Since the dawn of homeopathy, even during Hahnemann’s lifetime, a conflict has raged between practitioners using different methods, with or without the blessing of its creator: unicism, pluralism, complexism, only homeopathy, combination with other approaches, choices of potencies, etc… [References # 1 & # 2].
Based on one case (for which I have full permission to publish) among many treated the same way, I present my approach about synergy of diagnostic methods and synergy of therapies. It is my way. I have good results with it, even very good ones.
I do not claim it is the very best way, or a better way, or the only way, or the smartest way. I am asking you to read it and read the comments and explanations; then see if you want to reject it, adopt it, modify it to fit your personality and your experience with homeopathy and any other methods you might be familiar with. Feel free to curse me if it helps you…
The Case
A 23-year-old woman comes in May 2018 with the presenting complaint and symptoms of Grave’s disease (hyperthyroidism), treated with Carbimazole, to which she added the herbs Lycopus and Leonorus cardiaca, as well as some essential oils. The physical symptoms started about a year ago.
Despite the treatment, her blood tests are still abnormal, and symptoms are present:
Free T4: 33 pmol/L (10-24)
Free T3: 13.1 pmol/L (2.5-60)
TSH: <0.01 mIU/L (0.40-4.00)
Her symptoms were fainting frequently, cold sweats, lightheaded, sensation of palpitations, shallow breathing, hyperventilation, dizziness with nausea, sensation of burning heat, sharp, pulsating frontal headaches, alternating emotions. No exophthalmos. Unrelated, she has multiple food allergies.
Past history of recurrent infections since the age of 5, was on antibiotics for 9 months, ended up with a tonsillectomy; asthma since the age of 12; pleurisy recurring every year; big upheaval in the family, she lost all her friends and “disowned a brother” (she does not even want to talk about that).
Nightmares of running away, death and torture.
Fear of needles, ocean, and spiders.
Craving for sugar and salty foods, coffee, and fruits.
Used to be shy, now is able to speak in public, but it is not her favourite pastime… Was very restricted at home, strict and rigid education, unable and not allowed to express herself, but now has started to stand for herself; injustice <<<.
On examination, the thyroid is slightly increased in volume, soft, no masses felt; tachycardia with weak pulse, the TCM Kidney pulse is inexistant (marking adrenal exhaustion), her tongue is wide, dark red with the tip and borders even more red (TCM: Blood stagnation, Yang deficit, Liver, Heart, and Lungs actively pathologic in energetic terms). In my clinical notes, I have not mentioned the state of her Chakras, which I check as a routine.
The conventional treatment is obviously not helping. From my perspective, there is a clear link between her upbringing and inability to have her voice heard and the development of hyperthyroidism. This is a pattern often seen: that throat and/or cervical symptoms appear when the patient’s energy is not allowed to flow, is blocked at the throat chakra; any pathology can and does appear, not specifically thyroid ones.
Having a direct, linear correlation cause and effect, an obvious approach would be to treat the origin of the pathology, which should then disappear. But are we certain they would? It has been only one year, the patient is young, does not seem to have any other ailment, the choice seems logical.
On the other hand, the symptoms are debilitating, preventing her from leading a normal professional and personal life. Moreover, we know that untreated hyperthyroidism can lead to cardiac failure in an unpredictable manner, especially if there is a minimal preexisting cardiovascular anomaly that was asymptomatic and never detected; should that be the case, it can evolve rapidly and end up in congestive heart failure in an acute manner.
This is not theoretical or extracted from a textbook. I have witnessed that happening a few times in my previous life on the “other side”. Treating only the obvious clinical expression seems to take precedence but its effectiveness can be hampered by the continuous effect of the root of the disease.
My usual answer to that is to treat both, and it is not a dilemma, it is a pragmatic way of resolving a problem as fast as possible, for the benefit of the patient.
Here is the clinical repertorisation:
clinical; HYPERTHYROIDISM (119)
clinical; THYROTOXICOSIS (5)
neck; THYROID gland (170)
neck; GOITER (189)
neck; GOITER; enlarged (4)
heart & circulation; PALPITATION heart (577)
heart & circulation; PALPITATION heart; thyrotoxicosis, in (2)
clinical; HYPOTENSION (76)
mind; ALTERNATING states; emotional (309)
respiration; SUPERFICIAL (76)
vertigo; NAUSEA; with (215)
Graves’ disease (12)
I selected a few remedies that have a Thyroid gland tropism, with very similar symptoms in the Materia Medica, almost impossible to safely differentiate. From herbal medicine, we know those remedies are effective as a treatment for hyperthyroidism; this way we have both an energetic/homeopathic approach and a pharmacologic/herbal approach to the pathology; to this I added Crataegus and Leonorus cardiaca to support her cardiac function even though there are no real obvious symptoms or problems.
Rx/: Spongia tosta, Iodium, Lycopus, Badiaga, Leonorus cardiaca, Crataegus, together in the same bottle, in a Fibonacci Plasma Potency 5C+8C+13C (each remedy in those potencies), starting with one (1) drop in a glass of water to sip during the day; this way, the evolution of her metabolism is gentle with no sudden changes, allowing for a “soft landing” [Ref # 2]. Trying to repertorise without the clinical notion of hyperthyroidism leads to a flurry of polychrests, none of them really covering, also her following repertorisation of M/E and general rubrics and do not have the pathological organ as a precise target.
Within the original homeopathic theory, some should work, hypothetically, and I did not manage to extract more precise details and modalities that would lead to a more limited choice (the patient did not let me go deeper).
At the same time her general remedy in prescribed to be taken simultaneously with the abovementioned prescription.
clinical; ALLERGY (279)
clinical; AUTO-IMMUNE diseases (400)
clinical; ALLERGY; multiple (3)
skin; DRYNESS; perspire, cannot (81)
mind; DREAMS; frightful, nightmare (420)
mind; DREAMS; running (24)
mind; DREAMS; pursued, of being (137)
mind; DREAMS; death, of (280)
mind; FEAR; pins, pointed, sharp things, of (16)
mind; Fear; ocean or water (49)
mind; FEAR; spiders, of (34)
mind; CONTRADICTION; ailments from, agg (97)
The dominant remedy that was also obvious listening to her story was Carcinosin.
Rx/: Carcinosin in a full Fibonacci Series 8C, 13C, 21C, 34C, 55C, 89C, 144C and 233C, each potency to be taken, in that order, in 3 dilution glasses according to the evolution of her mental/emotional situation [Ref # 2]. In Murphy’s Materia Medica, under Carcinosin, we find this: “NECK – Hypothyroid. Goiter. Induration of glands. Swelling of thyroid”; in Stephenson’s proving of Carcinosin, there is a “sensation of lump in the throat”. I could not find any other mention of the thyroid in relation to Carcinosin in any of the Materia Medicas I possess.
She came back in October 2018, feeling a lot better. No more fainting, rare dizziness, rare palpitations, no shallow breathing; still hot and some headaches, still fluctuating emotions but a lot less; nightmares are still present. Her craving for sugar has diminished, replaced by a craving for oranges and pepper (!).
Blood results are a lot better:
Free T4: 14 pmol/L (N)
Free T3: 4.8 pmol/L (N)
TSH: < 0.01mIU/L (still low)
Interestingly, she did not take the Carcinosin after the 8C: it caused lots of emotional feelings to come up, accompanied by the sensation of a lump in her throat.
I explained why it was essential to use the full spectrum of Carcinosin, using a greater dilution of each dose to “soften the blow”. At the same time the “Hyperthyroidism complex” was discontinued and replaced by an Organotherapic treatment to repair the thyroid gland, help the function of the adrenals that are almost always involved in this type of endocrinopathy and help normalise the pituitary gland function.
Rx/: Organotherapy Thyroid + Pituitary + Adrenal, together in a Fibonacci low plasma potency 3C+5C+8C+13C+21C, 3 drops of the complex 3 times a day for a few months [Reference # 3].
Then I did not hear from her until June 2023, 5 years later… despite having asked her to keep me informed. The reason for her consultation was a post-concussion problem. She apologised for not keeping in touch and was very proud to tell me her thyroid problem was cured; the GP was flabbergasted and did not understand how this was possible. She agreed to proceed with new blood tests (probably out of guilt…)
Free T4: 14 pmol/L (N)
Free T3: 4.5 pmol/L (N)
TSH: 0.76 mIU/L (N)
All normal blood tests, no clinical signs or symptoms of hyperthyroidism whatsoever. That phase of her life seems to have been not only cured but erased according to our conversation, not related to the concussion.
Synergy of diagnoses
Do we really need a clinical, conventional, Western diagnosis to treat patients with homeopathy? Quite a few pundits claim that it is not necessary. After all, Hahnemann, Boenninghausen and their students who became our Masters and Teachers did not have the knowledge of physiology and physiopathology we have accumulated since their time, yet they cured people simply by using their symptoms and comparing them with the provings, which we still do today with good results.
Moreover, we all agree that many diagnoses are nothing but labels that cover a multitude of variations, often written in medicalese Latin gobbledygook to hide our real ignorance of what we are dealing with. Let’s be honest about that! I have done it for many years in my “previous life”.
On the other hand, we know that the same symptoms can relate to different pathologies that need more specific treatments, especially those that have a tropism towards particular organs or systems; we find those tropisms in the Materia Medicas of Boericke, Phatak and Vermeulen, to quote only those, the first few sentences at the start of each remedy.
Imagine a patient with severe, recurrent chest pains, who is not able to give too many specific details, modalities, etc… and those can be similar in different conditions: the starting episode of herpes zoster, muscular pain, articular pain (Tietze syndrome), pericarditis, pleurisy, angina pectoris, progressing MI (I should know that one, my Dad kept working with it for a week before a correct diagnosis was made…), intercostal neuralgia, vertebral problem, gastric reflux, oesophagitis.
Do I really have to write that no matter anyone’s specialisation, those different problems will be treated differently with different remedies, and one does certainly not want to treat a coronary obstruction with a remedy that focusses on a joint or on the stomach? Does that make sense?
We can find nowadays many more recent repertories that include conventional diagnostics, often with their various modalities in sub-rubrics… but, as you can see here [clinical; HYPERTHYROIDISM (119)], the number of possible prescriptions is very large and is of no real help without more details that only our way of taking a case can provide.
This clearly points to the need to be fluent in pathology, diagnosis and differential diagnosis, and also with the practice of physical examination: look into Kent’s repertory under Respiration or Chest, rubrics like “Pneumonia, hepatisation state” (quoting from memory) are present; how can you use those rubrics, and so many others if you do not know what this is and to recognise it?
Then, at least in my practice, I am often confronted with patients where no Western diagnosis has been made, multiple specialists have given different opinions and offered different treatments, which the patient has tried to no avail but some side-effects, and those “opinions” are nothing but “labels”.
This is where other diagnostic methods find their rightful place.
Looking at the tongue and taking the pulses in the manner of Traditional Chinese Medicine [Reference # 4], understanding the pathology through Chinese Physiology, the Cycle of Energy, the Five Elements, often points towards homeopathic rubrics and also allows a wider consideration of relationships between organs, systems, and their reciprocal influences.
In the case presented, the Kidney pulses reflected the exhaustion the patient was in and the need to solve the hypermetabolism consuming her body as soon as possible. At the same time, relating her mental, emotional, and psychological situation to the inability to express herself verbally and thus converting it to a metabolic pathology is now relatively well accepted in Western medicine as being “psychosomatic”, whereas the Ayurvedic diagnosis was related to her Throat Chakra. I am as yet too ignorant about Ayurvedic medicine to comment more on that aspect.
Here is another example, very frequent in a clinical setting: patient with a right frozen shoulder, no traumatic history, scheduled for surgery but quite understandably reluctant; has been treated with anti-inflammatories (conventional and herbal), physiotherapy, osteopathic and chiropractic adjustments with minimal and temporary ameliorations and a return of the symptoms, often with a vengeance.
Through the study and practice of Visceral Manipulations (Jean Pierre Barral [Reference # 5]) and very precise anatomical dissections, we know that the liver is innervated by the phrenic nerve, but also that the shoulder has its sensory innervation through a branch of the phrenic nerve, both conveying information to the spinal cord at the level of C4 (C3-4-5); at that level, the nociceptive information is transmitted to the brain, which often treats the signal “pain in the liver” as being “pain in the shoulder” thus immobilising the shoulder to avoid pain and further damage… that does not exist.
A simple test of inhibition of the liver (holding the liver area with slight compression while asking the patient to move his shoulder along all the axes; trust me on that one) removes the pain and restores mobility to the shoulder temporarily, indicating then the need to treat the liver through manipulation (and remedies in my practice).
But that is not all! One should ask “why is the liver suffering”? Back to TCM: the Liver holds the energy of Anger and Resentment; it can be checked through the pulses and the tongue that will both show a Liver “problem”, and at the same time the suffering of other Organs, clinically overshadowed by the actual complaint but apparent at the level of the Tongue and the Pulses.
Here I question the patient: “Do you have some ancient, repressed anger about old problems in your life?” with the patient generally being grateful that finally someone is willing to listen to his childhood events or whatever else, whose unresolved problems are the anchor of his Liver (energetic) suffering, leading to the frozen shoulder, the same way that in the presented case, her past history led to hyperthyroidism. Treating everything leads to a real wholistic approach and a resolution of pathology.
I hope this is quite clear…
Synergy of therapies
The dominant dogma in many schools of homeopathy is of course to use only homeopathy to treat the patient, although lip service is given to diet modification and some surgical measures, as Hahnemann also accepted those as valid.
He furiously criticised the practice of medicine in his lifetime, with good reason, as we do now, also often with good reasons. Only in Aphorism 47 did he mention that homeopathy is to be used preferably to any other therapeutic method… but we tend to forget that this criticism was aimed at the level of knowledge and practice of his time: bloodletting, strong purgatives, toxic doses of heavy metals (didn’t he create Mercurius solubilis hahnemanni as a milder replacement for the Mercury used in the treatment of Syphilis, later on potentised and proved?), toxic doses of herbs and mixtures that do not make any sense, especially when they are examined in the light on modern phytopharmacology.
Aphorisms 1 & 2 and their appendices tell us one thing, and one thing only: our duty is to the patient, to cure him as fast as possible with the least possible amount of suffering; that injunction never changed over six editions of the Organon, never.
Why drag the treatment over a few years, when a few weeks are enough to take the patient out of a danger zone, then continue the deeper treatment? A very famous homeopath for whom I have much respect (and I have all his books and yes, I read them all) once presented a case of congestive heart failure secondary to a broken heart, something that is now finally accepted by the cardiology ‘cartel’.
The treatment was Natrum muriaticum in very diluted daily doses of the same regular potency for…. 3 years… with the patient slowly emerging from her physical limitations as well as her mental state. Well done! But we know that congestive heart failure can quickly and suddenly decompensate and kill the patient; why then not avoid that threat with some material doses of Crataegus, some Digitalis (use 3X if you are not allowed to give the real tincture or the tablets), a bit of magnesium, or any other herbal remedies that are very well known for their effectiveness in treating CHF? What if the patient did decompensate? Are you willing to take that risk, are you willing to impose it on your patients?
Returning to the case presented and other concussion patients, a general finding I paid attention to is that all of them have restrictions in their cranial bones’ motility and perturbations in their craniosacral rhythm. Since I started examining them through the CST methodology and restoring the perturbed motility and rhythm before prescribing the indicated homeopathic remedies, the evolution and resolution have been faster and deeper, often needing only one CST treatment and one or two follow-up consultations… not good for business but excellent for the patient.
Asthmatic patients have their nutrition, spine, chest, pleura, and lungs adjusted, followed by a prescription including homeopathic remedies and/or herbs to use when needed (instead of Ventolin that is still at hand “just in case”) and a homeopathic in-depth treatment aimed at the root of the problem. And so on….
Is that a betrayal of homeopathy? On the contrary, this approach strictly respects the Hahnemaniann rules of Aphorisms 1 & 2: first and foremost, cure the patient!
Does that make me, and my colleagues who practice the same way, a “Jack of all trades, master of none”?
Blowing my/our own trumpet, I would modify that saying into “Master of one or two trades, well acquainted with many others”.
We all have our preferences, and most of us come from different backgrounds; we look at people with different filters, sometimes forgetting that all people are multicoloured, that all their colours should be treated if and when need be, not isolated on out a prism, focus on that one and wonder why our well indicated therapies and ministrations are not effective. The more tools I have, the safer I am and the more effective I can be.
References.
The first four books are mine, available from www.lulu.com. They contain detailed and specific references which can be consulted and not clog this article.
The website of the Barral Institute will give you a glimpse on what can be done with the help of this relatively new method of manual medicine, to be combined with CST.
- Unicism, Pluralism, Complexism in the light of the 21st
- Fibonacci Potencies. The last words.
- Organotherapy, Drainage and Detoxification.
- Homeopathy through the Chinese Looking Glass: Homeosiniatry revisited.
- The Barral Institute https://www.barralinstitute.com/
This is every patient’s dream, to have their health problems solved using a plethora of modalities. In many cases, more than one approach is needed. Nice work Dr. Joe.