KILLER AGGRAVATION – reality or misconception?

  The homoeopathic   aggravation Hahnemann explains, is the reaction of the  vital force to the artificial similar drug  disease  "called forth  in the diseased parts of the body by an  excessive  dose, diseased  parts being hypersensitive to `like' drug action".  With him  it  is "quite in order" and of good  prognosis  "if  excited within proper limits." Therefore,-"The doses of the homoeopathic medicines are invariably to be reduced (higher dilutions) so far that, after they have been taken, they  will merely produce an  almost    imperceptible    homoeopathic aggravation". And he says: "The doses be  reduced, provided  that the dose, immediately  after being taken, is capable of causing a slight  intensification  of  symptoms  of  the  similar   natural disease." Therefore, the higher the potency, shorter the duration of action on the physical level (though dynamic effect is increased), hence less the chances of an aggravation. i.e. if a patient were given a 30C potency and another a 10M, the chances of an aggravation are more likely in the patient taking the 30C.

ORGANON 6^th Edn. Aph 158: The globule of the high  potency  is best crushed in a few grains of sugar  of  milk which  the patient can put in the vial and be dissolved   in  the requisite quantity of water.**134*}     (with perhaps 8, 10,  12, succussions)   from   which  we  give   the   patient    one   or (increasingly)   several  teaspoonful  doses,  in  long   lasting diseases  daily or every second day, in acute diseases every  two or six  hours and in very urgent cases every hour or oftener.   Thus in   chronic  diseases,  every  correctly   chosen   homeopathic medicine,  even those  whose action is of long duration,  may  be repeated  daily for months with ever increasing success.  If  the solution is used up (in seven to fifteen days) it is necessary to add to the next solution of the same medicine if still  indicated one  or (though rarely) several pellets of a higher potency  with which  we continue so long as the patient  experiences  continued improvement ….. This quote explicitly means to say, that a drug can be safely repeated as long as its dynamisation is increased continuously.

This last strategy of suddenly jumping the potency in my experience can at times have disastrous results. I would prefer to add once again, the same drug in its previous potency to the solution and if necessary give a few doses with increased frequency to re-excite the Vital force and its  curative action.

As all Homeopaths would know, it is necessary to understand that the Homeopathic aggravation differs in its timing in acute and chronic diseases. In the acute disease it appears soon after commencing treatment. In chronic disease it may be expected towards the end of treatment – in other words just before cure is certain. Yet, if the above highlighted portion of the aphorism is read, it becomes obvious that the aggravation can be avoided and certainly need not be feared.

My interaction with thousands of patients and scores of Homeopathic practitioners has helped me interpret this event as follows:

1. The enthusiastic academician who in his haste to impress his patient embarks on a mission to enlighten his patient as well. Having learnt of this impending aggravation, the patient anticipates it and obliges the good doctor with his tale of aggravation.
2. The physician is not clear on the different concepts of acute and especially chronic homeopathic aggravations; hence poses leading questions to the patient who duly obliges the good doctor.
3. The physician is not certain of the disease and its natural progress and mistakes the deteriorating condition for a Homeopathic aggravation.
4. The hypochondriac patient who `jumps to the occasion’ because he is previously indoctrinated by another homeopathic enthusiast (many practitioners are not institutionally trained and may carry erroneous or preconceived ideas of this phenomenon). Incomplete and inappropriate information about homeopathy is freely transmitted from patient to patient and now is also available on the net.

I recollect losing several patients to this preconceived idea thanks to this increased `awareness’. It is amusing and defeating, to have patients paying my consulting fee, then refusing treatment saying “But doctor I cannot tolerate any increase in my suffering due to your treatment”. And this despite my fervent pleas that this is not going to happen! The Homeopath must learn to hold his tongue. To decide whether the reported increase in suffering is in fact an aggravation, it is always better to call the patient back to the clinic and re-examine him. The physician must judge for himself what the patient’s complaint is all about, rather than warn the patient about a phenomenon which may be nothing more than preconceived misinformation. Oftentimes the aggravation reported by the patient may either be an increase in the particular symptoms with relief of the generals (a classical Homeopathic aggravation), or a dissatisfied patient who insists that relief is not as quick as he/she expected it to be. In  this latter condition the patient irrationally  requests a change in remedy. 

To illustrate my point I will quote a case: Mrs M.P. was admitted to an orthopedic hospital for treatment of a fractured hip. She developed a severe diarrhea which was resistant to allopathic medication. After 12 days I was called to treat the lady who was passing 15 - 20 motions per day by her own admission. On the second day of treatment I went to see her and was confronted by an agitated patient who insisted that her condition far from being relieved, had worsened. I asked her repeatedly as to how many motions she had passed since morning. After avoiding the question several times she finally confessed that she had passed only one semi solid stools that morning!! Homeopathic aggravation or impatient patient????

To those who hold the theory of a Killer aggravation close to their hearts, I implore you to find such a reference in any of the provings (the basis of Homeopathy), where a pathology has been created or aggravated by Homeopathic medicines. 

Having practiced Homeopathy for 3 decades and more, and attended numerous seminars, I have come to the conclusion that there are three types of Homeopaths. 
1. The IMPRESSARIOS
2. The `HOLIER THAN THOU'  Go-by-the-book homeopaths and 
3. The PRACTICAL- `Let me cure my patient first' type.
The first type are not so worried about their cures. They do not have enough cures to produce a serial study of any disease. A serial study exposes the physicians approach, consistency and the efficacy of his approach. Instead they spend plenty of time and enough imagination to invent improbable theories using the liberty offered them by Homeopathic philosophy which they turn upside down on its head. It does make for great seminars, discussing ONE case for six hours. I have a better term for this hopeless exercise. I call it Mental masturbation!
The second type is the one who desperately wishes to sound academic and `accepted' and   `enlightened', like he just saw GOD. He forgets that we have all read the Organon and the Materia Medica which are our text-books. Text books are not gospels. They are knowledge repositories. Knowledge is to be applied skilfully through adaptation (if need be) to obtain a cure, whether by applying Key-note prescriptions, Generals or Mind symptoms. There can never be a `RULE' that defines our approach to every patient, just as a single size shirt wont fit every man. Some in this genre, stumble along, more interested in `LAWS' and the diagrams they draw in Power point presentations or the teacher's black board. Easier still is, when they attend a seminar and mimic the speaker as if he has just re-written the Homeopathic manuals.
The third type is the practical, no nonsense physician, who has the patient's interests in mind and will bring forth all the knowledge he has, adapt it to the case and the situation and cures the patient. He uses the text book as a frame work to support his prescription. He does not waste time on pontification. He does not waste time (more importantly other people's time) in improbable philosophy. This type of physician is the one who honestly and painstakingly accumulates data which can be analyzed, assimilated and disseminated for use by others. Dr. Samuel Hahnemann was this last type. He re-wrote the Organon 6 times as he gained knowledge and adapted it to the prevalent situation. The success of his doctrines are seen irrespective of whether you follow his fifth edition of the Organon or the sixth. For this very reason, Homeopathy is accepted and proliferates in India and many countries all over the world despite the onslaught of the `scientific' Allopaths and their Pharmaceutical industry. No Lancet can puncture our noble science thanks to the extremely meticulous and no-nonsense approach of the founder of Homeopathy. So solid was the foundation he cast, that after 250 years `SIMILIA SIMILIBUS CURENTER' remains the ultimate altruism.

 

HOMEOPATHIC SEMINARS - Is screening necessary?

After many years I decided to attend a seminar in Kolhapur, conducted by a reknowned Homeopath of Pune. He is reputed to have a 80 bedded hospital where-in (supposedly) all types of emergencies are handled. The publicity given, led me to believe that he treats cases admitted in the ICU on ventilator. I bit the bait.

I was curious to know how a Homeopath runs an ICU without the help of sophisticated life-saving equipment, I.V. fluids and Oxygen none of which he is trained to handle, leave alone legally possess. As the video presentation began it was evident that the cases he claims to have treated were in fact treated surreptitiously, in other hospitals, without the knowledge of the hospital staff, management or faculty. There is no evidence that the allopathic drugs were discontinued or modified to allow the administration or action of the Homeopathic remedies. The condition which the patients were suffering from (as we were told), in all probability involved the use of steroids as part of the treatment. Do homeopathic drugs act when steroids have disabled the immune system? No pathological reports, other than a photocopy of the hospital case-sheet were displayed to buttress the clinical diagnosis of the conditions under treatment- like Pompe's disease, Guillain Barre syndrome etc.

There are many questions which arise from this seminar. Is it ethical to treat a case in a hospital without the knowledge and consent of the treating physician? In the event of death of such a patient what liability does the Homeopath accept? Is he not vicariously responsible for any mishap, should it occur? If this practice is being followed, will the kind doctor release a statistical study of all the cases (of any and all conditions) he has treated in this fashion regardless of the outcome of  his treatment?

Every case presented certainly showed the recovery of the patient from the comatose condition he was in, but what about the pathological condition which the patient was supposedly suffering from, for which the good doctor claimed a cure? No follow-up reports or investigations were displayed which proved that the disease/condition was reversed! To top it all, the good doctor attempted to explain Type II Diabetes Mellitus as "a condition caused by deficient Insulin in the circulation due to destruction of the Beta cells of the pancreas"!!

The irony was that this seminar was organised under the aegis of several Principals of Homeopathic colleges from Maharashtra and Karnataka. It is my fervent plea to all heads of institutions to kindly screen the speakers of all such seminars along with the matter to be presented. We can ill afford to train our students in such dismal fashion and expose them to destructive or disabling law suits.

CLASSICAL HOMEOPATHY AND THE MYTH OF THE SINGLE DOSE.

It may be necessary, even a pre-requisite for a system to survive and be acceptable, if only it can be improved upon. However to re-invent a system is fundamentally different from attempts to rejuvenate it. Today there are many practitioners of Homeopathy who feel it incumbent on themselves to take a moral high-ground if they cannot re-invent Homeopathy. To claim its re-invention may attract a spectrum of criticism ranging from skepticism and cynicism to the risk of drawing the ire of the academics. Hence Classical Homeopathy was born.

The evolution of the optimum dose as I prefer to call it, had its origin in the concept of the minimal dose. The evolution of a single dose; later Hahnemann’s acceptance of his follower’s suggestions to use higher potencies, the invention of the LM potency and finally, repetition of the aqueous dose was a natural culmination of the master’s own experience in the treatment of obstinate chronic diseases. Hahnemann was dissatisfied with having to wait for the relapse of symptoms before repeating the dose as it involved an interminable wait for the cure and the uncertainty of curative finality in very chronic diseases.

Hahnemann published the 5^th edn. of the Organon in 1833 and the 3^rd, 4^th and 5^th edns. of `The Chronic Diseases’ in 1835, 1837 and 1839 respectively. During this time, provings were already being conducted with the help of aqueous dilutions. The theory of repetition appeared in the 5^th edition; based on the premise that medicines given in aqueous form and succussed before administration are safe. Hahnemann abandoned his theory of the single dose and advocated repetition at suitable intervals (not waiting for the action of the remedy to expire), to shorten the duration of cure by half or even less. Hence it would be retrograde thinking to advocate a single dry dose and resort to the wait and watch method discarded and discredited by Hahnemann himself.

GARTH BOERICKE: Homeopathy is based on the exact observation of natural phenomenon of disease and drug action, and the law governing their mutual relationship. On this solid ground of careful observation, all homeopaths base their practice. But not all Hahnemann’s theories as published in the Organon are proven. Hering says, to discard all theories, including those of one’s own fabrication, when they are in opposition to the results of pure experience.

SUMIT GOEL: The term posology originates from the Greek posos meaning how much and logos meaning study or discourse. The terminology of dose originates from the word dosis, which means the quantity of a drug or other therapeutic agent to be taken or applied.  A homoeopathic dose necessarily means the particular preparation of medicine, the quantity and form of that preparation as well as its repetition. In short, homoeopathic dosage includes selection of potency, dispensing (quantity and form) and repetition of the dose of the medicine.  Homoeopathic posology is based on the trinity of the principles of the single simple remedy, minimum dose and minimum intervention.

My own experience after 31 years of practice, dealing with many types of emergencies, even dire emergencies suggests that, repetition in acute diseases is to be condoned, even necessary. In chronic diseases too, repetition before the re-appearance of old symptoms can be indulged in judiciously as has been illustrated in the 6^th edn. of the organon and demonstrated in their respective Lesser Writings by Dr.Kent, Boenninghaussen; and the recorded cases of all the earlier masters who followed the 5^th Edn. of the Organon. The issue being not which edition of the Organon they followed but what they achieved. Scientific experiments to understand this issue are imperative and may even lead to acceptance of a different viewpoint. Philosophy is a stop-gap, and a poor substitute for Science.

A couple of days ago I came across a research paper in the form of a small booklet  written by the late Dr.P.Sankaran of Bombay. He has compiled the views of scores of Homeopaths of yesteryears. It is amazing to note that a majority of them favored repetition  even in chronic cases.

In my website I have published a topic `CAN HOMEOPATHY TREAT ALL TYPES OF CASES'.   It was not only a subject for future and present Homeopaths to mull over, but also a warning for what I felt was to come. My worst fears have come true. We now have a certain prominent Homeopath from Mumbai, India, who claims to treat congenital disorders. This means correcting deformities. To correct a physical deformity, it requires that the persons body part must change shape or grow to a natural length and shape which it has been unable to for various reasons, chiefly genetic. Certain toxins and drugs ingested by a pregnant mother may also have a similar effect. In such cases it would be a herculean task to decide whether a particular deformity is purely a genetic variation, a mutation, or a toxin effect. In any case, since the genetic code has suffered an injury (if I may say so), to make this deformed part change shape and grow naturally would be beyond the purview of any system of medicine. It would require genetic engineering at a mind boggling level. To claim that Homeopathy can change a genetic code or structure would require laboratory infrastructure at the level of the N.I.H. in the United States of America or elsewhere. That gullible followers of this Homeopathic doctor can believe such trash based on `Photographic evidence' shows their immaturity and the dangerous levels to which they can stoop to defame this glorious system of medicine. Such irresponsible behavior may justify and strengthen the hands of all those who wish to ban Homeopathy from the health care system.