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| Hpathy Ezine - June, 2007 | ||||
Understanding Aphorism 74-- Dr. Leela D'Souza |
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| It has been fun and enlightening writing this commentary to the Practical part of the Orgnaon, as part of my post graduate MD degree. I don’t regret the effort though it has been hard every month, as it delights me to see, in light of my experience, Hahnemann's deep perception of disease over 200 years ago. The human being has hardly changed much in those 200 years. The problems faced then, we still face now, though more modern terminology exists for various problems. It is important as homeopathic students to rediscover the wonder of Hahnemann’s genius insight into disease and its cure, and not be distracted by statements like, “its religion” or “its dogma”. The true principles of homeopathy will hold through any ‘new’ development. Those who can truly retain, master and respect the traditional along with support of ‘new’ ideas in an appropriate context will be the most developed homeopaths of the future. Understanding the significance of Hahnemann’s clinical advice in aphorism 74 is pivotal in managing complicated expression of disease. We begin to perceive why disease expression is complicated and why understanding the miasm theory is necessary for management. In this scenario, we question an excessive obsession with new remedies, and search for ultimate simillimum’s in the absence of making accurate homeopathic assessment of disease expression, and without a deep understanding of disease development in individual patients. Crucial in advanced pathology is to observe the course of healing in the right direction of cure. Hahnemann first begins to explain what exactly complex pathology in chronic disease is, from the homeopathic standpoint and how it is classified for the purpose of clinical management.
The first group of chronic disease expressions he speaks of above is the “drug miasm”. This is produced by prolonged use of large doses of drugs. He enumerates some of those commonly used in his day. One shudders to think of being treated with them. But today the vital force continues to be exposed to external ‘bombardment’ both from homeopathic and allopathic camps. Some modern substitutes of the list above are: Antibiotics, when
not prescribed for true acute disease [$72] I have a group of patients who are in this ‘inveterate group’ awaiting their healing. It requires perseverance and patience both from the patient and from the practitioner. I sometimes seek help of my professors as well. They have had 4-5 remedies in the course of 3-4 years and expereince much better health than they when they started treatment. Even though there may be a ‘constitutional remedy’, the number of ‘blocks’ interfering with its action are numerous and one needs intercurrent prescriptions to overcome these phase pictures. The key is to observe a change in symptom picture – something that a homeopath masters in time when well focused in a classical practice and knows what to look for either in mental state or physical characteristics. There have been numerous classical methodologies evolved to deal with these scenarios and learning them well can only help. I wrote some articles on Miasms Part 1, Part 2, Part 3, Part 4, that highlight some of these methodologies. But there are others as well. Confused clinical situations could even develop following apparently homeopathic treatment. We need to introspect: Could ‘homeopathic’
combinations for specific physical disease diagnoses, not followed-up
with accurate chronic simillimums be
truly homeopathic? Hahnemann categorizes observations made, following the weakening of the vital force by external drugs. He gives logical explanations based on homeopathic theory of health and disease. Let us understand his line of thought carefully.
One of the commonest observations is a weakened of the vital force. One sees these inveterate states of disease where the complexity of disease expression is so marked no remedy covers the picture adequately to cure. The time required for such a reversal of symptoms is long, while the vital force can easily be snuffed out with a strong dose of the simillimum. These are situations that require a palliative, partial, superficial remedy. And even then, one cannot be sure of a positive response. Euthanasia is more commonly observed here. Or else the vital force goes into survival mode and develops various modus operandi to stay alive.
One modus operandi is a “deviation” of the normal course of disease. There is a normal course of disease development from childhood to old age, these are easily cured or palliated with a remedy. Then there is an abnormal course of disease development which results from a deviation of the vital force and hence disease progression. This will not respond to single remedy treatment. A large group of cases today are in this state. Hence the obsession for finding a single ultimate simillimum, for this group of clinical cases would be inappropriate.
The second modus operandi is observed in patient’s unable to respond to accurate remedies due to an insensibility of the vital force (eg: Opium state) or they develop abnormal hypersensitivity to homeopathic remedies. The indicated remedy produces aggravations in any potency. The vital force is too confused to respond in a healing way. The homeopath needs to take the case frame by frame identifying layer over layer of ‘substance abuse’ giving a long time for each prescription to work, with accurate history and investigation into the case. Deal with each picture one after another with accurate remedies, watching closely for when a change of prescription is indicated. These cases need slow follow up over 2-3 years before they clear up for a good constitutional remedy to work. Important during this waiting is to know whether one is moving in the right direction or not. Hering’s Laws and Miasmatic analysis are necessary here. Eg: A patient of advanced granular conjunctivitis with chemosis and 'dry eye'. He had been given steriods for many years that stopped working now. He required 4-5 doses of antimiasmatic Thuja for 1.5 years, each of which aggravated initially, before his case cleared up adequately for his constitutional remedy to be obvious. When this happened, Calc Sulph was prescribed which completed the healing within the next 6 months! He’s been well ever since – its been 5 years now.
The third modus operandi is developing abnormal change in various body organs in an attempt to localize the deviation or derangement while attempting to preserve life. This is the philosophical basis, combined with miasmatic background for many expressions of varicose veins, vascular aneurisms, tumors in various organs, dilation of the heart, cirrhotic livers, cancers in various organs, etc. And yet the external assaults continue, unabated. At what point will we begin to respect our body, soul and vital force? When will we choose the truly gentle cure for the vital force? We question ourselves as patients as well as homeopaths. These cases when advanced are more often palliated than cured. Specific remedies for specific organ derangements work well in such scenarios. Acute remedies are often needed here before a constitutional remedy can help adequately if cases can progress towards cure. Eg: A case of cardiac failure with COPD (Chronic breathlessness) will fist need specific remedies dealing with the cardiac failure/breathlessness (Caardus, digitalis, Strophanthus, Naja, Antim tart, Antim Ars etc) depending on symptom expression, for a long period of time before a constitutional remedy will be adequately helpful in strengthening the heart function and general state. When cure is not possible, mother tinctures and low potency specific remedies like the above should be prescribed. Hahnemann supports this aphorism with footnotes on clinical observations of true “plethora” that occur in a woman pre-menstrually due to high hormonal level (progesterone) resulting in fluid retention.
The second footnote is a detailed tirade against bloodletting which was in “vogue” in Hahnemann’s time, propogated by a physician called Broussais. He condemns this method as cruel, irrational, murderous malpractice based on groundless and absurd theory. Hahnemann’s arguments below were VERY SOUND if we look at them in light of today’s knowledge of physiology and pathology. But, he was opposed strongly and vehemently by the old school for his opinion in that day – which produced an even stronger condemnation from him while he repeated the need for dynamic potencies for cure. Often we tend to look outside towards allopathy to find fault with “chemicals” used and suppression created. Have we the same critical eye on what goes on in the homeopathic community? Is being in “vogue” the best homeopathy? It seems criticism is easily available, but either it is ignored by people who refuse to listen, or is not constructive enough to produce positive change in those who need to introspect. Let us develop a healthy response to criticism, learn to perceive what is being said, and introspect into our practice for a change and life-long growth towards being expert and excellent homeopaths the world needs, seeking to cure as is our one and only mission.
Bibliography: 1. Hahnemann, Samuel;
Organon of Medicine
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