Extra Knowledge and Information which are Essential for BHMS & MD (Hom) Students
Every year around 13,000 BHMS & MD (Hom.) students have been passing out from around 200 colleges all over India. After passing out 10+2, many prefer homeopathy as the first choice among AYUSH systems. India, with the tag of ‘Super Power of Homeopathy’, has the highest number of homeopathic colleges, highest number of practitioners and highest number of patients in the world. Approximately 38% of total AYUSH doctors are homeopaths. As far as Homeopathy practitioners are concerned, Maharashtra leads the numbers with 63,076 registrations. It is followed by West Bengal with 36,851, Uttar Pradesh with 32,641 and Bihar with 31,717.[1] Interest in homeopathy is increasing day by day in the minds of the parents to enrol their children in the course. There are around 200 homeopathic medical colleges in the country with a well-structured curriculum in place by the regulatory body, the Central Council of Homeopathy. However, in order to excel in every aspect in the field of homeopathy, a student has to develop self-interest in exploring different areas within homeopathy like contemporary schools of thoughts, emergency case managements, contemporary homeopathic researches, scepticism on homeopathy and the truth behind it, knowledge ofhomeopathic digital tools like softwares and online courses, online listing portals of doctors and clinics, personality developments, basic needs and knowledge to set up a clinic, basic idea on the pharmaceutical trade and current regulatory aspects.
Different schools of thoughts
There are many contemporary homeopathic experts with different schools of thoughts. Every school of thought has its own advantages and disadvantages. As a student, one has to be open to learn the best from all such different philosophies. Usually the students after passing out from BHMS, (though they possess basic knowledge), faces certain difficulties and are mostly not well-versed in similimum, potency selection, case management, etc. Hence, attending seminars and lectures from such stalwarts from different ideologies will be helpful in developing the clinical skills. Such different schools of thoughts include Dr.RajanSankaran’s Sensation and Synergy methods, Dr.PrafullVijaykar’s Predictive Homeopathy, Dr.Banerjis’ Banerji’s Protocols and also the works of Luc De Schepper, David Little, Jeremy Sherr, Jan Scholten, Massimo Mangialavori, A. U. Ramakrishnan, etc. . Though the methods and ideologies are different from one another, the ultimate goal is to ‘to restore the sick to health, to cure’. In the learning phase, a homeopathic student should stay away from the tags like classical homeopath, clinical homeopath, complex homeopath, pluralistic homeopath, etc. but instead be an unprejudiced observer of different methodologies followed in homeopathy. Over a period of time, s/he will evolve gradually to apply the right method warranted for the right patient.
Emergency case management
A physician should be able to give first-aid measures in case of emergencies, especially when there is no hospital in close proximity. Failure in this aspect will have an overall impact on the homeopathic physicians. Required first-aid measures along with indicated homeopathic remedies will help to save the patient till the definitive medical treatment can be accessed. Exposure of students to such cases will increase their confidence level to manage critical situations .Further, students who are planning to practice at rural areas should be able to handle techniques like intravenous therapy, suturing a severe cut or wound, nebulisation, cardiopulmonary resuscitation (CPR), handling an oxygen cylinder, etc. This will help them to manage emergency conditions such as severe diarrhoea, profuse vomiting, road traffic or similar accident, bronchial asthma, a sudden heart attack or myocardial infarction, etc.
Contemporary research
Students who would like to pursue higher studies with MD and PhD should be aware of the contemporary researches in the medical field. Such recent breakthroughs inhomeopathy were on nanoparticle, electromagnetic waves by bacterial DNA sequences, thermoluminescence, gene expression, basophil activation/immune-modulation and a few others. A brief detail of these researches are given below for quick reference:
- A team of lead by Dr.JayeshBellare from Indian Institute of Technology, Bombay, has demonstrated the presence of nanoparticles of starting materials and their aggregates.[2]
- Researches by French NobelistDr. Luc Montagnier, who had co-discovered HIV and won Nobel Prize for that, had described the capacity of some bacterial DNA sequences to induce electromagnetic waves at high aqueous dilutions.[3]
- A study by Swiss chemist Louis Rey, using thermoluminescence has showed that ultra-high (homeopathic) dilutions emit light similar to the raw material. Ultra-high dilutions of lithium chloride and sodium chloride (10−30 g cm−3) have been irradiated by X- and γ- rays at 77 K, then progressively re-warmed to room temperature. During that phase, their thermoluminescence (i.e. emission of light from a substance when it is heated) has been studied and it was found that, despite their dilution beyond the Avogadro number, they emitted light which was specific to the original salts dissolved initially.[4]
- A hypothesis was proposed based on the experimental results to explain the mechanism and pathways of action of potentized homeopathic drugs that they act through regulation of gene expression by eliciting impulses similar to that of some hormones and enzymes.[5]
- Many studies have been carried out on stimulating the basophil by highly diluted Histamine. Histamine is known to elicit a negative feedback effect on anti-IgE and allergen-induced basophil activation. A series of experiments performed between 1981 and 1995 using a manual method showed biological activity of highly diluted histamine. J. Benveniste’s work on this is significant. Most of the experiments used histamine in the range 10−30 (15C)–10−36 M (18C). These results were confirmed by automated flow cytometry. This method is based on the selection of basophils by anti-IgE and analysis of basophil activation by anti-CD 63. Following this, there have been plenty of research publications on this line.[6],[7],[8]
Understanding such researches at the student level will trigger the minds for better research culture and orientation.
Scepticism on homeopathy and the truth behind it
There have been many sceptics who criticize homeopathy regularly. The only logic they put forth is that when there are no molecules of the active agent left in a solution, there cannot be any biological effects. Many international government agencies likeAustralia’s National Health and Medical Research Council (NHMRC) and the European Academies’ Science Advisory Council (EASAC) have published reports against the effectiveness of homeopathy. As a homeopathic student, one has to go through and understand the flaws behind such reports. Many organisations like Central Council for Research in Homeopathy, LigaMedicorumHomeopathica Internationalis and European Coalition on Homeopathic &Anthroposophic MedicinalProducts (ECHAMP) have responded to such criticism point by point. Googling on these topics will give more ideas in understanding them.
Knowledge of homeopathic digital tools like software and online courses
There are several homeopathicsoftwares like RADAR, Vithoulkas Compass, The Complete Repertory, Hompath, etc. which can help in faster repertorisation, better patient management, to enhance overall clinical practiceand clinical research.Repertorisationof the cases are important but manual repertorisation for every case is very difficult and time consuming. Knowledge of these softwares would be helpful to choose the best software available in the market. There are many online homeopathy courses available. They will also be helpful. One has to keep watching in journals for such courses to get benefit out of it.
Online listing portals of doctors and clinics
Listing a clinic in the internet has become essential. Basic ideas about the online portals listing doctors will help to enhance the public reach of a doctor. Google Business, Practo, Lybrate, Sulekha, JustDial, etc. are some of the sites. Many websites offer free listing and also premium services. Whenever someone searches for homeopathic doctors in that area, the search engines will throw results from these websites. On an overage, around 10% of patients are referred through these online listings.
Personality Development
A person’s personality is defined by their characteristics, behaviors, thoughts, and feelings. If we consider knowledge as the key to be successful then personality of individual is the method to deliver it. Good personality provides great confidence. Experiencing difficulties is quite common in workplace like how to boost confidence of patient, how to answer their various doubts and questions, etc. Emotional intelligence and personality go hand in hand. That is why personality development holds a very vital role in a homeopath’s ability to succeed.
Basic needs to set up a clinic
To start a clinic, listing the basic needs will help. Below is a short list which will help as a ready reckoner for the beginners.
- Good location
- Infrastructure
- Doctor’s chamber
- Council registration certificate
- Comfortable and neat table
- Doctor’s chair on one side
- 2 chairs on the other side for the attendants
- A stool for the patient
- Materia medica and other books
- Prescription pad
- Stethoscope
- Sphygmomanometer
- Tongue depressor
- Thermometer
- Knee hammer
- Torchlight
- Measuring tape
- Height measuring scale
- Weighing machine
- Examination table
- BMI calculator
- Instant glucometer
- Otoscope
- Cotton role
- Bandage cloth
- Calendula ointments and powders
- Suturing needle
- Scissor
- Microtape
- Wash basin
- Tissues
- Hand sanitiser
- Laptop with homeopathic and patient management softwares (optional)
- A pleasant ambience in the waiting area/reception
- Dispensing area
- A rack with medicines (a list of frequently used remedies in dilutions/pills, mother tinctures, trituration tablets and biochemics should be prepared to place orders)
- Different size of pills containers like ½, 1, 2 & 4 drams for pills and tablets
- Different size of liquid containers like ½, 1, 2 & 4 drams for mother tincture and liquid doses
- Pills (globules) and lactose
- Butter papers
- Patients’ folders
- Attractive name board with the doctor’s name, degree, contact number, timings and website if any
- Water facility
- Doctor’s chamber
- Pamphlets for distribution for awareness and outreach
- Inauguration of clinic with good publicity to make aware of the people about the clinic
Basic idea on the pharmaceutical trade
There are different types of pharma entities like manufacturer, wholesale distributor and retail seller. Depending upon the volume of purchase and the type of entity, there are different terms and schemes of trade available. As the initial purchase will be bulk, there will be good deal one can get. It is always better get proforma invoice/quotation/estimate of the medicines to be purchased from different vendors. Best deal could be finalised based on different aspects like time taken for supply, door delivery or not, discount structure, credibility, credit terms and other, but without compromising on quality. It is always advised to purchase the medicines manufactured by a GMP manufacturer.
Current regulatory aspects
One has to be aware of the current regulatory aspects related to homeopathic practice. First of all, it has to be found out that whether the place of practice is allowed for such professional actives or not. A few years ago, a satellite township of Delhi has restricted all kinds of commercial and professional activities in residential areas, including doctors, auditors and lawyers who have set up their offices at their residences. However, after sometime it was revoked.
One has to also be aware that the law does not permit the dilutions and mother tinctures in more than 100ml in dispensaries/clinics.
It is also to be remembered that a homeopath is entitled to issue certificates like certificate recommended for leave or extension or communication of leave and for fitness, certificates of birth or death or disposal of the dead under various Central Acts or State Acts, certificates of lunacy and mental illness under the Mental Health Act, 1987 (14 of 1987) and the rules made thereunder, certificates under the Education Acts, certificates under the Public Health Acts and the orders made thereunder, certificates under the Acts and orders relating to the notification of infectious diseases, certificates under the Employee’s State Insurance Act, 1948 (34 of 1948), certificates in connection with sick benefit insurance and friendly societies, certificates for procuring or issuing of passports, certificates of illness for seeking exemption from attending Court of Justice, in public services, in public offices or in ordinary employment, certificates in connection with matters under the control of Department of Pensions and certificates for procuring driving license.
Recently, Central Council of Homeopathy has amended the code of ethics that a homeopathic practitioner shall provide the prescription as requested by the patient.
End note
Though there are several aspects to be learned by homeopathic students, we have given here some brief yet essential points which should not be missed out. Hope this article will be useful to the students and beginners.
References
[1]AYUSH in India 2016, Planning & Evaluation Division, Ministry of AYUSH, Government of India
[2] Prashant Satish Chikramane, Akkihebbal K Suresh, Jayesh Ramesh Bellare and ShantaramGovindKane.Extreme homeopathic dilutions retain starting materials: A nanoparticulate perspective. Homeopathy (2010) 99, 231-242
[3] Luc Montagnier, Jamal Aissa, Stéphane Ferris, Jean-Luc Montagnier, Claude Lavallee, Electromagnetic Signals Are Produced by Aqueous Nanostructures Derived from Bacterial DNA Sequences. InterdiscipSciComput Life Sci (2009) 1: 81-90.
[4] Rey Louis, Thermoluminescence of Ultra – High Dilutions of Lithium Chloride and Sodium Chloride, Physica A, 2003; 323: 67-74.
[5]Anisur Rahman Khuda-Bukhsh.Potentizedhomeopathic drugs act through regulation of gene-expression: A hypothesis to explain their mechanism and pathways of action in vitro. Complementary Therapies in Medicine, March 1997
[6]Davenas E., Beauvais F., Amara J. et al. Human basophil degranulation triggered by very dilute antiserum against IgE.Nature 1988; 333: 816-818.
[7] Peter Christian Endler, Paolo Bellavite, Leoni Bonamin, Tim Jäger, SintiaMazon. Replications of fundamental research models in ultra high dilutions 1994 and 2015 – update on a bibliometric study. Homeopathy 2015; 104(04): 234-245
[8]Bastide M. Immunological examples on ultra high dilution research. In: Endler P.C., Schulte J. (eds). Ultra High Dilution: Physiology and Physics. 1994. Dordrecht: Kluwer Academic; pp 27-33.
[1]AYUSH in India 2016, Planning & Evaluation Division, Ministry of AYUSH, Government of India
[1] Prashant Satish Chikramane, Akkihebbal K Suresh, Jayesh Ramesh Bellare and ShantaramGovindKane.Extreme homeopathic dilutions retain starting materials: A nanoparticulate perspective. Homeopathy (2010) 99, 231-242
[1] Luc Montagnier, Jamal Aissa, Stéphane Ferris, Jean-Luc Montagnier, Claude Lavallee, Electromagnetic Signals Are Produced by Aqueous Nanostructures Derived from Bacterial DNA Sequences. InterdiscipSciComput Life Sci (2009) 1: 81-90.
[1] Rey Louis, Thermoluminescence of Ultra – High Dilutions of Lithium Chloride and Sodium Chloride, Physica A, 2003; 323: 67-74.
[1]Anisur Rahman Khuda-Bukhsh.Potentizedhomeopathic drugs act through regulation of gene-expression: A hypothesis to explain their mechanism and pathways of action in vitro. Complementary Therapies in Medicine, March 1997
[1]Davenas E., Beauvais F., Amara J. et al. Human basophil degranulation triggered by very dilute antiserum against IgE.Nature 1988; 333: 816-818.
[1] Peter Christian Endler, Paolo Bellavite, Leoni Bonamin, Tim Jäger, SintiaMazon. Replications of fundamental research models in ultra high dilutions 1994 and 2015 – update on a bibliometric study. Homeopathy 2015; 104(04): 234-245
[1]Bastide M. Immunological examples on ultra high dilution research. In: Endler P.C., Schulte J. (eds). Ultra High Dilution: Physiology and Physics. 1994. Dordrecht: Kluwer Academic; pp 27-33.