Dr Rajat R Chattopadhyay MD(Hom.) N.I.H.
Reader & HOD Practice of Medicine
Mahesh Bhattacharyya Homoeopathic Medical College & Hospital. Govt. of West Bengal
Email : [email protected]
Indoor patient department is the only and real way to learn homoeopathy in its proper sense. Not only the students, all the ardent followers of this system will make themselves enriched and experienced one by devoting themselves in the observation of the patients of IPD of the Homoeopathic Hospital.
There is no need to go through monotonous reading of materia medica to memorize it (both in the student life and as well as in the practitioners’ life), if one can observe and note down the different patients in different diseased condition and with utmost sincerity and carefulness make note of the patient’s complaints with all its details as per Organon of Medicine. The different modalities, aetiologies, sensations, concomitants are to be impregnated in the mind in comparison with the written words of the books of materia medica. Actually in the early part of the students’ life the students have to go through the medicine (Practice of Medicine) in the materia medica, without knowing the ABCD of Practice of medicine.
So, the real interpretation cannot be done, cannot be understood by the students. It can only be interpreted after the thorough knowledge of Practice of medicine. So, the bed-side clinic is the best effective tool to know materia medica and to understand the essence of it.
Another subject Organon of Medicine – as the name of the subject indicates – it is the best weapon (better to say only weapon) to know the Medicine from homoeopathic approach. As you all know it is divided theory and practical part. The practical part is the larger one to deal with and for this part IPD is the only class room to teach. From case taking to drug proving, classification of disease, remedy reaction, different patient’s reaction to remedy, dose and potencies reaction, comparative efficiencies of different scales, advice regarding diet and regimen, miasmatic presentation etc. all are to be thought properly, discussed with reasoning and examples and can be realized as a clinician of homoeopathic system of medicine. It is the field where you can make your subject live – you can make your philosophy very close to the rationality and by these you can give birth of immense confidence among the students of new generation and to those homoeopaths who has no faith on their own philosophy.
It is the field can boast of you pride to be a homoeopath and you can often the door to general people and the man of science to observe the evidence which can be reproduced again and again after the admission of each patient. The many laws like Hering’s Law of Cure, Law of Similia, and Law of Minimum etc. of our philosophy can be studied through the patient of IPD. Only by this the subjects of Homoeopathy can attract the students. This should be the ideal teaching procedure. Medicinal, homoeopathic or disease aggravation can be read from book but not be interpreted, as it should be, without the taking help of the patients of IPD. Now-a-days a basic trend is going on i.e. to get an idiopathic pleasure to violate the very basics and fundamentals of homoeopathic philosophy among the students and among the few clinicians. It is only due to the faulty teaching and due to non-functioning of the IPD in a Homoeopathic Medical College and Hospital.
Another homoeopathic subject Repertory – the subject is very closely related to Organon – the case taking part, characteristic totality, the evaluation of symptoms, miasmatic totality, even after repertorization the consultation with materia medica part – all these can be demonstrated better with the help of IPD patients. Each and every rubric of repertory is important and it is to be remembered that the intensity of the symptoms or signs or manifestations should remain very high to convert it to one rubric. That intensity can be only judged during case taking and that can be judged also in the observation period which can be done in OPD/IPD patient but better can be known from IPD patients.
Apart from homoeopathic subjects, the necessity of IPD for other allied subject is very well known to all. It is very humiliating one to go to the hospitals of modern school to see the patients of IPD. There is no lack of number of patients in the suffering humanity for taking admission to the hospitals; it is lack of our devotion, dedication, vivacity, sincerity and it is our indolence and ignorance for which the IPD of homoeopathic hospitals are not functioning properly. In clinical practice we show our scope in better way but regarding patient’s admission to IPD we can only show our limitation.
IPD of a homoeopathic medical college should differ from other hospitals.
- Here case can be admitted for academic interest.
- Few incurable cases can also be admitted for academic interest.
- The procedure should be maintained properly.
- Case taking: Exhaustive case taking.
- Provisional diagnosis.
- Totality of symptoms.
- Evaluation of symptoms.
- Miasmatic evaluation.
- Reportorial characteristic totality.
- Repertorization (each according to the case).
- Consultation with materia medica.
- Remedy selection and correct potency and dose (each based on the patient’s condition)
NOTE: ONE SHOULD NOT BE ROUTINIST/MECHANICAL TO DO ALL THESE THINGS.
- We should know our scope and limitations. There are no fixed limitations labeled to any type of disease. It is the state of the diseased patient, the disease state, the susceptibility of the patient which are the prime importance to know the scope to that very case. Homoeopathic physician should in search of the indications in a diseased patient and if it is not found then in many instances pathological similimum can be prescribed.
- Behind each prescription, the reason of prescription – choosing of remedy, potency selection, administration of dose, repetition about all these – clarification should be noted, so that the follow up will be better and students will be benefited.
- All the modern biotechnologies should be availed. From CT scan, MRI to all the biochemical tests, ELISA tests etc. should be there. If fund not permit then arrangement should made with collaboration of other company/hospitals.
- One drug proving unit should be mandatory in the IPD department. The protocol should be maintained with strict guidance and supervision.
- In few surgical cases the help of a full time surgeon is needed. In the pre-operative and post-operative phases the administration of homoeopathic medicine should be thought of in experimental basis.
- Trauma centre may be one of the important part of the IPD.
- Pregnancy is very natural phenomena and in non-complicated cases generally it is done under qualified nurses. The provision of labour room should be kept in an IPD. For complicated cases referral system should be good to make quick arrangement for refer to other hospital.
- As a principle there should not be administration of any allopathic drug in a homoeopathic hospital. You should refer the patient if situation demands.
- There is no harm to use any food supplements, if patient require it.
- There is no harm to give moist O2 or IV fluids in an IPD, but the legal side be thought of.
- Here we can quote Richard Hughes:
- The RMOs and MOs should have sound knowledge of Practice of Medicine, Materia Medica, Surgery, Gynae & Obstratics and of Community Medicine (although uniform knowledge of all subjects are the basic one).
- Homoeopathic hospitals should not be in the …..In the IPD patient’s medicine sheet, more stress should be given on the subjective symptoms and on the keen observation of the observer (MOs, RMOs, Internees, Housestaffs, PGTs, Visiting Physicians). Only checking BP, watching pulse, auscultatory findings, taking temperature are not the only points to be noted by homoeopaths. It should be noted but emphasis should be given on the above mentioned factors.
- All the hospital concerned staff should arrange the workshops, symposiums, seminars, clinical meetings in a regular fashion to keep pace with the advancement of Medicine.
- The students, staffs (teaching and non-teaching), the member of peripheral OPD, the general people related to those staffs should make aware of the hospital and to encourage to increase the number of admission.
- There should not be any provision in the homoeopathic hospital to administer the drugs of modern school for any purpose. If surgery is required with the help of allopathy, the case should be referred to that hospital. There should not be any type of inferiority complex in the mind of the future homoeopaths. A homoeopaths should not be a surgeon or obstratician in the future (as Govt. will not allow to perform surgery without the help of modern medicine and it ought not be) – he should remain as homoeopath. He is master in his own domain.
- It is very difficult to pinpoint the exact scope and limitation and there is no distinct demarcation between scope and limitation. It varies on different matters.
- Hospital oriented camp, awareness programs, blood transfusion camp can be organized.
- National program can be organized in the IPD without giving any type of allopathic medication. Only preventive part can be demonstrated through various posters, dramas, banners etc.
- Referral system should be smooth between different homoeopathic and allopathic hospital and even between the homoeopathic hospitals. There should not be one way referral system.
- All the homoeopathic hospitals can be connected through computers (LAN).
GREATEST ADVANTAGE OF IPD:
- Silent observation of the patient time to time and during its acute phase will give the way to the path of similimum.
- Most of the modern students know Anatomy, Physiology, Pathology, Practice of Medicine, Organon of Medicine, Materia Medica etc. but they have no capability to tackle the case, to individualize the case. There is lack of co-ordination between homoeopathic subjects with allied subjects. IPD will show the right co-ordination between the allied subjects and homoeopathic subjects.
- Health Statistics.
- Evidence based Medicine.
- Research activities.
- To observe the benefit of our laws/principles/huge volumes of philosophical writings and to note down the live efficacy in daily practice.
- Data recording with DVD etc.
The author will be satisfied if few PG students will be inspired by these writings. The author feels he will be really awarded if few PG students at least follow the suggestions and in the ultimatum the profession will be benefited. In the fast life, the application of Homoeopathic principles (as it really means) to the diseased are becoming the tough job to perform and there is no other way except learning………., learning,……….., observing,…………, observing,……………, gathering experiences accordingly and to believe what you have noticed in your own eyes(and/or through the eyes of your devoted Teachers) in the Homoeopathic profession. My dear colleagues, there is no short cut or readymade way to become the master of the system. According to author, with sound knowledge of the allied subjects (sound knowledge of clinical medicine) only we have to follow the Hahnemann’s directions and after careful, sincere observations you will be experienced enough to perceive the beauty of the Homoeopathic System of Medicine.
Try to keep away from the directions which are not in our Philosophy (in the name of modernization) because according to author The Organon of Medicine is a very up-date books which is very much relevant to the present scenario and for the so called modern thinkers, Dr Hahnemann made enough provision to add, if in reality any thing is to be added, in the form of ‘etc’ in many pages of the book.
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