Dr. Bhavisha and Sachindra Joshi practice in Vile Parle, Mumbai, India, where they have had an independent practice as Homoeopathic consultants for the last 13 years. The Joshi’s have a satellite practice set up in England & America and their work is recognized around the world. They have served as honorary doctors at the Mother Teresa’s Home for the Dying and Destitute (at Santacruz), and they have served as educators at the Juvenile Diabetes Foundation, Maharashtra Chapter, for the past 15 years.
V: The homeopathy world is split into two groups. There are some who practice good old classical homeopathy using repertories for picking out remedies. They stay true to the roots, so to speak. They oppose any change, research and development. For them, if it is not Hahnemannian style, it is not classical homeopathy. But the fact cannot be denied that the Sensation method has taken the homeopathy world first by surprise and then by storm. In your daily practice where do you stand?
S: Hahnemann wrote six editions of the Organon. Five were published while he was alive and the sixth came out after his death. If he had not changed his style and method, he would have remained content with the first edition. For any science to grow, it has to move and integrate newer approaches, and methods. That does not mean that we take each and every new technique that comes out of the blue. But we can take on methods that are based on the fundamental philosophy of homeopathy as given in the Organon, materia medica, proving symptoms, and the repertory. All of these, taken together, make the fundamental basis of homeopathy. Any approach that helps us use these in a better way for our patients, we should look at with an open mind.
In our day to day practice, Bhavisha and I try to implement this principle very strongly. We see what approach would work best for our patient. We aim to find out the symptoms that help us understand him as an individual and we do this by way of a very systematic and detailed case receiving process. We take our own observation of the patient into consideration. We put these two together. Then we use rubrics, materia medica, key notes, sensation method, or kingdom classification. By using any of these methods alone or in combination, we come up with the best remedy needed by our patient in any given time.
V: So, it is your patient and his needs driving the case taking, instead of you deciding, ‘this is what I am going to do’?
S: Yes, very much so. It is all about what the patient needs and not what we want to do.
V: What is your take on synergy in homeopathy?
S: It is very good. It is a way of bringing people of different schools of thoughts together. The sensation method seems to be out of context and groundless to many practitioners. It is not actually so. Synergy is a system of taking the sensation approach, and connecting it with the Boger/ Boeninghausen approach. By this, everything comes together in a systematic way and that is very important. By bringing genius, symptom and system, synergy approach creates a very solid platform where everyone can find something to connect with.
V: Students in the US are in a particularly tight spot. Their schools teach them the classical homeopathy. And when they observe the latest research in homeopathy, it is all about sensation method. What is your advice for the newcomers and students?
S: Learning classical homeopathy is very, very important. The fundamentals that I spoke about – the Organon, materia medica, provings, repertory, pharmacology of remedies, these have to be understood and mastered by all students of homeopathy. Once they have these basics clear, then they can learn and absorb any new method that comes their way and they will understand where this new method is coming from. They will be able to choose and apply what their patients need. Fundamentals of homeopathy have to be very clear for them and they have to realize that the castles cannot be built in the air. Homeopathy requires rigorous study for years. Deep study makes strong foundation.
V: How is the sensation method different from intuitively arriving at remedies? Besides using sensation method, do you arrive at remedies by way of intuition, dream, gut-feeling, or picking up some odd cues and remarks from the patient, even though these do not fit into the frame of the sensation method?
S: Some people are blessed with an insight. They can feel remedies and understand people’s state when they talk to them or see them. They arrive at a remedy intuitively. It can work in some cases. In some cases it does not work. The disadvantage of this approach is that no one else can repeat the result. Intuitiveness is someone’s personal quality. My gut feeling can differ from someone else’s. With intuitive prescribing, everyone will come up with a different remedy for a person. However, case receiving in a systematic manner that includes taking symptoms, general modalities, mental / emotional states, these create a simple and solid basis that cannot be disputed or argued upon, and by using these details, we can come to a remedy. In our practice, we would systematically arrive at a remedy and prescribe. There have been cases when I have given a remedy based on gut feeling. But I have done that with the awareness that my gut feeling could have led me to the right or the wrong remedy.
V: So the idea with intuitive prescribing is to be open for the possibility that it may or may not be the correct remedy. Another thing I hear from your answer is that intuitiveness and gut feeling is something you cannot teach someone.
S: The standard approach in homeopathy that takes into account all the basics is a system by itself, and that can be taught. The simplified and systematic approach can be learned by more people and used for helping a lot of patients. But gut feeling cannot be taught. We will be mocked for our science. Suppose we go to a medical conference and present a case of a patient who has really done well and has improved on a remedy. We will be asked about our approach. If we say that we gave a remedy just because we felt like it, this answer will not be acceptable, even though the patient has improved and the intuitive way of picking a remedy is not wrong at all.
V: Besides looking for core sensation and what the patient wants to express, what other factors do you take into account when you see patients? Do you note their dress, skin and eye color, facial features, hair line, handwriting, color preference, on a color chart, their dearly held beliefs and philosophies?
S: Everything is considered. All of these points tell you about the patient. Case taking starts at the time when the patient makes an appointment. We sometimes get feedback from our receptionist… she says this patient was very tricky, wanted to speak to you directly, fooled around me and had me pass her chart directly to you. We notice this special element in the patient. Our assistant tells us ‘This person is so sweet to you, but is very rude with the junior doctor and the receptionist. He does not want to talk to us at all’. Now, that tells a lot about the patient. Basically anything that can give information about the individual is helpful. But all of these are taken into account at the end. Case taking has to be done systematically and with clear logic so that we can arrive at a remedy and then all these points that you mentioned are taken into consideration for confirming the remedy and adding up new observations in materia medica.
For example, if all patients needing Naja wear spectacles with very sharp ridges, that is a very strong observation. Another strong observation could be that people with very rigid mentality who like to keep things hidden deep down in themselves, wear glasses with very thick and dark frames. This observation could be included in the repertory. This can confirm the prescription.
V: So, you have all those notes and you watch with very keen attention and find all the details.
S: I might not make a note on paper. I watch them as they enter the office. A particular way of walking, sitting, fiddling with something, fidgeting with napkin — all these are important observations. Hahnemann taught us to observe the patients.
V: A lot of patients are quite put off by the relentless questioning and ‘tell me more’ style followed in the sensation method. They feel that other than describing their presenting complaint they do not have anything more to say. They like to give answers in yes and no, sometimes not even saying these but just nodding their head for yay and nay. What is your approach with these patients?