Realities of practice.

For additional insight, Please read the comments attached to this post.

 

For whatever reason, a lot of people who have joined the ranks of homoeopathic practitioners over the last 25 years  (in the West especially)  have a strange view and understanding of homoeopathy. I read a lot of case reports detaining the ‘cure’ of individuals who have received some weird medicine and whom had been prescribed for on symptoms related to their “inner state or delusional view of life” or “their relationship to the universe” after several hours of interviewing.

Over the years, it has been a source of amusement and annoyance that these people exude an inner smugness and a condescending attitude towards the rest of us, and who themselves truly believe they are the real deal and have insight into healing. They talk of “healing” and give quasi spiritual psychological explanations for a patients state of being, and onlyconsult maybe 3 or 4 times a month. They will attend conferences and seminars having paid lots of money and listen to gurus telling their wonderful stories, and during the breaks these people discuss their own wonderful cures with people who are waiting their turn to tell of their own wonderful tales of cures.

The works in writing of Samuel Hahnemann and colleagues of his era are available for free on Google Books. Therein lies the recorded genesis and struggle and definitions and methodology for homoeopathic treatment. Therein lies how it has to be done, and how it will work consistently and repeatably IF the principles are applied.

Homoeopathy is a medical specialty within the framework of the field of medicine. It is NOT the complete answer for medical treatment. Osteopathy, surgery and physical/mental/emotional nursing healthcare coming to mind. It will not help someone who is dependent on drugs which have altered the body chemistry or killed functionality of an organ or gland. It will not act where in most cases, a natural immune response is lacking or not functioning due to external influences or an immune disorder.

It is however, the better course of treatment where a curative response CAN be elicited. It is the better course of treatment for general therapeutic treatment in primary and ongoing health care.  However, and this is the reality, it is only as good as the therapist prescribing for the problem. It is only good if a standardised methodology is employed based on Hahnemannian directives.

I realise that many people who are reading this will look back on their training and scoff… They ‘know’ it takes hours of painstaking casetaking to reach the real seat of the problem, the delusion or sensation that is the trigger to ALL their ailments. Well your argument is with Hahnemann and ultimately your conscience as the reality bites you.

Sorry to be a killjoy. Disease as individually expressed by a patient in their observable symptoms, are the key to prescribing. The rest is pure speculation. See Organon 5th and 6th editions paras 1-10 and 152-158.

I believe, no, I know, a properly trained homoeopathic physician could run a general practitioners office efficiently and successfully for exactly the SAME daily visits from patients as an allopathic physician has.

In the same knowledge, I also know, 99% of homoeopaths in the West could not do it. There is not the training. There is not the comprehension, there is not the ability to case take and prescribe quickly and efficiently, and there is not the understanding of how to manage cases and when to hand over care to another branch of the medical system for a short while.

I have had this conversation many times with practitioners. They all complain about the therapy of homoeopathy not being accepted or utilised properly within the health systems, and say “we can do so much better”.  Well……. no you cant.

To clarify, the therapeutics, ie the medicines that are prepared in the manner for use within the practice of homoeopathy, are better. They are able to create an artificial disease set of symptoms within the human economy and stimulate or re direct the overpowered immune system to react in a more focused way to restore health to the individual. NO DRUG EVER CURES….. the body does.

We all have to decide through our experience and understanding (and legal liability) when to change therapies or allow the influence of another therapy be utilised for the welfare of patients. I do not mind stating some of my delineated areas of patient concern where I, through experience will not hesitate too long before administering certain anti bacterial infection medications.

One is Tetanus. I have observed the path of the disease in Asian and Middle Eastern countries, and have managed some cases homoeopathically and some, I turned over to the influence of antibacterial treatment because the infection was life threatening. Clostridium tetani acts quickly flooding the body with neurotoxins. I have come to a settled understanding in my thinking that this falls under the sphere of Hahnemanns common sense approach to “removing maintaining causes” and as such, I see the body full of an infecting poison as being a maintaining cause. I will treat along side the A/B giving the patient the appropriate medicine for the individual dis-ease that they experience.

Another one is snake bite. I will immediately give homoeopathic treatment and have the patient monitored carefully. In India, where there are a high casualty rate of 45000 deaths a year from snake bite, there is anti-venom available in most hospitals and out station clinics. The problem with Snake bite is similar to Tetanus, a maintaining and presence of poison in the system, and a short duration of excruciating pain leading to expiry.

Symptoms of neurotoxicity, ranging from ptosis, dysphagia, respiratory distress and unconsciousness are all the result of the spreading poison. In many/most  cases, mechanical help with breathing is required. A polyvant administration of anti venom is administered, which has been culled from usually 4 of the most toxic snakes poisons in India, and this dilutes and flushes out the strong poison administered from the snake bite. (ironically, it works in a homoeopathic manner) I continue individualised homoeopathic treatment when the patient exhibits prescribing symptoms, but would advice continuation of the anti venom treatment until able to breathe unventilated and the poison is flushed from the system.

To get back to “No.. you cant.” A waiting room in a G.P.s clinic will contain people with minor ailments of an acute nature, and undiagnosed ailments of a chronic nature. a homoeopath will have to be able to do the following.

Firstly, a well trained Hahnemannian homoeopath will have a working knowledge of medicines which makes them able to differentiate symptoms from each other as they observe them. They will of course have the memory aid of a repertory to look up symptoms if they need to refresh their memories or direct them to a medicine or group of medicines for consideration on a combination of symptoms not seen before. With practice, an acute disorder can be dealt with in a 10 minute framework. If you have a good student homoeopath or nurse, they could even work with the acute disorders for you, and check with you for patients whom they are unsure about.

A chronic or undiagnosed major illness, can be treated in this manner in a busy homoeopathic clinic. I can only offer my own experience and practice methodology so its just an example.

A new patient is taken into a clinic room by a homoeopathic colleague/nurse/advanced student, and case taking is started. What is the complaint? it is written down, how does it affect them? it is written down. Where does it affect them? it is written down. What else are they affected by? It is written down. Some tests are applied to the relevant area, If necessary, blood is extracted for analysis and other tests applied if required. This takes usually 20 minutes. The patient is then shown into my office along with the written details, the practitioner will quickly summarize the patients details and then sit in with us as I go through the case with the patient.. In line with Hahnemanns suggestions, I will ask further clarifying questions based on their statements to the practitioner when being examined. I will double check some reactions or observations noted on the form to be sure, and then will ask any other questions I feel necessary.This should take no more than 15-25 minutes.

I will make a prescription if and only if I am sure of one and then the patient is taken to the dispensary and given medicine and directions for taking and then a return visit booked. In this manner, it is possible for a single practitioner with 2 or 3 nurses or undergraduate student to help to see 40-100 patients a day comfortably.

A common method of patient treatment in India, in some of the free clinics, was for student homoeopaths to walk down a line of patients and take notes of the symptoms. They would then return to the beginning of the line and relate the SX to the prescriber, who would listen and then prescribe and move on.. one minute to 2 minutes per patient. In this manner, there was an ability to get the key symptoms from each patient without the prescriber having to wade through other symptoms or memory lapses and humming and hawing from the patient. When there are 2 or three hundred or more patients to treat, it is the only way.

So for those who sit down and spend up to three hours per patient examining every detail of their life, you will not be able to run a clinic. I would also suggest you will not even be able to cure the patients you have now. Cure is not a relative term. Its an observed change of symptoms expressed. If they come with Asthma do they leave free of Asthma after treatment? Or is a cure considered if they are free of a spiritual issue instead, but still have the asthma?

As a therapy, Homoeopathy is in a dangerous place. Relatively few good practitioners to practice real homoeopathic application of principles left. disease is not an easy thing to work with at the best of times. Better to work with a therapy along guidelines with a proven record of success rather than not.

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11 responses to “Realities of practice.

  1. Thanks for posting this article using a medical criterion!

    When Dr. Hahnemann wrote the Organon definitely had serious arguments to feel great disappointment of the conventional methods of his time. However, time has passed and conventional medicine has made great advances in many fields.

    At the same time, many medical doctors have yielded to the truth raised by Dr. Hahnemann, even leaving aside some of the practices they learned in university. Furthermore, it appears that some homeopaths would have to yield on some issues and stop being so dogmatic.

    Definitely, Homeopathy should not be confronted with allopathy, but homeopathy must has a separated sphere of action.

    I think a good way to understand this separation is first to give recognition to the allopathic system regarding to the progress that has taken in the following items: (Hopefully this will be useful for students readers)

    I.-Surgery: “Any mechanical disease must be repaired mechanically through surgery”.

    Please, see Organon paragraph 186:

    “The treatment of such diseases is relegated to surgery; but this is right only in so far as the affected parts require mechanical aid, whereby the external obstacles to the cure, which can only be expected to take place by the agency of the vital force, may be removed by mechanical means”

    The use of surgery is an effective tool on which we support. Overall and talking mainly on generalities, let me give you a few examples:

    1.-Everything that is herniated (hernia): Intestines, inter vertebral discs, synovial capsule (synovial cysts). Through sutures, placement of artificial devices. (I.e. metal mesh)
    2.-Some fractures (broken bones): femur head, proximal third of the humerus, spine (or for example: lumbar radiculopathy), hips, etc. through the use of prostheses, plates, screws, nails, or spinal stabilization devices.

    3.-Any obstruction, or occlusion: Intestines, **Appendicitis, heart valves, arteries, veins. Through valve prostheses, angioplasty, cardiac catheterization, implants, bridges.

    **The pathophysiology of appendicitis can be summarized in one word, “obstruction”=Mechanical problem which is divided in several phases (inflammatory, hyperemic, necrotic-hemorrhagic, and perforated) that have an evolution of 16-24 hours since inflammatory until perforated (nobody wants to have a perforated appendicitis in his/her office). So, every homeopath should to assess the factor Risk-Time in order of NOT endanger patient´s life.

    4.-Hemorrhage: injury or trauma, rupture or perforation of ulcers (gastric or skin) through sutures, grafts, cauterization.

    5.-Obstetric and Gynecologic problems: As for example cefalo-pelvic disproportion, pelvic or transverse presentation, thrones ovary cysts, ectopic pregnancy, placenta previa, abruption placenta normally inserted.

    6.-Cancer: In the case of cancer homeopaths should be cautious and be aware of the results that have been taken with allopathic medicines, for example: In the case of Acute Lymphocytic Leukemia in children, chemotherapy is 95% of success (complete “cure” or suppression if you want, but giving more time to work homeopathically) and it would be a great omission not to give this great opportunity to a child with this disease.

    7.-Poisons (i.e. bites of venomous animals, intoxications by known chemical substances), : These cases should not be viewed as dynamic diseases, therefore must be treated with the antidote from conventional medicine and / or supportive measures such as dialysis, antibodies filtration and some immunoglobulin used in immunology for blocking of certain toxins.**

    8.-The case of certain autoimmune diseases in which it is fully proven effectiveness in the treatment and prevention as in: The maternal-fetal ABO iso-immunization or RH. Or in the case of immediate hypersensitivity (Anaphylactic Shock).

    9.-One of the great progress that has taken conventional medicine is in supportive measures, which must include hydro electrolyte management in hyperosmolar conditions and in respiratory or metabolic acid or alkalosis.
    Similarly it must be considered as a separate issue the management of Shock.

    10.-Any disease by deficiency (carencial diseases) or metabolic should include its allopathic exogenous, for example, insulin-dependent diabetes, hypothyroidism. We must not stop the treatment exogenous to our patients with this type of diseases.

    Once we have considered some of the many advances of allopathic system then we can consider how we can do a join of both systems without involving obstruction or homeopathic combination to our work. I mean “together but not scrambled”. We could even take into account the improving technology of conventional medicine such as computed tomography scan, radiography, contrasting, ultrasound, EKG, EEG, Papanicolaou, laboratory studies to determine locations, extensions, laterality, consistencies, blood condition, metabolic and hydro electrolytic condition in our patients.

    Homeopathy is for dynamic diseases (the most of all diseases, 95%).
    Kindly, my opinion is that we can coexist, even having great results and walking hand on hand offering to the patient all the options, even, it seems to be necessary since the new perspective of our times.
    Hope this helps.
    Dr. Guillermo Zamora

    **Microorganisms Producing Exotoxines
    *Exoenzyme (Taken from wikipedia):
    “An exoenzyme, or extracellular enzyme, is an enzyme that is secreted by a cellL and that works outside of that cellL. It is usually used for breaking up large molecules that would not be able to enter the cell otherwise.”
    *Exotoxine: (Taken from wikipedia):
    “An exotoxin is a toxin excreted by a microorganism , including bacteria, fungi, algae, and protozoa. An exotoxin can cause damage to the host by destroying cells or disrupting normal cellular metabolism. They are highly potent and can cause major damage to the host. Exotoxins may be secreted, or, similar to endotoxins, may be released during lysis of the cell.
    Most exotoxins can be destroyed by heating. They may exert their effect locally or produce systemic effects. Well known exotoxins include the botulinum toxin produced by Clostridium botulinum and the Corynebacterium diphtheriae exotoxin which is produced during life threatening symptoms of diphtheria.
    Exotoxins are susceptible to antibodies produced by the immune system, but many exotoxins are so toxic that they may be fatal to the host before the immune system has a chance to mount defenses against it.”
    It is according to the last paragraph where I would focus more, overall, to mention some of the most dangerous bacteria or bacterial gender in medicine.
    Taken from: “ Microbiología Médica de Volk, 3rd edition.”
     Staphylococcus Aureus:
    Gram + bacteria, which produces a light golden pigment, called Polysaccharide A. The ability of these to cause disease depends on its resistance to be phagocytosed and its production of extracellular toxins and enzymes, for example:
    Coagulase: This is an extracellular enzyme coagulase-reacting normally present in plasma (perhaps prothrombin) and plasma coagulation by converting fibrinogen into fibrin. The only pathogenic effect has been suggested for this enzyme is covering with fibrin microorganisms to inhibit phagocytosis.
    Staphylococcal hemolysins: There are four: Alpha, beta, gamma and delta: It has been shown that alpha toxin, damages the smooth muscle cells and also destroys the skin (it dermonecrotic). It is also toxic to macrophages, platelets, and causes degranulation of PMNs.
    Beta toxin is an enzyme that reacts with phosphorylcholine sphingomyelin to separate and further cooling causes cell rupture.
    Gamma toxin, produces red blood cell destruction.
    The toxin delta: injured a large number of blood cells and the injury apparently is a consequence of the reaction of hydrophobic amino acids in the phospholipids of the cell membrane.
    Leukocidin: This toxin is composed of two separable components that act synergistically to cause damage to polymorphonuclear cells and macrophages.
    Exfoliatina: This exotoxin, encoded by a plasmid, cause “severe exfoliative dermatitis” (Please see the case at the end); or also called “scalded skin syndrome of Staphylococcal origin”. It is characterized by the formation of wrinkles and exfoliation of the epidermis, resulting in significant loss of fluid through the skin bare. The epidermal sloughing is caused by an exotoxin diffusible, and thus infecting staphylococos may be present or absent in the affected skin area.
    Staphylococcal enterotoxins: This exotoxin, causes food poisoning characterized by severe diarrhea and committees. Have been described 6 antigenically distinct enterotoxins A, B, C1, C2, D and E. These toxins are not destroyed and can be termoestabiles even if the food is heated sufficiently to destroy viable staphylococci.
    Pyrogenic toxins: These toxins intensify the susceptibility to toxic shock (such as that occurs in women using tampons during menstruation) and cause a similar rash of scarlet fever.
    Penicillinase: Enzyme capable of destroying penicillin.
     Excherinchia Coli:
    E. Coli: This produces one or two different toxins, the so-called thermolabile LT and is destroyed by heating at 85 degrees C for 30 minutes, and the thermostable, designated with the letters ST and is not destroyed by heating at 100 degrees C for 30 minutes.

    E. Coli causes gastrointestinal infections in a severe way and sometimes fatal in infants. In adults, the infection is known by many names, for example, “Traveler’s diarrhea.” It can cause cystitis, pyelonephritis, abscesses, even sepsis.

    So, as these two microorganisms producing lethal exotoxines, there are some more such as the following:
     Shigella
     The Clostridium Genre, for exemple, Clostridium Perfringens , C. Boulinum
     The Bacillus Genre : Bacillus Cereus (Rare and are required high concentrations of microrganisms). Bacillus Anthracis.
     Pseudomona Aeruginosa.
    It seems that the quantity in number of bacteria is also important because for this it will depend the amount of toxins circulating in the body.
    According to Kenneth´s work on exotoxins, “the lethality of the most potent bacterial exotoxins is compared to the lethality of strychnine, snake venom”.
    Furthermore, and as I wrote above:
    “III.-Poisons (i.e. bites of venenous animals, intoxications by known chemical substances), : These cases should not be viewed as dynamic diseases, therefore must be treated with the antidote from conventional medicine and / or supportive measures such as dialysis, antibodies filtration and some immunoglobulin used in immunology for blocking of certain toxins”
    Now, I would add “And diseases produced by microorganisms producing lethal exotoxins should not be taken as dynamic diseases; therefore measures as stated above, and even antibiotics (if necessary), should be used on certain circumstances where lethal toxins are endangering the patient´s life”

  2. There are not only a lot of different speculative approaches being used in homeopathy but also a lot of speculation about what works best. The truth is we don’t know as we have never properly researched the subject. Its no use asserting right or wrong in homeopathy as we simply don’t know the truth. Does a homeopath using Kent’s repertory and the old medicines do any worse than a practitioner using a super computer, a $5000 computer programme and a galaxy of recently invented remedies? We simply don’t know. Does someone doing 15 minute consultations do any worse than someone doing 3 hour consultations? For that matter does someone prescribing mixed remedies and specifics do any worse than a Hahnemannian or Kentian? We all know the theories, arguments, speculations and justifications for the pros and cons but we don’t know the actual truth. We call homeopathy and art and science but in actual fact it does fit the definition of science very well at all. It is a jumble of beliefs and ideas and more akin to a religion with many sects and branches within it, than a science. This blog would fall in the ‘fundamentalism’ category, i.e. strident unquestioning adherence to what was written in a book two hundred years ago. You might hate to hear it but i don’t think you can disagree with any of this if you are honest.

    PS I have been practising with awareness and open mindedness full time for 33 years and don’t have the answers to any of these questions and haven’t met anyone who does.

    • Thanks for the comments Robin. But………. nonsense. Its not strident unquestioning adherence to a book written 200 years ago. Its researched applied application of a principle that has been tested and tried and categorized into a system that works. If you “dont know” then Im failing to see why you practice homoeopathy at all. I wouldnt. I would return to my cozy well paid medical job and not have a conscience at all. Perhaps that is the question you should be asking.

      • I could have written your reply for you it was so predictable. Are you aware of how many weird ways of using homeopathic remedies there are whose proponents would say “Its researched applied application of a principle that has been tested and tried and categorized into a system that works.” It is impossible for them all to be correct as their methods so often contradict each other. So what makes you more right then anyone else? How many ways of using remedies have you put to a proper scientific test? Thats my point. You can shout all you like about being the guardian of the truth and spout all the book learned philosophy you like, but your “nonsense” response only confirms what I said about religion-like belief rather than open minded investigation and questioning. Im honest enough to say there is a lot I dont know about the workings of homeopathy. Thats not because Im an inferior practitioner as you are suggesting, its because I have spent 3 decades thinking very deeply abut the subject and still have a lot of unanswered questions. For many homeopaths the possibility that they may not be the owners of the ‘truth’ is too scary to even consider so they just get angry and defensive in conversations like this. I dont expect any different from you but it is quite sad really.

      • Hi Robin
        The assumption is that I/we have not made an opened minded investigation and that your lack of ownership of knowledge should be the guiding principle to all things. Most of us here in the I.H.M. have a technical background in medical science and have been convinced by the efficacy of this therapy by systematic testing and application in life threatening situations. Some of us HAVE tried polypharmacy in rational testing, and some of us have tried some of the more extreme approaches feted as ‘homoeopathic’. We dont own truth. Laws of nature do not change. Application of a therapeutic approach can only be a singular experience based on a systemised and rational approach to test it for effective response. We have done that. We do not see any other approach as successful or repeatable. That is our experience. We prefer the medical and scientific formula of repeatable results.

  3. does fit definition of science should have read doesn’t fit

  4. Hi Robin,
    Further, the homoeopathic principle is separate from the ‘therapy’ of homoeopathy. Homeopathy is an application of therapeutics in a defined and tested and repeatable manner, which will invoke a recognised response from an organism via a tested and ratified notation of symptoms produced.
    I have NO objection to a medicine being made of 50 substances, as long as a testing/proving is made of the combined manufacture and then applied on the resulting provings. I DO have a problem with 3 substances made individually and then combined with each other and prescribed for elements of each. That is not scientific and not repeatable and as such, not really good medicine. So yes………. I can say that results based on rational protocol stand a better chance of working.
    Its a bit like buying a motor vehicle and ignoring the handbooks instructions on how to drive it… the vehicle WILL malfunction. It has been designed to work a specific way.

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