Blog - Shilpa Bhouraskar

Synthetic Prescriptions

Introduction

I was first introduced to synthetic prescriptions in my second year of homeopathy school around 1995 when we learnt the remedies in the mineral kingdom as groups.
It was taught by our well known HOD of materia medica who was a “classical” Kentian homoeopath.
We studied various groups of elements such as the Natrums, Calciums, Potassiums, Bariums etc as well as the Carbonicums, Muriaticums etc with respect to their physical and mental characteristics. This was based purely on materia medica and clinical experiences.
The purpose was that when these group symptoms were elicited in a clinical case, we would not just look at the main polycrest that came up in the repertorization grid but also look at the lesser known salts that did not show up as easily. This would also ensure that all these minerals were equally emphasised during the final prescription.

I was fascinated about understanding remedies in terms of groups. It also meant that if we knew the group symptoms well, and found a combination of these in our clients, we could combine two elements together and prescribe a virtually unknown salt to help our patients.
This was way before Jan Scholten and Sankaran's books or lectures on minerals and elements were introduced to us. It happened much later during our internship and early practice.

The understanding of this concept has now been well established in the last decade with the approaches at Stage 4.
Having said that I personally have found group analysis to be an extremely useful approach at Stage 3 when using a Kentian Analysis. (For more information on stages in homeopathy please read the free ebook on this page - The Quest for Simillimum-an overview.)

How to avoid pitfalls when prescribing a synthetic remedy at Stage 3

As much as this approach is fascinating, there are chances that one can go completely off track. The common mistake I have made in cases that have failed is when I have completely focused only on the mind symptoms to prescribe the remedy. Using only mental symptoms can polarise a case and it is quite easy to lose balance of the totality.

I remember learning some great tips from some excellent synthetic prescribers in our college OPD to prevent pitfalls in synthetic prescriptions.

I will try and share some really practical tips here -
To start with it is not a mathematical combination of two elements. Although you find themes of each element group the key to a good prescription is to find at least one key symptom that is a unique representation of the whole compound.

I remember the first case when I had observed this synthetic approach being used in my hospital clinic as an intern.
A lady in her late 20's came with cystic acne and menstrual irregularities.
We took her case. Her acne was around her chin area. They were hard and inflamed. She was overweight, perspired freely, sensitive to cold draft and complained of menorrhagia. She was still studying and was dependant on her parents and sisters. She was extremely anxious and fearful if something were to happen to them.
Not surprisingly the remedy that came strongly in the repertorization was Calcarea Carbonica.

When we came back to the OPD, the consultant asked her about her childhood. She was the youngest of three sisters. She mentioned that she was constantly being compared to her sisters and envied them. She struggled to keep up with their achievements to get the attention of her parents. She strived hard and remained at the top of her class for many years. She wept while narrating that she was pursuing a Ph D and even until today her parents have never really appreciated her for her pursuits.

The prescription she got was Calcarea Sulphuricum. One of the key symptom that confirmed this salt was Lamenting that she was not being appreciated.

She did very well on this remedy.

Today when I work at Stage 3 using a Kentian approach and use synthetic prescriptions the best way to confirm it is to differentiate it thoroughly with the related polycrest remedy. Looking for the key qualifying mentals from the provings is a good starting point. But if the proving is patchy as is the case in some of the lesser known remedies, then I look at the sphere of action or the organ of affinity of that remedy. Even in a patchy proving the main affinity will always come through in the toxicological or clinical information and I ensure that it matches with our main complaints.

Let me give you an example of how you can do this through this video from my own clinical case of a lesser known remedy.

Hope this helps you with your own cases.
I would love to hear about your own cases and how you use this approach in your own practice.

Discussion:

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Loved this case!

One thought came to me as you were describing his story of being so deeply hurt by his friends, and that was "Nat-mur". I'll tell you why, and why I though this hurt might have actually been the aetiology:

I had an aunt, who was the bane of our lives, a real nightmare.
She was always thinking the worst of us, suspicious, closed, bitter and prickly.

Her story was this: When she was was a young women of Jewish extraction in Germany, the nazis came to power, and suddenly all her friends and acquaintances turned against her. A huge betrayal.

The difference in her, once I cottoned on and gave her Nat-mur, was striking.

So now I consider the grief of a Nat-m aetiology to be not just that famous one from romantic disappointment, but also from perceived betrayal.

I so enjoyed the way you presented this case, and how it worked out to the Nat-ars with those physicals - isn't it just such a buzz when you look in the book and just about drop it because there is your case!

Thank you so much for your generous sharing: Such great learning!

eva

Thanks Eva for sharing your experience. That was a wonderful insight into Nat Mur.

Thank you Shilpa, this a great way to show how to look for a remedy, and as well be patient with the patients.

Thanks Shilpa - you explain the homework in such a clear and structured way. Thanks also for your comments about Nat Mur and betrayal Eva. Now that I am reflecting, I think Betrayal is perhaps the most common distressing emotion that comes my way - and one of the hardest for the person to resolve.

Nice Representation, Dr Shilpa,

Thanks Shilpa,
Excelent analysis & presentation from your end & thanks to Eva for sharing of her topics

Dr.Sanjiban Kuri

Hi Shilpa,

Very well presented case - Thank you for sharing!

Thanks Joanna :)

Hi Shilpa,

Did his sleep improve on the Natrum ars? In my practice, sleep improvement has been difficult to achieve in some cases, particularly when the sleep disturbance is one of the main complaints.

Unfortunately I do not have anything about his sleep in my notes Judith. Sleep was not his main complaint so probably he did not mention it once the itching and pains got better. But you are right, sleep is as a chief complaint can be tricky and I have frequently found Carcinosin and its derivatives as a great intercurrent to get these cases moving.

Thanks, Shilpa! Can you explain what you mean by derivatives of Carcinosin? Is poor sleep a feature of the cancer miasm?

Cancer miasm has a strong history of prolonged insomnia.
Tinus Smits's site will give you insight into the different kinds and combinations of this remedy.
http://www.tinussmits.com/3861/carcinosinum.aspx

Talk about coincidence. I have been working on a difficult case and this a.m. was looking at Kali Ars. I arrived at this because he has suicidal thoughts and drinks heavily to prevent anger from erupting. I thought your case was interesting because of the betrayal aspect. I have in the past prescribed both Nat. mur., and Ars. Alb. separately, my question regarding synthetic prescription, is if I don't have the combined remedy may I give the separate remedies in the same potency simultaneously and expect a similar result or is it necessary to have the combined remedy? Please advise.

thanks
D

Thanks Deborah.
I am sorry for the delayed response. Not sure how I missed this. If you do not have the combined remedy you should still be able to get some benefit from the separate elements. However there are certain peculiar symptoms due to the unique combination of the salt that will still remain unaddressed. So you will need some other remedy that helps unfold that aspect of the case. In short you will need to choose well and prescribe remedies that complement each other in series to unfold the pattern.

nice case Dr.shilpa !i realized that study of drugs in groups is very helpful in understanding. we can understand the main theme of the mineral which is present in the compound individually. but the new theme of the can be understood only by proving of the compound. finally, i hold-fast materia.medica only. but studying in groups keeps away the confusion and helps in differentiating the drug easily.

thanks Dr.Shilpa, Loved the insight of Natrum Arsenicum in a new way

Dear Shilpa
Very good case.Even i would have prescribed Kali-Ars. but the way you explained about organ affinity was very nice. Even the follow-up was very complete. Very helpful in my practice. Thank-you.

Dear Shilpa
Very good case.Even i would have prescribed Kali-Ars. but the way you explained about organ affinity was very nice. Even the follow-up was very complete. Very helpful in my practice. Thank-you.

Dear Shilpa
Very good case.Even I would have prescribed Kali-Ars. but the way you explained about organ affinity was very nice. Even the follow-up was very complete. Very helpful in my practice. Thank-you.