Homeopathy Papers

The Principles of Sequential Treatment in Heilkunst Practice

The Principles of Sequential Treatment in Heilkunst Practice


Heilkunst is a comprehensive system of healthcare grounded in principles derived from natural law. One of the realms within this system is medicine proper and the removal (cure) of disease(s). As was set out in the overview article in this issue, Dr. Hahnemann laid the foundation for a complex disease classification and identification (nosology), as well as providing the basis for the rational selection of the curative medicine for each disease (therapeutics).

A central part of this understanding is the fact that there can be more than one disease in a person at the same time and that, indeed, some individual diseases can combine within the human life force in various combinations to form complex or concordant diseases.

As Hahnemann states in Aphorism 1 of the Organon, the highest and only calling of the physician is to make the sick healthy (gezond or sound), to cure, as it is called. For Hahnemann soundness has to do with the absence of disease, not simply a balance of the sustentive side of the Living Power, which he termed wellness (wohlseyn).

In order to effect cure we must remove the impingement on the generative force of the Living Power, even if it occurred in the past. In this way we can restore the fullness of the Living Power in both its generative and sustentive aspects.

One of the challenges has been the treatment of past traumas that continue to have a deleterious effect on the health of a patient, recognizing that during a given lifetime the number of such diseases, large and small, will accumulate.

The diseases induced by traumatic events can still inhabit and inhibit the organism in the present. The problem is that in most cases the visible symptoms have receded, leaving only the disease itself, hidden in the complex of the patient’s behavior, circumstances and occurrents. By carrying the burden over time, the generative power is compromised, which results in a weakened life force.

Hahnemann himself recognised that such situations required a sequence of medicines to treat successfully. Such a treatment also engaged the identification of the primary, tonic diseases, including the chronic miasms.

A systematic approach to treating these events in the reverse order of their occurrence was first proposed by Dr. Jean Elmiger of Switzerland, mainly in the context of vaccination and drug shocks (iatrogenesis). He termed this approach “la thérapie sequentielle” or sequential therapy.

The current practice of Heilkunst has integrated Dr. Elmiger’s insights, grounded as they are in Hahnemann’s own writings, into its treatment protocol. The treatment of the timeline has been expanded to also include the serious mental and emotional shocks.

Development of the Principle of Reversal of Direction

Based on the work of Dr. James Tyler Kent over a century ago, itself stimulated by Hahnemann’s own insights, and as solidified by the extensive clinical research by Elmiger more recently, the treatment of the cumulative shocks and traumas is based on a natural principle. The principle of treatment is the reverse order in which the diseases were incurred.

This principle has frequently and mistakenly been attributed to what is commonly termed “Hering’s Law of Cure.” However, Dr. Hering’s famous principles refer to what occurs within a single disease and specifically that remediation progresses from more to less vital organs, from above downward (specifically in the case of pain), and in the same direction as the natural disease process.

It was Kent who observed that where several diseases (what he termed “groups of symptoms”) had developed in a patient over time, the remedial process would occur naturally in the reverse order of emergence of those diseases.

These observations form the basis for a rational sequential treatment of the traumatic disease states caused by physical action, emotional effect, or medical intervention. They are treated in the reverse order of their occurrence (as Kent observed should naturally proceed in the process of remediation) through life, birth, gestation and conception.

The secondary, pathic diseases are also treated, but when and if they arise during the sequential treatment of the primary, tonic diseases.

Elmiger observed that patients with unresolved physical issues had a correlate in the energetic systems of the body; the energy meridians remained blocked until the person was exposed to the remedy to cure the original exciting cause.

He labored to bring true science to these observations, to determine the nature of the blockages and the principles of cure. He discovered that if he did not respect the reverse chronological order, there could be a further entanglement of energies and impediment to cure.

His clinical observation was that the barrier to the life force was the disease proper (what Hahnemann termed the initial action of the disease agent) and could only be removed with the remedy that addressed that cause. Each remedy was related by principle to the cause and this meant the use of isodes and nosodes in many cases.

For example, if the drug cortisone was used and engendered a cortisone disease (labelled “side-effects” by allopathic medicine), the curative medicine would bear a relationship to the iatrogenic agent, namely a dynamised, potentised cortisone.

Elmiger also found great success by applying the remedy in the potency that matched the intensity of the causal event, and he believed that many failures in homeopathic practice resulted from an unwillingness to apply high potencies in a principled manner. Both he and Rajan Sankaran observed that the higher potencies penetrate deeper to the energy level where old traumas have been lodged.

In the last eighteen years, the work of Smith and Verspoor has shown that the emotional traumas sustained through life feature very significantly in traumatic treatment. While Dr. Elmiger did address some emotional shocks, the degree and extent of the impact of emotional shocks to the life force remained to be further developed.

Smith and Verspoor also revealed that the emotions sustained by a mother though pregnancy could be transmitted to the child, not to mention the impact of the emotional environment surrounding conception (see also the latest work by Scholten and Sankaran on this related to the periodic table of elements).

Thus, through the work and observation of Hahnemann, Hering, Kent, Elmiger, Smith and Verspoor a principled, lawful and effective method of treating the traumas and their expression has been developed.

Ariadne’s Thread

In following the life force back through time and removing the blockages impeding the restoration of health along the way, we are reminded of Ariadne’s thread laid down through the Labyrinth to allow Daedelus to escape death at the hands of the Minotaur.

If you follow the thread back to the source, you cannot get lost. The life force will accurately draw you through the process and reveal the next step even if it is not immediately apparent. One of the most helpful aspects of the principle of the reverse direction of cure is that a very accurate map can be set up at the start of treatment, based on the medical history and memory of accidents and emotional traumas. Where there are gaps in the map, these reveal themselves as the timeline is traversed.

Tonic/idiopathic disease

As noted, the sequential treatment of past traumatic events is based on the identification of tonic diseases. The tonic (Hahnemann would say “primary”) diseases are those that have no other disease as a cause or antecedent. They are idiopathic and exist unto themselves. There is a deeper cause but it is not another disease! The tonic disease is identifiable based on cause.

In tonic prescribing, one cannot get the wrong remedy for any particular cause once identified correctly. The issue would instead be that of the wrong diagnosis. Distinguishing the cause automatically gives the remedy (the cure) based on the principled relationship in each jurisdiction between cause and remedy (see section on Jurisdiction below). All events on the traumatic timeline are tonic diseases. This tremendously simplifies the diagnostic process, as the similar tonic disease always has the same cause and curative remedy.

Pathic disease

The pathic (secondary) diseases are dependent on the tonic, or primary, diseases, from which they issue. Hahnemann also referred to them as secondary diseases and further laid down the principle of first treating for the primary, tonic diseases.

Since this then removes many of the pathic, secondary diseases, the treatment of the remaining pathic diseases is immeasurably simplified. The remaining pathic diseases are identifiable only through their symptoms, not through the cause. Therefore, the curative remedy is determined by the symptom picture. This is then the true realm of homeopathy – repertorisation for similar suffering.

Concordant, complex disease

At any point in the traumatic timeline, there may be a simple or a concordant disease. The simple disease will require a single remedy based on Hahnemann’s principle of one remedy per disease. Hahnemann points to the situation of concordant diseases in aphorisms 40, 42:  Two or three diseases will reside in that part of the life force best suited for them. Not only can you have more than one disease in a person, but these diseases can come together and form a complex.

The concordant disease occurs in a synergy of time and space. Strictly speaking, this is not a single disease, but it acts as though it were a virtual disease. Because it occurred in a single moment, or close to it, it is better treated with all the remedies for the constituent diseases at the same time.

The single remedies, given in sequence, will not be as effective. The combination of remedies for all the diseases constituting the concordant disease will be effective – the “informed remedy” of Aegidi, the Auskunftsmittel.

For example, in the case of abortion, grief, anger or resentment, fear and guilt are often present. For these, the combination of Natrum muriaticum, Staphysagria, Opium, and Lachesis is effective (i.e., NSOL). The states of mind or disease are related by the phenomenological event of the surgery,
so they must be addressed at the same time.

Although you need more than one remedy for the concordant disease, you are still applying only one remedy for each fundamental disease. Many combinations and layers will interplay, and there are many patterns that can be developed and duplicated.

The remedy will include a complex of factors dynamically, chemically, biologically, botanically that will, in totality, meet the complex of disease. This is a principled formula rather than polypharmacy.

Another example: surgical events will all occur within a certain time and may extend to include the time in the hospital. The events are tied not by time, but intent, purpose and phenomena. What informs it is the wesen of the disease. The puncture wound, antibiotics, anesthetic, incision, and contusion are all lesser diseases with their own wesens.

They join together and form an arch-wesen, a power that controls the lesser powers. The practitioner must come up with the opposite complex (the similar) – the federation to oppose the arch-wesen.

The experiences of a child being treated for physical, emotional and sexual abuse that took place over a period of ten years may be treated as a complex if linked through the informed idea. There will be anger, fear, grief, violation and shame in the period, though not necessarily at the same time. The emotions are linked in the person’s mind, not held separately. Physical remedies may be required as well to address the issues on that level.

As always, the practitioner must be vigilant and not violate the natural law against polypharmacy. The practice of giving remedies that might have an effect, or which share some characteristics with the event, is unprincipled and unacceptable.

It is more likely to occur in the rough and tumble world of pathic prescribing, but it is important to remember that each remedy must be properly matched with the tonic occurrence with which it is intrinsically linked.

Further, the practitioner must guard against the befuddlement of “false diseases:” the conditions and syndromes that result from a complexity of pathic symptoms. The allopathic community, not having the distinctions of disease that Hahnemann made clear, mistakes these for disease and attempts to treat headaches and arthritis without seeking to annihilate cause.

Over time, it is possible to build a materia medica of formulas, the informed complexes to treat characteristic informed diseases.


The pathic realm (where we repertorise symptoms homeopathically) is not jurisdictional, but the tonic always involves jurisdictions. The order and rigidity of the exclusive relationship between jurisdiction and operating principle imply that this is through Natural Law.

Any treatment from any jurisdiction and modality can have an effect but this does not automatically imply that it is effective. The eclectic approach (as used in naturopathy) frequently doesn’t operate within the jurisdictions of Natural Law.

The approach mimics the handyman who has a limited number of tools and gets by with them. He will use one tool for a variety of uses and may do an adequate job. A cabinetmaker, on the other hand, has a huge number of tools, each slightly different from the other, each designed for a specific purpose. The tinkerer has an effect, but the cabinetmaker is effective.

If you step outside the jurisdiction, the treatment will not be effective in making happen what is meant to happen. In prescribing, render judgment in your jurisdiction; it must be lawful.

In the cases of the homogenic, iatrogenic, and pathogenic diseases, each results from an exciting cause. They are addressed by the homotonic principle – by remedies specific to a given cause and disease.

The homogenic trauma (cuts, bruises, falls, emotions), results from a disease irritant. It is the lowest level of medicine of the tonic realm. It may be superficial, but it can be very profound in effect. It may be physical (as a bruise) or emotional (as grief or loss) but is still a manifestation of a state of mind.

Thus, one will get a bruise when in a bruised state of mind and experience grief when in the state of mind of grief and loss. Therefore, we treat the state of mind with a remedy that will effect cure. We are susceptible to the homogenic diseases by the miasms already present within us.

Iatrogenic diseases result from the improperly applied intervention of doctors or medicine. It would include physical and surgical interventions, except that they are de facto homogenic traumas! The effect is like the handyman trying to repair a piece of fine furniture with his coarse tools, and making the situation worse.

The use of medications is an important cause of iatrogenic disease: everything from vaccines to birth control pills, painkillers and psychotropic drugs. The states of mind and disease engendered by the medications can persist through life unless removed by the curative remedy.

The pathogenic diseases are the classic infectious diseases. e.g., yellow fever, cholera, typhoid, measles, German measles, polio, mumps, chicken pox, whooping cough, and malaria. There is an infectious agent present (bacteria, microbe or virus) but these agents are not necessarily causative (exogenous) since the bacteria and viruses may be endogenously produced as an effect, expressive of the trauma, terrain, stress, or homogenic or iatrogenic disease.

Choice and timing of remedies

Given these principles, the diagnosis of timeline events and the corresponding remedies is straightforward: one always looks to the similar cause that provides the remedy.

In complex cases, there is a resultant complex disease. The component simple diseases must be recognized and included in the informed remedy since this greatly speeds up movement along the timeline and ensures the complete elimination of the disease state.

Each occurence must be observed independently rather than by rote. However, the components of the complex disease are easily recognised once they are well known. Some guidelines have been developed with clinical practice.

If there are several similar mental-emotional events in sequence or if there is a consistent emotional theme, the tonic remedies may be given only once for the group, with close observation determining whether the life force requires another round or a higher potency.

In the case of drug use (licit or illicit) Elmiger observed that the greatest shock to the generative power occurred with the initial event – the first time the drug or substance was given. In fact, without evidence of an intense reaction to a later event, one would treat for only the first event of drug use (including tobacco), vaccine exposure (for each vaccine or combination) or medication.

Other traumas or events are addressed somewhat differently. Each disparate event will be treated even (or especially) if there are a number of similar events in the timeline. Once the earliest occurrence of the similar events is reached, it is treated to a higher potency to assure the complete removal of residual effect.

Each event is treated with single doses of the remedy in ascending potencies taken daily (or less frequently). They are usually in a 30C, 200C, 1M and perhaps 10M, depending on the intensity of the event. The use of several potencies (into the higher ones) ensures that we address all the effects on the life force, as well as the several bodies that compose the organism (physical, etheric, astral). Further, the use of ascending potencies allows us to address the several depths of disease without putting at risk the health of the individual.

The chronic miasms that are treated after completing the temporal line are treated to higher potencies, in order to avoid disturbing the energy field.

Dramatic vs. Traumatic

Steven Decker has observed that there are two associated but distinct timelines which may proceed at different paces in treatment. The traumatic timeline is associated with physical accidents and events and effects within the physical body.

The dramatic timeline corresponds to events that have a very intense emotional component and relates more to the etheric body. It may be treated on an etheric basis, addressing the complex events with the emotional remedies.

However, these two timelines are not necessarily tied to the same rhythm of resolution. In some patients, therefore, it becomes prudent to distinguish between the two and treat each according to the pace at which it progresses. As always, the principle is to follow the action of the life force and treat what presents.

Some Considerations

On occasion, a patient may forget or disregard an event that has been held in the organism as a barrier to cure. The life force will bring it to the front, through memories, coincidental events known as occurents that represent the event, or with physical or emotional sensations that point to the event.

In general terms the interval between appointments will be six weeks, in order to ensure that the healing action of the sustentive power is complete and any discomfort of the counteraction is resolved. It is vital to allow flexibility around this time frame however, as the individual’s life force will proceed at its own pace.

An interesting phenomenon shows up in that the patient may manifests the symptom in anticipation of the next event to be addressed on the timeline sequence. The life force is moving outside time, in a dynamic or energetic action.

More and more frequently, patients will exhibit signs of the next needed remedy within three weeks or so. This depends on the individual involved, the issues being addressed and the place in the timeline.

If a slight recovery is followed by the return or exacerbation of symptoms, one can repeat with a higher dose or give the next higher dose (usually a 10M). This usually occurs when the patient (or practitioner) has not recognised the intensity with which the event affected them.

The sequential treatment approach gives the practitioner a profound, measured and effective tool in treating the chronic, complex cases that are presented by most, if not all, patients. The great gift of the method, however, is that it is to treatment, what a road map is to an actual trip. It is in the experiencing, the adventure and following the patient on their road to the ultimate destination that the value lies.

Following the treatment of the traumatic and dramatic timelines, the way is then opened up to treat, in systematic and principled fashion, the chronic miasms (see separate article in this issue by Patty Smith).

Sources and references

Jaynes, Julian, The Origin of Consciousness in the Breakdown of the Bicameral Mind 1976

Hahnemann Samuel, Chronic Diseases (B. Jain reprints)

Hahnemann, Samuel, The Lesser Writings, ed. by R.E. Dudgeon, MD (B. Jain reprints)

Hahnemann, Samuel The Organon of the Remedial Art ed. Wenda Brewster O’Reilly, based on a translation by Steven R. Decker, Birdcage Books, Redmund, Washington. 1996

Decker, Steven R., and Verspoor, Rudi, The Dyamic Legacy: from Homeopathy to Heilkunst, 2002

Elmiger, Jean, Dr., Rediscovering Real Medicine, Great Britain, 1998

About the author

Marion Elliot

Marion Elliot DMH

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