Sankaran - Element of Homeopathy

SANKARAN P. American institute of homoeopathy 1011 Arch Street Philadelphia, Pa., 1907 Office of the Journal ELIZABETH WRIGHT HUBBARD, m.d. Sept. 28, 1965 108 East 86th Street New York, NY. 10028 212-4-0686

To – Dr. Dinesh Dhoke

It has been my privilege at two world homoeopathic congresses to meet and to hear Dr. P. Sankaran of Bombay, India. He also came to the post-graduate summer school of the American Foundation for Homoeopathy held at the State Teachers Training College in Millersville, Pennsylvania, as a student. We, the teachers, soon found that we could learn from him, so brillant and well-informed was he. As a teacher he has not only rare humor but a sense of timing and repetition which make working under him a pure delight. He had a group of 28 doctors eager to learn homoeopathic Materia Medica spellbound. The congress at which I first meet him was the triennal one of the International Homoeopathic League, which was held this year in London and attended by Vice-Presidents from sixteen coutries and delegates from five continents. The International Congress in Philadelphia, which he later attended, and at which he taught, was under the auspices of the American Institute of Homoeopathy, founded 121 years ago two years before the A.M. A. - and the New York State Homoeopathic Medical Society (115 years old), the Pan-American Homoeopathic Congress, in its 36th year, the Southern Homoeopathic Medical Association, 80 years old, all joining in the centennial of the Pennsylvania State Homoeopathic Medical Society. The congress banquet speaker was Dr. James Z. Appel, President of the A.M. A. His knowledge and personality are such that we wish Dr. Sankaran could and will remain in the United States to teach Homoeopathy.

Dr. Elizabeth Wright Hubbard, M.D. , New York Foreword Dr. Rajan Sankaran asked me to write a foreword to the late Dr. P. Sankaran's collected writings which are published in two volumes entitled "The Elements of Homoeopathy".

I was glad and felt honoured in accepting this assignment because Dr. Sankaran was not only a close friend and valued colleague of mine but also one of the greatest homoeopathic physicians and teachers produced by India. During his life-time, I asked him why he was writing his experiences, etc., in so many small booklets instead of publishing the whole material in two or three large volumes as it is easier for us to locate references and keep track of his contributions. With his usual smile, he argued that with his periodical small publications, he was able to make his writings faster and make it easier for students and young physicians to buy them. Dr. Rajan Sankaran has fulfilled my desire by publishing all his books in two large volumes, thus making our access to the study of the material relatively easier. The profession must thank Rajan for undertaking this task. He has, of course, given his own reasons for republishing his father's writings in these two volumes. While writing the foreword, I go down memory lanes and seem to relive the great moments, sitting together with Sankaran and discussing the development of homoeopathic medicine in India, our reseach problems and educational activities and other problems. We often met whenever there was any seminar or homoeopathic conference. He was a most welcome figure on such occasions, as he charmed the audience by his contributions and papers on specific subjects. His talks were always punctuated with humour and wit. On those occasions, the subjects presented by him were always illustrated with practical case-records and that is why his talks were so convincing and popular. Most of his papers have been included in these volumes. On going through these volumes, one wonders how he could touch upon and write very authentic and authoritative articles on practically every aspect of Homoeoepathic medicine, whether it is provings, teaching techniques or Materia Medica, or ingenious ways of working out cases on different repertories; or homoeopathic philosophy or homoeopathic pathology or homoeopathic pharmacy. His views and methods of teaching Materia Medica are very interesting. He said that homoeopathic Materia Medica is very cumbersome - it is a dull study. Our drugs are living, vital personalities and should be presented as such to students, not only in classroom, but also at the bedside and outdoors. One cannot help being fascinated by his "Random Notes on some Remedies". Having a very large practice, he had a vast collection of case-records and from these records, he has given us glimpses of unknown facts of some of the remedies. His "Random Notes on some Remedies" testifies to his keen observation and meticulous record-keeping. He was always like a hunter, in search of a remedy's special action and its unknown clinical applications. For example, he talked of the action of Calc. Ars. in diseases of kidney and Syphilinum in "crying babies". His intense involvement in the field of Homoeopathy could be explained only on the facts that his conversion to Homoeopathy took place when he, being an allopathic and ayurvedic physician, could not cure himself of an obstinate sickness and was induced to try homoeopathic medicine, which ultimately relieved him of his troubles. He practically came to the conclusion that you cannot imbibe the true spirit of Homoeopathy unless you have suffered and been cured by homoeopathic remedy, especially when other treatments have failed. I, too, have undergone that experience personally. He has given his story of his conversion to Homoeopathy in one of these volumes. One of the subjects that he wrote about was the evaluation of symptoms, and his contribution here should be very useful to both students as well as practitioners. As I have

already said, all his statements on a particular subject are demonstrated by convincing caserecords from his clinical practice. In this connection, he has brought out an exhaustive paper on cross-references. In the evaluation and comparison of symptoms, especially in the references to mental symptoms, Sankaran was the first one in India to write about this subject. Boger had done it earlier but Sankaran realised that for proper selection of the rubrics for repertorial analysis, it is very imperative that we do not miss the right expression or at times even to combine two rubrics to avoid the likelihood of elimination of the indicated remedy. In this context, he has laid great emphasis on the role of Causation. At times, this take the first place in the Evaluation, in spite of a number of other mental aberrations. He has cited some cases to illustrate his points. From his writings, it is quite apparent that his clinical approach to Homoeopathic Medicine was very objective and scientific, and was not swayed by emotions. He was very correct in saying that emotion generally tends to cloud reason. He did not believe in fanatical adherence to some of Hahnemannian's writings. Regarding vital force, miasm and drug-disease, Hahnemann had given some postulation which could not be accepted as scientific or gospel truth. He did not mince matters when he found that certain sayings or theories advanced even by the so-called authorities did not convince him. In his vein, he exploded the adherence to some dietary restrictions when prescribing homoeopathic medicines. He has brought these things beautifully and convincingly in these writings. We find the same things when we read his comments on the Relationship of remedies. As a great thinker and observer, he has not hesitated in giving his own explanation, although he has quoted various authorities, whenever he felt that their contributions were relevant and useful. His unprejudiced and objective approach in the clinical evaluation of the action of homoeopathic remedies is borne out by his statements that symptomatic improvement may not be accompanied by a simultaneous improvement in the pathological picture. He cited cases of gall-bladder stones where X-ray pictures may continue to show abnormalities. One wonders how in his comparatively short span of life he could have done so much. He did not spare himself in his continued occupation with his teaching and writing in spite of a very large practice in a town like Bombay. On top of this, he actively participated in the periodic seminars, conferences - both national and international - and activities of the all-India professional organisations. He did not, however, waste his time in petty politics of some associations. Possibly because of these activities, he was able to leave behind such a rich heritage. I am quite sure everyone of us would like to add these volumes to our library. He spared no effort in collecting relevant data regarding the work done by Reseach workers in homoeopathic medicine. Actually, the account given by him in the chapter on research is a short updated history of Research in Homoeopathy, whether it is about the micro-doses of Homoeopathy or provings of new remedies or clinical research or efforts made by some in the detection of the indicated remedies other than symptom-similarity. He has referred to the work done by Abraham, Dr. Boyd and others. He dares to write the limitations of homoeopathic medicine and also the unpleasant side of difficulties in its practice. He had a wonderful knack of calling a spade a spade, but with a charming smile which would soften the hostile reaction of any of his listeners.

Dr. Jugal Kishore B. Sc., D.M. S., M.D. (Hom.) President Asian Homoeopathic Medical League

Dr. P. Sankaran A brief biography Dr. P. Sankaran was born on the 15th November 1922 in Madras, India. His father shifted to Bombay when he was 3 or 4 years old. He began his schooling here, but before he could complete it, his father died, leaving the family in a poor financial condition. The family of ten siblings was separated and were sent to various places to be supported by relatives. He went to Madras to stay with his paternal uncle Dr. Sharma, an Ayurvedic practitioner. Here he was put in a college where both Ayurveda and Allopathy were taught, and qualified with a Licenciate in Indian Medicine (LIM). After working in a few jobs, he somehow managed to start his own practice in the early 1950's, and was practising allopathy predominantly. Within 2-3 years of starting his practice, he fell sick and was not relieved by the best allopathic treatment of the day, but was cured of his ailment by a homoeopath (described in "My Conversion to Homoeopathy"). This removed his scepticism and he became an ardent learner. In 1955-56, he got the opportunity to go to London, where he studied in the Royal London Homoeopathic Hospital under famous teachers like Sir John Weir, Margery M. Blackie, Alva Benjamin, Foubister and others. It must be mentioned that the dominant emphasis in the Royal Hospital was on the Kentian method, with emphasis on the repertory and mind symptoms, etc. During this time, he also met Elizabeth Wright Hubbard, who invited him to New York. He came back to Bombay and re-started his practice with added vigour. As his practice grew in the Bombay suburb of Santa Cruz, he also started teaching in the Homoeopathic College and became Honorary Physician at the Govt. Homoeopathic Hospital. He married in 1959 and had a son in 1960.

He founded and edited the Journal of Homoeopathic Medicine, which was later amalgamated into the Indian Journal of Homoeopathic Medicine, of which he remained the editor till the end. In 1965, he went to New York to study under Dr. E. Wright Hubbard. She was much impressed by him and asked him to be a teacher (instead of a student) in the course. After hearing his first lecture on Lachesis, Dr. Hubbard wrote, "Dr. Sankaran's talk was so captivating with his knowledge of zoology, botany, psychology and homoeopathy, and with such a fine sense of humour that "The Sankarans" would be competition for "The Beatles", if only there were four of them!" He obtained a diploma in Homoeopathic Therapeutics from there. In India, he was one of the main persons responsible for the propagation of the Repertory. At that time, the dominant school of practice was that of the Calcutta Homoeopaths, with an emphasis on the Materia Medica to the near exclusion of the repertory. One of the first works he authored was the Card Repertory, which was a refinement of Boger's Card Repertory. Not finding a publisher, he started his own Publishing Company, and later on went on to write and publish 36 small booklets. He was one of the leading figures in the profession and was responsible for the organisation of many meetings, symposia and conferences which were purely scientific and non-political. Here he was much supported by his close friends who included Dr. J.N. Kanjilal (Calcutta), Dr. S.P. Koppikar (Madras), Dr. Sarabhai Kapadia (Bombay) and Dr. Jugal Kishore (Delhi). He was closely associated with Dr. L.D. Dhawale and Dr. S.R. Phatak, both great admirers of Boger. He was a member of the first Central Council of Homoeopathy which was instrumental in formulating standards and guidelines for homoeopathic colleges. He was one of the instructors in the Teachers' Orientation course where he taught the repertory to teachers of homoeopathic colleges. He presented papers in various international conferences. He was known for his warmth, his sense of humour, skill in communication, diplomacy, sincerity and a remarkable open-mindedness. He investigated diverse areas of science trying to improve and advance Homoeopathy. He worked on Kirlian Photography, Bowel Nosodes, Boyd's Emmanometer, did provings, experimented with the repetition of remedies etc. Beside Homoeopathy, he was interested in such varied things as Travelling, Psychology, Photography, and was learning the musical instrument, Veena. He practised in two places in Bombay, visiting each on alternate days. His practice was extremely busy, and he kept up his hectic schedule of practice, teaching, editing, organising etc., till the very end. His health gave way. In 1978, cancer in the second stage was diagnosed. He lived for 6 months after the diagnosis during which time, in between his pains, he managed to complete three of his booklets and write the last one, "The Selection of the Similimum and Management of the Patient". Dr. P. Sankaran passed away on 20th January 1979 in Bombay.

Editor's introduction I have been teaching Homoeopathy in India and abroad since 1986. It is my experience that students of Homoeopathy, from the very beginning, get drawn to some particular kind of homoeopathic practice as taught by various charismatic teachers. Of these teachers, each has his or her own individual style of Homoeopathy. I can be considered guilty of the same; each of us wants to teach what interests him and appeals to his mind. Being an art,

Homoeopathy has various aspects to it: just as there are various schools of painting, so are there different schools of Homoeopathy. Earlier, I had assumed that students had the same solid background of Homoeopathy that I had, through learning it in a systematic way as I myself was taught by my father. But over the years, as I taught several students in different countries, I found that students got diverted too early into specific schools of thought, and did not have their basics clear. Except for a few searching students, most opted for shortcuts and were not even aware of the works of past masters. Most students are unaware of the kind and extent of experiments and research done so far. Worse, I find a surprising lack of the most basic knowledge of the repertory, and such fine works as those of Boger seem almost unknown. All these things are the very ground on which I stand, base my understanding and construct my ideas. Lacking such firm ground, a student is easily swayed and is lost in confusion. When my father started his practice, there were mainly two schools of homoeopathic practice - the Keynote (Calcutta) and the Kentian (London). There was no theory of essences, of delusions, of dreams, of group provings or intuition, nor deep psychological theories about remedies and patients. Homoeopathy was simple, basic, based on symptoms found in patients and in remedies. At least, so it appeared. But behind this simplicity, there was a deep understanding of philosophy and the nature of remedies, an understanding developed through careful study and patient application of the law of similars. Every problem such as potency, repetition or repertory was grappled within clinical practice. My father did not believe in mere authority - he believed in experience and experiment. For each of these subjects, he studied long and hard, and from various sources, experimented and tried to find answers. And he had a vast practice to see the results for himself. The beauty of my father's work is that he distilled the various works of great masters in the light of his own experience and made it easily available to students and practitioners. The books he wrote represent his search, his study, his experiment and his experience. On going through the various chapters of this book and the cases mentioned therein, the reader may find some parts controversial. 1. Use of Nosodes: The use of nosode as an intercurrent remedy has been recommended by many homoeopaths, past and present. In his experience, my father found that a case with a family history of Tuberculosis or Cancer benefitted by initiating the treatment with the corresponding nosode, viz. Tub. or Carcinosin. He found that the indicated remedy seemed to work better after the nosode. This practice may not be fully agreed to by Purists who believe that the patient needs only the indicated remedy and none else. I am of this view too, presently. However, this subject needs more discussion and experimentation. The reader will also note that in some cases, where the indicated remedy seemed to stop working, a nosode of a past disease (e.g. Morbillinum) was given and the indicated remedy repeated again with effect. The idea was to remove the block created by the past disease by giving the corresponding nosode. This idea, too, needs further study and experiment. For purposes of this book, these observations must be taken as the experience of my father, and not as a rule. 2. Repetition of remedies: In many cases, it will be seen that the remedy has been repeated despite amelioration. Here, I can say that my father was influenced by D.M. Borland and Maganlal Desai, both of whom repeated high potencies frequently, the former especially in acute cases like pneumonia and the latter in chronic cases like active tuberculosis, gangrene and coma. Dr. Maganlal Desai practised in Bombay and Gujarat. He reported astounding success in some severe conditions where he repeated high potencies frequently e.g. Tub CM QDS for several months. His experience encouraged my father to experiment

with frequent repetition of high potencies, with some good results in some cases. Again, this must be taken as one man's experience and not as a rule. The subject of repetition is a difficult one, and students either thoughtlessly follow the diktat of some teacher or look around helplessly for guidance. To repeat or not to repeat - that is the question, and the answers proposed by various homoeopaths are mentioned (in the chapter on repetition) for us to weigh and judge for ourselves. There are many teachers in Homoeopathy who insist that repeating a dose while the patient is improving invariably spoils the case. The experience of my father in several thousand cases will at least disprove this notion. I hope this experience will initiate a discussion as to the logic of and conditions for repetition. Dr. J.N. Kanjilal, one of my father's closest friends believed religiously in a single dose - "wait and watch", whereas his other close friend, Dr. Sarabhai Kapadia would repeat at least two to three times a day as a rule in every case, often for months. The results and experience of these two stalwarts can be had from their books: Writings on Homoeopathy, Vol. I and II - J.N. Kanjilal Homoeopathic Reminiscences - S. Kapadia Also useful will be the book "Coma" by Maganlal Desai. 3. Repertorization: It may seem in some of the cases given in the book that the prescription was based solely on repertorisation, by a method of elimination. In many such cases, there is hardly any reference to the Materia Medica. Here, the reader must be aware that the remedy selected on the basis of the repertory was not prescribed solely on that basis but on a sound knowledge of the Materia Medica. I know that my father read the Materia Medica from cover to cover, especially Kent's Materia Medica and Boger's Synoptic Key. He carefully studied several others such as Clark's Dictionary of Materia Medica, the works of Ernest and Harvey Farrington, Nash's leaders, etc. These books are often ignored by the present day student, who read interpretations and commentaries instead. With his knowledge of the Materia Medica, my father could see immediately whether the remedy indicated by the repertory did indeed fit the character of the case, and he always insisted on such correspondence during his lectures. The reader must study these cases and note the choice of rubrics and their evaluation, giving importance to the causation, sensations, the general modalities, the mind and the characteristic particulars. His manner of repertorization was influenced by Boger and his most ardent follower, Dr. S.R. Phatak - who was my father's mentor and guide. Boger's Synoptic Key is a masterpiece condensing the whole remedy into a few words, thus bringing out its very essence. My father once taught me from this book. Teaching me Sepia, he pointed to its first word "Draggy". He told me that the word in this sense didn't exist in the English language but was coined by Boger to denote the feeling of Sepia, which is a dragging down: everything drags down - the face, the stomach, the uterus and the mood. The patient's energy itself is dragged down, making her weary, and the disease too is dragged out, becoming chronic, going on and on. Thus one word is used by Boger in his special way to express the whole of the remedy. In practice, the rubric selected must express this central symptom or feature of the patient best and most completely. Giving an example, my father said that if a person is worse after a later night out, we must see if it is (1) Loss of sleep, or (2) Alcohol, or (3) The excitement of company, or (4) Some other factor; or a combination of one or more of the above. One must examine the whole case and then choose the most appropriate rubric. After that, one has to refer to all possible repertories to study the symptom. Once again, he emphasized that the repertory was only an index to the Materia Medica. This part of taking the remedy for

study to the Materia Medica may not have been emphasized in all cases because my father was mainly teaching the repertory and assumed a good knowledge of the Materia Medica. For the present day student, I wouldn't make this assumption. 4. Drug Provings: There is a chapter on provings conducted by my father. These include substances like Diamond (Adamas) and Sea Water (Aqua marina). Even though these provings were conscientiously performed, one can see a relative paucity of symptoms obtained, as also an absence of a good mental picture that can make the remedy more understandable. In my experience, provings conducted with individual provers and strict controls do not produce the kind of effect they did in Hahnemann's time, for some reason. I have found that Group Provings help to accentuate the drug effect and bring out clear and usable pictures of these drugs. 5. Materia Medica: "Random Notes" was the only attempt by my father to write something on the Materia Medica. It was not intended to be a definitive Materia Medica but merely describes some of his experiences and ideas, and give a glimpse of the way he viewed the Materia Medica. In this, he may have been influenced by William Guttman, the American homoeopath, who was his friend, and whose book "Homoeopathy" contains some remarkably poetic descriptions of remedies. In all, this book covers a vast area of Homoeopathy - from its History to Research, from Pharmacy to Philosophy, from Case Taking to Repertory, from Provings to Potency. They reveal the secret of my father's success as a homoeopath and a physician. He never kept any knowledge hidden. All that he knew, he tried to communicate. Together these books have formed for me his legacy, have given me a bird's eye view of the entire subject. These books were very popular in the 1960's and 1970's. In the 80's, my attention was diverted and I was developing and communicating my own ideas. It is only recently, as I continue to teach more and more, that I realised that the fundamentals of Homoeopathy need to be taught first - even to senior students - without which all these new ideas serve only to distract and divert. My father's books are a relatively easy way to grasp the elements, the fundamentals of Homoeopathy. I thought it a good idea to collect his writings and arrange them in proper order, to remove articles that are repeated in various places, and to edit and publish them in the form of a book. The main work of making this book has been done patiently and accurately by Dr. A.V. S. Prasad. The typing has been done by Mr. Antony. To them, both the reader and myself owe a debt of gratitude. Rajan Sankaran

Introduction My conversion to homoeopathy Behind almost every conversion to Homoeopathy lies an anecdote - usually a very interesting one and I may be permitted to add my contribution to this. I studied allopathic and Indian Medicine in my college and started practising after graduating in 1943. My results were good and bad, all that a beginner could expect. And I had almost settled down to a professional routine. However, around the year 1945, I started developing a feeling of fatigue in the evenings associated with a feeling of internal warmth. Gradually these sensations increased and there actually developed an evening rise of temperature, upto 99 oF. As a member of the medical profession, all kinds of pathological and radiological investigations as well as the expert advice of eminent colleagues were easily available to me. Accordingly, the blood, stools, urine, etc., were examined, and radiographs were taken but the disease could not be diagnosed. All the time, the temperature continued to rise, regularly upto 100 oF or more in the evenings. There was also weakness associated with a loss of weight. I had lost about two 28 pounds in a month. It was clinically suspected to be malaria and I was given quinacrine. Nothing happened except that my body became yellow. Some hidden focus of infection was suspected and I was given sulpha drugs but these had to be discontinued because they produced severe vertigo. I also took liver extract without any improvement. It was then suspected to be amoebiasis and I took some emetine with temporary benefit. Ultimately it was suspected that it might be a case of incipient tuberculosis and I was advised change of air, as there were then no specific drugs for the condition.

The whole series of investigations and treatment were merely a source of disappointment to me. They only helped to discourage me more and more. So, as I looked around in desperation, I thought of Homoeopathy. I had no knowledge of Homoeopathy and I had no faith in it; my impression of Homoeopathy was that it was some sort of a medical fad. Yet, such "fads" were sometimes known to do the trick where the highly developed modern sciences had failed. So I decided to consult a homoeopath, particularly as there was a well qualified allopathic physician who had somehow become a convert to Homoeopathy. The physician asked me to write out my symptoms and bring them to him. I did so and presented the list to him. He did not examined me thoroughly physically nor did he go deeply into my various investigation reports. But he merely read my notes, asked me one or two questions, then referred to a book and prescribed a drug. While I was disappointed to see that this physician did not examine me thoroughly, I was annoyed that he looked into his book and prescribed, as though my case and my medicine were recorded in print! Further he asked me to take only one dose of the medicine he prescribed for me. When I enquired how often I should repeat the doses, he advised me to take only one dose and wait for 15 days. How could one dose of medicine act for 15 days... Surely this was stretching one's credulity too far. However, notwithstanding this series of shocks, I decided to experiment. I went to a homoeopathic pharmacy and ordered a dose of the medicine in 30th potency as directed by the physician. I expected that since this dose was to act for a fortnight, it must be a very powerful and, therefore, a very expensive drug. But to my utter surprise, the chemist charged me only one anna (one penny) for the dose, with the result that even the little faith I had completely evaporated. But, strange to say, within three days of taking this dose, I found such a tremendous beneficent effect that cannot be described in mere words. The feeling of fatigue and fever disappeared. I regained all the original energy that I had lost during my illness. I actually felt as if someone had removed from my body all my old and useless blood and replaced it by fresh blood. I quickly regained the weight I had lost and was able to take up all my original activities with redoubled vigour. I felt very well for at least six months after which I think the dose of medicine had to be repeated. That a single dose of medicine costing so little could give me such tremendous relief for six months, whereas the most expensive medicines prescribed after lots of investigations had failed miserably was a great surprise that I could not surmount for a very long time. Incidentally, I want to mention here my belief that the homoeopath who can appreciate the system most is the person who has suffered and has been himself benefited by homoeopathic medicine. This incident filled me with gratitude for the system and stimulated me to study this science which in the past I had always equated with quackery. During the next two or three years I studied all the books I could get hold of. I read Kent's Materia Medica and Robert's Principles and Art of Cure and several other books repeatedly. But still I had not the courage to test Homoeopathy on any patient. However, an opportunity soon arose for me to see the effect of Homoeopathy objectively. A child of 4 years in our family had a severe attack of smallpox from which she eventually recovered. But though she recovered, she did not regain her original health or vigour. On the contrary, she started weakening and emaciating steadily. She became more and more listless and inactive and soon ceased to stand up or walk. Still later, she failed to sit up too, she could only lie down. She even stopped speaking; when she wanted anything she would merely roll her eyes. Her condition was most pathetic but none of the several physicians whom we

consulted could do anything because all investigations that had been done failed to show the presence or nature of any gross disease. However, it was very clear that the child was declining very rapidly in health and perhaps in another fortnight or a month she would be lost to us. At this stage, a homoeopathic friend of mine arrived and I consulted him about this child. In this case also, without thoroughly examining the child but only on hearing the history that the child had been declining since the attack of smallpox, he prescribed three doses of Variolinum 30, 200, 1000 to be given, one dose daily for three days. In this case too, I was rather perturbed that this physician instead of taking very active steps, was merely putting his whole faith in three little powders of medicine. But again, strange to say, within a week the child's condition was reversed; she started regaining all her original activity and also grew as chubby as before, and in the course of a month or two became perfectly normal. In the words of the father of the child, who wrote a letter of thanks which can be considered a classic, the child regained her original vivacity and vitality and he considered that Homoeopathy had justified its greatness by this singular success! So, here again was a case which had completely stumped our allopathic colleagues who, not being able to see gross evidence of any disease even though the patient was declining and dying, could do nothing whatsoever, whereas Homoeopathy stepped in with a few doses and set everything right. So this encouraged me to study the subject of Homoeopathy more vigorously. Very soon, another occasion presented itself. A close relative of mine was getting recurrent attacks of intermittent high temperature for over three years. These attacks used to last for two or three weeks at a time. It had been diagnosed as malignant tertian malaria and had generally responded to quinine. But this time there was a recurrence of the temperature which had lasted for about a fortnight and in which quinine had no effect whatsoever. At that time, quinine was the only certain antimalarial remedy. So, the relatives of the patient were very much worried and they telephoned to me. This was on 7th November 1947. I responded to the call and went and saw the patient. The patient had a temperature of 107.1 F, a temperature which I had never encountered so far in my life. Naturally I was extremely upset and in panic I ran to my nearest Physician-friend. However, this physician was not available and, therefore, I left a word that he should come at once as soon as he returned to his clinic. Meanwhile, we procured some ice and rubbed it all over the head and body of the patient, but the temperature came down only by 0.3 F and stayed at 106.8 F. As quinine had already been tried without effect and no other measure was available except to take him to the hospital, I decided to try my Homoeopathy without, however, any hope that it would help. So, I studied his symptoms in the homoeopathic way and found the following points: Temperature 106.8 F; Pulse 112. Even with such high temperature patient was conscious and loquacious and was asking us why we were all looking so worried as, after all, nothing was wrong with him except for a little fever. He complained of great bodily soreness. The history was that almost every time he got the (recurrent) temperature, it used to rise very high but the patient would not feel it much. He was also listless. Finding the marked disproportion in the pulse-temperature ratio, the tendency to hyperpyrexia, the soreness, the feeling of well-being in spite of the seriousness of the condition, etc. I decided to try Pyrogen. Since I had not prescribed for a single case so far, I had no homoeopathic drug at all with me. So, I procured the drug in the 30th potency and administered one drop. Whereas I myself had very little confidence, the relatives of the patient had no faith at all that the one drop of medicine was going to do anything,

particularly, as his aunt remarked, "It was not sufficient even to go down his throat." However, as we watched with trepidation, the miracle happened again! We were measuring his temperature every 15 minutes being apprehensive that it might rise further but luckily it dropped rapidly as follows: 6.00 p.m. : 106.8 oF 6.45 p.m. : 102.4 oF 6.15 p.m. : 104.6 oF 7.00 p.m. : 102.0 oF 6.30 p.m. : 103.0 oF 8.00 p.m. : 100.0 oF He perspired so profusely that all his clothes were drenched but when we changed his clothes, he fell into a deep sleep. When he woke up next morning, he was quite well; he said that for the first time in so many attacks of fever, he was feeling fit in spite of the fact that he had suffered for a fortnight. Since then, he has not had any more such attacks in the last 20 years. These three instances in which I had found Homoeopathy acting like a charm were enough to convince me that this was the system which I should study and practise. So, I discarded all my original volumes of therapeutics and replaced them with homoeopathic books. To this day I have not regretted this change. On the contrary, I have earned far more appreciation and gratitude and derived far more satisfaction than I ever should have dreamt of securing by doling out routine prescriptions of other systems of medicine. Every aspect of Homoeopathy such as the intelligent case taking, the system of matching the disease-picture with the drugpicture, the single drug, the minute dose, etc., has appealed to me and I really enjoy practising Homoeopathy.

Homoeopathy - an explanation Its origin

Homoeopathy is a system of medical treatment founded by a celebrated German physician and chemist, Dr. Samuel Hahnemann. Born in Germany on 10th April 1775, he was spared a long and useful life of 88 years during which he benefited humanity immensely by introducing this new system of medicine. He first graduated in Medicine and practised for several years becoming very successful and famous. However, the practice of medicine in those days was very unscientific and crude, even barbarous, so that in spite of his success, he was thoroughly dissatisfied with the methods and the results of the orthodox treatment. Patients were purged and sweated, bled and branded. It was often in doubt whether the patients died of the disease or of the treatment! So, in disgust, Hahnemann gave up medical practice. But he continued to study and experiment in an effort to evolve a more rational method of treatment. Even in those days Cinchona, from which Quinine is derived, was famed for its specific curative effect in malaria. Hahnemann, in an attempt to discover its true mode of action, himself ingested some Cinchona, whereupon he was surprised to notice that it produced in him fever and chill, resembling Malaria. This unexpected result set up in his mind a new train of thought and he conducted similar experiments with other well-known drugs. To his surprise, every drug produced in his healthy body the same symptoms which it was reputed to remove from sick persons. So he was led to the inference that what a drug cures in the sick it causes in the healthy, and similarly, what it causes in the healthy it can cure in the sick. He, therefore, put forward the new principle of treatment "Similia Similibus Curentur", which translated means "Let likes be treated by likes". This principle, however, was not an entirely new discovery because it had been already enunciated and followed by ancient Indian physicians, as stated in the popular proverb (Poison cures poison), but Hahnemann was the first to confirm this by experiment and observation and to emphasize it.

Its development Applying this principle in practice, to know what a drug can cure, we have to merely find out what it can cause. This can be done by administering it to healthy human beings and noting down its effects. Following this approach, Hahnemann experimented with nearly a hundred drugs and recorded all the symptoms produced by them. Such experiments, which are called "Provings" *, are continued by his followers. Thus the real effects of more and more drugs are discovered, i.e. what they cause and therefore what they can cure. Hahnemann, adopting this principle, cured innumerable cases. Even within his lifetime, this method became worldfamous and ultimately when he migrated to Paris, he received patients from several countries. His system became known as Homoeopathy (Homoeos meaning similar and Pathos meaning Suffering). However, it was found that when cases were treated according to this new homoeopathic principle the disease symptoms became initially a little worse. This was only to be expected because the drug is similar to the disease in its effects. Therefore, in order to cut down this initial aggravation, Hahnemann reduced the dose, i.e. , the quantity of the medicine. As he gradually reduced the dose he observed that the patients improved better. The smaller dose seemed actually to have a better effect. So, gradually bringing down the dose further and further, he ultimately started diluting the medicine with some inert medium (like sugar or alcohol). Even when so diluted the medicines seemed to act very well. In fact they seemed to act better. So these dilutions became known as "Potencies". These potencies are a peculiar feature of Homoeopathy, and the idea of potentiation has been called Hahnemann's greatest gift to science. Such dilution with sugar and alcohol makes the medicines not only harmless and palatable but also very economical.

Its features

We shall now discuss the main features of Homoeopathy. They can be summarized as the Similar drug, the Single drug, the Small dose and the Single dose. By Similar drug, we mean the drug that is able to produce symptoms similar to the disease. To know to which diseases drugs are similar, homoeopaths administer to healthy persons a drug (in non-toxic doses **), and record its effects. Human beings are still preferred for such experiments because they are more sensitive than test-tubes, and, unlike animals, they can express their sufferings. At present the effects of over 2 000 drugs are available. From among these drugs whose effects are so recorded, the homoeopath selects the one which is most similar in the totality of its effects to the case that he wants to treat. In so selecting, he takes into consideration every symptom of the patient. He first examines and diagnoses the case like any other physician, for which purpose he must of course have all the knowledge possessed by the ordinary physician. But in addition to noting the symptoms of the disease he goes further and notes the symptoms peculiar to each patient. For example, when he deals with cases of Pneumonia, he notes that in addition to all the symptoms of Pneumonia like fever, cough, rapid breathing, etc., which are to be found in every pneumonia patient, the first patient is restless, the second is thirsty, the third is irritable, the fourth is drowsy and so on. Even though the disease may be the same, each patient reacts in a different way and as such produces some symptoms which are peculiar to himself. The homoeopath takes into consideration all the symptoms of the case - the common and the uncommon ones - giving more value to the latter which reflect the patient's individuality, and prescribes that drug which has produced an identical group of symptoms in the provings. The second feature of Homoeopathy is the Single drug. The homoeopath always prescribes drugs singly because only single drugs have been tested in homoeopathic provings. The effects of combinations of drugs have not been observed or recorded and so combinations and mixtures are not generally prescribed by the homoeopath. The third feature of Homoeopathy is the Small dose. As already explained, the dose of the drug in Homoeopathy is usually so minute that chemical analysis does not reveal any trace of the drug in the higher potencies. It seems that by the special method of dilution used in Homoeopathy all the energy of the drug is liberated and transferred to the medium of sugar or alcohol. Indeed the dose looks ridiculously small; but the development of physics has shown us what a vast amount of energy lies within the infinitely minute atom, awaiting to be released and utilised. The fourth feature of Homoeopathy is the Single dose. Homoeopaths usually prescribe one dose of the indicated medicine and then wait till its action is completely exhausted. While the patient is improving, the medicine is generally not repeated. * Sometimes this single dose is found to act for weeks or even months and occasionally the single dose often cures the case. By the way, we must mention that homoeopathic treatment is purely medical in nature. When a homoeopath comes across a frankly surgical case **, especially mechanical conditions requiring surgical intervention, he hands the case over to the surgeon. But even here homoeopathic medication before and after the surgery hastens recovery.

Its progress We shall now briefly consider the progress of Homoeopathy. Originating from Germany, Homoeopathy has spread all over the world. There are homoeopathic physicians almost in all countries, a good number of whom are converts from other systems.

In India, Homoeopathy was introduced by a German physician, Dr. Honigberger, who was called upon to treat Maharaja Ranjit Singh. The system then rapidly spread to Bengal and some of the best physicians of Bengal including Dr. Mahendra Lal Sircar were converted to Homoeopathy. It has then spread all over India and it is now recognised and accepted as a standard system of medical treatment in most States. Homoeopaths have been appointed as the personal physicians to the President of India. The homoeopathic approach is accepted and appreciated especially in India as it has a peculiar appeal to the oriental mind with its inherent acceptance of the non-material. Further, the modern trend of medicine in the West is also to view the sick organism as a coordinated whole and to give less importance to the individual organs. Considering all the factors, viz., the scientific foundation of Homoeopathy on the eternal principle "Similia Similibus Curentur", its Materia Medica built up from scientific experiments on healthy human beings, its single harmless dose, its curative effects, its power of aborting diseases in the early stages and of strengthening the human organism and also its economical nature, there is reason to believe that Homoeopathy, which seems to be actually in advance of its time, has a bright future, particularly in India.

Elements of homoeopathic pharmacy A remarkable discovery of Hahnemann is the potentized dose, a phenomenon which even the modern scientist is unable to comprehend, let alone explain, although it results from a ridiculously simple procedure. This makes homoeopathic pharmacy a fascinating and intriguing subject. This chapter attempts to introduce the newcomer to the elements of this subject. For more information, the reader should refer to standard books on the subject. Pharmacy is defined as that department of the medical art which consists in the collecting of drugs and the preparing, preserving and dispensing of medicines. Drugs are substances which have the power of altering the state of health of the living organism. When drugs are purified, processed and prepared so as to become fit for administration to patients they are called medicines. Medicines when properly administered in sickness are called remedies. Since the homoeopathic prescriber depends almost entirely on the infinitesimal doses of the single drug, it is essential that the homoeopathic medicinal preparation must be absolutely dependable. So the pharmacist must be learned, skilled, honourable and trustworthy and must be fully aware of his responsibilities. As there are no available tests to see if the medicines obtained are genuine, we have to depend completely on the pharmacist and therefore the pharmacist must be completely reliable. The most painstaking care and accuracy must be exercised by him in every step of preparation, handling and dispensing.

Collection Sources The sources of the medicines in Homoeopathy are mainly the following: 1. The Mineral Kingdom: Consisting of the various chemical elements and their compounds (organic and inorganic), e. g Arsenic, Calcium carbonate, Petroleum, Sulphur. 2. The Vegetable Kingdom: Consisting of the various plants, herbs and trees, their parts, exudates and extracts, e.g. Asafoetida, Lycopodium, Pulsatilla, Thuja.

3. The Animal Kingdom: Comprising of the healthy secretions and tissues of various animals, and other living creatures, e.g. Aranea diadema (Spider), Lachesis (Snake). 4. The Nosodes: The products of disease of human beings, animals and plants, e.g. Lyssin (Saliva of rabid dog), Secale cornutum (Ergot of Rye). 5. Imponderabilia: Non-material elements, e.g. X-ray, Sun's rays (Sol), Moonlight (Luna), the magnet. Hahnemann's discovery of the method of potentiation has revealed that every substance or element in the world, whether falling into one of the above groups or not, has inherent medicinal energy which can be released and developed by proper methods. * Drugs collected should conform absolutely to the descriptions and standards laid down in the standard homoeopathic pharmacopoeas. Plants are collected as far as possible from their natural habitat just before or during full bloom. Generally, the whole plant is used to prepare the medicines. Where fresh plants cannot be procured, the dried plants can be used. Recently the method of curing or removing the ill-effects (toxic or allergic) of crude drugs by the administration of the identical substances in potentized form has become popular. Mr. Dudley Everitt has coined the term Tautopathy for this therapy and Ramanlal Patel has written extensively about it. Preparation The actual art of preparing the medicines is termed Pharmacopraxy. The drugs (crude substance) are combined with some neutral substance in such a way that their medicinal energies are developed and preserved in the neutral medium. These preparations are called Potencies. They are also called Attenuations or Dilutions. The method of preparing such potencies is called potentiation or dynamization. For the purpose of preparing potencies, one of the following media is selected. Liquid media 1. Aqua distillata or distilled water. 2. Alcohol. Used for preserving green plant extracts, preparing mother tinctures from dry herbs and for making higher dilutions (liquid potencies). Strong alcohol (containing 94% by volume of Ethyl alcohol) is mainly used for preparing mother tinctures. Dispensing alcohol (obtained by adding 1 part of strong alcohol to 12.75 parts by volume or 10 parts by weight of aqua distillata) is used for preparing most of the dilutions because this is readily absorbed by cane sugar and milk sugar and is therefore suitable for medicating the sugar globules or powders. Rectified spirit is practically the same as dispensing alcohol. 3. Glycerine is used as a preservative for certain animal products, e.g. Crotalus horridus, Elaps.

Solid media 1. Sugar of milk (Lactose, Saccharum Lactis): The hard and sharp crystals of this substance make it an ideal medium for triturating drugs. 2. Cane Sugar globules are found very convenient to medicate and use. These are available in various sizes from 5 to 100, the number representing the diameter of ten globules put together and measured in millimeters e.g. the total diameter of ten globules of No. 5 put together would be 5 millimeters. Potencies The purpose of attenuation or dynamization is to divide and sub-divide the medicinal substance progressively in order thereby to liberate and develop its latent power by degrees and to retain it in a suitable form. This is generally done by dilution with alcohol and succussion (shaking) in the case of soluble substances; and dilution with sugar of milk and trituration (rubbing) in the case of insoluble substances.

Since the products of such attenuation seem to acquire more and more power, they are called "Potencies". In case of vegetable products and other soluble substance, this is done by expressing the juice of the plant and mixing it with alcohol. The mother tincture, designated Q, the basis from which potencies are run-up, represents one tenth of the drug strength. Further subdivision is done by diluting with alcohol and succussing (shaking it up). Such liquid potencies are called "Tinctures" or "Dilutions". When green plants are used, the amount of moisture in each plant is calculated and deducted. Only the quantity of the dry crude drug is taken as the starting point from which to calculate the strength of the medicine. Mineral and other insoluble substances are similarly potentized by mixing with sugar of milk and triturating (rubbing in a mortar). Such potencies are called "Triturations". Homoeopathic potencies are thus prepared in the form of (1) Tinctures, (2) Triturations. Potentiation Potentiation is usually done in two scales. a. The Centesimal, evolved by Dr. Hahnemann and b. The Decimal, evolved by Dr. Hering. c. In the last edition of the Organon, however, Hahnemann has described a new scale of potentiation, which is named the 50th Millesimal scale. Tinctures ( dilutions) 1. Centesimal Scale For the purpose of carrying out the preparation of potencies in liquid form, pour into a small, clean, new phial one minim (i.e. one drop) of the mother tincture of the drug (designated Q) and add ninety nine minims of dilute alcohol. Cork the phial tightly with a new cork, hold it in

the right hand with a finger on the cork, raise it above the shoulder and give a shake or a jerk to the contents in such a way that each shake terminates in a jerk against the palm of the left hand or on a book. Repeat this process ten times. This results in the first centesimal potency of the drug. If one minim of the 1st potency so prepared is taken and ninety-nine minims of dilute alcohol are added and shaken ten times, as described above, the second potency is prepared. Further potencies are prepared in the same manner by repeating this same procedure. 2. Decimal Scale During Hahnemann's life time, another scale of drug attenuation was introduced by his staunch follower Dr. Constantine Hering. According to this scale the first potency should contain 1/10th part of the drug substance, the second potency 1/10 part of the first potency and so on. Preparation of tinctures under decimal scale is made by taking one minim of mother tincture and nine minims of dilute alcohol and shaking the bottle ten times as described above, the 1X potency being thus obtained. The 2X potency is then prepared in the same manner by taking one minim of the 1x potency, adding nine minims of dilute alcohol and shaking as usual ten times. Further potencies are prepared in the same manner. In modern times such dilution and succussion are done with a potentizing machine in which the process is carefully and automatically regulated. Triturations 1. Centesimal Scale To one grain of the substance is added thirty three grains of milk sugar, and this mixture is rubbed vigorously in a mortar for 6-7 minutes; it is then scraped for 3-4 minutes. This process is repeated thrice so that the first centesimal potency results in an hour by the addition and trituration of ninety-nine grains of milk sugar, in three instalments of thirty-three grains each time, to one grain of the drug (1:99). For preparing triturations under the decimal scale, the same method as in the centesimal will be employed except that here ten grain by weight of the crude substance is triturated with thirty grains of sugar of milk each time and the process repeated thrice as described above, so that in all ninety-grains of milk sugar are added to the ten grains of the drug and triturated (1:9). Even minerals and other insoluble drugs when triturated upto the 6x potency become soluble in a liquid medium so that further potentiation can be continued in an alcohol medium. Nowadays trituration is done by machines in which the mortar and pestle are rotated by machines. Potencies prepared under the centesimal scale are marked by using simple numbers or by the number followed by the letter, e.g. Sulph 200 or Sulph. 200C. 2. Decimal Scale Potencies of the decimal scale are marked by suffixing an "X" to the number, e.g. Sulph. 200x, or by the Prefix "D",. e.g. Sulph. D 200.

Thus in the Decimal Scale we have potencies such as 1x, 2x, 3x and so on made up as follows: 1x - 1 part of dry substance and 9 parts of diluent: representing Drug strength - 1/10, 2x - 1 part of the 1x and 9 parts of diluent: representing Drug strength - 1/100, 3x - 1 part of the 2x and 9 parts of diluent: representing Drug strength 1/1000 and so on. In the Centesimal Scale, we have: 1 or 1C: one part of the drug substance to 99 of diluent: representing Drug strength 1/100 2 or 2C: one part of 1C to 99 of diluent: representing Drug strength 1/10000 and so on. It can be seen that in drug content, the 1C corresponds to the 2x, the 2C to the 4x and so on. Sometimes, the potency strength is designated by Roman numbers (especially the higher potencies), e.g. 200 as CC, 1 000 as M or 1M, 10 000 as 10M, 50 000 as 50M or LM, 100 000 as CM, 500 000 as DM, 1 000 000 as MM, and 500 000 000 as DMM.

3.

50th Millesimal Scale

Hahnemann had in the last years of his life envisaged another scale of potencies in which the drug is diluted with 50,000 parts of diluent and potentized. The potencies thus made are designated as 50 millesimal scale or LM scale of potencies. Everitt has calculated that these potencies can be compared or equated theoretically on paper to the traditional potencies as follows: New Scale Potency I - 16x II - Between 20x and 21x ( i.e. 10c approx.) III - " 24x and 26x ( " 13c " ) VIII - " 44x and 51x ( " 25c " ) X - " 52x and 61x ( " 30c " ) XII - " 60x and 71x ( " 35c " ) XVIII - " 84x and 101x ( " 50c " ) XXIV - " 108x and 131x ( " 65c " ) XXX - " 132x and 161x ( " 80c " ) In practice, however, they seem to be far more powerful. Medicines for external use Ointments

Ointments are usually prepared by mixing the mother tincture of the required drug with any simple base such as prepared lard, vaseline, etc. The proportion of drug content may vary from 1 in 10 to 1 in 40. Though "homoeopathic" medicines for external use are available, they are not commonly used. The homoeopathic concept is that all diseases including all manifestations on the skin arise from internal disturbance and therefore they are to be cured by internal medicine. By the use of external medicines, there is a possibility that the external manifestation is extinguished without a corresponding internal improvement and this will give rise to a false sense of satisfaction. Preservation Homoeopathic medicines should be stored in rooms which are neither too hot nor too cold, away from sunlight, dust, smoke and strong odours. The phials should not be coloured. Phials and corks should be washed and boiled, and then washed again in distilled water and dried before using. Phials used for keeping one medicine should never be used for any other medicine nor for the same medicine in any other potency. The same rule applies to cork also. Never use glasses for measuring, keeping, dispensing or administering potentized medicines because they become contaminated with the potency energy which is very difficult to destroy. Two phials containing different potencies or remedies should never be opened at the same time in close proximity. It is always safe to record one phial and put it away before opening another for fear that the corks may be interchanged. Always mark the name of the medicine and potency clearly on the cork, besides labelling the phial correctly, as soon as any medicine is prepared. Sterilisation: Hahnemann mentions that after preparing a trituration, if the mortar, pestle and spatula are made red-hot, the medicinal substance will be destroyed. But McCrae thinks this not enough. He lays down that if by chance any material or container has come into contact with the homoeopathic potentized medicine and has thus become contaminated with the drug energy, then such potency energy is never destroyed unless the material is sterilised by exposure to dry heat at 160 degree C. for one hour. Dispensing The practitioner can usually obtain his potencies from homoeopathic pharmacies both in liquid form (alcoholic dilution) and in solid form (globules, powders and tablets). They can be then dispensed in both forms. It need not be emphasized that the pharmacy must be a reliable one, particularly as it is very difficult to identify or analyse the drug or its potency *. Liquid potencies can be used to medicate globules by adding 5 to 6 drops to a drachm of cane sugar globules in a phial and mixing it very well after corking. The excess of liquid if any, is drained. Small globules, say size No. 20 or 30 are found very convenient. Both the liquid and solid potencies keep well for several years if kept well-protected as directed. Dispensing in distilled water: Pour the requisite number of drops or pills into doses. If distilled water is not available, use filtered, boiled and cooled water.

Bottles and corks should never be used again for another drug or another potency of the same drug. A case is also related in which a servant of a worthy lady in Silesia was to obtain a homoeopathic medicine from an apothecary, besides fetching a certain sort of wool (called Estremadura No. 5) from a shop and the pharmacist promptly supplied the medicine labelled "Estre madura No. 5"! While discussing how long the medicines can retain their potency McLaren states that he used a potency that was seventy years old and found it quite effective. Aegidi of Freienwalde reports having used in 1860 with excellent effect a potency of Cantharis in pills, which had been given to him by Hahnemann himself in 1831. Tomlinson mentions that a potency of Zinc sulph. 82M in his possession for 42 years continued to act. Phatak records that a potency of Ledum which he had with him for 20 to 25 years had turned black, but was found by him to act, though he did not expect it to act. Other ways of dispensing: 1. Put one drop of the dilution on a little sugar of milk, say 5 grains. This forms one dose. 2. A few canesugar pills medicated as directed above can be added to a little of sugar of milk, say 5 grains, and crushed so as to make a uniform powder. This forms one dose. The number of drops or the number of pills of the medicine makes little difference. Given at a time, one drop or one pill will have the same effect as many drops or many pills. The powders should be packed in clean new papers, preferably in cellophane or tissue paper. Where two different sets of powders are given, they should be dispensed in separate envelopes. Medicines, dispensed in whatever form, should always be neatly labelled, the name of the patient and full directions for use being written on the label. Administration The subject dealing with the route of administration of medicines is termed Pharmaconomy. Hahnemann has laid down that homoeopathic medicines may be administered in any of the following ways. 1. By oral route. 2. By inhalation. 3. By application to the skin. For many years he was administering medicines mainly by mouth. But in his last years, he favoured the inhalatory method. Homoeopathic medicines are generally administered singly and by the oral route. Administration by mouth seems to be most convenient and effective. Homoeopathic potentized medicines seem to require no digestion but seem to be absorbed directly from the mouth and then act through the central nervous system. If the medicine is dropped below the tongue (sub-lingual), even the possibility of a coated tongue interfering with the absorption and action of the medicine will be avoided.

In the writer's experience, medicines appear to act as effectively when administered as pills or powders or in the form of watery solutions. Hahnemann, however taught in his later years that the medicines should be invariably administered in water. During recent years, homoeopathic potencies have been introduced in the form of injectables. Since the medicines given orally seem to act effectively and promptly, the merits or advantages of the injectables is not clear. Further, no scientific or objective large-scale studies have been published comparing the relative effects of the injectable and the oral administration. So the need for and value of these injectables are yet to be assessed.

Pharmacology The exact mode of action of the homoeopathic medicine is still not known but it is known that the sick individual is most sensitive to the similimum (most similar remedy). Considering that the drug substance is in such infinitesimal quantity that it is practically impossible to analyse or detect it, the average allopathic physician refuses to believe that this can have any medicinal effect at all. So efforts have been made by various homoeopaths to show the presence or effect of drug substance even in high dilutions. The famous German surgeon Prof. Augustus Bier had demonstrated that it requires 250 000 times as much formic acid to affect a healthy person as is needed to cause a sufferer from gout to react. Tomlinson reports that he was able to make prints on sensitive photographic plates by the help of the radium contained in one part. Boyd has shown by very carefully conducted elaborate experiments that high potencies have an action on the rate of growth of yeast. Sir Jagadish Bose was able to demonstrate that plants are sensitive to the effect of very minute quantities of poisons. Anna Koffler et al proved that homoeopathic potencies are able to affect the growth of plants. Other examples are: A small amount of Selenium, e.g. 2.5 parts per million can poison young rats (not old ones!) and 0.7 per million can affect chick embryos; Colchicum in dilution of 1 part per billion can inhibit cell division; inhalation of 0.000 000 1 gm can produce a garlic odour in breath; LSD - 0.000 02 gm or 1/700 000 000 of body weight can produce hallucinations.

Materia medica The study of materia medica The importance of the study of the Materia Medica and its enormous value to the homoeopathic physician cannot be adequately described. It has a predominant role in the field of Homoeopathy. We can do no better than to quote the words of Clarke who says, "We must never lose sight of the fact that Homoeopathy is Materia Medica and nothing whatever else. All other branches of medical study are Homoeopathy's handmaidens buy take away Hahnemann's Materia Medica and Homoeopathy vanishes from the scene. So that in so far as we are homoeopathists, Materia Medica is our sole concern...

Books of Materia Medica and Repertories are the Road maps, Time-tables and Guide books of the powers at our disposal..." The homoeopathic Materia Medica is peculiar in its construction and differs very much from the orthodox Materia Medica. Whereas the orthodox Materia Medica traces the action and therapeutic uses of various drugs through physical and chemical properties, pharmacological action, etc., the homoeopathic Materia Medica provides no such material. In truth, it is mainly a record of the effects of drugs on healthy human beings. The original basis for our Materia Medica is the records of provings * and poisonings (accidental or intentional), the former being experiments done to intentionally produce drug symptoms on healthy persons for the purpose of advancing medical knowledge. These symptoms are later confirmed and augmented by clinical experiences. The Materia Medica Pura of Hahnemann is actually not a Materia Medica in the ordinarily accepted sense of the word but is purely a record of drug-effects. It is unfortunately rather dry to read and difficult to digest. If this Materia Medica Pura is put in the hands of a beginner, he is likely to be frightened away from Homoeopathy for life **. Meyer describes the difficulty in studying the homoeopathic Materia Medica. He writes, " We shall probably not be contradicted when we affirm that the study of the Materia Medica is the most difficult in the whole range of medicine. Who is there of us who has not, in the beginning of his practical career, often taken up Hahnemann's Materia Medica with the most energetic purpose and sincere intention of studying and mastering some one or other of the remedies there recorded by the hand of the master and has not, as often, thrown the book aside in despair and disgust? Our own experience will furnish the reason for this frequently repeated result. It is not from the absence of a scientific interest in the matter, nor from want of a steady perseverance; the difficulty lies in the Materia Medica itself. A single glance at a remedy presenting to us many hundred different symptoms is enough to shake the most earnest good intentions, and if we reflect further on the absolute want of connection between these phenomena and that at the most, the only link between them is the part of the body in which they make their appearance, it is not to be wondered at that so many remain mere bunglers in this department of our art, and that some, terrified by the apparently insuperable difficulties that beset the way should have rejected Homoeopathy and sought a resting place in the arms of their less exacting allopathic mother. In both ways our therapeutics have received great injury, and many of promising genius have been led astray." This is testimony concerning himself of one of our most excellent homoeopathic colleagues: "I am not ashamed to acknowledge", says he, "that if when I commenced the study of Homoeopathy, had I not had the most intimate conviction of the truth and excellence of the homoeopathic fundamental law, such were the difficulties in the study of the Materia Medica that they would have been near repelling me from it altogether." It requires very great insight to look into each symptom and pick out the characteristic features of each drug. But thanks to giants like Clarke, Dunham, Farrington, Kent and others it has been possible to construct out of these seemingly unconnected and fragmentary pieces, living throbbing images of the drugs. Their labours have lightened our task considerably and we are now able to comprehend well the individuality of the drugs even without going through the records of provings. By repeatedly refreshing our memory from these books, we are able to have a good grasp of the subject. Moore says, "Four requisites to an intelligent study and application of homoeopathic Materia Medica should be recognised. First, a thorough knowledge and intelligent understanding of the

philosophy of Homoeopathy so far as this is revealed; second, such a familiar acquaintance with the names, appearances and properties of remedies as comes not only from a knowledge of practical homoeopathic pharmaceutics, but from personal contact and handling of the remedies themselves... " Weisselhoeft advises the following method, "Now take the Materia Medica and divide it up in that way. Learn one medicine at a time, and then you are over the worst of it, but do not try to learn it alphabetically. That is like trying to learn a language by learning the dictionary by heart. All these methods require work and most people do not want to do that. Most of us would like to have a machine that would put it right into the brain without any exertion on our part. Take the chemical groups, the lead group,the arsenic group, the gold group. If you know one of the group well, you know considerable about the rest." Del Mass writes, "To study the Materia Medica so that one will not fall into some rut and become one-sided and weak in his armour of defense against disease requires many methods of study." "It is to be admitted that for the first years of study, each remedy should be studied alone until a vivid picture is obtained of its general characteristics, so that the physician would readily recognise in the symptoms of the sick individual the corresponding similia of the proven drug." "When we have to do with an art those end is the saving of life, any neglect to make ourselves thoroughly masters of it becomes a crime. "Do not think that when you have finished your college work you are thorough with the study of your Materia Medica; if you have learned how to study you have done well. It is when in active practice that the greatest amount of careful systematized study should be done." "There are great opportunities for modernization. We admit without hesitation that we have a cumbersome Materia Medica, but we also know that the real clinician is able to use it successfully. It is to be modernized first by literary research and analysis. The value is there, but we must subject the mass to modern methods to develop that which is of value." Different authorities suggest different methods of studying the Materia Medica. In general, all are agreed that the whole Materia Medica cannot be memorized. The Pulfords say, "We all know that it is impossible to memorize our Materia Medica. On the other hand, we all know how necessary it is to have an individual grasp of each drugs used." But many authors suggest that at least the leading characteristics of remedies should be memorized. Seibbert says, "We are called to the bedside of a patient, possibly a new family or an influential old family. We face a different proposition than books, quiz or society. We are facing a life and death situation. Under these circumstances it would be extremely hard to choose a remedy by totally relying entirely on memory. "I can call to mind cases in which I thought half our Materia Medica was indicated according to symptoms given, and then by chance, some leader would present itself and lead to the correct prescription. "For this reason I believe we should always keep leaders first in our memory, even at the expense of totalities." But yet, the process of study and simplification of the Materia Medica has not been taken to its logical conclusion, for, notwithstanding the coherent picture given by Kent and others,

students and neophytes find themselves struggling hard to grasp and retain in the memory the essential features of each drug. When we stepped away from the structure of Hahnemann's Materia Medica Pura and compiled a regular descriptive Materia Medica so that students may understand easily the action and uses of the various drugs, we have taken only the first step towards the goal of simplification. Further steps must necessarily follow. The idea is explained below. We do not conceive of drugs as mere inert material substances to be used in diseases on the basis of previous experience. Our conception is that drugs are living, vibrating personalities, each full of its own specific energy and capable of influencing life in all the three planes, viz. the physical, mental and moral (or spiritual). Each drug performs a specific type of work of a specified degree. We may even conceive drugs as constituting a separate world of their own specified field and function, just as we have in our society doctors, lawyers, teachers and so on. As in our human world, no one individual is completely similar to nor can completely replace another. Similarly no drug can be a completely satisfactory substitute for another. It should, therefore, be our object to study drugs as individuals and completely grasp their full individual characteristics so that at the right time we may call upon the right individual to do the right job. Symptoms evoked by a drug in the proving may seem unrelated to each other and even bizarre in nature. Yet, they have been produced by the particular substance owing to the impact of its own individuality on a particular organism which had been functioning in a coordinated and harmonious manner before the proving was done - the set of symptoms have been produced on account of an organised disturbance caused by the drug. Therefore, even though the symptoms appear to be parts of a jig-saw puzzle, if the essential personality of the drug is grasped, the various features will fit into a harmonious pattern. Therefore, the study of the action of the drug, viz., the Materia Medica should be done in an intelligent and imaginative manner. Pulford writes, "We must not merely teach our students to simply read the Materia Medica so that they may get just what little out of it they can but we must teach them how to study it, just what they must look for in a drug and how to find it. Our Materia Medica is vast, and the worst of it is that it is only a very small portion of what is to follow when the unfolding of Homoeopathy is completed; no single mind can grasp it; it staggers all newcomers who approach it, and it means no more than a vast amount of words to them, meaningless in their import, and thus a barrier. But with a charted map one can traverse the paths of what seems a vast tractless wilderness, with some degree of intelligence surely, and benefit." Diechmann says, "And we do not want to get the remedy diagnosis from physiological consideration but from the drug picture. Yet in modern medicine we must construct on the physical data, then the facts of the Materia Medica will stick more firmly in our minds and sometimes with very similar drug pictures it may be made easier to choose the right direction. It remains a matter of personal inclination how one creates order and lucidity in the compartments of one's brain." Schwartz writes, "To study the Materia Medica so that one will not fall into some rut and become one-sided and weak in his armour of defence against disease, requires many methods of study. "It is to be admitted that for the first years of study each remedy should be studied alone until a vivid picture is obtained of its general characteristics, so that the physician would

readily recognise in the symptoms of the sick individual the corresponding similia of some proven drug." In our efforts to study and understand the complete individuality of the drug, we should naturally proceed as we would do when we deal with a sick individual, for to the homoeopath the drug-picture and disease-picture are only counter-images of each other. Individuality comprises of the special inherited characteristic features moulded, altered or added to by the particular circumstances and influences to which each person is exposed. We have to study, understand, unravel and interpret the congenial and acquired attributes of the individual, subsequently modified by the circumstances. Every individual is to be studied in his own surroundings, in his own background, his actions and reactions being interpreted in that light. In absolutely the same way, we have to know, study and understand every facet of the make-up of each drug, to see if that could offer some clue to explain the peculiar activity of that drug. Such aspects as the morphology, habitat, physical and chemical properties, family relationships, group tendencies, elective affinities, the identity of substances, the sources and origin with particular reference to the nature of and behaviour of the original substance (mineral, plant or animal), traditional uses, physiological and toxic effects, medicinal and nonmedicinal uses, etc., should be considered and analysed. Every piece of information that may enhance our understanding of the drugs should be collected and collated. That morphology may offer some clue towards the action of the drug is a most ancient idea, from which arose the doctrine of signatures. This doctrine has been sufficiently ridiculed but, perhaps, it was not entirely baseless. The shape of the plants and animals, their size, colour, structure, etc., reflect their individuality. Even the crystals of various minerals ultimately assume the same shape and pattern with the result that we are able to recognise the original substance by looking at one microscopical part of it. So also is their individuality reflected in their actions (effects). If such is the case, if the shape and pattern as well as the actions reflect the individuality, is it not possible that the two are inter-related in a way we are unable comprehend or explain? The aspect of the Thuja patient, who has the waxiness and build resembling the plant, is but a crude instance of such a conception. Boger, writing on this subject, says, "The doctrine of signatures has been derided and is said to rest upon pure fancy but I know of no accident in nature and everything has an adequate cause; hence we should not be too ready to attribute such things to mere coincidences. Such correspondences are too numerous as well as too striking to be lightly passed over. It seems rather a case of not knowing just what they mean or what the real connection is. "At the risk of seeming to ask hard questions we may inquire why the time of the honey bee's greatest activity corresponds closely to that of the Apis aggravation? Why the poison of the sleepy surukuku snake is most active a little while after falling to sleep? Why Kali bichromicum crystals become tough on exposure to the air? Why the twining Convulvulucae cause twisting intestinal colics, etc., etc." The juice of Chelidonium is yellow, resembling bile, and it is one of the well-known remedies for jaundice and liver diseases; Corallium rubrum, the red coral cures red chancres. Boger further writes: "In the life history of every substance there is a mark which points towards its application. The doctrine of signatures is not all fancy even if correspondences have mostly been found in forms, a little understood subject. Striking things have their counterparts and their mutual connection is made clearer through symptomatology. While the

indications include subjective, objective, anamnesic and environmental effects, drug symptoms are also made up of much more than has been recorded and we read much between the lines." Clarke says, "Every mineral, every plant and every animal has its own living principle embodied in its form. The form is the expression of the principle. In a number of cases, the nature of the principle can be read from its form, and has been thus read correctly by primitive people from time out of mind. The common names of plants embody these character-readings; "Worm wood", "Worm seed", "Squaw root", "Snake-root" are a few samples. Arnica had been named "Fall Kraut" before Hahnemann discovered its power to produce bruises, and Bellis perennis, our Daisy (Day's eye), had been named "Eye bright", and Symphytum (which in Greek means: grow together) commonly known as "Comfrey" (from "confirm", which is the Latin counterpart of the Greek name, and means the same thing) had received its name "Bone-set or Bone-knit"- all before Hahnemann's time. Konig remarks, "The more we attempt to enter into the often impenetrable maze of the homoeopathic materia and try to bring order into the abundance and apparent random choice of all the symptoms, the more we feel the need for a new doctrine of signatures." Habitat has a great part in such moulding. Members of the animal and vegetable kingdom acquire certain properties by virtue of the soil and climate wherein they flourish, the quantity and quality of nourishment, water and sunlight they receive, etc. In this respect, they may be compared to human beings whose characteristics, habits and reactions are often moulded by the circumstances and environment of their life. Animals and even plants develop special methods of sustenance and self-protection suitable to the areas wherein they reside. One would almost think them to be human and that their behaviour is as much the result of intelligence as of instinct. All these inherited and acquired virtues and defects go to make up the individuality of the substance which is reflected in its actions and reactions. It is also considered by some that substances available on the spot are usually found most suitable to diseases arising in that area, as for example, Arnica montana which grows in mountainous areas, is useful for exertion and after-effects of mountain climbing, as also for the injuries sustained by climbers from falls. Aconite grows in dry soil and its symptoms are worse in dry weather. The idea is that the influences which go to produce the diseases peculiar to the place, also go to mould the drugs peculiar to the place which may prove useful for such types of diseases. The physical and chemical properties of a drug may be reflected themselves its symptoms. The yellow and red colour of Phos. reminds us of its action on the liver producing jaundice and its haemorrhagic properties. You must have observed that most substances with a strong smell like Ambra grisea, Asafoetida, Crocus, Moschus, Nux moschata, Valerian, etc., are hysterical remedies *. The chemical composition of substances often explains their action, e.g. the action of Spongia resembles that of Iodum closely, the latter being a constituent of the former substance. Both are better by eating. Ledermann says that the iodine component of Spongia can account for its effect on swellings of the testicle and epididymis. Lycopodium contains sulphur and hence much of its similarity to Sulphur; the close relationship of Pulsatilla and Kali-s, arises from the fact that Pulsatilla contains potassium sulphate. Lycopodium contains both Silica and Aluminium and has symptoms of both the drugs such as diffidence, constipation with soft but difficult stool, etc.; Antimonium crudum contains sulphur and it has similar aversion to and aggravation from bath and heat. Allium cepa also contains sulphur and has similar acrid discharge. Both Graphites and Petroleum contain carbon and have similar symptoms like Carbo vegetabilis. Graphites contains in addition 3% of iron and has several

symptoms of Ferrum in its pathogenesis. Kreosote also contains carbon and has black, offensive, burning discharges. Nux vomica contains copper and has all the spasms and cramps of Cuprum. Both Nux-v and Ignatia contain strychnine and produce similar convulsions. Belladonna contains Magnesium phosphate, and has spasms and pains. That marvellous teacher, Hubbard **, writes, "To simplify Materia Medica conning, one must ponder on the elements of which all other substances and man is made; one must analyse plants into their component simple substances, at least the predominant ones and feel one's way into the relationship of remedies. Who is not helped by knowing that Lachesis contains much sulphur or Lyc. lot of alumina? or Bell. some magnesium phosphoricum, and Nux vomica a share of copper?" Lapis albus is nothing but Calcium silico-fluoride and so covers tumours of bones. Pulsatilla contains Iron and both Pulsatilla and Ferrum have many common symptoms and are indicated in anaemic patients who are better by slow motion. Borax being Sodium Biborate belongs to the Natrum family and has similar aggravation from noise. Causticum, being a potassium compound has the weakness of the Kali group, extending to paralysis. Grimmer says Merc-s contains traces of Nitric acid; both are aggravated at night and are prominently anti-syphilitic. Analysing the action of salts Stonham says, "The analysis showed that in all cases the basic element predominates in its salt. The salt is more than the sum of the qualities of the elements that compose it. We may perhaps infer that the chlorides work in the direction of the arterial system, the bromides of the sexual organs, the iodides of the lymphatics and glands, and the phosphates of the skeletal and nervous systems, while the sulphates have a more general influence on the system generally. It may be that when we have a more certain knowledge of the correlation of the physiological action of drugs with their chemical structure, we shall be able to make a better prediction of the therapeutic value of their combinations." The family and group tendencies are also prominent, such as the sadness of the Natrums, the weakness of the Kalis, the neuralgic pains of the Magnesium family, the sluggishness of the Carbons, the glandular affections of the Halogens, the prostration of the Acids and so on." Further, a unique phenomenon exists in the field of chemistry, which Dr. Otto Leeser has explained in his book, that when all the elements of the mineral kingdom from Hydrogen onwards to Uranium are arranged in the order of their atomic weights (periodical table), every seventh element falls into the same group and exhibits similar chemical properties. The members of these groups of elements also exhibit similar drug effects in their provings. Under elective affinities, I wish to draw attention to the fact that most substances seem to have a strong affinity for certain tissues or locations. For example, Apis and Thuja seem to act well on ovoid organs like the kidneys, ovaries, testes, etc. Argentum metallicum acts on the cartilages, Bryonia on serous membranes, Cactus on circular muscle fibres, Capsicum on the mastoid process, Ceanothus on the spleen, Chelidonium on the liver, Digitalis on the heart, Euphrasia on the salivary and sweat glands, Kali-c on the lumbar region, Lachnanthes on the sternocleidomastoid muscle, Manganum on the ears, Nitric acid on muco-cutaneous junctions, Onosmodium on the female organs, Phytolacca on the mammary glands, Quercus on the spleen, Ruta on the periosteum, Sabal serrulata on the prostate, Staphysagria on the sphincters and genitalia, Terebinth on the kidneys, Ustilago on the hair and nails, Vipera on the veins, Xanthoxylum on the nervous system, Yohimbin on the sexual organs, Zincum on the brain and so on. By the identity of substances is meant the knowledge of what they actually are. Sometimes the homoeopathic Materia Medica is studied without a proper knowledge of the identity of the substances studied. One who has seen the jelly-like content of Aloe leaves will remember the

identical nature of the discharges produced and removed by the drug; one who has eaten the root-tubers of the Arum plant (Yam) especially in the raw or partly cooked state, will not forget the terrible rawness accompanied by great itching that it produces in the throat. Mercury on being dropped, scatters itself in a restless manner reminding us of the restless patient requiring Mercurius solubilis. Can we not understand the lachrymation and coryza of Allium cepa when we know it is the onion that has made cooks lachrymose? Similarly, we can appreciate the foetid discharges of Asafoetida; the pride under Platinum, a most expensive, and therefore proud, metal; the aggravation from petrol fumes and car sickness of Petroleum; the burning redness and pungency of Capsicum, the Cayenne pepper, etc., etc.

Sources and origin Knowledge of the source and origin of substances helps much. Sulphur comes from burning lava of the volcanoes and produces much burning. Amphisboena is prepared from the jaw bone of the lizard and acts markedly on the jaw. For substances of animal origin, quite often the behaviour and habits of the animals give a clue to their actions and uses. It is said that the Lachesis snake coils itself always from left to right, in which direction the symptoms of the drug also travel. One who has read about the habits of the Tarentula spider and its toxicological effects will easily comprehend the cunningness and quickness of the spider reflected in its symptomatology. Persons bitten become more or less insane every spring and then, on hearing the least musical sound, start dancing wildly. Though the music thus aggravates their condition at first, later they feel greatly relieved after they continuously dance for three or four days and become thoroughly exhausted. This is why, in homoeopathic repertories, this drug is given under the rubrics "Agg. from music" and "Amel. from music and dancing". The fact that the halogens, Bromine, Chlorine, Fluorine and Iodine as well as Spongia come from the sea explains their common characteristics and the influence of the sea on their symptoms. So also is the effect of the sea-shore exhibited in drugs like Nat-m, and Sepia, which originate from the sea. We can also appreciate the fact that animal poisons (like Lachesis and Apis), poison the mind and produce suspicion and doubt; that substances found together in nature like Carb-v and Kali-c, Selenium and Sulphur, Arsenic and Phosphorus, Cadmium and Zinc, are similar in symptomatology; that Belladonna grows in Calcareous soil and hence the close relationship between Belladonna and Calcarea. The very touch of the Spanish fly Cantharis produces a blister and it is thus a remedy for burns. The nature of the drug is also very useful. Drosera is an insectivorous plant. Whenever any fly sits on the leaf, the leaf slowly closes, imprisons the fly and secretes a juice which is able to digest the fly. It is also able to similarly dissolve bones and glands as in tuberculosis. Further, sheep eating Drosera leaves develop a nocturnal cough and die. Dro. is a well-known remedy for cough at night and for tubercular glands. The plant Rhus tox is said to be most poisonous in rainy weather and the symptoms of that drug are worse in that weather. Pulsatilla, also known as the wind flower, is a remedy for women who are reputedly changeable like the wind. Nat-m being salt produces a lot of thirst. Potassium has a toxic effect on the heart and Kali-c presents many heart symptoms. The traditional and other uses of drugs also give much information. Bellis perennis (Daisy) is used as a remedy for injuries. Even after being trampled upon, the flowers come up smiling. Aloe has been traditionally used for inducing abortion because it is able to bring out everything involuntarily, including the stools and the rectum. Bufo has been made use of to produce impotence by women who find their husbands sexually overactive. Stramonium has been given to produce insanity, Opium has been used to produce constipation and a sense of

well-being and when these symptoms are found in the sick, it is able to cure. Coffee is taken to produce insomnia, e.g. by students preparing for examination, and it is our well-known remedy for insomnia. Nux moschata is used by village women to keep their children quiet and drowsy while they go away for work. Cannabis indica is taken by addicts to experience glorious delusions and phantasies. Carb-v is used in modern medicine for flatulence since it has the capacity to absorb 40 times its volume of gas. Mercurius solubilis is used in the thermometers and barometers to indicate the changes of temperature and weather; Merc-s patients also react as quickly to such changes. Belladonna (Bella = beautiful, Donna = lady) was being used by women to produce brightness of the eyes and red cheeks so that they may look attractive. It produces all these symptoms in the sick, along with hot head and cold extremities. The dilated pupil * results in photophobia and the patient sees also visions as in Calcarea carb. Calc-c is the chronic complementary of Belladonna and it also has dilated pupils, hot head and cold extremities. Curare the famous arrow poison is used to catch animals alive since it paralyses the hind legs of running animals. Coca is a well-known remedy for the effects of mountain climbing. One traveller gives a remarkable incident showing the stimulant effect of the narcotic. He says, "An Indian was employed by me for very laborious digging; for five days he never tasted a mouthful of food nor took more than two hours of sleep at night, but at intervals of two to three hours he regularly chewed about a half ounce of coca leaves. Following this he travelled for two days across the high plains, keeping up with my mule, only halting to take his coca. At the end of this time he expressed himself willing to engage for a like amount of work and that without food if I would furnish him sufficient coca leaves. The village priest affirmed that he was sixtytwo years of age and had never been known to be sick a day... " Even when a knowledge of these various properties and features is unable to give us a comprehensive idea of the action of a drug, the essential symptoms of a drug may be remembered by an association of ideas and through hypothetical explanations. Such association of ideas and hypothetical explanations may not stand the test of scientific scrutiny but to the extent they may enable us to remember the symptoms, they will prove useful. For aiding the memory while learning, memorizing or teaching the Materia Medica, we can freely make use of mnemonics, e.g. Bry. is Dry (i.e. it has much thirst). Opium which comes from Poppy has P.P. P. (i.e. pin-pointed pupils). Podo. has Profuse, Putrid, Painless, Prostrating diarrhoea with Prolapse. Rhus-t is like a rusty hinge, i.e. worse on beginning motion; Apis had adipsia; Capsicum (the chilli) has generalised chilliness with local burning. Apis is derived from the honey bee. The queen bee is a most jealous creature, so jealous that after cohabitation with a male bee, it kills the drone because it cannot tolerate the idea of the drone having relationship with some other female bee, with the result that it is itself widowed. Apis is a remedy for the effects of jealousy and for widows. About the interpretations and explanations of the general actions of the drugs and their manifestations in various parts of the body, we no doubt find many precious hints, descriptions and explanations scattered in the writings of various authors, esp. Kent, Dunham, Farrington, Tyler, Wheeler, Neatby and Stonham, and Otto Leeser. Farrington writes: "We include all the symptoms that we observe. Then what have we? A mass of symptoms seeming to have no connection at all. They come from an organism that is all order and perfection, and all the parts of which are in perfect harmony. When even one of these parts is

out of order, then there must be a certain clue to string these effects together and picture a form of disease." So it is the stringing together that would help the beginner much but a task that is not completely done. To quote Dr. Wheeler, "Homoeopathy is primarily concerned with practice. If a symptom can be held to be the result of a drug-effect on the human body, then that symptom appearing in disease is an indication for the remedy. We may explain symptoms in various ways but their worth as pointers to a good prescription remains unaltered. "But to attempt to explain the possible mechanism of symptoms has value in that it may show relationship that makes possible symptom groupings. The memory is aided and it is conceivable if (or when) a fuller knowledge is available that a realisation of relationship will take the place of much more laborious symptom matching by enabling one or two observations to imply the whole picture. But while that day is far off, no apology is needed for an attempt to explain the why and wherefore of characteristic drug-symptoms." Thus Wheeler proceeds to explain the symptoms and attempts to give them a physiologicopathological basis so that the medical student can comprehend the picture fully. I shall also adduce some examples. Conium has symptoms such as "Great aversion to light without redness", "Agg. by seeing moving objects" and "Seasickness". Now if one can remember that Conium produces paralytic states, the whole thing is apparently explained. The paralysis of visual accommodation might be the cause of photophobia (without redness), and the inability to quickly accommodate to different distances may result in the aggravation from seeing moving objects (and also looking out from moving vehicles) and aggravation by turning the head quickly; the sickness at sea may also be added to by looking at the constantly moving waves. The constipation of Opium in the provings is not surprising when one knows that the drug produces profound depression of motor and sensory nerves and inhibits secretion. The inhibition of secreting glands may result in dryness of the alimentary tract and even when the rectum is full there may be no sensory impulses sent to the central nervous system; and again the expulsive power is lacking. The urinary suppression, and retention are also explained by the lack of secretion, insensibility, etc. The pathogenesis of Ip. and Ant-t contains dyspnoea, cough, vomiting, etc., possibly because they affect the vagus nerve, which supplies the respiratory passages and lungs, stomach, diaphragm and heart. The great congestion of the pelvic organs in Sepia must be responsible for the aggravation before menses, during coition, pregnancy, abortions, puerperium, menopause, etc., all of which produce congestion of pelvic organs. The ptosis of the organs owing to the atony of the muscles and ligaments result in prolapses and may be responsible for the sense of internal emptiness. Lachesis has agg. from touch and amel. by pressure. Hence in throat conditions swallowing of liquids and saliva aggravates, while deglutition of solid food causes relief owing to the pressure exerted. In Stramonium there is both agg. and amel. from light because the dilation of the pupils results in photophobia but in the mind there is a terror of darkness. This is why it has been described that the patient prefers to lie in a lighted room with his eyes turned towards the darkest corner.

Besides the use of the above data, we may even remember the symptomatology of a drug by imaginatively interlinking its symptoms and by visualising the underlying pattern. Let us take the example of Silica. Silica forms the major part of the earth's crust, upto 120 miles deep down. Just like the earth's crust, the Silica patient also gets heated and cooled easily and is agg. by heat and cold. The Silica patients are also characterised by deficiency somewhere and excess somewhere else. The head and abdomen are big and the body and limbs emaciated. There may be defective growth of bones, e.g. rickets, but there may also be exostoses; defective healing or excessive granulation; softening or liquefaction of hard tissue like bones, e.g. caries, or hardening of soft tissues like glands; weakening of fibre resulting in shyness and timidity, but strong will-power causing stubborness. In this last, it resembles their hair, which looks thin and yielding but is actually very strong, and of which Silica is a constituent. As the patient is stubborn, so do we find stubborn suppurations, ulcerations, sinuses, fistulae, etc. Silica has a peculiar lack of grit, the inability to carry out any task fully. This is even reflected in the constipation, where the rectum expels the stool but not fully, so that the stool recedes back. This has been called the bashful (shy) stool. Still more examples may be adduced to show how the personality of drugs can be comprehended by widening our horizon and trying to study all aspects of the drugs. But sufficient has been said to convey the idea. Such valuable hints, clues and pieces of information lie scattered all over homoeopathic literature, and it would take quite a long time for one to go through all these sources. If these details could be collected and presented in an interesting manner *, the beginner will have less difficulty in grasping the individuality of the drugs.

To the eager reader who wishes to follow this line of study of the Materia Medica, I may suggest the following literature:

Boericke William : Pocket Manual of Materia Medica Boger C.M. : Synoptic Key of the Materia Medica Clarke J.H. : Dictionary of Practical Materia Medica Farrington E.A. : Clinical Materia Medica Kent J.T. : Lectures on Homoeopathic Materia Medica Neatby and Stonham : A Manual of Homoeo-Therapeutics Lesser Otto : Text Book of Homoeopathic Materia Medica Pierce W.I. : Plain talks on Materia Medica Tyler Margaret : Homoeopathic Drug Pictures Wheeler C.E. : An Introduction to the Principles and Practice of Homoeopathy

Wright Elizabeth : A Brief Study Course in Homoeopathy Besides the above, I would also suggest to the reader to go through the various Materia Medica studies of Otto Leeser and D.M. Gibson in the British Homoeopathic Journal, of William Guttman in the Journal of the American Institute of Homoeopathy and Hubbard and Whitmont in the Homoeopathic Recorder. Random notes on some remedies As we practise Homoeopathy and are blessed with increasing success, our appreciation of Hahnemann turns into admiration, respect and reverence for his genius in discovering this method by sheer force of logic and experiment, in an age of ignorance and superstition, abounding as it was in bigoted quacks. The results of a few infinitesimal doses of the similimum, as compared with the effects of the large violent doses of the other systems, are simply delightful to watch and experience. To the convert especially, Homoeopathy is like an oasis and provides a cool refreshing drink after a hot and tiresome travel in the desert of palliative and suppressive drugging. Our repeated successes not only confirm the correctness of the similia principle but also provide verifications of the drug symptoms contained in the Materia Medica. The words of the Materia Medica begin to assume shape and take on life and form and the prescriber is able to see in actual practice what he has read in words. He thus becomes gradually acquainted with the drugs. First, when he meets them, he gathers an introduction, then a nodding acquaintance; as he meets them more and more in their various moods, he develops an intimate friendship and gets an insight into their make-up and personality. In course of time he is able to identify them more easily by their gait, speech, mannerisms, dress, behaviour, etc. Ultimately he can recognise them even if they are disguised. Thus, to the experienced homoeopath, the symptomatology of the drugs, which at first reading had appeared unconnected and even meaningless, slowly takes on some definite form and shape, at first blurred but gradually more clear-cut and distinct. His own mental images or concepts of remedies are naturally moulded, shaped or warped by the nature, extent and types of the cases he comes across, and since the experience of no two physicians can be exactly the same, it is quite understandable that these concepts of remedies in the minds of various homoeopaths, while being in general form identical, are likely to vary much in details. Therefore, it might be worthwhile to exchange our own concepts with those of others, for one's own impressions might prove new and useful to others. So, here follows a serie of rambling thoughts on some remedies. The reader who wishes to get more coherent and comprehensive pictures of the drugs should refer to standard books on Materia Medica. These notes were originally published in the Indian and foreign homoeopathic journals and I am grateful to the Editors for their kind permission to reprint them.

Alumina Alumina is not a remedy that is being used very often in homoeopathic practice but when one comes across the symptomatology of Alumina in a patient, one should carefully enquire if aluminium vessels are being used in the kitchen. It is well-known that in patients from cities, constipation is a common feature and very often patients give a history that they are forced to strain very hard at stool even though the stool is very soft. While this symptom might remind us of the remedy Alumina, it should also stimulate us to enquire about the use of aluminium vessels. Even if aluminium is not being used in the kitchen in the house, quite a

large number of people in the city take their lunch outside and in restaurants. The use of aluminium vessels for cooking has become very widespread all over the world because they are very light, become easily heated and are economical. There is no doubt that the aluminium from these containers gets gradually dissolved and ingested along with the food. Though a number of people may remain immune, it is certain that some people suffer severely from its effects, whether these effects are toxic or allergic. The role of aluminium in the causation of disease is not properly appreciated but anyone who has followed the investigations of Dr. Le Hunte Cooper, published in his various articles, will keep his eyes wide open for this source of trouble. Dr. Cooper, whose persistent and deep study of the problem is most admirable, in a learned article gives numerous instances of such reactions and sufferings. The booklet, "Aluminium, a Menace to Health" by Mark Clements also makes a strong case against the use of aluminium vessels. We are well aware that the cause of diseases should be traced and removed and/or neutralised and, therefore, one has to make careful enquiry in this respect to eliminate the possibility of aluminium contaminating the food. Among the numerous symptoms which suggest the possibility of aluminium contamination in the kitchen are two noteworthy ones. One is itching of the eyelids and especially the inner canthi, and another constipation where the patient has to strain hard even though the stool is very soft. The elimination of aluminium containers itself, where it is being used, often brings about improvement. I may quote from my experience one such case. "Mr. A.V. D., aged 18 years, consulted me for circular, bilateral and symmetrical patches of eruptions in both the feet below the ankles existing for two months. There was some itching with exudation of thin fluid on scratching and also formation of white scales. The patient was very fond of sweets and milk. He had constipation and had to strain for stool although it was soft. On enquiry, I found that aluminium vessels were used in his kitchen. Thereupon, I merely advised him to discard these and gave him no medicine. In nine days' time, he reported to me that the itching was much less and that the eruptions had started fading. In a month's time, without any medicine whatsoever, the patches had practically vanished though not completely. One dose of Morgan (Bach) 30 * removed the remnants." Incidentally, I have a feeling that many cases of skin disease, so common in modern times, may be due to the use of aluminium vessels. Alumina seems to be a most deep-acting drug and it has considerable resemblance to Causticum and to Lycopodium (Lycopodium pollen contain aluminium). It produces both paralysis and anaesthesia as well as paraesthesia. I have seen one or two cases of Alumina who had a craving for and aggravation from potatoes. One of my patients who needed Alumina, a young man of 28, used to eat raw rice by the handfuls. I was once able to cure a case of epilepsy where the patient reported to me that he got more seizures in summer and if he took potatoes. A very delightful case treated by me with Alumina is worth narrating. Mr. G.V. P., aged 51, consulted me on 15th April 1954 with the following history. In 1942, he had had an attack of Korsakoff's Psychosis. He was a cashier in the Railways, and one day he brought home all the office cash which was a considerable amount and told his wife that it was the money a friend had given to him for safe keeping. Next day, he did not go to office since he did not remember where he was employed but he explained to his wife that

it was a holiday. When he did not turn up for work, and as at the same time, so much cash was missing, the police were informed and they turned up at his house. When the truth came out and his peculiar behaviour became known, he was taken to the mental hospital where he became violent but after three weeks' confinement he became all right. In 1946, a second and similar attack occurred with defect in locomotion and other symptoms. He also developed a delusion that his friend had killed his child. This time he was examined by a good physician and it was diagnosed as a case of subacute combined degeneration of the cord. He was advised to continue liver extract injections daily for lifetime. Since then he has been regularly taking the injections. He became mentally sound and physically slightly better but otherwise his condition had remained stationary. When I examined him, he had a sense of weakness in the ankles and a sense of heaviness in the legs, but the soles felt numb and he felt as if he was walking on cotton or on a spring. On standing up, he was unable to move immediately, nor could he walk fast. He felt as if there was no life or strength in the nerves and in the chest. He could bear neither heat nor cold. He could not walk or stand with eyes closed. Previous history: In his younger days, his father had troubled him much and had driven him out of the house. Blood examination on 10.4.54 showed Kahn +++. I gave him a dose of Syphilinum 1M on 15.04.54 and advised him to discontinue the injections of liver extract. He experienced considerable improvement. The numbness and heaviness decreased markedly. On 20.07.54, the whole symptom-picture returned and I then gave him Syphilinum CM. He continued to progress were till 08.09.1954. His Kahn then showed one +. I now repertorized his case on Ken't Repertory and Boger's Synoptic Key with the following rubrics: Vertigo agg. closing eyes (K.p. 88); Agg. speaking (B.S. K.p. 28); Numbness of sole (K.p. 1043); Heaviness of lower limbs (K.p. 1015). It worked out to Alumina. I gave him Alumina 1M, 1dose and this produced remarkable improvement till 16.10.54. With this dose, he said he found "tremendous amount of good". He was able to walk much better, the feeling of walking on cotton became much less. Blood examination showed Kahn negative. I had to repeat the medicine on 16.10.54 and again on 24.06.55. Every time after the dose, he felt completely normal for several months. Unfortunately he went out of my observation and I could not check up on his further progress. But I am satisfied the Alumina did him "a lot of good". I was also pleased that he was able to discontinue the daily injections of liver extract and in its place got better improvement with 5 doses of medicine given during a period of 14 months. Ammonium carbonicum I was not using Am-c much and I used to wonder because the famous Dr. Benoyotosh Bhattacharya of Baroda had stated in a book that Am-c is one of the six gems among the homoeopathic medicines. Recently, a girl aged 18 years came to me suffering from repeated attacks of asthma agg. at new moon, agg. before menses, with cough agg. lying on the right side. I studied her case and came to three remedies, viz. Am-c, Lyc., and Sulph. Because Am-c had the respiratory symptoms, I gave her this remedy and she became completely well. We were giving her a dose about once in 15 days. Now she has been completely well for over one year.

I studied Am-c more closely and I was surprised to note that it is given in innumerable rubrics. It seems to cover many cases of Asthma. Many times I find that when we are using Ars., we ought to be using Am-c. Carb-v is a reaction remedy. We give Carb-v in chronic respiratory conditions where the reaction is poor. But actually, Am-c seems to act better than Carb-v as a remedy to promote reaction. For patients with coryza, who have obstruction of the nose at night, I used to give Ars. with some relief. When I looked into Kent's Repertory under the rubric "Nose, Obstructed, night", I found only three remedies in bold type, viz. Am-c, Lyc. and Nux-v. I gave Am-c and found that it gave much more relief than Ars. I had another very interesting case. "A boy aged 16 years, was extremely fat. 223 lbs in weight. Obesity is a symptom of Am-c though it is not given in Kent's Repertory under the rubric "Obesity". This boy had non-healing ulcers in the feet for many months. He used to spend money lavishly. If his father gave him some pocket money he would waste it. He would take a taxi and go round two or three times. Or he would take his friends to a paan shop and buy everybody a one rupee paan. He had excessive thirst for cold drinks. He would tell lies. He would often stammer. Am-c covered most symptoms. I gave him Am-c and all the symptoms improved." Since Am-c has 3 a.m. aggravation and is agg. by dampness, I think it might be more useful than Kali-c in Bombay. Am-c is very useful in old age. We give Carb-v to old people but Am-c may be equally good. You will find in the Repertory under "Obesity in old people", only Kali-c but Am-c also covers obesity and old people. So, many times when we give Kali-c, we have to consider if Am-c would be better. I have treated two other interesting cases: "Mrs. J.R. K., aged 49, consulted me on 9th April 1975 for rheumatic pains in joints, more on the right side of the body, worse in winter, worse by rest, better by motion. Recently, she gets pains in the right hip and pulsating, cramping and electric shock-like pains in right leg shooting down, worse at night between 1 and 3 a.m. She has to walk about to get relief or her husband has to press and massage the part. She is depressed in cloudy weather. Dreams of ghosts. The pains are in spots, moving or wandering and are associated with heat and redness. She gets angry when contradicted. Weeps easily and feels better. Used to weep while telling symptoms. She was disappointed with some relatives as she felt cheated. She had been given Rho. 10M, Sulph. 1M, Puls. 10M, Bry. 10M, Rhus-t 10M and Syph. 10M by some homoeopath without any relief. Her case was worked out with the following symptoms: Cloudy weather agg. Side right Pains, Wandering Motion amel. Rubbing amel. Pressure amel. Anger from contradiction.

The only remedy to come through was Am-c. Am-c also covered the background of grief, dreams of ghosts, etc. She was given Am-c 30, t.i. d. and she felt 25% better within a week. Thereafter, Am-c was repeated in various potencies ranging from 200 to 50M and she became 95% better. The rest was removed by Puls." Arnica montana If an allopathic physician is to be induced and introduced to study or practise homoeopathic medicine, the first remedy that I would recommend to him to study or use would be Arnica because this remedy is very simple to prescribe in case of injuries. When a person is injured, Arnica can be given without going into the detailed symptomatology and in quite a number of cases it is able to give relief. So the allopathic physician is able to use it easily and see the results. Later on, he can go into the philosophy of Homoeopathy and study and practise it the way it should be done. Whenever a person has been injured, not only the acute effects but even the chronic effects of this injury can be removed by Arnica, whatever its nature may be. I remember very well a lady who had developed a lipoma in the gluteal region after a fall. With few doses of Arnica, the size of the lipoma reduced considerably. Arnica is not only a remedy for the ill-effects of injury but also for the effects of overexertion. We know in this highly competitive society, every person specialises in the use of some particular organ, e.g. a typist or pianist has to continuously use his fingers, a singer his vocal cords, a trumpeter his lungs, an athlete his limbs, a proof reader his eyes and so on. All these persons can have relief from Arnica when they suffer due to the overexertion of particular limbs or organs. I once had a cricket player as my patient. This person used to start batting well but would soon become tired and get out. When he went to Australia with his team I gave him some doses of Arnica to be taken before and during the play. With these doses he was able to bat so well that I received a cable from his team-mates in Australia asking me to send the same medicine for all the eleven players! I once treated a girl suffering from Asthma which she had developed after overexertion. She had climbed a mountain with a party of her schoolmates. They made a bet as to who would reach the top quickest. This girl went ahead of everyone but after that she had developed Asthma. I saw her two years after the event and Arnica completely cured her. Sometimes Arnica relieves or cures a case in which there is history of an injury, however remote, and even though there seems no apparent cause-and-result relationship between the injury and the disorder. "Mr. A.D. C,. aged 38 years, consulted me for loss of vision in Aug. 1973. One morning on waking he found that he had lost his vision in the left eye. He consulted an eye specialist. It was diagnosed as due to vitreous haemorrhage. He took some vitamin injections and became well. The condition, however, relapsed after sometime and this time vitamins did not help. Now he had very little vision in the left eye. He could see vaguely the lateral part of the visual field. His blood sugar curve was normal. He gave a history that his left eye had been hurt by a stone in childhood. I asked him to consult an eye specialist. The eye specialist's opinion was "Vitreous haemorrhage in the left eye. The fundus could not be seen. Vision is reduced to perception of projection of light only for the left eye. Rt. eye is normal." Because of the old history of injury and the haemorrhage, I put him on Arnica 30, three times a day. After one month he told me that he was suddenly finding 2 or 3 big spots of clear vision through which he was able to see. And these spots of vision gradually enlarged. The same

medicine was continued and later, on 15.06.74 he was put on Arnica 200, daily one dose, which was continued upto 17.07.74. He was then able to read big letters like the headlines in the newspapers. Arnica 200 was continued and from 11.11.75 he was put on Arnica 1M, weekly one dose. In Jan. 1976, his office people offered to buy for him a scooter, if his vision was normal. He wanted from me a certificate that his vision was normal. As I felt that I was incompetent to give such a certificate, I sent him back to the eye specialist. The eye specialist examined him and certified that his vision was completely normal. So he was given the scooter by his office and this made him extremely happy." "I was consulted for Mrs. I.R. , aged 61 years, who had met with an accident days earlier. She had been knocked down by a scooter and had since then been comatose or semicomatose. She had been admitted in a hospital and treated but her condition had deteriorated and the attending physician had then said that the prognosis was bad, but that there was a small chance if she was operated immediately because he thought that it was due to a clot in the brain. Somehow, the relatives of the patient were not ready to submit her to an operation. So they decided to try Homoeopathy and I was called. When I saw her, she was semicomatose. If she was shaken and asked to protrude her tongue she would slowly open her eyes, pause and then respond slowly. Then she would lapse into coma. She could not speak. Since her bladder was not working, a catheter had been kept in. Her pupils were normal but not reacting to light. Because of the head injury and because she would respond and then lapse into drowsiness, I gave her Arnica 200, one hourly. Within 48 hours she was able to respond better, speak, and answer questions. Her coma was 50% better. Arnica 200 was then continued two hourly and after 4 days she was put on Arnica 1M, 3 hourly. She improved steadily. On the 12th day she felt an urge for urine and so the catheter was removed and she was able to pass urine by herself. She started complaining of severe pain in the bruised parts but later on this pain also came down. She then went home from the hospital. After going home she developed a rise of temperature. The urine showed 150 pus cells per field and the infection was attributed to the catheter having been retained in for many days. The symptoms indicated Lyc. With a few doses of Lyc. 30 the urinary infection also passed away. She is now quite well and is able to look after herself."

Arsenicum album Ars. is a remedy which is most useful when indicated in a variety of conditions, from asthma to arthritis, coryza to cancer, in the acute and chronic, benign or malignant conditions. Taking up my experience at the Govt. Homoeopathic Hospital I have to record that I have seen hundreds of cases of asthma and in nearly 50% of them Arsenic was found indicated. Originally it seemed to me that it could not be indicated in cases of asthma because asthmatic patients are aggravated by the least movement, whereas Arsenic patients are said to be better by movement. Very soon I realised that Arsenic is, of course, ameliorated by movement; but at the same time, it is aggravated by the least exertion, and movement is also a minor degree of exertion. This slight difference in interpretation gave a different angle and since then I have freely prescribed Ars. in cases of asthma and wherever it was indicated it

gave results. Thus in the treatment of a condition very rarely near death or dissolution, Arsenic has been found indicated very often and found to act very well, too. Incidentally it may be noted that only in a minority of cases fear of death was found in the patients. Ars. has nausea at the smell and thought of food, a symptom often found in jaundice associated with prostration. Ars. is a well-known remedy for jaundice (as well as for yellow fever). Another remarkable symptom is blackness. The discharges, the skin (eruptions, ulcers, discolouration, gangrene), lips, etc., all turn black. Arsenic is an antidote to tobacco and I have noticed that most smokers have black lips. When the stools are black, the possibility of haemorrhage from the upper part of the digestive tract should be considered; here again Arsenic may be indicated. I remember an elderly lady whose nose for some unknown reason had become intensely black. It was black as a crow. The lady felt like dying of shame. Whenever she went out, she used to cover it with a kerchief. Getting no other indications, I gave her Ars. which completely cleared it up. She became immensely happy. Ars. has not only burning sensation but the skin also looks black as if seared. Therefore, it has been found very useful in burns. Again in the treatment of extreme weakness amounting to prostration, especially after acute illnesses such as Influenza, where no other prominent indications are found beside the asthenia, Arsenic is found to be fairly effective. Where people complain of exhaustion without any other clear indications and without any apparent cause, Arsenic in low potencies does help. This seems to be such a wonderful drug, full of such wide possibilities and of benefit in such a wide range of diseases that I feel I could fill up three fat volumes only with Arsenic cases. But it not being my intention to give a full picture of the remedy, I only draw the reader's attention to some salient features. I also wish to draw attention to the mistake of putting undue emphasis on certain aspects of a remedy to the exclusion of other aspects. Greatest emphasis must be laid on one fact that seems to be widely misunderstood. Very often one is confronted with the question raised by brother homoeopaths: "How can you prescribe a drug when a symptom which is so characteristic of that remedy is absent? For example, how can you prescribe Arsenic when the patient has no fear of death?" The answer obviously is that the prescriber may expect all the characteristic symptoms of the patient to be present in the remedy but he should not expect all the characteristic symptoms of the remedy in any particular case; he will not overrule the choice of the remedy if it is otherwise well-indicated. Such absence can, at the most, have negative value only. If all the symptoms (given in the Materia Medica) of a drug, for example Arsenic be present in one patient, it is probable that he would commit suicide before he thinks of seeing a physician! When we notice how frequently this remedy seems to be needed in attacks of gastroenteritis and food poisoning, we are tempted to consider it almost as a specific for this condition. One of the keynotes is that whatever is ingested is vomited at once; and vomiting and diarrhoea occur often simultaneously. The effects of Arsenic seems to be rapid or sudden and intense, the emaciation, the weakness, prostration, the vomiting, etc., so that it is often needed in serious conditions and

emergencies. Arsenic is one of the lifesavers. Indeed, in so many cases which are serious or desperate, when death seems round the corner, Arsenic is often indicated and saves lives. I shall now describe some cases of Arsenic that I have treated. "A child, aged 31/2 months, was brought to me for diarrhoea. The child at birth had weighed only 4 lbs. and so was given a Durabolin injection for increasing the weight. He developed diarrhoea. But still, a second injection was given. Immediately the diarrhoea became worse. The child became so dehydrated that he had to be admitted in hospital and various medicines were given along with intravenous fluid. The child improved but the diarrhoea continued. They consulted good pediatricians and gave further allopathic treatment for nearly a month. But the diarrhoea persisted. Ultimately, they came for Homoeopathy. When I saw the child, he presented the following main symptoms: Diarrhoea agg. drinking; stool excoriating. On these and other symptoms Ars. 200 was prescribed. The child became completely well within four days." "The next was the case of a navigator, aged 43 years, working in an international airlines company. He suddenly developed a sense of sinking with nervousness and fear of death which was very much worse if he smoked. It was also worse by loss of sleep. He had all sorts of imaginary fears. He was most unhappy flying because he feared the plane would crash. He developed also trembling, vertigo and various other symptoms suggestive of neurosis. He had been given tranquilizers with no effect. Ars. 1M was prescribed. This cleared up everything. He said that within 3 hours of the medicine he felt completely normal in mind and body. The medicine had to be repeated four or five times for relapses but every time it helped him." Even where a case is incurable, homoeopathic treatment relieves the suffering and affords a painless end. Arsenic is one of the medicines which can do this. "An elderly lady, aged 58 years, came for consultation in 1953. She had severe burning pain in left hypochondrium with restlessness of two or three months duration. The burning was better by hot applications. She could not lie on the left side. She used to take 2 to 3 sips of water every half an hour. On examination, there was a hard tender mass in the area. She also had history of bleeding P.R. She had already consulted some doctors who had done Ba. enema and had diagnosed the condition as carcinoma of the transverse colon near the splenic flexure. The case was beyond surgery and only symptomatic treatment had been advised. Various sedatives had been given without any effect. The indications for Ars. were clear and I gave her Ars. 30. The very first dose aggravated her condition and so I changed to Ars. 6, t.i. d. With three doses of this medicine she felt dramatic relief, she felt completely all right in a day or so, and so she stopped the medicines. She remained completely well for six months without taking another dose of medicine. Then, one night at 1 a.m. she woke up, read some religious book, then had a sudden attack of dyspnoea, and she collapsed and died." "On 24 October 1960, I saw Miss P.D. , aged 7 years, with the following history and symptoms: She had puffiness on the face and around the eyes for the last 5 months. Five months earlier she had gone to see the Ajanta caves and had taken some allopathic medicine but then had developed puffiness of the face. She then took homoeopathic treatment and felt better but the condition has relapsed. In the last 10 days, the swelling has increased and she has put up

7 lbs. in weight. The average daily fluid intake is 600 cc and output is 300 cc. Oedema slight on feet. Ascites. No appetite. Thirstless. Wants cold air, uncovering, etc. Puffiness on face agg. morning. I gave her Apis 1M, 3 doses. She felt no better and the next day consulted some other homoeopath. She felt much better on his treatment for some months but there was again a relapse and I was called again on the case. I saw her now on 09.03.61 and the condition was as follows: The urine showed plenty of albumin, casts, and RBCs. It had been diagnosed as Nephritis. An eminent pediatrician had seen her and had given a very grave prognosis and had advised immediate hospitalisation. She had puffiness++ around eyes, oedema of feet and general anasarca. The urine output was 180 cc. No thirst. Fruits especially sour oranges, and curds agg. the swelling. The smallest piece of orange or apple causes immediate and intense swelling over the body with oliguria. I took the agg. from sour foods and from fruits as characteristic along with the other symptoms. On referring to Kent's Repertory, I found Ars. and Fer. coming through. As I could not decide between Ars. and Fer. I gave her Fer-a, 3 doses 6 hourly. Next day she had urine 3-4 times and stools 3-4 times. Swelling reduced. Fer-a 30 was continued, daily once for a week. The urine still showed proteins, ketones, pus cells, R.B. Cs, hyaline and granular casts. But the patient continued to improve steadily. Now and then there were relapses or short periods of no improvement, but in general she responded to Fer-a 30 every time and showed good progress. As the condition improved, the doses of Fer-a were reduced, first to one dose every 24 hours, then one dose every 48 hours, then one dose every 72 hours and it was stopped ultimately after ten months after the urine showed N.A. D. She remained well and was able to take all items of food including sour fruits. Later on, she had a severe attack of measles but recovered from it without any trace of albumin in urine. Repeated urine examinations done at various intervals showed N.A. D. and two years later she was still well." The following was a case of multiple sclerosis treated by S.R. Phatak. "Miss P.B. , aged 24 years, came on 21st Jan. 1971 with the following history: In 1964 her sandals started coming off her feet while walking. Later, one morning on rising she found she could not stand up. Also her legs felt heavy and she could not control her urine. She was kept in an allopathic hospital for 2 months and later on treated for 2 or 3 years with slight improvement. Again she got a relapse and then she could not keep her balance. In 1967 she was hospitalised again in another allopathic hospital and it was diagnosed as multiple sclerosis (postero-lateral sclerosis). She felt better with Vit. B1, B2, folic acid and Prednisolone, but gets agg. if these are stopped. Now she has weakness esp. in the legs. The body shakes if she stands. She goes back involuntarily while standing. Appetite, thirst, etc., are normal. Weeps easily, Irritable, Company amel. Past History: Severe smallpox at the age of 11/2 years. Fam. History: M. aunt had Parkinsonism. M. uncle had cancer. Sister had Koch's. On Exam.: Extremities are cold. Squint. Kneejerks ++ Jt. sense absent. Plantar extensor, Abdominal Reflexes absent. Power in lower extremities diminished esp. left. V.D. R. L - ve. Carcin. 1M and Tub-bov 1M, were given with no effect. On 13.02.71 she was mildly slapped on the back by her brother and after that she felt very weak. Arnica 200 and Rhus-t 200 were

given but the condition remained the same. Syph. 1M followed by Rhus-t 1M t.d. s. was given with no effect. She now said the weakness of lower limbs was agg. from anger. Zn. 30 and Zn-p 30 were tried with no result. So Dr. Phatak was consulted on 16.03.71. He prescribed Ars. 1M, b.d. for a week. She felt amel.. She was able to stand and walk better but the jerks were same as before. Power in lower extremities improved considerably. Ars. 1M for sometime and then 10M was given. By 26.06.71, she felt completely well. She has stopped the vitamins and other medicines and still feels well. Power in legs is much better but the plantars still remain extensor and abdominal reflexes are still absent." "Dr. M.M. S., aged 50 years, an Asst. Medical Officer in a Railway Hospital, saw me on 5th July 1972 for the following complaints: He had chronic gastritis with colicky pain in the lower abdomen in April 1971 and again in June 1971. It was associated with vomiting, the vomitus containing mostly acid, sometimes food material, sometimes brown and once fresh blood. Vomiting relieves the pain. He had a mental upset before the attack, as he became disappointed in his service, not getting promotion in spite of working hard. Gets pain in back and knees. Loss of sleep causes headache. Fats make him feel sick. Fasting upsets. Cannot tolerate tight clothing. He craves for sweets and has aversion to fats. He has quick ejaculation. He is suspicious, impatient, irritable, indecisive and gets offended easily. Past History: In 1938, he had Malaria; had suspected Koch's (lung) in 1950 and fully recovered. H/o fall from scooter, had become unconscious. Fam. Hist.: One sister had insanity. His case was repertorized in Kent's Repertory with the following rubrics: Grief, ailments from (p. 51), Food, fat, Agg. (p. 1363), Offended easily (p. 69); Desires sweets (p. 486); Vomiting, Amel. (p. 411); Aversion to fats (p. 480). Ars. alone came through. Ars. 30 was given b.d. for one week and then once a day for two weeks. He improved and continued to improve till he became well." Calcarea carbonica Although the mineral elements constitute a relatively small amount of the total body tissues, they are essential to many vital processes. The balance of ions in the tissues is of great importance. For example, normal ossification demands a proper ratio of calcium to phosphorus, the normal ratio between potassium and calcium in the extracellular fluid must be maintained to ensure normal action of the muscle and so on. Certain mineral elements, principally sodium and potassium are the major factors in osmotic control of water metabolism. Other minerals are an integral part of important physiologic compounds such as iodine in thyroxin, iron in haemoglobin, biotin, coenzyme A and lipoic acid. The animal body requires seven principal mineral elements, viz., calcium, magnesium sodium, potassium, phosphorus, sulphur and chlorine. These minerals constitute 60 to 80% of all the inorganic material in the body. At least seven other minerals are utilised in trace quantities, viz., iron, copper, iodine, manganese, cobalt, zinc and molybdenum. Several other elements are present in the tissues but their functions if any, are not clearly defined. These include fluorine, aluminium, boron, selenium, cadmium and chromium.

Clarke says, "Calcarea is one of the greatest monuments to Dr. Hahnemann's genius. The triad of remedies, viz., Sulphur, Calcarea and Lycopodium can be called Hahnemann's magnificient gifts to humanity. Indeed, we shall be extremely poor without these excellent remedies - Sulphur, the predominant antipsoric, Calc-c, the excellent antisycotic and Lyc., the marvellous anti-syphilitic." Hippocrates lauds the use of lime water in several diseases but it was used in its crude form and it was Hahneman's genius that created valuable remedies from apparently inert and innocuous substances like Calcarea, Silica and Lycopodium. Chalk which is a main source of calcium consists of the deposits of the remains of millions and millions of the shells of sea animals - of sea life that has come to a standstill. Thus calcification represents standstill, immobilization and death. In the human body dead tissues become calcified. Even the calcium in the blood goes out of circulation and is deposited (in the bones). The bones, as one of the hardest tissues in the body, represent stability and give firmness and stability to the body; as in case of the brain and spinal cord, the surrounding bony tissue, viz. the hard cranium and the vertebral column provide protection to the soft, pulpy nervous tissue. Calc-c is prepared from the snow-white middle layer of the oyster shell. The oyster shell is formed by the calcareous secretion of the oyster which is the result of its attempt to protect itself from the external environment. It is well known that all living creatures originated from the sea; the sea represents perpetual agitation and movement, whereas the earth represents solid stability and inertia. So the oyster in its attempt to protect itself creates a covering for itself (shell) and thus also provides itself with a house and thereby unconsciously stabilises itself on terra firma. The stabilisation and lack of mobility is exhibited in the symptoms of Calcarea by inertia and agg. on movement and exertion. Just as the solid oyster shell came out of the liquid sea, so also throughout the symptomatology of Calc. is the tendency to solidify, to precipitate, to coagulate. So this tendency is seen in the formation of calculi and clots, the clots of course serving to protect the organism from excessive bleeding. Calcium is present in the body in larger amounts than any other cation. It is the most abundant mineral in the body and 90% of the Calcium is found in the bones and teeth (in the form of calcium phosphate). The very small quantity left out of the skeletal structure is in the muscles and body fluids and is in part ionized. Ionized calcium is of great importance in blood coagulation, in the function of the muscles and nerve, and in the permeability of membranes. Calcium is never found in its natural state. It is generally found combined with carbonic acid (H2CO3 or H2O + CO2 , i.e. water and carbon dioxide) to form calcium carbonate. The acid element is reflected in its sour discharges, sweat, urine, stool, etc. Calcium promotes a tendency to hardening of the liquid and a tendency to soften in the solid. The bones become soft and even flexible as in rickets while the tissue fluids lose their watery element and may even coagulate, e.g. blood, milk, etc. In blood, calcium and phosphorus are always found in inverse proportions. If the calcium level is raised, the phosphorus level falls. The Calcarea and Phos. pictures are often opposed to each other - the Calcarea which is dull, slow, fat, while the other is sensitive, quick and grows thin and tall.

The parathyroid glands have a direct effect on the calcium metabolism. When their function is increased the blood calcium rises and this may lead to calcification of the renal tubules, formation of calculi, etc. When the parathyroid hormone is decreased, the blood calcium level falls and convulsions are produced (tetany). The body is constantly trying to protect itself from disturbances whether from outside or inside. The former is achieved by walling off, and the latter by stabilisation. The walling off can be physical, mechanical, chemical, biological, etc. The skin, the lymphatic glands, the bones (e.g. the cranium) all take part in this and Calcarea affects all these tissues. Once the body puts up a protective layer and walls itself, this walling itself symbolises a completion of development and an obstruction to further growth and development as is noted in Calc-c. Once the solids precipitate, the liquids naturally have to be eliminated and so we have a profuse elimination of fluids as sweat, urine, etc. In fact, the Calc-c patient has a hydrogenoid constitution and is worse by dampness, getting wet, washing, etc. Gutman has described the Calcarea patient as the boneless man. As calcium phosphate is the main ingredient of bones, the patient suffers from bone deficiency conditions like rickets. Even in late childhood the fontanelles may remain open. Calc-c is a chalky substance and it has whitish, milky discharges. It is also aggravated by milk. The patient may have a craving for inedible substances like chalk, rice, etc. This craving for peculiar substances termed Pica, is often associated with anaemia (causing pallor). The patient may crave for eggs and salt. The Calc. patient is notoriously aggravated by physical exertion. The physical stamina is extremely limited and he is worse by any exertion such as ascending, eyestrain, etc. Even mental exertion may aggravate and produce a sense of heat in the head. The following remarkable case will illustrate certain characteristics of Calc-c particularly the aggravation from ascending. "I was once called upon to treat a very fat gentleman from Goa, Mr. M., aged fifty. He had a peculiar symptom. If he went up the stairs or went up an incline he would develop haematuria. He was seen by an urologist who did a cystoscopy and diagnosed it as due to a polypus in the bladder. An operation was advised but the patient did not want to undergo the same. So he consulted me. I selected and gave him Calc-c. Within 2 or 3 days the haematuria disappeared and never recurred." We read that Calc-c children are usually fat and flabby. But my experience is that at least 50% of them are not fat and flabby, at least not in India. When you refer to Kent's Repertory under the rubric "Appetite increased with emaciation", you find Calc-c given in bold type which means Calc-c also covers emaciation. Secondly, I have treated many fat Calc. patients with Calc-c on the totality of the symptoms. On this remedy they feel considerable improvement but I find that they do not reduce in weight as I expect them to. In fact, I have found reducing a patient's weight a great problem. From the description in the Materia Medica, you feel that they are very chilly but sometimes they are not so. I have seen Calc-c patients who are as hot as Sulph. But unlike Sulph., even when they complain of burning in a part, that part is cold. Tyler aptly describes that the Calc-c patient has fatness without fitness, tissues of plus quantity and minus quality.

While the Calc. patient has less physical stamina, the Silica patient seems to have a lack of mental stamina, or grit. There are many resemblances between the two - both are aggravated during and have late dentition, have aversion to and agg. from milk, are agg. by exertion, have desire for indigestible things, etc., but the mental features are much different. The Silicea patient is more intelligent and active than the Calc. patient. This difference has been brought out very well by Borland in his wonderful book, "Children's Types". The Sil. child is said to be sharper than Calc., more shy, timid and obstinate. Calc. craves for salty food, Sil. prefers cold food. Both Calc-c and Sil. have offensive foot sweat. Calc. has painless glands while Sil. has painful ones. If I get an additional history that the child has had a very bad vaccination, I choose Silica. Calc. has a craving for eggs * and salt **, and an aggravation from both. A very large number of children seem to require Calc-c in my practice. They have gradually a large sweaty head and a large abdomen, spindly legs, with a h/o difficult and late dentition. Many of them do not put on weight. (I have noted that Calc. is one of the remedies for emaciation inspite of excessive appetite.) If the head is hot and extremities cold, they require Calc-c. If the abdomen is sunken, I prefer Calc-p instead of Calc-c. When a patient has a craving for a substance which aggravates him I consider this a very good symptom. E.g. Ant-c has craving for and agg. from sour foods, Nit-ac from fatty food, Nat-m from salt, Arg-n from sweets and so on. Calc-c has a big head and a big abdomen. The big head may be due to rickets or hydrocephalus or any other disease. I have treated successfully several cases of hydrocephalus with Calc-c. The big abdomen may be due to distension, fat, tumour or ascites or any other condition. We are not to worry about these, but only see whether the totality of symptoms is matching. Calc-c is also a remedy for growths including warts, polypi, etc. Some drugs have some peculiar symptoms which often guide us to the remedy. One such extraordinary symptom of Calc-c is that the patient is ameliorated when constipated. This symptom it shares with Pso. and Merc. I once treated a lady with many complaints who mentioned that if only she would remain constipated, all her problems would be solved. This put the remedy in my mind. Whereas Sulphur has heat in spots, Calc. has coldness and perspiration in spots. I have seen many Calc. patients perspiring on the head or elsewhere during sleep or while they are eating or drinking. One patient used to have perspiration on the forearm while chewing (betel leaf). Calc-c is a hydrogenoid remedy and is agg. by dampness like Rhus-t. It has got the same aggravation from lifting and pain as if sprained, and is a remedy for old sprains. Calc-c is often the chronic of Rhus-t. Belladonna is the acute of Calc-c and children who require Bell. for their acute attacks (such as tonsillitis, fever, etc.) will required Calc-c for a cure. Calc. has a hot head and face and dilated pupils like Bell. The patient has not only photophobia but he also sees objects beside the visual field or on closing eyes, or is sleepless. "Mrs. S.Y. D., aged 25 years, had urticaria of 5 years duration. This had started the last summer after her last delivery. Attacks of urticaria come on with chilliness. So she covers her body but then she gets burning. There is also burning in soles. The attacks are agg. by mental upset, becoming angry, if she is chilled, and by eggs. Last two years, she has frequent urging for urine with burning during micturition which is agg. in summer. She has an aversion to milk.

Thirst, 1 to 2 glasses per day. She is very obese. Menses are scanty. Her condition has been diagnosed as due to E. coli infection. Almost all her symptoms were covered by Calc-c. So she was given on 13.3.1962, Calc-c 200(3), 6 hourly. She started improving. Later, she was given Calc-c 1M and then 10M. By 21.10.62, she was quite normal." Whitmont summarizes as follows: "Calcarea is standstill, passivity, immobility, clinging, restraining, peripherally enclosing, restricting, ingoing, negative, a holding in, receptive principles." I have noted the following symptoms in my book under Calc-c : Coldness and sweat in patches, haemorrhages, cramps and convulsions, tetany; milky secretions, itching; sneezing amel.; vertigo agg. open air; coryza alternating with colic or diarrhoea; averse to warm cooked foods; hunger with coryza; frequent urination; hot semen; ammoniacal; cough agg. piano playing; cramps in calf, agg. night, stretching leg or foot, urticaria amel. open air. Other peculiar symptoms of Calc. compounds noted are: Calc-a, Royal calls this the kidney member - very sensitive to pressure in the kidney region; Calc-i has high fever; Calc-f covers leucoderma. Calc-hypophos has suppurative conditions, marasmus and night sweat. Also it has ravenous hunger agg. 2 hours after a meal amel. when stomach is full. Calc-p is agg. thinking of his disease, has pain in all bony prominences and hunger at 4 p.m. Carbo vegetabilis Carbo vegetabilis belongs to the famous carbon family. We meet carbon in its various forms in all the three kingdoms - the mineral, vegetable and animal. It is an essential constituent of all organic substances. It is found as coal, animal carbon, carbo sulph., the diamond (Adamas), graphites, petroleum, kreosote, lamp black (Fuligo splendens), etc. The various other carbon derivatives, and the various compounds of carbons like Am-c, Anthorkokali, Barc, Lith-c, Mag-c, Nat-c, and Stront-c, all used in Homoeopathy, have their own broad fields of action and wide indications, covering a large number of conditions. Staffelstein also mentions Carbocarnis made from calves' flesh and includes among carbons the roasted sponge and toasted coffee. Carb-s, Carbo oxygenisatum and Carbo hydrogenisatum are also well-known remedies. Hahnemann was laughed at by Pareira for filling up thirty five pages with the symptoms produced by the millionth of a grain of this inert substance, but prominent among the wonders of Homoeopathy is the miraculous development of the powers of inert vegetable carbon into a most extraordinary, life-saving remedy. Considering that it is an essential constituent of all living organisms, carbon can be called the basis of life. This life-giving property of the element can be seen in its action when it is able to save persons who face imminent death, or even those who show signs of apparent death. It has therefore been called the corpse-reviver, a designation it rightly and richly deserves as the following experience of mine will prove. "In the very early days of my practice when I had very little courage and even less confidence, I was called to see a poor patient living in a hut. When I went and saw him, I found him unconscious. The history as reported by the relatives was that he had been

vomiting and purging for the last 48 hours, on an average about 50 times a day! I found him in a completely dehydrated and collapsed state. The body was cold. The pulse was extremely feeble and thready. And as I was feeling it, it stopped for a few seconds and started beating again. This happened 3 or 4 times and I felt sure that he was dying. I was too nervous to treat such a serious case. Also, I honestly felt that he required hospitalisation so that he could receive glucose, saline and electrolytes which might improve his slender chance of survival. So I advised the relatives to shift him to the hospital immediately though I felt a doubt within myself whether he would reach the hospital alive. As I was preparing to leave, the relatives requested me to at least give him some medicine. Without any hope whatever, I gave them a dose of Carb-v 30, advised them to dissolve it in water and give it orally at the rate of one drop per second and then I left. This was in the morning. In the evening when the relatives came to report, I enquired whether the patient had been admitted to the hospital and if he was better. When they told me that the patient was still at home, I was enraged and I scolded them severely for their stupidity. Then they explained to me that no sooner had I left, they had called for an ambulance. The ambulance came in half an hour but by that time the patient had become conscious. He had asked for water, drank it and had retained it. So the ambulance driver told them to wait. For the next two hours there was no vomiting or stool, so the ambulance man left, promising to return at once if required. Till evening there was absolutely no vomit or stool. This was the situation. Entirely surprised by this news and yet unable to believe in the capacity of the medicines to tackle such a serious case, I warned them that still the patient may need immediate hospitalisation, and that though I was giving them a dose of medicine, they should be ready for any emergency. They promised to obey and left with another dose of Carb-v. Next morning they turned up again with the report that there was no further stool or vomiting. I was very pleased and surprised, and decided to go and see the patient. They then told me that I could not see him because, being poor, he had gone away for work!" This reminded me of the case of the washerwoman treated by Hahnemann who became quite well with his dose of Chamomilla but did not report to him because she was too busy working. The action of Carb-v and such homoeopathic remedies is so strange that we feel puzzled about the whole thing. How does the body restore its lost fluid and electrolytes without glucose saline and electrolytes being given? How does the patient get back his energy so quickly without rest, convalescence and tonics? Of course, this would be a typical case of Carb-v almost out of the text-books. But Carb-v is indicated in all kinds and degrees of lack of reaction from the mildest to the most serious. So we should not expect in every case all the typical symptoms such as coldness of the body, extremities, breath, tongue, etc., which are to be found only in the most desperate cases. Carb-v is an inert substance. The keynote of the drug seems to be inertia. The inertia or sluggishness may be expressed in diverse ways, in the sluggish reaction, in the sluggish digestion, in the sluggish circulation, etc. The deprivation of blood naturally starves the important organs of the necessary amount of nourishment and leads to deficient functioning, as, e.g. the stomach cannot digest the food, the heart cannot pump enough blood (causing breathlessness and/or air hunger), the body reacts badly in diseases so that diseases are not thrown off so easily and leave behind obstinate complications or sequelae. The poor circulation is also exhibited in the coldness of the extremities and the blueness of the skin surface, etc.

One of the finest indications for Carb-v is when a patient comes and reports that he has never been well since an attack of some infectious disease. Carb-v is considered almost a specific for asthma originating from an attack of measles or whooping cough. One of my teachers used to repeatedly state that the expression of a patient, "Never well since..." should always put Carb-v in one's mind whether it is after an attack of pleurisy, or any acute infection of even an injury. He has treated numerous cases successfully with Carb-v on this indication, even when the existing symptomatology of the patient was not characterised by symptoms of Carb-v. I have found this a most valuable and practical hint. Carbon is an inert substance and the remedy Carb-v puts in our mind the idea of inertia or sluggishness; its symptoms are characterised by sluggishness. The sluggishness is everywhere - in reaction, recuperation, circulation, digestion, etc. Let us first consider the sluggish reaction or resistance. In the last Asian Influenza epidemic, I myself suffered from flu. Thereafter, I became extremely weak and even prostrated, and the prostration persisted from day to day for several days without abating the least. The prostration was so severe that I had not the strength to lift my little finger. But two doses of Carb-v restored to me all my original vigor and strength and I was then myself able to treat hundreds of cases in the epidemic. During and after the epidemic, we had quite a large number of cases who turned up with similar post-influenzal asthenia and/or cough. Almost all of them improved quickly with Carb-v after they had been treated by the allopathic doctors without any result. The only difference was that instead of the two doses I had needed, many of them required several doses. Most of these patients required Carb-v 1M, twice a day for a week, some for a fortnight and a few upto one month before they were completely relieved. I can also recall two sisters who suffered after influenza. "Miss N.I. , aged 23, had developed the following symptoms after an attack of "Flu". A feeling of tightness of the skin of the face agg. in the evening. Itching of the inner canthi of the eyes. Profuse leucorrhea. M.P. irregular, scanty or profuse, blackish; pain in the throat, ears, back, spine and occiput. Feels as if she is pulled down to the ground agg. evening. Feels as if her breasts are falling or being pulled down. Stitching pains in fingers and soles. Feels prostrated. Tired of life. Fears being alone, disease and death. Feels guilty as if she has done something wrong. Pain in abdomen going into the genitals. She had indurated and tender swelling in both the breasts. After all investigations (including X-rays of the skull and spine) had shown N.A. D., it was labelled as neurosis. Ignoring completely her symoptomatology I gave her Carb-v 1M, t.d. s. at first. In four days, she felt about 40% better. The remedy was continued b.d. for 3 weeks and she became completely normal." "Her sister had also developed after "Flu" tender, indurated swelling of both the breasts, with sudden attacks of pain in them. I put her also on Carb-v 1M, b.d. for 2 weeks and she became well." Sluggish reaction is also a feature of old age and Carb-v is one of the remedies for complaints of old people. The mucous membranes of the stomach and its glands are sluggish and therefore the production of acid and pepsin must be poor. This leads to sluggish digestion which creates a

feeling of heaviness in the stomach. Coal is used for producing (coal) gas. It is often used in its crude state by allopathic doctors for absorbing gases in G.I. tract. (Charcoal is said to absorb 40 times its volume of gas.) It was also used as a deodorant and is applied to putrefying ulcers. But instead of using crude carbon to absorb the gas that is produced and to remove the offensiveness, we utilise potentized carbon to prevent the formation of gas and to prevent putrefaction. There is such flatulence that the patient feels bloated all the time though this is relieved by belching. The eructations relieve the patient as a whole. Probably the inactive stomach and sluggish digestion allow organic fermentation leading to formation of gas. Sometime back, I had developed for no apparent reason a sudden feeling of distension in the stomach while eating. I used to feel that with the first morsel of food, the stomach was bloating up like a balloon and stretching out. With two or three morsels, I would become actually uncomfortable and overfull and I had to stop eating but if I stayed on at the table for a few minutes, I would belch once or twice and then feel much better, and could take some more food. This went on for three or four days. Then I took a dose of Carb-v and within half an hour I could do justice to a real full-style Punjabi dinner. As compared to the distension in upper abdomen amel. by eructation of Carb-v, Lyc. has distension of lower abdomen amel. by flatus. And both are complementary remedies. (It is said also that a weekly dose of Carb-v helps to prolong the action of Lyc.) Sluggish circulation produces its own complications, such as varicose veins, varicose or nonhealing ulcers, oedema of dependent parts, icy coldness of the various parts such as hands, legs, knees, nose, tongue, etc., even the breath may become cold, and the physician may feel a cold fear clutching at his heart when facing a Carb-v such as amel. eructations, amel. fanning, etc.; then this remedy will be positively useful. The following case of varicose ulcer was an interesting one: "Mr. J.B. had thrombosis in the left leg in 1935 and since then has a permanent swelling in the foot. In 1952, he had vasectomy done and then had developed some eruptions which increased in size, suppurated, burrowed and opened, forming a painless ulcer, which had shown no tendency to heal for the last 8 years. I found the ulcer bluish in appearance. He was put on Carb-v 1M in August 1960 and in 4 months the ulcer healed completely." Coal (which is itself the product of combustion) and coal gas are used for burning as fuel. Carb-v has burning with external coldness, and the burning may be relieved by heat as in Alumina, Arsenic, Caps. and Lyc. When this coldness is associated with a condition of collapse, then we definitely consider Carb-v. Carb-v is as good a remedy for collapse as Ars. but the collapse picture of one is very different from that of the other. The Carb-v condition may come on gradually and can be somewhat anticipated whereas Ars. is characterised by suddenness. Secondly, the Carb-v patient may go on to collapse and may pass away quietly while the Ars. patient, even in the extreme stage of collapse, is restless; the Carb-v has no anxiety, whereas Ars. is full of agony and anxiety and so on. Carb-v generally contains small quantities of potassium carbonate and this may explain both the complementary relationship and the similarity between this remedy and Kali-c. Both are chilly, both antidote the ill-effects of loss of fluids, both are flatulent and weak and both affect the heart, producing myocardial weakness. But there is a main difference in the modality, viz. Carb-v is amel. by fanning and Kali-c is agg. by it.

Carb-v is one of our best remedies for the effects of too much drugging. This indication of Carb-v is particularly useful because many patients come to us after having been drugged a good deal. It is said that in 1930, the apothecary Thorey swallowed one gram of strychnine (which is ten times the lethal dose) along with 15 grams of charcoal powder but remained well. Carb-v is a remedy for death and local death leads to decomposition and offensiveness as in gangrene. While there is excessive gas in the upper abdomen, there seems to be insufficient aeration or oxygenation. We know how CO and CO2 have specific effects on the respiratory centre. There seems to be sluggish oxygenation with consequent desire for air or for fanning - Air hunger. There is desire for fanning even though the patient may be cold and may feel cold. Improper oxygenation also leads to another prominent symptom, viz. blueness or cyanosis. Lutze reports a very peculiar case. A lady had taken a large amount of charcoal tablets during her pregnancy, as she said in order to have a beautiful baby. The baby was not as beautiful as she had wished but at each nursing of the baby the mother had a severe cutting pain in the abdomen. Lutze could not find this symptom in any Materia Medica, but on the history mentioned above, he gave her Carb-v CM, two powders which cured the trouble. I am also reminded of a case of Koch's abdomen which responded to Carb-v chosen in peculiar circumstances. "This patient, Mrs. L.S. G., aged 35 years, was admitted in our hospital on 29.02.68. She had been directed by an eminent homoeopath from a mofussil town and had been already diagnosed as a case of Koch's abdomen. Her history and symptoms in brief were that she had pain in abdomen of four years' duration agg. by milk, agg. after eating esp. spicy food. She had oedema of feet which had appeared first in the left and then in the right foot, vertigo, weakness agg. in sun, burning in anus after stool, thirstlessness, poor sleep , amenorrhoea since 2 months with a h/o profuse menses; mentally irritable. Physical examination revealed a doughy abdomen and cracks in the angles of the mouth. Routine investigation showed: Urine n.a. d., Stool: R.W. ova., Blood: n.a. d. We repertorized her case and came to some remedy. She was given this remedy for three days with no change. But on 03.03.68 at 5.15 p.m. , for no apparent reason, she suddenly developed symptoms of collapse. She became comatose with extreme coldness of body, very low B.P. and with a feeble, thready pulse. We put her immediately on Carb-v 200 and then on 1M. She rallied and slowly came out of the state of collapse. Finding that she responded well to Carb-v even as regards her abdominal pain and other original symptoms, we continued to put her on Carb-v, giving it at intervals, first in 1M and then in 10M potencies. She responded so well that by 27.03.68, she was quite normal and we discharged her. Her weight went up from 27 kg to 32 kg. Then treatment was stopped. After nine months, she had a relapse of the abdominal pain (not collapse) but with Carb-v 10M she became completely well. She has remained well for eight years." Dr. Mistry, a surgeon from Sholapur, has reported several remarkable cases in which Carb-v has proved consistently far superior to any allopathic drugs in post-operative shock. China officinalis

The normal indications for the use of China (such as the ill-effects of the loss of fluids, flatulence not better by flatus, pain agg. by touch but amel. by pressure, etc., etc.) are known to all homoeopaths but I have found China useful in two different conditions which I shall describe. "Mr. J.V. D., aged 62 years, came on 01.01.74 for treatment of gangrene of the toes of the left leg from which he has been suffering since 1970. He had been advised amputation which he had refused. History and symptoms: In 1970, one toe was crushed and had suppurated. It was operated twice but did not heal and gangrene had set in. Later two more toes were affected. Then it was diagnosed as chronic vascular insufficiency due to atherosclerosis. He had pain in the leg agg. 10 to 11 p.m. , amel. pressure, agg. letting the leg hang down, agg. walking, amel. cold water application, agg. in sleep, even in afternoon sleep. He had a suicidal disposition. Head heavy, with vertigo and nausea sometimes. He also had twitching on rt. side of the face and rt. side of tongue with black patches on tongue. Lips black. Pain in soles at night, wakes up 45 times due to pain. Cannot wait for food. Loquacious. Prev. Hist.: Malaria in childhood. Used to smoke 50 cigarettes a day for 45 years. High B.P. since 1947. Now B.P. 200/130. The affected three toes are black and gangrenous with a very offensive discharge. I took the following rubrics in Kent's and Phatak's Repertory, viz.,Tobacco; Injury; Gangrene; Suicidal; agg. in sleep; Rt. side; Black. China alone came through. He was given China 30 and he started improving. With repeated doses of China 200, he became well. The gangrenous toes healed. We stopped the treatment on 29.03.75. " On looking into Hering's Guiding Symptoms, I do not see any indication of gangrene under China though I do find the following symptoms "Pain with swelling of the big toe worse by touch and motion, esp. evening and night", "Red swelling of the two tips". I have used China in two cases in which the patient had dark pigmentation of the skin. I have mentioned that I have found Ars. useful in this condition. But when Ars. fails, I think of China. The following two cases will illustrate this point. "Mrs. M.G. , aged 48, has black pigmentation of the whole Rt. upper limb, last 11/2 years. She had had a hysterectomy done and took pencillin injections. Two months after that, the pigmentation has worsened. Appetite, thirst, etc., are all normal. No other symptoms. This has been diagnosed as Toxic melanosis. I gave Ars., Sul-ac, Vipera, etc., all with no effect. Later on, I put her on China and thereafter she improved very well. She is now 90% better." "Miss P.S. K., aged 17, had blackish patches on the anterior aspect of both legs for last many years which were agg. with new moon (increasing with waning moon). I put her on various medicines like Phos., Ars., Puls., Merc-s, Calc-c, etc., with no amel.. Because of the experience quoted above, I gave her China and she is now nearly normal." I have found Chi-a indicated by the symptom, "Diarrhoea agg. from eggs and fish". The patient may be suffering from any disease but if this symptom is present, we must consider Chi-a.

The following cases will illustrate this point: "A boy, P.N. , aged 3 years, was admitted to the hospital on 11 June 1957, with a history of oedema of the lower limbs, puffiness of the face and oliguria of five years' duration with intermittent remissions and exacerbations. His case was taken thoroughly and all investigations done, and a diagnosis of hypoproteinemia was arrived at. The oedema was aggravated by taking fish or eggs. The symptoms indicated the probable similimum as Chi-a. Therefore, the patient was put on Chi-a 200, t.d. s. whereupon his urine output, which originally averaged 6 to 8 oz. per day, gradually and steadily rose to 78 oz. per day within a fortnight. The puffiness and oedema considerably lessened and then disappeared. The patient was kept under observation for six months and he continued to remain well." "I remember another case of a middle-aged person. He was admitted in the Govt. Homoeopathic Hospital with general anasarca and his case was also diagnosed as hypoproteinaemia. In his case also, he gave a symptom that his oedema was worsened by taking fish or eggs. On admission, his urine output was only about 6 or 7 oz. a day. But after Chi-a, the output increased steadily and went upto 170 oz. or so daily which continued for several days, so much so that he nearly became dehydrated. The medicine was discontinued and he became well." Chi-a has oscillating temperature in fevers like Pyrogen. I had the opportunity to treat such a case. "I was called to see Mr. S.S. K., aged 21 years, son of a well-known allopathic doctor who was also running a nursing home. The boy was studying for M.B. B.S. I saw him on 3rd Sept. 1972. He was getting fever from the 2nd week of July and had been treated with Chloromycetin and Betnesol. The fever had come down and he was well for 11/2 weeks. But he had fever again on 30th July. His W.B. C. count was 12 100 (poly. 62.5%) and he responded to Ledermycin and was all right for three weeks. He started attending his college. But again he got fever on 21st Aug. with shivering. This time it did not respond to any of the allopathic medicines. So I was called in by the parent who, being a doctor, had become anxious, especially because several consultants had prescribed for him with no result. The present situation was that he was having daily remittent temperature. The temperature would rise upto a maximum of 105 or 106 ºF at any time with chill. The fever used to go up and down very quickly. For instance, if the temperature was 98 ºF at 9 a.m. , it might be 104 ºF at 10 a.m. He gets burning of palms with the rise of temperature. Gets pain in left shoulder and hip and cramps in calf muscles occasionally. Gets offensive stools three to four times a day. His maternal aunt had suffered from T.B. His case was repertorized in Phatak's Repertory with the following rubrics: Fever high, hyperpyrexia (p. 105); Fever, Oscillating (p. 104): Fever, hectic (p. 104); Only Chi-a came through. Chi-a 200, 8 doses to be taken every 3 hrs. was given. Within 2 days he felt better. The maximum temperature was only 102.8 ºF. Now Chi-a 1M, 6 doses t.d. s. were given. Next day, the temperature was normal upto 4 p.m. but rose thereafter.

Chi-a 1M was continued t.d. s. and by 09.09.72 the temperature came down and remained normal and thereafter, it did not rise. The boy started attending college from the 11th. The father who had planned for a long convalescence was surprised both because I permitted the boy to attend his college from the 11th and also because the boy himself felt no weakness and was able to attend classes. There has been no recurrence of the fever for over 3 years." Where I have failed with Ars. and China in dark pigmentation of the skin without any other symptoms, I have succeeded with Chi-a. Cimicifuga racemosa On looking around for the collateral remedies of Ignatia, one comes across Cimicifuga. Boger calls it a hystero-utero-rheumatic remedy and, considering the wide incidence of hysterical, rheumatic and pelvic disorders in women, one feels that Cimic should have a wide application in practice but is not as well-utilised as it should be. Cimic is as bewildering in its symptomatology as Ign. It has a variety of pains: aching, shooting, soreness, shocks, etc., representing myalagias, neuralgias, etc. The symptoms change in location and nature so rapidly that the patient of today seems to be a different person from the patient of last week, and so one suspects a strong neurotic element in the case. Often one is unable to make head or tail out of the case, both as regards the remedy as well as the diagnosis, for the symptoms seem to be everywhere and of every sort. The patient is absolutely nervous and apprehensive as well as gloomy, so gloomy in fact that she feels "as if she is enveloped by a black cloud". Like Sep., this patient is also aggravated during puberty, climaxis, menstruation, suppressed menses and pregnancy. "One remembers the case of a nice old lady who came for treatment full of tears due to years of suffering. She was aged 60 and complained of pain in the left knee of twenty years' duration. She could not stand or walk and the pains were mostly aching with stitching pains being superadded sometimes. The pains were all over in various places and often shifted from place to place. She also used to get cramps in various muscles. She had vertigo on first beginning to walk with a feeling that she would fall to the left. Cold baths aggravated her. She also had an oedema of feet for the last 5 or 6 years. She mentioned the fact that she had menopause at the age of 40 after which all her troubles had started. The case was repertorized (with Boger's Synoptic Key) with the peculiar symptoms of Climaxis aggravation, wandering pains and aching. The only remedy that came through was Cimic. The very first dose of Cimic 200th gave her enormous relief. She received in all three more doses at intervals of 2 to 3 months, which wiped out the whole trouble. She is well now for over ten years." One has been led to the remedy by a peculiar symptom in the patient, viz. an aching, stiff or rheumatic pain in the nape of the neck which is relieved by throwing the head back and moving the neck to and fro. The impression has probably been created that this is a remedy for females only. This, of course, is false, for any remedy in the homoeopathic Materia Medica may be indicated in any person for any disorder, provided the symptomatology of the drug and the disorder correspond. The case of a male patient who required Cimic may serve as an example. "Mr. G.R. S., aged 36, a stenographer by profession consulted me for the following disorders:

He had been suffering from pains in all the joints and muscles of the body for the last two years. The pain was constant and aching in nature, especially worse during the cold wet weather and on rising in the morning. He had pain in the heels while standing, pain in the gluteal region while sitting, pain in the back while lying on his back, pain in the fingers and palms while writing, in the areas on which the pen exerted pressure. On analysis of the symptoms, they were reduced to the following rubrics in Boger's Synoptic Key: 1. Pressure, agg. 2. Dampness, agg. 3. Aching 4. Joints 5. Muscles. Only the remedy Bryonia came through but that did not seem to fit the case. But when the first rubric, pressure aggravates was bypassed in the repertory, one came to Bry., Cimic, Phyt. and Rhus-t. 1000th potency of this drug cleared up the case completely within two months." It is a pity that the drug is not mentioned under "Pressure agg." in our repertories. One might have completely failed in this case without a knowledge of/or reference to the Materia Medica. Basing one's conclusion on this case as well as on many other such cases, one is led to the impression that the symptomatology of Cimic is not wholly and well represented in our repertories. Conium maculatum Poison hemlock (Conium maculatum) has been made famous in history because the great philosopher Socrates died by drinking it. When Socrates was charged with corrupting the morals of young men and was condemned to death, it is said that he spent his last hours discussing philosophy calmly with his friends. As calmly, he took the poison and drank it himself. Then he died, after describing minutely the effects of the poison. His disciple Plato has written down a graphic description and this is one of the best descriptions of drug action, equalling the drug provings of Hahnemann. Conium has ascending sensations: the numbness and paralysis ascending from the feet, the coryza ascending from throat, etc. It has vertigo agg. by the least movement such as of the head or eyes. This, combined with its trembling, uncertain gait, progressive weakness etc., makes it ideally suitable for conditions of old age. Conium is a remedy for complaints associated with suppression of sexual desire due to (religious) celibacy or other causes. My friend Dr. Sarabhai thinks that it ought to be a good remedy for Christian priests, Jain Sadhus and others. It seems to have a specific effect on glands, particularly on the mammary glands esp.; effective in injuries to these glands and is a very well-known remedy for injury to the breasts. I have used Conium in the numerous such cases with great satisfaction.

"Mrs. M.K. , aged 28, came with the following disorder on 10th May 1959. She gets a cold swelling of the rt. forearm before every M.P. during the last two years. The swelling is painful and she describes the pains as "cold pains". Formerly, for 5 years she used to have painful nodular swelling of both breasts before every menstrual period. This is now replaced by the present disorder. If she gets swelling in the forearm, she does not get the swelling of the breasts. She now desires more salt. Fears being alone, yet dislikes company. Must drink water in order to swallow solid food. Vertigo on rising from sitting. Is afraid of robbers. Past Hist.: She gives a history of mild injury to the breasts some years back, just prior to the onset of the disorder. She has been married for 10 years but has no children. Phys. Exam.: No tenderness or redness in the swelling. Wt. 120 lbs. B.P. 130/80. Otherwise N.A. D. The characteristic symptoms of this patient were found under the remedy Conium. So, she was given, on 10.05.50, Con. 1M, 3 doses in one day. Next month she reported that she had no swelling of the breast before the menses. The third month it recurred again but one repetition of Conium 1M set things right and she has been quite well now for several years, neither the swelling of the forearm nor that of the breast having recurred." "Mrs. D.D. , aged 44 years, came on 12.01.60 with the following history: Two months back she had a lump in the lt. breast. Immediately mastectomy was done as it showed signs of malignancy. Now she feels stiffness in operated area. Has a node in rt. breast and constipation. H/o fall in childhood? Had dislocation but it was not diagnosed for 15 years. Because of the node in the breast and the h/o operation (injury) to the breast, I selected Conium. I gave her Conium 1M, 3 doses in one day, on 12.01.60. By 03.02.60 the node in the breast became smaller and the stiffness better. Conium 1M (3) was repeated twice again and by 29.04.60 the node disappeared and her condition became quite normal." "Mrs. M., aged 32, an English lady, consulted me on 23.10.73 with the following complaints: In sun, gets rt. supra-orbital headaches, the right eye feels bruised. Headaches are worse by smoking and lying with head low. She is afraid of thunderstorms. She gets constant pain in the breasts worse before the menses, the breasts become very sore and tender and the pain is worse stepping, jarring and turning over in bed. Past Hist.: She had fibroadenoma in the breasts which had been removed, first in the rt. then in the lt. I took the following symptoms for study., viz. Tobacco agg., Sun agg. and Pain in breasts before the menses. I got Calc. and Con. Of the two, I preferred Con. because of the modalities of the breast pain, viz. worse on stepping and turning in bed. With Con. there was marked improvement and she became completely well. She said that what all the medicines in U.K. had failed to do, the homoeopathic medicine had done, and for the first time, she was able to walk without consciousness of her breasts."

Ignatia amara In modern times the incidence of neurotic disorders seems to be rapidly rising and in this sphere Ignatia is particularly useful, of course, only when it covers the symptom-totality of the particular case. Modern civilised life, especially in the cities, seems directly to give rise to repressions and conflicts, and to expose the individual to many types of anxieties. The increasing demands of modern life present many problems, and as a result there is a constant sense of insecurity. Ignatia seems to cover very well the results of such tensions and emotional imbalance. The following interesting example may serve to illustrate how Ignatia helps to antidote the ill-effects of worry, however remote and persistent. "Mrs. B.V. , aged 33 years, consulted me for the following disorders: She had recurrent headaches, attacks of vertigo, periodical oppression in chest and wandering pains in the limbs. Her menses were irregular and the flow was generally very profuse lasting for six or seven days. She has been suffering for the last six years. The whole disorder had originated after a period of intense worry, just after the birth of her last child. She had consulted numerous physicians and gynaecologists and had taken much treatment without any benefit. She had come to me for consultation late at night and so I had taken down these few symptoms just to satisfy her. I called her back the next week in order to complete her case, but in the meantime as she insisted on getting some medicine I gave her one dose of Ignatia 30, more as a stop-gap, instead of placebo. She returned after a week and gave me the surprising news that the second day after the dose of medicine, she had passed through her vagina, a large black lump (clot of blood?) the size of an orange and since then, she is completely relieved of all her pains and troubles! She had her menstrual period also immediately following and, this time, it was quite normal. She thanked me profusely "for diagnosing the existence of the lump which no gynaecologist had been able to do and for expelling it with the medicine!" In the field of neurosis, where psycho-analysis and suggestions are used, often with unsatisfactory results, the appropriate homoeopathic remedies work most speedily and satisfactorily. Among such remedies Ignatia has its own wide sphere of application. It covers all the immediate and remote effects of worry, grief and disappointment. And is there any limit to the possibility of worry, grief and disappointment in people's lives? The wonder of Homoeopathy is that the appropriate remedies are able to antidote the end-results of all these emotional disturbances even while the causative factor might be still operating. They seem to restore to the mind a sense of proper perspective, equanimity and a new philosophical attitude. This attitude represents a completely re-adjusted state of mind and, therefore, is far superior to the artificial euphoria induced by modern tranquillisers, wherein the patient feels well but continues to be ill! The typical patient requiring Ignatia, afflicted by grief, becomes morose, shuns company and weeps, her weeping is worsened by company and consolation. The following case typifies some aspects of the Ignatia symptomatology. "Mrs. C., aged 30, consulted me for recurrent attacks of convulsions (hysterical). She is married to an old widower. There being a great disparity in their ages, she is apparently dissatisfied, sexually and otherwise.

Just as I was preparing to note down her case she got an attack and I was enabled to observe the symptoms of the actual seizure. During the seizure, though she appeared to be unconscious, she was weeping bitterly. Her teeth were clenched but at times there was involuntary to-and-fro movement of the lower jaw. She had a sighing respiration. I was told that these attacks lasted usually one or two hours, and that after the cessation of these attacks, she had a profuse flow of urine. I found all these symptoms under Ignatia. So a phial of Ignatia 1M was procured and as her mouth was clenched and shut, the phial was held below her nose so that she inhaled from the phial three or four times. Thereupon, she opened her eyes, sat up, went and passed urine and then was normal within about five minutes. Later on, Aur-m completed the cure." The sighing of the Ignatia patient, usually a symptom of grief or anxiety neurosis, may be described by the patient in different words and found under the appropriate rubrics in repertories, e.g. sighing, taking deep breath, inclination to take a deep breath, breathing deeply ameliorates, etc. When a person has been seriously disturbed by grief and continues to suffer from anguish, we think of other deep-acting remedies, which are complementary to Ignatia. Here is a friend who has suffered, perhaps, a serious financial loss, perhaps the loss of someone very near and dear. We console him and then leave him alone expecting that time will heal his wound. But when we meet him again sometime later, we find him still in the same state of depression, asking us, "What is the use of life when my so-and-so is dead ?" The next time he may ask us, "Is it necessary to live ?" or, "Why should I live?" When we meet him yet again, he might be more dejected and may ask, "Is it not better to die?" This may slowly change to a desire for death and ultimately end in an attempt at suicide. Many have committed suicide in this frame of mind. These are the various stages in any of which Aur. will help to restore the patient to normalcy. Then again, we have met the typical disappointed lover (so often depicted in our Indian films) who wanders from place to place in shabby clothes, with a shaggy beard, supremely indifferent to the environment and immune to the comments and criticisms of the people. Or he might sit in a place and go on staring blankly into space, completely disinterested in everything, even in food and drink. Nothing seems to touch him or affect him . He is like a piece of wood. His mind is blank. He remembers nothing except perhaps his disappointment. Sometimes he has polyuria, a symptom we found under Ignatia too. He only needs Phosphoric acid. The next patient, it is reported, has become sullen and irritable. He dislikes consolation, hates fuss and avoids company. No sooner we go and sympathise with him, he jumps at our throat. In addition he is much aggravated by heat especially of the sun and often has a craving for salt. Of course, he requires Natrum muriaticum in potency. This other victim of grief is a woman. Ever since she had a shock - possibly she has lost a dear child - she has become very irritable and moody. She detests fuss, hates sympathy and help. She hates her friends who fuss and despises her husband who comes to her help; she is annoyed with her children who make so much noise and who make so many demands on her when she is so tired. She abhors her very house where she has to work so hard wearing her fingers out, from morning till night. She loathes her miserable existence which is nothing but a

life of drudgery. In addition, she is chilly but the heat of the room is intolerable. Sometimes all food and drink tastes salty to her. She feels empty in her stomach but she cannot eat because she has nausea. She also has disgust for sex. Does she need anything more to make her disgusted and desperate? But life can once again become interesting and full of joy for her, if she has a dose of Sepia. Finally, we meet a girl who suffers from the after effects of grief. She weeps so easily and sobs pitifully and gains all our sympathy. Our sympathy helps her, for after the sobbing, having been patted and petted she feels bright once more. Of course she needs Pulsatilla. Unlike the Sepia patient who is often a mature adult with many children, and who as a result of much experience in life, pleasant and otherwise, ups and downs, has developed a lot of grit so that, however miserable she is, she does not break down or give vent to her sorrow soon, our Pulsatilla patient is usually a tender, inexperienced girl who is soft and easily upset. Physically she is agg. by heat and is thirstless. The effects of grief and their remedies can be tabulated as it may appeal to some minds: Grief Acute effects + Chronic effect= Ignatia Sadness + Depression = Aur. Sadness + Apathy (Suicidal) = Phos-ac Sadness + Irritability = Nat-m Sadness + Disgust = Sepia Sadness + Tearfulness = Pulsatilla Sadness + Quarrelsome = Staphysagria Sadness + Hysterical = Cimicifuga One can now see how the same causative factor affecting different persons is able to evoke different types of reactions, and how we have remedies which have provided in the provings varying types of effects, so that each individual kind of reaction can be matched perfectly, and the patient cured. The homoeopath is particularly looking for symptoms which are peculiar, strange or rare. When this strangeness of a symptom exceeds all limits and becomes paradoxical and contradictory and goes against all accepted ideas of physiology, pathology and commonsense, one should think of Ignatia. Wherever there are contradictory symptoms, even if such symptoms are not mentioned in the Materia Medica under Ignatia, one should consider Ignatia. Some examples are: Sense of lump in throat amel. swallowing solids; Difficulty in swallowing liquids but not solids; Vomiting amel. indigestible foods; Hunger with nausea; Emptiness in stomach not amel. by eating; Stool soft but difficult; Cough agg. by coughing; No thirst during fever. It should not be misunderstood that Ignatia is merely a hysterical remedy. It has been known to give relief to cases of dysentery, gastritis, diarrhoea and plague! The criterion is only whether the symptoms of the patient are covered by Ignatia.

We should remember that Ignatia contains strychnine, which is also found in Nux-v. The difference seems to be that the strychnine in Nux-v produces spasmodic or incoordinate effects, whereas in Ignatia it causes erratic or contradictory effects which, by the way, is an extreme degree of incoordination. There is a further major difference, viz. whereas the Ignatia patient is moody, capricious, lachrymose and morose, the Nux-v patient is extremely impatient, irascible and violent. The trigger for the Ignatia patient is grief while that for the Nux-v patient is anger. The Nux-v patient resembles Staphysagria. To sum up the mental state of the Ignatia patient, the symptoms of this patient are caused or aggravated by grief, anxiety, worry and chagrin and the patient is always sad, sighing and silently sorrowing. The patient likes neither consolation nor contradiction, and the symptoms are always worse when others are present. The patient is not only sad but also enjoys being sad! Kalium carbonicum "The Kali-c patient is a hard patient to study, and the remedy itself is a hard one to study." This sentence in Kent's Materia Medica had always intrigued me. I had always wondered why one particular remedy should be more difficult to study. However, I did notice that for many years the number of cases for whom I was prescribing Kali-c was very low as compared with the cases for whom I was prescribing remedies like Sulph., Calc., Sep., etc. So I came to the conclusion that I must not have understood Kali-c so well. However, I came to understand Kali-c better recently as I shall describe. My mother, for some reason, started emaciating and became steadily and progressively weaker. She went on losing in health to such an extent that I became very anxious. This had started after she got frightened when my brother had high fever and had to be hospitalised, apparently in a serious condition. She had right-sided complaints (like headache), fullness after eating even a little, irritability, weakness and pain in the lumbar region, etc. She was 65 years old. I gave her Lyc. She felt some relief but I myself could see that she got only partial relief but I studied her symptoms more carefully and got the following picture: 1. At the end of a meal she would feel a sense of blocking in the chest as if the food remained there, with nausea and retching. This was relieved by eructations. 2. Palpitation immediately after every meal forcing her to lie down. 3. Eating little causes fullness. 4. Eating a little more aggravates. 5. Difficulty in swallowing solids esp. if they are cold. 6. Chilly. 7. Anaemia. 8. Unable to sit, talk or walk because of weakness. 9. Weakness in lumbar region esp. while walking. 10. Throbbing in the suprasternal notch and epigastrium.

On studying the case I felt that the remedy was clearly Kali-c though in Kent's Repertory it is not found under the rubric "Ailments from fright". I gave her Kali-c and thereafter, she improved remarkably, became well and remains well now for several years though she requires doses of Kali-c on and off. My nephew once got an attack of whooping cough. Night after night he would get cough for 2 or 3 hours. I could not decide his remedy. So I, for 2 or 3 days, watched him and then noticed that the paroxyms of cough would start at 3 a.m. and would last upto 6 a.m. or so. I decided to give him Kali-c the next morning but I forgot to do so. The next night, he again started coughing at 3 a.m. After the first paroxysm of cough, I gave him a dose of Kali-c 30 though, advisedly, a remedy should not be given during a paroxysm. After that one dose there was no further paroxysm of cough that night or the next night or any other night. And I remember not to have heard him cough at all for the next several years. It so happened that I myself once required Kali-c. I had a number of symptoms like weakness in the lumbar back and pain in the lumbar region as if it was bruised or broken. I became very chilly and got headaches if exposed to the cold air. Also, in cold air there would be stitching pains in the ears. All these complaints were worse after coition or after seminal emission. Because my mother had improved on Kali-c, and I had so many symptoms of the remedy, I also took Kali-c and found that it had very good effect. For the next two years or so I noted very good improvement. A few weeks after each dose, when the effect disappeared, the pains, etc. would recur which would disappear again the next day when another dose was taken. Once Dr. Koppikar of Madras quoted Allen about Kali-c, that it covers complaints of old and fat people. At that time, I had a Sindhi lady patient who was old and fat and was having pain in the knees worse by beginning motion. It was diagnosed as osteoarthritis. Since fatness in old age itself is a peculiar symptom, though the case seemed to work out to Calc-c on all her symptoms, I decided to try Kali-c and was surprised to find good results. Since then, whenever I see any old, fat patient, I consider first whether they have Kali-c symptoms. This is because Kali-c does not come out very well when cases are repertorized. And because I depend much on the repertory, possibly I have been missing this remedy. And now when I am looking for Kali-c, I do find many cases requiring the remedy and improving. So now I understand Kent's remarks. Boger says under Kali-c, "Everything affects the small of the back." Though T.F. Allen says that Kali-c is not indicated in fever, I have cured a febrile case of pericarditis with effusion with Kali-c. "A female patient H.S. , aged 27, was admitted to the hospital with a history of pain in the left chest and pyrexia of four days' duration. The pain was stitching, stabbing and cutting in nature and was agg. from 1 p.m. to 4 p.m. and from coughing, and was accompanied by profuse perspiration. It was relieved by warm applications. She could not lie on her left side. There was dullness of the left base with diminution of breath sounds. A provisional diagnosis of pleurisy with effusion was made. The report of the X-ray taken later read as follows: "Huge dilatation of the heart, pericarditis with effusion - also pleural effusion left base and thickened pleura". The remedy Kali-c was found to cover the following symptoms in Boger's Synoptic Key. Morning and evening, agg. (p. 17)

Stitches (p. 45) Cough, painful (p. 63) Dropsy (p. 89) Cutting (p. 68) Sweat in general, easy tendency to (p. 104). Reference to the Materia Medica portion (p. 224) showed that the remedy also covered the symptoms "worse lying on, painful" or "left side" and "better warmth". So she was given Kali-c 200, six hourly. There was an immediate all-round improvement which continued steadily; in four days she felt considerably better. The second X-ray, taken on 15.05.59, showed Heart size markedly diminished. Slight pleural effusion still present. The patient was discharged a week later and has remained well. Aggravation time of the pains in this case was 1 p.m. to 4 p.m. as against the usual 1 to 4 a.m. of Kali-c. Such twelve-hourly reversibility (day instead of night and vice versa) of time modalities is met with in the homoeopathic Materia Medica. An Ars. patient may be worse at 1 a.m. or 1 p.m. ; Chel. and Lyc. at 4 a.m. or 4 p.m. ; China at 5 a.m. or 5 p.m. ; Nux-v at 6 a.m. or 6 p.m. ; Sepia at 7 a.m. or 7 p.m. ; Thuja at 3 a.m. or 3 p.m. and so on. "Mrs. R.P. , aged 42 years, suffering from cervical spondylosis came for homoeopathic treatment because the collar she was given did not give her relief. Her history was as follows: On 27.06.62, she had sudden excruciating pain in the rt. scapular region and shoulder at 2 a.m. She woke up from sleep due to pain. Since then the pain has been there constantly. The pain is agg. at 3 a.m. She invariably gets up with pain at that time. It is agg. before menses, sitting and lying on the right side, agg. using the hand, as in writing. Pain in shoulder joint is agg. letting the hand hang down, amel. heat, rubbing, pressure on nape and shoulder. Has bad throat and sinusitis last 6 years. This is agg. by cold and sour foods. Irritable, worrying type; faints with pain. Past Hist.: Had a serious shock two years back (due to suspected infidelity of husband), Amoebic colitis eight years back. Pleurisy 25 years ago. Her case was studied in Kent's and Phatak's Repertory and Kali-c was found to cover the following symptoms: agg. at 3 a.m. (K.p. 1343) agg. before menses (K.p. 1373) agg. lying on right side (K.p. 1373) Fingers, working with agg. (Ph.p. 107) On 3rd Aug. 1962, she was given; 30, 12 doses to be taken twice a day till relief was obtained. On 17th Aug., she reported pain less in intensity, can hang her hand down without pain. From then on, she was put on Sac-l and advised to take Kali-c 200, 3 doses and by Nov. 1962 she was completely well and so the treatment was stopped. Now she has been well for several years."

In one case of repeated attacks of abdominal colic, Colo. relieved the pain but did not cure. I read up Kent and gave Kali-c, which is the chronic of Colo. and the patient became well. If you show sympathy and if the patient weeps, it may be Kali-c, Lyc., Sep. or Sil. Lachesis mutus The study of various remedies in the homoeopathic Materia Medica is a most fascinating one. And among these remedies, the study of Lachesis can be particularly interesting. The story of how the terrible Surukuku snake - Lachesis mutus of South America was caught and how its venom was proved by the indomitable Constantine Hering is well-known to all Homoeopathic students. This snake poison is one of the most well-proved remedies in our Materia Medica. Not only are we provided with an almost complete picture of the drug action, thanks to Hering, but also the symptoms are so clear cut and characteristic that it is difficult to miss or mistake them in practice. Allen's Encyclopedia gives more than 3 600 symptoms of this drug and its symptoms occupy more than a hundred pages in Hering's Guiding Symptoms. Hundreds of homoeopathic practitioners have used this remedy, relieving and curing thousands of cases in different conditions, wherever its fundamental characteristic symptoms were met with. Clarke says that the physical characteristics of substances correspond with their dynamic effects and in the study of the symptomatology and clinical application of Lachesis also we find in the symptoms such a reflection of the basic characteristics of the snake from which the poison has originated. When the snake bites a person, the first thing we do is to try and stop the circulation of blood by applying ice or proximal to the bite a very tight tourniquent. By the application of ice or such tight pressure, we may save the life of the patient. Now this relief by cold and hard pressure are also found in the Lachesis patient in many of his symptoms. Beside the application of hard pressure, we also make an incision at the spot where the snake has bitten and let out the blood and along with it, the venom which is deposited there. This also helps the victim of the snake bite to survive. This general relief from bleeding is also found in the symptoms of the drug. One particular form of bleeding which is physiological is the menstrual flow and this gives great relief to the female patient. Among the drugs which have great relief from menses are Lachesis and Zinc. Not only bleeding, but almost any discharge gives relief to the patient, this being one of the most characteristic symptoms of the Lachesis patient. Once I was consulted by a person who was getting recurrent attacks of epididymo-orchitis. His wife was in U.P. When he went to U.P. and stayed with her, he would get no attacks, but when he returned to Bombay after 2 or 3 months the attacks would occur. And thereafter, the attacks would recur at quicker intervals. During the attack the allopathic doctors would treat him with antibiotics but they could not prevent the attacks. Of course, they considered the fact of the attacks occurring when he was away from his wife as irrelevant. We know that allopathy does not consider suppression of sexual desire as a significant factor in the causation of disease. I prescribed for him Conium with no effect. Then he went and consulted one Dr. Dagli. This doctor found that his testis was extremely sensitive to touch and combining this with the amel. from discharge prescribed Lach. and cured him.

While bleeding or any type of discharge gives relief, the suppression or non-appearance of a discharge or eruption aggravates the patient. In women they may have aggravation before and after the menses, or if it is suppressed, or if it ceases as in menopause. When the snake bites its victim not only is there localised blueness but if the poison is allowed to spread all over the body, there is a blue discoloration of the whole body due to cyanosis. Here again is a keynote of Lachesis. I have cured successfully with Lachesis a chronic non-healing varicose ulcer of many years * standing which was very much blue along the edges and was extremely sensitive to and bled easily from touch. The discharge, ulcers, skin, etc. may be bluish or blackish. (The Lachesis snake has blackish brown spots.) The snake is extremely sensitive to heat. It is said that the pit vipers have an exceptional sensitivity to cold and heat. The pits on their heads enable them to detect a mouse at a distance of one metre, even in complete darkness, by the heat radiated from it. Besides, since the sense organs are in pairs, they can detect the direction in which the mouse is moving. A frog, in dry air, is detected by the cool effect of the evaporation of water from its moist skin. A mere thousandth of a degree Fahrenheit is enough difference in temperature to alert the snake. It lives in deep pits or burrows where it is considerably cooler than on the surface. (The cobra, it is said, prefers to live beneath sandalwood trees.) It prefers the cool surroundings and that is why it ventures out more at night when it is cooler. The Lachesis patient also shows a tendency to be worse by warmth, by hot drinks, in the sun and in summer. The snake is very sensitive to touch and vibration (sound), and so is the Lachesis patient. The aggravation by touch and amelioration by pressure are also noticed in the throat symptoms. The patient is worse by swallowing liquids (touch) and is better by swallowing solids (pressure). We must remember that the snake, especially the Python, can swallow relatively very large creatures (solids) easily. This it is able to do because of the peculiar structure of the jaws which consist of four separate segments which are merely joined by ligaments in such a way that the jaws can open very widely and allow the snake to swallow animals far bigger than itself. The tongue of the snake is constantly darting in and out of its mouth. The Lachesis patient may exhibit the same constant to and fro movement of the tongue or he may exhibit it in the form of trembling of the tongue. In fact, there is a trembling of the whole body in the patient. (The sight of a snake induces fear and causes trembling.) Or there may be difficulty in putting out the tongue. The remarkable mobility of the tongue can also be exhibited in a constant flow of speech. The tongue of the snake is bifid, looking double and this is reflected in the patient's speech who uses double the number of words and also repeats his words. In fact, the first thing we may note about the patient is his or her loquacity. She may go on and on telling her symptoms and branching off in various directions, even repeating the same points. Loquacity is notoriously met with in women but it is also seen in men as the following case will show. Mr. U.A. M., a fairly well to do Muslim business man aged 53 years, consulted me on 12th Dec. 1962 with the following history: Some 5 years back, while in Surat he had a sudden attack of severe precordial pain with palpitations. His brother, a doctor, examined him and came to the conclusion that it might be a coronary attack. He was advised bed rest, then examined again after some days. This time the diagnosis of coronary thrombosis was revised and it was re-diagnosed as a case of cardiac

neurosis or neurasthenia but he was still advised to retire from business permanently, which he did unwillingly. He, however, continued to develop various complaints from time to time and was given various medicines for appetite, for sleep, for pain, etc., in all amounting to 24 doses per day. His present symptoms were: Pain in the precordium, worse on ascending steps, worse by talking for a long time. Swelling around eyes on speaking for some time. Pain along a line from frontal to the occipital region. Difficulty in breathing; has to take a deep breath, often with a groaning noise. Oedema of the feet, worse on exertion, worse in the evening. Stiffness of the left arm and left leg on beginning to walk. Abdominal distension after food. Pain in the left renal area, on and off, worse by cold application, worse by sitting long. If he discussed business for a long time and then passes urine, he feels very weak. Pain in the chest after stool in the morning, better after tea. Sleeplessness upto 2 a.m. Jerking and pulling of left leg, esp. of the left big toe during sleep at night so that it wakes him 4-5 times at night. This is worse if he gets sexual thoughts or if he sleeps near his wife. Appetite poor, but feels much better in general after food or drink. Head hot, eyes burn esp. in the morning and in general feels worse after sleep in the morning. Feels worse in summer. But if he is chilled, he gets pain in the joints. Extremely loquacious; repeats the same thing several times, talks for 5 to 6 hours non-stop; gives long lectures to his sons every day though it causes much chest pain. Will not allow others to talk or finish what they have to say. On examination: B.P. 150/90, Wt. 170 lbs. He was obese and had a prominent abdomen. There was oedema of both the legs, pitting on pressure. The indications for the remedy seemed clear. But I repertorized his case on Boger's Synoptic Key with the following rubrics: Sleep, during, agg.; Sleep, after, agg.; Spasmodic effects - Jerks, etc.; Side left; Loquacity. Lach. alone came through. It also covered the following symptoms

(in Kent's Repertory).

Convulsions from sexual excitement (p. 1355); Summer (p. 1404); Desire for deep breath (p. 766); Head, heat (p. 121); Eating, after amel. (p. 137); Motion, beginning agg. (p. 1374). I put him on Lach. VI (6th potency of 50 millesimal scale) in water to be taken daily once, diluted and succussed and asked him to discontinue forthwith all his daily 24 doses of allopathic medicine. From that day there was very steady progress and he never looked back.

He is now completely normal for several years without any medicine and is taking active interest in his work. (Incidentally under the symptom "Jerking of the leg in sleep" in Kent's Repertory, Lach. is not mentioned.) The skin of the snake is reddish brown in colour. We see the redness in the symptoms - red (bloody) discharge, dark reddish eruptions, red nose, etc. The snake is more ferocious and poisonous when hungry; so also the Lach. patient is agg. by fasting and amel. after eating. The neck of the snake is always the thinner portion of the body and this constriction of the neck is reflected in the sensation of constriction of the neck in the patient also. The neck, of course, is the most vulnerable portion for one who wishes to catch the snake always catches it by the neck. And we do find the neck prominently affected. The python and mamba snakes, incidentally, kill their victims by enveloping, constricting and crushing them. When the snake is held hanging by its tail, it invariably starts raising the head up and tries to come up. This upward direction is met with in several sensations such as the rush of blood to the head, the headache going up from the nape, etc. They say that when the mind is poisoned there is jealousy and this is again a very characteristic symptom in Lachesis. Suspicion and jealousy are met with in many of the cases. The following is a typical case. I was once consulted by a lady, Mrs. B., who had developed severe itching in her neck. She had been suffering thus for seven years. She had been scratching her neck day in and day out, till it bled profusely and had the appearance of raw beef. She had gone to a skin specialist who having done his best and failed, had given up. She had then gone to a psychiatrist but without any effect. I made a close enquiry about the origin of the ailment, and was rewarded by a very interesting account. It seemed that one day her husband Mr. B. had gone to his native town. It so happened that Mr. B.'s boss's wife, Mrs. J., had also gone to the same city at the same time and so when Mr. B. was about to return, his boss Mr. J. wrote to him and requested him to escort Mrs. J. When Mr. B. and Mrs. J. returned together and disembarked from the steamer, Mrs. B. was present at the pier to receive them. Just then a friend of Mrs. B. also present there whispered into her ears that surely Mr. B. and Mrs. J. must have travelled in the same cabin, perhaps in intimate company. Thereupon, Mrs. B. got intensely suspicious and jealous. The subsequent behaviour of Mr. B. seemed to confirm her worst fears. It was during this period that she had developed the skin disorder. Later on, her husband had convinced her by various acts that he was completely loyal to her and had nothing to do with Mrs. J. Mrs. B. appeared to be thoroughly convinced of his fidelity but it had made no difference to her ailment. The itching continued and she continued to suffer. She had consulted both a skin specialist and psychiatrist but neither had been able to help her. It only required of me to put one or two questions to her to ascertain that her remedy was indeed Lachesis. Two or three doses of this medicine sufficed to restore her completely to normal health so that Homoeopathy earned her eternal gratitude. In some parts of India, when a person is bitten by a snake large quantities of cold water are poured on his head and he is made to walk up and down constantly and is not allowed to sleep at all because it is considered that if he falls asleep he will die. This probably has some scientific basis. And it is also noticed that the Lachesis patients are almost invariably worse

during and after sleep. In fact, they may be worse even by closing the eyes. Incidentally, a snake has no eyelids. The symptoms of snake poisoning and alcohol are similar to a certain extent. There is dizziness, volubility, trembling, drowsiness, slurred speech, etc. The Lachesis patient is worse by alcohol. The snake coils itself from left to right and the symptoms of Lachesis proceed from left to right. Following is a typical case. "Mrs. L.C. , aged 62 years, consulted me on 12.03.58 complaining of the following: Six years back she started having pain and stiffness in the lumbo-sacral region which later descended into the left leg. Now, there is pain and swelling in left ankle which sometimes disappears from the left and appears in the right ankle, sometimes exists in both legs together, often painful, sometimes painless. Pain and heaviness in leg, agg. by motion and amel. by rest and agg. when legs hang down. Occasional pain epigastrium piercing to back. Sweats on palms and soles even in winter; sweat offensive. Feels hot in legs and body, wants to place the legs on cold floor and also sleep on cold floor; likes cold in general. Dislikes noise made by children. Recently has developed fear of thunder. Nowadays nervous, fears every little thing, fears something may happen, and trembles. Nervousness has started after the death of her husband who died of heart failure. Constipation, no urge for stool. Past history: Menses were generally very profuse. During menopause had much bleeding and other troubles. Also had high B.P. with headaches and vertigo. Vertigo was agg. looking up. On examination: Has varicosities in both legs; also oedema, more in left leg. Wt. 115 lbs, B.P. 150/100. The symptoms were evaluated and repertorized as follows in Kent's Repertory. Fear of thunder being a mental symptom and the latest to appear was taken first. This was combined with another mental symptom, the fear that something may happen. Fear, misfortune of (p. 46). Next came another mental - Sensitive to noise. Then came a general symptom, the intolerance to heat. Warm agg. (p. 1412). Now came the peculiar symptom that though there were varicosites in both the legs, the oedema appeared more on the left and travelled from left to right. Side, left, then right. Lach. alone covered these rubrics. It also covered the haemorrhagic tendency discovered in the previous history, "Perspiration offensive" (p. 1298) and the "Varices, lower limbs" (p . 1233). So she was given Lach. 30 on 13.03.58. There was an immediate and quick amelioration. The improvement continued and she became well in 3 months. There were one or two relapses but every time the same remedy in the 200th potency put her all right. All her symptoms have disappeared and the varicose veins give her no trouble. She is now well for many years." I have seen two cases of atherosclerosis going on to gangrene, in which the patients were agg. in sleep and woke up with pain at 3 a.m. Lach. helped them. One is the wife of a famous eye-specialist. By the way, in her case, I got good results with Lach. but better results when I gave her Lach. high and Sec-c low. "Mrs. M.R. B., aged 22 years, came for consultation on 4th Jan. 1969. She is getting attacks of Epilepsy since the age of 9 years. The minimum interval between two attacks is 15 days and

the maximum 3 years. It started after some neighbour hit her on the head out of malice. She gets frightened too. She is impatient, suspicious, depressed, irritable, proud and jealous. She has a suicidal disposition and has tried twice to commit suicide. Once while in school she swallowed a bottle of sleeping pills because she was not prepared for an exam. She was then unconscious for one week. She is excitable and talkative. Her appetite, thirst, etc., are normal. Her wounds bleed much, suppurate easily and heal slowly. Past History: H/o smallpox, mumps, pneumonia and nervous breakdown. Her case was repertorized in Kent's Repertory with the following symptoms: Suicidal, disposition (p. 85); Jealousy (p. 60); Suspicious (p. 85): Haughty (p. 51); Wounds bleed freely (p. 1422). Only Lachesis came through. She was given Lach. 200. She got a few more attacks, generally mild, all in sleep, but slowly she got out of them. She was given : 1M and then 10M and then she was relieved. She has remained well for over six years." " A girl R., aged 5 years, 6 m., was seen by me on 3rd June 1963 for the following complaints: She gets frequent epistaxis for last one year. Formerly used to get epistaxis every 2 months or so, but now gets it as often as once a week. The bleeding is very profuse and if she is made to lie down there is bleeding from the mouth. The blood is blackish and clotted. Bleeding occurs from the left nostril only. It is agg. in summer. Her appetite, thirst, etc., are normal. Generally, she is irritable after sleep. Many specialists were consulted. They said it was due to anaemia and that only blood transfusion would help her. O/E. there is a presystolic murmur in mitral area. At first, thrombocytopenia was suspected but investigations showed that the platelets are normal in quantity but they do not break down easily, so that there is bleeding. It is diagnosed as qualitative platelet change. (Thromboasthenia) Plasma Prothrombin: 13; Serum Prothrombin: 24 sec.; Bleeding time 8'; Coagulation time 7'30". Clot retraction present. Platelet count 234 000. I prescribed Lach. 1M, 7 doses, once a day and then placebo considering the following points: Left side; agg. in summer; haemorrhagic tendency; black discharge; agg. after sleep, etc. She started improving. There was no epistaxis for 25 days. Her blood exam. on 23.06.63 showed R.B. C. 2.7 mil. Hb. 27% W.B. C. 6 800. Lach. 1M, 6 doses, t.i. d. for 2 days, then placebo. On 28.06.63 she had epistaxis once again. Lach. 10M, 3 doses were given in one day followed by placebo. Her chest was screened on 22nd May. Report showed Heart size +, Marked hilar congestion. Two child specialists were consulted but they refused to hospitalise her. Lach. 10M was repeated on 18.07.63, 30.08.63 and 13.09.63. On 19.09.63, reported no further epistaxis. General condition much better. On 01.11.65, I heard that the child was quite well with no further attacks of epistaxis." " Mrs. D.D. , aged 46 years, came for consultation on the 4th Jan. 1972. She had a history of pain in abdomen 11/2 years back and it had been diagnosed as Colitis. It has now recurred for the last 21/2 months. The pain is agg. after eating,agg. lifting any weight, agg. after stool and urine. She gets attacks of convulsions during which she bites her tongue, her eyes turn upward and she gets salivation. Usually she gets such attacks while lying down. She gets

these attacks since the age of 17 years. It is suspected as Epilepsy though the E.E. G. is normal. She gets coryza agg. changes of weather. Gets cramps in left leg in sleep. Gets ecchymosis if hurt but only in left leg. Her appetite, thirst, etc., are normal. Feels depressed after sleep esp. agg. after afternoon nap. Gets scanty menses. She is sensitive. Likes to remain alone and does not like sympathy. No h/o Head injury. Is becoming obese since the last six months. On exam.: Tenderness all over abdomen especially in hypogastric region. Jerks and reflexes normal, except plantar left foot which is extensor. She is taking 3 phenobarbitone tablets daily. Was taking Gardinal for 6 years, then felt agg.. The remedy seemed clear but her case was repertorized using Kent's Repertory and Phatak's Repertory with the following symptoms: Sleep afternoon agg. (K.p. 1402) Menses scanty (K.p. 728) Lifting agg. (K.p. 1371) Discharge agg. (Ph.p. 69) Haemorrhage (Ph.p. 120) Obesity (K.p. 1375) Side left (K.p. 1401) Only Lach. came through. Lach. 1M, 3 doses t.d. s. and placebo given 15.01.72. No attacks. Slight pain in abdomen. Medicine repeated 01.02.72: No attacks: Lach. 10M, 3 doses t.d. s. and placebo given. The patient continued to improve steadily and became well." Lycopodium clavatum Lycopodium is one of our deep-acting polycrests. When indicated and administered the patient benefits from it for a very long time. The aluminium content of Lyc. probably explains many of its features. This is probably responsible for the flashes it produces when used in fire crackers. The alternating constipation and diarrhoea, the paralytic effects, soft stool passed with difficulty, the dryness (the lycopodium powder was used by pill makers as a dusting powder to keep their hands dry while making pills), burning pains amel. heat, the falling hair, the adaptibility to persons who appear prematurely old are all common to Lyc. and Alumina. I mentioned that Lyc., when put into fire, produces flashes. The Lyc. symptoms also may come in a flash, they can be sudden and intense, as for example the hunger and the sexual excitement but the satisfaction or satiety is also very quick or sudden. Lycopodium produces signs of senility so that the patient appears to become prematurely old. The hair falls causing baldness or it becomes grey; there is wrinkling of the forehead creating an old look; the power of retention in mind (as well as in sex) is poor, resulting in a weak memory so that the patient makes mistakes in speaking - he can't recollect names and slowly develops a sense of incompetence and lack of confidence. So this patient is a young old man. Whenever I see a patient who looks older than this age, I always consider Lycopodium.

I can recollect a case of Pneumonia in a child which responded dramatically to Lyc. which was selected because there was wrinkling of the forehead. Kent gives only Lyc. and that too in bold type under the rubric "Face, wrinkled, forehead with chest symptoms". Out of the numerous cases of Lyc. I have seen so far, I have come across many of the characteristic symptoms mentioned in the books, in one patient or the other. The remedy has a very deep range of action producing lasting changes in the nervous, digestive, respiratory, circulatory and urogenital systems. The plant Lycopodium clavatum is said to be one of the oldest plants which has survived thousands of years of change. Theoretically, I see no objection to give Lyc. straight away in a case if it is indicated clearly. But in practice, I must admit that whenever I saw Lyc. indicated and gave it straightaway as the first remedy, usually, it did not act well. Often Lyc. works out for cases of calculi. Cases of both renal and biliary calculi so often exhibit constipation and flatulence and are agg. by peas, potatoes, etc. The renal cases are relieved by micturition. After Lyc. is given either the calculi are passed painlessly or subsequent X-rays show their disappearance. The movement of the alae nasi is a symptom of respiratory embarrassment. Boger says that to be of value, the movement of the alae nasi should be independent of respiration. I shall now present a few cases cured by Lyc. Mr. S., aged 39 years, consulted me on 17th Nov. 1961 with the following complaint: Has recurrent coryza for the last 7 years. He got the first attack in Calcutta in 1956. A complete blood count revealed Eosinophilia. In Bombay, in 1957, he got the second attack. He consulted an E.N. T. surgeon. The nasal mucosa was cauterised and he felt better. In 1960, he got another attack, after the death of his mother. Again in 1961, he suffered a fourth attack. This time, he took autovaccine. The nose was also punctured but he felt no relief. Now, the attacks are provoked by dust and by taking fish or prawn and in the rainy season. During the attacks, his nose gets blocked or he gets a watery discharge. The attack is aggravated from midnight till morning and by lying down. The patient is constipated, so he takes laxative daily. He had flatulence amel. by passing flatus. Appetite, thirst, urine, stool, etc., normal. He weeps easily, he can't see or bear suffering. He is very sensitive, gets upset easily. Sometimes he becomes irritable and shouts. He is losing confidence since he entered a new department in his office, although he is very competent and can easily manage his work. He also gave a history of repeated vaccination and of tuberculosis in an ancestor. The following symptoms were taken for study and the case was repertorized using Kent's Repertory: Confidence, want of (p. 13); Sympathetic (p. 86); Wet weather agg. (p. 1421); Food, shell fish agg. (p. 1363). Only Lyc. came through. Lyc. was given in 1M potency, 3 doses to be taken in one day to be followed by placebo. On these doses, he felt much better for a month. There was a relapse on 29th Dec. 1961 and so Lyc. 1M was repeated.

On 10th Feb. 1962, he got back a skin lesion from which he had suffered originally and had been "cured" homoeopathically, but which he had forgotten to tell me about. I waited for some time and as the lesion persisted, Lyc. 10M, 3 doses were prescribed. He also received an intercurrent dose each of Thuja and Tuberculinum because of the previous and family history. On 1st Aug. 1962, he reported that he felt completely alright, except for the small patch of eczema. Lyc. 50M completely wiped off the remnants and he remains well till now (10 Dec. 1968). Comment: This was a good case of Lycopodium but readers will note with curiosity the fact that this patient was worse after midnight though Lyc. is well-known to have its amelioration after midnight. Mrs. J.T. , aged 23 years, consulted me on 15th Dec. 1961 for the following complaint: She suffered from pain in the middle of forehead for the last six months. Originally she had suffered from coryza which had been treated with some injections. The coryza had stopped but then the headache had started. She had consulted an E.N. T. specialist and he had diagnosed it as a case of Sinusitis. As the treatment of sinusitis was not satisfactory she had been directed to me. She had pain at the root of the nose but more especially in the middle of the forehead and over the eyes especially on the right side. Close questioning elicited no more significant symptoms except that she was constipated and that the headaches were worse if she worried or got upset about anything. Her personal, previous and family history revealed nothing unusual. So I repertorized the case using Kent's Repertory with the following rubrics: Head pain, coryza suppressed from having (p. 138); Head, pain, forehead, above right eye (p. 159); Head, pain, forehead, middle (p. 161); Head, pain excitement of the emotions, after (p. 139). Only Lyc. covered the above rubrics. I, therefore, selected Lyc. which I gave in the 200th potency. On 12.01.62, she reported that the headaches continued upto 27th and then ceased. As there was relapse I repeated Lyc. 1M on 03.02.62. She reported on 26.05.62 that she had no more headaches. She has remained well now for many years. Comment: I had to select the remedy purely on the local symptoms because of the absence of any other mental, general, concomitant or characteristic symptoms. Although this is not a procedure to be recommended, yet the homoeopathic remedy that worked out helped the patient. Mr. K.C. , aged 40 years, consulted me on 18th July 1962 with the following history: He is a high placed executive in a very important bank in India. His duties require that he should address important conferences and talk to V.I. P.s. He has found that, of late, he has a feeling of excitement (sexual) especially marked when his wife is away. But he has poor erections and quick ejaculations. Gradually he has also developed a sense of inadequacy in his work, a lack of confidence and a sense of insecurity. He becomes nervous before his boss. His memory is poor and he is not able to speak so fluently and easily. He says he had a period of severe strain from 1956 to 1959 when he had a tussle with his boss. He generally feels very hungry but is easily satisfied. No other symptoms of any importance were elicited.

To me the whole picture seemed to be a picture of Lycopodium. Probably the severe stress in his work reflected on the sexual sphere, and the sexual incompetence reflected on his work again. I gave him Lyc. 1M on 18th July 1962 with some improvement. On 30th not being satisfied with the improvement, I gave him Lyc. VI in the LM scale of potency. This brought about 50% improvement both in his work and in his sexual functions. Then I gave him a dose of Lyc. XXX in the LM scale which brought about 80% and then 90% improvement. The improvement progressed and by 08.04.63 he was completely normal . Still, I had to repeat this dose occasionally as he had relapses, but by 07.10.63 he was completely normal and so treatment was stopped. He dropped in to see me in June 1965 just to inform me that he was getting on extremely well in all spheres, thanks to Homoeopathy! Comment: For such cases modern medicine has little to offer except some reassurance or psychoanalysis or tranquilisers and sexual stimulants but our Homoeopathy can do wonders to rejuvenate these people. "Mr.T. R., aged 45 years, consulted me on 14th Dec. 1961 with the following history: Since age of 19 years, i.e. from 1935, he has eczema in the legs, has itching and on scratching a thin fluid exudes. The eruptions are black and are worse in summer. Since 1951, he gets attacks of giddiness. This has started after his son-in-law, aged 35, expired. This was a great shock to him and he was greatly depressed for one year. The giddiness is agg. after coffee and is amel. by vomiting. It is associated with throbbing in temples. Heavy foods cause discomfort in abdomen between 1 and 2 a.m. Prefers hot food and drinks and sweets. Milk causes diarrhoea. Gets tinnitus in ears on and off, started in the right ear, now in both, amel. fasting. Sometimes gets sprained pain in right scapular area , amel. by eructation. Feels generally better in the cold season. For the eczema he had taken X-ray exposures with no relief. On examination I found nothing abnormal except that he had external piles. This case was repertorized with the following rubrics using Kent's Repertory: Grief, ailments from (p. 51) Diarrhoea after milk (p. 614) Food, heavy, agg. (p. 1363) Food, coffee, agg. (p. 1362) Lyc., came through as the only remedy. The remaining picture also fitted in with Lyc. I prescribed Lyc. 200, 3 doses six hourly to be followed by Sac-l. By 25.12.61, he felt better in all symptoms: the eczema the vertigo, the tinnitus, the abdominal discomfort, etc. The remedy had to be repeated in the 1000th potency, followed by a dose of Carb-v 1M. Till now he remains well without any further medication." "Mr. G., aged 39, consulted me in 1957 for attacks of flatulent colic amel. flatus, amel. fomentation, agg. potatoes, onions, fruits, coconut, rice, heavy foods. Sweats with abdominal pain. Milk causes diarrhoea. Cannot stand hunger. Prefers hot drinks. Lumbar ache agg. rising in morning, agg. pressure. A Barium Meal X-ray showed an ulcer niche in duodenum with pseudodiverticuli due to adhesions.

On looking through the following rubrics in Kent's Repertory, viz. Fruit agg.; Onions agg.; Milk agg.; Perspiration with pains, I found that only Lyc. covered them all. Besides, Lyc. also covered the back pain. So he was given Lyc. 200 and was put on bland diet. His response to this prescription was very satisfactory. He continued the treatment irregularly taking Lyc. upto 50M but by 1964, he became completely well." Osteoarthritis is said to be a degenerative particular disease of old age for which even relief is not promised. The following case illustrates how even this can be cured in a limited sense, i.e. the patient made comfortable and symptom-free. "Mr. T.A. K., aged 69, came on 26th July 1963 with the following complaints: Has arthritis in knee joints agg. right knee for the last 10 years. Pain agg. rising from sitting, agg. beginning motion, agg. descending steps. It is diagnosed as Osteoarthritis. Has frequent urination at night. Weight is increasing. Has bilateral cataract. On looking up the rubrics "Descending agg.", "Obesity" and "Old people" in Kent's Repertory, I came to Bar-c, Con., Lyc., Sulph. Of these I preferred Lyc. as it was right sided, had frequent micturition at night, etc. So, I gave him Lyc. 200. He felt relief, but the medicine had to be repeated about once a month, in 1M and then in 10M potencies. Later I gave him doses of Lyc. in the 6th potency of the LM scale to be taken in water succussed daily once. On 17th Feb. 1965, he reported that he was completely well, there was no pain in the knees. The medicine was discontinued. He has remained well for many years now." Our books generally picturize the Lyc. patient as a thin, withered patient but sometimes it is not so. I have treated several obese patients with Lyc. "Mrs. M., aged 68, wife of an allopathic doctor saw me on 7th June 1972 with the following complaints: She is suffering from lumbago for the last 20 years. Now she cannot get up from bed due to the stiffness. Pain is agg. rising from sitting, agg. sitting long, agg. lying on back, agg. cold drinks, agg. stooping; cannot squat. It is amel. pressure and amel. by massage. Gets pain and heaviness in the thighs. She has become very obese. Her appetite, thirst, etc., are normal. She is amel. by company. Very irritable. Past Hist: She had thyrotoxicosis which was amel. with Neomercazol. Fam. Hist.: Her sister had tuberculosis. The case was repertorized using Kent's Repertory: Back, pain, lying back on (p. 896) Back, pain, lumbar region, lying back on (p. 906) Back, pain, rising from sitting (p. 897) Back, pain, lumbar region, rising from a seat (p. 907) Obesity (p. 743)

Cold drinks agg. (p. 1363) Lyc. and Puls. came through. I preferred Lyc. as she was very irritable. Lyc. 200, 3 doses were given in one day. By 17.06.72, she felt 25% amel. but still had pain. Lyc. 200 was continued, once a day. She continued to improve but with relapses, but by 30.08.72 she felt normal." "Mr. C.S. , aged 38, came with following symptoms: Burning in epigastrium agg. 4 to 10 p.m. Appetite poor. Distension with eructations. Alcohol and heavy food agg., causes acute pain in epigastrum. Stool irregular. Memory poor, lack of concentration. Weakness in legs agg. if he worries. No energy to work. Sour foods agg.. Summer agg.. H/o grief due to father's death. Suspected as ulcer, gastritis or colitis. On examination: Tenderness all over abdomen. On these symptom indications, he was given Lyc. 200 on which he felt amel.. He went on improving though he required doses of Lyc. on and off upto the CM potency. He felt and became so well that even after attending his office for the entire day, daily, he was able to work the whole night and drove a lorry for 3 full nights. Nowadays he comes to me once in 3 or 4 months and takes one dose of the "tonic medicine" - Lyc. CM." "Mr. P.P. T., aged 32 years, came to me on 7th Jan. 1953 for consultation with the following history: Nine years back, he had pain in chest as if an abscess was forming which was amel. by fomentation and hot drinks. Pain used to occur once in 10-15 days, at any time of the day and would last for ten minutes. After six months he developed a feeling of food sticking in oesophagus and had retrosternal pain only while swallowing food or drink. And if he lay down after food, 3 to 4 hours later, the food and drink used to ooze out of the nose, first the liquid element followed by the solid part, sometimes 3 to 4 cupfuls through the nostril of the side on which he lay. This started occurring once in 2 or 3 months; he would also then vomit everything for 3-4 days. At present, he has retrosternal pain on eating or drinking hurriedly. Appetite poor, likes sweets, but sweets cause nausea afterwards. He likes warm food and drinks. The sense of obstruction is much less with warm food and drink. Has rattling in chest during sleep, especially after 3 a.m. Dreams of business. A Ba. swallow X-ray showed Achalasia Gastrica with oesophageal pouch. Lyc. in different potencies including 50 milesimal scale potencies was given during a two year period. The patient showed considerable improvement and is now completely free from this trouble though he needs to take a dose occasionally. About one year later, an eminent surgeon was consulted for an opinion. He expressed the opinion that there was no doubt about the diagnosis and no doubt also that it was a clearly surgical condition but since the patient had shown such remarkable improvement and was practically free from the difficulty, surgery was inadvisable and homoeopathic medicine should only be given when necessary." And now, I shall give some diverse symptoms of Lyc. in verse: Look at Lyco., lean and hungry,

Not one to like for he awakes angry, As a little food overfills So, smaller grow his dinner bills, Very forgetful, so he makes Speaking and writing, many mistakes Worse in the evening four to eight, But troubles cease after midnight, Full of gas, abdomen tight, Complaints go to left from right, Thin, withered, full of gas, Alas! Cannot satisfy any lass! Mercurius solubilis Mercury is a very interesting remedy to study. To confess the truth I did not realise its full potentialities in the beginning. It was only later that I was able to understand its virtues, thanks to my good friend, Dr. Sarabhai. In acute colds and coughs due to constant change of weather from hot to cold, it is an excellent remedy esp. in Bombay. I must also tell you about my personal experience with Merc-s. For some years I used to get repeated attacks of colds and coughs (tonsillitis) esp. coming on if I took iced drinks. Therefore, though I was very fond of cold drinks, I could not take them. The symptoms of the attacks were: severe pain in the throat agg. empty swallowing, agg. cold drink, agg. at night with fever and chills. I would feel chilly but if I put off the fan I would feel hot and perspire. After perspiring I would feel worse. I also had complete thirstlessness. Normally I would take 6 to 8 glasses of water a day but during the attacks I would not like water at all. I used to work out my case in the repertory and it would come to Puls., but Puls. would not like water at all. I did not consider Mercury because of the thirstlessness. But once I happened to take Merc-s by chance (or Merc-i-r) and I felt immense and immediate relief. So the absence of thirst had fooled me until this time I felt it was a contraindication for Merc-s. Since then, I am able to take a lot of cold drinks with impunity and even if there is slight throat trouble a dose of Mercs or Merc-i-r puts me all right at once. Every time I enjoy an iced drink I thank Merc-s and think gratefully of Hahnemann who gave it to us. I would like to report a recent case treated by me. "A boy, aged 10 years, had nocturnal enuresis. He would pass urine in bed but continue to sleep over it. The urine was generally offensive. Sometimes he would pass urine involuntarily even in daytime and sometimes he was not even aware that he had passed urine. I repertorized his case, taking the symptoms "Urination, involuntary in bed", "Urination, unconscious" and "Urine, offensive" and found Merc-s alone coming through. Merc-s put him all right." A peculiar characteristic of the Merc-s cough is that it occurs in bouts of two coughs.

Merc-s is prominently agg. by lying on the rt. side. I remember the case of a girl who developed bilateral pneumonia and was under my treatment. She did not improve. So she went under allopathic treatment. Somehow, under the allopathic treatment she became worse and so came back to me. I then noted two prominent symptoms: (1) She could not lie down on the rt. side at all because of severe agg. in chest pain and cough, (2) Salivation ++. With Merc-s she was completely cured. I have a problem with Merc-i-f. It is said that in Merc-i-f the throat pain is better by cold drinks. But I have rarely seen throat troubles better by cold drinks. "Dr. H.G. B., aged 37 years, came in 7th Oct. 71 with the following complaints: He gets recurrent nasal congestion for last 5 years, coming on if he drinks iced water. First, the throat gets affected, then the nose gets blocked. It is amel. if he is engaged. He had also lachrymation from left eye esp. while eating. He had got ringworm infection in the groin which is agg. heat. His appetite, thirst, etc., are normal. Sweets cause bloating of abdomen. Wounds take long time to heal. Past Hist.: He had typhoid in childhood. He uses nasal drops. His case was repertorized using Kent's Repertory and Phatak's Repertory as follows: Cold drinks, agg. (K.p. 1362) Sweets, agg. (K.p. 1364) Coryza, ascending (Ph.p. 53) Only Merc-s came through. Merc-s 200 was given for a fortnight. He found no change. So I gave him Bacill. 1M, 3 doses followed by Merc-s 1M, daily once for a fortnight. He felt better and was able to get on without using nasal drops. With Merc-s 1M, then 10M and the VI (i.e. 6th potency of 50 Millesimal scale) succussed and given in water daily repeated at increasing intervals of time with intercurrent doses of Bacill. 1M, he became completely well." "Dr. M.B. R., aged 76 years, came on 21st June 1972 with the following complaints: At he age of 4, he had had a stone in the bladder. He was operated but burning in urine continued for one year. At the age of 8 months , he had had abscess and cellutitis above rt. iliac bone. This led to a sinus which lasted for 2 years. Amputation of the leg was advised by a surgeon but some lay woman cured it. At the age of 30, he got gout. At 35, had pneumonia. Since then he gets pain in joints agg. at night and agg. rainy season. Gets pain in knees which is agg. night agg. descending and agg. by motion. Gets heartburn at night. His memory is poor for names. Has enlarged prostate and fungus infection in nails. Prev. Hist.: He had bilateral inguinal hernia. Had prolapse of anus during stool. His case was repertorized with Kent's Repertory and Phatak's Repertory as follows: Extremities pain, joints, night (K.p. 1047) Wet weather (K.p. 1421) Nails (Ph.p. 186)

Calculi (Ph.p. 33) Only Merc-s covered all the symptoms. Because of the agg. at night, I gave him first Syph. 1M, 3 doses t.d. s. and then followed it with Merc-s 30 b.d. By 18.07.72, he felt much better. So medicine was discontinued. But he improved still further and became well." "Mr.V. , aged 39 years, came for help on 17th Sept. 1964 for the following complaints: For the last three months, he has had to strain a little for urine, sometimes the urine comes in a double stream, sometimes in a thin stream. The condition had been diagnosed as stricture of the urethra. He had an attack of typhoid treated with Chloromycetin three years back. Since then, he has had much bleeding from the gums; even now sometimes he gets sudden bleeding from the gums while washing the face. Past Hist.: He had had an attack of measles and chicken pox. Fam. Hist.: Married in 1952; has two children aged 11 years and 6 years. Father, mother and three sisters living and healthy. I first gave him Chloromycetin 30, b.d. for a week to eliminate any possible ill-effects of the original drug given for typhoid. This prescription relieved the straining a little and urine came in a single stream. So, on 24th Sept., I gave him 14 doses of Chloromycetin 30, to be taken daily once. But on 8th Oct., he reported no further progress. I then noted the following additional symptoms: Urging for urine on rising from sitting; sweat stains yellow; skin has turned dark. I now repertorized the case as follows on Kent's Repertory: Urination, forked (double) stream (p. 657) Urination, feeble stream (p. 661) Bleeding from gums Bathing (or washing) agg. (p. 1345) Perspiration stains yellow (p. 1301) Black, Dark, etc. (Phatak's Rep. p. 25) Only Merc-s came through and Merc-s was obviously the correct remedy. I gave six doses of Merc-s 1M to be taken t.i. d. for two days. The patient started improving. I had to repeat Merc-s 1M and then Merc-s 10M. On 19th Dec. 1964, he reported that he was completely well."

"I was consulted for Miss J.C. , aged 16 years. The girl was the daughter of a rich land-owner and she had developed behavioural defects. At birth she had had no hair on the body. She had been treated with Thyroid and Durabolin and hair had grown. She was now stunted in stature being only 4'2" tall. Her weight was 26.5 kg only. This had created a serious complex in her mind. Her father was tall, so she believed that her short stature was due to her mother. Hence she hated her mother. She had been mentally deranged for some time. For the last few months, she had been depressed and had talked of death and had expressed a desire for death. She had changeable moods. Milk used to cause diarrhoea. Her older brother aged 21 was quite normal. Recently, she had created a problem because she suddenly told her parents that she wished to marry the son of their cook. She also announced this to all her schoolmates and thus had become the laughing stock. She had been seen by a neurologist who had said that pituitary dysfunction was the cause of her stunted growth. X-ray had shown fusion of the epiphysis and so there was no possibility of increasing her height. She was behaving like a child and would eat with both the hands. She would eat in a hurry. She was shameless and foolish. She was very fond of sweets. She was very dirty by habit. She would often talk of marriage. She was very sensitive to music. She was averse to consolation. She had been treated by a homoeopath previously with Puls., Tub., Pso., etc., and had shown some improvement on these medicines. I repertorized her case with the following symptoms, viz. Dirty, Lascivious, Moods changeable, Sensitive to music, Hurry, Consolation agg., and Dwarfish. I got Merc-s. I put her on Merc-s, starting from 1M going upto the CM with intercurrent doses of Syph. In the course of 2 years her behaviour has become completely normal. Now, she has married some person of her own status to the satisfaction of her parents." Natrium muriaticum Nat-m, like Carb-v and Silicea illustrates the effects of potentizing and the power residing within apparently inert substances. Of course, Nat-m like any other remedy is able to relieve cases wherever it is indicated by the symptoms but cases of throtoxicosis, psychoneurosis esp. of the depressive types, hypertension, sinusitis, etc., often seem to require Nat-m. Nat-m is often described as a drug agg. by heat but it is better to remember that (like Sil., Lach., etc.) it may be agg. both by cold and heat. Dr. S.R. Phatak had recently described a case of a lady who became mentally unbalanced. On the history that when she had lost her child a while ago she had not wept, she was given Nat-m which cured her. Another such case was a boy who had continuous attacks of asthma since childhood. On the history that the boy had not cried well after birth, Dr. Phatak again prescribed Nat-m and this gave relief to the boy for several months. To me this appeared to be a strange interpretation of a common rubric "Sad but cannot weep" (Kent's Repertory p. 78). In another case, the symptoms were practically contradictory and hopelessly mixed up. Boger gives an indication under Nat-m, "Thin, thirsty and hopeless". By interpreting the word "hopeless" in a much broader sense, Dr. Phatak prescribed Nat-m which gave relief to the patient.

The more we study and practise Homoeopathy the more we realise in how many thousands of ways a remedy could be manipulated. Proceeding on this line of thought a little further, I may say that one might never be able to master all the possibilities of a single remedy in one's lifetime. This is a very sweeping (and perhaps a depressing) thought but I think that it is true. "Mr. H.J. S., aged 24 years, had recurrent pain in the left supraorbital region, of 4 years' duration occurring almost daily. The pain would increase and decrease gradually. It was agg. by fan, agg. in an air-conditioned room, agg. in the sun. With the pain there was swelling below the eyes, and lachrymation. The pain was agg. after sleep. Rising from the sitting position used to cause syncope. He had desire for salt and aversion for milk. Thirst: 5-6 glasses of water per day. His memory was poor, he was irritable and preferred to be alone now; he disliked consolation. It was a typical case of Nat-m. With Nat-m 200, 3 doses, 2 hourly in one day, followed by Sacl, he felt better in one week. He became quite well in a month with one more dose of Nat-m 1M, and reported well after 4 years. It is a complementary to Bry. and has the same dryness in the mouth and throat causing thirst, in the rectum causing dry hard stools, in the vagina causing painful coition, and in the skin. Considering the fact that three-fourths of the earth's surface is covered by sea water and that the major solid constituent of this water is ordinary salt and considering also that almost all human beings require and consume salt in their food, I think Nat-m should be a very important remedy for many disease-conditions and perhaps should be used more extensively. While going through Hering's Guiding Symptoms, I noted that Nat-m has got a crack on both the upper and lower lips, whereas all the Materia Medica writers only emphasize the crack in the middle of the lower lip. I wonder how they pick out and give some particular symptoms out of the large group of symptoms found in the provings. What must be their criteria of selection? For example, under Nat-m in the provings there are 34 symptoms given under "Face" in Hering's Guiding Symptoms. Out of these 34, Boericke gives 3 symptoms. How did he decide that these three are the important symptoms out of the 34? Does it depend on each writer's own experience? Incidentally, the biochemic practitioners, I think, use Nat-m extensively. They say that Nat-m is the remedy for disturbances of fluids, either excessive fluidity or dryness, e.g. lachrymation, diarrhoea, constipation, etc. There is lachrymation or weeping with laughter or laughter ending in weeping. They say Nat-m is chilly but it is also agg. by heat. Dr. Dhawale (Sr.) always used to emphasize agg. consolation as a very important symptom. By the way, Dr. Gutman told me once that Nat-m has no dreams of robbers though it is given in Allen's Encyclopaedia. It is Nat-c which has this symptom. It is said that Nat-m should not be given during fever. Dr. Phatak told me that in the beginning of his practice he used to give Nat-m during fever and found very bad aggravation. But in my experience, I have given it without aggravation.

Some people say Nat-m is a good remedy for high B.P. You know these patients are agg. by salt. Incidentally we have seen many patients with various diseases improving only by cutting off salt. This is usually the prohibition imposed by many ayurvedic physicians. I had one case. He could not forget an evil committed against him. He used to go on thinking about revenge. The patients brood over old grief and grievances. It seems they enjoy this pastime just as the Ign. patient enjoys being sad. Kent says that Nat-m is indicated when a girl falls in love with a married man or a person unequal to her in status. This is indeed a very remarkable indication for a remedy. I have verified this in my practice. "An uneducated Muslim girl, aged 20, was brought to me by a doctor for various types of symptoms including mental depression, indifference to life, etc. At the first interview in the presence of the doctor I could not get to know the proper background, but when she came again with her mother, I came to know that she was desperately in love with a person who was highly educated and of a comparatively much higher status. On enquiry, I was told that the object of her love was the doctor himself who had brought her to me, though he himself was not aware of her feelings for him. The girl knew that her love could never succeed. I gave her Nat-m and she became normal." Nux vomica Though the alkaloid of Ign. and Nux-v is one and the same, Strychnine, the two drugs provoke very different reactions. But both seem to be suited to the effects that seem to have resulted from the civilization of the human race, each in its own way. Nux-v seems to be the remedy ideally made for the modern city dweller. When one glances down the list of things or influences that would go to create the Nux vomica symptoms, one comes across: Anger Light Anxiety Liquor Coffee Mental exertion and fatigue Condiments Mortification Debauchery Noise Disappointment Odours Disturbed sleep (or late nights) Over-eating Drugs Purgatives Grief Rich food High living Sedentary habits Hurry Vexation One can easily recognise without reflecting that these are indeed the components and spice of city life and that almost every citizen is exposed to many of these influences. Besides, one has to put up almost every day with many annoyances, minor and major. Of how many irregularities in diet and habits, how much abuse of nature's laws, one is guilty! Therefore, it is no surprise that when one falls ill, these influences, singly or in combination, are often to

blame and then one finds Nux-v coming up to antidote the results of these transgressions. This is why this remedy is so often found useful in every-day practice. The Nux-v type is the impatient, intolerant, irritable type, the top-class efficient executive who tolerates no mistakes, no delays, who won't stand any nonsense, who becomes easily cross, and whose path every one is afraid to cross. Of course, he gets things done but he often leaves a bad impression behind because of his fastidiousness; he annoys and gets annoyed. The following case is a good example. "Once a very well-to-do, intelligent businessman came to consult me. By nature he was very meticulous and thorough, but impatient and intolerant of the least contradiction. The least contradiction would make him violent. The nature of his work confined him to his chair the whole day. Now, he had suddenly developed a shooting pain in the chest. Someone had diagnosed it as pleurisy and this had upset him considerably. But the pain was independent of respiration. As he preferred homoeopathic treatment he came to me, accompanied by a friend. When I questioned him about his symptoms, he merely pointed to his friend who had to explain everything on his behalf. When I asked more and more questions, he became impatient, flared up and shouted at me, "What do you mean by asking silly questions? Aren't you going to give me some relief ?" I gave him two doses of Nux-v 30, one to be taken at once and one after one hour if necessary. Within five minutes of the first dose, by the time he got into his car and left, the pain had disappeared." Irritability is the keynote - irritable mind, nose, throat, stomach, rectum, muscles, etc. For instance, the patient with the dry cough goes hack, hack, hack all the time; and when he sneezes, they amount to a dozen at least. Though Nux-v is usually effective in many acute conditions, it is equally efficacious in chronic conditions too, if the symptoms tally. The following instance will illustrate this fact. "An engineer by profession, Mr. K.A. L., aged 35, came to me with the following complaint: In Jan. 1954, while in the U.S. A., he had started vomiting at night. He was hospitalised and investigated. Ba. meal X-rays did not reveal any abnormality. Gastric analysis revealed hyperchlorhydria. He was treated for this in the U.S. A. (in the famous Mayo Clinic) and in England, but with little relief. At the moment he had heaviness of stomach with a dull pain starting half an hour after food and lasting an hour. With the pain, he had a headache, and he became very irritable and impatient. The pain was aggravated by heavy and starchy food, spices, tea and exertion and much relieved even by a very short nap. If the pain was very severe, he induced vomiting which ameliorated. The vomit was extremely sour. The pain was also ameliorated by sweating and micturating. He preferred eggs, hot foods and drinks. Otherwise, there was nothing worth reporting. The case was repertorized using Boger Synoptic Key and the following rubrics were chosen from. Sleep, amel. (p. 28) Discharges, amel. (p. 21)

Impatience, etc. (p. 51) Anger, irritability, etc. (p. 49) Sourness (p. 45). The only remedy that came through was Nux-v. The whole case fitted in with Nux-v and so one dose of the remedy was prescribed in the 1M potency. There was an immediate and very gratifying response to the remedy and the patient felt completely well in a week's time. However, there were all relapses, and the remedy had to be repeated twice, but with the last dose the whole condition cleared up completely." "Mr. K.S. M., aged 39 years, came on 5th July 1973 with the following history: In June 1946, he had an attack of haemoptysis. It was suspected as food poisoning and treated as such. Later he had abdominal pain which was diagnosed as duodenal ulcer with superadded amoebic infection. Allopathic treatment gave no relief. Now he gets abdominal distension 2 to 3 hours after food with burning, very offensive eructations or vomiting, both of which relieve. The vomitus is extremely sour. He has frequent, scanty stools. He has to strain even for a soft stool. He feels agg. lying on back and right side. Thirst: takes only one cup of water a day. Nowadays he does not perspire but feels amel. if he perspires. If he sleeps in the afternoon, he vomits on getting up. He feels suffocated in a closed room. He prefers to be alone. He is very nervous and irritable but suppresses anger and broods, is oversensitive and very punctual in his work. Past Hist.: In Oct. 1945, he was not allowed to appear in a departmental examination, and was very disappointed as a result. He suffered grief when he lost his son aged 2 years in 1951. Wt. originally 128 lbs is now 101 lbs. All the following rubrics in Kent's Repertory were found covered by Nux-v, viz., agg. Lying on back; agg. Lying on right side; Constipation difficult stool; Grief, ailments from; Brooding; Eructations, foul. Nux-v also covered most other symptoms and seemed to match the totality. So he was given on 19.07.63, Nux-v 200. He started improving on infrequent doses on Nux-v, given upto 10M and was completely relieved by 30.09.63. Three years later, I heard that the patient remains well. Unfortunately, a follow-up X-ray could not be taken." We have seen many reports of cases of strangulated hernia being relieved by Nux-v. It is also useful in ordinary hernia. "Master Nirmal, aged 6 years, had developed left-sided incomplete inguinal hernia since three months. It originated when one day his elder brother sat down with force on his abdomen. The boy had no other symptoms of significance. Because of the history of injury, Arnica was prescribed in different potencies but with no result. The case was then repertorized as follows using Kent's Repertory: Hernia, Inguinal, children, left side (p. 552)

Injury (p. 1368) = Nux-v Nux-v 6, twice a day for seven days was given with no effect. Then Nux-v 200, 3 doses in one day followed by placebo were given on 7th March 1962. On 10th April 1962, condition was better; the impulse felt on coughing was less. The boy was kept under observation and Nux-v in higher potency was repeated according to necessity. By 11th Aug. 1962, Nirmal was completely normal and medication was discontinued. He was still normal on 1st Nov. 1965. " Opium The study of Opium is an absorbing one. Opium is the air-dried juice obtained by incision of the capsules of the white poppy, Papaver Somniferum. The white poppy belongs to N.O. Papaveracaea and is grown in India, Persia, Asia Minor, Turkey, China and Egypt and is also cultivated in England and other cold countries like Russia and Yugoslavia. It is a highly complex substance, containing about twenty-five alkaloids combined with meconic, lactic and sulphuric acids. Of these, the most important is morphine which occurs in combination with meconic acid. Next in importance are codeine, narcotine, papaverine and thebaine. The various alkaloids have each a slightly different action but the total combined effect of these makes an excellent composite picture. This drug used by many narcotic addicts stimulates at first, and then depresses. The effects of the drug can be studied in three broad stages. 1. Stage of Excitement: During this stage, the symptoms are an increased sense of well-being and increased mental activity, freedom from anxiety, loquacity, restlessness or even hallucinations, flushing of the face and increased action of the heart. This stage is of short duration and may be absent if a large dose is taken. In children convulsions or a maniacal condition may be seen in this stage. The person may experience a feeling of euphoria (a sense of well-being) and he may develop very delightful visions or phantasies; he may also feel excited and sleepless. There may be exalted perception. It is for this stimulant effect that the drug is taken by addicts. 2. Stage of Sopor: The nerve centres are depressed during this stage, which sometimes comes in quite suddenly. The symptoms are headache, nausea, vomiting, giddiness, lethargic condition, drowsiness and an uncontrollable desire to sleep from which the patient may be roused by external stimuli. The pupils are contracted, the face and lips are cyanosed and an itching sensation is felt all over the skin. The pulse and respiration are still normal. 3. Stage of Narcosis: The patient now passes into deep coma from which he cannot be roused. During this stage the muscles are relaxed and the reflexes are lost. All the secretions are almost completely suspended except that of the skin, which feels cold and clammy. The face is pale, the lips are livid and the lower jaw droops. The conjunctivae are injected. Blood pressure begins to fall and the pulse is low, small and compressible. The respirations are slow, laboured and stertorous and the rate may be as low as 2 to 4 per minute. Even at this stage, recovery may take place by prompt and proper treatment. Otherwise lividity of the surface increases. The pulse becomes slower, irregular and imperceptible. The

respirations are slower, more feeble, and assume the character of Cheyne-stokes, death occurring from asphyxia. Convulsive twitchings in groups of muscles are observed, and the pupils are widely dilated towards the end. Vomiting may occur in some cases. Convulsions of a tetanic character are occasionally present, more frequent in children than in adults. Diagnosis: Opium poisoning has to be diagnosed from apoplexy, uraemic, diabetic, epileptic and hysterical coma, acute alcoholic, carbolic acid and barbiturate poisoning and compression of brain. In the stage of depression, there may be insensibility and loss of reaction and sensation. The sensory and motor nerves may both become sluggish and so the various organs like bladder, rectum, etc., may not send impulses to or react to impulses from the brain. There may, therefore, result constipation with no urge, retention of urine, etc. The glands may lose their function, and so fail to produce secretion and therefore dryness occurs everywhere, except on the skin. In the extreme stage of depression the patient may go into deep sleep resembling a coma-like stage. In this profound comatose stage there are pin-point pupils (P.P. P.) with a moist skin. There can be cyanosis also. In this connection I may relate the case of a child. "I was once called to see an infant aged 14 days who was in a cold, cyanosed and collapsed state. The child soon after birth had developed rattling respiration and cyanosis. A child specialist and later an eminent cardiologist had diagnosed it as a case of Fallot's Tetralogy which is a congenital malformation in the heart. And they had said that nothing could be done. So the child was sent home from the nursing home. When I saw the child she was practically in a moribund state. She had very loud rattling respiration which could be heard 20 ft. away. She was cyanosed and unconscious and I was told that she had passed no stool for the last 8 days. When I turned the child over to the side in order to auscultate the back, I found that the rattling suddenly ceased and when the child was again turned over to lie on the back the loud rattling started again. I took the rubrics "Rattling" (p. 42), "Lying on back agg." (p. 25) and, "Bluish, Purple" (p. 3), all in Boger's Synoptic Key. The three remedies that came through were Cup., Op. and Sulph. Out of these, I preferred Opium because of the prolonged constipation. You can imagine my surprise and happiness when after one dose of Opium 30, within ten minutes, the blueness entirely disappeared, the face became slowly red, the rattling lessened and the child became conscious. The child continued to live very happily, every time responding to Opium whenever she went into a cyanotic state, I advised them time and again to get the child operated but they repeatedly postponed it. Ultimately, when she was aged 4 years, one day while sitting on the mother's lap she laughed loudly and died." Opium seems to be an excellent remedy for the effects of fright. Foubister describes a girl of 31/2 years who was admitted in the hospital, dangerously ill with a temperature of 105 ºF, drowsy and delirious with a W.B. C. count of 38 000. She had evidence of sinusitis with large tender glands. The pupils were pin-point. There was a history that the child had been frightened by a wasp and with Opium CM she came round very well. He goes on to describe another case. "A girl of sixteen years of age was slow in recovering from influenza. Thinking back over the twelve years I had looked after her, this was the usual pattern, there was sluggishness in recovering from every acute illness for no obvious reason. Going back over the history, I discovered that the mother had been frightened by a doctor during pregnancy on being told that she might lose her baby. She said, "I felt the shock go

right through me." The girl was given Opium CM and made a quicker recovery, but not only that, she became physically more robust and her ability to study increased quite definitely." Opium eaters are known to suffer from very frightful visions of rats, mice and other fantastic animal formations jumping at them from which they try to escape by hiding themselves under the bed. Their looks, gestures and speech express the greatest fear of the animals which they fancied were incessantly chasing them. This is how the remedy has come to be beneficial for ailments arising from fright, particularly where the effect of the fright has persisted for a very long time. "In 1965, when I was returning from the U.S. A., I boarded the plane in New York at 9 p.m. After flying smoothly for about three hours, suddenly the plane started lurching and rolling and we could see that it was losing height rapidly. We all felt that something was wrong but we could not know what was wrong and how serious it was. After half an hour, the Captain announced that owing to some mechanical trouble, the plane would now return to New York. Now, we, the passengers, were unaware of the nature of the trouble and, therefore, we imagined that it must be something serious because the plane was pitching up and down. We felt that the plane might crash and feared we may not survive. This state of doubt went on to fear bordering on panic. (Next to me was a priest going to Rome and he took out his Bible and started saying his prayers.) This state of suspense and dread continued till we landed at New York around 3 a.m. We all then heaved a big sigh of relief and congratulated ourselves on our safe return. On the next day, I boarded the same plane to London. From London I flew to Paris and then to Bombay. I felt absolutely fine. Some time after I resumed my practice in India, I had to fly to Bhavnagar to see a patient. I got into the plane and when the plane took off, I started feeling nervous. The nervousness increased and became fear, and the fear became dread. I felt terribly frightened and kept thinking that the plane might crash. With every little movement or jerk of the plane up or down, every time it slanted, with every little change in the sound of the engine, I got the feeling that it was going to crash. I felt most miserable and unhappy during the journey whereas earlier I used to enjoy every flight. I felt relieved when the plane landed at Bhavnagar. Now this experience of the flight to Bhavnagar was repeated when I had to fly to Goa and then to other cities to see other patients. The last time when I had to go to Delhi for a seminar, a friend of mine, Dr. S. suggested that I should take some medicine when I explained to him that I would prefer to go by train because of my fear. Since the symptom was that the fear of the fright had remained, the remedy I chose was Opium. I took a dose of Opium 1M, 3 hours before the air travel. After getting into the plane, I looked forward with fear to the flight. But as the plane took off I was talking with my friends and after a few minutes I noticed that I was not feeling any fear at all. The plane went into a cloud and bumped up and down, but I did not experience any fear. I had thus a fear-free journey throughout though I would not call it an enjoyable one because I was all the time looking forward to a return of the panic. During the return trip again, I was without fear, and this time I could even relax and enjoy the journey. Since then, my air journeys have once again become enjoyable." T.F. Allen mentions that Opium is not far removed botanically from Aconite. This may explain how both are useful for fright. Stramonium has also the agg. from fright but it has wide staring eyes with wide dilated pupils.

One of the characteristic objective symptoms which can guide the physician particularly in a case of coma is the pin-point pupil (PPP). If we remember that Opium comes from Poppy, this is easy to remember. "The mother of a renowned E.N. T. surgeon, herself a gynaecologist, aged 72 years, became ill and gradually went into uraemic coma. She had anuria. Her blood urea was 120 mg. Her B.P. was high. Her general condition was poor. Several physicians had come and had said that nothing could be done. The lady suddenly opened her eyes and said, "Call a homoeopath" and then went back into coma (she had great respect for Homoeopathy). So, I was called. I examined her pupils. They were pin-point. They pin-pointed the remedy to me. I gave her Opium 1M. Within 10 minutes her pulse and the B.P. improved. In one or two hours she became conscious, passed urine and soon became completely well. Two and half years later she died from some other cause." Two of the most common afflictions found in most of the diseases are pain and sleeplessness and since Opium is able to suppress or relieve these two conditions in crude doses it has been used and abused enormously for centuries. And this is how again it had been praised as an agent of highest value by the great Hufeland and as the most injurious poison, by Stahl, two famous physicians. Since pain is the prominent symptom of most diseases and Opium has predominently painlessness in most conditions, it seems Opium is not needed often in homoeopathic practice. This is apparent from the few references to the remedy that we find in our literature. But the fact is Opium is enormously beneficial and is indeed a life-saver in certain conditions and diseases where it may be needed. Pain is a chief diagnostic sign for the physician and its total abolition may seriously handicap the discovery of the nature of the disease. Therefore, the physician should use morphine as a miser spends his gold. If an allopathic physician wants to study homoeopathic Materia Medica, Opium would be one of the best remedies to start with. The (toxic) effects of opium are fairly well-known to him and these symptoms are most faithfully reflected in the homoeopathic Materia Medica. Boger admirably sums up the action of Opium in one phrase, "Negative, torpid states". There is absence of pain where pain is expected (e.g. painless ulcers), absence of secretions, causing dryness in general (except on the skin), absence of reaction (to stimuli, to medicines, of the pupil to light, etc.), absence of suffering, absence of moral sense (tendency to lie and deceive), absence of discharges (suppression, retention, etc.) and absence of eruptions in eruptive fevers. The respiration is slow. The pause between the breaths is so long that this, together with the general non-reactive comatose state of the patient, may give an impression that he is dead. Or the respirations may be unequal as in Cheyne-Stokes respiration. Or it can be of a rattling type (resembling a death rattle), sighing, snoring or stertorous nature. Like the respiration, the pulse is slow. There can be paralysis of the bowels which together with lack of secretion and absence of sensation conveyed to the brain produces no urge for stool resulting in dry ball-like stools. The scybalous stools further promote constipation. Opium covers both a stupid sleepy state or stupor and coma as well as a sleeplessness caused by any emotion such as fear or even joy.

Morphine produces both sneezing and itching of the nose. Coma, P.P. Pupils and greatly depressed respiration suggest morphine poisoning. Leriche M. has reported eight cases of Puerperal fever treated by Opium. Bayes writes, "There is no single drug in the Materia Medica whose range of action is so fully known as Opium. From narcotism at one end of the chain to its action as energizer at the other, it leads us from allopathy and antipathy to Homoeopathy, and shows how these opposite methods may each coordinate in the preservation of human life and in the relief of human suffering. This drug has its uses and advantages in each of the several methods of its administration. "Again, there are some diseases where pain is so prominent a symptom and so terrible in its violence, as to be in itself a source of great danger to life. There are other diseases which are in certain stages wholly incurable, and in which there are severe and agonising pains. In such cases, the administration of opium or its salts is not only admissible, but becomes a clear duty. I may give as familiar examples of the former, the passage of gall stones or of calculus from the kidney to the bladder. In both these cases as I have pointed out (under the heading of Calcarea) that I have found Calc-c 30 gives full relief, when conjoined with the hot bath; still if I found these means disappoint me, I should not hesitate to give a full dose of Opium or Laudanum. It would be inhuman to permit the long continuance of such acute suffering when the means of relief were ready at hand. "Why, then, not give opium at once?", an allopath will say. Because if I can give relief by the simpler means, I avoid the injurious after-effects of opium and my patient is sooner a sound man. "Why give opium at all ?" says the high dilutionist. Because if my homoeopathic remedy failed me, I could not permit my patient to remain longer in an agony which might produce such exhaustion as to end in a prolonged illness." I shall now describe the case of a morphia addict. "In August 1959, I was consulted by Dr. S. He reported that he had taken morphia for 3 or 4 days for some pain and had then become addicted to it. He now required 1/4 grain of morphia per dose six or seven times a day. During the period of this addiction in the last 3 or 4 months he had lost 22 lbs. in weight and had become careless about his profession. He complained that if he did not take the morphia he would feel some unbearable discomfort in the abdomen and develop a diarrhoea with sudden and frequent urging for stool. The discomfort and diarrhoea would be eased as soon as he took the morphia injection. When he consulted me first, I just prescribed Nu-v 200 t.i. d., feeling that it would antidote the effects of the narcotic drug. This gave him much relief. So I continued the remedy and in the course of a fortnight, he was able to cut down his injection to 2 or 3 per day but he still could not give it up. I changed the prescription to Opium CM, t.i. d. * and this gave considerable relief and in the course of another ten days he was able to give up the morphia." Those who have read case histories of morphia addicts and have seen them suffer and slowly sink deeper and deeper into the habit, will realise what is owed to Homoeopathy. Secondly, these cases seem to illustrate the point that homoeopathic remedies may act in spite of all opposition with crude drugs. So homoeopaths who insist on a very strict, puritanical diet and regimen may pause, reconsider and relent and give their patients more amplitude. Phosphorus

Phosphorus comes in the red or yellow varieties reminding us (signature) of jaundice and haemorrhage and it is one of the best remedies for liver disorders and for haemorrhagic conditions. "Phosphor" means light and many symptoms of this remedy can be connected to light. The word light conveys symbolically the meaning knowledge, and knowledge is perceived through the senses and the nervous system. Phos. has a marked effect on the senses and the nervous system. The patient's senses are acute, perception is exalted, and he is worse by noise, touch, odour, etc. He is acutely sensitive, so sensitive that strong odours may cause headache, as illustrated in the following case. "Mr. R.S. S., aged 24 years, was seen on 8th June 1964 for the following: Frontal headache for last 10 years. Usually he gets it twice a month. It is agg. by scented hair oils, agg. fasting, agg. reading much, agg. closed room, and agg. smoking and cigarette smoke. He is allergic to oranges, lemons, i.e. sour food; they cause coryza. Whenever he gets coryza he gets pain in right supraorbital region, sometimes in left also. His appetite, thirst, etc., are normal. Feels sensation of heat in head. Diagnosed as a case of sinusitis. Prev. Hist.: Tonsillectomy done in 1952. Had mumps in 1963. Fam. Hist.: His mother and one brother are mentally unsound. His case was repertorized using Kent's Repertory as follows: Head pain, fasting, from (p. 140) Head pain, odours, from strong (p. 144) Food, sour agg. (p. 1364) Head pain, air open, amel. (p. 136) = Phos., Sulph. Phos. covered the other symptoms also. So Phos. 1M was given. The patient started improving. The medicine had to be repeated in 1M potency on 22.06.64, 10.07.64, 24.07.64, 16.10.64, 09.11.64 and in 10M potency on 18.11.64 and 02.04.65. Thereafter, he had no headaches." Not only is the Phos. patient's sensory perception acute but he may also develop extrasensory perception (ESP) such as clairvoyance. He may developed delusions also and hear voices. He is sensitive to slightest environmental changes: physical changes such as change of atmosphere, temperature, weather, etc., (human barometer) and also mental and emotional changes such as company, moods of companions, etc. The patient is also sensitive to light and dark. He prefers the light to dark and gets depressed as the darkness comes on. He is agg. at the borderland of light i.e. twilight and so he is agg. in the morning and evening. Light is perceived through the eyes and Phos. has a special effect on the eyes. The eyes of the Phos. patient may be bright, even brilliant, and many conditions can arise within the eyes (affecting all parts of the eye), such as cataract, haemorrhage, atrophy of the optic nerve, detachment of retina, etc. The eyes are also very sensitive. The following case will illustrate its use in an eye condition. "Master T.S. R., aged 13 years, was brought to me on 14th Oct. 1964 for the following complaint:

He had a penetrating injury in the right eye, when a flask containing hydrogen gas exploded. He was admitted in the hospital at Mysore and was treated surgically. Later on, two wellknown ophthalmologists of Bombay were consulted. According to them, it was a vitreous haemorrhage and prognosis was generally good in the long run, but they could not give any opinion as to whether the condition would clear up at all and if so when. Now he can only distinguish between light and dark but cannot count fingers. His appetite, thirst, etc., are normal. Prev. Hist.: He had polio at the age of 21/2 years but recovered without much damage. Had chicken pox last year. Fam. Hist.: His mother has bleeding tendency. O/E: The pupil of right eye is dilated. Arn. 200, 21 doses T.D. S. given. This produced no change. Arn. 1M was then given for a week. There was slight improvement. He was able to count fingers in sunlight. So Arn. 1M was continued. But by 30.10.64, there was no further improvement. Then the boy developed new symptoms, viz. unbearable hunger and headache on fasting. So Phos. 1M, 14 doses, daily once, was given. The boy reported much improvement and the condition cleared up on the same remedy so that his vision became completely normal." There is photophobia and the patient may see better by shading the eyes. These patients are truly sensitive to form and shape, to light and shade, and to colours and because of quick perception and finer appreciation of these things, they have a sense of beauty and they make some of the best artists. The patients themselves are well-shaped in body, and are slender, tall and graceful. They have long, drooping eyelashes and long tapering fingers (like artists). These patients have an active metabolism, with the result they grow quickly, and so grow tall and thin. They shoot up, so to say. Becoming tall and thin suddenly they seem to bend like a creeper which droops and so these patients may become stooped. The Calc-c patient is generally known to be dull, sluggish and fat but the Calc-p patient becomes tall, active and sensitive and may get growing pains in the joints. This is due to the Phos. element. Dr. Boman Behram writes, "There is no homoeopathic explanation as to why Phosphorus should act on such a constitution, but detailed biochemistry of Phosphorus on human and animal organism has revealed that it has a profound influence on the metabolism of glucose. By its action, it depletes the store of glucose in the liver, muscles and other tissues for rapid combustion. Naturally, the fats are also burnt alongwith glucose, so that there is no chance of the fat being deposited in the body, therefore, the persons remain lean. Secondly, Phosphorus has a marked stimulating effect on the growing ends of the bones so that the person grows tall. Hence you have the Phosphorus constitution which is essentially tall and lean." The symptoms of Phos. also shoot up or travel in an upward direction. These patients may eat well and still emaciate due to the active metabolism, as in tuberculosis. Like many other tubercular remedies they have a craving for salt. Just as the substance Phosphorus, which has a tendency to ignite and burn spontaneously, is safe only if immersed in large quantities of cold water, so also this patient has a thirst requiring large quantities of cold water, which quenches the burning sensation in the body or stomach. The burning in stomach is also relieved by eating which becomes a general modality. Phos. has helped many cases of peptic ulcers especially duodenal ulcers where the pain is relieved by eating especially cold foods, and extends from the abdomen to the back or chest. These patients also get hunger pains at night. Phos. acts upon the cavities in the body such as the head, chest and abdomen and acts on the organs contained in these cavities such as the brain, lungs, heart, stomach, etc. (which

organs themselves have cavities in them). It may produce a sense of fullness or tightness in the same organs or cavities. The emptiness can also become a feeling of lightness or vertigo (floating or flying, as if Phos-ac has this symptom in a greater degree, and the patient when lying in bed feels as if the legs are lifted up in the air). The remedy is also able to produce and therefore, cure cavitation in a semisolid organ like the lung, and Phos. is one of our good remedies for tuberculosis. I have mentioned that Phos. is related to light. Absence of light is darkness which is symbolic of ignorance and often ignorance is the cause of fear. Phos. has fear of all sorts such as fear in the dark, of being alone, of thunder, in the crowd, of death, of disease, of evil, that something may happen, of insanity, of ghosts, robbers and so on. I have a printed case form which I give to my patients, in which there is a question, "Have you become anxious or afraid of anything such as being alone, of a crowd, of death, disease, evil, that something will happen, of insanity, ghosts, robbers, sudden noises, thunder, etc.?" If the patient ticks most or all of them or writes yes, meaning thereby that he has all these fears, then I think his remedy is most probably Phos. and on a careful study I do find that his other symptoms often tally with those of Phos. The following case will explain this point. "Mr. M.S. , aged 20 years, came to me on 5th Nov. 1952. He has been emaciating for last 6 months. Sometimes he gets shivering and internal burning in the morning for 15 days. Has a poor appetite. Wants to drink ice cold water. Gets cough on lying down. Prefers cold open air. Has fear of being alone, dark, robbers and thunderstorms. Prev. Hist.: Severe injury to the head at the age of 8; took 5 to 6 years to recover completely. No definite diagnosis could be established. The case was repertorized using Kent's Repertory, as follows: Fear, alone of being (p. 43) Fear, dark (p. 43) Fear, robbers of (p. 47) = Phos. alone came through and it also covered the following: Fear, thunderstorm of (p. 47) Cough, lying agg. (p. 798) Appetite wanting (p. 479) Emaciation (p. 1357) Injury (p. 1368) Phos. 30, 3 doses T.D. S. and placebo given. 14.11.52: Cough in morning. His general condition and appearance have improved much. He was given Bacill. 200, 1dose and by 25.03.53 he felt normal, having added 14 lbs to his weight. There was a relapse in June 1953 but Phos. 30 again made him well." Phos. seems to have a peculiar propensity for company. The patient cannot be alone. Not only does he want company and is amel. by company but he would like to be touched, stroked

or magnetised. The child would like to hold the mother's hand. This touch will reassure the child and remove its fears. An extreme form of this may be a desire for a sex partner. It is said that a dog which was poisoned by Phosphorus got violent sexual excitement and died during sexual intercourse. Phos. has violent sexual desire and also is a remedy for homosexuality. Mentally, the patient wants to receive and give affection. He is also over-sympathetic and cannot see others suffer, (like Causticum with which, however, it is inimical). Phos. has the peculiar symptom of a sense of well-being before an attack. The patient will feel quite well and then an illness would occur. Since well-being is generally associated with a good appetite, the patient may also feel hungry before an attack. Increased appetite during fever is also noted as a peculiarity and this has helped me to cure many fever cases with Phos. Psychologists say that those who desire to receive love and affection may take food as a substitute. Phos. has a desire for affection, as well as increased appetite. Phos. affects the bones esp. the long bones and produces necrosis. It peculiarly affects the mandible. The phossy jaw of workers in match factories is well-known. In this action it resembles Amphisboena which is prepared from the jaw bone of the lizard and produces swelling of the jaw. "Mrs. P., aged 34, years came on 23rd Sept. 1959 for the following: Backache, lumbosacral, which has started after a delivery 3 years back. The pain is agg. sitting bent and by exertion, amel. sitting erect and by rest. Her menses are regular but very painful, pain is worse after the flow starts. She was given a pessary and was better for sometime but is now worse again. Flow is changeable. She is restless during the menstrual period. Dreams of dead people. Has fears of robbers. She has become very doubtful. She gets headache worse seeing films and worse in the sun. Past Hist.: She has had an attack of dysentery. Family Hist.: N.A. D. Her case was repertorized as follows using Kent's Repertory: Fear of Robbers (p. 47) Suspicious (p. 85) Dreams of the dead (p. 1237) Back, pain, lumbar agg. sitting bent (p. 907) Phos. alone came through. Phos. covered the rest of the symptoms also. So, on 3rd Oct. she was given Phos. 1M, 3 doses in one day. Her response to this prescription was very satisfactory and she showed all-round improvement. On 20th Oct., she reported that she had her menses. There was some pain and the flow was scanty. So she was given Phos. 10M. This had to be repeated on 20.01.59. Thereafter, she has remained well. In Aug. 1965, she reported that she had been normal and that she has had no more trouble." "Mrs. M.S. came on 5th Jan. 1970 with the following complaints:

For last 20 years she has been addicted to Dexedrine and Methedrine. Generally takes about 100 Dexedrine tablets per day (as she and her husband told me). Got low B.P. When these drugs were not available, she became irritable, aggresive, restless and violent and felt like killing somebody. When she became violent, she would resist with as much strength as four men. Was sleepless for a long time while she was taking the drug. Now gets palpitation, sinking feeling, restlessness and vomiting of bitter fluid. Feels that she will die. Palpitation is agg. sitting, agg. walking, agg. 1 p.m. to 4 p.m. and on lying down. She cannot bear hunger, cries when hungry, likes warm, spicy food, cold drinks and extra salt. Constipated. Feels drowsy all the time. She was upset as her first husband gave her a lot of trouble and drove her to the point of insanity. Was given electric shocks when she was nervous. She is afraid of being alone, of ghosts, thunderstorms, earthquakes, darkness, death and sudden noise. She tried to commit suicide twice. Weeps easily; contradiction makes her angry. She gets offended easily, is emotional, jealous. Puts on weight easily. Fam. Hist.: Her mother had tuberculosis. Her case was repertorized using Kent's Repertory, with the following rubrics: Fear alone, of being (p. 43) Fear, ghosts, of (p. 45) Fear, death, of (p. 44) Fear, thunderstorm, of (p. 47) Suicidal disposition (p. 85) Desires, salt things (pp. 48, 63) Only Phos. came through. Nux-v 1M, 8 doses were given first, to be taken every 4 hours to remove the effects of the drugging. She felt slightly better. Then Phos. 1M was given to be taken four times a day. With these doses she felt amel.. Thereafter, Phos. 1M was given as and when necessary. She went on feeling much better with Phos. and she was able to completely give up the addiction to Dexedrine." "Some years ago, I was called out of town to see a patient who was said to be very ill. The patient, Mrs. S.N. M., aged 64 years, was suffering from pneumonia for the last 13 days. She had been paralysed and was incapacitated for the last one and a half years and had developed pneumonia. A homoeopathic physician had prescribed for her but her condition had deteriorated and the homoeopath himself, becoming rather anxious, had suggested allopathic treatment. An allopathic physician had been called but he had refused to come because the patient had been under homoeopathic treatment. This particular family had great faith in Homoeopathy and was still keen to have homoeopathic treatment. The patient had all the signs of pneumonia. She was conscious but could not speak as she was paralysed. I noted the following symptoms also: She would laugh often and without reason. Secondly, she would try to remove her blouse. Even if she did not remove her clothes, if her body was exposed she would not mind it. She had marked thirst at night. She had rattling respiration with cough agg. lying on the left side. I learnt that she had become worse after she had taken a cold bath while she was already having slight fever. Now, I studied and repertorized her case with the following symptoms in Kent's Repertory and Phatak's Repertory:

Shameless, exposes the person (K.p. 79) Laughing (K.p. 61) Cough agg. lying on left side (K.p. 797) Chilled when heated (Ph.p. 43) The only remedy that came through was Phosphorus. I was told that the previous homoeopath had already given Phos. but he had given only two or three doses and had not persisted. I gave her Phos. 200, first every 4 hours and then thrice a day. She improved steadily and became well in a week." "Mr. G.M. , aged 37 years, came on 25th Dec. 1965 with the following history: He is suffering from cough for the last four years, diagnosed as Chronic Bronchitis. It is spasmodic and very violent. It is agg. cold drinks; agg. dust and agg. lying on back. His appetite, thirst, etc., are normal. He is bald in front (hereditary). He gets skin trouble in winter sometimes. His mother had carcinoma. Carcin. 1M, 3 doses T.D. S., followed by Ars. 30, 6 doses T.D. S. given. By 04.01.66, his cough became worse and constant but every time he coughed he coughed twice. Also he got pain in chest on coughing. His case was then repertorized using Kent's Repertory, with the following symptoms: Chest pain, cough during (p. 842) Cough, paroxysmal, consisting of two coughs (p. 200) Cough, constant (p. 784) Cough, amel. cold drinks (p. 784) Cough, agg. lying on back (p. 797) Only Phos. came through. Phos. 30, 8 doses Q.D. S. given. He was considerably relieved but he had some relapses and Phos. had to be given in 1 M potency and repeated thrice and after an inter-current dose of Bacill. 1M, had to be given thrice again in 10M potency, and yet once again in 50M on 15.09.66. This completely cured him." "Mr. M.R. H., aged 40 years, consulted me on 6th Dec. 1966. Since he went to Madras in 1960, has constant mild abdominal pain, which comes on 3 to 4 hours after food with nausea. It is amel. after eating. He gets substernal burning and sour belching 1 hour after food. He cannot wait for food; feels weak when hungry. Takes 8 to 10 glasses of water a day. Prefers cold food and drinks. Is fond of day-dreaming. Past Hist.: In 1948, he had dyspepsia. Treated as amoebic dysentery and felt amel.. Used to get vertigo on raising his head from the pillow. Ba-meal X-ray showed "Gastritis".

His case was repertorized using Kent's Repertory with the following rubrics, and Phos. came through: Hunger, from agg. (p. 1367) Desires, cold food (p. 484) Stomach, pain, eating, 2 to 3 hours after (p. 513) Phos. 200, 6 doses T.D. S. and placebo given. In one month he felt much better. He continued treatment but then gave up when he felt normal, after a dose of Phos. 10M and then Phos. VI (i.e. 6th potency of the 50 millesimal scale) given on 28.07.67. " "Mrs. L.M. , aged 29, came on 14th May, 1965 with the following history: She has pain in hips for the last 6 years. It started suddenly and it is agg. change of position. Chocolates and chillies cause bad throat and loud noisy cough. She loves cold things and chillies. Her appetite, thirst, etc., are normal. Does not feel fresh in the A.M. but amel. after an afternoon nap. She gets pain in one spot, bilaterally symmetrically in her thighs, very sensitive to touch and pressure. She is fond of company. Likes sympathy. Is nervous. Past Hist.: She had typhoid at 6 years, was serious, then could not walk for 6 months. H/o fall 14 years back. She got hurt in abdomen, then got pain on and off for 1 year. Had Pneumonia at 9 years. Arn. 200, 14 doses B.D. was given first. She felt much better but had relapses and the medicines was repeated three times. By 30.10.65 there was a change in the symptoms. She developed a pain in right lumbar region agg. rising from a seat and pain in throat (Rt.). Her case was repertorized using Phatak's Repertory, as follows: Rising from sitting agg. (p. 226) Spots (p. 248) Direction, side, right (p. 68) Injuries, constitutional effects (p. 148) = Con., Phos. Because of the agg. form chillies and sweets, I selected Phos. Phos. 200, 3 doses T.D. S. and placebo given. She started improving steadily but I had to repeat the doses on and off going upto Phos. CM and later to VI and XXX (of the 50 millesimal scale). She felt normal by 02.01.67 and discontinued treatment." "Shree K.V. P., aged 42 years, turned up for consultation on 23rd Oct. with the following history: He had fried food on 01.010.64. Then got abdominal pain on the 3rd or 4th. It has been diagnosed as hyperacidity. Since then he gets pain with eructations smelling of food. He takes extra salt. He prefers cold food and drink, he even likes his tea cold. His thirst, stool,

sweat, etc., are normal. He cannot stand heat. Is worried about trifles and is always tense, and nervous. Cannot stand suspense. Likes company. He has got a weak memory and poor concentration. Weeps easily. Past Hist.: He had epistaxis in summer till age of 25. Had pneumonia twice. Once he had a fracture of his leg bone. Fam. Hist.: His father and sister died of tuberculosis. Because of the family history of tuberculosis, Tub. 1M, 3 doses were given in one day. This was followed one week later by Phos. 1M which rendered him all right." "Mr. P.J. , aged 21, came for consultation on 19th Dec. 1963. He gets backache for last one year. It is agg. at night. He is unable to turn his head sideways easily. It is agg. cold season and monsoon, agg. lying on right side. On turning on the back, pain is agg. at first and then is gradually amel., and is agg. turning in bed. It is amel. taking brandy and tea, agg. pressure and amel. by sitting erect. He has got pain in the gluteal region, right or left, while walking, for last 5 years. It started when he had travelled in an air-conditioned ship and had had a cold beer during the journey. It is agg. in Bombay. He cannot exert himself as it causes pain in chest and a tired feeling. He gets pain in precordium once in 4 or 6 months which lasts one day and is amel. by stretching the body and neck. He gets pain in right side of the abdomen on exertion, sometimes in the left side also. Cold drinks cause toothache. Any irregularity in food or food-timing upsets his health too much. Appetite, thirst, etc., normal. Cold sweat on palms. Nose gets blocked in cold season. Bleeds too much from wounds. Is irritable and nervous. Wants to be alone and quiet. He had a shock 4 years back when one of his dear friends died suddenly. Is worried about failure in a love affair. Past Hist.: He had rickets, typhoid, chicken pox, whooping cough and diphtheria. Fam. Hist.: Mother has tuberculosis. Father died of cancer. O/E. Scoliosis, Bulging of Rt. chest. Feeble diastolic murmur in Mitral area. Tenderness over 10th and 11th Dorsal and L5 spine and also in rt. sacroiliac joint. SLR +ve on rt. side, 30 degrees. His gait is stooped. Consulted a specialist who diagnosed it as a case of Koch's right hip joint and advised X-ray. His case was repertorized using Phatak's Repertory as follows: Lying, side, on right, agg. (p. 171) Haemorrhage (p. 120) Chilled, from exposure to cold agg. (p. 43) Gait, stooped bent (p. 144) Only Phos. came through. Phos. 30, 9 doses T.D. S. given. His condition was 50 percent better. Placebo was given. When improvement lapsed Phos. VI (i.e. 6th potency in 50 millesimal scale) was given in water once a day. Later he had one dose each of Carcinosin 1M and Tuberculinum 1M and then Phos. XXX in water daily. He felt 90 percent better in 2 months and became quite well in 5 months." "Mrs. K., aged 28 years, consulted me on 5th November 1952. She was suffering from frequent attacks of dyspnoea since the last 2 years. It is agg. lying on the left side and back and agg. by moon phases. Her appetite, thirst, etc., are normal. Woollen clothes agg.. Open air agg.. Ascending steps agg. . Pain in joints agg. flexing and extending, agg. beginning

motion. She has to take a deep breath now and then. Diagnosed as Eosinophilia. O/E looks anaemic. The case was repertorized using my Card Repertory and the following cards were chosen: No. 190 : Lying on back, agg. No. 194 : Lying on side, left agg. No. 211 : Moon phases, during agg. No. 214 : Motion, beginning agg., continued amel. No. 17 : Ascending agg. These cards when put together revealed the remedies Phos. and Sep. Phos. 200, 3 doses T.D. S. and placebo given. By 13.12.52, the patient reported continuous improvement. Appearance much better. Dyspnoea nil. No medicine. 20.10.53: Condition reported to be normal." "Mrs. S.K. , aged 23, came on 29th Jan. 1953. She had headache (rt) for one year. It is irregular and is agg. exposure to sun, agg. excessive heat or cold, agg. exertion and agg. morning and evening, amel. binding the head. Pain is generally rt. sided but sometimes goes from rt. to lt. There is also pain and formication in rt. eye and pain in rt. maxilla and teeth which is agg. least motion, agg. stooping, agg. lying on painful side. There is thirst for ice cold water esp. at night. Slightly agg. after food. Desires salt from childhood. Gets pain in lumbar region on exertion. Has profuse menses. Gets vertigo also. Prefers to be in company. The case was repertorized using Boger's Synoptic Key and Kent's Repertory, with the following symptoms: Side right to left (B.S. K.p. 44) Morning and evening, agg. (B.S. K.p. 17) Thirst at night (K.p. 528) Desires cold drinks (K.p. 484) Desires salty things (K.p. 486) 31.01.53: Headache was considerably amel. but she had thick, yellowish discharge from nose. Placebo. No further medicine was given but by 23.02.53 condition was normal. She did not get headache in spite of going in the sun. Vertigo nil. No Medicine." "Mrs. P.D. , aged 40 years, suffering from Cardiospasm consulted me on 26th Feb. 1965. Her history was as follows: Towards the end of 1962, while lying down, she noticed a gurgling sound in throat with regurgitation of fluid. She then developed a choking sensation while swallowing esp. solids, and she could locate the obstruction in the lower substernal region. She consulted an eminent E.N. T. surgeon. Ba. swallow did not reveal anything abnormal but an X-ray showed obstruction in the cardiac end of the stomach. The surgeon advised an operation but another

surgeon advised against it. The patient took homoeopathic treatment from a colleague of mine and felt some relief. It was at this stage that I was consulted. At present: She feels that the food is first obstructed in the cardiac end of the stomach, but then it drops into the stomach. She has choking and regurgitation, agg. lying on the left side or back, if she lies down immediately after food. Choking is amel. lying on abdomen. She can swallow better while sitting erect. Sour and spicy food, eggs and beer make her worse. She has vague pains in the joints. There is also pain in the teeth which feel loose. Appetite, thirst, etc., normal. Sweat nil. Patient feels chilly even in warm weather. Pt. is nervous and shy. Past Hist.: Bronchitis often. Malaria at 15 years treated with Quinine. Her case was studied as follows using Phatak's and Kent's Repertories: Cold agg. (Ph.p. 46) Lying on left side agg. (Ph.p. 171) Lying on back (Ph.p. 171) Food sour (K.p. 1364) Constriction cardiac orifice on swallowing (K.p. 483) Quinine abuse, of (K.p. 1397) Only Phos. came through. The patient as given Phos. 200, 1M and 10M, and Tub-bov 1M, at long intervals. She felt much better in her condition but she developed some eruptions below and around the right ear itching and exuding thick fluid. But the prescription was not changed. On 09.12.66, she went to New York. I advised her to take the opportunity to consult my respected and beloved teacher Dr. Elizabeth Hubbard in New York. But as she continued to improve on Phos. 10M, she did not consult Dr. Hubbard. She returned and reported that she was normal." Pulsatilla pratensis I must mention that I came to know Puls. much better after I engaged a lady doctor as my assistant. She was typically Puls. She would develop different symptoms on different days. Today she would have headache, tomorrow a backache, next day a throat pain, then a vertigo and so on. But she had some constant basic symptoms. They were as follows: 1. Agg. from fat food. This would cause diarrhoea. 2. Agg. from sour foods. She would get headache and throat pain. Even if one drop of lemon juice was put into her food without her knowledge, she would have a violent aggravation. 3. Agg. in summer. 4. Agg. by cold and heat. 5. Generally thirstless.

6. Weeping on the least provocation. Even if a patient insisted on getting an earlier appointment or if someone did not pay his fees or if some patient was rude, she would weep. 7. Marked amel. by sympathy. If she received sympathy even her headache would disappear. 8. Any emotional upset would cause symptoms like backache, throat pain, fever, etc. She responded to Puls. everytime and her general level of health improved considerably and she put up 40 lbs in weight. I am grateful to her for she made me understand this remedy better. I remember my earliest Pulsatilla case. There was a watch repairer who came and told me that he was suffering from a complete loss of appetite for four years and was willing to try Homoeopathy, though he had no faith in Homoeopathy or in me as I was just a beginner, and because he had already tried the best doctors of other systems. I took his case carefully and found no characteristic symptoms at all. All that I could find was that he had complete loss of appetite. If he ate even one slice of bread he would feel heavy the whole day. He had no thirst at all and was spitting all the time due to salivation. I looked up these three symptoms in Boger's Synoptic Key and I got Puls. I gave him Puls. 30, 1dose without much hope. Two days later, he came to see me again and I made him wait outside for two minutes. When I called him in I found that he had gone. Later he came back and explained to me that he had rushed to his house as he had felt desperately hungry. Finding nothing edible at home he ate up all the curd which was the only thing available then! And now I shall describe a recent case of mine. A young girl, Miss D., aged 17 years, came to me from some town in Gujarat. She had oliguria. Her peculiar symptom was that even though she would pass urine only once in 24 hours, that amount would still be very scanty. This was going on for the last one year. If she travelled, urination become even less so that she would not pass urine even once in 24 hrs. But in spite of this, she had no discomfort or pain or swelling anywhere in the body. Her other symptom was very scanty, black and offensive menses. She had been examined by several doctors but no one could make a diagnosis nor could anyone relieve her. I worked out the case and it came to Kali-c and Puls. I gave her Puls. which did not act at first. But after some doses of Opium (as it covered the lack of reaction, infrequent urination and absence of discomfort) when Puls. was repeated, it acted nicely. We had to go upto Puls. 50M and then she was cured. Incidentally, the British Homoeopathic Journal has published an excellent paper on Puls. by Dr. William Gutman. Dr. Gutman is a great thinker and he comes up with excellent papers on various remedies. His paper on Pulsatilla is a classic. The Puls. patient is chilly but is agg. by warmth. I must confess here that I do not give great importance to chilliness and warmth because I have seen Sepia patients who are warm and Lachesis patients who are chilly. Under the rubric "Cold and heat agg.", you will find remedies like Puls., Sep., Sil., Lach., etc., which we think are predominently agg. by cold or by heat. Again our remedies were proved in countries with different climatic conditions and we do not know how far they will apply here exactly. So, unless the patient is very markedly aggravated by heat or cold, I do not consider this.

I find some of the Puls. patients very irritable though according to the book, classically Puls. is not irritable. The only difference is that when the Puls. patient gets angry she weeps, as the following case will show: "Mrs. V.P. , aged 40 years, was directed to me by a homoeopath from Ahmedabad. She had been suffering for 8 years from recurrent coryza, cough and itching of the palate, all usually agg. at night. Cough is agg. lying down. Since the last 6 months she gets a swelling of limbs and face which appears on and off. Gets attacks of pain and redness in the eye near the outer canthus, right or left, on and off for the last 10 years. Dysmenorrhoea since puberty. Pain is agg. after flow starts - more the flow, more the pain. Has pain and heaviness in breasts before menses, with scanty menses. Cramps in the abdomen 10 days before menses, agg. left side and agg. turning to left side. Walking fast causes substernal pain. Chilly. Feels cold especially in hands and feet. Seasickness. Appetite, thirst, etc., normal. Aversion to milk. Sweats in the morning after rising. Has poor sleep. Is irritable, oversympathetic and emotional. Weeps when angry. Desires company. Is putting on weight. Past Hist.: 10 years back had measles; dysentery in 1949, which recurs in attacks every monsoon. Breast abscess after 2nd delivery. Tonsillectomy 21/2 years back is since then coryza is agg.. H/o shock due to brother's death in an accident. Since then, very sensitive and not in good health. Vaccinated often. X-ray (1951) showed lesion in lung and was treated with anti-tubercular drugs. Fam. Hist.: Uncle had Tub. of bone. On Exam. fingers and toes cold. Her case was repertorized using Kent's Repertory and Phatak's Repertory with the following symptoms: Grief, ailments from (K.p. 51) Sympathetic (K.p. 86) Menses, before agg. (K.p. 1373) Abdomen, pain, menses, during (K.p. 559) Cough, lying agg. (K.p. 785) Obesity (K.p. 1376) Itching, palate (K.p. 406) Motion slow, gentle, amel. (Ph.p. 192) Puls. alone covered all the symptoms. Puls. 1M, 3 doses t.d. s. was given for one day and she felt 50 percent better. As she did not respond further to Puls. 1M, she was given Puls. 10M, 3 doses t.d. s. She then reported continuous improvement till she became well." Recently I have been noticing that more and more patients of mine seem to require Puls. Many patients come and give symptoms which lead up to Puls. Sometimes I get a doubt as to whether I am prejudiced in favour of this remedy. But as a good number of these patients improve on Puls., I often wonder why this remedy seems to be more often needed. Is it because Puls. antidotes the ill-effects of drugs and many patients come to us after drugging? Changeability is one of the characteristic features of Puls. Hence, Puls. patients can be irritable and/or thirsty. (Ref. Kent's Repertory - Mind, Irritability p. 58; Stomach, Thirst, Extreme

p. 529.) Therefore, the presence of irritability and/or thirst in a patient does not necessarily contra-indicate Puls. According to the homoeopathic principle, any symptom that is produced by a remedy is an indication for that remedy. If Puls. has produced one thousand symptoms, all these one thousand symptoms can be indications for Puls. Suppose a remedy has produced one thousand symptoms and out of these one patient exhibits three symptoms, e.g. symptom No. 77, symptom No. 93, and symptom No. 140, and if this combination of the three symptoms is found in only one remedy, say Puls., then Puls. is the remedy for this patient, whether the picture of this patient corresponds or not to the picture of the remedy as described in the books or the picture that you have in your mind. If these three particular symptoms are covered only by Puls., whether the picture fits within your conception of Puls. or my conception or Hahnemann's conception, Puls. is the remedy. Pyrogenium The Greek word Pyro means fever, heat or burning. Pyrogens are known to produce fevers. Our Pyrogen has many indications esp. in septic fevers. I have described a case of Malignant tertian malaria dramatically cured by Pyrogen. * The indications for Pyro. that I have often noted in fevers in my practice are: (1) Hyperpyrexia, (2) Pulse out of proportion to temperature, whether increased or decreased, (3) A sense of well-being in a patient even with high temperature. The following cases will illustrate these points. "Master S.S. , aged 7 years, was seen on 18th July 1953. He had developed temperature about seven weeks back. The temperature had risen steadily every day and had become continuous, ranging between 103 oF and 104 oF . When the fever had gone on for a fortnight, an allopathic physician was called in. He diagnosed it as Enteric fever and prescribed Chloromycetin. The temperature dropped to normal in three days but after a fortnight went up again. This time Chloromycetin produced no effect. When the temperature continued for two weeks more, homoeopathic aid was sought. When the boy was first seen by me, the following symptoms could be elicited. Temp. 103.6 oF, Pulse: 132 per minute, Resp.: 32 per minute, General condition fair. The temperature is irregular and remittent, and sometimes rises twice in a day. He picks at his nose, and sometimes at his bedclothes; his hearing has become dulled after the onset of the fever; he is constipated. He has polyuria with the rise of temperature. As the fever rises, his memory becomes sharper and he wants to read his lessons; he then becomes very particular about wearing clean clothes. Physical examination and laboratory investigation gave no indications as to the cause; so it was classified as Pyrexia of Unknown Origin. The alertness during fever was suggestive of Pyrogen. A look into Allen's Materia Medica of the Nosodes brought out the symptom, "Frequent call to urinate as fever comes on" under Pyrogen (p. 415). On these indications, the boy was given one dose of Pyrogen 30, on the 18th itself. After this one dose, the temperature started falling gradually by one degree every day and eventually

came to normal in five days without any further dose of medicine, leaving the boy healthy and well. No marked pulse-temperature disproportion was noticed in the case." "I was once asked to see a girl aged 20 years, who had fever. She had originally been treated as a case of typhoid with Chloromycetin. The temperature came to normal but again rose. This time the Chloromycetin had no effect. The temperature rose in the evenings daily. It was now suspected as T.B. of the caecum. The girl had by birth a deformity with the result one leg was so shrunken that it was only a foot or so long while the other was normal. This gave her an ugly appearance and also a very bad complex and an ugly temper. When I saw her, she had been having a rise of temperature every evening. The parents gave me two peculiar symptoms, viz., that the girl would be depressed, irritable, fault-finding and quarrelsome in the mornings when her temperature was normal but would become sweettempered, jovial and friendly in the evenings when the temperature went up. They also told me that although she used to be in bad temper normally, she had been in better humour after the attack of fever had come on. On these indications, I gave her Pyro. 200. With two doses, the fever went down and she remained normal." Sepia officinalis I think Sepia is a wonderful remedy to study and to use. A very eminent homoeopath has stated that if he were allowed to keep only one drug, he would choose Sepia. Experience in practice confirms its great usefulness and wide field of application. Sepia is complementary to both Ignatia and Nux vomica, and combines all the depression and sadness of the former with the irritability of the latter. Considering the fact that it affects the sexual organs in women and considering that many of its aggravations are connected with the sexual sphere, e.g. with menses, coition, pregnancy, abortion, menopause, etc., it is an excellent remedy for various complaints in women. If you add the fact that is also covers the bad effects of anger, fright, grief, disappointment in love, etc., you can imagine its wide range of action. Women are particularly emotional and sensitive and they live in a small world. Therefore, small things assume great significance for them. So when you combine this mental state with the physical condition, you get a good picture of Sepia. Generally, we have the impression that Sep. has great aversion for sex. But it has also got a symptom, "sexual-minded". However, though she may be sexual-minded she has great agg. from coition and so is unable to enjoy it. This is why Boger describes the Sepia patient as "Miserable". I think it is particularly needed for women who have had many children or many abortions. Incidentally, women seem to suffer more after an abortion than after a full pregnancy. Abortion seems to produce a kind of serious disturbance in health. I also think that where women terminate a pregnancy by inducing abortion because they don't want children, it may produce some kind of guilt complex. The keynote of the physical symptoms of this remedy is relaxation. All the muscles and ligaments are so relaxed that there is a displacement, esp. downward, for it is the ligaments that bind and keep the organs and limbs in their proper positions. We get the various degrees of ptosis, e.g. of the eyelids (cf. Gels., of which it is a complementary), visceroptosis, prolapse of the uterus or rectum, dislocation of joints, etc. There is also a concomitant congestion of the pelvic viscera which causes heaviness, aggravates the ptosis and produces the feeling of dragging down, which can be a very uncomfortable feeling indeed! The downward displacement of the abdominal organs also gives rise to a feeling of emptiness in the upper

abdomen which the patient may try to fill up with food, believing it to be emptiness of stomach, but as it is not so, and it only provokes nausea. * The nausea is agg. by the sight, smell or thought of food. This symptom may be found in pregnancy. So, even with hunger the patient cannot enjoy food which makes her miserable. The discomfort in the pelvis is naturally aggravated by any condition which would increase the congestion of that area. So in women there is great suffering before and during the menses, by coition, pregnancy, abortion and during menopause. Repeated pregnancies and abortions (which unfortunately are so common in India) with other concomitant physical and emotional stresses ideally produce the Sepia picture. These promote further relaxation and congestion in the pelvis. As a result of this aggravation by coition and pregnancies, the woman has aversion to and is disgusted by sex, and is terribly upset even if the husband should make normal demands. The displaced organs impinge upon one another provoking more symptoms, e.g. the uterus if displaced backwards may press upon the rectum and produce a sensation of a lump or ball in the rectum or a frequent sensation for stool (cf. Nux-v), so that the patient goes and strains without result and only succeeds in adding to her discomfort by increasing the congestion. So also it may press upon the bladder and provoke frequent urging for micturation. The sensation of a lump can be felt elsewhere also, e.g. in the throat (globus hystericus cf. Ign.) or in the abdomen. If one remembers that the pelvic viscera are attached by their ligaments to the posterior wall of the abdomen or the back, and also the fact that all the ligaments supporting the vertebral column become lax, then one can realise how much discomfort is referred to the back. And if the patient is forced to stoop and work, the back is further strained. So, you have the picture of a woman with a history of many abortions or pregnancies, a hard working house-wife with many children to attend to, working and washing and wearing herself away, who cannot enjoy her food, for she often has nausea at the sight, smell or even at the thought of food (cf. Hyperemesis gravidarum) cannot rest, and cannot even satisfy her sex urge, which is so fundamental. Is there any wonder she becomes disgusted by the home, by the husband, by the children who all make so many demands on her and by life itself and wants to run away from it all? Is it any surprise that though she may be full of love she has no apparent affection towards even her near and dear ones? The Sepia patient has got some kind of venous stasis and she improves very much by exertion, esp. by violent motion such as dancing. Here, it is the opposite of Puls. which wants gentle motion, and it resembles Tarn. which also wants violent motion. Margaret Tyler with her marvellous insight calls it a washerwoman's remedy. I shall now describe one of the best cases of Sepia I have ever seen. "Mrs. J.K. H., aged 26 years, came for advice on 23rd April 1953. She was a Polish national and had been in a Russian concentration camp during the war. She had tried to escape along with her father, brothers and sisters. But all of them, her dear ones had been shot dead, all in front of her eyes. Ultimately she had managed to escape alone. She had come over to India, had married and settled down here. She had a baby born in August 1952 and since then she has not been well. She now has headaches, vertigo, indigestion and leucorrhoea and feels very weak. Headaches occur almost daily and are worse from noon till evening, hammering in type agg. pressure, amel. lying down, in the sun. She has also developed vertigo with

suffocation agg. moving about; frequent diarrhoea agg. eating pulses and potatoes; great aversion to milk; desire for sour and spicy food; nausea after food, nausea while travelling in a bus. Dreams frequently of the dead. She sweats less; she is amel. in open air. She has become very irritable. Wt. 96 lbs. B.P. 100/80. Has a brownish butterfly patch on her face. Past Hist.: Typhoid 1940; Dysentery 1940; Malaria 1945; Vaccinated every year, no reaction. Family Hist.: Mother died at the age of 49 of typhoid; father, brothers and sisters were shot. Has three children, all healthy. The case was repertorized with the following symptoms in Boger's Synoptic Key: Pregnancy (p. 42) Swaying, swinging, agg. (car sickness) (p. 29) Ascending agg. (p. 19) Aversion to milk (p. 73) Saddle, brown, across nose (p. 94) The only remedy to come through was Sepia and I was quite satisfied that this remedy covered the case well. So I gave her Sepia 200, 1 dose and Sac-l B.D. She improved steadily without any further medicine and by 9.6.1953, she was completely well. She also put on some weight. On 10.4.1957, I found that she was still quite well." Though the displacement of the viscera is downward, the direction of sensations is generally upward. I have made a mark in my book Sepia as follows: There is a sudden rush of blood upward to the chest and head (e.g. menopausal flushes), the nausea with tendency to bring up food, pains shooting upwards in rectum, vagina, etc. This direction reminds me of another case. "A certain hysterical lady came to me with numerous symptoms, the prominent one being that she often had a feeling that a ball entered her foot and travelled up, upto the shoulder and then disappeared. She was what some would classify as an amazon; she had divorced once and her innate haughtiness was heightened by her second husband's confession made to her that she had been conferred on him by God after he had prayed for many years. She gave a history that since she had no wish to have any children and that she had induced abortion nineteen times. Since for certain reasons I did not wish to treat her, I sent her on to a colleague. He picked out her remedy as Sepia correctly, no doubt basing his selection on, (1) the history of repeated abortions, (2) the sensation as of a ball and (3) the ascending direction, the corresponding rubrics being (ref. Boger's Synoptic Key): 1. Abortion (p. 84) 2. Ball, lump, knot, etc., as if (p. 31) 3. Direction, ascending (p. 84)

The remedy helped her considerably." The Sepia patient is said to be chilly but one must remember that the typical Sepia washerwoman of Dr. Tyler was also agg. by the heat of the room and the heat of the iron. Kent gives this remedy under "cold and heat, agg." and this is often verified in practice. The Sepia fish, when it is attacked, throws out a brownish inky secretion (which was used by artists), and thus forms a cloudy protective screen to hide and to escape. The Sepia patient also develops emotional antagonism and, behaving as if she is being attacked, throws out a screen of indifference which clouds and masks her real tender nature and feelings. Pulsatilla and Sepia often resemble each other, both being very touchy, but the Sepia patient does not break down or weep so easily. Pulsatilla seems to be needed more by the immature, adolescent, sensitive girl of puberty, while Sepia seems to be indicated better in the experienced, hardened woman of climaxis. She has usually seen and put up with many more vicissitudes. She is, unlike Puls., very indifferent and irritable, disliking sympathy and company. She does not lack in love but in affection, which is the manifestation or expression of love. Even the love of self is stifled to such an extent that the patient becomes indifferent to her own affairs. Though the Sepia patient often moans or groans, one must remember that she is quite tough. She groans because of the intensity and variety of troubles she has to undergo which however she will not express freely. It might have been noticed that so many patients of Sepia are women. This sex shows a readiness to develop subacute and chronic inflammatory conditions in the pelvis and these respond very well to this remedy. Another symptom often seen is the brownish butterfly-like patch (Chloasma) * seen on the face with the wings on both sides of the nose. There is a recent belief in the medical field that certain areas of the skin correspond to certain internal organs, and that disorders in these organs produce corresponding changes in the relevant areas of the skin **. Homoeopathy has recognised much earlier such inter-relationship of various tissues and organs. Often Sepia resembles Nat-m. The latter is the chemical analogue of the former. After all, the Sepia fish is a resident of the sea and remains thoroughly soaked in brine. Here is another patient of Sepia who felt grateful to Homoeopathy for the relief she got. "Miss B.F. , aged 47, came on 14.09.59 with the following complaints: She has hypertension since 3 years. She gets vertigo and syncope if she looks upwards or downwards. Has pain in limbs which is amel. by bandaging. Her menses are scanty and painful, with pain agg. during menses. She passes urine three to four times at night. She is very irritable. On examination : Butterfly-like brownish patch on the face. Her B.P. is 200/120. Her case was repertorized using Kent's Repertory with the following rubrics: Vertigo agg. looking up (p. 100) Vertigo agg. looking down (p. 100) Pain uterus, during menses (p. 734) Puls. and Sepia came through. Because of her hyper-irritability I chose Sepia.

Sepia 1M, 3 doses in one day and placebo were given. She improved steadily, felt better and by 04.01.60, her B.P. came down to 130/80. " "Mrs. S. aged 33, saw me on 13th May 1964. Her complaints were : Hernia for last 5 months. A pain in the left lumbar region for last 2 months, which is amel. by bending forward and amel. by warm application. Her appetite, thirst, etc., are normal. Fried food and pulses cause flatulence and diarrhoea. Gets cough on exposure to fan. Likes open air. She is not well since her last delivery 21/2 years back. Feels a sensation of prolapse during her menstrual periods. She weeps easily at trifles. Gets irritated and beats children because she does not have a male child. She is worried. Past History: She has had typhoid twice, measles, whooping cough, chicken pox, flu, dysentery, rheumatism and tonsillitis. She used to get numbness of the upper extremities including the fingers. O/E Tenderness in umbilical region. She is obese. Has dark rings around the eyes. Her body smells offensive. Her case was repertorized using Kent's Repertory and Phatak's Repertory with the following symptoms: Food, fat, agg. (K.p. 1363) Food, beans and peas, agg. (K.p. 1362) Pregnancy, child bed, affections of/or since agg. (Ph.p. 213) Obesity (K.p. 1376) Female genitalia, prolapse, uterus, menses, during (K.p. 743) Only Puls. and Sep. came through. She was first given Carcinosin 1M, because of the h/o several infectious diseases. One week later, she received Sep. 1M, 3 doses in one day. Sepia was selected because of her irritability. She improved steadily and became well by 30.05.64. " "Mr. V.P. , aged 25 years, son of an allopathic doctor, came on 4th June 1971 with the following complaints: One year back, suddenly he got pain in both feet which extended upto the knees and thighs. He consulted some specialist and took treatment with no relief. Now gets pain in the knees alternating between left and right knee. It is agg. ascending, flexing, agg. beginning motion, agg. morning, and amel. hot application. His appetite, stool, etc., are normal. Takes ten glasses of water per day. Gets depressed easily. P/H: He had liver disease in childhood for which he has taken an ayurvedic preparation of zinc for a long period. H/o trauma to knees. Fam. Hist.: His grandmother had tub. adenitis. Great grandmother had cancer. His case was repertorized using Phatak's Repertory and following symptoms were selected: Alternating effects, sides, metastasis (p. 8) Motion, beginning, agg. (p. 182) Direction, ascending (p. 67) Thirst (p. 269)

Only Phos. and Sep. covered the symptoms. Because of the family history I gave him first Carcin. 1M followed one week later by Tub-bov 1M. Because Phos. covered the h/o trauma rather than Sep. I gave him Phos. 30, daily once. As there was no amel., I gave him as an antidote to the old Zinc medication, Zn 30, t.d. s. for a week followed by Sep. 30, b.d. for a week. Sep. was given because of his depressive moods. He started improving and the doses of Sep. were reduced. By 01.12.73 he became normal." "Mrs. L.D. , wife of an allopathic G.P. also practising Homoeopathy, aged 25 years, came on 22nd Aug. 1969. She was pregnant. She had intense nausea for the last 11/2 months. It was agg. in a closed room , strong odours , agg. 4 p.m. agg. talking, and agg. walking. It was amel. in open air and amel. vomiting. She had a bad or bitter taste in mouth. She was thirstless. She had an acute sense of smell. She felt completely relieved with Tab. 30, 200 and 1M. Unfortunately, she had a premature baby and the baby expired the day after birth. The next year she conceived again and developed nausea and vomiting. Now she gets nausea and vomiting since last 2 months. Tab., Lyc., Puls., etc., have been given without any relief. All the previous symptoms have returned. She has become very sensitive to noise, touch and odours. She has a desire for open air. Also has a strong desire for company. Cannot tolerate tight clothes on her body. Gets pain in abdomen which is agg. lying on back. She had frequent urination and leucorrhoea. Her case was repertorized using Kent's Repertory as follows: Sensitive, noise, to (p. 509) Clothing, intolerance of (p. 1348) Air, open, desire for (p. 1344) Company, desire for (p. 12) Urination, frequent (p. 657) Smell, acute (p. 349) Leucorrhoea, pregnancy (p. 722) Lying back, on, agg. (p. 1372) Sep. alone covered all the rubrics. Sep. 200, 3 doses t.d. s. given. She felt better and by 14.12.70 she became completely well with Sepia, given as and when necessary." "Shri E.S. N., aged 39 years, came on 14.12.63 for pain in epigastrium agg. when hungry, amel. after eating, amel. eructations, agg. by pressure and agg. by bending forward. X-ray report on 23.03.61 showed chronic duodenal ulcer. No other symptoms of value could be elicited. The case was repertorized using Boger's Synoptic Key with the following symptoms: Eating amel.; Pressure amel.; Bending agg..

Only Sep. covered the symptoms. Sep. 200, 3 doses in one day and placebo given. He got relief. With Sep. given in various higher potencies, he improved considerably. Later he required Kali-bi, and then again Sep. to cure him." I have also found it useful in chronic dysentery-like conditions. "Shri A.D. D., aged 25 years, came with the following history: Two months back he had an attack of dysentery. Since then he gets abdominal pain before passing stool. Pain is stitching and is shoots up. Pain is agg. by taking cabbage, potatoes, cold drinks or buttermilk, and agg. after stool. He dislikes hot drinks. He is irritable and gets tired by speaking. The case was repertorized with Kent's Repertory and the following symptoms were selected, viz.: Food, cabbage, agg. Eating, satiety, to Food, bread, agg. Food, potatoes, agg. Food, cold drinks agg. Only Sep. covered all these symptoms. Sepia starting with 200 and going upto CM cured him." Silicea terra Some years back there was an excellent paper on Silicea by William Gutman published in the American and British homoeopathic journals. Therein he starts by saying that Silicea is derived from the earth's crust. Having started at this point, he then goes on building up the character and explaining the characteristic symptoms of Sil. The crust consists of sand or grit and the patient shows lack of grit. The earth's crust gets easily heated by the sun and easily chilled also. The Sil. patient also is sensitive to cold and heat and is worse by cold and heat. (Some people think that the Sil. patient is only worse by cold. This is not true.) The earth's crust was originally soft consisting of lava and then gradually it became harder and harder. In Sil. also the soft parts become hard, e.g. the glands, the muscles, etc., become hard and the hard parts become soft, e.g. abscess formation of the bones, caries of the teeth, etc. There is an irregular distribution of matter. There may be overdevelopment of some parts and underdevelopment of others. For instance, the Sil. child has a big head and small body. A very large number of children are found to improve on Sil. if they have a large head, shyness and obstinacy, tendency to suppuration, a history of late or difficult dentition, etc. Borland describe that Calc. is dull, almost like Bar-c, while Sil. is extremely sensitive and alert. The patient may be mentally sharp and physically in poor shape. If you study the mind also you see a peculiar combination - of timidity and obstinacy. Timidity means lack of courage. So, when you find children with lack of courage, you think that these children cannot have will power. But they prove to be obstinate. Also the child may be stubborn or hard outside but soft or yielding inside like a coconut or an oyster in its shell. The oyster's shell is only the hardened secretion of the oyster and consists of silicea. Boger uses the word, "Stubborn" in a

general sense. The disease may be stubborn, or the patient may have stubborn-abscesses, non-healing fistulae or stubbornness in mind. People say that Silica represents the fibre of the plant which keeps it erect and it also affects the back-bone of the patient, mentally making him cowardly and physically producing curvatures. It has another good symptom i.e. nervousness. The patient is quite nervous and this may be exhibited in so many ways e.g. cold perspiration in the palms, soles, etc. The Sil. patient is worse by anticipation. I had once seen a boy who was the son of a High Court Judge. The boy was appearing for his law examination. He would start vomiting violently three days before each of his final examinations, so much so that he could not appear at all for the exams. For three years, year after year, this went on and the father was very much worried for his sake. Sil. set him completely all right. He appeared and passed in the examination. I have used Sil. when head injuries result in convulsions. They may be worse in sleep and during moon phases. Sometimes there is a history of late teething, walking, etc. There are more remedies for head injuries than those given in Kent's Repertory. * Of course Sil. can apply to epileptiform convulsions without a h/o head injury. In one case when I could not clearly distinguish between Calc-c and Sil., I have given Calc-sil with good results. Suppression of any symptom can never help the patient. And Sil. may be needed when there is suppression of foot-sweat, ear discharge, etc. Sil. is one of the most sensitive and nervous patients. He cannot bear noise, pain, etc. If Sil. seems indicated and fails I think of Sil. marina. The following is a typical case of Sil. A boy S.P. , aged 18 years, was brought to me for coryza of 3 years' duration. It is agg. in evening, agg. in rainy season, agg. if exposed to dust, agg. if he has a cold bath. He gets headache over eyebrows and pain in eyes as if they were popping out. He is nervous. Gets cold perspiration in palms and soles, when nervous. He is very shy and timid. Wants to cover himself with a blanket even in summer. Teething had started late He was very constipated in childhood. The remedy was clearly Sil. His father was so pleased that he took up the study of Homoeopathy and when he retired he himself started his consulting homoeopathic practice in the building next to mine! Sulphur The Sanskrit world for Sulphur is (Sulphari) which means enemy of copper *. From this word the Latin word Sulphuricum is derived. However, the great Greek poet, refers to Sulphur as Brimstone i.e. burning stone. Since on burning it produces a strongly smelling gas, it is called (Gandhak) **. Sulphur is mostly derived from the lava or the molten red-hot fiery liquid that erupts from the inside of the earth through the volcanoes. The character of the source can be seen reflected in the centrifugal force of the drug which drives and throws out everything on to the surface, bringing internal peace. The red-hot openings of the volcanoes have their counterparts in the red-hot orifices, e.g. eyelids, lips, nostrils, meatus of the ears, anus, etc., through which the red-hot burning discharges comes out. Sulphur itself catches fire easily and because of this quality, it was used in the manufacture of gunpowder by the Chinese several centuries ago.

The (liquid) outpouring can be seen in the diarrhoea, (Mag-s is a well-known purgative). Taken in mass, Sulphur is an inert powder and the greater part escapes unchanged with the stools, but some of it forms sulphides, mostly sodium sulphide, in the alkaline fluids of the intestines and these cause irritation of the mucous membrane, with consequent increased peristalsis and mild purgation. In some instances inflammation has been set up, with resultant pain and mucus and bloody evacuations. The skin is particularly vulnerable and exhibits various manifestations like eruptions, ulcers, warts, etc. (The eruptions of the volcanoes are reflected in the eruptions on the skin.) This is no surprise since the skin contains sulphur and has a particular affinity for sulphur. Ointments containing sulphur are used as external applications for various skin conditions in Ayurvedic and Allopathic medicine particularly for scabies, and Sulphur springs are very popular in patients suffering from skin diseases. Hydrogen sulphide (H2S) is one of the most offensive gases and this can explain the extremely offensive discharges of the Sulphur patients. Some of the sulphides are absorbed and destroyed in the organism with the liberation of sulphuretted hydrogen which escapes via the lungs and skin, giving the characteristic odour of rotten eggs to the breath and perspiration, others form sulphates and are excreted in the urine. The patient himself is found to be offensive. Water being the enemy of fire, the Sulphur patients are worse by washing and bathing. Antimonium crudum which is a sulphur compound (Antimony sulphide) also has aversion to and agg. from bath. The Sulphur patient also develops dirty habits. He is himself dirty and offensive and/or is indifferent to dirty and offensive surroundings. The yellow colour of the element is also seen in the yellow staining of the perspiration. The depletion by perspiration or diarrhoea may account for excessive thirst and the craving for salt. Insulin contains Sulphur and this may explain the craving for sweets and agg. from sweets. The metabolism itself is disturbed and so the patient is always hungry, he gets well but emaciates. He has also craving for fats. Of the 5 remedies in Kent's Repertory given for desire for fats, viz., Ars., Hep., Nit-ac, Nux-v, and Sulph. Sulph. is the only one agg. by warmth. The experiment of Prof. Augustus Bier is very interesting and gives us some idea of the nature of Sulph. He put a patient on Sulphur 3x and found that the patient started excreting daily 576 mg of Sulphur, which is sixty times the normal rate. Even after the Sulphur was discontinued he was found to excrete 117 mg on the day after, he then averaged 54 mg for ten days, and after 30 days he was still excreting about twice the normal. The seborrhoea about which he had complained was markedly improved and his general well-being decidely better than before the experiment. The patient was located two years later and agreed for the sake of experiment to make a retrial, although he considered himself cured. When he now took Sulphur 6x for 10 days, hardly any extra excretion of sulphur was found. The relationship between Arsenic and Sulphur is interesting. Sulph. is complementary to Ars., but they are widely different in nature. Ars. is agg. by cold and Sulph. agg. by warmth. Ars. is meticulous, wants everything in its place. Sulph. is indifferent, careless, slovenly and dirty. The excessive anxiety, hurry and restlessness of Ars. contrasts with the euphoric, slow, lazy state of Sulphur. Arsenic is an artist (the latin word for Arts is Ars.) while Sulph. is a scientist and goes on questioning everything. Sulph. is a good remedy to close the treatment of acute diseases and to begin the treatment of chronic conditions.

Almost every rubric in our repertories contains Sulph.; so, the neophyte is likely to select Sulph. for every patient. Only later on he will understand where Sulph. is really indicated, though of course it is needed in many cases. I narrate the following case not only to show how Sulph. acts when indicated but also to illustrate how it can overcome obstacles in the way of cure and help in addiction. "In Jan. 1965, Dr. S.M. O., in charge of a Govt. hospital, consulted me regarding his mother. She was a lady aged 60 years suffering from a very painful osteoarthritis of the lumbar spine. She could not stand up or walk, and could only sit up with difficulty. It was an agony for her even to turn in bed. Her son not being able to bear to see her suffering had one day given her Pethidine which gave her considerable relief. He repeated the injections for some days as she became restless and uneasy without them. But soon he realised to his dismay that she had now developed an addiction to the drug; this, in addition to her original disease. She suffered agony when she was deprived of the drug. She not only required the drug but even if the quantity of the drug was reduced slightly she would feel the difference. Being very perturbed by this, the doctor sought the help of Homoeopathy. I found in her symptoms like burning of the palms and soles, inability to withstand hunger, increased thirst, redness of the lips, early morning diarrhoea, etc., all indicating Sulphur. But before I prescribed for her, the doctor laid down the condition that even while under homoeopathic treatment if his mother craved for the drug and suffered without it, he should prefer to give her the Pethidine as he could not allow her to suffer. Finding that it was either a case of allowing the continuation of the drug along with the homoeopathic medication and taking a chance of providing relief, however slender, or giving up the case altogether, I agreed to the condition and gave her Sulphur 200, 3 doses in one day, followed by placebo. This gave some relief to her pains. Later on, I had to give her Zn and other drugs. She improved steadily. She continued to take Pethidin for a few days but the craving for the drug also decreased and we were able to discontinue it without any ill-effects. Tarentula hispanica Tarentula hispanica, the Spanish Spider remedy, is another fascinating one to study. Before studying the symptomatology of the remedy, it would be worthwhile to study the nature and behaviour of the spider itself. Spiders, in general, are known for spinning and weaving artful traps, into which they lure their victims. This spider is found in the western part of America, and in Italy. Before the rainy season it migrates in herds, travelling in leaps and bounds. It makes its nest in the ground in small holes in a burrow lined with web which turns a crooked angle after going down a few inches. There the spider sits to watch for its prospective prey. When it spies its prey, it does its work suddenly and violently - one sharp pounce on the neck of the victim and the ganglia are severed, paralysing or killing the victim. It strikes and disappears, never holding on. Before the victim is able to turn round, the spider has vanished from sight into its hole, so quickly that the victim may turn around and find nothing and imagine that probably nothing has bitten him and that it was all his imagination. Also there may be no immediate manifestations. But as spring comes on, the patient feels a certain terrible restlessness. For the victims of this spider poison, a peculiar treatment is adopted. As spring comes on, groups of pipers go from village to village and play particular tunes on their pipes in the village square. At the sound of the first note of music the victims of the spiders bite, persons who had been hitherto apathetic or drowsy, become restless and excited, start swaying

involuntarily and gradually begin to dance rhythmically. With this dancing movement they come out before the pipers, so that in a few minutes all the (bitten) victims in the village have assembled in the square, continuing their dance, the dancing becomes fast, then faster, then vigorous and then wild and frenzied but is continued and may last for days at a stretch. The pipers continue to play in relays. At the end of 3 days, all the victims sink to the ground thoroughly exhausted and soaked in sweat. But then, they find they are rid of the effects of the spider poisoning. Julia Loos describes the symptoms very nicely. She writes, "Tarentula Hispanica is a member of the spider family Lycosa, of tropic or sub-tropic origin, and is commonly known to the world for its fatal poison and the intense sufferings which this brings to its victims. The poison is a glandular secretion and this concentrated essence is a vehicle transmitting to the victim the characteristic nature of the creature which produced it. The provings of this poison and the indicated therapeutic uses following thereon are derived from a prepared tincture of the living spider, whose influence pervades this product. "The intelligence of the creature appears as disorderly. Instability is the outstanding feature: Instability of action, of purpose, in wisdom for carrying through its changing purpose. "Adroit, conceited of its cleverness; yet stupidly assuming that false methods and false motives will escape detection, it elaborates manoeuvers to deceive. Appearing in view, even parading its presence; then seeking cover, it hides from detection, unexpectedly to emerge from ambush to attack its victim elsewhere unaware. "All purpose, whatever and however carried out, excludes every consideration of the interest, the desire or the purpose of another. Only self-interest and desires are observed; and these are whimsical, changeful without limit, without calculation or foresight. Its habit is restless activity. "The guiding light is darkness; avoiding light, Tarentula shuns all investigation of its way or wish and, withdrawing to whatever convenient lair of the moment, by hidden devious path it makes its way to another point of vantage, resenting with insult any endeavour to change its course or to dislodge it. "Clever, adroit, furtive sly ways of carrying through courses of action which, were they announced, would be opposed by attendants or associates: these ways, and the doing of unusual things trivial in themselves and fulfilling no purpose engage the individual affected. Here are peerings and, "peekings" into things and into affairs; hiding from view; hiding things. He is destructive: interfering with plans; menacing the safety of himself and of others. "He loves to assume the false as a basis of conduct; and depends on whims for guidance; this mind does not submit its thought, its desires, to the light of wisdom or of truth. It shuns such gauge or investigation and darts from idea to idea with the ability and the seeming purposelessness of the spider. Defence from seeming interference is aggressive, through some sort of vicious thrust, cutting remark or threatened injury. "Restlessness, tormenting, intense, demands continued motion. In bed: rolling from side to side; when able to be out of bed, compels to walk, even though walking aggravates symptoms of the body. Herein is shown the contrariness within himself. "Chorea: twitchings and jerkings - continuing into night - of single muscles, groups of muscles, entire limb or head; and more general, in body contortions or in the dance. Ameliorated through influence of music.

"Sometimes a sweet cheerfulness and gaiety, while at other times, anger, irritability. Quarrelsome, excitable; exhilarated or sad: but whatever the emotion - quite unwarranted by circumstances or environment and unrelated to persons or incidents; merely an outcropping of the entire mood. "Aversion to company; but wants someone present. Making persistent demand on those present to minister to complaints. Complaints concurrent and so numerous, they cannot all be met nor ministered to at once; satisfaction is impossible. Gratitude and content are expelled from consciousness. Discontented with himself and with all things about him. "Delirium, mania, shrieking, singing; erotic mania, or stupefaction, or indisposed to talk. Yet the entire condition may be held in abeyance and positively ameliorated through persistent and habitual bathing... "In many instances, after attaining a measure of success with Arsenicum album, in acute or recent disorders or for repeatedly recurrent distresses, the prescriber is led to explore this subtle constitutional background. Arsenicum "covers the case" to a limited degree. The symptoms and the characteristics shown before Arsenicum was called out, together with the tendencies, the lowered resistance and the frailties which feature the patient's experience after Arsenicum has cancelled the acute disturbances, display a total condition frequently recognizable as Tarentula." All these features are represented in the symptoms - the quickness, suddenness, violence, destructive tendency, cunningness, etc. The great sensitivity to music is also found in the patient who on hearing any musical note becomes charmed and attracted and leaves off whatever he maybe doing. The remedy has both agg. from music and amel. from music because the music may excite him first but later on soothe him, or again whether the music has aggravating or ameliorating effect may depend on the type of music and the type of patient. The restlessness and the quickness are reflected in the amelioraton from rapid and violent motion, e.g. violent dancing (cf. Sepia). It is said the patients can run better than walk like the patient of Parkinsonism. The extraordinary cunningness is also noted in the patient who may behave in an entirely different way in front of outsiders. He may thus exhibit two types of personalities like Dr. Jekyll and Mr. Hyde. The destructive tendency of the spider is also reflected in the patient who destroys things without any purpose. The symptoms of this remedy are described beautifully by the late Dr. Margaret Tyler. She has quoted a case of Dr. Roberts. The patient was lying quietly on the cot when the nurse left the room for washing her hands. Suddenly the nurse heard loud crashing noises. When she ran back into the patient's room, she found the patient lying as quietly as she had left her. But everything on the shelf had been swept down and smashed within the few brief moments of her absence. "I had once an occasion to stay with an acquaintance. As soon as I hung up my coat he took charge of my wallet. When I asked him the reason, he gave me a long story somewhat as follows: He had an only son aged 14. This boy was brilliant in some ways but appeared mad in some ways. He would do the most crazy things without any reason. Once just before the whole family was leaving on vacation he invited all his teachers to his house for dinner. Next day, when all the poor teachers turned up with pleasant anticipation they found the doors locked. Not all his pranks were harmless. Once, he gave away his gold necklace to the servant and then reported that it had been stolen. The servant was put in prison. Once, he had his head shaved, begged at street corners, collected money and spent it. Once, he went to his father's

friend and wept saying his mother was dead and borrowed money for the funeral. He could tell the wildest lies without a moment's hesitation. He would pick the pockets of guests. Sometimes he was most cunning. He made the life of his parents most miserable and his father confided to me that he was so ashamed by his son's behaviour he was actually thinking of committing suicide. In spite of all these aberrations, there was one thing that captivated the boy and that was music. He was crazy after music. He had bought some musical instruments and without lessons or books, of his own accord, had become an expert on these instruments. Because of the cunning and malicious nature, the tendency to tell lies and steal, and his ardent attachment to music, I prescribed Tarentula hisp. 10 M. With a few doses and in the course of one or two years the boy became perfectly normal and a source of joy to his parents. He is now a professor of Hindi. An individual who was becoming almost a burden is now transformed into a useful member of society." "Another interesting case was that of an old lady aged seventy-one who was living with two of her daughters who were unmarried. For some unknown reason she had started behaving very oddly for the last 2 years. She was a widow and her three daughters had sacrificed much in order to make her happy. Two of them had remained single for her sake. But the mother had started abusing the daughters, using bad and even obscene language. She would demand from them more and more money, fine clothes, rich food, etc., things they could not afford to give. She would squander and waste their money. They had engaged a very good servant-maid but the old lady went after her blood. She would tear away the servant's clothes and then she would complain that she herself had been beaten. Nobody who saw her frail, wizened, old figure would believe that she was capable of hurting even a fly. After having eaten well, she would go to her neighbour's house and say she was starving and would eat in their house too. While taking food in her own house she would pick up some item of food, hide it, take it out and eat it surreptitiously, sometimes after 2 or 3 days when it had become stale. When her daughters were away at work, she would sell away all the furniture and household belongings for a song. She would put salt or water into the various dishes and spoil them so that no one could consume them. She would bang, damage and destroy things. She would pass urine or stool in the room. She would collect old and useless things and treasure them. In fact, she became a nuisance to her daughters and neighbours. They had decided that they could endure this no more and were actually going to put her in an asylum. It was then that they thought of trying Homoeopathy. One dose of Tarentula made an amazing transformation in her personality. Within 24 hours she was utterly changed. She started behaving in a completely normal manner. I was surprised myself, the daughters were delighted, the neighbours were astonished and everyone was vastly pleased and relieved. She lived for a few years more and was completely well with infrequent doses of Tarentula. Thuja occidentalis Thuja is a favourite remedy with my colleague Dr. Sarosh Wadia. That may be because he is practising near the naval quarters and the naval people have, I believe, more than their share of vaccination and gonorrhoea. (They say a sailor has a wife in every port.) Thuja is given for the ill-effects of vaccination. Now three questions arise in my mind for which I do not yet know the definite answers. Firstly, is Thuja to be given to a person who when vaccinated gets a violent reaction, or to one who gets no reaction? Secondly, people say Thuja is indicated by a history of repeated vaccination. How many times or how often should a person have been vaccinated in order to call it repeated vaccination? Thirdly, is Thuja to be given to a person with a history of gonorrhoea, irrespective of whether the symptoms of Thuja are present now or not? Carefully recorded experiences alone can provide the answers to these questions.

Homoeopaths think that vaccination is extremely harmful. Is this really so? Does vaccination help or not in the prevention of smallpox? I ask this question because of the following experience. Three years back, Mr. Everitt of Nelson's in London had written to me asking me to supply one drop of pus taken from a typical smallpox pustule. I had assured him that I would be able to supply this very soon because we always have in India, if not thousand, at least hundreds of cases of smallpox. At that time I was treating a doctor who was an R.M. O. in the the Infectious Disease Hospital here. She promised to get me a drop of pus as soon as the first typical case of smallpox came up. But imagine, she could not get this sample even after one year because they did not get a single typical case! It seems after compulsory revaccination has been enforced the cases of smallpox have dropped practically to zero. There was not a single case of smallpox admitted in the Infectious Disease Hospital! So, I could not get or send the drop of pus for one whole year. This fact has to be taken into consideration when we talk about vaccination and its ill-effects. I must also mention that in the last 4 or 5 years, I am seeing less and less cases of Diphtheria and Whooping cough. I do not know if this is due to routine immunization done with triple antigen by allopathic doctors. There are seven or eight remedies given under the rubric "Vaccination agg." in Kent's Repertory. There are still more remedies given by Allen in his Keynotes. We generally prefer Thuja. But S.R. Phatak prescribes Ars. for the ill-effects of vaccination. He says that he has found Arsenic effective for this purpose. Following is an interesting case of Thuja: "Smt. M.S. , aged 75 years, came for consultation to me, on 11.07.61, with the following history: Has a hard nodule or tumour of the size of a lemon in the rt. iliac fossa for last one year. She consulted Dr. B., a well-known surgeon, who opined that it is a calcified fibroid. Advised operation. Has occasional pain with no specific features. B.P. 180/100. Wt. 76 lbs. Calc-f 1M (3) doses for one day and then Sac-l. On 18.07.61; Has more pain, Aur-m-n 3, T.D. S. On 05.08.61; Has still pain and heaviness in abdomen. Calc-f 1M (3) doses for the first day and then Aur-m-n 3, twice a day for one week were given. She gave up the treatment but nearly four years later, she came with a different set of complaints. On 22.05.65: Burning in urethra after urination; flow intermittent, pain in Rt. iliac fossa agg. lying on rt. side, agg. pressure. Cond. was normal for three years. Now she has again pain in right iliac fossa. The case was repertorized using Phatak's Repertory: Urination, after (p. 287) + Urination intermittent (p. 288) + Tumours (p. 118) = Thuja. Thuja 1M (3) doses and placebo for a week was given. I then lost touch with her but she came to me early in 1968 for some minor complaint. I examined her and found the nodule gone and she told me she had taken no other medicines except those given by me." "Dr. S.K. , aged 38, approached me for brownish pigemented patches in the upper eyelids above the inner canthi. Though this usually indicates an excess of blood cholesterol, in his case the levels were only 158. The only symptoms I could get from him were that he was

addicted to alcohol and smoking and he had a desire for salt. He was obese. When I looked up these symptoms, viz. Alcohol agg., Tobacco agg., Desire for salt and Skin discolouration brownish spots, I found the following remedies, viz., Calc., Con., Sulph. and Thuja. I gave him Thuja 30 twice a day. There was remarkable reduction in the spots." Some notes on the nosodes Introduction The subject of Nosodes provides a most interesting study to the homoeopath and yet, strangely, the nosodes seem to have received much less attention that they deserve, in spite of their great utility and efficacy when indicated in practice. Goldberg says, "It may be aptly said of the nosodes that they have the unusual distinction of being the most abused, unused, and misused of all the remedies in the homoeopathic Materia Medica. Some physicians use when routinely, others use them rarely or not at all." We shall now try to make this even by bringing out the salient features of some of nosodes. The term Nosode is derived from the Greek word, "Nosos" meaning disease. Nosode is the name used to denote a remedy prepared either from actual disease tissue or disease secretion (discharge) or from disease-associated organisms, bacteria or viruses in culture form. In some cases the commercial vaccine, for instance polio vaccine or T.A. B. (Antityphoidparatyphoid) vaccine in potencies. Nosodes may be of vegetable (e.g. Secale cornutum), animal (e.g. Ambra grisea), or human origin (e.g. Psorinum). A very large number of nosode preparations have been produced, many of them only related to some specific disease or even a particular case of illness. Soon after Hahnemann propounded the similia principle which states that diseases could be treated by drugs which are most similar in their effects, it was realised that the most similar is only slightly removed from the completely similar or the identical substance (Idem). Naturally, efforts were made to utilise the identical morbific agent in the treatment of diseases, which led to the method of treatment known as Isopathy. Hahnemann clearly distinguished between isopathy and homoeopathy, being aware of the possibility of treating diseases by products of the same disease. For instance, he was known to have used in his practice Psorinum though he did not publish the indications of Psorinum, since it had not undergone systematic provings and he did not like to incorporate into his Materia Medica anything that had not undergone such investigation. Hering was the first to openly introduce disease products into Homoeopathy by proving Lyssin. However, one of his followers, Samuel Swan went further along these lines and developed a number of such disease-products. Later, H.C. Allen published his book "Materia Medica of the Nosodes" in which is incorporated the symptomatology of several nosodes. This book contains also, besides that of the nosodes the symptomatology of healthy animal products (sarcodes) and imponderable substances like Xrays. Nosodes have been compared to vaccines and even called oral vaccines. Boger writes: "When our late confrere, Dr. H.C. Allen, pointed to the nosodes as the most important of remedies in arousing reaction, he did the greatest thing of his busy life." Coleman says, "Vaccine therapy has found its way into general medicine of today. It is only a modification of the method taught by Xenocrates and introduced later thorough the homoeopathic school by Dr. Lux in 1823 under the name of Isopathy. Hering, Swan, Burnett and others did much along this line. Hering proposed the employment of the diluted saliva of a rabid dog for hydrophobia in 1833, antedating Pasteur. Swan antedated Koch in the discovery of Tuberculinum. Koch

introduced Tuberculin in 1890. Burnett began his work with this remedy (under the name of Bacillinum) in 1885 and obtained results never dreamed of by Koch. We do not have any idea of the exact number of nosodes and sarcodes available but over 20 are well-known viz: Agaricus, Ambra grisea, Anthracinum, Bacillinum, Eel's serum, Cholesterin, Diphtherinum, Castor equi, Influenzinum, Lyssin, Malandrinum, Malaria officinalis, Medorrhinum, Morbillinum, Parotidinum, Pertussin, Psorinum, Pyrogen, Scirrhinum, Thyroidin, Tuberculinum, Ustilago, Variolinum, etc. Clarke in his Dictionary gives 18 animal nosodes, 4 vegetable nosodes, 25 sarcodes and 12 sarcode derivations. In this list preparations of poisonous animals Homarus, Sanguisuga, Erythrinum, etc., are not included. More products have been added latterly. For instance, Clarke mentions a product called Cerebrin. This is probably a sarcode and not a nosode. Amongst the recent products added are Carcinosin, Iscador and the Bowel Nosodes. Autogenous nosodes can also be made from the secretions of the patient. For instance, Green reports a case of eczema which was cured by a potency made from the discharge itself, after Graph., Petr., Mez., Sulph., etc., had failed. Commenting on the utility of the sarcodes and nosodes Yingling writes, "The Sarcodes form a series of remedies of very great importance. They are remedies prepared from healthy animal tissues and organs, including the Sarcode-derivatives, such as Cholesterinum, Lac defloratum, Pancreatinum, Pepsinum, Saccharum lactis, Thyroidinum, Urea, Uric acid, and possible others. Some of these Sarcodes are well known today, such as Cholesterinum, Lac defloratum, Pancreatinum, Pepsinum, Castor equi, Helix tosta, Lac caninum, Lac felinum, Ovi gallinae pellicula, Thyroidinum, etc., and part of them are Polycrests used extensively. They are invaluable to us as curatives. It would be impossible to get along in active practice without part of them. A carpenter might as well try to ply his trade without a saw or the mason without a trowel. The list from this source may be extensively increased in the future." He also says, "What shall we say of the Nosodes, remedies derived from morbid tissues and secretions containing the specific virus of diseases? Some twenty of the animal and four of the vegetable nosodes are now used with success. The list may be extended largely. We, of this society, all know and appreciate their use and value. It would be impossible today to get along without them. Our usefulness would be wonderfully curtailed and menaced." Hubbard thinks that the practice of homoeopathic pediatrics cannot develop its best results without the frequent use of the basic nosodes. Various explanations have been offered to prove that nosodes are not isopathic remedies. It has been suggested that potentization alters the nature of the original substance so that the resulting product becomes similar and not identical. But the correct reasoning seems to be that the nosode represents a product of disease in a particular individual, animal or plant. Each disease-product is the result of an interaction between a particular individual and a particular pathogenetic agent. Since these two factors and the resulting reaction cannot be exactly duplicated, the resulting product can never be identically same for any other case of disease, though the outward disease-manifestations and the disease-label may be the same. For instance, in virus diseases, it is known that the virus may mutate from time to time. The virus of the Asian Influenza epidemic of 1956 was different from the virus of the Influenza epidemic of 1918. The manifestations were also different. The mortality of the 1918 epidemic

was high while the mortality of the later epidemic was practically nil. Similarly, when bacteria are attacked by antibiotics, these organisms are found to develop different strains which are resistant to the drugs. These are instances to show the variability in the nature of the invading organism. The variability in the nature of each nosode introduced by the other factor, viz., the sick individual has also not been fully appreciated. No two individuals in the world are exactly alike and the reaction of each individual to a specific circumstances or agent is bound to be different from that of any other individual, however, much the reactions may appear to the alike. As a corollary, a nosode-product developed from the diseased tissue of one individual will probably vary in nature and indications from the nosode-product developed from the diseased tissue of another individual, though the disease entity affecting both persons may be the same. McCrae has remarked upon the fact that so many nosodes, e.g. Bacillinum, Malandrinum, Medorrhinum, Psorinum, Pyrogen, etc., fall in the 8th Emanometer group, i.e. the same group, as Sulphur, the same group in which large number of patients tend to fall. This cannot be a mere accident. In fact, it seems the nosodes tend to fall under the same Emanometer group as the group of the sick person from whom it is extracted. It is also mentioned that when the same nosode is prepared from different persons, each preparation may fall under a different group; with the result, we may have a Syphilinum of the 8th group, one of the 7th group and so on, if we were to prepare the nosode from different sick individuals. The enormous implications of this discovery can be easily imagined. Unlike many other animal and vegetable products, the nosodes have not been subjected to any chemical analysis. This is probably because the products themselves are not chemical entities but biological products. However Judd Lewis has made an attempt to analyse Pyrogen. Indications The broad general indications of the nosodes are given hereunder. They may be prescribed: 1. On the indications of the actual symptoms of each nosode, i.e. on symptom-similarity. 2. For assisting the effect of the main remedy in certain cases, both acute and chronic, where though indicated clearly, the similimum does not act well. 3. For initiating the treatment in conditions where the indications for any regular remedy are very few, too few for a good prescription to be made. 4. For cases where there are indications for any drugs but for not anyone of them very specifically. 5. For eradicating the miasmatic background in chronic cases. 6. For antidoting complications or sequelae of acute infectious diseases. 7. When the patient traces the whole disorder to a previous acute infectious illness, however remote. 8. When convalescence after an acute disease is unduly slow, when the patient is apt to relapse and when after an acute infectious disease the patient, though apparently well, does not pick up health. When asked, "Do you see Pneumococcine?", Borland replies, "I use all the nosodes of that type much more for the after-effects than during the acute illness. I have been awfully disappointed by them during the acute attack, but they are simply marvellous in clearing up

the effects of pneumonia. For instance, if you have a patient who has never been well since a pneumonia, a dose of Pneumococcine simply makes a new man of him. And Dipth. is the same so far as I can see in the actual disease. We tried it here and without much effect in actual diphtherias, giving Diphtherinum didn't have the effect we had hoped, whereas giving the appropriate Mercury salt, as it mostly was, the result was astonishing. But a postdiphtheretic heart would jump ahead on a dose of Diphtherinum. "It is the same with "flus". Influenzinum does not work well in "flus", but it is astonishing what it will do for a patient with influenzal depression or something of that sort. "It is exactly the same in tuberculosis. I think Tuberculinum is definitely dangerous in an acute T.B. , and yet a tuberculous taint in the patient responds astonishingly to Tuberculinum. And there were some experiments carried out in gonorrhoea with Medorrhinum and they got no results at all, but you know the astonishing effect it has with a gonorrhoeal taint. "For the after-effects, I usually give 200 in single dose, and they seem to respond well. I repeat it in a couple of months' time." 9. When there is a family history of diseases like tuberculosis cancer, etc., and as a result the patient does not improve well on the indicated remedy, and 10. For the prophylaxis of infectious diseases. Wheeler recommends that in epidemics, the corresponding nosode in the 30th potency will protect for at least a fortnight. Others like Grimmer recommend one dose in high potency, once a year. We shall now discuss some of these indications: Speaking of the action of the nosodes in general, Hayes says that Ambra affects the solar plexus and disturbs nerve function, Psorinum affects the secretions, Pyrogen the lymph, Anthracinum the RBCs, and Tuberculinum the membranes, Diphtherinum the suprarenals, and Syphilinum the connective tissue. Gordon Ross writes, "Nosodes should not be used too often in one patient. They go deeper than our usual medicines and in my experience, they act more markedly on the young and middle aged and have little effect in geriatric work." However Tyler says, "In my experience the nosodes are not long acting. I have thought that their reactions are apt to run out in a month." The effectivity of the nosode in preventing infectious diseases seems to have been established. Samuel Swan has reported a number of instances where the administration of Variolinum has apparently prevented the onset of smallpox. Wheeler has conducted scientific experiments with potencies of Diphtherotoxin and has shown that the drug in potency has the power of altering the Schick reaction. Various other reports are also to be found in the literature which seem to prove that the various nosodes have prevented specified diseases. Of course in some cases, a drug which has produced a similar symptom picture also appears to have acted as a prophylactic, but between the two, the similar drug and the nosode, the nosode is apparently preferred, because of its greater similarity and easier selection. Particularly in tuberculosis, the nosode Tuberculinum seems to have a very definite effect in producing prophylaxis. Incidentally, the preventive virtues of Tuberculinum seems to be safer too. Kennedy has questioned the statement that BCG is absolutely safe. In a letter to the

Editor of the British Medical Journal, he gives instances of children who were adversely affected by BCG vaccination. The detailed symptomatology and indications for the various nosodes have been given by various authors in different ways. We shall only glance at some of the prominent features of some of the nosodes and sarcodes. Remedies Ambra grisea It is prepared from ambergris, the strange ash-gray wax substance formed in the alimentary canal of the sperm whale, used in the manufacture of perfumes. This is possibly a pathological product. Characteristic of this remedy is a liability to easy embarrassment, a tendency to avoid strangers through shyness, to cut across the street in order to avoid meeting someone. Is illat-ease in company, cannot, for instance, pass stool in the presence of anyone, even a nurse. Music is quite unbearable, may cause weeping tremors in the spine, or bring on a fit of coughing. There is sensitivity also to smells and noises. Depression, even despair, alternates with violent rage. The subject is likely to be weak, wasted and shaky, and may look prematurely old. It seems more applicable to older men. Physical complaints are widespread throbbing or pulsation; pains are relieved by walking out of doors or by lying on the painful part. The subject is warm-blooded, feels worse in a warm room, prefers cold air, cold food and cold drinks. Numbness and tingling are prominent symptoms. Skin affections itch, burn and are often vesicular. Anthracinum The source of this valuable remedy is a material from the spleen of an infected animal. The first preparation was made in 1830 and was found to be of definite curative value in both cattle and human subjects suffering from anthrax. It is most effective in treating boils or carbuncles associated with severe burning pain and great prostration. The centre of the lesion is often black and the surrounding area blue and possibly blistered. It resembles Ars. Anthracinum has the severe burning pains and malignancy of Ars. and the coldness and collape of Carb-v. It may help carbuncles and like conditions when Ars. fails. Gangrene with foul pus, with septicaemia, malignant erysipelas are other indications, also insect stings which are followed by lymphangitis. Boger says, "After serums, Anthracinum, Psorinum or Sulphur are often indicated." Hayes thinks Phos. is more often indicated. Carcinosinum While we are deeply indebted to W.L. Templeton for proving this nosode, the credit for exposing the extensive possibilities of its clinical application must go to D.M. Foubister.

Quite a number of potencies have been prepared from different samples of cancerous tissue. Experience has shown certain indications for the use of this remedy. One of these is "a strong family history of cancer, diabetes, or tuberculosis". A point emphasized in relation to the prescribing of this nosode as a constitutional remedy, however, is that it is probably unsafe to give it to patients suspected of cancer. Children requiring the remedy often show "a brownish, café au lait complexion, numerous moles and blue sclerotics" .They are often to be found sleeping in the knee-elbow posture. Fastidiousness is often noticeable. There is either a craving for or an aversion to salt, milk, eggs, fat and fruit. They are influenced by sea air, being either better or worse at the seaside. It is a remedy to be considered in relation to insomnia with delay in falling to sleep, frequent waking and a tendency to stay awake after 4 a.m. It has been found of value in emotional disturbance with a back-ground of fright, prolonged fear or unhappiness. I give it almost routinely; 1. to all patients who give a history of any blood relative having suffered from Carcinoma, 2. to all patients who give a history of having suffered from several (at least four or five) acute infectious diseases in their childhood, 3. to patients who have several naevi on the body. Whereas Foubister thinks that Carcinosin may act adversely and allow the disease to metastate if given to patients who are actually suffering from cancer, Le Hunte Cooper who used Carcinosin extensively says, "I would lay it down as a maxim that there is no case of carcinoma that Carcinosin will not benefit at some period of its existence, so much so, that I could suggest the proverb, "When in doubt give Carcinosin." I may here relate an interesting case which benefited from Carcinosin. I was consulted regarding a girl, aged 14 years, who was having nocturnal enuresis. Both the parents of the girl were physicians and so they had tried and exhausted all known and available medicines and methods without any benefit. They had become quite depressed and desperate, ready to try anything, even Homoeopathy. Particularly, the mother of the girl was quite skeptical and even hopeless because as she said, her own mother had suffered from nocturnal enuresis till the age of 20 and she herself (a doctor) had had it till the age of 25. She probably had calculated that her daughter, i.e. my patient, might continue to have the trouble till the age of 30 or so. They had consulted a good homoeopathic colleague of mine and tried his medicines but they had failed. I compared notes with this colleague and found that he had selected the medicines well but there was a strong family history of cancer and he had done nothing about it. So I gave now a dose of Carcinosin and you could visualise the mother's joy when she found that this completely cured the girl, a joy which she expressed in several ways. Sankaran and Matani posed a question whether in cases with a family history of Cancer a dose of Carcinosin will necessarily produce improvement or help the action of the main remedy if interposed as an inter-current remedy. To answer this question they gave a large serie of such cases Carcinosin and noted the results . The conclusion reached was that around 20% of the patients showed a good response out of whom some showed a splendid response.

Castor equi Farrington writes that this sarcode made from the rudimentary thumb nail of the horse has healed one third of his cases of sore nipples after parturition. It has affinity for the female nipples, hair, nails and bone esp. the right tibia and coccyx. Cholesterinum Yingling reports some cures of gallstone colic and other diseases of the liver (Medical Advance, p. 659, Aug. 1908) and arrives at the following conclusion: "In gallstone colic the patient suffers so severely that it is almost impossible to obtain symptoms. In such a case, when I cannot give a well-selected remedy, of late, I rely on Cholesterinum, and thus far it has never failed. It should have a proving. Until then it can be used instead of Morphine in cases where the symptoms cannot be obtained for the proper selection of a remedy. Where a case of routine work is necessary, as it is sometimes, I believe the homoeopathic guess should be given the preference. It is very improbable that a person suffering from gallstone colic will wait very long for the physician to study the case." Swan thinks that Cholesterinum which is prepared from gallstones is almost a specific for gallstones and relieves the colic at once. Allen says that Cholesterinum has great power over the pain of liver cancer. Diphtherinum This remedy is prepared from diphtheritic tissue. It is of value in the actual disease. Given early in a case with a positive throat swab it will quickly render further swabs negative. Its use is safer than that of antitoxin. Given to contacts it is a most effective prophylactic. It should also be considered when there is a previous history of an attack of diphtheria, followed perhaps by chronic ill health. It can also be prescribed in a case where paralysis of the soft palate has supervened after an attack of diphtheria. Allen says that he has used Diphtherinum as a prophylactic for 25 years and has not seen a second case occur in a family after it has been given. "Never well since Diphtheria" is a well-known indication for Diphtherinum. Margaret Tyler describes the picturesque results in a case to illustrate this. "With the doctor who is my clinical assistant, and who had previously seen the girl, we set out to find her some ten days ago. Her mother was emphatic in regard to the atrocious pain she used to suffer during her twenty year's martyrdom, and how it had ceased almost immediately, and finally, with the first dose, or doses, of Diphtherinum. She described how the wet rags she used to put on her head, to try to ease the pain, steamed. "Oh! If I had only brought her to you, all those years ago!" (during which, her head gradually enlarged, while she lost one eye after the other; one ear's hearing after the other; half the function of tongue and gullet), "She might never have been like this..." "I could not have helped her then; I had not the knowledge. As a matter of fact I treated her diphtheria, which she had at seven years of age! ..."

"Yes, she had it very badly. She very nearly died. And she has never been well since! All this has come from that illness... I should have come back to you directly" (I had not seen her for a year!), "if the pain had returned. But she has not had a scrap of pain since that first dose you gave her. (Some three and a half years ago!)" Powell writes that Diph. is curative in pharyngitis not amenable to other remedies. He says there is more pain that the appearance warrants. Cahis says, "It is a great remedy, it is not only a sure remedy against diphtheria (at present I have not only cured cases of diphtheria of the tonsils, the nose and mouth, but also those accompanying the scarlet fever, in which disease I have cured all the cases without any local remedies or any injections) but besides, it is the principal remedy for the paresis, the paralysis, the anaesthesiae, and all post-haemorrhagic or post-embolic nerve lesions. It is also the remedy for strabismus, prolapse of the womb, paralytic constipation, enuresis, atonic spermatorrhoea, passive haemorrhages and catarrhs. Of all this large sphere of action I have practical experience. There is not one of its applications from which I have not had at least a brilliant result." Allen considers that Diphtherinum is practically worthless in potencies below the 30th and that its curative value increases with increase of potency from 200th to CM. He also says that it should not be repeated frequently. I may here relate a remarkable case I had treated with Diphtherinum, though I have already reported this elsewhere. Master P.B. , aged 14 years, a young boy, was brought to me for consultation on 28th Oct. 1963, with very severe pain in the hamstring tendons of the right leg, of 15 days' duration. The pain was so severe and he was so much aggravated by stretching the leg, that the boy could not stand up or walk. He had to be carried to the bathroom by his father whenever he wanted to attend nature's calls. On examination, I found tenderness in the right popliteal fossa. The lateral tendon which is normally palpable on flexion could not be felt or seen. His appetite, thirst, stool, sleep, etc., were normal but enquiry revealed that one month previously he had had an attack of measles. Further, I learnt that in July 56, he had suffered from an attack of Diphtheria (?) from which he had recovered with the help of A.D. Serum but since, then his health had not at all been good. He used to suffer some disorder or other every day, throat trouble or fever or abdominal pain or vomiting and so on. Though the boy had approached me only for the acute condition of the pain in the hamstring tendons, I thought of treating the background first. After all, there was the possibility that he was suffering from ill-effects or sequelae of Diphtheria whether it was related to the present illness or not. So I gave him six doses of Diphtherinum 1M to be taken T.D. S., thinking I would clear up the background first. I was planning to work out the remedy for his acute condition, after two days. On 31st Oct. 1963, that is three days later, he returned to consult me and you can imagine my surprise when I found that the severe pain and tenderness in the legs had completely disappeared! He could extend his legs completely and was able to walk about normally. His mother reported that within the last two days his general health has become much better.

I gave him no further medicine. I saw him again on 11th Nov. 1963. His condition was normal. He got slight pain in the leg only if he walked very long distances. Till 1st August 1966, he has remained normal. Several interesting points rise in our mind on reflecting about the case described above. I shall mainly deal with one important point. When a person is affected by an acute infectious disease, e.g. diphtheria, measles, etc., then the patient is given treatment with antibiotics, sera or any other appropriate treatment available in modern medicine. The patient recovers and apparently becomes well. But very often he complains of some residual weakness. He is then given some vitamins or tonics to overcome this weakness and to build him up. But this usually does not suffice, because the residual toxins have to be directly antidoted. And only the proper homoeopathic remedy, perhaps the appropriate nosode, can do this. Serum anguillae Donald Gladish writes that he has found Eel's serum (Serum anguillare ichthyotoxin) very useful in hypertension with renal disease, presenting no guiding symptoms. Chiron reports a case of congestive heart failure cured by Eel's serum. I once had a very happy experience with this remedy. A close relative of mine aged 70 years living in Madras, who was much addicted to alcohol, once went into coma and was admitted in the allopathic hospital there. His blood urea was very high and it was suspected as a case of renal failure. After some days of treatment the physicians finding no response at all stopped all the medicines and told the relatives to take him back home because they had no hope of his recovery. A cousin of mine rang me up from Madras and asked whether I could suggest some medicine. When I enquired about the symptoms, he could give no indications at all except that the patient was comatose. Without any hope, I prescribed for him Eel's serum over the phone. A few hours later, I received a message that this remedy was not at all available in Madras. Though he was expected to survive only for a few hours, I sent the remedy from Bombay which reached them the next day. I was told that after two or three doses were given, the patient became conscious and his condition then gradually improved. His blood urea came down to normal and he was then discharged from the hospital after a few days. The improvement in the condition of this patient can be attributed only to Eel's serum because all other medication had been stopped in his case. * Lyssinum This nosode is prepared from the saliva of a rabid dog. The interest here is that Hering's work with this virus preceded Pasteur's discovery by some fifty years. It is used as prophylactic in cases of bites from a rabid animal, dog, wolf, bat or other. It is, nevertheless, of vital importance in as much as the disease once developed is invariably fatal. This nosode should be given after any dog bite whether the dog is mad or otherwise. Gibson says, "Any steps available should, therefore, be taken without delay in the event of such a bite or even a slight scratch or abrasion. As an additional precaution this nosode could also be given."

A peculiar aggravation is that all complaints are made worse by the sight or sound of running water. Mentally there is a fear of becoming insane. Convulsion may be induced by dazzling light or light reflected from water or a mirror, or even by light touch or a current of air. The sight of running water causes a desire to urinate. The heat of the sun is not tolerated. It is said to be of value in long-standing cases of uterine prolapse. Berridge reports a case of hydrophobia in which the nosode produced euthanasia. Woodbury says, "In sex difficulties of women at the mid-century, Med. or Syph. may be needed. Or if spasms are present and the patient wakes in the night with lascivious thoughts, consider Lys." Influenzinum Influenzinum is indicated for poor reaction, when the patient's recovery is poor after influenza. It also acts as a preventive if given in the autumn of the year. Someone has said Influenza is the cowbird of the disease family, "depositing its germ in the nest with every other infection". Fifty percent of all chronic cases have chronic influenza as one of its complications and often it is the sole cause of their chronic state. Obsessions, delusions and other anxious states may show their appearances to long after the acute attack of influenza as not to be readily associated with it. While Influenzinum is rarely of benefit in an acute case of influenza, its use in the chronic case is frequently astonishing. Patients who have been ailing or complaining since an attack of this disease, recent or remote, will also show a marked relief from their symptoms. It may also be given for prophylaxis with some surprising results. C.E. Wheeler says, "In any epidemic the corresponding nosode can be given for this purpose and will be found valuable. Generally speaking, a dose of the 30th will protect for at least a fortnight. For the more resistant and recurrent infections like influenza, in our judgement, the nosode Influenzinum is best mixed with one of the Tuberculinum nosodes, either Tuberculinum bovimum or Bacillinum. All the Tuberculins suit that type of patient who seems to pick up nasal catarrh on the least provocation and the mixture suggested is effective against the common cold as well as against influenza. A monthly dose of the 30th potency is usually sufficient to confer protection." The original Influenzinum was prepared merely from the nasal smear of a patient suspected to suffer from influenza. The smear probably contained several other organisms besides the virus. Further, the virus is known to undergo mutation, so that the virus of one epidemic differs from the virus of another. Gutman gives indications for this nosode. Stearns writes: "In the matter of influenza, the acute cases are quickly cured by the proper Influenzin nosode and the chronic cases are so modified by the nosode as later to make easy the selection of the true chronic similimum. "Every case of acute encephalitis required Influenzin, as does every chronic post-encephalitic case, but in chronic influenza as in all chronic conditions, the nosode will not complete the cure." "Infection originally occurs because of some constitutional tendency. The disease factor is best met by the nosode - the constitutional by the constitutional remedy. In post-encephalitic cases, remedies of the type of the Belladonna group are likely to be required after Influenzin

has done its work and, finally the more deeply-acting constitutional remedies are needed. In intuitive prescribing, however, the only guide to the follow-up remedies after Influenzin has finished, lies in the symptoms as they develop. It is like a house of mystery; Influenzin is the key which opens the front door but each room has a secret combination lock of its own." "Influenza is almost always associated with tuberculosis, and acute influenza often stirs up latent tubercular infections. Because of this, Influenzin usually is indicated when we begin treatment of tuberculosis and, on the other hand, Tuberculinum saves the most desperate cases of influenza. Remember that when Koch developed his original tuberculin, its use frequently caused pneumonia with patchy areas of congestion in the lungs, and note that patchy areas of congestion are found in the lung involvement of influenza. Koch's Tuberculinum 1M was a sheet anchor in the pneumonia type of influenza, during the 1918 epidemic." "Dr. Pierre Schmidt sent over the first influenza nosode, calling it Spanish influenzin and this has proved the best in the chronic forms of the disease, especially with patients who had severe attacks in the 1918 epidemic." "Influenzin antitoxin acts best in the recent acute cases and in the chronic form of more recent origin." "Influenzin meningeal is seldom useful, but it is needed it acts brilliantly." "Influenzin serum is sometimes helpful." "Recently we have obtained three new Influenzins, which are Influenzin nekel catarrhalis, Influenza vaccine polyvalent and Influenzin polyvalent. The last two are from Lederle." Some of the Influenzinums marketed by Nelson's of London are as follows: 1. Influenzinum (the 1918 epidemic) 2. Influenza virus A Asia/57 3. Influenza virus A England/42/72 4. Influenza virus B Hong Kong 5/72 5. Influenza virus A/Port Chalmers/1/73 6. Influenza virus A (Asian) 1954 7. Influenza virus B (Asian) 1954 8. Bacillus influenza 1918 9. Influenza virus Az Hong Kong 1968 10. Influenza virus Ar 1967 11. Influenza virus B 12. Influenza Co. (Combination of Az to 1918) 13. Influenza virus a1. They also have a combination of influenza strains with Bacillinum.

Tyler reports a case: "POST-INFLUENZAL EPILEPSY: "Fits ever since influenza twelve months ago." Severe fits several times a week, with enuresis. Also fits of very violent temper. Had been treated unsuccessfully for six months at a Children's Hospital. She was given Influenzinum 200, 3 doses, six hours apart. She needed no other medicine. The report was "No more fits", and now she is no more trouble than the other children." But personally I prefer to give Cadmium metallicum to antidote the sequelae of influenza. I have seen its remarkably beneficial effect in numerous cases. A patient whom I treated recently had not been well since Influenza. His symptoms were great weakness in the body, especially the legs, felt unsteady and heavy, confusion of mind, etc. All these symptoms had appeared since an attack of Influenza which had occurred two years back. Cad. completely cured him. This indication has been given by William Gutman who has published the provings of Cadmium metallicum. Insulinum Sukerkar gives the following indications for Insulin in potency. He says Insulin is indicated in: 1. Chronic intestinal disorders, especially with diarrhoea and enlarged liver. The more chronic the diarrhoea, the more Insulin is indicated. 2. Ulcers, boils, bed-sores, hypopion, etc., as sequelae of infectious diseases, with disordered liver. 3. Chronic otorrhoea and mastoiditis in emaciated children where the pus is thin, especially when associated with enlarged liver and chronic diarrhoea, or as sequelae of acute infectious diseases. 4. In some cases of eczema in patients with chronic liver disorders. It is a great reactive remedy in allergic eczema. 5. Suppuration of the scrofulous glands in the neck or any other type of suppuration of this part of the body to which it has a particular affinity. Muzumdar has published his experiments with Insulin in potency in cases of diabetes. He says that Insulin 30 or 200, given thrice a day reduced the blood sugar levels. Later, in some cases, even after the doses were reduced and discontinued, the blood sugar levels continued to remain normal for over six months. Matani has published her clinical observations with Insulin in potency. She has summarized the symptoms as follows: Vertigo when hungry agg. anger agg. looking up agg. moving Hair falling Headache when constipated Dimness of vision in the evening Pain throat worse swallowing liquids

Pain between scapulae in the morning Pain lumbar back worse sitting Pain right shoulder and knee Pulling pain behind knees worse rising from sitting Pain calf muscles extending upto gluteal region Pain calf muscles, right, then left Heaviness of legs when the legs hang down Pain left great toe Burning in soles Drowsiness Chill at 11 a.m. Weakness after stool Lac caninum Classified by Allen as a nosode even if it is not strictly so, it is a most interesting and valuable remedy. It is potentized bitch's milk, a substance which was used medicinally by the ancients. Characteristically, the symptoms fly from one site (or side) to another, or shuttle back and forth from one side of the body to the other. Mental symptoms are prominent. Full of fears and weird imaginings, bouts of rage with tendency to curse and swear - child cries and screams non-stop, forgetful, absent-minded, makes purchases, then walks away without them; sees "spiders, snakes", etc., but only in the light, not in the dark, seems to be "walking on air" or floating or when lying seems as if "not touching the bed". Throat symptoms are specially severe. Throat feels as if "closing", must keep mouth open lest may choke; swallowing is impossible; pain shoots into ears; throat looks shiny, glazed, with red or silvery white patches like China. The symptoms appear first on one side, clear up, then move to the other side, clear there and reappear on the original side. This is quite characteristic of the remedy. It can be used in acute diphtheria; also in prophylaxis; and if there is a history of diphtheria, even in the remote past. Sore throats which tend to appear preceding the menses is another valuable indication for Lac-c. Lac-c has a decided effect in drying up the secretion of milk in women who have weaned or lost their babies. Cases of ill-effects of the Schick test where no other remedy is clearly indicated often run to Lac-c. Its relation to this condition is similar to that of Thuja through the results of vaccination. The most interest case of Lac-c was the one treated by Lippe:

The patient, a man nearing 40, had been completely impotent, with no discharge of semen during coitus, for 10 years. He was referred to Lippe, who gave a single dose of Lac-c CM, which cured him in a very short time. Lippe based his prescription on the fact that the patient had suffered 10 years previously from an extremely severe attack of diphtheria, which had left him very weak, and in which the patient had the classical symptom of the lesion shifting from side to side. Clarke in a discussion quotes Perkins as saying that if Nit-ac doesn't work Lac-c should be given. He confirms this from his own experience. Dixon mentions that he has found Lac-c very useful in nocturnal enuresis. Malandrinum A nosode prepared from the "grease of the horse". It is described as a deep, long-acting remedy. It should be given in infrequent doses. It has been used as a prophylactic against smallpox, and is of value for ill-effects following vaccination. Other indications are: Intense pain in the small of the back, sacral pain, profuse foot sweats with carrion-like odour; feet burn when covered or warm; sore, bleeding cracks on soles, paronychia hands or feet; impetigo, boils. Puddhepatt writes that two doses of Malandrinum a week apart will immunize against smallpox for some months. Cooper used it as an intercurrent in his cancer cases. Medorrhinum Baker says that Medorrhinum though a most important remedy is much neglected. He thinks that "Sleeps in knee-chest position" is the best symptom. Another is "Intense tenderness of soles". He says Med. is agg. thinking of complaint, heat, covering, stretching, leaning head forward, thunder, motion, inland, sweets, bathing in sea, etc., and amel. at seashore, lying on abdomen, damp weather. It craves for liquor, salt, sweets, beer, ice, acids, green fruits, coffee grounds. Roberts clearly explains that Medorrhinum has a proclivity to affect the pelvic and urogenital organs such as the bladder, uterus, etc., and produces in them subacute and chronic inflammatory conditions and growths. I have given with great benefit an intercurrent dose of Medorrhinum in most of such cases. Bellokkossy describes several cases treated with Medorrhinum and describes several new symptoms of this nosode. Burnett called Medorrhinum, "Glinicum" and says he has cured half his left-sided sciatica cases with Med. especially if the patient has sour taste and filthy tongue in early morning. Medorrhinum is generally amel. at seashore but some patients are agg. also. Swan and Tyler found Med. a good antidote to the after-effects of influenza. Harvey Farrington describes some typical cases and refers to a drug called "Medorrhinum chronic". Further on, in a discussion, he mentions some characteristics of Med., viz., leaves off initial letters when writing, e.g. writes "ere" for "here". Aversion to salt. All symptoms amel. eating. Brick dust sediment in urine. Tumour in left labium cured by Thuja many years ago, repeated after a dose of Med. 10M. Enormous dilation

of heart and dropsy. Constant desire to wash hands. Child exhilarated, playful at night, cross by day. Hubbard says that the terminal cough which comes after some illness may clear up with Tub., Bacil., Med., or Influenzinum. Sutherland draws attention to the cough agg. candies (sweet-meats) of Med. Boger considers Medorrhinum as his most useful remedy in the vomiting of pregnancy. Underhill writes, "Medorrhinum is as frequently indicated as any remedy in pediatrics." Leon remarks that many rheumatic conditions and migraines had resisted treatment until Medorrhinum was given. Prostrated in morning, always brighter in evening. Euthanasia and bringing back to consciousness (many cases). Nail biting fits the nervous fidgetiness characteristic of Med. Gibson writes, "This is the gonorrhoeal nosode, a well-proven remedy with a wide range of usefulness." Symptoms are worse in the daytime, from sunrise to sunset and are aggravated in a thunderstorm. Lying in the prone or knee elbow posture affords relief, and there is definite amelioration at the seaside. Psychological features are prominent. The patient feels "as if in a dream"; everything seems unreal, time sense is confused and time seems to pass too slowly, feels hurried, hurried, in a haze; starts at slightest sound; annoyed by trifles, is apt to weep when telling symptoms; mental symptoms worse when thinking about them and at night. Legs and feet are intensely restless and fidgety. Hands and feet burn; wants them uncovered and fanned. Indicated, of course, if there is a gonorrhoeal history. Should be used with caution in acute disease." Baker says, "In some cases where men have been threatened with tuberculosis with intractable cough and where the symptoms seemed obstinate and did not yield to what I considered the proper remedies I have given Med. with good results." Boger states, "I can corroborate what Dr. Stearns says about Med. being useless in gonorrhoea. "Two prescriptions suffice for most cases of gonorrhoea in the acute stage. I give Cannabis, one drop twice a day for three days, then once a day for three days and Sac-l for five days. If it is a mild case one drop at night for five days and then Sac-l for five days. This is nearly always indicated and acts splendidly. It is the method of Jahr." I may here relate a case. Once I had to treat a young girl of 15 years of recurrent attacks of bronchial asthma. Several drugs had failed and it was then that I noticed during a routine examination that her breasts were icy cold, esp. the nipples, while the exposed parts of her body like the arms and legs

were warm. So this was a peculiar symptom and Kent's Repertory gave Med. as the only drug covering this symptom. Further enquiry brought out the fact that the patient's attacks were affected by the proximity of the seashore and that she slept most comfortably on the abdomen. Medorrhinum relieved her immediately. Morbillinum Foubister says, "As a matter of fact we have for years been making play with Variolinum, Tuberculinum, Lueticum, Medorrhinum; only, as said, Morbillinum and several others have till now not entered into the picture, and Morbillinum threatens to become the most important of the lot." He reports a case: "I had a case of this sort a few years ago, when no remedy seemed clearly indicated from the start. A University student had been unable to concentrate and suffered from attacks of vertigo when walking. He described this as feeling "as if he had put one foot in a small boat". This began after an attack of measles two years previously. The cause of the vertigo was obscure, he had been checked over at the E.N. T. department of a teaching school without a definite diagnosis having been made. Morbillinum 200, 1 dose was followed by a short aggravation, then complete cure." Schachterle writes, "Mrs. E.G. complained of visual discomfort, particularly on reading or sewing. Her vision could blur after a short time of close application, to be relieved by looking off at a distance. Other symptoms that were brought were: a vague headache around the hairline and the top of the head; generalised easy fatigue, a dull aching pain in the legs, a lack of sexual response. All followed an attack of measles three months prior to her visit. Morbillinum 200x was prescribed on discs to be taken four times daily. About two years later, she came in with a simple problem and stated that those little pills had made a new person out of her." Parotidinum Parotidinum has been used successfully in acute attacks of mumps, for the prevention of mumps and also for the after-effects of the disease. Pertussinum Mitchell remarks in a discussion that whereas Drosera is often indicated early in whooping cough, Pertussin is more useful late in the illness. For paroxysms of three coughs, Griggs suggests Marrubium. He also mentions that the worst and loudest cough is produced by Pertussin (also called Coqueluchin). = pitu-gl. = pituitrinum Ghosh who seems to have experimented widely with this sarcode says, "Pituitrin in potency is worth a place in heart attacks of old people where sometimes it is hardly possible to pick up a well-indicated remedy. It has a specific action in anginal attacks due to coronary trouble, in chronic uraemic conditions as well as in allergic subjects where it relieves readily." Sukerkar writes, "This is an important remedy and is generally indicated in retarded sexual and general development, obesity, asthma and other conditions indicative of defective (organic) coordination of the ductless glands. This nosode has an anti-spasmodic property and on account of this, it is useful in coronary spasms of old persons with shooting pain or a sense

of great precordial heaviness on slight exertion. It is also useful in irregular peristalsis, in chronic colitis and also in spasms of anus and rectum in asthmatic patients. "It is very useful in intussusception and in intestinal obstruction from other causes, especially in old people and in children. "It is a good remedy in strangulated hernia of old people, particularly asthmatics with intense griping pain and also in many cases, when the indicated remedies fail. "It is an excellent remedy in obstinate cases of spasmodic dysmenorrhoea. "Due to its action on the uterus and mammary glands, it is one of our sheet-anchors in delayed puberty and stunted growth with amenorrhoea and atrophy of breasts, due to endocrine imbalance. It regulates the action of Corpus Luteum in sterile women with defective development of breasts, amenorrhoea, cryptomenorrhoea and favours conception in many cases." I, myself, have conducted provings of Pituitary in 3x and 30C potencies which have been published in the Indian Journal of Homoeopathic Medicine. * Psorinum The first nosode to be used in Homoeopathy, it has proved extremely useful. The psoric cases requiring Psorinum are chilly and exhibit a mood of depression as against the cases of Sulphur who feel hot and show a care-free, over-optimistic or philosophical attitude. Psorinum can be tried when Sulph. fails to act. It has been called the "chilly Sulphur". It is useful in patients who do not recover fully after typhoid. H.C. Allen writes, "I have never succeeded in curing a case of eczema permanently without the use of Psorinum at some time in the course of the disease." Hahnemann called Psorinum "the great anti-psoric" and it is more frequently called for now than it was in his time, more frequently than even Sulphur. Psorinum has a very peculiar symptom, viz., "Feels unusually well before an attack". This symptom it shares with Bry., Nux-v, Phos. and Sep. I have had patients who have told me, "Doctor, I feel really very well. But I fear to express it because I may get an attack again." And they do! It has also other strange symptoms like "Asthma amel. lying down" and "Hungry before headache". That astute prescriber Hayes says that Psorinum is usually needed at some time in the treatment of fibroids. Guild-Leggest presents a comparison of the symptoms of Psorinum, Syphilinum and Medorrhinum under different headings. Woodbury quotes Enos to say that Pso. is the remedy for Infantile Paralysis. Rorke records the Psorinum symptoms - Fear of failure in business, fear of poverty, and even a conviction of failure. Underhill feels that Psorinum is often indicated after Pyrogen. He writes, "Pso. has periodic headaches, preceded by or associated with very putrid stool." I have always found some beneficial effect with Psorinum in chronic skin conditions. Pyrogenium

This rather old remedy might be described as a polyvalent nosode. Following experiments made on animals by Dr. Burden Sanderson in 1875, Drysdale, realising the potential of such substances in homoeopathic practice, made a similar preparation by exposing lean meat in water to the sun's rays for three weeks. The resulting material was put through various processes, including two boilings, and the final watery extract was named Sepsin. This product admixed with an equal part of glycerine was termed Pyrexin or Pyrogen. At a later date potencies were prepared from this product or from the pure extract without the addition of glycerine. It is an extremely active and most valuable remedy. It mainly affects the blood, causing a degeneration such as is met with in septicaemic states with resulting fever, rigors, interstitial and intestinal haemorrhages. The face and ears are red and hot or may change to the hippocratic facies with an ashy hue of the skin. The hands are cold and clammy. The subject is icy cold with evident air hunger. Fan-like movements of the nasi are seen. Restlessness is very noticeable, the sufferer being in constant movement despite the prostration and weakness. There is tendency for loquacity with rapid speech, but dryness of the tongue may make articulation difficult. This may pass on to a muttering type delirium, especially on closing the eyes. The head is rolled from side to side on the pillow. The temperature may go up very high and the temperature pulse ratio is totally disturbed - it may be high or low. The tongue is clean, fiery red and smoothly glazed as if with a coat of varnish. Mentally the patient may feel as if "she covered the whole bed", as if "he were two people", as if "crowded with legs and arms" or as if "the bed lain on were too hard and full of lumps" (cf. Arn., Bapt.). There may also be delusions of wealth or a sense of euphoria. A sensation of numbness starts in hands and feet and spreads all over the body. There may be extreme chilliness that no fire can warm but at the same time a craving for fresh cool air. Urging to urinate at the onset of fever is another feature of Pyrogen. The word Pyrogen, literally meaning "fire producer", is now generally accepted to mean substances derived from bacteria, moulds, viruses, white blood corpuscles or damaged tissue cells capable of causing fever. It has been established that the most powerful pyrogens are lipopolysaccharides which are especially to be found in the endotoxins of gram-negative bacteria. Foubister says that during the war, while serving in India, he found Pyrogen and Ars. the most commonly indicated medicines in outbreaks of dysentery. He says, "In any case of vomiting and diarrhoea without other information I first think of these two remedies." He also says that during the past two years Pyrogen has proved useful in the treatment of influenza especially in the later stages when a relative tachycardia was present. Pyrogen has an extensive record in successfully dealing with puerperal sepsis. H.C. Allen recommends it for septic fevers especially puerperal and for all complaints arising after puerperal fever. Pyrogen has also been found useful in dealing with retained placenta. H.C. Allen suggested that the administration of Pyrogen acted by raising the vital activity of the uterus thus

enabling it to expel its contents. Another well-tested use of Pyrogen is in chronic ill-health after an abortion or a severe labour, even without any obvious pelvic pathology and in the absence of offensive odours or any other symptoms of Pyrogen. I have prescribed Pyrogen on the basis of relative tachycardia or a swinging temperature when a septic focus was present when apparently indicated remedies failed often in the absence of any other Pyrogen symptoms and almost always successfully. Other pyrogens Swan potentized "the contents of septic abscess" and called it Septicaeminum which from its origin is obviously another pyrogen. A supply was given to a soldier fighting in the South African war with instructions to take a globule every four hours if attacked by anything like sinking or typhoid fever. The young man wrote home that "Septicaeminum is like magic in diarrhoea and dysentery in camp life" and asked for more as his supply was largely drawn on by his friends. Foubister writes, "Shortly after World War-II, we admitted a number of patients into the Royal London Homoeopathic Hospital suffering from osteomyelitis, children who had received antibiotic treatment with sterile pus still flowing. They all cleared up on homoeopathic treatment with intercurrent doses of individual 30C potencies of their own pus." Psorinum is complementary to Pyrogen. Those who have used Pyrogen with success marvel at the magical efficacy of the drug. It has very clear indications like hyperpyrexia, oscillating temperature double rise of temperature, a feeling of euphoria in spite of fever, etc. It has symptoms of several drugs like Arnica, Arsenic, Baptisia, etc., all rolled into one. It is indicated in a wide variety of fevers and it can be called the "homoeopathic broad spectrum antibiotic", of course acting on its own indications. It is almost a specific for puerperal sepsis. Foubister says that it may be prescribed even pathologically when there is a septic focus with either a swinging temperature or disproportion between pulse and temperature. Boger in a discussion states in 1930, "I have been in practice since 1888 and since Pyrogen was brought to my attention, I have only lost one case of general sepsis. That case was not given Pyrogen. What better testimonial to its efficacy can be expected?" Yingling quotes Swan to say, "In all fevers when other remedies do not act, think of Pyrogen." A severe agg. from Pyro. can be checked by Calc-s. On analysis Pyrogen is found to contain the following inorganic constituents; Aluminium, Arsenic, Boron, Calcium, Iron, Potassium, Lithium, Magnesium, Sodium, Phosphorus, Lead, Silicon and Zinc. I have had delightful experiences with Pyrogen which I have described in my book "Random Notes on Some Remedies". I feel that this drug is not fully exploited in everyday practice. Its symptoms suggest a very wide range of application, but unfortunately it is not well represented in the repertories. Staphylococcinum Foubister opines that Streptococcin is indicated where there is a history of acute streptococcal infections very probably including infection in the mother during pregnancy. He

noticed that more than half the patients who needed Streptococcin wept on being shown sympathy. He writes, "Tyler mentioned Streptococcin in relation to a rheumatic fever history, meaning that such a history would suggest Streptococcin should there be the indications for a nosode, as a constitutional remedy. Staphylococcal infection is common too, and Staphylococcin may be useful remedy. A mongol child of eight years suffered from furunculosis of her back and perineum which was sluggish in responding to treatment. Staphylococcin 30 was followed by a rapid clearing of the condition. Several months later there was a recurrence and again Staphylococcin 30 cleared it up, and it is still clear after some months." "A lad of 15 years of age had suffered from eczema practically all his life, accompanied by secondary infection on many occasions. It was widespread, and he had been in hospital almost half his life, partly because of the severity of his condition and partly because home conditions were far from good. He responded slowly and unsatisfactorily to homoeopathic treatment, till it was noted that he was always worse at night. A nightly aggravation is covered by about two hundred remedies, but when this remains an outstanding feature after apparently well-indicated remedies have been given, Lueticum is nearly always required. He was given Lueticum 30 and this was followed by great improvement. Then a month later, he developed widespread furunculosis. Staphylococcin 30 was given and there was a dramatic improvement. Staphylococcin had to be repeated six months later and he has been practically free from eczema and furunculosis for a year. It is, of course, impossible to assess the part played by Staphylococcin in this case, as Lueticum is associated with "successions of abscesses", a point also to remember in utilising the past history for prescribing. I mention this case as it illustrates the kind of case in which Staphylococcin seems to be indicated that is to say when there have been recurrent staphylococcal lesions over a long period of time and when staphylococcal lesions are widespread. At least, it is worth a trial in these circumstances when all else fails. It would take careful analysis of many cases to establish a "clinical proving" of Staphylococcin which I believe would be of value in respect of many of the nosodes of acute infections. "A clinical proving should be based on a large number of cases say at least 50. Before publishing the first paper on Carcinosin, we had detailed notes of over 200 patients. Some years ago, I made a brief study of Streptococcin from about thirty cases. The most definite symptom which emerged was "Weepy, consolation aggravates", and this has been of value in confirming several subsequent prescriptions. Another symptom which emerged not quite so definitely was "Better in the open air". Also Streptococcin has certain rheumatic symptoms indistinguishable from those of Rhus-t and other remedies which one might expect from its pathological relationship of Pyrogen, "Worse in wet weather, worse on beginning to move, better for subsequent movement". A woman of 50 had fallen on her knees and had pain which had persisted for some months although there was no evidence of a fracture or osteoarthritis. She had these symptoms and Rhus-t helped a little. Arnica and Rut. had no obvious effect. Many years previously she had suffered from quinsy and rheumatic fever. Streptococcin 30, 3 doses, 2 hourly was followed by a dramatic and lasting freedom from pain although she was not completely cured." Sukerkar writes: "There is very little difference in action between these remedies although Streptococcin is more useful in acute and Staphylococcin in lingering and chronic cases.

These nosodes are very effective in dysentery of the Bacillary type. Streptococcin is very effective in acute dysentery with excessive haemorrage and high rise of temperature and with toxaemia. Here it competes with Merc-c. It is particularly useful in dystentery occurring in summer. Streptococcin is also an excellent remedy for the sequelae of tonsillectomy and impetigoconditions which are very obstinate. Staphylococcin is indicated in chronic dysentery. It cures this condition quickly. Here a dose of anti-psoric remedy can be given to complete the cure. Streptococcinum Foubister opines that Streptococcin is indicated where there is a history of acute streptococcal infections very probably including infection in the mother during pregnancy. He noticed that more than half the patients who needed Streptococcin wept on being shown sympathy. He writes, "Tyler mentioned Streptococcin in relation to a rheumatic fever history, meaning that such a history would suggest Streptococcin should there be the indications for a nosode, as a constitutional remedy. Staphylococcal infection is common too, and Staphylococcin may be useful remedy. A mongol child of eight years suffered from furunculosis of her back and perineum which was sluggish in responding to treatment. Staphylococcin 30 was followed by a rapid clearing of the condition. Several months later there was a recurrence and again Staphylococcin 30 cleared it up, and it is still clear after some months." "A lad of 15 years of age had suffered from eczema practically all his life, accompanied by secondary infection on many occasions. It was widespread, and he had been in hospital almost half his life, partly because of the severity of his condition and partly because home conditions were far from good. He responded slowly and unsatisfactorily to homoeopathic treatment, till it was noted that he was always worse at night. A nightly aggravation is covered by about two hundred remedies, but when this remains an outstanding feature after apparently well-indicated remedies have been given, Lueticum is nearly always required. He was given Lueticum 30 and this was followed by great improvement. Then a month later, he developed widespread furunculosis. Staphylococcin 30 was given and there was a dramatic improvement. Staphylococcin had to be repeated six months later and he has been practically free from eczema and furunculosis for a year. It is, of course, impossible to assess the part played by Staphylococcin in this case, as Lueticum is associated with "successions of abscesses", a point also to remember in utilising the past history for prescribing. I mention this case as it illustrates the kind of case in which Staphylococcin seems to be indicated that is to say when there have been recurrent staphylococcal lesions over a long period of time and when staphylococcal lesions are widespread. At least, it is worth a trial in these circumstances when all else fails. It would take careful analysis of many cases to establish a "clinical proving" of Staphylococcin which I believe would be of value in respect of many of the nosodes of acute infections. "A clinical proving should be based on a large number of cases say at least 50. Before publishing the first paper on Carcinosin, we had detailed notes of over 200 patients. Some years ago, I made a brief study of Streptococcin from about thirty cases. The most definite symptom which emerged was "Weepy, consolation aggravates", and this has been of value in confirming several subsequent prescriptions. Another symptom which emerged not quite so definitely was "Better in the open air". Also Streptococcin has certain rheumatic symptoms indistinguishable from those of Rhus-t and other remedies which one might expect from its

pathological relationship of Pyrogen, "Worse in wet weather, worse on beginning to move, better for subsequent movement". A woman of 50 had fallen on her knees and had pain which had persisted for some months although there was no evidence of a fracture or osteoarthritis. She had these symptoms and Rhus-t helped a little. Arnica and Rut. had no obvious effect. Many years previously she had suffered from quinsy and rheumatic fever. Streptococcin 30, 3 doses, 2 hourly was followed by a dramatic and lasting freedom from pain although she was not completely cured." Sukerkar writes: "There is very little difference in action between these remedies although Streptococcin is more useful in acute and Staphylococcin in lingering and chronic cases. These nosodes are very effective in dysentery of the Bacillary type. Streptococcin is very effective in acute dysentery with excessive haemorrage and high rise of temperature and with toxaemia. Here it competes with Merc-c. It is particularly useful in dystentery occurring in summer. Streptococcin is also an excellent remedy for the sequelae of tonsillectomy and impetigoconditions which are very obstinate. Staphylococcin is indicated in chronic dysentery. It cures this condition quickly. Here a dose of anti-psoric remedy can be given to complete the cure. Syphilinum Whenever a patient is decidedly worse at night, whatever the disease, Syphilinum should be considered. I also find that wherever there is a history of many abortions Syphilinum will often be needed. I must relate a very novel case cured by Syphilinum. Once a child aged about 3 months was brought to me by its parents. The father complained that since the day of birth the child had been screaming all the time except while it was taking feed or while it was asleep. The rest of the time it would scream without a minute's pause. The child had been taken to many hospitals and child specialists and being unable to find the cause the physicians had merely prescribed sedatives. Even these sedatives would not work. The parents had spent sleepless nights and the neighbours were seriously annoyed. The father of the child who was a Pathan told me that his life had become a nightmare. He requested me that either I should cure the child or give some poison and finish it off. This request reflected his deep disgust. I could elicit no symptoms of homoeopathic value; there was no history of illness in the mother or injury to the child. There were no modalities. I was frankly nonplussed. I tried Chamomilla, Cina, etc. all with no effect. I, therefore, consulted my senior Dr. S.R. Pathak. He straightaway prescribed Syphilinum 1M to be given once in 6 hours. The father of the child reported most gratefully that with the very second dose the child had stopped screaming. I looked into Clarke's Dictionary and found under the heading "Syphilinum" the following, "Swan says that he gave crying infants when they developed the propensity immediately after birth, one dose of Syph. CMM, and it was difficult to make them cry after that." Since then I have extended the analogy and have prescribed Syph. when the parents complain that the child has been ill since the very birth, whatever the illness.

Also when Sulph. fails to act, or aggravates, we should think of Syphilinum. Olds writes that Syph. cures most terrible vertigos. The desire to wash hands is a well-known symptom of Syph. but Sir John Weir reports a case cured by Pso. (Med. also covers this symptom). Hayes finds Syphilinum and Medorrhinum to be complementary more often than other nosodes. Syphilinum is to be used in the Fluoric type of patient because he carries within him the syphilitic taint. Characteristics of Syphilinum are the following: Dread at night with physical and mental depression; Loss of memory, specially cannot remember the proper names; Alternating moods: exasperation and nervousness, apathetic or in different. Nighly pains, being with sunset and disappear with the rising of the sun. Pain appears and disappears gradually. Bone pains, pains of nerves, always linear, persistent and deep. Symptoms worse at night, on seaside and always better in the mountains. Pains wander from joint to joint and cause frequent changes of position in search of relief. Should be considered when response to the "indicated remedy" is disappointing. Desai reports some cases of fever treated with Syph. In the first case the boy with a chronic discharging ulcer, which refused to heal, had a depressed nasal bridge. In the second case, a huge scalp abscess was drained but the ulcer refused to heal. With Syph. healing occurred. Clarke reports cases with a history of Syphilis treated with Syph. Beronville writes, "Besides the ordinary Syphilinum (from the scrapings of indurated chancre) we have Hepato-Syphilinum (Syphilitic affections of the liver of the new born, an antigen). It is used in Syphilitic affections of the liver and viscera in tertiary period and in hereditary syphilis of nerves (tabes, meningitis, etc.). "Finally, we have Leuso Marmoreck P. a very interesting medicine prepared in association with high and low dilutions of Marmoreck and Syphilinum. Very frequently we used to give our patient a dose of Syphilinum and a dose of Tuberculinum because we have seen that we can act better in this way instead of giving them one after the other. One will find it very often interesting to associate the two factors which correspond to a double etiology. "About ten years ago, a homoeopathic doctor of America used in syphilitic patients numerous medicines strictly according to the law of similars. The Border - Wassermann reaction was tested before and after the treatment. Among the medicines that seem to negativise was Lycopodium. Syphilinum comes second in rank ex-aequo with many other remedies. Syphilinum is prepared from the serosity obtained by scrapings of syphilitic chancre. Skinner and Swan, two American homoeopaths, first made its provings. "It will act in old syphilitics aggravated by Sulphur, who had the symptoms of this remedy. Syphilinum is an antidote of Sulphur. When the patient is aggravated by Sulphur and when Pulsatilla, another antidote of Sulphur, does not give any results, we must always think of latent syphilis.

Syphilinum is to be considered in: 1. Prolonged convalescence of old syphilitics. 2. Patients aggravated by Sulphur. 3. Old syphilitics when well-chosen remedies do not act. 4. In old syphilitics who suffer without precise symptoms. Syphilinum will "make the symptoms to come out". "Syphilinum is used like Sulphur as a restorer of sleep. It is an excellent remedy of insomnia. "It is an important remedy of ulceration of the mouth, of nose, of genital organs and of the skin. There may be nauseating ozena, with bits of foul-smelling discharge. "It is indicated in all foetid ulcerations. It is a good remedy for repeated abscess. "The patient has great desire for alcoholic drinks. "The patient has stubborn constipation. Syphilinum is a remedy of anal fissures and prolapsus of the anus of persons having syphilitic antecedents. "The leucorrhoeic flow is profuse. "The falling of hairs is often related to very violent headache of neuralgic character, causing sleeplessness and delirium at night. Generally, headaches begin at 4 p.m. , become maximum at 10 to 11 p.m. and cease immediately with sunrise. The neuralgias of Lycopodium cease at 11 to 12 p.m. In Syphilinum the tibias and the cranial bones are painful. A curious symptom which is very real is that the patient very often washes his hands. There may be considerable emaciation of the whole body. "Interesting sensations are: Boiling, as if hot water and oil flowing through veins. Mania and paralysis of the tongue are possible. Head drawn backward as if by a weight. Sand in the eyes. The right eye is wide open, as if cold air is blowing within it. Something living in the teeth, as for example a worm. Sternum drawn backwards. Coccyx swollen. Bones are sawed. Soles of hands and feet as if pierced by needles.

"Aggravations are: by touch (tibia and neck of the uterus); by movement, by stretching the arms; at night (very important); in the weather, hot weather, on the seaside; in hot or in the cold weather. "Ameliorations are: In toothache by pressing the teeth one upon the other; Pains of the buttocks are ameliorated by walking; Headache by heat; Pains of the wrist and of the limbs are ameliorated by heat. "In the mountain, or in the fields (inverse of Medorrhinum)." I may also report the following interesting case: Master S.P. , a boy, aged 12 years, was admitted in the Govt. Homoeopathic Hospital on 18.01.69 with history of fever of one week's duration. On taking his case we noted that he gets fever with chill from 12 noon till 5 p.m. He also had gurgling in abdomen agg. lying on abdomen and itching eruptions all over body for last 2 days, which bled on scratching. He had burning all over agg. bathing in warm water. He had pain in the chest for days, more on Rt. side agg. lying on Lt. side agg. coughing. The pain extended to the back to the Rt. scapula. His appetite was reduced, he had bitter taste in the mouth, his thirst was less, he was constipated and there was burning micturition with high coloured urine. His sleep was disturbed. Perspiration slight. In past history he had had similar type of fever in 1963. His family history gave us no direction. His general physical examination revealed shining finger nails and slight oedema of feet. Tongue was coated. B.P. was 80/60. The temp. was 101.6 ºF. Pulse was 104, regular. Systemic examination revealed n.a. d. The following symptoms were selected, viz. 1. Rt. sided complaints, 2. Amel. lying on affected side, 3. Pain extends backward and 4. Thirstless during heat, and these symptoms on repertorization pointed to Pulsatilla. Puls. 200 was prescribed every four hours. After 3 days the condition was almost same. So on the finding of shining finger nails which generally signifies a tubercular background, Tub-bov 1M, 1 dose was given as the fever was not reacting to any medicine and as it showed a tendency to rise at night. There was some response. So Lueticum 10M, 2 doses were given next day and then the temp. suddenly came to normal and from 19th Feb. onwards there was no fever till the boy was discharged on 6th March 1969. Thyreoidinum Thyroidinum is prepared from the desiccated thyroid gland of the sheep. Rabe says, "Thyroidinum is related to such remedies as Calc-c, Kali-c, Iod., Phos., and Sil." Bidwell reports a case of hyperthyroidism cured by Thyroidinum. Clarke describes extensively the pathogenic effects produced by Thyroidin and mentions a case of thyrotoxicosis cured. Lambert describes a case of hysteria cured with Thyroidin. He also mentions that Thyroidin produces and cures symptoms of diabetes. Ghosh has observed: "This is a very neglected nosode in Homoeopathy. Seldom have homoeopaths taken services of this widely useful nosode. Particularly in cases with deepseated chronic complications, it unlocks many a tangle very easily and makes an easy way to cure." He has given numerous clinical indications for the use of Thyroidinum. Sukerkar says, "In prescribing Thyroidin, more attention should be paid to this basic condition in the background, where the symptoms are connected with want of metabolic, nervous and

vascular adjustment or a combination of some or all of them. Although symptoms manifesting functional imbalance and mal-adjustments are numerous and are so unlike in different persons, the remedy in all cases will be Thyroidin from the standpoint of the basic similarity which very often cures the symptoms, or it may serve as a reactive agent when other indicated remedies are not able, by themselves, to bring about a cure. "Its wide range of therapeutic use includes disturbances in childhood such as convulsions, epilepsy, vomiting and icterus, chronic diarrhoea, emaciation, anaemia with dropsy, excessive or want of appetite. It also covers nervous disturbances of adolescence such as irritability, whimsical mood, hysteric tendencies, vertigo, chronic headaches, etc. Thyroidin is a valuable remedy for what is commonly known as allergy, i.e. disturbed or defective and perverted functional nervous and vasomotor reactions of some organs or the patient in general. Thyroidin is a very useful remedy in rhinitis, as also in dyspnoea complicating various diseases or conditions without inflammatory affection of the bronchi and fever, dyspnoea without apparent cause or of obscure character. "It is very effective and is almost a specific for urticaria and angioneurotic oedema, which are manifestations of vasomotor imbalance. "Thyroidin is a most important remedy in Homoeopathy for diabetes mellitus, when symptoms appear with great rapidity and with extreme weakness." Bacillinum burnett Allen says, "The potencies of Fincke and Swan were prepared from a drop of pus obtained from a pulmonary tubercular abscess or sputa. Those of Heath from a tuberculous lung from which the bacillus tuberculosis has been found microscopically, hence the former was called Tuberculinum and the latter Bacillinum. Both preparations are reliable and effective." Moncrieff writes, "Clarke's Dictionary of Medicine makes reference to this under Tuberculinum. I consider it best to reserve the name "Tuberculinum" for this preparation of Koch as it is universally known by that name. Burnett's "Bacillinum" is now accepted as the name of the original homoeopathic preparation and though its originator, Swan, named it Tuberculinum, it owes its present position in therepeutics to Burnett, and it will be simplify matters if we make the term Bacillinum cover the homoeopathic nosode and Tuberculinum the preparation of Koch." He also writes, "I do not find any appreciable difference between the action of Tuberculinum and that of Bacillinum. My own impression is that they are practically identical, and that the one will answer to the indications of the other." Whenever he found a family history of Tuberculosis, however remote, he did not hesitate to give Tuberculinum unless there was a very well-indicated remedy. He usually commenced these cases with the 200th potency, and often did not require any other remedy. Tuberculinum seems to have a very wide range of action. One is surprised to find in it symptoms of several polycrest remedies which we use in everyday practice. Tuberculinum has to be considered especially in patients whose near relatives have been affected by the disease. Such patients may also give a history of having had measles or whooping cough in severe form (cf. Carcinosin), or repeated attacks of pneumonia. Such patients with pre-tubercular states are called, "tuberculiniques" by French homoeopaths. These patients may have repeated exacerbations of local symptoms, e.g. migraine, diarrhoea, intermittent fever, etc. Vannier gives a vivid description of their constitution. He

also describes an interesting sign elicited where a tubercular lesion of the lung has existed. When friction is applied to the chest wall on the both sides, a marked redness will appear and persist for some time on the area overlying the affected part of the lung. Recurrent attacks of cold, enlargement of tonsils and adenoids have all been ascribed to the tubercular miasm and all these patients may need periodical doses of Tuberculinum. Among all the symptoms, a peculiar one seems to be the great restlessness of the patient who desires to change his dress, diet, residence, occupation, activities, friends, etc., and even the doctor. The patient also feels better by travelling. We find the patient described as "Cosmopolitan". Even the symptoms change. A drug seems clearly indicated, the drug is given, the symptoms change and next day another drug seems as clearly indicated, and so on, the symptoms changing from time to time. A definite indication for Tuberculinum is that the symptoms are ever changing. Underhill says, "When the case changes every time you go and the symptoms imitate a different remedy at each visit, think of Tuberculinum." This is a cardinal feature of the remedy. Not only do the symptoms change but the patient wants to roam around and seek change of scenery to the point of restlessness. Kanjilal has described a case of Diphtheria in which he found the symptoms continuously changing indicating different remedies such as Merc-s, Phos.,etc. at different times. It was only after he had prescribed five or six remedies he realised that this changing of symptoms itself was a symptom and the prescribed Tub. and cured the case. Kent has described in general the symptoms of Tuberculinum under the heading Tub. bovinum. Actually, Tuberculinum is prepared from the tubercular abscess while Tuberculinum bovinum is made from the gland of infected cattle. But the indications for the different varieties of Tuberculin such as Tub. of Koch, Residual Tub. of Koch, Tub. aviare, Serum of Marmorek, Tub. of Rosenbach, etc., are given by Clarke, Wheeler, Cartier and others. Goldberg summarizes the indications well. Quinton was using Tuberculinum constantly in all cases of children and chest diseases or where a hereditary taint is suspected. Boger writes that he received the following advice from two senior homoeopaths: "When you have failed to find a remedy after trying your best, give a dose of Tuberculinum at long range, and then repeat the medicine and you will have success with the remedy you at first failed with." Wians describes a case of active Tuberculosis; when he gave Bacillinum CC it caused an aggravation of his symptoms which was soon followed by an amelioration. He also writes, "When a patient with the tuberculosis bent cannot get his intermittent fever cured with Quinine, nor apparently with any other remedy, a course of Tuberculinum will sometimes cure or make the patient curable. Tuberculinum bovinum has served well in many such cases." KOCH'S TUBERCULIN: Delayed resolution in pneumonias and influenzas. This was one of Clarke's favourite remedies for the after-effects of influenza vying with Psorinum. Power writes, "Koch Tuberculin 1M has accomplished much in delayed resolutions of influenza attacks. There may have been improvement under the remedies, and at the stage when

improvement appears at a standstill, the leading symptoms though modified still are in situ, this potency has done the needful." Clarke records his emphatic opinion that if a patient has never been the same since an attack of influenza - recent or remote - a course of Tuberculinum of Koch will be needed. Vannier considers that Residual Tuberculinum of Koch, is of value in patients who have recovered from tuberculosis, especially for those who develop arthritis, migraine, etc. This is a filtered culture of tubercular bacilli in broth. Fergie Woods mentions that when Tub-bov ceases to act, Tub. of Koch might bring great relief. TUBERCULINUM (SWAN'S): for glandular manifestations. TUBERCULINUM OF DENYS: is made by the French from the filtered broth in which tubercular bacilli were grown. This is useful in sudden attacks of depression, and weakness with nausea, diarrhoea, vomiting, etc., or in any sudden illness with no obvious cause. TUBERCULINUM AVIARE: made from chicken, acts on apices of lungs. Its sphere of action is in post-influenzal brochitis in which field it excels. It relieves the teasing, exhausting cough. History of influenza is an important indication. Baker says Tub. aviare 30x has served better than any other remedy for prostration after influenza. Tub. aviare 1M in its known sphere of bronchitis and influenza may be said to offer a valuable suggestion for the annoying, teasing cough so often remaining after the active symptoms of larger significance have subsided. In a good many such instances Aviare 1 000 has put an immediate end to this cough and any related discomforts. Jaisoorya remarks, "I have treated cases of broncho-pneumonia of over 400 rickety children with only one death and the secret is Aviare 30, 1 single dose." Hayes says that in his experience Tuberculinum bovinum benefits patients with pronounced localizations in the meninges, abdomen, skin, glands or joints; but the Aviare in those who have more evident depreciation of quality in the entire person at the same time such as after grippe or similar crisis. TUBERCULINUM BOVINUM: is said to have an affinity for the intestinal tract. Some use it upon indications similar to Tuberculinum aviare. BACILLINUM: frequency of colds leading to bronchial irritation. Sudden and deep seated cough. Low resistance to upper respiratory infection. McAdam says he has used Bacil. with excellent results in a variety of respiratory conditions and in cases where he suspects a tubercular soil. Usher, A. Clement and many others report actual cases of tuberculosis cured with Bacillinum or Tuberculinum. Winans describes several cases of tuberculosis, flu and appendicitis cured with Bacillinum. Waffensmith quotes Burnett saying that Bacillinum is the potentized portion of lung containing the tubercle bacilli. He mentions among its symptoms taste of blood in mouth, green colour of tongue, aversion to water, desire for eggs, etc.

McNiell in a discussion says that this was one of the remedies he used for cyclical vomiting. Children who had cyclical vomiting often had a tendency for papular urticaria and for these children he found that Bacil. was nearly always the most useful remedy. SERUM OF MARMOREK is made from Tubercular bacilli grown symbiotically with tricophyton. This is useful in Lupus. BACILLINUM TESTIUM is prepared from a tubercular testicle and acts well on effects of the lower part of the body. Alfred Heath mentions a case of stricture urethra and one of nocturnal enuresis cured by Tub. testium. Zoppritz also describes two cases of cystitis so cured. In nocturnal enuresis, when Tub-bov is indicated, Foubister suggests Bacillinum testium instead. Boyd has noted a very interesting thing. He had to treat two pairs of identical twins; one of each pair did very well on Ars-i and the other of each pair on Tuberculinum (Light Wilson). Discussing psychopaths, Tayler Smith says that two-thirds of the certified cases needed Tubbov followed later by Med. If Tub. produces an aggravation, Calc-c, or Calc-p in a lower potency may check it. That master, A. Pulford, writes that Tub. is almost routinely successful in herpes circinatus when other symptoms are lacking. Schwartz mentions that he has removed the ill-effects of typhoid inoculation with Tub. 10M. In a discussion, Krichbaum says that it is characteristic of the nosodes that they start a case towards a polycrest or an antipsoric remedy. Start with Pyrogen and it leads you to Ars. or Rhus-t, Tub. to China or Calc-c; Malaria o. to Ars. or Nat-m. "That means", he says, "we do not know much of these nosodes..." Boericke gives an indication that in dysmenorrhoea of Tuberculinum, pains increase with the establishment of the menstrual flow. He also says that he often used it, as others use Sulphur, as an intercurrent, having a great effect in stimulating the resistance of the organism, and he advises the 8x trituration. Patch writes, "With regard to the similarity between Pulsatilla and Tuberculinum, in my work at the hospital, I took down the characteristics of about a hundred cases with a view of working out several remedies for this disease, but Pulsatilla was the one most prominent. It would seem that perhaps Pulsatilla is an analogue - or that Tuberculinum is an analogue of Pulsatilla." In rheumatism when Rhus-t fails to cure though indicated, Lyc. or Tub. may be needed. In dysmenorrhoea when Mag-p palliated, Tub. cured. While suggesting remedies such as Rad. , Stro., X-ray, Uran-n, etc. for the ill-effects of nuclear radiation, Bellokkossy says that nosodes such as Tuberculinum, Influenzinum, Psorinum, Pneumococcin, etc. enhance the effects of these remedies. Krynicki says that Tub. has proved effective in the treatment of poisoning by poison ivy. It has also proved to be of help in the treatment of Asthma in adrenalin-fast patients.

For the symptoms that hang on after influenza, the cough, weakness and weariness and the sweating, always keep this remedy in mind, as also when treating sore throats with frequent attacks of tonsilitis and enlarged tonsils. A nosode in line with a patient's constitution or family history has frequently given striking results, allowing the previously well-indicated but inactive remedy to take hold. Sinha says, "It was in the year 1938 that the first idea of using Tuberculin flashed in the mind of Rober who wrote that the sputum rejected from the lung of a tubercular patient after its proper preparation can cure phthisis. Sometime before 1854, a Portugese Homoeopathic physician practising in Rio used Tuberculin. In 1975, Drs. Swan and Fincke prepared their Tuberculin from the abscess of a tubercular lung and prepared its "potency". In 1890, Dr. Burnett got this Bacillinum prepared from the contents of the part of a cavity and adjacent tissues of a tubercular lung by Heath. It was proved to some extent by Dr. Boocock. Five years later Koch prepared his Tuberculin from tubercular bacilli and applauded it for the cure of phthisis. After some time, he prepared another preparation by residual method and this was called "New Tuberculin of Koch T.R. " while the other was called Old Tuberculin (O.T. )... Hallock prepared a bacillary emulsion and after using it in a dilution found it very useful in some of his afebrile cases. Denys Tuberculin, which is also called Filtered tuberculous bouillon, is now used mostly by homoeopaths of France in true homoeopathic doses. It is usually called Denys Bouillon Marmorek. Dilute serum was introduced to us by Dr. Nebel and is called Dilute Serum of Marmorek though he does not believe in the tubercular infection. As a matter of fact, his preparation is an anti-toxic serum suiting to those tubercular patients who are prior to getting pulmonary tuberculosis and are very much susceptible to cold and cough. Some of the great French homoeopaths have spoken very highly and extensively of this nosode especially Leon Vannier, Nebel and Mordani. It is said of this nosode that after its ingestion, improvement is always preceded by a violent and severe aggravation which is likely to pass off very soon. Aviare is the Tuberculin from the bird. It was first used by Pierre Jousset who used this nosode extensively for tuberculosis but not confirmation of any cure has been given by him to us. But it has been found of immense value in the respiratory disease of the young ones, where it works like miracle. The whole range of Tuberculins comprises of the following preparations most of which have been sparingly used by our profession. Bacillinum, Tuberculinum bov. and Tuberculinum (Koch) are mostly used by us. Serum of Mormoreck and Denys have been used by our French colleagues and they have given us some meagre guidance for their use. Preparations that have been used till now by different physicians are *: 1. Tuberculinum (Swan and Fincke) 2. Bacillinum (Burnett) 3. Tuberculinum (Koch) O.T. 4. Tuberculinum (Koch's residual T.R. ) 5. Koch's Lymph 6. Aviare 7. Serum of Jousset 8. Allergine of Jousset 9. Bouillon of Denys

10. Dilute serum of Marmoreck 11. Tuberculinum bov. (Kent) 12. Human Tuberculin of Klebs 13. Immunizing bodies of Spengler 14. Dialysed Tuberculin 15. Auto-geneous products 16. Vaccine of Bossan 17. Serum of Movigliano 18. Pulverised Bacillary Emulsion of Hallock 19. Vaccine of Vaudremer 20. Chloroformed Tuberculin 21. Bacilli of Ostermann 22. Electronic Bacillinum of Whiting 23. Tuberculinum Procinus 24. Bacillus Testium 25. Diluted B.C. G. 26. Serum of Ferran Tyler writes, "Tub. and Drosera have seemed to, perhaps, help one another. But this insertion of doses of Tub. when there was evidently no call for them, the patient being in a state of healthful reaction, is I now think a folly of mine. One has a kind of suspicion that Tuberculinum acts on a different plane, and may not at all interfere. I have always thought so in regard to Tuberculinum and Silica, which seem to reinforce one another." Schwarts says, "The inertia produced by the shock of typhoid inoculation and even centripetal activity is met with by Tub. showing the relation of typhoid as an acture manifestation of a tubercular diathesis, i.e. I have frequently seen spoiled typhoids go into a tubercular state" and then says, "I have saved a number of Georgia victims of typhoid inoculation with Tuberculinum 10M." Hayes remarks, "We must carry Tub. always in mind while treating acute throat troubles. Our nosodes are so comparatively few, so broad yet obscure clinically that we must have their possibilities always in mind." Bernoville writes, "It is the Phosphoric type who requires the tuberculines. The tuberculines are : T.K. (Koch's tuberculine), Marmorek, Denys, T.R. (Residual Tuberculine). "T.K. may be compared with Marmoreck. Both of them act on oxygenoid ground. Marmoreck is a remedy for infants having a pretuberculous condition in whom the tubercular lesion is suspected. It is a remedy for an anaemic child who has some troubles of growth. This remedy should be applied in the first part of life, i.e. from the age of 1 to 35 years. T.K. is used in an

advanced age between 35 and 45 years. It is the remedy of the adolescent, of young adult persons, in whom a para-tuberculous condition or a confirmed tuberculous condition is suspected. "Denys is generally a hydrogenoid having a florid look. He is fat, having a healthy and deep coloured appearance. It is indicated from the age of 15 to 40 and corresponds to preturberculous condition. If the application of this nosode cause aggravation, it may be replaced by T.R. which is milder. "T.R. is a carbonitrogenoid. This is the remedy of old tuberculosis in whom the tuberculosis has become torpid. Tendency to sclerosis is a very important symptom of this remedy, pleural symphisis, deforming rheumatism. It is moreover indicated after 40 years of age. Its prescription is at this age harmless. "With Marmoreck we may compare Spengler (Immunobodies) and the Vaccine of Vaudremer. These are milder remedies. When there is the fear of aggravation we may use these remedies. We may compare with it Aviare which establishes a link between Marmoreck, Denys and T.K. "Bacillinum of Burnett is a trituration of the pulmonary tissues of the cavity, it is very often applied because it is easy to manipulate. It causes no aggravation. For this reason many homoeopaths apply it instead of T.K. , Denys or T.R. when they suspect an aggravation." McAdam says, "For cases of influenza which do not respond to the indicated remedy or for the aftermath, Bacillinum will help. It also acts as a prophylactic if given in the autumn of the year. We have a good basis for prescribing Bacillinum somewhere in the course of every pleurisy (esp. with effusion). Also in cases of cough where no remedy is clearly indicated resulting from neglected colds. Bacillinum is also of great value in lung infections resulting from influenza." He also writes, "And if the apparently indicated remedy does not yield prompt results - then the infallible remedy Bacillinum." Wilson reports that Burnett repeated Bacill. once a week. Tyler writes, "We are told that: Figures from cultures indicate that there is a relatively high incidence of bovine tubercle in alimentary canal, tonsils, glands, bones, kidneys: believed entry from milk." The above facts may help us to consider the use of Tub-bov in alimentary canal lesions, bones, glands, etc., and the use of Bacillinum in affections of the lungs. Tuberculinum Heathii which is totally distinct from Dr. Koch's was made by Dr. A. Heath in 1883. It is purely pathological preparation, in which the Bacillus Tuberculosus was found. It is the same preparation with which Dr. Burnett made the celebrated cures mentioned in his book, "Five Years Experience with the New Cure for Consumption". The remedy is called by him Bacillinum. Since the publication of this book, the remedy has been used by allopathic and homoeopathic physicians in all parts of the world, and its effects have been remarkable. The late Dr. S.S. Banker reported a peculiar case where the patient had two alternating groups of symptoms, each responding to a particular remedy. But no drug seemed to cover the whole picture. However, the patient had a peculiar symptom, viz. that he was definitely worse from 10 a.m. to 3 p.m. For this indication, Boger's Synoptic Key gives only one remedy, viz. Tuberculinum. When Dr. Banker gave Tub., the whole symptom-picture changed

and a new symptom-picture emerged for which a new remedy was found indicated which completely cured the patient. H.C. Allen writes as follows: "This remedy acts frequently best in the single dose. Strange to say, its symptom-list of diseases of the skin exceeds very much that of Sulphur in number. Hahnemann left us in his "Chronic Diseases" three or four remedies he pointed out for some of the constitutional dyscrasiae. Sulphur was one of the great anti-psorics, the king of chronic diseases; Thuja was the great anti-sycotic; Mercury the great anti-syphilitic. But if you will look into Psorinum, Medorrhinum, Syphilinum and Tuberculinum, you will find they will cure a great many of these constitutional diseases after Thuja and Mercury and Sulphur have failed, although as well selected as possible. The symptoms of constipation and diarrhoea are side by side with those of Sulphur. The constipation produced on the healthy has been most obstinate I ever met and very difficult to get rid of. The diarrhoea is more like Sulphur coming on in the morning, imperative, with a rush, the stool is profuse, watery, yellow, gushing, offensive, and unlike a great many of our remedies, painless and not exhausting. "There is extreme sensitiveness to atmospheric influences. There is no remedy in our Materia Medica so sensitive to change of weather, to cold and to heat as Tuberculinum. It is as sensitive as Lachesis or Sulphur to the heat of summer, as Kali-c to the extreme cold or winter; as Mercury or Rhus-t to weather changes. Like Pulsatilla, Kali-bi, Lac caninum, etc. it contains a list of the most erratic symptoms; not quite too peculiar or contradictory as Ignatia, nor yet too evanescent, it gives first one thing and then another." Tyler writes that she has, "Tuberculinum cases innumerable; where there is a family history of phthisis, or a previous personal history of any of the T.B. manifestations, as in Asthma of one year's standing in a woman of 38. Her mother had died of phthisis, and treatment was started with one dose of Tub-bov 200. In a month, "Very much better! Only twice awakened by it in the first week. Feels better; less chilly". Another month, and, with a cold, she had one more, her last attack. Last seen five months later when she had never had another attack. Sankaran and Matani posed a question whether in cases with a family history of Tuberculosis, a dose of Tuberculinum will produce improvement or help the action of the main remedy if interposed as an inter-current remedy. To answer this question they gave a series of such cases Tuberculinum and noted the results. The conclusion reached was that around 20% of the patients showed a good response out of whom some showed a splendid response. Sankaran noticed that quite often patients with a family history of tuberculosis were found to have glossy or shining fingernails. He says, "Noting this peculiar sign we made a detailed statistical survey of about 2000 cases and the result came out as given hereunder. "With regard to this glossiness of fingernails, though this was significantly marked in patients with a family history of tuberculosis, I did not notice a very high incidence among actual patients of tuberculosis. In order to verify this point we went over to the tuberculosis hospital and examined the fingernails of all the patients in the indoor department. This observation is given in the following table. "While making this observation about glossy fingernails, we also noticed that quite a number of them have a significant growth of hair on the back between the scapulae. Some of them also had a growth of hair in the lumbar region."

Sankaran further reports, " I once had a chance to utilise this observation in practice. I was called to see a lady, aged 30 years, who was suffering from an attack of acute rheumatic fever. She presented the usual picture of this disease with the swelling of joints, high temperature, etc. Her remedy worked out clearly to Rhus-t. So we put her on Rhus-t 30 every four hours, but with no result. Being sure of the remedy, we raised the potency to 200 and then to 1M, all of which produced not the least change in the condition of the patient. On the contrary, by the fifth or sixty day her condition became very much worse and she also developed and presented signs of a very severe form of conjunctivitis and keratitis. Her vision became blurred and she was not able to see anything. The husband and relatives naturally became panicky and they practically decided to change over to allopathic treatment. I examined her closely and I noticed that the lady had markedly glossy fingernails. They were shining as if nail polish had been applied. Naturally, I enquired if there was any history of tuberculosis in the family. The answer was negative. But still I gave her one dose of Tuberculinum 1M and then repeated the Rhus-t. The response was really dramatic. Within a few hours she became much more comfortable, the pains and swelling in the joints and the temperature came down, the condition of the eye and vision improved and she felt very much better. She improved steadily and made an uneventful recovery in a week's time. Now she has remained well for over two years. The condition of the patient had been so bad and the response to the medicine had been so remarkable that it impressed the whole community. "About two weeks after she had recovered, she came and told me that she had thought over my question about tuberculosis and had written to her mother who was away. The mother had replied that indeed she (the mother) herself had suffered from tuberculosis in her younger days. This fact, her daughter, that is my patient, had not been aware of. "This experience has been repeated numerous times in my practice." Tuberculinum bovinum kent Allen says, "The potencies of Fincke and Swan were prepared from a drop of pus obtained from a pulmonary tubercular abscess or sputa. Those of Heath from a tuberculous lung from which the bacillus tuberculosis has been found microscopically, hence the former was called Tuberculinum and the latter Bacillinum. Both preparations are reliable and effective." Moncrieff writes, "Clarke's Dictionary of Medicine makes reference to this under Tuberculinum. I consider it best to reserve the name "Tuberculinum" for this preparation of Koch as it is universally known by that name. Burnett's "Bacillinum" is now accepted as the name of the original homoeopathic preparation and though its originator, Swan, named it Tuberculinum, it owes its present position in therepeutics to Burnett, and it will be simplify matters if we make the term Bacillinum cover the homoeopathic nosode and Tuberculinum the preparation of Koch." He also writes, "I do not find any appreciable difference between the action of Tuberculinum and that of Bacillinum. My own impression is that they are practically identical, and that the one will answer to the indications of the other." Whenever he found a family history of Tuberculosis, however remote, he did not hesitate to give Tuberculinum unless there was a very well-indicated remedy. He usually commenced these cases with the 200th potency, and often did not require any other remedy. Tuberculinum seems to have a very wide range of action. One is surprised to find in it symptoms of several polycrest remedies which we use in everyday practice. Tuberculinum has to be considered especially in patients whose near relatives have been affected by the disease. Such patients may also give a history of having had measles or

whooping cough in severe form (cf. Carcinosin), or repeated attacks of pneumonia. Such patients with pre-tubercular states are called, "tuberculiniques" by French homoeopaths. These patients may have repeated exacerbations of local symptoms, e.g. migraine, diarrhoea, intermittent fever, etc. Vannier gives a vivid description of their constitution. He also describes an interesting sign elicited where a tubercular lesion of the lung has existed. When friction is applied to the chest wall on the both sides, a marked redness will appear and persist for some time on the area overlying the affected part of the lung. Recurrent attacks of cold, enlargement of tonsils and adenoids have all been ascribed to the tubercular miasm and all these patients may need periodical doses of Tuberculinum. Among all the symptoms, a peculiar one seems to be the great restlessness of the patient who desires to change his dress, diet, residence, occupation, activities, friends, etc., and even the doctor. The patient also feels better by travelling. We find the patient described as "Cosmopolitan". Even the symptoms change. A drug seems clearly indicated, the drug is given, the symptoms change and next day another drug seems as clearly indicated, and so on, the symptoms changing from time to time. A definite indication for Tuberculinum is that the symptoms are ever changing. Underhill says, "When the case changes every time you go and the symptoms imitate a different remedy at each visit, think of Tuberculinum." This is a cardinal feature of the remedy. Not only do the symptoms change but the patient wants to roam around and seek change of scenery to the point of restlessness. Kanjilal has described a case of Diphtheria in which he found the symptoms continuously changing indicating different remedies such as Merc-s, Phos.,etc. at different times. It was only after he had prescribed five or six remedies he realised that this changing of symptoms itself was a symptom and the prescribed Tub. and cured the case. Kent has described in general the symptoms of Tuberculinum under the heading Tub. bovinum. Actually, Tuberculinum is prepared from the tubercular abscess while Tuberculinum bovinum is made from the gland of infected cattle. But the indications for the different varieties of Tuberculin such as Tub. of Koch, Residual Tub. of Koch, Tub. aviare, Serum of Marmorek, Tub. of Rosenbach, etc., are given by Clarke, Wheeler, Cartier and others. Goldberg summarizes the indications well. Quinton was using Tuberculinum constantly in all cases of children and chest diseases or where a hereditary taint is suspected. Boger writes that he received the following advice from two senior homoeopaths: "When you have failed to find a remedy after trying your best, give a dose of Tuberculinum at long range, and then repeat the medicine and you will have success with the remedy you at first failed with." Wians describes a case of active Tuberculosis; when he gave Bacillinum CC it caused an aggravation of his symptoms which was soon followed by an amelioration. He also writes, "When a patient with the tuberculosis bent cannot get his intermittent fever cured with Quinine, nor apparently with any other remedy, a course of Tuberculinum will sometimes cure or make the patient curable. Tuberculinum bovinum has served well in many such cases." KOCH'S TUBERCULIN: Delayed resolution in pneumonias and influenzas. This was one of Clarke's favourite remedies for the after-effects of influenza vying with Psorinum.

Power writes, "Koch Tuberculin 1M has accomplished much in delayed resolutions of influenza attacks. There may have been improvement under the remedies, and at the stage when improvement appears at a standstill, the leading symptoms though modified still are in situ, this potency has done the needful." Clarke records his emphatic opinion that if a patient has never been the same since an attack of influenza - recent or remote - a course of Tuberculinum of Koch will be needed. Vannier considers that Residual Tuberculinum of Koch, is of value in patients who have recovered from tuberculosis, especially for those who develop arthritis, migraine, etc. This is a filtered culture of tubercular bacilli in broth. Fergie Woods mentions that when Tub-bov ceases to act, Tub. of Koch might bring great relief. TUBERCULINUM (SWAN'S): for glandular manifestations. TUBERCULINUM OF DENYS: is made by the French from the filtered broth in which tubercular bacilli were grown. This is useful in sudden attacks of depression, and weakness with nausea, diarrhoea, vomiting, etc., or in any sudden illness with no obvious cause. TUBERCULINUM AVIARE: made from chicken, acts on apices of lungs. Its sphere of action is in post-influenzal brochitis in which field it excels. It relieves the teasing, exhausting cough. History of influenza is an important indication. Baker says Tub. aviare 30x has served better than any other remedy for prostration after influenza. Tub. aviare 1M in its known sphere of bronchitis and influenza may be said to offer a valuable suggestion for the annoying, teasing cough so often remaining after the active symptoms of larger significance have subsided. In a good many such instances Aviare 1 000 has put an immediate end to this cough and any related discomforts. Jaisoorya remarks, "I have treated cases of broncho-pneumonia of over 400 rickety children with only one death and the secret is Aviare 30, 1 single dose." Hayes says that in his experience Tuberculinum bovinum benefits patients with pronounced localizations in the meninges, abdomen, skin, glands or joints; but the Aviare in those who have more evident depreciation of quality in the entire person at the same time such as after grippe or similar crisis. TUBERCULINUM BOVINUM: is said to have an affinity for the intestinal tract. Some use it upon indications similar to Tuberculinum aviare. BACILLINUM: frequency of colds leading to bronchial irritation. Sudden and deep seated cough. Low resistance to upper respiratory infection. McAdam says he has used Bacil. with excellent results in a variety of respiratory conditions and in cases where he suspects a tubercular soil. Usher, A. Clement and many others report actual cases of tuberculosis cured with Bacillinum or Tuberculinum. Winans describes several cases of tuberculosis, flu and appendicitis cured with Bacillinum.

Waffensmith quotes Burnett saying that Bacillinum is the potentized portion of lung containing the tubercle bacilli. He mentions among its symptoms taste of blood in mouth, green colour of tongue, aversion to water, desire for eggs, etc. McNiell in a discussion says that this was one of the remedies he used for cyclical vomiting. Children who had cyclical vomiting often had a tendency for papular urticaria and for these children he found that Bacil. was nearly always the most useful remedy. SERUM OF MARMOREK is made from Tubercular bacilli grown symbiotically with tricophyton. This is useful in Lupus. BACILLINUM TESTIUM is prepared from a tubercular testicle and acts well on effects of the lower part of the body. Alfred Heath mentions a case of stricture urethra and one of nocturnal enuresis cured by Tub. testium. Zoppritz also describes two cases of cystitis so cured. In nocturnal enuresis, when Tub-bov is indicated, Foubister suggests Bacillinum testium instead. Boyd has noted a very interesting thing. He had to treat two pairs of identical twins; one of each pair did very well on Ars-i and the other of each pair on Tuberculinum (Light Wilson). Discussing psychopaths, Tayler Smith says that two-thirds of the certified cases needed Tubbov followed later by Med. If Tub. produces an aggravation, Calc-c, or Calc-p in a lower potency may check it. That master, A. Pulford, writes that Tub. is almost routinely successful in herpes circinatus when other symptoms are lacking. Schwartz mentions that he has removed the ill-effects of typhoid inoculation with Tub. 10M. In a discussion, Krichbaum says that it is characteristic of the nosodes that they start a case towards a polycrest or an antipsoric remedy. Start with Pyrogen and it leads you to Ars. or Rhus-t, Tub. to China or Calc-c; Malaria o. to Ars. or Nat-m. "That means", he says, "we do not know much of these nosodes..." Boericke gives an indication that in dysmenorrhoea of Tuberculinum, pains increase with the establishment of the menstrual flow. He also says that he often used it, as others use Sulphur, as an intercurrent, having a great effect in stimulating the resistance of the organism, and he advises the 8x trituration. Patch writes, "With regard to the similarity between Pulsatilla and Tuberculinum, in my work at the hospital, I took down the characteristics of about a hundred cases with a view of working out several remedies for this disease, but Pulsatilla was the one most prominent. It would seem that perhaps Pulsatilla is an analogue - or that Tuberculinum is an analogue of Pulsatilla." In rheumatism when Rhus-t fails to cure though indicated, Lyc. or Tub. may be needed. In dysmenorrhoea when Mag-p palliated, Tub. cured.

While suggesting remedies such as Rad. , Stro., X-ray, Uran-n, etc. for the ill-effects of nuclear radiation, Bellokkossy says that nosodes such as Tuberculinum, Influenzinum, Psorinum, Pneumococcin, etc. enhance the effects of these remedies. Krynicki says that Tub. has proved effective in the treatment of poisoning by poison ivy. It has also proved to be of help in the treatment of Asthma in adrenalin-fast patients. For the symptoms that hang on after influenza, the cough, weakness and weariness and the sweating, always keep this remedy in mind, as also when treating sore throats with frequent attacks of tonsilitis and enlarged tonsils. A nosode in line with a patient's constitution or family history has frequently given striking results, allowing the previously well-indicated but inactive remedy to take hold. Sinha says, "It was in the year 1938 that the first idea of using Tuberculin flashed in the mind of Rober who wrote that the sputum rejected from the lung of a tubercular patient after its proper preparation can cure phthisis. Sometime before 1854, a Portugese Homoeopathic physician practising in Rio used Tuberculin. In 1975, Drs. Swan and Fincke prepared their Tuberculin from the abscess of a tubercular lung and prepared its "potency". In 1890, Dr. Burnett got this Bacillinum prepared from the contents of the part of a cavity and adjacent tissues of a tubercular lung by Heath. It was proved to some extent by Dr. Boocock. Five years later Koch prepared his Tuberculin from tubercular bacilli and applauded it for the cure of phthisis. After some time, he prepared another preparation by residual method and this was called "New Tuberculin of Koch T.R. " while the other was called Old Tuberculin (O.T. )... Hallock prepared a bacillary emulsion and after using it in a dilution found it very useful in some of his afebrile cases. Denys Tuberculin, which is also called Filtered tuberculous bouillon, is now used mostly by homoeopaths of France in true homoeopathic doses. It is usually called Denys Bouillon Marmorek. Dilute serum was introduced to us by Dr. Nebel and is called Dilute Serum of Marmorek though he does not believe in the tubercular infection. As a matter of fact, his preparation is an anti-toxic serum suiting to those tubercular patients who are prior to getting pulmonary tuberculosis and are very much susceptible to cold and cough. Some of the great French homoeopaths have spoken very highly and extensively of this nosode especially Leon Vannier, Nebel and Mordani. It is said of this nosode that after its ingestion, improvement is always preceded by a violent and severe aggravation which is likely to pass off very soon. Aviare is the Tuberculin from the bird. It was first used by Pierre Jousset who used this nosode extensively for tuberculosis but not confirmation of any cure has been given by him to us. But it has been found of immense value in the respiratory disease of the young ones, where it works like miracle. The whole range of Tuberculins comprises of the following preparations most of which have been sparingly used by our profession. Bacillinum, Tuberculinum bov. and Tuberculinum (Koch) are mostly used by us. Serum of Mormoreck and Denys have been used by our French colleagues and they have given us some meagre guidance for their use. Preparations that have been used till now by different physicians are *: 1. Tuberculinum (Swan and Fincke) 2. Bacillinum (Burnett) 3. Tuberculinum (Koch) O.T. 4. Tuberculinum (Koch's residual T.R. ) 5. Koch's Lymph

6. Aviare 7. Serum of Jousset 8. Allergine of Jousset 9. Bouillon of Denys 10. Dilute serum of Marmoreck 11. Tuberculinum bov. (Kent) 12. Human Tuberculin of Klebs 13. Immunizing bodies of Spengler 14. Dialysed Tuberculin 15. Auto-geneous products 16. Vaccine of Bossan 17. Serum of Movigliano 18. Pulverised Bacillary Emulsion of Hallock 19. Vaccine of Vaudremer 20. Chloroformed Tuberculin 21. Bacilli of Ostermann 22. Electronic Bacillinum of Whiting 23. Tuberculinum Procinus 24. Bacillus Testium 25. Diluted B.C. G. 26. Serum of Ferran Tyler writes, "Tub. and Drosera have seemed to, perhaps, help one another. But this insertion of doses of Tub. when there was evidently no call for them, the patient being in a state of healthful reaction, is I now think a folly of mine. One has a kind of suspicion that Tuberculinum acts on a different plane, and may not at all interfere. I have always thought so in regard to Tuberculinum and Silica, which seem to reinforce one another." Schwarts says, "The inertia produced by the shock of typhoid inoculation and even centripetal activity is met with by Tub. showing the relation of typhoid as an acture manifestation of a tubercular diathesis, i.e. I have frequently seen spoiled typhoids go into a tubercular state" and then says, "I have saved a number of Georgia victims of typhoid inoculation with Tuberculinum 10M." Hayes remarks, "We must carry Tub. always in mind while treating acute throat troubles. Our nosodes are so comparatively few, so broad yet obscure clinically that we must have their possibilities always in mind."

Bernoville writes, "It is the Phosphoric type who requires the tuberculines. The tuberculines are : T.K. (Koch's tuberculine), Marmorek, Denys, T.R. (Residual Tuberculine). "T.K. may be compared with Marmoreck. Both of them act on oxygenoid ground. Marmoreck is a remedy for infants having a pretuberculous condition in whom the tubercular lesion is suspected. It is a remedy for an anaemic child who has some troubles of growth. This remedy should be applied in the first part of life, i.e. from the age of 1 to 35 years. T.K. is used in an advanced age between 35 and 45 years. It is the remedy of the adolescent, of young adult persons, in whom a para-tuberculous condition or a confirmed tuberculous condition is suspected. "Denys is generally a hydrogenoid having a florid look. He is fat, having a healthy and deep coloured appearance. It is indicated from the age of 15 to 40 and corresponds to preturberculous condition. If the application of this nosode cause aggravation, it may be replaced by T.R. which is milder. "T.R. is a carbonitrogenoid. This is the remedy of old tuberculosis in whom the tuberculosis has become torpid. Tendency to sclerosis is a very important symptom of this remedy, pleural symphisis, deforming rheumatism. It is moreover indicated after 40 years of age. Its prescription is at this age harmless. "With Marmoreck we may compare Spengler (Immunobodies) and the Vaccine of Vaudremer. These are milder remedies. When there is the fear of aggravation we may use these remedies. We may compare with it Aviare which establishes a link between Marmoreck, Denys and T.K. "Bacillinum of Burnett is a trituration of the pulmonary tissues of the cavity, it is very often applied because it is easy to manipulate. It causes no aggravation. For this reason many homoeopaths apply it instead of T.K. , Denys or T.R. when they suspect an aggravation." McAdam says, "For cases of influenza which do not respond to the indicated remedy or for the aftermath, Bacillinum will help. It also acts as a prophylactic if given in the autumn of the year. We have a good basis for prescribing Bacillinum somewhere in the course of every pleurisy (esp. with effusion). Also in cases of cough where no remedy is clearly indicated resulting from neglected colds. Bacillinum is also of great value in lung infections resulting from influenza." He also writes, "And if the apparently indicated remedy does not yield prompt results - then the infallible remedy Bacillinum." Wilson reports that Burnett repeated Bacill. once a week. Tyler writes, "We are told that: Figures from cultures indicate that there is a relatively high incidence of bovine tubercle in alimentary canal, tonsils, glands, bones, kidneys: believed entry from milk." The above facts may help us to consider the use of Tub-bov in alimentary canal lesions, bones, glands, etc., and the use of Bacillinum in affections of the lungs. Tuberculinum Heathii which is totally distinct from Dr. Koch's was made by Dr. A. Heath in 1883. It is purely pathological preparation, in which the Bacillus Tuberculosus was found. It is the same preparation with which Dr. Burnett made the celebrated cures mentioned in his book, "Five Years Experience with the New Cure for Consumption". The remedy is called by

him Bacillinum. Since the publication of this book, the remedy has been used by allopathic and homoeopathic physicians in all parts of the world, and its effects have been remarkable. The late Dr. S.S. Banker reported a peculiar case where the patient had two alternating groups of symptoms, each responding to a particular remedy. But no drug seemed to cover the whole picture. However, the patient had a peculiar symptom, viz. that he was definitely worse from 10 a.m. to 3 p.m. For this indication, Boger's Synoptic Key gives only one remedy, viz. Tuberculinum. When Dr. Banker gave Tub., the whole symptom-picture changed and a new symptom-picture emerged for which a new remedy was found indicated which completely cured the patient. H.C. Allen writes as follows: "This remedy acts frequently best in the single dose. Strange to say, its symptom-list of diseases of the skin exceeds very much that of Sulphur in number. Hahnemann left us in his "Chronic Diseases" three or four remedies he pointed out for some of the constitutional dyscrasiae. Sulphur was one of the great anti-psorics, the king of chronic diseases; Thuja was the great anti-sycotic; Mercury the great anti-syphilitic. But if you will look into Psorinum, Medorrhinum, Syphilinum and Tuberculinum, you will find they will cure a great many of these constitutional diseases after Thuja and Mercury and Sulphur have failed, although as well selected as possible. The symptoms of constipation and diarrhoea are side by side with those of Sulphur. The constipation produced on the healthy has been most obstinate I ever met and very difficult to get rid of. The diarrhoea is more like Sulphur coming on in the morning, imperative, with a rush, the stool is profuse, watery, yellow, gushing, offensive, and unlike a great many of our remedies, painless and not exhausting. "There is extreme sensitiveness to atmospheric influences. There is no remedy in our Materia Medica so sensitive to change of weather, to cold and to heat as Tuberculinum. It is as sensitive as Lachesis or Sulphur to the heat of summer, as Kali-c to the extreme cold or winter; as Mercury or Rhus-t to weather changes. Like Pulsatilla, Kali-bi, Lac caninum, etc. it contains a list of the most erratic symptoms; not quite too peculiar or contradictory as Ignatia, nor yet too evanescent, it gives first one thing and then another." Tyler writes that she has, "Tuberculinum cases innumerable; where there is a family history of phthisis, or a previous personal history of any of the T.B. manifestations, as in Asthma of one year's standing in a woman of 38. Her mother had died of phthisis, and treatment was started with one dose of Tub-bov 200. In a month, "Very much better! Only twice awakened by it in the first week. Feels better; less chilly". Another month, and, with a cold, she had one more, her last attack. Last seen five months later when she had never had another attack. Sankaran and Matani posed a question whether in cases with a family history of Tuberculosis, a dose of Tuberculinum will produce improvement or help the action of the main remedy if interposed as an inter-current remedy. To answer this question they gave a series of such cases Tuberculinum and noted the results. The conclusion reached was that around 20% of the patients showed a good response out of whom some showed a splendid response. Sankaran noticed that quite often patients with a family history of tuberculosis were found to have glossy or shining fingernails. He says, "Noting this peculiar sign we made a detailed statistical survey of about 2000 cases and the result came out as given hereunder.

"With regard to this glossiness of fingernails, though this was significantly marked in patients with a family history of tuberculosis, I did not notice a very high incidence among actual patients of tuberculosis. In order to verify this point we went over to the tuberculosis hospital and examined the fingernails of all the patients in the indoor department. This observation is given in the following table. "While making this observation about glossy fingernails, we also noticed that quite a number of them have a significant growth of hair on the back between the scapulae. Some of them also had a growth of hair in the lumbar region." Sankaran further reports, " I once had a chance to utilise this observation in practice. I was called to see a lady, aged 30 years, who was suffering from an attack of acute rheumatic fever. She presented the usual picture of this disease with the swelling of joints, high temperature, etc. Her remedy worked out clearly to Rhus-t. So we put her on Rhus-t 30 every four hours, but with no result. Being sure of the remedy, we raised the potency to 200 and then to 1M, all of which produced not the least change in the condition of the patient. On the contrary, by the fifth or sixty day her condition became very much worse and she also developed and presented signs of a very severe form of conjunctivitis and keratitis. Her vision became blurred and she was not able to see anything. The husband and relatives naturally became panicky and they practically decided to change over to allopathic treatment. I examined her closely and I noticed that the lady had markedly glossy fingernails. They were shining as if nail polish had been applied. Naturally, I enquired if there was any history of tuberculosis in the family. The answer was negative. But still I gave her one dose of Tuberculinum 1M and then repeated the Rhus-t. The response was really dramatic. Within a few hours she became much more comfortable, the pains and swelling in the joints and the temperature came down, the condition of the eye and vision improved and she felt very much better. She improved steadily and made an uneventful recovery in a week's time. Now she has remained well for over two years. The condition of the patient had been so bad and the response to the medicine had been so remarkable that it impressed the whole community. "About two weeks after she had recovered, she came and told me that she had thought over my question about tuberculosis and had written to her mother who was away. The mother had replied that indeed she (the mother) herself had suffered from tuberculosis in her younger days. This fact, her daughter, that is my patient, had not been aware of. "This experience has been repeated numerous times in my practice." Variolinum Krynicki describes the treatment of smallpox vaccination reactions. He says both Variolinum and Malandrinum have proved useful. He thinks that it can be given either three times on the first day, twice the second day, and once on the third day, or just one dose a day for three days. He considers that one dose of Variolinum 30x can immunize against smallpox, as also Malandrinum. Variolinum is indicated in smallpox prophylactically and therapeutically and for the pitting and scarring results of the diseases. Tyler finds that this pitting of the skin due to the scars left behind after smallpox can be mitigated by Variolinum. She says:

"Cases with histories of smallpox forty to fifty years before, treated by Variolinum with marvellous improvement, till friends have asked, "Why, whatever have you done to your face?" Samuel Swan proved it on a large scale on 200 inmates of an institution. Boger describes a patient who had suppressed milk after an anaesthesia who improved very well on Variolinum DMM, which had been given to her by mistake. He also describes two girls who developed eczema after vaccination and were cured by Variol. DMM after Thu. had failed. Hallman reports 3 cases of smallpox cured and several children immunized with Variol. McLaren says Variolinum will prevent and cure smallpox. Dr. Jugal Kishore reports, "In an interesting experiment in a research, healthy young guinea pigs were given Variolinum 200, before and during artificially induced vaccinia by live vaccinia virus. In the control all the stages of vaccinia were noted and lasted for 12 days but in the experimental pretreated animals all stages were arrested except slight erythema in some. From the experiment, it appears that the preventive effect appeared to be more pronounced than its curative effect. This small experiment seems to have given us an evidence of an antiviral activity of Variolinum. Further experiments are indicated. I must mention one of my earliest experiences with Variolinum when I had not become a homoeopath. A child of 4 years in our family had a severe attack of smallpox from which she eventually recovered. But though she recovered she did not regain her original health or vigour. On the contrary she started weakening and emaciating steadily. She became more and more listless and inactive and soon she ceased to stand up or walk. Later on still, she failed to sit up also; she could only lie down. She even stopped speaking; when she wanted anything she would merely roll her eyes. Her condition was most pathetic but none of the several physicians whom we consulted could do anything because all investigations that had been done failed to show the presence or nature of any gross disease. However, it was very clear that the child was declining very rapidly in health and perhaps in another fortnight or a month she would be lost to us. At this stage, a homoeopath friend of mine arrived and I consulted him about this child. Without thoroughly examining the child but only on hearing the history that the child had been declining since the attack of smallpox, he prescribed three doses of Variolinum 30, 200, 1 000 to be given one dose each on three successive days. I was rather perturbed that this physician instead of taking very active steps, was merely putting his whole faith in three little powders of medicine. But strange to say, within a week the child's condition was reversed; she started regaining all her original activity and also grew a chubby as before, and in the course of a month or two became perfectly normal. In the words of the father of the child, the child regained her original vivacity and vitality and he considered that Homoeopathy had justified its greatness by this single case. I may also mention another interesting case. Once I had gone to Kota for a private visit. I was then casually consulted by a gentleman for his daughter aged 16 years. She was very backward in her studies and had failed in the same class for 3 years. I noticed that the girl had deep smallpox scars on her face. On enquiry, I learnt that indeed she had had a severe attack of smallpox and that since then she had become retarded. Without bothering further, I

prescribed for her Variol. 1M. Thereafter, I heard reports of her excellent progress. She got a double promotion in school and also came first in rank in her new class! Indeed our nosodes can produce amazing results in many such cases where allopaths have nothing to offer except tonics which are useless. Dd other nosodes Power describes a case of allergy to strawberries who was amel. with Fragaria vesca and another with craving for paper amel. on Lac felinum. Sloan and Case report cases of warts cured by Verrucinum. McLaren writes, "In some cases, (of warts) where I have failed, the warts have been cured by Verrucinum." * Lehman describes a variety of cases cured by Suprarenal in potency. He says, "One lady aged 35, has never been well since a spell of typhoid fever. There is frequent involuntary passage of urine and after every lifting there is a haemorrhage in the left lung which has been sore ever since the typhoid fever. Suprarenal 6x and 12x removed most of these symptoms." Hue Bon Hoa writes, "Micrococcinum was prepared from Micrococcus neoformans, which was found in a malignant tumour by Doeyn in 1901 and which he held to be the cause of cancer. Micrococcinum has been used by Leon Vannier since 1919 as a "specific desensitizer of the cancerinic state." Allen says, "Seeing that gonococcus, penumococcus, B. Coli, etc., may actually be found in the affected joints, and that one gets the greatest help by considering the patient's hereditary or personal history, in regard to acute fevers it is well always in these difficult and incurable disease to obey Hahnemann and treat the original disease - generally with its own nosodes." Oscillococcin was prepared from the oscillococcus described by a homoeopathic physician, Dr. Roy, in 1925. It also was soon used by Leon Vannier. Vannier himself described the results of his experiment. "In the cancerinic state, Micrococcinum and Oscillococcin are far from giving the same results as the potentized tuberculins give in the tuberculinique state. Oscillococcin is better known for its action against influenza. There are no keynotes: it seems to work as a pathological remedy for influenza (Chavanon)." He says Helios is a remedy for sunstroke. Pulex prevents troubles from flea bites. Pulford remarks that X-ray in potency is claimed to bring back urethral discharge. Power states, "Vaccinum 200 and other potencies has been of inestimable value in conditions of disordered and permanently impaired health from vaccination. These cases present the picture in many ways. There may be no tissue lesion observable, but the vaccination history, including the behaviour of the site of inoculation or symptoms attending it, and the course of impaired health will give abundant aid in fixing the prescription. On the other hand, there may be seen in some patients an area about the original scar, an areola of chronic inflammation, showing an effort of the organism to forestall systemic diffusion of the virus." He also describes a case of smallpox inoculation (ill-effects) not amel. by Vaccinum but relieved by Sil.

Garrison reports a case of tuberculosis cured by Vaccin. 200. Wilson mentions having used a nosode Coccal co. with remark. There are several other nosodes which have not been utilised much. Winter nosodes Brieger writes: "Efforts to reduce the incidence of upper respiratory tract infection in children and adults, particularly those who suffered attack on attack following each cold, had been relatively unsuccessful. Where asthma was present the situation looked even blacker, particularly when the patient was geographically inaccessible. Constitutional prescribing, though procuring some improvement of general health and stamina, had done little to alter the pernicious pattern, nor had the use of Bacillinum or Nelson's Influenza vaccine, given either according to their instructions or more frequently, any striking effect. On the contrary, the use of the latter not infrequently produced reactions which discouraged patients from taking it. Protection against secondary infection seemed desirable and a mental review of the etiology of these conditions has led to the preparation of what is known at Nelson's as, "Dr. Brieger's Vaccine". "As well as H. influenza A and B, the vaccine contains Bacillinum, Streptococcin and Staphylococcin in the thirtieth centesimal potency. As it seemed desirable to get an effect quickly, patients were advised to take 4-6 doses once a fortnight or in severe cases once weekly between October and March. My shame at this procedure was great and fear of the consequences, should my colleagues take cognisance of this unscientific procedure, acted as blinkers and stopped me registering results. However, it was patently obvious that my phone rang less this winter than ever before." Pneumococcin Tyler reports a case, "Chorea, girl of 9. Grimacing and twisting, temperature 99.6 ºF, heart irregular, with impure first sound at apex. Hyo. failed to help. Nat-m did but it did not cure, temperature was still 99 ºF and heart irregular. But she had had pneumonia twice, and once broncho-pneumonia, so she got a dose of Pneumoccoccin 200, and soon cleared up. Better than for years, said her mother a month later. Four months later, she remained well, and she never needed a second dose." Kerr mentions, "I have just written up the case where the lady in middle life and now, aged 77, had pneumonia three times and Pneumococcin helped her get over a neuritis since puberty in 1898 or so, which baffled London homoeopaths whom I know to be much better prescribers than I am." Colitoxine (bacillus coli) Cahis says, "It is a remedy of very large applications. According to my experience a special indication for its use is that stools are watery or at least soft. Constipation is a contraindication for its use. It is the great remedy for the paratyphoids with severe infection, but without great depression. Its first indication is the tongue covered with a white, uniform varnish and foul taste in the mouth. With it I have cured some chronic diarrhoeas resistant to other remedies. One of these was a lady from Gracia, who had been treated without any result by another homoeopathic physician. The prominent symptoms were marked borborygmi and sensations of something moving in the colon." The indications and use of bowel nosodes

Many of my homoeopathic colleagues, I am sad to see, do not utilise the bowel nosodes. This may be due to a lack of awareness of their usefulness or due to a spirit of conservatism. I can assure them that these remedies, though recently introduced into our field - and in spite of the fact that their indications have not been discovered through regular provings - have fully proved their value. Those who do not use them are indeed missing something very valuable, something which might come to their rescue in many awkward situations. The following brief description is intended only to introduce these remedies to the uninitiated and to create an interest in them. For a fuller, more comprehensive and authoritative account of their evolution, indications and uses, readers should naturally refer to the original literature on the subject especially the booklet, "The Bowel Nosodes" by Dr. John Paterson, and the book, "Up-to-date with Nosodes" by Dr. B.K. Sarkar. Evolution In the beginning of this century, a famous surgeon, Sir Arbuthnot Lane put forward a hypothesis that most of the chronic diseases were a result of autointoxication from the colon. On the basis of this assumption he treated many of his patients suffering from chronic diseases by removing a part of the colon. Whether that surgeon's hypothesis was correct or whether it was due to the psychological effect of the surgical procedure, many of the patients improved after the operation. As a result, this operation called the resection of the colon became extremely popular and even fashionable, just as Appendectomy became later on. About the year 1912, a very young, highly qualified and energetic physician, Dr. Edward Bach of England (1880-1936) also considered this possibility that most chronic diseases were the result of auto-intoxication from the bowels. He recognised that the intestinal content of both apparently healthy as well as diseased people, contained a class of bacilli - the B. coli which had hitherto been considered insignificant. This B. coli is a normal inhabitant of the intestinal canal and in a healthy intestinal mucosa it is not pathogenic but actually assists in maintaining the health of the host. These organisms, the various types of non-lactose fermenting bacilli belonging to the coli-typhoid group very closely allied to the organisms causing typhoid, dysentery, paratyphoid, etc., but yet they do not give rise to acute diseases. Since they were not directly connected with any specific disease condition they had up to that time been regarded as non-pathogenic and had been disregarded by bacteriologists and clinicians. Although these organisms are often regarded as non-pathogenic mainly because they do not give rise to active symptoms in laboratory animals and can be present for long periods in the human being without causing obviously associated disease, nevertheless they are so constantly present that even though they are relatively less virulent the persistence of their toxins has some kind of a cumulative effect, and chronic disease conditions result. A mass of evidence has gathered up to show that this sub-group of non-lactose fermenting bacilli which had hitherto been considered non-pathogenic is in reality one of the most important groups of organisms in nature, producing some kind of a chronic intestinal toxaemia, and laying the foundation for a variety of chronic diseases. The sufferers from the toxaemias become liable to all kinds of secondary infections, which further weaken them and complicate the diagnosis of their disorders. The symptoms presented by each patient will vary according to the constitution of the patient and the particular tissues of each patient which are more susceptible yield first. Moreover, most probably, toxins from different strains of organisms exercise selective powers

over different organs of the body so that each group of bacilli may give rise to a different set of symptoms. The above theory of chronic diseases propounded by Dr. Bach is set forth in the book "Chronic Diseases" by Drs. Bach and Wheeler. The clinical evidence in support of the truth of Dr. Bach's theory is overwhelming. Experimenting along with Dr. C.E. Wheeler, who incidentally was a homoeopath, Dr. Bach developed the idea of preparing an autogenous vaccine from the stool of each patient and using it on the same patient orally. They had such excellent results in hundreds of chronic cases that there were demands for such vaccines from all over the world. Besides preparing and treating cases with such autogenous and polyvalent vaccines, Dr. Bach was able to identify and classify the bowel organisms into seven major groups, viz.: 1. Morgan (Bach) comprising of the two sub-types Morgan Pure and Morgan Gaertner 2. Proteus 3. Mutabile 4. Bacillus No. 7 5. Gaertner 6. Dysentery Co. * 7. Sycotic Co. 8. Faecalis Dr. John Paterson of Glasgow (1890-1955) studied more deeply the characteristics of the bowel flora, especially their behaviour in health, in diseases and in drug provings. After doing patient and laborious research for over twenty years and after examining more than 20 000 specimens of stools, he came to certain definite conclusions. One of them was that whether these non-lactose fermenting bacilli are the cause or the result of diseases, they are definitely associated with the pathological or disease condition. The normal B. coli in the intestinal tract performs a useful function and is considered a harmless and non-pathogenic saprophyte. Any change in the human host which affects the intestinal mucosa will upset the balance between the host and bacilli and is followed by a change in the habit and biochemistry of the B. coli which may then mutate (i.e. change in character) and become pathogenic. While this alteration in the nature of the bowel flora might be a mere concomitant to the disease condition there is reason to believe that the change in the nature of the B. coli always follows an alteration in the state of the host, so that the conclusion seems inescapable that diseases are caused primarily and fundamentally as/by a disturbance in the patient (or host) and not by the microorganisms, the disturbance or alteration in the nature of the B. coli occurring only as a consequence and as a reaction to the change in the nature of the environment in the host *. Whereas the normal B. coli ferments lactose, it seems to lose this power when it becomes pathogenic. This alteration can be brought about in several ways, such as by diet, by the potentized drug and by the nosode. The effects of diet, though definite, are not so rapidly achieved and unless the patient persists in the diet, the B. coli goes back to the original state, the symptoms return and the condition tends to relapse. With the potentized drug or the nosode, however, the alteration in the bowel flora is more rapid also much more lasting.

Dr. Peterson grouped and typed the flora and by continuous experiment and observation he was able to detect a definite relationship between certain drugs and certain types of bowel flora. When particular drugs were administered in potencies, the bowel flora was altered in a particular fashion. By clinical study he was also able to bring out more clearly the indications for each type and develop further the technique of treating cases with these bowel nosodes. We have mentioned that originally each nosode was an autogenous nosode, that is, the bacilli from the patient's own stool were potentized and administered as indicated. This was comparatively simple when the organism could be isolated. Unfortunately, such isolation was not always possible, although the patient may present symptoms. So the next step was to use the nosode in a case showing similar symptoms. Gradually many vaccines were accumulated and put together in a composite vaccine of each organism, which might therefore contain many hundreds of different strains of these organisms. These vaccines were potentized and form what we now know as the nosodes Morgan, Proteus, etc. Provings, that is experiments on the healthy human beings, had not been made with the remedies. Therefore, in order to obtain a symptom-picture of each nosode, notes were kept of thousands of cases, of symptoms appearing in the patient when the corresponding organism was found in the stool and gradually a Materia Medica of each nosode has been thus built up through such clinical observations. Indications and choice of the nosode Bowel nosodes are particularly applicable to the treatment of chronic diseases. The bowel nosodes can be prescribed on anyone of the following indications. Symptom-similarity By virtue of symptom-similarity between the patient's picture and the nosode picture just as is done in everyday homoeopathic practice. As has already been mentioned, the Materia Medica of these nosode remedies has been built up by carefully observing the symptoms exhibited by thousands of patients in whom each type of organism was found in the stool. And this Materia Medica picture can provide the basis for symptom matching and prescription. When the apparently indicated remedy fails In a case where the apparently indicated remedy fails to act or there is a lack of response to previously effective remedy, an intercurrent dose of the appropriate nosode can be prescribed, e.g. Morgan (Bach) where Sulph. seems indicated but fails to act, Gaertner for Phos., Bacillus No. 7 for Kali-c, and so on. The corresponding nosode for each remedy can be looked up from the table of collateral remedies given at the end of this chapter. Later, the original remedy may be repeated, this time with beneficial response. No remedy clearly indicated In a case where several remedies seem indicated but none of them clearly and outstandingly, a nosode can be selected which is related to the majority of these drugs. If a remedy comes out from the "taking of the case", the rule is to give that remedy, but in many cases the choice is difficult and lies within a group of possible remedies. Here, the homoeopath can make use of the published list of remedies associated with the bowel nosodes, and repertorize the group of possibles. If the majority of remedies which repertorize out appear in anyone of the nosode groups that is the nosode of choice in that case. For instance, if a patient exhibits symptoms of Sulph., Calc-c, Med., and Nat-c, we can prescribe for him Morgan (Pure). In a

case where Merc., Phos., and Sil., all seem indicated, Gaertner (Bach) can be selected. Within the Morgan (Bach) group one may even be able to select Morgan (pure) or Morgan-Gaertner, but again if there is doubt, then the broader type of nosode - Morgan (Bach) should be used in cases where Merc., Phos., and Sil., all seem indicated. Extending this principle, if there is no outstanding group of remedies which would decide the choice of a particular nosode, you may start the case off with "Poly bowel (Bach)" formerly called, "P.B. B." which is the broadest of all the nosodes since it was made from all the nonlactose fermenting bowel organisms, excepting the Sycotic Co. (Paterson). Several remedies acted but none cured In an old, case where several remedies have helped but none has been able to cure the patient, we can select the nosode which is related to the majority of remedies to which the patient has responded well. For instance, if the patient has shown a good reaction to Anac., Arg-n, Ars., and Kalmia then he can be given Dys. co. (Bach). In taking the case, the life history of the patient must be included for here you may find the clue to a nosode from your knowledge of the acute phases - disease complexes - and their association with a basic chronic disease and the clinical proving of a bowel nosode. Dosage The selection of the potency of the nosode is guided by the same general principles that govern the selection of potency of other remedies. When the case is well covered with matching of general and especially outstanding mental symptoms, 1M potency or higher can be given. Where there is advanced pathology, e.g. as in rheumatoid arthritis, cancer, etc., a low potency, i.e. 6C or potencies below 6C can be used and given daily. In acute diseases, which are actually acute exacerbations of chronic diseases, a potency between 30C and 1M and can be given and must be repeated at intervals. Potencies above 1M can be given in single doses in acute diseases. When a nosode has been given especially in the 30th potency or above, it is wise not to repeat it within three months. Not only does the nosode not bear repetition for (at least) three months but, in fact, may not be required again for many months or years. When the patient has received any homoeopathic remedy in potency within the last one month, it is safer to give low potencies. When a nosode has been given in high potency, it should be repeated infrequently and only when necessary. But even while its action is going on, a homoeopathic remedy (simile) can be given in low potency to compliment its action as e.g. for a relief of some troublesome symptom. For instance, if a patient has received Syco co. in high potency for an arthritis, he may feel well in the joint pains on Rhus-t 3 or 6 in repeated doses. In case of chronic disease, which present symptoms demanding active treatment, e.g. extensive eczema with intense itching or a rheumatoid arthritis with persisting pain, it is practical and often beneficial to combine the action of a bowel nosode with a complementary remedy. The nosode may be given, say in 1M potency for a dose each of four nights, and concurrently a daily dose of the complementary remedy in low potency can be given.

This combination of nosode and remedy in varying potency has remarkable effect in the treatment of chronic disease in the dual sense of the word - diseases which have been of long standing and also of great depth of action from a basic miasm. Reaction After the administration of the appropriate nosode, there may be either amelioration of the symptoms or the symptom-picture, if vague or confusing, may clear up and give clear indications for some remedy. Alternatively, there may be no apparent change in the patient but if the nosode has been really well selected and has acted, the patient will now, i.e. hereafter respond much better to dose of the original remedy which had been indicated and given but had not acted well. Symptomatology Bacillus morgan (bach) Keynote : Congestion. Affects predominantly the skin and the portal system. Mind : Anxious and apprehensive, irritable; averse to company but agg. alone (cf. Lyc.),depressed and suicidal. Head : Congestive headaches agg. heat agg. thunderstorm agg. excitement agg. bus travel. Digestive : Heart-burn, bitter taste and vomiting in morning; "Bilious attacks" cholecystitis; gallstones; haemorrhoids pruritus ani, liver disorders. Respiratory : Repeated attacks of broncho-pneumonia in children. Sargunar who reports having used bowel nosodes in 5308 cases says that Morgan (Bach) relieves the attacks of bronchial asthma as quickly as adrenaline. Genito-urinary : Menopausal flushings. Skin : This nosode has outstanding action on the skin. Almost all infantile eczemas may need this remedy. Intense itching. General : Sluggish circulation; varicose veins; arthritis of phalangeal and knee joints; 4 to 8 p.m. agg. Of the two sub-types, Morgan (Pure) is more useful in skin eruption, bilious headache and gallstones; and Morgan (Paterson) in inflammatory conditions like cholecystitis, and in renal colic with 4 to 8 p.m. aggravation. Among the remedies related to Morgan (Bach) is the famous trio of Sulph., Calc-c, and Lyc., and many carbonates. Morgan (Gaertner) : Lt. sided renal colic and calculi. Bacillus proteus (bach) The Keynote of Proteus is suddenness and spasmodic conditions.

Mind : "Brain storm", sudden, violent temper agg. contradiction; will scream, kick, strike or throw. Digestive : Duodenal ulcer caused by prolonged nerve strain with tendency to perforate resulting in a sudden crisis. Skin : Angio-neurotic oedema (cf. Apis); herpetic eruptions at mucocutaneous juctions. Sudden oedema or sudden blanching. General : Convulsive seizures; spasm of peripheral vessels, intermittent claudication, angina, Raynauds' and Meniere's diseases, cramps (cf. Cup.). Roger Schmidt describes the following indications for this remedy. Rigidity, both of body and mind. The patients are mentally stubborn and unresponsive, and amongst the most difficult to treat, not only because of their mental attitude but also because of the intractable nature of their ailments. Often fixed ideas. Physically, they suffer from chronic arthritis, fibrositis, rheumatoid arthritis, osteo-arthritis, Meniere's disease, hysteria, brainstorms, irritation of the central and peripheral nervous systems, epilepsy, Raynaud's disease, intermittent claudication, bleeding, chronic ulcers. Cramps in the legs, numbness, tingling, paraesthesias of the extremities. Angina pectoris, acidity, heartburn, duodenal ulcers, constipation. Anal and genital pruritus. Dupuytren's contractures. Sciatica, Bronchitis in old people (Farrington). Herpes, hives and intractable dermatitis, usually prurigenous. Photosensitivity. One of the important keynotes of Proteus is violence, spasms, outbursts of temper, particularly in the young. Amont the remedies related to Proteus are many chlorides, esp. Nat-m. Bacillus 7 (paterson) Keynote : Mental and physical fatigue. Digestive : Fullness after food. Genito-Urinary : Feeble urinary stream; impotence. Respiratory : Asthma; tough, sticky expectoration. General : Slow pulse; low B.P. ; faintness on standing long and after sudden exertion. Among the remedies related to this nosode are many iodides. Bacillus gaertner (bach) Keynote : Malnutrition, esp. useful in earliest months of life. Mind : Hypersensitive; overactive. Digestive : For children when put on artificial feeding; inability to digest fat; chronic gastroenteritis; threadworms. General : Indicated in children and in old age; marked emaciation. Malignancy. E. Paterson thinks that where Cham. fails in teething troubles, Gaert. may help. Bacillus dysenteriae (bach)

Keynote : Nervous tension (anticipatory). It has special action on the nervous system and the heat. Mind : Nervousness agg. anticipation; (cf. Arg-n); agg. presence of strangers, fidgety. Head : Frontal headache agg. excitement agg. every 7 or 14 days. Digestive : Pyloric spasm and stenosis; pain abdomen agg. midnight agg. vomiting; duodenal ulcer (with nervous tension); cyclical vomiting in children. Skin : Small circinate scurfy patches. General : Choreic movements, chorea, (very nearly specific). Bacillus sycoccus (paterson) Keynote : Irritability, Catarrh. Affects mucous membranes esp. genito-urinary tract and kidneys. Mind : Irritable; fear agg. dark agg. alone. Head : Pain due to sinusitis or persistent headache in children (prodrome of tub. meningitis) (cf. Hell.); sweat on head at night. Digestive : Offensive diarrhoea, excoriating; urge on rising in morning; nausea agg. eggs (cf. Fer.). Respiratory : Catarrh of nose, throat and bronchi; enlarged tonsils and adenoids; cough and dyspnoea agg. 2 a.m. Skin : Warts on muco-cutaneous surfaces. Genito-urinary : Syc. Co. has special action on the whole genito-urinary tract causing inflammation; pain left ovary at menses; leucorrhoea. Adhesions. Gonorrhoea. General : Twitching of facial muscles; fibrositis agg. dampness agg. beg. motion (cf. Rhus-t); fidgety feet in bed; painful soles. Predisposition to influenza; convulsive seizures. The well-known antisycotic Thuja is related to this nosode. Bacillus mutabile (bach) Cystitis, asthma, alternation of symptoms. Elizabeth Paterson says that of all the bowel nosodes, the one most frequently met with in children is Morgan and next comes Gaertner. She says that as a rule it is better to begin the treatment with the seemingly well indicated remedy rather than the nosode. References Boyd W. : The Bowel Nosodes in Stomach Disorders; Souv. 17th A.I. Hom. Med. Conf., 77, 1988 Boyd H.W. : Some Lycopodium Cases (Disc.); Brit. Hom. J., 52, 27, 1963 Boyson W.A. : Time and the Nosodes; J. Am. Inst. Hom., 59, 209, 1966

Brown G. : Drs. John and Elizabeth Paterson; Hahn. Glean., 36, 353, 1969 Foubister D.M. : Vomiting in Infancy and Childhood; Brit. Hom. J., 92, 85, 1952 Griggs W.R. : Clinical Experience and Homoeopathic Research with the Morgan Bacillus (Pure); Hom. Herald, 7, 493, 1974. Griggs W.B. L. : Clinical Proving and Research of the Intestinal Nosodes Dysentery Comp. ; J. Am. Ins.t. Hom., 54, 75, 1961 Kennedy C.O. : Further notes on the Bowel Flora; Brit. Hom. J., 44, 100, 1954 Misra B. : Researches in Homoeopathy; The Bowel Nosodes; Souv. State Hom. Pract. Conf., 17, 1969 Paterson E.M. J : Bowel Nosodes in Four Dispensary Cases ; Brit. Hom. J., 35, 69, 1945 Paterson Elizabeth : A Survey of the Nosodes; Brit. Hom. J., 49,161, 1960 Paterson E. : Skin Disease (Disc.); Brit. Hom. J., 45, 153, 1956 Pateron J. : Up-to-date with Nosodes; Brit. Hom. J., 43,130, 1953 Powel M. : Nosodes; Proc. Int. Hahn. Assn., 93, 1919-1920 Ross T.D. : Vomiting in Infancy and Childhood (Disc.); Brit. Hom. J., 42, 60, 1952 Schmidt R.A. : Proteus - A Bach Nosode; J. Am. Inst. Hom., 58, 261, 1965 Sargunar H.T. P : Bowel Nosodes; The 50 Millesimal; 4, 510, Feb. 1973 The bowel nosodes and their related remedies Morgan (Bach) : Alum., Dig., Nat-c (A) Morgan : Bar-c, Calc-c, Calc-s, Carb-s, Carb-v, Fer-c, Graph., Mag-c, Med., Petr., Pso., Sep., SULPH., Tub-bov (B) Morgan-Gaertner : Chel., Hep., Merc-c (Paterson) : Chen., Lach., Sang. Colic : Hell., LYC., Tarx. Proteus (Bach) : Ac-m, Bor., Ign. Brain Storm : Am-m, Aur-m, Ap., Bar-m, Calc-m, Con., Cup., Fer-m, Kali-m, Mag-m, NAT-M, Sec-c. Mutabile (Bach) : Fer., Phos. Alternation : Kali-s Skin, Asthma : PULS. Bacillus No. 7 : Ars-i, IOD., Kali-i (Paterson) : Brom., Kali-bi, Kali-nit

Fatigue : Calc-i, Kali-br, MERC-I Mental and Physical : Fer-i, KALI-C, Nat-i Gaertner (Bach) : Calc-f, Nat-p, Puls. Malnutrition : Calc-hypo, Calc-sil, Kali-p, MERC-VIV, Nat-sil-f, PHOS., Phyt., Syph., SIL., Zn-p Dys. Co. : Anac., Arg-n, ARS., Cad., Kalm., Ver-a, Ver-v Sycotic Co. : Ac-n, Ant-t, Bacil., Calc-met, Fer., Nat-s, Rhus-t,Thu. Faecalis (Bach) : Sep. Some new provings Introduction As one studies and practises Homoeopathy and contemplates measures for its further advancement and progress, the possibilities of various forms of research open out before one's vision. For, though Homoeopathy, practiced as it is today by a minority, is very satisfying to thoughtful physicians, there are several aspects that are yet to be clearly defined, enlarged, delineated. Besides, new problems are constantly arising before the medical profession in view of the advancement in science and civilisation (e.g. atomic radiation hazards) and solutions will have to be found for those. As one considers the various methods of research that could be carried out within the field of Homoeopathy, relatively the most simple, inexpensive and yet the most fruitful form of research seems to be the conduct of Drug Provings. The discovery of the properties, effects and indications of drugs in our field requires no costly laboratory equipment, no deep knowledge of pharmacology, not even expensive animal experiments, but only very carefully conducted provings done with the help of enthusiastic, reasonably healthy and faithful volunteers as provers. Some of the most valuable therapeutic indications for our drugs have come only through this source, namely the experiments called Provings, initiated by the genius of the master Hahnemann himself. No doubt, careful clinical observations at the bedside have considerably added to and enriched the material made available through provings; yet the backbone or core of our drug symptomatology, forming the most reliable indications have come only through the provings. Considering that the most fundamental and fruitful form of research in Homoeopathy namely Provings, require no costly apparatus or technical "know-how", but merely reliable volunteers, it is a great pity that despite the fact that the homoeopathic profession in India boasts of thousands of vociferous adherents, very few provings have been conducted, so that the Materia Medica that our generation inherited practically remains static, unadded to. Compared to the tremendous whirlwind activities of the homoeopaths of the latter half of the 19th century, the activity of homoeopaths of this century appears very poor, and shamefully so, by contrast. I shall now give a brief summary of our attempts at provings at the Homoeopathic Hospital, Bombay. The first was a proving of Hydrophys cyanocincta, the sea snake. The fact that this sea snake is ten times as venomous as the cobra (Naja), prompted the feeling that it might be more powerful, if not more useful, as a remedy. When the proving was suggested to us by Mr. Dudley Everitt of Nelson's, London, we welcomed the idea with relish. We caught the snake with great difficulty from the Arabian Sea, had the venom extracted, sent it to London and got

it potentized by Nelson's. But, most unfortunately, very soon after the proving started, the whole group of provers were attacked by the Asian Influenza epidemic and so the proving had to be abandoned. Fortunately, however, Dr. Raeside has been good enough to prove the drug and enrich our Materia Medica, for which the profession will be eternally grateful to him. The next proving that we attempted was with China, two in the 6th potency, two in the 30th potency, two in 200th and two in 1 000th potency with four as controls. First, one dose was given daily, then two. But in one month, strange to say, not a single prover brought out a single symptom! In fact the provers felt that they had all been given only Sac-l. This was our second failure. However, we persisted and attempted to prove other drugs and I am happy to say we had some encouraging results. The results of our provings are published in this booklet. I am aware that these provings are somewhat fragmentary and the drugs will have to be reproved to complete their symptom-pictures. However, the full symptom-picture of a drug may not be completely available through provings alone. In fact, provings are only like rough diamonds and to bring out their full lustre they have to be cut and shaped through clinical experience, that is experience in practice. The symptoms brought out in the proving will have to be confirmed and the outlines sharpened by clinical experience. Therefore, I now appeal to my colleagues in the profession to study these provings, conduct further re-provings and try them out in practice on the basis of available symptoms delineate their full shapes through clinical experience. The provings were published in the British Homoeopathic Journal, the Journal of Homoeopathic Medicine, and other journals. I am most grateful to the editors of these journals for kindly permitting me to reprint them. Bombay, 15th December 1978 A proving of adamas Adamas Introduction A proving of Adamas * (the Diamond) was conducted in August-September 1969 and it was repeated in October 1970. The proving of the diamond was suggested by our esteemed colleague Dr. James Stephenson of New York. Dr. Stephenson told us that since the diamond was being extensively and successfully used in Ayurvedic Medicine, it deserved a proving in order that its homoeopathic indications may be discovered. When we requested A. Nelson's of London to prepare and send us a potency of Adamas, they found great difficulty in preparing a potency. As the diamond is one of the hardest substances in the world, they felt that it would wear away the mortar and pestle rather than get triturated. Ultimately, they overcame this difficulty by using a special mortar and pestle perhaps made of Agate. In the 1969 proving, there were 4 provers and 2 controls; in the 1970 proving there were 5 provers and 2 controls. The drug was given to the provers in 30th potency, two doses daily, one in the morning and one in the evening. Each prover was also made his own control by giving him Sac-l for the first one week. From the 8th day onwards, each prover was switched over to the potency of Adamas. In 5 provers the doses were discontinued after one month

while three provers continued the proving for 11/2 months and one prover for 2 months. The symptoms noted are now presented in a schematic form. One of the outstanding symptoms was headache associated with sugar ameliorated by eating. In one prover, this symptom lasted for 2 years after the proving was over. The proving is somewhat fragmentary and the drug will have to be reproved with more provers to know the full range of the drug. Symptoms in schematic form Mind Irritable, does not like to talk. Lethargic in morning. Does not like to work. Mind unstable. Does not stick to one decision. Fear of getting some serious disease. Fear of death. Mentally depressed. Suspicious that everybody is making fun of him. Listless. No desire to do any physical and mental exertion though no feeling of tiredness. Wants to stop in whatever work engaged and take rest. Forgetful; loss of memory for recent events, cannot remember the names of people, even of fast friends, or well-known objects. Fumbles in speech with difficulty in getting at certain well-known words. Makes mistakes in speaking - instead of "speech" says "speed" instead of "Shukla", says "Sachivalaya". Prostration. Vertigo Feeling of vertigo, sickness and sleepiness whole day. Head Heaviness of head from morning to evening. Head, pain amel. tea, amel. closing eyes,agg. exertion, agg. talking, amel. afternoon sleep,agg. getting wet. Head pain with burning in eyes.

Head, pain, throbbing, temporal region agg. 11 p.m. agg. afternoon till 9 p.m. agg. every step, agg. jar, agg. motion,agg. noise, amel. pressure, with nausea,agg. travelling in train or bus; with pain in eyes and above eyes. Head pain frontal agg. waking up in morning, agg. rising up, amel. after an hour. Head pain dull aching type agg. sitting. Head pain left side from frontal to occiput agg. exertion, agg. morning agg. afternoon upto 4 o'clock. Pain left lower 5th tooth with left parietal headache. Head, pain, right side 8-11 p.m. agg. lying left side, amel. lying right side amel. sleep. Head pain from left to right agg. 11 a.m. to 2 p.m. For the rest of the day, a little pain appearing and disappearing on left and right sides. Head pain amel. lying with head straight (90 degrees). Head pain gradually increases towards evening amel. 11 p.m. At 3 a.m. , a sensation as if spikes or sharp nails were trying to come out of the skull by radiating from a point somewhere deep in the brain. From 7 a.m. to 3 p.m. , sensation as if the cranial cavity is empty still,agg. rising from squatting (particulars agg. 8 a.m. to 11 a.m. ). Head pain when hungry amel. eating. Boil left parietal region. Sensation of something circulating in the head. Eyes Lachrymation with headache. Burning in eyes with headache. Pain in eyes and above eyes. Ear Feeling in the ear as if ear is filled with water. Having noise in the ear as if water is rolling inside. Mouth Dryness of mouth. Pain, sore, tongue and under tongue. Salivation throughout the day amel. night, agg. during sleep in afternoon. White coating on the tongue with red edges. Teeth

Pain tooth 2 p.m. to 7 p.m. agg. pressure. Pain left lower 5th tooth with parietal headache. Throat Pain agg. evening and night, agg. empty swallowing amel. drinking, amel. eating or drinking hot things,agg. drying up of throat. Pain sore with unproductive cough agg. all day. Pain stitching, pricking amel. tea. Sensation of mucus sticking inside which cannot be brought out by any amount of straining (hawking). Pain sore extending down the trachea. Stomach Appetite increased. Intense thirst, wants half a glass water every hour during the day. Thirst for chilled water. Abdomen Rumbling amel. passing flatus. Flatulence completely relieved after stool. Rectum and stool Passes stool in large quantities. Pulling sensation after stool. Flatus offensive in morning, non-offensive at night. Passes a lot of flatus before stool. Flatus, not noisy agg. night. Pain in anus after stool, relieved after some time. Desire to pass stool, urgent, agg. in the morning, agg. after tea. Has to wait long for stool. In the morning, has to rush for stool. While going to sleep sudden urging for stool. Watery stool with mucus and flatus. Passed little stool, hard in consistency. Watery stools in the morning about 6.45 a.m.

Stools yellowish, offensive. Reversed peristalsis agg. pressure. Constipation, passed stool with difficulty. Passed stool twice a day. Two normal stools, 2nd offensive or green and offensive in the morning. Constipation with hard stool. Urinary tract Burning sensation in urethra while passing urine every time. Burning sensation in urethra while passing urine agg. in the morning. Urine profuse, passed every three hours. Pain urethra amel. after urination. Genitalia Passed prostatic fluid after urination after much straining. Seminal emissions, very much sexually excited after getting up in the morning, and in the night also. Satyriasis. Seminal emission early morning. Nocturnal emission. Larynx Tearing pain in larynx with chill in larynx; sensation as if larynx would start bleeding agg. talking, agg. 11-12 a.m. Respiration Asthmatic, wheezing 2- 2.30 a.m. Lot of panting after running in the morning. Lot of panting after swimming. Rattling with explosive cough agg. day, amel. night, amel. open air. Cough Cough with coryza with jelly-like dirty-green discharge agg. daytime, amel. night. Explosive type of cough with much rattling in chest and occasional expectoration with much saliva agg. day, amel. night, amel. open air. Cough agg. in closed room.

Unproductive paroxysmal cough agg. 10 - 10.30 p.m. Expectoration Whitish, greenish, yellow, dirty green, thick expectoration. Chest Empty sensation in chest. Feels as if blood is flowing ouf of the heart and blood vessels agg. evening, agg. when not occupied. Feels heart beats have increased. Heaviness with substernal coldness. Pain sore, aching near the sternum. Heaviness precordial region. Pain amel. pressure, amel. hot application, agg. 7.30 p.m. to 10 p.m. Pain sides amel. lying on back, amel. pressure, amel. hot application. Pain intercostal spaces, parasternal area. Pain precordial agg. evening after dinner, agg. deep inspiration. Pain in left chest agg. evening, agg. deep breathing, agg. laughing agg. coughing bending, agg. lying on left side, amel. lying on right side amel. rest. Pain dull aching at the origin of sternomastoid muscle throughout the day agg. extending the neck, amel. flexing the neck and then pressing the muscle. Back Backache, lightning pain after getting up in morning. Extremities Pain upper limbs travelling from shoulder to finger, agg. pressure,agg. night, agg. lying on side, agg. going to bed, when pain amel. during day. Itching dorsum of left foot, painful after scratching, pain going upto the ankle. Knees cold. Hot burning sensation in the shoulder agg. in the sun. Coldness of palms and fingers esp. finger tips. Sleep and dreams Cannot wake up early in the morning. Feels sleep is not enough. During sleep in the night clenched the fists hard. Dreams of snake bite. Gets up frightened with palpitation for a few seconds. Dreams of friends betraying him and felt disappointed.

Had dreams but could not remember them. Skin Itching all over body. Part becomes red after scratching. Burning after scratching Itching at different regions. Skin symptoms agg. 1 p.m. lasted till going to bed (10 p.m. ). Summary of proving symptoms of adamas Lethargy in morning. Fear of getting disease. Fear of death. Forgetful of names of friends. Fumbles for words and makes mistakes in speaking. Headache from hunger amel. eating. Lachrymation with headache. Salivation throughout the day . Pain throat amel. by drinking. Stitching pain in the throat. Diarrhoea with urgent stools. Pain in chest on deep breathing. Emptiness in chest. Pain extending from shoulder to fingers. Coldness of the fingers and knees. Very frightful dreams. A proving of aqua marina Aqua marina Introduction The idea of proving Aqua marina (Sea Water) arose by reading in Clark's Dictionary under Aqua marina, "Sea water contains in solution every inorganic substance in the world". Now it seemed that if a solution should contain every inorganic substance in the world, surely it must have the widest range of action and utility. Besides, we may also consider the fact that the sea water is under a continuous process of dilution by virtue of the water being added to it in the form of rain as well as through the rivers which further enrich the water by addition of various minerals. Besides, the sea water is also undergoing a continuous process of agitation by virtue of the constant movement of waves. It is possible that this continuous (natural)

dilution and agitation, perhaps imparts some potency to the various inorganic compounds contained. Besides the inorganic compounds, we may also contemplate the fact that the secretion of various creatures like the cuttlefish, snakes like Hydrophys, etc., and the remains of the various animals, fishes, are also to be found in the sea water. While such is the chemical composition and nature of Aqua marina, whose several constituents have proved each a boon to suffering mankind, yet we were surprised to find that the symptoms of the sea water itself are dismissed with only a few lines in Clarke's Dictionary giving us the impression that the drug had not been seriously proved. The idea of proving sea water was strengthened by a suggestion from our valued colleague Dr. Ronald Livingston of London. He was also kind enough to supply us with ampoules of sea water to be proved by injecting it in healthy persons. This, unfortunately, we could not do as we could not get volunteers for this purpose. However, Messrs. Nelson's of London were kind enough to supply us with potencies of Aqua marina prepared by using Plasmo de Quinton which is nothing but sea water taken from the Bay of Biscay at a depth of 100 fathoms. We started the proving on 15th of March 1962, with eight provers of whom six were given the drug in the 30th potency and two were given Sac-l to serve as controls. The proving was done by the double blind method wherein neither the Director of the proving nor the provers knew who were the provers receiving the drug and who the controls were, getting the Sac-l. The drug was administered daily to the provers, one dose in the morning and one in the evening and was continued for 15 days. After 25 days, the drug was stopped but the symptoms were continuously recorded for a month. Whenever any prover found that he could not carry on with the proving, we had to give him the antidote on the basis of available symptomatology. The details of the symptoms evolved are given hereunder. I, myself, took part in the provings but since I was aware of the identity of the substance being proved, I had not included myself among the provers. I had intended to keep my symptoms separate from those of the others, but unfortunately it turned out that I was one of the controls who received Sac-l. I say, unfortunately, because I am by nature very sensitive to potentized drugs and might have brought out good symptoms had I received the drug. One important fact must be mentioned here. After the proving was over it was noted that two provers who had produced some very fine symptoms - some of them homoeopathically very significant - had actually exhibited the symptoms merely on Sac-l, since they had been among the controls. Whether these symptoms were the result of latent illness or latent neurotic trends in the provers, or of an expectant or over-wrought imagination or due to any other circumstances, the fact has to be taken in consideration that all the symptoms evoked during a proving, especially one conducted without controls, are not necessarily due to the drug. Applying this criterion to provings conducted without controls, as some were no doubt done even during Hahnemann's time, one can realise why some of the indications in the Materia Medica are found unreliable. Symptoms elicited in more than one prover are given in italics. Symptoms in schematic form Mind Delusion of being watched. (cf. Ars., Hyo.). Fears that others are seeing him doing work; during bath feels bathroom door is open.

Sensation as if all organs are swallowed (?). Restlessness. Forgetfulness. Tendency to lie down but no sleep. Worried. Does not want to do any work; no desire to read; uneasy; dull in class; understands what lecturer speaks but when trying to note down forgets it. Mixes one sentence with another. Very unrefreshed in the morning on getting up due to lack of sleep. Lascivious thoughts. Fear of becoming crazy due to persistent lascivious thoughts which forced him to be religious. Concentration difficult. Desire to lie down. Averse to bath (cf. Am-c, Ant-c, Sep., Sulph.). Becomes more sluggish. (All these symptoms persisted for four days.) Sense of well-being. Anxiety, cannot sit in one place, must move in order to ease the mind (cf. Ars.). Depressed feeling. Likes company. Anxiety amel. fast motion (cf. Ars., Sept.) amel. riding in carriage (cf. Ars., Nit-ac) moving (cf. Ars.) amel. perspiration, amel. icy cold drinks (cf. Phos., Sep.) amel. cool open air, amel. talking. Much restless, thinks of suicide. Anxiety amel. company, amel. walking, amel. direct wind on head. Straining of mind results in sudden loss of memory (for 10 days); (Had to take Anacardium 1000, 3 doses to relieve this). Anxiety agg. 2 to 4 p.m. Vertigo Vertigo with headache. Head Heaviness of head.

Frontal headache amel. pressure, amel. pressing teeth together. Headache temporal region. Headache amel. eating, amel. sleep. Headache, right eyebrow. Headache frontal to occiput. Dull headache in temporal region. Dull headache. Sour food causes headache. Frontal and temporal headache at 9 p.m. after dinner. Feeling of headache only after thinking of it amel. pressure and cold water application, disappeared completely after sleep. Occipital headache with heaviness at 6 p.m. amel. motion. Then the pain travelled to the nape of the neck with stretching and pulling pain, amel. in cold air, amel. rest, more in nape of neck. Occipital headache at 4.30 p.m. Heaviness as from weight amel. warmth, amel. pressure, distinctly amel. by walking slowly in open air. Occipital headache. Vacant feeling in head (cf. Sulph.) immediately after sleep (for 2 days). Eruption on forehead with pus. Eyes and vision Heaviness of eyelids immediately after dinner. (Thinks this is an old symptom coming up). Burning in the eyes in the afternoon from 4 to 6.30 p.m. amel. by cold application. Face Some eruptions on face appeared on both cheeks. Eruptions appeared on chin, left side, red, painful to slight pressure. Cracks appeared in the centre of lower lip; (cf. Nat-m). Slight burning in evening, burning agg. opening the mouth agg. laughing. Dryness of lips, felt only after another prover told that he is getting the same symptom. Dryness of lips more at night. Nose Sneezing on awaking. Coryza, watery discharge.

Blocking of left nostril. Coryza amel. tea. Blocking of rt. nostril, then left. Sensation as if cold only in the root of nose. Pain in the nose, in the corners of both nostrils since morning. Slow dull pain. Offensive odour. Mucus dropping from posterior nares. Feels as if stuffed, stopping of rt. nostril. Mucus thick white, very offensive, dropping from posterior nares copious in morning. Mucus from left side. Mucus, discharge, amel. after food, amel. after sleep. Sneezing. Burning water discharge amel. perspiration. Mouth Yellowish white mucous membranes. Offensiveness from mouth, with mucous membranes. Offensiveness from mouth, with spitting of blood. Offensive odour with burning in mouth. Pain in the left side of soft palate at 8 p.m. on empty swallowing amel. by cold drink. Pain in the left side of the palate in the morning on getting up which disappeared after 2 hours amel. cold drinks, agg. empty swallowing. Throat Pain in throat after eating. Pain in rt. tonsil agg. pressure, agg. night. Severe digging pain behind rt. sternomastoid at medial end of the clavicle agg. on swallowing esp. forceful swallowing, amel. hot drinks and hot application. Mucus, very offensive, on empty swallowing. The throat was looking congested, more on the left side. Constant oozing of offensive mucus from the left side of throat, more in morning on getting up, afternoon and evening. Tickling in the throat at 8 p.m. with desire to hawk. Pain in throat, left side 6 p.m. to 8 p.m.

Mucus more after afternoon sleep. Stomach Appetite increased. Thirst ++. Appetite increased at 11.30 a.m. , also felt after eating. Appetite increased at 11 a.m. after food. Pain in the pit of stomach amel. pressure, amel. hot application. Appetite reduced in the evening. Pain in epigastrium just below the xiphisternum felt in morning on opening the eyes, gradually increased after motion, amel. after hot bath, agg. straining, amel. resting. Abdomen Flatulence. Tenderness in abdominal muscle. Pain before and during stool though the stool was soft. Sensation of heaviness before stool. Burning in anus after stool. Bleeding per rectum. Stool first part large which tears anus and it bleeds. Bright red blood about 3 drops (old symptom). Stool Stool undigested, somewhat dry, brownish black with flatulence and rumbling sound. Passed small worms with stool (on successive three days though he had passed no works before). Stool slightly loose, slightly offensive. Constipated, unsatisfactory stool, slightly hard. First portion of stool hard followed by soft stool. Urinary organs Could not pass urine in public urinal. Urination every 2 hourly or 1 hourly. Genitalia Seminal emission early in the morning.

Seminal emission 3 times with subsequent weakness, drowsiness and great muscular pain with desire to lie down. Weakness of the sexual organ, does not get erect easily, though there is intense sexual desire (unusual symptom). Cough and expectoration Expectoration watery. Expectoration won't come out and can't be swallowed. Salty rust-like taste, mucus sticking on posterior aspect of throat. Cold, watery expectoration in the morning. Chest and back Backache at 5.30 p.m. with desire to lie down. Heavy pain behind rt. side of sternum at 10.15 p.m. (passed off after 15 minutes). Pain in nape of neck, difficulty in rotating neck. Pain in neck, rt. side behind mandible amel. by hot drinks. Started about 6 p.m. to 6.15 p.m. (successively for 3 days at 6.10 or 6.15 p.m. ). Stitching pain in chest amel. warmth of warm drinks, agg. by slightest touch, agg. slightest pressure. Pain in chest as if coming up from chest from behind 3rd interconstal space, just next to sternal articulation. Pain in chest at about 4 p.m. Pain in chest at 4.10 p.m. Pain in the lower 3 intercostal spaces, both sides on rising in morning, disappeared after half an hour. Diffuse pain in the lower 4th or 5th intercostal space in morning on rising, amel. pressure. Pain in the left side of back under the lower angle of scapula in the evening. Extremities Coldness of extremities. Pains in left shoulder at 9 a.m. Pain in rt. forearm from elbow to the tip of fingers. Pain severe, unbearable, more in palm and medial aspect of hand about evening, more severe at 9 p.m. (took sleeping pills for relief). Sore pain in sole and ankle joints after travelling. Sore pain in palms and soles, calf muscles.

Itching between thighs. Pain in rt. knee. Perspiration on palms and soles after taking bath in morning sticky, more in axilla, on rt. side. Pain in palm and lateral side of hand. Muscles painful on pressing. Pain arm upto scapula. Pain in rt. hand on medial aspect with trembling. Severe pain more at night, 12 to 6 a.m. amel. hot application amel. pressure. Shooting pain at 1 p.m. , severe from 2.30 p.m. to 9 p.m. Lightning like pain at night 12 to 6 a.m. Pain rt. arm starting in lunar aspect of palm shooting upto the elbow agg. rest, amel. pressure, agg. night, agg. cold air, agg. air-conditioning amel. hot application, agg. sour food, tomatoes. Coldness of upper arm. Tremor of both hands esp. rt. (pain had to be antidoted by Rhus-t 200). Eruptions on rt. leg with pus. Itching in bends of thighs. Involuntary movement of lef medially only when resting legs on floor. Offensive perspiration of the soles in the evening. Offensive perspiration, palms and soles. Itching of left palm and fingers of left hand. Itching around toe of left foot (persisted for 2 days). Numbness in legs especially in calf muscles agg. morning, agg. squatting, amel. walking. Chill and fever Fever in morning at 10 a.m. with much dryness of mouth (cf. Nat-m). Chilliness. Summary An attempt to prove Aqua marina was made and the results are published. It would be better to call this an attempt at a proving for in several ways, this proving falls short of optimum requirements. For example, we did not do pathological, bacteriological examinations as is being done in modern provings. However, we are publishing this proving with the hope that this will stimulate further provings of this substance by other interested homoeopaths, so that we shall be able to gather rich material concerning this substance.

Acknowledgement I am deeply indebted to the following students who were kind enough to volunteer as provers and who exposed themselves to much discomfort for the advancement of the science of Homoeopathy. Dr. D.P. Singh Mr. S.S. Shirke Miss S.P. Saraswathi Mr. C.Z. Pattani Mr. M.A. Moti Shaikh Mr. N.B. Patel Mr. S.D. Narkar I must also express my thanks to my house physicians Dr. (Miss) S.M. Nerurkar, Dr. (Miss) S.M. Mirchandani, Dr. (Miss) S.K. Nagpal and Dr. S.A. Jamdar for helping me in conducting the provings and to my friend Dr. M.O. Shaikh for assisting me in collating the results. Besides, I must also express my gratitude to Messrs. A. Nelson's of London for supplying the necessary medicines. Summary of proving symptoms of aqua marina Delusion of being watched. Dullness, no desire to work. Confusion of thought. Lascivious thoughts. Aversion to bathe. Restless. Depressed. Anxiety, worse 2-4 p.m. , better by movement, better by cold drinks. Thoughts of suicide. Sudden loss of memory. Frontal headache. Headache from sour food, amel. motion. Occipital headaches. Coryza with sneezing. Crack in the centre of lower lip. Offensive breath. Pain lt. side of palate better by cold drinks. Appetite increased at 11 a.m. Pain abdomen along the line of diaphragm.

Could not pass urine in presence of others. Sore pain in limbs. Fever in the morning at 10 a.m. A proving of atrax robustus Atrax robustus Introduction A proving of Atrax robustus - the venomous Australian spider - was suggested by Mr. D.W. Everitt of Messrs. Nelson's of London. He was also kind enough to supply detailed information about the spider, through photostat copies of pages from a Journal from the Australian Museum. The spider is said to be venomous and it is reported to have caused even deaths of human beings. Mr. Everitt was further kind enough to supply us potencies of the remedy and we conducted a fragmentary proving of the same in the Bombay Homoeopathic Medical College. In this proving 4 provers took part. One was given Sac-l as control and out of the remaining three who took the actual drug in the 30th potency, only one prover brought out the symptoms which are given hereunder in schematic form. The provers were given one dose daily for a month. At the end of a month the drug was stopped but the provers continued to observe their symptoms for a month more. Once a week, their notebooks were checked by the director of the proving. No change of any sort in the diet or activities was made during the proving. No pathological investigation before, during or after the proving were attempted. Extracts from this report are given in the Appendix. Symptoms in schematic form Mind Mentally exhausted in the evening, cannot do mental or physical work. Vertigo Slight vertigo in evening at about 7.30 p.m. only for a short time. Eyes Pain above lt. eye agg. at bed time, in bed before sleep. Discharge, white or little yellowish at night, copious, eyelids stuck in the morning. Redness of eyes esp. left, in evening. Pain in eyeball esp. left as if it is pushed forward, with copious yellowish white discharge. Ear Pulling sensation behind the lt. ear as if a string is tied between occiput and mastoid on lt. side (H/o ear discharge in left ear some months back). Pulling sensation behind ear has shifted to rt. side from lt. side.

Nose Yellowish thick discharge, sometimes black and sticky. Throat Sensation of lump in the throat agg. lying on back. Soreness in throat at about 2 a.m. Soreness increases esp. on left side of throat while swallowing so that he cannot sleep for about one hour, somewhat better in the morning. Sore throat , evening. Dryness in throat not relieved by drinking water. Soreness of throat agg. cold drink. Sensation as if thyroid cartilage is pressing on the outer surface of throat. Abdomen Slight crawling pain around the umbilicus at 8.30 a.m. developed gradually half an hour after meal amel. hard pressure, amel. lying on abdomen, amel. bending double, agg. bending back, agg. walking, agg. sitting erect. Cough Cough with expectoration, greenish, thick, easily expectorated. Urinary tract Urine feels a little hot and slightly excoriating. Frequent urination at night. Sensation as if something remained after passing urine. Last drop very hot and feels as if it is very concentrated, excoriating. Extremities Sudden weakness in both extremities in the evening esp. in lower; wants to lie down quietly. Relaxation in extremities. Pain in knee joint amel. by continued hard pressure. Generalities Exhaustion, remains till morning; gets up with tired feeling but slowly it disappears. Summary of proving symptoms of atrax robustus Mental exhaustion in the evening. Vertigo in the evening. Pain behind left eye at bed-time.

Pulling sensation behind left ear. Feeling of lump in the throat worse by lying on the back. Pain left side of the throat when swallowing. Dryness in throat not relieved by drinking water. Pain abdomen amel. bending double, amel. by lying on abdomen. Urine feels hot, especially the last drop. Sudden weakness in both extremities in the evening. Appendix The position of spiders in the animal kingdom * The Animal Kingdom is divided into certain groups called phyla of which the greatest in terms of numbers, if not in importance, is the phylus Arthropoda, which includes those animals with jointed legs and with a hard exoskeleton. The phylum Arthropoda is further subdivided into classes of which the Crustacea are aquatic for the most part, but the classes Insecta, Arachnida, Chillopoda (Centipedes), and Diplopoda (Millepedes) are, in the main, land animals, though many forms are aquatic or partly so. Spiders are members of the class Arachnida and are, therefore, not to be confused with insects which constitute the class Insecta or Hexapoda. Arachnida are eight-legged animals with leg-like feeling organs called pedipalpi structurally dissimilar to the thread-like or manyjointed antennae of insects. These latter often possess wings which do not occur in the Arachnida. Grouped in the class Arachnida are the orders Araneida (spiders), Scorpionida (scorpions), Pseudoscorpionida (false scorpions), Phalangida or Opiliones (harvest men), Acarina (ticks and mites). The order Araneida, in which the spiders are included, may be identified by their unsegmented body and in having a united head and thorax (cephalothorax) joined by a narrow waist to the abdomen. To the cephalothorax are attached the eight legs, and at the end of the abdomen are the small projections termed spinneret through which the spider spins the silk to catch its prey, line the shafts of its burrow, or spin egg bags. The poison glands are stated to be in the basal joints of the chelicerae in all mygalomorph spiders, while they may extend into the head in all the dipheumone spiders (which constitute the vast majority of spiders). Poison glands are wanting in certain spiders of the family Ulohoridae. The funnel-web spiders The members of the family Dipluridae do not construct lids to their burrows. This family includes our most harmful spiders, these belonging to the Australian genus Atrax being popularly termed, "funnel-web" spiders. In the United States, the spiders of this family are termed, "funnel-web tarantulas", but in Australia, as in other parts of the world, the term "tarentula" is loosely applied to most large spiders. Eight species belong to the genus Atrax which ranges from Queensland to Tasmania. Some of these species burrow in the soil in true Mygalomorph fashion, while others prefer to place

their silken tubes in stumps, rotting logs, rockeries, by the sides of fence posts, under stones, and in rubbish heaps. In the males of Atrax, a spur or group of spines is present on the underside of the tibiae of the second pair of legs. The female has a relatively larger abdomen than the male. Though all species of Atrax are potentially dangerous to man, only two are recorded as harmful. Extracted from the Journal of the Australian Museum. The sydney funnel-web spider The most toxic of all the spiders of the Sydney district is somewhat local Atrax robustus, for although the Redback Spider is common everywhere, it does not come so closely into the affairs of man in the city and suburbs as it does in the country. The Sydney Funnel-web is large, the male measuring about an inch in length and the female about one and one-third inches. The cephalothorax is black, smooth and shining, the abdomen, above dull brown while the body is reddish-brown beneath. The legs of the male are relatively longer than those of the female and it seems to be more active. It is greater wanderer than the female, judging from the numbers brought into the Museum. Specimens of both sexes kept in captivity proved very aggressive, being quick to rear back and ready to strike when disturbed, otherwise they would remain with their legs hunched up and, to all appearances, comatose. It is well not be deceived by this passive attitude. Though Atrax robustus is a ground-dwelling spider of the Sydney sandstone district and in gardens about the city, nevertheless it is said to enter houses through the ventilators, which may involve a high vertical ascent. The spider may also enter through windows or doors. Inside the house they may sometime be taken in laundry tubs or baths, or hide in slippers, shoes or boots, and three cases of bites are known (two ending fatally) as a result of these invasions. The spider seems to be chiefly nocturnal in his habits and specimens kept alive at the Museum seemed to shun strong sunlight. People have, however, been bitten while working in their gardens in the daytime, their hands having come too close to the spider which promptly showed its resentment by attacking them. Those thus bitten have remarked that it required quite a strong blow to dislodge the spider. Though much press publicity has been given to this spider, some of it rather ludicrous, many records of bites never appear in the newspapers. From some of these bites no symptoms develop, due perhaps to the fact the spider failed to introduce the venom into the wound made by the fangs, or the skin in the area bitten was too thick to permit the fangs to enter. The nature of the venom and habits of the spider still await investigation. Poison and treatment The poison of spiders is secreted by certain glands, probably corresponding to the salivary glands in other animals. It has been pointed out in an article on ticks that the products of these glands in the Dog Tick of the Sydney district may cause respiratory paralysis in man and the domestic animals. The secretions of the poison glands of snakes are likewise an aid to digestion in the animal, and to appreciate the nature of spider venom and arrive at a better understanding of its toxic effects, we may learn something of the venoms of snakes. In the past a great deal of research work has been done in Australia upon these reptiles by Dr. C.H. Kellaway, who has written:

"Snake venoms are beautifully adapted to their functions in the reptilian economy. They serve rapidly to immobilise living and active prey which is to be swallowed whole. To assist in the digestion of this unmasticated food, the venom must be distributed through the body of the victim while it is yet alive. These ends can only be achieved by the injection of the venom, and the venomous snakes are provided with a biting mechanism, which in its most perfect form anticipated the discovery of the hypodermic syringe." He then describes the nature of snake venoms and then goes on to say, "Neurotoxin is the most potent constituent of colubrine venoms, it possesses a special affinity for the cells of the respiratory centre and the blub, though it also involves nervous tissues elsewhere in the cord and brain." Dealing with the effects of neurotoxin on sheep he points out, "Respiratory failure is the common mode of death with all colubrine venoms and sheep die regularly from this cause." In the spiders of the world-wide genus Latrodactus all of which have a bad reputation as a cause of arachnidism (spider bite), the chief constituent of the venom is a neurotoxin but a haemolysin has also be described. Castellant and Chalmers also state that it contains a substance which increases the coagulability of the blood. It is doubtful whether this is so, and the undoubted increased coagulability can be attributed to the extreme dehydration which occurs. Certain difficulties appear to present themselves in overcoming the action of neurotoxin and some doubt exists as to the first aid treatment for neurotoxin poisoning. This is of primary importance in certain Australian snakes and in those spiders harmful to man. A proving of hirudo officinalis Hirudo medicinalis Introduction The International Homoeopathic Research League decided to take up the drug Hirudo officinalis or Sanguisuga officinalis for proving and accordingly we, of the Indian Unit, were requested to collaborate with other units in carrying out the proving of this drug. We agreed most willingly and we were able to conduct the proving in Bombay with 12 provers. The record of the proving is published hereunder. Hirudo officinalis or Sanguisuga officinalis is the common blood leech which is well-known as a blood sucker. From time immemorial it has been used for the purpose of blood-letting. The Ayurvedic texts mention this method of blood-letting practised as far back as 2000 B.C. The peculiarity of this creature is that when it bites and sucks the blood, the blood combines with the saliva of this creature and does not coagulate. To remove the leech itself is a very difficult job; hence the expression, "he stuck on like a leech". Even after the leech has been removed, the point at which the skin was punctured continues to bleed for a very long time probably owing to the effect of the saliva in retarding the coagulation of the blood. In Homoeopathy, the tincture of the living animal has been used. Burnett was the first to use the Sanguisuga officinalis as a homoeopathic medicine and had made a brilliant cure with the potensified drug. However, in Clarke's Dictionary we do not find any detailed record of the proving and we have to infer that the drug had not been proved but used only on an empirical or clinical basis. Considering the fact that the bleeding point continues to bleed, the drug has been used mostly for haemorrhages, especially bleeding per rectum.

The following record of providing was sent to the President of the International Homoeopathic Research League for incorporating it along with the records of the provings from other countries. The proving was conducted as usual by the double blind method in which neither the prover nor the Director of the provings knew which prover was taking the drug and who was on Sal-l. Five provers took the drug in 30th potency, four in 200 potency and three were put on Sal-l. The provers continued taking the drug daily once for a month. The provers were drawn from the students of the Bombay Homoeopathic Medical College and comprised of seven young men and five women, all in a reasonably good state of health. Out of these, 5 men and 5 women received the drug and the rest Sac-l. In the record of the symptoms before each group of symptoms the number of the prover in whom they were evoked is given, e.g. Pr. 1 referring to Prover No. 1. The potency which provoked the symptoms is also mentioned in parenthesis at the end of the group of symptoms, the potency mentioned in parenthesis referring to or being related to all the symptoms that precede the parenthesis. Blood letting was such a common and universally adopted form of treatment even in the West especially before Hahnemann that almost every physician carried with him a lancet and a leech. To such an extent did the physician become identified with these that he himself came to be known as the leech. And one of the oldest British medical journals still being published is called the Lancet. Symptoms in schematic form Mind (Pr. 11) No interest in any work, did not even feel like eating. Wanted to remain alone and quiet. Very irritable without cause or with little cause (30). Head (Pr. 9) Slight dull headache, whole head, agg. afternoon, amel. after dinner, agg. heat of sun. The headache continued for a week. Thereafter, never returned (200). (Pr. 3) Dull headache, whole day agg. by warmth, amel. pressure amel. open air, agg. direct draught of air, agg. walking. Severe headache, sometimes, same modalities. Severe pressing type of pain, amel. pressing, amel. at night, amel. lying down, agg. by fan. Pain felt in vertex agg. cold water application. Headache, vertex agg. morning. Frontal headache agg. afternoon. Headache sometimes at night. Severe frontal headache and heaviness about 2 p.m. while standing.

Severe pain in head-frontal and vertex amel. in the afternoon, agg. night (200). Slight dull headache, started in the morning at about 7.30 a.m. remained for some time (11/2 to 2 hours). Burning sensation amel. cold water application, amel. open air; agg. closing eyes, agg. looking at bright light, agg. movement of eye balls (30). Ear (Pr. 3) Pain the right ear, agg. afternoon, agg. cold air agg. draft of air. Feeling or sensation as if air is passing in the ear (200). Nose (Pr. 3) Severe cold, running of nose (200). Face (Pr. 3) Burning sensation all over face, whole day (200). Mouth, tongue and teeth (Pr. 3) Ulcers on the right cheek, pains while eating. Ulcers on the palate. Slight burning, agg. eating food, agg. drinking cold water. Soreness in the throat and rawness in the throat, agg. talking, amel. cold water, agg. night. Gums bleeding easily while brushing the teeth (200). (Pr. 9) Toothache (due to eruption of wisdom tooth?), amel. warm water application (200). (Pr. 11) Dry, white coated tongue, no thirst. No taste or bland taste for food. No offensive breath (30). Stomach and abdomen (Pr. 11) Morning thirst, has to drink water, very little at time. Pain in the abdomen, started in the evening (about 7.30 to 7.45 p.m. ); dull pain and discomfort in the abdomen near umbilical region. Gurgling noise especially felt in the lower abdomen; with it, there was sudden urge for stool, painless diarrhoea, semi-solid, yellow stool, not offensive. Passed stool only once. The discomfort, gurgling in abdomen stopped after stool. (Due to heavy dinner that evening?). Loss of appetite. Loss of hunger. Appetite + but not hungry. No appetite, aversion for food during pain in abdomen (30).

Pain in the abdomen before stool and after stool. Pain felt little during stool. The pain remained for an hour or so, after stool. The pain used to come intermittently, but suddenly in umbilical area and extend towards left side of the abdomen, then go round he umbilicus in a clock-wise direction, and used to disappear gradually. The pain was agg. by pressure, agg. lying on back, amel. lying on side, especially right, agg. walking, amel. bending double, amel. stooping, agg. stretching backward. (Pr. 9) Slight pain over left side of the abdomen remained for whole day; agg. on movement, amel. sitting (200). Pain in abdomen slightly relieved after stool (200). (Pr. 3) Severe pain in the abdomen, umbilical area, at 2 p.m. The pain was noticed for 11/2 hours. agg. walking, amel. bending, amel. lying down, amel. pressure (200). Rectum and stool (Pr. 11) Constipation noticed for 2-3 days. Then diarrhoea 3-4 times in a day for 2-3 days. Stool yellow or brown in colour. Liquid (not watery) semi-solid stool with pain in abdomen before and after stool (30). (Pr. 9) Constipated, ineffectual urge for stool (200). Urogenital system (Pr. 11) Slight burning sensation in the urethra while passing the first urine in the morning (30). (Pr. 3) Menses late by 10 days (200). Larynx and trachea (Pr. 11) Hoarseness of voice day and night. amel. cold water, drinking (200). Respiration Nil. Cough and expectoration (Pr. 3) Dry cough without expectoration (200). Chest and back v(Pr. 3) Pain in the chest, suddenly appeared and suddenly disappeared. Pressive pain over sternum agg. by pressure. Chest pain alternates with pain in abdomen. Pain in the chest remains only for a short time. Appearance of the pain between 10 a.m. and 11.30 a.m. (200).

(Pr. 11) Severe breaking pain felt in the cervical vertebrae and shoulders. The pain was not relieved or aggravated in my position or by pressure. Very restless due to pain (30). Extremities (Pr. 3) Burning of palms and soles amel. cold water application. Burning of left palm. Pain in the legs especially left, in the evening by walking. Pain in the left (lt.) agg. in the evening till 9 a.m. , amel. walking. Pains stopped suddenly after passing stool at night, agg. sleeping on lt. side (200). (Pr. 9) Pain in the legs especially in calf muscles (jut like every month) agg. night (with delayed menses) (200). (Pr. 11) No symptoms except aching in calf muscles (30). Sleep (Pr. 11) Sleeplessness. No sleep till 3 a.m. to 4 a.m. Disturbed sleep at night (30). (Pr. 3) Feeling sleepy. Went to bed early due to sleepiness; did not feel fresh after a good sleep. Felt heaviness in the head. Drowsy whole day (200). (Pr. 9) Sudden awakening from sleep in the night. Does not feel fresh after sleep. Heaviness of head, feels dull (200). Chill and fever (Pr. 9) Chill at 9.30 p.m. and is followed by slight fever amel. after food (200). (Pr. 11) Felt chilly in the morning, creeping chill, creeping from below upwards. Thereafter, felt feverish, but there was no actual rise of temperature (30). (Pr. 3) Slightly feverish with chill at night about 9 p.m. Temp. raised whole day. Temp. 103 ºF whole day, chilly whole day (200). Generalities (Pr. 11) Malaise, general weakness, bodyache, feverishness (30). (Pr. 3) Feeling very tired and exhausted (200). I have used Hirudin in 3 cases of recurrent Epistaxis. One case gave clear indications for Lachesis (with symptoms like Epistaxis worse in sleep, worse in summer, etc.) but gave only a limited response to Lachesis but was cured by Hirudo. Two of the cases showed a platelet deficiency - in one an actual deficiency in the number and in another a deficiency in quality. All the 3 cases improved and became well on Hirudo 12x given daily for a long period.

Acknowledgement I have to express my deep gratitude to the enthusiastic students who took part in the proving at great personal inconvenience and thus contributed to the advancement of Homoeopathy. I have also to think my friends Dr. P.S. Kumta and Dr. M.O. Shaikh for helping me to tabulate the results. I am also grateful to Messrs. A. Nelson's for supplying me the necessary material for the proving. Summary of proving symptoms of hirudo officinalis No interest in work. Wants to remain alone and quiet. Headache worse by heat of sun, better after dinner, better by pressure; pain frontal and in vertex. Burning sensation in eyes. Burning sensation of face. Burning in mouth worse drinking cold water. Pain abdomen before and after stool, better by bending double. Hoarseness of voice better by drinking cold water. Chest pain alternates with pain in abdomen. Pain in the legs better after stool. Aching in calf muscles. Sleeplessness. A proving of mimosa pudica * Mimosa pudica Introduction A proving of Mimosa pudica was carried out in the Bombay Homoeopathic Medical College in January and February 1969. This remedy was selected for proving by the International Homoeopathic Research Council, and at a meeting of members of the I.H. R.C. held in October 1965 before the International Homoeopathic Congress at New Delhi, it was decided to prove it internationally. M/s. Willmar Schwabe of Karlsruhe, W. Germany were kind enough to supply the remedy in potencies. The potencies were not marked on the bottles but only code numbers were noted. Though I, as the Director of the proving, was aware of the remedy by name, I had no information about its nature or its symptoms. Six provers took part in the proving and they were all young healthy male students selected from the College. Out of these only three provers brought out symptoms. All the provers were

given Sac-l for the first 7 days and they were then put on the drug from the 8th day onwards. The provers were not aware what they were taking. They continued to take the drug, daily one dose for 3 weeks and noted the symptoms for a further period after stopping the drug, as long as symptoms were noticeable. No pathological investigations were done before or after the proving. The potencies used were 3x and 6x. The symptoms produced by 3x are marked with asterisk. Symptoms in schematic form Mind Gets irritated with the thought of taking medicine, does not want to take medicine. Head Headache agg. closing eyes, agg. by eye-strain; amel. tight bandage, agg. jarring, agg. bright light (Had done strenuous reading at night). Supraorbital headache, throbbing agg. eye strain, agg. motion, amel. closing eyes. Headache over lt. eyebrow. Eyes Slight blurring of vision. Eyelids agglutinated in morning. When getting up, yellowish pus at canthi. Burning in eyes agg. draft of air. Photophobia with headache agg. in sunlight. Ears Sudden sharp stitching pain started in rt. ear at 11 p.m. continued throughout the night agg. lying on rt. side, agg. in draft of air, agg. hard pressure, amel. lightly closing the ear. Difficulty in hearing with buzzing in ear with too much noise. Nose Sneezing whole day with watery discharge. Irritation of mucous membrane. Mouth Profuse salivation all day. Saliva dribbles out from rt. side in sleep. Was not able to feel any taste in mouth. Throat Soreness at throat on waking not relieved by coughing, agg. talking, amel. drinking warm tea.

Tickling sensation in throat and larynx (H/o having taken ice cold drink). Stomach Pain in the epigastrium agg. coughing. Rectum Diarrhoea, passed 10 stools offensive with griping pain in the abdomen before stool, amel. after stool, rubbing the abdomen. Genitalia Male - Increased sexual desire. Respiratory Dull aching pain lower border of pectoralis major muscle agg. abduction of arm, agg. cold open air, amel. warm bath. Dry cough. Extremities Slight pain in both shoulder joints agg. cold open air, agg. warm bath. Back Backache. General Injuries take long time to heal. Wants fanning and cold open air; cannot tolerate heat. Likes open air. Feels body is very light. Summary of proving symptoms of mimosa pudica Does not want to take medicine. Headache worse by closing eyes, better by tight bandage. Sharp stitching pain in the right ear. Profuse salivation all day. Pain epigastrium worse coughing. Injuries take long time to heal. Feels body is very light. Appendix "Mimosa Pudica Linn. N.O. Leguminosae. *

Sansk. - Lajjalu; Ajalikalika; Namaskar; Varaha-kranta. Eng. - Sensitive plant, humble plant. Fr. - Sensitive commune. Ger. - Shamhafte Sinnpflanze; Fuhlpflanze. Hind. - Lajjalu. Tamil - Thottashurungi. Habitat : This sensitive shrub, a native of Brazil, has long been naturalised and is plentiful in the hotter regions of India; it grows wild as a weed in certain parts of the West Coast of India, in Mysore and Coorg. Parts used : Root and leaves. Constituents : Root contains 10 percent tannin. Action : Resolvent, alternative and carminative, the root is aphrodisiac. Juice is antiseptic, alternative and a blood-purifier. Uses : Root in the form of a decoction (1 in 10) is given in doses of 2 to 6 drachms for gravel and similar urinary complaints and for diseases arising from corrupt blood and bile. Infusion of leaves is also used in 1/2 to 1 ounce doses. Leaves and root in powdered form are given in milk in cases of piles and fistula... Juice is applied externally in fistulous sores, piles and scorpion sting. Leaves rubber into a paste are applied to hydrocele and glandular swellings, and their juice, with an equal quantity of horse's urine, is made into an anjan which is used to remedy films of the cornea by setting up and artificial inflammation. Juice of the leaves is used to impregnate cotton wool for dressing in any form of sinus. Leaves are employed as a bath in the pains of the hip and kidneys." If the leaves are touched, they tend to close or collapse. A proving of pituitary Pituitaria posterior Introduction A proving of the Pituitary was conducted in the Bombay Homoeopathic Medical College on two occasions, once in 1965 and again in 1967 by two different sets of provers. The Pituitary was selected for the following reasons: It is a well-known fact that the endocrine glands have a powerful influence almost over all bodily functions. And among all the endocrine glands the Pituitary gland has been variously designated as the "Conductor of the endocrine orchestra", the "Prime Minister of endocrine cabinet", etc. This is because the Pituitary gland has an overall controlling influence over all the other endocrine glands. With this background of the importance of this gland in the regulation of bodily functions and its supremacy, we were rather surprised to find very little mention of its provings or symptomalogy in the Homoeopathic Materia Medica. Allen's Materia Medica of Nosodes and Clarke's Dictionary make no mention. Even Allen's Encyclopedia does not mention it. Only Dr.

S.K. Ghosh has given numerous clinical indications and verifications in his book "Clinical Experiences with Rare Nosodes". A perusal of Boericke's Materia Medica gives an impression that the symptoms and indications given are not from the provings but rather taken from the physiological and toxic effect. This is why we were prompted to prove the remedy in our college. We used the 3x and the 30th potencies of the whole gland of B and T make, obtained from a reliable pharmacy. Nine provers participated in all, out of whom two were given Sac-l as controls. The rest, all of them, received potencies of the Pituitary - four of them received 30th potency and three 3x, which was taken daily once in the morning for one month. At the end of the month the drug was stopped but the provers continued to observe their symptoms for a month more. Once a week their notebooks were checked by the director. No change of any sort in the diet or activities was made during the proving. No pathological investigations before, during or after the provings were attempted. The symptoms elicited in the provings are given hereunder. When more than one prover brought out the same symptoms the number of provers is given at the end of the symptom. The asterisk (*) is put on the symptoms which are elicited with the 3x potency. The remaining symptoms were provoked by the 30th potency. Symptoms in schematic form Mind Changeable mood; No interest in anything. Read a line several times as if reading continuously - that is, failed to read ahead. Read one line, then re-read it thinking it to be another line. Though tried to read, failed to read, at last had to close the book. Vertigo Vertigo present when not in motion but becomes doubly severe on motion, especially of head, at the same time sensation of nausea with empty stomach, which he thinks will relieve him. Slight nausea like feeling with severe vertigo from 8 a.m. till 2 p.m. along with head symptoms noted below. Feeling of faintness in the afternoon agg. near fire, agg. standing, agg. exertion, amel. moving about, agg. lying down, amel. empty stomach agg. sun, stooping or bending forward, agg. due to loss of sleep, agg. early morning. Head Sudden stitching pain in both temporal regions at 3 a.m. and tearing pain in neck and deltoid of right had till 5 p.m. Dull headache in occiput from 9 a.m. to 6 p.m. Headache from temporal region to the neck upto scapula at 9 a.m. accompanied with slight vertigo and sensation of vomiting; all disappeared at 1 p.m. but headache continued upto 9 a.m. At 7 a.m. early morning on getting up, heavy dull head with severe vertigo (2), edges felt heavy and headache. Heavy feeling 2 p.m. to 5 p.m.

Headache amel. cold. Headache amel. bandaging, amel. pressure, amel. cold application. Headache in the evening and night agg. 4-5 p.m. * Headache frontal - 11 a.m. to 12 noon. Slight heaviness of head agg. sun, agg. tea, agg. mental exertion, amel. rest, amel. pressure, amel. closing eyes, sleep (?), agg. bending forward.* Headache, throbbing, bursting agg. noise, agg. sun, agg. strong artificial light, amel. closing eyes, amel. rest, amel. exertion. Headache disappears suddenly after one hour.* Headache starts as dull and becomes throbbing.* Severe headache on coughing.* Slight dull headache.* Eyes Burning pain amel. by applying cold water. Pain in left eye. Redness, painful agg. reading. When trying to close, burning in day time. Burning of eyes - at about 2 p.m. Tearing pain in eye ball (upper half of both) that through temporal region extends upto base of the neck, till 5 p.m. Heavy and swollen with headache and vertigo. Heaviness of eyelids as if aroused from deep sleep with redness and burning of eyes in the afternoon.* Nose Running of nose, left side. In the evening at 6 p.m. fluent coryza with sneezing. Studdy nose at night. Sensation of sneezing; thick discharge from nose, more from rt. side.* Right nostril blocked only upto 10 a.m. Severe watery discharge only from right side with headache.* Mouth Swelling below the tongue (left). Redness on left side; soreness in mouth on left side.

Dryness of mouth with thirst for large quantity of water at long intervals. Inflammation of gums around molar teeth.* Inflammation of tongue.* Food felt tasteless.* Throat Choking sensation with cough and expectoration. Tickling sensation in the throat. Tickling early morning as if choking agg. talking. Sticky mucus with cough. Obliged to hawk it out. Change in voice: Warm water amel. the pitch of the voice. Stomach Violent hunger at 12 noon followed by sinking with black circles in front of eyes; this stopped at 1 p.m. on eating. Thirst for large quantity of cold water after 3-4 hours, or at long intervals. Unquenchable thirst. Thirst for cold water at shorter intervals. Nausea 11 a.m. Pain in epigastrium agg. after lunch.* Thirstless.* Hungry feeling at 12 noon and 6 p.m. and excessive desire to eat mutton, onions and chicken.* No appetite - feels stomach is full.* Abdomen Heaviness and pain abdomen.* Heaviness in abdomen.* Slight heaviness in abdomen. Sudden pain with gurgling in abdomen, has to run for stool.* Rectum 3 stools in morning 2 black and hard stools. Constipated.*

Little semi-solid stool with great straining.* Soft stool but with a feeling as if something is left behind.* Stool became very scanty with feeling as if some stool is still remaining behind - not satisfied. Stools hard, slightly slimy. Stools very sticky, looks like jelly - not satisfied. Urine Excessive urination, 7 - 8 times. Respiration, cough and chest Cough with chilliness. Dry hard cough. Hoarseness of voice. Dry cough. Cough with slight expectoration. Slight difficulty in respiration with pain in chest. Choking sensation in throat with cough and expectoration. Pain in second right and third costochondral junction between 2.30 p.m. and 3 p.m. , followed by pain in left costochondral junction at 4 in evening; sharp pricking pain up to 5 p.m. * Chest pain in the morning at 8 a.m. , and at 12 - 1 p.m. , more in 3rd and 4th. left intercostal space with heaviness.* Palpitation at night before sleep agg. lying on left side.* Dry cough in the morning till evening, sometimes with little expectoration - white.* Sudden shooting pain in chest.* Cough with white, sticky expectoration.* Chest heavy in afternoon. Back Stitching pain in the left scapular region agg. open air. Pain in the back. Backache 11 a.m. to 3 p.m. Sudden severe pain in the left lumbar region, unbearable for 7 hours, continuous, started at 4 p.m. and lasted upto midnight.* Extremities

Pain in lower extremities. Both extremities paining. Slight pain in lower extremities with fever. Weakness in both extremities in afternoon between 2 and 3 p.m. * Neuralgic pain in left thigh in evening agg. walking * Cramps in calf muscles agg. evening, agg. walking.* Fever Fever 99 oF. Feverish more towards evening. Fever at night (3) Fever from 7 p.m. with headache. Fever at night with chill. Slight fever between 11 to 12 p.m. (night).* Fever upto 100 oF. from 6 p.m. to 11 p.m. * Sleep No sleep from 3 a.m. till morning due to headache. But great sleepiness at 3.30 p.m. Desire for sleep at 12 noon. Sleepy. Sleep disturbed.* Sleep restless at night, no sleep after 2 a.m. * Skin Red spot on the dorsum of hand, disappeared on 4th day of its appearance. Skin red with fever. Oedematous eruption on right side of neck. Oedematous eruption with itching. At 10-15 a.m. there was itching on skin of dorsal side of wrist of right hand, it was there upto 11 a.m. , very violent. Itching with skin eruption on elbow joint. Slight itching. Slight itching on palms. Generalities Aversion to motion. agg. in the evening and towards night.

agg. cold - chilliness. Weakness agg. evening.* Wants fan to sleep. Feels tired. Physically very weak.* Does not want to do anything; does not want to move parts of body also.* Summary of proving symptoms of pituitary Inability to concentrate. Vertigo worse from movement, especially of head, with nausea. Headache better by cold application. Headache on coughing. Redness of eyes; pain and burning in eyes. Food felt tasteless. Choking sensation in throat with cough. Thirst for large quantity at long intervals. Sinking in stomach at 12 noon. Nausea at 11 a.m. Cough with chilliness. Cough worse in evening. Palpitation while lying on left side. Weakness and pain in both extremities. Cramps in calf. Generalities Aversion to movement. Worse in the evening and towards night. Worse by cold. Weakness worse in evening. Does not want to do anything. Insulin - a clinical proving By dr. (miss) k.h. matani, l.c. e.h. , b. sc. (physiology), bombay Insulinum

Introduction A study of potentized Insulin in its 30th potency was under progress since early 1976 at the Central Research Institute for Homoeopathy at Calcutta, under the guidance of Dr. K.P. Muzumdar, the Director of the Institute. He was trying to study the effect of Insulin 30 on blood-sugar levels in hyperglycaemic patients. Since very little or insignificant information is available in respect of Insulin in our literature, it was decided to prove the same simultaneously when its clinical trial was being conducted. Materials and method Diabetic patients were the subject of study. The main purpose of the study was to note the effect of insulin in potency on blood sugar levels of hyperglycaemic subjects. Irrespective of their individual signs and symptoms, diabetic patients with high blood sugar levels were given Insulin in the 30th potency, 3 or 4 times a day, for 3 weeks at a time and the blood sugar level was recorded after 3 weeks. If the blood sugar level had not become normal by then, they were given the same medicine for a further period of 3 weeks and if necessary again for a further period of 3 weeks. Though the main purpose of the study was as stated above and the experiments were designed by Dr. Muzumdar, we felt that this opportunity could be also taken to study the symptoms produced or erased in each individual by the administration of this remedy. Since the drug was being given 3 to 4 times daily continuously for a minimum period of 3 weeks and in some cases for a further period of 3 to 6 weeks, we felt that some kind of a clinical proving may result. So we took the cases of these patients in great detail and carefully noted the signs and symptoms. They were then seen once a week and the change in the symptoms noted. Our observations are presented herewith. During the treatment no change in the diet was made. If the patients were already taking any anti-diabetic medicines (allopathic), they were allowed to continue the same. We felt that if the Insulin was found to have a definite effect in reducing high blood sugar levels, this would be a valuable piece of knowledge, no doubt. But we also felt that if we could develop some homoeopathic indications for the use of this drug, this would give us additional useful information. The number indicates that this symptom was found in three different patients. All other symptoms were noted in any one patient. Schematic presentation of symptoms relieved and symptoms caused Symptoms Relieved Symptoms Caused Vertigo agg. when hungry. agg. when angry, agg. looking up. agg. moving the head quickly. agg. fasting 3. * agg. morning. agg. in the morning.

Head Hair fall. Headache agg. when constipated with flatulence. Vision Dimness of vision in the evening. Throat Pain throat agg. swallowing liquids. Dryness of throat. Abdomen Heaviness of abdomen at night. Respiration Dyspnoea on walking. Back Pain between scapulae in the morning, after sleep. Pain lumbar back agg. sitting, agg. squatting. Extremities Formication hands agg. when constipated. Pain right shoulder. Extremities (Contd.) Pain right knee. Pulling pain behind knees agg. squatting. Stiffness of knees agg. rising from sitting. Pain calf muscles extending upto gluteal region. Pain calf muscles agg. standing, agg. walking, agg. ascending, agg. lying on painful side. Pain right calf muscle, then left calf. Heaviness of legs agg. when the legs hang down. Pain left great toe nail as if there is a boil. Burning in soles. Heaviness in soles. Sleep Drowsiness as if he has taken alcohol, agg. morning. Chill Chill at 11 a.m. Skin Itching eruption on body. Generalities Pain all over body agg. when constipated, agg. cold weather. Weakness agg. after stool. Feels as if intoxicated. Sudden lightness of body. Pain goes to side lain on. Summary of proving symptoms of insulin 30

Vertigo when hungry agg. anger, agg. looking up, agg. moving. Hair fall. Headache when constipated. Dimness of vision in the evening. Pain throat, worse swallowing liquids. Pain between scapulae in the morning. Pain lumbar back, worse sitting. Pain right shoulder and knee. Pulling pain behind knees, worse rising from sitting. Pain calf muscles extending upto gluteal region. Pain calf muscles, right, then left. Heaviness of legs when the legs hang down. Pain, left great toe. Burning in soles. Drowsiness. Chill at 11 a.m. Weakness after stool. Acknowledgement I must thank my senior Dr. P. Sankaran for guiding me in this work. Case taking and repertorization Some hints on case taking The first and a very important step in homoeopathic practice is the taking of the case and much of the success of the practitioner depends upon the accuracy and thoroughness with which the case is taken. It is said that a well-taken case is half-cured and this statement is indeed very true. Although case taking is apparently a simple and easy procedure, in practice, however, it requires all the alertness, intelligence, ingenuity, care and circumspection on the part of the physician and it would not be wrong to say that it may take years of experience to take a case well. Dr. Burnett states that in his opinion, only one in a hundred physicians takes a case well and lest we may feel he is cynical, he adds that even this must be a gross over-estimation! Rudolf Rabe, writing in an editorial, says, "There is no procedure in homoeopathic practice more important than a thorough knowledge of the right way to take a case. The ability to do this insures against humiliating mistakes and failures, prevents misconceptions of the sphere of homoeopathic therapeutics and paves the way to relief or cure where either is possible."

I must mention here my experience as a teacher and as a consultant. Very often, I have noted that the students and other practitioners who consult me bring to me their cases and I find that the vital indications for the remedy are missing from their case records, though they may contain a mass of details, all because they failed to probe and enquire a little further to discover the finer modifying factors or circumstances of the symptoms. Had they put the one or two more vital questions necessary, they might have found the answer to the case. Writing in an editorial, Alfred Pulford, that master prescriber, records as follows, "Case taking, as commonly understood, is a thorough examining of the patient from every possible angle that will give a definite clue in the search for the indicated remedy. It is the greatest problem with which the physician must contend and requires every atom of his ingenuity, skill and patience, for the case properly taken or canvassed is fully one half-cured. The physician must be a good listener, a very acute observer and a past master in the art of crossquestioning. He must know how to ask questions, when necessary without any hint of suggestion of the correct answer and watch the patient's every movement." H.C. Allen has remarked that a case well-taken insures accuracy and efficiency in the selection of the similimum. McKillop explains the other objects of case taking as follows: "The ultimate aim of homoeopathic case taking is of course to enable one to find the similimum, the remedy homoeopathic to the case, which will heal the sick person. But the indicated homoeopathic remedy is not the whole treatment. It is also necessary to ensure that the patient's environment is rendered conducive to recovery, and that such regimes of nursing, general hygiene and ancillary treatment are instituted as will assist towards this aim. Treatment, however, is not alone the sole aim of case taking, homoeopathic or allopathic. Treatment is but a part of the three-fold entity of Diagnosis, Prognosis and Treatment, three functions of case taking which are so inextricably involved with each other, that it is impossible to separate them. From Diagnosis we can assess Prognosis or probable progress of the case if untreated, possibilities and scope of recovery under treatment, whether a surgical catastrophe is imminent or not, whether pathological changes present are reversible or not, and hence we can decide what form of treatment to adopt, surgical or medical, or even both together, what sort of nursing regime to initiate and what sort of personal regime to the patient." Object The main object of the homoeopathic case taking is of course to record faithfully the picture of suffering of each individual patient in such a way that the indications for the similimum emerge out of it. Almost every master from Hahnemann downwards has given us lucid directions for taking the case and it is indeed difficult to add anything new on the subject. And yet every generation and in fact every physician approaches each problem in its or his own way and has some modifications or improvements to suggest. The following hints are, therefore, offered in this spirit, and are merely intended more to re-emphasize and add to certain well-known aspects, especially for beginners. In taking the case, we seek to record details of the sufferings of the patient, including the chief complaint, present symptomatology, previous history, personal history and family history, along with the abnormal findings on physical examination, and a summary of the previous treatments taken and their results. While taking the case we have to remember that we may come across the most significant symptom or symptoms at any stage of the case taking - while listening to the patient (or the

relative), interrogating him or examining him - and so we have to be very alert and keenly attentive always. It is very difficult to say beforehand which particular answer may provide the clue to the similimum. It may even be some chance remark of the patient. I remember a patient who, while leaving after the consultation said, "Oh! I must hurry up now. It is 11 a.m. and I am famished." This remark helped me to find his remedy. Dr. Stanton calls it aliveness and says, "Too often we examine a case ploddingly, when we should come to it alive in every fiber, keenly and vigorously on the scent. We must time our mood to the exigencies of the occasion, otherwise symptoms of inestimable value will inevitably escape us." We have also to intelligently evaluate each answer so that we may frame the succeeding questions suitably. Generally speaking, nothing that the patient says or what we notice about the patient is completely useless or insignificant. Precautions The very first precaution to observe before taking the case is to start with a blank paper and a blank mind. The "blank-mindedness" which is easier conceived than achieved, should continue throughout the period of case taking. It is possible that the first few symptoms of the patient may suggest to the mind of the physician a particular remedy but he should not allow himself to be biased and should think of remedies only after the case taking has been completed; otherwise objectivity in taking the case, which is so essential, will be lost. One point must be emphasized here. Disease is only an alteration in the state of health of the individual and this alteration is represented by symptoms. The physician must therefore ensure that all the symptoms recorded are actually part of the deviations from the originals or normal state of the individual and that therefore they form part of the disease-picture. It is useless to record details of the normal state of the individual because we are not going to treat the normal individual. We have also to ensure that the symptoms noted are fairly marked in intensity. These points are to be especially remembered in treating acute states; the physician should consider only the symptoms of that state with the exclusion of the symptoms of the original chronic condition that the patient might have been suffering from. To give an instance, if a chronic patient who is normally thirsty develops an acute syndrome say, gastroenteritis, and is thirstless during this attack, then it is this thirstlessness that would lead us to the remedy for the acute condition. When the acute picture is erased and is replaced by the chronic condition, then only the symptoms of the latter should be taken into account. Method After taking down the name, age, occupation and address of the patient, the physician can say, "Please describe all your troubles from the beginning and give me all the details." Then, as the patient proceeds to describe his illness, tracing its origin, course and progress, the physician continues to note down all the data while listening to the patient. As the case taking progresses, it would be wise on the physician's part to allow the patient to express his disorders without any interruption. His should be an attitude of "Watchful expectancy and masterly inactivity". All that should be asked in the beginning is "What is troubling you?" or some such question and the patient should be allowed to detail in his own words the description of his ailments. If he is too garrulous and his statements are quite irrelevant, then he should be tactfully brought back to the main point. Information provided by the patient voluntarily and spontaneously is of maximum value. To this extent a physician cuts down questioning and gets a picture of the case. Without much questioning, he will get more valuable information. Therefore, merely prompting the patient on and on, he should gather

the maximum information, encouraging the patient to describe his troubles in his own words, till he runs dry, so to say. Care should be taken never to interrupt since as a result of such interruption of his line of thought, what the patient was about to say might remain unsaid. All questions should be asked and doubts clarified only at the end without disturbing the patient's trend. Borland, that delightful teacher, has given some practical hints: "For a successful homoeopathic prescription the physician ought constantly to bear in mind the six following rules: 1. To observe 4. To question 2. To listen 5. To examine 3. To write 6. To coordinate 1. To observe without saying a single word, but with eyes wide open to notice the gait, behaviour, gestures, the smallest changes of expression, etc. 2. To listen to all noises, respiratory, digestive, articular, etc., and, of course listen without interrupting. If a patient talks, let him do so freely, otherwise he will reproach you for not having been able to utter a single word or, at the end of the consultation, he will come out with a long array of symptoms written in his notebook. Put him off until tomorrow if necessary but let him talk. First because to listen is a sign of politeness and, besides, you will let him do the extraversion so preached by the psycho-analysts. To be able to narrate one's ailments and feel that somebody is listening with interest and benevolence, constitutes a great relief. You know it. 3. To write and in the exact terms of the talker in order to be able later on to recollect his own personal expressions. 4. To question, bearing constantly in mind that all questions that can be answered by "yes" or "no" are badly put. Please read with rapt attention 84 to 104 in the Organon concerning taking the case. About this it is certain that if Hahnemann had been alive today knowing his love for detail, for accuracy and his extreme conscientiousness, he would have adapted his methods to the most modern way of investigations and adopted the last word in modern diagnosis, as applied by all good homoeopaths." During the process of the questioning, the physician should pose only such questions which are not leading in nature, viz. those that do not suggest any answers. Questions may suggest only the type of answer required. Leading questions may bring forth misleading answers. The patient sometimes gives the answer which he thinks the physician wants from him. For instance, we should never ask, "Are you thirsty?" but only enquire, "How much water do you take ?" In case the patient does not follow a question and finds it too vague, a more specific and even slightly leading question can be put but a number of alternatives should be placed before him. For example, we may ask, "What kind of pain do you suffer from? Is it burning, pressing, pricking, shooting, stitching, tearing?" We may ask, "What food or drink do you desire?" or, "In which position do you find relief from pain?", etc. Or we may ask, "Do you crave for any particular items of food, such as sweets, sour, salty foods, milk, eggs ?", etc. Or sometimes you can put a question leading in the opposite direction. If you feel that the patient is very nervous, you may ask, "You are not nervous, are you?"

The case taking may sometimes take two or three or even more sittings to be completed. Very often, in the first sitting the patient merely becomes aware as to what sort of symptoms we expect from him and it may be only by the second or third or later interview that he may recall, recollect or observe and offer voluntary information about those symptoms which he had formerly omitted to observe or describe or had ignored. Here, therefore, there is often need for greatest patience. Sometimes, I have spent a full hour of consultation merely looking at the various reports and X-rays and listening to the various treatments the patient had taken, without eliciting even a single symptom of homoeopathic significance. Of course, this refers to chronic cases. Julia Green, the veteran teacher, has given detailed hints about case taking. She says: "First, schematic form: by this I mean indentation writing so that each symptom reported will have a line of its own and all the modifications, aggravations, concomitants of that symptom will be recorded under it on lines further indented, so that in glancing down the page the reader may see coordinate statements under each other with the same indention and be able to read the whole at a glance. "Second: an entry for each date, giving changes in old symptoms and new ones in fullest detail. "Third: a separate column for dates and prescriptions so that one may see easily the remedies given and the intervals between them. These things are too often incorporated into the body of a record so they must be hunted out if wanted. "Fourth: a separate column for diagnosis and laboratory reports so that a summary of these may be seen opposite the symptom lists relating to them and the whole case made more comprehensible to the allopaths and general scientists." In acute cases, the case taking is somewhat easier. The changes due to the disease being more recent and more marked, both the patient and those around him are able to observe and describe these symptoms clearly to us. This makes our work lighter. In addition, the observant physician will be able to note various small but significant details such as the decubitus, the expression, perhaps a flapping of the alae nasi or twitching somewhere, etc., which will all add up to a totality. Boyson says about observation, "Before we begin to question him, our patient tells us much. The gait, the face, the eyes, the skin, the nails, the hair are all indications towards the individualisation of the patient." I may mention that in a case of pneumonia I was guided to the remedy by a wrinkling of the forehead of the patient. Van Tine has remarked, "There is no symptom in the sick room without its value, especially in acute and serious cases." Writing on the value of observation, McKillop says, "Observed symptoms are generally more reliable than those elicited by interrogation alone. I, for one, regard every patient as potentially incapable of telling the truth regarding his innermost nature and personal character. Even when they believe themselves to be truthful the judgement of most people regarding their own characters is apt to be widely off the mark. A symptom which does so correspond can be accepted with some confidence. I find that this tends to shorten one's case history. Think of the great number of valuable prescribing symptoms that can be observed almost without uttering a word. Why, one could often make out a reasonably complete case history, even including some parts of the physical examination, without uttering a word or laying a hand on the patient. On the physical side there are such signs, for example, as complexion, physical conformation and deportment, speech, gait, proptosis, glandular enlargements, breathlessness, etc. On the mental side are such symptoms as loquacity,

diffidence, easy embarrassment, timidity, tearfulness, anxiety, fearfulness, suspiciousness, impatience, haughtiness, egotism, excitability, depression, and many more. "Again, observation can be used as a test of the reliability of a patient's responses to interrogation. If a reply is enthusiastic it can be trusted. This test applies especially to physical desires and aversions and to desires and aversions to certain articles of food." Particularly in children, the observation of the physician plays a vital role. As infants and children are not so articulate, we have to compensate by keener observation. In recording the case, it is advisable to note down all the relevant informations as the patient describes his sufferings, preferably in his own words. The patient may be requested to detail the symptoms a little slowly in order that we may keep pace with him. After noting down the main features quickly as he narrates them, we may then enquire into each symptom leisurely, when the patient has exhausted whatever he has to say. The main features can be noted down line by line with intervening spaces wherein further details of each symptom can be filled in later on by careful enquiry. While taking the case the physician should have in his mind an order or plan of questioning so that nothing is left out. He may deviate now and then to go after some points but in the main he should stick to his plan and complete all the questions to get all the data. Stevens says, "The physician who would become skilful in case taking will arrange for himself a scheme or order to follow in questioning, so that no part or function of the body may be overlooked. The mental symptoms should be inquired into carefully as these often are of great value. Through all this, the physician should use his own powers of observation as accurately as possible and should note down the results." But this need not be done in a stereotyped way. Stearns thinks that the preliminary work which goes into the taking of a case is the most important help in the subsequent curing. But it is not to be done in a routine way. Different individuals approach a case in different ways; there may be nearly as many ways as there are prescribers but nine-tenths of them may arrive at the same result. In taking the symptoms, we attempt to record not merely a lifeless list of symptoms but to draw a picture of the suffering of a living individual and to try and understand the whole circumstance that has given rise to these symptoms. In other words we try to get at the background of the patient's symptoms and in so doing we go through his fears and doubts, disappointments and emotional feelings and also his social, economic, domestic and other circumstances so that we get a better understanding of the patient's difficulties as a whole. Further, we have also to try to define and delineate each symptom. When a patient says that he has an aggravation at a particular time we should try and visualise what the patient must be doing at that particular hour and how far the aggravation has to do with the circumstances then. For instance, if a patient says he is worse at night, we want to know whether he is actually worse at night or worse lying down or merely worse by heat of bed, etc. If he is worse in the afternoon, we want to know whether he is worse in the afternoon as such or worse while sitting in the office or worse after lunch, etc. Thus, in dealing with his symptoms we try to elicit as many circumstances as possible which modify that symptom. This renders each symptom complete with its location, sensations, modalities, causation, duration, extension , etc., and the case becomes clearer and easier. It is possible to carry out the interrogation of the patient in the form of a conversation or discussion rather than as a question-and-answer business. We must remember that by our

questioning we merely seek to secure information. We are not trying to force the patient to say something, to agree or disagree, as the prosecutor does in a court of law. So our interrogation should not be merely mechanical but informal, tactful, imaginative and intelligent, having our object in view. If the patient is unable to answer any question it is better to drop the question, or if he gives a doubtful answer it is good to omit the answer. Wherever his answers do not tally, it is better to put a query against the original answer. If the patient modifies his original answer such modifications should be entered. If the patient reflects very long before answering a question, usually the answer is not very valuable though the fact that he reflects long before answering can be a symptom. History The importance of a full and accurate history cannot be sufficiently emphasized. It may provide us with a very good idea as to the nature of the illness (diagnosis). To quote only one example, a history of convulsions in a young woman, which never occur in sleep and which never result in injuries to her person is highly suggestive that the disorder is of a hysterical nature. In most cases, the history also furnishes valuable data indicating the remedy required. Even textbooks on modern medicine lay great stress on recording the history fully and accurately. * In cases of children, the unconscious, the insane and in animals the history of the case and the objective findings (including the reaction and behaviour of patients as noted by the physician or by those around) generally lead to the remedy. The cause The exciting or precipitating cause of the illness ranks very high in importance. Farrington says that Arnica may well cure an illness originating from an injury, even though symptoms of Arnica may not be actually present in the case. Homoeopathy provides us with useful antidotes for varied types of causes, some of which our modern physicians may not even comprehend. And many times these antidotal remedies even help to remove the whole illness. Experience teaches us that in the majority of cases, through careful interrogation and by association of facts and circumstances, the exciting cause can be arrived at. The patient was once a healthy individual and something has happened to upset the balance called health. The knowledge of this factor - this "something" - is very important. It might have been an injury, an emotional upset, shock, a loss, greed, disappointment, fright, anxiety or vexation, an exposure to cold damp, heat or sun, an indiscretion in diet or activity, overexertion, suppression of discharges or eruptions, etc., or anyone of the numerous morbid influences which excite or activate disease conditions, and which the careful physician can uncover by close and intelligent questioning. Dixton notes, "I could cite cures following the finding of causes in history taking from diagnosis too, like a cataract following a suppressed foot-sweat, a nervous breakdown from an unfortunate love affair, an insanity from a fright, an epilepsy from a head injury, a tuberculosis from a suppressed eczema. But let's stop here by just pointing out again the moral: that it is easy if you take the time to get a complete history of the individual before you make that first prescription." Again, among the various types of causes, especially in adults, the emotional ones seem to be very common. Though the patient may fail to disclose these or may even hide them in the beginning or sometimes even till the end, the pattern of symptoms may suggest to the

experienced physician an emotional background to the case, the discovery of which will be very rewarding. When the patient describes or admits that he has become irritable, or suspicious, or jealous, impatient, restless, afraid, nervous, etc., when he has developed any of these negative traits, I suspect that there must have been some shock, disappointment, bad news, etc., some negative or unhappy experience at the back of these and by close and tactful questioning here some leading questions may be necessary * - I am usually able to discover what it is. The past history can prove to be of vital significance for the treatment of the case. Sometimes, especially in the absence of definite and useful present symptomatology, e.g. as in a case of cancer, the past history may help a great deal. Boger even says, "In chronic disease, it is useful to pick out the peculiarities of each past illness, combine this with the present complaint and then seek for the remedy, bearing in mind that the latest development most likely contains the real deciding symptom." I have generally found it more convenient to start with the present complaints and then to trace them back to their origin or cause. Then, after dealing with and fully defining and finishing each symptom, I fill up details of other aspects that might have been untouched, like appetite, thirst, urine, stool, sleep, sweat, general reactions, mentals, etc. Next, the previous history, family history and past treatment are to be made note of. After having completed all these, I will examine the patient physically. Physical examination One cannot but emphasize the importance of physically examining the patient, a procedure which unfortunately many homoeopaths tend to neglect in their over-eagerness to hunt for homoeopathic symptoms. Physically examining the patient may disclose to us many valuable objective symptoms, such as a deformed nail, offensive foot-sweat, keloids, warts, carious teeth, patches of baldness, tenderness anywhere, coldness or heat anywhere, localised sweat, etc. Particularly in skin diseases, I have found the location and appearance of the skin lesion very valuable. An examination of the tongue alone (the tongue can speak and tell a lot!) may give a wealth of information. A thorough physical examination may enable us to discover facts hitherto unknown to the patient such as a high blood pressure, pin-point pupils, extrasystoles, etc. While it enables us to arrive at or confirm the diagnosis and helps in the selection of the remedy, it also gives satisfaction to the patient and increases his faith. Mac Adam mentions, "There is one especial fault we homoeopaths have. We do not examine our patients sufficiently. We get down a most painstaking account of their subjective symptoms, but we do not examine the ears, eyes, nose, throat, stomach or even go carefully over the chest. This is often my mistake. I am so eager to get down symptoms that will be helpful in prescribing that I neglect to examine the objective conditions. "I think we run into more snags from neglect of these necessary and simple procedures than from anything else. And they are as simple as they are necessary." Underhill confirms this. He says, "It seems to me that as homoeopaths we have a tendency to neglect physical examinations, and local examinations to determine mechanical conditions." Mental symptoms I have generally found it easier to bring out the patient's mental symptoms during or after the physical examination, since by this time we have developed a rapport. Even otherwise,

by the time we have completed half the case taking, the patient becomes more relaxed and cooperative and is ready to tell us all his inner feelings, doubts, fears, etc. Sometimes, the patient may inadvertently reveal an emotionally disturbed state by the way he answers our questions or rarely even by an inflexion of his voice. Sometimes, a smiling patient may suddenly break down and weep bitterly when we have accidentally touched an emotionally sore spot. Sometimes the patient may avoid answering a question or hesitate, or he may give a vague answer or go round the question, or he may look down or look elsewhere while answering. All these generally indicate that he is trying to hide something. The importance of mental and emotional symptom, i.e. the changes that have occurred in the personality and temperament of the patient, cannot be adequately stressed, though they may require great patience and tact to elicit. The experienced prescriber is able to find, in a vast majority of cases, an emotional or psychic element in the patient. These elements are very valuable because they often have a dominant say in the selection of the similimum or they, at least, help us greatly to differentiate between competing drugs. At times, the patient may try to hide or refuse to reveal some emotional factor. It may be some tragic episode or one which may have an element of personal shame. Then I explain to him that the more he feels like hiding it, the more important it is for us, as it will help us to find his remedy. This always gets him to cooperate. In trying to discover the mental or emotional make-up and in uncovering the inner conflicts of the patients, it is always advisable to see the patient alone. Very often, there are thoughts and feelings in the mind of the patient which may be unknown even to his closest relatives, and which he may never reveal in the presence of anyone else, but only in complete confidence. The fourth homoeopathic scientific seminar, belgaum Discussion In conditions like Schizophrenia, symptoms have a very peculiar way of appearing suddenly, lasting for some time and leaving behind lucid intervals which may last for long periods. In these intervals, the patient will seem to be all right. And then suddenly there is an explosion. I asked my psychiatrist friend how long the cases should be followed up. He says that since this condition takes many years to develop, they should be followed up for many years. I will mention a case of Schizophrenia. A lady came from South Africa and asked me whether I could treat her daughter who was a schizophrenic. The daughter was an M.A. , L.L. B. When she came to my consulting room, I said, "Please sit down". The girl said, "Doctor, before I sit down let me know your fee." I said, "The fee is not important." She replied, "No, the fee is very important. You are a professional, and you have to make a living. So you must take your fee. But I am not rich and I must see if I can afford it. So I must know your fee." I said, "We shall discuss the fee later on." But as she insisted that we must discuss the fee first, I said, "Whatever you pay, I shall take." She said, "Why should you take whatever I pay? You do not know who I am. Why should you do me a favour?" Ultimately she sat down and I asked her, "What is the matter?" She said, "Nothing is wrong with me." I told her, "Your mother has brought you here." She replied, "My mother thinks I am mad, so she has brought me. I do not think I am mad. Am I not talking sense?" I said, "Your mother complains that you take bath for two hours." She said, "Which rule says that a person should not take bath for two hours? I like a bath, so I take bath for 2 hours. Does that make me mad?" So after one hour's discussion I could find nothing wrong. Then the mother and daughter left. After five minutes the mother

came back and asked me, "Do you think you can cure my daughter?" I said, "Cure her of what? I think she is O.K. " After five minutes the daughter came back and said, "Doctor, I forgot to tell you that when I was coming up in the lift I saw below the lift 20 dead bodies. Will you inform the police or shall I do so?" I said, "Don't worry I shall do it." See the peculiarity of this case. She talked for one hour and I found nothing wrong and she then came back and spoke nonsense. Now this is often the case with schizophrenia. You may watch them for months and you may find them normal. After two years you may find some abnormal behaviour. So, before you pass judgement on these cases you must be very careful. The details of the previous treatments taken and their results (including surgery) should also be carefully recorded since they might have suppressed the natural evolution of the disease or alternately they might have added drug effects to the natural picture. Osgood emphasizes this point. After the case recording is completed it would be advisable to verify the more important symptoms again by putting the same questions but in different ways to see whether the patient repeats, confirms or sticks to his original answers. Whenever the patient repeats any symptoms I underline those since they become confirmed. If he places greater emphasis on a particular modality, I write agg. or amel. to indicate the great degree of aggravation or relief. When a symptom which is already recorded proves on later enquiry to be doubtful, I enclose it in brackets. I use a number of abbreviations to keep pace with the patient during his narration. For example, I write F.L. H. 55 to indicate father, living, healthy and aged 55; 2 B, 2 S.L. H. denotes 2 brothers and 2 sisters living and healthy. Each physician can develop and use his own symbols or abbreviations to save time. Our case taking becomes so personal and intimate, and covers so much of the sufferings of the patient into which other physicians may not have enquired so closely or to which they may not have listened so carefully, that the patient is already much influenced and quite often he actually feels better by the time the case taking is completed, for in giving expression to many of his symptoms, including his hidden anxieties and doubts, he feels better by a process of psychological ventilation. It is a good measure of our success in case taking when the patient says by the end of the interview that he feels better or more hopeful. For those who desire to study the subject of case taking systematically and in detail, the following reading material is recommended: Boger C.M. : Study of Materia Medica and Case taking Close Stuart : Genius of Homoeopathy (relevant portions) Kent J.T. : Lectures on Homoeopathic Philosophy (relevant chapters) Kent J.T. : What the Doctor Needs to Know Nash E.B. : How to Take the Case Roberts H.A. : The Principles and Art of Healing (relevant chapters) Schmidt Pierre : The Art of Interrogation Schmidt Pierre : The Art of Case Taking

Wright Elizabeth : A Brief Study Course in Homoeopathy Analysis and evaluation of symptoms Next in importance to case taking or perhaps even greater than that, is the proper interpretation and evaluation of symptoms. Case taking merely affords us a mass of data, some useful and some useless, some of great value, some of lesser value from both the diagnostic and therapeutic points of view, out of which must emerge the characteristic symptom totality, which alone will lead us to the indicated remedy - the similimum. With a certain amount of experience and patience, case taking can be perfected and mastered to some extent but analysis and evaluation of symptoms will prove to be a continually challenging job requiring constant alertness and care on the part of the physician. It can be said that the greatest prescribers have been those who have been very successful in properly evaluating the symptoms. Classification Classification of the symptoms into various groups is called analysis. In analysis we may classify the symptoms into Mentals, Generals and Particulars. A different but more practical and useful method of classification is to divide the symptoms into two major groups, viz.: 1. Symptoms which characterise the disease that the patient is suffering from, that is the symptoms one would expect in that particular disease, and 2. Symptoms which do not actually belong to the sphere of that disease but yet are found in that particular patient and therefore form part of the symptom-picture of that particular case. If the totality of all the symptoms of a case is covered by a single remedy, there is practically no difficulty in choosing the remedy. But quite often such is not the case. A certain number of symptoms may be covered by one particular remedy and certain other symptoms by another remedy. In such a case we are called upon to evaluate the symptoms and select the more important ones upon which we should base a prescription. It is in such cases that this distinction helps us. The former symptoms which are called the Basic, Common or Pathognomonic symptoms, symptoms characterising the disease, help us to make a diagnosis. The latter, called the Determinative, Uncommon, Discriminative, Non-pathognomonic or Characteristic symptoms, do not contribute to the making of the diagnosis. They do not form part of the disease-picture and therefore, they reflect the individual reactions of the patient and so are characteristic of the patient. These symptoms aid us more in choosing the remedy. These symptoms, which are usually ignored or discarded by the allopathic physicians who consider them as irrelevant, are considered to be of the greatest value by the homoeopathic physicians who often base their prescription, mainly if not exclusively, on these symptoms. Even though these non-pathognomonic symptoms may not form part of the diagnostic picture and may be brushed aside as of no consequence by the orthodox practitioners, we, as homoeopaths, give them the highest importance because they are peculiar to this particular individual patient and therefore reflect the individual reaction of the patient in this particular case and to that extent help us to individualise each case. Because we are unable to explain these symptoms though they are present in the case, they fall under the group of strange, rare and peculiar symptoms. Quite often they almost exclusively decide the prescription.

Of course, the totality of the symptoms alone will lead to the choice of the remedy but within this totality, the individualising characteristic symptoms play a dominant role and may outrank and even overrule the diagnostic symptoms. And it is our repeated experience that generally remedies selected covering the totality of these characteristic symptoms also automatically cover and remove the disease, correcting the underlying pathology also, even if the pathological symptoms have not been considered and covered while selecting the remedy. An example may serve to illustrate what we mean by pathognomonic symptoms. A patient suffering from pneumonia turns up. He has a temperature of 102 oF, which has originated after he got wet. He has pain in the chest, cough with blood-streaked expectoration, pulse 120, respiration 60. He has restlessness, is worse after midnight and his tongue shows a triangular red tip. He has pain in the body worse by beginning motion, better by continued walking. The symptoms of this patient can be classified as follows: Pathognomonic Non-Pathognomonic Fever Origin after getting wet Pain, chest Restlessness Cough Worse after midnight Blood-streaked expectoration Triangular red tip of tongue Pulse-respiration disturbed Pain in body agg. beg., amel. continued motion. The symptoms on the left-hand side are those which help us to arrive at a diagnosis. They are the classical symptoms of the disease, pneumonia. The symptoms on the right-hand side do not fall under the clinical picture of pneumonia but yet they form a part of the totality of symptoms in this particular case and represent the characteristic reaction of this individual patient suffering from pneumonia. The latter are the symptoms which therefore individualise this patient, and these are the symptoms which mainly and generally help us to decide the prescription. This golden rule for the evaluation of symptoms, viz. that the more peculiar, strange or rare a symptom, the more important it is, has been emphasized by Hahnemann himself in para 153 of Organon and it is the opinion of many learned homoeopaths that this is one of the most important teaching of Hahnemann. When we are concerned with homoeopathic therapeutics, we notice that the more a symptom is important from the diagnostic angle, the less value it seems to have for selection of the drug. At the most, the diagnostic symptoms may only help us in choosing a particular remedy out of a group. So we notice that while a clinical approach may enable us to diagnose a case, when we want to select the drug, we have to put a stop to the clinical line of thought and proceed to study the non-pathognomonic or individualising symptoms. Stearns says, "As Dr. T.F. Allen puts it years ago the greater the value of a symptom in a diagnostic sense, the less its value in a therapeutic sense. In other words, diagnosis had

nothing to do with the selection of the remedy, and I really believe it may and often does lead people astray." Crutcher writes, "The interpretation of a symptom depends upon the accuracy of the patient's expression and also upon the doctor's ability to correlate them and give each its due importance and not to put undue importance upon any one that does not deserve it." Boger remarks, "In the abstract the same symptom may have the highest standing in one case and the lowest in the next all depending upon the general outline of the case, as delimited by the associated symptoms." Pulford states, "A mass of symptoms used according to our own notion, no matter how important they may appear, and put through any repertory, will not necessarily cause us to arrive at the coveted goal, unless they contain the core of the drug. Those rare, strange, peculiar symptoms are the only ones that mark the true individuality of the drug." The characteristic symptoms This is a very peculiar feature of homoeopathic prescribing that an apparently insignificant symptom, insignificant in the eyes of the patient or of the orthodox physician, may be to us the strongest pointer to the correct remedy. The patient may tell us the symptom in a most casual manner or might even omit to mention it because he considers it meaningless or absurd and yet that very symptom may prove to be a very important one, which may provide the clue to the similimum. How far a symptom is peculiar will depend upon various factors and the intelligent physician will have to be extremely discriminating and circumspective. A feature which may be quite normal at a particular age or stage or circumstance may be quite abnormal in some other age, stage or circumstance. This requires a clear knowledge of the functioning of the human organism. In evaluating we will have to consider every type of circumstance to decide whether a symptom is to be taken as peculiar or not. An ordinary symptom may become extremely peculiar under particular circumstances or in a particular background. Laughing over a joke is not a symptom; it is a normal thing. But laughing excessively or laughing over serious matters or laughing when sad or laughing without cause, laughing alternating with weeping, laughing with pain - these are all peculiar symptoms. A symptom which is common place in a particular setting may become peculiar in another setting, e.g. loquacity in a woman is not so uncommon as in a man esp. an old man. A tendency to weep easily is common in a young girl, not so common in an old woman and rare in an old man. So also impatience and hurry are the attributes of youth and are unusual in the elderly. Let us consider weeping. Weeping from disappointment or grief is a natural expression of a natural reaction. But weeping over trifles (I had an assistant who would weep if anything went wrong, e.g. if she could not oblige a patient with an early appointment), weeping without cause, weeping from consolation, weeping when telling symptoms, weeping when caressed, weeping before coughing, weeping from joy, weeping when looked at, as also not being able to weep when sad - these are all unusual. Let us see hunger. Hunger after eating, hunger in the middle of the night, hunger during fever, hunger with headache - these are strange.

Take thirst: thirst for small quantities often, thirst during convulsion, thirst after anger, thirst without desire to drink, thirstless with desire to drink, such are peculiar. The intensity of a reaction or symptom can also make it peculiar, e.g. excessive irritability amounting to rage, excessive fear amounting to phobia, etc. I have once treated a girl aged 6 years, who was so shy that she would ask her sister to go out of the room before undressing to be examined. Intolerable hunger or thirst, excessive pouring sweat, etc., can all be rare symptoms. I have seen an adult male patient who would hide under the cot if there was thunder; such was his fear! A male patient, aged 72 years, became violent if his wife refused to allow coition. This is unusual. This strangeness or peculiarity of the symptom may be exhibited in several ways, but its importance is undiminished. The strangeness may be in the location, e.g. : "Symmetrically bilateral eruptions" (Arn.) * "Crack behind the ear" (Graph.) "Root of the nose" (Kali-bi) Or it may be in the sensation itself, e.g. : "Sensation as if he had no head" (Asar.) "Teeth feel long" (Ant-c) "Sensation as if wound by a wire" (Cactus) "Bleeding from anus on passing flatus" (Phos.) Or it may be in the modality, e.g. : "Coryza , cold bath" (Calc-s) "Pain in knee agg. after stool" (Dio.) "Nausea amel. after eating" (Sep.) Or it may be in the causation, e.g. : "Convulsions from anger" (Cham.) "Convulsions from grief" (Ign.) "Convulsions from loss of sleep" (Cocl.) Or it may be in the extension, e.g. : "Pain spreading diagonally" (Agar.) "Symptoms proceed upwards" (Sep.) "Pain stomach extending to the testes" (Kali-c) Or it may be in the mode of onset and decline, e.g. : "Pain appearing and disappearing gradually" (Stan.)

"Pain appearing suddenly and disappearing slowly" (Puls.) "Pain appearing suddenly and disappearing suddenly" (Bell.) Or the peculiarity may be in the associating circumstances, e.g. : "Sleeplessness although sleepy" (Puls.) "Thirstlessness although mouth is dry" (Nux-v) "Strains hard although stool is soft" (Pso.) Or it may be in the peculiar association or juxtaposition of the Concomitant symptoms, e.g. : "Polyuria with headache" (Gels.) "Cough ends in sneezing" (Bell.) "Shortness of breath associated with pain" (Pru-s) Or it may be the absence of some symptom expected in a case, e.g. : "Vomiting without nausea" (Apoc.) "Painlessness of ulcers" (Op.) "Sense of well-being in fever" (Pyro.) These are thousands of such strange symptoms and strange combinations of symptoms which are found scattered all over throughout the Materia Medica and which can be found classified in the repertories. Some more examples are quoted here to give a better idea to the student, all the symptoms being taken from the pathogenesis of the remedy Alumina: "Exhausted even after a normal menstrual flow. Weakness in chest after speaking even a little. Craves for charcoal. Fear at the sight of knives. Nausea amel. eating. Must strain at stool to pass urine. Feels as if a hot iron was thrust through spine. Feels as if the white of an egg was spread on the face. Hasty but slow of execution." Such symptoms, known as characteristic symptoms and which characterise each remedy, may be found in every remedy. They are also known as Keynote symptoms. When such symptoms are found in a patient, they gain much importance. Very often such are the symptoms that give valuable clues to the indicated remedy. These symptoms characterise particular remedies and when a whole group of such characteristic

symptoms of a remedy are found in one particular patient, then the selection of the remedy becomes easy. We shall now discuss the value of different kinds of symptoms. It has been already mentioned that among all the symptoms, the peculiar or characteristic symptoms override all the other symptoms, the more peculiar the symptom, i.e. the more remote and unrelated the symptom is to the disease and the more inexplicable it is, especially from the point of view of diagnosis and pathology, the higher its merit. It must be emphasized that patients may not clearly express these peculiar symptoms. The physician will have to be alert to carefully note the different statements of the patient, juxtapose them and note or elicit the peculiar aspects of each symptom or the peculiar association of various symptoms. For example, a patient may complain that he is losing weight. Later while being questioned about his appetite he might say that his appetite and food-intake are quite good. The prescriber has to take note of the peculiar combination of these two symptoms. Similarly, when questioned about his thirst, he may say that he drinks one or two glasses of water per day and later, when questioned about micturition, he may state that he is passing urine several times a day in large quantities. One must also make very careful enquiry to assure himself that a symptom is indeed strange or rare. A patient says he is not refreshed in the morning on waking. We have to enquire if he has slept well. He says he did not. We ask why. He says he had to get up for micturition several times. Here the symptom is not "not refreshed after sleep" but, "frequent urination at night". While discussing the value of various symptoms, we shall first consider the value of the causative factor which is itself a symptom. The cause Where definitely available, the causation (emotional, physical, chemical, mechanical, dynamic, etc.) or origin of the disorder is considered to be of great importance. The patient was quite well upto a certain time and then he fell ill. Something has happened to make him ill, for without cause there is no effect. Every circumstance that contributed to the onset of the disease must be taken into account. A state of health cannot be disturbed to such an extent as to be replaced by a state of illness without a sufficiently strong provocative influence having come into play. Even though an apparently trivial cause such as getting wet might have brought into existence a serious illness, even this exciting cause reflects and reveals the nature of the original susceptibility and contributes its share to the knowledge of the symptom-totality. The intelligent and enquiring physician will be able, in a large majority of cases, to trace the illness to some causative factor, source or origin, though the patient may not be able to recall and give this information easily and at first. Fortunately for us, in Homoeopathy, we have different medicines which are able to antidote and remove the effects of various morbid influences even though these influences might have acted at some remote time and might have produced their effects a long time ago. Even when such influences continue to operate and disturb the patient's health, and we are unable to remove them, the suitable antidotal medicines are able to mitigate their continuing effects to a considerable extent.

Farrington writes that in a case which has originated after injury, even though the present symptoms may not coincide, the prescription of Arnica, and in conditions caused by incised wounds, the prescription of Staphysagria should be considered. Boger mentions that so much depends upon the knowledge of the cause of the disease that without it the choice of a homoeopathic remedy cannot be made with safety. I have seen numerous patients who have attributed the origin of their illness to a suppressing of anger and many of these cases have been cured by Aur., Cham., Ign., Sep., or Staph. - the remedies which cover this cause. A patient suppressed his anger and got pain radiating to the teeth. It was diagnosed as a coronary attack. Staph. helped him. I have cured many young men and women, who suffered from various troubles due to disappointment in love, with remedies like Ant-c, Lach., Sep. etc., based on this cause. A young girl climbed a mountain and then developed asthma. She was cured by Arnica. A girl developed nausea after taking too much ice cream. Ip. promptly relieved her. S.R. Phatak has reported a case of a patient who developed diarrhoea after drinking too much water in summer and who was cured by Gratiola. * Mental symptoms Next in order come the mental symptoms. The mental symptoms are important and rank very high especially if they are marked and strange. Mental symptoms which are of a mild nature, e.g. a slight irritability, or those which can be fully accounted for by the circumstances, e.g. fear in a lady or a child when alone in the dark, or depression in a patient who is suffering for several years and is not relieved by various treatments, are not to be much valued. A very large number of patients, however, will on careful questioning reveal some pyschological element in their suffering, either as an addition to or even as a causative factor for the whole disorder and these should be given much weightage. Paschero writes, "It is the person and not the disease that interests us in Homoeopathy. The symptoms expressing a human being's functions reside only in the mind, as in the conception of classical Psychology, but also through the body. Thus Homoeopathy bears out the prevailing psychosomatic ideas of modern medical thought. "A characteristic of the mind and personality of the patient may often be modality of a particular symptom, or simply an isolated symptom apparently unconnected with the syndrome of the local or organic disease. Consequently it stands out as a curious or "rare, strange and peculiar symptom". Named by Guernsey a "Keynote", it may lead us through the case to the patient's similimum. Peculiar modalities of local symptoms when not pathognomonic of the disease belong to the patient and not to the disease even though they do not seem general enough to express the patient's totality. But it is also necessary not to consider keynotes in isolation and not to prescribe on them only. The general symptoms and the mentals must agree and never contradict. The suppression of a single symptom does not mean the patient's healing; that will be reached only when the totality of symptoms is considered." Sometimes while being question the patient may feel shy, hesitate or refuse to disclose some mental or emotional symptoms because he or she feels they are too personal and embarrassing. Very often these symptoms prove to be of high value.

Among the mental symptoms, changes of the will and emotion come first, e.g. loves and hates, loathing, suicidal tendencies, lasciviousness or revulsion to sex, sexual perversions, fears, greed, various impulses, attitudes towards company, family, friends, etc., jealousy, suspicion, obstinacy, depression, weeping, loquacity, laughing, hurry, impatience, alcoholic tendency, etc. Then comes the understanding, e.g. , orientation in time and space, delusions, delirium, confusion, etc. Lastly come the symptoms of intellect and memory, e.g. , the patient's power of concentration, whether he makes mistakes in reading, writing, speaking, etc. It must be remembered that the Psyche (mind) and Soma (body) are inseparable constituents and constantly act and react upon each other. So, even in the so-called purely physical or mental diseases, the influence of one constituent upon the other cannot be overlooked. This is being increasingly recognised even by modern medicine and the psychological state of the patient is given very careful consideration both in diagnosis and in treatment. General symptoms Now come the general symptoms. A general symptom refers or applies to the conditions and reactions of the person as a whole, or to a particular sensation or modality referable to several parts of the body, e.g. , burning in the feet, hands and head. The more general the symptoms taken, the better the chances of getting at the proper remedy. Though the general symptoms come next in rank to the mentals and have greater value than the particular symptoms, if the general symptom is not very marked and is not peculiar, it will not be equal to a particular symptom which may be strange or characteristic. Among the components of the symptoms, the modality has a higher standing than the sensation, and sensation is assigned a higher place than the location. Modalities include the reaction of the patient or his parts to various influences such as weather, season, temperature, open air, motion, rest; position; touch, pressure, massage, light, noise, smell; sleep; eating and drinking, fasting, particular items of food and drink, company, emotions, such as anxiety, grief, etc., exertion - mental and physical, ascending, descending, bathing, washing, exposure to sun; discharges such as stool, urine, sweat, etc., clothing, covering, time, travelling, weather season, etc. Sensations * include all changes, felt or observed, locally or generally, such as burning, discolouration, swelling, etc. We have treated numerous patients suffering from various diseases with Lachesis because they all presented the general symptoms like agg. from sleep, agg. from heat, a bleeding tendency, etc. The concomitant symptoms The symptoms which coexist in the patient but which seem unrelated to the main diseasepicture are called the concomitant symptoms. These again reflect the individuality of the patient and help in choosing the remedy. In fact the totality of the characteristic symptoms is usually the totality of the concomitant symptoms. Boenninghausen has given greatest emphasis to concomitant symptoms. Because these symptoms are not explainable, because they seem unrelated to the main disease-picture and yet are present in the patient and form part of this disease-picture or symptom-totality, they come into the group of rare, strange or peculiar symptoms and therefore become very valuable.

Boger says that for the selection of the remedy, the concomitant symptom is more important than the main complaint itself. Frequent urination during headache (Vib.), nausea with haemorrhage (Ip.), are examples of concomitant symptoms. Particular symptoms The particular symptoms are important to the extent they are peculiar. Though in the repertory, they are classified under particular regions, symptoms referring to appetite and thirst, and the desires and aversions of the patient, and symptoms of sleep and the dreams, and in women symptoms of the menstrual states are considered very important and equivalent to general or even mental symptoms in rank. A remedy which covers the outstanding characteristic features of a case, however few they may be in number, is more likely to be the similimum than the remedy which merely covers numerous common symptoms. The peculiarity of a symptom adds to its value. A peculiar particular is more important than a common general and a peculiar general gets preference over a common mental symptom. The physician can assess or decide the strangeness or peculiarity of a symptom in two ways. The first is by his knowledge of anatomy, physiology, pathology, medicine, psychology, sociology, anthropology and above all, common sense, taking into consideration all aspects of the patient, e.g. his race, religion, diet, habits, background, circumstances, etc. By virtue of the above knowledge he expects certain diseases or patients to show particular features or expects the disease to take a particular course or expects the patient to behave or react in a particular fashion. When he finds some aspect present that he did not expect or something absent which he expected to be present, his expectations are belied and he considers it as peculiar. Or alternately, when he sees several patients of the same disease and finds some unusual feature in one particular patient not found in others, he finds something contrary to expectation and he considers this as peculiar. Objective symptoms While subjective symptoms are useful because they belong to the sphere of consciousness, objective symptoms have the advantage of being more reliable since the examining physician is able to observe and confirm their presence by his senses. Objective symptoms are especially valuable in cases where subjective symptoms cannot be obtained or relied upon such as in the unconscious, hysterical, insane or imbecile patients, in children and in animals. Pathological symptoms Pathological symptoms are usually assigned a very low value because such symptoms have not been evoked much in the provings. But when we come across pathological generals such as tendency to warts, tendency to form calculi, tendency to bleed, etc., such reflect the trend of the organism as a whole and are, therefore, to be considered. The later homoeopaths have observed and recorded at the bedside various pathological conditions caused and cured by homoeopathic remedies and these are not to be ignored. Further, in practice, several types of cases present themselves with a symptom-picture which is predominantly or even exclusively pathological and the homoeopath has no alternative but to match them with the pathological symptoms in our Materia Medica. Many homoeopaths, e.g. Boger, Dunham, etc., have been able to succeed even in such types of cases, by such selection, even though matching of the drug and the disease-picture purely on the pathological plane is not considered very satisfactory or advisable.

Common symptoms We have all along stressed the value of the peculiar symptoms as against the common symptoms. The common symptom has, of course, little or no value if there are characteristic symptoms which alone decide the remedy. But in the absence of such characteristic symptoms, if only common symptoms are available, the prescription has to be based on such common symptoms, though the chances of selecting the correct remedy are less. In other words, if in a case no characteristic symptoms are present we may have to prescribe on the diagnostic symptoms though this is not the ideal method. But still we may achieve a limited degree of success. For instance, I have successfully treated Appendicitis with Iris tenax and Vitiligo with Ars-s-f when no other guiding indications were present. Boger writes that the emphasis on the peculiar symptom does not mean that a diagnostic symptom can never be a major indication. He quotes as example the marked aggravation from motion equally prominent in pleurisy and the proving of Bryonia, and the 2 a.m. aggravation, frequent in both duodenal ulcer and the effects of Kali-bi. We have generally stressed the value of the peculiar symptoms and we have mentioned that these mainly, if not solely, decide the remedy selection. However, it must ever be kept in mind that there must be a general correspondence between the symptoms of the patient and those of the remedy, and that however helpful the peculiar symptoms may be in calling attention to certain remedies, they will not decide the prescription if there is no general similarity, for, after all, it is the totality of the symptoms that determine the choice of the remedy. Positive and negative symptoms Tyler writes, "Positive symptoms are all important. The patient has these symptoms and therefore requires this remedy. Negative symptoms may be less than of no importance; they may put one clean off the remedy. It is not safe to say that because the patient has not this symptom, he cannot need this remedy. It is what he has, not what he has not, that determines the remedy." Illustrations I should now like to describe a few cases to illustrate how a peculiar or characteristic symptom helped me to select the proper remedy. Once I was treating a child aged 11/2 years for recurrent eruptions on the body. He also had whitish stools and used to get diarrhoea from milk. But the peculiar aspect of the case as reported by the parents was that the child would be playing cheerfully all the while but as soon as the time approached for sleep, he would start screaming. We naturally expect that a child would become dull, drowsy and quiet before sleep but here it was the reverse. Under the rubric "Sleep before agg", three remedies are given prominents, viz. Bry., Calc., Puls. Out of these, Calc. covered all his symptoms. Further, the boy had suffered from very serious dentition disorders. This remedy given at intervals starting from 200 and going upto DMM potency completely cured him. Once I was consulted by a Christian lady for her sister. This sister who was married had gone to Africa with her husband and there she had become insane. She would have periods of insanity and periods of lucidity. When I took her case I found a very peculiar symptom. She had a peculiar aversion to four colours, viz. red, black, yellow and green. For aversion to each colour she attributed a reason, e.g. she said black represented funeral, red represented blood

and so on. In Kent's Repertory there is a rubric in the chapter "Mind" which reads: "Colour, aversion to red, yellow, green and black" under which only one remedy is given, viz. Tarn. This remedy brought about a remarkable change in her. Another patient, a young lady of 25, complained to me that she felt sad in cloudy weather. Through this symptom, I found her remedy to be Am-c, which is the only remedy given under the rubric "Sadness in cloudy weather" in Kent's Repertory. I had to treat a homoeopathic doctor once who had a peculiar symptom. He did not feel thirst, but he had inclination to drink water. I found that Caladium covered this as well as his other symptoms and this remedy relieved him. I once saw a child who was having a history of diarrhoea with 5 to 6 watery stools daily for over six months but had lost no weight. In fact the child was actually overweight! Phos-ac given on this indication ("Diarrhoea without weakness") cured the child. In another case of an allopathic doctor who had malignancy in the brain, Cham. gave enormous relief, prescribed on the symptom "Extreme irritability and violence during pain". A lady complained that on alternate months her menses were profuse. She was cured by Thlaspi bursa pastoris. In a case of malignancy of the bladder, I was led to the remedy Nit-ac - which gave tremendous relief to the patient - through a symptom he had, viz. "Burning in the rectum after passing urine". Several cases of patients with deafness have been helped by Graph. on the symptom "Hearing better in a noise". Pyrogen has a peculiar symptom in fever - with fever, the patient feels well. On this indication Pyrogen has helped many cases. In one case of typhoid, a boy with fever would become bright with the rise of temperature and would ask for new clothes. Pyro. cured him. Many female patients of asthma have been relieved by Kali-c because their attacks were agg. during the menses and many others by Sulph. because their attacks were aggravated before the menses. A young girl had a peculiar symptom that she would pass urine only once a day and even that scanty but had no discomfort whatsoever. She was cured by Op. Summary When a case has been well-taken, success is assured in Homoeopathy if the prescriber knows which symptoms are to be considered for prescribing and if he knows further how much value to attach to each symptom. I am convinced by experience that this is the real secret of success in homoeopathic prescribing. The value of the repertory In the selection of the homoeopathic remedy, the repertory has a very useful and important role to play. It is possible that some prescribers who have a profound knowledge of Materia Medica at their command and who are endowed with a prodigious memory are able to prescribe successfully for cases without the need of repertories, but such knowledge and memory are indeed very rare. These are not to be expected in the average homoeopath. The homoeopathic Materia Medica consists of two thousand or more drugs and out of these, the

average homoeopath may have a good grasp of only about forty or fifty or at the most a hundred drugs. Further, each of these drugs has in its symptomatology hundreds or even thousands of symptoms out of which even a good homoeopath may be able to recollect only fifty or a hundred symptoms. We realise that the task of remembering all the symptoms of all the drugs is a hopeless one, beyond human capacity and, therefore, some form of a reference book is quite necessary. Of course, it is a matter of good fortune to us that in many of the cases, certain outstanding characteristic symptoms of particular drugs, the so-called keynote symptoms, repeatedly present themselves, either singly or in particular groups or combinations, so that one who is well conversant with these keynote symptoms as described in Allen's Keynotes or Nash's Leaders or some such book can select the similimum fairly well. Yet if we can visualise the myriad of symptoms and combinations of symptoms which can present themselves before us in their everchanging mosaic forms, we shall feel more confident and safer with a reference book - the repertory at our side. Renner quotes J.H. Clarke as saying, "It is impossible to practice Homoeopathy as it should be practised without the aid of repertories." Grimmer states, "Repertory prescribing makes for greater accuracy and in the long run is a time saver, and with its use one grows in the knowledge of the Materia Medica." We have to appreciate the fact that the repertory will only help us to come to a group of drugs; it may merely indicate to us the list of possible drugs. It is for us to study this group carefully and select out of the group that one drug which fits our patient most fully - the similimum. The repertory is not a mechanical brain. It will not straightaway take us to the correct drug. It does not do our thinking for us. It does not replace our brain. It is only like a dictionary or a thesaurus in which various shades of meaning are given for each word, out of which we have to select the one meaning that is relevant to our context. The selection of the correct drug, the similimum, is an extremely delicate and intricate task. There are so many variable factors to be taken into account - the accuracy of observation and expression on the part of the patient, the ability of the physician to observe and understand the patient's sufferings and to properly interpret them, the incomplete nature of our Materia Medica itself, etc., etc. So a good physician must take care not only to minimise the variability of all these factors but to see that these uncertainties are not further added to by his placing complete faith and reliance on his incomplete knowledge and imperfect memory. He will try to take the aid of all possible sources of help in order to succeed in his task. The repertory offers such a medium which, wisely used, considerably lightens the task of the prescriber and helps accurate selection of the similimum. No doubt, all repertories have their own imperfections - some of them may even confuse and discourage a beginner - but if one can understand and overcome these little defects and use the repertories intelligently, they can be a tremendous advantage. Ewart writes, "If repertorization were more widely practised it may be that Homoeopathy would forge ahead and occupy a more exalted place in therapeutics than its present humble one." As Borland mentions, there is no repertory in existence which is complete in all respects. "But" he writes, "in spite of all the defects of the existing repertories, in spite of all the traps which repertory work lays for the uninstructed and the lazy, there is a need which a repertory alone can supply."

He writes further, "Without such a work the homoeopathic Materia Medica is an untracked wilderness. What mind can master, retain and reproduce at will our hundreds of drugs and their thousands of symptoms?" No better evidence is required than the statement of Dr. Pierre Schmidt, the world renowned homoeopathic teacher and prescriber, who writes in a masterly article that the possession of a good repertory and the perfect understanding of its use become for a good homoeopath both indispensable and of outstanding value. He mentions that in his library there were a hundred different repertories but that does not exhaust the list. He calls Kent's Repertory * the most valuable help, "the golden book", and mentions that every day he has occasion to refer to it at least fifty times (in spite of his deep knowledge and vast experience!). Of all the repertories available, Kent's is perhaps the most complete and therefore, the best. It is also the most popular. Indeed, it is a marvellous book and I salute the great author for his monumental work. On turning over the pages of the repertory, we are surprised to see that under each rubric many more drugs are given than those we are aware of. Even as we look into the repertory to seek some rubric, we come across several other rubrics and several drugs in various rubrics of which we have had no inkling at all. For instance, we find Puls. given under the rubric "Coryza, open air, agg." and Nux-v under "Coryza, open air, amel.", both drugs in bold type! And I have treated two or three cases of "Convulsions during menses" with Lachesis. Because of the repertory, we also learn that many disorders of the right leg are covered by Lachesis and of the left leg by Lycopodium! This itself is an education. Pierre Schmidt again lists the advantages of the repertory as follows: 1. It helps in case taking. 2. It shows us numerous remedies for such symptoms, that we do not know or think of. 3. It teaches us more about Materia Medica and makes its study interesting. 4. We learn the relative importance of various remedies in various symptoms. 5. It simplifies and helps in the selection of the remedy. 6. It allows comparison between different remedies. 7. It promotes the understanding of auxiliary remedies. Pulford summarizes the use of the repertory and says: 1. The repertory is a tool. It is not a piece of magical equipment. Its use must be learned by practice. It is only a time saving device and not a guarantee of an accurate prescription. Some cases may even defy the repertory, yet one skilled in Materia Medica may see the remedy at once. The Materia Medica, and not the Repertory, is the court of last resort. 2. The classical method of Kent and his Repertory are perhaps the most sound and safe. 3. Specialized repertories have their uses and are extremely helpful, but it is difficult to repertorize a case in full by using them. 4. One must develop his own method of use, the one which suits him best. 5. Do not pass up any repertory you can get your hands on.

I shall now briefly describe some cases for which the main indication for the correct drug came through the repertory. Once, a young lady came to me for a complaint of recurrent coryza. While I was taking her case, she gave me a most peculiar symptom, viz. that her coryza was always ameliorated by a cold bath. She was quite positive about this symptom. I knew several drugs which were relieved by cold baths, e.g. Pulsatilla, Fluoric acid, Mephitis, etc., but when I turned the pages of the Repertory (Kent's), I found a drug that I had never though of, viz. Calc-s. This drug actually helped to cure the patient. Another time, an elderly lady came to me with several complaints - with eczema, difficulty in breathing, high blood pressure, etc. While narrating her case, she gave me a very funny symptom, viz. that she always experienced a pain in the heart before and during micturition and which was relieved after micturition. I had no idea what the drug could be but Kent's Repertory again provided the answer. I found Lith. under all the three rubrics, "Pain heart, before urination", "Pain heart, during urination" and "Pain heart, urination after, amel." (p. 850). This drug considerably relieved the patient of all her complaints. One of my patients came to me with several symptoms all looking like Lachesis. Lachesis however failed to give satisfaction. Then she gave me a good symptom that she invariably developed palpitation after bath. It did not depend upon the exertion of the bath nor on whether hot or cold water was used but upon the bath itself. When I referred to Kent's Repertory, again it came to my rescue. Under the rubric "Palpitation, bathing agg." (p. 874), only one drug was found - Am-c *. This drug was found to cover the other symptoms of the patient also and it completely cured her of her whole disorder, including an eczema. I had to treat a young girl of 15 years for recurrent attacks of bronchial asthma. Several drugs had failed and it was then that I noticed during a routine examination that her breast and esp. the nipple was icy cold while the exposed parts of her body like the arms and legs were warm. So this was a peculiar symptom and Kent's Repertory gave Medorrhinum as the only drug covering this symptom. Further enquiry brought out the fact that the patient's attacks were affected by the proximity of the seashore and that she slept most comfortably on the abdomen. This drug Medorrhinum relieved her immediately. On one occasion, a middle aged Bengali lady applied for treatment for a severe, itching urticarial rash in the bend of the elbow which came on after eating fish. The rubrics "Fish agg." and "Eruption, elbow, bend of" when combined, brought out only one drug, viz. Caladium, which cured her. One day, a patient came to our hospital suffering from severe hypoprotememia with marked general anasarca and oliguria. His total daily urine output was only 150 to 180cc. His swelling was agg. by taking fish, eggs and fruits. The only drug that came through the rubrics "Food, agg. eggs,", "Food, agg. fish" and "Food, agg. fruits" was Chi-a. This drug had such a profound effect on the patient that the urine output went up from the 150 or 180 cc daily to 3 900 cc daily and maintained this level so that in a few days he became nearly dehydrated! Recently we had a patient admitted to the hospital. He was passing about 25 stools per day, with mucus and blood in every stool, for the last four days. He used to get such attacks on and off in the last three years. Stool examination showed that he was suffering from tape worm infestation. His attacks were generally provoked by taking fish and eggs. The repertory as mentioned in the above case showed his remedy to be Chi-a. This medicine rapidly cut down his disorder. With the first day's medicine he improved and passed only seven stools

with no mucus or blood. Next day, he had only one normal stool and thereafter the improvement was sustained. I was at one time called upon to treat a case of a girl of eight years suffering from acute nephritis. When I saw her there was complete anuria for over twelve hours. A child specialist had already seen the child and had given a very grave prognosis. The symptoms that were very characteristic were that she had become worse after eating apples. This was the third attack and every time it had been precipitated by taking sour foods or fruits. The rubrics "Sour foods agg." and "Fruits, agg." brought out Fer., and Ars. As the patient seemed to have symptoms of both the elements, I gave her Fer-a which completely cured the case. Subsequently, she passed through a severe attack of measles but there was not even a trace of albumin in the urine. One patient of Dr. S.R. Phatak was suffering from diarrhoea of 40 years' duration. He had consulted several eminent physicians of two generations with no relief. He was diagnosed as a case of mucous colitis. He gave the origin that during his marriage he had been asked to take some preparation of boiled concentrated milk. That very day he had developed diarrhoea. Taking the rubric "Diarrhoea, Boiled milk, agg.", Dr. Phatak found only two drugs, Nux-m and Sepia in Boger Boenninghausen's "Characteristics and Repertory". Out of these, he selected and prescribed Sepia which completely cured the patient. About three years back, I was called to see a young married lady suffering from retention of urine. Some five weeks earlier, she had developed fever which had been treated with Chloromycetin. The temperature had dropped to normal but on the same day she had developed retention of urine. Not being relieved by any medicine, she had to be catheterized four times a day. It was thought that the retention would gradually disappear but it did not. So, a neurologist was consulted who found nothing abnormal and thought it must be due to shock. She was discharged from the hospital without any specific treatment being suggested and so she had to continue to catheterize herself four times a day till I saw her. Since there was the possibility of a fright having caused the condition, I gave her Opium in potency with no good result. Thereupon, I consulted Dr. S.R. Phatak who diagnosed it as hysterical. On looking into Kent's Repertory under the rubric "Bladder, Retention of urine, in hysteria", we found only one drug and that too in bold type - Zinc. So she was given Zn 200. With the second dose of Zn she had a copious flow of urine without resorting to the catheter. Since then, she has neither required the catheter nor any dose of any medicine. A young girl of 20 consulted me for a peculiar and embarrassing disorder. She had itching of the nose, which at first, came on every time when she started eating but which later on appeared even at the sight of food. So bad was the disorder that she had not been able to eat anything for nearly a month. She has had to liquefy her food and drink it up. She had consulted several skin specialists but they could not relieve her. They had actually directed her to a psychiatrist. When she applied to me for medicine, I doubted if such a symptom could be found even in Homoeopathy. But when I referred to Kent's Repertory, to my surprise, I found the rubric "Itching of nose while eating" and under the rubric the following drugs, viz. Jatropha and Lachesis. Of the two, I preferred Lachesis because she was loquacious, and one dose of this relieved her completely. I once saw an infant aged 14 days in a state of cyanosis and collapse. It was actually a case of congenital heart disease, of Fallot's tetralogy. An eminent cardiologist had seen the baby and had expressed that nothing could be done. When I saw the infant, she was moribund but I noticed the following symptoms: "Rattling in the chest agg. while lying on back; Blueness;

Unconsciousness; Constipation for 8 days". I took the rubrics "Rattling", "Agg. lying on back" and "Blueness", all in Boger's Synoptic Key. The three drugs that came through were Cup., Op., and Sulph. Out of these, I preferred Opium because of the prolonged constipation. You can imagine my surprise and happiness when after one dose of Opium within ten minutes the blueness entirely disappeared, the rattling lessened and the child became conscious! A patient once entered our hospital with pain in chest, bleeding haemorrhoids, etc. He gave us a peculiar symptom that he had discharge of blood per anus whenever he passed flatus. On looking up this symptom in Kent's Repertory, we found only one drug, viz. Phos. This remedy helped him all round. I now quote two cases of my friend, Dr. Bhanu Desai. He once saw a patient who had fever and chill. The chill occurred with regularity at 3 a.m. and 3 p.m. daily. On referring to Boger's Synoptic Key under the symptoms "agg. 3 a.m. " and "agg. 3 p.m. ", he found five drugs, viz. Ant-t, Ars., Ced., Nat-m and Thu., covering the two rubrics. Out of these he selected Thuja because of some other symptoms. This drug relieved the patient. The second one was a case of eczema at the bend of the elbow. It was of an oozing type. After having tried and failed with such remedies like Graph., Mez., Pso., etc., he looked into Kent's Repertory and was surprised to find Cup. as the fourth drug, besides the three mentioned above given under the rubric "Extremities, eruption, elbow, bend of, eczema". Cup. was prescribed and the case was cured. Dr. Pierre Schmidt has described several cases and I shall quote two. The first was a physician of Chicago who has consulted Dr. Schmidt. He had an array of symptoms but among those there was one that was very curious. Every time he went to pass a stool, his nose used to run. Dr. Schmidt opened the repertory and found at once the only remedy given under the rubric "Nose, coryza, stool, during" (p. 328) was Thuja. Further questioning of the patient disclosed that he had a history of gonorrhoea and warts, and Thuja eliminated the whole symptom-complex. The second was a case treated by a doctor friend of his who was unaware of the use of the repertory. The patient had applied to him for the treatment of a severe vertigo. The prominent characteristic feature of the vertigo was that it was worse by reading for some time. The doctor was sure the symptom would be found in the Materia Medica but he did not know where he could find it. So not knowing the use of the repertory he started searching in the Materia Medica reading through symptoms of every drug beginning from 'A' and going through Abies nigra, Abrotanum, Aconite, Agnus castus, Ailanthus glandulosa, Allium cepa, Ammonium carb. and so on. If the symptom had been under some drug beginning with the letter C or P or S or some such letter, it might have taken the doctor several months to find it. But luckily it was in the letter A itself, under the drug Arnica and it took him only seven hours to find it. Had he possessed Kent's Repertory and known its use, he would have found it in two minutes. In this book, under the rubric "Vertigo worse by reading" a number of drugs are to be found but under the next very rubric "Vertigo worse by reading long", only one drug is given and that is Arnica. This gave an idea to Dr. Schmidt that there might be a history of injury. On being closely questioned, the patient recollected that some days earlier he had wanted to go somewhere in a hurry. He had gone in a taxi and when the taxi was speeding over a hump on the road, his head had bumped against the roof of the taxi. So Dr. Schmidt prescribed Arnica and the patient was rid of the vertigo.

I have seen coppery eruptions relieved by Ustilago, salivation with headache by Epiphegus, a case of left sided headache worse by touch and relieved by pressure and associated with loquacity by Paris quadrifolia (after Lachesis had failed), a case of Bronchiectasis with profuse offensive discharge by Phellandrium, torticollis by Lachnanthes and so on, in all these cases the drug having been arrived at with the help of the repertory. I have given above only some instances where the repertory has helped me and others in the choice of the remedy. It is my practice to refer to the repertory at every possible opportunity and I cannot sufficiently express how much it has helped me in the differentiation and selection of drugs and how much it has enriched my knowledge of drugs. I think that in many of my cases like the ones described above, I might not have succeeded without the help of the repertory. There are rubrics differing in shades of meaning and it may need all our intelligence, care and contemplation to fully realise these shades of meaning. In conclusion, I want to emphasize that each drug in our Materia Medica has numerous indications and vast potential. Each is like an ocean. Comparatively, our vision, understanding and experience are so limited that we cannot fathom any drug fully. Our concept of a drug and its field of application are almost like the concept the blind men had of the elephant. In fact, I believe that we may not comprehend even one drug thoroughly and completely, even if we were to devote a lifetime to its study. Under the circumstances the use of a repertory will considerably enlarge our vision, and help us to succeed in our work. As regards the actual process of repertorization, I am not competent to and anything more educative to what is described in standard booklets, "Repertorizing" by Sir John Weir and Margaret Tyler, Dr. Bidwell's book "Aid to Kent's Repertory" and Dr. B.K. Sarkar's "Synopsis of Homoeopathic Philosophy" (relevant chapters) should all be carefully studied by students. Repertorization Recurrent mastitis Mrs. M.K. , aged 28 years, consulted me on 23.08.58, with the following symptoms: She gets a cold swelling of the Rt. forearm before every M.P. during the last two years. The swelling is painful and she describes the pains as "cold pains". Formerly, for 5 years she had painful, nodular swelling of both breasts before every menstrual period. This is now replaced by the present disorder. This mammary pain used to be worse by stepping hard. If she gets a swelling in the forearm, she does not get the swelling of the breasts. She now desires more salt. Must drink water in order to swallow solid food. Vertigo rising from sitting. Is married for 10 years, but has no children. No physical findings except that the swelling of the forearm is tender but cold. Apparently it was a case of Conium and reference to Kent's Repertory confirmed this choice. Since they appeared to be part of the picture, I included old symptoms also for study

Pain, mammae, before menses (p. 846) Swelling mammae, before menses (p. 991) Desires salt things (p. 486) Coldness, forearm (p. 958) Vertigo, rising from a seat, on (p. 103) Pain, mammae, every step (p. 846) Conium was found under all the above rubrics. So on 23.08.58 she was given Con. 1M, 3 doses, 2 hourly. On 01.10.58, she reported that the swelling in forearm had disappeared and did not recur. Before the last M.P. , there was no swelling, no pains. But she had a recurrence of the painful swelling of the breast before M.P. , which she had suffered from formerly. This pain was aggravated by jarring. Dysphagia still present; but vertigo was nil. Since this symptom-picture persisted, she was given Con. 10M, 3 doses, 2 hourly. During the next menstrual period she had no trouble at all. Since then, till now, she remains well. Comment For the peculiar sensation of "cold pain", Conium may have to be considered along with other drugs like Agaricus, Arnica, Medorrhinum, Saccharum lactis and Syphilinum. Recurrent coryza A boy, S.P. , aged 18 years, was brought to me for consultation on 16th May 1963. He gets recurrent coryza for last 3 years. It started as coryza with rash and temperature, which subsided after 15 days. It is agg. in rainy season. He also gets headaches over the eyebrows and pain in the eyes with a feeling as if the eyes are popping out. The coryza is agg. if he is exposed to dust agg. if he takes cold bath and agg. in the evening. He is nervous before any function. He gets perspiration in palms and soles, when nervous. He is very shy and timid. Wants to cover himself with a blanket even in summer. Teething started late. He was very constipated in childhood. The remedy was prescribed without repertorization. Sil. 10M, 3 doses, thrice in one day and placebo given. 23.05.63 : Feels much better. Headaches nil. "Powders have done wonders!" Does not want any blankets now. Bacil. 1M, 3 doses in one day and placebo given. (I generally interpose Bacil. or Tub. in all cases of tendency to coryza.) 01.06.63 : Feels better. Sil. 10M, 3 doses, thrice a day and placebo given. 01.10.65 : Remains normal. For the information of students, the rubrics covered by Sil. are given below: (Ref. Kent's Repertory and Phatak's Repertory): Generalities, Cold, tendency to take (K.p. 1349) Wet weather (K.p. 1421)

Head, pain, forehead, eyes, above (K.p. 159) Eye, Pain, pressing-outward (K.p. 257) Dust agg. (Ph.p. 74) Chilled agg. (Ph.p. 43) Nervous (Ph.p. 191) Cold agg. (Ph.p. 46) Timid (K.p. 88) Teeth, Dentition, slow (K.p. 431) Extremities, Perspiration, palm (K.p. 1182) and sole (K.p. 1184) Melancholia On 10th January 1958, Mrs. R.F. , aged 60 years, came for consultation, complaining of the following: Last three years, has very poor sleep. Shooting pains in chest on and off, agg. speaking. Lightning pains in body, anywhere. Heaviness of body. Anorexia; Desires alchool; Thirstless. Constipation with hard stools. Dyspnoea on exertion and on ascending stairs. Very small soft warts all over the body, sometimes painful. Sweats when excited. Very nervous; any little thing frightens her. Very sensitive; easily offended; weeps easily. Gets easily hurt, contusions take long to clear up and pain for a long time. Almost all her troubles started after the death of her husband 3 years back. Always thinks of dead husband. Likes to be alone or only in company of her children. Feels she ought to be happy in every way but she is sad without reason. She becomes very irritable, flies into rage and abuses but regrets later. Prev. Hist.: N.A. D. Family History: N.A. D. Physical Exam.: Pt. looks emaciated. Wt. 96 lbs.

B.P. : 155/90. Otherwise N.A. D. In analysing and evaluating the above case, the symptom that struck me as very strange was the fact that she herself felt that she had all the ingredients of happiness but was unhappy without reason; this was a mental symptom. The apparent exciting cause, viz. the shock at the death of her husband, was also considered valuable as it had set into motion the whole panorama of mental and physical changes. Her recent irritability, the peculiar physical concomitant of painful warts, the constitutional tendency for wounds to heal slowly, were all given due importance and the case was repertorized as follows in Kent's Repertory: Grief, Ailments from (p. 51) + Sadness (p. 75) + Abusive (p. 1) = Am-m, Anac., Caust., Con., Hyo., Lyc., Nit-ac, Nux-v, Ver. + Wounds, heal, slow to (p. 1422) = Caust., Con., Lyc., Nit-ac + Warts, painful (p. 1340) = Caust., Lyc., Nit-ac + Warts small (p. 1340) = Caust., Nit-ac Out of the two, the drug Caust. seemed to fit the case better, esp. considering her depressive, brooding and hopeless mood, and so she was given one dose of Causticum 1M on 14.01.58. When she reported on 21.01.58, she was less sad and excitable; pain chest nil; pain in body less; sleep and constipation better. By 10.03.58, she was completely normal having received Caust. 10M, twice and Med. 1M, once, as an intercurrent remedy. She has remained well ever since. Emphysema Shri P.A. M., aged 86 years, came to me for consultation on 25th Dec. 1970 with the following symptoms: He has got asthmatic dyspnoea and cough for the last 12 years. Cough is amel. lying on right side. Cough and dyspnoea agg. strong odours. Sometimes he gets involuntary stool or urine on coughing. Expectoration is thick and sticky. His skin is very dry. The case was repertorized in Kent's Repertory as follows: Cough agg. lying. side (p. 797) + Expectoration, viscid (p. 820) = Alu., Am-m, Kali-c, Lyc., Merc., Phos., Plb., Sil., Spo., Stan. + Skin, rough (p. 130) = Alu., Merc., Phos., Plb. + Rectum, involuntary stool, coughing or sneezing on (p. 621) = Merc., Phos. + Urination, involuntary, cough, during (p. 659) = Phos. + Cough, odours, strong (p. 798) = Phos. Phos. also covered the symptom "old age" as given in Phatak's Repertory (p. 200).

Phos. 6, 1dose every 3 days relieved him considerably. Varicose veins Mrs. L.C. , aged 62 years, consulted me on 12.03.58 complaining of the following: Six years back she started having pain and stiffness in the lumbo-sacral region which later descended into the leg. Now, there is pain and swelling in left ankle which sometimes disappears from the left and appears in the right ankle; sometimes exists in both legs together. Pain and heaviness in leg, agg. motion, amel. by rest and agg. when legs hang down. Occasional pain in epigastrium piercing through to the back. Sweats on palms and soles even in winter; sweat offensive. Feels hot in legs and body, wants to place legs on cold floor; also wants to sleep on cold floor and likes cold in general. Dislikes noise made by children. Recently has developed fear of thunder. Milk causes diarrhoea. Prev. Hist.: She had a fall with injury to the head resulting in unconsciousness 13 years back. Also 12 years back her child died of diarrhoea. H/o shock due to father's death in accident 5 years back. She also had suffered from dysentery and recurrent coryza in past. Her case was now repertorized in Kent's Repertory as follows: The peculiar modality of the headache and the peculiar combination of numbness with pain was taken first. Head Pain, standing while (p. 148) + Numbness, suffering parts of (p. 1376) = Alu., Arn., Ars., Calc., Chi., Dig., Kali-c, Nat-m, Puls., Rhe., Rhus-t, Spo., Staph., Sulph., Ver., Zn. The aggravation from milk, a normal food item, came next. + Generalities, Food, milk agg. (p. 133) = Alu., Ars., Calc., Chi., Kali-c, Nat-m, Puls., Rhus-t, Spo., Sulph., Zn. + Stomach, Nausea, headache, during (p. 508) = Alu., Ars., Calc., Chi., Kali-c, Nat-m, Puls., Rhus-t, Sulph., Zn. The concomitant symptoms came next. + Vision, Diplopia (p. 277) = Calc., Kali-c, Nat-m, Puls., Rhust-t, Sulph., Zn. + Eye, paralysis of muscles of eyeball (p. 261) = Nat-m, Rhus-t In view of the h/o injury to the head and the h/o grief, I preferred Nat-m. So Nat-m VI (ie. 6th potency of 50 millesimal scale) was given, 1 dose to be taken in water succussed once a day. 10.06.64 : Condition much better. Headache amel. but eye condition same. Medicine repeated.

16.06.64 : Movement of eyeball is better but still had diplopia. Medicine repeated. 10.07.64 : Feels better. Dr. R., a physician, was consulted. All investigations were done and nothing abnormal was detected. But an intracranial spaceoccupying lesion was suspected. They are advised to have carotid angiography done after one month if she is not better. She still has headaches. Nat-m XXX (i.e. 30th potency of 50 millesimal scale) dissolved in water and with placebo, to be taken once a day succussed. 28.07.64 : Condition much better. Medicine repeated. 31.07.64 : Eyes are quite normal. Movements of eyeball are much better. Medicine was repeated. 01.10.64 : Patient reported that she was quite well. Note With regard to aggravation from items of food, I generally prefer the general rubric, e.g. "milk agg." to the particular rubric "Diarrhoea, milk agg." In this case, if the particular rubric "Diarrhoea, milk agg." had been taken, Nat-m would have been missed. Supra-orbital neuralgia Name: L.H. J.S. Age: 24 years Sex: Male. This patient consulted me on 30.11.59 for recurrent pain in the supra-orbital region of 4 years' duration occurring almost daily. He had been examined and investigated by many doctors and had taken much treatment (non-homoeopathic, all to no effect). The pain usually increased gradually and decreased gradually. It was agg. by fan, agg. in air-conditioned room, agg. by exposure to the sun. With the pain there was swelling below the eyes and lachrymation. The pain was amel. after sleep. Rising from sitting used to cause syncope. Appetite: normal; he had desire for more salt and aversion for milk. Thirst: 5-6 glasses of water per day. Sleep: less than 5 hrs, but felt quite refreshed. His memory was poor. His case was repertorized as follows in Kent's Repertory: Firstly, the fact that though he was a young man, he had aversion to company and consolation was taken. Company, aversion to (p. 12) + Consolation, agg. (p. 16) = Bell., Cact., Calc., Calc-p, Cham., Chi., Hell., Ign., Kali-c, Lyc., Nat-m, Nux-v, Plat., Sep., Tarn., Thu. Next, the craving was taken. + Desires salt things (p. 486) = Calc., Calc-p, Nat-m, Tarn., Thu. The peculiar nature of onset and decline of the pain was taken next. + Pains appear gradually and disappear gradually (p. 1377) = Nat-m

Nat-m also covered the other symptoms such as "Head, Pain forehead, eyes, above" (p. 159) and "Head, Pain, sun, from exposure" (p. 149). The first prescription made was Nat-m 200, 3 doses 2 hourly in one day, followed by Sac-l. The report in 7th Dec. 59 was: Feels better. No pain last 3 days. Sac-l was continued. He continued to improve steadily but Nat-m had to be repeated on 4th Jan. 1960 in the 200th potency and again on 12th Feb. 1960 in the 1M potency. Since then, he has had no more attacks and has remained very well. I have last seen him on 28th Dec. 1963 and he has required no medicine at all so far. Comment This is an example of a simple cure of a condition which our colleagues who practice modern medicine are unable to treat and cure so easily. This is also just one example of similar easy cures of apparently difficult disorders being achieved daily by the thousands of homoeopaths all over the world. Cervical spondylosis Mrs. R.P. , aged 42, suffering from cervical spondylosis decided to take homoeopathic treatment because the collar she had been prescribed was giving her discomfort without giving much relief. I saw her on 3rd Aug. 1962. Her history was as follows: While at Bangalore on 27.06.62, she had a sudden, excruciating pain in the right scapular region and shoulder at 2 a.m. She woke up from sleep due to pain. Since then the pain has been there almost constantly. The pain is agg. at 3 a.m. She invariably gets up with pain at that time. It is agg. before menses, sitting and lying on right side agg. using the hand, e.g. as in writing. Pain in shoulder joint is agg. hanging the hand down, amel. heat, rubbing, amel. pressure in nape and shoulder. Appetite, etc., normal, but milk causes flatulence. M.P. 3/28, regular. Had bad throat and sinusitis last 6 years. This is agg. by cold foods. Irritable worrying type, faints with pain. Prev. Hist.: Had a serious shock two years back (owing to her suspicion of her husband's infidelity). Amoebic colitis eight years back. Pleurisy 25 years ago. Her case was studied as follows on Kent's and Phatak's Repertory. The peculiar time and other modalities of the pain were taken first. agg. At 3 a.m. (K.p. 1343) + Before menses (K.p. 1373) = Am-c, Bor., Calc., Chi., Con., Dul., Kali-c, Kali-n, Mag-m, Nux-v, Sep., Staph., Zn. + Lying on painful side, agg. (K.p. 1373) = Am-c, Calc., Chi., Kali-c, Kali-n, Nux-v, Sep., Staph. + Sitting, while, agg. (K.p. 1401) = Do. + Food, milk, agg. (K.p. 1363) = Calc., Chi., Kali-c, Nux-v, Sep.

+ Fingers, working with, agg. (Ph.p. 107) = Calc., Kali-c, Sep. + Rubbing, amel. (K.p. 1398) = Calc., Kali-c + Food, cold, agg. (K.p. 1362) = Calc., Kali-c Between the two, I preferred Kali-c because it has more typically the 3 a.m. aggravation. So, on 3rd Aug. 1962, she was given Kali-c 30, 12 doses to be taken twice daily till relief was obtained. On 17th Aug., she reported that the pain had reduced in intensity; she was able to let her hand down without pain. From then, once she was put on Sac-l and was advised to take Kali-c 200 as and when necessary. She discarded the collar but still had no pain. She had to take in all Kali-c 200, 3 doses and by Nov. 1962, she was completely well and so the treatment was stopped. Now she has been well for over nine years. Bronchial asthma Mrs. J., aged 36 years, came to me for consultation on 22nd Jan. 1970 with the following history: She gets recurrent attacks of dyspnoea and cough for last 2 years. It is agg. in summer, agg. fat food, agg. ascending, agg. at night. Her appetite, thirst, etc., normal. Wants extra salt. Milk causes dysenteric stools. Perspires with attack. Very irritable. Weeps easily. Very loquacious. Fam. Hist.: Grandmother had cancer. She had one abortion. Weight: 88 lbs. The peculiar occurrence of dyspnoea and cough in summer was taken first and combined with the aggravations from the items of food. Her case was repertorized in Kent's Repertory: Summer, in (p. 1404) + Food, fat, agg. (p. 1363). = Ant-c, Bell., Bry., Carb-s, Carb-v, Nat-c, Nat-m, Nux-v, Puls., Thu. + Food, milk, agg. (p. 1363) = Ant-c, Bry., Carb-s, Carb-v, Nat-c, Nat-m, Nux-v, Puls. Next came the craving. + Desires salt things (p. 486) = Carb-v, Nat-m Now the mental symptom was taken. + Loquacity (p. 63) = Nat-m Carcin. 1M, 3 doses t.d. s. (because of the family history of cancer) and placebo given. 08.02.70 : Conditions same. Nat-m 1M, 3 doses t.d. s. and placebo given. 12.02.70 : Feels no amel., Tub-bov 1M, 3 doses t.d. s. followed after a week by Nat-m 1M, 3 doses t.d. s. 26.02.70 : Felt amel. but condition relapsing. Her husband lost some office money, about Rs. 1300. Since then, she gets severe attacks. Ign. 1M, 9 doses t.d. s. followed by Nat-m 1M, 3 doses t.d. s. 26.03.70 : Feels better but still gets dyspnoea. Nat-m 1M, 3 doses t.d. s.

She was feeling much better. The medicine in the same potency was repeated two or three times and then was given in 10M potency for about six times as and when necessary. She feels much better and she has been putting on weight also. Sciatica I was asked to visit Shri H.L. G., aged 55 years, on 2nd Sept. 1970 for the following complaints: In 1951 he slept on a wet cot in the rainy season and got stiffness which lasted for two years. Then, he was advised to dance on his toes and thus he got pain in the sciatic nerve. Then he was advised to have myelography done and undergo on operation which he avoided. He was using a belt and took some injections and felt better. Now, he gets pain in the left gluteal region which extends down the leg to the lateral three toes. There is numbness with the pain. The pain is agg. lying on left side, agg. beginning motion agg. standing and is agg. by hot application. Appetite, thirst, etc., normal. He smokes 20 to 25 cigarettes per day. Past. Hist.: In 1928, relapse of typhoid. In 1947, his younger brother was murdered. In 1956-60, had fistula for which he took ayurvedic medicine and felt better. Fam. Hist.: Nothing particular. His case was repertorized in Kent's Repertory and Phatak's Repertory. Whenever a patient says he has been smoking regularly, I take it that the tobacco must have disturbed his health and paved the way for the disease. So, I translate this symptom into the rubric "Tobaccco, agg.". In this case, I took this symptom and combined it with the exciting cause. Tobacco, agg. (K.p. 1407) + Lying, wet surface, floor, on or sitting on moist ground, agg. (Ph.p. 172) = Ars., Calc-c, Nux-v, Rhus-t, Sil. Next was taken the peculiar symptom, numbness with pain. + Numbness, suffering parts of (K.p. 1376) = Ars., Calc-c, Nux-v, Rhus-t, Sil. Then the peculiar particular modality of the pain came. + Pain, lower limbs, sciatica, standing agg. (K.p. 1065) = Nux-v Nux-v 200, 12 doses q.d. s. given. 10.09.70 : Condition slightly better. Nux-v t.d. s. given for a week. 24.09.70 : Condition better. Nux-v 1M, t.d. s. given for a week. 06.10.70 : Condition better. Medicine repeated. 22.10.70 : Feels 80% better. Nux-v 1M, b.d. given for a week. 24.12.70 : He has been given Nux-v 1M, twice a day and is much better. 02.02.71 : Feels that he is practically normal. Koch's abdomen Miss. R.S. , aged 23 years, turned up for consultation on 21st Oct. 1965 with the following history:

She gets pain in abdomen for last five years. It is agg. rich, fat food, agg. lying on left side or back agg. summer amel. knee chest position. Gets dysponoea on exertion; desires deep breath. She gets a ball-like sensation moving in the abdomen from epigastric region to lower abdomen. Ring-worm on right elbow for last two months. Gets dreams of snakes. Prev. Hist.: She had disappointment in love and since then she is not well. H/o Malaria suppressed by quinine. It had been diagnosed as a case of Koch's abdomen. He case was repertorized in Kent's Repertory as follows: The causation and the concomitant were taken first. Love, ailments, from disappointed (p. 63) + Respiration, deep, desire to breathe (p. 766) = Aur., Calc-p, Caust., Ign., Kali-c, Lach., Nuxm, Sep. The aggravation from a food item came next. + Food, fat, agg. (p. 1363) = Caust., Kali-c, Sep. The background of suppressed malaria came next. + Quinine, abuse of (p. 1397) = Sep. A peculiar particular was taken last. + Abdomen, ball, rolling in = Sep. Sepia 1M gave her profound relief but the remedy had to be repeated in 1M, 10M, 50M and CM potencies as and when necessary till she was completely cured by Aug. 1968. Haemorrhoids Mr. K.V. R., aged 46 years, came for consultation on 27th July 1963, with the following history: He has piles for last 6 years with pain and bleeding. Gets burning pain for 2 hours after stool. Occasional occipital headaches amel. pressure, agg. summer, agg. in sun agg. reading. He is slightly worried because his daughters-in-law are not cordial. He has severe constipation. First part of stool is hard, then it is soft. He has to strain hard even for soft stool. He gets pain in abdomen from morning to noon, with a feeling of tiredness and pain in joints for last 6 years. Pain starts when straining for stool amel. after stool, slightly amel. moving. No appetite. Thirst, etc., normal. Sleep: He cannot sleep on back. Gets bodyache in the morning . Prev. Hist.: 20 years back he had Double Pneumonia which lasted 3 months. Occasional dysentery. The case was repertorized in Kent's Repertory as follows: The peculiar stool and the modality came first. Stool, Hard, first, then soft (p. 638) + Rectum, Pain, burning, stool, after (p. 626) = Alumn., Berb., Caust.

+ Rectum, haemorrhage from anus (p. 619) = Alumn., Berb. The peculiar constipation was then taken. + Constipation, difficult stool (p. 607) = Alumn., Berb. The concomitant symptom was added. + Head pain occiput (p. 161) = Alumn., Berb. + Head, pain, pressure external, amel. (p. 164) = Alumn. Alumen 1M, 3 doses were given in one day. 03.08.63 : Patient gets bleeding + burning pain amel. itching + abdominal pain amel. Stool amel. Placebo given. As he was gradually feeling better and better, placebo was continued for about one month. The doses of Alumen had to be repeated in 1M potency on 07.09.63, 21.09.63, 15.10.63 and in 10M potency on 9.11.63. He improved considerably after each dose and became well. Peptic ulcer Mr. S.S. B., aged 46 years, came to me on 17th April 1963 with the following history: Patient suffers from duodenal ulcer since 1956. Originally it had been diagnosed as hyperacidity but later X-rays had revealed the lesion. Pain in abdomen is relieved by taking food or milk. The pain is at once amel. by passing flatus, amel. stretching, agg. pressure, agg. by wearing tight clothes around the abdomen. He has got constipation and piles. He has to strain even for a soft stool. Milk and rice cause flatulence. He smokes 30 cigarettes a day for the last 20 years. He is outwardly calm and unperturbed but actually he suppresses his feelings. He keeps things to himself. In the past, he had suffered from malaria. Also, in 1951, he suffered a shock, when his sister was killed in a car accident; at the same time, his wife and brother were also seriously injured. Family history: his mother had cancer in 1958 and died after five months. The case was repertorized in Kent's Repertory and Phatak's Repertory as follows: First the cause was taken and combined with the peculiar local modality. Grief, ailments, from (K.p. 51) + Clothes, loosening amel. (K.p. 1348) + Abdomen, clothing, sensitive to (K.p. 541) = Caust., Graph., Lach., Lyc., Nit-ac, Nux-v, Puls. Then, the habit of smoking which is known to aggravate an ulcer was added. + Tobacco, agg. (K.p. 1407) = Lach., Lyc., Nux-v, Puls. Then the peculiar constipation was considered. + Rectum, constipation, difficult soft stool (K.p. 607) = Lyc., Puls. Then again the local modalities were combined. + Abdomen, pain, flatus passing, amel. (K.p. 558) = Lyc. + Stretching (bending back), amel. (Ph.p. 24) = Lyc.

Lyc. seemed to fit the case well. Lyc. VI (i.e. 6th potency of 50 millesimal scale) in water, once a day with placebo given. 10.05.63 : Patient feels amel.; pain nil; slight heaviness only. Same medicine continued. 02.09.63 : Patient is much better but has a slight relapse. Medicine was repeated. He continued the medicine for some time and two years later I heard that he was well. Lumbago Mr. A.M. , aged 37 years, came for advice on 1st September 1970 with the following history: He has got a pain in the lumbar back for last five years. It is amel. by stretching backwards and amel. by lying down. He gets trembling of the body when he is hungry. Gets bodyache and has a feeling of inactivity. All the troubles have started after anxiety, when he had a business loss. Formerly he was irritable but now he is unable to get angry, even if somebody beats him. His appetite, thirst, etc., are normal. He was suspected as a case of Thyroid overfunction. His weight is increasing. Weight: 158 lbs. Fam. Hist.: Mother had tuberculosis. On exam.: Tremors in fingers. Lidlag sign negative. S.L. R. negative. He says that so far he has spent Rs. 5,000 for the treatment of his backache, with no relief. The peculiar change in his temperament was taken first followed by effect of hunger on him. His case was repertorized in Kent's Repertory as follows: Mild (p. 65) + Trembling hungry, when (p. 1409) = Stan., Sulph., Zn. Next was taken his extra weight which was increasing though his case was suspected as thyrotoxicosis. + Obesity (p. 1376) = Sulph. Sulph. 1M, 6 doses t.d. s. and placebo given. By 08.09.70, he felt much better. The medicine was repeated periodically and by 10.10.70, he reported that his condition was practically normal. Menopausal syndrome Mrs. K.P. , aged 50 years, was brought to me for consultation on 30th April 1970. She had got swelling all over the body. It had started after menopause. Gets dyspnoea on exertion, e.g. on ascending; headache agg. noise. Stiffness of back on waking. Sun agg.. Gets burning in chest, throat, etc., with headache at night waking her from sleep. Cannot bear hunger or fast. Feels agg. by talking. Feels something like a ball moving in abdomen. Wt. 188 lbs. The fact that her troubles had started after menopause, the origin was considered most important and was taken first. Then the general aggravation from sun was taken. Her case was repertorized in Kent's Repertory as follows: Menopause (p. 724) + Sun, from exposure to (p. 1404) = Agar., Bar-c, Bry., Calc., Gels., Glo., Graph., Ign., Lach., Pso., Puls., Sele., Sulph. Her excessive weight was taken next. + Obesity (p. 1376) = Agar., Bar-c, Bry., Calc., Graph., Lach., Puls., Sulph.

Her inability to fast was taken next. Then two particular peculiar symptoms were taken, viz. the headaches coming on from noise and the felling of a ball rolling in the abdomen. Head, pain, noise, from (p. 144) = Bar-c, Calc., Graph., Lach. + Abdomen, ball, rolling in (p. 541) = Lach. Lach. also covered the headaches coming on in sleep and the burning pains. Lach. 1M, 3 doses in one day followed by placebo given. 07.05.70 : Condition better. Swelling amel.. Medicine repeated. She continued to improve and had to be given Lach. 1M, 10M, 50M and CM potencies as and when necessary, with a few doses of Rhus-t 6 on and off for minor rheumatic pains. Later on she received Lach. VI (i.e. 6th potency of the 50 millesimal scale) and by 20.02.71 she had improved considerably and was practically normal. Osteoarthritis Mr. T.A. K., aged 69 years, from Surat, came to me on 28th July with the following complaints: Has arthritis in knee joints, esp. right knee, for last 10 years. Pain agg. rising from sitting, agg. beginning motion. agg. descending steps. Appetite good; urine 3 times at night; sleep good. Likes fan and cold air. Weight is increasing. On examination: No tenderness in knees. Has bilateral cataract. Previous History: Had asthma 40 years back, took homoeopathic treatment, but was not relieved. His case had been diagnosed as osteoarthritis. Because we expect a pain in the knee to be worse when ascending rather than when descending, and because we do not expect an old man to gain weight, I took the following symptoms as peculiar and worked out the case in Kent's Repertory as follows: Pain, knee, descending steps, when (p. 1072) + Obesity (p. 1376). I got Merc. and Ver-a. These two drugs did not cover "Old age". So I now worked out the case again taking "Descending agg." (p. 1356) as a general symptom. This was added to "Obesity". Then I got Am-m, Bar-c, Bor., Bry., Canth., Con., Fer., Lyc., Plb., Sulph., Ver. Now, I added "Old people" (p. 1376) and got Bar-c, Bry., Con., Lyc., Sulph. Then, "Motion at beginning of, agg." (p. 1374) was taken. Now only Con. and Lyc. remained. Of these, I preferred Lyc., as it was right-sided, had frequent micturition at night, etc. Besides, osteoarthritis was a destructive lesion rather than a paralytic one. So, I have him Lyc. 200, 3 doses in one day. He felt relief but the medicine had to be repeated about once a month first in 1M and then in 10M potencies.

On 2nd June 1964, he reported that his pains were relieved but he was unable to walk much. So I now put him on daily doses of Lyc. 6th potency of the LM scale to be taken in water succussed, daily once. On 17th February 1965, he reported that he was completely well; there was no pain in the knees. The medicine was discontinued. He has remained well still. Pneumonia A few nights ago, I was suddenly called to see a patient who was said to be seriously ill in a town about 200 km away. I left the next morning and reached the town at about 2 p.m. The patient was an old lady, Mrs. S.N. M., about 64 years, who was suffering from Pneumonia for the last 13 days. She had been paralysed and had been in bed for one and a half years and possibly she had developed hypostatic pneumonia. She had been under the treatment of a homoeopathic physician who had prescribed for her well, but her condition had taken a serious turn and the homoeopath had become rather anxious. Therefore, he had suggested allopathic treatment and an allopathic doctor had been called in. This gentleman, however refused to come and attend to the patient. No doubt he thought that the homoeopaths treat patients till they become very serious or moribund and then call in the allopathic doctor to take the blame. This particular family had been having faith in homoeopathic medicine for the last 35 years. So they were still very keen to have homoeopathic treatment. Therefore, it was decided that some other homoeopath should be called in and I was selected. So the case was before me now. I examined the patient carefully and I found she had all the signs of Pneumonia. But there was no temperature, which was due to the very weak condition of the patient. The patient was fortunately conscious but could not speak as she was paralysed. I noted the following symptoms of the patient: she would suddenly laugh without any reason; she even laughed at me. Secondly, she would try to remove her blouse. Even if she did not take off her clothing, if her body was exposed for examination, she did not seem to mind it. She had plenty of thirst which was more marked at night. She had rattling respiration with cough agg. lying on the left side. The pupils were small and reacting to light. Her husband mentioned that she had become worse after she had taken a cold bath at the time she possibly had a mild fever. Now, I studied the case with these symptoms and repertorized her case as follows in Kent's Repertory and Phataks' Repertory. Shameless, exposes the person (K.p. 79) + Laughing (K.p. 61) = Hyo., Phos., Sec-c, Tarn. + Thirst for large quantities (K.p. 529) = Phos. + Thirst, night (K.p. 528) = Phos. + Cough agg. lying on left side (K.p. 797) = Phos. + Chilled when heated (Ph.p. 43) = Phos. I found that the only remedy that came through was Phosphorus. I did not know if Phosphorus could be used in such a serious state. However, we gave her Phos. 200, 1 dose about 2 p.m. and after this there was a rise of temperature. I considered this a good sign because rise of temperature shows a re-establishment of resistance in the patient. I then advised them to continue the Phos., 3 times a day and then left for Bombay. Two days later I was informed

that she was feeling better and after another four days I was told that she was completely well. We were then able to start the treatment for the chronic paralytic condition. I am describing this case only to show how even very serious cases can be treated with homoeopathic medicines very nicely and easily, even when the allopathic doctors may consider these cases beyond the scope of their medicines. Seborrhoeic dermatitis The patient, Mr. G.A. , aged 33 years, consulted me on 10th February 1958, for suppurating crusty eruptions all over the body especially marked on all hairy parts such as beard, scalp, etc. He had been suffering for the last two years, and was usually worse in summer. The itching was very severe, agg. on sweating, and agg. at night. His body generally felt hot. Appetite was poor, thirst less. For past six months he had burning in abdomen, one to one and a half hours after dinner, amel. cold milk. Patient was very irritable. He also reported that the male organ became relaxed during coition. He had also inflamed cervical glands. B.P. was 130/90. Wt.: 111 lbs. Prev. History: Syphilis. Family History: not married. He had consulted eminent skin specialists but their prescriptions had proved ineffective. His condition, when I saw him was quite bad; so bad that each night his pillow had to be changed three or four times as each pillow got completely soaked with the pus that poured out from the eruptions in the scalp. Pathological investigations revealed the following: RBC : 4.04 m/mm3 Hb. 14.5 gm WBC 15 800/mm3 Diff. Count: Neutro : 80%, Eosino : 4%, Lympho : 13%, Monocytes : 3% Kahn: Positive. Stool: Ova of round worm. Urine: N.A. D. First, one dose of Sulphur 30 was given on 10.02.58 as it covered the suppurating eruptions and the deficient erection, but as the response was poor, the case was re-studied and repertorized as follows in Kent's Repertory: Eruptions on hairy parts (p. 1312) + Eruptions, suppurating (p. 1319) = Calc., Lach., Lyc., Merc., Nat-m, Nit-ac, Phos-ac, Rhus-t, Sil. + Eruptions itching at night (p. 1314) = Merc., Rhus-t + Eruptions, crusty (p. 13107) = Merc., Rhus-t Out of these Merc-s covered the agg. from sweating and the history of syphilis. He was given one dose of Merc-s 200, which resulted in a radical improvement on his condition. Within 2 months, and with only one more dose of Merc-s 200 he was very much improved. Then he failed to respond to Merc-s. But when put on Mez., there was further rapid progress which went on to complete recovery. His Kahn became negative. As far as I know, he never had a relapse.

The patient, Mr. G.A. , aged 33 years, consulted me on 10th February 1958, for suppurating crusty eruptions all over the body especially marked on all hairy parts such as beard, scalp, etc. He had been suffering for the last two years, and was usually worse in summer. The itching was very severe, agg. on sweating, and agg. at night. His body generally felt hot. Appetite was poor, thirst less. For past six months he had burning in abdomen, one to one and a half hours after dinner, amel. cold milk. Patient was very irritable. He also reported that the male organ became relaxed during coition. He had also inflamed cervical glands. B.P. was 130/90. Wt.: 111 lbs. Prev. History: Syphilis. Family History: not married. He had consulted eminent skin specialists but their prescriptions had proved ineffective. His condition, when I saw him was quite bad; so bad that each night his pillow had to be changed three or four times as each pillow got completely soaked with the pus that poured out from the eruptions in the scalp. Pathological investigations revealed the the following: RBC : 4.04 m/mm3 Hb. 14.5 gm WBC 15 800/mm3 Diff. Count: Neutro : 80%, Eosino : 4%, Lympho : 13%, Monocytes : 3% Kahn: Positive. Stool: Ova of round worm. Urine: N.A. D. First, one dose of Sulphur 30 was given on 10.02.58 as it covered the the suppurating eruptions and the deficient erection, but as the response was poor, the case was re-studied and repertorized as follows in Kent's Repertory: Eruptions on hairy parts (p. 1312) + Eruptions, suppurating (p. 1319) = Calc., Lach., Lyc., Merc., Nat-m, Nit-ac, Phos-ac, Rhus-t, Sil. + Eruptions itching at night (p. 1314) = Merc., Rhus-t + Eruptions, crusty (p. 13107) = Merc., Rhus-t Out of these Merc-s covered the the agg. from sweating and the history of syphilis. He was given one dose of Merc-s 200, which resulted in a radical improvement on his condition. Within 2 months, and with only one more dose of Merc-s 200 he was very much improved. Then he failed to respond to Merc-s. But when put on Mez., there was further rapid progress which went on to complete recovery. His Kahn became negative. As far as I know, he never had a relapse. Comment Though Kent does mot mention it under the rubric "Eruptions on hairy parts", I have found Mez., one of the most valuable drugs for this condition. Emotional diarrhoea Mr. A.R. T., aged 48 years, sought my advice on 29.03.65 with the following history:

In June 1947, he got paratyphoid and became very weak. In August 1947, he lost his father which was a shock to him. Then, one day, while travelling in the train, he got a cramp in the epigastrium, with shivering and sweating followed by a stool. This recurred again and then he developed a fear. After that he started passing mucus in stool. This was diagnosed as dysentery and he took a lot of anti-dysenteric drugs. The stools are agg. by excitement. He has also developed frequent sensation for stool which is agg. while riding on a motorbike. He has a lot of mental upsets and worries. He also gets shivering when he goes to the seashore. Weight has been reduced from 160 lbs to 125 lbs. Married in 1945. Had electric shock in 1953. He had arsenic poisoning due to injection given for Eosinophilia in 1956. Now, he has stopped eating non-veg. food and since then he has no mucus in stool. He has to suppress his sexual desire very often because his wife is disinterested in sex. Ign. 1M, 3 times a day for three days was given to him, because of the history of grief. On 02.04.65, he reported that his condition was the same. The case was then repertorized in Kent's Repertory as follows: Suppression of sexual desire (p. 711) + Grief, ailments from (p. 57) = Ap., Calc., Con., Phosac, Plat., Puls., Staph. + Diarrhoea on excitement (p. 612) = Phos-ac Phos-ac 1M, 3 times a day for three days was given. 29.04.65 : Patient feels much better. Feels he will be cured. Phos-ac 1M, 3 doses a day for two days was given. 27.09.65 : Feels amel. amel. mentally. Fear nil. Phos-ac 10M, 3 doses a day and placebo were given. Six months later I heard that he remained well. Dysentery Shri A.D. D., aged 25 years, came to me for help on 1st May 1959 with the following history: 2 months back he had an attack of dysentery. Consulted Dr. S.D. who is his uncle but did not follow his treatment. He gets slight abdominal pain before passing stool. Has only one stool per day. Pain is stitching and is shooting up. Pain is agg. by eating cauliflower, cabbage, potatoes, rice, fried food bread and by over-eating; is amel. by passing flatus, taking cold drinks and butter milk and after stool. He dislikes hot drinks. He is irritable and gets tired by speaking. The case was repertorized with Kent's Repertory as follows: All the modalities were added together, one by one. Food, fat agg. (p. 1363) + Food, cabbage, agg. (p. 1362) = Ars., Bry., Carb-v, Chin., Hell., Kali-c, Mag-c, Nat-m, Puls., Sep., Sil., Ver-a + Eating, satiety to (p. 1357) = Carb-v, Nat-m, Puls., Sep., Sil. + Food, bread, agg. (p. 1362) = Nat-m, Puls., Sep.

+ Food, potatoes, agg. (p. 1363) = Sep. + Food, cold drinks, amel. (p. 1363) = Sep. Sep. also covered "Abdomen, Pain, stool, before" (p. 560), "Abdomen, Pain, flatus amel." (p. 558), "Abdomen, Pain, stitching" (p. 591), and "Direction, Ascending" (Phatak's Rep. p. 67) Sepia 200, 3 doses in one day and placebo given. 16.05.59 : Pain was slightly better but has relapse. Sepia 1M, 3 doses in one day and placebo given. 03.07.59 : Feels better but still he gets pain twice a week. Sep. 50M, 3 doses in one day. 21.07.59 : Again got pain. Sepia CM, 3 doses in one day given. 29.07.59 : Practically no pain. Sac-l. 01.10.59 : Has remained well. Stress incontinence Shri B.S. , aged 27 years, came for homoeopathic help on 17th July 1963 for the following complaints: He has involuntary urination for last 8 years. It is intermittent. It is agg. jumping agg. exertion agg. when he squats cross-legged, agg. kneeling, agg. wearing woolen clothes, and with excitement. Formerly, it was associated with cough. He gets urging for urine after taking bath and after washing hands and feet. He passes urine every 4-5 minutes in day time in rainy season. His appetite is poor. He perspires too much since last year. His perspiration stains the linen yellow. He likes open air. He is irritable. He is very tired after coition. He has premature ejaculation. His memory is getting worse. He had bed-wetting till the age of 16 or 17 years. He took homoeopathic medicine in Secunderabad with no improvement. He is very sensitive to drugs. Urine report showed N.A. D. His case was repertorized in Kent's Repertory as follows: Urination, involuntary, exertion during (p. 659) + Seminal discharge, quick, too (p. 710) = Phos-ac + Memory, weakness of (p. 64) = Phos-ac Phos-ac 1M, 3 doses a day and placebo given. 23.07.63 : Appetite has doubled. Frequency of micturition is less. Placebo given. 25.07.63 : Feels better. Involuntary urination has almost stopped. Placebo and Phos-ac 10M, 3 doses, to be used if necessary, given. 01.10.63 : Condition reported normal. Cardiospasm

Mrs. P.D. , aged 40 years, suffering from Cardiospasm wanted homoeopathic aid on 26th Feb. 1965. Her history was as follows: In the end of 1962, while lying down, she noticed a gurgling sound in the throat with regurgitation of fluid. She then developed a choking sensation while swallowing, accompanied by vomiting. She experienced difficulty in swallowing esp. solids, and she could locate the obstruction in the lower substernal region. She consulted an eminent E.N. T. surgeon. Ba. swallow showed N.A. D. but an X-ray showed obstruction in the cardiac end of the stomach. The surgeon advised an operation but another surgeon advised against it. The patient took homoeopathic treatment from a colleague of mine and felt some relief. It was at this stage I was consulted. At present: She feels that the passage of food is first obstructed at the cardiac end of stomach, but then the food drops into the stomach. She has choking and regurgitation, agg. lying on the left side or back, agg. if she lies down immediately after food. Choking is amel. lying on abdomen. She can swallow better while sitting erect. Sour and spicy food, eggs and beer make her worse. She has vague pains in the joints. There is pain in the teeth which feel loose. Appetite, etc., normal. Sweat nil. Patient feels chilly even in hot weather. Nervous and shy. Prev. Hist.: Bronchitis often. Malaria at 15 years treated with Quinine. Her case was studied as follows in Phatak's and Kent's Repertories (Ph. = Phatak; K. = Kent ). Cold, agg. (Ph.p. 46) + Lying on left side agg. (Ph.p. 171) = Am-c, Bar-c, Colch., Kali-c, Lyc., Phos., Sep., Sil., Sulph. + Lying on back agg. (Ph.p. 171) = Colch., Phos., Sep., Sil., Sulph. + Food, sour agg. (K.p. 1364) = Phos., Sep., Sulph. + Lying on abdomen amel. (K.p. 1372) = Phos., Sep. + Constriction, cardiac orifice on swallowing (K.p. 483) = Phos. + Quinine, abuse of (K.p. 1397) = Phos., (Sep.) + Food, spices agg. (K.p. 1364) = Phos. Phos. covered the chilliness also (Heat, vital, lack of - K.p. 1366). Patient was given Phos. 200, 1M and 10M and Tub-bov 1M at long intervals. She felt much better in her condition but she developed some eruption below and around the right ear, itching and exuding thick fluid. But the prescription was not changed. On 09.12.66, the report was that she has gone to New York. She has been taking Phos. 10M at long intervals and is feeling completely well. Skin condition better. I advised her to consult my teacher Dr. Elizabeth Hubbard in New York but she did not do so as she felt considerably better. Anaemia

Mrs. D.S. K., aged 40 years, approached me for help on 24th Dec. 1970 with the following complaints: She has got stomatitis for about 15 years. It is agg. during pregnancy. Gets diarrhoea often agg. beans. Fasting causes headache, vomiting, etc. Car sickness. She is agg. every alternate winter. Itching in vagina before urination. Menses: Normal. Likes company and sympathy. Mild by nature. Fam. Hist. Her niece had tuberculosis. Her case was repertorized in Kent's Repertory and Phatak's Repertory as follows: Fasting agg. (K.p. 136) + Food, beans and peas agg. (K.p. 1362) = Ars., Calc., Carb-v, Chin., Hell., Kali-c, Lyc., Petr., Puls., Sep., Ver. + Riding in a wagon or in the cars agg. (K.p. 1397) =Ars., Calc., Carb-v, Kali-c, Lyc., Petr., Puls., Sep. + Winter agg. (K.p. 1422) = Ars., Calc., Carb-v, Kali-c, Lyc., Petr., Puls., Sep. + Pregnancy (Ph.p. 212) = Calc., Kali-c, Puls., Sep. + Alternating effects, sides, metastasis (Ph.p. 8) = Puls., Sep. Because she was mild by temperament, Puls. was chosen. Puls. 1M, 3 doses in one day and plabebo given. Advised routine blood examination. 31.12.70 : Condition same. Her blood report shows: Hb. 8 gms. (55%), R.B. C. = 3.15 per cu. m., W.B. C = 8 000 per cu.m. , N: 66%, L: 24%, E: 7%. Medicine was repeated. 15.01.71 : Much better except for slight pain in arms. Medicine was repeated. 28.01.71 : Feels amel. amel. Medicine repeated. 04.02.71 : Condition absolutely normal. Beans do not upset her now. Tub. 1M, 3 doses t.d. s., and one week later Puls. 1M, 3 doses. 01.04.71 : Remains quite well. Chronic bronchitis Master A.M. , aged 8 years, was brought to me for advice on 24th Dec. 1964 with the following history: He gets attacks of cough with dyspnoea for last eight months. Cough is loud, hollow, dry, brassy, spasmodic. It is agg. before midnight and 3 a.m. amel. sitting up. Gets cramps in legs while sitting long. Eats more than normal, likes sweets, sour and ice cream. Gets stool every three or four days. Prev. Hist.: Vaccinated every year. Has taken large quantity of antibiotics. He had Typhoid which was treated with Chloromyecetin. Measles in 1960. Tonsillectomy in 1960. The case had been diagnosed as Chronic bronchitis. Thuja 1M, 9 doses t.d. s. given (H/o vaccination+) 26.12.64 : Condition amel. but cough + Dros. 30, 14 doses b.d. given but to no effect. 09.01.65 : Condition same. Has got pain in left supra-orbital region. His case was repertorized in Phatak's Repertory as follows:

Eyes, over left (p. 91) + Cough, whooping, violent spasmodic (p. 58) = Kali-c, Sep. + Cough, dry, expectoration, without (p. 55) = Kali-c Kali-c 1M, 9 doses t.d. s. given. 14.01.65 : Headache amel. amel.; cough less intense and infrequent. Kali-c 1M, 14 doses b.d. The boy continued to improve on doses of kali-c which was given once a day and then stopped when he became completely well. His general health also improved. His weight was 56 lbs. On 27.08.68, he reported a relapse due to taking very sour food. He was otherwise quite well and now weighed 100 lbs Kali-c 10M, 7 doses were given to be taken daily once. On 20.10.70, there was a slight relapse of cough again. Kali-c 50M, 7 doses once a day were given and he became quite well. Note Kent does not give in his Repertory Kali-c under "Food, sour, agg.". Temporal arteritis Shri A.H. , aged 67 years, is the father of a medical practitioner and I was called to see him on 3rd Dec. 1968. He had been suffering from Koch's, had been treated and has been all right for the last 45 years. He went to Karachi in Jan. 1968, where he got diarrhoea. In October 1968, he got headache and it was diagnosed as a case of Temporal Arteritis. It used to recur on and off but now, for the last 20 days, he has a continuous headache. It is agg. lying down, agg. at night, agg. lying on the back. It is amel. after sleep and amel. by stretching the neck backwards. He used to get pain in the right temporal region, but now it is in the occipital region. On 27th Nov., he had vomiting which relieved his headache slightly, but then he felt giddy for 11/2 hrs. Since then the headache is associated with vertigo. And he has not been able to lie down for the last one week, so that he is sitting up day and night for the last one week. Previous History: He had met with a train accident in 1962. Fam. Hist.: H/o two still born children. On examination: Naevi on the body. Coldness of right leg. Swelling below eyes; right temporal artery is full and bounding. Syph. 1M, 3 doses t.d. s. were given first because of the h/o still born children and the agg. at night. This did not give much relief. Then his case was repertorized in Kent's Repertory as follows: Head, Pain, occiput, night (p. 162) + Head, Pain, occiput, lying while (p. 163) = Chel., Sep. + Vertigo, headache, during = (p. 99) = Chel., Sep. + Head, Pain, occiput, lying back of head on (p. 163) = Sep. Sep. 30, 4 doses every 4 hours given.

09.01.69 : Feels much better. Is able to lie down and sleep. The constant headache is gone but he gets pain once in 10 days. Sep. 1M, 1 dose, to be taken every 10 days given. 30.01.69 : Feels very much better; very slight headache. Syph. 1M, 3 doses t.d. s. followed by Sep. 1M, 3 doses t.d. s. after 15 days, given. With these doses the headaches disappeared and when last seen on 03.03.71, he was still quite well. Peptic ulcer Mr. G. consulted me on 18th Dec. 1969 for a pain in the abdomen. He gets pain when he is hungry. It is amel. after eating. It extends to the back also. Has desire to have cold food. Ba. meal X-ray had been done and it has been diagnosed as peptic ulcer. His case was repertorized in Phatak's Repertory as follows: Eating, amel. (p. 77) + Abdomen, backward (p. 1) + Fasting, agg. (p. 97) = Con., Phos., Plb., Sep., Tab. + Craving, cold things, for (p. 60) = Phos. Phos. 200, 6 doses t.d. s. followed by placebo given. 20.01.70 : Feel much better. Phos. 200, 6 doses t.d. s. to be taken every week and placebo given. His condition continued to improve and Phos. was repeated periodically, first in the 200 and then in 1M potency. By 17.09.70, he reported that he was quite normal. Chronic gastritis Miss A.M. , aged 17 years, turned up for consultation on 5th Oct. 1965. She has got pain in epigastric region for last two months. It is associated with burning. It is agg. before food agg. lying on back, and agg. stretching. It shoots to the back. It is amel. after food. Gets pain in the whole body and also trembling of hands. Abdomen bulges, then she belches, has nausea and vomits - vomit is bitter. Feels amel. by passing flatus. Aversion to sour food. Dryness of mouth with thirst. Her menses are late and scanty. Gets severe pain after the flow. She is irritable. Wants company. Likes sympathy. Prev. Hist.: Appendicectomy in 1962. Had measles, whooping cough and flu. Fam. Hist.: Grandmother and uncle had tuberculosis. Great grandfather had cancer. She is obese. Her case was repertorized in Phatak's Repertory as follows: Eating amel. (p. 77) + Direction backward (p. 67) + Abdomen, backward (p. 1) + Stomach, backward (p. 249) = Chel., Con., Kali-bi, Nat-m, Phos., Plb., Sep. + Lying, back, on, agg. (p. 171) = Phos., Sep. + Bending forwards or doubling up, amel. (p. 24) = Sep. Sepia also covered many of her other symptoms. Sep. 1M, 6 doses t.d. s. and placebo given.

18.10.65 : Feels amel.; Gets headache. Tub-bov 1M, 3 doses t.d. s. (H/o Tub. in family) and placebo given. Sep. 1M, 3 doses to be taken if necessary, also given. 13.01.66 : Felt normal all along. Only today has nausea. Sep. 1M, 3 doses t.d. s. and placebo given. 23.05.70 : Was much better. Now again has pain in epigastric region. Milk causes diarrhoea. Carcin. 1M (H/o cancer in family), 3 doses t.d. s. followed by Sep. 1M, 3 doses t.d. s. and plabebo given. 06.06.70 : Feels amel.. She had to be given Sep. 1M, once or twice more, then Sep. 10M twice and Sep. 50M once. By 29.12.70, she felt quite well. Appendicitis Master Kumar, aged 7 years, was admitted in the homoeopathic hospital with the following complaints: For the last 3 months, he gets pain in the abdomen agg. after eating and agg. milk. During pain he becomes restless, irritable and even violent and beats his mother. Pain started after an attack of fever. Now, he has aversion for milk. Thirst: 2 glasses per day. Stool, urine, sleep, etc., normal. With pain there is sweat on the forehead. Mother says that previously he used to get repeated attacks of cold but since the pain started he does not catch cold. Prev. Hist.: Milestones normal but had teething diarrhoea; dysentery at 6 months; whooping cough at 1 year; chicken pox at 2 years. Family History: Nil. On examination: Tenderness in the right iliac fossa. Investigation. Ba. meal shows stomach and duodenum normal. Follow up shows, "Appendix not visualised? Obstructed appendix." The case was repertorized as follows in Kent's Repertory: The peculiar mental concomitant was taken first and added to the probable cause, viz. suppressed coryza. Mind, Violent, Pain, from (p. 91) = Aur., Cham., Hep. + Nose, Coryza, suppressed (p. 328) = Cham. Cham. also covered "Abdomen, Pain, eating, after" (p. 558) and "Food, milk, agg." (p. 1363). Cham. 1M given every 4 hours gave prompt and complete relief. We would have liked to see the return of the coryza but unfortunately the patient discontinued the medicines as he felt well. Respiratory allergy * Miss H.L. Age 19 years.

Always catching colds. Nose gets blocked and in a few days goes to chest; there is always wheezing and she gets short of breath. Worse cold damp weather, better warm dry. Pneumonia at age of 2 years; has cough ever since mother had asthma and bronchitis, better doors and windows open, worse extremes of weather, worse warm room. Appetite very good; likes fat, sweet and salt; would sip vinegar; likes pepper and mustard. Is excitable; shouts at people; vivacious; enthusiastic; impatient. Critical and tidy. Cough worse nights, lying down, better lying on right side. Has had all sorts of treatment for nose. Said to be allergic to dogs? Had a skin condition? fungus. If the case is repertorized with the following rubrics in Kent's Repertory: Cold wet weather, agg. (p. 1350) Cold, tendency to take (p. 1349) Mind, Excitement, excitable (p. 40) Mind, Impatience (p. 53) Mind, Censorious, critical (p. 19) Air, open, amel. (p. 1344) Stomach, Desires fat (p. 485) Stomach, Desires sweets (p. 486) Cough, Night (p. 780) Cough lying , agg. (p. 796) Cough, lying, side, left (p. 797) The only remedy to come through is Ars. We were told that a few doses of Ars. completely relieved the patient. Gastro-enteritis *1945, April 1st, Mr. R. Albee, male, single, 29 years. Large healthy looking man without the endurance he should have; fat. Easily worried; full of apprehensions esp. about health. Hair falling fast, bald spot already. Extremely active; good student; particular about his appearance always. Home on furlough from Pacific.

Today at midday he ate a very hearty dinner with mushrooms, ice-cream, etc. Long walk for 2 hours right after dinner; illness began as soon as he returned. Vertigo for the first 1/2 hour. Sudden vomiting of food over and over again; all the food he had eaten. Simultaneously he had diarrhoea which persisted, watery stools, offensive. Cramps in abdomen come and go; come suddenly, doubles up with them. Cold perspiration all over, profuse. T. 97 ºF. Face pale, very anxious, apprehensive. Cramps in legs, rather violent. The patient was given Ars. 2C **, 1 dose every 15 minutes to be repeated in 2 hours if necessary. But the patient felt better within half an hour of the first dose. "Acted like magic". He felt quite weak for several hours, then well as ever. Only Ars. covered the following rubrics (Ref. Kent's Repertory). Stomach, Vomiting, sudden (p. 534) Stomach, Vomiting, ice-cream, after (p. 533) Stomach, Vomiting, diarrhoea, during (p. 532) Stomach, Vomiting, vertigo, during (p. 535) Stool, Odour, offensive (p. 640) Abdomen, Pain, cramping (p. 573) Abdomen, Pain, bend double, must (p. 557) Perspiration, Cold (p. 1296) Face, Discolouration pale (p. 359) Face, Expression, anxious (p. 374) Extremities, Cramps, calf (p. 975) * Bronchitis **Case (Jan. 24, 1893). Female, age, 23. Mill worker. Since 19th has had a severe cough, which wakes her at 3 a.m. and continues for an hour or so. Expectoration purulent and tough. Wheezing respiration. Perspiration excessive with slight exercise. Sticking pain in chest. Dyspnoea. Starting during sleep. Cold feet. This case is repertorized as follows in Kent's Repertory: Cough, Night, 3 to 4 a.m. (p. 781) + Mind, Starting, during sleep (p. 83) = Kali-c, Lyc., Op.

+ Chest, Pain, stitching (p. 863) = Kali-c, Lyc. + Expectoration, tough (p. 820) = Kali-c Kali-c also covers all the other symptoms as "Cough, Violent" (p. 809), " Expectoration, Purulent" (p. 817), "Respiration, Wheezing" (p. 776), "Perspiration, Exertion, during, slight" (p. 1297) and "Extremities, Coldness, foot" (p. 962). Dyspepsia ** "A stone mason, aged 47, brown hair, partially bald, grey eyes; spare of build, slightly stoop-shouldered with scrawny neck and thin arms. Married, father of four children. Has led the ordinary life of a working man. Present complaints: Has suffered from dyspepsia for the past many years, gradually getting worse. For two hours after eating spits up food but it is not acid. He is hungry, but a few mouthfuls of food seem to fill him to the throat. He drinks two cups of coffee during each meal. Much flatulence and rumbling in the abdomen. Belching of gas immediately, after meals which relieves the distention, temporarily. Food comes up with the eructations. Thirst for cold water to wash his throat, but it causes pain in the stomach. He complains of forgetfulness; uses wrong words in speaking. (He did so in addressing the doctor.) He is fidgety and keeps moving or walking about to quiet his nerves. On coming home from work he has his wife rub his right shoulder and back to relieve the burning pains which come on in the late afternoon. Due to his habits he is constipated. He frequently has ineffectual urging to stool. He perspires normally while working. The urine is sometimes highly coloured and burns slightly on voiding. On rising from the supper table he notices pains in his right wrist and right hip, especially if the room is cold. He is inclined to irritability and is depressed over his inability to do work as well as formerly. He has no sexual or family incompatibilities. The physical examination and laboratory findings, which are omitted, were in complete accord with the symptoms elicited. These symptoms were evaluated and repertorized as follows: (Numbers refer to pages in Kent's Repertory). Being a mental symptom, "Mistakes in speaking" (p. 66) was taken first. Being a peculiar symptom although a particular next was "Stomach pain, cold drinks, after" (p. 499). When combined, we get, = Arg-n., Calc., Calc-p,., Carb-s, Caus., Graph., Kali-c, Lyc., Nux-v, Sil., Sul-ac

Another peculiar particular was taken next. + Stomach, Fullness, eating ever so little, after: (p. 699) = Kali-c, Lyc., Nux-v, Sil. Now a general symptom was added. + Generalities, side, right (p. 1400) (because so many symptoms were rt. sided) = Lyc., Nuxv, Sil. Other particulars were added. + Stomach, Eructations, food (p. 494) = Lyc., Nux-v + Back pain, burning, dorsal region, scapula, right (p. 920) = Lyc. Lyc. seems to be the remedy as it covers the remaining symptoms also such as evening agg., pain in rt. wrist, irritability, depression, ineffectual urging for stool, etc. The same case can be repertorized from Phatak's Repertory as follows (by generalising some symptoms). Food and drink cold agg. (p. 109) + Eating a little agg. (77) = Chin., Lyc., Nux-v + Direction side Right (p. 68) = Lyc., Nux-v + Mistakes of speech (p. 181) = Lyc., Nux-v Now readers can compare these two drugs with the particular symptoms and select the correct remedy which seems to be Lycopodium. Anxiety neurosis *Mr. Gershom Bradford seen in July 1926, a male, married, 50 years, tall, slender; worried anxious look, dark complexion brought up by the sea; hard worker on ships; learned navigation early. Always nervous, apprehensive, imaginative. Not at ease in company; acute selfconsciousness. Fear of confinement overpowering. Fear of high places. Desperate if cannot get out; must have end seat or back-seat. Must hover on edge of crowd so as to be able to get away. Tendency to walk faster and faster when nervous. Afraid something will happen on the street. Worries in the night; "Will he be dead when he lies?" If alone in the night, breaks out in perspiration. Cannot travel alone. Likely to be chilly when nervous. Responsibility causes timidity. Consequences of all this: chill, faintness; profuse cool perspiration, especially large quantity of gas causing pressure in stomach amel. as soon as he eructates.

Tension; tingling. Dreams of the dead. Exhaustion, mostly mental, amel. as soon as entire change in the mental and emotional atmosphere. Tired, sinking sensation suddenly. Weakness so much so he can hardly lift a finger. Waves of nervousness wake him early in A.M. amel. after eructations. Drowsiness marked after nervous spell. The case was analysed and repertorized as follows in Kent's Repertory: Through the case there is the prominent mental symptom of fear, fear especially of something happening. So this was taken first. Mind, Fear of evil (p. 44) To this was added another prominent mental symptom. Fear of high places (p. 45) When these two rubrics were apposed, only the following drugs came through, viz. Arg-n, Puls., Staph., Sulph. Then, there is the prominent peculiar modality that eructations relieved the nervousness. This was added next. + Stomach, Eructations, amel. (p. 490) = Arg-n, Sulph. Then, there is another peculiar mental symptom. + Mind, Anxiety, walking, which makes him walk faster (p. 9) = Arg-n Now a glance into the Materia Medica will show that Arg-n covers the rest of the symptoms and therefore the whole case. Hypothyroidism *Mr. F.S. male, married, 32 years, tall, slender rather light complexion, looks older than his age. Silent, repressed, hard to get into conversation, takes long to feel acquainted with him. Restless, active, cannot be still, though appears to casual acquaintance slow, aloof. Lack of vital heat marked; woolen socks in summer. Faintness easily; has fainted many times, agg. getting up from bed, sight of blood, any ordeal. Hands shake when excited. Desires open air but agg. drafts. Sleepiness very marked; can sleep any time, e.g. sitting in chair. Thinks slowly; slow in reaching decisions.

Appetite good; desires sweet things. Sleep restless; grinding teeth; many dreams. Sneezing spells in A.M. may last until noon. Tendency to vertigo. Numbness feet if sits with legs crossed. Amoeba found in stools in 1934, not since then. Laughing loudly at something read to him which was really serious. Queer dreams and thoughts; cannot describe them. The case is worked out as follows on Kent's Repertory . The peculiar mental symptom of laughing loudly at a serious matter was taken first. Laughing, serious matters, over (p. 62) = Anac., Ap., Arg-n, Can-i, Cast-eq, Ign., Lil-t, Lyc., Nat-m, Nux-m, Plat., Sulph. This was combined with another mental symptom, viz. Slowness. + Slowness (p. 81) = Anac., Ign., Nux-m Now a general symptom was taken, viz. the tendency to faint from excitement. + Faintness, excitement on (p. 1360) = Ign., Nux-m Without further repertorization, considering the sleepiness and chilliness of the patient, it is evident that Nux-m is the correct remedy because it covers most of the remaining symptoms. Just for curiosity we looked into the repertory and found Nux-m under the following rubrics also, viz., "Talk, indisposed to" (p. 86); "Restlessness" (p. 72); "Heat, vital, lack of " (p. 1366); "Air, draft agg."(p. 1344); "Sleep, restless" (p. 1247), etc. Dr. Green reported that Nux-m 10M was administered and produced a prolonged and very satisfactory improvement. Introduction to boger's synoptic key I might as well begin by mentioning how I became familiar with this book. When I started practising Homoeopathy I was financially not in a position to buy books. And the only book which combined in itself both the repertory and Materia Medica and one which was within my dream was Boger's Synoptic Key. So I bought it and used it. Later on, I wanted to buy Kent's Repertory but even if I could then afford it, it was not available for many years as it was out of print. Second-hand copies were selling at exorbitant prices, which amounts I did not have the capacity or the heart to spend. And as I was using Boger's book and finding myself quite successful with it, I stuck to it. In fact I found it more convenient and familiar also. I may also mention that in treating my very first case by the homoeopathic methods - a case which is indelibly impressed in my mind - I took the help of this book. I have reported this case in "My Conversion to Homoeopathy" but the case is worth recapitulating and I repeat it here for the benefit of new readers and to show how this book helped me.

A close relative of mine was getting recurring attacks of intermittent high temperature which used to last for two or three weeks at a time. It had been diagnosed as malignant tertian malaria and had generally responded to quinine. At that time, quinine was the only certain anti-malarial allopathic remedy. But this time there was a recurrence of the temperature for the fifth or sixth time. The fever had lasted about a fortnight and quinine had produced no effect whatsoever. So the relatives of the patient were very much perturbed and they telephoned me. This was on 7th Nov. 1947. I responded to the call and went to see the patient. The patient had a temperature of 107 oF, a temperature which I had never encountered so far in my life. Naturally, I was extremely upset and in panic I ran to my nearest physician-friend. However, this physician was not available and, therefore, I left word that he should come at once, as soon as he returned to his clinic. Meanwhile we procured some ice and rubbed it all over the head and body of the patient, but the temperature came down only by 0.3 ºF and stayed at 106.8 oF. As quinine had already been tried without effect and as no other measure was available except to take him to the hospital, I decided to try Homoeopathy without however any hope that it would help. So I studied his symptoms in the homoeopathic way and found the following points: Temperature 106.8 oF, Pulse 112. Even with such high temperature the patient was conscious and loquacious and was asking us why we were all looking so worried as, after all, nothing was wrong except that he was having a little fever. He complained of great bodily soreness. The history was that almost every time the fever came on, the temperature used to rise very high but the patient would not feel it much. He was also listless. I repertorized the case using Boger's book as follows: Temperature, high (p. 46) and fever, hyperpyrexia (p. 379) = Bap., Chi-a, Iod., Phos., Pyro., Sulph., Ver-v + Pulse, temperature, discordant (p. 415) = Pyro. + Sore (pp. 45, 425) = Pyro. + Loquacity (pp. 52, 400) = Pyro. A reference to the Materia Medica showed that Pyrogen also covered the symptom, "Feels well in spite of high fever". So I decided to try Pyrogen. Since I had not prescribed for a single case so far, I had no homoeopathic remedy with me. So I procured the remedy in the 30th potency and administered one drop of it at 6 p.m. Whereas I myself had very little confidence as to the outcome, the relatives of the patient had no faith at all that one drop of medicine was going to do anything, particularly as, as his aunt remarked, "it was not sufficient even to go down his throat". However, the miracle happened! We were measuring his temperature every 15 minutes being apprehensive that it might rise further but luckily it dropped rapidly as follows: 6.00 p.m. : 106.8 oF 6.45 p.m. : 102.4 oF 6.15 p.m. : 104.6 oF 7.00 p.m. : 102.0 oF 6.30 p.m. : 103.0 oF 8.00 p.m. : 100.0 oF He perspired so profusely that all his clothes were drenched, and when we changed his clothes he fell into a deep sleep. When he woke up the next morning, he had no fever and felt quite well; he said that for the first time in so many attacks of fever, he was feeling fit in spite

of the fact that he had suffered from fever for a fortnight. Since then, he has not had any more such attacks in the last 23 years. My own Pocket Repertory and the Card Repertory are modelled on Boger's method though I have added many rubrics, many drugs, many punches and even made a few improvements. Dr. Phatak tells me that in the last 25 years he has by constant use completely worn out at least six copies of Boger's book. Dr. Cyrus M. Boger, M.D. , was born in 1861 and lived till 1935. He practised in the U.S. A. He was thus a contemporary as well as a follower of Kent * and he seems to have thoroughly imbibed the methods of Kent, as well as those of Boenninghausen. In his book, "Characteristics and Repertory", he seems to have attempted a synthesis of these two methods, implanting Kent's rubrics into Boenninghausen's method, taking the latter as the base. He seems to have been an extraordinary man, a seer and a sage, extremely industrious and ingenious, brimming with confidence arising from knowledge and with full and complete faith in the successful outcome of the application of homoeopathic principles, but a man of few words. The few cases reported by him are outstanding ones and are specimens of brevity and excellent remedy selection. In a discussion on typhoid, he reports that in the hundreds of cases of typhoid treated by him successfully, he had always prescribed only a single dose of medicine. There was never a need for a second dose nor for a second medicine. What amazing accuracy and confidence! He seems to have had rich experience with a large number of a wide variety of cases. He gives lists of symptoms, personally verified by him as elicited on his patients and these are indeed very formidable lists. His Additions to Kent's Repertory is a very comprehensive book. Whether he writes about philosophy or about Materia Medica, Boger writes in his concise, tense style. The concise style conceals a wealth of meaning and significance like the Sootras or our ancient Rishis (Sages) *. He seems to be so miserly about space that even for the abbreviations of drugs he makes use of very few letters, e.g. Cam. for Camph., Hyp. for Hyper., Sul. instead of Sulph., Pul. for Puls., Ip. for Ipec., and so on, but of course always with the meaning clear. ** Anyone who wishes to understand Boger's book must first of all read carefully and closely his masterly foreword to this book as well as his excellent Preface to the book, "Boenninghausen's Characteristics and Repertory", which has been edited by Boger. This preface is a marvellous explanation of the homoeopathic technique. My respected teacher, the late Dr. L.D. Dhawale used to say that the preface alone is worth the price of the book. Construction of the book I shall now discuss the construction of the book, first by taking up the repertory section. Repertory section Whereas Kent's Repertory and almost all other general repertories start with the chapter on Mind, Boger starts with Modalities. This has much significance. In his method of repertory study, the modalities carry much more weight, more than the mental symptoms. A little thought will reveal that among all the symptoms given by the patient the modalities are generally specific and precise - e.g. when a patient says pressure aggravates the pain, this is generally a fact, not an opinion. If he says that he gets up with an asthmatic attack at a particular time, say 3 a.m. , this fact can be verified. But if he says he is suspicious or afraid or irritable, we have to make sure that this symptom is definitely there, that it is abnormal

enough to become a symptom, and that his circumstances do not justify such an attitude. Boger here follows Boenninghausen's method and gives more value to the modalities than to the mental symptoms. A proper evaluation of mental symptoms requires a very good idea of the background of the patient, as also a keen insight into human psychology. Mental symptoms are also more difficult to elicit. It is my practice to give much more importance to the modalities, on this hint given by Boger. In numerous cases I have worked out the remedy mainly, if not exclusively, through the modalities and I have been quite successful. Even among the modalities, Boger begins with the Time modalities and thus hints at their greater value. Among all the modalities the influence of Time on the symptom in question is the most peculiar and inexplicable. Therefore, Time can be taken as the most characteristic modality and given prime importance. For example, in cases of malaria the time of occurrence of the chill will be a good indication for the remedy. I have cured many cases with Chi-s because the chill occurred at 10 p.m. Aggravation of all the symptoms at night is a wellknown indication for Syph. The late Dr. S.S. Banker had reported a case of headache which he had cured with Tub-bov because the pain used to occur between 10 a.m. and 3 p.m. (See Synoptic Key p. 18). I recall a case cured by my friend Dr. Bhanu Desai with Thuja because the patient had an aggravation at 3 p.m. and 3 a.m. (vide p. 18 and 19). The rubric headings, it seems, have been carefully selected. Certain rubrics found in this book are not to be found in other common repertories. Examples are, "Associated effects" (p. 30), "Forced through narrow opening, as if" (p. 36), "Pompous" (p. 53), etc. Boger gives certain special rubrics like "Pregnancy" (p. 42), "Children" (p. 32), etc. Rubrics like "Breakfast agg." (p. 20), "Eating long after" (p. 22), "Dinner agg." (p. 22), etc., are not found in Kent. Other such rubrics are "Females agg." (i.e. remedies applicable more to females) (p. 22), Directions (of sensations, pains, spread of symptoms, etc.) (p. 34), "Here and there" (p. 38),"Ill or sick feeling" (p. 38), "Internal affections" (p. 39), "Irregular effects" (p. 39), "Loose, as if" (p. 39), "Lumpy effects" (p. 39), "Medicine, sensitive to" (p. 40), "Opening and shutting" (p. 41), "Reaction violent" (p. 42), "Rising, then falling sensation" (p. 43), "Sexual disturbances" (p. 44), "Short, as if too" (p. 44), "Stretch, impulse to" (p. 46), "Thick, discharges, etc." (p. 47), "Thinness, spare habit" (p. 47), "Valve" (p. 48), "Venosity" (p. 48), "Vibration" (p. 48), "Violent effects" (p. 48), "Walk, impulse to" (p. 48), "Well, unusually, then agg." (p. 48), "Absorbent action" (p. 355), "Acidosis" (p. 356), "Conical formations" (p. 367), and so on. In the repertory section, if we compare the rubrics with their corresponding rubrics in Kent's Repertory, we find that Boger has taken drugs from Kent's but he seems to have picked and chosen with some idea *. Often he takes all the bold type drugs, sometimes those in italics and sometimes the ones in ordinary type. From some rubrics he has left out drugs and is some he has added new ones. For example, in the Mind chapter, Kent has given two rubrics "Absent-minded" and "Abstracted" (p. 1). Under these two rubrics he has given the following drugs in bold type, viz., Apis, Can-i, Caust., Cham., Hell., Lach., Mez., Nat-m, Nux-v, Phos., Plat., Puls., Sep., Ver. Boger combines these two rubrics into one and gives the following remedies, viz., Aco., Ap., Asar., Caust., Cham., Laur., Old., Plat., Puls., Sep., Sulph., and adds Calc-p (pp. 49, 355). In the rubric "Activity, fruitless" (p. 356), he gives Ap., Bor., Calc-c, Stan., Ther., whereas Kent gives only Stan. Under the rubric "Wild feeling" (p. 95) Kent gives Bapt., Lil-t, and Med., while Boger gives (p. 54) Amb., Cimi., and Lil-t. Under the rubric"Sighing" (p. 80), Kent has given Arg-n, in ordinary type and Calc-p in bold. Boger (pp. 53, 422) omits Calcp, and takes Arg-n and adds Apoc. Under "Forsaken feeling" Kent (p. 49) gives Aur., Psor. and Puls. in big type and many others. But Boger does not mention them but gives (p. 51) Aur.,

Bar-c, Calc., Meny. and Plat. Similar comparisons between Boger's rubrics and Kent's corresponding rubrics will show that there are many changes and additions. For instance, under the rubric "Answers slowly", Kent (p. 3) gives Merc., Phos. and Phos-ac in bold type whereas Boger (pp. 49, 357) gives Bapt., Gels., and Hyo., remedies not included in Kent's Repertory, and omits Phos. Under the rubric "Descending agg." Boger adds Gels. and Phys. but gives Stan. in bold type (pp. 21, 371) while Kent (p. 1356) gives it in ordinary type. Kent does not give Cina and Nat-p under "Sweet agg." (p. 1364) which Boger does (pp. 23, 381). Under "Fasting agg.", Kent (p. 1361) does not give Bry. Under "Moonlight agg." Kent (p. 1374) gives only Ant-c, Bell., and Thu. But Boger adds Sep. and Sulph. (p. 25). Under "Old age" Boger (pp. 41, 410) gives additional remedies such as Chin., Gins., Hyds., Lach., Phos., Sanic., Sars., Syph., Tub., and Ver-a. Under "Cautious" (p. 50), Boger omits all the four remedies given by Kent, viz., Caust., Graph., Ip., Mag-arct (p. 10) and gives four other remedies, viz., Ign., Nux-v, Puls., Ver-a (p. 50). Under "Trifles seem important", Boger omits the two remedies given by Kent, viz., Fer., and Ip. (p. 89) and gives ten other remedies, viz., Ars., Calc-c, Caust., Graph., Hep., Ign., Nat-m, Nux-v, Sil., (p. 54). Sometimes, he has changed the grading of the drugs in Kent's rubrics. He joins together the rubrics like "Hurry" and "Impatient" (p. 51) because Impatience is an attitude and Hurry is the external physical expression of it (p. 54). Kent gives a rubric "Attitude bizarre" in the Mind chapter. Boger has transferred this to the Generalities chapter so that it becomes both a mental as well as a physical symptom. Dr. S.R. Phatak has described a case of abdominal pain in which the patient felt relief only by adopting a strange (bizarre) attitude, viz. by sitting with one leg extended and one leg flexed. The patient was relieved by Plb. Boger gives rubrics like "Walk, impulse to", "Walk, must", etc., which are not found in Kent's. "Active"; "Care and worry"; "Mean"; "Moral perversions"; "Noisy"; "Profanity"; "Praying"; "Sarcasm", etc. Under Generalities, we find the following extra rubrics: "Automatic acts"; "Chronicity"; "Deadness"; "Death, apparent"; "Delicate"; "Drugs, Abuse of" , etc. Boger has also generalised many rubrics. For example, Kent gives rubrics such as "Discharge, black"; "Skin, Discolouration, blackish" (p. 1305); "Skin, Ulcers, black" (p. 1333); "Skin Ulcers, discharges, blackish" (p. 1334); "Genitalia, Female, Menses, black" (p. 724), etc. whereas Boger gives them all in one rubric "Black" (p. 31). If a particular remedy does not have "Black" as a general but has it as a particular he gives it in the particular rubric. For example, we find under the rubric "Stool, black" (pp. 80, 427), Lept., Stram., and Thu. given. Remedies given under the rubric "Offensiveness" (p. 41) can be expected to have offensiveness in general including offensiveness of any discharge such as expectoration, leucorrhoea, menses, urine, sweat, etc. But if a patient has offensive stool or urine it is better to look also under the rubric "Stool, bad odour" (p. 80), "Urine odour foul" (p. 83), etc., for additional remedies covering this particular symptom. There is a rubric "Greasy, oily, fatty" (p. 37), which can apply to anything, e.g. the skin, any discharge, taste, etc. Boger, it seems, started transferring the rubrics from the repertory section in the beginning of his book to the section at the end (headed as "Supplementary reference table") changing from the traditional scheme of Mind, Head, Eyes, etc., to a logical alphabetical arrangement as is to be found in any dictionary. But as this transfer seems to be incomplete, readers should refer to both the sections for remedies. This letter alphabetical arrangement is probably a more convenient and logical one. This idea has been followed up and completed by Dr. S.R.

Phatak in his popular repertory, A Concise Alphabetical Repertory and I feel this kind of arrangement makes for more convenient reference. * The rubric headings given by Boger are chosen very carefully and have deep and wide meanings. For instance, the rubric "Ascending agg." includes remedies which are worse by ascending in the air as in flying, or ascending in a lift or ascending up the mountain or ascending up the stairs. The rubric "Abortion" gives not only all the remedies indicated in actual abortion but also those which cover the after-effects of abortion and tendency for habitual abortions. The rubric "Forced through a narrow opening, as if" can apply to such varied conditions as hernia, stricture, stenosis, feeling as if food is obstructed in the oesophagus, cardiospasm, proptosis, etc. Boger appreciated the fact that in modern times pathological and objective symptoms are more prominent and predominent, and that such symptoms are sometimes more reliable than symptoms given by the patient which may be in abundance and yet may not be entirely and clearly dependable or useful. He, therefore, gives a number of such objective and pathological symptoms, e.g. Calculi, atheroma, (p. 32), Fibrous tissue (p. 36), Streptococcus infection (p. 430), Uraemia (p. 439), etc. He has also given some peculiar rubrics, e.g. "Pus tubes". There is a rubric "Menses, alternate months agg.". I was able to cure with Bursa pastoris, a remedy given under this rubric, a lady who had profuse menses every alternate month. I could not find the rubric in Kent's Repertory. Recently, I myself developed a peculiar symptom, viz., whenever I talked I used to feel that I was talking through a tube. (My own voice sounded in my ears as if it was coming through a metallic tube.) I saw the rubric "Tube metallic" (p. 438) and found only Merc-c. This remedy removed the symptom. Materia medica section In the Materia Medica section, Boger gives under each remedy clearly the locations, sensations, modalities, mentals, generals and particulars. The locations are given at the top on the left-hand side and the modalities on the right side before the text of symptoms. The general symptoms and sensations are given in the first few lines and these are followed by a number of dots. Next he gives the mental symptoms and these are followed by the particular symptoms. In the particulars it is to be noted that only the peculiar symptoms are given. A reference to any remedy will show that the symptoms are selectively given. He also gives various pathological symptoms and objective data. In the Materia Medica section every full stop, comma and semicolon has a meaning. For instance, under Stan. he gives the symptom "Extreme weakness", which is a general and then he goes on after a semicolon to say "aggravated in chest", semicolon "in throat", comma "Upper arms and thighs", semicolon "drops into a chair", semicolon "trembling or moving". All these aspects are related and are descriptive of the weakness. The selection of words for the symptoms seems to have been done very carefully. On the whole, the essence of the drug picture will be found given very concisely. Generally, it will be found that what Kent describes in a paragraph, Boger condenses into one line, sometimes even one word. Boger seems even to have chosen the drugs listed in the book. For example, he has given the remedy Zinc chromatum with more than a dozen lines of symptoms whereas this remedy is not even found mentioned in Boericke's Materia Medica.

In the Materia Medica section, under each remedy the first one or two lines or sentences give a concise general summary or essence of the whole remedial action. For example, under Sepia he says, "Draggy, relaxed females - lithaemic, plethoric - subject to prolapses or easy dislocations". Dr. Phatak explains that the word "draggy" applies to many aspects of the Sepia patient - e.g. the organs drag down, the eyelids droop, the joint come loose, the disease drags on, etc. Under Ignatia he writes "Erratic, contradictory or spasmodic effects". Almost all the symptoms of Ignatia can be put under these headings. Under Lycopodium he mentions "Thin, withered and full of gas". Under Natrum mur., he opens with "Thin, thirsty, hopeless and poorly nourished". The case may be hopeless in the sense that the symptoms are contradictory or make no sense, e.g. chilly but agg. in sun; the patient may be hopeless or he or she may develop hopeless love for some married person or someone of greatly unequal rank. * The serious student who will think deeply will see a depth of meaning and application in these generalisations. Method of working with boger's book Though Kent's Repertory is so comprehensive, yet 80% to 90% of the same repertory work can be done efficiently with the repertory section of Boger's Synoptic Key, provided the person handling it knows how to manipulate it intelligently. It may be necessary to go into Kent's Repertory only for specific or special, particular symptoms. Of course, as I have said, much depends upon how well one has understood this book and how well he is able to use it. I have elaborately worked out cases using Kent's Repertory, with many rubrics, spending half to one hour for each case and have found to my surprise Dr. Phatak picking out the same remedy quickly in a few minutes with the help of Boger's book. * In working with Boger's Synoptic Key, we take the most prominent generals, mentals and particulars, particularly the outstanding, characteristic or peculiar ones. Even among these I generally select the peculiar general modalities first, then add the characteristic general sensations and lastly, the general locations. Later, I add the outstanding particulars. This will reduce the eligible drugs to a few. Out of these for the mentals and peculiar particulars, sometimes it may be necessary to refer to Kent's Repertory, as well. Later I look up the remedies in the Materia Medica to ensure that the matching of the drug and disease-pictures are total and comprehensive, and not merely repertorial and mechanical. In working with this book it is better to generalise the symptom. Supposing a patient has itching in one part, it is better to see itching in general. If he has any offensive discharge, e.g. stool, it is better to take the remedies with offensiveness in general along with the remedies given under offensive stool. One must look always first in the supplemental reference table at the end and add to it the remedies given under the same rubric in the repertory section at the beginning. I shall now work out a few cases as illustrations. Illustrative cases Hyperchlorhydria The patient Mr. K.A. L., aged 35 years, an engineer by profession came to me with the following complaint: In Jan. 1954, while in the U.S. A., he had started vomiting at night. He was hospitalised and investigated. B. meal X-rays showed N.A. D.; Gastric analysis revealed hyperchlorhydria. He was treated for this both in the U.S. A. and in England, but with little relief.

At the moment he had heaviness in the stomach, with a dull pain starting half an hour after food and lasting an hour; with the pain, he had a headache, and he became very irritable and impatient. The pain was agg. by heavy food and starchy food, spices, tea and exertion and was much relieved even by a very short nap. If the pain was very severe, he induced vomiting, which ameliorated. The vomit was extremely sour. The pain was also amel. by sweating and micturating. He preferred eggs, hot foods and drinks. Otherwise there was nothing worth reporting. The case was repertorized in Boger's Synoptic Key and the following rubrics were chosen from it. Sleep, amel. (p. 28) + Discharges, amel. (p. 21) = Ars., Nux-v, Puls., Sep., Zn. + Sourness (p. 45) = Nux-v, Puls., Sep. + Hurry, Impatience (p. 51) = Nux-v + Anger, Irritability (p. 49) = Nux-v The only remedy that came through was Nux-v. The whole case fitted in with Nux-v and so one dose of the remedy was prescribed in the 1M potency. There was an immediate and very gratifying response to the remedy, and the patient felt completely well in a week's time. However, there were slight relapses, and the remedy had to be repeated twice but with the last dose the whole condition cleared up completely. Allergy A baby, S., aged 10 months, was brought to me on 14th Sept. 1963 with the following history: One month back she had Bronchitis. She was given Teramycin and got rashes all over the body which persist. The rashes alternate with diarrhoea and cough. Now she has eruptions on chest, face and back from which a thin fluid exudes on scratching. Itching is agg. after taking milk. She passes urine 10 times at night. Prev. Hist.: She had measles at the age of 3 months and immediately after that she got rashes on the cheeks. This was treated with homoeopathic medicine. The rashes subsided and she got very severe diarrhoea and vomiting with dehydration and had to be put under allopathic treatment. She was given a lot of antibiotics, but without no effect. Then she was given Ver-a and the whole condition cleared up in 6 hours. Her case was repertorized using Boger's Synoptic Key as follows: Alternating effects, states, sides, etc. (p. 30) + Food and drink, milk agg. (p. 23) = Phos., Puls., Sulph. + Drugs, abuse of (p. 35) = Puls., Sulph. + Micturition, frequent (p. 82) = Sulph. Morbil. 200, 3 doses thrice in one day (to antidote the bad effects of measles) followed by Sulph. 6, 8 doses, twice daily given. 19.09.63 : Eruptions agg. ; Urine frequency less. No medicine. 24.09.63 : General condition amel.; Has 3 to 4 stools per day.

Sulph. 6, 3 doses thrice in one day given. She felt better but she had to be given Sulph. on and off as follows: Sulph. 6. on 01.10.63, 08.10.63 and 19.10.63; Sulph. 30, 1 dose on 26.10.63; Sulph. 200 on 07.11.63, 19.11.63 and 30.11.63; Sulph. 1M on 06.12.63. Then she needed the same remedy in 10M, 50M and CM potencies and long intervals. After the last dose of Sulph. CM she became quite well by 29.06.64. I last saw her in 1970 and she was thriving very well. Sulphur Shri K.R. M., aged 29 years, consulted me on 27th July, 1963 for the following complaints. He gets pain in left lumbar region since 22.06.63 which is agg. while sitting, agg. while standing, agg. lying on left side and agg. when hungry. It is amel. by lying down, specially with legs flexed and amel. by applying heat. It extends to the umbilical region or right lumbar region. Appetite, etc., are normal. No definite diagnosis was made. The case was repertorized using Boger's Synoptic Key. Position, sitting, agg. (p. 26)) + Position, standing, agg. (p. 27) = Cycl., Puls., Rhus-t, Sep., Sulph., Val. + Bending or doubling up, amel. (p. 19) = Puls., Rhus-t, Sep., Sulph. + Eating before, agg. (p. 22) = Sulph. Sulph. 30 was given. He felt better after that but there was a relapse and so Sulph. 200, 3 doses were given in one day, 10.08.63. There was pain again and so three doses of Sulph. 1M were given thrice in one day followed by placebo. The doses of Sulph. 1M had to be repeated on 22.08.63 and 12.09.63 but thereafter, the pain ceased completely and he remained well. Staphysagria Shri N.S. P., aged 30 years, consulted me on 10th July 1959 for the following: 10 years back he had red patches on body and he consulted a doctor who diagnosed it wrongly as leprosy. Later on he was examined in the leprosy hospital and the possibility of the disease was excluded. He was hypersexual but was getting quick ejaculation. His wife had an aversion for sex, so she went away to her parents, and later committed suicide. This gave him a shock and he also felt ashamed. Later on he developed a syphilitic ulcer which was treated with allopathic medicines. Now his body remains cold; he gets tingling in extremities. Feels numbness and weakness in left leg. Feels as if bitten by mosquitoes and bugs. Gets burning, stitching, stinging, etc., in the penis which spreads all over the body. Has great sexual desire but has to suppress it. Gets throbbing in different places, here and there. Is sensitive to both heat and cold. The skin of soles is thickened and gets cracked. Is very irritable and abusive; fights with and insults his superiors. Cannot bear insults. Is fearsome; fears he may be knocked down by a cycle. Gets startled by noises. Feels lonely. Has poor memory. Shivers during micturition and stool.

His case was repertorized in Boger's Synoptic Key as follows: Here and there (p. 38) + Male organs (p. 84) = Aur., Graph., Lyc., Rhust-t, Staph., Sulph., Thu. + Anger (i.e. Quarrelsome) (p. 49) = Aur., Lyc., Staph., Sulph. Considering that there was sexual excitement with suppressed sex desire, h/o grief, quarrelsomeness, oversensitiveness, etc., I selected Staph. out of these remedies, and gave Staph. 1M, 3 doses in one day and placebo. 16.09.59 : Reported that his condition was much better for 2 months. Most of his complaints subsided completely and remained that way. But for the last fortnight or so, he feels the recurrence of symptoms. Staph. 10M, 3 doses thrice in one day was given, followed by placebo. The patient reported some time later that he was feeling completely well. Sepia Mr. A.S. , aged 24 years, saw me on 13th July 1965 for the following complaints: He has recurrent shooting pains in the abdomen for the last 21/2 years. He is not sure whether it started due to lifting a weight or going in the sun. Pain appears suddenly and disappears just as suddenly and is agg. by over-eating, fried food and while walking after food. It is amel. by lying on abdomen or on left side and amel. by pressure. Pain precedes every stool. He also gets stitching pain in left abdomen. Takes 4 to 5 glasses of water a day. Has poor sleep. On exam., there is tenderness in epigastric region on deep palpation and tremor of tongue. No diagnosis could be made. The case was repertorized in Boger's Synoptic Key and Kent's Repertory as follows: Shooting pains (B.S. K. p. 44) + Lying on abdomen, amel. (B.S. K. p. 23) = Bell., Colo., Nit-ac, Sep. + Food, fat agg. (p. 1363) = Bell., Nit-ac, Sep. + Eating to satiety agg. (K.p. 1357) = Sep. Sep. 200, 6 doses thrice a day and placebo given. There was immediate relief followed by further improvement but this was punctuated by interruptions and the medicine had to be repeated as follows: Sep. 200 on 20.07.65; Sep. 1M on 27.07.65, 03.08.65, 10.08.65, 18.08.65; Sep. 10M on 08.09.65, 16.09.65 and 07.10.65. By 28.04.66, the patient was completely well without medicine for over six months. Calcarea carbonica Mrs. H.V. S., aged 28 years, consulted me on 26th July 1961, with the following history: She has itching eruptions in the right cubital fossa and left popliteal fossa, and groins for last four years. It is agg. before menses. She has scanty menses. Gets recurrent headaches which are also agg. before menses. Prefers warm drink. Has aversion to milk. Gets cramps in calves at night. Her nose gets blocked often at night. Gets sudden attack of chill at night. Prev. Hist.: Tonsillectomy done.

Her case was repertorized using Boger's Synoptic Key and Kent's Repertory as follows: Menses, before, agg. (B.S. K. p. 25) + Skin, folds, flexures, etc. (B.S. K. p. 100) = Calc-c, Lyc., Nat-m, Puls., Sulph. + Side, crosswise, left lower and right upper (K.p. 1400) = Calc., Lyc. Calc-c 30, 3 doses t.d. s. and placebo given. 11.08.61 : Headaches, cramps, blocking of nostrils, etc. amel. but skin condition agg.. Placebo. 15.08.61 : Skin amel.. Itching amel.: Placebo. 29.08.61 : Condition amel. but some eruptions are still there. Calc-c VI (i.e. 6th potency of 50 millesimal scale), 1 dose. 26.09.61 : Was practically normal. Now slight relapse. Medicine repeated. 08.08.63 : Condition has been completely normal. Gets itching if emotionally upset. Calc-c XXX (i.e. 30th potency of 50 millesimal scale), 2 doses b.d. and placebo given. The itching subsided, she became well. I was once called to see a child, Baba U., aged about 11 months. He had developed itching eruptions all over the body. The father was very well-to-do and was impatient that his son should be cured quickly. The symptoms of the child besides the eruptions, were that he was obese and had whitish stools. And the most peculiar symptom was that though he might be lively and playful the whole day, as soon as he started feeling sleepy he would scream his head off. I looked into Boger's book and took the following rubrics. Sleep before, agg. (p. 28) + Stool white (p. 81) = Ars., Calc-c, Merc.,

Phos.

+ Children (p. 32) = Calc-c, Merc. + Obesity (p. 41) = Cal-c Calc-c 1M gave immediate relief though he had relapses after some time and I had to give the medicine repeatedly at intervals and I had to go up to Calc-c DMM to cure him completely. Peptic ulcer Shri E.N. S., aged 39 years, came for consultation on 14.02.63 for a pain in the epigastrium of two years' duration. The pain was agg. when hungry, amel. after eating, amel. by eructations, amel. by pressure and amel. by bending forward. An X-ray which had been taken on 23.03.61 showed "chronic duodenal ulcer". No other symptoms of value could be elicited. The case was repertorized using Boger's Synoptic Key with the following symptoms: Eating amel. (p. 22) = Con., Ign., Nat-c + Pressure amel. (pp. 27, 414) = Plb., Sep.

+ Bending or doubling up amel. (p. 19) = Sep. Sep. 200, 3 doses in one day, the remedy selected was followed by placebo. The patient started improving and was given Sepia in higher and higher potencies going upto 50M. But by 11.06.63, he stopped responding to this remedy. He was then given Dys. co. 12 again without improvement. Ultimately, on 25.12.63, as there was no further improvement, Dr. S.R. Phatak was consulted. He prescribed Kali-bi on which patient felt much better and the improvement persisted for about 3 months. Then, on 23.03.63, Dr. Phatak prescribed Sep. 200, and with this he was completely relieved of the pain by 13.04.63 and later, was cured of the ulcer, as shown by a subsequent X-ray. Pericarditis A female patient H.S. , aged 27 was admitted to the hospital on 22.04.59 with a history of pain in the left chest and pyrexia of four days' duration. On admission, her temperature was 99 oF; respiration 30 per minute and pulse 120 per minute. The pain was stitching, stabbing and cutting in nature, was worse from 1 p.m. to 4 p.m. and from coughing, and was accompanied by profuse perspiration. It was relieved by warm applications. She could not lie on her left side. There was dullness of the left base with diminution of breath sounds. A provisional diagnosis of pleurisy with effusion was made. The report of the X-ray taken later read as follows: "Huge dilatation of the heart; pericarditis with effusion; also pleural effusion left base and thickened pleura, left upper zone; congestive cardiac failure." The blood, urine and stool reports showed N.A. D. The remedy Kali-c was found to cover the following symptoms in Boger's Synoptic Key : 1. Morning and evening agg. (p. 17) 2. Stitches (p. 45) 3. Cough, painful (p. 63) 4. Dropsy (p. 89) 5. Cutting (p. 68) 6. Sweat, in general, easy tendency (p. 104) A reference to the Materia Medica portion (p. 224) showed that the drug also covered the symptoms, "Worse lying on painful side" and "Better warmth". So she was given Kali-c 200, 6 hourly. There was an immediate improvement which continued steadily. On the fourth day, the dosage was reduced to thrice a day and later to twice a day. The temperature rose and fell intermittently upto until 01.05.59 and then came down and stayed normal. Her pain lessened and disappeared. On the fourth day after admission, she was able to lie on the left side with comfort. The second X-ray taken on 15.05.59 showed, "Heart size markedly diminished; slight pleural effusion still present". The patient was discharged a week later and has remained well.

Comment: The aggravation time of the pains in this case was 1 p.m. to 4 p.m. instead of the usual 2 to 4 a.m. of Kali-c. Such twelve hourly reversibility (day instead of night and vice versa) of time modalities is met with in the homoeopathic Materia Medica. An Ars. patient may be worse at 1 or 2 p.m. instead of 1 or 2 a.m. , Thuja at 3 a.m. or 3 p.m. , Chel. and Lyc. at 4 a.m. or 4 p.m. , China at 5 a.m. or 5 p.m. , Nux-v at 6 a.m. or 6 p.m. , Sepia at 7 a.m. or 7 p.m. and so on. William Boericke in his Materia Medica writes that Kali salts should not be administered in fever cases. I have used Kali salts in febrile cases many times with success. Arthritis Shri K.V. V., aged 50 years, came for consultation on 28th Sept. 1959 with the following history: 11/2 years back, he, one day, experienced acute pain in the right sacro-iliac when he got up from washing clothes. Later on, more joints were affected. He took Irgapyrin, Cortisone etc. with no effect. Now, he has pain in all joints. Pain is amel. by taking rest but after some time he likes a change of position. The pain generally shifts from side to side and from joint to joint. The left shoulder and right knee are affected more. The pain is agg. beginning motion agg. standing and is amel. by continued motion, amel. by walking. In the past, he had suffered from pneumonia in childhood, malaria and pleurisy at the age of 23 and rheumatism of knees and ankles in 1942. He has no worries, and is quite happy. Fam. Hist.: nothing particular. The case was repertorized using Boger's Synoptic Key as follows: Motion, beginning, agg. (p. 26) + Position, standing, agg. (p. 27) = Con., Puls., Rhust-t, Sel. + Wandering, shifting, pains (pp. 48, 434) = Puls., Rhust-t + Alternating effects, states, sides, etc. (p. 30) = Puls. Puls. 30, 1 dose was given. There was no improvement and so he was given Puls. 200. After this prescription, he started feeling better. Later on, he was given Puls. 200 again, then Puls. 1M and Puls. VI (i.e. 6th potency of LM scale) and then the XXX. There was very remarkable improvement but on 09.08.60, he reported that pain is better but is agg. by continued motion and that he feels better by taking rest. Silicea 30, 8 doses were given, twice a day. He now improved steadily and recovered completely. Shri K.V. V., aged 50 years, came for consultation on 28th Sept. 1959 with the following history: 11/2 years back, he, one day, experienced acute pain in the right sacro-iliac when he got up from washing clothes. Later on, more joints were affected. He took Irgapyrin, Cortisone etc. with no effect. Now, he has pain in all joints. Pain is amel. by taking rest but after some time he likes a change of position. The pain generally shifts from side to side and from joint to joint. The left shoulder and right knee are affected more. The pain is agg. beginning motion agg. standing and is amel. by continued motion, amel. by walking. In the past, he had suffered from

pneumonia in childhood, malaria and pleurisy at the age of 23 and rheumatism of knees and ankles in 1942. He has no worries, and is quite happy. Fam. Hist.: nothing particular. The case was repertorized using Boger's Synoptic Key as follows: Motion, beginning, agg. (p. 26) + Position, standing, agg. (p. 27) = Con., Puls., Rhust-t, Sel. + Wandering, shifting, pains (pp. 48, 434) = Puls., Rhust-t + Alternating effects, states, sides, etc. (p. 30) = Puls. Puls. 30, 1 dose was given. There was no improvement and so he was given Puls. 200. After this prescription, he started feeling better. Later on, he was given Puls. 200 again, then Puls. 1M and Puls. VI (i.e. 6th potency of LM scale) and then the XXX. There was very remarkable improvement but on 09.08.60, he reported that pain is better but is agg. by continued motion and that he feels better by taking rest. Silicea 30, 8 doses were given, twice a day. He now improved steadily and recovered completely. Hernia Master N.V. , aged 14 years, was brought to me for consultation on 19th Dec. 1959 with the following history: He had hurt himself in left inguinal region 2 months back and then has developed hernia since. He feels pain around the umbilicus and in the left inguinal region. It is agg. after 3 a.m. agg. in morning agg. beginning motion and is amel. by lying on his back. He had had a hernia on the right side which had been operated 10 years back. His case was repertorized using Boger's Synoptic Key as follows: Protrusion (p. 42) + Side, right to left (p. 44) = Aco., Bell., Lyc., Sul-ac + Motion, beginning agg. (p. 26) = Lyc. Lyc. 200, 3 doses, thrice in one day given. 26.12.59 : Pain was better only for a day. Now pain is agg. by sitting with legs hanging down, agg. 3 a.m. to 6 a.m. and agg. beginning motion. He now says he is actually amel. by lying on abdomen. The case was re-repertorized using Boger's Synoptic Key as follows: Side, right to left (p. 44) Motion, beginning, agg. (p. 26) = Amb., Lyc., Phos. + Lying on abdomen, amel. (p. 24) = Phos. Phos. 200, 3 doses thrice in one day given. 02.01.60 : Pain is better but swelling is same. Placebo. 05.01.60 : Pain was much better but yesterday he got severe pain. Phos. VI (i.e. 6th potency of 50 millesimal scale) two doses, twice in one day and placebo given. 13.01.60 : Feels 75% better; it does not descend now. Placebo. 29.01.60 : Condition is much better; Hernia descends sometimes in the morning. Placebo. 05.02.60 : No impulse on coughing but still the region is sore agg. manipulation. Placebo.

12.02.60 : Pain has relapsed. Phos. VI, 2 doses in one day and placebo. 11.03.60 : Condition is better but a bulging can be seen on coughing. I now decided to antidote the old injury. Arnica 200, 7 doses given to be taken daily once. 11.10.62 : He has remained well. Master N.V. , aged 14 years, was brought to me for consultation on 19th Dec. 1959 with the following history: He had hurt himself in left inguinal region 2 months back and then has developed hernia since. He feels pain around the umbilicus and in the left inguinal region. It is agg. after 3 a.m. agg. in morning agg. beginning motion and is amel. by lying on his back. He had had a hernia on the right side which had been operated 10 years back. His case was repertorized using Boger's Synoptic Key as follows: Protrusion (p. 42) + Side, right to left (p. 44) = Aco., Bell., Lyc., Sul-ac + Motion, beginning agg. (p. 26) = Lyc. Lyc. 200, 3 doses, thrice in one day given. 26.12.59 : Pain was better only for a day. Now pain is agg. by sitting with legs hanging down, agg. 3 a.m. to 6 a.m. and agg. beginning motion. He now says he is actually amel. by lying on abdomen. The case was re-repertorized using Boger's Synoptic Key as follows: Side, right to left (p. 44) Motion, beginning, agg. (p. 26) = Amb., Lyc., Phos. + Lying on abdomen, amel. (p. 24) = Phos. Phos. 200, 3 doses thrice in one day given. 02.01.60 : Pain is better but swelling is same. Placebo. 05.01.60 : Pain was much better but yesterday he got severe pain. Phos. VI (i.e. 6th potency of 50 millesimal scale) two doses, twice in one day and placebo given. 13.01.60 : Feels 75% better; it does not descend now. Placebo. 29.01.60 : Condition is much better; Hernia descends sometimes in the morning. Placebo. 05.02.60 : No impulse on coughing but still the region is sore agg. manipulation. Placebo. 12.02.60 : Pain has relapsed. Phos. VI, 2 doses in one day and placebo. 11.03.60 : Condition is better but a bulging can be seen on coughing. I now decided to antidote the old injury. Arnica 200, 7 doses given to be taken daily once. 11.10.62 : He has remained well. Opium I was once called to see an infant, aged 14 days, who was in a cold, cyanosed and collapsed state. The child had developed, soon after birth, rattling respiration and a little cyanosis. A child specialist and later an eminent cardiologist had seen and diagnosed it as a case of Fallot's tetralogy which is a congenital malformation in the heart and they had said that nothing could be done. So the child was discharged home from the nursing home. When I saw

the child she was practically in a moribund state. She had very loud rattling respiration which could be heard upto a distance of 20 ft. away. She was cyanosed and unconscious and I was told that she had passed no stool for the last eight days. When I turned the child over to the side in order to auscultate the back, I found that the rattling suddenly ceased and when the child was again laid on the back, the loud rattling started again. I took the rubrics "Rattling" (pp. 42, 415) "Agg. Lying on back" (p. 25, 401) and "Bluish" (pp. 31, 361) all in Boger's Synoptic Key. The three drugs that came through were Cup., Op., Sulph. Out of these, I preferred Opium because of the prolonged constipation. You can imagine my surprise and happiness when after one dose of Opium 30, within ten minutes the blueness entirely disappeared, the face became slowly red, rattling lessened and the child became conscious! The child improved and became well and went on very happily, but used to get attacks of cyanosis on exertion which always responded to Opium. I had repeatedly advised them to get the child operated but they repeatedly postponed it. Ultimately one day while sitting on the mother's lap, she laughed loudly and died. Lachesis Mrs. N.V. S., aged 34 years, came for consultation on 10th April 1963 with following history: She has got itching around the neck for last 7 years. She has consulted several skin specialists. Dr. R., a dermatologist, diagnosed it as allergy and advised her to take some ayurvedic or homoeopathic medicine. She had no improvement with ayurvedic treatment for 2 years. Then she consulted Dr. M., a homoeopath, who treated her for 2 years without any relief. It is agg. in winter agg. at night. It is agg. before and during menses. She has itching in folds and flexures. Her skin becomes black, gets cracked and bleeds in winter. She desires cold food. She used to get diarrhoea on eating leafy vegetables and before menses. She is sleepless at night due to itching. She does not feel fresh in morning. Her menses are black and clotted. She is agg. in sun. Cold bathing gives her a kind of shock. She is very loquacious. She had become very suspicious, irritable and abusive especially towards her husband from 1946 to 1956. It is so even now. She feels guilty because she went through a D and C operation to induce abortion in 1954. Since then she has palpitation agg. noise. Her teeth are black and carious. She feels some sensation in nape on falling to sleep. She has one child who was born defective. Her case was repertorized using Kent's Repertory as follows: Mind, Suspicious (p. 85) + skin, discolouration blackish (p. 1305) = Acon., Ant-c, Ars., Aur., Crot-h, Lach., Nit-ac, Plb., Sec. + Mind, Loquacity (p .63) = Acon., Ars., Aur., Crot-h, Lach., Plb., Sec. + Menses, black (p. 724) = Lach., Sec. + Menses, before (p. 1373) = Lach. Lach. 30, 3 doses thrice a day and placebo given. 19.04.63 : Feels much worse, may be because her menstrual period is due. Placebo given. 26.04.63 : There was an aggravation for 8 days and then her itching is better. Her menses were scanty, not black, sensation in nape on falling asleep stopped. Irritability is better. Now cold baths do not aggravate her. Placebo given.

06.05.63 : Feels better. Itching continues but is less, otherwise she is much better. Lach. 30 was given on 4th and 5th, Lach. 200, 1 dose and placebo given. 16.05.63 : Finds much improvement but noise causes palpitation and vertigo. Skin condition is much better. Passes stool consisting of undigested food; gets frequent urging for stool and urine, placebo and Lach. 200, 1 dose in case of necessity given. 31.05.63 : Finds great improvement. Palpitation and vertigo nil. Frequent urging for stool and urine nil. Skin condition is much better. Now perspiration has appeared in neck region, which had disappeared. The same case can be worked out using Boger's Synoptic Key as follows: Menses, before agg. (Itching, diarrhoea, etc.) (p. 25) + Black dark, etc. (Teeth, menses, skin, etc.) (pp. 31, 360) = Lach., Ver. + Suspicious (pp. 53, 430) = Lach. + Loquacity (pp. 52 , 400) = Lach. Anacardium A recent experience of mine is worth recording. Some days back I suddenly developed a severe itching sensation in the right palm due to some allergy. The itching came on one night at 12.45, waking me from my sleep. I scratched my palm for half an hour and then went back to sleep. The next day the itching occurred in the palm of the left hand also. By evening I felt some crawling sensation on my chin and when I rubbed my chin gently, I got a number of eruptions on the chin. Later on similar small eruptions followed on the upper lip after gently stroking that part and then they occurred on my forehead. I felt heat on the face and wanted to apply cold water. The eruptions felt very sore to touch and also present was burning as is found in summer eruptions. That night again I had severe itching in both the palms around 2 a.m. I looked in the book and took Rhus-t which gave no relief. I then took Mez. because the eruptions had followed the itching but with no result. But I noted that the itching in the palms was much relieved if I placed my hands in very hot water so that they were nearly scalded. I then consulted Dr. Phatak who prescribed Sepia because one part of the body (palm) was better by heat and another (face) by cold and because the symptoms had gone up (palms, chin, lip, forehead). I felt slightly better with Sepia which relief, however, did not last. The next night I got severe itching at 3.30 a.m. and again in the afternoon at 3.15 p.m. I used to rub my palms together till they became very hot and then there would be slight relief. But I also noticed that if I scratched the palms the itching would increase. The itching became so bad that I was scratching myself in front of my patients and even in front of my students. I consulted Dr. Phatak again and he prescribed for me Anac. on the symptoms "Palms itch" (p. 411) and "Hot applications amel." (p. 24) both from Boger's Synoptic Key. I took Anac. 200, one or two doses and got 75% relief. With two more doses I became completely well. The case presents some interesting points: 1. I have mentioned that the itching had gone from the right palm to the left palm. Neither Kent nor Boger in their repertories have given Anac. under the rubric "Right to left". But when we look into Allen's Keynotes he says that Anac. symptoms go from right to left like Lyc.

2. Even though the remedy comes out in the repertory section of Boger's Synoptic Key, it does not come out in Kent's Repertory, though Kent gives Anac. under the rubric "Itching palm, night" (p. 1023) and "Skin Itching, scratching agg." (p. 1328). 3. In my case, the symptom (itching) extended upwards though under "Direction, Ascending" in Boger's Synoptic Key, (pp. 34, 371) Anac. is not given. The pocket repertory The pocket repertory went through five editions with reprints and served - as the original subtitle indicated - also as index to the card repertory. Though the title may seem inappropriate here, it has been retained to indicate the conciseness and sphere of utility of the repertory. - Editor Introduction In these modern times when speed has become an essential attribute of life, it becomes necessary for medical men also to keep pace with this increasing tempo. In this respect, the homoeopathic practitioner is somewhat handicapped, for the selection of the homoeopathic remedy is often an arduous and time-consuming process. Therefore, the busy practitioner would welcome any means which might help to save his time and energy expended in this selection. The card repertories hold out such a promise and so no apology is needed for adding the present Card Repertory * to those which already occupy the field. Construction This Card Repertory consists of 420 (four hundred and twenty) cards **, on each of which a different symptom is printed. Each card carries the abbreviated names of 292 (two hundred and ninety-two) homoeopathic remedies, which cover the majority of the cases met with in ordinary practice. *** In each card, punches are made below those drugs which cover the symptom printed in the top left-hand corner of that particular card. Method When working out a case, the characteristic symptoms of the case are selected, the corresponding rubrics chosen with the help of the Index to this Card Repertory, (The Pocket Repertory), which is provided, and the cards representing these rubrics are picked out and put together. When the cards thus selected are put in apposition, only those drugs which cover all the symptoms chosen will be found to show through in the Punched holes. It is usually from among this particular group that the prescriber finds he has to choose the appropriate remedy after consulting the Materia Medica and the bigger repertories for the finer symptoms not covered by this Repertory. Advantages There is no doubt that the card repertory is a very great help to the busy homoeopath. It serves as a most useful instrument to conserve his valuable time and energy by cutting down the laborious task of referring to the big repertories and by reducing the amount of paper work usually done on cases. As the prescriber gains a fuller knowledge of its applications and limitations and as he gathers more experience of its construction and usage, he is able to manipulate the card repertory to his complete advantage and satisfaction. Used not to replace more traditional and exhaustive methods of repertorizing but to circumvent the preliminary

work and to quickly pinpoint the probable remedy or group of remedies, its scope and value cannot be underestimated. This Card Repertory incorporates many improvements over the other ones. There are more remedies and more comprehensive rubrics, the remedies are better represented, and the index provides numerous cross references, so that the prescriber is generally guided to the proper rubric and the proper remedy. Limitations A word of caution, however, is worth uttering. It is impossible to depict the complete characteristics of each drug by means of a few symptom-cards. Hence, after arriving at a particular group of drugs by a process of elimination through the cards, the wise prescriber would always choose the indicated drug (the similimum) after a reference to detailed repertories, Materia Medica or records of provers, to satisfy himself that the matching indicated by the cards is real and not superficial. It is obvious that if the handling of the card repertory is to be rendered convenient, it should deal only with a limited number of remedies, and so it may happen that in some cases the exact remedy for the patient is one not included in this card repertory. In such cases the prescriber must select from without. For the same reason, viz., to avoid making the card repertory unwieldy, the number of rubrics are limited. This limitation has, however, been offset by combining several similar symptoms into general symptom groups. The aim has been to achieve a broader basing rather than fineness or particularness. As such, the prescriber seeking remedies for finer or more particular symptoms, should also refer to the bigger repertories. Some aspects Some aspects of the selection of similimum through the card repertory and Pocket Repertory need emphasizing. The prescriber, before repertorizing, would do well to make sure that the case has been well taken, that all the facts have been completely and accurately recorded, that the symptoms so recorded form a part of the disease picture and that they are sufficiently marked in intensity. Otherwise, any defects in the case recording will be transferred to the repertorization and the results vitiated. A proper analysis and evaluation of the symptoms are also essential before any repertorization is attempted; the more general the symptoms taken, the better the chances of getting at the proper remedy. Among all the symptoms, the peculiar or characteristic symptoms out-rank all the other symptoms; the more peculiar the symptom, i. e. the more remote and unrelated the symptom is to the case and the more inexplicable it is especially from the point of view of pathology, the higher its merit. Where definitely available, the causation (emotional, physical, chemical, mechanical, etc.) or origin of the disorder is taken to be of importance. Next in order come the general and the mental symptoms. A general symptom refers to the person as a whole or to a particular sensation or modality referable to different parts of the body. The mental symptoms are important and rank very high if they are marked and strange. Changes of the will and emotion come first, then the intellect and lastly the memory. Among the components of the symptoms, the modality is of a higher rank than the sensation and the sensation ranks higher than the location. Modalities include the reaction of the patient or his parts to various influences such as weather, temperature, air, motion, position,

pressure, food and drink, company, etc. Sensations include all symptoms, felt or observed locally or generally, such as burning, discolouration, swelling, etc. The particular symptoms are important to the extent they are peculiar. Among the particulars, the desires and aversions of the patient and in women symptoms of the menstrual states have some precedence and rank with the generals. A remedy which covers the outstanding characteristic features of a case, however few they may be in number, is more likely to be the similimum than the remedy which merely covers numerous common symptoms. In choosing the cards or rubrics with headings corresponding to the symptoms or in translating the symptoms into the language of the cards, a high degree of both care and imagination are generally called for. The rubrics on the cards are so worded as to include a variety of conditions, and to allow of a wide interpretation. For example: The rubric "Abortion" would include remedies which are indicated not only during abortions and miscarriages, but also those which cover habitual abortions as well as disorders originating from abortions. "Ascending, Agg." incorporates remedies which have aggravation from ascending the stairs, ascending in a lift, going up a mountain or in the air. The rubric "Coordination disturbed" would cover a wide range of effects such as ataxia, stammering, strabismus, etc. The rubric "Discharges, Amel." would include remedies which have relief from any kind of discharge whatsoever (physiological or pathological) such as eructations, expectoration, vomit, flatus, stool, urine, sweat, etc. The rubric "Old age, Senility" lists not only the drugs specially applicable in the field of geriatrics but also the drugs which cover premature senility, senile appearance, etc. Below many rubrics, references are given to allied or somewhat similar rubrics under the heading "Comp." (Compare). For the beginner In choosing the cards for repertorization, the beginner should always consult the Index first. This point cannot be over-emphasized. In repertorizing a case with the cards, it would be a good policy to take first the card representing the most important characteristic symptom of the case under consideration and then add one by one other cards representing the other symptoms in the descending order of their importance, until a few remedies alone are found to show through covering all the symptoms taken. No more cards are then to be added but further elimination of the remedies is to be done by reference to the exhaustive repertories and the Materia Medica. To some extent, the grading of the drugs indicated in the Index (The Pocket Repertory) by the use of different types may also help in deciding. The grading is given as follows: 1st grade CAPITAL e.g. ACO. 2nd grade Bold e.g. Aco. 3rd grade Ordinary e.g. Aco.

Note When a well-represented polycrest remedy, e.g. Merc-s, emerges after repertorization, it would be worthwhile considering if any less represented satellite remedy (e.g. Merc-c, Mercd,) is possibly indicated instead. In depicting the symptoms, technical terms such as asthenia bradycardia, insomnia, pyrexia, etc., have been avoided in favour of such terms as weakness, slow pulse, sleeplessness, fever, etc. as the homoeopathic Materia Medica and repertories are constructed in the language of the provers which is generally non-technical. Illustrations The following cases worked out with the help of this repertory may serve to illustrate the method: Case no. 1 Mrs. S. S. Age: 27 Yrs. Date: 9th June 1953. Present History : In October 1952, one day she had sudden pain in both the iliac regions; she was hospitalized and given penicillin, but a dull stitching pain in the regions continued for two months and then subsided. It recurred in April 1953 and has persisted ever since. At present : There is intermittent pain - as if sprained - located in the left ovarian region, occurring frequently, almost every day the pain travels to the lateral three toes of the left foot and here there is relief by applying pressure on the calf and by pulling the toes. Appetite, thirst, stool, urine, sweat, etc., normal. Is very sleepy in the afternoons. Menses: The discharge is profuse and continues for fifteen days. Has leucorrhoea which has set in along with the chief complaint. Nowadays she feels chilly and is unable to bear the cold. Gets stomatitis before the periods. She is very irritable before the periods. She gets pains and sprains in various parts of the body but they are invariably located on the left side. Physical exam : Tenderness in left iliac region on deep palpation. Weight. : 110 lbs. B.P. 130/85. Previous History : Malaria in 1931. Abortion in 1941 Family History : Father living: 68; healthy. Mother living: 60; healthy. One sister suffered from Tuberculosis of the hip-joint and recovered. Patient married in 1936: has two daughters: one had rheumatic fever.

Clinical Diagnosis : Chronic Oopheritis. The symptoms that characterized the case were: The agg. before the periods (irritability, stomatitis) - a general modality. The feeling of chilliness - a general sensation. The frequent sprains in different parts of the body - a general sensation. The left-sided nature of the complaints (pains, sprains, etc.) - a general location. The following cards representing these symptoms were chosen and put together. Card No. 200 Menses, before, agg. Card No. 43 Chilly, cold. Card No. 320 Sprained, Dislocated, overlifting, etc., As if and agg. from. Card No. 298 Side, left. Three drugs Phos., Sep., and Sulph., are seen to cover these symptoms. Out of these, only the drug Sepia is found under all the following rubrics in Kent's Repertoty (5th edition). Irritability, menses, before (p. 59) Pain, stitching, ovaries (p. 742) Abdomen, pain, extending to lower limbs (p. 562) Sleepiness, afternoon (p. 1249) Consultation with the Materia Medica also confirmed the choice and so the prescription made was: 10th June 1963, Sep. 30, 1 dose. There was an immediate improvement in her condition. Her menstrual period started on the 14th and ended by the 21st, with the discharge being less profuse. The pain in the ovarian region recurred only once after the prescription. The leucorrhoea ceased on the 16th. She received no more medicine and was completely normal by the 10th July 1953 and has remained well now for over ten years. Case no. 2 Name: K. B. Age: 60 years. Sex. F. Date of first observation: 12th March 1954. Present Complaint : Has a pain in the left knee joint for the last 20 years. Sometimes the right knee is also affected, cannot stand or walk.

She also has pains all over the body in various places esp. in the muscles and joints; and the pains generally shift from place to place; they are aching in character and are agg. by cold breeze and cold baths and amel. by warm applications. Vertigo in the morning. Oedema of both legs for the last 5 years, with pulling pain in the shins and knees, agg. in evening. Milk causes diarrhea. Previous History : Menopause at the age of 40 since which date all her troubles have started. Family History : Nothing particular. The symptoms were evaluated and the case repertorized as follows: The origin of her complaints from the menopause was given the highest importance, and the first card chosen was Card No. 44 Climaxis Agg. The peculiar shifting nature of the pains was considered next and the corresponding card taken: Card No. 379 Wandering, changeful, shifting, pains. The aching nature of the pains being a general sensation came next and the card taken. Card No. 4 Aching. The only drug to come through covering these symptoms was Cimicifuga. This drug further covered the pains in the joints, the cramps in the muscles, and the agg. by cold, and seemed to fit the personality of the case. So she was given on 13.03.54, Cimi. 200, 1 dose. There was a very good response and she felt considerably better in a week's time. The pains, vertigo, oedema, etc., decreased and disappeared. There were relapses and the drug had to be repeated thrice, the last time in the 1M potency on 11.10.54 but since then she remains well till today (01.09.65). Case no. 3 Mr. S. R. Age: 40 years. Date of observation: 10th December 1953. Present History : For the past two or three months, he feels weak and sluggish and whenever he is tired he has a sensation of great weakness and emptiness in the whole chest, while the back feels as if stuffed up. He has a burning sensation in the back, between the shoulderblades daily lasting from 1-30 or 2 p.m. till 7 or 8 p.m. which is agg. while sitting; amel. on lying down and amel. after sleep. His weakness is agg. while sitting, amel. on lying down and agg. when starting to move. In cold weather, he gets pains in various parts of the chest and the back. He has frequent involuntary seminal emissions, esp. during afternoon naps. Physical Exam. : N. A. D.

Wt.: 97 lbs. B. P.: 100/70. Family History : Father died at 65 of diabetes. Mother is 65 and healthy. He is married and has three children all healthy. In repertorizing this case, the following symptoms of the patient were selected as characterising the case, and corresponding rubric-cards chosen as noted: Agg. While sitting (weakness; burning): Card No. 301 Sitting, Agg. Agg. on starting to move (weakness): Card No. 214 Motion, beginning, Agg. Weakness and Emptiness (in chest): Card No. 102 Empty, hollow, sinking, internal weakness, sense of, etc. Chest (weakness and emptiness): Card No. 39 Chest, internal. Back, between shoulder-blades (Burning: Stuffed up): Card No. 290 Shoulders and Scapulae, between These cards when put together revealed the drugs Lyc., Phos., and Rhus-t, and of these drugs only Phos. was found to cover the following rubric which came next, viz.: Seminal emissions, afternoon, sleep during: (Kent's Repertory, p. 710). Reference to other repertories and perusal of the Materia Medica made it apparent that Phos. was the similimum for this patient as it alone covered the case fully. So, this patient received one dose of Phos. 1M. The result was most gratifying. All his symptoms subsided giving him marked relief and restoring him to complete normalcy by the end of Jan. 1954 without further medication. Several years later, he still remains well. Case no. 4 Dr. P.A. M., aged 86 years, came to me for consultation on 25th December 1970 with the following symptoms. He has got asthmatic cough for last 12 years. The cough is agg. Iying on right side. Cough and dyspnoea are agg. smells. Sometimes he gets involuntary stool or urine on coughing. Expectoration is thick and sticky. His skin is very dry and rough for the last few years. The case was repertorized on the Cards as follows: Card No. 193 Lying on side, Right, agg. Card No. 60 Cough Card No. 323 Sticky, stringy, etc.

Card No. 302 Skin Card No. 274 Rough, Scratchy Card No. 164 Incontinence, stool, urine, sexual, etc. Card No. 64 Coughing, agg. Card No. 234 Odours, Smells, etc., agg. Card No. 236 Old age, Senility The only remedy to come right through was Phos. Just for interest, the case was repertorized in Kent's Repertory also as follows: Cough, Lying agg, side, right (p. 797) + Expectoration, Viscid. (p. 820) = Alum., Am-m, Kali-c, Lyc., Merc., Phos., Plb., Sil., Spong., Stan. + Skin, rough (p. 1330) = Merc., Phos., Plb. + Rectum, involuntary stool, coughing or sneezing on (p. 621) = Merc., Phos. + Urination, involuntary, cough during (p. 659) = Phos. + Cough, odours, strong (p. 798) = Phos. Phos., first in the 6th potency and later in the 12th potency in infrequent doses, gave considerable relief to the patient. References In the grouping of the symptoms, wording of the rubrics as well as the placing of the drugs, Dr. Boger's unique and excellent arrangement as found in his Synoptic Key has been mainly followed. This is supplemented from the excellent homoeopathic alphabetical Repertoty of Dr. S. R. Phatak which I have found very useful in practice. For many additions made, Dr. Clarke's Dictionary of Practical Materia Medica has been mainly consulted. Among the other books drawn upon were Boericke's Pocket Manual of Homoeopathic Materia Medica, BogerBoenninghausen's Characteristics and Repertory, Kent's Lectures on Materia Medica, and Kent's Repertory. Acknowledgment It would be difficult for me to adequately express my deep indebtedness to the many friends and colleagues who have encouraged me and so readily offered their guidance and help but for which this task would have proved far more difficult if not impossible. Prophylactics in homoeopathy This chapter aims to give a list, pooled from various sources, of some of the known and reliable prophylactic remedies in Homoeopathy for certain common diseases and conditions. Though the efficacy of the Homoeopathic prophylactic remedies for various conditions has not been proved by controlled studies and statistical records, yet generations of homoeopaths have used these remedies to prevent these conditions and they claim to have done it

successfully. So their efficacy may be accepted on the basis of this experience even if it is not proved. Sutherland writes, "To the homoeopath trained in Hahnemannian thinking these arguments are readily understood and appear in consequence to be both logical and acceptable. Yet it must be admitted that, as far as the majority of the profession is concerned and to a great extent as far as the public is concerned, these arguments seem to be based on very weak premises. The one thing that is lacking is statistical studies which would serve to strengthen the ground upon which we take our stand. If asked for proof of each of the contentions mentioned above, we can adduce no statistical answer which would be convincing to the intelligent public, both lay and professional, and therefore, our arguments are not acceptable. We fail to realise that we live in a materialistic age and that our patients and colleagues are more impressed with facts and figures than by philosophical considerations, no matter how well-founded in truth the latter may be. "If the homoeopathic school is to put up an effective opposition to the growing demand for modern preventive medicine, it must be able to search for and present facts which will constitute irrefutable proof of the arguments we present." Jogi expresses his doubts as follows, "Some people claim that Mag-p is also a good preventive for tetanus and some people advocate Tetanotoxin 1M should be given. Thus, there is no unanimous opinion. Under such circumstances can we utilise our knowledge about prevention on a mass scale for immunisation? Most probably the answer is "No". This is precisely why some of the practitioners of Homoeopathy do not rely on Homoeopathy for prevention of tetanus. So unless we can prove by facts and figures, we cannot rely on the preventive value of these drugs." Pai, who is perhaps the only homoeopath to carry out experiments in this field, also expresses similar doubts about homoeopathic prophylaxis. He writes, "Homoeopathic remedies have been used over years as prophylactic agents in many countries, but the potencies selected and the manner of employment have never been uniform. Some prescribe a few doses of the very high attenuations while some others prefer medium potencies and weekly repetition over a few weeks and so on. In view of this varying procedure and because of the existence of natural immunity in every one except only those belonging to the lowest socio-economic group, it is difficult to assess the efficacy and value of Homoeopathic prophylaxis as practised so far," and says, "Most of our patients have remained immune against epidemics probably either because of their natural immunity or earlier vaccinations rather than as a result of our prophylactic treatment." He then quotes cases which developed infective conditions in spite of homoeopathic prophylaxis. He also records that children given Variol. before being vaccinated still developed moderate or severe reactions. He concludes: "It is well-known fact that any sort of prophylactic, potentized or crude, falling within the incubation period of any infection often not only fails, but leads to virulent, even fatal aggravation." Kanjilal is not impressed with these observations and considers our remedies still effective. Regarding the medicine to be used, Stearn says, "There is no doubt about the antibody formation induced by drugs. The drug that most closely simulates the disease in all its clinical aspects is more likely to be a prophylactic than one less similar." Kanjilal giving two alternatives says, "It goes without saying that, the best prophylactic remedy is the constitutional similimum of the individual. It is proved by experience that persons strictly following the homoeopathic line in their medical measures, rarely fall victims

to any epidemic disease. The next line of defence is the similimum of a particular epidemic the so-called Genus Epidemicus." In case of epidemics, the best prophylactic will be the remedy (Genus Epidemicus) obtained by examining typical symptoms from the accurate observation of the first few cases. For all conditions sought to be prevented, any remedy known to produce an identical condition suffices. Paterson was very chary of using a prophylactic if the child had already been exposed to infection. He regarded a prophylactic given after exposure, during the period of incubation, as unwise; it suppressed the disease and he would rather it came out and was treated as the disease itself. As regards the potencies to be used, and the frequency of repetition, very little authoritative information is available. Gibson states: "There is no hard and fast method for the use of potencies in prevention and the length of time protection may last is, of course, difficult to estimate. One plan is to give three doses of a 30 C potency spread over a period of 24 hours. Repetition in the event of continuing danger of infection should be under the guidance of a homoeopathic physician." The potencies recommended by different authors are mentioned in the text of this booklet. Wheeler and Kenyon write that a dose of the 30th potency of the prophylactic remedy will protect at least for a fortnight. Others advise one dose of the 30th once a week or the 200th once a fortnight till the epidemic passes. Grimmer considers that one dose of the 10M potency affords protection throughout an epidemic. The higher potencies seems to afford protection for longer periods as evidenced by the experiments of Dr. Paul Chavanon. (See footnote under Diphtheria). Disease/Condition Preventive Medicine Authority Abortion Alet., Cham., Croc., Op., Plb., Sabi., Vib-pr (Clarke) From fright or excitement Aco.

(Pierce)

Due to over-exertion or irritating emotions Heln.

(Blackwood)

Habitual from uterine debility Caulo., Heln.., Puls., Sabi. (Boericke) 2nd month Kali-c 1M (Neatby and 2nd and 3rd month Ap. Stonham) 3rd month Sabi. 1M 7th month Sep. (Schmidt) (see also Miscarriage) Adhesions, tendency to after operations Calc-f African fever Tereb.

(Boericke)

(Allen)

Air sickness Belladonna, Borax (Boericke) Alcohol, Craving for Quercus, Sterculia, Sul-ac (Boericke) Anthrax Anthracinum

(Denman)

Anxiety before exams and public engagements Arg-n, Gels. (Patrick) Apoplexy Nux-v * (Denman) Arnica (Vingals) Arteriosclerosis Nux-v * (Denman) Bee sting, Pain and Swelling of Arnica

(Tyler)

(See also stings) Urt-u ext. and int. (Tyler) Biliary Colic Chel., Chion. and Hydrastis, (Boericke G.W. ) 5-10 m, t.i. d. Bites of animals, ill-effects of Anagallis arvensis (Boericke) Ledum

(Kent)

Boils Berberis, Silicea (Dewey) Brain fag, before exams Aeth. (Foubister) Calculi formation Fragaria-v

(Boericke)

China (Clarke) Card-m (Karo) Calculi (in bladder) Hydrang., Lyc. (Pierce) Car-sickness Tabacum Cocl. 30

(Boericke)

(Foubister)

Catheter fever Camphoric acid (Boericke) Chicken pox Ant-c, Puls., Rhus-t (Mackenzie) Chilblains Sulph. 10M or Tub-bov 1M (Schmidt) Cholera Camph.

(Count Rubini) *

Ars., Alb., Cup-ac, Sulph. (Farrington) Choleratoxin 900 (cahis) or Camph. 200 or Lach. 200 or

Sulph. 200, 3 doses every day (Schmidt)

Camph., Cup., Ver-a (Hahnemann) Camph., Cup-ac (Clarke ** Ruddock) Ars., Cup-ac, Ver-a (Boericke) Sulph.

(Hering) ***

Cup., Ver-a (Epp.) + Coryza Nux-v

(Cartier)

Aco., Camph. (Mills) Coryza Recurrent Bacill. Croup (return) Phos.

(Boericke G.W. )

(Cowperthwaite,

Guernsey) Dentition disorders Calc-p (Boericke G.W. ) Diarrhoea, Emotional Gels. 10M, or Arg-n 10M (Schmidt) Bell. (Grimmer) Diphtheria Ap. 30

(Denman)

Ap. 30, Diphth. 30 * (Boericke) Merc-cy (Fergie Woods) Diphth. 10M, or Diphtherotoxin 1M ** (Schmidt) Diphth.

(Allen)***

Lac-c, Diphth. (Tyler) + Ac-ac (Grimmer) Carb-ac (Dienst) ++ Diphtheria, Carriers Diphth. Dysentery, Amoebic Ars. Dysentery, Bacillary Merc-c Engorgement of breasts (in weaning) Bry. (Clarke) Epilepsy (Chronic) Ign.

(Hahnemann)

Erysipelas Graph. 30 (Boericke) Ac-ac (Grimmer) Fatigue, Muscular (of Climbers) Coca (Farrington) Fear before operations See operations Felons Calc-s 12x (Leonard) Flea bites Pulex irritans (Yingling)

Furuncles Calc-s 12x (Leonard) Gall stones See Calculi Gangrene following injuries Sul-ac

(Boericke)

Gas Gangrene Led., Crot-h (Borland) * German Measles Puls. Gnat bites, Pain and swelling Canth. 200 (Tyler) Gout, Attacks of Fragaria-v (Boericke) Haemorrhage, Post-partum Mill.

(Allen)

Haemorrhage during operation See operations Haemorrhage after tooth extraction Puls. (Cowperthwaite) Arn., Phos. (Pierce) Haemorrhage at high altitude or rarefied air Coca

(Pierce)

Hay Fever Ars., Pso. (Boericke) Kali-p (Phatak) Heat exhaustion Nothing better than salt in Heat-stroke Glon. 10M

material doses

(Schmidt)

Hernia Cocl. (Cowperthwaite) Herpes Variol.

(Moore)

Herpes, Recurrent Hep. 10M (Schmidt) Hydrocephalus Ap., Merc-s, Pod. (Cowperthwaite) Calc-p, Sulph. (Pierce) Sulph. 6 and Calc-p 6 (Von Grauvogl) * Hydrophobia Bell., Canth., Hyos., Spir-ulm, Lyssin, Stram. (Allen) Hydrophob. (Hering) Bell.

(Hahnemann)

Stram. (Boericke)

Industrial Poisons Same poison potentized 30 weekly (Livingstone) ** Influenza Ars. (Clarke) *** Influenzinum-hispanicum 200 (3 doses, 8 hrs. apart)

(Schmidt)

Ars., Bry., Carb-v, Eup-pf, Gels., Lach., Phos., Rhus-t, Sep., Sulph. (Grimmer) Nelson's Influenza Vaccin., 30 + (Gutman) Gels., Mucobacter (Fergie Woods) Nux-v

(Younan) ++

Inoculation, Ill-effects of: Dick serum Ail.

(Grimmer)

Diphtheria Merc-cy, Diph. (Grimmer) Typhoid Bry.

(Grimmer)

Whooping cough Carb-v, Cup., Pertussin (Grimmer) Pertussin 200 (Schmidt) Puls.

(Pulford)

Dros., Vaccinum (Boericke) Yellow fever Cimi. 1M

(Thomas)

Ars. (Grimmer) Insulin, Ill-effects Insulin in potency Intermittent fever See Malaria Labour, difficult Caulo. (Tyler) Cimi. 1x (Boericke) * Caulo. 6 or 30 ** Malaria Nat-m, Ars., Chi-s (Grimmer) *** Tereb. (Allen) Eup-purp 200 or Malaria off. 200 or (Schlegel) Nat-m 200 (Schmidt)

Chi-s, Gels. (Denman) Nat-m 30 or higher (Boericke) + Ars., Chi., Sulph. (Hering) Malaria every spring or fall in cold wet weather Aran. (Grimmer) Marasmus Calc-p (Bell) Masturbation Buf. (Kent) Measles Bry., Aco., Ars., Puls. (Boericke, Ruddock) ++ Morbill. (Allen, Schmidt) Miscarriage Caulo., Vib-o (Hale) (See also Abortion) Morphia, Addiction to Avena sativa (Boericke) Mosquito bite Staph. (Mosquitoes will not bite) (Eisfelder) Pulex irritans (Boger, Yingling) +++ Mumps See Parotitis Neuralgia, Post-herpetic Variol. (Moore) Operation Pre-operative anxiety Phos. 200 or 1M (Foubister) * Sickness from chloroform Phos. 30 (Patrick) Post operative complications Arn. (Cade) ** Arn., Rhus-t (Patrick) *** Mid-operative and post-operative haemorrhage Arnica (Lange) + Mid-operative haemorrhage Cean Ø, 10-30 drops for 2 days before (Boericke G.W. ) (To be continued after Foubister Time-table) Foubister gives the following table and time-table for pre-and post-operative homoeopathic treatment

Pre-operative Treatment Evening Morning Immediately Post-operative Operation before of before Treatment operation operation operation Hysterectomy Arn. 30 Arn. 30 Arn. 30 Caust. 30 for

3 days t.d. s.

Gynaecological Repairs Arn. 30 Arn. 30 Arn. 30 D and C Arn. 30 Arn. 30 Arn. 30 Bell. 30, (III)

6 hourly.

Amputation of Breast Arn. 30 Arn. 30 Arn. 30 Ham. 30, (III) Varicose veins Arn. 30 Arn. 30 Arn. 30 Led. 30, t.d. s.

4 hourly.

3 days. Ham. 30

Appendectomy Arn. 30 Arn. 30 Arn. 30 Rhus-t 30, t.d. s.

for 3 days.

Partial Gastrectomy Arn. 30 Arn. 30 Arn. 30 Raph. 30, t.d. s. flatulence *

for 3 days and

Gall-bladder operations Arn. 30 Arn. 30 Arn. 30 Lyc. 30, t.d. s. Eye operations Arn. 30 Arn. 30 Arn. 30 Led. 30, (III) Tonsils and Adenoids Arn. 30

-

for 3 days or

s.o. s. for s.o. s.

4 hourly.

- Rhus-t 30, (VI) 4 hrly.

4 hrly.

Orthopaedic operations Arn. 30 Arn. 30 Arn. 30 Arn. 30 Involving cartilage and periostem Ruta 30 Ruta 30 Ruta 30 Ruta 30, (VI) Including spine Arn. 30 Arn. 30 Arn. 30 Hyp. 30(VI),

4 hrly.

4 hrly.

Mastoidectomy Arn. 30 Arn. 30 Arn. 30 Arn. 30 Haemorrhoids Staph. 30, Staph. 30, Staph. 30, Staph. 30, 4 hrly 4 hrly. 4 hrly. 4 hrly. for 2 or 3 days. Aesc. 30, Aesc. 30, Aesc. 30, Aesc. 30, 4 hrly 4 hrly, 4 hrly. 4 hrly. 2 or 3 days 2 or 3 days. Circumcision Staph. 30, Staph. 30 Staph. 30 Staph. 30,Arn. 30 Arn. 30 Arn. 30 Arn. 30 (VI), 4 hrly. Disease/Condition Preventive Medicine Authority Opium, Addiction to Berb-v

(Boericke)

Otitis media Bar-c (Blackwood) Parotitis Trifolium repens (Boericke) Parotid.

(Allen, Schmidt) *

Plague, Bubonic Cup., Merc-viv, Tarn. (Boericke) Crot-h, Lach. (M.L. Sircar) Poison ivy, Effects of

Tanac-vulg (Boericke)

Rhus-t 30, Anac. 6 * (G.W. Boericke) Poison oak, Effects of Rhus-t 200

(Denman)

Poliomyelitis Prevailing epidemic remedy such as Cocl., Cur., Gels., Lath. (Grimmer) ** Lath. (Bond) *** Carbolic acid or Lath. or Plb. 10M... or Physo. 1000 (Weir) Bell., Gels., Physo. + (Taylor Smith) Pulmonary form with diaphragmatic paralysis. Cup. 200, Op., or Sil. 200 (Schmidt) Pus formation See Suppuration Quinsy Bar-c 30

(Boericke)

Bar-c, Hep. (Pierce) Radiation sickness Phos. (Grimmer) Radium burns Phos., Cad-i is the most effective. (Grimmer) Rarefied Air, Effects of Coca (Farrington) Relapsing fever Camph., Nux-v (Ruddock) Renal calculi formation Lyc. (See Calculi) (Blackwood) Rheumatic fever or Rheumatism, acute Aco., Dulc., Sulph. (Ruddock) Scarlet fever Bell.

(Bayes,

Hahnemann, Denman, Nichols, Wilde *) Smooth type Bell. 30, Eucal. (Boericke) Coarse variety Bell. 1M, Scarlatinum 1M Malignant type Phyt.., Rhus-t, Ail. ** Sepsis, Puerperal Arn.

(Foubister)

(Schmidt)

Sea-sickness Arn. Cocl. and Apomorphia (Cash) *** Cocl. or Petr. 6x t.i. d. (Boericke G.W. ) Tabacum (FergieWoods,

Kent)

Apomorphine 6 (Pierce) Petr. (Blackwood) Cocl., Jab. (Allen Nash, Tab. 30 ++ (Henderson, Smallpox Maland.

Sharp +) Patrick)

(Chatterjee *,

Kanjilal **, Moore ***, Rabe +,

Raue ++,

Schmidt +++)

Variol. (Allen ±, Boericke Bonnel, ±±) Smallpox (contd.) Variol. (Knerr *, Pulford ** Ruddock ***, Vaccin.

Swan.)

(Allen +,

Blackwood, Burnett ++, Preston +++, Ruddock) Smallpox (contd.) Ant-t, Sarracenia, Sil., Thu. (Boenninghausen *, Hands **) Ant-t, Sulph., Thu., Tincture of Sulphur (Ruddock) Ant-t, Sarracenia, Sil., Thu., Vaccin., Variol. (Grimmer) *** Sarracenia (Cardozo +, Clarke ++) Stings of wasps, bees

and other insects Carb-ac

(Tyler)

Arn. locally and int. (Tyler) Styes Puls., Staph. (Pierce) Styes, recurrent Ap., Puls., Staph. (Boericke) Sulph. 10M

(Kent)

Sun-burn Bell., Canth. Sun-stroke Ilex paraguayensis, Glon. (Boericke) Suppuration (Septic conditions) Arn. Arn., Pyro.

(Boericke)

(Allen)

Surgical Shock Arn. 30 or 200 (See Operations) Calendula lotion ext. +++ (Henderson Patrick) Tartar on teeth Bacill., Calc. renalis (Blackwood) Fragaria (Boericke) Tetanus Led., or Thu., or Arn. 10M or Tetano-toxin 1M (Schmidt) Led. 30, a few doses (Henderson Patrick) Physo., Mag-p * (Grimmer) Hyp.

(Boericke)

Tobacco, Craving for Calad. (Boericke) Tonsillitis Bar-c (Blackwood) Tuberculosis Tub-bov

(Burnett, Kent) **

Typhoid Bapt. *** (also for carriers) (Grimmer) Typhus Bapt., Hyos. (Ruddock) Vaccination, Ill-effects Thu., Maland. (Grimmer) Thu. (Boenninghausen) Vomiting

from Chloroform Phos. (Kent) Warts, Formation of Fl-ac (Kent) Whooping Cough All-sat, Puls. (Lehman) Coqueluchin (Clarke) Dros., Vaccin. (Boericke) Carb-v, Cup., Dros. Pertussin (Grimmer) + Worms, predisposition to Nat-m (Hering) Yellow fever Ars., Crot-h, Phos. (Grimmer) X-Rays, Ill-effects of

Fl-ac, Phos., Sil. (Grimmer)

X-Ray burns See Radium burns Difficulties in practice The potency problem The selection of the potency in Homoeopathy is difficult and puzzling job to the homoeopathic physician. He is either faced with a lack of definite guidance or where such guidance is available, finds different and even conflicting opinions on the subject which tend to confuse rather than enlighten him. It is therefore necessary to review this subject. Before trying to frame any set of rules from available authoritative opinions and experience, it would be worthwhile to know about the scales and range of potencies and to consider the observations and conclusions of various well-known homoeopaths. Scale of potencies Homoeopathic potencies are prepared in three scales. 1. The Centesimal, evolved by Hahnemann, denoted by the numerical designation of the potency or by the number followed by the suffix C, e.g. 200 or 200C. 2. The decimal, evolved by Hering and denoted by the suffix X, after the number, e.g. 200x. 3. The 50 Millesimal or LM scale - also known as Quinquagintamillesimal or Q potencies. This was evolved by Hahnemann in the last years of his life and is described in the last edition of the Organon. In the following passages, reference is mostly made to centesimal potencies. Range of potencies Potencies may be broadly classified as low, medium and high. Low potency designates anything from O to 12C, medium from 12C to 200C and high from 200C upwards to DM, MM and DMM.

During Hahnemann's lifetime, he is known to have generally used only potencies upto 30C. But Farrington quotes Madame Hahnemann as saying that he had used the 200th and the 1 000th when necessary. The 1 000th, however, he seems to have used only once. Hochstetter describes the various methods in which potencies are actually made in different countries. Birnstill and Gersdorf say that the high potencies were first introduced before 1834 by a Mr. Korsakoff, but received very little notice at the time, and were forgotten until 1844, when Mr. Jenichen, in Mecklengburg, took them up, and proclaimed that he had discovered a new mode of preparation of high potencies. It is quite true that in various places at various times various physicians have used various potencies and have claimed and reported success with them. Richard Hughes was a staunch advocate of low potencies while Kent was a high potency prescriber. In France, high potencies are now banned by law (because they do not contain any material substance in them). So, naturally, present day medical experience in France is confined to low and medium potencies (below 22C). It is perhaps only in the USA, UK, India and some South American countries that high potencies are given freely though, here, low potency advocates are also available. There is a tendency for the low potency prescriber to look aghast at the high potency prescriber and for the high potency men to look down with contempt at the low potency men. A perusal of the available literature shows that there is efficacy in both fields. Some of the brilliant cures of very difficult cases (including cancer of the stomach) have been achieved by that remarkable physician R.T. Cooper with single doses of one drop of the O and they compare well with the equally dramatic results achieved by Kent with high potencies. Therefore, it is rather difficult to draw a conclusion easily. But Kent, though himself a high potency prescriber, has issued a grave warning against the indiscriminate use of high potencies in the following words. "It is well for you to realise that you are dealing with high potencies. I would rather be in a room with a dozen negroes slashing with razors than in the hands of an ignorant prescriber of high potencies. They are means of tremendous harm, as well as of tremendous good." So, it would be advisable for beginners to gradually feel their way up and resort to high potencies as they gain sufficient experience and confidence. Now we shall summarize the experiences and opinions of homoeopaths as found in our literature. Experiences and opinions Adams says, "The 6th and 30th potencies have been my main reliance; however, truth compels one to say that the 200th and 1000th have often cured when the lower failed. It is generally considered best for those of limited or no experience to begin with the lower potencies, the 6th to 30th." Agnes Moncrieff opines that in children and old people low potencies are safer. She always used high potencies for robust patients whether acutely ill or not. Allan advocates giving highest potencies in acute diseases and lower in chronic diseases. All C. states that the carefully recorded results of 860 cases leave no doubt in his mind as to the marked general superiority of the low potencies.

Allen H.C. speaking on the subject says we must be aware of giving high potencies to aged patients and babies. Alley James writes that though certain cases are more quickly relieved by medicines from the 30th to the 200th potencies, these cases are comparatively few. He says, "With all respect to Hahnemann, and his talented followers, we must entirely dissent from accepting this doctrine. Potentization and transmutation were the great mistakes of a great man." He thinks that in nearly all acute cases, remedies should not be used higher than 6th or 12th. He further says, "The subacute symptoms or those which are similar to the effects produced after Mercurius has been taken for one or two weeks, are best treated by medium preparations; whilst the actually chronic symptoms, or those which occur after a proving of several weeks are most surely cured by high attenuations." Anshutz generally prescribes low potencies, sometimes the 30th. Athalye mentions that the choice of an appropriate potency, as it stands at present, is left almost to the practitioner's own experience and recommends that research should be done on this subject. Bayes reports a case in which Bismuth 1 in the dose of 1/3 grain proved useless but given as one grain proved curative. He also says that he has made an abstract of a series of forty cases of pneumonia treated by Tessier, during his experimental enquiry into the homoeopathic treatment. Bell has had most satisfactory experience in the treatment of diarrhoeas with the 12th to 200th and higher potencies. Bellows affirms that he developed so much confidence with 3rd and 6th potencies that he used those almost wholly in this practice. Beronville writes, "The laws regarding the dilutions are not yet accepted by all homoeopaths. They should be considered with an open mind. However, most homoeopaths agree that the lower dilutions act superficially and for short time; the high dilutions act slowly, deeply and for a long time..." "When you treat a patient with a high dilution the duration of its action is not very long. Take for example: you administer Lachesis 200 to a patient who has never been treated or who is having homoeopathic treatment for the first time. In such a case the duration will not be more than 7 or 8 days. The negative phase is 24 hours; the positive phase begins on the 2nd day; amelioration continues for 6 days and from the 6th day the amelioration begins to fall and the patient feels less better. You repeat the dose and as gradually you go on repeating the dose even in the same dilution, the duration of its action will increase. If instead of giving Lachesis 200, you apply 1 000, the duration of action will be 15 days of positive action and next you will have one month with another dose of 1M and you will obtain a positive action for 2 or 3 months with Lachesis 10 000 (Korsakow)." "The duration of action varies according as the patient has only begun the treatment or he is having treatment for a long time. But, there are such frequent exceptions to this rule that in reality it can only be learnt by individual practice." "As regards the lower dilutions, they are to be applied rather in acute cases because they act superficially and for a short period. On the other hand for the drainage of a chronic case we must get a real hierarchy of actions by giving a high dilution which acts for a long time

followed by some functional remedies which are repeated every day or at an interval of two days for the reason that their action is short-lasting." "Very recently Cahis of Barcelona and Dr. Nebel have used mixtures of dilutions and it has been seen that by mixing dilutions, action is obtained which is intermediary between a high and a low dilution, acting at the same time very rapidly (because there is a lower dilution) and that the duration of action is intermediary. The mixtures of dilutions act soon, deeply and their duration is medium." "In practice we have made some mixtures for some remedies. Dr. Nebel often used to mix 30, 200, 5 000 or 30, 200, 500, 1 000. Cahis tried to obtain a violent reaction of the patient with these mixtures causing at the same time a fall of the potential. He used to give for example Silicea 18, the next day a mixture of 300 dilutions from 4 700 to 5 000 of Silicea. He used to give in this way 300 dilutions, simultaneously. This was a work of considerable patience. He had thousands of phials and worked on Sundays to prepare the dilutions which he applied during the following week. He obtained very interesting results by alternating one very low dilution with a very high dilution. He did this for example with Thiosinamin." "Nebel used mixtures of dilutions. I have also used them. The mixture of dilutions often diminishes the chance of aggravation." "(In my practice I have very often verified the rapid and sure action of a remedy by using two of its dilutions alternately. In chronic cases, I generally use a remedy in the following manner: 6, 200; 200, 1M, 25M, etc. applying the high dilution first following it with its corresponding lower one. The higher dilution is repeated in an interval more or less according as the dilution is high or low.)" "There is also another rule which has been equally formulated, but for which there are so many exceptions. It should be followed with great produce." "When it is necessary to act on very subtle symptoms as for example mental or sympathetic or nervous, it is better to use high dilutions. When you descend to the materiality of morbid symptoms apply medium doses in lower dilutions." Berridge reports a series of cases cured with high potencies. He quotes the rule given by Hahnemann that the more homoeopathic the remedy the higher the potency. Black, while not denying the action of the higher dilutions, claims more generally efficacy for the lower ones. He quotes Clotar Mullar as saying that Bryonia is more efficacious in the lower dilutions. Blackie reports that in cases of real organic change due to infective causes a high potency might clear them up. She had cleared up cases of rheumatoid arthritis and sinusitis with the 30, 200 or 20M. Boenninghausen was clearly in favour of high potencies. He wrote several papers in support of high potencies and listed therein many advantages, viz., that: 1. The sphere of action continually enlarges with high potencies so that in chronic ailments they hasten the cure, 2. In acute diseases, the effect appears quicker, and 3. They act in spite of indiscretions in diet.

Boericke uniformly suggests low potencies and sometimes the medium ones. Boger seems to have utilised all potencies but was partial towards very high potencies. His favourite prescription appears to have been a single dose of the DMM! Borland says that in treating purely local conditions, remedies with affinity for the organ or tissue may be used in low potencies, as also in advanced pathological conditions and sensitive patients. When there is general similarity in addition to local indications, medium or higher potencies may be preferred. He also says that the more acute the disease, the higher the potency. Boyd in his excellent book, "The Simple Principle in Medicine", has strongly criticised the idea of high potencies. He writes: "Unless one chooses to disregard the divisibility of matter, the entire knowledge of physical chemistry, the purity of vehicles, the problem of a perfect container and other factors, there is no scientific evidence favouring the so-called high potency, which can stand critical analysis. Many of the assumptions are entirely unwarranted, for there is no proof that shattering of the atom is possible by homoeopathic pharmaceutic technic." Boyd, Hamish report a case of early Pneumonia were the remedy Phos. helped after an intercurrent dose of Tub-bov 12. Bradshaw with 40 years experience feels that experience alone must settle the question of dose. Brisely says the medicine should be repeated going from the lowest to the highest and then in reverse. Burnett thinks dropping back in potencies, e.g. from 50M to 40M may increase the patient's reactability. But he often resorted to O and low potencies. Cameron records a large number of cases treated successfully with low potencies. Case, the master prescriber, discussing potencies says, "I would like to say a word as to the value of different potencies. I prescribe a potency of a remedy that I know is indicated and get unsatisfactory or no result; then I prescribe the same remedy in a lower or higher potency and get immediate results; this experience repeated a number of times leads me to believe that there is a homoeopathicity in the potency as well as in the remedy. "Years ago, I went to see Dr. Wells in Brooklyn. I had a patient at the time that needed Calcarea carb. I had used the 200th and the 1M with no results. I stated the symptoms to Dr. Wells, who said to me: "Go over to Dr. Fincke and get his 40M." I did so and it cured the patient rapidly. That case led me to the use of the 40M. I know that there is a difference in the higher potencies." "My rule is when a remedy holds only a short time, to give a higher potency and generally with good results." Throughout his book, "The Prescriber", Clarke recommends low potencies though in his Dictionary he reports some cases cured by him with medium and high potencies. He also reports a number of cases treated with low potencies like Nux vom. 1, Phos. 2, Ars. 3, etc. He says that for ordinary practice, with acute illness, the lower dilutions from the 1C to 3C will be most useful. For chronic diseases, the higher dilutions will be required. Clifton considers that the lower dilutions are more efficacious in most cases.

Close, that great homoeopathic philosopher, writes that the subject gave rise to so much misunderstanding and controversy that people got tired of it. He says that a well-selected remedy may utterly fail or even do harm because of wrong dosage. He gives the considerations which influence the choice of the dose. 1. The greater the characteristic symptoms of the drug in the case, the greater the susceptibility to the remedy and the higher the potency required. 2. Age: medium and higher potencies for children. 3. Higher potency for sensitive, intelligent persons. 4. Higher potency for persons of intellectual or sedentary occupation and those exposed to excitement or to the continual influence of drugs, e.g. , druggists. 5. In terminal conditions even the crude drugs may be required. He also writes elsewhere, "What has been said of remedies and the method of using them is in principle equally applicable to high potencies. No one is compelled to use them. But, there is as great an advantage in having a large scale of potencies as there is in having a large number of remedies. Different potencies, or developments of drug powers, act differently in different cases and individuals at different times and under different conditions. All may be needed. No one potency, high or low, will meet the requirements of all cases at all times. The exclusive devotee of one or the other stamps himself as a narrow minded individual who deprives himself and his patients of benefits which might accrue if he broadened his mind and learned how and when to use the agents which he now neglects. "Proof of the efficiency and sometimes superiority of high potencies, which our Swedish friend asks for, exists in reams and volumes in homoeopathic literature, the accumulation of a century and a quarter. Proof for the individual waits only upon his willingness to put a high potency of an individual medicine to the test of experience. The next time, Dr. Ekholm meets a case which indubitably calls for Aconite or Belladonna let him give a dose or two of the 200th or 1000th potency and watch the result. Unless he is like the Scotchman who was "willing to be convinced, but where is the man who can convince me", he will not need many such illustrations to bring him to a better mind on the subject of high potencies." Coleman pleads for the use of all potencies. He says, "We have to begin somewhere; a good rule is to start with 30th potency thus leaving room above and below to work as we consider necessary." Cooper describing a case of skin disease says that Calcarea 2x had a better effect than the 3x. But, he also reports a case of deafness cured with a high potency. Copeland in a paper cautiously disagrees with Weisselhoeft (who advises only low potencies) and Gatchell seconds him. Cretin mentions that he has never obtained that effect with high potencies which he got with the low esp. the unattenuated dose. Curie opines that in an acute disease the low dilutions are to be preferred - they succeed perfectly from the 3rd to 15th. But in chronic diseases, the high dilutions promise greater success, the 30th being preferable to every other. Dake, though he quotes two cases cured with high potencies, feels that there is no medicinal power in the potencies above 30.

Dewey in a comprehensive article, considers that remedies should be prescribed in a potency higher than those in which they have provoked symptoms in provings. He goes on to mention that in his experience, certain potencies of certain remedies are found to act better in certain conditions, e.g. Cham. in 12th; Gels. in 30th for migraine; Aco. in 30th for neuralgias; Bry. in 3rd; Graph. in 12th for gastric complaints; Nux vom. in 200th for constipation; Anac. in 12th; Can. sat. in 3rd for gonorrhoea and so on. Dixon remarks that by using Apoc. can. in O much of its value is lost. He found better results with the remedy in 200th and upwards. Dryry had been early led to the use of the 30th dilution having found it successful. Dudgeon defines that the dose should be always sub-physiological. Dunham regards the question of the dose as an open one though he reports cases cured by very low potencies. He then quotes Boenninghausen as saying that he does not hold himself exclusively to the 200th or to the high potencies. He is of opinion that cases frequently occur in which a remedy will act only in a certain potency, high or low. He quotes Chapman of London, a very keen observer, making a similar remark, furnishing striking illustrations of it from his own practice, and giving examples of an epidemic of dysentery in which Dr. Wells found that Nux vomica, the genus epidemicus had no effect in the O, low or medium potencies, but had immediate effect in the highest potencies, so that after this discovery a single dose of the 400th sufficed for every case. This might explain the discrepancies of testimony on the subject of Thuja in smallpox. Boenninghausen as well as Wilson in the London Homoeopathic Hospital, Hering and Dunham had all used in many cases of smallpox, Thuja 200, with remarkably good effect. But on the other hand Wurmb of the Vienna Homoeopathic Hospital reported failures with Thuja 200 in 15 cases. He further quotes Watzke as saying, that he himself, though so bitterly opposed to the advocates of high potencies, is constrained to state, "I am, alas - I say, alas, for I would much rather have upheld the larger doses which accord with current views - I am compelled to declare myself for the higher dilutions." He also mentions that in 1850 Wurmb and Caspar took charge of the Leopoldstadt Hospital in Vienna. They were physicians of great scientific attainments and of great devotion; and Wurmb at least had few superiors in an exact and thorough knowledge of the Materia Medica. Their views on the subject of the dose were no secret - they had no faith whatever in the higher potencies. Dunham says that during the ten years, from 1850 to 1859, all cases of pneumonia in that hospital were treated for the first 3 years with the 30C dilution, for the next 3 years with the 6C, and for the last 4 years with 15C. Then the results were compared. In all, 107 cases of pneumonia were treated. Every care was taken to obviate every source of fallacy. While the 30C was being used as the standard dilution, Wurmb frequently expressed his expectation that statistics would decide in favour of the lower dilutions. But ultimately the analysis revealed that in every point of view, the action of the 30C was more certain and more rapid than the 15C and the 15C better than the 6C though the experimentors' prepossessions were rather against the high potencies. Edgar reports having treated cases successfully for twenty five years with the low dilutions and Os. Ellis Barker states that one must select not only the right remedy but also the right potency. Then he gives a case in which Plumbum, the indicated remedy, given in the 3, 6, 9, 12, 15 and

29th potencies failed. Only the 30th helped. He again tried higher and lower potencies but all failed to help except the 30th. Emil Schlegal recommended only low potencies - his highest seems to be the 30th. Fincke narrates cases of hydroceles cured with Sil. 14M and says that this is a proof of the efficacy of high potencies. But he pleads that tests should be made with various potencies. He quotes Hahnemann as saying, "Man Kann sic fast nicht zuklein geben", (i.e. , one almost cannot give them too fine) and gives a number of different cases to show the efficacy of high potencies. He also further relates 2 or 3 cases which improved with very high potencies including a case of orchitis cured by a single dose of Spongia 1500. Gardner writing editorially remarks that he is uncommitted on the vexed question of the dose and its repletion. Gatchell, wherever he recommends homoeopathic medicines which is not always, suggests very low potencies like 2x and 3x. Gentry feels that in progressive diseases such as fevers and contagions, remedies must be given in medium or low potencies. Geo Foote records that while all credit is given to the low potencies, experience teaches that the high give more satisfactory results. George Lade and Dunn give a series of cases treated with the "lower" and "lowest" medicinal attenuations. Ghose, while stating that the question of potency can be decided only by experiment by every homoeopath, mentions that he has always been using lower and medium potencies successfully. He also mentions that M .L. Sircar, D.N. Roy, Salzer and others did the same as also J.H. Clarke, Burford, Stonham, Fergie Woods, George Royal, T.F. Allen, William Boericke and others. Gilbert proposes the following law of dose, "Such an attenuation will induce action in an opposite direction to that produced by the crude drug or the lower attenuations without previous aggravation of existing symptoms, the attenuation to be ascertained by means of provings." Gillon describes a case in which the remedy Ars. given in various potencies from 3rd to 200th failed but in the 1st potency completely cured the patient. Gladwin concludes that he gets better results with 10M and 50M than with the 200th. Gordon's thesis is that there is no such thing as an optimum potency except in the sense that a certain potency or drug may be the most similar to a diseased individual at a certain time. He holds that, "A patient who needs a 50M will be unaffected by a 30 and one who needs 12 may be killed by a 1M." He believes that Disington's discovery of plus dosage, "has proved its value beyond all question or cavil". He has long used the single dose and for the last two years has been experimenting with double dosage: "This consists in giving, instead of the familiar single dose, two doses of different potencies, 24 or 48 hours apart, e.g. Phos. 200(1) followed in 24 hours' time by Phos. 1M (1). Thereafter, treatment proceeds exactly as for single doses except that instead of Sac-l.(1) one gives two doses of Sac-l 24 hours apart." Gordon holds that this method in his experience applies only to chronic diseases; that it is particularly useful in cases in which the single dose has failed to give results, that these

double doses of the same remedy give results both deeper and quicker; that the average duration of action is usually, but not always, shorter ranging from about six to eight weeks; that is it is more profitable to repeat the double dosage in the same potencies at the second prescription and go higher for the third and fourth, and higher again for the fifty and sixty; that the lower potencies are more effective when the patient's vitality is low; that the double dose calls for a harm instead of good in cases of deficient vitality. He believes with Dr. Blunt that plus dosage is of little value for potencies above 30; also that when double dosage fails, esp. among neurasthenics, triple dosage may be effective given as follows: Nit-ac 1M (1) then 48 hours later Nit-ac 10M (1) and again 48 hours later Nit-ac 45M (1). Grauvogl enumerates some rules for the use of potencies. He writes, "(1) If we have to act on single parts, against single qualitative cause we had better use low dilutions, as in haemorrhage before or after child birth. (2) With high potencies, the symptoms pass away quietly leaving no trace. (3) In dealing with a change of a process of reduction or of oxidation, or vice-versa we must use the low dilutions. (4) But to dissolve processes of retention, high potencies are indicated. (5) Nutritive remedies act best in low dilutions, functional remedies in high dilutions. (6) A chronic disease, esp. when based upon retentions in a carbo-nitrogenoid constitution, can be cured best by high potencies; in fact it can be rendered incurable by the use of low potencies." Grimmer writing about the question of potency says, "This bitter controversy divided the American Institute of Homoeopathy into two antagonistic sections for over half a century. We now know that both the low and high potencies are necessary in obtaining the best results in homoeopathic prescribing. Any potency may be of use and needed..." He also says in a discussion that from the O to the 20th is quite an effective range but he adds that there is no need to be so rabid or so concerned about potency. He quotes Kent's practice which was to start with a 10M in chronic cases. When he got the response, then he would repeat the 10M and then go to 50M and CM. In some cases he went on to DM and MM. Grimmer thinks you do need the potency so high in acute cases. Guernsey seems to prefer high potencies. Gutman reports give carefully treated and observed cases and says, "Such experiments as I made in an unprejudiced way for many years convinced me - though I used to be a strict low potency man - that the high potencies work and they often work surprisingly better than the low potencies." But he also says that the has had some excellent results with the O. Hawkes writes, "When such names as Hahnemann, Boenninghausen, Hering, Lippe, H.N. Guernsey, Raue, Dunham and Allen can be quoted in favour of high potencies, and a host of successful physicians in favour of the lower, he is a bold and unreasonable critic who, without the knowledge, learning, experience and integrity of these men, presumes to rule either group out of the homoeopathic ranks." Then quoting from his twenty years hospital work, he says he has found both low and high potencies useful. Hayes, that remarkable prescriber, records that he had found certain potencies of certain makes very thorough in action, e.g. Jenichen's Manganum aceticum 3M, Tafel's Cistus canadensis 200th, Tafel's Lachesis 30th, Skinner's Lycopodium 30th, Tafel's Ferrum met. 8th and Nux vomica 30x and so on. He also says that high potencies followed by the lower ones act especially well in young healthy adults. Hayward and Wilcox speak in the same vein.

Houghton explains, "Being largely engaged in the treatment of chronic diseases, many of my patients being at a distance and never personally seen, I use very low dilutions, Os, first triturations, and even crude drugs, and have repeated these remedies more often than the strict homoeopathic rules permit, without being disturbed by aggravations, and with a degree of success, which leads me to think that some of our writers are far too timid and fastidious in regard to doses and repetitions." Hubbard the brilliant teacher, prescriber and editor, has formulated certain rules. She lays down that for diseases of manifestly psychic origin the high potencies should be employed. Functional diseases too with subjective symptoms respond well to high potencies. Acute diseases even with pathological changes will also need high potencies while in acute crisis of chronic diseases such as cardiac asthma, medium or low potencies would be preferable. In chronic prescribing, it is safe to begin with 200C. She prefers high potencies in cases with marked mental symptoms. She disagrees with Plumb Brown about blonds needing high potencies because she had seen brunettes who did wonders on the 50M and extreme Nordics who required a 12 or 30. She says that with some self-conscious sensitives we have to give low and gradually increase. Hutchinson formulates certain rules for selecting potencies. He says highest potencies should not be prescribed in extremes when the power of reaction is low. In disorders outside mental and nerve functions, low potencies cure speedily. The more the mental side and finer the symptoms, higher the potency to be selected. If high potencies fail, he suggests we should try low. Jousset finds the choice of potencies still unsettled. He thinks it would depend upon the drug and the disease but he generally recommends the low and sometimes the medium potencies. Jugal Kishore says that with regard to the potency problem there is little teaching but many opinions. The sensitiveness to potencies or susceptibility is highest in children and vigorous persons and diminishes with age. He says further, "The third factor modifying the reaction to potencies is constitution and temperament. The higher potencies are best indicated in sensitive nervous people, intellectual, impulsive and jealous, but the lower potencies elicit better response from persons of coarse fibre, sluggish, dull of comprehension, torpid and phlegmatic individuals. The susceptibility seems to be increased by intellectual occupation, by a life of excitement and sedentary occupation. It may be roughly proportionate inversely to increase in pathology. Thus in a case, for example, of advanced tuberculosis, pathological condition of the heart with congestive failure, advanced nephritis and in malignant growth, the treatment should be started with low potencies. The injudicious use of high potencies sometimes spells disaster. It is often observed that in such low grade conditions there are very few characteristic symptoms and one has to fall back on the so-called organic remedies and that in low potencies. "Habit and environment also influence our reaction to potencies. More "civilised" countries compared to primitive people require much greater potency range as well as drug range. People drugged with crude medicines or low homoeopathic potencies may require high potencies to initiate the curative reaction. People engaged in coarser occupations and manual labour and living on coarse food are less susceptible. Idiots, imbeciles and the deaf and dumb have low power or reaction to high potency energies. "The character and localisation of disease also influence our choice of potency. In certain malignant and rapidly fatal disease like cholera, we may require material doses of medicines

like spirit of camphor. Of course, the exceptions are there where high potencies have aborted such diseases." He further reports that in an advanced case of cerebral syphilis, Lycopodium 200 did not make any impression but the 30th was always able to relieve. He also says that he got better results with Senega in low than in high potencies and similarly with Kali-p 3x than with higher attenuations. Kennedy remarks that he is impressed with high potencies 1M, 10M and CM. Kent was not only an exponent of medium and high potencies but was also the preceptor of a generation of high potencists. It was because of his students that high potencies came into vogue in England, wherein all along now potencies had been used under the influence of Richard Hughes. The later English school of homoeopaths including Sir John Weir and Margaret Tyler, following the teachings of Kent, were prescribing high potencies. Kidd thinks that each organ requires its own special dose, e.g. the brain and spine need much smaller doses than the stomach, liver, kidney, etc. Kitchen says that Boenninghausen was obtaining more and more success from the high dilutions, than he formerly did with the 24th and 30th. He says the more acute the character of the disease, the higher the dilutions called for, except in the most inveterate chronic cases. He maintains that a single globule of the remedy in the highest power is enough to cure in the majority cases. Krichbaum mentions that he has never seen good results with high potencies (200 and up) in organic heart disease with which statement Boger disagrees. Kunkel of Kiel states, "Where I wish to act chiefly and primarily in a local manner, I give the low potencies; where I wish to act in a more general and lasting manner, I give the high ones." Lamb quotes several cases wherein a particular potency did not help whereas a higher or a lower potency helped. Laurie and McLatchie write that tinctures and low potencies, i.e. 1st to 3rd are better adapted to acute disease. Le Hunte Cooper got magnificent results with 3C but mostly palliative. Leadam asks, "Why should we be tied down to the 1st and 3rd dilutions?" Lutz considers that the initial dose should be a high potency and the later ones lower potencies. His writing is worth quoting. He says, "Dr. Underhill tells us that the constitutional remedy of a patient remains the same esp. after the 30th year of age, and recommends that we begin the treatment with a lower potency and then give higher. So far as I know, this is the course adopted by most homoeopaths and usually with results, and I myself followed this method of prescribing until I saw in Hahnemann's Materia Medica Pura that he advises us to begin with the higher potencies and then follow with the lower. This advice caused me to think and remember that in two or three instances the higher potency, following the low, seemed to antidote the latter and in one instance at least to cause an actual aggravation, and I have come to the following conclusion: that Hahnemann is right as usual. A sick person is more susceptible to any and all influences, such as cold, heat and remedies, than a person in normal health. The lower potencies of the homoeopathic remedy have produced on persons in

normal health, the very symptoms, the very disease we wish to cure; to give the lower potencies while he is sick is apt to aggravate the condition of the patient. As he improves, he can stand lower potencies better, should further repetition of the remedy still be needed. People in good health, as a rule, have their vacations in the summer and in the country, roam through the woods and are often poisoned by Rhus tox.: they then write for medicine, generally give no symptoms and I have never failed to cure them with a high potency of Rhus tox., usually the 195M. For these reasons, I now follow these with the lower, with good results ." McKillop in a discussion says that he himself used mostly high potencies but he had good results with low in general practice and he was convinced that there is a field for them. Madden describes some cases of acute rheumatism treated by Bryonia O. McDonough says that high potencies act with the speed of lightning and with great power. Mitchell quoting the observations of McCrae based on his work with the Emanometer formulates the following rules: "In a case of chronic disease, if there has been no potency treatment during the preceding year, the initial potency should be high. All succeeding remedies should be given low. In other words, once a high potency has been given that particular case must have no more high potencies until once more a year has passed since that last potency of any sort was given." Moore in a paper condemns high potencies because they contain no matter. In the discussion, Price and Conrad Weisselhoeft support him. H.C. Allen and Custis, of course, oppose them. Morgan began with the smallest dose, a high potency, and as its effect wore off, went to the next lower potency. He liked this method best. This was in keeping with the rules laid down in allergy practice. Nash was evidently strongly in favour of medium and high potencies. He describes a remarkable case which converted him to the high potencies. Neatby advises us to try using high potencies especially of nosodes and serums as local applications. Neidhard quotes several cases from his fifty years experience to demonstrate how low potencies cured where high potencies had been ineffective. He then says that a homoeopath will vary his dose from the lowest to the highest power. Depending on the patient's constitution and temperament and nature of the disease. Those who use exclusively low or high dilutions can never arrive at a certain conclusion about the dose. Neville Wood bemoans that with regard to the potency question, there is no law or even rule but we have to rely on routine, custom and caprice. Yet homoeopaths speak as if their own experience and practice forbade all further discussion. He further adds that he believes in the efficacy of high attenuations (from the 3rd to the 30th), in acute as well as in chronic affections. He rarely prescribed tinctures, and seldom went below the 3C. Ogden Jones reports cases cured with high potencies. Patch, speaking about Radium says that he had used the 12th and 60th potency with absolutely no results whereas he had remarkable results with the CM. Patel mentions that he gets excellent results with the 50 Millesimal scale of potencies.

Paterson opines that mental cases should receive high potencies. Payne Edwin regards the choice of the drug as more important than the potency. Pearson regrets that the tendency to prescribe tinctures for every ailment, in two-drop or two-spoonful doses, is bound to injure Homoeopathy wherever and whenever practised. Such crude medicines, and such doses will rarely fail to aggravate existing maladies. Pope believes that the size of the dose will be influenced by circumstances having reference to the patient, to the disease, and to the medicine. The patient's temperament, sex and age, climate, occupation, diet indulgence and the nature of disease will all go to decide the dose. While agreeing that the crude substance or potencies below the 3C should be generally used, he feels that occasionally higher dilutions may be more beneficial. Pierce uniformly prefers the low potencies. Plum Brown quotes H.C. Allen as saying that any potency would work if you had the similimum. Regarding potencies he admits to confusion and much embarrassment. Then, he says from his long experience and close observation that a blind patient will respond to high potencies, and that brunettes and patients with thick lips respond better to low potencies. Pratt reports a case of rheumatism in which Dulc. 3x aggravated but the 30th cured. Price taking part in a discussion opines that potencies above 30C should not be used because they have no drug content. He thinks Homoeopathy has suffered because of the claims of cures made for high potencies. Pulford A., that veteran homoeopath of USA, had, it seems, strong views on the potency question. He wrote: "To complete the true similimum the proper potency is an important part, if not the most important part..." and "From close observation we find that, as we have said above, the selection of proper potency is as necessary to complete the similimum as any or all of the symptoms that go to make up the prescription for the case, if we are to get the very best results without after-conditions arising." He seems to have had a very strong preference for high potencies. He wrote further, "Lower potencies simply allay the predisposition which amounts simply to suppression of the disease and not to an eradication of the predisposition which is absolutely essential to a cure," and "Close application has taught us that remedies for curative purposes below the 30x are useless, but for palliation or temporary relief they are good and then better for pathogenetic and physiological purposes. The low curative remedies range from the 30x to the CC (200th) potencies, especially for the acute cases which do not rest on, nor are part of a deep chronic malady. The medium curative remedies range from CC to 10M potencies in subacute cases all of which rest on some deeper dyscrasia. The higher potencies range from the 10M up for the chronic curable cases. In all incurable cases, the lower potencies should be used so as not to create any dangerous reactions", and, "Those who believe that the low potencies only may cure, have our sympathy, for the time was when we held tenaciously to the same belief." Again, "Bell failed to prove the high potency men fools. Hering failed to prove Homoeopathy a falsity and a delusion; ..." He also describes the following case to illustrate the effect of high potency.

"A Mrs. B. was referred to us, having been a semi-invalid for some time and growing gradually worse under allopathic treatment. Her symptoms were so clear that there could be no doubt whatever of the correct remedy. Here is what we found: A lady, robust and fleshy, 49 years old. Mild, yielding, melancholy, tearful, changeable disposition. Palpitation when lying on left side. Aggravation evening. Better in cold, open air; stiffness and lameness after sitting, better rising and walking slowly about. Worse in warm close room or room full of people. Aversion to and aggravation from fatty food. Little or no thirst... We, therefore, gave the lady Pulsatilla 30x, four times daily for one week. At the expiration of that time, she returned very much disappointed, there had been no change whatever. We waited five weeks so as to give the remedy time to either act or to wear off. At the end of five weeks we gave the lady a single dose of the 1M with prompt and continuous response, ending up by a rapid clearing up of the entire train of symptoms. She said, "I have not felt so well in years as I do right now." She can work harder, and walk fast, sight is better, and stiffness gone." He then gives the following rules: "In making a prescription and selecting the potency, the acuteness, the subsacuteness and the chronicity of the case to be prescribed for must be considered. If acute, we must decide whether it rests upon a normal system alone, or if it exists as an outburst of chronic active trouble; if the former it would require a lower potency, if the latter a higher. If the case is subacute and the chronic malady on which it supervenes is not active then the lower potencies of the medium range would be required, etc." But Coleman making a strong plea for all potencies, replies to Pulford thus, "What have the low potentits contributed ? Nothing according to Dr. Pulford, much according to me. Dr. Timothy Field Allen gave us his gigantic works, the "Encyclopedia of Pure Materia Medica" and the "Hand book"; Dr. Richard Hughes, "Pharmacodynamics and the Principles and the Practice of Homoeopathy"; Dr. Jousset, Goodno and Bartlett fine works on practice and therapeutics; Dr. Wilson and Dr. O'Connor, who prescribed both high and low, wrote excellent books on nervous diseases. The late Dr. Henry M. Dearborn, whose knowledge of skin diseases was second to none in any school, presented the homoeopathic profession with a grand work on skin diseases, including Materia Medica. The Dictionary of Materia Medica by John H. Clarke is a credit to our school and Dr. George Royal, himself, has written several excellent books. The provings of Ichthyolum and Radium bromide made by Dr. W.H. Diffenback, a member of our Society, certainly do not add strength to Dr. Pulford's assertion. I could add the names of other authors and investigators, but enough is sufficient." Puddhepatt writes, "You will always be safe to start low and go higher and if needs be higher still, so long as the remedy is doing good." Low potencies like the 3rd and 12th can be repeated two or three times a day. The higher you go the less often must the remedy be given. If you have to go high or very high, then give the unit dose and wait. The unit dose high or very high may work for 2, 3, 4 months and even longer. I have had a case where a dose of Sepia 1M worked for nearly nine months." Quinton says that he was interested to hear Vannier's views as to, "high potencies being indicated when mental symptoms preponderated, medium for functional derangements and low in lesional states". His own experiences did not bear this out, as every variety of case may react to any potency, at one time or another and he failed to see why mental derangement should be exclusively treated with high potencies. He was opposed to this, especially in the initial stages. If very excitable mental symptoms are present, the giving of a high potency may result in an explosion. His own views regarding varying high potencies are that the lower are quite effective in acute conditions, and that they are safer initially. When there is a possibility of aggravation, the

avoidance of latter has its advantages in that the patient may take alarm, under the mistaken conception that his condition is very much worse. As to the 30s, which may be regarded as "medium", these are of great use when appropriately prescribed, and may, in certain cases, be repeated frequently, violent reactions with them being rare. He has reasons for believing that "repetition" lessens the tendency to aggravation. He would select 30C as the best allround potency, outstanding indications for high potencies being mental symptoms. Rabe remarks that the finest cures are made with single doses of the high and highest potencies. Raue thinks that the more accurately we individualise, the more we may become inclined to choose the highest potencies, though he admits that there are undoubted facts which seem to favour both sides. Remington's experience is that the high potencies do aggravate, they are suited both to acute and chronic diseases and that more care is necessary to guard against "all foreign medicinal substances". He says that it is the duty of every homoeopath to try the high potencies in his own practice. Rice considers that both high and low potencies prove efficacious, depending on the case. Ritter says that the high potencies have often damaged the reputation of Homoeopathy in the medical world and that it has always been our vulnerable spot for the attacks of our opponents. Roberts advises that if the symptoms are very similar, we can go as high as we wish. The less sure we are of our similarity, then the lower our potencies. As a rule, where there is pathology, medium or high potencies may be dangerous. The similarity of the remedy to the case, as a rule, is the basis for the potency. Roger Schmidt has used all potencies with success but has a preference for higher potencies. He thinks the high potencies fit better refined, sensitive patients as also women and children. Rorke concludes that if a patient presents rich indications for the remedy and it is given in low potency, he will have an aggravation. Ryan, Pope and Nankivell suggest that experiments should be made by practising only with 1x to 3C dilutions. Sankaran writes that he has found the LM scale of potencies more effective. Pierre Schmidt reports resounding success with high potencies. Shirtliff always uses the 30th potency. Shuldham says that a spasm of the sphincter vesicae may disappear under Nux. 30 but a paralysis of the same sphincter will need at least the 3x. A paraplegia from congestion of the cord may give way to Strychnia 12 but a paraplegia from anaemia of the cord will require the 1C or even the 1x. This class of cases may come under the enantiopathic law as regards dose, for it will be conceded that the 1C or 1x of Strychnine will not paralyse, but will excite. Sloan refers to a case of injury in which Arnica 200 and CM did nothing but a few doses of the O cleared it up. Smith was able to succeed with doses between the 1x and 3x.

Stevens says that she has found the high potencies acting more quickly, their effects lasting longer. Templeton cites his experience that the result of repeated doses of low potency did not last as long as the higher ones. High potencies in cases with structural change produced aggravation. For ready results in acute cases, he thinks one must go high. In case of collapse, when it is a question of life and death, high is needed. He reports better results with high potencies and reports a case of warts in which Thuja 3x and 6x failed but the CM cured. Teste records that he has experienced better results with the higher potencies. Tuthill Massy used the potencies 60 to 2000 of Jenichens in various functional disturbances and found quicker results than with our ordinary low potencies. He says the high potencies should not be cast aside altogether. Tyler mentions that a compress medicated with Calendula 200 cures ulcers far more rapidly than one medicated with Calendula O. Underhill Jr. recommends a method which he thinks a majority of the very best prescribers and practitioners of Homoeopathy follow. He advises that a single dose of 200th potency should be given in acute cases. In chronic cases, he says we can begin with the 30th. If three doses of the same potency have been given as and when necessary, then the next higher potency may be resorted to. He thinks that in prescribing for chronic cases the 30th or above in the single doses gave a sharper reaction, one that is more easily recognised than when low potencies are employed. Ussher says that he does not often use high potencies because he gets on very well with the lower ones but quotes a case to show how the high potency alone may help in some cases. Waffensmith recounts that he had never, in any of his work out on the range, in the sheep camps, out on the ranches, anywhere that he has practised, ever used less than the 200th. He found those potencies did the work satisfactorily. Ward writes, "In homoeopathic prescribing with different potencies, we are more easily able to accomplish what we desire than with a single power. Any curable disease may be cured by any power, if the indicated remedy is chosen." Watson had observed that in skin diseases, large doses were required whereas, in nervous diseases, higher attenuations were needed. He also reports a case of intermittent fever in which Jousset, after trying various dilutions of Nux vom. without effect, finally cured it with the 200th. Watzke recommends high potencies. But he speaks against Jenichen's potencies: he says, "I have myself experimented with the high potencies, (both Jenichen's and Petter's) upon my own healthy body, and in more than fifty cases of sickness. The result was in every respect, null." Weisselhoft advises that only potencies below the 11th should be prescribed. Wells P.P. relates a case of an elderly lady with chronic cough who was not amel. by Lachesis 200, but was speedily cured by Lachesis 2000. He also reports a case of scarlet fever, where the remedy given in 30C and 200C failed but the five millionth cured quickly. Sir John Weir quoting from 35 years experience says low potencies should be used for physical illness, external conditions, skin conditions, etc. When mental symptoms are found,

high potencies are needed as they alone provoked such symptoms. He reports a case of cataract which cleared up in 13 months after one dose of Phos. 30. Wheeler writes, "It frequently happens that the high will relieve more effectively (otherwise they would have never come into use), but it also happens now and then that low potencies succeed when high have failed." He relies on the same rules to be quoted below but says further, "Explain it how you may, there is much clinical evidence to suggest that the action of the higher potencies is often (though by no means invariably) more profound than that of the lower." He also says, "The more the end results, the lower the potency." There are many exceptions to this rule and much depends on the sensitivity of the patient. He, at the same time, acknowledges the efficacy of low potencies and quotes a case of acute arthritis cured by Dr. Goldsborough with one or two doses of Puls. O. Wilson G.L. says that he gets the best and speediest results with a high potency, esp. in case of pain or haemorrhage. Wilson T.P. records that remedies must be given in high potencies in intermittent fever. Fergie Woods states that with sensitive patients, high potencies may aggravate. In cases with organic changes, lower potency is preferred. Particularly in cases of Phos. and Lach., he generally started with 12th only. He also mentions his opinion that the high potencies seem to act for a longer period merely because we give high potencies when we are more sure of the similimum. Wyld much preferred the low dilutions, viz. the 1x and 3x. Yeldham reports a series of cases treated successfully with low potencies, e.g. 1x and 1. He also reports two series of cases, one treated with the 200th potency and another with low dilutions. Yingling, that remarkable homoeopathic obstetrician, is so gratified with the effect of higher potencies in obstetric cases that he urges everyone to give them a fair trial. He reports that he has seen the most profuse haemorrhage case and the most distressing pains change like magic into regular labour pains after a single dose of high potency of the similimum. Discussing potencies he writes, "There is no question but that the crude or very low potency will cure when homoeopathic to the diseases condition. Experience teaches and proves this beyond a doubt. But the experience as fully and completely proves and establishes the fact that the high and higher potencies act more promptly and efficiently and will cure cases, especially of chronic diseases, that the crude cannot touch. It is erroneous to suppose that the high potencies excel in the treatment of chronic cases and are not efficient in the acute stages of disease. My experience goes to prove that the high potencies are more reliable and efficient in the acute cases and will abort sickness or restrict it to a few days, whereas the crude would require many days or weeks to accomplish the same." He also reports his own experience when he required Sulphur. He took it in 55M and CM potency with no relief but one dose in the DM potency cured him. Some tentative rules for potency selection Even though it becomes a difficult task to frame definite rules yet some tentative guidelines can be evolved from the experience and conclusions of the majority of the many veterans quoted above.

1. When in a case, the symptoms of the patient are very well matched by the symptom picture of the drug and especially if the mental symptoms are present and clearly marked, then a high potency seems advisable. 2. (a) Where the symptom matching is poor due to paucity of symptoms or (b) when the prescription covers only a superficial or local condition e.g. a skin condition such as a wart or (c) where pathological symptoms predominate, e.g. as in cancer, congestive cardiac failure, etc. or (d) where only a palliation is aimed at because the patient is incurable and has a very low vitality, low potencies seem more advisable. 3. Certain medicines seem to act better in particular potencies. For instance, drugs like Apocynum cannabinum, Sabal serrulata, Ornithogallum umbellatum, Hydrocotyle asiatica, Passiflora incarnata, Crataegus oxycantha, Adonis vernalis, Strophanthus hispidias, Carduus marianus, Blatta orientalis, etc., seem to act better in O. 4. Nosodes seem to act better in high potencies, e.g. 200 and above. 5. As regards bowel nosodes, certain rules apply. If the case is a new one and the patient has not received any potencies so far, a medium or high potency can be given when the bowel nosode is clearly indicated. If the patient has received any potency within the preceeding 3 months it is wise to give a low potency. John Paterson writes that where there is marked pathological evidence, low potencies (below 6C) can be given and repeated daily. In acute diseases, the single high dose is preferable. For acute phase of chronic disease, high potencies can be given and repeated at intervals. 6. If the patient has already received a deep-acting constitutional drug in high potency and is improving under the action of this, but has developed some superficial disturbing symptom, a low potency of a complementary drug may be prescribed for the relief of the symptoms. 7. Children appear to tolerate high potencies well due to their vitality while old persons may not tolerate high potencies so well. 8. When the patient is oversensitive to drugs, it is wise to use a low potency. 9. When the reaction is poor and a reaction remedy is prescribed to promote reaction, e.g. Carbo veg., a high potency is to be preferred. 10. Probably intelligent and sensitive patients and those engaged in mental occupations need higher potencies while the dull and the backward and those engaged in physical work may need the lower ones. Extending this idea, it seems that the less highly evolved animals may need lower potencies. 11. Certain potencies may produce certain effects, e.g. it is said that Silica given in low potency promotes suppuration, whereas if given in high potencies it aborts suppuration. 12. High potencies of deep-acting medicines such as Silica, Phos., etc., are contraindicated in advanced pathological states. The repetition of doses In homoeopathic practice, the selection of the proper remedy is probably the most essential thing, but after the remedy has been selected and administered in the proper potency, the homoeopathic physician should be able to watch out for, understand and interpret the remedy reaction and should know the proper "period for repeating the dose". This is considered so

important that masters like Kent warn us that a case can be completely spoiled by improper repetition of the dose. Repetition in acute cases In homoeopathic practice, in acute cases, the frequent repetition of doses, even of high potencies, seems to be generally and universally approved. Borland, for example, used to give in cases of pneumonia 1M or 10M every 2 hours. It is believed that in acute disease the pace of the disease is such that the effect of the doses is quickly exhausted. It must however be mentioned that there were masters like Boger who were prescribing single doses even in acute cases. Dr. Boger mentions, for example, that he had never given more than one dose of the remedy in the hundreds of cases of typhoid that he had treated. But such prescribers are exceptional. I quote here some of my experiences in acute cases. In the beginning, even in acute diseases I was taught not to repeat the dose until and unless the action of the previous dose had been completely exhausted. I was instructed for instance, that in a case of fever if the maximum temperature was 104 oF on the day I prescribed, I should never repeat the remedy even if the patient continued to have fever until and unless the temperature went up to 104 oF again. Even if the patient had continued or intermittent fever for a month, if the subsequent highest level of temperature after the dose of medicine was less than the original level, the remedy was not to be repeated because probably the previous dose was still acting. In the initial stages, I obeyed this teaching implicitly like Casabianca and possibly I lost many patients. But, gradually, I made one observation. In acute cases, I used to give my patients a number of doses but I used to instruct them strictly that the moment there was any evidence of improvement, e.g. in a case of fever as soon as the temperature started coming down, the doses were to be immediately discontinued. Some patients followed my advice to the letter but others did not. The latter who ignored my instructions and repeated the doses in spite of the improvement would say that, even though they felt much better or even though they became completely alright with the first few doses, yet to be on the safe side they finished off all the remaining powders. To my surprise, I did not find in these cases any dire consequences as I had been warned to expect. The acute disease was not aggravated nor did the symptoms return if they had ceased and the patient continued to remain well in spite of the doses having been thus repeated unnecessarily and against my orders. In fact, these patients appeared to have recovered quicker! In not a single case do I remember to have noted that the acute condition relapsed because the doses were repeated when not needed. On the other hand, the other group of patients, in whom the medicine was repeated only if and when absolutely necessary, i.e. only if and when they felt worse, seemed to take a longer time to come round. These were the patients who followed my instructions strictly and discontinued the doses, perhaps too soon. Thus I was gradually led to the conclusion that acute disease at least require more repetition of doses and that, at least in acute conditions, frequent repetition or repetition of doses, even when "not required", does not do any harm. Now, we come to the repetition of doses in chronic diseases. Repetition in chronic cases In chronic diseases, there are two standard procedures. In one, repeated doses of a low potency of the remedy are given till the patient is cured. In the other, a single dose of high potency is administered and then a wait follows till its action is over, Sac-l being given in the meanwhile.

Repetition of low potencies The frequent repetition of low potencies in chronic conditions seems to be generally acceptable. For instance, for hard tumours, Calc-f 6x given two or three times a day for several weeks or months is quite a common prescription though it must be mentioned that people like R.T. Cooper were curing even chronic cases like peptic ulcers or even cancer with single doses of the medicine. The real difference of opinion and disagreement seem to rise only about the frequent repetition of high potencies in chronic cases. Repetition of high potencies Going back to the teaching of Hahnemann, one is at first rather confused. Hahnemann in his teaching, upto and including the fourth edition of the Organon, has strictly warned against hasty repetition. We are advised not to repeat the dose until the effect of the previous dose is exhausted. In the 5th edition, he emphasizes this but there is a hint of a change. He mentions that "... this minutest yet powerful dose of the best selected medicine be repeated at suitable intervals." Later, in the preface to the third part of the 2nd edition of the "Chronic Diseases", he says: "... in chronic disease I have found it best to allow a dose (to wit, a spoonful) of such a solution of the appropriate medicine to be taken no seldomer than every two days, but more generally every day." This teaching is finally incorporated in the 6th edition and he writes, "The same carefully selected medicine may now be given daily for months..." No doubt, Hahnemann's clear advice in the 5th edition, that a remedy should be repeated only when the effect of the previous dose has been completely exhausted, was implicity obeyed and the wisdom of this teaching repeatedly confirmed by his great followers like Allen, Boger, Clarke, Dunham, Farrington, Kent, Lippe, and many others. But we must remember that these masters did not have access to the later teachings of Hahnemann. They knew that Hahnemann was making some radical changes in his methods but since the 6th edition of the Organon was not published till as late as 1921 - thanks to the intransigence of Madame Melanie Hahnemann - though it was ready as early as in 1842, these masters had no idea about the new methods. They naturally faithfully followed and endorsed the original teachings of Hahnemann proposed and practised by him earlier, so that the final teachings of Hahnemann went unknown and therefore untested, unpractised and unendorsed. During the 88 years that had lapsed between the publication of the 5th and 6th editions of the Organon, the teachings of Hahnemann as found in the 5th edition held the field, and it was natural that his great followers emphasized his teachings as contained in that edition. So when the latest edition came out in 1921, these new teachings apparently went against the weighty opinions of Kent and others and it was natural that no one seriously attempted to try them out. Here, it would be worthwhile to go over the opinions, impressions and experiences of various well-known homoeopaths, as recorded in our literature. Grisselich, after describing how Hahnemann had changed his idea about repetition in 1832 and had allowed earlier repetition, mentions that among his followers Aegidi was in favour of more frequent repetition. Also Tricks, Wolf, Gross, Kretshmar, Rau, Koempfer and Attomyr were all of similar opinion. Hering liked to repeat on the 2nd, 4th, 7th, 11th or 16th day, and until reaction or new symptoms appeared.

Ad. von Lippe (as quoted by Yingling) advises, where no response has been obtained, to repeat a lower potency in water every two hours till a good response is obtained, even if several days are required, and then to wait on its action. The single dose is an ideal dose but it is only applicable with the true similimum which is very difficult to get owing to the masked symptoms through promiscuous drugging. The farther removed the remedy is from the similimum, the greater must be the repetition to get necessary action upon which to wait for a cure or a change. Baker says that one powder dry on the tongue may be all that is necessary, but again it is better to give three powders an hour apart or to dissolve a powder in six or ten teaspoonfuls of water and give two teaspoonfuls every half hour. Sometimes he gives one power a day for three days or a powder night and morning for three days. But he never used this last method with potencies above the 200th. Bellokossy considers that the wrong remedy has always some bad effect though only temporary. The high potencies produce much worse effects than the low. He also thinks that repetition of the dose will generally make the bad effects manifest. He further notes that he began to prescribe MM and potencies much higher than MM repeated once or twice a day for weeks and months. The results surpassed all expectations and produced infinitely better results. He also mentions that in acute cases you have to repeat but it is not necessary to plus. The same potency will be just as good. Beronville says, "As a rule we must stop repeating as soon as we have effect from the medicine applied", and then suggests a new method which he says he has found very useful in his long experience. Repeat the dose, in however high dilution it may be, at short intervals until its action becomes apparent or give a high dilution and interpolate it with a lower one and stop the medicine as soon as its action is manifested and as long as it continues to act. If the amelioration is not complete, repeat in the same way. Berridge feels that some cases, chronic or acute, may be cured by a single dose; others will require a repetition. The cases which need repetition are: (1) those to which no absolutely perfect similimum can be found and (2) those in which external disturbing factors continue to operate. Blackley reports two cases of hydrocephalus treated with Hellebore 1x given persistently for months. Boger opines that the repetition of doses is one of the most difficult subjects that the beginner can possibly handle. In case of a disease like malaria, a disease which inherently has the habit of recurring, he has never cured it with a single dose, especially if it were chronic. In such cases he gives a dose night and morning until he sees some effect, then stops and waits to see how long that effect is going to last. He goes on say, "In the case of a disease where it does not give an immediate effect, I am in favour of giving the highest potency in a single dose and then waiting a long time, as in the case of a miasm although I would not give the so-called anti-psorics for that purpose." Then he mentions that in slow, progressive diseases like arthiritis deformans, it would be a mistake to prescribe a remedy and expect quick action because these diseases have a tendency to repeat and reassert their symptoms. In prescribing and administering the medicine, we have got to take into consideration the pace the natural pace of the disease. Then he further mentions that he has sometimes waited three months for a reaction. But he notes that sometimes repetition is necessary particularly of the newer remedies, e.g. Pyrogenum. He also says that an aggravation from a high potency can be avoided by giving the remedy in three doses two hours apart.

Bradshaw thinks the failures to cure by high dilution are due to frequent repetition. Buchmann says that he has often noticed aggravation from too frequent repetition and that he has frequently injured his patients by such undue haste. He says also that many remedies, e.g. Bryonia, Belladonna, etc., when properly selected, frequently show an improvement after the first dose. On repeating the dose, after some hours, an aggravation ensues at once, which increases more and more with every successive dose. So he never gives these remedies more often than twice a day even in acute cases. Pulford thinks one may have to repeat the dose until it starts acting. Campbell reports a case of Bar. carb. in which the 200th potency was given but did not relieve in a noticeably short time. Nevertheless, he persisted in giving it at four-hour-intervals for a number of weeks and got results. He feels that in an aged person the vitality may need many doses to gather sufficient momentum to carry the patient to a complete cure. G.H. Clarke considers that Hahnemann's dictum must be observed, viz. that the dose should not be repeated while the amelioration lasts. Coleman says that the secret of Burnett's successes lay in the infrequent repetition of the dose. This gave the body a chance to react. Infrequent repetition is the successful method of treatment by isopathy or vaccine therapy, today. Cooper strongly advises us to rely on a single and solitary dose, even if it is one drop of the O. He quotes the case of deafness of four years cured by a single dose of Mez. given by Dunham. He calls repetition "a barbarous habit". He also describes a case of skin disease in which he prescribed Calc. carb. 3 x t.d. s. The patient reported after six months that he was completely cured, not while taking the medicines, but three weeks after stopping it. So, Cooper decided to rely hence forth more than ever upon the single dose, and to allow a sufficient time to pass before repeating the dose. Since then, he says, his success proved to be much greater. Dhawale says, " In chronic cases, I generally use the single dose. In resistant cases , repeated doses of the same potency or in the ascending potency scale are employed to the point of reaction. In acute diseases, I repeat often till a definite response is obtained and then I cut down progressively on the frequency as improvement sets in." Dienst reports a case where he gave Carbol. acid 30, 4 hourly at least for 2 weeks. Dixon is against repeating the dose too early. Edward Philips considers that the rightly selected remedy will cure more effectively when given at distant intervals. Ewart writes, "High potencies are in some homoeopathic circles spoken of almost with bated breath. I do not know whether this is due to the famous warning by Dr. Kent: "It is well to realise that you are dealing with razors when dealing with the high potencies. I would rather be in a room with a dozen negros slashing with razors than in the hands of an ignorant prescriber of high potencies. They are the means of tremendous harm as well as of tremendous good." (Kent's Lectures, p. 453). This warning is calculated to make the beginner steer clear of high potencies for the rest of his life. It is however hardly couched in the cool language of science and may have been due to an unfortunate experience of the doctor giving a homoeopathic remedy to a moribund patient. When the lamp of life is burning low, the exhibition of a homoeopathic remedy, high or low, is probably like a gust of wind. There is

a last flicker, then extinction. At all events, in most quarters, high potencies are usually given at rare intervals. You can however find instances in homoeopathic books of cases where the CM potency has been repeated daily. I have done so myself on suitable patients, and nothing but good has resulted. Daily repetition in a sensitive patient should be avoided as it produces on excited restless state. "Although high potencies are used sparingly, most homoeopaths are more lavish with lower potencies, even in chronic diseases. Common sense would seem to suggest that if the frequent repetition of high potencies is dangerous, then the frequent use of lower potencies is more dangerous since the lower potencies contain many million times the quantity compared with the higher potencies. As lower potencies can apparently be repeated t.d. s. with impunity, why cannot high potencies? I have made such experiments on myself with the CM potency over the past few years with so far no untoward results, in fact with benefit. For example, two hard tumours on the right side of my nasal septum, which practically blocked the right nostril, have gradually reduced in size. They had been in existence some 20 years before the homoeopathic treatment. "The rule I have tentatively adopted in giving high potencies, which I find more curative than low, is to dissolve the pilules in about 8 oz of water, and give a tablespoonful as a dose, instructing the patient to wait 10 days or so for reaction; if no reaction to repeat daily until reaction (aggravation or improvement) appears when the doses should be stopped, the dose not to be repeated until improvement comes to an end." Fraser Kerr reports a case where he gave Bry. 1 M in plussed doses daily for forty-nine consecutive days. Gagliardi mentions having prescribed Nat-m 30 seven doses, one dose every 3rd day for a patient. George Royal quotes several cases - one of a child with a tumour on the head half the size of an egg for which he gave Calc-c 30 daily once for 2 weeks and than occasionally. For another similar case, he gave Lapis alba 12, twice a day for 3 weeks and then intermittently. Gordon believes that Dishington's discovery of plus dosage, "has proved its value beyond all question or cavil". He has long used the single dose and for the last two years has been experimenting with double dosage. "This consists in giving, instead of the familiar single dose, two doses of different potencies, 24 hours or 48 hours apart, e.g. Phos. 200 (1) followed in 24 hours time by Phos. 1M (1). Thereafter, treatment proceeds exactly as for single doses except that instead of Sac-l (1), one gives two doses Sac-l 24 hours apart." Gordon holds that this method, in his experience, applies only to chronic diseases; that it is particularly useful in cases in which the single dose has failed to give results both deeper and quicker; that the average duration of action is usually, but not always shorter, ranging from about six to eight weeks that it is more profitable to repeat the double dosage in the same potencies at the second prescription and go higher for the third and fourth and higher again for the fifth and sixth; that the lower potencies are more effective when the patients's vitality is low; that the double dose causes harm instead of good in cases of deficient vitality. He believes, with Blunt, that plus dosage is of little value for potencies above 30, also, that when double fails, esp. among neurasthenics, triple dosage may be effectively given as follows: Nit-ac 1M, one dose, then 48 hrs later Nit-ac 10M, one dose and again 48 hrs later Nit-ac 45 M, one dose. Grimmer while discussing Hahnemann's "New and Improved Method of Repetition" says, "Kent did say you could give in acute cases, the medicine in repeated doses, and he did it especially in febrile cases."

Harish Chand quotes Kamfor who suggested the repetition of remedies in increasing amount. Hayes thinks that there is one serious objection to giving repeated doses, and that is late aggravation esp. in chronic cases. He had seen quite severe aggravation occur several weeks - as many as twelve weeks - after good improvement. Horace Reed endorses the method of infrequent repetition in chronic cases. Houghton reports his method of repetition. He says that he has given nearly all the longacting remedies in several hundred cases, a single remedy at a time night and morning for four days at a time followed by another similar remedy for 4 days or a week and so on for 3 to 6 months. Alternatively, he used to select four or five of the most strictly appropriate remedies for a given case, each one covering as many symptoms as possible, and administer one dose of each remedy during a day (that is four or five doses in all) for seven successive days then to give single remedies, night and morning for four days and after a week, to repeat the series of five medicines, daily for another week, and so on for a month or two *. He further says, "For my own part, being largely engaged in the treatment of chronic diseases, many of my patients being at a distance and never personally seen, I have indulged in the use of very low dilutions, tinctures, first triturations, and even crude drugs, and have repeated these remedies oftener than the strict homoeopathic rules permit, without being disturbed by aggravations and with a degree of success, which leads me to think that some writers are far too timid and fastidious in regard to doses and repetitions." Hubbard describes how she repeated the dose in a case expecting the patient to be worse but he got better , "I was giving it in one dose. It seemed to me he was not getting well on the one dose. I am afraid I was just plain experimenting with that 30. I went to see him carefully. After he had had the four doses, if he had been worse, I would have stopped it instantly. He appeared to get better. I told his wife to stop it instantly if he appeared to get worse, at any moment, but he fooled us and got gradually better, so I am afraid I have no reason for it except God given despair." But she teaches generally a single dose. She quotes Borland's claim that frequently he pulls through the pneumonias with a single dose. She further says, "I knew Borland when I studied over there thirty years ago, and admired him immensely. I have never seen any results from this so-called plussing, just a few shakes and pounds on your hand. I never have liked that." John Weir thinks the rate of repetition is dependent entirely on the response of the patient. He quotes a case of Sulph. in which the patient was given a single dose to which he did not respond for 3 weeks but responded very well to it in the 4th week. Johnson considers the best thing to do is to wait. Julian says that if experience shows that regular repetition is more beneficial we need not blindly follow Hahnemann. Writing on the subject of repetition, Kanjilal emphasizes giving a single dose and waiting until the action of the single dose is definitely finished. He gives examples of cases spoiled by undue repetition. He quotes a case in which Ars. alb. 6 x gave relief to the patient for six months and another case where a dose of Sulph. 10M repeated to hasten the action of Sulph. 200 given earlier produced a fatal effect. He also describes another case in which a patient given Lyc. 200 did not find any effect for three weeks but then started improving. But, by mistake, he took a dose of Sulph. 200 and this made him worse and it took more than six months to repair the damage. He says, "From the very beginning to the end we never prescribe more than one or two doses of the indicated medicine and observe reaction for

weeks or sometimes months, never thinking of repetition or a second prescription so long as there is the slightest trace of the continued action of the previous dose. It is an irrefutable fact of experience of all, that as soon as there is any evidence of reaction of the previous dose or doses, further medication must be stopped until the reaction is completely over." Commenting on Maganlal Desai's, "adventurous" repetition of high potencies, he further says that he has an open mind on the question and feels that this frequent repetition method cannot be accepted until there is more strong objective evidence in its favour. Kostenlitz is of the same opinion as Julian. Le Hunte Cooper says that in his experience remedies in the 30th potency can be repeated every 3rd day while 100C and 200C will act satisfactorily at intervals of a week though much longer than this may, in special cases, be required for either. He personally had not found any adverse effects from such frequent repetition. Mahony writes that Calc-c can be repeated frequently in children but not in the adults or the aged... McLaren reports a case of rheumatic fever for which he gave Lachesis MM for five nights successively with very rapid improvement. He also records that Terril used to give two or three doses of the 200th potency everyday for a week or two with some wonderful results. Mohan Singh strongly advises against indiscriminate repetition and quotes cases which were harmed by such rapid repetition. Phatak, the veteran homoeopath, says that in his experience, more frequent repetition of doses seems to be needed nowadays than used to be needed some 20 or 30 years back. Possibly patients are exposed to more stresses and strains and other morbid influences; possibly they transgress the laws of nature more than before; perhaps foods are devitalised or contaminated, perhaps the atmosphere is disturbed by industrial or radioactive material. But whatever the reasons, the effect of the medicine seems to be less long-lasting. So there does seem to be a case for more frequent repetition. Pulford notes that he has seen excellent result with the single dose and thinks that the dose should be repeated only if its action is interfered with by some other cause. He advises even in acute cases such as pneumonia, a single dose of the 200th and cautions never to repeat until one is absolutely sure that the previous dose has ceased to act. But he also thinks that one may have to repeat the dose until it sticks, then any further dose will be superfluous. Puddhepatt says that low potencies like the 3rd and 12th can be repeated two or three times a day. The higher you go, the less often must the remedy be given. Quinton records that, in cases of high B.P. , he might give remedies like Sulph., Bar-c, etc., 30, daily. He further states that the average duration of action of 30th potency is a week or fortnight and that the 200 could be repeated certainly after 20 days. He feels it worthwhile to experiment and see if the patient would do better with the more frequent repetition of high potency. He also feels there is a tendency to leave the repetition of the doses too long whether they were light, medium or low potency. Referring to Hahnemann's teaching not to repeat the dose often, Quinton says he would disagree with him and no doubt many other homoeopaths would join him in disagreeing. He writes, "If a statement is incorrect and can be shown to be incorrect by experiments, then it really does not matter how great the man was who made the statement."

Rabe in his editorial notes describes a case of a woman who was suffering for 6 weeks from tearing pain in back. He gave her Rhus-t 30 four times each day, for six days, at the end of which she was decidedly better. So he then gave her Rhus-t 200, thrice a day for another six days and then found that she improved further. Reed thinks it is a fatal error to repeat the dose too soon either in acute or chronic cases. Ross writes that at the opposite extreme we have recent syphilis which, as Hahnemann pointed out, requires repetition of the homoeopathic remedy several times a day in physiological dosage, gradually diminishing the crude amounts of drug with potentizing as cure proceeds. In fact, he thinks that all illness due to continued active infection, with fever and high E.S. R., require frequent repetition of the remedy in water with minor changes of potency as advised in the 6th edition of the Organon until improvement is very obvious. He further quotes a case of sciatica in the hospital in which he had to repeat Tuberculinum 4 or 5 times within a month. Senseman says that when you want to prevent something, say a patient is under the continuous possibility of exposure to a contagion - just one or two doses will not suffice. They must be given for a lengthy period. Shirtliff records that Holcombe prescribed for a case of suspected tuberculosis Calc-c 200, daily one dose for 3 months. Stewart mentions that Burnett used to repeat Bacillinum once a week. Sutherland says that weeks and frequently months will lapse before it becomes necessary to give a second dose of the chosen remedy. It is remarkable too, how well these cases get along in the meanwhile. Tomlinson writes that Lippe used to give one dose of high potency and would even wait for six months before giving the second dose. He reports that in a very serious case seen in consultation with Moore and H.N. Guernsey, he had selected the indicated remedy the giving of which was followed by prompt improvement. Then turning to his conferrers he said, "Gentlemen, whatever you do, do not give the patient another dose; if you do, she will die." Some time after Lippe had gone, however, the temptation became too great to resist and they did repeat the dose. The woman died promptly as prophesied. Among the high potency prescribers also, Tyler was in the habit of giving 3 doses every 2 hours and then following it with Sac-l. She had the impression that such repetition at short intervals cuts down the aggravation if any. S.R. Phatak, C.C. Desai and others like them administer the dose 2 or 3 times a day till the effect becomes apparent and then they withhold their hands as long as this improvement continues. This dose can be called the single cumulative dose as against the single dose. The object is to get a single cumulative effect. Others also have experienced and noted the need for frequent repetition. Wilson writes, "Repetition appears to me to be more often necessary than it used to be. Here, I am generalising with other than skin troubles in mind." He quotes Borland as saying that in modern life, we would need to repeat much more often. Wilson describes a case of bronchitis where he had to repeat Tuberculinum every fortnight. Woodbury records that in dropsies of general origin Arsen., Samb., or whatever remedy is indicated will, if used in the 30th to the 200th potency and repeated frequently several days

and renewed when necessary, sweep out the fluid with great relief. He thinks that there might be cases in which a single dose might not suffice and that several repetitions might be needed. Yingling says that it is thought dangerous to repeat Lachesis especially in high potencies, yet Berridge of London, reports a case cured by the repetition of Lachesis MM, night and morning for one whole week. He then quotes what Kent had written to him some years earlier, that in low fevers it was usually necessary to repeat the dose even every two or three hours for days before getting the required impression of the drug essential for a speedy and complete cure. He writes, "These illustrations are made to prove that the crude drug will cure when selected according to the law of cure. But it will be noticed that the drug is necessarily repeated most frequently, even every fifteen to thirty minutes for day, then one or two hours for other days bordering on weeks even when the patient is better and the drug's action has been quite marked. While these cases were cured with the crude drug, they could have been cured more promptly and with less suffering and expense by the use of a potency from the 200th upward." Apart from the fact that no new methods have been considered or tried out, no experiment of any sort worth mentioning has been attempted. It must be admitted further with surprise that even the teaching of Hahnemann as found in the 6th edition of the Organon which differs materially from his original teachings as contained in the previous editions of the book have not been put into practice. Homoeopaths in general have shown a great reluctance to try out these methods. As an excuse for this hesistancy it has even been suggested by some that these latest teachings are the outcome of a senile brain of the Master and therefore valueless. These statements are not only unsubstantiated and unfair, but also unfortunate because Hahnemann has always appealed that all his ideas should be put to the test of practice. It would therefore be a pity if we, his followers, should condemn his teachings without testing, a fault which we find with our allopathic colleagues with reference to Homoeopathy. Hahnemann had evolved and practised this method of frequent repetition after he shifted to Paris, and it gains still more respect because it was in Paris that he became most successful and had the largest clientele. In fact his phenomenal success in Paris might have been due to the developments and modifications of his original methods. He himself writes very approvingly about these new methods. Sankaran reports that, considering firstly that nothing should be condemned without test; secondly that Hahnemann had clearly emphasized that his new method was born of further experience and that it had proved to be superior; and thirdly that Kent and others had no inkling at all that such a new method had been propounded by Hahnemann and therefore, had no opportunity to try them out and compare the results, he decided to put this new method to the test. Further, even though the 6th edition had not been published then at least one homoeopath in the shape of George Royal had envisaged such a practice. He wrote: "I should like to emphasize one point which I think is hardly appreciated by the younger men. When I left college, I went out with the impression that the application of the remedy should be more frequent in acute than in chronic diseases; that the acute disease was like an enemy that must be overcome by many charges before he would take himself away. The chronic disease on the other hand was supposed to be like an enemy entrenched but asleep, where the attack need not be repeated to overcome him. My actual experience is to the contrary and I believe that the remedy needs more frequent repetition in the chronic disease."

In order to test the results of the frequent repetition of high potencies in chronic diseases, to know whether they benefit or do harm, Sankaran conducted a number of experiments in the Government Homoeopathic Hospital, Bombay. Whereas the original practice had been to stop the medicine as soon as any effect became noticeable whether as a result of the single dose or the collective dose - the single effect being the aim - he started very gradually and cautiously repeating the medicine even when some improvement was evident as a result of the previous dose. Having satisfied himself that such frequent repetition did not bring about any untoward results, he slowly reached the stage of repeating the doses daily. A number of cases were put under the new schedule of dosage, the potencies varying with each case ranging from the 6th to the CM. He was carefully watching out for any unpleasant reactions but he noted only three cases which showed such reactions and which had hitherto responded very well to the unit dose. To selected cases he administered the indicated medicine in high potencies repeatedly and did not find any harmful effects. For instance, he reports that in a case of convulsions in which the remedy indicated was Cup. met., the patient was given one dose of Cup. 200. There was an immediate improvement which lasted 3 months. Then he had relapses at intervals and every time he was given Cup. at intervals in single doses as follows: 1M after 10 days; 10M after 63 days and 8 days; 50M after 55 days and 67 days; CM after 73 days and 35 days. He showed improvement with every repetition. Then, from 01.12.58 onwards as an experiment he was given Cup. met. 30, once daily for a week, then from 08.12.58, 200, once daily, from 06.01.59, 1M, daily once and from 27.07.59, CM, daily once upto 05.08.59. The effect of such repetition was in no way deleterious and the patient became practically normal. He then gives some more illustrative cases. Cases 1. A patient Mr. P.N. , aged 30 years, was admitted to the hospital on June 11, 1957, with a history of oedema of the lower limbs, puffiness of the face and oliguria of five years' duration, with intermittent remissions and exacerbation. His case was taken thoroughly and all investigations done and a diagnosis of hypoproteinemia was arrived at. The symptoms indicated the probable similimum as China ars. Therefore, the patient was put on Chi-a 200, t.d. s. whereupon his urine output which originally averaged 6 to 8 oz per day gradually and steadily rose to 78 oz per day within a fortnight. The puffiness and oedema considerably lessened. However, despite the steady rise in the urinary output and the proportionate improvement in the general condition, the medicine was continuously repeated and despite the repetition the improvement continued. Whenever the response to the drug lessened the potency was merely changed, being usually raised or sometimes lowered, whereupon the response increased. The patient was kept under observation for six months and in all during this period he received doses of China ars. as mentioned below. 6th potency, 87 doses; 12th potency, 14 doses; 30th potency, 65 doses; 200th potency, 14 doses; 1000th potency, 25 doses. On December 13, 1957, he was discharged as completely relieved. 2. Mrs. K.A. , aged 30, was admitted on September 28, 1957, for paraplegia of one year's duration. She had incontinence of urine and stool and flaccid paralysis of the lower limbs. She complained of heaviness of the body, stitching pains in all the joints, heaviness alternating with tingling and burning of the lower limbs, burning of the soles, etc. She was brought into the hospital on a stretcher.

Her case worked out to Causticum, and she was put on this remedy. There was an immediate and remarkable improvement even with the first few doses but the administration of the remedy was continued nevertheless. In all she stayed in the hospital for three months after which time she walked out, completely relieved. During this period she received Causticum as described below: 1M potency, 27 doses; 10M potency, 28 doses; CM potency, 15 doses. No ill effect of any sort was noticed at any time. Among the many subacute and chronic cases treated in this manner were cases of chronic bronchitis, bronchial asthma, eczema, paralysis, pulmonary tuberculosis, nephritis, papillomata, psoriasis, carbuncle, etc. Only in the three cases, as mentioned earlier some aggravation was noticed that could be attributed to the repetition. Of course, only about a hundred cases had been put on this schedule of dose during a period of one year and so both the number of cases and the period of observation are insufficient to come to any conclusion. But this much can be said that the original rule put forward by many homoeopaths that repetition of the medicine done while the effect of the previous dose is still evident will invariably do harm and that such repetition would retard the progress is perhaps not justified in all cases as judged by the limited experience quoted above. If the rule holds good at all, then it must be recorded that many exceptions were met with! Incidentally, Hahnemann has clearly mentioned that only potencies of his new LM scale should be repeated. So, Sankaran as also Ramanlal Patel have independently tried out repetition of these potencies and found beneficial effects from such dosage. According to the original methods of repetition of dosage taught by Hahnemann in the 5th and previous editions of the Organon, we are to give infrequent doses of the appropriate medicine in the appropriate potency. Each such dose is expected to produce a mild imperceptible aggravation followed by an amelioration. The dose was to be repeated only when the amelioration ceases. As per the new teaching in the 6th edition of the Organon, we are allowed to give even daily doses of the medicine in chronic disease, doses of the LM potencies, every subsequent dose being a slightly higher potency than the previous dose. These doses are expected to produce no aggravation, but only a continuous amelioration till cure is established. But when a cure is established the further repetition of the doses produce a recurrence of symptoms or aggravation. Then medication is stopped and the patient becomes normal. The process of cure by these two methods can be represented graphically as follows: New method of repetition - organon 6th edition Further careful experimentation by other independent observers will, no doubt, confirm or contradict these conclusions and will no doubt, reveal the fact whether repetition of the medicine while the patient is improving is actually harmful, harmless or beneficial. In recent times in our country, practitioners like Maganbhai Desai, Sarabhai Kapadia, Kripalsingh Baxi and several others have reported various cases in which the indicated remedy has been frequently repeated in high potencies with beneficial results. Particularly a series of cases of pulmonary tuberculosis, some even with cavities in the lungs, reported by Maganbhai Desai is noteworthy.

Now let us look at another aspect of the picture. First, it must be recorded that such rapid repetition of high potencies is not generally practised by the homoeopathic profession at large. On the other hand, they are taught to repeat only when the dose is absolutely needed again, if at all. So, notwithstanding the reported experiences, illustrations and arguments, such frequent administration of high potencies, e.g. the repeated administration of CM potencies, four times a day for four months as was done in a chronic case *, is at first bound to evoke a feeling of misgiving, fear or even alarm in the minds of orthodox homoeopathic practitioners. Homoeopathic practitioners, by and large, follow the techniques and precepts of Kent and most of them usually adhere, in chronic cases at least, to the method of giving a single dose of high potency of the homoeopathic remedy and repeating it at long intervals as and when necessary. Alternatively they administer low potencies more frequently. Almost all the galaxy of past masters from Hahnemann downwards to Sir John Weir and Pierre Schmidt (including Allen, Boenninghausen, Boger, Dunham, Farrigton, Kent, Lippe, etc.) have advised against frequent and unnecessary repetition of high potencies. Some of them think it can actually obstruct the cure. There is also the cardinal principle of Homoeopathy which expounds the use of minimum doses. The homoeopath believes that the sick organism requires only the minimal stimulus to overcome the illness and to return to its original normal state. Roberts says that the dose should be diluted in time as well as in space, meaning thereby that the dose should not be given frequently. He says further that the successful homoeopath knows how and when to wait. He also mentions that to do this, i.e. to hold one's hand, is the hardest thing for a physician to do and the really successful homoeopath will be the one who can do so. He, like the obstetrician, must know the secret of "watchful expectancy and masterly inactivity". Besides, if a minimum dose can cure why should we give the maximum number of doses? Maximum doses and frequent repetition are more commonly associated with the allopathic method of treatment. This is the view of most homoeopaths. Hahnemann himself has praised the value of sugar of milk, calling it "a gift meaning", thereby that the judicious use of this placebo instead of the medicine can be most beneficial. In spite of this concept which we have inherited, imbibed and confirmed, and which to us forms one of the pillars of Homoeopathy, we have to consider the experiences and claims of Desai and others, and see if their method of prescribing is superior to or an advancement on the single dose technique in anyway, for example, whether it hastens the cure of the patient. Unfortunately sufficient objective statistical data are not available by which we can form valid conclusions. No doubt the cases reported by these homoeopaths have been treated successfully with such rapid repetition of high potencies. But there is no comparative presentation and study of cases treated with infrequent repetition and similar ones treated by frequent repetition of high potencies to prove that the latter method is indeed infinitely superior and quicker in its action. Now again, the question will arise whether such frequent repetition of high potencies is harmful or not. There is the possibility that in sensitive patients, it may actually give rise to more symptoms of the same remedy which the innocent or ignorant prescriber may consider as clear indications for the further doses of the same drug. Sensitive patients may be aggravated, sometimes even badly, by the repeated administration of high potencies. We have known of cases in which the patients were violently upset by the repeated dose of even moderate and low potencies. Again, we have to consider the possibility, however remote, that some of the patients who took such treatment might have felt worse and therefore discontinued the treatment without the physician being aware of these results. This possibility must be considered since all the patients were not treated in an indoor hospital.

Therefore, it would seem rash to start prescribing CM potency three or four times a day in chronic cases indiscriminately for every case! At best, such a practice can be followed, if at all, only by an experienced prescriber and cautious physician who is completely aware of what he is doing and who can carefully interpret and control the effects and if necessary neutralise the ill-effects of such repetition. In the hands of the large majority of less experienced homoeopathic practitioners, who may not be able to assess things so carefully, this method can prove to be dangerous and the results absolutely disastrous for the patient and the physician. It may not be, therefore, advisable for the large majority of less experienced homoeopathic practitioners to adopt this method straightway. It would be preferable to conduct carefully controlled trials and note the advantages or disadvantages of this method before adopting it universally. The clinical relationship of homoeopathic remedies Bowel nosodes Remedy Related Remedies Morgan (Bach) A. Morgan Pure (Paterson) Alu., Bar-c, Calc-c, Calc-s, Carb-v, Dig., c, Nat-c, Petr., Sep., SULPH., Med., Pso., Tub.

Fer-c, Graph., Kali-c, Mag-

B. Morgan Gaertner (Paterson) Chel., Chen., Hell., Hep., Lach., LYC., Proteus (Bach) Am-m, Aur-m, Ap., Bar-m, Bor., Con., Cup., m, Mur-ac, NAT-M, Sec-c

Merc-s, Sang., Tarx.,

Calc-m, Fer-m, Ign., Kali-m, Mag-

Mutabile (Bach) Fer-p, Kali-s, PULS. Bacillus No. 7 (Paterson) Ars., Bro., Calc-i, Fer-i, IOD., Kali-bi, Merc-i, Nat-i Gaertner (Bach) Calc-f, Calc-hyp, Calc-p, Calc-sil, Kali-p, Phyt., Puls., SIL., Syph., Zn-p

Kali-br, KALI-C, Kali-i, Kali-n,

MERC-VIV, Nat-p, Nat-sil-fl, PHOS.,

Dysentery Co. (Bach) Anac., Arg-n, ARS., Cadm., Kalm., Ver-a,

Ver-v

Sycotic Co. (Paterson) Ant-t, Bacil., Calc-m, Fer., Nat-s, Nit-ac,

Rhus-t, Thu.

Dietetic restrictions in homoeopathic practice Among the many problems faced by the average homoeopathic practitioner in his practice is the problem of dietary restrictions. In this matter he is less fortunate than his allopathic colleague. Whereas the latter is impelled to impose only such restrictions as the nature and degree of the disease condition may require, the homoeopath is taught to enforce additional restrictions demanded by the nature of the infinitesimal dose of the medicines administered. Accordingly, the large majority of homoeopathic practitioners ensure and insist that their patients observe these restrictions also. As a result, homoeopathic treatment has more or less come to be identified with the prohibition of coffee, condiments, onions, etc. I know at least one good homoeopath who was respected as much for his prescribing ability as for the severe restrictions he used to lay down. If his patients took coffee once, he dismissed them for ever.

He would even forbid his Rhus-tox patients from taking bath for as many weeks as they were under the action of Rhus-tox! However, the average modern patient, especially the citizen used to uninhibited living, resents such prohibition and it does happen sometimes that patients, afraid of these restrictions, or irked by these limitations, decline to take homoeopathic treatment on this account. Homoeopaths coming across such patients are put in a predicament. They are neither willing to relax the restrictions nor willing to lose the patients. It would therefore be worthwhile to discuss this problem on the scientific place, short of all its traditional accretions. In the beginning of my homoeopathic practice, I, like my colleagues, took such instructions seriously and was very strict in applying them. If a patient refused to abide by these restraints, I would mercilessly refuse to treat him. But I once had an experience which completely changed my views on this subject. I was once consulted by a lady who was suffering from deep, painful, bleeding fissures in the palms and soles recurring every winter for twenty two years. The symptom-totality of the case clearly indicated Psorinum. She was a regular coffee addict and as Boericke mentions that the Psorinum patient does not improve while using coffee, I told her that I would treat her only if she would give up coffee. This she could not bring herself to do and so she went away without medicine. That winter she had a rather bad time with the fissures and so she decided to take the treatment after all. So she came back and I gave her one dose of Psorinum with the instruction that she should strictly avoid coffee. The response to the remedy was very good and the fissures disappeared within two months without any further dose of medicine. I congratulated her on the recovery and commended her discipline in avoiding coffee as she had been a very strong addict. But I was simply taken aback when she told me that she had actually been taking coffee regularly all the time, but in deference to my orders, she had been taking coffee only twice a day instead of her usual t.i. d.! And before she left, she did say that I seemed to be ignorant of the power of my own medicine. I had another experience when I was proving the drug Sepia on myself. By the seventh day after taking one dose of the drug, I had developed many of the classical symptoms such as "Emptiness in the lower abdomen with a sense of fullness in the stomach, hunger with nausea, lassitude, all food and drink tasting salty, etc."As the symptoms persisted too long to my discomfort, I decided to antidote the drug by taking coffee, twice a day. As I was not addicted to coffee, I expected that it would immediately abrogate the effects of Sepia. But the symptoms subsided only very gradually and took nearly twenty days to disappear. It appeared to me that the symptoms came down by themselves rather than due to any effect of the coffee. These experiences made me pause and consider, and created some doubts in my mind about these restrictions; so I decided to experiment in my practice. Whereas hitherto I had been very stern and had forbidden the use of all medicinal substances in the diet such as coffee, condiments, onions, etc, I now became liberal and allowed and even encouraged half my patients to partake of these items. I wanted to see if such relaxation would at least cut down the rate of improvement in such patients and I wanted to compare the rate of improvement in this group with the improvement in the other group on whom I continued to impose the original restrictions. If the relaxation of the diet restrictions (including the consumption of coffee) were to impede the action of homoeopathic remedies, then this group which had been given the freedom to have them should have shown much less improvement. But in actual practice this did not prove to be so. Both the groups improved at the same rate and therefore I allowed all my patients this freedom in diet. They seemed to improve as well as before if not better. I became known as one of the rare homoeopaths to permit a liberal diet and the

number of my patients increased very considerably instead of decreasing, as it ought to have done! On finding that the control group given freedom in diet improved as well as the other group, I permitted all my patients to have all these articles of diet which are usually forbidden by other homoeopaths. While this made all my patients happy, I did not find any decrease in the medicinal effects on account of this relaxation. If the inclusion in the diet of coffee, onions, etc., had cut down the effect of the medicine as it should have done, at least in course of time my results should have suffered and therefore my practice should have also come down. However, on the other hand, my practice seems to have increased enormously. These experiences gave me a jolt and so I went back to examine homoeopathic literature on this point. Naturally, I looked to Hahnemann for guidance. Hahnemann gives instructions as follows in the Organon: Aphorism 259 "Considering the minuteness of the dose necessary and proper in homoeopathic treatment, we can easily understand that during the treatment everything must be removed from the diet and regimen which can have any medicinal action, in order that the small dose may not be overwhelmed and extinguished or disturbed by any foreign medicinal irritant." Aphorism 260 "Hence the careful investigation into such obstacles to cure is so much the more necessary in the case of patients affected by chronic diseases, as their diseases are usually aggravated by such noxious influences and other disease-causing errors in the diet and regimen, which often pass unnoticed." Aphorism 261 "The most appropriate regimen during the employment of medicine in chronic diseases consists in the removal of such obstacles to recovery and in supplying where necessary the reverse: innocent moral and intellectual recreation, active exercise in the open air in almost all kinds of weather (daily walks, slight manual labour), suitable, nutritious, unmedicinal food and drink, etc." These aphorisms provide the basis of the widely held view that in order to achieve success by homoeopathic medication it is essential for the practitioner to insist that the diet of the patient should be as plain and non-medicinal as possible. A closer examination of the aphorisms from Organon quoted above and a consideration of the background may render to the liberal reader, an interpretation slightly different from the popularly accepted one as we shall see. Hahnemann himself must have been astounded by his incredible discovery of potentization and must have found it at first hard to believe that however much the drug is diluted (and succussed), it remains effective; nay, its effectivity seems to increase! Naturally, his contemporaries would not believe this and so this aspect of Homoeopathy, viz. the infinitesimal dilution drew their ridicule. As such, Hahnemann preferred to make sure that the action of these infinitesimal doses was not interrupted by anything whatsoever. So, he advised the prohibition from the diet of all articles having medicinal value. He was afraid that, as "the dose of the medicine given is so minute", it might be easily inundated by other medicinal or strong-smelling substances to which the patient may expose himself.

He wished to convince his colleagues, beyond any shadow of doubt that the drug is effective even in such astronomic dilutions. A bland diet would therefore be ideal for this purpose. No one could quarrel with this same advice. Further, a non-medicinal diet is certainly conducive to a quicker recovery, whatever the disease or its treatment. Yet if the question is put whether such restrictions are absolutely essential for a rapid recovery, one will hesitate before answering. Hahnemann could not have fully comprehended, as we ourselves are unable to do after so many years, that homoeopathic potentization develops in the drug dilutions an extraordinary amount of the specific drug-energy which is the real curative force. This energy is so allpervading and all-powerful that it not only seems to antidote all morbid influences, past and present, but it restores the vitiated vital force to its normal equilibrium and removes all evidence of sickness, at times even in the face of apparent obstacles to recovery. Of course, if the energy content of homoeopathic potencies is forced to overcome other resistances the process of recovery may not be so speedy, smooth or complete. But among the various resistances, that offered by an unrestricted diet is so very minimal, that in practice it seems to make little difference. In the face of the extraordinarily powerful homoeopathic potencies, the retrograde effect of the crude medicinal items of the diet, if there be any, seems to be insignificant. There is also another aspect to this question. In laying down that all items of the diet having any medicinal effect should be avoided, we actually make a differentiation only in degree. If the question is raised, "What are non-medicinal substances?", we feel non-plussed, for Hahnemann has himself demonstrated that every substance in this world has energy-content which can be released and made available by certain processes. The very milk and salt that we consider as innocuous are included in the homoeopathic Materia Medica. Should one avoid them as medicinal? If so, where is the limit? Milton Powel and John Hutchinson record that some fifty or more substances used as, or in connection with food, are already proved and go on to quote cases cured by potentized tomato, pineapple, sugar, milk, etc. Normal dietary elements in their crude state usually only have a constructive role and are not capable of disturbing health markedly or permanently. Their deeper or disturbing effects can only be developed by potentization. In their potentized state they seem to act in an entirely different manner, on an entirely different place. To speak of or to compare the effect of the crude and the potentized substances in the same breath is illogical. So also is it incongruous to think that any component of our diet with medicinal properties is capable in its crude (or underdeveloped) state of antidoting or markedly influencing the effect of potentized medicine. Boenninghausen, whose masterly and practical interpretations of the homoeopathic principles evoked the appreciation of Hahnemann himself also holds a liberal view. He considers that it is not necessary to be extremely rigid on this subject. To quote him: "And yet it is plain that every article of food ought to be free from medicinal virtue, since this causes variations in his condition, and thus must make healthy men more or less ill, even if this should be only transitory. Starting from this position, homoeopaths in their dietetic directions would at first naturally forbid many things which later experience caused them to see are less injurious. The long-continued use of many medicinal substances in many cases dulls the susceptibility for them, so that the vital force eventually is no more affected thereby. Even more important, in this direction is the observation frequently made that, as a rule, only such medicinal substances act in a disturbing manner on substances given before as have homoeopathic relation to it, i.e. which have the virtue and tendency of producing similar effects on healthy persons. On this alone, the antidotal virtue rests, which a number of medicines show, and by this may be explained how it comes that many an otherwise antidotal

substance passes by without causing any disturbance, if it only leaves untouched the present morbidly excited parts of the organism on which the medicine is intended to act. "Otherwise it has become known by many facts and observations that even the potencies which are this day carried higher and which are the especial offence and object of ridicule of the investigators, who merely speculate and have become alienated from quiet experiments, have so much increased the intensity (doubtless immaterial) of the medicinal virtue that all grossly material influences can affect it but little or not at all. "All this is now, of course, taken into consideration in the diet to be observed, and homoeopaths have on this account been able to yield a good deal of late, which they had to forbid before, from fear of doing harm..." Boenninghausen feels that an article of diet (or for that matter anything) ingested continuously for a very long time may cease to exert any marked (medicinal) influence on the body. It is well-known that when the body is exposed for a long time to any mild influence it develops tolerance and immunity. Therefore, the feeling is strengthened that there is no need to prohibit such articles. Gallavardin who writes explicitly giving his experiences says, "Apprehending that the action of medicines given in such minute doses might be diminished or even destroyed by certain foods or drinks, they had come to prescribe a regime suitable, for the disease of the subject treated, but for the medicine administered, in order that the latter might develop all its curative properties. Thus we see in the writings of the earliest homoeopaths a list of foods and drinks allowed or forbidden, and the practitioners used to give this list to their patients. "The strictness of this list was founded on simple supposition and not on experiment. But the latter, gaining power by degrees, has shown the uselessness of this regime prescribed in view of the medicines, and the necessity of ordering another regime in view of the disease to be cured." "However, homoeopaths, when they had reached this double solution, still continued to advise their patients to avoid medicinal influences (various perfumes, meddling with camphorated ointments, the neighbourhood of all scents, etc.) as capable of antidoting the action of the medicines administered. But these apprehensions, still founded on supposition, have disappeared before a much more careful observation; this has shown in fact, that the attenuated remedy will cure even when the patients live in the midst of these hostile conditions. There is another practice of homoeopathic doctors which is about to disappear thanks to the researches of a chemist doctor. I mean the habit of our conferrers of directing their patients to take their medicines at a certain distance from their meals. This practice, which may be advantageous in certain cases to be defined hereafter, is not indispensable, as the following facts go to prove." He then describes how Dr. Lambert demonstrated by experiment that homoeopathic medicines can be administered with effect even in undistilled water. He then logically concludes that naturally they can be given in foods and drinks also. "And as these patients would not have been willing to take the medicines dry, in globules or in water, I was obliged to have them administered in their ordinary foods or drinks." "With this object, I used to direct that six to eight globules should be allowed to dissolve in three to four teaspoonfuls of fresh water, and then stirred briskly for mixing. Then the whole

was to be poured into the soup, milk, coffee, chocolate, tea, wine brandy or rum. These aliments, or drinks, were to be taken at least ten minutes before or an hour after a meal, but sometimes, not having understood, or not being able to follow my directions, the persons charged with it administered the remedies in a cup of coffee taken immediately after a meal or else in the wine drunk during the meal, or even in a glass of absinthe. And inspite of this, the remedies produced the desired effect very well and in a very persistent manner. This has been demonstrated to me by more than five thousand experiments made in my practice or in psychical dispensary..." "A professor has discovered a very ingenious mode of administration which can also be used in like cases. He takes a ball of gum, makes a hole in it with a strong needle, and introduces six or seven globules of a remedy, and then offers as a bonbon to each patient the ball of gum containing the medicine appropriate to his state..." "A lady asked me for a remedy for her uncle, a bachelor of 75 years, very mistrustful, as people living alone frequently are. Not knowing how to administer the dose without his knowing she took advantage of a two or three minutes' absence which he made during dinner, and in this moment she put six to eight globules of Lycopodium 30 into his glassful of wine and water, without having time to stir it. Nevertheless, the drug produced perfectly the desired effect which lasted three months." Apart from this, it is also well known that the sudden withdrawal of anything to which the patient has been habituated or addicted is not only likely to render the patient uneasy, but may also give rise to certain withdrawal symptoms. These symptoms may induce excessive suffering and complicate the symptom-picture during the treatment. Considering all these aspects it would seem that there is a necessity for reorientation of the question of dietetic restrictions, so that homoeopaths might continue to render the maximum of help with the minimum of discomfort to the patient and make the system acceptable even in these modern times. The modern patient, consciously and unconsciously, exposed himself to umpteen avoidable and unavoidable morbid influences, and it is the experience of many homoeopaths that the homoeopathic medicine successfully restores him to health though these influences continue to operate. Therefore, there is sufficient reason for the readjustment and reversal of the idea so that Homoeopathy can continue its good work and achieve success and popularity. We shall now examine what some eminent homoeopaths had to say on the subject: Case remarks, "It is my rule to request patients coming under my care to stop drinking coffee, especially when they are taking it to excess. In the cure of that patient, I do not know how to measure the comparative effect of abstaining from coffee and taking the remedy. However, that may be the patient was cured and that was the object sought." The late Andrew Kellner who was an eminent cardiologist attached to the Royal London Homoeopathic Hospital described to us an interesting experience. A renowned actress used to be under his treatment. She would travel in Europe from place to place and whenever and wherever she fell ill she would telephone to Kellner. He would give his prescription over the phone and she would take the medicine from the stock of potencies she always carried. Once, back in London, she fell ill and Kellner was called to visit her. After he had examined her, she produced her box of medicines for him to select. When he opened the box he found it

reeking with smell from the numerous phials of perfumes it contained. Amongst these phials of strong perfumes lay the bottles of homoeopathic medicines always thus, and that in spite of being thus exposed to the perfumes they had always acted on her promptly. Writing under "Coffea Tosta", Clarke says: "On account of its extensive antidotal properties, coffee has largely been condemned by homoeopathic practitioners; but it should be remembered that it does not antidote all other medicines, and it is questionable if it counteracts the effect of many of the above named drugs when they are given in high potencies. In any case, it is desirable to forbid its use when Bell., Cham., Colo., Ign., Lyc. and Nux are being given." So it would seem that Clarke was particular of restricting coffee only for patients who required these six drugs. * Answering a question, he says, "... articles of food which are antidotal to special medicines should be interdicted whenever these are being taken, e.g. coffee when Rhus or Lycopodium are the remedies, but medicines will sometimes act under the most unfavourable conditions. We have known Aesculus removes the constipation of opium when no diminution was made in the daily dose of the drug. The higher the attenuation the less likely it will be to be affected by chemical action." One group of practitioners without imposing general blanket restrictions on all patients selects the restrictions for each case. If a patient requires Lycopodium, then they prohibit such items as onions, oysters, etc., i.e. such substances which we know may aggravate the Lycopodium patient. If a patient needs Oxalic acid they restrict strawberries, and so on. Eugene Underhill represents this opinion well. He writes: "Many patients take too much coffee or too much tea and these may interfere with the action of the remedy. In the average cases where the trouble does not centre in the digestive or nervous spheres, you may allow one cup a day each of coffee and tea. It has often been observed that the repetition of coffee one or more times a day has a detrimental effect. Cocoa is no more desirable than coffee. It contains a high percentage of ash and is hard to digest." "Do not force a patient to take any food to which he has an aversion." "Do not encourage him to take any food which he has found upsets him." "Foods known to be inimical to certain remedies should be carefully avoided. For example, the Pulsatilla patient is often averse to fat and aggravated by it, even if this has not come out after the remedy has been given. Therefore, caution the Pulsatilla patient against taking much fat. If you are sure of your remedy you can say, 'Be very cautious about taking much fat and avoid greasy foods for you have the kind of constitution that is easily disturbed by fats.' Many times the patient will then tell you what was omitted or unnoted in taking the case. 'Why, doctor, I can't bear fats, they always upset me.' If so, just look wise and say, 'Just as I would suppose in your type of case.'" But even this restricted restriction does not appeal to me very much. Although in the Materia Medica and repertory Lycopodium is given under various food aggravation rubrics, such as onions, oysters, etc, it is not every Lycopodium patient who is aggravated by such items (onions, oysters, etc.). Therefore, even these restrictions I do not impose. However, if a particular patient informs me that such and such item definitely disagrees with him, then I advise him to avoid it for a while. But after he has undergone treatment for some

time, I advise him to try out these same items so that it enables me to know how far he has improved. In a discussion in which stalwarts like C.M. Boger, Stuart Close, H.C. Allen and others took part, E.P. Hussey has remarked: "I remember very well that in the early days, the older men were in the habit of enjoining their patients from using certain things such as tea, coffee, tobacco and stimulants. Later, experience has led me to adopt a middle course and not to forbid those habitual things, the absence of which might put the patient into an abnormal condition of itself. Moreover it is my experience that if a high potency is indicated beyond question, it will act in spite of a good many discouraging circumstances. I have cured clerks in drug stores, men employed in chemical works and opium users without stopping the use of opium and so on." This coincides with one of my own experiences. Some years back, I was called upon to treat an old lady suffering from osteoarthritis of lumbar spine. Her son was an allopathic physician, the head of a hospital. She had developed very severe pains and his prescriptions had made no difference. So one day he gave her an injection of Pethidin and this gave her enormous relief. So he gave her the injections daily for some more days, till one day he realised with a shock that she had developed a craving for the drug. Try as he might he could not get her out of the addiction for even if he reduced the dose by one tenth part she would at once know the difference. It was then that he wired to me for help. I went to his town and saw his mother. I took her case and found her remedy to be Sulphur. However, before I could give her the medicine, the doctor warned me that whatever medicine I may give, whatever restrictions I may impose, he would not withhold the Pethidin because without that drug his mother suffered immensely and visibly he could not bear to see this. I reluctantly accepted the condition though I was extremely doubtful if the minute homoeopathic dose would act in the presence of this powerful drug addiction. I prescribed Sulphur in potency and came back. A fortnight later, the doctor wrote to me the happy news that not only his mother had improved clinically but he was also able to gradually and completely withdraw the Pethidin. Though this might be an extreme example, yet it serves to illustrate the enormous power of the similimum to overcome many of the obstacles placed in its way. Young reports a case of Chorea in which, in the midst of various allopathic medicines which were not helping, Mygale in potency was given and relieved the patient. King taking part in the discussion already referred to has said: "When I was a student attending one of Dr. Hawkes' Clinics, I saw him put one dose of Natrum muriaticum 200th, I believe, upon the tongue of a sailor that was absolutely covered with tobacco, and yet, it worked just the same, curing the intermittent with which the sailor was afflicted. Stuart Close give his experience in treatment of dipsomaniacs. He says, "I recall one case in which the mental characteristics of the patient were such that it was impossible to give him any medicine; suspicion was the leading characteristic. He suspected his family of trying to poison him, and he would not take anything like medicine if he knew it. What I prescribed for him had to be given in various drinks such as milk, tea, coffee or whiskey; in the latter as often as anything else.

"He would not see a physician and was virtually insane. He had been a prominent business man, but he lost his business and became a useless member of society. He isolated himself in his room and devoted himself to drinking. I made a study of his symptoms from what his wife could tell me. The recovery was quite rapid, he lost his desire for drink and at the same time the suspicious frame of mind disappeared. In two months he went away with his family to Maine. It was not long before he was back in the world again. I used no potency lower than the 200th. The remedies were Arsenic, Lachesis and Nux." H.C. Allen remarked, "That case reminds me of the late Dr. Gallavardin. He published a book on the treatment of this class of patients by giving them homoeopathic medicines without their knowledge or consent in tea, coffee or whatever was the ordinary drink of the patients. He brought marvellous cures in dipsomaniacs, kleptomaniacs, etc., irrespective of the habits of the patients." John Hutchinson has said, "I would like to relate a case that has been brought to my mind by the paper and by Dr. Allen's remarks about Dr. Gallavardin. I have had a woman under my care for some time; she has been a dipsomaniac for eighteen years. I had been assured by some old practitioners that no woman could be cured of dipsomania, but feeling sure that the remedy would plough its way through all things, I started in. The very first prescription had a pronounced effect upon the patient. It was given her without her knowledge, but she noticed the effect and evidently thought that something was being done for her; as a consequence she drank more than usual. The nurse could not control her. My medicines had a decided effect and in some instances I think did harm, for I got a number of provings. Some ten remedies were used over a period of twenty weeks. During the treatment she had acute nephritis and also gastritis. Finally, she gave up drinking entirely. For ten weeks she had drunk nothing at all in the shape of stimulants. The case was managed with many mistakes I am sure, but on the whole was successful." Answering the question, "What is the effect of homoeopathic remedies on coffee, tobacco and alcohol habits? Or Senna or Stramonium ?" F.E. Gladwin says, "Sometimes the remedy will act in spite of such habits and sometimes it won't." Answering the same question, Eugene Underhill Jr. says that coffee, tobacco, alcohol, etc., generally interfere with proper action of the remedy and are better avoided. In answer to the question, "What diet directions in connection with homoeopathic remedies should the physician give?", Gladwin writes, "When it comes to the question of diet I feel like quoting Ella Wheeler Wilcox, who said, "So many creeds, so many minds, so many paths that wind and wind, when just the art of being kind is what this said world needs." I study the chemistry of food to discover that in physiological laboratory there is something needed besides chemistry in foods, then I study the calories in food to find that something besides calories is needed, then I go for the vitamins one food for one kind of vitamin another for another, and I study the different kinds of vitamin foods until I wring my hands in despair, then I remember the last part of the verse and sternly forbid the patient to eat anything that disagrees with him, never to force himself to eat the things he does not like, then I expect the remedy to correct conditions so that he can eat anything in reason." Das in an editorial says, " Withdrawal of all or many of the articles of diet is not rational, as such an act of rigid restrictions will only weaken the patient... "Homoeopaths often make homoeopathic treatment unpleasant to the patients by forcing them to follow very rigid restrictions in matters of diet or in matters of personal habits and customs. Chiefly because of unwise and needless restrictions many patients try to avoid

homoeopathic treatment. Imposition of restrictions, if not very necessary, is an unwise act which brings in the minds of people suspicion about the truth of the new system of treatment and tends to create in their hearts a natural aversion to Homoeopathy. Hence in our zeal to cure we must not cause any serious difficulty to our patients in the matter of food or drink and bar all chances of progress of Homoeopathy." Answering a query as to the avoiding of tea or applying of vermilion (sindur) on the forehead of ladies, Kanjilal writes, "We do not find any utility in disturbing the usual habit or practice of the individual patient if not forced by the dictates of the factors as given just above. Any rash interference in the habits and practices of the patient often causes unnecessary complications." Referring to addiction to tea, coffee, liquor, etc., he says, "In our practical experience we never find these things standing in the way of the homoeopathic law or principles." Grisselich quotes Hahnemann as saying that he has cured the most difficult chronic diseases without any particular change in the diet. He concludes, "Notwithstanding the warnings of Hahnemann, his dietetic directions were not infrequently put into very narrow limits, while others again paid too little regard to diet, and in this the dietetics, especially for chronic patients, can become either a matter of torment or ridicule, or of frivolous negligence." Grace Stevens says, "Often I feel that both tobacco and coffee interfere with the remedy... I think that the potentized remedy not infrequently can override the crude drug, whatever it is. Sometimes even a patient will be under somebody else's care and is having digitalis in crude form, and a potentized remedy will help tremendously. I believe, even though the patient is having tobacco or coffee." My preceptor S.R. Phatak is not very strict about such diet restrictions and I know well that he gets excellent results. He writes as follows: "In this connection, I wish to bring to notice a misbelief which is very much prevalent not only among homoeopathic practitioners but among lay persons also. This misbelief is that when homoeopathic medicines are being given, the patient should avoid coffee, onion, garlic, strong smell of attar, etc. My own experience conclusively proves and I firmly believe that in spite of these things homoeopathic remedies act, provided they are selected correctly. These substances are very convenient excuses to cover our ignorance or incapacity to select the correct remedy." Koppikar gives his experiences as follows: "The great bugbear for a large number of homoeopaths is the number of taboos in "Pure or Orthodox Homoeopathy". What would happen if a patient took coffee or tea during treatment? Suppose he took an aspirin one day, will all the good done to him so far by Homoeopathy vanish ? Will our remedies refuse to work if given side by side with medicated oil-baths, ultra-violet rays, etc.? I have not been prohibiting my patients from taking coffee, tea, etc., for more than 30 years. Neither am I nor are they the worse for this." Kumta reports that he divided 340 patients into two groups, put one on restricted diet and the other on unrestricted diet and found no appreciable difference in the effects of homoeopathic medicines on the patients in both the groups. Pierre Schmidt, the renowned physician, says, "Patients were cured even without their knowing that they are taking the remedy because the remedy was given in the wine, even in the coffee and the milk and it worked beautifully. Of course we say coffee antidotes the

remedy but the coffee is in a crude state while the dynamised spiritualised state of the remedy is something quite different. But it acts still, even with coffee." Conclusion The imposition of very strict dietetic restrictions in homoeopathic practice does not seem to be absolutely necessary or justified by logic and experience. * "when the indicated remedy fails..." "When the indicated remedy has failed to act, that is when it has failed to produce any effect, what is to be done?" This is a question that often faces the homoeopathic practitioner and we have to find the answers to this question. If the indicated remedy has failed to act, we have to first consider and verify whether the remedy was really and correctly indicated at all. For this purpose we have to go back and examine every step we have taken so far to ensure that the steps were correctly taken, since any error at any stage will ultimately result in the selection of the wrong remedy. Let us consider the various possibilities one by one. Importance of getting correct and complete data When we say that a particular remedy is "the indicated remedy" or the "similimum", this often represents only our opinion, inference or conclusion based upon certain data. We have taken the case, studied the symptoms, matched the symptoms of the case with the symptoms in the Materia Medica (with or without the help of the repertory), and we have deduced deduction that such and such is the indicated remedy. But however strongly, however certain we may feel about it in our own mind, we have no positive proof to say that this indeed is the indicated remedy beyond any shadow of doubt. At the most we could assert its correctness because it would be backed by our study and clinical experience. Yet, in spite of the utmost certainty in our minds we might still be wrong. Gladwin quotes Kent as saying that whenever we say, "the indicated remedy did not act", we mean always "the seemingly indicated remedy". So, the first step when the indicated remedy fails is to assume that perhaps it was only apparently indicated. Therefore, in order to make ourselves more certain, we shall have to take the case again or go over the symptoms carefully a second time to make sure that we have not missed, misunderstood, mistaken or misinterpreted any of the symptoms of the patient. In my experience of many years of practice, I can say that very often the error is in not getting the complete and accurate information. Very often the patient does not reveal to us all details, considering some of them irrelevant or meaningless or of no significance. Or, he may not be aware as to what type of information is particularly valuable to us for the purpose of deciding the prescription. He may not know that the very symptoms which the orthodox physicians ignore or laugh over may be the ones we need to know most. So, we may have to take the case again more thoroughly. It also happens that many of our patients are not as observant as we expect or hope they would be. As a result, they might give us very few symptoms at the first or second interview, or they might give us wrong information. I have had patients who mentioned to me at the first interview that all their troubles were positively worse at a particular time or in a particular position or under particular circumstances, but on subsequent careful and close enquiry the fact turned out to be that they were actually worse at some other time or in some other position or under an opposite set of circumstances. It would seem that as a result of our

questioning they started observing and noting their symptoms correctly. Or, some patients try to conceal some facts out of a sense of shame or embarrassment. Such things like a personal disgrace or a disappointment in love may required a deal of close, delicate and intelligent questioning before they are revealed. Particularly, to obtain good mental symptoms, it may take us two three or more interviews and we may have to develop a certain rapport with the patient. I shall quote an instance of how I had to fix the causative modality. Once a Christian youth came to me for epilepsy. He had been suffering for seven years. When I enquired into his symptoms he told me that the attacks invariably occurred whenever he went for a dance. I could not decide if it was due to the dancing itself, or if it was due to the concomitant features such as consumption of alcohol, late nights, excitement, etc., which usually accompany dancing. So I asked him to try out separately, one by one the following, viz., first dancing in daytime without alcohol, then merely taking alcohol, then keeping awake at night, etc., to eliminate each factor. It then turned out that he got the attacks almost always if he kept awake. It had actually nothing to do with dancing itself. Kent in his Repertory gives only one remedy under the rubric "Convulsions from loss of sleep" and that is Cocculus. Two or three doses of this remedy completely cured the young man. Once a young man gave me the history that all his disorders had started after had been rejected by a girl whom he loved. I took it as disappointment in love and prescribed but failed. Later, on close questioning, he told me that the rejection did not cause disappointment, but it hurt his ego as he was a wealthy person and the girl was very poor, still she rejected him. Eliciting the cause In going over the case again carefully, apart from seeing to it that the symptoms have been delineated correctly, viz. that the location, sensation, modalities, extension, etc., have been depicted properly, we have to see if the cause origin or source of the whole disorder can be discovered and pin-pointed. For instance, if the whole condition has originated after an injury or a grief or a vexation, remedies suited to such cause, e.g. Arnica or Ignatia or Staphysagria, may have to be considered. Failure to include such circumstances may have lead us away from the real remedy. Sometimes the cause, if definitely known, may predominate the picture and dictate the remedy. Farrington says that whatever the symptom-picture, if it has arisen after an injury, Arnica should be seriously considered. Similarly, he says, for patients who are not well after an operation, Staphysagria should always be considered. I know many cases of patients who traced their troubles to a head injury being helped by Natrum sulph., and some who suffered after an operation relieved by Staphysagria. I should here like to describe a very interesting case treated by my teacher S.R. Phatak. He was once consulted by a gentleman who was suffering from diarrhoea continuously for over forty years. On enquiry the patient gave a history that the disorder had started during his marriage. At that time, he had taken some strongly boiled milk and soon had an urge for stool. Being in the midst of the marriage ceremony, he had controlled the urge. But from the next day he had developed the diarrhoea which had persisted so long. Naturally, he had consulted numerous physicians of two generations but had found no relief. Phatak placed emphasis on the origin, viz. that it had started after taking boiled milk and selected Sepia on this symptom. This remedy completely cured the patient.

I had at one time occasion to treat two sisters with unusual symptoms. They had great weakness, recurrent headaches, vertigo, fears of all sorts, loss of appetite, a feeling as if the breasts would fall off, etc. Both the sisters had suffered from Asian Influenza in 1956 and since then had not been well. When they consulted me, they had already suffered for one year. Their (orthodox) family physician suspected that they had become neurotic! Their symptompictures indicated some remedy which did not help but when I gave them Carbo veg. on the indication that they were not well since an acute infectious disease, the entire symptompicture vanished and they felt very well. * Another patient whom I treated recently had not been well since Influenza. His symptoms were great weakness in the body, especially the legs; the legs felt unsteady and heavy; confusion of mind, etc. All these symptoms had appeared since an attack of Influenza which had occurred two years back. Cadm. met. completely cured him. This indication has been given by William Gutman who has published the provings of Cadmium metallicum. Some years ago, I happened to treat a patient who was suffering from headaches with vertigo and some other symptoms. I prescribed carefully with no result. Having failed to help him, I enquired very closely as to the origin of his troubles. He could not recollect any circumstance except that his headaches had begun after he had started practising Shirshasan. ** Presuming that this might have caused an injury to the head, however, mild or insignificant, I gave him some Natrum sulph., which completely relieved him of all his symptoms. Elimination of maintaining causes Where the indicated remedy has been correctly chosen, we have to consider the possible obstacles to cure which as Whitmont says maybe "living habits, drugs, irreversible or mechanical pathology, psychological factors and the miasmatic background". Where the cause of the illness is traceable, whether it is physical, chemical, mechanical, dynamic, emotional or otherwise, and when such causes continue to operate, they should be naturally removed wherever possible. There is no sense in treating a patient who has been exposed to chemical fumes and thereby suffers, if he continues to expose himself to it. A traffic policeman having varicose veins will improve little if he continues to stand the whole day. If the patient is under the stress of some strong emotional factors, he must avoid such situations which excite him, "Tolloe causum" (Remove the cause) is a fundamental principle emphasized by Hahnemann himself. However, it must be admitted that sometimes the maintaining causes cannot be removed. They may continue to operate and disturb the patient and retard the improvement. Sometimes this factor may have such an overwhelming effect that the patient may respond feebly or not at all to the medicine, even though the correct remedy is usually able to overcome this effect. Value of previous history It is also possible that there is in the previous history of the patient, an incident, accident or illness which has either actually given rise to the present disturbance or the residual effects of which may be presently interfering with the improvement of the patient. I have known several patients who did not show any improvement with the indicated remedy, but who on careful further enquiry revealed that they had earlier suffered from some illness such as

Smallpox, Diphtheria, Measles, etc., and only after the effects of these previous diseases had been antidoted by suitable homoeopathic medicines such as Variolinum, Diphtherinum, Morbillinum, etc., these patients had started improving. Patients suffering from various diseases, who had failed to improve and who gave a history of repeated vaccination or of having suffered from the ill-effects of vaccination in the past, needed doses of Thuja before they started progressing. Sometimes, there is a remote history of injury not directly related to the symptoms or related in time to the onset of the disease, but which may have contributed to the illness. Here, I would like to quote an unusual experience of mine: Master P.B. , aged 14 years, a young boy, was brought to me for consultation with very severe pain in the hamstring tendons of the right leg, of 15 days' duration. The pain was so severe and was so much aggravated by stretching the leg, that the boy could not stand up or walk. He had to be carried to the bathroom by his father whenever he had to attend nature's calls. His appetite, thirst, stool, sleep, etc., were normal but enquiry revealed that one month prior to the consultation he had had an attack of measles. Further, I learnt that seven years earlier, he had suffered from an attack of Diphtheria from which he had recovered with the help of A.D. Serum but since then his health had not at all been good. He used to suffer some disorder or other, throat pain or fever or abdominal pain or vomiting and so on. On examination, I found tenderness in the right popliteal fossa. The lateral tendon, which is normally palpable on flexion, could not be felt or seen. Though the boy had approached me only for the acute condition of the pain in the hamstring tendons, I thought of treating the background first. After all, there was the possibility that he was suffering from ill-effects or sequelae of Diphtheria, whether it was related to the present illness or not. So thinking, I would clear up the background first, I gave him six doses of Diphtherinum 1M to be taken t.d. s. I was planning to work out the remedy for his acute condition, after two days. Three days later, he returned to consult me and you can imagine my surprise when I found that the severe pain and tenderness in the legs had completely disappeared! He could extend his legs fully and was able to walk about normally. His mother reported that within the last two days his general health had become much better. He has remained well without any further medicine. Dunham's famous case of deafness cured by Mezereum, wherein the prescription had been based on the original skin symptoms which had been suppressed and had given rise to the deafness, is also a case in point. Another brilliant example was the case of partial impotence and infertility treated by Adolph von Lippe. Wesselhoeft had treated the patient for more than eighteen months with little improvement. Lippe then saw him and gave him Lac caninum because ten years earlier he had suffered from an attack of Diphtheria and the character of the attack had been that it had gone from one side to the other and back again. The patient was completely cured of the impotence and infertility. Weisselhoeft writes, "As far as we know, Lac caninum has no sexual weakness. The fact disturbed Lippe very little in his selection. He looked deeper and found the cause and the remedy. This is true homoeopathic pathology."

Sometimes the origin of the illness might be so remote in time or so early in childhood that it might have been completely forgotten. Yet careful probing might elicit the real source. Foubister in an article gives numerous cases to illustrate the value of past history in prescribing. He quotes, for instance the case of a lady who had a ulcerative colitis and who clearly needed Sepia. Sepia however failed to help her but when she received Hypericum which was given because she had developed the condition after a fall on her back, she was cured. The family history The family history may also give a clue to this lack of response. I remember numerous patients showed no response to the remedy which was clearly indicated, but when after careful enquiry, I had elicited a family history of tuberculosis or cancer in the parents or ancestors, and on this basis I had given a dose of Tuberculinum or Carcinosin, as the case may be, these very same patients showed remarkable improvement. Wilbur K. Bond writes as follows: "I have wasted much time trying to find the remedy in cases with tuberculosis in the family. Now I give a dose of Tuberculinum and miracles happen. In cases of bronchitis and tuberculosis, McAdam says when the indicated remedy fails, the "infallible remedy" is Bacillinum. Patients whose mothers or fathers have died of cancer of the liver or of any other organ just don't do well until they have received a dose of Carcinosin 50M or Scirrhinum 50M." Foubister deserves our gratitude for exposing to us the use of Carcinosin. Here I may describe the case of a girl about whom her parents were greatly agitated. I was consulted regarding this girl aged 14 years who was having nocturnal enuresis. Both the parents of the girl were (allopathic) physicians and so they had tried and exhausted all known and available medicines and methods without any benefit. They had become quite depressed and desperate, ready to try anything, even Homoeopathy! The mother of the girl was quite skeptical and even felt hopeless because as she said, her own mother had suffered from nocturnal enuresis till the age of 20 years and that she herself (the doctor) had had it, till the age of 25 years! She probably had concluded that the patient might continue to have the trouble till the age of 30 years or so! They had consulted a good homoeopathic colleague of mine and tried his medicines but they had failed. I compared notes with this colleague and found that he had selected his medicines well. But there was a strong family history of Cancer and he had done nothing about it. So I gave now a dose of Carcinosin and you can visualise the mother's joy when she found that this completely cured the girl. I could assess their delight from the way they tried to thank me. I have noticed and also reported the fact that many patients with a family history of tuberculosis have glossy or shining fingernails. I shall describe how I made use of this fact in my practice. There was a lady aged about 30 years who had an attack of acute rheumatic fever. She presented the usual picture of this disease with swelling of joints, high temperature, etc. Her remedy worked out clearly to Rhus tox. So, I put her on Rhus tox. 30, every 3 hours but with no result. Being sure of the remedy, I raised the potency to 200 and then to 1M, all of which produced not the least change in the condition of the patient. In the meantime, by the 5th or

6th day, her condition became very much worse and she also developed and presented signs of a very severe form of conjunctivitis and keratitis. Her vision became blurred and she was not able to see anything. The husband and relatives naturally became panicky and they decided to change over to allopathic treatment. I then examined her closely and I noticed that she had markedly glossy fingernails. They were shining as if nail polish had been applied. Naturally, I enquired if there was any history of tuberculosis in the family. The answer was negative. But I still gave her one dose of Tuberculinum 1M and then repeated the Rhus tox. The response was dramatic. Within a few hours she became much more comfortable, the pains and swelling in the joints and the temperature came down, the condition of the eye and vision improved and she felt very much better. She improved steadily and she went on to an uneventful recovery in a week's time. Now she has remained well for over two years. About two weeks after she had recovered, she came and told me that she had thought over my question about tuberculosis in the family and had written to her mother who was away. The mother had replied that indeed she herself had suffered from tuberculosis in her younger days, and my patient had not been aware of this. Selecting the proper remedy by properly matching the disease and drug picture We have to make certain that the matching of the disease picture with the drug effects is accurately done. The symptoms may appear to match well but in reality it may be a quantitative similarity, not a qualitative one - a similarity in form, not in spirit or substance. For instance, both the Aconite and the Arsenic patients have restlessness, fear of death, midnight aggravation, thirst for little quantities of water often, etc., but in actual practice the Arsenic picture is as different from the Aconite one as chalk is from cheese. Horace Reed mentions too much dependence on Keynote symptoms as one of the causes of improper selection. In this respect, a careful repertorization and a reference to the Materia Medica will obviate this. It may sometimes happen that some striking feature of the patient or some aspect of his behaviour or some peculiar symptoms described by the patient or the recollection of a very similar case treated by us in the past puts into our mind some remedy and this notion may so prejudice us, that we may either fail to go further into the case or only place emphasis on those symptoms which fit in with the remedy in our mind. We should beware of this trend and keep a clear mind till the case taking is completed. I was once taking the case of a gentleman who was having some valvular heart lesion. His symptoms were "Palpitation worse lying on left side, agg. from heat of the sun, suspiciousness, envy, loquacity, etc.". It seemed like a good case of Lachesis and I had practically decided to give this remedy. But I just asked a final question, "At what time do you feel best or worst ?" To this he said that he always felt best in the morning. He further said that he always felt very much better after sleep. So I studied his symptoms with the help of the repertory and found that his real remedy was Natrum carb. This remedy gave him great relief. Proper potency Another cause of the lack of improvement may be the use of incorrect potency. It is known that certain remedies act better in certain potencies. Once there was a lady with renal failure and generalised anasarca for whom we had selected and administered potencies of Apocynum cannabinum with no response at all. She worsened gradually till she was on the verge of death. But when we switched over to the mother tincture of Apocynum cannabinum

there was a sudden and dramatic response, and she recovered fully on this dose of this medicine. Similarly, Sabal serrulata, Syzigium jambolanum, Hydrocotyle asiatica, Ornithogalum, Blatta orientalis, etc., are all known to act well in mother tincture. Nosodes seem to act better in high potencies. The need for a nosode If the remedy seemed clearly indicated and yet failed to act, a nosode may be needed. The past or family history may give a clue as to which nosode is wanted. For instance, if there is a history of many abortions, I give an intercurrent dose of Syphilinum. Many chronic skin conditions start to improve well after a dose of Psorinum. Many patients who suffer from recurrent attacks of cold feel better after a dose of Tuberculinum. A study of Robert's book will show what miasms are operating in a particular patient and a suitable nosode may be selected. Bowel nosodes have broad indications and a wide field of application. The indications are to be found in the appropriate books. Lehman praises the effect of Suprarenalin. He says, "As an intercurrent remedy it (Suprarenalin) has remarkable power in 12x or higher to resensitize the tissues so that they will react to present morbid conditions or to remedies which seemed formerly inert, and to nutrition." I may quote my own experience about bowel nosodes. Some years ago, I suddenly developed a few warts on my face. Being on the face, they attracted quite some attention. I had taken Thuja and Causticum with no effect and so I wrote to London and ordered for some Sycotic Co. 6. Meanwhile, a surgeon friend with whom I was practising, offered to cauterise them for me a week later and fixed an appointment, though I declined to have them cauterised. The next day, the medicine arrived from London. I took two or three doses a day and in three days the warts withered away. The kind surgeon who wanted to help me against my wishes turned up next week with his cauterising instrument and to his great surprise found no sign of the warts on my face. Allowing sufficient time Sometimes, the physician, who is impatient, anxious or over enthusiastic may, after giving the correct remedy, change it without giving sufficient time to act. No doubt, our remedies act rapidly in acute conditions and fairly quickly in chronic cases also, but sometimes they take time to act and the physician should have the patience to wait. Boger gives an extreme example that he sometimes found the remedy starting its action six weeks after the dose was administered. Poor reaction Sometimes, it so happens that the reaction or resistance of the patient is so poor that no remedy acts. In such cases one of the "reaction remedies" like Ambra grisea, Ammonium carb., Capsicum, Carbo veg., Laurocerasus, Sulphur, etc., may be chosen. Their indications are well described in Farrington's Materia Medica and other works. Franklin Smith says , "Very frequently I came across a case which is perfectly plain; the picture of the remedy is perfectly plain, and I give it in the attenuation that I consider best with no effect whatever. I change the potency, but without result. This may continue for a week or two. I then give a dose of Sulphur high every morning for three days, and then on returning to the original remedy it works like magic."

Gregory remarks, "I remember a case of spinal meningitis that I prescribed for without good results. I looked over Panelli on typhoid fever for some light, and found a short note added from Hering, that if the apparently indicated remedy did not work give Opium in a single dose. I did so, and then returned to the original prescription and it took hold." Interference from diet and habits Or it may be that the patient is knowingly or unknowingly doing, using, eating or drinking something that is interfering with the action of the remedy. Taking excess of tea, coffee or alcohol, smoking in excess, overexertion, ingestion of certain items of food like garlic, use of strong perfumes, etc., may also be interfering factors. Sir John Wier, in a discussion, answering a question on the subject quotes two cases in which the correctly indicated remedy failed to act because the patient was exposed in one case to camphor and in another to Sloan's liniment. He also mentions that he advises his patients to avoid medicated tooth pastes and to keep away from strong smelling substances. I may quote a recent case of mine. A patient of mine was suffering from headaches agg. loss of sleep agg. exertion of eyes. She was nicely improving on Natrum mur. but suddenly she became worse. On careful interrogation, she revealed the fact that she had been keeping awake at nights and stitching some clothes for her children because they were scheduled to put up a dance performance shortly. No wonder her headaches were worse! Roberts quotes a case of a persistent Coccus cacti cough which refused to yield to treatment, until the physician ordered the patient, a young woman, to stop the use of her lipstick whereupon the cough ceased promptly. Drugs And now we come to a major or serious interference with the natural process of cure and that is drugging. Many modern drugs are very powerful, powerful enough to subvert the normal harmonious functioning of the body. They may not only interfere with and prevent the action of the carefully chosen remedy but they may even produce various side-effects which may be toxic, allergic or of any other kind. A recent issue of the Practitioner of London had devoted nearly a hundred and thirty six pages to the toxic manifestations of various modern drugs. A separate group of diseases known as Iatrogenic diseases (i.e. disease caused by physicians or medicines) is now recognised and described. Proctitis caused by the use of antibiotics and liquid paraffin, the nerve deafness caused by Dihydrostreptomycin, various changes in the body due to the prolonged use of Cortisone are some examples. Many young women take contraceptive pills but may omit to mention this. Writing under the title, "Hindrances to the Homoeopathic Prescription" in the Homoeopathic Recorder, Grimmer the veteran homoeopath, has expressed very strong views on this subject: "When the homoeopathic doctor has given much time and labour to taking the case history which is the first great essential in every good prescription, and then devoted more time and labour to repertory study and research through the Materia Medica, he cannot afford to have such a prescription spoiled or interfered with by some foolish external action of the patient, which may nullify the expected results of all the physician's painstaking efforts and leave both physician and patient disappointed and discouraged. With these facts in mind, it behoves the

physician to instruct his patient emphatically that he must refrain from taking all other drugs such as pain killers, cathartics, camphor or menthol in any form." He also gives a long list of substances such as dentrifices, mouth washes, gargles, nose drops, face creams, soaps, processed foods, chlorinated and flouridated water, etc., which can interfere with the action of the homoeopathic remedy. Turner says, "This use of sprays, applications, mouth washes and gargles may be the reason why some cases fail to respond readily to what seems to be the indicated remedy." Modern homoeopaths remark that after the patient has taken cortisone the homoeopathic remedy does not act well. Stokes says that habit-forming drugs also interfere with the action of our remedies. Downer gives illustrative cases and says that first the road must be cleared of drugs that are hindering the true line of cure and then the indicated remedy must be given. That these drugs seriously interfere with and prevent a cure is known to the homoeopathic physicians. But fortunately for us, the same drugs, in potency seem to have the power of antidoting and nullifying the ill-effects of the massive drugging. Such treatment called Tautopathy was mentioned by Dudley Everitt and later on described by Ramanlal Patel. There is also a large amount of self-medication. People take all sorts of medicines that are being advertised but do not care to inform the doctor about this. Grimmer writes that the four best antidotes to the coal tar drugs like Aspirin are Arnica, Carbo veg., Lachesis and Mag. phos. to be given according to the symptoms present in each individual case. Again as Foubister says, the use of an anaesthetic may subvert the harmonious functioning of the organism. So he suggests that it is always wiser to enquire for a history of operations and the undue after-effects of any anaesthetic applied therein. Where the anaesthetic is clearly known, e.g. Chloroform or Ether, a potency of the same may clear up the ill-effects. The use of vaccines and sera can seriously interfere with the action of the indicated remedies. Grimmer writes further, "One more important source of interference with the homoeopathic remedy is the widespread use of sera and vaccines as protective agents against acute disease. The reaction to these products of diseases is often lasting in its effect and leaves the victims of this practice sick and suffering." For after-effects of serum Boger recommends Anthracinum, Psorinum or Sulphur and Hayes suggests Phos. L3 Aluminium The use of aluminium vessels for preparing and storing food can also be a source of illness as well as source of interference with the action of indicated remedy. Grimmer, writing in an Editorial, says, "Nothing has been said of the many food contaminations and even poisonings brought about by the use of aluminium cooking utensils. Aluminium poisoning is seldom diagnosed as such. It has been a universal infirmity. The use of vegetables and fruits which have been sprayed with lead arsenate is another difficulty in keeping the homoeopathic remedy free from interference."

He expresses himself strongly again on this point and writes, "... and most important of all he (the patient) must refrain from food prepared and cooked in aluminium ware and its alloys. He writes further, "The most pernicious of these interruptables is the aluminium toxin that enters the human system by way of aluminium cooking utensils and by water polluted with aluminium chloride which is used to soften hard water. This toxin acts much like one of the miasms and it must be eradicated from the system before a cure of the patient is possible. The most certain, rapid antidote for it is Cadmium oxide in potency, and of course the source of intake of the toxin must be discontinued. After the poison is removed by the Cadmium oxide, the remaining symptoms and conditions of the patient may be successfully attacked by the remedy that is indicated by the totality of remaining symptoms." He also says, "(when aluminium vessels have been used for cooking), many times even the indicated remedies seemingly will not act until at least a single dose of Cadmium has been given." Le Hunte Cooper in a well-documented paper describes the wide variety of symptoms and conditions that the use of aluminium cooking vessels can produce in sensitive people. Genuineness of the medicines used Lastly, one has to make sure that the medicines administered are genuine and most reliable. The homoeopathic practitioner is solely and entirely dependent on the homoeopathic pharmacists and chemists as he has no means of testing the genuineness or otherwise of the medicines supplied. So he has to see that the medicines used are obtained from the most reliable pharmacist. Payne writes, "No matter how thoroughly our drugs are proven or how carefully we select the remedy, if their preparation is carelessly undertaken, all our effort will be in vain and both we ourselves as well as our patient will be disappointed and lose faith in Homoeopathy." In this connection, the experience of the Berlin Homoeopathic Society in 1887 is interesting to note. In trying to find out how many homoeopathic pharmacists of the city were really honest and reliable, they cooked up a list of names of drugs, * some real and some purely imaginary and absurd, (made up by combining some latin terms), and placed an order for this list of medicines with eighty nine pharmacists in the city. To their utter surprise and indignation, seventy seven of the pharmacists supplied all these medicines! The same experiment produced the same results in several other German cities also. Pharmacists also supplied Ant. crud. 3, Silicea 3, Alc. carb. 3 all in liquid form whereas these drugs cannot be prepared in these potencies in liquid form! Cases outside the scope of homoeopathic prescribing We have also to ensure that the case really falls into the realm of the homoeopathic remedy. If the patient is unable to breathe because of a mechanical obstruction in the larynx as by a foreign body what the patient needs is a tracheostomy and not a dose of medicine. So, also with cases of pyloric stenosis, intestinal obstruction, intussusption, etc. Such conditions may require surgical intervention and not a homoeopathic remedy. Similarly a case may actually fall into the field of hygiene, nutritional deficiencies, mechanical defects, etc., and not call for homoeopathic treatment. Tyler mentions that pains dependent on mechanical causes will not be relieved by medicines. Whereas, inside the field of Medicine, the homoeopathic remedy is supreme and all powerful, if it is applied outside this field where it is not indicated failure will follow.

The importance of etiology in homoeopathy The approach towards disease and cure in Homoeopathy differs very much and in several respects from the concepts of modern orthodox medicine and among these, one that strikes our attention, is the recognition given to the enormous role of etiology in the production of disease. In saying this we must make it clear that the concept of etiology in Homoeopathy is vastly different from the concepts or connotations given to the term in other systems of medicine. In ordinary medical practice under the heading of Etiology, the incidence of, and gross factors and circumstances connected with the onset of the illnesses are generally discussed. Beyond this, it does not take us very far in the understanding of diseases. But in homoeopathic practice every little contributor or determining element, every little attendant fact, incident, or accident connected with the origin of the illness is given its due consideration and is properly assessed during the process of selecting the medicine. If the patient says that all his troubles originated after a disappointment or a grief or after a sunstroke or by getting wet, by lifting a weight or due to over-exertion, owing to overeating or because of loss of sleep, etc., etc., or in any one of numerous other ways, each of these factors gives us a clue as to the type of person involved and his susceptibilities and further provides a clue to the selection of the remedy. We know of at least one eminent and successful homoeopathic physician, who places great emphasis on this point of etiology and selects his medicine for a good number of cases basing his prescription mainly on the etiological or causative factor. One of the first questions he asks his patients is, "How did you become ill ?" and the answer to this question provided by the patient, in case he has observed and noted this point, considerably lightens the task of selecting the remedy. The concept, therefore, of etiology in Homoeopathy is as broad as the world itself and is not confined to merely factors like age, sex, religion and race. It may be a factor apparently too trivial or one which is not ordinarily associated with any particular disease. It may be even unusual or inexplicable and one that may look absurd in the eyes of the modern physician. But all the same it may be important. The etiological factor, gross or subtle, may serve to differentiate one case from another similar case and may help us to individualize the patient. A patient who develops a stroke after a long period of loss of sleep may need a different remedy from another with the same condition but with a history of suppressed anger. The pathology may be the same; the diagnosis or nosological label may be the same, but the etiology may make all the difference to a homoeopathic drug diagnosis and point to an entirely different remedy. Most fortunately we have in our armamentarium a variety of drugs to cover a variety of such etiological factors. A case of Dr. S.R. Pathak may serve to illustrate this point further. He was once consulted by a gentleman who was suffering from diarrhoea continuously for over forty years. He had tried a variety of doctors for all these years with no effect. On enquiry, the patient gave a history that the disorder had started during his marriage. At that time, he had taken some strongly boiled milk and soon had had an urge for stool. Being in the midst of the marriage ceremony, he had controlled the urge. But from the next day he had developed diarrhoea which continued so long. Dr. Phatak placed emphasis on the origin, viz. that it had started after taking boiled milk. Boger-Boenninghausen's Repertory gives only two remedies under the rubric, "Diarrhoea agg., boiled milk", viz. Nux mos. and Sepia. Out of these, he selected Sepia. This drug completely cured the patient.

In this case, the disease had been diagnosed as chronic amoebic colitis. This may have no relation to boiled milk in the eyes of the modern physician. All the same, the drug selected mainly on the basis of etiology cured the patient. We cannot better illustrate the importance of etiology than by quoting a few cases. We shall give illustrations by grouping the etiological factors under various broad headings. Physical factors We have known of a case of a patient who had a variety of troubles and who, on casual inquiry, revealed to us that all his troubles had originated after he had a very severe sunstroke some years back. Since then, he was suffering in various ways and he could not go in the sun even for a few minutes. If he exposed himself to the sun even for a very short time, he would get severe giddiness and vomiting. Basing our prescription mainly on the origin after the sunstroke, we gave him Nat. carb. which covered the rest of the symptoms also and this remedy completely cured him. Chemicals and drugs We had a case of a girl who had several troubles and who told us that all the troubles had started after she had been exposed to coal gas. When we gave her Bovista, she completely recovered from her illness. When we gave her Bovista, she completely recovered from her illness. Mr. S.R. P., aged 48 years, a lawyer from Solapur, consulted us on 28th April 1966, with the following complaint: In August 1965, he had developed weakness of the right arm and leg and had speech difficulty. He found difficulty in articulating. He gave us the history that in July 1965, he had an attack of typhoid which was treated with Chloromycetin but just when he seemed to be all right and when he was about to be discharged from the hospital, he became unconscious and developed paralysis. Some homoeopath had prescribed for him Causticum 200 daily once, which the lawyer had taken for forty days without any effect. When he came to us, we prescribed for him Causticum 1000, which also brought about no improvement. Now considering the fact that the whole trouble had started after the typhoid treated with Chloromycetin, we put him on Chloromycetin 30, three doses a day for three days and later on, on Causticum 1M. There was an immediate and very satisfactory improvement with the result that within a month he was able to attend to his work and was arguing in the court as well as before. When we gave her Bovista, she completely recovered from her illness. Mr. S.R. P., aged 48 years, a lawyer from Solapur, consulted us on 28th April 1966, with the following complaint: In August 1965, he had developed weakness of the right arm and leg and had speech difficulty. He found difficulty in articulating. He gave us the history that in July 1965, he had an attack of typhoid which was treated with Chloromycetin but just when he seemed to be all right and when he was about to be discharged from the hospital, he became unconscious and developed paralysis. Some homoeopath had prescribed for him Causticum 200 daily once, which the lawyer had taken for forty days without any effect. When he came to us, we prescribed for him Causticum 1000, which also brought about no improvement. Now considering the fact that the whole trouble had started after the typhoid treated with Chloromycetin, we put him on Chloromycetin 30, three doses a day for three days and later on, on Causticum 1M. There was an immediate and very satisfactory improvement with the

result that within a month he was able to attend to his work and was arguing in the court as well as before. Mechanical factors We have prescribed Rhus tox. and relieved many patients of a variety of troubles when they have told us that they had developed the trouble after overexertion or overlifting. The following case is impressed in our memory and so we shall repeat this case: A sailor consulted us in the year 1954 with a complaint of pain in the chest and in the left arm. It seems that about one year back while he was proceeding by ship to U.K. he had lifted some heavy object with his left hand and immediately developed pain somewhere inside the chest. Movement of his arms became severely restricted because the pain would increase if he raised his hands. He did not find relief with the medicines prescribed by the ship's physician. So he consulted eminent physicians in London but still found no relief. Then he proceeded to the U.S. A. and consulted some specialists there as well as in every port touched by the ship. Ultimately he returned to India and here also no physician was able to relieve this pain especially as every type of investigation failed to clinch the diagnosis. At last, he came to Homoeopathy. Without taking much trouble over the case, we prescribed for him three doses of Rhus-t 30, to be taken at six hourly intervals. When we gave him the medicine, he took one dose in our clinic and left. Ten minutes later, he phoned from the station mentioning that the pain had already disappeared and asked if he was to continue the powders still. He has remained well ever since. Dynamic cases Homoeopathy, like Ayurveda, recognises that diseases are dynamic disturbances and that they can arise from dynamic causes also. Very often we hear a patient coming to us and saying that he has suffered from an injury or from loss of blood and that even though measures were taken to repair the injury and to replace the blood lost, the patient has not been well since that episode. We, as homoeopaths, realise that loss of blood not only produces a certain type of anaemia but it also produces dynamic changes which may not be completely neutralised by replacement of the blood lost. We also have excellent remedies for such conditions, viz. for the dynamic disturbances following various causes. Emotional or psychic This is perhaps one of the most important of the etiological factors which modern medicine is just recognising. Homoeopathy places tremendous emphasis on the mind, mental symptoms and emotional factors. The experienced homoeopath finds that case after case comes to him giving the history of some emotional trauma and of having not been well since that traumatic experience. We could fill up page after page with cases in which the patient has never been well since an emotional experience. We may quote various diseases having an onset after the emotional trauma. We could give a dozen cases of illness arising from disappointment in love alone. The following cases may be illustrative. One of our students developed a peculiar set of symptoms. She would suddenly feel voraciously hungry and would actually ask for something to eat, but later would find that it was not hunger, it was only a sensation of hunger or emptiness. All at once she would get palpitation or vertigo. She had been suffering in this way for six months. We asked her how this had started. But we remembered that six months earlier she had appeared in an examination and when we enquired closely, we discovered that she had worked very hard and had expected to come out first in the examination but unfortunately she has missed this rank

and this had been a terrible disappointment to her. The whole set of symptoms had originated after this disappointment. A few doses of Ignatia cleared up everything. We once had an opportunity to treat a very interesting case. A young Parsee lady married and with a child had developed six months earlier very severe burning in the tongue. She had consulted a renowned doctor who had diagnosed it as vitamin deficiency but vitamins did not help. Antibiotics too were of no avail. Ultimately she came to us. Under tactful questioning, she confessed that a few months earlier she had fallen in love with another person. Every time she had tried to express her love to that person she had bitten her tongue involuntarily and then had developed a burning sensation. She had even considered taking a divorce and marrying the new person but did not do so because of the child. She herself was sure that her whole suffering was due to the disappointment but as no doctor had asked her, she had not disclosed this information. We took "Disappointment in love" as the principal symptom and found her remedy to be Lachesis. This remedy completely cured her. Innumerable such case-illustrations can be given to demonstrate how the knowledge of the origin, source or causative factor - be it an accident, illness or any other - contributes enormously in selecting the proper drug. But sufficient has been said to draw attention to the importance of such etiology. The scope of homoeopathy Pathology in homoeopathy Introduction Pathology is defined as that branch of biological science which deals with the nature of disease, through a study of its causes and its effects, together with the associated alterations of structure and function. It mainly concerns itself with the study of disordered function and deranged structure in diseases and their correlation with the clinical picture. As Boyd states in the introduction to his excellent Textbook of Pathology, the pathologist should endeavour not merely to attach correct labels to the lesions he sees, "but to reconstruct the course of events from the earliest inception of the disease to the final moment when we fall out of the splendid procession of life". Vital Force: As we all know the living body is an extraordinary creation. Thousands of chemical reactions take place inside the body to maintain the constancy of the body and life, and all these chemical reactions are perfectly controlled to an extraordinary degree. Naturally, therefore, there must be a force which we may call the life-force which keeps the organism in proper control and in proper health and at times even repairs the damaged tissues by itself without extraordinary medical care. It is to this vital element, the life-force, that Hahnemann gave the name vital force or vital principle. If there was no such force or control, the different parts and organs of the body would work in different ways in disharmony and create serious disorders. This force is also responsible for reproduction because we see that generation after generation is produced, which is possible only if there is a force or power behind it. Hahnemann announced his new principle and system of medicine over 150 years ago. During these 150 years, there have been tremendous advances in all sciences, including medicine and medical sciences like pathology, bacteriology, etc. Boyd refers to the particularly phenomenal advance in the science of pathology and says, "Explosive advances are

shattering the boundaries and frontiers of knowledge." Research and study have brought to light a tremendous amount of facts. The facts discovered have been so diverse and the data accumulated so massive that the pathologist and the physician among others are hard put to explain, correlate and integrate them. Naturally the thoughtful homoeopath must examine all these facts and consider how they fit in with and confirm his own concepts and experiences, concepts which he is confident are comprehensive enough to include every type of factual detail that may be discovered. The homoeopathic student, like any other student, studies the science of pathology and tries to interpret, correlate and integrate all the facts of science so as to harmonize these with his homoeopathic concepts, so that he can get an insight into the real state of sickness. But there is a snag because not all these facts fit in smoothly with his concepts and experiences. He is thereupon either confused or is forced to choose between the alternatives - the set of facts discovered by others on the one side, and his own verified experiences based on the findings of Hahnemann and others on the other side. Even though disordered functioning is known to precede derangement of structure and the study of functional pathology is now generally recognised and considered more important than structural pathology, and even though amazing facts concerning the biochemical nature and responses of the body in health and in disease are being daily unravelled, we are still on the frontiers of knowledge so far as biology and biochemistry are concerned. We shall try to correlate, explain and even attempt to interpret some of our concepts in terms of modern pathology. Relationship between pathology and homoeopathy The relationship between pathology and Homoeopathy has generally been either unrealised or often even misunderstood by the homoeopath. He depends mainly on the totality of symptoms and selects his remedy on the basis of this and often cures the patient. In this picture of the totality, for the purpose of deciding the prescription, the pathological state and symptoms arising from it rank quite low. Sometimes the pathology is even ignored. But in spite of the pathological state being given lesser or no value, it is noted that with the application of the similimum not only do the symptoms disappear, but simultaneously with it the underlying pathological conditions get corrected leaving behind only a healthy state. So, the homoeopath generally finds no need to consider or worry about the pathology. Dr. Jaisoorya, the brilliant homoeopath, wrote a scathing article against pathology titled "Where is pathology?" Diechmann writes, "Pathological investigations cannot help us for it is unreasonable to ask death alone for an explanation of the secret of the phenomena of life." But yet this neglect of the study and consideration of the pathology is not a satisfactory approach as we shall see presently. When a person is sick there is disturbed functioning and/or structure of tissues. The functional disturbance predominates and gives rise to the totality of symptoms at least in the early stages. It is only in the later stages that the alteration in structure becomes gross and evident and may dominate the scene. This may be so to such an extent that in the last stages of the disease, it may occupy the whole of the field and nothing else may be discernible except the gross structural disturbance or symptoms arising from it. As a result, the homoeopath may find it difficult even to get one good characteristic or individualizing symptom, the type of symptom on which he prefers to base his prescription. Now it must be understood that even though in the earlier stages structural changes are not gross enough or clear enough, every symptom must have as its basis some change in the

stage of organs or tissues - some pathology, however minimal, however immeasurable or undiscoverable. At least there must be some minute change of a biochemical nature in the tissue fluids. Roberts mentions the observation of McCollum who found that the quantity of manganese required in our diet is so minimal or infinitesimal that it is practically impossible to prepare a diet free from manganese. Yet if such a diet is prepared and birds are fed on this diet they lose their mother-love! This shows the effect of even infinitesimal quantities of the substances in our diet. Another consideration is that pathology was a practically undeveloped science in Hahnemann's time. Whatever little of pathology was taught was full of conjecture and absurd theories and beliefs. For instance, it was believed that the lump sensation felt in the throat by hysterical ladies was caused by the uterus rising into the throat! Only around Hahnemann's time and later on, some of the most important advances were made in pathology and bacteriology. Under the circumstances, Hahnemann had very little solid, reliable pathological data to go upon, and so his reliance on the totality of symptoms was not only a most logical and sound step but also a measure of his practical genius. Dr. Gibson Miller writes, "Hahnemann insisted that we must be guided in the choice of remedy almost exclusively by the symptoms, to the practical exclusion of pathology but I think there is a good deal of confusion with regard to this matter. So far as I can see Hahnemann did not object to the use of pathological changes as guides for theoretical purposes, but for practical ones. He was aware that pathology will remain imperfect and incomplete and therefore to rely entirely on it for treatment would be unwise." "It is true that to a limited extent it is practical to use pathology as our guide and we all do so use it. Whenever we have to prescribe for eruptions or ulcers - which are after all pathological changes - we do not hesitate to be governed by anything that is peculiar or characteristic about them such as their colour, shape and position because by means of their peculiarities we can differentiate. But, when we come to deal with gross pathological changes in the deeper organs we meet with two difficulties. In the first place we are unable in the living patient to determine those minute differences - though doubtless they do exist - which, if discernible, would enable us to differentiate." Carrol Dunham also reflects similar thoughts. He writes, "The grand old master reached at a single bound the same conclusions to which the labours of a half-century of able pathologists have at length, with infinite research, brought the medical profession." He further says, "And those of our school who insist upon pathology as a basis of therapeutics, who look only upon the single objective symptom and its nearest organic origin as the subject for treatment, and who deride the notion of prescribing upon the totality of the symptoms and claim to be more than mere symptoms-coverers, in that they discover and aim to remove the cause of the disease - these colleagues are as false in their pathology according to highest old school authority, as they are faithless as to the doctrines, and impotent as to the success of the founder of the homoeopathic school." But times have changed and pathology has become a well developed science. Detailed studies have been made of the tissue changes in various diseases to such an extent that an accurate diagnosis can be made from a small section of the tissue involved, e.g. in carcinoma. Pathological studies fully supplement clinical studies and help us enormously in diagnosing the case and assessing the prognosis. So wisdom dictates that we should utilise all the developments of pathology and in fact all sciences for our own purpose to the fullest extent possible, carefully interpreting them.

Further, we should carefully study the clinical picture and the pathological state in each case and correlate the clinical symptoms with the pathological condition. Dr. Gibson Miller continues: "And in the second place, very few of our remedies have had their proving pushed far enough to cause corresponding pathological changes. These, I take it, are the practical reasons that led Hahnemann to ignore pathology, and though our knowledge of this subject has enormously advanced since his day, his reasons still hold good. But we cannot, even in the selection of the remedy - to say nothing of its absolute necessity in all question of diagnosis and prognosis - ignore pathology, for without it we cannot understand the true course and progress of disease. Only by means of it can we know the symptoms that are common to the disease and hence those that are peculiar to the patient. We also thereby know at certain stages of some disease, no matter how similar the symptoms produced by certain remedies may appear to those of the patient yet that owing to the superficial character of their action, it is not possible for them to prove curative." Because of the second reason pointed out by Dr. Gibson Miller, viz. that our provings were never pushed to such an extent as to produce pathological changes, it is no surprise that there were and there still are and there probably will be less of pathological indications in our literature to go upon. Dr. Hubbard also writes, "It behoves us, therefore, even the strictest Hahnemannian among us, to give the pathological symptom its due." Foote mentions, "I have yet to see the physician of this class who does not acknowledge the advantage of a thorough pathological education, and who does not avail himself of the objective as well as of the subjective symptoms." He also says that the pure Hahnemannian collects and groups the symptoms of his patient both objective and subjective, which, with his knowledge of pathology, gives him a clear picture of the case. Campbell records, "If, when we speak of pathological conditions we refer only to internal functional and structural abnormalities then pathology is neither more nor less serviceable to therapeutics than what is loosely termed symptomatology. But if we take it as picturing the totality of the symptoms - external and internal cause and course of disease - then pathology is indispensable to therapeutics." Dr. Grimmer, taking part in a discussion on a paper read by Dr. I.I. Farr says, "We study the Organon and the writings of Hahnemann. We find that he stresses the totality of the symptoms alone, he included every symptom that he could get. Hahnemann went over his patients, he examined them. Everything that he could learn about his patients was recorded. This formed his picture. And so it is with the use of pathology. "Dr. Kent says it has a place, a relationship, it is in the schema; it has a valuable place sometimes. As the doctor here just stated, sometimes there is nothing left for us. How many unconscious cases of apoplexy are we called to prescribe for, often very successfully, only on what we can see?" This is why Dr. Dunham wrote clearly: "Clearly, then, Physiology and Pathology are quite indispensable to the physician, and they speak with little thought who affirm that these sciences are of no value to the Homoeopathist

and are disregarded by him. They are the sciences respectively of healthy and morbid phenomena. He cannot take the first step in the study of disease or of Materia Medica save by their aid. But he restricts them to their legitimate function. Pathology is for him not a guide in therapeutics, but an instrument which he uses in studying those phenomena which are to be respectively the subject and the agents of his therapeutic operation. "Pathology, restricted to its proper sphere, is an indispensable auxiliary to the study of the subject of therapeutics. It may be further subservient in enabling the physician to group the symptoms of a case in such a way as more readily to marshal and retain them in memory. Nor is generalisation of this kind at all repugnant to the letter or spirit of Hahnemann's method of the homoeopathic science." Dr. Farrington also emphasized this : "We include all the symptoms that we can observe. Then what have we? A mass of symptoms seeming to have no connection at all. They come from a human organism that is all order and perfection, and all the parts of which work in perfect harmony. When even one of these parts is out of order, there must be a certain clue to string these effects together and picture a form of disease; and when you get this form of disease, what have you? A pathological state. I hope that no diploma will be granted to any man in this class who does not study pathology. When you have the changes in toto that these substances have made on the system, you have the pathology of the case. You have the totality of the effects on the system." So when definite pathology is known and is covered by a drug, there is no need to reject it completely as having absolutely no value for the selection of our remedy. In the absence of other symptoms, and to differentiate between drugs of identical action, pathological data can be considered. Repeated experiences have shown the applicability of certain remedies in certain specific pathological conditions. For instance, cases of mastoiditis often respond to Capsicum, cancers to Cadmium compounds, splenomegaly to Ceanothus, uterine fibroids to Aurum muriaticum natronatum, warts to Thuja and so on. So, pathological symptoms need not be neglected when selecting the remedy. It is certain that careful clinical and correlative studies will reveal to us about the relationship between the symptoms and the pathological changes, and also between the pathological changes and the indicated remedy. Marsette writes, "In the second place, we must consider that with the use of only one drug we sometimes achieve cures that are spectacular which is the case when the basic or constitutional medicament coincides with the organic, symptomatic medicament. But when there are degenerations, injuries, sclerosis, serious disorder of an organ or tissue, it is not the same any more; in this case, the local trouble which is in many cases what brought the patient to the consultory, deserves as much attention as the disturbance that has upset the biological equilibrium, and which calls for the constitutional medicament. And although it is true that the mental symptoms have, in general, much more importance than the organic symptoms, for the selection of the basic treatment, it is not less true that the organic disorders may cause the appearance of mental symptoms that disappear when the local symptom improves." Far from believing or behaving as if pathology and symptom-totality are unconnected and poles apart, we should now apply our intelligent observation to elicit and study their interrelationship for, in truth, symptom-totality is the super structure and the pathology the foundation or at least, they are intimately associated like the two sides of a coin.

It is now necessary that we should not be satisfied with mere symptom-matching on the clinical level, but should go further and by careful correlative studies and clinical observations even try to fit our drug to the pathological condition. As we saw earlier, the science of pathology was very rudimentary or practically undeveloped during Hahnemann's time and he wisely based his therapeutic approach on the clinical level. But now that the science of pathology is very much developed and also because we do now meet more and more with purely pathological conditions or advanced stages of diseases in which the clinical symptoms of homoeopathic significance are absent, we shall have to be prepared to meet such conditions even on a pathological level. As Dr. B.K. Sarkar, who emphasizes the need for a knowledge of physiology and pathology, says the homoeopathic approach is based on the idea that the similar beginnings lead to similar endings. We are not able to match with our remedies the endings of the diseases, i.e. the pathology, and so we match the beginnings of diseases through characteristic symptoms, on the hypothesis that thereby the endings must also match. But we must appreciate that this may not be always so, or may not be enough and we must be able to match the disease and the drug pictures both in their beginnings and endings, i.e. both symptomatically and (at the end) pathologically. Otherwise in this age when pathology is so well-developed, when many disease conditions present themselves only through their pathological symptoms, we shall be left behind with our imperfect methods and instruments of cure. It is however true that the characteristic symptoms of the disease indicate the proper remedy and that this remedy which covers the totality of symptoms tends to cover the underlying pathology also. To give an illustration, we have had three patients who complained of a pain in the right hypochondrium which radiated to the back and was relieved by a warm drink. In all the three cases the remedy needed was Chelidonium. Even though the prescribing symptomtotality was the same in all the three cases, investigation revealed that the first patient was suffering from cholecystitis, the second from hepatitis, and the third from a duodenal ulcer. But all the patients were relieved by the same remedy, viz. Chelidonium. Clinical and pathological improvement Notwithstanding the fact that the remedy which covers the clinical picture also corrects the underlying pathology, it must be mentioned that in certain types of cases the homoeopathic remedy is able to obliterate the clinical picture and give the patient a sense of relief and wellbeing very early but the associated pathology takes some time to clear up e.g. as in pneumonia, pleurisy with effusion, etc. I may quote the case of a brain tumour in which the patient was completely relieved of all his clinical symptoms within two days, though the papilloedema (as revealed by fundoscopy) persisted very long. Only an ignorant optimist would hope that the tumour had also disappeared so soon (i.e. within two days). It is my experience in many cases, for instance in peptic ulcers, that almost the very next day after the proper remedy has been given, the pain disappears and the patient is able to take now without any difficulty all sorts of food such as spicy and acidic foods which had hitherto severely aggravated the pain; but X-ray studies repeated after a short time may fail to show a proportionately marked improvement in, or a disappearance of, the ulcer which may actually take three to six months to heal completely. Similarly, we have had other cases also, for instance, of biliary calculi, wherein all the patients' symptoms disappeared under the appropriate homoeopathic remedy and the patients felt very well. But the calculi disintegrated very slowly, after several months of treatment sometimes they did not disintegrate at all. So also we have noted in cases of pneumonia that the rapid improvement in the clinical condition of the patient is not reflected in the proportionately slower improvement in the pneumonic consolidation as revealed by X-

rays. I have also reported a case of anemia when the indicated remedy removed all the symptoms without altering the blood picture, and a case of ascariasis where all the symptoms were erased after the homoeopathic remedy but the patient continued to harbour the parasites. We are therefore led to conclude that in a few cases, symptomatic improvement may not be accompanied by a simultaneous and corresponding improvement in the pathological picture. Sometimes, the pathology may not clear up at all, e.g. large renal or biliary calculi. So it seems we have to differentiate between clinical and pathological improvement. Clinical amelioration may occur very early or even immediately after the exhibition of the correct remedy whereas pathological and radiological improvement may follow much later or occasionally not at all. Hence we should be very careful not to declare a case as cured until and unless we have made sure the pathology has also cleared up. Therefore, it seems necessary to assess the improvement of such cases under two separate headings: 1. Clinical 2. Pathological (and radiological). * How pathology is helpful to the homoeopath I have mentioned about the widespread impression that a knowledge of pathology is not helpful to the homoeopath and that it is even hindrance to his work. As such, it is also believed that a homoeopath has no need to know or understand pathology. Every clinical symptom reflects some underlying pathology which may serve as its cause, explanation or concomitant. And a good physician - as after all every homoeopath should be a complete physician as well - should know the type and extent of pathology. Our remedies, even if they are indicated by the symptom-totality, have certain range, depth and pace of action and cannot help in a case unless these aspects also match, e.g. Aconite is not useful in typhoid because Aconite does not have that range or depth; in other words it is not able to cover the pathology of typhoid. Further if two remedies seem equally indicated in a case on the basis of the symptom-totality, a remedy which covers the pathology would be naturally preferable. Even the famous Dr. Kent who did not look upon pathology with much favour has given us numerous pathological indications in his Materia Medica and Repertory. The following are a few examples of pathological rubrics in his Repertory: Abscess, Astigmatism, Atrophy of optic nerve, Cancer, Caries, Fistula, Hydrocephalus, Inflammation of brain, Polypus, Stricture, Staphyloma, Tumour, etc. The value of such pathological symptoms is indirectly indicated by the inclusion. Very few homoeopaths seem to have realised this aspect. Among them must be counted Dunham, Elizabeth Ens, Farrington, Hughes, and others. In recent years, Boger seems to have considered this problem for he gives in his book so many pathological general symptoms. The totality of symptoms In modern medical practice all efforts are concentrated on making the diagnosis, i.e. in discovering the organs or tissues involved, and the nature or type and extent of the lesion. Once this diagnosis is made, the treatment is easily decided as the treatment of various conditions are more or less standardised. The very approach implies that some tissues or organs are affected and the disturbances of their function or structure gives rise to the symptoms. Very often the treatment is aimed at the tissue involved and aims to eradicate the

local manifestation; for instance, if a patient has a wart the surgeon excises or cauterises it and is quite satisfied with such removal. But the wart may grow again showing that it is the result of a constitutional disorder. It is forgotten that the whole patient is ill and that what we see is only the local manifestation of the illness which again may be the ultimate result of some cause or combination or series of causes affecting the individual. The manifestation may be localised, and the pathology may show itself in particular organs or tissues or locations, but it is the whole patient who is ill. Homoeopathy has on the other hand the proper approach. It believes that the organism as a whole is ill and its functioning is disturbed and that this illness is represented by the totality of the symptoms which constitutes the sole and complete guide for the treatment. Every symptom that is met with is a manifestation of the total disturbance which has resulted in the abnormality of function or structure of some tissues. Even if the sign or symptom is noticed in a particular part, it necessarily means that the illness of the patient is manifested or reflected in the part and never that the part affected is alone sick or damaged. The actual nature of the lesion may not be evident, it may be a minute lesion in an obscure organ or it may be a very fine disturbance of the biochemistry of the body fluids or tissues but the result is the symptom which is an evidence. Since every symptom represents a disturbance, however unaware we may be of its source or explanation, we have to take it into consideration when deciding the prescription. And the totality of all these symptoms naturally represents and reflects the totality of the disturbance and, if this totality of disturbance can be corrected, normal health is automatically restored. As we study the manifestations of various illnesses closely, we shall recognise the minute differences between these - differences as exhibited in different patients and we shall also realise that each of these individualising differences has its own significance. One patient develops warts on the neck and another on the fingers. Why should the location of the warts be different? One patient of appendicitis complains of stitching pain while another patient of the same disease complains of burning pains. One may be aggravated by pressure and other relieved. The pain in one case may radiate upwards and in another downwards. Why are there these differences? One patient of malaria says he has the chill coming on at 1 A.M. accompanied by thirst and another suffering from the same disease has a chill coming on at 4 P.M. without thirst. We do not know why these two cases should differ in this way. The chill represents the occurrence of a particular cycle in the life of the malarial parasite but why should one particular cycle in one patient differ from that of another patient? We do not know the answer to these questions. But that does not alter the fact of such occurrence nor the fact that it must have its own significance. Any therapy which ignores such a fact cannot hope to cure the patient. To make diagnosis the basis of a prescription involves certain difficulties. Firstly, the diagnosis may not be clear in spite of the most careful examination and investigation. Secondly, the diagnosis may be wrong. It was mentioned by one of the physicians attached to a famous hospital that the diagnosis even in that hospital with the best of staff and equipment was wrong in 50% of cases as shown by the post-mortem studies. Thirdly, the diagnosis may take some time, till which time the correct treatment cannot be instituted. Fourthly, a diagnosis is necessarily based on symptoms and signs which can be explained, interpreted and correlated. Here is the snag. Not all the signs and symptoms of a patient may be capable of such explanation, interpretation or correlation. So, the physician is forced to pick and choose those symptoms which fit into a particular pattern and omit the rest as irrelevant - not because they

are really irrelevant but because he is unable to comprehend their significance and fit them into the pattern. Therefore, it is clear that it is more rational to base the prescription on the totality of the symptoms in which each and every symptom is assigned its own due place, i.e. the totality of the disease manifestation which can be clearly recognised, as against the totality of the underlying pathology, which will always be a matter for conjecture. It can be said that this approach to disease of Hahnemann reflects his genius and can be called one of his greatest contributions to the practice of medicine equalling his discovery of the potentized doses. Let us take a hypothetical case. A patient comes and complaints of three or four symptoms. He has increase of thirst and polyuria. He eats quite well but loses weight. He suddenly gets giddiness with cold perspiration at 7 p.m. He has diarrhoea from milk and has dreams of falling. He has also a shooting pain in the abdomen with dysuria and hematuria. A modern physician would diagnose and then do the necessary investigation and might confirm that this is a case of diabetes and may institute the necessary treatment. Out of the total clinical picture he selects the majority of symptoms and sees with which diagnosis they fit in. This diagnosis is confirmed by necessary laboratory investigations. The symptoms which do not fit in with this diagnosis, he may discard as incidental or he may make up an additional diagnosis. He may say this is a case of diabetes with a renal calculus. The homoeopath does not proceed thus. He considered that every symptom has some significance, having necessarily also a basis in the altered biochemistry of structure or function of some organ or of the whole body. Why does this patient react to milk in this way ? Why does he feel giddy and perspire at 7 p.m. ? These are questions which cannot be answered in the present state of knowledge; yet the facts themselves cannot be ignored or set aside. Whereas the allopathic physician ignores these symptoms which he is unable to correlate or interpret, the homoeopath considers that each symptom is significant and utilises each symptom as an indication for the selection of the correct remedy though he himself may be equally ignorant about its explanation, correlation or interpretation. This ignorance does not prevent him from utilising it just as the ignorance of the internal mechanism or working of a machine or instrument like the motor car, radio or watch does not deter us from using and utilising them to our fullest advantage. And there is always the possibility that with all the advances in science we may forever be unable to explain certain phenomena and therefore shall ever be in doubt. Or it may happen that our explanations are proved to be wrong. Suppression The concept of suppression is also rather peculiar to Homoeopathy. It is a well-known fact that if a sub-lethal dose of any drug is injected into the body, almost all of it is excreted through the various channels and thus eliminated. But for this, the body would accumulate all the drugs taken by a person and this alone would kill him in course of time. Similarly in various infectious diseases the body also throws out or excretes the various bacteria and their toxins through the mucous membrances. In cholera, for example, the stools contain the cholera vibrio and their toxins. This process of elimination appears to be a curative process and it is because of this we survive and remain healthy.

Proper homoeopathic treatment aids and accelerates this process of elimination of toxins leading to a cure. After taking the proper homoeopathic remedy, the patient may very often develop an increase of natural elimination (physiological discharge such as stool or urine or sweat) or an unnatural elimination (pathological discharge such as a leucorrhoea or a nasal discharge, etc.) and the onset of these discharges may generally be accompanied by an improvement in the clinical condition of the patient. Prof. Augustus Bier, the celebrated German surgeon, has reported a remarkable experiment. He had a patient who was suffering from furunculosis. He found the homoeopathic remedy for the patient to be Sulphur. He prescribed Sulphur in homoeopathic doses and simultaneously measured the excretion of sulphur of the patient. The patient, put on Sulphur 3x, was found to excrete daily 576 mgm of sulphur, which is sixty times the normal rate. Even after the doses of Sulphur was discontinued, he was found to excrete 117 mgm on the day after; he then averaged 54 mgm for ten days and after thirty days he was still excreting about twice the normal. The seborrhoea about which he had complained was markedly improved and his general well-being decidedly better than before the experiment. The patient was located two years later and agreed for the sake of experiment to make a retrial, although he considered himself cured. When he now took Sulphur 6x for days hardly any extra excretion of sulphur was found. This experiment of Prof. Bier demonstrates how the body is able to excrete undesirable toxic substances under the influence of the infinitesimal doses of homoeopathic remedies, so that health is restored. In other types of illness, the body may react in a different way and develop eruptions. For example, in eruptive fevers like smallpox, the patient develops, after a period of pyrexia, the eruptions on the skin. The eruptions represent the effort of the body to push the viruses and their toxins to the periphery. By the time the eruptions appear, the body has already battled with the invading agencies and if the body has been fairly successful the eruptions appear on the surface. As the eruptions appear, the temperature drops and the general condition may deteriorate and the patient might even develop convulsions which may indicate that the viruses and their toxins are affecting the central nervous system. It is now recognised that the skin is not merely a covering for the body but actually has several other functions to perform, one of which is to produce antibodies. It is often able to fix and neutralise or eliminate various toxins. This is why various diseases show skin manifestations. In smallpox, for example, the virus that has entered into the body and has multiplied a million times is driven to the surface of the body and here it shows itself in the vesicles. When the vesicles dry up and the scales fall off, these scales are known to be very highly infective. The homoeopath unconsciously recognises this particular fact and allows the skin and the mucous membranes (i.e. the internal skin) maximum play. When he comes across a skin manifestation in any disease he takes care not to suppress it. When he encounters eruptions or discharges appearing in any disease with consequent improvement in the general condition of the patient, he lays his hands off and finds thus that the curative reaction is furthered. The modern medical practitioners seem to be blissfully unaware of this phenomenon. Every surface manifestation, be it a discharge or an eruption, is vigorously treated with local measures particularly as the patient may find it inconvenient or troublesome and may demand its removal. The local manifestation treated by local measures often disappears from view to the detriment of the patient, but both the physician and the patient feel very happy.

Unfortunately nature is far from satisfied with such measures and sooner or later a deeper manifestation arises in place of the superficial one that has been suppressed. Under the proper homoeopathic treatment, the original suppressed manifestations almost invariably reappear and then there is considerable relief to the patient with noticeable clinical improvement. So when the old manifestations reappear the homoeopath greets them with joy and looks forward to a cure. He then concludes that the prognosis is favourable. I may illustrate with one of my own experiences. Long ago, before I became a homoeopath, I had to treat my sister's son aged 3 years for a very bad ulceration of the lips. It had been diagnosed as Cancrum oris. At that time, I did not know of Homoeopathy. I prescribed for the boy sulphonamide ointment for external use. With the use of the ointment, the ulcers healed but the lips became black. In about 2 or 3 months the blackness also disappeared and the boy seemed to become quite well. After 3 or 4 years I was consulted by my sister again for the same boy. She complained that the boy had become extremely mischievous, ill tempered and capricious. He would harass his parents for everything. For instance, he would ask for tea. When the tea was brought he would want it in a cup and saucer, then cool it, then complain that it was too cold, then heat it and ultimately he would not drink it. In fact, he had become a problem child. This change in his mental state had come on after the ulcers had healed. By this time I had learnt Homoeopathy and I prescribed for him a suitable homoeopathic medicine. There was an immediate transformation in the personality of the boy but as he improved the lips turned black. Later the lips became ulcerated and became as bad as they had originally been many years ago. Now my sister brought the boy to me for the treatment of the ulceration. As I was thinking what I should prescribe, she asked me if she could apply the old sulphonamide ointment which was still with her and which had "cured" the ulcer. I told her never to touch it. With the application of some bland ointment and a dose or two of the appropriate homoeopathic remedy internally, the ulcers completely healed and the boy remained well in mind as well as in the skin. This case was a lesson to me and a demonstration of Hering's Law. Even in modern medicine the laws formulated by Hughlings Jackson say that in destructive lesions of the central nervous system the faculties which are acquired first are lost last. For instance, speech is lost earlier than the power of gesture. Similarly, when the faculties are restored they return in the reverse order. Etiological factors The alert homoeopath who takes his case carefully is able to note that many of the patients who come to him for treatment are able to reveal either spontaneously or on careful questioning the fact that most if not all of the symptoms had originated after some incident, accident, illness or episode and are directly attributable to this cause. This cause, origin, source or circumstance may be physical, chemical, mechanical, emotional, dynamic or one which cannot be so classified. To give one instance, a patient of epilepsy may narrate that his convulsions had started after a period of loss of sleep, anxiety, mortification or head injury. Modern pathology may not be able to explain how any of these causes or originating circumstances could give rise to epilepsy and so it may even refuse to accept any relationship between the preceding factors mentioned and the epileptic seizures that followed. But the fundamental principle in science is that when an explanation is not available for a fact, the want or absence of suitable explanation cannot negate the fact. The fact of the cause or origin

of the disease is further confirmed when the homoeopath prescribes a suitable antidote for the cause and finds that the whole of the effects are nullified. So, the wise prescriber takes into account all these facts of causation and prescribes on that basis notwithstanding the fact that neither he himself nor the others may be able to explain how the originating circumstances have been able to give rise to the resulting disease or pathology. Let us take three patients who have developed epilepsy. One of them states that the disease had originated after a long period of loss of sleep. Another mentions that the condition has originated after a head injury. The third tells us that it came on after suppressed anger. In the case of the first patient what were the biochemical changes that took place in the body fluids by a sustained loss of sleep? How did the nervous centres and other organs try to adjust to these biochemical changes? Did any structural changes take place as a consequence? Did any damage ensue to any of the tissues affected? If so, when, how, of what type and to what degree? How did these biochemical or structural changes or organic damages differ in the second and third case from the first? We do not know the answers to any of these questions. But we do know that the three cases must be different from each other although the diagnostic labels which recognise only the resulting manifestations may be same - different because of the different circumstances and mode of onset. These differences are again discernible to the discriminating homoeopathic physician who will perceive how these minute individual differences in each case make up different totalities though the ordinary allopathic practitioner may lump them all together because of the clinical similarity or because of the similar E.E. G. patterns. It is certain that one day the advances in the science of pathology will be able to explain these differences, but till then it may be necessary to at least recognise and accept these individual differences and to make practical use of these in deciding the prescription. The clinico-pathological significance of peculiar symptoms In homoeopathic practice, we prescribe on the totality of symptoms but within this totality we give more emphasis or value to the peculiar individualising symptoms of the patient. The more strange, rare or peculiar a symptom is, the more merit we attach to that symptom. Sometimes some symptoms on which we prescribe seem so extremely strange that modern physicians laugh at them. But every symptom is a manifestation of the disturbance and is, therefore, of significance. It is possible that the basis of the symptoms is at present unknown or unrecognised and the underlying pathology obscure, but that does not mean that the symptom has no basis. The advance of modern medicine and pathology has, however, opened our eyes to the fact that some of the so-called strange symptoms can be explained. I shall give some examples. A patient may complain that while drinking from a cup he feels that the cup is broken. In paralysis of the mandibular branch of the 5th cranial nerve, the patient may not feel one side of the cup and therefore, he may get this sensation. Diarrhoea at night is said to be a common in diabetes. After head injury a change of position may cause vertigo. (Con. *) Headaches worse by coughing and sneezing (Bry.) is found in brain tumours. These headaches are worse after sleep (Lach.). Amelioration in the knee-chest position is found in patients of Bronchiectasis because this position helps postural drainage. Orthopnoea is found in both cardiac and in bronchial asthma. It is said that the angle of the patient bending forward is an indication of the degree of disorder in cardiac asthma. (Kali-c)

Cardiac asthma is said to be worse in the earlier part of the night (Ars.) and Bronchial asthma in the later part. (Kali-c) Pain in the chest better lying on the affected side is well-known symptom of pleurisy and pleuro-pneumonia. (Bry.) Pains in the anus lasting long after stool (Nit-ac) is generally found in fissure- in-ano. Patient has impaired hearing but he is able to hear better in a noise. This is a symptom found in Graph. This symptom is met with obstructive deafness. The patient has difficulty in swallowing but he is able to swallow solids better than liquids. This symptom is found in Oesophagospasm and Cardiospasm. (Lach.) Pain in the lumbar back on coughing is found in root pains and prolapsed disc. (Am-c) Loud eructations and eructations which give no relief are found in aerophagy. (Chi., Asaf.) Pain relieved by pressure and aggravated by releasing the pressure (Bry.) is known as rebound tenderness and is found in conditions like Appendicitis. A disproportion between pulse and temperature is found in Typhoid. (Pyrogen) A fast thready pulse is found in internal haemorrhage. (Ars.) Unilateral sweating of the face and exophthalmos are found when there is pressure on the cervical ganglion. Pain agg. touch is found in Trigeminal neuralgia. (Spi., Nux-v) Convulsions worse on seeing water are found in Hydrophobia. (Lyssin). Vertigo or syncope after a hot bath is noted in low blood pressure. Excessive ingestion of salt is known to produce retention of fluids and aggravate hypertension. (Nat-m) Walking on uneven pavements agg. (Con.) may be found in a case of slipped disc. Loss of sleep causing weakness (Phos.) may occur in Myasthenia Gravis. Stool difficult although soft (Nit-ac) may be noted in Fissure-in-ano. Vertigo agg. closing eyes (Ther.) is a part of Romberg's sign found in Subacute combined degeneration of spinal cord. Eats well but emaciates (Iod., Nat-m) is noted in thyrotoxicosis and diabetes. Cough agg. change of position (Kre.) - Bronchiectasis. Pain abdomen agg. lying down (Puls.) - Hiatus Hernia. Breathlessness amel. lying flat (Pso.) is noted in anaemia. Painless ulcer (Lyc., Op., Phos-ac) and serpiginous ulcer (Merc., Nit-ac) may be syphilitic in origin. Leucorrhoea, acrid (Alum., Kre.,) is noted in Trichomonas infection.

Sensation as if walking on cotton wool (Alumina) is found in subacute combined degeneration of spinal cord. Electric shock like pains (Phyt.) are noted in Tabes dorsalis. Vomiting without nausea (Fer.) is found in intracranial tumours. Aggravation going in the sun (noted in Nat-c) is often found in Disseminated Lupus Erythematosus. A brown saddle across the nose (Sep.) is found in Lupus. Agg. by beginning motion and better by continued motion (Rhus-t) is found in many cases of arthritis. Offensive odour from mouth on coughing (Caps.) may be found in lung abscess. Blue spots on body from mildest injury or even from pressure (Arn.) can be seen in Thrombocytopenic purpura. Symptoms appear suddenly (Bell.) - an example is Embolism. Symptoms appear slowly and progress - e.g. Benign Tumour. Lump in throat (Ign.) is often found in Hysteria. Hypertensive headaches are characteristically occipital and are noticed on waking in the morning. (Lach.) No doubt, the advance of science is able to explain and will continue to explain the significance and basis of various such symptoms. Thus many other symptoms whose significance was formerly unknown and which, therefore, were even considered irrelevant and absurd are now understandable. The advance of bioclimatology has revealed that various changes take place in the body as a result of changes in temperatures, seasons, etc. Weather affects four major functions: blood pressure, elasticity of vessels and peripheral resistance, autonomic nervous system and the physiochemical state of the blood, e.g. blood viscosity, clotting time, fibrinogen content and capillary fragility. Atmospheric cooling effects through the hypothalamic pituitary system on autonomic nervous function, endocrine function, the composition and properties of the blood, electrolyte balance and function of the liver. It also affects the production of antidiuretic hormone giving rise to increase of urine output. Solar radiations can seriously affect the physiological balance of the body particularly at high altitudes. It lowers B.P. , increases Hb. and RBCs, increases the serum Ca, Mg, and phosphate level and enhances protein metabolism. Continuous exposure to UV rays produces hypertrophy of the hypothalamus and of the anterior lobe of the Pituitary. Over-exposure to sunlight contributes to the production of skin cancer. Above a height of 1.5 meters the following physiological changes take place, viz.: change in composition and physiochemical properties of blood; increased pulse rate; stimulation of adrenal gland; increase in peripheral blood, change in reactivity of autonomic nervous system; improvement of thermoregulatory efficiency; changes in the secretion of gastric juice and change in urine output.

At various times, during the day and night, various changes are constantly taking place in the body. Dr. Karl Konig quotes Wachsmuth who has put together in his book the various phenomena of daily periodicity in man and for the phase at 4 a.m. He says that at 4 a.m. , there is a Maximum of Glycogen assimilated in liver, of fat resorption in the intestinal wall, of blood retention in the blood vessels, amount of melanophore hormone and of narrowing of the lumen of the capillaries. So, also there is a Minimum of bile secretion; of elimination of water, of pulse rate, blood pressure, of blood circulation, of venous return, and cardiac output, of vital capacity of lungs, metabolism and body temperature - all at 4 a.m. A statistical study of the mortality from coronary thrombosis and myocardial infarction between 1935 and 1958 in Netherlands shows that mortality was highest in January, February - the coldest months of Netherlands and lowest in July and August; there was almost perfect inverse relationship for all the months of year between the curves representing the average monthly temperature and the mortality recorded from arteriosclerotic heart disease. This observation is supported by similar studies in U.S. A. and by Paul Burch in New Orleans, who did experiments with climate chambers. Chronic diseases Diseases can be broadly classified into the acute and the chronic ones depending upon the mode of onset, pace of progress and tendency or otherwise to decline. Acute diseases have a tendency to end in spontaneous recovery or in death. Chronic diseases show no tendency towards recovery. It has been our experience that especially after the recent discovery of the antibiotics, cortisone, etc., modern medicine is able to show fairly or even remarkably good results in the treatment of acute diseases. It is able to quickly suppress or palliate the symptoms. But it also happens that most of these conditions are converted into sub-acute or chronic states, sometimes punctuated by recurrent acute attacks or exacerbations and here modern medicine is not able to relieve or cure. Lang says, "The main weakness, to my mind, is represented by the tendency of acute illness to recur, despite the use of the new drugs, and the large field of chronic illness." Hence all these types of cases come to the homoeopath. So, homoeopaths have a vital interest in the understanding of chronic diseases. Ever since the birth of scientific medicine - perhaps it takes origin from the time of Hahnemann - it has been recognised that disease in its real sense is the result of two sets of causes: one the internal or the constitutional (the hereditary) and the other the external or provocative (environmental) which Hahnemann calls respectively the fundamental and the exciting causes. Of the two causes, it is being recently recognised that the hereditary factor is indeed the more important or "fundamental" cause as Hahnemann had indicated. Elaborating on the nature of the inherited defects, Sodeman and Sodeman write as follows: "Although a biochemical defect is believed to underlie all hereditary conditions produced by a gene mutation, the biochemical abnormality cannot always be demonstrated in our present state of knowledge... "Conditions such as albinism are readily recognised at birth. There are other diseases in which an enzyme defect is present at birth put in which there would be no disturbance in the individual if it were not for the effect of extrinsic factors which occur after birth... "The severity of an infectious disease depends upon three factors :

1. The number of invading organisms 2. The virulence of the infectious agents, and 3. The resistance of the host. Host resistance is a complex phenomenon governed by genes which control the body chemistry so that there may be more resistance or less resistance to a particular infectious agents. The mechanisms which operate to make one individual more susceptible than another to infection are for the most part unknown..." Stewart states, "Virus infection of the host may be transferred to the off-spring of the host from generation to generation, a sort of vertical transference from one host to another host. This is also of interest to homoeopaths because it suggests modern confirmation of Hahnemann's idea that chronic disease may travel from parent to offspring through several generations." While it was formerly believed that hereditary factors play a role in the causation of only a few congenital defects, it is now being increasingly recognised that they have an immense role in the production of a large number of diseases. The hereditary factor has been studied extensively by following the life history of uniovular or identical twins - their behaviour, responses and pathological states. The study of such twins show that their responses and reactions are often identical even in diseases. Sinnot gives the following information: "1) Concordance and Discordance: The simplest kind of data which studies on twins can yield is qualitative comparison of various traits on pairs of identical and fraternal twins. When members of a twin pair both show or fail to show the trait in question, they are called concordant (symbols ++ or --). When only one of the twins shows the trait, they are called discordant (Symbol +-). Obviously, identical twins are always concordant with respect to fully penetrant hereditary characteristics, whereas fraternal twins are sometimes discordant with respect to such characteristics. This fact is, as pointed out above, used to distinguish the identical from the fraternal twins. If the variation in a trait is due entirely to the environment, the frequency of concordance and discordance should be alike among identical and fraternal twins, within the limits of statistical errors of observation. Table 22.1 shows a comparison of various diseases as they appear in identical and fraternal twins. "Measles, scarlet fever, and tuberculosis are infectious diseases that come from the environment. Nevertheless, the proportion of twins concordant with respect to tuberculosis is significantly greater among the identicals than it is among the fraternals. There is evidently a genotypic predisposition to this disease; the carriers of some genotypes are more likely than others to develop tuberculosis... and for measles the frequency of concordance is so high both among the identicals and the fraternals that all or nearly all, genotypes in this sample evidently make their carriers susceptible to infection with the virus that produces this disease." Table 22.1 Percentage of concordance (++) and discordance (+-) with respect of certain traits in pairs of identical and fraternal twins, of which one member was affected. Traits Twins pairs studied Identical Fraternal

Identical Fraternal + + + - + + + Measles 189 146 95 05 87 13 Scarlet fever

31 30 64 36 47 53

Tuberculosis 190 427 74 26 28 72 Tumours 62 27 61 39 44 56 Tumours (Specific kinds) 62 27 58 42 24 76 Diabetes mellitus 63 70 84 16 37 63 Feeble-mindedness 126 93 91 09 45 55 He continues further, "Several investigators in different countries have sought in prisons those who were members of twin pairs. Anybody confined in a prison was considered to have criminal record, irrespective of what law he had broken. The investigators then determined whether the co-twin also had a criminal record of any kind at any time. If so, the twins were scored as concordant; if not, they were entered as discordant. Identical and fraternal twins were distinguished, using (as in all such studies) fraternal twins only of like sex. The results are summarized in table 22.2. It is obvious that the proportions of concordant twin pairs is in every case higher among the identicals than among the fraternals." Table 22.2 Concordance (++) and discordance (+-) for criminality in twins. Investigator and Country Identical Fraternal +++-+++Lange (Germany) 10 03 02 15 Rosanoff et al (USA) 35 10 06 21 Legras (Holland) 04 00 00 05 Krans (Germany) 20 11 23 20 Stumpfl (Germany) 11 07 07 12 Total 80 31 38 73 Percentage 72 28 34 66 Julias Bauer in his excellent book, "Constitution and Disease" gives numerous examples to substantiate the fact that heredity has a dominant role in the production of diseases. He defines constitutions as "the sum total of an individual's characteristics as they are potentially determined at the moment of fertilization..." "The close similarity between identical twins furnishes evidence that nature (heredity) plays a far more important role than nature (environment)... "East considers the effect of any ordinary change of environment "negligible" as compared with the influence of heredity..."

"'Heredity plays a part in the etiology...' This statement is to be found in all textbooks of medicine in the discussion of the etiology of many diseases. It seems that certain inherited, that is, constitutional traits are acting together to bring about the derangement of vital processes characteristic of the disease under discussion. In other words, an individual constitutional predisposition is a prerequisite to the development of such a disease. Diabetes, obesity, gout, essential hypertension, peptic ulcer, cancer, neuroses and psychoses, many infectious diseases such as acute rheumatic fever and tuberculosis - to enumerate but a few belong to this third group of diseases that cannot become manifest unless the intrinsic constitutional factor plays its part..." He describes the constitutional factors which play a role in the etiology of various diseases and also constitutional factors which modify the clinical picture and course of disease and factors which necessitate modification of routine treatment. He gives various examples to show how constitutional or biological inferiority of organs and tissues can be exhibited in the production of diseases of bones and joints, kidneys, heart and blood vessels, respiratory tract, nervous system, eyes, ears, thyroid, digestive tract, connective tissue, etc. He then gives some major diseases in which hereditary factors constitute the etiology including diabetes mellitus, obesity, essential hypertension, anaemias, Hodgkin's disease, haemorrhagic diathesis, peptic ulcer, cancer, etc. The study of heredity shows thus that the pattern of response is practically set when the child is born and all that happens only takes place within a certain field. Taking the case of infectious diseases as an illustration, we can see that the bacilli cannot cause disease unconditionally. A certain susceptibility on the part of the patient is also essential. Only very recently the emphasis is shifting from the guest to the host. Dr. Vannier states quite clearly why he believes the study of typology to be a necessary part of the physician's work. Man comes into the world endowed with certain potentialities. His human function is to develop the latter to the greatest possible extent. But in order to do so, he must find out what he is, and what he can be - otherwise he may leave rich sources untapped, or, alternatively, strive uselessly after what can never be acquired. By studying his type, the physician hopes to be able to give his patient this knowledge, and direct him into the best ways of fulfilling himself - in this case by treatment with homoeopathic remedies. And in our own field John Paterson, the well-known bacteriologist and homoeopath who has done over forty years' research work on the bowel flora declares, "In the treatment of chronic disease - it is well nigh impossible to get successful results without a full knowledge of the Hahnemannian doctrine of the miasms." Far from believing that the bacteria are responsible for diseases, John Paterson considers that they are the concomitants of the diseases. But this research or careful study revealed to him that a change in the bowel flora always followed a change in the clinical conditions of the patient. Or, so to say that the bowel flora which was normally passive and harmless became pathogenic only after the patient became sick clinically. Therefore, it appears that Kent's statement that the bacteria are the results of the disease seems somewhat approximate to the truth though it may seem rather absurd. Discussing the question of Psora, Paterson illustrates the idea with the example of measles. In measles, the person is infected but before he produces symptoms, there is an interval which we call the incubation period. During the incubation period the body is not passive but highly active. There is a struggle going on between the virus which is multiplying and

producing toxin and the body which is resisting. Ultimately when the toxin production gets the upper hand, the body tries to produce antibodies to eliminate the virus and the toxin. In this effort it makes use of the skin which itself possesses the power to produce a maximum degree of antitoxin as compared with the blood plasma. We have noted clinically that when the eruptions on the surface of the body are maximum in the patient, the toxic effect on the patient is minimum and vice versa. So, the skin manifestation in measles is not an isolated local phenomenon but is a localisation of the manifestation and a reflection of the defence in which the whole body participates. It is quite possible that even in all the so-called chronic skin disease the skin eruption is a result of a successful effort on the part of the body to get rid of toxin or viruses. Bodman claims that all illnesses, which show local skin manifestations are always present as internal maladies before the eruption appears. The skin symptom may be cured or disappear of itself, but the chronic disease persists. He then describes some Russian experiments and concludes, "It can be taken then as firmly established that a blow to the nervous system, at whatever site it is inflicted, is followed in the majority of cases by a syndrome of widespread changes throughout the body..." He quotes a further series of experiments which showed that the initial impulse was the contact of tetanus toxin with nerve endings: if the nerve endings are anaesthetised, contact with tetanus toxin does not produce tetanus, even though it was shown that the nerve trunk connected to the endings contained lethal doses of tetanus toxin... While these investigations confirmed previous researches showing that tetanus toxin spreads along nerve trunks, they also proved that this diffusion does not play an essential role in the pathogenesis of generalised tetanus. "This complex reaction we call tetanus is produced as soon as the toxin encounters the peripheral nerve endings. But this has a familiar ring. Is this not an echo of Hahnemann's doctrine that infection takes place without doubt in one single moment, when the morbid fluid comes in contact with the exposed nerve which then irrevocably, dynamically, communicates the disease to the whole nervous system...!" If, therefore, skin conditions are part of the general reaction and have a protective role, it is a natural corollary that this avenue of elimination should therefore be kept open and encouraged, not suppressed. But modern medical practitioners many a time consider skin eruptions and skin manifestations as purely local disorders and vigorously aim to treat them as such with local and/or internal medicines. And we know very well how many of these cases who get rid of the skin conditions return with deeper, more internal disorders like asthma, bronchitis, etc. It is also our experience that as we treat them internally with proper homoeopathic medicines, the original skin manifestation reappears to the great general relief of the patient. Hahnemann himself seems to have been greatly satisfied with the discovery of the chronic disease theory. He wrote, "But how much more satisfied they would be now that I have perfected the method which has actually allowed me to prescribe remedies even better suited, the individual pharmacopraxy and pharmocotherapy of which I have described." But Westlake regrets that even homoeopaths have not fully realised the significance of the miasmatic influences. He says, "From reading homoeopathic literature I have the impression that homoeopaths have never really understood Hahnemann's teaching on Miasms, these potent and ever present causes of chronic disease."

Allen also writes, "Most of the homoeopathic treatment of today, like the regular school, is palliative in nature even with the single remedy and the potency. One reason for this is a lack of knowledge of the chronic miasm that lies behind the morbid phenomenon with which we have to deal. Many a time even homoeopathic remedies only palliate esp. when the remedy is not the real similimum. This should always be our guide. Remember that cure should always be from within out, so that vital organs are always protected." Paschero in an excellent paper gives an explanation of the miasms. He says, "By a " Miasm". I think Hahnemann meant a non-physical entity, or as we would now say, an etheric entity, which has the power or potency to produce aberrations or imbalances of the protein of the body (See McDonagh's "Unity Theory of Disease")... "One can, I think, say quite definitely that no chronic disease can be cured unless the miasmic cause is ascertained and eliminated." In the treatment of chronic disease which one meets with in practice, it is well nigh impossible to get successful results without a full knowledge of the Hahnemannian doctrine of the miasms, so that one may indeed choose "The most similar medicine possible". Foubister summed up the idea admirably in one sentence when he said, "Hahnemann's doctrine of chronic disease is essentially that all chronic ailments are secondary manifestations of an infection or infections, at their inception acute, later lying dormant till stimulated to flare up in the various guises of ill-health by adverse circumstances such as prolonged anxiety, environment, or relatively trivial inadequacies of diet and so forth." Wheeler's judgement still stands that behind virtually every manifestation of chronic disease there is a deep miasm, as he called it - toxaemia, as we might say, and that effective treatment must attack that more than anything else. Paschero writes, "Every experienced homoeopath knows positively that unless he reaches the dynamic, constitutional background of the patient, unless he had penetrated and understood the psychological personality and the vicissitudes of adaptation of life which give the earlier symptoms of neurovegetative dystoria determining the nature of his character and its particular pathology, he will never be able to cure." A new look at chronic diseases * In medical practice, acute conditions often look more serious and dangerous but are actually more easily amenable to treatment especially in Homoeopathy as the symptom-picture thrown out is clearer making the selection of the remedy easier. Chronic diseases on the other hand require much more attention, time and patience. They often have periods of exacerbations and remissions, and the remissions can be deceptively lulling leading us to believe that there is improvement. However, they show no tendency towards cure and may steadily progress and incapacitate the patient even if they do not prove fatal. This is why Hahnemann devoted so many years of his later life to the study of chronic diseases and propounded the theory of chronic diseases after prolonged study and contemplation and himself expressed great satisfaction over it. Many homoeopaths aver that this is the most important discovery of Hahnemann. For example, Pateron after over forty years of research work in the fields of bacteriology and Homoeopathy says, "It is the chronic miasm which determines not only the symptom-picture but also the type of micro-organism found in the disease." But others consider this theory as superfluous if not actually irrelevant. Hering, for instance, in the introduction to the third

American edition of the Organon has remarked, "What influence can it have whether a physician adopts or reject the psoric theory so long as he always selects the most similar medicine possible." Hughes called it "an entire mistake" to call the psora-hypothesis the homoeopathic doctrine of chronic disease and says that even if all Hahnemann's theories were proved to be wrong and abandoned, still Homoeopathy would remain the same. In 1838, the Central Congress of Homoeopaths in Frankfurt went so far as to pass a resolution condemning the doctrine! There are yet others who are completely unable to understand this theory. Such is the position. Every generation has tried to solve the mystery of chronic diseases and in our own homoeopathic field various interpretations of the chronic disease theory have been given from time to time. Recent homoeopaths who have attempted to explain it are, Bodman, Clignett, Eardley, Gordon Ross, Ross, Twentyman, Zissu, and others. Pateron's exposition is one of the best. Let us now consider a new explanation. To appreciate this explanation one must be aware of the experiments of Lisa Wurmser. For the benefit of those who may not be informed of it, I shall summarize it briefly here: As is well-known to students of bio-chemistry, certain minerals when injected into "the body are not completely eliminated, a certain amount being fixed and retained in the tissues. For example, after the administration of a strong but non-lethal dose of arsenic, a rapid urinary elimination is observed, about 35% of the arsenic being excreted in the urine during the first ninety hours following the injection. Thereafter, no further trace of arsenic is observed in the urine, the remaining arsenic remaining fixed to the tissues. Lisa Wurmser assisted by Mr. Ney and Madam Krautele working in the laboratory of Prof. Lapp in Strasbourg carried out a series of very intricate and interesting experiments to see if the infinitesimal dose of the same substance influences the elimination of the mineral previously fixed to the tissues. Experimenting with the 4th, 5th and 7th potencies of arsenic and bismuth in animals which had previously received large doses of the same substances, they found that these potencies definitely increased the excretion of the drugs. For example, the potencies of arsenic raised the initial elimination of arsenic from the normal 35% to 42%. Similarly, after every test injection of the bismuth in potency, a further elimination of the bismuth originally absorbed was observed. Now I shall quote a case I had reported earlier which can be kept in opposition and studied. Master P.B. , aged 14 years, an young boy, was brought to me for consultation on 28th Oct. 1963, with very severe pain in the hamstring tendons of the right leg of 15 days duration. The pain was so severe and he was so much aggravated by stretching the leg, that the boy could not stand up or walk. He had even to be carried to the bathroom by his father whenever he wanted to attend nature's calls. On examination, I found tenderness in the right popliteal fossa. The lateral tendon which is normally palpable on flexion could not be felt or seen. His appetite, thirst, stool, sleep, etc., were normal but enquiry revealed that one month previously he had had an attack of measles. Further, I learnt that in July 56, he had suffered from an attack of Diphtheria from which he had recovered with the help of A.D. Serum but since then his health had not at all been good.

He used to suffer from some disorder or other, throat pain or fever or abdominal pain or vomiting and so on. Though the boy had approached me only for the acute condition of the pain in the hamstring tendons, I thought of treating the background first. After all there was the possibility that he was suffering from ill-effects or sequelae of Diphtheria, whether it was related to the present illness or not. So, I gave him six doses of Diphtherinum 1M to be taken T.D. S, thinking I would clear up the background first. I was planning to work out the remedy for his acute condition, after two days. On 31st Oct. 63, that is three days later, he returned to consult me and you can imagine my surprise when I found that the severe pain and tenderness in the legs had completely disappeared! He could extend his legs completely and was able to walk about normally. His mother reported that within the last two days his general health had become much better. I gave him no further medicine. I saw him again on 11th Nov. 1963. His condition was normal. He got a slight pain in the leg only if he walked very long distances. Since then, he has remained normal. Now, in Lisa Wurmser's experiments a dose of mineral was injected and it was observed that a portion of this was retained in the body but was subsequently eliminated when the animal was given a homoeopathic dose of the same mineral. In the case of diphtheria cited where the boy recovered but not completely, the possible reason could be that all the toxin produced during the infection was not completely neutralised or eliminated. When the boy was later given the same toxin (Diphtherinum) in a homoeopathic dose, the remaining toxin was probably eliminated leading to complete recovery. This is how when a patient says he is not well after any infectious disease, we administer a dose of the potentized toxin (nosode) as a homoeopathic medicine. This probably helps to eliminate the toxin that might have remained in the body. But, since the concept of Homoeopathy is that the disease-energy and drug-energy are interchangeable forces, we can either administer the attenuated disease toxin (the nosode), or a drug most similar to the manifestation of the disease-toxin (the similimum), in order to neutralise or eliminate the remaining toxin. To illustrate, in a case of a patient who has not been well after an attack of Influenza, we may give a dose of Influenzinum, the nosode, or alternately a dose of Cadmium met. as suggested by William Gutman, here the disease effect of Influenzinum and drug effect of Cadmium met. being extremely similar and therefore interchangeable. This condition has been called chronic toxemia by Gordon Ross and intoxination by Vannier. If it is very deep-seated, it can be called a miasm. Foubister mentions that Tyler herself suggested the possibility that psora might consist of the aftermath of one or more of any infections, acute or chronic. That such toxemia or intoxination could be acquired or inherited, there is now increasing evidence. It is also known that diseases are not merely caused by external factors. A certain degree of inherent predisposition or susceptibility is essential which may be inborn. Boyd, the

pathologist, writes, "In the causation of disease, two great factors always demand consideration; these are environment and heredity. So far, we have been concerned for the most part with the environmental diseases, those caused by bacteria, animal parasites, trauma, physical irritants, chemical poisons and so forth. For the past century or more, medicine has concerned itself with these extrinsic agencies which are more readily studied and for which more can be done than in the case of hereditary defects of the germ plasm" and ends saying that these studies show that, "Men are not created free and equal but handicapped from the beginning." He then goes on to say that in inherited diseases if the gene is recessive it may remain dormant for many generations (hundred of years) before it gets a chance to be free and show its effects. Then he gives a long list of diseases of the blood, metabolism, skeletal defects, neuromuscular disorders of skin, of eye, mind, etc., which are all hereditary. To show the influence of heredity he also quotes many twins who developed identical disease around the same age. It is therefore, evident that this inherent susceptibility is inborn. Many times when there is a family history of tuberculosis and we give the patient a dose of Tuberculinum, he feels better whatever may be his actual disease. Here the attenuated dose of the disease product - the nosode - possibly helps in the excretion of the retained toxins or neutralises the products of the toxins - in whatever form - and naturally this leads to an improvement in the condition of the patient. Modern medicine considers that only certain types of diseases or disease-effects can be transferred to the next or succeeding generations. But we have strong reasons to think that even the residual effect of various diseases can be transferred to the next generation. For instance, Stewart mentions congenital deformities of babies caused by virus infection of the mother during pregnancy and says that the placental barrier does not always protect the child as German measles, smallpox, mumps and influenza have all produced abnormalities. The effects of Thalidomide are well known. Dulbecco, Resident Fellow of the Salk Institute, San Diego, mentions that viruses tend to be transmitted from one generation to another. Rose quotes Griffith Evans from his book, "Latent Syphilis and the Autonomous Nervous System" to say that the infection can be carried to the 3rd generation and says that latent syphilis can cause thyroiditis and goitre, allergies, dyspepsias, abdominal pain, peritoneal adhesions, chronic ulceration of mouth, pre-cancerous condition and even cancer. This is why Paterson, the eminent Bacteriologist says, "Chronic diseases are due to an inherited miasm." Hahnemann also says that miasms are present at birth. Unless these are neutralised the patient may not improve. With this idea in mind if we look at Hahnemann's theory of chronic diseases, we can see that there was truth and wisdom in his theory. Reversible and irreversible changes Modern pathology classifies certain changes as irreversible and considers these conditions as incurable. No doubt, there is a certain limit beyond which, if the pathology progresses, the disease will be incurable. But we, the homoeopaths, have found that in our experience some of these cases which are considered incurable by our allopathic colleagues, are amenable to treatment. To take an extreme example Hughling's Jackson states that nerve cells once destroyed can never regenerate. But we have seen at least three cases of optic atrophy recover their vision after the patients had been examined and told by well-known opthalmologists that the atrophy of the nerve is irreversible and that nothing can be done for them.

Cases of gangrene have been treated by Homoeopathy and circulation restored when the surgeons had declared after careful examination that amputation was essential. To illustrate I would like to describe a remarkable case of gangrene that I had an occasion to see in 1964. Some time in Oct. 1964, I was called to see a young girl of 15 years suffering from gangrene of the left foot particularly affecting the toe, which had become black. She was having very severe, unbearable pain in the limb, which was worse by putting down the foot. Originally she had started getting the pain about the 7th of August and she noticed that there was also a bluish discoloration of the foot which was gradually increasing. On raising up the limb, it would become pale. She was admitted into a hospital and was examined by several physicians and surgeons. It was first suspected as a case of Berger's disease. Aortography was done and then it was discovered that the gangrene was due to an embolus in the femoral artery. She was advised to have the leg amputated but the patient refused to undergo amputation and her father was also unwilling. So they got the girl discharged from the hospital. When the girl came out the physician in the hospital was kind enough to prepare and give a complete report. As this report is very descriptive, I produce it in its entirety, omitting only the names of the various doctors mentioned: "Dept. of Cardiology, ... Hospital, Bombay. Pt.'s Name : V.S. L. Sex : Female Age : 15 years Date of admission : 17.08.1964 Date of discharge : 06.09.1964 Summary of the Case This 15 years old school girl was admitted under us for: swelling and discolouration of the (L) foot of ten days standing. History dates back to around three months when she had high fever with rigors, intermittent, coming down after profuse sweating. With fever came up pain and muscle aches in all four limbs, which gradually subsided on its own with fever but for the pain (L) lower limb - associated with gradual wasting of the same limb. Pain was more or less continuous varying in intensity, stitching in type, aggravated by stretching the leg but relieved to an extent by massaging the same or by flexion at the knee. "About ten days back she had injured herself on the left foot by Tarcol drum, following which the pains have become more intense with burning sensation in the (L) foot, swelling of the same having come up later followed five days later by bluish discoloration of the foot which was gradually progressive. "On admission she was found to be in severe agony more or less, massaging her foot continuously. Radial pulse rate was 88/m. Upper and (R) lower limb pulsations were well felt while (L) Femoral was weak and (L) Popliteal and (L) Post Tibial and (L) Doralis Pedis were absent altogether with inability to record B.P. , in (L) lower limb. Remaining systemic examination revealed mere wasting of (L) lower limb. Local examination showed that (L) foot was swollen as a whole upto the ankle with bluish discoloration, skin over the foot was tense, and shining with no line of demarcation, temp. over it being a little subnormal and sensation a little blunted, while the movements of the great toe were greatly restricted owing to severe pain. She had high arch of the foot. "A provisional diagnosis of threatened gangrene was made and emergency surgical unit was summoned for opinion. Dr. P., M. S, E.R. C.S. , Dr. G., M.S. , F.R. C.S. and Dr. D., M.S. , F.R. C.S. examined her and the diagnosis was confirmed and advised to consult thoracic surgeons for their opinion regarding putting in an immediate graft. On consultation of our thoracic

surgeons, Dr. M., Dr. S., and Dr. V.M. , we were advised to have an urgent Aortogram done on her. "Before undertaking her aortography, neuro-physician was called in who opined that threatened gangrene is likely to be of vascular pathology and wasting of (L) LL can also be explained on the similar basis. "Aortogram was done on 24th Aug. 1964 under basal premedication - which revealed narrowed arterial tree on (L) side with a small embolus sitting at the junction lower third and fourth part of Femoral Artery. "X-Ray foot showed generalised Osteoporosis of (L) foot. "Routine blood count, urine examination, E.C. G. and X-Ray chest did not reveal any abnormality. "After joint consultation of our two chiefs, Dr. T. and Dr. S., we decided and put her on strict bed rest with Inj. Priscol 0.01 g every four hourly later to every six hourly with Ledermycin 250 mg four times a day, anticoagulants and Tablet Pelonin one three times a day, with local Nebausulph, sprinkling over the foot. "In her stay with us for three weeks she made steady improvement for the first two weeks and later remained static. Her swelling almost disappeared, bluishness was then restricted to the great toe only, with development of Paronychia and an abscess under the great toe with discharging sinus. Her pain as well as burning sensation improved considerably. "Finally Orthopaedic Surgeon's opinion was asked for when amputation of the great toe was contemplated. Our Hon. Orthopaedic Surgeon, Dr. J. examined her and opined that she was having Infected Paronychia with threatened gangrene and advised the removal of the nail and considered amputation at a later date once the infection subsides. "On explaining the matter to pt.'s parents, it was ultimately concluded to let her go as per request, as her father had an intention of consulting his own physician and surgeon before finally submitting her for amputation." After she was discharged, the patient approached a famous person in the film world who also knows homoeopathic medicine. This gentleman took up the treatment of this patient and prescribed certain homoeopathic medicines. As a result of these medicines, the girl found fast improvement in the severe unbearable pain in the legs as also in the bluish discolouration of the foot. When there was sufficient improvement, the parents took the girl back to the same hospital and consulted the same surgeon who had examined her previously. The surgeon, after examination, was very much surprised to find that the pulsation in the femoral artery was normal and had also appeared in the Popliteal artery. But, the surgeons gave opinion that amputation was still necessary. Again the parents refused to have the amputation and continued the same homoeopathic treatment. After some weeks, they consulted the same surgeon again and this time the surgeon was again surprised to note that the pulsation had returned in the Dorsalis Pedis. Still, he (the surgeon) suggested the amputation. The parents refused and the homoeopathic medicines were continued. It was at this stage that I was called in for consultation. In view of the remarkable and amazing history and the vast improvement that had already taken place, I gave my opinion that the same treatment was to be continued and there was no need for me to interfere at all. Accordingly, the same treatment was continued and in a few days time the gangrenous toe fell off by itself and the girl was quite free. I heard that even after two years, the girl was keeping good health.

In my many years of experience I have seen many remarkable cases but I must say this was one of the most remarkable ones and I must give credit to my friend, the lay homoeopath, who could do so much for his case. Even the scope of modern medicine is expanding and modern medical practitioners are now able to treat cases successfully which formerly they would have considered incurable. And it is our experience as homoeopaths that we get a larger share of these cases which have had treatment from allopathic medicine which had failed to relieve or cure them or cases which had been declared as incurable, or those which had been advised to undergo surgery. And it is our experience also that such cases, at least quite a large proportion of them, do get relieved and some even cured by our treatment. And, therefore, we are not able to accept completely the prognosis given by the previous allopathic physicians. The prognosis given by them is based on their experience of such cases and on the normal course of such diseases as noted by them but as we had mentioned both the course and termination of such diseases are considerably influenced and altered by homoeopathic treatment. Here again the prognosis under homoeopathic treatment depends on whether we are able to select the proper medicine and such selection again depends on whether we are able to get the proper indications for such a medicine. If such indications or what we call characteristic or individualising symptoms are absent then the prescription has to be based on the gross disease symptoms or pathology present. And in such cases excellent results need not be expected. However I must mention that, even in such types of cases, Homoeopathy has been able to cure. Burnett's famous cases of cataract, skin diseases, backward children, etc., come in this category. I may also mention a case of cancer treated by an allopathic colleague. This case was described to me in the following manner. I was once presiding over the Hahnemann Day Celebrations in a prominent city in India, the capital of a State. During the proceedings, a gentleman approached me, introduced himself as a surgeon and as the head of the biggest local Govt. Hospital and asked my permission to speak. I happily acceeded. Then he paid glowing tributes to Homoeopathy and described an experience of his. Some months earlier, a poor woman had been admitted into his hospital with a prominent, painful, hard tumour in her abdomen. Being a surgeon he straight away opened the abdomen but was horrified to see that it was a big and extensive inoperable carcinomatous growth of the uterus. So he closed the abdomen and thought of irradiating the tumour. But the radiologist advised against irradiation as it might only result in sloughing of the intestines and a quicker end. So the surgeon called the patient's husband and gave out the bad prognosis that she might live only a few days more. The patient's husband requested that she may be kept in the hospital for a few days. Since nothing else could be done, the surgeon thought of trying Homoeopathy. So, he approached a renowned local homoeopath, and asked him to prescribe some medicine. But, this homoeopath was himself seriously ill and so he gave this surgeon a copy of Boericke's Materia Medica and asked him to select the remedy himself. The surgeon who had no idea of homoeopathic selection naturally looked under the heading "Cancer of the uterus" and selected one of the first remedies which was Aurum muriaticum natronatum. He went to the shop, consulted the shopkeeper as to what potency should be used and bought the 6th potency. This he gave three times a day to the patient. To his surprise and amazement, he found that the pain gradually subsided and also that the size of the tumour slowly decreased.

There was such a steady and remarkable improvement that the surgeon kept the patient under observation for three or four months and still the condition improved further and further till she became apparently normal. The relatives were so pleased that they took discharge of the patient and took her home though the surgeon would have liked to keep the patient under observation for a much longer time. Since she lived far away from the city, the surgeon requested the relative to apply to him immediately if there was the slightest sign of relapse of the tumour or the pain but more than one year had passed and they had not applied to him. So the surgeon presumed that the patient was still well. This case had an interesting sequel. This case was shown to Dr. P.M. , head of the Ayurvedic Research Hospital, Jamnanagar, who was so impressed that he suggested that it should be brought to the notice of Dr. B., an eminent cancer specialist, who happened to be there at the time. This good doctor, after examining the case, opined, "This could not have been a case of cancer." But, when the slide taken originally (biopsy) before homoeopathic treatment was shown to him, he had to agree that indeed it was a case of cancer. But not believing that the result was due to homoeopathic treatment, he said, "This must be one of the rare cases of spontaneous cure!" Homoeopathy and surgery "Do you as a Homoeopath believe in Surgery, Doctor?" "Doctor, is not Homoeopathy against Surgery?" These questions of believing or not believing in surgery arise because its methods are being applied every day in certain types of conditions. So in posing these questions, what the patient actually seeks to know is whether we as homoeopaths find the need for permitting and utilising surgery or not. It is necessary to answer this question because there is even in the minds of medical practitioners, quite a deal of confusion and misconception about the relationship of Homoeopathy to surgery. There are surgeons who believe that Homoeopathy is totally against surgery just as there are homoeopaths who condemn surgery without realising what they say. Firstly, it must be clearly understood that every fully trained medical man must necessarily learn the disciplines of both medicine and surgery, and must be able to advise about the application of the one or the other or both as would be in the best interests of the patient. When a person falls ill, there are at first functional changes taking place in the body. The body tries somehow to adjust itself successfully to the new internal or external environment. It attempts to resist, neutralise and nullify the morbid influences, whether they be within the body, e.g. in the form of bacteria and their toxins, or without as for example, a sudden change of weather. If the body is able to successfully adjust itself, there is no disease and therefore no symptoms. But if there is failure of such adjustment, in part or in full, disease results and becomes evident by altered sensations and functions. If this functional derangement is allowed to continue and progress, and the body is unable to cope up with these changes, then the structural element of the body has to alter itself in a further effort to adjust itself to the new circumstances. And so gradually structural changes take place which we term as pathological changes. It is in this stage that we are able to clearly see the signs of the disease and appreciate the disease objectively. When the indicated homoeopathic remedy is administered, the whole process of evolution of the disease is reversed and changes in the tissues recede and regress till the patient is cured,

i.e. till the organism re-attains its original state of healthy, harmonious functioning of all the organs and tissues. But sometimes this process of reversal may not be complete and perfect, or it may not be at all possible for various reasons. Alternatively, the changes in the tissues may progress to such a stage or to such an extent that they become frankly surgical conditions, in which no amount of accurate prescribing can ever be done in the hope to correct them unaided by the scalpel. Third degree prolapses of the uterus or rectum, advanced cataract, large calculi in the kidneys, urinary bladder or gall bladder, large malignant growths, etc., are some instances. Of a different type but still needing surgical aid are the many congenital developmental defects such as hare-lip, cleft palate, oesophageal atresia, cardiac septal defects, etc. On the other hand it is equally true that some surgeons tend to look at all cases from the surgical point of view and are often devising surgical measures for conditions which are easily amenable to medication. Some instances are enlarged tonsils, tubercular lymph nodes, peptic ulcers, papillomata, sinusitis, chronic cholecystitis, and such other conditions. Between these two extremes, the frankly surgical and the frankly medical, there is a very large field of diseases in which the surgeon operates but in which it is found that careful prescribing by the physician, esp. the homoeopathic prescriber, may eliminate the need for surgery. We, as homoeopaths, consider that surgery is mostly needed only when medical therapy fails, and that generally a call for surgery is an admission of failure of medicine. Even when surgery is really needed, in most cases it is only able to remove the results of disease, because pathological conditions like abscesses, tumours, calculi, haemorrhoids, etc., are all only the ultimate manifestations of disease processes. They are not the diseases because disease is actually a change in the internal organisation and functioning of the body and this, surgery can never hope to correct. So even when surgery is needed, it should be preceded and followed by appropriate medical treatment. Stearns says, "There are many so-called surgical conditions which are really medical conditions where surgery should be incidental." Then he gives many instances to support this. He also quotes how Carleton had cured a case of tuberculosis of the knee and another of aneurism, while in both cases amputation had been advised but as the patients had refused operation, they had been treated with homoeopathic medicines and cured. Pleading for medical and surgical cooperation, he says many so-called surgical conditions are really medical conditions, e.g. some cases of varicose veins, boils and carbuncles, fistulae. Mattern writes, "From a consideration of over 15 000 treatments given to ambulant surgical cases in the dispensaries of the Hahnemann Hospital and St. Luke's and Children's Homoeopathic Hospitals of Philadelphia, and in private practice, it is apparent that the treatment is principally surgical. However, there are some cases where purely surgical treatment is slow or ineffective that are decidedly aided by the application of the indicated homoeopathic remedy. There are no absolute specifics in medicine, therefore a thorough knowledge of homoeopathic Materia Medica is especially beneficial. Long before the days of modern bronchoscopic removal of foreign bodies, before the days of X-ray, homoeopaths of the old line were removing foreign bodies by the application of the indicated remedy. The literature of yesterday abounds with cures that would be little short of miraculous in these days of ultra-scientific practice. Case after case has been reported by the old homoeopaths where the administration of Lobelia over a period of time has resulted in a hemoptysis with the foreign body being ejected with the flow of blood - a tooth, a button, a tack, etc. Citations of cases of this type are musing to many modern physicians. We may

doubt them yet how much better doctors we would be if we could couple their keen powers of observation, their comprehensive knowledge of Homoeopathy with our modern diagnostic aids." He cites cases of varicose veins (cured with Carduus marianus and Calc-f 6x) and many other apparently surgical cases cured with appropriate homoeopathic remedies. Grimmer explains the situation clearly as follows: "Surgery has to do with the things mechanical, with the end results of disease, or with injury to the material body or its parts. And because Homoeopathy is basic in its curative processes, if its aid can be invoked in time, surgical procedures will not be required, excepting such as may be needed in cases of injury to the body machine or in other rare instances of congenital physical defects. Much of surgery is but palliative at best, because it deals with the end results of disease, without having the ability to expel chronic inherited toxemias that are behind all disorderly life processes. Surgery, when indicated, is like the indicated remedy, a great blessing, and often saves lives and relieves suffering. The evacuation of pus from deep abscesses, and those hidden away in closed cavities of the body, the extraction of carious teeth, the removal of obstructions and stenosed channels and ducts and even the excision of benign growths pressing on important structures are some of many valuable things that surgery best accomplishes. When these hindrances and obstructions are removed the life force of the organism can better carry on its many and complex life functions even though the morbific agent which caused those slow forming mechanical end results remains unchanged..." "As physicians whose sole duty is to heal the sick, we cannot afford to ignore intelligent help from any source so long as the aid available is based on law and common sense. If we are steeped in homoeopathic philosophy, we may employ surgery and mechanical measures with tremendous good to our patients and with increased credit to the homoeopathic cause itself. From this angle we see two distinct types of surgical procedure, namely, the constructive and the destructive. The first type fits in perfectly with the doctrines of Homoeopathy because it conserves organs and parts of the body organism and aids in the maintenance of the perfect rhythm of the life force..." Stuart Close that master, remarks, "...I cannot be charged with having any undue leaning towards surgery; but there are times and places where good skillful surgery is an absolute necessity...we must acknowledge that we are finite and that we have our limitations. There are times when we cannot find the remedy; there are cases and states that mark a limit as far as any doctor should go in his own judgement, with the internal remedy alone; you must decide where it is a surgical case and call in a surgeon to help you. Do not ever allow a patient to die on account of your inability to get the right remedy, but call in a surgeon to help you." Then, describing a case of acute abdomen he says, "... other adhesions over the gall-bladder were found and broken up and entire recovery followed. In the presence of such complications we must not fall down; we must not let our devotion to the effect of the remedy and to the cause of true therapeutic science allow us to expect effects in cases which belong to the domain of surgery. That is to the detriment of the patient and of true science. On the other hand, I do not doubt that all of you have been called to cases where surgery had done its best, or where it was not indicated, and where the remedy was all that was needed to effect a perfect cure." Alfred Pulford writes very strongly to say that all surgeons must know Homoeopathy. To quote him, "Just why should all surgeons be compelled to study the practice of Homoeopathy? Study

the following exhibits and answer the question yourselves! Do not get me wrongly, I am not unalterably opposed to surgery. I am only opposed to unnecessary surgery! Surgery should only come into play as a dernier resort; a resort to be avoided wherever possible. The human body, more delicate than the most delicately constructed watch, once any of its parts are either removed or changed, can never again operate with the accurate precision it did before that removal. To remove parts without the most just cause to supposedly prevent their supposed occurrence, is a method born of crass ignorance, and does not speak for the intelligence of the operator. No sane man would think of snipping a cog from the wheel of his watch because it did not keep proper time..." Then he goes on to quote a number of "surgical" cases cured by homoeopathic medicines. Plumb Brown reports several cases including one of intestinal obstruction cured with medicines. Farr says that the judicious use of surgery, esp. conservative surgical interference, will considerably aid homoeopathic remedies. In the discussion, Underhill gives his opinion that 85% of surgery is unnecessary and Dienst quotes a surgeon as saying 73% was unnecessary. Coleman states, "Edmund Carleton, Gilchrist and William Todd Helmuth were surgeons who appreciated the value of homoeopathic prescribing, an art much neglected by the modern operator. Many operations have been prevented by the timely administration of the homoeopathically indicated remedy, and in those cases in which operations are necessary, and it behoves us to recognise such, the pre- and post-operative conditions are bettered by the proper use of drugs. The woeful lack of the employment of the similar and single remedy by the surgical specialist indicates the necessity for reform in his important field. Many times I have caused lumps in the breast, some of years' standing, to disappear under the action of Conium, Phytolacca, Iodine, etc., after operations were advised. The exclusive surgeon would say that they were only adenitis, with which diagnosis I fully agree, but why operate for "only adenitis" when such can be cured medicinally? I have cured a number of patients suffering from cervical adenitis with the indicated remedy. Operative measures were strongly advocated in many of these cases. I have prevented most appendicitis patients from going on the operating table, but not all. A few must be operated, and it is for the clinician to decide. Deep ulcerations in which amputations were advised after the failure of all known local treatment have healed rapidly under the beneficient action of the similia... Carbuncles have been cured promptly by such remedies as Arsenicum and Anthracinum after ordinary "up-to-date" surgical measures had failed. Hayes also thinks that many of the superficial conditions such as abscesses, carbuncles, etc., classified as surgical are really medical. Roberts sums up the position in an excellent manner. He writes, "The homoeopathic physician is first of all a physician and yet there is that in each of our experiences that which compels us to go beyond the real province of the physician and enter the domain of special branches of the healing art. Surgery is one of these special fields that demands of each of us peculiar faculties and definite training if we would be the means of conserving the work of the physician in the world. This is especially true of homoeopathic physicians. "Surgery is neither homoeopathic nor allopathic, but is surgery pure and simple. We are liable to err and place Homoeopathy in an unfavourable position in the class of classes coming under our care, that try the skill of the physician and surgeon alike to decide whether a given case is surgical or medical. It is very essential that we should be trained thoroughly to

discover the line that demarcate the one from the other. It is just as blameworthy to decide against surgery as in its favour unless we are correct in our judgement. It is ignorance here that becomes a crime, just as truly as when Hahnemann declared ignorance of the healing art a crime." Sarat Chandra Ghosh records having cured with homoeopathic medicines several cases of mammary tumours, five of abdomen and six cases of appendicitis. He then describes a case in detail to prove that "surgical" cases are sometimes amenable to homoeopathic remedies. Boger refers to careful homoeopathic prescribing and says, "I maintain, however, that under such prescribing, the surgeon will have to be called in, in not more than one per cent of such cases. The longer I practice medicine, the more confidence I have in my remedies and I would call your attention to the fact that just that is one of the distinctive differences between Allopathy and Homoeopathy. In the one, the longer the physician practices, the less use he has for internal medicine, in the other the longer he practices the more success and the more confidence he has in them. I wish everyone of you could get and read Boenninghausen's Aphorisms of Hippocrates, it is most useful to homoeopaths and abounds in pearls and diamonds from beginning to end. In treating this very subject, he comes to the same conclusion by a different sort of reasoning." "It is within the power of the indicated remedy, to convert noxious fluids in the shape of pus or other poison into innocuous fluids. At least in some way they become harmless. The pathologist will bear me out, in saying that exposure for a time to a harmful influence increases the power of the system to overcome it. After a certain time if the system is not overcome by it, pus may be allowed to remain in the body with perfect safety, in the same way bullets and other foreign bodies may be allowed to remain, with safety." Indications for surgery It now seems appropriate, therefore, to consider and classify conditions where surgical treatment may be clearly needed and may be expected to benefit more than medical treatment. The following conditions and circumstances may be expected to indicate surgery. 1. There may be actual defects or deformities of the organs at birth congenitally. In such cases, it is doubtful if these defects or deformities, at least many of them, can be corrected by medicine, e.g. Patent Ductus, Atrial or ventricular septal defects, malformation of organs such as cleft palate, hare lip, imperforate anus, oesophageal atresia, absent pinna of the ears, etc. In such cases mechanical correction, repair of the defects or reconstruction of the part will be necessary. 2. Sometimes the end-results or the pathological products of diseases themselves may be causing excessive discomfort to, and preventing improvement or even threatening the life of the patient. Examples are aneurisms of aorta, excessive ascitic fluid or pleural effusion, retention of urine, etc. In these cases, mechanical intervention such as tapping, catheterization, etc., may be required to relieve the patient and to promote a cure. 3. In some cases, while the disease may be corrected and even cured in the real sense, i.e. the organism is restored to order, the end-products of the disease may remain behind, e.g. a big calculus in the kidney or bladder may refuse to dissolve and these may have to be removed surgically.

4. For conditions arising from external causes such as wounds, haemorrhages, etc., surgical means may be needed. In fractures, setting of the broken bones and plaster application may be necessary. 5. In cases like the Pott's disease, complete immobility is to be achieved by (surgical) application of plaster. 6. In certain diseases for the purposes of diagnosis, surgical procedures may be needed, e.g. lumbar puncture, bronchoscopy, sigmoidoscopy, biopsy, etc. 7. While a patient is under treatment, suddenly an acute emergency may arise requiring surgical operation, e.g. perforation of peptic ulcer, or appendix, internal haemorrhage, strangulation of a hernia, sudden obstruction in the larynx as in diphtheria requiring immediate tracheostomy, etc. 8. In intractable lesions which refuse to clear up in spite of the most careful prescribing, e.g. trigeminal neuralgia, third degree of prolapse of rectum or uterus, gangrene, etc., surgical procedures may have to be adopted to give relief to and to save the life of the patient, however regrettable the step may be, and though this would be an admission of failure on the part of the physician. Here the ego of the physician should not interfere with the objective of giving relief to and saving the life of the patient, by the use of surgical measures when medical treatment has clearly failed. Even when surgical procedures are decided upon, adequate preparation and pre- and postoperative medication (homoeopathic) will cut down the hazards of surgery, if any, and hasten the recovery of the patient and his restoration to complete health. Majumdar considers that the sick patient be treated with the indicated remedy and then only should surgery be carried out so that the patient will respond much better to the surgery. In adopting surgical procedures one has to consider carefully and make sure that such procedures do not merely aim at the elimination or worse, suppression of a local pathology but rather the product of a disease which is perhaps impeding or retarding the cure or putting the life of the patient in risk. When a surgical procedure is proposed, its pros and cons are to be carefully weighed and then only should the matter be decided. Here the surgeon must work in close cooperation with the homoeopathic physician and then he will find his work more successful and rewarding. Some "Surgical" Cases: Of course, it is true that many of the conditions which from a surgeon's point of view would definitely need to be operated upon have responded most surprisingly to the correct homoeopathic prescription, defeating the worst fears of the surgeon. As a result many of the patients who have been advised surgery as the only solution to their problems, have fled from fear to the homoeopathic physician and have responded very well to the homoeopathic medication, making surgery superfluous. A few illustrative cases from the author's own experience are quoted here, though innumerable cases can be found recorded in the homoeopathic literature. Peri-tonsillar abscess

A boy of 18 years was seen with high temperature and a big painful swelling on the right side of the neck. He could neither open his mouth, nor could he swallow even a teaspoonful of water, nor could he even whisper. A junior homoeopath, who had seen him, had diagnosed it as Diphtheria and had suggested that he should be shifted at once to the infectious disease hospital. When his mouth was opened with some difficulty and the throat was examined a huge, tender, fluctuating swelling was found over the right tonsil. It appeared to be a case of peri-tonsillar abscess. He had excessive salivation, great difficulty in swallowing saliva, pain in throat amel. by cold drinks and such other symptoms which indicated Merc-i-f. One was not sure if the abscess should be incised and drained. So it was decided to consult a surgeon. Meantime, Merc-i-f 1M, was given every 2 hours. By next morning, the temperature had dropped to 99 oF, pain had decreased considerably and the boy was able to swallow and speak. On looking into the throat, the swelling was actually found pointing. It was felt that now at least a surgeon would have to be called in and the abscess incised but still as the patient was clinically much improved, the medicine was continued four hourly and calling in the surgeon was postponed. Next day, surprisingly the patient was quite all right; the swelling, pain, etc., had all disappeared! There was no need to call in a surgeon after all! Cervical rib syndrome Once, a medical student, a young girl aged 18, was getting severe attacks of shooting pain in the right arm. Examination revealed loss of power in the arm, wasting of the muscles of the palm and local cyanosis also. The least exertion, even writing a few lines, aggravated the pain. X-rays showed bilateral cervical ribs. She had consulted several doctors, physicians and surgeons and everyone was of the opinion that she needed an operation to remove the pressure on the nerve as it was a cervical rib syndrome. Three or four good homoeopathic physicians had prescribed for her with no effect and they also concluded that surgery was needed. As the most careful homoeopathic prescribing had no effect, it was decided that surgery was probably indicated. For some reason, the girl decided to get herself operated a month hence and so she wanted some temporary medicine merely for the relief of pain. So, she was given a last prescription. It seems the correct remedy had been stumbled upon this time - it was Kali-c - because she experienced profound relief from pain. Because of this the operation was postponed further and she continued to take Kali-c as and when necessary. Within two or three months she was completely free from pain and could undertake all normal work. Appendicitis There was a girl aged 15 or so who developed pain and tenderness in right iliac fossa with vomiting. It was diagnosed as appendicitis and an immediate operation was advised. The poor mother became distraught with anxiety and brought the daughter at once several miles to the homoeopathic hospital because she had great faith in Homoeopathy. In view of the opinion of the previous doctor, we were cautious but we were aware that in appendicitis expectant treatment is more favoured nowadays. So, we admitted her and gave her some medicine, possibly we gave her Iris tenax. Next day, she was completely well. It is now 8 years and she has never had any relapse of the pain. Of course the probability is there that the original diagnosis had been wrong and possibly it was not actually appendicitis but merely appendicular colic, but however a surgical intervention was averted. Cholesteatoma Once, there was a patient suffering from discharge of pus from the ear. He had gone to an eminent E.N. T. surgeon who had diagnosed it as cholesteatoma, and had advised an

operation since there was no medical treatment for this condition. The patient refused the operation and had come for Homoeopathy. Under a homoeopathic prescription in three weeks his discharge stopped. Some time later the ear specialist saw him and asked him why he had not turned up for the operation. The patient explained that he was normal. So, the ear specialist examined his ear and remarked with surprise, "It looks so clean, as if someone has operated on you!" When the patient told that he had taken homoeopathic medicine, the specialist was pleasantly surprised and developed respect for Homoeopathy. Sinusitis Some time later, the wife of this same specialist applied for treatment. She had been suffering from recurrent colds and headaches. It had been diagnosed as Sinusitis. The usual treatment of the husband, the E.N. T. surgeon, had not helped. So he wanted to inject some auto-blood into the nose. She had refused and had opted for homoeopathic treatment. Her remedy was found to be Pulsatilla. This relieved her soon and she is now free for over one year. She is very grateful to Homoeopathy. Rhinosperdiosis Then there was a patient aged 40 from Nasik. He was an employee in the Air Force. He was having prolific cauliflower-like growths growing from inside the nose and hanging outside the nostrils since the age of 17 or 18. He has been operated once a year eleven times but it had recurred every time. It had been diagnosed as Rhinosperdiosis, which is a sort of fungoid growth. He also gave the history that six of his brothers had the same disorder. When it swelled up, it used to fill up the nose and block the throat also, causing dyspnoea. He used to get epistaxis on blowing the nose. During every operation, it used to bleed a lot. He had also cauliflower-like growth on the tongue, occiput and back, each the size of a gooseberry. The Air Force surgeon had advised operation for the 12th time but the patient had refused and so he was in danger of being dismissed from service or downgraded in rank. His drug was found to be Thuja and this repeated at suitable intervals in various potencies entirely removed the growth to the astonishment of the surgeon. Gangrene A girl aged 14 was admitted in the hospital with severe shooting pains in the left leg. On raising the leg, the leg would become pale. It was suspected as Buerger's Disease (Thromboangitis obliterans) by X-ray (Arteriogram) revealed the actual cause to be a thrombus in the femoral artery. Since the toe had become gangrenous, the femoral pulsation feeble and the popliteal absent, the surgeon decided to amputate the limb at the level of the thigh. For some reason the girl obstinately refused and the parents also supported the daughter. They had a friend who is a famous film actor but who also knows Homoeopathy. On his advice the girl was shifted to the house. In a few days with his homoeopathic treatment, the girl felt much relief from pain. The same surgeon in the hospital was again consulted. He was a good man; he examined her and said that somehow pulsation had returned to the popliteal artery. So now amputation was to be done only below the knee. This again they refused and continued the homoeopathic medicine. After three or four weeks the same surgeon examined her again and found that now pulsation was felt in the dorsalis pedis artery also and so he opined that only the toe which was gangrenous needs to be amputated. It was at this stage only that we were consulted.

On examination the toe was found to be gangrenous with a clear line of demarcation. In view of the astonishing history, it was suggested that the same homoeopathic treatment be continued. In a week or two the dead toe fell off by itself and the patient remained well. Stricture of the urethra A gentleman, aged 39 years, applied for treatment with a complaint of dysuria of three months' duration. He had consulted an eminent urologist. The conditions had been diagnosed as stricture urethra and the patient had been advised to undergo periodical dilatation of the urethra. He had the following symptoms, viz. urinary stream double, urinary stream feeble, bleeding from the gums on washing the face, and dark discolouration of the skin. All these symptoms were found to be covered by Merc-s. This remedy in 1M and 10M potencies relieved the patient completely in two months. Duodenal ulcer Mr. G., aged 39 years, turned up for treatment with the following complaints: He gets periodical attacks of abdominal pain amel. by flatus, amel. fomentation, agg. if he takes potatoes, onions, fruits, coconuts, rice or heavy food. Milk does not agree, it causes diarrhoea. The pain is amel. by food; with the pain, he perspires. He had a desire for warm food and drink. There was also lumbar pain on rising from bed. X-ray after Ba. meal showed "ulcer niche in duodenum with pseudo-diverticulae due to adhesions". The radiologist opined that it must be a chronic ulcer. Almost all the symptoms were covered by Lyc. This drug in various potencies relieved him completely and after six months the X-ray was repeated. The report of the radiologist was "ulcer healing but very deep". He gave the opinion that it was still a case for surgery. This opinion was endorsed by a surgeon. But the homoeopathic treatment was continued and with occasional doses of Lyc. the patient felt complete relief. He is now without medicine for last four years but completely normal and on unrestricted diet. Cardiospasm Mr. P.P. T., aged 32 years, applied for treatment in January 1958 with the following history: Nine years back he had pain in the chest as if an abscess was forming, which was amel. by fomentation and hot drinks. Pain used to occur once in 10-15 days, at any time of the day and would last for ten minutes. After six months he developed a feeling of food sticking in oesophagus and had restrosternal pain felt only while swallowing food or drink. And if he lay down after food, 3 to 4 hours later, the food and drink used to ooze out of the nose, first the liquid element followed by the solid part, sometimes 3 to 4 cupfuls through the nostril of the side on which he lies. This started recurring once in 2 or 3 months; he would also then vomit everything for 3-4 days. At present, he has pain, retrosternal on eating or drinking hurriedly. Appetite poor, likes sweets but sweets cause baysea afterwards. He likes warm food and drinks. The sense of obstruction is much less with warm food and drink. Has rattling in chest during sleep, especially after 3 a.m. Dreams of business. Screening with Ba. swallow showed "Achalasia Gastrica with oesophageal pouch". He had consulted a physician and had been advised to undergo surgery.

Basing the prescription on the symptoms "Throat pain, swallowing warm drinks amel.", "Throat, swallowing difficult, solids", "Throat, liquids taken are forced into nose" and "Desire for warm food and drinks", Lyc. was picked out. This remedy in different potencies including 50 millisimal scale potencies was given during a two year period. The patient showed considerable improvement and is now completely free from this trouble though he needs a dose occasionally. Some one year back, an eminent surgeon was consulted for an opinion. He expressed the opinion that there was no doubt about the diagnosis and no doubt also that it was a clearly surgical condition but since the patient had shown such remarkable improvement and was practically free from the difficulty, surgery was inadvisable and homoeopathic medicine should be given as and when necessary. Biliary calculi Mrs. S., aged 45 years, came with the following history and symptoms: Has been having pain in epigastrium after fatty meals - last two years. This had started two years back, when one day she had taken some fried fish and got pain in liver area after some hours. Since then she had been having such pains every time she had fried fish. There was pain in the right hypochondrium extending to the back, relieved by fomentation. Fasting used to aggravate her, causing vertigo; Eating little would satiate; There was no urge for stool; She could not sleep on the back because it would cause palpitation, distension and heaviness of abdomen; Menses has ceased since 7 years, she could not remain alone; she felt better in company; She had anxiety and palpitation, worse by noise, when awakened from sleep, or when her son has returned late from work; Anxiety caused trembling; She was easily angered, worse by contradiction; could not sleep; She had great fear of thunder storm. Investigations done with X-ray of gall-bladder showed "multiple gallstones, concentration of dye is poor; fat response is sluggish". The case was studied with the following symptoms, viz.: "Lying on back agg."; "Menopause agg."; "Fasting agg."; "Company desire for"; "Fat food agg."; "Trembling from anxiety" and, "Fear of thunderstorms". The only remedy that covered all the symptoms was Phos. She was put on Phos. and after three months treatment, an X-ray of the gall-bladder was taken again. The radiologist gave the opinion, "that the stones were about 60% in size less as compared with the previous X-

ray." The treatment was continued and the next X-ray showed "No Radio-opaque calculi in the G.B. area". Renal calculi Mr. G., aged 40 years, got a sudden attack of pain in the left renal angle extending round the abdomen to the pubis. Urine showed R.B. C., pus cells. It subsided but recurred again four days later. An X-ray of the urinary tract showed, "Small radio-opaque opacities right renal area; Calculi right lower calyx; Radio-opaque opacity in pelvis 3/4" medial to right ischial spine and another large oval radio-opaque opacity on left side. Both lower uretetic calculi". His symptoms were: Very fond of eggs, sweets and potatoes; aversion to milk and cold food; He could not fast and was irritable when hungry; He desires company, is depressed when alone; fears ghosts and fears being alone at night, there must be someone by his side; has great fear of thunderstorm. Uncovers even in winter. The agg. from eggs, milk, potatoes, etc., suggested Calc., but the fear of thunderstorm, great desire for company and inability to stand hunger were covered by Phos. So, it was decided to make a combination and give Calc-p. So, three doses of Calc-p 1M were given. Three days later he passed a spiky stone, 1/2" long, 1/4" thick, with no pain or bleeding and got relief from pain. Nine days later, a plain skiagram of the urinary tract was taken. The report of the radiologist was, "No evidence of any radio-opaque calculi in whole of urinary tract". The original X-ray had shown the presence of three stones out of which he had passed one now. But the second X-ray revealed that the remaining two stones also had disappeared. Summary So it is that good homoeopathic prescribing cuts down the need for and risks from surgery. But one has to discriminate carefully and take advantage of all the advances and achievements of surgery whenever it can supplement, or even if necessary supplant the usefulness of the homoeopathic remedy because ultimately it is the welfare of the patient which should be the sole deciding factor and not any personal predilictions of the medical man. Limitations of homoeopathy In dealing with this subject, viz. "The Limitations of Homoeopathy" I am aware of the tremendous emotional feeling that may come up here. There are many homoeopathic physicians who feel that Homoeopathy is absolutely sufficient to cure every type of disease and that it does not require to be assisted, supplemented, complemented, or supplanted by any other measures, methods or medicines. I fully understand and may add that my own appreciation and respect for the logical principles of Homoeopathy and experience of the tremendous capabilities of their application are in no way less profound. But our subject today

is not of the extraordinary efficacy of Homoeopathy in many cases but of its limitations, and we shall discuss this subject unemotionally. Emotion generally tends to cloud reason and an emotional approach is generally not an objective or a scientific approach. We shall consider the subject in an objective and scientific way. No doubt the value of our discussion will be limited by our limited knowledge and experience; yet it is the duty of every practical physician to make public the knowledge and experience which he has acquired, no matter whether at the present moment these should be regarded favourably or unfavourably, for frequently their real value is finally settled in the future only. We shall deal with this subject in a very broad sense. When we discuss the limitations of Homoeopathy, we shall not merely discuss the limitations of the law but also the limitations of the practitioners, the literature, application, medicines, etc., besides various other factors like its speed of action, its easy applicability, etc., and also consider some of the reasons why it has not spread further and faster. Every honest homoeopath among us will have to admit that he meets with defeat now and then at least sometimes if not often. In spite of the greatest care on his part and cooperation on the part of the patient, failures do result. Naturally, it is puzzling to us because we know that Homoeopathy is quite capable of curing such types of cases but just fails to click in particular instances. We may rack our brains and try again but we may still fail. The causes of such failures, as well as several other aspects of Homoeopathy, require dispassionate investigation if we are to make further progress. In taking up the subject of limitations of Homoeopathy we are no doubt treading on very delicate ground. We have all seen some cases which we had at first considered very easy to cure by homoeopathic treatment, but which later had actually proved to be extremely difficult and refractory. At the same time, we can also remember or recall other cases, which we had at first concluded as being incurable and beyond all human hope, but which had actually responded promptly and surprisingly when treatment was instituted even without hope. Also we have noted cases which had refused to yield to our most carefully made prescriptions, but which had later responded very well and got cured by the prescriptions of some other homoeopath. And in the same way we can recollect patients whom other capable homoeopaths might have treated for long periods without any effect and who came to us subsequently and got well under our treatment. This being so, we have to carefully differentiate between the limitations of the homoeopathic practitioners on the other. This is an extremely difficult and delicate task but since the efficacy of Homoeopathy itself cannot be recognised and measured except through the effects of the medicines as prescribed by the homoeopathic prescriber, we find ourselves in the very difficult situation of deciding how far the limitations of the homoeopath reflect on Homoeopathy itself and convey an impression that it by itself has many limitations. Lest this may become an academical discussion, we shall have to go, for practical purposes, by what the homoeopaths in general are able to accomplish and what they are unable to achieve, irrespective of how extraordinarily capable Homoeopathy may be as a science and how ideal it may prove itself to be when handled by a perfect prescriber. We shall now discuss various aspects of homoeopathic practice and the limitations relating to each. The principle Applicability The similia principle is clearly applicable to all conditions where the vital force is deranged. It will not apply and will not be completely suitable to conditions and obstructions which are of a

mechanical nature, e.g. fracture, impacted foreign bodies, congenital absence or malformations of organs or tissues, chemical poisonings, states where the vital force is entirely suppressed (e.g. serious injuries with shock) and conditions which arise from hygenic or dietetic factors, deficiencies and other environmental conditions. Dr. Dunham has defined the field of applicability in a brilliant essay in his book, "A Text Book of Materia Medica". To apply the principle in such inappropriate fields would be to court failure. The symptom-totality approach The basis of the homoeopathic prescription is the symptom-totality. The symptom-totality is, as defined by Hahnemann, the deciding factor. The disease, he said, is reflected by the symptoms and symptoms alone and where there are no symptoms it is expected that there is no disease. But unfortunately we do come across conditions which are represented by no symptoms, e.g. asymptomatic hypertension, or conditions represented by a single symptom, e.g. a wart - the so-called one-sided diseases, manifesting themselves through a single pathological disorder such as alopecia, corn, tumour, vitiligo, etc., apparently unaccompanied by any general disturbance. We, ourselves, had one such patient who had a very high B.P. but this was noticed only accidentally when he went for Life Insurance medical examination. He had absolutely no other symptom and we did not know what to do. Again, there is a rider that within the symptom totality it is the group of characteristic symptoms which really decide the remedy selection and the prescriptions based on such symptoms are far more successful. However there are many cases particularly cases with advanced pathology, e.g. cancer, which present mostly the common symptoms. In such cases we are forced to prescribe on the symptoms available, i.e. the common symptoms and hope for the best. This is not a happy state of affairs. Of course, when the presenting picture is poor or deficient one can go back into the history and take the past pictures or illnesses or even the family history as the starting point and still achieve success but this would be a kind of an alternative method. Further even though all homoeopaths concur to prescribe on the symptom totality, this "Symptom-Totality" itself turns out to be a somewhat elusive or illusive entity. The symptomtotality image of the same patient may appear different to different individual prescribers depending upon the way in which each ingredient is given its place and value. Our reference books Materia medica Our Materia Medica is full of symptoms of a highly subjective nature. Linn Boyd calls it a "Hyper-subjective Materia Medica". And these subjective symptoms may not always be so reliable as they depend very much upon the powers of observation and expression, care, faithfulness, intelligence, etc., of the provers. Again, as many drugs have not been proved thoroughly, nor their proving effects well-supplemented by clinical observations, these leave many lacunae. I may quote an instance. I was once consulted by an allopathic doctor for his daughter aged about 8 years. She was abnormal in her behaviour. As soon as a visitor came to the house she would abuse him, spit on him or do some such thing. Needless to say the doctor was much distressed. I took her case, pitched upon Calc. carb. as the remedy and gave it in all the potencies from the 6th upto the CM, without the least effect. I then sent her eye-secretion to London and consulted Dr. W.R. McCrae who prescribed for her with the help of the

Emanometer - the remedy being Calc. ovi testae. This remedy completely cured her. When I looked up Clarke's Dictionary I found none of her symptoms given under the drug! I have also seen similar cures by other rare drugs, e.g. Linum usitassimum, Amni visnaga, etc., based on symptoms about which our books on Materia Medica do not make much mention. So, we have on the one hand numerous drugs with numerous symptoms some of which are unverified and on the other many drugs still to be proved or proved well. The symptoms recorded originally were derived from provings made on healthy persons but later on, it is known that even Hahnemann made some of his proving observations on his patients and added these to the Materia Medica. This might have been due to the paucity of provers or due to the fact the Hahnemann considerably broadened the scope of the term "healthy prover" or because he had the insight to know which symptoms were due to the drug. Controversies have ranged about the value of these clinical symptoms. But it is a fact that our Materia Medica, as it stands at present, has quite a large measure of these clinical symptoms and many of these have been of immense value in practice, notwithstanding whatever might be said against them on academic grounds. For instance, the symptom "Vomiting of cold drinks, after they become warm in the stomach" discovered by Dr. Lippe at the bedside is till considered one of the classical and valuable indications for Phosphorus. So, as against the academical assumption that our Materia Medica is made up of symptoms derived from provings made on healthy human beings, in actual fact it is a congregation of symptoms derived from different sources. Not all of these, therefore, can be considered of equal value. Besides, every symptom, whatever its source, depends for its value upon the source and the care with which it has been critically examined before being accepted. It is possible that some of these symptoms have not been so carefully assessed before being included. Indeed it has been suspected and questioned that some of the symptoms even of the provings, might turn out to be the product of the circumstances of the provers. For instance, Dr. Hughes with his monumental patience has carefully examined almost every symptom in the Materia Medica Pura and Chronic Diseases with a critical eye and has concluded that even certain symptoms recorded by Hahnemann should be rejected. He quotes the symptoms supplied to Hahnemann by Nenning. "How does Nenning produce such a vast amount of sexual symptoms from almost every drug he proved?", Dr. Hughes questions. In fact, Hahnemann himself had called Nedding a "Symptom-Buyer". In the circumstances, it seems that there are possibly as many defects on this side, i.e. the remedy's side as on the other side of the equation i.e. the patient's side. Therefore, in comparing the symptom picture of the patient with the symptoms and pictures of the drugs, we are comparing and trying to match two entities each of which is imperfect and defective to a certain extent. If in spite of these circumstances and handicaps we are able to select the drugs accurately and achieve success in practice, it is a credit to the immeasurable greatness of this science. Our repertories

Our repertories, though they are extremely useful, are not complete or perfect and are full of many gaps and pitfalls. Dr. Jugal Kishore and others have pointed out many of these in various articles. Working with imperfect books puts the prescriber in a handicap. We could also mention that, in certain cases, drugs which seem clearly indicated and act favourably also, may not come out on repertorization. Therefore, the repertory should be only taken as an aid or a guide and is not to be entirely depended upon to decide the remedy. The physician Though the principles of Homoeopathy seem easy to grasp and their application appears simple, yet in actual practice the homoeopathic physician is called upon to use the greatest alertness, care, industry, observation, patience, circumspection and intelligence both in taking the case, in selecting the suitable symptoms and in matching the disease picture with the drug-picture. Owing to our own inefficiency, lack of care or thoroughness we might have missed some important point in the case and thus lost a most important link or clue. Though numerous homoeopaths are practising Homoeopathy with varying degrees of success, yet only a few are seen to be really or outstandingly successful, being able to use Homoeopathy to full advantage. To put it in other words, probably the majority of homoeopathic prescribers only hit the simile while only a minority are able to select the true similimum. This very fact seems to be a limiting factor in that the average homoeopathic prescriber cannot and does not attain much success. Homoeopathy has probably earned a name more by the brilliant results of the brilliant few and not by the average good results of good number as happens to be the case with allopathic practice. The homoeopathic patient The case taking in our system is so highly specialised and thorough that we wish to know the most minute and intimate details of each patient. For this we have to rely too much on the powers of observation, memory, intelligent expression and cooperation of the patient. Unfortunately the patient may not be so infallible. He may not have noted or may not remember or may not be able to express or explain clearly the causations, modalities, extensions, etc., or he may be ignorant of some vital facts concerning his past or family history. Particularly in this modern era, it would seem that the average man's attention is diverted to or absorbed by numerous things, leaving him too little time to observe his own bodily or mental functions. Due to such lack of observation on the part of the patient we may secure only very few symptoms - and those too, such as may be of no significance to us. To illustrate how unreliable a patient can be, I shall quote an extreme case. I was once called upon to visit a lady of about 30 years who had arrived from Madras by train and had developed a severe pain in the thigh. On an examination of the part, I felt sure it was a fracture of the femur but she flatly denied any history of injury. While in the hospital, she was visited by a fat boy who had travelled with her in the same compartment of the train from Madras. When she complained to him that the doctors were repeatedly asking her if she had received any hurt which she had not, the boy reminded her that he had accidentally fallen on her from the upper berth in the train and that she had shouted with pain the whole night! Sometimes the patients may hide some symptoms from a sense of embarrassment or shame or omit them considering them to be quite irrelevant. Or, they may deliberately give us wrong symptoms. Very often, practitioners of the other system ask them only to describe their gross symptoms or sufferings, and so they do not realise the value of the finer or subtler symptoms, esp. the various sensations and modifying influences. The approach of modern medicine is

such that it places more value on signs than symptoms and seems to call for less subjective effort or cooperation on the part of the patient. To the average patient, words such as distension, heaviness, fullness, etc., (of the abdomen) carry much the same meaning and they may not be able to distinguish between and explain clearly the exact sensation and they may not care to be precise in their expression. Also they come to believe that the physician himself should be able to find out what is wrong by his own examination and investigation, and therefore, they contribute less information on their part. This almost total dependence of ours on our patients is not so commendable and is a source of great weakness. Another difficulty is, as I have mentioned, that there are patients who present only the common symptoms and are able to give us none of those symptoms - those characteristic or individualising symptoms - on which we rely so much for giving a good prescription. In such cases we are completely stumped. That this problem has been met with even in early days is known from our literature. For instance, Dr. Farrington taking part in discussion says, "We should everlastingly damn the doctrine of diagnosis as a guide to the selection of a remedy. But as our president (Dr. Houghton) has said, we occasionally meet with cases when we get nothing but common symptoms - symptoms that indicate only the name of the disease as for instance "Sugar in the Urine". What are we going to do in such cases? It seems to me as thinking men and women that we have a right to make use of any factor whatsoever, even diagnosis, if this is all we can get from a careful examination." It has also been sometimes our exasperating experience to find that the patient who had been quite definite about some symptom at the initial interview, either so modifies or alters his original statement at the next or later sitting that the whole picture becomes thoroughly changed, or at times he may add some very valuable piece which had hitherto escaped our most minute questioning, but which might completely change the complexion of the case. Besides these, in accepting the description by the patient of his symptoms in toto, we tend to attribute to and place on his observations, expressions or words, a certain degree of infallibility which they may not always or entirely deserve. This may perhaps be one of Homoeopathy's distinguishing characteristics and at the same time one of its greatest weaknesses. When a patient, for instance, complains of tinnitus, the allopathic physician is satisfied with the gross symptom whereas the homoeopathic physician wishes to ascertain what is the exact nature of the sound. That the homoeopathic enquiry goes so deep and realises the significance of such minutiae is a credit to the system. Yet from a purely practical point of view we find that the average patient is not able to distinguish between buzzing and whizzing, roaring and rushing. That the homoeopathic approach depends so much on the subject of the suffering while he himself is so fallible becomes one of its weak points. Yet again, in the interpretation of the symptoms, we may not be able to know, grasp or understand the whole background of each symptom. For instance, the patient who has an aggravation on chewing might tell us instead that he is aggravated by eating; another patient may state that when he perspires he gets an attack of coryza, whereas in actuality it may be that when he perspires and gets chilled thereafter, which is often natural he may be getting the attack. It we fail to put these symptoms in their proper perspective, we are likely to err. The methods The time taken for case taking It seems our methods can be improved and modernised. Lang writes, "Our method of defining the constitutional remedy is the same method evolved and used in the eighteenth century by Samuel Christian Hahnemann. In other words history taking and repertorization. I

certainly do not wish to disparage this, the classical method of finding the remedy, and I think it will always constitute the main method. However, it does take time and experience to use successfully, and I feel having to cope with the larger population of the twentieth century, we must be prepared to utilise modern scientific advances when they become available, to take some of the time-consuming effort out of symptom analysis." The highly individualising nature of the examination of each patient and the laborious matching of the symptoms may consume a lot of time and in this modern age of speed, some speedier methods may have to be devised. Reliance on the patient I have already referred to our total reliance on the patient. We treat his expressions as gospel. But in practice, as mentioned earlier, the patients are not found to be infallible. The symptoms they give may not be the result of a careful and accurate observation and their expression may also be wrong. The interpretation of symptoms Even though the patient may describe the history or express the symptoms easily and correctly, sometimes the interpretation and assessment of the symptom may require maximum understanding and ingenuity. Unless the symptom is understood in its correct perspective, it may prove useless. I shall illustrate this by the following example. I was once consulted by a lady who was suffering from repeated epileptiform convulsions for over 18 years. She described that she had been living in Rangoon at the onset of World War II. As soon as war was declared all Indian families in Rangoon were evacuated. She, with her children, along went on board the ship bound for India. Suddenly, there was an air raid warning and so the ship left the port in a hurry; as a result her husband was left behind. In the harbour itself she saw numerous dead bodies floating, which produced a sense of disgust in her mind. She was vomiting throughout the journey of fourteen days and took no food. As soon as she reached India she got her first convulsion. And since that was the last ship to leave Rangoon, her husband was able to join her only after several years, after the war was over. I tried to interpret the cause of the convulsion in various ways - as due to disgust, to vomiting, to fasting, to grief, to anxiety over the husband's welfare, etc., but there was no response to any remedy. Only when I took it as fright and gave Opium, there was a favourable reaction and improvement. Similarly, when there is a multiplicity of causes one is nonplussed as to which should be given greater value. Evaluation of symptoms Even though in theory the totality of symptoms is said to indicate the remedy, yet in practice all the symptoms need not be taken into account. The strange, rare or characteristic symptoms are mainly to be considered. There are some rules as to how these strange, rare symptoms are to be recognised, selected and evaluated, but here again there is great flexibility. There are such wide variations in assessing the value of symptoms that a symptom one homoeopath considers of great value, another may consider of little significance. Cases are also on record where the remedy based on one part of the totality to the exclusion of others has helped.

We know even of cases where the remedy selection has been based only on a single aspect of the case, e.g. the cause and that has proved successful. For instance, the most diverse conditions such as tumours, epilepsy, etc., have been cured by Arnica because they arose after an injury; similarly different disorders such as diarrhoea, skin diseases, etc., have been cured by Thuja because they originated after a vaccination. There are also records of cases in which one particular symptom has been given great importance and the remedy based on this symptom has been effective, e.g. a prominent aggravation at night, whatever the condition whether a fever or a fear, etc., has indicated Syphilinum, which has proved beneficial. A beginner is likely to include all the symptoms of the patient under the "symptom-totality" idea and is often likely to fail. I have known of beginners and even of very experienced homoeopaths who take all the symptoms narrated by the patient, be they 20, 30 or 40 and pass them mechanically through the Repertory spending two or three hours in the process. They invariably land with Sulphur and usually fail to help the patient with the remedy because Sulphur is not the remedy for all cases. Under the circumstances, it seems necessary for us to standardise and simplify the method of evaluating symptoms. We can lay down definite rules as to which symptoms should be given the highest rank and which the lowest. Of course, the value of a symptom will depend upon its background and circumstances in each case, e.g. a weeping tendency in a man is more peculiar than in a woman, and more strange in an old woman than in a young girl - and yet some standard formula for evaluation should be worked out and made available. Objective Symptoms: We have already mentioned that the subjective symptoms related by the patients are sometimes few and even those not totally reliable. A wiser alternative seems to be that we should study, in detail, the objective symptoms (including the pathological ones) so that when and where subjective symptoms are very few or unreliable, the objective ones may compensate for their deficiency. We have to "pick therefore, out and study" the objective components of the similimum. As the presence of these objective symptoms (signs) can be verified by us, they are quite reliable. Unfortunately, the study of these objective symptoms seems to have been devalued and discarded by some. Dr. Roberts writes, "Objective symptoms play but a small part in the record for they are of little value as curative symptoms." Many homoeopaths may disagree with this view, for in children, in the insane, in the mentally retarded, as well as in unconscious patients and in animals, subjective sensations are not available or are not reliable even when available, but objective symptoms are clearly perceptible and definite and therefore more dependable. One such good objective symptom is better than three nondescript and unreliable subjective ones. To give only one example, the state of the pulse and temperature are reliable objective symptoms. A disproportion between the pulse and temperature is one of the most valuable indications for Pyrogen and this remedy prescribed mainly on this indication has brought remarkable relief in numerous cases. One of the great homoeopaths who had foreseen this difficulty was probably Dr. C.M. Boger, for, in his book, "Synoptic Key of the Materia Medica", we find a multitude of objective (as also pathological) symptoms emphasized. With such a Materia Medica and repertory, where objective symptoms are given their true place, we would also be able to treat cases like leucoderma, warts, premature grey hair, alopecia, numerous skin and other disorders, etc., in all of which there generally appears little evidence of other associated symptoms on which

one could prescribe with confidence. Therefore, it seems we shall have to work out on these lines and also record numerous objective symptoms met with in practice. Objective method of remedy selection Considering the fallibility and unreliability of the patient it seems necessary that we should develop some method of drug selection or a method of confirmation of the remedy selected by the orthodox methods which does not depend on his subjective descriptions. For the sake of convenience, we shall call it an objective method of remedy selection. Just as in disease the functioning of the tissues are disturbed giving rise to various sensations, so also minute biochemical or biophysical changes are produced. Various persons have attempted to record these changes in various ways. The following are some: 1. The Pulse Test 2. The Emanometer 3. Pfieffer's copper chloride crystallization test 4. The flocculation tests 5. George McKenzie's test. The first four of these tests have been described in some detail elsewhere *. So I shall now take leave only to briefly describe the fifth one. The McKenzie Method: George McKenzie described in 1941 a method of testing and administering the similimum. In his method, the case is taken and studied and the probable remedies are selected among which one might be the similimum. Potencies of these remedies mixed in distilled water are injected intracutaneously, one by one, separately, at least 2" away from each other, in such a way as to raise a small bleb. A reading is taken after 24 to 48 hours. It is noted that the remedy which is indicated, i.e. the similimum, produces the most prominent and lasting response. There is a local erythema at the site of the injection which may persist even for several weeks or months. Medicines Reliability In spite of the tremendous advances in physics and chemistry, we are yet not in a position to assess or assay the available drug content or strength of our potencies. In fact we are not even able to differentiate between plain alcohol and our high potencies! As a consequence we rely heavily on the honesty of our pharmacists. This is not a very happy state because some of the pharmacists, at least, are not so scrupulous and meticulous *. When our prescription fails we can therefore never be absolutely certain whether our remedy selection itself was wrong or the remedy supplied by the pharmacists was not the one prescribed by us. The selection of the potency Though in general the selection of the correct remedy seems to be much more important than the selection of the correct potency, yet there are homoeopaths who assert that even the correct remedy, if given in the wrong potency, will not relieve or cure. There are also

many cases reported in our literature wherein this idea is confirmed. Therefore, the selection of the potency seems to be important. Now, unfortunately, though for the selection of the optimum potency, some criteria are laid down for our guidance from the experience of the masters, no definite rules are found propounded. Everyone is forced to fall back upon his own experience. It is said that when the famous Dr. Lippe was asked how he selected the correct potencies, after a long reflection he said, "After a long experience you will be able to do it but you will not be able to tell how or why." The dose The dose (quantity) of the homoeopathic medicine is so small that some patients are unable to believe that it can have powerful effect. This psychological disbelief or resistance has to be overcome. Administration The modern patient, even the villager, has come to believe that medicines given by injection act quicker and better. The desire could have a psychological basis **, or may be the result of propaganda. Invariably there is an unexpressed desire for injections. Whatever may be the psychological aspects, it is a fact that we have to satisfy the patient even as we cure him. With this objective in mind, if we consider the question of injections, we can see that injection is only a method of administration of the medicine like ingestion, inhalation, inunction, etc., where a particular route is employed and does not go against any of the basic principles of Homoeopathy. So we must conduct scientific trials with an open mind to see if the medicines when given by injection act as well as or better than they do when given by the oral route, and if they do so we should have no serious objection to using this route also. I may add that in certain specific conditions our colleagues in the West do administer homoeopathic potentized medicines subcutaneously. Duration of treatment Usually, the homoeopath is called upon to treat more than his share of chronic diseases because the allopath has little to offer in these cases. These chronic cases take a longer time to be cured because the underlying deep-seated derangement has to be corrected. Therefore, an impression has come about in the minds of many people that Homoeopathy is slow-acting. In the modern days of supersonic speed, patients are averse and unwilling to undergo such treatment for long periods. Every day of illness involves loss of many hours of work. Therefore, we have to take measures to correct this impression. We have also to ensure that the cure is speeded up as much as possible. Economics This is an age of vested economic interests which in the form of powerful cartels dominate most fields. And the pharmaceutical field is no exception. The allopathic pharmaceutical firms are mainly interested in selling more medicines and making more profits *. The homoeopathic profession unknowingly strikes at the very root of their commercial interests. If, for example, an average homoeopath treats 20 patients a day, the amount of money spent by the patients on (the cost of) medicines (homoeopathic) alone per day might be Rs. 2, calculating the cost of the medicine at the rate of 10 paise per day per head. But this single homoeopath may deprive some allopathic pharmaceutical firm of Rs. 40 per day. Notwithstanding the fact that he might have benefited the 20 patients by saving much of their expenses on medicine he

has made the commercial firms lose their revenue. At this rate, he will deprive the firms of a revenue of Rs. 14 600, (i.e. Rs. 40 x 365) per year. If a thousand homoeopaths were to practise thus, the total loss to the firms would be Rs. 14 600 000. No firm or industry would like to lose such sizable amounts and naturally they would resist the spread of this system tooth and nail, overtly or covertly, in order to survive. Dr. Julian summarizes some of the limitations as follows: "Here, the only valid reasons why no homoeopath should fail and they are in plenty. First, every drug has not been proved and even all the drugs he knows have not as yet been fully proven. But even at that he has infinitely more known drugs at his disposal than his allopathic brother. Secondly, all homoeopaths have not access to all the same books as many of the most valuable are out of print. Thirdly, the majority of homoeopaths fail to fully qualify especially in what is known as taking the case. This taking of the case is equivalent to the allopath's diagnosis. Fourth, the patient's inability to express himself properly so that the doctor can get a proper understanding of his or her case. This part is of utmost importance. And worst of all the system is so vast that no one mind can grasp it." Clinical and pathological improvement The Homoeopathic approach is a clinical approach and the treatment depends upon the clinical symptom-totality rather than the pathological state or the results of pathological investigation. When we prescribe on the clinical picture, we find the picture of disease receding to be replaced by a picture of health. The pathological conditions seems to get automatically corrected. It was reported that when Nasser came to power in Egypt, he immediately appointed Govt. auditors who were empowered to enter the pharmaceutical firms and assess the actual cost of production of various medicines. On these actual costs the firms were allowed to add profit of 30. As a result of this action, the cost of various medicines suddenly dropped. A medicine which was selling at Rs. 115 per gram came down to Rs. 11 per gram! However, this assumption or impression may not be always correct. Certain experiences of ours may be described to illustrate variations between clinical and pathological improvement in some cases. 1. We had a patient, aged 22 years, who had all the classical symptoms of an intracranial tumour. He had recurrent headaches, projectile vomiting, vertigo, diplopia, strabismus, tremors, exaggerated jerks and asthenia. Fundoscopy revealed papilloedema with minute haemorrhages in the retina in both eyes. He had already undergone all investigations which included X-ray studies of the skull and the tumour having been located, he had been advised to undergo surgical treatment. We were most reluctant to take up the case, but decided to keep him under observation and treat him for a few days. He gave a very clear history that three years back he had been involved in a minor train accident with consequent mild injury to the head. He had then been unconscious only for a minute or rather felt dazed, but since then he had lost interest in his studies and later had developed the whole symptom complex. On the basis of the history and other symptoms present, we prescribed Nat-s 200, 3 doses, two hourly. Imagine our surprise when within twenty four hours he responded very well and in two or three days he felt perfectly well. All his symptoms disappeared, except the papilloedema and retinal haemorrhages which conditions were found absolutely unchanged. So, we carefully watched the case.

His symptoms relapsed three or four times at intervals of one or two months every time, but every time he was restored (to all appearances) to a completely normal state by a few doses of Nat. sulph. In between the relapses, no one would suspect that there was anything wrong with his health. He used to travel a distance of 80 miles to attend the clinic every week. But the unchanged papilloedema and the fact that at every relapse the symptoms seemed more acute, suggested that appearances were deceptive, though the clinical improvement was almost magical. Considering himself cured, he discontinued the treatment. Ultimately after eight months the patient succumbed suddenly, after a short spell of unconsciousness with convulsions. 2. We had a case of a lady, aged 28 years, with severe anaemia, who exhibited all the symptoms associated with such a condition such as dyspnoea, pallor, amenorrhoea, anorexia, etc. In addition, she had certain individualizing symptoms such as extreme dryness of the vagina (the husband complained that the vagina had become too narrow), the amelioration by motion (while travelling, she felt very uncomfortable whenever the vehicle halted), etc. Her R.B. C. count was 1.2 million and haemoglobin was 25%. We gave her Fer. met., which seemed well indicated. There was an immediate and gratifying improvement with the result that all the symptoms, both the general and the individualizing ones, decreased and almost disappeared. She felt completely well within a few days. However, the blood examination repeatedly showed status quo. We gave her Fer. met. in varying potencies and intervals but during the two month period of observation and treatment, the blood picture remained absolutely unchanged. (Subsequently she left the hospital and continued the Fer. met., but in addition took Folviron tablets which she had formerly taken without any effect. Now there was a rapid rise in the haemoglobin and within one month it reached 97%.) 3. We have treated several cases of intestinal parasites, especially ascariasis, with homoeopathic drugs which appeared well indicated. We have found that in the majority of cases, all the symptoms generally attributed to the parasites, such as grinding of teeth, enuresis, boring into the nose, bulimia, etc., disappeared but no worms were expelled. Repeated stool examinations showed ova even after the patient was apparently normal. Later, if some allopathic anthelmintic was given, many worms were expelled. It will be noticed that in all the three instances, there were clear cut pictures and the selected remedies appeared to have been the correct ones, as not only almost all the symptoms abated but the sense of well-being was also restored to the patient. In fact, the patients desired to know if it was necessary to continue the treatment since they felt quite well. However, our own examination revealed (in the first case by ophthalmoscopy, in the second by haemoglobin estimation, and in the third by stool examination) that the improvement was only symptomatic and there had been no proportionate improvement in the pathological picture. But since the patients felt so well, we naturally expected that improvement in the pathology was certain to ensue. This expectation, however, was not fulfilled even after allowing sufficient time. In the first case, the patient stopped the treatment and died, in the second, the patient was restored to normal only after supplementation by other medicines and in the third the parasites had to be expelled by other medicines. Similarly, we have had other cases also, as for instance, of biliary calculi, wherein the patients presented a number of symptoms such as anorexia, vomiting, abdominal pain, agg. from fats, etc., all of which disappeared under the appropriate homoeopathic remedy and the patients felt very well. But the calculi disintegrated very slowly, after several months of treatment; sometimes they did not disintegrate at all. So also, we have seen cases of pneumonia get rid of their pain, temperature, cough, etc., and feel very well within two or

three days but the pneumonic consolidation, as revealed by X-rays, was found to clear up completely only two or three weeks after the patients had felt quite well. We have also noted that patients of peptic ulcers with severe pain are immediately relieved of the pain by the suitable remedy and the patients do not suffer from pain even if they take spicy or acidic foods; but the ulcer itself, as seen by X-Rays takes several months to heal completely. From these experiences we are forced to the conclusion that in every case, symptomatic improvement may not be accompanied by simultaneous and corresponding improvement in the pathological picture. Therefore, it seems necessary to assess the improvement of such cases under two separate headings: (1) Symptomatic and (2) Pathological (and radiological). It might be wrong to assume that symptomatic and pathological improvement are synonymous or simultaneous, to judge from the experiences quoted above. Very often the latter follows the former under appropriate homoeopathic treatment. But it would be an error to certify a patient as completely cured until they are normal under both headings, since it appears that our remedies have the power to relieve sufferings even when they are unable to influence the altered pathology. For instance, Dr. Franklin H. Cookinham, writing about the homoeopathic treatment of cancer of the breast says, "I think very frequently that our remedies will often relieve symptoms without affecting the pathological process underlying such symptoms." We must remember that pathological investigations have entered the field only comparatively recently, and before they were introduced, cases had been diagnosed and treated and the progress and cure assessed solely on the basis of their clinical appearances. Now that we have a deeper knowledge of the subject, we must make efforts to verify all cases cured by us, applying stringent criteria. Entire dependence on the remedy In passing, we must also mention the tendency of homoeopaths, esp. in India, to place their entire reliance on the action of the remedy selected, though this is more a weakness of the homoeopaths concerned than of Homoeopathy itself. This arises from a few reasons. One is the extraordinary efficacy of the remedy itself which in many cases seems to do everything necessary, by itself, to relieve and cure. Secondly, the majority of homoeopaths in India are either totally or partially uninformed of the role of medication in diseases and of the value of auxiliary measures, diet and proper management. The homoeopath should learn and train himself to be a physician rather than a mere prescriber and must be prepared to take all steps to ensure that the selected remedy has not only every scope to act fully but also that its action is helped in every way possible. Auxiliary measures While homoeopathic medicines can do everything that a medicine is capable of doing, yet we must ensure that no obstruction is placed in its way of action. Besides removing such obstructions and hindrances, we have to give every type of facility for the medicine to act favourably. Here the role of auxiliary measures cannot be sufficiently emphasized. Many homoeopathic practitioners who make brilliant prescriptions completely neglect to make use of auxiliary measures either because they are ignorant of their value or they are no conversant of the application of such measures or because of indifference or because their faith on the supreme powers of homoeopathic medicine is very great. Surgical conditions

We have already referred to the scope and field of homoeopathic medical treatment. It is true that many of the conditions in which our allopathic colleagues would prescribe surgical procedures are amenable to our homoeopathic medication. But it must be admitted also that there are at least a few conditions and stages of a few more conditions in which surgery is necessary and vital to save life. The homoeopathic physician must be always on the guard and must relegate such cases to the surgeon at such a stage when surgery is much advanced in modern times and the risks of operative procedures have been cut down considerably. Incurable diseases When all is said and done, even though our homoeopathic medicines are so extraordinarily powerful as to bring back the worst suppressions and cure many of the seemingly incurable cases, yet it will be accepted that there is after all a certain range or stage in diseases as, e.g. advanced rheumatoid arthritis in which the best of medication may prove insufficient to cure the really incurable conditions. This incurability of certain conditions had been recognised by Ayurveda also. This fact was brought to me in a rather forcible way in the following instances. A young Indian boy had gone to the U.S. A. to study after he had been thoroughly examined and found medically fit. In the U.S. A. however he developed an albuminuria and further investigations showed that he was having nephrosis. He was asked to go back to India. On the way, in London, his condition became rather serious. He consulted Sir John Weir who prescribed some medicine and the boy improved considerably. But after reaching India his condition again deteriorated and I was called to see him. I found in him the symptoms of Ars. I gave Ars. alb. in low potency and sent a cable to Sir John Weir asking for guidance. Sir John confirmed that his medicine was indeed Ars. but he added in the wire, "Prognosis bad. Make patient comfortable". I learnt later on that the boy died within a few days though the Ars. helped him. I was once called upon to treat a lady of 50 years suffering from a cerebral tumour. She had shown signs of a progressive space occupying lesion. The whole trouble had started after a number of frights. Her son-in-law had been operated in Nagpur but there was no news about his condition. Her daughter had become seriously upset after having delivered a third female child though she had hoped for a boy and had, as a result, attempted suicide thrice, and was still threatening to repeat the same. Slowly, this patient developed poor memory, poor concentration, paralysis of speech, etc., and ultimately had developed one sided facial paralysis. Her symptoms clearly indicated Opium and with Opium 1M the facial paralysis cleared up within two minutes! Gradually, her speech and memory were restored but her condition deteriorated again and again and ultimately she died of the same disease. Most cases of cerebral tumours are malignant and are generally incurable. Summary In order to practise Homoeopathy successfully, besides knowing the principles and methods of Homoeopathy we have also to be aware of the limitations of the system. Further, in the light of various advances and differing circumstances we may have to reorient ourselves and improve our methods without moving away from the basic homoeopathic principles. Some recent research and advances in homoeopathy There is, in some quarters, an unfortunate impression that the science of Homoeopathy is static and that no research is being done or advance made. This is quite untrue, for the simple reason that every science represents an eternal search for truth, and Homoeopathy is no exception. While the basic concepts of Homoeopathy are the same as propounded by

Hahnemann in the beginning of the nineteenth century, further studies have suggested wider fields of application, a newer understanding, new methods and newer approaches to the subject. We shall now briefly deal with some of the research done and the advances made in the last fifty years. Activity of homoeopathic potencies Research re the presence of matter in dilutions For many decades, substances diluted as high as 1 x 10-1 000 000 have been found often to have specific ability to relieve symptoms of illnesses. In spite of this clinical evidence, there have been few investigations of high dilutions using standard laboratory techniques. This lack of experimental investigation probably is because the action of substances in dilutions beyond 1 x 10-24 violates two firmly-held principles of physical chemistry Avogadro's law, and the Doctrine of the non-specificity of sub-atomic particles. According to Avogadro, the molecular weight of any material expressed in grams contains 6.12 x 1023 molecules. Theoretically, therefore, any substance diluted beyond 1 x 10-24 will contain no molecules of the original material assuming a homogenous mixture at each stage of dilution. Dilutions of this degree of fineness should then, contain nothing but the liquid vehicle in which the substance was first diluted, and should act in no manner different from it. Nor can the specific action of dilutions greater than 1 x 10-24 be attributed to electrons which became separated from the diluted material and remained in solution, for the other principle already mentioned, states that the electrons from one atom differ in no manner from those of any other atom. Therefore all high dilutions of electrons would have a similar, or non-specific action. Thus the apparently specific action of substances at dilutions greater than 10-24 has not as yet been explained, although many theories have been advanced to account for it. The question that has always puzzled medical men has been whether there is any matter at all, in the dilute homoeopathic medicine. The first question to be considered is whether our dilutions are just Aqua-Pura or whether they still contain some of the original substance from which the dilutions are made. If they still hold traces of that substance it could be only within the limits of Avogadro's number. If the dilutions are still active beyond, what is in these dilutions? These are two kinds of questions for which investigators have tried to find solutions. For this purpose chemical or physical methods can be used. Biological methods will be the link between research and the presence of matter in dilutions and the activity of these dilutions, since by reciprocity these methods enable one to detect the presence of a given substance by the activity of the product under investigation. From the scientific view point, first, the presence of matter in dilutions limited by Avogadro's number has to be established or existence of a "physical factor" beyond. To prove that there is something in a dilution is good: but it is not enough. This infinitesimal dose has to show a definite activity. Therefore, the necessity of biological and pharmaceutical research to study the action of infinitesimal doses. This study constitutes a new chapter of the science of pharmacology which is now growing rapidly. It has generally been found impossible to demonstrate physically or chemically the presence of any element in the higher homoeopathic dilutions. First comes the theoretical research of M. Berne which has deeply influenced the evolution of the scientific conception of dilutions. His mathematical studies have brought to the attention of homoeopaths the notion of the limit of divisibility of matter and the study of the dilutions phenomenon by washing (lavage) of photographic plates, which enables him to calculate the real concentration of the obtained

dilutions and therefore to establish a table of correspondence between the Hahnemannian and Korsakovian dilutions and showing thereby the difference between dilutions prepared by various techniques. He is no doubt the first to demonstrate the absorption phenomena which play such an important role in the amount of active principle of the Korsakovian dilutions. James Stephenson has published a review of investigations into the action of substances in dilutions greater that 10-24. Summarizing he says, "A review of the experimental literature since 1881 revealed 25 investigations into the action of various substances at dilutions greater than 10-24 (micro-dilutions). 1. W. Noyd, H. Junker and J. Pateron investigated the effect of microdilutions on the growth of paramecia and the alteration of Schick test. 2. W. Boyd and W. Persson investigated the effects of microdilutions on various enzyme systems. 3. P. Jousset, L. Kolisko, P. Narodetzki and J. Roy investigated the effect of microdilutions on the rate of growth of Aspergillus niger and Sterigmatocystis nigra muceliumi, and on the rate of germination of barley and wheat germ. 4. J. Boiron, A. Gay, P. Loch and L. Wurmser demonstrated the effect on light of a fixed wavelength and that microdilutions have capacitances which vary from the diluting medium. Boericke and Tafel took photographs with microdilutions of radium bromide. 5. B. Finke and G. Jaeger investigated the effect of microdilutions on the speed of nerve impulses and on the electrical field of human beings. 6. G. Henshaw demonstrated the effect of microdilutions on the degree of flocculation of the blood of rabbits; K. Konig and V. Vondracek on the growth of tadpoles; N. Krawkow on the venous flow from the isolated ears of rabbits and on the skin pigmentation and the blood of frogs; J. Roy on the development of tetanus and tuberculosis in guinea-pigs and G. Stearns and M. Stark on the degree of inheritance of genetically determined tumours of the fruit fly." The lower attenuations of homoeopathic drugs, called low potencies, can be shown to have in their attenuation definite electro-physical properties, for example: 1. Arsenic in an attenuation of 1 x 10-7 is capable of showing distinctive response to ultraviolet radiation by fluorescence. 2. Tincture of gold prepared by the method laid down by Hahnemann, an apparently clear transparent fluid, can be shown by spectroscopic method to be capable of modifying a beam of ultra-violet light. The modification is distinctive for gold. This tincture is in an attenuation of 1 in 107, i.e. 1 part in 10 000 000. 3. China, the famous cinchona of Hahnemann's early experiments, can be shown capable of physical action on ultra-violet light (selective absorption) in an attenuation of 1 x 10-7. 4. Nux-vomica can be shown to have a similar action in an attenuation 1 x 10-5. 5. Radium bromide can, by Geiger counter, be shown to have a radiation through air (having ionizing properties) which can ultimately be visually recorded by the oscillograph in an attenuation of 1 x 10-7 or 1 part in 10 000 000 and can be demonstrated by electroscope at least to 1 x 10-10 or 1 part in 10 000 000 000.

The physical methods have deeply impressed the homoeopathic world. In 1993, Loch built at the L.H. F. an apparatus named the Microlymeter for the demonstration of the presence of matter in dilutions and to establish the curves of these dilutions. In 1935, at the L.H. I. Congress in Budapest, Lisa Wurmser et al demonstrated the first results of their experiments. The principle of the apparatus is very simple. A galvanometer sensitive enough to detect the variations of light intensity of a ray hitting a photoelectric cell after going through a cell with parallel walls, contained the solutions to be studied. With this instrument, they investigated not only the deconcentration curves of dilutions obtained by the classical Hahnemannian method but they were also able to compare dilutions prepared by different techniques (Korsakoff's or Hahnemann's) and show the difference existing between dilutions obtained by the one or the other technique. Measurable changes were obtained for Quinine sulphate, Taraxacum dens leonis and Aesculus hippocastanum at dilutions from 10-24 to 10-30. W.E. Boyd, of Glasgow, published in 1936 the results of his research made with the spectrograph. There again, the limit of sensitivity reach the 7x for Aurum, Arsenicum and China. Other drugs gave interesting data but with stronger concentrations: Nux-vomica 5x and Lycopodium 3x. Let it be mentioned to clarify that a 3x represents in current language a solution of 1/1 000, which is in fact, a rather concentrated solution. With the arrival of artificial radioactive elements, a new phase in research was entered. Evidently, the technique based on the use of radioactive elements is not confined to Homoeopathy but the homoeopaths have used them for other goal. It is well known that the process of detection of radioactive isotopes is able to detect infinitesimal quantities of material reaching in particularly favourable cases upto 10-16. Daudel and Robilliart used the Geiger counter to measure the radioactivity of succeeding dilutions of radioactive Kali-b. The radioactive Bromium can be detected upto the 15x, and by extrapolation, the authors believe, justified the presence of substance active to the 18x or 9th CH, which is the last dilution allowed to official homoeopathic preparations (in France). Applied to Korsakovian dilutions, the reactions of the Geiger counter disclosed such irregularities that the authors stopped the study of dilutions prepared by this method. These Korsakovian dilutions, however, were studied by Bonet-Maury, Deysine and Voegeli with the same method but using Radiophosphorus. Radioactive Phosphorus can be dosed upto the 18x, widening the sensitivity limits of this method. The authors demonstrate that a 1000 Korsakovian still activates the Geiger counter, this proves that these dilutions still keep radioactive particles. Therefore, the 1000 Korsakovian dilutions are not "immaterial" and correspond approximately to the 18x. Besides, the authors studied with the same technique the influence of the shape of the vial, of the glass texture, of the shape of the spout, etc., in order to determine the norms of fabrication of the Korsakovian dilutions. At about the same time, O. Leeser and K. Janner published their research with radioactive Phosphorus. Their conclusions agree with those of the previous researchers. They find the limit dosages at the 18x. They state that the Hahnemannian method is the only one valid for obtaining regular results, for finding again the theoretical quantities; they confirm the influence of the glass texture, the shape of the recipient and the time of contact of the dilution with the vial. A process even more modern, the radio-activation of metals, changing the existing metal into a radioactive element, can control the amount of substance of a trituration and fix the limit of sensitivity, taking into account the inevitable impurities of the material used. Pijck was the first to use this method to study homoeopathic preparations. F. Dugain, in Analytical Chemistry, demonstrates the sensitivity of the technique and its

servitudes, the necessity of the proximity of an atomic pile is not to be forgotten. Besides, the limit of sensitivity nears 1 pp billion, i.e. 10-9 and the exactness of the results can vary with the elements under study and its location in the pile from ± 6% to ± 20%. This mighty display of energy required for the functioning of the cyclotron is certainly disproportionate with the results obtained. Indeed already from dilutions 10-7, results are difficult to interpret. The metals studied by Pijck are Gold, Manganese, Zinc. Gold can be detected to 10-10. Research of a "physical factor" The advocates of high dilutions, whether Korasakovian or Hahnemannian higher than the 9th CH (18th Dec.), thought that a substance diluted in a solvent was capable of modifying the physical constitution of the solvent with thereby became active. They then tried to demonstrate the existence of a "Physical factor" of an unknown nature which could explain the activity of the dilutions. They also tried to show the importance of "Dynamization" in the appearance of this unknown force. Working for the L. Boiron Laboratories at Lyon, Gay tackled this job. He published his result to the Society Rhodanianne. The title of his first communication is a program in itself, "Dynamization brings forth a physical factor variable in all homoeopathic dilutions even beyond Avogadro's number". Then, in 1951, 1952 and 1955, a series of studies were published either by Gay alone, or by Gay's montage baptized the "Gayograph". The "Physical factor" is evidenced by measurements of dielectrical capacity. Innumerable precautions were taken to avoid errors or possible pollutions. However, one wonders if in these delicate measurements certain variations are not produced by the glass solubility or by the use of corks. Wurmser remarks from personal experience that resistivity measurements can vary considerably by just touching the rim of a vial with fingers. The very complexity of these experiments have discouraged other investigators from trying to confirm or disprove these results. In the conclusion the author states surprisingly that the homoeopathic fact resides not in the dilution (whatever his reason) but in the dynamization which is the essential factor in energizing the drug: that the therapeutic properties are in the vehicle, and the presence or absence of these properties therefore, the inefficiency of the Avagardo's number. Elsewhere Gay states, "The place of the Homoeopathic phenomenon can be but a perfect elastic medium: the ether, which places the homoeopathic drug in the domain of the electronic physics." We can recall here the research of Heinz on "the physical action of dilutions" presented by the Com. Ristori at a C.H. F. Congress. The infra-red spectra were used to study these dynamizations and the author insists on the specific value of succession. We find there again the same stunning statement re "the importance of a perfect elastic medium (ether)". Finally, the author states: "The infra-red spectrographic examination proves that the homoeopathic dynamic phenomenon does not reside in the matter of the solvent since the same curve is obtained whatever the solvent, neither is it in the solute since, when changing the active substance, the results remain the same." Like Gay, the author finds in the infra-red the rhythmicity which makes him say that there are favourable points in the curves of dilutions, and the knowledge of these could help to choose the most active dilutions, therapeutically. With ultra-violet rays Heinz obtained results upto the 7x from which the author deduces that activity of the homoeopathic remedy is due uniquely to a dynamic action and as such independent of ponderable laws and of those regulating matter. Later Heinz changed his results and Gay wonders what external influences pressed out this retraction from him.

Physical researches include also those of Sevaux et al, who checked the "unpublished" experiments of Mrs. Vojna Radojicie re the impedance measurements of a Cum SO4 solution from the 1x to the 20x. The investigators completed these measurements by those of the pH and the rH2 obtained by the bioelectronometer of Vincent. They aver an identity of the given result with those of Mrs. Vojan Radojicie (increase of impedence surpassing greatly the initial values given by distilled water with wide oscillations between the 8x and 10x). Besides, they are struck by the importance of these oscillations - a phenomenon which, to them, remains "mysterious" - and ask for an explanation we cannot furnish at this stage. However, the description of their technique leaves a doubt which could possibly be easily lifted. Indeed the authors first state that their dilutions are made with the method of the sole vial, i.e. according to the Korsakoff method (which by itself justifies the stated irregularities, since it is now recognised that Korsakoff dilutions cannot be regular decreasing), then the authors give their results starting with the most concentrated solution and going towards the least concentrated, stating that it is useless to wash the vial between each experiment. On the other hand, a "control" is effected with distilled water after two simple rinsings of the vials. Then either the Korsakoff method is acceptable, and after N rinsings the solution still contains something, and then what to say of these two simple rinsings, or two simple rinsings are sufficient to erase all traces of substance and N such condition what to say of the dilutions obtained in the same vial upto the 22x and beyond. Brucato and Stephenson investigated the concentration of homoeopathic dilutions of mercuric sulfide by photometric techniques and obtained positive results upto 10-6 grams per litre. P. Loch and Lisa Wurmser in 1948, and J. Boiron and A. Gay in 1951 demonstrated the effect of microdilutions on light of fixed wave-length and showed that microdilutions have capacitances which vary from the diluting medium. In 1951, A. Gay demonstrated that microdilutions have dielectric indices which differ from their liquid vehicles and are specific both for the substances in dilutions as well as for the degree of dilution. His apparatus consisted of a "type of capacitance, a mercury armature and a dielectric easily interchangeable... introduced in circuit with galvanometer". The changes in capacitance of the various microdilutions were recorded as fluctuations of the galvanometer from zero. He obtained sinusoidal curves for microdilutions ranging upto 10-60 of Strychnos nux-vomica, Pulsatilla nigricans, Lycopodium clavatum, Cinchona officinalis, Ignatia amara, Castoreum, Moschus, Sodium chloride and Sepia. In 1951, Gay extended his work in collaboration with J. Boiron. Using the same apparatus, in 100 out of 100 attempts they were able to distinguish a flask containing sodium chloride 1054 from six other identical flasks containing distilled water. In 1952, Gay and Boiron reported the result of a series of exhaustive investigations into the action of microdilutions. In a comparison between the capacitance of distilled water and sodium chloride, carried through identical stages of dilution to 10-60, both dilutions gave sinusoidal curves which approximated each other fairly closely except that at 10-26, 10-38 and 10-54 they were in direct opposition. In addition they found that, "Ohm's law is not applicable for microdilutions... that the electrical resistance is not linear for frequencies between 1.050 and 2.650 periods per second". In 1906, a picture of a key was taken in the presence of the emanations of Radium bromide at a dilution of 10-60 (60x) as reported by Boericke and Tafel. This 60x triturate of Radium bromide was also found to cause fogging of photographic plate.

Homoeopathic medicine has been continuously faced with the problem of explaining the succussed high dilution (beyond 10-24) called by some the microdose. Since, according to Avogadro's law, any solute in a chemical dilution will disappear after 6.02 x10-23 dilution, or approximately the 24th decimal dilution, all drugs above 24x would be therapeutically useless. This premise is true if one thinks only of the solute as the therapeutic factor. Much, if not all, of the data concerning high dilution action in the last forty or fifty years has been so predicated. If on the other hand we are prepared to hold the premise that the solvent can be the therapeutic factor, we begin to get a new view of successful high dilution action. Richard and James Stephenson report a testing of radio-active potassium chloride in homoeopathic dilution by a scintillation counter which showed no significant results beyond a dilution of 1:108. Smith and Boericke have reported work on the continued use of Nuclear Magnetic Resonance and ultrasonics to study serial dilutions and succussions, and compare the resultant graphs to unaltered normal dilutions of identical solvent. The Nuclear Magnetic Resonance spectrogram showed a difference between succussed dilution and ordinary dilution. Stephenson in a paper giving references says that research has demonstrated that succussed high dilutions act in a particular manner, regardless of the testing method used. The presence of an initial solute, and its dynamization by succussion, was found to be necessary for their formation and boiling was found to destroy this action. These succussed high dilutions were able to alter infra-red absorption and electrical conductivity and capacitance and the intensity and wave length of a fixed light source. Dielectric strength tests were conducted on dilutions (decimal potencies) of mercury. The results were in voltages ranging from 2.40 to 6.05 kilovolts. A linear relationship prevailed only upto the 10/6 dilution (or 6th decimal potency). Beyond this dilution the voltage varied in a manner corresponding to the physical presence of solute far in excess of the known input, even in dilutions well beyond the limits of Avogadro's number. Nasiff quotes the work of a French engineer Monsieur Louis Tourrenna who, it appears, found by means of Radiesthesia with an apparatus that the potencies have more power the higher they are and by taking the length of the atomic power of Radium as standard he noticed that a third potency gives a wave of atomic length of 0.30 cm; a 6th, 7 cm; a 30th, 1.05 cm; a 200th, 1.20 cm; a 1 000th, 1.30 cm; a 2M, 1.35 cm; a 5M, 1.55 cm; while 1 Radium gives 1.55 cm. Chemical Chemical methods have not proved very useful because their sensitivity is rather limited since the most refined techniques satisfy the analysis when 1 ppm (one part per million) can be detected, i.e. 10-6 or the 3rd CH. In certain circumstances the 10-8 can be obtained, but we are still very far from the Avogadro number. In chemistry, there is no special technique related to Homoeopathy: only Microchemistry, Chromatography or even Capillary spectra can reach the limits of the sensible always around 10-7 or 10-8. Hass and Neugebauer have separately used methods to compare the techniques of manufacture and the influence of solvents. At the 1933 L.H. I. Congress in Madrid, Neugebauer gave the results obtained by capillary spectra, the best ones from Berberis and Hydrastis whose fluorescent spectra are visible up to the eight decimal potency.

The authors of The Loom of Creation (Dennis Milner and Edward Smart) write: "A few experiments have been made with homoeopathic remedy Pulsatilla starting with dilution D4 and further diluting with water in a comparatively random manner. Pieces of filter paper were moistened with the various dilutions and examined with colour film using the multiple pulse technique. The filter paper which was wet with Pulsatilla in its initial dilutions registered bluegrey with a blue surround. With further dilution the filter paper registered red and there was evidence of emanation from the blue surround. A change of this nature was reproducibly obtained. However, on one occasion, with greater dilutions the red colouration was much more intense and also spread throughout the surround and background. Much more precise control of the experimental conditions is required to evaluate this phenomenon than was obtainable with the electrostatic generator, multiple pulse technique. We think that dilutions of the Pulsatilla, combined with the application of a suitable rate of pulsing the expanside, dematerialising, light etheric force, has brought about a freeing of the etheric force associated with the homoeopathic remedy, and this has affected the light etheric registration on the colour film. It has been our experience that the rate of application of the light ether pulse to substances markedly affects the etheric emanations that are obtained from them, and that in some cases a particular result is quite critically dependent on this factor." Kirlian Photography which photographs the corona discharges (or aura) surrounding living matter may prove useful in detecting the effects of homoeopathic potencies, since there are alterations in the state of the aura depending upto the condition of the person. The French physicist Gustave de Bon demonstrated that sodium chloride in 1M potency sprayed into a vacuum will show a sodium band in the spectrum. W. Oswald demonstrated in 1923 that super-saturated solutions will crystallize out in the presence of dilutions of the solute ranging upto 10.9 (9x). Stephenson and Brucato studied the effect of sodium thiosulphate potencies in crystallizing supersaturated solution of sodium thiosulphate. Pfeiffer's copper chloride crystallization test Ehrenfried Pfeiffer, a student of Rudolf Steiner (founder of Anthroposophy), working with copper chloride solutions, discovered that the pattern of crystals of the copper chloride was affected and altered by the addition of any extract of a plant or the serum of an animal or of a human being. The alteration was so specific that if the serum of a patient was added to the solution of copper chloride while it was crystallizing, it was possible by studying the resulting crystal pattern to infer the nature and location of the patient's lesion. Thus even cases of cancer could be diagnosed long before the lesion becomes evident by virtue of its gross pathology. He and Knaur reported that a 5% solution of sulphate of soda when placed under the influence of the solar spectrum forms long and thick crystals in the red field and small and thinner ones, in the blue field. In their experiments with plant juices and blood, solutions of chloride of copper were found more suitable. They used solutions of 5, 10 or 20%. Ten cm3 of the solution are poured on a smooth glass plate which is covered by it to a depth not exceeding half a millimeter. Care must be taken to shield it from variations in temperature, from shaking (vibrations) and from currents of air. Crystallization commences about the end of fourteen hours and is complete in sixteen hours, and is of a definite character and appearance. If to this solution of chloride of copper, from one to three drops of an organic liquid be added and it is allowed to crystallise as before, the appearance of the crystallization will be altered. For instance the appearance of the crystallization, when a drop or two of the

juice of the water-lily or of the aloe has been added to the chloride of copper solution, will be different from that of the unmixed solution and from that of each other. The same result occurs when a drop of blood is added to the copper solution, a characteristic appearance of the crystallization is seen. Further, the appearance of the crystallization when normal blood has been added differs from that when blood from a diseased person has been added, and this again differs according to the nature of the disease. In this way the appearance of the crystallization of the chloride of copper solution when various diseased bloods have been first added to it, enables the diagnosis of the disease to be made. By experimenting with various plant juices, minerals, organic extracts (such as of the liver, heart, kidneys, endocrine glands, etc.), they obtained characteristic crystalline appearances for each and found that when the crystalline appearance caused by these substances was similar to that caused by the blood of the diseased person, the medicinal administration of such substance will cure or ameliorate the corresponding disease. They claim to have successfully treated cases of nervous and mental diseases, asthma, cancer and other disorders by administering medicines selected in this way. The article is illustrated by numerous plates showing crystallization in the above different circumstances. Pfeiffer also observed that if to the solution of copper chloride to which the patient's serum had been added, the similimum in potency was also added, it tended to normalise the (disease) pattern as reflected in the crystals. Biological methods The trials for the proof of action of infinitesimal doses have to be either biological, or pharmacological, on isolated organs or on the entire animal. The oldest experiments are those of Raubin, Charles Richet, Gabriel Bertrand and Javillier who demonstrated the role of oligoelements, so-called biocatalysts on the growth of Aspergillus niger or on yeasts (Silver, Zinc, Manganese) and on the lactase activity (Manganese). Of course these experiments are not "homoeopathic" but they are often cited by homoeopaths to prove the reality of action of infinitesimal doses. Jousset studied also the action of Silver Nitrate on the Aspergillus, and noted effects upto 30th dilution. We find, in a very interesting brochure of Dejust, several pertinent criticisms and a few references. Marage summarizes experiments made on the Kefir fermentation with Sodium bicarbonate diluted to the 12x. There is a constant increase of the activity but, "the results seem unrelated to the degree of concentration of the solution used, i.e. there is no proportion between the dilution and the action". We find again this same phenomenon in Pharmacology. This is one of the most important questions in the problems of Homoeopathy. Persson studied the influence of microdoses of various substances on the diastatic action of amylase, trypsine, persins, urease and diastase. Started in 1929, these experiments have been pursued through many years and presented at various Congresses of L.H. I. and published in Homoeopathic Moderne. On trypsin he studied the action of Iris, Phosphoric acid, Arsenic and Insulin. The dilutions of Iris have a maximum of specific action at the 10-10 dilution. With successive dilutions a sinusoidal curve is obtained with a tendency to fall, and we notice in the second half of the curve a certain retardation in the reaction (corresponding to dilutions 10-65 and 10-80). The curve reaches the line of abscissa at the 10-90 and 10-100 dilutions, with Phosphoric acid same sinusoidal reaction, but the curve reaches inactivity at 10-45. With Arsenic, the 10-9 dilution is very active, but the 15th is hindering. Finally, Insulin has no action on trypsine but at 10-5 acts on lipase. On erepsine Arsenic acts upto the 10-20 dilutions; the Mercurius corrosivus 10-16; Tartarus emeticus is also active upto 10-15. As for Ipecac, there is a zone of inactivity upto the 6x. Thereafter, it is active upto 10-20.

Podophyllum, Baptisia, Natrum sulf., produced no activity. As to the diastase of the frog muscle, Persson studies its action on glycogen in the presence of various drugs. There again we find the sinusoidal actions so characteristic of the study of successive dilutions. Arnica is active only from the 6x to the 10x, Rhus tox. from the 30x to the 15x, Strychnine is inhibiting at the 3x (toxic dose), then completely inactive thereafter, Merc-c in its sinusoidal activity touches twice at the 10x and 20x, whereas the 6x and 15x are active, etc. Taking again as material the Aspergillus niger (Sterigmatocystis nigra), P. Narodetzki presented a pharmacy thesis, "On the creation of a technique for the study of Homoeopathic dilution". The author studied Sodium borate and Merc-c, selecting for testing the weight of the mycelium obtained in the cultures. With Borax he observes no action, inhibitive or favorizing from the 1st CH to the 30th CH gives heavier cultues. The next dilutions upto the 30 CH are inactive. The author describes also in the most minute details the precautions taken with these infinitesimal dilusions in order to avoid the introduction of impurities. It is the more deserving to constate that this "technique for the study of homoeopathic dilutions" is so poorly efficient. One finds in this thesis excellent reference to the works of Raulin, Gabriel Bertrand and Javillier, cited above. The author insists on a point which attracted mostly his attention to this work, to wit: that whether with Manganese and Zinc it is possible to find doses activating or inhibiting. With Silver on the other hand, he could not find any exciting doses. Even at 1/10 000 000 (10-7), Silver remains toxic. Prof. Janot gave a lecture at the Centre Homoeopathique de France with typical examples "of the toxic action of mineral substances in infinitesimal doses and particularly Silver". Yeasts are often used as material for study. Saller goes back to Arndt and Schulz's first experience on yeasts from which these authors derived the law bearing their name of inversion of action depending on doses. Saller also used yeasts to study the action of Merccor, Iodine, Bromium and Salicylic acid and shows that in the weak doses these substances increase the multiplication of yeasts, yet strong doses kill them. Nebel, from Lausanne, presented to the L.H. I. Congress in Paris 1932, an ensemble of essays on the action of infinitesimal doses. For example, he reports an experiment on yeasts intoxicated by Merc-c at 1/40 000. After rinsing, the yeasts are put in a nutritive medium and contacted with the 30th, 200, M dilution of Merc-c. The intoxicated witness is then compared with their fermenting power by measuring the CO2 output. One can observe a detoxication of these yeasts by infinitesimal doses. We will see later that this phenomenon is recurring again and again presenting therefore a special interest. The reports of these experiments are only a reminder of the experiments made by Nebel in 1905, and published in Allgemeine Hom. Zeitung of April 27, 1905. More recently, Prof. Netien et al studied the action of infinitesimal dilution of Natrum arsenicosum on the growth of yeasts in functions of these dilutions. The author then reviews works made in the vegetable realm with "high dilutions". They aver that, "Unfortunately few are the works related to Homoeopathy and, no doubt, many results deserve to be confirmed. Therefore, it becomes difficult to demonstrate an activity of high dilutions with vegetable. On the other hand, the experiments related either to the metallic oligo-elements or to vitaminic oligo-elements or vegetable hormones are highly significant, unfortunately with relative low dilutions, rarely used in Homoeopathy." Microbial cultures are also good material. Lamasson studied the action of Korsakovian dilutions upto the M on cultures of Staphylococcus aureus, Sulphur, Calc-sulf., Hepar sulf. and even Staphylococcin, the author noted that the 6th Korsakovian was inactive, as the M.

However, the 200th was definitely inhibitive. Lamasson takes great care to emphasize that these experiments prove nothing re the action in vivo of these remedies in patients. In a particular case, rather than for general purpose, the Staphylococcus served as material study to verify the properties of Calendula officinalis. Daniaud and Tetau found in vitro neither bacteriostatic nor antibiotic action. Daniaud also investigated whether remedies for diarrhoea or congestion could be effective on colibaccillus cultures. There again, from the mother tincture to various dilutions upto the 10th CH no action was elicited. However, these in vitro trials cannot deny the efficacy in vivo of these remedies, because they can act on the terrain (although this poorly defined term does not correspond to anything well-known) or even it could be figured out that by analogy with certain drugs they act through transformation products or on enzymatic elements. Hinsdale has shown the inhibitive action of Calendula, on the Staphylococcus. He uses a decoction of dry flowers of Calendula. The results depend on both the importance of the seeding and on the concentration of the Calendula solute. But in general highly concentrated Calendula solutions are necessary and the effect is weak. Again in vivo it is only with 100% and 75% Calendula solutions added to a suspension of Staphylococci that a neutralization of the latter can be observed and therefore the absence of lesions in the guinea pig sacrificed four weeks later. The study of dilution on the growth of young plants is to be found in the considerable work of Mrs. Kolisko, the results of which were published in 1926. Lavezzari made a magistral presentation of it at the 22nd Congress of C.H. F. (1963) in his presidential address. Mrs. Kolisko demonstrates the action on the plant growth of dilution upto the 60x and even beyond to the 200x. She also finds rhythmic and sinusoidal curve plus the influence of solar and lunar cycles as well as horary variations (see also under "Botanical"). Recently, Prof. Netien, studied the action of Cobalt in homoeopathic dilutions on the breathing of wheat coleoptyle. He shows that Cobalt chloride inhibits this breathing with dilutions from the 2x to the 6x however increases it from the 8x to the 18x. ic. Checking these experiments with Natrum arsenicosum, M.J. Boiron and Miss Zervudacki obtained variable results depending on the dilutions. Upto the 5x Nat-ars is toxic and inhibits the breathing,. The 6x seems active, but the 7x is slightly stimulative. The 8x becomes again fairly strongly inhibitive. Then follows a series of inactive dilutions. Finally, from the 16x and the 18x, "the coleoptyle seem to regain a certain sensitivity independent of the concentration itself, which seems as we noted already to be one of the characters of the activity of infinitesimal dilutions". Inquiry into the limits of biological effects of chemical compounds in tissue culture Low dose effect of mercuric chloride Van Mansvelt, and Amons from the Dept. of Anatomy and Embryology at the University of Amsterdam have made a detailed investigation of the effect of Mercuric chloride, at dilutions as low as 0.9 x 10-25 M on the proliferation of a mouse lymphoblastic cell strain. Growth inhibition was detected down to a level of 0.9 x 10-17 M. The mercuric chloride solution was prepared by first making a 10% (weight/volume) solution of the substance: 100 ml of this solution was handshaked in a 200 ml flask for 4 min. Five ml were then removed and added to 45 ml of water in a second 200 ml flask, to give a 10-2M dilution. Successive 1:10 dilutions were made in exactly the same way; each pipette was used only once and each flask was chosen at random. After each dilution the flask was shaken

in the same way as on the first occasion. Glassware was cleaned and sterilized as for tissue culture, and the water used was double distilled and filtered through millipore filters. To the dilutions so produced was added a tissue culture medium and the resultant mixture was used in the incubation experiments. One ml of cell suspension, containing 2 000 cells per ml was placed in each test tube and to this was added 1ml of mercuric chloride dilution. The tubes were then incubated for 90 hours at 30.5 ºC after which the cells were counted with a model F Coulter counter. Three statistical tests were used in evaluating the results and a probability level of 0.05 was taken as the limit for accepting or rejecting the null hypothesis. (For further details of the techniques and statistical method used, the original paper should be consulted.) Detailed statistical analysis of the results showed that mercuric chloride in concentrations of 0.9 x 10-5 and 0.9 x 10-6 M was definitely toxic, as expected. However, toxicity was found at 0.9 x10-16 and 0.9 x10-17 M. Discussing these results, the authors point out that prolonged dilution of any substance would be expected ultimately to yield a flat dose-effect curve. The present study, however, shows that this is not necessarily the case. External factors such as variations in barometeric pressure, solar radiation, electro-magnetic wave pattern, and seasonal influences, as well as endogenous fluctuation in cell growth and mean cell volume can all, in the authors' opinion, be excluded. The authors do not advance any hypothesis to explain their findings although they refer in passing to the suggestion of G. Unger that modification in the structure of water might allow information to be passed from one dilution to the next. They conclude that their results are substantial indication towards "some as yet unconceived phenomenon (which) needs further study". The paper includes a useful brief review of the literature on the effect of high dilutions of various substances on cell cultures. The authors point out that preconceived ideas about the physiological effect of such very high dilution may lead to such effects, when observed, being dismissed as experimental errors of no consequence, or to unwarranted extrapolations from too few determined points. Robert Seitschek reports a very interesting series of experiments in which he demonstrated that definite qualitative change in the intensity of the oxydase reaction in the granulocytes of the blood are produced after the administration of the homoeopathic high potency. Among those who have tried to demonstrate such action through laboratory experiments was again, W.E. Boyd. With the help of a new biological heart rate recorded, and using 367 frogs for the experiments, he was able to record biologically the action of microdoses of strophanthus sarmantosus of the range of 6x to 11x potency. Jerricott in 1951 demonstrated that Veratrin sulfate in 60x potency decreased the contraction rate of the isolated gastrocnemius muscle of Rana esculenta; and Iberis amara in 36x and 236x potency slowed the pulse of the isolated heart of a turtle. It is well known that the ferment diastase produces hydrolysis of starch, converting it into sugar. Dr. Boyd by a series of most scrupulously planned experiments was able to demonstrate that the rate of activity of the diastase is changed by the addition to the ferment of microdoses of mercuric chloride in various high potencies from 61x to 71x. He had actually derived the clue from the earlier experiments of Arndt and Schultz, who had been able to demonstrate that the same drug, which in material doses acts as toxic agent to the ferment, merely inhibits its activity when diluted and actually acts as a stimulant when still further

diluted which had led to the enunciation of the famous Arndt-Schultz law. It took Boyd over twenty years to bring his experiments to a conclusion but he was able to succeed just before his death in demonstrating the activity of high potencies in the laboratory just as he had demonstrated their activity in the biological sphere with the help of the Emanometer. H. Boyd writes, "I would like to mention the biochemical experiments of the late W.E. Boyd, using potencies of mercuric chloride in a 30c dilution (10-60) and showing clear evidence of their action on the digestion of starch by diastase. Also the more recent work of Professor G. Netien of Lyon. He was able to demonstrate that the germination and growth of seeds obtained from plants treated with copper sulphate solution was increased when these seeds were grown on a 15CH potentized copper sulphate dilution. Prof. Cier demonstrated that the hypoglycaemic reaction produced in mice by an injection of Alloxan could be completely inhibited by giving a 9C potency of Alloxan intraperitoneally prior to the crude dose, and also that after a diabetogenic injection of Alloxan the blood sugar values returned to normal more rapidly when a 9C potency of Alloxan was given." Dr. stearn's experiments In 1920, the Foundation of Homoeopathic Research was founded in the United States for the purpose of investigating homoeopathic problems. Under the auspicis of this Foundation, two sets of experiments were conducted at the New York Homoeopathic Medical College, under the able direction of Dr. Guy Beckley Stearns. Experiments with guinea pigs Some experiments with guinea pigs were conducted to study the effect of potentized drugs on normal animals. Experiments were conducted in two series during two years. In these experiments two hundred and twelve animals were used, sixty-five being used as controls and one hundred and forty-seven for the experiments. The substance used in all the experiments was Natrum mur. in dilutions ranging from the 30th to the 2000th. These dilutions were made in the college laboratory in accordance with the rules laid down in the Homoeopathic Pharamacopoeia, with the exception that the dilutions were run up in distilled water instead of in alcohol. This means that 2 000 vials were used to make the 2 000th dilution. The experiments were made with the groups of fifteen animals. The control-animals were in separate pens, but all groups were cared for under identical conditions except that the controls were given plain distilled water every time the proving-animals were given a dilution of Natrum mur. Each proving group was given a certain dilution of Natrum mur. and the same dilution was repeated daily until all symptoms that followed its administration had ceased; then the animals were given a rest, after which another dilution of Natrum mur. was given. This second dilution was continued in the same way as was the first. The change from one dilution to another was always a wide jump; for instance, the 30th would be followed by the 200th, 200th by the 400th, the 1000th by the 1 200th. In every instance effects were observed. The history of a group of sixty provers with twenty controls illustrates the full extent of the experiment. The groups were placed in five pens, the provers in four groups of fifteen each, and the twenty control in a single pen. The arrangement of all the pens was as nearly as possible identical. The experiment was begun by giving the first group the 30th dilution, the second the 200th dilution, the third the 400th dilution and the fourth the 1 000th dilution, three or four drops daily. The control-group was given three or four drops of distilled water

each morning. In every other way the controls and the provers were under the same care and conditions. The first signs of proving-effects were noticed on the fifth to the seventh day. The effects began to wear off by twenty-second day and by the thirty-fourth day, all effects apparently had ceased. The animals were then given a rest for ten days, when a new series of potencies were given 200 dilutions higher. With the second series of dilutions, the first effect occurred from the eleventh to the fifteenth day and it was not until the fifty-fifth day that all effects of the proving seemed to have ceased. The third series began with two hundred dilutions higher for each group. It was nineteen days before any affect was observed here and the gross effects were not as marked as they had been in the first and second provings, although they dragged out much longer. The most pronounced obvious effects appeared to result from the cumulative effect of each succeeding dilution. The obvious effects were such as would be observed by any animal-dealer. There was lessened appetite, relative loss of weight, less alertness, diminished glossiness of hair, watery and lustreless eyes and a general appearance of not being in good condition. The more far-reaching results had to do with the reproductive function and progeny. The time between pregnancies was increased and there was a corresponding lessening of the number of young. The average weight of the young was markedly reduced while the mortality was increased. All of the progeny of both the controls and provers were retained and kept in the pens in which they were born, excepting as the increase necessitated new pens. At the end of six and one-half months the controls had increased to seventy-six, while the provers had decreased to forty-four. This brought the experiment into the summer vacation period but it was continued through the summer. Soon after the close of the college, the college officials deemed it necessary to reduce the experimental animals to the number necessary for clinical use in the hospital and through an error, the seventy-six controls were all disposed of, so that the remainder of the experiment was carried on without any controls. However, at the end of three and one-half months more, the proving group was reduced to twenty five provers, ten males and twelve females with three new-borns whose sex was not noted. No further experiments were conducted, but the proving groups were retained for observation, for six and a half months more, at which time there were seventeen remaining and towards the end of that time one more set of young was born, consisting of twins. At this stage, the experiment was ended through a mistake - a new janitor sending these observation-animals to the laboratory for clinical purposes. The result of this experiment can be summed up as follows: Sixty guinea pigs living in family groups of four females to one male, including all progeny born during a period of sixteen and one half months, were reduced to seventeen by giving dilutions of Natrum mur. ranging from the 30th to 2 000th dilution. * Twenty control-animals in seven months had increased to seventy-six. This ended the most elaborate experiment ever conducted for the purpose of ascertaining whether normal animals react to the highly diluted substances used in Homoeopathy and there is conclusive proof that they do. Experiments with fruit flies This experiment had to do with a strain of fruit-flies. The experiment was not undertaken for the purpose of determining if high dilutions would affect this insect, but to determine if an effect could be produced by potentized drugs on a lethal hereditary characteristic. The strain of fruit-flies used was the Drosophia melanogastor lethal No. 7. This strain is tumour-bearing, the tumours occurring, in accordance with the Mendelian law, in every fourth fly. The males are the only ones affected and those that bear the tumour die in the larval stage; thus only one-half of the males survive. These tumours have the characteristics of cancer. Dr. Mary Stark, a world-renowned genetist, who discovered the nature of the tumour which kills these

flies, did not claim that they are cancer-tumours but simply called attention to the fact that they are composed of the same kind of cells that constitute cancer. It was because of this cancer-characteristic and because of the inevitable death of all those that inherited the growth, that the experiment was undertaken to determine if any change could be induced by the administration of drugs known by homoeopathist is to have had a controlling influence in cases of cancer. Dr. Mary Stark carried out the experiments herself and to her is due all the credit for the labour involved. A mere recital of the result of the experiment would convey no idea of the enormous amount of work entailed. To appreciate this, one must have visited her laboratory and observed the hundreds of colonies, each colony consisting of about one hundred and fifty adult flies occupying its own special glass fruit-jar. These flies had to be counted and examined microscopically, individually so that each colony as it came out was accurately tabulated. Each adult colony would have amounted to approximately two hundred but for the fact that one-half of the males died in the larval stage. In order that part of the experiment might parallel the prevalent vaccine-line of experimenting, a trituration of the tumours themselves was made. The tumours were triturated with sugar of milk upto the 6x and from this trituration, dilutions upto the 200th were made. Among the remedies known to homoeopaths to have influenced cancer, Arsenicum was selected and at the suggestion of Dr. Boger, Mercury Nitrate was selected as a third drug. The potentized drugs were put in the agar-banana food supply that was placed in the bottom of the jars. Special precautions were taken to prevent any possible contamination of the cultures. Cultures of the flies were treated with 6x trituration of the tumours appearing as before. Later generations were treated with the 30th and then with the 200th dilution. This resulted in a culture where the tumours did not develop as formerly and subsequent cultures from this showed only a few with tumours. This indicated that successive doses of the 6x, 30th and 200th had had a permanent effect upon the development of the tumours. In other words, high dilutions of the tumour itself had in some way apparently modified the hereditary factor which caused the tumours. Arsenicum 30th and 200th were given to other colonies. With the 30th followed by the 200th in the third generation, a culture came through with the tumour eliminated. This experiment with Arsenicum was repeated twice with the other colonies, showing the same effect; one in the fourth generation and one in the sixth generation escaping the tumour inheritance. Mercury nitrate in the 30th caused at first a stimulation, for the colonies receiving it were abundant and vigorous, but no other effect was caused. Altogether, in this set of experiments, two hundred and eighteen cultures were made. This experiment is reported here because of the fact that the drugs used in the experiment were all in high dilution and it proves that flies, as well as guinea pigs, are affected by high dilutions. Another fact of even more important significance is that the effects are so profound that hereditary characteristics are modified. Both this and the guinea pig experiment also indicate that it may be necessary to give a succession of dilutions in order to bring about the most profound effects. Research in blood-groups One of the latest items of research to be done in the homoeopathic biological field was by Emile Florentin of Paris. It is common knowledge that the biological blood groups (A, B, AB and O) are so basically constituted that they never vary during an individual's life. On the other side, it is believed by some that the homoeopathic constitutional make-up of an individual is also basic and rarely varies during his life time. If so, it might be interesting to make a correlated study of the blood groups and homoeopathic types of individuals. With this idea, Florentin examined hundreds of blood specimens in various groups, and studied also the

make-up of the individuals concerned and has published the results of his study which are most interesting. Electro-physical and bio-physical research Ever since medicine became a science there has always been perpetual enquiry and inference regarding the actual nature of the fundamental process of the living cell, both in health and in disease. Various theories have been put forward from time to time only to be demolished later on. Concentrating on this subject, William E. Boyd, an eminent physician and scientist of Glasgow, after many years of patient research built up evidence to show that the inner intricate process of the body and mind are accompanied by activities in the bio-physical sphere, intracellular and inter-cellular, in which electrical activities, especially in relation to the cell membrances, play an essential part. Boyd also made the following observations basing them on some 10 000 Emanometer tests with some 1969 cases. He writes, "Among these findings the weight of evidence suggested some of the following points: 1. that an effect or radiation can be detected as proceeding from or related to, every object animal, vegetable or mineral, so far as tested, which is not an earthed conductor. 2. that all drugs register this effect; ordinary crude drugs with the least intensity, colloids with greater, and homoeopathic drugs with the greatest of all. 3. that living objects register with greater intensity than inanimate substances, with the exception of potentized substances. 4. that this effect or energy as recorded with specimens of human secretions can be analysed into numerous component parts, by means of the abdominal reactions of the recording subject taken together with instrumental readings. 5. that normally there should be balanced state among the component parts, with certain of them showing high intensity and others low intensity. 6. that in disease certain of these component parts of the total energy of the specimen show diminished intensity, others increased intensity. 7. that disease is therefore accompanied by, or is due to, a disturbance of this balance and curative treatment should restore the balance. 8. that this disturbance of balance may take place long before there is any evidence of pathological change. 9. that all methods of treatment which can provide the necessary energy for restoration of this balance will benefit the patient, but for this to occur, apart from the inherent tendency of the patient to regain balance, it is necessary that there be a specific selective relation between the energy supplied and the patient." Further steps in the recognition of the electrical nature and responses of the living organism as well as the electro-physical nature of drugs in potentized form were gradually taken and naturally attempts were made to define and measure this energy. These attempts have gradually led to the demonstration of a form of disease-activity as well as drug-activity, hitherto unknown, by certain methods involving body reflexes, though such work continues to remain highly intricate and unorthodox in type.

The development of electro-physical instruments The beginnings in this direction were first made in the earlier part of this century when Dr. George Starr White of Los Angeles * discovered certain curious phenomena. He noticed that in the human body there is an effect caused by the change of position in relation to the points of the compass. For example, if a person slowly turns from the east-west to the north-south direction and all the time his chest is continuously percussed, then there is an alteration noticed in the percussion note during the change of position. The percussion note is of a higher pitch when the subject is facing east-west than when he is facing north-south. Abram's discoveries Dr. Albert Abrams of San Francisco was one of the first physicians to turn his attention towards these wireless waves which emanate from the human body. In the same indirect manner as Roentgen had first obtained his X-ray effect while working at a different problem, so Abrams noted these reactions whilst studying the spinal reflexes by means of percussion. It was by chance that he found that all tubercular patients gave a dull note when tapped at certain spots on their back and that this dullness was present in all cases of tuberculosis, whether there was lung disease at that location or not. He further found that he only obtained this dull note when the patient was facing west, and that it disappeared when he turned the patients so as to face north or south. This fact suggested that there was a relation between the electromagnetic field of the earth and that of the individual. He further found that if he held a tubercular specimen, either a piece of tissue or a tube containing tubercle bacilli, over the back of the neck of a healthy person, the same dullness was present on percussion. This experiment certainly suggested that wireless waves from the specimen were received and recorded by the body and that these waves altered the character of the healthy tissues. His next experiment was to pass a wire from a patient to a healthy person, one end of the wire being placed over the lesion on the patient and the other placed over the cervical vertebra of the healthy subject. He found that on tapping the back and abdomen of the healthy person he obtained the same dullness as when tapping the diseased person. This may be regarded as an amplification of the earlier experiment and went to show that waves from the diseased patient passed along the wire, altering temporarily the electro-magnetic condition of the tissues of the healthy person, who was termed the subject. At about this time, Dr. Abrams made yet another discovery. He was percussing a patient, and found on the abdomen a dullness for which he could not account. On looking around he noticed that there was a bottle containing a cancer growth on his table. He had it removed and the dullness disappeared. The growth was brought back whereupon the dullness reappeared. He had thus found two separate reflexes on different areas, one for tubercle and another for cancer. This was surely an astonishing observation, and formed the basis of his future work. These experiments were repeated again and again, and each one gave fresh evidence of the passage of waves across space. Experiments followed with other diseases. He found that syphilis caused a reflex on much the same area as cancer. So area-reflex was not enough in itself. Further evidence was needed for differentiation. A measure of wavelength was required. The plan he adopted was to interpose a coiled wire resistance between the patient or the specimen and the subject. He had a coil wound with resistances marked in ohms on it. He then found that diseases came through on the human indicator or subject at certain points on the coil. He also found that the best place for the reception of the waves from the patient was the forehead of the subject when he was using the abdominal muscles of the subject as his indicator. The abdominal muscles of the

human being are peculiarly sensitive to the electro-magnetic condition of the organs and of the body in general, and just as a banjo string can be stimulated to vibrate to waves of sound, so also these muscles can be stimulated to reflex movements by changes in the electromagnetic field. When following this method of diagnosis through percussion, Abrams found that in cases of malaria, dullness occurred with his rheostat set at 32 ohms; with tubercle at 42; with an infection due to bacillus coli at 44; with acquired syphilis at 55; with hereditary syphilis at 57; with cancer at 50; with sarcoma at 58; with a streptococcal infection at 60, and so on. The apparatus which Abrams used for the diagnosis of disease consisted, in its simplest form, of a round black wooden box containing metallic contact points from which ran grounding wires. From the metallic top of this box passes a short insulating wire, having on its free end an aluminium electrode which is applied to the forehead of the subject. This apparatus has been modified and improved upon, but the above description is sufficient to show his system of working at its simplest. His method of using the apparatus was as follows: A specimen of the patient's blood was placed in the box and experimental percussion made on the abdomen of the subject, the indicator being moved at each tapping from one ohm upwards. When a dullness of sound was perceived, the reading on the rheostat was noted. And thus from previous experiments and readings taken from diseases tissues, he found that the disease could be identified. His next step was to experiment with drugs and he was able to gradually work out the readings for various drugs. For example, quinine gave a reaction when the rheostat was set at a resistance of 32 ohms. For some time he continued to pick out the drugs and treat patients with the help of this apparatus; but the results were not upto his expectations. Not being satisfied with the opposition of "disease vibrations" by "drug vibrations". Dr. Abrams built up a machine to generate suitable vibrations with which to cancel the disease force. This machine which he called the Oscilloclast (wave-breaker) was his device for destroying infections and malignancies through the application of measured vibrations. It operated from a battery or from the main and delivered the proper electronic destructive vibrations which were expected to break down the disease in the patient. This concept was probably wrong, but he obtained good results. Waves from the Oscilloclast cannot kill microorganisms; if they give relief; it is by stimulation of the patient's cells and the production of some protective energy. Boyd's emanometer Continuing the line of work before the stage of development of the Oscilloclast, Dr. Boyd of Glasgow (1884-1954) considerably modified and improved Abram's box and succeeded in 1922 in constructing a more accurate apparatus called the Emanometer for detecting the disease emanations and the corresponding drug radiations. In this apparatus, a drop of some secretion of the patient, for example, the lacrymal, salivary, etc., taken on a sterile blotter is placed in a compartment of the Emanometer. A healthy person is made to stand naked inside a screening cage in the machine and he is exposed to radiation from this secretion. It is ensured that the cage is quite intact and all parts of it have metal to metal contact so that the subject inside is completely screened and protected from all external electro-physical energies. The operator thrusts his arm through a panel for percussing and two copper cloth sleeves fit in closely over his wrists. The subject is exposed to the secretion of the patient and all the while his abdomen is continuously percussed. This person is used as a medium or sensitive reactor.

When a change in the percussion note on the abdomen is noticed, the distance at which such change is produced is noted and on the basis of this the patient is assigned to a particular Emanometer group. Then those drugs from this group are selected which seem likely to cover the symptomatology of the case and the potencies of these drugs are placed in the apparatus so that the subject is exposed simultaneously both to the disease energy and drug energy. When the change in the percussion note caused by exposure to the patient's secretion is neutralised completely by simultaneous exposure to a drug in potency, then this drug is found to be the similimum. Such an apparatus was being operated in London by Dr. W.R. McCrae, who has been a fervent adept of Dr. Boyd's method. Several years ago, the Royal Society of Medicine appointed a highly critical committee under the chairmanship of Sir Thomas Horder, to investigate the nature and use of Abrams' coil as well as allied phenomena. This committee carried on investigation for nearly two years. The committee was critical of the claims made for Abrams' apparatus but they were satisfied with the results of the Emanometer. Numerous tests were arranged to discover if the potency could be identified by such a bio-physical method. During the series of tests, Dr. Boyd was not only able to demonstrate a clear differentiation between Sulphur 10M and an inert sugar control but he was also able to distinguish between different potencies of sodium chloride (Nat-m) such as 30, 200 and CM. The Emanometer was also shown to be so adjustable that it could definitely distinguish between various drugs such as Arsenic, Pulsatilla, Belladonna, Calcium carbonate and Cocculus, all in high dilutions. The final crucial test consisted of eight demonstrations. In this series, a high potency of Sulphur was used as test material and in every test its presence was detected without error. The chances of accidental success ranged from 1 in 6 in the simplest, to 1 in 331/2 million in the complex cases. Dr. Boyd was thus able to completely satisfy this committee that the Emanometer is able to detect the activity of homoeopathic potencies although these potencies on chemical analysis reveal absolutely no drug content. This work was based on the following facts: 1. any humoral secretion emits a certain number of emanations; 2. these emanations are linked with the pathological status of the subject and let one establish his "humoral status" rather his "toxic coefficient"; 3. the various drugs, at the various dilutions, even very high (CM), emit emanations, so-called "drug emanations", permitting their identification; 4. there are in the homoeopathic and allopathic Pharmacopoeias drugs having an ensemble of emanations identical to those emitted by such or such humoral tested specimens; 5. according to Hahnemann's law, any drug the emanations of which are identical to these of tested blood (of the patient), annihilates emanations of the disease. In such conditions, this drug is the remedy which should be selected because it always improves the patient. However this technique is extremely delicate and H.W. Boyd believes that the results depended in a great part on the extraordinary sensitivity and skill of W.E. Boyd and of W.R. McCrae. To sum up, by means of this demonstration, Boyd was able to prove that there are some energies of a very delicate character inherent in highly diluted and potentized substances and that these energies evoke reactions on the human body that can be detected. On the basis of the kind and intensity of the reaction which is provoked by each drug, the various drugs have been classified into certain groups, twelve in number. It was also noted that there is a specific relationship between these groups. Groups 1, 6 and 10 were found related to each other as also groups 4, 5, 8 and 11. When a patient in a particular group fell ill he always changed into a related group. Patients rarely changed from one group to a

neighbouring group e.g. 4 to 5 or 10 to 11. They may move indirectly into it, as e.g. a 5th group patient may move into the 8th group and then to the 4th. It was also noted that, when a medicine selected and administered to a patient is actually from a neighbouring group instead of the patient's own group, he suffered an aggravation clinically. Bodily effects of drugs The experiments of Boyd were highly complex and required infinite patience and practice. But a similar and much more simple experiment can be carried out by anyone. A normal person is made to stand facing east or west. An observer percusses over his chest at the border of the heart. A third person across the room picks up a homoeopathic potency in his hand and approaches the subject while he is being continuously percussed. At some point anywhere from across the room to three or four feet from the subject, the percussion note will change. It will be found that different remedies cause this change at different distances showing the varying susceptibility of the subject to different drugs. Even flowers and plants evoke the same reaction. Even the energy from the third person who approaches this subject will produce this reaction but at a much shorter distance of two or three feet. Such effect caused by the radiation from drugs are not merely confined to this change in the percussion note. Many other effects can be discerned simultaneously, particularly on a sick person. If a drug related to the case (as for example, one chosen on homoeopathic principle) is brought close to or into contact with the patient, a number of reflex changes are excited. There is a dilatation of the pupil, changes in the character of the contraction of the heart, changes in the capillary circulation shown by a slight variation in the colour of thin skin areas, a slight momentary alteration in the colouring of the iris and a modification of the pulse as to character and rate. Further, if a glass rod is drawn delicately over the skin, it will seem to cling to the surface of the skin. From amongst all these reflex changes, the alteration in the nature of the pulse has been studied more closely and described and it has been found also to be helpful for the purpose of selecting the similimum. This is called the Pulse Test. The pulse test The Pulse Test is performed as follows. First of all twelve vials called Group-vial represents one group of the Emanometer classification of drugs and is composed of a number of representative drugs drawn from the list of drugs in that Emanometer group and mixed together. For example, Group vial 1 is made up by mixing up a number of drugs of the same potency, e.g. 200c from Emanometer group 1. Then these vials are placed on a table about two feet away from the patient. The patient is seated comfortably and his pulse is felt till it shows a steadiness in rate and rhythm. Its rate is then noted by counting for two or three minutes. Now the Group-vials containing the potencies are brought either very close to the patient or into contact with his arm quickly, one by one in succession. Even if the vials are corked the potencies influence the patient while the vial is in contact with the patient. The pulse is then counted for 15 seconds. Then this vial is put away and the next Group vial is taken up. It is now best to "short" the patient by asking him to hold a metal bar with both his hands so that a circuit is formed from one side of his body to the other. As each Group vial is tested a note is made as to which Group-vial tends to normalise the pulse most - slowing it if it is fast, accelerating it to the best effect, they can be retested, this time the pulse rate being counted for 30 seconds. The vial exerting the strongest influence towards normalising the pulse rate represents the patient's Emanometer drug group. Now from among the remedies in this particular Group those drugs are selected which appear to cover the symptomatology of the case in question and these drugs are tested individually

one by one exactly in the same way as the Group-vials were tested. If several drugs produce an effect the first time, they are tested again and again until, by a process of elimination, one drug is arrived at which clearly produces the greatest normalisation of the pulse. This best single drug may sometimes alter the pulse by 8 to 10 beats a minute. A difference of at least 4 beats is necessary to indicate a good remedy. The above test is most applicable to cases which show an abnormal pulse rate (for example, febrile cases). But in cases where the pulse rate is normal, a change in the character of the pulse is noticeable. The proper Group-vial and the proper remedy cause an instantaneous hesitation of the pulse followed by stronger beating which usually lasts a few seconds. It must be noted that the Group-vials can only be used for purposes of arriving at the correct group. They should in no case whatever, be prescribed or administered to the patient. The following precautions are necessary in doing the above test. The patient should be free from excitement. The drug vials should be brought into contact with the patient by a quick jerk without any fumbling. If the experimenter is observing the pulse with one hand and picking up the vials with the other, this other hand should be kept away from the vial until the right moment. If an assistant is available he can stand behind the patient so that the patient may not see what is being done. This test has been commended as being very practical and useful by some eminent physicians. The changes in the pulse as well as in the other reflexes observed, no doubt, result from the interaction of the disease and drug energies, this interaction being expressed through the autonomic nervous system of the body. It may be said that so far these are probably the only methods by which the drug energy and disease energy are easily detectable and measurable. Guyon Richards, preferring to follow the original methods of Abrams as against the technique of Boyd, has developed another variety of tuning circuit which is operated within a cage of perforated zinc. The patient sits in one compartment of the cage; the operator, his instruments and the subject are in another. With the help of this apparatus, he has been able to work out the figures of frequencies for various tissues and organs as well as for various drugs. His research embraces the fields of Homoeopathy, radiaesthesia, physics and metaphysics. Gutman describes an instrument which is basically an untuned oscillator and an amplifier which he has found very useful in selecting the proper remedy for the patient using only a specimen of the patient's blood or saliva. The knowledge which has come through electro-physical research makes it very apparent that the possible duration of potency influence continues for very much longer periods than has ever been suspected hitherto. In the treatment of minor everyday complaints, it has been noted that the period of action will not be less than two months on average. Very often it will last for three or four months. If a patient who has previously been stabilized in good health by useful medicine returns with a remnant of trouble, his response to further treatment will often show that potency influence can be detected for as long as six, nine or twelve months from the administration of even a single dose! This can happen even after a 6c potency. Botanical

In 1932, J. Roy made dilutions of the stems of germinating barley ranging from 10-3 to 10-12. He saturated barley grains with these various dilutions, planted them and weighed the amount of barley produced. Of 69 experimental groups, only two used dilutions above 10-26. Each of these two dilutions (10-60 and 10-12 ) differed from the control groups by 8 percent. P. Jousset, in 1902, investigated the effect of silver nitrate on Asperigillus niger mycelium and found it effective upto 50x dilution. Madam Lilli Kolisko working at the Biological Institute Dornach, for several years was able to show the effect on wheat seeds of various metallic solutions in the first to the sixtieth potencies wherein results showed even stronger activity in dilutions where no chemical action could be seen. The scientist demonstrated through her experiments that the different dilutions of the metal as far as the 60th potency have an effect on the living cell. Out of these experiments curves of maximal and minimal activity characteristic of each metal could be obtained. In 1923, she applied dilutions of iron sulfate, antimony trioxide and a copper salt upto 30x dilution to germinating wheat seeds and then measured the average length and weight of the leaves, stem and root comparing them with control plants. She found she achieved best growth with dilutions 26x and 30x and worst with 15x and 21x. H. Von Bonsart found that Chamomilla in a dilution of 11x increased the growth of bean seeds. P. Narodetzki in 1938 performed an exhaustive investigation of the effect of sodium borate and mercuric chloride in dilutions upto 10-60 on cultures of Steringmotocystis nigra. In order to avoid any possible oligodynamic effect, all the work was done in quartz, all glasses were cleaned 3 times in Quadruple distilled water, all chemicals purified by repeated crystallization and all dilutions were prepared by the poly-glass method. Six series of six trial blanks each were run showing a maximum variation in all 36 of 6.1%. Controls were then run for each series of materials tested. Karola Otte in 1937 found by geigerhubar curve that a heteroauxin concentration D 10-544 increased the growth of corn roots (Zeamys) by 100%. Anna Koffler has recently investigated the trace elements in various plants. She has also through painstaking experiments demonstrated the effect of various potencies of sulfur on the weight, growth and chemical composition of onions. Pelikan and Unger report experiments to demonstrate the activity of potentized substances on plant growth esp. Silver nitrate (from 6x to 19x). Zoological W.W. Young quotes some interesting experiments done by one Leroy Gardner of the Sarnac Laboratory for the study of tuberculosis, New York. The experiments were conducted with a variety of animals like cats, rabbits, guinea pigs, rats, mice, etc. A fragment of quartz weighing 2.5 grams was imbedded in the tissues of a pig for one year and during all that time led to the development of only a few nuclear cells along its borders. Smaller particles of the same material measuring 10 - 12 microns in diameter excited merely a foreign body type of reaction that progressed very little in a year or two, a reaction that exhibits no individuality is definitely local and extremely mild. Yet particles of still smaller size, say 1-3 microns in diameter, provoke rapidly progressive tissue changes. If one utilizes an even smaller particle

less than one micron, in a dose of 0.2 grams, there is an even more acute reaction with death in from one to eight months. Gye and Purdy some years ago demonstrated that the use of still smaller particles of silica was almost instantly fatal. Or, as Gardner puts it, "The rate of reaction to quartz is inversely proportional to particle size." Gardner has drawn the conclusion that the term drug-action is an antiquated and highly misleading one and should be replaced by the term tissue or cellular response. To quote his words: "It has taken us many years to realize that drugs are essentially inert substances possessing of themselves no histrionic ability. We are becoming more acutely aware of the fact that what occurs when an essentially inert substance is brought into contact with living irritable cells and tissues is determined by the reactive potentialities of the host and the characteristics of that reaction will be determined by the interpretation that the host's organs and tissues give to the reaction, and that, too, is conditioned by definite controllable factors. Among these are the avenue of administration, chemical state of, particle size of, etc., of the irritant." G.R. Henshaw (1932) demonstrated the effect of microdilutions on the degree of flocculation of the blood of rabbits; K. Konig (1927) and V. Vondracek (1929) showed the effect of high dilutions on the growth of tadpoles; N. Krawkow showed their effect on the venous flow from the isolated ears of rabbits and on the skin pigmentation and the blood of frogs; J. Roy (1932) showed their effect on the development of tetanus and tuberculosis in guinea pigs; and G.B. Stearns and M. Mark (1925) on the inherited characteristics of fruit flies and on guinea pigs. In 1932, J. Roy injected 1cc of an emulsion of earth into the right thigh of three pairs of male and female guinea pigs. Eighteen hours later he injected 2 cc of physiological saline in one pair; 2 cc of a 10-9 dilution of a young woman's blood serum into another pair; and 2 cc of a 10-80 dilution of the serum from the same woman into a third pair. The animals who received the 10-9 dilution died within a few hours. The animals who received the physiological saline died in a few days. The animals who received the 10-80 dilution did not die, nor did they develop any abnormal symptoms. Biochemical W. Person in 1930 investigated the effect of dilutions upto 10-120 on the rate of fermentation of starch by ptyalin and on lysis of fibrin by pepsin and trypsin. He used mercuric chloride for the starch experiment and various drugs like Lycopodium, Pulsatilla, Hydrocyanic acid, Aluminium, etc., for the fibrin. He found that all these dilutions showed their influence. Hepburn et al have published a laboratory study of twenty drugs, of their effect on blood chemistry. E.W. Hubbard working with E. Pfeiffer of the Biochemical Research Laboratory in New York studied the changes in the amino-acid content of human urine before and after the administration of the similimum and they noted that most of the cases showed improvement towards normal in the amount of amino-acids. As is well known to students of bio-chemistry, certain minerals when ingested into the body are not completely eliminated, a certain amount being fixed and retained in the tissues. For example, after the administration of a strong but non-toxic dose of arsenic, a rapid urinary elimination is observed, about 35% of the arsenic being excreted in the urine during the first ninety hours following the injection. Thereafter, not further trace of arsenic is observed in the urine, the remaining arsenic remaining fixed to the tissues.

Lise Wurmser assisted by Mr. Ney and Kadam Krautele working in the laboratory of Prof. Lapp in Strasbourg carried out a series of very intricate and interesting experiments to see if the infinitesimal dose of the same substance influences the elimination of the mineral previously fixed to the tissues. Experimenting with the 4th, 5th and 7th potencies of arsenic and bismuth in animals which had previously received large doses of the same substances, they found that these potencies definitely increased the excretion of the drugs. For example, the potencies of arsenic raised the elimination of arsenic from the normal 35% to 42%. Similarly, after every test injection of the bismuth in potency, a further elimination of the bismuth originally absorbed was observed. Earlier, Dr. Bier had performed similar experiments and had come to similar conclusions. One patient, put on Sulphur 3x, was found to excrete daily 576 mg of sulphur, which is sixty times the normal rate. Even after the Sulphur was discontinued he was found to excrete 117 mg the day after; he then averaged 54 mg for ten days and after thirty days he was still excreting about twice the normal. The seborrhoea about which he had complained was markedly improved and his general well-being decidedly better than before the experiment. The patient was located two years later and agreed for the sake of experiment to make a retrial, although he considered himself cured. When he now took Sulphur 6x for 10 days, hardly any extra excretion of sulphur was found. In 1922, Krawkow demonstrated in his laboratory the pharmacological activity of adrenalin, bichloride of mercury and copper sulphate in the 24x, and histamine and silver nitrate in the 32x potency. In a study of 20 drugs at the Hahnemann Medical College and Hospital, the research committee of the Homoeopathic Society of Pennsylvania found that Ant. crud. reduced the blood sugar, 9.9 to 40.9 mg in 29 days. They also noted that Apis, Echinacea 2x, Pulsatilla 30x, Baryta carb. 30x, Coccul. ind. 3x and Iberis amara, all had a favourable effect and reduced the blood sugar levels. According to the report of the committee, the blood sugar was influenced by the following drugs also: Ant-c 3x, Apis 1x, Bar-c 30x, Cactus 1x, Coccul. 3x, Cup-a 2x, Ip. 30x, Iris. 1x, Merc. cor. sub. 200x, Myrica and Nux-v 30x. Bacteriological J. Paterson and William E. Boyd in 1931 showed that Alum. precipitated Diphtheria-toxoid in 30C and Diphtherinum in 201C potency, given orally each separately, changed the Schick test from positive to negative in 20 out of 33 cases. H. Junker, in 1928, added various substances in dilutions-up to 10-27 to cultures of paramecia. The materials he used were atropine sulphate, caffeine, orange juice, lemon juice, cocaine sulphate, a sodium salt, potassium oleate, octyl alcohol, oleic acid, hydrochloric acid, acetic acid, uric acid, magnesium sulphate, copper sulphate, nonylic acid, sodium desoxychloate and a rubio vitamin preparation. Many sinusoidal curves were obtained, with rhythmic alteration of maximum and minimum. Results were expressed as the sum of the daily changes in growth of each culture of paramecia, at each particular dilution (expressed as percentages). They yielded significant changes for orange juice 10-26, a sodium salt 10-26, octyl alcohol 10-24 and 10-25, atropine sulphate 10-26, potassium oleate 10-26 and nonylic acid 10-24 and 10-27. Pharmacological

Research of proofs of activity of infinitesimal doses It is good to prove that homoeopathic dilutions are not just pure water and that either they contain still some of the initial substance or they initiate an "unknown physical factor" which can be detected with special apparatus. This is not sufficient. We have now to prove that these infinitesimal doses can produce an action which can be objectivised and measured. There is no doubt that the study of these infinitesimal doses presents arduous problems which have not, as yet, even been considered by the officials. However, a Pharmacology of the infinitesimal is now created which is due to grow and expand. Pharmacological research is conducted either with isolated organs or the entire animals. Any way, it is necessary to "prepare" the animal because generally, an infinitesimal dose is by itself inactive and becomes active only under special conditions which have to be created. It is in this research of "sensitization" of the animals that the success of the experiment depends. Experiments in vitro on isolated organs Jarricot spent many years to achieve a proper technique to study homoeopathic dilutions. Most of his studies have been gathered in the Documenta Homoeopatica. He studied the action of Veratrine on the muscular contraction of the frog gastrocnemius and concludes that a 30th Korsakovian favorizes the work of muscle. He then studied the action of Iberis amara on the isolated heart of frog or tortoise. Strong concentrations of Iberis (1%) have a negative chronotropic effect. This same effect can be observed with Korsakovian dilutions. Jarricot attributes to Iberis an "eurythic" action. These experiments took place either on isolated organs or perfused with the solutions to be studied, or on isolated heart injected beforehand with the Iberis dilutions. W.E. Boyd gave small doses of Crataegus, Digitalis and Strophanthus sarmentosus to the heart in situ of killed frogs. He registered ECGs and cardiac beats and noted detectable action upto the 10-11. The results are altogether different depending on the origin of the solutions, distilled water or Ringer solution. The author emphasizes the enormous variations observed on witnesses. Only 50 to 77% of the animals are sensitive. The percentage depends on the drug used. The sensitivity difference of animals, even selected, creates a pharmacological problem very difficult and is only too frequently encountered without finding a satisfactory explanation for these differences. Also J.R. Boissier noticed considerable differences in sensitivity in his experimental animals, some reacting this exceptional sensitivity as "Paradoxical". In order to succeed with experiments on infinitesimal doses, it would be desirable to select sensitive races, just as cancerous or other races are selected. Wurmser et al have used the isolated intestine to study: 1. the action of various doses of substances such as Butelline and there have demonstrated the invertive action depending on the dose, 2. the antagonism of Coffea Nux vomica, the drug used generally to palliate the toxic effects of coffee. Recently they have studied dilutions of Actea racemosa and found that they produce a sensitization of the guinea pig uterus to the post-hypophysis which would confirm the use of Actea rac. to ease deliveries. A non-homoeopathic experiment no doubt, yet it could be as it comes within the frame of what we have defined as necessary conditions for the study of infinitesimal doses, as that realised by R. Hazard, Savini and Ranier Cornec on the duodenum of the rat. Atropine at a concentration of 2 x 9-10 lessens the acetycholinic contraction, at a

concentration of 1 x 10-25 it is inactive, but at 2 x 10-18 it reinforces the acetylcholinic contraction. In dilutions between 10-15 and 10-20 the sensitivity to Acetylcholine is first diminished for a few minutes then in spite of the continued presence of Atropine, the contractions produced by Acetylcholine increase and equal the contraction of control. If at that time, atropine administration is stopped and the preparation laved with pure tyrode, an increase of sensitivity ensues...this increased sensitivity keeps at a plateau for 10-15 minutes... This sensitization phenomenon after-lavage is frequently encountered, and they have undertaken experiments particularly difficult to achieve in order to find out if this sensitization could not occur at once with even higher dilutions. Experiment in vivo on the entire animal Nebel related several experiments tried on the entire animal. He has been censured for using too few animals... so his experiments have not been duplicated. However he tried several approaches; a 30th or 200th of Malleine injected three weeks after injection of a live culture in the ear of a rabbit produced in intense vaso-dilation of the peritumoral vessels while the opposite ear intact does not react at all. A 12C of Tuberculin, every 8-10 days enables a guinea pig to survive at least 10 months, Cobra-venom on the dose. Whereas the pigeoncontrol dies within 11/2 hours, the M dilution protects it completely. Arthus studied the action of Calc-f in rickets, 1% of Calc-f in 3x prolongs the life of rats as compared with controls submitted to the same rachitogenic diet. At autopsy, the lesions of treated animals are more important than those of controls probably because they survived longer. It would have been interesting to sacrifice the treated animals at the time of controls' death in order to compare the status after the same number of days of rachitogenous diet. Together with Miss Pazin, Wurmser studied the reciprocal action of different doses of the same substance. Dilutions of Procaine from 10-6 to 10-10. diminish the sleeping time of epinoches when they are dipped for 10 minutes in these dilutions before being immersed in concentrated solution of Procaine (0.5 x 10-25). Hofmeister studies the action of Pulsatilla T. M. and D.T. on the genital function of the white mice. He states that it is not comparable with the action of hormones. Dr. Dejust cites a number of experiments made to confirm the simile principle. Papaud of Libourne, found out whether the rabbit could be vaccinated against the tetanus with Strychnine (1880-1890). The results are negative. Other experiments carried out by an Academy of Medicine Commission composed of Dujardine, Beaumetz, Gautier and Trasbot, on the Tansy, the essential oil of which is capable of producing symptoms similar to rabies, showed it could cure this disease. This positive experiment realised officially is of great interest. Kisskalt and Kahnkoph tried to verify the claim of the law of similars and since atropine produces symptoms remarkably identical to botulism, they tried experimentally if atropine in the 4th dilution can diminish the mortality of mice poisoned with botulic toxin. Unfortunately the results are negative. They also tried the action of Strychnine on the titanic toxin and observed that strychnine accelerates the death of the animals. Cantegrit tried to show the "euphylactic effects of a high dilution of Nux-vomica in guinea pig intoxicated with Strychnine". He claims to have effectively protected the guinea pig 30 minutes prior to the lethal injection - with a 7th CM Nux-vomica. Unfortunately, these experiments are not too conclusive because the guinea pig sensitivity to strychnine varies so much that definite results could be achieved only by numerous series of animals, and the results evaluated statistically. Martiny and Pretec studied anaphylactic phenomena. They proposed the hypothesis that anaphylactic reactions were triggered by the dilution of the

allergen in the blood (since the reaction occurs only after a certain time during which the greatest part of the allergen is eliminated). Consequently, if the preparing injection was made with a sufficient dilution of the allergen, the triggering reaction would be almost immediate, so it is with a preparing injection of a 10-12 Ovalbumine dilution, they get by an intracardiac injection of 1/2 ml of Ovalubumine at 1% the anaphylactive reaction after one hour. Such a phenomenon is never observed on new animals nor on animals prepared with 1% Ovalbunine solution. With less diluted solution, 10-9 for example, the crisis takes 24 hours to occur. "In short all these works allow us to conclude that the specific antibody gets its function not only from the presence of action of the antigenic element in its constitutional complex but also from the fact that this presence or action is linked to its infinitesimality." Trying to demonstrate the desensitizing action of Apis-mel. Doneche uses the white rat injected intra-peritoneally with 2ml of a 1/10th Pvalbumine solution. Apis 3rd CH or 5th CH injected at the same time as the Pvalbumine and then every one half hour lessens considerably the oedema. The frequency of the injection does not appear to influence the lessening of the clinical manifestations, the 3rd CH and the 5th CH have displaced a similar activity. Huguette Glay tried the action of a 9th CH dilution of B.K. on tuberculinized guinea pigs. Two groups of experiments responded as follows: 1. Animals tuberculinized treated with dilutions of B.K. 10-18 7 to 8 weeks after tuberculinization. The author estimates that the B.K. 9th CH protected the guinea pigs, giving them a longer life. Whereas the controls died in average of 93 days, six out of eight of the treated animals had a survival of 142 days. However, two treated animals died earlier. 2. Guinea pigs tuberculinized three months previously were particularly sensitive to B.K. 9th CH and died a few days after taking the dilutions. Here again we find the sensitization occurring from the time elapsed between the injection and the use of the homoeopathic dilution. A kind of mobilisation of the toxins seems likely overcoming the animal defences. Let us recall too that trials made to study the innocuousness of the B.C. G. in homoeopathic dilutions proved that these dilutions could, in a measure, protect the guinea pig against the tubercular infection. The most important experiments - since they took several years and involved a thousand animals - were those made by Devraigne, Bagros and H. Boiron involving not only animal experiments, but also clinical observations. These experiments have been repeated by Beja in a medical thesis. The authors studied the action of Folliculine on the adult rat, the castrated rat and the impubic mice. From the ensemble of these experiments, it can be concluded that the 7th CH dilution of Folliculine delays the Oestrus provoked in the castrated rat and, on the other hand, seems to stimulate the Oestrus in the impubic mice. With the gonadotropic hormone, the results are more difficult to interpret. The 3rd CH neutralizes weakly these doses in the rat and only partially in the mice. "It seems that antagonistic action occurs when the animal is placed in physiological conditions closest to normal, for example, ovarian stimulation of the adult rat with gonadotropic hormone. It seems contrariwise that the synergic action occurs when the normal physiological conditions cannot play their balancing role with gonadotropic hormone injection to the impubic mice whose ovary is overwhelmed, so to say by the sudden gonadotropic stimulation." The investigators studied also the 30th CH of Folliculine and found that this dilution upsets the inhibition of the oestrus provoked by repeated estradiol injections. However, the maximum oestrus is finally weaker than those of controls. The 5th CH demonstrated a very slight stimulation, the 9th CH however a very strong stimulation. The authors conclude that the balancing action of hormone dilutions and, also without any doubt, the 30th CH dilution of Folliculine, have regularly produced on the animals in determined conditions an undeniable biological response.

These first experiments, conducted in Strasbourg in Prof. Lapp's Laboratory opened the way for a big series of research in Lyon by G. Mouriquand, A. Cier, J. Boiron et al on the elimination of Arsenic and Bismuth in the pigeon and the influence of dilutions on the vestibular chronaxy perturbed by the metal intoxication. The authors confirmed the results of Wurmser on elimination and demonstrated that under the influence of infinitesimal doses of the metal, the vestibular chronaxy was brought back to normal much faster. Mouriquand's studies on vestibular chronaxy are particularly interesting because the lowering of the vestibular chronaxy is the only sign of the hidden intoxication, as the authors demonstrated mostly in cases of infra-clinical avitaminosis. The authors tried even the action of the 15th and 30th dilutions. The 15th dilutions were found active, the action of 30th was less evident. The authors rechecked the experiments of elimination provoked by tagged Antimony. Dilutions of the Antimony stable in the 7th CH bring a definite increase of radioactivity detectable in the excreta. It is, however, much weaker, than with Arsenic. New injections of emetic had no action - in other words the action of the 7th CH in such experimental conditions are not renewable. With the study of radioactive Antimony fixation on different organs, the authors thought that "the homoeopathic injections are capable not only to provoke a partial elimination of the toxic element fixed before-hand in the organism, but also its mobilization in certain essential organs", which agrees perfectly with Prof. Lapp's conclusions. A variation of these trials was realised by J. Boiron and A. Cier in "Experimental Research of an Isopathic Activity". They use in order to mobilize Arsenic an isopathic of the rat's blood taken three or four weeks after the massive injection of the toxin. The 7th CH, 9th CH and 15th CH dilutions of the isopathic have a positive action. The 30th CH was inactive. The authors having tried the isopathic action from the rat's blood on another rat still obtained positive, albeit weaker, results and conclude to the, "non-specificity" of these preparations. Can we, however, really speak of isopathy in these cases, where it does not seem that Arsenic combines with blood proteins? We should rather admit that a small quantity of circulating Arsenic is left, of course, undosable and may be unverifiable and that these infinitesimal doses have mobilized the Arsenic; this would lead us to admit that, in reality it is not a 15th CH which has been injected but a more considerable dilution of Arsenic, hard indeed to evaluate. Experiments on animals were made by J. and M. Tetau on "Pharmacology and Psychopharmocology of Thuja" and the "Psychopharmacology of Nepenthes". Operating on conditioned animals, the authors find that important doses of Thuja disturb the psychic balance of rats which lose their conditioning. These intoxicated animals see their troubles disappear under the effects of one dose of Thuja 9th CH with reappearance of the conditioning as regards Nepenthes. One cannot detect a stupefying effect but rather a trouble in readaptation to the test used on rats previously trained. However, the tests are less conclusive than with Thuja, because Nepenthes never produced a deconditioning intoxication similar to that produced by Thuja. Treatment of experimental disease In order to study the action of remedy, allopathic or homoeopathic, we have to create in the animal an experimental disease very close or similar to human disease. One is then confronted with great difficulties due to the fact that the artificial disease created in the animal is far from identical or even close to those observed in man. Therefrom, we see techniques created such as the ulcer due to coercion, the edema of the rats' paw, psychological troubles in animals trained to accomplish certain acts, experimental atherosclerosis, etc. Is such an experiment possible in Homoeopathy? Up to now any attempts made have been discouraging. For example, A. Cier et al tried homoeopathic

treatment of experimental hepatitis which in the conditions of the experiment remained negative. More recently the same authors, viz. A. Cier, J. Boiron, Miller Vinget and Braise have reported case of diabetes in mice induced by injection of Alloxan in crude doses being treated successfully with Alloxan 7 CH. Clinical veterinary experiments Without mentioning here the veterinary therapy which is in fact, a true experiment per se, we would like to report research re the therapy of certain disease more or less serious or resistant. Chavannon and Bardoulat obtained immunization of chickens against diphtheria, socalled Aviaire variola, by dilutions of the diphtheritic toxin (Diphtherotoxin). This is not isopathy since the aviare diphtheria has nothing in common with human diphtheria, but really homoeopathic therapy, i.e. therapy by the simile. Preventive as well as curative actions are obtained with the 7th CH. Vittoz demonstrates the remarkable action of Thuja 3rd CH on cattle warts. Prof. Bordet extends the application of this treatment to buccopharyngeal papillomas of the dog, and Mrs. Tegret presented a thesis on the treatment of warts on stallions. Generally, the results are obtained by taking X drops, t.i. d. for five days. In 1950, Plantureux published his results of personal experiments made several years earlier at the pasteur Institute of Algiers. He studied the possibilities of treatment and prevention of rabies in experimentally injected animals under the strict controlled conditions. No conclusive results in preventions, but more interesting ones in treatment of established over rabies. Whereas rabies innoculated in precisely controlled experiments in always lethal Plantureux achieved cures with various remedies such as Belladonna, Rabies virus, Lachesis and Guaco in 4th CH and 5th CH. Later, a control was carried by innoculating afresh the "cured" animal, which remained refractory to the infection, proof that the cure achieved immunity. Other trials were attempted by Plantureux on procine influenza successfully treated by Ferrum phos. Belarbre presented a theses on Pyrogenium and its indication, and Belloir in 1958 studied with the help of rays the action of a microdoses of Calcium in the treatment of non-suppurative osteitis of the horse. These "microdoses" of Calcium were made with a mixture of three Calcareas (Phos., Fluor and Carb.) in the 3x. Finally, urinary lithiasis treated by urinary isotherapy becomes, thanks to Prof. Bordet, a real scientific experiment. Pathogenetic experimentation on the animal Is a pathogenetic experiment possible on the animal? For sure, one can not get from the animal any subjective symptoms so precious for the remedy diagnosis, but we can obtain indications on the sphere of action of the drug, on the elective fixation or biological modifications which will justify the use of the drug in selected clinical cases. Amid these works, we can mention the proving of Sepia on the female guinea pig by Roy and mostly those of Hinsdale. According to this author, his goals in this research were, 1. to find a rational experimental basis for the Materia Medica, 2. to give the student the possibility to demonstrate the action of homoeopathic drugs in general and their elective actions on certain lesions of the organism, 3. to determine the pathological and pharmacological action of these drugs which are not studied in the Pharmacopoeia and, 4. to demonstrate scientifically the validity and truth of Homoeopathy and its therapy. In fact, many of these experiments have no bearing on the action of homoeopathic drugs, but are limited to the study of the symptoms of intoxication. It is in fact, toxicology with anatomo-

pathological tests, for demonstrating the affinity of the drug. The second part of his work is devoted to pharmacology with ponderable doses, then to chemical dosages in the blood. Along the line, one of the most peculiar experiments is about Diphtheritic toxin and Mercurius cyanatus. Merc-cy increases the same elements of the blood as the toxin does, and diminished the same elements in the same proportions. Injected together in the rabbits, they neutralize themselves and no other modification is observed. Therefore, the author concludes as to the Homoeopathy of these two substances. Experiments have been conducted to study the protection obtained by the dilution of a substance against the toxic action of the substance, provided the infinitesimal dose is given during the period of intoxication and at different times (Experiment with Tuberculins of H. Galy, of Nebel, of Miss Pazin on the putting to sleep of fishes, of Miss Vischniac on lead, etc.). This protection is demonstrated by considerable and prolonged survival as compared with untreated controls. Other experiments - non-homoeopathic - have also discovered this protective power of small doses. S. Bonfils demonstrated that Phenylbutazone at 10 mg dose per kilo can protect the animals against the ulcerating action of 100 mg/kg of the same drug. Likewise, an American cancer specialist succeeded in protecting animals against cancer provoked by Dimethylbenzanthracene by administering beforehand small doses of that same substance. So, one wonders if we are not rediscovering an old and historically known phenomenon under the name of "Mithridatisation". The ignorance, however, of the mode of action never stopped the action of the remedy nor its efficient use when well-indicated. Effects of microdoses Studies have been made of the effect of microdoses of various substances. They include: 1. Selenium, the element and its compounds. In a recent 400 page book, published in the U.S. A. about this interesting mineral, it is mentioned that 2.5 ppm of Selenium in grains can poison young rats, not old ones - or 0.7 ppm affects chick embryos. These dilutions are equivalent to 5x-7x potencies. 2. Colchicum, which has had a reproving in 1964-65, has amongst its poisonous effects the power to inhibit cell division. This it can do in dilutions of 1 ppm equivalent to a potency and in 6x dilutions it can act more powerfully still on cell mitosis, altering the number of chromosomes. 3. Tellurium can, like many rare minerals, produce poisoning in those working with it in industry. This occurs usually, through inhalation of vapours containing minute amounts of Tellurium, 1 micromole of Tellurium i.e. 0.000 1 g or 6x produces a garlic odour in the breath *. 4. In the case of L.S. D., 0.000 002 g or 1/700 000 000 of body weight produces a "trip". 5. In allergic disease, we have also a minute dose producing a reaction out of proportion to the size of the dose. This sometimes happens after a lapse of time in a way somewhat similar to our prover's reactions. 6. In modern physiological research a 10-6 g solution is frequently employed and is usually very potent. One ml. of a 10-6 g/ml solution (i.e. 10-6 g or 1 Ug) of acetylcholine, for example, when passed through any frog heart will stop it altogether.

The subject of homoeopathic pharmacology offers infinite scope for fascinating research, which opportunity has not been fully exploited. Among those working in this field must be mentioned Dr. Willmar Schwabe's Laboratory of Germany which conducts experiments to study the effects of various drugs in potency on the organism. Beryllium: 0.0001%. Be in alloys of magnesium reduces inflammability to an extraordinary degree. This is equal to 5x potency. We should also mention the experiments done by Prof. William Burridge, former Professor of Physiology and Dean of Faculty of Medicine at Lucknow, who proved that various drugs as, e.g. Nicotine, which act toxically on the myocardium in certain doses, merely inhibit it in smaller doses and actually stimulate it when highly diluted, thus confirming Arndt Schulz law. Judd Lewis has published a chemical analysis of Pyrogen. Elias reports a study of the effect of Corrosive sublimate and Arsenicum album upto dilution 10-10 on blood clotting "in vitro" and make a short comparison with certain thiols and Russel Viper venom. It is found that in potencies above 10-6 (6x) both are able to produce an opposite action, of which, the action of Merc-c is more prominent. It is also found that Arsenicum album in about 8x potency could neutralize to a certain extent the Russel Viper venom in vitro. Hans Wolter reports a study of the effect of Flor di Piedra in homoeopathic doses on small pigs by different experiments in which histological testing is done. It is found that the drug has power to regenerate the liver cells after the secondary fatty degeneration occurring as a result of strongyloids infection. Also it is proved that the drug has a great power to regulate the liver function to normal even after pathological changes of the organ have occurred. Deb et al have discovered that Conium has an effect on the ovaries of female rats. Templeton has described the experiments conducted which proved that Mustard gas administered in potency neutralized the poisonous effects of crude mustard gas. Taufiq Khan has published a number of papers related to homoeopathic pharmacy. K.P. Muzumdar, P.N. Varma and their colleagues have published a number of pharmacological studies of various plants used in homoeopathic medicines. Krishnamurthy reports about his research in cataract with Cineraria maritima and says that the remedy gives 60% surety in arresting and curing cataract. Clinical Schick's reaction Schick's reaction has been subjected to many investigations. Chavannon obtained desensitizations with M, 4M and 8M dilutions of Diphtherotoxin. Therefrom, to prove the vaccinating power of these dilutions is a short step. In 1939, to the International Homoeopathic League, he presented his first results of animal experiments on animals "vaccinated" with diluted diphtheritic toxin and concluded that everything seems to show that hens intoxicated with Diphtherotoxin... were immunized against a dose paralytic to hen controls... "Let us remember that homoeopathic vaccination has not been proven on man and that this technique cannot be used to establish official vaccination certificates." Paterson and Boyd obtained a certain percentage of negativation of Schick's reaction with the doses D 30 and D 200 of Diphtherinum.

Gay and Boiron studied the action of drugs on the Vittoz phenomenon. They observed changes of tracings registered when the remedy indicated by the patient's condition is applied - the reaction is practically instantaneous. The authors, after a long series of experiments and reasoning, confirm their hypothesis on the "energetic" nature of the drug, the activity of which is conditioned by intramolecular associations created by dynamization and the undulatory characteristics of the body used as original starting point commanding its specificity. Mattei, using his hemotests technique (hemolysis produced by titrated solutions of venoms and ophidian lipids) controls the biological action of tuberculins and the action of blood isotherapics in cancerous patients with regressive serology. He confirms dangers of aggravation of cancer by isotherapy when a residual focus has been overlooked, whereby the interest of checking the patient by hemotests before applying the isotherapic treatment. But the palm goes to Sevaux who worked persistently in various domains on the biological action in the patient of homoeopathic remedies. His first trials in collaborations with Emar studied the variations of blood normal elements under the action of high dilutions of various drug dosages which are recorded from the blood by spectrophotometry. Under the action of Phosphorus, Cuprum, Kali carb., Natrum mur., Natrum sulf., Psorinum, a very rapid regulation of the doses elements can be observed (Calcium, Phosphor, Magnesium, Potassium, Sodium). Likewise, Apis acts very rapidly on the albumin-globulin ratio. Finally, Sevaux (a cardiologist) studied with Milovanovitch the changes of the electrocardiograms and vectocardiograms. The variation of the electro-vectocardiograms under the action of high dilutions of Biotherapics (nosodes) are so to say instantaneous (this has been observed formerly by Gay in Vittoz's phenomenon), since they occur within 30 seconds to 5 minutes after absorbing a dose. There is no specificity to a given drug in the variations since they occur as well with dilutions of tuberculines or streptococcin, provided however that the drug is indicated. They express only, according to the authors, the stress produced by the biotherapic absorption. The patients were also checked with biological tests such as Vernes-resorcin and dosage of anti-streptolysins. At the C.H. F. Congress in 1962, Sevaux used allergic tests in microbial desensitization. He found that high dilutions of the alergens nullify the allergic tests. At the same time, Sevaux studies the alterations of electrocardiograms and the antistreptolysins ratio. He mixes antiorgan-sera dilution with the allergens, always under the control of the electrocardiogram. Max Tetau verifies the evolution of morbid alternations by the electrophoretic study of the blood serum. He finds an increase of the gamma globulins which he attributes to a "state of deep sensitisation expressed by anti-corps formation increasing gamma globulin of the fraction of the serum". The augmentation of the gamma globulins would be characteristic of alternating diseases and is not observed in non-alternating affections. Seitscheck published at the L.H. I. Convention at Amsterdam 1961, then at the C.H. F. Congress in 1962, his work on leucocyte reactions under the influence of homoeopathic dilutions showing tinctorial changes in intraleucocytic granulations. Frost studied the action of Apis on the ratio of anti-streptolysins in various affections. Hochstetter worked on the action of Baptisia on the formulation by this drug of agglutinins opposite Eberthinum and para A and B in healthy subjects. Baptisia in 1x or 1C produces, in healthy subjects, agglutinins and brings at 6x a rapid defervescence in the patients. Study of a few drugs

Placebo We wish to emphasize the experiments with placebo, because we are so often accused of prescribing only placebo for our patients. Daniaud took the lead in this research. 152 patients received placebo: 80 reacted with improvement; 52 no change; 20 failed to come back. Daniaud concludes, "... that there are no conclusions." Tests with placebo have been and still are much in fashion. The test of a therapy by the "double blind method" was suggested and seemed to give a maximum of security, but there is now a reaction against it. Indeed, Peguignot writes, "It seems abusive and fraught with danger to attribute everything to therapy, even more dangerous to attribute everything to the effect of suggestion, psychology or psychophysiology of the placebo type of the drug used." That is why Kissel and Barrucand, justly refused any value to the diagnostic (or prognostic) use of placebo. Coste says about sciaticas: "With placebos, one can observe: 54% of failures, but 29% of excellent results. With antiinflammatory drugs: 58% failures and 10% excellent results. With the traction treatment 22% of good results. How difficult to have an opinion on the value of the therapy. One can understand the perplexity of the physicians in his answers. Be it what it may. Each one should participate in a joint efforts to a better knowledge of Homoeopathy and of its possibilities." Homoeopathy in traumatic conditions C.V. Pink, who has had thirty years' experience of obsterics considers that Arnica in injury is well known to homoeopaths who have used it for this purpose for generations. Gross cerebral haemorrhage kills, and minor shock requires no treatment, but there is a considerable margin of cases in between, in which, to say the least, it is possible that the shock and after-effects of injury can be minimised. Kennedy suggests research on the use of Arnica and also other injury remedies. He has also published controlled studies on the use of Arnica in post-operative complications. Anthony Campbell has also carried out and published the results of two pilot controlled studies of the effects of Arnica in injuries. Gutman describes cases in which Sulphurous acid was used successfully in chronic obstructive pulmonary disease due to air pollution. Sankaran describes the relationship observed by him between glossy fingernails and growth of hair on the back of patients and a tubercular history in the family. Pai mentions his experience in cases of nephrotic syndrome. He has also published his experiences in the treatment of Hydrophobia treated with homoeopathic remedies and with sedatives. Maris G. describes his observation on the granulocyte reaction after the administration of homoeopathic potencies. Stewart narrates his experience of the effect of homoeopthic medicines in coronary heart disease cases. Krishnamurthi mentions his clinical observations with the use of the nosodes Cataractinums prepared from Immature Cataract (M.C. ).

Trexler has made observations on the use and effect of homoeopathic remedies in Industrial Medicine and believes that the employees were more comfortable and in many cases returned to work sooner. Hochstetter describes his research in the treatment of alveolitis with Borax. Ronald Troup has published some observations on the use of respiratory vaccine. In a series of 96 prescriptions he says: that 75.1% had protection full and complete against repeated colds. Prof. Augustus Bier, a celebrated surgeon and scientist of Berlin, experimenting with dilutions of Sulphur in cases of furunculosis, found such excellent results that he became converted to Homoeopathy which he had originally believed as "an unscientific humbug unfit to occupy the attention of a regular physician". Foubister has worked out clinically the indications for the nosode Carcinosin, which drug seems to have a very wide and deep range of action. He also draws attention to the constitutional effects of anaesthetics. Paul Daynaz, a French homoeopath, has recently reported good results in the treatment of endarteritis obliterans and coronary angina pectoris with weekly injections of Mercurius dulcis in the 1st decimal potency. Sankaran has published his observations on frequent repetition of remedies in chronic cases. Mesa reports the indications for the remedy Yage (Banisteria malpiguceae). Eikenberry refers to the McKenzie method of drug selection in which one minim of the medicine in potency is injected intradermally and in 24 to 48 hours there is a subjective as well as an objective finding of the results of the test. Boman Behram reports the effects of Steroidal urinary extract in subacute and chronic rheumatoid arthritis and says that it produced favourable results in fifteen out of seventeen patients. Shrivastava has published some studies of Ficus religiosa. James Runcie has experimented with auto-therapy making homoeopathic potency out of one of the patient's own secretions or excretion and helped some problem cases, apparently incurable by other methods, e.g. a breast tumour, acrid perspiration and many others. Flocculation test Garth Boericke, Professor of therapeutics at the Hahnemann Medical College, Pa, and his colleagues have developed a method for the selection of the homoeopathic remedy called the Lipoid Flocculation test. This test is performed with a menstruum which is made by dissolving lanolin in cold alcohol and dispersing this solution in cold distilled water in such proportion that a 1% lipoid concentration results. This menstruum is called the colloid. It has been found that one drop of the patient's blood-serum added to 3 cc of this colloid may result in flocculation in certain toxic cases, the rapidity of the phenomenon being a rough guide to the severity of the disease. It occurred to Boericke and others that if the patient's serum or it dilute factor caused flocculation, such flocculation may be considered as the resultant of the disease energy. To observe the effect on this flocculation of the homoeopathic remedies, one selects on the basis

of the symptomatology a group of drugs which seems likely to be indicated. Out of this group of drugs, tested one at a time, the drug that is able to completely prevent the flocculation is the correct remedy or similimum; one that prevents flocculation partially indicated. For purposes of the test, Boericke used the 6x potency of the drugs. Out of 680 cases tested only 2% of cases proved not amenable to the test. He also reports the results done on another series of 1048 cases. Evaluation of improvement Bellokossy has described a new method of judging the improvement in chronic case within 2 or 3 days of the administration of the drug. If the drug is the similimum, it acts favourably and normalises the temperature if it had been raised. The axillary temperature in the morning comes down to 97.5 ºF and the diurnal variation does not exceed 0.2 ºF. Similarly the blood pressure is also normalised, being lowered it was raised and being raised if it was lowered. The partially similar drug does the opposite and even lowers an originally normal blood pressure. Treatment of diseases Whilhelm Witzel of Wiesbaden, Germany, has described a new treatment for diabetes which he has devised suiting all those cases in which with or without the use of Insulin a static condition has been reached. In addition to the original management of the case, potentized cane sugar solution can be used as follows: 1 cc of the 6 C potency of cane sugar (containing 45% alcohol) is mixed with 9 cc of physiological saline solution. This solution is sterilised and injected, 2 cc subcutaneously or intramuscularly. In serious cases, these injections are given thrice a day. When serious symptoms subside, two injections a day suffice. Later, the frequency can be reduced to two or three times a week. Moger records that he has been able to bring down high blood sugar levels with Ant-c 3x, Echinacea and Pulsatilla. Studies of the homoeopathic treatment of cases of surgical Tuberculosis tested against controls done by Ledermann revealed that these cases showed more marked improvement that could only be attributed to the homoeopathic medicines. Kohler discusses the time factor in diseases, the time modalities and their relationship to the changing blood chemistry which changes with the hour. An attempt has been to see if the effect of exhibition of a single homoeopathic remedy chosen on the basis of "Similia Similibus Curentur" could be demonstrated by means of changes in amino acid excretion pattern as determined chromatographically. Prof. Hans Ritter discusses the limitations of Homoeopathy. Pai has published a study of cases of tetanus in infants treated with Nux vomica, Stramonium and Chloropromazine alone, in combination and in alternation. Krynicki reports excellent results in a variety of cases with trace doses of sex hormones. He also records several cases treated successfully with injection of the patient's own blood in potentized doses. Donald Gladish reports good response in hypertension with Eel's serum.

William Gutman has discovered that Cadmium metallicum is almost a specific for the aftereffects of Influenza. He also reports the impressive results of Influenzinum in preventing Influenza. Foubister reports good results in Mongolism with the use of Vit. A, Vit. E, Medorrhinum and Nosode M *, used in a series in potencies. Freeman describes the use of the pupillary reflex in the selection of the remedy. Balachandran has reported clinical trials with Hyoscyamus and Stramonium in cases of Schizophrenia. Knerr has mentioned about a new nosode - the Quadruple Nosode. Patel has published his observations of Luffa o. in Bronchial asthma. N.R. Chakravarti gives clinical confirmation for Chloramphenicol. Sankaran and Matani have tried out the effects of Tub-bov and Carcinosin on patients, with a family history of tuberculosis and Cancer respectively, to see if there is any definite specific effect. Aluminium Le Hunte Cooper after considerable research has traced the ill-effects of using aluminium vessels for cooking or storing food. Grimmer has reported that such ill effects can be antidoted by Cadmium oxide in potency. Prophylaxis Eisfelder has published a preliminary report on oral immunization of poliomyelitis with Lath. sat. based on 10 000 cases (observations). Treatment of cancer All are aware that a great deal of attention of the whole of the medical profession is concentrated on the problem of cancer. Homoeopaths have also been interested in cancer especially as they have the advantage of viewing the affected organism as a whole. Some research is also being carried on in the homoeopathic treatment of cancer. This is mainly based on the ideas scattered by Rudolf Steiner, a world famous philosopher. Steiner was an Austrian who had a deep insight into Indian philosophy and gave out ideas on various subjects like education, health, etc. Basing the research on his teachings, several doctors in Switzerland among whom is A. Leroi, have prepared an extract from a plant Viscum album found growing on various trees. This extract called "Iscador", when injected in particular potency, is found to have a specific effect on cancer, both in arresting and retarding its growth, thereby prolonging life. This drug is regularly used along with the similimum given orally, in cancer cases by L.R. Twentyman at the Royal London Homoeopathic Hospital with good results. Due to many reasons, it has not yet been possible to make this treatment a standard and universal one. Alexander Leroi, Rita Leroi and their colleagues and collaborators have published a number of papers on the successful use of Iscador in the treatment of malignant conditions affecting various parts of the body. Grimmer reports satisfactory results in cancer cases with the use of Cadmium compounds.

Other studies Bhavanishankaran discusses the role of the simile principle in genetics. E.A. A.A. D. De Ruyter gives a summary of his experience with the use of mini-computers. He writes, "Repertory analysis of homoeopathic cases has always been very time-consuming; for this reason homoeopathic doctors have often had to restrict themselves to searching for the most likely remedies." He then describes the use of a relatively inexpensive minicomputer for repertory selection from a total of 352 homoeopathic remedies on the 501 most common symptoms from Boericke's Repertory. The procedure greatly reduces the time needed for and improves the accuracy of repertory analysis. Several attempts also have been made to use the computer. Pirtkien has given his experiences. Arya has suggested a plan for feeding the computer. Ramayya has published some research studies in which he has attempted to correlate the immune types of persons with the homoeopathic drug constitutional types. The bowel nosodes In the early part of this century, a very young, highly qualified and energetic physician, Edward Bach of England (1886-1936) had developed a theory that most chronic diseases were the result of auto-intoxication from the bowels. Experimenting along with C.E. Wheeler, another eminent homoeopath, Bach developed the idea of preparing an autogenous vaccine from the stool of each patient and using it on the same orally. They had such excellence in hundreds of chronic cases that there were demands for vaccine from all over the world. Besides preparing such autogenous or polyvalent vaccines, and treating cases with them, Dr. Bach was able to identify and classify these bowel organisms into seven major groups, viz.: 1. Proteus 2. Dysentery Co. 3. Morgan 4. Faecalis Alkaligenes 5. Mutabile 6. Gaertner 7. Bacillus No. 7 Dr. John Paterson of Glasgow (1890-1955) studied more deeply the characteristics of the bowel flora and its behaviour in health, in disease and in drug provings. After doing patient and laborious research for over twenty years he came to the following definite conclusions. 1. The non-lactose fermenting non-pathogenetic bowel flora (B. coli) undergoes definite changes in disease conditions. While this alteration in the nature of the bowel flora might be a mere concomitant to the disease condition there is reason to believe that the B. Coli actually turns pathogenetic. 2. The balance of the bowel flora is disturbed in diseases. 3. Similar changes are also observed in drug provings.

He grouped and typed the flora and by continuous experiment and observation he was able to detect a definite relationship between certain drugs and certain types of bowel flora. When particular drugs were administered in potencies the bowel flora was altered in a particular fashion. By clinical study he was also able to bring out more clearly the indications for each type and develop further the technique of treating cases with the bowel nosodes. Bach and Paterson have thus made invaluable additions to the armamentarium of Homoeopathy. Drug provings Provings Provings of a number of drugs have been carried out and reported. The Drug Proving and Research Committee of the Faculty of Homoeopathy, London, conducted a number of provings under the able and energetic guidance of W.L. Templeton. These include among others Mustard gas, Quebracho, Alloxan, ACTH, Beryllium, Cadmium metallicum, Carcinosin, Cortisone, Rauwolfia serpentina and Strophanthus sarmentosus. Sutherland and Roberts carried out in 1940 a rigorous proving of Sulphanilamide on 200 provers. K.P. Muzumdar and his colleagues have reported a reproving of Kali-m and Abroma augusta. A proving of Pencillium galucum has been carried out by Whiting. Subba Raju has reported a proving of Pencillium notatum. Studler reports a proving of Sarothamnus scoparius. An elaborate proving of Radium bromide was carried out by William H. Dieffenbach in 1911. Fred Morgan gives records of provings of Lecithin done by J.C. Fahnestock and others of Ohio in 1908. Luna Castro quotes provings of Sulphanamido-christodine (Prontosil Rubrum) done by A.D. Sutherland in 1940. Royal E.S. Hayes describes a short proving in Iridium chloride done in 1904. Peter Engel has published a proving of Nidus edulis. Mezger reports provings of Araneus ixibolus, Aristolochia clematis, Hedera helix and Mandragora officinalis. Jacob Gringauz summarizes an experiment (proving) done with Histamine hydrochloride on human beings. Raeaside had published provings of Luffa operculata, Hirudo medicinalis, Hydrophis cyanocinctus, Triosteum perfoliatum, Venus mercenaria, Flor di Piedra, Mimosa pudica. Raul Horacio Massone of Argentina records proving of the vegetable drug Statica brasiliensis bois. Jugal Kishore has published a short proving of M and B 693, Abroma augusta, Tylophora indica, Cynodon dactylon and Rauwolfia serpentina.

Donald McFarlan gives a detailed proving of Pencillin in the 200 C potency. Lemus of El Salvador reports a proving of the centipede Virus scolopendra. Miller reports a partical proving of Chromium sulfate. William Griggs has proved Butyric acid, Glycerin, Hippuric acid, Indol, Menthol, Skatol, Sarcolactic acid, Thymol and X-ray. Herbert Unger has published a short proving of Peyote. Fitz Stockbrand and Karl Anton Kass give a detailed proving symptomatology of the drug Viscum album. William Gutman has collected and presented provings of new remedies along with illustrative cases. The drugs include Cadmium metallicum, Beryllium, Natrum fluoricum, Rauwolfia serpentina, Aethiops antimonialis and Bothriocephalus latus. Panon et al record a proving a Hirudin, Thallium and Thyroidinum and Tetanus toxoid. P.N. Pai reports a proving of Chloropromazine. Stephenson reports a proving of Lignum nephriticum done by J. Eggee. P.E. Vannier has published an excellent proving (pathogenesis) of Phenobarbital (Gardenal) and found interesting thereapeutic application in certain cases of pruritus. Guermonprex achieved an elaborate study of Penicillium based on a pure Hahnemannian experiment on accidental intoxications with strong doses and from the usual accidents occurring after the therapeutic use of the drug, either on the sick or on those manipulating the drug. Dano on the "anaphylactic lung" published a pathogenesis of this remedy now distributed under the name of "histaminated lungs". In France, O.A. Julian has rejuvenated the pathogenetic experiments achieved with a crew of collaborators. They included Chloramphenicol, Haloperidol, Rauwolfia, Cresol, Astragallus and Nepenthes distillatoria and very recently a pathogenesis of B.C. G. The results of recent trials of pathogenesis in the 30th CH are variable. For example, P.E. Vannier who tried a new pathogenesis with Aconite 30th CH got no reaction. On the other hand, F. Lamasson confirmed with a 30th CH the pathogenesis of Thymus serpyllym. He also published those of Tribulus terrestris and of Ramalina evernoides. Azam records a proving of Buthus australias. Sankaran reports a proving of Aqua marina, Atrax robustus, Hirudo medicinalis. Mimosa pudica, Adamas and Pituitary. Verma has published a proving of Tribulus terrestris. As is well known, fluoridation of the water supply in the cities of the United States is being done in an effort to control the high incidence of dental decay in the population. With a view to study and assess the effect on normal individuals of the continuous ingestion of the substance in small quantities, William Gutman of New York has carried out and published provings of Sodium fluoride.

Matani has published a clinical proving of Insulin 30. Krishnamurti reports a proving of Osteo-arthritic nosode. Reprovings Many drugs have been reproved to verify and re-establish their original pathogenesis. Following are some of the reprovings. Agnus castus, Aurum met., Aconitum napellus, Calc-c, Colchicum, Crocus sativa, Lycopodium, Penicillin, Rhus tox, Sulphur, Thuja, Thyroid gland, Viola odorata and Zincum met. by Donald McFarlan. Iberis amara by Garth Boericke. Ferrum metallicum by Panon, Rogers and Stephenson. Colchicum, Seleneum, Tellurium and Mandragora by Raeside. Bellis perennis, Calc. fluorata, Chromium sulphate, Mag-s by Julius Mezger. Taraxacum by Gutman. Tellurium by Schmidt. Toxicological and involuntary proving effects The toxicological effects of several drugs have been gathered and reported. Benjamin C. Woodbury gives a record of the pathogenetic effects of Sulfadiazine in 2 g doses given to 245 000 men and women in the U.S. Army as a prophylactic against coccal infections. Eisfelder describes the toxicological and proving effects of Amidopyrine, Chloromycetin, Pronestyl and Streptomycin. He also records involuntary provings of an alkaloid of Ergot, Lysergic acid diethylamide (Hydergine) and describes its most bizarre mental effects. R.S. Faris et al have collected the toxic effects of Butazolidin and Streptomycin. Carl H. Enstam gives the toxicological effects, partial provings and clinical experiences with a new remedy, Natrum pentachlorphenate. Homoeopathic pharmacy Hahnemann, in the sixth and last edition of the Organon, had envisaged a new scale of potencies in which he had suggested a dilution of the drug substance in 50 000 parts of the diluent instead of the original 99 parts. This scale is termed the Hahnemann's 50 000th scale or 50 Millesimal scale or LM scale. These potencies are marked by roman numerals as I, II, III and so on. Dudley W. Everitt has calculated that these potencies can be compared or equated theoretically on paper to the traditional potencies as shown in Table 25.1. Table 25.1 New Scale Potency I - 16x

" II - between 20x and 21x ( i.e. 10c approx. ) " III - " 24x and 26x ( " 13c " ) " VIII - " 44x and 51x ( " 25c " ) " X - " 52x and 61x ( " 30c " ) " XII - " 60x and 71x ( " 35c " ) " XVIII - " 84x and 101x ( " 50c " ) " XXIV - " 108x and 131x ( " 65c " ) " XXX - " 132x and 161x ( " 80c " ) In practice, however, they seem to be far more powerful. * For some obscure reason, these potencies have not been prepared or tried on any extensive scale, so far. However, Dr. Charles Pahud of Lausanne had used these potencies on some of his cases with success and has reported these results. Sankaran and Patel have independently published their observations on the effects of these potencies which seem to be satisfactory. Ritchie McCrae describes the unusual nature of potency energy and mentions how easy it is for homoeopathic potencies to be contaminated. He warns that the most careful precautions are necessary, when handling homoeopathic medicines. He has also discussed extensively the precautions to be taken in preparation, preservation and handling of potentized medicines. X-Rays Potentized Anaya Rees describes how he potentized X-rays. As a mortar he built a lead disc with ten equidistant holes and then solid spaces between them. He says: "If this round plate makes some rotations in a second we alternately have ten interferences and ten radiations each of them a tenth of second in duration. As a matter of fact, one rotation in a second can be regarded as the first attenuation of X-rays. If we increase the speed upto two rotations in a second, we have a second D. attenuation, and so on. "I named this appliance Electronic Attenuator X.O. Rays and you can adjust it to a little Xrays set. It has a large clinical use. According to Arndt-Schulz law this form of electronic energy can promote a gentle stimulation, paralyzing effect or accomplish a destructive process." From the technical pharmaceutical view point: Research re drug manufacture and the justification of the methods used, old and new: research re the control of raw material and finished products. This study has been presented by Mrs. Baronnet and Mr. Vischniac at the 23rd Congress of the Centre Homoeopathique de France (Mai 1964). Statistical research Statistical surveys which play such an important part in modern medicine, particularly in the efforts to assess the value of each drug, have been sadly neglected in Homoeopathy. After the

cholera epidemics of the nineteenth century, no major statistical surveys are to be found in the Homoeopathy literature. Noel J. Pratt has turned his attention in this direction and with the help of the members of the British Faculty, has collected and published valuable data on such points as, 1. the most reliable indications of Arsenium album, Lachesis, Lycopodium, Silicea and Calcarea phos., 2. whether in prescribing repertorization was always done, 3. how often the doses were repeated and 4. the effect ratio as well cure ratio in general practice with Homoeopathy. He has also collected and analysed a number of cases treated by various homoeopathic physicians. He has also analysed 100 consecutive homoeopathic prescriptions. Fergus Stewart has published a statistical survey of forty patients of coronary artery disease, treated at the Glasgow Homoeopathic Hospital. John English has published a work study analysis of the work of 38 homoeopathic physicians. A one week work study was undertaken by thirty-eight homoeopathic doctors in which data relating to age, sex, diagnosis, remedy and potency were collected and various comparisons were made with approximate standard figures. Recently a number of statistical surveys have been done mainly under the inspiration of James Stephenson, setting out an analysis of the cases as regards the drugs, dosage, duration, etc. These include a survey of 86 cases of eczema, 27 cases of cancer and 100 consecutives cases of arthralgia. Stephenson has made a further detailed survey of ninety-five cases of cancer treated with homoeopathic medicines and compared them. He summarizes as follows: "Of the 95 cases, 26 that were treated only with homoeopathic medicines and had unquestionable diagnosis of cancer, lost all signs of cancer for at least five years after the commencement of homoeopathic treatment. Only three of the 95 cases had died of cancer at the time they were reported and these died painlessly. X-ray and/or radiation treatment did not make future homoeopathic cure of cancer impossible. The majority of the cases reported either had metastasis or had been declared terminal by their attending physicians before commencing homoeopathic treatment and nearly all of these lost signs of cancer after homoeopathic treatment. Patients treated with 30C dilutions and higher responded more favourably than those treated with lower dilutions. This was in spite of those cases being mostly terminal. The medicines most frequently used for all types of cancer were Phosphorus, Silica, Arsenicum album, Sulphur, Conium maculatum, Radium bromide and Sepia officinalis in that order of importance.

Asterias rubens, Kali thiocynate, Psorinum, Trigonocephalus lachesis and Phytolacca decandra were found to be of great value in certain cases of breast cancer. Uterine cancer responded in particular to Arsenicum album; bone sarcoma to Silica; stomach and tongue cancer to Phosphorus. Liver cancer responded dramatically, in certain individual cases, to Cholesterinum, Lecithin and Butyric acid; intestinal cancer to Hydrastis canadensis and Hippozeaninum; colon cancers to Magnesia muriaticum." The longest series of cancer cases found in the homoeopathc literature was reported by W.E. Jackson. He followed up almost 1 200 cases over a 12 years' period and found a recovery rate of 92%. Most of them, according to Jackson, had been declared hopeless by their own physicians. The next longest series is described by A.H. Grimmer. He reported 225 cases treated from 1925 to 1929 with 50 deaths. Stephenson, alone and with Hubard has published several statistical surveys such as of 33 consecutive cases of Sinusitis. Pai has published an analysis of 260 cases of Tetanus in children treated with homoeopathic remedies. B.N. Chakravarti has published a statistical report on the effects of homoeopathic drugs in Tonsillitis. Kenyon has published an analysis of 100 consecutive cases. Faris and Stephenson studied the effect of the homoeopathic medicine in 23 consecutive cases. Mead has published an analysis of 31 consecutive case-histories. Paterakis et al have published statistical data on the aggravation after the similimum. Stephenson has analysed 20 consecutive pediatric cases and 35 consecutive cases of duodenal ulcer. He has also analysed 100 consecutive homoeopathic prescriptions. Hochstetter reports having tried Merc-s on 42 patients with gingivitis gravidica and finding good results as compared with controls. He also reports having treated 15 cases of alveolitis after dental extraction with Arnica 6x and Borax 6x. He says Arnica showed no results. But Borax produced excellent results. Baker reports having tried Osteo-arthritic nosode in thirty cases and finding good results. Cier A. Boiron, J. Miller Virgert and Braise have reported cases of diabetes in mice induced by injection of Alloxan in crude doses being treated successfully with Alloxan 7 CH. Survey Melman and Stephenson have published a survey of the literature on the properties of high dilutions in which they have quoted 106 references. Young in a series of articles has formulated the homoeopathic trends in modern medical thoughts, giving various quotations from current medical literature.

Conclusion Homoeopathy is a most fascinating subject and a number of aspects of this science and art await investigation and elucidation. A vast field lies ahead unexplored offering ample scope and opportunities for research to the scientific-minded and enthusiastic homoeopath. Due to various reasons, research and advances in our field have not been so intensive or extensive as one would wish for; yet quite a good deal of work is being done. A very brief review of the more important items of such work has been attempted in this booklet. Collected writings Is homoeopathy slow-acting? 1. I was consulted by a lady in 1954 with the following complaint: Name : K.B. Age : 60 years, Sex : F. Date of first observation : 13th March 1954. Present complaint: Has a pain in the left knee joint for the last 20 years. Sometimes the right knee is also affected; cannot stand or walk. She also has pains all over the body in various places especially in the muscles and joints; and the pains generally shift from place to place; they are aching in character and are aggravated by cold breeze and cold baths and amel. by warm applications. Vertigo in the morning. Oedema of both legs for the last 5 years, with pulling pain in the shins and knees, agg. in evening. Milk causes diarrhoea. Previous History: Menopause at the age of 40, since which date all her troubles have started. Family History: Nothing particular. The symptoms were evaluated and the case repertorized as follows, on my Card Repertory. The origin of her complaints from the menopause was given the highest importance, and the first card chosen was: Card No. 44; Climaxis, Agg. The peculiar shifting nature of the pains was considered next and the corresponding card taken: Card No. 379; Wandering, changing, shifting, pains. The aching nature of the pains being a general sensation came next and the card taken: Card No. 4; Aching. The only remedy to come through covering these symptoms was Cimicifuga. This drug further covered the pains in the joints, the cramps in the muscles, and the agg. by cold, and seemed to fit the personality of the case. So she was given on 13.03.54 Cimi. 200, 1 dose.

There was a very good response and she felt considerably better in a week's time. The pains, vertigo, oedema, etc., decreased and disappeared. There were relapses and the remedy had to be repeated thrice, the last time in the 1M potency on 11.10.54, but since then she remains well till today. (Effect Ratio: 7,300:7; Cure Ratio: 7,300:210) 2. Mrs. B.V. , aged 33 years, consulted me for the following disorder. She has recurrent headaches, attacks of vertigo, periodical oppression in chest and wandering pains in the limbs. Her menses are irregular and the flow is generally very profuse lasting for six or seven days. She has been suffering for the last six years. The whole disorder originated after a period of intense worry, just after the birth of her last child. She had consulted numerous physicians and gynaecologists and has taken much treatment without any benefit. She had come for consultation late at night and so I had taken down these few symptoms just to satisfy her. I called her back next week in order to complete her case; but in the meanwhile I gave her one dose of Ignatia 30, more intending it as a placebo. She returned after a week and gave me the surprising news that the second day after the dose of medicine she had passed, per vaginum, a large black lump (clot of blood?) the size of an orange and since then she is completely relieved of all her pains and troubles! She had her period also immediately following and this time it was quite normal. She thanked me for diagnosing her disease and curing it so easily. She has now remained well for over 6 years. (Effect Ratio: 2 190:2; Cure Ratio: 2 190:2) The cases quoted above are merely taken at random. It is quite probable that others might be able to present even better cases. However, these will suffice to show how quickly the homoeopathic medicine is able to act both in giving relief and in completely curing patient. The fourth homoeopathic scientific seminar First session discussion Suppose a patient comes to us and says something, often what he says is something and what he means is something else. Sometimes you say something to hide something else! What you see or what you record apparently is not the full totality. As you practise more, you will know that prescribing for an apparent totality is not a good idea. You have to go deeper. So the totality has two aspects, one that you can see and one that you cannot see. Sometimes the aspect that can see will be less and the thing that you cannot see will be more. This is the one-sided case. So, we must try to find out what is this real totality of symptoms. Case Mr. P., a muslim, aged 40, was seen with following symptoms: Pain abdomen agg. by stooping. Pain lumbar agg. lying on back. Formication in the legs. Sudden attacks of vertigo while lying with sensation as if he was floating.

The following rubrics in Kent's Repertory were consulted, viz. Vertigo, Floating as if (p. 99); Vertigo, sudden (p. 105); Vertigo, Lying, while (p. 101); Back, Pain, lumbar, lying on back (p. 906); Abdomen, Pain, stooping (p. 561); all brought out only Sep. Sep. cured him. The emotional readjustment of patients In the early years of our life when we are young, enthusiastic and brave, with stars in our eyes, when we take life as a challenge and we are ready even to challenge death, we set before ourselves very high ideals. Sometimes the ideal may be so high that it may seem impossible to achieve. The ideal may be personal or impersonal. Master A would like to become a famous film actor, Miss B the best dancer, Mr. C a world famous sportsman and Mr. D the President of his country. As we proceed in life we come across many difficulties. We realise that our ideals or ambitions may not be fulfilled 100 percent. Then, we become more practical and wise. We are forced to dilute our ideals a little, to make a compromise and accept the best that life has to offer. For instance we would like to have a partner in life who has all the most wonderful qualities that a woman can have. But when we actually marry, we might be a little disillusioned to find that the partner is after all a human being with all the good qualities, follies and foibles of a human being. In such a condition we are forced to make a compromise and accept her as she is if we want to be happy. When a physician starts practice, he would like to see that every patient is cured. But sooner or later he has to face the reality of life and he will find that every patient cannot be cured however hard he may try. If he persists in his original ambition and aim, he will only break his head and become frustrated. So in life we have to combine a certain amount of satisfaction at what we have achieved or what we are able to achieve and a certain amount of dissatisfaction at what we have yet to achieve. And we must combine the correct degree of satisfaction and dissatisfaction. Excess of satisfaction will make us complacent and lazy and excess of dissatisfaction will lead to frustrations and defeat. So there has to be a combination of the correct degree of both. Therefore, a person who wants to be happy has to make compromise. He has to look at both sides of the picture, the various assets he has been endowed with and achievements that he has been able to make and the various liabilities and difficulties he has and the achievements he still has to make. Only if a person takes a balanced view and continues to work for his aim to the best of his ability without disappointment or frustration then alone he can lead a happy life. I explain this to my patients. Some of them become frustrated because they feel they have not made quicker progress in life as they wanted to. They develop various complexes or actual disease conditions. Once this matter is explained to them and they are able to take a balanced view, there is a considerable improvement in their condition. Case - genista M.K. N., aged 25 years, consulted me for a chronic headache which he was having since his childhood. X-rays had been taken and it was diagnosed as sinusitis. The sinuses were punctured but this gave only transient relief. The symptoms were: Constant headache on lt. temple or frontal region agg. in sun agg. straining the eyes amel. eating and agg. loss of sleep agg. after coming to Bombay, generally agg. once a week esp. on Mondays. App. thirst, stool, etc., normal. Change of weather produces coryza.

Mentally he was normal. Prev. Hist. and Family Hist. were non-contributory. I repertorized his case with the following symptoms viz. "Head, Pain agg. sun", "Head, Pain, eating after, amel.". I got the following remedies, viz. Aru-t, Chi., Genist., Nux-v, Sulph. Because of the agg. from loss of sleep, I gave him Nux-v in various potencies. This failed to give relief. So, I looked up Allen's Encyclopedia and found that Genista fitted many of the symptoms. So, I prescribed Genista. With Genista 30, he got some relief. He required further doses of Genista 30 on and off and got completely relieved of the headache. Comment: With such rare remedies I do not expect a complete symptom-matching, simply because they are not so well-proved. Placebo Winston Churchill, while sick in the nursing home with a fractured femur, had a nurse who was a staunch laborite. They used to quarrel everyday on political issues and the woman had the last word as usual. One day Churchill saw this nurse carrying his bed-pan and he quipped in parliamentary language, "I see for the first time that a motion passed by me is carried by the opposition." What is a homoeopathic medicine? It must be clearly understood that the term "homoeopathic medicine" really means any medicine used in the homoeopathic manner on the basis of the similia principle. Medicines do not become homoeopathic simply because they are mentioned in the homoeopathic Materia Medica. For instance, Adrenaline and Emitine are mentioned in Boericke's Materia Medica. It will be clear on reading the passages that their allopathic used has been mainly described. So, any remedy in the homoeopathic Materia Medica can be used in the allopathic way. As example, when Opium is used in crude doses to reduce pain, it is used allopathically. Similarly, any remedy in the Allopathic or Ayurvedic Materia Medica can be used in the homoeopathic way, that is on the simile basis, esp. if the effects of the drug on healthy persons are known. When patients switch over from allopathic treatment to homoeopathic treatment, I have noticed that if they suddenly discontinue certain allopathic palliatives, e.g. Cortisone, there is a sudden rebound or aggravation of symptoms and the patient becomes nervous thinking that his "aggravation" is due to the homoeopathic medicine. So, in order to prevent these withdrawal symptoms I started advising the patients to cut down the number of doses of allopathic medicines slowly and progressively. I though that at the most the homoeopathic medicine will not start acting till the allopathic medicines are completely withdrawn. Never mind. This is better than making the patient nervous. But I actually found that in many cases, in spite of their using those medicines for some time, the homoeopathic medicine starts acting and ultimately they are able to discard the allopathic medicine because they do not find those medicines necessary at all.

I have also had experience of cases in which the effect of the homoeopathic medicine sometimes seems to have been supplemented or complemented by some non-homoeopathic medicines. I give two instances hereunder: 1. I have already reported the case of a lady aged 28 years who had severe anemia. Her R.B. C. count was 1.2 million and Hgb. was 25 percent. She had certain individualising symptoms indicating Fer. With Fer. there was an immediate and gratifying improvement with the result that all the symptoms, both the general and the individualising ones, decreased and disappeared. She felt completely well within a few days. However, the blood examination repeatedly showed a status quo. We gave her Fer. in varying potencies and intervals but during the two month period of observation and treatment, the blood picture remained absolutely unchanged. Subsequently, she continued the Fer. but in addition took Folviron tablets which she had formerly taken without any effect. Now there was a rapid rise in the haemoglobin and within one month it reached 97 percent. 2. I have treated several cases of intestinal parasites especially ascariasis, with homoeopathic medicines which appeared well-indicated. I found that in the majority of cases, all the symptoms generally attributed to the parasites such as grinding of teeth, enuresis, boring into the nose, bulimia, etc., disappeared but no worms were expelled. Later, repeated stool examination showed ova and with allopathic anthelmintics many worms were expelled. It is very well known that Homoeopathy is extremely effective in a large number of different types of cases especially in chronic cases. It is also known that some allopathic medicines, e.g. the antibiotics, cortisone, etc., are effective in giving immediate relief in certain types of acute cases. But there is a grey area between these two fields, viz. allopathic medicines afford definite relief. I believe that with reference to this grey area a good deal of unprejudiced research is needed. Case Miss S.P. , aged about 34, consulted me for the following: She had been diagnosed as having an intracranical space-occupying lesion since last 8 years, most probably a pituitary tumour. It had started with right-sided headaches with pain in the shoulder, back hands and legs. Last 2 months she is unable to walk, and has numbness and weakness of both lower limbs ascending from the feet upward esp. worse in rt. lumbar back up to the right knee, wants support to walk, cannot stand or walk freely, cannot turn quickly while walking. She has lachrymation with headache agg. after tonsillectomy. She has burning in the rectum and bleeding after stools, the burning lasts for 15 minutes. Her face is eggshaped, jaw is broadened and hands are broadened like a spade. She is oversensitive to noise. She has also burning in spots, wandering, and burning in the knee. Present Hist.: Had falls twice in childhood. Tub. glands in neck for which she took injections at the age of 12 years. Tonsillectomy done. Family Hist.: No h/o Tub. or diabetes. Father had Cancer. Appetite normal; food tastes salty to her. Aversion to sour foods. Thirst variable. Stool hard, has piles. Sleep better if pain is less. Sweat normal. Body becomes hot and cold alternately. On exam. Plantar is extensor. She was given a dose of Carcinosin 200 and the case was worked out in Kent's Repertory and Phatak's Repertory with the following symptoms. Taste, Saltish, food tastes (K.p. 425)

Weakness lower limbs (K.p. 1228) Direction, Ascending (Ph.p. 67) Numbness, lower limbs (K.p. 1040) Lachrymation with headache (K.p. 246) Puls. alone covered all these symptoms. Puls. also covered other symptoms like "Rectum, pain, burning, after stool" (K.p. 626); "Pains, wandering" (K.p. 1389); "Alternating effects" (Ph.p. 8). She was given Puls. 30, Q.D. S. and she started improving. With further doses of Puls. going upto Puls. 0/30; she went on improving and she is now able to walk freely and fast. Her face and hands have also improved in appearance and are looking normal. Miss S.P. , aged about 34, consulted me for the following: She had been diagnosed as having an intracranical space-occupying lesion since last 8 years, most probably a pituitary tumour. It had started with right-sided headaches with pain in the shoulder, back hands and legs. Last 2 months she is unable to walk, and has numbness and weakness of both lower limbs ascending from the feet upward esp. worse in rt. lumbar back up to the right knee, wants support to walk, cannot stand or walk freely, cannot turn quickly while walking. She has lachrymation with headache agg. after tonsillectomy. She has burning in the rectum and bleeding after stools, the burning lasts for 15 minutes. Her face is eggshaped, jaw is broadened and hands are broadened like a spade. She is oversensitive to noise. She has also burning in spots, wandering, and burning in the knee. Present Hist.: Had falls twice in childhood. Tub. glands in neck for which she took injections at the age of 12 years. Tonsillectomy done. Family Hist.: No h/o Tub. or diabetes. Father had Cancer. Appetite normal; food tastes salty to her. Aversion to sour foods. Thirst variable. Stool hard, has piles. Sleep better if pain is less. Sweat normal. Body becomes hot and cold alternately. On exam. Plantar is extensor. She was given a dose of Carcinosin 200 and the case was worked out in Kent's Repertory and Phatak's Repertory with the following symptoms. Taste, Saltish, food tastes (K.p. 425) Weakness lower limbs (K.p. 1228) Direction, Ascending (Ph.p. 67) Numbness, lower limbs (K.p. 1040) Lachrymation with headache (K.p. 246) Puls. alone covered all these symptoms. Puls. also covered other symptoms like "Rectum, pain, burning, after stool" (K.p. 626); "Pains, wandering" (K.p. 1389); "Alternating effects" (Ph.p. 8). She was given Puls. 30, Q.D. S. and she started improving. With further doses of Puls. going upto Puls. 0/30; she went on improving and she is now able to walk freely and fast. Her face and hands have also improved in appearance and are looking normal.

Repertory notes The wording of the rubrics depends upon the way the symptoms were expressed by the prover. The same symptom may be expressed in different ways, e.g. "Pain amel. lying on painful side" and "Pain agg. lying on painless side", "Headache agg. fasting" and "Headache amel. eating", "Disgusted of life" and "Wants to die". So a lot of latitude must be given when considering the rubrics. Study of the remedies through the repertory We have thought of a new method of studying the homoeopathic Materia Medica through the Repertory and that method promises to prove very interesting and novel. We took a remedy and went through the rubrics in Kent's Repertory and noted down all the rubrics in which this remedy is given. We took for example the remedies Tarentula and Tuberculinum and looked them up in the Repertory. (For the sake of convenience, we only noted down the rubrics in which that remedy has been given in big black type.) The result of our study is as follows: Tarentula Mind : Anger, when touched; Anger, violent; Contrary; Dancing; Dullness, sluggishness, difficulty of thinking and comprehending; Eat, refuses to; Hurry; Hurry, everybody must hurry; Hurry movement, in; Insanity, madness; Obstinate; Quarrelsome; Restlessness; Restlessness, nervous; Restlessness, anxious; Restlessness, compelling rapid walking; Restlessness, tossing about in; Sensitive, music, amel.; Threatening; Touched, aversion to being; Work desire, for mental. Head : Pain, morning, waking on. Stomach : Anxiety, in; Desires sand; Eructations; Eructations, empty; Thirst; Thirst, burning, vehement, vomiting, eating, after. Abdomen : Flatulence; Flatulence, obstructed. Rectum : Constipation, ineffectual urging and straining; Inactivity of rectum. Bladder : Retention of urine. Urine : Sediment, red; Sugar. Genitalia, Female: Itching, Itching, menses after. Respiration : Difficult, Difficult, heart complaints and ovarian troubles with. Cough : Paroxysmal. Extremities : Chorea; Formication; Motion, irregular, Restlessness; Restlessness music amel.; Restlessness, hand; Restlessness, lower limbs; Restlessness, lower limbs, evening; Restlessness, lower limbs, evening in bed; Restlessness, lower limbs, night; Restlessness, lower limbs, night, in bed; Restlessness, lower limbs, motion amel.; Restlessness, leg; Restlessness, leg, evening; Restlessness, leg, night in bed. Fever : Intermittent, chronic. Tuberculinum

Mind : Dullness, sluggishness, difficulty of thinking and comprehending. Head : Bores head in pillow; Motion, rolling head. Ear : Noises. Eye : Pain, moving eye. Nose : Discharge, crusts, scabs, inside; Discharge, offensive fetid, cheese-like; Discharge, purulent; Discharge, thick; Discharge, yellow, Epistaxis. Face : Discolouration, pale; Discolouration, red, afternoon; Discolouration, red, circumscribed; Discolouration, sickly colour, Eruption, herpes, circinatus; Heat. Mouth : Odour, offensive; Odour, putrid. Throat, external: Induration of glands like knotted cords. Stomach : Desires, delicacies, meat, smoked. Rectum : Diarrhoea, painless. Stool : Odour, putrid. Genitalia, Female: Menses, absent amenorrheoea. Respiration : Difficult while lying. Cough : Cold, on becoming; Dry, hacking. Expectoration: Thick, Yellow. Chest : Phthisis, Pulmonalis. Extremities : Pain, chill during; Pain lower limbs motion amel; Pain tearing; Pain, tearing fever, during. Chill : Chilliness, perspiration, with. Fever : Intermittent, chronic, Perspiration, heat, with; Shivering, uncovering, from; Uncovering, chilliness, from; Uncovering, aversion, to. Perspiration : Midnight, after, Profuse. Skin : Itching, heat of stove. amel. Generalities : Cold tendency to take; Wet weather agg; Weakness, enervation; Weakness, perspiration, from; Weakness, perspiration, at night; Weariness. Our answers For cases in which there is keloid after B.C. G. vaccination I combine the rubrics 1. "Keloid" and 2. "Vaccination, effects of", and I find only one remedy coming through, that is Silica. I must however admit that some cases take several months to be cured. This may be because the Keloid reflects a constitutional tendency. In cases of B.C. G. vaccination, I also interpose a dose of Tub-bov. Can homoeopathic prescribing be made simpler?

When we compare the average homoeopathic practitioner with the average allopathic practitioner we get the impression that the latter gets more success in his own way, than the former. The reason seems to be that in allopathic medical practice the method of diagnosis and remedy-selection are more standardised with specific remedies for specific conditions so that the prescriber has his work made cut and dry whereas in our system the evaluation of symptoms and remedy-diagnosis is highly individualistic and demands great discrimination. Perhaps because of this state of affairs we find that the students passing out of homoeopathic college feel diffident and discouraged even to attempt to prescribe homoeopathic medicines and become ready to clutch at the so-called allopathic specifics. The irony of this situation is that this is taking place even as many experienced allopathic physicians are showing a preference to take or prescribe homoeopathic remedies themselves. To remedy this situation, we must all put our heads together and see if we can simplify and standardise homoeopathic prescribing in such a way that even the average homoeopath will get somewhat good results, good enough to keep up his reputation and the reputation of Homoeopathy. By saying this, I do not mean that we should attempt to find specifics like our allopathic colleagues. Far from it. The very idea of specific remedies for specific diseases is almost the opposite of our approach. But I feel that within the ambit of the principles of Homoeopathy we can work out easier methods of remedy selection. Though we do not believe in any specifics for disease-conditions, we do believe in specifics for definite symptom-syndromes, e.g. the late Sir John Weir used to say that where ulcer patients were relieved by eating warm food and drink and lying down, the remedy is Graph. when a disease condition arises after injury one of the injury remedies will be useful, probably Arnica. We have also different remedies for different types of injuries. We have Opium for ailments from fright, Ign. for grief and so on. We have also specific organ-remedies like Ceanothus for spleen, Card-m for the left lobe of the liver and so on. We have also specific remedies for specific conditions like Iris tenax for appendicitis, Ruta for ganglion and so on. It is thus possible to select and develop these specific drugs for specific symptom-syndromes and thus help to simplify homoeopathic prescribing. We will have to develop Homoeopathy along these lines to make homoeopathic prescribing simpler and easier, esp. for the beginners. Case Mrs. M.R. B., aged 22 years, came for consultation on 4th Jan. 69. She is getting attacks of Epilepsy since the age of 9 years. The minimum interval between two attacks is 15 days and the maximum 3 years. It started after some neighbour forcibly hit her on her head out of malice. She got frightened too. She is impatient, suspicious, depressed, irritable, proud and jealous. She has got a suicidal disposition. She tried to commit suicide twice. Once while in school she swallowed a bottle of sleeping pills because she was not prepared for an exam. She was then unconscious for one week. She is excitable and talkative. Her appetite, thirst, etc., are normal. Her wounds bleed much, suppurate easily and heal slowly. Past Hist: H/O Smallpox, mumps, pneumonia and nervous breakdown. Her case was repertorized in Kent's Repertory with the following symptoms: Suicidal, disposition (p. 85); Jealousy (p. 60); Suspicious (p. 85); Haughty (p. 51); Wounds bleed freely (p. 1422).

Only Lachesis came through. She was given Lach. 200. She got a few more attacks, generally mild, all in sleep, but slowly she got out of them. She was given Lach. 1M and then she was relieved. She has remained well for over six years. Cataract Very often patients with cataract approach homoeopaths for treatment because they do not like to be operated. I have treated some cases of cataract. My experience is that the homoeopathic medicines prevent further deterioration of vision but do not clear up the cataract esp. senile cataract. The patients generally approach us with impaired vision. Usually, they have been told by the eye specialist to come back for the operation some months later when the cataract is mature. But if the homoeopathic remedy prevents further maturation of the cataract and yet does not clear it up, I feel it will put the patient in an awkward situation. The surgeon refuses to operate. Yet the patient does not get improvement in his vision. Our task Homoeopathy cannot be advanced by mere sympathy of the people or support of the Government, nor will it spread by our making vociferous demands or by arranging noisy gatherings and by holding heated discussions. It will only advance when we make it intrinsically strong, when we examine its concepts and methods closely and carefully and endeavour to establish them on a more scientific basis on the foundation of all the additional scientific data that have accumulated since the time of Dr. Hahnemann. And in so doing, we must be aware that there is no place for any emotional considerations but only for a purely intellectual and scientific approach. Management of the case In homoeopathic practice almost all the attention and energies of the homoeopathic practitioners are concentrated on discovering the correct remedy i.e. the similimum. This is true to such an extent that many practitioners even ignore other important aspects of the case like diagnosis, pathology, etc., which they think do not directly contribute towards finding similimum. Sometimes they fail to take into account the various causative and contributory factors which have led to the disturbance, the elimination of which might even suffice to correct the disorder. I may quote from my own experience four such cases. 1. A patient used to have recurrent headaches worse from eye-strain. Whereas I failed with my medicines, prescription of proper glasses corrected the refractive error and removed the headaches. 2. I once treated a child who had thick offensive discharge from one nostril. After I had prescribed a remedy and failed I looked into the nostril and found that there was a long piece of white paper which the child had rolled into a ball and had thrust into the nose. When I removed this piece of paper, the discharge eased. 3. A young girl had a painful oedema of one foot with "Rhus-t symptoms" which did not improve with Rhus-t. Later on, an X-ray showed that there was a fracture of the fibula. 4. I once had a patient who had a very severe shooting pain in the ear with impairment of hearing. When the ear was syringed a big piece of wax came out and then the pain ceased and the hearing improved.

After the correct medicine has been selected and prescribed, the homoeopathic practitioner becomes completely relaxed, so to say, so that he does not even consider the need or necessity for any other measures to relieve the patient. No doubt, the correct prescription plays a tremendous role in relieving or curing the patient even without any accessory aids or even sometimes in the face of various impediments. But this does not mean that the practitioner should fail to take all other measures which may accelerate or accentuate the action of the remedy. He must consider all the auxiliary measures that can be employed usefully in each case. In fact, these measures must be also taught in all the homoeopathic colleges as part of the curriculum. Textbooks on the practice of medicine describe the various auxiliary measures that can be used in various disease conditions. Generally speaking, these can be taken as guiding points. But it is not necessary that we should accept, adopt and apply all these methods. We have to examine them carefully and employ only such of those which will enhance the action of the homoeopathic remedy. Whenever any accessory treatment can be adopted which does not go against the interest of the homoeopathic treatment, I heartily recommend such measures *. After the first prescription has been made, there is a reaction exhibited by the patient which may be aggravations or ameliorations of various degrees and types. The textbooks of Homoeopathy describe very nicely how these reactions are to be interpreted and how the next prescription is to be made. So I shall not deal with this subject here. After prescribing the remedy I think the most important step the physician should take is to reassure the patient. Many patients have a lot of fear, most of them unfounded and baseless, but nevertheless these fears have to be exposed and removed. The patient may ask for an assurance or need an assurance that his condition is not very serious and that it is curable. This assurance goes a long way towards helping the patients. The second important step is the emotional readjustment of the patient, wherever this is necessary. We find that many patients are not well adjusted to their environment and this either contributes to the suffering or complicates it and retards the progress towards cure. If we can analyse the patient's feelings and his emotional reactions and show him how he should readjust himself emotionally this will help enormously. Since this is a very big subject, I would like to deal with it in a separate paper. Very often the patient enquires how long it will take for him to be cured. Only the inexperienced physician will make a guess and predict the period. We all know that an apparently trivial condition, e.g. a wart, may take a long time to be cured while at times a chronic case may sometimes come round quickly. So it is always better to tell the patients that he will soon be well rather than fix a definite period. Sometimes the patient asks for some kind of guarantee. In such cases no guarantee should be given. I tell the patient that I cannot guarantee my own life even though I am a healthy person. When a patient is being treated and he fails to respond, we have to take his case again and study carefully, to see if we have missed some points. If, in spite of this retaking the case, restudying the case and prescribing again we do not find any improvement, we can consult a colleague, preferably a senior, more experienced colleague since experience makes a lot of difference in practice. If a senior is not available, I consult someone of my own level because a colleague is often able to take a different view of the case. He may discover a symptom or aspect of the case which we had ignored or give a different evaluation and this may make a great difference to the case.

Sometimes the patient may be irregular in taking the medicine or in his diet or he may fail to follow the instructions given to him or do something which we had forbidden him to do. In all these cases I do not take a very serious view, I tolerate the patient's defect and try to help him. I do not criticise him severely or withhold treatment on this account unless he refuses to obey some instruction which is really very important. Sometimes the patient speaks or behaves in a childish fashion. This is quite natural because many times during sickness, the patient regresses or goes into a childhood state. He wants a lot of sympathy and encouragement. We should give him the necessary moral support and sympathy. When treating a patient the homoeopathic practitioner should not be satisfied by merely finding a clinical improvement. No doubt, a clinical improvement is the most important thing in a case, but the clinical improvement should be accompanied or followed by a corresponding improvement in the disease-pathology also. For instance, all laboratory and other investigations should also show or confirm a regression in the condition of the disease. When a patient, in spite of being under treatment for a fairly long period does not show appreciable improvement and when even treatment done after consultation with colleagues and seniors has brought about no improvement, it is better to tell the patient the fact and allow him to decide what he should do. I would then prefer that the patient be treated by other systems of medicine. If it is a surgical condition say for example, Hernia, Hydrocele, etc., and very careful homoeopathic prescribing has brought about no improvement, he can be advised to go for surgery. After the patient is completely symptom-free, we should stop the medicine and keep him under observation for a long period. Only when the patient is free for a long period even without the medicine, we can call it a cure. For chronic cases, I think a period of observation of three years is necessary. During the course of treatment many difficulties may arise for the patient. His close relatives and friends may advise him or insist upon him or force him to follow certain other treatments. My procedure is to help or guide the patient to find a way out of his difficulties. In all these cases I make it a point to look at the whole problem from the patient's point of view and try to help him. I am not satisfied by telling the patient that this is his problem and he has to find a way out himself. Alternation of remedies Alternation means prescription of two remedies in advance and in alternation. The prescriber decides beforehand, before the remedy is given and the reaction is noted, that after the first remedy is given after a certain interval the second remedy is to be given and again after a certain period the first remedy is to be repeated. For example the most common alternation known to us is Nux-v at night and Sulphur in the morning for piles. The doctor who prescribes tells the patient to take Nux-v at night and Sulphur in the morning. He does not examine the patient the next morning to see whether Nux-v has finished its action and whether the Sulphur is indicated, nor does he examine the patient the next night to see if Sulphur has finished its action and whether Nux-v is indicated then. If you are prescribing a different remedy after noting the reaction of the first remedy and after considering the changed picture, that is perfect Homoeopathy. But this is not what you do in alternation. When you take a case and you find a certain drug picture you have got to prescribe the indicated remedy. That is the rule in Homoeopathy. You cannot prescribe any other remedy.

And if after prescribing the indicated remedy you find a certain change in the symptoms of the patient, you have to study the case again and prescribe the best indicated remedy. You cannot anticipate in advance what will be the remedy. For instance, you may give Nux-v and find later that the next remedy needed is Phos. and not Sulph. So to tell the patient in advance to take medicine A in the morning and medicine B at night is unscientific. There was one Dr. Banker. He was the C.M. O. in the Railway. He prescribed for a case where the patient had one set of symptoms. After giving the remedy, after some time, another set of symptoms came on and he prescribed another remedy. There upon the original set of symptoms returned. He prescribed the original remedy and again the second picture returned. So he could not cure the case. Then he asked me. While describing the case he gave me one good symptom, viz. that the patient was always agg. from 10 a.m. to 3 p.m. Now for 10 a.m. to 3 p.m. aggravation there is only one remedy and that is Tub. Tub. also has alternation of symptoms. So I suggested Tub. Later on he told me that he gave Tub. and the patient was cured. So, it was not a question of two remedies in alternation but the third remedy which was indicated which he did not recognise. I think when people alternate they are actually searching for or missing a third remedy which they do not find. Because they do not recognise that a third remedy is indicated they try to cover up with the two remedies which are both not really indicated in my opinion. The remedy really indicated is not going to produce another picture which, when prescribed for, will bring back the first picture. It will be a third picture emerging if the remedy is correct. So, I have got very strong doubts about the justification of alternation of remedies. The homoeopathic physician who prescribes two remedies in alternation, usually prescribes so because he is not able to fix one remedy. He may find two remedies seemingly indicated almost equally. If one remedy had been clearly indicated he would not go for alternation. But when two remedies seem to be indicated and both equally, and he is not able to decide between them, he prescribes both of them alternately. When you prescribe two remedies in advance and order them to be alternated at stated intervals, which is also predetermined, you are not only deciding that after remedy No. 1, the remedy No. 2 is going to be indicated but you are also deciding that each remedy is going to act for a certain period. You know very well that our medicines can act for varying lengths of time depending upon the nature of the patient, the nature of the disease and many other circumstances. Therefore, when you prescribe in advance, you are deciding everything arbitrarily. I have made very careful observations about this. For example, I have given Lyc. to a patient. I have seen the first dose of the same potency, say the 200th, acting for one month, the second dose acting for fifteen days and the third dose acting for two months. You cannot be sure what will be the period of action of a remedy. But when you alternate a remedy you are arbitrarily deciding its duration of action. When you are giving Bell. and Calc-c alternately, what is the remedy indicated? Is it Bell. or is it Calc-c? Certainly it cannot be both. When you are giving Bell., is the patient in an acute condition or in a chronic condition? If he is in an acute condition and gives symptoms of Bell., certainly give him Bell. If he is relieved and goes into a chronic condition and gives indications for Calc-c certainly you can give Cal-c. But, then he may not go back into the acute condition and need Bell. again immediately thereafter. Actually speaking, there are no homoeopathic drugs and biochemic drugs. There are only potentized drugs. You may classify and call them homoeopathic or biochemic as you like but it makes no difference. When you say homoeopathic and biochemic remedies, you only make an artificial distinction. Both are potentized remedies. So the question comes whether two

potentized remedies could be given at the same time to a patient. That is the question. I do not think this should be done. Further, the symptom of pain has also to be individualised with modalities and concomitant symptoms and prescribed for; the remedy may or may not be Mag-p. Case Mercurius solubilis I was consulted for Miss J.C. , aged 16 years. The girl was the daughter of a rich land-owner and she had developed behavioural defects. At birth, she had had no hair on the body. She had been treated with Thyroid and Durabolin and hair had grown. She was now stunted in stature being only 4'2" tall. Her weight was 26.5 kg only. This had created a serious complex in her mind. Her father was tall, so she believed that her short stature was due to her mother. So she hated her mother. She had been mentally deranged for sometime. For the last few months she had been depressed and had talked of death and expressed a desire for death. She had changeable moods. Milk used to cause diarrhoea. Her elder brother aged 21 was quite normal. Recently she had created a problem because she suddenly told her parents that she wished to marry the son of their cook. She also announced this to all her schoolmates and thus had become a laughing stock. She had been seen by a neurologist who had said that pituitary dysfunction was the cause of her stunted growth. X-ray had shown fusion of the epiphysis and so there was no possibility of increasing her height. She was behaving like a child and would eat with both the hands. She would eat in a hurry. She was shameless and foolish. She was very fond of sweets. She was very dirty by habit. She would often talk of marriage. She was very sensitive to music. She was averse to consolation. She had been treated by a homoeopath previously with Puls., Tub., Pso., etc., and had shown some improvement on the medicines. I repertorized her case with the following symptoms, viz., Dirty, Lascivious, Moods changeable, Sensitive to music, Hurry, Consolation agg. and Dwarfish. I got Merc-s. I put her on Merc-s starting from 1M going upto the CM with intercurrent doses of Syph. In the course of 2 years, her behaviour has become completely normal. Now, she has married some person of her own status, to the satisfaction of her parents. I was consulted for Miss J.C. , aged 16 years. The girl was the daughter of a rich land-owner and she had developed behavioural defects. At birth, she had had no hair on the body. She had been treated with Thyroid and Durabolin and hair had grown. She was now stunted in stature being only 4'2" tall. Her weight was 26.5 kg only. This had created a serious complex in her mind. Her father was tall, so she believed that her short stature was due to her mother. So she hated her mother. She had been mentally deranged for sometime. For the last few months she had been depressed and had talked of death and expressed a desire for death. She had changeable moods. Milk used to cause diarrhoea. Her elder brother aged 21 was quite normal. Recently she had created a problem because she suddenly told her parents that she wished to marry the son of their cook. She also announced this to all her schoolmates and thus had become a laughing stock. She had been seen by a neurologist who had said that pituitary dysfunction was the cause of her stunted growth. X-ray had shown fusion of the epiphysis and so there was no possibility of increasing her height. She was behaving like a child and would eat with both the hands. She would eat in a hurry. She was shameless and foolish. She was very fond of sweets. She was very dirty by habit. She would often talk of marriage. She was very sensitive to music. She was averse to consolation.

She had been treated by a homoeopath previously with Puls., Tub., Pso., etc., and had shown some improvement on the medicines. I repertorized her case with the following symptoms, viz., Dirty, Lascivious, Moods changeable, Sensitive to music, Hurry, Consolation agg. and Dwarfish. I got Merc-s. I put her on Merc-s starting from 1M going upto the CM with intercurrent doses of Syph. In the course of 2 years, her behaviour has become completely normal. Now, she has married some person of her own status, to the satisfaction of her parents. Frankly speaking I also find another set of patients who suffer from emotional disturbances, e.g. a father comes to me and says, "Doctor, I made so much sacrifice for my son; I educated him and looked after him but he is ungrateful to me and does not do anything for me." When I question the father, "Why did you do all this for your son? Was it not because he was your son? Did it not give you pleasure to do all this for your son, even to sacrifice for his sake? If so, why should you complain? You did not make a contract with him that when he grows up, he will do everything for you in return. You merely did this for your son because he was your son, because it gave you satisfaction and pleasure, because he was a part of your ego. That is why you did it. So when you did something for your son, which gave you satisfaction and pleasure, in return how do you expect something more. No businessman expects or receive payment twice for the same item. Then how do you expect payment again for the same action?" I find this logic helps them to calm themselves and take on a more sober attitude. Our answer We have repeatedly emphasized that the symptoms of the patient must be present in the remedy selected and not necessarily vice versa. We have seen numerous cases of Ars., e.g. Coryza, who had no fear of death, many cases of Baryta carb. in which the IQ was not low. Suppose a patient had the following symptoms, viz. "Diarrhoea with lumbar ache"; "Flabby genitals"; "Erections when riding", these symptoms are covered by Baryta carb. The patient can be given Baryta carb. even if his IQ is not low. The remedy must cover the available disease picture and there should be no contraindications. For instance, a Lachesis patient should not say, "I am much better after sleep". The characteristic symptom-totality in practice A characteristic symptom is defined as a symptom which is not characteristic of the disease but of the individual patient. All symptoms, which are unusual and unexpected and do not fit in or conform to the disease the patient is suffering from, or do not conform with the accepted ideas and facts of pathology (disease-pattern), are considered as characteristic symptoms. For the selection of the remedy, only the characteristic symptoms are considered as far as possible. The totality of these characteristic symptoms is considered as the characteristic symptom-totality. So far, everything is smooth, and easy to follow. We have learnt these concepts as students and we have taught them as teachers. However, after practising for many years and after seeing a wide variety of cases and after seeing also the prescriptions of other eminent homoeopaths who are practising successfully, we find that this concept of characteristic symptom-totality is not as simple and as solid as it looks. Within this panorama of "characteristic symptom-totality" there seems to be wide variations in actually selecting the "characteristic symptoms". We have seen prescribers giving importance to or emphasizing some characteristic symptoms over the others ignoring the other symptoms and yet

prescribing successfully. We have also done this in our practice often successfully. Sometimes we have seen that within this characteristic symptom totality the characteristic symptoms to which we had given great importance and prescribed have led to failures whereas some other prescribers had given extra importance to some other symptoms or had interpreted the symptoms differently and had then succeeded. The reverse has also been true where we had succeeded when others had failed simply because to the symptoms that they considered of less value within this symptom totality, we had given greater value. A few examples will illustrate this point. Mr. J.J. , aged 54, saw me on 14.10.74. He suffered from sleeplessness due to uncontrollable rush of thoughts with throbbing in occiput. He consulted a psychiatrist and took some tranquilisers and felt only marginal relief. On falling to sleep, he used to feel as if his circulation stopped, so he lost his sleep. The whole trouble had originated thus. He had gone out of Bombay and had then handed over his work to his brother. When he returned he found his clients extremely satisfied and full of praise for his younger brother who had managed the business so well. This caused a feeling of intense jealousy. There was also the h/o tension, frustration and suppressed anger over some court case. I worked out his case with the following symptoms viz. Jealousy, Sleepless from rush of thoughts, and Falling to sleep agg., and got the following remedies, viz., Cof., Ign., Lach., Nuxv, Puls., Staph. A dear friend of mine, an excellent homoeopath, had already seen him and prescribed for him Lach., Cina. and Puls. all without relief. I too gave him Lach. first and failed but later gave him Staph. because of the h/o frustration, suppressed anger, etc., and he became completely well. He reported on 14.05.76 that he was completely well without medicines for at least 6 months. So, even though in theory and principle the totality of the characteristic symptoms is to be considered, we do find that it is possible to have different valuations for different symptoms within this totality. For instance, I have closely followed the prescriptions of my teacher, Dr. S.R. Phatak. I have often found him ignoring symptoms like desires and aversions, thirst, reaction to heat and cold, left-sidedness, right-sidedness, etc., and still his prescriptions are very successful. Therefore, this leads us to wonder what exactly is meant by the totality of the characteristic symptoms if some symptoms can be omitted safely. We would like that clear guidelines be laid down as to which symptoms can be omitted and which ones cannot be omitted. I would also suggest that we should lay down standardised procedures for deciding what exactly is meant by the characteristic symptom-totality. The selection of the medicine should not entirely become a matter of individual opinion and experience. If this happens the whole method can become unscientific. Therefore, I would like to request my colleagues here to discuss this thoroughly and lay down clear rules to decide which symptoms should be considered and which symptoms can be ignored in making up the characteristic symptom-totality. Emotional readjustment of patients Many patients come to us with emotional disturbances. These cause or contribute to their illness. We have to take cognizance of them and show the patient how to overcome them. It is but natural that in our life we come across various situations. We face various problems and

we are often forced to take certain decisions, whether we like it or not. In such situations, generally two alternatives appear before us. Either we may do something or we may not do it. We can say "Yes" or we can say "No". We may accept or we may reject a particular course of action. When facing such a situation, it becomes necessary for us, as intelligent persons, to consider carefully the pros and cons, all the points in favour and all points against a particular step or course of action and then after having weighed carefully the consequences of taking any step, we have to take a decision either for or against. When we take a decision we can only do it with the best of intentions, with the best of our intelligence based on our experience and knowledge. It is not possible or necessary that all our decisions will prove to be right. They may sometimes prove to be wrong and even unwise. Whatever it is, we are to face the consequences of our decision and face the situation that may arise. There is no use bathing ourselves in tears of regret or self-pity. As explained above, when we face a situation, we are forced to take a decision to accept or reject. As soon as we take a decision, whatever the decision is, whether the decision is to accept or to reject, our mind becomes free from tension. As soon as we accept, the tension eases. As soon as we reject, the tension ceases. But if we neither accept nor reject and remain in suspense there is a tension in the mind and this tension generally disturbs the harmonious functioning of the body contributing to or resulting in disease. So it is better to take a decision - to accept or reject. But while accepting we have to accept the situation totally with full heart without any regret, and if we reject, then also we have to reject this situation totally without any remorse. Let us take the example of a person working in an office. Let us say his boss is very rude to him or abuses him in the office. This person's ego is hurt and he has to consider carefully what to do. If he feels that, even if his boss is abusive, because he wants the job badly, he must stick on and get on somehow, then he must accept the situation with a full heart. If he does so, he has no trouble in his mind. If however, he considers his self-respect greater and thinks that whatever may be difficulty otherwise, he cannot work in this job under this boss, he can resign the job. Either way, his mind will be free from tension. But if he does not accept and does not reject but goes on working with suppressed anger, he is bound to suffer emotionally. This is the same situation when a wife becomes dissatisfied with her husband (e.g. if she finds him unfaithful) or if a person in business finds his partner dishonest. So I tell my patients to face the situation intellectually, not emotionally, and to take a decision for or against with a full heart and stick to the decision without any regret. Dr. S. Radhakrishnan, the great philosopher who was our National President, has given out a great philosophy of living in the smallest number of words in a most excellent way. I quote him: "Life is like a game of cards. We did not invent the game. We did not formulate the rules. We did not manufacture the cards. And we have no power over its distribution. Yet, when we get the cards, we can play the game wisely or we can play the game badly." If people think over this statement carefully they will understand how to be happy in life. In life we are born or endowed with some advantages and some handicaps. There is no use weeping over the handicaps because they are bound to be there. There can never be a life full of advantages alone. We have only to learn how to overcome and compensate for and how to live happily and successfully in spite of these. Similarly, a number of difficulties are bound to arise in life. We will have to face these difficulties and problems with fortitude and solve them or try to solve them to the best of our ability. Some of them may not be solved, in which case we will have to accept them and get along.

Placebo Post hoc ergo propter hoc * Recently we received a very unflattering letter from an admirer. He wrote, "Dear Dr., I am glad to inform you that I have read all the booklets written by you. I am now suffering from confusion. Can you please prescribe for me?" We wish that the writer of this letter had not put in the first and second sentence in the same paragraph implying thereby a connection between the two! Obstacles in homoeopathic practice When a patient undergoes homoeopathic treatment, the general impression of his relatives and friends is that he is accepting some unusual if not sub-standard form of treatment and therefore they are generally doubtful or pessimistic about the outcome. If the case takes longer to be cured or takes an apparent turn for the worse, immediately these well-meaning but ignorant and misguided friends and relatives start advising the patient and make him feel that he has taken recourse to a wrong form of treatment. If, by chance the disease continues to become apparently worse, immediately the best consultant in the allopathic side is called in and the patient is admitted in an allopathic hospital and subjected to all forms of investigations. In these circumstances, the homoeopath may find it difficult to keep up his confidence, composure and courage. In a particular case, if the patient develops some untoward symptoms and the homoeopath finds it necessary to hospitalise him or to get expert opinion from some specialist, then he is in trouble. The moment the homoeopath calls in a specialist to have expert opinion on any particular aspect of the case, he finds that the case itself is taken out of his hands. Even specialists who are sympathetic to the methods of Homoeopathy shake their heads wisely and gravely and suggest alternate methods of treatment. Few of them have the courage to encourage the homoeopathic treatment of the case. If, however, the specialist seeing the case side by side is not sympathetic to Homoeopathy, the result can be easily imagined. We remember many a case which was improving very nicely as per the opinion of specialist himself who was seeing the patient. But when he came to know that the improvement was due to the homoeopathic treatment that was being given, the opinion was changed and the case was declared to be deteriorating. With regard to surgical cases the position is still worse. The surgeon naturally feels that surgery is the only resort and it is difficult for the homoeopath to insist that surgery is not at all necessary. Naturally going against the weighty opinion of a surgeon and refusing to submit the case to surgery puts a very heavy responsibility on the head of the homoeopath. Then, there are some classes of patients particularly in the cities who get various investigations done frequently and if by chance the results are slightly adverse, e.g. if the urine should show a few more pus cells or if the blood urea goes up by one or two mgm the patient loses courage and switches over to other methods of treatment. Another problem arises in treating the middle class, upper middle class and upper class of patients. If by chance they require hospitalisation, then we find ourselves in a corner because we do not have homoeopathic private nursing homes with all the facilities available there and with a resident homoeopathic physician in attendance 24 hours. Therefore, at some stage or other these cases also invariably go out of our hands.

So it can be seen that the homoeopathic physician, even the expert, has to constantly battle against heavy odds in the form of psychological and other difficulties to demonstrate the superiority of Homoeopathy. The early establishment of suitable private nursing homes or hospitals having consulting arrangements with homoeopathically oriented specialists seems therefore called for. Sepia I think Sepia is a wonderful remedy to study and to use. Considering the fact that it affects the sexual organs in women and considering that many of its aggravations are connected with the sexual functions, e.g. with menses, coition, pregnancy, abortion, menopause, etc., it is an excellent remedy for various complaints in women. If you add the fact that it also covers the bad effects of anger, fright, grief, disappointment in love, etc., you can imagine its wide range of action. Women are particularly emotional and sensitive and they live in a small world. Therefore small things assume great significance for them. So when you combine this mental state with the physical condition, you get a good picture of Sepia. Generally, we have the impression that Sep. has great aversion for sex. But it also has got a symptom "Sexualminded". But though she may be sexual-minded she has great agg. from coition and so is unable to enjoy it. This is why Boger describes the Sepia patient as "Miserable". I think it is particularly needed for women who suffer more after an abortion than after a full pregnancy. Abortion seems to produce a kind of serious disturbance in health. I also think that where women terminate a pregnancy by inducing abortion, because they don't want children, it may be producing some kind of guilt complex. Another peculiar symptom is that the patient feels empty in the abdomen but if he eats he feels overfull and has even nausea. The nausea is agg. by the sight, smell or thought of food. This symptom may be found in pregnancy. So even with hunger, the patient cannot enjoy food which makes him miserable. I remember once I was proving Sepia and I had the sensation as if there was a partition between the upper abdomen and the lower abdomen, so that even when I felt hungry and empty, all the food I would take would seem to remain in the upper abdomen causing overfulness and even nausea. But at the same time there would be emptiness in the lower abdomen. These kinds of contradictory sensations are found much in Sepia. These patients may have hot flushes but they are very chilly and agg. by cold. Another symptom I have noted about Sep. is that the patient may be agg. looking down from a height. This is not given in the repertory. Here it is like Arg-n of which it is a complementary. Another peculiar combination is an aversion to company yet has fear of solitude. One characteristic symptom is drooping or sagging feeling of various organs. The patient may have drooping of eyelids producing a sleepy look, like Gels., of which it is a complement. It has also got a bearing down or dragging down feeling so that the patient feels that the internal parts may come out or contents of the internal part may come out in pregnancy causing a tendency for an abortion. Incidentally, I may mention that my teacher Dr. Templeton of London used to say that he generally thought of Sepia when the patient mentioned that she felt like screaming or when she said, "I feel like running away from it all." This kind of attitude is found in the Sepia patient. The Sepia patient of course has a lot of love for her family, but she cannot express this love. That is why it has a symptom "stifled affections". Of course, love is what we feel and affection is what we show. Love is of course always there but she cannot show it. I said the discharges are milky. They can be also fishy in odour. The Sepia patient has got some kind of venous stasis and she improves very much by exertion esp. by violent motion such as dancing and here it is the opposite of Puls. which wants gentle motion. It resembles Tarn. which also wants violent motion. I have noted in three or four cases of Sepia agg. from brinjal (baigan). One lady had gallstone colic agg. by brinjal. Another lady felt agg. even if she handled and cut a brinjal.

Sepia covers the effects of grief, though it is not given in the repertory for this. My first case of Sepia was a Polish lady. She was interned during the war in Russia. She herself, her two brothers, sister, father and mother all were put in a concentration camp and in the night they tried to escape. All of them were shot dead except my patient who escaped, came and settled down in Bombay. She had mental depression, h/o abortion, leucorrhoea, brownish patch on face, etc. When I asked, "Since when are you worse?", she said, "Since my own people were shot in front of my eyes". A curious case I was once consulted for a small child, aged 3 years, suffering from dropsy due to renal failure. The child had been admitted in a leading Bombay hospital, but her condition became worse. So she was discharged from the hospital and brought to me directly. I gave her some medicines and she became all right. About 8 years later, when she was aged about 11 years, there was a relapse of the dropsy. I was consulted again and I have her Colchicum and some other remedies with some relief. But one day her condition became serious and she developed swelling of the face, ascites and general anasarca and her condition looked hopeless. I gave her Sulph. 1M b.d. as her constitutional remedy and also Digitalis 3x t.i. d. for the dropsical condition. But I told the parents that I had no hope. They gave these medicines for 3 days with no relief. But they continued the same medicines and after 6 days she started passing more urine. In fact, she started passing urine so profusely that every act of passing urine itself continued for nearly 5 minutes. They still continued the same medicines and after 15 days she became much better. Rather, she began to look dehydrated; she became thin and her skin started hanging loose. The medicine was then stopped. After one month, there was a relapse but a repetition of the same medicines, in the same doses cured her completely. She is now well for many years. Lachesis Once I was consulted for the father-in-law of Dr. B., an M.B. B.S. doctor. This gentleman, aged 80 years, had been involved in an accident and had a serious head injury. He became unconscious and was taken to the hospital. There he developed difficulty in swallowing also. It was a case of compression and so they wanted to operate on him but did not do so because of his old age and poor general condition. Mrs. Dr. B. came to me with this report and I prescribed for her father Lachesis on the symptoms "Injury to head", "Unconsciousness" and "Swallowing, difficult". They gave him Lach. 1M every hour. After the second dose, he became conscious, could recognise people and could swallow but could not talk. The same remedy was continued and he remained conscious for 3 days. After that he lapsed into unconsciousness again. On the symptoms told to me I then prescribed Opium but there was no improvement and he ultimately succumbed. Calcarea carb. Calc. has got a peculiar symptom, i.e. constipation amel. If you get this symptom, you are lucky. One lady told me after I had treated her for some weeks, "Do not treat me for my disease, Doctor. Please give medicine only to constipate me. If I remain constipated, I will be all right." I did not know whether I should feel humiliated or happy. I gave her Merc-s and she was cured. Calc-c, Merc-s, and Pso.; these three remedies cover this symptom.

Skin manifestations - eczema The general principle of Homoeopathy is that the remedy should be selected on the totality of the symptoms. This principle is applicable to all diseases. In fact, there is no disease to which this principle is not applicable. In this totality of symptoms, we generally give greater importance to the general symptoms than to the local ones. But it has been my experience that particularly in skin conditions, the local symptoms are also important in selecting the remedy. In fact, in many cases of skin diseases I have been led to the remedy by the local symptoms. In some, I have selected the remedy only by the local symptoms and have succeeded. Therefore, in cases of skin disease I insist on examining the patient. For example, in a case of ulcer, the colour of the ulcer, the discharge, its nature, its border, whether there is bleeding, etc., these points may help us in deciding the remedy. In skin diseases we are generally very successful as compared with the poor results of allopathy. Recently an eminent skin specialist came to me and said, "Dr. Sankaran, you have been treating a number of my patients with your medicines but you did not know that they were my patients. I was watching them and I must say your medicines are able to produce wonderful results. So, I want to send you some more cases." I suggested to him that I would rather give him the books so that he can study Homoeopathy and prescribe for the patients himself, to which he said, "No! No! I don't want all this headache. I will send them all to you. Please treat them yourself." This shows how Homoeopathy is effective even as noted by an independent specialist who was observing the cases without our knowledge. Generally, it is my experience that I find aggravation in some skin diseases so that when I treat skin conditions, I am ready for an aggravation though I do not usually expect an aggravation in other diseases. This aggravation of skin diseases is specially worse with the use of high potency. But this aggravation may be necessary to cure the disease. Of course, you will have to slowly prepare the patient for it. An interesting case A few months back, I was called to see Baby M. The mother of this child, a young lady of 25 years, was a diabetic. This was the first child. The second day after birth, the child had developed convulsions. A child specialist was called in who diagnosed the condition as due to hypoglycaemia resulting from the insulin injection given to the mother during labour. Therefore, the child was treated with I.V. glucose. Perhaps a little glucose came out of the vein, this resulted in a big swelling at the site of the injection. So the needle was transferred to the other hand. But here also the same thing happened. Next day the child developed ulcers on the spots where the I.V. injections had been given, with black pus. When the pus was examined microscopically it was found to be due to the organism B. pyocyenus. For the treatment of this infection some special injections were ordered from England and were given to the child. But there was no improvement. On the other hand, the child developed bronchopneumonia. Therefore, the child was given some antibiotic injections but again there was not much improvement. The child used to cry at night and at this stage the lady doctor, a well-qualified gynaecologist who was attending on the child night and day and had spent many sleepless nights, consulted me. But two hours previously a child specialist had come and examined the child and had told them that there was no hope and that it was a question of a few hours. So it was in this atmosphere of gloom that I went and examined the child. I found the following symptoms: Ulcers, deep, black on both the wrists; pustular eruptions in both arms and legs, some desquamating; abd. distended; forehead blackish; face becomes blue on crying; crying more

in evening and a night; trembling of hands. Auscultation revealed rales in both bases. I encouraged the parents and dissipated the gloomy atmosphere. On the symptoms I found, I gave the child Cup. 30, 3 doses and followed this with Ant-a 30. In a few days, the child improved considerably. The deep ulcers healed completely leaving a long but superficial scar. Now the child has grown very well and has no complaint except occasional diarrhoea. Its general health and general condition are quite good, complexion has improved and his health is much better. He has put on weight and remains well. A few months back, I was called to see Baby M. The mother of this child, a young lady of 25 years, was a diabetic. This was the first child. The second day after birth, the child had developed convulsions. A child specialist was called in who diagnosed the condition as due to hypoglycaemia resulting from the insulin injection given to the mother during labour. Therefore, the child was treated with I.V. glucose. Perhaps a little glucose came out of the vein, this resulted in a big swelling at the site of the injection. So the needle was transferred to the other hand. But here also the same thing happened. Next day the child developed ulcers on the spots where the I.V. injections had been given, with black pus. When the pus was examined microscopically it was found to be due to the organism B. pyocyenus. For the treatment of this infection some special injections were ordered from England and were given to the child. But there was no improvement. On the other hand, the child developed bronchopneumonia. Therefore, the child was given some antibiotic injections but again there was not much improvement. The child used to cry at night and at this stage the lady doctor, a well-qualified gynaecologist who was attending on the child night and day and had spent many sleepless nights, consulted me. But two hours previously a child specialist had come and examined the child and had told them that there was no hope and that it was a question of a few hours. So it was in this atmosphere of gloom that I went and examined the child. I found the following symptoms: Ulcers, deep, black on both the wrists; pustular eruptions in both arms and legs, some desquamating; abd. distended; forehead blackish; face becomes blue on crying; crying more in evening and a night; trembling of hands. Auscultation revealed rales in both bases. I encouraged the parents and dissipated the gloomy atmosphere. On the symptoms I found, I gave the child Cup. 30, 3 doses and followed this with Ant-a 30. In a few days, the child improved considerably. The deep ulcers healed completely leaving a long but superficial scar. Now the child has grown very well and has no complaint except occasional diarrhoea. Its general health and general condition are quite good, complexion has improved and his health is much better. He has put on weight and remains well. Diabetes I have treated some case of diabetes mellitus and my experience is good. There was a professor from I.I. T. Kanpur. He was chronic diabetic and he was taking regularly 60 units of insulin every day. When he came here, I took his case and prescribed the medicine. I remember his medicine was Arsenic. He went back to Kanpur and started taking the medicine. On the next day he felt a little giddy and the doctor there said this was due to hypoglycemia. So they reduced the dose of insulin to 40 units. The next day again he had vertigo, again the insulin was reduced to 20 units. On the third day he still felt uneasy, so the insulin was stopped. But yet the same process repeated and so they increased his quantum of food, and then he felt better. This all happened within a week. They had to reduce the dose of insulin daily. He was taking two or three doses of Arsenic 6 daily.

Another case of diabetes was on insulin. I put him on Phos-ac. With the help of this medicine, he was able to get rid of the insulin. Now he is completely all right. So I have had this experience in six or seven cases like that and I have found that if there are no clear symptoms, Phos-ac is a good remedy. I give 6th potency twice a day. After we start the medicine within two days the patients feel stronger and better. I must mention my earliest experience of diabetes. I had a relative of mine who was a severe diabetic with diabetic neuritis. This relative had illtreated very badly his wife, who was a girl from our family. So I did not have cordial feelings for him. Once he consulted me casually while I was attending a marriage and equally casually without taking his case, I prescribed for him Phos-ac 3, b.d. When I met him many years later, I was surprised to know that with the help of this Phos-ac, he not only got rid of his diabetic neuritis but even the diabetes itself so that he was enjoying every type of food including sweets. This case was a real eye-opener to me. My general policy is to put the diabetic patients on homoeopathic medicines, and gradually discontinue and stop the other medicines. Our medicines seem to act in spite of all those drugs. Arthritis Shree E.H. A.P. , aged 67 years, turned up for consultation on 4th Aug. 1971. He has got pain in knee joints, left leg, toes and shoulders. Pain in knees is agg. rising from a seat, agg. ascending. He cannot squat. Pains are agg. in winter. Feels stiffness in joints on rising in morning, amel. after movement. Stiffness in nape of neck, agg. turning the head. Feels mucus in throat at night. Appetite, thirst, etc., normal. Past Hist.: 3 years back had sciatica on left side for six months; used to get burning in calves. Had undergone mastoid operation in youth. Fam. Hist.: Aunt and cousins had cancer. One cousin had tuberculosis. His case was repertorized in Kent's Repertory and Phatak's Repertory as follows: Motion, beginning, agg. (Ph.p. 182) + Old age (Ph.p. 200) = Ambr., Con., Lyc., Phos., Syph. + Throat, mucus (K.p. 456) = Ambr., Con., Lyc., Phos. + Ascending agg. (Ph p. 15) = Phos. Phos. 30, 14 doses b.d. given 21.08.71: Feels amel. after a severe agg. for one day. He had diarrhoea but felt amel.. Placebo given. 04.09.71 : Feels amel. but gets pain and stiffness in morning. Shooting pain in left toes. Phos. 200, 3 doses, t.d. s. for one day and placebo given. 18.08.71 : Pain amel. last 2 days; pain in Poplitlal fossa. Pain nape and neck turning head. Phos. VI (i.e. 6th potency of 50 millesimal scale) one dose. 21.09.71 : Knee joints are stiff and painful cracking in neck. Neck pain agg. moving head. Severe pain in hollow of knee on rising from sitting. Kent gives in his Repertory only one remedy under the rubric "Extremities, Pain, hollow of knee, rising from a seat" and that remedy is Ars-h. So, the patient was given:

Ars-h 6, 24 doses b.d. 02.10.71 : Feels considerably better all round. Medicine repeated. 30.10.71 : Medicine was continued in the same way as he was feeling better and better Carcin. 1M, 3 doses t.d. s. were given in between when the improvement was not continuous. He improved in all respect in all his symptoms and his last report was that he was feeling "exceptionally well" in all ways. Shree E.H. A.P. , aged 67 years, turned up for consultation on 4th Aug. 1971. He has got pain in knee joints, left leg, toes and shoulders. Pain in knees is agg. rising from a seat, agg. ascending. He cannot squat. Pains are agg. in winter. Feels stiffness in joints on rising in morning, amel. after movement. Stiffness in nape of neck, agg. turning the head. Feels mucus in throat at night. Appetite, thirst, etc., normal. Past Hist.: 3 years back had sciatica on left side for six months; used to get burning in calves. Had undergone mastoid operation in youth. Fam. Hist.: Aunt and cousins had cancer. One cousin had tuberculosis. His case was repertorized in Kent's Repertory and Phatak's Repertory as follows: Motion, beginning, agg. (Ph.p. 182) + Old age (Ph.p. 200) = Ambr., Con., Lyc., Phos., Syph. + Throat, mucus (K.p. 456) = Ambr., Con., Lyc., Phos. + Ascending agg. (Ph p. 15) = Phos. Phos. 30, 14 doses b.d. given 21.08.71: Feels amel. after a severe agg. for one day. He had diarrhoea but felt amel.. Placebo given. 04.09.71 : Feels amel. but gets pain and stiffness in morning. Shooting pain in left toes. Phos. 200, 3 doses, t.d. s. for one day and placebo given. 18.08.71 : Pain amel. last 2 days; pain in Poplitlal fossa. Pain nape and neck turning head. Phos. VI (i.e. 6th potency of 50 millesimal scale) one dose. 21.09.71 : Knee joints are stiff and painful cracking in neck. Neck pain agg. moving head. Severe pain in hollow of knee on rising from sitting. Kent gives in his Repertory only one remedy under the rubric "Extremities, Pain, hollow of knee, rising from a seat" and that remedy is Ars-h. So, the patient was given: Ars-h 6, 24 doses b.d. 02.10.71 : Feels considerably better all round. Medicine repeated. 30.10.71 : Medicine was continued in the same way as he was feeling better and better Carcin. 1M, 3 doses t.d. s. were given in between when the improvement was not continuous. He improved in all respect in all his symptoms and his last report was that he was feeling "exceptionally well" in all ways. Your questions Q. In Boger's Synoptic Key, in the repertory section, under Generalities there is a rubric "Associated effects". Can you please explain what this means? A. This question was referred to Dr. S.R. Phatak who is extremely well-versed with this book. His answer is as follows. The rubric "Associated effects" should be taken and the drugs given

therein considered if the patient has two concomitant unrelated symptoms, appearing simultaneously, where this combination of symptoms are not found in the repertory or Materia Medica, e.g. if a patient has headache and urinary troubles coming on together. Where one symptom precedes another and is not occurring together simultaneously, this rubric is not to be considered. Arthritis What do you mean by cure? If cure means relief for very long periods without recurrence, I think we can cure. If you mean by cure that there should be reversal of the pathological changes seen by radiology, then we may not be able to cure. I have treated one patient from Surat, aged 65 years, who was suffering from osteo-arthritis for over ten years. He is completely free from discomfort for the last six years without any medicine. In a broad sense this can be called a cure. Lyc. was the remedy. The need for scientific work Quality of work, whether of the individual or of the institution is extremely essential for the growth and progress of any science. Hitherto we have been demanding various rights, privileges, etc., from others but hereafter we should make demands on ourselves - to adopt a proper attitude and to improve the quality of our work. Homoeopathy is of course an excellent system of treatment but we have still to bring out in practical application its vast and fantastic potentialities. I am sad to confess that our general level of practice is still quite poor. In my estimate - I may be wrong and I do hope I am wrong - in the whole of India among the hundreds of thousands of homoeopaths, we may not have even a hundred persons who can be called excellent homoeopaths. It is perhaps the greatness of the system that even our average and mediocre practitioners are able to achieve some kind of good results which keeps up the name and prestige of Homoeopathy. But if we are to really advance the science, we should avoid irrelevant talk, useless show and disastrous fratricidal in-fighting and start working silently, sincerely, steadily and scientifically. We shall then relieve and cure many cases and thus demonstrate to the public unequivocally that Homoeopathy is indeed the real system of cure. This will involve hard work, proper methods of keeping records, proper methods of application, etc., for which we should prepare ourselves. Now I shall discuss some specific points. Though the principles of case taking and remedy selection have been laid down clearly by Hahnemann and have been further elucidated by his great followers, some of the cases reported in the Indian Homoeopathic journals are rather unsatisfactory. If they reflect the general level of practice then the level of practice itself must be considered unsatisfactory. Cases are described with insufficient data and random reasons are given for the remedy selection. Often no reasons are given. Sometimes cases are reported in which several remedies have been administered quickly one after the other or at times even together. The reader can only become confused. Naturally, one expects that the leading homoeopathic practitioners who have surely assimilated the principles and methods of this system and who are certainly curing many cases creditably would give a lead in this matter and come forward and report some of their cases in our journals. Such reports can enthuse and encourage the other practitioners, illustrate the efficacy of Homoeopathy and also prove to be models for others to know how cases are to be recorded, treated and reported. But we find that the leaders of our profession

have failed to do this. Very rarely do we see them reporting their cases, experiences or impressions. No doubt they are extremely busy but the reporting of cases successfully treated by them is also part of their work. Surely, they are as much committed to science as to their own practice. This astonishing apathy of our leaders contrasts strongly with the enormous vitality, activity and service to their science rendered by the leaders of the allopathic profession. Though they are also quite hard-worked, at the same time those leaders read a lot, teach, write, report, do research, etc., and do it all most systematically in their own way. I must also mention some case reports published in some of our journals in which extremely unorthodox methods of practice are reported under the heading of research. Research does not mean haphazard application of the principles and methods. It involves carefully conducted experiments in which every step is meticulously planned and carried out, and every fact and factor is taken into consideration in the final assessment so that very logical and unquestionable conclusions can be drawn from the experiments. But in our field the fundamental criteria of research are often ignored, incorrect data are mixed up and work is done at random to reach doubtful or false conclusions. We have to tackle and solve numerous problems in our field such as the nature of the homoeopathic potency, the standardisation of homoeopathic potencies, the discovery of specific rules for the selection of the proper potency and for the repetition of doses, the delineation between medically curable conditions and those which require surgical means, the discovery of a method by which the similimum can be selected with greatest surety, etc., etc. For this purpose we shall have to pool all our scientific skills. But we have not, it seems, learnt the art of collective observation and collective thinking. By contrast we find thousands of scientific papers appearing in allopathic journals. Someone reports some experience or treatment or puts up a hypothesis and within a short period many others make other observations or trials to confirm or negate this hypothesis. Pooling of knowledge and experience thus goes on and it helps to promote their science enormously. We should take a lesson from them in this point, make consistent and persistent studies and combine the results of our experiences to build up a sum-total of knowledge. I have only touched on some points to indicate how far away we are from the scientific route and how to move in the right direction. Value of the nosodes We have read in our books and we have seen in our practice that when a person has suffered from some acute infectious disease or has a family history of an infectious disease, the nosode of that particular disease is able to help. Dr. Foubister thinks that even if the patient does not say definitely that he has not been well since that infectious disease, if he has suffered from a severe attack of that disease, the patient benefits from the nosode. Further, he says that if a patient reports of having had several different acute infections (say five or more) in his childhood, then the remedy Carcinosin will be useful. Now, the question arises as to how many doses of the nosode will be required to set right the condition. Supposing a person has a family history of Tuberculosis, will one dose of Tub-bov suffice to remove the illeffects of that inheritance? Supposing he gives a history of having not been well since an attack of mumps, will one dose of Parotidinum clear up his case? Or will it require several doses? I am afraid that we will have to make a number of observations on patients before we can arrive at any positive conclusion.

The second doubt I would like to raise is this. If a patient has a family history of tuberculosis or cancer, is it necessary that he should receive the nosode of that disease before he will improve on his remedy? This point also requires much study. Mercury I would like to report a recent case treated by me. The patient was a boy aged 10 years. He was having nocturnal enuresis. He would pass urine in bed but continue to sleep over it. The urine was generally offensive. Sometimes he would pass urine involuntarily even in daytime and sometimes he was not even aware that he had passed urine. I repertorized his case, taking the symptoms "Urination, involuntary, in bed", "Urination unconscious", "Urine offensive", and found Merc-s alone coming through. Merc-s put him all right. Phimosis Phimosis in children - should it be treated medically or surgically? I can tell you that originally I was taught and so I used to believe that phimosis is a surgical condition. But I had chances to treat three or four patients with phimosis. They had retention of urine, pain , etc. Even though they were all relieved with homoeopathic medicine, I had advised the parents to have the children operated. They, for various reasons, postponed the operation and went on giving the medicine whenever there was trouble. The boys have grown up but they have no trouble at all. Therefore, I am nowadays thinking seriously that phimosis is medically curable with homoeopathic medicines. Natrum muriaticum Once I was treating a child for some complaints. As the improvement was slow I consulted Dr. Phatak. The parents had given the history that when the child was born he had not cried for a long time so much so that the doctor had been seriously worried. On this indication Dr. Phatak prescribed Nat. mur. There was very good improvement in the child's health. I asked him how this can be taken as an indication because the Nat. mur. patient is sad but cannot cry. To this he replied that when the child was expected to cry, it did not cry. This is an indication of Nat-m. Then he asked me jokingly, "How do you know the child was not sad?" Perhaps it is so. I remembered that the child's first cry is said to be a cry of protest because it is pushed out from a cushy warm environment into a cold cruel world. In another case the symptoms were practically contradictory and hopelessly mixed up. Boger gives an indication under Nat-m, "Thin, thirsty and hopeless". Giving a broad interpretation of this word "hopeless", Dr. Phatak prescribed Nat-m which gave relief to the patient. Materia medica While going through Hering's Guiding Symptoms, I noted that Nat-m has got a crack on both the upper and lower lips, whereas all the Materia Medica people only emphasize the crack in the middle of the lower lip. I wonder why they have omitted the crack in the middle of the upper lip. By the way, I also wonder how the various Materia Medica compilers pick out and give some particular symptoms out of the large group of symptoms found in the provings. I wonder what is their criteria of selection. Incidentally the biochemic practitioners, I think, use Nat-m extensively. Biochemic people say that Nat-m is the remedy for disturbances of fluids, either excessive fluidity or dryness, e.g. lachrymation, diarrhoea, constipation, etc. There is lachrymation or weeping with laughter or laughter ending in weeping.

Homoeopathy in emergencies I shall give you another case. There is a good friend of mine, a renowned E.N. T. surgeon. I had treated his wife for sinusitis. She was completely cured. One day his mother a gynaecologist, aged 72 years, became ill and gradually went into uremic coma. Her blood urea went upto 120 mg. Her general condition was going down. Several physicians had come and had said that nothing could be done. The lady suddenly opened her eyes and said, "Call a homoeopath", and then, went back into coma. She had great respect for Homoeopathy. So, I was called, I examined her pupils. They were pinpointed. They pin-pointed the remedy to me. I gave her Opium 1M. Within 10 minutes her pulse improved and the B.P. improved. In one or two hours she passed urine and became completely all right; 21/2 years later she died of something else. This impressed that E.N. T. specialist so much that when his mother-in-law got a heart attack in Bhavnagar he wanted me to go and prescribe for her. As we could not get seats in the regular flight, he tried to charter a plane to take me there! Importance of pathology Pathology has become a highly developed science and we are now aware of many minute tissue changes that occur in diseases. This knowledge can be utilised and integrated into our system as far as possible to explain and illustrate our principles and approach. Again you will notice that we get nowadays a number of cases where the pathological aspect predominates. We cannot tell a patient, "Since you have only pathological symptoms, we can not treat you". We must be prepared to treat the patient at any stage of the disease. This is why Boericke and Boger, in their books on Materia Medica, have given a number of pathological indications for various remedies. And Boger was not only one of the most successful homoeopaths of this century but one who had assimilated the principles of Homoeopathy thoroughly. Therefore, I think we must allow the pendulum to move to the other side and give importance to pathology at least where other symptoms are not available. If characteristic symptoms are available don't take pathological symptoms. But if they are not available, do consider the pathological symptoms. Hernia and hydrocele In considering this subject I had three points in mind. One is to know 1. whether hernia and hydrocele can be cured by Homoeopathic medicines, 2. and if so, can they be cured unconditionally? - By unconditionally I mean whatever the age of the patient, the degree of the lesion, etc. - 3. thirdly, if we are not sure about it but we think medical treatment should be tried, how long shall we try it and when shall we say, "Now this case is not curable; it is better to go for surgery"? I ask these questions because in many cases of hernia and hydrocele I have taken the case most carefully but I could not find real symptoms to prescribe upon. Is it worthwhile prescribing only for the hernia or hydrocele without any other symptom or is it better to tell the patient, "I am sorry I don't find any symptoms. You better go for surgery"? These are my doubts. When I say hernia, I am mostly referring to inguinal hernia. I find very good results in hiatus hernia. In many cases of strangulated hernia, I find quick and complete relief with homoeopathic medicine. Formerly we were taught in the college that in strangulated hernia if you do not operate immediately, the bowel will become gangrenous and that the patient may die and so on. And so, initially, I was always afraid of handling these cases. But after reading

and hearing many reports of cures, I also treated many cases with extraordinarily good results. So I have no fear nowadays. About hydrocele, I want to mention a funny experience of mine. Many years back when I was just starting my homoeopathic practice, I had been to South India to attend a marriage. Someone casually consulted me in the marriage for his stomach trouble. He told me only that he had much trouble of flatulence between 4 and 8 in the evening. I did not ask any question. I merely prescribed Lyc. 30, 1 dose to be taken once a month. (In those days I was very conservative about potency and repetition). He purchase the medicine and took one dose per month for one year and became all right. It seems, he had previously taken treatment for four years for suspected amoebic colitis and he said he had spent so far Rs. 800 (because he could afford only Rs. 800!) without any relief but this medicine costing 4 annas completely cured him! He wrote to me thanking me and mentioned with surprise that a very big hydrocele that he had been having had also disappeared! His friends used to tease him saying that wherever he goes as a clerk, he did not require a table - so big was the hydrocele. The funny thing was that he had not mentioned to me about the hydrocele. If he had told me then I might have asked him to get it operated. Some cases Herpes zoster This happens to be my own case. Early this year I was planning to go abroad. While making preparations I got myself vaccinated to conform to the travel regulations. Normally vaccination produces no effect on me but this time for some unknown reason, I got inflammation and suppuration of the vaccinated spots. They formed ulcers and then they healed very slowly taking in all about three weeks. One week after they had healed there was itching in the spots followed by suppuration again which subsided only after I took one dose of Thuja and one dose of Malandrinum. Even though the ulcers healed, they left behind depressed discoloured scars but there was still itching sensation in these scars which continued on and off. A few days later, we left for the U.S. A. and after three weeks in the States we went on to Europe. While in Paris I developed a slight swelling of the glands in the right side of the neck with pain. I ignored this and went on to Switzerland and there I developed numerous small painless eruptions on my chin. I did not take any medicine but the painless eruptions spread slowly over the right side of the face affecting my forehead, head, ears, neck, etc. Still, I ignored it and went on to Vienna to attend the International Homoeopathic Congress. But, while I was proceeding by train from St. Gallen to Vienna, I started getting pains in all these eruptions. These pains increased very rapidly and became extremely severe so that it made me restless and sleepless in the train. By the time I reached Vienna, the pains had become unbearable and I spent the day in Vienna in severe suffering. As it was a Sunday, I found all the pharmacies closed. So I got the address of Dr. Dorsci, the General Secretary of the Congress and reached his house. There, an important meeting of German homoeopaths was going on but Dr. Dorsci was kind enough to meet me. But I was not in a state of mind to enjoy anything. I requested him to give me some doses of Ran-b 200, which he was kind enough to give me at once. But this medicine did not relieve me.

Next day I was glad to meet my friend Dr. Jugal Kishore from India who prescribed for me Puls. on the basis of the symptoms I gave him but this remedy also did not give any relief probably I could not give him a clear picture. I could not get any homoeopathic reference books in English nor any high potencies of homoeopathic medicines. For three days and three nights, I suffered unbearable agony. Thereafter, I decided to leave Vienna. I flew to Split in Yugoslavia where I joined my wife and son. Even here homoeopathic medicines were not available. I was nearly mad with pain and so my kind and anxious friends there insisted on calling a local doctor. This doctor prescribed for me some antibiotic. I took this for two days and the pain became a little less but I completely lost my appetite and developed nausea. So, I stopped the medicines. Then we came back to Bombay via London and New York. After reaching Bombay I studied my symptoms which were as follows: Big crusty painful eruptions all over the right side of the face and head with severe stitching pains. The pains were as if a big brush made of red-hot needles was being thrust into my face and head every second. Severe shooting pain in the ear and on the face on the rt. side. Severe itching and formication all over the rt. side of the face and head. Severe burning pain in the face (right side) which was worse by warmth and covering, and better by cold. Application of cold water relieved the burning pain but increased the stitching pains. The burning would be worse by covering the face, while on uncovering the stitching would be worse. All pains were worse by lying down and worse at night. On the basis of the above symptoms, I selected for myself the remedy Mez. and I took Mez. 1M, four times a day. I felt 50% better in one day and 90% better in three days. I had to take also three doses of Mez. 10M; then I felt 95% better. But there was slight residual pain for about three days. Then, I consulted Dr. S.R. Phatak and he prescribed for me Variol. 200. This completely removed all the remaining pain. The eruptions had left behind black scars on the face, chin and cheeks but these also gradually disappeared. I have the feeling that this attack could have been due to the vaccination which I had taken before my departure and which had troubled me even before my departure. After the doses of Mez. and Variol., not only the pains of herpes disappeared but also the itching in the vaccination scars and the scars themselves which had been depressed became normal in shape and their colour also became that of normal skin. While making preparations I got myself vaccinated to conform to the travel regulations. Normally vaccination produces no effect on me but this time for some unknown reason, I got inflammation and suppuration of the vaccinated spots. They formed ulcers and then they healed very slowly taking in all about three weeks. One week after they had healed there was itching in the spots followed by suppuration again which subsided only after I took one dose of Thuja and one dose of Malandrinum. Even though the ulcers healed, they left behind depressed discoloured scars but there was still itching sensation in these scars which continued on and off. A few days later, we left for the U.S. A. and after three weeks in the States we went on to Europe. While in Paris I developed a slight swelling of the glands in the right side of the neck with pain. I ignored this and went on to Switzerland and there I developed numerous small painless eruptions on my chin. I did not take any medicine but the painless eruptions spread slowly over the right side of the face affecting my forehead, head, ears, neck, etc. Still, I ignored it and went on to Vienna to attend the International Homoeopathic Congress. But,

while I was proceeding by train from St. Gallen to Vienna, I started getting pains in all these eruptions. These pains increased very rapidly and became extremely severe so that it made me restless and sleepless in the train. By the time I reached Vienna, the pains had become unbearable and I spent the day in Vienna in severe suffering. As it was a Sunday, I found all the pharmacies closed. So I got the address of Dr. Dorsci, the General Secretary of the Congress and reached his house. There, an important meeting of German homoeopaths was going on but Dr. Dorsci was kind enough to meet me. But I was not in a state of mind to enjoy anything. I requested him to give me some doses of Ran-b 200, which he was kind enough to give me at once. But this medicine did not relieve me. Next day I was glad to meet my friend Dr. Jugal Kishore from India who prescribed for me Puls. on the basis of the symptoms I gave him but this remedy also did not give any relief probably I could not give him a clear picture. I could not get any homoeopathic reference books in English nor any high potencies of homoeopathic medicines. For three days and three nights, I suffered unbearable agony. Thereafter, I decided to leave Vienna. I flew to Split in Yugoslavia where I joined my wife and son. Even here homoeopathic medicines were not available. I was nearly mad with pain and so my kind and anxious friends there insisted on calling a local doctor. This doctor prescribed for me some antibiotic. I took this for two days and the pain became a little less but I completely lost my appetite and developed nausea. So, I stopped the medicines. Then we came back to Bombay via London and New York. After reaching Bombay I studied my symptoms which were as follows: Big crusty painful eruptions all over the right side of the face and head with severe stitching pains. The pains were as if a big brush made of red-hot needles was being thrust into my face and head every second. Severe shooting pain in the ear and on the face on the rt. side. Severe itching and formication all over the rt. side of the face and head. Severe burning pain in the face (right side) which was worse by warmth and covering, and better by cold. Application of cold water relieved the burning pain but increased the stitching pains. The burning would be worse by covering the face, while on uncovering the stitching would be worse. All pains were worse by lying down and worse at night. On the basis of the above symptoms, I selected for myself the remedy Mez. and I took Mez. 1M, four times a day. I felt 50% better in one day and 90% better in three days. I had to take also three doses of Mez. 10M; then I felt 95% better. But there was slight residual pain for about three days. Then, I consulted Dr. S.R. Phatak and he prescribed for me Variol. 200. This completely removed all the remaining pain. The eruptions had left behind black scars on the face, chin and cheeks but these also gradually disappeared. I have the feeling that this attack could have been due to the vaccination which I had taken before my departure and which had troubled me even before my departure. After the doses of Mez. and Variol., not only the pains of herpes disappeared but also the itching in the vaccination scars and the scars themselves which had been depressed became normal in shape and their colour also became that of normal skin. Addiction to dexedrine Mrs. M.S. turned up for consultation on 5th Jan. 1970 with the following complaints: For last 20 years, she has been addicted to dexedrine and methedrine. Used to take 100 dexedrine tablets per day (as she and her husband told me). Got low blood pressure. When

these drugs were not available she became irritable, aggressive, restless, violent and felt like killing somebody. When she became violent, she would resist with the strength 20 persons. Was sleepless for a long time while she was taking the drug. Now, gets palpitation, sinking feeling, restlessness and vomiting of bitter fluid. Feels that she will die. Palpitation is agg. sitting, agg. walking agg. 1 p.m. to 4 p.m. and on lying down; she cannot bear hunger, cries when hungry; likes warm, spicy food, cold drinks and extra salt. Constipated. Feels drowsy all the time. Menses regular. She is now married a second time. She was upset as her first husband was giving her a lot of trouble and tried to make her insane. Was given electric shocks when she was nervous. She is afraid of being alone, of ghosts, thunderstorm, earthquake, darkness, death and sudden noise. Twice she tried to commit suicide. Weeps easily, contradiction makes her angry. She gets offended easily; emotional; jealous; puts on weight easily. Fam. Hist.: Her mother had tuberculosis. Her case was repertorized in Kent's Repertory as follows: Fear, alone of being (p. 43) + Fear, ghosts, of (p. 45) = Ars., Bell., Brom., Dros., Kali-c, Lyc., Phos., Puls., Ran-b, Sep., Stram. + Fear, death of (p. 44) = Ars., Bell., Kali-c, Lyc., Phos., Sep., Stram. + Fear, thunderstorm, of (p. 47) = Phos., Sep. + Suicidal disposition (p. 85) = Phos., Sep. + Desires, salt things (p. 486) = Phos. + Fasting, while (p. 1365) = Phos. Nux-v 1M, 8 doses were given to be taken every 4 hours to remove the effects of the drugging. She felt slightly better. Then Phos. 1M, 8 doses given to be taken every 4 hours. With these doses she felt amel.. Thereafter, Phos. 1M was given as and when necessary. She went on feeling much better with Phos. and she was able to completely give up the addiction of dexedrine tablets. Mrs. M.S. turned up for consultation on 5th Jan. 1970 with the following complaints: For last 20 years, she has been addicted to dexedrine and methedrine. Used to take 100 dexedrine tablets per day (as she and her husband told me). Got low blood pressure. When these drugs were not available she became irritable, aggressive, restless, violent and felt like killing somebody. When she became violent, she would resist with the strength 20 persons. Was sleepless for a long time while she was taking the drug. Now, gets palpitation, sinking feeling, restlessness and vomiting of bitter fluid. Feels that she will die. Palpitation is agg. sitting, agg. walking agg. 1 p.m. to 4 p.m. and on lying down; she cannot bear hunger, cries when hungry; likes warm, spicy food, cold drinks and extra salt. Constipated. Feels drowsy all the time. Menses regular. She is now married a second time. She was upset as her first husband was giving her a lot of trouble and tried to make her insane. Was given electric shocks when she was nervous. She is afraid of being alone, of ghosts, thunderstorm, earthquake, darkness, death and sudden noise. Twice she tried to commit suicide. Weeps easily, contradiction makes her angry. She gets offended easily; emotional; jealous; puts on weight easily. Fam. Hist.: Her mother had tuberculosis. Her case was repertorized in Kent's Repertory as follows:

Fear, alone of being (p. 43) + Fear, ghosts, of (p. 45) = Ars., Bell., Brom., Dros., Kali-c, Lyc., Phos., Puls., Ran-b, Sep., Stram. + Fear, death of (p. 44) = Ars., Bell., Kali-c, Lyc., Phos., Sep., Stram. + Fear, thunderstorm, of (p. 47) = Phos., Sep. + Suicidal disposition (p. 85) = Phos., Sep. + Desires, salt things (p. 486) = Phos. + Fasting, while (p. 1365) = Phos. Nux-v 1M, 8 doses were given to be taken every 4 hours to remove the effects of the drugging. She felt slightly better. Then Phos. 1M, 8 doses given to be taken every 4 hours. With these doses she felt amel.. Thereafter, Phos. 1M was given as and when necessary. She went on feeling much better with Phos. and she was able to completely give up the addiction of dexedrine tablets. Some thoughts on research in homoeopathy There is always scope for improving the practical application and methods of our science and, for this purpose, research is constantly required. Research is also required to illuminate certain aspects of our science and art which are still in shadow areas. To mention a few: better and simpler ways of evaluating symptoms and selecting the medicine, some tests to verify if the remedy selected is really the correct one, rules for selection of the proper potency, rules for the repetition of the dose, the identity of the nature of the homoeopathic potency, whether various items of diet interfere with the action of the homoeopathic remedy, the value of homoeopathic prophylactics, the scope and value of the remedy given by injection, the scope for alternating or combining remedies, etc., are only some of the points which require research before they can be correctly evaluated. While the requirements of research are extremely rigid and strict and permit no compromise, the facilities and funds available in India for research in our field are very limited. Besides, the talent available is also limited. If real research is to be attempted, this will require concentrated and full-time attention of the research worker who should be very learned, conscientious, intelligent and industrious. Full-time availability of such workers is extremely doubtful because the remuneration which we are able to afford to such workers is very low and will not attract the persons of the proper caliber, to whom practice affords a much more attractive alternative. Therefore, some institutions engage part-time research workers and even then, some of these are even not well qualified and fitted for this difficult task. Such part-time workers, unless they are extremely dedicated to their work, will naturally prefer to pay more attention to their private practice and, therefore, the research work will suffer. The results of such research work may then turn out to be haphazard, unreliable or useless. Besides these factors, one will have also to take into account the attitude of the research worker. A good research worker must be conscientious, truthful and objective. He has to announce the results of his research as he finds them, irrespective of whether they confirm his hypothesis or not. Human nature being what it is, unless a research worker is extremely well-trained in this discipline, he may try to exaggerate or even falsify the records in order to make his conclusion more acceptable. This, of course, will have the most damaging effect on science. Therefore, before accepting the results of the research done, it will be necessary to have an independent assessment of the work done by persons who are not affected by the

results of this assessment. I may suggest that, on the national level, the Government of India must consider appointing an independent body to assess the research work done by various persons or organisations, including the various units engaged in research under the auspices of the Central Council of Research in Indian Medicine and Homoeopathy. Even the individual practitioner can contribute to the total quantum of knowledge if he is observant and honest and reports his experience and results truthfully. Unfortunately, we do not find even a good series of cases reported in our journals even though we proudly boast of having thousands of practitioners in our country. I am afraid that even the leaders of our profession are guilty of this neglect. The subject of research is a gargantuan subject and it is difficult to deal with it in a detailed way here. I have mentioned a few points that should be considered by every person who is concerned with this subject. Case Teratoma Master J.K. , aged 12 years, was brought to me for consultation on 13th Dec. 1969 with the following history: A lump was noted in the abdomen by the parents in June 1969. It was not given much importance since the child never complained of it. Incidentally the child developed an abscess in the ant. abdominal wall, which was incised and the wound healed within one week. Then, the child started having fever and diarrhoea in Sept. 69 for which a physician was consulted and this time a retroperitoneal fixed lump (more on right) was detected which was thought to be a retroperitoneal teratoma. Urine and blood examination, plain X-ray, chest and the abdomen were consistent with the diagnosis of R.P. teratoma. An exploratory laparotomy was done by a transperitoneal approach and an attempt was made to remove the lump. But it could not be done since it was adherent to the rt. border and the inferior vena cava. A piece was taken for biopsy. Histological report showed it to be a Neuroblastoma. His appetite, thirst, etc., were normal. Sour oranges and chocolates caused pain in stomach and diarrhoea. When the tumour was growing he was very hungry, eating much but becoming thin. Past Hist.: Had teething diarrhoea. Fam. Hist.: His maternal grandmother had cancer of the breast. He is dragging his left leg since the operation. On exam. a medium hard tumour occupying the whole of the lower abdomen esp. the left iliac fossa and the hypogastrium was felt. His weight is 29 lbs. He has been given 3000 units of X-ray exposures. Rad. 30, 14 doses b.d. were given to antidote the ill-effects of the X-ray exposures. Thereafter, he was given Con. 30, 21 doses t.d. s. (Kent's Repertory gives under the rubric "Abdomen, Tumour, hard" only Con.) There was no improvement. So, on 09.01.70, Dr. S.R. Phatak was consulted and he prescribed Ars. alb. as it covered the symptoms "Malignancy", "Hardness" and "Lump in abdomen". Ars. 30 was given t.d. s. By 15.01.70 his general condition was amel., but size and consistency of the tumour was same. Under Dr. Phatak's advice the same medicine was continued but, till 26.02.70, there

was no improvement in the condition of the tumour. So the boy was given Calc-f 30, daily once. In a fortnight there was some change. So the same medicine was continued with further improvement. In the meanwhile the parent consulted the physicians in the Cancer Hospital and on their advice gave the boy another course of deep X-ray therapy. But the condition of the tumour remained the same and so they came back for homoeopathic treatment. Calc-f was given again first in the 30th and later in the 200th potency and by 10.07.71 the condition was normal. The lump disappeared and the boy increased in weight and general health. He continues to remain well 2 years later. Master J.K. , aged 12 years, was brought to me for consultation on 13th Dec. 1969 with the following history: A lump was noted in the abdomen by the parents in June 1969. It was not given much importance since the child never complained of it. Incidentally the child developed an abscess in the ant. abdominal wall, which was incised and the wound healed within one week. Then, the child started having fever and diarrhoea in Sept. 69 for which a physician was consulted and this time a retroperitoneal fixed lump (more on right) was detected which was thought to be a retroperitoneal teratoma. Urine and blood examination, plain X-ray, chest and the abdomen were consistent with the diagnosis of R.P. teratoma. An exploratory laparotomy was done by a transperitoneal approach and an attempt was made to remove the lump. But it could not be done since it was adherent to the rt. border and the inferior vena cava. A piece was taken for biopsy. Histological report showed it to be a Neuroblastoma. His appetite, thirst, etc., were normal. Sour oranges and chocolates caused pain in stomach and diarrhoea. When the tumour was growing he was very hungry, eating much but becoming thin. Past Hist.: Had teething diarrhoea. Fam. Hist.: His maternal grandmother had cancer of the breast. He is dragging his left leg since the operation. On exam. a medium hard tumour occupying the whole of the lower abdomen esp. the left iliac fossa and the hypogastrium was felt. His weight is 29 lbs. He has been given 3000 units of X-ray exposures. Rad. 30, 14 doses b.d. were given to antidote the ill-effects of the X-ray exposures. Thereafter, he was given Con. 30, 21 doses t.d. s. (Kent's Repertory gives under the rubric "Abdomen, Tumour, hard" only Con.) There was no improvement. So, on 09.01.70, Dr. S.R. Phatak was consulted and he prescribed Ars. alb. as it covered the symptoms "Malignancy", "Hardness" and "Lump in abdomen". Ars. 30 was given t.d. s. By 15.01.70 his general condition was amel., but size and consistency of the tumour was same. Under Dr. Phatak's advice the same medicine was continued but, till 26.02.70, there was no improvement in the condition of the tumour. So the boy was given Calc-f 30, daily once. In a fortnight there was some change. So the same medicine was continued with further improvement. In the meanwhile the parent consulted the physicians in the Cancer Hospital and on their advice gave the boy another course of deep X-ray therapy. But the condition of the tumour remained the same and so they came back for homoeopathic treatment.

Calc-f was given again first in the 30th and later in the 200th potency and by 10.07.71 the condition was normal. The lump disappeared and the boy increased in weight and general health. He continues to remain well 2 years later. The case was directed by an allopathic physician who was observing the case throughout and he expressed appreciation of the effect of Homoeopathy. The repertory and repertorizing Homoeopaths who don't use the repertory, prescribe only by virtue of their knowledge of drug pictures. These drug-pictures are quite good to give an idea but they are dangerous if you depend on them exclusively. They are typical drug-pictures with typical symptoms. But in quite a large number of cases we come across non-typical symptoms - symptoms not so wellknown or publicised but still indicating the remedy. A drug-picture is not a permanent picture. It can be a changing and variable picture. Suppose for instance somebody says about me, "Dr. Sankaran is a most jovial person, always cheerful and happy." This may or may not be true. Unless you see me closely and in all my moods you cannot have a complete picture of myself. I may be also irritable; I may be angry with my assistants when they make mistakes. You may not be aware of this. Similarly about drugs, if you say Puls. is always mild and gentle, you will be wrong. I know Puls. patients who are irritable at times. Suppose a patient says, "I feel better after sleep", you may say, "Lach. is out." It may not be "out". Lach. is also better after sleep. You must know it. You say Lyc. is rt. sided but Lyc. affects the lt. leg. You say Lach. is lt. sided but Lach. covers the rt. leg. In "Convulsions during menses", you may not think of Lach. But it can be Lach. You may have a rigid idea about a drug but this may not be confirmed by the repertory. The repertory gives a much better idea than the ordinary Materia Medica. If you take an ordinary Materia Medica, say Allen or Boericke, you may find a number of symptoms given under a remedy. But the remedy might have produced more than 1 000 symptoms. So, what the Materia Medica writer has done is to select about a 100 symptoms or so and put them in his book under the drug. So, it does not give you a complete idea of the drug. If you read one hundred symptoms of Lach., you may think you know all about Lach., but you do not, because it has produced 1 570 symptoms. You have to read the original provings in Allen's Encyclopedia or Hering's Guiding Symptoms to know the full remedy. But since most people do not have access to these books or the time to read them, they depend on the small books. Again, the repertory is not complete. Recently, I was reading Boericke's Materia Medica and I found under Am-m that the patient is sad but does not weep. For this symptom, Kent has given only two remedies, Gels. and Nat-m. So, you have to add Am-m. You will see numerous such additions possible and necessary. So you see that the repertory is imperfect; even Kent's Repertory is imperfect. That does not mean that you should not use the repertory. Knowing the limitations and imperfections of the repertory if you use it, it will give you marvellous help. I may say that 90% of my success is due to the repertory. For me, this single volume (of Kent's Repertory) is worth its weight in gold. Now I shall give you practical hints. Before you touch the repertory, see that the case has been taken properly, because otherwise the defects in the case taking will be all transferred to the repertory. If you wish to build a good house you must buy good materials. If you bring half-baked bricks or adulterated cement you will only have a rotten house. All the best masons cannot help if the materials are bad. So make sure that the symptoms you have taken are correct and complete.

Be sure that what you are taking is a real symptom. Believe me, many homoeopaths come to me with their patients and I find that many of the symptoms taken by them are wrong - all because they failed to ask some more questions. The difference between a clever scientist and an ordinary scientist is that the clever one asks one more question. When the apple fell from the tree, Newton asked, "Why did it fall?" If you or I had been there, we would have happily gobbled up the apple and left. Even after everyone is satisfied, the clever man asks one more question. So check up and make sure of every symptom. Case taking is an art which is not easy to master. I have been taking cases for 25 years and yet am not perfect in it. Even after I finish taking the case, someone else is able to find out more symptoms. After taking the case, you must evaluate. You must consider each symptom and see which is the most important one, which is the next important one and so on, to ensure which symptoms must be covered by the remedy. I give an example. Suppose you are a young man who wants to marry. You wish to put in an advertisement for a suitable girl. What are the qualities you will expect and describe? You may say, "I want a girl who is beautiful, rich, educated, cultured and so on." Suppose you get applications in reply but no one fulfills all the requirements - you know young people have wild imaginations, so no girl may meet all your requirements - then you have to make a compromise. You have to decide. Therefore, you arrange the requirements in a particular order putting the most important one at the top, say "Beautiful", next the second important requirement say "Cultured", then the third important requisite say "Education" and so on, and select or eliminate the applicants one by one seeing which of them possess or does not possess each of these requirements beginning from the top. But while selecting you must also make sure that nothing is contradictory. Suppose you find a girl who fulfills all the requirements, but someone says that she has of course, all the qualifications but she will not be faithful to her husband. You will say, "No, no, no. I don't want her." This is a contraindication. So choose the remedy which covers the maximum number of symptoms from the top with no contradictions. And in evaluating the symptoms choose the most peculiar and give it the greatest importance. Now I will give you some examples. I once saw girl from Gujarat. I asked her, "How much water do you take?" She said, "Seven or eight glasses." I asked her, "How many times do you pass urine?" She said, "Once a day." I asked her, "Do you pass a lot?" She said, "No, it is very scanty." So here was a beautiful symptom. She took a lot of water but passed urine only once, that too scanty. And there was no oedema. While travelling she does not pass urine at all, even if she travelled for 48 hours. There is rubric "Urination, seldom" and another "Urine, scanty". Opium covers these two rubrics. So, Opium was the remedy. She responded to Opium, though later she required Puls. In this case, I would not have selected a remedy which did not cover the symptom "Urination, seldom". The third point is the conversion of the symptoms into rubrics. You know what you get from the patient is the symptom and what is given in the repertory is the rubric. The symptom and the rubric do not always tally exactly. So you should know how to convert the symptom into the rubric. For example, a patient is unable to decide. You look under "Indecision". But there is no such rubric. It is given as "Irresolution". This requires some understanding of and frequent reference to the repertory. The next step is to know where to find the rubric. You know that "Urination, seldom" is the rubric you want but you may not know in which chapter it is given. For example, "Axilla" is given under the chapter "Chest" and "Nape" under "Back". If you know all these steps you will be able to use the repertory with good results.

I once asked a patient, "How much water do you take?" He said, "I don't take water." I asked, "Even in summer?" He said, "Yes. Even in summer I don't drink water." I asked, "Do you not feel thirsty?" He replied, "I feel thirst. But even then I do not take water." I thought to myself, "What a beautiful symptom! Thirsty but does not drink water even in summer! Perhaps his remedy is Puls." As I started repertorizing, taking this as the most important or eliminating symptom, I got a little doubt and I asked him, "Why is it you do not take water when you are thirsty?" He replied, "Because the tap water we get is usually contaminated, I always take soda, about a dozen bottles a day." So what happens is that sometimes you think you have a marvellous symptom and then it turns out to be worthless. It is actually beautiful symptom of your stupidity. I should have simply asked him, "Do you take anything else?" Nowadays you know there are some people who do not know water, they only know Coca Cola. I asked another patient, "How much water do you take?" He said, "7 or 8 glasses per day." I asked him, "Even in cold weather?" "Yes", he said, "even then." I thought I have got a nice symptom - thirsty even in cold weather. Then I asked him, "So you are so thirsty?" He replied, "No, I am not thirsty." I asked him, "What do you mean? You take 8 glasses of water per day." He said, "Yes, but I do not feel thirsty. I just like to drink water." There is a rubric in Kent's Repertory "Thirstless with desire to drink". What a fine rubric! I looked into the rubric and I found his remedy to be Caladium. If I had not questioned him further I would have miserably failed because under the rubric "Thirst" there is no Caladium. A patient had severe pain in the back. It was a case of cervical spondylosis. I asked him, "What gives you relief?" He said, "Doctor, if only I can move my neck always, I will have no pain." Look into the repertory. For "Back, Pain, cervical region, better by motion"; only one remedy is given, viz. Aur-m-n, which relieved him. A patient came and vomited in my consulting room. I asked him, "What produces vomiting?" He said, "When I get urge for urine and I control it, I get nausea and vomiting." I found a rubric "Stomach, Nausea, urine, if retains", with Curare as the only remedy. Curare helped him. If you read the Materia Medica you may get the impression that Aur-m-n is only for uterine fibroids and Curare for paralysis. This is where the repertory helps. A patient had deep cough with involuntary urination during cough. If you combine these two rubrics, you will get only one remedy, i.e. Verbascum. Verbascum relieved him. In another case, a patient had pain in the lumbar back better by flatus. Kali-c cured him. I have cured two or three cases of whooping cough, wherein the paroxysms of cough ended in sneezing. The cases were cured by Agar. or by Bell. I can quote lots of such cases but the idea is only to emphasize the value and use of the repertory. The more you use the repertory the more you will gain success. This is an aid. In our system we cannot afford to miss any aid. Some must take care to use every aid possible and every aid is welcome. The more you use the repertory, the more you become a master. By using the repertory, you come to know the Materia Medica better and by knowing the Materia Medica better you can use the repertory better. Now we come to the question of simplifying the use of the repertory. When I used it the first time I found it very difficult and confusing just like when you enter a city for the first time you are confused. All the streets, all the houses look similar. But as I went on using the repertory more and more, I found it becoming easier and simpler to use. Therefore, to my mind the best way to simplify the use of the repertory is to use it more and more.

Pulsatilla pratensis A young girl, Miss D., aged 17 years, came to me from some town in Gujarat. She had oliguria. Her peculiar symptom was that even though she would take water about 5-6 glasses per day, she would pass urine only once in 24 hrs, and that also would be very scanty. This was going on for last one year. If she travelled, urination become even less so that she would not pass even once in 24 hrs. But in spite of this, she had no discomfort or pain or swelling anywhere in the body. Her other symptoms were very scanty, black and offensive menses. She was examined by several doctors and no one could make a diagnosis nor could anyone relieve her. We worked out the case and came to kali-c and Puls. We gave her Puls. which did not act first. But after some doses of Opium (as it covered the lack of reaction and infrequent urination), when Puls. was repeated, it acted nicely. She required higher and higher potency till we went up to Puls. 50M and then she was cured. A young girl, Miss D., aged 17 years, came to me from some town in Gujarat. She had oliguria. Her peculiar symptom was that even though she would take water about 5-6 glasses per day, she would pass urine only once in 24 hrs, and that also would be very scanty. This was going on for last one year. If she travelled, urination become even less so that she would not pass even once in 24 hrs. But in spite of this, she had no discomfort or pain or swelling anywhere in the body. Her other symptoms were very scanty, black and offensive menses. She was examined by several doctors and no one could make a diagnosis nor could anyone relieve her. We worked out the case and came to kali-c and Puls. We gave her Puls. which did not act first. But after some doses of Opium (as it covered the lack of reaction and infrequent urination), when Puls. was repeated, it acted nicely. She required higher and higher potency till we went up to Puls. 50M and then she was cured. According to the homoeopathic principle, any symptom that is caused is an indication. If Puls. has produced one thousand symptoms, all these one thousand symptoms can be indications for Puls. Whether Hahnemann has said this or not, this is so. Suppose a remedy has produced one thousand symptoms and out of these one patient exhibits three symptoms, e.g. Symptom No. 77, Symptom No. 93 and Symptom No. 140, and if this combination of the three symptoms is found in only one remedy say Puls., then Puls. is the remedy for this patient whether the picture of this patient corresponds to the picture of the remedy as described in the books or the picture that you have in your mind. If these three particular symptoms are covered only by Puls., whether the picture fits within your conception of Puls. or my conception or Hahnemann's conception, Puls. is the remedy. Two cases of malignancy 1. Dr. S., an Asst. Medical Officer in a railway hospital in a mofussil town about 200 miles away from Bombay, suddenly developed severe headaches in Aug. 1973. He had a previous history of having been diagnosed as having a malignancy in the brain for which he had been operated and X-ray exposures had been given four years back. He was now probably having a recurrence. Not finding relief with any medicines, he came to Bombay for a check-up. He was admitted in the cancer hospital. He was operated but when they opened the skull they found an extensive inoperable malignant growth and so they closed it up. The allopathic medicines did not give him even relief from pain. Actually the attending doctors had told the relatives of Dr. S. that he may not survive even for a few days. Dr. S. came to know of this and told them he would take homoeopathic medicine and come back to them after a month. From there he came to my room directly.

When he came to me he was having a large cold moist pad on his head since it gave him relief. He could not open his eyes, his vision was blurred, his speech was slurred and his gait was staggering. He told me that he was having very severe headache and wanted some relief. His wife told me that after the paroxysmal headache had developed, he had become very irritable. He loved his wife and children very much but he had become so irritable with the pain that he would beat them. I looked into the rubric "Violent from pain" in Kent's Repertory and found three remedies, viz. Aur., Cham. and Hep., all in bold type. I ruled out Hep. because of the relief from cold application. In spite of the grave prognosis and severe pain, he did not have any suicidal thoughts. So I ruled out Aur. I selected and gave him Cham. 200 to be taken three times a day. He took the medicines and went away to his town. This was on 6th Aug. 1973. I heard after a week that the headache had completely disappeared. His behaviour had become normal and he was walking around the town easily. I continued the same medicines. Later he went to Delhi and spent a week there as he had some work. He continued to improve and remain well. One month later he came to Bombay and went to the Cancer Hospital and told them he was free from pain and feeling well. He continued to have improvement and remained well. But 6 months later he suddenly developed a strangulated hernia for which an emergency operation had to be done. After this operation, however his condition became worse. His headache increase and he developed paresis of the limbs. He came to Bombay and was admitted in the hospital again. But he got no relief. Again Cham. 1000 helped him. He is back in his town and reports that he is improving. 2. Mr. H.P. , aged 51 years, consulted me on 14th Sept. 1973, for frequent urination, with haematuria and pain at the end of urination. He had been operated four years earlier for a tumour in the urinary bladder. He had now got a relapse for last 11/2 months. The frequency of urination was there night and day. While he was consulting me, he continued to got to pass urine every two minutes. He had also bleeding piles on and off. It had been diagnosed as a case of cancer of the bladder and he had taken 34 X-ray exposures without any relief. He used to bleed at the end of urination. Urinary frequency was worse by sour foods. X-ray on 04.09.71 had shown filling defect in the bladder. I first prescribed for him Ars. without any effect. One week later he developed a symptom - burning in the rectum after passing urine. I looked up the rubric in Kent's Repertory, viz. "Rectum, Pain, burning worse after urination". I found only one remedy, i.e. Nit-ac. I prescribed Nit-ac 30 on which he showed immediate improvement. From that time, he went on improving for a long time. When I told him to come for a check-up he refused to come saying that he was all right. Actually, he wanted to stop the medicines. Luckily, he wanted to go to Haj and for that he wanted my permission. I then insisted that he should take an X-ray of the bladder. The X-ray of the bladder was taken and it showed no filling defect. He is now perfectly all right. The homoeopathic approach to cancer The problem of Cancer proves as vexing to the homoeopath as it is to his allopathic colleague. No doubt, a number of cases of cancer are found reported in the homoeopathic literature as cured but these cases have to be viewed in a particular background. 1. In the 19th century, methods were not available to definitely establish the diagnosis of cancer and the cases were classified and treated as cancer mostly clinically. So it is possible that some of those cases were not really cancers.

2. Compared to the large number of different types of cases of other diseases treated by the homoeopath, the number of cases of cancer alone proves to be quite low. Also the number of cases of cancer treated by the homoeopath is again small as compared to the extent of prevalence of this disease. 3. In quite a number of different cases, a long follow-up has not been done so that cases which were relieved by homoeopathic medicine could have been taken as and reported as cured. However, the homoeopath suffers from a handicap, viz. the cases of cancer do not generally come to him straight in the very beginning. Only after they had consulted the allopathic physicians and have taken the usual treatment which may be either surgery, radiation or chemotherapy, do they come to the homoeopath. Even if the patient comes at an early stage and takes the treatment, well-meaning relatives and physicians frighten the patients to such an extent that he prefers to take orthodox treatment even though he is afraid of operation, radiation, etc. The homoeopath finds it difficult to treat these cases at this stage after they have undergone such treatments. Some experienced homoeopaths say that after surgery and radiation the response of the patient to the homoeopathic remedy becomes poor and this can be one cause of failure. Despite these considerations, there are many definite cases of cancer reported as cured and this is an encouraging fact because it shows that cancer can be cured. Fortunately, in spite of all these aggravating factors, the homoeopath does find that he is able to cure a few cases and definitely palliate and relieve the suffering and prolong the life of the patient in a large number of cases. The approach of the homoeopath to cancer is actually the same as his approach to patients suffering from any other disease. That is, he has to take the whole case into consideration and find a remedy which covers the symptom-totality. This remedy helps the patient. Frankly speaking After visiting some homoeopathic hospitals or public dispensaries, one sometimes feels depressed. In many of these institutions, one finds in the case records very little relevant information recorded either as to the diagnosis of the condition treated or as to the indications for the remedy prescribed. Sometimes one finds only the name of the remedy given, with no other information whatsoever. At times, the patient is given a different remedy at every visit without the reason for the change being recorded. As some of these institutions also serve as teaching institutions, the students attending here can be expected to pick up only such useless and unscientific methods. Is it any wonder if they become failures as homoeopathic practitioners? The management and the practising staff of these institutions are guilty of doing a great disservice to Homoeopathy, however good their intentions may be. In some such institutions the medical staff or the management sometimes proudly show that so many hundred patients had been treated every day or in the course of a few hours. By a simple calculation one can see that each patient could have received only one or two minutes. Even in the most simple cases, it is doubtful if a proper prescription can be made within this time. Only the most haphazard prescription can be made so that what the patient receives is only homoeopathic treatment in name. Having worked in a hospital for several years we can say that, in our experience, an acute case may require at least 5 to 10 minutes and a chronic case from 20 to 45 minutes, if we are to make a proper homoeopathic prescription.

The Central Council of Homoeopathy should, in the interest of the science, ensure that proper homoeopathic records are maintained at least in teaching institutions. A case of injury Dr. R.K. , aged 39 years, wife of a surgeon came on 16th Nov. 1974 for a pain in the rt. arm. On 19th May 1974, she was travelling in a car which had a mild collision. She had a fright and also got a jerk. Since then she has severe pain whole rt. upper limb. She has taken a lot of analgesics with no relief. Now she has pain and swelling in rt. arm with some loss of power. Pulling pain is agg. at night agg. pressing agg. cold agg. lifting a weight. Pain wakes her up. There are localised areas of warmth in the limb. She gets cramps in left calf in sleep. All investigations including blood sugar showed n.a. d. An injury to a nerve was suspected. I gave her first Hypericum 30 with no benefit. Then, I studied her case and gave Phos. 30 TDS. Kent gives in his Repertory only 2 remedies under the rubric "Injuries, Nerves, with great pain" (p. 1369), viz. Hyp. and Phos. Out of these two, Phos. is found under "Sleep, during agg." and "Side, left lower and right upper" in Kent's, under "Spots" in Phatak's Repertory. With 3 doses of Phos. 30 all her pains disappeared and she was able to do all her normal work for the last 2 months. She has not yet recovered full power but is feeling nearly normal. The value and application of repertory The value of the repertory Since the homoeopathic Materia Medica has over 2 000 remedies, most of them with hundreds and some with thousands of symptoms, it is clearly impossible for an average practitioner to remember all the symptoms and prescribe only on the basis of this knowledge and his memory. Therefore, the prescriber who does not want to fail will take the aid of the repertory which is a most useful and comprehensive aid. The intelligent use of the repertory can considerably lighten the work of the prescriber and also make prescribing more precise. Some people may mention that Hahnemann himself was not using any repertory. But Hahnemann had some distinct advantages. The number of proved remedies and their symptoms was comparatively limited in his days. Further, Hahnemann had directly involved himself in the provings and so he had an excellent first-hand idea of the symptoms. Besides, he had a remarkable memory. But in spite of these advantages, later on, when the volume of the homoeopathic Materia Medica became larger and unwieldy, he himself found it difficult to practise only with the help of his memory without referring to the books. He himself was then known to have welcome a repertory prepared during his life-time. Some prescribers feel embarrassed to refer to the repertory in front of the patients. Possibly they feel that this will lower their estimation in the eyes of the patients. But once the patients realise that this helps the physician to make better prescriptions, they do not mind this. Many great homoeopaths, for instance Margaret Tyler, Pierre Schmidt, Sir John Weir, Elizabeth Wright Hubbard among others, were using the repertory very freely. I am told that some leading homoeopaths in India, esp. in Calcutta, rely more upon their knowledge of the Materia Medica rather than upon the repertory and that they get very good results. They are to be congratulated and envied. I too am having some remarkable results in my practice, comparable to these results of my colleagues, but my results have been mainly achieved with the help of the repertory. I may quote two recent experiences. 1. A patient had most violent sneezing, so violent that it caused abdominal pain. I was able to select the remedy Indium.

2. A patient with pain in the left calf muscle worse on standing or walking (with absent pulsation of the arteries) was relieved by Arundo. Therefore, I would recommend a free and liberal use of the repertory to all my colleagues. Various repertories and their application Among the repertories the most complete one and most used is Kent's Repertory. Once its construction and method of use are grasped, it can be used very easily and to great advantage. Bidwell's book is an excellent guide to the use of this repertory. John Weir and Tyler have written a small useful booklet explaining its use, as also my learned friends Kanjilal and Patel. I shall not enlarge upon them but I shall only explain my own approach. My objective in using the repertory is to find the remedy. I do not want to miss the remedy under any circumstance. So when I translate a symptom into a rubric and look into the repertory, I do not confine myself to the particular rubric but I consult other rubrics also which are similar or nearly similar. For example when I see a patient who looks prematurely old, I see not only the general rubric "Old age, premature", but I also consult the rubric "Face, expression, old looking". If I want to see "Head, Swollen" I also see "Head, Enlarged", "Head, expanded", etc. Thus, I do not confine myself to the narrow walls of each rubric. Where there are two or more similar rubrics, I consult or take all these rubrics. Kent himself has numerous such references, e.g. "Mind, Fear, men, of" see "Fear, people, of" (p. 46), "Mind, Childish behaviour" (p. 11), see also "Mind, Foolish behaviour" (p. 43). These are very near in meaning. Other similar rubrics are "Eating, before, agg.", "Eating, after, amel." (p. 1357) and "Fasting, while, agg." (p. 1361); "Motion, at beginning of agg." (p. 1374) and "Motion, continued, amel." (p. 1375); "Lying, back, on agg." and "Lying, abdomen, on amel." (p. 1372); "Lying, side, on painless, agg." and "Lying, side painful on amel." (p. 1373); "Food, vinegar, agg." and "Food, sour, agg." (p. 1364). The repertory contains hundreds of such similar rubrics. In using the repertory we may find that the symptom-headings given in the repertory (the rubrics) do not exactly tally with the language of the patients. For example the patient says he has a cold; the repertory gives it as "Nose, Coryza". So the repertory user has to learn how to translate correctly the symptom into the rubric. While repertorizing you may find often that a rubric that you expect and look for in a certain place is actually located somewhere also. For example "Emaciation with increased appetite" is not found under "Emaciation" in Generalities where you would expect to find it but is actually found in the chapter Stomach as "Appetite, ravenous with Emaciation" (p. 479). In such cases it is better for us to insert below the rubric "Emaciation" in the Generalities chapter a subrubric "Emaciation with increased appetite". By thus cross-indexing the repertory liberally, we will find it possible to reach any rubric (symptom) we want easily. Cross-indexing of the repertory should be done in such a way that all possible imaginary allied rubrics should point out to where this particular rubric (symptom) - the one we are looking for - can be found. The prescriber should be able to reach the correct rubric easily without any difficulty or loss of time. For example, a patient looks frightened. We look for "Mind, Frightened look". There is no such rubric. But it can be found under "Face, Expression frightened" (p. 374). So we have to put in a rubric under "Mind, Frightened look" and give a cross-reference as, see "Face, Expression, frightened".

A patient has squint. We look for "Squint" in the chapter Eye. There is no such rubric. It is given as "Strabismus". So we have to make a note in the Eye chapter as "Squint" and give a cross-reference as, see "Strabismus". The idea is to put in references everywhere, wherever you are likely to look for a rubric and insert cross-references so that you will come to the correct place. Now, the next point I wish to mention is that if you do not find a proper remedy under a particular rubric; it is better to look into the general rubric also. For example, I saw recently a lady suffering from itching of genitalia worse before and after the menses. If you combine the rubric "Genitalia Female, Itching before menses" and "Genitalia Female, Itching after menses" (p. 720), you get Graph., Kali-c, Sulph., Tarn., Zn. Now, we all know that Lach., Sep. and other remedies also have "Agg. before menses" and "Agg. after menses" in general (pp. 1373, 1374). So, naturally these remedies should also be considered. Here by taking the general rubric also, the chances of arriving at the correct remedy are greater. If a patient has, for example, cough agg. from milk, fat food or sour food, I see not only under the chapter Cough but I also take the general rubric "Food, milk, agg.", "Food, fat food, agg." and "Food, sour, agg." to see if any of those remedies given in those rubrics will fit the patient. In repertorizing, I use and combine the rubrics with a great degree of latitude. For example, suppose we have a patient who has pain in right iliac region after menses, we look into Kent's. We do not find such a rubric. In such a case I take the rubric "Abdomen, Pain, Iliac region, right" (p. 566) and combine it with the rubric "Abdomen, Pain, menses after agg." (p. 558), (or even with the general symptom "Menses after agg." (p. 1374)), and if a remedy comes through, e.g. Kali-c, I consider if Kali-c will fit the patient. Boenninghausen's repertory edited by boger Boenninghausen applied his knowledge of law and logic and enlarged the scope of the homoeopathic Materia Medica. He split up each symptom into its three parts - the location, the sensation and the modality, and classified these three parts under three major chapters, viz. location, sensation and modalities. For example, if Sulphur produced "Burning of the soles at night", he put down Sulph. under the location Soles, under the sensation Burning and under the modality Worse at night. By splitting up all the symptoms in this manner and arranging them in the three different major sections of the repertory, he enlarged considerably the scope of the homoeopathic Materia Medica because instead of depending only on the symptoms which had actually come out in the provings which were comparatively limited in those olden days, he made it possible to synthesize and create new symptoms by taking the different parts of the symptoms - any location, any sensation and any modality and assembling them together. He argued that if Sulph. produced burning of the sole at night, it is capable of affecting the sole, of producing burning and of getting agg. at night. This is very much like the composing work of a printer who is able to create any number of words by merely assembling and combining the various letters taken from different compartments. Though Kent has criticised this idea whereby Boenninghausen made the symptoms flexible, yet this method of working offers much more scope in the repertory work. I freely use this method of Boenninghausen with Kent's Repertory and I have had very good results. I do not confine myself rigidly to Kent's method. This book also gives a variety of concomitant symptoms under each chapter, a feature which we rarely find in Kent's. Boger who was an extremely successful homoeopath used to give great value to concomitant symptoms.

Further, this book gives modalities for each symptom separately so that the remedy may be selected even if the symptom is incomplete. I do not want to give the impression that a practitioner can go on prescribing only with the help of the repertory and without referring to the Materia Medica. The repertory presents the image of the remedies only in a fragmented, disembowelled form and the picture that emerges out of these fragments may not really tally with the actual picture of the remedy or of the patient though technically it may be covering the symptoms. Therefore, even after repertorization, we will have to study the Materia Medica to make sure that indeed the matching of the picture is virtually correct and not only apparently so. I may mention that in repertorizing I have sometimes found most of the symptoms covered by one remedy, e.g. Lyc. or Phos. whereas the actual remedy for the patient as revealed by a matching of the total picture by a study of the Materia Medica was something else e.g. Puls. or Caust. We all know the contrasting points. But it is my strong feeling that the person who has an excellent knowledge of Materia Medica becomes a very good repertorian and one who makes good use of the repertory gathers an excellent knowledge of the Materia Medica. In other words, a good knowledge of Materia Medica helps us to repertorize better and the use of the repertory improves our knowledge of the Materia Medica. Just as a remedy may work out covering most of the symptoms but may not be the correct remedy, so also a remedy may not technically cover the symptoms in the repertory but may actually prove to be the correct remedy. Lyc., as you all know, is a right-sided remedy and generally affects the whole of the right side. But it is not found in a number of right-sided rubrics, e.g. "Perspiration, side right" (p. 1300) (though it is given under "Perspiration, side, one side"); "Abdomen, pain, Iliac region, right" (p. 343), "Eye, pain, right" (p. 248), etc. Yet it should be considered in all these symptoms. In repertorizing I freely interchange the general and particular rubrics. For example, if we take the rubric "Head, Pain, side left then right" (p. 1401) and vice versa. But if I have a patient, with this symptom I do look into the general rubric also and see if any of those remedies can cover this patient. I may say that by considering the generals also and by interchanging the locals and generals I have found much more success. I believe that the general includes the particular. Reading between the lines Though the repertory does not give some remedies under some rubrics, I feel that logically they should have come in there. For instance, under the general rubric "Side, Right then left" (p. 1401), you find remedies like Ac-ac, Arg-n, Aspar., Spong. Now these remedies are not given under the rubric "Side, right", I am unable to imagine how the symptoms could have gone from the right to the left side without remaining on the right side first at some time even if it was for a very short period or only for a fleeting moment. Therefore, when I have a rightsided case, I consider these remedies also. Similarly under the rubric "Side left, then right" (p. 1401), we find Calc-p, Elap., Kali-c, Nit-m-ac, Phyt. and Rhus-t. I think all these remedies should have been included under the rubric "Side, left". In fact, I have treated many left-sided complaints with Rhus-t. Similarly, under the rubric "Loss of sleep, agg.", there are many remedies. I believe this rubric is synonymous with the rubric "Sleep after amel.". If I have a patient who is agg. from loss of sleep and if I do not find the remedy in the former rubric, I look into the latter. In fact I have cured many patients having this symptom with Phos., though

Phos. is not given to the former but only in the latter rubric. Similarly under the rubric "Pain, appear gradually and disappear gradually", you find a number of remedies but under "Pain appear gradually" only a few remedies. I think all the remedies in the former rubric should be included in the latter rubric because irrespective of how the pain disappeared all these remedies definitely had pain appearing gradually. It is also possible that some provers noted only the gradual appearance and not the mode of disappearance. I shall now refer to a serious lacuna that can mislead us much if we are not careful. You will find throughout Kent's Repertory numerous rubrics followed by sub-rubrics wherein some of the remedies found in the sub-rubrics are not to be found in the main rubric. For instance: 1. You find a rubric "Chest, Pain, mammae, nipple" (p. 846) and below this rubric some subrubrics, e.g. "Pain nipples, morning": Con.; under "Pain, nipples, evening": Berb.; under "Pain, nipples, menses, after": Nux-v and Phyt. under "Pain, nipples, nursing, while" and so on. None of these remedies are found in the main rubric "Pain, nipples". Under whatever particular circumstances, these remedies might have caused or cured pain in nipples, they all caused or cured pain in the nipples - of this there can be no doubt! So I feel they should all have been given in the main rubric "Pain, nipples" also. I shall give a few more such examples. 2. The rubric "Pain, tearing, larynx" (p. 755) gives the remedies Anan., Bell., Bor., Ign., Lac-ac. But in the sub-rubric "Pain tearing, larynx, coughing, on", you find All-c, Bell., Bor., Calc., Cist., Med., Phos., Staph. I feel these remedies in the sub-rubric should have been in the rubric also because they all caused/cured tearing pain in the larynx. 3. "Nausea, throat, in" (p. 510) gives many remedies. This rubric has two sub-rubrics, one giving Graph. and the other giving Lach. but both these remedies are not given in the main rubric. There are three rubrics "Nausea, food, on looking at", "Nausea, food, smell, of" and "Nausea, food, thought of" (p. 507). I generally take these rubrics as one because the sight and smell of food, generally go together. If the mere thought of food is going to aggravate the Ars. patient, surely looking at it is also going to aggravate him, though Ars. is not given under the latter rubric. I can give you hundreds of such instances but I am only trying to draw your attention to the possibility of reading between the lines in the repertory so that you can take a wider view and make a broader interpretation. Personally, I use or manipulate the repertory in this broad manner and have benefited by it. Where I get particular (detailed) symptoms, I go for Kent's Repertory. Where I get very good concomitant symptoms, I make use of Boger-Boenninghausen's Repertory. If I get only generalities, I take the help of Phatak's Repertory. Where I get pathological symptoms, I seek the aid of the repertory section in the Boericke's Materia Medica. In general these are the four major repertories I consult. Other books I consult are Boger's "Times of Remedies", Bharadwaj's "Causation", etc. The limitations of the repertory The fact must be accepted that no single repertory is complete and perfect, not even Kent's. Kent's is the nearest to a perfect repertory but even Kent has mentioned that as there is scope for many additions to be made, he had left spaces in his printed book for these additions. After going through the homoeopathic literature in detail, I, like many of my friends,

find the need for making many additions to the repertory. And this, I think, we should make, so that the future generations of homoeopaths will find the repertory more complete. If we closely examine the Materia Medica, we shall see that some symptoms in the Materia Medica are found missing in the repertory. To give an example, Boericke gives under Ammmur., in Mind, "Desire to cry, but cannot". In Kent's, under the rubric "Mind, Grief, cannot cry" and "Mind, Grief, ailments from", we do not find Am-m, Ast-r, Lach., and Puls., all are better by weeping but we find them missing in the rubric "Mind, Weeping. amel." (p. 93). Clarke and Boericke mention Abies-n for bad effects of tea but Kent does not give it. Whatever the reasons that prompted Kent to omit them, surely they are indications if they are found in the Materia Medica. Many other such omissions are found in the repertory. Drugs proved in the last fifty years are naturally also missing. I believe that if our repertories can be made as complete and as perfect as humanly possible, the chances of our failure will be considerably diminished. With this idea I have been making additions in my own repertory from various authoritative books like Clarke's Dictionary, BogerBoenninghausen's Repertory, Boger's Synoptic Key, Allen's Keynotes, etc. However, I have been making these additions only in a casual manner - not regularly or systematically. But still numerous additions have gathered up and I have found these additions very useful. In fact, in some cases I have been able to select the remedy only because of these additions. Therefore, it occurred to me that I should publish these additions. So, I published some additions for the Mind chapter in the Indian Journal of Homoeopathic Medicine. But after publishing a few pages we faced two facts. 1. The additions I had made were comparatively less as compared to the enormous number of additions that are possible. 2. In my additions, I had not done the work systematically. For example, I had omitted to note down for each entry the authority from which I had taken it. I could only say that they had been taken from well-known authorities. My friend Dr. K.P. Mazumbdar, who was then the Asst. Director (Hom.) of the CCRIMH, told me that it would be better if I could note down the authorities also for each entry. So, I have been revising this work for the last two years or so. I have also noted down the authorities and I hope we shall be able to publish them chapter by chapter. Similarly, we hope to make additions to all chapters and to publish these additions. Three cases Abdominal colic I was called to see Miss H., aged 20 years, on 26.06.74 for the following: In the last one month she has had 4 to 5 attacks of severe abdominal pain with vomiting. All kinds of conditions had been thought of, but as no definite diagnosis could be made, an exploratory operation had been advised. I elicited the following symptoms. Abd. pain starting in umbilical region ext. upwards, amel. bending double amel. lying on abdomen. Pain is followed by fainting. Stools hard, once in 2 days. Face puffy and pale. Prev. Hist.: Haematuria once. No H/o. fall or shock. On looking into Kent's Repertory under the rubric "Faintness, pain in abdomen, from" (p. 1360), I found only Cocc. and Plb. Out of these, Plb. covered all the symptoms. She was given Plb 30 t.d. s. The constipation improved. Pain did not recur. So, the dosage was reduced and then stopped. She has had no attack of pain for the last one year now.

Headache Mr. J.S. , aged 35 years, is suffering from headache since 1958. The headaches are almost constant. It was diagnosed as sinusitis and he was operated upon but with no relief. The headaches are better if there is a nasal discharge i.e. coryza. They are always right-sided and they are worse in summer. He feels better with Cafergot. He feels chilly with headache but also has much perspiration then. Headaches are worse on alternate days and on lying on affected side. They start in the right shoulder region and extend to the nape and he feels as if a nail is driven in, amel. by pressure. He has a previous history of fever suspected as malaria and a history of epistaxis in summer. I repertorized his symptoms with the following rubrics in Kent's Repertory and Phatak's Repertory: 1. Chill with pain (K.p. 1269) 2. Perspiration during headache (K.p. 1297) 3. Head, pain coryza suppressed, from having a (K.p. 138) 4. Summer agg. (K.p. 1404) 5. Lying on painful side agg. (K.p. 1373) 6. Alternating effects (Ph.p. 8). I came to two remedies, viz. Lyc. and Puls. Because he was mild by nature, I gave him Puls. 200, 3 times a day. He had an agg. for 2 days and from the 3rd day the headaches disappeared completely. He told me that in the last 16 years he had never been free from headaches like this and was most grateful to Homoeopathy. He remains free of pain now for over six months without any medicine. L4 Gangrene Mr. J.V. D., aged 62 years, came on 01.01.1974 for treatment of gangrene of the toes of the left leg from which he has been suffering since 1970. He had been advised amputation which he had refused. History and symptoms: In 1970 one toe was crushed and had suppurated. It was operated upon twice but did not heal and then gangrene had set in. Later, two more toes were affected; then it was diagnosed as chronic vascular insufficiency due to atherosclerosis. He had pain in the leg agg. 10 to 11 p.m. , amel. pressure, agg. letting the leg hang down, agg. walking, agg. cold water application, agg. in sleep, even during afternoon sleep. He had a suicidal disposition. Head heavy with vertigo and nausea sometimes. He also had twitching on rt. side of the face and rt. side of the tongue with black patches on it. Lips black. Pain in soles at night, wakes up 4-5 times due to pain. Cannot wait for food. Loquacious. Prev. Hist.: Malaria in childhood. Used to smoke 50 cigarettes a day for 45 years. High B.P. since 1947. Now B.P. 200/130. The affected toes are black and gangrenous with a very offensive discharge.

I took the following rubrics in Kent's and Phatak's Repertory viz. Tobacco; agg. Injury; Gangrene; Suicidal; agg. in sleep; Rt. side; Black. China alone came through. He was given Chi. 30 and he started improving. With repeated doses of Chi. 200, he became well. His B.P. became normal. The gangrenous toes healed. We stopped the treatment on 29.03.75. Cardiospasm Mrs. P.D. , aged 40 years, suffering from Cardiospasm came to me for consultation on 26th Feb. 1965. Her history was as follows: At the end of 1962, while lying down she noticed a gurgling sound in throat with regurgitation of fluid. She then developed choking sensation while swallowing, accompanied by vomiting. She experienced difficulty in swallowing esp. solids, and she could locate the obstruction in the lower substernal region. She consulted an eminent E.N. T. surgeon. Ba. swallow N.A. D. but an X-ray showed obstruction in the cardiac end of the stomach. The surgeon advised an operation but another surgeon advised against it. The patient took homoeopathic treatment from a colleague of mine and felt some relief. It was at this stage that I was consulted. At present: She feels that the food is first obstructed in the cardiac end of stomach, but then it drops into the stomach. She has choking and regurgitation, agg. lying on the left side or back, if she lies down immediately after food. Choking is amel. lying on abdomen. She can swallow better while sitting erect. Sour and spicy food, eggs and beer make her worse. She has vague pains in the joints. There is pain in the teeth which feel loose. Appetite, etc. normal. Sweat nil. Patient feels chilly even in warm weather. Nervous and shy. Previous History: Bronchitis often. Malaria at 15 treated with Quinine. Her case was studied as follows in Phatak's and Kent's Repertories. (Ph. = Phatak; K. = Kent) Cold agg. (Ph.p. 46) + Lying on left side agg. (Ph.p. 171) = Am-c, Bar-c, Colch., Kali-c, Lyc., Phos., Sep., Sil., Sulph. + Lying on back agg. (Ph.p. 171) = Colch., Phos., Sep., Sil., Sulph. + Food, sour agg. (K.p. 1364) = Phos., Sep., Sulph. + Lying on abdomen amel. (Ph.p. 171) = Phos., Sep. + Constriction, cardiac orifice on swallowing (K.p. 483) = Phos. + Quinine, abuse, of (K.p. 1397) = Phos., Sep. + Food, spicy agg. (K.p. 1364) = Phos. Patient was given Phos. 200, 1M and 10M and Tub-bov 1M at long intervals. She felt much better in her condition but she developed some eruptions below and around the right ear, itching and exuding thick fluid. But the prescription was not changed. On 09.12.66, the report was that she has gone to New York. Has been taking Phos. 10M at long intervals and feeling completely well. Skin condition better. Mrs. P.D. , aged 40 years, suffering from Cardiospasm came to me for consultation on 26th Feb. 1965. Her history was as follows:

At the end of 1962, while lying down she noticed a gurgling sound in throat with regurgitation of fluid. She then developed choking sensation while swallowing, accompanied by vomiting. She experienced difficulty in swallowing esp. solids, and she could locate the obstruction in the lower substernal region. She consulted an eminent E.N. T. surgeon. Ba. swallow N.A. D. but an X-ray showed obstruction in the cardiac end of the stomach. The surgeon advised an operation but another surgeon advised against it. The patient took homoeopathic treatment from a colleague of mine and felt some relief. It was at this stage that I was consulted. At present: She feels that the food is first obstructed in the cardiac end of stomach, but then it drops into the stomach. She has choking and regurgitation, agg. lying on the left side or back, if she lies down immediately after food. Choking is amel. lying on abdomen. She can swallow better while sitting erect. Sour and spicy food, eggs and beer make her worse. She has vague pains in the joints. There is pain in the teeth which feel loose. Appetite, etc. normal. Sweat nil. Patient feels chilly even in warm weather. Nervous and shy. Previous History: Bronchitis often. Malaria at 15 treated with Quinine. Her case was studied as follows in Phatak's and Kent's Repertories. (Ph. = Phatak; K. = Kent) Cold agg. (Ph.p. 46) + Lying on left side agg. (Ph.p. 171) = Am-c, Bar-c, Colch., Kali-c, Lyc., Phos., Sep., Sil., Sulph. + Lying on back agg. (Ph.p. 171) = Colch., Phos., Sep., Sil., Sulph. + Food, sour agg. (K.p. 1364) = Phos., Sep., Sulph. + Lying on abdomen amel. (Ph.p. 171) = Phos., Sep. + Constriction, cardiac orifice on swallowing (K.p. 483) = Phos. + Quinine, abuse, of (K.p. 1397) = Phos., Sep. + Food, spicy agg. (K.p. 1364) = Phos. Patient was given Phos. 200, 1M and 10M and Tub-bov 1M at long intervals. She felt much better in her condition but she developed some eruptions below and around the right ear, itching and exuding thick fluid. But the prescription was not changed. On 09.12.66, the report was that she has gone to New York. Has been taking Phos. 10M at long intervals and feeling completely well. Skin condition better. The pooling of experience The external exciting factor, whatever its nature or dimension, merely serves to activate the internal miasm which is indeed the fundamental, or true cause of disease. But the type of agent that is able to awaken or trigger the disturbance provides us with a reflection of the nature of the constitutional susceptibility of the individual who suffers therefrom. And even this reflection is able to provide us with a very valuable clue to the selection of the similimum. So to say, it reveals one of the important modalities of the basic deviation of the constitution on the one hand, and sometimes indicates the starting point of the action of some remedies on the other. In discussing the cause-and-effect phenomenon, however, we are of course treading on thin ice. Even in cases where the disease occurs as a sudden explosion and becomes abruptly

apparent, the actual beginning may be remote in time and obscure in origin. It may be insidious, both in its inception and in its progress. It might have behind it not only a combination of causes operating simultaneously, but also a series of them coming one after the other, each initiating one stage and each pushing the disturbance a little further until its manifestations become very evident functionally and pathologically. It may be, therefore, difficult for us to exactly pinpoint the origin of the disturbance or put our finger on a particular factor and name with any certainty that as the one responsible. But, by and large, the first event of circumstance (which actually may be the last of the chain), that has made the disorder manifest, is taken as the important one and made use of in practice. Osteoarthritis Mr. T.A. K., aged 69 years, came from Surat on 26th July 1963, with the following complaints: Has arthritis in knee joints, worse right knee, for last 10 years. Pain agg. rising from sitting, agg. beginning motion, agg. descending steps. Appetite : good; Urine: 3 times at night. Sleep: Good. Likes fan and cold air. Weight is increasing. O/E: No tenderness in knees. Bilateral cataract. Previous history: Had asthma 40 years back. Took homoeopathic treatment, but was not relieved. His case had been diagnosed as osteoarthritis. I took the symptoms underlined as peculiar and worked out in Kent's Repertory first as follows: Pain knee, descending steps, when (p. 1072) + Obesity (p. 1376) I got Merc., and Ver-a. These two drugs did not cover "old age". So, I now worked out again taking "Descending agg." (p. 1356) as a general symptom. This was added to "Obesity". Then I got Arg-m, Bar-c, Canth., Con., Lyc., Plb., Sil., Ver. Now I added, "Old people" (p. 1376) = Bar-c, Con., Lyc., Sulph. Of these, I preferred Lyc., as it was right sided, had frequent micturition at night, etc. So I gave him Lyc. 200, 3 doses in one day. He felt relief, but the medicine had to be repeated about once a month in 1M, then 10M potencies. On 2nd Jan. 1964, he reported that his pains were relieved but he was unable to walk much. So, I now put him on daily doses of Lyc. 6th potency of the LM scale to be taken in water succussed daily once.

On 17th February 1965, he reported that he was completely well; there was no pain in the knee. The medicine was discontinued. He has remained well still. Etiology Master P.B. , aged 14 years, was brought to me for consultation on 28th Oct. 1963, with very severe pain in the hamstring tendons of the right leg, of 15 days' duration. The pain was so severe and he was so much aggravated by stretching the leg, that the boy could not stand up or walk. He had even to be carried to the toilet by his father. On examination, I found tenderness in the right popliteal fossa. The lateral tendon which is normally palpable on flexion could not be felt or seen. His appetite, thirst, stool, sleep, etc., were normal but enquiry revealed that one month previously he had an attack of measles. Further, I learnt that in July 56, he had suffered from an attack of Diphtheria from which he had recovered with the help of A.D. Serum but since then his health had not at all been good. He used to suffer some disorder or other, throat pain or fever or abdominal pain or vomiting and so on. Though the boy had approached me only for the acute condition of the pain in the hamstring tendons, I thought of treating the background first. After all, there was the possibility that he was suffering from ill-effects or sequelae of Diphtheria, whether it was related to the present illness or not. So I gave him six doses of Diphtherinum 1M to be taken T.D. S., thinking I would clear up the background first. I was planning to work out the remedy for his acute condition, after two days. On 31st Oct. 63, that is three days later, he returned to consult me and you can imagine my surprise when I found that the severe pain and tenderness in the legs had completely, disappeared! He could extend his legs completely and was able to walk about normally. His mother reported that within the last two days his general health had become much better. I gave him no further medicine. I saw him again on 11th Nov. 1963. His condition was normal. He got slight pain in the leg only if he walked very long distances. Till 1st August 1966, he has remained normal. Is homoeopathy scientific? Mr. F.X. R., aged fifty-six, was seen by me on 17th September 1960 with the following history. The notes were written out by his brother and I reproduce them verbatim in order to give a better idea. 1. Born March 1904 and studied upto Metric. Third of a family of nine. No mental case in family. 2. Joined father's business early in life. Business included bakery, building contracts, wood and fuel depot, house agency, etc. 3. Married, has five sons and one daughter. Eldest son aged twenty-one, failed B. Sc. this year, fourth and fifth sons failed in third and seventh standard school final exams.

4. Recently quarrelled with wife for giving a male servant too much liberty in day-to-day bakery business. As a result of wife's rebuke, he used to leave the house in the morning and subsisted on snacks for two or three days at friends' houses and returned home only at night. Wife was accused of saying that she would not dismiss the erring servant and would prefer that he (husband) should leave the house. 5. Talks too much and with confidence in his opinions, while formerly he was taciturn; says he believes in nature cure and not in doctors. Does not talk nonsense but repeats incidents in which he considers himself the central figure who can advise the local municipal members and others how to run their business. Wants to help poor Christians to earn a living by taking government contracts for fuel and charcoal and by giving charity. 6. Has spent over twenty thousand rupees to renovate the bakery and house. This included provision of rolling shutters, tiles for flooring, furniture, fire bricks for the oven, etc. 7. Takes cold bath at 1 a.m. and then prays. He rests after this and then goes very early to church, returning after four hours or so. This activity has started within the last month or so, and appears to have commenced after the servant's incident. Has bath again once or twice on the ground that he perspires too much. 8. Has developed a religious attitude and gives advice to all and sundry to attend church and receive the sacraments daily. Says he has special mission in life to do good and help people to live better. Wants to go out of his way to show sympathy to the less fortunate or to any person who appears to be friendly and would hear him. 9. Since his returning to Bombay he has been spending freely in charity for candles and small donations to the church, buying toys, etc., for children and in giving the nephews and nieces a good time at the Bandra Fair, now in progress. 10. His wife arrived yesterday evening and insisted that he should visit a doctor as he was "weak". He wanted to know whether she thought he was going mad and whether she wanted to send him to a lunatic asylum. 11. Wife made some remark about the offending servant last night after dinner. This upset him and both were shouting at each other at the top of their voices, until I intervened and told him that the servant would be dismissed. This calmed him down. Wife cried in self-pity. This morning she threatened to leave tomorrow without any apparent reason. 12. Wife is supposed to have confided to her youngest sister-in-law in Bombay that they have had no sex life for two years. This is in the nature of a surmise as it was too delicate a matter to be verified. 13. Feels that the sons also side with the mother and have aligned themselves against him, agreeing with her that the offending servant cannot be dismissed as he is irreplaceable. 14. Wife works very hard in the bakery business, especially in the confectionery section, but being full of self-pity is unable to show him the consideration needed in his state of health. 15. His financial position is fair and there appears to be no worries on his head, as far as I can see. The business premises yield good returns, but there appears to be no unanimity between husband and wife on the question of servants and how to run the business. He wants extra servants to relieve her of her work. She protests that he will ruin the business in this way.

16. Has had remorse of conscience on two occasions in the past with regard to money belonging to joint family which wife had concealed from other members. The symptoms of the patient were worked out under rubrics as follows (number refers to pages in Kent's Repertory). Remorseful (p. 71) and Loquacity (p. 63) = Ars., Aur., Bell., Caust., Chel., Cocl., Cof., Cup., Hyo., Lach., Nat-c, Nat-m, Nux-v, Sele., Stram., Sulph., Ver-a + Praying (p. 69) = Ars., Aur., Bell., Hyo., Stram., Ver-a + Religious (p. 71) = Ars., Aur., Bell., Hyo., Stram., Ver-a Out of these, praying at night has only Stram. So, I preferred Stram. as it seemed to cover his case better and gave him Stram. 200, 3 doses, six hourly on the 17th itself. By the 20th, definite improvement could be seen in his case and in a week's time he became completely normal. He came and thanked me personally and went back to his town. I have information that he is well till now. Before he saw me, this patient had already had several sedatives and hypnotics and they had all failed. Therefore, it was seriously being considered that he should be given electric shock therapy (E.S. T.) to restore him to sanity. Surely, Homoeopathy must take credit for restoring him to health so easily, gently and quickly. I once had a patient suffering from diarrhoea for several years who had taken lot of allopathic treatment for many years with no result. He came to me and as I was taking his case he mentioned a very peculiar symptom. He said that he had only one large watery stool in the morning every day which was preceded by rumbling in the abdomen but the peculiarity of the stool was that whatever the quantity of the stool, it would all drop out at one stroke. On this symptom I gave Gambogia and I think with one or two doses he was completely cured. I may again quote a case in which a girl used to get severe itching of the nose while attempting to eat. The thing was so severe that she had to stop eating and so she used to drink her meals. She consulted an E.N. T. specialist and then a skin specialist, both of them could do nothing for her. With one dose of Lachesis selected from Kent's Repertory she was completely all right. I had actually given her two doses but she needed to use only one. The funny thing was that her sister also developed the same symptom a month later and this girl gave her the remaining one dose and she was also cured. Personal experiences of homoeopathy I was once suffering from conjunctivitis. There was severe shooting pain in my eyes, first in the left and then in the right. I had not taken any medicines but I started using dark glasses, so that my eyes may be protected from the strong light. After starting to use the dark glasses, I noticed that I had more pain while I was using the dark glasses! I also noticed that if I closed my eyes and kept them closed, instead of getting relief as I should, I used to get more pains and when I opened the eyes, there was at once a sharp stabbing pain but this was followed by some relief as I continued to blink. Now I had no doubt about the medicine. I took a few doses of Rhus-t which gave me prompt relief and cleared up the whole thing. Urticaria

Recently some four months back on Holi day, I was consulted by a neighbour of mine, a lady doctor, Dr. Mrs. P., M.D. , D.G. O., F.C. P.S. , for her son aged two years. The history was as follows: Exactly one year back, on previous Holi day, as is the practice among Hindus, some people had been spraying coloured water on each other and some one had thrown this on this child also. On the same day, the child had developed rashes on his body like urticaria, probably as a result of allergy to the chemicals in the colours. Since then, every day without exception the boy had been getting these urticarial rashes for the whole of last year. His mother had naturally tried every type of anti-allergic medicines including cortisone but they would give only transient relief and had to be given daily. She was afraid to drug the child with cortisone continuously like this and so she had approached me. On taking the boy's case, I got only two good symptoms besides the chief complaint described above. One was that the boy had become allergic to eggs, which would produce extra aggravation of the urticaria. Secondly, he had become very sensitive to mosquito bites. Not only the bitten area would swell up but the bites would produce generalised disturbance. I consulted Kent's Repertory and Phatak's Repertory and took two rubrics: "Eggs agg." and "Skin, stings of insects". The drugs to come through were Ledum and Sulph. I chose Ledum because the mosquito bites had produced constitutional effects. I gave the child one dose of Ledum 30. Next day the mother reported that the allergic rash was much less. One more dose was given and the rashes disappeared. Now, the child is completely all right for the last four months. Further, eggs do not upset the child nor mosquito bites. Not only is the doctor-mother very pleased, she has directed to me some more cases of urticaria because she is sure that Homoeopathy is a specific system of treatment for urticaria! Aconite One night in Bombay, I was called upon to treat an elderly lady Mrs. X., aged about 60 years, who had become extremely restless. I found her pacing about to and fro agitatedly. She had been doing this for nearly twelve hours. It appears that three days back her daughter had left Madras for Delhi, unescorted. After the train had left Madras bound for Delhi, a telegram had been sent from Madras to the relatives in Delhi. So, the relatives in Delhi duly went to the station to receive her but she was not found in the train in which she should have arrived. So they grew anxious and made a trunk call to Madras. This only made the relatives at Madras also anxious and they, in turn, made a call to Bombay to see if by chance the lady had reached Bombay. (It turned out later on that she had, on an impulse, got down at Nagpur on the insistance of some friend). So, when Mrs. X. came to know that her daughter had left Madras but had not reached Delhi and so was missing, she became extremely restless and agitated and terrified. She was pacing to and fro, wringing her hands and moaning. She was saying, "Take me to Delhi or to Madras. Take me somewhere!" Her son wanted me to give her a sleeping dose. I agreed to do so. Considering that the causative factor was fright and anxiety and the result extreme restless with anguish, I gave her one dose of Aco. 1M. Next day her son turned up to thank me for the sleeping dose because she had slept well and was normal! Dysentery Psorinum and cina

Master I.U. , aged 5 years, was brought to me for consultation on 14th May 1957 with the following history: When he was 21/2 years old, he had an attack of dysentery. He was treated with allopathic medicines and felt better. This condition relapsed two or three times, and the child did not improve in his health. He once also passed a tape worm. But even then, the attacks of "dysentery" continued to recur and his general health did not improve. So Dr. T., a child specialist, was consulted but his prescriptions also had no effect. The child is sometimes well and sometimes falls ill. Sometimes he has ravenous hunger, sometimes he loses his appetite. He grinds his teeth in sleep, bores into nose. He drinks one or two glasses of water at night. He always sleeps on his abdomen. His stools are sometimes very hard like balls, sometimes watery and offensive with blood. He is very keen on bath particularly cold. Wants open air. He gets easily angered. The case was repertorized with Boger's Synoptic Key and Kent's Repertory as follows: Alternations (B.S. K., pp. 30, 356) = Pso., Puls. + Stools, bad odour (B.S. K., p. 80) = Sulph. + Reaction, poor (B.S. K., p. 42) = Pso., Sulph. + Cold, amel.; Uncovering, or cold bathing, or applications Amel. (B.S. K., p. 20) = Pso., Sulph. + Nose, boring in, with fingers (K.p. 324) = Pso. + Teeth, grinding at night (K.p. 432) = Pso. In my experience, generally, nosodes do not work out well through repertories and when they do work out, I give them great preference. He was given Psorinum 10M, 3 doses in one day. By 18.06.57, the condition was much better. Stools normal. Only thing was child still looked emaciated. The case was repertorized again with the symptoms that remained. Stomach, appetite changeable (K.p. 476) + Teeth, grinding at night (K.p. 432) = Cina., Pod. + Nose, boring in with fingers (K.p. 324) = Cina. Cina. 1M, 3 doses in one day were given. 05.07.57 : Child is improving very well. Stools are completely normal. 09.09.57 : Child is now perfectly normal. Master I.U. , aged 5 years, was brought to me for consultation on 14th May 1957 with the following history: When he was 21/2 years old, he had an attack of dysentery. He was treated with allopathic medicines and felt better. This condition relapsed two or three times, and the child did not improve in his health. He once also passed a tape worm. But even then, the attacks of

"dysentery" continued to recur and his general health did not improve. So Dr. T., a child specialist, was consulted but his prescriptions also had no effect. The child is sometimes well and sometimes falls ill. Sometimes he has ravenous hunger, sometimes he loses his appetite. He grinds his teeth in sleep, bores into nose. He drinks one or two glasses of water at night. He always sleeps on his abdomen. His stools are sometimes very hard like balls, sometimes watery and offensive with blood. He is very keen on bath particularly cold. Wants open air. He gets easily angered. The case was repertorized with Boger's Synoptic Key and Kent's Repertory as follows: Alternations (B.S. K., pp. 30, 356) = Pso., Puls. + Stools, bad odour (B.S. K., p. 80) = Sulph. + Reaction, poor (B.S. K., p. 42) = Pso., Sulph. + Cold, amel.; Uncovering, or cold bathing, or applications Amel. (B.S. K., p. 20) = Pso., Sulph. + Nose, boring in, with fingers (K.p. 324) = Pso. + Teeth, grinding at night (K.p. 432) = Pso. In my experience, generally, nosodes do not work out well through repertories and when they do work out, I give them great preference. He was given Psorinum 10M, 3 doses in one day. By 18.06.57, the condition was much better. Stools normal. Only thing was child still looked emaciated. The case was repertorized again with the symptoms that remained. Stomach, appetite changeable (K.p. 476) + Teeth, grinding at night (K.p. 432) = Cina., Pod. + Nose, boring in with fingers (K.p. 324) = Cina. Cina. 1M, 3 doses in one day were given. 05.07.57 : Child is improving very well. Stools are completely normal. 09.09.57 : Child is now perfectly normal. Sepia Shree A.D. , aged 25 years, came to me for consultation to me on 1st May 1959 with the following history: 2 months back he had an attack of dysentery. Consulted Dr. S.D. who is his uncle but did not follow his treatment. He gets slight abdominal pain before passing stool. Has only one stool per day. Pain is stitching and is shooting up. Pain is agg. by eating cauliflower, cabbage, potatoes, rice, fried food, bread and by over-eating; is amel. by passing flatus, taking cold drinks and butter milk, after stool. He dislikes hot drinks. He is irritable and gets tired by speaking.

The case was repertorized with Kent's Repertory as follows: Food, fat, agg. (p. 1376) + Food, cabbage, agg. (p. 1375) = Ars., Bry., Carb-v, Chi., Hell., Kalic, Mag-c, Nat-m, Puls., Sep., Sil., Ver-a + Eating, Satiety to (p. 137) = Carb-v, Nat-m, Puls., Sep., Sil. + Food, bread agg. (p. 1375) = Nat-m, Puls., Sep. + Food, potatoes, agg. (p. 1376) = Sep. + Food, cold drinks, agg. (p. 1375) = Sep. Sepia 200, 3 doses in one day and placebo given. 16.05.59 : Pain was slightly better but has relapse. Sepia 1M, 3 doses in one day and placebo given. 03.07.59 : Feels better but still he gets pain twice a week. Sep. 50M, 3 doses in one day. 21.07.59 : Again got pain. Sepia CM, 3 doses in one day given. 29.07.59 : Practically no pain: Sac-l 01.10.60 : Has remained well. Phosphoric acid Mr. A.R. T., aged 48 years, came for consultation on 29.03.65 with the following history: In June 1947, he got paratyphoid and became very weak. In August 1947, he lost his father which was a shock to him. Then one day while coming by train, he got a cramp in the epigastrium, with shivering and sweat followed by a stool. This recurred again and then he developed fear. After that he started passing mucus in stool. This was diagnosed as dysentery and he took a lot of anti-dysenteric drugs. The stools are agg. by excitement. He has also developed frequent desire for stool which was while riding a motorbike. He has a lot of mental upsets and worries. He also gets shivering when he goes to the seashore. Weight has been reduced from 160 lbs to 125 lbs. Married in 1945. Had electric shock in 1953. He had arsenic poisoning due to inj. given for Eosinophilia in 1956. Now he has stopped eating non-veg. food and since then has no mucus in stool. He had to suppress his sex desire often because his wife was disinterested in sex. Ign. 1M, 3 times a day for three days was given to him, because of the history of grief. On 02.04.65, he reported that his condition was same. The case was then repertorized in Kent's Repertory as follows: Suppression of sex desire (p. 711) + Grief ailments from (p. 57) = Ap., Calc., Con., Ph-ac, Plat., Puls., Staph. + Diarrhoea on excitement (p. 612) = Ph-ac Ph-ac 1M, 3 times a day for days was given. 29.04.65 : Patient feels much amel.. Feels he will be cured.

Ph-ac 1M, 3 doses a day for two days was given. 27.09.65 : Feels amel. mentally. Fear nil. Ph-ac 10M, 3 doses a day and placebo were given. Six months later, I heard that he remained well. Sulphur - a study The Sanskrit word for Sulphur is (Sulphari) which means enemy of copper *. From this word, the Latin word Sulphuricum is derived. Homer, the great Greek poet, refers to Sulphur as Brimstone i.e. burning stone. (Since on burning it produces a strongly smelling gas, it is called (Gandhak). ** Sulphur is mostly derived from the lava or the molten red-hot fiery liquid that erupts from the bowels of the earth through the volcanoes. The character of the source can be seen reflected in the centrifugal force of the drug which drives and throws out everything on to the surface, bringing internal peace. The red-hot openings of the volcanoes have their counterparts in the red-hot orifices, e.g. eyelids, lips, nostrils, meatus of the ears, anus, etc., through which the red-hot burning discharges come out. Sulphur itself catches fire easily and because of this quality it was used in the manufacture of gunpowder by the Chinese several centuries ago. The (liquid) outpouring can be seen in the diarrhoea (Mag-s is a well-known purgative). Taken in mass, sulphur is an inert powder and the greater part escapes unchanged with the stools, but some of it forms sulphides, mostly sodium sulphide, in the alkaline fluids of the intestines and these cause irritation of the mucous membranes, with consequent increased peristalsis and mild purgation. In some instances, inflammation has been set up, with resultant pain and mucus and bloody evacuations. The skin is particularly vulnerable and exhibits various manifestations like eruptions, ulcers, warts, etc. (The eruptions of the volcanoes are reflected in the eruptions on the skin.) This is no surprise since the skin contains sulphur and has a particular affinity for sulphur. Ointments containing sulphur are used as external applications for various skin conditions in Ayurvedic and Allopathic medicine particularly for scabies, and Sulphur springs are very popular in patients suffering from skin diseases. Hydrogen sulphide, H2S, is one of the most offensive gases in the world and this can explain the extremely offensive discharges of the Sulphur patients. Some of the sulphides are absorbed and destroyed in the organism with liberation of sulphuretted hydrogen which escapes by the lungs and skin giving the characteristic odour of rotten eggs to the breath and perspiration; others form sulphates and are excreted in the urine. The patient himself is found to be offensive. Water being the enemy of fire, the Sulphur patients are worse by washing and bathing. Antimonium crudum which is a sulphur compound (Antimony sulphide) also has aversion to and agg. from bath. The Sulphur patient also develops dirty habits. He is himself dirty and offensive or is indifferent to dirty and offensive surroundings. The yellow colour of the element is also seen in the yellow staining of the perspiration. The depletion by perspiration or diarrhoea may account for excessive thirst and the craving for salt. Insulin contains Sulphur and this may explain the craving for sweets and agg. from sweets. The metabolism itself is disturbed and so the patient is always hungry; he eats well but emaciates. He has also craving for fats. Of the 5 remedies in Kent's Repertory given for desire for fats, viz., Ars., Hep., Nit-ac, Nux-v, and Sulph., Sulph. is the only one agg. by warmth.

The experiment of Prof. Augustus Bier is very interesting and gives us some idea of the nature of Sulph. He put a patient on Sulphur 3x and found that the patient started excreting daily 576 mg of sulphur, which is sixty times the normal rate. Even after the Sulphur was discontinued, he was found to excrete 117 mg. On the day after, he then averaged 54 mg for ten days and after thirty days he was still excreting about twice the normal. The seborrhoea about which he had complained was markedly improved and his general well-being decidedly better than before the experiment. The patient was located two years later and agreed for the sake of experiment to make a retrial although he considered himself cured. When he now took Sulphur 6x for 10 days hardly any extra excretion of sulphur was found. The relationship of Arsenic and Sulphur is interesting. Sulph. is a complementary which follows Ars. well. But they are widely different remedies. Ars. is agg. by cold and Sulph. agg. by warmth. Ars. is meticulous, wants everything in its place. Sulph. is indifferent, careless, shoddy and even dirty. The excessive anxiety, hurry and restlessness of Ars. contrasts with the euphoric, slow lazy state of Sulphur. Arsenic is in artist (The latin word for Arts is Ars.) while Sulph. is a scientist. Sulph. has the abundant curiosity and inquisitiveness of a scientist and goes on questioning about everything. Sulph. is a good remedy to close the treatment of acute diseases and to begin the treatment of chronic conditions. Almost every rubric in our repertories contains Sulph. So the neophyte are likely to select Sulph. for every patient. Only later on they will understand where Sulph. is really indicated though of course it is needed in many cases. Case Lumbago Mrs. M., wife of the a doctor, aged 68 years, consulted me on 8th June 1972 with the following complaints: She is suffering from lumbago for the last 20 years. Now, cannot get up from bed due to the stiffness. Pain is agg. rising from sitting, agg. sitting long, agg. lying on back, agg. cold drinks, agg. stooping, cannot squat. It is amel. pressure and amel. massage. Gets pain and heaviness in thighs. She has become very obese. Her appetite, thirst, etc., are normal. She is amel. by company. Very irritable. Past. Hist.: She had thyrotoxicosis which was amel. with Neomercazol. Was operated for prolapse of uterus one year back. Fam. Hist.: Her sister had tuberculosis. The case was repertorized in Kent's Repertory as follows: Back pain, lying back, on (p. 896) + Back, pain, lumbar region, lying back on (p. 906) + Back, pain, rising from sitting (p. 897) + Back, pain, lumbar region rising from a seat (p. 907)]= Amm, An., Ap., Berb., Bry., Carb., Lyc., Nat-m, Puls., Rhus-t, Sep., Staph., Tell., Zn. + Obesity (p. 1376) = Am-m, Bry., Lyc., Puls., Sep. + Prolapsus, uterus (p. 743) = Am-m, Bry., Lyc., Puls., Sep. + Cold drinks, agg. (p. 1363) = Lyc., Puls.

I preferred Lyc. because she was rather irritable. Lyc. 200, 3 doses in one day. 17.06.72 : Feels 25% amel. but still has pain. Lyc. 200, 7 doses, daily once given. 21.06.72 : Felt amel. Lyc. 200, 3 doses in one day, to be taken weekly. 18.07.72 : Condition relapsing. Lyc. 1M, 1 dose was given. 30.08.72 : Condition normal. Lyc. 1M to be taken once a month, if necessary. The responsibility of clinical teachers We have emphasized in the past the fact that in the medical curriculum, the most important part is the practical training given to the students in the hospitals attached to the colleges. In the absence of proper practical training in well-equipped institutions with suitable teachers, mere theoretical teaching given in the colleges cannot be expected to prepare practitioners fit to handle the cases met within medical practice. It is known that in the olden days medical students did not have to study theory at all but they had to merely become apprenticed to experienced doctors. Of course, they thus learnt how to practice but such practical training without the infrastructure of the theory and the principles of approach cannot suffice because the student cannot understand the why and wherefore of the practice. In the same way, good theoretical teaching without proper practical training is also useless because the student is bound to feel bewildered when he meets actual cases. Therefore, the responsibility of those connected with the practical training of medical students is very great. They have to see that the students are given maximum amount of proper practical training in the out-patient and in-patient departments of the hospitals. The principles of Homoeopathy have to be applied at the bedside in front of them so that it is demonstrated to them that when the methods of Homoeopathy are scientifically applied, the results are most satisfactory. Not only will this help to educate them but it will also serve to impress upon them that Homoeopathy properly applied is as successful as, if not more than, the other systems. While ensuring such qualitative and quantitative practical training the clinical teachers at the bedside have also to exercise caution to see that the basic principle of Homoeopathy are not transgressed in an effort to devise short cuts. If the students are taught certain rules and methods in the classrooms, and these principles and methods are infringed at the bedside in the teaching institutions, nothing but confusion can arise in the tender minds of the learners. The less the gap between the theory and the practice, the greater and better will be the impression and impact on the minds of the students. This is not to say that the physicians at the hospital have no right or scope to experiment with different methods of application of Homoeopathy. Certainly they are free to experiment since experiment is often a pre-requisite for progress. Within the basic and broad frame-work of Homoeopathy they may try different methods of application, e.g. frequent and infrequent repetition of the doses, use of high and low potencies, alternation of remedies, etc., if they have a reasonable hypothesis or basis to proceed. But the cases treated by these methods, which are purely experimental and not established, should not be placed before the students who may not understand that these are only experiments and, therefore, may draw hasty conclusions without sufficient grounds. If this care is taken, such experiments can be conducted. But if the students are exposed to various methods, which are variations from what is taught in the classrooms, there can be nothing but chaos. So the clinicians must take

care to see that they teach the students only traditional methods at the bedside and also explain the rationality of every procedure adopted. What homoeopathy needs For the further progress of Homoeopathy a better method of drug selection seems called for, whereby drugs can be selected more accurately and easily without resort to the hit-and-miss and then-try-again method which many of us seem to be practising now. For this purpose it may be necessary for us to develop some kind of method of drug selection which does not exclusively depend upon the fallible observations, senses and intellect of the prescriber and the patient. Homoeopathy in general practice We, who are practising as consultants, have certain advantages. The patients who come to us are referred to us and come fully aware that we are homoeopaths. Probably many of them have tried and exhausted all the usual avenues of treatment and come to us as a last resort. So our work is cut and dried. There is not much need for us to convince our patients except by good results. The position of the general practitioner however is otherwise. He has to compete with his better equipped and more impressive allopathic neighbour. The significance of symptoms Medical progress will no doubt prove to the profession that every symptom has a significance that cannot be ignored and unless each is given its due place and importance, it is doubtful if the case will be treated fully and properly. The homoeopath is not in a position to explain fully or even partly the deeper significance of each symptom nor is he able to describe the mode of production of each symptom. Yet, by giving each symptom its due place in the total picture, and allotting to it its proper value, he is able to arrive at a much better prescription and tackle the disease in its entirety. In this respect the reach of Homoeopathy is astounding. We shall consider one or two examples. Let us take Epilepsy. The homoeopath first tries to trace the disease to its origin, source or cause. If the epilepsy can be traced to have arisen after an injury to the head, or anger or fright or suppression of emotions or exposure to heat or indiscretions in diet or mode of living or to a hundred other causes, which are peculiarly significant to the homoeopath, he is able to put his finger on groups of drugs each covering a particular origin or causation in addition to the rest of the totality of symptoms. Again, the nature of the aura experienced by each of the patients before the attack and the fact whether the attack starts from the feet, hands, face, head, etc., each indicates different sets of remedies. The actual nature of the convulsion, and the actual condition of the patient during the attack also indicate their own remedies. From among the cases of epilepsies treated, we may quote two as examples to illustrate. A patient reported a greater frequency of attacks in summer and got more attacks if he consumed potatoes. The orthodox physician may reject these facts as of no consequence, labelling them as incidental or accidental. But one or two doses of Alumina in potency, based on these data, removed the illness entirely. Another patient reported that the attacks were definitely precipitated by loss of sleep - again a fact which the orthodox physicians in the present state of their knowledge may ignore or discard as of no value; but based mostly on this modality a prescription of some doses of Cocculus restored the patient to health.

A patient mentions to us that he is very much disturbed by eating onions. The smallest slice of onion included, even inadvertently, in his diet, produces a severe diarrhoea. If this symptom is placed before an orthodox allopathic physician, he would merely diagnose that this patient is allergic to onions. Beyond advising the patient to avoid this offending item, the allopathic physician gives no significance to this symptom. But to the homoeopathic physician, this would be a most welcome and valuable clue to the selection of the proper medicine and he is able to select his medicine from a small group of drugs given under the rubric "Aggravation from onion". Many cases can be quoted in which, guided by this symptom, a prescription of Lyc., Nux-v, Puls., or Thuja has cured patients suffering from different conditions. Every homoeopath can give numerous such examples from his records. Let us take one more instance. A patient becomes psychopathic. He tries to commit suicide by jumping from a height. Now in tracing the case history of this patient, the homoeopath traces the disorder to the source or the exciting cause, and the various precipitating factors. It might have originated from suppression of some emotion or from a sense of shame or a feeling of guilt. Again, the actual symptoms also indicate different drugs, e.g. fear of darkness, thunder or robber, desire to be alone, talking to oneself, irritability, etc., etc. Again even when the patient has decided to commit suicide, the actual nature of the attempts by which he tries to kill himself e.g. whether by drowning, shooting, or jumping from a height, etc., also indicate different remedies. Which particular neurons or areas of the brain, or pathways of the nervous system, or what particular background of the patient decide the various impulses and the behaviour, i.e. the actual nature of the attempt, it is for psychologists and scientists to work out. But for homoeopaths these simple facts have deep significance and help in deciding the prescription. What is curable ? It has been my experience in homoeopathic practice that cases considered incurable by general medicine often get surprisingly cured under homoeopathic medicine. Sometimes, it also happens that cases which we are extremely confident of curing turn out to be incurable in our hands. In modern medicine, some degree of prognosis can be safely given on the basis of clinical and pathological findings. But in Homoeopathy it becomes very difficult. Even if the therapeutic test is applied, i.e. if a drug has been given and the patient does not respond to the drug, we cannot say that the case is incurable because we might have made a mistake in the selection and given a drug which is not the similimum. Therefore, even if we are confident in a case we might fail and it may so happen also that a case we consider incurable because our prescription evoked no response might turn out to be curable in the hands of some other physician. To illustrate my point, I shall give you a number of examples. 1. I have treated a case of Horner's Syndrome. The patient had unilateral anaesthesia of the face with coldness, perspiration and enophthalmos. He had gone to a physician and then to a surgeon and X-rays had shown that he had cervical ribs on both sides resulting in pressure on the cervical ganglion on one side contributing to the clinical picture described above. When he came to me I told him that in my opinion Homoeopathy could not help because it seemed to be clearly a case of pressure on the ganglion, which must be relieved by a surgeon. Some doctor had prescribed for him Carbo vegetabilis because he had symptoms of flatulence with amel. by eructations, and with this drug he was feeling better. He wanted to know why I could not give him better medicines. I took up his case and found that the whole trouble had originated after he had had a shock of seeing a neighbouring shopkeeper being robbed in front of him. The case worked out to Argentum nitricum, and when I gave this medicine,

within a few months the whole condition became normal. Now after three years the symptoms have still not recurred. 2. Next I will described a case of Ovarian tumour. A lady came to me from Nadiad with a massive ovarian tumour. Two years back she had begun to suffer. She had been operated upon and the tumour removed. The tumour had weighed 44 lbs! Indeed, a record, I think! A section was probably examined and found to be non-malignant. But unfortunately after one and a half years the tumour recurred again. It had now grown again almost to the original size and since the lady refused to have surgery again she came to me for medicine. I gave her medicines with very little hope. But to my surprise the tumour rapidly decreased in size and became almost half of its original size. Unfortunately, the lady went out of my care and I could not follow up the case. With all my experience in Homoeopathy, I have not been able to distinguish between or decide the criteria which delineate a curable from a incurable case under homoeopathic therapy. Failures - homoeopathy's or homoeopath's? Some one or two years back, I was called to see a young man suffering from general anasarca. The history was that he had been to U.S. A. for some study and there on routine examination of the urine, albumin had been detected. Further tests had revealed that the kidneys were not functioning properly. It was diagnosed as a degenenative disease of the kidneys (Nephrosis). So he was sent back to India. By the time he reached London en-route to India, his condition became quite bad. He then consulted Dr. Sir John Weir. Sir John gave some prescription and there was immediate and very satisfactory improvement. Then the boy came to India and here there was relapse. It was then that I saw him. I took down his case and gave him Ars. on his symptoms. But since Sir John Weir had already seen the patient and had produced improvement, we sent a cable to him describing the condition of the boy and asking for advice. The reply of Sir John Weir was, "Ars. alb. confirmed but prognosis hopeless. Make patient happy." The patient died after sometime and this case was an eye-opener to me, in this sense that even the correct prescription need not necessarily cure every case. Retention of urine Mrs. S. consulted me on 22.02.64 with the following history: On 14.01.64, she developed fever with vomiting. This was first suspected as jaundice but later treated as typhoid with chloromycetin. The temperature dropped to normal on 28.01.64 but on the same day she developed retention of urine. Not being relieved by any medicine, she had to be catheterised four times a day. It was thought that gradually the retention would disappear but it did not. So a neurologist was consulted who found nothing abnormal and thought it must be due to some shock. No specific treatment was suggested and so the patient continued to catheterise herself four times a day till the day I saw her. When I saw her she had the following symptoms : Has retention of urine. She gets fullness of the bladder and urge for urine every few hours but no urine is passed even if she strains. She had substernal pain if she walks fast. She has nausea on and off, amel. hot drink agg. after food.

Talking much causes palpitation. Appetite, thirst, stool, sleep, sweat, etc., are normal. Her previous and family history gave no clues. She was happily married and had two healthy children. She had no worries of any sort. There was no history of any fright or shock. I took the following symptoms, viz: Cold drinks agg. Fast motion agg. Speaking agg. Retention of urine and found Ars. and Sil. covering these symptoms. With Ars. and Sil. she got relief in the other symptoms but not in retention of urine. Then I gave her Opium 1M because of the possibility of some fright as the causation. But after the dose of Opium she developed shocks in the body occurring every 1/2 an hour and so I antidoted the dose of Opium 1M with Op. 30. Now, I consulted a senior physician, Dr. S.R. Phatak, M.B. B.S. He diagnosed the retention of urine as hysterical and prescribed Zinc met. 200 (Refer Kent's Repertory: Retention of Urine, in hysteria: Zn.) With the second dose of Zinc met., she had a copious flow of urine without resorting to the catheter and since then she is quite well now for over a month without the need for any more medicine. The need for sincerity The saving of Life is the supreme consideration of every physician, be he a homoeopath or anyone else. The homoeopath is physician first and then a homoeopath. The welfare of the patient is the first and only consideration. Nothing should come before this objective. But this should not be an excuse for a homoeopath to use allopathic medicines about which he is entirely ignorant. The subject dealing with the indications, contraindications, dosage, mode of administration, etc., of modern drugs is a very deep one. If the homoeopathic physician feels that he has failed or is likely to fail in a particular case, he can direct such a patient to a more competent homoeopath or even to an allopath. Many of our allopathic colleagues send us cases when they have exhausted their therapeutic resources or feel that their system has nothing to offer. We have to appreciate their honesty and sincerity. Surely we can develop the same type of honest attitude. Our ego should not stand in the way of directing them to more competent physicians of our own system or of some other system instead of monkeying with drugs, the therapeutic use of which we are not quite familiar. Nor do we have any moral or legal justification for using such drugs. Cholelithiasis Mrs. S.M. , aged 45 years, consulted me on 13.05.57 with the following history: She has been having paroxysms of pain in the epigastrium and right hypochondrium on and off for the last two years. These attacks are specially provoked by taking fried food. The last attack had come on because of fried fish.

She had consulted her allopathic family physician and, on his advice, had investigations done. Plain X-ray of the gall-bladder had shown multiple gallstones. Cholecystogram had shown poor concentration of the dye. The family physician had consulted a consultant and it was decided that her gall-bladder must be removed. When this decision was conveyed to the patient, she did not welcome it. She was averse to undergoing an operation and wanted to avoid it. She had heard that such cases can be treated by homoeopathic medicines and so wanted permission to try Homoeopathy. The family physician at first ridiculed the idea that gallstones could be treated by medicines but gave permission for the trial ultimately. But he gave her only three months time. So she came to consult me. Her symptoms significant from the homoeopathic point of view were: Pain in G.B. area agg. on taking fried food, extends to the back, and is amel. by fomentation. Feels as if something is swollen and constricted as by a hand there. When pain occurs the area becomes very tender and sensitive to touch; Pain is amel. by eructation or flatus; no vomiting. Other symptoms were: Fasting causes vertigo. Easy satiety; Distension after food. When disturbed from sleep, or on hearing sudden noises gets palpitation. Last two years, cannot remain alone; must have company. Late falling to sleep. Last 2 years, lying on back causes palpitation. Gets frightful dreams. Easily angered by contradiction. Full of anxiety; anxiety causes trembling; imagines the worst. Great fear of thunderstorm. Menopause 7 years back. Since then has anxiety and palpitation. Previous History: Father died, cause unknown. Mother died at 60 of diarrhoea. One brother died of diabetes. Has 6 children all healthy. The case was studied with the help of Boger's Synoptic Key and Kent's Repertory under the following rubrics: Liver and G.B. (B.S. K. p. 78) Direction backward (B.S. K. p. 34) Food, Fat agg. (Kent p. 1363) Lying on back agg. (B.S. K. p. 25)

Fasting agg. (B.S. K. p. 22) Company amel. (B.S. K. p. 21) Eating a little, agg. (B.S. K. p. 22) Sensitive to noise (Kent p. 79) Fear of thunderstorm (Kent p. 47) Menopause (Kent p. 724) The only drug that covered all the symptoms was Phos. So, she was given on Phos. 30, one dose. 29.05.57 : The response was immediate and very satisfactory. All symptoms improved but the dose had to be repeated whenever there was relapse, as follows: 29.05.57 : Phos. 30, 1 dose. 24.06.57 : Phos. 200. 01.08.57 and 28.08.57 : Phos. 1M. Now, as the stipulated 3 months' period was over, the X-ray was repeated and it showed that the stones were about 60% less in size as compared with previous plate. The family physician was somewhat impressed and allowed the homoeopathic treatment to continue. The radiologist who took the plates (who incidentally was the head of the department in a big allopathic hospital) was also much impressed. He came to meet me personally to express his surprise and to know incidentally the name of the medicine which can dissolve gallstones! The doses had to be repeated again on 28.09.57 (Phos. 1M), on 27.12.57 (Phos. 10M) and on 31.03.58 (Phos. 10M). By April 1958, she was completely normal and could take any type of fried food without any disturbance. So we stopped the medication. I now asked her to have the X-ray repeated but she refused stubbornly saying that since she was quite normal she needed no plates. At last, I could persuade her by the end of 1958 to have the X-ray which showed a perfectly normal G.B. with no Calculi. She remains well till the day of reporting (15.08.64). (I may mention some points of interest. The family physician who had originally laughed at the at the idea of homoeopathic treatment of gallstones later sent me several cases of chronic cholecystitis and cholelithiasis. This shows his understanding and professional attitude. The radiologist concerned asked my permission to demonstrate the X-rays in their radiologists' meeting because they had never so far seen or heard of a case of gallstones disappearing with medicine!) Question and answer

When we discuss our cases with allopathic physicians, they are very much puzzled, and quite often, we ourselves are not able to give any explanation. For example, I shall give you a case which I had reported in the Brit. H.J. A young man received a very slight injury on the head and immediately developed various neurological signs. He was examined by neurologists and it was diagnosed as Cerebral Tumour. It was a full-blown picture which no one could miss. He was advised operation which he refused. He came for Homoeopathy and one dose of Nat-s completely removed all the symptoms. However, fundoscopy revealed that the papilloedema was the same, and therefore, I presumed that the extent of the lesion was the same. But all the symptoms had gone! Now this case presents certain questions. There is no doubt that the tumour must have been growing for some time, perhaps some weeks. But how is it that the symptoms had developed after a slight head injury? No one believes that the dose of Natrum sulph. removed the tumour overnight. But how did it remove all the symptoms of the tumour? Do you think it reduced the size of the tumour within 24 hours? etc. Such questions arise. If it did not reduce the size of the tumour but relieved the patient of all the symptoms, then does it show that the homoeopathic medicine can bring symptomatic improvement without any improvement in the underlying pathology? Similarly, we have treated two or three cases of anaemia in which even though the hemoglobin was as low as 2 grams, the patient felt considerably better but the reestimation of the blood showed no change. How does this come about? These are very important questions I think and it is necessary for us as scientific practitioners to understand how our medicines act, and what is the relation of the homoeopathic medicine to the pathology of the case. Otherwise, a critic may say that homoeopaths merely bring about an improvement in the symptoms. In fact, some of them think that Homoeopathy treats the symptoms and not the disease! The secret of success Once a patient approached me for treatment for recurrent colds of 7 years' duration. As I was taking down her case she told me a remarkable fact: whenever there was coryza, if she took a cold bath, the coryza immediately lessened and disappeared. When I searched in the repertory under the rubric "Coryza better by cold bath", Calc-s alone was given and this drug made her well. Another lady, whom I was treating for some skin disease, told me that she had severe palpitation after a bath. It was not due to the exertion of bathing because no other exertion produced palpitation. It did not depend upon whether the bath water was cold or hot. The only drug given in Kent's Repertory for "Palpitation after bath" is Am-c. This drug relieved her completely of the skin condition and palpitation. Another patient came to me and gave me the remarkable symptom that he felt a weakness in the heart before, and during urination. The only drug that covered this symptom was Lith. which made the patient better. Eczema Mr. T.R. , aged 45 years, consulted me on 14th December 1961 with the following history: Since age of 19, i.e. from 1935, he has eczema on the legs. Has itching, and on scratching a thin fluid exudes. The eruptions are black and are worse in summer. Since 1951 he gets attacks of giddiness. This has started after his son-in-law, aged 35, expired suddenly which was a great shock to him. He was greatly depressed for one year. The

giddiness is agg. after coffee and is amel. by vomiting. It is associated with throbbing in temples. Heavy foods cause discomfort in abdomen between 1 and 2 a.m. Prefers hot food and drinks and sweets. Gets tinnitus in ears on and off; started in the right ear, now in both; amel. by fasting. Sometimes gets sprained pain in right scapular area, amel. by eructation. Feels generally better in the cold season. On examination I found N.A. D. except that he had external piles. For the eczema he had taken X-ray exposures with no relief. This case was repertorized as follows in Kent's Repertory: Grief, ailments from (p. 451) + Diarrhoea after milk (p. 614) = Ars., Con., Lyc., Nit-ac + Food, heavy, agg. (p. 1363) = Lyc. + Food, coffee, agg. (p. 1362) = Lyc. The remaining picture also fitted in with Lyc. I prescribed Lyc. 200, 3 doses six hourly to be followed by Sac-l. On 23.12.61, he reported that he had felt better for four days. I prescribed Lyc. 200 again. By 25.12.61, he felt better in all symptoms: eczema, the vertigo, the tinnitus, the abdominal discomfort all improved. The drug had to be repeated again on 30.12.61 in the 1000th potency, and this was followed by a dose of Carbo veg. 1M to keep up its action. Since then, the patient has been quite all right till now (20th June 1965) without any need for any further medication. Mr. T.R. , aged 45 years, consulted me on 14th December 1961 with the following history: Since age of 19, i.e. from 1935, he has eczema on the legs. Has itching, and on scratching a thin fluid exudes. The eruptions are black and are worse in summer. Since 1951 he gets attacks of giddiness. This has started after his son-in-law, aged 35, expired suddenly which was a great shock to him. He was greatly depressed for one year. The giddiness is agg. after coffee and is amel. by vomiting. It is associated with throbbing in temples. Heavy foods cause discomfort in abdomen between 1 and 2 a.m. Prefers hot food and drinks and sweets. Gets tinnitus in ears on and off; started in the right ear, now in both; amel. by fasting. Sometimes gets sprained pain in right scapular area, amel. by eructation. Feels generally better in the cold season. On examination I found N.A. D. except that he had external piles. For the eczema he had taken X-ray exposures with no relief. This case was repertorized as follows in Kent's Repertory: Grief, ailments from (p. 451) + Diarrhoea after milk (p. 614) = Ars., Con., Lyc., Nit-ac + Food, heavy, agg. (p. 1363) = Lyc. + Food, coffee, agg. (p. 1362) = Lyc.

The remaining picture also fitted in with Lyc. I prescribed Lyc. 200, 3 doses six hourly to be followed by Sac-l. On 23.12.61, he reported that he had felt better for four days. I prescribed Lyc. 200 again. By 25.12.61, he felt better in all symptoms: eczema, the vertigo, the tinnitus, the abdominal discomfort all improved. The drug had to be repeated again on 30.12.61 in the 1000th potency, and this was followed by a dose of Carbo veg. 1M to keep up its action. Since then, the patient has been quite all right till now (20th June 1965) without any need for any further medication. The psycho-somatic approach of homoeopathy I was once consulted by a lady, Mrs. B. who had developed severe itching in her neck. She had been suffering thus for seven years. She had been scratching her neck, day in and day out, till it bled profusely and had the appearance of raw beef. She had naturally gone to a skin specialist who, having done his best and failed, had given up. She had then gone to a psychiatrist but without any effect. When she applied to me for treatment, I naturally made very close enquiry about the origin of the ailment and was rewarded by a very interesting account. It seemed that one day her husband, Mr. B., had gone to his native town. It so happened that Mr. B.'s boss's wife, Mrs. J., had also gone to the same city at the same time, and so when Mr. B. was about to return, his boss sent him a letter and requested him to escort Mrs. J. to Bombay. When they duly arrived, Mr. B. accompanied by Mrs. J., and disembarked from the steamer, Mrs. B. was present at the pier to receive them. Just then, a friend of Mrs. B. also present there whispered into her ears that surely Mr. B. and Mrs. J. must have travelled in the same cabin, perhaps in intimate company. Thereupon, Mrs. B. got intensely suspicious and jealous. The subsequent behaviour of Mr. B. seemed to confirm her worst fears. It was during this period that she had developed the skin disorder. Later on, her husband had convinced Mrs. B. by various acts that he was completely loyal to her and he had nothing to do with Mrs. J. Mrs. B. appeared to be thoroughly convinced of his fidelity but it had made no difference to her ailment. The itching continued and she continued to suffer. It only required of me to put one or two questions to her to ascertain that her remedy was indeed Lachesis. Two or three doses of this medicine sufficed to restore her completely to normal health so that Homoeopathy earned her eternal gratitude. In 1963, I was consulted for a lady, aged about 35, who was behaving in a funny manner. She was happily married and had two children. About ten days earlier, her husband who was an officer in a bank had left for another city about 800 km away by plane. He had gone to attend a training course. It seems that after leaving Bombay he had not sent her any letter. On the fifth day, the daily newspaper which was supplied to their house happened to carry a photograph of a plane accident (in the U.S. A.). The absence of any letter from her husband and the very sight of the photograph of a plane accident (she did not care to read the caption below the photograph) seems to have combined to precipitate an attack. She became mentally unsound and started singing, laughing and weeping by turns. Sometimes she would suddenly leave the house and run away. Sometimes she would expose her person. A physician had been called and he had prescribed some sedatives, but to no effect. She was utterly sleepless and restless. When I visited her, she fell at my feet and prayed for help. When I asked her to sit down, she attempted to sit on my lap; later she started removing her clothes. I prescribed for her Hyoscyamus and in two or three days she became completely well. After recovery when she heard from her friends how she had behaved, it made her very much ashamed. She has remained well now for two years.

I was quite puzzled that such trifling circumstances should have precipitated such a major attack. So, I made close enquiries. But neither the husband nor the wife could give me any clue as to whether she had any background of mental tension or cause of such tension. It was only after a year that I came to know that her husband had knocked down and killed a boy while driving the car and that a law suit had been going on for nearly two years, creating much tension in their minds around the period when she had the attack; this dispute was, however, happily resolved some months later. Some time back I was consulted regarding an old lady of seventy-one. For some unknown reason, she had started behaving very oddly for the last 2 years. She was a widow and her three daughters had sacrificed much in order to make her happy. Two of them had remained single for her sake. But the mother had started abusing the daughters using bad language and even obscene words. She would demand from them more and more money, fine clothes, rich food, etc., things they could not afford to give. She would squander and waste money. They had engaged a very good servant-maid but the old lady went after her blood. She would tear away the servant's clothes. She would beat the poor girl and scream and when people gathered, she would complain that the maid she herself had been the beater! After having eaten well, she would go to her neighbour's house and say she was starving and would eat in their house too! While taking food in her own house, she would pick up some item of food, hide it, take it out and eat it surreptitiously. When her daughters were away at work, she would sell away their furniture and household belongings for a song. She would put salt or water in to the various dishes and spoil them so that no one could consume them. She would beg, damage and destroy things. She would pass urine or stool in the room. She would collect old and useless things and treasure them. In fact, she made life most miserable for her daughters and neighbours. They had decided that they could endure this no more and were actually going to put her in a asylum. It was then that they thought of trying Homoeopathy. One dose of Tarantula made an amazing transformation in her personality. Within 24 hours, she was utterly changed. She started behaving in a completely normal manner. I was myself surprised, the daughters were delighted, the neighbours were astonished and everyone vastly pleased and relieved. Lumbago - phosphorus Mrs. P., aged 34 years, turned up for consultation on 23rd Sept. 1959 for the following complaints: Backache, lumbosacral, which has started after a delivery 3 years back. The pain is agg. sitting and by exertion, amel. sitting erect and by rest. Her menses are regular, but very painful; pain is worse after the flow starts. She was given a pessary and was better for some time, but is now worse again. Flow is changeable. She has restlessness during M.P. Dreams of dead people. Has fears of robbers. She has become very doubtful. She gets headache worse seeing films and worse in the sun. Prev. Hist.: She has had an attack of dysentery. Family Hist.: N.A. D. Her case was repertorized as follows on Kent's Repertory: Restless during Menses (p. 75) = Ars., Bell., Ign., Mag-m, Merc.

+ Fear of Robbers (p. 47) = Nat-c, Phos., Sep., Sulph. + Suspicious (p. 85) = Ars., Bell., Nat-c, Phos., Sep., Sulph. + Dreams of the dead (p. 1237) = Ars., Phos., Sulph. + Back, pain, lumbar, agg. sitting bent (p. 907) = Phos. Phos. covered the rest of the symptoms also. So on 3rd Oct., she was given Phos. 1M, 3 doses in one day. Her response to this prescription was very satisfactory and she showed all round improvement. On 20th Oct., she reported that she had her menses. There was some pain and the flow was scanty. So she was given Phos. 10M. This had to be repeated on 20.01.59. On 21st Aug., she reported that she had been normal. There has been no more trouble thereafter. Nephritis The patient, a female, aged 45 years, was admitted in the hospital on 04.12.58 with a history of general anasarca, with ascites, dyspnoea and weakness of one and a half months' duration. There was also puffiness of the face, cough with serous expectoration and insomnia. Auscultation showed harsh breath sounds with rales all over the chest; screening showed hydrothorax. There was oedema on the extremities extending up to the thighs, pitting deeply on pressure. The output of urine was only 8 to 10 oz per day. The urine was loaded with casts and albumin. The patient was thirsty and chilly. The dyspnoea was agg. at night, agg. lying down and also by least exertion. She had a sinking feeling in the epigastrium. She was put on Apocynum cannabinum, min. T.D. S, as all the symptoms were found under the drug. The urine output started increasing at once and went upto 75 oz. a day, within a fortnight, associated with general improvement. This improvement continued upto 18.01.58 but then the improvement receded and she started steadily growing worse. We tried Apoc. can. 6 and 12, but to no effect. By 05.02.58, her condition became very critical and she was put on oxygen. Meanwhile, we had tapped her once and removed 40 oz of ascitic fluid and had tried various other drugs like Strychnine phos., Digitalis, Carbo veg., etc., as they seemed indicated, but got no results. On 09.02.58, she had gone into a comatose state (uremic) and her condition was grave. She had passed practically no urine for 24 hours. Ultimately, we put her on Apoc. can. 30, 3 hourly. There was an immediate improvement. The secretion of urine which had practically ceased was resumed again and the output slowly and steadily increased and went upto 110 oz a day within 3 weeks. The same drug was now given diluted and succussed every day and by 01.07.58, she was completely normal. There was no oedema whatsoever, and repeated examination of the urine showed no albumin or casts for nearly 3 months and then she was discharged as relieved. This case seems to confirm the view that the similimum is the correct drug in the correct potency. Objective method of drug selection

The subjective method of drug selection, which we all follow, is no doubt a very simple and excellent one as far as it goes but we have to confess that there are certain cases wherein the symptoms are all one-sided and there seems to be no general disturbance expressed by the patient. One can quote several disorders of the skin such as eczemas, warts, psoriasis, corns, leucoderma, etc., and other conditions like hydrocele, lipomata, alopecia, etc. There are also some cases where the patient seems to be apparently quite well but examination and investigation reveal some serious internal disturbance such as hypertension (asymptomatic), infiltration (pulmonary), calculus, etc. If our treatment is to embrace such conditions also, it is necessary that we develop more objective methods of drug selection. At present, we depend too much on the patient, giving importance to his every word. A lack of (or inaccurate) observation, deficiency of expression or absence of cooperation on his part or a lack of understanding or interpretation on our part can lead us far away from the correct drug. This is not a very happy state of affairs. Further, as our treatment stands at present, there is no court of appeal if two or more homoeopaths disagree on a particular case. Each homoeopath, depending on his training and experience, tends to place a differing degree of emphasis on each symptom and so there is a probability of difference in drug selection. When such difference arises, there is no criteria to judge who is correct. Drug addiction In August 1959, I was consulted by Dr. S. He reported that he had taken morphia for 3 or 4 days for some pain and had then become addicted to it. He required a quarter grain of morphia per dose, six or seven times a day. During the period of this addiction, in the last 3 or 4 months, he had lost 22 lbs in weight and had become careless about his profession. He complained that if he did not take the morphia, he would feel some unbearable discomfort in the abdomen and develop a diarrhoea with sudden and frequent urging for stool. The discomfort and diarrhoea would cease as soon as he took the injection. When he consulted me first, I just prescribed Nux-v 200, T.D. S., feeling that it would antidote the effects of the narcotic drug. This gave him much relief. So, I continued the drug and in the course of a fortnight, he was able to cut down his injection to 2 or 3 per day but he still could not give it up. I changed the prescription to Opium CM, T.D. S., and this gave him considerable relief and in the course of another ten days he was able to give it up. Now, for the last one and a half months he has not taken a single injection of morphia. In August 1959, I was consulted by Dr. S. He reported that he had taken morphia for 3 or 4 days for some pain and had then become addicted to it. He required a quarter grain of morphia per dose, six or seven times a day. During the period of this addiction, in the last 3 or 4 months, he had lost 22 lbs in weight and had become careless about his profession. He complained that if he did not take the morphia, he would feel some unbearable discomfort in the abdomen and develop a diarrhoea with sudden and frequent urging for stool. The discomfort and diarrhoea would cease as soon as he took the injection. When he consulted me first, I just prescribed Nux-v 200, T.D. S., feeling that it would antidote the effects of the narcotic drug. This gave him much relief. So, I continued the drug and in the course of a fortnight, he was able to cut down his injection to 2 or 3 per day but he still could not give it up.

I changed the prescription to Opium CM, T.D. S., and this gave him considerable relief and in the course of another ten days he was able to give it up. Now, for the last one and a half months he has not taken a single injection of morphia. Homoeopathic investigation The theory and principles of Homoeopathy are unequivocal, logical and easy to understand. But when attempt is made to apply them in practice, then we are assailed by a number of unexpected doubts. "What exactly is meant by Symptom-totality?" "To what extent should the drug be similar?" "How are we to select the optimum potency?" "How are we to ascertain that the drug and the potency selected are correct?" Numerous such questions demand answers. As a result, we find that what seemed to be a very simple and easy method turns out to be somewhat complex and difficult in practice. No doubt the majority of homoeopaths are able to achieve more or less satisfactory results without involving themselves in such intricacies. But a closer examination reveals that they have often zig-zagged towards a cure. The selection of the true similimum - the perfect prescription - which elicits a most happy response, is probably not as common as we would like to assume. Luckily, however, the law of similars seems to be so broad-based that even remedies selected of varying degrees of similarity seem to give relief, compensating for the imperfections of the prescriber. But this thought cannot give us adequate satisfaction. Therefore, the first of our immediate objectives must be to so simplify the practice of Homoeopathy so that even an average homoeopath will get better results. Homoeopathy's popularity and progress should not depend upon the brilliant but sporadic results of some good prescribers but rather upon the consistently excellent results of the majority of practitioners. Secondly, the means at our disposal have to be so shaped, and our methods so streamlined, that all chances of failure due to defects and deficiencies on this account are eliminated. To give but one instance, even the most exhaustive of our repertories are unfortunately incomplete, and any prescriber depending upon anyone of them exclusively might be led to fail. Many such examples can be quoted. Such defects must be removed so that the selection of the correct remedy will become a matter of mathematical precision in practice allowing, of course for vagaries arising from the biological nature of the subject. This objective can be considered a part or an extension of the first. Incidentally, most of the symptoms recorded in our Materia Medica are in the words of the provers and similarly in selecting the remedies too, we depend almost entirely on the expressions of the patients. Thus, knowingly or unknowingly, we attribute to their expressions a degree of omnipotence and rely much on their words. But we must remember that the patients are also fallible and that their thoughts and expressions are governed and modified by numerous factors besides their state of illness. Many of them lack powers of keen observation and intelligent, accurate expression. Moreover, language itself sometimes does not serve as a perfect medium for accurate and full expression of one's feelings. Further, the meaning intended may differ from what we understand of it. Therefore, taking all these facts into consideration, there is a necessity to develop, apart from the present method of drug selection (which we may call as "subjective" for the sake of convenience), an objective method also - if not of actual drug selection, at least a method of checking and confirming the correctness of the chosen remedy. Such methods have already been evolved to some extent by Boyd, Grimmer, Henshaw, Stearns and others. We have now to take up and complete this work.

If, by our efforts, we succeed in simplifying the practice of Homoeopathy and in making prescribing less arduous and more accurate, and if we can also evolve methods of confirming the correctness of the prescription, then we shall have achieved much. The science of homoeopathy Homoeopathy, which has evolved from the experiments of Hahnemann is, as it exists now, one of the most scientific systems of medicine. Certain basic principles of therapeutics have been laid down and the application of the principles brings about a high degree of success in practice. However, this is not to deny that there is much scope for research and improvement and further progress. To take only one example, we indicate that our prescription is based on symptom-totality, which means the summation of the characteristic symptoms. We then define the characteristic symptom as one that characterises the particular patient. So far, we are all in apparent agreement. But our concepts underlying this agreement are sometimes rather vague in this respect that when it comes to practice, each physician tends to place varying values on each symptom, building up his own characteristic totality from the symptoms of the patient and then prescribing, each in his own way. Ultimately, therefore, Homoeopathy may tend to become an individual affair, the physician becoming as much individualised as the patient! This is only one example. Many more such instances can be pointed out for consideration. All thoughtful homoeopaths will agree that this is not a most satisfactory state of affairs. The progress of the science requires that there be a greater degree of uniformity in our approach and that there be the minimum of divergence between the theory and the practice. Turning to physiology and pathology we have our difficulties too. Dr. Jaisoorya in his excellent paper published elsewhere, questions the validity of the discoveries and assertions of these sciences. It is too true that physiology and pathology, as taught at present, represent gross studies, dealing more with tissue structure and tissue changes, being a study more of the results than of the causes. To this extent it is defective as well as deceptive and any attempt to base prescriptions on such incomplete and gross knowledge is bound to lead us towards failure. Yet, this would be a criticism based on a narrow outlook of the scope of physiology and pathology. The latter should really include the study of the process of disease from the very inception to its termination, including the functional, biochemic and other changes in the organism. Viewed in this broad concept, none can deny that a medical student should be equipped with a knowledge of the process of disease, its causes, its nature, type, degree, extent, progress, etc. If such knowledge is sparse then it is our responsibility to spend our energies towards building it up. It is in this context that Farrington has remarked, "I hope that no diploma will be granted to any man in this class who does not study pathology." A total condemnation of knowledge of physiology and pathology without realising the full scope and functions of these sciences would be as bigoted as glorification of these sciences. If on the one hand modern pathology, though exhaustive, has failed to tackle the study of disease as it should then, on the other, we must confess that our own pathology is nebulous and ethereal. The concept of Vital Force, the theory of replacement of natural disease by drug-disease, etc., remain as Dr. Hahnemann propounded them, easy to believe but difficult to demonstrate. Dr. Linn Boyd in his valuable book has pointed out the several lacunae in our precepts and practice, which need to be worked by future generations.

Turning to homoeopathic pharmacology, we find still more difficulties. We can quote the following incident as an instance to illustrate our problems. Once when Dr. Jaisoorya was lecturing on Homoeopathy to the members of the Indian Medical Association (Allopathic) at Hyderabad, a learned member from the audience asked him, "When you say that the amount of drug-substance in the homoeopathic potencies is practically nil and that their blood level concentration cannot be measured, how can you assert that they act at all?" This question, an apparently logical one from the point of view of the questioner, spotlights the divergence of approach between the orthodox and the homoeopathic physician. The concept of action of a drug being determined merely by virtue of its blood-level concentration and the concept of the infinitesimal doses of Homoeopathy are as apart from each other as the concept of the atom in the Newtonian and the Einstein era. Yet, our explanation that the drug becomes converted to energy looks like a metaphysical explanation in this scientific era. Even accepting this, we have no idea at all how it becomes converted into energy. Further we do not know what kind of energy our drug energy is. Besides, we have no inkling how the various potencies differ from each other and how they act on the sick organism. Such and numerous other questions remain to be answered. Therefore, we appeal both to the teachers and the students of Homoeopathy to realise the great responsibility that lies before us and to work for the solution of these questions with speed and energy.

Repetition of doses A patient, aged 42, turned up for consultation with the following symptoms. At the age of 10, he had fallen down in church with giddiness. Since then, he has been getting electric shocklike sensations in the left arm passing up between the fingers and the shoulders. Whenever this sensation extended above the shoulder to the head, he used to fall down unconscious. The face then turned bluish or dark. These attacks came on more during sleep, in all 3 to 4 times a day, and were worse during moon phases. He was loquacious. He had been given Lachesis with partial improvement. His case repertorized as follows in Kent's Repertory: Convulsions, during sleep (p. 1355) Convulsions, left side of body (p. 1351) Convulsions, begin in fingers and toes (p. 1353) Face discoloured, dark (p. 359) Loquacity (p. 63) Further rubrics were referred to in Boger's Synoptic Key as follows: Direction, ascending (p. 371) Shocks (p. 44) Moon phases, agg. (p. 25)

This brought out only Cup. He was given Cup. 200 on 24.09.57. There was immediate improvement which lasted 3 months. Then, he had relapses at intervals and every time he was given Cup. in single doses as follows: 02.01.58 : 1M 05.03.58 : 10M 14.03.58 : 10M 08.05.58 : 50M 15.07.58 : 50M 28.09.1958 : CM 03.11.1958 : CM He showed improvement with every repetition. Then, from 01.02.58, as an experiment, he was given Cup. 30, once daily for a week; from 08.12.58, 200, once daily; from 06.01.59, 1M, once daily; from 04.02.59, 10M, once daily and from 27.02.59, CM, once daily upto 08.05.59. The effect of such repetition was in no way detrimental and he became practically normal. He still remains well. I must make it clear that I am not advocating indiscriminate repetition in every case. I am merely putting forward some observations and data I have gathered, though they are as yet insufficient and not sufficiently long-lasting to allow any definite conclusions to be drawn. The selection of the similimum and the management of the patient There are several books and booklets in which the methods of case taking, analysis and evaluation, and repertorizing have been explained. I shall now deal further with the subject of selection of the similimum and the management of the case. As I have mentioned elsewhere, the remedy selected must show a similarity to the disease on the basis of the Materia Medica. A remedy should not be given simply because it comes out through repertorization. If no remedy is clearly indicated in the beginning I give a nosode so that some new symptoms may be produced which will then indicate the remedy. Once a remedy has been selected by the physician, the next problem he faces is the problem of potency selection. Homoeopathic remedies are available from Mother tictures upto DMM potencies out of which the physician has to select the one potency which is required. For this purpose I have written a separate booklet called "Potency Problem" and therein I have given certain criteria for the selection of the correct potency. After the potency has been selected, the next question that arises is the one about repetition. In my practice, as I have mentioned, I try to select a remedy which fits in with and covers the symptom-totality of the patient as well as the cause, but I take the cause as the starting point as well as the most important symptom in the case. Then I take the case of patient in its entirety with all the symptoms present with their modalities and concomitants and out of this data I select such symptoms which seem to be strange, rare and peculiar, and try to find out

the one remedy which covers these symptoms. If such a remedy is found but it does not cover the common symptoms or the pathological symptoms, I do not mind. I still consider this remedy as indicated and I prescribe this remedy and I must say that in a large majority of cases I have been successful by this method. I have seen many of my juniors struggling with a number of common symptoms and trying to find the remedy and invariably failing hopelessly. I commend to them this method of giving importance to the strange, peculiar and rare symptoms as taught by Hahnemann in para 153 of the Organon. As I have already stated, there are many books which explain the principles and practice of Homoeopathy and which formulate various rules and lay down various procedures for the taking of the case and evaluating the symptoms and the different methods of repertorization and selection of the remedies. But in spite of all these teachings, ultimately the selection of the similimum seems to be a work of art backed by some degree of experience, though no doubt it is based on science. We shall now examine both the theoretical and practical aspects of the matter. Before we can talk about the selection of the similimum there are two important steps which have to be taken. One is the case taking and the second is the evaluation of the symptoms. Case taking itself seems to be an art. I have seen some homoeopaths taking the case in a mechanical way, recording page after page of desultory information without getting any useful symptoms. On the other hand, there are those who seem to be able to get the minimum number of symptoms all with maximum value in the shortest amount of time with the least effort. As regards the methods of questioning and eliciting symptoms, each homoeopath seems to have his own technique. I shall refer to these later. I need to mention here that any mistake that occurs in this step is bound to vitiate the ultimate step of remedy selection. A correct conclusion or judgement cannot be reached on incomplete or incorrect data. Next to case taking and a step which is equally, if not more important, is the evaluation of symptoms. It would seem that the most successful prescribers are those who know how to correctly evaluate the symptoms. The great masters are known to quickly identify from the mass of symptoms those specific symptoms and the underlying pattern which characterise the remedy. In the matter of guidance concerning the evaluation of symptoms, we naturally look to Hahnemann as the fountainhead of knowledge. And he, as usual, gives us clear instructions about this matter. He says that in the totality of symptoms the rare, strange, peculiar or characteristic symptoms will outweigh the other common symptoms in rank and those will mainly, if not exclusively, decide the choice of the remedy. Many people consider this as possibly the most important teaching of Hahnemann. In this matter, we differ widely from the allopathic colleagues. Having accepted this criterion of assessment, we have to decide what is strange, rare, peculiar and characteristic within the symptom-totality of each case. In this matter one may be guided by a knowledge of anatomy, physiology, pathology, clinical medicine, psychology (human nature and behaviour), and above all common sense. Having emphasized in aphorism 153 of the Organon the value of the characteristic symptoms, Hahnemann says in aphorism 211 that in almost every disease, even in the socalled physical disease, a change in temperament of the patient will be found and this change will often decide the remedy. He calls this change as "characteristic" thus correlating this aphorism with aphorism 153. We understand, therefore, that Hahnemann wants to give in

every case predominance to the mental and emotional symptoms which he calls changes in the temperament. His great follower Kent, apparently taking the clue from this aphorism, has laid great emphasis on the mental symptoms and has devoted 95 pages of his repertory to the remarkable delineation of the various types and nuances of mental symptoms. In Kent's method of case study and repertorization, great importance is given to these mental symptoms and the case is worked out starting from the mental symptoms. Kent considered that the mind is the centre of the whole functioning of the organism and that it is also the focal point from which the disease process starts. This is quite true as our present knowledge confirms that the mind has an extraordinary influence on bodily functions, in health and in disease. This fact has been well-confirmed by recent advances in the field of psychology. And research in the psychosomatic aspects of medicine has revealed that innumerable conditions, formerly labelled and considered as purely physical, actually take their origin from mental and emotional disturbances and are related to them. It is also well recognised that the mind and the body constantly act and interact upon each other and that disease is rarely purely physical or mental. Dunbar, Weiss and English, Walter Alvares, Julius Bauer and many others have given in their books numerous cases to illustrate these facts. It is the genius of Hahnemann that discovered this intimate inter-relationship between the mind and body and their constant interaction which produces the various symptoms and also the clinical significance of these symptoms. This is also noted by every homoeopath who examines each patient carefully. He finds that several types of disorders originate after some kind of emotional upset and that, even in the so-called purely physical disorders, there are concomitant symptoms in the mental and emotional sphere. He also finds that giving due consideration to these emotional causes and the mental symptoms of each patient in the selection of the remedy leads to success. This predominant emphasis on the mental symptoms for the selection of remedy is a feature of Kent's method. But now we shall consider the other method which is lesser known, but is equally useful and important, and that is the Boenninghausen's method. Boenninghausen was, as is well-known, a lawyer and botanist who became seriously ill and was miraculously cured by Dr. Weihe who prescribed homoeopathic medicine. Having been thus saved from a disease which was considered incurable and fatal, Boenninghausen decided to study the system which had saved him. At the age of 42, without even a basic knowledge of the medical sciences, he started studying Homoeopathy and became in due course, such a dedicated and devoted worker and later on such an acknowledged authority and contributor on the subject that he earned the lavish praise of the Master Hahnemann himself. He had a remarkable knowledge of law and logic and he applied this knowledge to the science of Homoeopathy and thus evolved a new approach and method. Boenninghausen also accepted and started from the idea that the strange, rare, peculiar and characteristic symptoms were the most important symptoms in the totality and that they often exclusively decided the remedy. But regarding the question as to which symptoms were to be considered as strange, rare ones, he had his own ideas and drew his own conclusions as described below. The totality of symptoms is that which includes all the symptoms of the patient. In this totality of symptoms, the most prominent symptom is the one which the patient complains of and is called the chief complaint. This chief complaint, though very important from the patients' point of view, need not necessarily carry the same value from point of view prescribing, for the homoeopath. There are various other symptoms within the totality which

seem apparently unrelated and yet are coexistent with the main symptom in the same patient often at the same time. Since these symptoms coexist in the same patient and since the organism always reacts as a whole to any morbific agent, there must be some inner inseparable inter-relationship between these symptoms even if this may not be so apparent on the surface. The presence of these apparently unrelated symptoms is very puzzling and no explanation is available as to their presence, in the present state of our knowledge. Therefore, these symptoms are usually ignored or rejected by other schools, being considered accidental, incidental, irrelevant, meaningless and therefore inconsequential. But the homoeopath considers each of these symptoms to be a consequence and evidence of the same underlying disturbance and to him these symptoms which are concomitant symptoms reflect the individuality of the patient. For example, there is no apparent reason why one patient with headache should develop a diarrhoea and another patient with headache should develop a frequent urination. But actually these coexisting or concomitant symptoms reflect the associated susceptibility of different organs of each patient and their simultaneous but different reactions to the same disturbing factor. Whereas the allopathic physician ignores or rejects them because these symptoms do not fit in into the disease pattern or inside the frame work of the diagnosis he has in his mind or the one he had made, the homoeopath gives to them added importance because they are not explainable by the available knowledge and therefore they come under the category of strange, rare and peculiar symptoms. On examining this fact a little further, we note that every disease-picture is composed of the totality of symptoms and that each totality is indeed made up of a totality of concomitant symptoms. As already explained these concomitants are always strange because they have not relationship to the main symptom but appear along with it. Boenninghausen considered that the selection of the remedy can be safely based on these coexisting symptoms. Boger went a step further to say that these concomitant symptoms are even more important than the chief complaint itself. For example, if a patient with uterine haemorrhage also has nausea as an associated symptom, this nausea has no apparent direct relationship to the haemorrhage and so this symptom, which is a concomitant symptom is a strange one. And this suggests a remedy - Ipecac. I shall again explain to you what is a concomitant symptom in any particular case. There are number of symptoms out of which one is main or presenting symptom. A patient comes complaining of headache. Headache will be the presenting symptom. As you go deeper into the case you will find that he will give you a number of symptoms, some of them connected with headache and some not connected at all with the headache, e.g. he may say the headache is worse by fasting. This symptom forms part of the headache but he may also give other symptoms, e.g. he may say that urination is retarded, or he may say that he gets attacks of nausea if he takes a particular item of food. These secondary symptoms which are not at all related to headache will be concomitant symptoms. So if the patient comes to you and gives you 3 or 4 symptoms as follows: Headache in the morning Urination, retarded Nausea form, sour foods and Jealousy, all the above symptoms form the total picture of the patient. In this picture the main, prominent, presenting symptom was headache and the other three symptoms are concomitant symptoms because they are not related to the headache but they are still

present in the patient. If the patient comes to you complaining of retardation of urination then the headache and other symptoms become concomitant symptoms. So, you now see that the totality of symptoms, is nothing but a totality of concomitant symptoms and since these concomitant symptoms are present in the patient and are a part of the disease and yet are not connected to each other, and since we have no explanation to give as to why these symptoms are present simultaneously, these symptoms become strange, rare and peculiar symptoms and therefore they must be given great importance. The concomitant symptom distinguishes one patient from another patient. For example, if patient A has headache with constipation and patient B has headache with diarrhoea, the constipation and diarrhoea which are concomitant symptoms differentiate and individualise each of these patients. That is why these concomitant symptoms have more value. The modality of each symptom distinguishes the symptom within the symptom. Similarly the concomitants distinguish the totality of each individual case. In comparing the two methods of approach, that of Kent and that of Boenninghausen, we notice that the following types of cases are more easily tackled through the Boenninghausen method. Cases with no mental symptoms Though, theoretically, in every type of case there should be some symptoms on the mental level, we do find in practice many patients who give no mental symptoms. Mental symptoms with no value Mental symptoms require a great deal of circumspection and tact to elicit and care to evaluate. If they are vague or general in nature or are explainable by the circumstances it is better to give them less or no value, e.g. a sense of depression is rather natural in a long suffering patient who has taken much treatment with no relief and this symptom deserves no value. Whereas, if a patient who, in spite of suffering from an ordinary disease, becomes depressed and develops fear of death, this will be unusual. Such really strange mental symptoms are difficult to obtain. Incomplete symptoms This method of giving value to concomitant symptoms also comes in handy when we have incomplete symptoms. For instance, if a patient has headache for which the sensation or modalities are not clearly available, but the patient has frequent urination with headache then this concomitant symptom leads us to a small group of remedies, viz. Bell., Gels., Lac-d, Ver., and Vib. I have studied the cases reported by some of the well-known master prescribers like Boger, Burnett, Case, Farrington, Hayes, others. I have also watched the work of many successful contemporary prescribers like Foubister, Hubbard, Jaisoorya, Phatak, Templeton and others. Even though they may have been guided by the principles of Homoeopathy and even though there is a fundamental uniformity or similarity in their approach, yet I have noted that in the actual evaluation of symptoms and selection of remedies there are differences in techniques. Paracelsus wrote, "That which is perceptible to the senses may be seen by everybody who is not a physician but the physician should be able to see things that not everybody can see. There are natural physicians and there are artificially made physicians. The former see things which the latter cannot see, but the others dispute the existence of such things because they cannot see them. They see the exterior of things, but the true physicians see the interior. The

inner man is the substantial reality while the outer one is only an apparition, and therefore the true physician sees the real man and the quack sees only an illusion." Clarke has stated that, "There are various avenues by which the same remedy may be found by different men and different systems which is a saving clause in medical practice." He writes further, " It is the glory of Homoeopathy that it permits every one to follow his own genius in perfect freedom without fettering him to any man's dictum or authority, be it Hippocrates, Hahnemann's, Gravogl's, Burnett's or Kent's. In the last resort every physician must and does create his own system from his own experience, and from such experiences of others as he is able to digest and make his own." When Burnett was asked for the secret of his success he said, "I do not look where you look, I let my imagination play about a case." Some of the cases reported by Boger are rather unusual and his prescription is somewhat difficult to comprehend. It seems he must have had a very deep understanding of and insight into symptomatology of diseases and drugs. I have also watched Dr. S.R. Phatak prescribe successfully in hundreds of cases. He has a peculiar knack of putting emphasis on certain aspects of the cases and selecting a medicine on the basis of these symptoms. At first glance it would appear to those who are uninitiated that the symptoms have been selected at random, but deeper study and thought will enable us to accept the approach and evaluation. Here again it would seem he has a grasp of the essential nature of the remedies. Therefore, it will be seen that there are individual differences and shades of differences in the final steps taken which spell the difference between success and failure. In contrast, I must also mention one or two other masters in Homoeopathy whose working I have watched. I have seen them proceeding in the most logical and scientific way possible, working out every case like a mathematical problem but quite often ending in failure. There are many reasons for this. The main reason is that though the homoeopathic method is scientific and logical, yet considering various factors, particularly the human factor, there are some imperfections. After all, the artistic element also enters into the prescribing. That is why homoeopathic prescribing cannot be done purely or solely like working out a mathematical problem, and experience compounded with a little flexibility of approach may make a great deal of difference. Blackie says homoeopathic prescribing is like bird watching. She wrote, "To begin with the study the flight, the size, the colour, the markings and all the rest and then have to go to some book, but when you have been at it some time, one glance, with scarcely a thought, and you can name the bird. That does not come without much experience and study." I shall now rapidly describe my own method of case taking, evaluation and selection of the remedy about which I have given some hints in various papers and booklets. While taking the case I invariably try to find out from a patient the cause, source or origin of the illness or the circumstances in which it started. In the earlier years of my practice, when I used to enquire about this, my patients used to generally reply either that they did not know the reason or that the illness had started without any apparent exciting cause. And I used to generally accept and be satisfied by this answer. But nowadays I find that by persistent questioning about this point I am able to uncover and expose in about 75% of the cases a definite cause, source, origin and/or circumstance from which the disease has taken shape. Further, I usually give very great importance to this etiology. And generally try to select a remedy which covers both the etiology and symptomatology. Sometimes, I have based my

prescription mainly or solely on this etiology and I have cured many cases this way. For instance, if the sufferings started after an injury, I may consider Arnica; if after an operation or mortification, Staphysagria; after getting wet, Rhus-t; after a suppressed skin condition, Sulphur; after a suppressed discharge, Lachesis. If after suppressed sexual desire, Conium; after a bad vaccination, Thuja; after wounded pride, Plat., and so on. Of course, I repeat that invariably, I try to select a remedy which fits in with and covers the symptom-totality of the patient as well as the cause but I take the cause as the starting point as well as the most important symptom in the case. Sometimes there is confusion in the minds of homoeopaths when they select a particular remedy on the basis of available symptoms. They are puzzled if some of the peculiar characteristic keynote symptoms of the remedy as known to them are not present in the patient. They must understand that in any particular case the patient may have only one throat symptom, two head symptoms and one symptom of the stomach from the remedy. I give hereunder a diagramatical picture of the same. These are the symptoms of the head, eye, ear, nose throat, and so on in each remedy. You have all the symptoms in the drug. The symptomatology of the drug is a huge thing, a panorama of symptoms out of this mass. But your patient will have only a few symptoms compared to the vast range of the drug. So all the symptoms of the drug need not be or cannot be present in one patient. But the patient's symptoms must be present in the drug. You will see that the complete symptom-picture of the drug will be found in the patient though its nature and features may be reflected. Even experienced homoeopaths sometimes come and ask me, "You say this patient's remedy is Lachesis but he is not jealous." It is not necessary that every patient of Lachesis should be jealous. Lachesis has many menstrual symptoms. But if the patient is a male you do not expect any menstrual symptoms. So, please remember, the symptoms of the patient must be in the drug, not vice versa. This is one of the important things you should remember. The second important thing you should remember is that no symptom should prove to be a contraindication. Suppose you are going to give Lachesis and you ask the patient, "Mister, how do you feel after sleep?" He says, "Oh, I feel quite well." You are not going to give Lachesis. If you give, you are making a mistake. I once saw a patient. It was a case of mitral incompetence. I asked him questions and he gave me various symptoms. He said, "I am jealous. I cannot go in the sun. I am very loquacious", and so on, all symptoms of Lachesis. I was just going to give him Lachesis and I asked him, "How do you feel after sleep?" and he said, "Oh, I feel very much better. I feel best in the morning." So I stopped there and asked him more questions. Then, I found that his remedy was actually Nat-m. Most of his symptoms were such that the case looked like Lachesis but there was a strong contraindication, i.e. he was better after sleep. So Lachesis was ruled out. Suppose the case looks like Pulsatilla but the patient says, "I do not like sympathy at all." I am sorry you must hestitate and reconsider. A student once asked me, "What is the harm, Sir, if one symptom is against prescription?" To this I replied, "Nothing should be against the prescription. Suppose you pass out of this college tomorrow. You are a good boy, you have studied well, you had a good rank, and you apply for the post of a house physician. We are just going to select you for the post, then somebody says, "Oh, once he has gone to jail for stealing." Naturally, we will drop you like a hot potato. Only one thing was against you, is it not? But is it not enough? Suppose someone wants to get his daughter married to you, then naturally they enquire about you. And somebody says, "He is a very nice boy except when he is drunk." Do you think the man will

give his daughter to you because there is only one thing is against you? So you see, if there is a strong contraindication, we would rather like to think of some other remedies." However, as you become more experienced, you may ignore such a symptom of this case, because the contraindication may be apparent and not real. I have prescribed Lachesis for "Convulsions during menses". You know among the remedies which have great relief during menses are Lach. and Zinc. So if a lady gets convulsions during the menses, you may think at first that Lach. cannot be indicated. But if you look into the repertory you will find Lach. included under this rubric. So, this is only an apparent contraindication. But if there is a real contraindication, you must think thrice before you prescribe the remedy. Now, as I told you, your cleverness in the selection of the remedy lies in the mass of the symptoms that the patient comes to you with. He comes to you with a number of symptoms, and at first you feel there is no head or tail to it, no clear indications for any single remedy. But when you study the symptoms rather closely, you will see that the remedy is hidden in the mass. It is like a jigsaw puzzle. You have all seen a jigsaw puzzle. They take a picture say of a cow or an elephant and cut it into pieces and they will present the pieces separately. If you place the pieces together in a particular way, in the proper way, in proper apposition, you will get the whole picture. So also, the symptoms of the case may look like a jigsaw puzzle at first. When you see first you may not make out anything. You will say, "What is this?" Then when you see closely, carefully and intelligently, then you will say, "Ha, this looks like a leg, this looks like an eye", and so on. Gradually, you will discover that it is a picture of an elephant. I shall give another example. You might have all seen childrens' building blocks. When you see the picture-blocks independently or separately, you may not be able to say what it is. But if you study them for sometime you will see that one block gives a picture of a leg, another of the horns and so on. Then you will be able to assemble them and find the total picture. Out of these apparently dissociated symptoms, you will find a coherent picture. I shall give another example also. Sometimes, you find a picture puzzle like the children's books in which there are a series of dots or numbers. They say you connect all the dots or numbers in their proper order and you will find an outline of some animal emerging, say a camel or an elephant. Suppose you are quite clever you can make out the outline or picture without connecting the dots or by connecting them in your mind. You can similarly identify the picture of the remedy in the patient. You will say, "Oh, this is a case of 'Phosphorus'." Of course, as you gain more experience, you will be able to do it more easily. I was telling you that the totality of the patient's symptoms must be in the totality of the remedy. And that is correct, but please remember whenever we use the word "totality" it generally means the totality of characteristic symptoms, not of all the symptoms, not the numerical totality. We call it the characteristic symptom-totality. What is a characteristic symptom? A symptom which represents the patient and not the disease. How do you find out which symptom represents the patients ? All those symptoms which do not form a part of the disease-picture but which are still found in the patient? Now let us take a case. This morning, there was a female patient who had a lump in the breast. It had been operated on twice but it has come back for the third time. Now the lump in the breast this is the main thing she presented with. But on taking her case you find that she likes extra salt in her food. This has nothing to do with the lump, this liking for extra salt. It is not necessary that people with a lump in the breast should have a liking for extra salt. So we take it. Then I asked, "What is your age?" She said, "42 years." "Are you married?" "No. I am not married." That is an extra symptom. All the symptoms which refer to the main disease, which form part of the diseasepicture, which form part of the pathology, to these we do not give great value. We just say O.K. and leave them like that. But all the symptoms which do not form part of the disease-

picture but yet are found in the patient, we consider them as characteristic symptoms. We ask the patient, "Does any item of food upset you ?" He says, "Yes, yes, if I take milk I get diarrhoea. I get abdominal pain." That is an important symptom. We give great value to such individualising symptoms and not to the symptoms which form a part of the disease-picture. And these are also called rare, strange, peculiar symptoms. So if you want to evaluate - the more strange the symptom, the more unusual it is, the more important it is and it must be covered. Suppose a patient says, "Whenever I get high fever I do not feel thirsty, but when there is no fever, I feel thirsty." This is a peculiar symptom. And so in every case you will find certain symptoms which do not form a part of the disease-picture but which are peculiar and belong to the patient. Those symptoms, you must take as very important. The more strange the symptom, the more important it is and it must be covered. That remedy which covers these symptoms is most probably the correct remedy. Now there are certain symptoms called keynote symptoms. A keynote symptom is a symptom which is peculiar to a particular remedy. Let us say, that a patient is thirstless even though his mouth is dry. This is a keynote of Puls. Weeping easily from sympathy, as e.g. on seeing sad scenes, this is a symptom of Causticum. Every remedy has got such keynote symptoms, a number of keynote symptoms. Now, these keynote symptoms are not the symptoms on which you should prescribe. Don't give Puls. simply because the patient is thirstless with a dry mouth. Ant-c is also thirstless. Don't give Causticum merely because the patient is sympathetic. Even Nat-m is sympathetic. So this keynote symptom should be taken as sign which shows the direction of the remedy. If you see a symptom "Thirstless with heat", think of Puls. Think of it, don't prescribe it straightaway. Think and see whether Puls. covers the other symptoms of the patient. So, the keynote symptom should be taken as a guide-post showing you the direction of the remedy, not the remedy itself. It shows you the direction, not the exact location. So, do not give Puls. simply because the patient is thirstless. Aversion to consolation does not mean that Nat-m is the remedy. A keynote should therefore, be taken not as actually indicating the remedy, but as indicating the direction of the remedy. Now, I shall discuss some aspects of remedy selection. In ordinary circumstances the totality of presenting symptoms is quote O.K. But suppose there is no totality of the presenting symptoms, no characteristic ones, suppose a patient comes to you completely bald and asks you, "Have you got any medicine for baldness?" What to do in these cases with absence of symptoms ? When there is an absence of symptoms there are some ways of managing it. In the absence of characteristic symptoms, one thing you can do is to prescribe on the common symptoms and take a chance. This is not a good method but sometimes it is successful. Suppose a patient has warts, not other symptoms, try Thuja. They may fall away. There is a 50-50 chance. Or, alternately you can take the absence of the symptoms itself as a symptom. If you open Kent's Repertory and see under "Mind" chapter there are rubrics like "Complains of nothing" and "Says he is well when he is seriously ill", Bry., Op., Phos-ac and such remedies are given in these rubrics. The patient may be serious with 104 oF temperature, no urine passed but he won't call the doctor and say, "Give me medicines." He won't ask for anything: "Asks for nothing", "Complains of nothing" - that is the symptom. Or very often, when we give a nosode it may unlock the case, it may open out the case and bring out a number of symptoms. Or, again in case there is a lack of characteristic symptoms, we can go back to the history, to the past history or family history. Therefore, in Homoeopathy it is not always necessary to cover all the presenting symptoms, it is not necessary to cover the pathology. Suppose the patient comes to you with symptoms of Lac-c and he has got mitral disease, you need not see whether Lac-c covers the mitral disease. The pahology is given the least importance, last importance. If the pathology is not

covered by the remedy selected, never mind. But if the characteristic symptoms are covered, the pathology is going to be covered and it will be removed. You can assure the patient so. Suppose a patient says, "I got an injury, after that I have developed hydrocoele." Do not worry whether Arnica covers the hydrocele or not. You need not bother. Give Arnica, and it will very often remove the effect of injury. So go to the previous history. You may all remember the case of impotency cured by Dr. Hering with Lac-c which was given because the patient had a diphtheria ten years before, in which the pain alternated from side to side. If the previous history gives no clue, go to the family history. If the patient says, "My father had T.B. , my cousin had T.B. ", give Tuberculinum and see what happens. In case these things give no clue, look for habits. Suppose there are no symptoms, ask the patient, "Are you smoking?" He says, "Yes, I smoke 30 cigarettes a day." So there must be in the body the bad effects of the smoking in some form, which must have produced the disease or at least prepared the ground for the disease. So you can take that as a symptom. Or the patient says, "I was taking a lot of alcohol." Or many times we find that the patients use aluminium vessels for cooking and they suffer from various toxic effects of aluminium constipation, skin diseases, falling of hair, etc. So, ask him, "Do you use aluminium vessels in the kitchen?" If he is using them, prohibit them and antidote its ill-effects. I have seen particularly Muslims and Parsis using aluminium vessels and generally having constipation. They generally take some laxative to relieve this constipation. You know Aluminium produces paresis of the rectum. Now, we come to children. How will you prescribe for children? Children don't give you the symptoms. Yes, but we can observe many symptoms. Yesterday I saw a small child aged 2 months stretching the body all the time. What the child does is a symptom. So we have to go by the behaviour. In children and animals their behaviour is very important. I have treated many dogs and cats. Animals are natural in their behaviour and our medicines act better on them. Once there was an elephant in the Vidharba forest. A big thorn went into his foot and he started limping. In course of time his limp became so bad that he became more lame and they decided to kill the elephant as he could not walk and he was useless. But some homoeopath gave the elephant some doses of Ledum and he was completely cured and his life was saved. So, Homoeopathy acts better on animals because the animals behave naturally and live naturally. They eat the food given by nature to them, in a natural form. They do not consume alcohol, they do not smoke. In unconscious patients, we have to observe the signs, e.g. the condition of the pupil. Always look at the pupil. The pupil can give you a lot of information, e.g. pin-point pupils or one pupil big, the other pupil small, or pupils not reacting to light and so on. There was a case in our hospital where the boy was unconscious but his eyeballs were moving to and for like a pendulum behind the closed eyelids. This was an indication for Benzene nitricum. So, in unconscious patients, you make out the case from the history and from the signs. Coming back to the characteristic symptoms, I can tell you again that generally we consider the cause as a very important symptom. If you know the cause give more value to it. Then secondly, mentals. If there are really good mental symptoms give importance to them, but peculiar mentals are the most important. In my own method I give grading as follows: 1. Peculiar mentals 2. Peculiar generals 3. Peculiar particulars

4. Common mentals 5. Common generals and 6. Common particulars. You will generally hear that generals are more important than particulars. But I give more value to a peculiar particular symptom than to a common general symptom. Among the parts of the symptoms - location, sensation and modality - I give importance to the modality. Many times I have succeeded in cases by only prescribing on the modalities. If you study the Materia Medica very carefully you will find most of the drugs are able to affect many parts of the body. They are also able to produce different sensations but as regards modality you will find the modalities are always constant - a Bryonia patient is always worse by motion; a Rhust patient is also always worse by beginning motion and so on. Because the modalities of the drug rarely change I give more importance to the modality. During the treatment of an acute disease, the patient will have to be seen at short intervals, say every day and the prescription decided upon every time. Dr. Boger writes that in the hundreds of cases of typhoid fever that he had treated, he had really never been required to give more than one medicine. Generally speaking this is also my experience in acute cases. If this is taken as an index, it would seem that most acute conditions required only a single remedy. So, if the single remedy is correctly chosen and repeated correctly, then the cases can be cured even with this single remedy. Only in cases where some complications arise, the remedy will have to be changed, in which case the new remedy required may be a complementary remedy. If in any case, acute or chronic the patient becomes progressively worse, if the internal symptoms become aggravated, if the patient feels generally worse or if he feels weaker or if the symptoms disappear in the wrong direction or order (as against the Law of Direction of Cure), then this remedy will have to be antidoted. For this purpose that remedy will have to be selected, which covers the totality of the symptoms present at the time when we wish to antidote. During the treatment of a chronic disease, there may be onset of acute troubles. If the acute trouble is an acute exacerbation which comes recurrently in the case (i.e. acute attack of tonsillitis, cold, headache, etc.) then the remedy for this acute condition may be one that is complementary to the chronic remedy that has been given. If however the patient gets an acute independent condition like influenza or diarrhoea then the picture of the acute condition will have to be studied independently and the prescription decided. This prescription may have no relation to the chronic remedy that has been given previously. After Administration of the Remedy: After a case has been repertorized, if only one remedy is indicated clearly and if this remedy can be confirmed by reference to the Materia Medica then there is no problem. This remedy is to be prescribed. But if there are two or three remedies coming though the repertorization, then it is necessary that we should look into the homoeopathic Materia Medica to make sure which of these remedies really covers the symptom-totality of the case. There are several remedies which produce identical symptoms but they vary in other details especially in the concomitant symptoms. When the correct medicine has been administered there is a response from the body which can be quickly recognised by the alert and the observant physician. I have, myself, noticed the following changes in many cases, after the administration of the correct remedy. I have noted these changes within a day or sometimes within a few hours in acute diseases and generally within a week in chronic diseases when the remedy administered has been correctly chosen.

1. There is an immediate change in the appearance of the patient especially on the face. The appearance of sickness is replaced by an appearance of health. If the cheeks were pinched, they fill up. If there were wrinkles, they seem to be less. There is a certain brightness and cheerfulness on the face. I can express this better by saying that the face takes on a healthy look. So much is this the case that at the second visit, from the very look of the patient, before he has spoken a word, I am generally able to recognise that the patient has improved. 2. I have also noticed a change in the mental outlook. The patient who was pessimistic now speaks or replies in an optimistic tone. He may now say that all his symptoms are there to the same degree but he feels that he will improve or he may say that he feels more peaceful. This immediate improvement in the mental state has been noted by Hahnemann himself in his patients. 3. I have also noticed in some patients a change in the colour of the skin. I have found that the patient, especially if he is dark-skinned, becomes a little fair. Some of the patients I have treated, especially girls, who were quite dark have become fair though neither the patient had mentioned it nor had I taken the darkness of skin as a symptom and nor had I expected any change in the same. I have found this so to such an extent that I am forced to conclude that many patients become dark during the illness, whatever the illness, otherwise why should they become fair under homoeopathic medicine? 4. In many cases, especially where the patient is emaciated, there is an improvement in the weight, sometimes even within the first week (in chronic cases). Further, the weight goes up steadily thereafter. So often does this happen that some of my young female patients have given up my treatment out of fear of increasing their weight too much though they had felt a considerable relief in their symptoms! Apart from these minor changes, the response of the patient to the similimum is such a total phenomenon and is so refreshingly marked that with a little experience we can easily decide whether the patient has received the similimum or not. With all other remedies - partial similies - the response is generally partial. Some symptoms may improve but there is never that total, immediate and remarkable improvement as is found under the similimum. No doubt patients are cured through the application of partial similars also one after another, by a kind of zig-zag method but the modus operandi of the similimum is vastly different and the results very pleasant to watch. To illustrate how quickly and how well the similimum can act, I shall quote an experience. I once saw an extreme case of a patient who responded immediately to the medicine. He was a patient of cholera. He had been vomiting and passing stools continuously for 24 hours and was in a state of collapse, quite unconscious. As I was examining him his pulse stopped and I feared that he was dying, if not dead. But with doses of Carb-v 30 dissolved in water and given drop by drop every second, the pulse revived. He became conscious, the continuous vomiting and purging stopped immediately, he recovered and became completely well within 24 hours. After the remedy has acted and the patient has improved, if there is a relapse, the remedy may be repeated as per the directions prescribed in the books or as guided by the experience of the physician himself. But as a rule the prescriber should try not to easily change the remedy which has acted very well. I can recall many chronic cases which have improved for very long periods under the same remedy. I have noted this particularly when deep-acting remedies like Lachesis, Lycopodium, Sulphur, Causticum, etc., happen to be the similimum. I have found the patient responding repeatedly to doses of the same remedy for many years.

One homoeopath reports a case of a patient who came for medicine after 20 years and even then he required the same remedy (Lyc.) under which he had originally improved 20 years ago. Therefore, as one of my teachers used to say, changing of the remedy should require as much deliberation as a surgical operation. One must consider for a long time before prescribing a remedy but once the remedy has been selected and prescribed it should not be changed easily. Kent advises that even when the symptoms change, one more dose of the same previous remedy should be tried which has given the patient considerable benefit. Again, when considering a change of prescription one should study the totality of (present) symptoms of the case and treat it like a new case, though here a knowledge of the remedyrelationships is of great use. It is said that every time the patient came to him, Hahnemann used to take the case anew. This method of the Master should be a lesson to us. But if the symptoms change after the administration of the remedy, then the case should be restudied with the new symptoms. Personally, when the symptoms change, I restudy the case and select the next remedy which may be a complementary remedy or the one that follows well. Usually, the complementary remedy can be selected from any book dealing with Relationship of the Remedies. From the list of complementary remedies that remedy is selected which covers the present symptomatology of the patient. If a patient fails to respond to the indicated remedy which has been given and repeated also, then necessarily we have to study the case again and search for the first prescription. The first prescription is the one which acts. The second prescription is the one that follows the first prescription which has acted. If the first prescription has not acted, that means that we are still searching for the first prescription. As I have mentioned earlier the second prescription can often come from the group of complementary remedies and will be a remedy which covers the existing symptomatology. And this remedy has to be given and repeated when necessary till its full action is manifested. And if the symptoms change again, we can go to a third remedy which will be again complementary to the second remedy. In my long experience of chronic cases I have generally found that the similimum selected in the beginning if chosen from the group correctly cures without any change of remedy. The more the number of remedies required, the more zig-zag the cure. It is our experience as homoeopaths that where the homoeopathic remedy has been correctly chosen and administered, the reaction of the patient is often quick, sometimes immediate or occasionally even instantaneous and the results most satisfying. To such an extent is this the case that very often we are also able to decide from the promptness of the reaction and the totality of improvement whether we have selected a remedy correctly or not. And this selection of the similimum depends to a far greater extent upon the prescriber's ability to correctly match the symptoms of the patient with the symptoms of the remedy rather than upon his knowledge of diagnosis. Therefore, some homoeopathic practitioners are able to cure cases solely by their ability to select and prescribe the correct remedy and achieve success even though they may be ignorant of the basic medical sciences and handicapped by a lack of knowledge of pathology and clinical medicine and/or the basic principles of medical management. Therefore, the crux of the problem in homoeopathic practice seems to be the choosing the correct remedy, i.e. the similimum. The physician must understand and appreciate that in almost all diseases, the patient's emotional element also plays a part and so even while prescribing the medicine, we must reassure the patient and readjust him to his circumstances. We must also readjust his diet, habits, etc., where necessary. In doing all this, psychologically we must be patient,

understanding, cheerful, honest, sincerely helpful, sympathetic and responsible. After all, in the treatment of a patient the medicinal element alone does not play such a major role. The relationship between the patient and the physician and various other factors also have their effect. I have seen some patients who, having improved under my prescription, later failed to improve under the same medicine prescribed now by my assistant and again started improving under the same prescription when given by me. One of the most difficult things in the field of medicine is to assess the effect of a medicine because the prescription of a medicine has so many concomitant features. Earlier I had referred to the fact that when the patient comes back to us we find in him a sense of optimism and I have attributed this to the medicine but it could be equally due to the effect of the physician's personality which cannot be ignored. Therefore, the physician who desires to be successful must develop not only his medical knowledge and prescribing ability but also improve his personality by developing the various positive qualities mentioned earlier and a positive approach to the case. An observant physician can note that when the patient comes to him for help, there is an undercurrent of fear - fear that his disease may be serious, crippling, incurable or fatal. It is the physician's duty to remove this fear and to assess the patient and even explain to him the nature of the disease so that he can cooperate in the treatment. Such an assurance is most important. Auxiliary measures The homoeopath, generally speaking, is almost exclusively absorbed in the selection of the proper remedy which is both interesting and intriguing, and quite often even time-consuming. His general experience is that once the remedy has been properly selected and administered, the reaction is so satisfactory that the patient is often relieved and cured even if the physician, out of ignorance or neglect, fails to pay enough attention to the other aspects of the treatment such as the auxiliary measures, management, diet, regimen, etc. However, it is necessary for us to take every advantage and make use of all available measures or auxiliary methods for the quick restoration of the health of the patient. Even though the administration of the proper homoeopathic remedy may be mostly sufficient or at times all that is necessary, yet every other additional measure that can make the saving of the patient's life more certain or can hasten the relief and cure of his condition should be availed of. In this respect the homoeopaths generally are very deficient - either they do not have adequate knowledge of the various auxiliary methods or even where they have such knowledge they usually tend to neglect these because of their tremendous faith in and repeated experiences of the efficiency, efficacy and sufficiency of the homoeopathic remedies. This, of course, is not a very commendable attitude. The homoeopathic physician has all the responsibilities of physicianship and a failure to learn and/or put to use all available measures which can help the patient without interfering with the homoeopathic treatment would amount to a neglect of duty. Therefore, we shall discuss the place of auxiliary methods in the treatment of diseases. We shall first take as an illustration diarrhoea in infants. Infantile diarrhoea is quite a common complaint in India particularly because of the poor nutrition, unhygienic methods of living and consequent infections. Very often children come to us having diarrhoea passing 5-6 watery stools a day which is sometimes associated with vomiting as in gastro-enteritis. Now, the fluid loss may not be considerable from the ordinary point of view but it can have a serious and even disastrous effect on the infant. It is said that if a child loses one tenth of its weight through fluid loss, the outlook is serious. Considering that the infant has a small body

weight by itself, even a comparatively small fluid loss is likely to put the child in danger. Therefore, having recognised this aspect now, physicians in general and pediatricians in particular are very anxious to replace this fluid to compensate the loss and maintain the electrolyte balance. In almost every case with marked loss of fluids, they hasten to replace the fluid. It is said that mere replacement of fluid has cut down infant mortality from diarrhoea considerably, as also mortality from cholera. Since this is the experience of our colleagues, then the homoeopathic prescriber should benefit from this experience and also resort to replacement of fluid wherever necessary in cases of diarrhoea. Should the fluid given happen to be superfluous it can do no harm, while on the other hand the depletion of fluid can have most unhappy results. Since such fluid replacement increases the chances of survival of the patient, it must be resorted to. This auxiliary measure is only given as an illustration. Now, we shall consider the treatment of hypoglycemia. The average untrained homoeopath may not be aware of the diagnosis or pathology and may go on giving the medicines which seem indicated whereas all that is necessary would be to give the patient some glucose to raise the blood-sugar level for immediate relief. I may quote a dramatic case I saw in the Royal London Homoeopathic Hospital. A patient was wheeled in on a stretcher in a comatose condition but within five minutes, after the administration of glucose intravenously, he was sitting up in bed, smiling and thanking the doctors. Similarly, in fractures and tuberculosis of the joints, immobilisation of the part with plaster may do as much good as the homoeopathic remedy itself. In fact the homoeopathic remedy alone, unaided by the joining and immobilisation of the fractured ends, may be unable to cure. The same is the case with physiotherapy in paralytic conditions especially in lower motor neuron lesions. Physiotherapy helps to keep the muscles alive and quite considerably adds to the effect of the homoeopathic remedy. So also oxygen should be administered in respiratory distress especially if associated with cyanosis due to pulmon ary causes. In constipation, while the indicated remedy may suffice, a small enema may considerably relieve the patient physically as well as psychologically. I have known many cases of fever in children with constipation where the temperature came down after an ordinary enema. In retention of urine, if the homoeopathic remedies fail, we must certainly catheterise and relieve the distended and possibly painful bladder. In case of ascites and pleurisy with effusion, where the accumulation of fluid becomes a source of embarrassment to the respiration, removal of the fluid may help. In hernias, even if the physician fails while treating the cases with medicine, a hernia belt maybe of use. So also in certain lesions of the lumbar spine such as prolapse of the disc, a lumbosacral belt may be very useful. Cases of pain in the heels due to calcaneal spur may improve with a padded heel as much as they improve with our remedies. In cases of prolapse of uterus, the use of a pessary may help the patient considerably till she is cured by medicine or relieved by surgery. Some cases of hypertension and polycythemia vera get relief by letting out the blood apart from the medical treatment that may be given. Transfusion of blood (or plasma) can be an extraordinarily valuable and life-saving auxiliary measure. The mortality in the last war would have been several times higher but for this measure. Even in cases of a medical nature like leukemia, Hodgkin's disease, haemorrhagic conditions, severe anemia, etc., blood transfusion can avert disaster.

In poisonous snake bites, application of a torniquet may spell the difference between life and death. In modern times, freezing of the limb to prevent the circulation and dissemination of the toxin is practised. Application of cold (e.g. ice) in hyperpyrexia or heat stroke, and of heat (such as infra-red or diathermy) in painful or inflammatory conditions, use of a hard bed in prolapse of the disc, feeding by nasal catheter where oral feeding is not possible as in comatose conditions, I.V. fluids and glucose in cases of persistent vomiting, and such other measures can be of considerable help. Diet The diet of a patient is important in three respects: 1. It should be such as will not worsen the condition e.g. in diabetes, excess of sugar or high caloric foods are harmful. 2. It should be nutritious and health-giving and preferably having a curative effect , e.g. in avitaminosis the items of food which can supply the particular vitamin deficiency. 3. It should not interfere with the action of the remedy. By virtue of knowledge and experience acquired over time, we have a fair idea as to which types of foods can be harmful in certain diseases and therefore, common sense demands that such items be avoided. For instance, sodium is said to lead to retention of fluid in the body and so salt is to be cut down in oedematous conditions such as congestive heart failure, hypertension, etc.: spicy foods can irritate and so they are to be avoided in peptic ulcers, dysentery, typhoid, etc., high cholesterol foods are best avoided in obese patients; alcohol is to be prohibited in cirrhosis of liver, gastritis, etc. Guidance about these points can be found in any standard medical textbook. It must be mentioned however that many homoeopaths who are completely ignorant about such dietary factors which can disturb are nevertheless still curing cases, thanks to the powerful role of the similimum which, it seems, is even able to overcome all these hindrances. However, it is possible that the same medicines may act still more powerfully and quickly if such hindrances are not placed in their way. So it seems advisable that such dietary restrictions should be imposed on the patient as will help him to recover quicker, if not throughout the course of treatment, at least in the beginning till the patient is well on the road to cure. 4. There are certain conditions in which a proper and well-adjusted diet can play a positive or constructive role in promoting health and in bringing about a recovery or cure. Deficiency diseases such as Kwashiorkor syndrome, simple malnutrition due to insufficient food, anemia due to iron deficiency, etc., all these conditions can be improved by supplementing the diet with suitable items of food. 5. Practitioners of Nature Cure complain that the average person or patient does not show any intelligent interest in the selection of the items of food he consumes or in their method of preparation. With the result, they say, the average citizens' as well as the affluent people's diet is mostly unbalanced, the methods of preparation robbing them of even the little nutritious values. They state that faulty foods and faulty eating habits contribute to the production and maintenance of ill-health. Further, in the preparation and preservation of foods and drinks e.g. in various soft drinks, various chemicals, preservatives and colours are used to improve their appearance which are positively harmful. There is no sense in taking

medicines to improve health if at the same time on the other side, we consume foods which are deficient or harmful. Since the body can only be built up out of the food consumed by us, it is necessary for us physicians to pay greater heed to the matter so that we can guide our patients properly. How to be a successful homoeopathic physician Readers will note that the title of this paper is "How to be a successful homoeopathic physician" and not "How to be a successful prescriber". I wish to emphasize that a physician is much more than a prescriber. He has many more functions to perform than to merely prescribe. I have known brilliant prescribers who were poor as physicians, and very capable physicians who were not so good as prescribers. Prescribing the proper remedy is only a part of a physician's function, a part of the treatment. He has to consider all aspects of the case. He must know how to diagnose, how to prognosticate, how to readjust the patient physically, mentally and spiritually, and how to promote and hasten a cure by all methods available, physical, psychological, mechanical, nutritional, hygienic and so on. And he must know not only how to guide the patient to recover his health but also how to maintain it. And all these functions are complementary to becoming a good prescriber. Therefore, being a good prescriber is not sufficient. But unfortunately many of our homoeopaths are and remain very good prescribers only and do not mature into complete physicians as they ought to. Qualities required The physician in order to fulfill these functions successfully must develop various qualities. It will be necessary for all physicians, whether they be homoeopaths or others, to develop and possess these qualities but these traits are more particularly needed in good measure in the homoeopathic physician because his understanding and ideal of a cure is much more profound than that of the others. Now the first attribute that is essential in a physician is Patience - unlimited patience. He must, in fact, have inexhaustible patience in dealing with patients. Nothing that the patient says or does should ever irritate, rile or shock him. Even apparently irrelevant words and acts of patients should be looked upon merely as the results or signs of his disturbed state. Patients can be careless, dishonest, foolish, idiotic, impatient, inconsistent, miserly, rude, unobservant, untruthful, unpunctual, unreasonable, ungrateful or anything else. But none of these defects or deficiencies in the patient should disturb the physician's equanimity. He must not only put up with all these faults and failings in the patient but must also make up for them by developing compensatory qualities like keen observation, kindness, diplomacy, discretion, etc. For example, a patient may be garrulous and may go on talking about irrelevant things but we must have the patience not only to listen but also to slowly guide him to bring out the relevant points. Impatience in a physician is an unfortunate and inexcusable defect and an impatient physician cannot be a successful one. One who is patient and tactful, irrespective of what the patient may say or do or whatever he may be guilty of, has the foundation for success. Many times when a patient has found no relief or has a mild aggravation and gets upset and speaks in a complaining or scolding way or talks direspectfully of Homoeopathy or makes derogatory comments, I have felt annoyed and had been about to tell him that he was free to leave any treatment but had controlled myself and have gained thereby. When the patient improves, he regrets his previous words and feels grateful for what Homoeopathy has done for him. In this way I have retained many cases which I should have lost had I been impatient.

The physician, particularly the homoeopath, has also to be Alert and Attentive because the patient may express or exhibit his symptoms in any way at any time by any words or actions, or by his posture, behaviour, speech or expressions or in any other way. Again he may give us his most important symptom in a most casual way. So we should always be alert to note all these things and to understand the significance and draw proper conclusions. We have to be as alert as a hunter in a dense forest who is not sure from which direction the tiger may spring, and as observant as a detective who may trace the criminal from the smallest clue, even a speck of dust. The physician should so develop his powers of Observation that they become very Keen and enable him to note very minute symptoms, minute changes in the condition of the patient. The homoeopathic physician takes into consideration far more minute details than his allopathic friend, details which would be considered insignificant, irrelevant, useless or even absurd by others. And to that extent he should develop his powers of observation. There are many things to be noted by him without asking needless questions. For example, I was recently taken for a visit. The gentleman who accompanied me to the patient took me in a car. While travelling in the car with him I noticed that his left eye and left side of the face were always twitching. I also noted that throughout the period of 45 minutes of our journey he was speaking to me constantly and monopolised the conversation to such an extent that I was hardly able to put in three or four words. At the end of the journey he told me that he himself also wanted to consult me for a feeling of suffocation he was getting in sleep. Without any additional data I could recognise that his remedy was Lachesis. I have reported a case of a child who was suffering from congenital heart disease (Fallot's Tetralogy) whom I saw in a moribund condition. The child was cold, collapsed and cyanosed and was having loud, rattling respiration. When I turned the child over to the side in order to auscultate the back, I noticed that the rattling suddenly ceased. This observation helped me to prescribe Opium which relieved the child. Dr. B.N. Chakravarthi has reported a case in which the alternate flushing and pallor of the face helped him to choose the remedy. (I think it was Ferr. met.) Unusual wrinkling of the forehead in Pneumonia has helped me often to choose Lyc. I have also reported a case where a very anaemic lady suffering from colitis flushed intensely whenever I looked at her or spoke to her and this helped me to select for her Ferrum met., which relieved her considerably. Once I had to see a young girl suffering from retention of the urine with pain in the bladder area. When I examined her I noticed that her whole body was warm except the area over the bladder which was cold. On this symptom I was able to select the remedy Lyssin * which relieved her very quickly. The physician has also to be Sympathetic. The patient is after all sick and has come for help. And being a sick man he needs, expects and deserves sympathy. So, we have to be more sympathetic because the giving of sympathy itself will elicit more cooperation from the patient, besides being in itself a part of the treatment. We have also to be Sincere. Now, when I say sincere I mean truthful to oneself. We should not see a patient or give advice half-heartedly. We should consider the patient as our own kith and kin, and give the maximum attention possible. We should give him such treatment as we ourselves would like to receive if we were sick. There cannot be one treatment for oneself and another for others. Every action of the physician should be motivated by such noble and sincere intentions.

We should do nothing that does not aim to calm, console, comfort or help the patient. We should even be on the lookout to see in how many ways we can soothe and smoothen his path of progress. As Osler said, "We should aim to cure sometimes, to relieve often, but to comfort always." Giving any medicine or adopting any procedure unnecessarily just to gain some money is most reprehensible. The physician who never worries about money but only about his patient's welfare will find himself amply rewarded sooner or later. If we work hard enough and sincerely enough, in course of time our efforts will be well compensated. People will recognise our sincerity and perhaps our merit and will come to us in such numbers that it may become impossible for us to see all the patients who ask for attention. And financial returns will naturally come to us, much more than what we had even hoped for or dreamt of. But if we run after money, if we do anything for the sake of money, in course of time the patient will realise that money is our main objective. This will bring us down in the eyes of our patients and will seriously affect our future. We have also to be Honest. Supposing we see a case in which the patient cannot be treated by our method, we should honestly admit that we cannot do anything. Dishonesty and insincerity will ultimately be discovered by the patient even though the patient has no means of measuring these qualities in the physician. We must also Study and Keep Up-to-Date not only in our own field, but also in the field of general medicine and allied sciences. We must remember that the diploma or the degree that is granted to us at the end of the medical course at graduation is not a seal to show that our knowledge is complete but is only a certificate which shows that we have the minimum equipment to practise and that we are fit to learn further. It is only a door opening towards further knowledge. We must always be eager to learn more and keep up-to-date. It should not happen that the patient should learn from the Readers Digest the latest development in the field of medicine and find that we do not know it. This can have an adverse impression on the patient's mind. Besides in the interest of the patient himself we should keep ourselves abreast of the advances in the methods of diagnosis, treatment, management, diet, etc. This particularly applies to homoeopaths because the understanding of drugs and their therapeutic effects is much a vast subject that there can be no substitute for reading and rereading. As Dr. George Royal has said, "Observe, think and read. Read, observe and think." Everytime we come across a patient with a particular set of symptoms or disease or indications for a particular remedy, we should go through our literature again to refresh our mind and know more about the subject and see the patient again to understand the practical aspect of the matter. By seeing the patient and reading the book again and again we can have a far better grasp of the disease picture and the remedy syndromes than by merely reading about them or by merely seeing the patient. Dr. Tyler, one of the most successful homoeopaths, has laid down that a homoeopath must read one drug every day and two on Sundays. Also we should always be able to Utilise Every Minute that is available. We must never waste our time. After all, time is the only currency, the most precious currency, with which we enter the world. We may wish to achieve something or many things in life - perhaps knowledge, fame, wealth, position, power, others' esteem, satisfaction, etc. Any or all of these can be achieved only by an expenditure of time. And unfortunately we have no idea how much time we have before us to achieve all that we want. We are rather like passengers in a train who do not know when and where they will be asked to alight. Therefore, we have to spend our time

most frugally, carefully and wisely, like a miser and ensure that every minute of our time is occupied by something useful. As a corollary to the idea of conserving and utilising time is the idea of Punctuality. I cannot tell you what a good impression it creates when the doctor is punctual. I have somehow been always punctual for my appointments, even though I do not carry a watch for the last 10 years. Now I shall describe an incident to illustrate the impression it creates. I was once called for a visit. I had told the patient that I would visit him at 3 o'clock. It so happened that I reached his house exactly at 3 p.m. Just as I was about to knock on the door the patient opened the door and let me in and said, "I have heard that you are quite punctual. So as it was 3 p.m. , I just opened the door and I find you outside." And then he added, "Doctor, if you are so punctual in your work, you must be quite good in your prescribing also." The patient's inference might not have been logical, but certainly my punctuality had created in him a tremendous amount of faith. The physician must also know that he should Never be in a Hurry either to diagnose or to prescribe except in emergencies. In my earlier years, I have seen and diagnosed cases in a great hurry because the picture seemed to be very clear, (and perhaps I wanted to quickly demonstrate my diagnostic acumen!) only to be told that my diagnosis is wrong and that somebody else has already ruled it out. I have in haste diagnosed a case as appendicitis for example and found that the appendix had been removed long ago! Similarly, we should never be in a hurry to prescribe. We can take all our time to prescribe especially in a chronic case. It is said that even in acute cases it is better to observe and think carefully before prescribing. It is when we prescribe precipitantly that we are often forced to change the prescription which also we do in a hurry and in course of time we can make a complete mess of the case. Also it should be noted that many times we prescribe the correct remedy but because we are in a hurry we change the remedy before its beneficial action could be noted and so patients, even though they have been given the correct prescription, fail to improve. Later on, some other homoeopath may prescribe the same remedy but insist on waiting and cure the case. Therefore, the time spent in assesssing the symptoms properly, making a proper diagnosis, selecting the proper remedy and waiting for its action is never time wasted. On the contrary it may facilitate quicker recovery and save the time of the physician in subsequent visits. Further we must never Show any Hurry in our work. Even if there is insufficient time we must not show it in our talk or actions. I have talked to the patient in a very leisurely manner even when I had only five minutes left to leave the consulting room for catching a plane. We may be in a desperate hurry but we do not want the patient to know or feel it. In this respect we have to copy ducks who appear perfectly calm outside and glide softly and smoothly over the surface of the water while they may be actually paddling like the devil below the water. Now another important quality is Not to have a False Sense of Prestige. No doctor in the world, not even the best, has ever cured every case that he has seen. Therefore, when we fail in any case, there is no need for us to be ashamed about it. We have to feel ashamed only if we have failed because of being careless or because we had been insincere or in a hurry or had failed to put in the necessary effort. But if we have been free from these faults and if we have tried our best and still failed, there is no need to feel shame. However, even after reviewing the case carefully again and again, if we have failed, it is better that we consult someone who has more experience than us. If such a person is not available, we can even consult a colleague because a colleague may be able to look at the case in a fresh way, from a different angle. And the patient (who incidentally pays for the consultation) always appreciates it when we consult somebody else. And even if he is cured by the prescription of our colleague, even then he will remain grateful to us and come to us for further treatment.

He notes the sincerity of the doctor who is all out to cure him by any and every means. Our colleague, who is called in, also feels honoured. The homoeopathic physician requires almost all the above qualities perhaps even in more intense degree than the other physicians. But he has also to develop certain other special qualities. He has to be a very Good Listener because practically everything that the patient says has some significance to the homoeopath and can be converted into a symptom. And those who are impatient and cannot listen well cannot be good homoeopathic prescribers. Osler is reported to have said, "Listen carefully to your patient because he is telling you the diagnosis." I am tempted to say, "Listen very carefully to your patient because he is describing his remedy." By listening closely and carefully, we can get in enormous number of symptoms and at the same time give great satisfaction to the patient. The patient by the very process of unburdening his troubles and expressing them to someone who is listening sympathetically feels much relieved and comforted and becomes happy and grateful. This is called, in psychology, "Ventilation". The homoeopath has also to be very Intelligent - intelligent in taking the case, in understanding the case, in affixing proper value to the symptoms, in putting together the symptoms and in comparing this disease-picture with the drug-picture. And in all these a high degree of intelligence is indeed needed. As William Gutman once said, "Homoeopathy can be practised only on intelligent patients by intelligent physicians." Now, in homoeopathic case taking, I have noted that many physicians, especially beginners and students, complain that the patient does not give good symptoms. For example, a student came and complained to me that he had gone to take the case of a patient but the patient did not cooperate. He did not give any symptom but he merely abused the student, spat on him and kicked him. To an intelligent physician all these three actions of the patient become symptoms and the prescription can be made even on these three symptoms. For instance, the repertory shows that the remedies Bell. and Stram. cover these three symptoms. Anything can be a symptom - the way the patient walks, sits, stands, moves, his facial expressions, his method of talking and even the tone (the tone can be crying or lamenting, etc). The homoeopath who blames the patient will ever remain a poor homoeopath. The homoeopath has also to be very Industrious. And there is no substitute for hard work. It is said that the secret of success is hard work; that success comes before Work only in the dictionary; that genius is 99% perspiration and 1% inspiration and so on. Even in my own case when people appreciate my work I remember how I had kept awake far into the night for many nights doing the work which has received this appreciation. One more quality required of the physician is Thoroughness. The physician cannot afford to be haphazard. In his work, if he is examining the patient, he must examine the patient thoroughly and note the findings. I know at least two cases where the patients had big swelling of the testes due to cancer and the two consultants who treated him never examined the testes! Every scientist has to be thorough and the homoeopathic physician who is also a scientist has to be thorough. Thoroughness in work, still greatly contributes to science. A Sense of Humour can help enormously. It can put the patient at ease and destroy the wall of reserve that exists between the physician and the patient. I have cracked jokes with many a patient and this has relieved the tedium of the consultation.

Finally, the physician must always be Polite and Well-Mannered. One who is rude in speech or rude in behaviour cannot bring solace to the patient or his family. Method of practice Now, I will take up the question how to practise. In every business, the client is the most important person. To satisfy the client is the supreme aim of every businessman. The medical profession is also, in one way, a kind of business and in this business or profession, the client is the patient and we should aim to satisfy him. Curing the patient is of course the supreme aim and duty of the physician but to satisfy him is also very essential. I do not mean that the patient should be merely satisfied and not cured; I mean that curing and satisfying should go side by side. Many excellent physicians neglect this aspect and the patient remains or goes away unsatisfied even though the physician might have made a brilliant diagnosis or prescription. When I see a patient, I always greet him warmly with a broad cheerful smile. The patient is in need of cheer and a cheerful smile will help him like a tonic. If we look serious, he may feel that we are angry, indifferent or hopeless. A smile costs nothing but can have a very beneficial effect. I think, except in the very beginning when we have very few patients, it is better for us always to see patients by appointment. This saves our time and the time of our patients. And when we give an appointment we have to be there on time to see the patient and we have to allot for him sufficient time. Fortunately, in acute cases the time required is much less. The whole picture is very clear and can easily be described in a few words or perceived in a few minutes and the prescription can be made in correspondingly quicker time. About fifteen to twenty minutes may suffice. But in chronic cases as we have to go into the background of the patient, personal and past history, family history, mental symptoms, etc., all in detail, it is therefore better to allot as much time as possible. In my experience, a chronic case may need at least one hour to take the case well. Perhaps with more and more experience, this time can be brouhgt down, to say forty-five minutes but it is better always to allot more time. In case one hour is not sufficient, as is found in some cases, it is better to call the patient a second or even third time, till we understand the case well. In the later years of one's practice, when one becomes very popular and there is a continuous clamour from many patients for appointments, it will be tempting to oblige more patients by giving more appointments allotting less time for each case, but I cannot think of a more foolish way of practice. When we have come to that level, when our reputation is well established, we have to maintain it. To the patient who comes, his health and life are most important. To us, the physician, also the health and life of the patients are paramount considerations but so also is our reputation and more so the reputation of Homoeopathy itself, so that even if the patients are willing that they should be seen only for a few minutes, we shall have to refuse because we do not want to spoil the case as also our reputation by devoting insufficient time. Therefore, it is wiser to refuse to see more patients than we can do justice to, because homoeopathic cases seen in great hurry will end in failure. Of course, I am mainly referring to chronic cases here. The next important thing is that we must keep complete and accurate records of all cases. This is necessary for several reasons. The patient may come to us at a much later date and his subsequent illness may be one that is related to this previous or present illness. And by comparison of the condition as noted in our records, we can understand whether he is improving or becoming worse. Also, in homoeopathic practice, we have noted that once we

have selected the constitutional remedy of a patient successfully, this remedy is able to help him for a number of years. Cases are on record where patients came after twenty or thirty years and still gave indications for and respond to the same original remedy. Therefore, if we have worked out the case of a patient successfully, the subsequent work on this patient becomes very much easy if we keep records. Further, the sequence of events is very important in a case to know if a patient is being cured by a proper process of regression as per Hering's "Law of Direction of Cure". Besides, sometimes the case itself in its totality can be built up from the daily notes. The keeping of records is necessary for proper scientific progress and makes also a very good impression on the patient. In deciding the prescription also we should take a lot of time. We should never hurry. We should consider all aspects of a case, think carefully and then prescribe. And once we have prescribed, we should wait. We should not develop doubts and change the remedy in a hurry. We can take as much time as needed before we make a prescription but once we make a prescription, we should not change the remedy without proper justification. And then, we should wait till the action of the remedy is completely clear or completely exhausted. In fact the rule as Dr. Roberts says, is, "When in doubt, WAIT". My teacher used to say, "To change the remedy requires as much reason as a surgeon requires to operate." I have always found it very useful especially in dealing with intelligent patients to explain the disease to them. The patients are eager to know what they are suffering from and by explaining it to them we find that their cooperation is available to us in a greater measure. A patient who understands can cooperate better. And as you explain to the patient what his disease is, he feels greatly relieved because he understands what it is and has no doubts that the disease is something else, perhaps something very serious as he might have imagined or feared. After all, ignorance is a major cause of fear and it also magnifies the fear. And as this explanation removes the ignorance, it can even help the patient to recover. It also helps him to face his disease with more fortitude, courage and confidence. And explaining the disease process also instills in him more faith in our ability. In many cases there is a want of communication between the doctor and the patient. The doctor often expects the patient to submit himself to treatment like an animal without knowing what is wrong, what is being given and what will be the result. I think the emotions and energies of the patient should also be utilised for a cure. In order to get the cooperation of the patient, we should explain to the patient what is happening, why it is happening and how it can be remedied. He then participates in the treatment, so to say, rather than submit himself to it. In all my dealings with my patients, I always try to be hopeful and encouraging. Every matter has two aspects - a bright one and a dark one. And so also every case. And I like in every case to throw maximum light on and emphasize the bright aspects and describe to the patients what the hopeful signs are in his case. As even the most hopeless case has some bright aspect, we can give the patient some encouragement. After all it must be accepted that medicine alone by itself may not be enough to cure. The patient's faith, spirit and desire to survive also help in the cure. There are some doctors who are pessimistic and emphasize the dark aspects of the case. But I know even of cases which had been declared utterly hopeless and have eventually survived without taking any treatment. I am reminded of two amusing experiences. Once I was consulted by a lady for a large variety of complaints. I took her case but could not decide the remedy because of the mass and jumble of symptoms. So I asked her to come two days later for the medicine. But she insisted on getting some medicine then and there. First, I decided to give her some placebo but then I gave her Ignatia because there was a history of grief. Later, when I studied her whole case, I found that while Ignatia merely

covered one aspect, Calc-c seemed to cover all her symptoms. When she visited me again, I was going to give her Calc-c but, strange to say, she reported that with the dose of Ignatia all her symptoms had disappeared, totally and as it later proved, permanently also. In another case, I had given the patient two packets of powders - the packet marked No. 1 being the real medicine to be taken on the first day and the doses marked No. 2 being placebo to be taken from the 2nd day onwards. At the end of the week, the patient came back and reported considerable relief. But she mentioned that she had misplaced the No. 1 powder and so had taken only the No. 2 doses! On the other hand, I know also of patients who developed anxiety neurosis which lasted for many years if not throughout their life because some doctor had told them that they were suffering from heart disease or cancer, or had declared in front of the patient that it was incurable. We should never destroy the hope of the patient even in serious cases such as advanced cancer. There is no use telling the patient that his case is hopeless. It is the hope in the heart of every patient which, to some extent, helps him to recover and to destroy, it is to kill the patient. We may inform the relatives about the seriousness of the disease but never the patient. Even when the patient says to you, "Doctor, tell me the truth", he does not want to hear the truth that his is a serious case. He only wants to hear that it is curable. He wants to hear from the physician soothing and encouraging words, words of cheer and hope. Even if he is not able to cure, the physician should do no harm - "Primum non nocere" as Hahnemann said. Even technically, it is not the patient who is hopeless, i.e. without hope. It is only the physician who has no hope. So one who tells the patient that his case is hopeless is really himself hopeless. Hence it is better to avoid giving a bad prognosis. If any such opinion is to be given, it should be only given to the patient's relatives. While we should be ready to explain to the patient about his disease so that he can try to cooperate, we have also to be careful to see that we do not talk too much and unnecessarily. The celebrated physician Sir William Osler has said that the words uttered by the physician in the presence of the patient are like the copper coins given to a child. To the person who gives these coins, they have no great value, but the child who receives them will turn them over and over in his hand and wonder at them. Similarly, the patient will turn over and over again in his mind the words of the physician and give new meanings and interpretations to the words uttered by him. So we have to be very careful. Even if we say a particular word in a particular context we cannot be sure what meanings the patient will attribute to it. I remember that I once examined a patient and told her that she required no medicine as she was perfectly well. She took it to mean that her case was so bad that it was useless for her to take medicine! One of the things the patient needs and expects from the physician is reassurance. It may be necessary to reassure the patient repeatedly or constantly. This can help sometimes more than the medicine and the physician should never feel tired of doing this. It is possible that the patient is whimsical. In that case, we need not satisfy his every whim but we can try to do so as far as possible. If, for instance, the patient wants to take medicine in the form of pills, we can certainly give it in the form of pills instead of powder or liquid. It is my policy never to criticise a patient. A patient may be full of faults and failings, he may not even cooperate or he may fail to carry out our instructions but even then I do not criticise him. The patient is like a child. In sickness he regresses to a childish state or behaviour and so we have to handle him like a child, firmly but tactfully. Even if a patient comes to me after a gap of many months or has taken medicine very irregularly his condition is worse. Sometimes the patient may leave our treatment and go to some other doctor. This, I do not at all mind. If I know in advance or if he tells me, I give a note to the new doctor providing him with all

useful data and the medicines so far administered. I do not wish that the new physician should experiment with the same medicines that I might have tried out or make the same mistakes that I might have made. And I do not consider the patient a piece of property and expect that he should not go elsewhere. If a client can purchase his goods from any shop why should not a patient go to any doctor he likes? If he leaves our treatment, it should be taken rather as a reflection on ourselves than on the patient. If he comes back, I welcome him as coolly as before. I stress this point because many doctors get flustered or annoyed if the patient goes elsewhere. I have known of one or two physicians who have chastised or threatened the patients for such behaviour. If any patient expresses a desire about consulting some other physician, I immediately endorse the idea and send him for a second opinion with a note from me. I see no harm in having a second opinion. But on the other hand there may be a wrong impression in the patient's mind if I refuse him permission to consult someone else. In all cases, I try my utmost to understand the patient and his behaviour. It is my firm belief that every person behaves in life as he impelled to behave, by his heredity and circumstances. I also believe that if I were to be in the place and position of Mr. X., most probably I would also behave in the same way as Mr. X. This understanding will enable us to pardon the patient's faults and mistakes and tackle his case sympathetically. We should create and maintain good will with other practitioners both homoeopathic and those of other systems. Particularly with our colleagues, we should not give a chance to cause any misunderstanding. When a patient comes to me from another doctor it is my practice to give a summary of the whole case and my opinion and suggestions to the doctor who had directed the case. I do not like to see this patient again if he comes independently again without any note from his doctor. I insist that every time he comes to me he should bring a note from his doctor. Otherwise I refuse to see him. I think it is not proper for a consultant to take away a case from any other doctor who may have directed the patient to him. I try to provide the patient with some literature to educate him about Homoeopathy. If he understands the principles and methods of Homoeopathy he can help us enormously. He is able to describe his sufferings better and give us all those peculiar little symptoms that help us so much to make a good prescription; and in case of any reaction, he does not become panicky because he understands the concepts of Homoeopathy. It is always better to read up the case in advance before the patient comes. When we mention to the patient points from his case from our memory he feels immensely pleased. Even the mention of his name and/or his address may give him a feeling that you are thoroughly conversant with his case and that you are paying individual attention to him. If possible, I study my cases and work on them in advance at home, behind the scenes so that the limited time at my disposal in my consulting rooms is conserved. I may then find it necessary to ask only two or three questions in order to decide the remedy. Also it leaves plenty of time to talk to the patient to get his symptoms and to reassure him. It is generally a good idea to make personal enquiries. For example, if the patient was directed to us by another friend we may enquire about the friend. Enquiry about the family set-up of the patient not only provides us with information which will be use to us in our own work but also gives a sense of satisfaction to the patient.

Anything that we want to ask or tell the patient should be told in an acceptable way. If, for example, I want to ask the patient whether he has suffered from syphilis, I always ask him whether there was any chance of his getting the infection. It is better to leave the money matters to the assistants. This gives us much more time to concentrate on the case and also relieves tension from our minds. When we do not know whether the patient is paying us or not, our attention to him is unprejudiced and will not be disturbed. Sometimes the question of fees brings in some delicacy and if it is left to the assistant, there is no embarrassment to the doctor or the patient. But even though the actual details of money matters may be left to the assistant, yet we must have some clear principles in our mind. I personally have a particular fixed fee for consultation and for a visit. This is my standard fee. I do not charge more from anyone, however affluent he may be because this is a fee for my services, not a tax on the patient's income. Incidentally, I do not charge more fees for visiting a patient at night or on Sundays. I feel that we should not penalise him for having fallen sick at an inconvenient hour. In case the patient pleads his inability to afford or even if I have an indirect hint, I take half the fees or even less. In case the patient is very poor, I charge no fee though I prefer to see such patients in the hospital. I do not wish that anyone should be deprived of my advice because he cannot afford it. I never argue about the fees. I may take what the patient pays. It is better to take less fees and retain the good-will of the patient than to do otherwise. Every patient has a circle of relatives and friends, bigger or smaller, knowing and watching his case and when you cure him you have unknowingly impressed this circle of people. This circle will come and give you enough fees. Even if a patient is relieved or cured and he does not pay us, we need not mind it because we have only done good and the rewards of doing good will always come at some time in some form; at least it will provide some satisfaction. Every case cured is like a seed thrown in the soil. In course of time it may grow into a huge tree and yield many fruits. It is my practice as a consulting homoeopath to charge my consulting fee and then supply the medicine myself free. I charge for every consultation because every consultation involves time and effort but I also provide the medicine. This saves the time of the patient in going to the shop for medicine and secondly I know that the medicines I furnish are reliable. Sometimes the patient asks for a prescription for drugs which are toxic and even lethal beyond a certain dosage, I do not see any reason why we should not give open prescriptions of harmless homoeopathic medicines. This will help the patient's future doctors also in case he may consult someone else. Some patients doubt that homoeopaths keep their prescriptions secret only for their own monetary benefit. Let us not strengthen this doubt. Now I shall give examples of questions asked by the patient and also describe how we can answer them cautiously and practically. Sometimes we see a very serious or a hopeless case and the patient himself or his relatives want to know whether the case will be cured. Even if it is a really hopeless case, I never tell the patient so. I never even give a hint to the patient but I say, "Do not worry, you will be alright." But to the relatives, I describe the seriousness of the case and the odds against us but I always end by saying, "Do not worry; God is great." I have known some cases where they took this to mean that the patient will be cured. This is because the patient is generally hopeful and wants a hopeful answer and the relatives too hope against hope for a miracle to happen. Sometimes the patients may ask, "Doctor, how long will it take me to become alright?" This is really a difficult question for us to answer even in our own minds because we know that different patients respond in different ways to the remedy. A case may respond very

remarkably and become cured with a single day's medicine whereas an exactly similar case of another patient may require months of treatment. I have always found it very risky to tell the patient that he will be cured in so many days or months because the stipulated days or months pass by very quickly and the patient wants to know why our prophecy is not yet fulfilled. If the patient asks me at the very first consultation how long it will take, I merely postpone the answer by saying that I cannot say till I see his reaction to the medicine. Luckily, many patients forget to repeat the question later on. In case they still ask and persist in getting an answer, I tell them frankly that is very difficult to say because different patients respond in different ways. But if they want a very rough answer I may say that for every year of suffering in a chronic case it may require one month of treatment. And I add that this too is an extremely rough estimate. It may be much less or it may take much longer. I have found that once the patient starts responding favourably and feels better, he does not bother about how long it may take. But it is also necessary for us to explain that the cure in Homoeopathy consists not in treating a mere portion of the disease or part of the patient but is actually a total removal of the disease stated and a total restoration to health and therefore this may be a long process. Sometimes the patients asks, "Doctor is it true that in Homoeopathy, the patient will become worse after treatment and that the whole disease will erupt?" I say, "Yes, it is said that the patient may feel a little worse in the beginning but in so many years of experience, I have not found the patient becoming much worse. There may be only a very slight or imperceptible aggravation of the symptoms. But even then the patient as a whole will feel better. This aggravation may not be such as to trouble the patient." Generally this answer is enough to satisfy the patient. It is good idea to report successful cases as also our interesting experiences. Thus we shall share our experiences with others and it may be that someone is benefitted by this. Besides, we, the medical practitioners, have strictly no scope for any publicity. But a series of successfully treated cases reported in the journals may be indirectly a source of publicity for the good work we are doing besides providing publicity for Homoeopathy itself. We must also take every opportunity to learn more by mutual discussions and by attending meetings. Another valuable way of learning is through consultations. When we consult others for our cases we learn new methods of looking at the cases and deciding the remedy. I have myself benefitted immensely by consulting my senior homoeopathic colleagues. To summarize, I may say that all our expressions and actions should always be guided by the best of intentions. We must speak, act and do what is necessary and beneficial for the patient and make it psychologically acceptable to him. This way lies the road to success. Some dos and don'ts I shall end by mentioning some simple Dos and Don'ts. Do not offer advice or medicine unless you are asked. Do not offer free advice or medicines. The value of anything that is given free is generally not well-realised. Do not ring up and enquire about the patient. Let the patient and his relatives inform you themselves. Refrain from offering your patients any refreshments in your consulting rooms. Also avoid accepting any food or drink in the patient's house when you have gone for professional work.

Do not tell lies to the patient. If he comes to know, he will never trust any word from your mouth. Do not criticise any other doctor. If the patient criticises any doctor, try to defend or at least keep quiet. The patient who criticises someone else today will criticise you tomorrow. If any other doctor has committed a mistake do not comment on it. We ourselves make many mistakes unknowingly. If we could see or realise all our mistakes and defects, we would be horrified. Do not make any contract with the patient. Do not give any guarantee to the patient because you cannot guarantee even your own life. Do not boast. Let your actions speak. Do not criticise hardly any other system of medicine. Subscribe for good journals and read them. Good books are good investments. Always have a receptive mind. Ever be ready to understand, appreciate and learn. Learn from everyone, from everywhere, from every source, from every incident. Learn, apply and utilise. Life is a glorious opportunity. Utilise this opportunity to the maximum so that we can say at the end as Hahnemann said, "Non inutilis vixi." ( I did not live in vain.) Notes by the editor There are some difficult and controversial points in the text which need clarification. I append my notes which will be helpful to the student while not interrupting the flow of the text. Editor Alternation of drugs Alternation of drugs is not advisable at any time. Even given a single drug, there is much difficulty in assessing the progress in a case. If more than one drug is given (e.g. Calc-c in the morning and Thuja - as intercurrent - at night), we cannot have an intelligent appreciation of the progress in a case. Also, suppression by our drugs is always a possibility, and the chances of a suppression are much greater when more than one drug is given - since both cannot possibly be indicated at the same time. The chances of a suppression are much greater if one of the drugs has a tissue-level, local affinity and is given repeatedly. Under such circumstances, disappearance of symptoms may not be good sign. When it is understood clearly that suppression by a homoeopathic medicine is possible, and that only one remedy can be indicated at a time, alternation of remedies under any pretext will cease. Selection of drug potency The selection of the potency depends, as Vithoulkas has stated, on the intensity, clarity and spontaneity of the symptoms expressed - especially of the peculiar symptoms, which reflect the individuality of the person. Consider the following: A patient comes and says, "I don't know why but I often feel that I am poor, that I look like a beggar and am wearing tattered clothes."

Here we have an intense, clear and spontaneous expression. In such a case, I would almost invariably give a high potency (perhaps 10M); all other considerations, such as pathology, etc., would be secondary. I had a case recently where the patient presented a clear picture of Mag-c. The dreams were especially vivid and clearly showed the Mag-c feeling. I had just written Mag-c, 10M on the case paper when she told me that all these dreams were of long ago - she had not had a single dreams in the past many years. I changed the potency to 200 C. Of course, the potency also depends on the nearness (similarity) of the remedy to the case. The patient may be clear about his symptom, express it with intensity and spontaneity, but the remedy selected may not have that feeling as intensely or clearly. In such a case, the potency will depend on the extent to which the drug selected expresses the feeling in the patient. For instance, in a Sepia case, if you have selected Nat-m, your potency must reflect the intensity of the Nat-m feeling in the case. Repetition There are some cases where frequent repetition may be useful but others where it can even be detrimental and, moreover, confusing to follow the progress of the case. If the patient presents a very clear mental and physical picture, and has no slow, progressive pathology, there is hardly ever a need for frequent repetition - a single dose at rare intervals should do. On the other hand, slow, progressive conditions like cancers, SLE, Diabetes and Parkinson's disease often need frequent repetition. If the mental and physical symptoms are not intense but are low-key, a single dose may not really help - it may be necessary to repeat in a low/medium potency. Such a presentation, however, is not common. There are some cases in which the disease process seems very deep rooted. These cases may need repetition often, but one has to proceed with caution: wait and see how long the last dose has acted. If there is maintaining factor which cannot be changed - e.g. discord in the family - frequent repetition may be required. It must be realised that most people do have maintaining factors of some kind or the other, but these are usually not so fixed and troublesome. It is in the few that are really stuck that the above consideration is applicable. Patients who take antibiotics or use skin ointments often antidote the remedy and need repetition. I have found this especially with antibiotics - even despite steroids, the homoeopathic medicine often continues to act, but antibiotics usually seem to interfere with our treatment. Usually, if you need to keep repeating frequently, it means that the "remedy" is not really the right one. The only way to be sure in such cases is to carefully see if the remedy has really caused a definite change in the mental and physical generals at the end of 6 months. The main danger of frequent repetition is that if the medicine is wrong, there is a strong likelihood of suppression. In other cases, there may first be temporary relief following each repetition, and at the end of three years, the patient continues to have all the original complaints in the same degree and extent. If the remedy is right, even frequent repetition in a high potency may not harm or may even help but, as the final proof of a correct prescription is long lasting improvement following a single dose, this practice may confuse.

In the context of repetition, the LM scale seems most logical to me. How long to wait This depends on how sure you are of the remedy. A good rule is never to prescribe till you are quite sure, and then to wait for the remedy to act. In a chronic case, I would not even consider changing the remedy for a month, unless there are some new, clear indications that do not fit in. A lack of improvement may only be apparent and not real. Look carefully for changes in all spheres including those other than the C/C. There may be a change in the sleep habits, dreams, etc. Sometimes, the patient is unaware of any change but you can see it. For instance, a spot on the face may not change in size or colour for some time, and the patient feels things have not changed, but you notice that his or her attitude towards the spot has changed. This could be an indication to assess the progress. Observe carefully. Acute and constitutional medicine There is no such thing as an acute or constitutional remedy. The only remedy is the indicated remedy - that which is indicated on the basis of symptom similarity. If a person has symptoms of Cham., even if the pathology is a cancer, we cannot give anything but Cham. The concept of giving a non-indicated "deep-acting" constitutional remedy after the indicated remedy is absurd. Usually, an acute condition only shows in bold relief the medicine that the person always needed. An acute crisis represents, as Hahnemann said, an explosion of a deepseated chronic problem ("latent psora"). In some cases, the acute crisis goes beyond the person's normal state and then a different remedy must be selected - because it is now indicated. In 95% of the cases, however, the same remedy that has helped the patient in the past is also found to be indicated during an acute episode. When we consider the range of action of remedies, we see that they have an acute counterpart as well, though this is usually not seen. For example, Sep. has the symptoms "Shrieking, must hold on to something, or she will shriek". This is not the common presentation of Sepia but in a very acute situation, the Sepia person can develop this feature. Thus, an acute exacerbation is actually a pointer to the correct remedy (similimum). In this connection, we cannot speak of an acute crisis while the patient is receiving and improving well under the homoeopathic treatment. Often, after the right remedy, the patient lands into a crisis - in the form of recurrence of old complaints, skin eruptions, high fever, etc. If this is managed well, Sac-l or the same remedy, the patient is much better after the episode. In such instances, giving a some "acute remedy" can prove a set-back to the whole case. Use of the repertory The function of a repertory is merely to indicate a possible remedy or group of remedies. The repertory is used to arrive at a single drug - to be considered, not given. If all the symptoms are worked out in repertorial rubrics but the drug does not seem to fit the case, drop it. In practice, I take a rubric that seems to be close to the patient's expression and study the drugs given under it. If none of them fit the case, I drop that rubric and select another which expresses the same feeling. The remedy which fits the case is often found in some related rubric. We do not keep a remedy in mind and select rubrics in which it is present - what we do is to discard a rubric when none of the drugs given under it fits the case, and select a related rubric to see if any drug fits the case as a whole. Use of nosodes

In my understanding, in order that a drug one considered homoeopathic to a case, it should be based essentially on symptom-similarity. The idea that a nosode (including Bowel Nosodes) may be given if you cannot decide between three or four similar drugs seems unscientific and based on hearsay and some empirical observations rather than law and logic. The homoeopathic medicine A homoeopathic medicine is one that has produced or is capable of producing in a healthy organism those symptoms and signs which are present in the patient. The similarity could be at a dynamic level (Mind and Subconscious) or at a organic, tissue level. Most cases are not at an organic level, i.e. the dynamic element is more prominent, even if there is some structural (pathological) change in the tissues. A drug which is similar only at a specific tissue level does not give lasting improvement. For example, Blatta Orientalis may help in attack of asthma, but it will not alter the tendency to the attacks (unless it is indicated also by the generals - mental and physical). This kind of treatment does not achieve the aim of a radical cure. In a few cases, however, the organic/structural element is so prominent that the similarity must be at this level to effect a change. The case of Eel's serum is one such example. It must be noted that there was no change in the mental state of the patient - his craving for alcohol and attitude towards life remained the same.