Remedy Kit

I'm posting these blurry pictures of my first remedy kit. I was suprised to be encouraged to purchase a kit and to start to try things out on the first weekend of the class; this was a clear contrast to medical school and it took me some time to get used to the idea of prescribing when my knowledge was still in such a rudimentary state. I'm in the process of writing up some of my first experiences...

Homeopathy Conference

I'm going to the national homeopathy meeting in April 2006:

http://www.homeopathic.org/cf06.htm

It looks interesting. There is a one-day preconference on research, and a talk on cost-effectiveness (an area I have worked in in the past). I get to see what all the authors of the textbooks I am reading look like (those that are alive, that is).

I'll be flying with Nomadic Healer. This will be my first trip to San Jose; if anyone has good restaurant (or other) recommendations, please let me know.

LIfe-force in Hahnemann's thought and in Judaism

The life force is an essential concept in homeopathy. According to Hahnemann: "in health, a spirit-like force 'enlivens' an individual; the rational spirit is free to use the self as an instrument to achieve the higher purpose of existence" (9). It is not clear to me thus far if the life force, in Hahnemann's view, tends towards the higher purpose of life or if this is something that completely comes from the rational spirit. I expect this is something that will become more clear to me as I have the opportunity to become familiar with Hahnehann's thought.


In Judaic thought (as I understand it) "life force" is more or less synomonous with "soul". The soul is conceptualized as having five levels of progressive refinement:

• The first level, NEFESH, is very subjective and focused on self; this subjectiveness blurs awareness of G@D***
  
• The next level, RUACH, is described as emotional awareness
• NESHAMA, the third level, represents passive creative imagination and active creative thought.
  
• On the fourth level, CHAYYIAH, life experience is connected to G@D
  
• On the fifth level, YECHIDAH, the soul is unified with G@D ^^^

The soul is felt to be given by G@D (which is the ultimate good), and with refinement the soul becomes progressively able to appreciate this good. The purpose of existence on a human plane is to create a receptacle for G@D on the physical plane.

In Hahnemann's thought, since the disease, the medicine, and the life force are all active on the same plane, the way to influence the life force and heal the suffering life force is through medication. The medicine is stronger than the disease, but resonates with a similar pattern. When the medicine is administered, it grabs and subsumes the disease like a larger flame would subsume a smaller flame. The medicine is not self-perpetuating and its resonance will die away, taking the disease which it has subsumed with it and leaving the life force of the individual to function normally.

The flame analogy has been used in Judiasm to describe the connection between the soul and G@D. In proverbs, 20:27 it is written: "A light from G@D is the soul of man, revealing all man's innermost parts." A jew is commanded to love G@D with all one's heart, all one's soul, and all one's resources. This is accomplished through patterns of individual and group behavior and prayer. Examples of behavior:

• ceasing from labor and experiencing a day of rest, peace, and enjoyment one day a week
• guarding speech to avoid saying bad things about other people (because speech has creative power)
• making blessings before and after eating

Examples of some individual prayers include;

• upon arising: "I give thanks before you, living and eternal ruler, for you have returned with me my NISHMATI with compassion, abundant is your faithfulness!"
• upon putting on the prayer shawl: "I am ready to wrap my body in the prayer shawl, so may be wrapped NISHMATI and my organs and sinews in the illumination of the prayer shawl...rescued may my NAFSHI, my RUHI, my NISHMATI and my prayer be from the external forces...."
• as part of the morning prayers: "My G@D the NESHAMA you have placed within me is pure. You created it, you fashioned it, you breathed it into me, you safeguard it within me, and you will eventually take it from me and restore it to me in the time to come. All the time that the soul is within me I give thanks before you G@D and the got of my ancestor, master of all works, lord of all souls. Blessed are you who restores souls to the bodies that are dead."

There are probably parallels between the mechanism of homeopathic homeopathic medicine in transformation of the life force as described by Hahnemann's and some very ancient Judaic healing practices. This would be a great topic for further exploration as I go through my training.

***(I'm writing G@D with a symbol "@" in place of the "O", because Jews don't believe that the concept of G@D can be expressed by anything having the limitations inherent in a single human-uttered word. Jews therefore have a practice of not saying or writing the word, lest we begin to accept G@D as a principle limited by the word "GOD". Very pious people will just say "ha-shem" (translation--"the name") when they want to refer to G@D. I have found this to be a very nice practice for getting rid of any pre-conceived notions one has about G@D)

^^^(This is from Mishnah Rabbah, Genesis 14:11 by way of Rabbi Gershon Winkler in "The Soul of the Matter, Judaica Press, Brooklyn, NY, 1981, p7).

How are symptoms used in homeopathy?

Symptoms must be present in order to use a homeopathic approach (aphorism 13). Each homeopathic medicine will cause particular symptoms in healthy people, and this disease-engendering power" indicates the particular medicine's particular "disease-curing power" (20, 21). A medicine which causes a particular symptom complex in healthy individuals is given to an ill individual exhibiting this symptom complex. When illness is cured (and "integrity" of the life force is restored), the symptoms disappear (12).

"Disease" in Homeopathy vs. Allopathy

Hahnemann writes quite disparingly (and entertainingly) of the "calamatious art" of "allopathy". He coined this term for the standard academic form of medicine practiced in the Western world during his lifetime, 1755-1843. He write that the goal of "allopathic" medicine is to supress symptoms with medicines that oppose them. This is in contrast to "homeopathy", which treats disease with medicines which would create symptoms similar to those a particular disease in a healthy individual. Hahnemann faults "allopaths" for losing site of the goal of "curing" the patient in their quest to intellectually understand the cause of the disease, and for failing to see that superficial symptoms as the result of an underlying process. He characterizes the allopathic conception of disease as a wholly material one which fails to grasp and adress underlying dynamic processes.

It is easy to share Hahnemann's disgust with the crude medical techniques of his time such as bloodletting and the use of hazardous substances such as mercury in high concentrations. It is problematic, however, to operate under the assumption that medicine has not evolved over the past 150 years and to therefore generalize Hahnemann's descriptions of "allopathic" medicine to conventional medicine as practiced today. As a fairly recently trained and practicing MD, while some of Hahnemann's descriptions strike a familiar note, it is difficult for me to see medicine in such a black and white way. I'm not sure that "allopathy" as described by Hahnemann actually exists today in practice. The most striking similarity for me is medicine's preoccupation with describing disease processes intellectually and sometimes losing site of the goal of curing the patient.

Hahnemann describes disease as a (aphorism #s in parentheses) a "spirit-like force" (16) which works through a "morbific agent inimical to life" (11) "disturbing" (8), "mistuning" (10) and causing the life force to "suffer" (7). A disease "disturbs health (4), leads to "irregular functioning and symptoms (11), and prevents the "rational spirit" from using the self "as an instrument to achieve higher purpose of existence (9). Diseases are "not separate from the living whole"(13). They do not have "absolute power", but only affect individuals who are "exactly and sufficiently disposed ...to be assailed (31) In addition, they are weaker than properly chosen and diluted homeopathic medicines(27).

Some of what Hahnemann describes as techniques of the physician such as "removing obstacles to recovery" (3) and taking into account, "constitution, character, occupation, lifestyle, relationships, age, activities" (5) are not the sole providence of homeopathy. Good lifestyle practices like a healthy diet and physical activity do not create disease in healthy people and are therefore not homeopathic and are utilized by many types of clinicians. Similarly, a good clinician would take many characteristics of the patient into account during diagnosis and treatment, but a non-homeopath would use this information differently than a homeopath.

What is a Wesen?

A word Hahnemann uses a lot, which I'd never heard before, is the word "wesen." No English word completely captures the meaning of this word. The word represents the dynamic, as opposed to the material, aspect of a thing; these aspects are not actually seperable, but can be viewed as seperate entities for the sake of discussion. Additionally, the "wesen" of something is characteristic and essential to that thing. As a dynamic thing, it perpetuates itself.

According to Hahnemann, human beings, medicines and diseases all have "wesens". He refers to these "wesens" in the first 34 aphorisms of the Organon. The "wesen" of a human being is what "enlivens" the material aspect of the person, giving it the ability to sense what is outside it, to be active, and to preserve itself. The "wesen" of a disease, is the "suffering of the life force", which is reflected in the totality of symptoms exhibited by the patient. The "wesen" of a medicine is its "spirit-like power to alter the human condition and cure diseases"; each medicine's unique "wesen" is only perceptable by the symptom pattern it causes in a healthy individual. O'Reilly points out that, "the life force, diseases, and medicines are all operating in the same dynamic dimension."

The Organon: 291 Aphorism's of Samuel Hahnemann

I am reading the "bible" of homeopathy, "Organon of the medical art" by Samuel Hahnemann. It consists of a series of 291 Aphorisms. Like Jews read the Torah once through every year, it is suggested that homeopaths read this "bible" once a year.

I'll outline the aphorisms below (at least the ones I'm supposed to read for the month of October):

1. The physician's only job is to make the sick healthy.
2. A cure should be rapid, gentle, and permanent.
3. To cure, the physician must understand the disease, understand the medicine, select the right medicine and give it properly and remove obstacles to recovery.
4. The physician must know what disturbs health and maintains disease and be able to remove them from healthy people.
5. The physician should attempt to discern the "occasion" of an acute disease and the most significant factors of a chronic disease, taking into account constitution, character, occupation, lifestyle, relationships, age, activities. "The fundamental cause of a protracted wasting sickness mostly rests upon a chronic miasm"
6. The disease is represented by perceptible signs.
7. The totality of symptoms = the outwardly reflected image of the inner wesen of the disease=the suffering of the life force; this points to the medicine
8. When the totality of sx is removed, health remains (disease is not a material thing; it is a disturbance of the life force.
9. In health, a spirit-like life force "enlivens" an individual; the rational spirit is free to use the self as an instrument to achieve higher purpose of existence
10. The material organism can't do anything without the "immaterial wesen" or life force
11. Illness results from "mistuning" of the life force (through a "morbific agent inimical to life", leading to irregular functioning and symptoms
12. When illness is cured, the "integrity" of the life force is restored and the symptoms disappear
13. Disease is NOT an "inwardly hidden wesen separate from the living whole"
14. Everything that is "curably diseased" expresses perceptible symptoms
15. The material organism + life force = the unity of the individual; these are inseperable but we separate them conceptually for purposes of discussion.
16. Only the spirit-like can affect the spirit-like life force to cause disease, and only spirit-like medicines can be used to cure it.
17. Curative medicines will take away the entire symptom complex of disease (ie the totality of the disease or the disease itself since not separable); the only goal of the physician is to do this.
18. The totality of disease is the only indicator of the choice of remedy.
19. Medicines work by "differently tuning" the human condition.
20. The "hidden spirit-like power in the inner wesen of medicines" is only discernable through its manifestations while "impinging on the human condition"
21. The only knowledge we can obtain about medicines is through the ways in which they "differently tune" a healthy person; this "disease-engendering power" = the "disease-curing power" of each medicine.
22. Medicines cure by causing an "artificial disease state" which "lifts and eradicates" the symptoms already present and should be chosen based on the totality of sx present in the patient.
23. If a medicine causing symtoms "opposite" to the disease symptoms are used, this may cause short-acting palliation, but not permanent cure ("antipathic, enantiopathic, or palliative method")
24. Only the homeopathic method is promising against disease.
25. Medicines cure those diseases whose symptoms resemble their own.
26. homeopathic natural law: "In the living organism, a weaker dynamic affection is permanently extinguished by a stronger on, if the stronger one is very similar to the weaker one in its manifestations"
27. Medicines should therefore have similar symptoms but stronger power than disease.
28. This can and has been shown empirically; it does not matter how it works.
29. The mechanism is as follows: 1) disease mistunes life force 2) homeopathic cure "seizes" life force 3) stronger medicine extinguishes weaker disease and life-force is "occupied soley" by artifical "disease-affection" 4) the artificial "disease-affection" plays itself out, the patient is "free and recuperated", and can continue life in health
30. The body allows itself to be more "effectively altered in its tuning" by medcines than by natural disease irritants, partly because the dose adjustment is controlled by the physician
31. Diseases do not have "absolute power" to "morbidly mistune" the human condition; the organism must be "exactly and sufficiently disposed and laid open to be assailed by the cause of disease that is present"
32. Medicines (ie--"artificial disease potencies") do have absolute power; peculiar sx will be distinctly conspicuous if the dose is large enough
33. 31 and 32 above have been shown by experience.
34. For a medicine to work it must be 1) given in the correct dose and 2) must be "capable of causing an articicial disease similar as possible to the disease to be cured"

Introduction

While I was in medical school, I heard the following quote about the speciality of internal medicine, "we don't get anyone better, but we have a lot of fun." As a general internist, I’ve found that the first part of this statement has a ring of truth to it. My medical training has been valuable in terms of offering me skills in interviewing patients, examining them, and working them up with diagnostic testing, but if I really want to get anyone better, I'm on my own.

Quite honestly, most of my successes in practice have come through the use of targeted nutrition and exercise interventions. Arguably, these should be part of the toolbox of any doctor but most often are not. I’ve found that these things have enabled me to do good, but I’ve often been frustrated by patients with crippling physical or emotional symptoms, who don't seem to fit into any diagnostic pattern I can identify. With these folks, I've tried the lifestyle approaches without any success and have referred to multiple specialists without reaching any definitive diagnosis or any useful therapy. In studying homeopathy, I’m looking for an effective approach to these “difficult” patients.