I have recently been asked about changing potencies in LMs, with people mentioning using odd numbers, even numbers, going up in steps of 2 potencies (LM1 – LM3 – LM5) etc.
I came across this issue before I started studying with David Little, from a post he wrote on the Minutus list, sometime around 2005. He mentioned that while most people do just fine on a series of ascending potencies (LM1 – LM2 – LM3 etc.) he had noticed that some seem to do better on odd or even numbers of dilutions or succussions. He also noted that Hahnemann didn’t always start with LM 1.
There are two issues in play here, in my view.
The first is the risk of putting theory before experience. The beauty of homoeopathy is that Hahnemann first observed, then developed a way of harnessing the power of the similar stronger artificial disease without harming the patient, and what he thought was the most probable explanation for what he was observing. In Aphorism 28 (and elsewhere), Hahnemann sets out the basis for his thinking on experience versus explanations of how something happens:
“As this natural law of cure manifests itself in every pure experiment and every true observation in the world, the fact is consequently established; it matters little what may be the scientific explanation of how it takes place; and I do not attach much importance to the attempts made to explain it. But the following view seems to commend itself as the most probable one, as it is founded on premises derived from experience.”
The second issue is the sensitivity of the patient, something that is difficult to assess ahead of time. In Aphorism 278 Hahnemann explains that individual sensitivity can’t be deduced through “fine-spun reasoning” or “specious sophistry.” In order to learn the appropriate dose, “pure experiment, careful observation of the sensitiveness of each patient and accurate experience can alone determine this in each individual case…”
To my mind it comes down to “specious sophistry” if we adopt a theory of odds and evens, where there is no solid backing for the theory, or to apply it and then say it worked – especially when there is a body of material showing that many patients do well just going up through the potency scale. On the other hand, some patients do especially well on a particular potency, but we cannot know if it was the potency itself or if the improvement was built up by the work of the previous potencies and only manifested itself with the current one.
And furthermore – although it is natural to look for protocols, for theories which provide rules for action which can be employed in every case, we will then have moved away from the individualization of the patient, and of the patient’s sensitivity.
In my own experience, many patients do very well going up the scale, some seem to advance more with specific potencies in the scale, and if the remedy is going to help it is usually already visible in the patient’s response to LM1.
However, looking for a pattern in the sensitivity of individual patients and developing theories to govern posology rather than drawing on pure experiment, careful observation and accurate experience on an individual case-by-case basis seems to be a case of putting the dazzling cart of theory in front of the plodding hardworking horse of experience. Specious to say the least.
I published this article on my regular blog, and thought it may be of interest here too. Vera.
To Do or to be Done To – That is the Question:
I was recently reading an article by Peter Drucker on self-management. He said, amongst many other useful things, that you have to know whether you’re someone who learns through reading written material or through listening to others. Really that you have to know who you are managing before you can actually do the job with any success. Brilliant? Hardly. Solid common sense without which you cannot really move ahead in any activity? Absolutely.
If you go against your nature, you either have to have a really good reason for doing so (I too occasionally stop eating chocolate) or you’re just setting yourself up for failure. And that, gentle reader, leads to…let’s say, disappointment.
How is this connected to deciding what treatment to go for when you have given up on conventional medicine or for whatever reason have decided to check out the alternatives?
My experience, both in homoeopathy and in my previous life as a reflexologist, medicinal aromatherapist, and – yes! – Reiki master, has taught me at least one important thing.
People are different.
Oh, you were expecting something more? Well, here’s more…
As far as treatment is concerned, most people seem to fall into two broad, somewhat ragged groups: Those who want to “do”, and those who want to be “done to”…somewhat inelegantly termed, but you get the idea, I hope.
Those who want to “do” usually don’t want to be undone, so to speak. They don’t want to loosen their clothing. They don’t want to lie down on that table. They don’t want to be kneaded, touched, poked, prodded, have anything stuck into them, or be asked about deep emotional issues. They certainly don’t want to take off any clothing. I usually have a treatment bed in my clinic – these are the people who on coming into the room for the first time look highly askance at that piece of furniture, unsure whether they have made the wrong choice…
(A propos clothing, when I was studying reflexology, a fellow student on offering a free treatment to an elderly man who lived nearby was a little surprised when she came into the treatment room to find her beaming patient had removed every article of clothing except the items he should have removed – his socks…)
Those who want to “do” want to be actively involved in their treatment. They are happier with any form of treatment where they are “doing”, whether they’re taking a medicine, following a diet plan, or doing a regular program of exercise.
Patients who want to be done to, now that’s a very different kettle of…er…patient…
Sometimes it’s personal preference. “Done-to-ers” want to be touched in treatment. Massage, needles, finger pressure, in water, out of water, bring it on… When there is no touch in treatment, even the light sting of a penetrating acupuncture needle, it’s as if there is nothing going on, or not much. Even pain may be welcomed. I was surprised as a reflexologist by the number of patients who would say, pleadingly (and perhaps somewhat creepily), “press really hard…hurt me…I can take it…”
Sometimes it goes beyond that. Very often, the people who prefer to be “done to” are extremely busy, whether in their lives or in their thoughts, and just do not have the mental and emotional space needed to be fully involved in their treatment. Giving feedback in-between treatments, being actively involved in monitoring their process, learning and following instructions (whether written or verbal) is something they just do not have time for. Their lifestyle doesn’t allow for it, and their headspace cannot make room for it. Can’t I just lie down and have you fix it? is the unspoken message.
By the same token, sometimes those who want to “do” want to maintain total control over the treatment situation, which is why it may be personal anathema for them to lie down on that table and have any kind of treatment, gentle, painful or weird (let’s face it, some forms of healing seem weird, just saying…). When I practiced reflexology many years ago I’d notice that there were those who would lie down and basically fall asleep after I’d been working for five minutes. Sometimes it was difficult to wake them up after the session. Then there were those who would ask if they could sit up so they could follow exactly what I was doing…
Sometimes it can be a good experience to try the thing you are not into. It can be good for the “do-er” to deliberately relinquish control and consciously lie down on that table in the spirit of trying something new which may be helpful. It can be a very positive process for members of the “done-to” preference to go for treatment where they must be more actively involved and follow through. But if you don’t understand up-front which group you belong to, you won’t be able to get the most out of the experience.
Homeopathy really is for patients who are willing and able to “do” – or in the case of infants and children, dementia patients or those who happen to be comatose during treatment, who have those willing to “do” for them. Those who come expecting to be “done-to” in some way will usually be disappointed. But those who know which group they belong to and understand that this will be more challenging for them are already in a better position to achieve good results from homoeopathy.
The results of treatment are so connected to knowing which group you belong to. In my experience, the best results in homeopathy are with patients who follow instructions, give regular feedback, and are happy to be part of the process. Homeopathy is entirely based on information I get from the patient. That information includes what the patient says (and sometimes what his or her spouse says…), what I see, hear, and sometimes smell (OK, TMI… no further elaboration here) during the session and the information the patient gives me during the treatment process, after starting to take remedies.
When I take on new patients I always say:
Me: while I’m working with you I’ll ask you for a lot of feedback after taking remedies. Are you OK with that? (or words to that effect?
Patient: Of course, I can give feedback and follow instructions (and in the thought bubble – what does she think I am, a moron? Who can’t give feedback or follow instructions?)
My homeopathy patients do best as they learn the process, so the nature of the emails they send me changes dramatically during the process.
Beginning patient: I took the remedy and then had a headache for two hours!! I haven’t had those headaches in years!!! I took four Advil!!! What should I do???
(not all use multiple exclamation marks and question marks, but I digress…)
Me: Did the headache come back?
Patient: No, I’ve felt really good since then…
Experienced patient: I took the remedy and had a headache for two hours. It’s an old symptom, didn’t come back and I feel great. That’s good, right?
Me: Yes, old symptoms can come and go during treatment. As a rule they won’t last long. Did you take anything for it?
EP: No, I drank a lot of water and saw if I could wait it out. I had Advil in the cupboard if it became unbearable but I didn’t need it.
In homeopathy, the do-ers enjoy being fully involved. But those who are really done-to-ers and don’t acknowledge it are miserable. Even though most are certainly well able to follow instructions and be involved in the process – they don’t like it. They don’t have time for it. And therefore usually don’t do it.
As with any theoretical construct involving two groups, there is always a shadowy third (as in Tevye’s legendary third hand in Fiddler on the Roof): Those who neither want to “do” or be “done to”. I will leave you to ponder on that thought… or on Tevye’s third hand, whichever you prefer…
The choice is always yours.
And because you read all the way to the end, click here for the link to the Peter Drucker article:
This is something I and other IHM practitioners often hear, or see on people’s faces when we talk about homoeopathy to homoeopaths. I can feel the thought echoing through the ether (so to speak…) when I write about homoeopathy to homoeopaths.
However, to warp an old idiom, knowing is as knowing does. If you really knew that – why don’t you do that?
Let’s start with the first basic tenet of homoeopathy: like cures like. Continue reading →
So what should it be – Aphorism 5 or Aphorism 6? Let’s look at them… (text taken from 6th edition)
Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.
The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.
So – which one is it? If the information described in Aphorism 5 is what is needed to make an accurate homoeopathic prescription, we can understand the Kentian-style intake, lasting hours and sometimes even days. We can also understand how Kent – with a little push from Swedenborg, ok, a hefty shove – came to the concept of the constitutional remedy. A remedy which encompasses the patient’s entire soul and psyche, in this life and – depending on your beliefs – in all those that came before and will come after…
Since Kent’s time, homeopaths have worshipped at the altar of the Constitutional Remedy, the simple substance – a Swedenborgian, not Hahnemannian concept – and this is what most non-homoeopaths and homoeopaths alike believe Classical Homoeopathy to be.
But then what do we do about Aphorism 6? This Aphorism and its instructions have been swept under the constitutional carpets of so-called Classical Homoeopathy for so long that the simple clarity of focus and objective has been lost to many.
Hahnemann’s language in Aphorism 6 is very clear. “Take note of nothing but the changes in the health of the body and the mind”. How on earth is it possible to ignore that? But it is ignored.
The thing is – this is not an “either/or” situation. Both Aphorisms are essential, but they serve different purposes. We cannot take what has changed (Aphorism 6), if we don’t know what was before (Aphorism 5). We cannot assess those changes and prioritize them if we don’t know whether there is an exciting cause, a maintaining cause, a miasmatic origin (or something that is harming the patient’s health and can be removed – see Aphorism 4) – if we don’t do the work set out in Aphorism 5.
But the central focus, the torch that has to guide us through the often labyrinthine nature of a complex case has to be Aphorism 6. So many patients today are subjected to never-ending sessions where they are asked to disclose their most intimate thoughts, dreams and fantasies, their sexual urges, their emotional relationships past present and future, their failed expectations and unexpected successes. The process is usually emotionally draining, hugely time-consuming, potentially harmful in terms of the patient-practitioner relationship, and without the context set out in Aphorism 6, of no use whatsoever and potentially hinders us from finding the best homoeopathic prescription for the patient.
I recently received my copy of P&W’s book version of the Therapeutic Pocketbook. And I must admit, it was love at first sight, and second, and third…
I must own up to being old fashioned. However much computers may have helped us in referencing many books, in finding correct rubrics, in the process of repertorization – it has reduced us to a bunch of small-screen addicts with heavy-duty tunnel vision.
One of the central flaws of science, replicated in the use of a computerized repertory, is that we determine what we’re looking for, and we look for it. Peripheral vision becomes irrelevant. Apart from synonyms, which can sometimes be useful, either what we’re looking for is there – or it isn’t. Anything interesting that may be lurking in the background becomes effectively invisible. Our gaze is honed in to what we’re looking for, what we find, and then to a search for alternative expressions of what we’re looking for.
I invite you now, if you will, to put down the mouse (or take your finger off the touch pad) and pick up the nearest book (no, no, a Kindle absolutely does not count). Flip through the pages without even looking for anything. Do you notice some ideas as you do so, some words that just jump out at you? If you’re doing this with a homoeopathic text, or something that interests you, you may even find yourselves noticing things you want to go back to, look at in more depth. It’s true – this can happen on the computer, but it’s a much easier process when you know what you’re looking for is sitting in your hand within the pages of the book you’re holding, and is not something you’re going to have to hunt through your browsing history to get at.
Tunnel vision is considered a problem because we are hard-wired to give importance to peripheral vision, although as a race we seem hell-bent on destroying any abilities we have in that area. We are programmed to notice something that is moving which should be still, something that has a different colour, a different shape, and our brains process a tremendous amount of information beyond that which lies in our direct focus.
The new P&W book allows us to do both. On the one hand, the book is quite large in terms of page size and lettering, and all sections are very clearly presented. When I’m looking for something specific, it’s very easy to find it. On the other hand – as I leaf through the Cough section looking for sweetish expectoration, I cannot help but notice all the other forms of expectoration appearing on the page. As I take a broader look at the page, I cannot help but notice how frequently Phos and Puls seem to stand out in their four point bold capitals, and notice the incidence of other remedies in these rubrics too. Looking at the page on Leucorrhea, I find myself wondering why I’m seeing much less of the Sepia I expect, and more of Mercury and other remedies to think about.
The point I’m trying to make is that while you can turn every computerized repertory search into a learning experience if you choose to do so, a hard copy book search will bring things to your attention just by looking through the book’s pages.
Another plus of the book is that it brings the Concordances section into focus and allows for clearer study and use of that section in repertorisation and case management.
The editors have kept their intervention to a minimum, and thus I know what I hold in my hands is faithful to Boenninghausen’s 1846 Therapeutic Pocketbook. To quote from the editor’s introduction:
“…We translated from the original German of the published first edition and had use of the handwritten printer’s edition in Boenninghausen’s own hand. We translated each rubric to bring it into modern English but retained the original meaning of each word and sentence…” P&W’s Synopsis program also has the original German edition, so it is possible to check back to the original rubrics as desired…”
Since I wrote most of the above, my software was knocked out by my antivirus gone rogue. Until I worked out the problem, which ultimately was easy to resolve, I was dependent on the book – and extremely relieved that I had it at hand. I think that for those of us who work constantly with computer software, having a hard copy which offers a faithful non-electricity non-computer dependent version is crucial for those days when nothing is working properly.
Ladies and gentlemen – a mystery. Not really, but I’d like you to look at the symptoms below before scrolling down, and think what remedy proving they belong to.
– Anxiety, thinks he will be ruined (aft. 1 h..).
– Anxiety in the region of the heart, with suicidal impulse, and feeling of inclination to vomit in the scrobiculus cordis.
– Trembling anxiety, as if about to die (aft. 1 h.).
– Anxious solicitude about his health.
– Restless state of the disposition, as if he did not do his duty properly (aft. 18 h.).
– Extreme hesitancy.
– Neglect of his business, hesitancy, sobbing respiration and loss of composure.
– Sometimes he wants to do one thing, sometimes another, and when he is given something to do, he will not do it (aft. 10 h.).
– Dull, cross, very chilly.
– Sullen, lachrymose, anxious. [Stf.]
– He is very silent. [Fr. H-n.]
– He hesitates in his speech; it vexes him to have to answer.
– Everything disgusts him; everything is repugnant to him.
– Her head is so quiet and all about her is so empty as if she were alone in the house and in the world: she does not wish to talk to anyone, just as if all around her were no concern of hers and she belonged to nobody. Continue reading →
Now you tell me, which of the following is more interesting:
“Sepia is suited to tall, slim women with narrow pelvis and lax fibers and muscles; such a woman is not well built as a woman… the remedy seems to abolish the ability to feel natural love, to be affectionate… she may even be estranged and turned aside from those she loves. This is on the border land of insanity… (Kent’s lectures)”
Sepia is suited to all men and women who exhibit symptoms pertaining to that remedy, to be determined first with reference to the proving and subsequently to other materia medicas. (VR et al, 2015)
Sulphur is a huge remedy. With 1969 symptoms listed in the Chronic Diseases proving, it is unwieldy to “just look at”.
You can work with provings just as you would use maps to get to know a new city. Perhaps Sulphur is an ideal proving to show the importance of this way of working. When visiting a place you have not been before, it’s often interesting to get to know it on foot, with no prior information, absorbing the sights and sounds and getting interestingly lost. Continue reading →
STATINS, the controversial heart drugs, add only three days to a patient’s life, research reveals.
By Lucy Johnston, Daily Express
The study contradicts the widely held view that they save lives and last night health experts demanded a radical overhaul in the use of the drugs – which have been linked with severe and debilitating side-effects such as diabetes, muscle pain and cataracts – claiming the research reveals patients have been “misled” over “exaggerated” benefits.
The British Medical Journal, which published the findings, called for a review of prescribing guidelines for statins which are routinely given to up to 12 million patients.
Professor Jesper Hallas led the research, which assessed 11 major studies on statins, including patients at lower and high risk of heart disease. It followed patients for up to six years. The research compared patients who took the drugs with those who unknowingly took a placebo. It concluded: “Statin treatment results in a surprisingly small average gain in overall survival within the trials’ running time.”
Statins increased life expectancy by just three days for those people who did not already have a diagnosis of existing heart disease or associated symptoms. Patients who had already suffered a heart attack, stroke or associated symptoms increased their longevity by four days by taking statins.
Professor Hallas, an expert on medicines at the University of Southern Denmark, said: “I have heard a lot of patients complain they cannot tolerate statins and they are told they have to put up with it. If I suffered side-effects from statins I would stop taking them, even if I was at high risk of heart disease.”
However, he said more research was needed to confirm his findings. His team is now carrying out work to assess whether statins reduce the risk of non-fatal heart attacks and strokes.
British Medical Journal editor Dr Fiona Godlee said: “The recommendations for the prescribing of statins should be reviewed in the light of this information.”
Dr Aseem Malhotra, a London-based cardiologist who has analysed the effects of the cholesterol-busting drugs agreed. He said: “This study strongly suggests the benefits of statins have been grossly exaggerated.”
Dr Malcolm Kendrick, an expert on heart health, said: “Patients have been manipulated and misled over these drugs.”
Earlier this year this paper revealed statins have been linked to almost 20,000 reports of side-effects – including muscle pain, cataracts, liver dysfunction, diabetes, fatigue and memory loss – and 227 deaths.
Doctors are currently recommended to prescribe statins for anyone who has a 10 per cent risk of heart disease within a decade.
As practitioners reading this blog will confirm, we often learn the most valuable lessons from our patients.
A patient mentioned to me that recently she found herself irritable and snappy, and didn’t quite know why. It turned out that since she stopped drinking coffee on a previous homeopath’s instructions, she had been drinking large amounts of chamomile tea. Continue reading →