3. Clinical Guidelines
In addition, we have gradually collected further important topics for modern, high-quality training and practice and summarised the information in a separate section entitled "Clinical Guidelines". This includes comprehensive descriptions of the pathognomonic symptoms and progression of pneumonia, the specifics of case history taking and case management, in particular the key points of dosology, and other therapeutic measures (e.g. oxygen administration, fluid intake, etc.).
In order to ensure a guideline-compliant approach, it was also important to us to define modern decision-making criteria regarding the boundaries between outpatient and inpatient treatment as precisely as possible.
In doing so, we also reviewed historical data to determine when and how treatment was administered in order to reflect developments in treatment (e.g. the increasing use of higher potencies and more frequent doses in the acute crisis of pneumonia treatment).
This also required incorporating the current state of other medical and scientific knowledge.
From a homeopathic-holistic perspective, this also resulted in a critical look at conventional approaches, for example, the treatment of fever, the effects of pneumococcal vaccinations, and much more.
Looking back, how would you assess the overall effort involved?
The project developed into a comprehensive process, always guided by the guiding principle of what else could be valuable in order to cover the topic of "pneumonia treatment" in a professional and differentiated manner. The concept of the book developed as a "work in progress".
What is special about this concept?
First, we wanted to collect all the essential information on a clinical area and make it available in one place.
Our aim was to create a prototype for modern homeopathic clinical literature – analogous to corresponding modern works in conventional medicine.
The aim is to compile all specific materia medica information with as few duplications as possible.
This provides a repertory of clinical experience based exclusively on referenced sources.
This means that all repertory entries can be found in the materia medica and in the cases. This is unique.
We were able to demonstrate the development and special features of dosology – for example, low potencies were used at the beginning, then over time, medicines in higher potency ranges or in solution were applied instead of individual dry doses; in addition, application instructions for unconscious persons, infants and young children.
Pneumonia remains one of the most common causes of acute death worldwide, especially in children. The burden of disease remains high worldwide, not only in developing countries but also in Western industrialised nations, especially in the context of hospital-acquired pneumonia with multi-resistant germs. The material provides a good basis for promoting homeopathic research efforts on such a global health problem.
The vision behind this is to compile free information (open source) with all the tools for homeopathic practitioners (digital app) worldwide (analogous to the Cochrane Society in conventional medicine), instead of hoping for proceeds from sales, which usually cover only a very small part of the costs.
We are promoting a merger of national and international efforts to support the financing and implementation of such projects. In our case, support came from Austria, Germany, Switzerland and Argentina, among others.
How did you deal with the change in clinical terminology?
We tried to work out the clinical terminology used (from 200 years ago) as accurately as possible and list it in a glossary.
We also addressed the question of which terms could be translated into modern terminology (e.g. terms such as catarrhal pneumonia, typhoid pneumonia, etc.).
How did you come up with the special content presentation of the Materia Medica?
The starting point was Pulford's Pneumonia Materia Medica. Then Borland's work was included due to its more comprehensive pneumonia-specific presentations and clinical expertise, resulting in a total of about 30–35 drug preparations.
Additions from other sources were made in the order in which we found them, with only those items that were not already included being added. This ultimately resulted in information on 146 remedies.
What criteria did you use to evaluate the case studies?
Key considerations were
- to present a realistic picture of clinical practice across the different time periods, including all errors, some of which were commented on by us,
- to highlight gaps and shortcomings in the case presentations,
- to preserve a large amount of information that is not documented anywhere else,
- to provide fundamental practice material for education and continuing professional training,
- to include referenced repertory entries from case studies only if they demonstrably achieved a curative effect,
- to apply, as a matter of principle, the same approach to small remedies with limited information as to polychrests,
- to identify and assign the clinical phases of pneumonia along with their characteristic features relevant to remedies.
How did you develop the repertory concept?
The basis of our repertory is Pulford's Pneumonia Repertory, which, according to Pulford, is based on the structure of Kent's Repertory.
Pulford included 28 remedies in his repertory and did not adopt all entries from Kent's repertory.
In the next step, all specific materia medica information was added to existing and new rubrics from the materia medica analysis, provided we found a clear source for the entry. This also applied to entries from Kent's Repertory.
We proceeded in the same way with the usable information from case studies.
We then checked current standard repertories (Synthesis, Complete Repertory, Murphy's Repertory, Knerr, etc.) again to see if there were any additional rubrics and remedy entries. Here, too, we only included information that could be clearly referenced by sources.
Which QM concepts were used for error correction?
All collected case reports were reviewed twice and repertorised to check whether all information could be found. Suggestions for the repertory were also developed and added.
The content of the clinical introduction was edited by a colleague from intensive care medicine with expertise in homeopathy.
The entire text was submitted to five highly experienced homeopathic colleagues for content review, including Dr Hans-Jörg Hee (CH), Dr Carlos Campora (ARG), Prof. Michael Frass (AUT), Tjado Galic (GER) and Dr. Andre Saine (CAN).
Living authors were presented with the information they had used for review and, where necessary, correction.
The English proofreading was carried out by a native American speaker.
Thank you very much for the interview and for this great work, which is now available to homeopaths worldwide.
