Answers, 1st Refresher course,1st session

[Homeopathic Newsletter CTCH]

Dear Colleagues,

Greeting from CTCH
With special thanks from your warm attending in our Refresher courses, Please find the answers of the first session of the first course here.
Mental Exercise:
The outline shows that investigator is going to execute a clinical trial.

The accuracy of Clinical trial will be increased if he considers below points:

Using random selection of case and control groups.

The patient and practitioner groups who will evaluate the outcome of treatment be blind about the group of patient (Case or Control) - Double blind.

More than above even the person who prescribes the medicine does not know the kind of medicine (Placebo or true remedy) - Triple blind

Controlling the confounding factors like Diet, Emotional disturbances, etc during trial.
About the proposed criterion for evaluating the efficacy of treatment, however it is better to use a scale for the severity of pain but it is not wrong because presence of pain in stomach is not the natural reaction of V.F to some external pathogen (Refer to The coming refresher course on the subject of “Pathology and Pathogen” in the near future) and therefore after correct Homeopathic treatment the pain can be completely removed along with repair process in the stomach.
Please note if you select this criterion (complete removal) which is a dual variable (+,-), your results will be falsely less than the real efficacy. Why? Because for example 80% decreasing in the pain during the period of trial (For example 1 month), which actually shows that the Homeopathic treatment has been successful, will be considered as negative efficacy because the pain has not been completely removed.
The most important mistake in this research is selection of a Homeopathic remedy for a medical syndrome (Acute Gastritis). As you surely know the Nux-v is only effective on the acute Gastritis which is in the state of Nux-v and it is completely (or relatively) ineffective on acute Gastritis which is in other states like Lyc or Puls or other remedies.
Therefore in this trial there is a very important confounding factor that has been completely neglected. For any reason if all the referred patients are in other Homeopathic states except Nux-v, the result will be falsely less than real one and vice versa.
One of these reasons can be as below:

The trial is carried out in a village during the summer and most of the patients are affected by acute gastritis because over eating of fresh fruits (Puls can be a better choice) and many more similar reasons.
Avoiding such mistakes, it is better to evaluate the efficacy of Homeopathy as a method in comparison of one allopathic medicine or placebo.
Materia Medica:
Thuj

Menyanthus
Case Presentation:
For a complete and successful reportorizing a case, we need to pass 7 steps in order:
Case Taking

There are guidelines in the Organon (83, 86-99) for taking a standard Homeopathic case. Please accept that the case has been taken on standard method.
Recording and Interpretation.

For finding several useful guidelines in this subject please refer to Organon. (84-85)
Defining the problem:

Patients say a lot of symptoms but all of them are not pathologic and do not need any treatment and will not removed after correct Homeopathic one.

Furthermore, in different method for evaluating the patient, you need to consider some symptoms and omit the others.

For example in epidemic condition you need to consider shared epidemic symptoms (Genus epidemicus) and neglect some non-epidemic and individual symptoms. (Organon 100-102).

Also in constitutional method we need to consider the constitutional symptoms even they are not pathologic.

We try to present the complete discussion about this subject in future cases.

The presented symptoms in this case have passed this part.
Classification & Evaluation of Symptoms:

It is obvious that entire the symptoms dont have the same importance. The simillimum remedy is which one that completely covers the most important symptoms. How should we classify the symptoms?

There are 3 different criteria that should be used in classifying a case

Turning-points

Severity of symptom

Kent’s pyramid
Below I try to explain above criteria and then classify the symptoms of the presented case.
Turning-points:

Turning points are one or few important accidents or events during the past history of patient that a group of symptoms obviously have appeared after it. For example: severe emotional stress like death of parents, Puberty, Marriage, Menopause and pregnancy. These events can be considered as turning-point especially if you observe some deviation in General Modalities like food Cravings and Aversions, Heat and Cold, Position of sleep, etc.

The symptoms which have appeared after the last turning-point are more important.
Severity of symptoms:

Not all of the symptoms presented by the patient have the same severity and the more severe the symptom, the more important it is. To define the severity of each symptom we should consider 3 criteria: Predominant, Persistent and Present (PPP).

Predominant:

The symptoms that patient have complained about them more than and before other symptoms.

Persistent: Symptoms which are present constantly.

Present: The symptoms that are present now and not in past history

(The complete discussion of this subject is available in CSHom course material, Methodology, Repertorization method)
Kent’s Pyramid:

Kent says that Mind and emotional symptoms (M) are the most important then the General symptoms (G) and the last ones are the peculiar Physical symptoms (P).
Now, I classify the symptoms of the case considering these criteria:
Turning-point: The pregnancy can be considered as turning-point however we do not have any supportive changing in modalities from this point. The symptoms that the patient had before the point are “Biting Nail” and “Skin eruptions”. The second one has increased after the pregnancy therefore we can consider it as other symptoms.

Severity of symptoms : Premature contraction (p, Not persistant, not present), Irritable (ppp), Head heat (pp, not persistant), Break things (pp, not persistent), Skin, Eruption, painful (ppp), Skin, Eruption, Pustule (ppp), Appetite, wanting (ppp), Bleeding, Gum (pp, not predominant), Burning, tongue (p, not persistent, not predominant), Stool ,undigested food (p, not persistent, not predominant), Tingling, lower limb, sleep during (pp, not predominant), Back, pain, lumbar, lying on back agg (ppp), Dream, falling (p, not persistent, not predominant), Dream, dead persons (p, not persistent, not predominant), Dream, disturbing (pp, not predominant), Biting, nails (pp, not predominant) Perspiration, odor, urine like (pp, not predominant), Food, cheese desire (pp, not predominant)

Kent’s pyramid: Premature contraction (P) Irritable (M), Head heat (P), Break things (M), Skin, Eruption, painful (P), Skin, Eruption, Pustule (P), Appetite, wanting (G), Bleeding, Gum (P), Burning, tongue (P), Stool ,undigested food (P), Tingling, lower limb, sleep during (P), Back, pain, lumbar, lying on back agg (P), Dream, falling (G), Dream, dead persons (G), Dream, disturbing (G), Biting, nails (M) Perspiration, odor, urine like (G), Food, cheese desire (G)
Final order of symptoms:
Irritable (ppp, M)

Appetite, wanting (ppp, G)

Skin, eruption, painful (ppp, P)

Skin, Eruption, pustule (ppp,P)

Back pain lumbar, lying on back agg (ppp, P)

Break things (pp, M)

Dream, Disturbing (pp, G)

Perspiration, odor, urine like (pp,G)

Food, Cheese desire (pp, G)

Tingling, lower limb, sleep during (pp,P)

Head, Heat (pp, P)

Bleeding, Gums (pp, P)

Dream, Falling (p, G)

Dream, Dead persons (p,G)

Premature contraction (p,P)

Burning tongue (p, P)

Stool, undigested food (p, P)

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Biting, nail (Before turning-point, pp, M)
To avoiding a tiring session, please let me explain the rest of steps (5.Erection of totality, 6.Selection of Repertory & Proper Repertorization, 7.Repertorial result) in future sessions.
After repertorizing, the remedies which cover all the 5 first most important symptoms are: Lyc, Sep, Rhus-t

Among these remedies the best choice which covers the most number of less important symptoms is Lycopodium.
Good Luck

Online education team
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