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Female Patient

Presenting Symptoms

Sciatica during pregnancy (28 weeks)

-         can’t deal with it

-         can’t roll over in bed

-         left hip extending to ankle

-         pain        – grabs – can’t move and can’t handle not moving

- must stop whatever she is doing

– must move into a less painful position

– pain catches you

- < having an argument with husband

Issues       - money as husband is very money oriented

- feels like she wants to run away

- always been a bit of a runner

Freedom    - always been a big issue

- go wandering on her own all the time

– wanted to go travelling

– been engaged three times before being married

– being her own boss

– do what she wants to do when she wants to do it

– doesn’t want to feel trapped

– has moved house a lot

– now she feels stuck

Has a short fuse – she counts to 3 instead of 10 when waiting for the children to do something.

Wants things done now or she smacks them.

Stuck with position (work), with family.

Feels she has more to do than her job.

Has her own car – has her freedom.

Pregnancy is a way of escaping from her job, but at the end of a pregnancy she goes stir-crazy because she cannot move, cannot do what she wants.

Husband is not very affectionate, so if she withdraws it there is none in the relationship.

Husband runs her down – she always gives in to him, always the peacemaker.

Inability to decide what she wants to do.

Feels she must do something really important with this life.

Feels she is running out of time, that the world is running out of time.

Feels she is wasting this life – has always achieved things before.

Something important is raising peoples’ consciousness, more tolerance, giving with your heart, leading by example, showing people a better way of living, making changes in someone else’s life.

She had a goal since childhood to be the first female prime minister, but she feels politics is full of lies and deceptions. ‘

She actually ran for public office once, put her heart and soul into it, but realised that in politics you have to compromise.

When she is angry, she slams doors, breaks into tears, gets really heated, rants and raves.

She expresses herself better when angry.

She is able to achieve her goals when angry, gets really focussed – “I’ll show them” attitude.

Pain - grabs really tight

-         feels like it will break

-         grasping, as if someone grabbed your arm really tight

-         spasmodic


Sensation (physical) is one of being grabbed, as if a hand had grabbed her.

Sensation (non-physical) is one of being stuck in her life, of being less than she could be (smaller).

Her reactions to this sensation are to feel caught (passive) and to want to get free (active), to keep moving , to be bigger than she is.

This leads us to the Cactaceae (cactus) family.

Miasm is represented by the desire to run, the need for freedom, the feeling of being trapped, the desire to travel, the desire to go wandering, and most importantly the feeling that she is running out of time.

This leads us to the Tubercular miasm.

The remedy that lies at the connecting point between the Cactaceae family and the Tubercular miasm is Cereus Bonplandii.

One of the key mental characteristics of Cer-b is the desire to be useful.

Quotes taken from a case by Dr. S. King:

“...doing big important political work.”

“ I want to make a contribution to something bigger than myself.”

“It is easier to devote myself to a group, to be a visionary, to do what is needed. Big and important things, useful things, relating to a community outside myself. “

Prescription = Cer-b 200, 10 drops once only.

Reaction: No noticeable aggravation. Almost completely pain free. Whole life has turned around. Feeling much better in herself. Much more positive attitude to life. Doesn’t feel trapped anymore. Work has turned around – several people suddenly joined her group which has made it easier and more financially viable. She has been considering studying natural therapies for awhile now, but could not decide which one. She wants to study homoeopathy, as she cannot believe how easy and effective it is.

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Dear Members

David posed the following question:

“However, did not Hahnemann state in the Organon that when prescribing for chronic disease it is often necessary to establish the history of the illness, that you will not be able to get a proper picture of the the true and complete shape of the disease from just the one consultation, and that in fact if you treat only what you see without looking at the history of the patient's disease you will not be able to cure the chronic tendency to relapse?”

The phrasing of the question only allows a yes or no answer, which either confirms David’s view or does not.  Therefore the question cannot be answered if we want to know the true nature of Hahnemann’s method.

I will rephrase the question:

>>What was Hahnemann’s  view concerning symptoms which form the indications for the now needed remedy in respect of the different nature of chronic and acute cases?

My last post outlines what steps to be taken select at a truly homeopathic remedy; to move the case forward towards cure or finish the cure. This method was promoted and applied by Hahnemann in all cases, regardless if they were of an acute or a chronic nature.

The difference in his experience is the following:

In acute cases, the whole malady is overcome with one, maybe two or three remedies in succession, each selected on the remaining symptom picture after the previous remedy has seized acting positively.

In chronic cases, this process can be much longer and go through the succession of many remedies. The cure of a chronic malady can take years, and often remains incomplete.

To have a good idea what kind of an “animal “ we have to deal with, it’s worth studying it right at the start, so that we (therapists) are under no illusion of what to expect.

To this end the book of the chronic diseases theoretical part was published. The second part is the MMP of a selection of remedies Hahnemann found helpful in treatment of the chronic miasmatic diseases.

But, despite of his discovery, the simile law never changed. It is still the NOW present Disease-symptom picture which determines the remedy, and not (which is one of the fundamental misconceptions!) the miasmatic diagnosis (which limits the choice to only a percentage of available remedies).

If it were the other way – remedies like Pulsatilla, Belladonna, Lachesis, Staphysagria would do NOTHING in psoric cases. But all these remedies did well whenever they were indicated by symptom similitude.

So, it comes as no surprise to me, that Hahnemann himself in the paris case books never diagnosed in terms of miasm, -- psora is never mentioned.

The same applies to any other classification, be it according to the periodic table or kingdoms, personalities, constitutions etc.

It is the homeopaths daily dilemma, that after narrowing down the choice of remedies to about ten possibilities, he has to wade through volumes of Materia Medica to find the symptoms where his remedies differ and to find the very one which is homeopathic enough to bring the case forward.  This is a tedious and time consuming exercise, which could easily take up hours, time we don’t really have.

Therefore the wiser homeopaths have studied MMP in advance, taken their notes and established a knowledge suitable to select the homeopathic remedy with ease initially in a few cases, but with increasing knowledge and expertise finally in almost any case, only occasionally needing to resort to a repertory to remind of similar remedies.

The method based on Boenninghausen, Hahnemann, Hering ‘s instructions but extended by my own findings is found here:

Hans something I did not pick up in an earlier post just struck me on rereading it. You say that to establish the complete picture of the disease, things falling under Aph. 5 are to be left aside. Why do you say that? Hahnemann does not appear to say that. In fact he says that to find the cure, one should find out "the most signficant factors in the entire history of a protracted wasting sickness..." and then he mentions specifically body constitution, mental and emotional character, occupations, lifestyle etc. Where does he say to leave out that information?

I see that this discussion has come around to a place that is very familiar - the argument about Hahnemann's 'intent' or the 'spirit' of his philosophy.

Hahnemann did consider the analysis and treatment of acute and chronic diseases to have a difference.

Aph 82: "In this investigation, some distinction is to be made between sufferings that are acute, rapidly arising diseases and those that are chronic....Since most of the acute disease presents itself spontaneously, there is much less that needs to be asked.Gradually advanced, chronic disease of several years duration are discovered far more laboriously."

This statement seems quite clear to me - you treat those cases differently. Not so differently that the basic principles change of course, but certainly in the amount or type of information that is gathered.It takes longer, you have to work harder to uncover the information you need. He repeats this observation again soon after.

Aph 99: "On the whole the inquiry into acute or otherwise recently arisen diseases is easier for the physician because all befallments and deviations from health but recently lost remain still fresh in memory, stll new and conspicuous for the patient and his relations. Here also, of course, the physician must know everything, however he needs to investigate far less since in part everything is told to him spontaneously."

Why are acute cases easier to take? Because the patient remembers everything with greater clarity. The required information is only recently lost - a statement that suggests symptoms do not need to be current to be relevent. Why are chronic cases more difficult? Because the patient must struggle to recall those symptoms - they are not 'fresh in his memory'. It is necessary to go further back, to ask about deviations from health that were lost less recently- things not current, and far enough back that the patient's memory of such events is less clear.

There is no disagreement over using current symptoms, he is very clear about that being of primary importance. He is also insistent that the entire gestalt of the disease may not be seen if you only look at the current symptoms.

Allopathy has become very good at suppression and palliation now. The majority of my chronic cases are as Hahnemann describes - complicated by the regular use of medication, which makes this particular piece of advice much more relevant to my needs in clinic.

When confronted with a patient who has been on medication for a signficant length of time, Hahnemann says

aph 91: "...symptoms and ailments suffered before the use of the medicine or several days after discontinuing its use give the genuine, fundemental concept of the original gestalt of the disease, and the physician must record these in particular."

Again, I feel this is a very clear instruction to take symptoms that are not currently visible, are not presently active. I do not know how the law governs this situation where you are Hans, but where I am I cannot in most cases ask or even suggest that patients stop their medication, not even for a few days, except in the most harmless of diseases (and even then I am walking on thin ice legally). It is necessary for me to attempt to gather those original symptoms instead.

Obviously not everyone would need to be examined like this, but it certainly was something that Hahnemann considered necessary at times.


I agree with you that the Law of Similarity has not changed, was never in question. But I do believe that as a concept it was expanded to include historical deviations in health, in order to establish a larger and more complete totality.


The idea that Hahnemann himself did not practice what he preached, so to speak, is a difficult argument to oppose. I can only work from his writings - did he in fact spend years developing his theory, dedicated enough to publish it and even repeat it in the last edition of his Organon, only to abandon it and return to the method he had found unsatisfactory? Did the evolution of his theories come full circle, and if so, how did he resolve the difficulties he originally experienced when treating chronic cases ? I would be interested to hear an answer to this question, as this is not the first time I have heard the Paris case-books used as justification for ignoring or moderating the advice Hahnemann gives elsewhere. Obviously for myself and for others, that very advice has proved fruitful in achieving cure for patients, so I find it difficult to accept that Hahnemann himself opposed his own ideas.

Hahnemann asked this question in Chronic diseases:


"Why, then , cannot this vital force, efficiently affected through Homoeopathic medicines, produce any true and lasting recovery in these chronic maladies even with the aid of the Homoeopathic remedies which best cover their present symptoms...?"


If he saw this as a problem then, how did he solve it in the last years of his life if he did indeed revert to using the medicines that best covered only the present symptoms? What changed for him, what else did he do to cure those patients?

Dear David, dear members

Regarding your question on par.:5 Org. read the following document which sets out what I said earlier in detail:

David shared the view:

>> Again, I feel this is a very clear instruction to take symptoms that are not currently visible, are not presently active. I do not know how the law governs this situation where you are Hans, but where I am I cannot in most cases ask or even suggest that patients stop their medication, not even for a few days, except in the most harmless of diseases (and even then I am walking on thin ice legally). It is necessary for me to attempt to gather those original symptoms instead.

In a way by following this procedure, the assumption is made, that symptoms which have been previously there but seem to have gone under allopathic treatment, would still be there otherwise, in exactly that form, if the allopathic medication would be left aside. 

This is quite likely not the case, for various reasons, one being, that chronic disease tends to shift from one symptom to another as time goes by, second, the symptom in question just being a acute fleeting symptom gone by now on it’s own account, third it could have been due to live circumstances, which in the meantime have changed, and the symptom be gone.

Par.: 6 Org. is clear here . Par.: 91 gives a clear idea, to preferably leave aside the medication first to see, what was the true nature of the disease, and then take this symptom picture, rather than using symptoms which were there before the use of allopathic medication.

In this context the following should not be overlooked:

Ongoing allopathic medication creates a chronic medical disease, which in Hahnemann’s observation can easily combine with Psora.  Hahnemann takes issue here: Par.: 74 / 75.

Par.: 76 is clear here:

Only for natural diseases has the beneficent Deity granted us, in Homoeopathy, the means of affording relief; but those devastations and maimings of the human organism exteriorly and interiorly, effected by years, frequently, of the unsparing exercise of a false art,1 with its hurtful drugs and treatment, must be remedied by the vital force itself (appropriate aid being given for the eradication of any chronic miasm that may happen to be lurking in the background), if it has not already been too much weakened by such mischievous acts, and can devote several years to this huge operation undisturbed. A human healing art, for the restoration to the normal state of those innumerable abnormal conditions so often produced by the allopathic non-healing art, there is not and cannot be.

Also par.: 273 needs to be kept in mind – which excludes all other medication when using homeopathy.

On the topic of chronic miasmatic disease, I want to revert to my article:

Read this carefully and if there are detail questions, then ask them. a lot more could be said, going into each and every detail / letter / publication etc. 

In a way, it seemed to me when I started to study Hahnemann’s case books in detail in the years 1994 ff., that he contradicted what he wrote in the Organon. This was quite disturbing, and it took me a while to figure out, that he did not contradict what he wrote in the Organon, but rather what I understood to be the teaching / philosophy. 

Initially, My understanding of the Organon was much influenced by Kents and later homeopaths interpretations of the work. Those interpretations made sens within themselves and sounded reasonable.

  So – I put this ”understanding” aside, looked at the translation, and found, that the translation already contains a lot of interpretation coming from an “American” understanding. 

These days, the par.:5 controversy started, -- it became clear and clearer, that Hahnemann’s understanding what disease is and what is  to be cured differs fundamentally from the American school and modern school of thinking.

Have a look here:

In the end, I found, that Hahnemann did not contradict any thing he wrote in Org.:6 in his daily work, the way he took cases, the way he selected the remedies, the way he followed up etc. By actually going that road, I had the opportunity to replace a lot of interpretation with hard facts, and to fully understand the rules and principles of homoeopathy by using them.

David asks the question:

>>Did the evolution of his theories come full circle, and if so, how did he resolve the difficulties he originally experienced when treating chronic cases ?

Regards the theory of Psora, in a way exactly this happenned and as a result par.: 246 second half reads:

>> And this (speeding up the recovery) may be very happily affected, as recent and oft-repeated observations have taught me under the following conditions:

firstly, if the medicine selected with the utmost care was perfectly homoeopathic;

secondly, if it is highly potentized, dissolved in water and given in proper small dose that experience has taught as the most suitable in definite intervals for the quickest accomplishment of the cure but with the precaution, that the degree of every dose deviate somewhat from the preceding and following in order that the vital principle which is to be altered to a similar medicinal disease be not aroused to untoward reactions and revolt as is always the case1 with unmodified and especially rapidly repeated doses.

It is notworthy, that there is no precondition like: the remedy has to be from the class off anti- psorics (sypilitics / sycotics) for the curativness of the therapy.

This echoes in paragraph 70 / 71 and others.

Thanks for continuing to engage in the discussion Hans. I am going to have a close look at the information and references you have given. It is a very interesting conflict of ideas.

Hans I have read your articles and your answers, and this is certainly a very interesting discussion. Such fine differences in the interpretation of the aphorisms certainly have caused very different ways of practicing homoeopathy. It seems all these 'ways' can be justified depending on how one interprets them in fact, which allows everyone to be 'right' when we simply argue about the words Hahnemann wrote in the Organon and elsewhere. I suppose this is the real trap, that homoeopathy becomes an argument about the 'true' meaning of the words of its creator, rather than a discussion about the genuine experiences of those who are practicing homoeopathy.

In regards to Hahnemann not mentioning antipsorics etc in some parts of the Organon, why then does he clearly mention their necessity in others? Was he really so conflicted or confused about what he meant, about what worked, about what needed to be done? I wonder why he didn't correct it all in his last edition if he no longer believed it?

In aph 222 he says (when talking about insanity) "...the patient should be given as soon as possible a continued antipsoric (and possibly antisyphilitic) treatment in order to entirely free him from the chronic miasm...".  He says in aph 221 that giving the medicine which suits the acute state (flare-up) will only put the patient back into their latent state, and clearly the medicine needed for this latent state is not the same as the acute state since a new medicine must be selected.

He says this again in aph. 227 "To ensure against a relapse into a similar mental disease (which can easily happen) the convalescing patient should be given a thorough antipsoric (and probably antisyphilitic) treatment."

Another interesting thing that Hahnemann says in aph 195:

"To achieve a cure in such not-rare cases, an appropriate antipsoric treatment should be undertaken after the acute state has been dispatched to a tolerable extent. The antipsoric treatment should be directed against:

1.  the ailments that remain after the acute state has been dispatched

2. the diseased condition-states that were habitual for the patient prior to the disease.

In chronic local diseases that are not obviously venereal, the antipsoric internal cure is necessary anyway."

Keeping in mind the things you have pointed out about those statements I have interpreted to support the use of disease history,  I can see the ambiguity of 'habitual diseased condition states" , but it leads me to feel he was in favour of examining disease-states that existed prior to the current or most recent acute one. Was the word 'habitual' the correct translation, because if so for disease-conditions to be 'habitual' they must be regular occurances over a period of time.

Is he also not directly confirming the need for antimiasmatic remedies? How do you interpret such statements in regards to your belief that miasms are irrelevant for remedy selection? What did he mean instead, if he did not mean what he said in these aphorisms?


There is another section of the Organon where Hahnemann talks about symptoms that are not currently present. I bring this up as we are discussing what was in Hahnemann's mind, what was his intention.

In aph. 201 he talks about local maladies, and how their appearance can ameliorate internal suffering while they exist. He says local sufferings can reduce the internal disease 'to silence'. What is interesting is that in aph. 202 when he mentions what happens when the local malady is treated and removed without the internal disease being also cured, he says

"...nature makes up for this by awakening the internal suffering and the rest of the symptoms that already existed and are lying dormant along with the local malady...".

Again, being much more aware from this discusion how easy it is to interpret according to already held beliefs, I see this as suggesting some symptoms cannot be perceived except by their historical existance, up until such time as they are 'awakened' due to treatment of the external 'vent' which the vital force was using to temporarily alleviate the internal suffering. It seems he is saying those symptoms in fact still exist, but they are silent, and will return under particular circumstances.

I can also see that he may mean that the local malady appears in order to stop the internal suffering from happening at all, but again it is not clear, and I can see many instances now of such ambiguity when looking at it from your perspective.

The words 'dormant' and 'latent' have been used in my translation of the Organon (aph 201, 221). In english such words suggest something hidden, not visible, inactive, existing as a potential. Was this translation made in error?

Something else he mentions in Aph. 204 also strikes me as very interesting:

"Each of the miasms was already in possession of the whole organism, having pervaded it in all of its parts, before the appearance of the primary, representative local symptoms that prevented the outbreak of the internal disease..."

He is saying here the miasm is present before the internal disease manifests, before the local symptoms can be seen. What is this he is describing? The progression of an unhealthy state that has not yet manifested as perceptible, active symptoms ? Is this miasmatic state  a prelude to the active outbreak of disease symptoms? Is he saying it cannot be perceived? What if it could be, but such diagnostic symptoms had yet to be determined by him? Such an idea is what has inspired later homoeopaths to look for such signs (which is not to ignore the current state but to see the whole disease process as starting earlier than the current disease). You can see how this statement by Hahnemann might stimulate such a search.


I am finding this whole debate quite fascinating, as it is definitely causing me to re-examine things I already held to be unassailable. It also has allowed me to see the validity of your viewpoint, for which I am quite appreciative.

Thanks David for sharing your views

I fully agree to parts of your first chapter, when you say, that every interpretation is right, because it is an interpretation.  Interpretations reflect the person’s own view in his / her conceivable environment. This may be correct, as long as we take the Organon out of its context, but not so, if we use all available primary sources.

We are nowadays in the lucky position to compare his views with what he actually did, which does not leave room for personal interpretation. We also have access to a lot of letters, be it to patients, but also to close friends.

I am now in the position to share the findings made by me and others over the past 15+ years research into Hahnemann’s case work in comparison of Organon  / chronic disease / Paris case books., combined with my own experience using Hahnemann’s Homeopathy for the past  12+ years.

I would therefore suggest to all those who belief they know about real homeopathy to follow the same path, as this is the only verifiable way to establish what true homeopathy is, and then, if they feel they need to correct my publication to please do so.

Regards chronic miasmatic disease, Hahnemann was quite clear, that before and after the discovery of psora the selection of the remedy purely was determined by symptom similitude and not by diagnosis of psora, and then selecting a remedy from a specific group. This is confirmed by his case work all along.

My research has not found a conclusive answer, why Hahnemann  emphasized on the importance of miasms in Org. 6 and on the other hand not even noted them in the paris case books.

 A hint could be a letter to Stapf (1835), where he expressed his disappointment about the improvements he hoped to make by discovery and application of his new theory.  He concluded, that the solution must lie elsewhere, and kept on searching. Result of that being the Q-potencies.

Here is another article relating to the same topic:

Here is the view I formed from above research:

The Organon contains a lot of contemporary medical thinking which is the allopathic part, and also the principles and rules governing homeopathy. Most of the allopathic thinking is overcome nowadays, and has only more historical value.

One of the contemporary allopathic ideas is the whole concept of chronic miasmatic disease. Attomyr already harshly criticized Hahnemann in Stapfs magazine at the time sting that Hahnemann himself destroys homoeopathy by the publication of the chronic disease and the newer versions of the Organon. Of course Hahnemann was less than impressed, and cut all ties to Attomyr for a few years, but at the end of his live came around to Attomyrs view.

We should be clear about Hahnemann’s fundamental conceptual mistake concerning Psora. He states in the CD, that all which is not due to syphilis, sycosis or external factors and is of chronic character, is due to psora ONLY. He rectifies his view, that only by remedies from the anti psoric group this psora has been cured, -- which is pure guess work!!

Reality is, that such “psoric “ cases were cured by him and others with remedies from outside the class of the anti-psorics, such like Pulsatilla, Bryonia, Lachesis, Staphysagria etc.  So Hahnemann found himself in a predicament, -- he could not publicly renunciate the whole idea, as he felt, that this would be the end of his homeopathy, on the other side he could not uphold above statement.  So—the solution was: we increase the number of remedies in the class of anti psorics, and soon he was at an amount, where no benefit was derived from the diagnosis anymore for the selection of the remedy, as there were too many anti-psorics, and further more, -- it could be also a remedy outside the group, which simply has not yet been included, which would be the simile, -- so the whole thing nullified itself, and IMO, so will other groups as well, if it comes to homeopathic prescribing. It came to the point, that Belladonna was at one stage an anti psoric and later on was withdrawn,--

Another thing we should bear in mind is this: Boenninghausen observed, that during the second whooping cough epidemic he needed different remedies than in the previous one, and the previously curative remedies did not work anymore.  So he had to change his list, and realized, that miasmatic diseases change, and with them the suggested remedies.

This is an important point: The remedies which may have been anti psorics in Hahnemann’s times may not be part of the group anymore nowadays, and should then be removed, and other remedies not being part those days could well be part of the group today, as chronic miasmatic diseases change their symptom picture over time. –

One way or another, its save to select the remedy on the now present individual disease-symptom-picture  by symptom similitude and see the whole idea of prescribing on anything else as what it is: an allopathic procedure!

Ok interesting. Then it appears I was right in my conclusion that Hahnemann himself created this divergence in homoeopathic thought. It is a strange situation indeed. That really is a bit of a mess - and it certainly removes the Organon as the primary guiding light for homoeopathic practice. We can trust some parts, but not others, and have to infer from Hahnemann's own cases as to what he ended up doing.

A Hahnemannian homoeopath then may not practice in the same manner as a homoeopath who follows the Organon. And yet both may claim to be classical. Bizarre, and I will admit a real eye-opener for me.

One opinion I would like to offer though, about Hahnemann proposing the theory (which he did with great zeal) and why he abandoned it in later years, is this.

Hahnemann simply was unable to get it to work the way he had devised it. The reasons for this appear to be (again in the opinion of myself and other homoeopaths):

1.The number of miasms was too few. This resulted in remedies being either moved around the 3 miasms he did have, or being placed in all 3 miasms which removed any practical use of determining the miasm at all. This appears to be the primary problem he had and it is likely he just did not have at that time enough information to define all the different disease patterns. This is the very issue you have identified with his classifications Hans.

2. He focused the determination of miasm to the physical aspects of disease, and was unable with his current case-taking techniques to find a way to perceive the precursor state to disease (the miasm as it invades the organism prior to disease breaking out).  It may be again that the paucity of clinical information simply prevented him from establishing what the signs were for the disease in this stage, and considering that miasmatic theory was being hotly contested and not often used by other homoeopaths, it would have been hard to establish the kind of bigger pictures he would have needed.

3. He appeared to confuse 'Psora' with the general concept of 'Miasm' and attributed far too many characteristics to it, for it to be practical in remedy selection. In fact, when you look at more contemporary versions of miasmatic classification, there are very few remedies listed as being purely Psoric. Hahnemann in fact seemed quite obsessed with Psora.

4. He hadn't clearly been able to distinguish between the miasm and the disease manifesting from the miasm. He theorises that these two things are connected but also able to be separated for diagnosis, yet is unable to do it. This in and of itself made it hard, if not impossible, to determine which remedy belonged in which miasm.

What has happened since Hahnemann's death, is that many more minds have applied themselves to the theory, to find ways to make it work. Although it appears Hahnemann could not achieve this, over the intervening years the number of clinical cures and provings has grown beyond anything he could have imagined. Due to the failures in using the system as it was provided to us, some practitioners were able to adjust it, hone it, and out of that process more consistent successes were achieved.  

So considering that relying on quotes seems an unreliable way to approach such a discussion, since each side appears to be able to find written justification for their viewpoint, I will instead talk about my experience and the observations I have made of other homoeopaths I have worked closely with.

I don't believe he was wrong. I believe he was way ahead of himself, of homoeopathy at the stage he had developed it. He simply was trying to apply a very advanced theory without the tools needed to carry it out in any practical fashion. No wonder he abandoned it. He couldn't apply his theory to his patients, at least not consistently, so why would he keep it?

I say this with confidence because other people clearly have been able to use a system of miasmatic classification to narrow remedy choices and to create cure in patients that otherwise were prone to relapse. I am amongst them, and I work with a group of homoeopaths who all utlise the concept of miasm with success in practice. Like Hahnemann, I found the system as he left it in the Organon and Chronic Diseases very unsastisfying and impractical. The basic concept was very exciting, but regardless it was of no use to me if I could not apply it regularly in clinic to enhance my ability to select the best remedy and cure patients.

The more contempory systems are much more workable, lead to many more successes, allow a much more practical application of miasmatic theory.

1.There are enough miasms to allow for more precise differentiation between remedies.

2. The remedies do not have to be constantly reassigned to different miasms (although in some cases there has been movement especially as the system has evolved).

3.Remedies do not sit across several or all miasms, avoiding  the situation where such classifications become pointless.

4. The symptoms relating to miasm have been separated more clearly from the symptoms of the current disease (understanding however that miasm is actually part of the totality and interacts fully with the presenting symptoms). As Hahnemann theorized, use of historical information helps to determine the reoccurring miasmatic themes for this purpose when incorporated into the picture of the current complaint.

5. The only symptoms used to determine miasm (and therefore remedy) are those that the patient themselves describes, those described by the people around them (if they are reliable) and those the practitioner observes, just as is done for any remedy prescription.

6. The miasmatic picture does not change over time, but remains a consistent theme throughout the span of a person's ill health unless changed in some way (usually due to treatment although some events like contact with similar diseases might also create change).

7. Specific diseases are not classified as being unique to particular miasm. It is possible to have any named disease follow the pattern of any miasm, even when that disease is traditionally related to the miasm (ie. you can have tubercular gonorrhea or sycotic tuberculosis).


One other thing I want to emphasize about using miasm and historical patterns when analyzing cases, is that such patterns should always be reflected in each signficant outbreak of disease in the person's life, and should be reflected in the current complaint. At no stage would the current complaint be ignored. This complaint provides the first clues, the history of disease provides confirmation. Because previous complaints may have been more serious and more intense, they may even provide clearer indications about the remedy if the same state keeps appearing. However, the practitioner should never lose sight of the primary complaint as the most reliable part of the case.

Such an approach has often been instrumental in selecting the correct remedy for a patient in my practice. Miasm as a concept, as a method of selecting remedies, has definitely been invaluable for me, but only in its more modern form. The old system was messy, chaotic, and of little use.

Hahnemann may not have been able to smooth out all those considerable problems he had with it, but fortunately for us others have been able to. I think it is very telling that he never recanted the theory, but merely left it alone. This suggests to me he felt it had merit, but he just didn't know what to do with it, how to advance it. Perhaps that shamed him, perhaps it embarassed him, who knows.

Dear Members

David wrote:

>>I say this with confidence because other people clearly have been able to use a system of miasmatic classification to narrow remedy choices and to create cure in patients that otherwise were prone to relapse

Question: does a remedy cure because it belongs to a speciffic class of remedies?

Answer: No

Question: Why does a remedy cure?

Answer: 1) it has to resemble symptom similitude, 2) ahs to be applied in the apropriate way, 3) obstacles have to be removed

Question: Why has a remedy cured after being selected on a basis of miasmatic classification?

Answer: Because the remedy selected happened to be similar by symptoms to the individual case.

Question: If this is the case, then if the symptoms alone were taken into consideration leaving aside a miasmatic classification, --would not have a remedy found by symptom similitude being curative anyway?

Answer: Yes.

Question: could it be, that in a given case it is not perfectly clear, what miasm is active?

Answer: yes

Question: could it be ,that the list of remedies under each miasm is incomplete or contains remedies not suitable anymore for the miasm?

Answer: Yes

Question: Are there situations, then where a remedy is selected, which seems homeopathic from the list of the diagnosed miasm, which does not cure?

Answer: Yes, for above reasons.

Question: are there cases where the miasmatic classification suggests a completely different remedy from the one being selected by individual symptom similitude?

Answer: yes.

Question: What is the way forward in these situations?

Answer: The homeopathic principle is: Cure by symptom similitude!, so the individual disease-symptoms form the prime indication for the selection.

As a result, we will give these symptoms primacy and set aside any pre-classification.


If this is so -- and obviously there is greater reliability to directly use the individual disease-symptoms, why do homeopaths still diagnose, select from a group?

Answer: I don't know, -- makes no sense to me.


Hans I actually understand and respect your particular view on this, but I disagree. Such disagreement comes from experience over the last 20 years of practice rather than a purely intellectual dissection of the issue.  I accept that you will not come around to my point of view and that is your right, but the reality is that there are homoeopaths working this way and curing patients even when measured against Direction of Cure and Hahnemann's conditions for cure. Such practitioners are not opposing the way you practice, for it is part of the way they practice (we practice).

I am still enjoying the debate though, and I do not often get a chance to sharpen my wits against someone with a keen mind and excellent knowledge.


I feel there are a few errors in your statements posed as questions though.

Does a remedy cure because it belongs to a speciffic class of remedies?

No it cures because of similarity. The question should be:

Do remedies in certain groups share symptoms/themes/characteristics which when matched to a patient's condition will cure it (as per the Law of Similars)?

The answer to this is yes.

Which leads to a bigger question of course.

Can we know something about the symptoms a substance can cause without doing a proving?

The answer to this is yes, and we already do this through clinical cures. In expanding where we are able to draw information on medicines to establish therapeutic pictures, such information can come from the provings of closely related substances too, which forms for us Group Themes.

The use of Group Themes was established early in homoeopathy by miasmatic classification. Although Hahnemann made a bit of a mess of those groupings initially, they have since been cleaned up (but there is ongoing refinement).

Why has a remedy cured after being selected on a basis of miasmatic classification?

Of course you are correct here, it cures through similarity which is the only way you can cure. However, it is not an 'accident' it is deliberate, repeatable, and can be taught to others. Why else would we continue to use it?

If this is the case, then if the symptoms alone were taken into consideration leaving aside a miasmatic classification, --would not have a remedy found by symptom similitude being curative anyway?

The answer here is not a definite yes, but should be 'possibly'. A skilled homoeopath who does not pay attention to the chronic reoccuring state (miasm) will undoubtedly be able to choose effective similar remedies. Because the primary complaint is an important part of the whole picture, there is a chance such a prescription will also suit the miasm, but this will be incidental.

You see it is not the skilled miasmatic prescriber that will 'happen' upon the deepest acting curative remedy, but the prescriber who only chooses to see one part of the whole chronic picture.

But, as Hahnemann and many other homoeopaths have observed, the patient will return often for further treatment either with the same remedy or with new remedies. New conditions will arise calling for further prescriptions, conditions which are not more superficial and less dangerous, but of equal or greater threat to the patient.The practitioner may comfort themselves by saying it is just the way disease works or that this is the limitation of homoeopathy (or healing generally). However, it is only the way disease works when the chronic state is not also considered alongside the acute flare-up as part of a larger totality.

Could it be, that in a given case it is not perfectly clear, what miasm is active?

Of course, just as the remedy might not be clear, or the obstacles to cure might not be clear. Again as Hahnemann observed it may take several interviews to establish the entire picture of the chronic reoccurring patter. Not only that, miasm is active in different patients to different degrees. Even within the same patient miasm may be more or less active at certain times in their life (depending on events like suppression of local symptoms for example).

Could it be ,that the list of remedies under each miasm is incomplete or contains remedies not suitable anymore for the miasm?

Of course, this is definitely going to be true. Miasmatic classification comes from clinical observation primarily, so such alterations will come as more information is collated and analyzed. This happens in many areas of science, even those that actually have machines to accurately measure (which we are working without).

This could also be said about our provings and materia medica, as the number of remedies continues to grow. We still do not have everything we could have, and we still do not have everything proven properly. Even some of our very old medicines are not well proven and we could easily see a change of that information should better provings take place. This is how any field of knowledge works. Homoeopathy is not immune to it.

Are there situations, then where a remedy is selected, which seems homeopathic from the list of the diagnosed miasm, which does not cure?

Again I have no problem with this statement as it is without a doubt true in some cases. However, this exact same situation can arrive using nothing but the highly visible current symptoms. No homoeopath cures 100% of the time, so no matter what method they use there will be failures. Miasmatic prescribing is concerned not just with the immediate relief of symptoms, nor with the next 3 months, 6 months or 2 years but with relief as long a period as is possible and as deep as is possible. Over short periods comparison of both methods does not usually show the true advantage of miasmatic prescribing.



Are there cases where the miasmatic classification suggests a completely different remedy from the one being selected by individual symptom similitude?

Actually, the answer to this would most likely be no. Since the presenting complaint forms the main focus for the consultation and prescription, whatever is prescribed must include the important symptoms of the complaint. Remember prescribers looking at the chronic complaint do exactly what you do, but then they do something more. The consultation will simply go further. It still starts in the same place and travels the same road for awhile.

To ignore the presenting symptoms and only look to things that happened in the past would be perilously close to Allopathy, and no miasmatic prescriber worth his salt would do such a thing.

So the remedy could be different, but it would include similar aspects to the one you might have thought of for the current complaint alone.

The homeopathic principle is: Cure by symptom similitude!, so the individual disease-symptoms form the prime indication for the selection.

Obviously there is no argument here. The Law of Similars as the pathway to cure it not being disputed. To clarify what is being disputed as exactly what forms part of that similar picture.

Miasmatic prescribing looks for the qualities (modalities, sensitivities, pace, depth, reactions, strategies, compensations etc) common to the immediately occuring complaint, and to the reoccurring conditions in the person's life. These qualities form a consistent, solid picture of the state that exists as a totality spanning a long period of time. By doing so, we eliminate those qualities that are fleeting, belonging only to the presenting complaint and which tend to change mercurial-like with each new complaint as it arises.

While it is possible to see the chronic state only through the presenting complaint, the image is distorted by those symptoms which are only going to be visible during this flare-up, and may never be seen again. Clearly, if you do it this way each time, the remedy could change every time the chronic state flares up. Those changes might be due to circumstance, the particular pathogen being encountered, temporary disfunction of an organ, or any other number of factors that may never occur again. This is precisely the problem Hahnemann observed, regardless of how much trouble he had finding a way to deal with it.

This is the true divergence of our methods. To me, disease exists over long periods of a person's life, and its true picture can only be established by looking for those reoccurring qualities. To remove that chronic reoccurring pattern means identifying it precisely,  free of all the temporary symptoms that will come and go each time a person's becomes sick.

This is not to say that at times those symptoms, that particular picture, will not be of primary importance, that it may not be vital to prescribe on it. For any true acute this is always the case, even for some acute flare-ups it is necessary to deal with what is happening right now, especially when the patient is in danger.   

But miasmatic prescribing also takes the long view, and when it is possible to take more time with the case, removing that thing that continues to undermine the person's health becomes the main motivation for treatment. 

One may be able to move forward by prescribing only on the current state, but miasmatic prescribing is also about not moving backwards, and about maintaining forward momentum towards long-term health.  

It is sad to realise from this discussion with you, that Hahnemann was not able to put his grand theory into proper practice. How frustrating that must have been for him. It was too soon, he was too far ahead of himself, as many great people are. But he was not wrong. He was right, very right. What he started he couldn't finish but we can at least continue working towards that goal.

In conclusion a few points to consider:

-- No patients name given
-- No dates given
-- remedy selection not directly on disease-symptoms, but on miasm + Kingdom
-- A  Remedy selected, which bears no similitude to the symptoms presented.
-- No producer of the remedy
-- No detailed follow-up information, which would be suitable to evaluate the progress.

Could it be possible, that this case is just a fabrication to promote this “sensation” method?


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