In Aphorism 3, Hahnemann discusses what you need to know to be a homeopath: The physician has to know:
…what is to be cured in diseases, that is to say, in every individual case of disease (knowledge of disease, indication)…
We have to remember here that Hahnemann is talking about individual cases of disease, and what is to be cured. For this we need careful, accurate case taking. While knowledge of common disease pathways is important, and understanding of physiology, anatomy and pathology is crucial, Hahnemann stresses the “individual case of disease”. It’s not the nature of the injury, it’s the way the patient is experiencing it, the unique symptoms and physical-emotional-mental symptom mix that the patient presents which leads us to appropriate remedies.
…what is curative in medicines, that is to say, in each individual medicine (knowledge of medical powers)…
How do we learn what is curative in medicines? First from tests conducted on healthy volunteers – i.e. provings. That is our primary source material for understanding what a medicine can do. Here we must also distinguish between poisoning (giving crude arsenic will give information perhaps more useful for killing than curing), and proving (who knew what table salt in homeopathic preparation could do to help cure?). Furthermore we must understand the true place of clinical experience within understanding what is curative in a medicine. When the individuality of each case is perceived and grasped, it should be clear that because a remedy helped five people with the flu, it doesn’t necessarily follow that the same remedy would be curative in all cases. There is a vastness in the individuality of each person, whether in terms of personality, remedy response, resilience, and response in general to the outside world. Many traits may be shared, but the individuality of the combination brings snowflakes to mind in their diversity. So we can see a certain hierarchy: provings, poisonings (frequently included in Hahnemann’s provings) and last, clinical sources. Many materia medica don’t distinguish between these sources of information in describing remedies. Which is why you should look at provings first.
…how to adapt, according to clearly defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient…
This requires case analysis, which can only be effectively conducted when the case has been properly taken and the individual case of disease understood, and when there is clarity about the principles for prescribing. This clarity about principles also indicates clarity about case management, which can often be much more complex – and rewarding and informative – than the first prescription.
And Hahnemann continues, when giving a remedy we must also take into account:
…the exact mode of preparation and quantity of it required (proper dose), and the proper period for repeating the dose…
How large should the dose be? Understanding how much and why is a crucial part of learning how to practice homoeopathy. As a rule, the size of the dose should be the smallest amount required to trigger a response. And that can be a very small amount indeed.
How often should a remedy be repeated? Confusion regarding repetition is one of the greatest pitfalls in practice. Repeating too often may muddy a case. Not repeating often enough may lengthen the time it takes to recover. When the principles of practice are clearly defined, this will give the practitioner a “road-map” for managing the case.
And one last thing? The practitioner must know
…the obstacles to recovery in each case and … how to remove them…
This often requires sleuthing (I recommend reading Sherlock Holmes…). Is there an obstacle we know nothing about? Apart from elements not reported by patients for “don’t judge me” reasons, there are many things that patients don’t report because it just doesn’t occur to them – whether it’s use of essential oils or that extra healthy supplement they started taking that contains a mix of homoeopathic remedies which will interfere with the case. Sometimes the obstacle can be a toxic relationship, sometimes a damp apartment or poor diet, or working occasional night shifts.
So any solid homoeopathy course curriculum should include all of these elements in its foundation course. To repeat the whole aphorism here:
If the physician clearly perceives what is to be cured in diseases, that is to say, in every individual case of disease (knowledge of disease, indication), if he clearly perceives what is curative in medicines, that is to say, in each individual medicine (knowledge of medical powers), and if he knows how to adapt, according to clearly defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient, so that the recovery must ensue – to adapt it, as well in respect to the suitability of the medicine most appropriate according to its mode of action to the case before him (choice of the remedy, the medicine indicated), as also in respect to the exact mode of preparation and quantity of it required (proper dose), and the proper period for repeating the dose; – if, finally, he knows the obstacles to recovery in each case and is aware how to remove them, so that the restoration may be permanent, then he understands how to treat judiciously and rationally, and he is a true practitioner of the healing art .
Workshop 15th November – and who’s in love with provings…
Earlier this week, I was accused of being in love with provings. To be a bit more precise, I was told “you’re in love with them – but no-one else is interested. Wake up and smell the antidoting coffee…” or words to that effect.
But, as I explained to my insistent interlocutor, I’m not in love with provings. I’m in love with certainty in prescribing. And one of the best ways to achieve that certainty is through – ta-da! – provings.
Even the best prescribers among us have to deal with some uncertainty – it’s part of what goes on in treatment. We can’t know the exact level of resilience a patient has, how much he or she can be restored to health. We can’t always know how sensitive the patient is to remedies at the outset. And we can’t know what the patient has not told us – the vaccination he was embarrassed to report, the home herbal remedy he was convinced wouldn’t interfere with treatment.
So personally, I take whatever certainty I can get, and knowing how to study and work directly with provings helps me towards the certainty I crave…
A little girl, a newborn, was suffering from a rash. There wasn’t much to go on and several remedies were indicated. I went through them looking for the eruption, and Phosphorus turned up trumps, with a description that fitted my little patient’s rash perfectly. The remedy also contained several others of the few presenting symptoms in the case. When I gave the remedy, I had a great degree of certainty that it would help my patient, because I knew for a fact that this substance can cause this symptom in a healthy person. And that, dear readers, is what homoeopathy is all about.
I’ll be giving a workshop on the study of provings in a couple of weeks. It will be a hands-on hard work seminar – you’ll come out of it knowing how to study provings and you’ll have a clearer idea of how to work with provings in prescribing.
Where?! Jerusalem, exact location to be announced.
When?! on Wednesday 15 November, from 9:45-13:30
How much will it cost?! NIS 370
Any early bird reduction?! Of course, NIS 320 for those who pay by Friday 10th November.
To register? Write to me on firstname.lastname@example.org.
I’m considering giving the workshop online at a different time. Please write to me on email@example.com or using the contact form if you’d be interested in such a workshop.
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