There are many different ideas in homeopathy today and many angles from which case-taking, analysis and prescribing is approached. The more recent theories come from homeopaths such as Scholten, Mangialavori and Sankaran, to name a few, who seek to enhance the comprehension of homeopathy, the familial connections of remedies and the methodological aspects of case-taking and case-analysis1.
We have already seen the development of approaches which differ from Hahnemann’s classical approach. These approaches have gained a valued place in the treatment of disease.
This essay investigates one of the `older´ approaches, that is different from the classical concept, but nonetheless homeopathic in its foundation2.The focus of this critical analysis is ‘Organopathy’, which describes a treatment practice where case-taking focuses on locality, and remedy selection on the symptoms of organs or organ-systems3. This approach implies that the vital force creates disease in the organs and that organs and organ-systems are interactive parts of the whole4.
The organopathic treatment approach is much older than classical homeopathic prescribing5. Beginning in folk medicine, prescribing by interpreting similitude of a healing agent to indications of internal organs was common practice. What found its origin in Paracelsian medicine and was regarded much as an earlier notion of the Hahnemannian understanding of similar, was further developed by Rademacher as an independent pragmatic medical art. It was refined and defined by Burnett in the 1900´s as organopathy5.
Paracelsus (1493-1541), 200 years prior to Hahnemann (1755-1843), pointed out that “similar must be compared to similar”6. He referred to plants as ‘external’ organs, and was the initiator of the idea that a “disease is cured with a substance which has the same essence”5. It was Paracelsus who first spoke of the idea of Similars7. But his understanding was not the same as what Hahnemann later incorporated into his Law of Similars. The difference between the Paracelsian view and the Law of Similars is of a pharmacological nature. To Paracelsus, ´similar` meant that the internal organs of an organism had an herbal counterpart in nature that was similar to the organ’s specific disturbance8. For Hahnemann, ‘Similar’ meant that the symptom picture expressed in an ill individual had to be similar to the symptoms experienced by a healthy person upon ingestion of a substance, in order to cure5.
Hahnemann (1974), as described in Aphorism 18, saw only the totality of symptoms expressing the ill state, and cure therefore should only be possible matching a remedy to the given totality.
Rademacher (1772-1850), who was a contemporary to Hahnemann, introduced the identification of the pathologic organ as origin of an illness9. Paracelsus and Rademacher alike understood an organ to express the state of the whole individual, and the curative action of a remedy on the diseased organ should heal the entire individual. Hahnemann refined this by taking into consideration specifics about the character of the indisposition and by seeking a comparative system of mapping remedial action identified in a healthy individual, with the symptom pattern of a disease7.
It was in the late nineteenth century that Burnett (1840-1901) sought to combine the Paracelsian view of the curative effect of remedies in nature, with the physical aspects of diseases that Rademacher had identified, and aimed at unifying this with the philosophy of the homeopathic treatment approach10. He thereby introduced a new joint approach to healing described as organopathy.
Burnett was member of the legendary Cooper club, where Skinner (1825-1906), Cooper (1844-1903), Burnett and Clarke (1853-1931) critically investigated the old and new theories of homeopathy. Whilst Skinner and Clarke were advocates of high potency prescribing, Burnett and Cooper were users of un-potentized tinctures and low potencies. During the time of the Cooper-club, these four investigated treatment approaches and remedies, and expanded the use and diversity of nosodes10, (preparations derived from pathological cultures or secretions11). Burnett made use of organopathy and the miasm theory, with the prescription of nosodes, especially in his treatment of cancer10.
Rademacher challenged the theories postulated by Paracelsus and researched the principles the latter had formulated. Rademacher had to acknowledge that organs could be seen as individual entities and as connected to the bigger whole2,8. He also had to confirm that in nature there existed sources of remedies that reflected organs in the body, and that the expressions of a disease were also influenced by the patient’s environment. In conclusion, he had to affirm that the “energetic principle of the remedy is curative of the disease” 8 (p. 540).
He identified and described ‘Universal remedies’ that reflected the theory that Hahnemann had found in his miasms. These were three basic ailment patterns he recognized inherent in patients, much like Psora, Sycosis and Syphilis8. To him the reaction of a remedy on the whole person was universal, and that affecting only an organ, of organopathic utility12. Rademacher therefore declared that a patient, whose pathology could not be helped by the use of organ remedies, would be subject to amelioration by a universal remedy related to one of the three principal patterns8.
Rademacher identified a disease as organopathic if the primary seat of the disease was the localization of pain in that particular organ. This ‘pecificity of seat’ was recognizable if in the acute flare-up, pain was felt longest in the organ of primary affection9. This did not mean however, that the symptom manifestation in an organ, necessarily identified the disease as confined to this one particular organ12.
Underlying this, according to Burnett, was the idea of a pathological perspective of homeopathy, where the simillimum selected is that of the disease and not just that of the symptoms. He believed that behind the holistic symptom expression is a more distinctive, a more precise symptomatology that identifies the “true pathologic simile” 2(p.95). To Burnett there existed different types of simillimum, namely the ‘pathologic simile’ reflecting the development of disease, the ‘simple symptomatic simillimum’ taking into account the totality as proclaimed by Hahnemann, and a ‘simple simillimum’ that has a superficial correspondence to symptoms expressed2(p.95).5
Comparison with Hahnemannian teachings
In order to compare Hahnemann’s and Burnett’s homeopathic approach, their two descriptive terms of homeopathic treatment have to be differentiated. Classical homeopathy is the Hahnemannian approach, where the prescribed remedy is selected in order to most closely match the totality of the individual symptoms in a particular patient.13,3 Clinical homeopathy comes closer to the fundamental principle of organopathy. In this, homeopathic remedies are selected according to a “disease name”14, that is, according to a clinical diagnosis and the symptom-similarity to the diseased organ13. Organopathy is therefore seen as quite close to allopathic, diagnostic treatment15.
Hahnemann’s and Burnett’s aspects differ fundamentally in terms of idiosyncrasy. Individualization is that fundamental key to Hahnemannian case-taking. Hahnemannian focus is on the individual, externally expressed signs created by the impaired state of health. Hahnemann sought to compile subjective, patient specific symptoms16 which could be descriptive of a defined anatomical area of the body, but not so refined as to be specific of an organ-pathology. This meant that with Hahnemannian case-taking, organ specific descriptions could be missed2. Burnett represented the belief that the pathologic aspect, the ailment inside the organism, needed also to be taken into consideration, and that “a case had to be homeopathic from the pathological perspective too”2 (p.95).
The detail of anatomical expression, specifically of physiological activity, to Burnett, described the organ that was pathologically impaired and reflected indicators to the remedy that had an affinity to that particular organ2. Yet Burnett believed that the simillimum to a patient’s diseased state could be found by application of either technique, Hahnemann’s symptomatic, taking into account the totality of symptoms, or his pathologic, disease-specific, simillimum approach2.
There are diseases that have no totality encompassing symptomatology, where the pathology is organ specific, organ symptomatic and confined to the locality of a specific organ17. Burnett was constantly aware and deliberate of retrieving the most ‘similar’ remedy for a disease, but recognized that organ diseases frequently required only organ specific healing18. This is much in opposition to what Hahnemann indicated in Aphorism 7 of the Organon, that the only form of healing is that which incorporates the totality of the patient, even if there is only a localized, organ-specific symptomatology19.
In prescribing, Burnett’s method was also in opposition to Hahnemann’s idea. Burnett could not confirm Hahnemann’s postulation that each case of illness of every individual required only one single prescription. Burnett’s emphasis was, that there was a requirement for well-reasoned multiple prescribing and administering of remedies2,20. But Burnett had to acknowledge limitations to organopathic prescribing. A health impairment on a constitutional level lies beyond the range of activity of organ remedies. Burnett saw this as the “inherent defect of organopathy”5 (p.18).The holistic organism is left unaffected by organopathic prescribing, only the interaction of organ and organism may be influenced positively2.
Particular indications for the use of this method included specialized areas of practice According to a survey done by Monk-Schenk in 2002 the main characteristics demanding the use of organ supporting remedies today, are indicated by chronic suffering where the central focus of symptom expression is on a particular organ. Organopathy is also indicated where expressed symptoms are localized and of a physical nature, and where the patient claims to never have been improved since the organ was affected2.
Whilst it has been repressed in classical homeopathy, locality is one main indicator for an organopathic treatment. Locality is of major importance, as Burnett points out that the pathology of symptom expressions needs to be encompassed by the chosen simillimum9. According to Blair’s (2009) article, Burnett found Hahnemannian homeopathy too limiting, as the Law of Similars only permits one interpretation of a simillimum and is therefore restrictive in finding the specifically matching prescription. Burnett pointed out that organs are individual systems within the organism, the bigger system, which have individuality in terms of their functions and their diseases. He indicated that if an organ autonomously suffers from disease it can be cured by treating organopathically. If on the other hand the organ is impaired due to the whole organism’s suffering of a chronic, miasmatic impairment, the organopathic remedies will act solely as palliatives and the great anti-miasmatic remedies have to be prescribed20. This becomes evident in Burnett’s treatment of Tumors in Cancer.
Burnett was described as a “great cancer doctor” in his time20. He insisted that in advanced physical pathology, the treatment with low potencies and tinctures is of greatest benefit to the patient10. It is with the combination of the high potency prescribing of classical homeopathy, the administration of Nosodes and organ-specific treatment that great success is seen in the treatment of cancer2,5,21. This combined treatment of local affinity and miasmatic trait is aimed at achieving a complete and permanent recovery4.
Burnett successfully treated the local affection and the effective disposition. The local destruction of the cancerous growth alone could never have been declared a healing, as long as the disposition was not eliminated4. “The chemical destruction of a tumor is pointless, because it is a sanguine growth that has to be cured vitally”4 (p. 5).
Burnett saw cancer as “the final stage of a chain of causal occurrences”4(p. 5). Whilst his belief remained strictly classical homeopathy in that the aim was to heal the vital force that had created the cancerous growth, he was convinced that only a series of remedies could cure a case. He believed that each individual remedy working in the direction of cure could, combined together, lead to cure of the cancer4. In his prescriptions for the treatment of cancer, he alternated between anti-miasmatic remedies in high potencies and organ-specific medicines in low potency. His repeated administration of remedies in high potencies did not follow Kentian specifications4, where a single dose of a single remedy was administered and a repeat or subsequent prescription would not be given until the prior remedy had completed its action22. Burnett would administer high potencies in a few weeks of one another and low potencies several times daily4.
This methodology has regained its importance and has been applied by Coulter and Ramakrishnan (2001). They have recognized that the affinities of organ remedies to an organ are thus also specific to the site of cancer development if it is located in that organ. Their treatment of cancer incorporates the alternation of an organ support remedy with one identified as constitutional.
Another indication for the use of an organopathic treatment approach is found in the methodology that is described as drainage. Here the aim is to select remedies that lead to a detoxification of the body23. Maury (1965) ascribes a dual role to drainage; that of organ stimulation and of excretion of toxic products that have been bound in the diseased organism. He postulates a three-fold benefit to the methodology. There is a benefit to the patient in that the detoxification of the organism will avoid an interaction of toxins with the remedies that are subsequently administered. The treatment of the excretory organs prior to remedy prescription may result in a more rapid onset of the effects of the remedy that is to follow detoxification. As a consequence, the homeopathic treatment will be experienced as a rapidly acting methodology without any aggravation24. A further indication for the use of organopathy in organ support, as Runcie (1972) points out, is to eliminate possible aggravations for patients who are sensitive25.
Implications for case-taking method
The organism is an entity, a co-existence of inside and outside that is monitored and operated by a dynamic life-force20. Therefore, prescriptions in homeopathy are sought to be individualized. Hahnemann (1974) in Aphorism 5 of the Organon points out that only the idiosyncratic totality of symptoms perceived in the state of illness can point the practitioner to the selection of an appropriate remedy. In Aphorism 185 he discusses the implications of a locally circumscribed disease that does not create symptoms other than those at the specific location. Yet Hahnemann never omits the aspect of individuality and totality of symptoms in his case-taking, much in opposition of the information that is needed in application of organopathic principles.
Case-taking with an organopathic focus is considered much more superficial than that of classical homeopathy, as only local symptomatology is considered26. Organopathic case-taking requires the practitioner to have vast knowledge of disease symptomatology and organ function2. To Hahnemann of course, this was the much rejected alliance of allopathy and homeopathy that he wanted to avoid and that opposed the acquisition of the symptom totality that he taught2.
The allopathic diagnostic techniques utilized by Rademacher, such as palpating the organ, were later adapted by Burnett5,8. Burnett had sought a system to utilize for prescribing, when with the classical Hahnemannian case-taking, the identification of a simillimum was not possible5. For an appropriate prescription, he considered three fundamental foci of action of an organ remedy. There had to be the considered the relation of a remedy to a particular organ, the character of action it was able to produce and its range of impact2. He also indicated that there was a posological and dosological aspect to organopathy. He pointed out that organ remedies had a stronger impact on disease in material dosage and in repetitive prescription, whilst the higher potencies were considered more appropriate for constitutional prescribing and less frequent administrations2. Here Burnett conformed to the principles laid out by Hahnemann. The dosage and potency that Burnett expressed, he justified as due to the reduced similitude that organopathic prescriptions have, whilst the remedies given constitutionally, in increased potency had a larger spectrum of similitude and therefore the dosage could be lessened18. The organopathic treatment was generally a single or compound prescription administered in low potency that was frequently repeated. The dosage was adjusted according to the patients´ reaction to the prescription. Rademacher pointed out that seldom is one single remedy sufficient to cure a case5.
Implications for conceptual analysis of materia medica
Organopathy has given a new approach to remedies and their prescribing. The organopathic remedies are selected by knowledge of their pharmacological activity on the local expression and their linkage to an organ and its pathology. There is a ‘doctrine of signature’ perspective in organopathic prescribing; where characteristics and structure of plants resemble organs of the body and have a therapeutic effect on the disease expressions in an organ27. “The healthy force from the plant can be utilized against the unhealthy force in the diseased person”10. This reflects the parallel to what was understood as the Paracelsian law of Similars, and is difficult to combine with the philosophy of Hahnemannian homeopathy10. Paracelsus was a firm believer that in nature there existed an herb for every ailment.7,8.
Being largely derived from plants and administered mainly in un-potentized form, the organopathic remedies are more commonly described in the herbal materia medica than in material medica of homeopathy28. Whether herbal or homeopathic, is therefore determined by a pharmaceutical and a clinical perspective. The pharmaceutical domain requires congruence in the production of remedies as outlined in existent homeopathic pharmacopeias. The manufacturing of homeopathic mother tinctures does not differ to that of phytotherapeutic fabrication. Whether a remedy is homeopathic is therefore determined by the clinical rationale behind the administration of a remedy, by the reference to signs and symptoms valued in the homeopathic case-taking29.
Burnett also began introducing Nosodes to his organopathic treatment2,5. Especially in cancer this is today common practice as can be noted in the treatment approach to cancer taken by Coulter and Ramakrishnan (2001).
More recently Ian Watson introduced and enriched the organ therapy by the use of Sarcodes30, remedies made from healthy organ tissue11.
Organopathy implies that a defect in an organ should be corrected, by removing the impairing influence. The appropriate remedy is the agent employed to stimulate repair within that organ28. Burnett’s methodology is one that complements Hahnemannian philosophy2. What initially was postulated a relic of ancient folk medicine, was refined and developed through time, mainly, by Paracelsus, Rademacher and Burnett, to become a vital method of homeopathy.
Organopathic treatment stands largely isolated and much in opposition to that of today’s contemporary homeopaths, such as Scholten, with his concept of series and stages31 or Sankaran with his designation of different potencies to different levels of sensation32. Their new ideas and approaches seek to find the simillimum in the spheres of remedy affiliations to groups or families1, and are more compliant with the single remedy prescribing of classical Hahnemannian homeopathy.
Another method that has complemented the diversity of homeopathic treatment approaches, is Schüssler’s biochemic remedies12. Schüssler’s focus of prescribing also lay in the realms of low potencies10 and was aimed at promoting the regulation of imbalance33.
Whether the homeopathic practitioner relates the disharmony of a specific organ within the Hahnemannian totality to the mental and emotional traits of the individual34 or associates symptomatology to a specific organ, as in organopathy, the only aim of the practitioner should be relief the patient as described in Aphorism 1 of the Organon19.
Keller16 (p.151) stressed one point about organopathy: “However great the differences may have been in the medical thinking of Hahnemann and Rademacher, in practice we are heirs of both”!
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