Introduction

Dr.Praveen kumar , a well known professor and speaker is rendering lecturing service at JSPS Govt Homoeopathic Medical College , Hyderabad. He had presented many scientific papers in many seminars. Recently he lectured on “Different types of prescription “ at “Reminiscence 04” organized by Tamil Nadu Homoeopathic Association, Chennai chapter, held at Chennai . Here we give some high lights of his speech.

As every drop of water reaches the ocean, every prayer reaches the God. Similarly every effort in practice is aimed at reaching the cure of the sick as aptly pronounced by our master. We encounter with different types of cases in our day-to-day practice and in each type of case our approach would be different and also our prescription. What are the guidelines for these different types of prescription? – A question ponders in every seeker’s mind.
Hahnemann had laid down the fundamental principles in order to achieve the desired result. At the same time he also classified the clinical presentation in to different classes, types, and sub-types with a clear message. Each class of the cases demands a different method of prescription and approach.

Hence it becomes imperative for the physician to take the case properly and place the case in the appropriate class as mentioned in the Hahnemannian clinical classification of diseases. This in turn helps one to select the relevant method and choice of prescription

When the basic exercise of case taking and assigning the Hahnemannian nomenclature of a class of a case is completed the actual management and treatment come into effect. For example in case of sheer indisposition one need not give any medicine and in the case of a surgical disorder the role of Homeopathy is limited. Whereas in the case of a chronic or Acute Dynamic disease the type of prescription would be accordingly selected to procure the desired result. Primarily the Prescription in Homeopathy is first or second. Second prescription is rightly defined as the one after the dose, which has acted. There are various guidelines as to what should be given in the second prescription based on the remedy response or in other words Kent’s 12 Observations.

But the first prescription itself is of several types based on the class of the case. There are several types of prescriptions according to the different types of clinical presentation of the case.

1. ACUTE:
This type of prescription comes in to vogue when there are acute conditions like infections, fevers etc., Example: Acute Bronchitis- Ant. Tart. In this method, while taking the case, one has to give importance to the observation, objective signs or symptoms and any keynotes besides the major symptoms. Try to find the causation which would definitely help you in the prescription.

2. AETIOLOGICAL:
The aetiology or the cause of a disorder is very important in determining the most similar remedy in any emergency, acute, or a chronic case. The causes could be mechanical, exciting, maintaining, etc., Example Injuries- Arnica, Fever after drenching in rain Rhus Tox.

3.CHRONIC:
In this type of prescription either chronic fully developed cases or chronic one sided disorders under the dynamic variety are tackled. Mostly the polycrest remedies are being prescribed excepting in one-sided variety wherein a specific remedy may be indicated.

4.CONSTITUTIONAL:
This prescription is based on the patient’s constitutional makeup which includes the patient’s physical, mental, temperamental, and emotional aspects.

5.INTERCURRENT
It is used when a well Indicated remedy becomes sluggish or fails to sustain itself. It is used where the Indicated remedy works well for a while and then begins to taper off. It can be in the form of a nosode, a complementary, or constitutional / Polycrest remedy.

6.MIASMATIC
Miasms are, in brief, the tendencies and predisposition to certain diseases either inherited or acquired. These Miasms could be dormant or active. Depending on the expression in a particular individual, the respective Miasm could be diagnosed and treated with an appropriate anti-Miasmatic remedy so as to achieve cure or have a headway in the case.

7.NOSOLOGICAL:
This method of prescription helps the physician mostly when there are acute infections with only common symptoms. For example in a case of Chicken Pox we may prescribe Rhus tox or Puls based on the name of the disease or Ran. Bulb in a case of Herpes Zoster. But always it is necessary to search for individualistic symptoms so as to give a right remedy.

8.ORGANOPATHIC:
some medicines have strong affinity for certain organs like Chelidonium for Liver, Crataegus for Heart, Avena for Brain, Lobelia for Lungs, Echinacea for Blood, Ceanothus for Spleen etc., These are usually pressed in to service as rejuvenators.

9.PATHOLOGICAL
Pathological prescription is given based on the similarity to the disease process or pathological changes as opposed to constitutional prescription, which is aimed at the person in general. Generally low potencies in repeated doses are effective for severe pathological conditions like cancer.

10.SYNTHETIC
Many mineral remedies exist naturally as salts. Nat.Mur is a synthetic form of Sodium and Chloride; Nat Mur is already available as a fully proven remedy. But in some cases wherein the symptoms of two mineral remedies appear some physicians prefer to give a synthetic prescription. For example, when a case looks like Cal Carb and Phos, One might give Calc.Phos, which is a synthetic form of those two. But one should remember that CP has definite drug picture than mere mathematical combination of CC + Phos.

11.TAUTOPATHIC
Some remedies are made from allopathic drugs or chemicals, which are known as tautopathic remedies Example: cortisone, Penicillin, etc., If a person has never been well since taking an allopathic drug or he is addicted and is trying to get off the drug, that specific drug in Homoeopathic form [tautopathic] can be prescribed. But as always one should try to select an indicated remedy failing which tautopathic prescription could be resorted to.

12.PAST HISTORY BASED:
When the case at hand doesn’t not have clear cut characteristic features and / or has got a definite past history very much relevant and responsible for the present clinical presentation this type of prescription comes into effect

13.FAMILY HISTORY BASED:
There may be certain cases wherein the present picture looks to be the offshoot of a family genetic background. In these cases the most suitable remedy could based on the family history alone.

14.PREVENTIVE:
This is one of the best fields for Homeopathy. Ranging from Prevention of Measles to J.E. Usually in epidemics the Genus epidemicus is selected as both preventive as well as curative.

15.PALLIATIVE
In terminally ill patients the whole aim of the physician would be to ensure painlessness, less discomfort and ultimately peaceful death to the patient. In this regard Homeopathy is effective without side effects.

16.KEYNOTE
There are some great stalwarts who prescribe based on one or two keynotes for the most of the cases with great success. We may try to emulate them but with a lot of hard work and dedication.
Depending on the caliber and efficiency of the physician the prescription could be scientific, artistic, or intuitive.

CONCLUSION:
For any success in the clinical practice the physician’s hard work backed up by the knowledge are most essential factors. If one tries to take the case meticulously and analyse according to Hahnemannian clinical classification the type of prescription would be automatically selected and the desired result could be achieved.