Homeopathic Training

OK, time for me to weigh in on this discussion. Though this may be slightly off topic on TSHM teachings, it does apply to our current state of treatments today.



Exactly what type of medical training did Samuel Hahnemann actually receive? He speaks of his dissatisfaction with his fellow medical doctors and their insistence on following practices that not only did not cure, but often was tortuous and frequently ended in termination of the patients’ life. I often wonder if things have really changed that much in today’s medicine, as I still see some forms of “treatment” that can only be described as archaic… burning, cutting, drug affects that only result in more disease and suffering with very bad horrific endings. One example is cancer………for all the sophisticated medical diagnostic testing, surgeries, chemo, and radiation et all……well you know the rest.



I humbly submit that patients who have visited my office have experienced both mental and physical improvements in their health and vitality with Homeopathic medicine that is gentle rapid and curative! When it is indicated, I have my patients go to their Mud’s who send then to their M.D. specialist for specific diagnostics. However, I find that at least 90% of the time, the patient has already undergone all the diagnostic and testing that is available to them through their allopathic doctors and have experienced no relief, and usually are in worse health from the experience. And not just physically, but mentally have experienced less than compassionate treatment with wrong diagnosis, wrong medications, long wait times – producing tremendous anxieties which proves to only worsen their health.



I am not suggesting that as a Homeopath I do not require more medical science and physical examination knowledge, I know it would only enhance what I am doing. I have studied for nine years, and expect I will be studying till I am no longer taking a breath. I will continue to gain experience and confidence in what Homeopathy offers. For me, I have found that when I have been able to focus full time on my practice, it has afforded me the most number of patients that have referred other patients to me…..as a result of the effectiveness of their Homeopathic treatment. In other words

“like attracts(cures) like”.



It sounds as if TSHM future graduates will be the beneficiaries of all or our combined learning’s – the good, the bad and the …….. We need to be very clear with future students on what it means to follow in the footsteps of the great masters. I for one have just begun and am loving it!

Carol Ann,

This is so well said. Thanks!
Nick and I were just babbling on the phone about this topic...seems to be a hot one! I think to expand on what you are getting at C.A, and correct me if I am wrong, but training as an MD in 1790s Europe was NOT the same as training in the 21st century...Hahnemann, LIppe etc were MDs but would be unrecognizable as such today...they would not have a clue about diagnostic testing today, I guarantee it...an MRI? and x-ray? More than one pulse??? Yikes...no way! So, instead of looking the masters of homeopathy as MDS and thinking we need to be just as up on our medical science training as they are...well, we are actually beyond them in medical science training, in some respects. The gold standard of medical science training isn't theirs these days....if you see what I mean. It is like comparing the training of naturopaths today with naturopaths 20/25 years ago...apples and oranges!

A lot of what we know, or need to know, we must experience for ourselves through our learning as clinicians...we cannot know without practicing. Listening to a thousand breath sounds can have value, for sure, but it is so very rare that a case would rest upon this precision. That said, it would be good to catch that rare moment, wouldn't it?

As for our patients, most of them have been through the wringer with doctors and naturopaths...they are so tuned in to what their bodies are doing, the tests they have had, the meds they are on by the time they see us...it is tuning in to themselves holistically that really puzzles them. People are quite willing to get tests results for us, in terms of covering diagnostic tests for collecting a totality. It is being able to read the test values that perhaps is a problem for some homeopaths.

I was remembering my nursing training way back in the early 80s and how I felt sick and sad every single day I had to be in that hospital, invading people's bodies and hearts. It takes its toll on patients and practitioners invading people like that so that begs the question: how much medical science do we actually need? This is really the specific question...thoughts?

Wonderful, wonderful discussion...thank you for so much engagement!
By the way, I am looking into some diagnositic courses right now and will keep you all posted about what i find out.

Andrea

Andrea wrote:training as an MD in 1790s Europe was NOT the same as
training in the 21st century...Hahnemann, Lippe etc were MD's but would
be unrecognizable as such today

Yes, I agree, there are stark differences in the training. The diagnostic methods of both eras are no doubt incomparable. Back in the 1800's, the art of diagnosis was subjective and a crapshoot. Today it's objective and more telling of the human body than Hahnemann and Lippe could've ever imagined. But there is one aspect of the training of the old homeopaths to consider that is requisite in becoming not only an excellent homeopath, but physician and scientist. Without it, homeopathy does not exist. Without it, we cannot become successful...induction.

MD's of today are far superior in the accuracy of their diagnoses because of technological advances, however, they are not taught and well-rounded in all the natural sciences as the MD's of old and this does have a bearing in the practice of medicine. The term natural science is used to distinguish those fields that use the scientific method to study nature. The practitioners of the 1800's had a wider and deeper breadth of knowledge of these natural sciences whereas MD's of today tend to be more focused solely on the health sciences while touching on the natural sciences. How did this translate in their practice?

I believe (i.e. I'm deducing) that the constant study of the natural sciences more greatly impressed upon the mind the ability to be inductive. We know that many of today's doctors believe they're being inductive when making claims of the plethora of randomized-double-blind clinical trials, i.e. their gold standard, in confirming and validating the efficacy of their medicines. The cruel irony is that the great majority of MD's today are no different than the allopaths of yesteryear as their medical practice is still based on deduction. Allopathy's clinical results, or lack of, will testify to the consequences of a deductive mindset. "Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them."

http://news.independent.co.uk/world/science_medical/story.jsp?story=471139

Why do they still cling to the deductive method of trying to fit reality into their theories, rather than having their theories fit reality? Why do they continue to ignore confirmed observations of nature?

Even when trained in the inductive method through the natural sciences, there is no guarantee that one will understand and correctly apply this requisite mindset, just as every commerce student who is taught and agrees with the principles of business ethics will not apply their knowledge in practice.

This lack of induction is evidenced by the many MD homeopaths of the 1800's who abandoned induction and deviated from the strict-inductive principles of homeopathy (and continue to do so today) simply because...they did not understand induction in the first place. To read a definition of induction in a dictionary or textbook does not, by default, impart or signal an understanding of it; or to put it another way, just because you read about an apple does not mean that you know what it tastes like.

It's very difficult to become inductive.

Studies in the natural sciences are based on classification, which is essentially a comparison of the similarities and differences of the subject/object being studied, or in other words, accurate and objective observations of nature. If we consider that back in the 1800's that MD's received far more training in all the natural sciences than today and were thusly exposed to the application of the scientific method, it's easy to see why homeopathy, being an inductive system of medicine, enjoyed its greatest successes.

The difficulty in adopting the inductive mind becomes even more apparent when we consider how few homeopaths understood it well enough to master homeopathy. There are very few masters. This lack of application of the inductive method is made even more glaringly apparent when we consider the inversely disproportionate number of homeopaths who are not clinically successful.

Homeopathy's decline in America coincided with the deviation from the inductive mind around 1845 with Dr. Julius Hempel, the teacher of materia medica at the Homeopathic Medical College of Pennsylvania, or "Dr. Aconite" to his students. He had been schooled in all the natural sciences and had been exposed to the application of the scientific method and probably did many lab experiments in medical school. He received all the training yet he still wandered from the inductive mind. Why? Why would he stray from the objectively confirmed, repeatable and reproducible principles of Hahnemann's homeopathy and prescribe 9 out of every 10 patients Aconite. Based on what? It was based on nothing more than his abandonment of the inductive mind and instead being guided by his own beliefs and opinions that were unconfirmed by reality (i.e. clinical results). (Hempel’s mistranslation and interpretations of Hahnemann’s texts, as well as his general teachings, also led to the confusion of homeopathy and he was also responsible for introducing into homeopathy a more reductionist and allopathic way of thinking.)

Today, many MD's claim to understand the scientific method even though in the great majority of diseases they are unable to objectively confirm the efficacy of their drug therapies beyond what is done in the research lab. The proof in their clinical pudding is unsavoury, again, perhaps because so many are unaware that they have lost their objectivity in disregarding this disconnect of results from lab to clinic.

Without being aware of their lack of objectivity and inductive mindset, it's difficult, nigh impossible, to observe the existence of the internal malady that is the primary cause for a great majority of diseases that are dynamic in nature, as Hahnemann did, and thus realize the folly of their treatment. The MD homeopaths of the 1800's lacked modern diagnostic technologies, but their education of the natural sciences exposed them to a method of scientific inquiry that is the fundamental basis in learning the skills to heal the sick according to natural laws, that is, to practice as a homeopath.

To be deductive is to be human. We have a tendency and need to explain away life according to our own experiences and opinions. There is also a tendency to displace our own experiences and universally extend and impose them onto others. When involved in discussions or arguments, we have a tendency to already be committed to an answer even before the question being asked is finished. To be governed by opinions is the right of any individual; but as a homeopath, our beliefs mean nothing if not substantiated. We are governed by pure observation. Our clinic is our lab and when our patients heals, we inductively confirm the Law of Similars yet again.

It's difficult to remove the deductive mind from our mental processes. In a recent poll we had on the importance of old Sx's, the possibility was there to either be led by deduction or induction. If we were to have said that we didn't believe that old Sx's of 20-years passing can be of such strong characteristic value so as to be one of the genius Sx's of the case, we must then ask ourselves, "On what am I basing my answer?"

If our answer is based on a firm belief, then we're being led by deduction. If our answer is based on extensive clinical experience to either confirm or refute this statement, then induction our guide. If we choose to suspend our judgment until a later time in which we can compare our observations with the statement, we remain inductive in our approach.

If old Sx's have accurately aided in the selection of the most homeopathic Rx on a consistent, reproducible and predictable basis over the span of 30 years of successful practice of a reliable, i.e. objective and inductive, prescriber, then it's difficult to disregard this clinical experience and we should take it as truth (unless later proven otherwise). For us to remain inductive in our approach to this information, we may refer to the mindset of Dr. Butler who was speaking with Dr. PP Wells on the subject of the efficacy of high potencies during an IHA transaction:

"I am frank to say, I don't know: I simply hold it in abeyance. I don't want to be understood as denying the possibility of such dynamic force, but I have no knowledge of it; nor do I wish to be understood as having no faith in the efficacy of high potencies, for the most powerful remedies that I have ever found to act curatively have been in the highest potencies, and I believe most thoroughly in them. I simply stand before this grand mystery of what it is that cures, in the attitude of one who would like to know." (IHA, 1886, What is the best method of selecting the remedy (P. P. Wells), p. 36)

My own journey to remove deductive tendencies has me seeing life from a completely different perspective. The more that I submit to the reality (and pain) that I truly don't know much, i.e. become aware that a lot of what I know is based upon opinion only, the more my cup is emptied. The more I realize that I don't know much, the more I'm able to know. The inductively-trained-natural-scientist homeopaths of yore were wise because they knew they didn't know and they were thus able to fill their cups with knowledge and success unparalleled by any generation of homeopaths or other system of therapeutics as a whole. Hahnemann brought medicine out of chaos through his keen intellect and honest insight as he realized the truth-bearing utility of the inductive method. Without it, homeopathy may never have been discovered, i.e. objectively observed as the language of nature. Caroll Dunham says, "It is a system claiming to be the only scientific system of medicine, inasmuch as it possess a "law of cure...and I will add that it is the only therapeusis which exists possessing the elements of a natural science; that it is the only science of therapeutics." (Dunham, Lectures on Materia Medica, part II, Principle of Homeopathy - Principle vs. Practical Knowledge)

Today's homeopathic training does not need an in depth study of all the natural sciences to nurture the inductive mind. The Taoists* never went to medical school in the 1800's yet they still understood the truth in purely observing nature. Our curriculum must incorporate the fundamental skill of developing the inductive mind.

*see article Induction and Taoism

Excellent discussion,

Glen[i][i]

Hi Glen,

I really appreciate your thoughtful comments, always! Thank you. I don't question the inductive vs deductive debate at all, and I don't think any of us could if we are attempting to continue a purer legacy than our homeopathic community does at large. So, your lovely post is cementing as a reminder, which is much needed, always.

I think the original debate, though, was about diagnostic techniques and what this really means. How much of it? What type? Tools? Props? Potions? Hours of body time required? Etc. The value of this is still up for debate, in the modern sense, as far as I am concerned. How far does one have to go to be "proficient"? How does a homeopath who considers themselves a diagnosician have the edge on someone who doesn't?
I have my own thought on some of these questions but would love further help with it...
Should we be going to medical school? ( love these emoticons, especially this one!)

Andrea

Hi, Andrea,

You are totally correct and I'm glad you brought this up. The broad topic of our discussion was our medical training which narrowed to diagnosing and here I veered a little. My response, though, was only part 1 of a 2 part response; part 2 deals specifically with diagnosis.

I actually started off with the intention of discussing diagnosis in my original response to this thread but as I was writing, my subject matter began to morph away from diagnostics as I realized that no amount of diagnostic ability will help us if our practices are not grounded in inductive thinking. And though we seem to know what it is and in spite of the posts ad nauseum on induction, why is it that there is still evidence of deductive thinking in our discussions? (Anyone else noticed this tendency?)

I've shared information with the group that was passed on by the clinical observations and experiences of some very reliable, and more importantly, succesful homeopaths. Much of this inductively confirmed info was new for many of us, i.e. we had no direct clinical experience with the information. Yet we still had replies that did disagreed with the information based on opinion. Here are some examples of our straying from induction:

E.g. It was reported that it was Andre's experience that a simillimum was prescribed if upon the 2nd dosing of a Rx, the reaction to the Rx yields an even greater improvement and for a longer duration of time. One of the replies to this verified, clinical observation was something to the effect of, "I can't believe that this always happens." We know that what one believes has nothing to do with reality.

E.g. Referring again to the poll about the usefulness of old Sx's, there was some email discussion about it as well as 3 poll responses:

Votes

Yes 1
No 2
Unsure 0

Most of us in the group have about 5 years of experience or less. So collectively we have some experience and we could argue that, yes, we have somewhat of a basis, though by no means extensive, to test and verify this information. But if we consider again that when this info was shared with the group, it was either new to many of us or not many of us were not considering the use of old Sx's in our case analyses because it was not actually modeled for us by many, if any, of our professors. So if this clinical point is not being applied in our practices, then we can't look to our clinical experience to validate its worth.

Were the two "No's" then guided by inductive principles? If yes, then that means this clinical point was applied and unconfirmed in their cases; if no, then it's conjecture. For those who did not have knowledge of this concept before the poll or that did have knowledge of it but did not actually test it out in their clinic, the right answer would've been, "Unsure." Again if, as I reason (deductively), that not many of us applied this concept clinically, then it stands to reason that no one selected the answer "Unsure". One person did answer, "Yes," and again, guided by what?

Are we truly inductive all the time? If not, it's a slippery slope. Our words need to be precise and we must therefore be aware of the angle from which our intellect is cutting...deductive or inductive.

I've realized how imprecise my own mind is, esp. when talking with Andre. I asked him during a lecture, "When you took that patient's case, you asked her how her pregnancy was 20 years ago. In another lecture you said that during physiological changes of life, like pregnancy, there is usually a a dynamic shift that indicates a different Rx. So how would this info have affected your prescription?" He looked at me and said, "I did not say "usually". You did." I said, "Oh," and was determined to listen to that portion of his lecture again because I was sure that he had said that. So that night I eagerly raced home thinking, "I gotcha now, Andre...you spoke about the subject in 2 places and I know you said it in at least one of those places." I found both places where he said it and to my disappointment and enlightenment, he, as he had told me, did not say, "usually". He said both times, there can be a shift. My imprecision continues to amaze me and Andre's reminders of it are appreciated. Over the course of 3 weekend lectures, I believe he said the refrain, "I did not say that, you did," 3 times. (*On a side note, I actually relayed this clinical info to our group and I apologize for giving you incorrect info.) My imprecision here is exactly the sort of misinformation that Dr. Aconite was spreading when he mistranslated Hahnemann's first works.

As these examples of imprecision and straying from induction are observable here in our own group, we can see how we, too, are susceptible to the exact same problems that led to the deviations from Hahnemann's homeopathy. We're not immune from this slippery slope that plagues all medical systems (allopathic, homeopathic or otherwise) and science, in general, from time immemorial because it's a natural human tendency. If being inductive is sine qua non to being a homeopath and we're not recognizing it, then I feel it's our duty to bring it to light, i.e. the more we discuss it, the more we can become aware of it. As induction is fundamental and antecedent to becoming a homeopath and it outranks diagnosing in terms of its importance to our training, it's the reason that it became part 1 of my response.

Again, it's very difficult to learn to be inductive. Andre's inductive minded has always impressed me and taught me greatly. In his lectures, I've often heard him reply, "I have no experience with it so I cannot tell you." Or, he may spiel off a response to a question from a student, but in the end if he truly doesn't know, he'll admit it, "blah, blah, blah...but I have no experience with it so I can't really say." When we went to lunch one day, I asked him in Joe's car as we were all talking casually, "When I think about the vital force and Chi, Andre, I believe that they're one in the same thing. What do you think?" His response, instead of giving me his experience with it, was..."What do you mean, Chi?" Always the man of science, he needed to establish clear parameters on what we were discussing first before he could respond. It's amazing how his mind never veers. Or if it does, he catches himself and admits it. It's this inductive mindset that's allowed him to excel to the successes he has; there are plenty of other brilliant people out there but they don't have the success because they practice what is unconfirmed and unobservable in reality. It's allowed him to pick up on the phenomenon of dissimilar diseases that Hahnemann mentions but is not really found much elsewhere in either the old or new literature or in the teachings of many schools. It's also allowed him to critically view Hahnemann's work in an objective manner to be able to point and sift out his mistakes. There's many other brilliant minds out there who've dogmatically, i.e. without critical questioning, taken every single word of what Hahnemann's said as truth, including his mistakes, and misapplied them accordingly, like for example, "miasmatic" prescribing. With our modern knowledge of science, it's been proved that the majority of diseases did not result from the droppings of the scabies mite that caused the itch, or psoric taint, yet people still prescribe according to this refuted theory of Hahnemann. Why do they ignore the science and live in a delusion?

If we continue to stay aware of our minds, to be objective and detached as we are when with a patient by not believing what they say and only doing so after verifying everything they say with, "What do you mean...e.g. < at night?"...if we can continue to do this outside of our case taking interviews and be objective and detached from our own thoughts, opinions and beliefs, then we will not stray, nay, I say, we will grow out our inductive minds. Overall, I think we are very much aligned with and doing a good job at understanding induction, after all, we're here together and having success.

So part 2 is diagnosis and I'll be sending my post soon. (I've searched the word "diagnosis" and its synonyms in EH and added a couple of extra synonyms to the EH search tool, specifically, "diagnosticate," and "diagnostician" and it was cited over 9 000 times. I've already compiled a bit of info from the hits and I'm still wading through the rest so that I can learn what the old daddy's thought about the subject.)

Till then, let's keep this great discussion going and let's keep sharing our thoughts, everyone! How do you guys feel about this? Agree , disagree or...unsure till confirmed later?

Cheers,

Glen

Hi Glen,

Thanks again...my original question stands (see email above yours)...still waiting on that one

Just one thought on the above in response to this comment, "why is it that there is still evidence of deductive thinking in our discussions? (Anyone else noticed this tendency?)``

Not to be argumentative but to give you my answer on that one:
a) we are humans having human exchange and we aren`t always talking to each other like we are taking a case, or analysing a case...thank god!

b) all that we discuss here on the forum in the inductive realm, i.e. cases, or case taking, is hearsay...none of us observed the cases being taken, and if we did, and we convey it here, it is hearsay...so that is not inductive right from the start. So, our language will reflect what with `I believe`, or `perhaps`, or `I suppose`` etc...I honestly cannot convey everything that goes on in the time I spent with my patient accurately. I write just fine but there is so much else...so that might address some of what I feel when you question our inadequacy to think or speak inductively. If you read some of the old case conferences, where cases are discussed second and third hand, inductive discussion is attempted but because only the case taker can be truly inductive in that exchange, well, then you encounter the same language we are using.

I love talking about homeopathy but I am human about it too...with humility and coming from a place of knowing how very inadequate I am...and being just fine with that. We are all very different people and I really love that about us, and at the school. I will never be a clone of Andre but I will appreciate all the learning he can give me as with Joe etc. That is what the teacher-student relationship is about, yes...

Hi, Andrea,

No worries...your response isn't taken as argumentative; on the contrary, I'm glad you're continuing the discussion...that's what I was hoping for.

To respond to your points...if the impression that I gave was to point out inadequacies, then I apologize. That was not my intention. My intention was to remind us that we need to be careful with our words and of our natural tendency to be deductive. (Remember, I included my own repeated gaffes in the examples.)

"...all that we discuss here on the forum in the inductive realm, i.e. cases, or case taking, is hearsay...none of us observed the cases being taken, and if we did, and we convey it here, it is hearsay."

I couldn't agree with you more.

"...we are humans having human exchange and we aren`t always talking to each other like we are taking a case, or analysing a case."

As humans having human exhanges, we can speak freely and subjectively and say, "I agree, disagree, believe, perhaps, suppose..." within our forum.

But as Hahnemannian homeopaths, in a pure homeopathic forum (i.e. pure = free from speculation, personal bias), when we do hear the observations/hearsay from reliable clinicians, isn't it our duty to follow up these subjective statements (e.g. I agree, disagree, believe...) with an inductive frame, like that of Dr. Butler's?:

"I am frank to say, I don't know: I simply hold it in abeyance. I don't want to be understood as denying the possibility [of it]...nor do I wish to be understood as having no faith in [it]...I simply stand...in the attitude of one who would like to know."

So nothing wrong in expressing our opinions and feelings on a matter, as long as we keep it real, that's all. (As I knew it was sacrilege to say to a group of Hahnemannians, "We're susceptible to being imprecise and deductive," you can see that I tried to compensate for it and lighten my post with an over-enthusiastic use of our beloved emoticons.)

Please chime in, folks...how do others on this?

PS. Andrea, I wouldn't want you to be a clone of Andre either...you'd look funny with curly, black hair (though your names are quite similar, a?!)

Hi Glen,

I hear you...this is great! I completely agree and I am just being semantic. I would love to observe more cases, always, and not just depend on hearsay but yes, this is the place to do that. I first assume that we here are all being as true to inductive science as possible rather than deductive first...kind of like being innocent until proven guilty.

Can I ask you the question again, the forum really...what kind of diagnostic training is needed now? To what extent? I understand the masters had the diagnostic training of their day but today, it is out of control. How much is too much? And how little is too little?
What kind of medical science training would, for example, AS find appropriate to being a true homeopath and not just a technician of homeopathy?

Remember Andre's past training and today's Naturopaths are qualified to practice NOTHING in Ontario if we go by the regulation standards of each indivisual modality. They do not have as much homeopathic training as a TSHM Homeopath. They do not have as much herbal training as a master herbalist. They do not have as much nutrition training as a Nutritionist or Holistic Nutritionist. They do not have as much training in TCM as a TCM specialist. They do not have as much training as a chiropractor or osteopath regarding spinal manipulation.

So again. What standard is Andre asking for? A few more hundred hours of pathology and DD? O.K. Well then Naturopaths should be called herbal technicians, homeopathic technicians, nutrition technicians, spinal manipulation technicians etc. I love Andre's homeopathic mind but this technician stuff is nonsense!!

Naturopaths have been riding the freedom train for a long time and you would think once all the regulation standards are in place in Ontario, the thinking politician and thinking public would figure out that Naturopaths don't meet the qualifications to practice any one modality in Ontario.

Bravo, Jack! This is exactly what I have been trying to get at with more verbosity (as always!). You nailed it!

I am concerned that regulation will do no such thing, however, in terms of recognizing the lack of qualifications of naturopaths in the modalities that they copy/hijack. They are much better organzed than we are, and than we may ever be. Doesn't mean we don't have a choice about that though, eh? Naturopaths are becoming more like family physicians every day.

And I am still waiting on the diagnostic training specifics from anyone who believes that we are not adequate homeopaths without it.

Andrea

My specifics:

Ability to order lab tests and be proficient in interpreting them.
Ability to Dx common illnesses. i.e., just like a family physician won't diagnose Parkinson's or Alzheimers, or Retinitis Pigmentosa we shouldn't either. Those Dx require much diagnostic testing and specialty. However, bladder infections, strep throat, tonsillitis, run of the mill ailments ... why not?
More proficiency w/ physical examination

Hey, All,

Jack, great points about how naturopaths are "a jack-of-different-complementary-modalities-and-master-of-none that go on to specialize one or more modalities that they find most beneficial." Andre should be calling them "technicians," too, as you say. I've heard him refer to us as "lay homeopaths" but not "homeopathic technicians," so I'm not sure what he means but I imagine for him it's one in the same thing. Taking a look at the definition of "physician" may help.

Physician is rooted in the Greek, phussis, which means "nature" and a physician is one who knows/studies nature.

One-who-knows-nature is able to observe the language of nature, in the healthy, in the sick, i.e. understand all phenomenological processes that are going on: anatomical, physiological, psychological, environmental, cosmic (e.g. effects of moon) and whatever other influences affects organisms. So in order to know nature, one should be able to give a diagnosis (= dia - through, gnosis - knowledge)
Once the diagnosis is made, a therapeutic system must then be applied in order to remove the disease and cure. So a physician needs two fundamental skills:

1. To be able to observe the language of nature, or diagnose.
2. Apply a law of healing to bring the sick to cure.

Perhaps "technicians" aren't meeting up to this definition. We could, though, consider MD's as technicians as they also don't measure up well to this definition of knowledge of nature + apply a law of healing. First, as precise as their diagnostic technology is in observing the language of nature, it sometimes suffers from human error (iatrogenicity). Second, allopathic medicines are generally ineffective in treating the great majority of chronic and acute disease. This leaves them well shy of and substandard to the definition of physician.

How about us "homeopathic technicians" or lay homeopaths? I believe we fall into the same category. Though we do fulfill the latter requirement of being able to remove disease and bringing about cure, our lack of proficiency in diagnosis leaves us shy of the fundamental requirements of being a physician. So here we perhaps have Andre's reasons for not giving lay homeopaths and equal standing as those of other regulated health professionals?

Regardless, here's why I believe diagnosis is important to us:

1. Allows us to diagnose whether the case before us is a case for homeopathy or not, i.e. dynamic or not.
2. If it is a case for homeopathy, it enables us to remove any and all obstacles that may impede cure.
3. Allows us to distinguish common Sx's of a disease from characteristic Sx's thereby helping in the selection of the most homeopathic Rx.
4. Allows us to give a prognosis.
5. During case management, it allows us to evaluate posology (= potency and frequency of dose), when to change prescription, when to use a complimentary Tx or refer out to other homeopaths/therapists/physicians.


Some of the things mentioned about diagnosis by us:

...just like a family physician won't diagnose Parkinson's or Alzheimers, or Retinitis Pigmentosa we shouldn't either. Those Dx require much diagnostic testing and specialty.

Wouldn't we benefit, though, from having the ability to order diagnostic tests and then be able to interpret the results to give a diagnosis?

If we indiscriminately accept and become dependent upon the diagnosis given to us by MD's or "specialists" without critically diagnosing for ourselves, we risk accepting misdiagnoses that may relegate the characteristic value of a leading Sx to that of a common Sx of the misdiagnosis. End result, we may be unable to bring the patient to cure.

...at least 90% of the time, the patient has already undergone all the diagnostic and testing that is available to them through their allopathic doctors.

Yes, this is true and to our benefit that many come pre-diagnosed. But why are we relying on the diagnosis of other physicians if we are supposed to be physicians ourselves? Isn't that like opening up your own mechanic shop and then asking a client to go down to the Canadian Tire first to get a diagnostic test and then bring you back the results?

Good diagnostic skills would also allow us to identify any patients sitting in front of us that may have a medical emergency.

When it is indicated, I have my patients go to their Mud’s who send then to their M.D. specialist for specific diagnostics.

Again, with our limited diagnostic training isn't "when it is indicated" relative to the individual diagnostic skill of each homeopath? Considering that MD's and specialists, with more extensive training and diagnostic technology, already misdiagnose with regularity and frequency "when [something] is indicated," it should make more poignant the fact how difficult it to become a very good diagnostician and to the fact that our skills require greater training.

I think we can go a long way with the training that we've received but we have to do a lot more learning on our own. If, however, our diagnostic training was more extensive, it would give us a greater chance at being successful. The public and the medical establishment would perhaps also give a little more credit to our profession.

To an MD, objective signs and subjective Sx's make up their diagnosis; for a homeopathic physician, all deviations from an organism's normal state of health make up the diagnosis including the objective signs and subjective Sx's used by MD's, as well as, the sensations, feelings, intensity, frequency, duration, onset, etiology, modifying factors (modalities) and concomitants of all altered feelings and functions. It seems reasonable and clear that developing diagnostic expertise goes hand-in-hand with understanding how to apply the Law of Similars. The old masters did a lot more with the lost art of diagnosing a pulse than modern labs do now for treating fevers, but both are still valuable in seeking the totality of Sx's.

This is a response from Joe Kellerstein regarding diagnosis and homepathic training.

The ability to diagnose to a reasonable degree is indispensible;

1.We must have reason to suspect issues which require emergency medical treatment or incipient medical crisis.A good professional knows when to send the patient elsewhere.
2.Without diagnosis we blind ourselves to the use of many rubrics in the repertory.
3.Without being able to categorize symptoms using diagnostic categories how do we distinguish common from peculiar.How do we distinguish different stages of disease to help identify the various remedies which might apply(see for eg Nash and the different stages of pneumonia.Raue and various stages of other pathologies).What about recognizing dissimilar diseases(multiple diagnoses).This can be especially so in various neurological or psychiatric illnesses(ie need to dd peculiar)

4.Without diagnosis how do we prognosticate?

5.We also need to know when a diagnosis is indeterminate.

6.The need to diagnose however should not intimidate us or make head for another profession.We need to fix our own education in many ways.This is one.As a group we have the power to create whatever educational tools we need.There several MD's from other countries who are very dedicated to Hahnemannian studies here and would love to teach in this capacity.

I have heard Joe say this too but he doesn't do a full physical examination to get at the diagnosis, nor does he diagnose in anything remotely like an allopath. We have talked about this and he doesn't fully agree with Andre on this.

So, Glen, you are answering in quotations, and with vague premise. Since you think we are lacking in the ability to diagnose, what do you think it is specifically that we are lacking? An x-ray machine in the basement? Or better recognition of presenting physical pathology so that we can send someone off for CBCs and MRI's? I am being painfully specific in my need to know. And obviously asking over and over again to try to hone in on what we do with this...

I understand the generalities but what about the specifics?

Andrea

Hey All,

I just caught an episode of the show Diagnosis X on TLC.

Here's the description of the show.

http://tlc.discovery.com/tv/diagnosis-x/diagnosis-x.html

At first I was rolling my eyes b/c the real life docs are playing themselves in the re-creation and it looked like a cross between Entertainment Tonight (docs being fascinating celebs) and Gray's Anatomy (good looking docs showing how important they are).

But as I watched it was very interesting see what these docs went through with regard to the process of trying to diagnose the illness of the ER patients. The show is shot so that the viewer is kept in the dark throughout the episode and must try and figure out what's happening just as in a murder mystery.

I found myself conjuring up diagnosis' after each test and screen came back. The docs were interpreting them. To my credit I was right on the ball with the docs and every time they were about to say what they thought was going on with the patient, I was playing right along and keeping up with them all the way. I know a lot more than I give myself credit for.

As well, it was fascinating to see how much these docs rely on modern diagnostic tests and almost comlpletely ignore simple examination techniques like questioning the patient.

I thought, hey, this would be fun to watch an episode of the show, use all of the diagnostic and gross pathology symptoms of the patient and add some fictional homeopathic generals (thirst, body temp, fever, temperment, SRPs etc.) and try to come up with the allopathic DX and the most indicated remedy.

One patient ended being Dx with endocarditis and had surgery to replace a valve and the other had arteritis of the kidney blood vessels.

I was bang on with the kidney patient but was unaware that patients with endocarditis can present with bruising of peculiar areas like the palms of the hands.

Either way, it took the docs days to figure out a Dx and sure enough the remedies ended up being surgery in one case and prednisone in the other. Now they don't follow up with the prednisone case except to show the patient now eating again a few days later and thanking the doc for her work.

Of course we know that probably that person will go on the have repeated episodes of arteritis or as with one of my patients, he was given high doses of prednisone for arteritis, had horrible side effects and once the arteritis was suppressed, several months later he developed severe Sjogren's.

The three days that went by without a Dx was an opportune time for the on-staff homeopaths to take the case possibly return the patient to health. In all seriousness, this is where homeopathy would shine. Treatment even without a diagnosis.

Here's an example of the show and how its filmed.

https://www.youtube.com/watch?v=gyEdGUCYsVo

So again, as Andrea has been asking... how much training do we need?

Cheers
Jack

"vague premise?"

Well done, Jack. What I wonder, though, is, do you think our graduates would be able to have the same success rate that you had? And do you think they should be able to achieve the same success rate?

I have no idea Glen. Like I said, I know a lot more than I think when put in the situation.

In this case (and its only one episode) I was able to solve one case but the other regarding endocarditis, never registered on my radar b/c I had no idea about the bruising. In all fairness, it took the MD 3 days to figure it out after ruling out other dxs. How many cases on endo have I seen in my small little practice ... zero. How many cases of arteritis, two.

I had the same training as other TSHM grads and in the last 5 years I have seen quite a few different illnesses so I have more knowledge to reflect back on.

Maybe I should watch a few other episodes and see if I can follow along.

I just thought that kind of exercise would be good for us. It keeps us sharp.

Wow, this is so cool! I will check out the link, Jack.
I have been watching medical shows since i was a little kid...in the 60s we had Marcus Welby and Medical Centre. Then it moved on to all the ones in the 70s, including MASH...I never missed them! This one sounds like House in reality format...leaving the diagnosis til the end...testing yourself to see what you know.

You are so right about these gaps in time being the opportune times for homeopaths to do their job. In an ideal world, eh?

And thanks too Jack, for reiterating that question I keep asking over and over and over again....how much training do we truly need?

Happy Tuesday!
Andrea

Vague premise Glen = without specifics.

I just have to say that not all graduates of medical schools are equal in excellence either, or nursing school, or chiropractic school or political science etc. So it isn't realistic to expect that of a homeopathy school, that all graduates are going to be exceptional homeopaths. I say to people here, we are all given the same tools...it is how you use them that matters.

Andrea

re: "without specifics"

If we know the reasons why diagnosis is important, then we have the basis around which to specify and create our education.

"we are all given the same tools"

I'm not sure what you mean by this...that we're given the same tools as other professionals? Regardless of that answer, shouldn't we be basing our education purely on what is relevant to becoming an excellent homeopath without comparing ourselves to other professions? Shouldn't we be taking charge of our educations to say, here is why diagnosis is important and here's what we learn to make that a reality?

We are very lucky to be living in a place where our patients come pre-diagnosed. If our graduates were to immediately move to a third world country or the U.S. where many patients can't afford medical insurance or to a rural area where people don't have immediate access to a diagnostic facility, then how prepared would we be? I don't believe we'd be nearly as successful as the diagnostic label is so important for distinguishing the common Sx's from peculiar.

If any of us moved to a 3rd world country without internet access, I think it would also be more challenging for us to have success. Of course we'd have our fair share of successes depending upon our own diagnostic capabilities, but the question is shouldn't we, upon graduating, all come out with a base set of diagnostic skills that would give us the opportunity to practice anywhere in the world and not just where we have the benefit of pre-diagnosed patients?

I am sorry, Glen. You misunderstood me. Everyone who graduates from TSHM is given the same tools as every other graduate from TSHM. I hope that is clearer and I will forgive the rest of your comments

You still have yet to answer the question about specifics....I love reading your babbling but I still have to keep asking for an answer. What, specifically, would you want ot see on a homeopathy curriculum for diagnosis in the allopathic sense? Blood testing? Interpreting lab tests (we already have this so I don't feel this is lacking)? What would make you, Glen, feel comfortable in the situations you are describing?

We have students in Africa, South America, Central Amercia, Asia (supposed 3rd world countries) and they all have internet access even if just through a neighbour, a library or other community project etc. This doesn't seem to be an issue, commonly.

And practicing all over the world often has nothing at all to do with our diagnostic skills. I study this and need to know this in my job, the laws of practice globally. It is being a homeopath AT ALL that is the issue, not the content of our training or abilities. MDs are still the favoured practitioners of homeopathy in most countries, including Europe (a so-called first world community).

Hi Andrea,

Just as a clarification, in my studies at TSHM we did not cover the interpretation of lab tests in any great detail. They were mentioned at times alongside some patholgy with Roger Carr and a smattering during our minimal physical examination studies. I believe the year I did Physical Examination, we had the least amount of education. I studied lab test interpretation on my own using the internet and through experience with my patients.

Thanks

Hi guys,

Well, that is different now...I am so glad to know this. I have handout of normal values of common lab tests, if anyone wants me to scan and email it to them.
If you receive lab results from physicians on behalf of your patients, the normal values are usually referenced next to the result for the patient.
The labs do this for the physicians because "normal values" vary from lab to lab, hospital to hospital, and from year to year.

Andrea

Thanks Andrea. I am aware of and comfortable with normal value ranges and such. Interpreting what each abnormality means is something different though.

For example do the handouts have info like an increase in TSH can indicate hypothyroidism while a descrease in TSH can indicate hyperthyroid etc.?

If so, I'd love to have copies of DD using lab values.

Thanks!