KNOWLEDGE OF PHYSICIAN

KNOWLEDGE OF PHYSICIAN (APH :3-5)

•Aph-1 & 2 Recapitulation….

APHORISM-3

•If the physician clearly perceives what is to be cured in diseases, that is to say, in every individual case of disease (knowledge of disease, indication),  if he clearly perceives what is curative in medicines, that is to say, in each individual medicine (knowledge of medicinal powers),  and if he knows how to adapt, according to clearly defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient, so that the recovery must ensue - to adapt it, as well in respect to the suitability of the medicine most appropriate according to its mode of action to the case before him (choice of the remedy, the medicine indicated),  as also in respect to the exact mode of preparation and quantity of it required (proper dose),  and the proper period for repeating the dose:-if, finally, he knows the obstacles to recovery in each case and is aware how to remove them, so that the restoration may be permanent : then he understands how to treat judiciously and rationally, and he is a true practitioner of the healing art.

APHORISM-4

He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health.

APHORISM -5

•Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause,  which is generally due to a chronic miasm.

 In these investigations, the ascertainable physical constitution of the patient (and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, ..etc., are to be taken into consideration.

If the physician clearly perceives what is to be cured in diseases, that is to say, in every individual case of disease (knowledge of disease, indication),

The physician should understand:

– 1st.  What is curable in  disease in general and in each

individual case (disease)  in particular; 

– 2nd. What is curative in  drugs in general and in each

individual drug in particular;  

– 3rd.  (Medicinal Intervention)  How to apply, with distinct

reason, what is curative in drugs to what is curable in

diseases, i.e.:

• A. How to match the proper remedy to the sickness,

• B. How properly to administer the proper dose.

• C. How properly to repeat the dose;

– 4th. And how to recognize and remove obstacles in the way of

recovery.

 A GOOD PHYSICIAN MUST HAVE

Knowledge of Disease and Individualization.

2. Knowledge of Medicine & Medicinal Powers (Materia Medica)

3. Knowledge of laws and methods by which he can apply the knowledge of medicines to his knowledge of disease process. (Therapeutic relation b/w Diseases & Drugs)

 These include:
-Remedy selection
-Potency and dose selection
-Repetition

4. Knowledge of causative and maintaining factors
If you develop a good understanding of all these variables, you will be able to perform many ‘ideal’ cures!

What is to be cured in disease ?

§Is it the symptoms ?

§the pathogen ?

§the pathology ?

§the nosological disease ? or

§the person as a whole?

Disease is an altered state of of organism & cure is nothing but restoration of this altered state of health to its earlier state of ease & comfort.

Hahnemann says -that you have to know what is curable in ‘every individual case of disease‘. This means that the focus of our treatment should be the individual who has the ‘disease’

Now this causes confusion

 Some People think that they have to focus all their attention on the ‘person’, the ‘individual’, and often ignore the disease. People will say

•fat, fair and flabby person ----– needs Calc-carb

•A pt who sits with stooped shoulders--needs Sulphur

Unless the remedy covers the symptoms of the disease process, such prescriptions are not justified. You do not have to study the person excluding his disease state.

SO HOW TO DESCRIBE A SICK MAN or WHAT CONSTITUTES KNOWLEDGE OF DISEASE ? ??????

•General symptoms (Which are common to a group of patients or Symptoms of the disease)

                                                     PLUS

• Peculiar or uncommon symptoms which define the individuality of a patient.

Disadvantages of treating a patient on the name of disease.........

  •CONCEPT OF DISEASE-

--How Homeopathy Differs from Allopathy or Modern Medicine ?

Allopathy—Attempts to Study the ‘disease the patient has’ (Disease determination by Diagnosing the disease)

Homeopathy--- Attempts to study ‘the patient that has the disease’ (Disease individualization & Diagnosis of the person)

iseased Man THE HEALTH

The WHO has defined the health as:

• “Health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity, with ability to lead a socially and economically productive life”.

Health as defined by Hahnemann:

• In health there is harmony in vital processes, feeling and  function is normal, there is a feeling of well   being,  the mind looks out, the senses are alert, the sense  perceptions are clear and normal.

THE DISEASE

WHO defined Health but not disease.

However the disease is defined By Hahnemann is as:

– In disease, there are disturbed vital processes, feeling

and function is abnormal, there is a feeling of ill being,

the mind looks in, the attention is attracted  by the

perverted sensations of abnormal organ function that

pass unperceived when normal. Thus in disease the

fundamental sense of existence becomes distorted and

mental concepts perverted. This phenomenon shows in

the profoundest manner the indissoluble connection

between psychic and physiologic life. The body is

cognized subjectively not objectively.

THE DISEASE

•Most acceptable definition of disease is – ‘ Dis + Ease’ easeEase’ = Not at ease..

•DiseaseDisease is expressed by ‘signs’‘signs’ and ‘symptoms’‘symptoms’..

•Symptoms signsSymptoms or signs as ‘units’‘units’ of disease expression.

•These sign and symptoms are like building blocks, when faithfully collected, and judiciously arranged (Totality symptomsTotality of symptoms) ) in a correct sequence will construct a disease picture.

THE DISEASE IN GENERAL

Broadly the disease are grouped in:

•Acute diseases

• Chronic diseases

Acute diseases

These are caused by transient explosion of latent psora. These are self limiting in nature and are characterized by:

•Sudden onset

•Rapid course

•Culminates in recovery or death

Chronic diseases

These are caused by chronic miasms and are characterized by

•Insidious onset

•Slow course

•Lifelong suffering and invariably ends with the life of patient

CONCEPT OF CHRONIC DISEASES IN HOMOEOPATHY

1. PSORA- Mainly skin & functional disorders

2. SYCOSIS- Mainly Abnormal growths, Tumors

3. SYPHILIS- Characterized by Destructions, Cancers

KNOWLEDGE OF DISEASE--SUMMERY

•Knowledge about all the sufferings of the individual patient (Case-taking, analysis, Totality of symptoms)

•Nosological knowledge of disease (classification, etiology, Common symptoms, Clinical examination, Required Lab investigations, Do’s & Don’ts)

KNOWLEDGE OF MEDICINE & MEDICINAL POWERS

•Drugs produce Disease –conditions just as Natural causes make the healthy sick.

•As we individualize patients, so we individualize drugs.

•In Homeopathy Knowledge of Medicinal powers determined by their ability to produce artificial diseases, when administered in healthy human beings(Drug proving).

•Drugs produce symptom-complexes & they effect cure by removing the symptom-complexes in a sick man.

•The sick-making properties of a drug are the sick-curing properties.

•Study of Drugs from an individualistic & clinical point of view is essential.

•Study about chemistry & physics of a drug will never give us an accurate knowledge of the sum-total of deviations  from normal state of health, which a drug can effect .

KNOWLEDGE OF THE THERAPEUTIC RELATION B/W DISEASES & DRUGS

•SIMILIA SIMILIBUS CURENTURE

i.e, Let likes be cured by likes

KNOWLEDGE ABOUT THE CHOICE OF THE REMEDY-ITS EXACT MODE OF PREPARATION & PROPER DOSE

References about Law of similiars before Hahnemann

•Hippocrates: “ The disease is produced by influences which act similar to the healing process and the disease condition is removed through remedies which produce similar symptoms to the disease”.

•Ayurveda: Records that there are 2 types of treatment namely “Vipareetah Chikitsa” (treatment by contraries) & “ Tadarthakari Chikitsa” (Treatment by similiars).

KNOWLEDGE OF OBSTACLE TO THE RECOVERY IN EACH CASE & HOW TO REMOVE IT

•Inherent power of the organism to adjust itself to inner & outer environment—within limits.

•When Limits being exceeded—deviation from normal state health may be adjusted & restored by suitable dietetic & hygienic measures.

•Beyond this adjustment----Disease proper.

•Importance of knowledge of Dietetic, Hygenic & any other factor which serves as exciting and/or maintaining cause of the deranged state of health.

To remove any  Obstacle to Recovery we should have Knowledge of:

•Physiology

•Diet

•Hygiene

•Pathology  &Bacteriology (Reversible/Irriversible)

•Knowledge of Health Preservation ( Aph-4)

Introduction To 6th Edition Of Organon of Medicine--A brief Summery

A Summary of Introduction to 6^th edition of Organon of Medicine

Medical Teaching During Hahnemannian era

Hahnemann’s Introduction gives a brief history of medical theory and practice. He describes the broad medical paradigm ( and several of its variations) which has been dominant for centuries, and which his revolutionary medical paradigm, presented in the body of The Organon of the Medical Art, almost diametrically opposes.

I. Theoretical Systems of Medicine

With civilization, diseases and theories for their treatment multiplied dramatically -------Formation of so called theoretical hatching's or systems.

II. The old School’s Material View of Disease

Origin of Allopathy----Mixtures of unknown medicinal substances were employed against arbitrarily erected forms of disease which were arranged according to material view in contradiction with nature and experience.

Rational Medical Art--- Old school claimed that theirs is Rational medical art, because they alone sought for and strived to clear away the cause of the disease.

Tolle Causam:  Means remove the cause. They never were able to find the  real cause of disease, since majority of diseases are of dynamic nature (spirit like), their cause is not discernable to senses. Then they tried to devise the cause for themselves. They drew conclusions from

1. Viewing parts of normal dead bodies (anatomy) compared with the visible changes in these parts in people who died of disease (pathological anatomy), and
2. Comparing the appearances and functions in healthy life (physiology) with their endless deviations  and countless disease states (pathology).

Which resulted in Prima causa Morbi---first cause of the disease, which was then both proximate cause of the disease as well the disease itself.

Common sense says----- the cause of a thing or an event can never be, at the same time, the thing or event itself. How can they cure the unknown disease with prescription of unknown mixture of medicines?

Foot note: The cure of a c/c disease depends upon the discovery of its origin. The originating cause of all chronic non-venereal diseases is psora.

Old school hypotheses about the general character of disease.---Inflammation, fever? Paralysis? Cramp? Blood excess? Excess of oxygen, carbon, hydrogen or nitrogen in body fluids? Raised or lowered arterial/venous pressures? Etc.

All guesses which were hypothetical to serve any practical purpose.

Only Homoeopathic medicines can cure disease, but these were banned by old school. Homeopathy is  individualized treatment, not the generalized treatment like Allopathy.

III. Old school Efforts to Remove Disease Matter

The adherents of the old school removed disease matter because they didn't acknowledge the dynamic nature of disease.

The old school believed that it could directly lift the disease through the removal of the (alleged) material cause of disease.

Common Removal procedures of Old school

• Removal of bile in bilious fever
• Emetics in so-called stomach-vitations
• Purging in worm troubles ( pallor, ravenousness, bellyache, and enlarged tummies of children)
• Blood letting for hemorrhages and esp all sorts of blood—extractions as its treatment-of-choice for inflammations, by applying leeches to affected parts. ( following the procedure of a well-known bloodthirsty Persian Physician Broussais)

LEECHING

• Old school considers the main material cause of all hemorrhages and inflammations to be an alleged excess of blood, which it has to remove and drain off through venesections (bloody cuppings) and leeches.

VENESECTION OF MALE PATIENT

• 
  
• Materia Peccans (offending matter): In general inflammatory fevers, in a/c pleuracy, the old school regards even the lymph in the blood, as the Materia Peccans which they tried to remove by repeated venesections, cuppings and blood lettings, even unto the brink of death. They didn’t understand that the inflamed blood is only a product of the acute fever.

CUPPING THERAPY

• It is impossible for the causa morbid (cause of disease) in this case to be an excess blood. The only true causa morbi here is a diseased dynamic inflammatory irritation of the blood system.

Surgical procedures of old school

1. tie off polyps
2. cut out cold glandular swellings or uses local heating means to artificially excite suppuration of the glandular swellings
3. enucleate encysted tumors.
4. Operate on aneurysms or on lachrymal or rectal fistulas.
5. cut out scirrous tumors of the breast.
6. amputate a necrotic limb, etc.

External treatments of the old school

1.    use repellents (things that repel)

2.    dry up old, ichorous leg ulcers through astringent compress, through lead, copper and zinc oxides.

3.    cauterize chancres

4.    topically destroy figwarts

5.    drive the itch diathesis away from the skin with salves of sulphur-lead, mercury-and zinc-oxides.

6.    suppress eye-inflmmations with solutions of lead or zinc.

7.    chase away the tearing pains out of the limbs through opodeldoc, volatile liniment, or fumigation with cinnabar or amber.

In every case they believe they have lifted the malady, conquered the disease and executed a rational causal treatment. But there was appearance of those maladies in different forms later, which they claimed as altogether new ones.

Evacuant procedures of the old school:

They thought the disease materials and acridities must be carried away through exhalation, perspiration, through urinary tract, through salivary glands, from the blood and lymph vessels, through the tracheal and bronchial glands as expectoration, through vomiting or purging through which body would get purified.

Procedures

1. cutting holes in the diseased body, which were converted into long-lasting ulcers kept up for years by introduction of foreign substances (setons, fontanels)----to draw materia peccans.
2. applying canthris plasters to the skin.

IV. Diseases are Dynamic, not Material

In short, the deranged materials and impurities that become visible in disease are undeniably, nothing more than engendered products of the disease of the abnormally mistuned organism.

Drainage and counter irritant methods of treatment imitate the life force’s self-help efforts of evacuation and diversion of symptoms.

Eg—sweating and urination—fever

Purgatives and emetics were used commonly, which they called aperients and dissolvent’s.

To assist this drainage method, related antagonistic irritates (stimulants) were employed.

1.    sheep’s wool on bare skin

2.    footbaths

3.    nauseants

4.    hunger treatment whereby the stomach and intestines were tormented with the pain of hunger

5.    means that produced inflammation and suppuration in near and distant parts, such as horseradish and mustard poultices, canthride plasters, setons, tartar emetic ointments, moxa, cautery, acupuncture etc.

duce natura ( guiding according to the nature), ministri natura (helpers of nature).

They thought they are following the nature’s method of cure by inducing evacuations, old school people thought that this way they can bring cure.

But they never thought that those discharges & eliminations (apparent crisis) created by the nature left to itself were, in c/c diseases, only palliative short lasting alleviations which are far from contributing cure, on contrary they lead to aggravation of  the original sickness.

Nature doesn't know how to overcome a c/c internal malady when left to it self; it brings the suffering outside through the external manifestations, or sufferings.

 The imitating method’s of old school:

1.    use of irritating plasters to imitate natural discharges

2.    use of leeches to imitate hemorrhoids

3.    Use of venesections to imitate coughed-up blood.

4.    use of emetics to imitate chronic nausea

5.    use of heating plasters to imitate swollen glands

6.    Use of sweating treatment to imitate night sweats and liquid stools. Etc.

7.    nosebleeds to alleviate headaches

8.    sweating or diarrhea for sudden illness

Nature’s imperfect efforts are best than the medical treatements that imitate and further them.

New symptoms appeared as a consequence of  local symptom removal by allopathic way of treatment, when this happens the allopath declares it as a totally new disease.

Suppressive treatment of old school

Use of repercutientia (reflectants) & repellentia (repellants)

They suppressed:-

1.    Chronic pains, insomnias & old diarrhoeas with daringly intensified does of opium.

2.    vomiting with effervescing salt mixtures

3.    Stinking foot sweats with cold footbaths & astringents compress.

4.    skin eruptions with lead & zinc ointments

5.    uterine hemorrhage with vinegar injections

6.    collequative sweats with alum whey.

7.    nightly seminal emissions with a great deal of camphor

8.    Frequent hear flushes of the body and face with salt paper, vegetable & sulphuric acids.

9.    Nosebleeds by tamponing of the nostrils with plugs dipped in alcohol or astringent fluids.

10. The ichorous discharges from leg ulcers with lead & zinc oxides etc.

The life force was ordained to conduct life in the most perfect way during health, not to cure disease. It can’t  have that intelligence where we human’s believe that life force can take care of itself in disease and can bring back the health, or we imitate the life force’s imperfect efforts to rescue itself from disease.

The process by which the homoeopathic medical art cures disease.

1.    It differently alters the life force which is diseased, by means of an affection similar to that of the disease, engendered by a  medicine that has been homeopathically selected.

2.    By means of this medicine, the life force is rendered medicinally sick to such a degree ( in fact to a somewhat higher degree) that the natural affection can no longer work on the life force.

3.    in this way the life force becomes rid of the natural disease, remaining occupied solely with the so similar somewhat stronger medicinal disease—affection against which the life force now directs its whole energy and which it soon overcomes.

4.    the life force there by becomes free and able again to return to the norm of health & to its actual intended purpose; that of enlivening & sustaining the healthy organism.

The Homoeopathic medical art teaches how to do this.

Effect of old school’s imitative & suppressible treatment on chronic & a/c diseases

Due to treatment of a/c & c/c diseases through enantiopathic & & draining (antagonistic & revulsive) means at the site other than the sick one, until the time when the natural course of the short malady was over.

Antipathic stimulating and strengthening treatments

ANTI-PATHIC STRENGTHENING & STIMULATING DRUGS

Another treatment procedure of old school, which is termed the stimulating (arousing) & strengthening treatment method ( through excitantia, nervina, tonica, confrontia, & roborantia ( excitants, nervins, tonics, comfortants & strengtheners)

Eg:

1.    Alcohol, cinchona & Iron preparations for debilitation.

2.    Nerve ointments or electric shock for incipient paralysis (electric shock for hardness of hearing)

3.    Excitants or aphrodisiacs for impotence

4.    antipathic action of excitant and strengthening means.

Alternative Treatments of the Old school

·         When they are used allopathically and in large doses, mercury-based medicines completely ruin the health.

·         When they are used allopathically & in large doses, cinchona & quinine suppress intermittent fevers but patients sick.

·         Valerian acts antipathically in nerve fevers, first producing liveliness and then increasing the patient’s stupor.

·         Digitalis acts antipathically in cases of c/c disease with an overly-rapid pulse, first producing a slower pulse and the increasing.

Flaws in the Old School’s Approach to curing Disease

The fundamental cause of the chronic (non-venereal) diseases and the remedies for them remained unknown for these old school practitioners who often boasted about their causal treatments & their research into the genesis in their diagnosis.

They thought the character of the disease as its cause, and therefore directed their treatments against cramp, inflammation (plethora), fever, general & partial debilitation, mucus, sepsis, infarcts etc. which they tried to clear off by administering antispasmodic, antiphologistic, strengthening, stimulating, antiseptic, dissolving, dispersing, draining, evacuating, antagonistic means.

They also claimed that defect or excess of oxygen, nitrogen, carbon or hydrogen in the bodily fluids are caused against irritability, sensibility, reproduction, arteriality, venosity, capillarity, asthenia etc. These all were the treatments but not for the welfare of the patient.

Compound Prescriptions

The making of compound prescription, they mixed medicines which were unknown in their true action and divergent from one another.

1.    One medicine was placed formost as the procipal means (basis) to conquire what the physician assumed to be the chief character of the disease

2.    another medicine was added for the dispatch of this or that accessory indicator, or as a strengthening means (adjuvantia)

3.    to this was added as alleged improvement means (corrigens)

4.    These were all mixed together (decocted, extracted)

5.    Medicinal syrup or distilled medicinal water brought still more medicinal properties into the formula.

Effect of compound prescriptions on the health of the patient.

In these prescriptions, one ingredient offset the action of another, either entirely or in part, and gave to it or to the others a functional quality and operational direction that was suspected nor supposed, so that the expected effect could not possibly be reached.

This resulted in---------New disease mistunement, which was often unnoticed.

F.N—writings against the use of compound prescriptions by old school dr’s itself in Hufeland’s journal.*****

From Allopathy to Homeopathy

Recent increased cruelty of allopathic treatments set the stage for the homeopathic art of cure.

Traces of Homeopathy found in Previous Practices

All real cures by the old school involved medicines that were homeopathic to the disease.

F.N—35  Homeopathic treatments used by the old school:

1. elder blossom tea for fever with sweating
2. warm poultices for inflammation
3. Red oxide of mercury for eye inflammation
4. Parsely juic for a painful urge to urinate
5. Pimprenel root for uterine hemorrhage
6. Sabina leaves for uterine hemorrhage
7. Opium for constipation
8. mercury for throat ulcer
9. Rhubarb for diarrhea
10. Belladonna for rabies
11. Opium for a comatose state with high fever.

Homeopathic Folk remedies

Home remedies….

1. cold application for frost bite
2. Homeopathic use of warmth and cold
3. cold treatment for frostbite
4. Hot water for a scald
5. Freezing water to  thaw frozen foods
6. Heat for burns
7. Homeopathic treatment of burns with alcohol

F.N—36: Isopathy versus Homeopathy.