Resumen
La filosofía es una actividad crítica que puede reflexionar sobre el paradigma que subyace al discurso médico hegemónico y a otros que se plantean como complementarios o alternativos (tradicional chino, naturista, homeopático o cuántico). En esta primera parte, se presenta la formación histórica de la medicina hegemónica, que es la cientificotecnológica, para ver cuál es el paradigma que subyace a su práctica y al discurso teórico que la justifica.
Palabras clave: Medicina cientificotecnológica; Filosofía crítica; Orden médico; Matematización; Paradigma.
¿Qué es lo que puede aportar hoy la filosofía a la medicina? Lo primero que hay que subrayar es que tanto la una como la otra se nombran de muchas maneras, por lo que hay que clarificar desde el principio de qué estamos hablando. Mi planteamiento de la filosofía no es metafísico, sino crítico, por lo que no pretendo construir una teoría metafísica desde la que fundamentar la medicina o una determinada medicina. La filosofía, como actividad crítica, quiere pensar las cosas de otra manera que como ellas mismas se presentan. Sócrates, fundador de la filosofía, no es un nuevo sabio, sino aquel que cuestiona el supuesto saber de su época, es decir, las creencias sociales dominantes. Lo que, por tanto, puede aportar la filosofía es una problematización de los discursos de las diferentes medicinas existentes en nuestra sociedad, lo cual puede relativizar los diferentes planteamientos, ver si son o no son compatibles entre sí y en qué medida. Si la respuesta es positiva, pueden ser complementarias unas con respecto a las otras o, en caso contrario, deben plantearse como opciones alternativas. En cualquier caso, hay que evitar también el relativismo del todo vale buscando criterios consistentes, a la vez racionales y empíricos, que cuestionen prejuicios encubiertos pero que dejan cada cosa en su lugar.
Mi definición de medicina es que es un conjunto de prácticas con eficacia curativa que se justifican a través de un determinado discurso. Esta eficacia curativa la defino de una manera operativa y, por tanto, cualquier práctica que se mantiene la tiene necesariamente. El antropólogo Lévi-Strauss definía la eficacia simbólica para describir la situación de una práctica que genera unos efectos por la confianza que la sostiene, aunque se derive exclusivamente de la fe que se tiene en ellos. En este sentido, cualquier práctica que cure, independientemente de por qué, es en principio medicina. La medicina es históricamente una práctica social necesaria que se ha desarrollado de manera empírica y que a partir de esta experiencia ha ido elaborando un discurso teórico más o menos estructurado para fundamentarla. Es una construcción social que está relacionada con otras muchas prácticas sociales y que, por ello, no es independiente de ellas.
En el mundo occidental (y con él en todo el planeta a través de la globalización actual), domina una determinada medicina, que es la que llamaré cientificotecnológica. Esta medicina tiene un carácter hegemónico, pero no único, porque coexiste con otras prácticas médicas que, dependiendo del lugar, tienen un carácter más o menos marginal, pero siempre secundario con respecto a aquélla (exceptuando, por supuesto, sociedades tradicionales en las que todavía no domina la globalización). Esta medicina tiene relación en una primera etapa con la revolución científica que se da en Europa en los siglos XVII-XVIII y con el dominio del sistema capitalista que se inicia en esta época. En una segunda época se corresponde con lo que se llama el capitalismo globalizador, que se inició en el siglo XX y se vuelve a desarrollar ahora a comienzos del siglo XXI. La historia de la medicina (1) construida por la propia sociedad occidental tiene también, como casi todas las historias, algo de mítico. El mito es considerar a Hipócrates (2) como su fundador, cuando Hipócrates tiene seguramente más que ver con las medicinas tradicionales, como la naturista, o con otras modernas, como la homeopatía. Pero la función que tiene este mito fundacional es que se utiliza a Hipócrates como padre fundador que constituye un orden médico (3) que da a sus representantes una posición de poder y un estatus elitista. A partir de aquí, se va constituyendo una medicina tradicional cuyo guía teórico era Galeno y que no tiene nada que ver con la medicina hegemónica de la actualidad, pero a la que se le da artificialmente una continuidad. Por supuesto, hay un proceso de transformación que va de la una a la otra pero quizás, al igual que en la ciencia moderna, acaba convirtiéndose en algo estructuralmente diferente.
En todo caso, pienso que en la constitución de la medicina cientificotecnológica hay que señalar los siguientes pasos fundamentales:
— La victoria teórica del mecanicismo y la matematización introducida por Galileo y, sobre todo, por Descartes (4) en el siglo XVII, que se consolidará por Newton en el siglo XVIII. El alma siempre se había entendido como un principio vital y a partir de Descartes se identificará con la mente, sustancia pensante. La vida forma parte entonces de la sustancia extensa que es el cuerpo y se entenderá como producto de mecanismos específicos que operan en él. A partir de aquí hay toda una serie de estudios basados en la comprensión del cuerpo y de la enfermedad como mecanismos. El mecanicismo derrotó al vitalismo. De la matematización ha surgido el dominio de la estadística y de la cuantificación.
— El triunfo de la mirada anatómica de Bichat (siglos XVIII-XIX). La comprensión de los tejidos del cuerpo como la base para la anatomía, la fisiología y la patología. La conclusión es que no hace falta una concepción orgánica de tipo global para entender la enfermedad, sino un estudio individual de cada tejido. El cuerpo se descompone así en piezas y mecanismos que pueden ser estudiados aisladamente. Combinado con el descubrimiento de la anestesia en 1840, tiene como consecuencia una valoración progresiva de los cirujanos, cuya labor pasa de considerarse un trabajo subordinado al médico al de un especialista del cuerpo, que adquiere un estatus muy elevado. El cirujano no sólo repara, sino que también sustituye o incluso, muchas veces, transforma, guiado exclusivamente por el deseo del paciente de mejorar su aspecto (cirugía estética).
— La formulación del paradigma (5) cientificista de la medicina moderna con Claude Bernard (6) (siglo XIX). Es el momento de constitución de la medicina experimental: la medicina tenía que tener una base científica y ésta sólo se podía adquirir en el laboratorio como interacción de la fisiología, la patología y la farmacología. El hospital va adquiriendo el lugar central para la medicina y sus investigaciones.
— El entusiasmo despertado por la teoría de la enfermedad como infección a partir de las investigaciones de Pasteur (Francia) y Koch (Alemania) durante la segunda mitad del siglo XIX. Es la concepción de la enfermedad entendida desde la teoría microbiana de los gérmenes como agresores externos. Pero la consecuencia no deriva en un interés por la inmunología como teoría sobre las defensas naturales, sino que es capitalizado por las empresas farmacéuticas para promocionar las vacunas y los antibióticos.
— El descubrimiento de la genética como predisposición interna a la enfermedad y el desarrollo de toda la investigación orientada a la adquisición de patentes y la creación de unas expectativas desmesuradas respecto a sus posibilidades.
— El cambio en la concepción de la enfermedad mental y la confianza en los fármacos como los medios adecuados para curarla o paliar sus efectos. Este giro lleva a una medicalización progresiva de la sociedad en la medida en que cuestiones que hasta entonces se consideraban intrínsecas al ser humano (dolor, desánimo) pasan a ser consideradas formas de malestar que se pueden tratar médicamente (antidepresivos, estimulantes, etc.). Y la medicalización progresiva de la infancia al generalizar de manera indiscriminada diagnósticos, como el de hiperactividad o déficit de la atención. Estamos aquí, por supuesto, con uno de los mayores negocios de las multinacionales farmacéuticas.
Estos son unos aspectos, entre otros muchos, que creo que vale la pena destacar para ver un proceso que nos ha conducido a un determinado lugar, en el que nos encontramos hoy. Y de esta situación actual marcaría los siguientes aspectos:
— Desarrollo de una medicina tecnológica centrada en un espectacular desarrollo de la cirugía y la microcirugía. Éste es el aspecto en el que hay que celebrar el éxito, siendo el único peligro su utilización injustificada (que la hay).
— Proliferación progresiva de fármacos. Podemos considerar que algunos de estos fármacos juegan un papel positivo, que otros son discutibles (vacunas) y que unos terceros son negativos, siguiendo el popular refrán es peor el remedio que la enfermedad. Los efectos negativos de los fármacos, vistos en su totalidad, son importantes, ya que la iatrogenia se convierte en una causa importante de enfermedad.
— Pérdida de la subjetividad del enfermo. En la medicina cientificotecnológica no hay un sujeto enfermo (con una biografía y una situación actual directamente relacionadas con la aparición de la enfermedad), sino enfermedades objetivas que se concretan en individuos (que sólo valen como ejemplos). Esto no sólo nos hace olvidar la singularidad del enfermo, sino también el medio social que como tal puede generar las patologías (forma de vida, condiciones laborales, hábitat, etc.). Esto lleva a una deshumanización de la medicina y también a una despolitización del tema de la salud, en el sentido que no nos preguntamos por el tipo de sociedad en que vivimos y cómo podría transformarse en una sociedad mejor.
— Instauración de la biopolítica como administración de la vida de los ciudadanos por parte del Estado a través de una medicalización progresiva de todos los ámbitos de la vida personal. Sistema universal de salud (en algunos países). El Estado controla al ciudadano y sus hábitos pero sin cuestionar nunca las estructuras sociales. Las multinacionales farmacéuticas buscan soluciones hasta el punto de "inventarse" enfermedades para un determinado fármaco. Aquí hay muchas cuestiones para tratar, unas positivas pero la mayoría negativas.
Este proceso ha generado un malestar que ya hace décadas denunció Ivan Illich (7) en un análisis discutible, pero radical e interesante. Paralelamente, Michel Foucault (8,9) también aportaría una reflexión crítica (y diferente a la anterior) sobre la medicina moderan en la sociedad capitalista. Pero son los ciudadanos los que cada vez más han buscado alternativas delante de los límites y efectos negativos de la medicina cientificotecnológica. Esto ha provocado la aparición de medicinas que se han presentado como opción alternativa a esta medicina cientificotecnológica. Entre este amplio espectro creo que podemos recoger 3 grandes grupos:
— Las medicinas tradicionales de otras civilizaciones (china, india, etc.).
— Las medicinas occidentales marginadas por la hegemónica: naturista, homeopatía.
— La medicina cuántica, como intento de integrar las medicinas tradicionales y una medicina científica basada en nuevos conceptos científicos que supuestamente no integraría la medicina hegemónica (como la física cuántica).
Creo que aquí tendríamos que entrar en la noción de paradigma (entendido como la matriz conceptual de las que surgen los conceptos y las prácticas de cada discurso) para ver en qué se fundamenta cada medicina: el paradigma de la medicina convencional, el de la medicina china como muestra de las tradicionales, el de la homeopatía, el de la medicina naturista y el de la medicina cuántica. A partir de esto, podremos sacar las consecuencias y ver, por lo tanto, si son compatibles o incompatibles. En la segunda parte lo trataremos.
Bibliografía
1. Porter R. Breve historia de la Medicina. Madrid: Ed. Taurus;2003
2. Langbein K, Ehgartner B. Contra Hipócrates. Barcelona: Ed. Robin book; 2004
3. Clavreul J. El orden médico. Barcelona: Ed. Argot; 1983
4. Descartes R. Meditaciones metafísicas. Madrid: Ed. Gredos; 1987
5. Khun TS. La estructura de las revoluciones científicas. México: Fondo de Cultura Económica; 2005
6. Bernard C. Introducción al estudio de la medicina experimental. Barcelona: Ed. Fontanella; 1976
7. Illich I. Némesis médica. Barcelona: Ed. Seix-Barral; 1975
8. Foucault M. El nacimiento de la clínica. México: Ed. S. XXI; 1993
9. Foucault M. Estrategias de poder. Barcelona: Ed. Paidós; 1999
Autor: Luis Roca Jusmet
Publicado en la Revista Médica de Homeopatía, Rev Med Homeopat.2009; 02(02) :97-9 - vol.02 núm 02
Fuente: http://luisroca13.blogspot.com/2010/01/filosofia-y-medicina.html
Placebo: El efecto de creer.
Mi idea de que las creencias controlan la biología está basada en los estudios que he realizado sobre células endoteliales clonadas, las células que forman la pared de los vasos sanguíneos. Las células endoteliales del medio de cultivo examinaban su entorno con detenimiento y cambiaban su comportamiento en función de la información que recaban del ambiente.
Cuando les suministraba nutrientes, las células se movían hacia esos nutrientes con el equivalente celular de unos brazos abiertos. Cuando las introducía en un ambiente tóxico, las células del cultivo se alejaban de los estímulos en un intento por protegerse de los agentes nocivos. Mi investigación se centraba en los receptores de membrana que controlan el paso de un comportamiento a otro.
El complejo que estudié en un principio tenía una proteína de membrana que reaccionaba a la histamina, una moléculaque el organismo utiliza corno sistema local de alarma.
Descubrí que había dos tipos de complejos, Hl y H2, que respondían a la misma molécula de histamina. Cuando se activaban, los complejos con receptores Hl desencadenaban una espuesta de protección, el tipo de comportamiento mostrado or las células con medios de cultivo tóxicos. Los complejos ue contenían receptores H2 desencadenaban una respuesta e crecimiento o desarrollo ante la presencia de histamina, imilar al comportamiento de las células en presencia de nutrientes.
Más tarde descubrí que la molécula que desencadena una respuesta de alerta general en el organismo, la adrenalina, también tenía dos complejos de receptores diferentes, llamados alfa y beta. Los receptores de adrenalina desencadenan exactamente los mismos comportamientos celulares que la histamina. Cuando el receptor alfa-adrenérgico forma parte de un complejo de PIM, desencadena una respuesta de protección en presencia de adrenalina. Cuando es el receptor beta-adrenérgico el que forma parte del complejo, la misma olécula de adrenalina desencadena una respuesta de crecimiento o desarrollo (Lipton, et al., 1992).
Todo esto resultaba muy interesante, pero el descubrimiento más excitante tuvo lugar cuando añadí adrenalina e histamina a la vez a mi cultivo celular.
Descubrí que las moléculas de adrenalina, que son liberadas por el sistema nervioso central, anulaban a las de histamina, que se producen a nivel local. Aquí es donde la política de la comunidad que describí con anterioridad entra en juego.
Imagina que trabajas en un banco. El director de la sucursal te da una orden. El presidente de la empresa aparece y te da una orden contraria. ¿A quién de los dos obedecerías? Si quieres conservar tu empleo, obedecerías al presidente de la empresa.
Nuestro sistema biológico sigue un sistema de prioridades similar que requiere que las células sigan las instrucciones del jefazo, el sistema nervioso, aun cuando sus órdenes entren en conflicto con los estímulos locales.
Me sentí entusiasmado ante semejante descubrimiento porque creí que revelaban, si bien a nivel unicelular, una verdad que también valía para los organismos multicelulares:
que la mente (actuando mediante la adrenalina liberada por el sistema nervioso central, por ejemplo) domina el cuerpo (que actúa en respuesta a estímulos locales, como la histamina). Quise explicar las implicaciones de mis experimentos por escrito, pero a mis colegas casi les dio un infarto ante la idea de incluir la conexión entre mente y cuerpo en un texto sobre biología celular. Así pues, hice un críptico comentario sobre el ignificado del estudio, pero no pude decir cuál era ese significado. Mis compañeros no querían que incluyera las conclusiones de mi investigación porque la mente no es un concepto biológico aceptado. Los científicos biológicos son newtonianos hasta la médula, si no hay materia, no existe. La «mente» es una energía no localizada y, por tanto, no tiene relevancia para la biología materialista. Por desgracia, esa idea es una «creencia» que ha demostrado ser manifiestamente errónea en el universo cuántico.
Placebos: el efecto de creer
Todos los estudiantes de medicina saben, al menos durante un tiempo, que la mente puede afectar al cuerpo. Saben que algunas personas mejoran cuando creen (de forma equivocada) que están recibiendo un tratamiento médico. Cuando los pacientes mejoran tras recibir una pastilla de azúcar, la medicina lo define como «efecto placebo». Mi amigo Rob Williams, creador del PSYCH-K™, un sistema de tratamiento fisiológico basado en la energía, sugiere que sería más apropiado denominarlo «efecto ideológico». Yo lo llamo «efecto de las creencias» para recalcar el hecho de que nuestras ideas y percepciones, sean acertadas o no, tienen su efecto en nuestro cuerpo y en nuestro comportamiento.
Celebro que exista el «efecto de las creencias», ya que es un testimonio extraordinario de la capacidad de sanación de la unión cuerpo-mente. No obstante, la medicina tradicional relaciona ese efecto placebo de «todo está en la mente» con curanderos, en el peor de los casos, y con pacientes débiles y sugestionables en el mejor. Las facultades médicas le han restado rápidamente importancia al efecto placebo a fin de que los estudiantes utilicen las verdaderas herramientas de la medicina moderna, como los fármacos y la cirugía.
Craso error. El efecto placebo debería ser un tema de estudio principal en todas las facultades de medicina. Creo que la educación médica debería formar doctores que reconocieran el poder de nuestros recursos interiores. Los médicos no deberían descartar el poder de la mente como algo inferior al poder de las sustancias químicas y el escalpelo.
Deberían desechar la convicción de que el cuerpo y sus componentes son estúpidos y de que necesitamos una intervención externa para conservar la salud.
La investigación del efecto placebo debería recibir importantes subvenciones. Si los investigadores médicos llegaran a averiguar cómo hacer uso del efecto placebo, los doctores dispondrían de una herramienta basada en la energía y sin efectos secundarios para tratar una enfermedad. Los sanadores energéticos dicen que ya poseen dichas herramientas, pero yo soy un científico y creo que cuanto más descubra la ciencia sobre el placebo, más oportunidades tendremos de utilizarlo en las instalaciones clínicas.
Creo que la razón de que la mente haya sido tan tajantemente descartada en medicina es el resultado, no sólo de su pensamiento dogmático, sino también de las consideraciones económicas. Si el poder de la mente puede curar las enfermedades del cuerpo, ¿por qué íbamos a ir al médico? Y más importante aún, ¿para qué íbamos a comprar medicamentos?
De hecho, descubrí hace poco que, por desgrada, las compañías farmacéuticas están estudiando a los pacientes que mejoran tras la administración de pfldoras de azúcar con la intención de eliminarlos de los ensayos clínicos iniciales. Como era de esperar, a la gran industria farmacéutica le molesta que en la mayoría de sus ensayos clínicos con placebos, los fármacos «falsos» demuestren ser tan efectivos como sus combinados químicos diseñados por ingenieros (Greenberg, 2003). Aunque las compañías farmacéuticas insisten en que su objetivo no es facilitar que se aprueben fármacos ineficaces, está claro que la eficacia de las pildoras de placebo supone una amenaza para su industria. El mensaje de las compañías farmacéuticas me parece de lo más evidente: si no puedes vencer a las pildoras de placebo, ¡limítate a eliminarlas de la competición!
Resulta irónico que a casi ningún médico se le enseñe a tener en cuenta el impacto del efecto placebo, ya que muchos historiadores dan pruebas fehacientes de que la historia de la medicina es en su mayor parte la historia del efecto placebo.
Durante la mayor parte de su historia, los médicos no disponían de métodos eficaces para combatir la enfermedad.
Algunos de los más famosos tratamientos prescritos por la medicina tradicional son las sangrías/ el tratamiento de heridas con arsénico y la legendaria panacea del aceite de serpiente de cascabel. Está claro que algunos pacientes/ los mismos que las estadísticas conservadoras cuentan entre el tercio de la población sensible al poder curativo del efecto placebo, mejorarían con esos tratamientos. Es posible que hoy en día, cuando los médicos se ponen sus batas blancas y aplican con decisión un tratamiento, los pacientes crean que el tratamiento funciona y por eso lo hacen, sea un verdadero fármaco o una pastilla de azúcar.
Aunque la cuestión de cómo funcionan los placebos haya sido obviada por la mayor parte de la profesión médica, recientemente algunos investigadores se han propuesto descubrirlo. Los resultados de sus estudios sugieren que no sólo los excéntricos tratamientos del siglo xix pueden provocar un efecto placebo, sino también los sofisticados métodos tecnológicos de la medicina moderna, entre los que se incluye la más «sólida» de las herramientas médicas, la cirugía.
Un estudio de la Facultad Médica de Baylor publicado en 2002 en la revista New England Journal of Medicine, evaluó la eficacia de la cirugía en pacientes con dolores graves y debilitantes de rodilla (Moseley, et al., 2002). El autor principal del estudio, el doctor Bruce Moseley, «sabía» que la cirugía de rodilla ayudaba a estos pacientes: «Todo buen cirujano sabe que en la cirugía no existe el efecto placebo».
Sin embargo, Moseley estaba tratando de averiguar qué parte de la cirugía provocaba la mejora en los pacientes. Los pacientes del estudio estaban divididos en tres grupos.
Moseley rebajó el cartílago dañado en uno de los grupos. En otro, limpió la articulación de la rodilla para eliminar cualquier material que pudiera estar causando la respuesta inflamatoria. Ambos tratamientos constituyen el tratamiento estándar de la artritis de rodilla. El tercer grupo recibió una «falsa» cirugía. Una vez que el paciente estaba sedado, Moseley hacía las tres incisiones de rigor y después hablaba y actuaba como solía hacerlo durante las intervenciones quirúrgicas reales.
Incluso metía las manos en suero salino para imitar el ruido producido al limpiar la articulación. Tras cuarenta minutos, Moseley cosía las incisiones como si de verdad hubiera llevado a cabo la operación. En los tres grupos se administraron los mismos cuidados posoperatorios, que incluían un programa de ejercicios.
Los resultados fueron sorprendentes. Sí, los grupos que se sometieron a una cirugía real, mejoraron, tal y como era de esperar. Pero ¡el grupo placebo mejoró tanto como los otros dos! A pesar de que se llevan a cabo seiscientas cincuenta mil operaciones de rodilla al año para mejorar la artritis, con un coste medio de unos cinco mil dólares cada una, el doctor Moseley tenía bastante claro el resultado: «Mi habilidad como
cirujano no supuso beneficio alguno en esos pacientes. Cualquier posible beneficio de la cirugía para la osteoartritis de rodilla se debió al efecto placebo». Los noticiarios de televisión ilustraron con todo detalle los asombrosos resultados.
Se mostraron imágenes de los miembros del grupo placebo andando y jugando al baloncesto, haciendo de pronto cosas que no podían hacer antes de la «cirugía». Los pacientes del grupo placebo no descubrieron que habían recibido una falsa cirugía hasta dos años después. Uno de los miembros del grupo placebo, Tim Pérez, que caminaba con la ayuda de un bastón antes de la operación, juega al baloncesto con sus nietos en la actualidad. Este hombre resumió el tema de mi libro cuando habló para el Discovery Health Channel: «Todo es posible en este mundo cuando te convences de ello. Sé que la mente puede obrar milagros».
Diferentes estudios han demostrado que el efecto placebo puede ser de lo más útil en el tratamiento de otras enfermedades, entre las que se incluyen el asma y la enfermedad de Parkinson. Los placebos son verdaderas estrellas en el tratamiento de la depresión. Tanto es así que el psiquiatra Walter Brown, de la Escuela Universitaria de Medicina de Brown, ha llegado a proponer que los placebos sean el tratamiento principal de los pacientes con casos de depresión leve o moderada (Brown, 1998). Se informaría a los pacientes de que están tomando un remedio sin principios activos, pero eso no debería disminuir la eficacia de las pastillas. Los estudios sugieren que incluso en los casos en los que los pacientes saben que no están tomando un fármaco, las pastillas de placebo siguen funcionando.
Uno de los indicios de la eficacia de los placebos aparece en un informe del Departamento de Salud y Servicios Humanos de Estados Unidos. El informe revela que la mitad de los pacientes con depresión grave que toman fármacos mejora, frente al treinta y dos por ciento de los que toman placebo (Horgan, 1999). Incluso esas impresionantes cifras pueden infravalorar el poder del efecto placebo, ya que muchos de los participantes en el estudio averiguaron que estaban tomando el fármaco auténtico porque experimentaron efectos secundarios que no sufrían los que tomaban el placebo.
Una vez que esos pacientes se dan cuenta de que están tomando el medicamento (es decir, una vez que comienzan a creer que toman el verdadero fármaco) se vuelven especialmente susceptibles al efecto placebo.
Dada la eficacia del placebo, no es de extrañar que la industria de los antidepresivos, que gana alrededor de ocho mil doscientos millones de dólares al año, sufra el ataque de los críticos que afirman que las compañías farmacéuticas exageran la eficacia de sus comprimidos. En 2002, en un artículo de la revista Prevention & Treatment de la Asociación Psicológica Norteamericana titulado Las nuevas drogas del emperador, el profesor de Psicología de la Universidad de Connecticut, Irving Kirsch, reveló que el ochenta por ciento de los efectos de los antidepresivos descubiertos en los ensayos clínicos podían atribuirse al efecto placebo (Kirsch, et al., 2002). Kirsch se vio obligado a recurrir a la Ley de Libertad de Información en 2001 para reunir información sobre los ensayos clínicos de los principales antidepresivos, ya que estosdatos no estaban disponibles en el departamento correspondiente del Departamento de Salud y Recursos Humanos. Los datos revelaban que en más de la mitad de los ensayos clínicos de los seis antidepresivos principales, los fármacos no obtenían mejores resultados que las pildoras de placebo fabricadas con azúcar. Y Kirsch resaltó en una entrevista en el Discovery Health Channel que: «La diferencia entre la respuesta a los fármacos y la del placebo era de menos de dos puntos de media en la escala clínica que va desde los cincuenta a los sesenta puntos. Eso es una diferencia muy pequeña. Es una diferencia clínicamente irrelevante».
Otro hecho interesante sobre la efectividad de los antidepresivos es que han mejorado su eficacia en los ensayos clínicos con el paso de los años, lo que sugiere que el efecto placebo es debido en parte a una avispada publicidad. Cuanto más se proclama en los medios el milagroso efecto de los antidepresivos, más eficaces se vuelven. ¡Las creencias son contagiosas!
Vivimos en una cultura en la que la gente cree que los antidepresivos funcionan, así que lo hacen.
Una diseñadora de interiores de California, Janis Schonfeid, que tomó parte en un ensayo clínico para demostrar la eficacia de Effexor en 1997, se quedó tan «asombrada» como Pérez al descubrir que había estado tomando un placebo. Las pildoras no sólo le habían mejorado la depresión que padecía desde hacía casi cuarenta años, sino que el escáner que le hicieron durante el estudio reveló que la actividad de su corteza prefrontal había aumentado de forma considerable (Leuchter, et al., 2002). Su mejora no era en absoluto algo que estuviera «sólo en su mente». Cuando la mente cambia, afecta por completo a tu biología. Schonfeid también experimentó náuseas, un efecto secundario frecuente cuando se toma Effexor. Ella es una de esos típicos pacientes que mejoran con el tratamiento placebo y después descubren que no estaban tomando el fármaco; estaba convencida de que los médicos habían cometido un error en el etiquetado, porque «sabía» que estaba tomando el fármaco. Insistió en que los investigadores volvieran a comprobar sus informes para estar absolutamente seguros de que no estaba tomando el medicamento.
Autor: Dr. Bruce H. Lipton
Extracto del libro "La Biología de la creencia".
Fuente: http://disiciencia.blogspot.com/2010/09/placebo-el-efecto-de-creer.html
Los Emociones son Señales Electromagnéticas que Afectan al Mundo por Candace Pert, Ph.D
Incluso antes de ser la responsable del departamento de la bioquímica cerebral del Nacional Institute of Health, Candace Pert hizo un descubrimiento que cambió la forma en que los científicos entienden la conexión mente-cuerpo. Encontró el receptor opiáceo; el mecanismo a través del cual una clase de químicos (los péptidos) alteran la mente y el cuerpo. Su investigación le llevó a la comprensión de cómo funcionan las emociones como sistemas regulatorios en el cuerpo. Desde el descubrimiento ella ha estado enfocándose en desarrollar un tratamiento para el SIDA usando péptidos, primero en la Universidad de GeorgeTown Medical Center y ahora como directora científica de RAPID Pharmaceutical.
Por su trabajo en las emociones, Dr. Pert fue una de las protagonistas de la película ¿Y tu que sabes? y da conferencias sobre la relación mente-cuerpo. El trabajo de Pert ha ayudado a cambiar el paradigma de “emociones como neurociencia” a “emociones como biología”. En su libro Everything You Need to Know to Feel Go (o)d –Todo lo que Necesitas Saber para Sentirte Bien/Dios- ella lleva la ciencia del sentir un paso mas allá y presenta el concepto de “emociones como física”
Las emociones, aclara Pert, no son simplemente química en el cerebro. Son señales electromagnéticas que afectan a la química y a la electricidad de cada célula del cuerpo. El estado eléctrico del cuerpo está modulado por las emociones cambiando el mundo desde dentro del cuerpo. A cambio, Pert descubre que los estados emocionales afectan al mundo fuera del cuerpo.
Le pedí a Pert que explicara como es posible que las emociones tengan ese poder. “No somos simples pedazos de carne. Estamos vibrando como un tenedor bailante, y mandamos vibraciones a la gente todo el tiempo. Emitimos y recibimos. Entonces las emociones orquestan las interacciones entre nuestros órganos y sistemas para controlar eso.”
Tal cual explica Pert en su libro anterior, “Moléculas de Emoción”, los neurotransmisores, llamados péptidos, cargan mensajes emocionales. “Tal como nuestras emociones cambian, la mezcla de péptidos, viajan a través de tu cuerpo y tu mente. Y literalmente cambian la química de cada célula en tu cuerpo.”
Esto es ciencia mainstrean –o tendencia mayoritaria- pero no explica como las emociones de una persona afectan a otra y al mundo. “Nosotros todavía pensamos en esto en términos químicos”. Se queja Pert. “Claro es química pero también física y vibración. “ Los neurotransmisores son químicos, pero tienen carga eléctrica. Las señales eléctricas de nuestra mente y cuerpo afectan la forma de cómo se comportan e interactúan las células y las funciones que realizan. Tienes receptores en cada célula del cuerpo. Son de hecho como mini bombas eléctricas. Cuando el receptor se activa por una “molécula de emoción”, el receptor pasa una carga a la célula cambiando la frecuencia eléctrica y química de la célula.” Pert dice que tal como nuestras células individuales llevan una carga eléctrica, así también en cuerpo entero como organismo. Como un campo generando electromagnetismo, Pert dice que la gente tiene una carga positiva en su cabeza y una negativa debajo. “Y así, de hecho nos mandamos varias señales eléctricas o vibraciones.”
“Los mensajes electroquimicos se pasan de una célula a otra. Señales semejantes se pasan al resto del cuerpo. Y cada una está cargada con “sitios recpetores”, una clase de buzón de correos para estos mensajeros electromagnéticos.”
“Todos estamos familiarizados con un tipo de vibración: cuando hablamos mandamos un tipo de vibración a través del aire que alguien percibe como sonido. Y tal como explico en el libro, también mandamos todo tipo de vibraciones. Es una ley básica de la Física que cuando estás cerca de una fuente de energía, tiene un efecto más grande y disminuye conforme te alejas. Pero cuando estás lejos no hay efecto.”
“No es algo que se pueda explicar en 25 palabras. Es un nuevo cambio de paradigma que básicamente te lleva a saber que no estás solo. Estás conectado a todos los demás. Y las emociones son la llave. Estamos en un despertar, cambiando ampliamente el mundo alrededor nuestro. El libro anterior de Pert, “Moléculas de Emoción” es en parte ciencia, en parte una biografía que cuenta su proceso de descubrimiento y aprendizaje.
Quizá todos los científicos que rompen un nuevo camino tiene que estar conducidos incluso obsesionados con su trabajo. “He aprendido a tener un mejor balance con mis hijos, con los tres y espero haber huido de la imagen de madre judía superprotectora”. Pert dice que su mayor reto fue llevar a la práctica las ideas sobre las que escribía. En su libro, “Todo lo que Necesitas Saber para Sentirte Bien/Dios” hace una relación implícita entre sentirte bien y conectar con Dios. Pert admite que esto es algo inusual para un científico “duro de pelar”. “Estoy enfadada con todos estos rabiosos científicos ateos que escriben libros que dicen que Dios es una ilusión. Cualquier científico bueno sabe que es imposible “desaprobar” algo. Las cosas solo se puede probar”. Aún así, Pert admite que como científico, lo metafísico le hace sentir incómoda.
“Mi ´persona científica´ es estrictamente lógica. Y por tanto, cuestiono lo supernatural. Y esa parte me hace sentir dolor agudo. Pero trabajando en la vacuna del SIDA (Pert ha desarrollado el péptido “T” contra el SIDA), los dos mundos se fusionan, mi mundo científico y ese otro donde cosas maravillosas ocurren. Es imposible pensar que mi descubrimiento fuera tan solo un accidente. El descubrimiento este es realmente increíble.
A nivel neurológico continua Pert, el sentimiento de estar conectado con Dios, de sentirse bendecido es una parte importante para el cerebro. La “bliss response” o “respuesta gozo” está directamente conectada con el trabajo de Pert sobre los receptores de opiáceos. Tal como los receptores de otros neuropéptidos desencadenan una respuesta celular, los receptores de opiáceos recogen la presencia de un neurotransmisor para la euforia. Los “químicos gozosos” que ocurren de forma natural se llaman endorfinas y son enviados por el cerebro y en el cuerpo como respuesta a los estados emocionales y a las actividades físicas.
Pert dice que la forma en como trabajan las endorfinas es evidencia del gozo como una necesidad de la evolución. “Es por eso que las endorfinas son moléculas altamente conservadas. Son los mismos en los organismos unicelulares y en los humanos. En su nuevo libro habla sobre la evolución de los receptores de opiáceos y como se encuentran situados en la corteza frontal, la parte mas evolucionada de nuestro cerebro.”
Es como si estuviésemos diseñados para hacer elecciones alrededor del placer. La parte más evolucionada e inteligente de nuestro cerebro está empapada de receptores que nos hacen utilizar el placer como criterio en las decisiones. Entonces está bien sentirse bien. Mientras está claro que los receptores del gozo está asentados en la corteza prefrontal, no esta tan claro la parte del cerebro que toma complejas decisiones. “Los científicos no pueden preguntar porque. Solo qué y como. Pero sabemos que la vibración en estos receptores median o lideran al organismo entero hacia al sentimiento de gozo. Y en el libro también hablo de cómo la vibración de las endorfinas es realmente el gozo de la unión divina.”
Así que cuando creamos ese tipo de resonancia internamente, estamos sintonizados con el ser divino. Este estado es la función natural del ser pero nuestra sociedad interfiere. No tenemos que enseñarles esto a gente indígena. La mayoría de nosotros ha perdido el sentido de la realidad. “Todo es solo cuestión de sentirse bien”.
Entrevista a Candace Pert, farmacéutica.
Fuente: http://medicinacuantica.net/?p=677#more-677
Otra entrevista sobre Psiconeuroinmunología aquí.
Crisis in Classical and Contemporary Thought
WHAT IS CLASSICAL HOMOEOPATHY?
I have been asked by my colleague, Dr. Manish Bhatia, to comment on the subject of traditional and modern methods in Homoeopathy. First of all, it is important to establish what is meant by classical and modern methods. To do this one should refer to the dictionary definitions of the terms classical or traditional methods. The true meaning of the word “classical” refers to a well established tradition with a recognized style or form or a set of procedures that follow a well known traditional pattern. Classical also refers to the period when a tradition of excellence was established such as ancient Greece or Rome. The term, “classic” is a closely related word which means something made of or belonging to the highest quality or a tradition that is established as the best. It also means something that is neat and elegant, especially a traditional style that will last irrespective of fashion and fads. The term, modern, means something that belongs to the present or recent times rather than being old or ancient. Non-classical or non-traditional refers to a system that is contemporary and has no roots in a time tested tradition recognized for its excellence.
Keeping in mind the above definitions it would become apparent that the term “classical Homoeopathy” should refer to the philosophy and praxis founded in the “classics” of the homoeopathic healing art. These classics begin with the Organon of the Healing Arts, The Chronic Diseases, and the Lesser Writings of Samuel Hahnemann. All of the methodologies that originate in these works certainly qualify as being “classical” in the true sense of the word. At the same time, the term classical refers to the period of great renaissance when our revolutionary art of healing was developed. This was the time of Samuel Hahnemann, Baron von Boenninghausen, Constantine Hering, G.H.G Jahr and the first generation. It is these individuals who developed the philosophy, recorded the first provings, wrote the first materia medicas, constructed the first repertories, and did the earliest experiments with potentized medicines.
Every established classical system is associated with certain maxims that express its core values. The four cardinal aphorisms of traditional Homoeopathy are Similars Cure Similars, the single remedy, the minimum dose and the application of the potentized remedy. These cardinal principles are then applied a number of ways that can be tailored to suit a wide variety of clinical situations. The principle of similar remedies was recognized by Hippocrates (c. 560 B.C.) showing that this method dates back to the classical age of Greece. He used a minimal amount of one medicine at a time, although his grandsons introduced “Hippocratic mixtures”. Nevertheless, the application of similar remedies was somewhat dangerous, e.g. the use of crude Helleborus in convulsions. Paracelsus (1493-1541) used single remedies by similars transmuted by alchemy but the inherent toxicity of many remedies remained. It was the perfecting of the potentized remedy by Samuel Hahnemann that opened up the use of similar medicines to general medical practice.
The use of the single remedy has been interpreted by some modern homoeopaths to mean that only one remedy should be used throughout a complete treatment. This, however, was not Hahnemann’s original intention as the single remedy refers to the administration of one, single uncompounded medicine at a time. This distinguishes Homoeopathy from systems that use mixtures common to polypharmacy. The minimal dose has been interpreted by some modern homoeopaths to refer to the small amount of the original substance found in a potentized remedy. This, however, was not Hahnemann’s original intention as the minimal dose refers the small amount of medicine contained in the homoeopathic pills. This distinguishes Homoeopathy from systems that use large amounts of medicine as a dose. The potentized remedy is the final key that opened the door of the materia medica to any substance found in the mineral, plant, and animal world. This distinguishes Homoeopathy from systems that use crude doses and chemical medicines. These cardinal principles make up a system of checks and balances that makes Homoeopathy a safe and effective healing art. Any school of practice that stays true to these cardinal principles has based their practice on classical Homoeopathy.
Hahnemann was of the opinion that the gathering of information about medicinal substances should be based on symptoms brought out in living persons. For this reason, he based his materia medica on the records of medicinal actions observed in patients in traditional medical works, over doses and poisonings, provings on healthy volunteers, and symptoms brought out in patients under treatment. All of these methods are mentioned in the aphorisms of the Organon. Each of these methods has one thing in common. They are all based on symptoms brought out in living persons rather than analysis through secondary means such as chemistry, taste, color, or the doctrine of signatures, etc. This is the most ethical and accurate method of “animal testing”.
In my study of Hahnemann’s public writings, personal letters and clinical casebooks, I have been able to document the methods used by the Founder on his patients. Certainly, the techniques that the Founder presented in his writings and used in the clinic must be considered “classical” in the true sense of the word. This includes a wide spectrum of medicinal applications such as the use of acute remedies; acute intercurrents; acute genus epidemicus remedies; chronic Gestalt remedies; chronic intercurrents; chronic anti-miasmatic genus remedies; and prophylactic medicines. Hahnemann’s clinical praxis included the use of a single remedy where one medicine was used for longer periods; the alternation of two remedies; tandem remedies where a single dose or few doses of one remedy was placed before a series of another remedy; intercurrents where one remedy was placed between the administration of another remedy; trios in which three remedies were rotated; and a series of remedies in a sequence spread out over time. All of these methods must be considered “classical” because they originate in the true classics of Homoeopathy, i.e. the written works and clinical methods of Samuel Hahnemann. This opens the applications of remedies far beyond what some consider “classical Homoeopathy”.
Today, some parties seem to have a rather narrow definition of “classical Homoeopathy” that is often associated with the term the “constitutional remedy”. This term is defined by some as the “one remedy for all situations” and others as the “one remedy for life’. Is this method truly classical in the true sense of the word or is it a modern concept? The term, constitutional remedy, was introduced by James Tyler Kent in the late 19th and early 20th century. Kent applied this term in a specific way which has nothing to do with many of its contemporary usages. For example, under the remedy, Bartya Carbonica in Lectures on Materia Medica Kent wrote:
“Bar-c. is an interesting study, because it is fully proved and a constitutional remedy. Such remedies are always more interesting than the short-acting, superficial ones. They take hold in deep-seated, longer lasting, miasmatic troubles.”
Kent’s term, the constitutional remedy, was used to make a distinction between the remedial powers of the chronic remedies that had anti-miasmic properties and shorter acting acute remedies. This concept is in complete harmony with Hahnemann’s original teachings on acute and chronic medicines.
It is important to point out that Kent’s term, constitutional remedy, has nothing to do with the idea of one remedy that treats both the acute and chronic conditions of the patient. Kent did not believe that one should use constitutional remedies in acute disorders where a crisis produced an active acute layer that suppressed chronic conditions. This teaching originates in what Hahnemann wrote in aphorism 38 of the Organon and other passages. In his Lectures on Homeopathic Philosophy, page 206, Kent states:
"This illustrates the doctrine of not prescribing for an acute and chronic trouble together. Never prescribe for any two conditions, unless they be complicated. Only chronic diseases can be complicated with each other. The acute is never complicated with the chronic; the acute suppresses the chronic and they never become complex.”
When Kent spoke of a “Calcarea Constitution” in his Lectures on Materia Medica his definition has nothing to with a particular genotype such as the classical Greek temperaments, the choleric, phlegmatic, sanguine and melancholic types. Although references to classical Greek temperaments were used by first generation homoeopaths like Hahnemann, Hering and Jahr, Kent did not approve of such titles. Kent made it clear that a “Calcarea case is to be known by the symptoms” not a constitutional mind-body type. The idea that there is one remedy for every patient for life is another modern idea that originated in the last 20 years. How many of us can show documented cases where the patient has been given the same remedy from the cradle to the grave over a period of 75 years? Nevertheless, the idea of using the deepest acting remedy over long periods in a number of different potencies is not new. One should always use as few remedies as possible not as many remedies as one can.
If one reviews all the relevant material it becomes apparent that many so-called “classical methods” are actually quite modern yet they are inspired by traditional methods. The fact that these evolutes did not originate with Hahnemann or Kent does not mean that they are invalid solely for this reason. We have to be open to the evolution of our art as long as the innovations include the cardinal checks and balances that make our system safe and effective. I have seen patients who reflected the same basic state of a particular remedy for many years. It is as if this one remedy suits them so well that it covers the deepest levels of their constitution and temperament. These cases, however, are usually fairly straightforward and not overly complicated by several divergent causes, layers of dissimilar symptoms, and complex chronic miasms.
In my experience the myriad of differing clinical situations varies far too much to be pigeonholed into one therapeutic absolute. For example, a chronic Pulsatilla patient may develop acute-like symptoms such as a bland discharge from the ears with very changeable pains. This acute-like crisis may be only an intensification of the similar symptoms of the chronic Pulsatilla state in that particular patient. Therefore, the acute-like symptoms are not strong enough to suspend the chronic state creating a true acute crisis. If the crisis becomes so severe there is the appearance of new dissimilar symptoms like convulsions with a cold body and a hot head, the patient may need an acute remedy like Helleborus, which is an acute complement of Pulsatilla. These are clinical situations that demand a differential diagnosis not absolutist theories like the one remedy for the acute and chronic state regardless of the symptoms, time and circumstances.
In some advanced chronic states with organic pathology the chronic remedy may be counter indicated because it can cause prolonged, unfruitful aggravations that increase pathology and weaken the patient. Therefore, the idea that the acute and chronic remedy may be the same is applicable in some conditions but it should not be regarded as a supreme truth that is valid in all patients at all times. There are patients in whom organic pathology becomes so advanced over the years that what was once their constitutional remedy is now counter indicated. This is why Kent said in his Lectures on Materia Medica under Kali Carbonica;
“Do not give that constitutional medicine that should have been administered to these patients twenty years ago, because there is not reaction enough in the life of the patient to turn him into order, and he will be destroyed. It seems paradoxical to say it, but to cure him is to kill him. The vital action that is necessary to restore him to health would practically tear his framework to pieces.”
When I studied the treatment of tuberculosis in 1980 with Dr. Isaac in Kerala, India there was a doctor at the hospital that believed in the exclusive use of “constitutional remedies” regardless of the nature of the symptoms or pathology. He ignored the warnings that such methods can be dangerous in serious pathological cases with compromised vital organs. He gave an advanced TB patient Lycopodium and the patient went into crisis, hemorrhaged and died. This is a perfect example of when NOT to give that constitutional remedy that a patient needed 20 years ago! Seriously ill patients often need to be treated carefully in layers with more superficially acting remedies until the organic pathology is reduced and they gain vitality. This layered treatment sometimes makes it possible to give them the constitutional remedy they may have needed 20 years ago to complete the cure. Therefore, one has to understand when it is appropriate to give deep acting chronic remedies and when it is best to treat the patient in layers stage by stage until they regain some semblance of health. Those that teach the one constitutional remedy for all situations for life should take into account these clinical realities.
A QUESTION OF BALANCE
There are some practitioners who are ultra-classical and some practitioners who are ultra-modern. On the one hand, some wish to return to what they perceive as the Golden Age of Homoeopathy and only use methods from the 1800s. They see themselves as the only persons doing pure Homoeopathy and speak as if they profess the sole true doctrine. On the other hand, there are those who scoff at anything old and only believe in new methods developed by current teachers. These persons feel that the traditional materia medica is outdated and they depend mostly on modern essences. Some proudly declare they don’t even need to use a repertory! It has been said that reading the Organon is like studying the aeronautical drawings of the Wright brothers’ plane in an age when we have already gone to the moon! Obviously, there must be a middle view that transcends these extremes and represents a point of balance that harmonizes classical and contemporary thought.
Einstein introduced the principles of nuclear physics and the theory of relativity at a time when going to the moon seemed almost impossible but the truths he elucidated helped make it achievable. Equations like E=mc2 are just as valid today as they were at the beginning of the 20th century. Hahnemann is the Einstein of Medicine in that the truths he postulated in the first half of 19th century are just as valid today as they were in his day. This is because both Einstein and Hahnemann uncovered universal principles that are part of the laws of Nature and introduced a new paradigm in their fields. Nevertheless, every generation must apply these universal truths to their respective fields and bring them up to date for their times. In this way the applications of timeless principles evolve.
Hahnemann is the Alpha of Homoeopathy not the Omega. If one studies Hahnemann’s German and French casebooks one sees Homoeopathy as an infant growing into maturity. In most of his casebooks he only used around 60 remedies and he rarely went outside his top 100 medicines. His repertories were limited to his handwritten Symptomlexicon, Jahr’s Repertory and Boenninghausen’s Repertory of Antipsoric Remedies and Repertory of Non Antipsoric Remedies. Most of the published information was limited to the 125 remedies found in the Materia Medica Pura and the Chronic Diseases. The Founder points the way to the Medicine of the Future but many are looking at his finger instead of where he is pointing. This is why Hering wrote the following in 1845.
It is the duty of all of us to go further in the theory and practice of Homœopathy than Hahnemann has done. We ought to seek the truth which is before us and forsake the errors of the past. But woe unto him who, on that account, should personally attack the author of our doctrine; he would burthen himself with infamy. Hahnemann was a great savant, inquirer, and discoverer; he was as true a man, without falsity, candid and open as a child, and inspired with pure benevolence and with a holy zeal for science.
The Chronic Diseases; S. Hahnemann (Hering’s Preface to the 1845 American edition translated by Hempel), page 9.
It is the responsibility of all to help in advancing the science of Homoeopathy in harmony with the universal principles on which it is founded. Homoeopathy is no longer Homoeopathy if the cardinal principles are removed any more than nuclear physics is still nuclear physics if Einstein’s equations are ignored. Energy and mass will be convertible as long as this universe exists just as Similars Cure Similars, the single remedy, the minimal dose and the potentized medicine are the key to homoeopathic healing. How these principles will be put into practice should evolve with every new generation of practitioners. In our times we have extensive computerized repertories and materia medicas with around 500 well proven remedies and another 500 on which we have at least some dependable information. We can search 100s of volumes in a few seconds and analyze symptoms from a number of vantage points. Homoeopathy has entered the age of information technology and the WWW, which allows homoeopaths to network worldwide in an instant. Homoeopathy has grown greatly since Hahnemann’s time and he would be amazed by our technology. Nevertheless, the vision of the healing arts found in the 4th, 5th and 6th Organon is still more advanced than any modern textbook. In fact, today’s modern homoeopaths are only using a certain percentage of the Founder’s original paradigm in the clinic. Now is time to recover all the lost teachings of Samuel Hahnemann and bring them up to date.
SYSTEMS VERSUS SYMPTOMS
There is much discussion about the three kingdoms of nature in contemporary Homoeopathy. Who was the first homoeopath to speak in terms of the mineral, plant and animal worlds? The answer is Samuel Hahnemann in The Chronic Diseases.
As a rule it was developed from their pure symptoms, that most of the earths, alkalis and acids, as well as the neutral salts composed of them, together with several of the metals, cannot be dispensed with in curing the almost innumerable symptoms of Psora. The similarity in nature of the leading antipsoric, sulphur, to phosphorus and other combustible substances from the vegetable and mineral kingdoms led to the use of the latter, and some animal substances naturally followed them by analogy, in agreement with experience.
The Chronic Diseases Their Peculiar Nature and Their Homœopathic Cure; S. Hahnemann (Theoretical Part), The Medicines, page 244.
In the above quote Hahnemann discusses the elements of the periodic table and explains how it is possible to use “analogy in agreement with experience” to uncover related properties in the plant and animal remedies. This established a system in which the symptoms of the remedies of the three kingdoms and their families can be compared. This method was taken up by Professor E. A. Farrington M.D. in his lectures at Hahnemann Medical College, which was founded by Hering.
“We are now ready to begin our study of the various drugs composing the Homoeopathic Materia Medica. For this purpose I have arranged the remedies in three grand divisions, according to the kingdom of nature from which they are derived.”
A Clinical Materia Medica, E. A. Farrington, Lecture I. page 14.
Hering so was impressed with Farrington’s knowledge of remedies that he said, “When I am gone Farrington must finish my materia medica”. It has been noted from an early period that each of the three kingdoms has its characteristic symptoms. In his lectures Dr. Farrington offers insights into the remedies of the animal world including the theme of “violence and intensity”. The great teacher wrote:
You will find, too, that these animal poisons are apt to affect the mind, especially the emotions. They arouse the lowest qualities in human nature, and produce a condition which is truly shocking. Some of them arouse the filthiest lust, the most intense anger, and passions of a kindred nature. A Clinical Materia Medica, E. A. Farrington, Lecture I1, Animal Kingdom, page 25.
In Homoeopathy and Minerals Jan Scholten develops a series of themes for the elements of the periodic table that use the method of group analysis in a creative manner. For example, Jan’s essences for the Magnesium group are Pacifism; Aggression; Fear of loss; and Pain. His essences for the Muriaticums are Self pity; Care and Nurturing; Mother; Attention; and Self-awareness. By combining the essences found in Magnesium with Muriaticum, Jan has postulated the following essential themes of Magnesium Muriaticum: Aggression leads to the loss of care from the mother; aggression is necessary to forcefully ask for care. Other combinations might include aggression to get attention or any combination of the main components. These themes are based on a synthesis of the characteristics found in the two elements that lead to a more developed picture of the composite remedy.
In Homoeopathy and the Elements Scholten further expands on his method by introducing a series of themes related to the evolution of the 7 horizontal periods and 18 vertical groups of the periodic table. By using this method of group analysis and the synthetic approach he has assigned certain symptoms to proven and unproven remedies. For a more complete understanding of Jan’s methods please refer to the original publications.
The use of the synthetic prescription is not new to Homoeopathy. For example, Dr. Clarke said, “Bar-i. has been used empirically, especially in cases of glandular enlargement and new growths, on indications suggested by its two elements”. Clarke was showing that if one has a decent understanding of Baryta and Iodium it may be possible to prescribe the remedy, Baryta Iodata. Hering offered a similar opinion about the use of remedies like Calcarea Arsenicosa. Other hints are found scattered throughout out homoeopathic literature. Nevertheless, some have questioned the very origins of this method. Where did the idea of synthetic prescribing originate?
The earliest recorded experiment of a synthetic prescription was in 1843 when Samuel Hahnemann gave Robert Everest (Casebook DF-14, page 13) Cinnabaris (Red Sulfide of Mercury) based on the combined symptoms of Mercury and Sulphur found in two rubrics in Boenninghausen’s repertory. This is a clear example of keeping one’s eyes open for the possible combination of elements while analyzing the symptoms of the patient in our reference works. This means that the synthetic method has been with Homœopathy since the beginning!
Dr. Rajan Sankaran is well known for his contributions to Homoeopathy which includes the central disturbance, core delusions, compensation, dream interpretation, etc. His more recent offerings include Insight into Plants, Volumes I and II and The Vital Sensation. His latest works introduce a new approach to the patient’s main complaint that focuses on the “vital sensation”, which is present in the symptoms of the body as well as the mind. Through the generalization of each plant family he presents what he believes to be the important sensations found throughout the entire family. At the same time, he notes which miasm is the most similar to each species found in the family in accordance with his sequence of ten miasms running from the acute to the syphilitic.
On this basis Sankaran has developed a grid of botanical medicines that is similar to the system Scholten developed for the mineral remedies. This schematic presents the vital sensations of the families and the miasms of each individual plant in a manner that is easy for cross reference. By matching the vital sensation with the corresponding miasm one may locate a plant remedy for the patient. Dr. Sankaran is now applying his new method of case taking to the mineral, plant and animal kingdom.
The methods of Scholten and Sankaran are considered by many to be the cutting edge of contemporary Homoeopathy. Nevertheless, is the new “systems approach” being used by some in such a one sided manner that it is overturning the cardinal principles of our healing art? Are unproven remedies being used in a way that lacks the consistency of the classical standard? Has the inductive reasoning of the Organon been replaced by methods that are based mostly on speculation? Hahnemann felt that the study of the natural kingdoms could provide hints about the potential use of homoeopathic remedies but he opined that provings and symptoms brought out on patients under treatment were essential to the method. In Essays on a New Principle Hahnemann wrote.
I am far from denying, however, the many important hints the natural system may afford to the philosophical student of the materia medica and to him who feels it his duty to discover new medicinal agents; but these hints can only help to confirm and serve as a commentary to facts already known, or in the case of untried plants they may give rise to hypothetical conjectures, which are, however, far from approaching even to probability.
The Lesser Writings of Samuel Hahnemann; S. Hahnemann (Dudgeon Edition), Essay on a New Principle for ascertaining the Curative Powers of Drugs, page 257.
Drs. Scholten and Sankaran are very experienced classical homoeopaths but their experimental methods are being taken up by students and practitioners new to the art. This method is being used by persons that have not yet mastered the traditional methods in a reasonable manner. They do not understand how to use the repertory or materia medica properly. They depend mostly on flow charts of essences rather than rubrics of our reference works. Others think they have found a short cut to the “highest method” and don’t really need to use the repertory. Some of these persons cannot even recognize a simple Calcarea or Arsenicum case standing right in front of them yet they are trying to use unproven and lesser known remedies by a simple two dimensional grid on paper.
Many practitioners do not have the background to understand when these experimental methods are leading in the wrong direction. In some cases the use of these new methods has become a fad or fashion, which is the antithesis of the term “classical”. When the use of the systems approach is supported by the classic methods of the repertory and materia medica the outcome may add very valuable insights. When these new methods replace the traditional techniques they lack the stability and consistency of the classical practice. The truth is that a well constructed systems approach is based on the generalizations of the symptoms approach and is not a separate system. The symptom and system approach should be used together in a balanced and practical fashion.
THE GESTALT OF THE DISEASE
Homœopathy is based on a Gestalt philosophy in which the whole is more than the sum of its parts. This holistic awareness is at the root of the philosophy that makes up the background for Samuel Hahnemann’s world view. For example, it is impossible to locate an object in space with just one vector. It takes at least three vectors to easily pinpoint an object’s position. That is why Hering said that we have to have at least three good characteristic symptoms to find a remedy. This idea is at the base of Hering’s famous “three legged stool”.
Is there any phenomenon in nature where one essential part is more important than the whole? Doesn’t an atom have electrons, neutrons and protons as well as quarks? Aren’t the elements of the periodic table made up of atoms and molecules in different combinations? Is an electron more important than a proton or neutron? Isn’t the universe based on gravity, weak nuclear forces, strong nuclear forces and electromagnetism as well as time and space? Is gravity more important than electromagnetism or strong nuclear forces more important than weak nuclear forces? Is time more important than space?
Aren’t plants made up of several compounds not one essential substance? Can the properties of any one compound act totally independent of the other compounds? Isn’t it apparent that nature is based on interdependent synergies that work together to make a whole, not on one “essential unit” that one can call absolute? The Newtonian idea that there is a permanent atom at the base of all energy is totally obsolete! Modern physics is a Gestalt science not a reductionist model in which one factor is held supreme. There are essential qualities that come together to make up a phenomenon but there is no one factor that is greater than the whole.
One cannot “see” the transcendental Esse (Gr. Wesen) but one can become aware of its activities through its Gestalt-pattern, which manifests as a total field of phenomena. In the same way, the totality of the signs, befallments and symptoms are the “outwardly reflected image of the inner Wesen of the disease, that is, of the suffering of the life force”. Hahnemann made this clear in the Organon and The Chronic Diseases. This is why Hahnemann said that one symptom is no more the disease state than one foot makes a human being. No one essence, theme or sensation can express all the potential variations of the whole all of the time under every circumstance. It is merely one facet that may be important at the moment but there are always other facets that are equally important at other times. This is true whether one is treating a particular patient or studying the essential nature of any given group or species.
It has become a cliché to say things like “In Homœopathy it doesn’t matter why - one only needs to know what”. Is this really true? Knowledge of causation and observation of synchronicity and circumstance doesn’t matter? Can the single question, “What? What? What?” really replace the six other essential questions: Who? Where? Why? What with? What mode? When? Hahnemann taught that the basis of case taking is causa, miasms, signs, befallments and symptoms of the body and soul with their attending circumstances. He was the first to use locations, sensations, modifications and concomitants as a guide to selecting remedies. Then Boenninghausen pointed out that a complete symptom is composed of these four segments because they make up one complete facet of the disease. Can a complete symptom be made out of a main complaint alone? Can a complete case be made out of a sensation alone? Can a complete case be made without a modality? Can a complete case be made without any concomitants? I think we know what Hahnemann and Boenninghausen would say about this!
Hahnemann taught that the emotional state is so important that it “often tips the scales in the selection of the homœopathic remedy.” This statement does not say the emotional state “always” tips the scales in the selection of the remedy. Turning “often” into the word “always” is a mistake made by the mind-only school. A mental symptom may tip the balance but it still does not make up the whole case. There are no absolutes in our relative world. An unusual “sensation as if” can be just as important as any mental symptom and an unusual mental symptom can be just as important as any sensation. A change in the psyche, sensations or functions according to time and circumstances can all be equally important. I personally was never of the opinion that a striking, unusual characteristic symptom of the body was inferior to a striking, unusual characteristic symptom of the mind. I judge the characteristic value of a symptom by its striking, extraordinary, unusual and odd qualities not by whether it originated in the body, on the vital plane or in the psyche.
When consciousness shifts energy shifts. When energy shifts then consciousness shifts. This is the nature of the Unconscious, which is the realm of dynamic archetypes. This is the level of non-linear synchronisms which have a deeper symbolic meaning. This is the plane that connects the name “Pulsatilla” with the mythological “tears of Venus” in a manner that one cannot logically explain! At the same time, the habitat and growth factors of the “Windflower” also provides clues about the remedy. This archetypal awareness is the great gift of the late, great Dr. Whitmont, who was a Jungian psychiatrist and classical homoeopath. In the final analysis linear causation and non-linear synchronisms are also complementary opposites that make up a whole which is more than the sum of its parts. All of this material is equally valuable depending on the time and circumstances.
Reductionism moves in the opposite direction of the Gestalt philosophy on which Hahnemannian Homœopathy is based. Some persons are so fixed on reducing cases to one mental essence, delusion, sensation and miasm with their keynotes and flow charts that they miss the forest for the trees. They are trying to prematurely narrow the symptoms before opening them up with the repertory and materia medica. They look only at two vectors (the horizontal and vertical) on a two dimensional grid without balancing this view with the “depth vector” provided by the repertory and materia medica. Patients, diseases and remedies are multi-dimensional phenomena that cannot be reduced to two dimensions on paper.
Those that think the repertory is only a “numerical system” do not understand how to use the repertory properly. No well trained homœopath goes by the numbers! A well trained homœopath builds images by uniting combinations of symptom segments that reflect the greater disease Gestalt until it produces a hologram with height, width and depth. The truth is that the repertory is the best medium for artistically combining individual symptom segments in such a manner that the collection is a multi-dimensional mirror image of the portrait of the disease.
The repertory is designed to allow one to collect facets of a greater Gestalt-pattern as represented by the characteristic symptoms and assemble them in combinations that may have never been seen before and that may never be seen again. That is the beauty of the open system view of the repertory that no “system based method” can replace! The repertory has the potential to combine symptom segments in an inconceivable number of combinations that represent the potential of the remedy even if that exact combination is not found in the materia medica. Once a unique picture has been constructed one reviews the materia medica to see which remedy has the potential to remove these symptoms. This is what Boenninghausen discovered when he developed the Therapeutic Pocket Book. Since that time the repertory is no longer just a simple index to the symptoms found in the materia medica. The repertory is an open tool that allows for maximum customization of an almost infinite variety of symptom segments allowing the most precise individualization. Although the repertory is not easy to learn, once it has been mastered it will provide information not found in any essence based system with their flow charts.
All cases present themselves in a unique manner and they require a customized case taking method. Some patients present clear causative rubrics related to a never-well-since syndrome found under a particular group of remedies. Some patients present clear constitutional portraits of remedies found in the materia medica and its commentaries. Some patients demonstrate clear redline, keynote characteristics found almost word for word in our materia medica. Some patients offer clear mental symptoms that lead to a well chosen remedy. Some patients present a main complaint that carries characteristic particularizations with sensations and modalities found only in a few remedies. Some patients present non-logical concomitant symptoms that have little to do with the main complaint that lead directly to the curative remedy. Some patients present pieces and fragments of symptoms that must be collected to make up complete symptoms leading to the remedy. Some patients may present a grand sensation that runs through all their symptoms that can be confirmed by the concomitant symptoms. Some cases may fit the symptoms method while others might suit the systems method better. Some are best solved with a combination of these methods. In all of these cases the essential nature of the totality of the symptoms offers the confirmatory signs necessary to prescribe a simillimum consistently. No one case taking method, no one mental symptom and no one sensation can stand in isolation from the total field of the symptoms represented by the Gestalt of the disease.
I support the study of the symptoms of the mineral, plant and animal families and their individual remedies. I was inspired to review remedy families by Hahnemann, E. A. Farrington, H. Farrington, E. Whitmont and M. L. Dhawale early in my career. I also appreciate the material on this subject offered by modern researchers like Dr. Scholten and Dr. Sankaran. Nevertheless, when I review the “essences” offered in the group studies I always see other equally valid threads that are not included. Our remedies are too multi-dimensional to be reduced to one simple essence that represents the whole potential of the medicine at al times under all circumstances.
I base my family studies on generalizing the similar symptoms of a family and cross referencing the differential symptoms and miasms found in particular remedies. Then I enhance this data by analogy in accordance with experience, which may include archetypes, mythologems, the source of the remedy, habitat, etc. I always review the symptoms of a family from a number of different angles so I gain an understanding of its multifaceted nature to avoid reductionism that may lead to stereotyping. I call on everyone who is interested in the genus method to study remedy families carefully and review the symptoms for themselves rather than rely on any one individual for all their information. In this way, the field of symptoms will be expanded by a group of peers and those rubrics which are confirmed by many can be taken as true characteristics.
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 Homœopathic 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 Homœopathy. In aphorism 108 of this work Jahr wrote:
Ҥ108. 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”.
Homœopathy 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 homœopathic 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.
1. True medical art is that cogitative pursuit which devolves upon the higher human spirit, free deliberation, and the selecting intellect, which decides according to well-founded reasons.
2. It does so in order to differently tune the instinctual (intellect- and awareness-lacking) automatic and energic life force when the life force has been mistuned, through disease, to abnormal activity.
3. It differently tunes the life force by means of an affection similar to that of the disease, engendered by a medicine that has been homeopathically selected.
4. By means of this medicine, the life force is rendered medicinally sick to such a degree (in fact to a somewhat higher degree) that the natural affection can no longer work on the life force.
5. In this way, the life force becomes rid of the natural disease, remaining occupied solely with the so similar, somewhat stronger medicinal disease-affection against which the life force now directs its whole energy and which it soon overcomes.
6. The life force thereby becomes free and able again to return to the norm of health and to its actual intended purpose: that of enlivening and sustaining the healthy organism.
7. It can do this without having suffered painful or debilitating attacks by this transformation.
Organon of the Medical Art; S. Hahnemann (OReilly 6th Edition), Introduction, page 37-38.
In homoeopathic healing the stronger temporary remedial disease replaces the sensation of the natural disease in the vital force. This is the role of the primary action of a homoeopathic remedy elucidated in point 4. Then Hahnemann states that "the life force now directs its whole energy" against the medicinal disease "which it soon overcomes”. This is the role of the secondary, curative action of the vital force elucidated in point 5. This healing process takes place without the loss of humors and sacrifices of tissue associated with crisis. Hahnemann further expands on the nature of primary and secondary actions in the main aphorisms of the Organon. Vide aphorism 64.
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
Author: David Little
Source: http://www.simillimum.com/education/little-library/homoeopathic-philosophy/ccct/article.php
I have been asked by my colleague, Dr. Manish Bhatia, to comment on the subject of traditional and modern methods in Homoeopathy. First of all, it is important to establish what is meant by classical and modern methods. To do this one should refer to the dictionary definitions of the terms classical or traditional methods. The true meaning of the word “classical” refers to a well established tradition with a recognized style or form or a set of procedures that follow a well known traditional pattern. Classical also refers to the period when a tradition of excellence was established such as ancient Greece or Rome. The term, “classic” is a closely related word which means something made of or belonging to the highest quality or a tradition that is established as the best. It also means something that is neat and elegant, especially a traditional style that will last irrespective of fashion and fads. The term, modern, means something that belongs to the present or recent times rather than being old or ancient. Non-classical or non-traditional refers to a system that is contemporary and has no roots in a time tested tradition recognized for its excellence.
Keeping in mind the above definitions it would become apparent that the term “classical Homoeopathy” should refer to the philosophy and praxis founded in the “classics” of the homoeopathic healing art. These classics begin with the Organon of the Healing Arts, The Chronic Diseases, and the Lesser Writings of Samuel Hahnemann. All of the methodologies that originate in these works certainly qualify as being “classical” in the true sense of the word. At the same time, the term classical refers to the period of great renaissance when our revolutionary art of healing was developed. This was the time of Samuel Hahnemann, Baron von Boenninghausen, Constantine Hering, G.H.G Jahr and the first generation. It is these individuals who developed the philosophy, recorded the first provings, wrote the first materia medicas, constructed the first repertories, and did the earliest experiments with potentized medicines.
Every established classical system is associated with certain maxims that express its core values. The four cardinal aphorisms of traditional Homoeopathy are Similars Cure Similars, the single remedy, the minimum dose and the application of the potentized remedy. These cardinal principles are then applied a number of ways that can be tailored to suit a wide variety of clinical situations. The principle of similar remedies was recognized by Hippocrates (c. 560 B.C.) showing that this method dates back to the classical age of Greece. He used a minimal amount of one medicine at a time, although his grandsons introduced “Hippocratic mixtures”. Nevertheless, the application of similar remedies was somewhat dangerous, e.g. the use of crude Helleborus in convulsions. Paracelsus (1493-1541) used single remedies by similars transmuted by alchemy but the inherent toxicity of many remedies remained. It was the perfecting of the potentized remedy by Samuel Hahnemann that opened up the use of similar medicines to general medical practice.
The use of the single remedy has been interpreted by some modern homoeopaths to mean that only one remedy should be used throughout a complete treatment. This, however, was not Hahnemann’s original intention as the single remedy refers to the administration of one, single uncompounded medicine at a time. This distinguishes Homoeopathy from systems that use mixtures common to polypharmacy. The minimal dose has been interpreted by some modern homoeopaths to refer to the small amount of the original substance found in a potentized remedy. This, however, was not Hahnemann’s original intention as the minimal dose refers the small amount of medicine contained in the homoeopathic pills. This distinguishes Homoeopathy from systems that use large amounts of medicine as a dose. The potentized remedy is the final key that opened the door of the materia medica to any substance found in the mineral, plant, and animal world. This distinguishes Homoeopathy from systems that use crude doses and chemical medicines. These cardinal principles make up a system of checks and balances that makes Homoeopathy a safe and effective healing art. Any school of practice that stays true to these cardinal principles has based their practice on classical Homoeopathy.
Hahnemann was of the opinion that the gathering of information about medicinal substances should be based on symptoms brought out in living persons. For this reason, he based his materia medica on the records of medicinal actions observed in patients in traditional medical works, over doses and poisonings, provings on healthy volunteers, and symptoms brought out in patients under treatment. All of these methods are mentioned in the aphorisms of the Organon. Each of these methods has one thing in common. They are all based on symptoms brought out in living persons rather than analysis through secondary means such as chemistry, taste, color, or the doctrine of signatures, etc. This is the most ethical and accurate method of “animal testing”.
In my study of Hahnemann’s public writings, personal letters and clinical casebooks, I have been able to document the methods used by the Founder on his patients. Certainly, the techniques that the Founder presented in his writings and used in the clinic must be considered “classical” in the true sense of the word. This includes a wide spectrum of medicinal applications such as the use of acute remedies; acute intercurrents; acute genus epidemicus remedies; chronic Gestalt remedies; chronic intercurrents; chronic anti-miasmatic genus remedies; and prophylactic medicines. Hahnemann’s clinical praxis included the use of a single remedy where one medicine was used for longer periods; the alternation of two remedies; tandem remedies where a single dose or few doses of one remedy was placed before a series of another remedy; intercurrents where one remedy was placed between the administration of another remedy; trios in which three remedies were rotated; and a series of remedies in a sequence spread out over time. All of these methods must be considered “classical” because they originate in the true classics of Homoeopathy, i.e. the written works and clinical methods of Samuel Hahnemann. This opens the applications of remedies far beyond what some consider “classical Homoeopathy”.
Today, some parties seem to have a rather narrow definition of “classical Homoeopathy” that is often associated with the term the “constitutional remedy”. This term is defined by some as the “one remedy for all situations” and others as the “one remedy for life’. Is this method truly classical in the true sense of the word or is it a modern concept? The term, constitutional remedy, was introduced by James Tyler Kent in the late 19th and early 20th century. Kent applied this term in a specific way which has nothing to do with many of its contemporary usages. For example, under the remedy, Bartya Carbonica in Lectures on Materia Medica Kent wrote:
“Bar-c. is an interesting study, because it is fully proved and a constitutional remedy. Such remedies are always more interesting than the short-acting, superficial ones. They take hold in deep-seated, longer lasting, miasmatic troubles.”
Kent’s term, the constitutional remedy, was used to make a distinction between the remedial powers of the chronic remedies that had anti-miasmic properties and shorter acting acute remedies. This concept is in complete harmony with Hahnemann’s original teachings on acute and chronic medicines.
It is important to point out that Kent’s term, constitutional remedy, has nothing to do with the idea of one remedy that treats both the acute and chronic conditions of the patient. Kent did not believe that one should use constitutional remedies in acute disorders where a crisis produced an active acute layer that suppressed chronic conditions. This teaching originates in what Hahnemann wrote in aphorism 38 of the Organon and other passages. In his Lectures on Homeopathic Philosophy, page 206, Kent states:
"This illustrates the doctrine of not prescribing for an acute and chronic trouble together. Never prescribe for any two conditions, unless they be complicated. Only chronic diseases can be complicated with each other. The acute is never complicated with the chronic; the acute suppresses the chronic and they never become complex.”
When Kent spoke of a “Calcarea Constitution” in his Lectures on Materia Medica his definition has nothing to with a particular genotype such as the classical Greek temperaments, the choleric, phlegmatic, sanguine and melancholic types. Although references to classical Greek temperaments were used by first generation homoeopaths like Hahnemann, Hering and Jahr, Kent did not approve of such titles. Kent made it clear that a “Calcarea case is to be known by the symptoms” not a constitutional mind-body type. The idea that there is one remedy for every patient for life is another modern idea that originated in the last 20 years. How many of us can show documented cases where the patient has been given the same remedy from the cradle to the grave over a period of 75 years? Nevertheless, the idea of using the deepest acting remedy over long periods in a number of different potencies is not new. One should always use as few remedies as possible not as many remedies as one can.
If one reviews all the relevant material it becomes apparent that many so-called “classical methods” are actually quite modern yet they are inspired by traditional methods. The fact that these evolutes did not originate with Hahnemann or Kent does not mean that they are invalid solely for this reason. We have to be open to the evolution of our art as long as the innovations include the cardinal checks and balances that make our system safe and effective. I have seen patients who reflected the same basic state of a particular remedy for many years. It is as if this one remedy suits them so well that it covers the deepest levels of their constitution and temperament. These cases, however, are usually fairly straightforward and not overly complicated by several divergent causes, layers of dissimilar symptoms, and complex chronic miasms.
In my experience the myriad of differing clinical situations varies far too much to be pigeonholed into one therapeutic absolute. For example, a chronic Pulsatilla patient may develop acute-like symptoms such as a bland discharge from the ears with very changeable pains. This acute-like crisis may be only an intensification of the similar symptoms of the chronic Pulsatilla state in that particular patient. Therefore, the acute-like symptoms are not strong enough to suspend the chronic state creating a true acute crisis. If the crisis becomes so severe there is the appearance of new dissimilar symptoms like convulsions with a cold body and a hot head, the patient may need an acute remedy like Helleborus, which is an acute complement of Pulsatilla. These are clinical situations that demand a differential diagnosis not absolutist theories like the one remedy for the acute and chronic state regardless of the symptoms, time and circumstances.
In some advanced chronic states with organic pathology the chronic remedy may be counter indicated because it can cause prolonged, unfruitful aggravations that increase pathology and weaken the patient. Therefore, the idea that the acute and chronic remedy may be the same is applicable in some conditions but it should not be regarded as a supreme truth that is valid in all patients at all times. There are patients in whom organic pathology becomes so advanced over the years that what was once their constitutional remedy is now counter indicated. This is why Kent said in his Lectures on Materia Medica under Kali Carbonica;
“Do not give that constitutional medicine that should have been administered to these patients twenty years ago, because there is not reaction enough in the life of the patient to turn him into order, and he will be destroyed. It seems paradoxical to say it, but to cure him is to kill him. The vital action that is necessary to restore him to health would practically tear his framework to pieces.”
When I studied the treatment of tuberculosis in 1980 with Dr. Isaac in Kerala, India there was a doctor at the hospital that believed in the exclusive use of “constitutional remedies” regardless of the nature of the symptoms or pathology. He ignored the warnings that such methods can be dangerous in serious pathological cases with compromised vital organs. He gave an advanced TB patient Lycopodium and the patient went into crisis, hemorrhaged and died. This is a perfect example of when NOT to give that constitutional remedy that a patient needed 20 years ago! Seriously ill patients often need to be treated carefully in layers with more superficially acting remedies until the organic pathology is reduced and they gain vitality. This layered treatment sometimes makes it possible to give them the constitutional remedy they may have needed 20 years ago to complete the cure. Therefore, one has to understand when it is appropriate to give deep acting chronic remedies and when it is best to treat the patient in layers stage by stage until they regain some semblance of health. Those that teach the one constitutional remedy for all situations for life should take into account these clinical realities.
A QUESTION OF BALANCE
There are some practitioners who are ultra-classical and some practitioners who are ultra-modern. On the one hand, some wish to return to what they perceive as the Golden Age of Homoeopathy and only use methods from the 1800s. They see themselves as the only persons doing pure Homoeopathy and speak as if they profess the sole true doctrine. On the other hand, there are those who scoff at anything old and only believe in new methods developed by current teachers. These persons feel that the traditional materia medica is outdated and they depend mostly on modern essences. Some proudly declare they don’t even need to use a repertory! It has been said that reading the Organon is like studying the aeronautical drawings of the Wright brothers’ plane in an age when we have already gone to the moon! Obviously, there must be a middle view that transcends these extremes and represents a point of balance that harmonizes classical and contemporary thought.
Einstein introduced the principles of nuclear physics and the theory of relativity at a time when going to the moon seemed almost impossible but the truths he elucidated helped make it achievable. Equations like E=mc2 are just as valid today as they were at the beginning of the 20th century. Hahnemann is the Einstein of Medicine in that the truths he postulated in the first half of 19th century are just as valid today as they were in his day. This is because both Einstein and Hahnemann uncovered universal principles that are part of the laws of Nature and introduced a new paradigm in their fields. Nevertheless, every generation must apply these universal truths to their respective fields and bring them up to date for their times. In this way the applications of timeless principles evolve.
Hahnemann is the Alpha of Homoeopathy not the Omega. If one studies Hahnemann’s German and French casebooks one sees Homoeopathy as an infant growing into maturity. In most of his casebooks he only used around 60 remedies and he rarely went outside his top 100 medicines. His repertories were limited to his handwritten Symptomlexicon, Jahr’s Repertory and Boenninghausen’s Repertory of Antipsoric Remedies and Repertory of Non Antipsoric Remedies. Most of the published information was limited to the 125 remedies found in the Materia Medica Pura and the Chronic Diseases. The Founder points the way to the Medicine of the Future but many are looking at his finger instead of where he is pointing. This is why Hering wrote the following in 1845.
It is the duty of all of us to go further in the theory and practice of Homœopathy than Hahnemann has done. We ought to seek the truth which is before us and forsake the errors of the past. But woe unto him who, on that account, should personally attack the author of our doctrine; he would burthen himself with infamy. Hahnemann was a great savant, inquirer, and discoverer; he was as true a man, without falsity, candid and open as a child, and inspired with pure benevolence and with a holy zeal for science.
The Chronic Diseases; S. Hahnemann (Hering’s Preface to the 1845 American edition translated by Hempel), page 9.
It is the responsibility of all to help in advancing the science of Homoeopathy in harmony with the universal principles on which it is founded. Homoeopathy is no longer Homoeopathy if the cardinal principles are removed any more than nuclear physics is still nuclear physics if Einstein’s equations are ignored. Energy and mass will be convertible as long as this universe exists just as Similars Cure Similars, the single remedy, the minimal dose and the potentized medicine are the key to homoeopathic healing. How these principles will be put into practice should evolve with every new generation of practitioners. In our times we have extensive computerized repertories and materia medicas with around 500 well proven remedies and another 500 on which we have at least some dependable information. We can search 100s of volumes in a few seconds and analyze symptoms from a number of vantage points. Homoeopathy has entered the age of information technology and the WWW, which allows homoeopaths to network worldwide in an instant. Homoeopathy has grown greatly since Hahnemann’s time and he would be amazed by our technology. Nevertheless, the vision of the healing arts found in the 4th, 5th and 6th Organon is still more advanced than any modern textbook. In fact, today’s modern homoeopaths are only using a certain percentage of the Founder’s original paradigm in the clinic. Now is time to recover all the lost teachings of Samuel Hahnemann and bring them up to date.
SYSTEMS VERSUS SYMPTOMS
There is much discussion about the three kingdoms of nature in contemporary Homoeopathy. Who was the first homoeopath to speak in terms of the mineral, plant and animal worlds? The answer is Samuel Hahnemann in The Chronic Diseases.
As a rule it was developed from their pure symptoms, that most of the earths, alkalis and acids, as well as the neutral salts composed of them, together with several of the metals, cannot be dispensed with in curing the almost innumerable symptoms of Psora. The similarity in nature of the leading antipsoric, sulphur, to phosphorus and other combustible substances from the vegetable and mineral kingdoms led to the use of the latter, and some animal substances naturally followed them by analogy, in agreement with experience.
The Chronic Diseases Their Peculiar Nature and Their Homœopathic Cure; S. Hahnemann (Theoretical Part), The Medicines, page 244.
In the above quote Hahnemann discusses the elements of the periodic table and explains how it is possible to use “analogy in agreement with experience” to uncover related properties in the plant and animal remedies. This established a system in which the symptoms of the remedies of the three kingdoms and their families can be compared. This method was taken up by Professor E. A. Farrington M.D. in his lectures at Hahnemann Medical College, which was founded by Hering.
“We are now ready to begin our study of the various drugs composing the Homoeopathic Materia Medica. For this purpose I have arranged the remedies in three grand divisions, according to the kingdom of nature from which they are derived.”
A Clinical Materia Medica, E. A. Farrington, Lecture I. page 14.
Hering so was impressed with Farrington’s knowledge of remedies that he said, “When I am gone Farrington must finish my materia medica”. It has been noted from an early period that each of the three kingdoms has its characteristic symptoms. In his lectures Dr. Farrington offers insights into the remedies of the animal world including the theme of “violence and intensity”. The great teacher wrote:
You will find, too, that these animal poisons are apt to affect the mind, especially the emotions. They arouse the lowest qualities in human nature, and produce a condition which is truly shocking. Some of them arouse the filthiest lust, the most intense anger, and passions of a kindred nature. A Clinical Materia Medica, E. A. Farrington, Lecture I1, Animal Kingdom, page 25.
In Homoeopathy and Minerals Jan Scholten develops a series of themes for the elements of the periodic table that use the method of group analysis in a creative manner. For example, Jan’s essences for the Magnesium group are Pacifism; Aggression; Fear of loss; and Pain. His essences for the Muriaticums are Self pity; Care and Nurturing; Mother; Attention; and Self-awareness. By combining the essences found in Magnesium with Muriaticum, Jan has postulated the following essential themes of Magnesium Muriaticum: Aggression leads to the loss of care from the mother; aggression is necessary to forcefully ask for care. Other combinations might include aggression to get attention or any combination of the main components. These themes are based on a synthesis of the characteristics found in the two elements that lead to a more developed picture of the composite remedy.
In Homoeopathy and the Elements Scholten further expands on his method by introducing a series of themes related to the evolution of the 7 horizontal periods and 18 vertical groups of the periodic table. By using this method of group analysis and the synthetic approach he has assigned certain symptoms to proven and unproven remedies. For a more complete understanding of Jan’s methods please refer to the original publications.
The use of the synthetic prescription is not new to Homoeopathy. For example, Dr. Clarke said, “Bar-i. has been used empirically, especially in cases of glandular enlargement and new growths, on indications suggested by its two elements”. Clarke was showing that if one has a decent understanding of Baryta and Iodium it may be possible to prescribe the remedy, Baryta Iodata. Hering offered a similar opinion about the use of remedies like Calcarea Arsenicosa. Other hints are found scattered throughout out homoeopathic literature. Nevertheless, some have questioned the very origins of this method. Where did the idea of synthetic prescribing originate?
The earliest recorded experiment of a synthetic prescription was in 1843 when Samuel Hahnemann gave Robert Everest (Casebook DF-14, page 13) Cinnabaris (Red Sulfide of Mercury) based on the combined symptoms of Mercury and Sulphur found in two rubrics in Boenninghausen’s repertory. This is a clear example of keeping one’s eyes open for the possible combination of elements while analyzing the symptoms of the patient in our reference works. This means that the synthetic method has been with Homœopathy since the beginning!
Dr. Rajan Sankaran is well known for his contributions to Homoeopathy which includes the central disturbance, core delusions, compensation, dream interpretation, etc. His more recent offerings include Insight into Plants, Volumes I and II and The Vital Sensation. His latest works introduce a new approach to the patient’s main complaint that focuses on the “vital sensation”, which is present in the symptoms of the body as well as the mind. Through the generalization of each plant family he presents what he believes to be the important sensations found throughout the entire family. At the same time, he notes which miasm is the most similar to each species found in the family in accordance with his sequence of ten miasms running from the acute to the syphilitic.
On this basis Sankaran has developed a grid of botanical medicines that is similar to the system Scholten developed for the mineral remedies. This schematic presents the vital sensations of the families and the miasms of each individual plant in a manner that is easy for cross reference. By matching the vital sensation with the corresponding miasm one may locate a plant remedy for the patient. Dr. Sankaran is now applying his new method of case taking to the mineral, plant and animal kingdom.
The methods of Scholten and Sankaran are considered by many to be the cutting edge of contemporary Homoeopathy. Nevertheless, is the new “systems approach” being used by some in such a one sided manner that it is overturning the cardinal principles of our healing art? Are unproven remedies being used in a way that lacks the consistency of the classical standard? Has the inductive reasoning of the Organon been replaced by methods that are based mostly on speculation? Hahnemann felt that the study of the natural kingdoms could provide hints about the potential use of homoeopathic remedies but he opined that provings and symptoms brought out on patients under treatment were essential to the method. In Essays on a New Principle Hahnemann wrote.
I am far from denying, however, the many important hints the natural system may afford to the philosophical student of the materia medica and to him who feels it his duty to discover new medicinal agents; but these hints can only help to confirm and serve as a commentary to facts already known, or in the case of untried plants they may give rise to hypothetical conjectures, which are, however, far from approaching even to probability.
The Lesser Writings of Samuel Hahnemann; S. Hahnemann (Dudgeon Edition), Essay on a New Principle for ascertaining the Curative Powers of Drugs, page 257.
Drs. Scholten and Sankaran are very experienced classical homoeopaths but their experimental methods are being taken up by students and practitioners new to the art. This method is being used by persons that have not yet mastered the traditional methods in a reasonable manner. They do not understand how to use the repertory or materia medica properly. They depend mostly on flow charts of essences rather than rubrics of our reference works. Others think they have found a short cut to the “highest method” and don’t really need to use the repertory. Some of these persons cannot even recognize a simple Calcarea or Arsenicum case standing right in front of them yet they are trying to use unproven and lesser known remedies by a simple two dimensional grid on paper.
Many practitioners do not have the background to understand when these experimental methods are leading in the wrong direction. In some cases the use of these new methods has become a fad or fashion, which is the antithesis of the term “classical”. When the use of the systems approach is supported by the classic methods of the repertory and materia medica the outcome may add very valuable insights. When these new methods replace the traditional techniques they lack the stability and consistency of the classical practice. The truth is that a well constructed systems approach is based on the generalizations of the symptoms approach and is not a separate system. The symptom and system approach should be used together in a balanced and practical fashion.
THE GESTALT OF THE DISEASE
Homœopathy is based on a Gestalt philosophy in which the whole is more than the sum of its parts. This holistic awareness is at the root of the philosophy that makes up the background for Samuel Hahnemann’s world view. For example, it is impossible to locate an object in space with just one vector. It takes at least three vectors to easily pinpoint an object’s position. That is why Hering said that we have to have at least three good characteristic symptoms to find a remedy. This idea is at the base of Hering’s famous “three legged stool”.
Is there any phenomenon in nature where one essential part is more important than the whole? Doesn’t an atom have electrons, neutrons and protons as well as quarks? Aren’t the elements of the periodic table made up of atoms and molecules in different combinations? Is an electron more important than a proton or neutron? Isn’t the universe based on gravity, weak nuclear forces, strong nuclear forces and electromagnetism as well as time and space? Is gravity more important than electromagnetism or strong nuclear forces more important than weak nuclear forces? Is time more important than space?
Aren’t plants made up of several compounds not one essential substance? Can the properties of any one compound act totally independent of the other compounds? Isn’t it apparent that nature is based on interdependent synergies that work together to make a whole, not on one “essential unit” that one can call absolute? The Newtonian idea that there is a permanent atom at the base of all energy is totally obsolete! Modern physics is a Gestalt science not a reductionist model in which one factor is held supreme. There are essential qualities that come together to make up a phenomenon but there is no one factor that is greater than the whole.
One cannot “see” the transcendental Esse (Gr. Wesen) but one can become aware of its activities through its Gestalt-pattern, which manifests as a total field of phenomena. In the same way, the totality of the signs, befallments and symptoms are the “outwardly reflected image of the inner Wesen of the disease, that is, of the suffering of the life force”. Hahnemann made this clear in the Organon and The Chronic Diseases. This is why Hahnemann said that one symptom is no more the disease state than one foot makes a human being. No one essence, theme or sensation can express all the potential variations of the whole all of the time under every circumstance. It is merely one facet that may be important at the moment but there are always other facets that are equally important at other times. This is true whether one is treating a particular patient or studying the essential nature of any given group or species.
It has become a cliché to say things like “In Homœopathy it doesn’t matter why - one only needs to know what”. Is this really true? Knowledge of causation and observation of synchronicity and circumstance doesn’t matter? Can the single question, “What? What? What?” really replace the six other essential questions: Who? Where? Why? What with? What mode? When? Hahnemann taught that the basis of case taking is causa, miasms, signs, befallments and symptoms of the body and soul with their attending circumstances. He was the first to use locations, sensations, modifications and concomitants as a guide to selecting remedies. Then Boenninghausen pointed out that a complete symptom is composed of these four segments because they make up one complete facet of the disease. Can a complete symptom be made out of a main complaint alone? Can a complete case be made out of a sensation alone? Can a complete case be made without a modality? Can a complete case be made without any concomitants? I think we know what Hahnemann and Boenninghausen would say about this!
Hahnemann taught that the emotional state is so important that it “often tips the scales in the selection of the homœopathic remedy.” This statement does not say the emotional state “always” tips the scales in the selection of the remedy. Turning “often” into the word “always” is a mistake made by the mind-only school. A mental symptom may tip the balance but it still does not make up the whole case. There are no absolutes in our relative world. An unusual “sensation as if” can be just as important as any mental symptom and an unusual mental symptom can be just as important as any sensation. A change in the psyche, sensations or functions according to time and circumstances can all be equally important. I personally was never of the opinion that a striking, unusual characteristic symptom of the body was inferior to a striking, unusual characteristic symptom of the mind. I judge the characteristic value of a symptom by its striking, extraordinary, unusual and odd qualities not by whether it originated in the body, on the vital plane or in the psyche.
When consciousness shifts energy shifts. When energy shifts then consciousness shifts. This is the nature of the Unconscious, which is the realm of dynamic archetypes. This is the level of non-linear synchronisms which have a deeper symbolic meaning. This is the plane that connects the name “Pulsatilla” with the mythological “tears of Venus” in a manner that one cannot logically explain! At the same time, the habitat and growth factors of the “Windflower” also provides clues about the remedy. This archetypal awareness is the great gift of the late, great Dr. Whitmont, who was a Jungian psychiatrist and classical homoeopath. In the final analysis linear causation and non-linear synchronisms are also complementary opposites that make up a whole which is more than the sum of its parts. All of this material is equally valuable depending on the time and circumstances.
Reductionism moves in the opposite direction of the Gestalt philosophy on which Hahnemannian Homœopathy is based. Some persons are so fixed on reducing cases to one mental essence, delusion, sensation and miasm with their keynotes and flow charts that they miss the forest for the trees. They are trying to prematurely narrow the symptoms before opening them up with the repertory and materia medica. They look only at two vectors (the horizontal and vertical) on a two dimensional grid without balancing this view with the “depth vector” provided by the repertory and materia medica. Patients, diseases and remedies are multi-dimensional phenomena that cannot be reduced to two dimensions on paper.
Those that think the repertory is only a “numerical system” do not understand how to use the repertory properly. No well trained homœopath goes by the numbers! A well trained homœopath builds images by uniting combinations of symptom segments that reflect the greater disease Gestalt until it produces a hologram with height, width and depth. The truth is that the repertory is the best medium for artistically combining individual symptom segments in such a manner that the collection is a multi-dimensional mirror image of the portrait of the disease.
The repertory is designed to allow one to collect facets of a greater Gestalt-pattern as represented by the characteristic symptoms and assemble them in combinations that may have never been seen before and that may never be seen again. That is the beauty of the open system view of the repertory that no “system based method” can replace! The repertory has the potential to combine symptom segments in an inconceivable number of combinations that represent the potential of the remedy even if that exact combination is not found in the materia medica. Once a unique picture has been constructed one reviews the materia medica to see which remedy has the potential to remove these symptoms. This is what Boenninghausen discovered when he developed the Therapeutic Pocket Book. Since that time the repertory is no longer just a simple index to the symptoms found in the materia medica. The repertory is an open tool that allows for maximum customization of an almost infinite variety of symptom segments allowing the most precise individualization. Although the repertory is not easy to learn, once it has been mastered it will provide information not found in any essence based system with their flow charts.
All cases present themselves in a unique manner and they require a customized case taking method. Some patients present clear causative rubrics related to a never-well-since syndrome found under a particular group of remedies. Some patients present clear constitutional portraits of remedies found in the materia medica and its commentaries. Some patients demonstrate clear redline, keynote characteristics found almost word for word in our materia medica. Some patients offer clear mental symptoms that lead to a well chosen remedy. Some patients present a main complaint that carries characteristic particularizations with sensations and modalities found only in a few remedies. Some patients present non-logical concomitant symptoms that have little to do with the main complaint that lead directly to the curative remedy. Some patients present pieces and fragments of symptoms that must be collected to make up complete symptoms leading to the remedy. Some patients may present a grand sensation that runs through all their symptoms that can be confirmed by the concomitant symptoms. Some cases may fit the symptoms method while others might suit the systems method better. Some are best solved with a combination of these methods. In all of these cases the essential nature of the totality of the symptoms offers the confirmatory signs necessary to prescribe a simillimum consistently. No one case taking method, no one mental symptom and no one sensation can stand in isolation from the total field of the symptoms represented by the Gestalt of the disease.
I support the study of the symptoms of the mineral, plant and animal families and their individual remedies. I was inspired to review remedy families by Hahnemann, E. A. Farrington, H. Farrington, E. Whitmont and M. L. Dhawale early in my career. I also appreciate the material on this subject offered by modern researchers like Dr. Scholten and Dr. Sankaran. Nevertheless, when I review the “essences” offered in the group studies I always see other equally valid threads that are not included. Our remedies are too multi-dimensional to be reduced to one simple essence that represents the whole potential of the medicine at al times under all circumstances.
I base my family studies on generalizing the similar symptoms of a family and cross referencing the differential symptoms and miasms found in particular remedies. Then I enhance this data by analogy in accordance with experience, which may include archetypes, mythologems, the source of the remedy, habitat, etc. I always review the symptoms of a family from a number of different angles so I gain an understanding of its multifaceted nature to avoid reductionism that may lead to stereotyping. I call on everyone who is interested in the genus method to study remedy families carefully and review the symptoms for themselves rather than rely on any one individual for all their information. In this way, the field of symptoms will be expanded by a group of peers and those rubrics which are confirmed by many can be taken as true characteristics.
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 Homœopathic 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 Homœopathy. In aphorism 108 of this work Jahr wrote:
Ҥ108. 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”.
Homœopathy 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 homœopathic 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.
1. True medical art is that cogitative pursuit which devolves upon the higher human spirit, free deliberation, and the selecting intellect, which decides according to well-founded reasons.
2. It does so in order to differently tune the instinctual (intellect- and awareness-lacking) automatic and energic life force when the life force has been mistuned, through disease, to abnormal activity.
3. It differently tunes the life force by means of an affection similar to that of the disease, engendered by a medicine that has been homeopathically selected.
4. By means of this medicine, the life force is rendered medicinally sick to such a degree (in fact to a somewhat higher degree) that the natural affection can no longer work on the life force.
5. In this way, the life force becomes rid of the natural disease, remaining occupied solely with the so similar, somewhat stronger medicinal disease-affection against which the life force now directs its whole energy and which it soon overcomes.
6. The life force thereby becomes free and able again to return to the norm of health and to its actual intended purpose: that of enlivening and sustaining the healthy organism.
7. It can do this without having suffered painful or debilitating attacks by this transformation.
Organon of the Medical Art; S. Hahnemann (OReilly 6th Edition), Introduction, page 37-38.
In homoeopathic healing the stronger temporary remedial disease replaces the sensation of the natural disease in the vital force. This is the role of the primary action of a homoeopathic remedy elucidated in point 4. Then Hahnemann states that "the life force now directs its whole energy" against the medicinal disease "which it soon overcomes”. This is the role of the secondary, curative action of the vital force elucidated in point 5. This healing process takes place without the loss of humors and sacrifices of tissue associated with crisis. Hahnemann further expands on the nature of primary and secondary actions in the main aphorisms of the Organon. Vide aphorism 64.
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
Author: David Little
Source: http://www.simillimum.com/education/little-library/homoeopathic-philosophy/ccct/article.php
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