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Q : How often do you change remedy in
your practice? Whenever you do change the remedy, does it
not mess up the action of the previous remedy especially
in cases with an acute flare up during chronic treatment ?
A : While treating the deep seated, chronic disease, once
the remedy is well-selected and administered, it does not
require a change for a long time. The higher potency may
be required at a later date.
The change of remedy is required in three main incidences:
One, if the remedy does not produce any effect, even after
administering a higher potency, it needs a change of
remedy simply because it is not indicated.
Two, the first remedy has done its job using one or more
potency, leading to a change of symptoms and calling for
another remedy. Third, if the patient is confronted with
an acute ailment during the treatment of a chronic
disease, he would require the indicated remedy to combat
the acute disturbance.
Whilst treating the acute disease, one may be required to
change the remedy frequently. This is because of the pace
of the disease, the symptoms change and hence the remedy.
For instance, the treatment of Pneumonitis may require,
Arsenicum in the early phase and then may later call for
Phosphorus.
There should be a reason for every change of remedy. At
the same time, one should not rigidly stick to the same
remedy when it's no longer indicated. An indicated change
of remedy cannot mess up the case.
Needless to say that no two remedies are ever indicated at
the same time.
Q: How much importance do you give to the miasms? Do you
regularly 'un-block' cases ?
A : Miasms are quite important. They give you an idea
about the depth of the illness, they give an indication
about the nature of the remedy required. It helps you
distinguish from superficial remedy to a more appropriate
deep acting remedy. For example, if you are confronted
with a case of lung cancer and the patient has the typical
fears of Aconite. If you give Aconite, it may help but
superficially. There is nothing wrong with it, but you
should be aware that the patient will later need a deeper
acting remedy, maybe Calcarea or Thuja
It was Hahnemann, as you know, who on witnessing frequent
relapses after initial improvement with indicated remedies
such as Belladonna, Pulsatilla and Hepar sulphuricum, came
to the conclusion that many of his cases required a deeper
'miasmatic' remedy for more lasting recovery.
I do not use nosodes to routinely unblock cases. But I
have observed that they are often indicated in many
chronic diseases. In many cases, a dose of the
corresponding nosode, administered at some time during the
course of treatment is part of the constitutional
prescribing strategy. Although, there are plenty of cases
which do not require a nosode throughout the course of
treatment.
However, the nosodes can be successfully prescribed as
individual remedies. For instance, we have numerous cases
of Tuberculinum, Carcinosin, Thyroidinum and so forth.
Q : Do you use organ remedies, mother tinctures,
bio-chemic remedies in your practice?
A : I have no experience with organ remedies and mother
tinctures. I feel, it is a crude form of homoeopathy. I
may be wrong...I do not use bio-chemic remedies.
Q: Do you usually go up through the scale of potencies or
repeat the same ?
A: Once the remedy has been selected, I, usually start
with a dose of 200c potency. Many cases may need a
repetition at the end of four to eight weeks. Some may
need a higher potency after 2-3 months and even higher on
a later date.
All cases are different, some may require just one dose of
200c and absolutely nothing for over a year. Some may need
a dose every month for about 4-5 months and then a higher
potency or change to a connecting remedy. Some cases may
require a repetition of remedy, say twice a day every day
for, as long as six months ?! It all depends on the case.
There are rules for every step in classical prescribing.
One just can not haphazardly act as per the whims. There
should be a logic in every action. The posology is a
methodical science.
Q: Could you tell us in brief about your approach to case
analysis on what you call 'hard-core prescribing ' ?
A : Well, hard-core prescribing, to put it in simple
words, is nothing but the prescription based on the solid,
logical, non- speculative and non-controversial totality
of the case. It should involve a sound method of analysis
whereby most prescribers could come to a similar remedy
prescription and the plan of treatment.
Homoeopathy, as we know, is an art. But, we should not
forget that the art is founded on scientific principles.
It is not an abstract art. In my opinion the homoeopathic
principles and their application should not be based on
vague ideas but rather on hard-core logic and facts.
Q : Do you think that there could be a method in
homoeopathy where all the prescribers could come to a
single remedy ? Is is really possible ?!
A : I think we must have a method whereby if not all, most
prescribers could come to a similar conclusion after the
case analysis. I understand that it is difficult, but I am
sure it is not impossible. What is more important is that
it is necessary to have some kind of standardization in
case taking, case analysis and the planning, without which
our science can not advance.
What happens in our field is that you attend the seminar
with the same teacher on the forth occasion but could not
solve a single case during the forth teaching encounter !
I am aware that the homoeopathy is quite individualistic.
However, I do not believe in escaping from the reality
that many of our methods fairly are un-standardized. This,
I think, is mainly because we tend to prescribe largely on
the variable data. We need standardization which, in my
opinion, is possible with hard-core prescribing.
Q : Do you propose some specific method when you talk
about such hard-core prescribing ?
A : I think whichever method you choose to analyse your
cases, should have sound logic and a hard-core totality.
You may choose to go Kentian or may prescribe on the
essence or using the key-notes, or a combination of
approaches, as the case may demand.
Q : You are often talking and teaching about the concept
of Facets ? What is it exactly and is it not a new
theorising ?!
A : The concept of Facets I talk about is something based
on logic. It is simply based on the drug proving. I assure
you that it is no new toy for theorising !
Q : What exactly do mean by the 'Facets of the remedy' ?
A : I believe that every remedy has multiple facets. It
depends on what we see in a patient at given time and how
we compare that with the remedy. I believe that it is
possible to use every polychrest more widely. We cannot
restrict the applicability of our remedies to any single
idea, for instance, Pulsatilla for timidity or Lycopodium
for cowardice. Cowardice or timidity are nothing but some
prominent facets of the said remedies. The facets is like
a symptom-syndrome, like a group of inter-related symptoms
in a remedy and proven together, in the same prover.
The concept of facets widens the application of our
materia medica. We have so many Pulsatilla cases which are
not mild or yielding but rough and rash.
Q : How do you decide or recognise the facets of remedies
?
A : Strictly from the drug proving. I do not believe in
any source other than the drug proving as far as basic
remedy appreciation is concerned.
Q : What about the clinical provings, i.e. symptoms cured
after giving a remedy which does theoretically cover those
symptoms...
A : No! I do not believe in adding those symptoms to my
repertory which are cured after administering the remedy.
This is simply because, I expect the remedy to do a lot
more than what it has been known to prove in the drug
proving And, whatever it can remove as a similimum, cannot
be presumed as what it can produce as a symptom.
Q : Can you further explain 'the facets' with some example
?
A : Yes. As I told you, my understanding of the facets of
any remedy comes from the drug proving. The interesting
thing is that I try to see what kind of emotions have been
produced together in the same prover.
For example. You know that sadness is produced in over 400
drugs. Similarly cowardice is produced in the drug
provings of 80. If you have a patient who has these two
prominent two features i.e. sadness and cowardice. What
will you do ? You will probably repertorise to see which
are the common drugs producing these symptoms, I will look
at it in a slightly different manner. My search will be
for a remedy which has the capability to produce cowardice
and sadness,at the same time, in the same prover...
Q : Is there any remedy like that...?
A : Yes, there is. It is Sulphur. Sulphur is probably the
only remedy in the entire materia medica which has
produced these two important mental attributes in the same
prover. This is the facet of Sulphur. Likewise Sulphur has
some other facets. Most remedies can be studied this
way...
Q : Sounds interesting. How do you get this idea at the
first place to study the facets...
A: Frankly, I can not recall how it happened. It was
around nine years ago when it occurred to me, that it is
important to see which symptoms were being produced
together in the drug proving. Constant study of the drug
proving and the repertory allowed me to identify this
unique concept which I have thereafter repeatedly applied
to check if it works. On applying it on numerous cases, I
could see it's application as well as the limitations...
Many medicines have been studied and evaluated with this
idea and it has helped me tremendously in my practice.
Q : Is it only the combination of the mentals, the
emotions that you look for or the physicals as well ?
A : It is not only the mentals. When you look into the
source books with the idea of such group of symptoms you
will find amazing things. There was a case of hemorrhoids
who has an irritable temperament. Even after a long study
there was no clarity. You have cases where you have a long
history written before you but it does not click ! In this
case, we tried to search for possible combinations. It was
interesting to find that Nux vomica has proved
irritability in the prover where it also proved
hemorrhoids. And we could see Nux vomica covered the
totality and curing it.
With the facet idea, many less important symptoms also
become valuable guideline for prescribing, we have
consistently observed.
Q : Why do you think a combination of symptoms in the same
prover is more important than a compilation of symptoms in
more provers ?
A : Well, when you study the source books and the
repertory, you find a huge mass of data, enough to get
lost in. Just imagine,3000 plus symptoms of Sulphur, over
1100 symptoms of Carbo vegetalis !
In practice, for a case with seven symptoms. Instead of
considering remedies, that have produced the seven in
separate provers, it's more logical to consider, the one
remedy that has produced three of the interrelated
symptoms ,if not all seven at the same time in the same
prover. For example, a remedy capable of producing
mortification at the mind level, neuralgic pain in the
lower limb and a wart like growth on the skin in a single
prover is more important rather than the remedy which
produces mortification in one prover, warts in another,
and the neuralgic pain in the third.
Q : Which is the remedy...and did you have a case...
A
:
Yes, a couple of cases. It was Staphysagria...
Q: Does this concept of facets, always work in practice ?!
A : One should not hesitate to doubt any new ideas. In
fact, one must ! I too was skeptical about its efficacy in
the beginning. But now, I can say confidently that it aids
greater understanding of the remedies and in selecting the
prescription. There are some rules and criteria that one
must follow. This concept facilitates case-analysis and
case-individualisation, whenever applicable.
Q : You have introduced another approach to case analysis,
which you call 'The Phenomenological Approach '. Can you
give some brief idea...
A : The Phenomenological approach per se is not new but
it's application in homoeopathy is original. The
Phenomenon idea is an extension of the Facet concept. It
is the consecutive event of symptoms in a patient being
compared with the drug proving. The drug proving is not
just the conglomeration of dissociated symptoms. If you
closely examine, there are so many symptoms occurring in a
chain form. For instance, the Lycopodium proving has
sadness leading to anxiety, eventually leads to
irritability. Very basic symptoms but very important
because they follow each other in a definite sequence.
This is what I understand by phenomenon.
The study of phenomena reveals, the individual's
characteristics enabling us to perceive the true portrait
of patient's personality. The Phenomenon, I have observed,
reflects the intricate nature of the inner man in a
decipherable manner. This is important.
Our drug proving sources are full of such phenomena and it
is extremely interesting to study them and apply in
practice. It has opened up new avenues for me in practice.
I think this concept can best be illustrated with the help
of cases.
Q : How do you perceive such phenomena in the patients and
in the remedies ?
A : Whilst taking a case, you have to find how how does
the patient behave on experiencing a strong emotion. Many
times patients tell us quite spontaneously.
To identify the phenomenon in the materia medica, as I
told you, you have to go back to the drug proving and the
repertory. You will be amazed to find that our repertories
have such phenomena listed almost on every page !
Q : What is your experience with the newly proved drugs
and new drug proving ?
A : I am somewhat conservative with regards new provings.
Although, it would be good idea to have new entries in our
materia medica. In my opinion, we have enough remedies,
over 3000 already ! I prefer to handle my cases with a
couple of hundred remedies, which have a well described
proving and well proved efficacy. I am unhappy about
learning, teaching and proving new remedies which can not
be made available in the pharmacy for the use of the
homoeopathic community at large. My proposal is to
re-prove some of the century old polychrests in the modern
light. Sometimes, I wonder, are we using the same
Tuberculinum which was proved in 1878, and is the source
of that Tuberculinum the same as one made today ?
Q : Can you share with us some of your successful cases...
A : I would rather talk about the failures in practice of
which which are plenty ! The nature of homoeopathy, gives
every homoeopath, irrespective of their background, his
share of failures. And at times, one has terrible
failures. You prescribe a remedy for acute hyperpyrexia or
a small patch of vitiligo, and nothing happens.
I tell you that every failure in practice is an
opportunity for introspection, offering an opening to
learn, to find out where you went wrong. I call failures
ego breakers, They keep you on your toes. As there is a
system of having a death-conference in hospital practice,
we homoeopaths should have a kind of failure conference...
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