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The gray areas mean the practical difficulties in homeotherapeutics where no clear guidance is available; where physician’s own experience and insight comes into play. Many times these are very trying situations where one has to fire in the dark. There is no limit to such occasions; hence the topic will remain open with the invitation for all fraternity to discuss and enrich with their personal problems and their tentative or absolute solutions.

One such problem is when a boil or a furuncle is formed, there are two situations: viz. when it has just appeared and no pus has formed, it is advised to abort it with very high potency of Hepar Sulph. Now our patient is a hot patient. He cannot tolerate heat, drinks very cold water and seeks cold places and fanning. Hepar Sulph is a cold remedy to the superlative degree; where even a small part of the patient’s body if exposed _such as his one hand or foot _ a chill will run down his spine. How and why Hepar Sulph should be prescribed and why will it act in such a patient? Similarly when the furuncle is very slow in ripening, or slow in discharging, same remedy , and also Silicea, are given the first choice. But if the patient is the same as described above, how these intensely cold remedies influence the extra warm patient?

If a very critical patient of a large carbuncle was much ameliorated by one dose of Tarantula Cuban. 200, and the carbuncle starts discharging very profusely with lessening of pain and restlessness, and you have allowed the medicine to work for 10 to 14 days, and the sore improving definitely, but very slowly, should you repeat the dose? Very difficult question!! You will find people, even established authorities repeating doses arbitrarily, every few days, say, 10 days or so. Others, no less authentic, will be wary of any repetition. I myself would be cautious of any repetition and, at the same time cursing myself for not being able to expedite the process of cure.

With the first prescription, few days before menses, in a case of dysmenorrhoea, with missing or scanty menses, of short duration, say one or two days, menses occurred at time, totally painless and ceased after right duration; should we wait for the next cycle without repeating the medicine few days before the expected date, or repeat the dose? Now if we repeat the dose and menses are facilitated, as before, we conclude that the repetition was in order and that it worked well. But if the case was spoiled and all the disease symptoms reappeared; the conclusion would be that the repetition should not have been done. There can be another suspicion that if the repetition was done in a higher potency, we could have avoided the reversal. Who knows!!

In paediatric practice the matter of right potency is a point of difference. Most people prefer low to medium potencies, while there are not few people who believe that the high and the highest potencies should be used. I for myself prefer the first notion. It can be safely supposed that most of the infants and children can be classed as sensitive patients, who should not be given high potencies for fear of over reaction, nor the dose be repeated too often. This is sagacious attitude on the part of the physician; but not a certain rule.

Sometimes a symptoms complex does not lead you to the possible pathology. The symptoms are so banal that the seriousness of the disease is never surmised. Such a case occurred to me of a little boy, of the age of 5 years. He could not retain urine; it was leaking all the time. Homeopathically it was a case of involuntary dribbling, but nothing doing. Pathological and laboratory finding revealed a case of renal malfunctioning and a ‘tag-like hanging or a protrusion’ on the interior wall of U.B. was witnessed. Serum creatinine and urea readings were also exorbitantly high. [Cautery for the ‘tag’ and incision of posterior urethral valve was done in the hospital.]

Many a pathology is asymptomatic. Many times renal calculi and, also, biliary calculi have no symptoms. So is the case many times with renal and pelvic cysts. The answer to this difficulty is, as I have elsewhere said, in making homeopathy, somewhat, pathology and laboratory oriented. The list of asymptomatic pathologies is quite a long one. So the dictum: ‘no symptoms no disease’ stands refuted. Here a Burnett’s mind is required!

Another example is the prostate disease, which is though not asymptomatic but has the same banal symptoms in the beginning, whether the disease is benign or malignant. But the early detection of the latter case can save life in time. A test of acid phos-pha-tase can pre-warn of cancer, in case of its increased ratio in the blood plasma.

A good number of miscarriages happen yearly owing to placental problems, such as detachment, insufficiency and abruption. Countless laps remain barren owing to non-standard handling and treatments of this emergency. An early detection and administration of heparin (Clexane: brand name, an anti-coagulant) in the form of injections can enliven those laps. It is a flawless and sure treatment; but not homeopathic.

The grayest area in homeotherapeutics is the potency selection and the size of the dose. Before going further, let’s lay bare the conventions in this regard. Conventionally a homeopathic prescription consists of a single dose of two globules, of the size of poppy seed, to be administered in chronic diseases; (two to three doses, in rapid succession, in a chronic case, can be counted as one dose); and a solution of two to three such globules in half a tumbler or cup of water, a spoon for a dose, administered for few doses, at set intervals, in an acute case. We can further imagine that a drop of a liquid (alcoholic) potency can moisten, at least, one hundred of such globules. So a drop of medicine can suffice for at least fifty patients. Mind you!!

Now let’s witness the actual practice! Here we find that there are as many versions and ways of administering medicine as there are homeopaths. Every homeopath is a law unto himself. We find people using from mother tincture to the highest potencies; from single dose to multiple doses per day; from single globule to many drops per dose. The erudite discussion on the repetition of a remedy in the same potency and the bad effects thereof (as discussed in Dr. Nagarajan’s blog, in the HWC forum), is quite logical and sensible theoretically, but practically we find people using and prescribing drop doses of the same medicine two to four times a day, for many days, even weeks, from medium to high potencies. More heroic feats cannot be imagined!!!

The rule for dose administration is: ‘Never repeat unless the action of the first dose is exhausted.’ Further ‘Before repeating, re-evaluate the case to determine whether the same medicine is still indicated or a new one is vying to appear.’ This is a classical dispensation, or a golden rule; but seldom practiced. We find many luminaries acting arbitrarily. We feel, seeing them doing so, as if they have some preset goal, and are following it sedulously. Dr. Burnett is a bright example of such cases. He has a beautiful way of his own. One month he prescribes a nosode, a dose every ten days or so; and some relevant organ remedy the next month. Should we follow him? Lovingly, we should; on principle, we should give a second thought…We are rational beings, after all!!!

I put here a full stop to my discussion, but the topic is by no means complete. As I’ve said in the beginning, it is a topic for everyone to bring his/her therapeutic problems and difficulties and relate how those problems were solved_ or not solved_ and how did they managed to go around or surpass them. Therapeutic difficulties in homeopathy are endless, where a physician experiences pricks of conscience. The solutions are, evidently, peculiar to his seeping and experience. Anyway you are invited to bring your difficulties for the people of HWC to discuss.

DR. USMANI Nov. 25, 2009

Usmani Resource Page

Copyright 2011/All rights reserved © Dr Usmani
Contact author for permission to use

Views: 116

Comment by Dr. MAS on November 25, 2009 at 2:16am
You said, "Every homeopath is a law unto himself"

This I got after spending above 20 years in homeopathic practice. :D

I have the honour of visiting so many homeopathic doctors at their clinics and found that each one has its own strategy to tackle the case and the patient and more interesting is that each one claims cure after treatment. ;)
Comment by Dr Muhammed Rafeeque on November 25, 2009 at 6:43am
Though we all are entitled as homoeopaths, the style of practice changes from person to person. The science is same for everyone of us, but the application of scientific knowledge (art) changes for each individual doctor. There are some controversial topics within homoeopathy, which can be nullified by sharing of knowledge.
Regarding renal calculi: I also had a bad experience in a case of renal calculi. After my treatment the patient felt better, but when i took the USG the size of the stone was double with hydronephrosis!
Comment by Dr.M.K.Sahani on November 25, 2009 at 7:27am
We are concerned with present practice of homoeopathy which varies from individual to individual. In our country we have a regulated graduation course(BHMS) in Homoeopathy, where we have uniform syllabus for all and applied at all the Homoeopathic college. Yet we observe this situation every where. Reason we may blame teaching pattern or the individual perception about Homoeopathy. We have look for qualitative aspect of education system. Dr.Hahnemann has dream t of uniformity in practice of Medicine. He talked of uniformity and mathematics approach.
Vastness of Homoeropathic therapeutics data and minute observation on patient needs to be put together. Dr.Hahnemann has widely appreciated the use of Repertory which is very close towards uniform prescription.
Let us make this discussion continue to explore more on this burning topic of uniformity.
Comment by Heidi Stevenson on November 25, 2009 at 12:46pm
Uniformity in practice is a concept that scares me. It's far too reminiscent of allopathic medicine, where we see only too often the rote prescription of drugs simply because that's the prevailing approach. I think it eliminates individuality, in both patient and practitioner.

On the other hand, I think that considering the allopathic diagnosis - especially in terms of identifying the precise physical problem - can be quite useful. Mangialavori points out that the physical symptoms are just as important as the mental. I agree with that. They represent the whole patient. It's like the fact that heart attacks tend to happen in the angry.

We should also consider the reverse - that anger tends to occur in people with certain heart problems. Why do we always assume that the mental causes the physical? It is, I think, a bit of an assumption on the part of homeopaths. Surely, ones innate physical characteristics will have an effect on the emotions. After all, physical changes affect the endocrine system - and who could possibly deny that the endocrine system is intimately related to emotions?

I also think that we need more studies - not of the double blind placebo type, but ones that recognize a factor in homeopathy, the power of observation, that is the basis of our art. We should try to set up studies that follow lots of patients with similar diagnoses (though we'd first have to define what diagnosis actually means).
Comment by Dr.M.K.Sahani on November 26, 2009 at 8:16am
Dear Dr.Usmani,
You have raised very crucial aspect. Today I discussed this subject with Homoeopaths of our place. Here we are meeting every thursday to share views. I will keep updated in this discussion.
Comment by Hans Weitbrecht on November 27, 2009 at 2:25pm
Dear Members

Gray areas of homeotherapeutics = gray areas of your knowledge?

One may see it in that light – then those who feel there are above gray areas have to go back to the drawing board, the Organon to speak.
There you find the answers to those uncertainties.

First know homeopathy, then teach others. – if teachers would follow that rule, all those questions would be answered long ago.
Comment by Dr. M. A. Usmani on November 29, 2009 at 4:18am
Comment by Hans Weitbrecht 1 day ago
Delete Comment Dear Members

Gray areas of homeotherapeutics = gray areas of your knowledge?

One may see it in that light – then those who feel there are above gray areas have to go back to the drawing board, the Organon to speak.
There you find the answers to those uncertainties.

First know homeopathy, then teach others. – if teachers would follow that rule, all those questions would be answered long ago.

Dear Members,

Dr. Hans Weitbrecht commented on my blog. I’m very grateful to him for showing my weakness. I’m a learner, not a teacher, and I want to remain as such. Knowledge never lets me to put a full stop to my query.

What I’ve said in my blog: ‘Gray Area…..’ was in the spirit of discussion, with the invitation to all members to contribute. Enquiry is not sacrilege, nor questioning a sin; nor any person has ever uttered the final word in any discipline of knowledge.

It is simple to suppose: had Hahnemann’s sojourn in this world been extended for more ten years, there would have been a seventh or eighth or ninth or so, version of the Organon. And whatever would have been the last version, our Professor would have made it his scripture, (against the spirit of the Founder).

In the 6th edition of the Organon the Master rejected (broke) his tenet of giving only one dose, and not repeating. Though under the plausible garb of LM potency.

The great disciple of Hahnemann, Boenninghauten broke the rule by giving two medicines at a time: the indicated remedy, the first day, interpolating it with the antimiasmatic or constitutional or the complementary remedy the second day, and repeating the first remedy the third day.

The Organon is the magnum opus of Hahnemann, and a guide and a reference book for the homeopaths; but with open mind and logical reasoning, keeping it mated with the new discoveries of science.

Istead of saying what Mr. Hans has said about my blog, he should have applied his energies to finding solution for the difficulties there enumerated. May be he would have mentioned the relevant paragraphs from the Organon to enlighten us.

Dr. Sahani’s attitude is what could be expected from a sympathetic, mature and dedicated person. He says:
Dear Dr.Usmani, You have raised very crucial aspect. Today I discussed this subject with Homoeopaths of our place. Here we are meeting every thursday to share views. I will keep updated in this discussion.

Dr. Usmani
Comment by Hans Weitbrecht on November 29, 2009 at 7:00am
Dear Members, dear Dr. Usmani

I have clear answers to most of your points of concern.

However, time and space does not allow me to elaborate in greater detail.

If there is enough interest, I may offer a post graduate course, addressing those questions.

To follow your wish, here are few hints from the Organon and the CD.

C-potencies: CD introduction of Volume: 5 (liquid application)

>> it is advised to abort it with very high potency of Hepar Sulph.
Such advice is not found in the Organon.

– However you may consult first:
Case taking: Organon par.: 83 – 103
Then selection of appropriate remedy: Organon: par.: 148 – 246
Application of the selected remedy: Organon paragraph 247 – 286

Btw.: The rubric carbuncle in Boenninghausen’s: TT suggests 90 remedies, of which I am sure, you will be able to select One suitable for the case at hand.

Repetition of the dose:

A lot of uncertainty remains when using C-potencies, some expressed in this article.
I am almost exclusively using Q-potencies. Repetition org.: 247
Also not to forget 246.

Hope this encourages further study.
Comment by Heidi Stevenson on November 29, 2009 at 8:52am
Dr. Usmani wrote:

"Enquiry is not sacrilege, nor questioning a sin; nor any person has ever uttered the final word in any discipline of knowledge."

Brilliant words. If we should think that we have the Truth, then we're headed for a fall. We have only what we understand at this point. If we cannot continue in the spirit of inquiry, then homeopathy is a religion. If study means only going back to a single book for The Truth, then homeopathy is a religion. I did not become a religious practitioner. I'm a homeopath, with the ability to think and question - and the obligation to do so.
Comment by Debby Bruck on November 29, 2009 at 9:29am
Could we imagine that there are more roads to the end point? Is it possible that there is not just 'one answer' to every case? Could it be the dynamism of the patient and the physician? Could bringing together two entities have the curative effect?

As in all relationships, we see with two sets of eyes. There is give and take, provider and receiver of information. Each human comes with a history, experience, knowledge and more.

Perhaps 'truth' is believing that we can find a solution together? Knowing that G-d provides at every moment what is needed in each situation, we move forward. Part of that may be realizing we do not have all the answers, and thus, we need help from others. We utilize the tools we have used in the past that have been effective until something new and better comes along.

Learning the methods of others means that we can be open to change and refinement. If, on the other hand, every time we try a new method and find that it does not result in improvement, then we can put it aside or creatively use it in another application. I believe 'trial and error' has moved humanity forward in her search for answers and is one form of science.

Part of the problem with The Scientific Method today is when a hypothesis is written there is already an answer in mind. Then the scientist goes about trying to prove his hypothesis and consciously or subconsciously may manipulate the data or the test to MAKE the answer fit his theory. This is when the conclusion becomes suspect.

As many have stated, it may be possible that due to the nature of healing, there may be required two or more standards of observation. The double-blind study may work for a completely mechanistic view of life where certain factors are a play. And another form of inquiry and observation is needed to conclude when a 'dynamic' and ever-changing relationship is being studied.

In a way, science today is the religion that believes there is only one-way, with one answer, one view-point and it is grounded in the material world without allowing the interplay of immaterial spirit and life-force into the equation.

Homeopathy and a number of other healing practices allows for this 'unknowable' entity into the equation, which enables the possibility of 'more than one way' and 'more than one answer' to every puzzle.

just rambling on here...


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