Tag Archives: case-taking

Homoeopathic to the Disease State.

dental_doctor-thinkingsmall“Whatever the emphasis or valuation put on any special symptom or group of symptoms, it first must be fundamentally agreed that the totality alone is essential to the selection of a remedy homoeopathic to the diseased state of the patient. No detail is too insignificant. Scrupulous and painstaking care in case taking is paramount. No values must be written into the record, nor over emphasis placed on any division of the symptom total; the mind kept open until all the evidence carefully weighed is in. To possess actual value symptoms must be reliable and definite, of the very warp and woof, unaffected by their appearance or use in other cases; in short, symptoms that clearly individualize the case under consideration- a totality that sets the case apart from any other previously observed. Until this totality is on paper before us there can be no ranking or ascribing of values. Hence the need, however tedious, of sound case taking, for it is fundamental and not to be compromised by bias or past clinical experience.

In order to match the genius of the disease with the genius of the remedy we then seek to rearrange and rank individual symptoms to better discern the remedial agent. Of the symptoms related or observed many may not particularly distinguish. What are some of these?

Pathological symptoms, so-called, indicative of the results of disease were described as ultimates by Kent. These evidences of tissue changes are helpful in diagnosis or prognosis, but because they are effects, not causes, they do not become of primary importance in pointing to a curative remedy. All processes have an origin, and it is their beginnings to which a similar drug pathogenesy may be comparable. Likewise in epilepsy, the remedy is not seem in the actual seizure, but rather in what has preceded perhaps long before.

Symptoms common to all cases of a certain disease are little indicative of a similar remedy. There is nothing here to be found individual and compelling our choice. Symptoms common to many drugs likewise do not stand out in the selection of a similar drug picture.

Symptoms due to drugging, or improperly chosen remedies, or too early repetition do not present the individual nature of the disease as manifested in the changed state and hinder differentiation. Again the long list given by a hysterical patient is difficult to value.

The predominating “my” symptoms in reference to particular parts of the body also belong in the class of lesser values, unless these are striking, or becoming general because they are similarly evidenced throughout the various parts of the patient. Particulars rarely distinguish the individual and to that extent are weak in value.

So are common symptoms, such as loss of appetite, headache, exhaustion, discomfort, etc., often indefinite and therefore not to be emphasized unless qualified further to really individualize the case.

What symptoms, then, stand forth, compelling and of major rank, pointing more directly toward what is essential for cure? A consideration of homoeopathic philosophy antedates proper symptom valuation. Very briefly, it is not the body of man that expresses disease, but the reaction of his vital force against invasion. Nature’s response is in the way of symptoms experienced through sensation, etc. Individualization means the reaction to any morbific agent as evidenced in the patient under our care. When this is clear to the prescriber, there is no thought of remedies based other than on the patient himself. Not the present symptoms alone, but those detectable from birth, show the conflict which has harassed the inner real life in its bid for mortal existence.

Ray W. Spalding MD

Whats in a name?

The single most misleading aspect of homoeopathic prescribing is the attribution of personalities to the remedies.

Prepared remedies are solely prescribed on their abilities to produce symptoms, PERIOD.

I tire of the plethora of books, Materia medicas and so called homoeopathic experts who espouse the personality aspects of remedies. We do not treat personal preferences, traits or idiosyncratic natures of people, we treat pathological changes of states that are the results of disease.

Anything else is not the practice of homeopathic medicine.

How to treat with homoeopathy.

hahnem14After 32 years of being involved in practice, and 7 years spent in intensive study of the masters, I have concluded that homoeopathy is less art than science. Most of what is taken for granted in terms, expressions, understanding and concepts in the therapy, come from Kent and Hering and NOT from Hahnemann.

Hahnemann was a scientist. A man given to accepting material evidence from experimentation and subsequent results. After reading the millions of words he has written over the years, and several times I might add, my observed conclusion is that his medical career was based on facts and not speculation and is to be trusted.

There is a simple premise to using the remedies for curative purposes. They are dilute substances that create observable symptoms in an organism. These symptoms are a direct result from whatever substance caused the reaction and have NOTHING to do with infectious disease states found in sick individuals other than the SIMILARITY of produced symptoms.

When matched symptom by symptom to the sick organism, the addition of the substance increases the reaction in the organism to amplify the specific symptoms upon which the natural immune response in the organism will focus on these heightened symptoms and attempt to remove them. In removing them, the natural disease, being slightly weaker will also be removed.

And for this reason and rationale, it is imperative that we find the right symptom or symptoms within the whole picture of the disease. Aph 6 points out how to find the picture of the disease but aph 153 tells us what we have to extract from this picture to prescribe on.

I have found that when faced with a patient suffering a known disorder, knowledge exists of the disease progress, organs involved, the patterns of the progress of the disease and the prognosis. Given these parameters, a patient suffering from the infection both acute and chronic, will only exhibit CERTAIN characteristics of the disease as the body tries to modify the illness for self protection. It is the total expression of these characteristics that will identify the individuality of the diseased individual and lead to selection of the right remedy or remedies. It is NOT the totality of ALL the symptoms that we look for.

For example, if a patient has a disorder that starts on the left and move across to the right, has perspiration only at night on the back of the head and has a fever after midnight that starts with a chill and then turns into heat, then we have individual characteristics of a personal disease state from the infection . If this repeats daily then this is the core of the state from which all other lesser important symptoms spring, like sleeplessness and mild headaches. It is always best to focus on the primary expression of the disease, the modifiers of the state and symptoms that are present that have no obvious affinity or reason to be present.

We at the IHM have found that in using the therapeutic pocket book, and focusing ONLY on the few important symptoms, that we use less than 5 rubric indicators and come to 3 or less remedies for consideration. A quick read of the remedies will determine which remedy to give or start with.

Do NOT use a mental symptom unless it is morbid and a CLEAR and obvious CHANGE in the state of the patient. Focus only on CHANGED conditions and symptoms that are part of the CHANGED pathology. You will do good work by following Hahnemann.

Problems after Cataract surgery.

eds momma2Eighty something year old woman, generally in good health and very active in her local community providing bread and cakes for folk.

Went in for Cataract surgery in both eyes. Post procedure, was suffering from dry eyes,  a ‘film’ of sticky mucus and obscured vision.

At the same time, an old problem had raised its head again. A diarrhea after eating bread or pancakes.

So the case was analysed: P & W 2015 edition of the Therapeutic Pocket book.

eds momma


The practitioner was really sure on each symptom he used for analysis.

eds momma1

After reading Pulsatilla, it was administered in water.

The results were within one day. The dryness cleared up, the sticky film disappeared and also the diarrhoea. The patient was advised to steer clear of wheat products.

The patient remains well 2 weeks later.

Practitioner: Ed Nunnery. Dhom med IHM. Sacremento California.




happy-woman-fotolia_12331389_subscription_xxlI received a phone call from a patient in the USA a couple of days ago. She is 12 weeks pregnant and suffering heavily with her seasonal allergies.

She related the following….

Just want to complain all the time
Feel uncomfortable in my body all the time
Farting all day and night
Congested worse at night
Wake up with tons of mucus
Violent sneezing, like I will head butt someone
Coughing when lying down
Eyes are very itchy, dry, red and swollen, esp at night, dry,
Feel better in nature and while walking
Worse with bright lights and technology
Worse after 4pm, very worse from 6-8pm
Better in the morning and in the sun
Insomnia because so congested and itchy
Wake up 5-6 times a night blowing my nose
Very irritable and dry
Don’t want to be touched, esp hot hands
I didnt even repertorize the case. I prescribed LYCOPODIUM 30c in water 4 doses.
Hi Gary, I have taken three doses so far and I have to tell you, I feel so fantastic. I finally have energy again! I wasn’t tired between 4-8 last night and even went out for a walk at 8pm, which never happens!!! I had a good 8 hour rest, only woke up 3 times to use bathroom (a miracle compared to 6-7 times) and slept a solid 4-hour stretch. I think the last time that happened was before I got pregnant. I was up at 6am and finally have the energy to clean my house. Wow. I can’t thank you enough!!!!!


Being brave.


Homoeopathy is an exact science. Yet…..

The problem with casetaking is that it requires accurate skills in observation. It requires a human to note and assess the symptoms, a human to make a judgement call on what he or she sees, and on this collection of data a remedy is selected.

I believe that the principle of homoeopathy never fails, only the homoeopath.

fever20babyOn Sunday the 24th of April at 5pm, Manuel and I met with a young mother whose 11 month old daughter had a high fever (40C) which had not resolved under Pulsatilla, Mercurius or Sulphur. These well indicated medicines failed to touch the situation.

The mother of the child has been a patient of Manuels for nearly 30 years since being a little girl herself. The family was opposed to homoeopathy so there was a little pressure on us to get it right.

So the symptoms were that the child had burning heat with no perspiration. The heat was centred on the chest and the temples. Huge thirst with the fever. There was a mild cough with some mucus.

The child was sleepless but extremely sleepy, restless and would only sleep when totally tired. She would wake into an aggravation and then go back to sleep again. Her hands were cold.

Manuel and I independently came to Phos. I was not happy with that prescription. So I sat back and observed.

The child was placed on the table at one point and began to cry. I felt the table and being a glass surface, was quite cold. I placed a cold object on the childs arm a little later and again the child began to cry.

I also noted that when the mother or grandmother picked up the child or moved its arms, the face registered discomfort as if the bones or muscles were sore.

What to do?

Well, I decided to trust my observations. So I repertorised on the following symptoms.

baby fever

I knew that Rhus Tox had bone and muscle soreness, so I kept that in mind.

Was I confident in the prescription? Not 100%… I read quickly through all the remedies in the 5 choices and concluded that if my observations were correct, then Rhus Tox was the closest in symptoms.

At about 8 pm that evening, the mother contacted Manuel to say that the fever had gone down and the child was happier in herself.

The day after, (Today) all symptoms had gone except for a little mucous and cough but that was getting better also.

The unprejudiced observer -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. 

It takes a lot of faith to trust in observation above clinical knowledge and the chatter of other peoples opinions. It takes a while for a clinician to accept that the organism via PATHOLOGY in the expression of a disease, will sometimes fly in the face of a known symptom that is opposite to what is known about the disease.

I believe that this observation is the true understanding of 153.

§ 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 symptoms 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. 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.

The art of Medicine: The “state.”

doctor-child-examine2In homoeopathy, we often talk about the “state” of a patient. The phrase, as well at the reality is that the “state” of a person is actually the full picture of the disease.

“The particular condition that someone or something is in at a specific time.”

The state represents the symptoms of a disease in its entirety. It is the picture a reactive process either mentally, emotionally or physically. It is how the pathology is arranged at a given moment or time.

Hahnemann understood this. He emphasised over and over that prescribing symptoms had to be characteristic of the patients expression of the disease AND the remedy. The patients “state” is represented by symptoms on which we prescribe. A patient can be in a state of “Belladonna” or a state of “Sepia”, but is not represented by every facet of the medicines, just the state that the medicines can produce and which the patients illness corresponds to at that moment of prescription. States change as the illness changes thus requiring a change of medicine.

Many practitioners that are unfamiliar with the Therapeutic Pocket Book, are surprised at the apparent paucity of mental symptoms.


This is the total collection of symptoms. Yet each symptom is a “state” of expression of pathology and is qualified and explained by other symptoms as expressed by the patients disease in other elements of the case.

Example. A child presents with marked irritability. In the case taking, it is found that the patient also has a fear of the dark and of being alone. Further exploration finds that the divorce of the child parents has led to internalising the grief which is expressed in the anger and irritabilty.


So we see that what appears to be an over generalisation of the “state”, in this case Irritabilty and anger, is qualified by adding the other symptoms that comprise the fullness of the expression of the disease.

A careful use of the repertory, will elicit a group of remedies that produce the state as seen, and differentiation is made by the symptom expressions in the reading.

A totality of symptoms if you will.




IHM Clinic Seville case. Herpes Zoster?

Patient, female, 10 years old presented with: Eruptions on body tentatively diagnosed as Herpes Zoster by hospital consultants.

homeopathy-2She has been infected for 3 or 4 days. Mother showed the onset of the problem which she thought was an insect bite. Was now 3 small red spots filled with dried blood on the right chest. Further eruptions had occurred on her right back and on her right arm.

3 clinic staff were present. Lilianne, Manuel and myself. We examined the patient and noted that the eruptions were vesicular in nature. They began as yellow spots. The skin was sensitive to a light touch. The patient had a slightly coated tongue. The patient complained that water did not just taste right but could not give a better explanation.

One other sx we uncovered was that she complained of a sensation that one of her head hairs felt like it was being pulled.

A full physical check was made and nothing else could be ascertained.

We repertorized on these SX:


The patients mother reported that the day after taking one dose of Phos 30c, that the eruptions had dried out and the patient felt much better…

The skin is now clear.

Why does Hahnemann say…..?

§ 5
Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease.”

dental_doctor-thinkingsmallClearly here Hahnemann is reiterating the fact that we are treating “disease”. Any other concept of treating the man and not the disease is False.

Homoeopathy treats the disease through the signs and symptoms that are exhibited by the individual sufferer of the infection or disease process. These symptoms, whilst having some affinity to the general production of disease symptoms, also have unique characteristics that are peculiar to the individual and expressed by him or her. THESE are the prescribing symptoms within the disease process that are to be found in one or a few remedies that can can produce the same state of disorder in a healthy person.

§ 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 symptoms 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. 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.

So why is it useful to know the particulars of the exciting cause of an acute disease?

It is good to know everything regarding the infection or mode of receiving the disorder because it may be possible to avert the disease process entirely if seen early enough.

Example: Take a patient who feels a little unwell and feels is getting a cold. The patient is anxious because cannot afford to take time off work and begins to feel a little fevered. A single dose of Aconite can relieve these symptoms REGARDLESS of what the disease might be, and in fact stop any further progress of the disease.

Example: Take a patient who is caught in the rain and gets really wet and cold. They go home and take a hot shower but still develop aching in the joints and a cold. Rhus Tox stops the further progress of the acute disease state.

It is also good to know the causation of the acute disease because a very clear wealth of information regarding the acute disease symptoms will become available to the clinician. This will enable the homoeopath to see what is common and what is peculiar in the way the patient expresses the disease.

a “peculiar” symptom is a symptom “characteristic” of the individual disease expression that came on with the disease state. It has nothing to do with personality.


In any complicated chronic case the recent symptoms are the deciding ones, cure your case in layers.