Hahnemann's unfinished revolution raises the provocative question whether homeopaths can effectively treat complex, chronic cases unless the treatment is done on the basis of causality rather than symptomology. It also raises the question as to whether these two approaches are in conflict or are actually complementary aspects of a more comprehensive homeopathy.

There is a story told of a famous wise man found on his hands and knees under the street light outside his home one night.

"What are you doing there," his friends asked.

"I am searching for my glasses," he replied. His friends asked him more precisely where he had lost them, so they might help him search.

"Over there, in the alley behind the house," he replied gesturing with his hand.

"Then why are you looking here in front of the house?" they asked, puzzled.

"Because the light is much better here," he answered.

Hahnemann knew he had to search in the shadows of homeopathic philosophy to resolve the problems he faced with patients getting progressively worse despite the brilliant removal of their immediate symptoms. However, he had greater difficulty integrating his discoveries into existing rules for treatment developed for a symptomological world and seemed to have returned to the light. The premise of this editorial is that since 1828, homeopaths have been searching more in the light than in the dark places where the solution is hidden. As a result, we have missed the shift in perception needed to complete Hahnemann's revolution.

David Little's scholarly and immensely readable article on miasms in the previous issue of Homeopathy Online has nicely, if perhaps unwittingly, set the stage for our discussion here. He underlines the importance of the concept of miasms and of taking etiology (cause) into account in homeopathic prescribing. Homeopathy since the theory of chronic diseases can not be seen simply as symptomology. We now have to contend with causality, the interloper that Hahnemann had initially chased from the temple.

The main articles in this issue point up very clearly the ongoing tension between symptoms and cause in homeopathic therapeutics. On Pseudo-Classical Homoeopathy, by Rajesh Shah, sets the scene by showing, from a survey of homeopaths, how much confusion there exists as to what homeopathy is and is not. It also indirectly points to a recent phenomenon which is, in my view, a function of the growing confusion in homeopathy between cause and symptoms, that of the creation of "classical" homeopathy. This term serves to divide rather than unite and confuse rather than clarify.

Causation in a Symptomological Universe: a Revolution in the Making, tries to give an overview of the role of cause in homeopathic philosophy, from the dawn of homeopathy to our present day. It is designed to provide a framework for the debate over cause and to introduce the thesis that the only way to resolve the tension between cause and symptoms is to shift one's perspective to a cause-centred universe.

Taking Homeopathy into the Shadows: a Sequential Causal Approach to Treating Chronic Disease, sets out a systematic and highly effective approach to treatment, which is consistent within a cause-centered universe as well as with Hering's laws of cure. It also provides a model case to illustrate this causal sequential approach.

Patty Smith, in Sam's Case, provides us with a case of a young child with severe chronic problems helped immensely by the use of this sequential causal approach.

Finally, you will find a counterpoint article by David Little, Causation, Time and Progression in Homeopathy, which provides a critique of Sequential Therapy in the light of the standards of traditional homeopathy. I then provide a kind of counter-counterpoint which argues that Sequential Therapy cannot be judged to be homeopathic or not based on the principles of a homeopathy which approaches chronic disease essentially from a symptomological world-view.

In addition, this issue contains an interesting materia medica of a fascinating remedy, Pyrogenium, which is often used for a specific condition, sepsis, regardless of the characteristic symptoms. It might be said to act as a homeopathic antibiotic, except that it is not "anti-bios (life)," but promotes life. I myself used it recently on a case of infection that was a close cousin of the flesh-eating bacteria seen in the headlines. It worked wonderfully, where the antibiotics were barely holding the infection at bay.

The Crocodile's Opinion, Michael Tomlinson's regular column, discusses a timely issue. As the demand for homeopathic practitioners grows, the demand for quality education and training will grow apace. Tomlinson's article, Homeopathic Education: What Should the Future Hold?, examines the issue of which model we should follow: that of rigorous training in the bio-sciences (a more allopathic bias) and less rigorous attention to homeopathic philosophy, or greater attention to what should be in the homeopathic curriculum (with a bias to "classical" principles) and less clarity about what exactly needs to be studied in the bio-sciences. Tomlinson also explores the possibility of a third model, which blends the two. This article is a good reminder that whatever path is chosen, must be consistent with Aphorism One of the Organon, and also be flexible enough to take account of changes within homeopathy beyond the last edition of that seminal work.

While dealing with acute rather than chronic case-taking, Robert Fordham's column, Education for Homeopathic Practice, An Acute Case-Taking Exercise, provides further insight into homeopathic education and the need to examine all factors affecting a patient.

As in other issues of Homeopathy Online, Ian Townsend provides us with an interesting case from his case files for Interactive Case Analysis. He states that this case illustrates certain aspects of the themes discussed in this issue.

Last, but by no means least, Chris Kurz' A Seminar With Faroukh Master provides an interesting link to the themes developed in this issue. In the first, an interview with Faroukh Master of Bombay, India (teacher of Rajan Sankaran and author of many books), Master speaks of the need for more structured learning, leaving seminars for more advanced education, and expresses concern about an over-emphasis in North America which are little used in practice. He also questions the increasing importance on psychological aspects of provings, noting the recent trend of interpreting dreams of provers to get at the meaning of the mind symptoms. In the notes on the seminar given by Master in California, Kurz notes Master's focus on the circumstances surrounding the pregnancy and birth in order to understand the child's case history, and also the need to get at the root cause of behaviour, particularly if there is some form of emotional stress.

This returns me to my thesis. Looking at homeopathy, the application of remedies based on matching similar energy patterns from a different perspective is not easy. As Michael Tomlinson points out, homeopathy has survived by being inherently conservative. But has it prospered?

The shift in perception needed to accommodate the cause-centered approach is equivalent to that needed in the middle ages when people had to accept that the earth revolved around the sun, and not the sun around the earth. The belief in the earth-centred universe persisted despite mounting evidence to the contrary. Rather than accept the shift in world-view, because of the religious and philosophical implications, changes were made to the charts of the heavens to account for the "anomalies." The charts became more and more complex, with ever more complex epi-cycles added to account for planetary movements that could only be properly explained if one took the view that the sun was the centre of our universe. This made for an awkward celestial chart, but it had the dubious value of preserving the prevailing theology and ideology dependent on the belief that the sun revolved around the earth. Similarly, in homeopathy we end up searching for more and more remedies to try to fit the complexities of the chronic disease symptom picture. There is also a growing body of literature that seeks to analyse the symptom picture from various perspectives (of pathology, acute state, constitutional state, miasms). All of these trends have existed since Hahnemann, but their application becomes increasingly complex. A causal approach allows us to approach the problem more simply. This can be seen in the case studies provided.

Approaching the problem of chronic disease from a sequential causal perspective is consistent with the natural process of healing, namely that the vital force will proceed in the reverse order of the disease process. Chronic disease is like a labyrinth with the threat of the Minotaur at every turn. In the Greek myth, Theseus was able to enter the labyrinth, slay the Minotaur and then find his way out of the labyrinth with the help of the thread given to him by Ariadne. Every sick person needs to retrace the steps of their personal labyrinth. To assist the healing, the homeopath needs to be there at every step to ensure than there are no blockages. We need to follow the thin, yet vital thread provided by the history of causes in order to help the patient re-emerge whole from their journey into the labyrinth of chronic illness.

The prevailing ideology in homeopathy is still symptomology. We can say that homeopathy operates in a symptom-centred universe. The evidence on the other hand is that when we are chronically ill, we exist in a world driven fundamentally by etiology (miasms and shocks in our life). The facts are the same, but it is only the perspective from which they are analysed that is different.

Through several articles and a series of cases this issue explores the place of cause in homeopathy. It also seeks to present a new approach to integrating the theory of chronic disease into therapeutics which has been tried effectively for over two decades and which is based "on easily comprehensible principles." I believe that this new approach is the key to integrating Hahnemann's theory of chronic disease fully into homeopathic treatment and making that treatment more effective in healing the many cases that no longer seem to respond to the remedy selected on symptomology.

I would not be surprised to find that the new approach proposed here will be controversial and opposed by more traditional homeopaths. It is, after all, nothing less than a shift in world views that is being proposed. I believe, however, that the proposed view is the logical culmination of what Hahnemann started in 1828 and towards which many homeopaths have, perhaps unknowingly, already been groping. This new insight into the origins of chronic disease in turn provides a more effective method of treatment and cure than has hitherto been possible.