Tag Archives: Boenninghausen

The Rationale behind the P&W Therapeutic Pocket Book

The P&W TPB is primarily an English language facsimili of the original 1846 edition of the aid to Materia medica as designed by Boenninghausen.

Vladimir Polony and Gary Weaver translated the German text into English utilising Medical Dictionaries of the time period. Vladimir, although fluent in German, also was ably helped by NATIVE German speaking colleagues to define language nuances and changes in meaning of words over a 200 year gap. Once the old German was translated into new German, but retaining the meaning of the original intention, we were then able to translate into English. Continue reading

Homoeopathy? Easy peasy…

Pulsatilla, anyone?

Pulsatilla, anyone?

“If it’s so easy, why isn’t everyone working this way?”

I was asked this question at a seminar I gave several years ago. This is a question that frequently puzzles us at the IHM. Because it is easy.

True, a lot of hard work is needed to get expertise, and then to improve expertise. To read, re-read, and analyze materia medica. To read and discuss cases. To comb the Organon and Hahnemann’s other writings for better understanding of the underpinning of homoeopathy – essential for prescription and case-management; for case-taking clues; for accurate work with remedies.
It’s not always easy to get rid of our preconceptions regarding remedies, to learn to be able to prescribe Pulsatilla on prescribing symptoms whether the patient is a sumo wrestler or a petite, sweet blonde. It’s not always easy to focus on absolute, presenting symptoms when our learned “knowledge” is giving us all kinds of useless hints regarding constitutionals, core delusions, sensations and similar.

Jewish tradition records a story of someone who came to a venerable Rabbi and asked him to explain the entire teachings of the law while standing on one leg.

Well here’s homoeopathy on one leg. Take your case. Take only what has changed and is presenting for prescribing, against the backdrop of the patient’s life and habits. Only use symptoms you could swear to in a court of law. Use symptoms which show the individual expression of illness in your patient.  Look for a remedy that can produce similar symptoms in the healthy, and thus create a similar, slightly stronger, artificial state in your patient. Find the core of that information in the proving. Prescribe.

Still standing here…

The thing is, once you drop the theories, the speculations, once you move away from trying to be clever and insightful, you start looking at what is in front of you. You work with the information the patient gives you about his state of illness (morbid state) – not with your speculations about his personality, or information about whether he’s always loved chicken, or whether he played with Barbie dolls as a child. You work with what you can know about remedies – information contained in the provings. You work with some information gleaned from poisoning and clinical work.  Some of this information was chosen by Hahnemann for inclusion in his provings.   This information should only be taken from the most reliable practitioners (in case you didn’t get it, at the IHM we focus mainly on Hahnemann and Boenninghausen’s work). You put it together and prescribe.

Aphorism 3, my friends. And as the learned Rabbi is reputed to have said, now go and learn the rest…

Viewed through proving: Sepia has left the gym…

exercise sudoku“… It is a sluggish state of the body which requires exercise, and violent exercise to keep it in a state of comfort. …The … symptoms are … better from exercise in the open air…”

What remedy does this describe? Sepia, of course. We all know that Sepia is better for lots of exercise. Don’t we?

This is where it gets interesting. In the proving, for the most part when any physical exertion is mentioned, it’s actually a cause for aggravation. Not amelioration. Walking is mentioned over 90 times in this proving. Around 7 instances are in the introduction, and amelioration from walking appears around 8 times in a proving containing 1655 symptoms. All the rest – approximately 75 mentions of aggravation from walking by my count. Around 21 on these mentions relate to walking in the open air, and Sepia provers did note sensitivity to cold, but that still leaves us with over 50 instances where walking aggravated.

The opening sentences are quoted from Kent’s lectures – most of those reading this probably first met Sepia through Kent. We met this unfeminine female, who is cold, angular, depressed, worn out, and needs violent exercise to keep her human. Add to that the image of the ink-spitting cuttlefish, attacking with sudden sarcasm and retreating – it all gets very picturesque, so to speak. The problem with all these images is that they stick so firmly in memory that even once you know they are fallacious they are very difficult to dislodge. I remember a live case where the homoeopath pointed at the patient, who shrank back in dismay, and declared in tones that brooked no argument – “behold Sepia, fix the image of this patient in your memories!” Needless to say (after such an intro) Sepia didn’t work…

It gets even more interesting however when we look at the therapeutic pocket book, where Boenninghausen included Sepia in amelioration from physical exertion – in 4 points. This brings us to the issue of the grading in the TPB, which is often erroneously considered to reflect the intensity of the symptom. The significance of the grading relates to the extent to which that symptom was verified in clinical use. A symptom appearing in 1 point is a completely valid remedy symptom – just one which has been used less and therefore verified less in the clinic. Sepia in 4 points in amelioration from physical exertion means that Boenninghausen saw this amelioration over and over again, sufficiently so to include it in his carefully and meticulously crafted TPB. Sepia also appears in the TPB under different expressions of aggravation from physical exertion, but only appears in one, two or three points.

So we have the proving – pointing to aggravation from physical exertion, repeated over and over again by provers and by Hahnemann himself in his introduction to the proving. And we have Boenninghausen’s TPB weighting the balance in the direction of amelioration from physical exertion. What’s the “take home” from all this?

I’d suggest the following:

1. Blank out the Kentian “image” (and those presented by other homoeopaths before and since). This image is not helpful for accurate, focused prescribing.

2. Amelioration from physical exertion was presented by Boenninghausen – a master clinician. This strengthens a modality which only found moderate expression in the proving. There is nothing to negate the symptom, and many clinical cases, together with Boenninghausen’s grading in the TPB, to support it.

And possibly most importantly:

3. If Sepia looks like a good fit but the patient is not ameliorated from physical exertion, or is even aggravated by it – don’t rule out Sepia. If it looks like the best remedy for the case, give it. Even if the patient is fair, round, has blue eyes, and is a 15 year old boy…

How to take the case and find the similimum-E.B. Nash

 Many failures to select the right remedy for the sick are due to a failure to select the line of properly taking the case. We might as well under take to recognise a person by looking at his hand, or hand and foot, as to cover the case with the appropriate remedy from a few symptoms when there are many to come into the complete picture.

Oftentimes in a case half reported the very symptoms that are most important, so far as the selection of the remedy is concerned, are left out. This is especially true with the homeopathic system of prescribing. It is so natural for a patient to think that if he tells us that he has a cold, or indigestion, or rheumatism, that we ought to be able to prescribe for him forthwith, and strange to say, I have met more than one physician who seemed to have no better conception of homeopathy than this; and evidenced it by asking such questions as , “Doctor, what is your best remedy for diphtheria”, or rheumatism, etc.

There is of course, only one proper answer to such a question, from a homeopathic standpoint, viz, the indicated one.

The name of a disease may be helpful so far as calling to mind a class of remedies that have been found curative, but the symptomatology of the case in its entirety, and especially in those symptoms which are peculiar and characteristic, in correspondence with the remedy which in its pathogenesis has the same, must decide which ONE of the class is the true similimum.

But some one will object, I cannot wait to hunt down a case like that. Life is too short. I answer “Then you will wait for your cure, and life may be too short for that”. Of course recovery may come (no thanks to us), but never cure.

Then if Similia Similibus Curanter is true, the taking of case in the entire range of its symptoms is of first importance.

Where shall be begin?

LOCATION

In the majority of cases, the patient will locate the trouble without your asking questions, as “Doctor, my head is troubling me.” It may be headache, vertigo or an eruption. It may be in the chest, as pneumonia,pleurisy, pericarditis or organic heart trouble; or it may be in the abdomen in the region of the stomach, liver, kidneys, or pelvic organs. In all such cases the patient will locate the pain, or other suffering, and we must if possible interpret in the light of our knowledge as physicians, and at the same time bear in mind the remedies known to produce similar pain and suffering, in the same localities. Or, if not borne in mind, all that remains for us to do is to hunt them up in our repertories, or Materia Medica. For instance: Is there a pain in the upper right chest, Arsenicum acts characteristically there.

Right middle chest? Belladonna, Sanguinaria, Calcarea ostearum, etc.

Lower right? Chelidonium, Kali carbonicum, Mercurius

Left  upper? Myrtus, Pix liquida, Theridion, Sulphur, Tuberculinum, etc

Left lower? Natrum sulphuricum, Phosphorous

Here I have named a few remedies that have a particular affinity for these locations in the chest, and in all these cases, this is generally in connection with lung troubles, and further examination will disclose the remedy  most appropriate.

If such pains in the chest region should occur outside the lung itself, it might indicate Bryonia, Squilla or Sulphur in pleuritic troubles, or Arnica, Cimicifuga, Ranunculus or Rhus tox in rheumatic pleurodynia, or intercostal rheumatism.

It is not the province of this writing to draw the distinction between remedies, which the case in all its local manifestations, concomitants and modalities would suggest, but to impress upon our minds the importance that must attach to locality.

But one will truly object that sometimes the sickness or suffering does not localise. The patient in answer to the question as to where the pain or suffering is located, answers : “All over, I feel badly all over; weak, aching, sore and trembling.”

This might be a case of incipient typhoid and Gelsemium or Baptisia would be in place, or the prostration might be a result of some drain on the system, as haemorrhage, leucorrhoea or loss of semen, and call for such remedies as China, Phos ac, Nat mur, Kali carb or Stannum.

Still although the trouble does not manifest itself in any particular part or organ (and some would relegate it to the realm of Sensation), I think it might come under the head of location, like absence of pain would come under the head of sensation. It is located all over and in no particular part. It is under the head of location in a negative sense and significant. Now, in either case we have made a good beginning in taking the case, and the next step is as to

SENSATION

Trouble in what location? What about it? Is it pain, coldness; heat or burning; sweating; cramping; emptiness; fulness; or any other abnormal sensation? Describe it as nearly as possible.

Is it a burning pain or sensation? Apis mellifica, Belladonna, Arsenicum, Cantharis, Capsicum, Phosphorous and Sulphur all have that very markedly

Is it sticking pain? Then Bryonia, Kali carbonicum and Squilla come to mind.

Sense of fullness? Aesculus, China, Lycopodium and Carbo veg; especially if in the abdomen, pelvis or anus.

Is it a sense of emptiness or goneness? Cocculus, Ignatia, Phosphorous, Sepia or Sulphur.

Constriction? Cactus grandiflora, Natrum muriaticum, etc.

Cramping? Cuprum, Colocynth, Magnesia Phosphorica.

Faintness? Ignatia, Hepar sulphuris, Nux moschata, Nux vomica, Sulphur.

Numbness? Aconite, Lycopodium, Platina, Rhus tox, Secale, are prominent.

And we might go on to mention many more sensations that have been observed in so-called disease and pathogenesis of drugs. These sensations are for purpose of prescribing, invaluable to the homeopathic physician, and occur in almost every abnormal state to which flesh is heir.

Not of less importance in the taking of the case than Location and Sensation is that which is termed

MODALITY

What aggravates or ameliorates?

First, as to time. Are the symptoms worse in the morning? Remember Nux vomica, Nat mur, Podophyllum, etc

Forenoon? The same.

Afternoon? Belladonna, Lycopodium, Apis mellifica.

Evening? Aconite, Pulsatilla, etc

Night? Arsenicum , Mercury, Rhus tox.

After Midnight? Arsenicum (1 to 3 A.M.), Kali carbonicum (3 A.M.), Rhus tox.

As to circumstances:

Aggravation on movement calls for such remedies as Bryonia, Nux vomica and Arsenicum

Amelioration of movement : Rhus tox, Pulsatilla, Ferrum, Lycopodium

Aggravation on descending : Arsenicum and Calc ost

Aggravation in wet weather : Dulcamara, Rhus tox, Natrum sulphuricum, Nux moschata, Rhododendron

Aggravation in dry weather : Hepar Sulphuris, Causticum, Nux vomica

Ameliorated by hot applications : Arsenicum, Magnesium phosphoricum

Ameliorated by cold applications : Apis mel, Pulsatilla

Aggravation in cold air : Hepar sulphuris, Arsenicum, Nux vomica, Silicea

Aggravation in warm air or weather : Antimonium crudum, Bryonia, Pulsatilla

Aggravation after eating : Nux vomica, Bryonia, Pulsatilla, Arsenicum

Amelioration after eating : Iodine, Chelidonium, Anacardium, Petroleum

Aggravated after fat food : Pulsatilla, Carbo vegetabilis

Fat food agrees and is desired : Nux vomica and Nitric acid

All these and many more may be classified under the head of what are by some called Generals. Another class is termed Particulars, because referring to regions or particular organs such as:

Diarrhoea aggravation in the morning : Sulphur, Bryonia, Podophyllum, Natrum sulphuricum and Rumex

At night : Arsenicum, China, Mercury, Psorinum.

Chest affections aggravation worse when lying : Psorinum, Laurocerasus.

Amelioration sitting : Arsenicum, Kali carb

Anal trouble, worse after stool : Aesculus, Aloe, Muriatic acid, Nitric acid, Sulphur.

Many more are there which are both general and particular just as important to show the equal importance of Modalities with Location and Sensation. To try and produce them here would be to incorporate a large part of Boenninghausen’s Pocket Book, and all the repertories extant.

We cannot use space to mention any of the many possible concomitants (another of Boenninghausen’s divisions), which are no less important than the preceding in the necessary “make-up” of a case, but will come to the apparent.

CAUSES

of diseased conditions. Boenninghausen includes these under the head of modalities, but they ought in my opinion to be seperated, as they often equal in importance the other three.
For instance was it fright? Aconite, Gelsemium, Ignatia, Opium, Lycopodium and Veratrum album occur to us.

Exposure to dampness or cold air : Dulcamara, Rhus tox, Natrum sulphuricum, Nux moschata 

or exposure to dry cold air : Aconite, Bryonia, Hepar Sulph, Causticum.

Cold bathing? Antinomium crudum, Rhus tox, Sulphur

Suppression of an eruption? Sulphur, Psorinum or other anti-psorics.

A badly treated or suppressed gonorrhoea? Thuja, Medorrhinum

We might under the head of causes mention many more than we have, but the skillful homeopathist will not under-rate any of them in his examination of the sick. And now, though coming late, we must not fail to call attention to another important thing for consideration, namely

CONSTITUTION AND TEMPERAMENT

Some would have noticed this first, and it is certain that the “personal” of the patient cannot be ignored and their diseases often present symptoms that find their similar in a certain class of drugs. Dr. TL Brown, one of the best prescribers I ever knew, used to say, that is he met a pure Pulsatilla temperament he would always find the symptoms and conditions to correspond. That is putting it strong, and it might be found that Nux vomica would be indicated in a Pulsatilla subject. These are the exceptions that prove the rule.

Sulphur will rarely be called for in a Calcarea ostearum temperament, an vice versa.

Iodine, Lycopodium and Nitric acid are three of the remedies that often find their indications in brunettes of spare habit, and so we find them in the remedies oftenest adopted to the sanguine, nervous and bilious subjects. Not only is this true in regard to the choice of remedies, but the rule holds good in the proving of drugs. The subject most responsive to the curative action of certain remedies will also be the most susceptible to their pathogenetic effects. Some undoubtedly place too much stress upon this feature in taking the case, and thus run into routinism, while others underestimate it. There is a point where extremes meet and form the completed circle.

Constitution and temperament must certainly come into the totality of the case.

This method of taking the case is the one adopted by Boenninghausen, and the outcome was his celebrated Therapeutic Pocket Book. There is another method in use, and employed by some of our best prescribers, which is also a good one, which I will illustrate by a case so taken. The symptoms are grouped under two heads Generals and Particulars:

Sr Generals 
(symptoms as given by the patient)
Generals
(Same as found in the repertory)
1 Worse from physical exertion Aggravation by physical exertion
2 Tendency to take cold Tendency to take cold
3 Efforts to think made the mind seem blank Aggravation by mental exertion
4 Easily hurt by what people say or do Sensitive
5 Mind dwells on breaking up of home Dwells on past disagreeable events
6 Which is a lasting grief Ailments from grief
7 She could not think or remember well Weakness of memory
8 Attacks of low spirits lasting days Sadness and mental depression
9 Has lost all ambitions Loss of ambition
10 Would hardly speak, even when addressed Aversion to talking
11 Fear of death, if left alone Fear of solitude
12 Trembling when tired or excited. Trembling externally
13 Felt as if going insane Fear of insanity
14 Worse after eating sweets Aggravated by sweets
15 Always weak since scarlet fever After scarlet fever
16 Felt very tired Weariness
17 Nervous prostration Nervous weakness
18 Lying down relieves Amelioration by lying down
19 Feels tired and bad in the morning Aggravation in the morning
20 Great menstrual difficulty Painful menstruation
21 Menses profuse Menses profuse
22 Menses long lasting Menses protracted
23 Menses too early Menses too early

 

Sr Particulars 
(symptoms as given by the patient)
Particulars
(Same as found in the repertory)
1 A bursting pain the front part of the head Bursting pain in the forehead
2 Redness of the nose Redness of the nose
3 Discharge from nose, bloody mucus Discharge from the nose, bloody
4 Nose is full of scabs Nose scabs
5 There are brown spots on the face Brown spots on the face
6 An unclean taste in the mouth in the morning Bad taste in the mouth
7 Intolerance of anything in her throat Throat sensitive to slightest touch
8 Stomach gets sour Sour eructations
9 Has heart burn Heartburn
10 Sensation of stone in the stomach Sensation of stone in stomach
11 Wind in stomach Flatulence in stomach
12 Stool is partly expelled and then recedes Stool slips back
13 Smarting pain in rectum Smarting pain in rectum
14 When not constipated stool is expelled like shot Stool shooting out
15 When desire for micturition is felt it has to be satisfied immediately, or urine cannot be retained Must hasten to urinate or urine cannot be retained
16 Colds of a croupy form Croupy
17 Hairs turned gray Hair becomes gray
18 Sensation of weight on her chest Heaviness in chest
19 Seems as if would strangle when coughing Choking when cough
20 When hurt very excited and heart palpitates Emotional excitement and palpitation
21 Curvature of the spine Curvature of the spine
22 Spine externally sensitive to touch Backs, pains, spine
23 Sudden desire for food which must be gratified Ravenous appetite
24 Palpitation caused by lying on left side Palpitation when lying on left side
25 Upper part of spine is stiff Stiffness of cervical region
26 Rubbing ameliorates Numbness ameliorated by rubbing
27 Burning in the back Heat up the back

This was the case, and was of one years standing. Before “chasing it down” in the repertories I predicted that Phosphorous would be the remedy. It was worked out by another physician, and when she got through the Generals she came to me with a smile and showed the result: Natrum muriaticum, 44; Pulsatilla, 39; Phosphorus, 38; Nux vomica, 38; Calcarea ostearum, 38; Sulphur, 37; Lachesis 32; Mercurius, 32.

“How about Phosphorus?” said she. I answered, work out the rest of it. The particulars stood : Phosphorus, 41; Nux vomica, 39; Sulphur, 37; Lachesis, 33; Pulsatilla, 31; Lycopodium, 27; Arsenicum, 27; Mercurius, 28; Calcarea ostearum, 25; Natrum muriaticum, 24.

Summary : Phosphorus, 79; Nux vomica, 77; Sulphur, 74; Pulsatilla, 70; Natrum muriaticum, 68; Lachesis, 65; Calcarea ost, 63; Mercurius, 60.

(After this work is done, I find that about the first seven remedies may be taken for further comparision. Not only the totality of symptoms, but those that are characteristic and peculiar. (See Organon paragraph 151), must be recognised. For instance if with the two remedies, Nux and Phos in the case, Phos had five characteristics, while Nux had ten, the later remedy would deserve preference and further examination of the pathogenesis, verified and unverified, would place it there. This is where the judgement and skill of the man with long experience and practice in the art of prescribing becomes invaluable)

Now I do not claim that I can with certainty always predict the remedy that will come out ahead. I remember another Phos case in which I predicted that Calc ost would be the remedy, and the result of the “hunt” placed it second.

To the skillful and experienced physician, the case so taken may sometimes stand out prominently in its characteristic and peculiar symptoms as to carry on its very face the sure indications for the remedy. But other cases will come to us so complicated that the best of us must make long and arduous study of it. Especially this is true in chronic diseases.

None, but the true homeopathic physician realises the importance of throroughly taking and working out such cases.

Rarely will a case come out so clearly that the cure can be performed with one remedy, but a succession of remedies will be necessary, and here is where the so-called complementary relations of remedies come in for recognition and skillful application.

  1. S.: On reviewing the foregoing, I feel constrained to add, lest we be charged with not being up-to date, especially in pathology, that for purposes of diagnosis, the tests for evidence of disease, bacteriological, chemical, etc should not be neglected. The urine, sputum, blood, excretions, etc, furnish important signs.

But for the purpose of prescribing, we do well to remember the teachings of Raue, who stood high both as a pathologist and prescriber. He said : “The symptoms which go to make up the choice of the remedy often stand outside those that go to make up the pathology of the case.” Every prescriber accorsing to Similia Similibus Curanter understands this.

Learning from History

Answer to Back pain Patient Prescription.

The repertory used for analysis was the 2015 P & W Edition of the Therapeutic Pocket Book (original 1846 release) by Boenninghausen.

Boenninghausen to Hahnemann

Haehl’s “Life of Hahnemann” [Volume 2 page 293-294]

From a Letter to Hahnemann from Boenninghausen, 1837

“…But I have many good reasons for strictly adhering to your precepts, among which the foremost is , that your axioms when rightly applied have never yet led me astray, and, therefore, I consider it absolutely necessary for the sake of the good cause, that your school should keep free from any foreign admixture.
The old luck which I have experienced in the practice of homeopathy has not forsaken me, and I attribute that solely to the care which I employ in making the choice of the remedy, together with the smallness of the doses which I administer with sparing repetition.”

Musings on Case-Taking

Dr gBy Gary Weaver

One of the things that is always in the forefront of my mind when taking a case, is that I need a picture of the diseased state in a complete form. It is often said in anecdote that homoeopaths treat the person and not the disease. Sadly, this is not quite the case, and for many physicians, has led to confused patient treatment and failure to halt or remove the disorder the patient is suffering from.

I do not need a picture of the patients preferences or desires, I need a picture of the disease as EXPRESSED by the patient.

For the observing physician, the above statement should encourage the re reading of case taking directives by Samuel Hahnemann, especially Aphorism 6. Without a full comprehension of what is involved in case taking, the physician will flounder and drown in too much irrelevant detail and become overwhelmed with the pages of notes that has been collected.

For those of you who have been through the various college systems, I can almost guarantee that you have not been taught Hahnemann case taking, as refined through the years of observation and experimentation by the originator himself. Im pretty sure that you have been sidelined by the new and wonderful methods of modern gurus of homoeopathy, which have deviated from the real medical practice of homoeopathy so much that our profession is in danger of imploding through lack of proper medical application.

I would expect from myself and staff in a busy clinic setting, and Im talking about a case load of 30-70 patients a day, a first prescription accurate matching of remedy to disease state of 75%-80%. In order to achieve these results, there has to be scrupulous adherence to protocol in the case taking, an accurate repertory, and a willingness to quickly review the Materia Medica as final arbiter for prescription.

Please read the following and see what useful information you can glean for your own practice.

§ 6 Sixth Edition
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

Gary Weaver

“If it is not done with exactness, let no one boast to have imitated me, nor expect a good result”

It is difficult to shift one’s mindset from an allopathic to a homoeopathic mode of interpreting and treating illness. However, once that shift is made, the new way of seeing things comes sharply into view, almost like the moment you are able to see an apparently three-dimensional image jump out of a two-dimensional page. Once you see it, you cannot “unsee” it.

Oddly enough, it seems to be even harder to make the shift from a Kentian, constitutional view of homoeopathy, to return to the original basics as practised by Hahnemann and Boenninghausen. Perhaps because so much is similar – even if the mistaken Kentian premise has catapulted the entire therapeutic method along a completely different trajectory than originally intended. The same terminology is used, often the Organon is quoted (usually minus Aphorism 6), the same polychrests show up, and despite the plethora of new and fantastically proven remedies (fantastic as in fantasy…), often many of the same older remedies are used.

Which brings me to a footnote that appears towards the end of the theoretical part of Chronic Diseases. I have always seen this quote as very clearly expressing the importance of experience over intelligence, the importance of recognizing and learning to use what works even if we don’t understand it. However, I find within this particular context, the following sentence stands out: “If it is not done with exactness, let no one boast to have imitated me, nor expect a good result.”

Or in colloquial British, ’nuff said. Over to Hahnemann:

  … It requires quite an effort to believe that so little a thing, so prodigiously small a dose of medicine, could effect the least thing in the human body, especially in coping with such enormously great, tedious diseases; but that the physician must cease to reason, if he should believe that these prodigiously small doses can act not only two or three days, but even twenty, thirty and forty days and longer yet, and cause, even to the last day of their operation, important, beneficent effects otherwise unattainable.

Nevertheless this true theorem is not to be reckoned among those which should be comprehended, nor among those for which I ask a blind faith. I demand no faith at all, and do not demand that anybody should comprehend it. Neither do I comprehend it; it is enough, that it is a fact and nothing else. Experience alone declares it, and I believe more in experience than in my own intelligence.

But who will arrogate to himself the power of weighing the invisible forces that have hitherto been concealed in the inner bosom of nature, when they are brought out of the crude state of apparently dead matter through a new, hitherto undiscovered agency, such as is potentizing by long continued trituration and succussion.

But he who will not allow himself to be convinced of this and who will not, therefore, imitate what I now teach after many years’ trial and experience (and what does the physician risk, if he imitates it exactly?), he who is not willing to imitate it exactly, can leave this greatest problem of our art unsolved, he can also leave the most important chronic diseases uncured, as they have remained unhealed; indeed, up to the time of my teaching. I have no more to say about this.

It seemed to me my duty to publish the great truths to the world that needs them, untroubled as to whether people can compel themselves to follow them exactly or not. If it is not done with exactness, let no one boast to have imitated me, nor expect a good result.

Do we refuse to imitate any operation until the wonderful forces of nature on which the result is based are clearly brought before our eyes and made comprehensible even to a child? Would it not be silly to refuse to strike sparks from the stone and flint, because we cannot comprehend how so much combined caloric can be in these bodies, or how this can be drawn out by rubbing or striking, so that the particles of steel which are rubbed off by the stroke of the hard stone are melted, and, as glowing little balls, cause the tinder to catch fire? And yet we strike fire with it, without understanding or comprehending this miracle of the inexhaustible caloric hidden in the cold steel, or the possibility of calling it out with a frictional stroke.

Again, it would be just as silly as if we should refuse to learn to write, because we cannot comprehend how one man can communicate his thought to another through pen, ink, and paper -and yet we communicate our thoughts to a friend in a letter without either being able or desirous of comprehending this psychico-physical miracle! [these days, we can add so much more to this list, driving a car, using a computer, using a cellphone and more…vr]

Why, then, should we hesitate to conquer and heal the bitterest foes of the life of our fellowman, the Chronic diseases, in the stated way, which, punctually followed, is the best possible method, because we do not see how these cures are effected?

Desires Refreshing things-What do you mean?

I present this post  originally posted by Vera Resnick on her blog.

One of the things Vladimir Polony and myself try to do, is explain what we learned when researching the meaning of words in the Therapeutic Pocket Book during translation to English. The meaning of words have change tremendously since the 19th century. Vera did some research on the word erquickendem and gives her finding below. I would also like to add one description that was found in our research, and that was “nervous stimulation”. In itself it means nothing but when combined with other phrases, a rounded comprehension of the meaning can be deciphered. We also refer to each remedy noted in the rubric, and see how the symptom is described, and compare with the other remedies.

*************************************

A refreshing cuppa char!

A refreshing cuppa char!

Yesterday I was working on a case of a 17-year-old girl who has an eating problem . She does not seem to be anorexic, but has difficulty with eating.

–   She does not get hungry – she gets stomach cramps which is how she knows she must eat. She also gets a “mouth” sensation that she wants something “with a lot of taste”, but when questioned it turned out that some of the foods she likes that fall into this category include pasta with olive oil and mild flavouring, cheese Danish, and similar. Her concept of “a lot of taste” did not mean highly spiced or strongly flavoured.

–   After she has eaten a small amount, she feels both full and disgusted with the food she has eaten.

I mentioned this case to Gary, and he asked “have you considered the rubric for desires refreshing food?”

Remedies for this rubric: Carb-an, Caust, Cocc, M-art, Ph-ac, Phos., Puls., Rheum, Valer.

The word “refreshing” has always put me in mind of watermelon, cucumber salad, chilled fruit juice, or (like the Brit I am), a strong cup of tea. But however much I love a really good shepherd’s pie, I have never considered it “refreshing”. However Gary’s question got me thinking: what does “refreshing” mean? And are the foods and drinks that come under this definition more or less objective – or is it an issue of why the patient requires a food (to refresh himself), rather than the nature of the food itself?

In this particular case I had considered remedies such as Lyc, Calc and Puls – which I had given to the patient on several occasions but which had never quite touched this symptom.

I did some research. The original German word is “erquickendem”, which a German linguist informed me is probably connected to Middle English terminology of “the quick and the dead”. Looking at thesaurus options for the word “refreshing”, I came across words such as “revive”, “restorative”, and I found myself remembering soporific events which people attended lured in by the hallowed words “refreshments will be served”… which often were far from refreshing in the sense I had understood it, unless insipid tea and dry buns fit the description.

I’m also reminded of the way my father would say  sitting back in his chair after eating something substantial that he had really enjoyed, “that was fit to revive the dead…”.

Back to our (refreshing?) onions…
I took two rubrics in this case:
Hunger and Thirst, Desire, Refreshing (306)
Hunger and Thirst, Hunger, Appetite without (274)

screenshot refreshing post

These rubrics led me to Rheum, a remedy I had not considered at all in this case. The Materia Medica Pura includes these symptoms, amongst others, and in general Rheum reads very well for many of the other symptoms in this case.

49. Great appetite, but the food though tasting nice soon becomes repugnant. [Gss.]
50.  Whilst he loathes certain things (such as fat, insipid food), appetite for a variety of things, but he cannot eat much of them, for they immediately become repugnant. [Gss.]
51. The food does not taste right, and soon becomes repugnant, though he has tolerable appetite. [Gss.]
52. Anorexia.
53. Hunger, but no appetite.
54. He feels qualmish (squeamish, loathing and inclined to vomit).

There are two issues that I wanted to highlight in presenting this case:

1. Our understanding of remedies and symptoms are inevitably complicated by nuance of language, by the way the sensations are literally lost in translation, first from the sensation itself into spoken language, and second from one language to others. This applies both in the way our patients report their symptoms, and in the way the symptoms of the provers were reported as presented in the Materia Medica. It emphasizes the need to look at older meanings of words we may think we understand when using the repertory and when reading provings on which the repertory was based. And it also means that we have to use the question “what exactly do you mean by that” frequently in our case-taking.

2. The repertorization is not intended to summarize the case in two rubrics, and in this example, not even to identify all the most important aspects of this case. It is really a tool,  intended to find some essential salient elements that will point a guiding finger towards relevant remedies that we need to look at in the Materia Medica.