Overview of Classical Homeopathic Philosophy

Classical homeopathy rests on a rich philosophical foundation first established by Hahnemann in his Organon of the Healing Art at the turn of the nineteenth century and refined over the past two centuries since.

Homeopathy is rare among systems of medicine in possessing a clear and thorough view of the dynamics of health and disease. In homeopathy disease is regarded as an affection of the spiritual core of the person, and the treatment of disease is guided by specific laws of healing.

The Law of Similars

First, the law of similars calls for the application of remedies made from substances whose pattern of illness best matches that of the person. This is the fundamental law of homeopathy, and the term homeopathy (“homeo” + “pathy”, from the Greek homoios [similar] and pathos [suffering]) derives from this idea. The pattern of illness is determined through a combination of sources including formal experiment and collected clinical data (as will be explored in future posts).

The Single Remedy

Second, the disease pattern encompasses the whole being of a person, so classical homeopathic treatment usually consists of prescribing one remedy at a time even when multiple symptoms are present, in order to address the (singular) spiritual cause of illness. A homeopathic remedy is a specially prepared formulation originating in some natural or synthetic substance and used in homeopathic treatment.

Individualization of Treatment

Because the single remedy depends on many factors and not just on the presenting complaint or medical diagnosis, the remedy is necessarily custom-fit to each and every patient. Thus homeopathy is said to offer an individualized prescription that cannot be predicted in advance of case analysis.

Suppression

Fourth, classical homeopaths are very attentive to the phenomenon of suppression, and carefully distinguish between it and true curative action. Suppression happens when symptoms disappear under some treatment but the person as a whole feels worse (more tired, depressed, or otherwise lacking in vitality). Many conventional and alternative therapeutic approaches rely on suppressive treatment (and sometimes suppression is necessary and even life-saving), but it is a harmful approach in the long term.

Order of Healing

Fifth, homeopaths note that usually healing under homeopathic treatment (or any other treatment that respects the natural laws of healing) takes place in a certain order of healing. During homeopathic treatment the following are positive indicators of correct (non-suppressive) healing:

  1. Past symptoms or sensations will frequently reappear (in weaker form and for a shorter period) before disappearing for good.
  2. In cases of deep pathology, symptoms relating to vital organs will improve first while superficial tissues (such as the skin) will improve later on.
  3. The head and upper body will tend to improve before the lower body and legs

Throughout treatment, it is essential for both the homeopath and the patient to respect this natural hierarchy of healing and not interfere with it.

The Minimum Dose

Finally, the ideal of minimum dose was the main reason that compelled Samuel Hahnemann (the founder of homeopathy) to establish a new system of medicine in the first place. Working as a conventional physician in late-eighteenth-century Germany, he was looking for a way of reducing the side-effects from the aggressive medical approaches of the time (which included the frequent use of mercury and bloodletting). Through this he was led to the serendipitous discovery that whenever there is a correspondence between remedy and disease state (following the law of similars), a medicinal effect will persist even if the original substance is diluted so much that it is no longer present in chemical form.

In summary, classical homeopathy rests on (1) the law of similars, (2) prescribing one remedy at a time in (3) individualized form, (4) avoiding suppression by (5) respecting the natural order of healing, and (6) prescribing the minimum possible dose required to achieve a therapeutic effect. This means that whenever a practitioner claiming to be practicing homeopathy does not respect one or more of these principles, he cannot be said to be practicing classical homeopathy, the original and still most-effective form of homeopathy.

How a Unique Diagnostic Method Results in Superior Clinical Effectiveness

You already know or at least assume that homeopathy is ‘holistic’ just like other forms of alternative medicine. Homeopaths will consider all of the patient’s complaints in their diagnosis, will strive to make the patient better on the whole, and so on.

This philosophical basis is of course the ideal foundation of all forms of natural medicine, and are embodied in the principles of naturopathic medicine. But there are features which further distinguish classical homeopathy even from many forms of alternative medicine. The following is one such feature.

Homeopathyic diagnosis leads directly to treatment

What makes the homeopathic perspective especially powerful is that the homeopathic diagnosis leads directly to homeopathic treatment. This is markedly different from conventional medicine where a clear diagnosis does not necessarily guarantee clear or effective treatment.

For example, in the case of the very common condition of hypertension, diagnosis is simple — three repeated blood-pressure measurements exceeding 140/90 are usually considered diagnostic — but treatment involves the permanent intake of drugs which do not resolve the underlying problem and cause side-effects of their own. Similarly, in autoimmune diseases such as asthma, allergies, arthritis and various skin conditions, diagnosis will often be obvious from the clinical signs, yet treatment is both usually complicated and frequently ineffective.

The homeopathic diagnostic method

Homeopathic diagnosis relies on a sophisticated and thorough clinical methodology. A typical first appointment lasts 1 to 2 hours or more, during which the patient is asked to describe his or her concerns in great detail (if needed, with the assistance of family members).

With the help of very specific yet open-ended questions the patient is led exactly to describe the symptomatology and own experience of the disease. Following that, areas which the patient has not already touched on are enquired about: major illnesses, traumatic events, childhood history, recurrent dreams, fears, food cravings or aversions, reaction to weather, etc. This allows for information from diverse aspects of the patient’s life to be used in determining the picture (recurrent pattern, morphology) of the disease.

The resulting diagnosis is only mildly dependent on the diagnostic label (‘flu’, ‘diabetes’, ‘depression’); rather, it is based mainly on many small details about the pathology (when did it begin in relation to stressful events in the person’s life? what is the exact sensation? what factors make it better or worse?) and about the person in general (stress factors, lifestyle and hobbies, physical constitution). So it may happen that two people with arthritis will receive completely different homeopathic treatment, and conversely that one homeopathic treatment can be effective for addressing multiple diseases.

This clinical approach, unique to classical homeopathy, results in superior clinical effectiveness by addressing much beyond the patient’s chief complaint. Homeopathic treatment typiclaly improves secondary complaints (in those who have more than one illness), and will increase energy, improve mood, and enhance overall vitality and joy-of-life

The Initial Homeopathic Intake

The first consultation in homeopathy, also known as the initial homeopathic intake, lasts about two hours for chronic complaints and as long as needed in the case of acute complaints. It is the beginning of an often fascinating journey of healing and self-discovery. A well-performed initial assessment provides the homeopath a solid foundation to guide the patient through this journey.

The interview process

The homeopath begins by listening to the details of the patient’s ailments as well as anything else that the patient feels is relevant to the case. In addition to eliciting objective symptoms relating to these complaints, the homeopath, through the use of many open-ended questions, encourages the patient to describe his or her exact experience of the illness or discomfort in progressively greater clarity, depth, and detail.

The aim of this interview process is for the homeopath to perceive the inner state of the patient, a single state that best points to the correct single prescription. This inner state is expressed through mind and body but is deeper than both. Although in everyday life many of us remain unaware of it, it is constantly expressed in the way we speak and interact with others, in what we choose to do in our spare time, in how we dress, and (often most clearly) in the content of our dreams.

How does the homeopathic assessment differ from a conventional one?

Unlike a conventional medical intake, which follows a preset formula whose goal is to choose from a relatively limited set of diagnoses, a homeopathic intake is open-ended. Because the homeopathic diagnosis is based on a wide variety of factors (including how the person reacts to the interview process itself), the homeopath gives maximum room for the patient to describe the ailment exactly as he or she experiences it.

This seemingly peripheral information is often more important than the objective information that medical doctors typically rely on, and it forms the basis of the homeopathic diagnosis. There are literally many hundreds of homeopathic remedies, which means that correct diagnosis requires great precision in understanding the patient’s state.

This elaborate interview process, when competently guided, inevitably leads to a holistic view of the patient’s state, and to a perspective that ties together seemingly disparate phenomena into a unified story and portrait of the illness at hand.

Basics of Homeopathic Case Analysis

In The Initial Homeopathic Intake I outlined what takes place the first time a patient meets a homeopath. The aim of the entire initial-interview process is to distill the portrait of disease, which can be physical, psychological, or spiritual in nature. But it now remains to translate this information, often referred to as the “totality of symptoms,” into a working diagnosis.

This totality is a carefully selected subset of the collected symptoms, one which emphasizes certain symptoms while de-emphasizing others. The least-important symptoms for determining the homeopathic diagnosis are general symptoms that lack qualities that differentiate them from person to person. Such symptoms are considered common, and they are rarely useful in pointing toward the correct diagnosis. Uncommon symptoms, on the other hand, are homeopathically the most important. They can be described as strange, rare, or peculiar:

  • Strange symptoms are ones that do not make sense from a logical point of view, for example a “pounding headache made better by hitting the head against a hard surface.”
  • Rare symptoms are phenomena observed only in unusual cases in the population at that time and place, for example a case of tuberculosis in contemporary North America.
  • Peculiar symptoms are very detailed symptoms whose presentation is unique, for example a “tickling sensation inside the left knee felt only when drinking water.”

Whether common or not, symptoms belong to one of two categories — pathological or characteristic:

  • Pathological symptoms are those that are bothersome to the patient or problematic from a medical point-of-view. These include physical pathology, pain, unpleasant sensations, and thoughts or feelings which interfere with normal functioning.
  • Characteristic symptoms that are phenomena that are non-pathological but nevertheless individualize the patient by distinguishing him or her from everyone else with the same pathology. These include details of the patient’s personality, reactions to external influences of food, weather, and the like, and significant past events in the patient’s personal and family history, such as accidents, emotional trauma, and serious disease. To these are added the homeopath’s observations of physical appearance and behavior.

The categorization of symptoms just described is in reality a highly refined art that can only be roughly sketched in words, an art which combines clinical experience, intuition, and a deep knowledge of human psychology. When correctly practiced, this method forms the first step of case analysis in classical homeopathy.

This and subsequent steps (which will be outlined in future posts) together aim for the ideal of individualization of treatment: each and every homeopathic patient is given a blank slate on which to draw his illness, and each will ultimately receive a different homeopathic treatment from the next patient complaining of the same ailment.

Basics of the Homeopathic Prescription

The homeopathic prescription, similarly to a conventional medical prescription, consists of the homeopathic remedy to be prescribed based on the homeopathic case analysis just performed, and the dosage, which in turn consists of potency and frequency of intake.

What is ‘potency’?

Potency basically refers to the strength and depth of effect of a homeopathic remedy. Potency is expressed in terms of the number of times the remedy has undergone the process of dilution and succussion (as described in The How and What of Homeopathic Remedies), and the factor of each dilution (1:10, 1:100, or 1:50,000).

Higher potencies are stronger-acting than lower ones, even though they are apparently more diluted (remember that the effect of the homeopathic remedy is not chemical, so the concentration of the original substance is unimportant to the potency). This counterintuitive fact is proven as valid in everyday clinical practice.

Frequency of intake

In the case of acute illnesses, homeopathic remedies are in a frequency proportional to the severity of the condition. For example, a stroke victim will receive a remedy once every minute or two to begin, then once every few minutes, and several times daily in the few days which follow. On the other hand, treating the common cold might require one to three doses per day.

In the case of chronic illnesses, where remedies are used in order to effect a gradual, deep change in the organism over many weeks and months, there are generally two styles of prescription. The first is the “single-dose, wait and watch” approach, whereby a single dose, usually of high potency, is given. Following this the patient’s state is observed for a while without further intake of the remedy.

How is it possible to give a remedy once and then wait for weeks or months with no further action? The answer to this lies in the fact that the homeopathic remedy does not cure directly. The effect of the homeopathic remedy is not like that of a medication, which attempt to cure directly but frequently cause symptomatic relief or suppression of symptoms. The action of the remedy is indirect, whereby it stimulates the organism’s self-healing capabilities.

The action of the homeopathic remedy is thus like that of a catalyst. Catalysts are used in chemistry to stimulate reactions to progress at a much faster rate than otherwise. Many chemical reactions that take place within seconds with the help of a catalyst would take many thousands of years to occur naturally. Similarly, the homeopathic remedy accelerates the body’s self-healing capacities . This is why a single dose of a remedy could, under the right circumstances, produce a long-lasting reaction from the organism. This reaction often persists for several weeks to several months before before further dosing is required.

The second approach involves regular (usually daily) dosing using a relatively low potency. This is done in some cases where a high potency might produce too strong an effect, or as a routine way of prescribing which avoids some potential pitfalls of the single-dose approach. For example, stressful circumstances and some other antidoting factors can blunt or even reverse the effects of a single dose, resulting in treatment delays if this is not addressed promptly by redosing once more, a step which usually requires a careful assessment by the homeopath. Another difficulty with the single-dose approach is determining exactly when the effect of the present dose has been exhausted sufficiently to warrant another dose.

On the other hand, the daily approach is frequently more agreeable to patients, many of whom feel uncomfortable with the idea of taking their “medication” only once every few weeks. The approach is also easier to customize to the patient’s particular condition, allowing for increased control of the pace of healing by the homeopath.

For much of the history of homeopathy the single-dose approach was dominant in the treatment of chronic disease. But because of the expectations of modern patients, and complicating factors that largely relate to modern living, it is becoming increasingly common to prescribe homeopathic remedies on a simple daily schedule, reserving the single-dose approach for small children (who respond very effectively to remedies) and rural people who live a healthier life under fewer environmental stresses.

Dispensing the remedy

The homeopathic remedy can be dispensed either in liquid form or in tablet form. The liquid form is based on a water-and-alcohol mixture, whereas the tablet form is made of sucrose or lactose suffused with the homeopathic remedy.

The choice of format is based sometimes on personal patient considerations, and sometimes on therapeutic considerations. For example, those averse even to the small amount of alcohol found in a daily homeopathic dose can opt for tablets; children can be give the sweet tablets to encourage intake, or conversely the liquid form to avoid sugar intake; those who are lactose intolerant can opt for sucrose tablets or the liquid form; and so on. In addition, there are subtle differences between the effect of these two formats of the homeopathic remedy that might also dictate the choice between the two.

Whatever the starting potency, frequency of intake, and physical format — as determined by the homeopath for each and every patient — the homeopathic remedy is taken over a period of time during which the dosage (potency and frequency of intake) is continually adjusted based on the progress of each individual patient. This homeopathic treatment is not only individualized with respect to the remedy given, but also to the management of the case.

The Followup Appointments

After the first prescription the patient returns for regular appointments so that the homeopath may determine the response to it and decide what to do next. These visits are scheduled once every few weeks—more frequently at first and less so as treatment progresses. The whole process of interview, analysis, and prescription is repeated during every appointment, albeit on a smaller scale than during the first visit. Just as important, the patient and homeopath continually discuss the patient’s experience of illness in order to facilitate the long-term spiritual healing that most patients ultimately desire and which classical homeopathy is capable of facilitating.

The How and What of Homeopathic Remedies

Classical homeopathy depends for its clinical effect on a homeopathic remedyremidies, remadies. A successul prescription requires a properly prepared remedy made from the correct source material as determined individually for each person.

Homeopathic remedies are made from a seemingly limitless variety of substances, but all of them share a similar preparation process. It is the specialized process of preparation that makes homeopathic remedies unique. In addition to being prepared correctly, a homeopathic remedy must be prescribed correctly according to the principles of homeopathic philosophy in order to act effectively.

Sources of homeopathic remedies

Each homeopathic remedy originates from a any one of a huge variety of substances of natural or man-made origin. Remedies can be prepared from various minerals, from plants, from animal products, from synthetic chemicals, and even from sources of radiation such as x-ray.

Samuel Hahnemann (the founder of homeopathy) prepared his first homeopathic remedies from substances that were in medicinal use at the time: chemicals such as mercury, silver, and sulphur; plants such as Belladonna and quinine; and animal products such as musk. By the time of his death in 1843 Hahnemann had prepared around 100 remedies.

Homeopaths that followed him have expanded the selection of remedies to well over 1000, preparing many remedies also from many more chemical and plant sources, from animal sources such as snake poisons, from microogranisms, and from various synthetic chemicals.

Remedies are prepared by alternating dilution and ‘succussion’

Whatever the source, the starting material is next dissolved in a mixture of water and alcohol. Soluble substances are dissolved directly, whereas insoluble ones need to be ground to a fine powder before they can be dissolved. Following the initial dissolution of the substance, the remedy is prepared by a serial process of alternating dilution and succussion. Dilution involves taking one part of the original solution and diluting it in a much larger portion (usually 10 or 100 times as much) water. Succussion involves vigorous mixing of the solution — a specialized process which is unique to homeopathy.

The entire process of dilution and succussion is repeated anywhere from three times to many thousands of times. This is nowadays performed by homeopathic pharmacies with the help of specialized equipment that automates this otherwise tedious process.

Final product

Regardless of the source product, the remedy is dispensed either in liquid form or as sugar-based tablets suffused with the mixture. The remedy contains very little or none of the original substance, because the process of preparation has diluted away the original substance to such an extent that there is no possibility that its action is through chemical means. Because of the remedy’s ultra-diluted nature, the patient need not ever worry about ingesting a harmful substance or about chemical interaction with other medications.

Mechanism of action

The claim that the homeopathic remedy does not act through chemical means alone makes most people view the claims of homeopathy with disbelief, because all medicines are assumed to work through chemical means. But the only effect that homeopathic remedies could have is through a mechanism, possibly electromagnetic in nature, that is still not understood by science but nevertheless is shown to work in the clinic.

Although homeopathy continues to be shunned by most scientists, in recent years several clinical trials have provided results that provide support for the mysterious efficacy of homeopathy, and research in the field is gradually becoming more and more widely known.

The Distinction Between Classical Homeopathy and Naturopathic Medicine

Homeopathy is very often confused with other systems of alternative medicine.

The first reason is that the term “homeopathy” is little-known and is often confused with other, similar-sounding terms. But underlying this linguistic confusion is the fact that most people know little more than what they pick up from the media. This state of confusion extends even to many patients of homeopathy.

Homeopathy’s exotic appeal

The word “homeopathy” has an exotic ring to it that has lent to its being used in advertising a whole range of health products, mostly ones that have very little if anything to do with homeopathy. Thus it is very common to find people promoting some “homeopathic remedy” that has helped them or, conversely, complaining about how the “homeopath” that they visited failed to help.

Telling homeopathy apart from other natural therapies

Because of patients’ confusion about the matter, it is important to outline some distinctions between homeopathy and other systems that are at best cousins rather than siblings of homeopathy.

One of those is naturopathic medicine, a medical movement and profession that has recently positioned itself at the forefront of health-care innovation in North America, and is beginning to exert a worldwide influence.

Naturopathic medicine is a comprehensive medical approach which integrates scientific knowledge with several well-established alternative therapeutic systems. It combines what has been known as naturopathy (an approach based on correct living, optimal nutrition, and herbal medicine) with up-to-date medical knowledge and a multifaceted perspective on healing.

The scope of contemporary naturopathic medicine

In addition to the methods of traditional naturopathy, naturopathic medicine currently encompasses the use of Chinese medicine and acupuncture, classical homeopathy, physical manipulation, and more. Practitioners known as “Naturopathic Doctors” usually possess a common medical educational basis followed by a specialization in one or more of these disciplines, including homeopathy.

In contrast, a “Homeopathic Doctor” is generally a practitioner who has been trained as a naturopathic or a medical doctor before specializing in classical homeopathy, while a “homeopath” is a practitioner who has not had extensive medical education. But because there is no worldwide consensus about these terms, they are often used interchangeably.

Homeopaths focus on spiritual aspects of health

While homeopathic doctors do encourage a healthy lifestyle with proper nutrition, their treatment focus is not on the material aspects of health but on its spiritual aspects. Often people who consult with homeopaths have already made significant changes in their lives, but find these changes ineffective or else overly restrictive. In these cases there are internal factors that contribute to ill-health, such as a fixed way of thinking or of perceiving things in daily life.

The influence of vitalism

Ultimately naturopathic medicine, homeopathy, and other natural method all share in the ancient philosophical roots of vitalism. To read more about these shared vitalist roots, see The Influence of Vitalism on Naturopathic Medicine.

The Influence of Vitalism on Naturopathic Medicine

The philosophical perspective on which the naturopathic clinical approach is based is that of vitalism. According to vitalist philosophy, living beings are not machines running according to strict cause-and-effect relations, but are beings whose existence is guided by a single vital force.

This runs contrary to the “mechanistic” view underlying conventional medicine, which is based on the principle that it is possible to subdivide the body into components and analyze their function independently of the rest of the body. Following this subdivision, medical scientists commonly ‘put it all back together’ and assume that the models they have just created correctly represents real-life patients.

Sometimes their models are sufficiently true-to-reality, and conventional methods then prove effective. But often enough their models will not accurately represent the patients in front of them, and in such cases medicine will not provide adequate solutions.

What we’re made of (according to vitalists)

While vitalists admit that the mechanistic perspective of modern medicine is often very useful, they insist that it is limiting in many cases and ultimately incorrect. Vitalists claim that a more accurate way of analyzing people is by noticing their pattern of being.

Each of us is imbued with a vital force which guides and unifies our being. Its components are not body organs, tissues, cells, and molecules, but components such as:

  • heredity
  • early childhood environment
  • family relationships
  • social environment
  • temperament (psychological tendencies, strengths, weaknesses)
  • past medical interventions
  • past physical or psychological trauma
  • stressful life transitions
  • food intake
  • physical activity, and
  • exposure to environmental toxins.

Together these constitute the complex web of interacting factors that form the corporeal (physical) and spiritual (non-physical) self.

What vitality is (according to vitalists)

Vitalists and non-vitalists differ in their understanding of health. Mainstream scientists and modern medicine (following a non-vitalist philosophy) reject the non-physical self, while vitalists embrace it. Although many scientists believe in elements of the vitalist tradition, when they publicly discuss psychological phenomena they usually insist that they are talking simply of the operations of the brain. But vitalists analyze bodily illness mainly in terms of the spiritual factors that might be contributing to it.

In other words, the person’s spirit or vital force determines the health of the body in a very real way. Vitalists point to the fact that we often feel better or worse depending on the extent to which we are able to be the masters of our life, especially during times of stress. Disease, accoring to vitalists, is simply a more advanced stage of the stress that we exhibit when we persistently fail in the pursuit of physical and spiritual goals.

Clinical implications of vitalist philosophy

The vitalist philosophical perspective translates into naturopathic treatment methods that do not target symptoms directly but instead strive to shift the organism away from its current state toward a state of better overall health. In fact, interventions that target symptoms without addressing the underlying pattern are generally regarded as non-ideal or ‘suppressive’ and are used only as temporary measures.

Ultimately, the attainment better health commonly requires one to stop chasing symptoms as they arise but instead focus on fundamental, long-term improvement, even at the cost of short-term suffering. That this strategy is often capable of re-establishing a healthy state when conventional medicine has failed is regarded by vitalists (be they homeopathic or various naturopathic practitioners) as proof of the validity of their philosophy.

This is Why Homeopaths Emphasize Clinical Results over Theory

Classical homeopathy is first and foremost a clinical science concerned with the healing of living beings. As such its main concern is the practice of medicine, in contrast with conventional medicine where theoretical considerations (such as through what mechanism a medication exerts its effect) are primary.

What cannot be explained is nevertheless real

What is important for homeopaths is that their observations correspond with the reality of the clinic rather than with the rational-scientific point of view in which we are taught exclusively to think. This is because many things about people do not make sense rationally but are nevertheless real. This is simply because reason can explain only part of human reality.

For example, we regularly experience symptoms that cannot be explained physiologically, unusual sensations that we find hard to describe without first apologizing that “they do not make sense,” and strange phenomena we have experienced but likewise find embarrassing to tell others (or at least our doctor).

Respecting patients’ experience leads to better treatment

Conventional medical thinking is based on the view that what cannot be explained cannot be addressed, so it regularly excludes many ‘strange’ symptoms that patients complain about. In contrast, homeopaths seek to include all such phenomena in their investigation of the patient, with the goal of fully perceiving the patient’s own life experience rather than imposing an external interpretation of it.

Clearly the first approach has its advantages, and conventional medicine is indispensable under some situations such as emergencies. What homeopathy offers, in contrast, is a system of medicine that respects all of our experiences and successfully integrates them within the homeopathic diagnosis. In this way it is able to deal with medical situations that make no sense to the medical doctor, as well as to cure many conditions which doctors declare as incurable.

At its best, homeopathic treatment can address lifelong spiritual challenges (e.g. self-defeating behaviours), mental-emotional issues (e.g. persistent thoughts or feelings), and constitutional weaknesses (e.g. allergic tendencies from birth).

To read more about the principles of homeopathy, see Overview of Classical Homeopathic Philosophy.