Rubric Selection in Blood Dyscrasias
The New England Journal of Homeopathy
Fall/Winter 1999, Vol.8 No.2
From Mark Gobel, BS, MedTech, of Oneonta, New York we read the following initial question which was posted on the NESH current student bulletin board.
I am working with a client that has idiopathic neutropenia. The white blood count is 2300/cumm. There is an inversion of the neutrophil/lymphocyte ratio. Two bone marrow biopsies have been unremarkable in pathology. Do you think that the anemia or leukocytosis rubrics can be used in this case? I am interested in any thoughts that you may have on rubric selection for this particular point in this case.
The first response came from Lysanji Edson ND, of Portland, Oregon.
Here are my thoughts on your question: The rubric Generals, leukocytosis has only two remedies listed, Tuberculinum and Vaccin attenue bilie (which has only 85 rubrics total!) so it is not a very useful rubric. Generals, anemia (183 remedies) could be used, I suppose, but you mentioned that the bone marrow biopsy reports have been normal, which would make me a bit suspicious of using this rubric. If I did use it, I’d be sure to have other rubrics grouped with it in a segment. Generally, when I have clinical signs or symptoms that I can’t find a rubric for I use a larger rubric that encompasses the idea. If I can’t do that, then I leave out that given sign or symptom and just repertorize the case without it. Once I do that, I can usually see where the symptom in question would fit into the cycle, especially if I had a rubric for it. So, I’d suggest you forget about the lab diagnosis for now and just take the case. What’s the thing that is most limiting for this patientÚ and build your cycle from there. Hope this helps. I’d be interested to know what happens. Best wishes.
Eric Doerfler CRNP, MSN of Harrisburg, Pennsylvania added: In the few cases where AIDS/HIV patients have asked to have their cases taken, I’ve used the symptomatology. The patients I’ve been able to follow have generally shown improvements in symptoms (including depression, anorexia, etc., problem co-morbidities that interfere with their quality of life), and so far they haven’t demonstrated any of the antiretroviral chemotherapy failure I’ve seen in patients not on constitutional remedies. I have used rubrics that get at an ideaßas Lysanji suggests aboveßas well as those that address generalities (anemia, emaciation, etc.). I just started treating a woman who’s had multiple problems with HIV chemotherapy, and wants only homeopathy for nowßdeclining CD4 and moderately elevated viral load. This will be interesting!
Todd Hoover MD who practices in Narbeth, Pennsylvania, then shared: My take is that the neutropenia is clearly part of the case, but may not be able to be repertorized. Therefore, including it in a larger idea is probably the best approach. Neutropenia/anemia both represent a deficiency, empty, nonproductive, weak stateßanything else in the case that looks like that would go into that segment including the neutropenia and anemia. I wrote a case of idiopathic thrombocytopenia in the last issue of the journal (NEJH Volume 8, #1, pgs 93-98), which is similar on some counts in that it probably is auto-immune in nature and the low platelets represent the deficiency. The article did not focus a lot on the cycle segments, but more on the meaning of a close but wrong remedy. Good luck, my guess is the patient is definitely treatable.
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