to see such dedication to one’s art.

Thankfully Chelsea’s complaints were marginal. She had some minor GI distress and a desire to quit smoking. There was a persistent anger issue directed toward her boyfriend and employer. It took a few different remedies over the course of a year, but these seem mostly improved. Each remedy (2) moved the case a bit over the course of one year to the point where the patient’s goals were generally met with the occasional backslide on the cigarettes.

Her energy level had improved overall and there was a renewed sense of purpose in her career. That initial drive lost momentum with the upswing in negative emotion (yes, I am vague but that is how the case left me feeling!)

Although somewhat successful, it was not a very satisfying homeopathic experience.

I had not heard from Chelsea in some time until some 2 weeks ago. She had been struggling with a bladder infection for about 4 weeks and had been put on 2 different antibiotics, both with no result. After consulting the bladder section of a popular homeopathic first aid publication, she of course played with Cantharis and Sarsaparilla with results equal to the 2 antibiotics.

The complaint most emphasized was a very troublesome sense of pressure in the bladder that was generally getting much worse and really did not vary much. It was not at all relieved by urination.

The burning pain during urination so classic in cystitis is a ‘gimme’ for questioning by the homeopath. We always want to specify where in the course of the stream the pain will peak. The different rubrics representing the various answers all have good differential value. In this case the answer was interesting. The burn kicked in a bit towards the end of the stream and was especially so after urination was finished.

Further interrogation (we have ways to make them talk) gave a very peculiar symptom that the whole thing was worse when the weather was cloudy!

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When putting all of this together in a repertory chart, the first 4 remedies seem to be most intriguing and so must be eliminated first. Mercurius looks very good and is generally known to have an aggravation of the pain when not urinating. This is not quite the case as it began notably at the close of the stream. Further, the urging was not very strong — it was the constant fullness. I asked that she look in the mirror at home (this was done from some distance away on the phone) to examine her tongue. No indentation and no excess saliva. I was not convinced.

The next idea to catch my flighty mind was the amazing symptom of aggravation from cloudy weather. Yes the intensity of the burning and the fullness both seemed worse in this weather and better on a nice sunny day. This is highly characteristic of Sepia. But wait a minute, I’d better be careful. I really tend to overprescribe that one. How can I confirm? I asked her about her mood during this time. Interesting answer. “I have been unusually calm as opposed to my reactive self.” (The well-known flatness of the remedy can also be seen as unusual equanimity). Well that was enough for “hair trigger Joe.” Off I went confident that I had won the day and the bathroom. I asked for a return call in 48 hours following Sepia 200 once now and once tonight before bed if there was no interim improvement.

The call came 48 hours later and my expected laurels were put on hold. No change and perhaps a bit worse. She was now more restless with the increasing bladder fullness and mentally I was desperately clinging to a crumbling ego crying for a dramatic bailout.

I gathered my dwindling mental resources and asked what other changes there were. “I seem warmer than I have been for some time.” Well I’m not proud, I jumped on the Sulphur bandwagon. I prescribed a 10M now and again tonight if no definite change by bed.

In the morning came the call that the siege had ended and the battle won. She had been asymptomatic since soon after that first dose.

The question then is what are the teaching lessons here. First, Joe cannot write enough of the obvious.

Interestingly enough these same 2 remedies were the ones I had used in the chronic case before. It did seem that Sepia was good for her. I did think Sulphur was better and acted in more ways.

Here in the acute case we see that Sulphur definitely has a higher degree of similitude for this patient and confirms itself as the remedy needed in the chronic case for this person. Finally, a sense of confidence in my otherwise shattered life.

So it may be that a definite result in an acute case can confirm the similitude of a chronic case.

Secondly, I gave a wrong first remedy in the acute, but the resultant new symptom (heat) brought me to the correct remedy. So be wrong, just do it quickly!


Kellerstein headshotJoseph Kellerstein, DC, ND graduated as a chiropractor in 1980 and as an ND in 1984. He graduated with a specialty in homeopathy from the Canadian Academy for Homeopathy, and subsequently lectured there for two years. He also lectured in homeopathy for several years at CCNM; for eight years at the Toronto School of Homeopathic Medicine; and for two years at the British Institute for Homeopathy. Dr. Kellerstein’s mission is the exploration of natural medicine in a holistic context, especially homeopathy and facilitating the experience of healing in clients. Dr. Kellerstein is presently teaching a post-grad course in Hahnemannian prescribing with Dr. Andre Saine. Its mission is to promote excellence in the basics of homeopathic prescribing; case taking; repertory; Organon as applied to real-life practice; and case analysis skills via modeling the masters. The course runs for three years; distance learning is available. Students can preceptor in Dr. Kellerstein’s clinic, and mentoring is available.

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