Polarity Analysis in Homeopathy – A Precise Path to the Simillimum
Author: Heiner Frei
First English Edition 2013
Reviewed by Dr. Firuzi Mehta
Published by Narayana Publishers
No. of pages:312
In recent years, there has been renewed interest in Boenninghausen’s Therapeutic Pocket Book (TPB) that was first published in 1846. This repertory follows Boenninghausen’s premise that valuable modalities, sensations and findings of a remedy are capable of generalization. His TPB was valued greatly for its precise grading of symptoms but fell into disuse eventually probably due to the popularity of Kent’s philosophy and the apparent ease of use of Kent’s repertory. The value of the Therapeutic Pocket Book (TPB) was pretty much unknown to generations of homeopaths as homeopathic colleges focussed on Kent and his works while touching upon Boenninghausen’s works only cursorily.
Over the centuries, homeopathic fundamentals have remained the same but homeopaths have constantly striven to make remedy selection easier and more accurate. A lot of new methods and schools of thought have arisen from these endeavours. The ideal method needs to be one that can reliably and reproducibly determine the required remedy. Most of the new methods have not been statistically evaluated.
Polarity Analysis (PA) was developed by Heiner Frei for a scientifically rigorous Swiss double-blind study with homeopathic treatment of hyperactive children. This study demonstrated a significant difference between high-potency homeopathic remedies and placebo. The main challenge in reaching this result was to improve the reliability of all the factors used to determine the remedy.
Polarity Analysis is a development of Boenninghausen’s concept of contraindications. PA is a working method for the Therapeutic Pocket Book and Heiner Frei’s book provides us with a practical introduction to it.
The book consists of 3 Modules and an Appendix.
Module 1 describes Polarity Analysis in detail. It shows how PA follows the founding principles laid down by Hahnemann and the practical methods of old stalwarts like Boenninghausen, Hering and Lippe. It explains the value and use of Polar Symptoms (those symptoms that can have an opposite aspect, an opposite pole) in improving the reliability of the remedy choice. The author clearly explains the kind of case-taking that is required for suitable Polarity Analysis to take place. The author has simplified our work for us by creating valuable checklists and questionnaires for acute and chronic ailments. The symptoms used for these lists are from the Therapeutic Pocket Book and use the same language as the repertory. No symptom with less than 10 remedies in it is used. The patients themselves need to mark out their symptoms on the questionnaire which the homeopath can then confirm. Since these lists are built with repertory language and are specific to the TPB, this eliminates the possibility of errors creeping in due to faults in interpreting a patient’s symptoms and then converting them to repertory language.
These checklists and questionnaires are given towards the end of the book. They are also freely downloadable from the author’s website, www.heinerfrei.ch
Heiner Frei lays down, in simple language, the rules to be followed for PA to be most effective. He also clearly describes the dosage he follows and how follow-up assessments are judged.
The method of Polarity Analysis focuses on the Polarity Difference and also emphasises the importance given to contraindications. However, these details cannot be explained satisfactorily in a review.
Highlights of Polarity Analysis:
- Mainly physical modalities are to be used, since they are the ones that are most reliable.
- At least 5 polar symptoms should be used.
- Characteristic symptoms during the ailment are to be used; not traits that are present even in health.
- Mental symptoms are to be left for later, when remedy coverage is checked in the Materia Medica.
The repertorization results are weighted in the following order of importance:
- Absence of contraindications and size of polarity difference
- Completeness of symptom coverage
- Suitability of remedy in Materia Medica coverage.
Heiner Frei recommends the software program version V 2.6.0, 2012 of the Boenninghausen Arbeitsgemeinschaft (Boenninghausen Working Group). This software is preferred because it is the only one that uses the revised edition of the TPB that contains his final views on the grading of symptoms. A 30 day free trial version of this software is offered on www.boenninghausen.de
After describing the PA method in detail, Module 1 discusses the procedure to be followed in Acute Illness, along with case histories demonstrating the same.
Module 2 comprises procedure and case histories for Chronic Illness and for Mental Illness in Children and Teenagers.
Module 3 does the same for cases of Multimorbid Patients (those that have 3 or more complaints at the same time). Module 3 also has a section on Statistical Evaluation Studies of Polarity Analysis with and without checklists, comparing results with conventional homeopathic prescription methods. This is followed by a listing of the tools that are to be used for Polarity Analysis – the repertory, checklists, questionnaires and case logs.
Throughout the book, there are Quiz Questions which deal with the information covered till that point. These are very useful for clarifications and proper understanding of the topic. Answers to each Quiz are given in the Appendix at the end of the book.
My Impressions –
After a thorough reading which generated a lot of interest in this method, I downloaded the checklists and questionnaires from the author’s website www.heinerfrei.ch. I also downloaded the 30 day free trial version of the software offered at www.boenninghausen.de
I got some family members and friends to fill in the checklists and questionnaires and then worked out their cases with this method. I also used it for some of my patients where I was not too satisfied with the results so far. In some cases it confirmed the remedies already prescribed while in some it threw up some interesting possibilities that I had not considered earlier. After prescribing, some of the patients showed a good positive response. I am hopeful that this method will open up a new path to solving our cases successfully.
On the whole, the method is easy to understand and use. The case-taking method is also simple and saves time compared to conventional homeopathic history-taking. The checklists and questionnaires, being in TPB language, remove the possibility of errors in interpreting a patient’s symptoms. The software is perfectly adapted to Polarity Analysis and is very easy to use. The fact that the questionnaires have symptoms in language of the TPB also makes the use of the TPB very easy for someone who is not conversant with the book.
The Notes in red alongside the margins are very useful when a quick reference is needed.
For beginners who may be fumbling with all the different and complex methods out there in the homeopathic world, this is a welcome break, with an assurance of good results, especially with more practice. For busy practitioners, it saves time, yet delivers better results.
The paper and print quality of the book is excellent; we have come to expect these high standards from Narayana Publishers.
Thank you, Heiner Frei!!
Great review Firuzi. I will now buy this book and study!
Thanks, Manish. Yes, the book is very interesting and the method very promising!
Kindly guide regarding how to purchase above said book..or e copy of such..
I have used this method since I first read Frei’s paper back in 2005. I use the Pocketbook module in RADAR created by Peter Vint which has a polarity option built into the wizard. I had good results in a case of polymyalgia rheumatica using euphorbium, based on analysis of the modalities of the case, showing euphorbium having the highest polarity score though not the highest totality score. The remedy worked very well. Since then, I’ve treated two other cases of polymyalgia rheumatica using the same analysis method, one with euphorbium again, the other with thuja… they responded too. Formerly I found this a difficult condition to treat. It is a high grade inflammation and conventional medicine uses oral steroids in quite big doses to treat it.
Thanks, Richard! That’s very interesting and more confirmation that this method is truly promising!! Thanks also about mentioning your use of RADAR for Polarity Analysis. I have been asking the Indian sellers about possibilities of Polarity Analysis with RADAR but have had no decent response yet.
My experience so far with contacting RADAR’s representatives is that they are not very interested in the Boenninghausen method and don’t know much about it. I had to go ahead and buy the Boenninghausen module and hope for the best. It does work well though I cannot say whether it works quite the same as Dr Frei’s criteria for choosing polar rubrics. The important thing with whatever repertory is that you check the remedy in the Materia Medica; everyone who writes about this approach agrees on that.
Great review, Firuzi! Certainly looks like a book to purchase.
Thanks for this really well constructed review. In Frei’s method it appears we finally have an innovation that makes finding the simillimum simpler, rather than more complex.
Boenninghausen mentioned in one article, that the polarity approach may furnish another support for an already to be chosen medicine. this idea was picked up many times before Frei’s publication and was dismissed for the following reasons:
A remedy is chosen on positive symptom similitude (= basic principle of homoeopathy)
It is and cannot be chosen on symptom absence (= symptom absence in the case compared to the MMP, or symptom absence of the mmp compared to case)
Therefore such a polarity cannot furnish an indication / contra indication for a remedy possibly suitable by symptom similitude to the disease-symptom-picture.
Your objection “such a polarity cannot furnish an indication / contra indication for a remedy”, Hans, seems a theoretical one,that is refuted by the success achieved by Frei and colleagues using just such indications. Practice and evidence trumps theory, surely? Or rather, calls for a revision of theory.
Dear members, dear Richard.
Richard, you are mistaken when alleging, that my comment is based only on theoretical considerations.
My contribution gives the reason why under homoeopathic basic principles and rules this approach is dismissed.
I don’t dsipute Frei’s successe in his case work, but this dispute that they were due to using polarities for the selection.
Primarily he actually used the normal positive results of the proving (via rep.) to determine a remedy which he then further confirmed by polarities.
If we take his cases to the test and select medicines exclusively on the positive symptom similitude (=leaving aside the polarities), the same remedy is/ would have been indicated and therefore cured by positive symptom similitude.
It is fact, that medicines can only be recognized by their positive actions upon the healthy living organism. So an absence of positive action, does not necessarily mean, that such remedy is unsuitable, as it has been seen over and over again when reproving, that new symptoms were brought out.
In this context you may consult Beonninghausen’s observations to Atropina Belladonna.
My experience using polarities ( 1993 on) shared by other members of the group probing into Boenninghausen’s way of prescribing found, that using this method is of no advantage and rather de solidifies an otherwise sound selection. We even experience cases, where we were lead to an unsuitalbe remedy because polarities excluded the correct remedy from the final case analysis.
We frequently ran into difficulties when trying to utilize this idea with remedies listed in opposing modalities. (compare heat< / cold< in TT)
As a result we dismissed the method completely.
Frei's idea to count how many times the remedy was mentioned for each opposing modality does not give the solution, as grade 4 and 5 in TT were arrived by clinical experience.
You may also consult Boenninghausen's own case presentations and records, to see how and when he used the polarities as an indication for or against a medicine. I would be most interested to be pointed towards such cases, as i haven't come across one single ONE in my more than 20 years of research.
Thank you, Hans, I appreciate your taking the time to explain your conclusions in more detail. I must admit, I’ve had more success using the TT to build complete symptoms (Location, Complaint/sensation, Modality) as vB instructed, than I have using the polarity system.
I still think, though, that as research is hard to produce in homeopathy — research that stands up to those who want to pull anything homeopathic to pieces, we should treasure work like Frei’s that is of good quality, and not dismiss it ourselves. If the medical-scientific world was truly objective, it would, on the basis of Frei’s research on ADHD, make homeopathy the treatment of choice in this condition, or at the very least, attempt to reproduce his work independently.
Dear Richard, dear Members
It is prudent to first assess a new method as to its suitability, reliability and risks before introducing it to the clinic. As therapists we are obliged to cure and not to experiment with our patients. We are dealing with sick and suffering people. Homeopathy is reliable as long as it is used according its rules and principles. If it becomes clear at the preliminary stages, that a new method is not conforming homeopathic rules and principles One should abstain from even testing it on our patients.
Following this approach I first study and compare innovations with the basic homeopathic principles.
After consulting par.: 50 / 70 / 71 it is clear,
1) that ONLY the positive signs and symptoms of the case of disease form the indications of the to be found medicine
2) That only the positive signs and symptoms brought out in the provings are indications for the curative medicine which becomes remedial when applied in suitable strength and frequency after removal of obstacles to cure.
This categorically excludes the selection of remedies on the absence of symptoms (= contra-indications)
Previous defenders of the polarity method pointed to footnote 213,
1 Thus aconite will seldom or never effect a rapid or permanent cure in a patient of a quiet, calm, equable disposition; and just as little will nux vomica be serviceable where the disposition is mild and phlegmatic, pulsatilla where it is happy, gay and obstinate, or ignatia where it is imperturbable and disposed neither to be frightened nor vexed.
This (213) is Hahnemann’s observation and does not in any way create a rule or principle. The opposite has been observed many times as well.
I don’t share Richards view to treasure the work of Frei.
Frei’s work introduces yet another method to HOMEOPATHY, which promises to increase reliability of remedy selection. His own method which is partially based on Beoenninghausen’s TT is not only NON homeopathic on the basis of above, but highly questionable regards statistical measures to determine reliabilities.
IMO: The more common “New methods” are easily identified to be NON – homeopathic (allopathic), this ONE takes a bit of basic understanding of homeopathy to see its true nature: A fraudulent misrepresentation of homeopathic method.
I have to say that I think what Heiner is doing is awesome. One of the biggest weaknesses in homeopathy is the lack of ANY evidence as to consistent efficacy with a particular method. There are those who believe in their own “pure” interpretation of homeopathy. These purists claim they are getting the best outcomes – but there’s no proof of that – no studies that confirm this — essentially an assumption. Same is to be said about new more modern approaches – no evidence beyond people’s claims. Frei is one of the first to actually put the time/money, and intent into creating a system that is reproducible. I’m sure it’s not perfect, but when it comes to reliability and long term good results – to my knowledge he’s the only one with that data.
I love Han’s W criticism’s. I’d love to hear Heiner’s response to his criticisms – that would be a very helpful dialogue. In any case, Han’s views are still mostly conjecture and not grounded in objective data. Here in the US, I don’t know anyone that is having 80 to 90% success rates with ADHD patients — consistently. We all have wonderful success using our methods. But until I know of studies that show a consistent very high hit rate, this is definitely MUCH needed in homeopathy.
I hope others get together high quality studies that verify our methods, not just homeopathy itself. I suspect the cynicism against homeopathy is so hardcore, that even if we had scores of high end studies verifying homeopathy, the cynics would just get more virulent. But as homeopaths, we need OBJECTIVE data – good studies and good data – that shows us which methods are really the most effective. Otherwise students, and even practicing homeopaths are flying blind.
I don’t assume the old school methods are best, nor that the new ones are. Frei’s is the only attempt to really confirm a high hit rate method. Were are they for the old school “purists” (like Andre Saine), Sankaran’s method, Massimo’s, Scholten’s ? They don’t exist, and without them, it’s all just our own biased opinions. I’m sure there are methods that are superior, that getter better and more reliable results and are simpler to train homeopaths with – we need such systems if we’re going to really help heal the masses. It’s up to us to actually get some studies going like Frei so we can really learn what gets the best results. If our goal is to do the most for our patients, we owe it to them and ourselves to ratify, confirm and determine the best homeopathic approaches.
This is a follow-up to my comment of 2017. After approximately 3 years using Polarity Analysis with more than 400 patients, I can definitely attest to it’s remarkable efficacy. It has become my goto for some pretty severe illness; cancer cachexia, “chemo-brain” (cancer patients with significant cognitive deficit due to chemo), Chronic Fatigue, many many multi-morbid complex disease patients, ADHD and many behavioral issue, etc.
Truly, it is an amazing tool.
I’m a homeopath who has spent most of my 20 years using contemporary theories – and have seem them work deeply and well many times. But when I compare my results between PA and contemporary homeopathy – there’s no comparison. My results with PA are more reliable, consistent, and WAY easier on the homeopath – and MUCH shorter visits. I use it for virtually everything and it just works great.
To my mind PA is a tool that is vastly underused in homeopathy. Heiner has put in the time and effort to develop something that works awesomely for acutes and complex chronic disease. He’s conducted numerous studies to both elucidate it’s efficacy as well as to refine the method.
Sure, it’s not perfect. But does it work awesome? Definitely (if you put in the time to REALLY learn it use it the way Heiner set it up). Is it WAY easier to use (and therefore is suited to beginners) than any other homeopathic system – definitely!
Does it have a research base that confirms it’s utility? Absolutely.
In a perfect world, homeopaths would be embracing something that is SO powerful and yet so simple. Instead we get into conversations about organon quotes, assumptions, and whether or not we are doing it “right.” Yet, those same homeopaths have NOTHING objective to back up their gripes. I wish the community would take one of Hahnemann’s most important quotes – the first aphorism more seriously. Now I’m quoting scripture!.
“The physician’s high and only mission is to restore the sick to health, to cure, as it is termed.1
1 His mission is not, however, to construct so-called systems, by interweaving empty speculations and hypotheses concerning the internal essential nature of the vital processes and the mode in which diseases originate in the interior of the organism, (whereon so many physicians have hitherto ambitiously wasted their talents and their time); nor is it to attempt to give countless explanations regarding the phenomena in diseases and their proximate cause (which must ever remain concealed), wrapped in unintelligible words and an inflated abstract mode of expression, which should sound very learned in order to astonish the ignorant – whilst sick humanity sighs in vain for aid. Of such learned reveries (to which the name of theoretic medicine is given, and for which special professorships are instituted) we have had quite enough, and it is now high time that all who call themselves physicians should at length cease to deceive suffering mankind with mere talk, and begin now, instead, for once to act, that is, really to help and to cure.”
Unfortunately, seems like homeopaths like to quibble over speculations/theories, etc rather than just look @ what’s happening over there with the patient. According to Hahnemann, that’s our job – to heal the sick. My interpretation of that aphorism is that our FIRST goal is to heal the sick, the theories/speculations, etc are secondary and definitely can distract from the first goal – healing the sick.
Theories SHOULD be changed when someone can demonstrate a great and consistent outcome. Hahmmenan himself continually did this. In fact, he chose Boeninghausen as his most preferred homeopath, and also championed his repertory.
Heiner has taken the Boeninghausen method and made it more accessible and ratified that it really works – over and over again (now something like 4 pilot studies showing 80% results or better, and one cross over study – also high success over 80%). He has delivered a MUCH simpler form of homeopathy that is unbelievably effective, yet it’s easier to use, easier to teach – and so far, more effective than any other method (at least, I’ve yet to see a success rate close to it using other methods – with the exception of other boenninghausen approaches).
In any case, I hope more homeopaths give it a true test as I have to see if it’s a useful tool in their practice. In some practices, I expect PA would become the dominant form of homeopathy, others not. For people who are already deeply ensconced in Boenninghausen’s method and are already getting great results, then maybe PA is not a great choice.
Do I think PA is the best form of homeopathy? No, not at all. I just think it’s a shame that so many homeopaths aren’t running to a super effective, simple to learn tool like PA.
Thank you for returning to share your experience.
It is heartening for students like me to hear from someone who has tested a method in hundreds of patients. Regarding your earlier post, I agree that a high quality study in a journal like the one that Heiner Frei has published is a rare thing indeed.