Advanced Homoeopathic practice guidelines

Dr V Krishnamurthy
The unmanageable patient who crosses his doctor
A patient is supposed to be subservient to his doctor, but suppose he challenges or argues with the doctor. He is crossing! Here two top-ranking remedies that should at once come to your mind are Chamomilla and Nux-vomica.

Rarely do we come across patients who are unmanageable.* (*Under the remedy Lycopodium in Boericke Mat. Med. we find the symptom ‘haughty and arrogant when sick’ which is a botheration for those around the patient, the family members and not for the doctor.  This is altogether a different matter.)

In respect of the so-called unmanageable patients you should not quarrel or argue with him, nor argue to say that his attitude is not justified. 

The word cross should come to your mind while dealing with such harsh and unmanageable patients.  Without keeping this word in mind mere repertorisation has led to failures.  Actual cured cases alone can illustrate this to avoid failures in these cases.  An allopath, in such cases, may simply write on the case sheet ‘patient unmanageable and not co-operating.’  But in homoeopathy “the high and only mission of the physician is to cure always…” (Section 1 of the Organon.)

Case 1:  A boy of twelve was having unbearable muscular pain in abdomen/hip extending to knee and it was intermittent.  A few months prior to this complaint, after diving in a swimming pool this pain started in a few hours.  Later it went off.  Now for the last few months the pain had been occurring intermittently but almost daily.

The mother pointed out to me one thing.  Seeing no improvement with various doctors of several systems of medicine, whenever a new doctor was proposed, the boy would tell that he would give only thirty days (one month) time.  If not cured within this time, he would stop that doctor.

This patient is ‘crossing’ the doctor.  No sane person would enter into argument or put conditions on the doctor.  Before learning the remedy for this case let us see next case.

Case 2:  Lady, forty-five, around menopause.  For a year she had been under my treatment for burnt hands.  I had been giving her herbal remedies.  Once I was asked to visit this patient.  She was in bed and her daughter told me that her mother was having excess bleeding from uterus.  When I entered the house, the patient asked the daughter (in this case the attendant of the patient) to get out of the room; after she left, the patient asked me in an irritable tone, “I have profuse and excess bleeding (menses.)  Is it because of the heavy herbal remedies (that you have given me) that caused this bleeding?”

I recalled that she never talked before in such a harsh tone.

A note on on the treatment of acute diseases.

In respect of repertorising in acute disease you need not pay much attention as to whether a symptom is ‘valuable’ or not.  You take only those symptoms which are changes from his otherwise formerly healthy state… Section — of Organon)

Final Repertory — IRRITABILITY: 12 remedies

I read the above twelve remedies listed under “HAEMORRHAGE FROM UTERUS” (Lilienthal.) In Chamomilla I found among other symptoms the word ‘irascibility.’  Again in the chapter  “MENSTRUATION AND ITS AILMENTS” under the remedy Chamomilla I found the following: “… great irritability and crossness all the time, though unnatural to her when well.”

Chamomilla-10M single dose arrested the excess bleeding and also she calmed down.  When I saw her a month later, lot of improvement in the burnt areas in her body.

When patient is irritable, cross and unmanageable, and there is not much of other valueable (uncommon, rare-strange-peculiar) symptom the two remedies which should come to our mind are Chamomilla and Nux-vom.

For case No.1 on page 1, we read both Chamomilla and Nux-v. in Lilienthal under colic and backache.  In the chapter ‘Colic’ under Chamomilla the words “Colic returns from time to time” agreed with the case under ‘Neuralgia’ under Chamomilla we find the word ‘crossiness’ (One important note: In Nux-vomica  the picture is slightly different.  Chamomilla patient shows crossness in words; Nux-v. patient in action.)

Long ago a patient went abroad to consult a popular homoeopath.  That doctor was about to leave his clinic after a day’s hectic practice.  When this patient entered and started telling his symptom, the doctor asked his assistant to give the patient Nux-vomica.  The patient, having come from abroad, took the doctor by his collar and said, “I have come such a long way not to get snap-shot prescribing.  I learnt that you take down the symptoms of patient, then work out the case.  Do it in my case also.”

The doctor sat down, took his symptoms, worked out the case and Nux-vomica came out.

In the practice of the author, a certain patient consulted for impotency.  I noted down on the Case Sheet (case sheet means plain white sheet on which you write the name of the patient his age, and date on the top.)

After he finished talking, I told him that I would give him herbal remedies for one month.  At that point he got up and said in a snappish manner, “I read in your books that you cure patients completely with one dose.  I want you to do that.”  To this I replied that it is possible in some cases, but his case requires herbal remedies too.  He took away the case sheet from my table and went away saying “In that case I don’t want your treatment.”

Sometimes you get the symptom after you have prescribed! I phoned up the doctor who referred that patient to me to give him Nux-vom.

The attitude of the abovesaid two Nux-vom. patients is aptly described by Boericke in his Mat. Medica in the preamble.  “Fiery, zealous temperament.” 

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