Author Archives: Vera Resnick IHM DHom Med (Lic)

What’s in a name? Hahnemann’s warning to beware of disease names

By Vera Resnick

shaHahnemann’s warning to prescribers – beware of disease names…

Treating fibromyalgia? pneumonia? asthma? cancer? gingivitis? diptheria? meningitis?

In his introductions to provings, Hahnemann often gives a list of diseases where the remedy in question has been helpful. Many seem to see this as a clear therapeutic indication for the diseases named. It is noticeable that Hahnemann himself, a very prolific writer, did not write any form of therapeutic catalogue. Continue reading

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Thou shalt never read in bed again…

By Vera Resnick

Many practitioners struggle with the question of how much to limit patients in terms of diet. Patients ask quaveringly “does this mean I can never have coffee any more?” as they clutch cans of caffeine-laden Coca-Cola with whitening knuckles. Is Homeopathy intended to be draconian in food and lifestyle restrictions? Continue reading

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

Restrictions during homoeopathic treatment – in Hahnemann’s words

By Vera Resnick

 

han2Reading Hahnemann is often a bracing experience. When I read his thoughts, which he expresses so succinctly and sharply, I find myself looking at my practice and wondering… Hahnemann’s introduction to China offers many expressions of the bracing sort… This particular subject, relating to medications and lifestyle of the patient while in treatment , appears in Hahnemann’s notes on his proving of China. Continue reading

Pathological desires in homoeopathy…

By Vera Resnick

But is it part of the disease state?

But is it part of the disease state?

A recent sample case showed a patient who said he kept wanting to move – even though he knew it would hurt him. When and how should we use such symptoms?

In this case the patient had dislocated his shoulder. He stated a constant desire to move even though movement was painful for him. Continue reading

Viewed through proving: Opium aggravates

Most of Opium’s proving symptoms can be summarized very simply in the following words: Opium aggravates.

The best overview of this remedy is that which Hahnemann gives in the introduction to the proving – so here it is. Go on, read the whole thing. You know you can do it. For those who get bored quickly, look for an important prescribing tip in the text relating to how to prescribe Opium effectively homoeopathically for pain relief.

Read on! Continue reading

News: NHS tests and drugs ‘do more harm than good’

sad-doctorNHS tests and drugs ‘do more harm than good’

Senior doctors have warned that patients are given drugs and tests they may not need because GPs and hospitals are paid for the quantity of treatment
By Laura Donelly, Health Editor

Click here for the full article in the Telegraph

NHS patients are being given drugs and tests they may not need because GPs and hospitals are paid for the quantity not quality of their treatment, senior doctors have warned.

The Academy of Medical Royal Colleges said patients should be encouraged to ask if their medical procedures were really necessary, in a bid to halt over-diagnosis and needless treatment of swathes of the population.

In an unprecedented intervention, the medics – who represent all 21 medical royal colleges in the UK- said too many patients were being forced to endure tests and treatments which could do more harm than good.

They said the payments system in the NHS, which means hospitals are paid according to the number of procedures they perform, and GP pay linked to diagnosis and treatment, could act against patients’ interests.

The senior doctors said it was time to “wind back the harms of too much medicine” and replace a culture of “more is better” with balanced decision making.

Patients should be encouraged to ask questions such as, ‘Do I really need this test or procedure? What are the risks? Are there simpler safer options? What happens if I do nothing,’ the doctors say.

It comes as a leading scientist said millions of people should stop taking antidepressants, because their long-term risks outweighed the benefits.

Prof Peter Gotzsche, director of a Danish research centre said drugs given to patients with depression, attention deficit and dementia were responsible for the deaths of more than half a million people each year in the Western world.

Writing in the BMJ, Dr Aseem Malhotra, a cardiologist, Prof Terence Stephenson, a former chairman of the Academy of the Medical Royal Colleges, and Prof Sir Muir Gray, from Oxford University, said doctors needed to be more honest with patients about the potential harms of treatment.

They said the current payment system in the NHS encouraged doctors and hospitals to carry out tests and provide treatment which offered limited benefit, and could result in harm.

“The system has no incentive to restrict doctors’ activity; the NHS in England has a system of payment by results, which in reality is too often a payment for activity and encourages providers to do more in primary and secondary care,” the doctors write.

They said family doctors were “increasingly pressured to focus less on open dialogue with patients and treatment options and more on fulfilling the demands of the Quality and Outcome Framework,” a system which pays GPs for performance.

Under the scheme, GP pay is linked to prescription of certain drugs, such as statins to protect against heart disease, and participation in checks for conditions such as diabetes, and screening programmes against cancer.

Hospitals are paid for the number of patients they treat, with a tariff of prices for each operation and test, prompting the concerns that NHS trusts end up being paid for the amount of activity they carry out, rather than the outcomes for their patients.

…The doctors said a “culture of ‘more is better,’ where the onus is on doctors to ‘do something’ at each consultation,” meant patients were too often left anxious after a diagnosis they could do little about.

They said this had led to unbalanced decision making and patients, “sometimes being offered treatments that have only minor benefit and minimal evidence despite the potential for substantial harm and expense.”

“This culture threatens the sustainability of high quality healthcare and stems from defensive medicine, patient pressures, biased reporting in medical journals, commercial conflicts of interest, and a lack of understanding of health statistics and risk,” they write….

Viewed through Proving: The Perfidious Poppy

red poppies

“It is much more difficult to estimate the action of opium than of almost any other drug.”

By Vera Resnick

You may already be familiar with my penchant for tables.  There’s a quote below which in usual unwieldy translation of originally unwieldy German is difficult to read.  Here’s the information in table form, and then read the quote: Continue reading

Homoeopathy? Easy peasy…

Pulsatilla, anyone?

Pulsatilla, anyone?

“If it’s so easy, why isn’t everyone working this way?”

I was asked this question at a seminar I gave several years ago. This is a question that frequently puzzles us at the IHM. Because it is easy.

True, a lot of hard work is needed to get expertise, and then to improve expertise. To read, re-read, and analyze materia medica. To read and discuss cases. To comb the Organon and Hahnemann’s other writings for better understanding of the underpinning of homoeopathy – essential for prescription and case-management; for case-taking clues; for accurate work with remedies.
It’s not always easy to get rid of our preconceptions regarding remedies, to learn to be able to prescribe Pulsatilla on prescribing symptoms whether the patient is a sumo wrestler or a petite, sweet blonde. It’s not always easy to focus on absolute, presenting symptoms when our learned “knowledge” is giving us all kinds of useless hints regarding constitutionals, core delusions, sensations and similar.

Jewish tradition records a story of someone who came to a venerable Rabbi and asked him to explain the entire teachings of the law while standing on one leg.

Well here’s homoeopathy on one leg. Take your case. Take only what has changed and is presenting for prescribing, against the backdrop of the patient’s life and habits. Only use symptoms you could swear to in a court of law. Use symptoms which show the individual expression of illness in your patient.  Look for a remedy that can produce similar symptoms in the healthy, and thus create a similar, slightly stronger, artificial state in your patient. Find the core of that information in the proving. Prescribe.

Still standing here…

The thing is, once you drop the theories, the speculations, once you move away from trying to be clever and insightful, you start looking at what is in front of you. You work with the information the patient gives you about his state of illness (morbid state) – not with your speculations about his personality, or information about whether he’s always loved chicken, or whether he played with Barbie dolls as a child. You work with what you can know about remedies – information contained in the provings. You work with some information gleaned from poisoning and clinical work.  Some of this information was chosen by Hahnemann for inclusion in his provings.   This information should only be taken from the most reliable practitioners (in case you didn’t get it, at the IHM we focus mainly on Hahnemann and Boenninghausen’s work). You put it together and prescribe.

Aphorism 3, my friends. And as the learned Rabbi is reputed to have said, now go and learn the rest…

Viewed through proving: Sepia has left the gym…

exercise sudoku“… It is a sluggish state of the body which requires exercise, and violent exercise to keep it in a state of comfort. …The … symptoms are … better from exercise in the open air…”

What remedy does this describe? Sepia, of course. We all know that Sepia is better for lots of exercise. Don’t we?

This is where it gets interesting. In the proving, for the most part when any physical exertion is mentioned, it’s actually a cause for aggravation. Not amelioration. Walking is mentioned over 90 times in this proving. Around 7 instances are in the introduction, and amelioration from walking appears around 8 times in a proving containing 1655 symptoms. All the rest – approximately 75 mentions of aggravation from walking by my count. Around 21 on these mentions relate to walking in the open air, and Sepia provers did note sensitivity to cold, but that still leaves us with over 50 instances where walking aggravated.

The opening sentences are quoted from Kent’s lectures – most of those reading this probably first met Sepia through Kent. We met this unfeminine female, who is cold, angular, depressed, worn out, and needs violent exercise to keep her human. Add to that the image of the ink-spitting cuttlefish, attacking with sudden sarcasm and retreating – it all gets very picturesque, so to speak. The problem with all these images is that they stick so firmly in memory that even once you know they are fallacious they are very difficult to dislodge. I remember a live case where the homoeopath pointed at the patient, who shrank back in dismay, and declared in tones that brooked no argument – “behold Sepia, fix the image of this patient in your memories!” Needless to say (after such an intro) Sepia didn’t work…

It gets even more interesting however when we look at the therapeutic pocket book, where Boenninghausen included Sepia in amelioration from physical exertion – in 4 points. This brings us to the issue of the grading in the TPB, which is often erroneously considered to reflect the intensity of the symptom. The significance of the grading relates to the extent to which that symptom was verified in clinical use. A symptom appearing in 1 point is a completely valid remedy symptom – just one which has been used less and therefore verified less in the clinic. Sepia in 4 points in amelioration from physical exertion means that Boenninghausen saw this amelioration over and over again, sufficiently so to include it in his carefully and meticulously crafted TPB. Sepia also appears in the TPB under different expressions of aggravation from physical exertion, but only appears in one, two or three points.

So we have the proving – pointing to aggravation from physical exertion, repeated over and over again by provers and by Hahnemann himself in his introduction to the proving. And we have Boenninghausen’s TPB weighting the balance in the direction of amelioration from physical exertion. What’s the “take home” from all this?

I’d suggest the following:

1. Blank out the Kentian “image” (and those presented by other homoeopaths before and since). This image is not helpful for accurate, focused prescribing.

2. Amelioration from physical exertion was presented by Boenninghausen – a master clinician. This strengthens a modality which only found moderate expression in the proving. There is nothing to negate the symptom, and many clinical cases, together with Boenninghausen’s grading in the TPB, to support it.

And possibly most importantly:

3. If Sepia looks like a good fit but the patient is not ameliorated from physical exertion, or is even aggravated by it – don’t rule out Sepia. If it looks like the best remedy for the case, give it. Even if the patient is fair, round, has blue eyes, and is a 15 year old boy…