Causation in Homeopathy

Much of what is professed by the sequential therapist is based on the assumption that causation is superior to symptomatology in the processes of studying a homeopathic case. It is true that causation is an essential aspect of homeopathy that is often overlooked if the homeopath focuses in a one-sided manner on the totality of symptoms. In Aphorism 5 of The Organon, Hahnemann begins to introduce the information necessary to form a complete case with introduction of the subject of causation. Vide The Organon:

Constitution and Aetiology, Aphorism 5

Useful to the physician in attaining the cure are the particulars of the most probable exciting cause of the acute diseases, and the most significant point in the whole history of the chronic diseases, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relationships, his age, sexual function, etc., are to be taken into consideration.

From this aphorism we can see that the first attention of the homeopath should be focused on the basis of the constitution, temperament and aetiology as well as a study of the case history in the relationship to time and progression. On the basis of this study of constitution, causation, disease patterns and the miasms, Hahnemann introduces the doctrine of the totality of the symptoms in Aphorism 6, 7, 8. Vide Aphorism 7 of The Organon:

The Totality of the Symptoms, Aphorism 7

In diseases where there is no manifest exciting or maintaining cause (causa occasionalis) to be removed, we can perceive nothing but the morbid symptoms. Therefore, it must be the symptoms alone by which the disease demands and points to the remedy suited to relieve it (Taking into regard the possibility of a miasm and with regard to the accessory circumstances. Aphorism 5). The totality of these its symptoms, of this outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force, must be the principal, or the sole means, whereby the disease can make known what remedy it required--the only thing that can determine the choice of the most appropriate remedy.

Hahnemann reminds one in this paragraph that the homeopath must take into account exciting, maintaining, and fundamental causes such as the miasms, while recording the totality of the symptoms. The signs and symptoms are a very important aspect in clarifying the nature of the causation and highlighting its effect. Thus in Hahnemannian Homeopathy, equal emphasis is placed on the innate constitution and its predisposition (the individual), aetiology (causation) and symptomatology (effects) when forming a complete homeopathic anamnesis. The details of the case history should then be studied in relation to how the causations, signs and symptoms developed and in what exact order. This brings us to one of the cardinal points raised in Sequential Therapy, the concept of the time-line and its relationship to the aetiology and the healing process.

The first time I really understood the importance of the theory of time and progression in chronic disease was when I came across the teachings of the late, great, Dr. M.L.  Dhawlae of Bombay. This was in 1981, when I was new to India and was amazed by the depth of treatment I was witnessing. Dr. Dhawlae stressed the nature of the time-line in relation to Hering's Laws and the reversal of the developmental order during healing. This provides one with an understanding of the fourth dimensional aspect of disease, which is its chronological and spatial movement in relation to causation and symptomatology. To treat a case while following the time-line backwards was a great breakthrough, as it made the path of healing clear and logical.

Over the last 15 years I have paid special attention to the chronological order of the aetiological layers and their symptom syndromes. I study this closely in every chronic case, as it often holds keys to finding the correct remedy, to forming a treatment plan, and it is essential for proper case management. Indeed it was Hahnemann who first observed the time-line in the relationship of the progression of disease and its reversal under a properly chosen homeopathic remedy. Vide The Chronic Diseases:

The Reversal of the Symptoms

The latest symptoms that have been added to a chronic disease which has been left to itself (and thus has not been aggravated by medicinal mismanagement) are always the first to yield in an anti-psoric treatment; but the oldest ailments and those which have been most constant and unchanged, among which are the constant local ailments, are the last to give way; and this is only effected, when all the remaining disorders have disappeared and the health has been in all other respects almost totally restored.