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VISION OF A PHYSICIAN
HOW NOT TO PRESCRIBE

Dr. M. A. Usmani

Naturally the role of a physician is to prescribe medicines for the sick. But being ever-
ready ‘to shoot’ prescriptions is not the mark of a good physician. He should know what
he can do, what he cannot do, and also what he can do but should not do. He should know
the limitation, interaction and interdependence of therapeutics and nutrition. Where
nutrition can settle the problem, medicine should never be prescribed. Let’s take a case:
A seventy years old lady, who was under treatment for cardiac problems with diabetes.
Her case was taken, in full detail, and since her Beta-blockers could not be discontinued
so abruptly, it was decided to deal with her diabetes first. Nutrition was given the first
chance. I advised her to leave one item from her daily foods, i.e. wheat. She was advised
to take black grams instead, in boiled form, making a bowl with them, with sliced onions,
ginger and tomatoes and lemon juice with salt and some spices; for lunch and dinner. In
the morning she was to take a small bread made of gram-flour, with tea. Within three to
four weeks her sugar was so low that it was advised to cut down the size of her
hypoglycemic drugs’ doses. Now it was the time to deal with her heart problems, which
were already much rectified, by the above regimen.

I HAVE DEVISED SOME TENETS FOR MYSELF:

IN MASSIVELY DRUGGED CASES, IT IS ADVISED TO HOLD BACK THE HOMEOPATHIC

PRESCRIPTION. Much of the symptoms in such cases are drug symptoms, they are not
the symptoms of the patient. And, as Kent has said somewhere that ‘there is nothing
homeopathic to reaction’, it is advisable to let the drug symptoms wear away. During this
therapeutic lull, deal the patient nutritionally; or at best, give him some organ(-affinity)
remedies, (the so-called, Drainage Therapy) at nutritional-level doses. This will
straighten up the case, and make it more responsive to similia prescriptions.

DON’T BE HEROIC OR INCONSIDERATE IN PRESCRIBING: when you should only palliate,

never think of curing. Aged people mostly require palliation. Their diseases are, in most
cases, past curability. Your enthusiasm to cure such cases would expose them to worse
circumstances than the sufferings they were already undergoing. I remember a decent
lady of eighty years of age, mother of a famous journalist, coming to me for, inter alia,
chronic scabies. She used to say: “I’m better, doctor, but the complaint does not leave
me”. I only used to smile, assuring her that she was getting the best care. Sense of
proportion and common sense should not be sacrificed at the altar of ‘Cure Mania’. It
reminds me of a fable. A king appointed a tutor for his son to teach him astrology. After
two years, the tutor brought the prince to the king, informing him about the completion of
the tutelage of his son. Overjoyed, the king took something in his hand, and closing the
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fist asked his son to tell him as to what was in his fist. The tutor and the disciple took
paper and pen and started calculations. After completing, the prince told the father that
the upper stone of a ‘chakky’ was in his fist. ( A chakky is a manually operated flour-mill,
consisting of two big, round stones, lower stone with a shaft fitted in the center, and
upper stone with a round hole in the center, and revolving around the shaft with a wooden
handle fitted at the periphery.) The king got infuriated. The tutor informed the king that
their calculations brought an object with a central hole in it. Now it was the common
sense and wits of your ward to judge whether it could be a stone of two and a half feet
diameter or a mere finger-ring. Astrology can teach the divination, not the common
sense. Similarly, homeopathy can teach the rule ‘similia similibus curenter’, not the
common sense. Palliation is as essential a tool as curative process. Art of cure is like the
fine art of painting with light strokes of the brush, not hard hammering of a blacksmith.
The mother of the journalist was treated very mildly and with utmost care. She lived
peacefully and died in peace….Now the next tenet:

NEVER CAPITALIZE ON THINGS INSIGNIFICANT: The Vision is not how to prescribe,

but how and when not to prescribe. To prescribe is a temptation, not to prescribe is
wisdom and sagacity. Restraint is always soaked in wisdom, and experience. Many so-
called chronic cases I started with sac lac (placebo) and ended with sac lac, and many
months in between. They were remedied with judicious regimentation and nutritional
instructions. In three to four months, in one such case, I didn’t prescribe anything and the
patient reported better on every visit. These are not the cases of chronic diseases but the
errors of chronic life style.

Another category of cases where I didn’t prescribe any medicine were the cases that came
to me from other homeopaths with sometimes homeopathic aggravation, and sometimes
jumbled up cases by injudicious prescribing by the last homeopathic practitioner, where I
thought to wait and see. In many such cases sac lac did the trick, with definite nutritional
regimen. No medication was ever prescribed.

CONTRARIA BETTER THAN SIMILIA, for emergencies during homeopathic treatment:

For the patients who are going on a journey, out of city, or belong to other cities or
countries, I strongly advise them that they should, in case of emergency, patiently wait
for the symptoms to abate or settle down on their own—as most of them will, if they were
caused by the deep-acting medicine that I had prescribed. If the emergency is so severe as
to necessitate medical help, they should better go to an allopath, instead of a homeopath.
This is because I do not want to spoil my case. The homeopathic medicines act in unison
with the vital force, and run very deep, while the allopathic medicines act superficially,
by dint of their drug action. They will never spoil the action of my constitutional remedy.
I even allow them, for the same reason, to use any sort of toothpastes except, the so-
called, homeopathic toothpastes.

With the same token, I don’t feel any compunction in prescribing ENO fruit salt, or a sort
of herbal carminative, prepared at home with herbal and conventional ingredients, for the
mild errors of foods, surfeit or gluttony; or taking Paracetamol or Dispirin for a traveling
headache or unusual tiredness. If they can assuage these troubles by taking rest or taking
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some pick-me-up drink, it would be better than drugs. Canons should not be shot for
killing sparrows.

To make the point more clear let’s suppose that our patient is, at the time, under the
curative action of 10M dose of Calcarea Carb., and is traveling away from the city.
Suppose he develops a traveling headache or any other emergency. In case he consults a
homeopath, and he prescribes, e.g. Sulphur 30, or 200, what do you think will happen to
your Calcarea Carb? No less than a catastrophe, for it will spoil your whole case.

Let’s take another hypothetic case. Suppose our patient is under the curative action of
Phosphorus 50M, and he happens to be on a journey in some other city, and contracts a
severe throat infection with high fever and utter hoarseness, verging on aphonia. Now if
he goes to a homeopath, he may prescribe Causticum. But we all know that Causticum
bears inimical relation to Phosphorus. It will again spoil the whole case, beyond
rectification. Even if such a remedy is chosen that has no bad relation with the already
given agent, then too the case will lose its smooth dynamic flow, as the level of both the
remedies, being both homeopathic, will nearly be the same and thus intermingling.

So we should not be shy of the contraria. We can partake of the above mentioned
temporary medicines, and herbal teas, as ginger tea, cinnamon, cardamom and fennel
seed teas; or coco tea as pick-me-up. I usually advise my elderly patients, going on
pilgrimage, to take Arnica 3X drops daily for tiredness. Any number of medicines can be
prescribed, on this nutritional level doses (3X to 6X) as preventive, and to allay daily
complaints in such trying situations. These won’t disturb the action of the deep acting
dose of their real treatment.

Medical fast is another tool to keep you from prescribing unnecessary medicines, and, at
the same time it is the best tool to deal with errors of food and surfeit; and also give you
time, to judge the real malaise. This fast is observed by prohibiting all sorts of grains and
usual meals; and allowing a generous intake of fruit juices and repeated doses of herbal,
and green teas with dates, or honey. Medical fast is at once a drastic cleansing process
that unburdens the vital force and rejuvenates the system. After this if medicine is at all
required, the same will work in a very smooth way without let and hindrance.

Only the sensitive and educated people can thus be dismissed with the advices as how to
live and change their mode of life without prescription. But for the illiterate and ignorant,
an envelop of sac lac is essential. This is the penalty as the wages of ignorance.

PREPOSESSION AND SUPPOSITIONS SHOULD NOT DETER ONE IN HELPING THE SO-
CALLED INCURABLE CASES. Kent has laid down the criteria for declaring curable and
incurable cases. On these hypotheses of Kent a good many cases can be branded as
incurable. Countless cases of chronic arthritis, diabetes, tumors and cancer, for example,
can easily be rejected as incurable. But, in my practice, I have never refused or drew
back myself from such so-called incurable cases. My mentors and luminaries, Burnett
and Jahr, prevent me from indulging in such (ruthless) fancies. They help every person:
Dr. Jahr, by remaining within the classical limits, and Dr. Burnett by devising new
approaches and methods, or searching unexplored areas and possibilities of uses of, even,
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the well proven remedies. His dictum is: “Incapacity to cure does not render the
uncured incurable”. This dictum should be inscribed in large letters in every
homeopathic clinic, worth the name. Greatness of Burnett is immeasurable, and posterity
can’t pay a befitting gratitude to this noble soul.

The point in such cases is not the ‘curability or incurability’, in the pedantic sense, but
how to help these miserable souls, and enable them to lead a practically useful life
without suffering. And that is very possible if one follows the above mentioned two great
authorities, in their learning and spirit. Their insight and practical skills should be
inculcated, and incorporated in every serious practitioner’s clinical approach. The
inventive mind of Dr. Burnett has blazed a trail for the generations of homeopaths to
follow. There is hardly any therapeutic field where Burnett might not have planted
unwonted insight. I’ll adduce a very small feat of this illustrious master, in the field of
gout and arthritis. He has given two medicines of incomparable worth to tackle this
disabling and crippling disease: that is, Urtica Urens, and Natrum Mur. 6. The last is
not Natrum Mur, mind you, but Natrum Mur.6. Burnett’s classic dose is six grains of
Natrum Mur.6 powder; and Urtica is prescribed in drop doses of mother tincture. I have
helped many tedious cases of this disease with these two agents. And I’m thankful to
Burnett for that. Trying to find or invent new ways to help the ailing humanity is better
than declaring a case incurable on suppositions. Nor be ever unnerved by a flood of
incongruous symptoms of a patient. Learn how not to prescribe, and help people without
prescription. Always think that diathesis is full of symptoms, while the disease proper
has dearth of them. For example Tubercular Diathesis is full of symptoms and
Tuberculosis has paucity of symptoms. Similarly Cancerous Diathesis has lot of
symptoms, while Cancer is left with scarcely any characteristic and uncommon
symptoms on which a satisfactory homeopathic prescription can be made.

Restraint and care is the first and last proviso for a successful practice. Think that eighty
percent diseases are begotten of age-old habits (culinary and otherwise) and the vagaries
of cultures. Hence

Hold back prescription!! That is the motto.