– Homeopathy : art or science ? (R. Pitt)
We often speak of homeopathy as a scientific system of healing based on principles unchanged since the time of Hahnemann. We also speak of the artistic application of these principles, how an individual homeopath can express nuances of observation and interpretation which enlighten our understanding of the homeopathic process.
We say that homeopathy is based on natural law; it is a fact, not susceptible to current whims of thinking. Yet its application is often as individualized as the patients we see. Hahnemann states in Aphorism 53 that homeopathy rests upon an eternal, infallible natural law. The pure homeopathic curative mode is the only correct one, the single most direct curative way possible by means of human art, as certainly as there is only one single straight line between two given points. Accepting that homeopathy works by natural law, the human art aspect challenges us to find the straight line between two given points. As homeopathy has never belonged to the field of materialistic science, in which the notion of absolute objectivity has been essential, the artistic application of homeopathic principles has always been important. The subjective sensations and experiences of the patient are acknowledged as well as the subjective analysis and interpretation by the homeopath which reflects the skill of the homeopath.
There is always some tension between the two equally important positions of scientific objectivity and artistic subjectivity. The fact that homeopathy accepts the subjective experience of both the patient and homeopath is already a more evolved position than the insistence of medicine to reduce the disease process to objective classification, making both patient and doctor subordinate to the protocol of disease diagnosis. However, there can be a critique made of homeopathic methodology in that it is too subjective and interpretative, lacking the clear methodology that is needed to call it a science. This criticism comes not only from outside homeopathy but also from within the homeopathic world. The most clear example of this is found in studying the so-called French style of prescribing, which pays more attention to objective disease classification and specific homeopathic treatment. The methodology based on the teaching of Dr. Reckeweg also examples this approach. Most “classical” homeopaths do not practice in this way. However, it does reveal different perspectives on methodology in which the “natural law” of homeopathy is applied.
Within classical homeopathy, how many of us have had the experience where a number of experienced homeopaths all come up with different remedies in a case. Although unavoidable because of the “artistic” application of homeopathic analysis it does reveal one of the most difficult points in the acceptance of homeopathy as a scientific discipline. It is interesting to see how the contrast between objective methodology-based on provings, clear signs and symptoms of disease, and characteristic mental, general and keynote symptoms-is being played out with the more subjective aspects of interpretation and analysis in homeopathic prescribing today. These two positions are not mutually exclusive but if one predominates too much then homeopathic practice becomes either routine and unimaginative or too imaginative and fanciful, with a tendency to project into the case things which simply do not exist. This latter situation is more commonly seen when remedies are given which either have not been proven, or have been inadequately proven and which are given on a more theoretical basis.
Although most of us would agree that it is best if all remedies prescribed would have a thorough Hahnemannian proving, it is simply not possible. Therefore, “new” remedies are going to continue to be given based on other forms of analysis. The problem is that it can be very difficult to understand the process involved by the homeopath in making this decision. It can also confuse homeopathic students who are struggling to understand homeopathic methodology. This problem is most commonly seen when there is an over focus on the mental and emotional symptoms in a case. Many students tend to focus on what they see as the emotional component in the case and pay less attention to physicals and generals. This comes from a desire to get to the bottom of the case, or to find what is often called the essence or core delusion. It is a fact that many people come with emotional issues which are either a major concern or at least are important to the patient. However, the dominant focus on emotional and mental symptoms requires the most objectivity and subtlety in our analysis. It is the easiest area to misinterpret and leads to the choice of wrong rubrics in the repertory and wrong choices of remedies.
Most experienced homeopaths will acknowledge that the mind section of the repertory is the most difficult to use as it requires the most interpretation. A clear physical keynote or general is often safer to use and ideally should be included in the choice of rubrics in any case. The problem again lies with homeopaths and students who tend to over focus on the emotional component. It is a trend in homeopathy to always want to seek the deepest core of understanding in a patient, to reveal the deepest issues and to find a remedy to cover this. However, homeopathy is not therapy. It is not necessary to always find out the deepest secrets of person. In fact, it is presumptuous to think we can even do this in one or two consultations. This can often be a mistake and lead to remedies given based on the projection of the homeopath. Although a homeopath should always be attentive to the inner dynamics of the patient, it is not always necessary to actively seek it out and pin it down. Furthermore, the body can often reveal key elements in the case without the need to understand the psychological core or essence. Ironically, this can also liberate the homeopath from giving remedies that always have a well-defined mental picture.
As we are always seeking what is characteristic in a case, it can be useful to pay attention to physical symptoms in predominantly mental cases and the mental symptoms in predominantly physical cases. This focus on concomitant symptoms has been well represented in the work of Boenninghausen, Boger and others. Although this is not new it is especially important that students avoid the pitfalls of over subjective interpretation. One approach can be to put the mental symptoms at the end of the analysis and to use them to help make final distinctions in a case.
The use of metaphor and doctrine of signatures in homeopathic analysis is also one in which homeopathic students can get confused. If a remedy has not been proven well, or at all, then it requires subtle interpretation to make the match. It also requires of the homeopath knowledge that a more well-known proven remedy is not indicated. This is not an easy task. The prescribing of a small remedy may be appealing but it can make us avoid seeing a more obvious remedy.
As homeopaths grow with experience, their knowledge of remedies grows. However, it can be difficult to maintain an intimate knowledge even of “polycrest” remedies when we are looking to incorporate new remedies into our repertoire. This is a constant challenge for all homeopaths. For beginner homeopaths, it can be both an advantage and a disadvantage to not have preconceived ideas of the importance of any one remedy. To see all remedies as equally important can be liberating. It can also be profoundly confusing.
However, the desire to prescribe beyond the confines of polycrest remedies has been one of the most evolutionary aspects of homeopathic prescribing in the last decade. As with all changes it can brings certain risks with it. The tendency is to give lesser-known remedies using analysis which requires more subjective interpretation. The symptoms from provings become less important than other means of analysis. But the same problem is seen with the prescribing of polycrest remedies. These remedies have been overused because of dependence on a generalized, somewhat generic analysis of the emotional and essence picture. It can be quite easy to see a Nux vomica “type” person or a Lycopodium “type” person. How many of us when we were studying homeopathy saw in ourselves many of the polycrests, depending on which remedy we were reading that week? Therefore, to justify a polycrest remedy it is good to look for very clear keynotes or general characteristics. Relying only on the psychological picture can be a big mistake.
The contrast between subjective and objective analysis is also revealed in the types of provings sometimes carried out. Provings in which the remedies are known by the provers, those done in seminars, or through dream provings, or when the supervisors and leader knows the remedy being proven, runs the risk of subjective interpretation and projection. These provings should be accepted with caution and ideally should be done again under clear objective protocol.
The accumulation of objective data of a remedy’s potential healing power and its therapeutic usage is fraught with difficulty. It is easy to see homeopathy as a highly personalized and arbitrary process. However, if we hold ourselves to the ideal that there is but one most similar remedy indicated at any given time, which can be said to be an objective, scientific fact, then our job is to find that remedy. Not only that, our challenge is then to be able to rationally justify why a remedy was chosen so we can all learn from the process. If no other homeopath can fathom why a particular remedy was chosen, perhaps it should be questioned.
This is especially important in the teaching of homeopathy. If students are not given a methodical, systematic and objective approach to homeopathic analysis, then the more subjective interpretations will be given too much authority. To expand the boundaries of our prescribing is important. However, it is one thing for an experienced homeopath to do this and quite another for a student.
This is the challenge for homeopathy. The tendency to hide in the more subjective part of homeopathic prescribing, perhaps as some kind of reaction to the falseness of the idea of objective methodology in conventional medicine, has to be balanced. As homeopaths we have a responsibility to define our work clearly. We have to be able to explain our thinking in a way that others understand it and be willing to question our own assumptions and prejudices. We also have to teach homeopathy in a way that stresses the need for clear, objective analysis of cases. It is important that future homeopaths are taught in a way that clarifies their thinking and challenges them to always think carefully when analysing cases. This is how we learn and how homeopathy grows, and the future of homeopathy depends on our ability to communicate our art with clarity and understanding.
Richard Pitt practices homeopathy in San Francisco. He is President of the Council for Homeopathic Certification and Director of the Pacific Academy of Homeopathy. He originally trained and practiced in England and has lived in the USA for the last 11 years.