I have often asked practitioners what they found the most challenging thing in the entire patient management process.
Over the years I have realised beginner practitioners have challenges in one of the following processes that incorporates a homoeopathic case management.
2) Case analysis that also includes miasmatic totality, susceptibility and prognosis.
3) Creating a Totality of Symptoms.
4) Matching this totality with the most indicated remedies in the Materia Medica – includes use of repertorization process.
5) Differential diagnosis and determining the first prescription and dose.
6) Eliciting Remedy Response and determining the second prescription/s until the case improves completely depending on the scope of homoeopathy.
Personally when I started my practice, the most frustrating part of case management process was matching my totality with the most indicated remedy in the Materia Medica.
While I seemed to do quite well with my case taking and I could even elicit the totality and core essence of a case well, I struggled to find a remedy that matched this state.
One possible reason could be that there were a just handful of remedies that I could say I knew really well in those years and prescribe confidently. While we were "taught" around 400 remedies in my training and were expected to memorize them well, I could never manage to remember them.
I could never understand remedies from reading a book directly because they lacked something. The only remedies that I could ever learn and still remember clearly were those those that were filtered through a clinical case. I found it extremely futile and boring to memorize a set of indications of remedies just because they were dumped together in a book.
Having said that I thoroughly enjoyed the clinical cases from books journals or in lectures. I spent hours going through journals and archived cases to find my remedies. I observed cases being prescribed by my teachers in practice and made sure I recorded the remedy indications and the response that followed during the followups. I would compare cases of the same remedy. The idea was to see the many varied expressions of a remedy in clinic, using various approaches and to really get that depth of the remedy understanding and pathogenesis.
Now this was a slower process and while I knew some remedies really well, my materia medica was quite limited. So it was rare for a remedy to pop in my head as soon as I took the case in my first few years of practice unless I had read or seen it prescribed before.
Hence the only way I could find remedies in most of my cases was by repertorizing and trying newer remedies if they were indicated.
The most tricky part for me was converting the symptoms into rubrics. While the totality of the case was quite clear and depended on the "stage" I took the case at, I wanted to make sure that the rubrics exactly represented the depth, core and essense of my patient's totality.
(For more information on the concept of stages and its relevance in homoeopathic practice, kindly have a read of the free ebook - The Quest for Simillimum on the left of this page).
Over the years after some extensive research into the repertorization process and making many mistakes, I could come to a stage where the process has become much easier. I want to share some hints that have helped me over the years to ensure that one can take the best possible rubrics that are represented in a case.
I will explain this through a case example so you can understand the subtle differences in the type of rubrics chosen, what to take and what not to take in a given patient.
Don't forget to put your thoughts on what you think about this in the discussion forum below.
Sohani Gonzalez Nov. 12, 2013, 10:23 p.m.
Just want to say Shilpa ~ a very clear and helpful description on how you found this remedy ( of which I have never used yet in 30 year s) I hope that a case comes my way now ~ all very exciting !
Shilpa Bhouraskar Nov. 13, 2013, 11:33 a.m.
Yes it is one of those remedies that needs to be a polycrest but isn't. I look forward to your experiences.
Sarah Daniel Nov. 12, 2013, 11:01 p.m.
Thanks for going through this case, Shilpa. As you described the dynamics of this emotional sensitivity leading to a diversion into pleasant fantasy I said to myself, I wonder if this could possibly be Pip-m? I have had some success with this remedy and have found that people who need it tend to be almost incapable of solving big problems in their lives (like real happiness at work, or what to do about health problems, or what to do about a relationship) because as soon as they get a signal that something isn't just right, they look away. Can't help it. It's an instantaneous response. I'm very happy to have seen this case of yours; it deepens my learning about how the remedy state might express itself physically, and how the case can be translated into the rubrics so the picture of which remedy is best comes clear.
Shilpa Bhouraskar Nov. 13, 2013, 2:55 p.m.
Thanks for sharing your experiences Sarah.
Niki Nov. 14, 2013, 12:48 a.m.
Thank you for posting such a beautiful wonderful case! You have no idea how much I just learned from you about kava kava. So, I approach homeopathy from a different perspective. In addition to being a homeopath, I am also a pharmacist and a hypnotherapist. I'm also a medical intuitive. My intuitive gifts are auditory, so usually within the first few minutes of someone giving me their case, if their problem stems from a past life trauma, I know what it is. (I do a lot of past life regression in my practice.) I am so glad that the kava kava works so well. I have never studied that remedy, and it makes me think that perhaps kava kava is a wonderful remedy for helping the person forget their past life traumas. I can't wait to read more about the natural history of that remedy. So, I will tell you what I got in the first minute - he was a dog in his past life. He had a wonderful life, and loved the family he was with. His dreams reflect the happy memory of his past life - laying on a lawn, and dreaming of chasing rabbits - his favorite past time.
After they dragged him away by the neck, they shot him in the head- in the temple. They were trying to protect their children - thinking that if he bit an adult, he might bite the children. But he was protecting the children, and he got shot. It was such a shock for him that he carried it with him into his next life.
I am so happy that the kava kava worked! You have given him back his joy and allowed him to live free and happy again. The only thing I would have done differently is that sensing that he had a past life trauma, I would have removed the trauma first with a past life regression so he wouldn't aggravate. (Aggravations are often caused from past life traumas.) But you can always do a past life regression at any time, to remove any subconscious trauma and allow him to get the learning of his past life as a dog!
I have to be honest, I am so sensitive to pain and trauma that I had to turn off the video several times! In fact, I almost didn't listen to the rest of the case, but if I hadn't, I never would have learned that Kava kava helps a person forget their past lives so they can move forward with joy and happiness in their current life. What a wonderful remedy.
I had a hard time listening to him suffer, when he saw his fellow animal friends being butchered, but I'm glad I listened to the entire case, because if I hadn't, I would have never learned about the wonderful useful properties as kava kava on past life traumas!
Kava kava is probably a wonderful remedy for homoepathic physicians, because they have so many people coming to see them, and they don't have time to do a past life regression on everyone with a past life trauma.
Thank you Shilpa, for teaching such a wonderful case, and for teaching me so much about the wonderful properties of kava kava!
Shilpa Bhouraskar Nov. 14, 2013, 11:20 a.m.
Thanks for sharing your insight and offering a fascinating perspective to the case. I have never done or seen past life regression therapy so I will definitely have a read of Brian's work.
Dr.Mehru seth Nov. 24, 2013, 11:56 a.m.
you ..I want to tell u I have learnt so much from you .
Thanks alot .look forward to u for further experiences and cases .
Asefa Adam Firdosy Nov. 27, 2013, 3:06 a.m.
Thanks Shilpa for explaining the case so clearly.I have not used this remedy yet.I have learned about the rubrics you gathered to reach the remedy.Through this interestin and wonderful case you have intoduce kava kava s wonderful properties.
Thanks Shilpa and waiting for more experiences and case study.
sarang Dec. 12, 2013, 11:10 p.m.
Good analysis of the case giving a nice understanding of the drug.
Prabhas Mishra May 18, 2018, 12:07 a.m.
It was great Shilpa! I understood the case analysis shared by you. It is really very enriching.
My concern can we not take a rubric like Ailments; grief after here along with other rubrics considered by you.