Homeopathy Papers

Taking the Case: An Insight into Pathological Cases

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The authors discuss the Synergy method of case taking as practiced by Dinesh and Urvi Chauhan.

A 2-day Seminar by Dr. Dinesh Chauhan at ‘the other song’


To treat pathological cases and deliver remarkable results is the real test of a homoeopath. While it is the dream of all homoeopaths to treat such cases successfully, many a times, there are several hindrances that a doctor encounters while treating these cases. Treating pathological cases necessitates an in-depth knowledge of medicine and pathology. It is equally important to know how to tackle acute states and exacerbations in chronic pathologies and cancers. While doing this a homoeopath also has to know what precisely is the scope and limitation of Homoeopathy in such conditions i.e. whether Homoeopathy can treat, palliate a certain condition or the patient might just as well opt for surgery or alternative treatment.

It is often a major cause of concern for most homoeopaths how to get the original unmodified picture of the disease especially in chronic cases with multi-systemic involvement like SLE or psoriatic arthropathy or HIV when there has been suppression with a battery of drugs earlier. How do we judge the prognosis and the posology for the case? How to deal with cases where major organs are involved? These are just a few from amongst a host of questions assailing every physician. To address these questions and to find a solution for such cases, the other song organized a seminar by Dr. Dinesh Chauhan Taking the Case: An Insight into Pathological Cases on the 11th and 12th October on its premises.

Dr. Dinesh Chauhan set the pace of the seminar by explaining about his approach in deep irreversible pathologies, i.e. the synergistic holistic approach, which works on the principle that what is true for one part, has to be true for other parts of the same system. The trio of Homoeopathy is similimum, individualization and holism and these three have to be at the centre of case analysis of every case. Every homoeopathic remedy and every human being has its own individualistic expression, what we generally term as PQRS symptoms, be it at the level of local symptoms, mental generals or physical generals. So when the mind and the body are connected, when the mental and the physical, the general and the particular come together, they form a whole; this phenomenon is holism. Simillimum is selected on the basis of this holistic expression of the individual matching the PQRS symptoms at both the general and the particular level of that remedy. So, the aim of case-taking should be to bring out peculiar symptoms at holistic level. PQRS at holistic level is the key to successfully analyzing any case individually.

The expression of the patient can be understood through the system, the symptoms and also through the genius, the common strand running through the complaints. When all these come together, we get a perfect amalgam, a Synergy. This Synergy of the expressions at a holistic level gives a very peculiar and individual understanding of the patient and his complaints. This combination when matched with the drug forms an accurate understanding, guiding us to the Similimum. So, when doing a case, every physician has to go deeper into the symptoms, so as to elicit them not only on a particular level, but to go beyond the isolated, scattered and meaningless, till they form a common connected thread, a pattern which is seen running through the whole picture, i.e. to form a holistic perspective.

The Sensation Approach founded by Dr. Rajan Sankaran, added a new dimension to the practice of Homoeopathy, giving a clearer and a firmer ground for prescription. Here, the system when used on one hand with symptoms on the other, provides a solid ground for prescription and analysis in most cases. When what we call ‘symptoms’ and ‘system’- left brain and right brain data – come together, it is like a match box and a match stick. You can add these two together – you can toss them into the same bag or drawer – and nothing happens. But when you strike them together it lights a fire. Then it is as if one plus one is not two; it is as if one plus one is a thousand. This is Synergy: when two things come together and the result is greater than the sum of those parts. Whether you first pick up the match box and bring it to the match stick, or you first pick up the match stick and bring it to the match box, it does not make a difference. When the two come together, fire is lit, the result is Synergy.1


Dr. Dinesh then talked about his experience with cancer cases. He said that the basic difference in the pathology between cancer (proliferative) and other degenerative diseases is that in cancer, the cells undergo mutation and become some different cells which are not in sync with the body, while in other degenerative diseases the healthy cells die. Though both are deep irreversible pathologies, their pathogenesis and mechanisms are different. Thus there are two things happening; one in itself is the original unmodified state and the other is the pathological state which has developed due to abnormal cell division and mutation. This can be easily compared to a pregnant mother who has two states, one of her own and other of the child she is carrying.

Cancer causes its own superimposed state too; the altered cells arising from the normal tissue represent an altered pattern at the local level. The patient’s central disturbance leads up to this disease, but the disease itself produces a corresponding and a definitive disturbances of the patient. Thus the state created by the disease, cancer is called the present pathological state which runs along with the already existing chronic state.

He then showed a few cases of degenerative and deep irreversible pathologies where he showed the analysis of the central point in the case as holistic interplay of mind and body. He presented a case of a lady suffering from chronic kidney disease, who had to undergo dialysis every fourth day over the last four months. On studying her life-history, it was seen that she was worried about her husband, her children and their health. This with some other features about her, made Dr. Dinesh think of Causticum for her. However, in such cases, the case-taking has to be a bit different, the difference lying in enquiring about the changes observed at the onset of the kidney disease, which would yield the present predominant pathological state. So here, the doctor asked about the changes seen since the disease started, mentally, physically and emotionally which were not a part of the person originally but came up when the disease started.

When this approach was adopted for the patient, she said that there was intense fear and panic the moment the doctor announced that she had kidney failure. The first experience was of shock, where she had no sense of what was happening around her. This was followed by thoughts of her mother-in-law who passed away from chronic kidney disease. She directly connected to her mother-in-law’s reaction when the doctors declared that her disease was incurable and how she collapsed and died on the spot hearing the doctors say that. This sequence of events was a shock to the patient.

For the patient, everything was burning from inside right from head to toe. She was completely normal except for the weakness and the burning and then suddenly her doctor told her that her kidney had failed. So all this was very sudden for her. When the patient undergoes dialysis, she has a feeling of chilliness externally which is aggravated by draft of air. With this external chilliness, internally there is an intense burning before and after dialysis as if from application of chilies. Since being diagnosed of renal failure, the patient gets a thought as if someone is taking her away when she is in the dark and she suddenly wakes up in shock. When the patient was asked about her likes and dislikes in food, it was found that she had a craving for potatoes.

After this, we have to find out how her original state was, so she was asked about her childhood. Here, the patient observed that she had fear of dark as a child too and would always be frightened that someone would take her away, so she panicked and the experience was again of a shock to her. The patient was aggravated by draft of air even as a child. This is as far as the details were concerned, which were quite apparent in every circumstance of her life, before and after the complaint. However, now we need to understand her complaints at a holistic level, in totality. So we go back to her anxious nature, where the patient is very worried about her family. She is worried if anyone is a trifle unwell and she takes tremendous care of them. This is because if any of them were to develop a serious illness, she would be shocked, which she would be unable to take it.

About the author

Sneha Vyas

Dr. Sneha Vyas, M.D. (Hom), Resident Doctor, the other song

Ruchita Shah

Dr. Ruchita Shah, B.H.M.S.

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