Getting in touch with the correct remedy – Homeopathic Case Taking Series: George Vithoulkas
In order to find the right remedy, the practitioner has to understand the importance of the symptoms given and of those withheld. He must also meet certain inner conditions if the patient is to trust him.
To find the right homœopathic remedy, the simillimum as it is called, means to save the patient much suffering. It means that he* is given a great boon: the possibility of becoming healthy and happy once again.
A healthy person is one who is free on all three levels of his existence — mental, emotional, and physical — and is therefore able to have a sense of well-being, a condition vital to a true sense of happiness. Therefore finding the correct remedy for a diseased individual gives this possibility, which is of course something of immeasurable value.
I would like to consider, first, the difficulties that attend such a task, and, second, the inner conditions that should prevail on the part of the patient and of the homœopath in order to maximize the likelihood of such a fortunate outcome.
Difficulties inherent in finding the simillimum
First, let’s look at the difficulties that the practitioner must overcome in order to arrive at the right remedy. We have experienced them in our everyday practice and know them all too well.
At the beginning of a case-taking, everything looks blank; while the information from the diseased person is forthcoming, everything is possible, but as you proceed toward a deeper and more complete investigation and evaluation of the case, your mind gathers momentum in analysing and combining the symptoms.
The greatest difficulty that you will then encounter is the evaluation of symptoms.
Which symptoms will you take into consideration?
Which symptoms will you be ignoring?
The struggle is difficult: you do not know whether the patient is giving the whole story, or how reliable the symptoms are that he is describing to you, or whether he is omitting substantial information!
Is he omitting something small but strange or peculiar and therefore an important symptom? Does he do so because of:
- lack of care about his symptoms?
- lack of observation?
- shame and timidity?
- mistaking certain ailments or discomforts as being of no concern to you?
- feeling that his symptom is insignificant or irrelevant to the case (even though this “insignificant” symptom constitutes the key to the case)?
- being unaware of having undue anxiety about his health?
- being unaware of a most important thing that is happening to him — perhaps an excessive underlying fear of death, a fear of cancer, a fear that he is going insane — that he does not want to acknowledge?
Intellectuals tend to give an ambiguous account of their health condition most of the time. It is strange that so many intellectuals have told me that, as they understand it, homœopathy is very difficult to practise, as it requires “very intelligent” patients (like themselves) who are able to correctly describe their symptoms!
The truth is the opposite. Simple, uneducated people tend to describe their symptoms more clearly than intellectuals, because they express directly their feelings without filtering them as intellectuals do. They tend to express nature as it is, while the others tend to distort nature, interpreting it according to their whims.
The inner conditions of both patient and practitioner required in finding the simillimum
Second, let’s look at the inner conditions required, when the practitioner and the patient meet, in order to create the greatest chance of that miracle for the patient: finding the correct remedy, the simillimum.
If you want to see the true picture of a person’s soul, that person has to “undress” in front of you. The practice of days gone by was for the doctor to have the patient completely undress regardless of the problem. It was symbolic of materialistic medicine: the doctor wanted to see everything he could see with his eyes on the physical, material level.
The homœopathic practitioner deals with the whole person — with the physical, emotional, and mental, and also with the subtle energies of the human being. He wants to see the subjective symptoms of the patient as well, all the distorted feelings and thoughts, in order to understand the totality of the inside structure of the pathology.
So the patient has to become completely “naked” before the practitioner.
But in order for someone to “undress” in front of the practitioner — to allow him to see his soul, his sorrows, his hurts, his fears, his unnatural desires and perversions, to see him totally naked in body, mind, and soul — there are requirements, understood both implicitly by the patient and explicitly by the practitioner.
First and foremost is a deep and sincere desire to assist the patient to heal.
This desire is an inherent quality of a healer, and patients seem to know the difference when the practitioner possesses it. If you do have this desire, even minimally in the beginning, it can be augmented by the years of experience and dedication that will follow after you have seen the positive results of your prescribing.
Most patients perceive quickly the inner intentions of the healer. If these are egotistical or out of self interest, he will not open up, he will not “undress”, regardless of the effort put in.
There are practitioners who become impatient with the patient; as they cannot see the right remedy, they push the patient to say what they want in order to fit the case to their preconceived idea of a specific remedy. There are others who have been unable to unravel the mystery and so end up prescribing several remedies together in the hope that one of them will be the correct one.
The sign that the practitioner has the talent or the ability to cure the sick is the initial enthusiasm that is generated in the heart of the student who first comes in contact with homœopathy. Later, what is needed is great patience to listen properly to the patient’s suffering without interference from preconceived ideas, without the noise of your thoughts and feelings.
The aware practitioner will sit in front of the patient as if he was a white board onto which the true symptoms of the patient will be written. It is vital as a practitioner not to interfere
by projecting subjective thoughts and feelings, and to make a real effort not to pass any judgment on the things the patient tells you that personally you may disagree with or not endorse.
Many patients, once they find a sympathetic ear, will open up and confess things that will not have been said to anybody before. Such is the power of your desire to help this person. The moment when the patient pours out his sufferings to you is a solemn moment. Let only your desire to help be obvious.
Second, you must gain the trust of the patient within the short period of time for which a consultation lasts. How is this accomplished?
Whilst it is not difficult, some conditions need to be met.
The first is that you have the confidence that you can really help, no matter how difficult a case may be. This confidence will spring from the all-round knowledge you will have as a result of your studies. This confidence is the number one condition that will make even the most surly and closed patient open up and trust you.
The more insecure the practitioner feels about the case, the less information he will be receiving. This is a strange phenomenon, because no words are spoken concerning the matter. The practitioner will not express in words that he is finding difficulties with the case, yet there is an atmosphere through which the patient perceives on a subconscious level what is going on, positive or negative.
Even a false overconfidence will cause the patient to extend some trust to the doctor. Such are the cases in which people are exploited by charlatans who seem to have an absolute confidence in their “medicines”, no matter whether they are effective or not.
The second is that you show a deep knowledge of the pathology of the case at hand. Then you will be able to demonstrate that the pathology is understood perfectly by you. In order to have this quality, you need not only to have a thorough knowledge of clinical medicine but also to be able to combine this knowledge with knowledge of the materia medica and with your clinical experience.
The third is a mutual sympathy or “homogeneity”, which can occur spontaneously or be developed as the process of taking the case proceeds.
This trust and openness on your part must not be mistaken to mean superficial familiarity and cheap exhibition of affection. Rather, it means establishing a nonverbal connection that allows a free and deep communication.
This is a most fortunate condition for both you and the patient. As trust is established unconsciously, the patient feels safe and is therefore able to expose his vulnerabilities and speak from his innermost being.
It must also be said that if this sympathy takes a turn towards the erotic, there is no chance that the individual will be helped by the healer, as the healer is then seeking out to “take” from the patient and not to give.
In my teaching experience, I have seen a lot of students who have become excited with the teachings and have seemed to comprehend the material really well but were unable to apply it to the cases in front of them, because they lacked this quality. Such individuals will turn to other avenues of expressing their talents, such as research, or academic careers, where they may excel; they will never become successful in practising classical homœopathy.
I remember a characteristic example from my student years in India. In the college where I was studying at the time, we had a teacher of materia medica who was able to reproduce by heart in great detail all the remedies and do it without any assistance from notes. This teacher was totally unable to match and apply this knowledge to patients. All the students sensed that, and no one would go to him to ask for help in cases where they had a health problem themselves.
Do not be seduced into thinking that, because some patients have been cured without all these requirements, you can be successful through bluffing.
Rather it is that the patient has no other chance, or has no way of comparing, as he has not experienced the warmth of the really interested healer against the coldness of a cool intellectual examiner with a professional veneer.
The fourth condition is respect for the freedom and the integrity of the patient. Do not try to intrude and violate his soul by rude force just because you want to find the remedy. Do not try to investigate things out of curiosity, or out of an urge to see similarities in your own life and justify yourself. If you do this, you will be unable to find the correct remedy most of the time.
From the moment the information given is enough for you to prescribe with certainty, then you must immediately stop your inquiries. You may be thinking that there were other interesting events that the patient could relate, especially concerning his private moments, but you should refrain from asking, as this further information is not crucial to finding the remedy.
A third inner condition is that you have great perseverance in search of the symptoms, especially in difficult cases.
Many times my students have been exasperated in attending the taking of a case by my perseverance to find the key notes to confirm the right remedy. Unless you have this quality, you are going to miss a lot of cases. In frustration, you will give up and you will choose a remedy when you are unsure about its correctness. It is better to say that you do not know what to do than to knowingly give the wrong prescription.
The last inner condition I’d like to discuss here is a silent moment of meditation.
When the patient has given you all the information necessary and you have taken the pieces and are collating them, this is a time for analysis and synthesis of the information. This is best done through an inner silent moment, which looks like a meaningless pause or a meditation. You become silent for quite some time. The patient will perceive it as a gap in the process but will never be irritated by it. You may be looking through the repertory or your computer, and the patient will sit patiently waiting for your next move.
Through such a process of constructing the information into a remedy picture, suddenly the right remedy clicks in your mind and then you know you have arrived at the correct answer.
The miracle has been accomplished!
It is a great moment, one that gives enormous satisfaction to the practitioner even before he has seen the actual result of his prescription.
When this click takes place, the homœopath knows that the patient will do well, as he has the certainty of having found the right remedy.
- The male gender is used purely for purposes of convenience and is not intended to discriminate in regard to gender.
George Vithoulkas has taught homœopathic medicine since 1967. He holds chairs at several universities and is the 1996 winner of the Alternative Nobel Prize for his efforts to upgrade homeopathy to the standards of a science, and is generally held to be largely responsible for the worldwide resurgence in homeopathy in Europe and the U.S. since the 1960s.
Professor Vithoulkas is the author of a popular book introducing the subject, Homeopathy: Medicine of the New Man, Arco, 1970 (republished, slightly expanded, as Homeopathy: Medicine for the New Millennium, IACH, 2000) as well as the classic textbook The Science of Homeopathy, vol. 1, Grove, 1980, and a Materia Medica that so far is eleven volumes in length, Materia Medica Viva, IACH.
Professor Vithoulkas is currently at work on The Science of Homeopathy vol. 2.