Specifics and Individualization 1

[David Little]

Dear Colleagues,

Homoeopathy is based on the methods found in the Organon, the Chronic
Diseases, the Lesser Writings and Hahnemann's casebooks. The methodology in
these works include single remedies, alternations, intercurrent remedies,
sequences and a series of remedies as needed. Hahnemann used acute
remedies, chronic remedies, anti-miasmatic remedies, acute and chronic
intercurrents, and prophylactic remedies. This shows that classical
Homoeopathy is much more than giving one single chronic remedy throughout
the entire treatment.

Nevertheless, a well selected chronic remedy (constitutional remedy)
can act alone for months even years and be repeated in progressively higher
potencies over a very long period of time. Those that think otherwise are
only using superficial remedies that do not address the inner essential
nature of the disease as represented by the Gestalt of the causes, miasms,
symptoms and attendant circumstances. The more understanding one has of the
patient and their disease the less (not more) remedies they will need to
use throughout the treatment. This is part of the maxim of Similia Minimus.

This said, there are times during chronic treatment that the
circumstances may demand the use of an acute or chronic intercurrent or
changes in the chronic remedies. This is more common in complex chronic
diseases involving divergent causes, complex miasms, dissimilar disease
states and advanced pathology. There are certain cases that present
themselves with advanced organic pathology of vital organs, compromised
organs of elimination, and weakened vitality. Such cases may have to be
treated in layers with a series of remedies over time. Some patients need
to be stabilized before deep action constitutional remedies can be given.
Homoeopathy is first and foremost a system of flexible response that can be
tailored to suit the causes and symptoms as well as the time and
circumstances.

Hahnemann wrote from early on that there were two major types of
causation. These are individual diseases based that often involves multiple
causations, and diseases with a single common cause and similar symptoms
that effect a homogeneous group. He noted that the approach to individual
and collective diseases are not identical so he developed the personal
anamnesis as well as the group anamnesis. The personal anamnesis is based
on unique causes, symptoms and circumstances of an individual while the
group anamnesis is used to find group specifics such as the acute and
chronic genus epidemics remedies.

Hahnemann spoke of specific remedies in his Common Source of Materia
Medica in 1817. In this work he pointed out that over the centuries there
are certain remedies that have proven to be specific for certain diseases
of fixed and constant character. He pointed out that Mercury was specific
for syphilis, China for marsh ague, Arnica for the consequence for blows.
falls, etc., and Spongia for goiter found in deep valleys. These collective
diseases include miasms, traumas, and environmentally educed diseases.
Hahnemann wrote:

"From the circumstances that constant remedies have already been
discovered for those diseases, few through they be, which have a constant
character, one might infer, that for all diseases of a constant character,
constant (specific) remedies might be found".

On this basis Hahnemann goes on to say that he has found several
specifics:

"And accordingly, since the only trustworthy way, the homoeopathic, has
been pursued with honesty and zeal, the specific remedies for several of
the other constant diseases have already been discovered."

Hahnemann then goes on to list a number of specifics for certain diseases.

1. Belladonna in scarlet fever.
2. Aconite (sometimes alternated with coffee) for purpura miliaris.
3. Spongia and Hepar Sulph in croup.
4. Drosera for whooping
5. Thuja for sycosis
6. Merc cor for autumnal dysentery.

This was written in 1817, the time that Hahnemann began his extensive
study of psora. By this time, the Founder had already come to the
conclusion that Thuja was specific for sycosis and Mercury for syphilis.
Krankenjournal DF-22 from 1821 shows that by this time Hahnemann was noting
the symptoms of psora with NB (Latin note well) and collecting symptoms
that would end up in the list of rubrics of psora in the Chronic Diseases.
It also shows that Hahnemann was already testing Sulphur as a possible
specific for the affects of psora. At this early date he was already
starting and ending many of his cases with Sulphur and using it as an
chronic intercurrent between other remedies! By this time it was already
his most prescribed remedy. He was to find out, however, that complex psora
was far too complex to be cured by any single remedy. For this reason, he
began to search for a group of antipsoric remedies by the group case taking
method. His group study lasted 11 years!

Krankenjournal DF 22 also shows Hahnemann using sequenced prescriptions
with remedies marked number 1, 2, 3, etc. The grand majority of these
sequences include a large amount of placebos. In chronic diseases the
sequenced remedies were usually changed around every 7 days. In acute-like
cases the sequenced prescriptions were repeated faster. Boenninghausen
later used a similar method of sequencing remedies in some of his cases.
This can be confirmed by reading the records found in Boenninghausen's
Lesser Writings. Some of his methods are reminiscent of Hahnemann's earlier
work, which the Founder for the most part left behind during the 1840s when
writing the 6th Organon.

Contrary to what some think, Hahnemann used more sequenced
prescriptions in 1821 than he did in the Paris cases of 1840 to 1843 when
using the C and LM potency in solution. Actually those who say that
Hahnemann used all sorts of complex prescriptions in Paris in the 1840s
have it totally backwards. The facts show less alternations and no long
sequences in the 1840s like those found in 1821! During his last years he
would occasionally use alternation (as he always had) but there are no 1,
2, 3, 4 sequenced prescriptions. Other than a few alternations the greatest
majority of all of the prescriptions made between 1840 and 1843 use 1
single remedy at a time. Many prescriptions marked with a 1 and 2 remedies
are the alternation of a medicine with a placebo!

In the 1840s Hahnemann started approximately 2/3 of his chronic cases
with Sulphur. In my opinion this was because he believe that Sulphur was
somewhat specific for the affects of psora, suppression, drugging and
maltreatment at the start of treatment. He also use Thuja against sycosis
and Mercury against syphilis. There were not, however, the only remedies he
used. So the idea of *specifics* for miasms and certain "constant diseases"
is a concept that is not outside the realm of traditional Homoeopathy.
Neither are the ideas of single remedies, alternations nor a sequence and
series of medicines over time.

Hahnemann was of the belief that specifics were most applicable in
diseases of common cause and similar symptoms like the miasms which led to
the acute and chronic genus remedies. It must also be noted that he also
mentioned environmentally induced diseases, endemic nutritional disorders,
and traumas. These techniques open the door to the idea of specifics for
"constant diseases" in traditional Homoeopathy. These specifics are found
by the method of the group anamnesis were a collective study is constructed
from the symptoms of many sufferers. Then the collective characteristics
are repertorized and studied in the materia medica.

In Boenninghausen's article, My Treatment of Membranous Croup (Lesser
Writings), the Baron discusses his "croup powders", which were composed of
3 remedies in sequence; Aconite, Hepar Sulphuris Calcareum, and Spongia in
the 200C potency. Membranous croup is an old name for diphtheria, a acute
miasm. This sequence of remedies appears to be based the two specifics for
croup introduced by Hahnemann in 1817 with the addition of Aconite. The
prescriptions is as follows:

1. Aconite 200C

Boenninghausen explains that this remedy suit the inflammatory condition.
He suggests the Aconite be given "few hours" to work and should not be
repeated quickly like every half an hour.

2. Aconite 200C.

The second dose of Aconite should not be given before 2 hours have elapsed,
and "only if the former symptoms return".

3. Hepar 200C

4. Spongia 200C

Boenninghausen notes that Hepar and Spongia have longer durations than
Aconite so they should be allowed to act for 3 to 5 hours before any more
doses are given. The Baron wrote of this method:

"The exact obedience to these directions has always proved itself most
perfectly effective, and I can give you my honest assurances that up to
this day I have not had a single case which turned out unfavorably." He
also wrote that if his directions were not followed properly he "declines
all responsibility" for the outcome.

Another facet of this method become clear in the article called The Use
of High Attenuations (Lesser Writings). In case VI Boenninghausen uses his
"croup powers" in a case of "quinsy" which threatened the life of the
infant. Boenninghausen's prescription was 1 Aconite 200C, 2 Hepar, 3
Spongia, 4 Hepar. In this case, the patient was cured by a single dose of
Aconite followed by a single dose of Hepar. The rest of the prescription
was NOT taken. The Baron wrote:

"After the second powder the infants was already perfectly cured, and
there was not need to administer 3 and 4."

This shows that Boenninghausen did not give these sequences mechanically
without assessing the individual reaction to the remedies. In the first
quote he speaks of waiting the right amount of time and not repeating the
second dose of Aconite unless there was a relapse of symptoms. In the above
case history he stopped giving the remedies as soon as the infant was
better from numbers 1 and 2 and did not administer remedies 3 and 4. This
show the proper use of a specific sequence of remedies for a dangerous
acute miasm.

The idea of specific remedies for "constant diseases" opens the door
for the investigation of traumas, group poisonings, endemic environmental
diseases, endemic nutritional disorders, miasms and other collective
disorders. Could such method be applied to "group hysteria", "mass
psychosis" or "war fever'? What happens when a whole country is traumatized
or caught up in a frenzy? What about collective archetypes found in mental
disorders in groups of patients? Can we expanded our understanding of
collective diseases and the group case into these areas also? The idea of
"specifics" is not restricted to one remedy alone as we have seen Hahnemann
had 48 specifics for psora! There can be groups of specific remedies for
collective disorders so one still must use individualization to find the
personal remedy for a person in the group. This is the meeting point of
the individual and collective!

Can collective specifics also be applied to one sided pathological
states? It seems that when pathology is very advanced, and there are
breakdowns in vital organs and systems the organ, tissue and system
remedies may play a role. At this time remedies that have very strong
regional relationships seem to come forward. Can advanced pathological
states be considered "constant diseases? For example, look at Ceanothus in
advance pathology of the spleen, etc. I am not suggesting that there is one
remedy for a each disease state etc. I believe this is a grand over
supplication but can organ, tissue and system relationships to be used to
find remedies in one-sided diseases with heavy pathological of long
standing constant character?

This investigation into the classical methods of Hahnemann show that
individualization and specifics both play a role in classical Homoeopathy.
So does the use of single remedies, alternations, intercurrents, sequences
and a series of remedies if necessary. When one looks at this fact one can
only come to the conclusion that the modern idea of classical Homoeopathy
is much narrower in its scope than what was introduced and practiced by
Hahnemann and the first generation. This shows there is room for all those
who follow the cardinal principles, including high potency
constitutionalists and mentalists and low potency physically oriented
prescribers. I personally do both as the patient, causes, symptoms and
circumstances dictates.

Now this said, these methods have little in common with the so-called
specifics chosen by disease titles alone nor alternating remedies or giving
long sequences in advance for weeks and months on end. It also does not
include the use of combinations medicines. In classical Homoeopathy
specifics are used in diseases based on a common cause and similar symptoms
that affects a homogeneous group. Hahnemann's writings show that they are
discovered by the historical review of potential specifics and the group
cases based on a collective study of the target disease. The most common
example are the acute and chronic genus remedies used for acute and chronic
miasms.

Hahnemann does, however, open the door to other collective states like
traumas, endemic nutritional disorders and environmentally induced
diseases. Such methods have also be found useful in group poisonings and
toxic exposures. The role of specifics in advanced pathology is more
experimental but also has some documentation. Experience shows, however,
that no one remedy suits all patients under every condition although a
group of specific remedies may be indicated more often than other remedies.
So with these ideas in mind let us review all the classical and
contemporary material with an open mind balanced by an understanding of the
checks and balances built into Homoeopathy that makes it a safe and
effective system.

Similia Minimus
Sincerely, David Little

[Tauseef Khan]

Dear Mr Little (Can I call you Dr Little? I have not seen you use
that expression anywhere)

I would like to thank you for your regular insightful emails on
homeopathic philosophy, prescribing and methodology etc. Your emails
are the only ones which I save in a separate folder and look forward
to them everyday.

Just curious, you are seeing patients, running your website and course
(which I plan on taking in future), writing books; how and where do
you find time to write such long meaningful emails.

Keep up the good work.

Regards,
Dr Tauseef A.Khan
P.S. As a recent conventionally trained doctor and epidemiologist I am
new to homeopathy. I started to read about it as a side project but
when I realised the depth of this art and the immutable law of nature
it is based upon I planned to learn this it in its fullest. Most
instrumental influence on my decision has been none other than David
Little's articles and interviews I read initially on the internet -
which pushed me to start learning this art with by reading the source
first, the Organon, rather than some rehash shortcut book! Thanks
again.