Summary
The homeopathic veterinary surgeon, as the doctor, has an
obligation to reduce to a minimum any prejudices whilst in front
of the patient and to observe some rules of objectivity that allow
him to make a better prescription. The most insidious enemy of
the homeopathic doctor is his own subjectivity. The purpose of
this work is to explain succinctly to homeopathic vet colleagues
a method already known for years in the department of human homeopathy
that, if correctly applied, tends to reduce drastically this subjectivity
whilst complying with the hahnemannian assumptions: it is commonly
called the Method of Pure Homeopathy (MPH).
Key words:
vet homeopathy– method – pure homeopathy
Introduction
The Method that I have the honour of presenting has
already been officially popularised in 1995 by Marcelo E. Candegabe
and Hugo C. Carrara of the Escuela Médica Homeopática Argentina
“Tomás Pablo Paschero” (E.M.H.A.) within a book entitled Aproximación
al Método Prático y Preciso de la Homeopatia Pura.
This work is the result of a series of consideration
inspired by the teachings of the late Master Paschero, founder
of the E.M.H.A., of his fraternal friend and spiritual heir, Eugenio
F. Candegabe, my Master, with whom the Authors have integrated
their experiences of many years of clinical apprenticeship and
the scientific present-day knowledge which confirm the Hahnemann
conception of the ILLNESS as A NEW ORDER IN THE MANIFESTATION
OF THE HUMAN BEING.
It will not be possible, during this session, to cover
completely all of the subjects linked to the Methods, therefore
we will try to develop a synthesis that can result interesting,
especially for we Vets, referring to the original work and to
the more detailed study.
Before going into the very heart of the exposition,
it is necessary to clarify the title of the Method that opens
with the word “approximation”. This is very important.
From its birth until today, Homeopathy has had a continuous evolution,
we could say a natural evolution, as foretold by Hahnemann himself
and by his successors, and so it will be in the future, considering
that till now many points are still completely absorbed into the
uncertainty of the hypothesis. For these considerations, it is
not the intention of the Authors of the Method the idea to consider
it definitive (hence the word “approximation”), although we are
convinced that it represents the maximum level of precision
[1] obtainable today in accordance with the present-day knowledge,
either homoeopathic or scientific, within the limits of classical
homeopathic prescription.
With this due introduction, from now on, we will, for convenience,
refer to the Methods simply as Method of Pure Homeopathy [2] (MPH), remembering that it has
been adopted with success by myself and few other colleagues in
the field of pets.
If this work succeeds in arousing curiosity and even inspires
a few colleagues to apply the MPH, it will already have been well
worthwhile.
The doctrinaire basis of
MPH
Naturally, the whole work of Hahnemann is fundamental,
but now we are going to emphasize only those parts that have inspired
the MPH.
In the essay entitled Spirit of the Homoeopathic
Medical Doctrine, Hahnemann says: “Illness is the result of
alterations in the way of living that man feels and puts into
practice, namely a dynamic changing, A NEW CLASS OF EXISTENCE
whose consequence must be a changing in the established material
principles of the body”.
And more, in another passage of the same work: “You
can see without difficulties that the dynamic alterations of the
vital character of our organism, to which we give the name of
illnesses, express themselves through an AGGREGATION OF SYMPTOMS
and only under this shape can we recognize them.”
We will never cease to be amazed by the incredible farsightedness
of the Master in his statements! The NEW CLASS OF EXISTENCE, is
absolutely confirmed by the experiences of Bénard Instability
and by Zhabotinski Reaction, cited by the Nobel Prize Winner Ilya
Prigogine for the explanation of Complex Systems.
Every human being is an open system that maintains an
unstable equilibrium, we could also call “susceptibility”, or
“predisposition”, or “psora” (in coherence with § 80 of Organon)
that makes possible the amplification of fluctuations within the
organism as a consequence of a particular stimulus (aetiology)
that, past a critical point, determines a change in the totality,
a NEW ORDER OF EXISTENCE, the illness.
The sole element that allows us to recognize the illness,
and that shows the idiosyncrasy of the patient, is that AGGREGATION
OF SYMPTOMS already cited and even this concept is confirmed by
modern science.
The physicist David Bohm, in his work Wholeness and
the Implicate Order, suggests a model of Universe made up
by an IMPLICATE ORDER of facts, where everything becomes united,
and by an EXPLICATE ORDER of phenomena, where parts appear separated
in front of the partial observer (as for example, the symptoms
of the patient in front of the doctor, who can accept them only
on the basis of his own experience).
According to Bohm, several events should therefore give
rise to the developing realization of the Universe and there exists
an inner relationship where THE PART IS EVERYTHING AND EVERYTHING
LIES IN EVERY PART, as represented in the hologram.
According to this theory, the Universe (which Bohm
calls Holoverse: from Greek holos = all, whole) is provided with
a movement, a flow of information which has as its chief characteristic
the REPETITION of phenomena (for example the symptoms, see Organon
§ 95).
These and other considerations, that deserved a separate
treatment, lead to the following synthesis.
Illness is a new order of existence that expresses itself in
many different regions of the organism, from mind to body, through
signs and symptoms, (explicate order) only apparently isolated,
that shows altogether a high degree of coherence with the totality
(implicate order), characterized by a particular individual pathological
constitution (idiosyncrasy).
All
that leads us to consider symptoms either on a physical seat or
on a temporal seat, increasing in this way our precision on the
hierarchy, as we will see later in connection with the Second
Step of MPH.
To conclude this doctrinal parenthesis, lets us remind
ourselves of the three qualities that a symptom should have to
be considered “a good symptom”:
INTENSITY, that is the power to create suffering in a certain measure;
HISTORICITY, that is the power to occur chronically (§§ 91 and 95 of Organon);
MODALITY, that is the circumstance that makes it peculiar (§§ 153 and 164).
Now we have sufficient elements to become immersed in
MPH, even if it will be necessary to open some further parenthesis
sometime during the course.
The 8 steps of MPH in the veterinary visit
First Step – Anamnesis and Systematic Interview
Everything begins with ANAMNESIS, in accordance with
§§ 83-84-85 and the SYSTEMATIC INTERVIEW, according to §§ 86-87-88-89.
We
will not comment upon these two phases, taking it for granted
that everybody should know them well. We will only say that such
moments, together with the OBSERVATION of the doctor (§ 90), lead
to the INDIVIDUALIZATION of the patient, that is, as Hahnemann
says in § 104, “the most difficult part”!
Strangely, however, it is just from now on that the
different schools of Homeopathy have split, that is on the part
that for Hahnemann should be the simplest. Let’s try to understand
the reasons.
We agree perfectly in considering the homoeopathic symptoms
as the basic scientific parameter, but relying on the partiality
of the doctor who, remember, is an observer conditioned by his
experience, such symptoms will be differently catalogued and chosen
for the research for the remedy: THE THERAPEUTIC CONCEPT CHANGES
IN RELATION TO THE WAY THE DOCTOR CONSIDERS THE ILLNESS. The different
schools of Homeopathy take as their model the three periods of
evolution of Hahnemann taken separately and hereby listed (Fig.
1):
I. Illness is a noxa that
attacks the organism; the therapeutic concept is the remedy for
the pathology;
II. Illness is conditioned by
miasmas, that make the individual vulnerable; the therapeutic
concept is the remedy for the working miasma;
III. Illness is a dynamic change,
a new order of existence; the patient is always himself in a different
way of being; the therapeutic concept is the treatment with constitutional
remedy.
We consider it logical to think that, if we continue
to give credit to Hahnemann and to his doctrine, we should consider
the experience that led him to revise his Organon at least
six times, of which obviously we no longer consider the first
editions (if not to understand exactly his evolution), while we
consider the Fifth from which the Kentism comes, with 200 years
of experience, and the Sixth with the innovation of the LM Scale.
Probably, Hahnemann took it for granted that it was so for everyone,
but obviously he made a mistake.
Anyhow, the next passages of MPH represent the effort
to make, despite everything, the simplest things, obviously starting
from the last realization of the Master who, as we know, when
was 80 years old, by his own admission, was lacking in life and
motivation, but after having met Melanie fell in love again, both with her and with Homeopathy
for the next 8 years of his life.
This has made possible the revision of the Fifth Edition
of Organon and therefore the following Sixth Edition, published
posthumously in 1921, 78 years after his death .
To exemplify the MPH in practice we will use the clinical
case, with two follow-up years, of Joy, CM 4 years old cat
which will illustrate the various stages. What follows refers
to the First Passage.
Anamnesis and Systematic Interview
The owner, who had
almost given up hope, brought in the subject in a serious condition.
The cat is already in therapy with different medicines and with
different clinical tests having been done with the aim of reaching
a certain diagnosis of FIP. She tells me with tears in her eyes:
"Doctor, if he dies I will also die”. Then, having said that,
she gently lays Joy on the visiting table. The animal seems alert,
but very weak; stays still and there is no need to hold him, as
he shows no sign of making even the least effort to move away.
Joy arrives with a
40°C fever but looks in quite a good state of nutrition, mainly
because his mistress is very clever at giving him assistance:
she has force-fed and hydrated
the animal (who would otherwise be probably much worse) for 15
days: "He has absolutely no desire of food; I try to put
it at his disposal, he comes nearer and then goes away feeling
sick [APPETITE - wanting - food - sight of, at; APPETITE - wanting
- food - smell of]. Neither drinks [THIRSTLESS - fever, during]
From analysis, what
stands out above all is an increase of WBC (24.000) and the shifting
of the formula towards the segmented neutrophils (20.255). The
biochemical profile shows an increase of creatinine (2.42). High
bilirubin in the urine with presence of hidden blood, proteins.
The echographic diagnosis talks about lympho-adenomegaly of abdominal
lymph nodes of a probable inflammatory origin and infiltration,
with correlated peritoneal reaction.
The
cytological diagnosis of the material drawn through hypodermic
needle talks about granulomatose lymphadenitis with strong hyperplasia
immunoblastic /plasmacytic.
Electrophoresis: light increase of gamma globulins.
All this, in an over
4 yeas old castrated male cat, can be compatible with an initial
state of lymphoma or of mycobacteriosis, rather than FIP.
The cat had been found
by the owner when he was almost 3 weeks old. She reared him to
become a healthy cat.
Although he has always
lived at home and never had contact with other animals and fellow
creatures, he has had two episodes of taeniasis. He has always
been fine.
With regard to sociability:
“The cat has always lived in symbiosis with me: since the time
he has lived at home we have always slept cuddled up to one another,
touching or not [MAGNETIZED - desire to be; MAGNETIZED - amel.].
After 8 months there was also a dog at home which has created
no problems. Then, as my job has lately become more demanding and I leave home at
7.0 am to come back at
8.0 pm, I have adopted a little cat to keep him
company. I thought about it a lot before deciding and towards
the end of September she arrived. On October 8th both
he and the little female cat suffered from an infection from coccidae
(anticoccidae therapy for 10 days.); on February 19th , 40.4 fever
with loss of appetite (amoxicillin/clavulanic acid); on 21st nothing has changed and the described tests
have been done with suspicion of FIP, with cephalosporins and
metoclopramide therapy for problems of nausea; on 27th
clindamycin is added to the treatment as a consequence of suspicion
of toxoplasmosis given by a cytological test.
During the first days
of the presence of the little female cat, he has not shown up
on my bed, because he was irritated by the fact that she was there
too [IRRITABILITY - taking everything in bad part]. After a while
he returned to his old habits.”
His way of acting
and reacting:
“He is a lazy cat,
touchy (he only protests, but then at once he forgets it) [OFFENDED,
easily], very affectionate. He has always been very insistent
and has a characteristic way of making himself heard, calling
and miaowing to obtain attention (I myself witness an episode
of this in my study-room, when tired of staying with me, he calls
the mistress in a characteristic way, a real protest) [DICTATORIAL][WEARISOME].
He does not have a cat’s temperament, he seems more like a dog:
when I arrive home he receives me lying on his back and has a
deep sense of limits, of boundaries: if I leave him in the garden
he stops by the fence [DUTY - too much sense of duty]. He loves
sleeping in the study wardrobe trying to thread through the boxes
of dresses or inside the plastic-bags, as if he needs to feel
protected.
He has a strong need
for physical contact: as soon as he can he tucks himself in and
sucks. The only thing that annoys him is the noise of aluminium
paper or when a plastic bag is picked up, then he runs away."
[SENSITIVE - noise, to - crackling of paper, to; FEAR - noise,
from]
As regards the general
symptoms: “He was (use of past tense, because he has lost his
appetite for 15 days and that he has to be fed by force) also
rather greedy, in the sense that he ate in a great hurry, in a
way I have never seen in a cat [HURRY - eating; while], he preferred
fish to meat and between beef and chicken preferred chicken. He
loves water very much and jumps into every sink, he plays there,
he played there till the moment he was taken ill... he had no
loathing for water [WATER - loves; BATHING - amel.].
To fall asleep he
“makes pasta” (like kneading with anterior legs)
and sucks as if he was 2 months old, especially if
I wear a fleece. He loves travelling with us by car and
gets into his carrying basket of his own free-will, without any
problem.”
Second Step – Layout of the illness-table
We remind ourselves that good Homeopathy method should
have four basic characteristics:
1. objectivity, that is the possibility
of minimising any kind of interference and prejudice;
2. precision, that is to minimise the
interpretation and to be able to assign the symptoms in the correct
hierarchical order;
3. simplicity, that is the possibility
to being adopted by everyone, regardless of experience, philosophy,
religion, etc.;
4. universality, that is every doctor
should be able to achieve the same choice on each type
of patient.
To fulfil such requirements, it is necessary to adopt
these schemes, which are simple, but such simplicity comes from
a hard and long work of careful analysis of hundreds of clinical
cases. In this Second Passage we begin the review of these schemes.
The Totality of Symptoms collected in the First Passage
needs now to be put in order (§ 104). For this purpose we propose
the following scheme where symptoms are put in squares (Tab. 1).
Table 1
|
Characterologic
symptoms |
|
|
Modalized symptoms |
Ø
Mental
Ø General
Ø Local |
|
Auxiliary symptoms |
Ø
Clinical syndromes
Ø Symptoms as such |
Such subdivision does not represent a novelty, nevertheless
some observations are necessary.
Characterologic Symptoms
– Analysing carefully what the Master says in §§ 210-211-212-213
of Organon, the Characterologic Symptoms are very important for
the confirmation of the cure, but not of its choice. In fact they
are not modalized and therefore do not individualize the patient.
These are symptoms such as JEALOUSY, TIMIDITY, LOQUACITY, OBSTINATE,
DICTATORIAL, AVARICE, AFFECTIONATE, etc. For example, Jealousy
belongs to Apis, Hyosciamus, Lachesis, Nux vomica, Pulsatilla
and others, but as such do not distinguish these remedies. The
symptoms of character are more important, because they prevent
the possibility of realization of the patient according to his
own original nature (§ 9), expressing in this way his existential
suffering, but must be related to the Totality to have the maximum
benefit: the remedy confirmation.
Auxiliary Symptoms
– These are important above all in the Prognostic Observation
according to Kent, and let us not forget that these are the
same things that often make us appear clever or less clever in
front of the patient as, for him, it is this that is worth treating!
Modalized Symptoms
– These symptoms deserve our highest attention during this phase.
They are the so called ‘adverb symptoms’, that reply to the famous
7 questions of Boenninghausen, that correspond to the patient’s
own vital necessities and are those characteristics of which Hahnemann
talks. The Hierarchisation and Repertorization processes base
themselves on them and for them the following scheme has been
prepared (Tab. 2), complementary to the scheme in Tab. 1, in order
to fit them in according to their hierarchical degree on two already
mentioned levels, psychosomatic and temporal.
Table 2
| Modalized symptoms |
Historical |
Intermediate |
Present |
| Mental |
9 |
7 |
3 |
| General |
8 |
5 |
2 |
| Local |
6 |
4 |
1 |
According to the Author’s
experience, a symptom to be considered is Historical when it is
present in more then 2/3 of the patient’s life, while it will
be considered Intermediate when it is present in more then 1/3
of the patient’s life. It should be noticed that a Local Historical
S. is to be considered more hierarchical than a Present Mental
S. and the more symptoms tend to occupy the highest left sector,
the more hierarchical they are.
Let’s see how our clinical case proceeds in this Second
Passage. Naturally, those signs that, according to the cat nature,
do not represent a symptom will not be considered: for example,
the desire for fish or “to act like making pasta”, which is an
attitude commonly noticed.
Layout of the illness table
- Characterologic s.:
dictatorial, irritable, tedious, desires of attention.
- Modalized s.: (in
hierarchical order with the value in brackets): eats hurriedly
(9), loves playing with water (9), desire of physical contact
(9), excessive sense of duty (9), hypersensitive to the crackling
of the paper (9), takes everything badly (3), lack of appetite
at the sight of food (1) and at the smell of food (1), lack of
thirst during fever (1).
- Auxiliary s.: asthenia,
fever, lack of appetite, lack of thirst, swollen lymph nodes.
Third Step – Intelligent Repertorization
In § 104 Hahnemann clearly says that we have to “pick
out the characteristic symptoms, in order to oppose to these,
that is to say, to the whole malady itself, a very similar artificial
morbific force, in the shape of a homoeopathically chosen medicinal
substance”.
That means that we have to take only the characteristic
symptoms and remember that a symptom is characteristic in proportion
to its historicity and to its modality.
When
we say “intelligent repertorization”, it does not therefore mean
that we are clever, but that it comes with respect to Hahnemann
suggestions and experience proves that such suggestions can be
put in practice with the addition of some simple rules:
to choose from 3 to 5 symptoms between those of modalized group and only in
case of absence or lack of those, consider the characterologic
ones, that will be essential in the Fourth Passage; this makes
it possible that not only polychrest remedies appear;
to choose repertory rubrics that have a minimum of 7 remedies and a maximum
of 100, except the presence of a certain symptom, historical,
very intense and with individualization for the patient, as for
example CHEST - ERUPTIONS - Mammae – itching (4 remedies); this
allows us to work with more secure rubrics;
to unify in just one rubric symptoms which can not be clearly differentiated,
as for example “GENERALS - CONVULSIONS - epileptic - anger; after”
and “GENERALS - CONVULSIONS - vexation; after;” this helps to
avoid leaving out remedies among which there could be the one
of interest;
to consider in the analysis all the remedies that hold half + 1 of the repertorized
symptoms: for example remedies covering 3 symptoms of the 4 or
5 modalized ones, or 2 symptoms of the 3 modalized ones.
And only in the case that the remedies are more than 12
in that time it will be considered the score expressed by Repertory;
experience has shown that this group of remedies nearly always
contains the simillimum and it is on such a group that we will
work in the next Passage.
Now come back to our subject.
Intelligent Repertorization
JOY
RADAR Licence
6301
| 1
|
MIND
- HURRY - eating; while |
38 |
| 2
|
MIND
- DUTY - too much sense of duty |
38 |
| 3
|
MIND
- SENSITIVE - noise, to - crackling of paper, to |
8 |
| 4
|
MIND
- MAGNETIZED - desire to be |
12 |
| 4
|
MIND
- MAGNETIZED - easily magnetized |
7 |
| |
caust. |
cupr. |
lyc. |
zinc. |
androc. |
ars. |
aur. |
calc-sil. |
calc. |
kali-c. |
| |
3 |
3 |
3 |
3 |
2 |
2 |
2 |
2 |
2 |
2 |
| 1 |
3 |
1 |
1 |
2 |
1 |
2 |
1 |
- |
- |
1 |
| 2 |
1 |
1 |
1 |
1 |
1 |
2 |
1 |
1 |
3 |
3 |
| 3 |
- |
- |
1 |
1 |
- |
- |
- |
- |
- |
- |
| 4 |
- |
1 |
- |
- |
- |
- |
- |
1 |
3 |
- |
| 4 |
1 |
- |
- |
- |
- |
- |
- |
- |
- |
- |
It will be noticed as this Repertorization, which observes
the cited rules, is composed of 4 symptoms, as the last 2 have
been united into one sole rubric of 19 remedies, and shows remedies
(not only polychrests) classified for sum of symptoms and in alphabetical
order, of which only 4 cover the half + 1 of rubrics.
Fourth Step – Connection with the Materia Medica
Up until this step, if the work has been well done,
the MPH does not leave much room for the doctor’s prejudice and
now places at our disposal a limited range of remedies from which
to choose the simillimum, as Hahnemann wanted.
We have already seen, the Characterologic S. now have
a particular importance for the remedy determination, which will
be carried out consulting the Materia Medica and reminding ourselves
that it should be a great mistake to rely solely on memory, even
only for the remedies that we believe we know well.
We will make a comparison with the symptoms listed in
Tab. 1, keeping in mind that, if for the Repertorization we have
used only the most hierarchical Modalized S., during this phase
we have to find correspondence with the Totality of the Patient.
The chosen remedy will be the one that will give us symptoms combined
in an harmonious and logical way, allowing us to have a NEW READING
of THE TOTALITY, that “of this outwardly reflected picture of
the internal essence of the disease”, as Hahnemann says in the
§ 7, that leads us to reveal the Morbid Constitution of the patient.
In this Passage, it is expressed much more the Art of
the doctor who has to investigate the different pathogenetic manifestations
in order to identify the same level of imbalance, the same idea,
the same pathological dynamism of the patient. The Totality not
as a jumble of symptoms, but as an INDIVIDUALITY.
Now come back again to our cat.
Connection with the Materia Medica
The analysis of the 4 remedies proposed by MPH shows Causticum
that covers the Totality, while Zincum should be more suitable
just for auxiliary symptoms. Particularly, Kent
says that the greatest characteristic of Causticum is the despair
with fear that justifies the greatest need of sympathy and protection
that it has (more of all in MM). Eugenio Candegabe adds: “As the
child who has to hold his mother’s hand during the night. Therefore
he needs the understanding and attention of others, who never
cease to call insistently: he is the typical imploring dictator
who loves adulation. In love sufferings and in grief he has two
important aetiologies. He bears the contradictions, because he
needs others, but he is polemic and contradicts. He is hypersensitive
to noises because he fears the environment and his insecurity
prevents him from venturing into places different from those he
lives in. Water and wet improve it (it is one of the fundamental
keynotes of the remedy).”
Causticum personality suits Joy and his way of feeling, acting and reacting
very well; besides, the remedy covers auxiliary symptoms as well.
Fifth Step – Addressed Reinterrogatory
In this step, with reference to Materia Medica, the
patient is questioned again with regard to the chosen remedy.
In fact, even if there were no doubts on the remedy, it is opportune
to improve continuously our performances and particularly:
to acquire knowledge of unknown remedies that appear in the repertorization;
to improve the collection of symptoms and the repertorization of the patient;
to confirm or modify the characterologic symptomatology;
to note down the symptoms not covered by the chosen remedy to observe them during
the development of the case and verify its presence in other patients
who need the same remedy.
Addressed Reinterrogatory
Causticum is confirmed
for Joy, but the correct symptoms are now “FEAR - noise” (not
“SENSITIVE - noise”) and “FEAR - happen”, “FEAR - range” (not
MAGNETIZED).
Sixth Step – Diagnosis of Dynamic Level of the patient
Although such subject is not directly treated in classical
texts, it is strongly suggested by § 15 of Organon and by the
following §§ 176-177-178-179-180-181-182 and also by Lesser
Writings of Kent
in the chapter The action of drugs as opposed by the Vital
Force.
The Vital Energy of the patient can be REACTIVE or WEAK.
In the first case we will have a lot of symptoms and intensive
ones, in the second, symptoms will be short and less intensive.
The Morbid Constitution of the patient can be COHERENT
or INCOHERENT. In the first case we should have hierarchical symptoms
that will show clearly a remedy, in the second case
symptoms will be less hierarchical and chaotic and will
show more remedies.
It is therefore possible to establish for the patient one of
the dynamic Levels resulting from the possible four combinations
of the characteristics of Vital Energy and Morbid Constitution
just described in accordance with the following scheme (Tab. 3):
Table 3
| Theory of the 4
Dynamic Levels |
Vital Energy |
Reactive |
Weak |
| Morbid Constitution |
Coherent |
1° |
2° |
| Incoherent |
3° |
4° |
Level 1 – It will
be given to patients with a lot of hierarchical symptoms (biopathographic
s.); we have to think of the prescription of simillimum remedy.
Level 2 – It will
be given to patients with few hierarchical symptoms (biopathographic
s.); we have to think of
the prescription of simillimum, but more easily of a similar.
Level 3 – It will
be given to patients with a lot of symptoms little hierarchical
(S. of the actual state, the last period of life); we have to
think of the prescription of a similar. Belong to this
Level, logically, even those patients Hypersensitive who will
show pathogenetic symptoms to every remedy prescribed to them.
Level 4 – It will
be given to patients with little symptoms little hierarchical
(S. of the present state, of the current pathology); we have to
think of the prescription of a similar but easily of a
palliative.
It may be noticed that the numerical progression of
Levels immediately shows the state of the patient (better in the
1st and worst in the 4th) and consequently also what will be the Homoeopath engagement to follow it.
The aim of the Level diagnosis, which we remember is
given exclusively by the QUALITY and by the QUANTITY of symptoms,
is to be able TO FORESEE BEFORE THE PRESCRIPTION what will be
the patient evolution through a Dynamic Prognosis that will be
described in the next Passage.
Diagnosis of Dynamic Level
We have historical symptoms
of Joy (biopathographic) and of a good number for a good diagnosis
of remedy: Level 1.
Seventh Step – Dynamic Prognosis
With this procedure, as already mentioned, a forecast
of the patient is made in connection with the different aspects
that we are now listing.
As regards the
Healing Law (Law of Hering):
Level 1 – the prescription
of simillimum will promote the Healing Law according to Hering, which stages will depend on
the injury state of the patient.
Level 2 – the prescription
of a remedy partially similar will make emerge, even with the
help of acute elapsing states, other symptoms that will allow
us to raise the patient to Level 1 and therefore to prescribe
the remedy simillimum. The Healing
Law will be observed at the end of the treatment.
Level 3 – the prescription
on the actual state will require many attempts before observing
the hierarchical symptoms able to lead to simillimum and
therefore to the execution of the Healing
Law.
Level 4 – the prescription
based only on symptoms of the pathology can only be palliative.
However it can happen that after many faulty prescriptions some
hierarchical symptoms appear to be able to raise the patient to
Level 2.
As regards the
Aggravation and the Amelioration
The Aggravation (primary effect of the remedy) is a
parameter of the Vital Energy and has its variability in the TIME.
The Amelioration (or Reaction, secondary effect of the
remedy) depends on the Morbid Constitution and its variability
is the SPEED.
With this premise, the forecast will be in accordance
with the following scheme (Tab. 4):
Table 4
| Level
1 |
Short
or absent agg. |
followed
by |
Fast
amel. |
| Level
2 |
Long
agg. |
followed
by |
Fast
amel. |
| Level
3 |
Short
agg. |
followed
by |
Slow
amel. |
| Level
4 |
Long
agg. |
followed
by |
Slow
or absent amel. |
As regards the
Acute Illness
When the patient presents a clinical acute table during
the therapy, symptoms offer the following important indications.
Level 1 – the acute
symptoms show the same remedy already prescribed.
Level 2 – in the prodromic
phase and during the acute event symptoms can arise that show
the already prescribed remedy, but many more symptoms that will
complete the chronic state helping to better explain the image
of the patient’s constitutional illness and therefore being able
to prescribe simillimum.
Level 3 – the remedy
of the acute state will be different from the one prescribed,
however during the convalescent stage hierarchical symptoms may
emerge which could lead to better subsequent prescriptions.
Level 4 – in these
patients the symptoms will change continuously and with them also
the remedies.
As regards
the New Symptoms
Such symptoms should be distinguished from Discharging
S.
Level 1 – the new
symptoms show a wrong prescription accompanied by an aggravation
of the illness; often they show a suppression.
Level 2 – they can
have the same previous meaning, but mostly, accompanied by the
few hierarchical symptoms that this Level presents, can
also show the simillimum.
Level 3 – on this
Level, the appearance of new symptoms can almost be the rule,
in consideration of the patient’s hypersensitivity (incoherently
reactive) and show the prescription of a similar.
Level 4 – they are
the only ones able show a change of remedy whilst awaiting a possible
rise in energetic expression of the patient, if this possible.
Dynamic Prognosis
For Joy we expect
to verify everything described about Level 1 except, obviously,
the appearance of New Symptoms!
Eighth Step – Judicious Prescription
As regards the Centesimal Scale experience shows as
follows:
a)
the unique dose is suitable only for patients whose Vitale Energy is fairly
reactive;
b)
the method in plus, recommended by Hahnemann formerly in the Fifth Edition
of Organon, has greater efficacy in avoiding aggravations.
Considering these facts, more than ten years of observations
have led to the following scheme prescriptive if compared to the
dynamic Level of the patient.
Level 1 – high dynamisation
(M-XM) in unique dose or in plus if we consider that, even
being reactive, the patient needs
more frequent stimuli, also for the presence of organic structures.
Level 2 – media dynamisation
(30-200) in plus.
Level 3 – high dynamisation
(200-M) in unique dose.
Level 4 – low dynamisation
(5-30) in plus.
As regards the Q or LM Scale, Hahnemann’s instruction
of the Sixth Edition of Organon (§§ 246-247-248) should be
followed, quite apart from the patient dynamic Level with
this personal comment: ON THE LEVELS 3 AND 4 IT SHOULD ALWAYS
BE USED THE LM SCALE for its characteristics of gentle action,
to limit to maximum every possible Aggravation of the patient
and for its greatest manoeuvrability in case of wrong prescription.
Judicious Prescription
Causticum LM 1 has
been prescribed to Joy, once a day.
Conclusions
The MPH represents the effort of preparation of a synopsis
perfectly faithful to Hahnemann doctrine, that gives us the better
approximation to the Pure Homeopathy practice, that is free from
prejudices, but obviously there is space to improve more.
In my own small way, I believe myself to have contributed
to the introduction of the LM Scale in MPH, with the approval
of Eugenio and Marcelo Candegabe and of Hugo Carrara, in the book
noted in the bibliography.
All this is followed obviously by the Prognostic Observation,
another great chapter of the Homoeopathic Clinic of which, probably,
we will talk about on another occasion to see how my Argentine
Masters explain this moment and how it applies very well to the
veterinary clinic as well.
But let’s see what has happened to Joy! Considering
the distance that separated us and the seriousness of the patient
clinical state, I have asked the cat’s owner, a very diligent
person, a primary school teacher, to keep a daily diary of everything
observed about the cat from the beginning of the therapy. This
is the unabridged text of such diary:
First medication, October 31st,
1 drop: a few minutes after the medication the cat makes an energetic
vertical leap (!?!). During the night he begins to suck again
and to “make the pasta”; he has several motions of the bowels
with dark limp excrement, really a great deal! The following morning
he begins to eat spontaneously again even if not abundantly. He
asks to go out in the courtyard. He is visibly weak, but shows
signs of amelioration.
Second medication: he keeps on getting
better, he is more vigorous, but does not eat satisfactorily yet.
It seems to me that his temperature has fallen and during the
night he goes to eat croquettes.
Third medication: he keeps on getting
better. He asks to go out more frequently and during the night
miaows insistently as if he was asking something.
Fourth medication, 2 drops: I don’t
have enough time to come back before he asks me for food and besides
that he does not come under the cover anymore, but stops at the
bottom of my bed. The stools are always very abundant and dark. During the morning
finally I see him as I remembered him and I can definitely interrupt
the wet food I offered him to tempt him.
Fifth medication: the Vet has transmitted
to me the PCR FIP test results, negative. Joy has begun to miaow
aloud again from the terrace to call me when I am out. He keeps
on sleeping at the bottom of my bed coming under the coverlet
just before I sleep and when I awake.
Sixth medication: I think that the
cat has practically completely recovered, eats heartily and has
got into the old habits again
Seventh medication, 3 drops: I think
that his usual characteristics are more accentuated, he is more
irritable, he calls me more often, asks for more attention, to
be petted again and has a great desire to go out. Everything else
remains unchanged, that is OK.
Eight medication, November 7th
. I have to notice that the pussy-cat is more vigorous than he
was before illness. Today he has climbed up a tree and has jumped
over 2 metres and half wall high, then he has gone on to the neighbour’s
shed and I had to recover him with a ladder for fear he could
end up wherever. Never had he pushed on so much!
Thirteenth medication, November
12th, 5 drops: the cat is very well, has a lot of energy
and he is also “a little bit nervous”. Two nights ago he attacked
a pussy-cat of the neighbourhood that used to come to our courtyard.
Tonight, after the remedy, he has attacked a dog, blowing and
trying to scratch him. He makes himself respected.
November 20th: tonight
he has sneezed twice … He is certainly more independent, He seems
to have found his real dimension of cat. He keeps on sleeping
on the bottom of my bed.
November 22nd: I have
done one of mine. I have put him the phial of Frontline® (anti-parasites) and he has immediately
begun to dribble as if he was nauseous. I have immediately washed
him with lukewarm water, something that made him euphoric, and
everything was immediately over.
November 26th: the pussy-cat
is really very fine and is much more in equilibrium. He is less
obsessive in asking for attention and is more independent. He
lets himself be petted on the sofa while I watch TV, but does
not press me too much. Nervousness has disappeared. He no longer
sleeps on the bottom of my bed, now he prefers the arm-chair or
a chair.
This diary is followed by this letter:
“Dear Dr. Brancalion,
I take the opportunity to thank you and inform you that I am really grateful
to you because you have given me back my dear pussy-cat and also
have shown me that homeopathy works!
We will come to visit you soon, when our business engagements allow, to show
you Joy.
Again, I thank you heartily!
Patrizia Gorizia, November 27th 2004”
Bibliography
Brancalion
A. – Scala LM e Prognosi nella pratica dell’Omeopatia-
H.M.S., Como, 2004.
Candegabe E.F.
– Materia Medica Comparata – red Edizioni, Como, 1989.
Candegabe E.F.
– Homeopatía: Estudio Metodológico de la Materia Médica
– Editorial Kier, Buenos Aires, 2003.
Candegabe M.E.
– Escritos sobre Homeopatia – Ed. Club de Estudio, Buenos Aires, 1996.
Candegabe M.E.,
Carrara H.C. – Approssimazione al Metodo Pratico e Preciso
dell’Omeopatia Pura – Centro Internazionale della Grafica,
Venezia, 1997.
Candegabe M.E.,
Deschamps I.L. – Bases y Fundamentos de la Doctrina y la Clinica
Médica Homeopáticas – Editorial Kier, Buenos Aires, 2002.
Dudgeon R.E.
– By Samuel Hahnemann, Organon of Medicine, Jain Publishers,
New Delhi, 2001.
EH™ Homoeopathic
Software – Vers. 2.1 – Archibel SA, Belgique.
Kent
J.T. – Lesser Writings – Jain Publishers, New
Delhi, 1991.
RADAR™ Homoeopathic
Software – Vers. 9.0 – Archibel SA, Belgique.