I need some help...mybrain is too full and my life is not calm enough for me to sit down with this case...my friend needs help, but I need help to help her...here is what I have gathered so far...

stonesting: real thick & clotted & dark blood still. cramping / pain on my right side mostly but occasionally sharp pain on the left

What kind of odor is coming from the blood? Um not much now, did smell like something died.
How heavy? Varies. It's probably about what most women's periods are like (mine are always real light so I'm not sure)
What do the clots look like? --if your are seeing any clots At first they were real big now they're more gooey strings if those are even clots now?
How far along? Thay can tell by a guesstimate between your cycle and the initial hormone level Initial Hormone level was 729 but I waited 2 days after the initial bleeding & pain to go see a doctor so that's not totally accurate & for point of reference, when I went back the next day it was at 549 so it drops a lot each day. I don't know what todays results were yet.....they did an ultrasound, correct? Yes- regular & with a wand they had me insert like a tampon , they found cysts on my ovaries & a real thick uterine lining but no baby And saw no life? No Life
Dark blood, what color? Dark maroon - blackish color clots... the blood is just red

How does the rest of you feel? Tired & Achey
Give me a head to toe analysis, please...
Head- tension headaches I think
Eyes- Dry
Nose- normal
Ears- normal
Mouth- normal
Neck- tense near top by my head
Shoulders- tight / tense
Arms- normal
Hands- normal
Chest- (breasts)- a little sore
Abdomin- feels bloated / like pressure kinda
Hips- normal
Tailbone- normal
Pelvic region- dull constant pain on right side, sharp random pain on both sides, mostly left side
Vagina-normal except for all the tests they did down there
Anus- no rmal
Legs- random nerve pain that goes from about upper thigh to my butt & makes walking uncomfortable
Knees- normal
Feet- sore but thats cuz I'm on them all day long
Toes- normal
...you think I am kidding ... No, I answered all the questions didn't I.

Better from... hot shower, massages, laying down
Worse from... lifting things at work , being really active at work, and stress at home

Hi sepia, you could go through the rubrics I looked at below.

Usually we try to look for an Ailments from which is very reliable to choosing the remedy. She hadn't mentioned, so maybe you can ask her.
She has given a good description of the bleeding symptoms and modalities. So that is what I've added in the list of symptoms.

The exertion symptom is interesting and I do wonder if there is any A/F to be found there.
the remedies that come up in order of importance are:
Rhus Tox (confirm with possible causation/overexertion/overlifting)
Sabina (early abortion)
Crocus (stringy bleeding)
Ars Alb (if weakness is predominant with chilliness)
Nitric Acid (harp cutting pain is more prominent)
Cinchona (weakness directly related to amount of bleeding, with other characteristics)



Female; ABORTION
Female; METRORRHAGIA; Abortion; after
Female; METRORRHAGIA; Exercise, after
Female; METRORRHAGIA; Exhaustion, with
Female; METRORRHAGIA; Dark blood
Female; PAIN; Sharp
Generalities; LYING; Amel.; during; bed, in
Generalities; BATHING, washing; Amel.; hot

Hope this helps you move ahead and make a prescription. Usually I may repeat a 200 or higher potency in water in order to STOP the bleeding. Frequncy can be upto 3 times a day - but alwasy tailored to the susceptibility. there should be significant feeling of relief by the second dose if it is the right remedy.
All the best!
dr. leela

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Dear members

First, we have to sharply define the disease symptom picture.

Even though the thread is named miscarriage, the main problem here is:

Bleeding from the uterine region non menstrual
 blood dark,
 Blood clotted, thick
 Blood bad smell

The modalities:
 < physical exertion, < mental exertion
 > external heat, rest
Have to be left out, as it is not specified, whether they actually brought on this problem or if they actually worsen or improve the bleeding.

The sensations:
 CC pain abdominal right side dull
 CC pain sharp abdominal both sides
Have to be lest out, as they are common to uterine bleedings of that kind, so that they don’t form part of the par.: 153 Symptoms.

Repertorization as follows: (all Boe TT)
1) Bleeding Uterine not menstrual
2) Blood dark
3) Blood clotted thick
4) Blood smelling bad

Result: Only those remedies are listed which have entries in all rubrics

BELL: 4, 3, 4, 5
BRY: 3, 3, 2, 5,
CHAM: 5, 5, 5, 4

Rhus-t is lacking Symptom: 2, 4. and has to be ruled out therefore,
Sabina is lacking symptom 2 and has to be ruled out
Crocus is lacking 3 and 4 and has to be ruled out
Ars-alb is lacking 1,2, 3, 4, and is unsuitable
Nit-ac is lacking 3 and 4 and has to be ruled out.
Cinchona: has the grading: 3, 3, 4, 2 and would need to be looked into if none of the higher graded remedies suit.

Let’s see what Cham could do for us here:
Extra-menstrual bleeding with offensive smelling blood thick in cloths (Boe characteristics)
Extra menstrual bleeding with abdominal cramps of a heavy offensive kind in cloths.
(Jahr MM)

From that and my own experience I did not look further and would give Cham in this case, provided, that the symptoms are still the above.
(Someone else could look-up Bell and Bry and see if they are equally suitable)

This elaboration shows, that it all depends to sharply individualize the case, then use reliable repertories and confirm it by the MM.

Easily enough the most suitable remedy is overlooked when using unreliable repertories or going by common indications

__________________
Hans Weitbrecht
Consultant Homeopath
homeopathy study guide: http://www.homeopathyworldcommunity....hy-study-guide

As far as I see it, post abortion is a very important indication as the hormonal levels clearly indicate to be so.

Chamomilla is interesting, I would differentiate with Cham based on a clear, reliable causative factor.
I would expect more sevre pains with Cham also associated with an obviously disturbed/hypersensitive mental state.

Also, just how offensive is smell of the blood?

So, there are your suggestions Sepia. it would be interesting to see what more history confirms the remedy.
BAsed on my experience with post miscarriage women < exertion, etc is directly related to the bleeding and possibly causative.
ED: What I percieve here is that this lady is quite stressed out with exertion in her family life. She must already have more kids, she has a physically active job (lifting things) and is on her feet all day. For someone in early pregnancy, this can be causative for a miscarriage. The causative factor becomes an important general modality when it also aggravates the bleeding.

But as in homeopathy, the individual characteristic expression is more important.

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dear members
Boenninghausen 1846:
ABORTION: cham 5
Kent:
ABORTION: cham 3
Boerricke:
Abortion: Cham 2

Causative factors are unsuitable for differentiation.
Any condition can arise after an incident. The then presented symptoms and signs wil call forth the correct remedies, not the causative factor.

For example: Arnica did not cause during its provings falls and injuries. But the situation we find expressed after having had a fall are often matched by the proving signs and symptoms of Arnica, yet depending on the exact nature of these symptoms other remedies can be more suitable to the point even that the choice may fall on a remedy which is not even listed in the ailments from fall rubric.

To not give the remedy because it is not listed in the rubric would lead to the wrong choice.

In many cases i have given remedies solely positively indicated through the now expressed disease symptom picture only, which were actually not found in the relating clinical rubrics such as >>Abortion<<, or in the clinical rubrics of the type: >>ailments from --<<.

The absence of a mental state or quality of pain normally associated to a particular remedy does not serve as contra indication.

It is -- and remains-- the aposition of the positive symptoms expressed in the provings to the disease-symptom-picture which determines in homeopathy the choice of the correct remedy by similitude.

__________________
Hans Weitbrecht
Consultant Homeopath
homeopathy study guide: http://www.homeopathyworldcommunity....hy-study-guide

Right, no disagreement there. Cham is in the rubric 'Abortion' that I have in 5th degree.

The point remains the history is incomplete and anything may be surmised unless it is clearly confirmed. My attempt was to open possible avenues of furthur confirmation to someone who is to tired to think right now.

Causation or ailments from, when found in a good history can clearly be indicative of a remedy even if some apparent characteristics don't fit. I was refering here to the causative factor BEFORE the miscarriage. Sorry I wasn't clear in my note aboce - I'll edit it.
So it works the other way round as well - if one remains of an open mind.

The ultimate aim is that a sick patient has to be cured. If the history taking is accurate, we stand a better chance of finding the indicated remedy after percieving the characteristics or using causation when present.

Any arguments for or against a remedy have to finally stand the clinical test of cure (-rather than individual ego scoring points).

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Dear members

Dr Leela wrote:
>> The point remains the history is incomplete and anything may be surmised unless it is clearly confirmed. <<

What, if this is all what is?
What if there is no history at all?

According to your view, you could not give a remedy even though it is clearly indicated by the now present symptoms.

Maybe by the time you have found all of the history of the patient your poor patient has died.

In homeopathy it is the now present signs and symptoms which determine the remedy.

>> My attempt was to open possible avenues of furthur confirmation to someone who is to tired to think right now.<<

I fully understand;
Beeing not to clear which symptoms form the disease symptom picture and of those which Ones would classify as 153 symptoms, using repertories which are not to be trusted, leaving off most important remedies to be considered ( for the case) would make ONE always suspicious about the correct selection. More information from the history would not bring One to the right remedy, which was overlooked at the start.

>> Causation or ailments from, when found in a good history can clearly be indicative of a remedy even if some apparent characteristics don't fit <<

Every Ones history has moments of great fear, only think the birth process – or moments of grief, the loss of a parent. So in every case according to your view, we could utilize rubrics such like: Ailments from fright, ailments from grief --.

The homeopathic principle reads different, and if One wants to work truly homoeopathically, then its worth to be familiarized with it. Org.: 7

§ 7
Now, as in a disease, from which no manifest exciting or maintaining cause (causa occasionalis) has to be removed1, we can perceive nothing but the morbid symptoms, it must (regard being had to the possibility of a miasm, and attention paid to the accessory circumstances, § 5) be the symptoms alone by which the disease demands and points to the remedy suited to relieve it - and, moreover, the totality of these its symptoms, of this outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force, must be the principal, or the sole means, whereby the disease can make known what remedy it requires - the only thing that can determine the choice of the most appropriate remedy - and thus, in a word, the totality2 of the symptoms must be the principal, indeed the only thing the physician has to take note of in every case of disease and to remove by means of his art, in order that it shall be cured and transformed into health.

>> Causation or ailments from, when found in a good history can clearly be indicative of a remedy even if some apparent characteristics don't fit. I was referring here to the causative factor BEFORE the miscarriage.<<

This has no bearing in an acute situation, a disease, which started once the bleeding started. (It did not start with this pregnacy or with any other previos ONe)
Utilizing other information than the already available would only lead to inappropriate remedies.

>> The ultimate aim is that a sick patient has to be cured. If the history taking is accurate, we stand a better chance of finding the indicated remedy after percieving the characteristics or using causation when present.<<

Which history do you refer to?

The disease history, the history of the different diseases the patient had in his / her live-time, or a live-time history of events?
>> Any arguments for or against a remedy have to finally stand the clinical test of cure (-rather than individual ego scoring points). <<

Disagree.

Every remedy if somehow suitable will change the symptom picture. So we cannot just try One and then try the next.
Hahnemann Org.; 169

§ 169 Sixth Edition
If, on the first examination of a disease and the first selection of a medicine, we should find that the totality of the symptoms of the disease would not be effectually covered by the disease elements of a single medicine - owing to the insufficient number of known medicines, - but that two medicines contend for the preference in point of appropriateness, one of which is more homoeopathically suitable for one part, the other for another part of the symptoms of the disease, it is not advisable, after the employment of the more suitable of the two medicines, to administer the other without fresh examination, and much less to give both together (§ 272, note) for the medicine that seemed to be the next best would not, under the change of circumstances that has in the meantime taken place, be suitable for the rest of the symptoms that then remain; in which case, consequently, a more appropriate homoeopathic remedy must be selected in place of the second medicine for the set of symptoms as they appear on a new inspection.

And if the ONE selected in this case cures partially, this would not mean, that a better selected One would not have cured. And as things have moved on, we cannot try ONE against the OTHER, to find out, besides doing medical trials on sick people being unethical. -- But being a doctor -- One does that all the time.

__________________
Hans Weitbrecht
Consultant Homeopath
homeopathy study guide: http://www.homeopathyworldcommunity....hy-study-guide

Wow, Leela and Hans,
I didn't mean to start such a back n forth, but I do appreciate the difference in perspective and approach...however, for someone of such lowly expirience-I, being just a home prescriber, it can be a bit overwhelming.
I can only go by what I was taught by my mentors...this is an acute case. This is not a constitutional picture, though I hope to encourage her that way sooner than later. I will also be sticking tot he basic set of remedies berses the expounded possibilities...
I had previously considered Bryonia, Lycopodium and Kreosotum...after having reviewed my list, and cross referenced it with both of yours', I have ruled out Bryonia. Lycopodium and Belladonna are both strong possibilties.Sabina is iffy. I will be doing a bit more research and then will keep you all up on our desicions and outcome.
Feel free to continue your discussion and I am still open to review suggestions.