Is there a need to rewrite the textbook of Practice of medicine
according to the need of homeopaths ?
Prof G R Mohan,
Principal, Devs Homeopathic Medical
College,
Ankireddipalli,
Keesara Mandal, -501301
R.R.District,
AP
A
Teacher is a performer like an actor- the only difference is that the teacher
expects learners to perform
Samuel Hahnemann states in The third aphorism in the Organon :
If the physician clearly perceives what is to be
cured in diseases, that is to say, in every individual case of disease
(knowledge of disease, indication), if he clearly perceives what is curative in
medicines, that is to say, in each individual medicine
Basic objectives of
education and training in a Homoeopathic institution is to prepare a competent
Homoeopathic Physician who is capable of functioning independently and
effectively under Rural and Urban set ups (CCH)
According
to C C H syllabus there are three papers for practice of medicine examination
which is scheduled in the final year of B H M S course. Two papers are mainly
concerned to homeopathic therapeutics. In true sprit a teacher in the
Department of medicine has to refer text book of medicine along with material
medica and Organon books to deliver a
lecture to satisfy the examination modalities. How far is this practicable?
Majority time of 85% is spent on medicine proper; in reaming fifteen percent of
time only homeopathic treatment is discussed in the class. Even for students it
becomes difficult to collect information with this cumbrous
syllabus.
Present day there is a criticism that newly passed out graduates are
not able to give correct prescription. How far is it correct ? It is a question
to be answered by every teacher in homeopathic medical college. Is it the fault
of the teacher ? Can it be the student? Or non availability of Homoeopathic oriented books ?
Late Prof. John Mitchell & his team have shown that :80% of the accurate final diagnosis &
100% of the management strategies, could be arrived at the end of reading the
referral letter and carefully listening to the patient. This clinical accuracy
could only be 4% more refined by all the physical examination and only 8% more
refined by all the investigations including PET scan.
Elizabeth Hubbard said : A
through physical examination and routine laboratory investigations has to be
done, so that the physician is thoroughly scientific.
Stuart Close
said : Hahnemann devoted twenty two paragraphs in the ‘Organon’ on
examination of the patient ( 83-105)
Really there are no good homeopathic oriented text books
for practice of medicine are
available but they are quite good number
text books in allopathic
oriented practice of medicine which
naturally impress on the student‘s mind the allopathic approach. Medicine books
are written by allopathic oriented authors with mechanical-materialistic
approach and outlook. Very
little attention paid to the dynamic vitalistic aspect of all these subjects .The
disease is described more from nosological diagnostic point of view less from
the angle of dynamic vitality and individualistic concept. Prognosis not
described according to the homeopathic point of view.
Medicine is essentially a practical science and can be
more learnt at the bedside than in a classroom. Care should therefore be taken
to impart an intensive clinical training to the students during the later part
of their study in the college.
Therapeutic
method of study consists of studying a remedy in relation to its action in
different disease conditions. For example
Nat.mur- Eczema, Headache etc.
Pulsatilla-
Mumps, Measles, Haemorroids
etc.
Iris Tenax-
Appendicitis.
As teachers we have to discuss the predominant site of action drugs which
are mentioned in Materia Medica with the knowledge of Practice of medicine e.g.:
Cheledonium- Liver, Ceanothus- Spleen,
Sabal ser- Prostrate , Ruta- Periosteum,
Hypericum- Nerves. Digitalis – Heart, Euphrasia – Eye and Iodum- Thyroid.
The modern
physiologist reflects the theory that the vast majority of human ills are
related in some degree to endocrine imbalance. Every drug in Materia Medica
should be studied in relation to the affection of endocrine glands.
Iodum-
Hyperthyroidism.
Graphites-
Hypothyroidism, Hypogonardism.
Fucus
Vesiculosus- Nontoxic Goiter.
Nat. Mur-
Addision’s Disease. Hyperthyroidism
In therapeutics explanation should be more scientifically like :Hardness of hearing> by riding in carriage
or train is seen in Otosclerosis (medicine), this symptom is present in Nit. Acid, Graph
(materia medica) Enlarged glands. Hodgkin’s Disease. Seen in Scrophularia. N.
Even in Materia Medica books contains a vast number of medical terms with
many nosological names of disease. So it is difficult to understand Materia
Medica without knowing the meaning of the term or signs and symptoms of the
disease.
Wen- Sebaceous cyst.
Paralysis
agitans- Parkinsonism.
Somnambulism-
Sleep Walking.
Hive- Urticaria.
Zona- Herpes zoster.
The
knowledge about the diagnostic symptoms i.e. the pathognomonic symptoms helps
in determining the individual characteristic symptoms which form the basis of
the prescription in homeopathic practice according to the concept of the
totality of the symptoms. It aids prescription by giving information about the
location and nature of pathological changes present – pathological generals. It
determines whether the pathological changes are far advanced and have affected
any of the vital organs. Diagnosis gives indication to use of deep acting
constitutional remedies like Silicea, Lycopodium, and Sulphur etc.
Administration
of the superficially acting related remedy, Use of high potencies frequent
repetition of similar deep acting remedies in acute diseases, the clear
diagnosis helps in the differentiation of a natural disease process from other
disturbances in the health, E.g.: Asiatic cholera from Arsenic poisoning,
cholera from Camphor poisoning .The clinical diagnosis helps the physician in
instituting the prophylactic measures (Genus epidemicus) at the time of
epidemics. It also makes possible the comparative assessment of the therapeutic
results, it also helps to know, to which stage of disease, the drug is more
similar. So helps in - Speed prescribing, - Prescription in case of the paucity
of symptoms- Comatose patient.
In reality
patients come to teaching hospitals either acute , psedochronic and chronic
type, but when a teacher in the practice of medicine has to teach according to
the above said classification so that for the plan of the treatment. A teacher
who is senior can tackle but for junior teacher it becomes difficult , because no
book covers the above problems.
Lastly even after introduction of post graduation in the practice of
medicine there is no improvement, even in examinations also when the student writes the
long or short case , he fails to mention the classification of diseases ,
fundamental cause exiting cause, answering blunders in Viva, Performing Very poor clinical examination,
writing very few remedies in
therapeutic part, no mention of diet
nor mentioning general management . Views of a cross section of
Homoeopaths who don’t know about the
difficulties in teaching comment like, No Homeopathic orientation, Poor clinical skill, no filtering in examinations and on teacher’s attitude
The practice of medicine , Orgonon and materia medica are interrelated , when
discussing about a remedy it should not
be theoretical oriented better it should be clinically oriented material medica to students. Twelve
observations of Kent are not shown at the bedside in some of the institutions. Majority
of homoeopathic hospitals admission strength is coming down as there is no
special care for admitted patients compared to out patiently treated patients.
It becomes difficult to demonstrate a good clinical case (successfully
homeopathically treated case).
It is for young dynamic teachers of this great system,to come out with a
book on the practice of medicine which cover all above said deficiencies.
*** article is published in Medicina Futura homoeopathica, vol :1 issue :9 Sept 2013
