Dear Calibluecrush, dear collegues

My approach to a situation like this would be:
1. Assess where the patient is coming from, eg how deep is this aspect of suffering, how susceptible is your patient to the experience of suffering
2. Is the experienced aggravation bearable or not
3. If it is unbearable challenge the patient and confirm that it s not just unpleasant but actually unbearable. In this instance you will have to act. If the remedy was correct but the potency too high you will have to induce a partial antidote, eg drink some coffee, smell some camphor, etc. If the remedy was incorrect you will ave to antidote homoeopathically with the applicable similimum.
4. If the experienced aggravation is possibly bearable use modalities only to palliate, eg temperature applications, pressure applications, etc.
5. In all cases you will have to assess the overall reaction to the homoeopathic remedy, ie physical, physiological, mental and spiritual aspects. It may seem that your patient suffers prolonged, because the suffering is in the patients' face and hence in the practitioners' face, make sure you do not oversee improvements on high evels of existence, eg increased compassion, improved social function, improved mental faculties, etc. You will always have to remain calm and steadfast adhering strictly to the principles, ie to the law of nature. Don't get easily sidetracked by some screams and mournings. Work with precision!

hans, you brought allopathy into this discussion, by your sarcastic swipe at homeopathy, for it is understood that you would like to see the homeopathic community forced into an early retirement, leaving the patients of the world in the hands of the allopaths, with no alternative. in this circumstance, wouldn't it be prudent, in keeping with your own favorite argument, to do a cost/benefit analysis, to determine whether the possible risks inherent in homeopathic treatment represented a graver or less grave alternative to the allopathic treatment to which, on the presumed retirement of the homeopathic community, our patients would be escorted by you and others of your ilk? i think we and our patients would prefer to decline your generous, if uninformed and disingenuous proffer of transportation, and put understanding of patient suffering in a proper context.

which requires understanding of the fluctuating fortunes encountered during course of treatment.

only the uninformed, untrained, and uneducated, and those who prefer black/white, yes/no, either/or, and digitized bits, to rational enquiry, would expect the course of treatment to be unexceptionable, and to be unable to entertain the notion that one might profitably differentiate aggravation from worsening of condition, even after a month.

certainly, it is amusing to read your little presumption that "...If you had a remedy and just feel worse after a month, the obvious conclusion seems to be that the remedy did not work." so much appears 'obvious' to the uninformed, doesn't it? sigh. hans, go back and read vitoulkas, for starters, and in particular the appendix in which he shows varying response patterns to dose. also consider that the common proof that a reaction is aggravation, as compared to worsening, is that after a few hours, or days, or weeks, or even months, improvement follows, amelioration follows aggravation, demonstrates the curative process of like curing like, the healing effects of the temporary medicinal disease. as usual, you are quick to jump to conclusions, when asking additional questions would be the more prudent course, especially when you are actually responsible for a patient's well-being.

a course of treatment doesn't end, hans, because one is having a hard passage. you watch patient progress and continue to intervene toward cure. the idea is not to tabulate statistics, but to involve in an actual life process. if you were more alert to this aspect of reality, you might have avoided the hrt, and the thalidomide, and the benaxaprofen, and the butazones. look at real ill effects, hans, demonstrable ill effects, not glib spedulations. there are simply no real world calamaties that can be attributed to homeopathy, in any measure comparable to the failures of allopathic regimes - supported by statistical research methodology, no less. only hubris can account for a failure of humility in the face of such a record.

and don't bother with your sophistries concerning the absence of proof, regarding amelioration following aggravation, or your rude and uneducated substitution of 'case story' for the proper term, 'case study,' as you only demonstrate by this ploy the absence of understanding of clinical assessment and documentation, the major source of your hubris. after all, even argument in favor of statistical method is not argument against efficacy of clinical method, in spite of this being one of your favorite gambits, in regards research methodology just as in regards treatment modality.

i know there are too many words here for you to follow well, thus doubtlessly qualifying this post, in your eyes, as yet another 'rant.' but, please, take a few weeks, read it carefully, look up vithoulkas, read the other posts and links, and try thinking instead of calculating. you'll be a better person for it.

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.

I will gladly modify it to: According to Hahnemann there is a clear difference between a homeopathic aggravation and simple deterioration due to lack of effective treatment.

However, I would then have to add that this distinction appears to be difficult to observe in real life, otherwise we would not get these debates.

And I would also need to remark that the account that started this debate is then obviously not homeopathic aggravation, but simple deterioration.

Hans

Edited to add: Bach, you didn't want to talk to me anymore, rememeber ?

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<i>You have a right to your own opinion, but not to your own facts.</i>

Dear Member, dear Hans

Quote:
>>However, I would then have to add that this distinction appears to be difficult to observe in real life, otherwise we would not get these debates.<<

I agree on that, -- it is difficult for the untrained person to exactly decide in every individual case which is which, even though I think, that the time aspect is easy to observe.

Another paragraph relating to the subject is par.: 161, which I want to include here+ my thoughts on the subject posted two years ago.

paragraph 161, Org.:

When I here limit the so called homeopathic aggravation, or rather the primary action of the homeopathic medicine, that seems to increase somewhat the symptoms of the original disease, to the FIRST or FEW FIRST hours, this is certainly true with respect to disease of a more acute character and of recent origin; but where medicines of long action have to combat a malady of considerable or of very long standing, where no such apparent increase of the original disease ought to appear during treatment and it does not so appear if the accurately chosen medicine was given in proper small, gradually higher doses, each somewhat modified with renewed dynamization –par.:247. such increases of the original symptoms of the chronic disease can appear only at the end of treatment when the cure is almost or quite finished.

If you follow the advice of par.; 161 you can cut out possible mistakes.

First: use LM,s: this cuts out the possibility of unnecessary aggravations in chronic cases resulting from C-potencies.

Second: call a homeopathic aggravation only strictly a hightening of the original disease-symptoms within the first few hours after applying the remedy.
Needless to say, that despite of this hightening, you observe independent improvement signs as listed in par.; 253.

This leaves you with all the cases where other symptoms are brought out, not contained in the original disease-picture, or where there is aggravations longer than the first few hours, or where the improvement signs are missing.

These cases are not ‘’homeopathic aggravations’’ No, they are: ‘’worsening’’.

Hahnemann refers to this situation in par.: 249-250

Worsening means: your selection of the remedy was faulty and needs replacement with a better one as soon as possible. Leaving it act on is at the least a waist of time and at the most bring your patient into great danger.

I think that far too many worsening’s are camouflaged as homeopathic aggravations nowadays by the homeopaths.

Do homeopaths adhere to the use of C-potencies, so they can blame the problems on the potency rather than on their incapacity to prescribe the accurate remedy and remain paralysed when action is needed?

Is there a list of original symptoms in every case established, where one can compare the now threatening symptoms with? –If not—How can anyone state that this is a homeopathic aggravation?

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Hans Weitbrecht
Consultant Homeopath

Aggravation is often the road to cure but not if that extended . Kent advises , and my experience confirms, that in situations like this a high - 10m- dose of Nat Mur will restore normal conditions and enable a restart - after a stabilising period !. Interesting that nat nur is a close relation of sepia .

another inaccuracy. in fact, i didn't want you to talk to me, if you were uninterested in the subject - at the time, the subject was the difference between physical processes at the macro and micro levels, if you recall, and you had decided this was inappropriate to discuss ....

more "obvious" conclusions from the presumptuous one? well, maybe you're right ... but otoh, calibluecrush, who started the thread, stated that after one month, the prescription "...aggravated all of the symptoms she [the naturopath] was trying to treat." if or to the degree this is true, then this would appear to be an aggravation, that is, a worsening of the original symptoms.

that this might have been an aggravation is, in fact, further supported by the fact that the patient was given two doses of sepia 1M, a high potency that could be expected to have strong effect, and which should not have been repeated before observing patient reaction. in this situation, the wrong potency indeed could produce a prolonged aggravation, the severity of which could possibly even mask the presence of signs of improvement. and if, on top of this, the patient was a sensitive ... or the prescription was inaccurate to a greater or lesser degree ....

i am, btw, unsure how to take H's stricture that aggravation was limited to the first few hours after the dose. even with LMs, isn't it true that an aggravation occurs near the end of the prescription, and announces an approaching amelioration? and if the prescription is innacurate, especially as regards potency or size of dose, won't the aggravation be prolonged? advice of (knowledgeable) members on these points is appreciated.

hansel, hansel, why on earth you persist in thinking that clinical situations are so easy to observe and to evaluate, that everyone - trained or untrained - would take one look at them and reach identical conclusions by a review of superficial details, is quite beyond me. treatment, hansel, is difficult work. observation and assessment are detailed, subtle, variegated, and time consuming processes. you don't just drop your calculator into your attache and pick up a stethoscope ... well, you do, but you shouldn't. debate and discussion are intrinsic to learning: the standardised format of the case study provides the "replicable" vehicle by which one learns to apply in vivo the principles of clinical diagnosis and intervention. you inability to respect these facts reflects deep ignorance (lack of education and training) and bias. why don't you take up another hobby, something you can doubtlessly master in short order, say, painting ... go out and paint a picasso. i'm sure the art world will await your productions breathlessly.

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.

ok, so on re-reading and re-considering, and assuming one has found the true similimum, it would seem that the 'homeopathic aggravation' is limited to the few hours after the dose, but that the 'aggravation' can indeed last longer than that, if the dose given is not the minimum dose, or if the potency is too high (or too low?!). in that case, however, it is still an 'aggravation,' though we then would have recourse to calling it an 'unnecessary aggravation,' that is, the result of writing an inaccurate prescription for the correctly chosen homeopathic remedy. nevertheless, the result will still be curative, but the cure will take longer than necessary, and will not be as gentle as possible, the rapid and gentle cure being a result of correctly specifying potency and minimum dose.right?

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.

Dear Bach
I like the last chapter you wrote at the end of your second last post, and why?
Because it’s from the heart.

Ease in observation and evaluation comes with master ship -- like playing the chaconne by heart on the violin –
And here I want to recall, that to even be able to play the chaconne on the violin it took me 10 years of practise to learn the craft of violin playing, of reading sheet music of learning to listen and feel.

What’s true to music applies equally to homeopathy.
It’s through learning the craft we can gain mastery.

Discussions, debates and practise cases can never replace the day-to-day clinical experience in its multi dimensional expression of disease in the patient.

Reading the label on the bottle one cannot experience the virtues of any medicines, it has to be taken, and so has homeopathy to be practised to be experienced.

The effort has to be made by you yourself
Masters can only show the way.

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Hans Weitbrecht
Consultant Homeopath

The following statement (stated above) is absolutely true ....


"......Discussions, debates and practise cases can never replace the day-to-day clinical experience in its multi dimensional expression of disease in the patient......"

hans,

well, this hitherto unsuspected gift, to be able to play the chaconne oneself, is certainly enviable. as is mastery of clinical practice. i do not remember the principals involved in the story, but did you hear the one about the violin master (let's call him Glenn) attending a performance by another master (whom we might call Nina) in florence, and he said to the performer, in a confused tone after the concert, "you know, Nina, i watched you play, but all the while i was hearing Tommy [a third violinist]?" "well," explained his friend, "as it happens, i left my stradivarius in new york, and when i arrived here, Tommy was kind enough to lend me his."

i tell you, hans, to even imagine that kind of virtuosity, to recognize the difference of effect as between this strad and that, and further to identify the performer who ordinarily played it, gives me chills.

aaanyway, it is not the easiest thing, i tell you, after practicing in one clinical profession for 25 years, to find oneself as a newcomer in another, which is why i have been so grateful for the courtesy and patience and consultation offered here and at hhbb by so many fine masters of homeopathy. in a similar vein to this, and to your own experience of studying for 10 years to master the violin, i think mozart himself must have felt a considerable amount of frustration, before he finally felt capable enough to pen his first score at 3 years old. the patience and hard work it must have taken!

aaanyway, as i'm sure you know, some of the expertise is transferable, from one clinical field to another, at least in recognizing the character of the clinical process, and certainly as compared to a scoffer, such as mrc-hans, who can toss off glib analysis as though it were high artistry, superficial opinion as though it were transparent fact. "fact," indeed. the discovery of which requires the ability to ask questions and formulate tentative opinions, more than selecting a convenient assortment of details that fit a preconceived notion. and to offer such a notion as though it were respectable opinion, no less in the presence of masters such as yourself, doctorleela, snoopy, divina, and others, is a nearly incomprehensible conceit.

but, remember, this is from the one who has devoted a web-site to a critique of hahnemann himself! hmmmmph.
bach

__________________
"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.