Leela: I have known some (incredibly few actually!) gifted people with a deep, perceptive ability to observe ‘central disturbances’ and ‘themes’ in mental states accurately, in the midst of a chaos of physical symptoms. But the majority definitely need be well versed in traditional methods first, as they would need to resort to them in many cases and clinical situations.
David: Even “gifted people” need to understand their basics very well or their cases become ungrounded and their remedies are either a “hit or miss” situation. There is no consistency when one leaves the inductive method of Hahnemann too far behind. If one gets overly subjective without the balance of objectivity their results lack coherence. I have seen this many times. When such homeopaths are confronted with degenerative diseases and complex pathology in a clinical setting they often do not know what to do. Why is this?
The psychic butterfly that resides in the brain has two wings. The right side of the brain emphasizes intuition while the left side emphasizes logic. In order for the psyche to “fly” its two wings must move in harmony. If one wing or the other dominates it will fall to the earth. What a homoeopath needs is a “whole brain” education in which they use both their right and left hemisphere in harmony. In this way, intuition and logic support each other in a manner that allows for understanding of both causal linear and a-causal synchronistic information. This makes one a true healing artist because they can response to a great variety of situations. To use logic and intuition together is the best of both worlds.
Leela: I couldn’t agree with that more!! Homeopathy is a system of healing that is an art as well as a science. One of my professors stated it like this: “While the (perception of the) totality of symptoms (Synthesis) is a product of using ones right brain, which is holistic and simultaneous since the right brain uses Intuition, analysis and evaluation is a product of using ones left brain, which is logical and sequential as the left brain uses Language.”
That is an interesting term “homeopathic reductionism”.
David: I’ll try to explain what I mean by this. Every homeopath needs to understand that the true central disturbance is the mistuning of the vital force which can only be witnessed through the essential nature of the totality of the symptoms with regard to causation, miasms and attending circumstances. In this endeavor the homeopath focuses their attention on the striking, extraordinary, uncommon and odd characteristic symptoms of the disease state not those symptoms common to all diseases (Aph. 153). It is these characteristic signs and symptoms that are the most appropriate aid in finding a suitable remedy for the patient.
In some cases our multifaceted medicines are being reduced to overly simplistic singularities. Then the multifaceted display of a remedy or family is replaced by a one sided essence that reduces rather than expands our vision, by ignoring other facets. Yes, we do need to study the essential threads of our remedies so we understand their important characteristics and generals symptoms. Nevertheless, when making themes is taken too far there is a danger of focusing on a one sided stereotypical concept. This is what I call ‘reductionism‘.
What such an approach ignores is that Homeopathy is a Gestalt therapy in which the prescription is made by the essential connections between the total field of causations, symptoms and attendant circumstances. A complete symptom should have a location, sensation, modification and concomitants. A complete remedy or family study should have a number of these complete symptoms. There is no single essence that can replace the essential nature of the totality of the symptoms in every patient at all times and under every circumstance.
Leela: How do you visualize case taking and the study of remedies and patients?
David: For me, studying patients, remedies and remedy families is like putting together a jigsaw puzzle. Every puzzle represents a complete portrait with form, color and meaning that is presented in fragments. One cannot tell what this portrait is from by just looking at 1 or 2 pieces even if they form the center of the puzzle picture. One must take all the individual pieces that fit together and connect them one by one until various areas of the portrait become clearly visible.
Once most of the pieces are in place, one begins to understand the nature of the total picture. As more pieces are connected together it becomes easier to see where the remaining pieces should go. When all the pieces are in place, then one sees the complete picture that carries an image which is more than just the sum of its parts. One piece does not makes up the whole puzzle by itself, as each section is part of a greater whole that is not known until all the most important sections are connected together.
Leela: Isn’t this the ‘fun‘ aspect of homeopathy? Even a simple common cold or diarrhea is a jigsaw puzzle waiting to be solved…like clues in mystery to be solved!
David: Precisely. After one fits together all the essential pieces of a jigsaw, they get a glimpse of the total picture. It is not enough to say that the portrait is a picture of a man or woman by looking at their nose. Are they young or old? Are they European, Asian or African? What color is their hair? What color are their eyes? What is the expression on their face? What position are they in? What are they doing? What is in the background? What are the time and circumstances related by the picture? Without understanding who,
what, where, with what, why, what modus and when, how can one understand the true portrait of the disease? This is at the root of the Gestalt philosophy on which Homoeopathy is based.
Leela: What are some of the modern approaches that you feel are losing sight of this?
David: Some persons are using flow charts with keynotes to try to reduce the entire symptom-complex of our multifaceted remedies and families to one single Miasm, one single delusion, one single symptom and one single theme that is supposed to represent the so-called essence. This, of course, often is hand and hand with a therapeutic absolutism where one single method is applied to all patients regardless of the nature of the disease state and the time and circumstances.
This leads to also perpetuating the idea that there is a grand constitutional remedy that is supposed to be good for all acute and chronic diseases for all times under every circumstance. One needs to be very cautious in propagating such an idea. Otherwise Hahnemann’s system of flexible response is replaced with one rigid case management strategy that is supposed to be good for all situations. I feel this is done with the idea of a pseudo-oneness which ignores the fact that true oneness is expressed by the interconnections between a diversity of phenomena that make up a greater whole.
Whatever happened to Hahnemann’s system of individualization and flexible response?
What happened to the chief chronic remedy?
What happened to the anti-miasmic remedy?
What happened to the acute intercurrent remedy?
What happened to the chronic intercurrent?
What happened to the preventative remedy?
What happened to the locations, sensations, modalities and concomitants that make up the totality of the characteristic symptoms?
What happened to the etiological constellation that includes individual cause, collective cause, exciting cause, maintaining cause and the fundamental cause?
What happened to the idea that proximate cause can never be really be reduced to the single event which is independent of a group of interrelated factors?
Leela: I see what you mean. There is a danger that the system of homeopathy is represented by “homeopathic reductionism”.
Some of us have lost sight of the fact that the traditional methods are quite effective in tackling complex disease or serious disease that has become so prevalent today. We have been distracted with finding an elusive, single constitutional similimum and may have become almost impotent in healing serious clinical disease consistently, except for the very occasional brilliant cures we have fortunately experienced. I myself have passed through this experience.
David: Yes, this is not good for a personal homeopathic development or the progress of homeopathy. Many homeopaths don’t seem to have taken the time to learn the fundamentals of Homeopathy before straying into modern short cut versions based on new keynotes, flow charts and essences. Whatever happened to learning how to use Boenninghausen’s Therapeutic Pocketbook, Kent’s Repertory, Knerr’s Repertory, Phatak’s Repertory, Boger’s Boenninghausen’s Repertory and General Analysis? What happened to studying Hahenamann’s Materia Medica Pura, the Chronic Diseases, T. F. Allen’s Encyclopedia, Hering’s Guiding Symptoms and Clarke’s Dictionary? Have they learned all the well proven and observed characteristics found in Kent’s Lectures on Materia Medica, H. C. Allen’s Keynotes, Lippe’s Redline Symptoms or Nash’s Leaders? In many cases the answer is, no they have not.
In some cases our complete symptoms with locations, sensation and modifications are being replaced with stereotypical essences like “Phosphorus is open and Natrum Muriaticum is closed”. This may be insightful in some cases but Phosphorus can appear so apathetic and indifferent that they seem closed and Natrum Muriaticum may appear too open under certain circumstances. Phosphorus may lack boundaries and Natrum Muriaticum may be prone to overly rigid defense mechanisms but such symptoms are only therapeutic hints not complete symptoms.
Leela: How do you think this tendency to “reductionism” has arisen? I know you are not criticizing the concept of constitutional treatment per se or even exploring new ideas.
David: I am emphasizing the need for a solid foundation so we can expand into the future in a grounded manner. To do this properly one must understand the idea of the invisible essence and its visible gestalt qualities. When ideas of ultimate oneness, the central disturbance, the core delusion or the grand theme of a remedy are trivialized they fall into another form of reductionism, mechanism and externalism. When one is focused on the essential nature of the totality of the symptoms, causation, miasms, attendant circumstances, delusions, dreams, general symptoms, particular symptoms, modalities AND the golden threads that tie them together, this composes a true oneness in which the whole is more than the sum of its parts!
There is no single symptom, special essence, or grand theme that can replace the disease-Gestalt in which each facet is an interdependent component that fits together making a greater whole. These symptom segments can be combined in a number of ways that may have been seen before or may be totality unique to that particular patient. In this way certainly, several different aspects found in a remedy or family can take the central role in selecting a remedy depending on the causes, symptoms, miasms, time and attending circumstances.
One cannot locate a point in space with just one vector any more than one can understand our multifaceted remedies by one single concept or essence. If one does not understand this, there is a danger of falling into a false oneness at the expense of the true unity found in a diversity of phenomena. As Hahnemann said, one symptom is no more the disease than one foot makes a whole person!
Leela: What I understand about a central essence is like looking into the “heart” of a person and perceiving the “delusion” there, which explains many of the peripheral behavior patterns. But I do feel that physical symptoms and modalities should support this type of analysis in remedy choice. This method cannot be helpful in every clinical case.
I think each of us needs to realize that being multifaceted homeopaths is what really counts in the clinical situation.
David: Yes this is true, I am not against any one person’s work, speaking against any one method, or rejecting any new information. In fact, these all insights and new concepts have their value when placed on the bedrock of the classics. I am merely advocating a middle path that integrates the best of the old with the best of the contemporary in a balanced fashion that does not overturn the Gestalt philosophy on which Homeopathy is founded.
Every time I see a “grand theme” of a remedy I see other symptom threads that are equally important. I prefer to look at the holographic image of the remedy represented by the totality of the characteristic symptoms of the disease-Gestalt because it can suit manifold patients under differing circumstances. There is a danger of losing one’s way if one falls into a pseudo oneness and therapeutic absolutism in the name of doing the “highest method”.
Leela: Well David, I sincerely hope everyone is listening attentively to what you’re saying. I am aware that you remain open to the contemporary or “modern” approaches when used in the appropriate context and clinical situation. Modernization should be clearly built on foundational principles already established.
David: Yes, I am a supporter of modernization in harmony with the foundation on which homoeopathy is based. The application of generalization and analogy in harmony with experience started with Hahnemann and Boenninghausen. These principles were central to the development of Boenninghausen’s Therapeutic Pocketbook and most of the repertories that followed. The use of generalization to bring out the major threads found in a remedy or remedy family is an old homoeopathic method. When generalization is combined with analogy it allows one to highlight the grand characteristics of a remedy and remedy family. When themes are based on provings and symptoms brought out on patients under treatment then they are based on the inductive method and logic. Once the objective symptoms are understood, one can use analogy to expand them into more subjective areas in a grounded manner.
When themes are based on the doctrine of signatures, they are intuitive and subjective and need to be confirmed by provings and clinical observations. One method always needs to be balanced with the other. This makes up the whole brain approach I spoke about earlier. Nevertheless some are spinning out new themes like spiders spin webs. Can such “home spun” symptoms always be taken as the grand characteristic of a remedy?
It is not difficult to say that remedies that come from “vines” are “dependent and need support” but does it really hold up as the grand keynote in a majority of patients? Can we then assume such remedies suit all clingy patients? I have seen pages written on a few images like this with very little clinical confirmations. Some of these essences seem to grow as easily as weeds!
Leela: (smile) We do need to be careful of getting carried away.
David: Once again this becomes a matter of taking a good idea too far into the subjective realm without any objective corroboration. When natural correspondences are confirmed by traditional means and provings they are useful and help one to remember remedies and families. Some of the new material may contain a quite few good clinical hints but should it replace material gathered from provings on the healthy, poisonings and new symptoms brought out on patients under treatment?
Proving remedies is time consuming but it involves experiencing the symptoms in an objective manner. One becomes a passive witness of the effects of the medicinal substance. At the same time, it takes years of experience to collect symptoms brought out on patients under treatment. It only takes a few minutes to spin out themes and essences by the doctrine of signatures. I can make up any number of images in few moments but does that mean they are really valid as grand characteristics of remedy? The answer to these questions can only come when the subjective methods based on analogy are balanced with provings and clinical confirmations.
Leela: How would you caution neophytes?
David: Today, few are willing to do the hard work of proving remedies in a traditional fashion and many are interested in fantastic sounding short cuts. So my caution to new students and old practitioners alike is simply this – try to keep a healthy balance between subjective and objective information and combine the best of the new with the best of the old. Also, if it is “too easy” it is most likely “too simplistic”. For example: I am all for studying natural correspondences in relationships to archetypes but I believe this must be done on the solid foundation of Jungian psychology. This also demands studying the traditional material. If not, much of this work takes on too many “new age ideas” and too many persons get “lost in space”. Does this mean they all need Hydrogen? I think not!
Some modernizers don’t even understand the basis of the system they seem to want to change into something new and more exciting! I wonder at times, if some of these people ever really bothered to read the classical texts or study the references found in traditional material in a serious fashion. So much has been lost or forgotten that only a small percentage of what Hahnemann introduced is really given a fair review and put into practice. Speak about these things and one hears is “all we need is the Essence” because this “doesn’t matter” and that “doesn’t matter”. In truth such persons are only using a small amount of what is offered by classical homoeopathy. Many persons have a very hard time admitting they still have much to learn from Hahnemann.
Leela: You perceive that some homeopaths are resistant to learning from what Hahnemann introduced in his last years? Why do you think there is this resistance?
David: The first problem in learning the methods Hahnemann introduced between 1835 and 1843 is the poor quality educational material available in English from that period. This is one of the reasons I have collected information for 12 years and written my 3000 page Homoeopathic Compendium. Too many persons speak as if the C and LM potency can be given daily in medicinal solution in a mechanical fashion to all patients. They take Hahnemann’s most advanced individualized method and turn it into a mechanistic system reminiscent of allopathy. In truth Hahnemann used single doses (usually by olfaction) followed by a series of placebos or a short series of doses interpolated with or followed by placebos. This “on again – off again” method is what is really found in the Paris casebooks. Dr. Croserio wrote to Baron Von Boenninghausan that it would be impossible to give all the shadings of Hahnemann’s treatment because is mode of action was “not always the same”.
The second problem is agenda-driven misrepresentations of the material found in Hahnemann Paris casebooks. This includes presentations by certain revisionist historians who are trying to shock those they see as “classical homoeopaths”. What they mean by classical Homoeopathy is usually a self creation based on the methods of a few one-sided constitutionalists that follow the 4th Organon. They try to make it seem that what Hahnemann practiced in the clinic was completely different than what he wrote in the Organon. All of this disinformation has helped to confuse new students and old practitioners alike and retarded the growth of Homoeopathy.
Leela: I agree with you. For a long time I wasn’t even aware of what these labels meant! The confusion around such labeling has fostered division which we know had not helped homeopathy today. What are some of these bones of contention?
David: Some are using polypharmacy terms like “dual remedies” to describe Hahnemann’s alternation of two single remedies at different times and call the Founder’s use of a series of single remedies “remedy combinations’. They try to portray these traditional techniques as secret methods Hahnemann used in Paris but in truth the Founder spoke of alternations, intercurrents and a series of remedies in the 1st Organon in 1810! These methods are found in every edition of the Organon and the Chronic Diseases and are nothing new to the Paris epoch.
Persons of this ilk also point out that the Paris casebooks show that Hahnemann did not always wait for the duration of a remedy action to cease before he repeated the dose or gave another remedy. They try to use this information to say things like “Hahnemann didn’t practice what he preached in the Organon so why should we?” Then they mix several remedies together and give them at the same time and claim they are practicing just like Hahnemann. The truth is that Hahnemann wrote in the 5th Organon in Germany that it was not necessary to wait for the action of the remedy to cease before repeating the remedy or giving an intercurrent medicine. He gives all the exact details of this method in aphorism 246 and its footnote long before he went to Paris.
Some point to Hahnemann’s extensive use of Sulphur as another example of Hahnemann breaking his own rules. Hahnemann taught that Sulphur was the principal remedy in psora in the Chronic Diseases in 1828 and his German casebooks show that was already using Sulphur in this manner by 1830! He also spoke about this method in the 5th Organon in 1833 where he gave very exacting details of the method. All of this material was already in the public domain long before the Founder went to Paris. My research of the Paris casebooks and eyewitness accounts show that what Hahnemann taught in the 6th Organon is in harmony with what he practiced in the clinic.
The third problem in learning all that Hahnemann taught, is psychic inertia on the part of homoeopathic practitioners. It is almost as if some persons are afraid to look at the past classics because it might suggest they are doing something wrong in the present. Others just resist change because they have become too complacent with what they already know. Speak about the medicinal solution and they begin to groan about all those bottles! Suggest they test Hahnemann’s more advanced posology methods and they say they are already doing just fine. Point out classic material they haven’t seen and they talk about the latest new technique they just learned at a seminar. Ask them to individualize their methods more carefully and they say they only need to use the constitutional remedy. It is always a case of diverting the attention to something else other than the point at hand.
Leela: David, this is making me laugh! It reminds me of myself as a young, fresh enthusiastic homeopath that hadn’t yet faced the REAL life of clinical disease and dealing with people’s problems with responsibility. Thankfully I learnt, and learnt fast, that there was no easy way around serious homeopathic clinical management!
Leela: Do you see the fact that Melanie delayed the publication of the 6th Organon more than 60 years after Hahnemann’s death as contributing to this confusion?
David: Yes it is very unfortunate that the 6th Organon was not published when persons like Boenninghausen, Hering and Jahr were still alive. Hahnemann appeared to be grooming Boenninghausen to help spread the word as he sent the Baron two LM cases in 1843. Both Boenninghausen and Hering tried to obtain the manuscript but all their efforts were in vain. This set Homoeopathy back 80 years. By the time the 6th Organon was published in 1920 all the first generation had passed away and no one was ready to pick up the mantle of the new method.
Leela: What about the lack of accessibility of many original documents in German or claims to inadequate or inaccurate translations of those already available?
Another factor I’ve encountered is the difficulty in accurately interpreting “old” German that Hahenmann wrote which seems to contribute to a sense of suspicion at one end or possible easy misinterpretation at the other.
David: The lack of access to the original German documents is a problem as most persons in Germany also ignored the early works! There is a great amount of material that needs to be researched in an honest fashion without the attachment of personal agendas for or against certain methods. In general, all the translations of the Organon are reasonable although not perfect. There will always be debates about this word or that sentence even in Germany but this is not the major problem. It is a matter of laziness and complacency found in the human mind. Many are more interested in the latest new method on the seminar circuit rather than digging through old dusty books and archives. My idea is to delve deeply into the little understood classics while reviewing the best of contemporary Homoeopathy. In a way, I am a “Renaissance man” in that one appreciates the old and new in equal light.
Leela: I recall Hahenmann attributing what you call ‘psychic inertia’ to “a Constitutional aversion to hard work” in his Chronic Diseases! I chuckled when reading that, thinking how an apt a criticism he had made!
David: Hahnemann actually spoke to his chronic patients at least once a week at the beginning of treatment. This was so he could make the clearest assessment of the progress of his prescription at the start of the case to speed up the cure when necessary. Ask some modern homoeopaths to follow their cases more closely and they complain that they don’t want to interfere in the progress of the cure. It doesn’t seem to matter to them if the patient is experiencing little or no improvement over the next month or two. It is as if some like to give the single dose and forget the patient as much as possible for as long as possible. Is this what the Founder intended?
Leela: (smile) To forget a patient as long as possible? I’m sure there are quite a few patients one wants to … especially those that have rattled us when we had no idea how to help them homeopathically …In truth, these are the ones that force us to learn the depth of homeopathy!
David: Unfortunately, when confronted with the possibility of change due to difficult clinical situations some retreat from future possibilities into their past attachments. When one speaks about the differences of the methods of 4th Organon compared with the methods of the 5th and 6th Organon one often hears “but the dry dose works”. Of course the dry dose works, wonderfully sometimes! In some cases, however, sometimes the medicinal solution works better. Then one hears excuses like “Oh, all those medicinal solutions are just too much trouble! Why not just give a single dry dose and tell them to come back in a month, and relax!”
I would like to ask some questions here. What is more important? That which is most convenient for the practitioner or what is best for the patient? Does the first aphorism of the Organon say “Do what is easiest for yourself” or does it say one’s highest and sole calling is to cure the patient? Does the second aphorism of Organon say, “Treat everyone the same even if the progress is slow” and that “aggravation is good”? No, it does not. It says the highest ideal of cure is the most rapid, gentle and permanent restoration of health.