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Vision Of A Physician: How Not To Prescribe

Dr. M. A. Usmani

Naturally the role of a physician is to prescribe medicines for the sick. But being ever- ready ‘to shoot’ prescriptions is not the mark of a good physician. He should know what he can do, what he cannot do, and also what he can do but should not do. He should know the limitation, interaction and interdependence of therapeutics and nutrition.Where nutrition can settle the problem, medicine should never be prescribed.

Let’s take a case:

A seventy years old lady, who was under treatment for cardiac problems with diabetes. Her case was taken, in full detail, and since her Beta-blockers could not be discontinued so abruptly, it was decided to deal with her diabetes first. Nutrition was given the first chance. I advised her to leave one item from her daily foods, i.e. wheat. She was advised to take black grams instead, in boiled form, making a bowl with them, with sliced onions, ginger and tomatoes and lemon juice with salt and some spices; for lunch and dinner. In the morning she was to take a small bread made of gram-flour, with tea. Within three to four weeks her sugar was so low that it was advised to cut down the size of her hypoglycemic drugs’ doses. Now it was the time to deal with her heart problems, which were already much rectified, by the above regimen.


IN MASSIVELY DRUGGED CASES, IT IS ADVISED TO HOLD BACK THE HOMEOPATHIC PRESCRIPTION. Much of the symptoms in such cases are drug symptoms, they are not the symptoms of the patient. And, as Kent has said somewhere that ‘there is nothing homeopathic to reaction’, it is advisable to let the drug symptoms wear away. During this therapeutic lull, deal the patient nutritionally; or at best, give him some organ(-affinity) remedies, (the so-called, Drainage Therapy) at nutritional-level doses. This will straighten up the case, and make it more responsive to similia prescriptions.

DON’T BE HEROIC OR INCONSIDERATE IN PRESCRIBING: when you should only palliate, never think of curing. Aged people mostly require palliation. Their diseases are, in most cases, past curability. Your enthusiasm to cure such cases would expose them to worse circumstances than the sufferings they were already undergoing. I remember a decent lady of eighty years of age, mother of a famous journalist, coming to me for, inter alia, chronic scabies. She used to say: “I’m better, doctor, but the complaint does not leave me”. I only used to smile, assuring her that she was getting the best care. Sense of proportion and common sense should not be sacrificed at the altar of ‘Cure Mania’. It reminds me of a fable. A king appointed a tutor for his son to teach him astrology. After two years, the tutor brought the prince to the king, informing him about the completion of the tutelage of his son. Overjoyed, the king took something in his hand, and closing the fist asked his son to tell him as to what was in his fist. The tutor and the disciple took paper and pen and started calculations. After completing, the prince told the father that the upper stone of a ‘chakky’ was in his fist. ( A chakky is a manually operated flour-mill, consisting of two big, round stones, lower stone with a shaft fitted in the center, and upper stone with a round hole in the center, and revolving around the shaft with a wooden handle fitted at the periphery.) The king got infuriated. The tutor informed the king that their calculations brought an object with a central hole in it. Now it was the common sense and wits of your ward to judge whether it could be a stone of two and a half feet diameter or a mere finger-ring. Astrology can teach the divination, not the common sense. Similarly, homeopathy can teach the rule ‘similia similibus curenter’, not the common sense. Palliation is as essential a tool as curative process. Art of cure is like the fine art of painting with light strokes of the brush, not hard hammering of a blacksmith. The mother of the journalist was treated very mildly and with utmost care. She lived peacefully and died in peace….Now the next tenet:

NEVER CAPITALIZE ON THINGS INSIGNIFICANT: The Vision is not how to prescribe, but how and when not to prescribe. To prescribe is a temptation, not to prescribe is wisdom and sagacity. Restraint is always soaked in wisdom, and experience. Many so- called chronic cases I started with sac lac (placebo) and ended with sac lac, and many months in between. They were remedied with judicious regimentation and nutritional instructions. In three to four months, in one such case, I didn’t prescribe anything and the patient reported better on every visit. These are not the cases of chronic diseases but the errors of chronic life style.

Another category of cases where I didn’t prescribe any medicine were the cases that came to me from other homeopaths with sometimes homeopathic aggravation, and sometimes jumbled up cases by injudicious prescribing by the last homeopathic practitioner, where I thought to wait and see. In many such cases sac lac did the trick, with definite nutritional regimen. No medication was ever prescribed.

CONTRARIA BETTER THAN SIMILIA, for emergencies during homeopathic treatment: For the patients who are going on a journey, out of city, or belong to other cities or countries, I strongly advise them that they should, in case of emergency, patiently wait for the symptoms to abate or settle down on their own—as most of them will, if they were caused by the deep-acting medicine that I had prescribed. If the emergency is so severe as to necessitate medical help, they should better go to an allopath, instead of a homeopath. This is because I do not want to spoil my case. The homeopathic medicines act in unison with the vital force, and run very deep, while the allopathic medicines act superficially, by dint of their drug action. They will never spoil the action of my constitutional remedy. I even allow them, for the same reason, to use any sort of toothpastes except, the so-called, homeopathic toothpastes.

With the same token, I don’t feel any compunction in prescribing ENO fruit salt, or a sort of herbal carminative, prepared at home with herbal and conventional ingredients, for the mild errors of foods, surfeit or gluttony; or taking Paracetamol or Dispirin for a traveling headache or unusual tiredness. If they can assuage these troubles by taking rest or taking some pick-me-up drink, it would be better than drugs. Canons should not be shot for killing sparrows.

To make the point more clear let’s suppose that our patient is, at the time, under the curative action of 10M dose of Calcarea Carb., and is traveling away from the city. Suppose he develops a traveling headache or any other emergency. In case he consults a homeopath, and he prescribes, e.g. Sulphur 30, or 200, what do you think will happen to your Calcarea Carb? No less than a catastrophe, for it will spoil your whole case.

Let’s take another hypothetic case. Suppose our patient is under the curative action of Phosphorus 50M, and he happens to be on a journey in some other city, and contracts a severe throat infection with high fever and utter hoarseness, verging on aphonia. Now if he goes to a homeopath, he may prescribe Causticum. But we all know that Causticum bears inimical relation to Phosphorus. It will again spoil the whole case, beyond rectification. Even if such a remedy is chosen that has no bad relation with the already given agent, then too the case will lose its smooth dynamic flow, as the level of both the remedies, being both homeopathic, will nearly be the same and thus intermingling.

So we should not be shy of the contraria. We can partake of the above mentioned temporary medicines, and herbal teas, as ginger tea, cinnamon, cardamom and fennel seed teas; or coco tea as pick-me-up. I usually advise my elderly patients, going on pilgrimage, to take Arnica 3X drops daily for tiredness. Any number of medicines can be prescribed, on this nutritional level doses (3X to 6X) as preventive, and to allay daily complaints in such trying situations. These won’t disturb the action of the deep acting dose of their real treatment.

Medical fast is another tool to keep you from prescribing unnecessary medicines, and, at the same time it is the best tool to deal with errors of food and surfeit; and also give you time, to judge the real malaise. This fast is observed by prohibiting all sorts of grains and usual meals; and allowing a generous intake of fruit juices and repeated doses of herbal, and green teas with dates, or honey. Medical fast is at once a drastic cleansing process that unburdens the vital force and rejuvenates the system. After this if medicine is at all required, the same will work in a very smooth way without let and hindrance.

Only the sensitive and educated people can thus be dismissed with the advices as how to live and change their mode of life without prescription. But for the illiterate and ignorant, an envelop of sac lac is essential. This is the penalty as the wages of ignorance.

PREPOSESSION AND SUPPOSITIONS SHOULD NOT DETER ONE IN HELPING THE SO-CALLED INCURABLE CASES. Kent has laid down the criteria for declaring curable and incurable cases. On these hypotheses of Kent a good many cases can be branded as incurable. Countless cases of chronic arthritis, diabetes, tumors and cancer, for example, can easily be rejected as incurable. But, in my practice, I have never refused or drew back myself from such so-called incurable cases. My mentors and luminaries, Burnett and Jahr, prevent me from indulging in such (ruthless) fancies. They help every person: Dr. Jahr, by remaining within the classical limits, and Dr. Burnett by devising new approaches and methods, or searching unexplored areas and possibilities of uses of, even, the well proven remedies. His dictum is: “Incapacity to cure does not render the uncured incurable”. This dictum should be inscribed in large letters in every homeopathic clinic, worth the name. Greatness of Burnett is immeasurable, and posterity can’t pay a befitting gratitude to this noble soul.

The point in such cases is not the ‘curability or incurability’, in the pedantic sense, but how to help these miserable souls, and enable them to lead a practically useful life without suffering. And that is very possible if one follows the above mentioned two great authorities, in their learning and spirit. Their insight and practical skills should be inculcated, and incorporated in every serious practitioner’s clinical approach. The inventive mind of Dr. Burnett has blazed a trail for the generations of homeopaths to follow. There is hardly any therapeutic field where Burnett might not have planted unwonted insight. I’ll adduce a very small feat of this illustrious master, in the field of gout and arthritis. He has given two medicines of incomparable worth to tackle this disabling and crippling disease: that is, Urtica Urens, and Natrum Mur. 6. The last is not Natrum Mur, mind you, but Natrum Mur.6.Burnett’s classic dose is six grains of Natrum Mur.6 powder; and Urtica is prescribed in drop doses of mother tincture. I have helped many tedious cases of this disease with these two agents. And I’m thankful to Burnett for that. Trying to find or invent new ways to help the ailing humanity is better than declaring a case incurable on suppositions. Nor be ever unnerved by a flood of incongruous symptoms of a patient. Learn how not to prescribe, and help people without prescription. Always think that diathesis is full of symptoms, while the disease proper has dearth of them. For example Tubercular Diathesis is full of symptoms and Tuberculosis has paucity of symptoms. Similarly Cancerous Diathesis has lot of symptoms, while Cancer is left with scarcely any characteristic and uncommon symptoms on which a satisfactory homeopathic prescription can be made.

Restraint and care is the first and last proviso for a successful practice. Think that eighty percent diseases are begotten of age-old habits (culinary and otherwise) and the vagaries of cultures. Hence

Hold back prescription!! That is the motto.

Usmani Resource Page

Copyright 2011/All rights reserved © Dr Usmani
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Comment by Veeraraghavan A.R. on June 4, 2011 at 3:41am

When a patient is active and his mental condition is normal, but his sickness is explained only by his attendant

(mostly in the case of children) we have to think twice about prescription. In this situation keeping the patient with placebo help us lot.

Comment by Dr. M. A. Usmani on December 24, 2010 at 2:34am

Thanks Debby, Dr. Bruce and Dr. Amir Saleem, and Happy New Year!




Comment by Dr. Bruce Arnold on December 9, 2010 at 11:14pm

Good article, Dr. Usmani. Thank you very much. I made the mistake in the past, as so many of us have done in younger days, of repeating doses too frequently because of the plea of the mother. Who was I treating? Not the disease of the patient, but the anxiety of the mother. Had I known then the wisdom of Sac Lac for the one and consolation for the other, I might have had a quicker and more certain success. As I was not utterly incautious, there was no lasting damage done. But it slowed down the cure and increased the aggravation, both of which I greatly regret. Your article has a lot of good advice which, taken to heart, could help to avoid such situations.

Comment by Debby Bruck on December 7, 2010 at 11:40pm
Dear Dr Usmani. How nice to have you back visiting HWC. Quite a few gems in this article.

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