Approach to oncology

Dr. Vinu Krishnan BHMS MD(HOM)Medical officer, Dept. of Homoeopathy, Malappuram.

Types of diseases

1. D`s which are managed without any aid. 2.D`s ……….with aid- 1.drug

2.surgery/chemo/

physio/etc

3.spiritual/

emotional 3.D`s …………..incurable

Cancer----Oncological cases

Disease with lack of “symptoms” No clear cut symptoms. No direct relation with vital process. Frequent remissions/haphazard endings! Unnatural morbidity & mortality at the end. Numerous pathological symptoms

(pathogenic)

False indications-

s/o seems to be of polycrest medicines. s/o seems to be pathogenic s/o of drugs. But if prescribed according to---- despair..!

One sided diseases (172-184)

s/o too few, belong to C/C d’s. The main s/o may be internal (H/A, C/C

diarrhoea, cardialgia etc) or external (local maladies).

How do we know which s/o to use at what moment?

Intuition….? analytical…? (repertory)

We need both..!

Various approaches

Essence (soul of the remedy)/true totality of remedy.

A deep understanding of the basic nature of a particular remedy. (flavor).

It includes-causation---grief/ suppression… tempo-----slow/ fast centre of pathology physiognomy---

Essences …

Cowardice / diffusion/ confusion/ retention….etc

Disadvantages- 1. essence does not appear in every case. 2. creates a superficial approach only.

Totality (both psychological & physical s/o)

A mechanical analysis of the information. Essence (3 dimensional)/ totality- 2 dimensional. More than one remedy will appear.

Key notes

Eg- puts feet out of covers- sulphur. s/o should be very emphatically &

unambiguously stated.

Family h/o & past illnesses

Miasmatic tendency Causation.

Past h/o of drug use

Changing s/o. complementary, inimical

Focus

Physical Emotional Mental

MENTAL

Complete Mental confusion Destructive delerium Paranoid ideas Delusions Lethargy Dullness Lack of concentration Forgetfulness Absent mindedness

Mental

EMOTIONAL

Suicidal depression Apathy Sadness Anguish Phobias Anxiety Irritability dissatisfaction

Emotional

PHYSICAL

Brain ailments Heart ailments Endocrine ailments Liver ailments Lung ailments Kidney ailments Bone ailments Muscle ailments Skin ailments

Physical

Confirmation

Includes organ system (particular tissue) Food cravings. Physical temperature, heat/ cold Effect from weather. Position of sleep.

Steps in analysing

1.What type of information do we have?.. essence/ totality/ key note….?

2.confirming the remedy. 3.contradictory s/o. 4. A lack of confirmation

Approach in cases with lack of s/o

Not able to sketch all s/o even after careful exmn.(83-98).

Select a medicine which is the then Homoeopathically indicated.

Accessory s/o

Accessory s/o are produced when imperfectly homoeopathic medicine is given.

But these are s/o of the disease itself which have been hitherto very rarely perceived.

Then the whole collection of s/o should be considered. (a 2nd medicine) 183

After each new dose of medicine has exhausted its action, the state of the disease that still remains to be noted anew. (layer concept)

Hierarchy in case analysis.

1. essence +totality + key notes 2. essence +totality/ essence +key notes 3. totality + key notes 4. totality only. 5. reliable s/o- when totality doesn’t clearly

give a solution & there is no essence. 6. Main pathology.

8. recent pathology- look at what has caused the drop in health…

9.3 Key notes, different areas (3 legs of a stool)

10.Key note essence.

11. Doublets, triplets- specific combination of s/o…eg. Mental dullness+ constipation- Alumina.

12. Combination remedy- we should have s/o from two different remedies+ one key note for that specific combination remedy.

13.Nosode – when we tried several remedies and they didn’t work or when we cant find the remedy intellectually.

Where not to prescribe?

A Study on Kent’s observations

Classification—> 8 + 2 + 2

<< observations. 1,2,3 Antidotal obs- 1,10,12 Ideal cure 4,11

>> observations 5,6,7 Palliative obs- 5,6,7 Law of cure 12

Possible out comes..

Too short relief (KO-6) <<<<…………! (KO-1) >> first but <<< (KO-5) Full>>>, but no relief (KO-7) New s/o … (KO-11) -ve direction of cure (KO-12)

1. Prolonged <<<,death..!

Deep d’s, deep medicine, deep potency, bad prognosis.

Should antidote.

5.> first, then<

Remedy palliative / pt incurable, prognosis

unfavorable. Prescribe another medicine

6.Too short >>

Interference from the pt.

a/c –inflmn of organs c/c- tissue changes Prognosis – bad. Prescribe another

medicine.

7. Full >>, but o improvmnt.

Palliation/ presence of malignant conditions.

Prognosis bad. Never be cured, / only

can palliate.

10. New s/o

Remedy wrong. Prognosis- bad. Wait . If s/o are trouble

some, antodote.

12. Direction of cure

If against direction of cure, remedy wrong, prognosis bad.

Antidote.

Where not to prescribe?

Long <, but will improve.(1)

<< quick, short & strong.(2)

Ideal cure(4) Old s/o reappear(11)

11. Old s/o reappear

Correct remedy. Prognosis very good. wait

Group classification of Vithoulkas

Group- I,II,III,IV Classified according to

the order of appearance of ACUTES

Group classification of Vithoulkas

Mainly 4 groups- 1 group- infrequent non severe Acutes organism strong. remedy clear. reacts well to H'Pathic remedy if Acutes appear not a good

sign.

Eg. For diseases of 1 Group

Migraine, conjunctivitis, rhinitis,lumbago, PMS, menstrual irregularities,, palpitations,

arthritis…

2nd group (Frequent & severe Acutes)

Organism not much stronger (weaker) eg- mild asthma, hay fever, spastic colitis, c/c

cystitis, c/c bronchitis, idiopathic HTN, arrhythmias, OA,…

( children with frequent infections/ allergic conditions)

Defense mechanism decreased. Allows frequent A/C to come. As it is being pushed down Mental /

emotional s/o start to appear. Herring’s law is not clear. HP<< more than in group 1

3rd group

Organism more weaker and deeper. A/C diseases disappears or only mild if

appeared. Heart and kidney conditions. Epilepsy, HTN, cancer (in curable limit),

Nephritis, RA, psoriasis, Alzheimer's, STD’S, ADHD.

No HP<<. If Acutes appear within first 3 days-a

fantastic reaction.(eg-sudden high fever in asthma & epilepsy cases), then Rpt same remedy frequently

If a/c appear within first wk

, ----Rpt the same remedy in the same potency rptdly./

or a series of remedies may be needed.

A/C within 1 month.

The more we go farther the more severe the reaction.

May be a ‘dangerous reaction.’ It needs treatment—if clear picture of A/C ---

give an acute remedy. If no clear picture Rpt the original remedy in

frequent doses.

A/C within 3rd month

It shows the case is of deeper level and will need more remedies.

A/C developing from this level will be severe and the level of health can be improved by right remedies to upper levels,

If it is a wrong remedy we will get relapses.

4th group

Organism still weaker. NO ACUTES.eg- schizophrenia, manic

depression, cancer, juvenile diabetes, late MS, ALS, Neuro muscular diseases, autism…

Immediate >> followed by <<<(KO-6). If A/C occurs a very good sign, it shows

correct remedy. If relapses occurs it points to another

remedy. As we go farther in group 4 ,A/C will be more

strong, the correct remedy will lift up to group 2nd where A/C occur frequently.

Some can’t survive from these Acutes. We can treat this Acutes even with

multiple remedies.

Assessment of improvement

252-256 If the selected medicine fails to make an

improvement-it shows something in the mode of life of the patient, that must be removed (maintaining cause)/

(KO-6)

Features

Greater degree of comfort, Increased calmness & freedom of the mind,

Higher spirits, return of the natural state. Only perceivable if dose is sufficiently minute

If the improvement delays too long---some error of conduct of the pt or other interfering circumstances.

If new signs & s/o occur----shows medicine not strictly homoeopathic.

How this be evident in cases?

Disposition of mind Appetite Sleep Bowel movements Urination Thermal Menses

GENERAL SYMPTOMS

Useful simple parameters in oncology

Appearance Hb, including TC & ESR Tumor markers. Wt . Temperature variations( including fever)

Also regulate diet& regimen

Coffee, chinese tea(herbal),liquors, tobacco, perfumes,highly spiced dishes,pork, sedentary life, debauchery, prolonged suckling, enervation, damp livings, suppressed sexual desire…..

Cases under other therapies

Surgery /chemo therapy/ radiation…? 91….s/o before the use of medicines/ after

they had been discontinued for several days..

Take the s/o of the conjoint malady of both medicinal & original diseases.

Past h/o of drug use

Changing s/o. complementary, inimical Recent pathology- look at what has

caused the drop in health…(has never been well…..!)

If after chemo----, after radiation……or after drugs (tranquilizers)….?

Pathological analysis

When the VF process is very weak & no definite s/o is not available take the pathological s/o as follows- a sector totality

Location( organ system)/ (physiology)- Modalities (Thermal ,Time,<<,>>) Specific drugs

so physiological doses---mother tinctures, low potencies(3c, 6c,12c, 1x, 3x, 6x…)in frequent doses till pt is carried to a better level where s/o are again evident.