Prescribing Methods

by Keith Souter

We all know that there are many ways to arrive at the homeopathic simillimum. Sometimes we use totality of the case, sometimes keynotes or some peculiar symptoms, layers, tautopathy, miasms, and we sometimes base our prescription on the causative factors alone etc. Most homeopaths have their own favorite clinical techniques that they use often in their practice. But have you ever wondered ‘HOW' people develop their clinical techniques and ‘WHAT' goes in their minds while they are trying to find out the simillimum?

This book by Keith Souter uses Behavioral Decision Research, Artificial Intelligence, rules of thumbs and heuristics to probe into this nascent area of the ‘mental process' of arriving at the simillimum.

This book is divided into 4 parts. The first part deals with the history of homeopathy and how much the practice of homeopathy has changed since the time of Hahnemann. The author has dealt with the factors like increasing complexity of available information, large database of symptoms and medicines, more complex posology and also modern advances and theories.

The second part deals with the ‘process of thought'. An algorithm is a detailed sequence of actions to perform in a finite number of steps in order to accomplish a task. Heuristics are rules of thumb that are used to come to a solution in complex and vague situations. Souter says that Hahnemann believed that his system will always work in an algorithmic manner - take the case properly, find the important symptoms, find the most indicated remedies and select the simillimum. However the rapid increase in homeopathic information in our material medicas and repertories, newer medicines, more number of patients, different approaches like those given by Sankaran, Scholten and Eizayaga, often make it impossible to come to a remedy in an algorithmic fashion. To simplify the process homeopaths often rely on heuristics or rules of thumb. Keith Souter has given basic technical information about the various heuristic models and how they apply to homeopathy. This section is a bit technical in the sense that there is free use of language related to artificial intelligence.

The third section deals with the practical application of these heuristics in homeopathy. The author has tried to answer the question ‘How do people choose the correct remedy?'. Using various examples, the various approaches used in homeopathic self-care, acute prescribing, chronic prescribing, keynote prescribing, therapeutic methods, biochemic remedies, constitutional prescribing have been explained from the heuristic point of view. This part also deals with how the heuristics can introduce ‘bias' and how the understanding of the ‘rules of thumb' can help us minimize such bias and thus improve our prescriptions.

In the end, there are five cases that have been solved using five different approaches as per the need of the case. The cases illustrate that ultimately it is the patient who will decide which technique will be most effective in his/her case and not the physician. The physician has to use the correct ‘heuristic' according to the case in hand.