Monthly Archives: February 2017

Why Hahnemann did not repeat medicines when they acted.

Aphorism 245 and 246 of the 5th edition were combined in the 6th edition to make clear the following principle.

§ 246 Sixth Edition
Every perceptibly progressive and strikingly increasing amelioration during treatment is a condition which, as long as it lasts, completely precludes every repetition of the administration of any medicine whatsoever, because all the good the medicine taken continues to effect is now hastening towards its completion. This is not infrequently the cause in acute diseases, but in more chronic diseases, on the other hand, a single dose of an appropriately selected homoeopathic remedy will at times complete even with but slowly progressive improvement and give the help which such a remedy in such a case can accomplish naturally within 40, 50, 60, 100 days. This is, however, but rarely the case; and besides, it must be a matter of great importance to the physician as well as to the patient that were it possible, this period should be diminished to one-half, one-quarter, and even still less, so that a much more rapid cure might be obtained. And this may be very happily affected, as recent and oft-repeated observations have taught me under the following conditions: firstly, if the medicine selected with the utmost care was perfectly homoeopathic; secondly, if it is highly potentized, dissolved in water and given in proper small dose that experience has taught as the most suitable in definite intervals for the quickest accomplishment of the cure but with the precaution, that the degree of every dose deviate somewhat from the preceding and following in order that the vital principle which is to be altered to a similar medicinal disease be not aroused to untoward reactions and revolt as is always the case1 with unmodified and especially rapidly repeated doses.
1 What I said in the fifth edition of the Organon, in a long note to this paragraph in order to prevent these undesirable reactions of the vital energy, was all the experience I then had justified. But during the last four or five years, however, all these difficulties are wholly solved by my new altered but perfected method. The same carefully selected medicine may now be given daily and for months, if necessary in this way, namely, after the lower degree of potency has been used for one or two weeks in the treatment of chronic disease, advance is made in the same way to higher degrees, (beginning according to the new dynamization method, taught herewith with the use of the lowest degrees).

Hahnemann first says that any noticeably progressing and strikingly increasing improvement during treatment excludes the repetition of the remedy because the cure is already hastening to take place.

This means that any time a single dose, or a series of doses, causes a strikingly progressive improvement any repetition is counter indicated for the time being. This is because the vital force is moving toward the cure at a maximum rate and any more doses will only slow down the cure.

Then the Founder takes up the subject when a single dose only causes a “slow, continuous improvement” that may take over 50, 60, or 100 days to complete the cure. In these cases the split-dose of the medicinal solution may speed the cure to 1/2,1/4, or less the time it takes the single static dry dose.

This goal may be accomplished under five conditions.

  1. The remedy must be a true homoeopathic simillimum.
  2. The remedy should be administered in medicinal solution.
  3. It must be administered in the smallest of doses.
  4. The medicinal solution should be repeated at suitable intervals.
  5. Each dose should be succussed prior to administering the dose.

This is the basis of Hahnemann’s advanced posology that teaches the practitioner when to wait and watch as well as when to act according to circumstances. This is what Hahnemann called the middle path approach to posology.

Homoeopathy is a system of flexible response in which the methods of adjusting the dose are central to case management.

The LMs act smoothly for their remedial powers considering their potency actions. For this reason, the LMs are far more suitable than the 200c and 1M for a good number of patients.

The large gaps between the 30c, 200c, 1M and 10M Centesimal are too large for many constitutions and chronic conditions. This Kentian system only offers 7 potencies while there are 30 different micro tonal LM potencies.

These individuals usually do very well on the LMs when they are given properly. If they take 200c or 1M (esp. the dry dose) it causes unproductive aggravations and accessory symptoms.

These are some of the differences. The LMs are safe and effective when the potency, succussions, and dose are individualized and the patient is not over-medicated.

 

By carefully reading the 6th Organon and the Paris casebooks much more information has come to light.

This situation is finally starting to change as homoeopaths experienced in the 4th Organon method take up experiments with the revisions introduced in 5th (1833) and 6th editions (1842).

The method of the Organon is an artistic method that must be individualized to the patient. There are no preconceived schedules that can guide one. The daily dose or alternate day dose may be correct for one person while one dose a week, month or year is sufficient in another.

Any time one gives too many doses one sees the side-effects of over medication. What a homoeopath learns is when to wait and watch as well as when to act to speed the cure.

Comments by David Little…

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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.

 

It works.

The largest study ever conducted by an official body on homeopathy concludes that homeopathy not only works, but is more economical than conventional medicine.

Dana Ullman

The Swiss Government has a long history of neutrality and perhaps for this reason the reports of this Government on controversial issues should be taken more into account than other reports from countries that are more influenced by current economic and political circumstances.

When it is known that two of the top five drug manufacturing companies are based in Switzerland, you might think that this country has a lot of interest in conventional medicine, but this assumption leads to error.

At the end of 2011, a report was published by the Swiss Government on Homeopathic Medicine, representing the most complete assessment of Homeopathic Medicine published by a Government, and has recently appeared in English ( Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety , Costs, Bornhoft and Matthiessen, Springer ). This report states that homeopathic treatment is effective and cost-effective and should be included within Switzerland’s national health program.

The Swiss government’s investigations into homeopathy and complementary and alternative treatments respond to high demand and widespread use in Switzerland of conventional medicine, not only by consumers, but also by doctors. Approximately half the population of Switzerland uses complementary and alternative medicine treatments and values them. And in addition, about half of the Swiss doctors consider effective complementary and alternative treatments. Perhaps most importantly, 85% of the Swiss population prefer therapies of this type that are part of the national health program.

Since 1998, the Government of Switzerland has decided to expand its national health system including certain complementary and alternative medicines, including homeopathic medicine, traditional Chinese medicine, herbal medicine, anthroposophic medicine and neural therapy. The reimbursement of the costs of these patients was an interim measure, while the Swiss government commissioned a study to determine whether they were effective and cost-effective. The provisional reimbursement for these alternative treatments ended in 2005, but as a result of this study, the national health program has again begun to reimburse homeopathic treatments and other alternative treatments. In fact, as a result of a national referendum, more than two-thirds of voters supported the inclusion of alternative and homeopathic medicines within the national health program (Dacey, 2009; Rist, Schwabl, 2009).

Swiss Government: Health Technology Assessment

The assessment of health technologies in homeopathic medicine is by far the largest report ever published by a government. Not only does this report carefully and comprehensively review the randomized, placebo-controlled clinical trials of homeopathic remedies, it has also evaluated its “real-world effectiveness” as well as safety and the relationship between Cost and effectiveness. The report also carries out a comprehensive review of preclinical investigations (physicochemical investigations, botanical studies, animal and in vitro studies with human cells).

And there is more, this report evaluates systematic reviews and meta-analyzes, study results and epidemiological research. This comprehensive review carefully evaluates the studies carried out, both for the quality of its design and for its execution (what is called internal validity) and how it is brought into common homeopathic practice (external validity). The issue of external validity is of great importance because there are scientists and physicians who perform studies on homeopathy and have no knowledge of this type of medication (some studies show that certain homeopathic medicines are used very little for testing, whereas Others use medications that are not indicated for certain patients). When these studies showed that homeopathic medicine did not work, an accurate evaluation indicated that such studies had been designed to refute homeopathy … or simply, the study was an exploratory trial that sought to evaluate the results of a new treatment (exploratory tests of this nature Are not intended to prove or refute homeopathic medicines, but only to evaluate treatment for a person in a specific situation).

“This report evaluates systematic reviews and meta-analyzes, study results and epidemiological research.”

After basic preclinical research and high-quality studies, the Swiss government’s report states that “high-potency” homeopathic medicines appear to induce regulatory effects (eg, balance or normalization of effects) and specific changes in cells And living organisms. The report also notes that 20 of the 22 systematic reviews of clinical research prove that homeopathic medicines mark a trend in favor of homeopathy “(Bornhöft, Wolf von Ammon, et al, 2006).

The Swiss report found evidence supporting the homeopathic treatment of respiratory tract infections and respiratory allergies.The report cites 29 studies on “Upper respiratory tract infections and allergic reactions”, 24 of which offer a positive result in favor of homeopathy. In addition, six of the seven controlled studies comparing homeopathic treatment with conventional medical treatment showed that homeopathy is more effective than conventional medical interventions (the study found another homeopathic treatment equivalent to conventional medical treatment). All these results of the homeopathic treatment did not carry the common side effects in the conventional pharmacological treatment. When evaluating only randomized placebo-controlled trials, 12 of the 16 studies showed a positive result in favor of homeopathy.

The authors of the Swiss government report acknowledge that part of the overall review of research includes negative reviews of homeopathic clinical research (Shang, et al, 2005). However, the authors noted that this review of the research has been widely criticized by both advocates and detractors of homeopathy. The report notes that the Shang team does not even adhere to the guidelines of QUORUM, which are widely recognized as standards for scientific information (Linde, Jonas, 2005). The Shang team initially evaluated 110 homeopathic clinical trials and then tried to compare them with 110 conventional medical trials. Shan and her team determined 22 high-quality homeopathic studies, against only 9 high-quality studies in the field of conventional medicine. Instead of comparing these high quality trials (which would have given a positive result for homeopathy), the Shang team set criteria that ignored most high quality homeopathic studies, thereby supporting their original hypothesis and Established prejudices around which homeopathic medicines are not effective (Lüdtke, Rutten, 2008).

The Swiss report also notes that David Sackett, a Canadian physician who is considered as one of the pioneers in “evidence-based medicine”, has expressed deep concern to researchers and clinicians as it is considered that only double-blind clinical trials Are the means to determine whether a treatment is effective or not. To make this claim, it should be recognized that virtually all surgical procedures are unscientific or untested, because very few have been randomized to double-blind trials.

In my opinion, for a treatment to be considered effective or scientifically proven, a much more thorough evaluation of what is usually done is required. Ultimately, the Swiss Government’s report on homeopathy represents an evaluation of homeopathy, including an assessment of double-blind randomized clinical trials, as well as other evidence, all of which together determine that homeopathic remedies are Effective.

_______________________________________________
Original text appeared in The Huffington Post.


Homeopathy03What is homeopathy?

Discovered at the end of the eighteenth century, thanks to the observations and experiments of Dr. Samuel Hahnemann, homeopathy is based on a biological reality, known by Hippocrates, the law of similarity: “Any substance capable of causing pathological symptoms in a healthy individual, Is capable, at infinitesimal doses, of treating those symptoms in a sick individual. ” Discovered at the end of the eighteenth century, thanks to the observations and experiments of Dr. Samuel Hahnemann, homeopathy is based on a biological reality, known by Hippocrates, the law of similarity: “Any substance capable of causing pathological symptoms in a healthy individual, Is capable, at infinitesimal doses, of treating those symptoms in a sick individual. ” This exact knowledge of the similarity between the drug and the disease justifies the specific goal of Homeopathy to individualize the patient and their treatment, using each person’s reaction capacities. Applying these principles, homeopathy uses organic substances, minerals and vegetables to stimulate the body’s immune defenses. In this way, the body can mobilize its own defenses, against pathogens, viruses and bacteria, and restore its balance, destabilized by the aggressions of modern life (stress, pollution, etc.). Homeopathy is based on two laws: the law of similarity or law of fellow beings and the law of infinitesimality.

In homeopathy, and especially in chronic diseases, the goal is to go beyond the relief of the symptoms that are appearing, it seeks to help the patient to restore overall their natural balance. To this end, the homeopathic doctor in the consultation will take into account, in addition to the symptoms or health problems that the patient presents, their physical constitution and their way of reacting and sensations in front of the disease, besides factors of improvement or of worsening. That is why it is said that the treatment, in homeopathy, is more personalized.

Brief Directions for Forming a Complete Image of a Disease for the Sake of Homoeopathic Treatment.


By Clemens Franz Maria von Boenninghausen

dental_doctor-thinkingsmall    “The invisible, morbid mutation in man’s internal and the change in condition perceptible to our senses in the external (the complex of symptoms), form before the eyes of creative Omnipotence what we call disease; but only the totality of the symptoms is the side of the disease, which is turned to the disciple of healingonly this is perceptible and is the main thing which he can know about the disease, and what he needs to know for the purpose of cure:” –Sam. Hahnemann, Organon of Healing. §6, Fourth Ed.

“The invisible morbid change within and the complex of the symptoms perceptible from without and belonging to the disease are as necessarily conditioned the one by the other and constitute the disease in such a unity, that the latter stand and fall with the former, that they must exist together and disappear together, etc...-Ibid. §11.

“The physician who would investigate the hidden relations in the internal of the organs, may daily make his mistakes; but the homeopath, if he with proper care seizes upon the true image of the complete group of symptoms, has a sure director, and if he succeeds in removing the entire group of symptoms, then he will have surely removed the hidden cause of the disease.-Royal Councilor Rau, “The homeopathic Method of Healing,” Heidelberg. 1824, p.103.

From the words quoted, which contain an important part of the principles of Homoeopathic Practice, we not only see what the physician must know about the patient, in order that he may be able to make a sure selection among the known remedies, but also why he must know it. One single symptom may it be ever so complete and plainly pronounced can never be the complex of all the signs of a disease, which are externally perceptible (i.e., the whole complex of symptoms), nor enable us to guess the rest. Still less is possible if our aid is asked against quite a general name of a disease, which is not otherwise defined (e.g., headache, eyeache, toothache or bellyache), or against an ailment which includes quite a variety of diseases (as, e.g., convulsions, fever, gout, eruptions or against some troubles like lack of appetite weakness, aptness to take cold, insomnia, etc.), which belong to the common symptoms of disease, which are therefore seldom characteristic.

Homoeopathy can only promise a gentle, sure and permanent cure where it is enabled to oppose to disease that remedy which corresponds with the greatest similitude to all its perceptible symptoms, thus where the physician is completely informed of everything with the patient, which is other than should occur with a patient who is in complete health and is of his age and sex. Of course there are cases where the physician is able after a few questions and answers to determine with certainty the selection of the remedy. But in such a case these must refer to the characteristic points of the remedy, which to the experienced Homoeopath not infrequently are so plainly pronounced that he cannot be in doubt. But only the physician who is familiar with the pure virtues of the remedies and the peculiar sphere of action of each one can judge of this, as in one case a symptom else hardly considered may be characteristic, while in another case it may not have any particular value, and will deserve less consideration.

If, therefore, a patient wishes to report his illness to a physician living at a distance, and enable him to select the suitable remedy, he has to act in the following manner:

  1. He should give a general image of the patient by stating the age, the sex, the constitution, modeof living, occupation and especially the dispositiowhen the person was well. In many cases it is also of importance to know other peculiarities, such as, e.g., the complexion, the colour of the hair, leanness or corpulence, whether slender or thickset, enc…., and this should be added.
  2. Then a brief mention should be made of former sicknesses passed through, together with their course and cure, with a remark as to any sequelai they may have left. Then it is very desirable to know the kind of treatment used and the medicines that were prescribed, and if this can be shown by enclosing the prescriptions used thisshould be given briefly but plainly and clearly.
  3. Then the present disease should be described, first in its general outlines, emphasizingthe most prominent or the most troublesome symptoms; then should be given exactly and circumstantially according to the whole extent all the symptoms, describing in every case just how the patient himself feels, or how those around him observe the matter, abstaining from the use of technical terms and learned names as far as possible, as these are general in their nature, while homeopathy must individualize most strenuously.
  4. Then let him give a complete register of all the morbid symptoms, i.e., an enumeration of all the sensations and phenomena with the patient which are not seen in a healthy person. To avoid all unnecessary prolixity and countless repetitions, every symptoms should be given clearly and completely. Withrespect to clearness the usual conversational language in which the internal sensations of the patient may be expressed is at all times the best, and we need only take care that all indefinite and therefore inexpressive words, such as pain and ache, be omitted, and instead of them the kind of pain be described in the best known and most unequivocal expression.

With respect to completeness in every case the exact location of the pain in the body (e.g., on the head: the forehead, the temples, the sides of the head, the vertex, the occupied; then also whether on the right or the left side, in the half of the whole of the head); so also the time and circumstances should be enumerated, which have an influence on the aggravation of amelioration of the pains. As to the time the exact times of the day (whether morning, forenoon, afternoon, evening, night, before midnight, after midnight) should be enumerated. So also the periodical aggravation or amelioration as to hours, days, or seasons should be exactly reported. Among the circumstances it should always be stated what influence is exerted by rest or by motion, and by particular, modes of the same (e.g., lying, sitting, standing, walking, running, riding on horseback or in a vehicle, etc.), so also the influence exerted by warmth or cold, the open air and the room, by various enjoyments, by touch, by baring the body, by overheating, by eating and drinking in general, by emotions, by dry or wet weather, by thunderstorms, by daylight or candlelight, etc., as to the aggravation or amelioration of the symptoms.

In order that there may be a natural sequence in the symptoms and that nothing may be omitted, the subjoined rubric of the condition of the patient should be followed, and in every case it should be noted what there is of morbid; in those cases, where there is nothing morbid, we pass it over, but that which is especially marked, should be underscored. Every new symptom begins a new line. The reporter must consider that every special symptom belongs always to one and the same disease, and that the homeopathic physician must view and weigh every group of symptoms even in epidemic diseases, as if it never before existed in the world, and now appeared for the first time.

The subjects to be considered and the order in which they are to be given are the following:

VERTIGO.

  • According to its nature(whirling around, falling forward, to the side, backward, in a circle, etc.).
  • According to the time of the day(morning, forenoon, afternoon, evening, night, before midnight after midnight).
  • According to position and circumstances.
  • Aggravated.
  • Improved (e.g., on rising from bed or from a seat, on raising oneself up, while moving, while at rest, when stooping, on awaking, before, during or after eating, while riding, during the chill, during the heat, in the open air, in the room,. while walking, riding, ascending, while lying on the back, on the side, while looking upward, during warmth, during cold, during or after stool, after drinking alcoholic beverages, etc.).
  • Attendant troubles (e.g., it becomes black before the eyes, nausea and vomiting, yawning, flushes of heat, various pains in the head or the body, bleeding in the nose, weariness and swooning, trembling, etc.).

OBSCURATION.

  • According to the sensations(e.g., numbness, unconsciousness, stupidity and dizziness, dullness of the head, staggering, drunkenness, chaos in the head, etc.).
  • According to the time of day.
  • According to the position and circumstances.
  • Aggravated.
  • Relieved.

III. IMPAIRMENT OF THE UNDERSTANDING.

  • According to its nature(e.g., exhausted by mental work, nervousness, difficulty in comprehending, inability to think, stupidity, delirium, fixed ideas, lack of thoughts, weakness of thoughts, excited fantasy, fanciful illusions, delusions of the senses, inability to remember distraction, insanity, etc.).
  • As to the time of the day.
  • According to the position and circumstances, aggravated or relieved.

LOSS OF MEMORY.

  • As to its nature: diminutionin the memory, weakness, loss, forgetfulness.

INTERNAL HEADACHE.

  • According to the sensations(rush of blood, boring, burning, pressure inwards or outwards, pulsation, heat, cold, sensation of looseness, crawling, pressing together, pressing apart, tearing, lancinating, with tension, numbness, digging, as if bruised, drawing, twitching, etc.-every time stating with exactness whether the pain occupies the whole head, or is in the forehead, the temples, the sides, the vertex, the occiput, predominantly on the right side or on the left).
  • With respect to the time of the day.
  • With respect to position and circumstances.
  • Aggravated.
  • Relieved.
  • Accompanying ailments.

OUTER HEAD.

  • As to sensations(e.g., dandruff on the scalp, eruptions of various kinds, burning, painful sensitiveness of the skin, swelling, falling out of the hair, painfulness of the hair, sensation of pulling on the hairs, and on the scalp, heat, coldness, twitching, knots and bumps, pain of various kinds in the bones, shuddering, perspiration, tension, lancination, drawing, twitching, contraction, etc.).
  • With respect to the time of the day.
  • As to position and circumstances, worse or better.

VII. AILMENTS OF THE EYES.

  • As to the sensations.
  • On the pupil and on the eye in general.
  • In the eyebrows.
  • In the cavity of the eyes.
  • On the eyelids.
  • In the corners of the eyes (everywhere not only with exactness the kind of sensation, as in the preceding, but also exactly the locality, e.g., on the upper and lower eyelids, in the inner or outer corner of the eye, etc.).
  • As to the time of the day.
  • As to the position and circumstances.
  • Improved.
  • Aggravated.

VIII. SIGHT, VISION.

  • Asto the sensations (dazzling of the eyes, blindness, flickering before the eyes, delusion of the sight as to colors, or as to objects which are not at all present, spots, sparks, mist,. fog, etc., shortsightedness, farsightedness, photophobia, weakness of the eyes, amaurosis, or cataract, dimness of vision, blackness before the eyes, etc.).
  • Asto the time of the day.
  • Asto the position and circumstances.
  • Aggravated.
  • Improved.

EARS AND HEARING.

  • As to sensations.
  • in the ears, various issues from the ear, boring, burning, pressure in and on the ears, changes and sensations inthe glands of the ears, heat, cold, itching, pinching, crawling, tearing, lancinating, tension, drawing, clawing, consistence of the ear-wax, etc.
  • In the hearing (e.g., sensitiveness to noise, delusions of the hearing, buzzing, ringing, tingling, hissing, singing, detonations, etc.-diminution in the hearing, hardness of hearing, deafness, etc.).
  • Asto the time of the day.
  • Asto position and circumstances.

NOSE AND SMELLING.

  • As to sensations.
  • On the nose (e.g., bleeding of the nose, bleeding when blowing the nose, eruption in or on the nose, various issues from the nose, ulceration, burning, swelling, redness, itching, of the nose, crawling sensation, tension, warts or other excrescences, etc.).
  • With respect to smelling (e.g., dulness or total lack of the sense of smelling, sensitiveness of the smell, various delusions as to smelling, etc.).
  • As to the time of the day.
  • As to position and circumstances.

FACE.

  • As to color andexternal appearance (e.g., paleness, redness, various spots, freckles, blue rings around the eyes, yellowness of the face, etc.).
  • As to the sensations.
  • In the face in general (e.g., eruptions of various kinds, swelling, burning, heat, coldness, perspiration, itching, tearing, lancination, drawing, etc.).
  • On the lips (e.g., peeling off, cracking open, bleeding, eruptions, ulcers, burning, itching, spots, swelling, knots, tension, lancination, tearing, etc.).
  • On the lower jaw (e.g., convulsive pain, lockjaw, crackling or getting out of joint, various sensations in the glands of the lower jaw, swelling of the bones, tearing, lancination, etc.).
  • On the chin (e.g., tearing, lancinations, eruptions of various kinds, itching, burning, etc.).
  • Asto the time of the day.
  • Asto position and circumstances, worse or better.

XII. TEETH AND GUMS.

  • As to sensations.
  • On the teeth (e.g., boring, burning, pressure, painful sensitiveness, breaking off and becoming rotten, becoming hollow, yellow or black; itching, cold, heat, pulsation, becoming too long, looseness, gnawing and fretting, crawling, tearing, lancinations, twitches and blows, dullness of the teeth, soreness, drawing, jerking etc.-stating in every case what teeth are implicated).
  • On the gums (e.g., bleeding, swelling, ulceration, redness, paleness, itching, drawing, tearing, etc.).
  • As to the time of the day.
  • As to position and circumstances.
  • Aggravated.
  • Improved.
  • As to the ailments connected therewith, and into what parts, if any, the pain extends.

XIII. MOUTH.

  • As to the sensations.(After what has been given so far, further specifications will be unnecessary.)
  • In the buccal cavity.
  • On the hard or the soft palate.
  • In the fauces
  • With regard to the saliva. .
  • On the tongue.
  • With regard to language.
  • According to the time of the day.
  • According to position and circumstances, worse or better

XIV. APPETITE.

  • As to sensations(e.g., aversion to certain kinds of food or drinks, or special fondness therefore, voracity, quick satiety, some kinds of food or of beverages disagree, troubles appearing, after eating, etc.).
  • As to the times of the day.
  • THIRST.
  • As to sensations and circumstances (e.g., during chill, heat or perspiration, thirstlessness, etc.).
  • b. As to the times of the day.

XVI. TASTE.

  • As to the sensations (various tastes in the mouth, as well during eating as also at other times, and strange taste of some things).
  • As to the time of the day.
  • According to circumstances, aggravated or relieved.

XVII. BELCHING UP.

  • As to sensations (among these things, belching up of food, of water, etc.-with, or without, any special taste, gathering of water in the mouth, heart burn, rising up in the throat, etc).
  • As to the time of the day.
  • As to position and circumstances.

XVIII. HICCOUGH.

  • As to sensations.
  • As to the times of the day.
  • c. As to the position and circumstances, worse or better.

XIX. NAUSEA.

  • As to sensations (vomituria, retching, vomiting of various taste, flabbiness, nausea with a statement as to the part where this is particularly situated, etc.).
  • As to the time of the day.
  • As to position and circumstances.
  • Aggravated.
  • Relieved.
  • STOMACH AND CARDIAC REGION.
  • As to the sensations.
  • In the stomach.
  • In the pit of the stomach (also here in every case should be accurately stated the sensations, with an avoidance of all indefinite expressions).
  • As to the time of the day.
  • As to position and circumstances, worse or better.

XXI. ABDOMEN.

  • As to the sensations.
  • In the epigastrium.
  • In the umbilical region.
  • In the side of the abdomen and the hypochondria.
  • In the region of the hips and loins.
  • In the hypogastrium.
  • In the whole of the abdomen.
  • As to the time of the day.
  • As to position and circumstances, worse or better.

XXII. THE OUTER ABDOMEN (the abdominal walls).

  • As to the sensations.

XXIII. LAP AND ABDOMINAL RING.

  • a. As to the sensations (among these are also ruptures).

XXIV. FLATULENCE.

  • As to the sensations, flatulence, its accumulation, incarceration and discharge, with various smells, noise in the stomach, colic.
  • Asto the times of the day.
  • As to position and circumstances, worse or better.

XXV. STOOL.

  • As to quality(diarrhea, constipation, hard, soft, bloody, knotty, sharp, of especial color or smell, mucous, watery, etc.).
  • Asto the accompanying troubles.
  • Before the stool.
  • During the stool.
  • After the stool.

XXVI. ANUS AND RECTUM.

  • As to the sensations(nature of the piles and the sensations in them, as in general on the inner and outer parts of the anus).

XXVII. PERINIUM

  • As to the sensations.

XXVIII. URINE.

  • As to its quality.
  • As to the sediment.
  • As to the discharge (differencein the tenesmus and the micturition).
  • As to the accompanying ailments.
  • Before the micturition.
  • In the beginning of micturition.
  • During micturition.
  • When concluding micturition.
  • After micturition.

XXIX. URINARY ORGANS.

  • In the bladder.
  • In the urethra.

XXX. SEXUAL ORGANS.

  • As to the sensations.
  • On the sexual organs in general.
  • On the glans.
  • On the prepuce.
  • On the penis.
  • On the testicles.
  • On the scrotum.
  • On the spermatic cords.
  • On the female sexual organs.

XXXI. SEXUAL INSTINCT.

  • As to the sensations(excitation of the sexual instinct, lack of it, impotence and weakness of the potency, seminal emissions, emission of the prostatic fluid, abuse, etc.).
  • As to the concomitant troubles.
  • During and after coition.
  • After pollutions.

XXXII. MENSTRUATION.

  • As to its quality(returning too early, too late, too weak, too copious, too brief, too long lasting, blood is discharged outside of the period, suppressed menses, quality of the blood discharged, leucorrhea of various kinds, etc.).
  • As to the accompanying troubles.
  • Before the menses.
  • When the menses appear.
  • During the menses.
  • When the menses are concluded.
  • Troubles connected with the leucorrhea.

XXXIII. CATARRH.

  • As to the sensations (running coryza, stuffed coryza, quality of the mucus, sneezing, dryness of the nose, nose stuffed up without a cold, etc.).
  • As to the times of the day, worse or better.
  • As to the accompanying troubles.

XXXIV. RESPIRATION.

  • As to the sensations(nature of the respiration as to the smell or sound during respiration, retention of the breath, shortness of breath, with deep respiration, dyspnea, angina, etc.).
  • As to the prevention of the respiration.
  • As to the time of the day.
  • As to position and circumstances, better or worse.

XXXV. COUGH.

  • As to quality(with or without expectoration, husky, deep, hollow, convulsive, a small dry cough, whooping cough, tickling cough, etc.).
  • As to the expectoration (withrespect to consistence, color, taste, smell and abundance).
  • As to the time of the day.
  • As to the excitation(as well with respect to the part where the irritation is located as the external circumstances which call forth the cough)
  • As to the accompanying troubles.

XXXVI. LARYNX AND TRACHEA.

  • As to the sensations.
  • As to the time of the day.

XXXVII. OUTER THROAT AND NECK.

  • As to the sensation in it, with an accurate description of the parts affected (the skin, glands, muscles, bones, etc.).

XXXVIII. CHEST.

  • As to the sensations.
  • On the inner chest.
  • In the outer chest.
  • In the axillary glands.
  • In the glands and nipples of the breast.
  • In the heart and the cardiac region.
  • As to the time of the day.
  • As to position and circumstances, worse or better.

XXXIX. BACK.

  • As to the sensations.
  • On the shoulder-blades.
  • In the back proper.
  • In the small of the back and the coccyx.
  • As to the time of the day.
  • As to position and circumstances, worse or better.

UPPER LIMBS (arms).

  • As to the sensations(in this case we must not only distinguish the exact spot, the shoulder, upper arm, lower arm, hand, finger, the joints of the shoulder, the elbow, the wrist, and the joints of the fingers, but also distinguish whether the sensation is more in the skin, the muscles or in the bones.)
  • As to the time of the day.
  • As to position and circumstances, worse or better.

XLI. LOWER LIMBS.

  • As to the sensations(here should be observed what was said above as to the upper arm).
  • As to the time of the day.
  • As to position and circumstances, worse or better.

XLII. GENERAL AILMENTS.

  • As to the sensations, here may be enumerated what would not find a suitable place elsewhere, so, also, a general description of the kind of pains or other morbid phenomena (e.g., emaciation, bodily exhaustion, varices, trembling and quivering, attacks of epilepsy, or other illness, lack of sensibility, or supersensitiveness, convulsions, paralysis, swoons, restlessness in- the body, tendency to colds, twitches, ere.), state this with the necessary clearness definiteness and completeness.
  • As to the time of the day,keeping in view more the general state of health.
  • As to position and circumstances, worse or better; under which heading would fittingly be given a recapitulation of all that belongs here, having an influence on the wholeas well as on the parts.

XLIII. DISEASES OF THE BONES.

  • As to the sensations, in so far as they have not before been enumerated, in which case it is sufficient to refer to that.

XLIV. GLANDULAR DISEASES.

  • As to sensations, withremarks as given in the preceding rubric.

XLV. CUTANEOUS DISEASES.

  • As to the sensations, especially in those cases where the ailment ‘extends over several parts, with an exact description of the kind of cutaneous disease, the eruptions, itching, burning, ulcers, tumors, blisters, spots, herpes, erysipelas, excrescences ., and their progression according to the time and external circumstances. It is of especial importance to know in ulcers, herpes and itching what change occurs after touching, scratching or rubbing of the same and also the nature of the pus in the ulcers.

XLVI. DISTURBED SLEEP.

  • As to sensations, time, position and circumstances(stretching and yawning, late in falling asleep, waking up at night, insomnia with its well known causes, sleepiness at various times during the day, morbid sleep, troubles during sleep, somnolence, etc.).
  • As to the quality of the dreams with respect to their number, time and subject.

XLVII. STATES OF FEVER.

  • Circulation of the blood, as to its nature, time, and the circumstances influencing the same,
  • Chill, as to its quality, time of day, circumstances and accompanying troubles.
  • Heat in the same way.
  • Shuddering, in the same way.
  • Sweat, in the same way, but especially with respect to the quality of the sweat, as to its color, consistence and smell.
  • Composite fevers, as to their whole characteristic, not only as to the sequence of chill, heat and sweat, but also as to the time of the day, duration, accompanying troubles, and such as precede and follow the attack.

XLVIII. MENTAL DISPOSITION.

  • As to its peculiarity (cheerfulness, changeableness, imaginary state of disease, impatience and hastiness, indifference and insensibility, suspicion and misanthropy, lack of determination, irresolution, anxiety and desperation, timidity and fearfulness, dejection and melancholy, sadness and weeping mood, vexation and obstinacy, excitement and irritability, quarrelsomeness, and passionateness, insanity, fury, etc.); for a sure selection of the right remedy, the most plain and definite information is necessary and it should always be particularly mentioned what was the patient’s disposition when well, and how changed through his disease.
  • As to the time of day.
  • As to position and circumstances, worse or better.

The more complete and faithful the image of the disease is composed in this way, the more safely can the selection of the most suitable medicine for the present group of symptoms be made, and the more surely we may expect help for the same. Only in cases where diseases have been treated with large quantities of allopathic or domestic remedies, there will generally be added to the disease the effects of the medicines, disturbing the image, and in such a case it is absolutely necessary, as stated above, to also inform the homeopathic physician by communicating to him the prescriptions or telling him about them.

In conclusion, I would remark that every time after the completion of the full action of a medicine a new image, of the disease should be taken. It happens at times, though not often, that the symptoms throughout remain unchanged. In such a case at the first presentation one thing or another has been overlooked, and the image had not been presented quite correctly, and the remedy which accordingly was incorrectly selected remained without effect. In such a case it will therefore be necessary to go over the whole image of the disease, one point after the other, and to supplement the presentation by the necessary corrections or explanations.

Most frequently it will be found that in chronic cases which are inveterate, the chief ailing has only been diminished, but still continues, nevertheless when the medicine has completed its action, the concomitant symptoms have suffered such a change that the former remedy will not appear at all applicable any more. In such a case the homeopathic physician can only make a sure selection after having been informed of these changes by a new complete image of the disease. For it is not only taught by experience, but it lies in the nature of all chronic diseases which have in consequence been interwoven with the whole organism, that rarely or never one remedy will cover the whole complex of symptoms; so that it will be necessary in order to destroy the whole malady fundamentally to let several medicines, selected after each report, operate, until nothing morbid may be left.

 

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