HMC: You have been teaching at many international seminars around the world, and you have clinics in different corners of the globe; you must be meeting people from all sorts of cultures and backgrounds.
Does the cultural background of the patients you treat influence how you approach them in your practice? Does it change your practice in any way?
Ajit: Yes, I just returned from Bulgaria after giving my 42nd international seminar, thanks to Roman Buchimensky, Director, ‘Via Homeopatica’ and Dora Patchova, the organizer of Bulgarian seminars, who allowed me to blossom.
The answer is a big yes. Meeting people from all sorts of cultures and backgrounds makes a difference at every level. As a human being, you have your own culture and your own value system, and you are trained in a specific manner. It is with this entire heritage that you start looking at other people. I have written in one of my articles that life is nothing but our own perceptual filter. We approach life, ‘take in’ the experience, and develop our own perception. It is like the saying ‘As we sow, so shall we reap.’ It is we who filter our vision.
We must define first what culture is and what its dimensions are. Culture is the enduring behaviour, ideas, attitudes, and traditions that get transmitted from one generation to the next. We see things through a cultural lens that tints, magnifies, shrinks, and otherwise shapes our perceptions. Our culture is a mindset that we develop during childhood socialization. What is normal in one culture may be regarded as abnormal in another. The interpretation of illness is influenced by culture. According to the 19th-century anthropologist and doctor, Rudolph Virchow, ‘Disease is a disturbance of culture.’ “Every culture has its own ‘Idiom of distress,’ the pattern of behaviour by which people in that culture signify that they are ill” (Alloy, Jacobson, and Acocella).
The influence of culture over society in general and individuals in particular is a matter of serious study. Culture profoundly influences thoughts, emotions, and behaviour. It operates at primary, cognitive, perceptual, and motivational levels. It acts as a blueprint for operation within our physical and social domain. The world is shrinking in size, and new cross-cultural networks are being formed. The period between two generations is diminishing progressively, and children are growing up sooner. The influence of media has encroached on mankind beyond control. People are moving away from nature in every facet of life. We must perceive this in the context of cultural background.
There are three levels of operation – as a human being, as a physician, and as a homeopathic physician. The roles concerning each of them must be clearly defined. When you are working as a human being, you have the onus to look at the sufferers through a humanitarian lens. When you are working as a physician, your role gets widened in terms of diagnosing the disease and overall management of the patient. But if you must perform the role of a homeopath, it is altogether a different level of consciousness. Defining the concepts of health, disease, and cure in the right appreciation and applying them to an individual instance becomes an obligation for a homeopath, given the holistic philosophy of homeopathy.
Culture does change the approach while treating with homeopathic therapy. One of the main reasons is that homeopathy approaches not only the body but also the mind and the life. Culture is always related to all three – body, mind, and life. The repercussions of culture have a bearing on the selection and interpretation of rubrics. Moreover, a homeopath must see that he does not suffer from cultural shock (a term coined by Kalervo Oberg in 1954) i.e. feelings of anxiety, surprise, disorientation, uncertainty, confusion, disgust, etc., that grow out of the difficulties in assimilating the new culture, causing difficulty in knowing what is appropriate and what is not.
HMC: How is your practice outside India different from that in India (where you practice most of the time)?
Ajit: The practice in India is different in many aspects from the rest of the world, especially Europe. Although the appointment system is followed in big cities in India, it is difficult to follow in rural India. Indian patients are of different castes and creeds and are not habituated to work on an appointment system. Many poor and illiterate patients do not even ring the doctor for an appointment, and they directly enter the clinic. They have already spent some money on travel and food, and refusing them is sometimes difficult. The position of a doctor in India is also different. A doctor has respect and honour in society, and in rural parts of India, a doctor is still regarded as a demigod. This might sound absurd. But there are many benefits to such an approach. First, the sense of responsibility on the part of a doctor increases manifold, and second, the patient has full faith in the doctor. This symbiotic relationship helps the patient to recover and to develop a doctor-patient relationship.
The major difference I have noted when I compare patients in India and outside is at the level of the clinical interview. Patients in foreign countries are theorizing types, and they require more energy and time to acquire accurate data. I can cite some examples. One patient, when asked about any effects of food on health, answered, “My soul doesn’t accept milk.” The simple meaning of this sentence is that milk is intolerable, and now we must ask, “What symptoms do you get when you take milk”?
Clinical interviews with Indian patients are easier. Indians narrate their complaints as they are and do not add to make things complicated. They focus more on giving objective data. Interpersonal problems are deeper and more frequent in foreign patients, as are feelings of loneliness and being abandoned.
Most Indian patients do not ask for the names of remedies. The classical prescribers often give a single dose, and then most of the practice is of placebo. In foreign countries, a remedy is usually prescribed, and a patient buys the remedy from a pharmacy. A homeopath gets his consultation charges for the prescription. In India, a homeopath cannot charge a heavy consultation fee. Although homeopathic practice evokes the most intellectual exercise, it is still regarded as a secondary medical therapy. Often, the situation in India is that a patient may spend heavy charges on investigations, but for a good case-taking that involves the total life space of a patient and more than an hour, a patient resents giving a homeopath his due right.
Giving placebo helps in getting money, and the effects of placebo are no doubt tremendous, especially for a homeopath, who must apply the principle of minimum dose. Placebo helps in making a patient health-conscious, in regular follow-up, in a special kind of physician-patient relationship, and gives time for a wise physician to make an appropriate decision. Hence, I maintain that giving placebo helps both the patient and physician steer towards recovery in a better way. But now patients tend to apply their half-knowledge of Materia medica, search the remedy on the net, and argue with a homeopath, making follow-up difficult.
Culture does play an important part in bigoted convictions and superstitions. In undeveloped countries, a homeopath receives patients with bizarre ideas that are stamped and carried forward. However, it does not mean that these ideas are not present in developed countries. I recall a case from India where a diabetic patient refused to eat unless it was 12:00 midnight on the day of a full moon and used to suffer from hypoglycemia.
There are some cultural variations in expressions and interpretations of body language as well. My observation is that patients from America and Europe use gestures more than Indians.
HMC: What can you say about the sort of diseases present in different parts of the world? Is there any difference? What about the social background of the patient? Does it reflect in the kind of diseases they tend to develop? Is there a difference in the type of diseases children tend to develop in different parts of the world?
Ajit: These two questions should be answered together in the context of earlier views. I see cases of atopic dermatitis and follicular tonsillitis much more in Europe. I am consulted for juvenile diabetes and juvenile rheumatoid arthritis as well. Obesity is more common in foreign countries, especially in Europe and America. I attribute this to the consumption of junk food in large quantities and a lack of exercise. I have several cases of arrogant adolescents on my record, and many parents are unable to handle them. This arrogance is a result of ego-hypertrophic training that parents and the educational system in general provide in nurturing their children.
It may be an exaggeration, but it is said that every home in Europe has at least one orphan. I have come across one more problem. In India, it is usually the father who plays a dominant role in the family. In Western society, it is the mother who controls. I have been consulted by many adolescents who narrate their grievances against their mothers during the interview.
HMC: Could you speak a little about the position of different governments around the world regarding homeopathy? Is there a palpable difference?
Ajit: First, it’s important to note that the popularity of homeopathy is on the rise worldwide. In countries like India, Mexico, Pakistan, South Africa, Bangladesh, and others, homeopathy is established as a primary, discrete healthcare discipline with in-depth undergraduate education and training, as well as a professional infrastructure that puts it on an equal level with conventional medicine.
In countries such as Australia and New Zealand, homeopathy is developing into a complete healthcare profession and is receiving government recognition through positive legislative changes.
In India, the undergraduate course is five and a half years and there is a three-year post-graduate course. India has become a global leader in homeopathy, with approximately 200,000 registered practitioners, 180 teaching institutions (including 31 post-graduate colleges), about 10,000 dispensaries in the public sector, around 250 hospitals, and 650 drug manufacturing units. A survey conducted by the Indian Council of Medical Research (ICMR) in 2003 revealed that homeopathy was preferred by one-third of surveyed households in India for minor ailments and by about 18% in cases of serious ailments.
Homeopathy is also recognized officially in countries like Bangladesh, Singapore, Dubai, Malaysia etc. Homeopathy is practised across Europe by an approximately equal number of non-medicos and homeopathic doctors. The distribution between countries is uneven with some countries having a proportionately larger number of homeopathic doctors. Some countries in Europe legally restrict the practice of homeopathy to doctors only- Austria, France, and Luxembourg. However, in other countries like Denmark, Finland, Ireland, Norway, and Sweden, the number of doctors who practice homeopathy is relatively low. Governments in Belgium, Denmark, Ireland, Netherlands, Norway, Portugal, and UK have recently introduced legislation to positively regulate the area of alternative medicine including homeopathy.
Homeopathy is also officially recognized in countries like Bangladesh, Singapore, Dubai, Malaysia, and more. In Europe, homeopathy is practised by approximately equal numbers of non-medical practitioners and homeopathic doctors. However, the distribution of homeopathic doctors varies across countries, with some having a proportionately larger number of homeopathic doctors.
Certain countries in Europe legally restrict the practice of homeopathy to doctors only, such as Austria, France, and Luxembourg. In contrast, countries like Denmark, Finland, Ireland, Norway, and Sweden have relatively low numbers of doctors practising homeopathy.
Recently, several governments in Europe, including those of Belgium, Denmark, Ireland, the Netherlands, Norway, Portugal, and the UK, have introduced legislation to positively regulate the field of alternative medicine, including homeopathy. In Denmark and the UK, integrated healthcare projects have been or are currently being carried out. Some of these projects involve homeopaths closely collaborating with conventional healthcare personnel.
The European Council for Classical Homeopathy (ECCH) was founded in 1990 and is represented in 27 countries in Europe, including all countries in Western Europe and an increasing number of countries in Eastern Europe. Over the past year, associations in three new countries have joined the council. Homeopathy has gained official recognition in countries such as Germany, Switzerland, Canada, and more.
In recent years, countries like the UAE, Thailand, Cuba, Argentina, Iran, and Russia have also granted official recognition to homeopathic systems. New teaching institutions are emerging, and research activities in the field are being revitalized.
Homeopathy is widely accepted and gaining popularity all over the world, including in countries such as Abu Dhabi, Austria, Afghanistan, Bahrain, Bermuda, Brunei, Brazil, Chile, Cameroon, Cyprus, Canada, Costa Rica, the Caribbean islands, Egypt, Fiji, Finland, Greece, Germany, Guinea, Holland, Hungary, Ireland, Israel, Italy, Imo State, Japan, Kenya, Lithuania, Mauritius, Muscat, Nigeria, Norway, New Zealand, the Netherlands Antilles, Panama, the Philippines, Qatar, Romania, Switzerland, Sri Lanka, Saudi Arabia, Scotland, Slovakia, Spain, Taiwan, Ukraine, Wales, and more. However, in many of these countries, there is no government patronage for homeopathy, although there is also no active opposition.
The homeopathic community in India enjoys greater government support than in most other countries.
HMC: Could you share with us a few short homeopathic cases to illustrate one of your points regarding culture?
Ajit: Certainly. I once had a case of an elderly American lady during one of my international seminars. This lady, at 78 years old, was remarkably active and had independently built a new home. She displayed characteristics of being egoistic, straightforward, and excitable. She could be quite rude to others and was even managing her own business while also taking care of her grandchildren. She had a unique demand of $100 per hour for babysitting if it extended beyond two hours. When I took this case for discussion in my weekly meeting at the Institute in India and asked my students to identify appropriate rubrics, one student chose ‘avarice’ while another selected ‘cruelty’ as rubrics. In Indian culture, it’s unlikely for grandparents to demand payment for looking after their grandchildren.
In Indian society, pre-marital and post-marital sex is often taboo, and when such cases are encountered in practice, students tend to choose rubrics like ‘excessive sexual desire,’ ‘lasciviousness,’ ‘adulterous,’ or ‘perverted sex.’ What is considered perverted in one culture may be viewed as normal in another. I recall a case where a young man had many girlfriends, and based on this behaviour, a student selected the rubric ‘frivolous.’ However, this young man was actually quite responsible and serious.
In another intriguing case, I treated a European lady for various psychosomatic complaints that stemmed from disharmony between her and her husband. Her husband wanted a divorce, and she was feeling somewhat indecisive. She became depressed, and I prescribed Manganum aceticum 10M. On her subsequent follow-up, she was content, greeted me warmly, and expressed her gratitude for the homeopathic treatment, which had helped her make the decision to pursue a divorce. This took me by surprise because, in India, women often face significant economic and social challenges after a divorce, and I had initially viewed the case through my cultural lens.
These cases illustrate how cultural factors can significantly influence the physician’s mind. They also highlight the need for homeopaths to consider and navigate cultural differences when providing treatment.
HMC: Usually, during homeopathic seminars, acute cases can emerge. Could you share one or two of the most memorable ones?
Ajit: Certainly, I have many memorable cases. During my first international seminar in Tel Aviv, an acute case presented itself on the second day at 9:30 a.m. It was a case of a cook suffering from severe conjunctivitis. Her eyes were intensely red, and she described a painful sensation of sand in her eyes. I took the acute totality and advised her to take Argentum nitricum 30 three times a day, with a follow-up scheduled for the next day. Remarkably, in the evening of the same day, she reported that within hours of taking two doses, her pain had significantly decreased, and the redness in her eyes had diminished. This led to applause from the homeopaths in Israel.
Another memorable case was during a seminar on the management of acute cases. I was presented with a challenging case of acute bronchial asthma. The child was experiencing dyspnea, restlessness, frequently asking for sips of water, and had a chest filled with phlegm, accompanied by loud wheezing. The clinical picture seemed to point toward Arsenic album, but I decided to prescribe Antimonium arsenicosum 200 every half an hour, as the patient was warm-blooded and had a white-coated tongue. To my delight, by the evening, the child was playing comfortably.
HMC: Have you had any experience with different cultural expressions of the same remedy?
Ajit: Once we know the culture and its influence, it becomes easier to process the data, study Materia medica and select an appropriate remedy.
It’s important to realize that applying our own cultural parameters to a case may not fully capture the essence of the patient. We must examine a patient’s behaviour within the context of his cultural background.
Similarly, while the fundamental functional action of a remedy remains the same, the expressions of that remedy can vary due to cultural influences. For example, I’ve observed that Calcarea carbonica individuals in Europe may dress differently, drive cars, and consume cigars and alcohol, which would be considered quite modern for a Calcarea constitution in India. I see more anxious and family-oriented Kalis in India and less Platinas. However, despite these cultural variations in expression, the core function and structure of the remedy, along with its essence, remain unchanged.
In essence, as a homeopath becomes attuned to the diverse cultural influences, they are better equipped to understand a patient’s true state of illness and how it aligns with the Materia medica. The key is recognizing that beyond culture, there is a unique individual with his own personal illness, and as homeopaths, our role is to observe them objectively and impartially.
HMC: Have you observed any recurring issues that homeopathy has faced in different countries in recent years? What advice do you have for addressing these challenges?
Ajit: One of the primary challenges that homeopathy faces, and is likely to continue facing, is the resistance and non-acceptance of homeopathy within the scientific and mainstream medical communities. There is a concern that various measures will be taken to discredit homeopathy, and it is crucial for the homeopathic community to actively counter these efforts by demonstrating that homeopathy is indeed a scientific discipline, despite its complex nature. This is undoubtedly a formidable task.
The relationship between homeopathy and different governments in various countries is also a significant concern. Homeopaths should actively advocate for the legalization and recognition of homeopathic practice in their respective countries.
Homeopathy has been tested in crucibles of time, has survived, and has now ‘come of age;’ it is no longer a domestic or first-aid system. It is now bold enough to meet the challenges of most obstinate, inveterate diseases that are impinging on humanity today. It is currently the second most widely practiced alternative therapy worldwide, and given its holistic nature and utility it needs to be disseminated largely for the sake of human suffering.
Another challenge lies in the lack of unity within the homeopathic community, with numerous schools and divisions. Many students ask me to enrol in my ‘body language school.’ I have written elsewhere, “There is only one school entitled ‘Totality’. Every homeopath should be a lifelong student at this school. Totality is the base; totality is the guide and without totality there is no homeopathy. It is like matter and energy that are inseparable. Totality renders the essence and the essence without totality is apparition. There are weird ideas with which homeopathy is practised. There are many layers and levels of homeopaths and there is no uniformity in educational modules and practical avenues. Strict standardization must be brought at educational, practical and pharmacy levels. Classical/non-classical, mono-pharmacy/polypharmacy, I am right/you are wrong – such influences make the wonderful design of homeopathy distorted in front of the public and aspiring students who want to work as homeopathic healers.
HMC: Thank you, Ajit, for sharing your insights in this comprehensive interview.
Ajit: Welcome.
(Courtesy: Homeopathy for Masterclass, Roman Buchimensky, Director Via homoeopatica)