In the teachings of homoeopathy much emphasis has always been put on the totality of symptoms and how following their eradication only health remains. In the majority of patients this is usually the case, but there are exceptions to this rule.
In some cases, the totality of symptoms seemingly disappears, but somehow ill-health still remains. To explore this problem, it was necessary to compare the deviations of those patients with the existing literature dealing with that particular topic.
As a result of this work it is possible to identify 2 separate groups of which the relationship between rhetoric and reality differ greatly. In the first group the tension lies within the medical progress of our times and in the second it lies within the treatment of the patient.
The implications as to the first group is to be aware that what could at first sight seem to be a real cure, could in fact be an incurable case and that case management should be arranged accordingly.
As for the second group, it is important to note that even for a reasonably experienced practitioner it is not always possible to foresee what exists or might happen in the body even if the patient has been having homoeopathic treatment for a while and cure seems to be progressing in the right direction. The importance of the chronic miasms needs to be stressed once again.
“It is not conceivable, nor can it be proved by any experience in the world that, after removal of all the symptoms of the disease and the entire collection of the perceptible phenomena, there should or could remain anything else besides health, or that the morbid alteration in the interior could remain uneradicated.” (Hahnemann, 1988 Organon § 8)
We are told by Hahnemann that homoeopathy cures gently, and once the totality of symptoms have been removed, nothing else but health can remain. (Hahnemann, 1988 Organon § 2 & 8). This paper is an attempt to illustrate and explain why in practice this is not always the case.
Some 10 years into my practice as a homoeopath a few patients took a different direction in their progress of cure than I had been used to seeing up until that time. Common to all of them was the fact that the totality of their symptoms seemed to have gone, but in one way or the other they were still ill.
This paper has given me an opportunity to examine these cases in depth and explore some of the questions, that for so long I have not been able to answer fully. As a result of my investigation I have been able to categorize these patients into two groups.
The first group of patients is a group in which the totality of symptoms disappears subjectively and objectively and the patient feels well, but it is still possible by tests to find deviances from the “normal” healthy condition.
The second group is a group of patients in which the totality of symptoms disappear and the patients are seemingly cured, but following that they suddenly become very ill, more so than before the onset of the homoeopathic treatment.
The former I am not going to deal with in any great detail as I was fairly quickly satisfied with the answers to that problem as a result of my study. In this group the tension between the rhetoric and the reality lies, as I see it, within the medical progress of our times. Today it is possible to carry out tests that were not possible at the time of Hahnemann which made it impossible for Hahnemann to detect any other deviations than those that met the naked eye; the objective symptoms and those that could be sensed by the patient; the subjective ones.
Vijayakar (2002) refers to those cases as “compensatory cures”. By the homoeopath those cases are considered to be cured, but by the allopath they are still considered “diseased”. Possibly some of the cases Hahnemann referred to as cured may through tests carried out today have actually still been ill. It would have been very interesting to know Hahnemann’s opinion on this type of case, and the tests.
The homoeopath has to be aware that this group of patients is incurable (Vijayakar, 2002), but the homoeopath is able to restore those patients to a near normal functioning, and prolong the existence of those patients despite the pathology, even achieving a sense of “well-being”.
According to Vijayakar (2002), however, we do not see the applicability of Hering’s law of cure in these cases. That has not been my experience though. For instance, in one patient I have been treating in which case the presenting symptom was struma, Conium took her right back through all her previous symptoms, the swelling of her thyroid disappeared, she felt and feels well, but according to her thyroid count she should not still be alive.
She has been fine for the past 23 years and is still doing well, despite her counts which are checked regularly and of great curiosity to her doctor. This, of course, raises a slightly different question as to how to measure health and disease? It carries an implication in regard to the sense of the well being of the patient if it is possible to detect “abnormalities” which are not felt by the patient.
It is not the purpose of this paper to deal with this issue, just important to mention that even doctors do not entirely agree on the subject (Wulf., Pedersen & Rosenberg, 1997). The latter group, however, is more complicated and needs much more careful examination. I have not been able to find any literature on the subject whatsoever, so I am going to try to offer my own attempts at explaining the matter. In order to do so I shall substantiate my findings on the basis of the case that caused all my reflections in the first place, and I shall try to justify those findings by other relevant literature.
Although I am under no illusion as to being able to cure everybody in my practice, I hold the presumption that at least if I do not manage to cure the patient, he or she will not be worse off when they stop the treatment than when they first came to see me. Unfortunately, in the patient I am going to present to you this has not been the case, and for that reason, it has been playing on my mind ever since.
In 2003 a girl of 9 years came to see me with her mum. She had 11 plantar warts scattered around both feet and they had been there over a year. She had had whooping cough for a little while and the cough had not left her. Mentally and emotionally there were quite a few symptoms and she had severe muscular pain.
She had had the usual childhood vaccinations. I knew the mother, I had been treating her for some months and she had been responding well to the remedy. The mother’s presenting symptom was alopecia, but the underlying cause was that of her husband’s tragic and accidental death while she was pregnant with her first child – the 9 year old girl.
Later on, it came to light that there was a strong history of diabetes in the family to which the mother had paid absolutely no attention. I took the case and to my mind she needed Calc-phos., which was what I then prescribed.
Over the next 8 months the girl became increasingly better. The cough went pretty quickly and after a while so did the warts. She even had a return of some old symptoms; cystitis and thrush which she had not had the past year. Gradually and with each repetition of the remedy the muscular pain disappeared too. She herself said that she felt better, and that was the impression of the mother too.
Last time I spoke to her mum, which was approximately 4 months prior to the sudden onset of diabetes, I saw her 8 months before the onset, she had been well and her symptoms had gone. I am going to examine what actually happened when the totality of her symptoms seemingly disappeared, I considered her cured, and she then suddenly 8 months later turned up in the clinic with diabetes mellitus.
A lot of thoughts rushed through my mind, when the mum told me, and I just could not understand that a seemingly healthy girl could develop diabetes mellitus, certainly not after an appropriate homoeopathic treatment. Where did I go wrong?
I would be able to understand if the girl got worse after the treatment, or part of her symptom picture got worse. What I am reflecting on is the fact that she seemed to be getting better and better and her symptoms were disappearing even according to Hering’s law of cure.
In my experience, people when better after a remedy, stay better, unless something happens in their lives which then makes the symptoms reappear either suddenly or gradually, depending on the person’s susceptibility or the impact of the occurrence. Or the influence of the remedy fades away and the symptoms come back to a greater or lesser extent depending on the stage of the process of cure.
Of course, it is possible to experience patients getting worse, or only partially better in which case it is necessary to find another remedy ( Hahnemann, Organon § 162, 163 and 249), but to have become so much better and then getting so seriously ill is a completely different matter, especially when there seemed to be no shock or any other change in her life at all.
I would have thought that in terms of suppression it would have been possible to detect signs that progress was not going quite according to Hering’s law of cure, or that something else was amiss.
Dr. Prafull Vijayakar (2002) substantiates my theory in that according to all his cases put forward on suppression it was possible on the follow ups to detect some deterioration in the patients before they either gradually or suddenly got worse than they were prior to the homoeopathic treatment.
One could ask several questions as to what might have happened? There is of course the most basic of all answers, namely, that I picked the wrong remedy. It could be that the girl and the mother wanted to please me by telling me that she was better, where in fact in some ways she was deteriorating. That just does not seem feasible in the way she looked and behaved and the way they described her life and symptoms before and after the remedy, but still that is a possibility I have to bear in mind.
Maybe I was treating the symptoms with a remedy matching the symptoms, but not the underlying cause. But, according to Kent (1921), when you treat the totality of symptoms you treat the cause.
It may be that I did not prescribe on the true totality of symptoms (Stuart Close, 1995). In which case I still find it peculiar that the girl became so much better in herself, and I would have anticipated some other symptoms to appear along the way. Of course one could say they did in the form of diabetes mellitus!!
It is possible that there was a deeper underlying cause like a blockage, Dr Jean Elmiger (2001), in which case, however, I would have expected nothing to have happened at all, or very little indeed, certainly not for the remedy to hold, the warts to disappear and the patient to feel better.
We still have to question whether the amount of medicine and vaccinations used today has an impact on some cases, so they are rendered even more difficult to cure than they would have been in the first place. Or they may proceed in the wrong direction according to Hering’s law of cure, despite the employment of the correct constitutional remedy.
This in turn, takes me to the theories by Tinus Smits and Eizayaga. Although not entirely concurrent, they believe that you may get to some deeper layers within the patient that need treating after the top layers have been dealt with. Tinus Smits (2006) talks about the “universal” Layer and Eiziyaga about the “soil” (Winston, 2007). Those theories coupled with the theory by Vijayakar (2002), that embryology is of great importance to a homoeopath as it is necessary to know at which stages organs and tissues develop in the embryo exactly in order to know which path disease may take, make me think of the fact that it could be that the shock the mother received when she was pregnant left an imprint on the foetus which inevitably would become apparent one day.
Unfortunately, I did not consider such matters apart from the shock when first treating the girl or her mother, so I never asked when in her pregnancy her husband died. Somehow, I do not find it consistent with homoeopathic treatment to become incurably ill, but is it likely that after having dealt with the top layers the susceptibility in the girl changed so much that a predisposition could come to the fore?
One could argue that it was in the girl’s make up and because of the strong history of diabetes in the family she would have developed the symptoms anyway. But is that not what we are taught, that sometimes we can prevent people from getting seriously ill by homoeopathic treatment or at least postpone it? Did I do the opposite; that is to speed up the process, by removing her warts?
In fact, the same thing might have happened if she had just gone along to the doctor’s and plain and simple had had the warts removed (Kent, 1900)! Perhaps at least I can rejoice in the fact that she felt better with it during the homoeopathic treatment, and perhaps she would not have done that if she had just had the warts removed by the doctor – but this question seems impossible to answer.
There seem to be quite a few contradictory states in this particular case, which in fact are mirrored in the few other cases I have seen like this one where the totality of symptoms have been removed, but the patient has suddenly become worse. The contradictory states are as follows:
It does not make sense to me when a patient seemingly has the totality of the symptoms removed, feels better in herself, progresses according to Hering’s law of cure, and then for no apparent reason takes a turn for the worse. I did not do what an allopathic doctor would have done, just remove the warts – or treat the whooping cough. I made an attempt at treating the whole person, that is to say the totality of the symptoms.
“And since cause continues into ultimates and things in ultimates shadow forth cause, the removal of all the symptoms will lead any rational man to assume that the cause has been removed.”(Kent, 1900 p. 110) and further:
“There should be a corresponding inward improvement whenever an outward symptom has been caused to disappear, and this will be true whenever disease has been displaced by order.”(Kent,1900 p. 28). As far as I can gather both these criteria are met, yet disease has not been displaced by order.
From the perusal of the cases and the relevant literature, the only explanation that makes any sense is the fact that the tension between the rhetoric and the reality in this particular group of patients lies somewhere within the treatment of those patients.
Obviously, as with everything else in homoeopathy it is highly individual, and every single case has to be viewed in its own context, but this girl reacted appropriately to the remedies given. It is, therefore, not as if disease just progressed without any aid from the remedies. BUT; “Unless causes are removed from beginning to end the disease can reproduce itself.” (Kent, 1900 p.111). And further according to Boger:
“It does us small credit to see someone who has always had homoeopathic care develop tuberculosis, cancer or what not. Remedies were evidently similar enough to remove passing disease pictures, but not deeply acting enough to eradicate true causative factors, in other words the simillimum had never been found or given.” (Bannan, 1994 p.42).
All this leaves me with the question as to whether the removal of her warts and the whooping cough (if not treated properly?) left her organism ” so shaken and irritated, that with many who seem restored, the psora which was before slumbering and latent now awakes quickly, either into itch-like eruptions or into other chronic disorders, which then reach a high degree in a short time, if they are not treated properly in an antipsoric manner?” ( Hahnemann, 1835 p.134)
Although I am not sure of the time-span Hahnemann refers to perhaps if I had seen her somewhere in between the “cured” symptoms and the onset of the diabetes there would have been basis for a deeper anti-miasmatic remedy?
From this case I have certainly learned that it is important to acknowledge that there are several aspects of life today that may influence a patient in ways that sometimes are difficult to foresee. In cases of trauma in pregnancy in future, I realise it is not enough to consider the trauma, but I shall definitely inquire about the time of the pregnancy in which the trauma took place.
Furthermore, I have to be more vigilant in pursuing the underlying miasm in a case, and to try to make absolutely sure that there is no progress of disease taking place in the innermost make-up of a patient.
As a result of this case I also have to say that I learned that there is a place for allopathy. It is very fortunate that insulin was invented because had that not been the case the girl would have died.
“After you have seen a great many cases you will find that you have killed some of them.”.. and further: “It is well to know the elements in the case; then if you have administered a remedy and killed your patient, you know at least what you have done. It is better to know what you have done if you have killed your patient, than to be ignorant of it and go on and kill some more in the same way.” (Kent, 1921 pp.577,578)
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Close, S.(1995) The Genius of Homoeopathy,(Reprint ed.) Delhi, India, B.Jain Publishers
Elmiger, J.(2001) Rediscovering real medicine,(paperback ed.) London, Vega
Hahnemann, S.(1835) The chronic diseses, (2nd Edition) volume 1, New Delhi, India, B. Jain Publishers
Hahnemann, S.(reprint 1988) Organon of Medicine (5th and 6th edition,paperback ed.) New Delhi, india, B. Jain Publishers
Kent, J.T. (reprint 1987) Lectures on homoeopathic philosophy, New Delhi, India, B.Jain Publishers
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Deepak Sharma, (online) 12.12.06
Tinus Smit,http://www.tinussmits.com/english/dynamic.htm?main=http://www.tinussmits.com/english/inspiring/intro.htm(online) 2006
Vijayakar, P. (2002)Theory of suppression ( 4th edition, paperback ed.) Dadar, Mumbai. Mrs. Preeti Vijayakar
Julian Winston,http://www.wholehealthnow.com/homeopathy_pro/eizayaga_layers.html(online) 2007
Wulf. H.R., Pedersen, S.A., Rosenberg, R (1997) Medicinsk Filosofi,(paperback ed.) Copenhagen, Denmark, Munksgaard.