At 01:40 PM 4/11/2003 +0100, you wrote:
Hello,
Stages of life can be very important in homoeopathy. One can not
consider children and aged to be in the exact same situation. When choosing
a remedy we must considered the causation, age, and the nature and stage of
the disease state, as well as the totality of the characteristic symptoms.
When treating geriatrics one is approaching at patient who is in the final
stage of life so we must approach them with this in mind. For example,
there are two major categories of disease, i.e. the functional and
pathological. A functional disease is one that is marked by changes on the
vital level, but as of yet, there is little physical pathology. A
pathological disease is one where there is organic tissue damage present in
major organs and systems. These situations can not be approach in the exact
same fashion. Normally, functional diseases support higher potencies and
moderate repetitions when necessary while in advanced pathological diseases
diseases one must be more prudent in these matters. Advanced pathological
can be terribly aggravated by too high a potency, too large a dose, and
over repetition. So all disease conditions can not be approached in the
same manner. One has to take into account the nature and stage of the
disease state as well as the condition of the vital force and vitality of
the patient.
Geriatric patients often have hidden and overt pathology. Sometimes, the
vital organs are partially compromised, and the organs of elimination
blocked. They also are prone to an unstable vital force and weakened
vitality. They can not sustain deep, long aggravations without danger of
increased pathology, an unsupportable physical crisis, and the draining of
their vitality. A good physical exam and lab test are sometimes necessary
to find out the state of their vital organs and systems. You have to be
careful with the aged. They are at the opposite end of life from a child.
Kent warns over and over about trying to treat those with advanced
pathology and weakened vitality as if they only have functional complaints.
This has lead to unproductive aggravations and some untimely deaths.
Functional complaints and the early stages of pathology are relatively easy
to manage when compared with advanced organic pathology and compromised
systems. One must keep this in mind.
When one is treating the age they should assume there is pathology
present. Even those who appear relatively healthy often have hidden
pathology in major organs and systems. For these reasons, one must
approached the aged conservatively and use prudence in the matter of remedy
selection, size of the dose, potency, and repetition. In general, it is
best to use a medicinal solution made with 1 small poppy seed size pill and
use a dilution glass to moderate the size of the dose. Keeping the size of
the dose very small is especially important in such cases. It is usually
best to start with the lower C potencies like 6c, 12C, 24C or 30C or the LM
0/1 potency. 200C is not the best potency to begin with in those who are
aged. When using the 30c or the O/1 LM potency the remedy bottle should not
be sucussed too many times in the beginning. Lower numbers like 3, 5 to
7succussions is often enough. The patient should be given a single test
dose and then placed under observation for a reasonable period. If there is
a strikingly progressive improvement on a single dose, DO NOT repeat the
remedy. Let this progressive reaction develop without interference. The
dose should only be repeat unitl this progressive amelioration slows down.
This is made clear in part 1 of aphorism 246 of the 6th Organon.
In part 2 of aphorism 246 Hahnemann explains that in those cases that
only SLOWLY improve on a single dose - the remedy may be repeated at
suitable intervals to speed the cure. There is a great difference between
strikingly progressive amelioration and a slow improvement that might take
30, 50 or 100 days to show any significant improvement. The repetition of
the split dose is only for those slow moving cases. If there is little or
no reaction to the single test dose, the patient should be given a test
series of 3 split-doses at reasonable intervals. To repeat the dose one
must judge the sensitivity of the patient on a scale of 1 to 1000. They
must also understand the nature and stage of the disease state, as well as
the state of the vital force and vitality of the patient.
What will not affect a number 1 sensitivity will cause dangerous
aggravations in the 1000th. Most age persons should NOT be given a daily
dose during this test. The daily dose is only used in the most
hyposensitive patients with good vitality. If the patient is very sensitive
the remedy should be repeated a infrequent intervals like once a week,
every two weeks, even once a month or LESS. Only those of more moderate
sensitivity can tolerate the LM 0/1 potency every 3, 4, 5, or days. Only
the most insensitive can utilize the remedy every other day or every day.
Even such a quick repetition is usually not needed for long if the remedy
is well chosen.
Anytime there is a strikingly progressive improvement during the
repetition the medicine should be stopped. Even in those cases that are
moderately improving the remedy should be slowed down to prevent
aggravations. As the patient moves toward cure the remedy repetitions are
progressively showed down. If there is an aggravation toward the end of
treatment when the patient is well in most regards, this is a sign that the
remedy should be stopped. After stopping the remedy the patient is again
put under observation. If the aggravation leaves and no new symptoms appear
the patient is cured. If the patient relapses during the period of
observation, the remedy should again be repeat but at longer intervals
until they no longer need the remedy.
All the major times of transition take special care that is
individualized for the age. This includes infancy, puberty, middle age and
old age. One must take into account the age - sex - nature and stage of the
disease state - domestic, social and environmental situations, - the
condition of the vital force, and the reserves of vitality when treating
patients. One must also consider the nature of the remedies. There are
certain remedies that must be very carefully used in the aged. This
includes strong anti-psoric medicines like Lyc, Calc-c, etc.., as well as
heroic remedies like Lachesis. In those age persons with advance pathology,
blocked organs of elimination, one-sided disease states, and a weakened
vital force - one may not be able to start the case with deep acting
minerals and animal poisons. One may have to treat the case in layers and
begin with apsoric plant remedies, etc.. This will support the vitality,
clear the organs of elimination, balance the vital organs and reduce
pathology safely. After the gross pathology is ameliorated one may move in
deeper with constitutional and anti-miasmatic remedies, etc.. Each an every
situation must be individualized by assessing all these factors.
I hope this provides some hints in the treatment of geriatric patients.
I have tried to offer some of the main points. I suggest students and
practitioners take up the study of case management very seriously. Many
cases are spoil because of a lack of understanding of case management
strategies. The correct remedy is often as dangerous as the wrong remedy.
The correct remedy can do great damage if given in too large a dose, too
high a potency and too often for the nature of the disease state and the
patients personal condition. Every case in the aged (an everyone else!)
must be individualized by the above factors and treated with the greatest
caution and respect.
Sincerely, David Little
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."
Samuel Hahnemann
Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000