The homeopathic veterinary surgeon, as the doctor, has an obligation to reduce to a minimum any prejudices whilst in front of the patient and to observe some rules of objectivity that allow him to make a better prescription. The most insidious enemy of the homeopathic doctor is his own subjectivity. The purpose of this work is to explain succinctly to homeopathic vet colleagues a method already known for years in the department of human homeopathy that, if correctly applied, tends to reduce drastically this subjectivity whilst complying with the hahnemannian assumptions: it is commonly called the Method of Pure Homeopathy (MPH).
Key words: vet homeopathy – method – pure homeopathy
The Method that I have the honour of presenting has already been officially popularised in 1995 by Marcelo E. Candegabe and Hugo C. Carrara of the Escuela MÃ©dica HomeopÃ¡tica Argentina “TomÃ¡s Pablo Paschero” (E.M.H.A.) within a book entitled AproximaciÃ³n al MÃ©todo PrÃ¡tico y Preciso de la Homeopatia Pura.
This work is the result of a series of consideration inspired by the teachings of the late Master Paschero, founder of the E.M.H.A., of his fraternal friend and spiritual heir, Eugenio F. Candegabe, my Master, with whom the Authors have integrated their experiences of many years of clinical apprenticeship and the scientific present-day knowledge which confirm the Hahnemann conception of the ILLNESS as A NEW ORDER IN THE MANIFESTATION OF THE HUMAN BEING.
It will not be possible, during this session, to cover completely all of the subjects linked to the Methods, therefore we will try to develop a synthesis that can result interesting, especially for we Vets, referring to the original work and to the more detailed study.
Before going into the very heart of the exposition, it is necessary to clarify the title of the Method that opens with the word “approximation”. This is very important.
From its birth until today, Homeopathy has had a continuous evolution, we could say a natural evolution, as foretold by Hahnemann himself and by his successors, and so it will be in the future, considering that till now many points are still completely absorbed into the uncertainty of the hypothesis. For these considerations, it is not the intention of the Authors of the Method the idea to consider it definitive (hence the word “approximation”), although we are convinced that it represents the maximum level of precision  obtainable today in accordance with the present-day knowledge, either homoeopathic or scientific, within the limits of classical homeopathic prescription.
With this due introduction, from now on, we will, for convenience, refer to the Methods simply as Method of Pure Homeopathy  (MPH), remembering that it has been adopted with success by myself and few other colleagues in the field of pets.
If this work succeeds in arousing curiosity and even inspires a few colleagues to apply the MPH, it will already have been well worthwhile.
The doctrinaire basis of MPH
Naturally, the whole work of Hahnemann is fundamental, but now we are going to emphasize only those parts that have inspired the MPH.
In the essay entitled Spirit of the Homoeopathic Medical Doctrine, Hahnemann says: “Illness is the result of alterations in the way of living that man feels and puts into practice, namely a dynamic changing, A NEW CLASS OF EXISTENCE whose consequence must be a changing in the established material principles of the body”.
And more, in another passage of the same work: “You can see without difficulties that the dynamic alterations of the vital character of our organism, to which we give the name of illnesses, express themselves through an AGGREGATION OF SYMPTOMS and only under this shape can we recognize them.”
We will never cease to be amazed by the incredible farsightedness of the Master in his statements! The NEW CLASS OF EXISTENCE, is absolutely confirmed by the experiences of BÃ©nard Instability and by Zhabotinski Reaction, cited by the Nobel Prize Winner Ilya Prigogine for the explanation of Complex Systems.
Every human being is an open system that maintains an unstable equilibrium, we could also call “susceptibility”, or “predisposition”, or “psora” (in coherence with § 80 of Organon) that makes possible the amplification of fluctuations within the organism as a consequence of a particular stimulus (aetiology) that, past a critical point, determines a change in the totality, a NEW ORDER OF EXISTENCE, the illness.
The sole element that allows us to recognize the illness, and that shows the idiosyncrasy of the patient, is that AGGREGATION OF SYMPTOMS already cited and even this concept is confirmed by modern science.
The physicist David Bohm, in his work Wholeness and the Implicate Order, suggests a model of Universe made up by an IMPLICATE ORDER of facts, where everything becomes united, and by an EXPLICATE ORDER of phenomena, where parts appear separated in front of the partial observer (as for example, the symptoms of the patient in front of the doctor, who can accept them only on the basis of his own experience).
According to Bohm, several events should therefore give rise to the developing realization of the Universe and there exists an inner relationship where THE PART IS EVERYTHING AND EVERYTHING LIES IN EVERY PART, as represented in the hologram.
According to this theory, the Universe (which Bohm calls Holoverse: from Greek holos = all, whole) is provided with a movement, a flow of information which has as its chief characteristic the REPETITION of phenomena (for example the symptoms, see Organon § 95).
These and other considerations, that deserved a separate treatment, lead to the following synthesis.
Illness is a new order of existence that expresses itself in many different regions of the organism, from mind to body, through signs and symptoms, (explicate order) only apparently isolated, that shows altogether a high degree of coherence with the totality (implicate order), characterized by a particular individual pathological constitution (idiosyncrasy).
All that leads us to consider symptoms either on a physical seat or on a temporal seat, increasing in this way our precision on the hierarchy, as we will see later in connection with the Second Step of MPH.
To conclude this doctrinal parenthesis, lets us remind ourselves of the three qualities that a symptom should have to be considered “a good symptom”:
INTENSITY, that is the power to create suffering in a certain measure;
HISTORICITY, that is the power to occur chronically (§§ 91 and 95 of Organon);
MODALITY, that is the circumstance that makes it peculiar (§§ 153 and 164).
Now we have sufficient elements to become immersed in MPH, even if it will be necessary to open some further parenthesis sometime during the course.
The 8 steps of MPH in the veterinary visit
First Step – Anamnesis and Systematic Interview
Everything begins with ANAMNESIS, in accordance with §§ 83-84-85 and the SYSTEMATIC INTERVIEW, according to §§ 86-87-88-89.
We will not comment upon these two phases, taking it for granted that everybody should know them well. We will only say that such moments, together with the OBSERVATION of the doctor (§ 90), lead to the INDIVIDUALIZATION of the patient, that is, as Hahnemann says in § 104, “the most difficult part”!
Strangely, however, it is just from now on that the different schools of Homeopathy have split, that is on the part that for Hahnemann should be the simplest. Let’s try to understand the reasons.
We agree perfectly in considering the homoeopathic symptoms as the basic scientific parameter, but relying on the partiality of the doctor who, remember, is an observer conditioned by his experience, such symptoms will be differently catalogued and chosen for the research for the remedy: THE THERAPEUTIC CONCEPT CHANGES IN RELATION TO THE WAY THE DOCTOR CONSIDERS THE ILLNESS. The different schools of Homeopathy take as their model the three periods of evolution of Hahnemann taken separately and hereby listed (Fig. 1):
I. Illness is a noxa that attacks the organism; the therapeutic concept is the remedy for the pathology;
II. Illness is conditioned by miasmas, that make the individual vulnerable; the therapeutic concept is the remedy for the working miasma;
III. Illness is a dynamic change, a new order of existence; the patient is always himself in a different way of being; the therapeutic concept is the treatment with constitutional remedy.
We consider it logical to think that, if we continue to give credit to Hahnemann and to his doctrine, we should consider the experience that led him to revise his Organon at least six times, of which obviously we no longer consider the first editions (if not to understand exactly his evolution), while we consider the Fifth from which the Kentism comes, with 200 years of experience, and the Sixth with the innovation of the LM Scale. Probably, Hahnemann took it for granted that it was so for everyone, but obviously he made a mistake.
Anyhow, the next passages of MPH represent the effort to make, despite everything, the simplest things, obviously starting from the last realization of the Master who, as we know, when was 80 years old, by his own admission, was lacking in life and motivation, but after having met Melanie fell in love again, both with her and with Homeopathy for the next 8 years of his life.
This has made possible the revision of the Fifth Edition of Organon and therefore the following Sixth Edition, published posthumously in 1921, 78 years after his death .
To exemplify the MPH in practice we will use the clinical case, with two follow-up years, of Joy, CM 4 years old cat which will illustrate the various stages. What follows refers to the First Passage.
Anamnesis and Systematic Interview
The owner, who had almost given up hope, brought in the subject in a serious condition. The cat is already in therapy with different medicines and with different clinical tests having been done with the aim of reaching a certain diagnosis of FIP. She tells me with tears in her eyes: “Doctor, if he dies I will also die”. Then, having said that, she gently lays Joy on the visiting table. The animal seems alert, but very weak; stays still and there is no need to hold him, as he shows no sign of making even the least effort to move away.
Joy arrives with a 40°C fever but looks in quite a good state of nutrition, mainly because his mistress is very clever at giving him assistance: she has force-fed and hydrated the animal (who would otherwise be probably much worse) for 15 days: “He has absolutely no desire of food; I try to put it at his disposal, he comes nearer and then goes away feeling sick [APPETITE – wanting – food – sight of, at; APPETITE – wanting – food – smell of]. Neither drinks [THIRSTLESS – fever, during]
From analysis, what stands out above all is an increase of WBC (24.000) and the shifting of the formula towards the segmented neutrophils (20.255). The biochemical profile shows an increase of creatinine (2.42). High bilirubin in the urine with presence of hidden blood, proteins.
The echographic diagnosis talks about lympho-adenomegaly of abdominal lymph nodes of a probable inflammatory origin and infiltration, with correlated peritoneal reaction.
The cytological diagnosis of the material drawn through hypodermic needle talks about granulomatose lymphadenitis with strong hyperplasia immunoblastic /plasmacytic.
Electrophoresis: light increase of gamma globulins.
All this, in an over 4 yeas old castrated male cat, can be compatible with an initial state of lymphoma or of mycobacteriosis, rather than FIP.
The cat had been found by the owner when he was almost 3 weeks old. She reared him to become a healthy cat.
Although he has always lived at home and never had contact with other animals and fellow creatures, he has had two episodes of taeniasis. He has always been fine.
With regard to sociability: “The cat has always lived in symbiosis with me: since the time he has lived at home we have always slept cuddled up to one another, touching or not [MAGNETIZED – desire to be; MAGNETIZED – amel.]. After 8 months there was also a dog at home which has created no problems. Then, as my job has lately become more demanding and I leave home at 7.0 am to come back at 8.0 pm, I have adopted a little cat to keep him company. I thought about it a lot before deciding and towards the end of September she arrived. On October 8th both he and the little female cat suffered from an infection from coccidae (anticoccidae therapy for 10 days.); on February 19th , 40.4 fever with loss of appetite (amoxicillin/clavulanic acid); on 21st nothing has changed and the described tests have been done with suspicion of FIP, with cephalosporins and metoclopramide therapy for problems of nausea; on 27th clindamycin is added to the treatment as a consequence of suspicion of toxoplasmosis given by a cytological test.
During the first days of the presence of the little female cat, he has not shown up on my bed, because he was irritated by the fact that she was there too [IRRITABILITY – taking everything in bad part]. After a while he returned to his old habits.”
His way of acting and reacting:
“He is a lazy cat, touchy (he only protests, but then at once he forgets it) [OFFENDED, easily], very affectionate. He has always been very insistent and has a characteristic way of making himself heard, calling and miaowing to obtain attention (I myself witness an episode of this in my study-room, when tired of staying with me, he calls the mistress in a characteristic way, a real protest) [DICTATORIAL][WEARISOME]. He does not have a cat’s temperament, he seems more like a dog: when I arrive home he receives me lying on his back and has a deep sense of limits, of boundaries: if I leave him in the garden he stops by the fence [DUTY – too much sense of duty]. He loves sleeping in the study wardrobe trying to thread through the boxes of dresses or inside the plastic-bags, as if he needs to feel protected.
He has a strong need for physical contact: as soon as he can he tucks himself in and sucks. The only thing that annoys him is the noise of aluminium paper or when a plastic bag is picked up, then he runs away.” [SENSITIVE – noise, to – crackling of paper, to; FEAR – noise, from]
As regards the general symptoms: “He was (use of past tense, because he has lost his appetite for 15 days and that he has to be fed by force) also rather greedy, in the sense that he ate in a great hurry, in a way I have never seen in a cat [HURRY – eating; while], he preferred fish to meat and between beef and chicken preferred chicken. He loves water very much and jumps into every sink, he plays there, he played there till the moment he was taken ill… he had no loathing for water [WATER – loves; BATHING – amel.].
To fall asleep he “makes pasta” (like kneading with anterior legs) and sucks as if he was 2 months old, especially if I wear a fleece. He loves travelling with us by car and gets into his carrying basket of his own free-will, without any problem.”
Second Step – Layout of the illness-table
We remind ourselves that good Homeopathy method should have four basic characteristics:
1. objectivity, that is the possibility of minimising any kind of interference and prejudice;
2. precision, that is to minimise the interpretation and to be able to assign the symptoms in the correct hierarchical order;
3. simplicity, that is the possibility to being adopted by everyone, regardless of experience, philosophy, religion, etc.;
4. universality, that is every doctor should be able to achieve the same choice on each type of patient.
To fulfil such requirements, it is necessary to adopt these schemes, which are simple, but such simplicity comes from a hard and long work of careful analysis of hundreds of clinical cases. In this Second Passage we begin the review of these schemes.
The Totality of Symptoms collected in the First Passage needs now to be put in order (§ 104). For this purpose we propose the following scheme where symptoms are put in squares (Tabacum 1).
|Modalized symptoms||Ã˜ Mental|
|Auxiliary symptoms||Ã˜ Clinical syndromes|
Ã˜ Symptoms as such
Such subdivision does not represent a novelty, nevertheless some observations are necessary.
Characterologic Symptoms – Analysing carefully what the Master says in §§ 210-211-212-213 of Organon, the Characterologic Symptoms are very important for the confirmation of the cure, but not of its choice. In fact they are not modalized and therefore do not individualize the patient. These are symptoms such as JEALOUSY, TIMIDITY, LOQUACITY, OBSTINATE, DICTATORIAL, AVARICE, AFFECTIONATE, etc. For example, Jealousy belongs to Apis, Hyosciamus, Lachesis, Nux vomica, Pulsatilla and others, but as such do not distinguish these remedies. The symptoms of character are more important, because they prevent the possibility of realization of the patient according to his own original nature (§ 9), expressing in this way his existential suffering, but must be related to the Totality to have the maximum benefit: the remedy confirmation.
Auxiliary Symptoms – These are important above all in the Prognostic Observation according to Kent, and let us not forget that these are the same things that often make us appear clever or less clever in front of the patient as, for him, it is this that is worth treating!
Modalized Symptoms – These symptoms deserve our highest attention during this phase. They are the so called ‘adverb symptoms’, that reply to the famous 7 questions of Boenninghausen, that correspond to the patient’s own vital necessities and are those characteristics of which Hahnemann talks. The Hierarchisation and Repertorization processes base themselves on them and for them the following scheme has been prepared (Tabacum 2), complementary to the scheme in Tabacum 1, in order to fit them in according to their hierarchical degree on two already mentioned levels, psychosomatic and temporal.
According to the Author’s experience, a symptom to be considered is Historical when it is present in more then 2/3 of the patient’s life, while it will be considered Intermediate when it is present in more then 1/3 of the patient’s life. It should be noticed that a Local Historical S. is to be considered more hierarchical than a Present Mental S. and the more symptoms tend to occupy the highest left sector, the more hierarchical they are.
Let’s see how our clinical case proceeds in this Second Passage. Naturally, those signs that, according to the cat nature, do not represent a symptom will not be considered: for example, the desire for fish or “to act like making pasta”, which is an attitude commonly noticed.
Layout of the illness table
– Characterologic s.: dictatorial, irritable, tedious, desires of attention.
– Modalized s.: (in hierarchical order with the value in brackets): eats hurriedly (9), loves playing with water (9), desire of physical contact (9), excessive sense of duty (9), hypersensitive to the crackling of the paper (9), takes everything badly (3), lack of appetite at the sight of food (1) and at the smell of food (1), lack of thirst during fever (1).
– Auxiliary s.: asthenia, fever, lack of appetite, lack of thirst, swollen lymph nodes.
Third Step – Intelligent Repertorization
In § 104 Hahnemann clearly says that we have to “pick out the characteristic symptoms, in order to oppose to these, that is to say, to the whole malady itself, a very similar artificial morbific force, in the shape of a homoeopathically chosen medicinal substance”.
That means that we have to take only the characteristic symptoms and remember that a symptom is characteristic in proportion to its historicity and to its modality.
When we say “intelligent repertorization”, it does not therefore mean that we are clever, but that it comes with respect to Hahnemann suggestions and experience proves that such suggestions can be put in practice with the addition of some simple rules:
to choose from 3 to 5 symptoms between those of modalized group and only in case of absence or lack of those, consider the characterologic ones, that will be essential in the Fourth Passage; this makes it possible that not only polychrest remedies appear;
to choose repertory rubrics that have a minimum of 7 remedies and a maximum of 100, except the presence of a certain symptom, historical, very intense and with individualization for the patient, as for example CHEST – ERUPTIONS – Mammae – itching (4 remedies); this allows us to work with more secure rubrics;
to unify in just one rubric symptoms which can not be clearly differentiated, as for example “GENERALS – CONVULSIONS – epileptic – anger; after” and “GENERALS – CONVULSIONS – vexation; after;” this helps to avoid leaving out remedies among which there could be the one of interest;
to consider in the analysis all the remedies that hold half + 1 of the repertorized symptoms: for example remedies covering 3 symptoms of the 4 or 5 modalized ones, or 2 symptoms of the 3 modalized ones. And only in the case that the remedies are more than 12 in that time it will be considered the score expressed by Repertory; experience has shown that this group of remedies nearly always contains the simillimum and it is on such a group that we will work in the next Passage.
Now come back to our subject.
RADAR Licence 6301
|1||MIND – HURRY – eating; while||38|
|2||MIND – DUTY – too much sense of duty||38|
|3||MIND – SENSITIVE – noise, to – crackling of paper, to||8|
|4||MIND – MAGNETIZED – desire to be||12|
|4||MIND – MAGNETIZED – easily magnetized||7|
It will be noticed as this Repertorization, which observes the cited rules, is composed of 4 symptoms, as the last 2 have been united into one sole rubric of 19 remedies, and shows remedies (not only polychrests) classified for sum of symptoms and in alphabetical order, of which only 4 cover the half + 1 of rubrics.
Fourth Step – Connection with the Materia Medica
Up until this step, if the work has been well done, the MPH does not leave much room for the doctor’s prejudice and now places at our disposal a limited range of remedies from which to choose the simillimum, as Hahnemann wanted.
We have already seen, the Characterologic S. now have a particular importance for the remedy determination, which will be carried out consulting the Materia Medica and reminding ourselves that it should be a great mistake to rely solely on memory, even only for the remedies that we believe we know well.
We will make a comparison with the symptoms listed in Tabacum 1, keeping in mind that, if for the Repertorization we have used only the most hierarchical Modalized S., during this phase we have to find correspondence with the Totality of the Patient. The chosen remedy will be the one that will give us symptoms combined in an harmonious and logical way, allowing us to have a NEW READING of THE TOTALITY, that “of this outwardly reflected picture of the internal essence of the disease”, as Hahnemann says in the § 7, that leads us to reveal the Morbid Constitution of the patient.
In this Passage, it is expressed much more the Art of the doctor who has to investigate the different pathogenetic manifestations in order to identify the same level of imbalance, the same idea, the same pathological dynamism of the patient. The Totality not as a jumble of symptoms, but as an INDIVIDUALITY.
Now come back again to our cat.
Connection with the Materia Medica
The analysis of the 4 remedies proposed by MPH shows Causticum that covers the Totality, while Zincum should be more suitable just for auxiliary symptoms. Particularly, Kent says that the greatest characteristic of Causticum is the despair with fear that justifies the greatest need of sympathy and protection that it has (more of all in MM). Eugenio Candegabe adds: “As the child who has to hold his mother’s hand during the night. Therefore he needs the understanding and attention of others, who never cease to call insistently: he is the typical imploring dictator who loves adulation. In love sufferings and in grief he has two important aetiologies. He bears the contradictions, because he needs others, but he is polemic and contradicts. He is hypersensitive to noises because he fears the environment and his insecurity prevents him from venturing into places different from those he lives in. Water and wet improve it (it is one of the fundamental keynotes of the remedy).”
Causticum personality suits Joy and his way of feeling, acting and reacting very well; besides, the remedy covers auxiliary symptoms as well.
Fifth Step – Addressed Reinterrogatory
In this step, with reference to Materia Medica, the patient is questioned again with regard to the chosen remedy. In fact, even if there were no doubts on the remedy, it is opportune to improve continuously our performances and particularly:
to acquire knowledge of unknown remedies that appear in the repertorization;
to improve the collection of symptoms and the repertorization of the patient;
to confirm or modify the characterologic symptomatology;
to note down the symptoms not covered by the chosen remedy to observe them during the development of the case and verify its presence in other patients who need the same remedy.
Causticum is confirmed for Joy, but the correct symptoms are now “FEAR – noise” (not “SENSITIVE – noise”) and “FEAR – happen”, “FEAR – range” (not MAGNETIZED).
Sixth Step – Diagnosis of Dynamic Level of the patient
Although such subject is not directly treated in classical texts, it is strongly suggested by § 15 of Organon and by the following §§ 176-177-178-179-180-181-182 and also by Lesser Writings of Kent in the chapter The action of drugs as opposed by the Vital Force.
The Vital Energy of the patient can be REACTIVE or WEAK. In the first case we will have a lot of symptoms and intensive ones, in the second, symptoms will be short and less intensive.
The Morbid Constitution of the patient can be COHERENT or INCOHERENT. In the first case we should have hierarchical symptoms that will show clearly a remedy, in the second case symptoms will be less hierarchical and chaotic and will show more remedies.
It is therefore possible to establish for the patient one of the dynamic Levels resulting from the possible four combinations of the characteristics of Vital Energy and Morbid Constitution just described in accordance with the following scheme (Tabacum 3):
Theory of the 4
Level 1 – It will be given to patients with a lot of hierarchical symptoms (biopathographic s.); we have to think of the prescription of simillimum remedy.
Level 2 – It will be given to patients with few hierarchical symptoms (biopathographic s.); we have to think of the prescription of simillimum, but more easily of a similar.
Level 3 – It will be given to patients with a lot of symptoms little hierarchical (S. of the actual state, the last period of life); we have to think of the prescription of a similar. Belong to this Level, logically, even those patients Hypersensitive who will show pathogenetic symptoms to every remedy prescribed to them.
Level 4 – It will be given to patients with little symptoms little hierarchical (S. of the present state, of the current pathology); we have to think of the prescription of a similar but easily of a palliative.
It may be noticed that the numerical progression of Levels immediately shows the state of the patient (better in the 1st and worst in the 4th) and consequently also what will be the Homoeopath engagement to follow it.
The aim of the Level diagnosis, which we remember is given exclusively by the QUALITY and by the QUANTITY of symptoms, is to be able TO FORESEE BEFORE THE PRESCRIPTION what will be the patient evolution through a Dynamic Prognosis that will be described in the next Passage.
Diagnosis of Dynamic Level
We have historical symptoms of Joy (biopathographic) and of a good number for a good diagnosis of remedy: Level 1.
Seventh Step – Dynamic Prognosis
With this procedure, as already mentioned, a forecast of the patient is made in connection with the different aspects that we are now listing.
As regards the Healing Law (Law of Hering):
Level 1 – the prescription of simillimum will promote the Healing Law according to Hering, which stages will depend on the injury state of the patient.
Level 2 – the prescription of a remedy partially similar will make emerge, even with the help of acute elapsing states, other symptoms that will allow us to raise the patient to Level 1 and therefore to prescribe the remedy simillimum. The Healing Law will be observed at the end of the treatment.
Level 3 – the prescription on the actual state will require many attempts before observing the hierarchical symptoms able to lead to simillimum and therefore to the execution of the Healing Law.
Level 4 – the prescription based only on symptoms of the pathology can only be palliative. However it can happen that after many faulty prescriptions some hierarchical symptoms appear to be able to raise the patient to Level 2.
As regards the Aggravation and the Amelioration
The Aggravation (primary effect of the remedy) is a parameter of the Vital Energy and has its variability in the TIME.
The Amelioration (or Reaction, secondary effect of the remedy) depends on the Morbid Constitution and its variability is the SPEED.
With this premise, the forecast will be in accordance with the following scheme (Tabacum 4):
|Level 1||Short or absent agg.||followed by||Fast amel.|
|Level 2||Long agg.||followed by||Fast amel.|
|Level 3||Short agg.||followed by||Slow amel.|
|Level 4||Long agg.||followed by||Slow or absent amel.|
As regards the Acute Illness
When the patient presents a clinical acute table during the therapy, symptoms offer the following important indications.
Level 1 – the acute symptoms show the same remedy already prescribed.
Level 2 – in the prodromic phase and during the acute event symptoms can arise that show the already prescribed remedy, but many more symptoms that will complete the chronic state helping to better explain the image of the patient’s constitutional illness and therefore being able to prescribe simillimum.
Level 3 – the remedy of the acute state will be different from the one prescribed, however during the convalescent stage hierarchical symptoms may emerge which could lead to better subsequent prescriptions.
Level 4 – in these patients the symptoms will change continuously and with them also the remedies.
As regards the New Symptoms
Such symptoms should be distinguished from Discharging S.
Level 1 – the new symptoms show a wrong prescription accompanied by an aggravation of the illness; often they show a suppression.
Level 2 – they can have the same previous meaning, but mostly, accompanied by the few hierarchical symptoms that this Level presents, can also show the simillimum.
Level 3 – on this Level, the appearance of new symptoms can almost be the rule, in consideration of the patient’s hypersensitivity (incoherently reactive) and show the prescription of a similar.
Level 4 – they are the only ones able show a change of remedy whilst awaiting a possible rise in energetic expression of the patient, if this possible.
For Joy we expect to verify everything described about Level 1 except, obviously, the appearance of New Symptoms!
Eighth Step – Judicious Prescription
As regards the Centesimal Scale experience shows as follows:
a) the unique dose is suitable only for patients whose Vitale Energy is fairly reactive;
b) the method in plus, recommended by Hahnemann formerly in the Fifth Edition of Organon, has greater efficacy in avoiding aggravations.
Considering these facts, more than ten years of observations have led to the following scheme prescriptive if compared to the dynamic Level of the patient.
Level 1 – high dynamisation (M-XM) in unique dose or in plus if we consider that, even being reactive, the patient needs more frequent stimuli, also for the presence of organic structures.
Level 2 – media dynamisation (30-200) in plus.
Level 3 – high dynamisation (200-M) in unique dose.
Level 4 – low dynamisation (5-30) in plus.
As regards the Q or LM Scale, Hahnemann’s instruction of the Sixth Edition of Organon (§§ 246-247-248) should be followed, quite apart from the patient dynamic Level with this personal comment: ON THE LEVELS 3 AND 4 IT SHOULD ALWAYS BE USED THE LM SCALE for its characteristics of gentle action, to limit to maximum every possible Aggravation of the patient and for its greatest manoeuvrability in case of wrong prescription.
Causticum LM 1 has been prescribed to Joy, once a day.
The MPH represents the effort of preparation of a synopsis perfectly faithful to Hahnemann doctrine, that gives us the better approximation to the Pure Homeopathy practice, that is free from prejudices, but obviously there is space to improve more.
In my own small way, I believe myself to have contributed to the introduction of the LM Scale in MPH, with the approval of Eugenio and Marcelo Candegabe and of Hugo Carrara, in the book noted in the bibliography.
All this is followed obviously by the Prognostic Observation, another great chapter of the Homoeopathic Clinic of which, probably, we will talk about on another occasion to see how my Argentine Masters explain this moment and how it applies very well to the veterinary clinic as well.
But let’s see what has happened to Joy! Considering the distance that separated us and the seriousness of the patient clinical state, I have asked the cat’s owner, a very diligent person, a primary school teacher, to keep a daily diary of everything observed about the cat from the beginning of the therapy. This is the unabridged text of such diary:
First medication, October 31st, 1 drop: a few minutes after the medication the cat makes an energetic vertical leap (!?!). During the night he begins to suck again and to “make the pasta”; he has several motions of the bowels with dark limp excrement, really a great deal! The following morning he begins to eat spontaneously again even if not abundantly. He asks to go out in the courtyard. He is visibly weak, but shows signs of amelioration.
Second medication: he keeps on getting better, he is more vigorous, but does not eat satisfactorily yet. It seems to me that his temperature has fallen and during the night he goes to eat croquettes.
Third medication: he keeps on getting better. He asks to go out more frequently and during the night miaows insistently as if he was asking something.
Fourth medication, 2 drops: I don’t have enough time to come back before he asks me for food and besides that he does not come under the cover anymore, but stops at the bottom of my bed. The stools are always very abundant and dark. During the morning finally I see him as I remembered him and I can definitely interrupt the wet food I offered him to tempt him.
Fifth medication: the Vet has transmitted to me the PCR FIP test results, negative. Joy has begun to miaow aloud again from the terrace to call me when I am out. He keeps on sleeping at the bottom of my bed coming under the coverlet just before I sleep and when I awake.
Sixth medication: I think that the cat has practically completely recovered, eats heartily and has got into the old habits again
Seventh medication, 3 drops: I think that his usual characteristics are more accentuated, he is more irritable, he calls me more often, asks for more attention, to be petted again and has a great desire to go out. Everything else remains unchanged, that is OK.
Eight medication, November 7th . I have to notice that the pussy-cat is more vigorous than he was before illness. Today he has climbed up a tree and has jumped over 2 metres and half wall high, then he has gone on to the neighbour’s shed and I had to recover him with a ladder for fear he could end up wherever. Never had he pushed on so much!
Thirteenth medication, November 12th, 5 drops: the cat is very well, has a lot of energy and he is also “a little bit nervous”. Two nights ago he attacked a pussy-cat of the neighbourhood that used to come to our courtyard. Tonight, after the remedy, he has attacked a dog, blowing and trying to scratch him. He makes himself respected.
November 20th: tonight he has sneezed twice … He is certainly more independent, He seems to have found his real dimension of cat. He keeps on sleeping on the bottom of my bed.
November 22nd: I have done one of mine. I have put him the phial of Frontline® (anti-parasites) and he has immediately begun to dribble as if he was nauseous. I have immediately washed him with lukewarm water, something that made him euphoric, and everything was immediately over.
November 26th: the pussy-cat is really very fine and is much more in equilibrium. He is less obsessive in asking for attention and is more independent. He lets himself be petted on the sofa while I watch TV, but does not press me too much. Nervousness has disappeared. He no longer sleeps on the bottom of my bed, now he prefers the arm-chair or a chair.
This diary is followed by this letter:
“Dear Dr. Brancalion,
I take the opportunity to thank you and inform you that I am really grateful to you because you have given me back my dear pussy-cat and also have shown me that homeopathy works!
We will come to visit you soon, when our business engagements allow, to show you Joy.
Again, I thank you heartily!
Patrizia Gorizia, November 27th 2004″
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 With the word “precision” we mean the absence of prejudice by the doctor during the patient examination and the following phases of the visit, up to the prescription.
 For “pure” we mean “not polluted” by varied contrivances, therefore “faithful” to the Doctrine.