|
 |
|||||||||||
| ||||||||||||
Forums
Courses
Shop
Diseases
Articles
Journal
Directory| |
|||||
Homeopathy Articles |
|||||
| |
|||||
| Hpathy Ezine - June, 2007 | |||||
|
|
Crisis in Classical and Contemporary Thought -- David Little |
 |
|||
| Page 1, 2 - | |||||
| TERMINOLOGY Another area of discussion is the validity of using terms like the “constitutional symptoms”. There are some who believe that these terms were introduced by James Kent and have nothing to do with the teachings of Samuel Hahnemann and the first generation. This, however, is not the case. The door to studying the constitutional attendant symptoms was opened by the Founder in The Chronic Diseases. When speaking of gonorrhea caused by an acute miasm Hahnemann said: They yield either to a dose of one drop of fresh parsley juice, when this is indicated by a frequent urgency to urinate, or a small dose of Cannabis, of Cantharides, or the Copaiva balm according to their different constitution and the other ailments attending to it. The Chronic Diseases (Theoretical Part), page 150, B Jain Publishing. In this quote Hahnemann speaks of prescribing remedies by the symptoms in accordance with the variations of different constitutions and their concomitant ailments. G.H.G. Jahr, a close student and confidant of Samuel Hahnemann, expanded on these views in The Doctrines and Principles of the Entire Theoretical and Practical Homśopathic Art of Healing published in Stuttgart in 1857. My attention was drawn to this work by the English-German translator Gaby Rottler of Germany. She has written a wonderful article called Constitution and Chronic Diseases - The Value of Constitutional Symptoms as seen by G. H. G. Jahr. In Gaby’s review she points out that Jahr was the first to elaborate on the use of the term constitutional symptoms in detail and explain their role in Homśopathy. In aphorism 108 of this work Jahr wrote: “§108. In chronic diseases the constitutional additional symptoms provide the characteristic indications for the choice of the remedy. Jahr spoke in terms of the pathognomic symptoms of the disease and the constitutional concomitants of the individual. The pathognomic symptoms represent the nature of the disease state while the constitutional symptoms represent the reactions of the patient. Jahr suggests in aphorism 106 that the remedy should be selected by the “essential or pathognomic signs” of the disease and the non-pathognomic characteristics of the “individual constitution of the sick individual or by other accidental conditions”. These symptoms are not caused by the disease per se as they are adaptations of the individual to his or her condition. For example, ten persons my have “arthritis” with joint pains but one patient is < in summer and one patient is < in winter; one patient feels cold while another feels hot; one patient feels angry and resentful and another feels sad and apathetic, etc. This is why ten arthritis patients might need ten different remedies. Jahr suggests that the best remedy will contain the “most essential constitutional symptoms of the patient” (Jahr §108). He went so far as to say that the “symptoms determining the choice is not to be searched for in the pathognomic signs of the local ailment”. The determining rubrics are the “essential constitutional symptoms” which exist beyond the range of the pathognomic symptoms of the disease. Some persons say that Homoeopathy treats the patient not the disease while others say that Homoeopathy treats the disease not the patient. It has been said that aphorism 153 of the Organon states that one does not treat the symptoms common to the disease - they treat the strange, rare and peculiar symptoms of the patient. What Hahnemann actually says is that one prescribes on the “more striking, exceptional, unusual and odd (characteristic) signs and symptoms of the disease case” not those indeterminate symptoms “seen with almost every disease’. This means that the symptoms common to ALL diseases (pain, weaknesses, discomfort, etc.) are not as important as the characteristic symptoms of THE disease case under study. There is no reference to the patient per se. James Kent is frequently blamed for speaking in terms of the patient not the disease but where did this idea really originate? The eyewitness account of the poet Legouve offers a glimpse into the teachings of Hahnemann in Paris. These personal testimonies help us to understand what it was like to actually be with Samuel Hahnemann. He taught his colleagues that the names of disease are only relative while the essential nature of the totality of the symptoms is the true Gestalt of the disease. In this letter the well known poet quotes Hahnemann in the following manner. At another time I heard him [Samuel Hahnemann] make use of this expression, which sounds so strange if taken in a literal sense, but which is so profound if properly understood. ‘There are no such things as diseases; there are only patients’. The Life and Letters of Dr. Samuel Hahnemann; T. L. Bradford, page 413. The first to speak in terms of the patient not the disease was Samuel Hahnemann! This insight was passed down through every generation of homoeopaths and will continue to be passed on in the future. The orthodox school studies the features common to the disease while ignoring the individuality of the patient. The homoeopathic tradition reminds us that the individuality of each patient is very important. Jahr stated that the pathognomic symptoms of the disease are essential but the constitutional symptoms of the patient are more important symptoms in finding a remedy. Even Mr. Legouve understood that Hahnemann’s statement was not to be taken literally but in a metaphorical sense that offers insight into the patient as an individual. There is no disease without the patient and there is no patient without the disease. Therefore, the homoeopath speaks of the patient AND their disease from different perspectives depending on the situation. HOW HOMOEOPATHIC REMEDIES WORK It has become popular in some circles to say that the vital force plays no role in homoeopathic healing. They object to the idea that the remedy stimulates the vital force in any way. In other circles little emphasis is given to the role of the remedy and most credit is given to the vital force. These one-sided concepts, however, have no basis in Hahnemann’s explanation of how homoeopathic remedies work. Samuel makes it clear that healing occurs through the interplay of the primary action of the similar remedy and the secondary, curative action of the vital force. In the Preface of the 6th Organon the Founder emphasizes the importance of the secondary action of the vital force in the healing process. He also states that the stronger the vital force the quicker and more certain the healing process takes place. Therefore, he tells us not to do anything that would compromise the vital force and vitality. Homeopathy is aware that a cure can only succeed through the counter-action of the life force against the correctly chosen medicine. The stronger the life force that still prevails in the patient, the more certain and faster the cure that takes place. Samuel Hahnemann, confirmed Paris, 184-. Organon of the Medical Art; S. Hahnemann (OReilly 6th Edition), Preface, page 4. In a similar vein Hahnemann wrote in a Letter To My True Disciples that the homoeopathic cure is effected through the reserves of life force present in the human organism. In this quote he clearly states that the remedy “stimulates” the vital force into “this helpful activity”. Homśopathy alone knows and teaches that the cure is to be effected only by means of the entire reserve force still present in the system, and stimulated to this helpful activity by the accurately chosen homśopathic remedy administered in a suitable dose. Samuel Hahnemann, His Life & Work; R. Haehl, Volume II, page 279. The interaction of the similar remedy and the vital force is further elucidated in the Introduction of the 5th and 6th Organon. In these works the Founder wrote a detailed explanation of the homeopathic cure in seven italicized points.
As seen from the following examples, during the initial action of the artificial disease potences (medicines) upon our healthy body, our life force appears to comport itself only conceptively (receptively, passively as it were) and appears as if it were forced to allow the impressions of the artificial potence impinging from without to occur in itself, thereby modifying its condition. The life force than appears to rally in one of two ways. 1. Where there is such a one, the life force brings forth the exact opposite condition-state (counter-action, after-action) to the impinging action (initial action) that has been absorbed into itself. The counter-action is produced in as great a degree as was the impinging action (initial action) of the artificial morbific or medicinal potence on it, proportionate to the life forces own energy. 2. If there is no state in nature exactly opposite to the initial action, the life force appears to strive to assert its superiority by extinguishing the alteration produced in itself from without (by the medicine), in place of which it reinstates its norm (after-action, curative-action). Organon of the Medical Art; S. Hahnemann (OReilly 6th Edition), Aphorism 64. A chronic miasm lasts a life time as it cannot be removed by the vital force. A homoeopathic remedy replaces the permanent natural disease with a stronger but temporary medicinal disease that the vital force can extinguish without difficulty! As the remedy replaces the natural disease the vital force strives to “assert its superiority” by removing the mistuning from “without” while reinstating homeostasis within. Hahnemann called this process the “secondary, curative action”. In aphorism 65 Hahnemann reviews the excessive counter actions of the vital force witnessed when exposed to non potentized substances (§64, part 1). In aphorism 68 he reviews homoeopathic healing with small doses of potentized medicines (§64, point 2). After the primary action of the remedy has completely replaced the natural disease only a transient, short-lived medicinal disease remains. Now the vital force only needs to use as much counter action as necessary to remove this fleeting medicinal disease and return the organism to the full state of health. When this process is done correctly there are no excessive counter actions of the vital force as witnessed with large doses of non-potentized medicines. In the Preface of the Paris edition of The Chronic Diseases Hahnemann elucidates the primary action of the remedy and the secondary action of the vital force in great detail. This model explains the role of energy in the process of cure and clarifies how the secondary, curative action takes place in stages. This explanation offers a glimpse of how a medicinal solution administered in split-doses of gradually ascending potencies returns the organism to health. But if we physicians are able to present and oppose to the instinctive vial force its morbific enemy, as it were magnified through the action of the homoeopathic medicines – even if it should be enlarged every time only by a little – if in this way the image of the morbific foe be magnified to the apprehension of the vital force through homoeopathic medicines, which, in a delusive manner, simulate the original disease, we gradually cause and compel the instinctive vital force to increase its energy in degrees, and to increase them more and more, and at last to such a degree that it becomes far more powerful than the original disease. The natural disease deranges the vital force in such a manner that it cannot tell self (the Esse) from other (the natural disease) and takes part in damaging the organism. If the healing artist is able to “present and oppose” the instinctive vital force with the primary action of the remedy it will replace the natural disease with a stronger but temporary medicinal disease. This is why a patient suffering from a disease characterized by tightness and cold should be given a potentized remedy that is characterized by tightness and cold. In this way the “image” of the natural disease is “magnified” to the “apprehension of the vital force” in a “delusive manner”. The primary action of the remedy is a form of information transfer that allows the vital force to perceive the disease as separate from self. This causes the secondary, curative action of the vital force to “increase its energy in degrees” until it “becomes far more powerful than the original disease”. An increase in vitality is one of the signs that a remedy is well chosen. In the process the tightness and cold associated with the disease state is overcome by the relaxation and warmth of the healthy organism with restored vitality. Once the vital force is completely free from the natural and medicinal disease it returns to enlivening and sustaining the healthy organism. When a patient who is tight and cold is given a relaxing and hot remedy the symptoms will be momentarily suppressed, but in time, the counter action of the vital force will produce even more tightness and cold. If the suppressive medicines are continued they may cause the mutation of the symptoms inward to more important organs and systems. This centripetal movement is in the opposite direction of the centrifugal movement of the law of cure. This is the essence of Hahnemann’s action-reaction model and how the vital force responds to similar and contrary medicines. POSOLOGY AND CASE MANAGEMENT There are those who give a single remedy and wait and watch until there is a clear relapse of symptoms and those who repeat the remedy at rapid intervals all the time. The protagonists of the first consider what they do to be pure “classical Homeopathy”, while the second group claims they are doing what Hahnemann did in his last days. The truth is that Hahnemann taught the wait and watch method in the 1st through 4th Organon but he modified his case posology and case management procedures in the 5th and 6th editions. From 1833 to 1843 Hahnemann taught that anytime during treatment there was a perceptibly progressive and strikingly increasing amelioration the remedy should not be repeated as long as this state lasts. In cases where a single dose will only produce a slow progressive improvement over a period up to 100 days or more he suggested repeating the dose at suitable intervals to speed the cure. To repeat the remedy to speed the cure Hahnemann recommended that the remedy be prepared in medicinal solution and given in divided doses. He called this method the “middle path” as it stands between the exclusive single dose and the mechanical repetition of the remedy. So in some ways both groups are right and both groups are wrong. It is not a matter of using the single dose versus the repetition of remedies at definite intervals. It is a matter of knowing when it is best to use the single dose and wait and watch and when to act and observe the repetition of the remedy to speed the cure. Such an advanced method requires the ability to make a differential analysis of the progress of the remedy. Some persons only use the dry dose and some persons only use the medicinal solution. In truth, even in the 6th Organon Hahnemann reviews the use of the dry dose (§272), oral medicinal solution (§246) and olfaction (§248). All of these methods are effective on their own levels. Although Hahnemann emphasized his preference for the medicinal solution and split-doses he did not completely rule out the use of the dry dose. In my study of the Paris casebooks I have found only 1 case where Hahnemann appears to have given the patient a dry dose. This shows that even in his final years he had not completely rejected the dry dose although he opined the medicinal solution offers the practitioner many more options. This is because the liquid dose can be succussed prior to administration in such a manner that the patient never receives the exact same potency twice in a succession. The liquid dose can also be adjusted in a number of ways that are not possible with the dry dose. This does not mean, however, that the dry dose is invalid in its own paradigm. The techniques of the 4th, 5th and 6th Organon are all valid on their own levels and it is best to understand the methods of all three editions. Hahnemann’s action-reaction model also has important ramifications in the areas of posology and case management. There are some who imagine that all actions observed after the administration of the homoeopathic remedy are the reaction of the vital force. For this reason, they think “every reaction is a good reaction” as if one can do no wrong. This modern concept, however, is not the case. Too much primary action of the remedy causes unnecessary aggravations while too much secondary action produces antagonistic counter actions of the vital force. The reason for these excessive responses is usually hypersensitivity and over medication. Samuel Hahnemann worked his entire career to overcome these excessive actions and make the homoeopathic cure as rapid, gentle and permanent as possible. To practice Homoeopathy in a safe and effective manner it is important to understand all the major remedy responses. There are five major remedy reactions i.e. a smooth amelioration; a similar aggravation; a dissimilar aggravation; accessory symptoms; and a natural healing crisis. A smooth amelioration is a sign that the dose, potency, remedy and repetition (if necessary) are harmonious. A similar aggravation is a sign that the remedy is correct but the patient has been given too large a dose, too high a degree of potency or the remedy has been repeated when it is not needed. A dissimilar aggravation is the production of new and troublesome symptoms not appertaining to the disease under treatment. This is the sign of a wrong remedy. Accessory symptoms are medicinal side-actions of the remedy caused by a partial simillimum. In this case, the patient may improve in one area but new symptoms appear in other areas changing the natural symptom pattern. A similar aggravation, dissimilar aggravations and accessory symptoms are caused by the primary action of the remedy. A natural healing crisis is the movement of the symptoms from within to without, from above to below and the appearance of old symptoms in accordance with Hahnemann’s direction of cure commonly called Hering’s laws. A natural healing crisis may also be accompanied by an increase in the action of the organs of elimination producing a discharge, skin eruptions, sweats, profuse urination, excessive stool, etc. This type of eliminatory symptoms should pass quickly and be followed by an increase of the sense of well-being and more vitality. If they are more prolonged and stronger than the original complaints then this is a form of similar aggravation due to over medication. A natural healing crisis is caused by the secondary curative action of the vital force. Excessive counter actions of the vital force are idiosyncratic reactions due to over medication where the patient seems almost “allergic” to the remedy and a cacophony of contradictory and confusing symptoms take place. Every homoeopath should be aware of this action-reaction phenomena but the truth is that this area of practice has been overlooked by many teachers. I am constantly contacted by patients who experience strong aggravations that last for months. Many of these patients are told this is a “good sign” yet many experience new troublesome symptoms for long periods. Even a similar aggravation caused by the right remedy but wrong posology can cause prolonged actions that drain vitality. If the primary action is too strong for too long it drains so much vitality that there will be little or no curative secondary action. The patient may take on medicinal “proving” symptoms that last for life if not corrected. Each of these negative responses demands a specific case management procedure that produces a corrective action in a timely fashion. If you have not been taught about all these responses in school or by your teachers, then it is time you learned about them through a study of the classical literature. It is important to seek out teachers who understand these clinical realities. In the Organon Hahnemann taught that the sensitivity of a patient may vary on a scale from 1 to 1000 (§281). This means that potencies that will not even affect a number 1 hyposensitive will cause severe long lasting aggravations in a number 1000 hypersensitive. At the same time, it is important to study the predisposition of the constitution; the nature, stage and magnitude of the disease; the nature of the remedy; as well as the state of the vital force and vitality. There are also other attendant factors such as the age, sex and environmental influences that may play a role in potency selection. The totality of these factors must be taken into consideration when selecting the delivery system, size of the dose, the degree of potency, and the repetition of the remedy. This is the basis of the traditional method that originated with Hahnemann and has been enhanced by generations of classical homoeopaths. Today there are those who are teaching a hierarchical method of potency selection based on the level of the symptoms. Potencies like the 6C are used based on the name of the disease. Potencies like the 30C are used based on the facts related to the disease state. Cases that are on the emotional level receive the 200C while cases based on delusions receive the 1M. If the case is based on a vital sensation the patient receives the 10M. If the case demonstrates the level of energy the patient receives the 50M, etc. In this hierarchical analysis the individual sensitivity of the patient, the nature, stage and magnitude of the disease, the condition of the vital force, and the nature of the remedy is not taken into consideration. This method is being taught to new students who have little or no clinical experience with the classical methods of potency selection. It is a clinical fact that many of the most hypersensitive patients are those who are suffering from emotional problems and delusions of various sorts. They are so sensitive that they feel emotions too strongly and tend to imagine all sorts of things! Just because a patient says “I feel” several times does not necessarily mean that they need a 200C. Just because the case includes a characteristic delusion does not necessarily mean they need a 1M. Even if you have found a grand sensation that appears to tie together all the symptoms, this does not necessarily mean that one must give the 10M. What if the patient is the 1000 degree hypersensitive, suffers from advanced pathology in the vital organs, has an unstable vital force and is very weak at the same time? Should we still give such a patient the highest potencies? I have spoken to many persons that have been aggravated for months with no improvement by such methods. This is because the most important factor in the selection of the potency is the individual sensitivity of the patient followed by the nature, stage and magnitude of the disease and the condition of the vital force, etc. The hierarchy of the symptoms may be one feature in assessing the potency but to use such a method in isolation from the totality of other factors that affect potency selection is insufficient. Once again a new method may provide insights but they should not be used in isolation from the traditional techniques that broaden the foundation and make the prescription safe. BRINGING IT ALL TOGETHER It has become apparent in this discourse that the classical Homoeopathy introduced by Samuel Hahnemann and the first generation represent the starting point of many techniques that evolved in later periods. The Founder’s clinical technique was a system of flexible response that included a wide number of applications depending on the cause, symptoms, time and circumstances. The Founder used single remedies over a longer period of time, alternations, tandem remedies, intercurrents and a series of remedies as well as acute remedies, chronic remedies, anti miasmatic remedies, and prophylactic medicines whenever necessary. Therefore, the uses of acute, chronic and preventative remedies all find their origin in the work of Samuel Hahnemann. Techniques like Burnett’s ladder where a series of remedies is used in complex cases and Kent’s long-term use of a constitutional (chronic) remedy, all have their seed in the works of Samuel Hahnemann. The alternations used by Boenninghausen, and the chronic intercurrents used by Hering, all find their roots in the works of Samuel Hahnemann. Speaking in terms of the three kingdoms, the elements of the periodic table and using synthetic prescriptions are all branches of the works of Samuel Hahnemann. Since all those following the cardinal principles share the same family tree, why isn’t there more unity in the homoeopathic community? Why do those who like to use constitutional remedies disapprove of those who use acute remedies? Why do those who use one remedy over a longer period of time criticize those who use a sequence of remedies when necessary? Why do those who use curative remedies disapprove of those who use preventative remedies? Why do some say Homoeopathy treats the disease not the patient and others say Homoeopathy treats the patient not the disease when the patient and the disease are a functional unity? Why do some say that the vital force cures while others say only the remedy cures when Hahnemann taught that it is the interplay of the primary action of the remedy and secondary action of the vital force that heal? Why do some insist on a one-sided monism while others proclaim a rigid dualism when there is unity of purpose in the one and the many? Why do some always treat the whole patient at once while others treat everyone in layers when both methods are useful depending on the time and circumstances? Why do all these one-sided dichotomies exist? Why do some say we should use only low potencies and other say we should use high potencies when Hahnemann used from low to high potencies depending on the sensitivity of the patient and the nature of the disease state? Why do some say the C potency is the best while others claim the LM potency is superior when Hahnemann used both side by side in his last years? Why do some only use a single dose and others only use a series of doses when Hahnemann taught the proper time to use the single dose and the proper time to repeat the remedy to speed the cure? Why are some using only old methods and some only using new methods, when a combination of the two is the best way forward? Why is it that human beings like to take a whole truth and break it into two halves and turn one side against the other? If one investigates the true “classics” they will find the source of the best of the new methods. They will find that these ideas grew into many schools of practice but they all have their basis in the classical period of Homoeopathy. Knowledge of the source has vanished because we have lost our roots. We have depended too much on second hand information instead of seeking the true genesis. We have listened to what popular teachers opine without thinking for ourselves. We have taken our knowledge for granted without asking the proper questions. We have followed trends and fads while ignoring the time-tested traditional techniques. Why are so many persons seeking to change a classical system that they never really learned in the first place? It is my heartfelt advice that everyone studies the Organon, The Chronic Diseases and The Lesser Writings very closely. At the same time, study the history of Homoeopathy and all the eyewitness accounts and letters in publication. Build the strongest possible foundation in the works of Hahnemann, Boenninghausen, Hering, Jahr, T.F. Allen, H.C. Allen, Kent, Boger, Whitmont and others. Learn how to use the repertory and materia medica well and study the characteristics of the most proven remedies daily. Base your homoeopathic house on the bedrock of the classical tradition rather than the shifting sands of fashion, so that when the winds and rains of clinical realities blow, your practice will not fall down! If one harmonizes the classical and contemporary methods one has a solid basis from which to reach for the sky without losing one’s balance. I have taken the time to write this rather lengthy discourse because I really care about Homoeopathy. I do not consider myself to be an innovative master or an advanced practitioner. I am just a well trained homoeopath in the traditions of Hahnemann and the subsequent generations. Over the years I have learned more from my failures than I have from my successes as I search for the most rapid, gentle and permanent method of cure. It was my cases that did not go well that drove me to study the various editions of the Organon in depth and to dig deeply into the classical period. In this fertile ground I found the answers I was looking for, and for over a quarter century, I have done my best to bring these methods up to date for our times. It was in Hahnemann that I found the truths that unified all the schools of Homoeopathy. This is why I have written a 6 volume 4000 page textbook called the Homoeopathic Compendium, which will be in print in the not too distant future. As I near the September of my years I look to the next generation as they are the ones that will carry the torch of the healing arts forward. In my heart I know the Medicine of the Future will be safe in their hands and true classical Homoeopathy will never be lost. Similia Minimus Sincerely, David Little |
|||||
| <-- Previous -- | |||||
|
|||||
