This book review is reprinted with the permission of the American Institute of Homeopathy
925 E. 17th Avenue
Denver, CO 80218

Reviewed by George Guess, MD, DHt

A Homeopathic Approach to Cancer, a rather small book, is a potential tour de force. If the methodology presented in these pages weathers the homeopathic profession's intense scrutiny, the result will be truly groundbreaking! And scrutinize we must, for the authors' ideas diverge from strict classical tenets. The work requires verification, beyond that extensively provided in the text itself, before the ideas presented here can become mainstream. Should they be validated and the proposed method become widespread, the boon to cancer patients worldwide will be inestimable.

Readers of the Journal will be at least partially familiar with the Ramakrishnan method of treating cancer. (JAIH Spring 2000: "Homeopathy in Breast Cancer: A Bright Outlook," p 39; JAIH Spring 1998: "A Homeopathic Approach to the Treatment and Palliation of Cancer," p 14.)

The basic premise is that most cases of cancer require initially an organ specific remedy for the tumor(s); this remedy should then be given in alternation with the appropriate nosode, most often Carcinosin, less often Scirrhinum (if the tumor is hard), and much less often one of the other nosodes. Through his own clinical experience, Ramakrishnan has determined that patients fare better by this alternation, conducted on a weekly schedule. Also, unique to the Ramakrishnan method is the practice of remedy administration involving an intense plussing technique. Three pellets are dissolved in eleven teaspoons of water; then one teaspoon of the liquid is taken orally (preceded by stirring or shaking) every fifteen minutes for two and one-half hours-a total of ten doses; the remaining teaspoon is saved for the following day's dosing. This intensive dosage schedule is performed daily for one week; the next week the nosode is taken in the same way, and so on indefinitely if the reaction is positive. Ramakrishnan asserts that such intensive dosing is vital to obtaining optimal results from homeopathic cancer treatment, which he differentiates from the treatment of all other conditions.

Ramakrishnan was trained in the classical homeopathic tradition and practiced it faithfully. Margery Blackie was his tutor. His early failures with several cancer cases caused him to experiment with differing methods of cancer treatment. Thus, this new methodology was born.

The idea that advanced cancer cases might require a smaller, more organ and tumor specific remedy is certainly not new. I recall Andre Saine asserting same in a seminar he gave in Chicago on the treatment of cancer. What is strikingly different about Dr. Ramakrishnan's approach is his insistence on almost always starting cancer cases with the specific remedy (plus nosode) as opposed to the more constitutional remedy. (There are always some exceptions, of course, which he readily acknowledges and illustrates in the book.) Remedies are changed if the results are disappointing, and Ramakrishnan expects evidence of favorable reaction fairly quickly, within one to two months. Potency is raised as needed. Essentially all cases are begun with 200C potency. Later, after definitive results have been attained on the cancer condition, the constitutional remedy, if apparent, is given. One last element of his treatment plan which diverges from the classical method is the prescribed duration of treatment, invoked because of the insidious persistence of cancer; even after a clear cure has been attained. Ramakrishnan will continue treatment, albeit less intensive, with alternating doses of remedy and nosode for about two years in an effort to prevent recurrences.

The book itself is a testament to Ramakrishnan's experience and skill and Catherine Coulter's organizational and writing abilities. It reflects a splendid collaboration. For the most part the book is clear, concise, very well organized, and very thorough. The methodology is thoroughly explained and illustrated by 126 case histories covering twenty-five types of cancer. Indications for the majorcancer-specific remedies and nosodes are provided. The rationale for the selection of each remedy is provided. Both clinical and laboratory verification of diagnosis and treatment results are offered, making a compelling case for the success of this method. A compilation of Ramakrishnan's treatment results appears in chart form at the end of each chapter. Usually his professed rate of success(success being defined as nonrecurrence over five years) runs about 70% or higher using the plussing technique as opposed to 30-50% in his pre-plussing technique days. There are some notable exceptions, as in uterine cancer (45% success rate), cancer of the liver (32%) and colon (40%). Admittedly some of these latter cases were in pretty dire shape when Dr. Ramakrishnan was first consulted.

Included in the book is information about pretty much every aspect of cancer treatment: striving for curative results, palliation, pain control, treatment during and for the adverse effects of surgery, biopsies, chemotherapy and radiation therapy; and cancer prevention. In each instance numerous case examples are provided to illustrate the method. The book is well indexed. Commonly asked questions are answered in the appendix. Clinical pearls and useful tips abound. The book is attractively and solidly hardbound, the print crisp and easy to read, and the paper of high quality.

Now, for some of the shortcomings of this volume: In some of the cases cited the justifications given for the remedy selection were inadequate or confusing. For example, at times it was apparent that one of the principle specific remedies for a certain cancer was also the apparent constitutional remedy of the patient, yet instead of prescribing that thoroughly well-indicated remedy, another, even more specific cancer remedy was given. This at times confounded me and was seldom addressed. Consequently, at times my classically-trained homeopathic mind rebelled and was inclined to dismiss the book's contents as too rote for the reality of daily practice. Other inconsistencies appear: In case 58, one wonders why Aurum was prescribed when the condition was painful bone lesions, a principle indication for symphytum or hekla lava, which had been given in a similar circumstance presented in case 57. There is no explanation for this detour other than that Aurum can favorably effect severe bone cancer pains. Likewise case 57 is confounding because hekla lava is prescribed for painful melanoma bone metastases even though earlier in the text Symphytum is extolled as the principally indicated remedy for secondary bone metastases while Hekla is to be preferred for primary bone lesions. Perhaps the choice fell to Hekla because it was a case of "plasmatic melanoma," but this is not mentioned in the text. Again, confusing and poorly elaborated. Then in case 78, one of stomach cancer with burning pain and coffee-colored vomitus, Hydrastis was prescribed while, based on the description provided in the text, Cadmium sulphuricum would seem far preferable. (This case was terminal and presented as an example of successful palliation. Might Cadmium sulphuricum have been curative?) In case 35, one where Baryta iodatum was prescribed successfully and on very vague and common indications, one wonders why neither arsenicum album nor Ceanothus was mentioned. Case 40 is one of cancer of the ascending colon; the eight-week follow-up mentions evaluation of the mass by digital exam. The examiner must have had a very long finger to evaluate a lesion of the ascending colon digitally! The book could benefit from another, more thorough editing to weed out these inadequacies and apparent errors.

Then there is the issue of the style of case presentation used in the book. Very sketchy is the first description to come to mind. Often only a few of the facts relating to the cancer-its location, resultant pains, some associated symptoms and pathological details-are provided. In some cases a brief two to four sentence paragraph detailing some constitutional symptoms and characteristics is included. This brevity contrasts sharply with what professional homeopaths encounter in daily practice. Cases which, when written up, require two to five or more full pages to include all of their details are the norm for my practice, and I suspect most of our readers'. The old adage "the Devil's in the details" seems especially appropriate here. Freshly taken cases in all their detail tend to present a number of decision-making dilemmas to the homeopath: Which symptoms demand priority? Are the local, cancer-related, symptoms consistent with the apparent constitutional remedy's profile? And if that constitutional remedy is included in the rubric for the cancer in question, should not that be prescribed as opposed to a specific remedy with even more affinity for the cancer? What should one focus on when a patient has an a symptomatic cancer and at the same time a myriad of other chronic health problems both physical and emotional? The list goes on and on. Because of these real-life dilemmas, I would have preferred the case presentations to have been far more detailed. I would have appreciated being able to witness for myself how Dr. Ramakrishnan sorted and sifted the details of each case and made the difficult decisions. The added insight gleaned from a more complete understanding of the process would be of great benefit in the implementation of his method in daily practice.

The above failings aside, A Homeopathic Approach to Cancer impresses this reviewer as a potentially very valuable guide to the treatment and management of our most difficult cases. As the authors note, the treatment of such cases can be quite difficult, at times the symptoms sparse and common, thus frustrating any attempt to treat strictly classically. For such cases, and for those practitioners lacking the experience and knowledge to manage these challenging cases classically, the Ramakrishnan method might provide a means to treat quite effectively. I say "might" because, as stated initially in this review, the claims made in this book, though I have no doubt of the integrity of the authors, must be substantiated before our homeopathic community can embrace this methodology as a preferred way of dealing with cancer cases. The stakes are too high and there is too little room for error. I would call upon all of us, worldwide, to put this technique to the test on several cases for the next few years. Report your results in our journals. If the Ramakrishnan method is all the authors believe it to be, we must find out.

Journal of the American Institute of Homeopathy
Volume 94, Number 3, Autumn 2001