Rinse, lather and repeat -

Single doses Versus Repetition

 

Have you ever read the instructions behind a shampoo bottle? It’s that teeny tiny label, which reads “Directions to use- take a coin size shampoo in your palm and then rub it in your scalp. Rinse, lather and repeat.

I had grown up reading this, and had become comfortable with the outcome of the shampooing, no matter the repetition! Imagine my shock when I read Hahnemann’s single dose, wait and watch methodology. I kept reading it back and forth 20 times, hoping the word “Repeat” would magically appear.

Then 10 sentences down, I finally saw it. I exhaled with relief. Of course retrospectively this made sense. One can’t expect “rinse, lather and repeat” on a homeopathic bottle! The worst one can get with an extra shampooing is frizzy dry looking hair or extra soapy hair. Not much at stake, I would think.

Now, a follow up of a patient is very much like shampooing, except without the soap and the bubbles. A follow up by definition is a continuation or repetition of something that has already been started or done

In the early years of practice or any stage of your practice, the health and the return of our precious patients for a follow up, is very much at stake.  Not only are the patients anxious to get better, so are the doctors to get them better. As the anxiety increases, the rate at which we repeat the remedy also increases. Thus, safely concluding that posology was at a risk of being directly proportional to the levels of our ‘performance’ anxiety.

 “Now there are circumstances when it is necessary to repeat, but this is so difficult to teach, and so difficult to lay down rules for, that the only safe plan is to begin cases without repetition, to give a single dose and wait, and watch its effects” – James Tyler Kent.

To prevent ‘the desperate time calls for desperate repetition’ syndrome, Hahnemann came up with this wait and watch methodology as a safe plan. It ensures enough space for the symptoms to come in an unambiguous manner after a dose, and then allows us to prescribe with clarity and keep in mind the individuality of the patient. Having said this, ‘wait and watch’ does not mean that it needs to be a single dose for all cases or that one extra dose will cause aggravation, never to return from!!

Yes ‘wait and watch’, prevents any kind of unnecessary aggravation in the state of symptoms. However it does not mean that after a single dose, we are watching every symptom for aggravation.  This fear of homeopathic aggravation (which is so strongly embedded in us) can even make us forget the most important point, that the aggravation of a symptom can itself be a symptom. It can simply indicate disease progression rather than indicating homeopathic aggravation. It does not mean a single remedy should cause cure. The dosage is tailored according to the patient. The label does not read ‘single dose voila! Here comes the cure!’

And yet, we all get impressed by any cases which improved by a single dose, as if to suggest an ideal cure is only by a single dose. If a case improved and got cured by a single dose, is because it was that case; which needed a single dose, not that there were some powers in the hands of the homeopath, who prescribed that single dose.

Cure can be with a single dose, in an acute illness. However in a chronic illness, it might or might not be in a single dose (highly unlikely though).  In chronic diseases, we carry the patient to the very end of cure, through a series of steps. Each step needs to be evaluated whether a dose needs to be repeated or not.

Foolishly waiting and not giving a dose, (even when required) because of some faulty notion that a cure should be either in a single dose or very few doses, is wrong. There are no ‘should’ in healing and medicine. The human body is such, where 1 +1= can be 4. We are the science aimed at treating the individual as a whole. Every individual is different. Hence it needs to be customised to their needs (as and when indicated).

And when sometimes after doing your best, you still find yourself at a stage, where you don’t know; whether you should continue the dose, simply stop doses. The path becomes very clear after that. Hence, the conclusion is not to jump to conclusion. Neither should we jump the gun too fast to repeat nor to stop the dose in a panic.  Balance is the key.

And no, there is no genus epidemicus when it comes to repetition. Its rinse, lather and wait!!

 

• By Dr.Shraddha Kedia