Creating Waves of Awareness
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Part Three of Eruptions Presentation
PROFESSOR DR. KASIM CHIMTHANA-WALA
Dr Kasim's family has been practicing homeopathy for 102 years within four generations of physicians. Dr Kasim passed his MBBS from the Government Medical College Nagpur in 1968. He did his post graduate studies in dermatology, earning a diploma from Calcutta University in Tropical Medicine from School of Tropical Medicine Calcutta, and a diploma in Homoeopathic Medicine and Surgery from the West Bengal Board of Homoeopathic Medicine.
For the past four decades, he has been serving the society as a Homoeopathic Consultant. Dr Kasim and Dr. Aadil, are the only father-son duo who have qualified in both allopathic and homoeopathic medicine.
Along with his wife, Dr. Sagira, Dr Kasim started the first Homoeopathic Hospital in Central India, Shaad Hospital, near Itwari Railway Station. He is attached with a number of National and International Homoeopathic Associations. He has authored ten books on homoeopathy namely, "Textbook of Miasm," "Casetaking and Management," "Nosodes-The Multipolycrest Remedies," "Skin- Mirror of the Sick Economy," "Calcutta School of Medicine," etc. He has presented several papers in various international congresses. His National Academy of Homoeopathy, India is the only training centre in homoeopathy on Guru-Shishya cult running for more than 30 years.
He has established more than 40 homoeopathic clinics in various urban, and rural places like Chandrapur, Dhamangaon, Jalgaon, Nagbid, Dondaicha, Chimthane, and Anjangaon Surji, He has been conducting innumerable homoeopathic camps, blood donation camps and aiding the government agencies for various health programs.
Achievements | Dr Kasim has been honoured with the ‘Award for Excellence in Homeopathy’ by the South Delhi Homoeopathic Association in 1998. He was also honored with the, “Life-Time Achievement Award”, at the International Seminar on Holistic Healing, Nagpur as well as the prestigous “Dr. Hahnemann National Award” by the Homoeopathic Research Society of India.
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PROFESSOR DR MRS SAGIRA CHIMTHANAWALA
A founder fellow of The National Academy of Homoeopathy, India, Prof. Dr. Mrs Sagira Chimthanawala obtained her homeopathic graduation way back in 1978 from Bombay Board of Homoeopathy and Biochemistry, Mumbai. She worked briefly as a Lecturer and Associate Professor in the Department of Materia Medica, Nagpur College of Homoeopathy. Since that time, she has been practicing for the past 30 years as a Homoeopathic Gynecologist and Obstetrician at her indoor Hospital, Shaad Hospital Complex and Research Centre.
Dr Sagira now Heads the Department of Gynecology and Obstetrics at the Academy and is an active member of the faculty of Postgraduate Training in Homoeopathy. She has offered her expert services as moderator and examiner for BHMS examinations conducted by University of Nagpur.
An excellent orator, Dr Sagira has delivered a number of lectures at different clinical meetings all over the country. She is one of the few physicians who run a Homoeopathic Indoor and conducts deliveries and Caeserean sections. She manages preoperative and post operative cases with Homoeopthic remedies, a rare feat indeed. She was the organizer of the Late Dr. Sarla Sonavala Memorial 5-Day Workshop on Gyn and Obstetrics, & GOHOM 2011 conducted by NAHI.
She received “Life Time Achievement Award” by the Indian Institute of Homoeopathic Practicioners last year. She has penned a book - Manual of Gynecology & Obstetrics giving her rich experiences of 39 years. Her calm and caring nature, ever smiling face and the willingness to help anyone anytime clearly shows the polish of this gem of our academy.
The principles and Art of Cure by Homœopathy by HERBERT A. ROBERTS, M.D.
Presented by Médi-T CHAPTER XIV REMEDY REACTION
One of the first things required of a homœopathic physician is that his powers of observation shall be highly developed. His powers of discrimination should be very keenly attuned, first, that he may observe the patient in the analysis of the symptoms and the selection of the remedy, and second, that he may have the keen perception of the import of the symptoms after the remedy has been carefully selected and administered. After the administration of the simillimum some action should result. It is upon the development and interpretation of the action of the remedy, or the reaction of the vital energy to the remedy, that successful prescribing very largely depends.
What are we to expect after the remedy has been administered? According to Hahnemann, the nearer similar the remedy the more reaction we may expect (Organon, 154, 155). If the exact simillimum is found we are apt to get a slight aggravation before relief comes. On the other hand, if no changes take place, too long patient waiting is useless, for it is evidence that the simillimum has not been found; but the nearer the symptoms of the patient are to the symptoms of the remedy, the more sure we are to have some reaction. It is for us to determine what the reaction means and to interpret it in prognostic terms. We must be able to listen to the patient's report and from it and our powers of observation to determine what the remedy is doing. We know that when the remedy acts the symptoms will change, in either character or degree. There may be a disappearance of the symptoms, amelioration of the symptoms or increase of the symptoms, and these changes are the manifest action of the remedy on the vital energy or vital force; and it is these manifestations we must study.
Among the most common reactions after the remedy has been administered is aggravation or amelioration. Now there are two types of aggravations, either of which may be manifest. There is the aggravation which is an aggravation of the disease condition, in which the patient grows worse. There may be a very different type of aggravation, in which the symptoms are worse, but the patient is growing better. He will say, "I feel better, Doctor, but such-and-such symptoms are worse." The aggravation from the diseased state is an indication that the patient is growing weaker, and therefore the diseased state is growing stronger while his vital energy is ebbing. On the other hand, the aggravation of the symptoms while the patient reports himself as feeling better is an indication that his vital force is being set in order, but individual symptoms may show aggravation.
We must also observe how the aggravation or amelioration occurs and the duration of these periods. In this connection we must always bear in mind that is the patient's welfare we are seeking, and it is for us to determine whether he is improving or declining. Sometimes he will say that he is weaker, yet on analysis of the symptoms you will find this is not true. The story of the symptoms is often of greater importance than the patient's opinion. After we have assured him of the amelioration of his condition and called his attention to the particular instances of improvement, he will better immediately.
The aggravation when the patient is growing actually weaker is a sure indication that the symptoms are taking on a more internal phase and the vital organs are more affected. In other words, it is an illustration of the reversal of the order of cure. In these states the patient may sometimes declare himself better, because of the absence of some trying symptoms, yet the careful homœopathic observer will know he is worse because the natural course of cure is reversed and the disease condition is attacking more vital parts. By these differentiations we know whether the patient is progressing or retrogressing. In many of these cases there is corroboration between the patient and the symptoms in the mind of the patient himself; and just in so far as there is this corroboration, the truth of his observations is valuable. We should find whether the symptoms are tending toward the exterior and away from the inner parts. In other words we should know whether there is a peripheral tendency, or a tendency in the reverse order.
The aggravation of the diseased state may come from an incurable state which is stirred to its foundations by the potentized remedy, and unless the remedy is counteracted the disease will become worse and more rapidly approach a fatal termination. In borderline cases, cases bordering on fatal termination, the use of extremely high potencies may react on the vital energy so deeply as to cause an aggravation of the disease, whereas a more moderate potency (say the 30th or 200th) would not give such dangerously powerful effects. However, no fatal aggravation will occur unless it is already foreshadowed by the symptoms manifest in the patient. The potentized remedy will never produce a fatal aggravation, or a destructive aggravation, that would not have been possible and even probable from the symptomatology; but it may, and often does, when used without discretion, speed the case to a fatal termination. In other words, a single dose of the high potency will not produce disease conditions; it has the power to develop conditions that are already present if it is used carelessly or ignorantly. More careful study might reveal the indications for a less deeply acting remedy, which when administered would greatly mitigate much of the fatal suffering.
You must remember that we are warned in the Organon to discern what is curative in medicine, and also what is curable in disease. This point cannot be too greatly stressed: that in profound states we must be very careful not to stir the vital energy to its depths. There should be more time allowed for attempt at a gradual restoration, as there has likewise been a gradual decline. Very often less deeply acting remedies will react and palliate incurable diseases because they act more superficially. They act upon the sensorium and do not act upon the deep recesses of the vital force itself, and yet make the patient much more comfortable by relieving the symptoms annoying through the sensorium.
We can know, then, whether changes are occurring from the depths of the vital force or whether the patient may recover. The direction taken by the symptoms is the sure indication.
In this connection, the first observations is often a prolonged aggravation and a final decline of the patient. Now just what has happened? Possibly there has been too deep an antipsoric administered and it has set in motion the vital energy and developed a destructive process. In these profound states of incurables the vital reaction toward cure is impossible and we can be assured that it is an incurable case. In such cases as these profound incurable conditions we should avoid giving a high potency we may be able to go on and develop the case gradually until later it may possibly react favorably to a higher potency. This is well illustrated in advanced cases of tuberculosis, where it is never safe to give a very high attenuation of the exact simillimum. It is probably wiser not to use an antipsoric in these conditions. However, this applies only to those who are profoundly ill with chronic troubles.
In cases where there is not so profound a disturbance, after the remedy has been administered, the aggravation may be long and severe, yet the final reaction and amelioration comes. Sometimes in these states the aggravation may even last for weeks, yet improvement in general is continually taking place and then comes the amelioration and slow but sure recovery, so that the second observation would be a long aggravation but final although slow improvement.
In these borderline cases there has already been established some marked organic changes, and where pathological changes have actually taken place the period of aggravation will be longer, but the general improvement in health in the curable cases will be manifest.
Then there is another reaction, where the aggravation is quick and short and strong, with rapid improvement of the patient. When you find such a reaction to the remedy you will always find rapid improvement. The reaction is vigorous and there has been structural changes they have been of a superficial nature and near the surface and not of the vital parts, such manifestations as furunculosis or abscess formations on the surface. These are surface changes and are not comparable to the effects of the changes in the deeper organs, like the kidneys, the heart, or the brain.
It is well to take note of the difference between organs changes that take place in the vital organs that sustain the economy, which we cannot do without, and those that take place in less vital parts of the body and are not vital to life itself.
An aggravation that is quick, short, and strong is to be desired, because we know that improvement will be rapid.
Again, there is another class of indications where we find no aggravation whatsoever. There is no organic change: there is no tendency to organic disease. The chronic condition causing disturbances to which the remedy is applicable is not of very great depth, it belongs to the functional conditions, exhibiting its effects in the nervous manifestations and the relations of the patient to his surroundings and to tissue changes. There are changes in the vital force that are so profound as to cause many symptoms that are very trying to the patient and yet so slight that with all the instruments of precision we do not observe any pathological changes. It is in these conditions that we sometimes get considerable suffering, yet cures will come without any aggravation. In these cases the single remedy in a moderate potency (say the 200th) will probably complete the work. In such cases we know the potency and the remedy are correct.
Then we have some cases with amelioration coming first and aggravation coming afterward. This amelioration comes on to last usually for three or four days; the patient seems to be better but at the end of a week or ten days all the symptoms are worse than when he first came to you. These are usually cases that have a great many symptoms. We find that, in spite of what we thought at first was a favorable reaction, the ultimate condition is unfavorable. Either we selected too superficial a remedy, that could act only as a palliative, or the case is incurable and the remedy has been somewhat similar but not completely so. In order to determine the cause of the reaction we must examine the patient and find out whether the symptoms related to the remedy or to the disease. Sometimes you will find the remedy was in error. You will find usually in these cases that the remedy was similar to the most pronounced symptoms but it did not cover the whole case, and therefore did not strike at the constitutional state of the patient. Here in evaluating the symptoms we missed the essential concomitants, and we based our prescription on the generals only. It may be that we have an incurable patient. It will be fortunate for such cases if the symptoms come back exactly as they were when you first saw the case, but the symptoms often come back changed. Then we must wait, and this will require patience on the part of the physician and cooperation on the part of the patient. It may be necessary to take the patient into your confidence, if he evinces sufficient intelligence to warrant it.
The higher potencies will set in motion in the vital force curative functions which will act a long time, because often times in these chronic conditions it takes a long time to establish order, and the vital energy takes its own time to cure. During this process no medicine should be given.
In cases that are proceeding to a perfect cure, if the improvement continues for some time and then suddenly comes to a halt, find out if the patient has been doing something that is against the rules of health or has interfered with the continuation of the curative action of the remedy. This will often be found to be the cause of too short a period of relief from the symptoms.
In the third observation you will remember there was a quick aggravation followed by a long amelioration. Note the difference here. You have just considered the amelioration, that was of too short duration. In instances where you have an aggravation immediately after the administration of the remedy, and then a quick rebound, you never see too short amelioration of the remedy. If there is a quick rebound, the amelioration should last. If it does not last, it is because of some condition that interferes with the action of the remedy. It may be something that the patient is doing entirely unconsciously, or it may be something that he is doing deliberately and intentionally. A quick rebound means everything to the case. It means that the remedy is well chosen, that it covers the condition of the vital economy; and if everything goes without interference, it will bring ultimate recovery.
There is this to remember: some remedies have an aggravation immediately after administration, and some have a sharp aggravation some little time after administration. For instance, Phosphorus may have a sharp aggravation, but it rarely occurs under twenty-four hours after administration, and it may be forty-eight hours or longer, and it may last for some little time.
A word about the acute cases in conditions where you get a quick rebound and amelioration lasting for a few hours, only to have another aggravation, when the action of the remedy on the vital force is exhausted. The action of the remedy is much more quickly exhausted in the rapid pace of acute diseases than in the more moderate progress of chronic manifestations, and more frequent repetitions of the remedy may be demanded. The most satisfactory amelioration in acute cases is where amelioration comes gradually and takes an hour or two after the administration of the remedy before it is markedly manifest.
If amelioration is too short in chronic diseases it means that structural changes are taking place and have destroyed or threatened to destroy the proper functions of the patient. It takes close observation to discern these changes from the reaction of the remedy. However, one may acquire much help from careful observation of these indications in detecting the course and progress of the case.
Once in a great while you will find a full period of amelioration of the symptoms, yet no special relief of the patient. This you will encounter in cases where you have structural changes, where the patient will improve on the remedy for some time and then improvement will cease. They can improve only to a certain point, and then improvement can go no further. We meet these conditions where organs like the liver or kidneys are partially involved and can function only in part. The remedy may keep the patient comfortable, however; and by careful repetitions of the remedy at infrequent intervals the patient may be kept comfortable for a considerable period of time even though you will not be justified in expecting a cure.
There is another reaction that we find in some patients, and that is purely hysterical. They seem to prove any remedy you may give them and get an aggravation from it. This may be because of an idiosyncrasy for the remedy or because of too sensitive reaction of the vital energy. It may be almost impossible to do anything with them in a curative way, but it may be of inestimable help in proving a remedy. Before a remedy is used the constitutional condition of the patient should be very carefully noted. Write down the peculiarities of the patient in as much detail as possible, and then these observations should be deducted from the proving.
In a case where the symptoms found by careful questioning seem to be entirely adequate to cover the case and to warrant a good selection of the simillimum, we may note a reaction where a great number of symptoms appear after the administration of the remedy. If these are a return of former symptoms that have been forgotten, it is an indication that we are on the right road to recover and it is a truly homœopathic action. Old symptoms reappearing we know to be a step in the right direction of cure: CURE TAKES PLACE FROM WITHIN OUTWARD, FROM ABOVE DOWNWARD, FROM THE IMPORTANT ORGANS TO THE LESS IMPORTANT ORGANS; AND SYMPTOMS DISAPPEAR IN THE REVERSE ORDER OF THEIR APPEARANCE.
If, however, these are actually a number of new symptoms, it is an unfavorable sign. Old symptoms reappearing are a step in the right direction, as we know; therefore a group of entirely new symptoms appearing after the administration of a remedy is evidence that we have made a decided step in the wrong direction. We have probably mixed the case.
We occasionally find another class of reactions after the administration of the remedy. In these cases, too, we find the appearance of new symptoms after the administration of the remedy, but in the first place these cases offered few symptoms for an adequate prescription. It is usually possible to get a complete symptomatic picture of the case if we take the necessary amount of care in taking the case, but we do occasionally meet cases where there is little presented in the way of symptoms, or the symptoms presented have little in the way of modifications as to modalities and concomitants upon which to base a satisfactory analysis of the case. Hahnemann deals with such cases in the Organon, Paragraphs 172-82. In these conditions where even the most careful case-taking fails to reveal an adequate basis for prescription of the simillimum, we may yet find that if the few symptoms are sufficiently well marked a remedy may be selected which will either eliminate the marked symptoms found in the first consideration of the case, with consequent general improvement, or there will be a development of more symptoms.
If there has been a general improvement, the first remedy was homœopathic to the case, and not alone to the few symptoms presented on our first consideration. In the second instance, the first remedy was probably one of a group of similars, and it has served to bring to light the other formerly hidden symptoms which were a definite part of the case. It has unfolded the case to us. In this instance, then, the closely related remedies to the one first administered will probably contain among them the simillimum which will be the remedy to cover and assist most in curing the complete case.
Even in these observations we must be very careful to consider whether we have administered a similar remedy that has unfolded the case to us, or whether our selection has been so far from the similar that we have merely mixed the case.
Diseased states are progressive, ever developing deeper and deeper manifestations. Disease is destruction; cure is constructive development. Cure is always centrifugal, as growth is always centrifugal.
By careful observation of the symptoms before selecting the remedy and by careful observation of the reaction after the administration of the remedy, we may have the assurance that comes from intelligent comprehension of our work, and we can know when we are making satisfactory progress in each individual case.
Aadil I appreciate your family's work to growing homeopathy and thankful to your family for providing us the best learning platform. I pay congratulation to PROFESSOR DR MRS SAGIRA CHIMTHANAWALA who received “Life Time Achievement Award” by the Indian Institute of Homoeopathic Practitioners last year.
Dr. Aamir Mustafa
As salaam alekum Dr. Aamir! Thanx a lot for your kind words and on behalf of Dr. Sagira I thank you too. With your co-operation we all grow together in Homoeopathy.
Dr. Aadil you and all your family deserving this. Thanks.
Keep it up sir.
Dear Dr. Muhammed Rafeeque! Gratitude's for your constant love and appreciation. Never let it die Take care Dr. Aadil Chimthanawala
Will homeopathy flourish? Yes of course,you bet.If family doctors like the Family of Chimthanawala who have over 102 years of accumulated experience and who also are qualified conventional doctors, and who have dedicated their life for teaching Homeopathy with touch of modern times, Homeopathy remains in safe hands.I salute you all for your dedication.
I am sure Hahnemann would be happy in heaven to see such human beings practicing his art and defending it with knowledge and strength.
As salaam ale Kum Dr. Wequar Saheb!
I am humbled by your kind words.