Qualifications of a Physician ?

[Dr. Joe Rozencwajg, NMD]

You are correct, it is in the Materia Medica, not included in the repertory.

OK, here is a real case I had about 2 years ago; we will make it a quiz if you do not mind.

Elderly lady in her seventies; for the last 18 months is loosing weight steadily, associated with abdominal pain as soon as she eats, < fatty foods.
At the same time complaint of dry eyes.

Very little stool as she is barely eating. No modalities or concomitants to the abdominal pain except for < eating, < fatty food.

GP and specialists did gastroscopy, colonoscopy, US abdomen, CT abdomen, only feature is some aortic calcification.

Now, as an educational test, what do you do?

Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind"

[Rosemary C Hyde PhD]

Is there a medical sleuth with a reputation the equivalent of Sherlock Holmes in criminal cases? If so, this sounds like a good case for an outstanding detective!

Assuming that the various tests would have revealed obvious pathologies such as tumors, obstructions, gallstones, enlarged organs, hiatal hernia.... (is this a valid assumption?)...

Did the dry eyes start at the same time as the abdominal problem? (are they related in some obvious way?)

Is her salivation normal when she eats?

Is there observable dryness elsewhere?

Where in the abdomen is the pain upon eating, and what are its qualities -- which can often be diagnostic, physiologically as well as homeopathically...

Most importantly, what was going on 18 months ago, and how did this develop?

I guess my first impulse is to ask more questions.

The dry eyes would suggest a possible autoimmune process of some kind, if related to the abdominal problems. There could also be an emotional etiology.

I'll look forward to other approaches and to learning what you did (which I assume was the correct approach, in terms of solving the problem).

These symptoms alone don't give enough information for finding a remedy, in any case.

)) Rosemary

[Julian Winston]

At 5:15 PM -0400 10/18/04, Ellen Madono wrote:

I recently had to make a quick run to the hospital for some x-rays,
and while in there emergency room, I was seen by a medical student
(from India) who did a pretty good physical exam, including a lot of
percussion, and listening.
Such stuff is rare.
There are not a lot of old-time physicians any more.

JW

[APEX PRECITECH]

Hello Rosemary,
What a nice reply ?
I have read almost all mails in this thread and my
answer may reflect some other's mail too.
The shadowing an old timer allopath is good. One of my
first purchases in homeopathic literature was
"Children's Diseases" by C G Raue,a disciple of Hering
and a pathologist- homeopath. I have picked up
whatever I could in terms of physical diagnosis.
Especially the way he wanted us to see the throat of a
sick child. Take a spoon and just press the tongue
while inspecting the mouth and the child will gag a
second expanding the mouth and the entire throat will
be seen. But, he says, in that split second you have
to see all that's necessary.

But, what I wanted to say originally- is the
importance given to the diagnosis. Where
symptomatology is kept behind the pathology- this was
what irked me.

Dr Rozenkwajg's mail is interesting too. Truly how
many are like him ?

When I did not know homeopathy,but still believed it
could work, I went to a homeopath for my constipation.
The first thing he asked was my stool test. Later,
when I sat analysing my case, I wondered how many
characteristics were there for one to analyse !

As a person who is never tired of accumulating
information and knowledge, I find all the diagnoses
informative. But from a Homeopathic perspective, what
difference they create ?

Even in cases of cancer, I have seen the diagnosis
written boldly on top and the homeopath will write the
characteristics below and the medicine WILL correspond
to the characteristics and not the diagnosis. So , why
all the fuss ?

The docs out of college today in India are a miserable
lot.They know lots of anatomy and pathology. They have
done cadaver dissections. They know not what the
meaning of "Characteristic" is. They mug up the
organon and cough up at the exams: they know not that
a single remedy is what represents a single case of
sickness.

If a homeopath knows HOMEOPATHY FIRST I have no
objections to his mastering the allied arts.
Regards
Venkat

--- Rosemary C Hyde PhD
wrote:

________________________________________________________________________
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[andyh]

On Sunday, October 17, 2004, at 08:28 PM, Dr. J. Rozencwajg, MD, PhD.
wrote:

)))) Diagnostically in terms of chinese medicine and because the liver
is a fat processor-- a liver meridian problem exists of some
severity-(inadequate eye lubrication, abdominal pain after eating
fats). Secondarily spleen or pancreas (earth organs also involved with
digestion) may be involved. The losing weight and loss of appetite and
abdom pain could indicate a liver tumor or other liver disorder
impairing its function--the weight loss and low appetite are possible
warning signs for a growing CA (an Earth proliferation on a base of
disordered Wood (grandparent to earth and controller of earth). So
would send her to a liver specialist for a liver plate and whatever
test/scan needed to rule out LI , SPL, or PAN CA. Maybe were missed
by the US and CT previously for some reason--second opinion likely
needed.

Tx beyond or including what pt and specialist might want whether
something direly threatening exists or not:

sx given
Dryness [sen] eye [rem] fatty [sen] agg [rem] pain [sen] abdomen [sen]
eating [sen] after [rem] liver: acon.8, ant-c.155, ant-t.8, arg-n.8,
ars.8, 2ars-s-f., asaf.8, bell.8, bry.155, calc.8, calc-s.8, carb-an.8,
carb-v.155, caust.8, chel.187, chin.155, colch., cupr.8, ferr.8,
gran.36, graph.155, hell.8, hep.155, ip., kali-bi.155, kali-c.155,
kali-m.85, kali-n.8, 3Kali-sil., lach.155, lyc.155, mag-c.187,
2mag-m.8, mag-s., merc.155, merc-c.8, mez., nat-ar., nat-c., nat-m.155,
nat-p.8, nit-ac.155, nux-v.8, 2ol-an.8, phos.8, plb.155, podo.187,
psor.8, ptel.8, puls.155, 2sang.8, sec., sep.155, sil.8, spong.8,
2staph., sulph.155, tarent.8, thuj.36, tub.188, verat.54

==============
if tumor found in LI
Cancer/tumor [sen] liver: abr., alf., all-c., allox., alth., ammc.10,
anag.77, anan.8, arg-n.233, arn.3020, ars.8, ars-i., astac., aur.58,
bell.54, beryl.119, bol-f., bor.54, cac., cadm., calc-ar.110,
camph-br., caps., carb-an.54, carc.146, carc-brn., carc-hep., chel.92,
chelo.62, chion., 3Chol.36, coff., con.8, cuc-p., cund.8, dict.,
dios.8, euph.110, euph-he.73, falco-p., ferr.209, foen., form.,
graph.37, hep.223, hura, 2hydr.8, insulin160, kali-i.110, kreos.32,
lac-cpr., lach.8, lact.8, laur-n., lent-e., lept., lyc.8, lycpr.,
lyss., mag-c.219, mag-m.209, med.8, merc., mur-ac.160, myric.223,
nit-ac.223, nux-v.8, ol-an.223, onos., ph-ac.3020, phos.38, pic-ac.223,
pip-n.36, plat.8, plb.20, plut-n., podo.8, psor.149, puls.8, rhus-t.8,
senec.188, sep.54, sil.8, sol-t., spect., stroph., sulph.103,
t-rex.233, tab., tarax., tarent.8, ther.223, trig-f-g., uran-n.,
urt-u.223, vanad.209, visc., zinc.8

crossing the symptoms of the case with the (hypothetical) LI tumor:
Elimination: arg-n., ars., bell., carb-an., chel., ferr., graph., hep.,
lach., lyc., mag-c., mag-m., merc., nit-ac., nux-v., ol-an., phos.,
plb., podo., psor., puls., sep., sil., sulph., tarent.

==============
Symptoms of the "patient" (eg characteristic, psychical) may be able to
be applied to determine the rx for the totality, or a more specific
lesional rx may be needed in low potency/tinct for liver (eg
chelidonium only as example); in addition to surgery or what other
modality pt chooses to employ.

Would be my quiz contrib.--thanks Dr. J-please keep em coming if more
up your sleeve on diag. education
Best,
Andy

========
Notes:
--Cancer/tumor [sen] spleen: alth., arn.1016, bell-p., bor.54, cadm.,
cadm-i., calc.11, calc-ar.100, carb-an.8, cean.62, cedr., chin-ar.,
crot-h.8, ferr-ar., form., 3Kali-br.8, kali-i.110, lach.8, meli.,
mez.8, plat.8, plb.20, squil., 2verat.20, visc.

--Cancer/tumor [sen] pancreas: abel., abrot.188, allox., bals-p.,
bar-c.117, beta., bold., cadm-i., 3Calc-ar.8, calc-o-t., camph., cean.,
chol.223, cit-v., iod., jasm., juni-c., laur-n., lup., lyc.1101,
nat-ar., oci-b., phos.1181, podo., rob., salv., scut., syr., thea.,
verat.223, visc., zing.

--From Tang Rongchuan, A Treatise on Blood Disorders (Xuezheng Lun),
1884:
Spreading is the nature of wood. The transformation of food qi relies
entirely on the spreading and dredging function of liver wood once the
food enters the stomach. If the liver's pure yang does not rise, it
cannot spread and dredge the grain and fluids, and distention and
discomfort in the middle region will inevitably result.
The liver is associated with wood. Wood qi is characterized by its
upward momentum and its innate desire to be straight. As long as the
flow of liver qi is not impeded, the blood vessels will remain open and
unobstructed.
The liver is the organ that is in charge of storing blood. It also
commands the ministerial fire (xiang huo). If there is sufficient
blood, this fire will be warm but not fierce. As a result, the blood
can circulate smoothly through the body's three burning spaces; it will
reach the pores, and every single place in the body will benefit from
its warming and nourishing function.

From Zhang Xichun, Chinese at Heart But Western Where Appropriate:
Essays Investigating an Integrated Form of Medicine (Yixue Zhong Zhong
Can Xi Lu), 1933:
Liver and spleen function together by assisting each other. However,
people are always quick to point out that an excess of liver wood can
injure the spleen earth, and thus have a detrimental affect on the
proper digestion of food. But nobody seems to pay attention to the fact
that a weak liver cannot circulate the spleen qi and thereby also cause
maldigestion. Below, the liver connects to the Sea of Qi [lower
dantian, associated with the kidney], which means that the liver is
closely associated with the body's ministerial fire. It can utilize the
power of this fire to produce earth. The food which enters the spleen
and stomach relies on this power to be 'cooked.' This is what is meant
by saying that the liver and the spleen function by assisting each
other.
[Non-text portions of this message have been removed]

[Robyn]

>
***some great suggestions so far.

I would like to add that, it is very tempting to be drawn in by the few
symptoms presented namely

Abdo pain soon after eating espec. fats.

This symptoms is a classic cholecystitis symptom, and even though can be
confused with duodenal ulcer, the pains for the ulcer do not have the timing
of the cholecystitis pain which is after eating and espec. fats.

This condition can be chronic, and can be of the acalculus form, therefore
on ultrasound there would be no evidence of stones, and the condition can go
on for years. There are some attending symptoms that could be investigated,
to see if this is the case - therefore would be necessary to 'take the case'
in the location sensation, modality, concomitant sense.
There is a persistence of flatulence with this condition as well as more
often than not a referred pain to the scapula or the neck, as well as the
pain in the abdominal region.

One cause of this condition seems to be sedentary lifestyle, which is common
in the elderly, leading to stasis within the gallbladder - and getting
moving has helped lots of these patients. The usual treatment is
cholecystectomy, but I believe it can be helped by homoeopathy, especially
if the obstructions to cure can be dealt with.

Loss of weight due to lack of food due to pain would be expected, and with
that the possibility of anaemia (pernicious likely), which can have symptoms
of dry eyes if I recall. This condition is more prevalent in people over age
60, and is dietary related in many cases.

As Andy mentioned, the possibility of a cancer of one of the organs he
mentioned is also worthy of consideration.

And the usual idea of a psychoneurotic basis is often considered when no
pathology or physical cause can be found.

These things should be able to be discerned by thorough case taking and
investigations - stool evaluation for fats - steatorrhea (even though there
is not much in that department)
There is another condition called 'spastic gall-bladder' which has much the
same symptoms as acalculus cholecystitis, which could also be considered
(apparently this was relieved by Belladonna in the old days!)

One other thing that came to mind, which causes abdominal colic, but maybe
does not have the sensitivity to fats issue, is lead poisoning, which can be
subacute and cause similar symptoms. Paint in old houses often is a problem,
and this could be investigated. Apprently examination of the gums can show
tell tale signs of lead (blue), copper (green) and other toxicities.

That will do for now

Best

Robyn
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[Chua Ching Yee]

Couldn't resist sending this : ))

A famous Viennese surgeon told his students that a surgeon needed two gifts:
freedom from nausea and the power of observation.

He then dipped a finger into some nauseating fluid and licked it, requesting
each of the students to do the same. They steeled themselves to it and
managed it without flinching.

With a smile, the surgeon then said, "Gentlemen, I congratulate you on
having passed the first test. But not, unfortunately, the second, for not
one of you noticed that the finger I licked was not the one I dipped into
the fluid. ~ Anthony de Mello

Ching Yee
on 18/10/04 7:29 am, Rosemary C Hyde PhD at rosemarychyde@mindspring.com
wrote:

[Ellen Madono]

Dear Andy,
I see you crossing Chinese Medical diagnosis with homeopathy. The Chinese medicatl diagnosis comes to me without me asking so it must be in my path. Unfortunately, I put Chinese medicine in one part of my brain and do not cross it with homeopathy. How do you keep both forms of diagnosis going?
Blessings,
Ellen Madono
[Non-text portions of this message have been removed]

[Shannon Nelson]

(What does "matity" mean???)

I too would ask more questions -- what was happening 18 months ago, more
about generals, mentals, her appearance, what's changed.

For a tentative start might rep
GENERALITIES; OLD; people, complaints in (107)
GENERALITIES; FOOD and drinks; fats and rich food; agg. (84)
EYES; DRYNESS; general (136)
abd pain on eating (25) : aloe, bar-c., calc-p., carb-v., caust., chin.,
colch., coloc., croto-t., dor., dulc., ferr-i., grat., kali-bi., kali-p.,
mang-acet., mur-ac., nux-v., phos., pitu-a., plan., plb., psor., sep., zinc.

and consider carb-v, caust, sep, nux-v, phos, chin. But that is *only*
tentative!

Eager to hear more!
Shannon
on 10/17/04 10:28 PM, Dr. J. Rozencwajg, MD, PhD. at jroz@ihug.co.nz wrote:

[Julian Winston]

At 11:06 AM -0500 10/18/04, Bob&Shannon wrote:

I think folks are jumping ahead here.
We wwere talking of physical diagnosis.
Joe asked: "Now, as an educational test, what do you do?"

And, here you have a list of possible remedies.
THAT is not the answer.
The question is: WHAT is to be TREATED?

Too many homeopathy want to know, "well, what's the remedy?"
Ands I've been to too many seminars where the great gurus played the
"Guess the remedy" game.

The remedy is only a PART of what the case is about. You first have
to find out what needs to be fixed.

Best!

JW