Families in Homeopathy Melanie J. Grimes, R.S. Homeopathic (NA), CCH
With the increase in the number of homeopathy remedies, from the 100 or so in Hahnemann’s time to the many thousands today, different systems have evolved to track, compile, reference and eventually prescribe the simillimum.
Computers have greatly enhanced our search abilities, enabling a much more specific exploration. With this renewed ability, comes elevated responsibilities, as is true in all areas of life.
The responsibility we now face is to accurately conduct provings, to accurately extract the data, to accurately add data to the repertories. People of integrity are now charged with organizing repertories and applying standards, as the gatekeepers of this accuracy.
The bottom line is the patient. Can we more accurately and specifically prescribe for each individual. And do the ends justify the means? Most important to consider is ease of use, speed, i.e. time needed to find a correct prescription, and short training period to learn.
When I began studying homeopathy in 1972, repertization was done by hand on paper. Daily, I am grateful to the computer programmers who spared me and us all from this tedium. In fact, I do not think homeopathy would have had the revival it now enjoys were it not for the computerization of the repertory and materia medica databases.
This brings us to the subject of families.
Each remedy is a unique entity, as each individual is a unique entity. That being said, there is something to be gained by grouping like with like. A creature that lays eggs and flies is more similar to another egg-laying flyer than to, say, a fur bearing, four legged live bearing creature, which eats egg-layers for breakfast.
What constitutes family? What parameters are needed to include a remedy in a family? Can you group animal, vegetable, mineral remedies in one family? Do we need families?
My opinion is that organization is the keynote of science and society, and any system that seeks to organize itself is a sign of intelligent design.
Rather than bicker over whose organizational system is right, I say, the proof is in the pudding. Or it will be, when an increasing number of cured cases raises homeopathy to greater visibility as a curative healing modality. Or not. The truth will out.
Families of plants have, even in recent times, been classed by the color of their flowers. This is a simple classification; easy for even a child to do and most useful if you are arranging flowers on the dinner table. A classification of plants by flower color is not the best for homeopathic similitude, because the ability to produce a red or white or yellow flower doesn’t indicate a particular characteristic commonality, as say,the ability to produce fever. What is useful to homeopathy is a classification that allows a list, or rubric if you prefer, with any remedy that might treat a specific system. The current use of “families” is sometimes useful in this regard, and sometimes not. Again, time will tell.
One thing all homeopaths agree on is that the words of the patient, or perceiving the words and actions of the patient, leads to finding the remedy, if not the cure. Wouldn’t it be wonderful if somehow the patient’s words could be used to search for a remedy, without the cumbersome step of translating into 19th century language? (How do you find “fear of flying” in Kent’s Repertory?) Or remembering where you last saw the rubric, “generals, worse heat, worse waking, left side, pain in spots”, or was it “left side, pain in spots, heat agg.? The new computerised word-search databases have been a mighty asset in these situations.
Miccant’s new software, Families, is another leap forward in this regard. It gathers every word in the case and analyses its probability. I think this is a brilliant use of our modern technology, and provides a way into a case without repertization.
What? No repertory? Homeopaths will scream. But your complaints fall on deaf ears, as I remember the day when those same individuals complained about losing paper and pencil repertorization.
The bottom line is this. Great skill must still be taken in case taking, as garbage in = garbage out.
The case will be found in listening, perceiving what needs to be cured in the case. If a practitioner can do his/her part of the work, it, the Families software, will greatly aid in the rest.
Melanie Grimes Award-winning Screenwriter Professional Homeopath Adjunct Faculty Bastyr University Author and Medical Editor Journal Editor: The American Homeopath Board Member: Pacific Northwest Writers’ Association
Melanie Grimes has been a writer since the age of seven. Her published works include books, journals, articles, essays, screenplays, teleplays, and librettos.
Melanie began studying homeopathy in 1972 and has been a registered member of the Society of Homeopaths (NASH) since 1992. She is the editor of The American Homeopath, and lectures internationally.
Ever had one of those cases that you can’t get to grips with? Having trouble finding a remedy that covers the case well? A Families based approach to case analysis can be used to clarify the case.
What if you really want to use a Families oriented approach but don't know how to? Now you can set aside your rubrics, symptoms and modalities and let the innovative 'Guided Analysis' gently lead you towards the most indicated remedy using our Families software.
Some practitioners use the same methodology for each patient and others choose the methodology to suit the patient.
I have been developing homeopathic software for nearly 30 years and while I have received wonderful feedback telling me how my work has aided practitioners I am always striving to do better. As I travelled the world listening to many teachers explaining their systems and methods, something has become very apparent to me: they all achieve good results!
This suggests to me that many different approaches to case analysis work and while some practitioners get good results focusing on one method or system only, there are also practitioners who use a variety of different methods (depending on the case) who also get good results (so there's room for versatility)
Who I created Families for
When I developed the Families software I kept in mind two distinct groups of homeopaths:
1st Group Those who like to work primarily with a families approach to case analysis - these types of practitioners would want to see the themes of the case pointing to the Ranunculacea family before giving Pulsatilla, for example.
Or they may decide a patient needs a mineral rx, want to see the themes of the Kalis in the case before prescribing Kali-s (a similar rx to Pulsatilla)
2nd Group The second group are what I would call the 'more traditional' homeopaths.
Much of the time they will break up the words of the patient into specific rubrics and repertorise their cases.
This second group might use the families approach as a supplement to more traditional methods (and homeopathic software) rather than using the families approach exclusively. This group would see the families approach as 'another string to their bow' as it were.
In other words when the more traditional approach either doesn't lead to a remedy that seems to fit well, or when a remedy prescribed in the more traditional way doesn't bring good results - other approaches are then considered.
Certainly one of the problems with repertorisation is that the polycrests will always dominate the smaller remedies.
The following quotation from David Mundy (an eminent homeopath in the UK) explains this well:
"Rather than jumping to specific symptoms I first decide the Kingdom, Sub-kingdom and Miasm of the case . This can be done by looking at the themes and language of the patient. This is where the 'Families software' helps. Then I repertorise and only consider remedies within the group/family that I had narrowed the patient down to. The problem with repertorisation is that polycrests always come up high - the more symptoms you put in the more likely Sulphur, Lycopodium, Calc etc come up. And if you pick the wrong rubrics you get the wrong remedies coming up.
However, I (do) always place the greatest importance on symptoms with definite Modalities, and that includes physical symptoms. These can and should be repertorised. I think that these days, where much of the case history is emotional suffering, it's a minefield and it's easy to get confused. But.. "Headache relieved by urination"... that's a great symptom! "
When Families might be used
The following scenario shows why being versatile could be very useful!
Just imagine..a client walks through your door. He is 6 feet tall and heavily muscled - it is obvious he works hard in the gym! A few minutes into the case you have quickly found that he has come for help with his asthma. You find out that he has a thick yellow nasal discharge, he is made much worse working outside in the sun but that he also prefers open (fresh) air. He also tells you that he drinks very little.
Now, what are you thinking? Like me you might quickly say - this has all the classic keynotes of a Pulsatilla case.
Some practitioners would prescribe Pulsatilla. Others would say - "I need to take more of the case. Let me find out what kind of person he is...how does this illness make him feel,,,is he weepy and tearful and mild".....and so on
Further conversation reveals that he is actually a very angry person with history of repeated violence. Although he has a very successful regular job he chooses to work 3 nights a night as a doorman at a local nightclub. His is racist, sexist and every other 'ist' you can imagine. He curses and swears all the time when talking to you. He is openly motivated only by money and sex - which he pursues all the time. He tells you that 'everything is about money and how to get it - "at least I am open about it - most people just lie and hide". You feel uncomfortable with him as you sense the violence is 'real'.
Now what? Would you still give Pulsatilla?
As a homeopath I would expect that you don't prescribe rx (like Pulsatilla) simply on a few keynotes no matter how 'obvious' they seem. If you possess computer software no doubt you would repertorise the case which would lead you to Pulsatilla and hopefully some other 'Pulsatilla-like' remedies for you to consider.
As you know, however, there are many situations when the patient may return (if you are lucky) after a month to report no improvement from the Pulsatilla you gave. What do you do then?
Many homeopaths are now realising the value of using different case analysis approaches. The Families software allows you to view your cases through the prism of a families based analysis.
How does the Families analysis work?
One very important thing to understand is that the Families software does not use rubrics or modailities or symptoms. Rather the software leads you through a Guided approachto case analysis.
You are then prompted to ask the following 4 things:
What are actual deep seated PROBLEMS that need to be addressed?
How does the client perceive their own SITUATION?
How do they FEEL about the situation they find themselves in?
How do they REACT to their issues (what conditions do they have and how do they react)
....and for each of the above many choices are given - all you have to do is select each one that applies. The software will then match these choices to its large database and display for you the leading Remedies, Families and Miasms.
Using Families will certainly make your case analysis more versatile and will hopefully improve your results. I also took time to include lots of educational material about each family/group in the software. This means you can also deepen your knowledge about families as you use the software
How I created Families
Over the years I have been collecting many of the various themes and expressions that homeopaths have observed as related to certain families.
The pioneering work of Jan Scholten and also Rajan Sankaran has widened our understanding tremendously. As more and more new remedies have been proven and themes of more and more families understood our collective knowledge has grown.
I believe homeopathy is indebted to the work of Scholten and Sankaran - without these brave pioneers our work would be poorer. Where Scholten unlocked the elements and minerals for us, Sankaran opened up the plants and animals! By utilising the knowledge of both of these masters the Families software allows you to easily analyse your cases across all the kingdoms.
More recently, these and several other authors have published amazing and informative works that explain the themes of the various families.
I created a large database of words, themes and expressions of all the families - drawing on the findings of many modern day masters. And then I created the Families software to examine the words and issues of the patient and to match them to the words assocoiated with al of the families!
The result is a tool you can use alongside your favourite repertory software if you traditionally repertorise your cases or you can use it as a primary tool to help get you quickly into the 'right area'.
Families will allow you to work with the Lanthanides as easily as the Solanacea and the Snakes as easily as the Kalis!
Presented with softening of bones of leg in a boy aged 18 months. Initially came in shortly after dislocating elbow and also complaining of knee pain.
Suffers from recurrent diarrhea and asthmatic breathing. Observed to be very restless. Loves music. Cheerful and happy. Hot. Mother says he wants to be carried everywhere.
Rx : Cham 200c
4 months later returned with no improvement. Increased knee pain prompted return visit. Now affecting both knees. No evidence of any trauma.
Time to re-evaluate !
Here is an xray taken before homeopathic treatment which clearly shows curvature of the bone of the leg:
Here is a blood test confirming the likelihood of 'Ricketts'. An ALP test can be used to determine weakness and softening of the bones:
Observations of the child:
Never sits still. Mischevious, cheeky little boy. Stubborn. Ignores being told off. Has been known to hit his grandmother back after she smacked him for being naughty. Pinches you if you refuse to do what he wants. Bored easily. Mum says he laughs naughtily if he sees anyone get dressed. Dominant when playing with other children (not a bully though). Knocks toys over rather than allow another child to play with it
Kept coming round the homeopath’s desk to see what he was writing. Observant. Touching everything. Pressing keys on homeopath’s computer! Mother couldn’t control him. She shouted at him and he got angry and waved his fist at her. The homeopath decided to intervene and asked the boy sternly to stop – the boy threatened to punch him also.
So what do we know already? Quickly and easily? We have reliable indicators from:observing the child, the nature of child and the generals of the child.
Using the S.E.A. approach described in the previous article we know the boy is:
Sociability :Approaching (no hesitancy, totally forward and approaching) Energy : Hyperactive (cannot keep still, always moving) Anger response : Destructive (punching, pinching, threatening)
From the case taking we also know the following :
Thermal : Hot Thirst : Thirstless
Constitutions and Character : Disobedient - Mischevious
Here is a repertorisation in Vision:
Rx : Tarentula 200c (one dose)
Xray after 6 months with before for comparison:
The ALP blood test was re-run after 6 months:
The ALP test now reveals normal levels. Success! But would you ever have considered Tarentula? Or would you have also gone for Chamomilla? This observational approach allows you to work cases out quickly through observation and at a deep level.
Our little patient is no longer Destructive and Hyperactive as the indicated remedy brings about a state of balance. However this is still an active outgoing little boy with restless tendencies – that is his real nature!
Has since twice needed Ars for acute conditions.
The observational approach and use of the S E A axis is a very practical way to observe children and not to get bogged down with simple rubric chasing. This can be seen by the first (failed) prescription of Chamomilla probably based on superficial 'symptoms' e.g. desire to be carried!
In the final article in this series I will present an additional case from Dr Jain in which the remedy was much harder to find.
Please consider integrating this approach into your practice by purchasing Dr Pravin Jain's excellent work - click for details:
Introduction For many years I have supported and used an approach to case taking with children developed by my colleague and friend Dr Pravin Jain of Mumbai, India.
I have found his approach practical and immensley rewarding. To me, it feels like a refreshingly authentic approach to homeopathic case taking, rather than the almost academic theorising that seems to typify a lot of our normal case taking and analysis.
In this series of articles I am pleased to share this information with you for the first time as I think it deserves a wider audience. Feel free to comment and make suggestions below!
The Problem Historically many homeopaths seemed to prescribe only a limited range of "commonly known child remedies". This is because information on Pediatric materia medica was limited and there was no clear approach as to how to take the case in pediatrics. So everyone seemed to be observing children in their own way and using their own interpretations of these observations. There was no methodical, scientific approach and hence, consistent results were often lacking. Senior homeopaths, because of their experience, were achieving good results, but the rest of us were perhaps not so successfull!
In Pravins own words:
"Not surprisingly, in my initial days of practice I found pediatric cases to be very difficult to treat. Shivers used to run down my spine on seeing a mother accompanied by a child at my clinic. Even before a customary “hello!”, questions like “What do I ask? How do I ask? How does one judge the constitution of a child?” would jump into my mind. Unlike adults a child doesn’t tell you about its problem. The evaluation of these cases is usually based on the history that is provided by the guardian and on the physician’s INTERPRETATION. There is no definite method to understand and prescribe for a child.
So awkward was my state that whenever a mischievous child came into my clinic, I would instruct the mother to leave the child in the waiting room and come inside alone, so that I could completely concentrate on the case taking and avoid distraction by the hyperactive child. After the information from the mother was gathered, I called in the child, and then too my focus would be more on the expensive furnishings and trinkets in the clinic than the child, for fear of those being damaged by the tiny rogue."
In summary the problem was:
1. No special pediatric repertory/rubrics to make the task easier
2. No specific pediatric case taking approach
3. Very little pediatric MM
Dr Pravin Jain decided to specialise in the area of pediatrics. He was initially inspired by reading the famous 1977 study of Thomas and Chess who identified different Temperaments in children. This approach confirmed to him that there was a way of getting to homeopathic remedies in a more structured way then simply 'rubric hunting' in the repertory based on the words of the parent.
Over the years, he has tried to streamline the 3 major aspects of prescribing as follows:
1. Formulation of a scientific method of casetaking using consistent language
2. When taking and then analysing the case - using the same language/terminology (as used during casetaking) also used in repertory rubrics
3. When arriving at a group of remedies, once again using the same language/terminology in Materia Medica to help differentiate remedies.
Again in Pravin's words:
"The birth of my own daughter raised my anxiety. There were many questions in my mind …What about vaccinations? What is her constitution? Is she chilly or hot? How is her thirst? Common questions, the answers to which a homeopath ought to know seemed to me like an abyss I feared to look down into. My anxiety led me to refer the pediatric books in great detail. Simultaneously I started honing my observation skills, observing my daughter closely. After observing her, and correlating her behavior with the pediatric psychology books, I found the key to many of my questions. The same child who used to scare me in my clinic became a joy to observe.
Now I started asking the mother to wait outside, so that the mother did not distract from my observations!"
Pravin first developed this way of working and analysis after many years in practice and since decided in 2002 to specialise in child care. He has opened 15 branches across India each with its own Child Observation Area (COA). Pravin places great importance on being able to observe and interact with our little patients to gain a true understanding of their nature and problems. Although you may not be able to have a dedicated COA in your clinic setting I hope that the techniques and system explained here can be taken and adapted to your own situation.
At time of writing this article Dr Jain estimates that his clinics have treated over 10,000 little patients and have been achieving consistently good results
The Approach Dr Jain finds it most important to observe and interact with children and not simply engage with the parent in 'rubric hunting'. He also analyses his pediatric cases in a very practical and straightforward way - using what is actually observed in the child's behaviour.
This article will explain in overview the approach Dr Jain takes. Subsequent articles will be cases to explain and support the approach.
For a detailed explanation and materia medica please consider purchasing Dr Jain's book 'The Essence Of Pediatric Materia Medica' which I am proud to support. To order please click on the image below :
Here is an overview of the method used to observe and interact with children to arrive at well indicated remedies.
Each section will be explained in more detail below:
The idea is that by observation and interaction you decide on all of the above - with the 3 most important factors at the top - these are the SEA axis (Sociability, Energy, Anger).
Step 1 : Determine Sociability of child - is the child 'Approaching' or 'Withdrawing'?
This refers to the initial response to a new situation or a new stimulus. How a child responds to a new experience, such as meeting a person (guest, doctor, stranger), tasting a new food, or being in an unusual situation (doctors clinic). Observe the ease with which the child accepts and adjusts to changes in his environment and lifestyles. Some children move easily into new settings, taking very little time to join a new group of playmates, while others may observe the scene for a long time before going into a new situation or simply stay away.
Approaching children jump right in. Withdrawing children hold back cautiously until they feel comfortable.
Observation of the interaction between the child and mother, between the child and the doctor (you), between the child and a stranger, between the child and a new stimulus will help find the sociability of a child. Record this and use remedies reliably indicated and proven in practice as per this chart:
Step 2 : Determine Energy level of child - is the child 'Energetic and Restless' or are they 'Lacking energy'?
Make sure to differentiate between Mental energy/restlessness and Physical energy/restlessness as the remedies indicated for both vary! Does the child rush around the COA flitting from activity to activity? Do they engage in the more mental activities or do they stick to physical things such as running, skipping, jumping, climbing? And also look for lower than expected levels of energy.
Again there is a chart of well indicated remedies for each:
Step 3 : Determine Anger/Frustration response
If the child does not get their own way or what they desire, how do they react? You may need to interact personally with the child to make this determination!
Destructive reaction : smashing, ripping, knocking over/down, tearing paper / clothes often directed at the nearest available target
Non-destructive reaction : temper tantrum, throws themselves to floor, rolling around, writhing around, screaming loudly. Not directed at anyone or anything (unless further provoked)
Once again there is a chart of the remedies associated with each reaction:
Brief example of 'Billy' and how he was analysed A very friendly and affectionate toddler. Trouble is he’s a running and walking disaster zone! Rushes around everywhere. Throws terrible tantrums when he doesn’t get his own way and rolls around the floor shouting. He’s definitely on the ‘tubby’ side. His mother tells you he is very ‘picky’ about everything....his food and his possessions have to be ‘just so’. Can’t get to sleep at night. Wets the bed. Ezcema on hands. Mild asthma.
So Billy is:
Once you have decided on the SEA axis you can quickly repertorise/cross these 3 'rubrics' to arrive at a small group of well indicated remedies. The following articles will show you real cases and analysis arrived at.
This approach allows you to spend far more time observing and interacting and less time on the technique of repertorisation - using just the 3 rubrics SEA will save you lots of time and guide you towards the indicated remedy!
Step 4 - Find the TT's!
What are the TT's? These are very reliable general modalities that help you narrow down the choice of remedy - Thirst and Temperature
Is the child thirsty or thirstless or neither? Are they hot or chilly or neither? Knowing this can be really helpful in case analysis.
Step 5 - Find the CC's!
What are the CC's? These are the Constitution and Character of the child. Often called the Disposition and vitally important in helping you make the final choice of remedy. The Disposition or CC's either confirm or reject the remedy prescription as the disposition of the child absolutely must correspond with the known disposition of the remedy.
Examples - is the child : Happy? Neat and tidy? Do they do as they are asked e.g. could you please tidy up all these toys? (obedient) Are they Shy or Bashful? Are they a Bully? Are they Confident? Are they Rude? Do they Complain or Moan a lot? And so on.
Conclusion to First Article
In the next article I will present a worked case with repertorisation and follow up so you can see the approach in action!
Please comment on this article below. I read every comment personally and will reply if appropriate and I am sure Dr Jain would appreciate your feedback also.