MB: David, welcome to the Hpathy Hot-Seat. As you already know, our April issue is going to be a special tribute to Dr. Hahnemann and as you are one of the greatest authorities on all things Hahnemann, I am going to explore a lot about Hahnemann, his life and works with you.
First of all, I would like to know, what are the most positive and significant aspects of Hahnemann’s legacy in your opinion?
DL: The most significant contribution of Samuel Hahnemann is the development of the cardinal principles of Homoeopathy; Similars cure Similars, the single remedy, the minimal dose, and the potentized remedy. Hahnemann also constructed a pure materia medica through testing remedies on the healthy and collecting symptoms brought out on patients under treatment. His presentation of homoeopathic philosophy, case taking, and case management in the Organon of the Healing Art is still many years ahead of its time. These teachings contain the checks and balances that make homoeopathy a safe and effective healing art.
In aphorism 6 of the Organon Hahnemann taught that the essential nature of the totality of the symptoms makes up the only perceivable “gestalt of the disease”. On this basis, Homoeopathy is founded on a gestalt philosophy in which the whole is more than the sum of its parts. This is why Hahnemann said that one symptom no more makes up the whole disease than one foot makes up a whole person. This holistic vision stands apart from the reductionist view associated with orthodox medicine. Rather than standardizing patients by the most common symptoms associated with the names of disease, Homoeopathy individualizes the striking, exceptional, uncommon and odd symptoms characteristic of the patient.
Taking a homoeopathic case is like putting together a jigsaw puzzle so that one can see the nature of the portrait it contains. Each piece of the puzzle only contains one fragment of a total picture that must be placed in combination with other related parts in the proper manner to solve the riddle. One may look at one piece and see that it is a nose but one cannot tell whether that nose belongs to a man or woman let alone the color of their eyes and hair, the expression on their face, what they are doing, nor what is in the background. Only when a number of the most important pieces are placed together can one see the bigger picture.
In a similar manner each symptom fragment represents one piece of a puzzle that makes up the gestalt of the disease. The homoeopath has to select the most important symptom segments and fit them together in the proper order until the underlying portrait of the disease becomes visible. In this manner, the inquirer uses the characteristic locations, sensations, modifications and concomitants to make up complete symptoms that are united in the unique patterns of distinctive homoeopathic remedies. The vehicle used to accomplish this goal is the homoeopathic repertory, which acts as a guide to the greater materia medica.
The repertory is an open systems tool in which the symptoms of homoeopathic remedies have been redacted and distributed by the regions of the human being from the mind within to the skin without. This allows for the recombination of the various rubrics in innumerable permutations that reflect the medicinal powers of the homoeopathic remedies found in the materia medica. This system of reference forms a large integrated data base that allows for the maximum individualization of the causes, symptoms and attendant circumstances. These are some of the most important aspects of the philosophy and practice that Hahnemann introduced in the Organon, the Chronic Diseases, and the Lesser Writings.
MB: What do you think is the greatest danger to homoeopathy in modern times?
The danger to Homoeopathy today is twofold; one is from without and the other is from within. It is obvious that segments of the orthodox establishment have declared war on Homoeopathy in a number of places around the world. A combination of narrow minded reductionist scientists and so-called quack busters would like to reinstate an “inquisition” in which homoeopaths are declared medical heretics. This is not the first time in history such a campaign has been run as there have always been those that seek to destroy any alternative to allopathic medicine. That is why it is important that homoeopaths around the world defend the right of patients to choose homoeopathic treatment. I would like to thank you, Dr. Manish Bhatia, and your colleagues for taking up this challenge whole heartedly.
My second concern is that some homoeopathic educational institutions and educational programs are not teaching the history, philosophy and practice of homoeopathy in the proper manner. In some courses little or no effort is made to teach the classical paradigm associated with the 4th, 5th and 6th Organon, the Chronic Diseases, and the Lesser Writings. There are some students and teachers that have never really bothered to study this material seriously. They depend almost exclusively on information provided by popular teachers over the last 35 years. Today, we have an increasing number of new systems being presented to persons that do not have a proper education in the traditional works. If this trend continues the foundation of Homoeopathy may be weakened in such a manner that it gives way from within.
I agree with Hering, that it is the duty of all of us to go further in the theory and practice of Homoeopathy than Hahnemann, but without overturning the universal principles on which our healing art is founded. Some persons have yet to master the repertory and materia medica, while at the same time they are trying to use a number of experimental methods taught on the seminar circuit or in certain schools. I have heard persons say that they have gone “beyond” the repertory and materia medica when they never really learned it in the first place. Others opine they do not need all that “old stuff” because they are already practicing the “highest methods”. On questioning one usually finds out that such persons do not have much experience with the true classical methods.
Some of the new insights have been developed by well trained classical homoeopaths while others are being spread by those who never practiced the traditional methods in a proper manner. Some of the methods are harmonious with the traditional teachings while others stand in complete opposition. It is our opinion that the best of the new information naturally acts as a complement to the traditional repertory and materia medica, not its replacement. It is best to have a solid education in the classic methods before taking up new, experimental ideas. This is because without a proper education it is impossible to separate the wheat (useful, new information) from the chaff (unsafe, unreliable methods).
MB: That Hahnemann was a genius and much ahead of his times, is something upon which we all agree. But I have found that nearly every school, everyone with a new thought or a divergent philosophy and practice, finds something from Hahnemann to support its work. Some people misquote the words, present opinions without references, and even tell untruths at times. What in your opinion is the most significant misinformation about Hahnemann and his work?
DL: Perhaps some of some of the most distorted information circulates around how Hahnemann actually gave his remedies. Some of the reasons for this lack of understanding are that Hahnemann’s German and French casebooks have not been studied in detail until more recent times. Some of the early information on Hahnemann’s Paris casebooks was done by persons that did not know what was in Hahnemann’s German casebooks, or what methods were actually published in the 1st through 5th editions of the Organon, the various editions of the Chronic Diseases, and other lesser known writings. The mystery was further compounded by the fact that the 6th Organon was not published until 1920, after Hering, Boenninghausen, Jahr, Lippe, Allen and Kent had died. For this reason, one does not find any discussion of the methods Hahnemann used between 1833 and 1843 in the writings of most classical homoeopaths.
Another problem with much of the early information is that it was spread by persons who had no practical experience in the methods discussed in the 6th Organon, the Paris casebooks, or the LM potency. For the above reasons, they imagined that Hahnemann was using all sorts of methods he never used before and was keeping them secret. This lack of understanding of the historical progression of Hahnemann’s works led to the claim that Hahnemann did not really follow the methods he taught in the Organon in his final years in Paris.
Some persons have even claimed that the Founder was routinely using more than one remedy “at the same time” but did not make it public because it would be so controversial. They use polypharmacy terms like “two remedies at once” to describe Hahnemann’s alternation of two single remedies at different times, and “remedy combinations” to describe his application of a sequence of single remedies over time. These individuals tend to make up their own combination remedies or use mixtures produced by certain companies. They say that they are following the way Hahnemann practiced in his final years. What is the truth about such assertions? What do Hahnemann’s casebooks have to say about this?
I have been studying Hahnemann’s German casebooks from 1821, 1830 and 1833-35 as well as his French casebooks from 1835-1843. These journals contain the record of how Hahnemann actually practiced in the clinic. In the 1st, 2nd and 3rd Organon Hahnemann wrote that due to the limited number of remedies it was sometimes hard to find one remedy that covered the totality of the symptoms. For this reason, he evolved strategies that involved a chief remedy in alternation with an intercurrent medicine. This method, he said, worked better than only using one partially fitting remedy.
The use of a chief remedy, alternations, intercurrents and a sequence of remedies are found in German casebook D-22 (1821). This casebook corresponds to the period just after the 2nd Organon and records cases two years after Hahnemann began his group study of Psora. Hahnemann was marking symptoms that he considered psoric in nature with “Scab” “NB scab” or “NB sc”. Later these symptoms appear in the rubric list found in the theoretical part of the Chronic Diseases in 1828. Some point to Hahnemann’s use of Sulphur in Paris as if this was something completely new, but even in these early years Sulphur was his most prescribed remedy. His use of Sulphur was based on the presence of a psoric terrain and its group symptoms. At the same time, Hahnemann used a number of intercurrent remedies for a variety of reasons depending on the symptoms, time and circumstances.
In chronic disease these sequences were usually started, continued and ended with Sulphur. The doses of Sulphur were typically complemented by the interspersing of intercurrents and placebos at various intervals. The Founder would send the patient home with various numbered packets that contained medicinal and non-medicinal doses. The most common intercurrent remedies in the German casebook D-22 were Nitricum Acidum and Stannum, both of which would later be classified as anti-psoric remedies. The application of alternations and intercurrents in acute disease did not generally include the use of Sulphur. Nevertheless, the most commonly used “intercurrent remedy” was actually a placebo that accompanied a single remedy. Hahnemann used placebo to control the patient and mark the spacing between doses and remedies.
In some prescriptions the use of Sulphur seems to be directed at the psoric terrain while the other remedies were prescribed more on the individualized symptoms of the patient. In other cases, the role of the intercurrent remedy seems to be to calm the organism and prepare the vital force for more repetitions of Sulphur. The most common interval for sequencing a chief remedy and the intercurrent medicine was around 7 to 8 days. This period seems to correspond to what Hahnemann wrote in aphorism 279 of the 3rd Organon. In this paragraph he stated that the primary action of a remedy of the potencies he was using at the time generally lasted for around 7 to 8 days. This may be the reason for the near weekly doses in the remedy sequences.
In the 4th Organon in 1829 Hahnemann removed the aphorisms on the chief remedy and the intercurrent medicine from the main body of the text although references to alternations were still found in the footnotes. It seems that by this time, Hahnemann felt that there were enough well proven remedies to find a single remedy in most cases. At this time, the Founder’s main focus was on the anti-miasmatic remedies and the treatment of the miasms psora, sycosis and syphilis.
By this time, Hahnemann was starting most of his chronic cases with Sulphur, in accordance with his belief that psora is the principle cause of chronic disease. For example, Hahnemann’s German casebook D34 (1830) includes 74 first prescriptions. Out of these 74 first prescriptions, 57 are of Sulphur, which makes up 77% of the cases. Hahnemann appeared to use this method in patients who suffered from a combination of psora, suppression and drugging. Although the liberal use of Sulphur has been associated with the Paris epoch, in truth it started well before Hahnemann left for France in 1835.
MB: What were some of Hahnemann’s most controversial experiments?
In 1833 a student of Hahnemann named Dr. Aegidi suggested that Hahnemann test the use of two remedies given at the exact same time. A record of these trials is found in Hahnemann’s German casebook D-37, which records some unusual prescriptions between June and August 1833. For example, on August 3rd, 1833 Hahnemann gave a patient “Coloc with Graph” and 14 placebos (D-37, p. 338). For a time Hahnemann considered including this experiment in a footnote in the 5th Organon but he changed his mind due to a combination of clinical realities and concerns about the negative effects that such a method would have on homoeopathic theory and practice.
Hahnemann noted in a letter to Boenninghausen (Samuel Hahnemann, His Life and Works, R. Haehl, VII, p. 253) that “As it is never, as we know, absolutely necessary” to use a double remedy, any advantage gained from this sometimes useful method was greatly overbalanced by the disadvantages that would arise from its misuse. If Hahnemann thought that it was absolutely necessary to use double remedies, the advantages of the method would have surely outweighed the abuse of the technique, but this was not the case.
Hahnemann wrote that out of his “many attempts of this kind only one or two have been successful, which is insufficient for the incontrovertible establishment of a new rule”. If most of Hahnemann’s many attempts had turned out well, he might have had a different opinion. In the same letter Hahnemann called this procedure “a very difficult and doubtful method” (Samuel Hahnemann, His Life and Works, R. Haehl, V.II, p. 253-254). After discussing the ramifications of Aegidi’s method with his followers, Hahnemann decided that it would be best to withdraw the footnote on the subject from the 5th Organon and write a strong caution against the procedure instead.
In a footnote to aphorism 272 of the 5th Organon Hahnemann wrote that administering two remedies at the “same or almost same time” was “a hazardous experiment, which can never be necessary, though it may sometimes seem to be of use”. In January 1834 the Founder wrote a letter to Dr. Aegidi in which he emphasized the difficult and doubtful nature of the double remedies. He also points out that if the homoeopath finds a well suited remedy based on the characteristic symptoms there is no need to find the next most suitable one. In this light, Hahnemann wrote:
“You presuppose that imitators could easily find the correct Simmilimum in such a case of illness not only for one part of the symptoms but also the other part and in such a way that they could always achieve good results. Ah! if most homoeopaths could or would discover only ONE remedy, exactly suitable in accurate similarity to the characteristic symptoms, we would gladly excuse them in the necessity of finding the nearest suitable one!…..For my part I find the discovery of the right remedy difficult and laborious in every case. Therefore I do not see how they would hit upon the first, to say nothing of the second twin remedy so easily! Pardon me for being so incredulous in this matter.”(Samuel Hahnemann, His Life and Works, Haehl, VI, p. 395).
In aphorism 273 of the 6th Organon Hahnemann continued on the “not necessary” theme when he stated that “In no case of cure is it necessary to employ more than a single simple medicinal substance at one time with a patient. For this reason alone, it is inadmissible to do so.” The double remedy method is not necessary because if one well chosen remedy needs to be complemented, a second remedy can be given in the form of an alternation, a chief remedy and intercurrent medicine or a tandem prescription in which one remedy follows after another. These methods are much more sophisticated in terms of application and timing than is possible with the double remedies. That is why Hahnemann said, “It is wrong to attempt to employ complex means when simple means suffice”.
MB: What about the idea that Hahnemann “continued” to give two remedies for a chronic disease in the same day?
DL: Where are the case histories? How many times did Hahnemann do this? Where are the exact references with casebook numbers, names, dates and page numbers? Such a method is either very rare if not completely non-existent. Proof of this assertion would require a number of clear case histories where the prescriptions say something like “today take remedy A and B” with full details. Vague listing of more than one remedy with words like “then” or “after” or suggested remedies in brackets proves nothing.
In the 1833 to 1835 casebook (D-38) Hahnemann writes single remedy prescriptions as well as numbered sequences of medicines as he had done earlier in his career. For example, on March 6th, 1834 Mrs. Carlin von Roitsch (D-38, p. 44) was given a prescription in which two chronic remedies are noted. The journal reads, “28, 1 sulph.., 15 calc ./X”. The number 28 records that the treatment plan spanned 28 days. On the 1st day the patient was given Sulphur 30C and on the 15th day she was given Calcarea 30c.
An example of an alternation of two remedies can be found in the case of Mr. Keil (D-38, p. 9). The patient came to see Hahnemann on December 9th, 1833 and was prescribed “7, 1 sil 3 euphr 5 sil”. This means that in a 7 day period the patient was given Silica on the 1st day, Euphrasia on the 3rd day, and Silica again on the 5th day. This is the alternation of an acute apsoric remedy and chronic anti-psoric medicine.
Hahnemann sometimes used a series of remedies in which three remedies were given in a particular sequence. On February 16th, 1834 the Founder gave Mr. Reiche (D-38, p. 34a) a multiple prescription that included; “28 1 sulph, 10 natr m, 19 hs”. This mean that over a 28 day period the patient was given Sulphur on the first day, Natrum Muriaticum on the 10th day, and Hepar Sulphuris on the 19th day. The rest of the time the patient was given placebos. Hahnemann’s favorite days for numbered sequences of remedies appear to be 1st, 3rd, 5th; 1st, 5th, 9th; 1st, 8th; and 1st, 15th; and 1st, 10th, 19th. Sometimes he would write down to take one remedy for a specific number of days and another remedy afterwards.
The greatest majority of the prescriptions in the Paris casebooks (1835-1843) are of one single remedy at a time. By the time Hahnemann began writing the 6th Organon in the 1840s there are no prescriptions involving numbered sequences and preconceived schedules let alone the routine use of two chronic remedies given in the same day. At this time, Hahnemann was more conservative with his remedies than he had been during his earlier career.
Occasionally, Hahnemann would alternate an acute remedy with a chronic remedy or two chronic remedies in the case of complex miasms. For example, in the case of Robert Everest (DF-14, p.7) Hahnemann gave Cannabis 30C in medicinal solution for the primary symptoms of gonorrheal sycosis on December 28th, 1842. This prescription was followed by placebos on January 4th and 7th. On January 11th the patient was given an olfaction of Thuja and placebos that was followed by more placebos on January 14th.
On January 18th Hahnemann gave an olfaction of Cannabis and more placebos and noted that he was planning to alternate Thuja and Mercury to clear the presence of sycosis and syphilis. On January 21st he gave an olfaction of Mercury and four placebos. Then on January 25th Hahnemann gave Thuja 0/1 in a medicinal solution. On February 3rd he gave Thuja 0/2 in medicinal solution. This was followed by placebos on February 10th and 17th. Finally, on February 25th Hahnemann returned to Mercury in the 0/1 potency in medicinal solution. This was followed by placebo on March 7th. This treatment successfully removed the acquired gonorrheal sycosis and addressed an underlying syphilitic miasm.
In this case, Hahnemann first alternated Cannabis and Thuja interspersed with periods of placebo over a period of days to treat the primary stage of gonorrhea and the sycotic miasm. After this he alternated Mercury and Thuja interspersed with placebos and periods of waiting and watching for syphilis and the remaining sycosis. These timely alternations were not done by preconceived numbered remedy schedules. They were the alternation of single remedy prescriptions in accordance with the nature of the signs and symptoms and the actions of the remedies on the patient. This is characteristic of the way in which Hahnemann alternated acute and chronic remedies and used intercurrent medicines between 1840 and 1843.
Some individuals try to portray the Paris casebooks as if they contain all sorts of unusual methods not found in Hahnemann’s published works. The entire way the Paris epoch is presented by these revisionist historians is absolutely backwards. The historical truth is that Hahnemann used more prearranged alternations and numbered sequences of remedies in 1821(D-22), 1830 (D-34), 1833 (D-37), and 1833-1835 (D-38) than he did in the French casebooks from 1835 to 1843 (DF-2 through DF-14). All of these techniques were already published in the various editions of the Organon, the Chronic Diseases, and other lesser known articles. In the years 1840 to 1843 Hahnemann’s most common prescription was a single remedy and his most popular “second remedy” was a placebo!
MB: Many people who support complexes even go to the extent of calling Hepar-sulph and Causticum to be complexes prepared by Hahnemann! Is there any validity in such ideas?
DL: Our medicinal substances are made up of the minerals of the periodic table, and organic molecules in various combinations. The minerals of the periodic table readily combine according to their atomic structures which forms more complex organic plant life and finally zoological species. All of our medicines involve combinations of these building blocks of life. The point here is that each homoeopathic remedy has been tested on the healthy as a single remedy and the symptoms brought out during treatment of the ill have been recorded. Then the most dependable of these symptoms have been included in our materia medica.
Hepar Suphuris Calcareum is made from Calcarea Ostrearum and flowers of Sulphur that was proved and tested as a single remedy. In a letter to Boenninghausen in 1836 Hahnemann wrote that “Hepar Sulphuris and the neutral alkalis, which in accordance with the laws of nature, always contain their constituent parts in the same proportion”, and that such a remedy can “be used suo jure as simple remedies and gives no excuse for that dangerous heresy and mixture”. Natural combinations of elements of the periodic table through chemistry are not the same as mixtures of several diverse remedies such as Nux Vomica, Lachesis and Plumbum that do not combine naturally. In the same letter Hahnemann called combination medicines “an abominable heresy which give the death blow to true homoeopathy and throws it back to blind allopathy”.
Homoeopathic remedies are tested on living human beings as single remedies and given to the ill as single remedies based on similar symptoms. To think that such a careful scientific method is the same as mixing several remedies together in the form of unproven mixtures is rather misguided. No one can predict the action of several different homoeopathic remedies given in combination all at once. How can one tell which remedy is well suited from one that might be counter indicated or causing aggravations or new symptoms? Using combination remedies makes case management more confusing and runs the risk of producing idiosyncratic reactions. This is one of the cardinal reasons Hahnemann rejected polypharmacy and the mixture of homoeopathic remedies.
MB: Hahnemann also experimented with the vehicle, scale and dilutions. He moved from dry dose to liquid solutions to LM potencies. What was his preferred method to dispense medicines at the time of writing the 4th, 5th and 6th editions of Organon? Do his case records reflect what he wrote in the Organon?
DL: At the time of the 1st edition of the Chronic Diseases (1828) and the 4th Organon (1829), Hahnemann was dispensing his remedies on poppy seed sized globules that were given dry or occasionally dissolved in water as he described in the Chronic Diseases. In these works, Hahnemann suggested allowing the remedy to act as long as there was an improvement and only repeating the remedy when the case came to a standstill or there was a relapse of the symptoms. This is called the “wait and watch method”.
In aphorisms 245 and 246 of the 5th Organon (1833) Hahnemann revolutionized his approach by explaining when to allow the single dose to act alone and when to repeat the remedy to speed the cure. In aphorism 245 the Founder wrote that “Every perceptibly progressive and strikingly increasing amelioration” completely precludes the repetition of the remedy as long as this state lasts. This is because the strikingly increasing effect of the remedy is already moving toward completion as fast as possible. In this case, any additional doses may “disturb the work of amelioration” and cause a relapse of symptoms or aggravation.
Then Hahnemann says, that on the other hand, there are cases where a single dose only produces a “slowly progressive amelioration” in which the single dose accomplishes all the good it can over a period of “40, 50 or 100 days”. In many cases even this slow continuous improvement does not take place. Therefore, it is a matter of great importance to reduce this period to ½, ¼ or less of the time so that a more rapid cure takes place.
Today, homoeopaths tend to fall into two general groups. There are those who always give a single dose and wait and watch for longer periods and those who repeat the dose at short intervals in all their cases. What Hahnemann is offering is a protocol that transcends these polarized extremes and presents a middle path that embraces both methods used at the proper time in the proper way.
In cases where a single dose produces a striking, increasing healing action the remedy should be allowed to act as long as this condition lasts. In those cases where a single dose can only produce a slow improvement over a longer period of time, the remedy may be repeated at the appropriate times to speed the cure. To accomplish this goal, Hahnemann states that first of all the remedy must be well chosen and given in a small dose at “suitable intervals”.
Therefore, whether one only gives the single dose over a longer period, or whether one repeats the remedy at shorter intervals depends on the nature of the remedy action in the individual patient, not on a rigid belief system or a preconceived notion about what is right or wrong for everyone. If there is a strikingly progressive increasing improvement then it is best to allow the single dose to act alone. If there is only slow improvement that will take many days, weeks and months to show significant results, then the remedy may be repeated at suitable intervals to speed the cure as long as it causes no aggravations, accessory symptoms or new symptoms.
MB: How did Hahnemann administer his remedies at this time?
In aphorisms 286 to 288 of the 5th Organon Hahnemann states his preference for administering remedies in medicinal solution but he did not give exact details on how to prepare the medicine. In the footnote to this aphorism Hahnemann offers his most detailed explanation of olfaction. He wrote that in his experience olfaction has the same strength and duration as the oral dose, but it acts more gently on the vital force. He also wrote about this liberal use of olfaction in his preface to Boenninghausen’s first repertory published in 1833. He felt that olfaction caused fewer aggravations when repeated than the dry dose, yet acted just as deeply. He often used this method to speed the cure. The German casebook D-38, which covers the years 1833-1835, confirms that the majority of Hahnemann’s doses were given by olfaction not the dry oral dose.
In March 1834 Hahnemann’s casebook records the use of the liquid solution in which 1 pill was placed into ½ teaspoon of water and given to the patient. In May, 1834 the casebook shows Hahnemann placing the pills in a cup of water, stirring the solution and giving the patient teaspoon doses. It also records the use of brandy as a preservative when a remedy was going to be used over a longer period of time. So even during the early 1830s, Hahnemann was moving away from the dry dose to olfaction and the medicinal solution.
The first clear explanation of the preparation of the 7 to 20 tablespoon medicinal solutions appears in the preface to the 1837 edition of the Chronic Diseases. In this work Hahnemann speaks of making up a remedy bottle and giving the patient spoonful doses over a longer period of time. Paris casebook DF-5 from the same year shows that Hahnemann was already using the medicinal solution and dilution glass method by this time. Therefore, the medicinal solution and dilution glass method was first developed for the C potency and then later applied to the LM potency.
In the 6th Organon (c. 1842-1843) Hahnemann combined the information found in aphorism 245 and 246 of the 5th Organon into aphorism 246 and applied it to the LM potency. In the first sentence of the aphorism Hahnemann offers a slight variation on the theme he introduced in aphorism 245 of the 5th Organon. The Founder states that, “Every perceptibly progressive and strikingly increasing amelioration during treatment” completely precludes any repetition of the remedy as long as this state lasts.
This, he states, is often the case in acute disease, but in chronic diseases, it is more common to witness a slow progressive improvement that takes place over 30 to 100 days. Then Hahnemann states that this longer period may be reduced by ½, ¼ or less the time it takes with the old single dose wait and watch method provided certain conditions are met.
These conditions are that the remedy is a suitable simillimum, is highly potentized, dissolved in water, given in a proper small dose, and the medicine is repeated at suitable intervals that experience has shown to be the most appropriate for the acceleration of the cure. He also notes that the medicinal solution should be succussed prior to administration so that the degree of potency of every dose is slightly different. This, he opined, allows the life principle to be altered in a beneficial manner without the antagonistic counter actions witnessed when repeating the unmodified dry dose.
In aphorism 248 and its footnote Hahnemann explains in detail how to prepare the medicinal solution which includes both a remedy bottle and a dilution glass, as well as a specially prepared solution in a vial for olfaction. At this time, Hahnemann’s predominant delivery system was the oral medicinal solution but he still used olfaction on a good number of occasions. The Paris casebooks from the years 1835 to 1843 show that Hahnemann gave all of his remedies in this fashion.
MB: What was Hahnemann’s protocol for repeating remedies during this period?
It has been said that Hahnemann always gave the LM potency daily or more often even in chronic diseases. They point to aphorism 246 and its footnote and say that Hahnemann said you should give the LM potency daily for months. They ignore the first sentence of the aphorism that states that any time in treatment there is a clearly progressive and strikingly increasing amelioration, the remedy should not be repeated. This means that if the first, second, third, or more doses suddenly causes a dramatically increasing amelioration the remedy should be stopped and the patient put under observation.
On this basis, Hahnemann proceeds to explain how to repeat the remedy to speed the cure in chronic diseases where a single dose, or infrequent doses, can only produce a slow response. Then in the footnote Hahnemann says that with his new method a well chosen remedy may now be given daily for months, WHEN NECESSARY. It does not say that one should give the daily dose to everyone for months! If it is NOT necessary such a rapid repetition for very long periods runs the risk of causing serious aggravations and grafting strong medicinal symptoms on the vital force.
In aphorism 248 Hahnemann teaches how to give the remedy in chronic cases that do not respond quickly to a single dose or infrequent repetitions. He says that in protracted diseases the remedy may be given daily, or on alternate days, or in the case of olfaction, every 1, 2, 3 or 4 days, etc. The remedy may be repeated as long as the patient improves and there are no aggravations, accessory symptoms or new complaints. These are signs that the repetitions of the remedy should cease. The repetition should also be stopped if there is a visibly progressive and strikingly increasing amelioration anytime during the treatment. In this way, one learns when to wait and watch and when to act and observe the action of repetition.
The Paris casebooks record the way the Founder actually gave the LM potency in the clinic. At the beginning of treatment, Hahnemann tended to give either a single dose (usually but not always by olfaction), or a short series of 3 to 7 liquid doses over a period of one week. Then he would reassess the action of the remedy on the patient. At this time, Hahnemann would either repeat the medicine or give the patient a series of placebos depending on the nature of the remedy action. As the case became more stabilized he might see the patient after two weeks.
An example of a single dose of the LM potency may be found in the case of Mr. Tarbocher (DF-13, p.56). On May 22, 1842 Hahnemann gave the patient a single olfaction of Sulphur 0/1 followed by 8 days of placebos. Then Hahnemann repeated the process. In a letter found in Boenninghausen’s Lesser Writings (p. 213), Dr. Croserio confirms that Hahnemann “frequently” used this method in his final years. In his eyewitness account he states that in chronic diseases Hahnemann would not allow the patient “to smell the medicine oftener than once a week and would give nothing but sugar of milk besides”
Although Hahnemann often gave the LM potency daily or every other day, he also repeated the dose at longer intervals. For example, on April 30th, 1842 Hahnemann gave Madame Gardy (DF-13, p. 410) a dose of Graphites 0/1 in medicinal solution every third day. On the two intervening days he gave the patient placebo. The Paris casebooks show that Hahnemann sometimes gave the LM potency daily, every other day, every third day, every fourth day, or once a week, etc.
The case of Robert Everest (DF-14, p.7) is an example of how Hahnemann alternated a series of medicinal doses with a series of placebos. On October 5th, 1842 Hahnemann gave the patient a series of doses of Sulphur 0/1 and on October 12th he gave Sulphur 0/2. This was quickly followed by 12 days of placebos from October 14th to October 26th. Then Hahnemann gave the patient a series of doses of Sulphur 0/3 until November 4th. After this the patient received placebos for one month until December 3rd when he received Sulphur 0/4. Over a period of seven months Hahnemann gave this patient 17 remedial prescriptions interspersed with 16 prescriptions of placebos. Even during the LM epoch Hahnemann gave almost as much placebo as medicine!
This “on again-off again” method is witnessed in a great majority of Hahnemann’s LM cases. I have not seen one LM case in which Hahnemann gave the daily or alternate day dose for months on end without interspersing placebos and periods of waiting and watching. The Paris casebooks show that Hahnemann gave the C and LM potency in medicinal solution in a great variety of ways and made liberal use of placebos. The idea that Hahnemann gave all his patients the daily dose for weeks and months on end is a complete myth!
MB: Apart from the misrepresentation of prescriptions, many people say that Hahnemann did not practice what he preached and that it’s difficult to find cured cases in his records. What is your opinion about this? Are his cases not documented properly?
DL: Those who say Hahnemann did not practice what he preached usually connect such statements with comments like “so why should we”? This is used as an excuse to ignore everything Hahnemann wrote in the Organon so that the individual can do whatever they like in the name of Homoeopathy. Individuals who say such things usually have no idea of what Hahnemann actually introduced in the various editions of Organon and other writings. The contradictions they pose are usually based on bits and fragments taken out of context without regard for the historical time-line in which they developed.
The truth is that what one finds in Hahnemann’s German and French casebooks corresponds perfectly with the successive editions of the Organon, the Chronic Diseases, and Hahnemann’s letters to colleagues. If one mixes up all this material and turns it on its head, one comes up with all sorts of peculiar ideas, which more often than not, have a hidden agenda behind them.
I have reviewed hundreds of Hahnemann’s cases and one clearly finds a number of cures, a number of cases that partially improve over time, and a number of cases that do not go very well. Hahnemann had good success with acute and simple chronic diseases, but like most of us, he had a much harder time with patients who suffered from chronic miasms, suppressions and heavy drugging. One must remember that Hahnemann was breaking new ground and did not have the advantage of several generations of knowledge. His major role was to open the door for all those who followed.
How many of Hahnemann’s critics could have developed the complete homoeopathic system in the first place? How many could have accomplished what Hahnemann did in one lifetime? Dare I say none? They are benefiting from Hahnemann’s 50 years of experience but they don’t want to give the Founder any credit for it! Hahnemann pointed the way to the medicine of the future but some are only looking at his finger. Is it any wonder they cannot see the bigger picture? They live in ivory towers and have yet to learn that those who live in glass houses should not throw stones.
Hahnemann is the Alpha of Homoeopathy not the Omega. He introduced a sophisticated system of healing that is unequalled in many respects. He set the foundation on a sound philosophy and a clear system of checks and balances that makes Homoeopathy a safe and effective system. What one finds in his casebooks is the growth of a new system from its infancy toward maturity. We are not saying that everyone should stop with Hahnemann’s works, but we are saying that everyone should start there.
Hahnemann only used around 100 remedies and his access to repertories and materia medicas was quite limited. Today we have hundreds of well known remedies and very large repertories and materia medicas that are easily searchable by computers. Homoeopathy has grown greatly over the years and we are the carriers of this legacy. Nevertheless, many of today’s homoeopaths are only employing a small percentage of Hahnemann’s original paradigm. Most are still using the methods the Founder developed in the 3rd and 4th Organon and too few have truly integrated the teachings found in the 5th and 6th editions in any practical manner.
In many areas modern Homoeopathy has stopped growing with the methods of the 1820s, while most of the enhancements Hahnemann introduced in the 1830s and 1840s are overlooked. Many persons are busy seeking new avant-garde systems before they really understand the original classical paradigm. In truth, those that are best suited to use the new, experimental methods are those who truly understand Hahnemann’s legacy. This allows such persons to reach for the sky while keeping their feet well planted on the ground. Others try to climb too high without any grounding so their practice ends up lacking the reliability and safety of the classical system.
All I can say about the situation is that it is much easier to tear down than to build up, to cover over than to discover, and to divide and rule than to unify and share. The constant flood of poorly sourced research and iconoclastic attacks on the Founder do more to cloud than enlighten and do not make us better homoeopaths. Much of the information that is being passed around about Hahnemann’s life and works is so distorted that it only serves to confuse students and teachers alike. It is high time that credible research by experienced homoeopaths takes place and the historical record is corrected in our educational institutions. This material is not easy to assess if one has absolutely no understanding of the clinical methods they contain. Some of the bitterest critics have never even practiced classical Homoeopathy in a clinical environment for any period of time.
MB: I have personally used the liquid solutions of the centesimal scale with great success, and in fact, they are my preferred way to give homeopathic medicines these days. I wonder why the liquid solutions never came into vogue and are still only used by a handful of homeopaths. Can you share your own views and experiences about this?
DL: James Kent taught that the size of the dose and the delivery system made no difference in the action of the homoeopathic remedy. He never saw the 6th Organon and had no access to Hahnemann’s Paris casebooks. His sources of information were rather limited and his application of the dose never progressed past the methods of the 4th Organon. He did not think it mattered whether one gave 1 or 1000 pills or stirred the pills in water and gave 1 or 100 spoonfuls. This is because Kent believed that potentization reduced the remedy to the “simple substance”, which had qualities but no quantity.
Most homoeopaths still follow Kent’s views and use his series of seven potencies, i.e. 30C, 200C, 1M, 10M, 50M, CM and MM. Those who follow Kent’s teachings tend to use a random number of dry pills of the high and highest potencies. They do not seem to understand the importance of the minimal dose, and often mistakenly think that this term refers to the negligible amount of original substance found in potentized remedies. These ideas are still being taught by most educational institutes although the winds of change have begun to blow.
Hahnemann taught that the size of the dose and the method of the delivery system have a great effect on the action of homoeopathic remedies. In this view each pellet is considered to hold a certain quantum package of remedial power that increases when 1, 2, or 3 pellets are used. In aphorism 276 he made it clear that the more perfect the remedy, and the higher the potency, the more important the size of the dose becomes. Too large of the dose of a potentized remedy is directly linked to the production of aggravations and antagonistic secondary actions of the vital force. This is the reason that Hahnemann progressively reduced the size of the dose as he increased the potencies of his medicines.
At first, Hahnemann used material doses in grains and drops. He began to dilute his medicines to reduce what he perceived as toxic side effects but later came to understand that many of the aggravations he witnessed were caused by the primary action of the remedy. As he increased his potencies in the 1820s, he took one drop of the pharmaceutical potencies like the 30C and dropped the alcohol preparation on 300 tiny pellets. Later he increased the number of pellets to 500 per drop. Then the Founder would use 1, 2, or more of these pellets as a dose. This was a significant reduction in the size of the medicine that was made for clinical reasons.
By the 1830s Hahnemann began to reduce the size of the doses further, by dissolving 1 pill in various amounts of water that was given in divided doses via the oral tract. He also administered the minimal dose through the inhalation of the subtle vapors of the potency via the olfactory nerve and respiratory tract. At this time, Hahnemann was experimenting with higher potencies like the 60th, 90th, 100th, 150th, 200th, and 300th. The movement toward the medicinal solution and olfaction was the direct outcome of his use of progressively higher potencies. By 1837-1839 these methods were more or less perfected.
By 1839 to 1840 Hahnemann changed the direction of his experiments and was engaged in clinical trials in which he tested a number of new potency systems. These experiments were witnessed by Reverend Everest, his patient and close confidant. In 1853 Everest wrote about the nature of these experiments in a letter to Dr. Luther published in the London Homoeopathic Times. After testing a number of experimental potencies side by side the Founder came to the conclusion that the 1/50,000 ratio called the LM or Quinquagenimillesimal potency was the most suitable new potency system. Now Hahnemann applied the liquid delivery system and olfactory methods he originally developed for the C potency to the LM potency. This brought about certain modifications in his posology and case management procedures that were further elucidated in the 6th Organon.
MB: What are some of the advantages of using the medicinal solutions?
DL: The process of reducing the size of the dose and refining the delivery system was intimately related to the changes in Hahnemann’s case management procedures introduced in the 5th Organon and the 1837 edition of the Chronic Diseases, and the 6th Organon. The method of speeding the cure by repeating split-doses at suitable intervals is best carried out by the use of the more flexible medicinal solution. The stagnant, unmodified dry dose does not bear repetition as well and more easily leads to aggravations, accessory systems and antagonistic counter actions of the vital force.
Hahnemann taught that the sensitivity of patients varies in a scale of 1 to 1000. A preparation that would not even affect a number 1 hyposensitive patient will produce serious complications in the number 1000 hypersensitive patient. The great advantage of the medicinal solution is the methods of adjusting the dose to suit the patient’s sensitivity, the nature, degree and magnitude of the disease state, and the condition of the vital force and vitality.
These adjustments include the size of the medicinal solution, the use of 1 or more pills, different sizes and numbers of teaspoons, varying numbers of succussions prior to administration, and the option of using a series of dilution glasses for hypersensitive patients. This allows for the fine-tuning of the remedial powers in a manner that is impossible when using the dry dose. In this way, it is possible to speed the cure with the use of split-doses when necessary, while at the same time, avoid aggravations and crises.
MB: Can you tell us about your personal journey and how you came to the way you practice today?
DL: James Kent was a great homoeopath whom I admire and whose works I have studied for over 35 years. In my first decade of practice he was my primary source of information and I followed his posology methods. Nevertheless, his teachings that the size of the dose does not matter is linked with his acceptance of strong aggravations as more or less normal during the process of cure. Using too large a dose of the high potencies was also responsible for some of the prolonged crises produced during the reversal of symptoms as witnessed in Hahnemann’s direction of cure, usually called Hering’s laws.
In my Kentian years everything was very dramatic. The successes were dramatic, the aggravations and crises were dramatic, and the failed cases were dramatic. Everything was far too dramatic! I remember those phone calls and interviews in which the patient told me how aggravated they felt, and I can still hear myself telling the patient that this was a good sign. This is because we were taught that without pain there is no gain. Somehow, I never really believed it because there were also cases of radical cure that took place without any such aggravations. I felt that something was wrong and it bothered me greatly. This is the reason I began to read the Organon more seriously and it changed my practice forever.
Hahnemann wrote in the 2nd aphorism of the Organon that the cure should be a “rapid, gentle and permanent” restoration of the state of health. Well, I had seen the rapid and permanent but many times the “gentle” evaded me. I noticed that a quick, short aggravation was usually followed by a rapid and well sustained improvement. I also noticed that in stronger and more prolonged aggravations this was often not the case. Through reading the Organon I came to understand that an aggravation is caused by the primary action of the remedy as it replaces the natural disease. It is not a natural healing crisis. Now I understood that the secondary curative action of the vital force was actually working to remove the similar remedial disease from without while reinstating true health within.
Now it became clear that too large a dose, too high a potency, and giving the remedy when it was not needed, was the source of most aggravations. I also noticed that prolonged aggravations actually used up the patient’s vitality, leaving little or no vital energy for a long enduring amelioration. To attain a rapid, gentle and permanent cure involves finding the right remedy or remedies, giving one single remedy at a time, and using the minimal dose in a suitable delivery system in the proper potency. These are the checks and balances that make homoeopathy a safe and effective system.
It was Hahnemann who taught the basics that every homoeopath should know. I learned through a careful study of his works that the size of the dose and delivery system are a very important part of posology while most persons were only thinking in terms of potency. Then I applied Hahnemann’s advanced methods in a step by step manner in a series of clinical trials that lasted years. Once I made this change the number of aggravations and complications were dramatically reduced and my cures were truly more rapid as well as gentle.
I call on all open minded homoeopaths to study Hahnemann’s advanced posology and case management procedures and then run their own clinical trial. Use the dry dose wait and watch method on one group and Hahnemann’s advanced methods and the medicinal solution on the other group. Administer single doses and infrequent repetitions of the medicinal solution, in those cases that respond in a strikingly progressive manner. Use split-doses of the medicinal solution at more rapid intervals in protracted disease states that require more frequent repetition to speed the cure.
Learn the methods of adjusting the size of the dose and the number of succussions to suit the sensitivity of the patient and the time and circumstances. Learn Hahnemann’s advanced methods properly from the start and follow the protocols we have discussed carefully. If you do this for one year you will see that the size of the dose really matters and the dynamic liquid delivery system is a very efficient way to give remedies. You will also see that it is truly possible to speed the cure of slow moving cases dramatically.
MB: In India, there is a trend to give the liquid potency (not solution) directly on the tongue of the patient, especially higher potencies. Is this appropriate?
DL: Yes, there are those who use pharmaceutical liquids without using the intermediate step of medicating a number of small pellets. It was Hahnemann’s practice to medicate 500 small pellets with 1 drop of the pharmaceutical liquid and use 1 or 2 pills in medicinal solution. This means that one or two drops of the pharmaceutical liquid is 500 to 1000 times larger than Hahnemann’s standard dry pellets. If one uses 3, 4 or 5 drops, the size of the dose is increased accordingly.
These large doses are certainly not suitable for persons who are sensitive; suffering from organic pathology in the vital organs and systems; have compromised organs of elimination, and an unstable vital force and weakened vitality. Perhaps, some do it because they still think the size of the dose doesn’t matter while others believe in the maximum rather than the minimal dose. Hahnemann noted that such large doses contribute to prolonged aggravations, strong accessory symptoms and antagonistic counter actions of the vital force.
Hahnemann taught that the optimum amount is the smallest possible dose prepared in the most dynamic medium. The most energetic delivery system is the medicinal solution. In this system, tiny poppy seed sized pellets are used to measure and store medicinal powers in precise quantum packages. Then 1 or 2 (rarely more) of these potentized pellets are used to impregnate a larger aqueous solution with medicinal energy. Then the medicinal solution is “potentized anew” with perhaps 8, 10 or 12 succussions just prior to administration so that the patient never receives the exact same potency twice in succession. This is truly the most dynamic way to give a homoeopathic remedy.
The olfactory dose is transmitted through the olfactory nerve to the brain and passes through the sinuses, trachea and respiratory tract. The oral dose comes in contact with the mucous membranes of the tongue, mouth, throat and stomach. During this process, the dynamic remedy comes in contact with many more nerves and surfaces than the dry pellets placed on the tongue. Hahnemann felt that this difference was important as he considered the nervous system to be the medium by which the vital force perceived a homoeopathic remedy (aphorism 16).
In my experience, a small dose of the medicinal solution produces the gentlest yet most penetrating primary action and stimulates the longest enduring curative secondary action of the vital force. This not only prevents aggravations but also makes the remedy far more suited to be repeated in split-doses to speed the cure when necessary. In this way, the vital force increases its energy in degrees until it is much more powerful than the original disease and complete vitality is restored.
Any time one uses too large a dose, they run the risk of producing too strong of a primary action in the form of unneeded aggravations and accessory symptoms. If the dose is exceptionally large it runs the risk of producing an antagonistic secondary action, which constitutes a negative reaction of the vital force itself. For these reasons, Hahnemann taught that it was best to start with the smallest sensible dose, and only increase the amount of the remedy, if and when necessary.
MB: It is believed that Hahnemann was a Freemason and his association with this secret organization was responsible for the vitalistic concepts of Homeopathy. To what extent is this true?
DL: First and foremost, Hahnemann’s teachings on the vital force are influenced by Hippocrates and his teachings on Physis, the healing power of nature. Hippocrates also taught that similars cured similars and medicines should be given alone in a minimal amount. He, above all others, was the source of Hahnemann’s inspiration. Hahnemann was also influenced by the Hippocratic medical school at Montpellier, France. This includes the teachings of Dr. Stahl on the Anima Mundi and the Vital Principle and Dr. Barthez on synergy and the Force Vitale. These are not occult concepts, but rather, the faithful observations of personages such Pythagoras and Hippocrates whose teachings are the foundation of Western music, mathematics, physics, philosophy and medicine. This vitalist tradition is more than 2,500 years old.
This does not mean that Hahnemann was not influenced by the free thinking of the Deist philosophers of the Age of Reason and his affiliation with the Masons. In fact, the teachings in aphorism 9 about the indwelling, rational spirit freely using the living, healthy instrument for the higher purposes of existence comes from Masonic writings. Hahnemann clearly stated that the study of philosophy was essential, especially to the practice of the healing arts. He was truly a man of the Enlightenment who spoke a great number of languages and could read original Greek, Latin and Arabic texts. He was also familiar with the teaching of Confucius and the oriental philosophers. There is no need to be ashamed of all this knowledge and wisdom. It makes me proud that our Founder was such a well rounded, educated human being.
MB: Some people also believe that the 6th edition of Organon was either written or heavily influenced by Melanie. Some even see some possible contribution of Boenninghausen’s son. Is there any merit in these doubts? Is there any evidence to support such beliefs?
DL: We know from letters that Hahnemann had finished at least most of his manuscript of the 6th Organon by 1842, although it appears that he added a few passages in 1843. If one studies the 4th and 5th editions of the Organon and the prefaces of the various editions of the Chronic Diseases one clearly sees the development of the system that finds its final form in Hahnemann’s last work. This is a step by step process that began in 1810 and progressed though the 1820s, 1830s to the early 1840s. The teachings of the 6th Organon did not appear in a vacuum as if they came out of nowhere. They are the natural progression of all that came before.
These teachings are mirrored in the Paris casebooks (1835-1843), where one finds the elements of pharmacy and practice that appear in the 6th edition. This includes the LM potency, medicinal solution, olfaction, single doses, split-doses, and repeating the remedy to speed the cure when necessary, etc. We also have the eye witness account of Reverend Everest who observed Hahnemann’s development of the LM potency. Dr. Croserio, a close colleague of Hahnemann, wrote about how the Founder used his remedies in his final years. Boenninghausen also wrote about the 6th Organon and shared two LM cases Hahnemann sent to him in 1843. The information in these letters and articles, the prescriptions of the French casebooks from the 1840s, and passages from the 6th Organon all match very well.
The original manuscript of the 6th Organon is in the library at Stanford Medical School in California, USA and has been shown to be authentic. There is no trace of Melanie’s or Karl von Boenninghausen’s handwriting in this document. Most of the work is in Samuel’s handwriting, although a few passages seem to have been dictated to a secretary. Richard Haehl also added a few notes that may have been reconstructions of damaged parts. I think individuals would be much better served by a deeper study of Hahnemann’s writings and applying them in the clinic, than imagining that Hahnemann’s final work is a forgery.
MB: There have been many debates about the accuracy of the English translations of the Organon. Do you feel that the translations have had an effect on the proper understanding of Hahnemann’s words? If yes, to what extent?
DL: Well, this is a very valid area to discuss but in a positive, educational manner. Of course, there are flaws in the English translations but not every German-speaking person agrees on what the Organon says either! It is written in a classical aphoristic style in long complex sentences in old fashioned German and uses some out-of-date medical terms. In fact, it is the last of the great medical classics in the tradition of Pythagoras and Hippocrates.
To understand the Organon one needs a background in the teachings of the Greek naturalists as well as medical history and the medical philosophy of Hahnemann’s times. The Organon cannot be comprehended only intellectually by persons that do not practice classical Homoeopathy. This is because to understand Hahnemann’s work takes years of clinical experience in the methods under discussion. For these reasons, no one, German or English-speaking, can speak for Hahnemann. All we can do is our best and work together.
Every homoeopath should look for a deeper understanding of important German words like Gestalten, Stimmung, Verstimmung, Geist, Gemuet, Lebenskraft, etc. We should all try to understand the meaning of the key phrases in their original context. For example, Boericke translated the German word “Gesammtheit” as the totality when Hahnemann spoke of the totality of the symptoms but he did not differentiate when Hahnemann actually used the word “Inbegriff” instead.
The term Inbegriff means essence, inner idea, or the nature of a phenomenon. The root of the word, Inbegriff is the verb “begreifen”, which means to touch, to handle, to comprise, to comprehend, to understand in the sense of coming in contact with something. This means that we not only need to collect the totality of the symptoms, we also need to grasp their essential nature so we understand their meaning. This idea is completely lost in the English translations. So we all, German and English speaking persons, need to study the philosophy and terminology of our classical works more fully. Hahnemann worked with a host of languages including those of the Ancients. He did not rely on second hand information when it came to important words and their meanings. Perhaps we should do likewise.
MB: Since the time of Kent, the trend to give more importance to the mental symptoms has come in vogue. Is there any historic evidence on why Kent gave so much emphasis on the mental symptoms?
DL: In his comments on taking a case Kent discussed using the mental state as the primary elimination rubrics because he felt that these rubrics were cardinal confirmatory symptoms. Nevertheless, when one studies Kent’s cases, letters to his colleagues, and commentaries on the materia medica, one finds that he did not prescribe predominantly on the basis of mental symptoms. For example, in Kent’s Lectures on Materia Medica, he shared his observations of important mental threads of the remedies, but he gave more time to their physical generals and characteristic particular symptoms. To imagine that Kent prescribed mostly on mental symptoms is a grand misnomer.
In a personal letter to Margaret Tyler in 1912 Kent explained exactly how he took his cases in the clinic. He wrote that first one should discover 3, 4, 5 or 6 symptoms that are strange, rare and peculiar because “these are the highest generals”. Then he states that it is important to make sure that there are “no generals in the case that oppose or contradict” these rubrics. Kent recommends “if the keynotes look like Pulsatilla, see to it that she is NOT chilly, likes windows open, wants cool air, to walk in open air, and is better from motion, thirstless, tearful, and gentle”. In the Use of the Repertory Kent wrote that there are “strange and rare symptoms, even in parts of the body, which experienced physicians learn are so guiding that they must be ranked in the higher and first classes [of symptoms].”
Kent opines that the keynote symptoms of our remedies are often the most “characteristic symptoms” but if the keynotes are taken as final and the generals do not conform, such a method leads to failure. In this letter Kent called the strange, rare and characteristic symptoms the “highest generals” and said nothing about the mental symptoms per se. This is because the hierarchy of mental symptoms is relative while the striking, exceptional, unusual and odd (characteristics) symptoms of aphorism 153 of the Organon are absolute. Out of the 109 cured cases Kent included in his Lesser Writings, only 35 cases include mental symptoms and the other 74 cases are built around redline characteristics and physical general symptoms. This means Kent only recorded the mental symptoms in 33% of his cured cases.
A rare, peculiar sensation or unusual complaint of the body has a higher value than the common mental symptom. The mental symptoms are only preeminent when they are truly striking, uncommon, unusual and oddly characteristic. Too many times remedies are given by stereotypical mental essences in which the patient is pigeon holed into preconceived concepts rather than matched to a uniquely constructed set of rubrics that mirror the individual perfectly. After all, no two human beings are exactly the same although some may be similar.
Since the time of Boenninghausen’s Therapeutic Pocket Book the repertory was no longer just a literal index of the symptoms found in the materia medica. It is an open systems tool in which unique rubric segments can be combined in an innumerable number of permutations that make up complete characteristic symptoms that reflect the patient’s unique mind-body state.
In this way, it is possible to construct a portrait of the disease in a manner that may have never been seen before and may never be seen again yet the remedy has the potential to produce such a picture. This artistic method can be applied to symptoms of the intellect, emotional disposition, delusions, dreams, sensations as if, desires, aversions and modalities in general as well as the uniquely constructed characteristic symptoms found in the regions of the body. Such a technique can only be carried out by those with a true understanding of the repertory and materia medica, for they see characteristic patterns where others see only chaos.
MB: Is there any reference in Hahnemann’s writings in this relation? How much importance did Hahnemann give to the mental symptoms?
DL: The first homoeopath to give great emphasis to the mental symptoms was Samuel Hahnemann! He wrote in aphorism 211 of the Organon that the “patient’s emotional state often tips the scales in the selection of the homoeopathic remedy”. He paid special attention to mental and emotional states during the provings, and when collecting symptoms brought out on patients under treatment. He integrated this material into homoeopathic materia medica, which includes more psychological data than any other system in medicine.
In 1875 and 1881 Hering published his Analytical Repertory of the Symptoms of the Mind. In this work, Constantine wrote “Every real follower of Hahnemann ought to know what he said in his Organon, from the 1st to the 5th, about the importance of the mind symptoms“. Then Hering quotes aphorisms 88, 206, 211, 212 and 213. Hering’s repertory is a unique study of the mental concomitants to physical symptoms and vice versa. The importance of the mental symptoms has been an integral part of Homoeopathy from the beginning.
Nevertheless, there are those who have taken the mental symptoms to the extreme and fallen into the mind-only school. They tend to ignore the physical generals and characteristic particular symptoms and have little understanding of how to use locations, sensations, and modifications to construct characteristic symptoms. They do not seem to recognize that the feelings and sensations found in the mind are also reflected by the feelings and sensations found in the body, in unusual ways that represent symptoms of the highest class.
It is important to learn how to use the unique “sensations as if” found in the regions of the body and read the instinctive language of the physical organism. Some imagine a rigid hierarchy that separates the mind and body rather than perceive a synergetic mind-body complex that acts as an integral unity. The instinctive body language of the physical organism is a mirror image of the archetypal powers of the psyche. To the careful observer these are two sides of the same coin.
MB: Another trend that has come up more recently, is not just to take the mental symptoms of the person, but also the innate characteristics like optimism, pessimism, etc., into account. Hahnemann said that in a sick individual, we should notice nothing but the deviation in the state of health. How appropriate is it to take into account the characteristics that define the person in health, for deciding the remedy?
DL: The first homoeopath to use the qualities of the natural temperament as part of the overall study of the totality of the symptoms was Samuel Hahnemann. The Founder wrote about this in the Materia Medica Pura when discussing Pulsatilla on page 345. First he noted that the successful employment of remedies take place when both the physical symptoms and the “mental and emotional alterations peculiar to the drug encounter similar states in the disease to be cured, or at least in the temperament of the subject of treatment”
Then he goes on to say that Pulsatilla will be most effective when it matches the physical symptoms, and at the same time, “the patient has a timid lachrymose disposition, with a tendency to inward grief and silent peevishness, or at all events a mild and yielding disposition, especially when the patient in his normal state of health was good tempered and mild (or even frivolous and good humouredly waggish). It is therefore especially adapted for slow phlegmatic temperaments, on the other hand it is but little suitable for persons who from their resolutions with rapidity, and are quick in their movements, even those they may appear to be good tempered”.
In the above portrait Hahnemann compared the natural disposition of the patient when feeling well (mild and yielding disposition, good tempered and mild, frivolous and good humouredly waggish) with the emotional symptoms during a time of distress (timid lachrymose disposition, inward grief and silent peevishness). Then he stated that this remedy was “especially adapted for slow phlegmatic temperaments”, and not suited to those who make up their mind rapidly, are quick in their movements, etc. This is the origin of the rubric “Well adapted to” in which the first generation recorded innate Hippocratic temperaments, natural dispositions and physical constitutions as guides in the selection of homoeopathic remedies.
Understanding the natural disposition, innate temperament, and physical constitution are teachings of Hippocrates that were integrated into Homoeopathy by Samuel Hahnemann. This study includes the four classical temperaments, the choleric, phlegmatic, sanguine and nervous melancholic, as well as diathetic constitutions like the scrofulous, bilious, tubercular, etc. This method compares a patient’s natural temperament in a time of health and happiness with emotional states during a time of illness and upset.
In aphorism 5 of the Organon Hahnemann wrote that it was very important to understand the fundamental cause of chronic disease and its relationship to the chronic miasms. The Founder states that in this study of the condition of the bodily physique, the character of the intellect and emotional disposition, the occupation, lifestyle and habits, social and personal relationships, age and sexual functions should be taken into account.
Hahnemann called these concomitants the *attendant circumstances* as they offer insight into the diathetic constitution, the character of the intellect and emotional temperament, predispositions, susceptibility, inherited and acquired miasms as well as the situational and environmental factors that affect the patient. On this foundation, Hahnemann introduces the totality of the objective signs, co-incidental befallments and subjective symptoms that make up the gestalt of the disease in aphorism 6. Then in aphorism 7, 18 and 24 Hahnemann reminds homoeopaths that a complete case history is based on causes, miasms, symptoms and the attendant circumstances. These areas of study are part of the original homoeopathic paradigm and very helpful when used in the manner originally intended by Hahnemann.
Boenninghausen wrote in “Brief Directions for forming a Complete Image of the Disease”, that the practitioner “should give a general image of the patient by stating his age, the sex, the constitution, mode of living, occupation, and especially the disposition when the persons was well. In many cases it is also of importance to know other peculiarities, such as, e.g., the complexion, the color of the hair, leanness or corpulence, whether slender or thickset, etc.” In “A Contribution to the Judgment Concerning the Characteristic Value of Symptoms”, the Baron wrote that the condition of the constitution and temperament should be assessed for differences during times of health and illness.
Hering expanded on this area of study in his Guiding Symptoms in a section called Stages of Life and Constitutions. For example, Constantine wrote that Calcarea was well adapted to Leucophlegmatic temperaments with light complexions, blue eyes, blonde hair and fair skin; Fat persons; Nervous temperaments with delicate constitutions; Plethoric women; Fat flabby children, with red faces, who sweat and catch cold easily; For drunkards, etc. One also finds other references to rubrics associated with constitution, temperament, sex, age, lifestyle, habits, etc., in the works of first generation of homoeopaths like Hahnemann, Hering, Boenninghausen and Jahr as well as H.C. Allen, J. H. Allen, H. Roberts, E. Whitmont, etc.
Although most modern commentaries lack a deeper understanding of classical constitution and temperament, the inclusion of the innate disposition in the study of homoeopathic remedies is an old method. Some modern writers, however, depend too much on their patient’s character traits and too little on the unique mental symptoms found in individual remedies. This can lead to stereotypical pictures where only one of several potential manifestations of a remedy is recognized. Therefore, it is best not to fixate too much on preconceived constitutional portraits at the cost of assessing the unique nature of the totality of the symptoms in each individual patient. When constitution and temperament, predisposition, occupation, talents, habits, relationships, sexuality, and miasms are studied in the proper manner it assists in finding homoeopathic remedies.
MB: You said earlier that Hahnemann is the Alpha of Homeopathy. What will be the Omega? Where are we headed?
DL: Constantine Hering felt that Homoeopathy will be the Medicine of the Future. I believe this is true. It may take 50 to 100 years before the establishment understands the true nature of an energy medicine that depends on the reaction of the vital force. At this time, orthodox medicine is still in the chemical age where doctors think only in terms of molecular structures. Homoeopathy transcends the chemical paradigm and works in ways that are more akin to the four forces of physics. Hahnemann pointed to this in the footnote to aphorism 11 when he spoke of the dynamic power of remedies as being similar to universal energies like electromagnetism and gravity.
Therefore, it will be physics not chemistry that provides the answers when humanity evolves beyond the carbon age and into a pure electrical age in which our world will be powered by renewable sources. This transformation has already begun, but it will take time to complete the process. A similar transformation will take place in the realm of medicine. No longer will remedial powers be thought to reside only in chemical structures. At some time in the future, energy medicine will become main stream and the powers of the minimal dose of the potentized remedy will be truly understood. This will lead to an Omega that is beyond our wildest dreams.
MB: David, I know you have been busy writing your 6 volume, 3000+ page compendium for a long time. I would like to know the story behind this special work of yours. How did it start and develop?
DL: My research started out of necessity. I became dissatisfied with the Homoeopathy I was practicing for my first 8 years, although it was not without its success. The door to change opened when I first started reading the Organon seriously and discovered that I did not really know what I was doing! Another problem was that the first version of the Organon I read was the 6th edition, which included the LM potency, medicinal solutions, and split-doses, which no one knew anything about.
Then I found a version of the Organon that compared the 5th and 6th editions and had some passages from 4th edition. I immediately came to realize that the way I was practicing Homoeopathy was more similar to the dry dose wait and watch method of the 4th Organon, than the methodology contained in the 5th and 6th editions. I was amazed that the methods Hahnemann introduced in his last 10 years were virtually unknown. This led to my first work on the subject, Hahnemann’s Advanced Methods, which I placed on my website many years ago.
At that time, I began to study as many eyewitness accounts as I could find in books, articles and letters. Then I decided that it was very important for me to get a firsthand look at Hahnemann’s casebooks so I could see how Hahnemann actually gave his remedies in the clinic. With this goal in mind I purchased the microfiches of the Paris casebooks (1835-1843) from the Robert Bosch Institute, Stuttgart, Germany. They have been extremely supportive and given me the rights to publish this information including digital images of the prescriptions, etc.
Fortunately, my wife Jill reads French so we worked on translating the cases into English. During this project we received great assistance from our French and German colleagues. They helped us with the translations and offered insights into the meanings of words and technical terms. We also collected a good amount of information from Hahnemann’s German casebooks for comparison. On the basis of Hahnemann’s writings, casebooks, eyewitness accounts and personal letters, we were able to reconstruct Hahnemann’s life and works in a manner never done before. Then we applied these methods in a clinical environment.
After this we expanded our research to include the works of Boenninghausen, Hering and Jahr as they assisted Hahnemann in developing the original Homoeopathic paradigm. In my studies I came to learn that Hahnemann practiced a wide variety of methods that included acute remedies, chronic remedies, acute intercurrents, chronic intercurrents, acute genus remedies, chronic anti-miasmic remedies, as well as prophylactic medicines. He also used a good amount of placebo to control his patients during periods of waiting and watching.
Hahnemann’s clinical practice included a single remedy over a longer period of time, the alternation of two single remedies, the rotation of three anti-miasmic remedies, tandem remedies where one remedy was placed in front of another remedy in a row, and a sequence of medicines spread out over time. For the last 10 years of his practice he delivered all these remedies in medicinal solution or by olfaction, in single doses or series of doses depending on the time and circumstances. This material expands the application of homoeopathic remedies far beyond what many consider “classical Homoeopathy”.
For these reasons and more, we decided that it would be best to write the Homoeopathic Compendium, Volumes I through VI. It is our hope these textbooks will provide students and practitioners with a large amount of information not readily available. At the same time, we wanted to counter the misinformation about Hahnemann’s life and works spread by those who do not understand the principles on which these methods are founded. There is no reason to review this part of the discussion as we have already spoken about it in great detail. The book will be out this year, hopefully within the next few months.
MB: Can you give us a sneak peek into the volumes? What can our readers expect from the 6 volumes of this compendium, which I believe will be historic in many ways?
DL: Volume 1, Philosophy and Practice, is a comprehensive review of Hahnemann’s life and works presented in such a manner that the information becomes useful in the clinical environment. It draws extensively on Hahnemann’s German and Paris casebooks and provides more detailed, documented material on this subject than is found in any other work. It has chapters on medical history and Hahnemann’s practice at the time of the 1st, 2nd, 3rd, 4th, 5th and 6th Organon, as well as key points of his philosophy and clinical methods. It also includes chapters on subjects like the cardinal principles, Hahnemann’s biomedical view, the laws of natural healing, the direction of cure, the treatment of acute and chronic diseases and homoeoprophylaxis. Volume 1 paves the way for the material presented in Volume II.
Volume II, Repertory & Case Management, presents an in depth review of the repertory and case taking methods of Hahnemann, Boenninghausen, Hering, Jahr, Kent and Boger. This review points out the specialty of each of these methods and concludes with a grand synthesis of all these ideas brought up to date. The volume progresses to study a number of case management strategies tailored to fit a wide variety of clinical situations. It also discusses some modern innovations and their place in the overall homeopathic paradigm. It has chapters that explain the similarity and differences between the C and LM potency and offers insights into when one potency system or the other may be most useful. There are detailed discussions of sensitivity, dose, potency and repetition and a study of remedy reactions. It follows the process of cure from the first appointment to the completion of the cure. Volumes I and II are companion works that offer a complete commentary on the methodologies of the 4th, 5th and 6th Organon.
Volume III, Psora and Antipsoric Treatment, is the most extensive text ever written on the nature of the chronic miasms in general and the treatment of psora in particular. It presents expanded lists of the primary, latent and secondary symptoms of Psora and offers details on the treatment of the itch disease found nowhere else. It presents an inclusive study of the cardinal anti-psorics Sulphur, Lycopodium, Calcarea and Psorinum and gives a new, dependable rubric of anti-psoric remedies. It contains sections on the anatomy and physiology of the miasms and their interdependent origin and shows how and why their symptoms arise as they do.
Volume IV, The Chronic Miasms and Cancer, presents a review of the primary, latent, and secondary/tertiary symptoms of sycosis, pseudopsora TB, syphilis, vaccinosis and new miasms under the titles of hepatitis, lymphosis and HIV/AIDS. It also includes a study of the cancer diathesis and offers symptoms of all its stages with remedies. It covers the treatment of cancer from the constitutional viewpoint as well as organ, tissue and system remedies. Volumes III and IV acts as a commentary to Hahnemann’s Chronic Diseases and introduce a great amount of new material.
Volume V, Constitution, Temperament and Maps of Consciousness, is an extensive study of constitution, temperament and psychology. The first part (Constitution and Temperament) is a comprehensive review of diathetic constitutions, classical temperaments, predispositions and disease states. It includes an examination of the anatomy, physiology, physiognomy and the symptoms of the four classical temperaments and their twelve mixtures.
This volume includes a unique description of the geometrical design known as the Mappa Mundi (Map of the World) and shows how the teachings of the Pythagorean-Hippocratic lineage are contained within its symbols. This helps the practitioner understand how the 5 homoeomeries (earth, water, fire, air and ether) manifest in the outer and the inner world of the patient. It also includes a well-documented look at the four temperaments in the homoeopathic materia medica and offers new repertory rubrics for various constitutions and temperaments.
The second part (Maps of Consciousness) starts with the history of psychology from the ancients to the pre-Freudian studies of the early homoeopaths. It follows with a study of the works of Freud, Jung and Whitmont, who integrated Jungian psychology into Homoeopathy. There are sections on the four major mood disorders, the five forms of neurosis, the twelve personality disorders, and specific states like paranoid disorders, schizophrenia, multiple personality disorder, psychosexual disorders, Autism Spectrum Disorders (ASD), Attention Deficient Hyperactivity Disorders (ADHD), etc. It is a complete manual of psychological disorders and mental illness with detailed symptoms from the homoeopathic point of view with new repertory rubrics.
The section on Jungian psychology looks at the development of human history from the view of mythologems. It offers a comprehensive study of the persona, shadow, anima-animus, collective unconscious and the Self, the five layers of the psyche. It also presents Jung’s psychological types, the four male and female archetypes and discusses the Oedipal and Electra complex, the Dionysus complex, the Aphrodite complex, etc.
This volume contains precise information on how to approach the patient and transform the homoeopathic case taking into an interactive discussion with the Unconscious of the patient. It teaches one to observe the patient in such a manner that one can use the spontaneous unconscious reactions of the patient as a guide to uncover their essential delusions, emotional complexes, mythologems and archetypes. It also reviews the subject of sensations as if and offers guidance on how to collect these symptoms, which are expression of the complete mind-body complex.
This interactive case taking method can be used like a lie detector to break through the emotionally repressed material that hides the patient’s core issues from the homoeopath. It utilizes the eye modes, facial expressions, breathing changes, voice alterations, instinctive body language, gestures and word association to understand how the Unconscious of the patient is responding during the interview. This method uses the 7 essential questions to guide the practitioner through the physical, vital and mental levels to the realm of pure consciousness so they may communicate in the deepest manner.
The study of interactive methods also includes the Electronic Reactions of Abrams (ERA) and teaches how to use Automatic Reflex Testing (ART). This technique turns the standard physical exam used to assess the patient’s health into an interactive meeting with the vital force. This dynamic system utilizes pupil dilation and changes in vascular pulses, heart sounds, respiratory response, percussion, palpation, galvanic skin response and postural alignment to test remedies before they are given. This biofeedback allows one to discover which of the tested remedies and potencies is the most indicated and identify counter indicated medicines.
Volume VI, Maps of Consciousness, the Materia Medica, presents the most important remedies based on the information, symptoms and rubrics in Volume V. This materia medica gives details on the nature of the remedy and its family and has sections on Images and Archetypes; Constitution and Temperament; Suitability to the 12 personality disorders; causations; miasms; mood disorders; neuroses; psychosis; paranoid states; suicidal tendencies; deranged childhood actualizations and disorders like Autism, ADHD, and multiple personality disorder. This is followed by a presentation of the most important mental rubrics in the form of a picture along with the most characteristic symptoms and their possible causes.
Specific mental disorders are discussed under separate headings like depression; mania; hysterical neurosis; hypochondria; anxiety; fear, paranoia, phobias; delusions and dreams. Then the physical concomitants are presented with their general symptoms, keynotes and redline characteristics. This section includes the remedy’s grand sensations that express the complete mind-body complex and the sensations as if found in the regions. This is followed by the modalities. Volume V and VI are complementary works that help put into practice the information found in the preceding four volumes.
It has taken me 35 years of research and 10 years of writing to produce around 3500 pages of ground breaking material. My goal is to offer a set of textbooks on Homoeopathy that will provide a solid foundation for new students and old practitioners alike. I have done my best to uncover the lost gems from the past and bring them up to date for practice in our times. I also have presented a good amount of contemporary research that I hope will be useful in a practical manner. At this time, the torch of Homoeopathy is being passed to a new generation. It is this passing of knowledge that will make Homoeopathy the Medicine of the Future. I am pleased if our work can contribute to this process in a meaningful manner. May everyone be healthy and happy!
MB: David, It looks really exciting! I would like to order the first copy of your book!! Where do I send the cheque? I am really looking forward to reading it.
It has been an absolute pleasure to hold this discussion with you. I hope every homeopath will read this interview and feel enriched. You have been very generous in giving us so much of your time while being so busy with the work on your compendium. I would like to thank you for sharing your knowledge and wisdom with us and wish you all success for your upcoming compendium. Thank you!
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Special thanks to Jill, David Little’s wife, for for her help in editing the interview!
Homoeopathic Online Education (H.O.E).
Visit David Little’s website:
http://www.simillimum.com
