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Thursday, October 26, 2006

PREDICTIVE HOMEOPATHY
CHAPTER 5

CHAPTER 5

SCIENTIFIC EXPLANATIONS OF THE GOLDEN RULES

BE A MINIMUM PRESCRIBER

BE A SINGLE REMEDY, SINGLE DOSE PRESCRIBER.

THERMAL AXIS






SCIENTIFIC EXPLANATIONS OF THE GOLDEN RULES

BE A MINIMUM PRESCRIBER:

He who prescribes the least is the best Homoeopath. This is a Golden Rule. One who wants to be a successful homoeopathic physician has to be wary of prescribing unnecessarily. He should in the first place be aware of 'when to prescribe and when not to'.

There are thousands of books on Materia Medica, as well as Organon and Philosophy which give you indications of prescribing remedies. None of these tell you when not to!

But in my practice of 25 years, that has given me credit and that too predictive credit is 'No-Prescribing' or 'Minimum-Prescribing'- both in Acute as well as Chronic diseases!

Paradoxical as it may sound this Golden-Rule of NON-PRESCRIBING has a Scientific base.

Case: A patient having acute infective diarrhoea came to me complaining, Doctor, today is the third day of severe watery diarrhoea. I have been suffering since two days. I have passed more than 25-30 stools all liquid, almost transparent or sometimes yellowish. As soon as I would eat, I had an intense urge to run to the toilet. If there was a fraction of a second delay, I was unable to control my stools. When asked-"Why didn't you come to me yesterday or 2 days back?"

Prompt came the reply "I had no strength to move about nor did I have any control over my stools to wait in your clinic for 2 hours". "Then how did you come today?" was my next question. He said "I just couldn't eat, drink since I had no desire to. Hence, I felt weak and drowsy since 2 days. Since yesterday, the number of stools have gone down, I could get the desire to eat and today, since morning, I have passed only three loose motions. I have the energy to walk after a good night 's sleep and so I came to you."

Next question to the patient from me "do you really feel like eating today or you have forced yourself to eat?" "No-no I had a real desire to take my breakfast today almost after 3 days!"

In the above case the diarrhoea which occurred was no doubt due to some infection or some toxins which were consumed with food. The body or the system of the human being is so made up that it tolerates no nonsense or no toxins or nothing which can cause harm to the person. Hence, it has its own defensive mechanism which instantly starts throwing out the toxins in the gut by inducing hyper-peristalsis which appears to us as diarrhoea. In fact, diarrhoea at least in this case, was a defensive mechanism of the body to cure itself. The Cure was already taking place and after the eviction of the toxins from the system the patient was already feeling better e.g. less of tiredness, less weakness, good sleep, less stools. He was gaining in strength and his appetite was already back.

Overall, the general parameters of health in a human being e.g. desire to move, to work, stamina to work, desire to eat (not forcefully) and sleep are more important than the loose motions. If these parameters are better then, it goes without saying that the loose stools HAVE TO STOP! Stop is a wrong word used here. What should happen is, stools have to become normal and this normalisation should occur at the most in the next 24 hours. Thus, what the patient required was placebo with a sure short prediction- "Go, your stools will be normal by tomorrow morning"!

Such predictions are possible, if you understand the physiology of man well.

The Internal Physician residing inside the body has to be respected.

When HE is Curing, a Homoeopath (or even an Allopath) has no right to interfere for HE knows what is best for him.

Case: A child coming to us for treatment of fever since 4 days.

The child was dull, drowsy, coughing badly at night with thirst for little quantity often.
This child when treated with Homoeopathy or Allopathy before coming to you has to be assessed not in terms of what medicine to prescribe, but in terms of whether he requires a remedy, as on today. First of all, find out whether the range of fever has come down in the last 3 days or not. Find out whether the child is less cranky today. Find out whether the child has asked for something to eat today or not? If yes, then the child is definitely on the improving path.

If the child is playful today vis-à-vis yesterday, and asked for something to eat by itself is a clearcut indication (even if the fever persists) that this child is 'curing' itself (the allopathic physicians may call it a self limiting viral infection). It is not only WRONG to treat this child with indicated (or non-indicated) remedy but grossly 'criminal'! Any prescription or stimulation of the child's immunity is bound to bring about exacerbation or aggravation of the fever or diarrhoea and the child's recovery will be prolonged. Respect the Internal Curative Immune Mechanism of Man.

When not to prescribe and yet Cure is a hidden art of Homoeopathic practice.

BE A SINGLE REMEDY, SINGLE DOSE PRESCRIBER.

If a Homoeopath wants to see miracles happening; if he wants to see typhoid fever vanish in just 24 hours; if he wants to see pneumonia's clear up (radiologically too) within 48-72 hours; if he wants to see 100-135 pus cells in urine disappear within 48 hours; or for that matter wants to surprise his allopathic counterpart, it is only possible with a single dose of a SIMILIMUM and the similimum is always a SINGLE REMEDY.

Doctors who prescribe mixtures, patents and combinations of say Ferrum phos 3x, Kali Mur 3x, Nat. Mur 3x for fevers or Aloes 30, Podo 30, Crot. Tig 30 for diarrhoeas etc, etc are entirely not at fault for Abandoning the very principles of Similia Similibus Curantur or the Seven Cardinal Principles of Homoeopathy.

There has been up-to-date NO REAL EFFORT on the part of Homoeopathic Scientists to justify these principles scientifically (i.e. as much as or as far as science has advanced). Secondly, Homoeopaths practising rightly have never expressed their views on HOW TO STICK TO THE CARDINAL PRINCIPLES and yet get results. Thirdly, EGO of other friendly neighbour Homoeopath is so big that he refuses to accept anything which another Homoeopath proposes and sticks to his own guns. Fourthly, the knowledge of the right prescribing image or drug picture not being available, failures abound.

Example:- a) Patient coming with chills at 3 a.m.; followed by fever at 4 a.m.; intense thirst for ice cold water during chill; headache after fever and chill has subsided; the patient lies dull no sleep though; wants fan despite chilliness; no bone pains or bodyache; does not complain much. When the case is analysed and repertorised :

a) Chill at 3 a.m.- Symptom Rubrics which can be considered
1) Chill (chapter); Night; midnight after; 3 hrs on waking- only Ferr

2) Chill, night, midnight after- Ars, Calad, Hep, Op, Thuj, Coff, Dros, Mag-s, Mang, Merc, Mez, Petr, Sil, Sulph

3) Chill (chapter); Time, 3 hrs- Aloe, Amm-mur, Canth, Cedron, Cimic, Cina, Eup-perf., Ferr, Lyss, Nat. Mur. Rhus. t. Sil, Thuja..

4) Same rubric: 3 a. m- Ars (complete repertory)3-5a.m. Kali. Carb (complete repertory)

5) Fever (chapter); succession of stage Chill followed by heat- 98 drugs.

Such rubrics when considered confuse the homoeopath completely. Besides, the questions asked by the physicians, confuses and frustrates the patient.

The smaller rubric of Chill followed by perspiration with thirst or without thirst and heat following chill and perspiration whether it is before the heat or after the heat or chill etc, are totally confusing with different repertories giving different versions and indicating different remedies. Thus, the Homoeopath is taken on a wild goose chase. He lands up with two, three or at times six remedies(?) being indicated commonly in chills, heat, thirst and administers the mixture every 2 hourly or 1 hourly as the emergency demands. The fever comes down gradually from 103 F to 102 F to 100F on the 3rd day and may disappear on the 4th day. The homoeopath is pleased and happy that he has kept the patient away from anti-typhoid drugs or anti-malarial drugs or at least away from an allopath. He does not realize that the fever has subsided because it had to subside. The viral or the bacterial infection had to run its course and the immunity was geared up again to gain equilibrium.

I have in the beginning of my career practised in all these and other ways frantically trying to get results. I even admit of being so non-confident with so many drugs and so many repetitions that many cases were referred to the allopathic physicians saying that serious diseases have no treatment in homoeopathy. "You take a course of antibiotics, control the acute infection, then, I will strengthen your immunity". These words are not just mine. I'm sure most of us who have a conscience will agree that they have done this innumerable times in their practice. BUT and this is a real BUT when I started understanding the importance of treating Man in Disease and not Disease in Man the whole world changed. To treat disease i.e. fever I had to give so many medicines, repeatedly, to literally hammer down the fever or diarrhoea etc. To treat the MAN, I had to just stimulate the man with a single dose of similimum! I had to just perk-up the immunity, to just encourage the man "come on-fight the disease.

You'll remember, when we are seemingly doing this in modern medicine. Yes, it's when we vaccinate, Vaccination is Homoeopathic in principle. We stimulate the immunity with an antigen which is either the bacteria in subclinical form or an immunogen which simulates the bacteria which is injected inside the body. This stimulus procures a reaction in the body which subsequently develop antibodies to the antigen or bacteria and thus defend our body. It 'cures' and protects by 'Reaction'. (and not action). Our Homoeopathic medicines also cure similarly by REACTION and not by ACTION. Now, a million dollar question is when allopaths can use Homoeopathic Principle Similia Similibus Curantur. (i.e.: inject tubercular bacilli for protection against Tuberculosis and Tetanus toxoid to cure tetanus) and for all this require only one dose per month or then at the most three doses (spread over six months or five years) to make the person healthy. Why? Oh Why? Should a Homoeopath whose science is based on this principle require repeated Stimuli and Repeated doses? Do the allopaths require three or four types of bacteria to be attenuated and injected together to give immunity to a patient from Tuberculosis? Then, why do Homoeopaths require two or three or more remedies to be administered to boost the patient's immune system? If Allopathic vaccinations can work (selectively though) with a single dose and single bacterial stimulus, the Homoeopath with his holistic approach has to cure following Law of SIMPLEX and Law of MINIMUM DOSE.

Thus, by this method of single dose single drug practice, one manages to adhere to two of the most important cardinal principles of Homoeopathy.

By not using mother tinctures and sticking to dynamised single doses, the third LAW of DRUG DYNAMISATION IS ALSO ADHERED TO.

Coming back to case A, the importance should never be given to chill, the time of chill, the type of chill, the succession stages, the headache, the time of perspiration. This chill and shivering is a symptom of disease or rather a general mechanism of heat production. It has manifested itself only when the patient is diseased.

Chill or shivering occurs as a temperature increasing mechanism when primary motor centre for shivering situated in the dorsomedial portion of posterier Hypothalamus is excited by cold signals from skin and spinal cord. This results from feedback oscillation of muscle spindle stretch reflex. Shivering causes body heat production to kill the bacteria or virus or parasite. This is a part of immune or defensive mechanism of the body and no doubt may be exhibited differently in different constitutions. But with the profuseness of material available in the repertory all of which may not be reliable, one is bound to be confused. And above all, it is a disease symptom, a reaction to a disease. Then, if we don`t consider fever, chill, what should we consider for prescribing?

We are interested in treating the MAN in disease. The MAN or CONSTITUTION or the changed IMAGE is what is required by us, to understand and prescribe the SIMILIMUM. No doubt, every symptom whether it is a pain, or a chill, or the type of fever is going to be the representative of the ill person, but some are more representative of the person than others! These vital representatives of the VITAL FORCE are on the Activity-Thermal-Thirst axis in acute illnesses, to which we add other important symptoms to get the similimum.

Activity - Thermal - THIRST - (Mental) Axis

What we would like to know is, has the constitution been affected so drastically as to bring about a change in Activity, other Generals and thermals, thirst and mentals. This means, how has the constitution reacted to the ACUTE ILLNESS? If, and only if, the Generals, the thermals, the thirst and the Mentals have changed from the 'original' then, and only then, should the patient require something different from the original constitutional drug.

This means that if there is change in ACTIVITY of a person the Generals have changed. If there is a change in tolerance to Heat and Cold - the THERMALS have changed. If there is a change in water intake, - the Thirst is changed. If there is a change in Mental attitudes e.g. irritability, anxiety, etc., - the 'MENTALS' have changed. Thus, the ACTIVITY-THERMAL-THIRST (MENTAL) AXIS has changed. A new remedy which is 'Similimum' to the new Activity-Thermal-Thirst Mental Axis is required to bring about a 'cure' on the basis of our cardinal principle of SIMILIA.

Generals - Activity: Why 'Activity' is important in assessing the changed constitution is already explained in the previous chapter of ACTIVITY (ref. Page 27- for scientific explanation)

Q. What to Assess in Activity?
ACTIVITY of a person may be
a) INCREASED
b) DECREASED or
c) NO CHANGE

This change should not be asked by a direct question but has to be observed by the physician; except ion case of infants.

Activity Decreased

Normally an active person, talkative person, fast moving person, becomes dull, inactive, quiet and slow. He either
1. just lies down not doing anything
2. Sleeps continuously.
The mother may point out that the child is sleeping today almost for 10 hours, and did not wake up to eat or to drink etc. In the above case (a) the patient was dull though not sleepy; hence, we chose the first option. 1. Dull and just lies down. Decreased activity is due to large amount of energy i.e. ATP from the mitochondria of the cell is being used up to combat the invader, or transfer the toxins from cell to cell by means of active transport.

Activity Increased: This increase in activity can take place in physical sphere or mental sphere. The mental activity can result in either mental anxiety or mental hyperactivity causing loquacity. Thus, Increased Activity is further divided into
a) Physical Restlessness (without mental Anxiety)
b) Mental Restlessness (with Anxiety)
c) Verbal Activity (Loquacity)

Physical Restlessness:- Here, the patient just moves or is compelled to move by inner unknown urge. The patient just does not sit in one place. Moves constantly; knows not for what. He either paces the floor or goes out for walks just to keep moving.

Mental Activity: Here, changes in the biochemistry of the patient make him ill-at-ease in mind hence, the patient becomes ANXIOUS. A child keeps on crying or becomes snappish or just becomes ununderstandably obstinate and starts kicking, striking, biting, etc. an adult cannot bear anybody disturbing him or asking him questions all of which send him in a fit of Anger. In short, the mental tolerance to all external stimuli is reduced causing the patient to go in a state of anxiety; a state of insecurity as to what will happen to me next?

Verbal Activity: In certain constitutions an acute illness can cause confusion in Wernicke's area in the brain wherein due to unsynchronized impulses from the neighbouring areas, the interpretation area of Wernicke's sends chaotic messages to Broca's area of speech thus causing loquacity. This is expressed in three forms
(a) Singing,
(b) Makes Verses and
(c) Cursing.

SINGING:- The patient, as the fever or toxicity rises becomes more exhilarated and rhythmic. He starts singing or talking in rhyming language. Singing always does not mean actual singing song. He starts becoming rhythmic, starts substituting words from famous songs by his own words. "Jack and Jill went up the hill to fetch a pail of water!- nursery rhymes or a famous film song is repeated again and again.

c) No Change: There are certain conditions which do not change under the ravages of acute infections or illnesses. This means there is no change in ACTIVITY of the patient. The patient has neither dulled nor become hyperactive.

For all practical purposes these patients are the ones who tolerate their illness without complaining.

No complaint are be due to various causes
(a) because of contentment e.g. opium;
(b) because the patient is averse of pity sympathy from others e.g. Nat. Mur.,
(c) or the patient does not want others being troubled for him nor does he or she wants to miss his duities, work or school e.g. silicea.


Question 2. We come to the next question whether the patient is
hot
chilly

THERMAL AXIS -- Hot or Chilly: This is controversial. I've seen Homoeopaths not believing in Hot or Chilly. Excuses being given for not believing are: -

a. Hot or Chilly recorded in books are by western standards, which may not be true by Indian standards.
b. If mentals or PQRS or all other symptoms are coinciding with a particular remedy, neglect the thermals.
c. Hot or Chilly are very difficult to derive, hence neglect it.

My answer to this:

a. If Hot or Chilly has been recorded in the western temperatures even 4-a.m. aggravation or mid-night aggravation is also by western standards. Should we then convert it to Indian standard time and take mid-night aggravation as 7 p.m. or 8 p.m.? Then, arsenic will be given to Bryonia etc. If time is relative so also is temperature. Hot or Chilly is to be taken according to the Indian standards, which also varies according to altitudes.

A Chilly patient of Punjab may feel hot in Mumbai or Chennai. A Hot patient of Mumbai may feel Chilly in Delhi.

Hot patient does not mean repertorily "Heated becoming aggravation" or "Warmth aggravation" or "Sun aggravation".

Similarly, Chilly patient does not mean "Cold aggravation" or "Cold air aggravation" or "Cold becoming aggravation" as given in the repertory.

Hot or Cold aggravation makes it a particular. We are concerned with "GENERALS". Now, we are concerned with the tolerance of that person to heat or cold as compared with others around him in the same environment.

a. Decreased tolerance to heat (as compared to others in the same climate) can safely be taken as HOT.

b. Decreased tolerance to cold (as compared to others in the same climate) can safely be taken as CHILLY.

c. Increased tolerance to cold (as compared to others) can safely be taken as HOT.

d. Increased tolerance to heat can be taken as Chilly.

Examples:
(i). People who cannot sit in a place without AC or fan even in winters or pleasant climate in which others are comfortable are distinctly HOT. People who need AC or Fan to be comfortable even in a pleasant climate are bound to be hot. People who rarely wear sweaters or are the last to wear sweaters as compared to his friends or family members are apt to be HOT.

(ii). People who require double clothing or put-on a sweater easily on the slightest drop of mercury are mostly CHILLY. People who can sit comfortably with Tie and closed collars in a warm sultry room can be taken as CHILLY.

Many a times one finds the patient mentioning " I feel heat as well as cold very easily". There are patients who say, " I cannot bear the extremes of both heat and cold". These are Ambi-thermal drugs. e.g. : - Merc-sol, Antim-crud, Natrum-carb, Cinnabaris may be constantly sensitive to, intolerant to, and aggravated by both heat and cold.

Mercury in acute diseases like cough, cold, coryza, fever or diarrhoea i.e. in PSORIC conditions presents itself as Hot. In chronic conditions like hypertension due to atherosclerosis, ulcerative colitis etc. i. e. when sycotic or syphilitic miasm prevails mercury presents itself as Chilly.

In demonstrating Chilly constitution please do not ask for warm bathing or cold bathing. I have students being misled by bathing water temperature.

Bathing with warm or cold water is not reliable because it is more of a habit. In cities and advanced urban areas where electricity is easily available and heaters and geysers are easily available there is tendency of bathing with warm water which ultimately becomes a habit. The more the sophistication the more the people tend to incorporate geysers and heaters even in a warm climate as in Mumbai. In the rural areas or not so advanced areas where heating of water daily is impracticable one shall find people bathing with cold water even in coldest of winters, but it does not stamp them as hot. It is more of habit.

Sitting and working daily in an airconditioned environment is also habit forming. One finds that chilly person working continuously in AC and that too chilled environment through the day but hates AC or even fan at night when he is going to bed. He has a constant tussle with his wife or room partner who puts on the fan when he goes and switches it off again and again.

Talking of beds, one finds many patients saying, " I have to have a thin or a thick covering on myself when I sleep at night"; again here it could be a habit. In such patients, one has to take the nature of the patient into consideration before stamping him as hot or chilly.

A timid constitution like Calcarea who prefers to retire into a shell finds blankets and covers simulating a shell and hence wants them for comforts irrespective of hot or chilly.

Another point to note in this hot or chilly section is, in most of the neurotic hysterical patients, one can safely neglect the importance of thermals. This sounds antagonistic. The reason here being that hysterical patients as the word hysteria suggests have a tendency to react more than normal to natural-normal stimuli. Say for instance an ordinary tussle for fan at night between husband and wife is going to be exaggerated by one of them to lead to a divorce to suicide; one of them is positively reacting hysterically. When ordinary contradiction by one sends the other into a rage the person is hysterical. In short, when any reaction to a situation is out of proportion to the action or stimulus the sensitivity of that person is increased bordering on hysteria.

Here in thermals too, same rule applies. Heat or Cold is a stimulus. If a patient is already hypersensitive to all stimuli he/she is bound to react more to heat or cold as well. Hence, hysterical drugs cannot be confined to the mathematics of hot or chilly. They either react excessively to both or on the other hand you find them changing from hot to chilly at a drop of a hat with swings of the moods. Pulsatilla, a definitely a hot remedy in acute illnesses with intolerance to heat and closed rooms with desire for cold open air is known to be chilly at times albeit when hysterical symptoms predominate. The changeability of Pulsatilla can also make it swing from hot to chilly or thirsty to thirstless with its famous now well-now ill constitution.

Other hysterical drugs like Moschus, Valeriana Asafoetida etc. should be considered similarly.

Now, comes the "Million Dollar Question" whether one should consider the genetic constitutional hot or chilly or the changed state of hot or chilly in acute illnesses.?
HOT AND CHILLY: In order to understand the importance of Hot and Chilly it is important to study and understand the Insulator system of the Body.

THE INSULATOR SYSTEM OF THE BODY

There are two Temperatures of the Body.

1. Core temperature
2. Surface temperature

The temperature of the deep tissues of the body the "CORE" remains almost exactly Contrast within +/- 1؛ F, day in and day out except when a person develops a febrile illness.

The Surface temperature, in contrast to the core temperature, rises and falls with the temperature of the surroundings. This is the temperature that is important when we refer to the ability of the skin to loose heat to the surroundings.

The mechanisms for control of the body temperature represent a beautifully designed control system, which operates in health and in disease.

IN HEALTH

The skin, the subcutaneous tissues, and the fat of the subcutaneous tissues are a heat insulator for the body. The fat is especially important because it conducts heat only one third as readily as other tissues because most body heat is produced in the deeper portions of the body, the insulation Beneath the skin is an effective means for maintaining normal internal core temperature.

Heat is continually being produced in the body as a byproduct of metabolism differently in different constitutions. Body heat is also continually being lost to the surrounding. The various methods by which heat is lost from the body are
(1) Radiation 60%
(2) Evaporation 22%
(3) Conduction 18%
when the rate of heat production is exactly equal to the rate of loss the person is said to be in "Heat balance".

The factors that are important in determining the rate of heat production are

Basal rate of metabolism of all the cells of the body

Increase in rate of metabolism caused by muscle
activity.

Increase in metabolism caused by the effect of
epinephrine norepinephrine and sympathetic
stimulation on cells.

Increase in metabolism caused by increased
temperature of the body cells.

Effect of thyroxin on body cells.

Hence heat production in every individual depends upon the basal metabolic rate, muscle activity, amount of epinephrine, nor-epinephrine thyroxin and sympathetic stimulation. All these are different in different individuals depending upon their genetic constitutions (code) To maintain the heat balance in every healthy individual and make all the systems function normally the amount of heat radiated has to be controlled, This means people who have less heat generated through their metabolic or muscular activity have to conserve heat by accumulating more fat underneath the skin. Therefore Chilly people will have excess fat. This is proved by the fact that three or two marks drugs listed in the repertory under General rubric of Obesity in Synthesis Repertory are mostly chilly drugs. Out of 30 drugs mentioned 24 drugs are out right chilly.

OBESITY:

3 Grade remedies - CALC, CAPS, FERR, GRAPH, PHYT,
All 3 grade remedies are CHILLY

2 Grade remedies -
CHILLY REMEDIES: acon, am-br, am-c, am-m, ang, ant-c, ars, asaf, aur, bell, calc-ar, calo, coc-c, cupr, elaps, fuc, hura, hyos, kali-bi., kali-c, lac-d., phos, pitu-a, thyr.

HOT REMEDIES: apis., croc., lyc., nat-m., puls., sulph.

Their excessive fat is deposited to prevent the loss of internal heat to the environment by radiations.

Vice-versa the patient or constitutions which have excessive heat produced within them have to release it out to the surroundings Hence fat which is a poor conductor of heat as mentioned earlier is an obstacle and should be done away with so lean thin people like Iodum, Tuberculinum, Secale cor, Bry, etc. shall be hot.

The above idea is not a hard and fast rule but just an indication of how the constitution of a person can have an effect on his built and how thermals i.e. tolerance to heat or cold is a part and parcel of the constitution prescribed for.

IN DISEASE

In acute cases i. e. during fevers or loss of fluids from diarrhea, maintaining the heat balance is slightly more intricate and different. It is the neuronal effect mechanism that decreases or increases the body temperature here. When the hypothalamic thermostat detects the body temperature as either too hot or too cold it institutes appropriate temperature decreasing or temperature increasing procedures.

Temperature decreasing mechanism are: -
(a) Vasodilatation all over the body caused by sympathetic centres in posterior hypothalamus,
(b) Sweating too causes heat loss by evaporation.
(c) Decrease in heat production by inhibiting shivering and chemical thermogenesis.

In order to achieve this the changes which are brought about in the activity of person as a whole, the osmotic regulation increasing or decreasing the thirst, the increase or decrease in secretion of epinephrine, nor-epinephrine and thyroxin thereby giving rise to change in the behaviour of the patient. All these constitutes an image as a drug picture which may or may not be the constitutional, but definitely has to be in relation to the original constitutional similimum.

Example: If a constitutionally known 'sulphur' patient has to suffer from fever with rigors. If he has changed thermals from hot originally to chilly. If he, who liked being with many friends suddenly starts getting angry at the crowd around him or gets irritated at slightest noise or questions or when disturbed and has tremendous increase in thirst than it is Nux vomica single dose which is indicated and not sulphur because his Activity-Thermal-Thirst-Mental axis has thus changed (For Chilly and Hot remedies chart see page no.157)

Relationship of Remedies:
It has been observed that this world is mathematics. Human being and its beautifully well-balanced feedback systems are all in homeostasis because of mathematics. Even the intricate mechanism inside a cell or in human is governed by the laws and mathematical formulae.

Nernst equation that governs the sodium and potassium in all tissues and cells. States.

Diffusion Potential (in millivolts) For sodium







= - 61 X log concentration of sodium inside
Concentration of sodium outside

Permeability of a cell membrane to various elements is given by a formula

Permeability of membrane
= No of channels per unit area X Temp









Resistance of channels per unit length X length of channels X square root of molecular weight .

These and many other mathematical formulae abound in physiology textbooks. The definite values quoted as normal for hemoglobin, leukocytes, M. C. V., M. C. H. C., blood sugar fasting and post-prandial, cholesterol, triglycerides, proteins etc. are in it self ample proof of mathematicity of the body.

It will be only adamancy (if not foolishness) on the part of physician who does not agree that if any changes occur in the nature or behaviour or in other words in secretions of neurotransmitters which result in anger and fear (adrenaline), depression and sadness (serotonin, epinephrine) etc. are unrelated to the original nature of a person.

In short, if changes are temporarily seen in genetic constitutional similimum during acute phase the new drug picture is almost certain to be in relation to the original drug picture that is a Sulphur might develop diarrhoea of a Nux vomica or a Pulsatilla or an Aloe Soc. or Arsenic all etc. A Calcarea Carb constitution in fever shall develop generals e.g.. Thirst and thermals of Belladonna or a Rhus tox or Nux vomica or Sepia or Silicea or Graphites or Nat Carb if chilliness in thermals is still maintained. If the thermal has changed from chilly to hot during the fever then it may mathematically manifest the symptoms of Lycopodium or Pulsatilla etc.

Lycopodium constitution if affected by dynamic stronger influence may change to manifest general symptoms of Lachesis, Sulphur, Pulsatilla, Bryonia, Iodium, Kali Iod or Ignatia, Ipecac, Silicea, Sepia, Nux vomica, Phos.

Thus it is of utmost importance to know the relationship of remedies.

This knowledge may accidentally help us or guide us to find the right genetic constitutional simillimum. A case of tuberculosis of the lungs which I have cured amply demonstrates the upper concept.

Case: A lady aged 38years suffering from Pulmonary koch's came to me with a picture of Rhus Tox. She would be better and relapse again and again and dose of Rhus Tox every 15days would relieve her. But the X rays follow-up after 1 month did not show any change in her cavity. This led me to interrogate her husband about her nature again. He insisted that she has not told me her real nature. He summed up her whole nature as "unlivable with". She's so touchy, anxious, irritable and discontented that everybody in the house is afraid to talk to her. We keep distance from her because of her irritating nature. Then she nags and nags and complains that we don't care for her. She wants me to be with her everywhere she goes. She is so restless that she just cannot sit and do anything continuously (This restlessness perhaps had misguided me to Rhus Tox). Here after seeing Rhus Tox act partially I was sure the constitutional was not far off. I had only to open the relationship book to find out which drug had Rhus Tox following well. Since Rhus was acute the constitutional drug has to have Rhus Tox following well.

The remedy Cina showed Calc, China. Ignatia, Nux vom, Plat, Puls, Rhus tox, Silicea and Stannum following it well. With the picture now clearly showing the mentals and generals of Cina. I did not hesitate to prescribe a single dose of Cina 200. Believe it or not the cavity disappeared within 3 weeks never to relapse again.

Thus knowing of relationships of remedies is a must.

Those who do not feel the need to do so perhaps are not practicing "holistically hence when I used to practice it that way haphazardly. I never realised the importance of relationship of remedies.

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