David Little – 2

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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?

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!


Special thanks to Jill, David Little’s wife, for for her help in editing the interview!

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About the author

Dr. Manish Bhatia

- BCA, M.Sc Homeopathy (UK), CICH (Greece), MD (Hom)
- Associate Professor, Organon & Homeopathic Philosophy, SKH Medical College, Jaipur
- Founder Director of
- Editor, Homeopathy for Everyone
- Co-author - Homeopathy and Mental Health Care: Integrative Practice, Principles and Research
- Author - Lectures on Organon of Medicine vol 1, 2, 3. CCH Approved. (English, German, Bulgarian)
- Awardee - Raja Pajwan Dev Award for Excellence in the Field of Medicine; APJ Abdul Kalam Award for Excellence in Homeopathy Education
- Visit Dr. Bhatia's website

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