Constitutional versus specific remedy
Posted: Sat Aug 16, 2008 6:05 am
Reading up for a case, I came across this bit, which speaks directly to
a debate we've periodically had, i.e. the usefulness (or not) of
prescribing "constitutionally" (and here I use the word in the sense of
chronic remedy, I guess) for specific and/or local problems. So, I
thought I would share it. This is from a seminar presentation on a
case of debilitating sciatica, which had received extensive treatment
by other homeopaths without result, and he describes how he identified
the remedy that cured. (It's also a nice piece on the remedy Ginseng.)
She vividly describes the patient, her situation, and some
characteristic (and unusual) responses. She lists the numerous
remedies the patient has already had for the sciatica, without benefit.
She remarks, "At the time, I did not know what remedies she had
received homeopathically, but I knew a number of excellent homeopaths
had prescribed for her. So, I figured I could remove the regular back
remedies from consideration. [...] (She decides to focus on those
remedies listed under the rubric "Courageous.")
- I read the small remedies until I came to Ginseng. I read
Boericke. I found nothing of compelling significance there. [...]
- According to Clarke in his Dictionary of Practical Materia
Medica, J.H. Henry said that Ginseng acts on the lower part of the
spinal marrow, as indicated by "bruised pain in the small of the back
and thighs (on rising from the bed)." Henry also mentions "nightly
digging in the right lower limb from the hip to the big toe, cramp,
pains from right hip to toes." Henry considers Ginseng specific for
lumbago, sciatica, and chronic rheumatism, with frequent desire to
urinate.
Ginseng is an aromatic stimulant and removes feelings of fatigue,
imparting a joyous sense of vigor and elasticity to the limbs,
especially the upper limbs, and clearness of the mind...the right side
of the body is most affected. Many symptoms are worse at night and from
bending or turning, descending stairs, or sitting. [N.B.: Some of the
preceding are examples of where *positive* traits can be used in
prescribing. In the case, just this sort of extraordinarily positive
attitude in the face of tremendous suffering and "challenge" was a
striking feature. So one isn't trying to "cure" her "joyous sense of
vigor" etc.; but they are nonetheless characteristic and indicative of
a state which *is* cured by the remedy.]
- Clarke says the mood is "quiet and contented, with good
courage." The mind is generally calm, but the patient can have
impatient impulses and a fear of accidents. (She noted that before
taking the remedy she had a tremendous fear of accidents. When she was
a passenger in a car, she was terrified there would be an accident.
This symptom resolved with the remedy.) I do believe this is a common,
but under-represented, symptom. Many people who have lived with a lot
of pain can't tolerate the possibility of another injury."
[The speaker continues:]
"How Do We Find Remedies?
- There would have been no way to find this remedy by
repertorizing her back symptomatology. Even in retrospect, it is not
possible to find this remedy by looking through back symptoms in
ReferenceWorks. I don't think this problem is unique to this case.
- The musculoskeletal rubrics, as a group, are weak and
incomplete. Osteopathic physicians who treated patients 50 years ago
say that people's bodies were much healthier then. They were easier to
treat and help. Something terrible has happened to our tissues, as we
can see in problems like chronic fatigue syndrome, environmental
illness, AIDS, and other unknown and undefined weaknesses in the
system. The skeletal system inevitably reflects these problems;
however, the repertory does not yet do so.
- So, how do we find remedies? About 30 to 40 percent of the time
the back rubrics will lead you to the remedy, such as finding Kali
carbonicum in Case Number 1. About 20 to 30 percent of the time, the
essence will lead you to the remedy and the materia medica will confirm
the back pathology, as Clarke confirms Ginseng so nicely for us. The
rest of the time, about 20 or 40 percent, the remedy cannot be
confirmed with back symptomatology. These are the cases we too often
miss. We must base the remedy on the essence and generalities we find.
We must think of as many ways as possible to come to know the core of
the person. In this case, I believe her central core is represented by
courage."
And further:
" The Courage of Other Remedies
- Other remedies are courageous in different ways. Persons
needing Ignatia develop a hard shell so as to endure the world's
assaults on their sensitive systems. Within the confines of this hard
covering, they are capable of considerable fortitude in very difficult
situations. Tabaccum has a kind of exhilarated fierceness that drives
them to run over the hot coals of their pain. Phosphorus people tend to
float over situations and move forward almost untouched by the
awfulness that they must overcome. Or, perhaps, Phosphorus people tend
to become involved in awful situations because of their sensitivity to
others - situations that others might more wisely avoid.
Pathological Courage?
- Did courage in these Ginseng cases have a tinge of pathology?
Possibly. In the first case, she may have pushed herself too hard, too
sure of her own vital, physical strength. Whereas some cultures demand
a lot of emotional suppression, as we have seen in some of the English
and some of the Asian cultures, perhaps America drives people of talent
to "burn out" and pushes most of us to our limits. Aristotle said that
core virtues are based on a balance between two extremes. Courage is
the balance between recklessness and cowardice on either side.
- Our greatest strength can also be our weakness. Many tragedies
are written from this perspective. So, in this case, we can see her as
trudging through hardship with fortitude, creativity, and discipline -
surviving a winter that might destroy someone else. And we might only
suppose that her vitality and strength also prompted her to try to
survive mountain ranges with fierce blizzards. Such an attempt could
certainly jeopardize her health and well-being.
Look to the Best
- On the other hand, I think it is dangerous to repeatedly see
people in a pathological light. In the Organon of Medicine, Hahnemann
initially talked about the incredible healing and positive power of the
vital force. I believe that, like osteopaths, he too had an awe and
respect for this vital force. As many religious traditions state, if we
look to what is best in the person we can link with their vital force
and people will heal. If we sense what moves them and their core of
genius - where their heroism, courage, tenderness, and concern lie -
then we will know them. Then, we will find the remedies that most
reflect the deepest part of our patients, and they will heal."
a debate we've periodically had, i.e. the usefulness (or not) of
prescribing "constitutionally" (and here I use the word in the sense of
chronic remedy, I guess) for specific and/or local problems. So, I
thought I would share it. This is from a seminar presentation on a
case of debilitating sciatica, which had received extensive treatment
by other homeopaths without result, and he describes how he identified
the remedy that cured. (It's also a nice piece on the remedy Ginseng.)
She vividly describes the patient, her situation, and some
characteristic (and unusual) responses. She lists the numerous
remedies the patient has already had for the sciatica, without benefit.
She remarks, "At the time, I did not know what remedies she had
received homeopathically, but I knew a number of excellent homeopaths
had prescribed for her. So, I figured I could remove the regular back
remedies from consideration. [...] (She decides to focus on those
remedies listed under the rubric "Courageous.")
- I read the small remedies until I came to Ginseng. I read
Boericke. I found nothing of compelling significance there. [...]
- According to Clarke in his Dictionary of Practical Materia
Medica, J.H. Henry said that Ginseng acts on the lower part of the
spinal marrow, as indicated by "bruised pain in the small of the back
and thighs (on rising from the bed)." Henry also mentions "nightly
digging in the right lower limb from the hip to the big toe, cramp,
pains from right hip to toes." Henry considers Ginseng specific for
lumbago, sciatica, and chronic rheumatism, with frequent desire to
urinate.
Ginseng is an aromatic stimulant and removes feelings of fatigue,
imparting a joyous sense of vigor and elasticity to the limbs,
especially the upper limbs, and clearness of the mind...the right side
of the body is most affected. Many symptoms are worse at night and from
bending or turning, descending stairs, or sitting. [N.B.: Some of the
preceding are examples of where *positive* traits can be used in
prescribing. In the case, just this sort of extraordinarily positive
attitude in the face of tremendous suffering and "challenge" was a
striking feature. So one isn't trying to "cure" her "joyous sense of
vigor" etc.; but they are nonetheless characteristic and indicative of
a state which *is* cured by the remedy.]
- Clarke says the mood is "quiet and contented, with good
courage." The mind is generally calm, but the patient can have
impatient impulses and a fear of accidents. (She noted that before
taking the remedy she had a tremendous fear of accidents. When she was
a passenger in a car, she was terrified there would be an accident.
This symptom resolved with the remedy.) I do believe this is a common,
but under-represented, symptom. Many people who have lived with a lot
of pain can't tolerate the possibility of another injury."
[The speaker continues:]
"How Do We Find Remedies?
- There would have been no way to find this remedy by
repertorizing her back symptomatology. Even in retrospect, it is not
possible to find this remedy by looking through back symptoms in
ReferenceWorks. I don't think this problem is unique to this case.
- The musculoskeletal rubrics, as a group, are weak and
incomplete. Osteopathic physicians who treated patients 50 years ago
say that people's bodies were much healthier then. They were easier to
treat and help. Something terrible has happened to our tissues, as we
can see in problems like chronic fatigue syndrome, environmental
illness, AIDS, and other unknown and undefined weaknesses in the
system. The skeletal system inevitably reflects these problems;
however, the repertory does not yet do so.
- So, how do we find remedies? About 30 to 40 percent of the time
the back rubrics will lead you to the remedy, such as finding Kali
carbonicum in Case Number 1. About 20 to 30 percent of the time, the
essence will lead you to the remedy and the materia medica will confirm
the back pathology, as Clarke confirms Ginseng so nicely for us. The
rest of the time, about 20 or 40 percent, the remedy cannot be
confirmed with back symptomatology. These are the cases we too often
miss. We must base the remedy on the essence and generalities we find.
We must think of as many ways as possible to come to know the core of
the person. In this case, I believe her central core is represented by
courage."
And further:
" The Courage of Other Remedies
- Other remedies are courageous in different ways. Persons
needing Ignatia develop a hard shell so as to endure the world's
assaults on their sensitive systems. Within the confines of this hard
covering, they are capable of considerable fortitude in very difficult
situations. Tabaccum has a kind of exhilarated fierceness that drives
them to run over the hot coals of their pain. Phosphorus people tend to
float over situations and move forward almost untouched by the
awfulness that they must overcome. Or, perhaps, Phosphorus people tend
to become involved in awful situations because of their sensitivity to
others - situations that others might more wisely avoid.
Pathological Courage?
- Did courage in these Ginseng cases have a tinge of pathology?
Possibly. In the first case, she may have pushed herself too hard, too
sure of her own vital, physical strength. Whereas some cultures demand
a lot of emotional suppression, as we have seen in some of the English
and some of the Asian cultures, perhaps America drives people of talent
to "burn out" and pushes most of us to our limits. Aristotle said that
core virtues are based on a balance between two extremes. Courage is
the balance between recklessness and cowardice on either side.
- Our greatest strength can also be our weakness. Many tragedies
are written from this perspective. So, in this case, we can see her as
trudging through hardship with fortitude, creativity, and discipline -
surviving a winter that might destroy someone else. And we might only
suppose that her vitality and strength also prompted her to try to
survive mountain ranges with fierce blizzards. Such an attempt could
certainly jeopardize her health and well-being.
Look to the Best
- On the other hand, I think it is dangerous to repeatedly see
people in a pathological light. In the Organon of Medicine, Hahnemann
initially talked about the incredible healing and positive power of the
vital force. I believe that, like osteopaths, he too had an awe and
respect for this vital force. As many religious traditions state, if we
look to what is best in the person we can link with their vital force
and people will heal. If we sense what moves them and their core of
genius - where their heroism, courage, tenderness, and concern lie -
then we will know them. Then, we will find the remedies that most
reflect the deepest part of our patients, and they will heal."
), so