Creating Waves of Awareness
GRAY AREAS IN HOMEOTHERAPEUTICS
The gray areas mean the practical difficulties in homeotherapeutics where no clear guidance is available; where physician’s own experience and insight comes into play. Many times these are very trying situations where one has to fire in the dark. There is no limit to such occasions; hence the topic will remain open with the invitation for all fraternity to discuss and enrich with their personal problems and their tentative or absolute solutions.
One such problem is when a boil or a furuncle is formed, there are two situations: viz. when it has just appeared and no pus has formed, it is advised to abort it with very high potency of Hepar Sulph. Now our patient is a hot patient. He cannot tolerate heat, drinks very cold water and seeks cold places and fanning. Hepar Sulph is a cold remedy to the superlative degree; where even a small part of the patient’s body if exposed _such as his one hand or foot _ a chill will run down his spine. How and why Hepar Sulph should be prescribed and why will it act in such a patient? Similarly when the furuncle is very slow in ripening, or slow in discharging, same remedy , and also Silicea, are given the first choice. But if the patient is the same as described above, how these intensely cold remedies influence the extra warm patient?
If a very critical patient of a large carbuncle was much ameliorated by one dose of Tarantula Cuban. 200, and the carbuncle starts discharging very profusely with lessening of pain and restlessness, and you have allowed the medicine to work for 10 to 14 days, and the sore improving definitely, but very slowly, should you repeat the dose? Very difficult question!! You will find people, even established authorities repeating doses arbitrarily, every few days, say, 10 days or so. Others, no less authentic, will be wary of any repetition. I myself would be cautious of any repetition and, at the same time cursing myself for not being able to expedite the process of cure.
With the first prescription, few days before menses, in a case of dysmenorrhoea, with missing or scanty menses, of short duration, say one or two days, menses occurred at time, totally painless and ceased after right duration; should we wait for the next cycle without repeating the medicine few days before the expected date, or repeat the dose? Now if we repeat the dose and menses are facilitated, as before, we conclude that the repetition was in order and that it worked well. But if the case was spoiled and all the disease symptoms reappeared; the conclusion would be that the repetition should not have been done. There can be another suspicion that if the repetition was done in a higher potency, we could have avoided the reversal. Who knows!!
In paediatric practice the matter of right potency is a point of difference. Most people prefer low to medium potencies, while there are not few people who believe that the high and the highest potencies should be used. I for myself prefer the first notion. It can be safely supposed that most of the infants and children can be classed as sensitive patients, who should not be given high potencies for fear of over reaction, nor the dose be repeated too often. This is sagacious attitude on the part of the physician; but not a certain rule.
Sometimes a symptoms complex does not lead you to the possible pathology. The symptoms are so banal that the seriousness of the disease is never surmised. Such a case occurred to me of a little boy, of the age of 5 years. He could not retain urine; it was leaking all the time. Homeopathically it was a case of involuntary dribbling, but nothing doing. Pathological and laboratory finding revealed a case of renal malfunctioning and a ‘tag-like hanging or a protrusion’ on the interior wall of U.B. was witnessed. Serum creatinine and urea readings were also exorbitantly high. [Cautery for the ‘tag’ and incision of posterior urethral valve was done in the hospital.]
Many a pathology is asymptomatic. Many times renal calculi and, also, biliary calculi have no symptoms. So is the case many times with renal and pelvic cysts. The answer to this difficulty is, as I have elsewhere said, in making homeopathy, somewhat, pathology and laboratory oriented. The list of asymptomatic pathologies is quite a long one. So the dictum: ‘no symptoms no disease’ stands refuted. Here a Burnett’s mind is required!
Another example is the prostate disease, which is though not asymptomatic but has the same banal symptoms in the beginning, whether the disease is benign or malignant. But the early detection of the latter case can save life in time. A test of acid phos-pha-tase can pre-warn of cancer, in case of its increased ratio in the blood plasma.
A good number of miscarriages happen yearly owing to placental problems, such as detachment, insufficiency and abruption. Countless laps remain barren owing to non-standard handling and treatments of this emergency. An early detection and administration of heparin (Clexane: brand name, an anti-coagulant) in the form of injections can enliven those laps. It is a flawless and sure treatment; but not homeopathic.
The grayest area in homeotherapeutics is the potency selection and the size of the dose. Before going further, let’s lay bare the conventions in this regard. Conventionally a homeopathic prescription consists of a single dose of two globules, of the size of poppy seed, to be administered in chronic diseases; (two to three doses, in rapid succession, in a chronic case, can be counted as one dose); and a solution of two to three such globules in half a tumbler or cup of water, a spoon for a dose, administered for few doses, at set intervals, in an acute case. We can further imagine that a drop of a liquid (alcoholic) potency can moisten, at least, one hundred of such globules. So a drop of medicine can suffice for at least fifty patients. Mind you!!
Now let’s witness the actual practice! Here we find that there are as many versions and ways of administering medicine as there are homeopaths. Every homeopath is a law unto himself. We find people using from mother tincture to the highest potencies; from single dose to multiple doses per day; from single globule to many drops per dose. The erudite discussion on the repetition of a remedy in the same potency and the bad effects thereof (as discussed in Dr. Nagarajan’s blog, in the HWC forum), is quite logical and sensible theoretically, but practically we find people using and prescribing drop doses of the same medicine two to four times a day, for many days, even weeks, from medium to high potencies. More heroic feats cannot be imagined!!!
The rule for dose administration is: ‘Never repeat unless the action of the first dose is exhausted.’ Further ‘Before repeating, re-evaluate the case to determine whether the same medicine is still indicated or a new one is vying to appear.’ This is a classical dispensation, or a golden rule; but seldom practiced. We find many luminaries acting arbitrarily. We feel, seeing them doing so, as if they have some preset goal, and are following it sedulously. Dr. Burnett is a bright example of such cases. He has a beautiful way of his own. One month he prescribes a nosode, a dose every ten days or so; and some relevant organ remedy the next month. Should we follow him? Lovingly, we should; on principle, we should give a second thought…We are rational beings, after all!!!
I put here a full stop to my discussion, but the topic is by no means complete. As I’ve said in the beginning, it is a topic for everyone to bring his/her therapeutic problems and difficulties and relate how those problems were solved_ or not solved_ and how did they managed to go around or surpass them. Therapeutic difficulties in homeopathy are endless, where a physician experiences pricks of conscience. The solutions are, evidently, peculiar to his seeping and experience. Anyway you are invited to bring your difficulties for the people of HWC to discuss.
DR. USMANI Nov. 25, 2009
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