This article was published in Similia in June 2014 and is reprinted here with the permission of the author.
The following article outlines the concept of general patterning as a homeopathic case analysis method and proposes the argument that general patterning is an easier and more consistent methodology for finding the simillimum in chronic non-contagious cases than focusing on the mind or emotions.
For more than ten years I practiced and attempted to learn a form of homeopathy known as “classical”. I put the word classical in parentheses because it isn’t clear exactly what classical means in the context of homeopathy other than Hahnemannian, and even that term is highly elastic. Generally speaking “classical” encompasses aspects of homeopathy that Hahnemann considered sacrosanct. These would be the law of similars, potentisation of substances, giving the least amount required to gain an outcome, and using the concept of totality. Most practitioners of homeopathy agree on the concept of the law of similars. At a base level it means matching the symptoms of a proving to the symptoms of a patient. Potentisation is a simple enough process, and although there are a few potency scales, the instructions for making a homeopathic remedy are relatively clear even if there are a few questions regarding succussion. Posology is a much argued area of homeopathy but essentially where the correct simillimum is chosen – whether a high or low dose is given – the correct simillimum will bring about a positive effect for the patient. This leaves totality as the main area that has many different meanings. I will not touch on another idea of Hahnemann’s – the miasm – as this has been covered in another article within this issue of Similia (see Grant Bentley).
Totality means the entirety, the whole, the fullness, the completeness, the inclusiveness or the unity. Totality is a very broad concept that is interpreted in different ways within our profession, especially in relation to case analysis. Some practitioners take every symptom or abnormality within a case and choose 20 or more rubrics to find the simillimum. Others look for one core concept – often related to the mind of the patient. It is common to view mind symptoms as superior, or more important, than body symptoms.
Homeopathy attempts to differentiate itself from conventional medicine in many ways, and the focus on the mind over the body is one of these discriminating areas. Since early times philosophers have pondered the relationship between the mind and the body. Many ideas and interpretations have resulted, from Descartes’s 17th century dualism model, where there is a rigid distinction between the mind and matter, to monism where mind and matter (the body) are seen as one and the same. Homeopathy – since the earliest provings – has allied itself to the monism model where mind, emotions, and physicals, have all been viewed as pertinent to case analysis. Kent wrote in ‘Use of the repertory,’ ‘These, the mental symptoms, must first be worked out by the usual form until the remedies best suited to his mental condition are determined, omitting all symptoms that relate to a pathological cause and all that are common to disease and to people. When the sum of these has been settled, a group of five or ten remedies, or as many as appear, we are then prepared to compare them and the remedies found related to the remaining symptoms of the case.’ (1)
The Monkey Mind
Kent leaves no doubt in his belief of the superiority of the mind over the body, and since Kent’s time homeopathy has joined the modern alternative movement that places the majority of emphasis of all health problems on the mind.
If one studies meditation, the first object is to still the mind. The “monkey mind” as it is known, jumps and moves endlessly and it becomes the greatest challenge for the meditator to still the mind in order to create balance throughout the whole body. Behavioural psychology points to the automatic nature of our mind – its ability to fill in missing concepts, to prejudge situations, to draw on previous memories in order to rationalise current situations – in particular during stressful circumstances. Apart from the automatic and changeable nature of our minds, we also have our emotions to deal with. Our minds can be irrationally influenced when hormonal changes occur. Emotions are often changeable and erratic. The question becomes why do we attempt to explore, dissect and interpret the mind or emotions at all? Patients come to our clinics on their best behaviour and many don’t want to dig over unpleasant events that have previously, or may still, impact on them. They are sick and all they want is to be well. They have come to us (often as a last resort) to get some answers, and some positive treatment. While we cannot provide answers – who are we to judge why things have gone the way they have, whether physically or emotionally – we can find that wonderful simillimum that will calm and balance both their mind and their body.
The body displays what the mind has created
My intention with this article is to remind students and practitioners that the mind and the emotions are difficult areas to navigate when it comes to finding the simillimum. There is an easier way – and while not as glamorous for the practitioner – it brings rewards to the patient that are both consistent and quick acting. I recently heard a fellow practitioner say that we should look at the subtle aspects of the case and not the gross aspects. But why? If we believe that the mind and the body are truly one and the same thing, why not study the gross (much easier) aspects of the case to find the simillimum? While it is true that many of our physical ailments are a consequence of aberrations or stresses of the mind, the body itself can only display what the mind has created. So the body is an equally satisfactory aspect of a case to view. The cases at the end of this article illustrate how the body was used to find the simillimum.
Before I continue with this line of thought there is another important aspect to consider. That is the knowledge or understanding of our remedies. I am a researcher, user and avid supporter of using Homeopathic Facial Analysis (HFA) (2). Once this system became known, the very first criticism from other homeopaths was the number (and type) of remedies that we were using. That is the polychrests – and less than one hundred of them. In the last twenty years, homeopathy has been fast tracking towards finding as many remedies as possible – in fact quantity over quality has been the norm. Gone are the comprehensive and well tested remedies of the 1800’s, to be replaced by literally thousands of substances, many of which are portrayed using the doctrine of signatures, an approach which Hahnemann himself wrote about in Materia Medica Pura.
‘‘It is impossible to divine the internal essential nature of diseases and the changes they effect in the hidden parts of the body, and it is absurd to frame a system of treatment on such hypothetical surmises and assumptions : it is impossible to divine to medicinal properties of remedies from any chemical hypotheses or from their smell, colour, or taste, and it is absurd to attempt, from such hypothetical surmises and assumptions, to apply to the treatment of diseases these substances, which are so hurtful when wrongly administered. And even were such practice ever so customary and ever so generally in use, were it even the only one in vogue for thousands of years, it would nevertheless continue to be a senseless and pernicious practice to found on empty surmises our idea of the morbid condition of the anterior, and to attempt to combat this with equally imaginary properties of medicines.’ (3)
The polychrests – only a hundred or so remedies – are the foundation and most important aspect of homeopathy. I was notified a few years back that a prominent and senior lecturer of homeopathy publically declared that “the polychrests don’t work anymore”. This is not what we find in our clinics. How could such a vast difference of opinion occur?
From the 1980’s, many colleges (especially in western countries – and including my own where I learned homeopathy in the mid 90’s – VCCH) taught a threefold view of remedies. Firstly, some remedies were good matches for first aid situations – for example Arnica for bruising, Hypericum for nerve damage and Apis for stings. Then there were a group of remedies that were good for acute (contagious) illnesses – such as Pulsatilla for measles, Ant Tart for Chickenpox, and Mercury for mumps. However the vast amount of remedy learning was for a third type of illness known as chronic illness. Remedies were learned in stages from keynotes to pathologies to the mind. Usually the first insight into remedies was the keynotes. For example Sulphur < 11 am, hot feet in bed, Phosphorus < twilight, afraid of thunderstorms, and Arsenicum restless, sips drinks. Then the types of pathologies associated with remedies were observed, Sulphur = skin, Phosphorus = lungs, Arsenicum = influenza or cancer. Keynotes and pathology were not enough to differentiate remedies, so more keynotes and more pathologies were added, but in the end it was the mind where most of the focus was placed. The Sulphur patient was stooped and thought rags were riches, the Phosphorus patient was creative and artistic, and the Arsenicum patient was fearful and focused on money. But it didn’t end there. Soon we were reading books with whole chapters dedicated to remedy pictures – with the majority of the focus on the mind of these remedies – and the amount to be learned became overwhelming. Each new seminar brought new remedies and new interpretations.
Another fallout of this search for greater quantity was that the polychrests got lip service at year one or two level and then were forgotten, or type-caste into such limited pictures that the link between patient and remedy became difficult to see. Teachers and students “knew” the polychrests so well that a game began where teachers got students to guess remedies after a case was presented – but before it was analysed. I will use this same game below to highlight how typecasting can be ineffective in some situations. It was rare a student who could guess correctly because of two built in factors. One, most cases had a new and unusual remedy to wow the audience, and two, good homeopathy means there should be no prejudgement of either the patient – or the remedy – until a full analysis is completed – and preferably where the remedy has been given and has worked.
While the essence of remedies was reaching new heights, something interesting happened in our HFA clinics. The concept of general patterning emerged. Initially we kept looking at the mentals of cases – and sometimes we still do – but more and more we came to find excellent remedy choices through using two forms of generals – the general patterning of the face and the physical generals of the rest of the body.
The physical body is examined at a micro level by conventional medicine, yet at the same time it is sadly under utilised by homeopathy. In the never ending chase to define and capture the mind or the emotional state of a patient, the physical body has been overlooked. The physical generals are often more stable, they present themselves consistently throughout the history of the case, and the rubrics that match them are easy to find. The face may change as we age, but the fundamental force that shapes its contours and angles remains the same. The face can be used as a confirming set of general (miasmatic) patterning for every case of non-contagious chronic disease (NCCD).
Does the mental and emotional state of the patient have any importance? The answer is yes – but not always for the purpose of the remedy choice itself. Patients want and need to express themselves, and this information helps in forming an open relationship, and is helpful for case management purposes. However the correct remedy can be found without patient’s opinions, emotions and mental outlook influencing the choice. And there is a good reason it is best for both practitioner and patient that the mind or the emotional state is not used to determine remedy choices – and that is bias.
Use of polychrests
The polychrests are the best proven and longest used remedies – they are all that is required for at least eighty percent of cases. Let us look at what we know about these remedies. Firstly, many of them have many thousands of symptoms which in turn have been allocated to rubrics. Pick any polychrest – or better still have someone else pick a remedy without you knowing which one – and open all that remedy’s rubrics in a homeopathic software package. Then see if the remedy matches you (or your patient) in just the mind section alone. You will find at least ten and possibly thirty or more matching mind rubrics – for almost all polychrests – and for most cases. The same is true of the physical rubrics. The reality is that every polychrest has so many permutations and combinations of symptoms that almost any remedy can match any patient – it just depends on the subjective view of the person analysing the case. However, instead of creating modified versions of these complex substances, or writing them off as not working anymore, or searching for more and more “smaller” remedies, we can use general patterning to find simillimum polychrests.
General patterning can also be used for cases where the mind symptoms (behavioural problems) are more prominent than physical symptoms. When we are in a negative state of mind our physical body responds to that state, but conversely, if we are in a good mood, but happen to hurt ourselves physically, our mood will be adversely affected by the physical pain we experience. The mind and the body are a two-way street – each leads to the other – both are entwined. However the physical body is much easier to read than the mind.
Here are some case examples. These cases are short in their presentation – the information given was all that was used to find the correct remedy. The case taking session was approximately an hour for all cases, and physical generals and facial structure were used to choose the remedy. Two cases used a mental or behavioural trait in the repertorisation for differentiation. For the purposes of this article the facial structure is described, but the matching of miasm to the facial structure and its relationship to the remedy is not detailed. The aim of this article is to enlighten practitioners to the accuracy and simplicity of general patterning. Facial structure is another skill set that is learned separately, but once taught, takes less than ten minutes to apply to each case.
Each polychrest has a myriad of presentations. Try to guess these remedies from the information provided – the answers are printed below.
1 – Male aged 12, migraines
Case symptoms – hardly speaks during consultation but not shy with others, needs to sleep with his brother, < afternoon, small appetite fills easily (easy satiety), lots of sporting accidents, suffers with twice weekly or more migraines < left, throbbing pain
Rep – reserved, > company, < afternoon, easy satiety, injuries, migraines, < left, throbbing pain
Facial structure – asymmetry eyes, eyes wide set, nose wide, nose ball shape, lips full, chin ball, hairline straight, hairline crowded growth on forehead, chin cleft, teeth almost even (natural), slight dimples, forehead shape straight, bridge of nose full/straight, chin slopes back, ears slope right side only, chin defined shape
Case outcome – single dose 30 C once daily. Migraines reduced in two weeks – gone in four weeks – continued gone for treatment period of six months.
2 – Female age 46, allergies and hormonal issues
Case symptoms – many life issues – stress with ex-partner and children but managing well emotionally, however skin irritated easily – sensitive to waxing, bandaging, history of endometriosis and menses clotted and menses long, < coffee, < sweets, flushes and/or chills easily (not sure in what order) heat in the knees
Rep – Generals sensitive external, menses protracted, menses clotted, < coffee, < sweets, extremities heat knees, generals flushes
Facial structure – eyelids full, almost upturned eyes mainly right eye, asymmetry nose and mouth, 2 lines between eyes, sloped forehead, bridge indented, nose tip lower than width of nose, lips thin, lines cheeks, lines under eyes, dental arch compact, hairline possible widows peak, eyes, exopthalmic
Case outcome – single dose 30 C once daily. Flushes and chills reduce within a few days, irritation of skin gone completely two weeks to one month. Case continues well over six months treatment.
3 – Female age 88, chronic tinnitus & depression
Case symptoms – patient is non-English speaking – her elderly husband gives some brief information and answers to direct questions. A few years earlier she was in an accident and lost consciousness – woke with mild concussion, black eyes and mild tinnitus. One year later ear infection – ear syringed resulting in increased noises in ears (trumpets). Right ear almost deaf – forty years onset. Noises < night. Hiatus hernia with reflux and nasal discharge < waking but during this time tinnitus is >. <<< hot weather, heat, hot food. < fried food. Generally depressed.
Rep – ailments from accidents, hearing impaired with noises in ears, < night, discharges amel, < fats/rich food, < heat
Facial structure – down turned eyes, wide nose, recessed lids, asymmetry eyes, mouth, chin defined, lines nose to mouth, teeth (dentures), hairline high, 2 lines between eyes, lower lip thin, upper lip full, dental arch narrow, M shaped hairline, forehead sloped, multiple lines cheeks, nose long downturned, ears sloped, forehead lines (note older people have more miasmatic features than younger people in general)
Case outcome – single dose 30 C once daily. Tinnitus disappears over a few weeks and is gone for almost a year. It returns at intervals (every few months in the second year) – three different remedies (from the same miasm) continue to keep the tinnitus either gone or at very low levels over a period of three years. Depression is lifted from the first remedy, “she is back to her old self”.
4 – Female aged 9, anxiety, urinary tract infections
Case symptoms – very anxious, easily frightened and reactive, urinary issues < morning, nausea < morning, < going to school, constant urging to urinate, continual urinary infections, low thirst, headaches, doesn’t like sweets, bowels changeable, < milk, < oil (makes her vomit), des meat, drinking coke makes her pupils dilate, can’t get to sleep till 1 am. Barely speaks during consultation.
Rep – urination morbid desire, < sweets, < fats/rich food, sleep falling asleep late, stomach vomiting, sweets aversion, mind frightened easily
Facial structure – asymmetry eyes, chin, mouth, nose ball shape, lips upper thin, lips lower full, ears stick out, front teeth prominent, dental arch compact, chin sloped, bottom teeth inward, bridge indented, forehead slightly curved one profile, forehead sloped one profile, ears low, hairline high, hairline crooked
Case outcome – single dose 30 C once daily. Urination normal, less reactive, nausea gone, anxiety gone, sleep normal after one to two weeks. Case continues well over almost one year.
Remembering every detail of a remedy is virtually impossible (100 remedies multiplied by – on average – 10,000 symptoms per remedy = one million rubrics), but through general patterning a polychrest can be brought to our attention, and then raised to the top of a smaller list of remedies through the miasmatic classification of facial structure.
- Kent, James Tyler – Comparative Repertory of the Homoeopathic Materia Medica – BJain Publishers, 2004 – introduction “Use of the repertory”
- Bentley, Grant – Appearance and Circumstance (2003) Pennon Publishing Melbourne
- Hahnemann – Materia Medica Pura – Volume 2, Radde W (1846) Princeton University (digitized November 2008 – Google books)