Good example. Hahnemann's approach to what the Chinese would have called
an "external evil" (such as trauma or dietary indiscretions) in the midst
of chronic treatment was to use intercurrently a medicine suitable for
restoring the patient to the condition of chronic ill-health in which a
suitable dose of a suitable medicine would then act. This makes sense in
light of our understanding -- not yet, as far as I know, disproven [1] --
that, except in cases of complex diseases, one state stably predominates.
The understanding that only one such state should be treated at one time
arises directly from the basic principle of homoeopathy: that the known
effects of the medicine should be as similar as possible to the state of
illness being treated.
It would seem to be as common today as in Hahnemann's day [2] that at least
one of these disease processes shall have been medicinally rather than
naturally invoked.
Hahnemann's observations on a "complex" of syphilis and psora mention his
conviction, on a basis of careful observation and experiments, that even in
cases in which syphilis and psora at length join in one apparently complex
disease process, no real almagamation of the two takes place; each
appeared, to him, to occupy "the parts that are adapted for it", and he
found that "their cure will be completely effected by a judicious
alternation of the best mercurial preparation, with the remedies specific
for the psora, each given in the most suitable dose and form" [3].
Whether Hahnemann was even correct in his deduction that the two coexisting
dynamic disease processes could occur in discrete parts of the organism is
open to question. The notion certainly strikes me as inconsistent with the
balance of our understanding of the dynamic nature of disease, which
affects the entirety of the organism even if only part expresses symptoms.
But let's assume that he had this right.
So far, so good. Are we then to interpret Hahnemann to mean that we should
act exactly as we would if these simultaneous disease processes (syphilis
and psora) were acting in two individuals, prescribing two medicines for
them and taking no account of the one patient in prescribing for the other?
That is, is there anything in Hahnemann's instructions, or anything
arising from the homoeopathic principle, suggest that we should take no
account of the effect of one medicine before prescribing the second?
No. There is not. Even in this admittedly rare state, Hahnemann's
instructions are not to give two medicines, each for one disease process,
one after another as if they should together constitute one prescription.
To the contrary, his instructions clearly state that the two should be
used in "judicious alternation" -- which he elsewhere repeatedly expands
upon by emphasising that no medicine should be prescribed without checking
the patient's response to the previous medicine.
Apart from the demands of common sense, why should a homoeopathic
prescription require that the prescriber be aware of the patient's dynamic
state at the time of the medicine's administration? It is because the
nature of the homoeopathic response is that only a medicine *similar* to
the predominant state may gently act to annihilate that state for a time by
dynamically replacing it -- and, in meeting that purpose, the homoeopathic
physician cannot dismiss the previous prescription's alteration of that
dynamic state but must take it wholly into account. It is for this reason
that Hahnemann is at such pains to emphasise [4] that the prescription of a
second medicine that had appeared to cover the balance of the case that the
first had not must not be done without first checking the effect of the
first medicine; and it is for exactly this reason also that Hahnemann
instructs a use of "judicious alternation" rather than serial prescription
of a second medicine on top of a first. One uses the homoeopathic
principle to prescribe; the other prescribes in ignorance.
But the assumption would in any case be unwarranted that a complex state
must always exist. As Hahnemann pointed out, it is far, far more common
that when two dissimilar disease states arise in the one organism, one
suspends the other [5]. That is, there is no reason to suppose an
instability in the dominance, in the organism, of one process over the
other. And if there is no reason to suppose it, then what possible reason
is there to act on the supposition?
Let's explore the example you gave: a history of long-standing eczema;
recent measles; very recent injury; emotional responses to injustice.
Presumably we can learn whether the patient's emotional responses are
aberrant -- and, if so, whether that aberration is part of the chronic
state. (I'd have thought that anybody being fired from work on the basis
of having been injured might feel the same way, and that what was required
was support and assistance rather than medicine. So it seems, though I
don't want to jump to conclusions, that you're raising this as an example
of emotionality reflecting the patient's state of health.) So we have a
chronic state that may or may not have flared up in inappropriate
emotiveness. We have a recent history of an acute state. And we have an
injury.
Reading between the lines, the message I'm getting is that a homoeopathic
physician is not entitled to regard any one of these states as being more
urgent than another, to be treated and watched for response before treating
the next. Yet, even in this contrived example, I see no reason for such
restrictiveness. Not one of these states is imminently life-threatening;
if it were, though, then surely it would warrant first treatment. There is
nothing to suggest, though, that a second state should then be treated
without regard to the changes in the patient that follow from the first
prescription.
And this is the strong point of difference that I see between homoeopathy
as understood everywhere -- use of medicine *known* to be capable of
causing in the healthy the symptoms of the patient -- and Irene's
polypharmacy. In ignorance of the symptoms of the patient following
prescription; or in ignorance of the symptoms that the prescribed medicine
-- however simple or complex, and however many nanoseconds or hours
separate administration of its component parts -- is capable of inducing;
or, as Irene would have us, in ignorance of both (!), we cannot possibly
prescribe homoeopathically.
In addition, Hahnemann makes the case very well [6] that, having prescribed
a number of medicines in succession or together without knowing the results
of any one of them, we render ourselves incapable of learning the cause of
any new symptoms they excite and thus lose a precious opportunity to add to
pathogenetic knowledge.
It is not necessary that I point out that the ignorance that multiple
prescription entails of which medicine acted and in what way it acted also
prevents intelligent interpretation in preparation for a following
prescription; that has been pointed out so many times by others that it
surely cannot be far from our consciousness.
I find two aspects of the ever-returning refrain for a "homoeopathic"
polypharmacy amazing:
(1) that those (and this remark is not made with you in mind) who promote
blind polypharmacy without the least understanding of homoeopathy's
principle perceive no least problem in practising in such a way as to make
themselves not only incapable of discerning whether the patient is
improving or worsening and whether the patient's illness has been replaced
or suspended by a medicinal one, but also unable even to guess which
medicine had this indecipherable effect; and
(2) that they imagine that the clinical "results" that they read into the
consequences of their stumbling against the patient in the darkness may
nevertheless contribute, by some backward reasoning process from the
results they've rendered inaccessible, useful knowledge of medicinal
primary action!
Kind regards,
John
[1] Actually I don't think it's possible to disprove it. It seems to me
that it is a matter less of discovery than of definition. If, when two
processes occur in the one organism, one does not, in some way, repel or
annihilate the other, then what is left but that they coexist? And if such
coexistence is not detectable by the symptoms, then what is left but to
conclude that one process has predominated over the other in some way?
[2] See § 41.
[3] § 40, footnote 32.
[4] § 168: "And thus we go on, if even this medicine be not quite
sufficient to effect the restoration of health, *examining again and again
the morbid state that still remains*, and selecting a homoeopathic medicine
as suitable as possible for it, until our object, namely, putting the
patient in the possession of perfect health, is accomplished."
§ 169: "If… the totality… would not be effectually covered by the disease
elements of a single medicine -- owing to the insufficient number of known
medicines -- but that two medicines contend for the preference in point of
appropriateness *it is not advisable, after the employment of the more
suitable of the two medicines, to administer the other without fresh
examination*, and much less to give both together (§ 272, note), for the
medicine that [had] seemed to be the next best would not, under the change
of circumstances that has in the meantime taken place, be suitable for the
rest of the symptoms that then remain; in which case, consequently, a more
appropriate homoeopathic remedy must be selected in place of the second
medicine for the set of symptoms as they appear on a new inspection."
§ 170: "Hence in this as in every case where a change of the morbid state
has occurred, *the remaining set of symptoms now present must be enquired
into*, and (without paying any attention to the medicine which at first
[had] appeared to be the next in point of suitableness) another
homoeopathic medicine, as appropriate as possible to the new state now
before us, must be selected."
§ 171: "In non-venereal chronic diseases… we often require, in order to
effect a cure, to give several antipsoric remedies in succession, every
successive one being homoeopathically chosen in consonance with the group
of symptoms remaining after completion of the action of the previous
remedy."
[5] See § 38.
[6] See § 274 and footnote 160.
On 29 December 2011 10:50, Dr. J. Rozencwajg, NMD. <jroz@ihug.co.nz> wrote:
> Allow me to simplify that even more:
>
>
>
> ONE remedy per patient's disease = a disease/pathological entity/phenomenon
> as modified by the physiology/vitality/Ki/Prana/Jedi force/whatever you
> call
> it/ of the patient.
>
>
>
> Julian Winston used to write: it is not important that the patient has
> measles, but how the patient is measling..........
>
>
>
> Therefore a patient may suffer from "a form of what we call eczema since
> childhood", get the measles last week, fall in the stairs today and as a
> result be fired from work leading to anger, frustration, grief and anxiety
> about the future.....
>
>
>
> One single remedy for all that? I don't think so.
>
>
>
> One remedy for each condition in the order of relevance and importance to
> the patient, with a tentative order of going from recent to old,
> superficial
> to deep.
>
>
>
> Where does a complex/combo fit here? Bone injury, fracture, I would give
> Calc Phos and Symphytum together to speed healing, adding Ruta as the
> periosteum is always injured. I would NOT consider Bryonia as a trauma is
> always aggravated locally by motion but would use it SEPARATELY if the
> PATIENT feels better while not moving or RHUS TOX also separately if he is
> pacing around, especially if those remedies also fit his mental state after
> having been fired...........and separately because he might need just a few
> doses while the "bone combo" will remain indicated at least 2-3 weeks.
>
> And yes, I do consider Calc Phos, Symphytum and Ruta to be each
> homeopathically similar to the injury situation. Similar means resemblance
> and by the same token there are differences, the similarity is not the same
> for each remedy, hence bridging the gap of the differences and allowing a
> better, faster, deeper repair.
>
> Is this theorising? Yes
>
> Has that been proved? No
>
> Does that work in practice? Yes and that is what I am interested in, not in
> psychobabbling.........
>
>
>
> Clear??????????????
>
> Helpful????????????
>
>
>
> Joe.
>
--
"And if care became the ethical basis of citizenship? Our parliaments,
guided by such ideas, would be very different places."
—Paul Ginsborg, *Democracy: Crisis and Renewal*, London: Profile, 2008.
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