Dr Heiner Frei-The Boenninghausen Method & Polarity Analysis (Part 2)

Okay, this is a 4 year old boy who suffers since 3 days of a sore throat with fever 103 degrees F. Headache, pains in the limbs, and he is very weak, and can hardly swallow. On examination I find a bright red inflammation of the throat, severely swollen tonsils, then petechial bleedings on the palatal arch. The tongue is also bright red and the cervical lymph nodes are very severely swollen and painful. And at the look at the skin I find typical rash. What’s the diagnosis? Scarlet fever. I hear? Yes, it is a scarlet fever patient.
Now checklist Ear-Nose-Throat. I have written symptoms. Mouth odor, dry mouth, then underlined thirst, swallowing worse, food and drinks cold things better, cold in general worse, warmly from wrapping up better, aversion to open air and open air worse, movement worse, physical effort worse, lying position better, standing worse, pressure external worse. As usual, I just use polar symptoms because we have so many. You see, you have 12 polar symptoms. We do not enter Scarlet fever because this is a possibility. We have in the repertory there are some diseases as diagnosis in it. We can enter it if we do not have enough symptoms. Or if we have enough, we would not use this because it's not quite correct.
Now you see we have quite many remedies covering all symptoms. 2, 4, 6, 8, 10, 11. And we have very prominent Bryonia, Second place Mercurius, then Natrum Muriaticum, third place. This is actually, what is in question for him. All the others have quite a number of contraindications. Now if we include scarlet fever rash which is a symptom, only Bryonia and Mercurius Solubilis remain. So Natrum Muriaticum falls out.
In the Materia Medica comparison we find Bryonia; dry tongue, sticking pain, on swallowing pain in throat, quickly prostates, shuns all motion, when being moved pain everywhere. And for Mercurius; we have redness and swelling of soft palate, tonsil and oral cavity, difficult deglutition, burning in throat, painful dryness of throat with mouth full of saliva, suppuration of tonsils, lymphatic glands of throat – hard and large.
Well! now we are quite in a clinch. Aren't we? You see we have a very clearly high polarity difference and a very much lower polarity difference in Mercurius. And we have Materia Medica comparison that would fit Mercurius rather better than Bryonia. What do we do? What would you do?
Yes, I would take Bryonia. It's just because I have made the experience that the polarity difference is so important. So I took in this case, Bryonia 200 C. In the following night, he sleeps well but still has slight fever. Next morning 12 hours later, throat pain and headache have come. And at the follow up consultation a week later all the previous findings are normalized and he is completely healthy again.
So what do we learn from this case? Polarity difference is more important than Materia Medica comparison. That is one point. Another warning is that scarlet fever is normally not a very dangerous disease but there are some variations of it are extremely dangerous. So if you treat scarlet fever you must be sure of yourself. Be very careful with these patients.
Okay. I have another case history. How do we? One more and then we stop. It's a special case. 19 year old young man. I know him since he was a small child. He lives with his mother who suffers of severe multiple sclerosis. And he has taken over many duties that would actually be the task of his absent father. Now he goes first time abroad on a trip to Amsterdam and he tries to escape his situation and smokes 2 joints. I see him 4 days later because he has an enduring feeling of being 'high'. He sees everything as through fog, has a feeling of pressure in the head and in the ears and suffers of vertigo.
At physical examination, I find only that he is slower than normal. What is your diagnosis? Well! it's not so difficult. He has pathologic reaction to Cannabis. Cannabis can make very severe pathologic reaction up to Schizophrenic symptoms. Fortunately he is not that bad but certainly this is. It’s a form of intoxication of Cannabis. What would you do? What did I do? You know, it's very tempting, you give him Cannabis. I did that. But I also I was a bit skeptical that it would work and I also gave him the Neurology questionnaire and told him to prepare it for comprehensive case taking. What do you expect from Cannabis C200 in this case?
Well! probably nothing. This is not Homeopathy. What I did was actually was a pure mistake. It is Iso-treatment of treatment of the same thing with the same substance. And normally this can't at least give a slight relief of the symptoms. And that actually it didn’t bring anything. Nothing happened.
4 days later he comes with the questionnaire and I have the following symptoms; visions as through mist, pressing headache, vertigo, indifference, warmth in general worse, warmly from wrapping up worse, standing worse, sitting worse, walking worse, after sleep upon awaking worse. Then he has a special symptom; urine scanty and urination interrupted. This was a bit surprising for me and I thought this is a certainly an important point to see.
Now for repertorisation if we use the polar symptoms alone, we have not the differentiation of the remedies that is clear enough. So we include the special symptom; extra ordinary symptom 'vision as through mist'. And here you see the repertorisation you see very very many remedies. 15 remedies cover all symptoms. And 10 have no contraindications. You don't see all of them here. But we have 2 remedies standing out. One is Opium and the second one is Nitric acidum. They stand out due to the height of their polarity difference.
Now we make a Materia Medica comparison. Opium; we have confusion of mind, dullness of head, stupid indifference, drowsiness, obscuration of sight, almost constantly frontal headache, vertigo with anxiety and delirium when rising as after intoxication. Urine retained, suppressed.
And Nitricum acidum; Indifference, tired of life, sensorium dizzy, dull, stupid and heavy. Drowsy all day from debility. Sight obscure while the reading, pressure in forefront of head and upon eyes, vertigo in morning, must lie or sit down with obscuration of sight. Painless retention of urine.
Okay, what do we do? I think Opium is fitting better. I think because it is a narcotic remedy, so we are closer to the similimum. And I give him Opium 200 C. After a short initial aggravation, he experiences considerable improvement. But after 4 days he still has difficulties with his visual perception. Everything else is normal. He says the improvement is 70 %. I wait because I still have impression, the improvement increases. A week later he comes again because vertigo and headache have reappeared. And now I give him Opium C 500 which makes the pathology to disappear completely.
Do you have questions to this case? What do we learn of it? To give Cannabis C 200 in a Cannabis intoxication is Isotherapy, and is stupid because at best it can be diminish the symptom slightly. We could actually………
We have a few results I would like to present you before we go for lunch. It’s only 5 minutes I think. You know when you invent something in Homeopathy, you must as I said be very careful, and I have really to test it with outcome studies. And to make an outcome study you need to define outcome criteria. And our outcome criteria in acute disease we have to find as follows :
First hit is; an improvement of 50% or more after a Homoeopathic remedy; potency 200 C within 48 hours. No other medication necessary. Second hit; patient needs a reserve remedy, also 200 C, after 48 hours because his improvement is less than 50 %. The second remedy improves 50% or more within 2 days at the most. No other medication necessary. That means after remedy one or two the patient is cured.
Now reaction. Neither the first nor the second remedy leads to cure. Second consultation necessary.
So these were for all studies that I made with acute disease, the uniform outcome criteria. We make quite a number of studies. One with Influenza, one with Hay fever, one with Acute otitis media, one with tonsillitis, sinusitis, infection of upper airways, infections of lower airways and enteritis. In total 256 cases, we had 143 first hits and 79 second hits. No reaction in 34 patients.
Graphically you see we have this. 56 % first hits, 31 second and 13 % no reaction. I have made already such outcome studies before I started with Polarity analysis. So I could compare it with Boenninghausen method without Polarity analysis. And these results are slightly lower than with Polarity analysis. So it’s about 10% difference; 10% increase of good remedy selections.
What are the pre conditions for good results? You need precise observations by the patients. Optimally they do it with checklist and this is really a very critical point. You need to educate the patients to observe their symptoms. Symptoms must be correct. No mechanical entry in the repertory. Discuss on clear points with the patients. And do not mix Homeopathic methods. Don’t make a Kentian case history and then use Polarity analysis. Kent is for Kent and Polarity analysis is for Polarity analysis.
What are the advantages? You have a simple and precise remedy determinations. They are efficient. The whole procedure is time saving. And the remedy selections are reproducible. And you have often healing effects that go beyond the acute pathology.
So conclusions. Most striking conclusion for me in this work with Polarity analysis is that polar symptoms are a mirror of the disturbed vital force. A very good mirror! And Polarity analysis very often goes directly to the core of the case.
You solved yourself after making this introduction into acute disease but having this live case certainly was much better. So we move now on to simple chronic disease. The second part of the seminar. And when we have time in the end, we can make this exercise cases then.
Now what is the goal of the second part of the seminar? We have the objective that you can apply polarity analysis in the treatment of patients with simple chronic disease. What is a simple chronic disease? A severe chronic disease is either the result of a long lasting degenerative process affecting the patient's physical or mental condition or it is a disorder that causes permanent physical or mental damage or debilitation.
And a simple chronic disease we consider pathological process that lasts longer than 2 months and that needs treatment. The severe chronic diseases are part of a later seminar which we do not…. I think it's not the room here to do this.
Now, what’s the difference in case taking between acute disease and a chronic disease? In chronic disease I make a case taking in 2 times. Patients must come twice for case taking. The first consultation I make the case history, physical examination, then I order additional examinations if indicated, I make a conventional diagnosis and after I've made the indication for Homeopathic treatment I explain them the questionnaires which they have to fill in to prepare the second consultation when I then determine the remedy.
At the second consultation about a week or two later, I look at the questionnaires, discuss the symptoms they bring along, ask them they really mean what they underlined, that’s very important. Then I make a repertorisation and then I have a look at the result of the repertorisation. A good repertorisation normally gives a comprehensive result like that Borax we had before. It was a clear result one remedy covered practically everything.
If you have and has a high polarity difference, that is very important too. If you have many symptoms and not the outstanding polarity difference in a remedy, there must be something wrong with the case taking. So this is quite important. It must make sense. So I ask all this after repertorisation, additional questions. I am interested if this remedy that comes out is really clear or not. Or if none clearly comes out I must find out where the fault in the history. Then I make the Materia Medica comparison and finally the choice of the remedy.
So the important thing about this is, the second consultation is a dialogue between patient and doctor. It’s not a thing that doctor can do alone in his office without the patient because you discuss what the patients bring you and you need to be able to ask additional questions.
We have 13 questionnaires for chronic disease. You can also download all of them from our website. I have…. I don't see if you personally are going to download my questionnaires but I can see from where all over the world if people use my questionnaires, and it's quite instructive. The most Southern most part of the use of my questionnaires is Christchurch in New Zealand. the most Northern most part is Kiruna in Northern Sweden; the most Western most part is Vancouver. So they are practically used all over the world. And recently I found someone who seems from a small Atlantic islands, South of Africa, who intensively uses polarity analysis. So it's very impressive to see how this spreads. So feel completely free to use everything that is on our website.
We have these questionnaires again from head to foot; neurology and Nose-throat-eyes, airways, cardio vascular disease, gastro intestinal tract, gynaecology, urinary tract, musculo skeletal system, disturbances of perception, ADD/ADHD, Sleep disturbance, then Mind questionnaire. Believe it or not. And questionnaire for the additional symptoms.
How are they structured? We always give the patient the questionnaire that concerns the main symptoms. So if someone comes for migraine, he gets a neurology questionnaire. And he also gets a questionnaire for additional complaints which is again from head to foot but on one paper. So we get everything not just the main symptom. First they have the opportunity to make a free formulation of the main symptoms and then they have a choice of polar symptoms as you have seen already on the acute disease checklists, with including sensations, organ specific symptoms, mind symptoms and the additional complaints. That’s exactly the same but you have for every section of the body, you have a line where you can write what bothers you.
The practical procedure is as I said; questionnaire for main symptom and additional. And for multi morbid patients; they receive a questionnaire for each complaint. They need quite much time. Then finally to determine the remedy there I normally need a little bit over an hour for the second consultation. Normally if you have a simple chronic disease I know within 15 or 20 minutes what remedy is the right one. That goes very fast.
Now what are the rules for determining a remedy in chronic disease. The main symptom has priority over additional symptoms. This is quite important. And the multimorbid patients, the more recent symptoms have priority over the older ones.
Now how do we handle polarity analysis in these cases? The more symptoms the patient has the more important is the size of the polarity difference. Contraindications in remedies with a high polarity difference must be discussed; very important! And you must check if alternative formulations of a symptom could eliminate contraindications. So if you have for instance, the symptom; Food and drink cold water ameliorates, you have 21 remedies and this is a contraindication, you must look at the symptom; Food and drink cold things ameliorates; 53 remedies. This might eliminate it. And so you have a broader spectrum of possibilities. Covering of the totality of symptom is a bit less important than in an acute disease.
Now we go right into a practical case. Again, an adult patient. A 50 year old mother who comes with her children; both ADHD; daughter ADD, son ADHD, since years in my practice. And now she suffers from severe shoulder pain in the right side since several months. And she went into the emergency unit of a local hospital and they made a diagnosis. I don't tell you what now. And started a heavy analgesic treatment with non steroid anti-rhuematics(NSAR), Paracetamol, Mefenamic acid and Novaminsulfon for analegtic medications. But this did not significantly improve pain and caused dizziness. So very unsatisfactory conventional treatment.
On examination I find an adipose, quite pale patient. Her right shoulder is unusually hot and sensitive to touch. Lifting the arm sideways is very painful and I have no other pathologic findings. Is there something you suspect here as a diagnosis? Rheumatoid Arthritis? Frozen shoulder? Okay. We see what it really is.
I made an X-ray as I had another suspicion. The radiologist made an X-ray of the right shoulder and here now is you see what she really has. It's a special technique after Morrison and you see the yellow arrow pointing at this structure here. What is it? It’s a calcification. It’s an extended periarticular calcification in the region of the supraspinatus tendon. And you know now the diagnosis. It’s tendinitis calcarea. Quite frequent complaint. We see that quite frequently.
I give her the questionnaire for the musculoskeletal system. As main symptoms she writes; stinging pain in the right shoulder. And the polar symptoms are the side; on the right. Then worse in lying position, lying on the side on both sides up on only on the painful side, raising the affected limb is painful, Cold in general, touch pressure, let the arm hanging down. And she has a desire for movement. So we have quite many good polar symptoms. If we enter them, you see the repertorisation here, only the polar symptoms. We have 18 remedies that cover all symptoms, quite many. And but we have only 2 remedies that really stand out with their polarity difference. One is Silicea. Then we have also Ranunculus Bulbosus. And if we look a bit further back here, we have also Ferrum Metallicum with a polarity difference of 19. But there is one symptom missing. The external pressure that aggravates is missing in Ferrum. So actually these 3 are our point of interest.
What would you do now? We go back and ask about this symptom. Did she test that really? She is extremely sensitive to touch. She is certainly lets nobody press on this point. So she didn’t really test if pressure is worse. That’s only her expectation. So you see that's an important thing we have to stick to the facts, to the observations. And sometimes patients have expectations, and they might or might not be true. Perhaps it would have been true. Well our case we would show what really is. We make a Materia Medica comparison and found in Silicea; pain in the right arm by warm wrappings , better by warm wrappings and a momentary sharp pain in the right shoulder.
Then we have in Ferrum Metallicum; pain shooting and tearing from shoulder joint into upper arm and farther downward which makes it impossible to rise it. Boring in right shoulder worse from motion, better from heat, worse from weight of bed clothes. So you see again extreme sensitivity to touch. Actually if we look at this, we would rather think a Materia Medica comparison, we would rather think that Ferrum metallicum is the better remedy. Don’t you think? But since I did not question this symptom; pressure worse so much, I decided for Silicea as first remedy. I gave her 200 C and it had absolutely no effect.
When I'm not sure, I always give also in chronic cases, I give a reserve when I'm not sure or otherwise not. Here I was a bit unsure so I gave her Ferrum Metallicum as a reserve. Then she called after 2 days, I told her to take Ferrum Metallicum.
Now the pain improves 40 to 50 % within 5 days. And now I switch due to previous experience with that tendinotis calcarea to Q potency. I have noticed that these patients very quickly use the effect of a Homoeopathic remedy disappears relatively quickly. So I had made better experiences with Q; liquid Q potencies that we give every day. And with that the improvement rises to 80 % within 4 weeks. And with higher Q potencies, it completely disappears.
You have this picture here. You know what this is? You know this thing? It’s a piece of stone. It’s a; we call it Ammonite. It’s an animal that lives, somewhat lived millions of years in the ocean. And you know, Switzerland was once at the bottom of the ocean. And so we find in Switzerland stony remnants of that Age. And near where I grew up, there was an iron mine. And in that iron mine, they found very many of these stony remnants of old animals. And as children we used to go there with the bike. It was about 2 or 3 hours by bike and searched for these ammonites. And this is one of them. And what is special about it? What do you think is special about it? It has a strange colour, doesn’t it? It is red. And why is it red? It is iron core. It is full of iron. So this is a nice piece of an original substance by which we make or could make our remedies.
After this patient was free of pain. We made another X-ray. Here you see it. Can you see it? It’s a bit dark. If you look at this region, that's where the calcification was, it's gone, it’s completely gone. So you see that is a contradiction to what Dunham and Jahr said about pathognomonic symptoms. It is this would be such a symptom and it disappeared the structure. And it's not the only case, I have several documented cases of tendinitis Calcarea where the calcification disappeared. And when you tell the radiologist what treatment the patient has or had, they are usually extremely surprised. They would think that has been done by surgery.
So what can we learn from this case? It is very important to stick to the facts, not to the expectations of the patient. Now if we take out the symptom; Pressure worse, you see it looks quite different. Ferrum Metallicum is the first remedy, with the polarity difference Silicea the second and Ranunculus the third. Do you have questions to this case?
A = Audience; S = Speaker
A : You have mentioned Q 3, 6. That I, I don't know about this.
S : Do you know Q potencies?
A : Q I know. That is mother tincture.
S : Q is the. Another expression for Q potencies is LM potencies. They are diluted 1 to 50,000. And starting from C3. So the Q1 is C3 diluted by 1 to 50,000.
A : Q1 is the C3.
S : C3 and dilution 1 to 50,000. Okay. So Q potencies are actually highly diluted low potencies. And in difficult cases they often have a more profound effect in single doses. So I for sometimes use nearly only Q potencies in ADHD patients because I consider them very difficult. Today as you those who have heard the speech in the college yesterday have seen, it’s 25 % of ADHD patients need Q potencies and the rest goes well on single doses.
And when we use Q potencies we usually give… these are liquid potencies, we give them daily 2 drops diluted in 100 ml of water, shaken and diluted. And you give it for 4 weeks and then you change to a higher level of Q potencies. Normally we change 3 steps from Q3 to Q6, then Q9, Q12. Because otherwise if you take one level only, it might be that the Q potency doesn’t work anymore. Because if the patients have shaken vigorously, the Q potencies, they have already reached that level with the Q3.
A : So we need to jump one step further.
S : You may call it 3 steps.
A : It’s not Q1 or Q2. Yes, you begin with Q3 normally, and then go onto Q 6, 9, 12, and each for a month. After a month you change. Well! LM actually correctly is the single dose C or K potency 1 to 50,000 and Q potency is the thing I explained now. But in the English literature very often Q potencies are called LM potencies which is not quite correct. Any other question?
A : I just made 2 days. Yes after the first remedy. Because in these cases the pain is so severe that you need a fast effect. So after 2 days you don't have clear effect, you must proceed with the next remedy. I have seen one patient with the same disease tendinitis Calcarea who was unable to sleep, unable to do anything. She was…. It was such a severe pain she had. She was a teacher. She could not work anymore, she could not do anything anymore. And this lady I gave Ledum. And Ledum did the exactly the same effect; calcification disappeared but it was Ledum single dose only worked for a short time. So after several days she needed to repetition. But after the first dose, she slept in the night. So she did very well on that remedy. So we did not change it but juts had to repeat it in higher potency. And finally Q potencies.
A : When to choose single one and?
A : The question is when do I choose centesimal potencies and when do I choose Q potencies. Centesimal is routine. Normally I use Centesimal potencies. In difficult cases like one of these or ADHD or if you have a cancer patient, you need to… who gets Chemo therapy and I treat in parallel with homeopathy then to, or if the patients need other severe conventional treatment, it's better to use Q potencies. Any other question?
A : In febrile cases how much long would you like to wait for, if you have got acute case presenting with high grade of fever?
S : Normally in acute disease we wait 2days. If it's not at least 50 % better, we change the remedy.
A : But patients are…. the relatives are panicked. So in that conditions….?
S : I didn’t understand. Can you repeat?
A : It’s a fever; acute high grade fever. Patients…. How much time we should wait?
S : All that depends on the condition of the patient. In some patient you have time because there general condition is quite good despite the high fever. In others they have a poor condition and then you have, then you may not wait that long. This concerns also patients with pain. This is even a more prominent example. Like in children with acute otitis media, I expect a correctly prescribed remedy to improve the symptom; the pain, within 6 hours. After 6 hours when the pain is still severe, we change the remedy. And that would be the same in acutely critically ill patient. If you don't see an effect within a reasonably short time, you must change.
A : Sir, can I know what is your experience in treating the ADHD, Autism and genetic level diseases like in children. Mental retardation also.
S : I had yesterday.
A : What is your prognosis and how to take the case analysis.
S : That's quite broad topic to answer. I had yesterday 2 hours speech on that. Well, in short, you can expect in a long run over many years that 3 or 4 ADHD patients go well with homeopathy. And the prognosis is, when you treat them over quite a long time like several years, you have lasting improvement of the ADHD symptoms of over 50%, a little over 50% even after stopping Homeopathic treatment. That’s our experience. Now we have made it. We have a long time study now, over 12 years and that is the result of it.
A : Sir, you are treating on single remedy or you are treating ADHD with single remedy?
S : Single remedy or Q potency. As I said, I use 2 potencies routinely in our ADHD double blind study because they have a more profound effect. But since then most of these patients we had in the study came into puberty and it got more difficult to apply medication daily. So gradually I have changed quite a few of them to single doses which we repeat in monthly intervals. Today we have 25 % on Q potencies and 75 % of the patients on single doses. But with single dose, it's very important to repeat them after 4 weeks. Some even need repetition after 3 weeks because in ADHD the effect often diminishes after that time. If you don't repeat them frequently, they get these ups and downs and nobody tolerates such treatment.
A : Sir, in severe profuse mental retardation what is; how?
S : In mental retardation. Well in autism especially in Aspeger's syndrome, I have some experience. It works as well. Patients with Aspeger usually can lead a normal life if you make a correct Homeopathic treatment. The principles are practically the same as in ADHD. In severe mental disability, you can only improve certain symptoms. Of course you cannot cure brain defect. But you can cure may be the motor, motoricity. They become calm, they become better to handle. But you cannot cure the disease I think. Other questions?
Then we move on to case study 2. Now we come to an ADHD patient.
He is 10 year old and he has received Sepia Q potencies for his ADHD over 2-3 years. His Conner's Global Index that is an intensity rating of ADHD has improved from 18 points; that's medium severity of ADHD to 2 points which is completely normal. And at school everything is going well.
But now puberty begins, he again becomes restless, irritable and aggressive. And in addition, he has daily epileptic attacks when he falls asleep and in the early morning. These epileptic attacks are very well described by the parents and by the child. They begin with a sensation like ants crawling over his tongue and over the left cheek. Next, the face is distorted and begins to twitch. Then the left arm trembles and he cannot control it anymore. Afterwards he begins to salivate and cannot speak. All these last about 3 minutes and it can be interrupted by another person touching him. That’s a very interesting aspect.
Of course, I make an EEG. And the neurologist finds focus on the left frontal temporal side with biphasic spikes and waves. And he diagnoses Rolandic epilepsy. He wants to install an anti epileptic treatment due to the high frequency of the attacks but the parents declined it and want homeopathy instead.
Now, do you know Rolandic epilepsy? It’s a special form seen mainly in young patients, in children and young adults. And typical are the focal attacks. Frequency is about 2 patients per 10,000 people. I have 2 or 3 patients with Rolandic epilepsy among 15,000 patients who I treat or who I have treated. I give them the questionnaire for neurology and also for perception disturbances; ADD, ADHD.
So we have the symptoms. We already know he had crawling like ants and so on. Then worse by falling asleep, on awaking, then swallowing when speaking, salivation increased. Touch better. Then this perception we have; desire for movement, understanding difficult, warmth worse, on covering better, irritability.
You see here are remarks of me, desire for movement in an ADHD patient is an unreliable symptom. It should not be used for repertorisation because many people say, many parents say, he has a desire for movement but in fact the child is just fidgety. That’s not the desire for movement. If he does constantly like this, this is fidgetiness.
We repertorise again primarily with the polar symptoms. And you see we have 5 remedies covering everything and only one has no contraindication. This again is a situation which seems quite clear. It is puzzled and fixed together. Also Phosphorus does not have highest polarity difference. It covers all symptoms completely. You see here the highest polarity difference in China and second in Mercurius. But in both we have important symptoms missing. In China especially we have the epilepsy with consciousness missing, that’s a symptom we cannot discuss away. So China is not in the circle of remedies. While down here we have touch better in Mercurius. That is not a symptom we can discuss either, this is a reality because it interrupts the epileptic attacks. So it is clear that Phosphorus is the remedy of choice.
If we make a Materia Medica comparison, you see epilepsy with consciousness in Phosphorus, saliva increased, speech difficult and weak, slow. Jerking of single muscles, spasms on paralysed side. And in Mercurius we have involuntary motions, salivations, speech impeded, difficult or loss of speech, jerking convulsions. Here too Phosphorus seems to fit better than Mercurius. So we give Phosphorus 200 C.
The attacks disappear but restlessness and aggression remain. To be difficult. I give Phosphorus 1M a month later. And that causes no further improvement. The attacks are absent but he is still restless and aggressive. So I try Mercurius 200 C. And what happens? He has 7 epileptic attacks within 4 weeks. So I made a mistake. With the next dose of Phosphorus, the attacks again disappear and he has no more attacks since then. But the pubescent restlessness and aggression remain unchanged.
So what do we learn from in this case? It’s a clear proof that homeopathy is not the placebo treatment, nor psychotherapy. What matters is the right choice of the remedy. Because if it would have been either placebo or psychotherapy, also Mercurius would have functioned.
You have questions here? No questions.
Now comes a more complex case. This is a child. 4 month old little girl which was initially healthy and so far is unvaccinated, which has a severe eczema. A Homoeopath gave her in the second month of life 'eugenic cure'. You know what that is? It's that something that makes sense. It didn’t seem to me. And he received M potencies of Lachesis, Nux vomica and BCG vaccine nosode. And within 3 weeks an eczema appears all over the body. She is now given 2 more doses of Nux vomica, then 2 doses of Pulsatilla and finally Arsenicum Album, all with intervals of one week. The eczema becomes catastrophic and the paediatrician which was not me, wants to treat with Cortisone. But the parents declined this and they come to our practice.
Here you see her skin. This is not the worst condition, it’s just one of the pictures I have. It was covered all over the body with these crusts and it was also wet eczema and extremely itchy. She is irritable, scratches herself constantly and cannot sleep anymore due to itching. Worse…. also she is even failing to thrive with a dramatic fall off in her growth and weight curve. This is very serious. If a Child does not grow or gain weight, it is a critical condition. But we have no other pathologic findings.
I give mother the checklist for infants and small children. And I get these symptoms; wet, crusty and itching eruption over whole body, Symptoms preventing falling asleep, Emaciation, worse by noise, better by open air, worse in warm room, while falling asleep, warmth of bed, all worse. She is irritable and is thirstless.
We first use as usual the polar symptoms for repertorisation and important is that we use polar symptoms that affect the general state of the child, not the skin. If we take skin symptoms, we are superficial. And the healing probability is much smaller with skin symptoms than with internal symptoms. Or we can use too in addition to the polar symptoms is the perception symptoms; noise worse, aggravates. We want. Do you have experience with treating small children with neurodermatis? It’s a very difficult matter. The problem is that often they don't have internal symptoms.
In generalities; skin diseases are difficult because if we make a if we undertake the adventure to try to find the remedy only with skin symptoms, we are superficial; also in a deeper sense. And that means that our probability to find the right remedies is much smaller.
We once made a test in the Swiss association of Homeopathic physicians where we had a group who treated patients with skin diseases using only skin disease for repertorisation and other group using internal symptoms and avoiding skin symptoms for repertorisation. And the result was smashing. In the skin disease symptom group we had 27% success; very bad. And in the internal symptom group we had nearly 70% success. Normal, the internal symptom group is about the normal success rate that we can reach with the good treatment. So do not use if ever possible skin symptoms for repertorisation. If ever possible. Some patients don't have anything else then you don't have a choice.
So this is the repertorisation. You have 2, 4, 8, 12, 14, 16, 17 remedies that cover all symptoms. No that's not correct, many symptoms are covered. Many remedies that cover all symptoms are only 4, who have no contraindications. And the one with the highest polarity difference is Ipecacuanha. And in second place we have Sepia. That's quite surprising. Ipecacuanha for skin disease is extra ordinary.
Now we find in the Materia Medica comparison, itching-unchanged by scratching, emaciation and sinking in of the abdomen, starts up in sleep. The child cries and screams violently and incessantly. And so we have more or less in the Materia Medica these symptoms. We have very little skin symptoms, only this I found.
And I gave her actually, surprised but I gave her Ipecacuanha. In skin disease, I always begin the treatment with 30C potency, not higher, because if you give a higher potency, there is a danger that you have a severe aggravation. That is not so easy to control. So I always begin with that and make them report in 14 days.
How it goes? After 2 weeks she's better and not very much better but a little better and I give her now the 200C potency. And 3 weeks later she is much better, 80% better that parents say. The skin itches less. She's milder, she can sleep again. But now the healing process stagnates and I give her the next dose Ipecacuanha 500C. We get an aggravation and then the rash disappears completely. And the weight curve returns to normal to the 50th percentile.
But the battle is not won yet. The story goes on. Few weeks later the eczema reappears on the elbows and knees. This is just a small area but you see we didn't have a victory yet. And I make a new case analysis now. And we get also some general symptoms. Why do we get now this aggravation? What do you think and why do we get general symptoms? What does this child do now?
We have a first symptom here; salivation increased. When do they salivate? When the teeth are coming out. So this teething and we see often that pathology comes out when teething. She has a desire for open air, she is thirstless, she is better in open air, rest is improving, warmth of room aggravates, and she is still or again worse before falling asleep.
We make a second repertorisation now also again only with polar symptoms. And you see again we have very broad differential diagnosis; 27 remedies cover all symptoms, 18 of them have contraindications. So at least many fall out, but we still have 9 without contraindications. We find out polarity difference in Asarum, Sabina, Phosphorus and Magnetis Polus Arcticus. Sound quite an interesting combination, isn’t it? Quite unexpected. Again we have remedies that we do not expect at all in the small child except Phosphorus.
Due to the highest polarity difference, I give her Asarum 200 C. That is a remedy which is practically not known to have any skin symptoms. Within 4 weeks the skin again improves 90% but higher doses of Asarum have no further effect. So this is like flying blind now. The next I take just the next remedy with the next highest polarity difference, that is Sabina. Do you know Sabina? Sabina also is a remedy with only very few skin symptoms, but with potencies 200, CM, XM and LM at monthly intervals, the skin improves completely. And now it looks like this.
What do we learn from this? Well! the role of this eugenic cure in the aetiology of eczema is quite unclear. My opinion, I'm sure yours too is that homeopathy is a method to treat diseases, and a remedy determination requires symptoms. Anything else is speculation. Of course we suspect that the eugenic cure has elicited this neurodermatis.
Then I said, we have a chance of about 25% that within childhood until puberty such a severe neurodermatis disappears. 75 % of these patients go on to allergic rhinitis and asthma. And this case shows that severe chronic disease often needs more than one remedy to be cured.
Do you have questions to this case?
A = Audience; S = Speaker
A : Why did you change Asarum? It has given much improvement.
S : Well! it did not made any further improvement. That’s why we had to change. Here the question was why did I change Asarum because it did had made an improvement. It had made an improvement up to 90% and then it was finished. And the goal was 100 %. That’s why.
Other?
A : When not to repeat and change the remedy and when we can repeat the dose?
S – Why do not repeat.
A : The dose of the same remedy.
S : I did repeat it but it did not react anymore to Asarum, and then I changed. =That's the way I was doing it. Other questions?
A :Repeating in different potency? One get exhausted, we go to the next potency provided the patient remains the same?
S : I always begin with 200 C, then LM, CM.
A : Symptomolgy remains the same, and the potency that could have been worked, and it is not working?
S : Okay. The question is why do I don't give the same potency again.
A : or different potency rather than changing the remedy all together?
S : This is quite a difficult question, you know. What we know about dosage of Homeopathic remedy is extremely limited and there are absolutely no scientific studies that show us what really is the best way to those remedy. And I have adopted for myself that I… if the improvement does not go any further with the next higher potency, if it stops going any further I give the next higher potency. If it does not react to this higher potency, I change the remedy.
A : Then lower the potency, 200 to 1M, instead we go from 200 to 30
S : I never did that. But I am sure that functions.
What we do in ADHD patients, in chronic treatment, is that we go up the ladder; 200, XM, LM, CM and then we re- start with 200. So you would have given a C 30?
A : Like Stuart Close mentioned a model case. He was treating the case with dilution and he was not improving. Same patient went to allopath, who gave grain dosage and he improved.
S : That's interesting. So I will certainly try this the next patient I have with this problem. Thank you very much. Other questions? There is another question over here.
A : Sir, miasmatic interpretation in this analysis? In this polarity analysis, what is the use of miasms?
S : None. I don't use miasms anymore. I use them in my earlier phase with Kent especially in my first 5 years of my homeopathy, I used miasms. But since I work according to Boger and Boenninghausen, and now especially with polarity analysis, I do not need them anymore. It’s very surprising. I know this is surprise for all those who are used to look at miasms. And it was a surprise for me too when I stopped looking at it that it still works.
A : How do you value the nosodes? Nosodes are not included in Boenninghausen repertory like Tuberculinum.
S : Okay. The problem with nosodes is that Boenninghausen didn't have them. So I rarely use them. I use them only when I have impression now this patient really needs a nosode. But that's quite rarely the case. So you see, homeopathy comes back to the very early phase and to the basics if you do this. And it works. I think actually the old Homoeopathic doctors were very successful in treating cases because otherwise homeopathy could not have spread that well.
A : Sir, in your case when we are at the Phosphorus, Asarum and Sabina stage, instead of prescribing Asarum, if we would have directly given Sabina, would we have reached.. we would have reached directly 100% cure? What is your retrospective on this? Opinion on this?
A : In the previous case where you have prescribed Phosphorus and then later Sabina, so they are asking that if you would have prescribed Sabina first, would the process of treatment be short?
S : I would not have because the symptoms clearly indicated Phosphorus first. You always have the symptoms who show you, who say, what kind of remedy the patient needs. I don't think that it would have worked better if I would have given Sabina first. On the contrary I think Phosphorus was the right remedy, at that point and the healing process proceeded to Sabina.
A : I want to know whether it is only the polarity difference that you consider for giving the next remedy or are you using the concordance chapter also; The remedy relationship.
S : I don't use the concordance. I just use the symptoms and polarity difference.
Evaluation of polarity analysis in chronic disease :
As in all these disciples when I tested polarity analysis, we made prospective outcome studies and compared them to the results that we had earlier. So we had cohort with polarity analysis of 153 patients with a representative mix of diseases treated in our Paediatric practice. And we made groups for each questionnaire.
Minimum number of patients for the questionnaire was in gynaecology and cardio vascular system with 8, and the maximum number of cases was with neurology. And then we had a comparative group in conventional Boenninghausen homeopathy using the ranking of symptom of Hahnemann as a Boenninghausen repertory, and ranking of symptom of Hahnemann. And in this group we had 50 patients.
Also they had a representative mix of diagnosis as we see in our practice. The outcome criteria for both groups were successful treatment. We counted a remedy that caused improvement of at least 50%, 2 months after a dose in the potency 200 C. And to determine this 50 % or this percentage improvement. Patients had to rate each symptom after 2 months if it is unchanged, better, completely healed or worse. And after that rating of each symptom, they had to make a global improvement rating.
This was the result. You see the control group is blue and polarity analysis is green. We had successful treatment in the control groups in 68 %. And global improvement in the control group of 75%. And with polarity analysis successful treatment rose to 84% and global improvement also 84 %. And here you see the results of questionnaires. You see that neurology is may be the one that has least improvement. But you see an overall approximate improvement of about 80% with both the criteria.
So what can we say against polarity analysis? We can say against it that we limited open case taking through the questionnaires and that maybe important information, individual information can get lost. I think this maybe the cause in a limited manner. But still of course I talk to the patients. I do not just give in questionnaires or checklist symptoms to find the remedy. And the results speak against this that it is a disadvantage to do it this way.
Now we already discussed that we rely on Boenninghausen's grading of symptom. And other Homoeopathic doctors would probably or possibly make other gradings . Again we have the results that contradict this argument. We have only 133 remedies in Boenninghausen's Therapeutic Pocket book. But we can solve 85% of our cases with these remedies. Sometimes you need a sequence of them to achieve a cure. That was the normal way the old masters did it.
We have on the other side the advantages. The questionnaires lead to very precise information about the patient's symptoms, and the determination of remedies is precise, efficient and reproducible as reflected in the success rate. So overall the mountain we had in the beginning in front of us, decreases quite sharply and that’s why it’s worth to try it with polarity analysis. If you would want to have further information on this method, you find it in my book, 'Polarity Analysis in homeopathy' and you find a lot of things you can use on our website.
So far the introduction into the chronic disease. And now the next step. That’s not the end of the seminar but now we would like together to solve some chronic cases.
Now 2 chronic cases; paper cases together. Or I was asked that I might say something about ADHD which would not be involves self in the cases of your side but I would just present our experiences and our insights into ADHD. Would you prefer ADHD?
So first of all, what do we want with this? What are the objectives of this last part? I want you to introduce you to the Homoeopathic treatment of ADD/ADHD with Polarity Analysis and we leave the research part away because we don't have the time for this part.
What is ADD/ADHD? That’s a picture where you can see about all the faces of this syndrome. You see this little fellows, they don't shy away, jumping over short bulls or they are may be even swing through short bulls. They are often very creative. You know this picture; is a Picasso. Get into situations that might become uncontrollable and move on to the next adventure. And when they are through that, go back and start again. That’s the way it circles around all the time.
Most prominent symptoms of ADD/ADHD are listed in the Conner's Global Index which we use as an assessment scale for the intensity and also as a treatment control. The children are
• Excitable and impulsive
• Cry easily and often are
• Restless, fidgety
• Always on the go
• Destructive
• Lack of stamina,
• Poor concentration
• Rapid mood changes
• Easily frustrated and
• They disturb other children.
As diagnostic criteria we have these 3 main criteria, i.e,
• Inattention
• Hyperactivity in the ADHD component and passivity in the ADD component and
• Impulsivity.
And the symptoms must begin before age 6 years, and they need to have a minimal duration of 6 months to make the diagnosis. And they must be present in at least 2 settings such as family, school, work, etc.
The prevalence of ADD/ADHD in India is 11% as I found in the literature. The same is in the United States. And I would day it’s exactly the same in Switzerland and Germany. These figures are old ones. There are no newer ones and I'm quite sure they are not any more up to date. 80% of the patients are boys and 20 % are girls.
The conventional treatment of this syndrome is counseling of parents because these children are very difficult to handle, Occupational therapy, Psychotherapy and pharmacotherapy. And unfortunately today's society tends to stick mainly to this and to Methylphenidate. You know Methylphenidate? This is an Amphetamine derivative related to Cocaine. And the final substance is psychopharmocon is Atomoxetine which is not under narcotic legislation like Methylphenidate but still has quite many side effects. So you see that conventional treatment is either very time consuming or it is very medical pharma weighted.
If we look at the Methylphenidate consumption in Switzerland from 1996 to 2011, you see an exponential increase. In 1996 we had 10 kilos consumption of Methylphenidate in Switzerland. In 2011 it was 349 kilos. And this trend is unbroken. I'm sure it’s up here somewhere now. And since many parents do not want to treat their children with Cocaine, if we can formulate this quite pointedly, they search for alternative treatments. And may be the best alternative treatment is homeopathy. A bit less effective are herbal remedies, omega 3 and omega 6 fatty acids, then much less effective is diet or training methods like EEG biofeedback.
Now I first show you a case study which shows you how we approach these patients. It’s a 12 year old boy. He I s impulsive, restless, irritable, cannot finish off things he starts and quickly gets frustrated. At school he is slow in learning, finds it difficult to pay attention. And he also suffers of severe headaches from lack of sleep, excitement and when he is upset or afraid. As a small child he was very fearful but this has now diminished.
We confirm the diagnosi s with a neuropschychological examination and the parents rate the intensity of his ADHD of 20 on the Conner's Global Index, that’s ADHD of medium severity. He is a large, reserved, rather pale, adipose patient with poor muscle tone. And I'm surprised how he can behave relatively calmly in my practice.
The parents receive the ADHD questionnaire and the questionnaire for additional complaints as any chronic disease and they bring the symptoms back. We have strained vision worse. Strained vision that means looking on T.V, iphone, P.C, etc. Then he is on the warm side, warmth is worse, uncovering better. He has difficulties with fine motor skills and he is slow in understanding complex matters. And his muscle tone is low. And 2 symptoms of reduced reliability are; sensitivity to noise and an improvement by movement.
On the questionnaire for additional complaints we find, mood swings, overweight, sweating strong, headache, better in open air, worse lack of sleep and worse with mental exertion. And here you see now these symptoms marked with little stars. They are symptoms of limited reliability. We will talk about this later on. For repertorisation we primarily use only the reliable perception symptoms. And symptoms of reduced reliability and symptoms of additional complaints are only included if the differentiation of remedies is insufficient if we use only reliable symptoms.
Now in this patient, the reliable symptoms give this result here. You see we have 12 remedies covering all symptoms. And we have 3 that have contraindications, so we can exclude them. And we have 2 that clearly stand out; Lycopodium and Calcium, due to their polarity difference.
Now we look for confirmatory symptoms. And this patient has many confirmatory symptoms for Calcium Carbonicum. When you hear the story, you think, well! Clear, that's a clear Calcium case. I often think this but it’s very important; Calcium is the most frequent remedy in hyperactive children astonishingly. We had in our studies which encompass a 150 ADHD patients, in 14 % Calcium Carbonicum. So that's why it comes first too.
And here we have quite many confirmatory symptoms for Calcium; Over weight, sweating strong, pale, flabbiness, shyness, fearfulness and he is not dictatorial. I rarely give Lycopodium to a patient who is not dictatorial. I think that's more or less an obligatory symptom in this remedy. Sometimes the parents say they are not dictatorial. But when you ask them how they behave in the familiar; in a family towards siblings, they say, “oh yes, here they are dictatorial.” And outside of the house they are often shy. But this one is really not dictatorial at all. He is just shy.
Here you see what the origin of Calcium Carbonicum is. This is an European Oyster, alive animal sticking to a rock in Brittany in France. And in Brittany you have very high tides. You have a tidal difference of 4 meters. So when the tide is low, you see Calcium Carbonicum live out in the fresh air which is rare otherwise.
So I give him Calcium Carbonicum Q3 in liquid form daily and we call him in another month. And his mother says that he is now, he can cope much better with many things at once and can concentrate better on his work. His Conner's Index has dropped from 20 to 12. After another 4 weeks now with Calcium Q 6, the CGI is 9. The family and teachers are impressed with the comprehensive changes in such a short time. I am impressed too because this is the exception that you have such a fast improvement. It’s really not ordinary that we get there so fast. And with further Q potencies of Calcium his CGI drops to 6 where it remains in a long run.
Here you see the graph showing the CGI. It is very important to treat these children over many years. If you do so, they remain stable after stopping treatment. If you stop treatment in an early phase like after a few months, they will relapse.
So what are the teaching points in this case? In ADHD patients we have observed that most symptoms parents report to the doctor are non specific and stereotyped. You cannot use any symptom of the Conner's Global Index for determining the remedy. This doesn’t lead anywhere. What is really individual is the combination of perception deficits that differ from child to child. So we look mainly at this.
Now come the prestudies and I think we just skip them. We also skip the double blind study. May be one interesting thing. The double blind study is we tried to prove, we means the 3 Homoeopathic doctors tried to prove the maturity of the team that homeopathy is not placebo. All these were doctors of the university clinics. And here I was the treating physician and 2 colleagues from Institute of Complimentary medicine. And we could convince them that it is not placebo by significant result of the double blind study trial. That was quite tough, quite tough. But we go now. Would you like to know that, the results of the study? Or would you like rather to know how to do it? Okay.
Here is one thing you must know. If you do it right, you have the long time results of 5 years. After 5 years we have… we could still follow most of the patients. I think 2 or so got lost for follow up. Here you see the Conner's Index at treatment starts and you see here in the green bar, the patient's Conner's Index are who still are on homeopathy after 5 years, it was 28 of these patients 46.7%, and they have the best results. They have Conner’s Index of 7 above.
Then you have the most interesting group. That's the one who stopped any treatment. 25 patients have stopped to take anything at all and they had a small increase of Conner’s Index and they went up to 8.5 points after stopping treatment. But we still have this improvement from 19 points to 8.5 points. So this is more than 50% remaining improvement which is a healing effect. Then we had a small group; 11.7 % of the patients who stopped taking homeopathy and changed to Retalin to Methylphenidate. And they had the worst Conner’s Index. So that is what you can expect of a treatment in a long run.
The conclusions of the study were that homeopathy effects are not placebo effects, that we can stabilize 70% of patients on homeopathy alone. And for optimal improvement, the Homeopathic remedy must fit the individual symptoms exactly.
What are treatment limits? The time requirement. We cannot treat emergencies because the improvement is only slowly. Then the parents have to observe, have to be able to observe symptoms exactly and the tolerance of the teachers. It’s very often that the teachers make pressure against children and parents.
Maybe still another thing that might be interesting. We tried to publish it in the Lancet, this study. Well you might; yes you might be surprised, I demanded a fast track procedure. A fast track procedure in Lancet you get only for the best studies. And we got it. But their finding after 10 days was this is an excellent study but our journal is not the right place for it’s publication. In the same year they published the Shang's study and proclaimed the end of homeopathy which certainly was a bit premature. But you see this is publication bias. This is completely unfair what they did. And they were violently attacked for this Shang's study. I think they might have learnt something, I hope. We could easily publish it afterwards in another top European conventional medicine journal; The European Journal of Paediatrics. We got very fastly through. No big thing. And if you want to read the study, you can also download it from our website.
Now what were the effects of this study? None. Perhaps none. There are still quite many opponents of homeopathy. You pretend that there are no Homeopathic double blind studies. This is s blank lie because there are quite many Homeopathic double blind studies. Ours is ADHD study was one of the strict scientifically strictest because most of the team wanted to prove that it is non sense what we do. So they really made conditions difficult to get there. Was it rejection? A German science journalist wrote, it is imprudent that homeopathy uses scientific methods to conduct studies. This is so absurd that they always say, make scientific studies and when we do it, they criticize us. They are so stupid.
Rethinking our scientific advisor was professor Steinlin, Head of the Peadiatric Neurology department of the University clinic. And she said on German TV, we have clearly failed to prove that the effects of homeopathy are placebo effects. That’s is a very courageous statement in public and she was violently attacked by the opponents with very ugly emails. But still she said and she stood also up in the faculty in Bern and said, this study is a serious study and we have failed to prove that this is placebo effect. So that made her no friends but she is a courageous woman, and I admire her for that. She is very tough but she stands for it. And she also said when we started out, whatever comes out in this study, we will publish it. And of course she expected that we will have to publish a negative result. But in the end she did everything to get it published.
So what came out for homeopathy? The discovery of Polarity Analysis. That was the best thing that could happen to us. So now we go to this topic and how we can do it. If we treat ADHD patients with conventional Homeopathic approach, our success rate is very small. Well! mine was very small. May be you are here is much better. That is the study that I made maybe 20 years ago. And my hit rate in the first try was 21 %. Second try 40%, third try 48. I ended up after 5 tries with 67 %. That’s about what we had at that time otherwise in primary prescriptions in other diseases. So it was much much worse than anything else. And actually I left this syndrome for 2 or 3 years on side because I thought that makes no sense. But then the parents made pressure that I should really treat it with homeopathy and I restarted a new try.
I restarted it with trying to find why it is so difficult to get successful prescriptions in ADHD. And to find that out, we needed 100 successfully treated patients. And we analyzed the prescriptions before we got the best ones and looked at what symptoms have prevented us to get primarily to the best prescription, to the best remedy. And the result of this analysis was smashing because nearly everything that we had used was once or more times cause for a failure, for a false prescription.
Mind symptoms in ADHD, and mind modalities – 44 failures of 77, General modalities- at least 11 failures, Perception symptoms – 4 failures, Musculoskeletal symptoms – 6, Nutrition desires aversions and modalities 6, and weather and climate modalities, things that we usually consider as reliable were have here proved to be quite unreliable. So I don't want to take the carpet away from, you are standing on. This is just ADHD. This is not general homeopathy. So it’s a relative finding.
There was one consequence of this analysis. That is, do not use ordinary complaints for repertorisation in ADHD patients because they are non specific. What is the basic problem in ADD/ADHD? The basic problem are perception disturbances, Disturbances of visual perception, gearing, tactile, balance, sensitivity to temperature, taste and smell. Either the children over sensitive to stimuli or insensitive. Or they cannot select what is important to them being flooded by inputs and that makes them so fidgety and unconcentrated and tiring. Or they react inadequately to these inputs that come over the peripheral sensory organs.
What is the consequence number 2 of the study. Find symptoms related to perception. Now these are pathognomonic symptoms. And we tested them and we saw that the results if we use them, get much better after 3. When we introduce this, we had after 3 prescriptions the best one, before we needed prescriptions for that. What are reliable, visual symptoms? We have a few and how do you find them, maybe this is not the question. You find them and if you search in the repertory what could be relevant in this field.
So we have 3 relevant visual symptoms that is, light aggravates and oversensitivity to bright light. Then strained vision that aggravates. Like watching T.V, mobile phones and this PCs etc. And reading aggravates. Dislike of reading, tires easily when reading. That’s all we have in this field. With hearing we have the symptom speaking aggravates, slow speech development and speech disturbances. Tactile; we have an over sensitivity to touch. These patients dislike to be touched.
Then temperature; we have quite much. Warmth in general aggravates, uncovering ameliorates the warm patients, warm room aggravates, over heated room. Then we have the cold ones. Cold in general aggravates, wrapping up warmly ameliorates. It is very important to get if ever possible this xxxx, we need to know if they are on the warm side or on the cold side because if we don't, it becomes very unsecured, the remedy determination.

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