Is there any phenomenon in nature where one essential part is more important than the whole? Doesn’t an atom have electrons, neutrons and protons as well as quarks? Aren’t the elements of the periodic table made up of atoms and molecules in different combinations? Is an electron more important than a proton or neutron? Isn’t the universe based on gravity, weak nuclear forces, strong nuclear forces and electromagnetism as well as time and space? Is gravity more important than electromagnetism or strong nuclear forces more important than weak nuclear forces? Is time more important than space?
Aren’t plants made up of several compounds not one essential substance? Can the properties of any one compound act totally independent of the other compounds? Isn’t it apparent that nature is based on interdependent synergies that work together to make a whole, not on one “essential unit” that one can call absolute? The Newtonian idea that there is a permanent atom at the base of all energy is totally obsolete! Modern physics is a Gestalt science not a reductionist model in which one factor is held supreme. There are essential qualities that come together to make up a phenomenon but there is no one factor that is greater than the whole.
One cannot “see” the transcendental Esse (Gr. Wesen) but one can become aware of its activities through its Gestalt-pattern, which manifests as a total field of phenomena. In the same way, the totality of the signs, befallments and symptoms are the “outwardly reflected image of the inner Wesen of the disease, that is, of the suffering of the life force”. Hahnemann made this clear in the Organon and The Chronic Diseases. This is why Hahnemann said that one symptom is no more the disease state than one foot makes a human being. No one essence, theme or sensation can express all the potential variations of the whole all of the time under every circumstance. It is merely one facet that may be important at the moment but there are always other facets that are equally important at other times. This is true whether one is treating a particular patient or studying the essential nature of any given group or species.
It has become a cliché to say things like “In Homœopathy it doesn’t matter why – one only needs to know what”. Is this really true? Knowledge of causation and observation of synchronicity and circumstance doesn’t matter? Can the single question, “What? What? What?” really replace the six other essential questions: Who? Where? Why? What with? What mode? When? Hahnemann taught that the basis of case taking is causa, miasms, signs, befallments and symptoms of the body and soul with their attending circumstances. He was the first to use locations, sensations, modifications and concomitants as a guide to selecting remedies. Then Boenninghausen pointed out that a complete symptom is composed of these four segments because they make up one complete facet of the disease. Can a complete symptom be made out of a main complaint alone? Can a complete case be made out of a sensation alone? Can a complete case be made without a modality? Can a complete case be made without any concomitants? I think we know what Hahnemann and Boenninghausen would say about this!
Hahnemann taught that the emotional state is so important that it “often tips the scales in the selection of the homœopathic remedy.” This statement does not say the emotional state “always” tips the scales in the selection of the remedy. Turning “often” into the word “always” is a mistake made by the mind-only school. A mental symptom may tip the balance but it still does not make up the whole case. There are no absolutes in our relative world. An unusual “sensation as if” can be just as important as any mental symptom and an unusual mental symptom can be just as important as any sensation. A change in the psyche, sensations or functions according to time and circumstances can all be equally important. I personally was never of the opinion that a striking, unusual characteristic symptom of the body was inferior to a striking, unusual characteristic symptom of the mind. I judge the characteristic value of a symptom by its striking, extraordinary, unusual and odd qualities not by whether it originated in the body, on the vital plane or in the psyche.
When consciousness shifts energy shifts. When energy shifts then consciousness shifts. This is the nature of the Unconscious, which is the realm of dynamic archetypes. This is the level of non-linear synchronisms which have a deeper symbolic meaning. This is the plane that connects the name “Pulsatilla” with the mythological “tears of Venus” in a manner that one cannot logically explain! At the same time, the habitat and growth factors of the “Windflower” also provides clues about the remedy. This archetypal awareness is the great gift of the late, great Dr. Whitmont, who was a Jungian psychiatrist and classical homoeopath. In the final analysis linear causation and non-linear synchronisms are also complementary opposites that make up a whole which is more than the sum of its parts. All of this material is equally valuable depending on the time and circumstances.
Reductionism moves in the opposite direction of the Gestalt philosophy on which Hahnemannian Homœopathy is based. Some persons are so fixed on reducing cases to one mental essence, delusion, sensation and miasm with their keynotes and flow charts that they miss the forest for the trees. They are trying to prematurely narrow the symptoms before opening them up with the repertory and materia medica. They look only at two vectors (the horizontal and vertical) on a two dimensional grid without balancing this view with the “depth vector” provided by the repertory and materia medica. Patients, diseases and remedies are multi-dimensional phenomena that cannot be reduced to two dimensions on paper.
Those that think the repertory is only a “numerical system” do not understand how to use the repertory properly. No well trained homœopath goes by the numbers! A well trained homœopath builds images by uniting combinations of symptom segments that reflect the greater disease Gestalt until it produces a hologram with height, width and depth. The truth is that the repertory is the best medium for artistically combining individual symptom segments in such a manner that the collection is a multi-dimensional mirror image of the portrait of the disease.
The repertory is designed to allow one to collect facets of a greater Gestalt-pattern as represented by the characteristic symptoms and assemble them in combinations that may have never been seen before and that may never be seen again. That is the beauty of the open system view of the repertory that no “system based method” can replace! The repertory has the potential to combine symptom segments in an inconceivable number of combinations that represent the potential of the remedy even if that exact combination is not found in the materia medica. Once a unique picture has been constructed one reviews the materia medica to see which remedy has the potential to remove these symptoms. This is what Boenninghausen discovered when he developed the Therapeutic Pocket Book. Since that time the repertory is no longer just a simple index to the symptoms found in the materia medica. The repertory is an open tool that allows for maximum customization of an almost infinite variety of symptom segments allowing the most precise individualization. Although the repertory is not easy to learn, once it has been mastered it will provide information not found in any essence based system with their flow charts.
All cases present themselves in a unique manner and they require a customized case taking method. Some patients present clear causative rubrics related to a never-well-since syndrome found under a particular group of remedies. Some patients present clear constitutional portraits of remedies found in the materia medica and its commentaries. Some patients demonstrate clear redline, keynote characteristics found almost word for word in our materia medica. Some patients offer clear mental symptoms that lead to a well chosen remedy. Some patients present a main complaint that carries characteristic particularizations with sensations and modalities found only in a few remedies. Some patients present non-logical concomitant symptoms that have little to do with the main complaint that lead directly to the curative remedy. Some patients present pieces and fragments of symptoms that must be collected to make up complete symptoms leading to the remedy. Some patients may present a grand sensation that runs through all their symptoms that can be confirmed by the concomitant symptoms. Some cases may fit the symptoms method while others might suit the systems method better. Some are best solved with a combination of these methods. In all of these cases the essential nature of the totality of the symptoms offers the confirmatory signs necessary to prescribe a simillimum consistently. No one case taking method, no one mental symptom and no one sensation can stand in isolation from the total field of the symptoms represented by the Gestalt of the disease.
I support the study of the symptoms of the mineral, plant and animal families and their individual remedies. I was inspired to review remedy families by Hahnemann, E. A. Farrington, H. Farrington, E. Whitmont and M. L. Dhawale early in my career. I also appreciate the material on this subject offered by modern researchers like Dr. Scholten and Dr. Sankaran. Nevertheless, when I review the “essences” offered in the group studies I always see other equally valid threads that are not included. Our remedies are too multi-dimensional to be reduced to one simple essence that represents the whole potential of the medicine at al times under all circumstances.
I base my family studies on generalizing the similar symptoms of a family and cross referencing the differential symptoms and miasms found in particular remedies. Then I enhance this data by analogy in accordance with experience, which may include archetypes, mythologems, the source of the remedy, habitat, etc. I always review the symptoms of a family from a number of different angles so I gain an understanding of its multifaceted nature to avoid reductionism that may lead to stereotyping. I call on everyone who is interested in the genus method to study remedy families carefully and review the symptoms for themselves rather than rely on any one individual for all their information. In this way, the field of symptoms will be expanded by a group of peers and those rubrics which are confirmed by many can be taken as true characteristics.
Another area of discussion is the validity of using terms like the “constitutional symptoms”. There are some who believe that these terms were introduced by James Kent and have nothing to do with the teachings of Samuel Hahnemann and the first generation. This, however, is not the case. The door to studying the constitutional attendant symptoms was opened by the Founder in The Chronic Diseases. When speaking of gonorrhea caused by an acute miasm Hahnemann said:
They yield either to a dose of one drop of fresh parsley juice, when this is indicated by a frequent urgency to urinate, or a small dose of Cannabis, of Cantharides, or the Copaiva balm according to their different constitution and the other ailments attending to it.
The Chronic Diseases (Theoretical Part), page 150, B Jain Publishing.
In this quote Hahnemann speaks of prescribing remedies by the symptoms in accordance with the variations of different constitutions and their concomitant ailments. G.H.G. Jahr, a close student and confidant of Samuel Hahnemann, expanded on these views in The Doctrines and Principles of the Entire Theoretical and Practical Homœopathic Art of Healing published in Stuttgart in 1857. My attention was drawn to this work by the English-German translator Gaby Rottler of Germany. She has written a wonderful article called Constitution and Chronic Diseases – The Value of Constitutional Symptoms as seen by G. H. G. Jahr. In Gaby’s review she points out that Jahr was the first to elaborate on the use of the term constitutional symptoms in detail and explain their role in Homœopathy. In aphorism 108 of this work Jahr wrote:
“§108. In chronic diseases the constitutional additional symptoms provide the characteristic indications for the choice of the remedy.
Jahr spoke in terms of the pathognomic symptoms of the disease and the constitutional concomitants of the individual. The pathognomic symptoms represent the nature of the disease state while the constitutional symptoms represent the reactions of the patient. Jahr suggests in aphorism 106 that the remedy should be selected by the “essential or pathognomic signs” of the disease and the non-pathognomic characteristics of the “individual constitution of the sick individual or by other accidental conditions”. These symptoms are not caused by the disease per se as they are adaptations of the individual to his or her condition.
For example, ten persons my have “arthritis” with joint pains but one patient is < in summer and one patient is < in winter; one patient feels cold while another feels hot; one patient feels angry and resentful and another feels sad and apathetic, etc. This is why ten arthritis patients might need ten different remedies. Jahr suggests that the best remedy will contain the “most essential constitutional symptoms of the patient” (Jahr §108). He went so far as to say that the “symptoms determining the choice is not to be searched for in the pathognomic signs of the local ailment”. The determining rubrics are the “essential constitutional symptoms” which exist beyond the range of the pathognomic symptoms of the disease.
Some persons say that Homoeopathy treats the patient not the disease while others say that Homoeopathy treats the disease not the patient. It has been said that aphorism 153 of the Organon states that one does not treat the symptoms common to the disease – they treat the strange, rare and peculiar symptoms of the patient. What Hahnemann actually says is that one prescribes on the “more striking, exceptional, unusual and odd (characteristic) signs and symptoms of the disease case” not those indeterminate symptoms “seen with almost every disease’. This means that the symptoms common to ALL diseases (pain, weaknesses, discomfort, etc.) are not as important as the characteristic symptoms of THE disease case under study. There is no reference to the patient per se.
James Kent is frequently blamed for speaking in terms of the patient not the disease but where did this idea really originate? The eyewitness account of the poet Legouve offers a glimpse into the teachings of Hahnemann in Paris. These personal testimonies help us to understand what it was like to actually be with Samuel Hahnemann. He taught his colleagues that the names of disease are only relative while the essential nature of the totality of the symptoms is the true Gestalt of the disease. In this letter the well known poet quotes Hahnemann in the following manner.
At another time I heard him [Samuel Hahnemann] make use of this expression, which sounds so strange if taken in a literal sense, but which is so profound if properly understood. ‘There are no such things as diseases; there are only patients’.
The Life and Letters of Dr. Samuel Hahnemann; T. L. Bradford, page 413.
The first to speak in terms of the patient not the disease was Samuel Hahnemann! This insight was passed down through every generation of homoeopaths and will continue to be passed on in the future. The orthodox school studies the features common to the disease while ignoring the individuality of the patient. The homoeopathic tradition reminds us that the individuality of each patient is very important. Jahr stated that the pathognomic symptoms of the disease are essential but the constitutional symptoms of the patient are more important symptoms in finding a remedy. Even Mr. Legouve understood that Hahnemann’s statement was not to be taken literally but in a metaphorical sense that offers insight into the patient as an individual. There is no disease without the patient and there is no patient without the disease. Therefore, the homoeopath speaks of the patient AND their disease from different perspectives depending on the situation.
HOW HOMOEOPATHIC REMEDIES WORK
It has become popular in some circles to say that the vital force plays no role in homoeopathic healing. They object to the idea that the remedy stimulates the vital force in any way. In other circles little emphasis is given to the role of the remedy and most credit is given to the vital force. These one-sided concepts, however, have no basis in Hahnemann’s explanation of how homoeopathic remedies work. Samuel makes it clear that healing occurs through the interplay of the primary action of the similar remedy and the secondary, curative action of the vital force. In the Preface of the 6th Organon the Founder emphasizes the importance of the secondary action of the vital force in the healing process. He also states that the stronger the vital force the quicker and more certain the healing process takes place. Therefore, he tells us not to do anything that would compromise the vital force and vitality.
Homeopathy is aware that a cure can only succeed through the counter-action of the life force against the correctly chosen medicine. The stronger the life force that still prevails in the patient, the more certain and faster the cure that takes place.
Samuel Hahnemann, confirmed Paris, 184-.
Organon of the Medical Art; S. Hahnemann (OReilly 6th Edition), Preface, page 4.
In a similar vein Hahnemann wrote in a Letter To My True Disciples that the homoeopathic cure is effected through the reserves of life force present in the human organism. In this quote he clearly states that the remedy “stimulates” the vital force into “this helpful activity”.
Homœopathy alone knows and teaches that the cure is to be effected only by means of the entire reserve force still present in the system, and stimulated to this helpful activity by the accurately chosen homœopathic remedy administered in a suitable dose.
Samuel Hahnemann, His Life & Work; R. Haehl, Volume II, page 279.
The interaction of the similar remedy and the vital force is further elucidated in the Introduction of the 5th and 6th Organon. In these works the Founder wrote a detailed explanation of the homeopathic cure in seven italicized points.
True medical art is that cogitative pursuit which devolves upon the higher human spirit, free deliberation, and the selecting intellect, which decides according to well-founded reasons.
It does so in order to differently tune the instinctual (intellect- and awareness-lacking) automatic and energic life force when the life force has been mistuned, through disease, to abnormal activity.
It differently tunes the life force by means of an affection similar to that of the disease, engendered by a medicine that has been homeopathically selected.
By means of this medicine, the life force is rendered medicinally sick to such a degree (in fact to a somewhat higher degree) that the natural affection can no longer work on the life force
In this way, the life force becomes rid of the natural disease, remaining occupied solely with the so similar, somewhat stronger medicinal disease-affection against which the life force now directs its whole energy and which it soon overcomes.
The life force thereby becomes free and able again to return to the norm of health and to its actual intended purpose: that of enlivening and sustaining the healthy organism.
It can do this without having suffered painful or debilitating attacks by this transformation.
Organon of the Medical Art; S. Hahnemann (OReilly 6th Edition), Introduction, page 37-38.
In homoeopathic healing the stronger temporary remedial disease replaces the sensation of the natural disease in the vital force. This is the role of the primary action of a homoeopathic remedy elucidated in point 4. Then Hahnemann states that “the life force now directs its whole energy” against the medicinal disease “which it soon overcomes”. This is the role of the secondary, curative action of the vital force elucidated in point 5. This healing process takes place without the loss of humors and sacrifices of tissue associated with crisis. Hahnemann further expands on the nature of primary and secondary actions in the main aphorisms of the Organon. Vide aphorism 64.
As seen from the following examples, during the initial action of the artificial disease potences (medicines) upon our healthy body, our life force appears to comport itself only conceptively (receptively, passively as it were) and appears as if it were forced to allow the impressions of the artificial potence impinging from without to occur in itself, thereby modifying its condition.
The life force than appears to rally in one of two ways.
1. Where there is such a one, the life force brings forth the exact opposite condition-state (counter-action, after-action) to the impinging action (initial action) that has been absorbed into itself. The counter-action is produced in as great a degree as was the impinging action (initial action) of the artificial morbific or medicinal potence on it, proportionate to the life forces own energy.
2. If there is no state in nature exactly opposite to the initial action, the life force appears to strive to assert its superiority by extinguishing the alteration produced in itself from without (by the medicine), in place of which it reinstates its norm (after-action, curative-action).
Organon of the Medical Art; S. Hahnemann (OReilly 6th Edition), Aphorism 64.
A chronic miasm lasts a life time as it cannot be removed by the vital force. A homoeopathic remedy replaces the permanent natural disease with a stronger but temporary medicinal disease that the vital force can extinguish without difficulty! As the remedy replaces the natural disease the vital force strives to “assert its superiority” by removing the mistuning from “without” while reinstating homeostasis within. Hahnemann called this process the “secondary, curative action”.
In aphorism 65 Hahnemann reviews the excessive counter actions of the vital force witnessed when exposed to non potentized substances (§64, part 1). In aphorism 68 he reviews homoeopathic healing with small doses of potentized medicines (§64, point 2). After the primary action of the remedy has completely replaced the natural disease only a transient, short-lived medicinal disease remains. Now the vital force only needs to use as much counter action as necessary to remove this fleeting medicinal disease and return the organism to the full state of health. When this process is done correctly there are no excessive counter actions of the vital force as witnessed with large doses of non-potentized medicines.
In the Preface of the Paris edition of The Chronic Diseases Hahnemann elucidates the primary action of the remedy and the secondary action of the vital force in great detail. This model explains the role of energy in the process of cure and clarifies how the secondary, curative action takes place in stages. This explanation offers a glimpse of how a medicinal solution administered in split-doses of gradually ascending potencies returns the organism to health.
But if we physicians are able to present and oppose to the instinctive vial force its morbific enemy, as it were magnified through the action of the homoeopathic medicines – even if it should be enlarged every time only by a little – if in this way the image of the morbific foe be magnified to the apprehension of the vital force through homoeopathic medicines, which, in a delusive manner, simulate the original disease, we gradually cause and compel the instinctive vital force to increase its energy in degrees, and to increase them more and more, and at last to such a degree that it becomes far more powerful than the original disease.
The natural disease deranges the vital force in such a manner that it cannot tell self (the Esse) from other (the natural disease) and takes part in damaging the organism. If the healing artist is able to “present and oppose” the instinctive vital force with the primary action of the remedy it will replace the natural disease with a stronger but temporary medicinal disease. This is why a patient suffering from a disease characterized by tightness and cold should be given a potentized remedy that is characterized by tightness and cold. In this way the “image” of the natural disease is “magnified” to the “apprehension of the vital force” in a “delusive manner”. The primary action of the remedy is a form of information transfer that allows the vital force to perceive the disease as separate from self. This causes the secondary, curative action of the vital force to “increase its energy in degrees” until it “becomes far more powerful than the original disease”.
An increase in vitality is one of the signs that a remedy is well chosen. In the process the tightness and cold associated with the disease state is overcome by the relaxation and warmth of the healthy organism with restored vitality. Once the vital force is completely free from the natural and medicinal disease it returns to enlivening and sustaining the healthy organism. When a patient who is tight and cold is given a relaxing and hot remedy the symptoms will be momentarily suppressed, but in time, the counter action of the vital force will produce even more tightness and cold. If the suppressive medicines are continued they may cause the mutation of the symptoms inward to more important organs and systems. This centripetal movement is in the opposite direction of the centrifugal movement of the law of cure. This is the essence of Hahnemann’s action-reaction model and how the vital force responds to similar and contrary medicines.
POSOLOGY AND CASE MANAGEMENT
There are those who give a single remedy and wait and watch until there is a clear relapse of symptoms and those who repeat the remedy at rapid intervals all the time. The protagonists of the first consider what they do to be pure “classical Homeopathy”, while the second group claims they are doing what Hahnemann did in his last days. The truth is that Hahnemann taught the wait and watch method in the 1st through 4th Organon but he modified his case posology and case management procedures in the 5th and 6th editions. From 1833 to 1843 Hahnemann taught that anytime during treatment there was a perceptibly progressive and strikingly increasing amelioration the remedy should not be repeated as long as this state lasts. In cases where a single dose will only produce a slow progressive improvement over a period up to 100 days or more he suggested repeating the dose at suitable intervals to speed the cure. To repeat the remedy to speed the cure Hahnemann recommended that the remedy be prepared in medicinal solution and given in divided doses. He called this method the “middle path” as it stands between the exclusive single dose and the mechanical repetition of the remedy. So in some ways both groups are right and both groups are wrong. It is not a matter of using the single dose versus the repetition of remedies at definite intervals. It is a matter of knowing when it is best to use the single dose and wait and watch and when to act and observe the repetition of the remedy to speed the cure. Such an advanced method requires the ability to make a differential analysis of the progress of the remedy.