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Every patient has an individual story to tell and a myriad of emotional responses to the life they are leading and have experienced so far. We know there is a relationship between which remedy we choose and the presentation of the patient and spend many hours studying remedies looking for their elusive “inner essence”. We form character pictures and learn them and look for them as our patient begins to tell us of their illness and the events preceding and accompanying that illness.
In the same way we have developed mind pictures we have also developed physical pictures of presenting illness – with accompanying physical characteristics. These pictures we call the keynotes of a remedy. They are distinctive physical manifestations known to that remedy or a small group of remedies that we can remember due to their individuality.
For example if a patient comes into our clinic and is egotistical, has hot burning feet in bed at night and gets hungry at 11 am our mind jumps quickly to the remedy Sulphur.
MIND; EGOTISM, self-esteem (31)
EXTREMITIES; HEAT; Foot; burning (37)
STOMACH; APPETITE; increased, hunger in general (280)
GENERALITIES; FORENOON, nine am. - noon; agg.; eleven am. (34)
But when we repertorise on these four rubrics that best represent our case Phosphorus is also covered by all rubrics. Also Lyc, Puls, Calc, Nux, Sep, Agar, Ars, Lach and Med only miss out on one rubric each. And in reality patients have far more than one presenting mental and three physical symptoms. We also have to assume our characterisation of egotistical is correct and not part of our own bias or misinterpretation.
We know that the repertory covers the best allocation of symptoms from the provings presented in an order that we can find. We know that the materia medica gives us a sample of the remedy proving in a presentation that is sorted (usually from mind to head to toe). But neither the repertory or the materia medica covers every aspect or potential of that remedy. So how do we find our remedies?
The above patient example highlights a number of problems when looking for and finding remedies
· Essence pictures in combination with keynotes usually match one of a possible group of remedies but often disregard remedies that also match those symptoms
· Patients have far more complicated presentations (both mentally and physically) than just a few keynotes or even a single essence
· Repertories do not have every possible symptom from each remedy allocated to all possible rubrics
· Materia medicas have even less information than repertories and yet we often use them as our final deliberator of the remedy we will choose
Hahnemann and many great teachers since have emphasised that the practitioner must be unprejudiced. It is easy to maintain a distant observatory stance when viewing physicals but how do we achieve impartiality with a mental picture of a patient? As human beings we are designed to judge others on their presentation and behaviour. This is a natural part of protecting ourselves from possible harm and an extension of how we find our place in complex communities. We cannot help but to extend this judgement to all aspects of human behaviour. In the clinic it can be impossible to be impartial and not judge behaviour in light of our own personal experience.
The combination of different types of patients, different practitioners with individual personal experiences, limited repertories, reduced remedy information in materia medicas and finally different interpretations of remedies makes remedy selection for chronic illness seem overwhelming and at times almost impossible. Then after great deliberation we choose what looks to be the best remedy and it doesn’t always work.
One of our famous homeopaths CV Boeninghausen saw all of these problems and developed a method using generalising. Generalising mental or emotional concepts and even physical presentations is easier and often more accurate than specific interpretation. This type of interpretation allows the practitioner to really become an unprejudiced observer and to allow themselves to never know their remedies in advance but to be able to choose them accurately. The only way to achieve this state is to have broad categories of symptoms (generals) which can be accurately chosen to fit the patient. As broad categories are almost always large (and seem the antithesis of individuality and yet in combination express individuality perfectly) they can only be chosen and worked with through the process of repertorisation. That is, combining large ideas and concepts (generals) whilst performing a natural reduction of possibilities to end up with a limited remedy choice.
Energy resonance is the crux of how the homeopathic remedy works and how it represents the vital force of the patient. Energy comes before the material and an energy imbalance will precede every expression of physical and mental illness. It may be traced back a few months, a few years or in some cases a lifetime. Energy can only be seen from its physical manifestation. The homeopath is trying to replicate this energy through their remedy choice and must use their skills as an unprejudiced observer to determine this energy. The life pattern of a patient can be a useful way to determine one or a few mental rubrics.
Life patterns or life themes highlight the dominant energy of the patient and are represented by the events that surround the patient over extended periods of time. In many cases they represent a lifetime pattern but can sometimes represent shorter more intense periods of time. A life theme is a generalised way of looking at the mental state of the patient. Whilst every patient has a myriad of emotional expressions that come and go with daily events, a life theme shows more consistency and represents longer periods of time. Often a life theme will be an ongoing factor that drains the energy of the patient and contributes to the patient's lack of well being.
Physical structure is also a representation of our internal energy. The face displays generalised shapes and structures with commonality but in combination allows for individuality of appearance. Using the basic shapes and structure a generalised grouping for patients can be made. This grouping is what we call a miasm or a survival instinct. The energy of the patient is manifested in both their appearance and in their life events and in their physical symptoms.
Using generals to express both the mental state and the physical state of the patient allows for the least unprejudiced interpretation of the patient and lets the remedy be delivered to the practitioner rather than the practitioner attempting to know everything about remedies and patients in advance.