Causation in a Symptomological Universe Post 1

13Jul

Homeopathy, as a revolution in medical thought and practice, is itself in the throes of an internal revolution. A philosophy of medicine based seemingly on a close reading of the characteristic (individualising) symptoms of a patient for a prescription has been grappling with the time-bomb left by its creator, the re-introduction of causation into prescribing.

Samuel Hahnemann founded homeopathy as a system of prescribing based on using symptoms as the external manifestation of the internal (invisible) disease and then matching that symptom picture to a remedy which, when given to healthy persons, produced the most similar symptom picture. Causality had been chased from the system. Scarcely twenty years later, however, he found he had to re-introduce causality in the form of miasms and life traumas, both of which acted as blockages to the action of the remedy selected on the basis of the presenting symptoms. Re-introducing causality into a symptom-based system poses several problems. It brings into question the basic principles of homeopathy as derived from the central idea of symptoms: individualisation, the single remedy.

Hahnemann grappled with the implications for treatment of his discovery, but was unable to reconcile the two satisfactorily. The Organon provides little guidance in how to integrate knowledge of blockages to cure (miasms and life traumas) into treatment.

Homeopaths since have generally been uneasily aware of the reality of both causes of disease, but have been confused as to the means of taking them into account in practice. Certain rules of thumb have emerged — treating for “active” or latent miasms (where a blockage to the action of the well-indicated remedy is suspected but not obvious in the symptoms); treating for traumas where there is a situation of “never been well since.” These violate the strict rules of prescribing on symptomology, but the violation is tolerated so long as the central idea of symptomology is maintained. We are allowed to stray from the principles when nothing else seems to work. Prescribing on causality is seen as the exception that proves the rule.

This partial integration of causality into homeopathy is illogical and ultimately limited in effectiveness. The full power of Hahnemann’s insights into chronic illness can only be applied if one completes the revolution begun in 1828. This means adopting an etiological perspective in the treatment of chronic cases. It does not mean abandoning symptoms, but they become secondary as a basis for prescribing remedies.

The Various Phases of Homeopathy

Homeopathy as a system of medicine has gone through several phases in its development. This latest phase is as momentous as that which culminated in the foundation of homeopathy with the publication of the Organon of Healing in 1810.

The first phase of homeopathy was the long period of preparation prior to Hahnemann’s work. The concept of using medicines on the basis of similars, similia similibus, has a long lineage, back to the Hippocratic writings and even earlier, based on observation. This concept coexisted with the idea of contraries, contraria contrarius, however and was also applied on a hit-or-miss basis.

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