Homeopathic consultation

As with any medicine, homeopathic treatment involves a consultation between someone seeking help and someone else who considers himself/herself capable of providing treatment. I am not saying anything new or particularly insightful for those who have always been truly attentive to the meaning of the therapeutic relationship, but today, after 40 years of working as a doctor, I feel I can say that, between declarations of intent and obvious statements, what happens when a doctor and patient meet remains largely a mystery: an encounter that deserves to be understood, thought about and felt in any therapeutic relationship. Even surgical procedures are never the same: even on an operating table under the lancet, there is always someone there before, during and after being put to sleep. Even in consultations that last only a few minutes, as in the case of some of our Indian colleagues who have to see dozens of patients a day, something always happens that goes beyond a simple prescription. We may or may not be aware of it, we may participate or remain indifferent, but something always happens that goes beyond the prescription, the contact made by glances or a body that allows itself to be touched more or less willingly.

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As already mentioned in the previous pages, a homeopathic consultation is not merely an equation where a certain remedy corresponds to a certain disorder. I am well aware that there are those who believe this and practise it in some way, but this approach, when and if it works, is limited to fortuitous and temporary results, mainly confined to generic acute disorders or something that can really be attributed to a placebo effect.

For medicines that are not based on the concept of similarity, the result of a certain therapy on the majority of patients is a necessary and very significant acquisition. Modern phytotherapy, like conventional medicine, for example, researches and uses drugs that have been shown to be effective for the majority of patients suffering from a particular disorder or disease. In this case, the subjectivity of the person is not important at all; if anything, it is classified as an insignificant or even annoying variable.

When the founder of Homeopathic Medicine, Samuel Hahnemann, began his studies, he was mainly motivated by the search for an effective therapy with as few side effects as possible. He thus discovered that substances used as remedies could be diluted and still have an effect on humans, provided they were also succussed. In keeping with the vocabulary of our founder, we homeopaths say “dynamised”.

Hahnemann decided not to settle for what was written in toxicology books: he wanted to experiment and test the effects of these diluted and dynamised substances on humans. He noticed that each person involved in these experiments manifested both completely personal symptoms and many others shared by the various experimenters. It is precisely these shared symptoms that form the starting point for the study of a homeopathic remedy.

Hahnemann’s attention to the interaction between Anthropos and diluted and dynamised substances was not limited to a few data points, however. He observed what happened to these experimenters in great detail, noting any variation from their usual behaviour and considering it significant if it was present in the majority of cases: from food preferences to intolerance to certain foods, from mood to sleep quality, from the characteristics of pain to the time of its onset, from what could actually improve or worsen general symptoms to specific ones. The result of these experiments, aimed at finding shared symptoms, consists of several hundred symptoms for each diluted and dynamised substance.

At this point, it is necessary to clarify a few concepts and a perspective of fundamental importance. Our discomforts, disorders, mood swings, pains … defined too generically as symptoms, are certainly unpleasant, difficult and sometimes very hard to bear experiences. Who among us would not want to quickly get rid of any ailment or anything else that forces us to pay attention to our body, to how we are functioning or malfunctioning?

These symptoms are not just something to be eradicated, to be got rid of as soon as possible, they are also something to think about and recognise: something that has meaning.

If we start from the assumption that every system has its own biological intelligence, its own resilience, its own autopoietic capacity, these symptoms are also the expression of that organism’s best possible attempt to organise and reorganise itself in difficult conditions. It is easier if we think of vomiting, diarrhoea or abundant phlegm production as ways of eliminating something potentially harmful. Fever, first and foremost, is a defence mechanism, necessary for our immunity to function at its best. Even an organism in a coma organises its resilience as best it can, limiting vital functions to what is essential for survival. Obviously, whenever possible, treatment must be provided by all means, but this does not detract from the fact that something from outside always interacts with something else that works from within.

If we think of the glass as half empty, we support our organism with something external, something that replaces or supplements our functions; if we think of the glass as half full, we stimulate its resilience.

The problem is that, from the perspective of the glass being half empty, therapies that demonstrate broad-spectrum efficacy work better: on homo sapiens, in as many patients as possible and using weighted doses of pharmacological substances, with the inevitable concomitant side effects and varying degrees of toxicity depending on the dosage. From the glass half full perspective, ad personam therapies work better: again on homo sapiens, but only on those most sensitive to a particular stimulus.

It is essential to clarify that in this case, the same rules of conventional medicine cannot be applied to study a drug or procedure. It is not true that serious studies cannot be conducted on personalised therapies, but it is essential to acknowledge and respect the existence of another paradigm: abandoning the arrogance of believing that the conventional approach is the only or the best possible one.

This is why two brothers with the same disease are treated differently by a serious acupuncturist, a skilled osteopath, a competent psychotherapist and a true homeopath.

The limitation of personalised therapies is precisely that of a real functional deficiency: it is possible to stimulate an organism to improve the activity of its thyroid gland, it is possible to improve the secretion of its pancreas, but if those functions are truly insufficient, supplementation with the relevant hormones is essential. This does not mean that therapy is unnecessary or useless, as its objective is to treat a system and not an isolated organ. Not to mention that much of the prevailing medical misinformation aims to convince us more and more of our inadequacy, powerlessness, incapacity, and the absolute necessity of taking drugs that are supposed to do what our organism is unable to do. To give just one example, I can recall that the phenomenon of antibiotic resistance in Italy today accounts for 12,000 deaths per year, and 35,000 in Europe. If we do not reverse this trend towards the appropriate and responsible use of antibiotics, both in humans and in animals, we risk this problem becoming the leading cause of death within a few years.

When the testing of a homeopathic remedy is completed, it is demonstrated that the diluted and dynamised substance produces a certain set of symptoms in healthy humans: a mode of functioning of our body induced by that specific substance.

According to the “glass half full” perspective, when a patient presents his subjective set of symptoms, he is expressing his best resilience, his best chance of reorganising his system, his personal way of functioning when in difficulty. Not that of homo sapiens.

Often, this moment of crisis is enough to overcome the discomfort: this is what happens when we fall ill and recover without any treatment. However, it can also happen that the resources activated during this moment of crisis are not sufficient and that our body continues to manifest a certain set of symptoms.

The principle of “similitude” in Homeopathic Medicine is based precisely on this. The therapy is a stimulus to function in accordance with those specific modes of resilience, through a remedy known for a set of symptoms as similar as possible to those of the patient.

It is like saying that if we “intoxicate” our organism with a certain remedy, it reacts in that way in healthy people, through that set of symptoms. We therefore respect that reaction in a patient who exhibits the same set of symptoms: we recognise an organisation similar to their ability to react, to their resilience.

The homeopathic remedy does not act directly through biochemical components but through physical information present in the solvent of that remedy, induced by the substance that has been diluted and dynamised. Technically, it acts through the way the particles of the solvent are organised and the way the water clusters are oriented.

I hope this necessary introduction has not been boring, but in order to understand why a serious homeopathic consultation with a chronic patient takes time, it is essential to understand that it is not enough for the homeopat to know that his patient has, for example, rectocolitis. A homeopathic consultation is a medical act and, in addition to the conventional diagnosis, we are particularly interested in knowing how the rectocolitis presents itself in that patient. Without this information, it is not possible to find the remedy whose set of symptoms is most similar to that of that person and not to all patients suffering from rectocolitis.

Obviously, a medicine worthy of the name must also work for acute or very acute disorders.

One myth, one nonsense, that I never tire of hearing is that homeopathic therapies are long and time-consuming. Nothing could be further from the truth! When faced with an acute problem, administering the most effective homeopathic remedy works in a very short time. Midwives working in India could not deal with postpartum haemorrhage, and our colleagues who treat snake bites or asthma attacks in countries without healthcare facilities cannot wait for hours. When I became passionate about this wonderful medicine and left my surgical studies, it was precisely because I had the good fortune to meet a homeopathic doctor who had left his town to treat poor indigenous people in a forgotten village for free. Perhaps without that experience, without having seen it with my own eyes, I would have thought, like some simpletons suggest, that homeopathic medicine is nothing more than over-the-counter remedies. This perspective certainly makes a lot more money for the big homeopathic drug manufacturers, who are not ashamed to advertise in this way.

As I wrote earlier today, in the West, the majority of patients who choose a serious homeopath suffer from chronic conditions, they are dissatisfied with the results obtained with other therapies and for whom solutions are difficult to find. Situations of this kind, by definition, require much longer treatment times than acute conditions, regardless of the type of medicine or therapist consulted.

It is certainly understandable that a patient disappointed with the results of a therapy should seek something else, but it is equally curious to be confronted with the magical expectations of certain patients who, after a few weeks of treatment, declare that this kind of therapy does not work. Bizarre, isn’t it? To give an example, it seems obvious to me that if the therapy suggested by a cardiologist does not produce the desired results, it should be reviewed, working together with the doctor to find other drugs. Or it may make sense to consult another cardiologist before declaring the therapy undertaken to be ineffective. What, then, are the expectations when faced with homeopathic therapy?

It may be a good idea to ask yourself this question before consulting a homeopath when you are suffering from serious problems. In addition to this, it is really important to consider another cornerstone of Homeopathic Medicine and its treatments, especially if we remain in the realm of chronic diseases. Another characteristic of personalised medicines, those that start from the assumption that the glass is half full, is a truly systemic interpretation not only of how we function but also of the therapy.

Disease, understood as a nosographic entity, one of the many names we can find in a medical textbook, is and remains an abstract entity: a guide for medical students, a useful definition for the purposes of a more accurate diagnosis, a reference for tables drawn up by insurance companies, etc.

Especially in adults, and almost always in older adults, it is rare for a disease not to be accompanied by other disorders or diseases. There are patients who say they “have” several. And even in that case, there is a whole world between the disease of homo sapiens, or Mr Smith, and the suffering of that precise person: real suffering always belongs to someone, it is his individual story, his context, how that experience is subjectively lived. This perspective is diametrically opposed to guidelines and protocols.

The ultra-specialised drift of recent conventional medicine has certainly allowed for insights that were unheard of until a few years ago, but I believe it is undeniable that there has been a progressive loss of the overall, systemic view. The network of assistance provided by various specialists, general practitioners and other possible therapists is too often a mere declaration of intent, for many reasons that cannot be addressed here.

Having strayed so far from the overall perspective of a biological system is not just a presumption of homeopathic philosophy, but rather a very concrete fact whose repercussions on our health are not merely conceptual.

A trivial example to try to explain myself better. A patient suffering from a widespread form of eczema, treated with a specific therapy and with good results thanks to steroid therapy. Good result: both the specialist and the patient are satisfied. Perhaps after some time, the same patient begins to experience asthmic problems, which are treated with good results with bronchodilators and perhaps other steroids. The asthma improves significantly, with good results and both the specialist and patient satisfied. After some time, significant intestinal problems arise, perhaps treated with other steroids and mesalazine. The symptoms are under control, but the therapy may last for years. The diarrhoea improves significantly, again with good results: the specialist and patient are satisfied.

I will stop here without speculating on a possible “anxious-depressive” drift, which will probably require other drugs correctly recommended by another specialist.

Each of these colleagues did their job well, but if we try to read what happened to that person from a systemic perspective, we cannot deny that their overall quality of life has significantly deteriorated. That organism, that biological system, has produced more serious, more debilitating diseases over time, affecting more vital functions and requiring heavier medication. That person’s coenesthesia, his quality of life, has clearly deteriorated.

Coenesthesia. From Treccani: an indeterminate sensation (connected with the general physical and mental condition of the individual) that is perceived by the consciousness only when its tone is disturbed. In such cases, it manifests itself as a particular sense of well-being (positive variation) or discomfort (negative variation).

I often wonder why this word was much more popular when I was a student than it is today. I honestly don’t think it was a haughty or snobbish expression; rather, I fear that the concept itself is less and less considered in the medical field, especially in research and the observation of long-term results.

Far be it from me to claim that every form of dermatological disorder necessarily evolves as I describe. This is just one example of how many “diseases” begin with a form of suffering that always affects the whole system, and little by little the whole organism can worsen its condition, passing through other diseases that manifest themselves in the same person.

Keeping in mind that we are always treating a person, a real organism and not an abstract disease, a system, necessarily means caring about how that individual lives, grows and evolves.

Far be it from me to claim that the use of homeopathic medicines prevents these unfortunate developments. I do, however, maintain that Homeopathic Medicine reads and treats the patient from this perspective, which is concerned with assessing and monitoring how that person develops their ailments and how they live with their disorders as a whole. As the years go by, our entropy moves in one direction: as we age, our health does not improve, but we can also become concerned about our coenesthesia.

This is the goal of homeopathic therapy; the prescription of homeopathically prepared medicines is something else entirely. Any product other than conventional medicines, any therapy other than conventional therapies, is not homeopathic, as we too often read in the dramatically misinformed, if not malicious, media.

I hope I have at least attempted to explain how much happens during a homeopathic consultation and how many things a homeopathic doctor has to pay attention to. How much emotion, knowledge and the need to express a complicated conventional diagnosis and an even more complex homeopathic diagnosis are involved in the consultation: the relationship with a patient, which is always a unique experience.