Hello BWV,

I'd like to pick up on the points you expressed in the above post.

You wrote:
"The complications to which you refer to are very common in my practice as well, but they don’t necessarily deter me from complicating my treatment by introducing more than one intervention at a time; they might, but not necessarily."

These complications are common enough in my homoeopathic practice too as I'm sure they must be in anyone's chosen modality. The broadscale use of allopathic medicine in conjunction with popular alternative therapies is on the increase. People who seek out homoeopathic treatment very often have no thought beyond "trying something different" for their chronic condition which is already being medicated. It does require me, as the practitioner, to carefully explain from the outset the process of homoeopathic healing and what it entails. When the person understands the nature of homoeopathic cure - that is, not merely suppressing annoying symptoms, the length of time it may take to achieve this outcome, the need for accurate detail in their description of symptoms, and their committment to ongoing treatment, they are then in a much better position to make important decisions about their healthcare options.

BMV - "For one thing, when you are familiar with the various interventions, you are often able to know, almost intuitively, which factor is acting. Patients who respond well to Paxil (is that an oxymoron?) have a characteristic demeanor, posture, affect. Patients who respond well to elimination of dairy, especially if their improvement is very rapid and very dramatic, show characteristic behavioral changes, and even physical/physiological changes, such as relaxed posture, reduction in the ruddiness of their complexion, production of sinus symptoms, etc. And so on."

Yes these are important distinctions. And thankyou for their description. In the case mentioned by Snoopy on the other thread the lady in question experienced a cessation of headache pain for 10 days after 2 doses of a homoeopathic remedy. The MOST IMPORTANT criteria for us in this remedy reaction is to discern whether the remedy has acted palliatively or curatively. Obviously, when someone who suffers chronic pain has temporary relief from it, they are going to say they are happy with this outcome. However, as homoeopaths, we need to know so much more. There has been insufficient information given as to how true this "amelioration" was. All we know is she felt "foggy" most of the time, due to??? X number of factors, withdrawal of other medications as well as coffee!
What we do know is that she experienced an intense disturbance from a 30C potency given twice. Aggravation Number One from Lachesis.
When this remedy was repeated in a 6C potency twice daily for 4 days, the headaches returned after the first 2 days and were severe enough to warrant a pain killing injection. Aggravation Number 2 from Lachesis.
Normally as homoeopaths we are careful to avoid unnecessarily aggravating the patient with our dosing because then the aggravating symptoms themselves become tantamount in case management. For some reason a further stronger, higher potency of the same remedy was advised, "to be sure"? This is a scenario we would wish to avoid and it is only complicated by the addition of other multidisciplinary therapies in use at the same time.

BMV - "Often enough, though, you are right, its not possible to know for sure what’s going on, and that certainly obscures the clinical decision-making tree."

Homoeopathy is an energetic system of medicine, so is acupuncture, although they have a different pathway to cure. Allopathic medicine is largely suppressive except when it follows the law of similars. This patient's Vital Force has received stimulation from how many different sources? Homoeopathy is a vitalist medicine, if we can't use the Vital Force as a guide, how are we to act effectively?

BMV - "But my objection to the single course of treatment idea remains, in many cases at least, and can be summarized thusly: if you ‘cure’ without removing obvious pathogens, including dairy, mercury, pesticides, etc., and your patient feels good, then you have provided a false sense of security, and placed the future at risk."

How well do you understand miasmatic weaknesses? It is possible through homoeopathic treatment to strengthen inherent weaknesses in the patient's constitution. We are never (at least in my generation) going to live in a pesticide-free, chemical-free environment. I have patients who have been on all kinds of this-free, that-free diet regimes, imo it increases sensitivity levels overall.

BMV - "If anything, removal of toxins should come first, and ‘treatment’ later. But who wants to wait?"

We don't have to wait for the perfect situation to begin homoeopathic treatment. I do homoeopathy with people who are chemically sensitive to plastics, pesticides, intolerances to dairy, wheat, or who are on cortisone medication.

BMV - "If parenting skills training can help, and diet changes can help, why not do them both and put up with the confusion? ..."

Yes definitely, I would encourage this, as well as psychotherapy, meditation, gentle exercise, hobbies, whatever the patient has always wanted to do for years but has been putting off. Shop for organic foods. But I have an objection when a patient actually becomes phobic about eating something, or goes about thinking they have coeliac's disease because they've been given that diagnosis by an iridologist on duty at a health food store on any Saturday morning.

BMV - "With homeopathy, the impact may be somewhat different, but I would not want to see a homeopath who told me to hold off removing my mercury fillings so he could get a clear symptom picture. Rather, I would want him to view the changes wrought with the extraction of the amalgam, as comprising a new symptom picture requiring the case to be re-taken."

If a person is determined that to have their mercury fillings replaced, it is hardly my role to talk them out of it or delay them. Are we even sure if this is a safe procedure? The advice is often contradictory. How many people are truly sensitive to mercury fillings? In any event I can homoeopathically support them throughout the dental process, before and after.

BMV - "The single-intervention model is most defensible, I think, in uncomplicated cases in which the elements of treatment seem fairly clear. In complicated, chronic, intractable, or severe cases, the layering of pathology and the complexity and variety of etiological factors often, to my thinking, actually demand a complex response; admittedly, though, even these cases may at times respond well to a single intervention."

Homoeopathy is able to achieve cure in both simple and complex mixed miasmatics states. Sometimes a remedy is capable of removing several layers of pathology, moreoften a complex mixed miasmatic case requires many different remedies to achieve cure. It's good that you've also seen this too.

BMV - "And in between the uncomplicated and the complicated case, all manner of variations. In all of them, clinical judgment must step in to decide the question, on the merits of the individual case, and the skill and confidence of the practitioner. I think we haven’t the time, and certainly not the opportunity, to implement the other features of the scientific method—we may be able to control variables by the single remedy, but we cannot replicate the “experiment,” since “it” needs to get on with his life."

Personally I couldn't give a rat's ass whether homoeopathy can ever be scientifically proven. All we need to know is that the person was cured because we applied our remedies according to the law of similars, the minimum dose, the single remedy, and according to the direction of cure.

BMV - "I have been aware of homeopathy for some time, but have been investigating it intensively for only about a year. So I speak from a solid position of considerable ignorance. And yet, clinical judgment tends to be clinical judgment, and the issues in one branch of practice at least similar to the issues in another branch. My question then, back to you, I guess, is, “How do we differentiate innovation from the violation of basic principles?”"

The most innovating thing I have personally witnessed in homoeopathy in the last several years is a return to the fundamental principles as laid down by Hahnemann. The education is better, the information is clearer, the availability of practitioners is increasing, but our profession is no more immune than any other to iconoclasts within its ranks.

BMV - "I incline to the conservative side in practice: that is, honestly, I am loathe to ignore the principles you are advocating. And yet I know that innovations can be useful. Seriously, I hold on tightly to such principles, and resist the impulse to try something new, yet constantly try new things because the old are inadequate or incomplete."

There is nothing intrinsically wrong with trying something new. The problems arise when there is a stubborn refusal to let go of a 'comfortable' way of prescribing in spite of clinical and empirical evidence that it does not work, or that it contributes to further ill-health. Many homoeopaths find that their prescribing style goes through many changes over the years. In our own ways we are all truthseekers, and we are very passionate about what we do. There is nothing to be gained by dismissing the fundamental truths of homoeopathy as inadequate or incomplete if you have not taken the trouble to investigate them and apply them thoroughly.

BMV - "It’s a tense struggle, and a complicated one. I have pretty strong convictions, but many, many questions as well. On the road to knowledge, I think, a journey of a thousand miles turns out to be longer than expected."

Yeah, then it seems to have passed in the blink of an eye! Happy searching.