Nowadays in homoeopathic practice, with newer approaches addressing thematic representations of remedies and with newer provings emerging, practitioners have forgotten the fundamental and basic principles of homoeopathy and have largely shifted away from the practice of traditional and foundational homoeopathy.
My approach to homoeopathy can be summed up in one word, simple. Most things in life are simple and should be kept simple, and homoeopathic practice is not an exception to this tenet. To be a fine homoeopath, one does not need to be intelligent, wealthy or have good contacts. A fine homoeopath must be honest, dedicated, and most importantly, have a large amount of courage to survive against all odds. My approach is overall very simple – the aim is to find out the most characteristic symptoms in the case and prescribe on these very symptoms. These characteristic symptoms can come in the form of Keynote(s), rubrics, themes, pathologies, or even a sensation. When this characteristic symptom is established and is sure, the remedy is prescribed based on this.
The Kolkata Approach is backed by impressive clinical results and a growing acceptance of homoeopathic practitioners and students all across India. The goal is to simply share and spread this knowledge of homoeopathic medicine to my colleagues in India and all over the world in order to facilitate more success in homoeopathic practice.
I should also mention that my experience and practice has been mainly and hugely influenced by Dr. Burnett. I have read and memorized all of his material, and the results have been fruitful. His work has helped me tremendously in my own clinical practice. Other masters, including Pulford, M.L. Tyler, Allen, Boericke, Boger, P. Sankaran, Hering, Nash, Knerr, Bernoville, Blackie, Borland, N.M. Choudhuri, John Henry Clarke, Farrington, Lippe and Teste. Matthew Woods has influenced my clinical practice greatly as well. Also, my in-depth reading of Allopathic Pharmacopeia has contributed to my vast knowledge which has definitely helped me to become a well-versed practitioner.
Another word about the role of other remedies, like sarcodes, allopathic drugs, Indian drugs, biochemical drugs, organ-specific drugs. Many of these types of remedies are needed in pathological cases. Using one remedy and one dose in pathological cases, has not proven to be efficacious in my clinical practice.
What is greatly needed for prescription is the current symptom totality. I look at the current symptom totality, see which remedy is the closest to this totality, and I prescribe it. I also take into account the pathogenesis of the remedy and the patient.
For me, the first prescription is just the beginning. Often, in pathological cases, the patient requires a change in the remedy. In fact, this change can happen as often as every 1 or 2 months, because disease patterns are rapidly changing.
Most diseases today are complicated by allopathic medicines, hormonal dysfunctions, addictions like alcohol and tobacco, and past history of illnesses. All of these factors must be taken into account when prescribing.
My earnest appeal to the younger generation, who practice homeopathic medicine, is to try and learn the materia medica and repertory from their heart. More importantly, apply it and have the guts and confidence to prescribe homoeopathic medicines even in pathological cases.
When I approach a case I begin looking for a chronology of events and ask questions such as, when and how did it start, what were the first symptoms, which organ system is affected, what were the characteristics of those symptoms at that time? In addition, I also look at the direction in which the symptoms move – which side did it start, did it move or did it stay in a local area?
I aim to elicit exact symptoms and look for the causative factors – there may be one, or usually, there are many. With each symptom, location, sensation, modality and concomitant are critical to complete the symptom and to aid in prescribing an accurate remedy.
When investigating each symptom, I explore it in depth until I get a peculiar characteristic. This can be in any area of the case, mental, emotional or physical. I emphasize the importance of peculiar symptoms because that is what will ultimately help to match the patient to the remedy. I also place great importance on concomitant symptoms as they will help to quantify and qualify the experience of the patient.
Usually, the mind symptoms come at the very end. Unlike other schools of homoeopathy who investigate the mind and mental picture of the patient first, I choose to leave it to the end. If we start with mind symptoms, then we theorize and conceptualize what the patient says. This is dangerous because if the mind symptoms are not clear and exact, then you are at a risk for theorizing. It is much more useful to start with the symptoms that are sure and dependable – choose symptoms that are factual.
In a clinical setting, we must try to understand the “apparent” behavior of the patient, and must question whether or not what they are showing is true – is there a shield that the patient is putting up or are they revealing their true self? We have to distinguish between persona versus reality – persona is a mask or shield, and as homoeopathic practitioners, we have to aim to remove the mask and find the reality. In order to do this, we must first and foremost analyze ourselves before others. If the patient is comfortable with the physician then you can find out hidden information. When there is a good bond at an emotional level with the patient, you can ask about the mental symptoms. Once your patient is weeping in front of you, that is the best example that there is a good bond developed.
At each level of the case, I choose the symptoms that are factually reliable, dependable and solid. Once I have a good grasp on these symptoms, I have a few remedies in my mind and the rest of the case is just confirmation of one of these very remedies. Eventually I find a remedy that correlates with most aspects in the case.
Objective observations (ex. white-coated tongue, mapped tongue, hot body and cold extremities) and overall constitution (ex. fat, thin, tall) are also critical to success in clinical practice. I often use physical examination and objective observations as confirmatory symptoms. Physical generals like perspiration, menses history, appetite/cravings/aversions, and sleep position are also key in clinical practice and aid in confirming the remedy of choice. Family history and personal history are also areas which I investigate throughout my case-taking. Other important things to consider include addictions (ex. smoking and alcoholism) and what the patient is exposed to (ex. does the patient work in close quarters with petroleum or cement). Dreams are also important and can assist in prescription.
In summary, when I take a case, I build a solid foundation, addressing the pathology, toxicology, symptomatology and then the mind. It is a hierarchy which helps to organize my approach to cases and case-taking.
I also frequently utilize the Ladder of Remedies concept of Dr. Burnett, to assist in chronic, complex cases. A ladder approach uses a series of remedies one after another, which ultimately lead to the restoration of the health in the patient. I find that to effectively help patients, the ladder approach is very beneficial because it targets the patient’s current ailments at the same moment they are experiencing them – with the ladder approach, you can treat the presenting picture of the patient and move onto the next remedy when that picture is no longer present. It should be mentioned that I do not employ or use polypharmacy (prescribing 2 remedies at the same time). Suppose a patient comes with an organ-specific problem, we can simply employ the use of an organ-specific remedy to alleviate their suffering. Once this suffering has been reduced or eliminated, a new picture of the patient will come up – and we can prescribe on the new totality.
Case of Grade 2B Squamous Cell Carcinoma of the Cervix
This is a case of a 52-year-old woman who had four children.
Her symptoms were:
- Blood mixed with vaginal discharge
- Menopausal for the past 2 months
- Extremely chilly patient
- Cannot tolerate damp weather
- Cough and cold in damp weather
- Pain in lower abdomen on the left side
- Warts on the external os
- Family history of cancer
- Mentally, she gets scared easily, is fearful, and does not have dreams
Initial Investigations on 24th January 2013:
Ultra sonography of abdomen report shows that there is a mass in the cervix, 3.15cm X 2.29cm. This is indicative of a cancerous mass.
1) Calendula 10M, 4 doses
- Damp weather agg.
- Warts at cervix os
- Recurrent cough and cold – rainy weather
- Past history of cancer
Also one of Burnett’s hydrogenoid remedies and one of most useful remedy in CA.
2) After 15 days –Radium bromide 30, BD for 14 days–This is one of the main remedies which I give as an intercurrent in cancers – especially cancer of the cervix with hard indurations. I use this drug in cases of CA with severe burning and degeneration and erosion, more as an organ remedy. This remedy is especially useful in squamous cell carcinoma more than sarcomas. Another indication for this remedy is: damp weather agg, hot bathing amel (this was not there in the case but this one of the confirmations). Used mainly in C potency and I have seen in my experience, it is useful to repeat this remedy.
Follow-up after one month:
Patient is better and the bleeding/pains stopped. The remaining symptoms of damp weather aggravates is still there.
1) Calendula 10M, 4 doses
2) Placebo, for 15 days
3) Hydrocotyle asiatica 1X, BD for one month – This is the main remedy for cervical cancer and erosions/thickening. It is one of the most famous Indian drugs that I use as an intercurrent, beautifully given in Dr S. C. Ghosh’s Drug of Hindustan. The main indications for this drug are:
- THICK dry burning and degeneration of skin especially climacteric around the cervix area
- Bleeding especially – dark colored menses with burning
I often use this remedy in LOW potency in deep pathologies – especially of female genital tract cancers and more recently I am using it clinically for difficult cases of cerebro-vascular stroke.
Follow-up after one more month:
There is bleeding of a dark color, with pain.
This is an indication for the remedy Ficus religiosa.
1) Ficus religiosa 200, BD for 15 days
2) After 15 days – 5-Fluorouracil 30, BD for 14 days – This is one of the allopathic drugs, that is a pyrimidine analog which is used in the treatment of cancer like breast neoplasm , ovaries and cervix neoplasm, it does help decrease the growth of malignancy. I am using this remedy based on the principle of similia in difficult cases of cancers of breast and cervix as intercurrent. I am also formulating the homeopathic indications of this remedy – which I have collected from patients. One of them being warm drinks agg.
Follow-up after 2 more months:
The patient overall is much better. The pain is not there, although the bleeding increased.
1) Ficus religiosa 200, BD for 15 days
2) Placebo, for 15 days
Follow-up after another one month:
The patient is feeling chilly, she cannot tolerate hunger, is having vaginal discharge, but there is no bleeding. She is wearing thick, woolen clothing, and has revealed that she had a history of skin eruptions.
These are all indications for the remedy Psorinum.
1) Psorinum 10M, 4 doses
2) Placebo, for 15 days
3) Hydrocotyle asiatica 30, BD for 15 days
Overall the improvement has been remarkable. Refer to the investigations below for visible evidence.
Most Recent Investigations on 4th May 2012:
What can be observed in this recent investigation, the mass has disappeared and the diagnosticians have written that the cervix is slightly thickened. This shows that the pathology has reversed.
My earnest appeal to the younger generation, who practice homeopathic medicine, is to try and learn the materia medica and repertory from their heart.
This is soo true! A large number of our failures come because of lack of a solid foundation. Well said!~
It’s very true!
Amazing article by Dr Sarkar, what a gem of a man!- Heard him live at the Other Song Academy- was blown over by his humility & depth of knowledge . If ever you get a chance to hear him live- make sure you never miss the opportunity- he finds it hard to stay on one topic, but like a true master he can meander through Homeopathic Therapeutics like a magician- & his knowledge is backed by solid – i mean teak -wood solid clinical Homeopathic Practice- God Bless Dr Sarkar- looking forward to learn from him. God Bless to team at Other Song & Dr Sankaran for showcasing this dedicated Homeopath.
Thank u Dr Sarkar,Fantastic case,well managed with a pragmatic approach.Post more such cases.