Hi Everybody,

I would appreciate if someone could shed light on the following:

What is the standard protocol that a good homeopath follows on seeing a patient in order to reach at a suitable remedy.

Do the following steps cover it all or something is missing:

1. Interview with the patient to gather a list of symtpoms and a physical exam if needed.
2. Listing down all symptoms and finding remedies for these symptoms. (repertorization? A computer software would make repertorization very easy and fast. But the final pick for the remedy is where a good homeopath comes into play.)
3. Picking out the common remedies from the above.
4. Choosing the one which suits most of the symptoms.
4. Giving a suitable potency to assess response and then deciding on the potency and dosage.

Thanks.

__________________
Don't take life too seriously, it aint permanent.

It's not just a list of symptoms. You have to understand what's behind the symptoms and how the patient feels about what he is experiencing.

Again it's not the list of symptoms. You need to analyse the case and determine what needs to be cured and what is 'front and center' at this time.

It might be one of the uncommon remdies.

Not necessarily. Again, it's the one that most suits what needs to be cured in the case and what is 'up' for the patient at this time.

You have to decide the potency and dose before you give the remedy.

The follow up and case management is even more difficult than picking the initial remedy and also extremely important.

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Shirley Reischman

Very good question! You seems to me a good homeopath

Although we do not treat disease but to diagnose the patient first is the paramount importance to me.

When you will diagnose the patient you will automatically cover many points / aspects as you have mentioned. Of course at the last leg we have to prescribe the remedy according to the symptoms homeopathically. I have no doubt in mind on this issue.

[ 17. May 2003, 03:42: Message edited by: Dr. Salim ]

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<b><a href="mailto:drsalim@inbox.com.pk">drsalim@inbox.c om.pk</a></b>

Thanks a lot for the kind feedback. Here is what I think and would like to hear comments:

If your line of questioning to the patient is based on what is written in the MM (materia medica) and the subsequent repertories, why can't you choose the perfect remedy based on this this simple approach.

Let me clarify myself with the following example:

A patient comes with a complaint of sore throat only. Assuming I already have a questionnaire (lets say Snoopy's questionnaire or Sankaran's) developed based on the Boericke MM after reading maybe 50 remedies and start asking him from Mind till Extremeties giving hints to the patient about what type of details I need from him.

Based on his list of symptoms, I repertorize and then use the software for suggestion of remedies. Lets say there are 10 remedies in descending order that the software suggests. I go through all of them again in the MM and then select the one which has most of the symtpoms of that patient mentioned in it. (I would need to do this because of my lack of experience, an experienced homeopath who knows the symptoms of the remedies by heart would not need to read the MM again to confirm which remedy to give)

Then I select 30 potency for that remedy in a single dose and wait for the results in 2-3 days. Using the guiding principles of homeopathy I get to know if the remedy is right or not and then accordingly adjust the dose and potency and/or change the remedy to the stand-by remedy that was decided already while reaching at the first choice of remedy.

The intent here is not to undermine the years of professional education and formal training but to ascertain and understand as to why this simple approach can't work. We have been taught all our lives in engineering, that unless things follow simple logics and rules, general acceptance and understanding can't be achieved. I am trying to fit that philosophy here also.

__________________
Don't take life too seriously, it aint permanent.

I have to second what Shirley said. It's not as straight-forward as it looks. You have to know what to ask. First of all, the patient will come to you with a certain problem. You'll need to know:
The chief complaint--the patient's description
The onset--sudden or gradual
The etiology (what caused it: a grief, the weather, sleep loss, an injury, suppression of a discharge, etc.)
The local symptoms and their sensation, location, and modalities (what makes them better or worse) and discharges--color, odor, consistency
The general symptoms (their body temperature, appetite, food and drink cravings, their energy--
hyper, nervous, etc., their sleep situation, how they're reacting to the weather and temperature, etc.
Concomitants--unrelated symptoms occurring at the same time.
Mental/emotionals as they depart from their normal state.

Even having said this, there are questions specific to each condition.

Eventhough you asked a very simple question, you might as well have asked, "Can someone teach me homeopathy?" We've gone to school for years to be able to get a handle on this. You need more than a repertory and Materia Medica. You need
therapeutic books, you can't practice without them. You could start very simply by going to
www.minimum.com and ordering Jonathan Breslow's
HOMEOPATHIC MEDICINE AT HOME. It's an introductory course book that even comes with the promise of a certificate if you sign up with Jonathan and allow him to be your tutor, and it's cheap for around $300.00! (The tutoring. The book is around $30.00.) That would be my best suggestion:

Homeopathic Medicine at Home, 3rd edition
Correspondence Study Course
By Jonathan BRESLOW

A course manual you can use on your own.
Printed in USA, 155 pages, paperback
Dimensions (in inches): 11.00 x 8.50 x .50
This item was in stock when this catalog was last updated on 4/18/03.

#2583, $29.95


Snoopy

[ 17. May 2003, 02:56: Message edited by: Snoopy ]

If you ask questions based on your knowledge of the remedies, you will not get the patient's case, but rather you will get a case that fits one of those remedies.

See above answer. Also, a questionairre is helpful if you cannot talk to the patient, but if you have someone sitting in front of you, just let them talk. Do not use a questionairre. When you ask questions, you don't get the patient's case, you get your case! Even when the patient says all he has is a sore throat, if you let him talk about it, you will begin to get the symptoms you need.

You need to learn case taking skills! Let the patient give his case. When he stops talking be still until he starts back up again. If after a few minutes he doesn't say anything, ask 'What else?' Keep asking 'What else?' over and over again until there really isn't anything more. You can then ask for clarification of things they have already mentioned. Do not ask leading questions. Do not ask yes or no questions. If you absolutely must ask questions, be sure it's about something he has already mentioned. If you absolutely must ask a leading question, phrase it in the opposite way from the remedy you are thinking of. People want to please you, so they will answer yes even if it's not strongly indicated, so ask the opposite.

No, based on what needs to be cured after you have done a thorough analysis of the case, you repertorize.

No, you find the one that fits the patient the best, not the one that has the most symptoms the patient mentioned.

No, you select the potency that best matches the case. It could be anywhere from a low 6X to a high 10M or you might choose the LMs. And again, the length of time you need to wait is dependent on the case. It may be 15 minutes, it may be a month.

Using the guiding principles of homeopathy, you need to know this before you dose the patient the first time. If you don't, please do not practice homeopathy. You'll cause more harm than good.

Read The Organon! Homeopathy may sound simple, but it is very hard to practice.

Don't. If human beings were machines, you could use an engineering approach, but human beings are not machines, and homeopathy is NOT engineering.

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Shirley Reischman

Thanks again for the enlightening response. Here are my thoughts:

quote:
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If you ask questions based on your knowledge of the remedies, you will not get the patient's case, but rather you will get a case that fits one of those remedies.
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We ask questions based on what is written in the MM (not my knowledge of remedies) because that is the source from where you will finally choose the remedy based on the symptoms. If we were to follow your rule, we might get a case that has no symptom mentioned in the repertory, how do you select a remedy for that.

quote:
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No, based on what needs to be cured after you have done a thorough analysis of the case, you repertorize.
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What needs to be cured would have some symptoms, you will analyse those symptoms and then repertorize. Isn't it.

quote:
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No, you find the one that fits the patient the best, not the one that has the most symptoms the patient mentioned.
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Symptoms are of a patient and hence the remedy selection must follow that. If the remedy whose symptoms match the patient the most is not the best then what else is the guiding principle for remedy selection. Who is the judge of declaring that which remedy is the best suited to the patient. Isn't this one of the major reasons for homeopathy to be still in the trial & error phase as there is no standard protocol that everyone follows. Maybe this is also one of the reason that 10 homeopaths will come up with 10 different remedies for the same case.

quote:
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No, you select the potency that best matches the case. It could be anywhere from a low 6X to a high 10M or you might choose the LMs. And again, the length of time you need to wait is dependent on the case. It may be 15 minutes, it may be a month.
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If the patient has already not been taking a remedy, would you dare begin with 10M ? I am interested in an example of a case where the response comes within 15 minutes. Isn't it the standard protocol to being with a lower dose, preferrably 30 and then decide where to go.

quote:
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Using the guiding principles of homeopathy, you need to know this before you dose the patient the first time. If you don't, please do not practice homeopathy. You'll cause more harm than good.
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Agreed absolutely.

quote:
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Read The Organon! Homeopathy may sound simple, but it is very hard to practice.
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If it is such an ideal system of healing why doesn't it produce consistent & reproducible results. The element of doubt always is there, you keep wondering whether a remedy would work or not and that's why you keep a stand-by remedy or remedies. I think we need to open our arms to change. Maybe the Organon needs to be revisited or the principles of homeopathy need to be revisited. Maybe a paradigm shift is due.

quote:
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If human beings were machines, you could use an engineering approach, but human beings are not machines, and homeopathy is NOT engineering.
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Human body is probably the most intricate, delicate (and robust at the same time) of all known machines. Controlled by a central processing unit called brain. The entire body works on chemical reactions and all reactions follow the basics of science which is kind of engineering, not art. Thats why we now have bio-engineering, genetic engineering and so forth. So I wouldn't agree that human bodies are not machines. We can argue over the semantics but you know what I am talking about. Unless homeopathy is based on solid scientific basis the element of "chance" and "doubt" will always stay there.

__________________
Don't take life too seriously, it aint permanent.

Dear Fitness,

Hopefully Shirley will respond to your questions;
I just wanted to say that we fully hope and expect that ordinary people will be able to treat a simple sore throat, upset stomach, and so on using homeopathic medicines, and they certainly don't need a repertory, MM and a long questionnaire to do it. Many, many therapeutic books are out there, in the health food stores, the online book stores, the homeopathic bookstores, that tell you: here are a list of common illnesses and here are the remedies that are most often used for them along with their profiles; so, you read down the list and suddenly you see the remedy you need; you say, "Oh, Arsenicum! This is the only one with burning pains, and that's what I have!"

As I said earlier, these therapeutic books are essential. Go to www.minimum.com and you will see so many of them: Homeopathy for Children,
Homeopathy for Women's Health, and so on.

It's good to start an acute case with a 30C.
Put it in water. Stir or shake before each dose.
3 or 4 doses the first day or 2; by the second day, you should have results, you should know if you've chosen the right remedy. In a severe case,
like a bee sting or wasp sting, results should be immediate--in minutes or even seconds. A sore throat or cough may take 2 days. A very severe case may require a 10M--like post-surgery, for instance; or a terrible fright; or an animal bite.

Snoopy

Fitness First,

I will try to address your latest set of responses. However, unless you read The Organon and begin to understand the basic philosophy of homeopath, continuing this discussion is futile. I'm not saying this to discourage you, but rather to encourage you to get a solid grounding in homeopathic philosophy. Start by reading The Organon. It is free on-line in the Reference section of this site. Once you've done that I am willing to try to answer as many questions as I have time for and am able to answer.

Also, when you reply, if you scroll down, you will see the UBB Codes. Click on 'Quote', then do a copy and paste when you want to show something in a previous post. It will save you time.

We don't ask questions. We let the case unfold however it unfolds. We also go to the provings for the 'final word' on the remedy. This is one of the basic principles of homeopathy. We may occasionally get symptoms that are not in a repertory or materia medica or even in the provings, but we always get a case, even if it's one sided. Hahnemann addresses how to deal with one sided cases in The Organon.

Yes, but sometimes deciding what needs to be cured is one of the most difficult parts of the job. It's not necessarily what the patient is coming to you for.

Not all the symptoms are necessarily what need to be cured and there may be symptoms that need to be cured that are not in the repertories or materia medicas. Homeopathy is not trial and error, contrary to many peoples opinions. There are different approaches and different ways of analyzing a case. If you have 10 homeopaths, you may come up with three different approaches, but if they are all well trained, you will not come up with 10 different remedies. Allopathy is the same. It's quite possible to go to several allopaths and get several different approaches to the problem. That's because the practice of medicine is an art as well as a science.

Yes, I would dare to begin with a 10M if the intensity of the disease and the strength of the vital force warrent it. In a very acute situation, you had better have a response within 15 minutes or you may loose the patient. Again, there are different approaches, particularly between the low potency and high potency prescribers. You will need to study the philosophy of both to have a good understanding of when to use which potency.

On the one hand, the old masters seem to have much higher success rates than we do today. Maybe because they understood the philosophy better than the average homeopath does today. On the other hand, there are a number of modern master who are breaking new ground and they should also be studied.

Semantics has nothing to do with it. If you truly believe that humans beings are machines, however intricate, then please leave homeopathy and study allopathy. This is basic. It is only the material body that is subject to the laws of physics and chemistry, and a person is much more than a material body.
Paragraph 9 of The Organon
In the healthy condition of man, the spiritual vital force (autocracy), the dynamis that animates the material body (organism), rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purpose of our existence.

Paragraph 10 of The Organon
The material organism, without the vital force, is capable of no sensation, no function, no self-preservation (It is dead, and only subject to the power of the external physical world; it decays, and is again resolved into its chemical constituents.), it derives all sensation and performs all the functions of life solely by means of the immaterial being (the vital principle) which animates the material organism in health and in disease.

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Shirley Reischman

Good and logical explanation. Thanks again to both of you for your time and effort in trying to explain the logic of homeopathy to me.

Sifting can be done online but genuine reading can only be done in printed form. Now let me first go through the Organon and then get back with some questions - maybe after a couple of months as first I have to arrange the Organon and then read it slowly in my free time. (I still haven't stopped reading the Boericke MM in the meantime till the get the Organon)

Best regards and God bless you for your sincere thoughts and selfless help.

__________________
Don't take life too seriously, it aint permanent.