I am fortunate in having a preceptor

Tuesday, April 8th, 2008

I am fortunate today in having a preceptor .I don’ t know that she feels the same way. It seems difficult to control my enthusiasm for Homeopathy. The verbal runoff can be considerable when a captive audience is present.

Yes, I should get a life but wait a minute-no I have one.This stuff is amazing.No two situations are alike.Every symptom elicited is a challenge.The excitement is first in the chase for characterizing symptoms, then in the search for an artistic match to the portrait of disease in the Materia Medica.It culminates with participation in the wave of curative process. Ok,I read that.I am sick.

Olga was seen 2 weeks ago presenting with a chief complaint of mild but persistent depression of some 5 years duration.Sulphur 10m was given and she reports feeling much relief in that department within 2 or 3 days but this week brought a return of old back pain but with tremendous severity.The pain was distressing so that it brought on tears and made it quite impossible to be away from bed for long so our conversation was on the phone.

“Tell me all about this problem”.

“The pain is on the right side of my low back. I also feel it on the outside of the right thigh and in my right big toe. I cant make a move to get out of a chair without it really hurting”.

Here we have a fairly spontaneous assertion.This is the aggravation uppermost in the patients mind from her experience so this is where I begin.However I wont accept anything without challenge, but not now.Later after the spontaneous narrative is exhausted. For the present I will use the rubrics back pain worse rising from a chair-same for lumbar pain and for sciatica.

“What more can you say about the back pain?”

“Mornings are just awful.I dread getting out of bed”

There is a pause.I feel I need clarification. “So that first move to get out of bed is a real problem?”.

“No that is not so bad.It’s after I’m up and about. Around the time I brush I can really feel it.I wonder how to make it through the rest of the day.”

So the symptom,after we dust it off a bit is really aggravation after rising in the morning.

The flow of information seems to be dry.

“Take me on a tour of the rest of the day and night with this suffering.”

“Well after brushing I help it a bit by bending backward,stretching backward”

“That makes a big difference?”

“No it helps a bit,mostly I just feel like will help so I do it and it gives me a bit more mobility”

I will avoid emphasizing bending backward amel.There is a rubric,I think in the generals about desire to stretch.I will double back on this idea later and see if I can verify or deny in other ways.Wait a minute I have an idea.

“How is sleep with this problem?”

“It’s fine. There is no disturbance with this.”

“So all positions are equally good?”

“No,I like being on my belly.It gives comfort and feels great on my back”

Lying on the abdomen ameliorating is kind of unusual for a sciatica.The natural desire to be in this position for comfort adds emphasis to it and possibly adds emphasis to the modality of bending backward ameliorates. I will add both to my repertorization.

Now the river of narrative and general and even probative questioning has been exhausted.No more information regarding this syndrome.How can I get more characterizing information?Maybe if I check for any changes in the general symptoms.First the thermal profile.

“So you’re still very warm especially in bed at night?”

“Yes.”

“All parts of you are equally warm?”

“Yes. I am very warm….except of course for my legs.”

“Tell me about this..you have different thermostats going on?”

“My legs are cool.The rest is hot.”

“Your feet are normal temperature,not hot or cold?”

“That’s right.”

“So you don’t wear socks at night in bed?”

“Well actually I wear socks always.If not my feet feel icy cold.I could not sleep without socks.”

I am beginning to feel like Columbo here.We now have the symptom icy coldness of the feet.

“I don’t know if this is important(which often signals a key point)but my legs,they feel as if somehow twisted.Not on straight.”(wow,another nugget.)

So far the situation looks a bit like the graph above when translated into our technology for purposes of comparison with the Materia Medica. What are the most peculiar?I tend to think the bending backward and the twisted sensation. The remedies which both these traits are Dios,Sep,Zinc and if we do an extended search Hypericum as well.

It’s at this point that I might tell the reader what I did and finish the story but in this case the story is not finished.I only prescribed this past week.The story itself however was so exemplary of the process of everyday practice and the detective work necessary that I wanted to have you join me in the chase.

You know of course that the disease may not yet have expressed in its fullness or the patient(or Dr) may have omitted needed information. Each visit until definite curative action is aroused is a fresh search.
Which remedy do you think? Or do you think the case is incomplete?Stay tuned. I will.