Letters to the Editor
NATIONAL JOURNAL OF HOMOEOPATHY 2000 July / Aug VOL II NO 4.

Ed: A reader's response is always the benchmark of a good Journal. Therefore we always urge readers to write in-both appreciation and criticism. This issue the readers' page is solid and we are happy.

1. I was really glad to see your response to my letter. Like you said I firmly believe that Homoeopathy is a holistic approach and I myself never advise patients to go away from it. Nor do I want to say that Homoeopaths handle only 20-40 % of the problems. In my view, out of 100 problems, that we may have, in our day to day life, 60-80% are spiritual which a normal person is unaware of and is content to handle the other 20-40%. I am really obliged that you took interest and printed the contents of my letter. My e-mail address is ansan71@hotmail.com
Dr Anjesh Kanaglekar, Belgaum

2. Thanks and congratulations for the success of NJH. The article on Homeopathy and Bioenergy was indeed knowledgeable, because this is the basis of health. Congratulations Dr Bansal (Nov-Dec 1999)

Health = Balance Of Life + Mind
i.e. Mental + Physical

Nature has everything to give; the only catch is in us- how quick we are to attune ourselves to nature. Like cures like, then why to bother to know the origin of disease. It is not going to be irrelevant just as eating a dish without knowledge of it's preparation. For this Homoeopathy has its widespread roots. The only thing is to appreciate its utility.

Thanks Dr Vishpala again for NJH giving scientific basis of every solution and trying to further the cause of Homeopathy so that it stands like a rock with other allied medicines. For the year 2000 awaiting suggestion for Nov-Dec is

1. Obesity or
2. Conversion to rubrics from simple patients language

1. Mediquiz: was compiled by Dr Amitha Baliga, Lecturer Fr Mueller Hom College, Mangalore 575002.
2. b) The Tuberculosis research paper of Dr CP Jain and Dr Bipin Jain was a project under the aegis of ICR Mumbai
3. The address of advt in Nature course isincomplete. Please note it: Mira road, Mumbai.

The case has been presented in the tabular form of L, S, M, C. Under location origin, duration and progress has not been mentioned adequately. Under 'S, M, C' after every symptom, a line is drawn which gives the impression that each symptom has a different modality. (Ed: printer's devil!) To illustrate: nose block < pollution or congestion chest < after sleep or breathlessness > sleep. The totality of respiratory symptom is basically a syndrome consisting of several symptoms. Although accepted that each symptom may have different modality, usually we find that modalities pertain to the group in general, thus helping the physician in evaluation. For remedy selection. the data must be presented in totality- keeping in view pace of the disease, phase of the disease, susceptibility as well as miasmatic diagnosis,. Nowhere in the tabulated form the grades of the symptoms have been mentioned. This puts the reader in a difficulty as to the evaluation on which the further data processing has to be performed by a conscientious homoeopathic physician. (Ed: if no grades are given, maybe they were not stressed enough by pt. But in general, yes grades should be given)

In the same presentation, cough has not been mentioned under R S section. Under Location, fever has been mentioned which should be under sensation; I think its proper place is under concomitant. Fever totality with chronological evolutionary development has not been mentioned. This deprives the reader in comprehending the pattern of disease presentation.

Ref: life situation and rubrics selected from Robin Murphy, many points are raised. The author first mentions the boy as 'shy & clinging'. The author provides the evidence how the boy clung tightly to the mother. However the author takes the rubric- 'caressed - aversion to' - does the child present with contradictory symptoms? The data that the child has aversion to caressing does not appear in the entire write up. 'Does not want attention' and 'content if left alone with his family' can have interpretation like - Independent, Conservative, Reserved etc. The rubric - 'stronger presence agg.' is self explanatory to describe mental state of the child, while the author doesn't put evidence of 'looked at - can't bear'.

According to me the final selection of rubrics should be -

1. Clinging
2. Stranger presence of Agg.
3. Fear of dogs
4. Aversion to light
5. Talk slow learning to
6. Walk slow learning to
7. Salivation, sleep during
8. Sweat profuse
9. Sweat scalp
10. Shyness
11. Wakes frightful
12. Irritable, fever during
13. Contradictory symptoms

The assessment of repertorial filter is -
Nux Vomica - 14/8
Baryta Carb - 15/6
Calcarea carb - 15/6
Mercurius - 10/4
China - 16/6
Nat mur - 19/8
Pulsatilla - 18/7
Sulphur - 18/7

The selection of Calc-iod only because it is a hot Calc. appears to be a 'jump' out of synthetic prescribing. Synthetic prescribing does not mean union of cation and ion. The remedy should get represented in terms of its data in materia medica or repertory. Conceptually too, at least, symptoms pertaining to Iodum must be present. The data presented by the author does not fit within the portals of Iodum or Calcarea-iodum. If the same theme of hot Calcarea is perceived why not Cal-sulph? Sulphur by the way ranks high in repertorization.

Strong tubercular base has been the derivation of the author. Past history of only one febrile convulsion - 1998 does not put forward the strong evidence of 'strong' tubercular base. One could regard this as a tubercular base. However fat and flabby constitution with profuse sweating and shyness mentioned by the author typifies more the sycotic miasm. Even nose-block and profuse expectoration point more towards sycotic base. The family history of cervical spondylosis, osteoarthritis. DM incline towards sycotic miasm more than the tubercular. Should I mention once more that due to absence of totality of gradations how a physician is facing the difficulty in working out the case?

'Under conclusion' the author mentions about everything being classical - case, response, Prescription and Cure.

All these words could have legitimacy if the case would have responded to a single dose of the chronic constitutional remedy. Instead the author has given five doses - two doses up to 1M after one dose of Calc-iod 200 and two doses of Merc 200.( Ed: Acute remedy MIK was followed by C each time.)

To conclude:

1. The data must be provided to the readers adequately and accurately.
2. The data must be processed from all angles.
3. The reasons of prescriptions must be given through logical workout.
4. Differentiation with the similar remedies must be given to know the thinking process available in the mind of the author.

Editor Replies:
Thank you, Supriya Mullya for such a detailed working. It is indeed heartening to see the depth in which the NJH is read. You have worked out the case thoroughly and the analysis presented. But we shall look forward to original contributions- in form of articles and cases from Supriy's own practice, as thoroughly worked out. As regards some O/S revised, suggestions are well put and will be acted on. Now some answers:

1. Lines are typing errors. Some other small points are not being answered.
2. Data: Yes on going back to the case-book, some data marks are missing which we give herewith. This happens when an article goes thru many proofs and many hands. These are not excuses, just practical difficulties of running a Journal.
3. Breathlessness was when child was10 mths old.and breath-holding spasms at 1yr. Fever was usually 101 more at night. Wakes cranky. Loves Fan3
4. About Repetition: and Follow-Up: even I myself have rarely given such a detailed FU along with the reasoning at every stage. Do read it again. Remember, Minimum dose does not mean 1 single dose in one life-time! It means as little as possible. And in this case really very few doses - 2 of acute, 2 if IC and 1fo Constitutional. Now it is a further 1yr and the pt came to me only once in this yr for the beginning of the cold. Only IC and C were give which aborted.
5. Selection Of Remedy
   Calc Selection is well represented even in the fresh Rep. working of Supriya where Sulph, Calc-c, Nat-m even Baryta top the range
   Perspiration scalp, delayed milestones, Fears + hot Calc: Calc-I, Calc-s Calc-fl
   Nat-mur has more likelihood of coming in where single milestone, esp. talking, is delayed. Along with some more specific characteristics, which would help to point to Nat-m without doubt. In my understanding of remedies, the conglomeration of shy, fearful, clinging, delayed MS and perspiration scalp, favours Calc more.
   Now about the salt selection: Calc-s more likely to have some skin complaints, some suppuration and the mental make up is very distinct- much more jealousy. Both the recent ICR seminar in Poona and Rajan's description of Calc-s will merit reading and understanding. Calc-fl is again a different picture- more hardness, less fears, caries etc.
   Again each of the salts are miasmatically different too. In this pt- recurrent colds febrile convulsion, recurrent urticaria, high Diabetes in PGM and PGF are Tub 3. F/H: osteo-arthrits, Cerv S is Syp2. Calc-iod is more tubercular.
   Of course, in any working the top 4-6 remedies will cover most of the rubrics. Therefore you will always find that in practice, the final selection of the remedy is always a balancing act based on one's understanding and appreciation, with stress on some characteristic data, which tilts the balance. There is no denying that in practice one could always be wrong and whenever we find that a case does not respond in say 3 mths,a re-evaluation becomes necessary. The proof of the pudding is always in the eating- i.e. cure. And if one wants to continue to learn from others, then work backwards from the cure, and find convincing enough reasons for the prescription. If one goes on the basis that the remedy given was wrong, then one will have to explain why the result? Just fluke, or was it one of those cases which would have got well anyway with or without treatment?

Dr Padmaja Pai-Shenoy Writes: Undoubtedly we all need to continually re-evaluate and improve ourselves. Supriya's response is detailed, which is good. Where she goes wrong is in the final weightage. Here there is no doubt that the child responded to Calc-iod. The author has given all available data. If it is felt that it is illogical or inadequate, then it is probably the differing perceptions. Perhaps that is what makes Homoeopathy so interesting and simultaneously so difficult and so exasperating and fascinating.

Please, let us be gentle when we deal with a case presentation. It requires a great deal of courage in the first place to send in cases. This is obvious from the fact that we have such difficulty in getting senior Homoeopaths to write cases for the NJH.

Constructive criticism is healthy and welcome and real learning can occur. But for that we need to be open and flexible and humble.

Issue Editor Dr Rama Writes: So Supriya, you have opened up quite a Hornet's nest. Certainly we would like to have your own general feedback- but not in terms of slicing split hair. Because remember, however much discussion can go on, the final weightage can only be given to demonstrable results.

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