Tag Archives: Case taking

“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.

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………..

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

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 and 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.

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.