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Q : How often do you change remedy in
your practice? Whenever you do change the remedy, does
it not mess up the action of the previous remedy
especially in cases with an acute flare up during
chronic treatment ?
A : While treating the deep seated, chronic disease,
once the remedy is well-selected and administered, it
does not require a change for a long time. The higher
potency may be required at a later date.
The change of remedy is required in three main
incidences: One, if the remedy does not produce any
effect, even after administering a higher potency, it
needs a change of remedy simply because it is not
indicated.
Two, the first remedy has done its job using one or more
potency, leading to a change of symptoms and calling for
another remedy. Third, if the patient is confronted with
an acute ailment during the treatment of a chronic
disease, he would require the indicated remedy to combat
the acute disturbance.
Whilst treating the acute disease, one may be required
to change the remedy frequently. This is because of the
pace of the disease, the symptoms change and hence the
remedy. For instance, the treatment of Pneumonitis may
require, Arsenicum in the early phase and then may later
call for Phosphorus.
There should be a reason for every change of remedy. At
the same time, one should not rigidly stick to the same
remedy when it's no longer indicated. An indicated
change of remedy cannot mess up the case.
Needless to say that no two remedies are ever indicated
at the same time.
Q: How much importance do you give to the miasms? Do you
regularly 'un-block' cases ?
A : Miasms are quite important. They give you an idea
about the depth of the illness, they give an indication
about the nature of the remedy required. It helps you
distinguish from superficial remedy to a more
appropriate deep acting remedy. For example, if you are
confronted with a case of lung cancer and the patient
has the typical fears of Aconite. If you give Aconite,
it may help but superficially. There is nothing wrong
with it, but you should be aware that the patient will
later need a deeper acting remedy, maybe Calcarea or
Thuja
It was Hahnemann, as you know, who on witnessing
frequent relapses after initial improvement with
indicated remedies such as Belladonna, Pulsatilla and
Hepar sulphuricum, came to the conclusion that many of
his cases required a deeper 'miasmatic' remedy for more
lasting recovery.
I do not use nosodes to routinely unblock cases. But I
have observed that they are often indicated in many
chronic diseases. In many cases, a dose of the
corresponding nosode, administered at some time during
the course of treatment is part of the constitutional
prescribing strategy. Although, there are plenty of
cases which do not require a nosode throughout the
course of treatment.
However, the nosodes can be successfully prescribed as
individual remedies. For instance, we have numerous
cases of Tuberculinum, Carcinosin, Thyroidinum and so
forth.
Q : Do you use organ remedies, mother tinctures,
bio-chemic remedies in your practice?
A : I have no experience with organ remedies and mother
tinctures. I feel, it is a crude form of homoeopathy. I
may be wrong...I do not use bio-chemic remedies.
Q: Do you usually go up through the scale of potencies
or repeat the same ?
A: Once the remedy has been selected, I, usually start
with a dose of 200c potency. Many cases may need a
repetition at the end of four to eight weeks. Some may
need a higher potency after 2-3 months and even higher
on a later date.
All cases are different, some may require just one dose
of 200c and absolutely nothing for over a year. Some may
need a dose every month for about 4-5 months and then a
higher potency or change to a connecting remedy. Some
cases may require a repetition of remedy, say twice a
day every day for, as long as six months ?! It all
depends on the case. There are rules for every step in
classical prescribing. One just can not haphazardly act
as per the whims. There should be a logic in every
action. The posology is a methodical science.
Q: Could you tell us in brief about your approach to
case analysis on what you call 'hard-core prescribing '
?
A : Well, hard-core prescribing, to put it in simple
words, is nothing but the prescription based on the
solid, logical, non- speculative and non-controversial
totality of the case. It should involve a sound method
of analysis whereby most prescribers could come to a
similar remedy prescription and the plan of treatment.
Homoeopathy, as we know, is an art. But, we should not
forget that the art is founded on scientific principles.
It is not an abstract art. In my opinion the
homoeopathic principles and their application should not
be based on vague ideas but rather on hard-core logic
and facts.
Q : Do you think that there could be a method in
homoeopathy where all the prescribers could come to a
single remedy ? Is is really possible ?!
A : I think we must have a method whereby if not all,
most prescribers could come to a similar conclusion
after the case analysis. I understand that it is
difficult, but I am sure it is not impossible. What is
more important is that it is necessary to have some kind
of standardization in case taking, case analysis and the
planning, without which our science can not advance.
What happens in our field is that you attend the seminar
with the same teacher on the forth occasion but could
not solve a single case during the forth teaching
encounter !
I am aware that the homoeopathy is quite
individualistic. However, I do not believe in escaping
from the reality that many of our methods fairly are
un-standardized. This, I think, is mainly because we
tend to prescribe largely on the variable data. We need
standardization which, in my opinion, is possible with
hard-core prescribing.
Q : Do you propose some specific method when you talk
about such hard-core prescribing ?
A : I think whichever method you choose to analyse your
cases, should have sound logic and a hard-core totality.
You may choose to go Kentian or may prescribe on the
essence or using the key-notes, or a combination of
approaches, as the case may demand.
Q : You are often talking and teaching about the concept
of Facets ? What is it exactly and is it not a new
theorising ?!
A : The concept of Facets I talk about is something
based on logic. It is simply based on the drug proving.
I assure you that it is no new toy for theorising !
Q : What exactly do mean by the 'Facets of the remedy' ?
A : I believe that every remedy has multiple facets. It
depends on what we see in a patient at given time and
how we compare that with the remedy. I believe that it
is possible to use every polychrest more widely. We
cannot restrict the applicability of our remedies to any
single idea, for instance, Pulsatilla for timidity or
Lycopodium for cowardice. Cowardice or timidity are
nothing but some prominent facets of the said remedies.
The facets is like a symptom-syndrome, like a group of
inter-related symptoms in a remedy and proven together,
in the same prover.
The concept of facets widens the application of our
materia medica. We have so many Pulsatilla cases which
are not mild or yielding but rough and rash.
Q : How do you decide or recognise the facets of
remedies ?
A : Strictly from the drug proving. I do not believe in
any source other than the drug proving as far as basic
remedy appreciation is concerned.
Q : What about the clinical provings, i.e. symptoms
cured after giving a remedy which does theoretically
cover those symptoms...
A : No! I do not believe in adding those symptoms to my
repertory which are cured after administering the
remedy. This is simply because, I expect the remedy to
do a lot more than what it has been known to prove in
the drug proving And, whatever it can remove as a
similimum, cannot be presumed as what it can produce as
a symptom.
Q : Can you further explain 'the facets' with some
example ?
A : Yes. As I told you, my understanding of the facets
of any remedy comes from the drug proving. The
interesting thing is that I try to see what kind of
emotions have been produced together in the same prover.
For example. You know that sadness is produced in over
400 drugs. Similarly cowardice is produced in the drug
provings of 80. If you have a patient who has these two
prominent two features i.e. sadness and cowardice. What
will you do ? You will probably repertorise to see which
are the common drugs producing these symptoms, I will
look at it in a slightly different manner. My search
will be for a remedy which has the capability to produce
cowardice and sadness,at the same time, in the same
prover...
Q : Is there any remedy like that...?
A : Yes, there is. It is Sulphur. Sulphur is probably
the only remedy in the entire materia medica which has
produced these two important mental attributes in the
same prover. This is the facet of Sulphur. Likewise
Sulphur has some other facets. Most remedies can be
studied this way...
Q : Sounds interesting. How do you get this idea at the
first place to study the facets...
A: Frankly, I can not recall how it happened. It was
around nine years ago when it occurred to me, that it is
important to see which symptoms were being produced
together in the drug proving. Constant study of the drug
proving and the repertory allowed me to identify this
unique concept which I have thereafter repeatedly
applied to check if it works. On applying it on numerous cases,I could see it's application as well as the
limitations... Many medicines have been studied and
evaluated with this idea and it has helped me
tremendously in my practice.
Q : Is it only the combination of the mentals, the
emotions that you look for or the physicals as well ?
A : It is not only the mentals. When you look into the
source books with the idea of such group of symptoms you
will find amazing things. There was a case of
hemorrhoids who has an irritable temperament. Even after
a long study there was no clarity. You have cases where
you have a long history written before you but it does
not click ! In this case, we tried to search for
possible combinations. It was interesting to find that
Nux vomica has proved irritability in the prover where
it also proved hemorrhoids. And we could see Nux vomica
covered the totality and curing it.
With the facet idea, many less important symptoms also
become valuable guideline for prescribing, we have
consistently observed.
Q : Why do you think a combination of symptoms in the
same prover is more important than a compilation of
symptoms in more provers ?
A : Well, when you study the source books and the
repertory, you find a huge mass of data, enough to get
lost in. Just imagine,3000 plus symptoms of Sulphur,
over 1100 symptoms of Carbo vegetalis !
In practice, for a case with seven symptoms. Instead of
considering remedies, that have produced the seven in
separate provers, it's more logical to consider, the one
remedy that has produced three of the interrelated
symptoms ,if not all seven at the same time in the same
prover. For example, a remedy capable of producing
mortification at the mind level, neuralgic pain in the
lower limb and a wart like growth on the skin in a
single prover is more important rather than the remedy
which produces mortification in one prover, warts in
another, and the neuralgic pain in the third.
Q : Which is the remedy...and did you have a case...
A :
Yes, a couple of cases. It was Staphysagria...
Q: Does this concept of facets, always work in practice
?!
A : One should not hesitate to doubt any new ideas.
In fact, one must ! I too was skeptical about its
efficacy in the beginning. But now, I can say
confidently that it aids greater understanding of the
remedies and in selecting the prescription. There are
some rules and criteria that one must follow. This
concept facilitates case-analysis and case-individualisation,
whenever applicable.
Q : You have introduced another approach to case
analysis, which you call 'The Phenomenological Approach
'. Can you give some brief idea...
A : The Phenomenological approach per se is not new but
it's application in homoeopathy is original. The
Phenomenon idea is an extension of the Facet concept. It
is the consecutive event of symptoms in a patient being
compared with the drug proving. The drug proving is not
just the conglomeration of dissociated symptoms. If you
closely examine, there are so many symptoms occurring in
a chain form. For instance, the Lycopodium proving has
sadness leading to anxiety, eventually leads to
irritability. Very basic symptoms but very important
because they follow each other in a definite sequence.
This is what I understand by phenomenon.
The study of phenomena reveals, the individual's
characteristics enabling us to perceive the true
portrait of patient's personality. The Phenomenon, I
have observed, reflects the intricate nature of the
inner man in a decipherable manner. This is important.
Our drug proving sources are full of such phenomena and
it is extremely interesting to study them and apply in
practice. It has opened up new avenues for me in
practice.
I think this concept can best be illustrated with the
help of cases.
Q : How do you perceive such phenomena in the patients
and in the remedies ?
A : Whilst taking a case, you have to find how how does
the patient behave on experiencing a strong emotion.
Many times patients tell us quite spontaneously.
To identify the phenomenon in the materia medica, as I
told you, you have to go back to the drug proving and
the repertory. You will be amazed to find that our
repertories have such phenomena listed almost on every
page !
Q : What is your experience with the newly proved drugs
and new drug proving ?
A : I am somewhat conservative with regards new provings.
Although, it would be good idea to have new entries in
our materia medica. In my opinion, we have enough
remedies, over 3000 already ! I prefer to handle my
cases with a couple of hundred remedies, which have a
well described proving and well proved efficacy. I am
unhappy about learning, teaching and proving new
remedies which can not be made available in the pharmacy
for the use of the homoeopathic community at large. My
proposal is to re-prove some of the century old polychrests in the modern light. Sometimes, I wonder,
are we using the same Tuberculinum which was proved in
1878, and is the source of that Tuberculinum the same as
one made today ?
Q : Can you share with us some of your successful
cases...
A : I would rather talk about the failures in practice
of which which are plenty ! The nature of homoeopathy,
gives every homoeopath, irrespective of their
background, his share of failures. And at times, one has
terrible failures. You prescribe a remedy for acute
hyperpyrexia or a small patch of vitiligo, and nothing
happens.
I tell you that every failure in practice is an
opportunity for introspection, offering an opening to
learn, to find out where you went wrong. I call failures
ego breakers, They keep you on your toes. As there is a
system of having a death-conference in hospital
practice, we homoeopaths should have a kind of failure
conference... |
