Compassionate Palliative Care: Homoeopathy’s Role in Future Care for Incurable Diseases

Compassionate Palliative Care: The Role of Homoeopathy in Future Palliative Medicine for Incurable Diseases

Keywords

Homoeopathy, Palliative care, Compassionate, Incurable diseases, Holistic treatment, Symptom management, Quality of life, pain.

Abstract

Homoeopathy has emerged as a promising approach in palliative care, offering a holistic and individualized treatment methodology that addresses the physical, emotional, and spiritual needs of patients with incurable diseases. By leveraging the law of similia, homoeopathic remedies provide a gentle and non-invasive way to manage symptoms, alleviate suffering, and improve the quality of life for patients. This article explores the potential of homoeopathy as a future palliative medicine, highlighting its benefits, applications, and future directions in providing compassionate end-of-life care. So, let’s explore this unique characteristic of homoeopathy in palliation of my 28 years of practice. I have used many times Homoeopathic pioneer advised palliative medicines in my practice found useful.

Introduction

Palliation denotes temporary relief of symptom of a disease. Here though the symptom is relieved, the disease remains and remains at the same place and in the same form.

Palliation = Temporary Relief of Symptom

On the contrary, suppression denotes temporary relief of symptom with consequent involvement of internal vital organ(s). Here the existing symptom is transformed into the symptom(s) of other disease. Repeated palliation in curable cases turn the case into incurable one because of consequent involvement of internal vital organs. (suppression).

 Homoeopathic science understands their limitation in case management that not all cases are meant to be cure. There are many cases with irreversible pathology requires palliation to improve the quality of patient’s life. 

The various aspects of a physician’s mission are:

• To cure in curable cases.
• To palliate in incurable cases.
• To preserve health.

In cases, where pathology is so advanced so as to become irreversible, homoeopathic medicines can provide a great soothing effect. Homoeopathy has a positive role in improving the quality of life in incurable chronic diseases like cancer, HIV/AIDS, terminally ill patients and incapacitating diseases like rheumatoid arthritis, etc.

Conditions Where Palliation Is Justifiable Even in Homoeopathy –

A. Palliation by Homoeopathic medicine in incurable cases

• In cases with advanced and irreversible tissue changes
• Patient lacking in any of the vital organs

B. Palliation by some other means

• Only in more urgent cases were danger to life and imminent death allow no time for the action of a homoeopathic remedy.
• In sudden accidents to previously healthy individuals as a preliminary measure in sudden poisonings.
• Palliation & Suppression.

1) Palliation by homoeopathic medicine of incurable cases: The basis of cure is the fundamental law of similars. Similarly, the law of similars is also the fundamental law in the palliation of incurable states. Master Kent says, the physician who applies the single remedy in potentized form under the law of cure for any length of time will easily be convinced that, there is no other way of palliation that holds out permanent hope for the patient. The palliation by homoeopathic medicine is justifiable in the following type of incurable cases.

2) In advanced cases with irreversible pathological changes: When we are facing these incurable conditions, the administration of the similar remedy almost always ameliorates the situation, at least for the three or four days and usually for a longer period. Then we may have a return of symptoms, when the indicated remedy will be called into use again. Thus, the patients can be made much more comfortable.

3) A case of incurable cancer with distant metastasis developed involuntary urination with absolutely no control. Her remedy was one of the Calcarea group. For this troublesome symptom of involuntary urination there are five remedies of equally prominent rank in the repertory which we may consider- Arsenic, Natrum Mur, Pulsatilla, Rhus tox and Causticum. With the constitutional similarity of the patient to the Calcarea, Causticum was the only remedy to be considered, and one dose of Causticum 200 restored complete control over the disagreeable symptom, and make the patient more comfortable in general. Incurable cases are a source of great anxiety to every physician, but the physician who will follow the law of similars with the use of single remedy in potentised form will give quicker and more sustained relief than all the massive doses of allopathic palliatives.

4) Patient lacking in any of the vital organs: Palliation should be the only method of choice in cases where the patient lacks in any of the vital organs.

5) After splenectomy or in a patient with one kidney, complete cure is not possible for obvious reasons. The patient at best may lead a more or less normal life through the compensatory mechanism supported by palliative treatment, when necessary.

When Palliation is Necessary Even in Homoeopathic Practice

Even in Homoeopathy, palliation is needed (Organon of Medicine, footnote sec. 67/1) in the following cases:

1. Only in the most urgent cases, where danger to life and imminent death allow no time for the action of a homoeopathic remedy.

2. In sudden accidents occurring to previously healthy individuals for example, in asphyxia and suspended animation from lightning, from suffocation, freezing, drowning etc.

It is admissible and judicious, at all events as a preliminary measure, to stimulate the irritability and sensibility with a palliative, as for instance, with gentle electrical shocks, with strong coffee, with a stimulating odour, gradual application of heat etc. When the stimulation is affected, the play of the vital organs again goes on in its former healthy manner, for there is no disease to be removed, but merely an obstruction and suppression of the healthy vital force.

3. In sudden poisonings. Example. -Alkalies for mineral acids, Hepar sulphuris for metallic poisons, coffee and camphor (and ipecacuanha) for poisoning by opium.

• In incurable diseases.

DR H. A. ROBERTS, OPINION OF PALLIATION BY HOMOEOPATHIC MEDICINES IS JUSTIFIABLE IN THE FOLLOWING TYPE OF INCURABLE CASES:

A. In advanced cases with irreversible pathological changes: Administration of the similar remedy in these cases almost always ameliorates the situation, at least for the three or four days and usually for a longer period. Then we may have a return of symptoms, when the indicated remedy will be called into use again. Thus, the patients can be made much more comfortable.

B. In cases of insomnia: Insomnia may be treated with crude palliative measures so that the patient secures sleep, but at best this is an unnatural sleep; while if the insomnia is considered as a part of his symptomatic picture, and given its proper place in that symptomatology and the man himself is treated not alone one or two symptoms he will gain his natural, refreshing sleep and he himself will be improved in general health.

C. Pain: When the symptom of pain itself is complete, with the location, type, aggravations, ameliorations and concomitants (which may lie in the conditions of aggravation or amelioration but which are often from seemingly unrelated symptoms) a carefully selected remedy will relieve the pain promptly, and the patient will be much more comfortable and happier in general than with any narcotic.

D. Surgical cases: Homoeopathic medicines can act as substitute for narcotics in surgical cases, either before or after operation. Here the indicated remedy does excellent service, and the patient will go through the mental and physical distress very happily. These remedies will be indicated partly by the symptomatology of the patient and partly by the immediate causes of distress, such as lacerated wounds, strenuous vomiting, shock and incarcerated flatus.

PIONEERS CONCEPT IN UTILITY OF PALLIATIVE MEDICINES:

Many Homoeopathic pioneers mentioned about the cases and medicine used   for pain palliation and their successful results.

  Pioneer – Dr Dunham in his book quotes Harley.

Name of Medicine – Conium maculatum – In cancer, he considers ‘hemlock’ a palliative, in that it allays muscular spasm, and thus mitigates pain. In glandular enlargements, and in cerebral diseases, he has found no benefit from Conium.

Pioneer – Dr J.T. Kent

Name of Medicine – Carbo animalis – It has cured these troubles in old feeble constitutions with night sweats and much bleeding. It has relieved in incurable cases, and has apparently removed the cancerous condition for years, even though it comes back afterward and kills. This remedy is often a great palliative for the pains that occur in cancer, the indurations and the stinging, burning pains of course, we do not want to teach, nor do we wish to have you infer, that a patient with a well-advanced cancerous affection, such as scirrhous, may be restored to perfect health and the cancerous affection removed. One may comfort that patient and restore order at least temporarily, so that there is freedom from suffering in these malignant affections.

Pioneer – Dr C. M. Boger

Name of Medicine – Phosphorus – In adeno-carcinoma of the uterus with haemorrhage and almost no symptom to guide me, it was found that patient had three attacks of pneumonia which were typical of Phosphorus but she did not receive it. Phosphorus controlled the bleeding, stopped pain, and palliated.

Pioneer – Dr W. A. Dewey

Name of Medicine – Chamomilla, China officinalis and Berberis vulgaris – One may use morphine as a palliative in cases of severe pain, intense pain such as the passage of a biliary or renal calculus, but even here let it use be postponed until you have tried such remedies as China officinalis and Berberis vulgaris. Do not give it in every pain which seems severe. Remember that many patients seem oversensitive to pain and the remedy may be Chamomilla instead of morphine. The less of it you use the better for your patients.

Pioneer -Dr Richard Hughes

Name of Medicine – Silicea terra, Arsenicum album, Chlorate of potash, citric acid        Silicea terra in substance, and Arsenicum album, in the higher dilutions, have been found palliative of the pains of scirrhus while unbroken; chlorate of potash and citric acid locally when ulceration has occurred.

Pioneer – Dr Rastogi mentioned about palliation in homoeopathic recorder as follows, the drug so selected, and administered according to natural laws is sure to bring about a cure in curable diseased conditions and an effective palliation in incurable conditions. The most painful conditions are efficiently palliated or cured with a rapidity which is possible consistently with the nature of the disease. Quicker and longer-enduring results are achieved in relieving pain than with morphia, aspirin etc., and without any injurious after-effects. The physicians’ high and only mission, according to Hahnemann, is to restore the sick to health, to cure as it is termed.

Usefulness of Few Palliative Homoeopathic Medicines

1. Magnesia phosphorica can be tried for muscular pain, cramp, abdominal pain, and even headache.
2. If the person has just had surgery or an injury then Arnica Montana is needed.
3.  All the remedies known for helping a dying person, Arsenicum album is best known for soothing the fear of death, and is indicated when there is agitation, restlessness, thirst, great anguish, internal burning heat with external coldness and desire for warmth.
4. Relieving nausea and vomiting for a person near end of life is particularly helpful, because it is so common for patients to suffer with it. Ipecacuanha can be tried when nausea or vomiting occur, with a clear tongue. Another remedy could be Nux vomica when the tongue is coated and toxic looking.
5. China officinalis may be used for the weakness experienced afterwards from the loss of fluids.
6. Calcarea carbonica might help very sick people who are putting out lots of perspiration (diaphoresis)which happens when one is in shock or having a medical emergency.
7. Carbo vegetabilis is a great collapse remedy, known for great weakness with bluish lips, icy cold skin and cool breath.  Though they are cold they want a draft of air.

“Breathing at end of life can become shallow and quickened, or slow and laboured. The person may make gurgling sounds, sometimes referred to as the “death rattle.” If the person seems to be having laboured breathing, is wheezing or having asthmatic symptoms or burning pains, Arsenicum album usually helps. Arsenicum album is also known to help the anxiety around not being able to get a good breath.  When secretions build up and create rattling in the chest, Antimonium tartaricum is the main remedy, especially when the person is very weak and becoming unresponsive.

• If acute fear and panic occur, with or without the well-known symptom “predicts the time of death”, Aconitum napellus can be given. Aconite is the best remedy when a fearful panic has gripped the body and mind and the heart is racing, and the mind cannot relax itself away from the distressing thought pattern.  They may have a look of fear in their eyes or be so tense that it is noticeable in their appearance.
• Taking the cell salt, Kalium phosphoricum, which is known to be a tonic for the nervous system, may help care givers who feel tense, stressed and overwhelmed.
• Insomnia can be helped by Coffea cruda, for alertness when it is time for sleep because they are wired and upset. Arsenicum album helps those who cannot sleep due to worry and fear and Ignatia amara helps a grieving person sleep.
• Cocculus indicus is known to help those who have been care takers of the sick and now have grief and health problems.
• Phosphoricum acidum is for grief when there are very low energy and debility of the nervous system.

• Palliative treatment is not a good process for curing the disease due to the following reasons:

1. It cannot bring about the cure.
2. The condition of the patient becomes worse after initial relief.
3. To get effective result it is necessary to increase the dose of the drug day by day.
4. Due to application of large doses of palliative drug. artificial drug-disease is formed.
5. Here the treatment is based on one or two troublesome symptoms.
6. It is against the natures law of cure.

Merits of Palliation

By Palliative method we can give some initial relief in most urgent cases where life is in danger. Palliation provides much needed relief of complaints to incurable cases with advanced pathological changes.

Demerits of Palliation

1. This is an extremely unsystematic treatment where the physician devotes his attention in one sided manner to single symptom. So, it cannot give relief from the total disease.
2. This method of treatment is injurious in long standing disease, because after transient amelioration, there is aggravation of the symptoms.

We advocate antipathic treatment for the following conditions, § 67/1, FN:

(a) In most urgent cases were danger to life and imminent death allow no time for the action of homoeopathic remedy.

(b) Accidents such as asphyxia, drowning, poisoning, shock.

(c) Where there is no disease to be cured but an obstruction or suppression of the healthy vital force is found.

(d) Where symptoms are either absent or difficult to get.

(e) When to gain patient’s confidence quickly.

(f) Where there is gross structural change after administration of homoeopathic drug, there is too short relief of symptoms, here we may not be able to cure the patient, as there is some destruction of vital organ such as kidney, or a massive valvular heart disease.

  CONCLUSION

Homoeopathic therapeutic system as a method of healing science has goal of providing relief to suffering humanity. In my 28 years of practice, it is clear that homoeopathy provides a greater relief in patients with incurable disease conditions. At present, in such a disease over burdening situation, homoeopathic science helps modern medicine to manage the cases and giving a hope of healthy world to suffering humanity.

In present era, medical science fights very hard with complex pathology to offer a better health. Continuous research and advancement in treatment method are ongoing activities that help medical science in this battle. Every day, there is emergence of new complex pathology or treatment resistance which blocks the path of holistic healing. In this situation, integrated approach is necessary for providing holistic health to persons suffering from complex irreversible pathological illness. Homoeopathy along with other complementary sciences helps modern medicine for better case management. Palliative treatment can be done by antipathy, allopathy and also by homoeopathy where we do not consider the constitution and the miasmatic background of the patient. Homoeopathy proves itself as a good healing science in irreversible cases with its gentle palliative care.

REFERENCES

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Co-Authors –

Mr. Padmraj Jineshwar Yaligouda     B.H.M.S. Final Year.

Bharatesh Homoeopathic Medical College & Hospital, Belagavi, Karnataka. India.