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Pathology Factor in Remedy Selection Synopsis 20190614132833

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Pathology Factor in Remedy Selection

DR. ASHOK BORKAR


Bachelor of homoeopathic medicine and surgery (B.H.M.S.)

Visiting faculty: The other song international academy of


advanced homoeopathy
Pathology Factor in Remedy Selection

© Dr. Ashok Borkar


All rights reserved. No part of this publication may be reproduced, trans-
mitted or translated into any language in India or abroad in any form or
by any means without permission of the publisher.

Printed in India
First Edition: 2013
ISBN: 978-93-80355-87-0

Printed by
Repro India Ltd., Mumbai.

201, Dinar, 20, Station Road, Santacruz (West),


Mumbai 400 054, India Telephone: +91 22 2660 5680
Fax: +91 22 2660 5776 Website: www.rajansankaran.com;
www.onlinehmp.com Email: accounts@onlinehmp.com
hmp@rajansankaran.com
p

p
Dedications

This book is dedicated to my beloved wife Preeti, who has been


instrumental in my success as a physician and a teacher. She has
always encouraged me to do inspirational and insightful work.
Among the many blessings I have received from my parents, Gurudas
Borkar and Kumudini Borkar, I have inherited an open mind that helps
me in learning new things. I sincerely hope that the experiences that
I have shared throughout this book help to alleviate the suffering of
humanity by improving the efficiency of homoeopaths around
the world.
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Pathology Factor in Remedy Selection

II
Contents
Foreword V
Acknowledgement VII
Author’s note IX
The Golden Eagle V
Preface XI
1. Essentials of a good prescription 1
2. A Case of Ovarian Mass and Ovarian Cyst 5
3. A Case of Cholecystitis with Diabetes 17
4. A Case of Indian Childhood Cirrhosis 21
5. The Burnett Experience 24
6. A Case of Multiple Myeloma 28
7. A Case of Alcoholic Cirrhosis 31
8. A Case of Systemic Lupus Erythematosus 40
9. A Case of Infertility with Vitiligo 47
10. A Case of Keloids 50
11. A Case of Painful Keloid 53
12. A Case of Wrist Drop and Imbecility 58
13. A Case of Cerebral Hypoxia with 64
Hallucinations and Stupor
14. A Case of Cerebral Parenchymal Oedema 66
15. A Case of Epilepsy 70
16. A Case of Cervical Spondylolisthesis 82
17. A Case of Cerebral Frontal Lobe Atrophy 88
18. A Case of Lumbo-Sacral Spondylolisthesis 91
19. The Importance of Diagnosis 98
20. Technique of Case Solving 102
21. Case Taking 109
22. The Final Diagnosis 114
23. Discussion with Dr. Borkar 116
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III
Pathology Factor in Remedy Selection

IV
Foreword
I have known Dr Ashok Borkar as my student and later as a very sincere
and good practitioner and popular teacher of classical homeopathy.
He has a large practice in Goa and has impressed me with several
good, well-taken cases. This book by Dr. Ashok Borkar, his first one, is
an important contribution.
It highlights the fact that beyond matching the Sensation and
the symptoms of the patient with the remedy, one also has to consider
if the genius matches too.
This facilitates healing at the deeper levels and not only relief of
symptoms or state of mind.
The genius includes: sphere of action, pathological generals, general
modalities and Sensation: in short the very nature of the patient or
the remedy.
The several cases in the book illustrate the combined use of all
the three sides of the triangle: namely symptom, system (sensation
and miasm) and genius.
A note of caution is called for. We need to be flexible - as the last case
of the book shows, there are no fixed rules. Each case needs careful
evaluation. If one finds in a given case a very strong peculiar symptom,
or a very clear sensation and miasm, one can give the remedy even if it
is not known for the pathology in the case. We have seen this repeatedly.
After all, the pathological indications of many remedies only came after
their clinical use. So, nothing is absolute.
Yet this book does make a point that is sometimes overlooked: it is
important that the match between the patient and the remedy should be
at several levels, and the genius, the affinity and pathological tendencies
known about a remedy are certainly among the important and sometimes
crucial areas that need our attention.

- Rajan Sankaran July 3, 2012.


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Pathology Factor in Remedy Selection

VI
Acknowledgement

I am immensely grateful and indebted to my teacher Dr. Rajan Sankaran,


who has been my greatest source of inspiration. It is only because of
him that I could realize the depth and nuances of Homoeopathy.
I am thankful to Monalisa Vales, Deepa Prabhudesai, Riddhi Gharse,
Bency Dsilva, Veena Sukhatnkar, Razia Pires, Preeti Choudhury and
Linoshka Dsilva for sharing my burden of attending to the patients and
helping me find the time to write this book.
A heartfelt thanks goes to my colleagues Gururaj Joshi, Daya Joshi and
Domnic Dias for always encouraging me to carry out my research.
Special recognition goes to my daughters, Simran and Tanushri who
helped me type out the matter at hand and for speeding up my work
process.
Further, I would like to thank Sneha Thakkar and Sharlini Udayakumar
for their contributions.
Special credit and thanks goes to Joanna Vogler for her wonderfully
innovative cover design.
I appreciate and would like to thank Winifred Dsouza for proof reading
the book.
Special thanks to Oonagh Taeger for proof reading the book and
enhancing the quality of the book by fine-tuning it.
I sincerely thank Mr. Haresh Shah for his efforts in compiling this book.
In addition, I would also like to recognize and acknowledge Gaurang
Gaikwad for his hard work in putting together the logistics of this book.
Finally, I would like to profusely thank the editor of this book, Armeen
Jasavala, for her dedication and genuine efforts to make this
publication the sharpest it could be.
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VII
Author’s note
To derive maximum benefit from this book, the reader is advised to read
in serial order from the first to the last page. This will help to systematically
build up the reader’s ideas, concepts and personal understanding of
the book in the right perspective. Only then the reader will be able to
use this material to good effect. Every chapter in this book is connected
to the previous chapter and to the one that follows it and the continuous
flow of this work is maintained up to the concluding chapters.
Also, I chose to design this book in a way that resembles an effortless
conversation. I decided to select this way of delivery in order to convey
my thought process throughout a case. Additionally, I utilize
the conversational style of presentation even while teaching at seminars
and in the classroom, and overall this interactive method of lecturing is
appreciated by my interns, students and fellow colleagues.
It is also of importance to point out the use of archaic English in
the chapter, “The Burnett Experience”. I avoided changing the language
and manner of writing, as I did not want to disturb the originality and raw
essence of his work.
Furthermore, many cases in this book have clinical and diagnostic
investigations attached which demonstrate immense changes before
and after the homoeopathic remedy of choice. This in itself is a true
indicator of how much homoeopathy can influence and improve various
pathological diseases. For homoeopaths, my message is that we always
must remember that we are physicians first, and must recognize and
understand the pathology in order to prescribe the right homoeopathic
remedy.
My final words of thought include sending a heartfelt thanks to all of
you, the readers. I wish you the best in your experiences, and hope you
will evolve after reading this work.

VIII
The Golden Eagle
A man found a couple of eagle’s eggs and placed them under a brooding
hen. The eaglets hatched with the chickens and grew to be like them.
They clucked and cackled, scratched the earth for worms, flapped their
wings and managed to fly a few feet in the air.
Years passed and one day the eagles, who were very old, saw a
magnificent bird above them in the sky. This bird glided along in graceful
splendor against the powerful wind, with scarcely a movement of its
golden wings. Spellbound, the eagles inquired of their neighbor, “Who
is that?”
“That is the king of the birds…the great eagle,” said their neighbor.
“He belongs to the sky and we belong to earth because we are only
chickens.”
One of the eagles believed this story, so he lived and died as a chicken,
for that is what he thought he was. The other suddenly became aware
of his majestic wings and attempted to test his own abilities. As he
released his wings, he soared high in the air.

All the abilities and tools that you need to do good work are
easily and readily available to you. Once you become aware of
them, you will be able to put them to good use and get amazing
results. Let the eagle within you soar high into the sky!

IX
Pathology Factor in Remedy Selection

X
Preface
On the 26th of January 1992, barely 3 months into my homoeopathic
practice, I was called upon to treat a 56-year-old lady who was suffering
from continuous uterine hemorrhage for six months. She was gasping
for breath and her hemoglobin was 3mg%. The Tata Cancer Hospital,
Mumbai, had diagnosed her as a case of Carcinoma of the uterus and
they had advised her not to undergo surgery, radiotherapy or
chemotherapy. They said that she was in the advanced stage of
endometrial cancer and she would be unable to bear any of these
aggressive remedial procedures. The tumor was huge and it extended
from the pelvis to the epigastrium. It was as hard as a cricket ball. When
I asked her what was happening she directly talked about wanting to
eat spicy food. She was restless and she wanted her relatives to change
her position constantly, as she would feel anxious if she were in one
place. I got her admitted to the hospital and the first thing she said on
admission was that the place was so dirty that she felt like taking a
broom herself and cleaning up the whole place. I gave her Arsenic alb
30C three times a day, and there was drastic improvement within a day.
She could talk without gasping for breath. The bleeding stopped
altogether in another three days. The remedy was continued three times
a day for about a month, and the tumor went on reducing in size.
The tumor disappeared completely in about one year and she enjoyed
good health for the next twelve years.

The remedy was prescribed on the following rubrics:


 Restless, anxious
 Restless; move must
 Desires spicy food
 Washing, cleanliness mania for
Around the same time I treated a 35-year-old tailor who was not able to
hold scissors as the joints of his hands were painfully stiff and swollen
with rheumatoid arthritis. He would spend sleepless nights worrying
and caring for his four-year-old son, who suffered from idiopathic
thrombocytopenic purpura and had to undergo platelet transfusion every
month. His anxiety had worsened after his son’s ill health, although
previous to this he was always worried about the health of his relatives.
He would be the first person to take sick people to the doctor. Another
peculiarity of his character was that he was not firm in his decisions. His
new house was under construction and the whole project was getting
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XI
Pathology Factor in Remedy Selection

delayed because he was not able to take a final decision in these matters.
Finally, he would get very angry whenever he was contradicted.
The remedy selected was based on the following rubrics:
 Anxiety, night watching from
 Anxiety, health about relatives
 Irresolution
 Anger from contradiction
Single doses of Cocculus indicus 200 were given infrequently, about
three times in six months. This medicine cured him completely and
he has been in good health ever since.
These successes early on in my practice made it clear to me that
the scope of homoeopathy is unlimited, provided we make a good
prescription.
It should be noted that good results in such so-called ‘incurable cases’,
or cases with structural changes, were few and far between. There was
no consistency. The few good results would confirm the truth that
homoeopathy works well and cures such cases. However, the many
failures would drive home the fact that homoeopathy itself works, but
homoeopaths themselves fail.
So the question arose: ‘Why did I succeed in some cases while I failed
in others?’ On looking back, I observed that all of my prescriptions were
based mainly on mental symptoms. If that was the right technique, then
it should have worked well for all of my patients. Obviously, I was missing
something and I realized that I needed to improve my skills as a
prescriber. After twenty years of practice, I realized that there were a
few good results because unknowingly, I had done something right in
those cases, but what was that?
To find a solution to this question I embarked upon an intensive journey
to study the subject. I attended various seminars, observed many cases
of successful homoeopaths and read many books. Not entirely satisfied
by what I saw and heard, I started studying the successful cases in my
clinic and tried to find out what was common in all of them. Was there a
pattern running through and through? What was it that I was ‘doing
right’, albeit unknowingly in these cases? To my amazement, I found
the answers I was looking for and this book is a result of the study and
the conclusions derived thereupon.
This book is not the final word on the subject. Rather, it should be treated
as a study in progress.
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XII
Essentials of a Good Prescription

Essentials of a Good Prescription


A good homoeopathic prescription consists of two parts:
1. Proper case taking
2. Correct case analysis
For correct case analysis, it is absolutely essential that the case history
be taken according to the principles laid down by Hahnemann in
The Organon of Medicine.
To improve your case taking and case analysis skills, I strongly
recommend that you learn the Sensation Approach introduced by my
teacher, and world-renowned homeopath, Dr. Rajan Sankaran.
Dr. Sankaran and other well-regarded teachers of homoeopathy have
now come together and started The Other Song International Academy
of Advanced Homoeopathy in Mumbai. This academy imparts excellent
education to homoeopaths from all over the world, in an effective and
reproducible way.
Dr. Sankaran has made a vast contribution to homoeopathy by clarifying
the concepts of kingdoms and their differentiation, in addition to
introducing the ten coping up mechanisms (called miasms). These
advancements have made the task of remedy selection much easier.
By using the concept of kingdom differentiation we can safely and quickly
come to a small group of remedies. It then becomes easy to select the
exact remedy required for the patient. W e now have a clear
understanding of the common features of each kingdom—the plant
kingdom, the mineral kingdom and the animal kingdom, and accordingly
we can easily classify the patient into one of these three kingdoms.
To quote Dr. Sankaran, “Patients who need remedies from each of these
three kingdoms differ fundamentally in the way they perceive and react
to reality.”
The main issue in the mineral kingdom is regarding the patient’s
STRUCTURE. There is either a lack or a loss of structure. The main
issue is, ‘The problem is with my structure. The problem lies within me’.
In every area of his life the basic problem is with his ability, his
development, his needs, and what he has lost, or needs to gain or
maintain.
In the plant kingdom, the main issue is about his SENSITIVITY. The basic
feeling is, ‘I react to different stimuli or situations with a specific sensation’.
In every area of his life, you will see that the same sensation comes up.
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Pathology Factor in Remedy Selection

In the animal kingdom, the main issue is SURVIVAL. The basic feeling
is, ‘Me versus You’, or ‘Victim versus aggressor.’ In a patient needing an
animal remedy the perception is that the other person is the problem:
‘He is doing things to me; he should be put down’. There is comparison
and competition. In a patient needing a remedy from the animal kingdom,
we observe multiple sensations and they describe a process. It may be
a process of attack, defense, feeding, locomotion or death.
In order to understand the kingdom correctly we have to explore
the following seven areas of the patient’s life: the chief complaint,
the associated complaints, his experience in stressful situations, fears,
dreams, childhood, and hobbies & interests.
The other important concept taught by Dr. Sankaran is the concept of
miasms. Dr. Sankaran has presented ten miasms otherwise known as
the ten coping mechanisms. The miasm [or coping mechanism] of each
patient can be classified into one of the following:
1. Psora [possible type]
2. Sycosis [fixed type]
3. Syphilis [impossible type]
4. Acute [panic type]
5. Typhoid [crisis type]
6. Ringworm [doubtful type]
7. Malarial [harassed type]
8. Cancer [chaotic type]
9. Tubercular [claustrophobic type]
10. Leprous [isolated type]
Every patient has one predominant miasm at a given point of time and
needs a remedy that covers that miasm. To know the miasm, we have
to understand how he copes with his problems. This is depicted by
the subsequent criteria:
1. His perception of the situation
2. His reaction to the problem
3. The degree of desperation with which he experiences
the problem
4. The pace of his problem
5. His attitude towards the problem
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2
A Case of Ovarian Mass and Ovarian Cyst

A Case of Ovarian Mass and Ovarian Cyst


This is a case of a37-year-old woman who presented with menorrhagia
and had an ovarian mass along with an ovarian cyst. The following
case history was taken in May 2009.
D: Tell me, what is your problem?
P: My problem is bleeding.
D: Okay
P: And pain in the right side of the abdomen and sometimes pain
in the legs. Nothing else. Sometimes cough. That’s it.
D: Bleeding and pain. What else?
P: That is my main problem.
D: What other problems do you have? Tell me whatever is
happening to you, tell me everything.
P: Only that thing, my bleeding doesn’t stop. It goes on
continuously. Shall I start from when it started?
D: Yes. Tell me whatever you want to tell me; tell me everything.
P: My baby was delivered normally. But the placenta remained
inside. So they had to manually take it out. They operated and
they gave me an injection in the backbone. And it was taken
out. And after four months my periods started. It was normal for
five days and then it stopped. After ten days it started again,
little by little. A little bleeding was there. Later on it increased a
little bit more. And since then I have been bleeding.
D: For how many days was there continuous bleeding?
P: Continuous, for a whole month.
D: A whole month?
P: Almost two months.
What are the important aspects of this case so far?
We observe in this case that the area of affinity is the uterus and she
has been bleeding continuously for the last two months.
She had a history of retained placenta.
I asked her more about what happens symptomatically, and she
mentioned that she gets pain in the abdomen.
Let us see the rest of the case…
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Pathology Factor in Remedy Selection

D: How is this pain now?


P: The pain is bearable. Means I can walk. It’s just feeling heavy.
D: Heavy means? How is that?
P: Heavy means, if I want to get up I cannot get up and jump.
I have to get up slowly. But it is bearable, not paining a lot.
D: How does it affect you?
P: A little bit. Not much. Means I can do normal things. But you feel
there is pain. You feel the pain.
D: So how do you feel because of the pain?
P: I don’t feel like going out or doing anything, just feel like taking
rest.
D: Don’t feel like going out? Don’t feel like doing anything, just want
to rest?
P: Yes.
D: Tell more. How does it feel?
P: I cry when I get the pain.
What is our understanding of the case at this point of time? Has
the patient given us anything peculiar?
She has not given us anything peculiar, but we have understood
something important about her. We can see that her problems are
bearable, not severe.
How does this help us?
It helps us to understand the degree of desperation in her case.
Why do we want to know the degree of desperation?
We need to know the degree of desperation in the case in order to
understand the miasm.
We have not observed any desperation in her coping up mechanism.
Let us continue…
D: How do you feel at the time when you are feeling heavy and
don’t feel like doing anything?
P: I just want to rest.
D: You just want to rest. How do you feel at that time?
P: If I rest, I don’t get the pain. The bleeding is not much. If I do
something then the bleeding increases.
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6
A Case of Cholecystitis with Diabetes

A Case of Cholecystitis with Diabetes


This is a case of a 65-year-old retired police officer. The history was
taken in April 2004. He was a very aggressive, angry person who was
addicted to smoking. He was suffering from cholecystitis for twenty-five
years and diabetes for the past ten years. He told us that he did not
believe in homoeopathy and his wife had to persuade him a lot to take
homoeopathic medicine.
D: What is the problem?
P: I have gallstones. I have been advised to undergo
cholecystectomy. I have diabetes and high blood pressure.
D: Tell more about it.
P: I get pain in the right hypochondrium and epigastrium. I get
burning pain in the epigastrium. The pain is unbearable. I become
restless with the pain.
D: Tell a little more.
P: I am tortured by the pain. Because of the pain I lose my
equanimity.
D: Tell more about it.
P: During the attack of pain, I feel everything coming from this
side and that side [points out to the areas below his epigastrium]
and giving me pain. Something hits me from down below.
Something comes up from down below and hits or strikes
the epigastric area (Hand Gesture).
D: Describe this (Hand Gesture).
P: The pain is as if someone hits you with a lathi (stick).
D: Describe this a little more (Hand Gesture).
P: (The patient got up and hit his fist on the wall.) To strike means
to go, go, go and hit with a lathi. Striking is done on purpose.
Striking is as if you are hit a thousand times. In a lathi charge
people are struck and they run away and we arrest them.
D: Tell me about your fears.
P: The word ‘fear’ is not in my dictionary. If someone comes with a
pistol, I won’t get scared. I can defend myself even with my
bare hands. Even if five or six people come, I will not surrender.
I will see that my entire family is saved.
D: What are your hobbies and interests?
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17
A Case of Indina Childhood Cirrhosis

A Case of Indian Childhood Cirrhosis


A10-year-old girl was brought on March 29, 2007 with a painfully
distended abdomen and a sickly-looking pale face, with marked pallor
and jaundice. She was diagnosed as having Indian childhood cirrhosis
with portal hypertension. She had liver cirrhosis, ascites and massive
splenomegaly. All her liver function tests were highly abnormal.
The doctors at the biggest private hospital in Goa told the parents that
she would start vomiting blood and die in fifteen days. The parents were
very scared and had been crying continuously for two or three days
after they were given this news. The child wanted to eat every fifteen
minutes but she would not put on weight. She could not tolerate hunger.
She could not tolerate heat. She would get very angry, scream and cry if
anything was done against her wish. She had pain in the legs and
heaviness of the head. She would sleep only when her forehead was
lightly rubbed and she wanted her head and legs to be pressed and
rubbed. Her abdomen was so distended that she could not wear her
school uniform. She had burning pain in the neck, back, head and eyes.
She was hospitalized in June 2006, December 2006 and March 2007
when she had severe episodes of vomiting, fever and epigastric pain.
End of case.

Case analysis:
The following rubrics were considered for this case.
(Complete repertory):
 Abdomen; enlarged spleen
 Abdomen; cirrhosis liver
 Abdomen; dropsy, ascites.
 Emaciation general, appetite ravenous, with
 Fasting, while, aggravates
 Rubbing ameliorates
 Pains, burning
 Hot patient
Iodum 6C was given twice a day for 15 days.
When she was brought to the clinic the disease picture was dominated
by the cirrhosis of liver and the massively enlarged spleen. So I had to
make sure that this was covered by the remedy. As we know from
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Pathology Factor in Remedy Selection

The Burnett Experience


While studying the works of great homoeopaths of the past, I came
across Burnett’s Collected Writings. In the chapter ‘Curability of Tumors
by Medicines’ he mentions the importance of:
1. Seat of action
2. The kind of action
3. The range of action
4. Stop-Spot of the action

Seat of Action:
About the seat of action he writes,
Hahnemannic medicine in its pristine purity is based on pure
pharmacodynamics. It is in fact therapeutically applied
pharmacodynamics; its first and deepest groundwork being
the principle that given drugs affect given organs (parts) by self-
elective preference.

The Kind of Action:


About the kind of action he says,
If we admit that certain remedies do really affect definite organs
and parts specifically, we come at once to the question, ‘How?’
What is the quality of such action?
All things considered, the symptoms producible by a drug, give
to a certain large extent the answer.
Thus, in pneumonia and phthisis, blood comes from the lungs,
and we know from experience that the pulmonary lesions found
in consumption and inflammation of the lungs fully explain why
it is that blood is extravasated, and a consideration of the lung-
functions shows why it is cast out by expectoration.
Now, if we examine into the effects of phosphorus on the lungs,
we find that it also produces pulmonary lesions like those found
in certain cases of phthisis and pneumonia. The homoeopath
can foretell, with scientific precision and accuracy, what remedy
should be given in your lung disease. How?
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Pathology Factor in Remedy Selection

A Case of Multiple Myeloma


A 52-year-old man was diagnosed as having multiple myeloma on
January 4th, 2012. When he was brought to the clinic on the January
10th, 2012, he appeared very frail and he was barely able to walk.
He was in severe pain and from observation he looked like he was
82 years old.
The x-rays showed multiple, tiny, well-defined osteolytic lesions in
the skull, ilium, pubis and the upper femoral shafts. An x-ray of
the lumbosacral spine showed marked osteoporosis, sacralisation of
L5, and lumbar spondylosis. The normal spinal curvature was lost
resulting in the straightening of the lumbar spine. His lower ribs showed
multiple lytic lesions.
He had been suffering for the past two months before he came to
the clinic. He said that one day he got a sudden, sharp, poking pain in
the chest when he sneezed. It was like a catch. When he sneezed
again, he got the same type of pain in his back on the right side.
The pain was like a cramp. Since then, his ribs had started paining.
He also suffered from severe pain in the back due to which he could not
turn sideways at all. He needed support to stand and also had dragging
pain in the waist area. He needed to rise slowly from the chair and after
walking slowly for a while, he felt a little better. When he sat, the dragging
pain would start again and he would get a cramp in that area. Whenever
he turned in bed he would get a sharp poking pain. On coughing, he
would get pain in the chest. Whenever he would get a catch, he was
unable to move due to the pain and would get stuck in that position.
In addition to this, he was getting recurrent cramps in different parts of
his body. He also had fullness of the abdomen after eating. Even after
eating a little food he would get the fullness. In order for him to not have
the fullness, he would not eat anything at night. Furthermore, he had a
peculiar sensation as if waves of water were flowing down his chest.
Rhus tox 30 was prescribed. A single dose was given first and later on
it was given twice a day for four days. The remedy was given this way
because his pain had increased and he was unable to rise from
the bed.
By January 16th his condition worsened. The cramps had increased
and he would now get a cramp when straining to urinate. The pain was
sudden, very severe and it was worse with the slightest movement.
He would scream with the sudden pain and could not bear the pain at
all. He described it as a sharp poking pain and it would last for ten
minutes. He wanted to be fanned in this state. Another important
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28
A Case of Alcoholic Cirrhosis

A Case of Alcoholic Cirrhosis


This is a case of a 52-year-old male, suffering from alcoholic liver
cirrhosis. He was hospitalized five times from October 2011 to January
2012. When he came to the clinic he was feeling very weak and he had
just been discharged from the hospital.
D: What is happening to you?
P: It started with loss of appetite. Then they checked my blood and
detected jaundice. Then I took the injections that they gave me.
Then, I got an abscess here, (inguinal area) and I was again
admitted to the hospital for jaundice. Then it was okay. After
that, they detected diabetes. My blood sugar was above 180.
Then, I became weak. The sugar levels then came down and
after that I suddenly got pain in abdomen. That was relieved
with intravenous fluids. Then I started getting pain here (sides of
abdomen). Then, they did USG. Two stones were found in the
kidney. Now I am getting pain here (epigastrium).
D: What happens there?
P: It pains here.
D: What exactly happens?
P: Nothing, it pains. It is as if you get urge for stools. I get proper
motions in the morning.
D: How is it over here? Urge for stool means?
P: It is as if you are having an urge for stool. The sensation is as if
you have an urge for stool.
D: It happens over there?
P: Yes. Now I have swelling on my feet. They said it is because of
the liver.
I asked him what other problems he was having, and he said that he
had developed vitiligo spots in the last five months.
P: The spots are there since six months. They are on the hands
and feet. But I don’t have any problem.
D: What else?
P: Nothing else.
D: What troubles you the most?
P: Nothing troubles me much. I feel weak.
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Pathology Factor in Remedy Selection

A Case of Systemic Lupus Erythematosus


This is a case of a 40-year-old woman who was diagnosed with systemic
lupus erythematosus (SLE).
D: What is the problem?
P: I am having fever.
D: Since when?
P: Since two months.
D: What happens to you?
P: I feel cold, so I cover myself fully. I wear a monkey cap and
cover my head and ears also.
D: Tell more.
P.: I get pain in my ribs (points to the axillary area of the chest ).
The pain is as if I have got a blunt injury there. It is as if somebody
is hitting with a hammer (hand gesture).
D: Describe this pain a little more.
P: It is as if somebody has given you a blow with his fist (hand
gesture of hitting with a closed fist). I get pain on this bone (points
to the ribs). I get pain when I breathe in.
D: What other problem do you have?
P: I get pain on the dorsum of my foot. My foot is swollen.
D: Since when are you having this swelling?
P: Since a long time. If I press with my finger it produces a
depression on the foot. There is black discoloration on my foot.
This black area pains if I press it. This pain is also as if I have
got a blunt injury there. Just like the pain in my ribs. There is no
difference, the pain is exactly the same type of pain.
D: Explain that.
P: (Thinks for some time and answers:) It is not poking pain. (Again
thinks for a long time and answers:) The pain is as if I have got
a blunt injury.
D: What other problem do you have?
P: I have these black patches below my elbow. They also pain the
same way when I touch them. It is the same type of pain. No
difference. The pain is as if I have suffered a blunt injury. When
I press, it pains the same way as my foot and the ribs. When it is
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A Case of Infertility with Vitiligo

A Case of Infertility with Vitiligo


This is a case of a 28-year-old woman with extensive vitiligo all over her
body. The vitiligo began at birth and increased as she grew up. One and
a half year back, she started getting it on the face and now 80% of her
face had white discoloration. She was married at the age of 17 and
conceived immediately but there was intrauterine fetal death at seven
months.
She used to get nausea whenever she would travel by bus or car even
for a short distance. She had pain in the vertex area of the head.
She had papular eruptions on the neck which were itching. She was
unable to eat well because she would feel nauseated when eating.
She was thin before, but recently had put on a lot of weight.
What bothered her most were her white patches. She would feel very
conscious to go out of the house. Whenever she would see good clothes
she felt that it was no use wearing them because her body does not
look good. She felt that others do not like her because she looks like
this. When she went to her village in North India, she felt that others
think that she has committed some sin. When her husband shouted at
her she felt that he is angry with her because her skin is like this and she
does not have a child. She would just sit in the corner and cry and feel
that her face is spoilt. She would not talk to anybody because she felt
that nobody would want to sit next to her. She felt like going out, but did
not want anybody with her. She preferred being alone. She felt that her
husband would leave her and go away because of her disease.
She was irritable but she kept most of her anger inside. She would cry a
lot but would not show others that she was crying. Crying would make
her feel better. Her vitiligo had increased after a fight between her
husband and his brother. The brother-in-law said bad things about her.
After that incident she felt as if the brother-in-law was the owner and
they were the servants in the house.
She had a dream that she went to the toilet and there were feces
everywhere. She felt dirty and did not know where to step, as there was
no clean place available.
Another dream was that a person who looks like her husband comes
and lies down next to her. She tries to touch him to see if it is her husband.
When she sees that it is someone else she gets scared that he will
molest her and then tries to push him away.
She was very scared of darkness. She feared ghosts and even at 7:00
PM she would take her husband along with her if she had to go to
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Pathology Factor in Remedy Selection

A Case of Keloids
This is a case of a fourteen-year-old boy who had been suffering from
keloids since the age of twelve.
The patient said that all of this began when he had a fall on a tar road
and his right knee was injured. Later, he had a fall again and there was
a cut at the same site. He also had eczema on the left ankle, which had
started when he was nine years of age and would come up again and
again. He suffered from recurrent headaches and he would also get
recurrent throat infections with difficulty in swallowing. He would get
sneezing, running nose and cough, which were aggravated in
the monsoon and from change of weather.
The keloid was reddish in color. He said that since the first injury, his
wounds do not heal completely and they become black. The pain in
the keloid would become severe when he moved his leg, and so he
could not move his leg easily. It was numb.
This is how the history proceeded:
D: How is the pain?
P: The pain is as if someone bites you. It is as if someone is pinching
you. I can’t do anything.
D: Tell more about it.
P: The pain is sudden. Like a sudden, tight pinch.
D: Explain a little more.
P: The pain is as if teeth are going into it. It pains a lot and stops.
There is sudden burning. I feel as if skin was going to come out.
D: Tell a little more.
P: It is as if someone is biting through you. I feel like hitting that
person. The pain is as if something has suddenly pierced through
your skin and gone through. It is like a sting. The whole part
becomes numb. You can’t do anything about it.
D: How is this ‘sting’?
P: ‘Sting’ feeling is as if it will tear and bleed. You get a burning
sensation.
D: Burning?
P: You feel hurt. It is painful. You want to hit that person so that he
stops.
D: Tell more about burning?
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A Case of Painful Keloid

A Case of Painful Keloid


This is a case of a fifteen-year-old girl with a keloid on the left arm.
P: I have a keloid on my arm. It pains a lot. It hurts me when I am
studying and even when I go out. It appeared after a BCG injection
[vaccination against tuberculosis] was given at birth. It was very
small when I was five, but now it has increased and itches a lot.
D: Tell more.
P: It hurts me. It pains very badly. It is like a strike on the arm.
Sometimes, I can’t raise my arm. It strikes me here. It hurts me.
If anyone touches it, then it pains a lot and then it pains the
whole day. It pains more in winter. It hurts a lot and in between,
it strikes.
What important symptoms did we get so far?
She feels that the pain is as if she is struck on the arm. It pains even on
touch and it pains a lot.
D: Describe this a little more.
P: It is like a pin. As if a safety pin has pricked and I feel like pressing
it tight with my hand. But it goes on hurting. Pinning, pinning,
pinning. That’s the way it hurts me. It also happens when I am
sitting idle. It pains when I am studying. Then I can’t study. I just
hold the arm with my hand till the pain is better. When the pain
goes, I start studying again. Then after some time, it hurts again.
When I am sitting, I am always conscious that this arm should
not be touched. It pains horribly and I feel as if I am going to
faint. It pains as if I have hit a cupboard door. I try to press very
hard so that it stops. But it continues. I feel like crying. It hurts
very badly like some sharp object is beating on my body. Like
somebody coming and beating me again and again. Then, the
pain radiates down the arm. It’s like hitting me, ‘Thaak! thaak!’
One second it hits me, and after two seconds again it hits me. It
hits at regular intervals. After five seconds, it becomes continuous.
What do we understand about her from the history we have got so
far?
The pain is poking like a pin. She presses the part tightly. It is as if
beaten, or as if you have struck somewhere. It is intermittent when it
starts. The pain radiates down. It pains horribly—this indicates the
intensity of the pain. She feels she will faint with pain and finally, she
cries with pain.
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Pathology Factor in Remedy Selection

A Case of Wrist drop with Imbecility


This is a case of a 37-year-old male patient who approached me with a
peculiar problem. He said that he is not smart.
He said, “Make me smart doctor. In front of people, I behave as if I don’t
understand anything, as if I am an idiot. I keep my mouth open and I get
dribbling of saliva. I just keep looking down.”
He was on allopathic treatment and if he did not take it everyday, then
he was unable to get out of bed. Sometimes he would not go to work for
days together. He was prescribed Pregabalin, which is given for
neuropathy and generalized anxiety disorder.
This is how the interview started:
D: What troubles you the most?
P: My abdomen gets bloated.
D: What else happens to you?
P: I am unable to have sex. I have sexual problems. I don’t have
any sexual desire.
D: You don’t have any sexual desire?
P: I don’t have any sexual desire. If I do more exercise, then only I
get it. When I do exercise for two to three hours, then I get it.
Otherwise, I don’t get it.
What do we observe here? What is peculiar?
We can see that exercise ameliorates his sexual desire.
D: When you don’t do exercise, then what troubles you the most?
P: The thing which troubles me the most is that I feel lazy; I don’t
feel like doing anything. I don’t get proper digestion. I don’t feel
thirsty; I don’t feel like doing anything; I can’t remember anything;
I don’t feel like working; I can’t do any calculations. If I take
the tablets then only I feel better for some time, but this also
does not work much. I feel better for some time after exercise.
D: You don’t feel like working? How do you feel?
P: I feel lazy. I feel bored.
D: Bored means?
P: I feel bored and lazy.
D: You feel lazy means?
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Pathology Factor in Remedy Selection

A Case of Cerebral Hypoxia with


Hallucinations and Stupor
This is a case of an 85-year-old woman who had started hallucinating
and was not in her full senses. Her daughter came to the clinic to give
her history on October 4, 2011.
She said, “She has become forgetful. She does not remember how many
children she has, but after reminding her, she remembers it.
She does not want to talk. If you ask her anything, she does not answer
back. You have to ask her three to four times and then
she answers by just moving her lips but no words come out, or
the words are very soft, of a low volume. Or she does not answer at all.
She appears lost. She is a little better when her relatives are around.
She just wants to lie down. She is not focusing. She does not look at our
faces. She looks elsewhere. She has hallucinations.
She sees children and tells us to give them something to eat.
She wants to go back to Mumbai to stay (this place had been sold eleven
years ago).There is total apathy. She is just not interested in anything.
The other day I burnt my fingers and I was showing her again and again
but there was no response from her. No reaction. There is a blank
look on the face. She is disinterested. Everything is slow.
All her movements are slow. Her hands are icy cold. She cannot
grasp objects and she can’t hold a teacup or a spoon. She likes fruit
juices and cold drinks.”
End of case.

Case analysis:
The following rubrics were chosen for this case (Complete repertory):
• Generalities; Reaction, lack of, old people, in
• Generalities; Food and drinks, juicy things, desires
• Extremities; Coldness, hands, icy
• Mind; Dullness, understands questions only after repetition
• Mind; Indifference, apathy, everything to
• Mind; Talk, indisposed to
• Mind; Forgetfulness, of old people
• Mind; Homesickness
• Mind; Slowness of old people
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Pathology Factor in Remedy Selection

A Case of Cerebral Parenchymal Oedema


This is a case of a 38-year-old female who came to the clinic on
December 8, 2009.
In this case, the history was given by the patient’s husband and also by
the patient.
History given by the patient’s husband:
In 2003 she had headache. One day suddenly, she stopped talking.
We asked her something and she answered something else.
She couldn’t put on her footwear herself. When we were taking her to
the doctor, instead of getting into the autorickshaw she started walking
away in another direction. On the way, she kept asking us, “What is
the time?” again and again. In the clinic she screamed suddenly and
got a convulsion. She became unconscious. She was put on steroids.
After that she was admitted twice for headache and since then, she has
been on continuous medication.
History given by the patient:
P: I get a headache. It comes suddenly. With the headache I get
heaviness of the eyes. There is pain at the root of the nose. I get
pain in my ears when I lie on them. I get cramps in my hands
and feet. I don’t remember what I have to bring and bring
something else. I forget where I have put things. I forget what
work I have to do. I know that now I have to boil water but after
some time, I forget it. I get pain in the lower ribs at the back
which is more when I turn in sleep.
D: What else?
P: I don’t remember now what I have to tell. Even when my brother
rings me up, I forget what I have to tell him. I have swelling of
the legs.
D: What is your main problem?
P: Headache and forgetfulness.
What is the main sphere of action?
The main sphere of action in this case is the cerebrum.
D: Tell about it.
P: The headache is as if a heavy stone is there inside the head.
During the headache I cannot concentrate when anyone is
talking. For the last three days, I am not getting sleep. I get up
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Pathology Factor in Remedy Selection

A Case of a 16-Year-Old Girl with Epilepsy


This is an unedited case. The patient was uneducated and lived in a
village. She was quite dull when answering questions. There were three
attendants in the room and they had done most of the talking in the first
part of the history. In a case of epilepsy, the history given by the attendant
is very important, as they have seen the convulsions. A proper description
of the convulsion is very valuable for a good prescription.
D: Tell me what happens to you.
P: I get convulsions but I don’t come to know that I am getting it.
Sometimes I can make out and sometimes not.
Attendant: Most of the time she can’t make out.
D: Tell me what else happens to you.
P: When I get convulsions, I get very angry.
What is important here?
The first and spontaneous symptoms given by the patient are always
very important. They offer you a totally unprejudiced view of the disease.
We have two important symptoms here:
1. She does not know that she is getting it. She is not conscious at
that time.
2. There is anger associated with the convulsion.
Attendant: That time she does not want to eat anything. When she
vomits, her head becomes lighter. If she vomits she feels
better, otherwise she sleeps the whole day.
D: After getting this, she sleeps?
Attendant: After she gets a convulsion she can’t do anything, so
she sleeps till her head becomes lighter.
D: How does it start?
Attendant: I had seen her when I had gone to Vailankani, Madras,
that, before she gets convulsion she can feel it and then
she says that she is not feeling well. Then she becomes
unconscious and she gets froth in her mouth and
she remains unconscious for almost two to three minutes.
When she is unconscious we don’t touch her, but
automatically she gets her senses back. Then she feels
drowsy. Then, we make her lie down on the bed.
D: Whatever you have seen, just describe it again.
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Pathology Factor in Remedy Selection

A Case of Cervical Spondylolisthesis


This is a case of a 50-year-old male who presented in July 2010 with
unbearable pain in the cervical back and right arm. He was put on traction
and given the latest painkillers, but there was no relief. He had a history
of three surgeries in the past. He was operated for anal fistula in 2007.
He was in an accident in 2008 in which his femur bone was broken into
three pieces, and there was a ligament tear in the knee due to that
accident. Then he developed stones in his right kidney, and he was
operated for that also. After one month, he again developed two stones.
He also suffers from diarrhea whenever he eats pungent food—he has
been suffering from this since he had dysentery at the age of ten.
He had been crying day and night with severe pain, and he had to touch
his C6-C7 vertebrae constantly to get some relief. He would touch this
area even at night in bed, as he would not get sleep due to pain.
His posture was unusual during the interview. The whole history was
given with the patient touching his fingers to his cervical spine with
the elbow pointing upwards. And every now and then he would try to
bend backwards.
His MRI read as follows:
Reversal of the normal lordotic curvature with retrolisthesis of C6 over
C7. Large extruded right foraminal and posterolateral disc herniation at
C5-C6 causing severe compression at the right traversing and exiting
nerve roots and mild indentation of the cervical cord. Disc bulges from
C3-C4, C4-C5, C6-C7 intervertebral discs causing mild thecal sac
indentation.
Let us see what he says about his pain.
P: When I am looking at the computer at one angle, I get the pain.
All of a sudden, I started developing shooting pain down in the
right shoulder to the mid-arm. When I touch that part at the back,
I feel a little bit of relief. This pain is especially in the night, doctor,
and sometimes it is unbearable.
So what do we know about his pain now?
His pain is of a shooting type and goes down the right arm. Also, it
comes all of a sudden and it is unbearable. When he touches the part
he feels better—this symptom is peculiar. His severe pain is better by
touching the part, so he touches it all the time. Further, he says it is a
nagging pain and he feels better by pressing it with his hand.
P: This part feels as if there is a knot or as if the muscle is twisted
inside. It pains terribly and I can’t sleep on the right side. Nor
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Pathology Factor in Remedy Selection

A Case of Cerebral Frontal Lobe Atrophy


This is a case of a 61-year-old woman. Her C.T. scan shows mild frontal
lobe atrophy and hyper-density in the soft tissue on the right side.
Here is an edited version of the history that she narrated when she
came for the interview. She began by saying:
Four months back, I started getting numbness of the toes, and slowly
the whole left leg, left hand and the left side of my face became
numb. The skin of the soles of my feet feels thick and numb.
The left side of my tongue also feels numb. I get throbbing in my
nerves and feel like rubbing the area. I feel better by stretching.
I am not able to hold anything in my hand. If I hold anything in my
left hand then the grip is not good. It feels loose as if there is no
strength. I get cramps in my toes and calf muscles. My toes get
twisted and become tight. I feel better by massaging. I can’t bear
any noise. I feel irritated and shout at them. I want them to stop
immediately. If my daughter says anything to me, I brood over
the same thing again and again. I don’t get sleep the whole night.
I feel nobody gives any value to me. I am tensed that when my
daughter gets married and goes away, I will be alone. There is no
one to take care of me. Who will take care of me? With tension,
I get numbness of the left hand and left leg. Then I am not able to do
any work. My husband was an alcoholic. So I felt that I don’t have
anybody. I am alone, no support to look after my daughter. I was all
the time in this tension. If something happens to me, who will look
after her? This feeling is still there. I have this anger that instead of
him supporting me, I had to work and support him. He doesn’t give
importance to my words, doesn’t listen to me. He never gave me
support. I felt my own people have cheated me by marrying me to
him. Whenever I am tensed, I experience weakness and I don’t feel
interested in work. As if there is no strength in my body. I don’t mix
with others. Nowadays I get itching on the left side of my face.
The doctor told me that it is the first sign of paralysis. So I’m tensed
that if something happens to me, then who is there to take care of
me? Now when I’m telling you all this I’m getting numbness in my
left hand and head. In my childhood, my mother would not treat me
well. Even today, I feel that I didn’t get my mother’s love. Nowadays
I wear a sweater and socks to prevent numbness.
End of case.
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A Case of Lumbio-Sacral Spondylolisthesis

A Case of Lumbo-Sacral Spondylolisthesis


This is a case of a 33-year-old male, suffering from lumbo-sacral
spondylolisthesis for three years. He was in severe pain and had tried
different therapies. He was advised to undergo surgery.
P: I have lumbo-sacral backache. I cannot stand or walk for more
than two minutes. The pain is more when my pants are tight.
This sciatic pain goes down my right leg. It is intermittent.
It restricts my physical activity. There is a piercing, radiating
pain down the leg as if needles are piercing. I also suffer from
allergic rhinitis. There is itching and redness of the eyes with
running nose. I feel breathless in the chest. It is always from
8:00 PM to 8:00 AM. I also have fullness of the abdomen. It comes
up every day at the same time.
D: What else?
P: I want a financial position, not marginal, but very big. I want
success which brings name, fame, money and a luxurious life.
I can’t see the way to this kind of growth. That saddens me. In
my life my enemies always had an upper hand on me.
They cheated me in money. I could not see through their
designs. There has been a lack of strategy in countering their
designs. Since I feel I am lacking in strategy I started playing
chess. I got a coach also.
About stressful incidents in life:
P: Ten days back I met a boy from my school who would never
greet me. I was in my car. He fired a bad word at me. It simply
shook my system. That night and the next day I was thinking,
how I am going to counter this man?
About his dreams:
Once I got a dream that my wife and I go to the Wagah border
(Indo-Pakistan border) and stray into Pakistan. I say that these
people are going to catch us and finish us. I say to myself, “How can
you make such a mistake? Can’t you see through?”
D: Any other dreams?
P: Two cousins who have been estranged from our family have
come back. I am not willing to patch up with them. All have
gone for a picnic and I don’t want to join them.
D: What exactly do you feel?
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Pathology Factor in Remedy Selection

The Importance of Diagnosis


After observing all of the cases mentioned, we have learnt that we must
use a combination of the Sensation Approach, the rubrics,
the materia medica and the key notes as well as the pathology to arrive
at the right remedy.
In certain cases, we succeed in understanding the patient at a very
deep level. We are able to see the kingdom, the subkingdom, the
sensation and the miasm clearly. If we have understood the patient
correctly, then you will see that the same remedy will be indicated by
the rubrics, the materia medica, the key notes and the peculiarity of the
pathology. However, if we have made an error in understanding the
patient, then the rubrics, the materia medica and the pathology will not
indicate the same remedy and we will have reason to doubt our
understanding and will have to review the case.
When we use rubrics to solve a case, we come to a small group of
remedies after repertorization. Our knowledge of the Sensation Approach
will help us to zero in on the right remedy. The peculiarity of the pathology
will also help us in the final prescription of the remedy. If our rubric
selection is wrong, then we will see that the Sensation Approach and
the peculiarity of the pathology do not point to the same remedy.
The two points that are mentioned above need to be clarified, so we
should ask ourselves:
1. How do we make sure that the rubrics selected are correct?
2. What do we understand by the term ‘peculiarity of the pathology’?
First, we will try to understand the peculiarity of the pathology and we
will talk about rubric selection in the chapter “Technique of Case Solving”.

Peculiarity of the pathology:


What makes the pathology peculiar?
A patient’s individuality is expressed clearly in the peculiar location,
sensation, modality and concomitants of his symptoms.
A given drug substance has the power to influence certain organs, as is
evident from our drug provings. This is the unique quality or property of
that drug substance. It is a characteristic symptom of that drug.
For example:
 Bryonia affects the serous membranes
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Pathology Factor in Remedy Selection

Technique of Case Solving


The essentials of a good prescription are:
1. The important rubrics in the case should be covered
2. The materia medica should indicate the same remedy
3. The keynotes should be covered
4. The Sensation, the kingdom, the subkingdom and the miasm
should suggest the same remedy
5. The pathology has to be covered
Success in practice will depend on how we use these tools. However,
we should ask ourselves what we should give more importance to in
any given case. Whether to give more importance to the rubrics,
the pathology, or the sensation will depend on that individual case.

Situation 1:
If we have a clear-cut Sensation in the case, our task becomes very
easy. If you have taken the case properly then the kingdom and miasm
approach will quickly take you to the exact remedy or a very small group
of remedies. From here we read the remedy from the materia medica
and note the similarity, check out the rubrics and confirm that
the pathology is covered. Then we are ready with a good prescription.
The case of Fel tauri (cholecystitis) and the Aranea diadema case
(sciatica) were solved with this approach.
What if you come to a new remedy (unproved remedy) or a remedy
that has not had an extensive proving?
In this case, we have to check out the toxicology of that substance and
see if the pathology is covered. It may happen that you come to a known
remedy, but the pathology is not covered. Then we have to find out
more information from alternate sources such as the internet. Read
about the toxicology of that substance. W e do not know all
the toxicological effects of all the remedies given in our materia medica,
and the internet can be put to good use to get this information.

Situation 2:
If you do not have a case with a clear-cut Sensation or if you do not
know the Sensation Method, then the following technique will be of
great use:
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102
Case-Taking

Case-Taking
Our case analysis techniques can be put to good use only if we have
taken the history correctly. Faulty data will lead to wrong analysis. So it
is imperative that we learn the art of case-taking.
I would once again like to suggest that every homoeopath make
the best use of the courses offered at The Other Song International
Academy of Advanced Homoeopathy, where the art of case-taking is
taught by some of the world’s best teachers of homoeopathy.
Here are some guidelines that will help you enhance your technique of
case taking:

The aim of case taking


The aim of case taking is to understand the individuality of the patient
and to find out what is most peculiar about him. Only this will help us to
select the right remedy for the patient (Aphorism 153).

Where do we look for his individuality?


In order to understand a patient’s individuality, we have to explore
the following seven areas of his life:
1. Chief complaints
2. Associated complaints
3. Emotional state in stressful situations
4. Fears
5. Dreams
6. Childhood
7. Hobbies and interests
While exploring these seven areas, you will observe that there are some
issues that come up over and over again in different areas. These are
known as the core issues of the patient or the essence of the case.

How do we go about it?


Hahnemann has given important instructions regarding case-taking in
the following aphorisms. These guidelines have to be followed strictly.
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Pathology Factor in Remedy Selection

The Final Diagnosis


The experience and ideas expressed in this book will surely help you to
treat your patients more efficiently. However, as I have said before, this
is not the last word on the subject. A lot more work needs to be done in
this field. It is not just the right remedy, but the right potency is equally
important to succeed in such cases. In my experience, the sixth and
thirtieth potencies of the centesimal scale yield the best results in cases
with extensive structural changes.
In the chapter, “Essentials of a Good Prescription”, I mentioned that for
a prescription to work well we have to make sure that the same remedy
is indicated by a combination of the following:
1. The Sensation Approach
2. The rubrics
3. The keynotes
4. The materia medica
Once you have understood this book correctly, you can add one more
essential factor to this list:
5. The pathological process
The diagnosis usually spells out the pathological process going on in
the body. It tells us the seat of action, the kind of action, and the range
of action of the disease. W hen investigating the peculiarity of
the pathology, we must look at the location, sensation, modalities and
concomitants.
In order to wisely use the pathology in making a successful prescription
one must follow this rule:
Arrive at a small group of remedies after applying the knowledge of
Sensation Method, rubrics, materia medica and keynotes. Then refer
to various books and sources to see which remedy covers the peculiarity
of the pathology.
The essential books to refer to include: Phatak’s Materia Medica
(‘Generalities’ section), Burt’s Physiological Materia Medica, Hughe’s
Encylopedia, and Clarke’s Dictionary of Materia Medica.
In addition to these literary works, reading the toxicology of the particular
drug substance will aid in choosing the remedy. This information can be
found in Vermuelen’s Prisma or on the Internet.
Once this is done you are in a position to make a good prescription.
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Pathology Factor in Remedy Selection

Discussion with Dr. Borkar


Q: What is the pathology factor and how do you find it in a
patient?
A: There are different things to be considered while making a
prescription. We have to decide the approach that we are going
to take. Are we going to use the Sensation Method or rubrics
(and if we are using rubrics, do we take the mental symptoms or
physical general symptoms first) or materia medica, or keynotes?
What do we give more importance to? Rubrics, materia medica,
and keynotes have been used traditionally to prescribe a
homoeopathic remedy. More and more homoeopaths are now using
the Sensation Method (kingdom, miasm and source a p p r o a c h )
successfully.
There is one more factor that has to be considered other than
these four factors. The fifth factor is the pathology that is present in
the patient. I have heard colleagues say that the pathology should
not be considered for prescription and to be frank, even I thought
so earlier in my practice. However, I started to consider and use
the peculiarities of the pathology for prescription and this gave me
much better results in cases with structural changes.
If you know the diagnosis of the case under consideration then you
are in a position to understand the main sphere of action of the
disease in the patient, and the disease process going on in his body.
Q: Which homeopathic literature is best to find the pathological
factor?
A: Boger’s Synoptic Key gives maximum space to the sphere of action.
Phatak’s Materia Medica which is based on Boger’s book is my
personal favorite. In Phatak, if you read closely, the process of
disease is given in italics and the sphere of action is given in bold.
Phatak gives more importance to the sphere of action and the mode
of action.
Other sources Include Burt’s Physiological Materia Medica, Hughes’
Encyclopedia, Clarke’s Dictionary, and Vermuelen’s Prisma.
Q: In the book you have prescribed rare remedies like Aranea
diadema and Fel tauri. In pathological cases, what gives you
the confidence about these rare remedies, when many authors
say that 90% of cases require polycrest remedies?
A: I give most importance to those factors that are clearly observed in
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Pathology Factor in Remedy Selection

Bibliography

1. Burnett J, 1992, collected works of Burnett, 1st edition, Delhi, B Jain


publishers.

2. Clarke.J.H., 1900, A Dictionary of Practical Materia Medica,


Philadelphia, Haswell, Barrington and Haswell.

3. Hahnemann S., 1921, Organon of Medicine, sixth edition, Delhi,


B Jain publishers.

4. Phatak S .R 1977,Materia Medica of Homeopathic Medicines,


Mumbai, B Jain Publishers.

5. Sankaran.G.R., 2004,The Sensation in Homoeopathy, Mumbai,


Homeopathic Medical Publishers.

6. Sankaran.G.R., 2002, An Insight into Plants, volumes 1 and


2; Mumbai, Homeopathic Medical Publishers.

7. Sankaran.G.R., 2008,The Other Song; Mumbai, Homeopathic


Medical Publishers.

8. Sankaran P., 1996, Elements of Homoeopathy; 1st Edition, Mumbai,


Homeopathic Medical Publishers.

9. Vital quest, Mumbai, Homeopathic Medical Publishers.


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The other song : International Academy
of Advanced Homoeopathy
Headed by Dr. Rajan Sankaran and supported by Homoeopathic
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Pathology Factor in Remedy Selection

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Website : www.theothersong.com
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