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| Hpathy Ezine - Sept., 2005 | |||||
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David Little<-- Interviewed by Dr. Leela D'Souza |
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| Leela: Where did
you experience the Indian homeopathic practice first-hand? David: I decided that I best tour the
country and see how the Indian practitioners worked under the weight
of such a patient load and treated such a wide variety of acute
and chronic complaints. At this time, I studied with a Doctor Isaac
who was the head of a homeopathic collage and hospital in Kerala,
South India. I was absolutely thrilled to see a full homoeopathic
hospital and out patient clinic in operation. I knew there used
to be homoeopathic hospitals in the USA but they closed before I
was born. During the first days in the outpatient clinic I suffered
from severe culture shock as I watched Dr. Isaac and his students
treat around 100 out patients and then do the hospital rounds in
the afternoon. Leela: Our
readers would love to hear more of what you call the ‘culture shock'
of your Indian experience. David: Dr. Isaac would sit at his desk with no repertory or materia medica with a long line of patients in front of him and a few chairs around his desk. He would quickly assess the patients in the line, prescribe a remedy, and then say "next". Occasionally, he would pull a person out of the line and make them sit next to him so he could question them further at the same time as he continued to ask questions to those in the line in front of him. It was obvious that these were cases he wished to give a closer look. At times he would reach into his desk drawer and pull out an old battered copy of Kent's Repertory and look up a few rubrics. As soon as he was satisfied he would write down the prescription and excuse the patient. In this manner he would sit with a long line passing in front of him and 3 or 4 persons in chairs around him. Once in awhile he would tell the nurses to admit a certain patient in the hospital ward. In this manner he would examine several cases at once. As I looked around at the masses of suffering patients seeking help I wondered how anyone could treat so many cases effectively. I was used to taking 1 to 1-1/2 hours during a first consultation and now I was expected to prescribe in around 10 minutes! One morning Dr. Isaac looked at a patient, asked him a few questions, and then wrote down Calcarea. I said, "Why are you giving him Calcarea?" He told me to take the patient aside and interview him more closely and see for myself. I took the patient aside and began to ask him questions. In no time out came symptoms like cold head sweats, coldness in spots, the desire for eggs and meat, longing for fresh air, the fear others will notice their decline, etc. I was quite surprised and went back to Dr. Isaac and asked him, "How did you know?" Dr. Isaac looked at me with a twinkle in his
eyes and said that after 40 years of sitting at his desk "patients
were no longer just people standing in line. They were remedies
waiting to be given!" I decided that I would do the follow
ups on his new cases so I could see how well these patients were
doing on remedies chosen so quickly. To my great surprise most of
these patients were responding quite well to the first prescriptions.
Those that were not doing well were taken out of the line in the
outpatient clinic and put in the chairs next to Dr. Isaac. Now he
would take their cases more carefully and give his second prescription
if necessary. In this manner Dr. Isaac cured 10,000s of patients
who came from far and wide to see him. Leela: This must have been his honorary
(free) work at the government hospital right? Did he practice
privately as well? David: Dr. Isaac also ran a private
practice at his home on the weekends. Here the case load was much
lighter and we had more time to examine each patient. He was treating
a good number of mongoloid children and getting great results! I
examined youths that were in their teenage years who did not even
look like mongoloids. If one looked very, very closely one could
see certain physical signs like high cheekbones and the Mongolian
lids but nothing more. They were all doing very well in school and
considered absolutely normal by others. These persons had been his
patients since childhood. Leela: How interesting!! Mongoloid Children
leading a near normal life! This is what I was talking about with
a colleague earlier. There has never been any clear documentation
done in India of treatment of these types of (incurable) cases that
make up a confident reference point for the young homeopath today.
How did Dr. Isaac explain this improvement? David: He told me that the key was to begin treatment when they were infants and stay with them throughout the early growing years and puberty. If this was done they would live a normal life. Those who came later in life showed significant but less dramatic improvements. I looked at the records of these cases and found no new fancy tricks or unusual remedies. Most cases were resolved with remedies like Bartya Carbonica, Bartya Muriaticum, Calcarea, Bufo, Phosphorus, Natrum Muriaticum, Medorrhinum, Syphilinum, etc. The major teaching I learned from Dr. Isaac was to learn the major characteristics of the most proven 300 remedies very well. In this manner one can do good work under even the heaviest patient load under the worst conditions. Now it is 25 years later and I understand
what Dr. Isaac was trying to teach me all those years ago. Now,
I can work under the most difficult conditions with a large number
of patients when necessary. I have treated up to 50 patients in
one day with my assistants. Sometimes I hardly have time to look
at the repertory or materia medica and must use my inner experience
alone. I do not do my best work in such demanding circumstances
but I can do good work because I have learned the basic materia
medica very well. Leela: We were constantly reminded in MedicalCollege to read and re-read the Materia Medica of the commonly indicated remedies every day of our professional lives. It was the only way to be an efficient homeopath. Today we have computer software that
makes the job easier for us. We tend to rely less on that ‘inner
experience’. I think as homeopaths this reliance on our inner experience
based on solid, factual Materia Medica, should be an aim to achieve
in our homeopathic development, as we understand remedies and their
symptomatic expressions. David: The computer is a blessing. It allows
the homoeopath to access and assess a great amount of data very
quickly and easily. The digital medium is perfectly suited to a
large data based system like Homoeopathy. I remember the old days
when one had to depend on repertory sheets to assess the numerical
value of rubrics. Much of ones practice was dependent on one's study
of the materia medica and how well they recognized the leading 300
remedies. We had to concentrate on learning the golden characteristics
of the remedies and understanding how to observe them in various
forms in patients. The repertory was often used to confirm a few
important symptoms rather than to base ones entire case upon. Leela: Yes many of our senior professors
knew the Materia Medica like the back of their hands! They could
tell you which page of Lippe or Boericke to turn to, to look for
a particular characteristic symptom of a remedy! "Check page
352, in the top right hand corner, 6th line ..." David: With a computer today, it is much easier to find the smaller remedies one might have overlooked due to the difficulty of dealing with so much information mechanically. Nevertheless, the old computer maxim "garbage in - garbage out" was never more applicable. One must be very careful to judge the characteristic value of the symptoms they choose so that the symptoms they collect are of a high quality. It is much better to use a smaller number of characteristic rubrics of a high quality than collect a larger number of poor quality rubrics in the name of a false totality. It is so easy to use 10 or15 symptoms of rather poor quality and come up with fictitious answers. One must be very careful to judge the characteristic value of the symptoms they choose so that the symptoms they collect are of a high quality. Many homeopaths are forgetting how important it is to study the
materia medica daily. There is a tendency to think of case taking
solely as electronic information gathering and sorting rather than
an application of the experiential materia medica to our patients.
One must remember that the symptoms of the materia medica found
in the repertory have been divided, redacted and redistributed.
The original images and their complete symptoms with locations,
sensations, modifications and concomitants have been broken up for
easy indexing. Leela: What is your advise in dealing
with this new "electronic" situation in case taking and
analysis? David: One must remember to carefully rebuild the symptom segments found it the repertory in such a manner that they form complete symptoms as seen in the materia medica. If this reconstruction is not carried out in a careful manner the rubrics become fragmented. Then they do not represent the proving data or the symptoms collected from patients under treatment. One ends up using common symptoms segments that lack coherence and cohesion. For this reason, it is very important to understand how the symptoms are presented with in the materia medica and not overly depend on the (computer) repertory alone. When using the computer repertory there is danger
of thinking in a vertical manner where one symptom is placed on
top of the other. One must also think in a horizontal manner by
observing how the symptom segments fit together to make complete
images with locations, sensations, modifications and concomitants.
The repertory should be used to construct complete characteristic
symptoms that show balance through interrelatedness. Otherwise it
results in fragmentation without the integration necessary to reflect
the essential Gestalt of the disease as found in the materia medica. Leela: What you're saying is that these
different presentations are complementary and comparitive for remedy
selection, as we relate the symptom picture with the image present
in the materia medica? David: Yes. The materia medica is based on collecting bits
of data that are built into complete images for a grand overview.
The repertory is based on breaking down complete images into segments
and redistributing them for easy indexing as bits of data. When
this functional polarity is used together it provides for access
to the symptoms as segments as well as complete patterns. In this
way, a case can be worked from both directions, i.e., from whole
to the parts and the parts to the whole. This forms the complete
system of homoeopathic information retrieval. One must balance the
use of the repertorium and materia medica in such a manner that
they present a greater whole. Leela: One should exercise caution
in using computer software for case analysis till this idea is properly
understood. David: Yes, one of the major dangers of the modern age is becoming completely "computer dependant". There are some practitioners who cannot even take a case without their computer! If you take them out of the comfort of their private offices and 1 to 2 hour appointments and place them in a found-line clinic with a larger number of patients they do not know what to do. The problem is that they don't really know the grand generals, keynotes and redline characteristics of the most proven 200-300 remedies very well. They have not committed these cardinal remedies "to heart" yet because they are more used to looking at a computer screen than living patients. Some persons feel alienated when a homoeopath spends most of their time looking at the computer rather than at the patient. I once had a person tell me, "How can he know what is wrong with me when he didn't even touch me and spend all this time looking at his computer". If one is not careful to bond with the patient the computer can come between the practitioner and client. The old homeopaths were "hands on" practitioners that gave their patients a physical exam. This is not only essential for collecting symptoms but also brings in a element of human contact, touch and feeling. One must remember to look at and touch the patient during the process of case taking and not become overly obsessed with the computer. In truth it is not the fault of the computer. It is the fault of our educational system. The computer is nothing but the digital images of our books in an easy to access format. The old homoeopaths used to quiz each other on the characteristic symptoms found in the materia medica all the time. Whether they were in the clinic, out for dinner or at a play they constantly questioned each other about the remedies reflected around them. They loved to make up jokes, songs, and poems about our medicines. They liked to find strange, rare and peculiar symptoms and their concomitant circumstances that others had yet to digest. One always had to be ready to guess the remedy by a few odd symptoms presented by a colleague. This kept everyone on their toes at all times until the images in the materia medica were no longer just words written in black and white in a books. These images came alive in the people, places and circumstances of every day life and remedies became the living persons around them. Working in Asia has taught me that Homoeopathy does not have to
be an exclusive medical system with a long drawn out affair that
costs 100s of dollars. In the hands of experienced practitioners
Homoeopathy can also be the medicine of the common person in the
streets as well as the poor and downtrodden. I would love to see
Homoeopathy readily available in the West for those who cannot afford
to see a homoeopath as it stands today. This could be done if everyone
offers a bit of their time to selfless service. Leela: In India, it is a motto for every practicing doctor to give a part of their services free (I think it is part of the Hippocratic Oath). I think homeopaths are expected to do so to a greater degree. Especially as in India, homeopathic remedies being cheap; it is the medicine of the poor. You mentioned once about how your sons
helped you in your clinical work. What part has your family played
in your homeopathic practice? David: I met my wife, Jill, in India in 1978. She is British and traveled overland through Turkey, Iran, Afghanistan and Pakistan before entering Northern India at Amritsar, in the Punjab. She has always helped me with my work. We have three children, two sons (24 and 21) and a daughter (11). Our two sons grew up speaking perfect Hindi and from a young age acted as translators in the clinic. They understand the hill dialects as well as pure Hindi and are good linguists. In the free clinic days, one son worked with my wife and received the patients and the other stayed with me and acted as the compounder and explained how to take the remedies. My wife and oldest son would start the case
history and my youngest son would make up the remedies. With this
four-person team we faced the masses on a day-to-day basis for many
years. I could not have accomplished what I have done without my
family. My daughter is excelling in the sciences and has a great
knowledge of anatomy and physiology for her age. She already has
a good idea of how Homoeopathy works. My children have watched patients
come and go since they were infants. This was the first phase of
their training. Later they worked next to me in the clinic. What
they do in the future will be their own choice but they will always
know how to take care of themselves, their families and those around
them. Leela: That’s
a wonderful and perfect introduction into homeopathy for your children!
It is what makes great homeopaths of the future. A living homeopathic
legacy. David: In the last few years
I have moved to a new area and reduced the number of patients
I am seeing in an effort to finish my written works. Now the same
team is working to complete my literary projects, which includes
a 6 volume 3000 page textbook on Homoeopathy. My eldest son, David
Jr., takes care of all the household and business duties and also
helps takes cases. My younger son, Adam, runs the computers and
is in charge of the book project as well as helping on cases. Both
sons have a good knowledge of Homoeopathy as well as several other
aspects of the healing arts. My wife acts as the editor and heads
the proof reading team, etc. Once again it is a family affair. Leela: Yes isn’t that great? I consider it truly a blessing from God to have your family committed to your work with homeopathy. I can imagine how fulfilling it is to work in supportive partnerships that have a similar mindset and thinking in homeopathy. Could you
tell us a little more about your book? David: I hope my work, The Homoeopathic Compendium, Volume 1 through 6, will be available next year. It has taken me 12 years to put together this material and our whole team has been working on it for the last five years. I have gone to original sources for my material and drawn heavily on the data found in the Paris casebooks to demonstrate different methodologies used by Hahnemann. I have done my best to bring all this material up to date for practice in our times. Volume 1 and 2 includes history, philosophy, case taking, posology, and case management and teaches the clinical methods of Hahnemann, Boenninghausen, Hering, Jahr, Kent and Boger. These volumes cover all the areas raised in the Organon. Volume 3 and 4 offers the largest study of
the chronic miasms ever presented and reviews little known areas
found in the classic literature as well as new data never before
published. In this work I take up the subject of old and new miasms
and predict what is to come in the future. These volumes cover all
the area raised in the Chronic Diseases. Leela: That is something we certainly
need! David: Volumes 5 and 6 are a study of constitution and temperament
as well as psychology and metaphysics. Volume 5, Constitution, Temperament
and Maps of Consciousness, is a fully illustrated work that will
act as textbook on psychology and Homoeopathy. This volume reviews
the ancient teachings found in the Mappa Mundi and Greek classics
as well as traditional Freudian, Reichian and Jungian psychology.
Leela: Now
this is something I know very little about, though I have read Jung
with great interest. I think he has the most homeopathic outlook
towards psychology and management of a psychological case than any
other school of psychology today. He made some very interesting
observations about synchronicity as well. David: One of the reasons Jungian Psychology dovetails so well with Homoeopathy is that it has its roots in the same schools of philosophy. Jung based his work on the Greek classics, the works of Kant, Swedenborg, Schopenhauer, Nietzsche, and Goethe, as well as the best of the Oriental traditions. His presentation of the fivefold human psyche and the Self are greatly influenced by India. Jung's term the "Self" as that which initiates individuation is based on the Vedanta teachings on the Atman. His work is an attempt to fuse the best of the Occident with the best of the Orient as well as the best of the old with the best of the new. Jung introduced many concepts into modern language
including the terms introvert and extrovert, the collective unconscious
and archetypes. Unlike the Freudian psychiatrists, Jung integrated
mythology and metaphysics into psychology as a part of the human
mind that cannot be ignored. I would suggest that Homeopaths take
advantage of the large volume in material available on Jungian psychology
and go to the original sources. His works offer a map of the Unconscious
that shape to the formless psyche. This can be very helpful in taking
cases and understanding remedies. Leela: We
will. I don't think I've fully grasped his explanations on archetypes,
etc., and I look forward to reading what you've written. From the
little I have read though, homeopathic concepts of disease and its
cure largely concur with Jungian psychology. What about your final
volume? David: Volume 6 is a special 200 remedy materia medica that emphasizes mental illness, personality disorders, neurosis, psychosis, schizophrenia, autism, hyperactivity, archetypal complexes, etc. and their physical concomitants. In Part 5 Constitution, Temperament and Maps of Consciousness, I review the history of philosophy and psychology beginning with the ancients to the advent of homoeopathy and ending with modern psychiatry. I explain the terms of psychology in such a manner that I hope it provides a roadmap of the psyche that will be easy to follow in case taking. Volume 6 is a special 200 remedy materia medica that emphasizes mental illness, the 12 personality disorders, 5 forms of neurosis, psychosis, schizophrenia, autism, hyperactivity, archetypal complexes, etc. and their physical concomitants. Volume 6 allows for the practical
application of the volume 5 and put all the material in a clinical
perspective. These two volumes represent around 1000 pages of original
material on these subjects. I hope that it helps to provide a foundation
for the skillful application of Homoeopathy and psychology in contemporary
practice. Leela: I’m sure it will! I am also
aware that you did a lot of reading and study on the use of various
potencies and their effects. How did all this come about? David: Yes, I was intrigued about why potency selection continued to remain an arbitrary choice among homeopaths today. The first books I studied deeply were Kent's Repertory, Lectures on Homeopathic Philosophy and Lectures on Materia Medica. I also began to read the 6th Organon of the Healing Art and the Chronic Diseases by Samuel Hahnemann. I immediately related to Organon passages on the vital force and the general philosophical structure of the work but I was totally confused by the posology and case management procedures. This was because I was reading about the LM potency of which I had no knowledge and no one I knew ever used. I was taught the single dry dose wait and watch method with an emphasis on high potency centesimal remedies. Most of what Hahnemann was really saying went right over my head and I must confess I did not understand what he was talking about most of the time. As the Organon gathered dust on my book shelves, I went on to study the works of C. Boenninghausen, C. Hering, T. F, Allen, H. C. Allen, J. H. Allen, H. A. Roberts, Nash and others. I was using Kent's Repertory, and although I had a copy of Boenninghausen's Therapeutic Pocketbook, I did not truly understand its construction or usage. The second time I read the Organon it shocked me because I began to realize that I did not really understand the basics of Homoeopathy yet I was treating the ill! What troubled me the most was that I was taught the Kentian idea that the size of the dose, the number of pills, and the delivery system made no difference in the action of a remedy on the patient. Hahnemann, however, was clearly stating that the size of the dose was critical in the action of the remedy and became more crucial as one used higher potencies! He pointed out that the size of the dose, subtle changes in potency and the delivery system were very important factors in posology and central to case management. |
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