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Levels of Health


George Vithoulkas offers a schema that allows us to identify a patient’s level of health, which aids in prognosis and treatment.

Excerpted from George Vithoulkas’ book Levels of Health- Published by International Academy of Classical Homeopathy



In this chapter we will provide the parameters that define the level of health to which a patient belongs. In order to gain more insight into the disease states of patients and consequently be able to reach a better prognosis, both before and also during the treatment, we classify patients according to different levels of health. This classification helps us to understand the patient’s general condition and therefore provides us with an opportunity to both refine the prognosis and intelligently use the manifesting symptomatology so that we can correctly evaluate the remedy reaction. It should be clear that this classification has many advantages and can be very helpful in the process of considering which course of treatment to take.


General description of levels of health

Each organism functions on a certain level of health. At present we do not know exactly how many different levels there are. However, to be able to apply this theory in daily practice, for the time being, we will consider twelve levels of health categorised into four groups (see figure 1)



Figure 1: scale with twelve levels of health divided into four groups, the highest level of health is at the top. This illustration depicts the genetic predisposition with which individuals are born and also the degree of strength of the defence mechanism


At the top of the scale we find the organisms with a good general condition and well-functioning defence mechanism, without heavy hereditary predispositions. As we go down the scale, the strength of the defence mechanism becomes weaker and weaker and the immune system compromises more and more, so that the tendency to develop serious pathological conditions increases. As the defence mechanism is strong in the higher levels, it is unlikely that deep degenerative diseases will manifest unless the individual comes under tremendous stress and an underlying hereditary predisposition becomes activated.

It is, however, important for the homeopathic practitioner to understand that almost any pathological condition may arise on any level, but that the prognosis is different according to which level of health the patient belongs to. This means for instance, that cancer may appear in a patient who is on level one or indeed any other level. The vital difference is that the cancer that occurs in a patient on level one will be curable – with the correct remedy – while the cancer occurring in a patient with a lower level of health will be either much more difficult to treat or will be incurable.

Therefore, insight into the levels of health should help to clarify for the practitioner the reasons why he succeeds in accomplishing a cure for a certain pathological condition in one patient, while in another patient with the same pathology he fails. For instance, Parkinson’s disease can be cured if it is manifesting in a patient who is in the first group (the three uppermost levels) but similar results will not be obtained in another patient who belongs to one of the lower groups.


The fluctuation of the organism within the same level

There is another point relating to the idea of the levels that also needs to be clarified here, which has to do with the fluctuation of the organism within one level.

As all of us can witness in our daily lives, our energy and sense of well-being differs from day to day and even from hour to hour. We all have good days and less good days. So it has to be understood that our organism is constantly in a dynamic state that is not steady or fixed but fluctuates within the same main level all the time. These fluctuations are due to the influence of external or internal stresses.


To give an example: if an individual who is on level four Wakes up in the morning refreshed and feeling quite well, we assume that he is functioning in the uppermost part of his level (see figure 2). When, in the evening, due to exertion or exhaustion, he’s feeling extremely tired, he is then functioning on a lower part of the same level. If this individual continues to overexert himself, he may get a common cold and because he does not rest he may develop bronchitis or even pneumonia with high fever. At this point he will have reached the lowest part of his ‘usual’ level four. This, however, does not mean that he has changed levels as far his chronic condition is concerned. He remains on the same fourth level of health he was on in the first place, only in another part compared to when he had no acute disease. If this acute condition is treated with suppressive measures, like heavy doses of antibiotics, and after the acute phase has passed this individual has a slight aggravation of some of his chronic symptoms, such as, he wakes up in the morning unrefreshed, then that will indicates that he is still functioning on level four but in a lower position. This would indicate that his defence mechanism has already compromised to a certain extent. This will mean that the next time he exerts himself, even though it is less than the previous time, he will again get an acute attack. If this happens more often and if he receivers suppressive treatment over and over again, his health state will in time drop down one level and he will find himself on level five (see figure 3). After this has happened, he will be predisposed to get colds even more frequently and under less exertion or stimulation, which may again end up in bronchitis or pneumonia with high fever.


If within this level of health these repeated acute conditions are treated with suppressive measures, such as chemical medications, then the underlying hereditary predisposition of the patient can be activated and a serious chronic condition may develop. One example of this would be if this patient developed an asthmatic condition. Once this has been established, he will then function on level six, with very frequent bronchitis for which he will have to take antibiotics almost constantly.

At a certain point in time, the acute attacks with the high fever stop appearing and a chronic asthmatic condition will be established. In such a case, the patient will have dropped down yet one more level and find himself on level seven. If he is careful, the patient with his chronic asthma may manage to stay on the higher part of this level where his dyspnoea is tolerable and may be controlled with a minimum dosage of bronchodilators. However, if he comes under a great deal of stress, either emotionally or physically, his asthmatic condition will worsen and he will have to increase the dosage of his allopathic medication. As time passes, he will need more and more chemical drugs in order to breathe and will eventually need to be on cortisone all the time. The patient, in such a case, will have dropped to the bottom of health level seven (see figure 4).


The story may not end there. One day under major stress the defence mechanism may further weaken, the asthmatic condition will disappear and a state of constant extreme exhaustion with depression, total indifference and a miserable life will be established. This patient will have dropped one more level to level eight or nine. In such a case the cure is going to be much more difficult for the homeopath and will require a series of remedies. If this patient is treated correctly, he will go through the same stages in reversed order, from depression to asthma to rhinitis while his health is really improving. At the same time he will be climbing in levels of health with the aforementioned modalities.


Potency selection

To a large extent, the levels of health determine the best potency to be used. In general we can say that people with a good state of health can be given a high potency to start with. This means – as you may understand – that the lower the overall health the lower we have to start with the initial potency.

The potency selection, however, depends on a combination of factors of which the following are the most important:


  1. Sensitive patients, who prove every remedy or who are highly sensitive to emotional and mental impressions, or those persons whose organism produces symptoms due to small stimuli – similar to what we see in nervous constitutions or those suffering from multiple allergies – are often sensitive to homeopathically potentised remedies. Therefore, some caution should be used with the initial potency – preferably not higher than 30C, or even no higher than 12C or Q5. Q potencies are supposed to act mildly, but I have often seen strong reactions to these potencies as well. For example, I had a young boy with eczema and respiratory problems due to multiple allergies. His reactions to the lowest Q (quintesimal) potencies were so strong that the mother had to dilute them into several glasses. He only took the remedy when he had a relapse but still the reactions were not manageable. When I resorted to low D (decimal) potencies the reactions were much more stable. He slowly recovered and the treatment went well.
  1. The general good health state of the patient and the level of health (the higher the level of health the higher the initial potency).
  1. The depth of the pathology (the deeper the pathology the lower the initial potency).
  1. Whether the health of the patient is in imminent danger (for instance, in cases that have severe heart problems it is better to start with a low potency, usually the 30C will be best).
  1. The degree of similarity of the selected remedy to the symptomatology of the patient (the more similar the higher the initial potency).
  1. A consideration of all these parameters and a final decision upon the combination will be necessary in some cases.


The following is advice to be considered when choosing the potency in the different groups:


Group A: We can start with any potency, from the lowest up to CM. ln the higher levels the lower potency will also work but the effect can be slower. For example, using D6 will take twenty days to get an effect instead of three days when a 50M is used.

Group B: At the fourth level of group B we can start with a potency up to 10M, and at the fifth and sixth levels up to 1M.

Group C: in this group we should not start with a potency higher than 200C.

Group D: ln this group we should not start with a potency higher than 30C.


Repetition of doses

In the highest levels of health one dose of a remedy should be sufficient to get a good reaction. When the defence mechanism weakens considerably, however, the initial aggravation to the simillimum can increase. So care should be taken not to give a too high potency in order not to create a big initial aggravation. One can always increase the stimulus by raising the potency or the frequency of the doses if there is no reaction. This is easier to adjust and less uncomfortable for the patient than an overreaction from a too high potency.

When the pathology is deep and the general state of health is bad, then we need to give low potencies repeatedly.

In group D we have to give more frequent doses of the suitable remedy, for example, 12C one to four times a day or 30c once a day. ln these cases we also use row potencies more often (Centesimal, Decimal or Quintesimal). We may continue with these low potencies as long as we progress. If the case comes to a standstill, then we have to raise the Potency one step. Therefore, cases where a 12c has been given will then be given a 13C, later on a 14C and so on until the remedy no longer acts. At this point in time most of the symptoms will have changed and we will be able to find a new guiding symptom to continue with the next remedy.

There is however, a possibility that when administering the remedy say, from 12C, with a gradual increase in potency, there comes a point when the potency will not act, for example, the 18C, while there are no signs of a new remedy pattern. This could be due to wrong potentisation of the remedy, but it could also be that this specific potency (in this example 18C) does not harmonise well with the organism of the patient. In such cases we need to go back to the previous potency or jump a few more steps until we succeed in improving the patient’s condition again.

All these rules are meant to act as a general guide. Each homeopath should try to see what works best for his clients according to his experience and expertise. It should also be noted here that different races of people can react differently.

About the author

George Vithoulkas

George Vithoulkas is an Honorary Professor of the Moscow Medical Academy, Professor in the Kiev Medical Academy, Honorary Professor at the University of the Aegean, Greece, Collaborating Professor in Basque Medical University (2001-2004) and Doctor Honoris Causa of "Doctor ViktorBabes" University of Medicine and Pharmacy of Timisoara in Romania. In 1995, he established International Academy of Classical Homeopathy in Alonissos, of which he is the director. In 1996, he was honored with the Right Livelihood Award (also known as Alternative Nobel Prize) "for his outstanding contribution to the revival of homeopathic knowledge and the training of homeopaths to the highest standards".

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