The Fifth Phase: Coming to Terms with Cause — Uneasy Truce?

The fifth phase of homeopathy would involve the efforts of Hahnemann and his early followers to incorporate the insights of the theory of chronic disease into homeopathic therapeutics (treatment). This would not be easy, and Hahnemann himself was only partially successful, his followers to date only marginally more so.

Homeopathy, that is General Homeopathy, was and remains by its nature symptom-driven and symptom-centred. There was initially no room for cause, other than obvious external causes in accidents. The rules of General Homeopathy dictated that one observed the totality of the symptom state and then matched that picture to the remedy with the most similar symptom state (derived by means of provings on healthy persons). A single remedy based on symptoms individual to the case at hand.

The concept of cause changes all this, however. The concept of cause has profound philosophical implications which in turn has profound implications for how we should be treating. Philosophy may seem arcane to most, but it is philosophy which determines how one acts. As Margaret Tyler wrote in her article "How Not to Practice Homeopathy," without the right philosophy you might as well stop practicing.

Disease for Hahnemann came to represent more and more a disturbance of the normal harmonious functioning of the vital force. To treat for this meant increasingly to treat for the cause of the disturbance. The cause was both exciting, meaning those shocks to the vital force during one's life, and fundamental, meaning those genetically acquired predispositions to disease. Cause means there is less individualisation. Mainly, Sulphur for psora, Thuja and Nitric acid for sycosis and Mercury for syphilis. Cause means that one has to pay attention to time and the concept of layers of disease. Cause means that there can well be more than one remedy for a given case of disease to cover the various disease states over time. Indeed, the more cause plays a role, the greater the likelihood this is the case.

General Homeopathy, based purely on the totality of symptoms, is without cause. General Homeopathy is the simpler Newtonian world of natural disease with few or no miasmic elements or blockages to cure caused by modern, civilised (that is, urbanised) life. Once we introduce the element of disease brought on by man himself as a reasoning being, we enter a different world, a world where the normal rules of homeopathy do not necessarily apply.

This is the problem: how to adapt the special circumstances of chronic disease to the rules created for acute disease. Hahnemann's solution, and that of homeopaths generally to date has been, as was mentioned earlier, to graft the new insights onto the symptomologically-centred foundation of General Homeopathy. He counseled that cause must be taken into account (Para 5 of the Organon, 6th edition), but the basis of prescription remains, in theory and practice to this day, the characteristic symptom picture.

This has worked reasonably well until recently, when the impact of modern society on disease has increased the interference factor of miasms and blockages to cure (both physical — drugs and vaccines — and mental/emotional) exponentially. Despite the successes with more traditional methods, we need to ask why there seems to be an increasing number of difficult and "incurable" cases. It is hard to be precise about this, as it is not in the interest of any homeopath using traditional methods to reveal that this is occurring. That is the sense I receive in private discussions with experienced and well-known homeopaths. I believe the problem is growing larger, not smaller, as the miasms deepen and the stresses of modern life accelerate. A recent conference in Ireland is reported to have discussed why the cure rate for homeopathy was now closer to 30 per cent than the previous 80 per cent. Indian homeopaths coming to Europe or North America wonder why their previous high success rate cannot be duplicated.

Homeopaths are generally aware that the miasms and the shocks during life can act as blockages to cure. These are generally ignored, however, unless the remedy based on the total symptom state (the well-indicated remedy) does not work. Then cause must be addressed. The most common adaptation of cause is in the "never been well since" rubrics in the repertory. These are rubrics of cause, not symptomology based on provings. Certain remedies have been found useful in clinical practice to clear the effects of a trauma to the vital force where there is a visible change in health following the trauma. This is fine as far as it goes, but it ignores the traumas which have contributed to the weakening of the vital force, but have not yet produced a noticeable change in the state of health. This is akin to Burnett's ladder analogy. When asked by students to identify which of the several remedies he had given in a case as the one that cured, he asked them in turn to take a ladder and climb to the roof of their house and then tell him which rung of the ladder it was that had brought them there.

The solution for the miasms has generally been to identify an active miasm and then search for a remedy that is known to be effective in treating that miasmic state. Sometimes, however, there is no means of identifying the miasmic state except through the fact that certain disease states or symptoms existed in the family tree. Then it is permissible to prescribe a remedy, usually the nosode, for the miasmic blockage.

It is clear that we are still very much dealing with the maintenance of an orthodoxy based on the world of General Homeopathy (symptomology), while trying to accommodate the embarrassing realities coming from the world of Special Homeopathy (the etiology of chronic disease). All traditional textbooks and teachings emphasize that recourse to prescribing based solely on knowledge of a trauma or miasm suspected to be blocking the action of the well-indicated remedy is only permissible when the well-indicated remedy fails. The responsibility of the homeopath is to search diligently for the simillimum, the one remedy that represents the total symptom picture. When prescribing is done other than on this basis, it is seen as an anomaly and recourse to other approaches as the exception that proves the rule.