Homeopathic Methodology

Author

Todd Rowe, MD, CCH, DHt, RSHom

(1958 -     )

Todd Rowe was born October 14, 1958 in Lake Forest, Illinois.

Dr. Rowe received his medical degree from Rush Presbyterian St. Lukes Medical School, Chicago, Illinois. He completed the four-year program at the Hahnemann College of Homeopathy in 1995. He has been in homeopathic practice since 1989.

Since 1994 Dr. Rowe has been the Homeopathy Study Group Education Coordinator for the National Center for Homeopathy. He sits on the Board of Directors of the Council for Homeopathic Certification and the Council for Homeopathic Education. He has been President of the National Center for Homeopathy since 2000. Dr. Rowe has been the Director of Desert Institute School of Classical Homeopathy since 1996.

Dr. Rowe has produced audiotape and videotape homeopathy courses for physicians. He is author of Homeopathic Methodology, The Homeopathic Journey, and contributing author for the Clinician's Rapid Access Guide to Complementary and Alternative Medicine.

He has been involved with the provings of Heloderma suspectum (Hila Monster), Carnegeia gigantea (Saguaro Cactus), Urolophus halleri (Stingray), and Cathartes aura (Turkey Vulture), Oxalis acetosella, and Argemone polyanthemos.

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Reviews

From:
HOMEOPATHY TODAY
Reviewed by Julian Winston

Todd Rowe, of Scottsdale, AZ, is a psychiatrist specializing in homeopathy. He is Director of the Desert Institute of Classical Homeopathy and an instructor at the Hahnemann College of Homeopathy. He is a board member and Vice-president of the NCH.

This is an introductory level workbook that addresses two of the "three pillars of studying homeopathy"-the use of the repertory, and case taking. The third "pillar," materia medica, is not discussed. The author presupposes an understanding of the fundamental principles and concepts of homeopathy. He suggests that Vithoulkas' The Science of Homeopatky be used as "a good overview."

The book is presented as a series of "Lessons." After each chapter is a short quiz, the answers to which are found in an appendix.

Lesson One is about case taking -how to do it. It is the kind of information that appears in other introductory books and includes discussion of: the chief complaint, causation/etiology, mental
symptoms, strange, rare, and peculiar symptoms, sexuality, sleep, perspiration, and food/thirst.

Lesson Two continues with more practical aspects of case-taking: understanding the obstacles to cure, reviewing the bodily systems, determining the "center of gravity" of the case, and assessing
the "strength of the vital force." This is followed by a brief description of the actual recording of the case on paper and the usefulness of "underlining" as Vithoulkas teaches.

Rowe mentions the difficulty in treating patients who have had much psychotherapy, as they often bring their therapist's theories with them and it is hard to see the "natural state" of the case.

In Lesson Three, Rowe discusses the theoretical aspects of casetaking including linear, circular and transcendent thinking, perception, "listening with the third ear," self-observation, judgments, and
techniques for "going deeper" such as found in the work of Milton Erikson and the use of cognitive dissonance.

Lesson Four is an introduction to the Kent Repertory. The date of Kent's book is given as 1877 which is a typographical error. It was first issued in 1897.

In the section "How is the Repertory Used?" Rowe discusses the use of grading of symptoms and says: "The remedies are entered into corresponding columns as either grade one (1), two (2), or three (3). The numbers are totaled to see which remedy(s) are best repre-
sented in the repertorization."

This is what has been taught from Kent on, so it is understandable why Rowe has included it; however, the latest thinking based on careful inspection of Kent's sources is that the gradings as found in Kent are very unreliable as to the importance of the remedy in the rubric and, more often than not, should be disregarded.

How does one choose the rubrics? Rowe advises to avoid symptoms that are common, and "choose rubrics that are uniquely characteristic of the individual person ... Homeopaths prescribe for the person and not for the disease."

Now, a few pages earlier Rowe says, "The most important symptoms used in prescribing a homeopathic remedy are symptoms based on diseased states. The healthy areas of an individual's life are usually not helpful in finding the correct remedy. " The exhortation to "choose rubrics that are uniquely characteristic of the individual person" can lead to confusion as to which symptoms to work with.

This is a major stumbling block in the selection of symptoms, as often practitioners do not understand this caveat and use symptoms that are of the healthy person. I wish that Rowe had spent a bit more space on explaining the differences between the "symptoms of the diseased state" and those that are "uniquely characteristic of the individual person."

The Quiz in Lesson Four contains the following question: Repertories are mostly based on which of the following:
A. Pathological symptoms
B. Poisoning symptoms
C. Proving symptoms
D. Cured symptoms

The answer given is "C"-which is, I believe, too simplistic. Many of the symptoms found in the materia medica (on which the Kent Repertory is based) have been gleaned from deliberate provings and toxicological information. Kent added a lot of symptoms from his clinical practice as well as symptoms gleaned from a number of other practitioners. The answer to the question asked is better answered as "all of the above."

In quiz four, three cases are presented, and computer repertorizations are shown. In two of the repertorizations, the remedies given received the highest scores and were in all the rubrics, but in the third example, the curative remedy for the "nausea and vomiting of pregnancy" did not appear in the rubric

"Stomach; Nausea; pregnancy during." How was this remedy (Cocculus) arrived at? Why was not Sepia given-which was in the rubric but not in another rubric? There is no explanation offered for this very simple conundrum which prescribers see all the time.

Lesson Five concerns the "Mind" section of the Repertory. "The mind section is one of the largest and perhaps is the most important section of the repertory" Why? Because Hahnemann says in Paragraph 211 of the Organon that "In all cases of disease to be
cured, the patient's emotional state should be noted as one of the pre-eminent symptoms..."

Yes. But ... Paragraph 211 exists in the section of the Organon on "Mental Diseases" (Paragraph 210-230), and the statement quoted applies, in the thinking of Hahnemann, to mental diseases-and is not necessarily a statement about disease states in general. Furthermore, Hahnemann said that the "emotional state" is to be considered-which is very different from the "mental" state and many of the symptoms found in the "mind" section of the Repertory.

Says Rowe: "In the past homeopathic cases were frequently solved by focusing on physical symptoms. As suppression has increased in relation to allopathic drugging ... symptoms have been suppressed deeper and deeper into the organism. This has resulted in the increasing importance of mental and emotional symptoms in helping to find the right remedy."

This is a controversial issue. Although some would agree with Dr. Rowe, I know many homeopaths who would take strong exception to the above statement.

Lesson Six describes the "Generals" section of the Repertory, and is well structured.

Lesson Seven (Vertigo through Mouth) through Lesson Nine (Cough through Skin) offer a view of the appropriate sections, the "important rubrics" (i.e., ones that you will probably see in practice) and a brief directory of "Confusing terms" (i.e., those that need translating like "Nates," in the "Back" section, which refers to the buttocks).

Lesson Ten covers "Case Analysis." Saying, "The best method is one that leads to a good result," Rowe mentions the need to discover, in the case, what is characteristic and what is common. He advises that it is often helpful to look for the essence, totality, and characteristic symptoms. After a discussion of "Essence," he says this about "Totality":

"Once a case has been taken, the next step is to evaluate the totality of the patient's symptoms ... the ones that are given the most importance are the ones that are the most peculiar and intense and reflect the whole person."

A case example is shown (a 16-year-old boy with possible appendicitis). In the example, both Bryonia and Nux vomica come through all the rubrics chosen-but there is no explanation as to why Bryonia was chosen above Nux. A discussion of the differential would have been a useful addition.

After defining "Characteristic symptoms" he says: "Prescribing based solely on these characteristic symptoms is a more one-dimensional type of prescribing. The most helpful characteristic symptoms are ones that reveal the core of the person."

Again, I know several homeopaths who would take strong exception to this view.

After discussing "Confirmatory Questions" and "Etiology" (with a nice list of 'Ailments from ... "), Rowe discusses the concept of "Kingdoms/Families"-families of remedies that share characteristics. He talks about'Animal remedies" (characterized by aggression and flashy clothes), "Plant remedies" (those people who have a sensitivity to the environment), and "Mineral remedies" (those folks who are focused on structure).

This concept, now the latest vogue in exploring the materia medica, is far more complex than these simplistic examples and, while of possible value in advanced prescribing, does not, in my opinion, have a place in an introductory workbook.

A case example is given-a woman with a sore throat. The sore throat came on after she encountered a snake while out running. She began to have recurrent dreams of "jungle snakes." Lachesis was the chosen remedy because it is "left sided" and the remedy "needed to be a jungle snake."

When I looked at the symptoms presented and ran them through Kent's Repertory, Lachesis was clearly the remedy. Why complicate the case by looking for "snake remedies" and "animal energies"? The woman was clearly exhibiting a Lachesis sore throat - with many of the characteristics of the remedy-and that remedy cleared the case.

Rowe then steps further afield by discussing the "Doctrine of Signatures"-a concept that was strongly frowned upon by Hahnemann. An example is given: Thorn Apple (Stramonium) "grows in disturbed soil and often in graveyards," so "it is the main remedy for fear of cemeteries." This kind of speculation is exactly what Hahnemann was trying to avoid when he developed his system based on the concept of provings.

Rowe presents a case cured by Culex (mosquito), given because the patient, a little boy (with colic), "flitted from room to room," 'made a humming noise with the colic pains, and bit people to the point of drawing blood. This was like a mosquito ... Although this type of prescribing seems to be in vogue these days too, this fanciful explanation, in my opinion, should not be in an introductory book.

After discussing pathology, miasms, the role of the family in the case, and chaotic cases, Rowe says, "The best results are obtained when a variety of analysis strategies all confirm the same remedy," and then admits that "this seldom happens."

So ... what does one do with an unclear case? Says Rowe, "This is when imagination, perception, and deep study are the keys to unlocking the heart of the case." Easier said than done-and not the job of an introductory text. Such a vague statement can leave the beginning student uncertain as to what can be done.

Lesson Eleven contains ten practice cases. They are all very simple. The rubrics are very clear. Most of the cases lead to only one remedy in the repertorial analysis. In one case, the simillimum was not the first in the list, and there is a discussion of why the specific remedy was chosen-a good differentiation and a good lesson.

The appendices consist of
an acute case taking template
a sample review of systems questionnaire
a sample family history questionnaire
a list of remedies and their abbreviations from Kent's Repertory ,(includes the 60 most frequent remedies in the Repertory)
a list of the sections of Kent's Repertory
the layout of Kent's Repertory
a well-done glossary of descriptors of pain terminology
glossary of confusing terminology
a repertorization template
a diagram of the abdominal section of the Repertory (i.e., locations of right hypogastrium and left lumbar, etc.)
the lesson quiz answers, and
a glossary of homeopathic terms.

In Summary
Much of the material that is introduced (like "essences" and "families") is currently in vogue in some homeopathic circles and in some sense an introduction to this material is useful to the more advanced student of homeopathy. The author, obviously, believes it useful to expose a beginner to all these concepts.

But the book is, by its own title, an introductory level workbook to the repertory and case-taking. When one has been doing anything to a level of competence, it is often hard to go back to the beginning and make the lessons basic enough. In a sense, you forget where you started, and you want to tell the audience what you know now- somehow forgetting the long path it took you to get to this point.

Over the last 30 years I have been involved in the teaching of art and design at the university level. For 25 years I have been teaching (through a book I wrote in 1975) the basics in playing pedal steel guitar. For the last 20 years, I have been teaching homeopathy. My love has always been, in all three fields, the teaching of the basics. Much of what is discussed in this book is, in my opinion, a bit beyond material of an introductory level.

The book is well presented, and the concept of a "workbook;' that is, lessons, quizzes, answers, is a good one. It is, on one level, very basic and gives good information, but it lapses into concepts that belong in a much more advanced level book.

Despite the praises lavished upon the book as seen in the quotes on the back cover, I believe that the author - in an effort to give a broader picture - has put too much into not enough space, and the depth of possible content has suffered.

Homeopathy Today
November 2000, Volume 20, Number 10

Reprinted with permission from the National Center for Homeopathy

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Contents

Foreword by Roger Morrison, MD -- v-vi
Introduction – vii

Lesson 1 - Casetaking Practical Analysis, Part One -- 3-13
Lesson 2 - Casetaking Practical Analysis, Part Two -- 14-21
Lesson 3 - Casetaking Theoretical Aspects -- 22-27
Lesson 4 - Introduction to the Repertory -- 28-38
Lesson 5 - Mind Section of Kent's Repertory -- 39-47
Lesson 6 - Generalities Section of Kent's Repertory -- 48-58
Lesson 7 - Vertigo Through Mouth Sections of Kent's Repertory -- 59-71
Lesson 8 - Teeth Through Respiration Sections of Kent's Repertory -- 72-86
Lesson 9 - Cough Through Skin Sections of Kent's Repertory -- 87-100
Lesson 10 - Case Analysis -- 101-116
Lesson 11 - Practice Cases -- 117-122
Appendix A - Acute Casetaking Template -- 123
Appendix B - Sample Review of Systems Questionnaire -- 124
Appendix C - Sample Family History Questionnaire -- 125
Appendix D - Remedies and Their Abbreviations in Kent's Repertory -- 126-130
Appendix E - Sections of Kent's Repertory -- 131
Appendix F - General Layout of Kent's Repertory -- 132
Appendix G - Descriptors of Pain Terminology from the Repertory -- 133-134
Appendix H - Glossary of Confusing Terminology in the Repertory -- 135-139
Appendix I - Repertorization Case Template, Sample Repertorization Case -- 140-141
Appendix J - Layout of the Abdominal Section of the Repertory -- 142
Appendix K - Answers to Quizzes -- 143-148
Appendix L - Answers to Practice Cases -- 149-155
Appendix M - Glossary of Homeopathic Terms -- 56-158

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