Homoeopathy in general practice W I L L I A M L A N G , M.B. , Cr[.B., D .~ .C .O.G. , M.F.HO~I.

Homceopathy is a system of medicine whereby all the information tha t a doctor can collect from a sick person can be utilized to determine the selection of a single remedy which, if accurately chosen, will remove that person's disease. Indeed this m a y happen so painlessly and undramatieally as to put the original diagnosis, even with biopsy confirmation, in doubt in the minds of the non- homceopathically orientated.

Samuel Hahnemann evolved the system more than 150 years ago and based it on the principle that if a substance can produce symptoms in a healthy person, these same symptoms, if found in a diseased person, can be removed by the administration of the substance in question. One hundred and fifty years represents an awfully long time to be using the same remedies according to the same principle on which they were originally used. To the sympathetic, however, the very fact tha t Homceopathy has stood and survived this long test of t ime is proof tha t it is based on a sound principle. To people who have never had an opportunity to witness the fact that it does work, this long period of existence, without adequate recognition or scientific explanation implies that it is a hoary survivor of a medical era which has long since disappeared in the evolution of medical thought, and which is itseff heading for extinction.

I t was therefore with great interest tha t I recently learned tha t a young English contemporary of Hahnemann, Charles Babbidge by name, invented a principle in 1832, the fulI use of which has only been fully utilized in the last two decades. The principle was tha t of the "analytical engine" which is the automatic computer of the present century and Babbidge is acknowledged as the originator of the modern automatic computer.

Thus is demonstrated tha t t ime alone will not tarnish a t ruth and I am quite convinced myself that, just as Babbidge's infant was helped through to matur i ty with the help of modern scientific technology, Hahnemann 's brain child will in t ime and with proper scientific appreciation similarly achieve maturi ty. Until such time, the rationale underlying the homceopathic phenomenon must remain unexplained, an obstacle which prevents recognition in other medical schools. However, despite the absence of the explanation, one can become convinced tha t Homceopathy does work by witnessing the practical results of the ex- perienced homceopathie practitioner and by examining the steps he has taken before coming to the choice of a remedy.

This is an age in which more and more specialization is occurring and the very existence of general practice is being threatened. This has not been helped since the introduction of the National Health Service in 1948, by the emphasis put by successive governments on the hospital side of the Service to the detriment of the lot of the general practitioner. However, thanks to a lot of "belly-aching" and recognition at last of an increase in medical emigration, neglect of the

A paper read to the Faculty of I:lomceopathy in February 1967

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general practitioner side of the Service is being slowly rectified and things are looking a little more promising. As increased financial help is given with premises and ancillary staff, it should be possible for the keen general practi- tioner to maintain his standard of medicine with less difficulty.

I have introduced a flavouring of medical politics deliberately because, in order to practise Homoeopathy successfully, a doctor requires to be keen on maintaining clinical standards and he must have, and be prepared to spend, a reasonable amount of t ime for each patient.

Hom~eopathy does not lend itself to every type of general practice. I t is a fact tha t some general practitioners can cope adequately with 3,500 patients on their panels. A man who can do this is both an efficiency expert and a master of his craft combined, and he has my unstinted admiration. I would venture to suggest that 2,500 patients represents an approximate upper limit to the ideal number of patients per panel, if a doctor is to give himself adequate t ime for doctor-patient contact to allow him to introduce Homceopathy.

In addition, I think that it is important to be thoroughly convinced tha t Homceopathy does work before one at tempts to practise it.

At the beginning of one's use of Homceopathy the path is liable to become littered with failures. This is the point at which, I think, a lot of would-be homceopaths become completely disenchanted and throw the idea of further pursuance of Homceopathy out of the nearest window. This is why I think tha t a background conviction onto which one can fall back is so important. I have fallen backwards in this manner on quite a number of occasions, and it was only my conviction tha t kept me aware tha t the fault lay with my ineptitude and not with Homceopathy.

I would therefore strongly advise those contemplating Homoeopathy to expose themselves to the practical ability of the top prescribers and see for themselves what can be done homceopathically in disease, so that conviction can grow and be adequate to see them through what I consider the inevitable initial period of disappointing results. Only then is the beginner properly prepared psychologically to start practising an art which although not too difficult, is not easy. I t is easy to prescribe a homceopathic remedy, but good results will only occur with consistency if the drug picture is t ruly similar to the disease picture which presents itself.

James Tyler Kent was an American homceopathic physician who had a vast knowledge of the subject and who compiled the repertory, or dictionary of symptoms, which a great many homceopaths find indispensable in their every- day practice. He was a perfectionist and practised pure Hahnemannlan Homceopathy--i .e . he used one remedy, in a single dose, at long intervals. He was singularly intolerant of doctors who tried to combine Homceopathy with the remedies of other schools of thought and referred to them disparag- ingly as Eclectics and even founded a Hahnemannlan Society, members of which had to undertake to practise pure Homceopathy to the absolute exclusion of all other remedies.

One can sympathize with his thinking in that at the beginning of the century the pharmacopeia of the other medical schools was lacking such drugs as insulin, the antibiotics, and the steroids which were to prevent so much human suffering later on. In the absence of these life-saving drugs, a doctor at the commencement of his career in Homceopathy had greater freedom in using Homceopathy alone than he enjoys today. Kent says in his lesser writings: " In the beginning of one's practice many acute diseases run their course, in

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advanced years they are nearly all aborted." With the help of penicillin and related antibiotics, acute pathology incidence has been cut down dramatically and no young doctor can afford to dispense with this valuable remedy in pre- venting acute pathology.

Granted, as Kent states, tha t the older homceopathic physician will almost always abort his acute cases; nevertheless the doctor who is new to Homceo- pathy, and indeed a lot of doctors who are not so new, require to use penicillin and related antibiotics to he]p abort acute pathology until they learn to do so by Homceopathy alone, having ascended the Hahnemannian heights.

I t is an incontrovertible fact tha t thousands would not be alive today but for the intervention of the antibiotics.

In his last address to the Scottish Branch Dr. Gordon Ross reminded us that Homceopathy is a discipline, and I feel that discipline is the key to Homceo- pathy. When we first qualify as doctors our clinical discipline is probably at its peak, but those of us who have gone into general practice are liable to have what discipline we acquired as clinical students eroded by having to cope with an overloaded daily schedule of visits and consultations. However, with the introduction of post-graduate courses for general practitioners, there has been a great revitalization going on and clinical discipline has increased amongst those who attend such courses, particularly those who have managed to organize their practices and " train" their patients.

To those who have the necessary clinical discipline and who are drawn to at tend homoeopathic post-graduate courses it should be emphasized tha t results in Homceopathy are directly proportional to the effort expended in each individual case. This is particularly true at the beginning of one's use of Homceopathy when discipline can show encouraging results which do not occur with any consistency if the necessary effort is not expended in obtaining and analysing information from the patient.

One of the unwritten moral obligations of a homceopathic medical practi- tioner is to proselytize, that is, to t ry and gain converts to Homceopathy. To do this one has to a t tempt to impress on inquirers the advantages to be gained by practising Homceopathy.

I have given this subject some thought and nothing would give me greater pleasure than to be able to say tha t not only is Homceopathy superior to any other system of therapeutics, but that results are easily come by, and, fur ther , , tha t one has merely to don the mantle of Homceopathy in order to revolu- tionize one's practice.

Let me first emphasize tha t I am wholly in accord with the idea that Homceo- pa thy is superior to all other methods of drug therapy. However, I personally do not find Homceopathy easy to practise. Nevertheless, I do practise Homceo- pa thy despite the difficulties because, firstly, it works; secondly, because it works well, especially when there may be no other answer; thirdly, because I get great stimulation from the fact tha t it provides a method enabling one to tackle not only every recorded disease, but in addition, every possible disease of the future. The simple reason for this being that no mat ter what the disease label may be, no mat ter what letter of the alphabet it begins with, or who was the first to have his surname immortalized by it, the patients with each and every one of these disease labels will always have symptoms available for hom~eopathic analysis in the form of "mentals", "desires", "aversions", "generals", and "particulars"; the various and multiple combinations and permutations of the five latter phenomena having been already meticulously

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recorded during drug provings on healthy persons. The more one becomes aware of this tremendous advantage the more one finds it impossible not to practise Homoeopathy.

Most of the cases I intend to present today are rather ordinary run of the mill types, but I think they do illustrate what the function of the GP i s - - to catch disease in its "ordinary" phase or early form and prevent it developing into the stage of acute pathology, which incidentally provides the hospitals with a lot of their work and television companies with a lot of dramatic material. I f increasing emphasis was put on the importance of medicine outside hospital there would be shorter waiting lists for hospital beds and indeed less need for hospital beds.

In treating a patient homceopathically, recording the date, complaint, and the t rea tment given is inadequate though one may be pushed to this extremity by weight of numbers. This type of production line practice should now be on the way out with the help one gets with the new financial arrangements designed to encourage the employment of staff for the introduction of appointment systems, etc.

In addition to adequate histories and examination of the patient we must t ry and record the why's and the wherefore's. This is important not only in finding the simihmum, but comes in useful in revising the case where our first remedy has been ineffective. Another advantage of adequate records is, of course, in the preparation of cases for presentation to colleagues and students.

The working out of a case along homceopathie lines is really a piece of research. The essence of research involves the noting down of each individual step in the process so tha t the latter can be repeated if successful, by any fellow worker. Therefore to neglect taking adequate notes on how one finds the homceopathic remedy is simply not scientific, because, in the event of a successful result, not only are the why's and the wherefore's denied to an interested colleague, but the prescriber of the remedy may be unable to recall himself why the remedy was given.

Before I present to you a few examples of cases which have responded to Homoeopathy in my practice, X thought it might be useful to consider the methods used by homceopathic doctors in their approach to the patient and so define my terms of reference.

The emphasis in medicine nowadays is being laid more and more on the preventive aspect of things, and three methods are used in homceopathie circles: hygiene, the homceopathic remedy including the Schussler salts, and the prophylactic antigens, t tahnemaml was very much aware of the need for hygiene in the life of the patient before any t reatment was instituted and knew tha t the beneficial effect of a homceopathic remedy could be prevented by adverse influences such as defective diet, damp living quarters, etc.

The "heal thy" patient 's constitutional homceopathic remedy, obtained from a consideration of his mental characteristics, his desires and aversions to food and drink, and his general reactions to such things as time, temperature and food, makes it possible for the person who receives such a remedy to either resist disease completely or have much briefer episodes of disease.

The prophylactic antigens must be mentioned because they do prevent disease and represent a kind of Homceopathy which is sometimes termed isopathy, i.e. a method of t reatment in which the actual disease product or substance which the patient has been shown to react to in a morbid manner is used in a dilute form to prevent further episodes of the disease. The advantage of the

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homceopathic type of isopathy is tha t the substance used is not merely diluted but also potentized, i.e. progressively diluted to an extreme degree with system- atic succussion. This method avoids producing the violent reactions which some patients develop when given simple "physiological" dilutions, such as the diphtheria inoculation and smallpox vaccination. Nevertheless most homceo- pathic doctors realize their value and use these immunizations despite the disadvantageous reactions.

Having dealt briefly with the prevention aspect, we can now consider the approach to the patient suffering from actual disease. We first consider the four aspects of the history: present, past, family, and social.

From the present and past history we can sometimes get information which can lead us to a "specific" remedy. Hahnemarm used this method in dealing with acute epidemics. In such circumstances he recommended that the epi- demic remedy be defined from the information available from early cases so that subsequent cases could be dealt with en masse by one remedy.

My idea of a specific remedy is the use of Hypericum where a person has jammed his finger in a door. Hypericum, used in such a case acts like a local anaesthetic, and I can vouch from painful experience. Another example is the isopathic use of Morbillinum, the remedy prepared from the measles virus. I once gave this to a child who had been salivating profusely for two years following an a t tack of measles and the salivation ceased within days of his being given the remedy.

Having taken the history we must examine it for symptoms which are of significance and value in prescribing homceopathically. Hahnemann 's definition of these was "the symptoms which appear 'strange, rare, and peculiar' " The patient will usually dwell on those symptoms which cause him discomfort and which are therefore his immediate concern. These are usually felt in a part or organ of the body and are of the least value in determining a homceopathic remedy. They are referred to as "particulars" but if they appear strange, rare, and peculiar, their importance will be enhanced accordingly. The really important symptoms in ascending order of importance are the "generals", the "desires" and "aversions", and the "mentals". These have usually to be obtained by further questioning the patient, and to obtain the "mcntals" in particular a certain rapport with the patient is a great help, because we are dealing here with the private thoughts of the person and if he feels he can speak without inhibition sometimes a lot of information comes out which the physician may not even have thought about asking after.

In considering the "particulars", "desires", and "aversions", we may come across a very strong reaction the patient has to a particular substance or food. Using this item or "keynote" of information a potentized preparation of this substance or food may be administered to the patient with very beneficial results. This method I would categorize as isopathic and Dr. James Runcie uses it with excellent results. He terms his procedure Autotherapy.

At this point, when we have all the historical information assembled, we proceed to examine the patient and from the clinical examination we may obtain further mental characteristics which have not been elicited during history taking and of course the physical findings which may be of value too in finding the remedy as well as in establishing the disease diagnosis.

The remedy may be determined by several methods. Briefly considered, the first is the keynote method, in which a remedy can

be chosen on one symptom only. This is the equivalent of trying to guess what a

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jigsaw picture looks like when one is supplied with a single piece. I think "guess" is the operative word here. However, if one can obtain at least three significant symptoms to form the "three-legged stool" one can sit on this and more confidently assess what the picture is.

Another method of getting the remedy is to use a card system in which the more significant "rubrics" are printed out on individual cards and the remedy is obtained by using punch-hole techniques. An Indian physician who visited Glasgow last year told us tha t using his card system in acute prescribing, he could obtain the remedy in about three minutes.

The third method of finding the remedy from the information available is to use the repertory, which is a dictionary of symptoms arranged systematically in rubrics. By the use of this it is possible to get the similimum when one has a great many "jigsaw" pieces. The method is rather laborious, but when it is found to be productive of accurate prescriptions the labour becomes less tedious and is offset by the stimulating effect of getting results.

Computer analysis is a method which I think has great potential in Homceo- pa thy and one which may eventually enable homceopathic doctors to determine the remedy very quickly. Doubts have been expressed regarding the difficulties of feeding the computer with accurate enough information, with particular reference to Kent ' s Repertory, but this has already been used to program a computer in Stuttgart , presumably despite the difficulties. I feel tha t eventually the computer will be used to digest all available basic information on provings from Hahnemann to Raeside and not be confined to the works of any individual physician, no mat ter how brilliant.

In addition to the four basic methods I have mentioned there are three other methods available for determining the remedy. These involve the use of techniques which I briefly mention.

The emanometer technique, evolved by the late W. E. Boyd, involves the use of a machine which can pick up evidence of an energy or emanation from a saliva specimen of the patient. The information obtained by the emanometer enables the doctor to place the patient in a group. Each group consists of a small selection of remedies from which the indicated remedy can thus be more easily determined. The technique can only be mastered if one has the necessary sensory and extrasensory gifts.

By culturing stool specimens according to the technique of the late John Paterson we can group patients according to the non-lactose-fermenting bacillus found in the culture. Paterson demonstrated tha t the administration of certain homceopathic remedies was followed by the appearance of the same organism in the stool of the patient. He was thus able to group remedies according to the organism they produced in the stool and this in turn enabled him to find an individual pat ient 's remedy more easily than would perhaps otherwise have been the case. The method involves bacteriological technique and had not been practised since the death of Dr. Elizabeth Paterson until recently revived by Dr. Robin Gibson in Glasgow.

Radiesthesia I shall mention because it is being used with success by homoeo- pathic doctors. This method depends on the ability of the physician to detect, via the reactions of a pendulum suspended from his fingers, emanations coming from a blood spot specimen from a patient. The reaction of the pendulum is then noted over a range of homceopathic remedies, seeking the one capable of producing a reaction similar to the reaction evoked over the blood spot. Thus is the selection of the remedy facilitated. However, it is obvious tha t the

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method is limited in its application to the gifted few who have developed a degree of extrasensory perception. Radionic devices are electronic devices which have been developed to mechanize radiesthesia and improve the accuracy obtained.

At this point, where the history and clinical examination have been rich and productive as regards significant prescribing symptoms and signs, in all probabili ty one outstanding remedy will present itself. On at least an equal number of occasions, we may be left with a group of remedies. This is where a materia medica check is valuable in order to narrow the field down to the one remedy.

Having determined the homceopathic remedy diagnosis, we must proceed to determine the disease diagnosis from a scrutiny of the history orientated in this direction, and by our findings on clinical examination aided by such investigations in the X-ray and pathology departments as arc thought necessary.

Now, having established both the remedy and the disease diagnosis, we are in a position to institute treatment. This consists in removing any impediments to the action of the homceopathic remedy by advice on hygiene, diet, etc.; administering the homceopathic remedy, and if the patient appears to be in great distress, prescribing such doses of physiological drugs as may be required-- the use of diuretics for example, to rid him of excess body fluid associated with cardiac failure. Surgery has an important part to play in dealing with patients with acute abdominal conditions such as appendicitis, or advanced pathology such as gall-stones, ovarian cysts and operable carcinomata.

There is a method of t reatment used by homoeopathic doctors for patients who have inoperable carcinomata or secondaries. This t reatment involves a series of injections of a preparation of mistletoe called Iscador. This remedy was originally thought of by Stciner, who observed that mistletoe grows, like cancer, in the manner of a parasite. Patients usually respond to this remedy either by a recession of the growth or at least by a recession of the toxic manifestations.

The Schussler "Tissue" salts are often useful in prevention and treatment. Schussler was a physician who had the bright idea of determining the nature of the salts left after the human body had been exposed to combustion. He decided upon twelve, although others were added later by followers of the system, and of these, which by the way are all homceopathic remedies, I find Ferrum phos. 12x to be a wonderful help in dealing with acute congestions of all kinds, particularly in children when the mother had noticed that the child looks perhaps a bit feverish and would otherwise have given an aspirin. I find it an excellent remedy for mothers to have handy where their children are liable to develop bronchial colds.

I would now like to go on to speak of some cases which have responded to Homceopathy in practice.

C A S E 1

Mr. J.A.R. Aged 52.

Complaint: Vertigo six weeks. Mental blackouts of increasing frequency. (Confirmed epileptic.) Two years.

P.H.: Plastic iritis • 6 between 1950 and 1964. Perforated duodenal ulcer February 1954. Subphrenie abscess and ophthalmit is--May till October 1954.

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Meningitis 8.11.54 till 21.12.54. Total retrograde amnesia for the duration of this episode.

Attacks of petit mal since 1963. Cannot tolerate "adequate" doses of Luminal because of incapacitating drowsiness. Mysoline makes him ill.

14.6.65: Vertigo 6/52 duration. Worse every Monday. Better eyes shut. Burning affecting face and ears.

O/E: Lean build. Chooses his words carefully. Immaculate suit. Spots on forehead--has noticed that these precede attacks of iritis.

(P) Vertigo better eyes shut: Con. Gels. Pip m. (P) Burning affecting external ear: Agar. Clem. Rhus t. Tell. (P) Burning heat of.face: Bapt. Bell. Bry. Cina. Clem. (P) Pimples on .forehead: Nat. c. Sang.

Ambr. Bor. Calc. p. Clem. Led. Mur. ae. Nat. p. Ph. ac. Psor. Rhod. Sep. Sulph. --Clematis 30/1.

19.6.65: Has noticed a slight improvement in the vertigo. 26.6.65: Vertigo practically gone. 14.8.65: No further vertigo. No further blackouts. Attributes this to the

effect of a good holiday at the end of June!!! 3.3.66: Pains in the eyes extending through to the occiput. Worse on

moving the eyes. Feeling of panic. No further blackouts. (P) Pain worse moving the eyes: Ars. Berb. Bry. Carbo s.

Carbo v. Chin. Cupr. Gels. Hep. Kalm. Lac d. Mang. Natr. m. Prun. Ran. s. Rhus t. Spig. Sulph.

(P) Pains eyes through to the occiput: "Strange, rare, and peculiar." Bry. Natr. ars. Natr. ars. 30/3 prescribed.

10.3.66: Neuralgia went after taking two powders.

CASE 2

Mr. W.R.F. Aged 21 years.

Complaint: Hair coming out over top of head. Eighteen months' duration. Lack of confidence in electric plugs recently. Finds that he is

going back again and again to see if he has switched off. So with front door of house. He goes back again and again to confirm that he has locked it.

P.H.: Excellent health. Plays football regularly. Father well-"thatched". O/E Well built. Reddish hair. Thinning on top.

(M) Memory poor for what he has done: Acon. Bar c. Calc p. Hyos. Nux m. Onos.

(M) Lack of confidence: Anac. Aur. Bar e. Bry. Chin. Kali e. Lac. e. Lyc. Puls. Sil.

(P) Baldness: Anac. Apis. Bar c. F1. ac. Graph. Phos. Sep. Sil. Zinc.

14.2.67: Baryta carb. 30/3 prescribed.

D I S C U S S I O N O N C A S E 1

Mr. J.A.R. Aged 52. Vertigo 6/52. Neuralgia 2/52. Epilepsy (petit mal) two years. This man has had a lot of illness and has required a lot of treatment involving physiological drugs and surgery as well as Homceopathy. He is blind

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in the right eye and I am bound to admit tha t but for the rapid resort to mydriatics and hydrocortisone drops at the onset of iritis, which he has frequently, he might possibly be blind in his other eye.

At the onset of his at tacks of vertigo I had been already treating him for his "blackouts" which had been occurring for two years and were beginning to jeopardize his career as an executive with a large industrial concern. A diagnosis of epilepsy had been made by the neurologist to whom I had referred him and who had recommended Mysoline for the patient. Unfortunately Mr. J.A.R. was made ill by the tablets, so they had been stopped and Luminal substituted. He proved to be less sensitive to the latter, but his sensitivity to physiological doses made it impossible for me to prescribe an adequate dose to control the episodes which did not simply put him to sleep.

Such was the situation when he complained of his dizziness. His symptoms were all "particulars", but nevertheless, after repertory

analysis the remedy Clematis was shown to "come through" and this was prescribed after checking the materia medica.

The results were very gratifying and both the vertigo and the epilepsy were abolished. Thus is illustrated how, using the homceopathie method, neuro- logical conditions can be treated by "reading" the skin symptoms.

Clematis erecta, the remedy used here, has not, according to Clarke's Dictionary of Materia Medica, produced symptoms of peti t mal in its provings, but where the remedy fits in other respects, the patient usually improves totally. Indeed a patient who has improved in respect of his original complaint will often volun- teer tha t another malady, which he had not mentioned, has cleared up.

In dealing with the neuralgia, the "particular . . . . Pains eyes through to the occiput" was considered a "strange, rare, and peculiar" symptom and the value of this symptom was thereby enhanced. Natrum ars. was chosen in preference to Bryonia because I had fore-knowledge of the patient and he was more of a sensitive Arsenicum type than he was an "irritable Bryonia type".

DISCUSSION ON CASE 2

Mr. W.R.F. Complaint: Increasing baldness 18/12. My first reaction to this patient was tha t of irritation tha t he should have come along at all with what appeared to be one of the later secondary sexual characteristics. However, in view of his comparative youth I decided to see what I could do.

On being asked about the state of his nerves, he volunteered the information about his current at t i tude to electric plugs, gas taps, and his front door, which I was accordingly able to interpret as "Lack of confidence", and "Memory poor for what he had just done". Baryta carb. occurred in both rubrics and I was also delighted to find it occurred in the "particular"--"baldness" in the first rank.

I have only seen him once, but the remedy diagnosis resting as it does on what appears to m y mind to be a solid "three-legged stool", his next report should register an improvement. The other reason for quoting his case was tha t it appeared to contrast well with the previous one. The latter, a neurological case, wlfich responded to a remedy the indications for which were "read" from the skin symptoms; whereas, this second case was a skin case, the remedy for which was based largely on the mental symptoms of the patient. Thus is demon- strated the scope of Homceopathy when symptoms at one extremity of existence can facilitate t rea tment of signs at the other and vice versa.

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CASE 3

Mr. J.C.D. Aged 54. 15.12.66. Subacute tracheitis Complaint: Had an attack of traeheitis the previous two weeks and by the

tone of his voice indicated that it was lamentable that he was taking so long to get over a feeling of weakness, a feeling he never normally got with a cold, as his health was normally excellent.

He further disclosed that prior to going off work he had been constantly harassed by workers going off for trifling reasons.

O/E: He appeared a thin, wiry, precise, and conscientious type. Clinically the chest was clear and I had this confirmed by X-rays in view of the concern he displayed.

I considered that I could take four mental characteristics from his story: pride, impatience, mortification, and a tendency to lament.

Repertory: (M) Pride: Caust. Chin. Hyos. Ipecac. Lath. Lye. Pall. Plat.

Staph. Strata. Sulph. Verat. (12). (M) Impatience: Acon. Apis. Ars. Ars. h. Ars. i. Bry. Chain.

Coloc. Dule. ttep. Hyos. Ign. Iod. Ipecac. Kali. bi. Kali e. Laeh. Lye. Med. Nat. m. Nux v. Plant. Plat. Psor. Puls. Rhus t. Sep. Sil. Sul. ac. Sulph. (30).

(M) Mortification: Arg. n. Aur. Bry. Cham. Coloc. Ign. Lye, Nat m. 0p. Pall. Ph. ae. Puls. Seneg, Staph. Sulph. (15).

(M) Lamenting: Acct. ac. Arn. Ars. Aur. Bell. Bism. Bry, Calc. Canth. Chain. Chin. Cic. Cina. Coff. Coloc. Cor. r. Lach. Lye. Mosch. Nat. c. Nux v. 0p. Puls. Sulph. Verat. Verat. v. (26).

Lycopodium prescribed 30/6. 28.12.66: Feeling more like his "usual" self.

D I S C U S S I O N ON CASE 3

Mr. J.C.D. Aged 54. Subacute tracheitis. This case illustrates how mental traits can be observed without even asking any questions. This is where the reading of the "mentals" section of the repertory is valuable because it gives you an idea about the type of mental symptoms and traits to be on the look-out for.

I t is only fairly recently that I realized that the repertory caters for the patient who is a "Greetin Teeny" or a "Moaning Mimly". These terms, of course, do not appear as such, but the synonym "Lamenting" does and this appears to me to describe these people reasonably accurately. I t is really quite remarkable how many people enter one's surgery who fall into this category.

I have mentioned the use of synonyms and the ability to think of a synonym is a great help in the interpretation of symptoms where there is not an exact rubric to match in the repertory. This ability comes with practice, but a synonym finder such as Roger's Thesaurus could prove a useful part of the library of a homceopathie practitioner.

CASE 4

Mr, C. McC. Aged 51.22.8.66. Tracheitis and prostateitis Complaint: Barking cough for two weeks. Worse 3 a.m, onwards.

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O/E:

Repertory: (P)

(P)

(P) (P)

(P) (P)

22.8.66: 29.8.66: 23.12.66:

Worse lying down at night. Tickle in throat. Thick adherent sputum. Frequent urging to urinate for three years. Occurs suddenly. Jovial type. Moderately obese. Bags below the eyes. R.S.: NAD. CVS: B.P. 160/100. GIS: NAD. GUS: Prostate smoothly enlarged.

Dry cough at night: Am. c. Am. m. Arg. n. Ars. Bell. Calc. Caps. Carb. an. Carb. s. Carb. v. Cham. Chel. Clinic. Con. Cupr. Dros. Hep. Hyos. Ign. Ipecac. Kali e. Lach. Lyc. Mag. c. Mag. m. Med. Merc. Mez. Nit. ac. Nux. m. Nux v. Phos. Phyt. Puts. Rhus t. Rumx. Sabad. Sang. Sil. Spong. Stict. Sulph. (42).

Cough worse lying down at night: Ars. Bell. Carb. an. Con. Dros. Dulc. Kali c. Laur. Meph. Ph. ac. Phyt. Pu/s. Rumx. Sang. Sep. Thuj. (16).

Cough worse at 3 a.m.: Am. c. Ars. Kali ar. Kali c. Tickle in the throat: Apis. Caust. Cham. Con. Ign. Iod.

Rumx. Sang. Sil. (9). Viscid sputum: Ars. Kali c. Rumx. Sudden urging to urinate: Rumx. Rumex 200/6 prescribed. Cough and urging better. Bladder function remains normal.

CASE 5

Mr. A.L.L. Aged 41.25.11.66. Thyroid cyst Complaint: Swelling of the neck for two months.

Feeling rather overwrought from business worries in the past two months. Depressed.

O/E: Appears calm and in control of the underlying anxiety about his neck.

No exophthalmos, lid lag, or tremor of hands. (R) lobe of thyroid swollen 1~: by l�88 inches and firmly cystic. Referred for surgical opinion. Natrum mur. 6 (pills) prescribed.

15.12.66: Surgeon reports swelling disappeared three weeks ago.

I)ISCUSSlON ON CASE 4

2r C. McC. Aged 51. Tracheitis and Prostatitia. This case again illustrates how when the treatment is based in Homceopathy, on the whole man, but directed in the first instance on the patient's main complaint, it can result, if the pres- cription be accurate, in the main and also the associated malady clearing u p - - often to the surprise of the patient, if not of the doctor.

DISCUSSION ON CASE 5

Mr. A.L.L. Aged 41. Thyroid Uyst. I referred this man to the surgeon at his first visit to me because of the possibility of malignancy, in view of the short

G L O S S Y F I N G E R - N A I L S - - A N O B S E R V A T I O N 67

history. However, in view of the fact that he would in all probability not see the surgeon for at least ten days I thought I would give him the benefit of a homoeopathic remedy, using the keynote method without the use of the repertory and basing the prescription on his depression, reserved type of personality, and his underlying tension.

The fact that the cyst had disappeared shortly after starting the medicine shows I think the influence of the homceopathic remedy in acute conditions involving pathology. However, I always cover myseff where acute pathology is concerned either with an antibiotic umbrella or a surgical opinion, because in these conditions an answer must he found quickly, e.g. in such conditions as advancing paronychia, breast abscess and, of course, the manifestations of an acute abdomen.

C O N C L U S I O N

And so, ladies and gentlemen, having briefly commented on the history of I-Iomceopathy, medical pohtics, the importance of conviction, the necessity of eclecticism in the beginning of one's career in Homceopathy, the need for discipline, why I practise Homceopathy, the need for adequate working out, having presented a summary of the homceopathic approach and defined my terms of reference, and having finally presented a few cases which have re- sponded to Homoeopathy, I thank you for your kind attention.

Glossy finger-nails an observation D a . P . S A N K A R A N

As honorary physician at the Government Homceopathic Hospital, which is a public hospital, I have had opportunities to examine and treat several thousands of poor-class patients, while in my own consulting practice I have occasion to t reat middle-class and well-to-do patients. I had been noticing that in the hospital, even though the patients were generally very poor, some of them even unclean, many or in fact most of them had glossy or shiny finger-nails. By "glossy or shiny finger-nails", I refer to a condition where the finger-nails look polished and are able to reflect light. Often, such glossiness of the finger- nails noticed by us stood in contrast to the general malnourished or unclean appearance of the patient himself. This observation intrigued us and when we studied their case histories in detail we were able to note that among these hospital patients there was a much higher incidence of tuberculosis in some member of their family, related to them by blood. A large majority of these patients with glossy finger-nails either gave a history of tuberculosis in some