The evolution of homeopathic practice

Each homeopathic practitioner has his or her own individualistic approach of understanding cases. This individuality in practitioners is a true testament to the individuality of our science.

Some homeopaths commit to their memory remedy keynotes from Guernsey or Allen. Some focus on the concepts of generalization and general symptoms like from Boenninghausen, Boger and Phatak. Also, many practice by example of Boger, Kent and Hering, where they study through comparisons based on symptomatology. There is also study by Repertory - Kent and Phatak for example. Finally, there is the study of cases by classification into different groups, such as Plant, Animal or Mineral kingdoms.

Most recently, we are adopting a synergistic approach to studying cases, which means that we study the case from three different perspectives:

1. Symptoms
2. System and Source (kingdom and subkingdom)
3. Genius (general traits, pace, modalities and nature)

Symptoms include the traditional use of rubrics, keynotes, characteristics, and clinical symptoms. The System includes the newer approaches such as kingdom, sensation and miasm. Finally, the Genius is the common strain or character that runs through every aspect of the case. When looking at these three sides, matching the qualities of the patient to the remedy must always be in the backdrop.

To best understand the nuances of each case, one must study it from all angles and aspects. The goal is to integrate the older and more traditional ways of studying cases with the newer and more contemporary approach in order to get an all-encompassing view.

Looking at a case from many perspectives, you come to a place where everything speaks a similar language. You can then be sure of your knowledge and confidently apply that understanding to the patients.

In the following article, we will study cases from both the old and new perspectives. We will see three cases using the traditional approaches in homeopathy and three cases illustrating the modern concepts, both yielding positive results.

Cases using traditional approaches in homeopathy

Case 1

This is a case of a nine-year-old child. He came with a paroxysmal cough, which had lasted for the past four months. I had given him Drosera, Cuprum metallicum, and several other remedies, but they did not benefit him. You may ask, what can a homeopath do when the indicated remedy fails? In my understanding, s/he has to look at the case again and prescribe!

This is what I had been taught: When the indicated remedy fails, it was not indicated! Find the correct one and it will work.

In college, I was not told: “When the indicated remedy fails give Tuberculinum or give Sulphur.” They did not advocate these escape routes! As students, we were told: “Break your head like a coconut and the case will open up!” So, this is what we do.

I called the child to the clinic again one day around 8:30 pm, after I had finished my practice and made him sit down. I told him that he was not moving from this spot until I found the remedy. I observed him for forty minutes, and then I suddenly noticed a very strange thing. The child was coughing in a very peculiar manner. He would hold the side of his chair, and every time he coughed, his knees would go up and his head would go down. I opened the COUGH chapter in Kent’s Repertory, in search for this peculiar symptom. I read from the first to the last page of that chapter because I did not know where to look for it! It was not until the last page that I found the rubric:

• Cough, violent, spasmodic jerking of the head forward and knees upward

The remedy that was mentioned under this rubric was Theridion.

I was not very sure about Theridion, so I asked his mother whether he always coughed like that. She told me: “Always. Even when he is lying down in his bed on his side, his body just comes together during the cough, he doubles up and it has been like this since the beginning.”

When the mother was telling me all this, her voice was quite loud, and the child said to her: “Keep quiet mother, I am getting a vomiting sensation.”

I looked up this second symptom in Kent’s Repertory:

• Nausea, noise, from

There were only two remedies listed in this rubric: Cocculus and Theridion, both in italics.

I now had the courage to give Theridion 200 because it covered the main general modality of the case, and that was “Aggravation from noise – tremendous sensitivity to noise, so much that it causes nausea.”

Theridion cured the child within twenty-four hours. I observed the child for six years after this prescription and there was no more cough.

Case 2 

This is a case where observation helped me greatly in prescribing. It was the case of a twenty four-year-old unmarried girl who worked as a research scientist in a research institute.

She presented with chronic cough. During the case, I observed that her hands were very restless. Along with this, she would glance from side to side to see if anyone else was in the room. Even though she gave a lot of physical complaints, when I investigated her mind, she would become silent and again glanced around, saying very little and answering “No” to most questions.

This whole attitude – secretive, glancing from side to side with restless hands – was noticeably peculiar and gave me the idea that she was behaving as if she was a criminal.

The rubrics I used included:

• Restless hands
• Answers in monosyllables
• Delusion, she has committed a crime

From this simple repertorization I came to the remedy Kalium bromatum. There is another rubric that is covered by this remedy too: Delusion, thieves, accused of robbing.

Then, out of curiosity, I asked her: “Why are you so scared. What have you done that is making you so worried?” She was taken aback by this question and told me how she was in love with a scientist from the same institution and this was not approved of by their parents, so they had to keep it all a secret.

For me, this was surprising because both individuals were independent and could have just announced they were going to get married, but she felt as though she was committing a crime and that others would find out.

I gave her Kalium bromatum. She did very well on the medicine and ultimately got married to that man!

My observation was confirmed when I asked what her interests and hobbies were. She liked to knit and play the sitar, which involved the use of her hands. She liked to keep busy mentally and physically, especially her hands.

In this case, using detailed and accurate observations helped me to understand the state of mind of the patient. For example, if you see a restless child, you must ask what kind of restlessness is there. Does he want to change place? Is it the restlessness of constantly touching things or changing occupation? Is it restlessness of a kind in which he wants to be carried about? What feeling could lie behind his restlessness? Such accurate and sensitive observation is the sign of a good homeopath.

Case 3

This was a case of a patient who was admitted to a homeopathic hospital with very severe pains in her abdomen. The consulting surgeon diagnosed an ulcer and advised surgery.

When I saw the patient, she was lying on her abdomen and said that this was the only comfortable position for her. When I asked her the effect of hot and cold drinks, she said that cold drinks suited her a lot. She continued to say that when she drank something cold, she could feel the coldness going down through her esophagus and then into the stomach, which felt very cold. The whole process of drinking cold drinks gave her some relief. I was struck by this description and opened the repertory to miraculously find the rubrics:

• Stomach, coldness internal, as if ice water were rising and descending through a cylindrical tube
• Stomach pain, lying on abdomen ameliorates.

The remedy which emerged prominently from this repertorization was Elaps. There was a very dramatic relief of her pains with this remedy.

Cases using modern approaches in homeopathy

Case 1

This was a case of a man who had mild hypertension and lots of fear. He told me that he had a great fear of leaving the house: “I have to travel in my profession a lot. I am afraid of travelling by plane, I feel that someone has planted a bomb in the plane.”

While describing these thoughts, his expression appeared to be one of terror. His eyebrows remained raised and his eyes were wide.

I asked him if there were any physical complaints along with this and he mentioned.

Patient (P): “I get gas and hyperacidity and palpitation. It starts with the anxiety of catching a flight. I feel it when I am packing my things to travel. The pressure builds up. Suppose the plane vibrates due to bad weather, again the anxiety starts. It is not possible to relax and enjoy. If I start thinking, my blood pressure shoots up. I have a fear that something will happen. Suppose the pain starts, what will happen to me? Suddenly my heart starts pumping. What will happen now? Driving the car, do I stop it in the middle of the road and run to a telephone. What should I do? I keep brooding all the time and cannot make any progress. I am very fast in my work. I finish things quickly in the office.

I asked if he had any other fears and he explained.

P: “I liked my mother's milk too much as a child. In order to get me off my mother's milk, my parents told me there was a ghost in the attic. They said, ‘If you continue to demand your mother's milk the ghost will get you.’ Since that time I have had fear of ghosts. Then when I was between the ages of eight to ten-years-old, I had a severe poisonous snake bite. I asked if I would die but they took me to an Ayurveda hospital and I got over it. At age twenty-four, I had a jaundice attack. Years back, I was in England and instead of getting rest I got the feeling of ants all over my head and my blood pressure shot up. I had severe palpitations. I was sure something would happen. I went to the doctor and wrote down exactly what was happening to me. He asked if I had taken any homeopathic treatment. I said ‘no’ and he said he would treat me. The doctor gave me many investigations and all the tests were normal. He gave me treatment and my pressure became normal. But this problem has been since the past twelve years.”

I asked him to tell more.

P: “I had once gone to Singapore and I was sitting on a plane. We were continuously drinking. The next morning, I had the same problem. The doctor told me to keep some medicine when I travel. After that, I stopped drinking for three months. Then, I started having professional problems. I felt a wrong had been done to me. That hurt my ego enormously and I felt the insult socially, I felt degraded. I felt it was the end of the world and I would not be able to travel and no one would respect me. I recited and chanted God's name all the time. That was the only thing that I could do. I carry my prayer books and medicines with me all over the world. I feel secure only when I have all these things with me.”

He further explained.

P: “Most of the fears on the intake form are applicable to me. The thought that I am growing old and I could not travel, since much is scary to me. I am especially afraid that something will happen to me when I am traveling away from home. This is when I seek the safety of my medicines or my prayer books. This is very important.”

I asked him about his dreams

P: “I dreamt I was taken to the gallows and hanged. I was terrified in this dream. It really works on my mind. Then, I also have dreams about snakes. I had a dream of four or five yellow big snakes biting a boy, and then, I heard the news that my daughter was dead.”

Understanding the case

This is a case of a man with sudden episodes of high blood pressure and panic. Something happens and his reaction is immediate and too intense. He narrates the story of being at his mother's breast and the terror of the ghost coming to get him. It is as if he is still reacting to episodes in his life with this same intensity of panic, like a child. At these times, he suddenly calls for help. He calls the homeopath for medicine and chants the name of God. He is easily reassured. In between times, he does not contact the practitioner. All is fine. This is the pace of the acute miasm.

His dreams are of him being taken to the gallows and of snakes, with the same feeling of terror. This is the sensation of the Solanaceae family.

The basic quality of a plant is sensitivity. It is a living organism rooted in the soil. To survive, it needs to be sensitive to changes in the external environment and also must be capable of adapting and reacting accordingly to these changes.

In the human being, the Plant experience is that of sensitivity. They are affected by many things and must adapt and adjust to them. Throughout this person’s interests, stressful situations, relations, and nature, we can see that there is the same Sensation and reaction.

Prescription: Belladonna 1M

Follow-up three months later: “The next morning after the remedy, I felt like I was in the Garden of Eden. My head and ears felt red-hot. I felt as if the blood pressure was too high. I telephoned and you told me to come in and the BP was fine. After that, I never needed to check my BP. I felt a feeling of well being and no fear of anything happening. These fears disappeared slowly. Now, if there is a tension at work, I still wonder if I can take the load, but then it passes. Now, my responsibility has increased and I am traveling to new places. Physically, the pains on waking have disappeared.”

I asked him about his dreams: “Now, I have all pleasant dreams and no more fearful ones. No dreams of being taken to the gallows.”

This case has been followed for ten years, though sporadically. He no longer has panic attacks and his blood pressure is not a problem.

Case 2

This is a case of a forty-six-year-old woman who came with joint pains and asthma. After she told about her physical complaints in great detail, I asked about her fears.

Patient: “I am scared of the dark. When in the dark, I feel two hands coming from behind me to grab me. I do not go into a dark room; I send my children before me to switch on the lights. If I see any little reflection in the night, I feel someone is coming to grab me, to kill me. If I am alone at home with my servant, I feel ‘now he is coming to grab me.’ Wherever I am sitting, I can only think of my death.”

I asked her to tell more about this fear

P: “I had gone to secure a transfer for my daughter to a college in Bombay. The man handling it told me that it won't be possible. That night, I dreamt that I killed both of the men in charge.”

This was the point where I asked about dreams

P: “I always see somebody doing something bad to me in my dreams, but if you were to actually see it I am doing something bad to them. If somebody is sitting next to me, I may be talking nicely to her but inside of me I am thinking that I am better than her. I feel ‘what was there in her?’ I was just talking to her nicely and putting her up.

“I am different outside and different inside. That is the reason I do a religious chant, and even while chanting, I am thinking something bad. I am really weird. On the outside, I look very saintly. I think that there must be no one as saintly as me. I give people religious lectures. Inside, I don't believe in God myself!”

I asked her to tell more about her dreams.

P: “I was the richest woman in the world, living in my own beautiful, big house and able to do whatever I wanted to. But if anyone gave me misery, I had people around me who could do what I wanted him or her to. When you become big you have a lot of enemies around you. I thought that I was the biggest person, so I must have enemies.”

I asked her to tell about her nature.

P: “That bullying nature is still there in me. I want to show everyone that ‘yes I am really big! I am better than you!’

“I feel that there is somebody talking constantly inside. Whether I am occupied or not, I see those two people talking, constantly talking. Whenever I am cooking, I can see these two people; one says to do one thing, the other says not to do it. I can constantly see these two people talking within me.”

Understanding the case

In the Animal kingdom, there are issue of survival, competition, victim aggressor, sexuality and attractiveness, hierarchy (superior and inferior, high and low), a split within themselves (an animal side and the human side), deceitfulness, maliciousness, and jealousy. The human being who needs an Animal remedy will have all of these issues. Among the animal remedies, different groups and classes will each have their own characteristics.

In humans, we can see the reptile expression in the form of camouflage, where these individuals remain hidden and employ devious tactics to go unnoticed. Suddenly, they will spring into action or change their behavior. There is a constant feeling that they are at a disadvantage, and potential for extreme violence follows. Snake remedies, when compared to other animal groups, are especially jealous, deceitful, silently malicious, and garrulous.

The main feeling of this case was the fear that someone would kill her from behind; the danger was from behind. In Reptile remedies, this idea mimics the hidden tactics and camouflage, followed by a lunge and attack in the snakes. The other features of duality, loquacity, jealousy, and deceitfulness are common to all Snake remedies, not only Lachesis.

I selected the following rubrics:

• Delusion, people sees, behind him someone is
• Thoughts of death when alone
• Dreams of murder

Prescription: Crotalus cascavella 200C and with this, her asthma and her joint pains improved. Her overall mental state, suspiciousness, jealousy, and fears of the dark and of being killed also improved remarkably.

Case 3

This is a case of a man with fibromyalgia. He also came with recurrent cold and cough that he gets three to four times a day, and for which he had to take antibiotics (Augmentin 1000 for fifteen days). He is only better when he is taking the antibiotics. Occasionally with this condition, he also gets breathlessness. In his history, he reports that he has been operated for sinusitis. His blood tests reveal that he is deficient in Vitamin B12 and Vitamin D.

Patient: “My feet are not able to take my weight. I have a disturbed sleep; I am tired throughout the day and feel very sleepy. I am the head of marketing and for the past one to two years, I feel a loss of confidence. I feel breathless and need to take a rest. I am also losing hair for the past fifteen years or so. I have had dandruff for a long time; someone has even said it is psoriasis.

“I have two kids. A younger daughter, who if I carry her, I feel I will drop her. I cannot hold her properly. I use to be very short tempered and now I am too irritable. I shake when I am angry and feel I will fall down.

“There is constant burning sensation in my eyes even after a good sleep. I have cramps in my legs, especially when going to bed, and my legs are in a lot of pain. I get tired very soon. When talking, I am feeling very tired and breathless.

“My weight is stable at 74-76 kilos for the past three to four years. Every part of my body is shrinking, my bones are shrinking; my entire body is shrinking. I get pain not only in my legs but also in the lower back when sleeping or when walking for long periods of time. I have flat feet. I am getting pain all over my body.

“My job is OK, not that much stress. I don’t travel a lot, my life style is good, but my food habits are bad. I also get acidity which is troubling me a lot. There is problem in my stomach.  The acidity is affecting my throat. I have observed that when my stomach is not well, then it disturbs my throat and my sinuses get infected.”

After he narrated his complaints, I asked what was the effect of these problems on him.

P: “I am not able to concentrate on my job. I need to think a lot, I need to communicate, and I want to be an innovator. I am not able to concentrate at present; no one is raising a doubt but it is breaking my confidence. I feel I will not be able to survive.

“For any product to be launched you need innovation. It’s a new experience in life for everybody, something that is nonexistent in the world has come up. You need to be very well-versed with the requirements of the customers. One needs to be fresh, confident, concentrated and thoughtful, thinking about something that is to be newly launched.

“I take care of advertising the brand, communication, and thinking. I am not confident. I feel breathless, my saliva has become thin, so I have to spit when talking, my speech does not flowing naturally; I have to put 110% in that. I had to give a presentation, but I couldn’t speak for five minutes, it was the worst presentation of my life. I felt guilty towards the company and the brand, everyone was looking at me. I felt like, ‘what will they be thinking? What a joker he is, he is not capable of presenting a brand!’ I just wanted to vanish and not be visible to anyone.”

I asked him how he experienced this situation.

P: “I was shaking, I wanted someone to take me out physically, I was psychologically broken for five or ten minutes. I was not able to speak, I lost my confidence. What a fool I am!

“I was just not able to look at myself in the mirror, not able to convince myself that I will be good. These days, I have to be in front of a crowd much more often than in the past.

“I feel discomfort when talking, I feel I need to have proper oxygen. Initially, when I started to talk to you, I was feeling breathless but now I am a little more relaxed.

“I need a deep breath when talking, more when starting to talk and better after twenty minutes. I feel a dryness in my mouth. I spit while I am talking. What will others think about me during the presentation? Everyone will be laughing, feeling that ‘he is not capable of taking responsibility’. You need to take a deep breath.

“My voice gets affected, I am not comfortable, I lose control of my speech, and the words are not right. When this happens, you feel you have not done well, you feel uncertain about the future, like you are hopeless.

“There is always this fear of failure crossing my mind; the feeling that I may have to give up due to my health. What will become of my family, of myself? I believe I am very intelligent but now I tend towards the extreme point of hopeless.”

I asked him what else was bothering him.

P: “In 1993, I suffered from typhoid. After this episode, I started feeling weakness and abdominal pain; I felt a lump in the right side of my abdomen after eating food. When I passed stools, the lump got better. It was like a spasm, a cramp-like colic. I could not lie down during the pain and I had to sit bent forward and apply slight light pressure. Then, I underwent diagnostic surgery, but no diagnosis could be made; they removed my appendix but the pain persisted. I took ayurvedic treatment for this and my motions became very clear whereas previously they were very hard and irregular. The right side of my abdomen was more distended after eating, with bloating and gas formation; after a while it slowly decreases. I become restless with the pain, needing to stand up or down in order to relax. Pressing slightly on my abdomen helps to relieve the pain by passing a little wind.”

After understanding this problem fully, I asked him about his dreams.

P: “I don’t get many dreams as my sleep is disturbed. For the past six to twelve months, my energy is very low and I always feel very sleepy. I do not have any positive dreams, mostly negative. I dream of losing my parents. I have two daughters. I lost a baby boy; during my wife’s delivery there were complications and the child died, but even before losing my child, I dreamt of carrying my child’s body.”

I asked him what he wanted to see from the treatment.

P: “I need to concentrate, every job needs concentration. You have to be innovative; you are taking care of all of India’s marketing. For the past six months, I am feeling low, not healthy, feel weak, sleepy and tired throughout the day. I am going to work, but I don’t feel like going. I feel like going away, taking a break to take proper rest and sleep. I am just working because I am supposed to. Due to the tiredness, I have made a couple of wrong decisions. I have almost resigned three times in the past eight months. There is no pressure from my job, everyone is happy with my work, but out of frustration and irritation, I get restless and irritable.

“I am shrinking; even my clothes do not fit. If my clothes fit me, it gives me confidence. If they are very loose, I feel I am shrinking. I feel as if I am losing something, like losing vitamins in my body or having flat feet. Then, I feel that that which was there in my body is not there anymore. Losing is like a particular element or a thing that was within me which I don’t have now.”

Understanding the case

To solve this case, we must look at the general nature of the problem. This general nature is also known as the Genius or the essence of the remedy or of the patient. Finding the Genius makes for an easier and quicker understanding of the case. In this case, the nature of the pathology is very important and we need to match this with the overall themes of the case.

I first looked at the nature of his pathology. He says: “I have a lot of body aches. I can never stand, I am always tired and I’m losing confidence, losing control. I am going to fall down, as if I can’t hold something. I’m so tired that it feels like my bones are shrinking and I will fall down.”

From this, we can conclude that the nature of the pathology is fatigue; it is as if his muscles, his bones, his brain and everything else has become tired and weak and has lost its capability. The Genius or general idea here is tiredness and fatigability. Consequently, what I want to look for in the Materia Medica is a remedy that has at its very center, core, and in its very essence, this fatigue and tiredness, weakness, falling, and exhaustion.

Life becomes easy when you know that there are very few remedies with this kind of weakness. Once we get these few remedies, then what we have to do is see the themes of one of those remedies and match it to the patient!

In this case, we have, on the one side, this fatigue and tiredness, weakness and exhaustion, and on the other side, we have: “I cannot concentrate, I cannot work, I cannot innovate, I cannot communicate, my confidence is very low, I have no ability, and it is affecting my career.”

Here, we know that the patient is talking about the Mineral kingdom issues, because he is losing his capacity and capability to innovate, to communicate, to use his voice, and he is losing control of his voice.

Minerals have to do with structure. The central theme common to remedies in the Mineral kingdom includes the feeling that something is lacking: lacking in structure or in performance. It can be a lack of identity, lack of support, lack of position, lack of relation. In human beings, the Mineral experience corresponds with the stages of human development, which finds its reflection in the seven rows and columns of the Periodic Table of Elements. Each Row has its own respective themes and symptoms that correspond with that stage of human development.

In this case, there are a lot of issues that have to do with his voice; he gets tired when he speaks, he trembles on speaking, and his voice does not come out when he is speaking.

When you put these together you get Stannum metallicum (commonly known as tin).

In this remedy, the first modality listed by Phatak is: Worse: using voice. Secondly, Stannum is an element in Row 5 of the periodic table of elements. In this row, the main themes are creativity, communication, performance and speech. The main feeling is that he has lost it, that he is a failure, he wants to resign, to give up. He has lost the capability to do things, to be creative. Further, when we see his mind symptoms we have a prominent symptom: Very sensitive as to what others say about her. We saw this symptom clearly when the patient was worried about what others would say about him when he was going into the meeting.

In the Materia Medica, Stannum metallicum reads as follows:

• Anxious, nervous, sad …Miserable and discouraged
• Cannot get rid of an idea once fixed in her mind
• Taciturn and dislike of society
• Sudden fits of passion
• Forgetful and absent minded
• Uneasy, knows not what to do with himself
• Hopeless, despondent; feels like crying all the time

In generalities we find:

• The chief action of tin is centered upon the nervous system, causing extreme weakness, which is especially felt in chest, throat, stomach, upper arms and thighs. The patient is unable even to talk; he drops into a chair instead of sitting down, and trembles on moving.
• Weakness is felt much more on going down stairs than going up.
• Paralytic heaviness or a weakness.

This patient said that when he climbs the stairs, he feels as if he has run a marathon. This is the kind of weakness and exhaustion sensation that he feels in his legs. In Stannum metallicum we see the following symptoms:

• He trembles on moving, he drops himself on a chair instead of sitting
• It is a paralytic weakness and weakness of nerves

What can be understood is that this weakness is also a nervous weakness, therefore any anxiety makes it worse.

• There is also a key symptom of Stannum: PAINS, INCREASE GRADUALLY AND GRADUALLY SUBSIDE, which matches our patient. In his past complaints, he had abdominal pain for five years. The following physical symptoms are representative of our patient:

• Pain, pressure amel.
• Pain, bent bending double amel.
• Pain, eating agg. after
• PAINS, INCREASE GRADUALLY AND GRADUALLY SUBSIDE
• Pain, Night restlessness with
• Stool, Hard
• Abdomen, distension, sides right
• Flatulence, after eating
• Flatulence, obstructed
• Flatulence, pressing on abdomen amel.

The symptoms from the mind that matched our patient included:

• Concentration difficult attempting to, vacant feeling has a
• Despair exhaustion from
• Dreams misfortune of
• Mind - EXHAUSTION, mental, prostration - talking, from
• Mind - EXHAUSTION, mental, prostration - trembling, with
• GENERALS - REST - amel.
• GENERALS - REST - must rest
• Standing agg.

Mentally, our patient was empty, weak, and drained. It was as if everything had come to an end and he had lost control. This in turn made him weak and empty, as if life has drained away.

Prescription: Stannum metallicum 1M

Follow-up: his fibromyalgia pains and his voice’s complaints improved dramatically, and he was overall in a much happier mental state.

This contemporary approach in homeopathy, termed Synergy, has evolved over the last thirty years and has come to be advantageous when utilized in homeopathic practice. While utilizing in depth knowledge in fundamental and traditional tools of homeopathy like the Materia Medica, Repertory, and the Organon, the Synergy method also values the newer approaches like Sensation, Kingdom and Miasm understanding. This is a system that is unique – its design can be taught, practiced, and replicated successfully by students and practitioners. The method has brought together both the old and the new approaches in homeopathy.

Photos: Shutterstock
Coconut in motion; Jag_cz
Atropa belladonna; vladimir salman
Tin can; Anthony McAulay