Having had the opportunity of studying homeopathy and Hahnemann’s advanced methods under David Little within the scope of his online course, I came to learn homeopathy at its deepest level. I greatly enjoyed working through the lessons and the correspondence with David Little, who willingly shared his wealth of wisdom. This I wish to share in this article, to give you the opportunity to learn from his multifaceted knowledge. I’m sure you can learn a lot from his explanations, and you may even feel inspired to join his unique homeopathy course!
(Note: The complete archive of David Little’s four year online course is now on sale. The course is being sold at a discount of a $100, making the already reasonable price of $450 a great deal at $350. The sale starts on the 15 of April and continues until the 31 of May. To find out more please visit their website http://www.simillimum.com/ or email them at [email protected] )
KS: Can there only be three miasms as there are only three defense mechanisms of the organism (physiological=psora, constructive=sycosis, destructive=syphilis) ?
DL: Hahnemann taught that the acute, half acute and chronic miasms are the effects of infectious diseases. He makes this extremely clear in his writings and he is the Father of modern epidemiology. Now, Hahnemann did not know the extent to which microorganisms may infect human beings, but he understood the process BETTER than modern medicine. What we have to do is bring Hahnemann’s miasms up to date for our times. So “Hahnemann’s miasms” are definitely the inherited and acquired effects of infectious disease. Why shouldn’t homeopaths include epidemiology in their system? We have the best medicines for infections and strengthening resistance. The use of the group cases to prevent, abort and treat acute, half acute and chronic miasmic infections is an extremely valuable teaching.
Now, Hahnemann’s study of infectious disease also includes a study of how the human organism fights disease. So the study of how the defense mechanism works is also valid. There are the stage of alarm, stage of resistance and the stage of exhaustion in all disease. This is a pathological process by which the human organism defends itself against stress and infection. This is modern science. This does not mean, however, that there are only 3 “miasms”.
Miasms come from different genus families and have different bands of susceptibility. There are 7 genus families that include a great number of miasms. They all produce different characteristic symptoms but the body still uses the same processes to defend itself. The characteristic symptoms are a combination of the infectious miasms and the stages of the organism’s reaction. They are two sides of the same process. You cannot limit all the signs and symptoms of the acute, half acute and chronic infections to three however. That is clinically not true. It takes two elements to make the symptoms of disease. i.e. the miasmic infections + the stage of defense the organism is using = the characteristic signs and symptoms.
Hahnemann never limited the number of miasms. Hahnemann’s miasms are the effects of acute, half acute and chronic infections and the reaction of the human constitution to them. He only pointed out what he was observing in Europe during his time. He clearly taught that the acute miasms are self limiting infectious disorders. He states rabies-hydrophobia was a half acute miasms that was self limiting but takes more time to reach crisis than the acute. Psora, sycosis and syphilis are chronic infections that last lifelong.
There are many chronic universal miasms such as psora (soft tissue infections), sycosis, syphilis, tuberculosis, vaccinosis, chronic hepatitis, HIV/AIDS, etc. All these miasms pass through the same 3 phases. To know the phases is good but it is not everything. Hahnemann gave us the group case to study the characteristic symptoms of NEW miasms and find their specific remedies. This is the real essence of his teachings in the clinical sense.
Hahnemann did all this work BEFORE orthodox science understood susceptibility and primary, latent and secondary infections, etc. So, IMO, Hahnemann has been proven correct by modern science.
KS: So, there are many miasms but there are only three major phases of defense reaction.
DL: Yes, in this sense, every miasma, including psora, can go through these 3 phases but in a characteristically different manner.
KS: Psora is often said to only cause functional disturbances. However, Hahnemann lists a great many of diseases with advanced pathology for Psora.
DL: To say that psora is only “physiological” is wrong. Hahnemann’s psora can kill! Only the early phase is the physiological/alarm stage. As the process goes on psora reaches the latent/resistance stage and then finally reaches the pathology/exhaustion stage with organic damage that causes rapid aging and untimely death. This is true for every miasma and they all do this in a unique, characteristic way. Therefore, the miasms are many but the stages the constitution passes through is three and the symptoms diverse and unique.
KS: The homeomeries have been related with the medical arts in several ways. Could you explain their relationship to miasms ?
DL: The homoeomeries are NOT the “miasms” per se. The miasms, however, can be studied through the homoeomeries as they follow similar archetypal patterns.
There has been a tradition in medicine to use certain primary numbers as categories for phenomena. Pythagoras called these the homoeomeries, i.e. the similar archetypes from which all phenomena are composed. He called these the 5 elements (earth, water, fire, air, ether) and related them to the numbers 1, 2, 3, 4 and 5. All these numbers are very important. These are the patterns that one sees in the natural world in the mineral, plant and animal kingdom. Each world, family and species reacts to their environment and stress in their own unique way. They all share similar patterns due to the homoeomeries but in their own way.
There is only 1 vital force; 2 types of miasms i.e. inherited and acquired; 3 stages of disease, i.e. the alarm, resistance and exhaustion; 4 stages of pathology i.e. inflammation-irritable; infiltration-induration; suppuration-scaring; and ulceration-necrosis. The 5th is the time and space in which all these things progress. These are archetype phenomena that come from the Collective Unconscious. All these ideas are valid if they are put into perspective and taken as relative truths.
KS: Are psora, sycosis, and syphilis universal miasms that are to be found in every living form with their peculiar characteristics ?
DL: These are not the easiest things to speak of. Now plants do not get sycosis or syphilis but they do get diseases involving overgrowth and degeneration.
First of all, animals and plants DO get diseases including infections but their miasms are not the same as human miasms. They are similar but NOT identical. Plants and animals are susceptible to infections by parasitical organisms including bacteria, viruses, fungi, etc., but they are often, but not always, different than human diseases. This is part of the doctrine of similar correspondence which uses analogy in accordance with experience to understand nature. To really know plant and animal “miasms” one has to study plants and animals diseases. The homoeomeries are the archetypal patterns that we observe in health AND diseases. To think plants have “sycosis” is mistaking the homoeomeries (grand categories of similars) with the miasms (one type of similar). They don’t have sycosis but they do get diseases of the water element involving infiltration, swelling, indurations and overgrowth. This relates to the second phase of disease progression. These relationships are part of the Mappa Mundi, the map of the world.
Hahnemann was the first to construct a complete system of epidemiology including diathetic constitutions, inheritance, predisposition, innate temperament, the moment of susceptibility and infection as well as the primary stage, latent stage, and the secondary diseases. (And much more). Not only this but he also developed the group anamnesis to find remedies that can abort, prevent and treat the acute, half acute and chronic miasms.
Most likely plants go through a similar three stage process involving the alarm stage, stage of resistance and adaptation, and the stage of exhaustion. That is because the number 3 (+ 0 -) is a very important “homoeomerie” and are universal in nature. Just as there are electrons, protons and neutrons in the atom. Nevertheless, the atom does not have psora, sycosis and syphilis! The numbers 1 through 10 are all symbolic of EVERYTHING if one understands the Pythagorean teachings.
Paracelsus also used the number 3 extensively and symbolized them as the action of Sulphur (+), Salt (0) and Mercury (-). This is the same idea in alchemy. There are always positive, neutral and negative poles in nature. The Indian Ayur Veda calls it the tridosha i.e. vata (0), pitta (+) and kapha (-), which means that which moves, that which heats and that which cools. Vata is made from ether and air; pitta from fire and earth; Kapha from water and earth. That is how the 5 element fits into the three forces. The Greeks called the 3 forces the natural force (-/ earth and water), the vital force (+/fire and air) and the psychic force (0/ether). All of these relationships are relevant to the healing artist that understands.
The alarm stage involves mostly inflammation and irritation. The resistance and adaptation involves walling off, isolating and trying to live with the latent pathogen. Exhaustion involves losing control over destructive processes and dying off. In a human being this action is controlled by the nervous (0), endocrine system (+) and immune system (-). This was the work of Dr. Hans Selye MD, the father of modern endocrinology. These processes of human physiology are not “miasms”, which means a fault, taint or pollution, etc. They are archetypal functions.
KS: In case of a new miasmatic, primary infection and already existing symptoms of the secondary or tertiary stage of the miasm, does the primary infection necessarily call for a different remedy due to the different stages?
DL: Normally, during a crisis or acute phase only the symptoms of the acute are addressed first and then the chronic state is addressed during the follow up. You would treat the primary infection first and then follow up on the chronic symptoms.
KS: In case of suppressed sycosis or syphilis, psora might become the active miasm. Does the suppressed miasm stop developing at this moment ?
DL: Suppression may activate latent or internal psora, which then becomes an active layer. You can tell this by the symptoms. The case will have a sudden appearance of psoric symptoms. The venereal disease may either become a little more latent or just stay active as a complex disease. If the suppression is very strong the venereal disease may become dormant. For example, the patient has gonorrhea and gets antibiotics and then becomes quite psoric afterwards. The venereal disease is dormant because of suppression and psora. Once the psora is lessened the venereal disease will become more active and ready for treatment because the suppression is removed. I have seen cases like this!
KS: Is latent psora, after curing all other miasms, the best state a patient can be in?
DL: I don’t subscribe to the idea that all one can do is make psora latent. Cure is the goal, BUT everyone gets old and dies. The reason is usually a failure in the weakest organ or system in the constitution, which is mostly genetic and partly acquired. So “cure” is a relative word. What we are speaking about is quality and length of quality years. The human frame is impermanent by nature. The only true cure is realization of the Self and one’s individual myth. This is a philosophical but also a rational clinical view.
KS: Considering that psora is so contagious, would the patient not get infected again shortly? Or, is the susceptibility to get infected with psora also curable?
DL: First comes terrain, predisposition and susceptibility. If one does not have a terrain in which psora can grow, one will not become re-infected. Realistically, to contract psora one must get a non-self limiting soft tissue infection caused by mites (scabies), bacteria (staph), fungi (tinea) or a virus (herpes). So, yes, one could become re-infected but if the primary symptoms are treated homeopathically there will be no latent or secondary psora and resistance will increase.
I used to pick up scabies on my hands doing village free clinics. After curing a primary eruption with Sulph 0/3 I never have got scabies again. This is around 25 years ago and I must have been exposed many times because I did the same type of work for many years. It seems the Sulphur removed my susceptibility to the infection. Now I am semi-retired and not doing volume practice in the villages.
KS: How is it that remedy and symptoms are assigned to different miasms by several homeopaths?
DL: Yes, all the symptoms need to be reviewed and corrected where necessary. See what you think of my miasm symptoms and remedies. I have been rather more exclusive then inclusive. In the end you have to learn the characteristic symptoms of the miasms well enough so you don’t depend on the symptoms lists in books. You can see the miasmatic symptoms in the MM and someday you will know more about them than what is written.
KS: When is a remedy assigned to a certain miasm ?
DL: For a remedy to be truly anti-psoric it has to have the characteristics of all three stages of psora in its symptoms and fit the group anamnesis. It is not good enough to have one part or another as it must have the whole. The list of Psora in most books is useless because they include almost every remedy including remedies like Nux-v, etc. Nux does not but it DOES cover sycosis!
KS: You write that there are non-miasmatic layers possible, trauma for example. However, would the patients reaction to the trauma not always be characterized by their miasmatic state?
DL: Not necessarily. A very strong trauma can be an active layer. A car accident can really change the patient. Anything from which the person is “never well since” can form a layer. If a person stays in a damp basement for 20 years it can cause serious chronic conditions. These factors and their concomitant symptoms must be figured into the remedy. These are not miasms in the Hahnemannian sense. You are right, however, to consider the miasms a strong conditioning factor and they can not be ignored as predisposition’s, etc. A person with sycosis may develop pathology much quicker in a cold, damp basement then one without sycosis. So again one must individualize each and every case by the cause, symptoms and attendant circumstances.
KS: The usual definition of Pseudopsora (TB) as a mixed miasm differs greatly from yours.
DL: This idea was suggested by J.H.Allen also. I don’t agree with it. TB is caused by TB not psora and syphilis. Modern medicine has confirmed this. This is an area that needs correction. As Hering said, we have to correct the errors of the past and go further than Hahnemann. The miasms of 1828 are to be brought up to date according to our principles in harmony with modern science. If one checks Hahnemann’s symptoms of psora they find many tubercular symptoms mixed up with the symptoms of psora. It is possible that Hahnemann was beginning to note the difference between psora and TB in his later years. It is now clear that this is the case.
KS: Does pseudopsora always require tuberculosis, or, are there any other infections that might also cause the tubercular miasm ?
DL: If one is defining pseudopsora as the Tubercular miasm…. Yes.. TB is the root. There is a spectrum of closely related fungi that piggy back on the inherited and acquired TB miasm. These fungi cause symptoms that are similar to TB. Like all the miasms they open the patient to related opportunistic infections.
KS: Can all the miasms be transmitted by blood transfusion ?
DL: Blood transfusions… good question. Hahnemann taught that psora was transmitted by its primary lesions, but he also spoke of passing it through body fluids like breast milk and possibly to the fetus. Therefore, congenital infection was possible as inherited effects. One would think they could be transmitted in some form by transfusion. The inherited effects can be transmitted dynamically without the transmission of microorganisms. Obviously, syphilis, AIDS, Hep, etc., are transmitted.
KS: There are many identical yet also different symptoms in the patterns of the acquired and inherited miasms.
DL: The inherited miasms mimic the acquired disease but in a modified form. For example, the sycotic patient may not have chronic gleet but they may suffer from NSU, etc. There may be discharges caused by related opportunistic infections that mimic the chronic gleet. During treatment they may even have surrogate discharges that mimic the original infection in the ancestors.
KS: If the acquired miasm has not been suppressed then must it be addressed first?
DL: There is a meeting of the time of infection and the strength of infection in the timeline. For example, for the person to get a new dissimilar miasm it must be stronger than the old one or the older layer would repel it. Therefore, the new miasm becomes the top most active layer and the older one becomes more latent or dormant. It is quite common for new acquired miasms to repress the older inherited miasms.
If psora is activated by the suppression of a veneral disease (VD) it will have to be addressed first. In such cases, the symptoms of psora will arise after the suppression of the venereal disease. Once the psora is calmed the VD symptoms become active again showing what remedy is needed.
KS: Do I only have to treat the currently active miasm or all existing miasms at the same time with a remedy that represents them accordingly?
DL: Hahnemann did not know the multi miasmatic powers of remedies like we do and had a limited materia medica. Sometimes, one remedy may suit the entire situation if it has a deep affinity with the patient’s constitution, temperament and symptoms. Sometimes, we can find the remedy that matches the whole complex disease based on several miasms. If such a remedy cannot be found, alternation or rotation are an option. The remedy must, however, have the most active symptoms. Always highlight the most recently developing symptoms as they hold the key to the active layer and open the door to cure. Many times one remedy will peel off layers like an onion skin. Be open to both and act according to the time and circumstances.
KS: If all miasms are latent which one shall be treated first?
DL: Always start with the miasm that has the most symptoms and is the most active. That will be the top layer. It is rare for all the miasms to be completely dormant.
KS: So the patient’s symptoms are grouped according to their miasms and then an appropriate remedy is chosen for the predominant miasm?
DL: The characteristic symptoms of the miasm stand out as different while the more common symptoms may not. Miasms may cause similar diseases in the end but the pathway to this state is different. For example, psora is oversensitive, things hurt worse then they look and everything itches while syphilis is less sensitive, things hurt less than they look, and nothing itches even skin lesions that look like they should ! These are the symptoms that matter. Chart all the symptoms and note next to them which miasms they are most related to. Then see what fits the whole case first. If nothing fits the whole case then you will have to work in layers. Always treat the most active layer first and see what happens. You may be surprised how deep it actually goes! Let the symptoms be your guide. Start with the most active miasm and follow on the presiding symptoms. If the remedy is working well don’t change it until something changes. As the most active layer is weakened the next most active layer will surface for treatment. When this layer becomes weaker the other layer may be momentary stronger so it will surface. Let the symptoms be the main guide and then go by the circumstances if necessary.
Give the remedy for the most active miasms at the time it is active. This will weaken the first miasm until the second miasm becomes the stronger layer and surfaces. Then change the remedy for the second miasm while it is the most active. This will weaken the second miasm until the first miasm becomes the stronger layer and resurfaces. In this way, one follows the alteration of the strong more active miasm as the symptoms surface. This is not the mechanical method of just alternating two remedies in some fixed schedule like one a week. In this method one alternates the remedies in accordance with the way the symptoms alternate. Let the active symptoms be the guide!
KS: Is it better in older people not to activate the miasms?
DL: If the patient is quite old, weak and has compromised vital organs and blocked organs of elimination it is best to go very slow and careful with them. In such cases one must treat the patient carefully in layers. Start with the most affected organs, systems and tissue with remedies that are more local in their action. As they gain health, vitality and the organs of elimination are more open one can go deeper step by step. If the symptoms of a miasm become active they may be treated. As the vital organs recover they ma even be given constitutional remedies, etc. One must always be cautious with older patients and act according to their age and condition.
KS: You write that it is a bad sign if the shape of the body does not agree with the shape of the head.
DL: When the shape and size of the head is a “Miss fit” to the rest of the body this is often due to inherited states. Symmetry is always a good sign and lack of symmetry is often a bad sign. Unusual head shapes have been related to chronic miasms and mental disorders.
KS: In The Chronic Diseases Hahnemann writes about using Thuja and Nit-ac to treat cases of uncomplicated sycosis. Would these remedies always be indicated or may the symptom picture call for another remedy?
DL: From what I have seen he used more remedies like Cann and Cinn etc. Although Thuja, Med, Nit ac, Nat-s, Cinn are leading anti-sycotics, there are many more that could be just as indicated in an individual. One also has to remember that Hahnemann’s chronic genus remedies were used mostly in acquired states. Inherited states are more complicated. Hahnemann tended to use Sulphur as a specific for the effects of psora, suppression and maltreatment but he also had 47 other anti-psorics that he used according to the presiding symptoms. The same may be somewhat true with sycosis and syphilis. There may be some leading remedies. Nevertheless, if the case is not going well with symptom remedies, one thinks of the nosodes and cardinal anti-miasmatic remedies to get things moving. Sometimes, they will break open the case. It might be good to give these cardinal genus remedies at the start, but I like to see some confirmatory symptoms that match.
KS: How do you define cancer and the cancer miasm?
DL: This is an area that can be confusing. Hahnemann used the term miasms to describe the affects of infection and its suppression on the human constitution. This miasmic terrain may be inherited or acquired. That is the first point. Second of all, cancer is a disease ultimate, which may have many different causes from radiation to chemical toxins, to mixed miasms, etc. Some cancers, however, do involve viruses and these may be considered miasms in the Hahnemannian sense. The cancer miasm is usually said to be a mixed miasm where all four miasms, psora, sycosis, tuberculosis and syphilis are active.
KS: Does this not contradict § 40 Organon in which Hahnemann writes that miasms (chronic diseases) do not combine but rather form complex diseases ?
DL: The miasms do not combine in the sense of they become one new disease. They produce complex states that may cause a more serious, complicated state such as cancer, due to the decline of the internal terrain. In this case cancer represents the deadly symptoms of the complex miasms. These types of cancers are a symptom of a diseased terrain not an independent miasma.
With cancer, however, no particular germ has yet been identified, although some microbial pathogens may be linked to the development of cancer, like mononucleosis, HPV, etc. But, the cancer miasm has its own distinct characteristics which may force us to see it as a separate miasm.
There is no doubt that certain cancers thrive in particular terrains such as those caused by mononucleosis, CMV, HPV, etc. These are also miasms, which adds weight to the idea that cancer is the outcome of mixed miasms. The more miasms the more the rise of cancer increases, especially combined with bad diet and exposure to radiation, chemicals, etc.
As I said cancer is a disease ultimate that has many causes such as depression, loss of love ones, nuclear radiation, electromagnetic radiation, chemical toxins and other carcinogens. Certain cancers, however, have been linked directly to specific viruses. These may be single miasms.
Cancer is a disease with a number of causes. Almost anyone can get cancer if they are exposed to too much radiation, etc. This has a strong external cause. Other cancers are caused by carcinogens like smoking which some persons get more easily than others but many heavy smokers get. Some cancers are caused by the negative internal terrain produced by mixed maisms include viruses like CMV, HPV, etc. Some cancers are caused directly by viruses in the right terrain. This needs to be sorted out.
In general, for the above reasons I don’t automatically call cancer the “cancer miasm”. There are certain cancers, however, such as Kaposi’s sarcoma that are known to be caused by a virus. This virus, however, thrives in the terrain caused by HIV. In most people with a healthy immune system these cancers do not normally develop.
So as you can see this is an area where we need to do more research. We need to combine the vitalists principles and homeopathic pathology with the information recorded by modern science.
KS: How are certain cancer forms defined as psoric-sycotic-syphilitic (Scirrhus), or sycosis-psora-syphilis (Adenoma), or syphilitic-sycotic-psoric (sarcomatous cancer) ?
DL: Different complexes of miasms cause immunodeficiency and a terrain in which cancer cells proliferate without being attacked by the immune system. The terrain caused by different miasms may predispose toward one cancer or another. This seems possible.
KS: Organic tissue remedies are mostly used in the third stage of cancer. How do you define the stages of cancer, according to orthodox medicine ?
DL: The third stage is when there are full tumor formations. I define the stages in a similar manner but we have more details as to predisposition’s and the cancer diathesis. We can often spot the potential cancer patient long before they do, because we know the symptoms better.
KS: Could you make some comments on the danger of engrafting symptoms ?
DL: Hahnemann wrote this about ONE-SIDED diseases. This entire section is about treating one-sided diseases not the normal condition (aph 172-184). In a one-sided disease a main symptom represses the ability of the organism to bring out the rest of the symptoms, so a good remedy may bring out these symptoms. Bringing out more symptoms in a one sided disease is a sign that the organism is becoming more responsive and points more clearly to the next remedy. This helps the practitioner select the next remedy. To bring out new symptoms in a case that already demonstrates a full array of symptoms is the sign of the wrong remedy. If one brings out more new symptoms in a person with ample symptoms this is not the best situation.
KS: I think of Hering and his lifelong paralyzed arm after taking Lachesis in too high a dose/potency. Was his paralyzed arm an engrafted “Lach” symptom?
DL: Certainly sounds like it.
KS: When a patient has some occasional symptoms from overdosing a remedy do I have to include them in repertorization ?
DL: If the symptoms are moderate they are included in the symptoms picture with the natural symptoms. If they are very strong one may have to try and antidote them with a dynamic antidote.
KS: Could you make some comments on the treatment of the hypersensitive patient?
DL: You must be VERY careful with them! Do no use very high potencies or large doses, nor repeat remedies very often. If they are aggravated too many times they may become allergenic to potencies making them susceptible to antagonistic counter actions, etc.
In some cases, one must treat the hypersensitivity as the most important symptom and focus remedies at calming down the VF. Hahnemann suggested negative magnetic strokes for over reaction to remedies. I would think around 5 times very slowly is probably enough to start with. You have to see how patients react. A calming Reiki treatment might help.
KS: Is hypersensitivity a constitutional feature?
DL: People are hypersensitive for different reasons. Sometimes it is a constitutional predisposing factor that is genetic in nature and is somewhat bonded onto the vital force. Nervous temperaments are often the most sensitive. Sometimes it is emotional due to stress, etc. Sometimes it is psora and TB miasm. Sometimes it is due to over exposure to chemicals and toxins. Sometimes, it is because they have taken too many different high potency remedies. One must study the case closely for causations and circumstances.
Hypersensitive patients come in degrees. Hahnemann wrote that the sensitive may be viewed on a scale of 1 to 1000. The moderate hypersensitive (700) will have a tendency toward the aggravation of the symptoms they have experienced. We have to be very careful with them. A 1000 sensitivity will just “prove” all sorts of symptoms of the remedy. Some will even come up with antagonistic counter actions of the vital force, which is very intense reactions that are chaotic. Using potencies can be a real problem and ultra-hypersensitivity can make it hard to use potentized remedies.
KS: Tubercular patients might be hypersensitive. Do you agree with the recommendation to give a dose of Tuberculinum 200C ?
DL: Psora and TB both cause hypersensitivity but this does not mean one should just give the nosodes. This is prescribing off of 1 symptom. You have to have a few good characteristic symptoms to give such nosodes. This is a something to look at but not in isolation from the essential nature of the totality of symptoms.
KS: How do I best administer remedies in hypersensitive patients ?
DL: One needs to use lower rather than higher potencies, dilute remedies in large amounts of water and be careful about strong succussions. The remedies should be given in single doses and one must wait and watch for some time.
KS: My experience is that even olfactation causes strong aggravations in them.
DL: Olfactation is a good method but the air gap between the remedy and vial should be large and they should take a very gentle short sniff.
KS: Have the old masters also had difficulties with hypersensitives?
DL: Boenninghausen was the first to offer specific rubrics and symptoms for over reaction to the remedies. He made a list in his Repertory of Antipsorics in the 1830’s. When the patient is prone to violent aggravations and antagonistic secondary actions of the VF – this symptoms is taken as the main complaint. There are certain remedies that are known for this condition.
GENERALITIES; REMEDIES; oversensitive to, violent reactions to: acon., arn., ars-i., asar., bell., caust., cham., chin., coff., cupr., hep., ign., lyc., nit-ac., Nux-v., ph-ac., puls., sep., sil., Sulphur, teucr., valer., zinc.
GENERALITIES; REMEDIES; oversensitive to, violent reactions to; high potencies, to: ars-i., bell., caust., cupr., hep., lyc., nitricum acidum, nux-v., sep., zinc.
Then one fills out the sensations, modifications and concomitants to make up complete symptoms. If zinc was the closest fitting remedy than one might try zinc, etc. Sometimes, the remedy is used by itself over a period of time or it may be used as an intercurrent to calm things down.
KS: Some homeopaths like Thombre argued that Hahnemann replaced the term Vital Force (5th edition Organon) by the term Vital Principle (6th edition Organon). Does he really mean something different?
DL: He used three different words in the 6th edition i.e. vital force, vital principle and vital energy. They are all aspects of the same living power but may involve different vantage points as in the Wesen and Lebenskraft.
KS: I think that it is a misunderstanding due to the bad English translations, especially Boericke who is confusing in his words. Also Künzli and Dudgeon are not perfect, prefaces or footnotes are missing, the paragraph’s are quite short and the English isn’t really beautiful.
DL: Yes, this is true.
KS: You write about the homeopathic aggravation after 8 or 10 days or more. Is this the same for the C as well as for LM (Q) potencies ?
DL: Hahnemann wrote the above in the 5th Organon when speaking about the C potency. At this time, he was using mostly the 30C. Of course, aggravations can appear earlier or with some of the high potencies later than this. It depends on the individual, the size of the dose, the potency and how often it has been given. The LM potency acts more quickly in many cases than the C potency. If you use a proper small dose or the lower potencies than one can avoid most aggravations at the start of the treatment. If you slow down the repetitions of the remedy as the patient improves you should see NO aggravations. The goal with both the C and LM potency is to cause no aggravations. Similar aggravations are caused when the right remedy is given in too large a dose, too high a potency or repeated when it was not needed.
KS: If there is a similar aggravation how do I know whether the dose or potency was too high?
DL: This is always difficult so one must go by trial, error and success. Normally, I reduce the dose through diluting the remedy in more water and may lower the succussions and potency of the next dose if the aggravation was very strong. If you keep the size of the dose small then the problem is usually with the succussions and potency. When the potency is too high it really produces energetic aggravations that come very quickly. Too large dose comes on a bit slower in waves. These are just hints not absolutes.
KS: The 200C is called the “great aggravator”. How do I best use it?
DL: The 200C is a quick acting aggressive potency. The 200C is a great potency in strong trauma and virulent acute miasms. It also can be very useful for chronic diseases that begin with the sharp crisis and then progress rapidly. It is not so well suited to chronic cases that have developed slowly over time and have much organic pathology. If the vital organs and organs of elimination are compromised it can cause strong unneeded aggravations. It also is not the best for those who are hypersensitive in general. You should be careful with it but not avoid it. You must learn how to use it properly.
KS: Homeopaths differ in their views on pathology. Whereas some argue that the simillimum will cure every disease if chosen properly and don’t include pathology in repertorization, others pay special attention to pathological rubrics and argue that the remedy must cover them as well as it must be able to cure the disease. Which argument is more reliable?
DL: I think both ideas are valid depending on time and circumstances. What works best depends on individual, the nature of the cause, stage of the disease, and the time and circumstances. When the disease is more functional or in the early stages of pathology a remedy chosen by the mental, and general symptoms will usually work without much stress on the pathology. This is Kent’s method. Here the constitutional remedy should be able to remove the present pathology when it fits the mental and general symptoms well even if it is not known for this. The first to clearly state this idea was Jahr. He taught that the constitutional concomitants are often the most guiding characteristic symptoms but he also paid attention to the pathognomonic symptoms. It is not that the pathology is ignored but it is looked at by the nature of its signs and symptoms not the pathological generals (disease names) and location of the disease. This is the above to below method where the mental and general symptoms are stressed.
KS: However, if pathology advances, treating the case and cure becomes more challenging.
DL: In advanced pathological states where there are organs and systems are deeply affected the nature of the pathology becomes more important. These are cases where Kent said “Don’t give them the constitutional remedy they needed 20 years ago.” Why? Because the aggravations it can produce will tear the patient to pieces! When there is advanced pathology you have to approach cases differently. You can’t ignore the heart in advanced heart disease. You need remedies that have the locations, sensation and modalities of the heart complaint as well as the concomitants of the patient. Then the mental symptoms are used as confirmatory symptoms. This is Boenninghausen’s method. Boger was also an expert at using pathological generals and concomitant generals. This is the below to above method. Even great Kentian homeopaths stated that Boenninghausen’s method was more appropriate for cases marked with heavy organ pathology in the regions and systems.
So both are valid but you have to know when one method is more appropriate than the other. Much depends on how the case presents itself. Use Kent’s method if the case presents clear mental symptoms that have sub rubrics from Kent’s or Knerr’s. If the case has few characteristic mental symptoms and is presented in locations, symptom segments, and fragments that are easily generalized, then Kent’s method is useless and Boenninghausen’s method is more appropriate. Some cases suit the mental approach of Kent while others suit the physical approach of Boenninghausen. One has to take the door that is open and fit the approach to the way the rubrics are presented.
In one-sided cases, advanced organic pathology and compromised organs of elimination one may have to treat the patient in layers. At this time, it is better to use Boenninghausen’s and Jahr’s methods. This is when the grand constitutional remedy and the “one remedy for all situations” either doesn’t work or it caused big problems. It is better to carefully note the locations, tissues, organs and symptoms, their sensations, their modalities and then look for constitutional concomitants to confirm the remedies. This method makes sure the remedies are not suppressive. At this time, it is best to use lower potency Cs or the LMs rather than the 200C, etc.
KS: As Hahnemann recommends to apply the remedies to the mother or wet nurse in nursing infants, I wonder how to proceed if both, mother and child, need a different remedy ?
DL: Yes, this can be done when the mother is healthy. If the mother is ill and the child is ill with the same symptoms the remedy can be given just to the mother. If the infant seems to be different than mother I give the remedy to the infant. If the mother and child appear to need different remedies I give the most similar remedy to the mother and child.
KS: Proceso Sanchez Ortega has written an interesting point on this: “So to speak the child is the continuation of the mother with other medicines during the lactation period. The requirements of the child let us know more about the requirements of the mother. The symptoms of the child are quasi the symptoms of the mother expressed in the child which is ‘one’s own flesh and blood’… Often it is not necessary to ask the mother for her ailments but it does suffice to take the history of the child, as it has been versed before the child was born. The constitutional symptoms of the mother agree with those of the child, therefore the remedy acts in mother and child likewise.”
That would mean that during lactation the child also needs the mothers remedy, just as during pregnancy, and that only after weaning a possible different symptom picture would come to the fore?
DL: That is interesting but is it always true in the clinic all the time and under every circumstance?
I have seen the mother and child both need the same constitutional remedy but I have also seen where the mother and child seem to need completely different remedies. In such cases, I give the mother what she needs and the nursing child what it needs. I have not really seen any problems when giving infants small doses of remedies, especially in liquid in small portions.
It seems that the mother and child are so bonded that they often do well on the same remedy. I would, however, watch the child very closely to see what the true effect is without having concepts that nothing can ever happen. In my experience, anything can happen at least sometimes.
KS: So, the best is to be prepared. Hahnemann wrote that the miasms speak a very clear language during pregnancy. Often the mother displays symptoms during pregnancy which disappear after giving birth. Does the pregnant mother express her own symptoms or those of the unborn child during pregnancy? Does this depend from the strength of their dissimilar diseases?
DL: The symptoms of pregnancy may include symptoms of the mother and child depending on the circumstances. If the symptoms of the mother are the strongest then they will dominate the symptoms with the symptoms of the child being more latent or dormant. If the symptoms produced by the child are stronger than the mothers then they may dominate the symptoms with the mothers symptoms being more latent or dormant. Sometimes, when the symptoms are rather equal in their power they may form a complex disease with the symptoms of the mother and child. So some cases may be presented in layers while others may form a complex disease. The main point is to assess the essential nature of the totality of the symptoms and follow the case by the presiding symptoms as they are presented.
During pregnancy I believe good treatment of the mother is good treatment of the fetus. Obviously, they are sharing the same blood and terrain. If the fetus is producing symptoms then the mother will reflect this in some way. If you treat the mother you are treating the fetus. They are a unit at this time. If the fetus has symptoms they are reflected in the mother’s symptoms. A healthy mother has healthier babies. In some cases with modern technology and unusual cases or emergencies we may be able to study some symptoms of the fetus and that might effect the choice of the remedy. For example, if the baby has water on the brain, is mal-positioned, etc.
That’s it. INDIVIDUALIZATION. I go by the symptoms, time and circumstances.
KS: If both get a different remedy, will the mother’s remedy not be transferred to the child during nursing and disturb the treatment and symptom picture of the child?
DL: What is the mechanism of transmission? First of all, the potency is dynamic. I doubt that there are “material parts” of the remedy in the blood or milk. The transmission must be dynamic. Remedies cure by a similarity that acts on a heightened similar susceptibility to the remedy. Individuals normally do not react strongly to remedies that are not truly similar if given in small doses and if not repeated unnecessarily. If the infant’s individual susceptibility is fulfilled by a similar remedy there is less chance that they will react to a dissimilar remedy taken by the mother. Of course, large doses and over repetition might cause a proving in the child as well as aggravation in the mother.
KS: What, if the remedies don’t relate well to each other?
DL: Yes, I might wonder if the remedies had an inimical relationship so I would check this. Now I don’t think one can rule out completely the possibility of an idiosyncratic reaction. I do keep an eye open for negative reactions in the child and follow the cases closely. I have not done this that many times but as of yet I can not remember any particular problems. This is an experimental area and I do not consider myself an authority on the subject. I should do clinical trials and test giving the mother the remedy and see what happens. Sometimes, that is the only way to find out.
KS: Hahnemann writes in §141 Organon that provings are beneficial for the prover’s health. How is this possible if only the simillimum can cure?
DL: Yes, Hahnemann attributed his long life to doing proving. I guess if one proves remedies is it like giving preventative remedies that strengthen the VF and increase resistance to stress, etc. To be healthy provings must be done VERY carefully. There are stories of some who were never well since proving remedies.
KS: Yes, especially for hypersensitives a proving can turn out to be a nightmare even if they often provide the best symptoms. For example, the Carcinosin proving made in Austria in 1993 was done without adhering to the rules and caused a lot of troublesome ailments which finally lead many provers to leave the proving.
DL: You must be VERY careful with hypersensitives! Do no use very high potencies or large doses nor repeat remedies very often. If they are aggravated too many times they may become allergenic to potencies making them susceptible to antagonistic counter actions, etc.
Now with a relatively healthy person the proving symptoms are produced by the primary action of the remedy. These are normally not severe if the dose and repetition of the proving is kept under strict control. An overdose, however, can produce long lasting medicinal symptoms even pathology. This is one reason to be very careful when doing provings.
One difference between a prover and a patient is that the prover is generally in good health and the patient is not. That is why one has to be careful when including symptoms brought out on a patient under treatment to the MM. That is why Hahnemann said this method is best left for masters of observation.
KS: If I have to avoid anti-psoric remedies for acute, intercurrent treatment why is Arsenicum listed as the acute remedy for Thuja, or Hepar sulph for Silica? Both, Ars and Hep, are strong anti-psorics. So why should I not use them if indicated?
DL: Sometimes a person comes with a crisis that is only an intensification of the chronic state. It is not really an acute disease. For example, a Puls patient shows up with a yellow ear discharge but the rest of the symptoms are not new or changed. Here the chronic remedy may still be indicated and Puls may be given. During a true acute crisis the new symptoms will repress the chronic symptoms and offer a new acute picture. Here it is best to use an acute intercurrent remedy because only the acute state is active. This remedy must be chosen by the exciting cause and acute symptoms.
Now such a remedy may have both acute and chronic symptoms. Let us use Ars for an example. If a remedy like Ars fits only the cause and symptoms of the acute crisis such as food poisoning it can be given by its acute symptoms alone. The same for Hep in croup, etc. If the remedy ONLY fits the symptoms of the acute crisis it can be given by those acute symptoms and it will only act as an acute. The warning not to give deep acting remedies is for serious pathological crisis where the vital organs and organs of elimination are compromised. Here one has to be more careful with the deep acting anti-psoric remedies, especially the minerals and plant and animal remedies with strong mineral components like Lycopodium and Calc-c. So once again it is a matter of the individual time and circumstances.
KS: During curative treatment symptoms have to disappear according to Hering’s rule. What about the more functional symptoms like sleep, can we expect them to normalize early during treatment or also according to Hering’s rule?
DL: Hahnemann introduced the reversal of symptoms in The Chronic Diseases in 1828. He wrote that drugging and suppression could disrupt this process. He also wrote that some old long standing local pathologies were also not removed until the patient was better in most other regards. Old pathologies can linger on. These exceptions must be taken into account. Hering first wrote about the direction of cure in the 1845 preface of the American edition of The Chronic Diseases. He did not list these exceptions so the “law” is often taken too rigidly or rejected. So it is a general movement from within to without, above to below and in the reversal order, but one must look at the whole pattern not just one sign in isolation from the others. So, yes, some functional states may disappear before old pathologies and not in accordance with the exact timeline. Many cases may not involve the rigid above to below, etc. but the overall movement is in the right direction.
KS: How did Boenninghausen chose intercurrent remedies in advance?
DL: Boenninghausen tended to use complementary or remediese that fit the case from different vantage points. For example, if two remedies seem to cover the case better from different angles than one remedy, they might give both remedies but at different times. Hahnemann did this in his early years but as time passed he did it less and less. He did this more in the 1820’s than the 1840’s. At this time, he only seems to alternate two remedies when there was an acute disorder obstructed by psora. He might use Acon and Sulph. He did not seem to use two remedy prescriptions in chronic diseases in his last years.
KS: How are chronic intercurrents best given?
DL: First and foremost, chronic intercurrents are used for the removal of obstacles to the cure caused by chronic miasms. Whenever you take a case look at the miasmatic symptoms underlying the disease state and note the miasms and their chief remedies and nosodes on the paper. Say for example you are going to give Phos and you see the symptoms of TB in the background you might note Tuberculinum or Bacillinum. If there comes a time the Phos no longer works well or the case gets stuck sometimes such nosodes may be used as a simillimum or a chronic intercurrent remedy.
KS: How did Hahnemann alternate remedies?
DL: In Paris in the 1840’s Hahnemann would occasionally alternate remedies for miasms like Thuja and Merc, etc. He did this by the symptoms and circumstances not in a mechanical fashion. He also did not always use one dose. Sometimes it was a series of doses of one then the other. Again it depended on the action of the remedy. He individualized such alternations and rotations according to the time and circumstances. In the case books one could sometimes see the changes in symptoms while at other times it seems it was just time to change.
KS: The old masters often had to treat their patients by zigzagging with partial similes. Can there really be a cure with partial similes or will there always remain symptoms which call for the true simillimum?
DL: When using a true simillimum the cure is a straightforward affair. This can be without any major changes in the symptom pattern. This is the shortest distance between two spaces and the quickest cure. Of this there is no doubt. When using a partial simillimum the cure is not a straightforward affair nor is it the shortest distance between two spaces and the quickest cure. Nevertheless, if the remedies are close enough to the center of the diseases states they will not produce any strong accessory symptoms that impair the cure nor will they act as suppressive remedies. It just takes longer and may not be smooth. What one could do with 1 remedy may have to be done with 2 or 3 remedies.
If the partial simillimum are too far from the center of the case they will produce new symptoms that may increase. This starts to move away from the cure, and if carried too far, may become disruptive or suppressive. It is only a matter of degrees between a partial simillimum that is close enough to do good work but may have to be followed by another remedy to complete the cure, and a partial simillimum that is too far and is a wrong remedy. We always want to give the closest simillimum possible but everyone “zigzags” a bit sometimes. For this reason, one should recognize the signs of a true simillimum and partial simillimum and know how to act accordingly.
There are five major remedy reactions: