Michelle Kardys, Alejandra Iniguez, Debbie Noah Yolande Grill, Cyndi Meyer, ?, Nancy Tichenor, Neepa Sevak, Martha Aubrey, Jyl Steinback, Eric Rudnick, Audrey Ward, Front:Greg Meyer MD(H), ? , Reza Sharifi, ? Judy Schmitz
Michelle Kardys, Alejandra Iniguez, Debbie Noah Yolande Grill, Cyndi Meyer, ?, Nancy Tichenor, Neepa Sevak, Martha Aubrey, Jyl Steinback, Eric Rudnick, Audrey Ward, Front:Greg Meyer MD(H), ? , Reza Sharifi, ? Judy Schmitz
Most homeopathic practitioners regularly attend homeopathy conferences and study groups. (The Homeopathy Association of Arizona has organized three study groups in the Phoenix area alone!) These usually include presentations of cases, or descriptions of how specific individuals have been helped by homeopathy. Case reports are typically thought to be simply narrative stories that chronicle a case from beginning to end. But how you choose, prepare and present that case can make a significant difference to what others are able to learn from it. Case reports should always be geared to specific audiences, which can vary widely from members of the general public who want to learn more about the process of homeopathic care to students of homeopathy who want to learn more about how to take, analyze and manage a typical case. Although in the end we are all students of homeopathy, this discussion focuses on case presentations aimed for a conference or study group audience comprised mainly of professional homeopaths.
Case studies are actually a type of research method. Of course, homeopaths do not take cases for research purposes; they take them so they can help heal individuals. But similar to case study researchers, homeopaths collect data from a number of different sources, including interview notes or transcripts, direct observation and other objective data such as laboratory test results. Using different information sources to help understand a case in this way is referred to as “triangulation”. Homeopaths also use techniques similar to those employed by researchers to analyze their cases, such as pattern-matching (seeing if an individual’s symptoms fit a remedy pattern), repeated observations (looking for repetitions of this pattern within the case), explanation-building (using timelines to investigate symptom etiology) and testing rival explanations (looking for evidence in the case that might contradict the suspected pattern)[i]. As a result of these and other similarities, there are lessons that can be learned from case study research that can be applied to case reports shared at homeopathic conferences and study groups. So in order to improve the learning from your case, you may want to consider asking yourself the following questions:
This question is central since it partly determines which case you choose to share. Generalizability is the key to maximizing what others can learn from your case since it helps them transfer the lessons you learned to their own cases. In order to figure out if your case is generalizable, you are looking for what might be typical in your case, so you might ask yourself: How common is the main health condition in my case? If uncommon, is there a need among homeopaths to learn more about it? How small or large is the population my case falls within? How likely is it that other homeopaths will encounter clients in this group? Did I use resources available to most other homeopaths in working through the case? The answers to these questions provide the context for your case and help others determine how and whether the lessons learned might apply to their cases. Even if your case deals with a rare condition and/or a small sub-population or employs a tool that is unavailable to most homeopaths, it would be helpful to communicate this clearly so that audience members can assess whether your case is generalizable to their practice.
This question also relates to the case you choose to share. An audience of professional homeopaths is mostly interested in adding to their understanding of the healing process (theory) or improving how we facilitate healing (methods). Here, what you are looking for is what makes the case unique, which on the surface might seem to be the opposite of what might make a case generalizable. The Journal of Medical Case Reports advises that case reports should include a “new association or event” or what is “previously unreported”, “unusual” or “unexpected”. Of course, homeopathic care is clearly different from conventional medical treatment because it is individualized, however, the process of teaching and learning about a case is actually similar. What makes the case unique is not what is unusual or unexpected about the individual who is the center of the case (i.e. their childhood, symptom etiology, etc.), but rather, what is unusual about the case (what it illustrates generally about healing or how to bring about healing).
In order to help figure out how to identify what is unusual or unexpected about your case, here are some questions you could ask yourself: Did I use an approach to case-taking, case analysis or case management that is not yet well established? Did I prescribe a well-known remedy for a symptom or condition not normally associated with it? Or a lesser known remedy within a well-known remedy family? Did my client’s healing follow an unusual path? If the answer to all of these and similar questions about theory (the healing process) and methods (how to bring about healing) is “no”, then your case may still be engaging, but might have limited learning value for your audience. That said, simply thinking about these kinds of questions may help you identify new lessons from your case that you didn’t previously consider and can share with others.
You have now chosen your case based on the balance between what is typical about it (generalizability) and what is unusual or unexpected about it (adds to knowledge). It’s now time to plan the presentation. It is at this point that it’s important to distinguish between a story and a case report. Details in homeopathic cases are always critical in the process of providing homeopathic care, so it is tempting to want to share as many of them as possible in case presentations. While the basic story of the case is almost always necessary, story details tend to direct the attention toward the storyteller and his or her personal abilities as a practitioner rather than the lessons others can learn from the case. So rather than fill all the available time elaborating on the particulars of the case, it may be constructive to take some of that time to spell out the reasons for how and why your case is generalizable and how it adds to knowledge. This requires a higher level of analysis over and above telling the story.
This may seem like a strange question, but describing what you did not do and why you didn’t do it also further helps others learn what is unusual or unexpected about your case. So you could ask yourself the following questions: Did I explain how the outcome of my case might have been different if I had chosen a more typical approach to case-taking (or case analysis, or case management)? Or why my attempt to employ the usual approach did not or would not work? Answering these questions might help sharpen the focus on why your case is significant.
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The ultimate purpose of sharing case reports at conferences and study groups where the audience consists primarily of practicing homeopaths is to communicate what you have learned from a case that has enhanced your practice and helped make you a better homeopath. So perhaps the most important question to ask yourself is: How and why did this case transform my practice? This is what others want to learn from you!
[i] Robert K Yin (1994) Case Study Research: Design and Methods 2nd edition. Thousand Oaks: Sage. This book is actually in its 5th edition (2014).
It’s that time of year. Always lots of media hype and controversy. Everyone has to make their own decisions based on the information available and their own situation. I’m not going to tell you what to do. I am going to tell you what I do.
I never get a flu shot, and never will. Mainly because I know that if I should happen to get the flu, it is easily treatable with a homeopathy remedy. Homeopathy became really mainstream in the 1800’s because of its success in treating epidemics, including the flu. I have personally treated patients with the flu that have improved within an hour of taking a homeopathic remedy. There are several over-the-counter homeopathic remedies that may be useful to treat the flu. Which one is best for you is determined by your individual particular symptoms. This link gives the common remedies, and explains what remedy to use, and when.
Just look at the data on death rates during epidemics of influenza on people treated with homeopathy. The numbers speak for themselves. In the 1918 flu pandemic the death rate for allopathically treated patients was 28%, with homeopathy it was 1%. There are many similar studies.
Working in the medical field, it is not uncommon for me to see patients with a cold, or illness, and they say “how can I get sick, i just had a flu shot 10 days ago.” Random coincidence? I don’t know. I saw a 60 year old woman a few weeks ago that was in a wheel chair. She got transverse myelitis after a flu shot 5 years prior, and now can’t walk. This very rare, but it happens. Even the FDA drug insert for the H1N1 Vaccine even lists it as a possible side effect.
The vaccine prevents some people from getting the flu, but at what cost? I’m not sure, and perhaps it is really difficult to measure that. I am not so sure the medical community even wants to know the answer. I think multiple vaccinations can affect the body in an adverse way. You may not get the disease that you are trying to prevent, but your body may be weakened in other aspects, so that slowly other chronic problems now appear over time. And, the vaccine is not that effective….18% effective!
In the regular monthly postings, we have touched on “How to cope with research” (August 12, 2015) which deals with the sometimes dizzying and often confusing world of research in homeopathy. “How does homeopathy work?” (September 23, 2015) focused on Dr. Iris Bell’s extremely useful answer to this question. This month, we turn our attention to an important aspect of research in homeopathy: homeopathic provings.
A “proving” is a special type of research unique to homeopathy initially developed by its founder, Samuel Hahnemann, (a German physician-chemist who lived in the late eighteenth and early nineteenth centuries) that documents the action of homeopathic preparations of specific substances on humans. One of the important and enduring distinctions between homeopathic provings and conventional medical research is that homeopathic medicines (“remedies”) are tested on healthy subjects rather than those who have already succumbed to disease symptoms. This is due to one of the central principles of homeopathy: ”like cures like”, which means that a substance capable of inducing symptoms in a healthy individual can cure those same symptoms in a sick person. Information gleaned from provings combined with scientifically-based information on sources (the material from which homeopathic remedies are made) along with clinical observation and outcome research form the body of knowledge on which homeopathic prescribing is based.
Hahnemann on homeopathic provings
Chapter 4 of Hahnemann’s famous book The Organon (the last edition completed in 1842) is dedicated to homeopathic provings. In it, he describes the possible internal processes related to the action of medicinal substances on the human body during a proving (aphorisms 111 to 115); prescribes the preparation, potency and dosage of the substance to be administered to “provers”, or those who are testing the substance (122-4, 128-37); outlines basic instructions for provers after taking the medicine (124-6); and provides instructions to provers on how to document and record symptoms (133, 138-9). In addition, Hahnemann describes the “qualifications” of provers in that they must be healthy rather than sick (106-8,141-2) and specifies that provers should be both male and female (127, 135). This last point is significant in that as recently as 20 years ago– over 150 years after Samuel Hahnemann’s death!– modern medical research was conducted mostly on men. He further states that provings should be repeated multiple times on many different provers, addressing the important issue of replicability, or the repetition of research findings. Over the many decades that Hahnemann conducted provings, he observed that some symptoms appeared among provers more frequently (116), others were more rare (“idiosyncratic”, 117), and that not all symptoms appeared in all provers (134).
Modern homeopathic proving research has built on this foundation, but has added other features. In the US, Arizona’s American Medical College of Homeopathy (AMCH, now part of the Phoenix Institute of Herbal Medicine and Acupuncture, PIHMA) has been conducting provings since the 1990s and has set a high standard for this type of homeopathic research. AMCH provings use a double-blind randomized design in which roughly 20% of proving participants are given placebo. All provers must be 18 years or older, cannot be pregnant or lactating, have serious medical conditions, or be taking prescription drugs. Research ethics guidelines established by the Department of Health and Human Services that are used in conventional medical research are also followed for homeopathic provings. These guidelines include verification of lack of financial interest on the part of the principal investigator, preservation of the confidentiality of information, informed consent, and appropriate monitoring and response protocols in the event of adverse effects.
Steps for conducting a proving
The first stage of an AMCH proving consists of establishment of a thorough baseline of symptoms for each prover through labwork, prover logs and an extended interview. After this, a low-potency homeopathic preparation of the substance is administered daily for up to seven days or when signs or symptoms first appear. The observation phase lasts for three weeks, during which subjects keep a daily log of their symptoms. A final exit interview is conducted after one month. Follow-up continues for up to sixty days or when the prover no longer has signs or symptoms. Not infrequently, symptoms in some provers are actually cured, and in this case the prover is followed for an additional period in order to determine if the improvement is sustained.
The accumulated data from all research subjects (interview transcripts, daily logs, etc.) are then qualitatively analyzed and a remedy “picture” is constructed based on these data. A final open meeting is held for all provers, supervisors and interested members of the general public at which the remedy substance is named and the main findings are summarized. The accumulated symptoms for the remedy are then entered into homeopathic “repertories” (the databases used by homeopaths to look up symptoms) so they can be accessed by homeopaths prescribing for their clients. Following some additional steps, the remedy monograph can be added to the Homeopathic Pharmacopeia of the US (HPUS), which is overseen by the FDA (see http://www.hpus.com/what-is-the-hpus.php for more information on HPUS).
This is a fascinating process to participate in! For examples of provings done by the American Medical College of Homeopathy, or if you live in the Phoenix area and are interested in taking part in homeopathic research, call 602-274-1885 or send an E-mail to email@example.com. You can also visit the AMCH website at http://www.amcofh.org .
In our last post, we talked about a coping strategy for how to deal with research in homeopathy. This time we will attempt to address an important question: how does homeopathy work? Because the physico-chemical research underlying this question continues to unfold, it is not possible to provide a definitive answer. However, Dr. Iris Bell of the Department of Family and Community Medicine, College of Medicine at the University of Arizona has assisted us greatly by providing the closest thing to an answer in plain language. In a 2012 online article that can be found at http://howdoeshomeopathywork.net/ , she draws on 26 recent scientific articles from journals such as the International Journal of Nanomedicine and Environmental Science and Technology. Here is my attempt at a very brief and partial summary of what she says (all quotes below are taken from her article):
Homeopathic medicines are made using a serial dilution process resulting in 1/10, 1/100 or 1/50,000 ratios, which is why they are frequently dismissed as mere placebos. However, the scientific evidence has repeatedly confirmed that homeopathic remedies are actually “nanoparticles, not ordinary bulk forms of source material”. Dr. Bell asserts that “this fact changes the scientific issues completely from a debate over ‘placebo effects’ to a serious scientific consideration of how nanoparticles can act in the body to stimulate healing processes”. For this reason, homeopathy can probably now best be viewed as a type of nanomedicine.
What are nanoparticles and what makes them special?
Nanoparticles are very, very small amounts of substance measured using a special “nanometer” scale. Research has shown that nanoparticles “have biological, chemical, optical, thermal, electromagnetic and quantum mechanical properties that larger particles do not”. When employed as medicines, nanostructures “require lower doses to get the same effect, can have longer durations of action and fewer side effects compared with ordinary conventional drugs, herbs or vaccines”. This is probably the reason why we know homeopathic remedies to be effective, gentle and safe.
One of the interesting properties of some types of nanoparticles is that they can “stimulate beneficial changes whereas higher doses of the same material can inhibit function or cause adverse effects”. In other words, nanoparticles can have the opposite effect on an organism as higher doses of the same substance. So unlike conventional drugs that work in the high-dose range “trying to just barely avoid toxicity and causing ‘side effects’ while suppressing or inhibiting function”, medicines made from nanoparticles appear to trigger “adaptive processes within the overall cell or whole organism”. This might help explain how a single dose of the correct homeopathic remedy can effect a permanent change toward health in an individual.
Homeopathy: an early personalized system of medicine
Dr. Bell concludes that the properties of nanoparticles make homeopathy “one of the first systems of personalized medicine in which the individual’s complete pattern of health problems leads to a precisely-targeted treatment choice”. While the field of modern nanoscience is relatively new, it seems that the German physician-chemist Samuel Hahnemann, who founded homeopathy more than 200 years ago, was “among the first to discover how to make nanoparticles from natural products and use them for medicinal purposes”. It is only now that we are beginning to more fully understand his profound contribution to medicine and human health.
This monument located in Washington DC to Samuel Hahnemann, the founder of homeopathy, was dedicated 57 years after his death in 1900, and is visible from the White House.
For a fuller and more indepth scientific explanation of how homeopathy might work, see an article by Iris Bell and Mary Koithan published in BioMed Central Complementary and Alternative Medicine called “A model for homeopathic remedy effects: low dose nanoparticles, allostatic cross-adaptation and time-dependent sensitization in a complex adaptive system”, which can be found here: http://www.biomedcentral.com/1472-6882/12/191 .
Another believer. They left urgent care, and were headed to the local Whole Foods Market to pick up some Arnica 200C. The 13 year-old boy had jammed his finger playing basketball yesterday. His finger was swollen, and a little bruised around the PIP joint, (the first joint in the finger). It was hard to flex his finger with the swelling. The xray showed no fracture. I gave him a couple Arnica tablets on the tongue, put on a splint, and explained to him and his father that if it is going to help, it should do so within the next half hour. He could also take some Ibuprofen if desired. 5 minutes later he pulls the splint off and can almost make a fist, and states that the finger doesn’t feel as sore now.
Wow. There’s nothing like the power of energetic medicine. It works whether you believe in it or not. Since you are not waiting for it to enter the bloodstream via the stomach, it can act remarkable fast, and with no side effects. Homeopathy works under the idea that “like cures like”. Arnica montana has the “feeling” or energy of: hit, bruised, swollen, and don’t touch me. So if you have the same feeling whether from being rear-ended in a car accident, falling off your bicycle, hitting your thumb accidently with a hammer, or hitting it with a basketball, etc. Arnica is a first-aid treatment that can actually help the body heal itself. It doesn’t just cover-up the pain. I recently recommended it to a marathon runner. After pounding the pavement for 26 miles the front of his thighs are especially sore. After his last marathon he took some Arnica. He called me later the same day to say how effective it was in reducing the soreness and speeding-up the healing. Now they it is part of their training kit.
Finally some modern scientists are taking homeopathy very seriously. Healers throughout history have known this basic principle of “like cures like”. Hippocrates (460 – 350B.C.), regarded as the “father of medicine,” who authored the Hippocratic oath, wrote, “By similar things a disease is produced and through the application of the like is cured.” Aristotle (384 – 322B.C.) knew the principle as well, and wrote, “Often the simile acts upon the simile.” Or, as Dr. Samuel Hahnemann said, “Like cures like,” (or traditionally in Latin, “Similia similibus curentur”).
Our next meeting in September 9th at Phoenix Natural Medicine and Detox Center: 301 W. Roosevelt Ave: Ste #2 at 6:30 pm. And, don’t forget to promote our conference!
See you soon!
I was recently at a conference in Seattle, and strolling up and down the hilly streets with old worn-out sneakers and by the time I returned to the hotel, I could barely walk. And, of all things – I did not bring any remedies with me! I usually do, of course, carry a first aid kit when travelling, however to my dismay – had left it on my kitchen table.
Well, I struggled through the next couple days and when I got home, mixed up a combination homeopathic remedy once I realized what I was actually dealing with – Plantar fasciitis! I also soaked my feet in hot water with Epsom salts and it started to heal fairly quickly. In fact, it was just about healed, when I stepped up to get in a van and I felt it RrrrrrIiiiiPpppp and tear deep in my heel – ouch!
Well, I started my combination remedy again and soaking my feet again – and again – it is almost all healed after 3 weeks because of the severity of the injury!
A question I have repeatedly heard – why are you soaking your feet in hot water and Epsom salts, shouldn’t you be using ice and an ice bottle to roll your foot on? Ahhh – the beauty of the principle “like cures like”. Now, surely if you need to use ice in an emergency, by all means please do! However, I want to get the blood flowing to the area thereby healing the area! When you restrict or suppress the natural tendency of your body to heal itself – healing takes longer!
Another question – what is in the remedy? One of the main remedies in the combination is Phytolacca which is specific for inflammation and pain where the tendons attach to the bone. My cousin who is a marathon runner asks for this remedy a couple times a year and says “its a miracle remedy”. She had been struggling with Plantar fasciitis for several months and at her wits end decided to take me up on my offer to send it to her. Within 2 weeks she was off and running again. She has used Arnica and other remedies as well in her running adventures.
At this point, with 2 bouts of this injury and a back injury in-between – well, you must also listen to the messages the universe is sending you! But, that’s another story!
In Mach-April 2013, Judy Schmitz, CCH and I travelled to Chintheche Malawi, Africa as volunteer homeopaths through Amma Resonance Healing Foundation (ARHF), a medical charity organization located in the Netherlands and headed by Dr. Harry van der Zee, MD and Peter Chappell, Hon FShom.
ARHF established the Chintheche clinic in Malawi in late 2011 and in March 2012 an invitation was sent out by Dr. van der Zee for homeopaths to go there and serve. We contacted him and also set up a phone call with him about this program since we were not sure about credential requirements. Requirements to go there was to have experience in any medical field. As a homeopath, a few years experience was sufficient to go. We were grateful to be able to go and use our homeopathic skills to help and serve others.
The work we did in Malawi was very rewarding in many aspects. It was thrilling to see people respond to this healing method and become well. It helped us to change how we were taking cases and how to use the tools we had at hand, and it also helped us tremendously in our PRACTICE, which we got lots of.
We worked with a few local people who were trained (and being trained by visiting homeopaths) who helped in translation. Because of translation much of the information was lost due to insufficient experience in homeopathic case taking. Many times, the translator would use his/her own ideas rather than translating exactly what the patient said. Other issues were that in some cases, the translator would not ask the questions we wanted asked. But with all these issues we were able to get enough symptoms in order to select a proper remedy.
Following are some of the chronic conditions that the patients who came to the clinic needed help with:
For these health issues we used PC (Peter Chappell) and regular homeopathic remedies. In some cases only PC remedies were given and other times PC and regular homeopathic remedies were placed in the same bottle due to cost and unavailability of supplies. The beauty was that people responded positively to these medicines. Some cases were quick (almost over night) and other cases it would take some time, but in almost all cases that we treated the patients became well, either with the PC remedy, the single homeopathic remedy, or a combination of both.
What are PC Remedies?
PC (Peter Chappell) remedies are developed by Peter Chappell. You can read and learn more about PC remedies here: http://www.arhf.nl/pc-technology. Peter Chappell & Harry van der Zee wrote the book, Homeopathy For Diseases. We read the entire book prior to our trip to become familiar with the PC remedies and how they were dispensed and its efficacy. The book contains many stories of healings of various chronic diseases such as HIV/AIDS, Malaria, TB, and others.
Our experiences with PC remedies
We observed many people who came in with the various chronic diseases mentioned above, that after taking the PC (and/or homeopathic remedies) they showed positive effects and a general well being. It enabled them to get their strength back and go to work and provide for themselves or their families.
How they are prescribed and frequency
PC remedies are given in ½ litter bottles. Patients need to bring their own bottles which was a problem for some because they could not afford an empty water bottle. In those cases the clinic provided a free bottle to those patients. In the bottle we would place a few drops of the master PC, plus some alcohol (as preservative) then fill the bottle with water.
The following graph shows the number of patient we saw as well as their demographics during our stay in Chintheche Malawi.
Judy took several thousand pictures while there and I took a few and some videos. We created short videos about various aspects of life in Malawi utilizing mostly the pictures. You can see the ones that have been created at http://activehomeopathy.com/malawi-africa.html. Also on this page you will learn a bit more about this trip.
Where to get more information
For those who are interested in volunteering in Africa or elsewhere you may check ARHF (http://www.arhf.nl ) page for more detail. ARHF recognizes that there are spiritual, mental, psychological, and physical dimensions to healing diseases and embraces a holistic perspective in these matters. They also provide more up to date information on various opportunities for using your skills as homeopaths (or any medical profession) to serve other people of other countries.
You also may write the author if you have questions or are interested in learning more about ARHF and Malawi.
Reza Sharifi, CCH
Research, volunteer, Malawi Africa, homeopathy, PC remedies, HIV/AIDS, TB, Malaria.
Man is always fighting something. Fighting the war on drugs, fighting the war on cancer, fighting illegals coming into the country. Fighting real wars, in many countries. Fighting depression. Fighting resistant bacteria causing infections. Fighting taxes. Fight Wall Street, fighting forest fires. Fighting, fighting, fighting.
Since you begin to resonate with what you think about.…perhaps we shouldn’t focus so much on fighting, but on healing. It’s a subtle shift, but an important one, and it brings a whole different energy into play.
Mother Teresa said
“I was once asked why I don’t participate in anti-war demonstrations. I said that I will never do that, but as soon as you have a pro-peace rally, I’ll be there.“
Forest fires clear the path for new growth, and return nutrients to the soil. Sort of wipes the slate clean, so the cycle starts over, but doesn’t end. When fighting a forest fire I suppose we can at least slow things down, and save homes. But stepping back and looking from a higher perspective taking ourselves out of the arena – maybe gives a different perspective.
The war on disease has given us antibiotics, but now there are super bugs that are resistant to some of the strongest drugs we have. This is a setup for a new epidemic of old diseases that we will have no allopathic drugs left to fight with. In fact, Eckhart Tolle brings up this very point in his book, A New Earth.
“Homeopathy and Chinese medicine are two examples of possible alternative approaches to disease that do not treat the illness as an enemy and therefore do not create new diseases.”
“War is a mind-set, and all action that comes out of such a mind-set will either strengthen the enemy, the perceived evil, or, if the war is won, will create a new enemy, a new evil equal to and often worse than the one that was defeated.”
I’m not saying don’t support that which is good, but try not to give as much attention to what is bad. Rather than curse at the darkness, light a candle, and see what is good.