The complexities of homeopathic prescribing or how do we decide to do what we do?
13 December 2017 (online)
It is just so difficult, isn’t it? Not only do I need to master pathological, local remedies, repertorisation, miasmatic theory (old and new) and a Kentian ‘classical’ approach to homeopathic prescribing, but now I also feel bound to understand families, themes, isopathy and other nosode-based approaches and have a reasonable acquaintance with Scholten's and Sankaran's ideas (to name but a few currents of thought). How is a homeopath to choose what to do to decide on a remedy for the suffering individual who has consulted them?
Some prescribers rigidly adhere to one ‘school’ or method of prescribing. Others allow everything to influence them and accord respect uncritically to all methods. There are those who are deeply averse to non-traditional, non-Hahnemannian approaches in materia medica research and prescribing[ 1 ] and even some who assert that the choice of a particular remedy hardly matters anyway, holding homeopathic responses to be non-local phenomena which depend on the special attention given in the consultation.[ 2 ]
This issue of the journal illustrates the diversity of methods of selecting the similimum. Included in this issue is a paper from Van Hootegem[ 3 ] who uses a psychotherapeutic framework and techniques to allow the prescription of a helpful remedy in a broadly traditional sense, without full repertorisation. The way this is reported makes sense from outside but obviously depends for its success to a large extent on the particular range of expertise of the prescriber. However, one can imagine the methods being expanded and applicable in other cases.
The case series from Iran, also in this issue illustrating the effectiveness of homeopathy in trigeminal neuralgia (TN) (at least as good as conventional options in this small series) shows the results of a more usual, ‘classical’ method of remedy selection.[ 4 ] Perhaps we all feel we could achieve this and we are more familiar with how one might arrive at a prescription for TN in a repertorisation-based ‘classical’ way.
The account of the ‘Bombay method’[ 5 ] of case taking and remedy selection by Liz Thompson and Julie Geraghty provides an illuminating insight into one of the methods currently becoming most widespread and in vogue. It is not a new idea to set remedies in the context of comparing their materia medica with others derived from their natural groups. Over 100 years ago, Farrington based the whole organisation of his Materia Medica lectures on this principle,[ 6 ] but modern interpretation has gone much further. A very good example of new ways of thinking about natural substances and their place in the order of things and then analogising with the patient's predicament to find an appropriate remedy can be found in the book on spider remedies by Drs Mangialavori and Zwemke.[ 7 ] Here, zoological, mythological and homeopathic knowledge are synthesised to build up a wide picture of when these remedies might be helpful.
In the rush to describe and prescribe remedies from evermore esoteric substances and in the drive to make homeopathic prescribing somehow ‘easier’, we should be careful not to forget where it all comes from. We neglect basic homeopathic theory and skills at our peril and if the whole process of giving a remedy is to be reduced to simple formulae, we risk losing the human interaction of the homeopathic consultation, which seems to be an essential part of our healing work. In the end, people will always bring an amalgam of their reading, analysis and experience to bear on the particular clinical situation their patient presents to them. The papers in this issue of the journal show us that this still holds true and an understanding of a multiplicity of approaches to finding the similimum is to be welcomed as part of individuals’ practice.
- 1 Vithoulkas G. A proving of Thiosinamine (letter to editor). Br Hom J 2001; 90: 172.
- 2 Walach H. Magic of Signs: a non-local interpretation of homeopathy. Br Hom J 2000; 89: 127-140.
- 3 Van Hootegem H. Can homeopathy learn something from psychoanalysis?. Homeopathy 2007; 96: 108-112.
- 4 Mojaver Y.N., Mosavi F., Mazaherinezhad A., Shahrdar A., Manshaee K. Individualized homeopathic treatment of trigeminal neuralgia: an observational study. Homeopathy 2007; 96: 82-86.
- 5 Thompson E.A., Geraghty J. The vital sensation of the minerals—reducing uncertainty in homeopathic prescriptions. Homeopathy 2007; 96: 102-107.
- 6 Farrington E. A Clinical Materia Medica. Third Revised edition. Philadelphia: Boericke & Tafel; 1897.
- 7 Mangialavori M, Zwemke H. Bitten in the Soul. Experiences with Spider Remedies in Homoeopathic Medicine. Modena: Matrix Editrice, 2004.