| The E-zine team has taken on the sensitive project
of creating an environment where the protagonists of different trends
in homeopathy can explain their views to other homeopaths. We aim
to forge this project based on mutual interest and respect, to help
further progress and harmony.
The purpose of this article is to provide some general information,
to help the reader form his own opinion, after reading various articles
in the coming months. In this article I will touch broadly on the
evolution that has given rise to the different schools. I then propose
to discuss some of the questions that shape the various schools
of thought and that should help in enriching homeopathy for all.
The beginning: Hahnemann’s work:
When Hahnemann started using his new homeopathic remedies, he treated
diseases rather than patients. Hahnemann’s first major achievements
were the successful interventions in various epidemics during his
time. These results drew the attention of others who formed the
basis for his following that forged the spread and survival of homeopathic
medicine. His initial work consisted of helping the patient with
the present complaint. At first, Hahnemann did not appreciate what
is now called the biopathpography of the patient: the patient’s
medical history before and after the consultation. The patient came
with a complaint and when this complaint was successfully addressed,
the patient and Hahnemann were satisfied. When Hahnemann started
to notice how patients returned time after time with the same complaints,
he wanted to improve his new technique to allow lasting cures. His
research into the causes of the reoccurrence of symptoms and diseases
led him to write his work on Chronic Diseases. Based on three concepts,
he developed the idea of the ‘Miasms’. - He used the
following schema of disease evolution: contamination- incubation-
vicariate symptoms- suppression, which comes from what was known
in his time about venereal diseases. A disease can be contracted,
then evolves into its usual symptoms followed by a cure or suppression
of its symptoms, through (suppressive) treatment. The suppression
causes other symptoms to appear. From the phenomenon of epidemics
he uses the concepts of ‘collectivism’ and ‘contagion’.
Many people can be affected by the same disease and can pass on
this infection from one to another and through the generations.
Based on the concepts of ‘epidemic’ and ‘pathogenesis’
he creates the entity of miasms which are composed of a large group
of individuals. A miasm is like a collective disease or epidemic
for which a unique remedy can be found by using the ‘homeopathic
symptoms’ of the miasm to determine what remedy pathogenesis
would cover these symptoms. Hahnemann took a step forward with the
conceptualisation of homeopathic thinking but he takes a step backward
methodologically. Instead of prescribing for the individual, he
now decided to prescribe for the ‘individual miasm’
(one of the three miasms or the expression of this miasm). As a
consequence, following these new findings, many of his prescriptions
started with Sulphur, Thuja, Nitric acid or Mercury, depending on
whether the patient belonged to the psoric, sycotic and or syphilitic
group. After these initial prescriptions, he attempts to make more
individually tailored prescriptions. The concept of miasms as developed
by Hahnemann relies on the cause of disease lying outside the patient.
When the patient falls ill, it is the miasm that infiltrated the
patient, that causes the patient to become ill; through contagion,
sexually or otherwise.
Another evolution that took place in Hahnemann’s work was
the establishment of the importance of the second consultation.
After his research into the observation of chronic illnesses, Hahnemann
realized that the second consultation was as important as the first
to make sure a long term cure would be obtained. In his work on
the Chronic Diseases, Hahnemann mostly explained what not to do
during this second consultation. He did not have enough time at
his disposal to finalize his work on this subject and give positive
advice on how to proceed during this consultation.
J. T. Kent.
It is Kent who clearly explained in his conferences how to interpret
the second consultation in order to decide what should be done next.
All of us who have spent time studying homeopathy have learned about
the twelve possible evolutions of a patient after taking a remedy.
This was a great step forward in the methodology of homeopathic
prescription.
Homeopaths were given a tool to judge the evolution of the patient
through a sequence of homeopathic prescriptions. Kent’s work
is still the basis for guidance on prescription for many homeopaths.
When we decide whether to repeat a remedy or use a different remedy
we rely on the work of Kent.
The remedy for life.
The next big step forward was made by Gathak. He introduced the
principle that the disease has an endogenous origin. This new concept
is of major importance to allow the further evolution of homeopathic
conceptualisation. The cause of the disease would be present inside
the patient and not be some sort of ‘infection’ acquired
from the outside in the way Hahnemann portrayed it. In 1920, Woodward
already writes about the remedy for life, but it is Paschero who
really puts forward this new concept when he discovered Ghatak’s
work. The ideal of the prescription has changed. Whereas previously,
homeopaths would rely on Kent’s interpretation of the second
consultation to prescribe one remedy after another, after Paschero,
homeopaths could imagine finding the patient’s remedy. Whether
we want to call it the remedy for life or the constitutional remedy,
this was a leap forward in homeopathic thinking. A valid remedy
for life would be capable of helping the patient to sail through
his/her acute and chronic upheavals. The remedy for life concept
still now divides the world of homeopathy. Broadly speaking, we
can describe two groups of schools: those who promote the idea of
sequential remedies following Hahnemann and Kent’s work and
those who work towards finding the best possible remedy in the patient
that will conduct the patient through a large part (or all) of his
or her life. It is easy to see how some homeopaths attach primary
importance to all the writings of Hahnemann and Kent to structure
their homeopathic approach in using sequential remedies. Other homeopaths,
who have taken on the idea of the prescription of a near perfect
similimum as their primary goal, tend to rely less on all of the
writings. The separation of these two groups is not a clear line.
The ‘similimum’ is a principle that is used in both
schools of thought. The importance attached to finding this one
remedy is different between the two schools. One of the main consequences
is the way in which remedies are studied.
Dr A. Masi.
Masi is the architect of a new methodology for the study of the
materia medica. He made the ideal of one remedy for life accessible
through a different look at the materia medica. Paschero had paved
the way for Masi to propose a classification of the materia medica
for each remedy. Paschero proposed to determine in the patient two
groups of symptoms: the symptoms that illustrate the ‘suffering’
of the patient and the symptoms that are a consequence of this ‘suffering’.
Masi used this model to study the materia medica and turned each
remedy into a ‘cone’. At the top of the cone he places
what he considers to be the most original symptoms of the remedy,
the ones that represent the essence of the remedy. At the bottom
he places the most common symptoms. Consequently, Masi defined a
new type of qualification of remedy symptoms: - Kent had given degrees
of reliability of presence of symptoms in the materia medica; a
degree of confirmation that a symptom can be associated with a certain
remedy. - Masi added a second kind of qualification to symptoms:
their specificity to the remedy; a degree of reliability that the
presence of a certain symptom in the case indicates with a high
certainty a particular remedy for the patient. These are the symptoms
in the top of the cone, they cover the essence of the patient, his
suffering. These symptoms increase the chance for the remedy to
be indicated and become a constitutional remedy or remedy for life,
for the patient. This is one of the most important consequences
of the idea of the remedy for life: the way in which the materia
medica is studied. The notion of the essence of a remedy appears.
This notion of the essence is used by many around the world to produce
new materia medica which are not compilations or syntheses of pathogenesis
but the result of looking for what is specific for each remedy,
based on the study of the materia medica and on clinical experience.
The study of individual remedies is pushed in different directions,
from situational descriptions of remedies to more and more refined
pictures that allow the incorporation OF the ‘hyper’,
‘hypo’ and ‘dys’ reactions (inspired by
the theories of miasms) present in each remedy. Some of the better
known studies are: G. Vithoulkas’s ‘Materia Medica Viva’
and R. Sankaran’s ‘Souls of Remedies’. In the
French speaking world, there are groups who continue to use Masi’s
approach through the Thomist view on the world to refine the understanding
of remedies (Afadh, Guy Loutan). My colleague, Marc Brunson, promotes
the study of remedies through the filter of what is peculiar about
the substance that makes up the remedy. In the same spirit of the
search for the similimum, a number of colleagues have recently developed
the classification methods through the kingdoms, families and other
groups that reflect the scientific classification of substances.
This line of approach takes homeopathy in a new direction. Whereas
in the study of the individual remedy there is always room for change
of the remedy picture through work of individuals and groups, the
classification method has a more static character.
This short overview has depicted how the various schools have developed
in different directions. In 1796 Hahnemann formulated the essential
characteristics that suffice to define the homeopathicity of any
future evolution of the art of healing: 1) experimentation of remedies
by healthy provers. 2) individualiZation of the patient. 3) choice
of medicine according to the law of similars, this implies the unicity
of treatment. (one remedy only) 4) the principles of dilution and
dynamization. This definition is very clear and simple but as with
many simple principles the consequences are complex. (Look at Einstein’s
relativity theory)
Experience based medicine:
To this basic definition of homeopathy has joined the experience
of many homeopaths trying to apply the basic principle. Out of their
experience has grown the different directions in homeopathic thinking.
One hears so many times people saying: ‘that is what works
for me’, or ‘that is what I found efficient’.
Herbal medicine is a good example of experience based medicine.
Indications of herbs are mostly based on the experience of their
use, transmitted orally and through written tradition. One striking
observation when studying the renowned properties of many popular
herbal medicines is that they have such a variety of indications
that they seem to be indicated in nearly all cases. Also, their
indications vary according to the culture in which they are used.
When I discovered this, it made me become suspicious about renowned
efficacy of remedies in general.
Homeopathy with its basic definition of prescription technique
differentiates itself from experience based traditions. That is
the attraction of homeopathy and it is also the difficulty of homeopathy.
We have to ask ourselves what reservations we must have when we
hear others say ‘It works for me’, not to let homeopathy
become a pure experience based type of medicine. Pluralistic homeopathic
prescriptions are also an example of experience based tradition.
Depending on your view point you may or may not agree on the validity
of pluralistic (or complex) homeopathy. Some of the experience from
homeopathic prescription is valid and can be added to our Repertories
and materia medicas. Other experience, giving rise to the different
approaches, has a more philosophical and therefore changing nature.
It is important to appreciate this changing nature of homeopathic
practice caused by ‘experience’. Experience is always
relative. It is determined by everything that makes up the culture
in which the homeopath(s) live and work. Different cultures cause
different experiences which form different schools of thought. When
you read the writings of other homeopaths try to discover how their
thinking evolved.
The published case.
When we talk about experience we need to take a short look at the
published cases. What is their role in homeopathy? They are good
tools for studying. They show how other homeopaths selected a remedy
for the patient and they produce useful material to work on the
construction of remedy pictures. They offer a proof of efficacy:
both efficacy of homeopathic prescription and the efficacy of a
certain approach to prescribing remedies. They help in confirming
remedy pictures. Before we can use published cases we have to decide
when a case can be called successful. A really acute case that resolves
itself after 3-4 days of taking a homeopathic remedy can hardly
be called a success. It is possible that the case improved regardless
of the remedy. A chronic case where the patient is better for a
few months is not convincing, although the case might teach us something
about the remedy used. There are many questions we should study
when we treat published cases: How severe do you judge yours and
other homeopath’s work? What are the parameters that decide
that a homeopathic prescription was successful? How frequently can
a remedy be used when we try to agree that its action was homeopathic
or not? How long should the patient be without the need for a remedy
to decide that the last prescription was successful? Should we only
publish cases where very few remedies have been used or can we publish
cases where a succession of remedies have brought health to the
patient? Do published cases have to mirror perfectly our daily practice
or should published cases only be there to help to improve our understanding
of remedies: i.e. have long feed-backs with patients that are stable
on very few doses of one remedy?
For the benefit of all I would like to draw attention to some common
shortcomings of published cases: - too short a feed-back - unclear
remedy selection method/justification for prescription - unclear
dose and repetition of the remedy given - absence of any mention
of other treatments used. It is important that we apply a certain
rigor in judging our own work. We should not convince ourselves
of the efficacy of homeopathy by listening to ourselves or others
but by producing tangible results that others will, or can, acknowledge.
The efficient prescription.
Of course we all want immediate success for our patients. Have
you not spent time and money (buying books and software) looking
for the perfect tool that will guarantee this success? The next
issues of the Homeopathy 4 Everyone editions will be filled
with explanations by leading names on how they achieve their results.
Because we all want to participate in their results, we are ready
to jump on their bandwagons hoping to share their results. It is
advisable to be wary of letting our enthusiasm blind our spirit.
Read the articles, be critical, try to understand and read between
the lines. The fact that there are divergent schools of thought
must indicate that nobody carries the full truth. But also, listen
to all different opinions. Not long ago I overheard a colleague
saying: ‘Be a sponge, even if you don’t like what somebody
else writes, try and understand it, absorb it and when you squeeze
your sponge, golden liquid may come out.’ There are two sayings
in French for which I don’t know the English equivalent. These
are the translations: He who knows everything knows nothing. He
who is ‘only’, is nothing. Both these sayings express
the same idea: ‘if you consider your idea to be the only true
one than you still have much to learn.’ This shouldn’t
stop things moving along, and it is necessary that there are people
who pursue one particular idea to allow its development.
Remember, be a sponge.
I would like to end with a quote of a colleague: Joel Shepperd.
He wrote in Homeopathic Links (Spring 2004, Vol. 17; 11-12) suggesting
the same idea: ‘It is discouraging to me that students are
no longer taught the original homeopathy with accuracy and depth
in many existing schools, and that they are no longer making the
effort to master the original techniques before trying to enrich
it.’
Acknowledgement.
This article is based on a presentation made by Marc
Brunson. I thank him for giving me an insight in the writings
of many of our predecessors who helped to shape current ideas in
homeopathy.
I have added material from the many articles I have read on the
subject of homeopathic thinking on www.hpathy.com
and in other magazines that have helped in forming my understanding
without making explicit reference to them. |