I was introduced to the cycles and segments philosophy and approach to case taking of Paul Herscu, by attending a seminar given by himself and his partner, Amy Rothenberg, in Keighley, October, 2012. I booked for the seminar only days before, expecting to receive a seminar of general advice on the case taking of children, but was very pleased and fortunate to chance upon his “new” cycles approach of analysing cases. From this experience, and after meeting the organizers of the seminar, Tony and Monica Robinson of the Yorkshire College of Classical Homeopathy, and expressing my enthusiasm for the Herscu method, I was invited by them to attend the Yorkshire College to acquire some proficiency in using the Herscu system, and to stay for as long as I wished, and until I felt comfortable with having a reasonable grasp of the application of the method. I have now attended the Yorkshire College since the very beginning of 2013.
The “shopping list” method of case taking, i.e. the gathering of all the relevant symptoms taken and then selecting from this list a number of symptoms to use as rubrics, is very effective for a good deal of cases, and obviously all that is required for what seems an obvious remedy choice. However there are too many cases where we can be left with a dilemma in choosing between a small number of remedies. How then does Paul Herscu substantially improve his general success rate of remedy choice? His success develops from his important breakthrough recognition that remedies, and therefore diseased states, have cycles of a number of different and definitive states, and that these states (which he calls segments) always follow in a same sequence for each remedy. Thus for Nux vomica, and beginning with the competitive aspect of this remedy (or competitive segment), and following Herscu’s schema, the next state the patient needing Nux vomica experiences due to the being so competitive, is a highly sensitive state or sensitive segment i.e. from the competitiveness evolves a heightened sensitivity, and this extra sensitive state leads on to the next segment idea which is a high irritability and easy aggressiveness. This highly irritable phase leads the patient to a new state phase of the patient needing lots of stimulation and being even though worse for the required stimulation. The next segment idea, i.e. the evolution from all the stimulation, is a state of being overwhelmed, and eventually to a sixth segment of a closed down and aversion state, and being a cycle, the competitiveness shows again from the closed down state, and so back and back again through the cycle.
The philosophy that each remedy has a definite cycle, means that in studying remedies in this fashion, you can get to know remedies in a much more intimate and holistic way, as it demands full concentration upon the cyclic and general context of all the symptoms of a remedy in relation to one another, i.e. opposite to the effort to try and understand and learn remedies more in a list like way. As homeopaths we all make links between the symptoms of particular remedies but this system takes this contextualizing full circle so to speak.
Part of his cycle philosophy also says that every remedy has two (or more) states/segments that are directly opposite one another, which includes sometimes an opposite segment to the state which we most commonly associate with the essence of the remedy. For example, in the Nux vom example given we have the commonly accepted very competitive highly charged state, whilst it also has in its cycle picture the very opposite state, the very closed down segment. If therefore, a patient needing Nux vomica shows up at the consultation in a very closed down state, perhaps moving us away from thoughts of Nux vom, having some knowledge of cycles we are kept more aware against remedy prejudice.
When more familiar with the cycles philosophy of remedies, a good deal of the questioning during consultation, as well as obtaining required information in a regular classical type fashion, can directly follow the understanding that there is a “cycle” at work in the patient. The questions also include having something of a concentrated eye to finding a cycle sequence in a case, which involves perceiving symptoms which reflect or represent a similar ideas, and so adjusting the questioning to find other segment ideas in relation to whatever segment idea information is already perceived. For instance, if there are several examples of physical inflammation in the case, and the patient is highly irritable, then the inflammations and mental irritability, and any other irritability type symptoms are grouped together under an irritability segment, so we now know one part of the cycle as irritability. We can then use the irritability knowledge to get to an understanding of other segments. By enquiring as to what can make the patient irritable, we can begin to decipher the segment in the cycle prior to the irritability, and by asking what do they do to feel better when irritable, or when they are irritable, we can begin piecing together the idea of the segment following the irritability segment.
Paul Herscu explains it with a diagram consisting of one large circle with usually six small circles placed around the circumference (the average number of segments per cycle for each remedy he has as six), each segment in the cycle represented by one of the smaller circles. When presenting a full case example, he places useful symptom information into one or other of the smaller circles, therefore grouping together the same idea symptoms in their relevant circle or segment, whilst simultaneously working out the order of these segments in the case. There arelots of shared segments between remedies, but it is their order in a cycle that is important, and Herscu also states that each remedy has at least one segment unique to itself.
The repertorisation involves, (using the Herscu software), repertorising the rubrics of each segment separately, and then crossing the results of these to find which remedies appear in all segments, and then doing the materia medica assessment of these remedies. We are guided in this by knowledge of cycles as well as by general knowledge of remedies. Because there are a range of rubrics chosen to represent each segment idea, there is less need to be too precious about choosing very specific rubrics to represent any particular symptom, though of course full care is taken with rubrics, and in fact the system encourages the choosing of several similar rubrics to cover a particular symptom. This decreases the chances of the remedy escaping the net, which can easily happen if being too specific with rubric choice.
It is the contention of Paul Herscu, that most of the homeopathically useful symptom information obtained from a patient will fit into one or other of the segments of the needed remedy, and as one gets sufficiently versed and sharply tuned in the method, one can then partition the relevant symptom information into separate segments.
The teaching at the YCCH concentrates exclusively around the Herscu method, whilst also of course providing for the rest of the essentials of a good classical professional homeopathic training and philosophy. There are plenty of live cases at the college weekends, so students have precious hands on experience in analysing together the Herscu way. It is a very friendly, very welcoming place to study, comfortably informal, but very serious of course about professional standards.