Tag Archives: case-taking

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

The most common reason a prescription fails.

After studying the writings of Hahnemann for over 30 years, I am more than convinced that he was very clear as to the procedure for taking a case, and what symptoms are required to be used for prescribing symptoms.

It is no coincidence that practitioners who attend the IHM course, and are shown from the Organon and Chronic Diseases the instructions, and are presented with MANY case examples and discussions regarding each case, manage to go back to their homes and revisit difficult cases and have success. Not because the IHM have a modern conception and methodology but  simply because we work in the Hahnemannian manner.

The IHM decided many years ago to bypass all the practitioners of the era who offered explanations as to what Hahnemann was saying, and just take Hahnemanns own writings as good enough. By doing this, or members and students and practitioners have avoided the most common mistake made.

Nowhere does Hahnemann state that one symptom has priority or seniority over another.

In aph 6, he instructs to take ONLY symptoms that have changed since or just prior to the disease/infection, of the body and the mind. Here there is NO differentiation of mental or physical changes in terms of rank.

In aph 153, he states: In this search for a homoeopathic specific remedy, that is to say, in this comparison of the collective symptoms of the natural disease with the list of symptoms of known medicines, in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms of the case of disease are chiefly and most solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure. The more general and undefined symptoms: loss of appetite, headache, debility, restless sleep, discomfort, and so forth, demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and from almost every drug.

Again NO differentiation between mental and physical symptoms.

If we be logical about this, Hahnemann is stressing to find altered expressions of disease in the now sick person, WHEREVER they are and WHATEVER they are.

In aph 133 he states: On experiencing any particular sensation from the medicine, it is useful, indeed necessary, in order to determine the exact character of the symptom, to assume various positions while it lasts, and to observe whether, by moving the part affected, by walking in the room or the open air, by standing, sitting or lying the symptom is increased, diminished or removed, and whether it returns on again assuming the position in which it was first observed, – whether it is altered by eating or drinking, or by any other condition, or by speaking, coughing, sneezing or any other action of the body, and at the same time to note at what time of the day or night it usually occurs in the most marked manner, whereby what is peculiar to and characteristic of each symptom will become apparent.

This applies to ANY symptom mental or physical.

Logic also dictates that if a sick person does not have an altered mental change… WE CANNOT USE IT! We do not use personality in our prescription ever,  UNLESS ALTERED.

Many practitioners during the time of Kent and since have been taught that the mental disposition is the key to solving each case.

They Quote aph 211 to support this postulation. 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.

However: a read of the aphorism in conjunction with the topic under discussion from 210 to 230, will show that 211 is the cornerstone of dealing with one sided mental diseases only!

If a practitioner spend his or her time searching for mental or emotional states for the patient, they will miss out on the correct prescribing symptoms.

That is why we defer to original writings only and leave out interpretations so as to not make a mistake.

 

 

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.

laptop2

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

gary-w

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

Homoeopathic to the Disease State.

dental_doctor-thinkingsmall“Whatever the emphasis or valuation put on any special symptom or group of symptoms, it first must be fundamentally agreed that the totality alone is essential to the selection of a remedy homoeopathic to the diseased state of the patient. No detail is too insignificant. Scrupulous and painstaking care in case taking is paramount. No values must be written into the record, nor over emphasis placed on any division of the symptom total; the mind kept open until all the evidence carefully weighed is in. To possess actual value symptoms must be reliable and definite, of the very warp and woof, unaffected by their appearance or use in other cases; in short, symptoms that clearly individualize the case under consideration- a totality that sets the case apart from any other previously observed. Until this totality is on paper before us there can be no ranking or ascribing of values. Hence the need, however tedious, of sound case taking, for it is fundamental and not to be compromised by bias or past clinical experience.

In order to match the genius of the disease with the genius of the remedy we then seek to rearrange and rank individual symptoms to better discern the remedial agent. Of the symptoms related or observed many may not particularly distinguish. What are some of these?

Pathological symptoms, so-called, indicative of the results of disease were described as ultimates by Kent. These evidences of tissue changes are helpful in diagnosis or prognosis, but because they are effects, not causes, they do not become of primary importance in pointing to a curative remedy. All processes have an origin, and it is their beginnings to which a similar drug pathogenesy may be comparable. Likewise in epilepsy, the remedy is not seem in the actual seizure, but rather in what has preceded perhaps long before.

Symptoms common to all cases of a certain disease are little indicative of a similar remedy. There is nothing here to be found individual and compelling our choice. Symptoms common to many drugs likewise do not stand out in the selection of a similar drug picture.

Symptoms due to drugging, or improperly chosen remedies, or too early repetition do not present the individual nature of the disease as manifested in the changed state and hinder differentiation. Again the long list given by a hysterical patient is difficult to value.

The predominating “my” symptoms in reference to particular parts of the body also belong in the class of lesser values, unless these are striking, or becoming general because they are similarly evidenced throughout the various parts of the patient. Particulars rarely distinguish the individual and to that extent are weak in value.

So are common symptoms, such as loss of appetite, headache, exhaustion, discomfort, etc., often indefinite and therefore not to be emphasized unless qualified further to really individualize the case.

What symptoms, then, stand forth, compelling and of major rank, pointing more directly toward what is essential for cure? A consideration of homoeopathic philosophy antedates proper symptom valuation. Very briefly, it is not the body of man that expresses disease, but the reaction of his vital force against invasion. Nature’s response is in the way of symptoms experienced through sensation, etc. Individualization means the reaction to any morbific agent as evidenced in the patient under our care. When this is clear to the prescriber, there is no thought of remedies based other than on the patient himself. Not the present symptoms alone, but those detectable from birth, show the conflict which has harassed the inner real life in its bid for mortal existence.

Ray W. Spalding MD

Whats in a name?

The single most misleading aspect of homoeopathic prescribing is the attribution of personalities to the remedies.

Prepared remedies are solely prescribed on their abilities to produce symptoms, PERIOD.

I tire of the plethora of books, Materia medicas and so called homoeopathic experts who espouse the personality aspects of remedies. We do not treat personal preferences, traits or idiosyncratic natures of people, we treat pathological changes of states that are the results of disease.

Anything else is not the practice of homeopathic medicine.

How to treat with homoeopathy.

hahnem14After 32 years of being involved in practice, and 7 years spent in intensive study of the masters, I have concluded that homoeopathy is less art than science. Most of what is taken for granted in terms, expressions, understanding and concepts in the therapy, come from Kent and Hering and NOT from Hahnemann.

Hahnemann was a scientist. A man given to accepting material evidence from experimentation and subsequent results. After reading the millions of words he has written over the years, and several times I might add, my observed conclusion is that his medical career was based on facts and not speculation and is to be trusted.

There is a simple premise to using the remedies for curative purposes. They are dilute substances that create observable symptoms in an organism. These symptoms are a direct result from whatever substance caused the reaction and have NOTHING to do with infectious disease states found in sick individuals other than the SIMILARITY of produced symptoms.

When matched symptom by symptom to the sick organism, the addition of the substance increases the reaction in the organism to amplify the specific symptoms upon which the natural immune response in the organism will focus on these heightened symptoms and attempt to remove them. In removing them, the natural disease, being slightly weaker will also be removed.

And for this reason and rationale, it is imperative that we find the right symptom or symptoms within the whole picture of the disease. Aph 6 points out how to find the picture of the disease but aph 153 tells us what we have to extract from this picture to prescribe on.

I have found that when faced with a patient suffering a known disorder, knowledge exists of the disease progress, organs involved, the patterns of the progress of the disease and the prognosis. Given these parameters, a patient suffering from the infection both acute and chronic, will only exhibit CERTAIN characteristics of the disease as the body tries to modify the illness for self protection. It is the total expression of these characteristics that will identify the individuality of the diseased individual and lead to selection of the right remedy or remedies. It is NOT the totality of ALL the symptoms that we look for.

For example, if a patient has a disorder that starts on the left and move across to the right, has perspiration only at night on the back of the head and has a fever after midnight that starts with a chill and then turns into heat, then we have individual characteristics of a personal disease state from the infection . If this repeats daily then this is the core of the state from which all other lesser important symptoms spring, like sleeplessness and mild headaches. It is always best to focus on the primary expression of the disease, the modifiers of the state and symptoms that are present that have no obvious affinity or reason to be present.

We at the IHM have found that in using the therapeutic pocket book, and focusing ONLY on the few important symptoms, that we use less than 5 rubric indicators and come to 3 or less remedies for consideration. A quick read of the remedies will determine which remedy to give or start with.

Do NOT use a mental symptom unless it is morbid and a CLEAR and obvious CHANGE in the state of the patient. Focus only on CHANGED conditions and symptoms that are part of the CHANGED pathology. You will do good work by following Hahnemann.

Problems after Cataract surgery.

eds momma2Eighty something year old woman, generally in good health and very active in her local community providing bread and cakes for folk.

Went in for Cataract surgery in both eyes. Post procedure, was suffering from dry eyes,  a ‘film’ of sticky mucus and obscured vision.

At the same time, an old problem had raised its head again. A diarrhea after eating bread or pancakes.

So the case was analysed: P & W 2015 edition of the Therapeutic Pocket book.

eds momma

 

The practitioner was really sure on each symptom he used for analysis.

eds momma1

After reading Pulsatilla, it was administered in water.

The results were within one day. The dryness cleared up, the sticky film disappeared and also the diarrhoea. The patient was advised to steer clear of wheat products.

The patient remains well 2 weeks later.

Practitioner: Ed Nunnery. Dhom med IHM. Sacremento California.

 

 

Allergies

happy-woman-fotolia_12331389_subscription_xxlI received a phone call from a patient in the USA a couple of days ago. She is 12 weeks pregnant and suffering heavily with her seasonal allergies.

She related the following….

Just want to complain all the time
Feel uncomfortable in my body all the time
Farting all day and night
Congested worse at night
Wake up with tons of mucus
Violent sneezing, like I will head butt someone
Coughing when lying down
Eyes are very itchy, dry, red and swollen, esp at night, dry,
Feel better in nature and while walking
Worse with bright lights and technology
Worse after 4pm, very worse from 6-8pm
Better in the morning and in the sun
Insomnia because so congested and itchy
Wake up 5-6 times a night blowing my nose
Very irritable and dry
Don’t want to be touched, esp hot hands
I didnt even repertorize the case. I prescribed LYCOPODIUM 30c in water 4 doses.
Response?:
Hi Gary, I have taken three doses so far and I have to tell you, I feel so fantastic. I finally have energy again! I wasn’t tired between 4-8 last night and even went out for a walk at 8pm, which never happens!!! I had a good 8 hour rest, only woke up 3 times to use bathroom (a miracle compared to 6-7 times) and slept a solid 4-hour stretch. I think the last time that happened was before I got pregnant. I was up at 6am and finally have the energy to clean my house. Wow. I can’t thank you enough!!!!!

 

Being brave.

 

Homoeopathy is an exact science. Yet…..

The problem with casetaking is that it requires accurate skills in observation. It requires a human to note and assess the symptoms, a human to make a judgement call on what he or she sees, and on this collection of data a remedy is selected.

I believe that the principle of homoeopathy never fails, only the homoeopath.

fever20babyOn Sunday the 24th of April at 5pm, Manuel and I met with a young mother whose 11 month old daughter had a high fever (40C) which had not resolved under Pulsatilla, Mercurius or Sulphur. These well indicated medicines failed to touch the situation.

The mother of the child has been a patient of Manuels for nearly 30 years since being a little girl herself. The family was opposed to homoeopathy so there was a little pressure on us to get it right.

So the symptoms were that the child had burning heat with no perspiration. The heat was centred on the chest and the temples. Huge thirst with the fever. There was a mild cough with some mucus.

The child was sleepless but extremely sleepy, restless and would only sleep when totally tired. She would wake into an aggravation and then go back to sleep again. Her hands were cold.

Manuel and I independently came to Phos. I was not happy with that prescription. So I sat back and observed.

The child was placed on the table at one point and began to cry. I felt the table and being a glass surface, was quite cold. I placed a cold object on the childs arm a little later and again the child began to cry.

I also noted that when the mother or grandmother picked up the child or moved its arms, the face registered discomfort as if the bones or muscles were sore.

What to do?

Well, I decided to trust my observations. So I repertorised on the following symptoms.

baby fever

I knew that Rhus Tox had bone and muscle soreness, so I kept that in mind.

Was I confident in the prescription? Not 100%… I read quickly through all the remedies in the 5 choices and concluded that if my observations were correct, then Rhus Tox was the closest in symptoms.

At about 8 pm that evening, the mother contacted Manuel to say that the fever had gone down and the child was happier in herself.

The day after, (Today) all symptoms had gone except for a little mucous and cough but that was getting better also.

The unprejudiced observer -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. 

It takes a lot of faith to trust in observation above clinical knowledge and the chatter of other peoples opinions. It takes a while for a clinician to accept that the organism via PATHOLOGY in the expression of a disease, will sometimes fly in the face of a known symptom that is opposite to what is known about the disease.

I believe that this observation is the true understanding of 153.

§ 153 Fifth Edition
In this search for a homoeopathic specific remedy, that is to say, in this comparison of the collective symptoms of the natural disease with the list of symptoms of known medicines, in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms of the case of disease are chiefly and most solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure. The more general and undefined symptoms: loss of appetite, headache, debility, restless sleep, discomfort, and so forth, demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and from almost every drug.