It was with great interest that I read Robin Murphy’s interview in the December 2010 E-zine. His passionate plea for homeopaths to tackle all problems that are thrown at them is very welcome and is indeed important for the survival and even progress of homeopathy. His willingness, and the efforts he makes to spread the word to all those interested, are a credit to him. His suggestion that we should learn from a number of different homeopathic schools is indeed very good advice.
Nevertheless, after reading the interview, there are a few points I would like to open up for discussion. I think they are important points for the understanding and progressive discussion between homeopaths from different schools and for the general presentation of homeopathy towards the official channels of medicine, which of course is nowadays mainly controlled by orthodox medicine, also called modern medicine or scientific medicine.
Before I start, I will briefly explain my background. I am a conventionally educated vet who still practises conventional medicine for a good part of his time. Luckily, I started studying homeopathy many years ago. Studying and practising homeopathy has certainly allowed me to become a much better conventional vet and it has of course also given me a fantastic tool (homeopathy) allowing me to help patients beyond that which conventional medicine cannot even dream of.
The type of homeopathy I was first taught was a mixture of Kentian homeopathy, clinical prescribing, French pluralism and a form of complexism (Kollitch). I learned to use the repertory and I walked away with lists of diseases and the remedies that were most likely indicated in these diseases. But none of my initial attempts to use homeopathy made much difference to my patients. Although I had understood and sensed the value and importance of homeopathy as a medical technique, after 3-4 years I had not got it, the remedies were nothing but lists of symptoms. Maybe this was because I did not study enough at the time. I certainly don’t have a very good memory for static information and I was probably too naive about all the new things I learned in the course.
Through luck, I stumbled into a school run by a vet (Mark Brunson) who gave me the keys to move forward. His way of studying remedies and of retaining a dynamic that allows the remedy to be used in various situations has been indisputably the principal factor that I still practise homeopathy. I walked away with a much better technique of repertorisation and armfuls of nuggets of knowledge about homeopathy in the real world. I started to produce the odd result and little by little I evolved by listening to many others to arrive at my current situation where clients come back or send their friends.
My patients don’t believe in homeopathy, and a number of my clients don’t either. In a way I purposely stayed in conventional medicine to make sure that when I practise homeopathy, results are not dependant on my clients beliefs, but because my patients clearly get better.
One thing that I never do is to prescribe conventional medicine and homeopathy within the same consultation. This has allowed me to progress in homeopathy and make a clear distinction between improvement of the patient due to any modern medication that may already be taken or due to my homeopathic prescription. Good homeopathic success usually allows many of the modern prescriptions to be dropped.
The first point I would like to pick up in Murphy’s interview is ‘philosophy’.
Firstly, I don’t think it is helpful to say that conventional medicine is devoid of philosophies. The problem is that it may have two philosophies. One can even argue that there is a third philosophy: the philosophy of ‘business’ which has nothing to do with modern medicine but is how many medical professionals (and businesses) have appropriated the results of modern medicine’s efforts to tackle (word used on purpose) disease and respond to the demands of modern society. Suggesting that this third philosophy is central to modern medicine is a big mistake: it is certainly a by-product of modern society and its efforts to look for solutions on the medical front and is a driving force in the production of medicines, diagnostic tools, procedures and other medical organisations and businesses, but it is not central to it. The fact that it has developed some very skewed and damaging forms of medicine does not change this. The discussion on this subject should be taking place in socio-economical, political and philosophical contexts and are food for journalists and ethical committees. Of course I don’t expect many of these to start making much wind for the time being. Heavy economical pressures do weigh in here. Also, society wants top notch technical modern medicine which is very expensive to develop and use in any way. This is not a black and white issue.
But, let’s go back to the basic philosophies of modern medicine:
The first and central one is that before a disease can be treated, it must be scientifically examined and understood in such a way that a medicine and/or a technique can be developed that can be explained and proven to be efficient in that particular disease. To achieve this, all modern scientific tools available should be used. This driving force or central philosophy which was the start of modern medicine came about at the same time (or just a little before) that Hahnemann developed homeopathy as a medical principle, as a reaction (just like Hahnemann) against charlatan type medicine.
Because the scientific tools used for learning about life and disease have for a long time been like using boxing gloves to do lace embroidery by a poorly sighted person, the results of the scientific research did not benefit the refined intricate details and complexities of each individual patient. In the last ten or twenty years, some of the tools used have become much more refined, and some of medicine’s modern findings are approaching the need for individual treatment for each patient that can begin to compete with the individuality principle which is central to homeopathy. The problem is that the economical side-kick of modern medicine has lost interest in this progress because it may not be (is not) affordable for society or business or by the individual (or rather a mixture of these three) to develop this new, more individual, approach of modern medicine into practice (develop into treatments). There is no doubt in the world that we have made enormous progress in the knowledge of health and disease. This has led to a huge amount of progress in a number of narrow fields but were medicine has not made much progress is in the understanding of health and disease.
This takes us to the second philosophy of modern medicine, which in one way we could call the rescue philosophy of modern medicine. Because, even when we cannot scientifically determine what the best treatment is, it is possible to ‘discover’ a medicine (by accident or any poaching means) and through statistical analysis (and sometimes manipulation) determine in what condition(s) this medicine can be used so that sufficient patients can benefit from it. This happens while we wait (!?) for better answers from all the scientist who spend their entire lives, and more, on pushing modern research to more and more complex levels whilst many patients have so far not received any help at all.
Upon reflection, maybe I have this wrong: this second one is not really a philosophy, is it? This is more a convention between the governments who make the rules and the salesmen who sell the cures: if you can prove it works you can use it. In other words, they are the modern version of the old travelling salesmen of elixirs now working with a licence given to them by society.
What is the philosophy of homeopathy?
It is important to be clear about this when we criticise modern medicine to make sure we don’t make similar mistakes in our philosophical approach to the patient and prescriptions.
I suppose not many people will disagree when I say that the philosophy of homeopathy is individuality, similitude, minimum dose and remedy (medicine) testing on healthy provers (people).
If we try to word this, one should say the following in order to understand better what these principles mean: first, substances have to be tested on healthy people and then studied to understand their homeopathic activity = indication/ effect/ nature/ essence/ picture or in one word: dynamic. When we want to help/treat a patient we have to prescribe a substance that is capable of causing a homeopathic activity or better dynamic when administered that is similar to the one present in the patient: the dynamic that determines the expression of the ‘disease’, symptoms and or suffering of the patient. The key to the dynamic in the patient and the key to the dynamic of a substance lies in the homeopathic symptoms that we and the patient (and/or the prover of a remedy) discover through careful observation and examination. This is the concept of homeopathic medicine.
This is where homeopathy is so different from conventional medicine: the examination of the patient is not aimed at understanding the disease and making a diagnosis which will determine the treatment but at finding the (homeopathic) symptoms that will direct the practitioner to find the best possible prescription for the patient/case out of the remedies that have been tested and are known to the practitioner/homeopathic community. Similarity between remedy dynamic and patient/disease dynamic is required for a remedy to be curative in a given case.
I pointed out earlier how modern medicine has made much progress in the understanding of disease. However a gap between this understanding, the possibilities arising from it, and the need to treat patients has created the need for (and a way of) developing/commercialising treatments irrespective of essential research into the understanding of disease.
One can say that a similar gap exists in homeopathy: a gap between the simple and profoundly efficient principle of using ‘like cures like’ and determining how to study remedies, how to remember them, how to distinguish between different remedies, and which symptoms in the patient will guide one to the best possible remedy. This has led to the development of many different prescription techniques. At the two extreme ends of the scale these techniques range from prescribing remedies based on their herbal indications (like arnica for bruising for instance: very little individuality, just empiric experience), to the techniques where similarity is pushed as far as possible, to obtain the best possible similarity between case and remedy.
Furthermore, to understand how much better the patient is doing after a prescription, homeopathy needs a philosophy of the patient and his or her disease. A disease in the sense of modern medicine is a reasonably well (?) defined descriptive set of symptoms and diagnostic parameters. Disease in homeopathy is more a description of the state of the patient which is a mixture of the diagnosis (disease as defined by modern medicine) and other signs, symptoms and sufferings the patient presents, now and (possibly) in the past. Here a big evolution has taken place over homeopathic history from looking at the patient of the moment to looking at the patient in time (patient with their past). Not everybody agrees with this evolution of the conception of homeopathy which is fine as long as this is made clear.
Although I very much agree with many things Robin Murphy explained in his interview, he is not always clear where his concept of homeopathy is in relation to the above. This leads to confusion between the technique of making a prescription and the concept of homeopathic medicine/thinking which can be shared with as many homeopaths possible and also those people who do not practise homeopathy. When Robin Murphy explains how hygiene, nutritional and herbal techniques come into play in his daily practice this is an explanation of how one’s medical practice functions, not how to practise homeopathy.
Why am I making this fuss? Because it is important that homeopathy becomes a clear medical principle to all (in and out of the homeopathic world) and that everyone understands that differences between schools only exist because of the difficulty in applying this principle which gives way to the various attempts of many to create practical systems to make (successful) homeopathic prescriptions or even successful (helpful) medical practice. Is what the old masters did the only way of practising homeopathy? I don’t think so. Within the old masters there are differences in how they used homeopathic remedies just as nowadays there are differences between various schools in how they use remedies. That is why I agree with Robin Murphy when he says that it is important not to study one school only and to be sure to listen what others have to say and, from understanding their clearly explained concepts (which are not always available), decide how to best use various ideas to progress one’s own work.
Homeopathy in Haiti or the big town?
In any given situation one has to deal with what is presented: in Haiti you treat the people in Haiti with their problems in their situation and with the possibilities available. In the big town you prescribe for the people in the big town with their problems in their situation and with the possibilities available there. Surely one can learn much from prescribing in an area such as Haiti and apply it in the big town, and in a perfect world a whole homeopath should be capable of working in both situations. There are no grounds here to argue that homeopathy should not try to progress towards techniques that are more individual than those used by our predecessors: the only thing we do is push the boundaries of individualism or in other words develop/ refine the concept of homeopathy.
It is possible to practice good homeopathy with 75 remedies, but extending this number to 400 or even 3000 through improvement of the understanding of individuality of patients and the individuality of remedies can only benefit patients. This will place extra demands on the homeopath, but do we not owe this to the patient? For my own sake, life would be easier if I could stick to just 75 remedies. I would spend much less time studying and going to meetings and conferences. My experience is that one fails too many patients by so doing.
Robin Murphy is correct to say that one has to master as many prescription techniques as possible, but of course the modern additions to homeopathy are just extra tools one can learn and master.
Over a period of time, some of these newer approaches will prove to be merely new ideas, whilst others will be called progress of homeopathy by future generations.
Constitutional homeopathy and a few other loose observations.
I am not sure I really like the use of this word, as if there can be a difference between homeopathy and homeopathy. Is this not about opinions and arguments about what symptoms on which to prescribe and how to assess homeopathic improvement of the patient? Is this not just about trying to help the patient rather than solely address the reason for which he/she comes to see us; offer the patient more than maybe he/she expected because homeopathy is capable of doing more. Is this not about reducing the need for the patient to come and see us again the following month? Trying to make the cure as long lasting as possible, helping the patient to thrive within their situation?
If a patient comes with a gangrenous toe and that is what needs prescribing on because that is where the crux of the case is, of course one should prescribe for the toe. If the improvement in the patient is not sufficient, another remedy can be found at a later date, if this is required (by the patient).
Should we distinguish between ethiology and symptom? Ethiology and symptoms are no different the one from the other: one has to prescribe on what is homeopathic in the case: sometimes that is a particular symptom, sometimes that is the ethiology. A homeopath should always be a clinical homeopath, and a clinical homeopath who is going to give all the depth possible he can to the patient in the given situation. Physical signs of a homeopathic quality (unusual, peculiar, striking) are often very reliable leads to find a very good remedy for the case.
I would have reservations about promoting a search amongst remedies classified under disease names. Here there is a danger of falling into the conventional approach to medicine: the clinical diagnosis indicates a treatment. Unless one is a homeopath of the stature of Robin Murphy, whose grip on remedies, I am sure, is excellent, there is a very serious danger of abandoning the concept of homeopathy (individuality, similitude). The concept of individuality of the patient is also often abandoned when practitioners prescribe for a given miasm they perceive in the patient: the prescription is made for the individual disease that is found in the patient and not the individual patient.
If a lesser individual type prescription makes us prescribe a remedy that is alien to the patient and which we keep on repeating because we are convinced that it is the right one, are we not likely to cause side effects from such a prescription, even when the patient initially may have been happy with the prescription? It is not because this remedy is diluted homeopathically that it is incapable of causing side effects. Can we say at the same time that homeopathically prepared substances are efficient and innocuous?
In any case a remedy only really becomes homeopathic when it is prescribed in a case where there is a similitude between the dynamic of the remedy and the dynamic of the patient. Otherwise a remedy is just a dilution of a substance made according to a particular rule.
Of course using this technique of prescribing for a disease (diagnosis, miasm) may well be very helpful in making progress with the patient but I find too little emphasis in writings differentiating between concept of homeopathy (homeopathic individuality as perceived by the writer) and the technique of his/her practice.
What if, by using a more ‘intellectual’ technique, one can speed up the healing process by finding a more individual remedy for the patient rather than ‘wandering from one level to the another level prescriptions’, using a number of remedies over a long period. I still know that if no good similimum comes up from the homeopathic consultation, I can use a less individual prescriptions based on any other technique and that at a later date, progress by me, the homeopath, and the patient may allow for a good (better) follow on prescription.
Some (much) of the information in homeopathic materia medicas comes from accidental poisonings, cured cases and historical empirical type of prescriptions. This information is necessary and helpful to study the remedies (which is the purpose of the materia medica) but if we fall into the attraction of using remedies because of their previous successes in certain diseases or for certain symptoms for which they were previously effective, we may develop a non-homeopathic reflex prescription style: an empiric way of prescribing based on experience rather than good homeopathic remedy selection technique. One can never caution the reader enough about how this path reduces the power of homeopathy. Even when such prescription lines are more popular and practical, I am not sure it is always in the interest of the patient and homeopathy to promote them without indicating its limitations.
I nearly forgot to touch on one thing: minimum dose. That is of course about reducing side effects from administering medicines. Here I applaud Robin Murphy’s advice that the concept of aggravation is not a necessity and needs to be approached with caution.
The minimum dose principle also underpins the individuality principle: of course the more individual the prescription, the less remedy is required. Would it then not be in every patient’s interest to find a remedy that needs very little repeating (minimum dose); a remedy that has a lasting and profound action? And again I repeat, the choice of the technique for the case is based on the circumstances and the type of results desired/needed.
When on the farm, the animals don’t respond (or not sufficiently) to the first aid classical, Bryonia, Belladonna, Pulsatilla and other common remedies, if I want to make a difference, I have to dig and dig until something unusual can be found which points to a remedy maybe never used in a farm situation before or about which I have never read any cases or even have little knowledge. If the remedy’s dynamic is similar to the dynamic in the case, animals return to normal health and production. It may take me two, three, or sometimes more, attempts but it is more often than not worthwhile. The prescription may well be based on one or two mind symptoms. My experience is that such situations are common and therefore it is important for all who use homeopathy to always be aware of this. This should not stop anybody from using first line homeopathy, but it is important to always be aware of the limited nature of this approach. Again, we owe it to the patients (and homeopathic medicine) to make sure we do as well as possible.
This is not only my personal experience. A number of my colleagues in French speaking countries have the same experience. I have translated and edited many (101) of the veterinary cases they published over the years in a book called ‘Homeopathy. What to expect?’. For me, these cases represent real homeopathy: from a case of straight forward Bryonia for respiratory symptoms to Helleborus for a case of collapse in a cow. From Cannabis Indica for an over-grooming cat to cuprum for a feather-losing myna.
I have been pedantic in this article. I have done so because it is my opinion that this discussion is necessary for the progress of homeopathy. The message of homeopathy has to be taken out to the broader public for use ‘in the kitchen’. At the same time we also have to bring the message that homeopathy has a number of requirements which we have to always bear in mind if we want to serve the patient to the best of our abilities. This may have a drawback in that it risks deterring those who only want simple solutions. I am sure that they will eventually learn that such simple solutions are less likely to bring long term benefits.