Category Archives: case-taking

What is the true understanding of aphorism 153?

“In seeking for the specific homoeopathic remedy, i. e., in this juxtaposition of the phenomena of the natural disease and the list of symptoms of the medicines, in order to discover a morbid potency corresponding in similitude to the evil to be cured, the more striking, particular, unusual and peculiar (characteristic) signs and symptoms of the case should especially and almost solely be kept in view; for there must especially be some symptoms in the list of the medicine sought for corresponding to this if the remedy should be the one most suitable to effect the cure.’

Strange rare and peculiar is a phrase often used in homoeopathic circles, and one in which it appears to give licence for any symptom to be used in the case taking.  However, from the aphorism 153 taken from the 5th edition above, we can see the explanation and understanding of the meaning clearly, or we should if we dismiss the veil of Swedenborgianism from Kent that obscures the true case-taking skills as outlined by Hahnemann.

All disease is a collection of symptoms that define the ‘type’ of disease, and from this collection of symptoms, a disease can be classified and if well known, the pathology and progression and even prognosis can be elicited from knowledge.. and within that disease, we can pick out the defining expression that is peculiar to the reaction of the sick person to its influence. (this is not dismissing those diseases that have never been seen before and affect the host in a very unique way).

Reading carefully, we can see that the symptoms that are to be used, are the ones that define the host’s reaction to whatever the infection is, in a characteristic way AND also are defined in a remedy in a similar manner.

To complicate matters, the defining symptoms, may or may not be known to be within the sphere of the presenting disorder, yet are present.

Let me give an example from a remedy, and from a presenting symptom. It is my experience, that a marked and strange and characteristic symptom can be present and have nothing to do with the complaint, yet will also contain the symptoms taken in the intake.

Take a patient with a respiratory disorder. Lack of oxygen has caused the lips to discolour. Normally will be blue, yet in this patient, the skin is mottled, blue and orange and red, and diffuse over the lips.

Another patient with severe psoriasis, on close examination, has the same mottled skin all over her legs between the eruptions.

Yet another patient with skin allergies has presented patches of the same discolouration across his back.

In taking the case of each, the characteristic symptom is the skin discolouration. using that, regardless of the problem, there are few remedies, if actually only one, that produces that patterning. In the main, you will also find that other symptoms of each individual disorder are present in the remedy.

That remedy is Psorinum.

If a symptom is present to such a marked degree, it can become characteristic of both the disease AND a remedy..

We will talk more at another time regarding characteristic symptoms.

 

 

 

Thoughts on case taking

If you ever want a high paying job other than homoeopathy, Id recommend marine electrician… everyone i contacted is booked out………..

That aside, case taking and why many cases fail.

simply put, it usually is because the wrong remedy is given.

Its not hard to fail. We all do it. In order to overcome a large percentage of failures, we have to examine ‘Why ‘ we fail, and usually, it comes down to a singular reason in the case taking. The bottom line is that we are picking the wrong symptoms, plain and simple.

So what is the key to picking the right symptoms?

During this period of lockdowns and distancing, its a wonderful time to study the Organon in a guided manner……..to REALLY understand what is required to treat a person.

Let me dispel a myth. This singular misunderstanding ruins so many cases that it needs to taught time and time again.

§ 211
This holds good to such an extent, that the state of the disposition of the patient often chiefly determines the selection of the homoeopathic remedy, as being a decidedly characteristic symptom which can least of all remain concealed from the accurately observing physician.

The huge mistake here is not reading the Organon in context. Kent et al use this as the primary state of the patient to prescribe………….and it is incorrect. If you use this as prescribing criteria, you may be prescribing on the personality and not the disease.

Aphorism 210 to 230, is discussing…….

§ 210
Of psoric origin are almost all those diseases that I have above termed one-sided, which appear to be more difficult to cure in consequence of this one-sidedness, all their other morbid symptoms disappearing, as it were, before the single, great, prominent symptom. Of this character are what are termed mental diseases. They do not, however, constitute a class of disease the condition of the disposition and mind is always altered;1 and in all cases of disease we are called on to cure the state of the patient’s disposition is to be particularly noted, along with the totality of the symptoms, if we would trace an accurate picture of the disease, in order to be able therefrom to treat it homoeopathically with success.

So contextually, looking here….

§ 6 Fifth Edition
The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.1

No where does Hahnemann state that anything other than altered symptoms be taken into account….dont base the prescription on personality or desires unless altered and opposite to the norm, and of a marked observable nature….

This one shift in taking a case will raise your prescription success rate higher immediately………..

The principles of homoeopathy part 4. (final 4/4)

This is the last post in this short series.

Principle:

“a basic truth that explains or controls how something happens or works”

“a fundamental truth or proposition that serves as the foundation for a system of belief or behaviour or for a chain of reasoning.”

We have principles in homoeopathy. Medical principles that should guide us through all aspects of treatment and patient management. We have example after example with thousands of cases that show success in the face of mainstream and herbal medicine failure.

One principle that homoeopaths seem to neglect continuously, is acceptance of the law and principle of similars, this being the bedrock of the therapy of homoeopathy.

Too often I read homoeopaths suggesting or recommending other therapies like naturopathy, vitamins, acupuncture, TCM, reflexology etc as ‘helpful’ in the current coronavirus spread.

I’m disappointed. It would appear that people claiming to be homoeopaths are not prepared to lean on the principles of homoeopathy and pursue them vigorously to cure patients utilising the law of similars. Why is this? Do they think that other therapies are stronger than the law of similars? Did they forget that Hahnemann showed how naturopathy did not and could not work in the curative principle when he translated Cullens work?

For those wanting a prophylactic for the disease in their area, they need to STOP looking outside of the law of similars and find the similar as per the law. It is ridiculous to leave medical principles behind and look for combination remedies, or herbal solutions as the answer. Do not take any suggestions from naturopathy or Thai traditional or TCM or acupuncture as these do not conform to the law of similars. If a person claiming to be a homoeopath keeps pushing ‘solutions’ outside of the therapy, Let me remind them that they have committed to the principle of similars, and if they do not hold to it, my strong suggestion is that they should re-educate themselves or cease being known as a practitioner of Hahnemann’s therapy. They will do more damage than good.

Given that the majority of members of our profession subscribe to a false practice, it is essential that those wanting to be known as effectual practitioners, know what they are doing conforms to the directives as set by Hahnemann.

Don’t let an emergency cloud your training or judgement. Homoeopathy never fails, just the practitioner.

Homoeopathy faces enough criticism for the practice. Let us not add to it by encompassing other ineffective therapies that contradict the principles into it.

 

 

August 2019 Four day course for entry to IHM register.

This August, as for the last 6 years, we offer the intensive 4-day enrolment to the IHM Register for successful practitioners. Membership is not automatic. However, the training is of superior quality and will benefit all participants.

The course is held at one of our clinics in Seville Spain and will be conducted by one of the creators of the OPENREP SYNOPSIS computer repertory program Gary Weaver (Dhom med) utilising the updated and corrected manuscript of the original (not Allens version) Therapeutic Pocketbook 1846 version.

You will learn Solely from Hahnemanns thoughts and writings. You will see how to view a case from his perspective and how to analyse the case using Boenninghausens repertory for a successful prescription.

For August only, we include the OPENREP program($799)  in the training fee of €1000 Euros.  Never done before.(Windows only)  300 texts and Materia Medicas. 17 Repertories.

 

You will learn:

  • Casetaking
  • Case management
  • SX selection
  • Observation skills and hints
  • What is a miasm and when to use in case analysis
  • LM medicines.
  • multiple case examples and breakdown
  • Use of remedies
  • How to read a remedy
  • etc.

Help Desk <education@instituteforhomoeopathicmedicine.com>

 

 

The loneliness of the long distance homoeopath

One day.

Recently a close colleague and friend refered a patient to me. I dont think he felt confident in his abilities to deal with the issue. I totally refute this erroneous notion but once I looked at the scans supplied of the patients disorder, I understood why. I was filled with sadness and dismay. Rarely have I seen such an infiltration of tumours in organs. I knew we were dealing with a small time frame in which to attempt to get get the body to heal itself if at all possible.

One day.

We talked on the phone and as I took the symptoms as felt by the patient, I was struck by the determination to overcome the problem, yet I also felt that the patient knew how difficult a position they were in. I was not asked for a prognosis, because between us in the short time we knew each other, only one hour, there was an openess and honesty present. We both knew what we were dealing with.

We got the core of the issue quickly. I believe our conversation allowed the patient to accept some things about life and let go of troublesome feelings. Relaxation was heard in the voice.

My mind had formulated a symptomatic choice of remedy, yet I wanted to be sure so as to not make a mistake. We talked on the Friday and I said that I would contact again on the Sunday with the remedy choice and protocol for taking.

One day.

24 hours later, the patients life ended due to being overwhelmed with the disease.

Im not a person to cry easily. I am a person to be affected deeply though by emotions. Death is so final. It is the culmination of life. Where there is hope and a quality of life to be had, I expend all my efforts to try and make it happen. I trust my therapy as the best one generally to facilitate that.

I cannot carry this experience as a failure on my part simply because I didnt get to initiate treatment. I am however grateful that I had the chance to talk with the patient and had the chance to extend support and kindness and human love in the hour of need. No promises, no false hopes, just a sharing.

There is no one to blame. It is the results of human biology and hereditary and environmental situations.

Would homoeopathy have helped? Who knows. Sometimes the human body will not respond depending on the maintaining causes, and sometimes a gentle persuasive touch from the similar remedy alters everything towards health.

I know the law of similars is the only real chance a living body has… so I keep going.

Im sorry I wasnt there earlier for you.

 

 

Online training

We are investing in Audio and video equipment to facilitate a high quality online teaching environment.  For the last two months, I have written outlines for podcasts to explain the rationale behind the instructions contained within the Organon, and how best to carry out then in practice.

We intend to have a 2018-07-21_091637comprehensive collection of files available in due course that will benefit practitioners who wish to practice according to the way of Hahnemann. We will cover aphorisms in-depth as well as explaining the 8 or 9 protocols involved in finding a similimum that comply with Hahnemanns instructions.

These videos/podcasts will be invaluable to newly graduated students from colleges, and for working practitioners who wish to work more closely with Hahnemannian principles in their clinics. We will include case examples and examine each step in choosing symptoms and why, along with the rationale for case management and development towards health.

 

Intuition and Homoeopathy.

There is a trend with Kentian trained homoeopaths, to learn remedies based on personality prescriptions. The training undergone by the practitioners is slanted that way to make it ‘easier’ to prescribe.

The problem with this type of prescribing and remedy comprehension, is simply that it is wrong and dangerous.

Remedies dont have personalities. They are a collection of symptoms produced by a substance. The substances ‘poison’ the living host to produce reaction and the reactive host develops symptoms based entirely on the content of the substance and in the same manner every time. By attributing personalities to the remedy, it destroys the rationale of finding a disease state in a person or animal based on individual symptoms rather than being influenced by the ‘personality’ of the remedy, ie, sulphur is a dirty unkempt dreamer of many things.

I have been in the company of a ‘homoeopath’ for a week who uses intuition and kinesiology to prescribe. A sick patient was in his clinic and he asked me what I would give… after 5 minutes and checking a symptom in the repertory, I made a prescription. He took the bottle of the medicine I prescribed, placed it on her neck and raised her arm. He said, “I dont feel this remedy is correct” and gave her something else. I said to him gently that the patient was very sick and that the remedy I prescribed, in my experience and knowledge of both the disease and the remedy, would be effective in stopping a progression the acute disease.

He said that his intuition confirmed by the muscle testing said otherwise. Later that day, the patient worsened and was taken to hospital…. The homoeopath explained to me that obviously the patient was too sick for the remedy to work! The father of the patient, who had been in the room during our conversation, phoned me later that night, and told me the sx were the same and wanted to know the remedy name I prescribed to give the child. He came to my clinic, picked up the remedy and administered it. The child broke the fever, perspired and was feeling better in 7 hours.

I consider myself intuitive. I see intuition as a subconscious assimilation of experiences, observations and learned knowledge that is tucked away in the recesses of the mind. Many times in observing a patient, I have a feel for a medicine, BUT is based on symptoms expressed that I subconsciously have picked up through my senses and have observed before or have read about… I still balance this intuitive feel with the concrete reality of the Materia Medica.

Having the experience of thousands and thousands of patients over the years, there is knowledge assimilated of symptoms that respond to a certain remedy or treatment protocol. I see a triad of symptoms and recognise the ‘picture’ of a remedy which has these clinical characteristics, and despite the disease name, are present.

I am also keenly aware of subconscious behavioral changes in my relationships. I know when something is not quite right or is different or off. I may not know why, however I know something is going on. I think humans develop similar body behaviour patterns that a discerning observer can pick up subconsciously and relate to previous experiences and thus see what is going to happen shortly, and it does.

Intuition based on solid experience and training is helpful. Based on a false spiritual foundation will fail all too often.

When I work with my colleague Manuel in the clinic, we will come to a remedy based on solid logical reasons. However a few times, Manuel will say to me “you are not happy with this prescription are you?” This is a cue to re-evaluate the case and look for things we had missed.  I am unhappy with the prescription simply because it did not match the pace, pitch and power of my experience with the remedy. It does not “feel right” even though the symptoms match.

We had a child with a bad cold and pains in his body…difficult to get sx as was just less than 2 years old. He had been sick for a week. We arrived at a remedy…. this was a  “you are not happy with this prescription are you?” time.

So we just observed a little more. He was sat in the clinic, the temp was hot, just a diaper on… when the fan blew on him, it did not bother him at all. Our clinic table is glass. I picked the child up and placed him on the table. He immediately began to cry. A minute later I placed his hand on the table and he began to cry again.

I used the rubrics AGGRAVATION cold becoming, part of the body, and touching an object cold. These and other symptoms led us to RHUS TOX as the remedy. he was better the next day.

The correct use of intuition, willing to trust the inner knowledge gained with experience, is a good thing. However, is best to hone the intuition with checking the facts.

 

Homeopathy and Microorganisms Producing Exotoxines

The IHM is posting a wonderful and informative article by Dr. Guillermo Zamora, MD , Homeopath written in 2010.

As Homoeopathic physicians, we are often asked if usage is made of antibiotics in cases of infection, and I have long held that at times, judicious application of them may be necessary.  This article will give food for thought. (Editor G.W.)

****************************************************************

It is clear that at Dr. Hahnemann´s times, was unknown the existence of microbial life, however, it seems to be that Dr. Hahemann in some way alluded to the possibility that something else could cause illness. We can see this in the following paragraphs of the Organon:

Paragraph 31, Organon, 6th ed:

The inimical forces, partly psychical, partly physical, to which our terrestrial existence is exposed, which are termed morbific noxious agents, do not possess the power of morbidly deranging the health of man unconditionally1; but we are made ill by them only when our organism is sufficiently disposed and susceptible to attack of the morbific cause that may be present, and to be altered in its health, deranged and made to undergo abnormal sensations and functions – hence they do not produce disease in every one nor at all times.”

In the next paragraph, Dr Hahnemann refers to the infectious miasmas:

  • 78 Sixth Edition

“The true natural chronic diseases are those that arise from a chronic miasm, which when left to themselves, and unchecked by the employment of those remedies that are specific for them, always go on increasing and growing worse, notwithstanding the best mental and corporeal regimen, and torment the patient to the end of his life with ever aggravated sufferings. These, excepting those produced by medical malpractice (§ 74), are the most numerous and greatest scourges of the human race; for the most robust constitution, the best regulated mode of living and the most vigorous energy of the vital force are insufficient for their eradication.1”

Please read the footnote.

“1 During the flourishing years of youth and with the commencement of regular menstruation joined to a mode of life beneficial to soul, heart and body, they remain unrecognized for years. Those afflicted appeal in perfect health to their relatives and acquaintances and the disease that was received by infection or inheritance seems to have wholly disappeared. But in later years, after adverse events and conditions of life, they are sure to appear anew and develop the more rapidly and assume a more serious character in proportion as the vital principle has become disturbed by debilitating passions, worry and care, but especially when disordered by inappropriate medicinal treatment”.

Often come to mind the famous quotes of the famous Dr. Kent:

“I wonder if scientists reflect when they make statements about bacteria. Naturally they would say that the more bacteria the more danger, but this is not so.”

“Save the life of the patient first and don’t worry about the bacteria. They are useless things.”

“The Bacterium is an innocent feller, and if he carries disease he carries the Simple Substance which causes disease, just as an elephant would.”

In this last sentence, I wonder if the bacteria would transport only the simple substance or they are able to carry more than that, for example: Exotoxins.

*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 staphyloccocus 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:
  1. 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

Furthermore, and as I wrote in my article “How could coexist conventional medicine and homeopathy?”:

“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 exotoxines should not be taken as dynamic diseases; therefore antibiotics should be used on circumstances where lethal toxins are endangering the patient´s life”

Of course, I would like to know about cured cases regarding this matter. Kindly, I invite you to share them with me.

This is a staphylococcus skin case of mine which was treated homeopathically for 5 days. A Lycopodium patient, male, 6 years old (Lycopodium the first two days was improving burning pain, itching, drying vesicles).

4 days of evolution (behind left knee)

Neck.

Behind right knee

After 5 days the patient still was developing new vesicle eruptions and the vesicles that had dried, they were wet again. Furthermore, the patient started to get sloughing and fall of large areas of skin (exfoliation or desquamation) on more than 10% of body surface (As if he were burned). I made several changes: Belladonna (on the third day) and Arsenicum (5th day) … No results. Neither worsening nor improvement.

In this article, I could talk about my successful cases, however, it could be that I had failed (homeopathy never fails), or it could be that there is the need to establish new criteria in order to increase the patient´s safety. I must say that after 5 days, I took the patient to the hospital, and I administered antibiotics against Staphylococcus aureus. Locally, I washed his skin lesions (Three times a day) with soap and water and later I used Cantharis MT (5 drops into a glass water). The patient improved almost 100% in two days, therefore he was taken out of hospital. Doctors were surprised for the quick response and nobody believed that during six years the child had never taken antibiotics, but only homeopathy.

Case taking errors.

A few words written here to offer direction from Hahnemanns instructions to us. In the previous article written by Boenninghausen,  https://instituteforhomoeopathicmedicine.wordpress.com/2017/06/25/the-choice-of-remedy/

it was pointed out one of the commonest mistakes made in case analysis, is the incompleteness of taking the symptoms.

In our clinic recently, a similar set of circumstances arose in a particular case, and we agreed on a remedy that presented in every way to a similimum. However….. Even though the remedy chosen fitted well, Manuel said to me, ” you have that unconvinced look again” and so we reviewed the case over, asking more questions. We found a modality that we had missed and one which WAS the key to the case.

There is an issue that faces all homoeopaths. That is one of taking an accurate and complete notation of all the ALTERED symptoms of the disease state present. A brief look at what is required:

§ 85
He begins a fresh line with every new circumstance mentioned by the patient or his friends, so that the symptoms shall be all ranged separately one below the other. He can thus add to any one, that may at first have been related in too vague a manner, but subsequently more explicitly explained.
§ 86
When the narrators have finished what they would say of their own accord, the physician then reverts to each particular symptom and elicits more precise information respecting it in the following manner; he reads over the symptoms as they were related to him one by one, and about each of them he inquires for further particulars, e.g., at what period did this symptom occur? Was it previous to taking the medicine he had hitherto been using? While taking the medicine? Or only some days after leaving off the medicine? What kind of pain, what sensation exactly, was it that occurred on this spot? Where was the precise spot? Did the pain occur in fits and by itself, at various times? Or was it continued, without intermission? How long did it last? At what time of the day or night, and in what position of the body was it worst, or ceased entirely? What was the exact nature of this or that event or circumstance mentioned – described in plain words?

In our case, which is still ongoing, had we not followed the instructions Hahnemann gave for taking precise symptoms and modalities, we would have GIVEN THE WRONG REMEDY and failed to elicit a cure.

Why?

We did not examine each symptom and COMPLETE the location, the sensations and the modalities. In my clinical experience, it is the modifying factors of a symptom that give the leading clues to the correct remedy. I make it a practice to NOT IGNORE ANY SYMPTOM IN ITS ENTIRETY as it may prove the key to remedy selection.

You may find that a single modality present in each symptom MIGHT  becomes a general symptom of the case. Without having each symptom itemised into its components, There is no accurate case to prescribe for. You may find that a modality is singular to a particular symptom, and on that basis alone is key to the case. I often hear inexperienced prescribers say that they dont like to use rubrics that narrow down the list of remedies too early in case “they miss something”. I personally look for symptoms that CANNOT be ignored and have but few remedies in them.

We will look at this logically.

A known infecting agent will produce a known set of pathological symptoms. By virtue of this knowledge, a name can be given to the disease state, and expressions of that disease will be exhibited in the patient so that, for example, measles can be diagnosed as the “Disease”.

A patient before us has a known disease. This disease has symptoms of

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z.

Not all symptoms will be exhibited in the patient. Our patient for example, will present E J K P V W X Y and Z. However, the collection of these symptoms is the descriptor for the named disease.

So we look at the exhibited symptoms that the patient presents, and note (for example) the Fever, the skin eruptions and the feeling of Nausea.

We start with examination of HOW the fever affects the patient. Is it hot? cold? is it followed or accompanied by perspiration? Is there a time modality? Is it worse for covering or uncovering? What affects it? Is it better or worse from heat? etc etc.

We look at the skin symptoms and examine each and every eruption, location, modality etc.

We look at the Nausea and do the same.

From this we can conclude that Hahnemann fully accepted that the illness was due to infection, but that the reaction to it IS INDIVIDUAL TO THE ORGANISM INFECTED. On this basis, we must keep in mind what is common to the infection and NAMED disease symptoms, and YET peculiar to the individual…….in their individual expression, from which we can elicit the prescribing symptoms for a remedy match.

The choice of the remedy in any concrete case of disease can not be made too carefully or too cautiously. No less in the healing art than in morals, the motto holds good: “Bonum ex omni parte, malum ex quorumque defectu.” Many failures occur, especially with unpracticed beginners, because in examining the symptoms the one or the other was overlooked. Even with the older and more experienced homeopathic physicians, especially such as are very busy, such an occurrence occasionally takes place. (Boenninghausen)

Never be afraid to re look at a case that is not resolving. Of such a case Boenninghausen wrote:

“………But I was cruelly and painfully disappointed when the patient after this period appeared before me, for he was not improved in any respect; on the contrary, his sickly appearance and the threatening redness of the cheeks had increased and the feverish symptoms had been suspiciously augmented. In the meantime the remedy had been used exactly according to my directions, and nothing had been overlooked either in diet or in his mode of life. What then had been the reason for my total failure? Under such circumstances the only reason could be the defective or incorrect examination of the symptoms, so I went over them again carefully, one by one.”

The choice of remedy.

The Choice of the Remedy
— C. V Boenninghausen

Address delivered before the Meeting of the Homeopathic Physicians of Rhineland and Westphalia, at Dortmund, July 28, 1859.

The choice of the remedy in any concrete case of disease can not be made too carefully or too cautiously. No less in the healing art than in morals, the motto holds good: “Bonum ex omni parte, malum ex quorumque defectu.” Many failures occur, especially with unpracticed beginners, because in examining the symptoms the one or the other was overlooked. Even with the older and more experienced homeopathic physicians, especially such as are very busy, such an occurrence occasionally takes place.

This cannot, however, prove either the insufficiency of Homeopathy in general nor the inadequacy of the small and rare doses, and the experienced practitioner, who always looks with suspicion on such excuses, will in such cases first of all subject the image of the disease which he has formed to a new revision, and look for the lack of his success in his medication first in this direction.

It is not, indeed, my intention to offer anything new here to the practiced and experienced physicians. But it does seem to me as if an incidental warning to such as are about to enter on this field might not be altogether superfluous, and I consider it on that account allowable to introduce a case that happened lately, and which will put what I desire to say into its proper light. I do not intend to speak here of curing merely by the name of the disease, the so called “Medicina nominalis”, which is altogether a different matter, and which is still doing untold mischief, for such a treatment is very acme of irrational and unconscionable routine, and warning against such a practice would justly be considered an insult even by the youngest of our colleagues.

Merchant Ph. M., thirty years of age, had caught a cold last winter while traveling; he did not at first pay any attention to it, but the increasing ailment demanded medical assistance. Treatment by an allopath had remained without effect; in fact, during this treatment, lasting three months, nearly all the symptoms had grown considerably worse, so that now, as is so frequently done, the homeopath was called for aid. The following symptom formed the image of the disease:

For the last three or four weeks there has been a hollow, dry cough with hoarseness and much toughness in the larynx, most violent during night. Constriction of the chest with stitches in the left side while lying on that side. Internal heat, without thirst. Severe exhausting perspiration. Striking timidity. great drowsiness, but restless sleep, waking up frequently, while an internal anxiety prevents his going to sleep again. The face pale and collapsed, with a circumscribed redness of cheeks. Pressure in the stomach after eating especially after eating, especially after milk, often with vomiting, first of ingesta and then of gall. Augmented, watery urine. Extraordinary emaciation. He prefers warmth, and it agrees best with him. he feels better in moderate motion than in continuous rest. He had never been unwell much, and had never been actually sick He could take a deep breath without any trouble, and frequently he felt impelled thereto. I could not find out anything about the allopathic remedies which he had used.”

After careful consideration and a protracted comparison of all the symptoms present with our matera medica, every homeopath will agree with me that Phosphorus seemed most indicated of all the remedies, and this so decidedly that none of the other remedies could at all compare with it. I, therefore, felt no hesitation at all to give to my patient my usual dose (a high potency 200c) of this very efficient remedy, and to direct its administration in the usual manner (dissolved in water), recommending to him the usual diet, and directing him to report to me in person in two weeks.

But I was cruelly and painfully disappointed when the patient after this period appeared before me, for he was not improved in any respect; on the contrary, his sickly appearance and the threatening redness of the cheeks had increased and the feverish symptoms had been suspiciously augmented. In the meantime the remedy had been used exactly according to my directions, and nothing had been overlooked either in diet or in his mode of life. What then had been the reason for my total failure? Under such circumstances the only reason could be the defective or incorrect examination of the symptoms, so I went over them again carefully, one by one.

The mistake then appeared in the feverish symptoms, which were only superficially indicated, and which in the patient had an unusual and, therefore, unrecognized form, which was at the same time very characteristic. For while sleeping he was suffering continually from  a dry, burning heat, which on his waking up immediately passed into a very profuse perspiration, which continued without interruption while he was awake, until he fell asleep again, when at once the dry heat reappeared.

Thus the conundrum was solved. This symptom is found only in Sambucus, while in Phosphorus just the opposite is found. Since all the other symptoms coincided my patient received at once a dose of the high potency I usually employ, and the result was then so complete that in two weeks he was freed from all his ailments and felt as well as ever before.