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Fine Tuning Symptoms: A Critique of Classical Homeopathy 3

FINE-TUNING SYMPTOMS: A Critique of Classical Homeopathy Part 3

 Dr. M. A. Usmani

Homeopathy, to get a semblance of a science of therapeutics, must come to terms with pathology as the basic science of therapeutics. And unless homeopathy incorporates the nomenclature and schema of diseases recognized and used by the dominant school, there is no escape for homeopathy being branded or stigmatized as quackery.   


Homeopathy took a great stride when Hahnemann invented Miasms, and made them the basis of therapeutic. This was a fundamental change that made many of his disciples baffled and dumfounded. With this cataclysmic shift the practice of empty, mechanical and brainless symptoms-matching, for finding the indicated remedy, fell into disuse and disrepute. Many homeopaths felt totally lost; especially the class of homeopaths whom we have called ‘lay-practitioners’, in one of my previous articles, i.e.


But the concept of 3 Miasms was rather too limited. There is no restriction to remain confined to this limited number. More miasms can be coined and added to this list, as Tubercular miasm, Cancerous miasm, Marsh (or Malarial) miasm or Haemorrhagic miasm (caused by the bite of some insects, as Dengue mosquito, or some spider or reptile), where the tendency to hemorrhage becomes chronic.  But these miasmata are in fact categories and not the individual diseases, which are legion. Nomenclature of diseases is stupendously vast and varied. A homeopath should accept diseases as real entities, recognizable by their symptomatology and laboratory analyses.  The next work for the homeopathic profession is to classify the whole data of diseases according to miasms, which can only be accomplished by first acquiring full etio-pathological knowledge of individual diseases; then tucking them into the related super class of a miasm. This, I admit, is an uphill task, disturbing the whole routine practice of a homeopath. Surety and success will come this way. This is akin to knowing the pathology of the drug that will, ultimately, be compared with the pathology of the disease. Dr. William H. Burt says—(I have quoted him in the above referred article):


  • A physician who cannot diagnose the pathology of a drug, need not to expect to be successful in the treatment of disease.
  • We are fully persuaded that to endure the crucial test of science, the Materia Medica of the future must stand upon a physiological basis.
  • The first thing to learn about a drug is its physiological and pathological action upon the healthy human organism. To know what tissues it acts upon, and just how it affects them, leads directly to its curative action.

The knowledge of this localized action gives us the key to its therapeutics; for a reflex symptom is far less valuable than a primary and idiopathic one.


What a doctor can he be who cannot have a prescience of a coming disaster, and cannot do something for it? So it is a meritorious work of the predominant school of having created such a comprehensive data-base of diseases—with etiology, pathology and prognosis. A good and competent doctor should be conversant with it.


When you do not know the real background of the disease your patient is suffering from, you, in your good faith, will go on dealing or ‘curing’ his day today ailments, and always coming up with flying colors. You and the family of your patient are totally satisfied. Then one day your patient is brought in an alarming shape by the family. You come to know that they had been away in some other city for quite some time, and the little patient had fallen seriously sick. The doctor there diagnosed ‘Hereditary Telangiactasia’ by examining his sclera, etc. The diagnosis was confirmed by a hospital. In short the patient died in a few months of respiratory complications.  Now, I heard the name of this disease for the first time. Signs and symptoms of the patient were confirmatory. The diagnosis will be the same, may one be living at the South Pole of the earth or at the North. The etiology and pathology and prognosis will be the same at all geographic places. He had satisfactorily been dealt with whenever he fell sick. Even nosodes had also been given according to the family background. But his real disease remained un-tackled, as it was unrecognized. So diseases should be accepted as identifiable entities: having definite determinable identities. Symptoms similarity-prescribing can go a little far, but will always fall short of the real cure. Diagnostic symptoms of diseases are constant, recognized as such all over the world. But they need not be always tangible and apparent to the senses. There can be grave pathologies without symptoms. Only laboratory procedures can reveal them—or, even, predict them. Cases of renal failure are striking examples of such cases. So keep your scientific attitude always awake and intact. If diseases can become hereditary as, for example, celiac disease, epilepsy, Alzheimer, asthma, tuberculosis, etc., how can we say that ‘disease is nothing, and there are only symptoms’? This hereditary field is a fertile ground for the working of our nosodes.   


After acquiring full pathologic knowledge of most of the diseases, a homeopath will strive to sort out the whole data to categorize and assign a super classification according to the miasms. Then a list of the relevant miasmatic remedies will come to the fore from which the indicated remedy (or remedies) will be selected; and from the latter the similimum will be determined after whetting with the help of fine-tuning chapters of the repertory.


When a drug disease is known in this manner and having it been already classified under  particular miasms, the similar drugs come to the fore for determining their homeopathicity to the case in hand. Here the ‘Fine-tuning’ symptoms, with their relevant chapters in repertory, come into action, and help us to determine the similimum.   


After knowing the pathologic scope of every remedy, and knowing its predominant miasm, prescription will become easy and certain. Instead of putting some general or mental symptoms, at the beginning of repertorization, you will put instead pathology or the pathologic name of the disease at first, and then find out the remedies from among the relevant list. The similimum will be among this list that will be determined with the help of ‘fine-tuning’ gadgets.  


For example, in a case of sterility (or infertility) with Fibroid uteri and—as concomitant—disorderd  catamenia, and various vaginal discharges, one should begin the repertorization by putting the gross pathology first, followed by other related complaints, e.g.:


1-    Fibroid Uterus;

2-    Irregular and missing menses;

3-    Meager or copious blood flow; for short or long duration;

4-    Other Vaginal discharges; their times and occasion for occurring; and their pathological laboratory analysis;    


From these pathologic symptoms quite few remedies will come out. The similimum would be that which may cover the maximum number of fine-tuning symptoms, such as:


a)    Cravings and aversions, which may be related to:

  • Palate: as Foods and Drinks, or other culinary delicacies
  • Sexual: as Satyriasis or Nymphomania, or a total aversion to sex.
  • Mental pursuits or Aversion to mental work, etc.


b)    Temperament as: Mild or Violent; Sympathetic or Cruel; Lachrymose or Irritable, or Angry. 


c)     Social or Asocial, Anthropophyllic or Anthropophobic


d)    Proud or Amicable;


e)     Thermal Responses as: better or worse from cold or heat; or wet or dry weathers.

and so many other such qualifications.


But all the fine-tuning symptoms or chapters, in repertory, are not of equal importance. Food’s cravings or aversions should be given the lowest grade as those are whims oriented and created or modified by personal accidental happenings and situations: as someone may abhor fish, having been frightened by seeing it whole, in his or her childhood. Someone in life might have prolonged dyspepsia, and every doctor asked him to take rice, with the result that he developed an aversion to rice. There can just be an opposite reaction also. A man suffering from celiac disease, in his childhood, and having taken rice for quite few months or a year developed a craving for rice. Or owing to misbehavior of a step parent to a child it makes him violent and hateful towards society, or he may become a meek personality. So we come to the conclusion that mind’s symptoms and the food liking and aversion symptoms, should not be given precedence over the exact and striking physical symptoms.  These should not be depended upon or given a high rank in the anamnesis of a case.

Along with ‘fine-tuning’ symptoms there are sometimes qualifying symptoms under the main complaint. Such symptoms also help fine-tune the case. Take, for example, a long-standing case of remittent fever. Now under the rubric of remittent fever we find other fixing symptoms: e.g. aggravation of fever in morning, afternoon, evening or night. Here if the time of aggravation is morning, it would be a sterling symptom, as we know that the time of aggravation of this class of fever, in 80% of cases, is afternoon or evening. We have only 6 remedies for morning aggravation, while 31 for the afternoon—so, less remedies to choose from. There are some other qualifying sub-rubrics under the Remittent Fever, e.g. ‘infantile’, ‘occurring every autumn’ and ‘prone to become typhoid’, etc. 


 In some other cases with gross pathology, to which the dominant school has given a definite nosological name, and there is no rubric in our literature with that name, I’ve seen our doctors starting their repertorization with such generals as:


  • Aggravation Summer, or winter;
  • Aggravation from Sun, e.g.  Headache;
  • Desire for open air; or aversion there to;
  • Aggravation Warm Room;
  • Agg. or amel. heater; or radiated heat;
  • Thirsty or thirstless;
  • Then Desires and Aversions of foods, etc.


By following this route sometimes one reaches a remedy that may do some good, but this is evidently not a learned approach, and merely a hit and trial method. Developing such a methodology in repertorization would be uncouth and slovenly practice. A successful doctor would be he who grapple the disease phenomenon and search from his armamentarium drug phenomenon that matches the disease phenomenon.


Here, in such situations, my mentor, the great Burnett, would proceed sagaciously and logically. When pathologic name of the disease is not found in homeopathic literature, his way was to discover the organ or system at fault, identify the mode of its affection and affliction, and recognize the miasm at work; then find the organ affinity agents—or Organ Remedies, as they are usually called,  in our armamentarium, or search the rich sources of the Naturopaths or the Organopaths: as Paracelsus (or Hohnheim) and Rademacher, et al. Apply them judiciously for at least a month, in drop-doses of low attenuation, then give the anti-miasmatic remedy, at most three doses a month. Organ remedies stimulate the organ so that the organ itself becomes active against the encumbrance and tries to unburden itself. The anti-miasmatic remedy, takes charge of the whole organism and tries to loosen the ages-long grip of the inborn impedimenta or miasm; thereby the organ gets a boost towards health by shedding its hereditary disease tendency. Next month when the organ remedy is repeated or a new one is chosen, it will act more intensively and extensively, because the miasmatic encumbrance has been lessened. There can happen, during this process of strategic alternation, a conglomerate of symptoms emerges on the scene showing a true picture of some homeopathic medicine. This medicine should definitely be employed for as long as it works. When, after short or longer time, it ceases to work further, it is the time for either the repetition of the same remedy or some other remedy will come to the fore. Or there can be a situation where no definite homeopathic remedy is indicated. In the latter situation it is the time to resume our process of alternating organ remedy with the miasmatic remedy.


Take for example a liver patient: may he have hypertrophy, fatty liver, or cirrhotic condition. Let’s talk about Fatty Liver. Much liver symptoms fall under psora, Cancer is more syphilitic than anything else—usually it is a combination of all the miasms. Tubercular miasm usually do not have much relevance with liver diseases unless there may develop a tubercular abscess. About Sycosis Allen says that liver is dormant in this miasm. But if a fatty liver patient become prone to diarrhea, developing diarrhea from the slightest indiscretion; evidently the patient is drifting towards hydrogenoid constitution of Grauvogle, hence toward Sycosis. But the case advancing towards cirrhosis is a miasmatic transition from Sycosis to Syphilis. Symptoms at the time of prescribing will decide how to proceed. Only functional ailments as anorexia, aversion to fats and warming foods, bitter taste, fullness and nausea from rich foods, etc., would reveal the activity of the Psoric stage of the liver. So you have to go according to the situation. The organ remedies though can be used at any stage, but have great relevance at the Psoric stage.


Similarly in gynecological practice, in a case of infertility (sterility): ultra-sound revealing ovarian cysts and tumors and fibroids, with copious leucorrhea, would point to Sycosis. But this neoplasia taking a malignant turn will terminate in Syphilis. Simple discomforts and pains without any physical deformity will be taken as Psoric: as simple dysmanorrhea and bland leucorrhea. Bur vaginal catarrh many times has a definite tubercular taint at its base, which disappear as charm with one or two doses of Bacitub—a combination of Bacillinum and Tuberculinum.


The last mentioned category of cases—and also the liver cases—have effectively been cured and managed by Burnett. Anybody can testify the veracity of Burnett’s methodology. One should have intensively extensive knowledge of Organ Remedies and insight of the great old physicians as Hohnheim and Rademacher. Burnett took great advantage of intercurrent usage of some ‘pick-me-ups’, as Vanadium, Rubia Tnctoria, and few others. This step gives pep to the system and few days’ respite to the struggling organs.


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Comment by Dr. M. A. Usmani on October 20, 2014 at 5:40am

Debby, How sweet you've comeback. I didn't expect only 'liking' from u. Give ur opinion.

Thanks dear Dr. Wequar. Sincere friend, that you are!

Comment by Dr. Wequar Ali Khan on October 19, 2014 at 4:02pm

Thank you Dr Usmani, your each article is a learning experience. Your examples give us a guideline as to how one should go about. Knowledge is power;

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