Shouldn’t There be a Dog Barking

First published in Homeopathy Today, the magazine for the National Center for Homeopathy.

I recently met a woman at a dinner party whose eyes grew large when she heard I was a homeopath. “I just had my first consultation with a homeopath for a terrible sore throat.”

“Ah,” I replied, “and how did it go?”

She proceeded to go into quite some detail about her terrible strep throat, and then went on to describe the homeopathic experience–from her own perspective–the viewpoint of the patient.

sobering … and instructive

I find this amusing at times and sobering at others, and always instructive. I held my breath … hoping that this was going to be one of those “incredible but true” experiences. It was. Phew! I felt pleased for my colleague (the homeopath concerned) and for homeopathy in general, and made so many interested noises that I heard the whole story. Not that my new friend needed much encouragement! She was bursting all over to spill her beans. The experience had been so unusual for her, so different from any other medical consultation, that it was plain to me she was still trying to work out where it fit into her understanding of medicine and healing in general. She admitted to telling her story to anyone who would listen.

She talked about how her homeopath had asked a great number of questions and how encouraging it was for her that the practitioner was so very interested in all of what she was experiencing in her whole person, and not just the sore throat. She was amazed that the homeopath could somehow make sense of the increasing quantity of symptom data. She was impressed at the way her homeopath homed in on her symptoms, asking general questions and then becoming more and more specific. And finally she was slightly spooked by the accuracy and specificity of some of the questions. “She asked me if I liked tight things around my neck. I hate them. How did she know to ask that? And then she asked me if I dreamt of dead bodies. Is she psychic or what?”

I smiled, knowing that the homeopath had identified Lachesis as a possibility and was asking specific (keynote) questions to confirm it.

all-knowing … and all-seeing

How easy it is to appear to be all-knowing and all-seeing once we can identify the constitutional remedy! (i. e., the remedy that fits that person in sickness and in health) This can be a tall order, especially with patients who are chronically ill, who have had many years of suppressive treatments and so on. But it is fun to ask about the craving for vinegar in those who plainly need Sepia or about the hot feet that are poked out of bed in those who are screaming out for Sulphur. I always explain what I am doing at this point (when I am with a patient) and demystify the process (having enjoyed it for a moment or two) so that patients don’t make the mistake of thinking I am some sort of shaman.

Anyway, back to my dinner party. I sat there munching on my salad and was about to talk about the work that we homeopaths do as being something akin to a medical detective when my fellow diner leaned forward with Great Intensity emanating from her every pore and said triumphantly, “You guys are just like MEDICAL DETECTIVES.” I choked a little, as it is the Lachesis patient who is clairvoyant and who can take words out of other people’s mouths–although in this situation she was merely stating the obvious!

I resisted the urge to do a jig on the table because this is what I love most about my work: hunting for clues to make sense of a picture that has yet to be found! And I can become really enthused when others get excited about it too!

“So what happened next?” I asked, anxious to hear the outcome. “She gave me snake venom,” she said proudly. (Of course!) “And within three hours the pain subsided. I had had pain for two whole weeks. Isn’t that incredible? What is homeopathy? How does it work? Could I be a homeopath?” She deluged me with questions …. it felt like divine retribution for all the questions I ask of patients. We had a fine old time together.

empty vessels

Her story reminded me of another patient, a twenty-six-year-old computer consultant who consulted me some years ago for a sore throat. I gave him Lycopodium because his symptoms, although paltry, seemed to fit Lycopodium well. His pain was right-sided, worse on waking in the morning and better for hot drinks. The Lycopodium didn’t help at all, and he rang me four days later from his Sick Bed saying that he was going to get antibiotics in the morning if he wasn’t any better and did I think there was any point in trying another remedy. I thought there was a point and tried to elicit some symptoms. It was difficult. This is one aspect of my work that I can find frustrating. It is hard for patients to know what we need to know in order to prescribe. Even those who have studied homeopathy can find their brains are empty vessels when it comes to reporting symptoms in an acute illness.

He said it felt like he was swallowing over a lump, and the pain had moved to the left side. He could not give me any more information. His throat still hurt especially when he swallowed (big deal … that is the commonest symptom of all). It was still worse in the mornings on waking and better for hot drinks. He felt hot and sweaty.

I tried to get more information and failed. I had no obvious cause (etiology) and only boring, old common symptoms which meant that I had a big group of polycrests to choose from. I decided to give Sulphur because it was the only remedy that covered each of his symptoms (a totality prescription) and offered to drop it off on my way home.

He stood in his doorway, a sorry sight in his crumpled pajamas, and as he reached out for his remedy I noticed a packet of chips in his other hand. I snatched the remedy back and asked him whether he was eating the chips. “Sure,” he said. “They’re the ones I like. This is my fourth bag today.” There was definitely something wrong with this picture.

no woofing

Sherlock Holmes was once described as someone who noticed when a dog wasn’t barking. And when I am working at my best there is a way in which I perceive a space where there should be a “dog barking.” Something is wrong, is missing, is out of place. Something doesn’t add up, something (a dog) isn’t barking.

Patients with sore throats do not generally eat chips (or toast or other hard foods). What an odd thing to do, to eat something rough and hard when your throat hurts so much. This doesn’t add up. Unless they need Lachesis.

Lachesis is for sore throats which are worse in the morning (all their pains are worse after sleep). The pain is aggravated by empty swallowing (including saliva) and drinks (especially warm drinks). And there is a constant desire to swallow because it feels as if there is a lump in the throat and swallowing helps this feeling, but only temporarily. The pain is bad and has the unusual (characteristic) symptom of being better for eating (and swallowing!) foods, especially hard foods such as toast. This is because although light pressure (e. g., liquids) aggravates, hard pressure ameliorates. I decided to give him Lachesis even though his pains were better for warm drinks because the characteristic symptom was so strong and I had a couple of confirmatory keynotes to reassure me (the lump sensation and the aggravation after sleep).

The remedy worked like magic. He was back at work the next day. Several months later his wife consulted me in a flood of tears and told me her husband had left her unexpectedly for a friend of theirs with whom he had apparently been having an affair for quite some time. I turned to the rubrics “Adulterous” and “Deceitful” in the Complete Repertory (MacRepertory) and Lachesis was listed under each one. I guess I got lucky with the chips. There is no doubt that this was the right remedy for his acute complaint but the situation raised the question of whether Lachesis was really his constitutional remedy. If it had been the right one shouldn’t he have stayed with his wife? Or maybe he was able to leave his wife because the action of the remedy (the correct stimulus to his vital force) gave him the courage to come clean about his affair. Of course we shall never know, but I am not sure that homeopathy is as powerful as we would like to believe it can be. I think it CAN help people to take actions that are already forming inside of them, or give the additional push needed by the vital force to make a particular decision. I don’t think we can make people do the right (or wrong) thing simply by giving them a homeopathic remedy. And surely it must be unwise of us to judge this anyway. But this is another issue that deserves much more space and one I shall come back to at some point in the not too distant future.

patterns & pictures

The hard part of being a medical detective is when I can’t find a pattern, when I can’t identify a whole picture that makes sense, when I can’t match the information the patient gives me with information that is known to me from the materia medica, and when I can’t perceive the clues I need to do my job. It is hard because it makes me feel helpless, and I struggle when I am under this type of pressure not to get cross with my patients for not giving me a clear picture … one that can enable me to help them so we can both feel better!

It is rewarding to be a homeopathic Sherlock Holmes on a daily basis, even though there are times when I never find those blessed clues and never perceive the whole picture. Sometimes I may solve “who dunnit” but I may not identify the “motive” … and in some cases that detail is revealed in the fullness of time.

Copyright ©2018 Miranda Castro