Applied Materia Medica in learning & practice

Dr Arun Prasad K P

“The most expert healer is the man who knows how to handle his Materia Medica”

The words of CM Boger highlight the importance of Materia Medica in practice.   Needless to say, where most of us, especially the beginners have problem is in the “handling” of Materia Medica.

Applied Materia Medica is quite simply the art of applying Materia Medica (“handle”) in practice.   We have before us a wide range of Materia Medicae, and each one of us may have a favourite – Allen’s key note, Boericke etc.   But many have found that it is one thing to “study” Materia Medica for the exams, and quite another to apply this knowledge in practice.   This article examines the common problems faced and possible ways to overcome these.

Difficulty in applied Materia Medica arise due problems at two levels

1. The way we study and understand our Materia Medica
2. The way we apply this knowledge in practice 

Problems at the second level  are strictly not problems with Materia Medica – It has to do with application of case processing methods, including case taking, analysis and evaluation, erecting totality, repertorisation etc.   Needless to say, any amount of Materia Medica knowledge will come to naught if these crucial areas are ignored!

We will focus on the first level, as a major share of the problems in application arises because of faults in the way we study and understand our Materia Medica.

What is the objective in studying Materia Medica?
Similia similibus is about comparison of natural and artificial disease, and perceiving the latter is a crucial step.   Dunham has put it quite clearly that we study Materia Medica “In order to select from a number of candidates one which most nearly resemble a given standard”.   And to be able to select one from a group of very similar candidates one should perceive “……. Peculiarities of each drug which are not met with in any other, and which therefore serve to individualize and give character to the drug”

We should study Materia Medica in such a manner therefore, that individual remedy pictures are clearly brought out.

What are the problems in achieving this objective?
There are difficulties in the very nature of our Materia Medica, and in the methods of study

No Standardisation
Quite simply there are too many, too voluminous, and too different Materia Medica available. As opposed to our allopathic counterpart, we don’t have one book which gives us all or nearly all the information.   The structure and writing styles are different as well, adding to the confusion.   We wish our beloved “key notes” will be nearly enough, but practice teaches us differently!

Moreover, the kind of information included depends on authors’ school of thought – and these have been many and often opposed to each other.   So we find ourselves choosing between the” pathological” school, the “keynote” school, the constitutional school (not to mention Indian variants – Dr Sankaran’s “Bombay school”, Dr Sehgal’s “mind only” approach, Dr Vijayakar’s approach etc) etc.   These differences have been always there since the beginning of homoeopathy, but there have been especially sharp divisions between the so called “modern masters”.    The protracted and public spat between Vithoulkas and Sankaran in recent times comes to mind.

All this puts the beginner (and often those with “experience”) in a dilemma – Which school / Materia Medica to follow? All of them claim that they are right?

Problems in studying /method

• Language – Perhaps the most critical problem face by many  – purely because we are mostly a group of non-native speakers of English trying to understand the eighteenth and nineteenth century English translation of what provers and patients have said in mostly eighteenth century German (not to mention really obscure medical terminology) !   So we have doubts about “indignation”, “vexation” and “reserved displeasure”, apart from “zymosis” and “fungus hematodes”
• Disbelief – Some of the sensations mentioned in our Materia Medica is so wonderful and “out of this world” that it beggars belief.   Would a patient really experience a pain as if “a slipknot has been tied to the intestine which has been gradually tightened and suddenly released (Chionanthus)?
• “Usual Reading” – Self explanatory – what is usually done twenty four hours before an exam!
• Prejudice – We think of being ”unprejudiced”  as a necessity in case taking and case processing etc, but what is true of forming portrait of natural disease is also true of artificial disease.   Prejudice can interfere with successful application of Materia Medica in different ways.
• Fixed “Images” – Arsenic album has to be squeaky clean and fastidious, Sulphur has to be dirty and “ragged”, Calcarea has to be obese etc
• Favourite remedy – a form of prejudice affecting many.   A simple exercise will bring forth the degree of prejudice – Go through all the case records of the past six months / one year, and list the no. of chronic acute prescriptions made.   It can be guaranteed that for most the number will not exceed 25 – 50.    That is less than one-fourth of the BHMS syllabus!
• “Useless” remedy – A corollary of the last prejudice.   Also is a reflection of how well we know a remedy – the less we understand a remedy, less chances there are of us prescribing it. This applies for rarer uses of common remedies as well – For e.g. Drosera is a “cough” remedy for many of us, for ML Tyler it was a frequently indicated remedy for any condition when h/o TB is present

How to remedy these problems?

No Standardisation
As confusing as it may sound, the diversity in our Materia Medica, writing styles etc can actually be a boon.   It gives us diverse experiences and views about each remedy (besides preventing the boredom of having to read one book all the time!).   Each author completes parts of the whole picture, and a thorough reading of various authors gives us the whole story.   At the same time each author by themselves may give an incomplete picture.     It is especially important that we don’t get “stuck” in one school of thought, nor should we reject something because it appears at first sight to be useless or nonsensical.

“Anekantavad” and homoeopathy
To put things in a better perspective, it may be helpful to recall the concept of “Anekantavad” (a tenet of Jainism).   Anekantavad prepares us to the possibility of “manyness of truth”, to the fact that there can never be only one point of view.   Problems occur because of inability to see the other’s point of view, to acknowledge that one’s version of truth is just that – one version!   In the homoeopathic context it asks us to be more broadminded in our outlook to methods different from our own.   At the same time it is equally important to avoid the trap of becoming the jack of all trades!

Which materia medica to read ?
Lord Bacon said “Some books are to be tasted, others to be swallowed, and some few to be chewed and digested”.   It is for each one of us to decide which of our Materia Medica are to be tasted, swallowed or chewed!  But as a very broad suggestion the author would like to especially recommend in addition to usual Materia medicae like HC Allen, Kent, Choudhury, Nash, Tyler etc

• Boger’s Synoptic Key – To be read only after reading some of the above
• Phatak’s Materia Medica (includes Boger’s + Boericke + Phatak’s experiences) 

While reading…..

• Try to reflect on what is read to understand fully or imagine the symptoms / totality
• “Reading maketh a full man, conference a ready man, and writing an exact man” – says Bacon.    Very often putting it on paper helps in fine-tuning our understanding of a symptom / remedy.    Take notes whenever you read a book or hear a speaker on Materia Medica
• Do not hesitate to consult language dictionaries / Medical dictionaries to get to the true meaning of a symptom.   For understanding older medical terminologies, specialized dictionaries or websites can be consulted (e.g. http://www.antiquusmorbus.com/)
• Consulting source books for ambiguous or contradictory statements of authors can be useful e.g. Euphrasia in Allen’s key note gives >open air as a modality, making it very similar to Allium cepa.   A reference to the source books confirms that many of the symptoms are < open air, and what is > open air is the headache
• Mental symptoms – Try to get the true meaning from classical authors (refer dictionary, source books as needed).   Then and only then one may look into the experiences of modern authors like Vithoulkas etc
• Expaaaaand! – Key notes are indeed very useful, but can be more useful if the symptom can be made complete especially with regard to modalities.    A sensation or location by itself has little value.   Boger says “A concise view not only includes the time and order in which symptoms arise, but also the things which modify them – the modalities”.    E.g. Allen’s Keynote stresses on the acrid lachrymation and bland coryza of Euphrasia.    Reference to the other Materia Medica gives the modality of coryza < night and lying down (with cough > night and lying down!)
• Note small remedies – and try to get characteristic indications to expand its utility.   E.g. Robinia is routinely prescribed for “reflux” symptoms, heart burn etc.   Reference to Materia Medica gives Heart burn < night on lying down and heartburn associated with headache as characteristic indications.
• Use repertory – not for repertorisation, but as a tool to study Materia Medica.   Especially useful for studying smaller remedies or unusual symptoms
• E.g.  If asked about the mental symptoms of Aethusa many will recall the “idiocy” or “examination funk”.   A reference to Kent’s repertory gives a more peculiar symptom, “fear to close eyes lest he should never wake up” where Aethusa is the only remedy!
• Use software library – E.g. Electronic libraries like Encyclopedia Homoeopathica can make searching for symptoms, source books etc very, very , easy.
• Note relationship of remedies – One of the most practical but most neglected aspect of remedies.   Studying a chronic remedy’s satellite remedies may give us a clue on the possible remedies needed in acute situations e.g. Calc is complementary of Aethusa, and follows well after Pulsatilla, Rumex and Drosera.  A Calc child with vomiting may need Aethusa, with respiratory symptoms may need the other three remedies 

A question of “Tips”
“Tips” as it is known, has a bad reputation! Many advise completely disregarding tips given by other homoeopaths while some blindly follow it.   This author would like to tread a middle path and propose

• “Tips” or clinical hints are essentially experiences of authors / other homoeopaths and are inherently valuable
• Tips of classical authors are of course most valuable.    Many authors have published their unique experiences, cases etc.   Books on therapeutics are a good place to search for particular authors’ experiences.   Some examples are given below
• Pointers to common remedies – ML Tyler
• Therapeutic pointers to some common diseases – EA Farrington
• Testimony of the clinic – EB Nash
• New Remedies, Clinical cases,……….. – Dr. JT Kent
• Some of the above books also give a fairly good idea on the expertise of our classical authors .   E.g., a case of ring worm from Kent’s ”Lesser Writings” had the totality of
• Many of us would have prescribed Tuberculinum, Kent cured with one dose of Helleborus 1M !
• Tips from contemporary homoeopaths – Do not ignore, but try to get a confirmation from the Materia medicate or source books if possible.    Also try to expand the “Tip” into a small workable totality with A/F, sensation, modality and concomitant as possible
• E.g. the author got a tip from a senior homeopath that Mezerium is a “good” remedy for Peptic ulcer.   The information by itself may not have much value – Referring to other Materia Medica the single symptom can be developed to give the following totality for peptic ulcer.
•  Stomach pains – corroding, raw, burning > eating.   Anxiety felt in the stomach < slightest noise.   Pains with chilliness.   A/F or H/O Suppressed skin eruptions.
• As an aside, one also learnt that many “skin” remedies have stomach pain > eating – Graph, Petr, Mez, Anac etc.!
• Ringworm / Craves meat, refuses everything else / Grinds teeth, rolls head during sleep 

Conclusion
The suggestions given above is only one approach to learning Materia Medica, and is necessarily colored by the authors experiences.   The one rule which is applicable to all – beginner or expert –  is to keep reading !.   Maybe we can try to emulate ML Tyler who said “read a drug every day, and two on Sundays”

References
1.Kopikkar SK. “Koppikar’s Clinical Experiences of 70 Years in Homoeopathy”
2. Dr. Ajit Kulkarni  – “Anekantavad and the Study of Materia Medica”

Dr Arun Prasad.K.P BHMS,MD(Hom)
Govt.Homeopathic Medical College. Karaparamba.P.O, Calicut. 10. Kerala
Email: appoo.ap@gmail.com