On Sunday 21st January eighteen participants (another arrived late) from Dr A. U.Ramakrishanan’s 2007 Clinical Practice gathered in a conference room of the Residency Towers Hotel, in Chennai (Madras) India, to be briefed on what to expect. Our party consisted of the Irish contingent, some I had met previously at the Irish Conference last year, participants from Wales, Scotland, England, and representatives from Canada, New York and the Philippines. Some were at the end of their homeopathic studies and others like myself had been in practice for a few years.
We were expected to leave the hotel on the next morning at the unearthly hour of 8 am in time to get to the Hospital at 9 am, which was the start of morning clinic. I am pleased to report that this got later each day as it didn’t take as long to get to the clinic as expected and since the first half hour was slow if we arrived at 9.30am that was fine!
Our arrival at the Venkateswara Homeopathic Medical College and Hospital on the first day warranted a little welcome ceremony when we were each given a rose and invited to rub turmeric on our hands.
Opening Ceremony
The clinic was in a poor area and the place stank of the mothballs which were in each sink to keep the cockroaches out. The curtains and white plastic chairs had seen better days. There was a manual blood pressure monitor and stethoscope in each ‘cabin’ (consulting room) both which had seen better days. Very efficient fans kept the rooms cool but the electricity did seem to have a mind of its own. In the second week I got a red, very sore eye which seemed to come on every time I went near the fans in the clinic. I think I must have been allergic to some dust it was throwing around. This meant I couldn’t wear my lenses and had to go around with a pair of magnifying specs around my neck.
(Dr Ramakrishnan gave me Dulcamara 200 in water- based on the fact that it was a change in temperature- and he told me to take a sip ever hour for 6 doses. After about 3 doses it was noticeably better. The following day it started up again but with different symptoms, more burning and irritation. One of the internists repped it out as Silica and prescribed a powder in 30C .Again it seemed to do the trick. From then on I stayed out of the firing line of any of the fans!! )
There were 3 ‘cabins’ in the clinic and in each were up to 6 internists and the homeopath wearing white coats.
Interns
The homeopaths working in the clinic had been chosen as the best of their year at college. They qualified between 1-8 years ago. In each cabin there were tables and chairs where maybe 2 sets of internists might be taking a case, and around the main table the homeopath would be speaking to a patient and someone else would be sitting by the side waiting for their turn. Surrounding this table were other internists. There was no privacy for the patient but no one seemed bothered. If the homeopath wanted symptoms repped out, one of the internists would be asked to do it and write the result in the patient’s notebook with a differentiation between the 2 best remedies. The patients paid 15 rupees, about 10p,(2007) for a week’s treatment including the remedy which they got from the pharmacy.
We were told that homeopathy was for the poor and allopathy for the rich. The hospital makes its money from the students who pay to attend the college. All the students are medically trained as well as homeopathically in their 5 years at the college. The homeopaths sometimes would send patients for investigations at an allopathic hospital e.g. x-rays or scans. We were told that there was provision for inpatients and there was an operating theatre but it hadn’t been used for years. At the clinic I was struck by the fact that all the patients I saw had physical complaints, not the “stress” and “depression” that make the majority of my workload!! There were lots of respiratory complaints, after effects of Chickungunya carried by the mosquito and presenting as fever with arthritic pain, (Eupatorium Perf and Rhus Tox), Vitiligo, hemorrhoids, hair fall and cracked, bleeding feet. Many patients were type 2 diabetics which apparently is rife there. Patients would also come for medicine for their relations! They seemed to use the same group remedies for most patients; Arsenicum, Calcarea, Lycopodium, Nux Vomica, Phosphorus, Pulsatilla and Sulphur and amazingly, boasted a 70% success rate.
A typical morning would see six of us in a cabin together with up to 8 students, all watching the cases being taken. The clinical practice was fascinating. The language was Tamil and everything was translated for us. We had to continually ask the homeopaths to slow down because they spoke so quickly. One morning I saw 40 patients. The homeopaths can do it because the internists- those that are in their last year of study- take the case and rep it and present that all written up in a little notebook to the homeopath! The notes were all written up in English and their beautiful writing put mine to shame. The notebooks were ready stamped in a set format, Past History, Personal History, Family History, treatment History, Chief Complaint, Modalities, Location, Sensation, Modalities, Concomitants etc.
The homeopaths were dedicated and the college obviously was of a high classical standard. They seemed to use a narrow number of remedies and the posology was the remedy in water taken twice a day for 3 days and then the patients returned for a follow up. The remedy would then be continued if working and they would come back in a week. Anything that came up was treated with another remedy. If there was no improvement in the condition, the patient would be sent off with a couple of the internists to have their case retaken. The format appeared to be: give the acute remedy, if that didn’t work, go up in potency. Next give the miasmatic remedy and finally the constitutional remedy when indicated. I didn’t see any consideration for return of old symptoms, as they just prescribed on what they saw. There also appeared to be a continual taking of a remedy policy albeit in water. I didn’t see or ask if sac lac was used. There was a private examination room if needed. Stethoscopes were used over clothes.
The homeopaths said that they had to prescribe as taught at the college but wouldn’t necessarily prescribe like that in their private practice.The homeopaths also relied heavily on tatty, well used MM books that Dr.Arumugan had written, outlining the keynotes of remedies. All prescriptions were in the first instance found from the Physical and Mental generalities taken by the internists and confirmed by the keynotes. Murphy’s was the repertory used. Many of the repertories had the covers off and were falling to bits from use.
I saw many prescriptions of a constitutional remedy given in a 30 C and then an acute e.g. Rhus Tox 200C to be taken 10 mins after. This I couldn’t get my head around but it was the way it was taught at the college. In the clinic our input was welcomed in the form of questioning the patients and remedy suggestions The patients were not told what remedy they have been given.
There was no appointment system and patients turned up as they found convenient. The all waited patiently to be seen. I was told that there was provision for patients to be fed free at a canteen if this was needed. There was ‘drinking water’ available for the taking in a big tank, although we were presented each day with our sealed bottle of mineral water. Monday and Tuesday were quiet days but evenings (3.30- 7.30pm) and weekends were the busiest. Friday morning was also quiet as patients pray at shrines then. We were in the clinics from 9am until 12.30 for the morning session and from 4.30 until 6.30 for the evening session if we chose to stay for it.
Overall I was really pleased that I participated in this India experience. To be engulfed in so much homeopathy in such a short time was amazing.
