ART OF PRESCRIBING ON BASIS OF OBSERVATIONS

1. C.M.E. PROGRAM
ORGANISED BY
DEPT. OF AYUSH
ON 12TH FEB. 2014
PRESENTATION BY: DR. BIPIN
JETHANI
Reader, Department of Organon of Medicine,
Nehru Homoeopathic Medical College & Hospital,
New Delhi

2. IMPORTANCE
OF
OBSERVATION
IN
HOMOEOPATHIC
PRESCRIBING

3. CLINICAL EXPERIENCE OF
BOENNINGHAUSEN
…..at present there is in this
region a pernicious whoopingcough among children…………
the
sick
children
were
characterized by a remarkable
puffiness and swelling, not so
much of the whole face as
especially above the eyes,
between the lids and the
brows, which was frequently
like a thick little sac,….
BOENNINGHAUSEN’S ORIGINAL PREFACE
–

4. CLINICAL EXPERIENCE OF
BOENNINGHAUSEN
…………….a
symptom
which,
hitherto, has been observed
only in kali carb., and in fact
from the beginning of the
epidemic, this has been the
only quick and permanently
curative medicine. Only in the
latter period of the disease,
there appeared another form
characterized by cold sweat on
the forehead during vomiting,
which called for veratrum alb.

5. CLINICAL CASE OF J.T. KENT:
Lesser Writings Of J.T. Kent
• A case of Epithelioma of several
years standing on the left upper
lid reported in spring season
with fissures and bleeds. He
observed the lesion had a dark
red hue.
• No constitutional
obtained.
• Lachesis
months.
4m
cured
symptom
in
six

6. CLINICAL CASE from
koppikar’s clinical experiences
One day we were walking around road at
about 9 am and my uncle was surprised to
hear lot of loud talking going on behind
partition, which seperated living quarters.
We peeped in and saw Krishna lying on
mat, shivering and talking in delirium.
My uncle sent him Podophyllum 200 to be
given every 2 hourly and he never got
another chill paroxysm.

7. Case of K.C. Bhanja
• K.C. Bhanja was called upon to treat a case
of hyperpyrexia in a child. He found the
child to be playful even in such a state of
high fever. He simply touched the tip of
nose and found it very cold to touch.
• He prescribed ARNICA MONTANA 200/
dissolved doses and the fever came down in
just 3 hours.

8. CLINICAL CASE of dr. l.m. khan
A anamnesis of comatose patient (?bacterial
meningitis) revealed that he developed fever
after taking very cold water coming from lot
of physical exertion in sun. He had
convulsive movements and twitchings
around lips with hyperextension of foot.
This observation was found in BBCR in
Dulcamara which was prescribed in 6
potency with marvellous results

9. ASTUTE OBSERVATION:
KEY TO PRESCRIBING
The stalwarts of homoeopathy relied
upon their power of astute
observation and their wisdom of
Materia Medica, which often led
them to the similimum in shortest
period of time.

10. ‘…….. In order accurately to perceive
what is to be observed in patients, we
should direct all our thoughts upon the
matter we have in hand, come out of
ourselves, as it were, and fasten
ourselves, so to speak, with all our
powers of concentration upon it, in
order that nothing that is actually
present, that has to do with the
subject, and that can be ascertained by
all the senses, may escape us.’
SAMUEL HAHNEMANN: THE MEDICAL
OBSERVER
Lesser writings of Hahnemann

11. IMPORTANCE OF OBSERVATION
IN CASE PERCEIVING
‘………... The duty of the observer is only to
take notice of the phenomena and their
course; ……………, not only that nothing
actually present escape his observation,
but that also what he observes be
understood exactly as it is.’
THE MEDICAL OBSERVER
Lesser writings of Samuel Hahnemann

12. A WORD OF CAUTION:
Concept of ‘GESTURE CLUSTER’
• Nonverbal cues occur in what is called a
“gesture cluster” – a group of movements,
postures and actions that reinforce a common
point.
• Similarly, single observation (that too if not
unequivocal) in clinical practise should not be
the basis of prescribing but rather should serve
as a clue in the search of similimum which
should be selected on basis of ‘cluster of
observations and subjective concomitants’.

13. CLINICAL CASE
STUDIES WHERE
OBSERVATION HELPED
TO REACH TO THE
INDICATED MEDICINE

14. A KNOWN CASE OF VITILIGO
A 48 yrs old male patient,
known case of diabetes
(controlled on OHA) had
reported with c/o hypopigmented spots on face, neck
and upper extremities.
ON OBSERVATION: The patient
had marked pouting lips,
broad nose with slightly
depressed nasal septum.

15. Case analysis
• Desire
for
salty food.
• Thirst
increased for
cold water.
• Sleep
disturbed
in
• Patient
suffered
from
recurrent
headache which
he showed was
in a line over
the
vertex

16. SIGNIFICANT FEATURES OF THE CASE
Facial characteristics
Tendency
to
LINEAR
HEADACHE.
Patient
strong
further
Family
revealed
history
alcoholism and liver disease
of

17. BEFORE AND AFTER PRESCRIPTION OF
SYPHILINUM 200/ UNIT DOSE,
followed later in 1m potency
PRE-TREATMENT
POST-TREATMENT

18. A 32 yr. old male patient, mesomorphic build,
wheatish complexion with dark blackish
mole of left cheek reported with complain
of localized alopecia of scalp region.
His other complaint was pain in knee joints
especially in cold weather
>: hot fomentation

19. CASE ANALYSIS
• The complaint of hairloss had started 2 years
back with no ascertainable precipitating
etiology. The hair loss had gradually increased
and was more marked in rainy weather.
• Past history revealed h/o severely erupted
chicken pox at age of 21 yrs.
• CHILLY PATIENT

20. • ‘Hitherto we have had only
one remedy, so far as I
know, namely, Sepia, which
corresponds with the sores
on the upper side of the
joints of the fingers and
toes…………………..
Concerning the Relative Value
of
Symptoms
and
ERUPTIONS ON THE Something about Borax
SMALL JOINTS OF
HANDS
(LESSER
WRTINGS
BOENNINGHAUSEN)
OF

21. BEFORE AND AFTER PRESCRIPTION OF
SEPIA 200/ repeated at infrequent intervals

22. A Contribution to the Judgement Concerning the
Characteristic Value of Symptoms
(LESSER WRTINGS OF BOENNINGHAUSEN)
‘Every Homoeopath knows the efficacy of
Sepia in these ulcers of joints, which have no
otherwise distinguishable features when this
remedy is taken internally without any
external medication it will have a sure effect.
Medicines which correspond to similar
ulcers on other parts of the body in such
cases are utterly useless.’

23. • A endomorphic corpulent female reported with
c/o erythematous scaly eruptions on both feet
(medial aspect of both feet ------ SYMMETRICAL
LESIONS)
• The other noteworthy observation in this case
was COLD SWEAT OF THE PATIENT.

24. • On interrogation, patient revealed marked
desire to sleep on abdomen.
• The position during sleep coupled with
observation of SYMMETRICAL ERUPTIONS
& COLD SWEAT LED TO PRESCRIPTION
OF THYROIDINUM .
• The patient is still under treatment and showing
improvement in her skin complaints
PRESCRIPTION OF THYROIDINUM

25. A CASE OF ADHD
WITH STUNTED GROWTH

26. A CASE OF ADHD
WITH STUNTED GROWTH
• The mother of this 6 year old child
complained of his utter inability to
concentrate with extreme hyperactivity. He
was very destructive ---- would throw things
and scratch others. He was unmindful of
putting
himself
in
dangerous
situations………..s/o ADHD (mixed type)
• STUNTED GROWTH

27. ASYMMETRY OF
BODY PARTS

28. DIAGNOSED AS
A CASE OF
SILVER - RUSSEL
SYNDROME
BY WELL KNOWN
PEDIATRICIAN

29. SILVER-RUSSEL SYNDROME
• After many failures; this observation of
pediatrician
(ASYMMETRY
AS
A
PATHOLOGICAL GENERAL) along with his
destructive behaviour and family history of
craving for alcohol (found later on enquiry) led
me to prescribe SYPHILINUM 200 in weekly
doses.
{ASYMMETRY is a marked syphilitic taint}
• The result has been very encouraging with
hyperactivity reduced and child’s attention span
increasing.

30. A CASE OF
ADENOIDS
• This patient was prescribed FLOURIC ACID in LM
potencies on basis of his SYPHILITIC FACIAL
FEATURES (BIG EARS AND EYES WITH
DISPROPOTINATELY LARGE FACE) coupled with the
concomitant of his desire to bathe in cold water even in
winters.
• He showed marked symptomatic improvement (recurrent
URTI, nasal blockage and growth) within a span 5-6
months and is still under treatment.

31. PRESCRIBING CLUE :
CHARACTER OF TONGUE
ONE SIDED COATING OF TONGUE
RHUS TOX, DAPHNE
PARALLEL FISSURES IN TONGUE

32. OBSERVATIONS DURING COUGHS
NAT.
MUR
Flow of
tears with
cough
SANG.
ALLIUM
CEPA
Grasps
CIRCUMSCRIBED
REDNESS OF
CHEEKS WITH
COUGH
Cough ends
in a sneeze
throat while
coughing
NATRUM
SULPH.
CAN.
SENEGA
ARNICA
Rattling
cough with
desire to
hold chest
with hands
MONTANA
WEEPING
JUST BEFORE
OR WITH
COUGH

33. IMPORTANCE OF LOCATION
ILLICIUM
PIX LIQUIDA
CHENOPODIUM GLAUCI
DULCAMARA
HEPAR SULPH
SEPIA, BORAX
ANACARDIUM,
MURIATIC ACID

34. CASE OF
RECURRENT HEADACHE
• A 36 year old male patient complained of
recurrent headache in right temporal region
accompanied with thick yellow nasal
discharge since 8-9 months. The pain was
worse in a warm room and better in open air.
• He was not better even after taking lots of
homoeopathic medicines

35. CASE OF
RECURRENT HEADACHE
• The strange peculiarity in his case was THIN
NECK ………………….. A very important clue in
prescribing of NATRUM MUR.
• I prescribed him Natrum mur. in LM potencies
and he showed remarkable improvement in his
c/o headache.

36. CASE OF VITILIGO
IN A 3 YEAR OLD CHILD
• A 3 yr. old girl presented with hypopigmented
macules on her right hand. She had taken lots of
treatment but the hypo-pigmentation kept on
increasing in size.
• She was very active child.
• H/o Delayed walking (started at age of 16
months)

37. TEETH DECAY AT EDGE
OF GUMS AND BREAK OFF

38. PRE-TREATMENT
POST TREATMENT
THERE HAS BEEN MARKED REDUCTION
IN HYPOPIGMENTATION AFTER
PRESCRIPTION OF SYPHILINUM 200/ 1
DOSE REPEATED AT VARIED INTERVALS

39. Case of URTI (?VIRAL EXANTHEMA)
A 28 year old patient reported with the complaint
of low grade fever with erythematous rashes
(bright red blotches) on neck, upper extremities
especially hands since 3 days. Fever was
accompanied with slight pain in throat with
slight difficulty in swallowing. On observation,
the tonsils and surrounding fauces showed
extremely bright red hue.
Fever had no particular pattern. There was
significant prescribing clue…???????????

40. STREPTOCOCCINUM IN A CASE OF
VIRAL EXANTHEMA
ERYTHAMATOUS BLOTCHES
ESPECIALLY FOLDS OF SKIN
BRIGHT RED HUE OF FAUCES &
TONSILS WITHOUT MUCH PAIN
STRAWBERRY TONGUE

41. ARNICA MONTANA IN BOILS
• Tendency to SMALL, PAINFUL BOILS,
one after another, extremely sore.
……….H.C. Allen’s Key notes

42. PERCEIVING ARNICA FROM MATERIA
MEDICA PURA
396. On the side of the nape a pimple that causes
shooting and ulcerative pain when touched.
(This kind of pimple, so painful when touched, with
an inflamed red areola, which arnica produces
specifically, bears the greatest resemblance to
the
well-known
boils
(furunculi),
and
consequently these are homoeopathically cured
by arnica, and in persons who are frequently
troubled with them are prevented by the use of
arnica, and their future occurrence warded off, as
experience has taught me.) (aft. 48 h.).

43. BOENNINGHAUSEN ON IMPORTANCE OF
OBSERVATION AND VALUE OF
CHARACTERISTICS
‘Ought, we not to be able to introduce
something similar in homoeopathy, so as to
considerably lighten the work of incipient
(perhaps also of older) homoeopaths, and
to simplify the selection of remedies
without, in the least endangering their
sureness, but rather securing it? I believe
so. Yes!’
LESSER WRITINGS OF BOENNINGHAUSEN

44. Good judgement comes from
experience, and experience
comes from bad judgment.
…………..Barry LePatner