Case management: placebos and repetition branching From LM aggravations

[Ellen Madono]

Hi Julian,

Ellen's response to Julian copied below concerning placebos:

When you give a placebo, the patient feels nothing from the placebo. He may feel something from the previously taken remedy, but nothing from the placebo. So how does that create sensitivity to one's symptoms or trust in the prescriber? Sensitive people feel something each time they take or don't take a remedy. Wouldn't it confuse the patient? It seems to me that you are trying to build understanding of the homeopathic healing process so confusion is not productive. We are talking about insensitive people, but I would not want to increase their insensitivity.
Julian said:

Julian's response:

Then do the single dose and placebo routine. But routine giving a
remedy when it might not be needed strikes me as bad practice.

Snip snip, topic low doses
Julian said:
A while back I presented a case on line
where I gave someone a single dose of Nat mur 6X for a cold. It had a
major life-changing effect. I just cannot understand, within the
context of what Hahnemann talks about, why a dose has to be routinely
repeated. Three times a day for ONE DAY might make sense.

Ellen said:

In one day you usually don't get much response. Within 2-7 days you do.

So Hahnemann did not repeat doses routinely? How did he stay in contact with patients? They didn't have a telephone. People came from far away, didn't they? If people could not quickly contact the doctor, wouldn't they aggravate and just continue taking the remedy as prescribed? In effect they would follow the doctor's routine, until they could see the doctor again. Today because of improved communications, we would try to avoid that long wait and extensive aggravations. People were probably tougher then too. They were not spoiled by allopathic "miracles."

Concerning the low potency that hits the mark when a higher potency does not, Tom give the Eizayaga class example of the 6 year old boy with exzema since babyhood who did not respond to 1M, 200c or 30 c that an Eizayaga student was giving him. Eizayaga took one look at the boy and said: "No No, 6c." 6c hit cured the exzema. Tom theorizes something about the boy's vital force being missed by the higher potency. Start low and gradually bring up the potency and that does not happen, he teaches.

Is there a way to objectively compare this sort of data or otherwise learn from it?

Blessings,
Ellen Madono
[Non-text portions of this message have been removed]

[Julian Winston]

At 10:55 PM -0400 4/29/04, Ellen Madono wrote:
My understanding was that you were continually giving the remedy. I
said that that could lead to an aggravation, and the old prescribers,
*if they felt the patient NEEDED something to take regularly* gave
placebo after a real dose was given in the office.
OR... they sent a not to the pharmacy which said, in effect: "Give
this person 30 packets numbered 1 to 30. Put a dose in number 2 and
3."
First you are talking about sensitive folks, and then you are talking
about insensitive folks. And I am getting lost.
I am speaking top only ONE issue-- the continual giving of the remedy
when it is not needed.
In the example I gave, the 6X was for an acute problem. There was a
response in a day. What I was commenting upon was that this dose (he
actually repeated it later in the day) of 6X resulted in an amazing
(and accidental) cure of his chronic condition, and changed his whole
life.
All that was needed was ONE dose of a very low potency to have major
results for the next six months.
Hahnemann had MANY prescribing strategies. His patients stayed in
touch by letter. All the records are still extant.
He did nothing routinely. He gave one dose and waited, he gave
increasing potencies of liquids, he went up the scale and down the
scale.
Understand that this was VERY EARLY in the development of homeopathy
and he was still experimenting.
Better results are seen through Boenninghausen's casebooks, and
better are seen through the journals and articles from practitioners
through the late 1800s and early 1900s.
They were tougher and the illnesses might be seen as simpler. But
what Hahnemann (and all others who came after) was trying to avoid
was the extensive aggravation. If there is a lengthy aggravation then
it is the wrong potency or the wrong remedy.
Most people teach that. The question is "how low do you start?" Kent
rarely went below 30c. That was one of his failings.
Read P. Sankaran's short paper on the "question of dose." Half didn't
respond to low and high cured, the other half was the reverse.
There is NO routine. It ALL must be individualized. And THAT comes
with experience.
I don't think so. All cases are individual swo they are hard to compare.

JW

[Ellen Madono]

Dear Julian,

I hear you saying in your reference to P. Sankaran that there is no good reason except for a lack of professional experience to separate into high and low dose camps.

I feel that there have been so many tricks of interpretation in the low dose prescribing that I have seen so far, I would be very cautious in trying high doses only because I imagine that it is an equally subtle art.

Thanks for the placebo usage method.

Blessings,
Ellen Madono