Homeopathic remedies, constitutional prescribing.
Frey, Rebecca J.
Definition
Constitutional prescribing of homeopathic remedies refers to the selection
and administration of homeopathic preparations over a period of time for
treatment related to what practitioners call miasmic disorders, those caused
by a generational predisposition to a disease.
Purpose
The purpose of constitutional prescribing of homeopathic remedies is the
treatment of what is known as miasms, or miasmic disorders. The term miasm
comes from a Greek word meaning stain or pollution. As in acute prescribing,
constitutional prescribing is holistic in that it is intended to treat the
patient on the emotional and spiritual levels of his or her being as well as
the physical. Constitutional prescribing is also aimed at eventual cure of
the patient, not just suppression or relief of immediate symptoms.
Precautions
Constitutional homeopathic prescribing is not appropriate for diseases or
health crises requiring emergency treatment, whether medical, surgical, or
psychiatric. In addition, constitutional prescribing should not be
self-administered. Although home treatment kits of homeopathic remedies are
available for acute self-limited disorders, the knowledge of homeopathic
theory and practice required for constitutional evaluation is beyond the
scope of most patients.
Description
Constitutional prescribing is based on the patient's symptom profile and
specific aspects of homeopathic theory.
Homeopathic classification of symptoms
Homeopathic practitioners use the word symptom in a more inclusive fashion
than traditional medicine. In homeopathy, symptoms include any change that
the patient experiences during the illness, including changes in emotional
or mental patterns.
Homeopaths classify symptoms according to a hierarchy of four categories:
. Peculiar symptoms. These are symptoms unique to the individual that do
not occur in most persons. Homeopaths make note of peculiar symptoms because
they often help to determine the remedy.
. Mental and emotional symptoms. These are important general symptoms that
inform the homeopath about the patient's total experience of the disorder.
. Other general symptoms. These are physical symptoms felt throughout the
patient's body, such as tiredness, changes in appetite, or restlessness.
. Particular symptoms. Particular symptoms are localized in the body; they
include such symptoms as nausea, skin rashes, or headaches.
Miasms
Homeopaths regard the patient's symptom profile as a systemic manifestation
of an underlying chronic disorder called a miasm. Miasms are serious
disturbances of what homeopaths call the patient's vital force that are
inherited from parents at the time of conception. German doctor Samuel
Hahnemann, who developed homeopathy in the late 18th century, believed that
the parents' basic lifestyle, their emotional condition and habitual diet,
and even the atmospheric conditions at the time of conception would affect
the number and severity of miasms passed on to the child. Hahnemann himself
distinguished three miasms: the psoric, which he considered the most
universal source of chronic disease in humans; the syphilitic; and the
sycotic, which he attributed to gonorrhea. Later homeopaths identified two
additional miasms, the cancernic and the tuberculinic. The remaining major
source of miasms is allopathic medicine. It is thought that specific
allopathic treatments--particularly smallpox vaccinations, cortisone
preparations, major tranquilizers, and antibiotics--can produce additional
layers of miasms in the patient's constitution. Constitutional prescribing
evaluates the person's current state or miasmic picture, and selects a
remedy intended to correct or balance that state. The homeopath may
prescribe a different remedy for each miasmic layer over time, but gives
only one remedy at a time directed at the person's current state. The basic
principle governing the prescription of each successive remedy is the law of
similars, or " like cures like. "
Hering's laws of cure
The homeopathic laws of cure were outlined by Constantine Hering, a student
of Hahnemann who came to the United States in the 1830s. Hering enunciated
three laws or principles of the patterns of healing that are used by
homeopaths to evaluate the effectiveness of specific remedies and the
overall progress of constitutional prescribing:
. Healing progresses from the deepest parts of the organism to the external
parts. Homeopaths consider the person's mental and emotional dimensions,
together with the brain, heart, and other vital organs, as a person's
deepest parts. The skin, hands, and feet are considered the external parts.
. Symptoms appear or disappear in the reverse of their chronological order
of appearance. In terms of constitutional treatment, this law means that
miasms acquired later in life will resolve before earlier ones.
. Healing proceeds from the upper to the lower parts of the body.
Healing crises
Homeopaths use Hering's laws to explain the appearance of so-called healing
crises or aggravations in the course of homeopathic treatment. It is not
unusual for patients to experience temporary worsening of certain symptoms
after taking their first doses of homeopathic treatment. For example, a
person might notice that arthritic pains in the shoulders are better but
that the hands feel worse. Hering's third law would indicate that the remedy
is working because the symptoms are moving downward in the body. In
constitutional prescribing, a remedy that removes one of the patient's
miasmic layers will then allow the symptoms of an older miasm to emerge.
Thus the patient may find that a physical disease is followed by a different
set of physical problems or by emotional symptoms.
Preparation
The most important aspects of preparation for constitutional prescribing are
the taking of a complete patient history and careful patient education.
Case-taking
Homeopathic case-taking for constitutional prescribing is similar to that
for acute prescribing, but more in-depth. The initial interview generally
takes between one and a half to two hours. The practitioner is concerned to
record the totality of the patient's symptoms and the modalities that
influence their severity. Also included are general characteristics about
the patient and their lifestyle choices. For example, a practitioner might
ask the patient if he or she likes being outside or if he or she is
generally hot or cold. There is also an emphasis on the patient's lifetime
medical history, particularly records of allopathic treatments.
Patient education
Homeopaths regard patients as equal partners in the process of recovery.
They will take the time to explain the theories underlying constitutional
prescribing to the patient as well as taking the history. Patient education
is especially important in constitutional prescribing in order to emphasize
the need for patience with the slowness of results and length of treatment,
and to minimize the possibility of self-treatment with allopathic drugs if
the patient has a healing crisis.
Homeopathic remedies
The preparation, selection, administration, and storage of remedies for
constitutional prescribing are the same as in acute prescribing. These
procedures are described more fully in the article on acute prescribing.
Aftercare
As in acute prescribing, constitutional prescribing of homeopathic remedies
is followed by close observation of the patient's responses. Based on the
principle of minimal dosing, homeopathic practice does not give a patient a
second dose of medicine until the first has stopped acting. In acute
prescribing, the patient is expected to show some response to the remedy
within hours or at most a few days if the proper substance has been
selected. In constitutional prescribing, the homeopath evaluates the
activity of remedies over a much longer time frame. This is assessed by a
follow-up visit, generally 4-6 weeks after the remedy has been given.
The length of constitutional treatment varies widely, depending on the
patient's basic level of health and his or her previous treatment with
allopathic medicines. Given the homeopathic emphasis on treating the whole
person and tailoring treatment to his or her unique symptom profile, most
practitioners are reluctant to define the length of time needed for complete
recovery. One rule of thumb that has been offered, however, is that the
patient will need one month of treatment for every year that he or she has
suffered from a chronic disorder.
Risks
The primary risks to the patient from constitutional homeopathic treatment
are the symptoms of the healing crisis and possible limitations in the
practitioner's expertise. The complexity of constitutional prescribing
requires homeopaths to have detailed knowledge of the materia medica and the
repertories, and to take careful and extensive case notes.
Normal results
Normal results of homeopathic constitutional prescribing are eventual if
slow recovery from chronic disorders, and/or overall improvement of the
patient's basic level of energy and functioning.
Key Terms
. Aggravation
Another term used by homeopaths for the healing crisis.
. Allopathy
Conventional medical treatment of disease symptoms that uses substances or
techniques to oppose or suppress the symptoms.
. Constitutional prescribing
Homeopathic treatment for long-term or chronic disorders related to
inherited predispositions to certain types of illness.
. Healing crisis
A temporary worsening of the patient's symptoms during successive stages of
homeopathic treatment.
. Law of similars
The basic principle of homeopathic medicine that governs the selection of a
specific remedy. The law of similars holds that a substance of natural
origin that produces certain symptoms in a healthy person will cure those
symptoms in a sick person.
. Laws of cure
A set of three rules used by homeopaths to assess the progress of a
patient's recovery.
. Materia medica
In homeopathy, reference books compiled from provings of the various natural
remedies.
. Miasm
In homeopathic theory, a general weakness or predisposition to chronic
disease that is transmitted down the generational chain.
. Modalities
The factors and circumstances that cause a patient's symptoms to improve or
worsen. Modalities include weather, time of day, the patient's body
position, the effects of foods, and similar factors.
. Repertories
Homeopathic reference books consisting of descriptions of symptoms. The
process of selecting a homeopathic remedy from the patient's symptom profile
is called repertorizing.