SPECTRUM OF HOMEOPATHY
Jürgen Hansel ¦
VARIOUS REMEDIES
18
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.
copyright ¦ Bayerischer Hospiz- und
Palliativverband / press photo