The Homeopathic Diet – Coffee and Cigars..

cappucinoThe Homeopathic Diet – Coffee and Cigars…

Many practitioners struggle with the question of how much to limit patients in terms of diet. Patients ask quaveringly “does this mean I can never have coffee any more?” as they clutch cans of caffeine-laden Coca-Cola with whitening knuckles. Is Homeopathy intended to be draconian in food and lifestyle restrictions? Continue reading

Beware of the interesting…

Penny farthings. So now you know

Penny farthings. So now you know

I have a friend who accuses me of being drawn by anything new, bright and shiny – by anything interesting, not to put too fine a point on it. And I have to admit, he is right.

So much in life is boring, especially for a homoeopath. We plod through tales of stools, stomach pains and ‘that niggling feeling I get in my head when I go to the bathroom’. We discuss sputum, coryza, leucorrhea, diarrhea and constipation ad infinitum. The floaters in the eyes ‘only when I look up’, the sinus pain ‘only when I look down’, the belching after eating and the incontinence after a pint…

And we have to wade through that morass (sorry about the image but there it is) looking for how the condition is individualized in the patient. What makes it better. What makes it worse. And how to handle the patient who can only produce one answer – ‘I don’t know’. We ask ‘how has your mood changed?’ We ask if the child is clingy now he has yellow-green discharge which we examine in great detail.

How can this not be boring? How much more interesting is it to say ‘who needs all this, just look at their face shape?’ Or ‘you have to discover the patient’s core delusion’! Or ‘what is their innermost sensation’? Or ‘what colours do they like’? And then the expression which justifies all. ‘Do this, and you’ll see it’s the key to homoeopathy / the key to solving the case / the key to the world, the universe and everything…’. It’s that sense of a locked door creaking open, a locked trunk delivering up its secrets if we only had the key…

Finally things are getting interesting.

Only problem is – those of us who are honest with ourselves, who are capable of seeing the Emperor’s new clothes for what they are, will find that in place of a shiny brass key we are holding a fat red herring in our hot little hands…

As Sherlock Holmes (required reading for all homoeopaths) probably said at some stage, the only key to a crime are the clues showing that a crime has been committed. The patient is basically an ongoing crime scene (yes, strange image but bear with me, m’lud…). The clues begin with what the patient sees, hears, smells, touches and tastes, what we see, hear, smell, touch (usually not taste but more dedicated physicians in olden times were not averse to tasting a steaming beaker of yellowish liquid for diagnostic purposes…). . And ditto for the patient’s friends and relatives. The clues begin with what changed, leading to this crime. The detective frequently asks “Did he usually eat…drink…travel in this direction…ride a penny farthing bicycle…” because changes, in any good crime fiction, are the key to solving the puzzle.

The clues do not begin with whether the person on whom the crime is being perpetrated has a pointy chin and eyes spaced wide apart. The clues do not begin with whether his parents loved him, hated him, or dressed him up in women’s clothing. The clues do not even begin with his deep and enduring love for chicken…The clues begin with the victim of the crime (a.k.a. the patient) there in front of you, and with the information that has relevance to the crime. Or to switch back to homoeopathy – the information that is pathological.

Can you imagine the scene in a courtroom before a judge if the following happened?
“M’lud, I put it to you that my client was the victim of attempted murder”
“And how would you support your claim?”
“It’s clear, M’lud, he was wearing a brown jacket at the time, and has sunken cheeks.”
“Does he usually wear brown jackets?”
“No, M’lud, he has been known to wear green, or even yellow ones, but brown is his favourite.”
“And the sunken cheeks?”
“Oh, M’lud, it is known that people with sunken cheeks are usually victims of attempted murder…”
Thud of gavel.

Is anyone reading this waking up to what is happening in homoeopathy? Please don’t tell me that it’s only thee and me…and lately I’m not too sure about thee…

The presenting symptoms which have changed are the only starting point that has any validity in homoeopathy. It is the only place where we can seek certainty. Of course there is more, every homoeopath has been deluged with information from patients at one point or another, all of it apparently relevant. But every homoeopath should be extremely wary of those bright shiny non-symptoms, which lead to even brighter, shinier and above all, interesting (and also  harmful) speculations.

The place where homoeopathy becomes interesting, to me, is when a constellation of really useful, 100% certain symptoms come together to closely mirror the proving of one remedy only. And the place where homoeopathy becomes fascinating and rewarding is when after prescribing, the patient calls to say a problem she has experienced for years is shifting and easing. And that, my friends, is the true bright shiny thing that is homoeopathy.

Desire in Homoeopathy – a musing

shoulder injuryDesire in Homoeopathy – a musing

A recent sample case showed a patient who said he kept wanting to move – even though he knew it would hurt him. When and how should we use such symptoms?

In this case the patient had dislocated his shoulder. He stated a constant desire to move even though movement was painful for him. Continue reading

How confident are you? How confident should you be?

Organon pic

On confidence:

How confident should we be as practitioners? This is a question which worried me greatly when I started out. I felt uncertain (not surprisingly as I was entering the world of sickness and health armed with a copy of Kent’s repertory – a copy of which a colleague justly through out of a window in a different continent – and some basic core delusions about Sankaran’s teaching.). I was qualified, I had the grades, supervised clinical work and diploma to prove it. And after all that training, I did not feel confident.

It will come, some said. The more patients you work with, the more confidence you’ll feel. Until a cold voice cut through the general internet babble, as a colleague (armed with a handbag full of plumbum crude – if you’re reading this, you know who you are) said sharply “if you’re not confident in what you’re doing, you shouldn’t be practicing.”

I see my own inner debate of that time reflected in many forums, where some few honest souls admit to worry and lack of confidence. With hindsight and its freedom of constraint, I see that confidence, for a homeopath, actually relates to at least two separate issues.

We must feel confident in our tools. If we do not feel confident in the principles of homoeopathy – not a blind faith but a clear understanding of the rationale of our practice, if we only know how to parrot “like cures like” without understanding what that means and more specifically, what that demands of us – we really should not be practicing. If we do not grasp that there is a quirk and a default in nature, whereby a stronger similar disease can annihilate a weaker one and will always do so unless something else is standing in the way of cure, whether it is a maintaining cause or a deeper inherited miasmatic taint – if we don’t get that then we really should not be practicing. We’re not talking about confidence in our ability. Here this is the confidence that our tools work. That “like cures like” is a prescribing principle, not a holistic “airy-fairy” slogan.

Personal confidence is another thing altogether. We have to get used to working with patients, to eliciting the information we need for prescribing, to listening to our patients without interrupting, to allow the picture of the disease to take shape before our eyes. We have to keep studying Organon, materia medica, provings, Hahnemann and Boenninghausen’s writings and works of similar value to keep our abilities honed and our homoeopathic knowledge checked and re-checked. We have to gain confidence in prescribing, in case-management, in effective follow-up.

Personal confidence is something every practitioner gains in time – in any field. But without confidence in our tools, that personal confidence is worthless. It’s worthless in the sense that if we are genuinely trying to work according to principle and don’t understand it, our confidence is a thin shell, a shiny veneer covering a world of insecurity in practice.

However, the worst expression of the worthlessness of personal confidence without true professional conviction is that those bumping up their levels of such personal confidence to overcome the lack of professional conviction are drawn to the new and the shiny, to developing their own new and shiny theories to astound the world.  As a result, they never investigate the tools properly, and learn to work faithfully and honestly to principle.

Something Hahnemann said in the Organon within a slightly different context seems an apt quote to close this post:

“A true homoeopathic physician, one who never acts without correct fundamental principles, never gambles with the life of the sick entrusted to him as in a lottery where the winner is in the ratio of 1 to 500 or 1000 (blanks here consisting of aggravation or death)…” (note to Aphorism 285).

Homoeopathy – on one leg…

Pulsatilla, anyone?

Pulsatilla, anyone

“If it’s so easy, why isn’t everyone working this way?”

I was asked this question at a seminar I gave several years ago. This is a question that frequently puzzles us at the IHM. Because it is easy.

True, a lot of hard work is needed to get expertise, and then to improve expertise. To read, re-read, and analyze materia medica. To read and discuss cases. To comb the Organon and Hahnemann’s other writings for better understanding of the underpinning of homoeopathy – essential for prescription and case-management; for case-taking clues; for accurate work with remedies. It’s not always easy to get rid of our preconceptions regarding remedies, to learn to be able to prescribe Pulsatilla on prescribing symptoms whether the patient is a sumo wrestler or a petite, sweet blonde. It’s not always easy to focus on absolute, presenting symptoms when our learned “knowledge” is giving us all kinds of useless hints regarding constitutionals, core delusions, sensations and similar.

Jewish tradition records a story of someone who came to a venerable Rabbi and asked him to explain the entire teachings of the law while standing on one leg.

Well here’s homoeopathy on one leg. Take your case. Take only what has changed and is presenting for prescribing, against the backdrop of the patient’s life and habits. Only use symptoms you could swear to in a court of law. Use symptoms which show the individual expression of illness in your patient.  Look for a remedy that can produce similar symptoms in the healthy, and thus create a similar, slightly stronger, artificial state in your patient. Find the core of that information in the proving. Prescribe.

Still standing here…

The thing is, once you drop the theories, the speculations, once you move away from trying to be clever and insightful, you start looking at what is in front of you. You work with the information the patient gives you about his state of illness (morbid state) – not with your speculations about his personality, or information about whether he’s always loved chicken, or whether he played with Barbie dolls as a child. You work with what you can know about remedies – information contained in the provings. You work with some information gleaned from poisoning and clinical work.  Some of this information was chosen by Hahnemann for inclusion in his provings.   This information should only be taken from the most reliable practitioners (in case you didn’t get it, at the IHM we focus mainly on Hahnemann and Boenninghausen’s work). You put it together and prescribe.

Aphorism 3, my friends. And as the learned Rabbi is reputed to have said, now go and learn the rest…

Homoeopathy in acutes – some points for ponderation…

sconesI received an invitation to a homoeopathic conference on acutes. Nice, I thought, as I perused the program, with coffee breaks and lunch artfully sandwiched between urinary tract infections, diarrheas, sunstroke and the like. I’ll have that coffee and cake thank you, with a nice heat rash on the side…

Which got me thinking about basics for treatment in acutes. Of course. So I’d like to offer up a few points for ponderation, alas, without sandwiches. Or cheese butties. Or even pita bread. But I digress.

  1. You may not be able to help someone in an acute. You may be all they’ve got, so you should definitely improve your skills and keep a stock of remedies on hand. But you have to be able to assess your skills and tools effectively, and not try to treat if you should be sending the sufferer off to someone else or even to the emergency room. And then of course – there’s common sense… no amount of Arnica in any potency, dry or in water, is going to stitch the wound or set the bone…
  1. Even if you can’t help – do not abandon the patient. Do not run off to hide in the corner, drowning in your self-loathing and disgust, or hightail it with a swagger and a “not-my-problem-anymore” attitude (even though admittedly, it can be a tremendous relief to shift the buck). This is not about you.  It’s a difficult lesson to learn, but often, even if we can’t help, the patient really appreciates us just being there. After all – we were the ones they turned to for help. Keep tabs on the patient, check in to see how they are doing, take an interest. If you couldn’t help at that crisis time, you may be able to help after the initial emergency, and they will want you to do so.
  1. There are a ton of books on what remedies to give in acutes, therapeutic directions, triads of remedies for treatment and more.   Perhaps my first major disappointments with homoeopathy were when I found that the books were… how shall I put it…fairly useless…  In acutes, as in all prescribing, look for what has changed. And in acutes, look often because things can change quickly. Are you really going to sit there wondering if your patient is yielding because they are blonde and blue-eyed, and do blonde highlights count anyway – when the patient is presenting Pulsatilla symptom after Pulsatilla symptom in ever increasing intensity? Are you going to ignore the presenting symptoms because “the book says”…? I think not. Forget all prejudice, there is no time for that. Focus on the presenting symptoms. Focus on what is there – not what is absent. The resulting remedies may surprise you – if you’re sure of the symptoms you’ve used and the materia medica you’re using, give them anyway.

Acutes can be the joy and the bane of a homoeopath’s practice. Witnessing what homoeopathy can do in acutes has brought many a doubter into the fold, and I think has kept many of us fascinated with the tool we have learned to use. On the other hand, treatment of acutes can involve a tremendous amount of nail-biting anxiety and frustration, when sometimes we see a case that has been progressing well turned over to allopaths and then relapsing, or when we hear the oft-repeated words “I think I was feeling better just before I started taking your remedy” or “I don’t think it was the remedy, I think it was Aunt Florence’s tonic of gin, mangoes, paprika and eye of newt which did the trick…” (perhaps less oft-repeated but you get the general idea).

Here endeth the soliloquy. Back to scones and sunburn… or perhaps just scones…

Aphorism 273: If something is not necessary it is not permissible…

just another IKEA philosophy statement...

just another IKEA philosophy statement…

As I think people reading this blog are aware, I have no patience with those who relegate the Organon the status of philosophy, and thus consigning it to dusty shelves rather than using it as a manual of practice. It’s a bit like calling the instruction leaflet you get with your IKEA kitchen / bookshelf / cupboard “the IKEA philosophy statement”, and not referring to it when you try to build the darn thing.

Continue reading