Planning and programming of treatment

Dr Riya Susan George

ABSTRACT: This article includes the criteria for the selection of dose and potency after case taking. A detailed analysis of the case on the following parameters should enable the physician to plan further operations with ease and confidence.

KEYWORDS: Homoeopathy, Dose, Potency, Repetition

INTRODUCTION

The fundamentals of homoeopathic posology are represented in the trinity of,

• Single remedy
• Minimum dose
• Minimum repetition

Any error in the selection of dose and potency can immediately reflect either a poor response or an exaggerated response even though the remedy has been correctly selected.

The law of dose states that,

“The curative dose, like the remedy, must be similar in quantity and quality to the dose of a morbific agent which caused the disease”

Hence a proper understanding of dose and repetition is essential for an intelligent grasp of the most important aspect of homoeopathic practice.

PLANNING AND PROGRAMMING OF TREATMENT

This section in the standardized case record focuses on the various parameters to be taken into consideration while formulating planning and programming of treatment in terms of selection of potency, repetition of doses, and use of different remedies guided by the need of the time and circumstances

STRUCTURE

	DEFINE WITH REASONS THE STATE	POTENCY-CHOICE	REPETITION
1	SUSCEPTIBILITY (Tissues)
2	SENSITIVITY(Mind and Nerves)
3	SUPPRESSIONS(If any)
4	CORRESPONDENCE(Degree and Level)	CONST. Rx
5	CORRESPONDENCE(Degree and Level)	SECTOR Rx
6	CORRESPONDENCE(Degree and Level)	INTER-CURRENT Rx
7	FUNCTIONAL CHANGES
8	STRUCTURAL CHANGES
9	VARIATIONS(proportionate with time)
10	GENERAL VITALITY
11	PRESENTATION
	A)   FUNDAMENTAL MIASM
	B)    DOMINANT MIASM
	C)    SECTOR(Acute/Exacerbation)
	D)   RECENT GROUP (State from…….)
	E)    CONFUSED

All pages divided into 3 columns

1^st column- Parameter of assessment and the data on which it is based.

2^nd column- Potency selection based on understanding the implications of the assessment done in the first column.

3^rd column- Assessment of repetition.

DIVISIONS

• 1^st integration- At the level of the reactivity of the patient to external stimuli. This is divided into a) reaction at tissues and cellular level(susceptibility)

1. b) Reaction at the level of sensitivity – at the level of nerves (sensory-motor response) and the mind (sensitivity)
2. c) Finally the impact of the suppression of the system as a whole or the individual organ or system.

• 2^nd level of integration – At the level of the patient’s susceptibility to remedies selected.
• 3^rd level of integration- It involves pathogenesis, the changes in the disease expression along with the changes in vitality.
• The final level of integration involves the manner of a presentation concerning the fundamental miasm, dominant miasm, sector (acute/exacerbation), recent group (state from), confused. These help us to understand the different levels of expression of the patient in terms of miasm, regional presentation – acute disease/ acute exacerbation of the chronic disease, mixed picture with no clear remedy, or a confusing picture.

PARAMETERS

• SUSCEPTIBILITY

Susceptibility is an inherent capacity in all living things to react to stimuli in the environment at the level of tissues/ cells.

The more similar the remedy, the more clearly and positively the symptoms of the patient take on the peculiar and characteristic form of the remedy, the greater the susceptibility to that remedy, and the higher the potency required.

Potency And Repetition	Indications
High potency with infrequent repetition	§  A good number of characteristics Less pathological changes (tissues)
Moderate potency with infrequent repetition	§  A moderate number of characteristics and §  Changes not limited to a functional zone §  Irreversible structural changes
Low susceptibility with frequent repetition	§  Fewer characteristics §  Unable to prevent structural changes at the tissue level

• SENSITIVITY
• Inherent capacity to react to stimuli in levels of mind and nerves

Assessment

• Intensity and presence of characteristics at both levels(mind and nerves)
• Patient’s tendency to react(mentally and physically) to distress produced by illness

Potency And Repetition	Indications
High with infrequent doses	High level of reactivity and characteristics at the level of mind and nerves
Moderate with an infrequent dose	Moderate level of reactivity and characteristics
Low with frequent repetition	Low emotions Poor characteristics

• SUPPRESSIONS

Physical (ointments) – internal organs involved

A case may present with a paucity of symptoms or absence of expected indications or involvement of deeper organs after the disappearance of external manifestations. This occurs as a result of procedures that do aim at curing the disease within. (Suppression). As a result, the susceptibility gets undermined.

Potency And Repetition	Indications
Low /medium potency in frequent repetitions	Poor susceptibility

• CORRESPONDENCE(DEGREE AND LEVEL) CONSTITUTIONAL REMEDY

The levels of similarity of the selected constitutional remedy i.e., mind and body, and the extent of depth of the disease process need to be stated.

Potency And Repetition	Indications
High potency infrequent repetition	Complete/total similarity (both mind and body)
Low/moderate infrequent repetition	Partial /superficial similarity

• CORRESPONDENCE(DEGREE AND LEVEL) SECTOR REMEDY

This aspect is seen while handling an acute episode or a one-sided chronic disease

 

Potency And Repetition	Indications
High potency, infrequent repetition	complete  similarity
Low or  moderate potency	Partial/ superficial similarity

• CORRESPONDENCE (DEGREE AND LEVEL) INTERCURRENT REMEDY

Intercurrent totality takes into account certain characteristic general features as well as miasmatic features from the case.

Potency And Repetition	Indications
High potency	If characteristic generals and miasmatic features are similar
Medium potency	If similarity only at miasmatic levels

• FUNCTIONAL CHANGES

The quality and quantity of the functional v/s the structural component in the changes in the disease process must be studied.

Potency And Repetition	Indications
High or medium potency with infrequent repetition	Predominant functional changes

• STRUCTURAL CHANGES

Potency And Repetition	Indications
Medium or low with infrequent repetition	Reversible structural changes
Low potency with frequent repetition	Irreversible structural changes
Low potency at infrequent repetition	If for palliative

• VARIATIONS

Proportionate with time

Diseases characterized by erratic and rapid changes in the symptom pattern would demand a cautious approach

Potency and repetition	Indications
Medium potency with infrequent repetition	Symptoms rapidly changing or shifting

• GENERAL VITALITY

Determined by the state of vital signs and the functioning of vital organs.

Potency And Repetition	Indications
High potency in infrequent doses	If vitality is good
Low potency in frequent repetition	If vitality is poor
High potency in frequent repetition	In acute illness with low vitality or reaction

• PRESENTATION

1. Fundamental miasm: This is determined by the family history and past illness of the patient.
2. Dominant miasm: This is determined by the miasmatic expressions dominant in the presenting complaints.
3. Sector (acute/exacerbation): Represents the organ/system where the disease is localized.
4. Recent group (state from): In chronic cases, the symptomatology appears to be all mixed up. Under the circumstances, the best course will be to consider the symptomatology from a chronological standpoint and to fix the first prescription based on the group of symptoms that have appeared in the last.
5. Confused: When the system is under suppression, the susceptibility is not able to throw clear pictures. In such conditions, we get confused images and the use of intercurrent remedies to clear the picture becomes essential.

CONCLUSION

The selection of the dose is as much an integral part of the process of making a homeopathic prescription as the selection of the remedy and is often quite as important. A well-selected remedy may fail utterly, or even do injury, because of wrong dosage and repetition.

REFERENCES

1. ICR operational manual –Dr. M L Dhawale
2. Principles and practice of homoeopathy- Dr. M L Dhawale
3. The Genius of Homoeopathy- Dr. Stuart Close.
4. Organon of medicine- Dr Samuel Hahnemann.

Dr Riya Susan George
Part 1 MD
Department of Organon of Medicine and homoeopathic philosophy
Father Muller Homoeopathic Medical College, Mangalore