Thank you for the replies so far. While I have been thinking about the case I had the patient on Sil 6x which did not help. The abscess has continued to increase in size without coming to a head also the patient has been experiencing headaches when meals were eaten later than normal time, this symptom was new for the patient so I figure this is a proving symptom. So I stopped the Silicea.

I decided to look at this case using Boenninghausens method. I have The Boenninghausen Repertory (TBR) by George Dimitriadis and find it priceless when I come up to cases like this one.

So focussing on Complaint with Location, Sensation, Modality, Causation and Concomittant I try and find my three legged stool (i.e. at least three of the above) and use those rubrics.

The numbering after each rubric is the rubric number found in TBR

1. Teeth and Gums - Gums #261
2. Teeth and Gums - Gums - lower #263
3. Eruptions - Abscess #1741
4. Eruptions - Painless #1793
5. Excrescences - Spongy #1898
6. From Situation and Circumstance - Injuries cuts #2390.

(The symptom Spongy I was able to get from the patient after I asked her to stop the Sil.)

I chose these rubrics b/c Gums and Gums lower describe the location. Eruptions abscess, painless and Excrescences Spongy describe the compaint. Injuries Cuts describes the causation. So I have a complaint, location, sensation and causation.

The results from the above rubrics gave me two remedies that were found in all six rubrics:

Staphysagria and Sulfur


There were no remedies that were found in five rubrics.

There were a number of remedies that were found in four rubrics: Ant-c, Conium, Merc, Nat-c, Petr, Ph-ac, Phos, Sil.

I thought Sulfur may be a possibility. In Concordant MM by Frans Vermeulen under Silicea "Followed Well By ... ... ... Sulph [if improvement ceases under Sil. a dose or two of Sulf will set up reaction and Sil will then complete the cure]. However Sil did not give any improvement in the first place.

Staphysagria has an affinity for the teeth and alveolar perisoteum and while I was studying the case (I had just finished repertizing and was doing a materia medica comparison between Sulph and Staph) I was contacted by the above patient who had remembered some more information (I asked during the initial consult if there was any major life event, change, distressing situation etc. i.e. I was looking for a mental or emotional symptom of which the patient could not remember any). The swelling probably did come up after an emotionally traumatic event which was an attempted sexual assult.

Well, well, well I thought to myself. I think this has just made my differential diagnosis between Staph and Sulph much easier.

I am giving Staph 30c to be olfacted once a day. (The patient is very sensitive and prefers taking remedies by olfaction) If required we can take the remedy orally later as it is easier to increase the dose slowly than it is trying to handle an aggravation.

The first dose will be taken tonight. I will keep you posted on any changes.