Spectrum - Palliative

SPECTRUM OF HOMEOPATHY

Jürgen Hansel ¦

VARIOUS REMEDIES

PALLIATIVE

A centrally coordinated multidisciplinary team is responsible

for the individual treatment of each patient: symptom control

(pain, thirst, breathlessness, and other symptoms) is provided by

specialists and care is given by specially trained carers. Volunteers

are an integral part of treatment. If we nowadays view palliative

medicine as a multi-professional task, Saunders was exemplary

in that she embodied all the key professions in one person: she

trained as a nurse, social worker, and doctor.

PALLIATIVE MEDICINE AND HOMEOPATHY

If we examine the principles of palliative medicine as defined by

Saunders, we can see some basic similarities with homeopathy,

chiefly the holistic approach with the aim of including all aspects

of human existence. The subjective sense of wellbeing is first

and foremost, not objective data. As in homeopathy, Cicely

Saunders was concerned with offering her patients individual

rather than standardized treatment.

Yet, homeopathy has paid little attention to palliative medicine,

as can be seen by the dearth of books, journals, and seminars

on this topic. One reason for this situation can be found in the

origins of homeopathy. Since Samuel Hahnemann, the concept

of palliation has had negative connotations because the founder

of homeopathy associated the term with the effect of the

allopathic medicine of his time.

In paragraphs 55 and 58 of his Organon of Medicine, he wrote:

“One would have long since abandoned these allopathic physi-

cians if it were not for the palliative relief obtained at times

from certain empirically discovered means whose almost in-

stantaneous flattering action was conspicuous to the patient.

To some extent, this bolstered the physicians’ credit … This

is a very faulty, merely symptomatic treatment wherein only

a single symptom, thus only a small part of the whole, is

one-sidedly provided for.” For his own method of healing, by

contrast, Hahnemann postulated in paragraph 2: “The highest

ideal of cure is the rapid, gentle and permanent restoration

of health; that is, the lifting and annihilation of the disease

in its entire extent.”

A solely palliative approach cannot hope to meet this standard

of cure. Yet, of course, there are patients we meet in homeo-

pathic practice for which Hahnemann‘s highest ideal of cure

does not apply. This is true above all for patients whose

illness meets the 1990 WHO definition: “Palliative medicine

is the active total care of patients whose disease is not

responsive to curative treatment. Control of pain, of other

symptoms, and of psychological, social and spiritual prob-

lems is paramount.”

According to this definition, there is a phase in the pro-

gress of severe illness in which there is still a prospect of

healing – or at least remission – and prolongation of life.

And then, there is a phase in which there is no more hope

of healing, when the only prospect is relief of symptoms

and improvement of the quality of life. This terminal phase

is an exception to Hahnemann‘s postulate and requires

from us homeopaths palliative treatment in the original

sense: just as Saint Martin divided his cloak (Latin pallium)

in two and gave one half to warm the beggar, without

aiming to alleviate his poverty, we should aim to relieve the

suffering of the incurably ill by treating their complaints

symptomatically. In the curative phase, we ideally search for

a simillimum, the so-called constitutional remedy.

Flexible approach:

in practice, however, it is seldom possible

to draw a clear boundary between the curative and palliative

phases of illness. The boundaries are rather blurred and so there

are frequently situations in which the attempt is still made to

treat curatively or at least to prolong life, while at the same time

palliative treatment is provided to improve the quality of life. For

the goal of prolonging life by chemotherapy and radiotherapy,

there is generally acceptance of severe side effects that require

accompanying palliative measures. With homeopathy, we can

HOSPICE: FOUNDER CICELY SAUNDERS

The word hospice is derived from the Latin hospitium,

meaning an inn or a place of hospitality. In the early Middle

Ages, hospices were hostels offering protection, lodging,

and care to pilgrims, the ill, the old, and the weak. The

founder of the modern hospice movement is the English-

woman Cicely Saunders (1918–2005). As a doctor, nurse,

and social worker, she was very concerned with both the

terminal care of the seriously ill and the alleviation of their

pain. The Latin “pallium” means cloak or covering in the

sense of alleviation, referring to the comprehensive care of

someone when healing is no longer possible. The first mo

dern hospice was St Christopher’s in London, which opened

in 1967 with donations collected by Saunders.

Palliativverband / press photo