LMs – what are the odds (or the evens)…

hardworking horses…

I have recently been asked about changing potencies in LMs, with people mentioning using odd numbers, even numbers, going up in steps of 2 potencies (LM1 – LM3 – LM5) etc.

I came across this issue before I started studying with David Little, from a post he wrote on the Minutus list, sometime around 2005.  He mentioned that while most people do just
fine on a series of ascending potencies (LM1 – LM2 – LM3 etc.)  he had noticed that some seem to do better on odd or even numbers of dilutions or succussions.  He also noted that Hahnemann didn’t always start with LM 1.

There are two issues in play here, in my view.

The first is the risk of putting theory before experience.  The beauty of homoeopathy is that Hahnemann first observed, then developed a way of harnessing the power of the similar stronger artificial disease without harming the patient, and  what he thought was the most probable explanation for what he was observing.  In Aphorism 28 (and elsewhere), Hahnemann sets out the basis for his thinking on experience versus explanations of how something happens:

“As this natural law of cure manifests itself in every pure experiment and every true observation in the world, the fact is consequently established; it matters little what may be the scientific explanation of how it takes place; and I do not attach much importance to the attempts made to explain it.  But the following view seems to commend itself as the most probable one, as it is founded on premises derived from experience.”

The second issue is the sensitivity of the patient, something that is difficult to assess ahead of time.  In Aphorism 278 Hahnemann explains that individual sensitivity can’t be deduced through “fine-spun reasoning” or “specious sophistry.”  In order to learn the appropriate dose, “pure experiment, careful observation of the sensitiveness of each patient and accurate experience can alone determine this in each individual case…”

To my mind it comes down to “specious sophistry” if we adopt a theory of odds and evens, where there is no solid backing for the theory, or to apply it and then say it worked – especially when there is a body of material showing that many patients do well just going up through the potency scale.  On the other hand, some patients do especially well on a particular potency, but we cannot know if it was the potency itself or if the improvement was built up by the work of the previous potencies and only manifested itself with the current one.

And furthermore – although it is natural to look for protocols, for theories which provide rules for action which can be employed in every case, we will then have moved away from the individualization of the patient, and of the patient’s sensitivity.

In my own experience, many patients do very well going up the scale, some seem to advance more with specific potencies in the scale, and if the remedy is going to help it is usually already visible in the patient’s response to LM1.

However, looking for a pattern in the sensitivity of individual patients and developing theories to govern posology rather than drawing on pure experiment, careful observation and accurate experience on an individual case-by-case basis seems to be a case of putting the dazzling cart of theory in front of the plodding hardworking horse of experience.  Specious to say the least.

 

 

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 vera.homeopath@gmail.com.

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I’m considering giving the workshop online at a different time.  Please write to me on vera.homeopath@gmail.com or using the contact form if you’d be interested in such a workshop. 

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Pimples, Pustules and Boenninghausen’s Questions

Pimples Pustules and Boenninghausen’s Questions

I was recently asked about Phosphorous in eruptions. Specifically I was asked why Phosphorous doesn’t appear in the TPB symptom Eruption, pustules (symptom no. 1426 in P&W Synopsis), when the word “pustule” appears twice in Hahnemann’s proving.

In the proving “Pustules” appears in the following contexts:

Preparation of medicinal solutions

I’m often asked about preparation of remedies for dosing, especially in connection with use of LM potencies.  I’ve quoted David Little’s article on Solutions Large and Small below in full.  You can read the original here.  David also describes the experiments he carried out.

 

Solutions Large and Small
Preparation of the Medicinal Solution

The question of how to make a medicinal solution has been raised. Our research group uses the Hahnemannian Standard as discussed in The Chronic Diseases and The 6th Organon of the Healing Arts. The reason for this is twofold.

Dr. Fickel and the high priests of homeopathy

Dr. Alphonse Noack, whistleblower

In January 1836, the appropriately named young Dr. Fickel took up the position of Chief Physician at the Leipsig Homoeopathic Hospital, an institution Hahnemann had scorned due to allopathic influences in its staffing.

What was fickle about Dr. Fickel, you may ask? He had been appointed the Chief Physician in a homoeopathic hospital – without knowing anything about homoeopathy. Dr. Fickel was an allopath who deliberately insinuated himself into the company of homoeopaths to harm the profession, cobbled together books on homoeopathy which he published under pseudonyms, and was offered the position of Chief Physician of the hospital by its governing association without knowing the first thing about homoeopathic treatment. During the 7 months that he held his position, most of the time he relied heavily on his assistant Dr. Seidel for actual prescribing, primarily dispensed sac lac, and left cures to nature.

You can read the whole sordid story in Haehl and in Bradford. It has all the elements of a good thriller, with money changing hands, people lying about their credentials, criminal negligence, unmasking and punishment of the wicked. Or something like that.

Fickel produced three works on homoeopathy, which would probably still be considered part of homoeopathic literature if he hadn’t been exposed at the time. All three were published under pseudonyms.

In the first he pieced together works by Hahnemann and other homoeopaths, and discussed effects of remedies. The book was well received by Stapf’s Archiv.

Fickel then produced a “Cyclopedia of the whole of theoretical and practical homoeopathy,” supposedly authored by a “Union of homoeopaths”. Hartmann, one of Hahnemann’s students and a member of the prover’s union who should have seen through it even if he and Hahnemann did part company, pronounced it to be “the most comprehensive, the most accurate and practical work”.

In 1835 Fickel published his third masterpiece, again under a pseudonym: “Homoeopathic manner of healing in surgical cases, together with the pure medicinal effects of a new and important anti-psoric.” The work was commended by Stapf and Haubold, and Haubold even claimed to have cured a condition of leucorrhea with the new remedy.

Fickel’s masterworks included descriptions of fictitious provings and cures, clearly tailored for his gullible audience, who chose to have blind faith rather than to check references.

Despite stories which were already circulating to the effect that Fickel was not the most plausible or well-intentioned homoeopath, and despite the warnings the appointment board had received, “The priests of homoeopathy opened wide to me the portals of their temple, not so much in confidence as from a blind sense of devotion…” wrote Fickel.

Suspicion continued to grow. Finally in March 1836 after more prodding and criticism of his work by Dr. Alphonse Noack, Fickel owned up to his penmanship and to his ulterior motives. He announced that the “insipid innacurate work” had a definite purpose, “the whole thing was nothing but irony and satire… against the prevailing charlatanry of our time”. In a pamphlet published in June or July 1836 Noack exposed the entire fraud, and Fickel resigned in August.

Several years after Fickel’s unmasking, he went public in attacks on homoeopathy, such as his “Direct Proof of the Futility of Homoeopathy as a System of Healing, for Doctors and Laymen”, published in 1840.

This sordid episode raises so many questions, many of them relevant today. Why did hardly anyone see through Fickel? Why were his works not more severely critiqued? And how on earth could someone who knew nothing of homoeopathy be appointed to one of homoeopathy’s top official positions of the time, as a senior practitioner?

Why relevant today? Because the dangerous mixture of apathy and mindless adulation of the great is alive and well. Because Hahnemann’s Organon is fast becoming an obsolete work – and without reading the original method, would-be practitioners will know nothing of homoeopathy except the regurgitated messes dropped by their teachers into their eager waiting mouths….

Fickel got as far as he did because few had the courage to challenge the “old boys network” of the time, to demand sources complete with chapter and verse for works. Has anything changed?

Birth control pills and IUDs – cause and maintaining cause

Sometimes it’s a question of finding reasons, not giving remedies.

 

A patient came to me recently suffering from anal fissure, hemorrhoids and constipation.  In that order – the fissure began several years previously, then the hemorrhoids appeared, and in recent months she began suffering from constipation.  In itself this progression looks odd, as usually we’d expect the constipation to come first.  But then the patient reported that she was completely clear from symptoms during pregnancy and immediately after giving birth. And then the nightmare began again.  Curiouser and curiouser, to borrow an expression.

Video presentation: Case-Taking in Emotional Trauma

Case-taking in emotional trauma can be much more effective if we have more clarity about what we want to learn from the patient.  I’ve set out a more focused way of working with cases involving emotional trauma in the video below.  I’ve disabled comments as I don’t always have time to keep track and reply, but if you’d like to comment please drop me a line on the contact form.

I hope you find this presentation helpful.

Viewed through repertory: Senega

VIEWED THROUGH REPERTORY: SENEGA

There are often remedies which show up in repertorization which we overlook – remedies which we aren’t familiar with, have never used and are just not part of our prescribing “vocabulary”.

Senega is such a remedy.  I have never prescribed it, but I do see it showing up on occasion in repertorization.

Polygala Senega, or snake root is of North American origin. From Wikipedia:
This plant had many uses among Native Americans. The Cherokee used it as an expectorant and a diuretic, and for inflammation, croup, and common cold. The Chippewa used preparations of the root to treat convulsions and bleeding wounds. The Cree chewed the root for sore throat and toothache.[5] According to Canadian botanist Frère Marie-Victorin, the Seneca may have been inspired to use the tortuous root to treat snakebite by its resemblance to the tail of a rattlesnake. It’s still in use for treatment of pneumonia.

Senega was proved by Massie in 1803. More detailed results of the proving can be found, among other sources, in Hughes’ Cyclopaedia of Drug Pathogenesy. The following are some examples from the proving:

1. Dr. MASSIE took 10 dr. of gum dissolved in water.
In 5 minutes sensation in esophagus as if membrane had been abraded, lasted 1 hour.
Pulse, 84 before experiment, at 15 minutes was 78, 20 minutes 73, 30 minutes 70, 35 minutes 68, thence gradually rising to 76.
He then took 20 gr.
Irritation in esophagus was again felt, with some nausea; the drug also operated slightly as a purgative. (Inaug. Thesis, Penns. Univ., 1803; from ALLEN.)

2. Mr. L. took 20 gr. of powdered root. In 10 minutes burning sensation in esophagus with considerable discharge of mucus from trachea (still continuing in slight degree 1 1/2 hour later).
Pulse, 65 before experiment, in 10 minutes was 70 and fuller; later 72, whence it fell again. (Ibid.)

3. Mr. L – took same.Had similar feeling in esophagus, with much hawking of mucus.
In 30 minutes nausea, which increased up to 40 minutes.
Pulse, 65 before experiment, gradually rose in 5 – 40 minutes up to 90, and was still 80 – 86 after 1 – 2 hours.
In 1 1/2 hour skin became very hot; in 1 3/4 hour profuse perspiration set in, and disagreeable symptoms were quite removed. (Ibid.)

4. Mr. W. took same. Same irritation in esophagus; pulse, 68, was 80 at 30 – 40 minutes, and only returned to its starting-point in 2 1/2 hours (Ibid.)

So what does Seneca look like in the repertory?

Seneca appears in four points in the following rubrics. However, it takes its place among many other remedies, and does not appear in four points in any rubric with less than 50 remedies.

What about rubrics with less remedies?  Seneca is prominent in the following, and appears in three points:

So far this gives us a picture of a remedy state where the patient has a tendency to dryness, lack of perspiration and to an increased production of mucus in the larynx and trachea. There is very clear aggravation from mortification in this remedy state, and also relaxation of the body (pathological) and very deep sleep. In its appearance in three points in “Mortification” Senega is accompanied by Chamomile and Phosphoric Acid, with Colocynthis, Ignatia, Natrum-Muriaticum and Staphysagria in four points.

Where does Senega stand in terms of relationships with other remedies? For this I’ve done a search of its position in the Concordances section.

From this search we see Senega is noted as an antidote to Arnica and Bryonia, as having some connection in terms of modalities with Angustura, Crocus Sativus, Kali Carbonicum, Kali Nitricum and Rhododendron Chrysanthum. In Generalities we find it in concordance with Aurum, Caladium, Carbo Vegetabilis, Causticum and Digitalis. The only remedy where we see Senega appearing twice is in Kali Nitricum, in modalities and in body parts.

This is just the tip of the iceberg in terms of what can be learned about a remedy through searching through the repertory. I did one last search, to see where Senega appeared in any grade, in rubrics with 10 remedies or less, and got the following result:

Senega’s only partner in the symptom Amelioration from Chewing is Bryonia. Its only partner in the symptom of Imaginary Odors resembling Pus is Sulphur.

In the concordance symptoms and in this last search, for the most part Senega appears in one point, indicating that Boenninghausen did not have much clinical experience with the remedy for these symptoms. However, its appearance in the TPB means it has definite significance in such cases, where it matches the totality of the disease state.

Aphorism 224 – mental disease

These days so many situations are classified as mental disorders, from defiance in children to reasonable depression (where it is normal to be unhappy, due to  temporary or changeable situations of loss, firing etc.) in adults.  So many people are on anti-depressants these days, and the age of those taking the drugs is constantly dropping.

But where will these mental states fit into our prescribing?  Are we looking at early stages of a mental disease, which is part of a systemic problem, or at a reasonable mood change resulting from events and lifestyle where what is really needed is encouragement and advice from friends or professionals?  I am of necessity simplifying a complex differential for this article, as when a reasonable mood change becomes prolonged and entrenched, encouragement and advice may no longer be of use.

Are homoeopaths killing homoeopathy?

The article below was written by Gary Weaver and posted on the IHM main site.  You can see the original here.  I have deliberately “amped up” the headline. 

Homoeopathy has been under attack almost since its inception.  The principle  of cure by similars was too foreign, the idea that very small amounts can stimulate the body to heal itself was too bizarre, and cures were dismissed as a “fluke”, as placebo, even when the cures involved babies or animals.  In addition, our society is still used to the idea that the body must be nagged at like a recalcitrant child – if it doesn’t respond to a medicine, give more.  This has resulted in an addicted society – most people I see today are addicted to some form of medicine, whether anti-depressants, analgesics, anti-biotics, nasal sprays, prescription and non-prescription medications for indigestion and heartburn – the list goes on and on.  People have learned to bless modern medicine for providing these means for palliation.  They have learned to fear any threat to the supply of their fixes.