Case Taking: Best Practice and Creating Meaning in the Consulting Room (The Landscape of Homeopathic Medicine) Volume-1

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It is a pleasure to write a foreword for Alastair Gray's volume on case-taking. It would be misleading to suppose that Alastair has written solely about case taking. Rather, as the title of this book suggests, he has scanned the landscape of homoeopathy and has sketched his impressions in great detail, affording us an overview of the many diverse approaches to the vast terrain of homoeopathy. In this context, taking the case is only a lens through which one may view the whole art, searching for a 'best practice' definition, the noble destination of Alastair's voyage.

I will start with a few words about Alastair, since my impression of him has some bearing on this book. I first met Al as a student at the Dynamis School in 1994. I remember the year vividly, for that was the 'unfortunate' year chosen to prove Plutonium nitricum. They bore this burden well, and Alastair's proving left a vivid impression, illuminating the hidden nature of this incredible substance. In his proving, Al had repeated 'double dreams'; at first he would dream of an event such as a race or burglary as an observer from a vantage point high above. Later on that night he would dream the same dream again, but this time as a participant in the event.

It occurs to me that Alastair has taken a similar approach here. While surveying the homoeopathic landscape he has at first sketched a broad overview, later on delving into the details that make this a scholarly as well as an insightful book. This was always Al's skill; to examine a subject from many points of view without being attached to any one teaching other than the most logical choice. In his foreword he calls this critical thinking. It is this critical thinking that defines the higher levels of knowledge which is so often lacking in homoeopathy these days. As the profession undergoes a lengthy period of uncontrolled expansion, a few logical boundaries become necessary.

Case taking is not the most controversial aspect of homoeopathy; that distinction lies with other aspects such as case analysis or classical versus non classical approaches. Nevertheless case taking tends to shape itself around a particular methodology, a case of the foot molding to the shoe. Once we adapt our case taking techniques to our prescribing techniques, prejudice enters the process. Freedom from prejudice is the one and only point Hahnemann recommends when taking a case, a point to which much lip service is paid to but which so easily vanishes in the quest for methodology; methodology has a goal, and a goal is never free.

It is the patient rather than the practitioner that should dictate the case taking outline; this is the essence of individualization. Any form, routine or framework impedes the natural flow of a case and its unique information. Worse still are the various case taking methodologies that enslave themselves to 'finding the remedy', either by questioning along the lines of a remedy, or the more subtle but none less dangerous questioning along the lines of a 'system'. To be truly free from prejudice there should be no goal in mind, no aim.