New Methods: Need to evolve from “how-it-works” to “how-to-work with”

This paper was published in the January 2016 issue of Hpathy.

Genius, Sensation, Source and Periodic Table – Making it work

In the editorial of Hpathy Journal August 2015 issue, Alan Schmukler raised an excellent opportunity to explore the new emerging methodologies in Homeopathy, especially the Genius, Sensation, Source, Periodic Table and the like, collectively called the New Method in this essay.

Old wine …?

Some scholars consider the works mentioned as a clever spin on the Doctrine of Signatures(1)Little, David: The Compositae Family, The Three Kingdoms, http://www.simillimum.com/education/little-library/materia-medica/tcf/article.php, while some oppose the idea of limiting each remedy to one miasm (as redefined by the New Method). To such critics I would quote Aristotle who said, “It is the mark of an educated mind to be able to entertain a thought without accepting it”. That could provide us a good starting point for exploring these ideas.

Understanding the evolution of the Idea

To begin, one must understand that Sankaran has identified seven features that describe the Sensation – they are described as being Persistent, Primary, Permanent, Pattern, Pervading, Perpetual and Projecting. These features are considered to be global in scope or expression. The purists need not be too concerned, as this is really a re-statement of the principle of Generalities enunciated by von Bönninghausen, more than 150 years ago.

The second point to note is that miasms and sensations in the New Method were derived by analyzing and finding a sort of qualitative common denominator that ran through one family, by carrying out a search of rubrics using the MacRepertory. This was a novel application of the newly developed computerized repertorial tools made available at that time. But as all of us know, our Repertories derive from Materia Medicas, which derive from Provings, and Provings may not be complete. Furthermore, a lot can be lost in the process of this transmutation.

All computerized search engines are virtual statistical machines. The process of assigning causal associations to statistical groupings are purely a construct of the human mind, and there is no inherent “truth” that is revealed. For this reason Sankaran appropriately cautioned prospective users of the New Method that, “One should refrain from drawing any conclusions about the remedy without having reached the Level of Sensation”. This Level is to be perceived when the patient uses the so called Universal or Non-Human Specific language(2)Sankaran, Rajan: page 673 – The Sensation in Homeopathy, Homeopathic Medical Publishers, Santa Cruz, Mumbai, 2004.. Now this can be tricky – for example, how do we understand the statement, “It feels as if my joints are rusty and don’t have enough oil”? Is it a Delusion (an altered perception of reality) or is it a Non-human expression as the patient is talking about a “rusty joint”, as if it were a machine part? It may be argued either way, without helping much in adopting the Method, as the two interpretations will lead to different Levels, committing you on a different trajectory in search of the simillimum.

Understanding family resemblance

Regarding “Families”, the discerning practitioner must realize that even in personal life, members of the same family can be so different. It was Wittgenstein (1889-1951), the German philosopher, who had popularized the philosophical idea of “family resemblance”. He argued that things which may be thought to be connected by one essential common feature may in fact be connected by a series of overlapping similarities, where no single feature is common to all. Interestingly, Generality as defined by von Bönninghausen (1785-1864) comes close to this definition. Contrariwise, it has also been argued that members exhibiting family resemblance may share properties with each other, but have no properties that are singly necessary and jointly sufficient for family membership!

Let us take a look at Hahnemann’s views on family relationships. In his Lesser Writngs, he writes:

“But how can a similarity of action be expected amongst groups of plants, which are only arranged in the so-called natural system, on account of often slight external similarity, when even plants that are much more nearly connected, plants of one and the same genus, are sometimes so different in their medicinal effects”.

Understanding science

There is a lot of acrimony, debate, discussion and vilification that is happening in homeopathic discussion forums – one School pitted against another. That may be so because essentially philosophy like politics thrives on differences. But if we consider Homeopathy to be Science, then it would be a good idea to look at some ideas emerging from some contemporary science educators. One theme that is emerging is that of a “consensus approach”. According to this view, some points that are largely to be accepted are that, (1) scientific knowledge is empirical (i.e. relies on observation and experiment), (2) it is reliable but tentative (i.e., subject to change and thus never absolute), (3) partly the product of human imagination and creativity, and importantly, (4) theory-laden and subjective (i.e., influenced by beliefs, bias, culture etc.). Finally (5) there is no single scientific method that produces secure knowledge.

Indeed this may not be a complete or holistic view, but at the very least it opens us to the acceptance of new methodologies. How would we view “classical” Homeopathy and the New Methods in the light of these tenets? Consider tenets (1), (2), (3) and (5) above – could we consider the Banerji Protocols a logical evolution of Homeopathy? By the same token, the New Method should gain acceptance on the basis of tenet (1), (3), (4) and (5) above. But neither satisfy all the five criteria.

Understanding heuristics and limitations

Ultimately all methodologies in Homeopathy are heuristics; be they the Keynotes, Delusion, Miasm, Sensation, Periodic Table, Repertories and the like. Disease names, diagnosis and similar clinical labels are heuristic devices too – they help identify or categorize – to define taxonomy or an order of sorts. So let us not miss the woods for the trees – heuristics are neither the truth nor the science – they are tools that lead us on our path, like a map and a compass. To argue that this or that is “Not Homeopathy” is a limited view. Newtonian physics had to come to terms with Quantum Mechanics, but that does not make Newtonian physics irrelevant – it can still take us to the Moon, and beyond.

Medical Art is not a logical science, because what is logical is not always true. “Truth” in Medical Art is that which is seen, felt and experienced objectively as well as subjectively. Medical practice relies heavily on heuristics. However, the heuristic component of the reasoning process inherently encourages us to accept the conclusions we believe in, and reject the conclusions we don’t believe. So those of us, who have a belief in the New Method, will be inherently biased towards fitting the facts to the model. Thus, for one to assume that the New Method is the final resting place in our search for the simillimum would be a fallacy, because, each of these methodologies is just another piece in the multi-dimensional mosaic presented by the person in disease. Perhaps this is what prompted Hahnemann to underline the importance of the unprejudiced observer.

Understanding patterns

As humans, we have a brain that is constantly seeking patterns – that can either lead to superstition or science. Even superstitions have value in survival. A rustle in the grass can be just a current of wind, or it may be a snake. If the cost of believing a superstition is less than the cost of disbelieving it in the context of survival, then the superstition has value. In a life threatening situation – better superstitious than sorry!

Francis Bacon had observed, “Humanity has a proclivity to suppose the existence of more order and regularity in the world than it finds.” Patterns are perceived order from which we build concepts, but patterns are not concepts by themselves. That is why different individuals may conceptualize the same pattern in completely different ways. In his editorial Alan Schmukler has rightly pointed out that, “Sensation is a skill and discipline that requires much study and practice to master. As with all difficult tasks, some people are tempted to look for short cuts”. 

Paradoxically, the New Method was supposed to make the task of finding the simillimum more certain and more simple. This only means that there is more ground to cover. As Sankaran candidly admits, “I know that the Sensation idea holds true but I am not rigid about the approach of case-taking” (3)Sankaran, Rajan: page 25, The Synergy in Homeopathy, Homeopathic Medical Publishers, Santa Cruz, Mumbai, 2012, and further, “Sometimes I need to tell them that I do not fully believe in Sankaran!

How to Work with more important than How it Works?

In all fairness Sankaran has put in immense intellectual effort and his professional reputation at stake in developing a heuristic tool to deal with the fundamental problem of arriving at the simillimum. But clearly we are now well past the need of being convinced about its worth!  What is needed now is a collation of the integrated view. Dr. Bach (of Bowel Nosode and Bach Flower Remedies fame) was wont to destroy all copies of his older editions when new editions were published, so as to unburden the reader of the history of evolution of his method. Critical-mission industries like aviation archive all old publications and only allow access to the current version available for reference. Indeed reading through all of Sankaran’s works may prove to be an exciting journey for a student of the History of the New Method. What a practitioner needs is a precise, concise, crisp, and succinct crystallization of his ideas at one place.

Repertorization had fallen out of favor till the advent of computerized programs that integrated Materia Medicas, Repertories, Provings and a slew of homeopathic literature which allowed the practitioner to go beyond mechanical repertorization. Can the practitioner of today “leapfrog” the necessity of this heuristic tool which was ideally suited to an era when homeopathic software was available to too few, was too expensive and needed improvement. Today it is possible to form your own rubrics based on the actual language of the patient. In fact, the New Method was possible only because of these tools. So it is time this heuristic is formalized into a useable tool. The airplane invented by the Wright Brothers, was a contraption only they could fly. It was a few decades before it became a machine that could be handled by others too. The process has been perfected to the extent that we take the landing of an airplane with 500 souls on board, in unforgiving weather and zero visibility conditions to be just another routine, non-reportable event. Ask any aviator – every landing is as just unique and individual as each of our patients.

The New Method needs to graduate to that level, where successful cases are routine and rarely make it to seminars and conferences. At this point of time, we ought to have a simple way to work with the New Method, rather than knowing How it Works.

Overcoming our hemispheric asymmetry

To work effectively with his Method, Sankaran has pointed out that in perceiving a case, the left and the right brain both need to be active, because you are getting both conceptual as well as factual information. That may appear to be a tall order, but it can be achieved, only if the student of homeopathy moves out of the confines of a rigid strait jacket of logical science and dons the mantle of humanities as well. Only with practice and training can the two halves of the brain be harnessed. Is that achievable? Is the Method replicable? I think we ought to take a serious look at what we teach our students. Is it the educational foundation and the primary outlook of our practitioners that needs some improvement?

Healing and Humanities go together

To begin with, the reader is requested to peruse through the syllabus of a Central Council of Homeopathy approved BHMS program at a typical Homeopathic Medical College in India(4)BHMS syllabus: CMP Homeopathic Medical Collegehttp://www.homeopathyinstitute.in/pdf/bhms_all_17082012_1402.pdf. In the rigorous 4 year course (followed by one and a half years of clinical internship), the subjects covered include Anatomy, Physiology, Biochemistry, Materia Medica, Organon, Pathology, Parasitology, Forensic Medicine, Toxicology, Microbiology, Surgery, and only in the Final Year, Repertory and Case Taking. Out of a maximum total of 4,400 marks that can be scored over 4 years, the Repertory and Case taking are worth only 200 marks (approx. 4.5 % only).

Shouldn’t Homeopathic education include subjects like History of Science, a short course in Philosophy, some exposure to appreciation of Literature, and a methodical approach to inquiry and discussion to promote critical thinking through dialectics? A report on nursing education in the US revealed that the majority of nursing programs (77%) include content and/or experiential learning in complementary health and healing in the curriculum. A wide range of content related to mind-body healing, alternative medicine, herbal supplements, manual and energy healing, and environmental modalities is included(5)Richardson SF: Complementary health and healing in nursing education, Journal of Holistic Nursing 2003, March. If we seek acceptance from the allopathic school, shouldn’t we educate ourselves with supportive methodologies in healing? This will not only widen the intellectual horizon of young entrants in our profession, but also equip them to bear the brunt of assault from pharmaceutical industry and allopathy. All this must be viewed in context – students who enter a Homeopathic Medical School (in India) are typically 17-19 year olds, and their last brush with subjects related to Humanities has been at Year 10 of High School (ages 15-16 years). How can we expect our budding homeopaths to at the very least, “entertain without accepting” the ideas of Scholten and Sankaran, or appreciate Vermuelen’s rich Arcana of Materia Medica, without a dialectic examination of mythology, ethno-medicine, even astrology?

US Medical Schools respect for Humanities

Compare this with medical school admission requirements in the US. Most schools clearly state that aspiring entrants must, “demonstrate aptitude in the biological and physical sciences during their undergraduate years, but not to the exclusion of the humanities and social sciences. No preference is given to applicants who have majored in the sciences over those who have majored in the humanities(6)Harvard Medical School: Requirements for Admission https://hms.harvard.edu/departments/admissions/applying/requirements-admission. Indeed, the subject of medical humanities lies at the intersection of medicine and humanistic disciplines such as philosophy, religion, literature, and the fine and performing arts. According to a 2012 study published by the Association of American Medical Colleges, such disciplines inculcate compassion and empathy alongside science and data, and there is evidence that humanities lessons may be linked to better disease outcomes, too(7)Association of American Medical Colleges: https://www.aamc.org/newsroom/reporter/may2014/380438/humanities.html. Most students described the humanities program as “the tether that helped them reconnect and hold on to the reasons they wanted to become a doctor in the first place”. Is it unreasonable to believe that these shortcomings do not affect the outcomes of our practitioners?

Conclusions

In conclusion I would like to state that we are now well past the stage of debating whether or not the concepts of Genius, Sensation, Periodic Table, Source etc., are valid. We need to move beyond exhibitions, seminars, and workshops, and instead deliver a workable tool for use in the consulting room. What Repertories did more than a hundred years ago, we need to do that for the New Method. If James Tyler Kent (1849-1916) could do it on his desk with a paper and pen, a 100 years ago, with virtually no institutional or community support, our 21st century situation should make it possible sooner than later.

 

References   [ + ]

1. Little, David: The Compositae Family, The Three Kingdoms, http://www.simillimum.com/education/little-library/materia-medica/tcf/article.php
2. Sankaran, Rajan: page 673 – The Sensation in Homeopathy, Homeopathic Medical Publishers, Santa Cruz, Mumbai, 2004.
3. Sankaran, Rajan: page 25, The Synergy in Homeopathy, Homeopathic Medical Publishers, Santa Cruz, Mumbai, 2012
4. BHMS syllabus: CMP Homeopathic Medical Collegehttp://www.homeopathyinstitute.in/pdf/bhms_all_17082012_1402.pdf
5. Richardson SF: Complementary health and healing in nursing education, Journal of Holistic Nursing 2003, March
6. Harvard Medical School: Requirements for Admission https://hms.harvard.edu/departments/admissions/applying/requirements-admission
7. Association of American Medical Colleges: https://www.aamc.org/newsroom/reporter/may2014/380438/humanities.html

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