The Clinical Medicine Guide -
A Holistic Perspective

Reviews by homoeopaths:

Misha Norland, Principal and Founder of the School of Homoeopathy, Devon, UK

"Dr Gascoigne's book fills the gap in current literature between orthodox medical knowledge and perspective and that which needs to be known by the prospective practitioner of healing. The philosophy of healing is understood in its universal application and this is woven into the fabric of the text. We use it as a basic text at The School of Homoeopathy."

Jeremy Sherr F.S.Hom., B.Ac.

"I wish I had had this book when I was at school! Dr. Gascoigne has produced a much needed and excellent work. This volume combines orthodox pathology with energetic concepts in a clear and precise way. A must for every alternative student and practitioner. I truly think this is a wonderful book!"

Miranda Castro, Homeopath, Author, International Lecturer

"I opened up the book today to take a quick peek and an HOUR later was deep into it. Rivetted. It is clear and detailed, comprehensive and concise, all at the same time. You've incorporated lots of pragmatic distillations (rather than the millions of useless words in the big medical manuals or the not very helpful home symptom guides). The differential diagnoses (integrating holistic medical thinking and common sense) are excellent. The cases inspirational. Congratulations! I shan't hesitate to recommend your book whenever and wherever I can."

Nick Hewes RSHom, Editor 'The Homeopath', Journal of Society of Homeopaths, Autumn 2001

Stephen Gascoigne's book betrays its inner virtues from the very outset; in the very first sentence of his introduction he tells us of his sense of disillusion as a conventional GP: I always had the feeling that something didn't sound right. I felt the fabric of conventional medicine didn’t hang together in a logical way."

The first chapter, after the introduction, is entitled simply "philosophy", and again this is significant, as it reflects the author's search for meaning and value in alternative medicine, after his experience of the arid technicalities of orthodoxy: "There is always a philosophical view that drives our actions. We cannot operate without a belief system", he emphatically tells us.

Throughout the book one encounters this movement from orthodoxy, towards a vitalistic viewpoint, culminating in his enthusiastic espousal of Traditional Chinese Medicine (TCM). Take, for example, the end of chapter eighteen, concerning HRT: first of all, we are given the commonly accepted facts: - "Oestrogen and progesterone...suppress the function of the ovary...they may be used to increase oestrogen levels around the time of the menopause."

This is followed however, by a vigorous rebuttal of orthodoxy: - "the menopause is not a diseased state. Nor is any normal physiological stage of life."

Lastly, the author gives us a fascinating view of HRT, as seen from the viewpoint of TCM (please forgive excessive abbreviations): in Chinese medicine, he tells us, the menopause is seen as a time of 'Empty Heat'; the female hormones present in HRT, on the other hand, are cold (yin) in nature; thus they have the effect of cooling the whole system down. This can lead to a systemic stagnation, because "the extra yin has swamped the yang"; and this stagnation can ultimate in obesity, high blood pressure, even in cancer. Throughout the book, Stephen Gascoigne chooses to summarise a physiological process in terms of Chinese medicine, and this will be very useful for those homeopaths who sometimes incorporate the use of the elements in their case-analyses, whilst making the book essential reading for practitioners of acupuncture and shiatsu.

This dialectical movement from orthodoxy, to rebuttal, and thence to vitalism, reflects the writer's own career changes, from having to work for a system which "separates the spirit from the body", through disillusionment and rebellion, and eventuating in the conviction "that there is a vitalistic principle behind and encompassing any physical object."

The great strength of Stephen Gascoigne's position is that he's been there, he's done it, and he definitely doesn't want to go back! He makes it clear that he has made a complete break from conventional medicine, because: "If conventional medicine tends to be suppressive, and holistic medicine tends to be curative, it is difficult for them to work together to any great extent. They are doing opposite things". By following-through the logic of his argument, and foregoing the safety-zone of general practice in favour of the relative insecurity of a career in alternative medicine, the author is able to speak to us as a committed and enthusiastic equal; there is never any sense that he has descended from a higher plane, or that he represents in any way the innate free-masonry (metaphorically speaking) of the establishment, which blights so much professional life in this country.

Of course, one never really knows if the strictures of our own class-system are any more limiting than those in other parts of the world, but this subject reminds me of a talk I gave several years ago, to a group of doctors. As soon as I began to speak, roughly half of the audience discreetly left the room “as if one person”, and took up a position, for the rest of the evening, next to the tea urn; whilst the remainder of the group, numbering perhaps a dozen doctors, listened intently to my talk, some of them leaning forward and questioning me enthusiastically, one even going so far as to say that his mother had been a keen adherent of homeopathy, and had raised the whole family on it! The uncanny thing was that the group who stayed and listened were entirely of Asian origin, whilst the escapees were white and British to a man. For the latter group, it was as if my very presence in the room wasn't just a challenge philosophically, but more seriously, it rep- resented an affront to the grey eminence of orthodox medicine as a political entity.

The relevance of this story, in the present context, is that this kind of professional ossification has always struck me as a particularly British (brutish?) phenomenon; and it is very interesting that Stephen Gascoigne has escaped from the 'Norman yoke' physically, as well as professionally, by moving across the water to Ireland, where the rigidities of institutional stratification are less oppressive and life is on the whole more egalitarian (unless, of course, you’re involved in the Catholic Church!). Accordingly the author's views, on the importance of medical knowledge to alternative practitioners, are uncoloured by any political considerations: "I strongly believe that confidence as a homeopath arises out of your skill and competence at homeopathy. Conventional medicine deals with fear and limitations, not with health and freedom. Therefore the study of conventional medicine can only ever be an adjunct to your practice, never a replacement." His approach throughout the book is similarly enthusiastic, fresh and supportive, and designed to give confidence, thus rendering unnecessary what Janet Snowdon used to describe as our need, as homeopaths, of Lycopodium as a collective constitutional remedy.

As a work of reference (which is what it is) the Clinical Guide is accessible, clear and informative. Especially helpful is the section on "Investigations", which methodically lists the significance of the various readings and measurements upon which orthodoxy relies so heavily. Never again, when a patient opens a consultation with the words "I've been for a test, and they say it's eleven", will I have to inwardly groan "eleven what!". Investigations are ranked according to how invasive they are, and the author advises us to only have an investigation "if the result will change the management of the case"; (he suggests that this is the outcome in less than one-per-cent of cases, a figure which exposes the whole system, laden as it is with a cumbersome bureaucracy of referral, as a massive waste of time and energy). The book is worth buying for this chapter alone.

The book is very readable, primarily because the author is able to infuse his writing with the vigour of his opinions. Whether he is debunking received medical wisdom: - "Almost 90% of the total decline in childhood mortality between 1860 and 1965 occurred before the introduction of antibiotics and mass-vaccination", or whether he's making a case for a more holistic vision: "It is not possible to eliminate subjective truth, and to detach it from objective truth...The subjective element is the very factor we aim to utilize in our treatments. It is the unseen, the vitalistic principle that pervades us all", one always feels the author's enthusiasm for his subject, and a sense of enjoyment in his freedom to say exactly what he pleases. Ultimately, the reader is left with the impression that Stephen Gascoigne has come from a place of doubt and confusion, into a more rational and optimistic ambience, and this sense of a journey towards the light pervades the entire book.