I work in a charitable hospital where there are four different cabins of doctors serving Allopathy, Ayurveda, Homoeopathy and eyes specialization. It is a normal practice with patients to report personally for taking medicines in all these faculties but it is abnormal if some one comes with the request that he needs medicine for the patient at home.
Except Homoeopathy, all the other systems have provision to oblige the absenting patients. The children and old patients who are unable to come to the clinic are not generally entertained in Homoeopathy even for a fever, cough or diarrhoea. This makes Homoeopathy isolated and unpopular.
There is no hesitation in saying that Homoeopathy has limited provision, in strict compliance of principles, for prescribing a single remedy, to absenting patients.
We have been giving medicines to infants and children who are unable to speak. This is based upon detailing by the parents, physical examination and checking with the constitution. But is it possible to execute physical examination and constitutional assessment in a crowded charitable hospital where large number of patients queue-up for their turn and the time to see patients is two hours for the doctor.
Under such conditions, selection of remedy is based upon hearing from parents. Coming to the patients not seen but prescribed, we miss physical examination, constitution assessment and habitual mannerism. If we refuse to prescribe medicine for absenting patients, the relatives of the patients are compelled to move to the conventional system of medicine. Homoeopathy looses its clientele. Not only this, the doctors refusing to give medicine without seeing the patient are declared incompetent. People do not recognize our helplessness due to binding to principles of Homoeopathy. To solve this dilemma, is it not possible to prescribe the remedy upon Homoeopathic-etiology?
Homoeopathic Etiology or causation
Each system of medicine considers ’cause’ of disease important to assess the extent of disease and Homoeopathy is no exception. There are three types of causes for a disease. The inherent, the regular (or maintaining) cause, continued cause and acquired cause. The inherent cause or organic-constitutional cause is difficult to cure and patients always present themselves for treatment and hence this does not come under the purview of this article. The continued cause is due to miasmatic effect and should be considered ‘chronic’. People present themselves for these problems, too. It is also out of the jurisdiction of this article. The only left out cause is ‘acquired’ for which the people do not present themselves, for which we are discussing. This we can also call exciting cause. This may be due to virus, bacteria and other microorganism.
Allopathy believes in this causation too much and gives opposing medicines to fight the infection. Homoeopathy has its own stand in respect of such type of exciting cause and deals through correction of miasmatic probe. The causes which Homoeopathy deals are generally food, climate, environment, thermal states, abuse of drugs, consumption of liquor, suppression of discharges, fear, anger, chagrin, over-lifting, injuries and so on. We have a long list in this category. It must be taken as granted that when we prescribe on causation; we are dealing with ‘acute’ diseases and not chronic diseases. So, the patients not seen but prescribed belong to ‘acute’ phenomenon. Acute diseases have a sudden onset, short duration and end in either complete cure (most of times) or sudden death.
Acute diseases are also due to epidemics, sporadic, trauma bases, vocational and environmental. These are all causes. When a person lives in such states, occupations, and areas and undergoes changes due to foods and moods, there ought to be alteration in the state of health. This altered state is what the patient describes and what is known as symptom in Homoeopathy. Homoeopathy is based upon symptoms and symptoms are products of alterations from normal health. Alteration is product of external stimuli. If we know stimuli, we can prescribe remedies without seeing the patient. Be rational and think over this aspect. We cannot say ‘No’ to this argument.
One has to innovate his or her method to prescribe on causation. This is learnt by studying theory of homoeopathy associated with good lot of experience.
This is a technique which has not been given due importance when a student is taught practice of medicine in the class. Students are taught cause of ailments with reference to material agents, diseases owing to deficiencies or excesses and metabolic changes. In the Organon lectures of the class, more emphasis is given on loss or derangement of vital force added by miasmatic theory. All these confuse the students and they do not understand etiology. The motive of education should be to make the students aware of the practical aspects of Homoeopathy as well. (I stand to be corrected for my remarks on education system).
We have hundreds of medicines, which have ailments from emotional excitement, grief, bad news, fear, anger, disappointed love, abuse of drugs, sexual excesses, loss of vital fluids, and exposures to thermal states and variety of foods. How to isolate them for converting medicine into remedy for the patient not seen? Here are few examples.
Let us take examples of fever. If it is told to be due to exposure to dry cold air, think of Aconite. Now enquire about the other symptoms of Aconite i.e. getting chilled when perspiring, fright, anger, cold sweat, coldness and heat alternating, thirst and restlessness presence, dry heat, red face and sweat relieving. If the answer is affirmative, Aconite can be given. Similarly Bryonia, China, Sulphur or Cina fevers can be identified.
If it is during dentition or from bathing, washing the remedy is podophyllum. Now enquire about its related symptoms such as watery, jelly like mucus, painless, profuse, gushing and offensive. Similarly if the cause relates to after eating cabbage, during pregnancy, stormy weather or after riding a carriage, it is petroleum. Now enquire about symptoms of petroleum such as diarrhoea during day time only, water, itching in anus, empty feeling in stomach and so on. Similarly China, Aloe, Arsenic etc. can be identified.
If the patient is old, has dry cough with great rattling of mucus and difficult expectoration, the remedy is Baryta mur. Now enquire about the symptoms of this remedy like icy coldness of body, general weakness in the morning, muscular stiffness, all gone feeling in epigastria and so on. Similarly if the cough is in warm weather after cold weather sets in, from cold drinks, dry cough worse after eating with pain in chest, it is Bryonia. Now enquire about other symptoms of this remedy like abnormal thirst, hunger, loss of taste, nausea after rising up, pressure in stomach as of stone, constipation and so on.
It is not necessary that your every enquiry will match the remedy, you have thought over but if most of the symptoms tally, go ahead, Even if the remedy given by you does not work, you will not be blamed because of the lacuna of absence of patient. The best effect of your taking interest in the patient and enquiring and giving medicine will be that the relatives of patients will support and promote Homoeopathy in future. If you have confidence in your ability, there is no reason why even a placebo should fail to yield successful results.
Dr. Shiv Dua