1.11 Case scores for evaluationCase scoresEvaluating cases can be difficult. It’s already difficult for the patient and the homeopath, thus the more so for the reader. One wants to be sure of the remedy. The remedy must have been curative in order for the case to be interesting. Some authors take a duration of cure of one year as the criterion. But how can one know if the case didn't relapse after that year? Other authors use as a criterion that no other remedy has been given for a year or so. But how can one ascertain if another remedy was needed, but not given. The prescribed remedy can also have been palliative instead of curative.
GradualIn considering these questions my first conclusion is that the division into good and bad prescriptions or cases is artificial. It’s not a split. It’s more a gradation from bad to good. Many cases are somewhere in the middle, reasonable to good, but not perfect. There are very few perfect cases and if we have to wait for a case to be perfect, we will have to wait 10 years. Then we probably will have forgotten it and the patient has forgotten the problem too and won’t be coming anymore. It’s like sickness. No one is completely healthy and hardly anyone is completely sick. Most people are reasonably healthy, but even then they have some pain here, a hay fever or a food intolerance there, myopia, a hearing problem or some food desire.
For these reasons I developed assessment scales. I chose the range from 0 to 10 because it’s easy and many people are familiar with it.
AspectsCases can be interesting for different reasons. Sometimes only one aspect is interesting. A case doesn't have to be a full case of only one remedy. I doubt if such cases exist anyhow.
1. WidthWidth describes how big the problem is for the patient. It tells how much of the case is covered by the remedy. For example, if we prescribe
Calcium carbonicum constitutionally and the patient has been that all his life and his parents were the same and all his problems and diseases in life were coming from that state and hardly any other problem exists in his life, the width is 10. If we prescribe Arnica for someone with a bruise and the bruise is only a minor problem and the problem is not related to other aspects, disease and problems in the life of the patient the width is 1 or less.
The width is the scope of the diseases, how much it covers the patient, his life story, character, build and other diseases.
2. DepthThe Depth score describes how deeply the problem is engraved in the patient. A genetic disease is deeper than eczema. A psychosis is deeper than a grief. The deeper the problem, the higher the score is.
The Depth score is a reflection of the level of the disease. The general division is of the 7 worlds or bodies. At the physical level the same kind of division can be made. This division in 7 is also found in the 7 series of the Periodic Table. For a fuller description, see the chapter “7
Levels”.
This makes scoring sometimes a bit difficult. Is fear of cancer deeper than cancer? Is a minor hay fever deeper than a very disturbing eczema?
One method of scoring the depth is by using the Quality of life. The Quality of life, QL, is the answer of the patient to the question " How would you score yourself now, on a scale from 0 to 100, when 0 would mean that everything is as bad as it can be and 100 would mean that everything is perfect?".
3. CureThe cure score is the most important one. It tells how much the patient has changed, or more precisely, how much of the problem is gone, how curative the remedy was. A low score makes the prescription uninteresting. Only higher scores make cases worth publishing.
This score is a combination of several aspects. First it gives an idea about how much of the problem is cured. When the problem is completely gone the score is 10.
The second aspect is the level at which the cure took place. The deeper the level, the higher the score. The 2 aspects mostly go together. A total cure will be on all levels, bringing insight, a deeper understanding and unlocking the fixed energy.
Sometimes they can be conflicting. For instance a patient with autism from birth onwards has no contact with anyone or anything. A change to make some contact with people will be a great result. The level of cure is the behavior, indicating a 5, but the amount of the effect for the whole patient is still little, indicating a 1. Such a prescription though can still be interesting.
4. DurationThe duration describes the time of the curative effect. This is the easiest to ascertain. In this score too problems can arise. First is the evaluation of the value. In the case of migraine, we are quite content with a duration of a year or so. But in the case of a mammary carcinoma, even a duration of years will be questionable.
The second problem is that the duration doesn't exclude palliation or suppression. Although palliation is more unlikely with a duration of a year or so, it’s far from impossible, according to my own experience. This is more likely with repetitions of the remedy.
Another problem arises when new complaints come up in the patient. Are the complaints really a new problem, indicating a new remedy? Or are they just another expression of the earlier state? With the principle of Diadoxy (e.g.
Laws of Hering) one can often differentiate the 2 possibilities. But that’s not always clear. When the cure has a high score, it’s very unlikely that the state will return.
Table of case evaluation scoresScore Width Depth
% life Problem QL Level
0 0% 100 None
1 ± 10% Very small ± 90 Skin
2 ± 20% Small ± 80 Membranes
3 ± 30% Partial ± 70 Connective tissue
4 ± 40% Moderate ± 60
5 ± 50% Medium ± 50 Organs
6 ± 60% Big ± 40 Neurological
7 ± 70% Very big ± 30
Constitution8 ± 80% Most of life ± 20 Inborn genetic
9 ± 90% Whole life ± 10 Disabling
10 100% Everything 0 Death
Score Cure Duration % Change
Time of cure
0 0% None 0 days
1 ±10% Complaint 1 day
2 ±20% Feeling 1 week
3 ±30% Energy 1 month
4 ±40% Emotional 4 months
Hering
5 ±50% Behavior 1 year
6 ± 60% Belief 2 years
7 ± 70% Insight 4 years
8 ± 80% Life change 7 years
9 ± 90% Almost OK 15 years
10 100% All OK 30 years