Casus Hahnemann

PulsatillaDec. 1815

W – e, a weak, pale Man, 42 years old, engaged mostly in sedentary work

W – e, a weak, pale man, 42 years old, engaged mostly in sedentary work, complained the 27. Dec. 1815: he is already sick for five days.

1) The first evening he was nauseated and dizzy with profuse eructations, without real cause,2) the next night (at two am.) sour vomiting,3) the following nights violent eructations,4) also today bad eructations, offensive and with sour taste,5) he feels as if all food lies in his stomach raw and undigested,6) he feels sensitive in his head, a hollow and empty feeling.7) he is very sensitive to even the slightest noise,8) he is of a mild, yielding, patient nature.

1) The first evening he was nauseated and dizzy with profuse eructations, without real cause,

Commentary Hahnemann (3, 7 are # for Sx in the proving, "Materia Medica Pura/MMP", vol. 2, 3th Ed., 1833, P. 273-342, total 1153 different Symptoms for Puls.):

Ad 1. some remedies cause vertigo with nausea, such as Pulsatilla (3.), which remedy has vertigo mostly in the evening (7.), something observed in just a few other remedies.

Sympt. 3:

"Vertigo, like that which occurs on turning round for a long time in a circle,

combined with nausea"

Sympt. 7:

"Giddy staggering, as from intoxication, with internal heat of head and

paleness of the normally warm face, especially in the evening."

see Repertorization

2) the next night (at two am.) sour vomiting,

Commentary Hahnemann

Ad 2. Vomiting of sour and sour smelling mucus is produced by Stramonium (Stram.) and poison nut (Nux-v.), but, as far as we know, not at night. Valerian (Valer.) und Cocculus (Cocc.) produce nightly vomiting, but not sour. Only iron (Ferr.) has nightly vomiting (61. 62.), and kann produce sour vomiting (66.), but does not cover the other relevant symptoms of the patient.Pulsatilla not only produces sour vomiting in the evening (349. 354.) and nightly vomiting (355.), but also covers the symptoms not covered by iron.

Sympt. 61 (Ferr.): The vomiting is before midnight, worst when she is lying, and especially when she

lies on the side. Sympt. 62 (Ferr.): Vomiting of food, immediately after midnight, whereupon there

follow dislike to food and repugnance to the open air(6 hours after remedy). Sympt. 349 (Puls.) After

exercise in the open air, towards evening, nausea and vomiting of something salt or sour. Sympt. 355

(Puls.) Nocturnal vomiting with shooting drawing pain in the back towards the scapula

see Repertorization

3) the following nights violent eructations

Commentary Hahnemann

Ad 3. Nightly eructations are a feature of Pulsatilla (296. 297.).

Sympt. 296:

"Bitter eructations at night."

Sympt. 297:

"bilious eructations in the evening"

see Repertorization

4) also today bad eructations, offensive and with sour taste,

Commentary Hahnemann

Ad 4. the offensive, fetid (259.) and sour eructations (301. 302.) are also features of Pulsatilla.

Sympt. 259:

"After dinner eructation with the taste of putrid flesh, and this same taste

remain afterwards in the mouth, with inclination to vomit" Sympt. 301:"After drinking coffee a sour fluid is eructate (belched) up into the mouth." Sympt. 302:" In the morning sour eructation."

see Repertorization

5) he feels as if all food lies in his stomach raw and undigested

Commentary Hahnemann

Ad 5. The sensation as if food lies undigested in the stomach is only covered by a few remedies, and in none so complete and typical as in Pulsatilla (321. 322. 327.).

Sympt. 321:" Sensation as if the stomach were deranged."

Sympt. 322:

"Symptoms of very much deranged stomach."

Sympt. 327:

"Sensation in the stomach as from eating too much; the food came up again into the

mouth, as if it would be vomited."

see Repertorization

6) he feels sensitive in his head, a hollow and empty feeling.

Commentary Hahnemann

Ad 6. Except for Ignatia (Ign.) (2.), which however does not produce the other symptoms, Pulsatilla produces also this symptom (39., compared with 42. 94. 98.).

Sympt. 39:

"Emptiness and hollowness in the head; his head felt like a lantern."

Sympt. 42:

"Dullness in the head; his thoughts leave him."

Sympt. 94:

"Dimness of vision, like a mist before the eyes, on rising from a seat and walking."

Sympt. 98:

"In the morning on rising from bed, it is very dark before his eyes."

Sympt. 2 (Ign.):

Feeling of hollowness and emptiness in the head. see Repertorization

7) he is very sensitive to even the slightest noise

Commentary Hahnemann

Ad 7. Pulsatilla produces the same (995.), like it also produces an oversensitivity of the other senses, f.e. vision (107.). And though the sensitivity to noise is also found in poison nut (Nux-v.), Ignatia (Ign.) and Aconite (Acon.), homeopathically they nevertheless do not readily apply to the other symptoms.

Sympt. 995:

"When he wakes up from sleep the sound of words seems to him to be too loud, and

vibrates shrilly in his ears."

Sympt. 107:

"One eye or the other suffers shooting pain, almost without inflammation of the white, and

he cannot look into the flame of a candle; he can only open the eyelids a little way."

see Repertorization

8) he is of a mild, yielding, patient nature

Commentary Hahnemann

Ad 8. Referring to the mildness of mind: according to the community feedback about Pulsatilla, this is something that covers the remedy very well.

In the introduction to the proving Hahnemann writes: "Hence the medicinal employment

of pulsatilla will be all the more efficacious when, in affections for which this plant is

suitable in respect to the corporeal symptoms, there is at the same time in the patient a

timid, lachrymose disposition, with a tendency to inward grief and silent peevishness, or

at all events a mild and yielding disposition, especially when the patient in his normal

state of health was good tempered and mild (or even frivolous and good humoredly

waggish). It is therefore especially adapted for slow, phlegmatic temperaments; on the

other hand, it is but little suitable for persons who form their resolutions with rapidity, and

are quick in their movements, even though they may appear to be good tempered."

see Repertorization

Commentary Hahnemann after giving Puls.

The following day he was free of any complaints, his digestion in order, and so he remained, as I heard from after a week.

Searching for the remedy for such a small case is readily done by some body with some experience who has the remedy picture mentalized, or knows how to easily find them. But to document such a case with all pro and contra arguments (Differential Diagnosis) (so easily done in practice by head), is, as one observes, quite a exhausting enterprise.

More generalized repertorizationMore specific repertorization

Repertorization a la Hahnemann

Repertory Rubrics Complete Repertory 2009

Vertigo; NAUSEA; With (m, 184, 19-36)Vertigo; EVENING (t, 97, 5-18)Vertigo; ERUCTATIONS; During (m, 22)

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Repertory Rubrics Complete Repertory 2009

Stomach; VOMITING; General; sourStomach; VOMITING; General; night

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Repertory Rubrics Complete Repertory 2009

Stomach; ERUCTATIONS; General; night

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Repertory Rubrics Complete Repertory 2009

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Stomach; ERUCTATIONS; General; foulStomach; ERUCTATIONS; General; sour

Repertory Rubrics Complete Repertory 2009

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Stomach; INDIGESTION (p, 303, 88-396)

Repertory Rubrics Complete Repertory 2009

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Head; EMPTINESS, hollow sensation (p, 128, 35-79)

Repertory Rubrics Complete Repertory 2009

Mind; SENSITIVE, oversensitive; General; noise, to (p, 271, 40-221)

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Repertory Rubrics Complete Repertory 2009

Mind; MILDNESS (p, 99, 16-18)

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Repertory Rubrics Complete Repertory 2009

Further generalization of the rubrics

Repertory Rubrics Complete Repertory 2009

Further specification of the rubrics