Category Archives: Guest Comment

What has changed, or constitution? Aphorisms 5 and 6 revisited

By Vera Resnick

James Tyler Kent

So what should it be – Aphorism 5 or Aphorism 6? Let’s look at them… (text taken from 6th edition)

Aphorism 5:

Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.

Aphorism 6:

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.

So – which one is it? If the information described in Aphorism 5 is what is needed to make an accurate homoeopathic prescription, we can understand the Kentian-style intake, lasting hours and sometimes even days. We can also understand how Kent – with a little push from Swedenborg, ok, a hefty shove – came to the concept of the constitutional remedy. A remedy which encompasses the patient’s entire soul and psyche, in this life and – depending on your beliefs – in all those that came before and will come after…

Since Kent’s time, homeopaths have worshipped at the altar of the Constitutional Remedy, the simple substance – a Swedenborgian, not Hahnemannian concept – and this is what most non-homoeopaths and homoeopaths alike believe Classical Homoeopathy to be.

But then what do we do about Aphorism 6? This Aphorism and its instructions have been swept under the constitutional carpets of so-called Classical Homoeopathy for so long that the simple clarity of focus and objective has been lost to many.

Hahnemann’s language in Aphorism 6 is very clear. “Take note of nothing but the changes in the health of the body and the mind”. How on earth is it possible to ignore that? But it is ignored.

The thing is – this is not an “either/or” situation. Both Aphorisms are essential, but they serve different purposes. We cannot take what has changed (Aphorism 6), if we don’t know what was before (Aphorism 5). We cannot assess those changes and prioritize them if we don’t know whether there is an exciting cause, a maintaining cause, a miasmatic origin (or something that is harming the patient’s health and can be removed – see Aphorism 4) – if we don’t do the work set out in Aphorism 5.

But the central focus, the torch that has to guide us through the often labyrinthine nature of a complex case has to be Aphorism 6. So many patients today are subjected to never-ending sessions where they are asked to disclose their most intimate thoughts, dreams and fantasies, their sexual urges, their emotional relationships past present and future, their failed expectations and unexpected successes. The process is usually emotionally draining, hugely time-consuming, potentially harmful in terms of the patient-practitioner relationship, and without the context set out in Aphorism 6, of no use whatsoever and potentially hinders us from finding the best homoeopathic prescription for the patient.

Nash: thought of the day

Nash states: “The old saying used to be (and was sanctioned by Hahnemann) that acute diseases generally tend to recovery ; chronic never.

There is much truth in it. None but the true homoeopathic physician realizes the importance of thoroughly taking and working out such cases. It is worth $25 to $100 to make the first study of a very difficult case, and mark out the line of treatment. Rarely will a case come out so clearly that the cure can be per- formed with one remedy; but a succession of remedies will be necessary, and here is where the so- called complementary relations of remedies come in for recognition and skillful application.

Some will object that they cannot afford to pay such a price for a single study of a case. Well, it is probable that such will pay more than that for work done over and over again, because not well done at the start ; and worse still, will stand little if any chance of ever getting a cure. It is a clear case of ” penny wise and pound foolish.’ ‘

Many persons go through life invalids, patching symptoms, or temporary manifestations of disease, which, if understood and dealt with in their entirety, as they should have been at the start, they might have been well and happy. To be sure it is for the pecuniary advantage of the physician to do that kind of patching a few dollars at a time, without curing it. It makes him, or some brother physician, a ” job” for life. If the patient gets tired, or disgusted, and goes to Dr. A., one of Dr. A.’s patients does the same thing, and comes to him, and so the good work goes on. Physicians are about the only profession that are expected to do a good job for the same pay as a poor one. They are not expected to charge any more for prescribing for phthisis pulmonalis or any other chronic case that takes a week of careful study to do good work than they do for a simple case of indigestion from over-eating, which would get well of itself if let alone. The physician cannot therefore in justice to himself and the family dependant upon him spend the necessary time upon it. The pay is the same. So the doctor gets discouraged because he is not paid for good work, and the patient because he, or she, gets no benefit.

The biggest humbugs on earth get more wealth out of patent nostrums, out of the “grand elleptical Asiatical panticurial nervous cordials” that are warranted to cure all the ills to which flesh is heir than the most educated, able and conscientious physician in the world. Hence there is small encouragetnent for the educated physician, and less hope for the victims. Clairvoyants, ignorant Indians, charlatans and quacks of all shades and varieties ” boom their wares,” and the true physician looks on disgusted, but helpless.

The people as ignorant of medicine as those who impose upon them “want to be humbugged” and are. If we object we will be met with the bluff that “you are mad be- cause you want the money there is in it.” What do the quacks and pretenders want ? But there is after all a bright side to this picture. There are persons, and quite a good “many of them, who believe in the educated physician as well as educated men in the other professions. They know how to appreciate the study, time, patience and pains-taking of the honest physician who works for them, and are willing to pay him. Only for this the practice of medicine, scientific medicine, would become a lost art. “

Naturopathic doctors gaining new powers

Naturopathic doctors in Ontario and British Columbia are celebrating legislative gains that will allow them to prescribe drugs as well as natural products, and naturopaths in Manitoba and Alberta may soon be joining the party.

In Ontario, the provincial Standing Committee on Social Policy voted in October to approve Bill 179, which will amend the Naturopathy Act to allow qualified naturopaths to dispense, compound or sell drugs listed in accompanying regulations. Although the bill requires third reading and passage by the legislature, the Ontario Ministry of Health and Long-Term Care supports it and, given the Liberal majority, it is expected to pass.

The regulations that will determine which drugs naturopaths will be allowed to prescribe must still be hammered out — a process that could take up to three years. Although naturopathic doctors in Ontario believe they will eventually be able to prescribe basic primary care drugs and crash-cart medications, as in British Columbia, they also expect some lobbying against that power from organizations representing medical doctors.

“We feel very positive about the changes, the new regulations in British Columbia and what’s being proposed in Ontario,” says Shawn O’Reilly, executive director and director of government relations for the Canadian Association of Naturopathic Doctors. “What we’re seeing is that shared scope of practice legislation is being tabled and approved across the country, and naturopathic doctors are being included in that legislation.”

The changes are in the best interests of patients and will foster comanagement with medical doctors and others, she adds.

Not everyone appears warm to the notion of expanding naturopath prescribing rights beyond natural health products, though.

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Will that be an herb? Or a drug? That prescriptive option will soon be available to many naturopathic doctors in Canada.

“The intent is just to allow them to do what they are already doing with the natural health products,” says David Jensen, a spokesman for the Ontario Ministry of Health and Long-Term Care. Whether pharmaceuticals are added to the list of products naturopaths will be permitted to prescribe, compound and dispense “will need to be seen as it is spelled out in the regulations,” he says.

In a statement, Dr. Suzanne Strasberg, president of the Ontario Medical Association, raised concerns about the proposed expansion of the scope of practice for naturopaths. “We believe that the use of pharmaceuticals or synthetic drugs is completely outside naturopathy’s educational framework and scope of practice,” she stated.

In British Columbia, the government last April passed legislation allowing naturopathic practitioners to prescribe Schedule I medications, which include basic primary care drugs such as antibiotics. In addition, qualified naturopaths will be able to prescribe hormones, botanicals, high-dose vitamins, amino acids and other natural substances they have traditionally used in their practices, but which are increasingly coming under federal control and scheduling limitations. In many provinces such as BC, only medical doctors, dentists and veterinarians could previously prescribe substances such as digitalis and other botanicals and hormones that naturopaths normally used.

Under BC’s legislation and accompanying regulations, naturopaths will not prescribe certain restricted classes of medications, such as antipsychotics and chemotherapy drugs. The regulatory board that governs naturopathic doctors is now finalizing the standards and list of substances that naturopaths will be allowed to prescribe.

But they will first have to meet educational requirements and pass a qualifying examination, says Christoff Kind, president of the British Columbia Naturopathic Association. “The whole thing really is just based on providing for a shared scope of practice model here in BC, which I think is coming across the country,” he says. “Professions that have the training should be allowed to practise to their level of education and expertise.”

The changes will mean that if a naturopath has a patient with acute pneumonia, for example, he will be able to prescribe an appropriate antibiotic instead of sending the patient to their family doctor, Kind says. “It will allow for more streamlined health care.”

Meanwhile, Manitoba has just approved umbrella legislation regulating health care professions that is similar to that of BC. Naturopaths are expected to be included “as part of the second wave moved under that legislation,” O’Reilly says. Alberta has done the same and regulations have been drafted there but not yet finalized.

In the United States, 11 of 16 jurisdictions that regulate naturopathic medicine have awarded naturopathic doctors prescribing authority. Although the pharmaceutical formulary varies in different states, it is extremely broad in Hawaii, California and Washington. In Arizona and Oregon, naturopaths are allowed to prescribe most pharmaceuticals except some therapeutics and narcotics. In Utah, they may prescribe and dispense all non-controlled drugs, while in Maine, they must first complete a one-year collaborative relationship with a medical doctor.

Kent, the Constitutional Remedy, Aphorisms 5 and 6

Here is another viewpoint as to why Aphorism 5 is misunderstood.

Authored by Vera Resnick on https://pandwisrael.wordpress.com/2014/06/16/kent-the-constitutional-remedy-aphorisms-5-and-6/

Kent. James Tyler


So what should it be – Aphorism 5 or Aphorism 6? Let’s look at them… (text taken from 6th edition)

Aphorism 5:

Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.

Aphorism 6:

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.

So – which one is it? If the information described in Aphorism 5 is what is needed to make an accurate homoeopathic prescription, we can understand the Kentian-style intake, lasting hours and sometimes even days. We can also understand how Kent – with a little push from Swedenborg, ok, a hefty shove – came to the concept of the constitutional remedy. A remedy which encompasses the patient’s entire soul and psyche, in this life and – depending on your beliefs – in all those that came before and will come after…

Since Kent’s time, homeopaths have worshipped at the altar of the Constitutional Remedy, the simple substance – a Swedenborgian, not Hahnemannian concept – and this is what most non-homoeopaths and homoeopaths alike believe Classical Homoeopathy to be.

But then what do we do about Aphorism 6? This Aphorism and its instructions have been swept under the constitutional carpets of so-called Classical Homoeopathy for so long that the simple clarity of focus and objective has been lost to many.

Hahnemann’s language in Aphorism 6 is very clear. “Take note of nothing but the changes in the health of the body and the mind”. How on earth is it possible to ignore that? But it is ignored.

The thing is – this is not an “either/or” situation. Both Aphorisms are essential, but they serve different purposes. We cannot take what has changed (Aphorism 6), if we don’t know what was before (Aphorism 5). We cannot assess those changes and prioritize them if we don’t know whether there is an exciting cause, a maintaining cause, a miasmatic origin (or something that is harming the patient’s health and can be removed – see Aphorism 4) – if we don’t do the work set out in Aphorism 5.

But the central focus, the torch that has to guide us through the often labyrinthine nature of a complex case has to be Aphorism 6. So many patients today are subjected to never-ending sessions where they are asked to disclose their most intimate thoughts, dreams and fantasies, their sexual urges, their emotional relationships past present and future, their failed expectations and unexpected successes. The process is usually emotionally draining, hugely time-consuming, potentially harmful in terms of the patient-practitioner relationship, and without the context set out in Aphorism 6, of no use whatsoever and potentially hinders us from finding the best homoeopathic prescription for the patient.

The Homoeopathy of Emotion – Enlightened Case-Taking

First published in May 30, 2011. A tongue in cheek look at modern homoeopathy.

By Priscilla Rowbottom, FHom, DHom, XHom, PQRS (Dip) (Lic), HomQuack

I am so excited, I felt I had to share this with my readers world-wide. I took my first case yesterday using a sensational new method – The Homoeopathy of Emotion. I invented it myself. The name is so catchy, don’t you think? I just felt that all this dry, symptom-based case-taking and repertorisation was so… so limited. Unenlightened. Vibrationally low. After all – what can be expected from a method where they ask you about your…(if you’ll excuse me)…shhh…stools…

Anyway, an asthmatic patient came to my clinic the other day. I do so love having a clinic, I have my name on the door, a secretary outside who runs my appointment book, and I’m very fortunate to have a large clientele. Patients usually only come once or twice – after that they are clearly cured as I never see them again. But there are always more where those came from…

I digress. This asthmatic patient stumbled into my room yesterday. It was urgent – he had been taken ill while arguing with the secretary about the cost of his vitamins.

He sat in the chair, wheezing and blue. It seemed to ease as he sat down, and he croaked “can you get me some ice-cold water, please?” As he sipped the water slowly, the colour returned to his face. He shivered and pulled his sweater on, even though it was quite a warm day. He burped, and grinned, saying “that’s much better… now can you help me with my asthma, doctor?”

I rubbed my hands in glee. What a perfect opportunity to test out my new method! There was clearly not much else to go on…

“Tell me,” I asked, “do you love your wife?”. I do so believe in getting straight to the point.

He looked bemused. I could see I had to press him.

“Do you feel any love in your life?” I asked, putting on my glasses and gazing at him sternly for greater effect.

“Er…yes…um…” he stumbled, “but what’s that got…”

Ah, I noted to myself, there’s a rubric for this, Answering, Aversion to, Refusing to Answer…was it possible that I had arrived at the core of the case within 5 minutes? Of course it was, after all, I always do…

“You must know,” I lectured, “we treat the whole human being! We must know all facets of your case before we can prescribe! Now tell me, do you, or do you not love your wife?”

“I’m not married,” he responded, somewhat sheepishly.

“Well, why not?” I pressed on regardless, one does have to be relentless in this inspiring work. “Are you sexually impaired?”

“What?” he asked, looking dazed. “Why-?”

I had clearly hit the center now. Male Genitalia, Sexual Desire, Wanting.

I quickly wrote out a prescription for Phosphoric Acid 10M and sent him on his way. He appeared to be wheezing as he left, and as he was settling his bill I heard some shouting, a thump and then frenzied cries for an ambulance.

I’m sure he’s doing much better as a result of my prescription as I haven’t seen him since…

In conclusion – as you can see, it’s only through enlightened case-taking that you can really see through to the core of the case. The patient’s asthma reflects his refusal to respond to the questions life places on him by making him dependent on respiration for life. In addition, his clear lack of sexual desire, obvious from the hangdog look in his eyes, is reflected in his asthmatic state, as his low vibration prevents him from participating fully in the joys life has to offer.

It’s so wonderful to be a homoeopath! I do thank Hahnemann daily for the generous gift of homoeopathy! Especially since my seminar on my new method, scheduled for tomorrow, already has 50 participants, prepaid!

Relearning true homoeopathy

By Dr Guillermo Zamora.

This is a translation from the Spanish. It has not been cleaned up from my poor attempts and google from the Spanish. as I was afraid to lose too much of the meaning.

The full Spanish translation can be found at: https://pandwespanol.wordpress.com/2015/01/10/reaprendiendo-verdadera-homeopatia/

 

When you start your studies in homeopathy, either as graduate or undergraduate, you have no idea what is homeopathy; and when you have, you think that any school or college that offers courses “Hahnemannian” do so on the basis of its creator, Dr. Hahnemann.

It begins to study and as time passes, who had the desire to have studied something medically worthwhile, we engage in a kind of disappointment, noting that we had gotten into something quasi psychological and spiritualist. Using overlays that make teachers in relation to the claims of Samuel Hahnemann inherited from misinformation and lack of research, draw us to Hahnemann always sitting in an armchair by speculations on the principles of homeopathy. This, for those who enjoy speculation and believe themselves discoverers of something beyond human understanding, love to think of a Hahnemann that way. The truth is that, regardless of Hahnemann was also a polymath, he preferred grounded through observation and experience to obtain knowledge; so he said: “I believe more in the experience in my own intelligence.”

Far from the speculative, devious, philosophical, and lazy Hahnemann we paint at school, found through their writings rather a completely observer, recorder, active, experimental, scrupulous critic himself, trying to distort their own hypotheses. He, along with his best pupil, Dr. Boenninghausen, leave us a legacy that few are interested in studying; and in contrast, we find an educational system completely distorted what Hahnemann wanted to establish as a methodology into believing that Kent (and its derivatives) is in complete agreement with him.

After a while of graduates and after tinkering with estereotipándolos remedies with certain personalities of patients, peers, teachers and even parents, we begin to realize that our cup is full lowered effectiveness, if not very poor (at best, 30%, and that thanks to shots of luck). The best we can say is that our patients feel mentally better; like the work of a doctor was merely be a spiritual counselor or psychologist (that is with all due respect to professionals in psychology who I mean everything that has to do with personality disorders).

He had the privilege of meeting Dr. Gary Weaver, who with a distinguished career of over 30 years and having traveled the world visiting museums, libraries, and persons possessing original materials, has researched the true Hahnemanniana methodology. With great generosity, and aware of my interest in knowing the truth, he has shared with me his teachings and after a number of years of practice I am clear that what is taught as homeopathy Hahnemanniana in schools, ironically has nothing to do with Hahnemann simply because Kent did not follow its guidelines and therefore its methodology crowded with religious beliefs and moral prejudice is unsuccessful in most cases where it is applied. All I had to do to relearn and make a turn in my profession, was to accept the facts and teaching without prejudice, at the most consistent and appropriate tools.

Once one entrains on the rationale for Hahnemann, start noticing results. One begins to look more closely at the signs and most notable case and particular symptoms and begin to understand the correlation of their method to the structure, classification and organization of the rubrics in the repertory of Boenninghausen. The TPB is not only a repertoire, but a SYNOPSIS what the Hahnemannian method involves. Both teachers were in harmony and coordination to establish a guide for the homeopath to synthesize all that Hahnemann claimed and desired to convey.

In this sense, teachers accredited seminaries of the Institute for Homoeopathic Medicine, Dr. Gary Weaver, Vera Resnick and Dr. Guillermo Zamora, we use almost exclusively the Therapeutic Pocket Book 1846 (Version 2015 Polony & Weaver) in our daily homeopathic medical practice. And although occasionally one finds that the remedies may not seem the most suitable for the analysis, we find practical tools within the program to view Materia Medica and so do our homeopathic diagnosis.

On the other hand, the Institute for Homoeopathic Medicine has made public its disagreement with the deplorable situation which has led to homeopathy as a medical therapy but has also published for free key points of the truth of Hahnemann, doing translations and sharing material of great value to the homeopath who has a concern relearn and practice their profession from a medical angle efficient, safe, and accurate.

As a final thought, I express my deepest regret to conflict of interest we have closed the doors to impart methodology as defined according to Hahnemann. Some schools and laboratories in Mexico City in Guadalajara Jalisco and Oaxaca. They do not give back to IHM, they give to Hahnemann, and everything seems to indicate that his main interest is to continue autoerigiéndose as “Modern Gurus” and make policy through a medical system that only calls us to a target as indicates the aphorism 1 Organon of Medicine (6th edition.):

“The unique and important mission of the physician is to restore health to the sick, which is what is called cure”

The dubious benefits of Statins. Malcolm Kendrick.

What is T?

Some questions puzzle me, and I search for the answer. For a number of years I am trying to establish. ‘What is T?’ My wife helpfully remarked that it is a drink with jam and bread. Ho, ho.

Moving swiftly on. My question relates to the concept of Number Needed to Treat (NNT). The NNT is a figure widely used in medicine as an outcome measure. It means how many people do you need to treat ‘T’ to achieve a benefit of some kind. The benefit can be many different things, for example: pain relief, curing a chest infection, improving pain and mobility following a hip replacement.

In these cases the ‘T’ is pretty clear cut. You have a medical problem and you intervene in some way to make it better, or cure it. But what is the ‘T’ when you are in the world of preventative medicine? If you are trying to stop something happening e.g. a heart attack, stroke, pulmonary embolism, or death, can you call preventing such things a form of ‘treatment?’

In reality, in preventative medicine, the ‘T’ turns into something else. It has become ‘P’, as in prevent. But treating and preventing are not the same thing, and you can’t use them interchangeably.

If you have a chest infection and I give you antibiotics then I have, in most cases, treated the infection. On the other hand, if you have a high blood pressure and I ‘treat’ it, all I have done is the lower the blood pressure. I have not immediately done anything else. A high blood pressure causes no symptoms, and there is nothing to be treated – other than future risk.

In fact, if lowering the blood pressure were a form of treatment, the NNT would be very nearly one, in that I will lower the blood pressure in almost every case where I prescribe a drug. But the NNT does not refer to the effect on blood pressure lowering; it refers to the number of people you need to treat to prevent, say, a stroke, by lowering the blood pressure.

As I hope is clear, in preventative medicine, the NNT should really be the NNP.

So what, you may think. Everyone working in this area knows that the NNT is really an NNP. You just need to know that when we use the term NNT, we are really talking about the number needed to treat to ‘prevent’ an event. Yes, this is true. However, the underlying problem with nomenclature does not disappear if we change NNT to NNP. The focus simply shifts to the word prevent itself. To prevent something means to stop it happening – forever.

Now, let us imagine death.

Can we prevent death? No, clearly we cannot. We do not make people immortal by lowering their blood pressure. All we can do, the very best we can possibly do, is to increase life expectancy – by some amount. Which means that prevention does not actually mean prevention. When we look at death as an outcome, prevention can only mean life extension. Or, turning this the other way round, the amount of time by which we delay something from happening.

At this point, I hope it has become clear that ‘T’ in preventative medicine has almost nothing to do with ‘treating.’ We treat nothing, we prevent nothing, we simply delay. At least that is all we can do with death. It is possible that we may prevent things such as non-fatal strokes, although we don’t really know, because we do not usually follow people up for long enough to be certain.

Why is this important? It is important for the following reason. When many clinical trials finish, and there is a difference in the number of deaths between the treatment and placebo arm, it is claimed that the difference represents lives that have ‘been saved.’ Which is another way of saying that death has been prevented which is, in turn, a different way of saying that death has been treated. NNT.

To give an example of how this work in real life I shall switch to statins and the Heart Protection Study (HPS)

Heart Protection Study
HPS1

This graph shows the ‘mortality’ curves for the statin and placebo arms. At the start of the trial everyone is alive, 100% in both groups. Five years later, the end of the study, 92.6% of those in the statin arm were still alive, and 90.8% of those in the placebo arm were still alive. A difference of 1.8%.

This was presented, in the HPS press-release, as follows:

‘In this trial, 10 thousand people were on a statin. If now, an extra 10 million high-risk people worldwide go onto statin treatment, this would save about 50,000 lives each year – that’s a thousand a week.’ http://www.ctsu.ox.ac.uk/~hps/pr.shtml
This is a very clear statement. Treat ten million people, and you will save 50,000 lives per week. But are these lives actually saved. No, of course not. Below, I have re-drawn the graph and extended both ‘survival’ lines by a year. We now have a year six.

HPS2

As I hope is clear, by year six, if we assume the lines continue along their previous trajectory, every single extra person who was alive in the statin arm, compared to the placebo arm, is now dead. Thus 1.8% of people did not have their lives ‘saved’. In fact, the average increase in survival time for these 1.8% was approximately six months. [Half of the 1.8% would have died after six months, which give you the mean/average].

So what is ‘T’ in this case. It is certainly not treatment, prevention, or number needed to treat to prevent death. Nor is it 1.8% of lives saved. It is a life extension of six months, for 1.8%.

Or, to put this another way. If you treat one hundred people at very high risk of heart disease (secondary prevention) with statins, what you are achieving is the following:

• 1.8 will live, on average, an extra 6 months.
• 98.2 will gain no benefit

What is ‘T?’ What indeed. Not perhaps what you first thought. T, at present, is taken to mean treatment. With preventative medicine treatment is taken to mean prevention, and prevention is taken to mean lives saved. But you cannot save a life, all you can do is extend life.

So, when someone says….

‘In this trial, 10 thousand people were on a statin. If now, an extra 10 million high-risk people worldwide go onto statin treatment, this would save about 50,000 lives each year – that’s a thousand a week.’

…they are talking nonsense.

In very short summary. NNT is a widely used treatment outcome, and it guides both clinical and economic decisions on what drugs should be used, or not used. It is a pity that in preventative medicine, NNT is meaningless, because ‘T’ has no value attached to it. Indeed, it might as well be a drink with jam and bread.

A Stubborn Case of Doctor Failure-Boenninghausen to the rescue

from Dr Joseph Kellerstein. Canada.

Monday, December 8th, 2008

Marie is a 55 year old lady who walks down the hall using a cane. Her measured steps punctuated by physical effort and lots of obvious pain. She has a charming smile and soft manner that has been strengthened by determination over the years to counter the reflex grimace that suffering demands.

Chief Complaint. Patient presenting November 3/04 – Arthritis. Knees.

Beginning in 1990 she woke up one morning and the left knee ‘went out’. Since then it kept getting worse. She has had 4 surgeries on the knee. 2 arthroscopic,1 osteotomy,and finally a knee replacement. The patient relates that recoveries from the procedures have always been long. In general although the replacement has helped there is a feeling that the pain has been much worse since the first arthroscopic procedure.

For years there has been this incredible pulling down in my knee. Like a weight pulling me to the ground so severe it stops my legs from moving.

The right knee has a sharp pain that will make me cry out.

Stiffness is worse in the morning.

Knees are worse before rain or snow(latter is more obvious)

Better summer

Worse spring and fall

Worse hot humid

Worse warm applications.

Fibromyalgia.

I ache terribly in muscles. It all acts up at the same time (joints and muscles).

Hot flushes.

I am always hot. Profuse perspiration. It is worse any exertion. Since a recent D and C flashes are worse.

Emotional stressors.

Working as an assistant to an executive I felt like a servant, as if I was being targeted. I was ordered around and got all of the worst jobs. I have always had a problem taking things personally. I am a pleaser.

Chronic Case and Medical History.

Sleep.

I am tired at 10pm and go to sleep. Wake after 1.5 hours due to knee pain and become restless. Best sleep is 6 to 8am. Dream of snakes occasionally.

Grief.

In 1979 patient gave birth. Very shortly after all 4 parents died. This was followed by Hypertension. Soon after there were a series of 3 gout attacks.

Assessment

What struck me initially was the idea of great heaviness in the affected part,worse before the snow, slow healing and grief in a menopausal lady. Sepia sure looked good. Sep 30c

b.i.d.

November 17/04 – 25% less fatigue. Thinking is sharper. More dreams. No other changes Assessment; for this early on looks promising. Plan; continue.

Dec 8/04 – As of one week the knee pain has gotten worse and continued bad steadily. Fatigue has returned. Patient has been weepy. Very reliant on cool applications which offer lots of relief. Assessment and Plan; Sepia had some degree of similitude but not enough to move the pathologies. No new symptoms but latest most intense symptoms indicate Puls.

Puls 30 b.i.d.

Jan 5/05 – Some improvement in stiffness, energy and muscle pain but it relapsed within 2 weeks. Now feel much worse. That incredible sense of weight pulling me down; worse before storm, worse weather change warm to cool. Assessment and Plan; A closer simile but no bull’s-eye. We relapsed to a more intense version of the initial case. The body is trying to tell us these are the leading indicators. I just can’t find the remedy.

I will spare myself the humiliation of the next 8 followups and a similar tale.The symptoms simply talking back to me saying nice try but no cigar.That is no movement in that small cluster of symptoms more than a week and if I went up in potency – no result.

Finally after these wrong prescriptions I sat myself down again and took stock of what was clear.The intense heaviness. The worse before a snow. The various other atmospheric modalities.I was unclear so I called the patient and went through it again carefully. As it turned out she was aggravated with any change of weather especially warm to cold. A computer search led me to a lovely little Boenninghausen rubric in the CompleteRepertory-Heaviness internal, as from a load. I lead with this rubric and followed with worse snow air and worse change of temperature; warm to cold. Suddenly Mercurius became obvious. It still is not a cure. Its too soon but there has been a steady improvement in all symptoms for the last 6 weeks.

And so it goes. Successive approximations until even I can see it.

Homoeopathy – recommended reading

booksRecently I saw a series of responses to a request for recommendations of books on homoeopathy. Predictably, nothing by Hahnemann was recommended. The list – for those who want to know – ranged from Kent’s philosophy, through Vithoulkas, Boericke, Clarke, Coulter, and all the usual suspects. Just not the Organon. No original Hahnemannian provings. No earlier writings at all, really.

I was trying to feel fired up about writing a response, a post, something about how you cannot proceed with homoeopathy without understanding what it was intended to do, using what mechanism and what recommended methodology. But I found I was just too tired of it. Tired of seeing homoeopaths talking about homoeopathy without once mentioning the law of similars – or when they did mention it, making it clear that they did not understand it. Tired of hearing that those (such as me…) who say you have to start where it all started, with Hahnemann, the Organon, the first provings – are pseudo-religious nutters, hanging on to old texts with maddened zeal, ranting (as Hahnemann did) rather than accepting the brilliance and experience of today’s homoeopaths.

But the Organon is really the place to start. It is the only place to start. It is pointless and worthless (and expensive) to invest in a large library of books before you understand what the person who discovered and developed the method intended. It’s not easy to read the Organon. But it’s not easy to be a homoeopath either. If you think you want to be a homoeopath, see first if you can survive the Organon. If you understand the principle and methodology. And then read it again, and again.

If you’re reading later materia medicas you also need to research who copied whom. You will find symptoms repeated from book to book in exactly the same language – which is something of a dead giveaway. This repetition often gives an artificial importance to a symptom, as if many writers are concurring about its relevance – which is clearly not the case. Sometimes the copying was intended as clinical corroboration, but most writers don’t specify that.

The worst is when writers explain Hahnemann – as if their explanation is so perfect that it absolves you from reading the original. That’s almost as bad as claiming to know someone through what other people say about them on facebook.

So what books would I recommend? Before Vithoulkas, before Stuart Close, before Coulter, before Kent, read Hahnemann and Boenninghausen.   Organon. Chronic Diseases. Materia Medica Pura. Lesser Writings.   These books set the foundations, the grounding for your future reading.  Once you have these works solidly under your belt, you will have the tools to assess any other work you read, to see what is useful and disregard the rest.

re: The sensation method.

Hi,

I have read the method in all the books published by Sankaran so far as also
attended his seminars. It is the very enchanting video presentations at the seminars and the captivating material presented in his books that prompted me to use it  side by side with the age old traditional hahnemannian method for some time. I concluded  after thorough study that the theoretical basis on which this entire method is based is flawed. But such is the orchestrated hype about this method in US and Europe that it is hard to get anything published against this method and prove to be a useless exercise that ends up in frustration.

Unfortunately we have not evolved benchmarks to judge any method being propagated  as homeopathy and as a first step we should do it.

The very basis on which Hahnemann founded homeopathy was his discovery :

1. that any medicinal substance is capable of inducing a field force to distort the vital  force of healthy human beings; the nature of distortion presents a recognizable field pattern and it is as true as the law of gravity or any other natural laws.

2. that the same medicine is capable of nullifying any disease force that establishes  a similar distortion of vital force in a human being.

The SIMILARITY of the disorted picture or pattern of the vital force induced by the  medicinal substance in a healthy human being and that created by the natural disease  is essential for curative action to occur.

If Sankaran can prove that the vital sensation can be induced by a medicinal substance in healthy human beings and then prove the correspondences of this artificially  induced vital sensation to the one present in the cured patient – then and then only it qualifies to be a homeopathic method.

I hate to waste any more time discussing this method of madness, an aberration of an otherwise super genius whose convoluted thinking process reflects of a major portion of his brain cells gone awry….alas…

V.T.Yekkirala.