a) What is the change offered by Revolutionized Medicine?
Simply, a change of emphasis, a minor variation. Classical Homeopaths agree that if we can have dependable mental symptoms we can ignore the physicals, but that mental symptoms are not to be found in every patient. It is from here that R. H. differs with them in concept. It observes that no individual at any given time, is without any mental state. If a person requires medicine, that is, if he is sick, it is not necessary that he must be angry or weeping or anxious. He may be a normally behaving person covered by rubrics like ‘CHEERFULNESS’, ‘ECSTASY’, ‘EXHILARATION’ etc.
Here I will quote the case of a religious head settled in London where he runs a big Ashram. He was suffering from allergic asthma. My brother wrote to me that he is a devotee of the ashram and wants his priest to be treated by me, because the priest finds a lot of difficulty in his meditation and in conducting Havana (a ritual in Hindu religion performed around the fire through offerings consisting of butter, oil, grains and perfumes, to the various Gods and Goddesses). I told my brother, “Let your Swamiji write me a letter in his own hand in a simple way and contact me by phone after a few days for a few minutes. Swamiji wrote his case history, giving all symptoms of allergic asthma. He wrote, “Although I am quite indifferent towards feelings of love or hate, because I have renounced everything in this world, still I feel a little uneasy when I find obstruction in the performance of my religious duties.” On the phone I asked him only one question: “Do the obstructions cause any effect on your mental state and force you to abandon midway the functioning of your normal routine work, rituals, prayers etc.?” He said, “No, I accept it as a reality, which perhaps I have to live with, and I don’t allow anything to overpower me in the performance of the religious rites.” On the following rubrics:
- RECOGNIZES, everything, but cannot move
- INDIFFERENT, lies with eyes closed
Cocculus. Ind. 30, was prescribed in three small doses, to be taken every 15 minutes. It is now about a decade that there is no further attack of asthma. The priest was so grateful that he propagated his recovery amongst his followers all over the city of London. They put pressure on my brother to call me to the U. K. What I want to emphasize through this example is that it is the present mental state, in whatever form and style it may be, that is important and needs be given attention to. I shall go into the details of the way I interpret rubrics in the pages to follow.
(b) How to select a remedy?
Since the mind is a vast field, for the purpose of selecting a remedy we must select from the present mental state, Persistent and Predominant symptoms, which I call signals.
(c) What is the meaning of PPP? Present, Predominating, Persisting symptoms.
What persists is that which is trying to settle permanently, what predominates is that which is the uppermost and all powerful and covers the whole show. In other words it does not allow other symptoms to raise their heads. In the case of Swamiji, at times there may have been many thoughts in his mind about his sickness, yet one final thought, of identifying and accepting the reality, was predominant. Let me tell you here that this phenomenon has a scientific background. It is the powerful that prevails. In the criteria of so called infections, if a person is already suffering from a powerful infection, no infection weaker than it, like seasonal fever etc. can have any effect on him. If he is suffering from a disease which is less powerful than the invading infection, the former will get subdued and the latter will predominate and will be required to be treated first. When the system is cleared of the powerful infection, the lower will present itself and demand treatment.
(d) Case taking and implementing triple P (P P P)
For selecting a remedy, treat a patient as a computer in a human frame, that emits signals in the form of speech and actions, which when combined, form expressions. Convert these expressions into the language of rubrics as listed, in the repertory, in the Mind section. In other words it is decoding or deciphering the signals of mind in a “mechanical” way. It is as if the data has been pre-fed by whatever order or disorder that is going on in the body and the computer is throwing this data on the surface. Why I call it mechanical, is to guard you against becoming emotional at the time of case -taking. It may be that the patient is abusing you or misbehaving in the worst manner. You have to remain detached. Your relation is exactly like that between a meter and a meter -reader. The job of the meter reader is to concentrate and try his best to read the meter accurately. For example, let us take the case of the father of the boy mentioned earlier, who refused to cooperate. Ordinarily you might have heard homoeopaths complaining about their patients, “How can I help him if he does not co-operate?” Here lies the fault with the homoeopath himself, because the act of non cooperation on the part of the patient is his present mental state which requires to be taken into account for prescribing. Be true to one’s job.
(e) When not to prescribe
I am of the opinion that before the doctor examines a patient he should check whether he himself is fit to do the job well. As in judicial norms it is well known that a judge should sit for judgment only when he is in a normal mood, i. e., only when his presence of mind is intact. In the same way a doctor should be in a normal frame of mind when he prescribes medicine. We have many rubrics like, “GROPING, as if in the dark”, “CAPRICIOUSNESS , CONFUSION”, “CALCULATING inability for” etc. If the physician is himself under the influence of any of these mind rubrics, he should not expect himself to be in a position to select the right remedy. The right course for him in such a situation will depend upon the type of patient in front of him. If you feel that the patient is cooperative, you can tell him the truth that your mind is not properly working at the moment, requesting him to come on the next day or at any other suitable time. Your image will go up in his eyes. He will feel reassured that he is in proper hands. The second course is to send the patient back with placebo, i.e. blank pills, with the instructions to report on the next day so that you have the time to study his case with a clear and stable mind. The third option is in the case of the patient who is in a more serious condition. If the patient really cannot wait, you can request him to consult someone else. These three norms will never let you down in your practice. So while you have to be mechanical in your approach you also have to use your intelligence to understand the symptoms of the patient accurately. To conclude, the main criterion is to arrive at the indicated remedy with the help of the tenets of present, predominating and persisting symptoms without any bias or prejudice; that is, without considering its grade as given in the repertory; without keeping in mind whether the remedy is “short” or “deep acting” and without looking at whether it covers any miasma.
(f) Requirement of successful prescribing
What is required for successful prescribing? Before answering this question let us recall, the job involved in it. The job is to convert the expressions of the patient into the rubrics of the mind and this can be done only if we have proper knowledge of the rubrics. The question remains “How to know the rubrics?” The first thing that is needed is to know the exact dictionary meaning of each word of a rubric with its position in grammar, whether it is a noun, adjective, adverb etc. so as to grasp the precise sense of every word and the rubric as a whole.
The second thing is to know every rubric and to keep it in your memory. The third and the most important thing, is the expansion of its meaning by drawing broader interpretation and inferences needed to capture the very soul of the rubric (Refer ROH Series 1 also). Here the point to be kept in mind is that the conversion of the expression into rubrics should not be mechanical but mathematical. In mathematics we have exact equations e.g. 1+9=10, 2+8 is also equal to ten. Likewise we can have various other equations of ten. Similarly we have rubrics like “Fear” “Anxiety” and “Anguish”. We need to know precisely the difference between the very sense conveyed by them. Fear, is a sort of discomfort aroused by an impending pain, danger or evil, which is specific in nature. A person knows and can identify the object of his fear. He says that he fears a dog, or a lion, or a certain person or a specific thing. “Anxiety” is also a discomfort aroused by an impending pain, danger or evil. But it is not certain or specific as in the case of fear. Something is causing discomfort because the patient does not know what is in store for him. For example a patient says, “God knows when my disease will go. When will it leave me?” Another example, “Whenever my husband goes out I remain uncomfortable till he comes back, as many types of forebodings come to my mind.” Anguish” is about a discomfort which one is experiencing at the present moment. For example a mother says, “Nothing pains me much in this world as the feeling that my son, the product of my own womb, has betrayed me.”
(g) What is expected of a medicine?
(a) What is the meaning of first and second action?
(b) How to verify that your selection of medicine is correct?
In my experience, if the selection of medicine is correct, it must react in two ways. They are the first and the second actions of the medicine. The “first action” means immediate or rather instant relief in the physical as well as mental agonies. The “second action” is the reversal of the original complaints. The relief under the “first action” may last for only a few seconds, minutes, hours or days and it is sometimes here that we are required to be vigilant, because it is the “first action” that gives the indication that the remedy is right. And if this gets missed from our observation and when the patient comes to us, he happens to be under the influence of “second action”, you will get mislead and change the medicine or raise its potency etc. And the case will take a wrong road from the very beginning.
The “Second action” is quite opposite to the first, because the ailments on which the medicine was prescribed, come back. Here you have to apply your mind whether the return of the complaints is due to the advance of the disease or the curative action of the medicine – as part of the total Curative process. To verify this you have to first make sure what happened to the symptoms of mind on which the medicine was prescribed. For example, earlier to the commencement of the treatment, your patient had in his psyche one of the rubrics IRRITABILITY, pain during . You have to investigate whether there is any change in his present state of mind. Usually the patient reports when he is under the second action and says there is no relief. Don’t take him on his words. You have to remind him, “The last time when you came to me you were weeping and annoyed. Today you don’t seem to be so. Likewise while on your previous visit you were not walking as easily as at present. This is how we have to educate ourselves as well as the patient about the progress of the case.
(h) The discipline followed by the second action
(i) ITS DURATION
The second action follows a fixed discipline. It lasts over a fixed period of an odd number of days – like 1,3,5, and so on. The middle day is the peak day. It gradually starts, reaches the peak and thereafter declines. It is mostly on the day of the peak that you will receive phone calls or call at your door from your patients. You simply have to ask the patient when the reversal of his complaints had started. Since, in most of the cases, the return of ailments lasts for five days, the patient replies “Sir, it is the third day today.” You simply have to tell him to wait for a few hours and thereafter the pain will start declining. In most of the cases the patients cooperate and, the next morning when they find things happening the way they were told, their faith in you gets deeper. But in certain other cases the patient does not agree and insists that he should be given a medicine. Such a patient is to be tackled with placebo. In such cases what I generally do is keep ready certain packets of placebo with cross marks – i.e. of single (x), double(xx) and triple (xxx) etc. and give it to the patient, telling him, “Keep them in reserve. Before taking any of them wait as long as you can. Take only if you feel you can bear the agony no more. Preferably it is better if you avoid taking the EXTRA DOSES because it may obstruct the process of your cure.” This is just a scare to manage the patient psychologically.
(ii) DISCHARGES of the TOXIC MATTER
The other thing that is expected from the process of “second action” is the discharges that may take place from the five natural outlets: nose, mouth, anus, urethra and skin. This means, if the deposits of the toxins are in the head, the nose is its natural outlet. If they are in the liver or in the respiratory system or stomach their exit is the mouth. If the toxins are in the intestines they have to discharge through the anus. If they are in the urinary tract they find an outlet through the penis and if under the skin they come up in the form of some sort of skin eruptions.
(iii) FUNCTIONING of the CURATIVE PROCESS
At this point let me state that these phases are the signals of the curative process. Each phase will be lesser in intensity, duration and frequency, than the previous one and they keep recurring till the body is finally cured. This process may last for some weeks, months or years. It is to be kept in mind that the “first action” is the permanent and the second is the temporary. The “first action” is the feeling of well-being. It is permanent, and the “second action”, which is the feeling of return of agony is temporary. This is exactly opposite to the action of the medicine prescribed on the basis of the tenets of Classical Homoeopathy. There the first action is aggravation i.e. painful, and is called “temporary” which is expected to be followed by relief, the “permanent action”. In R. H. it is relief first (hope), and then the aggravation. Since the intensity, duration and frequency of the second and temporary action is on the decline, day by day the “first action” (relief) is gradually eliminating the “second” leading toward the ultimate goal of health / complete cure (Refer ROH Series).
(iv) SIGN of PERFECT HEALTH
As a rule in health these discharges should take place periodically or over a period of time with the same discipline (as stated above) i.e. in phases of odd numbers of days, without any physiological and anatomical alteration and with a general feeling of well being. In natural health the body is expected to keep itself in perfect order by following the rules as stated above.
(i) What does this change of norms bring to us?
What catches one’s eye (the attention) is the relationship between the PPP which reflects the mental attitude of a person and the process of eliminations, which is purely a physical activity. What is this correspondence? The first answer to a layman will be that the self-healing process which somehow for some reasons gets deviated, is put back on the rails with the help of the Revolutionized prescription – as after this, the body starts healing itself and there ends the job of the medicine. To put it in other words, after a few seconds or minutes of the administration of the medicine selected according to R. H. the distance between the ill-health and health comes to an end, because after that the job of the medicine ends and the mechanism of self – healing takes over. To a layman, when he asks for the cause of his ailment, I simply reply that your self- healing process is derailed and I shall be putting it back on its track through the medicine, and without further questioning about the cause of his suffering he feels satisfied.
The second and more appropriate answer will be that there is some physiological relationship between PPP and the eliminations. It is assumed that it is the cumulative action of a group of nerves belonging to the central nervous system, at a point in time which is linked with the eliminating process, and that is why the automation comes into action.
Further, one needs to understand the meaning of the general efficiency – being regained (after the 1st action) side by side with the elimination (i.e. after the 2nd action ) – without the help of any sort of vitamins. We infer that under the 1st action the body as a whole starts meeting it deficiencies with perfection from the normal daily intake. As a result, the eliminations also take place with utmost efficiency, which seems to be the secret behind the restoration of the normalcy in the body. Hence a conclusion that there will be no disease, if both the processes of assimilation and elimination, remain in perfect order. By this finding we feel proud that we have placed Homoeopathy on the top of the so – called medical sciences, because Homoeopathy is based on natural laws and others are on data.
(j) How to assess the overall progress
Here it is very important to note that while prescribing, our parameter is different. We simply read the dial (mental state) which indicates the medicine, but while assessing the progress of healing we have to consider the anatomy, physiology, pathology and the latest uppermost mental state. That is why sometimes diagnostic investigations, especially relating to the vital organs which we cannot see with our eyes e. g. diseases belonging to lungs, liver, kidneys, heart – etc., will require such data to properly assess the action of the medicine. Sometimes it has been seen that in spite of the best overall progress, the particular diseased organ shows no improvement. For example, there was a case of twitching of eyelids. The lady regained overall efficiency, her sleep became normal, her appetite and routine eliminations became regular including eliminatory system but the problem for which she came remained the same for a long time, which means that the medicine was acting partially and not covering the whole.
(k) Wait and watch
How long should one wait and watch whether to change the medicine or the potency? Before answering this question I will say that you should ask yourself why you want to wait and why you don’t want to wait. You must have proper reasons for that. What is to be taken into consideration is the totality, in the sense whether the man, in total, is coming out of the woods. Sometimes the medicine provides partial benefit but does not push the case forward and is given undue weight to wait more than is needed. You may have to change the medicine, sometimes many times a day, till the case stabilizes creating a condition for requiring no change for a long time.
(I) Need to Identify the drugs
There was a question: “If you say that practice according to R. H. is Present, Predominant and Persistent symptoms (mental state), then why do you talk of drug pictures as advocated according to Classical Homoeopathy?” The first answer to this is that R.H. is not simply to oppose any method but that it changes the emphasis where needed. We need to identify drugs as individuals, especially in those cases where P. P. P. has many drugs. For example, the rubric, “LIGHT, desire for” has many drugs, and unless we know their distinguishing features it will be difficult to identify the real indicated medicine. Obviously it makes the selection quick, easy and sure. In actual practice we have three ways of selecting a Revolutionized Homoeopathic remedy.
Translating PPP expressions of a patient into the rubrics of mind
Comparing to other remedies sharing a common meaning conveyed by the single rubric, as stated above. As an individual, independent of any connection with other drugs, keeping in view its established and unchangeable disposition.
In fact the founder Dr Samuel Hahnemann said that the disease occurs in the spiritual, mental, and physical, i that order. He laid utmost stress on mental symptoms. It was carried forward through the monumental repertory work of Dr J.T.Kent, where he stressed the highest weightage tobe given to mental symptoms. Dr Madal Lal Sehgal’s Revolutionised Homoepathy further builds and expands on it. Let us agree that “mental state” is the most common and characteristic of remedies, the physical manifestation varies greatly with individuals as there are numerous possible variations that may be caused by a remedy (or a disease). And hence the importance and success of the Revolutionised Homeopathy.
The practical problem is the efficiency/effectiveness of a doctor in correctly capturing the PPP of the revolutionised homeopathy, and this leads to prolonged treatment and frequent visits, and the patient has to pay for every (un)successful selection of the ‘right’ remedy for the patient.
Homeopathic doctors must find an ethical solution to this problem.
Dr. Sehgal’s Revolutionised Homoeopathy is a very innovative approach of prescribing correct Homoeopathic Remedy for radical cure. However, in day to day clinical practice it may be difficult to use this method in every case successfully. But despite this difficulty, we must remain grateful to Dr. M. L. Sehgal for his wonderful contribution to Homoeopathy.