Minutus

Hi Joe,

In answer to your questions, may I put my hand up as one who would probably be classified as a 'purist' - and not because of anything elitist but because I am so flat out trying to do my best at homeopathy that there is little time left for anything else.

That probably results in a couple of things. Hopefully, one of them is that I am continuing to improve as a homeopath but it also means that I won't ever become expert in another area. It also means that I have found homeopathy more than capable of managing a large variety of health complaints and have been able to build a successful practice with homeopathy alone.

I don't offer anything else but homeopathy. I don't sell other products such as supplements but when necessary do provide health related information, mainly about whole food 'treatments'. If there is something I can't manage, or something I think would be better treated in a different way, then I refer elsewhere.

About a third of my clients come out of the public education I am involved in. As a result, they have some sort of expectation of how they will be treated. The remainder who come by recommendation usually have little or no understanding of homeopathy and just want to get better.

My observation is that many other practitioners are forced into becoming a 'jack of all trades' (not you - I was very impressed by the bowel manipulation) when they would really rather not be. They have to try and be all things to all people in an effort to keep the doors open and put food on the table.

This is an area that as a profession we should try and address as it results in large numbers of graduates losing confidence in homeopathy alone (not that I am suggesting that everyone should only do homeopathy) as they don't have the opportunity to become expert in it. It does diminish our standing as a profession and after years of homeopathic study is surely not what these people ended up thinking they would do. We have to look at how to better support beginning homeopaths - your email group is one way of achieving this.

Interestingly, the 'jack of all trades' approach may be counter-productive. I have had a number of people say that they were only prepared to have a consult with me (as homeopathy was not something they would normally do) because I was not one of those people who advertised themselves as doing 'everything' on their front door.

And in relation to your gluten story - my approach is to try and treat it. I have many cases of gluten and other food intolerances being corrected homeopathically - in conjunction with their other health problems, and sometimes surprisingly quickly. If it was not responding quickly, of course I would then recommend abstinence or reduction for a period but only so I had more time in which to try and achieve a 'cure'. For better or for worse, this is the holy grail I chase with homeopathy because I know it is possible.
But I would be very interested to hear your, and others' answers to those questions.
You have started that thread as being an ethical challenge; those questions I asked are very basic ethics of practice.
I do not intend to throw anathema at anyone, I just would like to know how "purists" are conducting their practices and if they practice as they preach.
You already do know how *I* practice but let me detail a little bit further, to get the ball rolling:
- I have had patients calling and saying "I would like to book an acupuncture session for XYZ condition": to them I say that first we have to have a full consultation and determine what is the best approach for their condition; most agree, some are fixed in their acupuncture vision; those I refer to a traditional acupuncturist; why? Because I would feel very uneasy if I realised that another form of therapy would be better, faster and deeper but did acupuncture because the patient wanted it........it is a selfish approach, but it works for the both of us.
- I have had patients asking "Are you a Kentian homeopath?" in which case I answer "No, I am a pragmatic homeopath" and explain my approach to treatment, including the non-homeopathic ways.
Branching out to Liz's latest answer, here are a few cases, very shortly:
- a young mother comes with her 5 weeks old baby, who is crying day and night; seems hungry (fully breast fed) and appears to eat well, but lowish although not abnormal percentile, maybe some abdominal pain without real clear cut modalities (pressure, heat/cold, extension....); questioning Mum, she is eating truckloads of bread and cereal, flour,etc,...... My approach: gluten intolerance in the baby, so completely changed the mother's diet.....surprise, surprise, baby is doing well. I could have gone with the usual suspects, colocynthis, dioscorea, etc,.......but even if they "worked" and helped with the pain and the crying, the exposure to toxic gluten would have continued with further damage. So this is a situation where homeopathic treatment IMO was definitely NOT indicated.
- a patient I have known for years, cured from depression, high blood pressure, etc,... Stopped all his drugs, doing well with no treatment whatsoever any more, phones to tell me that for the last few weeks he had some kind of morning nausea (insert here the usual joke about him being pregnant), gets better over the day but still some "discomfort" during the day although that does not prevent him from doing anything. Also stools are liquid, not painful but not formed. Gave him a few simple tricks to try, no help so he comes for a full consultation: the whole symptomatology is frustrating, does not make any sense and the few straws I use for repertorisation lead to some remedies but none makes real sense........ So we start again from the time before the symptoms appeared.....nothing, nothing, nothing until I asked "any trauma, any injury?" Answer is "no, nothing.........hang on, just before that I fell on my butt and broke my coccyx, chiropractor settled it but I was blue and painful for a few weeks........and yes the nausea started after that". Bingo! Morning nausea after injury = Nat Sulf......but still I examine the patient and realise the caecum is not moving at all and the sigmoid has barely some mobility and motility; this means that those 2 parts of the colon are not working properly and explains why his stools are liquid. This is also covered by Nat Sulf but I have him under my hands, so I do a quick visceral manipulation and lo and behold the "discomfort" disappears, the motility and mobility of the organs comes back......... Patient agreed to an experiment, to wait and see what is happening and not take the Nat Sulf (anyway it was taking a few days to arrive from the pharmacy) and let me know how he is doing. Phone call the next day, extremely happy, no symptom whatsoever, formed stools.......wait. After 2 weeks a hint of the nausea came back, took Nat Sulf, case finished. What do I mean to say here? How could I NOT treat him manually as he was right there, under my hands? THAT would have been highly unethical!!! And I believe that quick starting his colon allowed the Nat Sulf to act deeply at the cellular memory level of the trauma.
Do you see what I mean?
Joe.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

No, John. It's not accidental. My reply is just that - no more. I'm fed up with answering your questions.
Liz

Hi, Liz --

Oh dear. This would be funny if I didn't it reflected on your anguish in finally replying responsively.

You didn't need to defend either the misrepresentation or the lack of integrity in taking the money as being either inadvertent or considered. I simply asked you to make clear how you proceeded in such cases. And I appreciate very much that you have confirmed finally that you do indeed charge the patient anyway. Thank you.

That's one "No", then, for willingness to reject payment when practice differs from the advertised conformity to homoeopathic practice.

No other souls practising as homoeopaths but prescribing as they see fit have been willing to declare their position one way or the other.

Where have all those other militant representatives of polypharmacy as "a kind of" homoeopathy disappeared to? Has the contradiction between claim and reality finally shamed you into silence? Let's hear from some others as brave as Liz has forced herself to be, with some straight answers.

Again, all of you who, in your declared capacity as a homoeopath, prescribe multiple remedies (including compexes and combinations):

In such cases, do you reject payment?

Let's, please, hear from the other vocal kind ofs.

John

I am not questioning anything, John, I am trying to push the boundaries of your ethical challenge out of the realm of hypothetical question into the realm of practical daily consultation.
Joe.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

Great! (although I disagree with the gluten treatment, but that is something else).
This also implies the ability to recognise the need for some other ways of therapies, therefore a basic knowledge and understanding of them..............as well as good diagnostic skills.
Joe.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

Great! (although I disagree with the gluten treatment, but that is something else).
This also implies the ability to recognise the need for some other ways of therapies, therefore a basic knowledge and understanding of them..............
Yes, agreed. And skill at walking the fine line of knowing WHEN to continue with homeopathy alone, when to stop, and when to refer.

And also the skill of knowing when to use a top-down or a bottom-up approach and educating the patient about these so they can make the decision of what is in their best interest at that time - and all comfortably within the space allocated for the consultation so we don't go into burn-out ourselves - not an easy thing to do!
as well as good diagnostic skills.
Yes, agreed again - sometimes critical for homeopathic prescribing, more often adjunctive. This is probably where homeopaths without a medical background should try and develop a relationship with an accepting doctor so that patients can be referred for diagnostics and a medical opinion. This can be difficult to achieve. Sometimes the patient still has the 'doctor is God' mentality and if the doctor starts making allopathic suggestions, will follow these rather than the homeopathy, and of course doctors face accusations of negligence if they don't make and follow-up on these suggestions. It is a difficult situation for both parties.
Joe.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

Hi, Joe --

That's fair enough. Perhaps I phrased that poorly. I didn't want to misinterpret your intent, so I was looking for confirmation that what you're raising in your examples is that, in the real world, it often won't be possible to know till the consultation is under way that something other than homoeopathy -- and the colon manipulation is an impressive example -- seems a more suitable response to the patient's condition than homoeopathy does.

Does that fairly sum up the point you were driving home?

Cheers!

John
I am not questioning anything, John, I am trying to push the boundaries of your ethical challenge out of the realm of hypothetical question into the realm of practical daily consultation.
Joe.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

Correct.
I appreciate the fact and the desire that a clear definition of what is done is used at all times (although not at all the way the message is conveyed.....).
The real world is quite different.............
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

Thank you, Joe. And I appreciate your clarity in discussing it.

Something strikes me as most obvious about your examples of what are, if you like, ad hoc decisions: the decision to remove the trigger for the baby's distress and the decision to manually manipulate displaced visceral organs. It is that neither was a decision to violate the principle of homoeopathy -- for any urgent or non-urgent reason.

The homoeopathic principle clearly does not require that one prescribe a medicine even if no appropriate medicine is known or no medicine is appropriate. Good practice of the principle, as in any health practice, rather requires, as Hahnemann states, that "maintaining causes", such as an environmental toxin or a surgical displacement, be removed, and it is surely no violation of the homoeopathic principle to make an effort to do so.

Your approach and Fran's to the import of gluten in the diet differ, so that whilst you may treat it as a problematic "maintaining cause", Fran treats it as a modality. Is either of you violating the homoeopathic principle in taking your respective approach? Does the answer to that depend upon whether gluten intolerance arises from an inherent medicinal capacity to derange health in normal dietary doses (in all people or in some) or arises merely contingently (from circumstances that may include, perhaps, having been excessively vaccinated)?

Clearly it does not depend on that, as we cannot know the answers to all such questions and must be able to practise the priniciple on the basis of limited knowledge. Both your approach and Fran's to the identical situation must reasonably fall within the bounds of homoeopathic practice: you adhere to the homoeopathic principle and remove such maintaining causes as you perceive.

Similarly, whilst it may be possible that a medicine homoeopathic to the symptoms of the patient with displaced visceral organs could provoke their replacement (just as potentised Silicea has been known to induce expulsion of splinters), it is at least as appropriate to take a harmless physical approach as the first option, and the attempt to do so is the attempt again to remove a "maintaining cause".

On this basis, then, your examples don't appear to be analogous to an entirely different kind of ad hoc decision: the kind that consciously revokes the homoeopathic principle in favour of an allopathic one.

What do I mean by this?

The three broad medicinal relationships that Hahnemann discussed were:

(i) the enantiopathic or antipathic, in which the medicine's effects are known to include one opposing the symptom of interest to the physician;

(ii) the homoeopathic, in which the medicine's effects are known to mimic, to a greater or lesser degree, the patient's entire state (which Hahnemann emphatically distinguished from a single symptom); and

(iii) the allopathic, including all other medicinal relationships: both unknown medicinal relationships and those known to be relationships of dissimilarity (i.e. of no particular similarity or oppositeness).

Since, by definition, all known medicinal relationships fall into one of these three categories in relation to a medical decision, and unknown medicinal relationships fall into the last, it is not a difficult logical maneouvre to conclude that any medicine that is (a) not known (through pathogenesis or toxicology, including normal allopathic usage) to offer an antipathic relationship to the symptom of interest (it's generally a single symptom, and in the message that launched this discussion was a cough) and (b) not known (through its pathogenesis) to enjoy a relationship of strong similarity with the patient must be, in Hahnemann's terms, (c) allopathic to the patient's condition.

So when a practitioner -- whether she calls herself or a homoeopath or not -- decides to prescribe for a patient a medicine that clearly is not known (and, in the case of medicinal mixtures, cannot be known) to be homoeopathic to the patient's condition but that also is not known to be antipathic to the condition (here, the cough), in that circumstance the practitioner is not practising homoeopathy but allopathy of one school or another -- in Hahnemann's terms, which by definition include under that head such practices as herbalism and all speculative (non-pathognomic) bases of prescription.

And it's in that circumstance that I suggest that any practitioner with a conscience cannot pretend to be practising homoeopathy but must acknowledge practising something else: herbalism, doctoring, experimental medicine, whatever it is.

Given this circumstance, the question launching this thread of discussion was whether any such practitioner, having committed both herself and the patient to a homoeopathic consultation, is willing to make her allopathic prescription -- a prescription of a medicinal mixture with undefined medical relationship to the patient's condition -- without charge.

Clearly, this question is not even applicable to you, for all the reasons given above. Equally clearly, it is applicable to several others on the list. Liz has had the courage to admit that she does not refuse payment in that circumstance, a courage I applaud. Others have been conspicuous in their sudden silence.

Interesting, isn't it.

Kind regards --

John
Correct.
I appreciate the fact and the desire that a clear definition of what is done is used at all times (although not at all the way the message is conveyed.....).
The real world is quite different.............
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com

That is where the term "allopathic" has to be redefined.
Although it meant "different, unknown action" in H's time, todays it has the meaning of antipathic, as most if not all drugs and herbs and other methodologies have their mode of action very well defined, not only through traditional use but through pharmacological and biochemical studies.
Mind you, much of the herbalism is in fact homeopathy in the rough; anyone interested can compare homeopathic provings and herbal materia medica.
Ortho-bionomy is known as "homeopathic osteopathy" (and IMO visceral manipulation is there too). Other techniques like acupuncture and TCM herbalism work through readjustment of energies and metabolism, certainly not antipathic treatments. Which leaves us with some specific circumstances (bar needed surgery) where an antipathic drug might be needed.
A typical example is the sudden crisis of very high blood pressure with the threat of stroke or MI, in which case I do not give a damn how it is done, I want that BP down to non threatening levels.
Therefore I think we can conclude that semantic exploration of the term homeopathy by saying that although those techniques do not fit the strict definition of homeopathy as H established it, it cannot be said or argued that homeopaths should not master some of them and be familiar with others, and use them when indicated during their consultation and treatment, even if they call themselves strictly pure homeopaths.
To return to the Organon, it is not by chance that the first aphorism tells us about our duty to cure the patient, and it is not by chance that H never found it necessary to add that the cure should be provided by the means of homeopathy alone, as he could definitely have been entitled to write.
And so, IMO again, I think it is fair that on a list devoted to "Classical" homeopathy, other techniques can be discussed as synergistic methods.
Joe.
 
Dr. J. Rozencwajg, NMD.
"The greatest enemy of any science is a closed mind"
Visit my new website www.naturamedica.webs.com