Tag Archives: Case taking

Post Covid symptoms that persist.

Sometimes this infection persists in some people.

Symptoms of long COVID

There are lots of symptoms you can have after a COVID-19 infection.

breathing20problemsCommon long COVID symptoms include: (taken from the NHS website)

  • extreme tiredness (fatigue)
  • shortness of breath
  • chest pain or tightness
  • problems with memory and concentration (“brain fog”)
  • difficulty sleeping (insomnia)
  • heart palpitations
  • dizziness
  • pins and needles
  • joint pain
  • depression and anxiety
  • tinnitus, earaches
  • feeling sick, diarrhoea, stomach aches, loss of appetite
  • a high temperature, cough, headaches, sore throat, changes to sense of smell or taste
  • rashes

Homoeopathy has remedies which can produce these symptoms.  A skilled practitioner can induce the immune system to combat the effects with the specific remedy that covers the presentation of the symptoms experienced. There is no single ‘blanket homoeopathic remedy’ that will cure, only the gentle restoration of health via the individualising of symptoms and the appropriate remedy at the right time.

immaculate-but-homely (1)We can treat as an out patient in our clinic. Should a person want a rest and homoeopathic advice, we offer a 3 or 7 day stay at our Bed and breakfast residence in Eastbourne.

The residential stay will be starting late August or before if the small remodeling is completed.

 

Difficult cases. Leg unknown infection.

In Seville, Spain, a long time patient of my colleague Manuel went into hospital for several weeks after developing a strange leg infection. The skin was peeling and deep cracks appeared in the heel and ankle of the right foot. These photos were taken after being released from hospital.

Manuel asked Antonio and myself to come to the clinic and observe and offer suggestions. As you can imagine, walking was difficult and the lady was in a lot of pain.

We put her in the reception room as it was easier for her to sit there, and raised her leg onto another chair to view the issue.

We took an hour looking at it. I examined thoroughly, came to no conlcusion as to the cause, noted that the hospital treatment of antibiotics had reduced the infection a little but the problem persisted.

She cried when we touched the areas of skin that has peeled and the inflamed leg. Very painful. I asked what made it better and she said that nothing did.

leg1Going into the bathroom, I moistened a paper towel and came back and placed it on her ankle and top of her foot. She said how much it felt better. I touched the area and she didnt notice or complain as previously.

 

20170612_17385020170618_112850

Aphorism 153 indicates that we solely keep the view on the characteristic, the strange and the rare in the expression of the disease.

§ 153 Fifth Edition
In this search for a homoeopathic specific remedy, that is to say, in this comparison of the collective symptoms of the natural disease with the list of symptoms of known medicines, in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms1 of the case of disease are chiefly and most solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure.

We also note, Hahnemann indicated the more ‘ striking’ symptom must be taken into consideration. On this basis, I took the following rubrics:

leg

I didnt add the locations, simply because MOST remedies are in leg and foot and ankle. I took the effect of the disorder on the person, ie the cracking of the skin in the ankle and heels, and the nature of the disorder in terms of the flaking of the skin. For me, the outstanding modality was the immediate relief from moistening of the skin.

Manuel saw the patient one week later and the patient was walking. The skin was healing, still red but healing. No more peeling and the cracks had gone. I saw her about 6 weeks later and apart from slight redness, everything was better.

Why 3 rubrics only.?

The choice covered the disorder in its entirety. The modality was a clear indication of the bodys response to the disease. The essential symptom of both in the disease AND the remedy. The TPB showed that only 23 remedies had that modality. Combined with the other two rubrics, Pulsatilla was the only remedy to produce both the amelioration and the characteristics of the problem.

153: for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure. The more general and undefined symptoms: loss of appetite, headache, debility, restless sleep, discomfort, and so forth, demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and from almost every drug.

What is the true understanding of aphorism 153?

“In seeking for the specific homoeopathic remedy, i. e., in this juxtaposition of the phenomena of the natural disease and the list of symptoms of the medicines, in order to discover a morbid potency corresponding in similitude to the evil to be cured, the more striking, particular, unusual and peculiar (characteristic) signs and symptoms of the case should especially and almost solely be kept in view; for there must especially be some symptoms in the list of the medicine sought for corresponding to this if the remedy should be the one most suitable to effect the cure.’

Strange rare and peculiar is a phrase often used in homoeopathic circles, and one in which it appears to give licence for any symptom to be used in the case taking.  However, from the aphorism 153 taken from the 5th edition above, we can see the explanation and understanding of the meaning clearly, or we should if we dismiss the veil of Swedenborgianism from Kent that obscures the true case-taking skills as outlined by Hahnemann.

All disease is a collection of symptoms that define the ‘type’ of disease, and from this collection of symptoms, a disease can be classified and if well known, the pathology and progression and even prognosis can be elicited from knowledge.. and within that disease, we can pick out the defining expression that is peculiar to the reaction of the sick person to its influence. (this is not dismissing those diseases that have never been seen before and affect the host in a very unique way).

Reading carefully, we can see that the symptoms that are to be used, are the ones that define the host’s reaction to whatever the infection is, in a characteristic way AND also are defined in a remedy in a similar manner.

To complicate matters, the defining symptoms, may or may not be known to be within the sphere of the presenting disorder, yet are present.

Let me give an example from a remedy, and from a presenting symptom. It is my experience, that a marked and strange and characteristic symptom can be present and have nothing to do with the complaint, yet will also contain the symptoms taken in the intake.

Take a patient with a respiratory disorder. Lack of oxygen has caused the lips to discolour. Normally will be blue, yet in this patient, the skin is mottled, blue and orange and red, and diffuse over the lips.

Another patient with severe psoriasis, on close examination, has the same mottled skin all over her legs between the eruptions.

Yet another patient with skin allergies has presented patches of the same discolouration across his back.

In taking the case of each, the characteristic symptom is the skin discolouration. using that, regardless of the problem, there are few remedies, if actually only one, that produces that patterning. In the main, you will also find that other symptoms of each individual disorder are present in the remedy.

That remedy is Psorinum.

If a symptom is present to such a marked degree, it can become characteristic of both the disease AND a remedy..

We will talk more at another time regarding characteristic symptoms.

 

 

 

Thoughts on case taking

If you ever want a high paying job other than homoeopathy, Id recommend marine electrician… everyone i contacted is booked out………..

That aside, case taking and why many cases fail.

simply put, it usually is because the wrong remedy is given.

Its not hard to fail. We all do it. In order to overcome a large percentage of failures, we have to examine ‘Why ‘ we fail, and usually, it comes down to a singular reason in the case taking. The bottom line is that we are picking the wrong symptoms, plain and simple.

So what is the key to picking the right symptoms?

During this period of lockdowns and distancing, its a wonderful time to study the Organon in a guided manner……..to REALLY understand what is required to treat a person.

Let me dispel a myth. This singular misunderstanding ruins so many cases that it needs to taught time and time again.

§ 211
This holds good to such an extent, that the state of the disposition of the patient often chiefly determines the selection of the homoeopathic remedy, as being a decidedly characteristic symptom which can least of all remain concealed from the accurately observing physician.

The huge mistake here is not reading the Organon in context. Kent et al use this as the primary state of the patient to prescribe………….and it is incorrect. If you use this as prescribing criteria, you may be prescribing on the personality and not the disease.

Aphorism 210 to 230, is discussing…….

§ 210
Of psoric origin are almost all those diseases that I have above termed one-sided, which appear to be more difficult to cure in consequence of this one-sidedness, all their other morbid symptoms disappearing, as it were, before the single, great, prominent symptom. Of this character are what are termed mental diseases. They do not, however, constitute a class of disease the condition of the disposition and mind is always altered;1 and in all cases of disease we are called on to cure the state of the patient’s disposition is to be particularly noted, along with the totality of the symptoms, if we would trace an accurate picture of the disease, in order to be able therefrom to treat it homoeopathically with success.

So contextually, looking here….

§ 6 Fifth 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.1

No where does Hahnemann state that anything other than altered symptoms be taken into account….dont base the prescription on personality or desires unless altered and opposite to the norm, and of a marked observable nature….

This one shift in taking a case will raise your prescription success rate higher immediately………..

Maintaining Causes and Anxiety.

Over the last year, I have seen an increase of patients with Mature onset anxiety. (Age 58 on). A variety of reasons and a variety of medicines. However, the commonality among the patients is the age. So what could trigger off this debilitating condition?

Minerals.

Recently, I have been looking at water, its composition, the process of filtration from the supply companies and what we actually end up with despite what the label says. Im disappointed to say the least.

We live in a damaged world. Greed and ease of process take precedence over the wellbeing and welfare of humanity. Processed food, genetically modified food and food devoid of essential minerals and vitamins is the norm. My research into anxiety led me to make an astounding discovery, and one which I suspect is a cause for an increase in patients experiencing anxiety disorder.

In 95% of the patients I have with anxiety, they have low Magnesium. Investigations show in the USA that 75% of the population have low Magnesium. It is no wonder that Antidepressants are prescribed so much in the USA. Only 25% of the population have just enough Magnesium to fulfill their needs.

Medical wisdom states that 200 to 300 mg of Magnesium a day will help or rectify a severely anxious person, and true enough it does help. However, if the supplement is stopped, the problem returns.

I am working on the hypothesis that water is the best re up take medium for minerals and have postulated a premise for evaluation and am conducting my experiments as outlined further in this article.  Bear in mind, Homoeopathy and the law of similars is the ONLY medical therapeutic approach I take for applying a cure.

What I am doing here comes under the heading of ‘removing maintaining causes’. If an absence of a required mineral causes a problem, then the answer is to replace the mineral and no medical intervention is required.

In my home, I have this cheap €59 water dispenser. I love it because it holds 7 litres of water and can give room temperature or cold water. Here in Sevilla Spain, the current outside temperature is 42C so the cold dispenser is used a lot. The water is usually either Spring water or Distilled water. I put a gallon of the Spring or distilled water in the top container, and I add a teaspoonful of Himalayan rock salt into it. I stir and leave for about 2 hours. This adds back, firstly TASTE to the water without it being salty, and secondly it adds 84 minerals in balance including Magnesium.

Now I dont suffer from anxiety attacks or generalise anxiety, but I think its likely that I perhaps have depleted Magnesium levels so this will help. It has been my experience that this gentle intake of minerals through water is something that works well and lasts longer.

Drinking Soda and coffee will remove Magnesium… Soda will really block the intake… coffee can be overcome with a glass of mineral rich water.

So why is this being mentioned on a homoeopathic site? Simply because we can be in a hurry sometimes to prescribe a medicine when simple steps can rectify a situation. I would be called to elderly patients exhibiting signs of weakness, spaced out, dizzy, incoherent etc, and the answer was either give them water with electrolytes, (Dehydration) or a multi vitamin infusion.

Im looking at anxiety in the same manner where there is no obvious cause or rationale. Many ‘cures’ have been made with Magnesium replacement and so I feel it pertinent to mention. It is a lack of basic requirements for the body.

A Strange case: answer and analysis. 2/2

The Case:

A lady patient talked to me on the phone from the USA and presented the following disease condition for prescribing.

At first, it was easy to hear her, but as the call went to the 15 minute mark, her voice became harder to hear and was becoming quieter and quieter.

She told me that for the past 6 months, she had suffered from a sore throat and extreme weariness and tiredness of the body. She said her knees felt heavy and weak, her hips also, in fact all her lower limbs were weak and tired. Her profession is a trainer for phone consultants for a technology company, and she had been off work for a couple of weeks due to voice issues. She said she would cough , some phlegm would come up and the tone of her voice would change, usually to a higher pitch, much weaker and empty sounding… sometimes she would be unable to talk at all.

Further enquiry produced the following symptoms. The coughing would induce the phlegm (green) to expectorate. She said the taste was like a spoon of sugar and not pleasant. Along with the cough , there would be a feeling of lassitude and weariness in her arms spreading across the upper chest with difficulty in breathing. She felt better not moving at all and deep breathing helped her to breathe more easily.

She stated that she needed to urinate more frequently at night, but did not really feel an urge, just the fullness of the bladder informed her of the need.

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

There were a number of ways to approach this case. We here at the IHM primarily use the SYNOPSIS P&W THERAPEUTIC POCKET BOOK as our guide to analysis. For those that know this particular remedy, it would not be necessary to repertorize as the SX are clear, however we present analysis from the TPB to show how it is done.

The above are the presentation of the throat sx. We then could look at the other sx associated:

These two reportorising sheets are for demonstration only to show a choice of SX to use in rubric form. If we converge them we get:

We do not advocate using more than 4-6 rubrics to cover a case, as the TPB works best on accurate sx and will lead to a choice of few remedies quickly.

Indeed, this is how I repertorised:

In looking at the patients reaction to the infection, we see that WEAKNESS is the state. A state of lassitude which amplified when coughing into the upper chest and arms. A read of STANNUM in the MM will show this particularity. It will also show the condition of urination and feeling clearly…

I have a practice over the years of reading EVERY medicine that am to prescribe until I form an accurate picture of the proven SX in mind… if I have any doubt, I always read again.

 

 

 

A strange case.. not really. 1/2

A teaching case.

If you know this remedy, the symptoms presented would immediately bring it to mind. The disease state as presented is CLASSIC in terms of the match for a remedy. If you do not know the remedy, this case will help you to see the symptom production of the provings.

We will present the answer and analysis tomorrow.

A lady patient talked to me on the phone from the USA and presented the following disease condition for prescribing.

At first, it was easy to hear her, but as the call went to the 15 minute mark, her voice became harder to hear and was becoming quieter and quieter.

She told me that for the past 6 months, she had suffered from a sore throat and extreme weariness and tiredness of the body. She said her knees felt heavy and weak, her hips also, in fact all her lower limbs were weak and tired. Her profession is a trainer for phone consultants for a technology company, and she had been off work for a couple of weeks due to voice issues. She said she would cough , some phlegm would come up and the tone of her voice would change, usually to a higher pitch, much weaker and empty sounding… sometimes she would be unable to talk at all.

Further enquiry produced the following symptoms. The coughing would induce the phlegm (green) to expectorate. She said the taste was like a spoon of sugar and not pleasant. Along with the cough , there would be a feeling of lassitude and weariness in her arms spreading across the upper chest with difficulty in breathing. She felt better not moving at all and deep breathing helped her to breathe more easily.

She stated that she needed to urinate more frequently at night, but did not really feel an urge, just the fullness of the bladder informed her of the need.

Using the T.P.B. successfully.

Polony and Weaver have many thousands of copies of the SYNOPSIS software in general use in the homoeopathic community. People write us asking why they cannot find certain locations or symptoms in the Therapeutic Pocket Book and find it limiting because of this. Its not actually true, however there is a small learning curve with the T.P.B.

5 weeks ago, one such comment was made by a local practitioner regarding a patient of his with cancer. He presented me with a 5 page dossier of the case notes and another 3 pages of notes related to working out the case.

I laughed and told him to just tell me the symptoms of the physical disease expression. Within 5 minutes, I gave him a remedy to consider. He was stunned how on, in his words, a prescription could be made on “an incomplete case analysis”.  Big mistake, huge. For the next 20 minutes I went through his case symptom by symptom and demonstrated how each of the expressed sx were covered by the remedy. I showed him HOW the disease could only be considered on altered sx and that all of his mental emotional notes were either unchanged or personality and thus of no use.

He decided to prove me wrong and gave the remedy to the patient. To his amazement, the patient has begun to respond well to the prescription and is doing much better.

How long does I take to work a case out in the T.P.B.? Usually only a few minutes and either a single remedy is found or there may be 2 or three for consideration. A read of them in the MM will decide which should be used.

To use the T.P.B. is relatively easy. To understand the methodology requires a practitioner to change the method of casetaking a little. No bad thing when you realise is really moving closer to the method utilised by Hahnemann. More accurate and more successful.

The IHM will be running 2 day intensives shortly on how to take the case and how to use the P&W Therapeutic Book to maximise results. It seems such a shame to have the repertory that Hahnemann approved and not know how to use it properly.

We will conduct in Spanish and English here is Seville Spain. Contact us if you have a group that would benefit from learning Hahnemanns method.

education@instituteforhomoeopathicmedicine.com

When things you love hurt you.

Female age 35. Computer software writer. Pleasant personality, outgoing, no physical problems found on examination.

Feb 2017, presented with a feeling daily malaise and sickness. She had just started a new job 3 months ago and the problem began one week after commencing. She did not feel stressed or anxious with the job and actually looked forward to going in every day.

The sick feeling started after breakfast 7am, during the ride to work. It was a general feeling of discomfort and feeling just ‘off’. Occasionally when walking she would have to stop with a sensation of nausea.

When sat at her desk, she had a sensation of mild dizziness which ameliorated when she got up and did another task.

She complained of a recurring toothache for which the dentist could find no causation.

Upon enquiry as to the foods she ate, it seemed that she had begun experimenting with changing her diet to see if foods were the problem. She took orange juice, yoghurt, cereals or toast.

She drank about 3 cups of coffee a day. Upon enquiry as to the type of coffee, she said it was Instant as the coffee machine had broken and the management were a little slow in replacing the machine.

In my experience, in some people, coffee especially instant coffee (primarily consisting of the stronger and more bitter Robusta berries) can aggravate the digestive system very strongly. It can cause nausea, retching, a sense of unwellness, vertigo during sitting upright and many other symptoms. One remedy that can produce these symptoms exactly is Chamomilla. I did not need to repertories this case but have done so based on the EXACT symptoms she presented.

Click on rep chart to enlarge.

 

 

I gave her Chamomilla LM 0/1. One single dose. I asked her to NOT drink instant coffee again. She said the result was immediate. Within 10 minutes the sensation of malaise had left. The next day she did not get sick traveling to work and was not dizzy during the day. The coffee machine was replaced a little later and she enquired if she could have coffee again. I told her to try it. There was no untoward reaction from it.

I heard from her in Late April of 2017, no further occurrence of the problem.

Following the instructions.

Its a hard lesson to learn. Not only for the patient but also for the practitioner.

I am not proud to admit that some of my failures in treatment have been because of not understanding WHY Hahnemann wrote to not repeat the medicine whilst improvement was happening in a patient. In my mind, repeating the dose would speed along the process and so in the early days I would re prescribe when improvement was slowing down rather than having stopped.

Here is what we sometime forget, or in many cases, do not know. NO MEDICINE CURES. Once we grasp this simple fact and fully take this on board, we can begin to understand the process of what happens when we prescribe for a patient. It is the immune system of the patient that cures.

A patient will present a set of symptoms that have arisen from an infection or disease process. We collect the information and place the expression of the existing state in a collation of symptoms. We then analyse the problem in terms of the pathology and change from the normal expression of health, and examine each symptom in relation to its:

  • Origins
  • Location
  • Sensations
  • Modifying factors
  • Relationship with other symptoms.

In doing this for each expression of the disease, NOT the preferences or personality of the patient, we begin to see HOW the disease is reflected individually in the patient. With this knowledge, we look for a well proven homoeopathic medicine that has the ability to create a similar set of symptoms, in effect produce an (increased) state of DIS-ease in a healthy person. In administering a medicine of similarity, what we are doing is amplifying what we consider the key symptoms or centre of the disease, and thus making the immune response ´focus´more intensely on dealing with this stronger disease state.

At this point we have modified the immune response to a singular assault on the strongest presenting problem, be it artificially induced, we observe changes in the economy as the process of removing the disease begins. Given that we do NOT know HOW the immune system will work or what it needs to clear first, we need to ALLOW the process to work to completion, or as Hahnemann states, we will ruin the case.

What does this mean in real terms?

In chronic cases, it took a long time for the patient to develop symptoms to the point where they are in the grip of a disease. Each part of the disease process followed another part and laid an extra layer of pathology until the presenting state is before you. We can only remove from the presenting symptoms with the newest symptoms taking precedence. In this way we hope to remove the disease state slowly back to the core issue layer by layer… the reality is that we do not know which symptoms are tied in to the underneath problem, and therefore might require time and various potencies of the same medicine to work We also do not know HOW it will work or when. What we do know is that as long as the patient is responding to the remedy, no matter how slowly is that the immune response is working. I find that I am reluctant to interfere with that process simply because my experience of working with LM or Q potencies shows me that over medicating can cause problems for an already weakened immune system.

Case example:

Male, late 50s presented with skin eruption on lower limbs of both legs. Hot red p1060321and flaking. Started interior side of right lower leg and round spots developed on anterior side of lower limbs growing to same size as original area. Itching, red flaking. The eruptions then started on the left leg mirroring the right left from starting on the inside and then going to the outside of the leg.p1060332

Based on the prescribing symptoms.. Sulphur 200c was given in water, 2 doses 5 hours apart. (due to initial dose manufacturer doubts over the medicines viabilty. )The patient reported tiredness and increase in itching a week later. By the end of 4 weeks, the redness had disappeared, the flaking stopped and the eruptions shrinking. Although the tiredness continued, the medicine was allowed to work for 2 months. After two months mild itching returned and the eruptions were not progressing further. This time the patient was given a single dose of LM 01. The eruptions then continued to clear up. a month later, the patient had a prostate issue with a mild infection. In the repertorisation Sulphur was again indicated so the medicine was allowed to work uninterrupted. Despite increase in desire to urinate and mild aching in the prostate, no medicine was given. 2 weeks later, these symptoms cleared up by 80%. The patient is due for re evaluation soon t see if the same medicine is indicated or a change required.

We must be careful not to interfere with the immune response from implementing a medicinal action. Too much medicine is far worse than too little especially in a weakened state. Better to wait than to initiate a problem. In this case it is obvious that there are things going on in the patients health that needed treating carefully and sparingly. Due attention to detail and not being in a hurry to over medicate is a must. Once the medicine is given, the immune response goes into action and it will do what imust and take as long as it needs. We help it along when no further progress is happening and not before.