Institute for Homoeopathic Medicine. P & W OpenRep

Institute for Homoeopathic Medicine. P & W OpenRep Blog: http://instituteforhomoeopathicmedicine.wordpress.com/

04/10/2026

In general

I find it genuinely saddening that so many practising homoeopaths appear to have an incomplete, or sometimes incorrect, understanding of Hahnemann's teachings. This starts from the teaching schools.

This is not simply a matter of historical accuracy or differing interpretations of old texts. It has direct implications for the way we think about our patients and approach our cases.

Our understanding of Hahnemann's instructions must inevitably influence our case-taking, our assessment of symptoms, our understanding of disease and, ultimately, our prescribing.

If the foundations are misunderstood, how can we expect the clinical thinking built upon them to remain sound?

I believe we have a responsibility to return to Hahnemann's actual writings, examine them carefully and distinguish his teachings from the many interpretations and additions that have accumulated over the years.

My concern is not to criticise individual practitioners, but to question whether we are practising the homoeopathy Hahnemann actually taught.
There are patients' lives and wellbeing involved. Surely that alone makes it worth getting the foundations right.

There is one thought I would particularly emphasise:
The problem is not merely that some practitioners may misunderstand Hahnemann. It is that they may build an entire system of case interpretation upon that misunderstanding without realising it.

This is a fundamental concern than a disagreement over individual remedies or prescribing techniques.

04/10/2026

A Clinical Case with a Miasmatic Overlay

The following is a fictional teaching case designed to demonstrate how a practitioner might investigate a chronic patient using Hahnemann's case-taking method, while considering the possible miasmatic background.

The important distinction is that the case is taken first from the patient's actual symptoms. The miasmatic interpretation is an additional layer, not a substitute for individualisation.

The Patient
Female, aged 54
Main complaints:
Chronic eczema affecting the hands and lower legs for approximately 20 years.
Recurring respiratory catarrh and sinusitis.
Increasing joint stiffness, particularly in the mornings.
Poor sleep and persistent tiredness.
Constipation alternating occasionally with loose stools.

History of the Present Illness
The eczema began in her twenties, initially as small itchy patches on the hands. Over the years it became more widespread.
She has used various steroid creams, which suppress the eruption temporarily, but it returns when treatment is stopped.

Other observations:
Itching worse at night and with warmth in bed.
Scratching produces temporary relief, followed by burning.

Skin becomes dry, thickened and occasionally cracked.

Respiratory catarrh occurs several times each winter.
Joint stiffness has gradually increased over the last five years.

Mental and Emotional Symptoms
On further questioning:
Anxious about her family's welfare.
Tends to anticipate problems.
Dislikes confrontation.
Suppresses irritation rather than expressing it.

Becomes discouraged when her health does not improve.
Feels that she has gradually lost her previous energy and confidence.

Family History
Relative Health history
Mother Chronic eczema and asthma
Father Hypertension and heart disease
Maternal grandmother Rheumatoid arthritis
Brother Psoriasis
Daughter Recurrent allergic rhinitis

This history is important, but it must not be treated as proof that the patient has inherited a particular miasm.

The Ordinary Case-Taking Investigation
Before introducing any miasmatic interpretation, the practitioner investigates:
Exact nature and location of the eczema.
Sensations: itching, burning, soreness and dryness.
Modalities: heat, cold, bathing, time of day and clothing.
Concomitant symptoms.
Sleep, appetite, thirst and digestion.
Mental and emotional characteristics.
Previous illnesses and treatments.
Chronology of symptom development.
Family history and possible hereditary tendencies.
This is the individual patient's case, not yet a miasmatic classification.

Introducing the Miasmatic Overlay
We can now consider the same case through Hahnemann's chronic disease theory.

Possible Psoric Features
Itching and recurring skin eruptions.
Dryness and cracking of the skin.
Functional digestive disturbance.
Anxiety and susceptibility to recurring complaints.
These features could be considered in relation to Hahnemann's description of Psora.

Possible Sycotic Features
Thickened, chronic skin changes.
Persistent or recurring catarrhal complaints.
Possible tissue changes.

However, none of these findings alone establishes Sycosis. We would need to investigate whether there are more characteristic manifestations, such as a history of gonorrhoeal infection, which is central to Hahnemann's original account.

Possible Syphilitic Features
Cracking and fissuring of the skin.
Progressive joint complaints.
These are not sufficient to establish a syphilitic component. More specific destructive manifestations, ulceration, characteristic bone symptoms and relevant history would require investigation.

Looking at the Chronology
The chronology is particularly important.
Early adulthood
Itching eruptions begin. The patient has a history of recurring skin complaints.
Following years
Eczema becomes more extensive. Repeated suppression with topical medication occurs.
Middle age
Recurrent respiratory catarrh becomes more noticeable.
Recent five years
Joint stiffness and reduced energy develop.

The chronology allows us to investigate whether the disease has changed in character, whether new symptoms have appeared independently, and whether treatment has influenced the manifestations.
It does not, by itself, demonstrate that one miasm has transformed into another.

What Does the Miasmatic Overlay Actually Contribute?
This is the important question.

The practitioner now has two distinct sets of information:
Individual case Miasmatic consideration
Itching eczema Possible psoric background
Thickened skin Requires interpretation in context
Recurrent catarrh Chronic susceptibility to investigate
Joint stiffness Requires independent investigation
Family eczema and asthma Possible hereditary susceptibility

Family psoriasis and arthritis Relevant family history, not proof of a miasm

The miasmatic overlay provides a possible historical and theoretical interpretation of the chronic disease. It does not provide a new set of symptoms that the patient must be made to fit.

How Would Hahnemann Approach This?
I would distinguish three things:

1. The disease as presented by the patient
The totality of characteristic symptoms remains the starting point. The practitioner must not overlook individual symptoms because a presumed miasm appears to explain them.

2. The chronic disease background
In The Chronic Diseases, Hahnemann develops his explanation of chronic disease, particularly the role he attributes to Psora and the other chronic miasms.
This adds a theoretical dimension to the investigation of chronic cases.

3. The selection of the remedy
The remedy must still be selected through the correspondence between the patient's actual symptoms and the materia medica.
A presumed miasmatic diagnosis must not override the individual symptom picture.

An Important Distinction
Consider two practitioners examining this same patient.

Practitioner A:
Sees eczema, catarrh and joint stiffness. Immediately decides that the patient is predominantly psoric with a sycotic component and selects an anti-miasmatic remedy.

Practitioner B:
Takes the complete case, establishes the chronology, investigates the characteristic symptoms, examines the previous treatments and family history, and then considers whether Hahnemann's chronic disease theory helps explain the background.

Practitioner B is following the more defensible approach to Hahnemannian investigation.
The miasmatic theory should not become a shortcut around case-taking.

The Central Lesson
I would express the principle this way:
> The patient does not come into the consulting room presenting a miasm. The patient presents a collection of individual symptoms, a history of disease and a personal susceptibility. It is the practitioner's responsibility to investigate these thoroughly before considering how Hahnemann's theory of chronic miasms might help explain the underlying disease process.

The miasmatic overlay should deepen our understanding of the case, not dictate what we see in it.

02/10/2026

To amplify Richard Laing's comment about turn of the century homeopaths and Allopathic schools.

The late-19th- and early-20th-century American homoeopathic physicians who allowed their colleges to move toward, merge with, or become conventional medical institutions, there was a fundamental strategic mistake: they increasingly treated institutional survival and orthodox medical education as more important than preserving a distinct Hahnemannian therapeutic identity.

There were several different mistakes involved.

1. They confused medical education with the therapeutic system
The early homoeopathic colleges had actually been established precisely because orthodox medical colleges would not teach homoeopathy. The 1848 charter for the Homoeopathic Medical College of Pennsylvania, for example, specifically provided for the ordinary medical subjects plus Materia Medica and therapeutics according to the Law of Similia and drugs proved on the healthy

That was potentially a very strong model:
Give the physician a thorough medical education without surrendering the homoeopathic method of treatment.

The later tendency was increasingly:
Become indistinguishable from the orthodox medical school, while retaining “homoeopathy” as an increasingly small part of the curriculum.

That distinction is crucial.

2. They accepted the premise that homoeopathy had to become “scientific” in the orthodox sense
This was probably the deepest intellectual mistake.
A homoeopathic college could quite reasonably teach anatomy, physiology, pathology, surgery, obstetrics, diagnosis and hygiene. None of those subjects necessarily contradict Hahnemann.
The dangerous step was allowing the therapeutic philosophy of the institution to be determined by the prevailing medical paradigm.

Flexner's 1910 report makes the conflict particularly clear. He described homoeopathic schools as declining and argued that the future lay in a unified scientific medical curriculum.

But there is an important historical nuance: Flexner did not simply cause homoeopathy's decline. The decline was already underway. There were 22 American homoeopathic colleges in 1900, and the number had fallen substantially before and around the Flexner period.

So the mistake was partly allowing external standards to determine what constituted legitimate homoeopathic practice.

3. They believed that institutional compromise would preserve homoeopathy
This is where history becomes particularly interesting.
Hahnemann College in Philadelphia, for example, had originally been a specifically homoeopathic institution. Its history shows repeated institutional adaptation and redefinition. Modern historical scholarship describes the college as repeatedly renegotiating its identity under pressure from modern medical science and professionalisation.

The logic was understandable:
“If we adapt sufficiently, we will survive.”
But the historical result was frequently:
“If we adapt sufficiently, the distinctive thing we were trying to preserve disappears.”

That is a very different outcome.

4. They failed to protect the homoeopathic curriculum as an independent intellectual discipline
This is perhaps the most relevant lesson for Hahnemannian argument.

A college could have said:
teach medicine thoroughly;
teach surgery thoroughly;
teach pathology thoroughly;
teach obstetrics thoroughly;
teach anatomy and physiology thoroughly;
but teach Hahnemannian therapeutics as Hahnemannian therapeutics.

Instead, as the medical curriculum became increasingly dominated by laboratory science and conventional pharmacology, homoeopathic instruction became increasingly marginal.

One modern historical review describes the eventual consequence explicitly: homoeopathic schools revised their curricula toward the Flexner model, which substantially curtailed homoeopathic training.

5. They underestimated the danger of losing independent institutions
Once a homoeopathic college becomes administratively, financially and academically dependent upon the conventional medical establishment, the question eventually becomes:
What justification remains for maintaining a separate homoeopathic faculty?
If the answer is merely “because we have historically called ourselves homoeopathic,” the institution is already vulnerable.

By 1923, only two of the 22 American homoeopathic medical schools existing in 1900 remained, according to one historical review. By 1950, the last schools teaching homoeopathy had closed.

So institutional integration did not simply preserve homoeopathy within conventional medicine. In many cases, it helped remove the institutional environment in which homoeopathy could reproduce itself as a distinct discipline.

But there is an important qualification
I would not say that the homoeopaths were simply foolish or that every merger was a betrayal.

They were facing very real problems:
increasingly demanding medical-education standards;
competition for students;
financial weakness of small colleges;
pressure from licensing authorities;
increasing prestige of laboratory medicine;
difficulty maintaining hospitals and teaching facilities;

professional exclusion by the orthodox medical establishment.
Flexner himself recorded that the homoeopathic colleges were financially vulnerable and suffering falling enrolment.

And earlier homoeopathic leaders had actually demonstrated that raising educational standards was not incompatible with homoeopathy. Hahnemann Medical College of Philadelphia introduced an optional three-year graded course in 1869, and its proponents regarded this as an important advance in medical education.

So the historical mistake wasn't:
“They educated their physicians too well.”
It was closer to:
“They eventually allowed improvement in medical education to become assimilation into another therapeutic system.”

The deeper Hahnemannian question

Could they have produced highly educated physicians without allowing Hahnemannian therapeutics itself to be altered?

I think that is the crucial historical issue.
Hahnemann never required ignorance of ordinary medicine. Quite the opposite: his writings demonstrate extensive knowledge of contemporary medicine. The question was what the physician did with that knowledge when actually treating the patient.

So there is a distinction worth making:
Medical science → knowledge about the patient
versus
Hahnemannian homoeopathy → the principles governing the selection and use of the remedy.

If those two were kept conceptually separate, a homoeopathic medical college could have become more medically educated without becoming less homoeopathic.

That may be the most important lesson from what happened around 1900.

And it also connects directly with the broader concern about modern homoeopathy becoming increasingly something other than what Hahnemann actually instructed: the institutional loss came first, but the intellectual loss could follow it.

01/10/2026

A successful health outcome is only as good as the abilities of the practitioner responsible for the patient's care.

This is an important principle, particularly in homoeopathy. The effectiveness of any therapeutic approach depends not only on the principles of the therapy itself, but also on the practitioner's ability to understand, interpret and apply those principles correctly.

A practitioner must possess more than confidence in their chosen method. They need:
A sound understanding of the therapy they practise.
The ability to recognise the limits of their own knowledge.
Competence in assessing the patient's condition.

The ability to recognise when a condition requires conventional medical investigation. Knowledge is important.

A willingness to question their own decisions when treatment fails.

The discipline to return to the original sources rather than rely on assumptions or inherited doctrines.

Perhaps the most important point is this:
A practitioner cannot compensate for a lack of knowledge by having confidence in their treatment. Nor can a good therapeutic principle guarantee a good outcome when it is misunderstood or incorrectly applied.

Ultimately, the patient is dependent not only on the therapy being offered, but on the knowledge, judgement, competence and honesty of the person administering it.

The responsibility is therefore considerable. A patient's health should never become the testing ground for a practitioner's confidence.

01/10/2026

I recently had a discussion with a non-medically qualified homoeopath who felt that he could do a better job than most doctors.

I challenged that confidence on two grounds.

Firstly, I felt that his medical knowledge and clinical skills needed considerable development. Having confidence in one's ability to prescribe homoeopathic remedies does not make one medically competent. Understanding disease, recognising serious pathology, appreciating complications and knowing the limitations of one's own abilities are essential responsibilities when dealing with patients.

Secondly, I questioned his knowledge of homoeopathy itself.

Modern homoeopathic practice has developed numerous interpretations, methods and philosophies that are not necessarily those taught by Hahnemann. Becoming familiar with these modern approaches does not necessarily mean understanding the original therapy.

I believe that anyone claiming to practise homoeopathy has a responsibility to understand its foundations. That means going back to Hahnemann's actual writings, examining his instructions and distinguishing what he taught from what subsequent practitioners have added or changed.

We should be cautious about claiming superiority over another medical practitioner when we have not properly established the limits of our own knowledge.

Ultimately, confidence is no substitute for competence, and familiarity with modern homoeopathic methods is no substitute for understanding Hahnemann.

When patients place their trust in us, the responsibility is considerable. Their welfare must always come before our professional pride.

01/10/2026

Hahnemann explicitly said that he himself had never been psoric. In the Chronic Diseases, he explained why he believed he could recognise Psora so clearly:

“I, as is rarely the case, was never psoric…”
He then says that from birth into his eightieth year he had remained free from the ailments he was describing, although he had experienced considerable mental exertion and emotional distress and was susceptible to acute epidemic diseases.

But there is an important qualification
Hahnemann did not say that he could prove the absence of Psora by some special test.

His reasoning was essentially comparative and clinical:
he observed large numbers of patients whom he considered psoric;
he compared their states with his own state of health;

he believed he had never experienced the characteristic history of itch/Psora;

he had not developed the chronic symptom-complexes that he associated with latent Psora;

and he remained healthy despite circumstances that, in his theory, could awaken latent Psora.

He actually presents this as an advantage in observation: because he considered himself non-psoric, he believed he could compare the manifestations in affected people against a relatively unaffected baseline.

And this creates a fascinating problem
Hahnemann simultaneously says that Psora may remain latent for years and that a person can appear completely healthy while Psora is “slumbering” internally.

Therefore, strictly speaking, Hahnemann could not demonstrate with absolute certainty that he had never been infected merely because he had no symptoms.

His own claim rests on his life history and absence of the characteristic manifestations, not on a laboratory or objective test.
And this is especially important when reading §§78–80. In §80 Hahnemann calls Psora a chronic miasm and associates its completed infection with the characteristic itch eruption; he then extends the concept to the internal chronic disease.

So I would put the point this way:
Hahnemann did not “test himself for Psora.” He concluded from his lifelong clinical history that he had never been psoric, and he regarded his apparently complete freedom from the characteristic ailments as evidence supporting that conclusion.

Did he allow for transmission very early in life? Yes. He refers to transmission in der Wiege.

Did he establish that every hereditary descendant must carry Psora?

No.
That conclusion cannot be drawn from these passages.
There is also a historical limitation: we are examining Hahnemann's own explanatory model, not establishing the biological validity of Psora as an infectious or hereditary entity by modern medical standards.

My interpretation of the central problem
I think the most important distinction is this:
Hahnemann's assertion that he was never psoric is not equivalent to proof that he had never been infected.

He appears to have regarded the absence of the characteristic signs of latent and developed Psora as sufficient grounds for describing himself as non-psoric.

That was his conclusion from his observations and his understanding of the condition.

But if we ask the question more strictly — could he exclude an entirely unrecognised, symptom-free infection or transmission? — his writings do not provide a conclusive answer.

And we should not manufacture one on his behalf.

The further question I believe deserves investigation
There is one particularly interesting question arising from this examination.
If Hahnemann believed that latent Psora could be recognised through minor signs, what exactly distinguished a person who was genuinely free from Psora from one who carried latent Psora but had not yet developed recognisable symptoms?

This deserves a close examination of three groups of original German passages:
Chronic Diseases, 1835, §§ concerning latent Psora: particularly the passage immediately preceding footnote 126 and the complete list of signs that follows it.

Organon §§78–80: the distinction between chronic disease, miasmatic infection and the external manifestation.

Chronic Diseases, discussion of transmission: particularly mitgeteilt, Ansteckung, in der Wiege and the references to parents and older relatives.

I would pay particular attention to the difference between Ansteckung (infection or contagion), Mitteilung (communication or transmission), Anlage (disposition or constitution, where used), and Psora itself.

My position at this stage is that we should preserve Hahnemann's exact statement without extending its meaning.

01/10/2026

My conclusions about Miasms.

In Hahnemann’s Organon, a miasm is essentially a chronic disease-producing infection/disposition that, once established, can persist in the organism and produce a characteristic pattern of chronic disease.

In his terms:
Acute miasm → produces an acute disease and generally runs its course.

Chronic miasm → establishes a lasting tendency to chronic disease.
Hahnemann identified psora, sycosis and syphilis as the principal chronic miasms.

Importantly, in §§78–80, Hahnemann does not simply mean “hereditary disease.” He describes chronic miasm as something acquired through infection, which can subsequently become deeply rooted and manifest in many forms.

If we stay strictly with Hahnemann, knowledge of the miasms is useful in case-taking—but not in the way it is often used in modern homoeopathy.

In Hahnemann's approach

The miasm is primarily something you recognise from the patient's history and totality, rather than something you decide at the beginning and then use to construct the case.

For example:

Acute disease: the immediate disease picture may be sufficient to prescribe.

Chronic disease: if the illness persists or repeatedly returns despite appropriate treatment, Hahnemann asks us to consider the underlying chronic disease.

Psora, syphilis and sycosis: these are Hahnemann's proposed chronic disease sources, identified through the patient's history, manifestations and course.

Family history: it can be relevant evidence of disposition, but it should not automatically be converted into a conclusion such as "this patient has a hereditary psoric miasm."

The crucial point is that the miasm does not replace case-taking.

What should happen in practice?

Take the case first. Recognise the disease pattern from the case. Then ask whether Hahnemann's doctrine of chronic miasms helps explain the persistence or character of the disease.

It becomes dangerous to reverse this:
"This looks psoric, therefore I need a psoric remedy."
That can easily lead to prescribing from a theoretical label rather than from the patient's actual symptoms.

This fits particularly well with §5 and §§78–80 of the Organon. Hahnemann wants the physician to investigate the patient's history, circumstances and previous diseases, and in chronic disease to recognise the underlying chronic miasmatic disease. But the individual symptoms remain the material from which the prescription is made.
So, in a Hahnemannian case-taking framework, I would regard miasmatic knowledge as contextual and diagnostic, not as another repertory category to be mechanically added to the patient's symptoms.

We must not allow the study of miasms to become more complicated than Hahnemann's actual instructions warrant.

There is a tendency in modern homoeopathy to build elaborate miasmatic classifications, hereditary interpretations and psychological profiles.

But we should ask of every such interpretation:
Where did Hahnemann say this? What did he actually mean? Does the original German support the interpretation?

If it does not, we should be very cautious about incorporating it into practice.

My suggested guiding principle would be:
Understand the miasms, but do not look at every patient through the miasms. Look at the patient first, understand the disease, and use Hahnemann's chronic disease theory only to the extent that his actual writings justify.

01/10/2026

Comment

In presenting this material, it is important to clarify the methodological approach.

All source material is available to every practitioner. All the writings of Hahneman in German, the writings of Hering, the writings of Kent and numerous monologues of the time. I BELIEVE it is up to the practitioner to do their own research to validate their own approach to the practice of hahnemannian medicine.

The research draws on original German sources, with the aim of interpreting Hahnemann’s words as accurately and faithfully as possible. The explanations offered reflect the most evidence-based interpretation of the original material that the research has established

These interpretations and conclusions remain open to evaluation and revision in light of further evidence or more persuasive analysis.

The central methodological principle has been to return to the original sources rather than rely primarily on later interpretations, established opinions, or secondary accounts.

Substantive correction is welcome, particularly when supported by evidence from the original material. Alternative interpretations may contribute to the discussion, but their existence alone does not determine which interpretation is best supported by the evidence.

The purpose of this work is not to prescribe what others should believe, but to present the research, explain the reasoning underlying its conclusions, and enable readers to examine the material independently.

Ultimately, Hahnemann’s own words should remain the primary basis for evaluating their meaning.

30/09/2026

Hahnemanns thinking as to why a well selected remedy might fail

Looking closely at the German of the 6th Organon, Hahnemann gives us a much more disciplined way of dealing with an apparently “failed” remedy.

The key point is that “no improvement yet” does not automatically mean “wrong remedy.”

§160 — don't mistake the initial reaction for failure

Hahnemann writes:
„...eine merkbare, homöopathische Verschlimmerung dieser Art“
He is describing an apparent increase of the disease symptoms produced by the medicine itself. In an acute, recent disease this may occur during the first hours.

But §161 makes the distinction particularly important for chronic cases:
„...wo aber Arzneien von langer Wirkungsdauer ein altes oder sehr altes Siechthum zu bekämpfen haben...“
Hahnemann says that with an accurately chosen remedy, properly administered, such an apparent increase should NOT occur during the course of treatment in an old chronic disease.

So the modern idea that “a big aggravation proves that the remedy is working” does not fit §161 very comfortably.

§162–165 — perhaps the remedy was only partially similar
This is an extremely important section for the question.
Hahnemann acknowledges that sometimes the best available remedy does not contain the complete correspondence to the disease.
§162:
„...nur ein Theil von den Symptomen der zu heilenden Krankheit...“
Only part of the disease symptoms may be found in the remedy.

He therefore says that an „unvollkommene Arzneikrankheits-Potenz“ may have to be used because a more complete one is not available.

Then §164 gives an important qualification: even a remedy containing relatively few corresponding symptoms can cure when those symptoms are „von ungemeiner, die Krankheit besonders auszeichnender Art (charakteristisch)“ — unusually characteristic of the disease.

But §165 is much more sobering:
„...von den auszeichnenden (charakteristischen), sonderlichen, ungemeinen Symptomen des Krankheitsfalles... nichts in genauer Aehnlichkeit vorhanden...“
If none of the characteristic symptoms are represented in the remedy, Hahnemann says the practitioner should not expect an immediately advantageous result.

Then §249 becomes decisive
Hahnemann says:
„Jede für den Krankheits-Fall verordnete Arznei, welche im Verlaufe ihrer Wirkung neue, der zu heilenden Krankheit nicht eigenthümliche... Symptome hervorbringt...“
In other words, if the medicine produces new troublesome symptoms that do not belong to the disease being treated, it is not capable of producing genuine improvement and should not be regarded as homoeopathically selected.

And his footnote is remarkably strong:
„...beweiset stets nur Unangemessenheit der vorigen Arznei in diesem Krankheitsfalle, deutet aber nie auf Schwäche der Gabe.“
A worsening through new symptoms indicates the inappropriateness of the previous medicine; Hahnemann explicitly says it does not indicate that the dose was simply too weak.

That is a very important distinction.

§250 — when you know you've made a wrong choice
Here Hahnemann gives an unusually practical rule.

In an urgent case, if after 6, 8 or 12 hours the patient's condition is clearly worsening from hour to hour with new symptoms and complaints, he says it is not merely permissible but the physician's duty to correct the mistake with a remedy that is as appropriate as possible to the present state.

So:
New symptoms + progressive deterioration → reconsider the remedy.
Not:
No improvement → automatically repeat or increase the dose.

§252 — the chronic case is different
This is perhaps the most interesting answer to the question.
Hahnemann writes:
„...die bestens homöopathisch gewählte Arznei... die Besserung nicht förderte...“
If, in a chronic disease, the best homoeopathically selected remedy, in the appropriate smallest dose, does not promote improvement, Hahnemann says this is a „gewisses Zeichen“ that a cause maintaining the disease is still operating.

He then directs attention to:
„in der Lebensordnung des Kranken oder in seinen Umgebungen“
Something in the patient's way of life or circumstances must be removed if a lasting cure is to occur,

That is quite different from simply saying:
“The remedy didn't work, so find another remedy.”
§253–255 — first establish whether it really failed
Hahnemann then tells us how to judge the response.
§253:
„eine größere Behaglichkeit, eine zunehmende Gelassenheit, Freiheit des Geistes, erhöhter Muth, eine Art wiederkehrender Natでürlichkeit“
The first signs of improvement can be a greater sense of comfort, increasing calmness, freedom of mind, renewed courage and a return toward natural behaviour.

Then §254 says to look for either:
improvement
diminution of the original symptoms
without new symptoms
or aggravation
new symptoms
or increased existing symptoms.

And §255 tells the practitioner to go through the recorded symptoms one by one rather than relying simply on the patient's statement that they feel “no better.”

So, what should you actually do when a well-indicated remedy appears to fail?
From these aphorisms, I would formulate Hahnemann's sequence like this:
1. Don't immediately prescribe another remedy.
↓
2. Establish exactly what happened after the prescription.
↓
3. Look for genuine improvement—not merely disappearance of the chief complaint.
↓
4. Ask whether new symptoms appeared.
↓
5. If new, troublesome symptoms have appeared, question the remedy selection (§249–250).
↓
6. If there is simply no progress in a chronic case,
investigate maintaining circumstances (§252).
↓
7. Re-examine the original case and the characteristic symptoms (§§162–165).
↓
8. Only then decide whether the remedy needs to be changed, repeated, or whether something obstructing the cure needs attention.

And there is one particularly important lesson here for the Hahnemannian approach:
A “well-indicated remedy” is not proven to be correct merely because it looked good on paper.

Hahnemann ultimately gives us an empirical test: what happens to the patient after the prescription?

That is why §253–255 are so important. The prescriber has to observe, not defend the prescription.
The remedy is not made “right” by our reasoning after the event.

If the patient deteriorates with new symptoms, Hahnemann tells us to recognise the mistake. If there is no progress in a chronic case, he tells us to look for what is maintaining the disease. If there is improvement, we should recognise it even when it is subtle.

That is a much more rigorous approach to a “failed prescription” than simply moving down a repertory ranking.

Address

Eastbourne
BN227AS

Website

Alerts

Be the first to know and let us send you an email when Institute for Homoeopathic Medicine. P & W OpenRep posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Shortcuts

Share