Minutus

Dear List members,

I was going thru Organon , ahp 3. and was thinking
over what Hahnemann wanted in a physician.
1. Knowledge of disease and its indications
2. Knowledge of medicines and indications
3. The knowledge to connect the case of disease to
the medicine. i.e to find what is curable in
disease and what is curative in medicine.

As a medical layman,I was so overwhelmed (but not
given up) by the medical jargon. But, as I am getting
my organon right, this is what is dawning in me.

1. That, knowledge of disease is not mere names of
disease. Hahnemann's description is the totality of
"externally perceptible morbid symptoms". To know what
is morbid,does one need to know the daunting details
of pathology? Still further, need one know what is the
name of the affection, which, according to Hahnemann,
is an "absurdity" and which "nature knows nothing
about" ?

2.There is an argument that 'knowledge of common
disease symptoms is necessary to help locate the
uncommon symptom that characterises the patient and
the remedy'. This may partially hold for acute
diseases but never for chronic diseases. Even in
acutes, the physician who knows point 1 and 2 will
know enough that a fever is too common symptom and
will start grouping all the symptoms of fever -
weakness, generalised pains, loss of appetite, hot
skin etc and will isolate the uncommon symptoms in
other areas like thirst,mentals, sleep, nature
of pains etc.

My question is this: what is the necessity of a
training of four plus years in a medical school of
which two and more years are consumed for anatomy,
pathology etc. ?

3. The use of diagnostic aids such as blood and urine
routines:
Is there any real use for them ? What will a true
homeopath do in a chronic case ? gather symptoms and
prescribe or wait for lab tests ? What inference will
he get in a lab test ? The argument "that this reduced
after that drug" can not hold since we have better and
much much more reliable indicators of cure - even a
law for direction of cure.

4. The Indian Government has stipulated that a student
complete all the allopathic routines to get a
homeopathic bachelor's degree.(obviously on the advice
of some half cock homeopaths sitting in administrative
positions who never comprehended Hahnemann's
requirements for a physicians.

5. For all of us who swear by Hahnemann, who said that
a. diseases are produced by the Vital force
b. they are known by their totality of the
affections of the vital force
c. all diseases are dynamic
d. each individual case of sickness is unique
I pose this question. Is the medical curriculum of
present right ? Do we not see the overwhelming impact
of allopathy in all this ? Is the anxiousness to pose
as a reasonable therapeutic method at the root of all
this ?

Some points to ponder.
Regards
Venkat

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Hi, Venkat.

Personally, I've found the information on Anatomy, Physiology, and, especially, gross (as opposed to micro) pathology that I've gotten along the way in my training (and outside it) to be extremely helpful in figuring out what's actually going on with a patient. What's "common" in disease is incredibly complex as a field of knowledge.

Also, I'd say at least 50% of the time, what the patient reports is actually not what's happening. On a simple level, where is the pain in their "stomach" actually occurring and why (i.e. what are the "common" concomitants, and which are characteristic)? On a more complex level, their "heart pain" or "migraine" -- are these accurate diagnosess (even if made by an allopathic physician), or is the patient experiencing musculo-skeletal pain or digestive system pain, for instance?) Personally, I've found that the Repertory and Materia Medica describe actual symptoms rather than perceived ones, and that if the patient's perceptions or medical diagnosis are inaccurate, as they so often are, following that wrong track will lead to an inaccurate remedy choice.

I don't know if you need to study four years of medicine to be a good homeopath, but a deep knowledge of the above three subjects on the macro level (which most allopaths don't learn in such depth any more with the dominance now of laboratory tests as the basis for diagnosis) certainly provide incredibly powerful assistance to good homeopathic case taking.

"Shadowing" an old-fashioned allopath who learned physiology and pathology in depth before there were all the lab tests, and learning everything that person can teach about physical diagnosis, gives you one of the most incredible therapeutic tools imaginable.

FWIW, Rosemary

Wow Rosemary, That's a wonderful idea to shadow an old time physician.

I thought that the Repertory and MM described perceived symptoms. Knowing what is actually going on at my level and the level where I hope to reach, beyond my expectation.

Blessings,
Ellen Madono

Do that fast, we are a disappearing breed...............

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

Dr. R speaks the truth -- most doctors nowadays receive a much more superficial training in physicial diagnosis than they did in the old days. Now they're taught what tests to prescribe. But it used to be that doctors were taught to discern almost everything going on inside by using sensory evidence (by observing symptoms)-- not only vision but also hearing, touch, smell, and taste -- and this knowledge base is reflected in the repertories. This knowledge of what's important to observe, especially in its finer points, is disappearing fast. A small example: the information on blood pressure is contained in the rubrics on "pulse."

Rosemary

Absolutely.

And in fact, we homeopaths will be the keepers of the old techniques of clinical and physical diagnosis..........guess who is in a pickle when there is no electricity to run the machines........we are still functional and with the help of a stethoscope, a BP cuff, a few lights and a few tubes we can still properly diagnose and cure.

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

Could either of you (and anyone else) toss out a few "tidbits" about this?
Things that those old-time docs use instead of lab tests, and that we would
learn if we were fortunate enough to have this chance?

Some of this must still be written of *somewhere*???
Shannon
on 10/17/04 6:29 PM, Rosemary C Hyde PhD at rosemarychyde@mindspring.com
wrote:

on 10/17/04 6:43 PM, Dr. J. Rozencwajg, MD, PhD. at jroz@ihug.co.nz wrote:
Dr. R.,
Could you (pretty please) say a little more? Give some examples?
(Presumably much of it needs to be shown as well as told, but can you say
more?)

You start by doing what we all have learned to do: listen in detail then ask questions.

You take into account every detail you see (and do not play with your computer like many GPs do now):

- the way the patient walks: a child came in the rooms bent to the right side, crying, looking feverish and holding his hand on the right iliac fossa: presumed diagnosis is appendicitis; short history and very light palpation confirms the diagnosis, operated immediately, appendix necrotic; total time between arrival and surgery: 20 minutes.......

- the odour of the patient: as students and interns, we were put in presence of patients with different infections, told to smell their wounds or their excretions and then told what the bacteria was; it then becomes easy to differentiate bewteen a common E.Coli, a dangerous Pseudomonas and a life threatening gangrenous Clostridium.........all confirmed with swabs taken to the lab

- inspection of the patient: 1/2 a chest does not move properly: pleural effusion, broken rib, pneumothorax come to mind, the history and the other symptoms give you the rest

- palpation: very few GPs do touch their patients any more.............

- percussion: you can hear masses, solids and gaseous, you can elicit the vibrations in fluids collected..... depending on what you find, it directs you towards a different pathology; look in Kent under Chest, matity on percission, it is all there..............

- auscultation: not only the lungs and the heart, the abdomen too, the joints: you can hear crackling in the joint (even just with the ear on the joint while moving it) you immediately know there is arthrosis or cartilage destruction..........

And so on...........

Look in Barbara Bates book on physical diagnosis, the French dictionary of differential diagnosis, DeGowin and DeGowin textbook of bedside diagnosis, plenty of them collecting dust in the librairies...........

Is that enough?????? want a real clinical case????????

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

Yes please, a real clinical case!
What is "matity on percussion"? In Complete re "percussion" I find only
"aggravates" and "cannot tolerate". What's missing?
on 10/17/04 7:35 PM, Dr. J. Rozencwajg, MD, PhD. at jroz@ihug.co.nz wrote: