BHA

Patient-centred healthcare

The art of individual healing

Using two case histories, Dr Andrea Wiessner highlights how homeopathy treats the person and not the disease, as well as providing an interesting insight into how a homeopathic physician selects the correct remedy.

When I first became interested in homeopathy, what attracted me most was its individual approach to the patient. While conventional medicine routinely uses specific medicines for particular conditions, homeopathy treats the person rather than the condition. To do this we need to look at the person as a whole to understand what is characteristic – physically, emotionally and mentally – for each individual, in order to match these characteristics with those of a suitable remedy.

We try to understand what is unusual and might not fit the expected symptom picture of a particular condition, because this can be seen as an individual feature of the person and therefore guide us to the indicated remedy with a similar symptom picture.

In this process “key notes” can be extremely helpful. These are very characteristic symptoms known for particular remedies and if we can find these in a patient they can point us towards the indicated remedy. These key notes can be symptoms on the physical or emotional level or can be symptoms of the mind. If they fit the more general issues of the patient, they can be used as valuable pointers towards an indicated homeopathic remedy.

To illustrate this, I would like to describe two cases where both patients had particular key notes for a specific homeopathic remedy.

Case 1
Mr P was 56yearsold and had been referred to me by his GP for treatment for his pronounced urticaria (nettle rash). He had a nineyear history of terribly itchy, raised, red patches that could appear anywhere on his body, except his face, and would stay for two to four days. After a few days he would have another similar episode of very itchy skin. At the time it was thought that his urticaria might have been triggered by Aspirin, which he was put on for his heart condition, as the onset of the rash coincided with him first taking this medication. Aspirin was therefore stopped and another drug that lowers the risk of blood clots forming, Clopidogrel, was prescribed instead – but the urticaria persisted. As Mr P has a history of heart disease, hypertension and had already suffered a heart attack, as well as a mild stroke, he was on a variety of vital and necessary conventional medication. Mr P was also taking antihistamines daily for his urticaria.

He has told his GP that he feels pressure makes his condition worse. And the only thing he found relieved the intense itching was to run hot water over the affected part of the body. He had already seen a dietician and various exclusion diets were tried, including a low salicylate diet (salicylates are chemicals that occur naturally in plants, including many fruits, vegetables and herbs), but to no avail. It was then that the GP decided his patient might benefit from a different approach and referred him to me for a homeopathic consultation.

During the consultation I began looking for other symptoms and features to help with the choice of remedy. Mr P was a warm blooded person who loved sweet food, disliked cold and windy weather and could be short tempered. I also noted that Mr P’s legs were constantly moving during the consultation.

As homeopathic practitioners are trained to look out for the uncommon, not easily explained and individual symptoms and features of a patient, I felt that the moving legs, as well as the fact that Mr P was running hot water over the itchy body parts, were the most unusual things to note in his case. These two features are both key notes for the homeopathic remedy Rhus tox (Poison ivy). The fact that hot water was, somehow, relieving his itching is unusual and doesn’t make sense, as most people would rather use cold applications to soothe a severe itch. Therefore this symptom is particularly important, as it is not explained by the nature of the condition but by the individuality of the person.

Consequently I prescribed Rhus tox, initially in a high 200C potency, followed by a lower potency after three weeks of 12 C to be taken from Mondays to Fridays every week.

After three and half months Mr P came back to see me and was already 50% better. He was no longer using the antihistamines on a daily basis, although wasn’t yet able to stop them altogether. I suggested we repeat the Rhus tox remedy, again starting with the higher potency, to be followed by regular doses of the lower 12C potency.

When I saw him three months later his urticaria and itching were 90% better. It had also been possible for him to stop taking the antihistamines completely. Once again I prescribed Rhus tox at the 200C potency and then the 12C potency from Mondays to Fridays. I arranged a followup appointment in four months.

On examining the patient at the followup appointment I found that all symptoms of his urticaria had subsided. We decided to stop the regular doses of Rhus tox and Mr P remained well, apart from one minor episode of itching after he had eaten some cabbage.

Case 2
Mr K was referred to me by his GP for treatment of his eczema. The patient was 72yearsold and had suffered with this condition for 12 years. During this time he’d used various steroid creams which gradually had to be increased in strength. His GP had put him on Diprosalic ointment, which Mr K had been using for quite a while in conjunction with emollients. Despite the treatment his skin was still very dry and itchy.

While different weather conditions didn’t appear to affect his eczema, Mr K believed that artichokes made the eczema worse and the only thing that was relieving his itch was hot water. At times his skin was so bad that he felt as if his hands and feet were “melting”. Having suffered with the condition for so long he felt that the eczema was controlling him.

His eczema usually consists of patches made up of little vesicles (a vesicle is a small blister), filled with water, which were present when I saw him first. Not only did he have very dry eczema on his palms but also on his fingers, in particular in the joint areas with some cracks as well. The soles, heels and sides of his feet were affected too.

Mr K also had a history of heart disease and hypertension for which he was taking medication. He’d also had an episode of depression in the past and an episode of pneumonia. During the consultation I discovered that Mr K is a night person, he feels better by the sea and is very thirsty for water – his mouth and throat are very dry, in particular at night. He isn’t a great sleeper and has catarrh sticking in his throat, mainly at night. Overall Mr K is a good natured person but can have a temper. He loves nature and the natural world.

The most striking feature in this man was again the fact that his itch was relieved by hot water. This, along with the vesicular eruptions filled with water, are again typical symptoms of the homeopathic remedy Rhus tox. In the absence of other unusual or individual features, I felt these symptoms fitted the case most. So I decided to prescribe Rhus tox. His thirst and dry mouth and throat, in particular at night, supported the choice. I gave a 200C potency as a one-off dose, to be followed after three weeks by a 6C potency twice daily, in conjunction with Calendula cream to add to his present regime of creams.

I saw Mr K again after three months and his eczema was much better. His skin was softer, the itching less pronounced and he had been able to stop the Diprosalic ointment and only used Calendula cream as well as emollients. We repeated Rhus tox at 200C to be followed again after three weeks by the lower 6C potency, twice daily. At the follow-up appointment four months later Mr K’s eczema had improved further. He felt his condition had improved by 80-90% since starting homeopathic treatment seven months earlier. His hands were particularly good. On examination there were very few vesicular eruptions between his fingers and only similar mild eruptions on the medial aspect of his feet. Mr K had also noticed that his catarrh had improved. We again repeated the Rhus tox 200C potency followed by the 6C potency to be taken twice daily after three weeks. Although I haven’t seen Mr K since, I am quite confident that his residual symptoms will gradually subside.

It is interesting to note that the eczema on Mr K’s hands improved quicker than on his feet. We sometimes observe that an improvement in symptoms start from the top of the body and move down. This phenomenon relates to one of the tenets of Hering’s law, which describes the direction of the cure and is observed not only in homeopathic medicine but in other forms of holistic therapies too. It’s also interesting to see that the patient’s catarrh improved, even though this wasn’t what Mr K wanted treatment for. This clearly shows that the health of a patient improves on a more general level. Frequently practitioners will observe that not only the presenting complaint improves after taking a homeopathic remedy, but other symptoms improve too.

Gentle healing
I hope that these two cases illustrate how homeopathy treats the person as a whole and not just the condition, as indicated by the more individual and particular symptoms and features of that person.

Although in the two cases I’ve featured one patient suffered from uticaria and the other from pronounced eczema, they both received the same remedy. In these cases the prescription was based on key notes of the remedy Rhus tox, which were seen in both patients.

Rhus tox is not only useful for skin conditions, it is also a very valuable remedy for rheumatic conditions; but only if it fits with the individual symptoms the patient presents with. This is always the aim of the homeopathic practitioner. We try to understand what is strange, uncommon, unusual and typical and individual for the person in front of us and try to match it with the homeopathic remedies we know to have similar characteristic pictures and features. The more peculiar the symptoms, and the less they can be explained by the pathology of the condition, the more important they are for us in the choice of the remedy because they can be seen as an expression of the individuality of the patient.

This makes homeopathy such a wonderful and enjoyable discipline to practise. Routine never comes into it, as we always have to look afresh at each patient. Quite often this is not always a clear or easy process and it can be challenging, but ultimately worthwhile nevertheless.

Homeopathy allows doctors to work with their patients to find out what their suffering is about. For me this is both a pleasure and a privilege. And when it’s followed by significant improvement in the patient’s health, it is obviously even more rewarding. Let us hope that in future many more patients can enjoy the benefits of this elegant and gentle way of healing, and that more doctors and healthcare practitioners, as well as providers, come to appreciate its value.

Dr Andrea Wiessner State Exam Med 1989, MFHom*, Associate Specialist at the NHS Royal London Hospital for Integrated Medicine.