| United States Patent |
5,797,839 |
| Herscu |
August 25, 1998 |
Homeopathic treatment selection system and method
Abstract
A system and method for assisting a homeopath in the diagnosis and selection
of treatments for a patient. The system includes a digital computer adapted to
store information related to symptoms and remedies for symptoms. The computer is
adapted, via a program, to assist the homeopath in case-taking by prompting the
homeopath for collection of symptoms by providing case-taking suggestions. The
computer is further adapted via the program to group symptoms into segments, and
to facilitate the homeopath in building a cycle of segments. The segments are
utilized to index into the stored information to select remedies for the
symptoms incorporated into the segments. The system is further adapted to
interact with the homeopath in the selection of which particular symptoms go
into a particular segment.
| Inventors: |
Herscu; Paul (Amherst, MA) |
| Assignee: |
Apple Blossom, LLC (Amherst, MA) |
| Appl. No.: |
772415 |
| Filed: |
December 23, 1996 |
| U.S. Class: |
600/300 |
| Intern'l Class: |
A61B 005/00 |
| Field of Search: |
600/300 128/920-925 434/262 |
References Cited [Referenced
By]
U.S. Patent Documents
| 5463548 |
Oct., 1995 |
Asada et al. |
600/300. |
| 5619990 |
Apr., 1997 |
Kanai |
600/300. |
| 5619991 |
Apr., 1997 |
Sloane |
600/300. |
Other References
|
Homeovia, "Welcome to Radar Homeopathic Software", http://www.homeovia.com/radar/intro.html,
pp. 1-11, Jul. 1996. |
Primary Examiner: Lacyk; John P.
Assistant Examiner: Gilbert; Samuel
Attorney, Agent or Firm: Choate, Hall & Stewart Pasternack; Sam
Jarrell; Brenda H.
Claims
1. A computer-implemented method for facilitating the selection of remedies
for a patient, the method implemented on a computer with an input unit, a
display unit, a database providing a data file containing a plurality of
indexed data records containing symptoms, rubrics, and remedies, the symptom
data records containing indications of rubrics, the rubrics containing
indications of remedies, the method comprising:
a) receiving via the input unit a first set of input data identifying
patient symptoms;
b) receiving via the input unit a first command to create at least one
segment consisting of at least one rubric, the segment being associated with
a subset of the symptoms;
c) creating the at least one segment by indexing via the database into the
data file for a set of rubric data records related to the symptom data
records,
d) receiving via the input unit a second command to create at least one
remedy from the at least one segment; and
e) creating the at least one remedy by indexing via the database into the
data file remedy data records indicated by the set of rubric data records in
related to the at least one segment.
2. The method of claim 1 further comprising the steps of repeating steps a),
b) and c), collecting each at least one segment so created into a set of
segments, repeating steps d) and e), and collecting each at least one remedy
into a set of remedies for the set of segments.
3. The method of claim 1 further including the step, prior to step a), of
prompting, via the display unit, a first set of assisting prompts.
4. The method of claim 1 further comprising the step, after step e), of
displaying via the display unit the at least one remedy.
5. A computer-implemented method for facilitating the selection of remedies
for a patient, the method implemented on a computer with an input unit, a
display unit, a database providing a data file containing a plurality of
indexed data records containing symptoms, rubrics, and remedies, the symptom
data records containing indications of rubrics, the rubric data records
containing indication of remedies, the method comprising:
1) building a set of rubrics until receiving a completion indicator via the
steps of
a) receiving via the input unit a first set of input data identifying
patient symptoms,
b) receiving via the input unit a first command to create at least one
rubric from the symptoms,
c) creating the at least one rubric by indexing via the database into the
data file for the symptom data records matching the first set of input data
and reading the indications of rubrics in the symptom data record,
d) collecting the at least one rubric into the set of rubrics;
2) receiving via the input a second command to create at least one segment
from the set of rubrics via the steps of
e) indexing via the database into the data file for rubric data records
matching the rubrics in the set of rubrics and collecting the rubric data
records into a set of rubric records,
f) creating via the database an at least one segment data record containing
at least a portion of the rubric records, the segment data record
representing the at least one segment; and
3) creating the at least one remedy by indexing via the database into the
data file for remedy data records related to the at least a portion of the
rubric data records in the at least one segment.
6. The method of claim 5 further including the step, prior to step a), of
prompting, via the display unit, a first set of assisting prompts.
7. The method of claim 5 further comprising the step, after step 3), of
displaying via the display unit the at least one remedy.
8. An apparatus for assisting selection of a homeopathic treatment
comprising:
a digital computer;
an input unit connected to the digital computer for inputting data;
an output unit connected to the digital computer for outputting data;
a computer readable memory adapted to store a program for control of the
digital computer;
a storage system under control of the digital computer containing data
stored in records, the data containing information including symptoms,
rubrics, and remedies; and
a program in the computer readable memory adapted to control the digital
computer to
prompt, via the output unit, a first set of prompts for input,
receive a first input containing a set of patient symptoms via the input
unit,
output a second set of prompts for input to identify a major symptom
representing a portion of the set of patient symptoms,
build a first segment representing said major symptom,
retrieve from the storage system records rubric information related to the
first segment,
retrieve from the storage system records containing remedy information
related to the retrieved records containing rubric information, and
display the information in retrieved remedy records.
9. The apparatus of claim 8, wherein said program is further adapted to
build a second segment after building the first segment.
10. The apparatus of claim 9, wherein said program is further adapted to
respond to an input instruction by merging said first segment and said
second segment into a single segment.
Description
FIELD OF THE INVENTION
This invention is related to computer systems which facilitate the selection
of medical treatments stored in a database of a information system. More
particularly, the invention is related to an information system for the
selection of homeopathic treatments stored in a database.
BACKGROUND OF THE INVENTION
History and Definitions
Homeopathy was
developed by Samuel Hahnemann in 1790. While he was translating a materia
medica from english into german, he came across a reference that the
prevalent prescription for malaria at that time was cinchona bark. The
reason stated for its efficacy it stated was that it was quite bitter. Dr.
Hahnemann was well versed in the current use of medicine and decided there
must be another reason besides its bitter qualities that made it work. He
reasoned that other medicines were bitter but were not useful in the
treatment of malaria. To prove his point, he experimented on himself by
taking cinchona bark and observed the effect. Within a short time he
experienced chills, fever, palpitations, sweats, in short, all the symptoms
of malaria. He wrote down these effects in the text that he was translating
as a footnote.
The more he studied and translated medicine and medical texts, the more he
observed this phenomenon. If healthy people took massive amounts of a
particular drug, the drug would actually cause the same symptoms it was
supposed to cure. Hahnemann began to wonder what would happen if you matched
the symptoms of a sick patient to symptoms that a drug produced. He began
experimenting with this method and developed a new branch of medicine, which
he called homeopathy.
This is actually the definition of homeopathy,
homeo, meaning the same, and pathos, meaning illness.
Hahnemann and some of his healthy colleagues, while in a healthy state,
began taking many of these drugs to find their effects on the healthy. They
carefully recorded and collated the symptoms that each drug produced. This
testing and recording of a homeopathic drug on healthy people is called a
proving. Provings are recorded and collated, and then assembled together in
a reference text called a materia medica.
The current materia medicas have up to 5,000 proven drugs listed. The drugs
are derived from plants, minerals and animal substances. The remedies are
listed in alphabetical order in the materia medica. The materia medica has
grown to include not just symptoms that were proven but also to include
toxicological symptoms as well as symptoms that were actually cured in sick
patients using that particular remedy. The symptoms in the materia medica
are categorized in order from the top of the body on down. So all the
symptoms in the head are categorized together, then the eyes, ears, nose and
so on until the extremities.
Some remedies have only 40 symptoms listed in the materia medica, while
others have 15,000 symptoms. Since it is impossible to remember all the
symptoms of each remedy, about 150 years ago the information was collated
into a reference form. All the remedies that affect a certain place in a
certain way were placed under a particular category. The book that contained
these categories is called a repertory. The categories listed in the
repertory are called rubrics.
The repertory of the materia medica is actually a reference tool that lists
all the symptoms cured or produced and list every remedy that has treated
that particular category/rubric. For example, a rubric might list: Head:
pain, above left eye, 3pm lasting to 6pm, with one remedy listed under the
rubric. Rubrics can be very specific like this one, or very general. A
general rubric would be Head; pain, and that general rubric would contain
hundreds and hundreds of remedies. The more specific the rubric the better
for a homeopath, as it truly indicates a closer match. However, specific
rubrics are likely to be too specific and incomplete and therefore
misleading.
Over the years, there have been many changes and additions to the
repertories. Ten years ago, repertories were computerized into several,
databases to speed up the search process. Six or seven years ago, an expert
system was added to one of the databases to further help with remedy
selection by setting certain guidelines that will then give more weight to
some rubrics and less weight to other rubrics.
Essentially, homeopathy
is a very simple medicine to practice. You simply try to match perfectly the
symptoms of the patient to a remedy. There are, however, a few difficulties.
For instance, it's impossible to match all the symptoms of a patient to a
remedy. Mathematically speaking, it stands to reason that when all the
patient's symptoms are included the remedies with 15,000 rubrics will come
up more often than those with only 50. This means that the repertory has a
natural leaning to show the large remedies as the right remedies if you take
into account each and every symptom the totality.
It then becomes a question of taking the logical totality of a patient. In
other words, which symptoms shall practitioner consider that truly represent
the whole disease state of the patient.
The hardest part of homeopathy
then is in the symptom selection. Depending on how you select your symptoms,
you will either be led to the correct or incorrect remedy. There can only be
one correct remedy at a time for a patient.
There are several theories on how to select the appropriate symptoms, but
there are no clear designations of when to use which theory, so one is left
with confusion as to which symptom to choose at any one time.
The Method for Selection of a Remedy
The method a homeopath practices for selection of remedy is broken down into
several parts.
1. The patient comes to the homeopath to be treated. The homeopath will
spend up to 90 minutes eliciting the symptoms that the patient. This is
called the anamnesis or case taking.
2. The symptoms are then analyzed and the homeopath decides which symptoms
to try to match.
3. The homeopath tries to translate the words that the patient spoke into
symptoms/rubrics listed in the Repertory.
4. The homeopath then tries to find which remedies were listed in the
greatest number of rubrics listed in the repertory. Steps 3 and 4 are called
the process of Repertorization.
5. The homeopath then reads the materia medica for a full description of any
of the remedies that ran through all the rubrics and are in consideration.
The homeopath makes the final remedy selection based on the reading of the
materia medica The homeopath then prescribes that remedy to the patient and
the visit is ended.
Difficulties with the Repertory
Historically, homeopathic philosophy says you must match the symptom of the
drug with the symptom of the patient. However, there are a few problems with
the theory.
First of all, the patient's words might be difficult to match to the
original proving language. For instance, a patient may say, "when I
have a headache, I'm in a funk," or, "When I have diarrhea I blow
off work." What does this mean? How does a homeopath relate these words
to the proving language that may have been written 200 years ago.
Another problem is that the remedy you are looking for may not be listed in
the appropriate rubric, because the remedy has not been proven well enough.
In addition, there are numerous mistakes in the repertory which further
complicate the database that is used. And lastly, it often requires several
years of careful study and practice to understand how to elicit the
necessary information to prescribe upon.
To summarize the problems are 1) it's difficult for the homeopath to elicit
the information, 2) it's hard for a homeopath to know if he or she has
elicited enough information from the patient, 3) incomplete remedy proving
prevents listing of the preferred remedy, 4) there are errors in the
repertory, and 5) underlying language difficulties.
Thus. it is an object of the present invention to provide a computer system
to facilitate the selection of homeopathic remedies.
It is an additional object of the invention to provide a computer system for
facilitating the selection of symptoms for a treatment.
It is an object of the invention to provide a computer system containing
homeopathic rubrics and treatments.
It is also an object of the invention to provide a computer system to assist
the homeopath in eliciting information from the patient.
It is an additional object of the invention to provide a computer system to
assist the homeopath in knowing when the homeopath has enough information.
It is a further object of the invention to provide a computer system that is
capable of modifying the database homeopathic treatments.
Other objects and advantages of the subject invention will be apparent to
those skilled in the art from consideration of the attached drawings and the
detailed description set forth below.
SUMMARY OF THE INVENTION
This invention is related to computer systems which facilitate the selection
of medical treatments stored in a database of a information system. More
particularly, the invention is related to an information system for the
selection of homeopathic treatments stored in a database. The invention
assists the homeopath in case-taking, remedy selection and treatment. The
system utilizes a predefined database of homeopathic information and
facilitates case-taking by prompting the homeopath for additional
information based upon a state of the case-taking. The system facilitates
remedy selection by focusing the homeopath on the cycle of the disease and
selecting remedies based upon such a model. The system facilitates treatment
by allowing a historical record to be kept of each patient thus allowing the
homeopath to track the course of disease and modify the treatment
accordingly.
One embodiment of the present invention is a computer-implemented method for
facilitating the selection of remedies for a patient, the computer
containing an input unit, a display unit, and a database providing a data
file containing a plurality of indexed data records containing symptoms,
rubrics, segments and remedies. The database contains the symptom data
records that further contain indications of rubrics, rubric data records
that further contain indication of remedies, and segments segment data
records containing an indication of rubrics within the segment.
The system carries out the steps of building a set of rubrics until
receiving a completion indicator via the steps of first receiving via the
input unit a first set of input data identifying patient symptoms. Next,
receiving via the input unit a first command to create at least one rubric
from the symptoms followed by creating the at least one rubric by indexing
via the database into the data file for the symptom data records matching
the first set of input data and reading the indications of rubrics in the
symptom data record. Then collecting the at least one rubric into the set of
rubrics.
The system further is adapted to receive, via the input unit, a second
command to create at least one segment from the set of rubrics via the steps
of indexing via the database into the data file for rubric data records
matching the rubrics in the set of rubrics and reading the indication of
segments in the rubric data records, and creating via the database an at
least one segment data record containing at least a portion of the rubric
data records.
The system is further adapted to identify at least one remedy by indexing
via the database into the data file for remedy data records related to the
at least a portion of the rubric data records in the at least one segment.
BRIEF DESCRIPTION OF THE DRAWINGS
A preferred embodiment of the invention has been chosen for purposes of
illustration and description and is shown in the accompanying drawings,
forming a part of the specification, wherein:
FIG. 1 is a block diagram illustrating the cycle of the vital force caused
by an imbalance in the system;
FIG. 2 is a block diagram illustrating the segments in a cycle of a disease
connected by relationships between segments; components;
FIGS. 3, 4 and 5 are flow charts of an embodiment of the present invention
illustrating the steps of the method; and
FIG. 6 is a block diagram illustrating an embodiment of the present
invention computer
FIG. 7 is a block diagram illustrating the blocks within the computer system
of the present invention; and
FIG. 8 is a diagram illustrating an example embodiment of the display of the
present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS OF THE SUBJECT INVENTION
We come into the world with a body and spirit and our vital force. It
animates us and, in a sense, is us. But the health of that vital force will
vary from one person to the next. From the moment of our conception, it is
affected by various genetic as well as environmental factors. Then along
comes a stress that the person is susceptible to, and the vital force is
overwhelmed and knocked out of balance. And that's how disease begins.
Disease is a unit. It is one disease for one person at one time. It begins
in a single place (usually the individual's weakest spot) but it also shows
itself throughout the whole being in many ways, manifesting through many
signposts which are called signs and symptoms. It is a homeopath's job is to
ferret out that one disease for that one person. The vital force's job is to
help us find it by producing signs, or symptoms, that show us the pattern of
the disease.
How does the vital force do this? When it first gets `untuned`, it strains
to adjust to the stress, in order to reestablish its balance. This straining
is what produces the symptoms that point out the disorder and signal what is
wrong. Another way of putting it is that the vital force, thrown off balance
by the stress, no longer has the ability to cure. It is flawed. Its efforts
fail. This failed attempt is itself the chronic disease illustrated in full
color. Thus, the symptoms are not the disorder itself but in some way show
the disorder, by mirroring it or embodying it.
How can a homeopath best see the message that the vital force is struggling
so hard to show us? It is flashing the pathology of the whole patient, if
only the homeopath could see it. Its message can be detected in every
symptom of the patient. That is the genius of the vital force. It is doing a
great job. If, by giving us dozens or maybe hundreds of examples, the vital
force can say in a nutshell, "This is it. This is the disease,"
why can't we? What a help it would be if a homeopath could describe with a
single statement every symptom that a remedy can produce or cure.
But there is a nagging question getting in the way. If there is only one
disease, how do all the symptoms fit together? Not just most of the
symptoms, not just the ones a practitioner selected, but all of the
symptoms, the mental state, the sleep position, the food cravings and
aversions, the common as well as the characteristic symptoms.
Until now, homeopaths have been forced to settle for the bulk of the
symptoms and let go of the rest. They have learned several mechanistic
models of understanding, and with trial and error eventually found success
more and more. But here comes that nagging again: Why not every symptom? If
the disease is throughout the being, then every single symptom, from
unimportant ones to important ones, should in some way mirror that disease.
So what can be done? Homeopaths need to understand and match not just the
symptoms of the illness, but more importantly the way of being sick.
Another Voice
As T. S. Eliot said in his Four Quartets, ". . . next year's words
await another voice." Although homeopathy
has a strong vitalistic philosophy, that the practical application has often
been mechanical at best. So, in order to create a more practical, effective,
streamlined way of case taking and repertorization, new words must be found
for saying what a practitioners have to say and new ways of saying it.
The present invention is a system and method of studying and practicing homeopathy.
Using a common language this method could act as a matrix for classical
homeopaths to express their different ways of teaching, prescribing, and
writing. By so doing, they can add to each other's findings, thereby
refining homeopathy
and propelling it forward.
The present system involves formulating a phrase or sentence for each remedy
that will substantially fit every symptom of that remedy, every patient
treated who needed that remedy, every materia medica utilized, every lecture
heard, and every live case as well as paper cases studied of that remedy. It
must be a sufficiently precise phrase that sums up not only all that this
remedy encapsulates, but also the dynamic aspect of it, how it moves from
one stage of the illness to the next. For Stramonium such a sentence might
be: Driven by confusion, fears, and vulnerability, Stramonium is engaged in
an ongoing and violent battle between the unconscious and the conscious,
between darkness and light, between succumbing to the death realm and
yearning to exist in the life realm. Examined carefully, everything about
Stramonium should fit this picture.
If a homeopath can begin to understand each remedy in the materia medica in
this way, there will be much less need to memorize facts and facts and
facts. This would be quite in line with the picture Hahnemann painted--a
picture of the vital force putting on a show (for the purpose of preserving
the patient). The vital force strains to shout out the plot. The symptoms
are the main characters, not just bit players entering and exiting in some
haphazard fashion. They move within a script in a logical pattern. It is
this logical pattern that homeopaths have been trying to perceive all along.
This pattern is what Hahnemann meant when he spoke about a totality of
symptoms. By totality he did not simply mean the total number of symptoms,
but rather the total pattern of the disease. That is the real totality. The
pattern is not as simple as being just mental or emotional or physical. It
is a pattern of unfolding. It does not begin or end at any one point.
What is that unfolding, or movement? The vital force gets knocked off center
by some stress. To correct that and re-establish a balance, it strains. As
illustrated by FIG. 1, the strain shows itself in signs and symptoms 10.
These symptoms grow stronger as the vital force compensates too much 11,
until they finally overshoot the mark 12. The overshoot must be corrected 13
to maintain some semblance of balance. That, in time, brings the patient
full cycle back to (or at least near to) where he started 10.
In this way the cycle is reinforced, over and over again. It is as if you
are getting on a train trying to go directly to a certain destination. But
the train instead makes a loop, stopping at various places along that loop
and finally coming back to where you first began. This loop or cycle is the
disease, and it keeps repeating itself over and over again. We will see this
later in the Cycle of Stramonium.
How can the cycle ever be broken? A shift is needed in the underlying
balance so that the patient can return to health. But change is hard to come
by; it is easier to go on and on in the rut of the cycle. If you reflect
upon your own life, you may recall times when you found yourself in somewhat
of a `stuck` mode, and you struggled to get free of it, but the more you
tried to break the pattern or habit, the deeper you got into the rut.
The fluid action of chronic disease is like that. It first establishes a
certain pattern and then renews itself by falling into the same groove over
and over again, each time sinking deeper, spiraling downward. The
deterioration shows up in the mental and emotional and physical spheres in
different ways. This pattern, this cycle of events, will (in some way) be
recognizable everywhere--in all the symptoms of the patient, in all the
symptoms listed in the materia medica for that remedy, and in all the
symptoms brought out in the provings.
If we can look at disease in this way, we will be better able to identify
and isolate the main elements or ideas, which I call fundamental segments,
within each of the remedies. That will allow us to recreate the chain of
events showing the pattern that fits not only everything known about that
remedy, but everything known about every patient who has ever needed it. It
will even give us the freedom to predict the direction the disease will
take.
The Fundamental Segments within the Cycle
Everything a homeopath observes in the patient is showing the same balancing
act of the vital force. Every single symptom a person expresses is an
example of one of the fundamental segments operating in that person's cycle
of disease. This includes even our strong symptoms, our mental symptoms, our
sleep symptoms, everything. Each one is an example. This explains why we get
in trouble when we take the keynotes literally. That is, we think the person
must desire sweets in order to fit Stramonium. But sweets is only an example
of the yearning for comfort in this isolated and lonely person. In other
words, a symptom does not stand alone. It has a relationship of some kind to
other symptoms. And so, that desire for comfort or consolation, which is one
of the fundamental segments of the remedy, will show up over and over again
in many places and many ways through various symptoms. Some of these
symptoms will be found in rubrics, some will not. That doesn't matter. It is
the segment, the idea, that matters. That segment is something which
absolutely belongs to that remedy.
As illustrated by FIG. 2, the cycle itself is a flow of events that is
composed of a number of fundamental segments, for instance 20, 21, 22 and
23. Each one of these segments could be described by a word or phrase, such
as yearning for comfort or violent overreactions. In the model showing the
cycle, you will see that each segment is linked by an arrow to the next
segment, representing its direct effect leading to the one that follows. It
in some way pushes the person to the next segment. Each segment flows into
the next until you come full cycle again. The cycle is the disease. You can
jump in at any point, start with any segment. The pattern is a continuous
flow.
Another way of looking at it. Picture for a moment a circle of stepping
stones surrounding a flower bed. A different cluster of flowers is planted
next to each stone. As you move from one stone to the next you see a whole
new cluster. Each is part of the total design. At some point you return to
the original cluster. In the cycle of a remedy, these clusters are the
fundamental segments of the cycle.
To stretch the metaphor a bit further, different flowers are planted and
bloom and die at different times, and there may be others to come up in
their place. Like that, the disease is not stationary but continuously
flowing, moving, and changing--but only within certain parameters. But one
thing is sure--every item that appears in a materia medica must in some way
fit into one of those idea clusters, or segments, that make up the total
pattern of the remedy. This is why I call it a fundamental
segment--fundamental because it is intrinsic and essential, segment because
it is a part of the whole cycle.
Another point. Within every remedy you will see certain segments that seem
universal, such as weakness. At first this may seem confusing. How can you
differentiate between dozens of remedies if they all have segments in
common? Easily. The uniqueness of that remedy will be apparent in
specifically how that element or segment (weakness) is expressed. Also every
remedy will have at least one segment that is somewhat unique unto itself.
However, every symptom of the remedy is not unique and cannot be treated as
such, for the vital force is not split in pieces. It strains as one, it
reacts as one, and it must be seen as one. This point was made clear by the
example of a pregnant woman who said that as soon as she washed her face she
began to bleed from the vagina. Now there is no rubric like `threatened
miscarriage from washing the face`. But there is one saying that washing the
face causes a nosebleed. This asks the question, "Well, if bathing can
cause bleeding in one place, why can't it cause it anywhere?" The
location is secondary to the bleeding and to the modality. The remedy
chosen, Arnica montana, stopped the miscarriage and the child was born
healthy. This same principle has been applied to babies who after birth have
an epileptic fit when bathed and later are shown to have had a bleed within
the brain.
So, at times it is possible, even useful, to generalize a symptom.
Boenninghausen was the first to state this point clearly. It is the job of
the homeopath to do this kind of generalizing, grouping all symptoms into
segments or units that make sense. In most remedies there will be found four
to six fundamental segments. Each of these can be broken down into smaller
segments, giving even more flavor to the remedy. For example, in the
Stramonium cycle presented here, I chose to make hyperactivity into a
subsection of the violent overreaction segment.
Once a homeopath understands these clusters of ideas that belong to a
remedy, he will easily be able to predict other symptoms that might fit
under one segment or another. And he will also be able to predict with some
accuracy the rubrics that the remedy should be found in. Thus, the present
invention would be invaluable in checking findings as not possible before.
Which Symptoms Go Under which Segment?
The tough part at first is learning how to figure out which rubrics to group
together to form each segment in the cycle. Some of the segments will be
easier than others to work with. For example, take three different symptoms:
a cramp in the abdomen, a cramp in the calf, a twitch in the toe. Although
they are in different locations, they are similar in the idea of cramping.
So it is easy to see that cramping will be one of the fundamental segments
for this patient.
Of course, different homeopaths perceive things differently. Some look for
similarities, some look for differences. Some will see cramping and
twitching as similar. Some will see them as different. Some will see
cramping and obstinacy as similar. That is less obvious. What if you have
cramping and twitching and constipation? What do they have in common?
Contraction. What about constipation, cramping and obstinacy? This shows
that they all are holding on to things. Even though all these symptoms
represent the same idea, some will see that and others may not.
Sooner or later a homeopath will have a patient who is sensitive to light,
touch and noise, and you will see that what these symptoms have in common is
sensitivity. Less obvious but also similar would be sensitivity to noise,
aversion to touch, and fear of robbers. Are these similar? Yes, they all
represent fear of invasion, another grouping of symptoms. It is almost
uncanny how much you can predict with this form of assessing. Not only can
you predict symptoms you will find in the patient, but even symptoms you
will find in the materia medica.
Some of the fundamental segments or groupings will be more abstract than
others. Those will be harder to perceive at first. For instance, what do the
following have in common: desire to be rubbed, desires consolation, desire
to be carried? Comfort. That one was easy. But what about desire for milk,
sweets, pies, ice cream, and fruit? Actually all of them are comfort foods,
the kind of foods we seek when we want comforting or when there's an issue
of being forsaken. So the homeopath has a patient who is ameliorated by
consolation, but when you look up that rubric the remedy the homeopath feels
is correct is not there. Every homeopath eventually faces this--finding good
rubrics that do not contain the correct remedy. What then? What can be done?
Look at the patient's food cravings--one happens to be sweets, a comfort
signal. You choose that, simply because you can see in it the same segment
you find running throughout, that same emotion of yearning for comfort. And
here's where predicting comes in. The homeopath will find many other
symptoms in that patient which represent the same idea That same idea must
be there, everywhere, because it is a fundamental segment.
Another thing that can be frustrating is getting a great symptom that is
rare and peculiar, but there's no rubric for it. Or finding the rubric for
that peculiar symptom but lo and behold, the expected remedy is not there
(as in the comfort example above). Then what? The cycle of the segments is a
way of solving some of these common problems.
The Flow of the Cycle
Once the homeopath sees the relationship of a number of symptoms such as
desires consolation, craves sweets, pain better from touch, and ear pain
better from being carried, then one has understood one of the fundamental
segments in the patient's cycle. Next one has to find out what events caused
this to arise in the first place. How did this need for comforting come into
being? And what keeps it functioning? And after the homeopath has understood
where it came from, the next question is where does it lead the patient?
What does it make him do next? The answer to these questions will lead you
right into the next segment. Perhaps his need for comfort and consolation
makes him overshoot and go into excessive behaviors, outbursts, or some
other form of overreaction. If so, you will find similar ideas in the body
symptoms that will belong to this group. If the excesses (in this patient)
then lead to exhaustion, you have now moved into another segment. And so it
goes from one idea to the next to the next, until you come full cycle. At
this point the whole cycle will be clear to you.
The job of the homeopath is to keep figuring out how and why each segment
leads to something else, or even moves on to a different pathology, but one
that shows the same issues, the same elements. One can find a more complete
example in The Stramonium Cycle.
These patterns are patterns of the whole person, not just of the mind or the
emotions or the body. Some of patients will show the pattern and even tell
it in the sequence that matters to them. Other cases will not be so easy
because the symptoms may seem so far apart, making it harder to see what
they have in common.
For example, a woman was treated who said, "I have thoracic pain that
feels like someone is poking at my back . . . I am afraid of crowds . . . I
like to sit on the aisle . . . I lock the doors at night." All of these
symptoms contain an element of suspiciousness, a feeling of mistrust or
doubt, an idea that something is wrong. Even the back pain fit that idea. So
it was no surprise that it was necessary to spend another fifteen minutes
talking about the remedy and about homeopathy,
because of her suspicious nature.
These main ideas that cycle around are the most important thing to look for
in the patient. They cycle around, one after another popping up to show the
pathology. They are the pathology. Once the homeopath has seen these main
ideas or fundamental segments, the next job is to arrange the bulk of the
symptoms under each segment. The history and analysis are over and it is
time to repertorize.
Practical Application of the Theory
As illustrated by FIG. 2, the visual layout is of a cycle broken by several
junctions where symptoms may be listed, with arrows linking one segment to
the next.
With reference to the flow charts found in FIGS. 3, 4 and 5, the present
invention takes pre-existing data, (the repertory,) collates the material to
aid in remedy selection. The flow charts illustrate an example of steps
performed by an embodiment of the present invention. The present invention
also assists the homeopath on the questions necessary to elicit the proper
information from the patient. Once collated, the homeopath is able to look
at all the symptoms and decide which ones should be used in the analysis.
The system is adapted to allow the homeopath to write the symptoms that the
patient describes into the computer in as text. Throughout the case, or
after it's finished, depending on preference, the symptoms can be tagged
with an identifier such as a number or a letter. Each identifier represent a
certain fundamental segment.
Throughout the case, or after it's finished, depending on the users
preference, the present invention assists the homeopath separation of the
case into fundamental segments. For example, if there are three symptoms of
sharp pain in eye, sharp pain in toe, and sharp pain in the rectum; or,
bleeding from the nose, bleeding ulcer, black and blue spots. As the
patients tells the homeopath the symptoms, they are being recorded and
tagged under the homeopath's direction. For instance, those symptoms
representing sharp pains are tagged with a segment number, those
representing bleeding are also tagged with a different segment number. At
the homeopath's discretion, by simply pushing a button the case is separated
into fundamental segments utilizing the tagged symptoms.
The case can be stored two ways: the way the case was originally taken as a
story, and into fundamental segments.
Once the segments are created, the present invention translates the symptoms
into rubrics. Once all the rubrics are listed, the homeopath can select the
rubrics for repertorization. By clicking on the rubrics they are
automatically designated by the program for repertorization.
With the click of another key, the rubrics are automatically selected in
each segment coalesce to become one large rubric per segment, which now
contains every remedy within the rubrics selected, all within the same
segment. All segments are gone through in the same method.
The user ends by indicating the end of coalescence which begins the search
to come up with the remedies that are in common in all the fundamental
segments. To find the remedy that is found in each of the segments.
There are other ways of using the program. For example, the patient's
complains about a particular problem. The homeopath writes the complaint and
tries to discover the most important part of that complaint.
If the answer is very clear, then it will be treated as the first segment.
The first symptom found thus far will be the first symptom listed within the
first segment.The rubric name may become the name of the segment or a
different name may be taken to indicate the general idea of that segment.
The homeopath then asks for other similar complaints, or if anything affects
the patient in a similar way. For instance, if a complaint is bleeding gums,
and during the course of the interview the patient reveals bleeding in the
vagina and rectum. These are all listed under the same segment, which is
entitled bleeding. (The answer may turn out to be no, yet the patient also
has profuse diarrhea, bleeding from the nose, frequency of urination, and
profuse perspiration. Bleeding, it turns out, is not the common segment,
instead it would be loss of body fluids.)
Within any segment you may have up to ten symptoms written down. There is a
certain criteria of how many to use in the repertorization process. Even
though the symptoms are all written down under each segment, they are
entered without any value. They are there for reference sake and for
understanding. To be included in the repertorization they must be tagged
with a code or number. Once they are given a code, all the rubrics with the
same number or code within the same segment combine to become one rubric.
(This eliminates the difficulty with mistakes and the rubrics being too
small and incomplete.)
Generally speaking, one would like to combine it so that the combined number
of remedies does not exceed 120 remedies. One might just take one rubric if
there were 150 remedies listed, or three rubrics if 40 to 50 listed, or five
or six if 15 to 20 were listed in each.
Once the homeopath understands the segment, the computer can prompt to say
that homeopath is picking too many rubrics. For instance, if the user of the
present invention decided to pick three rubrics within one segment and each
one has 150 remedies, the user could be prompted not to pick as many large
rubrics, or even as many.
Generally speaking, it is better to pick relatively unrelated rubrics within
the same segment. For instance, one mental and one physical within the same
segment, or one mental and two physicals from different parts of the body
would give you a good representation per segment.
Now that the symptoms are picked and the homeopath understands the rubrics
for that segment, the present invention will prompt with questions like:
What does this lead the patient to do?
What are the natural outcomes of this segment?
What can't the patient do?
What does the patient have to do because of this segment?
What does the patient have to do to avoid this segment?
This prompting actually helps to train the doctor in case-taking, and
helping the doctor focus the interview into understanding what the second
segment is. Therefore, the present invention not only collates and searches
but may also function as a aid in training the homeopath to elicit the case.
When the prompting questions are asked the answers will reflect the second
segment, which exists because of the first segment. The process renews
itself.
The prompts and questions assist the homeopath in asking more questions to
understand more and more symptoms that belong in the second segment. The
present invention then lists them, translates them into rubrics, and tags
the rubrics the homeopath wants to use.
Again the system will prompt the homeopath by asking the questions such as,
"what does this lead you to?" The answers to those questions will
lead to the third, and then to the fourth segment, and so on.
It's possible that if more than five segments are selected there may be a
mistake. To facilitate correction of this situation, the present invention
may also ask if one segment represents another. The homeopath would then be
able to check and compile the two segments into one.
If the homeopath is stuck, not having completed the cycle, the present
invention may prompt with the question, "what led to the first idea, or
what situations bring out those symptoms listed in the first segment?"
Prompts such as this assist the homeopath in backing into the cycle.
In one embodiment, the screen is divided into two parts. The top lists the
remedies that were represented in every one of the segments alphabetically.
The bottom lists the smaller remedies, combined salt remedies, and the
nosodes that may have come up in all but one or two segments. This allows
for a further check to make sure that the remedies that are poorly
represented in the repertory do not get lost. The remedies listed can be
clicked on and the keynote important symptoms of the remedy pops up for easy
reference.
Example Implementation
A data processing system 70, suitable for implementing a display system for
a medical information system in accordance with the present invention, is
illustrated in FIG. 6. The data processing system 70 may be a stand alone
computer system or may be a client station 80 and one or more workstations
71 and 72. With reference to FIG. 7, the host or client workstation includes
an input unit 81 and an display unit 82. The input unit receives the
case-taking information that the homeopath 74 has elicited from the patient
75, and may utilize a conventional keyboard and/or mouse. The display unit
82 is used to display information to the homeopath and would typically be a
CRT or printer. The processing system typically contains a main memory (not
shown) for holding data which may be used by users of the system. A
secondary memory (not shown) is also provided, such as a disk drive, for
maintaining the integrity of the database. A processor (not shown) is
provided for reading and writing of data from the database stored in memory,
and for executing other operations requested by users at other host
stations, at workstation.
In the preferred embodiment at the time of filing this application, the
workstations and host stations are personal computers such as those
manufactured by Apple Computer Corp., Compaq Corp, Dell Computer Corp. These
computers may be connected by an I.E.E.E. 802.3 network, and provided with
the Microsoft Windows operating system. It should be understood that the
invention is not limited by the specific computers, network and operating
system shown and described. Other data processing systems may be used in
connection with a database to practice this invention, Such a system may be
programmed to embody the present invention, such as by using a programming
language such as the C++ programming language and its corresponding C++
compiler. As an alternative, or in addition, the system may utilize a
database system such as Microsoft Access, also from Microsoft Inc. The
database may be used to store and index system information, such as
symptoms, rubrics, segments and remedies. In addition, the database may be
utilized to store patient information. It should be understood that many
other programming languages, compilers and databases are available for this
purpose and the invention is not limited thereby.
The computer display system and method of the present invention further
includes a database 85 of homeopathic information 86, 87, 88 and 89. In one
embodiment of the invention, the database contains a variety of records
containing homeopathic information. Specifically, the data records 85
contain symptoms 87, rubrics 88, segments 86 and remedy information 89. The
symptom information is related to the rubric information so that a given
symptom can reference related rubrics. Rubrics information is related to the
segment information so that a given rubric can reference related segments.
Rubric and segment information is related to remedy information so that a
given rubric or segment can reference related segments.
In a further embodiment of the invention, the database may also contain
prompting information 90 to guide the homeopath in use of the system.
Prompting records related to symptom, rubric or segment information can
contain prompts to facilitate the homeopath in case-taking, rubric
identification and segment formation. For instance, if the patient relates a
cramp in the abdomen, the symptom can prompt the homeopath to ask about the
presence of cramps in other locations. In addition, the system can prompt
the homeopath to ask about symptoms related to cramping, such as twitching.
In this fashion, the system can prompt the homeopath to probe for additional
information.
The following example illustrates the operation of the system. FIG. 8
illustrates a display 101 of the information utilized to implement the
present invention. Display 101 may be divided into fields, such as symptoms
field 102 and rubrics field 103. Other fields may be created as required, or
fields 102 and 103 may serve multiple purposes. For instance, the symptom
field may also display rubric information related to the symptoms. The field
102 may also display segments as they are formed.
Prompting information may also be displayed in area 104 to facilitate
case-taking. The location of the fields, and their size, on display 101 is
not material to this invention; however it may be preferable to fill the
display with the appropriate information for the step under execution by the
system. Such information may be displayed graphically. For instance, as
segments are build a graphical representation of the segment may be
displayed.
The fields 102 or 103 are typically made up of a number of rows. Initially,
each row represents a position for entry or display of information. For
instance, the homeopath may enter cramp in the abdomen as the first symptom.
At this point, the system can index into the database to access prompting
records related to the entered symptom. The system then displays in a
further datasheet the prompting information from the related records. The
homeopath can then utilized the prompting information in questioning the
patient.
As additional symptoms for a segment are entered, the system will continue
displaying the symptoms and related prompting information. The symptoms are
converted by the system into related rubrics. The homeopath can label each
of the symptoms/rubrics in a segment with a label, grouping related
information by placing the same label on each. At some point, determined
either by the homeopath or the system, the symptoms/rubrics may be coalesced
into broad rubrics. In this operation, the symptoms, via symptom and/or
rubric records, are related through the database to segment records.
At this point, the system may provide additional prompting to the homeopath.
The goal is to continue case-taking until a cycle is observed. Once the
homeopath observes the cycle, the homeopath tells the system to repertorize
the selected segments. The system accesses the remedies related to the
identified segments by accessing rubrics included within the segment and
then accessing the related remedy records. The system then displays the
remedies to the homeopath. At this point, the homeopath may further refine
the list of remedies by selecting/deselecting symptoms for specific
segments, creating or removing segments or adding symptoms.
The system may further be modified to include storage for patient
information including the information just gathered in the case-taking
process. Thus, at the conclusion of a case-taking, the homeopath may elect
to have the patient information stored within the system. The information
thus stored may be recalled at a future date. This aspect of the system
assists the homeopath in tracking a course of treatment for each individual
patient. For instance, after the initial case-taking, the patient is placed
on a course of treatment based upon the remedies selected utilizing the
system. In future visits by the patient to the homeopath, the case
information is retrieved from the system by the homeopath. By reviewing the
retrieved information, the homeopath can determine which of the past
recorded symptoms are no longer present, which symptoms are new and modify
the case information accordingly. A new set of remedies may then be
identified, remedies appropriate for this stage of the disease, by running
the current symptoms through the system as done in the initial case-taking.
Over time, a historical record of treatments is built for the individual
patient, allowing the homeopath closely track and treat the course of the
disease.
The system may also be modified to create a set of "segments"
based upon the materia medica information stored within the system. This
allows the information in the materia medica to be reorganized in a new
fashion, unifying related symptoms by criteria other than the physical
location of the symptom. For example, rather than listing all of the
discharges under each specific body part effected, all discharges can be
grouped together. In this way, if a discharge is identified in one location,
the system can quickly suggest and prompt the homeopath to look to other
locations for similar symptoms. This is additionally helpful in the
selection of a remedy. Every homeopathic remedy has a cycle. The system can
be modified to also allow the homeopath, upon selection of a particular
remedy, to reorganize that remedy into the remedy's underlying cycle. This
facilitates the proper selection of remedies by allowing the homeopath to
examine the remedy's cycle and compare it to the patient's cycle. In
addition, by using the reorganized materia medica information, as the remedy
cycle is examined the homeopath can be prompted to look for symptoms related
to the remedy cycle.
It is to be understood that many variations on the system are possible. For
instance, the information in the records need not be stored in a database
system. The user interface may vary by displaying additional information.
The system may also be designed to access a remote database.
Having now described embodiments of the invention, it should be apparent to
those skilled in the art that the foregoing is merely illustrative and not
limiting, having been presented by way of example only. Numerous
modifications and other embodiments are within the scope of one of ordinary
skill in the art and are contemplated as falling within the scope of the
invention as defined by the appended claims.
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