Dr. Leela: I remember a lot of these ‘Inveterate’ cases handled as in-patients in our hospital. I think, most important at this time, is to have a philosophically sound interpretation and management plan for them. Do give us some examples of your cases so we can understand better how you handle them.
Dr. Barvalia: Here are a couple of examples:
The first is a case of a person diagnosed with Bronchial Asthma, suffering for 17 years. She was on allopathic medication and had now reached a point where she was developing serious side effects to Steroids and they were not even helping any more. She developed severe osteoporosis besides the chronic immuno-suppression. She, on her own began to taper off the Steroids and went into a severe withdrawal exacerbation of asthma that would not respond to any bronchodilators. This was her condition when we first saw her. We had to concentrate on the acute totality to give her immediate relief. Along with this she continued with the nebulizer and bronchodilator as an ancillary measure that was reduced and stopped as she responded to the remedy.
The acute remedy indicated worked for about 7 days, then on the 8th day the acute picture changed. So, we changed the indicated acute remedy. She remained on this remedy for the next 5 months! In between, Thuja was the indicated anti-miasmatic remedy which was prescribed when its miasmatic indications came up. It was only after 5 months that her recurrent exacerbations settled and could be shifted onto her chronic constitutional remedy. She remained stable ever since with occasional inter-current prescriptions that were treated on an Out-patient basis.
Dr. Leela: Five months on an Acute! One certainly needs to be philosophically very sound to be happy with that J Just shows that we ALL have a lot to learn in terms of management of various types of cases.
Dr. Barvalia: (Smile) That’s right. Another example is a patient with Rheumatoid Arthritis who was on Steroids and NSAIDS for many years. She presented with an acute exacerbation of evening rise of fever spiking to 103F -104F. The NSAIDS and Steroids could not bring this fever down and the Rheumatologist had given up trying to treat this case. That’s how we were called in. Now the focus was to treat the acute exacerbation before we dealt with the chronic picture. The only characteristic symptoms in this presentation were the evening rise of fever with high spikes that was not responding to any conventional drug. Along with this was a pronounced weight loss recently. The interpretation was that the disease was in a miasmatic stage of expression that needed a nosode as inter-current to arouse the reactivity. The symptoms pointed to the tubercular miasm and the remedy of choice was Tuberculinum. She was given Tuberculinum 1M and the fever responded immediately. It was repeated as needed if the symptoms increased again.
Once her symptoms settled, the chronic picture came up more clearly of extreme coldness of the extremities which along with other features, pointed to Calc Silicata as the constitutional remedy. This was a case that needed a more frequent interpolation of Tuberculinum 1M during the course of treatment in order to arouse the reactivity even to the chronic remedy. In addition while she was hospitalized, she was gradually tapered off Steroids and went home on her chronic remedy along with NSAIDS, till the latter could be tapered off as well.
Dr. Leela: Thanks for sharing your invaluable experiences, Dr. Barvalia. I think this explains how an anti- miasmatic intercurrent helps a case move forward. From Hahnemann’s Theory of Chronic Disease, I have understood that this is exactly how Hahnemann prescribed Sulphur, Mercurius, Thuja and his other anti miasmatic remedies. (Sepia, Nitric Acid, Hepar Sulph, etc).
Importantly though, one has to be taught the ability to perceive the miasmatic picture of disease expression. Our readers must understand, that an advanced study and training in miasms is required to perceive and make use of this theory clinically in treating serious cases – so here is a great opportunity to learn with Dr. Barvalia.
Dr. Barvalia: Here is one more case in this category. We had a patient with Rheumatoid Arthritis come to us for treatment who had already been put onto Gold salts for pain control. As you know, this is the tertiary line of treatment in Modern Medicine, when NSAIDS and Steroids don’t work any more. She was however taking both the Gold salts and the NSAIDS. We admitted her in the wards and began to withdraw the gold salts (while the NSAIDS continued). Almost immediately she got worse, her pains exacerbated and she developed a peculiar symptom, that of greatly increased salivation. From the Materia Medica we know that Merc Sol is an antidote to Gold. Our philosophical interpretation was that an antimiasmatic, inter-current prescription was needed at this stage that covered the presenting picture. Reaching the point of needing Gold Salts for pain relief indicated a syphilitic miasmatic expression.
Hence Merc Sol was prescribed and she did very well on repeated dosing right through the withdrawal of Gold salts. Over a period of time the constitutional features began to emerge and she was completely off the gold salts. She was given her Chronic remedy in frequent repetition and sent home still on NSAIDS. The next step was to wait for her to be stable enough to start withdrawing the NSAIDS, to which she would have developed a metabolic dependence that needed to be overcome.
Dr. Leela: Yes, here I have in Relationship of Remedies:
Aurum metallicum, foliatum colloidale, Aurum foliatum, metallic gold, Au, A. W. 1968; Antidoted by (15) : am-c., arg., arg-n., Bell., camph., chin., cocc., coff., cupr., hep., kali-i., merc., puls., sol-n., spig.
These cases are revealing! I think our readers will have a better idea of which cases you term “inveterate”. Often homeopaths are unable to handle such cases homeopathically because they do not understand the concept of antimiasmatic remedy, or the need for multiple dosing or else they have a prejudice against prescribing when allopathic medication is going on. I view this as another ability a homeopath has to develop: learning to perceive homeopathic characteristics required for a prescription even while the picture is distorted by allopathic medication.
Tell us now your experience with Multidisciplinary treatment.
Dr. Barvalia: I agree. Yes, the final category of hospital cases I group are those that require Multidisciplinary treatment. This group includes cases like Developmental Disabilities and Genetic Diseases. It must be stressed that we’re still focusing on homeopathic treatment as the central therapeutic modality. While many of these can be treated in a multidisciplinary way in the out-patient department, some of them require hospital management as well. We are actively working with this group of patients at Spandan. Let me explain this with a case of Cerebral Palsy that I have under treatment. This is a Spastic Child who has been on his chronic constitutional remedy for the last few years. He has improved with his constitutional remedy to a very large extent, not only in terms of his behavior but in his cognitive abilities as well. This child was diagnosed as Athetoid Diaplegic with Cerebral Palsy. His involuntary motion and tremors also responded very well to the remedy, while the muscle tone improved about 20%. An Orthopaedic Surgeon had been regularly evaluating him and when the child reached this level of improvement, he opined that the child was at the right point to be taken up for Surgery to release the adductor’s. He thought that the clinical improvement would be significant following surgery given the tremendous positive changes that had taken place on the constitutional remedy.
After the surgery, he was managed post-operatively only with acute homeopathic remedies well supported with intensive physiotherapy. After this his chronic homeopathic remedy was continued. The child is still under treatment but the transformation in his life and daily functioning capacity is indeed wonderful to behold! This is a perfect example of hospital level multidisciplinary care for the best therapeutic result, where 3 important experts were involved – the Homeopath, the Orthopaedic Surgeon and the Physiotherapist in order to bring about the best possible clinical success for a child with CP. We will be able to do all this more easily and for more people once the hospital in Deonar is ready.
Dr. Leela: Remarkable! That is one blessed CP child!
Dr. Barvalia:Thanks to the hard work of my team mates- Dr Piyush Oza as clinical coordinator & Dr Vijaya Patil, Dr. Purnima Patil and Dr Vrishali Mayekar, the Childcare project has really shaped up well. The immense help from my friend and trustee Mr. Sudheendra Kulkarni caused my dream of this institute to become a reality.
Our success in Autism is due to a scientific synthesis of sensory Integration & homoeopathy. We have now a database of thousands of disabled children who have benefited from Homoeopathy. In fact, our AUTISM centre has attracted children not only from various parts of country but from abroad too. My wife Dr. Alka Barvalia has integrated Yoga & Homoeopathy into our child care programme.
With all this in the background, we wish to evolve the DEONAR: SPANDAN HOLISTIC MOTHER CHILD HOSPITAL into good reference Institute.
Dr. Leela: In addition, I understand within the basic focus of the Spandan group, catering to the under-privileged is a core issue. Also, your vision is necessarily based on sound ethical principles and a focus on the humanity in every sick person.
Dr. Barvalia: Yes. For any project to be truly successful and serve humanity, there has to be the hand and blessing of God with it. For that purpose, we have to be ethically sound in our intentions. The activity of Spandan is important and necessary today, where we see an increasing commercialization of the medical profession. Health care has become inaccessible and unaffordable to a vast majority of the population. Most of our work in Spandan has been with the under-privileged children whose parents cannot afford expensive, specialized care in large hospitals. “Every child born into the world is a new thought of God, an ever fresh and radiant possibility“. I found it necessary to provide this high quality of service and healing for these socially less fortunate. We have regularly organized free multidisciplinary medical child-care camps through Spandan. In fact, Rajan Sankaran and Divya Chhabra were our chief guests at our camp held in February 2005.
This hospital will be situated right in the middle of 2 large slums of Mumbai in the “M” and “N” Municipal ward. People in these slums are of every religious and cultural community in India; many migrant families searching for work in Mumbai, and those who often have just one meal a day to survive on. The Deonar project will directly benefit these under-privileged people.
Over the last few years, government, municipal and legal supports have been very forthcoming and granted official permissions to lay a solid foundation for the hospital to be built. Numerous well intentioned individuals in each of these groups have helped us. And now all we need to realize this possibility is adequate funds to begin building the project.
Dr. Leela: I’m sure, that will be forthcoming as well J God never lets us down when He’s already started something big. Please tell us a little more about what you have planned for this hospital.
Dr. Barvalia: Briefly, our plan for the Hospital Project has 3 components:
1. Holistic Mother-Child Care center
2. Super-specialty Multidisciplinary Hospital Complex with HIV/AIDS Department
3. Research Institute
The building plan in the picture is only proposed and may be modified. But the super-specialty multidisciplinary hospital will integrate the best that modern medicine has to offer, tailored to the homeopathic perspective. These will be included in departments like Neurology, Orthopaedics, Pediatrics and Neonatology, Ophthalmology, ENT, Psychiatry, a specialized Surgical Unit with fully equipped Operation Theaters for children with neuromuscular disorders, and an advanced unit for neurological and neurosurgical disorders. Over time, we will also include an Intensive Care facility (ICU) in the hospital.
The diagnostic section will include advanced metabolic and biochemistry tests; Genetic Screening; EEG; EMG; CT Scan; Audiometry; BERA, etc. The therapy center will be well equipped for Occupational therapy, Physiotherapy, Sensory Integration, Neuro-development therapy, Speech therapy and AIT and Play therapy.
The Psychology section will include a counseling and resource center as well as psychometric evaluations.
Dr. Leela: I’ve been reading the brochure which also states that you will continue to include and expand the existing Spandan activities and also include Mental Health and the Educational component in your vision for its future.
Dr. Barvalia: Yes our plan is to be able to develop an integrated and holistic educational approach for children with developmental problems, Autism, and Vocational training center. This is inclusive of a “Half Way Home” rehabilitation unit for Psychotics. All this will also provide advanced educational training for professionals working in the field of Rehabilitation and Mental Health. Our emphasis is also on Yoga and other complimentary alternative therapies to develop the emotional and physical wellbeing of people.
Dr. Leela: That’s great Dr. Barvalia. There is a real need today for professionals and homeopaths specializing in Mental Health, to get hands on experience with integrated, humane and holistic therapy. Mental health problems have become increasingly common today, right from childhood.
Dr. Barvalia: My interest when starting with Spandan and its activities was that we would really serve not only the underprivileged, but also the homeopathic community at large with a model for a well integrated multi-disciplinary method of functioning that will benefit everyone. It becomes a win-win situation all around, where while homeopathy remains the MAIN method of therapeutics, the homeopath is not isolated any more. He is now able to make use of various tools required for holistic healing, including the professional opinion of trained and experienced people from the medical and paramedical fraternity. We have to understand that modern medicine has a lot to offer when packaged with the right healing perspective. We have to learn to make use of these scientific advancements and integrate them into our homeopathic set up without compromising on our homeopathic principles while also maintaining a high standard of homeopathic care.
Dr. leela: A futuristic vision which I see as a realistic possibility! I am keen for the international homeopathic community to read this interview and be aware of the scope and future for homeopathy. Sir, let us end with another of your wonderful experiences in hospital care. I was delighted to hear your recent case of the schizophrenic boy in renal failure who was given a fresh lease of life only through homeopathic remedies and management. The homeopathic phase of treatment in a case like this could possibly be managed at your own Doenar hospital in the future.
Dr. Barvalia: Yes, the story starts as a Case of Surgical Shock in Renal Failure and is like this. Dr. K was a dermatologist and Dr. (Mrs.) K was physician, both allopathic practitioners. They consulted me for their son aged 18-19 years, who was hospitalized for the last 7 to 8 days. This boy was studying in an engineering college & was diagnosed as schizophrenic a year earlier. One day, he jumped from the balcony of his second floor residence in an impulsive act under a psychotic spell. He was rushed to the hospital & was admitted in the I.C.U. He had feeble pulse, cold-clammy skin & was unconscious. He had fractured his hip bone & transverse process & also had Haemo pneumothorax.
He was admitted in well equipped allopathic hospital. After 24 hours he became conscious. But even after 6 days, his urine output was poor. The day I saw him his urine output was hardly 100 ml. His S. Creatinine and BUN were gradually increasing. Twice they carried out HEAMODIALYSIS but there was no change in renal function. The situation was grim as he was approaching an almost total renal shut down. A renal transplant was being considered. All this prior history was obtained from his parents.
His father took me to the hospital. I saw this boy who greeted me with faint smile. He hardly spoke anything. The following observations I made were extremely valuable: Right from day one, he never lifted his limbs. He felt as if there is no ‘POWER’ at all in his limbs, is how he explained this to me. Neurologically there was nothing wrong as he had no head injury. He had fracture of hips and transverse process – but no reason for his limbs to be ‘powerless’. I interpreted this as characteristic “PARALYTIC WEAKNESS”.
Add to this the component of Surgical shock – Cold clammy skin, haemorrhage’s, post surgical renal shutdown. We have from Boericke only 5 remedies:
Generalities; SHOCKS; Surgical (6) : acon., bism., camph., carb-v., stront-c., verat
Strontium Carb in Boericke’s Materia Medica states: Rheumatic pains, chronic sprains, stenosis of oesophagus. Pains make patient faint or sick all over. Chronic SEQUALAE OF HEMORRHAGES, after operations with much oozing of blood and coldness and prostration. Arteriosclerosis. High blood pressure with flushed face pulsating arteries, threatened apoplexy. Violent involuntary starts. Affections of bones, especially femur. Restlessness at night, smothering feeling. FOR SHOCK AFTER SURGICAL OPERATIONS. NEURITIS, great sensitiveness to cold.
Strontium Carb in Clarke’s Dictionary states:
Causation: Operation (photopsia).
Hemorrhages (chronic sequelae)
Extremities: Immobility of the limbs, on one side only (the right side of the body), like paralysis, in the evening. As if all power had left the left arm. Numbness, almost paralytic, of the forearms and hands.
Dr. Leela: Strontium Carb! Amazing!
Going by your line of thinking would this be an appropriate rubric from Boericke:
Generalities; INJURIES; Postoperative disorders (20) : acet-ac., apis, arn., bell-p., berb., calc-f., calen., camph., croc., ferr-p., hyper., kali-s., mill., naja, nit-ac., raph., rhus-t., staph., stront-c., verat.
The rubric you mention from Boericke, I found in Complete Repertory 2005
Generalities; SHOCKS; Surgical (6) : acon., bism., camph., carb-v., stront-c., verat.
How do you interpret this rubric philosophically to decide on Strontium Carb? I would never have considered Strontium Carb though, as first choice. Just shows how much more I need to evolve as a homeopath.
Dr. Barvalia: The philosophical observation and analysis is followed by Materia Medica and repertorial integration to determine the indicated remedy. This is how I analyzed the situation:
The Ailments/from Trauma led to hemorrhage & shock which resulted in symptoms of cold- clammy limbs & the unconscious state. This is “SUSPENDED ANIMATION” as per foot note of Aphorism 67 in The Organon. Here we can see that the vital force has been suspended under “massive, intense shock.” In spite of best supportive medical care in the ICU, the vital force had not fully recovered and hence the situation continued to progress towards RENAL FAILURE. We needed a homeopathic remedy which could remove the suspension, eliminate the profound adverse impact of the shock & could restore the vital force to health. In short, what we were looking for was a “CORPSE REVIVER”. Strontium Carb, based on the Materia Medica, is a corpse reviver and covers the homeopathic characteristics of the situation.
Dr. Leela: That, Dr. Barvalia is an amazing analysis! This perspective and arriving at the similimum remedy, you say, is the result of a homeopath being properly trained in the applied aspects of homeopathic philosophy, materia medica and repertory? This it what your advanced training seeks to develop in every homeopath, right?
Dr. Barvalia: Quite right. This case beautifully demonstrates the application of ORGANON, REPERTORY and MATERIA MEDICA, to manage a critical, life threatening emergency. It is possible in future, that this case could be managed with interdisciplinary Intensive Care (ICU) at our proposed Deonar facility.
Dr. Leela: I will be signing up for your advanced training for sure! I could do with some polishing of my philosophical perspectives. So how did this case develop and respond?
Dr. Barvalia: The progress to cure was very interesting. After starting on the Strontium Carb 200C on 9-11-94, the patient began a tremendous improvement within 3 days. The dose was repeated 4 hourly. His haemodialysis was stopped after 3 days, but instead he developed tremendous weakness. This along with the pathological destructive changes evident in the renal function tests, a tubercular miasmatic block was perceived and a dose of Tuberculinum 200c was interpolated as anti-tubercular remedy. He was continued on Strontium Carb 200, 2 hourly for the next 10 days till his BUN (Blood Urea Nitrogen)(Normal – 7 to 20 mg/dl) came down to 42 from 120 and Serum Creatinine (Normal – 0.8 to 1.4 mg/dl) came down to 3 from a high of 9.
The patient continued to do well for a month. Suddenly, he came down with BRONCHO PNEUMONIA, while still in hospital. There was a distinct evening rise of fever, haemoptysis & chest pain < inspiration with earlier concomitants of starting in sleep & Nightmares. Phosphorous 200 4 hourly given for 5 days brought about good relief. The following changes took place:
- Almost 80% relief in respiratory symptoms.
- X-ray showed resolving pneumonia.
- Starts/Nightmares = zero
- Fever only in evening persisting.
- Thermal state – distinctly hot.
Since there was now a change in the thermal state the acute prescription was changed to Lyco 200 based on additional characteristics. It was prescribed in frequent doses as well, following which the entire episode resolved.
Later on the detailed case was studied and MAGNESIUM SULF was selected as chronic constitutional medicine that helped him with his Psychotic issues in the long term. That, of course, is another long story.
Dr. Leela: Thank you for this exciting case Dr. Barvalia. I’m sure people will appreciate more deeply why I considered you a visionary influence to me, right from the time you lectured to us on homeopathic philosophy and the scope of homeopathic therapeutics in college – way back in 1986-87!
Dr. Barvalia: We are indebted to our Master Homeopaths – Hahnemann, Hering, Boenninghausen, Boger, Kent, etc., who have given us so much. We owe our vision to them and we reciprocate by giving back of ourselves to the profession and to the society. Let us pray that our Master’s Grace remains eternally present with the homeopathic community.
Have I given you enough for the interview?
Dr. Leela:(smile) Absolutely, more than adequate Dr. Barvalia! I can’t remember when I read so many exciting and inspiring cases one after another – apart from the article by Stuart Close that appeared last month. I don’t think we have another ezine issue with so much of EXCITING HOMEOPATHY to read about in one place! Thank you also for the Status Epilepticus Emergency case.
This has been a tremendously inspiring interview for me personally. You have touched on various areas that interest me as a homeopath very deeply. I look forward to this providing the start to a global vision in homeopathic hospital management. I encourage all those with a similar vision for homeopathy to come to Mumbai and experience this first-hand through Spandan and later through the Deonar Hospital.
I recently discovered that you received an award from ROTARY INTERNATIONAL. Please permit me to add information about it to this interview. Here is what it states:
Rotary International District 3140 has pleasure in presenting this citation to Dr. Praful Barvalia. This is to put on record our sincere appreciation for his having won one of the most prestigious award titled ‘Service Above Self‘. The award has been instituted in honourable memory of the Noble Soul of late Dr.A.M.Pai. The ‘Service Above Self’ Award has been awarded to Dr.Praful M. Barvalia for following the path treaded by Dr.A.M.Pai of Selfless Service. Dr.Praful M. Barvalia is a God sent soul to Mentally and Physically Challenged children and has spent many years in uplifting the life of these unfortunates. Over the past many years his continued efforts have benefited countless numbers of Mentally Retarded and Autistic children by promoting Holistic Health and Value Based Education. He has himself won several prestigious awards and this award adds further glory to his outstanding community service rendered to the Mankind in field of Medicine and Education. We wish Dr.Praful Barvalia a long and healthy life and wish he be inspirational to many more to tread his path of “Service Above Self”.
I wish you and your work, sir, the abundant blessings of God for your dedicated service to society, especially those He cares for the most – the underprivileged.
I am reminded of an inspiring Power Point presentation on Mother Teresa, which has been circulating the cyber world. Maybe we can put in a link here. For her, every human being, even human soul was a creation of God – dying or destitute. All anyone had to do she believed, was love that priceless soul empowered with the love of Jesus. She did that faithfully, for one person at a time, every day of her life. But she changed the lives of millions of people!
For me, these two aspects; serving people with the love of God, and healing through the principles of homeopathy are two sides of the same coin : the effect is rapid, gentle and permanent.
Dr. Barvalia: Yes, thanks a million for sending me those heart touching slides!
Dr. Leela: On that note, Sir, I join innumerable of my colleagues in Mumbai and around India, who have been and continue to be touched with your vision, to wish you great success in this noble venture.
Click here for announcement for Jan ’07 Workshop
Dr. Praful Barvalia can be contacted at:
Dr. Praful M Barvalia, MD(Hom)
148, Hingwala Lane Extention
Near Popular Hotel
Ph: 91-22 – 2516 5985
91-22 – 2513 4467
Email: [email protected]
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