Werkboek Klassieke Homeopathie

By David Little

Part 1

The question of stages and degrees is an interesting area of study so I thought I would comment on the subject. Understanding the 4 stages of pathology offers insights into the nature the disease and its corresponding remedies. This includes functional and organic pathological states as well as stages and degrees of pathology. A function disorder only incudes changes in the functions of system, organs and tissues. These changes produce dynamic symptoms but as of yet there is no organic pathology. This is associated with the earlier stages of pathology.
An pathological state includes organic tissue changes in systems, organs and tissues. This is considered part of the later stages of disease. These two major states also have fours stages that included different degrees. These types complaints cannot be approach in the same manner. The nature, degree and stage of the disease have relevance to the choice of remedy (acute, chronic, anti-miasmic, intercurrent, alternation, etc), the size of the dose (small, medium. large), the delivery system (dry, liquid, oral, olfaction), the potency system (C or LM), the potency degree (low, medium, high) and the repetition (single dose, split-dose, timing of the intervals)

The four stages of physical pathology are:
1. Irritation and inflammation
2. Infiltration, induration and swelling
3. Suppuration, scarification, bleeding
4. Ulceration and necrosis

These four stages are found in both acute and chronic diseases. For example, in the first stage of a acute cold, flu and other infections there is usually redness, heat, irritation, and inflammation of mucus tissue. In the second stage the is usually swelling and a clear or white discharge. In
the third stage there is sacrifice of white cells and the production of pus at the inflammatory barricade with mucus discharges of yellow to yellow green color sometimes tinged with blood. In the forth stage their is usually sores and ulceration of the mucus membranes with the discharge of foul, yellow-green to brownish -to to blackish mucus.
This signs show the stages and degrees of the pathology and come with corresponding concomitant systemic symptoms. For example, the first stage may have prodromal chill and malaise then remittent fever and irritability; the second continuous fever, sweats, weakness, moodiness, etc.; the third chill, heat, sweat, hectic fever with high spikes, restlessness, etc; and the fourth with high fever, coldness, depression and collapse. These are only illustrative ideas of a process rather than fixed examples witnessed in each and every case.
The same pattern is noted in chronic diseases. They also start with irritation and inflammation and progress with infiltration and indurations,that tend to suppurate, bleed and scar and end in ulceration and necrosis. For example, the diseased blood vessels first become inflamed and irritated; then thickened and occluded; then hemorrhagic and scared; then degenerative and necrotic; and THEN .the patient is dead!

The development of the miasms also has four stages and differing degrees of pathology. These are the prodrome period, the primary symptoms, the latent states and secondary or tertiary stage..Each of these stages has unique symptoms that progress from early functional to early pathological to moderate pathological to advanced pathological states. The road to cure is the reversal of the advanced pathology to moderate pathology to early pathology to functional stages to the state of health. This is part of Hahnemann’s direction of cure commonly called "Hering’s laws".
The late, great Dr, Dhawlae MD pointed out many years ago that the four stages of pathology correspond to the four major characteristics of miasms, psora, sycosis, pseudopsora TB and syphilis. Psora is exemplified by irritation and inflammation; Sycosis by induration, infiltration, and over growth; Pseudospora TB by suppuration, scarification, and bleeding; and syphilis by ulceration and necrosis. The non venereal miasms like psora and pseudopsora TB involve heat, inflammation, suppuration, bleeding, scarification, etc., while the venereal diseases like sycosis and syphilis are more prone to infiltration, induration, swelling, over growth, degeneration, ulceration and necrosis. This show the different in infections spread by skin contact the droplets and those passed by sexual intercourse.
As the miasms progress from 1 to 4 they also tend to include some of the symptoms of the previous miasms. For example, pseudopsora is an intensification of some of the symptoms of the psora. Syphilis is an intensification of some of the symptoms of sycosis. An illustration of this is that pseduospora starts with inflammation similar to psora but then moves to quickly to easy suppuration, bleeding and scaring and systemic syphilis first starts with an over growth called gumma which is similar to sycosis but it quickly breaks down into necrosis and ulcerations. HIV/AIDS has all of these symptoms in various degrees and aids in the proliferation of psora and TB. There are many such relationships.

Chronic remedies and anti-miasmic medicines also have different stages and degrees of disease that reflect these four areas. Some remedies like Aconite reflect mostly in the first phase of inflammation and acute diseases while others like Mercury have all stages in differing degrees but has very marked ulceration and necrosis. Some remedies are more adapted to a single physical type of constitution, temperament and miasma. Others suit several different types of patients due to their broad action over human constitutions, chronic diseases and complex miasms. Nevertheless, each remedy has a characteristic pattern in which its own stages, degrees, adaptability and anti-miasmic actions are predominate.
The four stages of pathology also show up on the psychological level. This is also a very interesting and gratifying area of study.

The four major stages are:
1. This is the early functional stage. This involves of coping mechanisms, compensation, and other methods of control used to repress complexes while maintaining the appearance of normality.
2. This is the late functional and early pathological stages. This involves the breakdown of coping mechanisms and the temporary or intermittent loss of control over the complexes.
2. This is the establishment of the full pathological stage with neurotic states. This is where the complexes are exerting control over the patient.
4. This is the advanced pathological stags with psychotic states. This is when the complexes have complete control over the patient.

Persons in the first stage are controlling their emotions through coping mechanisms and compensation. For the most part they appear "normal" but it is a contrived state in which the persona puts on a good face but the shadow will react by showing opposite states sooner or later. A person with repressed anger will speak very softly in an effort to control their emotions but there is stiff masking of the facial expressions and corresponding body postures. It is impossible to keep up this front forever because there is a need for problem solving. There will be moment of uncharacteristic moods accompanied by "Freudian slips" combined with automatic actions, rigid body posturing, and obvious inner tensions. The anger will leak out and others will wonder "what has gotten into them?". It is not what got into them. It is what is coming out of them. This will be noticed by those close to the person as they are often part of the triggering mechanism or a convenient target of the "kicking the dog" syndrome . This corresponds to the state of inflammation or irritation.

The second states begins when the coping mechanisms begin to break down and the emotions can not longer be compensated or totally repressed. The anger will now be expressed and the symbolic powers of the word association, tone and setting will now begin to take over. Certain situations will trigger inappropriate actions in which the patient appears to be overreacting to others. The energy of the undigested archetypes and the complexes in the personal unconscious begin to activate and take control of the persona and the mask begins to fall off. At this time the patient alternates between control and coping and loss of control and troubling moods. The signs of mood affective disorders like depression and mood swings begin to show themselves. The patient is obviously trouble but as of yet they are for the most part still in control of their emotions. This corresponds to the stage of infiltration or induration.

In the third stage the patient begins to take on neurotic behavior which is noticed by the patient and those around them. This is when anxiety, hysterical, obsessive compulsive and hypochondriacal neuroses and paranoid disorders begin to take shape. The undigested archetypes and complexes in the personal unconscious now control the action of the patient and the coping mechanisms no longer work. Mood affective disorders like simple depression takes on the signs of clinical depression and mood swings become manic depressive bipolar states. The patient begins to suffer all the classical symptom of full melancholia. The patient life becomes a drama of symbolic actions and the power of the undigested archetypes rule that person’s actions. Mood, setting and situations trigger stronger reactions that the patient cannot control and they begin to avoid certain persons, places and things. Paranoid disorders with fear and phobias increase. There may be fits of violence toward self and others and suicidal behavior may be noted. This is corresponds to the stage of suppuration and scarification.

The fourth stage the patient begins to lose contact with reality and their delusions, projections and hallucinations are taken as the sole reality. They no longer see their own behavior as inharmonious and lose self awareness of their actions. They believe that their actions and thoughts are rational and the actions of others are irrational and perverse. At this point, the energy of the undigested archetypes takes the patient over completely and they act out their complexes on the stage of the delusions and believe that this is the real world. Now the neurosis gives way to psychosis and schizophrenia and the patient is considered truly insane. This corresponds to the stage of ulceration and necrosis.
Many times the concomitant physical symptom will correspond with the mental pathology. The body becomes inflamed, infiltrated, suppurated and necrotic as the psyche becomes more irritated, indurated, scared and ulcerated. The systems, organs and tissues become targets for related psychosomatic disorders and conversions diseases. The psyche and soma become mirror images and the brain will take on chemical imbalances that affect the nervous system and endocrine glands. This is very common in mood affective disorders, neuroses, and paranoid diseases.
In some cases, however, the former physical disorders are transferred to the psyche and the body will remain relatively normal. This is occasionally witnessed in psychosis and schizophrenia. The patient may appear strong and healthy although they are seriously compromised mentally. Mental diseases that start with organic degenerations often have more serious physical symptoms than those that start at the level of psychic then target the body. The physical symptoms that original in the psyche are often transferred back and forth depending on the situation.

There are many potential manifestations of these states so each situation must be individualized according to its causes, symptoms and attendant circumstances.
If one analysis the remedy with these four stages in mind it become very easy to see the layers and strata within the proving symptoms and their clinical confirmations. Our remedies are extremely multi-faceted and multi-polar. This includes both the physical and psychological symptoms. That is why not one single essence or theme can completely cover the entire Gestalt pattern of a homeopathic remedy. They have phase in which their symptoms are the opposite of other phases. This makes it impossible to pigeon hole the remedies into one signal keynote. Trying to categorized remedies in simple categories like hot or cold is impossible. There are few remedies that are completely hot or cold. One can call Sulphur a "hot remedy" but it also is a 3 for lack of vital heat! This multifaceted nature is true with most of the deep acting chronic remedies. Looking at the remedies in stages helps to clarify why a remedy is hot at one stage, has mixed thermals at another, and is cold in the end.

Stages and degrees also explain how to use symptoms that might appear "healthy" like cheerfulness. In the first stage cheerfulness is often a coping mechanism to cover up sadness by compensations that are not natural. When someone is too cheerful bordering on hysterical laughter this is not a healthy state. One can almost here them crying in the tone of their laughter! When so-called healthy states that are presented are part of persona mask it is a form of compensation not healthy conditions. Excessive of normal beneficial emotions are also diseases. Pride is good but the pride of Platina is pathological because it involves ego-inflation and delusions of being royal, precious and better than all others.

Stages and degrees also shows one how contradictory symptoms fall into place. For example, a keynote of Natrum Muriaticum is said to be sadness, depression, and a closed grief stricken state where the patient is unable to cry, etc. This, however, only relates to Natrum Muriaticum in the 3rd stage of mental pathology. In the first stage Natrum Muriaticum is cheerful, open, romantic, hopeful and cries fairly easily. In the second stage they suffer mood swings in which they are sometimes cheerful and sometimes sad and sometimes they laugh and sometimes they cry, etc. In the third stage they become depressed, emotionally rigid, hopeless, and suicidal and never cry or show much emotion. In the fourth stage their complexes take over and they act out there undigested archetypes and express their complexes in a manner that is complete psychotic. These could manifest as an extreme form of any of the symptoms of the previous stages. They now become what people call insane because they are completely out of touch with reality.
This same analysis in stages and degrees can be applied to diseases, patients and remedies. Nevertheless, one should realize that any system of analysis can only function relative to the time and circumstances to which it is applied and has it exceptions. The observer is always part of the observation and should not think that reality is easily place in neat, little boxes. I hope this helps elucidate the stages and degrees of illness as well as the multifaceted nature of our remedies.

Part 2

I have already made my opinion of "essences" fairly clear. I am of the opinion that it is extremely difficult to reduce all the symptoms of a remedy to one single cause because this process can easily lead to stereotyping and narrow vision. That is why it is important to study the portraits of more than one experienced homeopath as one patient seems to suit one picture and another a different picture. If we could see the Esse this would not be a problem but what we see are different facets of the Esse through provings and clinical confirmations on living human beings. What we record are relative observations subject to the time and circumstances of the prover-patient and the view of the observer.

My approach is to try to "psychoanalysis" the entire remedy-Gestalt like we do a human beings. The paradigm I use is Jungian philosophy because there is a large body of experience behind these observations, not just my own concepts. This means that I look at the Psyche of remedies and patients through its components Persona, Shadow, Anima-Animus, Collective Unconscious and Self. The persona is the mask the person wears on the outside and the shadow is the compensation for this mask. The Anima-Animus makes up the personal unconscious, which is polarized opposite to the sex of the individual’s body. The self is the deep integrative aspect of the Psyche which is always working for individuation and Self-realization. As one can see the Psyche is based on component parts and functional polarities not a monolithic structure.

It is far beyond the scope of this post to try and explain what each of terms mean but one can read about them in published works on the subject. I have chosen to work with the traditional body of Jungian information rather than introduce my own personal Neo-Jungian ideas as many are doing in Homeopathy. This is because I can discuss experiences within the exact same paradigm with colleagues and those with great knowledge in the field and we know exactly what each other is talking about. I also have access to a massive amount of theoretical and clinical material on the subject. I also find some of the new age versions of archetypal psychology a bit simplistic and incomplete. Some people using terms and changing a system they did not really understand in the first place.
Images from the Unconscious manifested through spontaneous actions, dreams, fantasies and altered states of consciousness that share certain religious, mythological, philosophical, literary, and alchemical motifs that are expressions of the collective unconscious. These themes that reoccur in all cultures and all time periods are called Archetypes. One cannot see the absolute essence of the archetypes but one can observe their relative Gestalt phenomena through their dynamic characteristics in living human beings. These Archetypes are part of the structure of the Psyche and give human life their meaning. They seek to reach the surface through every avenue of human activity.

When I review a remedy I generalize the characteristic symptoms by common threads (with sensations, modalities, etc.) as much as possible and study very closely the dreams, delusions and deliriums. I try to interpret the dreams and delusions as one does with living patients in psychology. These are message directly from the Unconscious. I look for common themes as well as atypical symptoms that seem different than the main threads. I consider these very important. I review the remedy symptoms in terms of classical psychology as if I was looking at a patient.
I study the symptoms related to mood affective disorders like mania, depression, manic-depression and melancholia and see how each individual remedy would act if suffering such a state. I take a good look at the symptoms of the 12 personality disorders like obsessive compulsive, passive aggressive, narcissistic, hysteria, antisocial, avoidant, dependent, borderline, schizoid, etc., and review the symptoms related to anxiety, obsessive compulsive, hysterical, hypochondriacal and phobic neuroses. I study at the fears related to paranoid disorders very closely. The fears, imaginations and anxieties are very important as they show problem areas. I look at all the rubrics of our remedies in relations to these classes of psychopathology and try to judge them in accordance with the four stages of pathology, the pseudo functional, the early breakdown stage, the neurotic stage and the psychotic stage.
I review the mind/body/postural relationships in terms of infantile orificial activations. I look at sex in accordance with Riech’s function of the orgasm teachings as well as archetypes and complexes..I look at the potential psychosexual disorders like exhibitionism, Pedophilia voyeurism, nymphomania, satyriasis, impotency, frigidity, etc. I also study possible gender issues.

When speaking to patients I sometimes investigate sexual and masturbation fantasies as they also are a door into the deeper state of the Psyche. The repression, suppressed, mistreated, frustrated, distorted power of the sexual libido is a source of very deep symptoms and a power behind many neurotic and psychotic states as well as physical diseases.
At the same time, I study the psychosomatic channels and possible conversion diseases affecting to the body and what they might mean psychologically. I take all this material into account and attempt to integrate it in a homogeneous portrait that bring out the grand characteristic but also maintains the more complete individual symptoms that are strikingly, uncommon, rare and odd. I find many essences are too over generalized and use common symptoms that incomplete rubrics without sensation, modalities or concomitants. Everything is reducing to the lowest common denominator instead of the most unique, individualizing characteristic threads. This is how I study remedies and patients. So when I say that our deep acting remedies can reflect more one undigested archetype, complexes, neuroses, personality disorders, etc, I have these classes of psychopathology in mind. I am using these terms in relationship to classical psychology.

We cannot be totality "conscious" of the Unconscious because the nature of the Unconscious is to be UNCONSCIOUS. This is like trying to look at the entire ocean from the beach. We can only experience the the waves, currents, colors, reflections, smells, etc., that are observable to our senses but the ocean is much greater than this. It has unseen plant and creatures, plants as well as floor with volcanic vents, etc. The ocean is an image of beauty, expansiveness as well as danger the unknown. This is why the Ocean is one of the timeless symbols of the Unconscious. Every Psyche is based on primordial Archetypes. Religion, mythology, philosophy, fables, superstitions, the arts, history, even physics is an attempt to make sense of the dynamic fields of this Priori. The problems arise when the energy of these Archetypes is undigested, distorted, and deranged in such a manner that it produces complexes that disrupt the integration of the fivefold Psyche.
For example, Dionysus was an ancient Pelasgian divinity representing natural life, death, resurrection and eternal life. In his pure form Dionysus was first identified with Zagreus, who was a Cretan divinity. He was the son of Zeus, chief of the Immortals, and Demeter, the Earth Mother. The other gods were so jealous of his beauty that they tried to kill him.
The Titans tore Zagreus to pieces and threw his remains into a cauldron. Athena rescued his beating heart and took it to Zeus for resurrection. Zeus then gave him new life in the form of Dionysus and struck the Titans down with his thunderbolts. From this point on Dionysus, "the twice-born" became a divinity of everlasting life. The remains of Zagreus were reconstituted as an underworld god who welcomes the souls of the dead and helps them with their purification.
Plutarch wrote that Dionysus is a "god who is destroyed, who disappears, who relinquishes life, and then is born again". The Dionysus Archetype teaches that one must use titanic effort to tear to pieces the false ego until only the beating heart of the Self remains. Then one can be resurrected in the eternal life of the spirit. The myth of Dionysus shares many symbols with Osiris, Asclepius, Orpheus, Jesus, etc. The inner meaning of the life of Dionysus was presented as a sacred drama showing his birth, passion, death and resurrection. This mystery play is the origin of western drama and tragedy. The term tragedy literally means "goat song" in reference to the sacrifice of Dionysus’s animal form. Tragedy was a religious experience that was designed to purify the participant through awe and sympathy. Dionysus became one of the first in a long line of "scapegoats" for the human consciousness.
Dionysus is associated with wine, vegetation, moisture and natural living. Wine is a symbol of divine intoxication. Everyone wishes to feel the bliss of divine intoxication but they do not know how to attain it. Therefore, rather than seeking the wine of the spirit within they look to the outer world of drugs and alcohol to alter their consciousness. This, of course, can never satisfy the soul so they fall into the vicious cycle of addiction and abuse. Vegetation, moisture and natural living are symbols for fertility and procreation. Self-sacrifice often involves the violent and chaotic destruction of the false ego and an aggressive restructuring of the psyche. Dioinysus represents the forces of nature.
The temptations of intoxication, abuse of sexual energy and angry aggression are so powerful that even a god can become trapped in this cycle. After Dionysus discovered the grape vine he traveled all over the world and became a civilized man. It was only when Dionysus became a god of civilization (rather than nature) that drugs, sex, and violence got out of control. This is analogous to the fall of humanity. The fallen followers of Dionysus reveled in uncontrolled drunkenness, frenzied sex orgies, violent rampages and human sacrifice. Dionysus inflicts madness on those who misunderstand or deny his proper manifestation causing them to tear to pieces their loved ones, especially their children. Drug addition, promiscuous sex, and violent rampages are being more and more common.
I have seen the undigested Dionysus archetype destroy of the lives of many persons who were creative and inspired but could not control their addictions, sexuality, and violent impulses and committed conscious or unconscious suicide. Even if they wished control themselves the undigested power of the Dionysus complex drove them further and further toward death with a false idea of resurrection. One might say that the entire "drugs, sex and rock and roll and punk culture" is a manifestation of the Dionysus complex. . In the 1960s there arose a cultural Dionysus mystery drama on a mass scale. The the story of Jim Morrison and the Doors is only one example. Some integrated the archetype and moved on and others did not and were destroyed. Glimpses of the undigested Dionysius archetype can be seen in remedies like Anac., Androc., Fl-ac., Cant., Hep., Hyos., Iod., Kali-br., Lach., Lyss., Med., Nux-v, Phos., Plat., Stram., Sulphur, Tarent, Verat and other remedies. Aspects of this archetype appear in psora but reveal themselves more fully in sycotic and syphilitic miasms.

I hope this offers a view into what I mean when I speak of undigested archetypes, complexes, personality disorders, neurosis, etc. I am writing about all these classifications in detail and composing specialized Materia Medica of psychopathology with physical concomitants for my never ending book project. My daughter just told me "Dad, STOP stop writing! You have been writing since before I was born." Is 12 years too long? Gosh, talk about obsessive-compulsive disorder!

Similia Minimus,
David Little