Mastering Homeopathy—Accurate Prescribing for a Successful Daily Practice

Jon Gamble Karuna Publishing, NSW, Australia, 2004 Price: £20, ISBN: 0-9752473-0-1.

The preface says that this book is intended for ‘competent and fully trained homeopaths who are familiar with the homeopathic aggravation, the primary and secondary response triggered by a medicine, and Hering's Law of Cure. Also, one should be familiar with the common symptomatologies of disease’. This is good advice, as the homeopath is often asked to examine the patient with an otoscope or sphygmomanometer and diagnose pneumonia, bronchitis, glue ear, breast lumps, etc. These are all subjects covered in this book.

Gamble originally studied arts/law and went on to study homeopathy after being successfully treated himself. He has run a busy practice in Woolagong, NSW Australia, since 1987, also participating in the Sydney Ear Clinic which led to the writing of this book. The idea is to have a desk top reference to the common problems that come our way in G.P. Each condition has one or two pages devoted to it and lists of remedies to try are given. The regimes are described as ‘pathological prescribing’ because they focus on the particulars, not the generals.

The layout reminds me of Dr Noel Pratt's book ‘Homeopathic Prescribing’ (Beaconsfield 1980), which I used a lot when I first introduced homeopathy into General Practice. You look up the condition and find a list of remedies that might help. Dr Pratt, however, gave no advice about potency, so at first I always followed Dr Jack's advice about using 30C for most situations until I got to know it. There is no general advice about potency in Jon Gamble's book. Instead for each condition a list of remedies is given with a suggested potency. For example, for otitis media the list is:

Belladonna 3: red drum;

Ferrum phos 200: pink drum;

Hepar sulph 200: ear pain from tonsillitis;

Chamomilla 30: ear pain with teething;

Aconite 4X: ear pain after exposure to cold wind+restlessness; Arsenicum 3: Ear pain unresponsive to other remedies.

Six remedies are suggested for chronic bronchitis, five in the 200C potency and one (Tub Bov) in the 1M.

This book mainly concentrates on acute prescribing, which can be difficult at the best of times. Having said that, I think most people end up with a group of remedies they tend to use under certain circumstances, which work for them. The question is does everyone have the same list for the same conditions? There has been no research into this aspect of prescribing. Jon Gamble's list is often different to mine. His list on page 97 for shingles does not contain Ranunculus bulb which I find the most helpful remedy. This may reflect the fact that he works in Australia and I in the UK.

I was confused by Gamble's advice on the use of the different potencies. There is no explanation as to why they have been chosen. It would mean asking the pharmacist to keep a large range of potencies in stock, or keeping them yourself.

Hahnemann discusses potency and repetition of the dose in the Organon (para 128 and following). Very high potencies are advised if the problem is mainly in the mental sphere. There is no explanation in Gamble's book why certain potencies are used, eg for acute thrush Candida 20M is advised bd for 10 days. This is a potency I have never used, but I find Candida 30C usually works. There is no explanation why this unusual potency is preferred.

Part 2 is 13 pages long and devoted to ‘illnesses in women’. There are an interesting two pages on oestrogen dominance with clinical presentation, differential diagnosis and treatment. This condition is described as iatrogenic, resulting from H.R.T., oral contraceptive and ingestion of xeno-estrogens and associated with hypothyroidism. Thyroidinum 200 is advised with Folliculinum 30 which is said to be a specific for removing synthetic estrogens although the rational is not stated.

However, advice is given about chronic prescribing, or at least the repetition of the dose. 6C, 30C, or 200C is given every second or third day and 1M weekly. Potencies are also mixed, for example for asthma, Bryonia 30 and Arsenicum 3 are mixed and taken for many months. The patient is advised not to withdraw the medication until improvement occurs. In my experience of treating chronic asthma the correct remedy improves the symptoms right from the introduction of the remedy, and it is usually not necessary to keep taking it for months, as this indicates a poor choice of remedy.

One section deals with gallbladder stasis and advises using Cholesterolinum 1M bd for 4 weeks followed by lemon juice and olive oil. Gamble says that he has never had a stone get stuck in the common bile duct with this regime, but he does not say how many patients he has treated. It would have been nice to have had some serious outcome studies from this work but you get the feeling that this is a book written about impressions of outcome. Anecdotal evidence is the start of research.

Finally there are eight case histories described. One of hyperactivity, three of asthma, one each of middle ear effusion, chronic otitis externa, hypothyroidism and chronic fatigue syndrome. They illustrate different aspects of prescribing including the layered approach, paucicity of symptoms to prescribe on and the relationship between the physical and mental symptoms.

A useful book to keep by you for a quick guide to a choice of remedy. If all the G.Ps in the country had a copy and a rudimentary knowledge of homeopathy prescriptions for antibiotics would decline considerably.