Transcript Case management

Hahnemannian Case Management
Based on Luc De Schepper’s
‘Achieving and Maintaining the Similimum’
Interactive PowerPoint Presentation
Just ‘click’ the situation your patient presents!
START
Version © Homeopathy 4 Everyone, January 2007
Original © Marc Van Wijk - 2006
ABOUT…
Select what happens after you administer the remedy
Administration of remedy
Immediate improvement on all planes
Isolated physical improvement without
general relief nor increase in well-being or
in M/E outlook
No reaction on any plane
Immediate improvement on all planes
but of short duration followed by long similar
agg
Initial improvement on all planes,
then return of unaltered sx
Long-term improvement (weeks-months)
then sudden similar agg
Quick, short agg. Followed by improvement
and increase of strength
Sx following Hering’s Set of Observations
Long lasting agg. with eventual but slow
progress to improvement
New Sx appear
Prolonged similar agg followed by slow
continues decline
Similar agg after every dose, no matter
which potency
Key: Sx=symptoms
Case management
Stop program
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
Case management
Obstructions to the cure
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Lifestyle
Diet
Bad habits that cancel the remedy
How was remedy taken?
…
Case management
New acute event
Acute intercurrent
All possibilities after administration of remedy
Case management
Miasmatic block
Nosode
Striking response
Brings forth a
clearly indicated
remedy
Continue nosode
while patient is
improving
Case management
If no response after
3 weeks, give
previous remedy if
still indicated
Psychological block
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A remedy can cure a kid, not educate it…
Attitude; denial of ones own behavior…
Patient isn’t introspective, honest…
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 enough
• Increase potency and/or
• Increase frequency and/or
• Increase succussions
Case management
Severe pathology
Internal damage/pathology so severe
that cure is impossible
Work from C6 up to LM
Case management
Lifestyle
• Preserving harmful lifestyle
• Did the patient take allopatic drugs or other healing
modalities?
• When the body is beginning to cure, using the
positive support of the homeopathic remedy, it
needs time to adjust to the renewed sense of
wellness!
Don’t let the patients abuse their body’s again!
Case management
Intensity and timing of returning Sx
• Patient calls after initial improvement…
• Problems in work or relationship are
tugging the progress…
• Returning Sx more severe? Incurable
case…?
Case management
Quick, short agg. followed by improvement
and increase of strength
• Selected potency and/or dose were a little too
high…
• Adjust by:
– decreasing number of succussions
– decrease amount of given remedy
– decrease frequency of dose
– increase amount of water used to dilute
remedy
– increase volume of remedy solution bottle
Case management
Long lasting agg.
with eventual but
slow
progress to
improvement
Potency too high
Extensive
pathology
Case management
Unrecognised
one-sided
disease
• Potency and/or dose too high…
• Hypersensitive patient…
• Adjust by:
– decreasing number of succussions
– decrease amount of given remedy
– decrease frequency of dose
– increase amount of water used to dilute
remedy
– increase volume of remedy solution bottle
Case management
Extensive pathology
• Borderline of incurability…?
• Present extensive pathology already
known? If not, refer for further tests…
• Always use very low potencies…:
– Start with 6C
– Adjust dose/potency/succussions…
– After 6C, ascend to 12C, to 18C, to 24C, to
30C; from then, switch to LM
Case management
Unrecognized one-sided disease
• Advanced pathology becomes active layer
• Use von Boenninghausen!
• Don’t use deep-working, miasmatically
chosen remedies!
Case management
Prolonged similar agg
followed by slow
continues decline
Unrecognized
hypersensitive
patient
Incurable case
Case management
Unrecognized hypersensitive patient
• Potency and/or dose far too high
• Cancel remedy with camphor or
corresponding antidote; if it was the
similimum, give same remedy in lower
potency by 5th edition method.
• Start again with much lower potency/dose
• Olfaction can be used (6C) or microsolution.
Case management
Incurable case
• VF has no strength left to react
• Advanced and terminal pathology…?
• Only palliation is possible:
– Acute ‘zig-zag’ prescribing with 5th edition
method
– Use von Boenninghausen
– By preference, use vegetable remedies
Case management
Similar agg
after every dose,
no matter
which potency
‘Hysterical’
patient
Hypersensitive
patient
Case management
‘Hysterical’ patients
• A case of unmet emotional needs…?
• Need of attention…? Ask other family
members.
• Fixed delusions…?
• Give placebo until similimum is indicated
or until real emotional picture shows…
Case management
Isolated physical improvement
without general relief nor increase
in well-being or in M/E outlook
Distant simile and/or
Suppressed
symptom
Lifestyle and
related
treatments
Miasmatic block
Extensive pathology
Case management
Distant simile and/or suppressed symptom
• Similimum not found…
• Possibly the external manifestation of
disease has been suppressed
• Acted as placebo…?
• Retake the case
Case management
Immediate improvement on all planes
but 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
remedy …:
– keeps on doing sport while being treated
for sport injury…
– takes ‘antidoting’ food or drinks during
treatment…
Case management
Rarely, some remedies have a deferred
aggravation…
Don’t change your prescription too hastily!
Case management
Long-term improvement (weeks-months)
then sudden similar agg
• No more repetition of the remedy!
– VF needs no further stimulus of remedy
– Repeating would create a remedy disease!
Case management
Sx following Hering’s Set of observations
• Healing takes place:
– from within out
– from more important organs to lesser important
– from above to below
– in reverse order of appearance (reversible, presenting
and suppressed sx)… Make a timeline during
anamnesis!
• Duration of old, recurring sx depends on nature of
disease, VF, potency, nature of remedy.
Case management
New symptoms
appear
Natural healing
symptoms
Wrong prescription
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 symptoms
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Rashes
Joint pains
A ‘cold’
Discharges
Returning ‘signs of life’
• No new prescription needed! Go on
judiciously
Case management
• Remedy is right
• Potency and/or remedy dose a little too high…
• Adjust by:
– decreasing number of succussions
– decrease amount of given remedy
– decrease frequency of dose
– increase amount of water used to dilute
remedy
– increase volume of remedy solution bottle
Case management
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
not…
Until I read the most wonderful books of Luc De Schepper: Hahnemann revisited and
Achieving and maintaining the similimum. All of a sudden, the hidden aspects showed
themselves to me! Dr Luc seems to have the marvelous capacity to ‘translate’ the
texts of Hahnemann into clear, pure, understandable language…
Especially ‘his’ strategic case management resulted in more successful homeopathic
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
will be able to find out how to act, using your patient’s information, during his second
visit.
The more successful 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
homeopathy itself.
Using homeopathy in a correct way, resulting in successful prescribing is in fact a tribute
to Samuel Hahnemann; it’s the proof that his Similia Similibus Curantur is still living!
Marc Van Wijk
Belgium
2006
[email protected]
Case management