Homeopathy Tips for 4/14/09 Systems of Prescribing

     Homeopathy is not a new medicinal art. It has been around for more than 200 years. The information that we have available to us today is a compilation of two centuries of dedicated homeopaths sharing their knowledge. This is why homeopathy exists today. Had there not been many successes for the many early pioneers of homeopathy, it surely would have passed away as another fad in medicine. But we have many successes and by sharing them openly have expanded homeopathy thereby insuring its existence.

         Along the way many doctors of medicine have discovered homeopathy and shared their successes with us. I commend them for this. Others have written books with wonderful systems to prescribe by. It is with great reservation that I accept their recommendations.

       Homeopathy is as much art as it is science. We have wonderful information and repertories to organize it. If we are good repertizers we are able to use the repertory to analyze cases including the most important symptoms. This method will help us find remedies, but if left to only strict repertization we will be successful only a small percentage of the time.

        Some doctors have written wonderful books about many different diseases and the remedies to treat them with.  Some have even offered a system of prescribing for these diseases. The protocols tell when to give what medicine and in what potency and order of repetition. I do not agree with this approach as it is allopathic not homeopathic. Remember homeopathy is the reason to give the medicine, not the medicine itself.

       Any system of prescribing that treats the disease and does not address the individual is an allopathic approach. It falls into the same drug mind of western allopathic medicine that one size fits all. This is the antithesis of homeopathy. Hahnemann made it perfectly clear in the Organanon that we are to treat the individual and not the disease.

      The homeopath should never treat with a protocol.  By doing so he is ignoring the vital force. The homeopaths greatest challenge is to understand the vital forces’ expression. It is only this that animates every individual. No two people are the same so no two expressions of disease are the same. When a protocol is offered for the treatment of disease then the individual is not being considered. We are much more than the expression of our disease.

        The success rate of this type of prescribing will be low. Yet I find that many homeopaths, in their desire to systemize homeopathy to make it easier, will gravitate to these systems and use these systems to prescribe. Understand that they are an allopathic approach using “potentized medicines”. I hesitate to call them homeopathic medicines because at this point they are really allopathic.

       There are no systems in homeopathy. This is what frustrates most homeopathic students. Every case is a different expression of a vital force; no two are alike, even if many are similar. The remedy selection, the repetition of dosing and potency selection will be different in every case.  There is no system that will standardize this medicine. Be careful of such systems when they are offered. There might be very useful information about remedies or cases that the author has seen that could be useful in helping you with a case you are working on, but be very careful to never loose sight of your patient and what is asking to be healed. In every case I have seen it has never been a named disease that is asking to be healed. There is always something that is keeping the person from moving forward in their life that is at the root of the physical manifestation of their dis-ease. It is not about the pathology. It is always about the person and their dis-ease.

       When you come across a system that promises to cure specific named diseases be very careful to not slip into the allopathic mindset. It can be easy to do if you focus on the disease. But you will never fall into this trap if you adhere to true homeopathy and prescribe to the person and not to their disease. The only system I recommend is a spiritual one that helps you become more of an unprejudiced observer and learning more Materia Medica.

22 comments so far

  1. harmanpreet on

    sir,
    thanks for guideline-homeopath should not treat with protocol- harmanpreet

  2. Zacarias on

    Dear Sir,
    I am in full aggrement with the guideline.I have
    verified this myself.Protocol treatment is a
    liability to the magical cure by homeopathy.I would say
    your wonderful guideline could be summed up in the
    beautiful phrase you have made “there is always
    something that is keeping the person from moving forward
    in their life that is at the root of the physical
    manifestation of their dis-ease. It is not about the
    pathology. It is always about the person and their
    dis-ease” This dis-ease is the EGO.

    Zacarias

  3. Dr.H.C.Malaker on

    Dr.Robert Field,thank you for your good guidance for treating a patient and not the diease.Our every medicine has some disease,the repertorization is essential.Please clear it what point should taken into consideration first i myself first look on mental and secondly modalities.Regards,malaker

    Hello Dr Malakar,
    I also use good clear mental symptoms before modalities as well. When they can be used in combination with modalities and the main pathology is a theme in the remedy then you really are on to a very good remedy selection.
    Robert Field

  4. Pat on

    While it may be frustrating for a student, especially a new one, to not have an easy “formula” to use to prescribe, the fact that homeopathy is so individualized is the beauty in it. Developing one’s ability to see each person as the unique expression that they truly are is a gift. Learning to move oneself out of the way to do that is even a bigger one!

  5. Maria Margarita Estandia on

    Any person that is like Hipocrates, the father of medicine knows that there are no sicken but sick people, you cant take a sicknes and treat everybody the same that will make Hipocrates die. That is why no there is so much iatrogenic treatments because the doctors are not doctors but tecnitians of medicine taking away the feelings of the people , just because there is a big indutry in medicine and medicines l think many times when you go to a MD you become half ill so he can stay earning money he and the insurance co and the farmacy. Sorry but that is what l think. l think you have to see every pacient individualy.

  6. K. Rajagopala Kurup. on

    I do agree with you.
    If clear mental symptoms are available, on the mental symptom itself, we can get good results. Even modalities does not become an issue at times.

  7. Gerald Field on

    Thanks, Robert, for this clear explanation and reminder. I was about to buy one of those books, and then thought, this isn’t even Hahnemanian.

  8. Dr Mukund Suvagia on

    organon has given clear cut guideline in apho 1 , 3 n 11
    it will b nearlly almost an arrow to proceed ahead

  9. M.Supriya on

    hello dr
    can u suggest me sum books in my treatment i.e to develop my practice skills

    hello Dr Supriya,

    Dr Malaker has quoted below from The Art of Cure by Homeopathy by Herbert Roberts. This might be a good start.

    Robert Field

  10. Dr.H.C.Malaker on

    Only good materia medicas written by dr.Kent,dr.Allen,dr.Nash and Boericke are the best to have knowledge about selection of a remedy to a patient.Dr.Kent’s repertory is a clear guidance but its too hard to study as rubrics some time shows a numerous name of remedy.In my openion the most important pre-requirement for successful homeopathic treatment of all conditions it is better to apply homeopathic remedy according to the principal of similarity (Simila similibus curenter) e.g when pain aggravate and when pain is less severe,if rest aggravates and movement ameolirate in that case we can think simila as it has in Rhustox.Learned doctors of this forum to please expand your hands co-operation and share your clinical technique how you select a remedy to have quick result.Thanks

  11. Dr. Poonam Batra on

    Its very true that each case presents in a unique way and medicine selection is based on the totality of that particular case. Your article is quite appreciating, stressing on the real art of prescribing. Keep up the good work, through your reminders.

  12. Dr.H.C.Malaker on

    The principles and Art of Cure by Homśopathy
    by HERBERT A. ROBERTS, M.D.
    Presented by Médi-T
    CHAPTER XIV
    REMEDY REACTION
    One of the first things required of a homśopathic physician is that his powers of observation shall be highly developed. His powers of discrimination should be very keenly attuned, first, that he may observe the patient in the analysis of the symptoms and the selection of the remedy, and second, that he may have the keen perception of the import of the symptoms after the remedy has been carefully selected and administered. After the administration of the simillimumsome action should result. It is upon the development and interpretation of the action of the remedy, or the reaction of the vital energy to the remedy, that successful prescribing very largely depends.
    What are we to expect after the remedy has been administered? According to Hahnemann, the nearer similar the remedy the more reaction we may expect (Organon, 154, 155). If the exact simillimum is found we are apt to get a slight aggravation before relief comes. On the other hand, if no changes take place, too long patient waiting is useless, for it is evidence that the simillimumhas not been found; but the nearer the symptoms of the patient are to the symptoms of the remedy, the more sure we are to have some reaction. It is for us to determine what the reaction means and to interpret it in prognostic terms. We must be able to listen to the patient’s report and from it and our powers of observation to determine what the remedy is doing. We know that when the remedy acts the symptoms will change, in either character or degree. There may be a disappearance of the symptoms, amelioration of the symptoms or increase of the symptoms, and these changes are the manifest action of the remedy on the vital energy or vital force; and it is these manifestations we must study.
    Among the most common reactions after the remedy has been administered is aggravation or amelioration. Now there are two types of aggravations, either of which may be manifest. There is the aggravation which is an aggravation of the disease condition, in which the patient grows worse. There may be a very different type of aggravation, in which the symptoms are worse, but the patient is growing better. He will say, “I feel better, Doctor, but such-and-such symptoms are worse.” The aggravation from the diseased state is an indication that the patient is growing weaker, and therefore the diseased state is growing stronger while his vital energy is ebbing. On the other hand, the aggravation of the symptoms while the patient reports himself as feeling better is an indication that his vital force is being set in order, but individual symptoms may show aggravation.
    We must also observe how the aggravation or amelioration occurs and the duration of these periods. In this connection we must always bear in mind that is the patient’s welfare we are seeking, and it is for us to determine whether he is improving or declining. Sometimes he will say that he is weaker, yet on analysis of the symptoms you will find this is not true. The story of the symptoms is often of greater importance than the patient’s opinion. After we have assured him of the amelioration of his condition and called his attention to the particular instances of improvement, he will better immediately.
    The aggravation when the patient is growing actually weaker is a sure indication that the symptoms are taking on a more internal phase and the vital organs are more affected. In other words, it is an illustration of the reversal of the order of cure. In these states the patient may sometimes declare himself better, because of the absence of some trying symptoms, yet the careful homśopathic observer will know he is worse because the natural course of cure is reversed and the disease condition is attacking more vital parts. By these differentiations we know whether the patient is progressing or retrogressing. In many of these cases there is corroboration between the patient and the symptoms in the mind of the patient himself; and just in so far as there is this corroboration, the truth of his observations is valuable. We should find whether the symptoms are tending toward the exterior and away from the inner parts. In other words we should know whether there is a peripheral tendency, or a tendency in the reverse order.
    The aggravation of the diseased state may come from an incurable state which is stirred to its foundations by the potentized remedy, and unless the remedy is counteracted the disease will become worse and more rapidly approach a fatal termination. In borderline cases, cases bordering on fatal termination, the use of extremely high potencies may react on the vital energy so deeply as to cause an aggravation of the disease, whereas a more moderate potency (say the 30th or 200th) would not give such dangerously powerful effects. However, no fatal aggravation will occur unless it is already foreshadowed by the symptoms manifest in the patient. The potentized remedy will never produce a fatal aggravation, or a destructive aggravation, that would not have been possible and even probable from the symptomatology; but it may, and often does, when used without discretion, speed the case to a fatal termination. In other words, a single dose of the high potency will not produce disease conditions; it has the power to develop conditions that are already present if it is used carelessly or ignorantly. More careful study might reveal the indications for a less deeply acting remedy, which when administered would greatly mitigate much of the fatal suffering.
    You must remember that we are warned in the Organon to discern what is curative in medicine, and also what is curable in disease. This point cannot be too greatly stressed: that in profound states we must be very careful not to stir the vital energy to its depths. There should be more time allowed for attempt at a gradual restoration, as there has likewise been a gradual decline. Very often less deeply acting remedies will react and palliate incurable diseases because they act more superficially. They act upon the sensorium and do not act upon the deep recesses of the vital force itself, and yet make the patient much more comfortable by relieving the symptoms annoying through the sensorium.
    We can know, then, whether changes are occurring from the depths of the vital force or whether the patient may recover. The direction taken by the symptoms is the sure indication.
    In this connection, the first observations is often a prolonged aggravation and a final decline of the patient. Now just what has happened? Possibly there has been too deep an antipsoric administered and it has set in motion the vital energy and developed a destructive process. In these profound states of incurables the vital reaction toward cure is impossible and we can be assured that it is an incurable case. In such cases as these profound incurable conditions we should avoid giving a high potency we may be able to go on and develop the case gradually until later it may possibly react favorably to a higher potency. This is well illustrated in advanced cases of tuberculosis, where it is never safe to give a very high attenuation of the exact simillimum. It is probably wiser not to use an antipsoric in these conditions. However, this applies only to those who are profoundly ill with chronic troubles.
    In cases where there is not so profound a disturbance, after the remedy has been administered, the aggravation may be long and severe, yet the final reaction and amelioration comes. Sometimes in these states the aggravation may even last for weeks, yet improvement in general is continually taking place and then comes the amelioration and slow but sure recovery, so that the second observation would be a long aggravation but final although slow improvement.
    In these borderline cases there has already been established some marked organic changes, and where pathological changes have actually taken place the period of aggravation will be longer, but the general improvement in health in the curable cases will be manifest.
    Then there is another reaction, where the aggravation is quick and short and strong, with rapid improvement of the patient. When you find such a reaction to the remedy you will always find rapid improvement. The reaction is vigorous and there has been structural changes they have been of a superficial nature and near the surface and not of the vital parts, such manifestations as furunculosis or abscess formations on the surface. These are surface changes and are not comparable to the effects of the changes in the deeper organs, like the kidneys, the heart, or the brain.
    It is well to take note of the difference between organs changes that take place in the vital organs that sustain the economy, which we cannot do without, and those that take place in less vital parts of the body and are not vital to life itself.
    An aggravation that is quick, short, and strong is to be desired, because we know that improvement will be rapid.
    Again, there is another class of indications where we find no aggravation whatsoever. There is no organic change: there is no tendency to organic disease. The chronic condition causing disturbances to which the remedy is applicable is not of very great depth, it belongs to the functional conditions, exhibiting its effects in the nervous manifestations and the relations of the patient to his surroundings and to tissue changes. There are changes in the vital force that are so profound as to cause many symptoms that are very trying to the patient and yet so slight that with all the instruments of precision we do not observe any pathological changes. It is in these conditions that we sometimes get considerable suffering, yet cures will come without any aggravation. In these cases the single remedy in a moderate potency (say the 200th) will probably complete the work. In such cases we know the potency and the remedy are correct.
    Then we have some cases with amelioration coming first and aggravation coming afterward. This amelioration comes on to last usually for three or four days; the patient seems to be better but at the end of a week or ten days all the symptoms are worse than when he first came to you. These are usually cases that have a great many symptoms. We find that, in spite of what we thought at first was a favorable reaction, the ultimate condition is unfavorable. Either we selected too superficial a remedy, that could act only as a palliative, or the case is incurable and the remedy has been somewhat similar but not completely so. In order to determine the cause of the reaction we must examine the patient and find out whether the symptoms related to the remedy or to the disease. Sometimes you will find the remedy was in error. You will find usually in these cases that the remedy was similar to the most pronounced symptoms but it did not cover the whole case, and therefore did not strike at the constitutional state of the patient. Here in evaluating the symptoms we missed the essential concomitants, and we based our prescription on the generals only. It may be that we have an incurable patient. It will be fortunate for such cases if the symptoms come back exactly as they were when you first saw the case, but the symptoms often come back changed. Then we must wait, and this will require patience on the part of the physician and cooperation on the part of the patient. It may be necessary to take the patient into your confidence, if he evinces sufficient intelligence to warrant it.
    The higher potencies will set in motion in the vital force curative functions which will act a long time, because often times in these chronic conditions it takes a long time to establish order, and the vital energy takes its own time to cure. During this process no medicine should be given.
    In cases that are proceeding to a perfect cure, if the improvement continues for some time and then suddenly comes to a halt, find out if the patient has been doing something that is against the rules of health or has interfered with the continuation of the curative action of the remedy. This will often be found to be the cause of too short a period of relief from the symptoms.
    In the third observation you will remember there was a quick aggravation followed by a long amelioration. Note the difference here. You have just considered the amelioration, that was of too short duration. In instances where you have an aggravation immediately after the administration of the remedy, and then a quick rebound, you never see too short amelioration of the remedy. If there is a quick rebound, the amelioration should last. If it does not last, it is because of some condition that interferes with the action of the remedy. It may be something that the patient is doing entirely unconsciously, or it may be something that he is doing deliberately and intentionally. A quick rebound means everything to the case. It means that the remedy is well chosen, that it covers the condition of the vital economy; and if everything goes without interference, it will bring ultimate recovery.
    There is this to remember: some remedies have an aggravation immediately after administration, and some have a sharp aggravation some little time after administration. For instance, Phosphorus may have a sharp aggravation, but it rarely occurs under twenty-four hours after administration, and it may be forty-eight hours or longer, and it may last for some little time.
    A word about the acute cases in conditions where you get a quick rebound and amelioration lasting for a few hours, only to have another aggravation, when the action of the remedy on the vital force is exhausted. The action of the remedy is much more quickly exhausted in the rapid pace of acute diseases than in the more moderate progress of chronic manifestations, and more frequent repetitions of the remedy may be demanded. The most satisfactory amelioration in acute cases is where amelioration comes gradually and takes an hour or two after the administration of the remedy before it is markedly manifest.
    If amelioration is too short in chronic diseases it means that structural changes are taking place and have destroyed or threatened to destroy the proper functions of the patient. It takes close observation to discern these changes from the reaction of the remedy. However, one may acquire much help from careful observation of these indications in detecting the course and progress of the case.
    Once in a great while you will find a full period of amelioration of the symptoms, yet no special relief of the patient. This you will encounter in cases where you have structural changes, where the patient will improve on the remedy for some time and then improvement will cease. They can improve only to a certain point, and then improvement can go no further. We meet these conditions where organs like the liver or kidneys are partially involved and can function only in part. The remedy may keep the patient comfortable, however; and by careful repetitions of the remedy at infrequent intervals the patient may be kept comfortable for a considerable period of time even though you will not be justified in expecting a cure.
    There is another reaction that we find in some patients, and that is purely hysterical. They seem to prove any remedy you may give them and get an aggravation from it. This may be because of an idiosyncrasy for the remedy or because of too sensitive reaction of the vital energy. It may be almost impossible to do anything with them in a curative way, but it may be of inestimable help in proving a remedy. Before a remedy is used the constitutional condition of the patient should be very carefully noted. Write down the peculiarities of the patient in as much detail as possible, and then these observations should be deducted from the proving.
    In a case where the symptoms found by careful questioning seem to be entirely adequate to cover the case and to warrant a good selection of the simillimum, we may note a reaction where a great number of symptoms appear after the administration of the remedy. If these are a return of former symptoms that have been forgotten, it is an indication that we are on the right road to recover and it is a truly homśopathic action. Old symptoms reappearing we know to be a step in the right direction of cure: CURE TAKES PLACE FROM WITHIN OUTWARD, FROM ABOVE DOWNWARD, FROM THE IMPORTANT ORGANS TO THE LESS IMPORTANT ORGANS; AND SYMPTOMS DISAPPEAR IN THE REVERSE ORDER OF THEIR APPEARANCE.
    If, however, these are actually a number of new symptoms, it is an unfavorable sign. Old symptoms reappearing are a step in the right direction, as we know; therefore a group of entirely new symptoms appearing after the administration of a remedy is evidence that we have made a decided step in the wrong direction. We have probably mixed the case.
    We occasionally find another class of reactions after the administration of the remedy. In these cases, too, we find the appearance of new symptoms after the administration of the remedy, but in the first place these cases offered few symptoms for an adequate prescription. It is usually possible to get a complete symptomatic picture of the case if we take the necessary amount of care in taking the case, but we do occasionally meet cases where there is little presented in the way of symptoms, or the symptoms presented have little in the way of modifications as to modalities and concomitants upon which to base a satisfactory analysis of the case. Hahnemann deals with such cases in the Organon, Paragraphs 172-82. In these conditions where even the most careful case-taking fails to reveal an adequate basis for prescription of the simillimum, we may yet find that if the few symptoms are sufficiently well marked a remedy may be selected which will either eliminate the marked symptoms found in the first consideration of the case, with consequent general improvement, or there will be a development of more symptoms.
    If there has been a general improvement, the first remedy was homśopathic to the case, and not alone to the few symptoms presented on our first consideration. In the second instance, the first remedy was probably one of a group of similars, and it has served to bring to light the other formerly hidden symptoms which were a definite part of the case. It has unfolded the case to us. In this instance, then, the closely related remedies to the one first administered will probably contain among them the simillimum which will be the remedy to cover and assist most in curing the complete case.
    Even in these observations we must be very careful to consider whether we have administered a similar remedy that has unfolded the case to us, or whether our selection has been so far from the similar that we have merely mixed the case.
    Diseased states are progressive, ever developing deeper and deeper manifestations. Disease is destruction; cure is constructive development. Cure is always centrifugal, as growth is always centrifugal.
    By careful observation of the symptoms before selecting the remedy and by careful observation of the reaction after the administration of the remedy, we may have the assurance that comes from intelligent comprehension of our work, and we can know when we are making satisfactory progress in each individual case.
    What is the most necessary attribute of the homśopathic physician? (Answer: His sense of perception).
    What are we to expect after the administration of the remedy?
    What are the most common reactions (Answer: ).
    What do we infer when the patient feels better, but the symptoms are ?
    When there is actual aggravation of the diseased state, after the administration of the simillimum, what is our prognosis?
    Does the homśopathic remedy ever produce a fatal aggravation, if there has been no such indication present before?
    When actual aggravation of a diseased state gives a prognosis of a deep-acting disease after a deep-acting remedy has been administered what can we do to help the patient? (Answer: Sometimes a complementary remedy, of less depth of action, will actually assist the patient to a place where cure may be carried out by the deep-acting simillimum; or it would surely palliate the dangerous and distressing symptoms if no cure were possible).
    What is the sure guide for our prognosis?
    What is the most desirable reaction after administration of the remedy? (Answer: A short, quick, strong aggravation, with closely following amelioration and recession of the symptoms in the order of cure).
    What do we infer when we find first a strong amelioration, then < ?
    In case seemingly proceeding to a perfect cure, when amelioration comes suddenly to a halt, what is our next step? (Answer: Find out if the patient is doing something to interfere with the action of the remedy, or if it is just a cycle of the disease symptoms).
    What is the difference between an aggravation occurring immediately after the administration of the remedy, and one occurring two or three days after its administration?
    If we find too short an amelioration after administration of the remedy in chronic disease, what is our prognosis?
    What do we infer from the patient who seems to prove any remedy that may be given him?
    If many symptoms appear after the administration of the remedy, what must we consider?
    How do you know that the remedy has acted? What is the first indication of it?
    What is the prognosis of the aggravation of the symptoms?
    What is the prognosis of the amelioration of the symptoms but the patient does not feel as well?
    Can you always depend upon what the patient says?
    In case of aggravation, and the patient is actually growing weaker, what does this indicate?
    When the patient feels better, but is growing weaker, what does this indicate? (Answer: Reversal of the order of cure, symptoms are taking on a deeper form, although there may be actual amelioration of the more noticeable symptoms).
    Why do we have to observe closely the natural course of cure, after the remedy has been administered?
    Does this take precedence over what the patient tells us of the opinion he holds as to his improvement or less in condition? Why?

  13. Dr.Sarfaraz on

    This is very important and basic concept in the homeopathy.Very comprehensive message has been conveyed in this lecture.I liked it very much and sending to my homeopah friends.Thanks a lot.

  14. Dr.H.C.Malaker on

    Thanks Dr.Robert Field for your active co-operation regarding my thread posted above.The thread will surely help to develop the skills of new comer in homeopathy.Regards,malaker

  15. dr naseer on

    resoect robert

    very interesting topic for daily practice.

    homoeoapathic art and science. science is mechincal
    ]’
    methods which called repertory arts methods is case
    taking according to the symptoms of repertory similar
    of the patient and medicine. arts methos is depends
    great experience of practice with homoeoapthic materia
    medica and repertory.

  16. Dr.H.C.Malaker on

    Dear Dr.Robert Field,in continuation of my previous request kindly make a tips for cervical and lumber spondylosis.Other doctors of this forum should think over the matter.Expecting an early action.Regards,drmalaker

  17. MAIMOONA BANGASH on

    dr. robert thank you verymcuh for your benificial informative knolwge of homeopathy. as you know everybocy is taking advantage from your discussion and pay tritribute to you, including all members who are sharing informative knowledge in the filed of homeopathy.
    maimoona

  18. ginni on

    Thank you Dr. Malaker for your time and and energy in entering such comprehensive and precise information helpful and revisionary to all of us.

  19. mah-jabeen on

    thanks , this information

  20. rakesh on

    I want to know which potency is high 30CH or 200ch or Q —- and which is to be given.

    rakesh

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