FIAMO CONGRESS 10,11,12 November 2006 Rome (Italy)
HOMEOPATHY IN HIPPIATRY (Part two) PRATICAL AND ETHOLOGICAL ASPECTS OF THE REPERTORY CLASSIFICATION/REPERTORISING IN EQUINE CLINICAL PRACTICE
Dr. Carla de Benedictis – Medico Veterinario – Dipartimento Veterinario F.I.A.M.O. – Delegata per U.M.N.V.V. per I.R.M.S.O. – Via Rioli n. 64 – 00049 Velletri (Roma).
Dr. Alessandro Battigelli – Medico Veterinario – Dipartimento Veterinario S.I.M.O. – Via Oretti 15 – 40139 Bologna.
ABSTRACT: Based on clinical experience the ethological and behavioural aspects of the horse are outlined in relation to the physio-pathological and reportorial characteristics.
The use of the repertory needs constant interpretation and revision in homeopathic clinical practice of veterinary medicine. Knowledge of instinctive and acquired behaviour cannot be excluded when repertorising the equine patient’s symptoms.
As happens in small animal clinics, there is a need for further knowledge and investigation in order to use the repertory and homeopathy correctly.
The application of homeopathy in hippiatry not only has ethical and deontological aspects but also poses important methodological and practical questions. In clinical practice, cases present a variety of problems such as shoeing and transport, loss of performance and even obsessive compulsive attitudes. Often veterinary assistance is sought for lameness or colic but after following homeopathic procedures to build up a careful case history, a series of behavioural problems characterising the patient’s suffering emerges. The ability to translate the discomfort the horse shows into repertorial language is tied to a thorough knowledge of the ethology and behaviour of the species. Only in this way can the difference between instinctive behaviour and acquired behaviour and the psycho-physical pathologies that result from them be understood. Faced with a range of symptoms that appear in the repertory, the choice has to be made taking into account not only the mental and behavioural symptoms, but also the etiologic symptoms, the condition, the general symptoms and the localised symptoms coherent with the morpho-functional and ethological characteristics of the species. The concept of health care in veterinary medicine is subject to variables decided by the Bioethics Committee, by previous medical records and by clinical practice.
MATERIALS AND METHODS
In order to identify useful repertory symptoms when adopting homeopathic methodology in equine veterinary medicine, the following aspects must be taken into consideration:
1. Animal wellbeing
2. Ethological and behavioural characteristics
3. How a stereotypy is formed
4. Cure concept
Chapter 1: Animal Wellbeing
Think like a horse
This is just a brief introduction and does not aim to be a specialist treatise. However we hope that veterinarians and experts in this field who have not yet approached this controversial topic might find it of use to take into consideration the horse’s point of view and the benefits of homeopathy.
The term ethology means “the study of animals in their natural environment”. A distinction needs to be made between ethology and veterinary ethology because that involves the process of domestication. Domestication is a process by which Man takes control of the breeding, rearing and care of the animal and therefore it is an unnatural state under human control and the contrary of the definition of ethology.
Begun in past, this process has still not been completed. Controlling reproduction and taking care of animals continually increases and intensifies the interaction between Man and animal. The control Man wants to have over animals has grown enormously in the last century. The level of responsibility man has assumed in the control of both wild animals at risk of extinction as well as domesticated ones is a relevant illustration.
If we released one of our finely bred horses into the wild, it would probably not be able to survive; firstly because man has become the sole selector of genetic material and secondly because natural selection has not been functioning for them for some time.
Domestic animals, defined as “plastic animals” by a renowned ethologist and “technical animals” by a well-known university professor veterinarian, can only survive in “unnatural” or “plastic” environments. Thus man has manipulated the genetic heredity of traditionally domesticated animals forcing them to adapt to a modified environment which has then become a “natural” environment for them.
In recent decades, the exploitation of animals for material ends by industrialised society has finally drawn increasing attention to the dangers deriving from a mechanistic vision of life. Organisations for the protection of the health and the respect of animals have been formed. Paradoxically the greatest hostility towards these organisations and to this new scientific branch of veterinary medicine, animal behaviour, comes from veterinary science and the deontological code. The emotional and sentimental arguments of ordinary people have no effect on veterinarians, particularly those who work with reared animals. Busy treating relevant numbers of stock to deal with diseases that are ever more difficult to eradicate, they view the animals as productive machines, often merely a nuisance. Animal welfare does not necessarily match the criteria of business management. What do we care if chickens are shut up in overcrowded cages or if a sow is in a sty for life or calves are tied to a chain?
It has to be said that until recently there were no regulations and fines for those who did not respect the rules of animal welfare. Veterinarians who were angered by the suffering they saw had no support from the institutions.
The nickname “the sleeping beauties of animal welfare,” referring to certain veterinarians, derives from their strongly mechanistic attitude to animal exploitation.
In veterinary science, the study and practice of animal behaviour is somewhat lacking at present, whether it concerns small animals or those that provide an income. It is considered marginal, futile and of scarce practical use compared with pharmacological treatments which meet utilitarian and economic demands.
The devil teaches us his tricks but not how to hide them. So fate has decreed that the drugs available to cure behavioural pathologies in the horse do not work for long and have many side effects, a paradox or divine justice precisely in the most medicated species where the use of drugs has reached astounding levels.
Although this situation allows homeopathy to compete with this reality because in some way it supplements it, it also meets much prejudice and resistance. It makes one reflect how among the animal diseases brought about by man, those that are tackled by drugs or by surgery in line with academic university practices are given priority. Suffering and behavioural problems acquire value in the concept of animal well-being only when they have economic repercussions. Cannibalism in intensive farming of pigs, chickens and hens is a practical example of this.
Chapter 2: Ethological and behavioural aspect
A brief glance at equine ethology will allow us to begin to understand how a herd of horses is structured and how distress in domestic animals, reared in an unnatural way, arises.
In Nature, horses are social animals and live in groups. Horses are not found alone except when they are ill, traumatised or near death. The herd consists of two social groups: the harem grouping where the dominant stallion is accompanied by various mares and their progeny until the age of three and the bachelor group of young males and stallions upwards of three years old. As in a properly functioning group everyone has his role and social status. This scheme promotes social, sexual and parental harmony, exogamy and defensive strategies inside the group. The head mare has her place at the centre of the group and is protected by a circle of mares of inferior status. She is the most important member, elected to her position by general agreement of the group, and it is she who makes the decisions. Her position is not maintained by aggression or tyranny.
The stallion has a reproductive and defensive role: he uses authority, not force, to maintain discipline in the herd and spends part of his time relating with other members of the group.
He only uses force in two situations, when the young females and young stallions have to leave their native group and are expelled and to re-establish his hierarchy as leader of the herd.
Those who think that the stallion is acting competitively have a very narrow view; the aim is out-breeding or exogamy, to avoid interbreeding within the group.
When the young are forced to leave their native group, they form a group of young bachelors and look for another herd to join. The new arrivals cause great interest and excitement in their new group and two of the higher ranking horses spend most of the first day by their side, like guides, confirming their admittance to the rest of the group.
A herd of wild horses spend about 75% of its time eating and looking for good quality grazing, maintaining a state of continuous alertness and ready to flee in haste. Any individual, of any social status and age, can lead the group towards new pastures – an unconscious example of democracy and individuality.
When a herd is grazing, all the components are strategically located according their social status. The two most important elements, the stallion and the head mare, are in the centre, defended by the others, and the lowest ranking members are on the edges. If an alert occurs, the sentries who are on the outer edges will warn the group and the head mare will decide whether to flee and in which direction, whilst the stallion will leave the group and face the enemy, so giving weakest time to escape.
It is almost impossible to get near the herd without being noticed, even downwind.
Another factor, beside the social organisation, influences the behaviour of wild horses and that is the home range, the zone where they belong and regularly graze.
The home range is the area the horse travels in the search of food, which also includes water holes, shade, wind breaks (areas sheltered from the wind) and shelters against insects and can vary from 0.9 – 48 sq. km. Spending about 16 hors grazing, consuming as much as 60 kg of grass, the herd can cover up to 80 km in a day. From this brief summary, it is possible to compare conditions in the wild with those in the domesticated reality:
WILD STATE DOMESTICATED STATE
Structured group hierarchy Imprisonment Confinement Stabling
Lengthy walker Work and sporting use at specific times
A great eater Anti-physiological diet
Strong interaction with v Interaction with stable, Anti-physiological, work stress
Flee instinct of prey animal v Instinct exploited by man for training
Chapter 3: How a stereotypy is formed
The plastic horse
Every situation which differs from the home range and group concept system can cause repercussions in behaviour and create the beginning of a stereotypy.
In the taming process the horse has had to learn certain attitudes and the experience it derives from this, whether positive or negative, will influence its behaviour for ever.
For example if the horse experiences pain associated with physical coercion during medical treatment or the use of the twitch during shoeing, when a similar situation recurs it will react with fear and flight and, if this is not possible, with aggression. This is Pavlov’s classic conditioning process where a stimulus, shoeing, which initially caused no reaction, becomes associated with a state of pain or fear which the horse faces up to with opposition and aggression, because it has been immobilised. This terminates in a process of conditioning such that when the situation is repeated, the reaction that follows is coherent with the experience and the stimulus received.
Emotional states leading to impotence and fear can be created at quite an early stage in horses. There are two critical moments that can mark their psycho-somatic attitude and create the basis of a stereotypy: weaning and breaking in.
Precociously separating a foal from its mother and putting it in total isolation, where it grieves for days seeking the strong ties with the herd, is unfortunately quite a common occurrence. Similarly, a violent breaking in, involving maltreatment and punishment incomprehensible to the horse, creates frustration and distress which the horse often does not know how to deal with.
Water is on hand and food does not have to be sought out by the domesticated stabled horse. A concentrated ration and hay can be consumed in 2 or 3 hours. Our horses spend only 15% of their time eating and in addition live isolated from their peers. Isolation is one of the most common causes of frustration in horses; for example, it takes away the practice of grooming. Grooming, the cleaning of one horse by another, has been shown to reduce heart rates and, consequently, levels of stress. Once stabled, they cannot walk around freely or eat continuously. Studies have shown that the further animals travel in the wild, the greater is the likelihood of stereotypies occurring in that species.
A classic example is that of lions and tigers pacing their cages in the zoo. Stabled horses very often live in boxes with iron gratings which prevent any type of socialisation and are often only taken out to be worked. Even putting the horse alone in the paddock during the day has the same effect if he cannot socialise with his peers. Are we sure that by keeping an animal confined in a stall we are fulfilling the concept of welfare, i.e. wellbeing?
Prof Roger Brambell defines welfare as: “a general term which includes both the physical and mental wellbeing of the animal. Any attempt to evaluate it, therefore, must include available scientific evidence relating to the animals’ feelings deriving from their structure, their functions and their behaviour”. He lists 5 freedoms for animals:
Freedom from thirst, hunger and malnutrition
Freedom from discomfort – appropriate environment, shelter, resting places provided
Freedom from pain – prevention and prompt treatment of injuries and disease
Freedom to express normal behaviour
Freedom from fear and distress
(British Farm Animal Welfare Council, 1979)
Freedom from thirst, hunger and malnutrition. The use of compound vitamins and additives aim to supplement malnutrition caused by a poor quality diet.
Freedom from discomfort – an appropriate, comfortable shelter. A comfortable shelter is aimed at managing the horse and therefore a box, however comfortable it may be, creates isolation.
Freedom from pain – diagnosis and prompt treatment of injuries and disease. Diseases are treated to make horses fit for their established use. If it is not economically profitable, then euthanasia or the slaughter house is the solution.
Freedom to express normal behaviour. To bring this about horses should be set free in paddocks allowing them to graze and socialise with their peers.
Freedom from fear and distress. This depends on the man – animal relationship and how weaning, breaking in and training are carried out.
Various levels of adjustment to stress occur and these can be more or less rapid and/or reversible taking into consideration genetic, physiological and behavioural traits.
If the stress agent imposes its control system too forcefully on the organism, then the animal’s capacity to adapt is reduced and behavioural and physical modifications are provoked.
STIMULUS ——– STRESS ——– ADAPTATION
STIMULUS ——– STRESS ——– NO ADAPTATION ——– DISTRESS
Horses can also become very phobic, aggressive and dangerous, thus reducing their economic value and this can lead to euthanasia or the slaughterhouse being contemplated as a solution.
It is clear that the bioethical balance of the animal’s wellbeing is strongly influenced by economic criteria.
The abnormal behaviours of stabled horses are considered to be vices, as if the horse were guilty of such, and furthermore considering it responsible for its conduct.
The homeopathic approach is multi-faceted because it considers all aspects of the horse’s life, distant past, emotional state, living environment, concentrated feeds and hay, current diseases, sub clinical pain, time spent in the fresh air and social interaction. The homeopathic approach in hippiatry therefore has the instruments to deal with a complex case, based as it is on an integrated psycho-emotional and psycho-somatic vision.
We can hypothesise a pyramid of examples of behaviour and poor adaptation which lead up to stereotypies.
Chapter 4: Repertorial Entries
When a vet is called out for a visit, it is clear that he cannot avoid considering whether the state the horse is kept in meets welfare criteria. Referring to Roger Brambell’s 5 freedoms in the British Farm Animal Welfare Council (1979) document, we find that reality does not often coincide with these conditions, sometimes due to the owner’s lack of awareness or because they are not always adequately informed or receptive to such problems.
The balance between discerned mental symptoms and an apparently unconnected physical pathology, e.g. lameness presents us with moral, ethical and deontological implications. Which comes first: satisfy veterinarian/client contractual requirements possibly with medical and legal complications e.g. in doping, or respect for the animal’s needs for psycho-physical equilibrium?
Let’s leave this question, which put like this seems rhetorical, but in equine veterinary practice forces us to walk a tightrope, as referred to above, of a moral, ethical and deontological nature.
When we are dealing with an equine patient with even a low grade behavioural complaint, we need to decide what we have to treat. Should our approach be organicistic, aimed at treating the present problem and satisfying the client’s needs, or should we concentrate on the horse’s mental state and discomfort, which bit by bit, will compromise its health?
Dr. T.P. Paschero in “Lezioni alla Luimo” says: “a carefully considered clinical experience leads us to form a conclusion based on the recognition that what must be treated in the patient is the mental distress and its somatic component, in other words the anguish in a quest for the meaning of his life” (or in a quest for one’s own archetypal state – Ed. Note).
In the light of the above consideration, in order to repertorise a horse and choose the remedy that is closest to its clinical, mental and physical conditions, it is essential to understand the characteristics of the species, its behaviour and the most common diseases.
It seems appropriate to quote the words of Dr. T.P. Paschero in “Lezioni alla Luimo” again obviously interpreting, transferring and comparing them with the animal status and hypothesising an animal “biopathography”:
“The biopathography is none other than the history of the emotional vicissitudes through which the patient has lived his own process of maturing and adapting to life, always under the tension of the conflict between the erotic-aggressive stimulus which satisfies his unconscious desire for assertion and power (law of the herd, hierarchies, reproduction), and the environmental, familial and cultural restraints of the world in which he lives, (stabled and isolated), whose personality identification will follow him like a permanent punishing conscience (start of the stereotypy)”.
“Everything that refers to the play of instincts, like the primary will to live, (archetypal reference) as much as in desiring as in rejecting, in loving as in hating, in the physical or the moral order, has primordial value for homeopathy. The desire to live (life in a group) is synonymous with the desire for alimentation and assimilation (grazing assimilation of life). Are the appetites and cravings for sweet, salty, acids, fats or different foods, just as the symptoms of the digestive and metabolic system, symbolic expressions of the desire to live, therefore the desire to grow and be strong, at a biological level?” (Taking away continuous feeding and movement is like taking away life and the possibility of biological evolution according to the laws of nature).
The repertory, precisely because it is structured on a human model must be used with discernment and caution. It requires knowledge of ethology and of the behaviour of the species under examination. It must be stripped of all those symptoms that presuppose uncertain or unsound objectivity as the horse acts with strong, dynamic instinct and its reactions, both immediate and secondary, result from a stimulus based on the memory of previous experience.
Horses express their emotions very clearly. You can tell whether their attitude is intimidating or affectionate by the tone of their voice and they are able to show when they are suffering acute pain. There is no pain more agonizing for a horse than to suffer from colic and such an experience is difficult to forget.
Horses’ eyes are very expressive and they reveal the emotions they are currently feeling. The extremely mobile ears are also an important indicator of an emotional state, when the horse is hyper vigilant they always stand up attentively but a chronic twitcher, removed from the reality in which it lives, turns them sideward.
Their limbs and the way the tail is held also indicate their emotional state.
Body language is fundamental in evaluating their psycho-physical state too; a horse with a steady gait, arched neck, upright ears, who looks around is certainly in better health than one who walks with its head down, its ears pointing sideways, who drags its feet, moves slowly and is indifferent to what is going on around it.
We must not forget that horses have certain anatomical structures particular to the species such as the hoof and its proprioceptive sense and the larynx with its guttural pouches. Due to their anatomical characteristics, they are unable to vomit. They have a small gastric volume and an extremely large volume in the cecum and colon where the fermentation process takes place. They have a seasonal poliestrous cycle and pregnancies of almost a year as well as highly specialised senses of smell and sight, extrasensory feelings (orientation, homing, premonition), sweating and continuous growth of teeth and nails.
The sight process in the horse is very distinctive; the anatomical-functional characteristics of the sight apparatus is very emblematic, developing from a sort of systemic eye lens in the species, with monocular lateral and rear vision, binocular vision to the front, two blind spots and a wide-angle panoramic vision comparable to a 28mm. lens.
Paradoxically the rear blind spot coincides with the position the rider sits in. For a horse who is about to be broken in, one needs to consider the justifiable diffidence in accepting a possible predator in an area it cannot check!!!!
These anatomical structures so different from those of a man and other species are also sites of diseases: of the eyes, the intestines and the limbs. In addition, horses are also subject to severe, invalidating and fatal diseases such as a colic and laminitis as well as intestinal parasites. They are also vulnerable to parasites in the blood and viral and bacterial diseases of their species different from human ones, except for an analogy with the protozoa illnesses.
It is also very useful when selecting a remedy to take into consideration that horses affected by stereotypies produce a great quantity of chemical mediators and hormones, including endorphins and endogenous opiates. These help them to live with their frustration but isolate them from the context in which they live. A horse affected by stereotypies behaves like a lunatic and uses every occasion to act badly and raise the level of endorphins in its blood.
Homeopathic veterinarians have to use the repertory which is based on experimentation on human beings, apart from some exceptions like Hekla lava, Veratrum album and the casual pathogens obtained veterinary toxicology. Thus it becomes fundamental to learn and apply the classic methods to the real needs of the species. More than personal experiences which have immense value but are just single clinical cases, this integration allows us to look for the simillimum coherently in that patient in that animal species. When stereotypes are involved, that is structured, mental pathologies, using the repertory can be made easier if we identify the symptoms we must treat in that particular case.
The mental symptoms referring to everything that, in our experience, has led to a behavioural problem and a stereotypy are listed below. By analysing such symptoms we can form an objective hypothesis based on our experience and our knowledge of clinical hippiatry.
In this table we can find distress and unhappiness disorders: it is difficult to differentiate which of the two a horse is really suffering from and although it is important for us to take these symptoms into account, the entries should be put together.
The same is also true for the entries of mortification and wounded pride disorders.
The nostalgia entry, for horses that leave their home or the place where they have been for a long time, for example, can become an anthropomorphic distortion and should be considered cautiously. Instead we should evaluate whether or not the suffering is due to the loss of connections (stable companions and owner).
Proceso S. Ortega, the great master, says: “if we take into account the fact that there are many similar sensations, but that they do not mean the same thing and also meaning something similar they do not give the same result if one is confused with another, we come to understand the absolute necessity to try and precisely define the various symptoms a patient presents.”
For all other symptoms a correct interpretation and repertorising is the rule. Symptoms with a single remedy or generic symptoms with a large number of remedies need particular care and attention.
In this table, the repertorial entries “fear of punishment and of scolding” are difficult to separate and should be put together in our opinion. Owners often do not disclose certain facts and instead inform us that the horse reacts badly when scolded. In private, however, if the horse does not obey and refuses to do something e.g. clear a combination jump, it is punished with blows or empirical methods such as lifting up and dropping the bar on its shins when it jumps. The memory of the pain, which we have seen to be so decisive for horses, can result in two types of behaviour:
1. At the next jump, fearing the pain, it will lift its legs, thus satisfying its owner but generating a state of anxiety which will lead to a fall in performance and a refusal to work.
2. A downright refusal to jump, despite beatings which negatively reinforce its behaviour, such as to lead to aggressiveness at the sight of a jump.
Each single symptom should be considered according to the criteria of classic homeopathy.
Our discussion opens with a comparison of experiences and the symptoms valency in each case.
This starting point leads to the objectivity needed for repertorisation.
Careful observation of the behaviour a horse exhibits during a stereotypy helps us to characterise the movements, gestures and thesequence that is followed, so allowing us to confirm one remedy rather than another.
It is possible to put together similar entries which could be misinterpreted. The owner’s account giving his “version” should always be filtered and the symptoms researched, asking questions of all those who are involved as well. One should therefore become a detective who, by investigation, manages to complete the puzzle which will lead him to the truth, the simillimum.
The particular characteristics of each animal species need to be appraised and studied as they appear in the wild. Domestication, sporting and zoo-technical uses, intense genetic selection has led to modifications and the development of recurrent pathologies in certain environmental situations. Horses are among the most medicated species. Taken advantage of owing to their functional versatility, their wellbeing and health are sacrificed to economic and sporting interests.
Homeopathy is a valid tool, uniting the concepts of animal wellbeing, utilitarianism and human interests.
Homeopathic veterinarians need to know the ethology and behaviour of the horse in order to avoid mistaken interpretations and anthropomorphisms of the repertory in the mind section. They must build up a precise case-history, evaluating information that comes from the owner and from observing the animal in its environment.
A veterinarian’s training must obviously include the study and knowledge of ethology and animal behaviour. Every system of animal management must be evaluated from an ethological point of view before considering the diseases and traumas. This approach favours prevention over cure, educating the client to consider the animal as a whole in relation to the environmental and human interests.
The objectivity of the symptom, the repertory study of single remedies, the general symptoms and the characteristics lead us to the most suitable remedy for that animal. Thus we have a further tool to treat the stereotypies, along with a revision of the management, of the environment and a programme of behavioural rehabilitation.
EQUINE ETHOLOGY, EQUINE BEHAVIOUR, HOMEOPATHY IN HORSES, STEREOTYPIES IN HORSES, WELFARE.