APPROACH TO DENGUE & ACUTE CASES (part II)
The article below is based on the experience of treating several hundreds of cases of potentially fatal illness, including post operative complications, cases advised immediate surgery and cases forsaken by specialists of the allopathic school.
The following guidelines may be observed which by far are neither exhaustive nor complete.
1. Ensure your medical diagnosis is right. This helps in case selection and prognosis.
2. Assess the patient’s clinical condition especially his general condition.
3. Explain the seriousness of the patient’s condition and take the relative’s informed consent
Get a good case history. First, note down the disease symptoms to justify the medical diagnosis. Below each symptom that is elicited note down the concomitants and below each concomitant, note the modalities. In infants thermals are difficult to elicit. It is important to note down the sequential order of appearance of the symptoms and their concomitants. In infants, mentally challenged individuals and in unconscious patients, observation of the patient’s particulars (objective symptoms) and few symptoms as told to you by the relatives will have to do. Relatives may exaggerate or attempt to focus your attention on to symptoms they regard as important or serious, especially during follow-up. OBSERVATION is the watch word.
The past history may be irrelevant. Many ailments especially pneumonias are known to be seasonal i.e. < winter, monsoons. Some of the symptoms expressed by the patient/relatives may be iatrogenic. Rule these out of the therapeutic totality. TOTALITY is not in the number of symptoms you have collected. Read Lesser Writings – Kent and Boenninghausen.
The PQRS symptoms are nothing but the concomitants and their modalities and never the disease symptoms. (Read Guernsey, Kent’s lectures on the use of Guiding symptoms)
REPERTORIZATION: Select general symptoms, then particulars with modalities & concomitants. Avoid rubrics of single drugs with one mark.
PRESCRIPTION: The indicated drug is the simillimum and vice versa.
POTENCY: Medium to high potencies give the best results.
REPETITION: In acute cases frequent repetition is permissible. Read Organon aph: 247, foot note to 247; aph.248 (compare with Vth edn.). Read also Dudgeons lectures, Stuart Close, Kent’s lectures, Boenninghaussens Lesser writings, Borland’s Pneumonias. My personal preference is to repeat every 15 minutes or 1/2 hourly for 4-5 times then decrease repetition to 2 hrly or 4 hrly as the case may deserve.
RECOVERY: The most skillful part of treatment is to assess recovery. The concomitants subside first. The concomitants disappear in the reverse order of their appearance, Herings law is ambiguous. He stresses on the skin being a less important organ than say the heart or the lungs. FACT: One can survive and lead an almost normal life with one lung, kidney or lobe of the liver. The clinical onset of Cirrhosis begins only after almost 90% of the liver is destroyed. The heart with only 50% of its ejection fraction can still pump enough blood through the body. Can one survive with 50% burns of the skin? IMPROBABLE. Trash such irrelevant opinions if you wish to see progress.
The recent failure of antibiotics and the rise in resistant strains of bacteria and viruses have provided an opportune moment for us to re-assert ourselves and this system in the treatment of acute cases.
The pleasure of treating such cases:
1. You have saved a patient from imminent death
2. The skill involved in treating such cases is appreciated by both patients and other professionals
3. The cure takes place so rapidly (see my other cases on this website & blog), that practice becomes a pleasure
4.Acute cases are more remunerative and more patients can be treated due to shorter history and follow-up.
5. Publishing statistics and analyses of hundreds of cases is scientifically possible with easily reproducible results. (No one publishes statistical analysis of chronic complaints for very obvious reasons – Philosophy makes for easier seminars).