Importance of observation in homoeopathy
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Importance of observation in homoeopathy

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ART OF PRESCRIBING ON BASIS OF OBSERVATIONS

ART OF PRESCRIBING ON BASIS OF OBSERVATIONS

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  • 1. C.M.E. PROGRAM ORGANISED BY DEPT. OF AYUSH ON 12TH FEB. 2014 PRESENTATION BY: DR. BIPIN JETHANI Reader, Department of Organon of Medicine, Nehru Homoeopathic Medical College & Hospital, New Delhi
  • 2. IMPORTANCE OF OBSERVATION IN HOMOEOPATHIC PRESCRIBING
  • 3. CLINICAL EXPERIENCE OF BOENNINGHAUSEN …..at present there is in this region a pernicious whoopingcough among children………… the sick children were characterized by a remarkable puffiness and swelling, not so much of the whole face as especially above the eyes, between the lids and the brows, which was frequently like a thick little sac,…. BOENNINGHAUSEN’S ORIGINAL PREFACE –
  • 4. CLINICAL EXPERIENCE OF BOENNINGHAUSEN …………….a symptom which, hitherto, has been observed only in kali carb., and in fact from the beginning of the epidemic, this has been the only quick and permanently curative medicine. Only in the latter period of the disease, there appeared another form characterized by cold sweat on the forehead during vomiting, which called for veratrum alb.
  • 5. CLINICAL CASE OF J.T. KENT: Lesser Writings Of J.T. Kent • A case of Epithelioma of several years standing on the left upper lid reported in spring season with fissures and bleeds. He observed the lesion had a dark red hue. • No constitutional obtained. • Lachesis months. 4m cured symptom in six
  • 6. CLINICAL CASE from koppikar’s clinical experiences One day we were walking around road at about 9 am and my uncle was surprised to hear lot of loud talking going on behind partition, which seperated living quarters. We peeped in and saw Krishna lying on mat, shivering and talking in delirium. My uncle sent him Podophyllum 200 to be given every 2 hourly and he never got another chill paroxysm.
  • 7. Case of K.C. Bhanja • K.C. Bhanja was called upon to treat a case of hyperpyrexia in a child. He found the child to be playful even in such a state of high fever. He simply touched the tip of nose and found it very cold to touch. • He prescribed ARNICA MONTANA 200/ dissolved doses and the fever came down in just 3 hours.
  • 8. CLINICAL CASE of dr. l.m. khan A anamnesis of comatose patient (?bacterial meningitis) revealed that he developed fever after taking very cold water coming from lot of physical exertion in sun. He had convulsive movements and twitchings around lips with hyperextension of foot. This observation was found in BBCR in Dulcamara which was prescribed in 6 potency with marvellous results
  • 9. ASTUTE OBSERVATION: KEY TO PRESCRIBING The stalwarts of homoeopathy relied upon their power of astute observation and their wisdom of Materia Medica, which often led them to the similimum in shortest period of time.
  • 10. ‘…….. In order accurately to perceive what is to be observed in patients, we should direct all our thoughts upon the matter we have in hand, come out of ourselves, as it were, and fasten ourselves, so to speak, with all our powers of concentration upon it, in order that nothing that is actually present, that has to do with the subject, and that can be ascertained by all the senses, may escape us.’ SAMUEL HAHNEMANN: THE MEDICAL OBSERVER Lesser writings of Hahnemann
  • 11. IMPORTANCE OF OBSERVATION IN CASE PERCEIVING ‘………... The duty of the observer is only to take notice of the phenomena and their course; ……………, not only that nothing actually present escape his observation, but that also what he observes be understood exactly as it is.’ THE MEDICAL OBSERVER Lesser writings of Samuel Hahnemann
  • 12. A WORD OF CAUTION: Concept of ‘GESTURE CLUSTER’ • Nonverbal cues occur in what is called a “gesture cluster” – a group of movements, postures and actions that reinforce a common point. • Similarly, single observation (that too if not unequivocal) in clinical practise should not be the basis of prescribing but rather should serve as a clue in the search of similimum which should be selected on basis of ‘cluster of observations and subjective concomitants’.
  • 13. CLINICAL CASE STUDIES WHERE OBSERVATION HELPED TO REACH TO THE INDICATED MEDICINE
  • 14. A KNOWN CASE OF VITILIGO A 48 yrs old male patient, known case of diabetes (controlled on OHA) had reported with c/o hypopigmented spots on face, neck and upper extremities. ON OBSERVATION: The patient had marked pouting lips, broad nose with slightly depressed nasal septum.
  • 15. Case analysis • Desire for salty food. • Thirst increased for cold water. • Sleep disturbed in • Patient suffered from recurrent headache which he showed was in a line over the vertex
  • 16. SIGNIFICANT FEATURES OF THE CASE Facial characteristics Tendency to LINEAR HEADACHE. Patient strong further Family revealed history alcoholism and liver disease of
  • 17. BEFORE AND AFTER PRESCRIPTION OF SYPHILINUM 200/ UNIT DOSE, followed later in 1m potency PRE-TREATMENT POST-TREATMENT
  • 18. A 32 yr. old male patient, mesomorphic build, wheatish complexion with dark blackish mole of left cheek reported with complain of localized alopecia of scalp region. His other complaint was pain in knee joints especially in cold weather >: hot fomentation
  • 19. CASE ANALYSIS • The complaint of hairloss had started 2 years back with no ascertainable precipitating etiology. The hair loss had gradually increased and was more marked in rainy weather. • Past history revealed h/o severely erupted chicken pox at age of 21 yrs. • CHILLY PATIENT
  • 20. • ‘Hitherto we have had only one remedy, so far as I know, namely, Sepia, which corresponds with the sores on the upper side of the joints of the fingers and toes………………….. Concerning the Relative Value of Symptoms and ERUPTIONS ON THE Something about Borax SMALL JOINTS OF HANDS (LESSER WRTINGS BOENNINGHAUSEN) OF
  • 21. BEFORE AND AFTER PRESCRIPTION OF SEPIA 200/ repeated at infrequent intervals
  • 22. A Contribution to the Judgement Concerning the Characteristic Value of Symptoms (LESSER WRTINGS OF BOENNINGHAUSEN) ‘Every Homoeopath knows the efficacy of Sepia in these ulcers of joints, which have no otherwise distinguishable features when this remedy is taken internally without any external medication it will have a sure effect. Medicines which correspond to similar ulcers on other parts of the body in such cases are utterly useless.’
  • 23. • A endomorphic corpulent female reported with c/o erythematous scaly eruptions on both feet (medial aspect of both feet ------ SYMMETRICAL LESIONS) • The other noteworthy observation in this case was COLD SWEAT OF THE PATIENT.
  • 24. • On interrogation, patient revealed marked desire to sleep on abdomen. • The position during sleep coupled with observation of SYMMETRICAL ERUPTIONS & COLD SWEAT LED TO PRESCRIPTION OF THYROIDINUM . • The patient is still under treatment and showing improvement in her skin complaints PRESCRIPTION OF THYROIDINUM
  • 25. A CASE OF ADHD WITH STUNTED GROWTH
  • 26. A CASE OF ADHD WITH STUNTED GROWTH • The mother of this 6 year old child complained of his utter inability to concentrate with extreme hyperactivity. He was very destructive ---- would throw things and scratch others. He was unmindful of putting himself in dangerous situations………..s/o ADHD (mixed type) • STUNTED GROWTH
  • 27. ASYMMETRY OF BODY PARTS
  • 28. DIAGNOSED AS A CASE OF SILVER - RUSSEL SYNDROME BY WELL KNOWN PEDIATRICIAN
  • 29. SILVER-RUSSEL SYNDROME • After many failures; this observation of pediatrician (ASYMMETRY AS A PATHOLOGICAL GENERAL) along with his destructive behaviour and family history of craving for alcohol (found later on enquiry) led me to prescribe SYPHILINUM 200 in weekly doses. {ASYMMETRY is a marked syphilitic taint} • The result has been very encouraging with hyperactivity reduced and child’s attention span increasing.
  • 30. A CASE OF ADENOIDS • This patient was prescribed FLOURIC ACID in LM potencies on basis of his SYPHILITIC FACIAL FEATURES (BIG EARS AND EYES WITH DISPROPOTINATELY LARGE FACE) coupled with the concomitant of his desire to bathe in cold water even in winters. • He showed marked symptomatic improvement (recurrent URTI, nasal blockage and growth) within a span 5-6 months and is still under treatment.
  • 31. PRESCRIBING CLUE : CHARACTER OF TONGUE ONE SIDED COATING OF TONGUE RHUS TOX, DAPHNE PARALLEL FISSURES IN TONGUE
  • 32. OBSERVATIONS DURING COUGHS NAT. MUR Flow of tears with cough SANG. ALLIUM CEPA Grasps CIRCUMSCRIBED REDNESS OF CHEEKS WITH COUGH Cough ends in a sneeze throat while coughing NATRUM SULPH. CAN. SENEGA ARNICA Rattling cough with desire to hold chest with hands MONTANA WEEPING JUST BEFORE OR WITH COUGH
  • 33. IMPORTANCE OF LOCATION ILLICIUM PIX LIQUIDA CHENOPODIUM GLAUCI DULCAMARA HEPAR SULPH SEPIA, BORAX ANACARDIUM, MURIATIC ACID
  • 34. CASE OF RECURRENT HEADACHE • A 36 year old male patient complained of recurrent headache in right temporal region accompanied with thick yellow nasal discharge since 8-9 months. The pain was worse in a warm room and better in open air. • He was not better even after taking lots of homoeopathic medicines
  • 35. CASE OF RECURRENT HEADACHE • The strange peculiarity in his case was THIN NECK ………………….. A very important clue in prescribing of NATRUM MUR. • I prescribed him Natrum mur. in LM potencies and he showed remarkable improvement in his c/o headache.
  • 36. CASE OF VITILIGO IN A 3 YEAR OLD CHILD • A 3 yr. old girl presented with hypopigmented macules on her right hand. She had taken lots of treatment but the hypo-pigmentation kept on increasing in size. • She was very active child. • H/o Delayed walking (started at age of 16 months)
  • 37. TEETH DECAY AT EDGE OF GUMS AND BREAK OFF
  • 38. PRE-TREATMENT POST TREATMENT THERE HAS BEEN MARKED REDUCTION IN HYPOPIGMENTATION AFTER PRESCRIPTION OF SYPHILINUM 200/ 1 DOSE REPEATED AT VARIED INTERVALS
  • 39. Case of URTI (?VIRAL EXANTHEMA) A 28 year old patient reported with the complaint of low grade fever with erythematous rashes (bright red blotches) on neck, upper extremities especially hands since 3 days. Fever was accompanied with slight pain in throat with slight difficulty in swallowing. On observation, the tonsils and surrounding fauces showed extremely bright red hue. Fever had no particular pattern. There was significant prescribing clue…???????????
  • 40. STREPTOCOCCINUM IN A CASE OF VIRAL EXANTHEMA ERYTHAMATOUS BLOTCHES ESPECIALLY FOLDS OF SKIN BRIGHT RED HUE OF FAUCES & TONSILS WITHOUT MUCH PAIN STRAWBERRY TONGUE
  • 41. ARNICA MONTANA IN BOILS • Tendency to SMALL, PAINFUL BOILS, one after another, extremely sore. ……….H.C. Allen’s Key notes
  • 42. PERCEIVING ARNICA FROM MATERIA MEDICA PURA 396. On the side of the nape a pimple that causes shooting and ulcerative pain when touched. (This kind of pimple, so painful when touched, with an inflamed red areola, which arnica produces specifically, bears the greatest resemblance to the well-known boils (furunculi), and consequently these are homoeopathically cured by arnica, and in persons who are frequently troubled with them are prevented by the use of arnica, and their future occurrence warded off, as experience has taught me.) (aft. 48 h.).
  • 43. BOENNINGHAUSEN ON IMPORTANCE OF OBSERVATION AND VALUE OF CHARACTERISTICS ‘Ought, we not to be able to introduce something similar in homoeopathy, so as to considerably lighten the work of incipient (perhaps also of older) homoeopaths, and to simplify the selection of remedies without, in the least endangering their sureness, but rather securing it? I believe so. Yes!’ LESSER WRITINGS OF BOENNINGHAUSEN
  • 44. Good judgement comes from experience, and experience comes from bad judgment. …………..Barry LePatner