A Report on the ICR Mumbai Symposium on Exploring Dr C. M. Boger’s Philosophy & Its Application in Clinical Practice
Dr Sachin Junagade, MD (Hom)
Assistant Professor, Dept of Organon of Medicine,
Dr M. L. Dhawale Memorial Homoeopathic Institute, Palghar
As a part of their continuing educational activity, the Dr M. L. Dhawale Memorial Homoeopathic Institute (MLDMHI), Palghar, and the Institute of Clinical Research (ICR), Mumbai, organised a symposium on Exploring Dr. C. M. Boger’s Philosophy & Its Application in Clinical Practice.
Dr Anoop Nigwekar, Professor & HOD, Dept. of Repertory, MLDMHI, was the symposium director and Dr Nikunj Jani, Associate Professor, Dept. of Repertory, MLDMHI, Palghar was the symposium coordinator. A total of 187 delegates (students, teachers, and practitioners) from Mumbai, Palghar, Pune, Kolhapur and other parts of Maharashtra, Sumeru, Vadodara and other cities of Gujarat, and from Chennai benefited from this Dnyanyagna.
Most of us equate Boger with pathological generals. However, a detailed study of his literature in volumes of the Homoeopathic Recorder and in Dr Robert Bannan’s C. M. Boger – Collected Writings reveals that Dr Boger demonstrated a strong affiliation with concepts of dynamism, individualisation of person and his disease, and, of course, treating man as a whole. He denounced the then prevailing practices of key-note prescribing and promoted the principles taught by Dr Hahnemann.
The symposium was organised to offer the attendees a platform to learn from the clinical experiences that were intended to explore all the aspects of the application of Boger’s philosophy in practice. A wide range of cases, from one-sided and mental diseases, to acute emergency cases in the hospital, acute cases in OPDs / tribal settings / rural settings, and cases from urban personal clinics were selected.
The symposium opened the doors for an analysis that shed light on the concepts on which Dr Boger’s philosophy was developed as well as the methods and techniques of applying this philosophy in clinical practice.
Dr Anoop Nigwekar began the symposium by highlighting the life journey of Dr Boger, where he narrated the influence that the masters, Hahnemann and Boenninghausen, had on Boger, and how Boger modified Boenninghausen’s approach by incorporating the concept of time. He also introduced the group to the techniques of studying the Materia Medica and application of repertory that were adopted by our masters, Dr L. D. Dhawale and Dr M. L. Dhawale. He had painstakingly collected the evidence from their used copies of Boger’s Synoptic Key and BBCR, which he presented to the group. He introduced a set of 21 cases, through which the application of Boger’s philosophy, the study of Homoeopathic Materia Medica, and the structure and application of Boger’s repertories were to be discussed over 3 days. The presentation was an eye-opener for the audience.
Case Discussion –
Two cases of pneumonia were discussed, out of which one was of pneumonia in an immune-compromised adult; it demonstrated the importance of LOCATION – lung, SIDE – left, TISSUE – parenchyma, and TIME – the evolution helped the physician in the choice of approach and of simillimum. Both the cases of pneumonia also highlighted assessment of susceptibility and application of Dr Borland’s concept of lysis and crisis in the management of pneumonia in clinical practice.
Four cases of indolent ulcers were presented. One of the cases was of a venous ulcer where Secale cor was the prescription, supported by the evidence of the sphere of action and the pathological generals. The importance of the subconscious mind for differentiation in selecting the right remedy – Cenchris – was the take-home learning. It also clearly depicted the concept of keynote and concept of concordances in the remedy selection after the 1st prescription.
In an acute case of encephalitis in a 47-year-old woman in a rural set-up near Bangalore, the sphere of action (neuromuscular junction) and the characteristic sensations were pointers to Zinc met.
In a case of thrombosed piles, the role of Homoeopathy was demonstrated in cases where otherwise surgery is the recourse. We saw how an experienced physician’s eyes and mind could perceive the remedy Vipera, through the tissue affinity (veins) and pathological general (thrombosis).
A case of a rare genetic disorder (Williams’s syndrome) was extremely enlightening. It demonstrated how pathological generals like emaciation, weakness, and hypotonia helped the physician to determine the right remedy, but the final choice of remedy was most strongly influenced by the pace. The lesser used Calc hypophos was selected. The rubric – rapid progressive emaciation with atrophy – from Phatak was the basis for selecting the remedy. The group was enlightened about a lesser known and seldom used remedy.
The case of a 1.5-year-old child with muscle wasting after intramuscular injection demonstrated the importance of causation, tissue affinity (muscles), and pathological general (muscle wasting), all of which helped the physician use Boger’s approach and prescribe the similimum – Ledum pal.
A case from the geriatric care setup at RHH Palghar, a bedridden lonely old man with Cerebro-Vascular Accident, had the potential to demonstrate the model of man in Homoeopathic practice and its importance in formulating the portrait of disease. This case showed the importance of the observer as an asset in the clinical set-up. It emphasised the importance of the Clinical Session Evaluation Form as a tool to overcome prejudices. It also showed how SCR tools help the clinician to stabilize the self, construct a totality, and determine the Homoeopathic similimum. This case also demonstrated the importance of physiotherapy and in-patient rehabilitation in the healing process.
A case of alcohol withdrawal emphasised the value of pathological generals in selecting Carboneum sulph as the simillimum. This case also demonstrated how to study the Homoeopathic Materia Medica.
A case of injury brought in focus the importance of the concept of the sphere of action, onset, duration, and progress in helping the clinician to form the totality and arrive at a group of similar remedies. It also showed the importance of disposition, sympathy, and irritability in selecting the simillimum.
A case of coma treated in the rural set-up with limited resources stated the importance of observation and history from the attendants in understanding the evolution of disease and in selecting the simillimum.
Another case, of a non-healing wound in the tribal rural set-up with limited resources, demonstrated the concept of causation (external and internal) in the genesis of pathology. The role of observation in understanding the causation and evolution of disease to select the approach was the important lesson in this case. This case also demonstrated the role of a constitutional remedy (Silica) in delayed wound healing.
In a nutshell, this bouquet of 21 cases demonstrated the unique facets of individualization as presented by the master prescriber Boger. Understanding this approach helped us to widen the scope of our perception while treating cases, especially in the following areas:
- Cases with advanced structural pathology and surgical cases where disease expressions are the only characteristics available
- Importance of evolution of a disease (time). The pace of the disease process helps in differentiating between remedy
- Understanding the location, the seat of disease as perceived by Boger as well as the difference between pathology and pathogenesis in individualization
- Importance of remedy relationship or concordance in selecting remedies that follow the first prescription well to complete cure
- Understanding a seldom prescribed remedy like Calc hypophos, which increased our knowledge of the Homoeopathic Materia Medica
- Handling of a case with minimal symptoms (one-sided cases) due to poor reactivity and / or susceptibility. This approach enables the clinician to use whatever data is available, yet provides excellent results
- Understanding the concept of man in his environment, the importance of sensitivity training and the significance of an observer in the clinical set-up
- Importance of a geriatric care unit in rehabilitation and healing
- How to read and understand Boger’s Synoptic Key
- Choice of Repertory and how not to confuse philosophy with the choice of repertory