To India and Back

Reflections on our profession

1. Looking Out:

I have spent the year 2002 in India with homoeopathic physicians and in homoeopathic institutions. Here I would like to share my experiences with fellow-learners and practitioners, hoping that the issues raised in this article are of relevance, or at least interest, to others.

The reason for going to India was to give my homoeopathic education a decisive push. Like quite a few of us I was in the position of doing part-time homoeopathy, while still holding a full-time job. I realised that if I wanted to practice homoeopathy effectively, I had to give it my undivided attention. At the time of graduation I felt ill-prepared for practice, although I received my licence from the highly professional North West College of Homoeopathy. There were many unresolved questions I had regarding the ‘science’ of homoeopathy. I was dissatisfied with the fact that all too often relative answers were given, even by highly experienced teachers, suggesting that homoeopathy is mostly a mystery, and that the commonest answer to most questions is: ‘Sometimes’.

The same vexed questions over what homoeopathy is, arise in India as much as they do in the West. As in the West, one sees in India the whole range of practice: From polypharmacy to single remedy with all sorts of ancillary measures like Tissue remedies, Bach Flower remedies, Organ remedies, drainage; modern Classical Homoeopathy to pure Hahnemannian Homoeopathy. My reason for going to India was to sort out fundamental confusions about the practice and philosophy of homoeopathy, and here I found myself confronted with the same issues.

Before coming to India I was adamant that polypharmacy has nothing to do with homoeopathy. I also felt strongly that the single remedy with their multiple ancillary measures represented a kind of cop out, based on the limited understanding of pure homoeopathy by their practitioners. What I was especially interested in was an apparent conflict between the Classical Homoeopaths versus the Hahnemannians. There was a time (roughly up to the 4th year of my studies at college), where I thought they were the same, because the modern Classical Homoeopaths like to mention the name of Hahnemann. For me Classical Homoeopathy represented the only genuine form of homoeopathy, and that those who wanted to be Hahnemannian were a kind of radical fringe who were rigid, retrograde and dogmatic in their attempts to prove the untenable. It was as if those I’d met treated the Organon like the Bible, and Hahnemann was the infallible pope.

While trying to become clear on these issues, I came across the interview with Andre Saine in LINKS (0/2 2001), which made me look at everything I learned in a radically different way. I realized that if Saine was right in what he was saying, then everything I thought that homoeopathy was, could only be a one-sided view of things. Worse, my understanding might be incorrect.

The interview made me realise that we have become blind to our own homoeopathic heritage, that we have not only neglected Hahnemann, but also the period directly after him up to Kent. It occurred to me that we are now so heavily influenced by modern Classical Homoeopathy that we don’t even know anymore what Hahnemannian Homoeopathy is. These realisations came into much sharper focus while in India, and made me look at our own homoeopathic scene from outside. I hope that what follows will stimulate a debate about our own future as a profession.

2. Looking In:

We call ourselves professionals and want to be recognised as such. At the same time, we cannot agree on the definition of our profession. Instead of engaging in a thoroughly critical debate on the definition of homoeopathy, we try to be inclusive and look for agreement and consensus, which we achieve on the basis of the lowest common denominator. Our broad definition of homoeopathy is accepted in the name of tolerance, which preempts the arguments of those, who aim for a more precise and historically sound definition. It is a curious situation when those, who remind the profession what Hahnemannian homoeopathy is, was and should be, are labelled ‘divisive’. In fact it is only an insistence that we adhere to the original definition and practice of homoeopathy.

Without wanting to take the side of George Vithoulkas (that is besides the point), the recent acrimonious debate exposed the sensitivity of the modern Classical Homoeopaths to being scrutinised and questioned. What was focused on in the debate generated by Vithoulkas (on the current ‘danger men’ in homoeopathy) was the tone of the debate, the allegedly personal nature of the attack, rather than any acknowledgment of the genuineness of his concern that we are losing direction. My feeling is that only few of us understand the full implications of the modern teachings for our profession.

Rajan Sankaran and Jan Scholten , for example, operate methodologically in distinctly different ways than Hahnemann and his close followers. The great breakthrough occurred when Hahnemann introduced for the first time in the history of medicine a materia medica which was not based on speculations, a priori assumptions or only empirical clinical data, but on meticulously observed facts. The process of the provings laid down, more than anything else, the method of homoeopathy. The establishment of the picture of the artificial drug disease enabled us to recognise much more precisely the portrait of the natural disease, and establish optimum similarity between the two. The basis for this similarity are symptoms, diligently recorded symptoms in Artificial Drug Disease and Natural Disease. On this foundation the homoeopath had to appreciate the interconnectedness of the symptoms and create the ‘form’, the image of the disease.

The main concern for Hahnemann was always the reliability of the data. No compromise was possible on this point. In the foreword to Aurum in Chronic Diseases he speaks how the ‘superstitious, inexact observations and credulous conjectures have been the source of innumerable untrue statements as to the virtue of medicines in materia medica […].’

Paragraph 110 in the Organon states

that the only possible way to ascertain their medicinal powers is to observe those changes of health medicines are capable of producing in the healthy organism. […] for the pure, peculiar powers of medicines available for the cure of disease are to be learned neither by any ingenious a priori speculation, nor by the smell, taste or appearance of the drugs, nor by their chemical analysis […].

And none of the homoeopaths, who have not gone into oblivion, and are still the mainstay of our homoeopathic education, have ever deviated from the premise of establishing similarity on the basis of a wholly reliable materia medica. Kent wrote:

It is not the material stone, earth, or quartz and mineral salts; nor is it the colour of plants, leaves, buds and flowers; nor of stems and stalks; nor of the chemical and physical properties of animal substances used, and the natural eye to behold, that one should think.

It is not the density of the platinum, or the whiteness of the aluminium, or the yellowness of gold, or the toxic nature of arsenic that one must turn his thoughts.

In contrast, when we look at the work of prominent modern homoeopaths like Sankaran or Scholten, we see an indiscriminate use of ‘sources’. They glean their data from a variety of areas, each with their own complexities and problems: Botany, Periodic Table, Mythology, Repertory, meditative provings, weekend provings, and also from established and reliable sources. The latest book by Rajan Sankaran is instructive in this respect. It is called Insights into Plants, which is a misnomer, since the book has nothing to do with plants, but with homoeopathic remedies taken from the kingdom of plants. In this book there is no reflection on the classification method of botany, and in what way that could be problematic. The book makes no distinction between the repertory and materia medica as ‘source’. Within materia medica no difference is made as to the quality of the sources: Everything is grist to the mill of the hypothesis which Sankaran wants to prove. Methodologically this is problematic, to say the least. Right from the word ‘go’ the learner has no ground to stand on.

In the quotation above Kent pointed very clearly at the main problem- it is the ‘turn of our thoughts’, which decides over success or failure in our practice. From my own experience I know that our perception and thinking are not directed towards the peculiar, characteristic symptoms (be they physical particular, physical general, mental emotional, mental intellectual, dispositional, precipitating, maintaining, ailments from, mental subconscious), but at something much more vague than that: Maybe an expression of the patient (verbal or otherwise); maybe a ‘theme’ we are postulating; maybe a behavioural assessment of the patient as animal-, mineral- or plantlike; maybe a symbolic correspondence; maybe a coincidence; maybe a correspondence taken from depth psychology; maybe our interpretation of patient’s free association on a colour.

What I feel we must appreciate is that we are doing something fundamentally different from what Hahnemann did and exorted us to do. Hahnemann looked for strict similarity and not for correspondences on various, and potentially numberless, levels. Hahnemann knew all about the temptations of shortcuts, because he knew how hard it is to keep precision in establishing similarities: ‘But this laborious, sometimes very laborious, search for and selection of the homoeopathic remedy most suitable in every aspect to each morbid state, is an operation which, notwithstanding all the admirable books for facilitating it, still demands the study of the original sources.’ (Organon, paragraph 148).

Unfortunately, this original method is not tried and therefore tested on a regular basis anymore, rather excuses are put forward to avoid testing it: From the whacky proposition that the old polycrests do not vibrate anymore with the energy of the New Age, and that we therefore need new remedies, to the contention that our lives have become too complex for such a simple method to be effective. Thus, pure homoeopathy gets discredited because of the impatience of modern practitioners and teachers. And therefore we are incapable of arriving at an exclusive definition of homoeopathy based on the original method. Which in turn does not allow us to standardise our procedures, which is a prerequisite for any profession.

We are probably further away from standardisation than ever before, mistaking the proliferative growth of individual and often idiosyncratic experience for deepening knowledge of our art and science. But it might well be the type of experience Hahnemann writes of in the footnote to paragraph 25 in the Organon:

They always saw something in them, but knew not what it was they saw, and they get results, from the complex forces acting on an unknown object, that no human being but only God could have unraveled – results from which nothing can be learned, no experience gained. Fifty years’ experience of this sort is like fifty years of looking into a kaleidoscope filled with unknown coloured objects, and perpetually turning round; thousands of ever-changing figures and no accounting for them.

To have clarity on these issues is of the utmost practical importance, and not, as some think, an academic debate, which has no bearing on day-to-day practice. I am speaking from my own experience. I would say that most of us struggle in our practice for one reason or another. Many of us are possibly running a practice where the results are just about good enough to keep us going with homoeopathy, but where we face many indifferent and unresolved cases. The worst of it is that we do not even know why our results are not more consistent. Often we cannot even account fully for our successes.

We try to find answers. Perhaps our knowledge of materia medica is faulty? We can buy one of the new software programmes ( access to an often haphazard collection of homoeopathic literature, new remedies and revolutionary approaches, etc) What we rarely, or never do, is to question our basic concepts of homoeopathy.

My studies with the Institute of Clinical Research (I.C.R.) in Bombay and Pune for the last 9 months have convinced me that Hahnemannian Homoeopathy is not a theoretical position, based on nothing more than a remote ideal, but the most practical and rational form of homoeopathy, which exists. It gives the physician the tools to receive, analyse and process the case. And it gives clear explanations about the actions taken, and the results obtained. The main teachers of modern Classical Homoeopathy are encouraging us to give up more and more specific homoeopathic positions: Thorough, detailed case analysis is hardly practiced anymore. Instead we go straight to the ‘core issue’, ‘sensation’ (formerly ‘central delusion’), or the theme without safeguarding the way.

No clear assessment is made as to which method is most applicable to the case: Repertorial approach? If so, which? Boenninghausen, Boger, Kent (with all the modern variants)? If not repertory, what are the rules for a non-repertorial approach, e.g. structuralisation, keynote prescribing? The whole area of posology seems to have been abandoned. Instead of tying the potency in with detailed examinations of susceptibility, sensitivity, disease activity, functional versus structural changes, we choose potency often on the basis of inexplicable intuitions or gross distinctions between mental and physical levels.

Detailed studies of remedy reaction are often substituted by eliciting the overall general feeling, the increase or decrease in general energy levels. We also seem to have problems recognising acutes, then knowing what to do with them in chronic diseases, etc. The problem is that we are losing the specificity of the homoeopathic method, and fill the gaps with bits and pieces of other disciplines, of which most of us have only a poor grasp – mythology, psychology, esotericism, etc. A learner today can get the impression that homoeopathy is not a clearly defined discipline, but an amalgamation of various and often incompatible fields of investigation. This in turn fosters the idea that one cannot ‘limit’ homoeopathy to one definition, because it is far too big for that.

The student may get the idea that s/he is transcending all other disciplines (including medicine, of course) and that homoeopathy is a kind of grand synthesis of all worldly knowledge. It becomes a kind of meta-philosophy, which not only cures every disease, but is a panacea for humanity’s ailments. This is an inflated image of our activities and our status. What we do not realize, or do not want to realize, is that we are not even masters in our own home.

As long as this situation prevails, we will not be able to agree on a clear definition of homeopathy. It means we will not be able to standardize our procedures, and this will prevent us from becoming a recognized profession. The sad fact is that even Senior homoeopaths have given up on Hahnemannian Homoeopathy, allegedly, because it doesn’t work. It might sound dramatic, but I think that my generation of learners could well turn out to be a lost generation of homoeopaths if we continue in this way. We will be less and less able to explain what we are doing, less and less equipped to communicate with the medical world, and, worst of all (from the patient’s point of view), more and more inconsistent when it comes to results in practice.

What can be done? We need (affordable) postgraduate training courses, which address this situation. Much can be done in a relatively short time if the focus is correct and the teaching foundation sound. Those of us who are confused need to recognize our confusion and start making a determined effort to rectify the situation. The results in practice, the confidence, which goes with that, will speak for itself. Other people will become curious, and might also want to follow a reliable method. There are good colleges in this country, which provide a good basic training. But it is not enough to turn out practitioners, if they are not fully equipped to face practice. Again, I would like to stress that I am speaking from my own experience, and do not mean to criticize my fellow-learners and colleagues. We need to have access to experienced practitioners and teachers, who can provide expertise and backup for further education, and who have the needs of learners in mind. This of course is not the solution but at least a start to solving some of the problems this article has tried to outline.