Key skill: Synthesising

The combining of often diverse conceptions into a coherent whole; 

  also: the complex so formed  – merriam-webster.com

 “Notice patterns, make connections”

 

energymedc.com

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Examples of synthesis

When a choir sings, and you hear no individual’s voice.

The combination of hydrogen and oxygen to make water.

When you wear clothes that together add up to a style.

 “A few weeks ago I had a revelation and told my secretary that I could give him a synthesis of forty-six years of living with economic policy. It is: ‘Economic policy is random with respect to the performance of the… economy, but, thank God, there isn’t much of it.’” Herbert Stein

Maxwell’s theory of electromagnetism brought together in synthesis, as different manifestations of one phenomenon, both static electricity and magnetism.

 

1        Understanding humans

“Notice the stories going on around you”

 We start with the challenge of considering our place in the universe because (1) our understanding of ourselves influences the way we comprehend health and treat disease, (2) our understanding of humanity is constrained if we only consider matters of which we are individually certain, and (3) both scientific and spiritual understanding has influenced the history and development of homoeopathy, as with all other medical systems. These matters will take up the first section of this book, as we aim to develop a working hypothesis of humans and health. Whatever our individual beliefs, homoeopathy acts worldwide, distinguishing neither between the atheist, the agnostic nor the followers of many world religions. So, our common starting point should be universal, and without creed or dogma.

Humans as self-conscious beings

One of the ways we humans learn about ourselves is through telling ourselves stories. Many of these insights appear in our religious books. For example, in Genesis, Christians, Muslims and Jews are introduced to the first humans. We see people who:

value the company of, and unity with, others of their species; take risks for knowledge, but can develop inflated ideas of their own potential importance in the world; can be easily influenced; make a mess of things, but don’t like to own up to it; have a notion of a better or perfect world; experience a sense of having lost that better or perfect world;

are familiar with a spiritual power bigger than themselves; regard both toil and childbirth as a curse; already have issues between the sexes; have taken to wearing clothes, although the external environment does not appear to require it; aren’t fond of snakes; and, die.

I don’t believe you will have difficulty recognising these facets of humanity, even if you reject some or feel uncomfortable with the source. We know humans are social and reproductive beings, both co-operative and competitive, with the capacity for work which can transcend mere survival, and have the brain capacity for introspection and problem solving, including learning from mistakes. We can never be certain about whether we are significant beings, something special or random in creation, but we have the intellect, tools and information skills to debate this eternally.

We are able to observe in ourselves or others: emotional habits of seeking perfection or symbols of perfection; a common failure to achieve it; and, the pull of these concepts – or their failure to attract us – at various times in a life. Just like, so our stories tell us, the first humans. Our desire to explain ourselves and our place in the universe, and our ability to do this explicitly through written language, whether to affirm or deny its significance, is a distinctive quality of the species.

Humans in nature

Consider this representation of mineral, plant, animal and human life (as far as I understand, it is not contentious, although animal lovers and tree huggers may bemoan its sheer inadequacy):

Plants are distinguishable from minerals by observable life and growth systems (you can kill a plant). Animals differ from plants by, at minimum, a level of consciousness of movement (animals can of course be knocked unconscious). And humans differ from animals by self-conscious thought and action which we can evidence with embarrassing diaries, inspiring literature, and endless texts. If humans lose self awareness and conscious movement we talk of them being in a vegetative state, and in this way express our understanding of the difference between self awareness and (just) life.

Matter cannot be destroyed. Life, being conscious and being self aware are states that can be destroyed or can diminish. There is a progression implicit in ‘matter, life, conscious life, and self awareness,’ because there is always something lost by going the other way. An appropriate starting point in developing human solutions to our problems (like disease), then, would want to accommodate an understanding of the self-aware human.  Samuel Hanemann, homoeopathy’s founder, sought to do this. His phrase for the animating and aware quality of the material body, is often translated as the “vital force.” For homoeopaths, the “vital force” is part of our working hypothesis about humanity. Our body (and I’m deliberately not distinguishing between the physical body and other aspects of any body) should be understood in a way which acknowledges our humanity in the round: all of its distinctive nature and its animal, plant and mineral qualities.

For, even as self-aware beings, we carry within us aspects of the mineral, plant and animal kingdoms. Whether it is matter in transit as digesting food; and, more permanent features. For example, the average 70kg body contains:

40 litres of    water;

16kg of         carbon, enough for 9,000 pencil leads;

14kg each of  fat and muscle;

1 kg  of          calcium, the same as 1,450 pints of skimmed milk;

140g of          potassium, 333 bananas’ worth;

100g of        sodium, equivalent to 32 bottles of ketchup

4.2g of         iron, enough to make two 2.5cm nails

2.6g of         fluorine, the same as 26 large tubes of toothpaste

2.3g of         zinc, equivalent to 181 oysters

72mg of       copper, enough for a 10.6cm piece of modelling wire;

0.2mg of        gold

0.1mg of      uranium, enough power for a 100w light bulb for 10 minutes.

(Don’t sell your body, the gold is only worth about a penny.)

Humans and plants both: need oxygen and water; reproduce (humans make babies, plants make seeds); grow and develop; share a common basic life unit, the cell; and, contain similar chemicals. Humans and animals also share the 4Fs: feeding; fighting, fleeing; and, sex.

Homoeopaths reflect our relationship with the natural world through our medicines, remedies overwhelmingly sourced in nature. The table of body minerals above illustrates, for example, why Carbonicum, Calcarea, Kali and Natrum remedies based on carbon, calcium, potassium and sodium, feature heavily in a homeopathic pharmacy for bodies out of balance (diseased).

Whether we choose to describe complex humanity in terms of the well-developed function of the brain’s neocortex, prefrontal cortex and temporal lobes; prefer explanations spiritual or material, accidental or with a greater purpose – our design for human medicine should be able to accommodate all the dimensions of being human. Homoeopathy is characterised by an uninhibited and unrestricted understanding of human experience in health and disease. Good homoeopaths don’t limit humans.

Humans as energy systems

It would be more faithful to Sam’s original text to talk about our “life force” as the human’s animating and aware quality, instead of “vital force” ; Lebenskraft was the word he used most. An earlier German scientist, Leibniz, favoured a similar phrase, lebendige Kraft (living force) or its Latin equivalent, vis viva, to describe how movement became embodied in an object. Both Hahnemann and Leibniz were concerned to explore how material objects became animated, whether it be the material body or inert matter. This sense of something dynamic, moving, is reinforced by Sam’s use of the Greek word “dynamis” as part of his vocabulary; he uses it when he is trying to capture the essence of a human. Dynamis implies potential – the promise of action, a power that can be put to use (usable power).

A common dictionary definition of energy is “a capacity to perform work” (OED). The Merriam Webster Dictionary preferred term is “a usable power;” they also offer “a dynamic, a potential, a fundamental and transferable entity.” Our bodies are a usable power, a dynamic, a potential; and our life force or dynamis is a fundamental entity (and in some religions, a transferable one).

Leibniz contributed building blocks to our understanding of kinetic (movement) energy and energy conservation. Sam explored body responses which looked forward to future neurological and epigenetic understanding, in his search to understand the dynamic qualities of the body, health and disease. [Epigenetics = changes in gene function that cannot be explained by DNA sequence; a typical research problem could be, why is only one of a pair of identical twins susceptible to a certain illness?]

Sam’s conception of a dynamic life force carries an energetic quality, and homoeopathy is sometimes talked of as an energy medicine. Is this notion metaphor or reality? There are coherent expressions of humans as energy systems; explanations embodied in the ancient traditions of Indian chakras and Chinese meridians are immediately accessible, for those who wish to study them. An ambition to develop an understanding of ourselves as an energy blueprint within western scientific culture (and Sam’s own Enlightenment heritage) is however still a work in progress, needing additional research and co-operative working.

We will look at two contributions. Vithoulkas [Science ch 4] sought to position homoeopathy within a developing science of electromagnetism and the human body. This remains a valid line of enquiry; an ECG could not measure heart activity without the natural presence of electrical current stimulating the heart muscle. Exploration of electrical signalling within the body reinforces the significance of sodium, potassium and calcium we have already seen, and of chloride ions. Writing over two centuries earlier, Sam [stanza 286] recognised the potential for electricity as a dynamic healer, but could not embrace it until it had a sure (and safe) application. The bad news is: he could be writing a similar statement today. So, maybe we should illustrate energy flow through the living system of the body (the study of bioenergetics, a branch of biochemistry) rather than seek to co-opt it at this stage as either explanation or potential healer.

Three energy systems work together to power an athlete:

• From a standing start, the ATP-PC system will make the greatest contribution in the first five seconds. This is energy available for immediate, explosive and/or heroic use. The ATP (adenoside tri-phosphate, the energy molecule in human beings) here is stored in muscles, and PC (phosphocreatine) ensures its replacement in a self-managed, oxygen- and waste-free manner. The body’s ATP-PC reserves, even for the Olympic sprinter, are unlikely to last more than 10 seconds. This is the immediate response unit.

•  The second player is the Glycolosis (sometimes called Lactic) system which overtakes ATP-PC as the powerhouse from about the 5^th second of activity, once it has undertaken its own necessary preparation, and is the principal energy source until around the 30^th second. In the first five of the ten reactions, the body invests energy to achieve a net gain of 2 ATP molecules per glucose. The body can sustain this process without oxygen for 1.5 to 3 minutes, during which time the lactic acid production supports a self-sustaining circuit of chemical reactions, before it builds to a level which is self-defeating and hampers performance. Gymnasts need efficient glycosis systems; it is the body’s early and time-limited defence against damage.

• Our marathon runner is the Oxidative system. A bit slower off the mark and relying on the circulatory system to supply oxygen, it breaks down carbohydrates, fats and proteins to generate ATP  through a variety of processes and chemical reactions involving carbon, hydrogen and oxygen.

[https://www.youtube.com/watch?feature=player_detailpage&v=hGYD7aUi6fk  for how the energy systems work together]

A medical model wishing to learn from our energy supply would consider where it can replicate body processes of emergency response, short-term defence mechanisms, and sustainable function. We will learn that homoeopathy has care guidelines reflecting all of these (having this in common with much medical practise), and that additionally, there are models for correlating the strength of our medicines to these different situations.

As part of our design for human medicine, we could legitimately anticipate that effective body responses like those outlined above are understood and respected, and worked with as partners or principal actors in any treatment plan. This is not something that we can take for granted, as the Approaches to Human Health chapter illustrates, but is a feature of good homoeopathy.

And so, to the second contribution. I once got 17% in a chemistry exam, my worst ever mark, so you’ll forgive me if we leave biochemistry behind, and consider today’s science of dynamism and universal cause and pattern, theoretical physics. My contribution will be explorative rather than authoritative, taking reassurance from Barenger’s introduction to chaos theory which says: [http://necsi.edu/projects/baranger/cce.pdf] “chaos destroys… the dream that we have absolute power if we only know enough about the details.”  Any mistakes in interpretation are my own.

Humans as expressions of chaos theory

Because this is illustrative, and about perceiving patterns, do not worry too much about what you do and don’t understand about chaos theory. You will be in very good company when you are uncertain.

“The signature of time-chaos” according to Barenger, “is something called “sensitivity to initial conditions”. It says that, if you have two sets of initial conditions, or two points in phase space extremely close to each other,” [phase space is the set of all possible values of all variables] “the two ensuing trajectories, though close to each other at the beginning, will eventually diverge exponentially away from each other.” To put it another way: suppose two people are exposed to and become ill from the same bug; unless the initial conditions are absolutely identical (for example, they are both in exactly the same state of health), the development of their illness will differ, with the level of distinction growing as time passes. This implies that we cannot reliably treat disease according to a simple plot: disease name, related medicine, predictable outcome. We need to know what was going on in the individual prior to and at the time of infection.

To put it another way: If we are to be sensitive to initial conditions as part of our tracing of the trajectory of illness, we need to know what is distinctive about the initial state. Accordingly, homoeopaths explore objective and subjective causation, and the health history of the body experiencing those initial conditions. We will return to these ideas when we review understandings of health, the causation of ill-health, and different guidance for the treatment of epidemic and acute disease and of longer term chronic illness.

Barenger continues, “Edward Lorenz, the discoverer of sensitivity to initial conditions, also called it “the butterfly effect” because… it is possible for a butterfly, by flapping its wings on some Caribbean island today, to change completely the weather pattern in Europe a month from now.” If we translate this into the body, we would be foolish to judge the magnitude of the impact of something seemingly trivial on our health ecosytem. It has the capacity to develop disproportionately, magnified through the numberless small adjustments made within the body’s autoregulation system (for example, heating up, cooling down) and immune responses (for example, inflammation) which normally serve us so well. In a similar way, every motorway driver has experienced traffic jams without explanation; the consequence of hundreds of sensible, minor braking adjustments.  Identifying: the initial stressors on the body; tracing body reactions and patterns of reactions, and where these get stuck or become self defeating in the body’s self management of disease; and, working without any preconceptions – all are fundamental to homoeopathic case taking. We will return to this later on, under Symptoms.

Barenger goes on to talk about complex systems. As humans, we fall into the category of self-reproducing complex adaptive systems. The characteristics of a complex system are:

•    many constituents interact in a non-linear way;

•    it has interdependent constituents (removing half a leg has a whole body impact);

•   at every “scale” of the system there is a structure, with its own global interactions (you cannot understand walking by examining only the leg or the head); and

•   it has the capacity for self-organisation, changing its structure or creating a new one; &

•   the interplay of chaos and non-chaos (“Then there is the edge of chaos, i.e. the precise value of the control for which the nature of the dynamics switches.”)

If we are to intervene in complex systems, physicians should be capable of investigating its interactions (and, so have a holistic frame of reference, and be interested in whole-body as well as local phenomena) and accommodating non-linear phenomena (accordingly, homoeopaths are guided by individual symptomatology rather than the common symptoms of the disease.) Many a weary homoeopath may yearn for linear expressions of disease, but (to adopt some of Barenger’s language) the individual’s health dynamic switches through an interplay of the predictable and unpredictable. Homoeopaths at the edge of chaos isn’t the next blockbuster movie, it’s our everyday work.

Understanding humans: the argument

1        Our body should be understood in a way which acknowledges our humanity in the round: all of our distinctive nature and its energetic, animal, plant and mineral qualities. Human medicine should be able to acknowledge us as self-aware beings.

2        Homoeopathy has an unrestricted view of human experience in health and disease. Good homoeopaths don’t limit humans. Aspects of our interrelationship with nature are reflected in our choice of medicines.

3        Homoeopaths understand that there is a dynamic, energetic quality to health and disease but struggle to find everyday language to communicate it, in the absence of a coherent expression in western science of humans as energy systems.

4        Exploring the energy supply of bodies reveals patterns of emergency response, short term defence mechanisms and long term sustainability. Much human medicine, including homoeopathy, reflects a similar classification, most commonly expressed as emergency, acute and chronic treatment.

5        Human medicine should be able to understand and work with effective self-generated body responses, respecting them as partners or principal actors in any treatment plan. (Good homoeopathy does.)

6        If we understand humans as self-reproducing complex adaptive systems (as theoretical physicists do), we cannot reliably treat disease without knowing the initial conditions of the individual, and cannot take for granted the trajectory or path of any illness.

7        Homoeopaths research initial conditions in detail: the health history of the individual and factors at play at the time they became ill.

8        The impact of something that seems trivial on a complex system can be entirely out of proportion. As well as identifying the initial conditions, human medicine should seek to trace patterns of bodily reaction and interaction which make the problem worse, rather than better.

9        Homoeopaths seek to observe without preconceptions or prejudice, the way the individual body is developing in disease.

10      Human medicine should be capable of investigating body system interactions and accommodating the unpredictable.

11      Homoeopathy has a whole body system of reference, as well as being able to explore in detail local phenomena. Good homoeopaths are guided in remedy choice wherever possible by unpredictable symptoms, as they are more characteristic of the individual path or trajectory of a person’s disease.

2        Approaches to human health

You are in a building with a large, round, open, common space in the middle. Around the space there are arches. Beyond the arches, a perimeter corridor takes you to areas dedicated to different forms of medicine, based on distinctive views of humanity and the human body, The middle is flooded with light and beautiful, but people rarely venture into it; they don’t want to be conspicuous in its emptiness.

It is, in fact, the Basilica di Santa Maria della Salute in Venice, built on 1,156,657 piles of oak and larch reaching down into the solid ground beneath the lagoon, and started after the plague of the 1630s receded, leaving 1 in 3 Venetians dead. Beyond the arches are shrines to different saints. It serves our purpose here, because it is commonly known as “San Salute,” literally Saint Health, and I don’t know of any other place of worship dedicated in this way; and also as an image of most health practise – most practitioners are too busy in their own discipline to explore the space in the middle. I’ve tried to identify some of the piles which should be holding up the middle space in chapter one. I may have made a mistake in trying to claim a lot of them for homoeopathy – an understandable mistake, given the subject of the book. But if we can identify universal principles for health, this provides a launching pad for working together as mature professionals across disciplines, and the basis for evaluating the strength and weakness of different approaches. In this chapter, I want to illustrate the way our understanding of humans can influence, and in some cases has informed, the delivery of a health service.

The person as machine

If you have a mechanistic view of humanity, these health principles follow:

The human can be understood, diagnosed and treated structurally through dissection and the study of anatomy (knowledge of the machine parts), and by intervention in the body through surgery or pharmacology (exerting a biochemical and/or physiological effect on constituent parts).

This model would tend to:

•    ignore some dimensions of the self-aware human

•    be compatible with an emergency, acute and chronic approach to treatment

•    be least effective where surgery or drug treatments have not proved effective interventions

•    intervene in ignorance of, or even opposition to, self-generated body responses

•    focus on diagnosis of machine malfunction, rather then be concerned with a broader understanding of initial conditions

•   and, likewise, envisage a restricted range of machine responses and outcomes; &

•  seek to repair the observable machine fault rather than exploring machine interaction (the bits of the car, rather than its electrical system, which requires more sophisticated diagnostics).

A fair judgment on these principles may be, that they are limited. The limits sometimes offer clarity of diagnosis and treatment, but can put the mechanic in opposition to the body they underestimate.

The person as spirit       

Often presented in opposition to the mechanistic view of the person, health principles for a spiritual view of humanity are probably more diverse. I hope this expression is adequate:

Life is sustained and explained by an immeasurable, intelligent force or energy. The functions of a living organism are due to a life principle distinct from the physical body and its biochemical reactions.

The human can be understood, diagnosed and treated as a spiritual manifestation, through non-material intervention. Tools vary from seeking to channel divine power or guidance, through attempted dissection of the subconscious, and the study of manifested spiritual, mental and emotional symptoms consistent with the “higher” levels of consciousness of the patient.

This model would tend to:

•   ignore those dimensions of the human which relate to the physical body and shared experience with non-human life

•   not be illuminated by emergency, acute and chronic understandings of treatment

•   be least effective where there is an observable musculoskeletal or machine problem which could be remedied by surgery

•   promote least harm with regard to the risks of frequent pharmacological interventions

•   be either very respectful of – or completely discount – self-generated body responses

•   focus on diagnosis of consciousness or spiritual malfunction or inadequacy, rather then be concerned with a broader understanding of initial conditions; &

•   be limited in its exploration of system interactions within the body.

A fair judgment on these principles may be, that they are also self-limiting. In their narrowing of the scope of significant human health expressions, this model and the mechanistic view help to fill each other’s gaps. Therapeutic responses have less clarity than the mechanistic model, and may require the investment of a lot of faith in the physician.

The person as eco-system

If you have an ecologist’s understanding of the human, your health mantra might be:

Life is evidently adaptive and capable of regenerative activity. Human experience of health and disease is influenced by the social and the instinctual, alongside any material expression.

The human can be understood, diagnosed and treated through recognition of its nature as a living and integrated system, the study of maladaptive responses and connective processes, and intervention through the use of mild stimuli.

This model would tend to:

•   accommodate the self aware human, interdependent with nature

•   be capable of working within an emergency, acute and chronic approach to system failure, illuminating both sustainable long term treatments and leaving things alone

•  be least effective where there is an observable musculoskeletal or machine problem which could be remedied  by invasive surgery

•   be effective in intervening with awareness of, and as a complement to, self-generated body responses

•   investigate initial conditions broadly

•   recognise system patterns, system interactions and whole eco-system symptoms as significant indicators; &

•  be sensitive to multiple causation, interaction and different scenarios of  developing imbalance (disease).

A fair judgment on these principles may be, that they are widely accommodating of individual difference, breadth of enquiry, patterns and interactions, and observation-led responses. They are demanding of the physician or healer in their analysis, and in their identification of interventions which are minimally invasive but maximise outcomes.

The person as energy system

Our body’s energy is all of “A vitality; a power; a capacity to perform work; a dynamic; a potential; a fundamental and transferable entity; a usable power” (the definitions of energy). Starting from this point, your health principles might be:

The universe is energy, with everything material an embodiment of that energy as mass. Energy can convert its form, but is neither created nor destroyed; it is governed by balance in its inflow and outflow.

The human can be understood, diagnosed and treated as an energy system requiring an appropriate energetic reaction to the body’s energy action in diverting energy from conservative equilibrium (its own autoregulation) into symptoms of disturbance (disequilibrium).

This model would tend to:

•  be less concerned with the self-focussed human, but able to take for granted multi-dimensional expressions of energy within the human and their environment

•   be capable of working within an emergency, acute and chronic approach as expressions of varying energy flows rather than discrete health models

•  possibly illuminate the more dynamic emergency and acute expressions of disease

•  be least effective where there is an observable musculoskeletal or machine problem which could be remedied by invasive surgery

•  be most in sympathy with self-generated energetic body responses and seeking to balance them

•  investigate initial conditions (energy flows) broadly

•  recognise system patterns, system interactions and whole energy system symptoms as energy flow indicators; &

•  be sensitive to multiple causation, interaction and scenarios of developing imbalance (disease).

A fair judgment on these principles may be, that they provide a common thread through individual difference, and are widely accommodating of breadth of enquiry, patterns and interactions, and observation-led responses. They are particularly demanding of the physician or healer, seeking to intervene in support of energy system balance, in the absence of a clear and/or broadly-held framework of understanding of humans as energy systems. Translating understanding into therapeutic actions is inevitably therefore more experimental.

*

Which understanding of the human does homoeopathy promote or reflect? My perception is, this lacks coherence. It is probably easier to say what we do not stand for: Homoeopathy does not have an understanding of the human as machine. This frees the profession from a limiting mind set.

Sometimes, too, it is a weakness; the role of surgery is probably inadequately discussed in homoeopathic education; and, some homoeopaths’ understanding of the body lacks those insights that the mechanical tradition of health has offered.

Some homoeopaths have an understanding of their craft based on the human as spirit, particularly those whose training has been dominated by Kent’s interpretation of the Organon, homoeopathy’s founding manual. (Later, I will evidence that Kent restricted rather than reflected Sam’s teaching in this particular respect.) This liberates a significant area of health activity. The risk associated with this mind set is that it can also be self-limiting, and can result in isolation from, or opposition to, most other health care.

Homoeopathy often describes itself as energy medicine. We have seen briefly that this is a plausible model of healthcare, but one with significant gaps in our knowledge and understanding, and one also where we lack in the west the language for communicating it to the patient. A therapeutic model articulated well and in everyday language based on healing the person as an energy system remains an ambition for the profession, and a good ambition. There may be some who feel it has been done to their satisfaction; I believe we’ve barely started. I make my own contributions below, knowing they are far from the synthesised understanding I crave.

I know of only one homoeopath who talks about the human as an eco-system – me. I believe this offers a useful working health hypothesis for today. It has many features in common with an energy analysis and at times complements it. It offers a language that is less alien and less abstract, and one that we can verify with our senses.

As you read on, I invite you to evaluate homoeopathy’s practical application against the understanding of the human as both an eco-system and an energy system.

Copyright: George Garlick

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