by Matthew Wood
The third step concerns the estimate to be put upon the patient’s own description of his sensations. This is a very vital point, and in order not to be misled it is always well to ascertain if any of the following primary sensations are present: Burning, Cramping, Cutting, Bursting, Soreness, Throbbing, and Thirst.
… Next in order of importance comes the entire objective aspect or expression of the sickness: This should especially include Facial Expression, Demeanor, Nervous Excitability, Sensibility, restlessness or Torpor, State of the Secretions, and any abnormal coloring that may be present.
Lastly, the part affected must be determined; this also brings the investigation in touch with diagnosis (Boger 1931, from unpaginated introduction).
The qualities capitalized are rubrics or headings in Boger’s Key. Notice that Boger, like Boenninghausen, does not go into great detail under emotions and psychology, but only mentions major types of emotion (Sadness, Fear, etc.). This is the approach taken in Traditional Chinese Medicine and in The Earthwise Herbal Repertory. The bare essentials of the psychological presentation are often all that is needed; modern homeopaths and herbalists, by comparison, often take extensive psychological profiles but do not understand pathological symptoms. The practitioner can develop his or her own approach to psychological issues.
Not having been trained in psychoanalysis, I prefer to let the physical body guide me to the constitutional remedy whenever I am at all doubtful of the psychological component, which is fairly often.… The main advantage of this method is that far less psychological interpretation is required on the part of the practitioner in order to arrive at the indicated remedy. Interestingly, I have often found that a remedy selected this way is later discovered to cover very fundamental psychological symptoms in the case that were either missed or misinterpreted by the practitioner or withheld by the patient (Ian Watson 2004, 68).
The first major additions to Boenninghausen’s work were made by the English homeopath John Henry Clarke. The first edition of his Prescriber came out in 1886 and has been in print (with updates) ever since. In The Prescriber he explains, “My work has been to approach practice from the clinical side. Boenninghausen’s work approaches it from the symptomatic side.” Clarke’s Clinical Repertory (1904) is an addendum to Boenninghausen’s Pocket Book.
What is the difference between a repertory and a prescriber? A repertory is based on cross-referencing symptoms, without including clinical details, while a prescriber is based on disease names, pathological conditions, and keynote symptoms frequently encountered in practice. The prescriber is therefore a practical clinical guide, not a comprehensive index for arriving at a remedy through the analysis of symptoms.
Because The Earthwise Herbal Repertory is based on a system for cross-referencing symptoms (tissue state, organ, specific indication), it is a repertory. However, it often lapses into the model of a prescriber since herbalism does not have the rich knowledge of symptoms that homeopathy possesses. Most of the so-called herbal “repertories” up to this point have been prescribers. If herbalists are to incorporate this method from homeopathy, they should understand such distinctions. This is part of the reason for our extensive treatment of reportorial history and layout in this part of the book.
The Earthwise Herbal Repertory resembles the baron’s approach since it is based on tissue states and organ affinities, which are similar to sensations and locations. Herbalists have not accumulated much knowledge of modalities, but to the extent these are known, they would largely identify tissue states. The practitioner arrives at the remedy (or several remedies) through cross-referencing symptoms, not necessarily by looking up the name of the disease.
A repertory following Boenninghausen and Clarke was compiled by Oscar Boericke and included in the back of the ninth edition of his brother William Boericke’s Pocket Manual of Homoeopathic Materia Medica (1927). This repertory included many plant remedies, and was used by both Michael Moore and myself (Matthew) in the construction of our repertories. In print to the present, Boericke’s is the last of the traditional repertories descended from Boenninghausen until Indian homeopaths began to make new contributions in the 1960s.
A completely different approach to repertory construction was pioneered by James Tyler Kent (1849–1916), the still-controversial revisionist of Hahnemannian homeopathy. Quite remarkably, Kent is the only major homeopath we know of who was educated inside the idiosyncratic walls of the Eclectic Medical Institute during the tenure of Dr. Scudder. We see in him the ruthless independent medical thinking of Scudder and the eclectics, who took “whatever worked” from wherever they wanted. Kent embraced this spirit, but came to despise the “mongrelism” of the eclectics and any homeopaths “tainted” by open-mindedness to other medical systems. Living in St. Louis, isolated from the homeopathic educational lineages established by Hahnemann’s followers in Boston, New York, and Philadelphia, Kent’s approach was a departure from the past. He developed a completely new interpretation of homeopathy—which, however, he represented as the true, more profound teachings of Hahnemann.
Kent was highly influential, and the split he caused in homeopathic circles has not ended to this day. The homeopathy he formed and shaped is called “classical” or “Kentian” homeopathy, while that which adheres to the teachings of Hahnemann and Boenninghausen we call “traditional.”
“Kent, in his writings, admits that he could not use the Boenninghausen method, and it made no sense to him,” wrote Julian Winston (2001). He did not think like the baron. Like many nineteenth-century American homeopaths, Kent was a follower of Emanuel Swedenborg, a visionary who taught that the universe is laid out from an internal essence to the outward physical expression; though the outer person does not necessarily notice it, over the long run the inner self dominates the outer personality. This agreed with an additional law of homeopathy introduced by Constantine Hering, a student of Hahnemann, which is usually called the “law of direction of cure” or “Hering’s law.” As a cure takes place, writes Hering, the symptoms move from vital to less vital, from inner to outer, top to bottom, and in the reverse order in which they arrived.
Kent called this principle “government from center to circumference.” He looked upon it as a universal law, and applied it to every aspect of homeopathy. His repertory is therefore organized to cause the practitioner to analyze the case from the psychological and constitutional indications outwards towards the peripheral, purely physical expression of the disease. This encouraged a tendency in homeopathy to focus more on the psychological and constitutional, and to overlook “mere” physical disease. This tendency increased in the last half of the twentieth century, when most homeopaths no longer had any training in physical medicine.
Using Aristotelian language, already long out of date, Kent organized his information “from generals to particulars,” or from the unified theme of a remedy to its particular or local expressions. Combined with his Swedenborgian tendencies, Kent managed to anchor homeopathy into a metaphysical backwater that the rest of the world soon passed by.
Kent lectured on Hahnemann’s Organon as if the founder’s ideas were in concert with his own. He was a persuasive orator, intolerant of other views, and he bent the homeopathic stream towards his own theory and practice. While his contributions are undeniably substantial, he introduced a note of intolerance and a “one-size-fits-all” attitude that has not been healthy for homeopathy. It had already suffered a certain amount of this due to Hahnemann’s own penchant for dogmatism and intolerance—though that lessened in his later years as his loving wife apparently smoothed out his sharp edges.
One innovation introduced by Kent, which influenced nearly all homeopathic schools, as well as the development of Dr. Edward Bach’s flower essences, and eventually the herbal world as well, was his emphasis on the “essence” or primal unity holding all the properties, uses, pharmacology, and symptoms of a remedy together into a whole. This eventually found its way into herbalism; we see the influence particularly in the appro
ach of Dorothy Hall, Matthew Wood, Eliot Cowan, and Stephen Harrod Buhner. For further studies on Thomson, Hahnemann, Scudder, Kent, and Bach, see Vitalism by Matthew Wood (2000).
Robin Murphy suggests that the complex format of Kent’s repertory, used in many homeopathic schools, is partly responsible for a high rate of attrition among homeopathic students. Boenninghausen’s approach, by contrast, is much gentler on the mind. The simplicity of his Pocket Book, and later the condensed clinical repertories based on it, are the remedy for everyone who has ever looked to homeopathy with hope, only to encounter a byzantine maze of shotgun remedies in old books with more Latin abbreviations than a legal document, couched in either overly simplified or agonizingly complex, woefully out-of-date descriptions. Also, Kent did not break the symptoms down, as Boenninghausen did, but used them whole. This made his repertory longer than the Bible!
As homeopathy began to decline in North America in the twentieth century, it began to flourish in India. Before Boger died, he corresponded with homeopaths living on the subcontinent and handed on to them the lineage from Hahnemann, Boenninghausen, and himself. This included S.R. Phatak and the elder Sankaran. Together they reestablished the “traditional” method of prescribing by keynotes, locations, sensations, modalities, and concomitants. Contemporary advocates of this system include David Little, Ian Watson, Helmut Sydow, and Robin Murphy.
The introduction of the personal computer has, in the last twenty-five years, completely revolutionized the homeopathic repertory, many versions of which are available online and as software. Cross-referencing symptoms is perfectly suited to the computer age. Both the Boenninghausen and the Kentian lineages are represented in this renaissance. Roger van Zandvoort is the representative of the traditional, non-Kentian approach. His Complete Repertory gives access to the whole plant database of homeopathy (www.completedynamics.com).
The Kingdom Issue
The mineral and animal kingdoms have always shared medical cauldrons with herbs. The old Greek pharmacopeia, like that of the Chinese, is full of all manner of “stuff.” Paracelsus vastly expanded the role of minerals when he introduced alchemy into medicine. Culpeper closed his fantastical career focusing on a universal alchemical gold remedy. Mineral and animal remedies rub shoulders with plants in TCM. Homeopathy is preponderantly plant-based, but incorporates nearly everything under the sun—including sunlight itself! Herbalism can be practiced as a primary general medicine, but history suggests that herbalists should know about mineral and animal remedies as well, and homeopathy provides a safe, inoffensive way to use them.
Homeopathic clinician and historian David Little (2015) points out that the superficially acting acute-ailment remedies in Hahnemann’s Materia Medica Pura tended to be plants, while the deep-acting chronic-ailment remedies in Chronic Diseases tend to be mineral and animal in origin. Does this suggest that there is a medicinal difference between kingdoms?
Many of the plant remedies are well known for their role in cases where the organic pathology becomes the active layer and appears as a regional affection. The biochemical qualities of plants differ from the inorganic minerals in that the botanical world represents carbon-based organisms. This structure is founded on protoplasm (CHON) [carbon/hydrogen/oxygen/nitrogen], which reflects the cellular organization as witnessed in the human organism. This is why the plant remedies have special affinities with specific systems, regions, organs, and tissue (Little 2015).
Continuing with this analogy, minerals would be best suited to deep changes on the mineral level of the body—involving primal activities regulated by mineral-dependent electrolytes and enzymes. Animal-based medicines, on the other hand, are associated with the nervous system, as are plant alkaloids, and as such have deep actions in this sphere. Plants act on the cellular level that underlies so much of organic function.
The same distinction between vegetable and non-vegetable medicinal sources seems to appear in biomedicine as well. The innocent, nontoxic herbs of grandma’s cupboard are laughed at, while toxic jungle plants containing powerful alkaloids, along with minerals and some animal substances, are the source of much of the pharmacy of modern medicine.
The rebound effect may provide a reason for this difference among kingdoms. Nontoxic herbs, with their secondary metabolites and low-level toxicity, do not easily lock the organism into a primary response, as does a drug or poison. Therefore, they are better suited to diseases where the rebound mechanism is not overwhelmed. Poisons, found in the mineral and animal kingdoms (from snakes, insects, etc.), can force a primary reaction more powerfully and perhaps traumatize the self-healing mechanism more deeply, trapping the body in the primary response. This will suppress the self-healing ability, while plant medicine will support it by normalizing between primary and secondary reactions.
Energetic Expense
Many years ago Matthew noticed a statement by Dr. Edward Bach that herbs have a “positive” healing action, in contrast to the “negative” effect of homeopathic remedies. A letter to the Bach Centre in the UK at that time, asking what this meant, elicited only a kindly response saying that it didn’t mean homeopathic remedies are unsafe. Matthew reported this to me (David), and I contemplated Bach’s statement for many years. Without a literary record, which seems to have been lost, we cannot know exactly what the good doctor was thinking. However, his idea stimulated both of us.
Our first consideration is that nontoxic plants may be considered “positive” simply because they are less toxic and more natural and innocuous in their healing effects. Second, the plant organism is analogous to the cellular level of organization that we find in our own bodies. Are they not, therefore, well suited to the treatment of the ills of humanity? The same idea has occurred to other homeopathic practitioners. After spending lifetimes in homeopathy, David Little and Robin Murphy came to the same conclusion: plants are our natural medicine chest. Hahnemann himself never completely abandoned plant remedies; his remedy box at the time of his death still included a handful of herbal tinctures.
Then what would make a homeopathic remedy “negative” in comparison? The potentized homeopathic remedy acts by forcing the vital force or immune system to react against it (in the secondary effect following the primary). Robin Murphy notes that this may be an energetically expensive process, and may have a wear-and-tear effect on the vital force or immune system of the patient. The nontoxic herb doesn’t force the body like this, unless it is a large dose intended to do so. Several observers note that excessive use of the high potencies (as is common in classical/Kentian homeopathy) can exhaust a person. On the other hand, well-selected lower potencies (more common to traditional homeopathy in chronic disease) seem to wake up the vital force.
Also, as we become more toxic, stressed, and poisoned as a society, the constitutional and chronic disease remedies used by homeopaths—often in broad-spectrum therapy to elicit a response in the organism (Sulphur and Nux Vomica come to mind)—may be quite stressful to the organism. These are reminiscent of the “heroic” medicine of the old allopaths, or of Samuel Thomson and the “puking doctors” who favored emetic treatments.
Homeopathic remedies—especially the high potencies—do not just cure but more or less command. The vital force is forced to act—and now! In this way it is somewhat like allopathy. The rebound effect is especially pronounced in addiction recovery; this warns us not to stimulate the rebound effect in a wanton or careless manner.
Can the Two Sisters Get Along?
Clarke reckoned that thirteen homeopathic remedies were enough to cover half of his cases: Sulphur, Lycopodium, Calcarea, Arsenicum, Thuja, Aconitum, Nux, Pulsatilla, Silicea, Hepar Sulphuris, China, Belladona, and Bryonia. Would it not also behoove the herbalist to become familiar with these remedies and their indications?
There are other considerations as well that recommend homeopathy to the herbalist. Where herbs need harvesting, processing, storing, decanting, bottling, labeling, etc., a homeopathic pharmacy can be a thing of compact beauty and
versatility. Many herbs are easily available in low-potency homeopathic form. Homeopathic remedies have a shelf life of decades, possibly even centuries, for all practical purposes, despite expiration dates mandated by the FDA. An herbal remedy may also be unavailable in a pinch. With budgets increasingly tight, the low-potency homeopathic remedies made in India are almost free. And it is possible that in the future we may be dealing with remedies becoming unavailable due to excessive government regulation. Even more significantly, homeopathy may provide the only source for botanicals that are becoming unavailable due to environmental stress. Examples here include Cypripedium pubescens (lady’s slipper) and Aletris farinosa (true unicorn root).
Homeopathy can fill gaps in an herbal and/or bodywork practice; it can provide, perhaps most importantly, a whole new way of looking at symptoms, health, and disease.
Homeopathy is a truly practical form of medical alchemy. As a medical system it is portable, life-saving, scientific in its own sphere, and clinically adaptable and flexible beyond virtually all other healing arts in the hands of a competent master prescriber. Yet it has its cost: it requires vital force to digest and assimilate the remedies, and our bodies have a limited amount of this. And the increasing hypersensitivities in increasing numbers of people make it inadvisable to use the high homeopathic potencies.
What do homeopaths need to learn from herbalists? Homeopaths need to recognize that the law of contraries is built into the proving of remedies, and is in fact a basis for prescription as much as similarity. The rebound effect explains both the law of similars and the law of contraries.
What else? Homeopaths tend to be far too wary of the innocent, nontoxic little herb. Herbs in fact have already enriched the homeopathic apothecary. Much of this inclusion resulted from experimentation by doctors who were, in their time, criticized by other homeopaths for being too open-minded. One thinks here of Edwin Hale, William Burt, James Compton Burnett, and William Boericke—who surreptitiously introduced many of John Scudder’s specific remedies into homeopathy. Schools are often by their nature creatures of habit, but experimentation should always be allowed.