Blog - Shilpa Bhouraskar

How did Kent manage his followups?

The final assignment

I have been busy discussing the last assignment with my class this year. This is one of my favourite assignment where my final year students present homeopathic case studies based on a strategy of their choice. And right now I have just finished reading a long email from one of my students about this assignment.

She had been looking at some followups of Kentian cases from a journal because her presentation was on Followup and Secondary prescriptions in long term chronic cases.But somehow she was very frustrated. Because what she learnt in theory in the Organon was not exactly what she could see happening in the actual followups of those clinical cases.

Hence she had lots and lots of questions on repetition of the medicines, making changes in prescriptions when the picture was shifting and so on...

Learning from an actual casestudy.

Now the reason I love this assignment is because I am personally a big fan of learning strategies from real case studies rather than a theory book. This is exactly how I learnt my homoeopathy. It was either from observing patients in a clinic or looking at actual cases studies or lesser writings of Boenninghausen, Boger, Kent, Nash and so on. I admit I learned more about real Hahnemannian homoeopathy from his Paris cases rather than the Organon…

But learning from cases is a bit different than learning from an actual book. There is no direct information. You need to read in between the lines and scan through a lot of cases to find the pattern behind the process. So no single case can tell you the whole story.

So in this video I want to share learning from cases.To help my student in the process I have chosen a long term chronic case by Kent himself. And I am going to walk you through the case and share my reasoning and insight for every action that he takes during the followup management.

Now while I do not claim that every reasoning or insight I share is exactly what he had in mind and nor do we have an answer for every decision he made, but I am sure this case will provide you much more clarity on the practical aspect of the Kentian followup process and provide immense food for thought that no theory book can ever do…

So to simplify this casestudy, I have broken the followups and created a flow chart for this case. The symptoms are all in blue, the prescriptions are in red and my insight and reasoning is in black.

So this was my take on certain aspects of the case that I found interesting. But I would love to know what are your thoughts about this case. What do you think about his decisions?

Please share your inputs in the comment section below..

Discussion:

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It is interesting to note the perhaps unusual potencies that he used like 71M etc. I wonder was it intuition that made him use these potencies or just that through experience he found them to be the best. Normally I may use 1M;10M;CM:MM potencies and find those ranges quite okay so it has left me wondering about his thoughts when prescribing those potencies. For me changing the remedy is quite common place when there is a change of symptoms as this is what the body is dealing with at that time. It would also be interesting to know if the patient had a return of symptoms that she had had before her arthritis started like the stomach upsets etc.

Yes you are right Leigh. These are unusual potencies. But what is more interesting is that the type of remedy response was not particularly different than regular potencies. I wonder if he found the pace of remedy action or rate of amelioration was faster for these specific potencies than regular ones.
Lots of food for thought

Thank you Shilpa. What a nice gift to homeopathic community on this auspicious day of Festval of Lights. Happy Diwali Shilpa.

Thanks Prithwish. Wish you a joyful Diwali too.

If any one doesn't know what Diwali is check Utube "the president observe Diwali"

thanks Shilpa more learning,of actual cases.Potencies were unusual.

What is the word you use for placebo sag something and what did he use. This is the first time I hear of such high potencies and they worked very well. the highest I have use is 10m.

It is SL Irene.(short for Sacchrum Lactis or plain milk sugar powder).

In UK we just use the term Sac Lac or to write on a patient's packet Esselle !!!

I wonder if this case is where the triad SCalLy (Sulphur,Calc, Lyco,) originally came from?
How on earth is he mange to run up such high potencies? Did did he have some kind of machine by then? It would take days to do.
Brilliant case and so easy to follow. Thank you.

Thanks Rochelle. With your question on how he managed to create those high potencies? He used the centesimal fluxion machines. Probably it also explains why he had such odd potency numbers because of the nature of these machines. You will find some information here http://www.homeoint.org/morrell/articles/pm_kent.htm

Funnily enough after I wrote that comment I started writing a review of Farokh Masters book "Understanding Posology in Classical Homeopathy (revised 3rd edition)" for Hpathy.com and it explained all about these machines. :)

Thanks Shilpa for taking all the trouble to go through that Kent case and for giving us the http://www.homeoint.org/morrell/articles/pm_kent.htm link. Your analysis was great and Peter Morell's article also was very interesting and explained many things for me; I mean how it came about that certain dogmatic ways of prescribing came to be laid down by certain of the homeopathic Great Men, each of whom doubtless had convinced themselves that they had worked out 'the best way'!

It may well be that Kent's emphasis on those extraordinarily high potencies gave his allopathic opponents an extra argument with which to argue that homeopathic remedies couldn't possibly 'scientifically' have any physical effect on a patient and therefore couldn't be the reason for any cure which took place. However Rockefeller and Carnegie's dasdardly conspiracy, with the connivance of the AMA elite, to use their millions to ensure American universities and medical schools eventually taught an exclusively allopathic approach to medicine whose doctors would essentially become their willing pharmaceutical drug pushers, would one feels sure have succeeded even in the absence of that 'extra argument'.

In my own homeopathic training I quickly became a fan of Compton Burnett's different approach. He of course also was generally speaking a 'single remedy at a time' prescriber as far as I can make out from reading The Best of Burnett etc, but having experimented on myself with many herbal tinctures through the years, and seen their regular cures, within 5 - 15 minutes sometimes, of a wide range of ailments, I could identify easily with his regular prescribing of tinctures as well as homeopathic dilutions.

As far as I know all or nearly all the UK homeopathic training colleges encourage to a greater or lesser degree the 'try and find the simillimum (single) remedy. Use some rules of thumb for choosing a potency you feel appropriate. Prescribe it and wait to see the result for a week, month' approach.

This guidance however gives what I would term 'the intellectually satisfying approach' because if one happens to hit immediately on the one remedy that cures the client in short order, the prescriber gains the intellectual satisfaction of knowing that that precise remedy was absolutely right for the totality of the symptoms he/she had observed in the patient.

However, if that approach fails to achieve satisfying results on the first prescription, what has one done? One has wasted time in helping the client towards the goal of complete cure. So, over the years I'm afraid that the pure Hahnemannian single remedy prescribing approach has been set aside and combination prescribing, often taking the form of Narayani remedies, has been adopted instead, alongside single organ support homeopathic remedies and tinctures where they seem indicated - and nutritional advice! Oh, and I also rely a lot on dowsing for a remedy when faced with too many choices. That really seems to work well, at least for this prescriber, though having said that when intuition just takes me I go with a single remedy and wait and see for a few days whether it is working up to expectations. I have sounded out my bi-monthly homeopathic group and many are also prescribing combination remedies from time to time, and a few use the odd tincture. There are many ways to the top of the mountain :)

Thanks Tim. It is great see you share your experiences with different approaches from organ support to dowsing. As you say there are many ways to the top and it is all about finding the most suitable way for the patient in front of us...

In Hahnemann's 6th edition of the Organon, where he introduced LM potencies, he stressed the importance of changing the potency with each repetition of the remedy and that NOT to do so was actually harmful. This has made me nervous about repeating dry doses but I see how in Kent's case there is no problem. What are we to believe?

Thanks Riitta. Yes we see that there are many roads to the top of the mountain. So we listen to all these practitioners and we learn what works best in what situation and in which patient. And finally choose the best individual strategy for the patient in front of us. You will find a lot of resources in the homeopathy network that help you in the process.

So who do we believe? We believe only what our patients and our own clinical experience tell us.