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Question and Answer
Success in Prescribing

Dr. Jose Zachariah BHMS
CERCH, P.O., Road, Kottayam-1

Prescribing in Homeopathy is primarily based on similarity. Law of similars is more important than the principles of single medicine and repetition of dose. The concept of similarity is subjective depending on the depth of knowledge of the practitioner.

The method adopted by each successful prescriber is different from the other though all are practicing Homeopathy and producing results to the extend required by the patients. Asserting that knowledge in Materia Medica is the reason for their success in prescribing may highly simplify the issue as if granting a bonus to encourage unprincipled practice.

As a homeopath, we have got a repertoire of more than 2000 medicines. But how many of us are going beyond 100 medicines? Unless you know when and how to use a weapon, you cannot fight against the enemy effectively. I believe that this explains the failure rate of most homeopaths.

Homeopathic 'Materia Medica' is so vast and even confusing to the beginner ("One who is not going in the right direction will always be a beginner i.e. till his death".'Chronic Diseases'- Samuel Hahnemann) that you can feel apparent similarity in every case presented before you even if you know only 20 medicines.

Homeopathy is a science, which is highly demanding from its user. It implies that prescriber should have a thorough understanding of a vast number of remedies, a deep knowledge of how to use the repertory, skill in taking what is needed from a patient and above all ability in choosing the right medicine from seemingly similar drugs. Students of Homeopathy after completing their curriculum-oriented studies from colleges will have a symptomatic understanding of most of the polychrest remedies. In the beginning of their practice, quiet naturally they will tend to focus the attention towards polychrests or in other words they cannot think beyond polychrests for it is not in the area of their awareness. More than that there is an innate trap in the symptomatology of polychrest which invariably leads most of the beginners into believing that it covers almost all the diseases.

After experiencing bitter failures from using the so-called 'infallible law' the lesser minds (those without determination and true faith-which sadly is a major percentage) become deeply disappointed to the degree of even denouncing Homeopathy altogether. Some will go for short cuts in prescribing-like giving tinctures and patent medicines. Those with a better understanding may go for keynote prescribing. A certain other percentage will seek the advice of experienced and learned homeopaths. The advises offered are mostly derived from personal prejudices like Lycopodium 10M is the only potency effective in the treatment of impotency etc; clearly deviating from the principles resulting in further disappointment.

There is another group of highly dedicated people who faithfully follow the law, condemning everybody who deviates from it, and believing blindly in the concept of totality to arrive at the medicine. It is very sad to say that these very same classical homeopaths will also have a limited percentage of success unless they grow above the polychrests and formal repertorisation. A large percentage of homeopaths are having callosities in their brains which prevents entry of proper understanding of Homeopathy and thereby curbing their usefulness in utilizing the vast potentiality of Homeopathy.

"In homeopathic therapeutics, most of our treatment failures are not the result of an inadequate knowledge of large polychrests, but a lack of familiarity with smaller remedies.As a consequence, we inappropriately attempt to employ polychrests for tasks better suited to the lesser remedies. Our success rate would be much higher if we know the entire range of pathogenesis of these seldom indicated remedies and when to use them".Materia Medica 'Viva' by G. Vithoulkas.

On passing through words of Vithoulkas, the great exponent of Homeopathy in recent times, it is quite obvious that, anybody who aspires to have a good success in homeopathic practice should have some knowledge of almost every medicines. In other words, the more you know Materia Medica the more is your success. Who are the most successful practitioners? Naturally it will be those with a lesser percentage of failures and those who attract large number of patients. There are a number of such practitioners who could be named in our state. Even though most of them are not abiding completely to the principles of classical Homeopathy, the goodwill they have brought to the profession cannot be denied at any cost. What is the big secret behind their therapeutic effectiveness? I have given deep thought into that question, since I myself would like to practice classical Homeopathy. Why many of them are highly successful even at the cost of ignoring the laws of repetition and I am sorry to say, the law of single medicine itself? The answer might be that the law of Similars is more important than all other laws. What is the point in following other laws with a wrong prescription?

STUDY OF MATERIA MEDICA

It is almost certain that a wider range of prescriptions carries a better success rate. How can you hope to attain mastery in prescribing the lesser-known remedies? I personally don't believe that it will come from" clinical tips" (mostly biased information). The real fact is that every one of the successful prescribers had spent a lot of time in understanding the Materia Medica throughout their career. The greatest of prescribers of all times, Dr. James Tyler Kent had amply put it in the Preface of his Lectures on Homeopathic Materia Medica. The continuous study of the Materia Medica by the aid of a full repertory for comparison is the only means of continuing in a good working knowledge. The Organon, the Symptomatology and a full Repertory must be the constant reference books, if careful homeopathic prescribing is to be attained and maintained.

DIFFICULTIES IN PRESCRIBING RARE REMEDIES

The foremost thing is the lack of awareness about most of the medicines. Unless you know something about a medicine, it is almost impossible to think about it when a case is presented. Secondly, even if you feel a medicine, many of the practitioners hesitate to give it since they have no previous experience in using it and have very little confidence in its effectiveness. If common salt is a very potent medicine, then anything can be a medicine in Homeopathy is the very simple logic for those non-believers in small medicines.
Thirdly, even if one decides to try a medicine, there is the big problem of non availability of most of the rare medicines in our pharmacies which invariably curbs the enthusiasm for trying it because many of the prescribers do not have the grit and determination to firmly believe in their judgements of remedy selection and will go for a better known alternative medicine, mostly a polychrest rather than taking pains to collect the rare medicine from available sources. There must be at least one store in every district, which supplies all medicines in most of the potencies. If there is a demand, pharmacies will definitely keep the stock.

REPERTORISATION

Formal repertorisation most often leads to polychrest medicines. Many numbers of times I have heard the question being asked, what is the medicine, which came up after repertorisation? This is quite a meaningless question for everybody knows that repertory is not an end in itself. It is the comparison of the remedy images with patient image, which decides the selection of drugs. So after repertorisation if you cannot find a confident similarity with a medicine from among the top of the list, ignore about the whole thing and try to find out a meaningful but lesser number of symptoms that are crucial to the case. Look for the presence of any keys, which may lead you to rare remedies. For that you should have a better awareness of almost all medicines.

CONCLUSION
In nutshell, everyone of homeopathic prescribers should study meditatively, the Materia Medicas of Kent and Boericke, and keep at least important information about most of the lesser known remedies and be able to employ it at the least opportunity presented before them to verify the truth of the law of Similars.

N.B: The aim of this article is not to convey an impression that laws of single medicine and repetition of dose are unnecessary or repertory is useless. In the coming issues we shall discuss in detail about these issues. The beauty and power of homeopathic cures are most visible is true classical Homeopathy.

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