Minutus

Dear all,

this original discussion (which centred around aphorism 42) was about the
presence of more than one dis-similar disease. It seems now to have
meandered away from this into other aspects of theoretical knowledge,
understanding (or lack of it), interpretation and misinterpretation. I also
feel that we are often near to a precipice of rudeness during some of these
discussions (I have to include myself in this as I get marginally irritated
at the manner in which people's opinions are stated).

However, if I am right in my understanding then Andrew's first claim was
that if more than one dis-similar disease co-exist they can possibly require
different remedies (not at the same time).

I don't think there can be too much argument with this. In the presence of
more than ONE chronic disease state which, when the case is fully taken,
will not/do not correspond to ONE simillimum then, in my opinion, it nearly
always becomes evident which is the more dominant state, the more life
threatening and the one which has to be prescribed on first - and the choice
is made for you. I personally think it is rare for this not to happen.

Even in the presence of more than one acute state - say, for example, a
debilitating 'flu with a life threatening high fever - then they fall out of
bed and break an arm and there is excruciating and unbearable pain and these
two states will not/do not correspond to one simillimum then the life
threatening high fever has to be attended to. If there is no dangerous high
fever then excruciating and unbearable pain of the broken arm can be
addressed. With the right remedy, dose and potency the pain or fever
(whichever is dealt with first) will begin to subside almost immediately (or
certainly should do).

In my understanding the other point that was being made was that if it was
becoming obvious that the various diseased states will not/do not correspond
to the ONE simillimum then it is important not to force them together and
then arrive at a poorly chosen remedy - based on what Andrew called the
'mythical' totality. This would be bad practice and will never obtain a
cure.

Careful, diligent, factual case-taking is imperative every single time.

Anyway that's my last tuppence worth.

Best wishes, Joy Lucas

At 08:43 PM 6/16/2002 +0100, you wrote:

Dear Joy,

Hahnemann clearly noted that more than one dissimilar diseases can be
present in the human organism without detriment to the unity of life. In
aphorism 40 he offers the example in the footnote where two or more chronic
miasms are present and suggest each miasm be treated with its appropriate
anti-miasmatic remedy. Sometimes Hahnemann accomplished this by a series of
remedies and at other times alternation is used. I have found examples of
both in his writings and Paris casebooks.
Andrew mentioned "dual remedies", which is an incorrect use of a
polypharmacy term. Hahnemann did not use dual remedies. In complex diseases
he alternated different remedies at different times according to the signs,
symptoms and circumstances or gave a series of remedies if needed. It must
be pointed out, however, that since Hahnemann time many remedies have be
discovered to possess multi-miasmatic powers and may treat more than one
miasm with one prescription. There are many clinic cases histories that
prove this point. Much depends on the nature of the signs and symptoms as
well as the time and circumstances. If the symptoms clearly point to such a
multi-miasmatic remedy is may be administered. If the symptoms do not point
to such a remedy it is best to treat the strongest miasm first as Hahnemann
suggested.
Hahnemann's example is about chronic diseases states in particular. At
first a new stronger dissimilar disease with suspend the older weaker
chronic state but after a longer period of time they may form a complex
disorder where each settles in those areas to which it has affinity. Layers
become complex disorders and complex disorders still have layers. Layers
and complex disorders are not mutually exclusive. This is obvious in the
quotes from the Chronic Diseases I posted. In this case, one treats what
Hahnemann called the "most prominent" miasm first and then treats the
others as the symptoms dictate by layers.
Boenninghausen spoke of seven major types of causation. In his
categories the above is not really two acute diseases. One is a acute miasm
and the other is a traumatic befallments. Only the most one-sided
constitutional extremist would ignore the above facts. Kent makes it very
clear in his writings that when two acute miasms are present it is best to
prescribe for the strongest acute miasm first and then the less stronger
will come forward for treatment. He also makes it very clear that one
should not mix the symptoms of acute miasms and chronic miasms together. It
is ironic that some of todays Neo-Kentian prescribers try to give one
remedy for all situations all the time and do not believe in acute and
chronic diseases or layer and complex disease states.

I might point out that there are a few cases in the Paris casebooks
where Hahnemann alternated an acute and chronic remedy. One such case was
when a very psoric fellow fell off a horse. It seems that Hahnemann thought
that the psora was activated by the injury and was an obstacle to the cure.
In this case he alternated Arnica and Sulphur until the traumatic symptoms
abated and then he continued the Sulphur alone. Such cases are a rarity in
his casebooks but there are a few.
The principle of the totality of the symptoms is essential in
homoeopathic prescribing but it must be applied properly. It in itself is
not a mythical idea but to take traumatic befallments, acute miasms and
chronic symptoms and mix them all together is not the proper way to
prescribe in most cases. One has to look at the nature of the patient's
suffering and assess the individual condition. One has to treat the patient
by the proper priorities. Kent wrote that to artificially mix together
symptoms that do not belong together can be a mistake. There are some cases
that manifest their disease symptoms as a constitutional expression and
other cases that are presented in layers and/or complex states.

One must, however, be very careful about what they call separate
"diseases". There are those that express the opposite extreme of the
one-sided constitutionalists. They want to treat a every headache,
backache, or stomach and other such allopathic titles with different
remedies (sometime in combinations) as if these constitute diseases in
themselves. As we know such manifestations are often only concomitant
expression of a unified state of disorder. So each case should be treated
in according to the circumstances.

Hahnemann noted basically two states, i.e. acute and chronic. Among the
chronic diseases there are those that are singular, those formed in layers,
and those that are complex disorders. Layers and complex disorders,
however, are not mutually exclusive states. Layers become complex diseases
and complex disease still have layers according to their strength and
activity. These layers are like strong currents in that they still can
affect the waves on the surface. Sometime one sees waves and currents on
the surface of the ocean that are moving in different directions and at
different speeds. It is very rare to see two complex miasms of the exact
same strength and activity at the same time. Hahnemann made this clear in
the Organon and Chronic Diseases.

Once one has come to a different diagnosis as to whether they are
witnessing a acute or chronic state they must decide is this case is
expressed in a unified constitutional expression or in layers and/or
complex states. A correct remedy must be based on totality of the symptoms
that includes the locations, sensations, modalities and concomitant
symptoms that fits the situation at hand.
Amen
Yes, I think I have about talked this one out for myself. To me homoeopathy
is a system of flexible response that can be individualized to suit the
particular diseases case at hand. There is no one technic that can do
everything all of the time.

Sincerely, David Little
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000

David, thank you for your long post which I have heavily edited as I am sure
most have read this discussion. I have to say (and hopefully not
disrespectfully) that I have learnt much of what you wrote, although none of
us ever stop learning I don't feel that at this point in time I need the
lessons! I was merely trying to escape (for want of a better word) the maze
of intellectualisms and "Organon Speak" which didn't seem to be going
anywhere (for me) beyond the original points made. The whole discussion
began quite innocently and I don't think any of us disagree when you read
over the posts that have been exchanged.

However, having said that, it is the paragraph at the end of your post which
floored me. After all the intellectualisms you seem to be promoting an 'any
which way' approach.

I definitely rest my case.

Joy Lucas
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At 04:55 PM 6/18/2002 +0000, you wrote:

Dear Joy,

This was not a lesson I was personally giving you. I always write for
the silent majority, especially students. Therefore, I tried to deal with
the diversity of clinical possibilities. I have moved my posts away from
whether complex disease exist or not (I pointed out they existed right from
the start) to how to recognize different disease states and treat patients
in the clinic. I used references from the Organon, Chronic Disease and the
Paris casebooks as well as clinical examples.
First one has to get some intellectual comprehension of clinical
realities and then one must gain clinical experience. I am sharing both. Is
this what you are speaking of?
Homoeopathy is a system of flexible response that makes it possible to
treat a diversity of clinical situations. You can not treated an acute
disease like a chronic disease nor a singular disease like a disease that
is in presented in layers or as a complex. Each clinical situation takes
differential diagnosis and an appropriate case management strategy. Far
from intellectual ideas these are clinical realties.

Next time I will just address my thoughts to the greater group.
Sincerely, David Little
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000