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| Hpathy Ezine - October 2008 | ||||
What's Your Success Rate?Inquiring Minds Want to Know! - Elaine Lewis, CHom |
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| In a previous editorial, Dr. Bhatia posed the question: What's your success rate? Someone asked Andre Saine that very question during a lecture some 20-odd years ago and he modestly pish-poshed the whole thing. "I don't get into that," he said. It's very hard to talk about cure rate when there are so many variables, making comparisons impossible. All cases coming to the homeopath are not equal! For example, Andre Saine only takes the hardest cases, "incurable" cases. He could conceivably have a success rate of 30%, which under the circumstances would be fantastic, but not so great if he were treating colds and flus!
Then there's the issue of the "Imperfect Patient"! Our patients are dissimilar in so many ways! In an ideal situation, the patient puts out a single remedy picture, like my brother-in-law! Even I, with my beginner's luck back in 1994, was able to appear to be a genius by discerning: his obsession with candy, marital infidelity, stinginess, deference to peers and superiors but dictatorial at home, desire for warm drinks and fresh air....it was clearly Lycopodium all the way! But what happens when we get a case complicated by Rx drug suppression, addiction to sleeping pills and laxatives, numerous pathologies some of which are side-effects of the drugs they're on, ailments from poor lifestyle choices which they're unwilling to change? How well is the so-called "simillimum" going to work in these cases? IS there one simillimum in such a case? Does it reflect badly on the homeopath if he can't cure a case like this? I say no. And what about the patient who won't follow instructions? I had a client once whom I told to order Calc-carb for her baby with insomnia and to inform me the minute it came in; instead, she started dosing her child on it right away based on the "instructions" on the bottle and caused an aggravation with repeated dry doses! She said the child was doing well after the first dose but with subsequent doses got worse! I went into complete shock. "Didn't I say to call me when the remedy came in?" I said. "You've caused an aggravation!" (Any striking improvement precludes further dosing.) I sent her antidoting instructions. I never heard from her again. I guess she was embarrassed. So, what would you call that, a "cure" because I got the remedy right? I don't know! And then there are clearly all the patients who are lost to homeopathy by practitioners who are not up on what Dr. Luc De Schepper calls "Hahnemann's Advanced Methods". This is a real shame. All homeopaths should be conversant with aphorisms 246, 247, 248 and 249 of The Organon, which clearly state that you MUST put the remedy in a bottle of water, you must succuss before each dose, and you must begin your chronic cases with the lower potencies so that you can adjust your dosing schedule and methods in accordance with your patient's response to the first and subsequent doses and you should not allow aggravations in chronic cases which would not occur if you started the case with the smallest possible dose, raising the potency as the lower one wore off.... but who practices this way? How many patients are fleeing homeopathy because of aggravations and the feeling that their homeopath has abandoned them? And then, when you never hear back from your patient, do you assume you've had a success, that he must have gotten well or he would have come back? How many of those patients are telling their friends to stay away from homeopathy because of how "dangerous" it is? I recently heard this on the Hpathy discussion board. Someone wrote in saying his whole family had been damaged by prescribing methods which Hahnemann clearly warned against in The Organon! How many of us are familiar with aphorisms 275 and 276 where Hahnemann warns that the correctly chosen homeopathic remedy in too high a potency, or with too many repetitions can "...endanger a patient's life or make the case incurable"? But isn't that how most of us prescribe? I'll never forget the lady who wrote in to the Hpathy discussion board about her husband who had been given Arsenicum 1M by a really famous practitioner, and she thought he was going to die! "I think he's dying!" she said in desperation. Her homeopath wouldn't return her phone calls, that's why she was posting his case on the internet. This is aphorisms 275 and 276 come to life! I've often read in various books that mental cases, in particular, have to be started with a 10M! I'm sure you've heard this too! I start them with 6 or 12C--in water, with succussions before each dose-- just like I do all my chronic cases, and you would be surprised how quickly you see results! See my Anacardium case, "Hell Is Right Here", which I started with a 12C potency once a day: http://hpathy.com/casesnew/lewis-anacardium.asp We have to end the mythology that aggravations are a good thing and, even worse, a reason to keep dosing! My instructions to clients always include the following: If there's a striking improvement, stop dosing. If there's an aggravation, stop dosing! I would encourage everyone within the sound of my voice to read Dr. Luc's Hahnemann Revisited and it wouldn't hurt to read Achieving and Maintaining the Simillimum too so that your cure rate might zoom! By learning Hahnemann's advanced methods, you'll be able to wend your way through difficult and convoluted cases for which one dose of a 200C generally isn't sufficient. Then there are the acute cases. Our success rate here should be very high! (And here's where you need your high potencies!) This is where homeopathy can shine and where you as a practitioner can really make a difference! We can't always help the person with chronic disease, but acutes are usually attended by clear remedy pictures! Being able to spot the remedy and give it can make all the difference between suffering and relief--even life and death! Whether it's a virus, a toothache, facial neuralgia or a head injury, your success rate should be very high! But unfortunately, a lot of homeopaths don't know how to take an acute case! They think they have to take the person's whole life, a two hour case! Then they mix acute with chronic symptoms, as in, "He wants ice cold drinks, give him phosphorus!" The problem is, he always wants ice cold drinks, it's not part of the acute case! But if a person who is always thirsty suddenly becomes thirstless, this is a great clue to the remedy and possibly leads us to Pulsatilla! Jonathan Breslow's Homeopathic Medicine In the Home teaches us how to take an acute case. I've modeled my Acute Case Questionnaire after it. In an acute case, you have to know what to ask, that's the trick to solving these cases; otherwise, you'll be overwhelmed by desperate-sounding information from the patient and you'll panic! You'll say, "I don't know what to do, geez, I just don't know; have you thought of going to the hospital?" When people tell me they're sick, I always say, "Fill out the questionnaire!" The Quiz section of the ezine is the result of all the acute cases I've taken. I can't do it without the questionnaire. For example, there was "Inez's" case, the child with tonsilitis, whose case was solved by the answer to the question, "What is most striking about your condition, what is most peculiar?" "She's eating butter off the stick," came the mom's reply. That's Pulsatilla! Now, how would that have ever surfaced spontaneously without the questionnaire? You have to know what to ask, that's the whole trick in a nutshell, an appropriate set of questions, the leading ones of which are: Sensation, Location, Modalities. If you can just remember that! "What's the sensation? Where's the location, does it stay there, or radiate or extend to somewhere else? What makes it better or worse?" You can go far with just these three questions! I strongly recommend Breslow's book. Another book I'd like to recommend is Mati Fuller's Beyond the Veil of Delusions. I must say, it is one of the most lively and informative materia medicas I've ever read. She's brought to life pictures of Arsenicum, Phosphorus, Staphysagria, Nux vomica and others in ways I never knew existed! What do you know about the Staphysagria male? I rest my case! For an example of Mati's work, please see her ezine article, "Give My Regards To Arsenicum!" in the February 08 issue (http://www.hpathy.com/materiamedica/fuller-arsenicum-2.asp) . That is my absolute most favorite ezine article ever! As long as I'm plugging materia medicas, I can't leave out Paul Herscu's Stramonium! Do you know why this book is important? It makes the point that a lot of homeopaths, unfortunately, are not aware of: There's a certain catagory of remedy you're going to need for extreme behavior, even though the totality of symptoms leads you to Calc-carb and Lycopodium and Sulphur, and other polychrests. You can have a child who eats 800 eggs a week, sweats on the back of his head and has cold and clammy hands and feet, but if he's autistic and blows up and screams and cries if you try to interfere with him; that's not Calc-carb! You have to address this. You're always looking for "the worst thing" when you take a case; you can't ignore "the worst thing" just because you see eggs! I have a client right now who blows up when he's interfered with and he bites and screams and kicks and threatens and hits and bangs his head against the wall and I look down the list of remedies this child has had -- Calc-c, Nat-m, Silica, Phosphorus, Arsenicum, Staphysagria, Aconite, Ignatia and many more, and I can understand why all these remedies were given because they each represent some feature of the case but they don't cover "the worst thing"! This is the important lesson in Herscu's Stramonium. And he also says that there's a predictable transition back to the "normal" remedy; for example, after you've given Stramonium (or Belladonna or Hyoscyamus or Tarentula, etc.), you may next encounter a nosode, like Medorrhinum or Tuberculinum, before you finally get to Sulphur or or Calc-carb. There's a hierarchy of remedies, in other words; the "totality of symptoms" doesn't hold for a child with violent behavior. So, I would like to strongly recommend Stramonium for those who want to improve their cure rate with their extreme and difficult patients. So, in conclusion, my list of must-reads to improve your success rate: Hahnemann Revisited Homeopathic Medicine in the Home Beyond the Veil of Delusions Stramonium It's a modest list so I don't wanna hear any complaints!
I'll be in The Quiz section if anybody needs me....
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| Elaine Lewis, DHom, CHom takes online cases. Visit her website at: www.hpathy.com/office/ElaineLewis.asp |
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