A Homoeopathic Approach to Palliative Care
Palliative care is derived from the Latin word palliare, which means “to cloak.” It refers to specialised medical care for people with serious illnesses. It is focused on providing people with relief from the symptoms, pain, and stress of a serious illness whatever the prognosis. The goal is to improve quality of life for both the sick person and the family.
A World Health Organization statement describes palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.”
While palliative care may seem to offer a broad range of services, the goals of palliative treatment are concrete: relief from suffering, treatment of pain and other distressing symptoms, psychological and spiritual care. It is a support system to help the individual live as actively as possible and a support system to sustain and rehabilitate the individual’s family.
Need for palliative care :
Palliative care is required for a wide range of diseases. Majority of adults who need palliative care have chronic diseases such as cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), Acquired Immune deficiency Syndrome (AIDS) (5.7%) and diabetes (4.6%). Many other conditions may also require palliative care such as kidney failure, chronic liver disease, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological disease, dementia, congenital anomalies and drug-resistant tuberculosis.
There is a lack of awareness among policy-makers, health professionals and the public about what palliative care is and what are the benefits that it can offer patients and the society at large.
Palliative care needs to be provided in accordance with the principles of universal health coverage. All people, irrespective of income, type of disease, or age, should have access to a nationally determined set of basic health services, including palliative care.
Homoeopathic approach to palliative care :
The phrase ‘SAPERE AUDE’ in Latin, meaning ‘dare to be wise’ is used by Hahnemann, as he thought it most appropriate to his new school of medicine – Homoeopathy, and also probably to tell his followers to know for themselves, the true art of medicine. The phrase was first used by the Roman poet, Horace, and subsequently quoted by the German philosopher, Immanuel Kent, from where probably Hahnemann was inspired to use this.
Homoeopathy works on the principle of law of similars (a principle of homeopathic medicine stating that a drug capable of producing morbid symptoms in a healthy person will cure similar symptoms occurring as a manifestation of the disease).
The founder Dr. Christian Friedrich Samuel Hahnemann has mentioned certain principles in the form of aphorisms in his book, Organon of medicine, to guide homoeopathic practitioners.
The first aphorism says, the physician’s high and only mission is to restore health to the sick and to cure.
Second aphorism is the highest ideal of cure. The highest ideal of cure is rapid, gentle and permanent restoration of health, or removal and annihilation of the disease in its whole extent, in the shortest, most reliable, and most harmless way, on easily comprehensible principles.
The third aphorism is the knowledge of the physician. What is curable in disease? What is curative in medicine? How to adapt to what is curative in medicine to what is curable in disease according to clearly defined principles? The practitioner should know of the obstacles to recovery in each patient and must be aware of how to remove them so that the restoration may be permanent, and he/she must understand how to treat them judiciously and rationally, which then makes him/her a true practitioner of the healing art.
The aphorism 193 says internal similar medicine removes local external diseases. Medicine, employed only internally (and if the disease is of recent origin, often by the very first dose of it), the general morbid state of the body is removed along with the local affection, and the latter is cured at the same time as the former, proving that the local affection depended solely on a disease of the rest of the body, and should only be regarded as an inseparable part of the whole, as one of the most considerable and striking symptoms of the whole disease.
Palliation of incurable states:
The law of similars is the fundamental law also in the palliation of incurable states. Either for palliation of incurable diseases or for the cure of the curable diseases, the symptomatology of the remedy must simulate, as much as possible, the disease picture in order to bring relief and where periodicity or alteration is a part of the symptomatology, the remedy must have this characteristic feature if we expect it to be effective.
In all possible cases, the physician endeavors in repeated conversations with the patient to trace the picture of his disease as completely as possible, according to the directions given above, in order to be able to elucidate the most striking and peculiar (characteristic) symptoms, in accordance with which he selects the first remedy having the greatest symptomatic resemblance, for the commencement of the treatment, and so forth.
That the best selected homoeopathic (antipsoric) medicine in the suitable (minutest) dose, which does not produce an improvement is a sure sign that the cause that keeps up the disease still persists, and that there is some circumstances in the mode of life of the patient or in the situation in which he is placed (the maintaining cause), that must be removed in order that a faster relief would ensure.
In aphorism 207, Hahnemann guides us to procure detailed history of the treatment taken till date, regarding perturbing medicines most frequently used, external applications, baths, pernicious artificial operations the patient has undergone. This is to enable the physician to avoid the employment of medicines that have already been improperly used.
It is clearly mentioned that too strong, wrong, and/or harsh medications can itself cause harmful effects on the body hence, the medical history needs to be accurate before starting the treatment.
Other factors such as age of the patient, mode of living, diet, occupation, domestic position, social relations and so forth, must be taken into consideration, in order to ascertain whether these factors have tended to increase the malady, or in how far they may favor or hinder the treatment. In like manner the state of disposition and mind must be attended to, so as to learn whether that presents any obstacles to the treatment or requires to be modified.
As Dr. Stuart Close says in his book, “Genius of Homoeopathy” in cases of chronic renal failure or hepatic colic for example if the physician is skillful he may be able to alleviate the agonising pain to an amelioratedend by the use of homoeopathic remedies alone. Circumstances arise occasionally which make it necessary temporarily for the homoeopathic physician to use drugs in physiological (really, pathogenic) doses for their palliative effect.
In incurable cases, or seemingly incurable cases, we must not put a limitation on the possibilities of the similar remedy, for in many seemingly incurable conditions the simillimum will so completely meet the situation as to obliterate the symptomatology of disease and the pathology, and will restore the patient to health.
Pain is one of the most frequent and serious symptoms experienced by patients in need of palliative care. The need for opioids will be reduced remarkably if the similimum (the exact medicine considering physical, mental and general symptoms of the patient) is administered to patients in cancerous conditions. The severe nausea, vomiting, diarrhoea, anaemia, headache, hair fall and other side effects of the chemotherapy can be effectively handled in homoeopathy. Studies have shown that wound management is also effectively managed using homoeopathic tinctures, ointments and lotions.
- Hahnemann S. Organon of medicine. 6th edition. Andesite Press. 2017.
- Roberts HA. The principles and art of cure by homoeopathy. B Jain Publishers. 2002.
- Close S. Genius of homoeopathy.1st Edition. B. Jain Publishers. 2008.