Review of the Course Resolving Difficult Cases (1)

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Pure Water, Pure Food, Pure Air and Pure Homeopathy
Nicholas Nossaman M.D., D.Ht.

At the end of March I attended an extraordinary seminar featuring André Saine, D.C., N.D., F.C.A.H. sponsored by the Homeopathic Association of Naturopathic Physicians. The setting, Breitenbush Hot Springs, was homesteaded in the 1920’s, then resurrected by a community of ecology-minded individuals in the 1970’s. It was as peaceful a place as I have ever been. Extremely rustic and simple, in a heavily forested area on the slopes of the Cascade Mountains, the community has its own water-powered electrical system, serves incredibly tasty vegetarian fare and creates an atmosphere which fosters relaxation, focus and renewal. My mornings began with a dawn walk to the small geothermal pool in the meadow to bask and muse and watch the first light of the sun illuminate the misty valley.

The course was entitled, “Resolving Difficult Cases“, and was grounded in basic, original and undiluted homeopathic principles from the source, Hahnemann, the way we first learned them. Friday evening was devoted to discussion of reasons for failure in cases. Inadequate case-taking is the primary reason, and, on Sunday, walking his talk, André demonstrated a complete casetaking in a live consultation with a woman with multiple sclerosis. This process for him is conducted in a meticulous, detailed and thorough fashion, usually taking three or more hours, sometimes five hours or longer in complicated cases. In the consultation, he teases out the details of the unique nature and modalities of each symptom. He exhaustively evaluates striking and peculiar, general and mental symptoms to clarify and confirm them as they are experienced by the patient.

Over the course of the next two days, Dr. Saine presented four cases: The first case was a child with agenesis of the corpus callosum, severe chronic diarrhea and mental retardation with many features of autism. The child, nine and a half years old, was nearly blind, almost totally disconnected from his environment and barely functional when first seen. After two doses of the original choice, the correct remedy, Aloe socotrina, was found, by use of reference to the original provings. Dramatic improvement resulted and the child experienced transformation to the point of complete functionality, suffering mainly from a delay in learning from the first nine “lost” years of his life. It is significant to note that, in this case, the boy had begun to respond initially to Calcarea carbonica, including disappearance of some physical symptoms, some clear improvements in his overall awareness and connection with the world, which would have certainly led me to stay with that medicine longer. The fact that his diarrhea (severe and of nearly two years’ duration) became worse after the Calcarea, rather than better, led André to conclude that there was a better remedy, even though he had responded to it. This was because the diarrhea was a functional and more recent symptom and should go away more quickly after the simillimum. He acknowledged that the boy could have gone on to a better and more functional state if he had stayed with the Calcarea carbonica, but was looking for complete resolution of the problem.

The second case was of a feeble five-year-old boy with primary idiopathic glomerulonephritis (IgA nephropathy) who had persistent gross hematuria and a prognosis for renal failure within 10 years. Again, a long and tortuous course of prescribing of 12 well-chosen remedies showed only marginal success until an acute sinusitis and the awareness of the persistence of the symptom of his constant licking of his lips led to the remedy which transformed his state of health. Numerous careful repetitions of the medicine in ascending potencies over the next year were required in the process. He is now a normally functioning and energetic child, with no sign of the autoimmune disease which threatened to end his life at a young age.

The third case, of severe obsessive-compulsive disorder, was a 22-year-old man who was initially treated by mainstream psychiatrists for psychosis, ultimately with Zyprexa. With partial subsidence of his previous psychotic symptoms, he developed severe obsessive-compulsive symptoms, such as requiring three to four hours to pass a stool, and being unable to bathe because of the hours of ritualistic behavior required to accomplish it. These symptoms, along with his continuing thought disorder, rendered him barely functional and unable to participate in school. Following the early prescriptions by Dr. Saine, his OCD symptoms worsened, and he became violent and suicidal.

Again, Saine’s persistence prevailed over a nine-month period, until study of Baryta carbonica in Hahnemann’s Chronic Diseases revealed the exact symptom experienced by the boy. The symptom in the case was that the patient was always extremely excited to go somewhere (to a wedding, for example), but when it was time to leave, he refused to go. Dr. Gross, one of Hahnemann’s associates, proved Baryta acetica, the symptoms of which are included in Hahnemann’s materia medica for Baryta carbonica (distinguished by an identifying mark) and which included the exact symptom of this patient.

Finally and dramatically, the case began to yield, with aggravations after each successive dose of the medicine, followed by incremental and ultimately remarkable improvement to the point of virtual total subsidence of his OCD symptoms, and his discontinuation of the antipsychotic drug.

The fourth case was of a 22-year-old woman, the daughter of an immunologist who later turned to allergy and ultimately to homeopathy, who suffered with attention deficit disorder, chronic fatigue syndrome, severe environmental allergies and depression. A strong and peculiar symptom of hers was her tremendous fear of and resistance to change, watching the same movie or reading the same book over and over and having strong resistance to all changes in her life, including moving. Curiously, her simillimum turned out to be Aloe socotrina, the same medicine finally required for the first case, this time chosen as the first prescription. A series of ascending potencies over the next year and three-quarters helped her resolve the emotional, energetic, allergic and mental functioning aspects of her pathology.

The cases and their management were impressive in many respects:
1. All of them had severe pathology, and most of them did not show dramatic signs of yielding to the first, or even third or seventh prescription, but André persisted. I found remarkable the manner in which he “keeps his eye on the prize,” knowing the correct medicine is there and trusting the vital force to reveal it so that he can perceive it through continuing diligent study and observation.

2. The cases were not solved with emphasis on mental or emotional or “essence” features, though they weren’t disregarded, but on matching the striking individual symptoms of the patient (often particular symptoms or modalities) with those of the medicine, mostly from the original provings as recorded by Hahnemann, and sometimes those in Hering.

3. Common symptoms were not totally disregarded, but were usually only confirmatory of the correct prescription, at most. The striking and peculiar symptoms, a phrase we’ve heard and read hundreds of times, were the ones which led to the correct medicine, though the totality of symptoms is always considered. The peculiar symptoms are the ones which have no connection whatsoever with the recognized pathology of the disease the patient is experiencing. For example, grinding of teeth at night, a good and solid symptom used by many of us when we find it, was de-emphasized in the first case because it is common in autism and mental retardation. The persistent licking of the lips noted in the second case above was subtle but crucial in leading to the correct medicine. The implication here, of course, is that the prescriber must first know the common symptoms of the disease the patient has, necessitating an awareness of pathology and disease-presentations, a substantial task in itself.

Also we must use our common sense and experience in determining whether a symptom really is striking and peculiar, when it seems to be so. For example, the symptom “excitement during thunderstorms” seems striking and peculiar, however it is relatively common, as is the symptom, “unable to urinate if someone is nearby in the bathroom.” These are both only relatively uncommon (a straw vote among those attending the course showed that 50% had the former symptom, for example).

4. Dr. Saine’s case-taking is the most thorough and detailed I have ever seen. He literally leaves no stone unturned and persists in gathering information until he has chosen the medicine on the spot, while the patient is still in the consulting room. He makes liberal use of computerized repertorization.

He spoke of many other things during the course of the weekend, and I’d like to include some of them:
André emphasizes the significance of acute illnesses in leading to the cure of chronic illnesses. For example, chronic cases which are defective or one-sided can be started toward resolution by precise prescribing in the case of emergence of an acute illness in the patient, when it finally occurs, and he asserted that half the time the simillimum for the individual can be found through careful analysis of the symptoms of the acute.

He asserted also that the correct remedy for the back pain symptoms of the patient is the correct remedy for the whole patient, 80% of the time.

Sometimes patients can have idiosyncratic responses in that they respond better and longer to a certain potency of the correct remedy during a long course of treatment with the same remedy and this will happen each time this potency is started anew, even if it is given years later. Dr. Saine suggests giving the same medicine in the same potency two or three times in a 24-hour period if the patient hasn’t responded to a single dose, and if one is convinced it’s the correct one. Also, one can give two or three doses of the medicine if the patient is responding less to a series of single doses with the same potency, including in times of more stress. In addition, his observation has told him that patients will often respond better to the 50M potency than to any other when the medicine has a high degree of similarity, and that the response will be the same when it is given again years later. Also, if the choice of medicine is correct, the second dose repeated after a relapse should elicit a stronger and longer lasting response. If it doesn’t, it is likely to be the wrong choice.

He emphasizes that homeopathy is based on laws of nature and can promote cure in situations when nature can reverse the pathology. Functional symptoms (such as rashes, local inflammatory processes) should respond quickly to the correct remedy, more structural problems (ulcerations, biochemical abnormalities, neoplastic changes) will be slower to change, and scarring will change little or not at all, for example in long-term cases of multiple sclerosis, Parkinson’s disease, fibrosis and scarring of joints from rheumatoid arthritis, etc. Dr. Saine uses a form of electrotherapy, developed in France and utilized by his father in his many decades of medical practice, to reverse CNS scarring in multiple sclerosis patients. He has apparently had substantial success with this, following completion of the extent of the cure able to be effected by nature and homeopathy.

In accord with Hahnemann’s teachings, he avoids intentional palliative measures, such as herbs, salves, analgesics, etc. which serve to blunt the full expression of the vital force and thereby to obscure the clear emergence of prescribing symptoms.

He doubts the medicine is correct if it doesn’t elicit an aggravation within a few days, although the aggravation can be subtle and/or brief.

He says that our weakness makes us unable to practice homeopathy correctly and thoroughly, and encourages us to “let homeopathy make us strong” by practicing it correctly, through pure observation and prescribing using the pathogenesis of the original provings and reliable confirmed cured symptoms.

In reading this, we see utilization of basic homeopathic principles, nothing fancy. What makes André Saine’s work and teaching different? Why does he aid in the cure of more serious pathology than most other homeopathic prescribers? The single most important answer is unswerving dedication to the original principles and utilization of the original proving data, as elucidated by Hahnemann and his followers. Secondly, he is singularly focused on the goal of helping the patient heal, by way of pure and complete discovery of the symptoms of the patient, scrupulous study of the striking and peculiar symptoms of their case and meticulous matching of those symptoms with the reliable materia medica. Third, he is relentless in his pursuit of the simillimum, while acknowledging that he doesn’t always find it. He is undaunted by palliative or absent responses to medicines he has chosen, and continues to comprehensively reassess the symptoms of the patient until he finally understands what the vital force of the patient is trying to tell him. He is passionate, and seems to subordinate his ego to the task at hand: to help the patient in their healing. This was abundantly clear in his live case-taking. He is extremely focused and directed, and he sets a blistering pace in his pursuit of the practice of pure homeopathy.

As I’ve said, André emphasizes pure observation and sound conclusions from scientifically valid data (reliable materia medica), and, in following his logic and decision-making process through the weekend, I’m convinced that an additional element of intuition and inspiration plays a role in his work. This is not difficult for me to assimilate, because good science is almost always accompanied by an intangible measure of art, as I see it.

Saturday night Dr. Saine presented a slide show of the professional life of Adolph Lippe, who — like André Saine himself — was unbending in the application of the basic principles of homeopathy as illuminated by Hahnemann, and eminently successful in his application of the art and science. His record of successes in devastating infectious disease epidemics, for example, was astounding. Arguing against the proposed opening of the American Institute of Homeopathy to all applicants, Lippe said, “There is no freedom when it comes to following a law of nature.” As Lippe was leaving what proved to be the last meeting of the International Hahnemannian Association he would attend before his death, he was asked by the chairman of the meeting if he had any words before he departed to catch his train to Pennsylvania. He replied that he felt great comfort that homeopathy was now in good hands and would continue to flourish.

André Saine challenges us to use the principles which we already know from the Organon, in a complete and comprehensive fashion, to solve our cases much like Sherlock Holmes, using sound conclusions based on pure observation. In that way, this unique and wonderful art and science will indeed flourish. The words he said which seized my attention most of all were, “Let nature guide you”.

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