Category Archives: case-taking

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.

 

Homoeopathy and personal observations

Medicine is a difficult thing to define. So many branches within the conceptual understanding of the name.

Many practitioners of homoeopathy erroneously think that homeopathy IS “medicine”, and the reality is that homoeopathy is a branch of medicine. The therapy has a well defined role to play in its application of therapeutics, but can only be effective within the boundaries of what it can cure.

Let me be very clear about my positional stance. I firmly accept that the law of CURE is answered in the Like cures like definition. The therapeutic approach of similars as defined by Hahnemann is the medical application of that law utilising substances that can produce symptoms that can be matched to symptoms that appear within disease states. Substances do NOT produce the disease itself. Substances produce SYMPTOMS. Substances have no personality or TYPE or affinity to human traits, they merely produce SYMPTOMS. There is no SULPHUR personality… only symptoms in disease that produce symptoms that require sulphur for a curative effect.

Homoepathy cannot be used in place of surgery. Sometimes the necessity for surgery can be removed by treatment with homoeopathy, but in general, where mechanical intervention  is required, then a procedure will take place. Homoeopathy is useful in helping the post operative recuperation by aiding the immune system to work with focus.

Homoeopathy cannot replace the need for substances like insulin, but can reduce the volume required. I have seen this many times.

In an emergency situation of trauma, where time is of the essence and the immune system is not working, then primary care application of medicine and procedures must take precedence. Hahnemann recognised this:

A small dose of every one of them certainly produces a primary action that is perceptible to a sufficiently attentive; but the living organism employs against it only so much reaction (secondary action) as is necessary for the restoration of the normal condition.§ 67 Fifth EditionThese incontrovertible truths, which spontaneously offer themselves to our notice and experience, explain to us the beneficial action that takes place under homoeopathic treatment; while, on the other hand, they demonstrate the perversity of the antipathic and palliative treatment of diseases with antagonistically acting medicines. Only in the most urgent cases, where danger to life and imminent death allow no time for the action of a homoeopathic remedy – not hours, sometimes not even quarter-hours, and scarcely minutes – in sudden accidents occurring to previously healthy individuals – for example, in asphyxia and suspended animation from lightning, from suffocation, freezing, drowning, etc. – is it admissible and judicious, at all events as a preliminary measure to stimulate the irritability and sensibility (the physical life) with a palliative, as for instance, with gentle electrical shocks, with clysters of strong coffee, with a stimulating odor, gradual application of heat, etc.

With the advent of modern drugs that will stimulate and revive functionality, I have no problem in adding these to the list of times when emergency treatments are required.

As physicians/consultants/health advisors, we the practitioners have but one responsibility to the patient, that is their welfare. My experience and observation is that applying the law of similars is the best we can offer, yet times will arise when the organism will not respond to the application of the proven remedies to immune deficiencies or damage by drugs or other influences.

We must not be so single minded to ignore facts in our search for cure.

Homoeopaths require expressed and observed symptoms to prescribe. Without a single or multiple symptom or disease expression, we have nothing to base a prescription on.  We need individual reaction to an infection. I am singularly frustrated at times when a patient comes to me in apparent good health without a solitary expression of disorder, and yet examination shows a tumour or life threatening change internally that is not reflected externally as a change in health. These type of disorders require a deep examination of the Materia Medica which may or may not yield a remedy to prescribe.

I have been called to situations where a prescriber has failed to aid elderly patients with confusion and weakness with well indicated remedies, and yet failed to to see that all that was required was a multi vitamin shot or to rehydrate the patient…. common problems associated with the aged.

I have seen prescribers show a complete confidence in prescribing low potencies for pathology and high potencies for other reasons, and yet on observation of the patient, I have observed major aggravations and effects of the remedies in the patient, some for long periods of time.

I have seen prescribers work to the “Herings law” in observation, only to wonder why a practitioner would ignore KNOWN pathological progression of an individual disease state ebb and flow and consider it a good sign?.  (Hint: Hering NEVER made a law… yet another fallacy of the homoeopathic community.)

Practititioners ignore sound observed changes in favour of personality traits and emotions that (are NOT part of an altered pathology) and wonder why a patient does not improve…

I see daily repetition of medicines made (Even with LMs) with the practitioner ignoring aggravations and ameliorations in contradiction to Hahnemanns directions. This is especially concerning because too much medicine can cause a sensitivity in a patient and complicate matters.

Turn back to Hahnemann and learn the brilliance of his observations and advice on case taking, observations, applications of medicine and how to manage the case. It is the real homoeopathy. The only homoeopathy that works consistently.

A Strange case: answer and analysis. 2/2

The Case:

A lady patient talked to me on the phone from the USA and presented the following disease condition for prescribing.

At first, it was easy to hear her, but as the call went to the 15 minute mark, her voice became harder to hear and was becoming quieter and quieter.

She told me that for the past 6 months, she had suffered from a sore throat and extreme weariness and tiredness of the body. She said her knees felt heavy and weak, her hips also, in fact all her lower limbs were weak and tired. Her profession is a trainer for phone consultants for a technology company, and she had been off work for a couple of weeks due to voice issues. She said she would cough , some phlegm would come up and the tone of her voice would change, usually to a higher pitch, much weaker and empty sounding… sometimes she would be unable to talk at all.

Further enquiry produced the following symptoms. The coughing would induce the phlegm (green) to expectorate. She said the taste was like a spoon of sugar and not pleasant. Along with the cough , there would be a feeling of lassitude and weariness in her arms spreading across the upper chest with difficulty in breathing. She felt better not moving at all and deep breathing helped her to breathe more easily.

She stated that she needed to urinate more frequently at night, but did not really feel an urge, just the fullness of the bladder informed her of the need.

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There were a number of ways to approach this case. We here at the IHM primarily use the SYNOPSIS P&W THERAPEUTIC POCKET BOOK as our guide to analysis. For those that know this particular remedy, it would not be necessary to repertorize as the SX are clear, however we present analysis from the TPB to show how it is done.

The above are the presentation of the throat sx. We then could look at the other sx associated:

These two reportorising sheets are for demonstration only to show a choice of SX to use in rubric form. If we converge them we get:

We do not advocate using more than 4-6 rubrics to cover a case, as the TPB works best on accurate sx and will lead to a choice of few remedies quickly.

Indeed, this is how I repertorised:

In looking at the patients reaction to the infection, we see that WEAKNESS is the state. A state of lassitude which amplified when coughing into the upper chest and arms. A read of STANNUM in the MM will show this particularity. It will also show the condition of urination and feeling clearly…

I have a practice over the years of reading EVERY medicine that am to prescribe until I form an accurate picture of the proven SX in mind… if I have any doubt, I always read again.

 

 

 

Hahnemann, Kent and the IHM.

One of the questions we get asked a lot by practitioners, is why concentrate solely on the teachings of Hahnemann, the provers Union and Boenninghausen. We have found over the years that it is always better to go to original sources for accuracy.

Homoeopathic historians have started to address the issues caused by influential homoeopaths from the 19th century on and recognise the confusion that is caused in practice. We sidestep all these issues simply by using the Organon, Chronic Diseases, the other writings of Hahnemann, Boenninghausen and approved sources. If your practice is not as successful and you would like, we would encourage you to revisit some of the methodology you employ in casetaking and repertorisation and pharmaceutical practice, or alternatively take a small seminar with us to educate yourself on the original practice methods.

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Kent is not a Hahnemannian: Differences Between Kent and Hahnemann

By  S. Hehr, M.B.B.S., D.P.M.

(Originally Published in British Hom. Journal as “Was Kent a Hahnemannian?”, Vol. 73, No. 2, Re- edited by Dr R.S.Mann after consultations with Dr. G. S. Hehr)

Kent has been hailed as a true disciple of Hahnemann.1 There should be a reassessment in light of the following contrast between the view of Kent and Hahnemann:

On “authority” and “experience”

KENT:

“We must begin by having respect for law … Let us acknowledge the authority.”2

“… and medicine today, outside of homoeopathy, is a medicine of experience…It is necessary that the exact and proper position of experience should be realized  … Experience has … only a confirmatory place. It can only confirmed that which has been discovered by principle…Experience leads to no discoveries … One who has no doctrines…imagines he discoveries by his experience”.3

HAHNEMANN:

“Medicine is the science of experience…”
“The true healing art is in its nature a pure science of experience …”5

“…the complete true healing art, can never be the work of self satisfied ratiocination…, but that the requisite for this … are only to be discovered  but due attention to nature by means of our senses, by careful honest observations and by experiments conducted with all possible purity and in no other way…

“I demand no faith at all, and do not demand that anybody should comprehend it. Neither do I comprehend it; it is enough that it is fact and nothing else. Experience alone declares it, and I believe more in experience than in my own intelligence.”

“But what and how much …can be determined by no speculative reason or unreason, but experience alone must determine…and in the domain of facts there is no appeal from experience…”8

On relation of skin symptoms to internal malady

KENT: “But this very scientific ignorant doctor has made a failure: he has driven what was upon the surface and harmless into the innermost precincts of the economy and the patient is going to die as a result of scientific ignorance.”9

HAHNEMANN:

“The diseases … springing from such a one-sided destruction of the chief skin symptom (eruption and itching) which acts vicariously and assuages the internal psora (which destruction is erroneously called ‘Driving the itch into the body’)…”10 

“All miasmatic maladies … are always present as internal maladies … before they show their local (skin) symptoms.”11 

“… when the development of the (internal) venereal disease has been completed, only then diseased nature endeavors to mitigate the internal evil and to soothe it,  by producing a local symptom…”12

“…some wretched casuists have considered as resulting from driving back of the poison out of the chancre into the interior body…”13

On psora

KENT: “Psora is the beginning of all physical sickness. Had psora never been established as a miasm on the human race, the other two chronic diseases would have been impossible. All the diseases of man are built upon … it (psora) goes to the very primitive wrong of the human race … that is the spiritual sickness from which … the race progressed into … the true susceptibility to psora…”14

HAHNEMANN:

“…the ailments and infirmities of body and soul … (if they do not belong to the two venereal diseases, syphilis and sycosis) are … manifestations of (psora).”15 

“In Europe and also in other continents … only three chronic miasms are known…”16 “….and indeed so many that at least seven eights of all chronic maladies spring from it (psora) … while the remaining eighth spring from syphilis and sycosis, or from a complication of two of these three … chronic diseases, or (which is very rare) from a complication of all the three of them….”17

On vitalism

KENT: “Hahnemann could perceive this immaterial vital principle. It was something he arrived at himself, from his own process of thinking (but all historians mention that it was Joseph Barthez, b.1734, d.1806, who introduced the term “vital principle”18).

There was paucity of individual ideas at that time… but Hahnemann thought much, and by thinking he arrived at the ideas contained in this (i.e. the 9th paragraph of the 5thedition of the Organon), which only appeared in the last (i.e. 5th.edition of 1833).”19

(Allusion to “vital force” appeared in the Chronic Diseases20 published in 1828, and in the fourth edition of the Organon that we shall refer shortly, Kent substitutes “simple substance for “immaterial vital principle” in the paragraphs subsequent to the one sited above – vide reference 19. This new expression appears to be Kent’s own coinage. Imputation of “much thought” to Hahnemann appears to be Kent’s projection of his own thinking, the result of which was the new expression. Hahnemann’s views on reasoning and speculation are clear in reference 8).

KENT: “…simple substance is endowed with formative intelligence…”21

HAHNEMANN:

“… the instinctive, irrational, unreasoning vital force (instinktarige, verstandlose. keiner Uberlegung Fahige .. Lebnskraft — this could also be translated: instinctive, unable to reason/understand, without capacity for reflection) 22 (the contrast between Kent and Hahnemann over the attributes of vital force is obvious from these words)…

“…unreasoning, merely animal vital force (die verstandlose, bloss aminal ische Lebenskraft).”23

On bacteriology

KENT: “Hahnemann did not adopt any such theory as bacteriology”.

HAHNEMANN:

“… the cholera miasm … grows into an enormously increased brood of those excessively minute, invisible creatures …”24 (How else could one have described bacteria at that time!)

Why was Kent so often wobbling off the pivot? Perhaps it was not for nothing that Jouanny wrote:

“The second trap is to do what certain absent-minded homoeopathic doctors do, namely to consider only the symptoms of the patient in his reaction to his disease, and in particular his psychic signs. This was the attitude of Kent and his spiritualistic school which went so far as to say that the pathognomonic signs of the disease have no importance in the selection of the homoeopathic drug.”

“This is a philosophical attitude which makes homoeopathy into a theology, and considers man to be made only of the soul. There is a great danger here…”

“This attitude has practically destroyed homoeopathy in America where it was at one time a flourishing discipline. It is now practiced by a few esoteric doctors.”

“One can say that this attitude is not in conformity with the methods set out and defined by Hahnemann, because generally the ‘psychic symptoms’ taken into consideration by the followers of Kent, are not experimental changes in the mental behavior of a patient, but the psychological characteristics of susceptible types of individuals. This is the result of the subjective interpretation of the experimenter and the patient. These doctors select the homoeopathic drugs on the basis of psychic symptoms … such a practice can be justifiably criticized …”25

Kent’s homeopathy is not necessarily always Hahnemannian. As Campbell recently put it : “Nevertheless, it does not take a very detailed study of the history of homoeopathy to show that modern practice actually differs in quite significant ways from Hahnemann’s own practice. In both England as well as America, for example, the influence of J.T.Kent, who imported certain ideas derived from Swedenborg, has been paramount since shortly after the turn of the century”.26

Hahnemann’s distinction between the responses of the animate and the inanimate; his view about adaptive responses of the organisms”, 28 his stress on the value of signals in biology;29 his almost foreshadowing of “the law of initial value” of Joseph Wilder,30his near modern views on nutrition31 and his suggestions for psychological exercise32are all missing from Kent’s writings. One feels constrained to ponder how far the words of Inglis (on relation of Galen to Hippocrates) would apply also to the relation of Kentto Hahnemann.

“Ostensibly by the Hippocratic School, he was to subvert its teachings. Hippocrates, Galen admitted, had lead the way … ‘He opened the road, I have made it possible’ … Galen was able to impose his views on how the road should be followed; and as a prolific writer, he saw to it that they were published.33 

Conclusion-  

  1. Kent was a Swedenborgian, and he can be accused of including the fundamental concept of mystical correspondence between spirit world and humans to Homoeopathy. Which distract the Homoeopathic philosophy from Hahnemann’s “Rationality” to Kent’s “Metaphysical”.
  2. This shift from basic nature of reality of human system compel the Kent to start unrealistic and unbalanced emphasis on “Mind” or “Mental Symptoms” or “Mental Origin” of every disease. Hahnemann is realistic and balanced in his approach in an individual case of sick, he searched for the totality where it actually lies but Kent arranges the “Mind” always on the beginning of a case. Kent pushed the basic methodology of Homoeopathy towards “Irrationalism”.
  3. On Miasm, Hahnemann is certain about three different basic causes of diseases, Psora, Sycosis and Syphilis but for Kent, Psora is only basic cause of all the diseases, including two other miasms too.
  4. Hahnemann always talks about the “gentle restoration” of the sick with only mild aggravations, but Kent admitted his was to cure with severe and long homoeopathic aggravations.
  5. Kent underlined the return of all the past symptoms, eliminations and exteriorization (developing skin lesions etc.)  in a case is a good indication and path towards cure, whereas Hahnemann marked them as organism’s defense or reaction against wrong prescriptions and excess of doses.
  6.  Dr Kent may have been a good, efficient and ardent homoeopath but his concepts and theories vary from Dr Hahnemann on most of the basic understandings of Homoeopathy which makes for differences in approach, methodology for treatment of a patient.
    7.  So accepting Kent as a true disciple of Hahneman, as Kent himself claims, undermines the value of Hahnemannian theory and concepts of Homoeopathy. We need to read and practice Homoeopathy as a Hahnemannian methods and Kentian Methods, with their respective theories, concepts and differences from each other.

References:

1 Kanjilal et al – An Appeal to the Homoeopaths of India to Save Homoeopathy. Hahnemannian Gleanings 1979,XLVI,471

2 Kent J.T. – Lectures on Homoeopathic Philosophy. P.19,Chicago : Ehrhart & Karl,  1954.

3 Ibid – P.43.

4 Dudgeon R.E. – Lesser Writings of Samuel Hahnemann. P.439, New Delhi: Swaran (reprint of New York; Willian Radde, 1852 edition)

5 Hahnemann  S. – Organon der Heilkunst, P.7, Dresden: Arnold, 1819.

6 Ibid – P.15 -16.

7 Dudley P ed. – The Chronic Diseases by Samuel Hahnemann, P.124, f.n. New Delhi, Jain Reprint

8 Ibid –P.325

9 Kent J.T. – Lectures.P.27

10 Dudley P. – The Chronic Diseases, P.17.

11 Ibid – P.32.

12 Ibid – P.36.

13 Ibid – P.36 f.n.

14 Kent J.T. – Lectures.P146.

15 Dudley P. – The Chronic Diseases, P.8.

16 Ibid – P.9.

17 Ibid – P.14.

18  Castiglioni A. – A History of Medicine, P.586, New York: Alfred Knoff, 1958.

19 Kent J.T. – Lectures.P.76-77.

20 Haehl R. – Samuel Hahnemann: His Life and Work. P.136, New Delhi, B.Jain Reprint.

21 Kent J.T. – Lectures.P.79.

22 Hahnemann  S. – Organon der Heilkunst, P.IV, Dresden and Leipzig, Arnold, 1829.

23 Ibid – P.146.

24 Hehr G.S. – Bacteriology and Homoeopathy.Br.Hom.J. 1982, 71,62,64-5.

25 Jouanny J. – Essentials of Homoeopathic Therapeutics, P.39, Laboratories Boiron, 1980.

26  Campbell A.C.H. – Editorial, Br. Hom. J., 1980, 69, 3.

27 Hahnemann  S. – Organon der rationallen Heilkunde, P.5-8, Anm.  Dresden, Arnold, 1810.

28 Dudgeon  R.E. – Lesser Writings of Samuel Hahnemann. P.62, Para 289-290.

29 Hahnemann S. – Fingerzeige auf den homoopathischen Gabrauch der Arzneien in der bisherigen praxis. Neues Journal der practischen Arzneikunde von Hufeland 1807, 43.

30  Dudgeon R.E. – Lesser Writings of Samuel Hahnemann. P.34.

31 Hehr G.S. – Hahnemann and Nutrition. Br. Hom. J. 1981,70,208-12.

32 Hehr G.S. – Self awareness and Homoeopathy, Br. Hom. J. 1983, 72, 90-5.

33 Inglis B. – Natural Medicine, 0.18. London, Collins, 1979.

The compiler expresses his gratitude to “Institut fur Geschichte der Medzin der Bosch Stifung”, Stuttgart, for their generosity in supplying Xerox copies of many paper and microfilms of all editions of Organon, without which the paper could not have been completed.

Difficult case clinic.

Spanish and English Speakers. Appointments in person and also by telephone and SKYPE.

El I.H.M. ha establecido una consulta medica en Sevilla.Cada uno de los médicos que trabajan en ella han sido formados en el método Hanemaniano homeopático y en el uso del Repertorio de Boenninghausen para el análisis de los casos clínicos.


The I.H.M. Has established a consulting clinic in Sevilla. Each of the attending physicians is trained in the Hahnemannian method of Homoeopathy and uses the Boenninghausen Repertory for analysis.

Actualmente Gary Weaver reside en Sevilla y es el encargado de la toma del caso junto con Antonio Gil Ortega y Manuel Gutierrez Ontiveros. institutodemedicinahomeopatica.wordpress.com/institute-staff/

Currently, Gary Weaver is resident in Seville for the case taking along with Antonio Gil Ortega and Manuel Gutiérrez Ontiveros.

Igualmente ofrecemos formación clínica para terapeutas que quieran resolver sus casos difíciles, veríamos el paciente en la consulta con la presencia de su terapeuta y le demostraríamos la metodología Hanemaniana en la toma del caso y su posterior análisis.

We also offer clinical training for practitioners for their own difficult cases. We will see the patient in the clinic with the practitioner present and demonstrate the Hahnemannian methodology in the casetaking and afterwards in the analysis.

Nuestra consulta se encuentra en la Barriada los Príncipes Parcela 7 Bloque 8 Sevilla.

Por favor llamen por teléfono 606 207 345 a Manuel Gutierrez para concertar cita.

We have the clinic at Barriada los Principes Parcela 7 Bloque 8 Sevilla. Please phone Manuel on 606 20 73 45 to book your appointment or alternatively you can e-mail us below:

Email: education@instituteforhomoeopathicmedicine.com

Using the T.P.B. successfully.

Polony and Weaver have many thousands of copies of the SYNOPSIS software in general use in the homoeopathic community. People write us asking why they cannot find certain locations or symptoms in the Therapeutic Pocket Book and find it limiting because of this. Its not actually true, however there is a small learning curve with the T.P.B.

5 weeks ago, one such comment was made by a local practitioner regarding a patient of his with cancer. He presented me with a 5 page dossier of the case notes and another 3 pages of notes related to working out the case.

I laughed and told him to just tell me the symptoms of the physical disease expression. Within 5 minutes, I gave him a remedy to consider. He was stunned how on, in his words, a prescription could be made on “an incomplete case analysis”.  Big mistake, huge. For the next 20 minutes I went through his case symptom by symptom and demonstrated how each of the expressed sx were covered by the remedy. I showed him HOW the disease could only be considered on altered sx and that all of his mental emotional notes were either unchanged or personality and thus of no use.

He decided to prove me wrong and gave the remedy to the patient. To his amazement, the patient has begun to respond well to the prescription and is doing much better.

How long does I take to work a case out in the T.P.B.? Usually only a few minutes and either a single remedy is found or there may be 2 or three for consideration. A read of them in the MM will decide which should be used.

To use the T.P.B. is relatively easy. To understand the methodology requires a practitioner to change the method of casetaking a little. No bad thing when you realise is really moving closer to the method utilised by Hahnemann. More accurate and more successful.

The IHM will be running 2 day intensives shortly on how to take the case and how to use the P&W Therapeutic Book to maximise results. It seems such a shame to have the repertory that Hahnemann approved and not know how to use it properly.

We will conduct in Spanish and English here is Seville Spain. Contact us if you have a group that would benefit from learning Hahnemanns method.

education@instituteforhomoeopathicmedicine.com

Case analysis using Boenninghausens Therapeutic Pocket Book.

It is true that the TPB only contains 125 remedies for evaluation. However, in practice, it is also true that most practitioners do not know the value or scope of most remedial actions. It is amazing to find out the curative power of remedies that we have a pre- conceived opinion of as to its field of action, and see it restore sickness to health outside of our comfort zone.

Let me give an example of a recent case with few symptoms. I tried a few remedies in the first 2 days of the presented fever, and nothing really worked. In the end I sat down and looked for what could be observed visually.

The patient had a sticky greasy perspiration. Mainly on the left side of his body.

I repertorised these 3 Sx .  I saw Bryonia clearly was top in the numerical values and as such I was preparing a dose of LM potency to give…

However, given that numerical values are only an indication of the frequent presence of a symptom in a remedy and not an INTENSITY value,  I went back and looked at the patient again and noticed yet another symptom. The perspiration was not clear, it had a brown dirty colour to it on the skin. Discoloured perspiration is not in BRYONIA.

I gave CHINA LM 0/1. Within 4 hours the patient was recovering.

What do we learn from this case? I believe that accuracy in symptom gathering is the requirement of the day. Once gathered, it must be assessed SOLELY on the basis of the symptoms and repertorised ACCURATELY and without prejudice to what we THINK the remedy is. Where a physical SX exists it cannot be ignored if it is a result of the infection.

We must then READ THE PROVINGS TO BE SURE.

March 2017. Mentor training course.

So you have spent a lot of money, invested a couple of years of your life in training, observed several different methods of approach to casetaking and prescribing,  now hold your piece of paper and are on your own in the world of homoeopathy.

Feel alone? A sense of being lost? Not confident in your approach and results?

clinic1The Institute for Homoeopathic Medicine, established in 1986 is very familiar with your situation. The IHM conducts an average of 7 international seminars a year and many thousands of training hours teaching individuals the Hahnemannian methodology of casetaking and case evaluation through the Therapeutic Pocket Book approach by Boenninghausen.

Due to the multitude of prescribing methods taught, we see the confusion in a graduate many times.

Hahnemann developed a very precise and penetrating case analysis mode for ascertaining the precise sx of the disease state.  Modern ‘homoeopathic’ approaches do not utilise ANY of the founders instructions and therefore success in clinical terms is not high on the list.  I often hear, “but the patient feels better”… yes, but they still have the problem they came to you with….

Boenninghausen was Hahnemanns most competent student. To the professions benefit, Boenninghausen managed to encapsulate the manner in which Hahnemann examined a case via symptoms, and was able to formulate the process in an invaluable repertorial process known as the Therapeutic Pocket Book.

tpbpwVladimir Polony and Gary Weaver undertook to do a re translation work (starting in 2007, completed in 2010/11) into English from the original 1846 edition, thus repairing many of the errors found in Allens version. It is now available in English, Spanish, Italian and Hebrew.

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the IHM is offering a special 3 day personal mentoring and teaching weekend with Gary Weaver.

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During the month of March 2017 dates:

17th-19th inclusive.

24th-26th inclusive.

31st-2nd April inclusive.

The 3 day course is available to both Medically qualified and non medically qualified practitioners.

Based in Sevilla Spain.

ENGLISH language only. 

(We can supply a Spanish homoeopathic translator for an extra €150 if required)

There will be a section of the course regarding understanding Materia Medica that will be conducted via Internet with Vera Resnick D.Hom med I.H.M.

What will be included in this 3 day Training.

  • All refreshments and snacks.
  • Tapas lunch.

The training is dedicated to the study of Hahnemanns methodology for case taking. We do not overlay with Kentian/Swedenborg influences and rely solely on the instructions given by Hahnemann,

This will involve:

  • A deep study of the related Organon sections to casetaking.
  • A comprehensive analysis of his rationale for understanding what disease is,
  • What to look for
  • How to complete a symptom
  • How to find the expression of the disease in an individual
  • How to link symptoms for a complete picture of the disease.

We will demonstrate each step of the process with video and powerpoint and multiple case examples.

We will also:

  • Demonstrate Hahnemanns thinking through the analysis process formulated by Boenninghausen in the Therapeutic Pocket Book.
  • This work when used correctly, can quickly point to the generals of a case or indeed the specific single symptoms that point to a remedy for use.
  • We will examine:
  • Miasms
  • Causal events
  • Organ failure
  • Acute diseases
  • Chronic diseases.
  • Totality treatment in one sided diseases
  • How to treat concurrent different diseases.
  • Repetition of medicines.
  • Alternating remedies.
  • LM or Q potencies. How to dose, Repetition, case management and how to deal with aggravations.
  • How to read Materia Medica to get the right medicine.

We award a Diploma for attendees and the chance to qualify for I.H.M. membership. http://ihmstaff.boards.net/board/5/licentiate-practitioners

Fees: The course is offered as stated for €750 per person or less if multiple attendees come in a small group.

education@instituteforhomoeopathicmedicine.com

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.