PAH2011

Sunday 02.22.09 class notes

2/22/09 morning session with Karen Allen - Review of deck from first classes

Critical reasoning/ Pattern recognition review
- understand how pattern recognition applies to case analysis
- distinguish btw ration and irrational decision making
- discuss chars of effective differentials

Homeopathic concepts we need
- potato-ness of a remedy: difference btw potato chip, baked potato, fries, etc.
- granularity of data: boulders, rocks, sand, silt

* Elise video: boulder = fatigue, silt= writes poetry (not important, part of plot line)

-bias of keynotes: thinking of remedies while case is being presented
-relationship of MM to Repertory

Pattern recognition
- like cures like- identify client pattern, match client to remedy pattern
- done via repertorization and clinic exp.

we need to understand:

• how is a pattern defined?
• how do we recognize it?
• how much of a pattern needs to be there for it to be the pattern??

Pattern: our clients exhibit the pattern as do the provers, aconite is a pattern, etc.

Recognition: defining elements of the known pattern

Patterns defined by:

• rule, law, guideline- good for chess, not homeopathy
• example: case in point for a pattern, built of accumulation of examples, bad for chess good for homeopathy
• analogy and ref: we can describe something else w/same features/pattern
• generalities: [missed]
• abstraction: we separate pattern from the entities that have the concept separate from the entity

Patterns are Formal or Informal
Chess game: formal, fixed rules, fixed pieces have set movements, pattern of game is always displayed

homeopathy: informal, partial patterns always present, complex with unpredictable variation, no specific rules, no fixed points, subject to interpretation and distortion, test case always contains multiple pattern fragments in it, multiple solutions (remedies) may seem to be applicable [seems to be two remedies at once]

Remedy pattern definition

• remedy patterns are def on various levels
• physical symptom details; modality, location, sensation
• idiosyncratic presentation of SRPs
• miasmic affinity
• themes of mental/emotional state
• concomitant

The full pattern is complex and extensive and will never be seen in any ONE case. The pattern encompasses the full remedy state.

The remedy state is a def of all entities that exhibity a representative paternt or symptoms
- remedy states overlap w/each other
-- same Sx in mult remedies (lyc and chel: <R side)
-- same Sx , increasing intensity ( fear in Ars and acon)
-- same miasmatic pattern in multiple remedies (calc and sulph)

-remedy states have remarkable variation w/in them
-- imagine a platina shy little 4 yr old w/recurrent UTI
-- imagine a platina 42yr gay man w/trigeminal neuralgia
-- imagine a platina 17yo teen boy w/eating disorder (need to appear tall and thin)

Isaiah Berlin: created value pluralism concept
- validity of one choice does not invalidate the validity of another choice
- EVERY  case has multiple remedies that CAN work and that could apply
- H says ONE remedy will act the best, but there are plenty of other remedies that would also work but maybe not the best, we aren't omnipotent

Occam's Razor - stick with the simplest case that adequately accounts for the data
- 3 legged stool analogy- there should be at least three good reasons for each remedy choice

Decision trees: allow you to map test case data to conclusions  about the case. Each branching point marks a symptom, each limb rep's a presentation of that symptom. a leaf rep's the remedy state matching the values of the symptoms all along the tree
- relates to the Symptom clusters that Lynn mentioned yesterday, it allows you to make choices about where to go on the decision tree

Remedy Recognition
- No fixed points : can give Aconite if person has no fear, does not predict hour of death
- Characteristic features: most of MM is SAND level of boulder, rock, and and silt. Most of our data about remedy states is sand.

Directionality: we are determining if the case exhibits the pattern, not if the pattern exhibits the case

Multiplicity: differentiation must be rigorous and free of unnecessary assumptions

Bias Prevents Recognition
- expectation, bias, and agenda interfere w/pattern recognition- confusion about which data are "useful" and which are "irrelevant"

- research consistently confirms that expectation influences outcome

Intuitive vs. Reflective reasoning
- intuitive: gut reaction, no reflection
- some people are really accurate, but cannot explain how it works so they cannot teach you
- you may or may not have these gifts, be sure to track your data to confirm this or not

-Reflective reasoning- reliance on well-articulated reason, allows for improvement

Constructs of critical reasoning
satisficing: done when 'good enough' solution is identified

temporizing: this choice is 'good enough' for now (giving Hypericum for person's foot nerve pain, something to do to improve person and their feeling for homeopathy while you research)

availability: recent info is more readily recalled

association: one word of keynote supports a decision - you listen in a limited way

affect: positive or negative emotional reaction anchors perception- alters your perception of the client based on how they impact you, can be helpful or not- know how you react

dominance structures: one good enough option diminishes others, the resulting investment in that option can motivate subconscious re-framing or definition of the problem or options to support the 'to-be-chosen' option

Irrational vs. Rational thought
- aim for complete, mature, judicial thinking

6 steps to effective Rat thinking

1. IDENTIFY the prob
2. DEF the context - what eveidece of limtation and pathology?
3. ENUMERATE choices - ident 3-4 remedies
4. ANALYZE options: what is the considred best remedy choice
5. LIST reasons explicitly- exactly why are we making this choice
6. SELF CORRECT: looking again, what did we miss?

Effective Differential Characteristics
- factual: opinions welcome when noted as such
- relevant to case: show how remedy applies
- congruent: w/ the prioritization and repertorization
- use all levels of granularity of data
- well referenced: to MM and Repertory
- free of bias, conjecture, situation, fiction, negative logic (ineffective logic, not as clear as 'I am doing X', ex: of negative logic "I'm not going to give Puls to this person because it doesn't have X')

7 simple differentiation strategies
- use 2 levels 9crucial then confirmatory)
- reference the Repertory with MM as back up (MM is the final word, never the Rep)
- fill in the gaps to confirm or decline a symptom
- compare all of the symptoms, from boulders to silt
- Ignore MM remedy data that is not relevant to this case
- be persuaded by preponderance of data, not by bias or expectation of remedy presentation
- be diligent, thorough, procedural, and disciplined

Discussion of Elise's case in class

...............................................
Afternoon class: Karen Allen
discussion: Miasms

"sequella" after effects of disease

KA believes proportions of people in each miasm is diff now than it used to be

H and Chronic disease
- cases of relapse- people who never got completely healthy
- he looked at the breadth of human illness
- H spent 12 yrs developing theory of Chronic diseases

Miasm def= an unwholesome atmosphere
- orig use was of swamp gas, an insubstantial unhealthy thing
- in homeopathy it's a taint, a morbific influence
DEF: A PREDISPOSITION TO PREDICTABLE PATTERNS OF DISEASE - ACQUIRED OR INHERITED - AFFECTS SUSCEPTIBILITY

The psoric miasm is related to being human
We are born with miasmic patterns, it provides the soil we grow in in layers of healthy or unhealthy

TIME: Acute hours/days  vs. Chronic (years)
SCOPE: body part/organ   ...  Whole Person
GENERATION: indiv.... family (genetics)

OTHER SUBSETS: Race, gender, nationality, epidemic, geographical

Can be based on location, environment can predispose the population to be susceptible to a disease

Geography can affect you as well- moving to a new place can introduce you to allergies or other localized symptoms that you would never have at home/elsewhere.

Epidemics: H found one or two remedies that could be applied to Everyone who had certain epidemics- those worked for all who had the disease.
EX: yellow fever, typhoid, cholera

Disease appears at each level; remedies can be chosen for any level

The State- different views
acute state: brief, self resolving, remedies relieve or reduce the suffering
chronic state: longer time to cure, relapsing

** 100 yrs ago most people died from ACUTE ailments, nowadays mostly Chronic

Impaired vital force: the organism is constrained, no longer able to resolve, and ability to respond to a remedy is limited
ex; physical tissue change, amputation, nerve damage, advanced lung cancer, because of medical treatments, lifestyle of accumulated habit choices, family history (history of tuberculosis- this makes you predisposed to have the tendencies and also to not respond to it well because your vital force is constrained)

* a "state" can be healthy, balanced and stable- healthy end vs. unhealthy end

Vital Force+ miasm (terrain) = State + Morbific influence = Disease

* you are born with miasmatic history, and this influences your physiology
* terrain = "soil" you grow up in
* diathesis - the ground on which your case is based, miasm is only a piece of that (interchangable with terrain)

(*terrain, diasthesis=miasmatic influence (cf:  somatypes))

What does Chronic Disease look like?
- disease state arises from the terrain when the state (susceptible) meets a morbific influence, some of which are strong and some are weak

- the disease cannot be eradicated by the body's own powers
-- when it has become chronic this is true- in acute cases your body can often throw it off by itself

- treatment (homeopathic or otherwise) palliates but does not cure- the disease relapses or modifies but it still continues

'Obstacles to Cure'  = Prevent Healing
'Maintaining Causes' = Support Illness
- H noted that diet, stress, sleep deprivation, climate, emotional shock , etc. can impact health and s/b addressed to improve health ( and advised that ill people cannot take advice!)
-- as they get better, help them make better choices- provide good information instead of advice

- H observed an even deeper obstacle to cure, not explained by any of these factors, that prevented the chronic disease which ended only with death

Contagion and Inheritance
- contagion is an energetic process
-- infuses the entire being instantly, is not an 'infective' process
-- psoric miasm can be conveyed from person to person by one touch- alters the entire organism instantaneously
- contagion of the active disease can create the miasm
--sycotic miasm- the active disease is gonorrhea or chlamydia (H and Clarke unable to distinguish,e ven though we can now)
-- if it's resolved you will not have the miasm, if you don't resolve it you will have it forever
- the miasm is inheritable
--diseases can create a miasm
--typhoid miasm, malaria miasms, ringworm miasms  - these are often subsets of the main three miasms
-- the miasms do not change, but how they are presenting in the population that does have them, does change

Eugenics: Quality of the race
- branch of biology regarding knowledge which generic man needs to continue to persist as a species in the best possible way
--optimizing the species
--homeopaths have an active opportunity to affect this with EVERy case we do
-- it is not enough to safeguard the individual, who is a passing phenomenon; it is more imp to safeguard the species
---this is how homeopaths get into eugenics: through the lens of health and freedom from limitation/pain
---freedom to pursue the highest goals of a person's life
---this helps them not only now but for their future, prevents suffering
---also prevents issues from transferring to their children as well- changes the future of the species

Miasmic Prescribing
- this is a form of prophylaxis for future generations
- to cure a person does not mean only to free him from present suffering, but also to spare him from future suffering

Predominant Miasms
- Psora: Eruptive diathesis
- Sycosis: Proliferative diathesis (over-produce)

Psora: "The Itch"
- Disease in it's simplest form appears as an eruption
- H called it the '1000-headed hydra' because it manifests in so many diff ways
- if it is suppressed (ointments, cautery, etc) a deeper and more complicated illness replaces it
-- the body has an 'economy' - the VF (Vital Force) tries to maintain it's state and fix it's disrepair in the most economical way (like a tiny wart). It has to keep everything running, so if it doesn't have full power it will slowly start to break down, or particular parts may not work because it can't keep track of everything. The most superfluous parts break first because body keeps the most essential stuff running until it can't.
- Oldest, deepest, most persistent chronic disease
- Like a 'swamp gas' hovering around the person's VF
- Affects large numbers of people, affecting health

* KA most of the cases she sees are NO LONGER psoric- they are either sycotic or syphilitic

Psora: Underfunction
- Psoric people will complain a lot, but are not about to die- they have complaints, but they aren't serious
- Functional complaints for body parts that under function: lack of ovulation, digestion problems, not enough oil in the skin
- Reaction: irritation, inflammation, reactivity
- All kinds of skin eruptions
- Affinity to skin, lungs, G/I tract
- Nosode: Psorinum, Ringworm, Leprosinum

exception: not herpetic eruptions, which are sycotic

- The basic psoric state is one where you deal with your skin separating you from all that is, unable to be part of the ALL, interferes with the client's perception of being part of the universe/human race.  Separation from the Divine- dissatisfied, incomplete state.

Def: nosode: made from diseased tissue
- Psorinum: made from scabies vesicle
- Ringworm: has an incomplete proving, is a fungal infection not a parasite like scabies or lice, made from scrapings of the eruption. It has a mental process of struggling and then giving up in hopeless despair. Then they gather the resources to struggle again, only to give up in despair. Constant struggle or hopeless inactivity.
- Leprosinum ( also called: Lepromium): You should store Camphor and Leprosinum AWAY from all other remedies in your kit according to homeopathic lore (although KA doesn't do that).
--Leprosinum-H : made from human leprosy tissue
--Leprosinum-A : made from a leprous armadillo

Sycosis: Hydrogenoid Constitution - OVERFUNCTION
- water imbalanced: many complaints related to water, cold, damp weather or conditions
-- don't deal well metabolic water complaints, EX: edema, dehydration, frequent urination, massive thirst
-- etiology from cold water: 'menses suppressed after bathing in a cold river'

- Overproduction of mucous, rheumatoid arthritis, early heart disease, genito-urinary complaints
-- EX; sinus infections, recurrent vaginitis, mucous in stool, cystitis, kidney issues, herpes, warts, HPV
-- Family history: rheumatoid arthritis, heart disease (heart attacks in young men [under 40])
-- cocaine use

- Affinity: genito-urinary tract, mucous membranes (mucous discharge), heart

- Nosodes: Medorrhinum, Chlamydia, Streptococcinum, Staphylococcium
med: loud and out there, better at the ocean
chlam: quiet and retiring, shy and inward, core belief that there is something ugly or shameful about me- must hide it, 80% of ppl with it have no symptoms and do not know they have it

- mental state: over-doing, over-working, over-producing, hyper-activity, inquisitiveness, desire to acquire/have/own (grew in popularity in US over past 50 yrs)
- sex, drugs and rock and roll type
- shame and hiding, drug use
- Keynote: Theorizing- coming up with stories, Violent outbursts
- Children of Medhorrinum may have HORRIBLE diaper rash
- Keynote: risk taking, conflict, rebellion

polychrest: guards against multiple miasms, related to multiple miasms

Syphilis: Distorted Function : Suppurative
- Destructive: distortion or breakdown
- Congenital deformity, pointed or saw teeth, necrosis, ulceration, pus formation
-- exception: when pregnant mothers are on drugs which impact the baby
- Affinity: Genito-urinary tract, eyes, nervous system, bloody discharges
- Nosodes: Syphilinum

* mental state: is really weird, could be nihilism - so into despair that it becomes nihilism, OR madness on the edge of genius
* c/b blocked artistic expression which leads to incredible despair
* lots of mental illness: schizophrenia, multiple personality

* This is Breakdown: breakdown of the body OR the mind
...............

Imagine a Tree of Miasms
* the giant foundational trunk : psora
* large branches:
**sycosis
**syphilis
**psora + syphilis = tuberculosis
** cancer: can be psoric, syphilitic, sycotic - tends to be a further progression than psoric alone
** past cancer, AIDS

cancer indicators: family history of skin diseases/mononucleosis/diabetes, trouble individuating self

 

*"Time"; "vaccuum" (imponderable remedies) used by Noula Eising for schizophrenia
.................

Sankoran: when a person is in a SOLVABLE dilemma and they do NOT solve it, it is a sign of illness
- ex: in India drains connect to ground- rats and snakes, etc. Each sink has a stopper in the drain to stop those. When you use sink you remove stopper, put it back. Going to sleep you wonder if you put the stopper in the drain. It takes you hours to go to sleep thinking about it. It would have taken 30 secs to go look- but he didn't. He stayed in the conflict instead.

video: Cliff , drug use- he is caught in total conflict
* you see his behavior and him explaining it away
* you can write it off too, based on your own pathology (I could discount X as "just allergies")
* if you didn't believe the guy was really mean because he seemed nice, you will screw up your rubrics
* sycotic: inherent deceit,  water stuff, sinus infections
* Medhorrhinum case: KA gave a dose, he came back and he was really mad at me "now, when I really want to go smoke dope I can't relax about it I can't blow it off and lie to my wife, you have ruined the one part of my life that was enjoyable to me."

video: Drug Use

Cliff - Drug use

previous:
Sinus infections
Remedy kali-bic

job: law enforcement

the job I have smoking pot is not ok - law enforcemnt
every time I do it I put myself at risk
c/b end of my career basically
at the same time there is
no down time at work, bring hoem with me
yr on 24 hrs a day
at home it's in back of my head
getting high is a way to let it all go

I think I need that in spite of the risk or carerr jeapordizing behavior

my wife argued
what if I got caught
I don't smoke in front of her anymore
I have two lives going on
I have no intention of stopping
I don't want to stop
on one level I thin of it as dangerous stupid high risk behavior
on other hand why can't I be entiteld to do what I want in my own space, relaxation
I feel strongly about that
in that part of my life i cont to do what I want to do

social thina bout it, if you're with other ppl getting high it's kind of a communal thing
that was more when I was younger
now I do it on my own
social cocktail hoour

stress releiver- I need that
nothing else I need to do
I know I won't be doing anything else
all the other stuff in you r life is gone
I like that
I'll lie in bed
my mind will wander
it's kind of creative, not like what I usually do
it sends me off to daydream land
I like the idea of being out there, carried over from being a kid- a rebel thing

night time
that's when I feel most engaged
not a morning person
effort to get out of bed
long time to get going
sun goes down energy level goes up
always been that way

as a kid my dad got impatient for me sleeping in
now whatever I find myself doing, nighttime is..I'm much more oriented that way

my dad was never comf w./me sleeping in
he was a morning person
eh'd get my bro's and sis' up in the morning
he passed away a few yrs ago
wehn i was pretty young he had heart disease
he had a coouple open heart surgeries one, then other one 12 yrs later
second in his early 40's died not long after

I htink the angriest I was, one of the
involved work
we worked this case 6mo's we finally had this guy tracked, caught him coming out of apt building
we went in bldg after he left, there was a fam there and it was not a good situation
we were tailing him,
we fin caught up w.him
all of this stuff over the last 6mos when I finally grabbed him
building up, building up
it wasn't him but all the other victims of his
I lost it
he put up a bit of resistance
as soon as he did that
all this emoiton came out
I beat him
pretty badly
we cuffed him
I swerved around
I got him a couple more times
I had a couple guys I work w/ who were yellign at me to cool it
and fin I did, got control of myself
that was one time I really lost control
I think ti was a build up of all the stuff of the last 6 mos
I was carrying the hist of this guy around
something I regret

I can sense it
most of the time I control it

I've got sinus probs quite a while
I can tell now when coming on
get stuffed up
all around face, clogged up
tap face it's kind of sore
it even effects my visiton
squit, head in fog, don't think as clearly
not something you can just ignore

so I was w/ a buddy trav in Eur, had a great time, met a bunch of ppl
stay in cheap hotels
saw a lot fo churches, art- go to pt of seeing enough churches, gothic cathedrals
smoked some pot on reg basis while there
what was really fun, we'd go to, we'd get on this track, we met some ppl in Brussells and 2 mo's later we saw again in Greece
3-4 mos later in Spain
wk before left saw in london
small world
taht's one of the things that tsuck with me
unusual in this case, in 4 diff countries

went to the ... del sol in Morocco
cult'y so diff
Switz, cows w'/bells on neck- looks like poster

love the water, part the ocean
couple diff things about it, big, stuff you have no idea what's in there, swim, surf, sail
like the whole envir
part places that aren't built up
salt air, get out salty and crusty but clean
warm day roll in sand after you get out
play in waves, body surf
ppl, when they're at the ocean are happy
not a lot of grumpy p-o'd ppl
enjoying themselves
typic-y relaxed, pace is slower

yeah I smoke and I know I shouldn't do it
but I really like it
some of the thgs I like about i
provides me a break throughout the day
stop and enjoy a cigarette
smokers are all outcasts
stad outside w/others- camaraderie
chat it up
some level James Dean kidn of rebellious thing
most ppl start when teenages- when not supposed to

physiologically does a lot for me
in teh sense that - does bad things too
energy boost
if you're hungry it minimizes that, can go a long time w/o eating
accelerates heart rate
gives energy
like a pacifier
if you're uptight/nervous whatever, it's a pacifier
those are the good things

video: Chronic Fatigue

Video
Elise: chronic fatigue

really tired all time
worst mid-morning
mid of morning energy drains out of me
sit and not do anything
pick up in afternoon
all I can do to finish teaching class

dizzy
like going to fall down
has to sit down
have to grip edge of desk

not good with a lot of ppl around
hesitant
doesn't like being around ppl
some fine
some days in a crowd where I get a chill going up in my neck and back
neck and back get stiff- stays that way until I get away from ppl

write poetry
love the most
really impt to me
what I teach
I love it

invited to give readings, I love doing it
I love the idea of it more
the day of I get a lot of anxiety coming up
gripping me
tongue goes numb
up in front of ppl want to do this, tongue frozen, all I can do get up there

things that others can do I can't do
things are dangerous
I can't face anything
anything I try to do I'm not up to
can't meet challenges very well
fells like rest of world is really scary and hard
things I want to do I can't face them
get to end of day realize I've been tense all day, get back home to feel safe

sometimes I don't feel up to anything

VERTIGO, Standing while
MIND, Anxiety, speaking when
MIND, Anxiety, House in, amel. in
find: anticipatory anxiety

GENS, Morning, 10am, 11am
GENS, Lassitude
CHILL, Anxiety caused by
MIND, Anxiety, company, when in + MIND, Anxiety, crowd, in a
*MIND, Timidity, appearing in public
MOUTH, Numbness, tongue +MOUTH, Paralysis, tongue, sensation of
BACK, Coldness, up the back + BACK, Coldness, Cervical region
VERTIGO, Sitting while, amel.

Saturday 02.21.09 notes

Saturday: Lynn Amara

topic: Recognizing Signs and Symptoms

Alexander technique: wide sitting stance, back straight, head tall, lower back pillow

Discussion of Clinic yesterday

Case taking notes-
Most important notes include: adjectives, adverbs, idioms

Skills: take notes while not looking at your writing
Develop your Peripheral Vision! this is good for men, children, taking notes, noting behavior that you wouldn't see otherwise

Practice: go out in flat field, dark night, walk - this develops your peripheral vision

If you're not having a good time in your practice, it's your fault- not the clients. If you're too rushed or stressed out, it doesn't work for everyone.

You are in charge, it's your construct. Know your boundaries for people, types of clients.

Also think about what kinds of cases you want to take! Know you limits/preferences.

It's a skill to learn how to tell the truth in a way that is nice to the client: saying you know other practitioners who you can refer to, etc.

People who make demands of you are not going to be good clients. Be aware!

Skill: when you finish the analysis of the case, close it in your head- don't carry it around with you at all times.

Karen: at end of the day does ritual hand washing
?? banishing, ringing bells to break up the energy
..........................................................

Internet search
- can be like a personal assistant

When you talk to a client first
- find out what they want to come in for
- find out what medicines they are taking

This prepares you to receive the client.

Three types of clients:
- clients that know they have something
- clients who are in deep deep denial
- clients who have done more internet research than a doctor

The people who come to homeopathy are the ones who have been ill-diagnosed by allopathic medicine. They are the ones with continual problems who haven't been served well.

Some Rx's often take 5-9 YEARS to diagnose:
thyroid disease, depression, bi-polar, ovarian cancer (often diagnosed as IBS), endometriosis, polycystic ovarian symptom, Lyme disease

What to Research

1) Research the diagnoses

2) Research what the diagnoses is

3) Research medications and supplements

4) Research homeopathic remedies

5) Research homeopathic therapeutics

6) [missed]

7) Cured cases

When does research occur?

1) Pre-interview:
- your confidence will increase
- your clients will appreciate and trust you more if they think you know what you're talking about
- knowledge ahead of time will free up your brain to pick out the SRPs
- if you are more prepared you will be more free to hear what you need to hear

a) list client complaints
b) client medications

2) During the interview
- client comments
- client relates Dr. comments- you pause to look it up during the interview, happens rarely
- this gives you & the client peace that there is understanding and you can move on to another topic

3) Studying the case

4) Restudying the case

cautionary tale: Young woman client, very physically fit, came in for emotional issues. After a month or two there was an injury from yoga. This began to repeat, stories of injuries. She is in pain, sees lots of massage/chiro practitioners.
Re-studying case showed that after first injury there was an MRI which had a diagnosis of spondylolisthesis  - this is a condition where bones get injured all the time (vertebrae move when they should not), and if this had been noted initially there would have been a totally different path of treatment.

How does research occur?

1) Manual labor
- Indexes
- Chapters
-- of books
-- of periodicals
- Files
- Library system

2) Electronic labor
- Radar
- MacRepertory

3) Ask around (1 to 7 degrees of separation)
- Use your teachers and peers

4) Internet
- ask the Internet how to research the Internet
http://www.lib.berkeley.edu/Teachinglib/Guides/Internet/FindInfo.html

- www.virtualsalt.com/evalu8it.htm

- www.lib.monash.edu.au/vl/www/wwwcon.htm

- search engines, health portals, illness specific sites, blogs and forums
www.betterhomeopathics.com

** Do not get into habit of lecturing a client, which may turn adversarial
*** Option B: send a follow-up email to blog with articles on (ex) constipation, and let the client read it or not. This is a good example as constipation is most often related to lifestyle habits
***Option C: make a handout for a particular thing (ex) like excema, with causes and options. This way you don't need to RE-explain the same thing multitudes of times.

What is the process of Internet Research?
- list of sources
.com = company
.gov= government source
.org= organization
.net = educational or philanthropic
.edu = educational

* TIP: Document your SEARCH
cautionary tale: client used NO (Nitric Oxide supplement) - for dropping hypertension and also used by body builders to bulk up. Did a really complex search that found stunning results. Thought it was the National Institute of Health. But it wasn't and now it's totally lost- because the search wasn't saved.

* TIP: add a bookmark, check browser history, SAVE page as PDF File (Firefox only)!
* TIP: make a book with handwritten tidbits- things not worth bookmarking or saving as a PDF. Otherwise these will be lost forever.
* TIP: can make a quick page print and put article in client's file for future reference

2) IF you know the diagnoses:

www.medscape.com
www.webmd.com
www.medlineplus.gov (www.nlm.nih.gov/medlineplus/
www.nih.gov
www.mayclinic.com
www.4women.gov
google images
en.wikipedia.org
medical university sites
support societies

* TIP: beware the inaccurate diagnoses
............................................
CASE #1 51 yr old woman, skin eruption that developed out in the garden
- hot day, wearing camisole
- L forearm red and raised
- L upper arm and R shoulder near arm pit, red raised and burning
- heat and cold apps do not help
- + day, blisters form and weep
-- not healing, felt like a burn, chemical burn, deep inside, as if inner veins and arteries were bursting with pain
-- no remedies helped: ARS, CAUST, CANTH, URTICA URENS, ARN

6 wks later
- fig leaf touched hand, felt burn

Seeing articles on this diagnosis (phytophotodermatitis) is helpful for the patient: tell them to avoid fig, ficus, eating figs, etc.
Prognosis
FInd out that fig + sunlight = burn, it's a chemical burn, and once we know that we can use that information in finding a homeopathic remedy.

GEN, Burns
**(can also look in SKIN, but Injuries are in Generalities, should look at both and compare remedies. You look in GEN because your body reacts systemically to injuries, regardless of which part got injured.)

GEN, Inflammation, blood vessels
GEN, pain, burning, as from, blood vessels

Remedy:  HAM [hamemalis] (witch hazel)  - feel in blood vessels
HAM for Pizza Burn mouth/ tongue/ lips
hemorroids, varicose veins

phytophotodermatitis

Cautionary tale: can indicate auto-immune process, body starts having strong allergic reaction to strange things. One lady had this prior to being Rx'd with Rheumatoid arthritis.

Cautionary tale: can be from farm workers or people with overload exposure

...................................
Case #2 52 yr old woman
What I know:
- since 9yrs pain when eating
- dental issues - front teeth cracked
- depression, bi-polar, manic
- back and neck injury
- face pain and headaches
- L facial pain, dental broke through L sinus
- back surgery, fused spine
- nodule on R lower lung
- feel like I'm going to pass out
> Milk
21yr old sinus tachycardia, pulse in 100's

What I don't know
abdominal pain
what happened 9yrs for pain eating?
sinus tachycardia

This was NOT a stomach case, but a heart electric system problem, nerve issue, it's a nerve running from throat to abdomen causing heart and abdomen issues. Numa Gastric Nerve problem- needs a heart doctor.

This case is overwhelming with symptoms, it helps to look up all of her old symptoms until you understand what the underlying problem is.

Researching Homeopathic Remedies
- search the name of the remedy
- go to a book seller like minimum.com
-- use search field for 'Venus'
-- results show chapter headings and book list of all relevant books
- Collaborative research
- Quizzes for symptoms/diagnosees like PCOS, or BiPolar disorder, Depression, ADHD

*TIP: look at Phrasing of the quizzes, suggest saying 'you have the SIGNS and SYMPTOMS that might be indicators of X' instead of 'you would probably be diagnosed with X'

- you and the client have concerns about family health
familyhistory.hhs.gov

- you and client have concerns about their general vitality and 'biological age'
www.realage.com

......................
Case #3 58 yr old female, all things that have changed since turning 50
- extremely healthy all life except Br.chitis from 2nd hand smoke over the years

TIP: do NOT ask how a person "feels" , say 'with all that has happened to you, how has that AFFECTED you? What did you DO with that? What habits did that create for you? What was the physiological response to that?

 [student asked 'how did that make you feel? what happened to your real mother? - both of those encourage more of the Plot stories]

In the US using the word 'feel' encourages PLOT stories rather than symptoms.

TIP: Hypericum great for foot damage due to wearing High Heels or ballet slippers

TIP: Sjogren's Syndrome- can suggest client go to doctor to be Tested for this, often times rheumatoid type illnesses are not diagnosed well- tests come back indecisive or incorrect

note: Nausea is not a great symptom as it applies to too many things, hard to narrow down the field.

TIP: The trick to this case is to THROW out the symptoms of Sjogren's as those are COMMON for the disease

So you need to find out what individualizes the case.
You must find the organ or the system that is the initial source of it all

TIP: trust the physicals, the mental is interesting, but the physicals do not lie. They are good for finding the remedy, and excellent for follow-up. If you do not check physicals it's really hard to tell if the person is better or worse later- it's a good indicator of progress.

........................................................................................................
Afternoon class: Karen Allen

We are now starting the real work of homeopathy. We studied what is a symptom, what is a remedy, what is a remedy pattern?

Morning review:
* Pre-Interview: this increases your confidence walking into the first interview, if you are informed. Know their complaints and their medicines.

- Rest of the year will be spent learning case taking, will learn:
take case
prioritize data
choose rubrics
repertorize
identify likely remedies
investigation and comparison
choose a final remedy

Homework discussion:

Case B
Acute exacerbation of a Chronic state
characteristic: of person and of the state:  She is mad and mortified, pain expressed in the abdomen

Discussion of Dental acute cases

Discussion of Allen 2.10-2.12 GI/ Urinary/ Reproductive symptoms

Discussion Mag Phos card: Liver affinity

K.A. is a big fan of BioPlasma: helps pregnant women in first and third trimester just due to the metabolic load on the body
- good for puberty, or growth spurts during puberty
- whenever your body is doing something hugely productive
- good for newborns and teething babies

- also good for massive studying 2-4x day while studying for finals, board exams, etc.

info: nat mur and apis are complimentary
phosphorus is inimical to causticum

CLARKE's practical dict. of MM: has a section on "relationships" which lists those remedies which are incompatible

KENT: Repertory page 1427 list of relationships between complementary and inimical relationships
* question the "anti-dote" column's efficacy

antidotes:
-many think nux vomica or coffee are good for antidoting
-honestly it may be best to find a new remedy for the new state the person is in

APRIL: Repertory Olympics: prizes, books

Appendicitis: Bryonia 1M per Karen

Allen: Workbook for Homeopathic Repertory Ch 3: Using the Repertory for Cases

Allen Ch 3.3 Combining and Crossing Rubrics

- Two sets of remedies can be combined in the case of small similar rubrics, counts as one rubric : combining rubrics
- The union of two sets

- Comparing two rubrics and using only the remedies present in both, repertorizing them as if one rubric had been used: crossing rubrics

3.3.1 Combining

- Cough, Burning, chest, in // Chest, Pain, burning, cough during
- one very small rubric with one larger one, combining remedies to improve your chances of listing the best remedies for this symptom

- On repertorization sheet write both rubrics with a plus sign between them
- if there is a difference in grade for a remedy in both rubrics, you make the choice to emphasize or de-emphasize
  - being cautious suggests using the lowest grade

- Combining rubrics expands your possible field of choice
- You can combine two- four or more rubrics
- Useful when multiple rubrics could apply
- Useful when you have a few small rubrics that, when grouped together, describe symptom

- Evens out the rubric set if you have several large rubrics and one small one- the small one might be combined with a larger one so that when you repertorize the small one does not get more weight than it deserves
- This technique widens the playing field of options

...
3.3.2 Crossing

- Crossing two rubrics involves taking only those remedies listed in both rubrics
- This technique narrows the playing field of options

- This can save you time and cut down on repertorization work, allows you to focus more narrowly
- This may not work well with small or medium sized rubrics, but is a help for rubrics that have hundreds of remedies in them

- On repertorization sheet write both rubrics along with an 'X' to indicate they were crossed
...
3.3.3 Sample Case with Crossing and Combining
...
3.3.4 Veterinary Notes
- Crossing rubrics for different parts of the body (stomach rubrics with either eye or nose)
...
3.4 Selection of Rubrics

3.4.1 Goal: Rubrics Set Describes the State of the Patient

3.4.2 Prioritizing the Information in a Case
What needs to be healed in order for this person to reach a homeostatic state of balance and feedom?
...
4.3.2.1 What is not useful?
Eliminate the common and ordinary symptoms, anything that is not a key feature.
Remove names of diseases.
Pay attention to how the patient exhibits the symptoms of the disease, rather than the diagnostic label

3.4.2.2 What is the most useful?
SRPs

3.4.2.3 What is left?
Remaining are neither most unusual nor most common.
Some may be saved for confirmation symptoms.

3.4.2.4 Why Not Repertorize Everything: Totality Approach to Repertory
Time consuming, does not prioritize if you utilize everything equally.
You must pick the Boulders.

3.4.3 Identifying Key Features of the Case

Repetition

SRP

Conflict (ex: desiring things which are bad for them, like spicy food w/IBS)

Etiology

Recent Change from 'Normal'

Oddly Explained Symptoms

Life Threatening Symptoms

3.4.3 Repertory Contra-indications
Symptoms are not good candidates if they are common symptoms characteristic of physical pathology that have no individualizing etiologies, sensations or modalities.

Avoid:
- Symptoms Modified by Meds
- Ambiguous Symptoms
- Conjecture Symptoms
- Historical Symptoms
- Irrelevant-but-easy-to-repertorize Symptoms

3.4.5 Translation to a Rubric
Once key features are determined, look for one or two rubrics that describe each of those features.

Look at small vs. large remedy rubrics.

Keep true to what the patient said, ideally verbatim.

Rubrics with large remedy sets are intimidating, even when they may be the best choice.

Stick with the individualizing features of the case, select reasonable rubrics, and staying within a limited set of 4-8 rubrics.

3.4.6 Veterinary notes
Animals like small children cannot report their experience. Observation is key. Give priority to symptoms which are the most limiting to the animal.

It is important to match bone to bone and organ to organ, making sure that you have the correct anatomy for specific symptoms when you find rubrics.s

...
3.5 Covering the Case

Make sure rubric set covers evenly the set of symptoms and does not weight too heavily in any specific area.

3.5.1 Proportion
Each of the features should be fairly represented in proportion to their importance to the case.

3.5.2 Variety of Body Systems
Ensure that rubrics cover a variety of body systems. Too much emphasis on mental or physical symptoms will also slant the rubrics and resulting set of remedies.

3.5.3 Rubric Set Case Example
...
3.6 Focusing on the Center of the Case
The core or center of gravity is the most limiting factor in the person's health.
Is it on the physical or mental level?
On the mental level is the greatest limitation in thinking (mental) or feeling (emotional)?
Is there an evident etiology?
...
3.7 Case-taking Impacts Repertorization
Individualization of a case often arises in modalities, sensations, and locations of symptoms.

The burden for obtaining data rests with the practitioner.

Useful to start with the location of the symptom.

Get specific nature of the pain, or particular sensation.

Determine any modalities for the symptom.

Concomitants add another dimension- ask what has changed since onset of symptom.
...
3.8 Repertorizing Acute Cases
Verify that it is an acute case, rather than a recurrent or seasonal appearance (something with a history, a repetition).

Repeatedly ask whether or not a symptom has begun or changed since the onset of the acute condition.

Address only symptoms of the acute illness.
...
3.9 Repertorizing Chronic Cases
Focus will be longer term for chronic cases.
Could use majority of general symptoms in repertorization.
Another technique is to put extra weight on mental symptoms.
Some focus on modalities.
Some focus on more recent events.
Large general rubrics are often helpful.

The bottom line is that all of these techniques help, and none is infallible. You may need to combine approaches, and different cases will call for different types of analysis.
...
3.10 Common Mistakes
Short cuts!

3.10.1 Seeing only Bold Type Remedies

3.10.2 Seeing only Remedies you Know

3.10.3 Deliberately Choosing small rubrics

3.10.4 Can't Give it if it's Not in this Key Rubric

3.10.5 Heavy Reliance on Easy Rubrics

3.10.6 Remedy I Want to give is in This Rubric!

3.10.7 Rubrics for People, not Pathology
Look at your value judgements of 'healthy' or 'normal' prior to selecting a rubric

3.10.8 Rubrics in the Practitioner's Case

3.10.9 Reading Your Bias into a Rubric

3.10.10 Rubrics based on Assumptions

3.10.11 Reaching for the Repertory too Soon

3.10.12 Giving a Remedy because it Repertorized Well

3.10.13 Rubrics Covering Part of the Case

3.10.14 Choosing LOTS of Rubrics

3.10.15 Repertorizing an Inadequately Taken Case

3.10.16 Giving up in Frustration

Vithoulkas: The Science of Homeopathy Ch 14: Case Analysis and First Prescription

Vithoulkas Ch 14 Case Taking and First Prescription

It may seem as if there is a set of rules and algorithms that may correctly calculate the correct remedy for a case, but this is not something based on concrete rules.

The laws and principles upon which decisions are made are definite and verifiable.

The application of laws and principles is open to interpretation. The results are a fusion between art and science.  The laws and principles are solid and the application of them to the individual is artistic.

This process requires a great deal of mental effort and insight into the patient.

There is always the temptation to find "keynotes" in an attempt to shortcut the system. The results are poor in the long run. It is important to commit yourself to intense study in order to gain true understanding and good results in practice.

Homeopathic treatment costs are higher. However more time is spent on each case and results are better than in allopathy. In the long run costs are less for homeopathy because the level of health is higher and medication is less costly.

Once a homeopath has mastered prescribing and is demonstrating reliable results he or she can make an excellent living and be assured of a busy practice.

...
Initial Prognostic Evaluation

During the initial interview, a crucial decision must be made in regards to the seriousness of the case.

Some people may have same complaint but with a totally different impact on their life. It may not hinder them in any real way or it may have great mental and physical repercussions related to the complaint.

The patient looks to the homeopath not only for treatment, but for education. There are questions regarding expectations on how long it will take to treat their symptoms, what they can expect, etc.

Incomplete or unrealistic expectations may discourage the patient, and may cause them to abandon homeopathic treatment.

The homeopath should be able to assess the situation, and determine what level of impact the complaint has on the patient. They must give the patient practical advice and expectations, while not depriving them of hope. Patient should be taught to expect some difficulties and to be patient, as well as the importance of adhering to the treatment process.

How to make this determination?
1) A limited degree of freedom of expression in life : Determine how limited the patient is by their complaint. Able to do so by how they present themselves.

2) The center of gravity for symptoms : If the center of gravity is emotional or mental problems, a poor prognosis can be expected. Patients move towards cure very slowly over time. Other patients who do not have this center of gravity will improve much more quickly.

3) The degree of hypersensitivity to stimuli : People who are oversensitive to their environment, react strongly to interactions with others, are sick frequently- if this is the case it is signifying that their defense mechanisms are constantly being brought in to maintain equilibrium, signifying that their systems are unable to remain stable.

4) Past history and family history :  People with a past history of deep and serious diseases, who have had a lot of suppressive therapy are more likely to encounter problems on the way to cure.

If any of the above factors are observed, the index of suspicion should be raised immediately. Typically if one of the factors appears, more than one is present.
...
Case Analysis for the Beginner

After the initial prognostic evaluation, the next task is to find the simillimum.

The initial remedy given is the most crucial decision made in homeopathy.

The first remedy is the one which opens up the case, which brings out the true healing potential of the defense mechanism.

    Occasionally the initial case is very obvious, but this is not the norm.

    If the remedy is clearly indicated, the first remedy will often give dramatic results. It is then very important to wait for a long time before either repeating the remedy or giving another one.

A more common pattern is a mixture of of symptom pictures.

   More thought and study is required to make a decision for a remedy that truly covers the totality of symptoms.

If the beginner is unsure on how to go forward, the best procedure is to "repertorize" the case.

  Begin with the SRPs, continue to listing and grading the rubrics.

  Never give a remedy just because it scores highest on the rubrics.

  Repertory sheets, or any similar tools are not recommended for the beginner- it is best to write it out longhand as a learning tool.

Attention should be paid to "small" remedies which run through a few rubrics. "Small" remedies are those whose provings are as yet incomplete, and therefor the number of symptoms listed for them is small.

Often a particular remedy runs through all rubrics except 3 and 5, when they are listed in order of importance.

It is frequently found that the simillimum does not cover all the important symptoms in a case.

After years of practice the repertorization process may be streamlined a bit, using "elimination" techniques. This must be done with extreme care. Symptoms are listed in order of importance and severity, arranged with great care. The remedies listed with the first symptom are written down. Only remedies which appear in the rubric for the second symptom are written down, etc. until all but a few remedies are eliminated.
...
Case Analysis for Advanced Prescribers

With more experience, less reliance is placed on formal repertorization. Often techniques are used which appear simple but are highly sophisticated and which are formed from years of experience.
...
Selection of a Potency

Once a remedy is selected, the next choice is the potency. There are no set rules, experience and observation will play a large role in making this decision.

Potency selection is less important than the remedy chosen.

  If the correct remedy is selected then it will act curatively in any potency, although a correct potency will act more gently.

  Incorrect remedies can be either inactive or disruptive to a case, regardless of potency.

Low potencies (12X to 200) are generally indicated:
- patient has a weak constitution
- elderly people
- hypersensitive people

Risks include overstimulation of weakened defense mechanisms, resulting in aggravations.

Frequency can be higher with lower potencies, with instructions to stop if any dramatic aggravation or amelioration takes place.

Oversensitive people should begin with a 30 or 200 - such people are very reactive to low potencies on a physical level and high potencies on an electrodynamic level.

Cases with known malignancy should not go over 200. Suspected malignancy should not go over 1M.
...
Single Remedy

One of the fundamental principles in homeopathy is to prescribe only one remedy at a time.

Multiple remedies or correlating treatments obscures results- both positive and negative.

Aphorisms 204 - 209: The Chronic Miasms

Aphorisms 204 - 209 The Chronic Miasms

Syphilis, Sycosis and Psora

204: If we discount all illnesses generated from an unhealthy lifestyle, and those caused by allopathic treatment, then what is left are the three chronic miasms: internal syphilis, internal sycosis, but especially (in greater proportion) internal psora. Each of these miasms was already in possession of the entire organism prior to the appearance of any of the local symptoms. These primary symptoms serve to prevent the outbreak of the internal disease.

If these local symptoms are repressed or removed externally, the miasms are robbed of their outlet of expression in local symptoms (which allay the general suffering.) When this happens, the miasms must express themselves fully, as an wide variety of chronic diseases. If these three miasms had been treated with internal homeopathic medicines much human suffering would have been avoided, instead of treating the external topical symptoms.

205: The homeopathic physician never uses local means (neither external, dynamically acting one nor mechanical ones) to treat these primary symptoms of chronic miasms. Nor is local means used to treat any of the secondary maladies which have germinated from the miasm's further development. When symptoms of either primary or secondary nature appear, the homeopath cures the underlying miasm. In this way the primary and secondary symptoms in addition to the miasm are cured and vanish of themselves (except in some inveterate cases of sycosis).

Unfortunately most homeopaths treat patients who have already had allopathic for their primary external symptoms. Thus it is much more common to treat secondary symptoms or miasms expressed as chronic diseases.

205a: Therefore I cannot recommend the removal of facial or lip cancer, which is perhaps the fruit of highly developed psora, sometimes combined with syphilis [using Cosmo's arsenical preparation]. It is extremely painful and often fails. More importantly the fundamental malady has not been alleviated, and something worse ensues.

205b: Primary symptoms of psora, syphilis and sycosis are: itch diathesis eruption, the chancre (or inguinal bubo) [syphillis], or figwarts [gonorrhea].

How to Treat Chronic Miasmatic Diseases

206: Beginning the treatment of a chronic malady, careful inquiry is required to determine whether or not the patient has had a venereal infection - either syphilis or gonorrhea.

1) If the only symptoms are those of syphilis or gonorrhea the treatment must be focused on those alone. However such pure cases are rare.
2) Any case of psora combined with a history of venereal infection must include these when considering treatment. Almost every case that initially appears as an old venereal disease is more likely a case complicated with psora. This is because the internal itch diathesis (psora) is by far the most frequent fundamental cause of chronic diseases.
3) Occasionally it will be necessary to combat psora and syphilis which are further complicated with sycosis, in chronically diseased bodies in which sycotic infections had once occurred independently.
4) More frequently the homeopath will find cases in which psora is the only fundamental cause of all remaining chronic sufferings,  but which has been complicated and worsened by allopathic treatment.

207: Once that information has been obtained, careful record must be made of what allopathic treatment the patient has received. Primarily what invasive medicines were used and how often, what mineral baths, and with what results. This will provide information on the patient's original state and to understand to some extent the degeneration since then.

208: Consideration must be made of what elements in a patient's life might increase their malady, or to what extent they could improve or hinder the treatment. The physician must consider the patient's:
1) age
2) lifestyle and diet
3) occupations
4) domestic situation
5) civic relations, etc.

In the same way the patient's mental and emotional state should be considered to determine whether it hinders treatment, and to determine if additional psychological treatment is necessary.

209:  After this information has been obtained, and these considerations made, should the physician seek over the course of several interviews to sketch the disease image of the sufferer. The aim being to trace out the most striking and singular (characteristic) symptoms.

Based on these symptoms, the physician starts treatment by selecting the medicine that has the utmost possible similarity of signs to those of the disease.

Aphorisms 72 - 81: Definitions of Acute and Chronic disease

Aphorisms 72-81

Definitions of Acute and Chronic disease

72: Diseases of humanity are in part acute and in part chronic. Acute diseases progress rapidly from the abnormally mistuned life principle. Chronic diseases are from dynamically mistuned living organisms with small, subtle beginnings which gradually progress until health is removed. The life force cannot oppose chronic diseases on it's own and must allow them to proliferate, which causes the mistunement of the life force to be exacerbated. Chronic diseases arise from dynamic infection by a chronic miasm.

Acute Diseases
73:  Acute febrile disease may be caused by exposure to the disease. They may be brought on by lifestyle excess or deprivation, exposure to extreme temperatures, physical trauma or strain. Fundamentally these acute fevers are flare-ups of latent psora which then return to a dormant state.

Sporadic acute diseases attack several people all at the same time. These may occur in different places, but at the same time. Only a few people possess the receptivity to become prone to the disease at the same time.

Epidemic acute disease seize many people with similar complaints from a similar cause. These diseases tend to be contagious, especially in largely populated areas. Each epidemic has an unique fever, and an unique cause such as war, floods or famine.

Some acute epidemic diseases are particular acute miasms that recur in the same manner. They either happen once in a lifetime (such as mumps, measles, smallpox) or they recur often in a similar way (levantine plague, coastal yellow fever, Asiatic cholera, etc.)

73a: The homeopathic physician does not get caught up in labeling diseases. Treating diseases which have been given a traditional name by traditional treatment is a mistake which ignores the individual nature of each set of symptoms.

73b: Since 1801 physicians have mistaken purpura miliaris (roodvonk) fever with scarlet fever. They have different symptoms and different treatment, and now have combined at times to become a new type of fever not treated by aconite or belladonna.

Chronic and Other Protracted Diseases

74: Among chronic diseases, iatrogenic illness (caused by allopathic treatment) is one of the most difficult to cure. Over a prolonged period the life force must alter the organism to uphold life while being weakened by the allopathic treatment. This causes:
1) parts of the body to no longer respond correctly, the ability to arouse or be sensitive is being forcibly dulled or unduly heightened
2) dilating or contracting parts
3) slackening or hardening parts
4) annihilating parts
5) causing organic defects which cripple the body in both the interior and exterior

The life force slowly alters the organism in an effort to protect it from complete destruction, in the face of continued attacks by treatment delivered allopathically.

74a: Broussais; treatment of bloodletting and starvation is one of the most debilitating. Bloodletting especially does nothing other than weaken the patient and remove their ability to recover.

74b: Abnormalities found during autopsy are often caused by the treatment, not the disease.

75: Of all chronic diseases, these cases of the body being altered by continuous allopathic treatment are the saddest and most incurable.

76: Homeopathy was designed to cure natural diseases only. No human medical art can reverse the alterations of the life force caused by long term allopathic treatments.

77: Diseases should not be called chronic when suffered by people who:
1) continually expose themselves to avoidable malignities
2) regularly consume harmful food or drink
3) have immoderate habits of inebriation which undermine health
4) undergo prolonged deprivation of things that are necessary for life
5) live in unhealthy places (especially marshy areas)
6) reside in cellars, damp workplaces or other confined quarters
7) suffer lack of exercise or open air
8) undermine health by excessive mental or physical exertions
9) live in a state of constant vexation or upset

These types of illnesses resolve themselves when the underlying causes are removed, provided no chronic miasm lies in the body. These cannot be called chronic diseases.

78: True, natural, chronic diseases arise from a chronic miasm. Left to themselves these diseases go on increasing. Even with a healthy lifestyle they worsen throughout the span of a lifetime.

78 note: Chronic miasmatic disease often become dormant in one's youth, only to reappear with a vengeance with age and adverse circumstances.

79: Until now only syphilis has been known as a chronic miasmatic disease, which left untreated would persist throughout the patient's life span.

Uncured sycosis (figwart disease) is another chronic miasmatic disease that cannot be cured by the life force alone. Treating the outgrowths neglects the residual wasting aspect of this disease.

80: The chronic miasm of psora is much more serious than syphilis or sycosis. Syphilis comes as an internal wasting disease and sycosis develops cauliflower-like growths and psora documents itself by peculiar skin eruptions. Psora is the true fundamental cause of almost all the other remaining forms of disease. These include mental as well as physical diseases in a truly vast range of symptoms.

80 note: Discover of psora as the source of countless forms of disease

81: Psora is expressed in countless disease forms, as it has evolved through millions of human organisms over the course of generations.

81a: Some causes of psora manifesting as chronic maladies:
1) climate and quality of the location where you live
2) irregular childhood, including neglected, distorted or over-refine development of body or spirit
3) misuse of the body or spirit in your job or primary life relationship
4) diet
5) human passions
6) customs, practices and habits of many kinds

81b: Pathology books have lumped a variety of different disease states under one name.  Often diseases are the same in only one symptom between patients, so why would you treat them all in the same manner? Some epidemics propagate differently each time they appear, and yet they are all marked as the same.

Vithoulkas: The Science of Homeopathy Ch 15: The Follow-up Interview

Vithoulkas Ch 15 The Follow-up Interview

- Much importance is placed on the initial patient interview and the initial remedy given, however it's also important to correctly interpret the patient's response to the remedy

- Most common homeopathic Rx = "wait"

- If first Rx is the most important decision made, the follow-up prescription is likely the most difficult decision made

- Is the patient truly better? is the remedy producing desired response or it produced only a partial effect? is a new remedy needed or a different dosage? does time need to pass before a clear picture emerges?

- What is really happening to the patient must be determined, outside of whether or not the remedy was the right one

-Patients also respond difference between first and second interview
-- Some may focus on details instead of overall change
-- There is always hope that the remedy is acting
-- They may be overly cautious in revealing the response, or carried away
-- Patients may be emotionally open or closed, hypochondriacs, or just oversensitive

- Patient responses must be inquired into with greater detail
- The risk is to not realize a remedy is working and to prescribe a new one, starting a chain of events which may change the patient's state

- DEF: second prescription : one which follows a remedy which has acted
-- If a remedy did not act at all it isn't counted, if it acts even a little it is
-- This is key when dealing with inimical remediesunnnnnn
.....

Time intervals

- Follow up for acute cases depends on the severity of the illness
 -- usually 6-24 hours

- Follow up for chronic cases is ideally two months, however this is usually too long if the patient does not respond to the remedy at all so a one month compromise is usually done

- Follow-ups are really important for gathering data
- It is not needed or recommended to give a remedy for every visit, although greater number of visits increases the pressure on the homeopath to "do something"
....

Format of the follow-up

- Less time than the initial interview
- Homeopath must be vigilant in note-taking and observation
- Not good enough to mark better or worse next to each symptom

Follow up decisions:
1) What was the true response to the first remedy- above and beyond patient's description? Has the medicine produced a curative response? Was it a partial remedy producing only unimportant changes? was it suppressive, causing ultimately a worsening of the overall health of the patient? Or was it merely an incorrect prescription?
2) Is another medicine required or is it best to wait?
3) If another medicine is required, what is the correct remedy and potency?

Basic format of questions:
1) How does the patient feel in general? Better, worse, different?
2) Has the degree of energy been affected? More, less, same?
3) Has there been any change in the physical chief complaint?
4) What changes have occurred on the mental and emotional planes?
5) The original case should be reviewed to determine whether changes have occurred for better or for worse.
6) Any new symptoms should be inquired into.
7) Patient should always be allowed to elaborate on previously described symptoms.

Four primary areas: overall state of health, general energy level, the chief complaint, and the mental/emotional changes

.....

Homeopathic Aggravation

- Concept: the simillimum for a patient causes the same symptoms in healthy people. Therefore, it isn't unreasonable to think that there may be some aggravation of symptoms in the patient after taking the simillimum- in fact this may be a desirable as it signals a truly curative response.

-One circumstance where aggravations can be bad is when a poorly indicated remedy is re-applied.

- Another circumstance to be cautious of is for patients with severely weakened constitutional power.
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Hering's Law: cure proceeds from above downward, from within outward, from the most important organs to least important organs, and in the reverse order of appearance of symptoms.

Human guinea pigs

This could be titled 'what is a medicine?' as it's related to my last post. Another class demonstration this year had us split into groups preparing remedies, the homeopathic equivalent of medicines. In advance I thought it was a neat idea, and good practice to know how to prepare things myself.

On a side note, this is part of why homeopathy will never be big business- anything where you can and in fact are encouraged to prepare your own medicines will never be hugely profitable. In fact the core texts all expect practitioners to make their own remedies by hand, and to never trust things that were prepared in unknown circumstances. The fact that almost all of the remedies are made from natural items, the cost is quite low- more reason why there are political reasons why homeopathy was shut out of the public eye.

At any rate, this experiment had two components. Both are inert substances. One was lactose, or powdered milk sugars, the other was graphite- the kind that is used in a pencil. These could both be part of the 'inactive' ingredients list on the side of a bottle.

Just looking up the word 'inert' I found these descriptions:
3.  Chemistry: Not readily reactive with other elements; forming few or no chemical compounds.
4. Having no pharmacologic or therapeutic action.

So we prepared a trituration of Graphites. In English we took a mortar and pestle, and ground together some lactose and graphite. At first I was primarily interested in the proportions, and watching how it was done.

Soon, however, I was able to see reactions to this process in each of the members of the group. We weren't eating this, or putting it on our skin- and yet there were both mental and physical reactions to watching someone else grind up this powder. Obviously we surely inhaled some dust, but again these were supposedly inert substances.

People started laughing inappropriately, and itching and showing an assortment of real reactions. Initially I felt nothing- and I admit to wondering if this was sort of like watching a bunch of people get a contact high. And then it hit me and I couldn't ignore that I was suddenly feeling just the same. Not only were people exhibiting the same types of behaviors, I could literally see red flushing and patches on people's skin! We compared notes later and also had the same reaction of returning to normal after a few hours away from class.

All from being near a preparation of two inert substances. It really made me question how our bodies react to pretty much everything we are exposed to in our environments. It also demonstrably showed me the power of something I assumed was 'inert' and therefore completely inactive. The more I learn, the more I question a lot of assumptions I've had about how everything works.

What is a poison?

According to a hospital's definition: a poison is any product or substance that can harm someone if it is used in the wrong way, by the wrong person, or in the wrong amount.

This is one of the first topics we discussed in class this year. When looked at in this really simplified way, it's easy to see how practically anything can be a poison. I mean, we've all heard the story of how you can kill yourself by drinking too much water.

In this sense anything can be a poison. Or perhaps medicine- as long as the conditions of the definition are met. One of the fascinating things about homeopathy is how using remedies made from things that are typically defined as "poisonous" end up being helpful and healthful. The crucial part being given the correct remedy in the correct dosage.

In homeopathy the doses are so microscopic as to not be detectable by scientific tests. This is part of the mystery surrounding how it works. Personally I am not terribly bothered by this. To me the only thing that matters is whether or not it's effective. I can only assume that some day our level of science will develop to the point where it can explain homeopathic medicine and how it works- but up until then I don't need that reassurance in order to believe in it.

For example I take a remedy made from arsenic to help with my asthma. I'll even admit that I wouldn't necessarily volunteer this information to my mother. Why? Because the explanation would have to surmount her reflex reaction towards taking a poisonous substance. Telling her there aren't any full molecules of arsenic left in the remedy would probably not reassure her.  Trying to explain the transference of 'energies' between molecules tends to make people's eyes glaze over or to become dismissive of so called "hippie-shit".

And yet I've found it to be really effective, often as much as my inhaler, for stopping asthma attacks. Again, it goes back to what works.