Tag Archives: case-taking

When a prescription does not work…

135-49433-cutebaby-1376348651It happened to us in the clinic the other day. 3 moderately competent homoeopaths. A 1.5 year old baby girl presented with Fever.

High fever, burning, no perspiration and thirstlessness…  I prescribed, Pulsatilla. Nothing changed. The next day, the parents took to the hospital for a check, and nothing found except fever. Manuel then prescribed Phos on the symptoms that had slowly added to the picture. Nothing…He then prescribed Sulphur, nothing.

He called me and on the slightly newer picture, I prescribed Arsenicum Album..Nothing.

I looked at the case again, and with the new symptoms, I wanted to give Mercurius. In the meantime, the father of the child, and the mother of the child and the baby sitter all came down with the same fever, but with the added SX of aching in the joints and a couple of other things. We noticed then that the baby made a whimpering noise when moving the arms or legs…Manuel prescribed Rhus Tox on the collective SX of what now appears to be an epidemic of this ailment, and now the baby is better.

That evening, I was called by a family member in England with her child having the same type of symptoms. I saw mercurius in her case, and even knowing that the general epidemic was RHUS TOX, I gave mercurius. The baby was better in 5 hours.

What can we learn from this case? When SX are in transition, there is but a small window to give the correct remedy. The Pulsatilla failed because the baby did not get the medicine for at least an hour after prescribing, and already the disease process had changed internally. The Phos and the Sulphur failed because again, the full SX had not been observed in the child.

In looking at hundreds of case histories from the archives of the masters, we can see this pattern time and time again. The State of the acute disease will only respond to the correct remedy at the correct time. Many times we have partial SXs and the remedy given is incorrect for that reason. Be prepared to chase the SXs until a remedy works.

So why did the mercurius work in the same illness in the UK? I think perhaps because I caught it in the right state for Mercurius…. A while later it would have been Rhus Tox.

 

I wonder sometimes…

bosswithstopwatchAre you really a homoeopath?

In listening to my medical colleagues, I see that there is level of thinking that being a medical doctor makes for a superior homoeopath. Of late, my antipathy to that statement has been reinforced by a series of events and clinical observations.

Being a homoeopath does come down to knowledge. Knowledge of homoeopathy as opposed to anything else. Clinical knowledge is useful for diagnosis and prognosis, yet is less useful in the case taking and analysis for finding the curative remedy.

To be a homoepath requires a deep understanding of Hahnemanns writings. Very few have taken the time to read and comprehend. Here in Spain I see that the training in homoeopathy consists of having learned the works of individuals from South America in the main, and that information is tainted with the teachers own lack of understanding of the writings of Hahnemann.

Before accusations are hurled in my direction pertaining to elitism or self promotion as to a methodology that I/we are promoting, please be aware that the IHM is a research organisation and that I/we only present thoughts from Hahnemann as written by him and validated by his clinical experience. In seminars, we often meet resistance by individuals who promote their own version of homoeopathy, so we ask them to validate it via Hahnemanns writings, and then we show them what Hahnemanns thoughts on the matter REALLY are from the original sources. They are often amazed and state that it appears that Hahnemann and Kent are not saying the same thing, to which we respond: “Exactly”.

Although we can and do in specific seminars outline the differences in full, we prefer that each practitioner take every concept and understanding as to their practice and examine it against the Organon themselves.

Recently in treating a few patients that are homoeopaths, I was struck by their lack of understanding of how the system works, and the high level of allopathic thinking in the treatment protocols. For the purpose of this article, it is enough to outline one case only, in order to demonstrate the problems both for them, their medical training and their ability to grasp the differences in homoeopathic treatment and allopathic approach inherent in their psyche.

I have a patient suffering fron an onset of asthma. The patient has been under the care of an able practitoner. Recently, after reviewing medical tests, every time the oxygen levels go down in the blood, the patient resort to steroids. It has got to the point of reliance on the tests to determine whether the prescription is working or not.

There is a lack of comprehension as to how homoeopathy works. NO MEDICINE CURES. The body cures. The remedies only emphasise the state by amplifying the symptoms and the body works on the artificial disease state and removes the ailment along with the real disease.

One of the problems with allopathic thinking is that a decrease in oxygen in the blood is a sign that something must be done immediately. Yes, the respiration gets a little worse for a while, yes it is uncomfortable. However, the remedies are strong and is driving the body to take care of the issue. Nowhere in Hahnemanns writings does he suggest that cure is painless.

A practitioner cannot and must not be forced to change a remedy because an allopathic test shows a worsening of blood saturation, the practitioner can only be driven by symptoms exhibited as to location sensation and modalities.

This patient in resorting to cortisone is flirting with using it the remainder of life. Remedies are given on symptoms and the reaction is impeded by the cortisone. There is no faith in homoeopathy simply because cure did not take place immediately. There is no understanding of how it works and the time it takes sometimes for a deep disease to be impacted by the remedies.

Sometimes Asthma is part of a deeper disorder that needs to be cured first.

In all cases, we can only be guided by the exhibited symptoms.

Is this patient going to benefit from the treatment? Only if they stop all other therapies and allows the medicines to establish a curative response.

There are too many successful asthma cases in my case notes to accept that homoeopathy is not strong enough to cure. Some have taken a couple of months and my longest took 5 years. Those with steroid use took the longest.

It makes me wonder if homoeopaths give up to soon.It makes me wonder how many medical doctors who give remedies know what they are doing….

Case taking tips # 3

Take the case that is presented before you. Not the case you want it to be.

A tip for you………..

630-01876398tThe biggest single obstacle to curing a case is to mix in the personality of the patient. Personalities are not prescribing symptoms. Never have been and never will.

Take only morbid symptoms that have altered or changed from the patients normal state.

Aph 6.

 

Quick Acute onset.

Got a couple of phone calls last night from mothers with children issues. Both were resolved.

The one case of interest was from a mother who always had difficulty in treating her son once a fever developed. She called with the following symptoms that he expressed.

mattongue

The tongue is red on the tip and around the edges. He has a white coating on the back of the surface of the tongue.

Le duele la garganta, la tiene roja, la faringe con los foliculos rojos en la pared posterior. The pharynx is red and the throat is sore.

There is no noticable change in his disposition, His face is slightly pale and a slight warmth to the touch of his skin. I asked her to look at his eyes. She said that they looked normal.. We talked a little more, then I asked her to look again at his eyes. She said they now looked brillantes, bright and shiny, more than normal.

I prescribed Belladonna 30c in water as she had that in the house. She gave one dose and then put the boy in the shower. After the shower she gave another dose and he went straight to sleep. His temperature was 37.5.

She said he awoke at 3 am and wanted to sleep in her bed. There was no fever and he was a lot better…

These acutes that come on suddenly and for no reason can be treated quickly and successfully if all the basic signs are observed. Pulsatilla came up in the repertorising,  but I know that Puls does not have in general the redness of the tongue tip or sides. Note too that the absence of a change in the mental state does not preclude an accurate prescription to be made. Take only symptoms that have changed.

We posted this in 2012: Polarities.

4 years ago, P & W implemented a polarities feature into the Therapeutic Pocket book for trialing and testing. The results of our findings led us to conclude that the inclusion of the polarities model was detrimental to a homoeopathic  prescription.

In the entire writings and case examples of Boenninghausen, NO  WHERE do we see the numerical value of a rubric used as an arbiter for prescription.

The grading of the symptom rubric defines the occurrence or reliability or clinical observation of its usefulness for consideration, NOT its intensity or absoluteness in a symptoms presence.

A value of 1 or a value of 4, does not negate a choice of a lesser “value” symptom if the Materia Medica indicates that the remedy with the smaller numerical value is the most similar.

In short, a medical proving of a substance either shows the production of a symptom or it does not. An absence of a symptom is NOT included in a repertorization analysis, and should have no bearing on the choice of medication. Neither should a “lesser value” be taken into consideration as the combination of rubric choices should lead to a study of indicated remedies in the Materia Medica for sole selection of a similar.

The inclusion of the Polarities table, in our researched conclusion, is detrimental to the homoeopathic prescription. It is flawed from the beginning by making the Therapeutic Pocket the instrument of remedy choice rather than using the book as defined by Boenninghausen as a guide to the Materia Medica.

We would encourage every physician to concentrate on accurate case taking and learn to use the T.P.B. as intended for accurate, precise and repeatable good prescribing.

Below is a research trial documented, which concludes that the use of the polarities is efficaceous. We would point you to a single telling insertion in the study, which we believe is the weakness of the whole premise:

The study, being a rigorous clinical test of homeopathy, also unmasked weaknesses of the method. Due to a low percentage of initially correct prescriptions the suspicion arose, that parents do not report symptoms precisely. Analysis of 100 unsuccessful prescriptions in children who finally improved with another homeopathic remedy, enabled identification  of  misleading  symptoms.  Frequently  these  were sensations and mind symptoms, while modalities  (especially aggravations) and polar symptoms usually proved to be reliable information for repertorisation. The exclusion of unreliable symptoms led to an improvement of results,but also often resulted in oligosymptomatic cases, i.e., cases with only few usable symptoms. This problem was resolved by an experimental reintroduction of (pathognomonic) perception symptoms into repertorisation, which again improved our positive treatment results significantly.

The prescribers in this single paragraph, indicate a telling lack of knowledge of how to use the T.P.B. There is a singular and collective mixing of unrelated symptoms based on a lack of correct application to the case. The whole reason for initial case failure is contained therein.  This is not a criticism of individuals, just a scientific observation of their own findings.

[gview file=”http://www.heinerfrei.ch/downloads/Downloads%20Publikationen/DL_13_YHOMP474.pdf” cache=”0″]

 

 

 

Homoeopathy case-taking – in search of the truth…

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The following is a post I originally put up on my general blog, aimed at the not-necessarily-homoeopathy-oriented public. However, as I’ve mentioned previously probably (possibly?) more than once, getting “true” answers and being aware of the less than “true” ones is so crucial to our case-taking that I decided to put this article up here too for your perusal.

I could also have titled this post “On homeopathy, marketing, treadmills and chocolate.” Read on. You will get my drift.

Modern culture is all about marketing and sales. How you present yourself has become all-important, and just being “you” seems to never be enough. It’s all about the spin.

When people come to me for treatment, I ask a lot of questions. But I’ve found that in many cases, certain questions are just asking for a marketing response, a how-does-this-make-me-look response, a spin. These responses are inventive, creative and make good marketing copy. But they are not true. The following examples relate to exercise and diet. Please note – I’m not talking here about whether people should or should not eat salad or exercise. I’m talking about how the responses may be so skewed for image and presentation that the questions themselves have become fairly useless in eliciting any truthful (and for homeopathy that means useful) response.

Q. Do you exercise?

In our times, regular exercise has moved right up there, next to cleanliness and godliness. From being a practical activity which some enjoy and some abhor, it has become a value-laden concept. If you don’t exercise regularly, you are lazy, a burden to society, doomed to suffer many unmentionable diseases, with no hope of salvation. The place of worship for this quasi-religion may be the gym, the track, or that little room at home where you keep your treadmill and personal rowing machine. If you do exercise regularly, you are demonstrating your value as a person, your sound willpower, your responsibility to your health, and your commitment to looking good reflecting a positive attitude to life. No pain, no gain is also part of the backstory here, denoting either serious masochism or the much-lauded ability to overcome limitations.

As with any religion, there are the exercise dissidents. Those for whom admitting to regular exercise means admitting to being uptight, uncool, addicted to lycra workout leotards. Gym membership (or “health club” as it is righteously termed nowadays) is tantamount to becoming “one of them”, someone who doesn’t think for themselves and lacks individuality, someone who follows the modern “quasi-gods” of the health and fitness columns, advocating toned bodies and cardiovascular wellbeing. The dissidents may well exercise regularly but they will find it hard to admit, often muttering something about a love for hiking in response to the question, while insisting that they would never give up smoking…

Here’s another loaded one:

Q. What do you like to eat?

As with exercise, we have the adherents of the food spin, and the dissidents. Some patients will wax lyrical about the Joy of Salads, describing their love of plant food in glowing terms. There are even those who make assumptions about my preferences, and seem to play to those assumptions. “I don’t eat any meat” they say shyly, looking at me for my approval. Others will inform me how healthy food is essential, and they always follow a healthy balanced diet, and will proceed to lecture me on what a healthy balanced diet is (don’t get me wrong, that doesn’t bother me). Then there are those who will describe how they never eat flour/carbs/meat/sugar/chocolate as they don’t like it/become instantly sick from it/can’t bear the sight or smell of it. One such patient, after expressing a deep seated love of raw vegetables in many colours, later came to me asking if I could do anything for weight loss. You will realize that I was slightly bemused – I had no idea that raw vegetables could have that effect. I have heard many descriptions of food preferences, which similarly have not been observed in practice. Like the lady who – in her desire to appear elegant, soignee and above such base pleasures – refuses dessert, the food preference responses often have more to do with image than truth.

And then we have the dissidents – those who insist that their eating habits are unhealthy because, let’s face it, there is nothing cool, or even slightly louche, about a salad. Some of these patients will assume that as a homoeopath, I could never, ever possibly have cravings for a really good, well done steak with chips, and they will declare their food preferences to me defiantly, with in-your-face aplomb. These people will tell me about their poor diets, their addictions to cake, chocolate, ice cream, burgers, pizzas, red meat. For some this is the truth. But for others – it’s yet another spin, plain and simple, and on investigating further, it turns out that their terrible diets are really not so bad after all.

This is why I prefer to ask very different questions, to get a more accurate picture of the patient’s state of sickness, and how it compares to their state of health. I have learned to ask questions where spin is irrelevant – where it’s more trouble to look for an alternative to the truth, and there isn’t really any perceived need to do so.

For example:
When you get a headache – can you turn your head? Can you move your eyes from side to side? Can you look up? Can you look up without moving your head?

Does your back hurt more when you bend backwards? Forwards? When you’re getting up from a chair? When you go from standing to sitting?

Do you get your stomach ache before a meal? During a meal? Afterwards?

Is your depression worse in the morning? Afternoon? Evening?

Are your sleep problems more connected to not being able to fall asleep? To waking frequently for no reason? To waking too early?

Even these questions could lead to some form of spin in the answer, but the chances of that happening are much less. And I challenge anyone to find a good reason to spin answers to questions about whether their runny nose is green, yellow or white, whether their haemorhoids are more painful sitting, lying down or standing, and whether that diarrhea is …. OK, I’ll save that one for a private conversation.

Face shapes and other red herrings

By Vera Resnick

I have a friend who accuses me of being drawn by anything new, bright and shiny – by anything interesting, not to put too fine a point on it. And I have to admit, he is right.

So much in life is boring, especially for a homoeopath. We plod through tales of stools, stomach pains and ‘that niggling feeling I get in my head when I go to the bathroom’. We discuss sputum, coryza, leucorrhea, diarrhea and constipation ad infinitum. The floaters in the eyes ‘only when I look up’, the sinus pain ‘only when I look down’, the belching after eating and the incontinence after a pint… Continue reading

Do Doctors make better homoeopaths?

You would think so wouldn’t you? Hahnemann was a doctor. All the original practitioners were doctors, the American writers of homoeopathy were doctors, and they are held in high esteem in books and writings about them. Kent was a Doctor. Hering was a Doctor. Both supposedly able homoeopaths.

However, the greatest homoeopath of all in terms of cure and surety in prescription after Hahnemann was not a Doctor. Boenninghausen was his name.

The question should really be: What makes a good homoeopath?

A good homoeopath is someone:

  •  Someone who has read and understood all of Hahnemanns writings, starting with the rationale for its very existence.
  • Someone who understands the difference between a named disease, the results of a named disease, and the REAL disease as expressed by the patient in signs and symptoms.
  • Someone who does not confuse preferences or personality in tracing the picture of the disease.
  • Someone who understands what a prescribing symptom is.

I know a lot of medical doctors who practice homoeopathy. There are very few who meet the criteria of being a homoeopath with regard to adherence to the above requirements. There is also the problem of the main body of westerners who think they are practising homoeopathy by utilising the methodologies of Scholten, Sankaran Vithoullkas and others.

A few years ago, I was a member of a discussion group which included several prominent names in the homoeopathic community. One time, a question arose as to whether it was important to send a patient for a testing if cancer was suspected. A member, who is the president of a prominent American Homoeopathic Association emphatically stated that it was vital to do so. I asked him why.

“So the patient could get the appropriate and correct treatment for their cancer!” was the response.

I asked, “in your opinion, what is the appropriate and correct treatment for cancer?”  we all waited for the reply………. there was none. It was then that I realised that the allopathic view and treatment of patients had never changed to that of a homoeopath in him or most doctors.

I left the group.  There are clinics of doctors world wide who treat cancer with “homoeopathy” and once the tumour starts to diminish, then they will remove with surgery rather than allow the treatment to fix the problem. It is a bastardized process which actually is allopathic in nature using potentised medicines. I hear all the arguments for the process and get told of the successes, but are also aware of the failures with comments like, ” the cancer was too far advanced” “Secondaries started quickly and there was nothing we could do”…….. There are times when surgeries are necessary due to obstruction and complications, but to routinely remove cancer or without allowing the medicines to kill the disease process first, is asking for trouble.

So the question is, are YOU a homoeopath? Do you understand what homoeopathy can cure and where other therapeutic aids need to be implemented and why? Do YOU have confidence in the medicines? Do YOU know how to use homoeopathic medicines properly? Do YOU know what signs to look for and when to change a medicine?

This applies to medically qualified personnel as well.

 

 

 

Case contradictions.

gary Two important points in studying and examining a case by Bœnninghausen’s method must not be overlooked : 1. To see that no contradictory symptom is admitted into the final synthesis. Let us comprehend clearly what we mean by contradictory symptoms. No symptoms are contradictory if they actually occur in a patient and are true ; what we must avoid as contradictory symptoms are those symptoms that a patient may report in one breath, to refute in the next. Or we may find that the symptoms reported when the patient tells his story are contradicted in a review of the case. It may be that we will find seemingly contradictory symptoms through a lack of concept of the relationship of the various elements, or through your failure to interpret the case clearly. Thus a patient may complain that she is worse out of doors, yet her coryza is better out of doors. What she may mean is that her coryza is better out of doors, but her rheumatic complaints are worse out of doors. This may be because of the various relationships of locations, sensations and aggravations, or it may be that she is better from being where it is warm or where her body is warmly clothed, and her pride prevents her from the wearing of a necessary amount of clothes ; it may not he a question of open air at all. It may be that a patient will report a dry mouth, and an excess of saliva. These are not necessarily contradictory symptoms ; they may be manifestations of an alternation of symptoms that are not contradictory, but actually valuable concomitants of the case.