Homeopathy Papers

Removing Obstacles to Cure – To Blind or Not to Blind, That is the Question…

obstacle

Should you tell the patient the name of the remedy? The author makes a case for not doing so and presents three cases to illustrate his reasons.

What is “Blinding” the Remedy? According to Yasgur’s Dictionary something that is ‘blind’ is not visible, (it may be hidden). And Webster’s Encyclopedic Dictionary, defines blind as ‘of concealed or undisclosed identity’.

To answer this question I thought it would be a good idea to search The Organon to see what Dr. Hahnemann had to say about obstacles to cure. Here I include some of his aphorisms (from The Organon of the Medical Art1 edited by Wenda Brewster O’Reilly) to help us with the question posed as the title of this article.

Aphorism 1 states that: “The physician’s highest and only calling is to make the sick healthy, to cure, as it is called” and at the end of aphorism 3 he states: “…. Finally, the physician must know the obstacles to recovery in each case and be aware of how to clear them away so that the restoration of health may be permanent.” And in Aphorism 4 he states: “He is likewise a sustainer of health if he knows the things that disturb health, that engender and maintain disease, and is aware of how to remove them ….” {note: bold italics are my emphasis}. In aphorism 260 (and the footnote) under the heading “Recommended regimen for chronic diseases”, Dr. Hahnemann says:

§260: For the chronically ill, it is all the more necessary to carefully seek out such obstacles to cure since the disease has usually been aggravated by such malignities and by other morbific actions. Often, these are errors in the patient’s regimen, which have not been discerned.” 260

260 Patients with chronic diseases should avoid the following: Coffee; fine Chinese tea and other herb teas; beers adulterated with medicinal vegetable substances not suitable for the state of the patient; so-called fine liqueurs prepared with medicinal spices; all kinds of punch; spiced chocolate; many kinds of colognes and perfumes; strongly scented flowers in the room; medicinally compounded tooth powders and tooth spirits [mouthwashes]; perfumed sachets; highly seasoned foods and sauces; spiced cakes and frozen goods [ices and ice creams] prepared with medicinal matters (e.g. coffee, vanilla, etc.); raw medicinal herbs on soups; vegetable dishes with herbs, roots or sprouting stalks (such as asparagus with long green tips); hop sprouts and all vegetables possessing medicinal powers (celery, parsley, sorrel, tarragon, all kinds of onions, etc.); old cheeses and meats which are putrid; foods which have medicinal side effects (e.g. , the meat and fat of pigs, ducks and geese; all-too-young veal; sour foods; all kinds of salads).

All of these are to be removed from chronically ill patients, who should also avoid: every excess, even that of sugar and salt; alcoholic drinks not diluted with water; heated rooms; woolen clothing next to the skin; a sedentary lifestyle in closed quarters or, more often, only passive movement (through riding, driving, swinging); excessive breast-feeding; long afternoon naps lying down (in bed); reading in a horizontal position; keeping late hours; uncleanliness; unnatural voluptuousness; enervation from reading lubricious material; onanism, incomplete coition or abstinence from coition (either from superstition or to prevent the engenderment of children [pregnancy] in marriage; objects of anger, grief or vexation; passionate play; mental or bodily overexertion, especially immediately after a meal; dwelling in marshy regions and stuffy rooms; penury, etc.

All these things must be avoided as much as possible or removed if the cure is not to be hindered or even made impossible. Some of my imitators, by forbidding far more, rather indifferent things, seem to make the diet of the patient unnecessarily difficult, which is not to be sanctioned.”

(Underlined and bold emphasis are this author’s emphasis)

Nowhere in the Organon (to the best of my knowledge) does Hahnemann specifically say to blind the remedy. However, when we realize that something can be an obstacle to cure, then we must try to remove it in the best way possible so that healing can progress. In aphorism 260 he says: “… morbific actions, …” and in the footnote to this aphorism he says: “….objects of anger, grief or vexation…” as items that can be obstacles to cure.

So how do these comments relate to blinding a remedy? I hope the following examples will show that knowledge of the name of the remedy can become an obstacle to cure for some patients, and as practitioners of homeopathic medicine it is our duty to minimize (or remove) any possible obstacles.

During Hahnemann’s lifetime people did not have access to medical information in their day-to-day living. To find any information about medicine they had to spend days searching, even if that information was available. Nowadays with so many people having access to computers and information readily available anywhere in the world, anyone (almost) can find what they are looking for.

In today’s world of Internet and information explosion what is the best approach when we prescribe a medicine to our clients? Depending on where we are located on the globe, different approaches may be necessary. My experiences are only within the United States and so this paper addresses the behavior in the US.

It is good that more people are taking their health into their own hands, empowering themselves and becoming knowledgeable about various options they have, rather than completely relegating their well-being to a physician and following blindly his or her advice. As homeopaths we have to educate our patients about homeopathy and homeopathic medicines; in a sense it is to protect them from inaccurate information. Many people do not know how to be a homeopathic patient.

The old adage that a little knowledge is a dangerous thing can be true here. Not all the information they discover is accurate – especially about medicines in general and homeopathic medicines in particular. Sometimes patients want to direct the treatment based on what they have read, which may or may not be accurate or complete.

In my practice I have come to learn and appreciate the benefits of not revealing the name of the remedy to my clients until sometime later. ‘Sometime later’ depends on the level of curiosity and eagerness on the part of the patient to discover what remedy they received. In my policy and procedures I indicate that the remedy name will not be revealed for a period of 18 months from the start of treatment. I start the process of educating my clients by explaining to them the reasons behind blinding the remedy name and in almost all cases they understand and agree that it is a good idea, and to their benefit. I explain to them that in order to get a true picture of the remedy action at the follow-up, it is imperative that their mind is not biased with the remedy symptomatology. It is during the follow-up that we truly know if the remedy has been helpful or not, when we compare the changes that the patient has experienced with the symptoms they had when they first came for treatment.

The following examples from my practice illustrate that premature knowledge of the remedy was not useful in the patient’s treatment.

Case 1: In 2008, A 60-year-old nurse came in for pain control and issues with her immune system. She was unable to concentrate, function at her work, and unable to follow orders for taking care of her patients in the hospital. She had self-prescribed many homeopathic medicines in the past 15 years with minor success. She was under treatment by a naturopath whom she respected highly and she believed what he told her. A few months before she came for homeopathic treatment she had been recommended by her medical doctors to remove all her remaining teeth (she had about 20 or so good teeth left before they were extracted). They attributed the problems of thyroid and compromised immune system to her teeth decaying and causing the problems she was facing. Once the teeth were removed she developed bone spurs, which were causing more pain and suffering for her. Removing the teeth did not solve her other issues.

After her case was taken, a remedy was selected based on her current condition and state. This helped her with many of the issues from which she was suffering. Due to her sensitivity, the dosing had to be adjusted to reduce the aggravations. The remedy was given in Q (LM) potency and was kept blind because she told me she would research it on the Internet. At the first follow-up one month after the initial intake, she reported some improvements in her mental, emotional, as well as physical states. She was able to focus on the task at hand as well as performing her job with more confidence and ease. We continued with the same remedy and dosing.

Between the first and second month of treatment, she contacted me and asked for the remedy name because her naturopathic doctor wanted to know what it was. I asked her to have her doctor make this request in writing so I could provide that information to him. After the information was sent to the naturopath, I got a call from the patient that she wanted to stop treatment. With further inquiry, she said her naturopath had told her that the remedy I had her on (he had told her the name of the remedy) was wrong and does not address any of her issues. She told me she was going to wait a while and perhaps come back later on. She did not come back.

Case 2: A young boy 12 years of age was brought by his dad and was given a remedy. After the first follow-up the remedy was changed because the boy was exhibiting a completely different symptom picture. The new remedy provided some relief but not a deep healing. During the course of treatment, he developed some acute problems, which the original remedy did not help, but a new one was selected to help the acute. The father wanted to know what the remedy was. The name was given to him and he had immediately searched the Internet to learn about it. He contacted me right afterward being very upset and questioning why this remedy was chosen. He said the remedy not only did not have the issue his son was suffering from, but it had other problems that his son possibly would get as a result of the remedy. Trying to explain the depth and breadth of the remedy to him did not accomplish anything. He was angry and stopped his son’s treatment.

Case 3: In a more recent case, a 40 year old woman came complaining of a terrible rash and itching she has had for the last 2 years. She had tried various allopathic drugs and creams without true relief or healing. After 3 hours of case taking and another couple of days of analysis a remedy was chosen. I felt this was a very strong remedy for her condition. The remedy was labeled blind with a code so that my records could be traced to the actual remedy. Through email and phone calls she was persistent in trying to find out what the remedy was. I politely told her that the name would not be revealed until sometime after treatment and explained my reasons to her. She understood the explanation and agreed to let it go for the time being because she had started to feel relief and ease of her complaints almost immediately after she took the first dose.

This woman and her husband had searched the Internet several times trying to find what caused the rash and the itch. They had found information about Scabies and she was afraid that she had “the bug” under her skin. During the case taking process she had mentioned “bug under skin” and I tried to understand this “bug under skin” comment and whether she had felt this bug before in her life and the modalities of the bug. As I inquired more about this bug she responded: “Oh no, I got this from the Internet, they showed pictures of the bug under the skin and I think I have the bug too…”. We need to be extremely careful when taking cases and probe deeper to understand clearly the issue, because this can take us in a completely different path if we do not. Because of her curiosity and lack of knowledge of homeopathy, it proved right to withhold the name of the remedy from this patient as well. She still continues treatment, has done well, and no longer has a desire to know what remedy she has taken. She also has brought other family members for treatment.

The examples above have been a great lesson for me to let the clients know up front that the name of the remedy will not be revealed until sometime in the future.

Conclusion:

For some homeopaths, withholding (or blinding) the remedy name seems to be unethical and breaks the trust that is created between the homeopath and the patient. We need to reflect and remember that blinding the remedy is the same as when we use placebo, but we do not tell the patient they are getting unmedicated pellets (placebo). We do not tell the patient they are getting placebo because we know that if we do, the process will be halted and the patient will not be happy. The patient may even get angry and stop treatment as soon as they realize they are taking placebo. We use the placebo in order to help the process of healing move forward, and to help the patient feel that they are doing something about it, mainly taking something. In America many people want to be taking something, and think the more they take the better. This is a false sense of security they have developed over the years.

We also need to remember that when we perform provings of new substances, the name of the substance is not revealed until after the proving period has ended. As we all know, if the name is revealed up front, we may not get a true symptom picture for the substance. It may be biased with our prejudice, thoughts and superficial knowledge of the substance. So based on the information presented here, it is reasonable to blind the remedy when appropriate in order to engender cure for our patients by removing a potential obstacle to cure.

We must practice with common sense and honor what is right in our hearts and minds. After all, each of us strives to help another human being to heal and improve the quality of their life.

In my experience in North America, it appears to be a good practice to blind the remedy for some period of time, or at least until the client is more balanced, at which time the name can be revealed, if still desired by the client. Many practitioners with whom I work keep the remedy blind, which allows the process of healing to continue without us worrying about the patient getting nervous that he or she will acquire symptoms of the remedy they are taking and worry that they will get sicker and not better.

If you decide to blind the remedy or if you already are doing this, then in your intake form, you may want to clearly mention it, so they know well in advance and can ask about it if they need to. It is also good to share that, either at the beginning of the case taking while you explain the process, or at the end when you are closing the session.

So “To Blind or not to blind” is really an individual choice each homeopathic practitioner has to make based on each individual case. The customs and government regulations in each locality may be different and that also needs to be considered. To close you may want to consider “If in Doubt, Blind it Out.”

Reference:

The Organon of the Medical Art, edited by Wenda Brewster O’Reilly, Birdcage Books, Redmond, WA, © 1996

Yasgur’s Homeopathic Dictionary and Holistic Health Reference, by Jay Yasgur, 4th edition, Van Hoy Publishers, © 1998

Webster’s Encyclopedic Unabridged Dictionary of the English Language, by Dilithium Press, Ltd. © 1989

1 Based on the 6th edition of The Organon

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About the author

Reza Sharifi

Reza Sharifi

Reza Sharifi Is a registered Classical Homeopath in the state of Arizona in the USA. He is CCH Certified by Council for Homeopathic Certification (CHC). He has over 17 years of experience in homeopathy and has been practicing for the last 7 years. He graduated from the American Medical College of Homeopathy (AMCH) and currently is practicing at AMCH clinic. He specializes in treatment of First Aid, Acute and Chronic conditions for children and adults.

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