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.

The second phase of homeopathy began with the rejection of allopathy (meaning, based on no guiding principles whatsoever) and antipathy (using the concept of contraries). The genius of Samuel Hahnemann was that he took one of several medical concepts, healing with similar substances, and provided convincing evidence that it was the natural law of cure. The other approaches were suppressive, damaging or palliative. Hahnemann then provided the means to apply it systematically to individual cases of disease. An idea is of little use if it remains a theory and cannot be systematically applied, as Hahnemann argued, on the basis of "easily comprehensible principles" (Organon, #3).

Hahnemann provided the means through the use of provings on healthy persons (a concept again which he had not invented, but used more systematically). These provings generated the materia medica pura. He also provided a means in the serendipitous discovery of the power of potentisation, which opened the door to healing through the use of bio-energy. All of this was set out in a series of writings which culminated in the publication of the first full description of this "new" method of healing Hahnemann chose to call homeopathy (similar suffering). This is the homeopathy of symptomology.

Hahnemann roundly rejected the allopathic attempt to find the cause of disease through dissection, chemical analysis, and endless theories. He ridiculed the allopathic battle cry, tolle causem (find the cause) and asserted that one could only know disease through the full individual (characteristic) symptoms of each sick person, the totality of symptoms. These were the language of the inner disturbance. One could not see the disturbance in health except through the outer expression graspable by the senses, the symptoms of the patient. Here homeopathy is firmly established as a symptomological universe. The cause of the disturbance to the vital force revolves around the symptoms produced by that disturbance. The proper focus for the physician applying the new knowledge of disease was to be the symptoms, not the apparent cause (what Hahnemann ridiculed as the proximate cause). To say that one is depressed because the chemicals in the brain or the endocrine system are imbalanced is to identify a proximate cause, but this begs the question as to what caused the chemical imbalance.

The third phase of homeopathy began when Hahnemann, ever the perceptive and honest observer, noticed that despite brilliant and quick cures of his patients' ailments, their underlying state of health often continued to worsen. Hahnemann faced a crisis of faith — either homeopathy was valid or it was not. He could not accept the latter and choose to look within homeopathy itself for the answer to his dilemma. Hahnemann was only working with a handful of remedies at the time, so he could have chosen to believe that the answer lay in the paucity of remedies and re-doubled his efforts at proving new remedies. He rejected this as the right explanation, however, on the grounds that the problem was not that the remedies had not acted, as they had, often brilliantly, but that they had not touched the underlying state of health (or ill-health) of the patient. This lead him to a twelve-year search for the answer to the problem.

The fourth phase of homeopathy is represented by Hahnemann's discovery and publication of his theory of chronic disease. Hahnemann himself recognised the radical nature of what he was proposing, and knew that it would meet much opposition. Indeed, it led to the first split in homeopathic ranks, and more or less destroyed what bridges there existed with the allopathic medical community in Germany and elsewhere. Doctors could accept the law of similars for it was a familiar concept, and they could accept, with some misgivings perhaps, giving small doses of medicines (Hahnemann was still working more or less with low potencies). However, the theory of a predisposition to disease that could be triggered by a parasitic (microbial) ineffective agent and then passed on to future generations if not treated properly was too much for most doctors at a time when the concept of infection was yet unacknowledged.

The break in homeopathic ranks is what interests us here, however. For what Hahnemann had done was nothing less than re-introduce the concept of causation into his system after he had seemingly chased it out. He recognised the important effect of this discovery of miasms on previous homeopathic philosophy right at the beginning of his book, referring now to the homeopathy of pure symptomology as "General Homeopathy." This could only mean that the rules of General Homeopathy, which are symptom-based, were solely applicable in cases involving natural diseases with few or no chronic elements (inherited predisposition or blockages to cure).