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What your mind
does not know, your eyes can’t see”. So to have a clear
perception and observation. One must have clear understanding of
the subject proper. At the same time the, most important part in
the Homoeopathic practice is proper observation and assessment
of changes effected by the administration of seemingly similar
remedy. Much time is allotted for taking the case and making the
first prescription but same amount of hard work and attention is
not applied while assessing the changes effected by the remedy.
In fact it is important step upon which the successful
prescribing very largely depends.
We must be able to
listen carefully to the patients report and from it and with our
powers of observation; we can determine what the remedy is
doing. We know that when the remedy is administered there are
different possibilities viz, no change {status quo},
amelioration of symptoms in character or degree and aggravation
of symptoms.
The common
mistakes committed or obstacles in assessing the changes
after administration of drugs are mainly two types
I. Physician oriented
II. Patient Oriented
Physician oriented:
1.
Defective Orientation: The’ first and foremost important
obstacle is that the physician is not properly oriented in the
assessment of changes effected by the remedy. Each individual
class of disease requires different types of prognostic criteria
nd accordingly the physician has to observe the changes. The
prognostic criteria fixed or the one sided cases is different
from that of a full blown case, If the physicians fails to
discriminate it leads to chaos.
2. Inadequate Attention: Owing to the time constraint or
impatience one may fail to observe the changes effected by the
similar remedy right in front leading to non observation or
mal-observation resulting in faulty conclusion.
Patient
Oriented:
I. Insensitive: Lack of sensitivity on the part of the
patient leads to failure to appreciate the minutest changes in
the symptomatology. All his attention is towards the more
nagging common symptom. Ex. In pyrexia, when you prescribe for
fever, the patient expects a sudden fall in temperature and if,
on contrary there is gradual decrease of temperature, he may
fail to appreciate the gradual decrease and may report as no
change in the fever even though other concomitants of fever are
reduced like restlessness, body pains, appetite, and thirst
pattern. On the other hand oversensitive (hypochondriac)
patients also cause problem to physician in assessment change as
they exaggerate the symptomatology.
2. Patient’s
background: Patient’s background also acts as an important
obstacle in the assessment of remedy response. There are so many
myths, false beliefs concerning the homoeopathic medicine which
may act as an obstacle in assessment of changes
Ex: - the common belief among the patients is that invariably in
homoeopathic practice there is an initial aggravation followed
by relief. If there is no initial aggravation patients fails to
interpret that as no change
The
possible responses after administration of medicine are
Remedy reaction and patient’s response
Change in the symptoms No Change in the symptoms
[If yes] [Status Quo]
Aggravation Amelioration
— ? Homoeopathic ? Partial relief of symptoms [palliation]
— Disease ? Complete relief of symptoms [cure]
— ? Medicinal
No Change In Symptoms What So Ever
After taking medicine no change whatsoever
Different possibilities for status quo and action to be taken
in those cases.
1] Patient did
not take medicine
Make sure that the patient takes the medicine correctly.
Commonly it happens in clinic practice when medicine packet is
given along with the placebo packets, where the patient takes
the placebo not the medicine. To avoid such possibility some
senior most practitioners prefer administration of medicine in
the clinic itself.
2] Remedy selected is wrong
If the medicine is not similar to the given case it produces
no action what so ever Re-examine and review the case whether
the medicine is still similar to the given situation or not.
3] Potency selected is wrong
Even though if the medicine is similar to the patient’s
symptamatology but the potency is not matched in these cases
also we observe no action what so ever. Asses properly the level
of the susceptibility of the patient and match it with the exact
potency
4] Wrong diet and regimen
Enquire about the diet and regime of the patient, which may
be inimical to the action of the medicine. Dietic errors or
intake of foods, which will have nullifying effect on the action
of the medicine, or environmental conditions, which are acting
as exciting or maintaining causes will also obstruct the action
of medicine leading to status quo.
5) Quality and genuineness of the medicine
Last but not the least and by far the most important thing
is genuineness of the medicine. In spite of the best efforts and
care if the desired result is not established then suspect some
thing wrong with genuineness of the medicine. Think of changing
the make of the medicine.
Aggravation of
symptoms after administration of medicine may be
Homoeopathic aggravation
Medicinal aggravation
Disease aggravation
Homoeopathic aggravation
Patient experiences a quick, short and strong aggravation,
followed by quick improvement, the improvement being long
lasting. T he slight aggravation of the symptoms that occurs in
the first hours after the remedy in an acute sickness, or during
the first few days in a chronic case.
1] Remedy is correct
2] Potency is correct
3] Reaction vigorous
4] No organic changes
5] Prognosis good
What to do?
Wait and watch is the
important rule in these types of cases. Do not interfere in the
action of the medicine.
Medicinal aggravation:
After administering the medicine there are new array of
symptoms, which are not present earlier and these were produced
by the drug. This is the state where surplus susceptibility is
induced by giving medicine in higher potencies or frequent
repetition of the medicine. It is also observed in oversensitive
and idiosyncratic persons as they prove every remedy they get;
patients inclined to be hysterical, overwrought, and
oversensitive to all things. The patient is said to have an
idiosyncrasy to everything, and these oversensitive patients are
often incurable. Many of them are born with this sensitivity and
they will die with it; they are not capable of rising above this
over-irritable and over-wrought state.
Amelioration
Aggravation
The knowledge of Materia Medica will help in distinguishing
it from other types of aggravation.
What to do?
Give the medicine in appropriate potencies.
Disease
aggravation:
After administration of the medicine there are new array
of symptoms, which are not present earlier and not present in
the provings these were produced by the natural progression of
the disease. This type of aggravation is most commonly seen
where the medicine is not the similar to the given case and also
is seen in those cases where marked irreversible tissue changes
are present. Knowledge of clinical medicine will help in
differentiating it among the other types of aggravations.
Judicious use of mv estigatory procedures will also help in
diagnosing the disease aggravation.
Review the Totality and try to find the most similar drug [
relation to pathology] Review the plan of treatment [ palliative
line of treatment]
The other common expected change after
administration of medicine being relief of symptoms
Which can be either
Pártiŕl relief of symptoms. [palliation]
Complete relief of symptoms in definite order [cure]
Partial relief of symptoms. [ palliation]
After administration of medicine there may be relief of some
symptoms without corresponding general improvement and positive
change in generalities like appetite bowel movement, sleep,
thirst etc. Some times the relief may not be in a definite orde
and the symptoms wilt disappear in the same order of appearance
leading to transformation of disease into more vital organs.
This initial relief of symptoms is invariably followed by
aggravation of symptoms. This type of partial relief is seen
where the drug is partial similar covering only the more
superficial symptoms and not covering the entire totality
leading to palliation of troublesome symptoms & aggravation of
original disease. Extensive irreversible tissue changes, absence
of bodily organs and in cases of surgical suppressions like;
hysterectomy, are all the conditions where partial relief of
symptoms is only possible and these are the cases best suited
for homoeopathic palliative treatment with out grabbing the
vitality of the patient.
What to do:
1] Review the totality the given medicine is acting as
partial similar drug.
2] Assess the extent of the underlying pathology. Presence of
extensive irreversible tissue changes may hinder the complete
recovery of the patient.
3] These are the cases best suited for palliative line of
treatment.Cure is not possible in cases where there is absence
and surgical removal of the bodily organs.
COMPLETE RELIEF OF
THE SYMPTOMS [CURE]
By far
the most cherished and desired change a homoeopathic physician
expects after administration of the medicine is complete relief
of symptoms. The high and only mission of every physician is to
attain this ideal cure. After administration of the medicine
there is complete relief of symptoms with corresponding change
in the generalities of the patient in a definite order. This is
commonly observed in acute cases where there is superficial and
reversible pathology with the administration of similar medicine
symptoms disappear spontaneously with general well being of the
patient &corresponding changes in all biochemical and
serological tests. In the cases of chronic in nature, after the
application of similar medicine, the patient improves slowly and
in the Process we can also observe the appearance of old
symptoms leaving behind a complete healthy state.
This type of complete relief of symptoms in definite order after
administration of similar medicine shows that the patient’s
susceptibility is intact, no exciting and maintaining causes are
in operation & the underlying pathology is reversible in nature.
Bibliography:
l. Organon of Medicine VI edition
ll. Lectures on Homoeopathic Philosophy J.T.Kent
III. Science of Homoeopathy George Vithoulkas
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