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The following interview was recorded in January 1994 in Vienna by Liga members Drs. Friedrich Dellmour and Gerhard Willinger, who discussed some basic questions concerning Homeopathy with Dr. Saine on the occasion of his visit to Austria. It was originally published in the Journal of the Liga Medicorum Homoeopathica Internationalis 1995 (Winter): 45-52.
André Saine is a graduate of the National College of Naturopathic Medicine in Portland, Oregon and a a Diplomate in the Homeopathic Academy of Naturopathic Physicians. He has been teaching and lecturing on Homeopathy since 1985. One of the main points of his clinical work is the treatment of patients suffering from very serious chronic diseases. In addition to his private practice in Montreal, Canada, he has been the Dean and the main instructor for the postgraduate program of the Canadian Academy of Homeopathy since 1986.
Q: Which are the best works on materia medica for a beginner?
André Saine: That is a complex question to answer because the field of materia medica is a very vast one. There are two points that must be considered in your question. The first point relates to quality and the second to accessibility of the work. For beginners, the most important criterion for quality of a materia medica is the reliability of the author. The best works on materia medica are not necessarily easily accessible to the beginner. If I was to tell a beginner to start with Hahnemann without further instructions, I might not be giving him the best advice.
Of course, for reliability, Hahnemann is by far the best but there is a great risk the beginner will be overwhelmed by the sheer volume of Hahnemann’s works on materia medica. Take for instance Sulphur, in Hahnemann’s Chronic Diseases. It has over 1900 symptoms. Without further instructions on how to use these books, the beginner may feel hopeless. It’s no use just to recommend a book to a student—he has to be taught how to use it. He has to learn how to study and use Hahnemann’s Chronic Diseases, Hering’s Guiding Symptoms or Allen’s Encyclopædia of Pure Materia Medica. He ought to know how these works were developed and how they were meant to be used.
To return to your question: for somebody who has never studied materia medica, who knows nothing about it and wishes to begin, I would first recommend Nash’s Leaders, as a quaint and pleasant introduction to the materia medica. Another book along the same lines would be Margaret Tyler’s Homœopathic Drug Pictures. It is simple, reliable, full of interesting anecdotes and contains many quotations from reliable authors: Hahnemann, Lippe, Hering, Nash, Kent, etc.; it’s a simplified approach to our vast materia medica.
Along the same lines, I could also recommend two other books in which the authors have used more modern expressions of language, viz. Gibson’s Studies of Homeopathic Remedies and Harvey Farrington’s Homeopathy and Homeopathic Prescribing. So these are the four books I would recommend to the beginner as easily accessible and reliable. Later on, in order to progress further, the serious student of homeopathy has to be taught how to use the major works.
Q: Many homeopaths have tried to arrange and summarize the symptoms of certain remedies to make those remedies easier to comprehend. What is your opinion of such “drug pictures”?
A.S.: Well, there is certain danger in that and it is necessary to be very careful. If you have a drug picture, there is always a danger of taking one aspect of the remedy and generalizing, saying “This is the remedy.” Or you may be completely wrong in your picture and thus be unfaithful to reality. Whenever anybody says to you: “This is the nature of the remedy, this is the picture of the remedy”—take it with a grain of salt. It could be totally unreliable and lead the student astray for years to come. There is a great danger in generalizing.
The key is whether the one that is generalizing is basing the generalization on a close study of the provings supplemented with extensive clinical experience. I have not much quarrel with Hahnemann when he says not to prescribe Nux vomica if the patient is mild and phlegmatic or Aconitum if the patient is calm and undisturbed, as long as the student clearly understands that there are exceptions to these generalizations. These generalizations depicting the nature of the remedy or the state of the patient needing this remedy are usually very helpful to the beginner for perceiving with greater ease the remedy.
Unfortunately not everyone who is teaching materia medica and generalizing has made a close study of the provings, is a reliable observer and has had extensive clinical experience. The danger of making false interpretations and creating false images is enormous. These generalizations are not much of a problem as long as the student understands that a close study of the proving is always the best way and the last word on deciding the degree of similarity—not someone’s opinion, regardless his name.
I have no quarrels with P. P. Wells when he says that Belladonna is characterized by violence in the function of the mind or body. Here is a very reliable author with extensive clinical experience who has studied the provings closely. This type of generalization is very attractive to the student of materia medica and we can easily appreciate how misleading it can become if the author is not reliable, which is the rule rather than the exception today.
Nowadays, you are more likely to be misled than to be properly led, as anyone can easily advertise themselves as masters of the materia medica. Self-styled “masters” are quite common, they often have a large following of devoted disciples, but mostly, it’s a case of the blind leading the blind. I know some physicians who have followed such teachers as one would follow a guru—some of them have spent as much as ten years prescribing on false images before waking up, and even now, they find it difficult to get rid of these ideas.
At times, when they refer cases to me—of course, cases in which they have failed—what I hear most often from them is “Why didn’t I see this remedy? How did I come to miss it?” The answer is simple. They do not follow the basic blueprint of Hahnemann, which is first to take a complete case. Once this is done properly, even a beginner would be able to find the remedy because we have a pure description of the morbid phenomenon. Otherwise, with an incomplete case or a case full of misleading interpretations, even an expert would not be able to find the correct remedy.
The second step is to analyze the case so to find among the totality of the symptoms the most characteristic, peculiar and striking ones. The totality of these characteristic symptoms forms what Guernsey called the genius of the disease. Similarly, when we study the materia medica we will try to identify in a remedy it’s genius, what constitutes its identity or individuality, what distinguishes it from all others.
In studying a case, we would compare the genius of the disease to the genius of the remedy. This is the basic method. If we take a case and we are carried away by our prejudices and carelessly interpreting what the patient is saying, then we are not paying attention to the pure language of nature, and as Hahnemann puts it “carefully and honestly” interrogating. Then when we come to the analysis of the case and we superimpose all our interpretations of the remedies, we are no longer following Hahnemann’s blueprint but rather practicing something that cannot be called the science of homeopathy anymore, it is closer to esoterism.
The more we crystallize the remedy picture the less we will be able to recognize all its many different clinical presentations. The more we narrowly conclude about a remedy picture the more likely we will have distorted reality to the point of not being able to recognize its indication, even though very clear for an unbiased prescriber.
Of all the great many additions to the repertory, I find that ninety percent of the ones I confirm daily in practice are from Hahnemann. Ten percent are from all the other authors, and the bulk of these are from Allen’s Encyclopædia and Hering’s Guiding Symptoms. It does not say much for all these modern authors, except almost complete unreliability. You see, if we want reliable information, we have to start with Hahnemann—and then move on to Lippe. Lippe took Hahnemann’s writings, just as he found it, applied it to the letter and then published his confirmation of it. He had fifty years of experience to sustain what he says. After reading Lippe, we can go back to Hahnemann to better comprehend him.
Lippe was—and is still—the best teacher to better understand Hahnemann’s work, especially regarding the clinical aspects of homeopathy. Lippe’s writings are powerful, attractive, intelligent, logical, clear, profound, critical and to the point. Hering is also very reliable. He gives us a broad perspective and like Hahnemann had an investigative mind. Then, there is Dunham. Every homeopathic physician ought to read Carroll Dunham’s Homœopathy, The Science of Therapeutics. It’s a gem, containing some of the best and most clear writing in the history of homeopathy. He tackles difficult subjects like the place of therapeutics in relation to hygiene, or the primary and secondary symptoms of drugs, the alternation of remedies, the use of high potencies, the question of dose, the relation of pathology to therapeutics, etc.
He wrote about these subjects because there was a need to clarify aspects of homeopathy which were confusing in Hahnemann’s writings. Dunham’s writing is very clear and definitive. Take for instance the difficult subject of primary and secondary symptoms of drugs. Hahnemann wrote about this in many places in the Organon and in other works. The more you read Hahnemann the less clear it is. Dunham takes up the subject and makes it perfectly clear. Later on, Kent takes up the subject and again we are led to confusion. And then, whatever you can find by Nash is always of great value, just like H. N. Guernsey, P. P. Wells, Joslin (senior) , Yingling, Skinner, H. C. Allen, Harvey Farrington, Pierre Schmidt, Herbert Roberts, Elizabeth Wright-Hubbard, Julia Green. For contemporary writers, there is Jacques Baur, who is the editor of an excellent French journal, les Cahiers du Groupement Hahnemannien du Dr. Pierre Schmidt. Dr. Baur is presently working on the publication of a compilation of Pierre Schmidt’s writings collected over the last thirty years.
It will be worthwhile to read coming from such a refined pen as his. Altogether, there is a lot to be learned from good journals. I recommend my students to seek good journals, old and new, and to regularly read them. It’s an excellent way to do continuing education. There are some old journals that can be read from cover to cover. This is the case of the Homœopathic Physician, the Organon or the Hahnemannian Advocate. Take this last one which is very rare.
There were nine volumes published containing wonderful articles by excellent writers such as Nash or Yingling. These are very valuable, usually richly illustrated with interesting cases. There is very much to be learned from journals of such quality as so much of it has not been written in books. This would apply to the teaching of many of the masters of the past such as Lippe or Wells. These are the people we should regard as our leaders and on whom we should rely for our training.
Q: Could you give us a summary of what, in your opinion, are the essential points of case-taking?
A.S.: I have a lecture on how to take a case; it’s a long lecture of about ten days. I start the lecture with about a dozen key points which are important to understand when taking a case. If I were to try and pick out the most important point in case taking it would be for the physician to strive to maintain his objectivity. It is the basis for obtaining accurate observation. We have to listen to the patient with all our powers of observation on the alert.
As soon as we introduce our bias or use direct questioning, the information we obtain loses it’s value. During the act of taking a case, the moment we focus on a certain remedy we have lost our objectivity. It is crucial that we keep our neutrality until the end of the case. This does not mean that we do not think of certain remedies while taking the case. As we are making the discovery of characteristic symptoms it is inevitable to consider certain remedies.
The frame of mind here should be to rule out rather than try to confirm a certain remedy. Of course the temptation is great to jump to conclusions quickly. We have to be on constant watch to maintain our objectivity. The use of direct questioning is a good way to fool ourselves. For success in medicine, as in science, it is not one of our options to lose our objectivity. We have to observe as if we were not there, as observers of nature devoid as much as possible of our biases.
The second point is that we have to adopt a method that will induce patients to open up and “deliver the goods,” so to speak. Patients will open up to the physician they trust. They will trust most the one who is sincere and competent. There is no better way than homeopathic case taking to develop this trust from patients. If we spend thirty minutes investigating a patient’s chief complaint, let’s say in a case of multiple sclerosis, and when questioning about the modalities which affect the symptoms the patient mentions that all the symptoms are aggravated just before a storm.
There is a magical moment that develops between the patient and the physician. First of all, we have spent more time thus far questioning the patient about the problem than most neurologists have done. Second of all, the patient notices our reaction of interest by mentioning the fact that the symptoms are aggravated before a storm. Not only is the patient feeling that this doctor is listening to me but that my story is really important after all (contrary to the neurologist for whom it was an insignificant fact). And then we ask the patient about sleep position, whether the body or parts get warm or cold in sleep, dreams, food cravings, etc.
Inevitably there is a complicity that develops between the physician and patient. Our patients cannot help but sense our interest in them. We eventually come to ask our patients to talk about their personality, their sensitivities, their anxieties, the most intimate aspects of themselves; at this time they will reveal anything we need to know.
By this time they are like an open book. It is the best way to discover the truth which is the only way for success. The way Hahnemann taught us on how to take a case is very classical. I was told that medical students from Harvard University are encouraged to preceptor with homeopathic physicians for developing their skills in case taking. It is difficult to imagine a better way to have patients open up to the physician. Of course to inspire such trust in our patients we must be sincere. This must be present when first deciding to undertake the study of medicine.
The basic principles of case taking were set down by Hahnemann in the Organon. However in the second volume of the American edition of the Materia Medica Pura, Hahnemann wrote about the importance of becoming good observers. It is a marvelous article of classical medicine.
In it, he says that, “This capability of observing accurately is never quite an innate faculty; it must be chiefly acquired by practice, by refining and regulating the perceptions of the senses, that is to say, by exercising a severe criticism in regard to the rapid impressions we obtain of external objects [so we must be critical of our sense of observation], and at the same time the necessary coolness, calmness, and firmness of judgment must be preserved, together with a constant distrust of our powers of apprehension.” You see when we take a case we must not arrive at a conclusion too quickly. We must learn to keep our “coolness.”
We must always check and double check with the patient through skillful questioning until we have a clear picture of what is really happening to our patient. We must be patient. To practice homeopathy, a physician that is not patient to start with would have to learn it or may have to change professions. Without patience we cannot be good observers.
Like any real scientist, in order to adequately observe we have to let things unravel at their own rhythm. It is essential to be very patient and understanding, to be compassionate with the patient. If we don’t have compassion the patient will not open up to us. We may as well go into business. I should say that objectivity, sincerity, patience and compassion are some of the essential ingredients for obtaining a good case.
Another aspect is thoroughness. Ask yourself whether Sherlock Holmes when examining the scene of a crime would accept to leave out half of the scene, or rather would want to include all circumstantial evidence; nothing is being a priori ruled out. He does not impose on himself any limit to his investigation. In other words, the clues to a crime can lie in the time the crime was committed, the position of the corpse, the mud on the shoes of the victim, a telephone number in a side pocket, the job that the victim had, the family inheritance, etc.
Case taking is very similar to the process of investigating a crime. Both look for clues. While one looks for clues leading to a suspect, the other looks for clues leading to a remedy. The clues in the case can lie in any idiosyncrasy, such as a time of aggravation, a sleep position, a food craving, a peculiar mental state, an objective symptom, an old symptom not present anymore, in the past medical history of the patient, in the family history, etc. We can not guess a priori and we cannot leave any stone unturned. We must not consider anything as being unimportant a priori. We must look for clues everywhere in the case.
As many of my cases come in critical condition, any laxity in my thoroughness would reduce the patient’s chances of recovery. Not to be thorough is not one of our options.
Another aspect of taking a case is to seek to develop a global understanding of the patient and his problem. In other words, by the end of the case, all should be clear to the physician. The circumstances, the causes, the onset of symptoms and the course of the disease should all come together to form a comprehensive whole. The case is not finished until we have reached a sufficient level of understanding.
Also when taking a case, we must keep good records so that ‘the story’ written down is not only comprehensive to us but to anyone else who may eventually need to use the case. All that is pertinent to diagnosis, prognosis, case management, proscription or prescription should be clearly written down. The symptoms should be written in the exact words used by the patient with the least interpretation possible.
Of course only the peculiar symptoms that are relevant for the prescription of the simillimum would need to be outlined, so that in the end in surveying the case you will be able to quickly see the few outlined characteristic symptoms in the case. Lastly, after the physical exam we must write our impressions as well a description of the patient’s morphology, physiognomy, complexion and the objective aspects of the patient’s temperament and personality. There are other aspects to case taking but I think I have outlined the basics here for you.
Q: What are the essential points of case analysis?
A.S.: When you have a complete and well taken case then it can be relatively easy from there. In paragraph 104, Hahnemann says that when a case has been thoroughly and carefully investigated and precisely written down, then the most difficult task of the physician has been done. Now, that we have all the facts in front of us, we ask ourselves the question: what is most striking in this case? It is not obvious to the uneducated physician.
In order to know what is striking, first, we have to know what is common to human nature, how people function and how common or uncommon is a certain symptom in a certain pathology or a certain behavior in a certain context. This would include the knowledge of behavior, or ethology, through various cultures. Let me give you an example: What is the percentage of people in the Western world who feel a certain degree of shyness when using a public washroom with others close by?
In fact our washrooms are built so that we are somewhat hidden (protected ?) from one another, besides the fact that we are trying to keep a certain distance from one another. From inquiring among my patients, I would say that the figure can be as high as 90%. However, in other cultures in which people are used to relieving themselves with others around, it is an everyday occurrence. In our culture, it would be more striking if someone had no inhibition at all, or that someone would show an unusual degree of inhibition to the point of avoiding public washrooms totally. The characteristic value of the symptom depends on the level of intensity of the symptom which is relative to the norm of the group to whom the person belongs.
Another example: when I ask who among the students in a classroom have a craving for sweets, the figure is usually between sixty and seventy-five percent; so a craving for sweets is not very characteristic in itself as compared to a craving of the same intensity for ice. What I am trying to say is that the more we understand human nature, the more we become capable of distinguishing what is characteristic for an individual from what is common to the group.
To know human nature demands of the homeopathic physician a broad knowledge in many fields including ethology, sociology and psychology. To be able to recognize what is characteristic in a human being the homeopathic physician must also know pathology. The study of pathology should not be restricted only to the study of the end results of the disease process as we have in present textbooks of pathology but to the study of the entire phenomenon of disease from beginning to the end with special emphasis on the study of causes.
Also, of course, we have to know materia medica very well, because the more we know about it, the more easily we will be able to distinguish what is striking from what is common. Lastly, clinical experience will round out this knowledge. It is the ultimate test. It is here that we obtain our confirmations. It is here that we learn for instance that on one hand a characteristic symptom of a remedy, such as the ascending paresthesia of Conium, is not characteristic and in fact of little significance in the search of a remedy in a case with multiple sclerosis, as it is a common symptom of the disease.
On the other hand, it is through clinical experience that we learn that we can have common symptoms of a disease condition, such as dilation or movement of the nostrils seen in an advanced state of respiratory failure, as in a serious case of pneumonia, be a very reliable guiding symptom.
To return to your question of how to analyze a case, first after taking a complete case, we make a list of the most characteristic, and, therefore most valuable symptoms. If the patient presents only one disease state or disease picture, we assemble all the characteristic symptoms in a one totality. We arrange these characteristic symptoms with the ones with the highest value at the top of the list and the lowest at the bottom.
The ones at the top of the list are the guiding symptoms while the ones at the bottom of the list are called differentiating or confirming symptoms. With the aid of the repertory, the first ones guide the prescriber to a group of remedies while the later ones help to differentiate or confirm one or more remedies that are very similar. This totality of characteristic symptoms then constitutes the genius of the case. The last step is to read the materia medica to find which remedy best matches the genius of our case.
However, if the patient is presenting with two or more dissimilar diseases then the characteristic symptoms will be assembled under each dissimilar disease. For instance, we will commonly see a patient presenting an acute state, let’s say pneumonia, and a chronic state which includes for instance chronic arthritis, digestive difficulties, insomnia, fatigue and nervousness. Very commonly in such a case, the symptoms of the acute condition are dissimilar from the chronic state. Then, the characteristic symptoms will be divided in two totalities, all the symptoms that have appeared since the onset of the acute condition in one totality and all the symptoms of the chronic state in another one.
Also, there are more complicated cases in which two or more chronic dissimilar diseases are mixed together forming what Hahnemann called a complex disease. As much as possible each dissimilar disease state must be identified and their characteristic symptoms be duly separated. There are a great number of possibilities for the coexistence of two or more dissimilar diseases in the same person. In diseases which evolve in stages, whether acute like pneumonia or chronic like kidney failure, each stage of the disease may be a dissimilar disease, thus requiring a different remedy for each stage.
Q: Let us talk a bit about potentization of remedies and about posology. What potencies do you use in your practice?
A.S.: The answer to this question should not take too much importance. A physician can learn to master any set of potencies, stick to them and address whatever problem with them. However, I am like Nash on this point. In his Testimony of the Clinic, he says that he used to tell his classes in the college “that he who confines himself to either the high or low preparations of remedies cripples himself from doing the best possible for his patients. We do not have to restrict ourselves in the matter of posology to the ‘demonstrable divisibility of matter,’ but can and should avail ourselves of the whole scale, from the crude drug to the highest of a Fincke, and abide the result according to the finest of all tests, the physiological.”
Regardless of the set of potencies used, what I found to be the most efficacious is to adapt the posology to the patient. What I call optimal posology. It means to choose a potency that would be optimal for the patient at that time. As for the repetition, it should also be optimal, not too early, not too late.
Generally speaking, I start a chronic case with a two hundredth Dunham or a 10 M Korsakoff. If the patient is too sensitive for a two hundredth, I will tell him to take a teaspoon or less of the remedy diluted in one or more glass of water. Some patients are even more sensitive than this and then I will go down to a thirtieth or even lower to a sixth centesimal. In some cases, when diluting the remedy in water is not enough, I may have the patient briefly smell the remedy. Hahnemann did this quite often.
The key here is to obtain maximum benefit with the minimal discomfort to the patient. Usually, I use the same remedy in the same potency for as long as the patient is deriving increasing benefit from it. So for instance, if I use a two hundredth potency and the patient does better for five weeks after the first dose, and for six or seven weeks after the second, I will continue giving the same remedy in the same potency in the same way as long as the patient is obtaining increasing benefit from it and the picture remains the same.
But when a patient is losing his sensitivity to a potency of a remedy, when he is not reacting as well to a succeeding dose and it has nothing to do with outward circumstances and nothing has happened to interfere with the reaction to the remedy, then it is a sign to move on to a higher potency, as long as the presenting picture remains the same. At this point, we could also go to a lower potency as Hahnemann did for many years. It does not matter much.
As a rule, I prefer to go up the scale. I will go up in this way to the MM potency and then if needed start again with medium potencies. At this point, however, I will use whenever possible intermediary potencies, such as five hundredth, five thousandth, twenty thousandth, etc. The longer we wait to reintroduce a potency of a remedy to which a patient had in the past lost his sensitivity, the more the sensitivity to it will eventually return. Giving twice the same remedy in the same potency without any plussing is contrary to what Hahnemann taught. However, I find it more efficacious to evaluate the sensitivity of the patient to a remedy if at the time of a relapse the same potency is again given in the same way. It is the closest we can come to repeating the same experiment in medicine.
The results of such experimentation provide the physician with all kinds of very useful information regarding curability of the patient, the degree of similarity of the remedy and much more, all of which can be very important. It would be too long to go into that right now. To return to the repetition of the remedy, it should be repeated optimally. Otherwise if less than optimal, the patient will recover more slowly with more significant relapses and, if too often, the patient will lose his sensitivity to the remedy. Always keeping in mind that the patient must recover his health in the most rapid way.
As to the best time to repeat the remedy, it is when the patient has stopped responding to the previous dose and has perhaps stabilized or is starting to relapse again. In an acute case, the approach is a bit different on two points. First, the potency to start with will usually be proportionally elevated to the severity or the ascendancy of the acute condition. Here, it is not unusual to start a case with a 10 M or 50 M. Second, the repetition of the remedy would have to be done in such a way as to prevent a relapse. It is clear that it would be unfortunate to obtain a relapse in cases of pyelonephritis, meningitis or pneumonia.
Q: In your experience, are there any differences in the effects of C-, D-, LM- and Korsakoff potencies?
A.S.: This a very difficult question to answer. There are all kinds of ways to produce remedies by varying the concentration, the number of vials used, the number or strength of succussions (Jenichen, Dunham), providing us with all kinds of potencies such as Hahnemann’s centesimal and fifty millesimal, Korsakoff’s centesimal, Jenichen’s with few dilutions but repeated strong succussions, Dunham’s powerful force applied in succussing, Fincke’s continuous fluxion and Skinner’s interrupted fluxion. Hahnemann’s centesimal potencies are fine except the scale is limited to up to the two hundredth or the 1 M potency. Korsakoff’s and Skinner’s potencies are fine and provide us with the higher scale. Fincke potencies are excellent. They were Lippe’s favorite. Unfortunately they are not available in pharmacies.
It is interesting to note that Fincke’s and Skinner’s receive no succussions except that of the force from the jet of the water stream. Hahnemann’s fifty millesimal and Jenichen’s potencies are actually low potencies and can be too limiting. Also, there are more people that will respond to the lower than to higher potencies as the degree of similarity does not need to be as great to obtain a response. As a result, our search for the simillimum may become more difficult with the lower potencies, as we obtain too many false positive responses. Dunham’s two hundredth potencies I find to be the best in their category of two hundredths.
The response of the patient to them seems overall deeper and longer lasting. I use Dunham’s two hundredth potencies, Hahnemann’s centesimal potencies, the old handmade Bornemann’s potencies, the Skinner’s made by Boericke and Tafel, the old Fincke’s and also Korsakoff’s potencies. All of which provide excellent results.
In my opinion, the problem most often, does not lay with the remedy and its method of fabrication, but with the prescriber. The real key lies in finding a remedy with the highest degree of similarity that we can find. The higher the degree of similarity, the greater will be the vital reaction, and therefore the recovery of the patient.
Q: How about LM-potencies?
A.S.: This is a very delicate question. I do not want to offend any of your readers but the question must be exposed and discussed openly. For a moment, let’s briefly review Hahnemann’s personal evolution regarding posology. What we find out is that he was constantly trying to improve on posology.
First, he started to dilute the remedies, in order to make them less toxic. He started with dilutions of one in five hundred; then he did one in ten thousand and so on. Then he went to make successive dilutions by changing vials. Eventually, he systematically adopted the centesimal dilutions without succussion at first and later on with succussion. He experimented with the number of succussions from a hundred down to two, and up again. Then in his last eight years, he started using higher and higher potencies.
By 1840, he was commonly using the two hundredths. At the beginning of 1841, he started to experiment with the fifty millesimal. In total, he had only about a dozen remedies prepared in this way and the highest was Sulphur LM 20. He experimented with these for about two years. In the later part of 1842, he made fewer prescriptions. In 1843, he barely practiced. He made his last patient’s entry in his case book in early May 1843.
By that time he was preparing the sixth edition of the Organon for publication. Apparently, he felt that he had enough experience to authoritatively recommend the LM potencies to his colleagues. I have read in Hahnemann’s case books almost every case in which he used the LM potencies. Truly, it is very difficult to be satisfied with his success.
When we study Hahnemann as a person as well as a scientist, we soon find out that he tended to be very dogmatic in his writings by rendering his last experiment as the ultimate way. This approach of his is contrary to the great scientific mind he had. When we read his works in a chronological order, at each step of its evolution he impresses upon the reader that the method has now been developed to absolute perfection and, that is it. Period.
Then comes the next work, and now he tells us that further experiments are now permitting him to negate what he had previously said with such great certainty and that the method has now reached a new state of perfection, and so on. If we read any work of Hahnemann, including the sixth edition of the Organon, we may ourselves get stuck in his dogmatism and not go beyond the last work just read. I would think that we would do greater honor to Hahnemann by further developing homeopathy, and medicine in general, through understanding and adopting the inductive method which is the basis of his achievements, rather than by adopting his dogmatism and repeating his mistakes. Wouldn’t we be fools not to learn from his mistakes?
In my mind, the real Hahnemannian is not the one who does as Hahnemann said to do but the one who proceeds with the positive aspect of his approach, the inductive method. That is the real Hahnemannian, not a follower, but one who understands.
It is likely that if the sixth edition of the Organon had been published earlier the question of potencies would have evolved differently. Perhaps fortunately, as soon as Hahnemann died Bœnninghausen started to systematically prescribe Lehman’s two hundredths. Later on, the Hahnemannians, especially in America, started to experiment with the high and higher potencies.
Since our most reliable prescribers have consistently abided by them for over one hundred and fifty years, starting with Hahnemann himself, followed by Bœnninghausen, Lippe, Hering, Dunham, Skinner, Nash, etc., the higher potencies have been proven and are here to stay. I am not sure if we could achieve similar results if we would limit ourselves to the lower potencies, and in reality the LM are very low potencies. I have stayed away from them, first because I did not need to use them, second because it is too complicated (in keeping in mind the second paragraph of the Organon: “… on easy comprehensible principles”) and third a few reliable authors, such as Pierre Schmidt and P. Sankaran (the father), have tried them only to later abandon them.
It does not mean they don’t have a role to play but I don’t think they are what Hahnemann wanted them to be, the ultimate homeopathic preparations. We cannot deny the incredible success we have had with the higher potencies on which, unfortunately, we do not have Hahnemann’s experience. I do not want to take any credit away from the LM potencies but things have to be considered in a broad perspective. Hopefully, the perfection of our potencies will continue to evolve. Like Hahnemann, our aim should be to always try to perfect our method, including the potency question. Like him, we should favor change, positive changes.
Q: You talked about four distinct schools or methods of Homeopathy, the Hahnemannian, the Kentian, the Classical and the Neo-classical. How would you distinguish these four and how would you evaluate them?
A.S.: I once wrote a paper on this question. Basically, Hahnemann developed a therapeutic method with clearly defined principles which he called homeopathy. It should be basic whenever anyone is using the name homeopathy it is in reference to the therapeutic method clearly defined by Hahnemann. Unfortunately, for different reasons, many, who do not understand homeopathy, have assumed the right to use the word homeopathy for a completely different way of practicing medicine.
Since the time of Hahnemann, many have thus improvised themselves as homeopaths and misrepresented the profession. This is not right. If a person after finding out about homeopathy wishes to be treated by such an approach and calls on someone presenting himself as a homœopath, should he not expect to receive the best of what homeopathy can offer? Unfortunately for this person, no impostor would be able to provide him with the promises of homeopathy. If practitioners want to practice something else they just have to call it something else. There is no justification for their usurpation of the word homeopathy. The word homeopathy should suffice to clearly identify a practice according to the method developed by Hahnemann.
In the same way, I do not favor the word classical not just because of its recent use but because of the false elitism associated with it. It usually means Kentian or supra-Kentian homeopathy. In the nineteenth century (prior to the time of Kent), the followers of Hahnemann formed, at Lippe’s request, the International Hahnemannian Association (IHA) to differentiate pure homeopathy from misrepresentations. As a rule the leaders of this association understood homeopathy very well.
Then came Kent, who went along with the IHA for some time, later left it and eventually formed with his students the Society of Homœopathicians. Kent introduced his own prejudices, along with the teachings of Swendenborg into the practice of homeopathy. There is no doubt that Kent was a good clinician and a well sought after teacher, but he was not one of the great masters. He was not up to the standards of quite a number of the people who had preceded him. As he was very charismatic, people in the twentieth century followed almost blindly his teachings without digging deeper into the masters of the past or even Hahnemann.
It became one of those myths, one after another, students followed Kent’s teachings assuming that he had mastered homeopathy. As his writings are authoritative like the ones of Hahnemann, a form of idolatry has developed around the persona of Kent. This idolatry prevented students from studying with a critical sense Kent’s writings and at the same time prevented them from reading the works of the masters which preceded Kent. Later, in the twentieth century, people influenced by the teachings of Kent became even more dogmatic than him, what we could call supra-Kentians, more Kentian than Kent himself. Kent had already deviated from the teachings of Hahnemann so these supra-Kentians are floating in some faraway galaxies. Further and further the homeopathic profession in the twentieth century drifted away and became disconnected from its roots.
I would hope that the admonition of Hering mentioned earlier in this interview about deviating from the strict inductive method of Hahnemann would ring more bells. Nowadays, we have people practicing this supra-Kentian homeopathy and in general calling it Classical which is in effect Neo-classical. Few of them have read the works of Hahnemann and the old masters of the past.
Classical homeopathy should be the homeopathy of Hahnemann and of the Hahnemannians, or in other words, pure homeopathy. Unfortunately, few study history; in my opinion, this is a great mistake. Hopefully more and more of us will remedy this situation not only for our own sake but for the sake of the sick ones and the profession.
Q: Thank you for giving us this interview.
A.S.: You are very welcome and I thank you for giving me an opportunity to share my views.
