homeopathic case management
TRANSCRIPT
Hahnemannian case managementHahnemannian case management
based on Luc De Schepper’s based on Luc De Schepper’s ‘Achieving and maintaining the similimum’‘Achieving and maintaining the similimum’
Interactive PowerPoint PresentationInteractive PowerPoint Presentation
Just ‘click’ the situation your patient presents!Just ‘click’ the situation your patient presents!
Marc Van Wijk - 2006Marc Van Wijk - 2006STARTSTARTABOUT…ABOUT…
Case management
Administration of remedy
Immediate improvement on all planes
Similar agg after every dose, no matterwhich potency
Prolonged similar agg followed by slowcontinues decline
New Sx appearLong lasting agg. with eventual but slowprogress to improvement
Sx following Hering’s Set of ObservationsQuick, short agg. Followed by improvementand increase of strength
Long-term improvement (weeks-months)then sudden similar agg
Initial improvement on all planes,then return of unaltered sx
Immediate improvement on all planesbut of short duration followed by long similar
aggNo reaction on any plane
Isolated physical improvement without general relief nor increase in well-being or
in M/E outlook
Stop programStop program
Case management
Immediate improvement on all planes
Stop taking medicine
Case management
No reaction on any plane
Increase potency
All possibilities after administration of remedy No reaction
Case management
Still no reaction
Obstructions to the cure Psychological block
New acute event Hyposensitive patient
Miasmatic block Wrong remedy?
Case management
Obstructions to the cureObstructions to the cure
• LifestyleLifestyle• DietDiet• Bad habits that cancel the remedyBad habits that cancel the remedy• How was remedy taken?How was remedy taken?• ……
Case management
New acute event
Acute intercurrent
All possibilities after administration of remedy
Case management
Miasmatic block
Nosode
Striking responseBrings forth a
clearly indicatedremedy
Continue nosodewhile patient is
improving
If no response after3 weeks, give
previous remedy ifstill indicated
Case management
Psychological blockPsychological block
• A remedy can cure a kid, not educate it…A remedy can cure a kid, not educate it…• Attitude; denial of ones own behavior…Attitude; denial of ones own behavior…• Patient isn’t introspective, honest…Patient isn’t introspective, honest…• Not willing to change…Not willing to change…• ......
Case management
Hyposensitive patient
Adjust potency/dose
Case management
Initial improvement on all planes, then return of unaltered
symptoms
Potency not strong enough Judge intensity and timing of returning Sx
Lifestyle ? Miasmatic block
Severe pathology
Case management
Potency not strong enoughPotency not strong enough
• Increase potency and/orIncrease potency and/or• Increase frequency and/orIncrease frequency and/or• Increase succussionsIncrease succussions
Case management
Severe pathology
Internal damage/pathology so severethat cure is impossible
Work from C6 up to LM
Case management
LifestyleLifestyle• Perserving harmful lifestylePerserving harmful lifestyle• Did the patient take allopatic drugs or other healing Did the patient take allopatic drugs or other healing
modalities?modalities?• When the body is beginning to cure, using the When the body is beginning to cure, using the
positive support of the homeopathic remedy, it positive support of the homeopathic remedy, it needs time to adjust to the renewed sense of needs time to adjust to the renewed sense of wellness!wellness!Don’t let the patients abuse their body’s again!Don’t let the patients abuse their body’s again!
Case management
Intensity and timing of returning SxIntensity and timing of returning Sx
• Patient calls after initial improvement…Patient calls after initial improvement…• Problems in work or relationship are Problems in work or relationship are
tugging the progress…tugging the progress…• Returning Sx more severe? Incurable Returning Sx more severe? Incurable
case…?case…?
Case management
Quick, short agg. followed by improvementQuick, short agg. followed by improvementand increase of strengthand increase of strength
• Selected potency and/or dose were a little too Selected potency and/or dose were a little too high…high…
• Adjust by:Adjust by:– decreasing number of succussionsdecreasing number of succussions– decrease amount of given remedydecrease amount of given remedy– decrease frequency of dosedecrease frequency of dose– increase amount of water used to dilute increase amount of water used to dilute
remedyremedy– increase volume of remedy solution bottleincrease volume of remedy solution bottle
Case management
Long lasting agg. with eventual but
slowprogress to improvement
Potency too high Extensive pathology
Unrecognisedone-sideddisease
Case management
• Potency and/or dose too high…Potency and/or dose too high…• Hypersensitive patient…Hypersensitive patient…• Adjust by:Adjust by:
– decreasing number of succussionsdecreasing number of succussions– decrease amount of given remedydecrease amount of given remedy– decrease frequency of dosedecrease frequency of dose– increase amount of water used to dilute increase amount of water used to dilute
remedyremedy– increase volume of remedy solution bottleincrease volume of remedy solution bottle
Case management
Extensive pathologyExtensive pathology
• Borderline of incurability…?Borderline of incurability…?• Present extensive pathology already Present extensive pathology already
known? If not, refer for further tests…known? If not, refer for further tests…• Always use very low potencies…:Always use very low potencies…:
– Start with 6CStart with 6C– Adjust dose/potency/succussions…Adjust dose/potency/succussions…– After 6C, ascend to 12C, to 18C, to 24C, to After 6C, ascend to 12C, to 18C, to 24C, to
30C; from then, switch to LM30C; from then, switch to LM
Case management
Unrecognized one-sided diseaseUnrecognized one-sided disease
• Advanced pathology becomes active layerAdvanced pathology becomes active layer• Use von Boenninghausen!Use von Boenninghausen!• Don’t use deep-working, miasmatically Don’t use deep-working, miasmatically
chosen remedies!chosen remedies!
Case management
Prolonged similar agg followed by slowcontinues decline
Unrecognizedhypersensitive
patientIncurable case
Case management
Unrecognized hypersensitive patientUnrecognized hypersensitive patient
• Potency and/or dose far too highPotency and/or dose far too high• Cancel remedy with camphor or Cancel remedy with camphor or
corresponding antidote; if it was the corresponding antidote; if it was the similimum, give same remedy in lower similimum, give same remedy in lower potency by 5th edition method.potency by 5th edition method.
• Start again with much lower potency/doseStart again with much lower potency/dose• Olfaction can be used (6C) or micro-Olfaction can be used (6C) or micro-
solution.solution.
Case management
Incurable caseIncurable case
• VF has no strength left to reactVF has no strength left to react• Advanced and terminal pathology…?Advanced and terminal pathology…?• Only palliation is possible:Only palliation is possible:
– Acute ‘zig-zag’ prescribing with 5th edition Acute ‘zig-zag’ prescribing with 5th edition methodmethod
– Use von BoenninghausenUse von Boenninghausen– By preference, use vegetable remediesBy preference, use vegetable remedies
Case management
Similar agg after every dose,
no matterwhich potency
Hypersensitivepatient
‘Hysterical’patient
Case management
‘‘Hysterical’ patientsHysterical’ patients
• A case of unmet emotional needs…?A case of unmet emotional needs…?• Need of attention…? Ask other family Need of attention…? Ask other family
members.members.• Fixed delusions…?Fixed delusions…?• Give placebo until similimum is indicated Give placebo until similimum is indicated
or until real emotional picture shows…or until real emotional picture shows…
Case management
Isolated physical improvement without general relief nor increase
in well-being orin M/E outlook
Distant simile and/orSuppressed symptom
Lifestyle andrelated
treatments
Miasmatic block Extensive pathology
Case management
Distant simile and/or suppressed symptomDistant simile and/or suppressed symptom
• Similimum not found…Similimum not found…• Possibly the external manifestation of Possibly the external manifestation of
disease has been suppresseddisease has been suppressed• Acted as placebo…?Acted as placebo…?• Retake the caseRetake the case
Case management
Immediate improvement on all planesbut of short duration followed by
long similar agg
Distant simile Miasmatic block
Cancellation of remedy Limit of curability
Deferred similar agg
Case management
• It is possible the patient cancels the It is possible the patient cancels the remedy …:remedy …:– keeps on doing sport while being treated keeps on doing sport while being treated
for sport injury…for sport injury…– takes ‘antidoting’ food or drinks during takes ‘antidoting’ food or drinks during
treatment…treatment…
Case management
Rarely, some remedies have a deferred Rarely, some remedies have a deferred aggravation…aggravation…Don’t change your prescription too hastily!Don’t change your prescription too hastily!
Case management
Long-term improvement (weeks-months)Long-term improvement (weeks-months)then sudden similar aggthen sudden similar agg
• No more repetition of the remedy!No more repetition of the remedy!– VF needs no further stimulus of remedyVF needs no further stimulus of remedy– Repeating would create a remedy disease!Repeating would create a remedy disease!
Case management
Sx following Hering’s Set of observationsSx following Hering’s Set of observations
• Healing takes place:Healing takes place:– from within outfrom within out– from more important organs to lesser importantfrom more important organs to lesser important– from above to belowfrom above to below– in reverse order of appearance (reversible, presenting in reverse order of appearance (reversible, presenting
and suppressed sx)… Make a timeline during and suppressed sx)… Make a timeline during anamnesis!anamnesis!
• Duration of old, recurring sx depends on nature of Duration of old, recurring sx depends on nature of disease, VF, potency, nature of remedy.disease, VF, potency, nature of remedy.
Case management
New symptoms appear
Wrong prescription Natural healingsymptoms
Case management
• Are they ‘accessory sx’? You might have a simile…
• Sx are not ‘old, forgotten’; the patient never had them before…:
STOP and retake the case
Case management
Natural healing symptomsNatural healing symptoms
• RashesRashes• Joint painsJoint pains• A ‘cold’A ‘cold’• DischargesDischarges• Returning ‘signs of life’Returning ‘signs of life’
• No new prescription needed! Go on No new prescription needed! Go on judiciouslyjudiciously
Case management
• Remedy is rightRemedy is right• Potency and/or remedy dose a little too high…Potency and/or remedy dose a little too high…• Adjust by:Adjust by:
– decreasing number of succussionsdecreasing number of succussions– decrease amount of given remedydecrease amount of given remedy– decrease frequency of dosedecrease frequency of dose– increase amount of water used to dilute increase amount of water used to dilute
remedyremedy– increase volume of remedy solution bottleincrease volume of remedy solution bottle
Case management
Since about 20 years, I’ve been studying homeopathy. Step by step, reading all those Since about 20 years, I’ve been studying homeopathy. Step by step, reading all those inspiring books, homeopathy became clear to me; however, some aspects of it, did inspiring books, homeopathy became clear to me; however, some aspects of it, did not…not…
Until I read the most wonderful books of Luc De Schepper: Until I read the most wonderful books of Luc De Schepper: Hahnemann revisitedHahnemann revisited and and Achieving and maintaining the similimumAchieving and maintaining the similimum. All of a sudden, the hidden aspects showed . All of a sudden, the hidden aspects showed themselfs to me! Dr Luc seems to have the marvellous capacity to ‘translate’ the themselfs to me! Dr Luc seems to have the marvellous capacity to ‘translate’ the texts of Hahnemann into clear, pure, understandable language…texts of Hahnemann into clear, pure, understandable language…
Especially ‘his’ strategic case management resulted in more succesful homeopathic Especially ‘his’ strategic case management resulted in more succesful homeopathic prescribing; indeed, the second prescription is often the most difficult one.prescribing; indeed, the second prescription is often the most difficult one.
It is for this reason I made this interactive powerpoint show. In a few mouse-clicks, you It is for this reason I made this interactive powerpoint show. In a few mouse-clicks, you will be able to find out how to act, using your patient’s information, during his second will be able to find out how to act, using your patient’s information, during his second visit.visit.
The more succesful our prescribing becomes, the more motivated we – as homeopaths – The more succesful our prescribing becomes, the more motivated we – as homeopaths – become. And this is in the interest of our patients, as well as in the interest of become. And this is in the interest of our patients, as well as in the interest of homeopathy itself.homeopathy itself.
Using homeopathy in a correct way, resulting in succesful prescribing is in fact a tribute to Using homeopathy in a correct way, resulting in succesful prescribing is in fact a tribute to Samuel Hahnemann; it’s the proof that his Samuel Hahnemann; it’s the proof that his Similia Similibus CurenturSimilia Similibus Curentur is still living! is still living!
Marc Van WijkMarc Van WijkBelgiumBelgium
[email protected]@skynet.be
Case management
• Possibly, your remedy choice is wrong, so Possibly, your remedy choice is wrong, so you have to you have to retakeretake the case. the case.
• However, don’t take this decision too However, don’t take this decision too hastily ! This mistake is made too often !hastily ! This mistake is made too often !