Exclusive Interview with Dr Ajit Kulkarni, India for Homeopathy Master Classes Weekly
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 person you treat have any influence over the way 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’ who allowed me to blossom.
The answer is a big yes. When you meet people from all sorts of cultures and backgrounds, it makes a difference at every level. As a human being you have your own culture, 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 the life, take in the experience and develop our own perception. It’s like the saying ‘as we sow, so shall we reap’. It is we who filter our vision.
We have to define first what is culture and what are its dimensions. Culture is the enduring behaviour, ideas, attitudes and traditions and it gets 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 individual 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 getting formed. The period between two generations is diminishing progressively and children are growing up sooner. The influence of media has encroached mankind beyond control. People are going away from nature in every facet of life. We have to 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 have to be clearly defined. When you are working as a human being, you have the onus to look upon the sufferers through humanitarian lens. When you are working as a physician, your role gets widened in terms of diagnosis of the disease and overall management of the patient. But if you have to perform the role of a homeopath, it’s altogether a different level of consciousness. Defining the concepts of health, disease and cure in the right appreciation and applying them on 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 soul. Culture is always related to all three – body, mind and soul. The repercussions of culture have bearing upon selection and interpretation of rubrics. Moreover, a homeopath must see that he doesn’t suffer from cultural shock (a term coined by Kalervo Oberg during 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, esp. Europe. Although 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 appointment system. Many poor and illiterate patients don’t even ring the doctor for appointment and they directly enter in the clinic. They have already spent some money on travel and food and declining them is difficult. The position of a doctor in India is also different. A doctor has respect and honor in the society and in rural parts of India, a doctor is still regarded demi God. This might sound absurd. But there are many benefits of such an approach. First, the sense of responsibility on the part of the doctor increases manifold and secondly, the patient has full faith in the doctor. This symbiotic relationship helps the patient to recover and further to foster the required forces.
The major difference which I have noted, when I compare patients in India and outside, is at the level of clinical interview. The patents in foreign countries are theorizing which requires more energy and time for acquiring the accurate data. I can cite some examples. One patient while asking about any effects of food over health, answered, “My soul doesn’t accept milk”. The simple meaning of this sentence is that milk is intolerable and now we have to ask “What symptoms do you get when you take milk”?
Clinical interview with Indian patients is easier. Indians narrate their complaints as they are and don’t add to make things complicated. They focus more on giving the objective data. Interpersonal problems are deeper and more frequent in foreign patients as also the feelings of loneliness and being abandoned.
Most of the Indian patients don’t ask for the names of remedies. The classical prescribers often give a single dose and then most of the practice is on 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 can’t charge 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 for investigations, but for a good case-taking that involves total life space of a patient and more than 2 hours, a patient resents giving a homeopath his due right.
Giving placebo helps in getting money and effects of placebo are no doubt tremendous esp. for a homeopath, who has to apply the principle of minimum dose. Placebo helps in making a patient health conscious; it helps in a regular follow-up, in a special kind of physician-patient relation and gives time for a wise physician to take an appropriate decision. Hence, I maintain that giving placebo helps both patient and physician to 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 and the follow-up becomes difficult.
Culture does play an important part in bigoted convictions and superstitions. In undeveloped countries, we get many patients with bizarre ideas that are stamped and carried forward. However, it doesn’t mean that these ideas are not present in developed countries. I recall a case from India where a diabetic used to refuse to eat unless it is 12-00 midnight on the day of 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 of America and Europe make use of gestures more than Indians.
HMC: What can you say about the sort of diseases present in particular parts of the world in relation to other places? Is there any difference?
Ajit: Yes, there is difference and it is related to culture and consequent life-style. In Indian society, we get more cases of psoric and sycotic miasms while outside India, esp. in Europe, cases with strong pathologies are observed that are of tubercular and syphilitic miasms. In India, though nuclear family system is gaining popularity, the joint family concept still dominates. There is much more sharing of emotions and nurturing in joint families and we get fewer patients with abandoned and isolated feeling. In contrast with this, the personal space which the foreign patients maintain is a larger one and often it is surrounded by an impenetrable fence and people don’t get adequate catharsis. To go for a deeper interview, hence, requires special techniques. It also makes a difference in psychotherapy. I find that cases of auto-immune disorders, malignancy, metabolic disorders and addictions are much more common in foreign societies, than their Indian counterparts.
The indulgence in alcohol is higher in European countries and is a matter of concern. Cases of alcoholic males severing the relations and heading for divorce are on the rise.
A conscientious homeopath must always take into account the totality.
HMC: 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 disease children tend to develop in different parts of the world?
Ajit: These two questions should be studied in the context of earlier views. I see more cases of atopic dermatitis in children in Europe and cases of follicular tonsillitis. I am being consulted for Juvenile diabetes and Juvenile rheumatoid arthritis. Obesity is more in foreign countries esp. European and American. I attribute this to junk food which is consumed in large quantities and lack of exercise. I have on my record several cases of arrogant adolescents, difficult to be handled by their parents. This arrogance is by virtue of ego-hypertrophic training which the parents in particular and the educational system in general render 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 keeps 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 in 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 note that the popularity of homeopathy is on the rise, today, all over the world. In countries like India, Mexico, Pakistan, South Africa, Bangla Desh etc. homeopathy is established as a primary discrete healthcare discipline with an in-depth undergraduate education and training and a professional infrastructure, which puts it on 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 enabling of legislative change.
In India, there is a post-graduate course of three years in homeopathy being run by private institutes and government (the undergraduate course is of five and half years). There is a research wing, namely Central Council for Research in Homeopathy (CCRH), governed by central government. Despite the fact that homeopathy owes its origin to Germany, India has become the world leader in homeopathy, with about 2 lakh registered practitioners, 180 teaching institutions, including 31 post-graduate colleges, about 10,000 dispensaries in public sector, about 250 hospitals and 650 drug manufacturing units. A survey conducted by ICMR in 2003 reveals that homeopathy was preferred by 1/3rd of the 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 practiced across Europe by approximately equal number of non-medicos and homeopathic doctors. The distribution between countries is uneven with some countries having 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, 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.
In some countries as Denmark and UK integrated healthcare projects have been or are being carried out. Some of these projects include homeopaths that work closely together with conventional health care personnel. The European Council for Classic homeopathy (ECCH) is 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 parts of Europe. Over the past year associations in three new countries have joined the council. Homeopathy has got official recognition in Germany, Switzerland, Canada etc. In the recent past countries like UAE, Thailand, Cuba, Argentina, Iran and Russia have granted official recognition to these systems, new teaching institutions are coming up and research activities are being revitalized. Homeopathy is widely accepted and getting more popularity all over the world also in Abu-Dhabi, Austria, Afghanistan, Argentina, Bahrain, Bermuda, Brunei, Brazil, Chili, Camarone, Cyprus, Canada, Costa rica, Caribbean islands, Egypt, Fiji, Finland, Greece, Germany, Guinea, Holland, Hungary, Ireland, Israel, Italy, Imo state, Japan, Kenya, Lithuania, Mauritius, Muscat, Nigeria, Norway, New Zealand, Netherlands Antilles, Panama, Philippines, Qatar, Romania, Switzerland, Sri Lanka, Saudi Arabia, Scotland, Slovakia, Spain, Taiwan, Ukraine, Wales etc. However, in many of these countries, there is no govt. patronage though there is no opposition.
The homeopathic fraternity in India enjoys the support of government much more than any other country.
HMC: Could you share with us a few short homeopathic cases to demonstrate one of your points in relation to culture?
Ajit: I once took a case of an old American lady in one of my international seminars. The lady was very active and at 78 years of age, she built up her new home independently. She was egoistic, straightforward and excitable. She may be rude to others. She was doing her business with all her energy and also looking after her grandchildren. She accepted the request of her son and daughter-in-law to take care of her grandchildren daily for 2 hours. But it happened that she had to give more time and she refused to take care and quarreled a lot. Finally, she negotiated and asked for 100 $ per hour if the time limit of care crosses 2 hours. In India, I took this case for discussion in my weekly meeting of Institute and asked my students to find appropriate rubrics. One student took ‘cruelty’ as a rubric for repertorization.
Pre-marital and post-marital sex is tabooed in Indian society and whenever such a case is confronted in practice often the students select the rubrics like excessive sexual desire, lasciviousness, adulterous or perverted sex. What is regarded as perverted in one culture may be regarded as normal in other culture. I remember one case where a boy had many girlfriends and only on the basis on this, a student took the rubric, ‘frivolous’. Actually, he was a very responsible and serious guy.
I had once an interesting experience. I treated one European lady for many psychosomatic complaints and the cause was disharmony between herself and her husband. Husband wanted to divorce her and she was a bit irresolute. She became depressed and I gave her a dose of Manganum aceticum10M. On her next follow up, she was happy, greeted me and appreciated the homeopathic treatment which helped her take the decision of divorce. I was taken aback, as a lady suffers a lot from economic and social problems after divorce in India and I was looking at the case through my cultural parameter.
Many such cases helped me explore beyond known dimensions of human behaviour.
HMC: Usually during homeopathic seminars an acute case appears. Could you share with us one or two of the most memorable ones?
Ajit: Oh! I have many memorable cases. My first international seminar took place at Tel Aviv and on the second day at 9-30 am, I took a case of a cook before the group. The cook was suffering from acute severe conjunctivitis. The eyes were very red and she had very painful sensation of sand in eyes. I took the acute totality and advised her to take Argentum nitricum 30 three times per day and report next day. In the evening on the same day, she gave her follow-up on the platform that within hours after taking 2 doses, her pains diminished and the redness of the eyes was much less. I got applaud from Israel homeopaths.
I recall one more case. I gave a seminar on management of acute cases and I received a challenging case of acute bronchial asthma in the seminar. The child was dyspneic, restless, frequently asking for few sips of water and the chest was full with phlegm and there was loud wheezing. The picture was apparently of Arsenic album but I selected Antim ars 200 every half an hour as the patient was warm blooded and tongue was white coated. In the evening the child was playing nicely before the group.
HMC: Do you have any experience with different cultural expressions of the same remedy?
Ajit: Once we know the culture and its influences, it becomes easier to study Materia medica and select an appropriate remedy. We must first understand that applying our parameter of culture to the case will do no justice to the case. We have to examine the behaviour in the light of patient’s cultural background. In a similar way, although the remedial functional action remains the same, the expressions of a remedy do change due to culture. I can’t imagine a Calcarea carb lady with a modern dress in rural India, but I saw many Calcareas in Europe driving their cars and consuming cigar and alcohol. This will be too much for the Indian Calcareas, even ‘ultra-modern’. I see more anxious and family-oriented Kalis in India and less Platinas. See, uniformity in diversity is the very base of human beings and of our Materia medica too. Cultural variations will go for a different projection of form but the very function and structure of a remedy with its quintessence will remain the same. In other words, once a homeopath adapts himself with the variable cultural influences, he will be in a position to know the real sickness of a patient and its correspondence with Materia medica. ‘That there is a person beyond culture, that his illness is very personal and that as a homeopath, I have to observe him as he is, objectively and dispassionately’ is to be perceived.
HMC: Have you seen a pattern in the kind of issues homeopathy has been facing in different countries in the past years? What is your advice for overcoming those issues?
Ajit: The chief problem homeopathy is facing and likely to face in more magnitude is non-acceptance and resistance to homeopathy by the scientific community and by the mainstream medicine. I fear that every measure will be used against the salubrious science of homeopathy to defame and it is here that homeopathic community should not lag behind in proving that homeopathy is a scientific discipline. Given the complex structure of homeopathy, this is a herculean task.
The relationship between homeopathy and governments of different countries is a matter of concern. Homeopaths should take an active role to legalize the practice of homeopathy in their respective countries. Homeopathy has been tested in crucibles of time, has survived, and has now ‘come of age;’ it is no more a domestic medicine or first aid or ‘before the doctor-or-the specialist-arrives’ system. It is now bold enough to meet the challenges of most obstinate, inveterate diseases that are impinging on humanity today. Now homeopathy is the second most alternative therapy in the world and given its holistic nature and utility it needs to be disseminated largely for the sake of human suffering.
Homeopathic community is not united. There are many schools and divisions. Many homeopaths refer to me as ‘originator of body language school’. I have written elsewhere, “There is only one school and that is of totality. You can name it as a ‘School of totality’. Every homeopath should be a lifelong student of this school. Totality is the base; totality is the guide and without totality there is no homeopathy. It’s like matter and energy that are inseparable. Totality renders the essence and essence without totality is apparition.” There are weird ideas with which people practice homeopathy. There are many layers and levels of homeopaths and there is no uniformity in educational modules and practical avenues. Strict standardization has to be brought at educational, practical and pharmacy levels. Classical/non-classical, mono-pharmacy/poly-pharmacy, 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 your comprehensive interview.
Ajit: Welcome.
(Courtesy: Homeopathy Master Classes)