Creating Waves of Awareness
Boenninghausen: Minding the Mind
By the team at Dr Kamlesh P. Mehta’s Homoeopathic Health Care Center
Hahnemann rediscovered homoeopathic principles. He worked tirelessly despite all odds against homoeopathy to give us a sound therapeutic system and made it perfect through his experiences.
Dr Boenninghausen probably was the first one to give an expert system, supporting the same diligently for more than 35 yrs and also has contributed relentlessly to the literature of multiple dimensions, regarding Homoeopathy for physicians and also for the general public like Homoeopathic philosophy, Materia Medica, Repertory, Therapeutics, Remedy relationship, Affinities of remedies, Posology, Diet etc..
Credit also goes to him for correlating experience of Hippocrates with Homoeopathy in his invaluable 'Aphorisms of Hippocrates'.
Moreover, he has always remained progressive with time so that rather than to continue with same structure of the repertory he reconstructed its structure, and worked on it tirelessly for almost ten years presenting us with his indispensible Therapeutic Pocket Book.
He simplified and presented detailing of Hahnemann’s philosophy and guidance regarding Homoeopathy; hence we find the applied aspect of homoeopathic principles in his literature and that too in the lucid manner. He remained honest towards Homoeopathy and dedicated himself to the ‘Restoration of Sick to Health’.
Subsequently it is we, who have divided Homoeopathy into various approaches by the way of Boenninghausen, Boger, Kent etc, he never intended branding, it is we who have distributed this simple system based on Nature's Laws into various sects based on the literature given by each pioneer.
Boenninghausen’s and J. T. Kent’s works are very complimentary to each other and we find that Dr. Kent has very respectfully included Boenninghausen’s contributions in his work. Even Boenninghausen's contribution is so trustworthy that it has become a fundamental and an unavoidable part and parcel of 21st century Homoeopathy.
There was a time when his contribution was considered obsolete because of its mechanical application. Then during the periods of 1900 and 1905, C. M. Boger compiled his work, which drew the attention of homoeopathic fraternity towards Boenninghausen’s work.
By this time Homoeopathy had grown both in regards to the number of drugs proved and practice. Now a days there are more tools, more learning opportunities, software and teachers available which not only made the practice simpler, but also took away the diligence from the study of Homoeopathy and somewhere, some sort of compromise became the norm, so conveniently Homoeopathy was divided into different approaches, and in this process
Dr. Boenninghausen was accepted only as per face value and understood only by the commentaries and teaching on his literature. Following is an attempt to understand his guidelines and their applications in practice.
It is very important to understand that he presented integrated Homoeopathy in toto.
Boenninghausen and Hahnemann were contemporaries. All his works on Homoeopathy were strictly based on observation of working of the laws given by Hahnemann. So there were no hypotheses or assumptions of any sort in his work or in his literature. By his relentless work he gave a simplified version of literature already provided by Hahnemann, expanding on it further for a deeper understanding and clarity. This noteworthy contribution of Boenninghausen was thoroughly reviewed and approved by Hahnemann.
Hahnemann’s central idea for restoration of sick to health (i.e. cure) centered around 'What is to be treated in every case' (§3) and the 'Essence of the disease' (§7). His focus never deviated from the fundamental duty of the physician (§1).The rest of his expositions are in the form of aphorisms, where he has explored the application and rectifications of the same, and are all about understanding the disease i.e. the ‘SICKNESS’ and the application of the 'Curative power' based on the 'Law of Similia'. Boenninghausen took no liberty from this fundamental core.
Hahnemann focused on the individuality of disease (sickness, suffering), its indications in the form of characteristic symptoms (§ 153 & § 3). We can see his faithfulness from §1 itself to the sick & to the sickness rather than to the personality part.
Observing the fact that the patients having similar pathology were found to have different 'sufferings', 'reactions' and 'meanings of the diseases'; a reflection of the same was seen in the Materia Medica, that almost all drugs were found to affect all parts of the body, with almost a similar set of signs and symptoms, but differing in the reactivity. Hence, the idea of what is to be treated in every case emerged, rather than only treating the pathology. These reactions which are fundamentally related to the DISPOSITION of the patients are an expression of the internal process of imbalance (mental and physical), hence they form the sole guide for deciding the similimum.
The point of deviation from health to disease (§ 6 ) is very vital for defining ‘the disease’ as well as for the management of the case. The ‘disease’ as Hahnemann suggested is expressed by characteristic symptoms i.e. specific, well defined symptoms, which are 'Striking, Singular, Rare, Strange, and Uncommon' (§. 153). Boenninghausen simplified this guideline of Hahnemann analytically by explaining ‘Characteristic’ through various components of the symptoms mainly location, sensation, modality, time, concomitant and causation, besides the ‘change in personality’ during the evolution of disease (sickness) by his article 'Characteristic Value to Symptom'.
This change in personality involves changes at physical and mental level and these changes are the earliest guidelines to select the homoeopathic medicines, even much before the establishment of a diagnosis. This aspect of Boenninghausen’s guidelines definitely suggests importance of both physical as well as mental changes in the patient during evolution of sickness. Likewise, he always considered dispositional features, physical as well as mental for the final selection of the remedy, though they were not specifics. It is needless to say that whatever decides the remedy cannot be of least importance but of ‘prime importance’!
'Mis-minding' regarding Boenninghausen:
The issue is never regarding about how important are the mental symptoms to him, but the point always remains about the authenticity or reliability of the symptoms for the purpose of selection of the remedy due to problems at multiple levels- the physician’s ability and subjectivity, patients’ and also Materia Medica. Otherwise why did Hahnemann need to emphasize regarding unprejudiced observation, sound senses, fidelity of mind and freedom from speculation? So Mind it!
In his Original Preface to the Therapeutic Pocket Book, he mentions as follows:
Hence TPB is as a filter helping to sieve secondary symptoms and giving us pure primary symptoms as rubrics. Thus it provides us the most reliable symptoms as an 'Ideal Repertory' does.
Widening the horizons:
TPB took almost 10 years to have its structure reformed from the Repertory of Antipsoric remedies (the current BBCR is based on structure of Repertory of Antipsoric Remedies); he did this to make the repertory handy, which is another important feature of any 'Ideal Repertory'.
The structure of Therapeutic Pocket book is more, giving us freedom for logical and tested permutations and combination of symptoms of one section with other. Thus TPB has the potential of serving countless mental symptoms by combining its Mind chapter with all other chapters as aggravation / amelioration and association as concomitants to a great extent so as to overcome limitation of proving.
Minding the observation :
In the era of the 18th century the disease pathology was individualised by its evolution and characteristics along with patient’s treatment in terms of anxiety, sadness, anger, irritability etc. This data from the patient, relative and observation by physician (§.6 and §.84) becomes an integral part of the holistic approach as it is related to the disposition of the patient, which is why Hahnemann has warned us against prescribing Nux vomica in a mild and phlegmatic patient and Aconite in a calm patient (F.N. § 122 to § 213).
Hence these observations that are unspecified but are found in a broader way like anxious, worrisome, irritable, sad, depressed etc. help to finalize the remedy and they require to be taken at the end even they are not specified (as per §. 153). If case processing is started primarily with such symptoms, it would give an unnecessarily large group of drugs, hence they are considered at the end rather than ignoring them though they are unspecific. The same is true for the physical dispositional features as well.
Since we have differed from Hahnemann’s and Boenninghausen’s literature and made our own ‘simplification’ and ‘explained’ them, we need to go back to original literature which is amply available and is self explanatory, so as to improve the quality of our homoeopathic practice to its optimum. There has been much recent advancement in homoeopathy all of which are connected to Boenninghausen and need to be understood in some or the other way, necessitating rectification following his original works.
An attempt to present his views which can be applied to practice to improve results.
Share your views.
Thank you Dr Kamlesh,for this particular aspect of Boenninghausen's book. I was told by my mentor when i was introduced to Boenninghausen,that to understand and learn Boenninghausen one has to sort of "unlearn" many aspects.
What i am writing are my own perception and understanding, i may be wrong, and will appreciate to stand corrected.
In learning Kent lot of emphasis is on Mental symptoms, yet in Boenninghausen if you see directly, there are only a few mind symptoms to contend with, yet if you go deeper into the subject you find that the mind symptoms has to be treated with other related symptoms bearing in mind the location, sensation,modality and concomitant;(as per my own understanding)before you can build up your case.
In many of today's repertoy and software there are so many rubrics, few example are "Hypertension" "Diabetes", "Sciatica",but Boenninghausen is sort of silent on it ,yet if you follow his "TPB" and based on his dictum of Location, sensation, modality, and concominant,you can find the most appropriate remedy,which can also be confirmed by going to MM Pura, and other established MMs.
Lately many software have surfaced using Boenninghausen ,but the work Done by Dr Demetriardis of Australia is worth mentioning. In his book in which he deals with TPB, he has embellished it with hundreds of researched footnotes to Boenninghausens work,which has clarified many anomalies and made it a "must read" book.
One software in the market is P& W software,which has incorporated some embellishment and works well.
When talking about Boenninghausen's repertories it is often forgotten, that his main repertory was the SRH. The SRH is the basis of Kent's and of Boger's Boenninghausen's characteristics and repertory 1905 and contains several mind rubrics with sub rubrics. The BB1 is an English version of the SRH which includes additional rubrics from the TT.
Dear Dr. Wequar Ali Khan,
I appreciate your comments.
It is interestingly presented by the majority that Dr. Kent has emphasized more on Mental symptoms. Then who has emphasized affection of mind less? No one!! Yes, Dr Kent has indexed mental symptoms to its specific level by way of particular rubrics. Hence it has more rubrics. By his time number of drugs were more as well awareness and acceptance for homoeopathy, colleges and hospitals of homoeopathy and practice of homoeopathy was more. As per understanding and demands, Dr Kent contribute his best by 1916 than what Boenninghausen did his best by 1846 and then by 1864.
In TPB apparently it appears very few number of mental symptoms. These are basic dispositions mainly seen in patients. They appear too general. Does this mean that he compromised on characteristics of mind symptoms?
If one has given criteria for defining what makes symptom characteristic and in that one has given 'Quis? - Who?' as the first one, how would he not give importance to Mental symptoms? It took 10 years for him in reforming repertory. He took care to avoid secondary symptoms while indexing; as secondary symptoms are maximum in mind section, so special care was taken by restricting to most reliable symptoms in the section.
In TPB each section is crafted in the manner that each one is supportive to the other if required. Hence modality component of mental symptoms has to be referred in < & > chapter. Likewise other chapters can be concomitant to mental symptoms. Thus we see that we get more number of mental symptoms than any other repertories.
Importance to mental symptoms will be decided by the case if it has characteristic mental symptoms and that too if more characteristic than other symptoms in the case. Without mind symptoms also Dr Kent has treated cases successfully.
Thanks for sharing your experience.
- Dr Kamlesh Mehta
Thanks. pl share these foot notes compiled by Dr Demetriardis of Australia. I could not locate any deails of hom on Google search.
We've always been told that a Complete Symptom has:
"Sensation, Location, Modality, and Concomitant."
And it has confused us endlessly as we search for the Concomitant.
Dimitriadis pointed out that those four characteristics describe a Complete "Case".
A Complete Symptom has only the "Sensation, Location, and Modality."
A Concomitant will have all three as well, and it becomes a Concomitant by its nature of being another (other than the main) symptom in the case, even though it may appear unrelated to the main complaint.
The patient has headaches (the main complaint), and this main complaint has Sensations, Locations, and Modalities.
The person also has (upon further questioning) stomach/digestive pains, and this side symptom also has Locations, Sensations, and Modalities.
As a whole symptom, it becomes a Concomitant to the main complaint, and it is the combination of these two that points to the remedy."