The Wednesday Summit - Toronto 2011

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The Sensation Approach

 

No science is static; each science is dynamic and evolves through observation and experimentation.

Hahnemann’s Organon has always been the foundation of homoeopathy and it will continue to remain so. However Hahnemann never implied that the Organon was the last word. He himself changed it six times in his life time between 1810 – 1843, which means in 33years it underwent six reviews and some of them quite significant. Sensation Approach takes the Organon as a starting point ; as the base.

“If the physician clearly perceives what is to be cured…in every individual case of disease…if he clearly perceives what is curative… in each individual medicine…and if he knows how to adapt, according to clearly defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient, so that recovery must ensue…then he understands how to treat judicially and rationally, and he is a true practitioner of the healing art.” - an excerpt from Aphorism 3

The intention is to make our tasks of perceiving the morbid and of selecting the appropriate remedy simple, consistent, definite and systematic, so that recovery must ensue more surely and predictably in every individual case of disease. How does the Sensation Approach aim to do this? There are many concepts that are apparently new, and many that come from a natural progression of ideas proposed by homoeopaths through generations. So how relevant is the Sensation Approach to Hahnemann’s homoeopathy? We may look at the many concepts and approaches of this method to understand this.

1. The expansion of miasms

2. The concept of delusion

3. The concept of the vital sensation

4. The understanding of kingdoms

5. The levels of experience

6. The approach in case-taking

1. Miasms

The early understanding: Hahnemann observed that frequently well-indicated remedies failed to produce “true and lasting recovery in…chronic maladies.” After much thought on the reasons, he proposed the theory of the miasm – a derangement of the vital force more fundamental than the current manifestation of the disease, originating from a contagious and hereditary “primitive disease”. He identified three such ‘primitive diseases’ – psora (the itch), sycosis (gonorrhoea) and syphilis. He essentially perceived the miasm on the physical plane and listed the main symptoms of these miasms.

However the lists of symptoms are very large. He put the majority of remedies in the psoric miasm. He left out a number of remedies such as Belladonna and Nux vomica, that he felt may belong to “various acute miasms”. He ascribed Thuja to sycosis and Mercurius to syphilis. Boenninghausen noted :

Other homoeopaths added remedies to the various miasms, however confusion occurred because one remedy was ascribed to more than one miasm. J.T. Kent added a psychological dimension to the understanding of these miasms. C.M. Boger correlated pathology with miasms. J.H. Allen introduced the tubercular miasm, which he felt arose from psora and syphilis. He proposed that when sycosis is added to the tubercular miasm, it causes a malignant hue. Later, Vithoulkas stated that the tubercular miasm is a separate miasm. Homoeopaths have attempted to describe the predisposition, disposition, constitution, diathesis, generalities and modalities of the miasms. Foubister proposed a cancer miasm, thus bringing the total to five. Ortega described mental and physical characteristics of psora as inhibition, sycosis as excess, and syphilis as destruction.

In the attempt to define the concept of miasm, the following criteria have been stated:

1. It stems from an infectious disease.

2. There is a distinct inherited predisposition.

3. It has a corresponding nosode.

4. There is a specific pattern of physical and mental symptoms and behaviour connected with it; a systemic totality.

While cancer does not arise from an infection, it has the other criteria, and so is accepted as a miasm.

Boenninghausen wrote:

“And yet the much reviled and ridiculed theory of the three miasms laid down by the founder of our Homeopathy is nothing else than a consequential application of the doctrine of anamnesis of chronic disease, as this is most plainly laid down in aphorism 5 and 206 of the Organon (5th edition). It is therefore totally incomprehensible how this has been so overlooked, unless other, by no means praiseworthy motives, have been brought into play. For all the fair phrases about the exact obedience to the fundamental principles of homeopathic Therapy cannot deceive the experienced practitioner and persuade him that he may at all times select the most appropriate remedy by means of whole sheets of images of the disease in which there is nothing therapeutically characteristic.


“I do not wish to deny by any means that there may be perhaps beside the three above mentioned anamnestic indications, and beside the medicinal diseases, one or another additional miasm to which may be ascribed a similar influence upon health. Nevertheless such a miasm has not so far proved by means of demonstrative documents and it must therefore be left to future investigation. ” (Allg. Hom. Zeit Vol. 65).

Thus Boenninghausen makes two points: First he says that long lists of symptoms often do not help us to find the simillimum – something is missing which for him (and Hahnemann) is the knowledge of the miasm of the patient and of our remedies. Second he explicitly states that there may be other miasms beside the original three mentioned by Hahnemann which he leaves for future investigators.

Dr Manish Bhatia (in Hpathy) comments:

“I cannot dwell deeper on Sankaran’s approach here but I would like to say that although Sankaran’s miasms appear very different from Hahnemann’s miasms, they are actually not. Sankaran has picked all his miasms from infections and uses physical symptoms too, to identify a miasm just like others. The difference in his work is that he has been able to associate different mental states with each miasm and the transition from one miasm to another is shown through successive changes in the mental state.”

I quote below the relevant part of an extensive and scholarly article from the National Centre of Homeopathy:

The next major stage in the development of miasmatic thinking has been the introduction of other miasms. If the three major miasms, stemming from the primary afflictions that Hahnemann spoke of - to the thematic expressions that Ortega and others described - act as a foundation, then practically speaking, the miasms of Tuberculosis and Cancer belong in a very similar category. However, there are distinct differences between the two miasms, the most important one being that Cancer is the only miasm that does not stem from an infectious disease. The other four all have an infectious disease or contagion principle involved in it. However, for all intensive purposes, it conforms to all the other major criteria for a miasm, in that there is a distinct inherited disposition to it, there is a clear nosode with a profound remedy image and there is a larger pattern of physical and mental symptoms and behavior connected to it. In other words, there is a systemic totality.”

The Sensation Approach: We are looking at the same thing – an infective disease – from a different window. With a view to further simplifying an understanding of them, I studied a number of well-known syphilitic remedies and perceived a pattern of destructiveness, physical (in ulcers, for example) and mental (in suicidal and homicidal behaviour, for example). Hence I hypothesized that those with the syphilitic miasm have a destructive attitude. If we take this a little bit deeper we can see that this destructive attitude is accompanied by a sense of despair or a hopeless feeling. For example in Aurum metallicum we have: “Intense hopeless depression; and disgust of life. Talk of committing suicide.” In Syphilinum we have: “Hopeless despair of recovery, antisocial, horrid depression.” So, what we can also see in syphilitic remedies is the mental despair related to the destructive pathology.

Similarly if we now study sycotic remedies, well known sycotic remedies, what is the pattern we observe? Take the example of Thuja, Medorrhinum, Silica, Pulsatilla, Causticum as sycotic remedies. What do we observe in these remedies? We observe anticipation and caution; we observe certain fragility and the need to cover up. We do not see the destructive aspect of syphilis but we see a kind of fixity and caution. From this fragility and caution also comes a kind of overreaction whether it be in the form of egotism or over cautiousness. This kind of overreaction can also be seen on the physical level by over reaction to vaccination, allergies and asthma and the presence of tumors and warts.

So now we have another pattern the sycotic pattern and we can understand sycotic maism not only from the etiology point of view but also from a pattern point of view. Hahnemann has given us three miasms. The question is: are there only three miasms or patterns?

By studying several thousand cases; I observed that there were more patterns than the three already mentioned. Homoeopaths in the past had recognized one more pattern, the tubercular pattern. This pattern is consistent with the behavior of tuberculosis as an infection. The hectic pace, emaciation and wasting and the tendency to a destructive pathology. As reflected in remedies like Tuberculinum, Phosphorus, Drosera and Calcarea phosphoricum.

There is one more pattern that was being increasing recognized, the pattern of cancer. Remedies like Carcinocin, Argentum nitricum, Arsenicum. When we observe the pattern in them we see the main concern is of control and the loss of control. The tremendous need to keep things in control arises from a perception that there is chaos and everything is in disorder which threatens to destroy. This of course is very close to the idea of disease cancer itself.

It can be said that the profession is more or less accepting these patterns; of psora, sycosis, syphilis, tubercular and cancer miasms. On studying further I found that a few more patterns were clearly distinguishable. These were the pattern of malaria, typhoid, ringworm and leprosy. A detailed account of how I researched into each of these and evolved the pattern of each of them can be found in my books for example; The Substance of Homoeopathy and The Sensation in Homoeopathy. This idea of miasms as patterns in my view is just a development of the ideas of Hahnemann. My colleagues and I have found it valuable in our practice. These ten patterns of the ten miasms is a useful map in which we can trace where the patient is and find a remedy of corresponding miasm or pattern.

So we have an understanding of the attitude, which arises from the depth of desperation that being infected with that particular disease brings about in the sufferer. This attitude, along with the pathology, makes up the pattern. Similarly we can see attitudes in the sycotic miasm (anticipation, avoidance, acceptance) and cancer miasm (control).

However, even more infective diseases exist, and other patterns can be identified, quite distinct from the five earlier discovered. I identified the specific attitudes (depth and pace of desperation) of those infected with acute diseases, typhoid, ringworm, malaria and leprosy. Hence more miasms have been identified and the understanding of attitudes is helpful to systematize the use of miasms further.

The usefulness of the expanded list of miasms

A man in psychiatric depression came for treatment. He was living in an isolated manner. No relations, no contact. His father had died recently, but he had been very scared of his father, and wanted to kill him, because in his childhood his father would chase him. Recalling this, he would wake up at night screaming in fright. If you take the symptom ‘Screaming in fright,’ you would give him Stramonium. A colleague did so, but there was no response. When I interviewed him I found that the depth of desperation he was experiencing was akin to severe isolation, with disgust and helplessness. There was a feeling of having no one he could turn to. This extreme sense of isolation is a hallmark of the leprous miasm. I gave him Mandragora, which is in the same family as Stramonium, but with a different attitude. He improved greatly and even wanted to understand his father better. There is no way this case could have been solved without the concept of miasm.

Similarly Sujit Chatterjee prescribed Colchicum successfully in a case of meningioma, and Laurie Dack effectively used Physostigma in a case of rectal cancersimply by applying the new understanding of miasms.

2. The Concept of Delusion

“The state of the disposition of the patient often chiefly determines the selection of the homoeopathic remedy, as being a decidedly characteristic symptom.” – from Aphorism 211.

A ‘state’ is a condition or a mode of being. It is an entire attitude that influences the person’s habitual temperament. Hahnemann therefore did not specifically identify just mental symptoms; he understood them as part of the entire mode of being, characterizing the individual. However, he also gave a lot of importance to understanding the subjective experience of the patient.

“We should listen particularly to the patient's description of his sufferings and sensations, and attach credence especially to his own expressions wherewith he endeavors to make us understand his ailments.”- from Aphorism 98

Mental symptoms have been understood and used in different ways. We can find rubrics such as ‘Company, aversion to’, ‘excitable’ etc. in repertories dating back to Boenninghausen. J.T. Kent “picturised” drugs as people with tendencies to certain mental and emotional behaviours as well as symptoms and pathology. M.L. Sehgal developed a way of interpreting mental rubrics such as ‘frivolous’ and ‘fear of extravagance’. Many practitioners apply mental rubrics as part of a repertorial ‘totality’. Often we may find mental rubrics useful, such as ‘Emotional excitement, effects of,’ but there is much subjectivity in interpretation when we apply other rubrics such as ‘dictatorial’. There is much scope for error.

The Sensation Approach: We focus deeper on the person’s subjective experience, which is essentially, how the person perceives the reality around him. The perception is revealed in remedies and patients as the delusion. Delusion itself arises from a deeper subjective experience, namely, a sensation. It is at this level that one can understand the connections between apparently disconnected mental symptoms, and the entire subjective experience can be recognized as a whole. If, for example, you want to understand the state of Thuja more holistically – why he is so cautious and has a fear of falling – then the delusion that he is brittle is an important clue. This delusion itself arises from a sensation of fragility. Similarly the sheer panic with desire to flee of Stramonium can be better understood in the context of the delusion of being alone in the wilderness.

3. The concept of Sensation

“As the organism, in its normal condition, depends only on the state of the vitality, it follows that the changed condition which we call disease or sickness must likewise depend, not on the operation of physical or chemical principles, but on originally vital sensations and actions – that is to say, a dynamically changed state of man – a changed existence, through which, eventually, the constituent parts of the body become altered in their character.” – from a preface to the Materia Medica Pura, Hahnemann

In this and aphorisms 29, 89, 98, 126, 130, 137, 141 Hahnemann directed the attention of the accurately observing physician to the sensations and functions subjectively experienced by the patient.

He believed that the subjective sensation was so important that being able to discern it is an important ability of a prover. He describes, in Aphorism 137:

“The more moderate, within certain limits, the doses of the medicine used for such experiments are - provided we endeavor to facilitate the observation by the selection of a person who is a lover of truth, temperate in all respects, of delicate feelings, and who can direct the most minute attention to his sensation - so much the more distinctly are the primary effects developed, and only these, which are most worth knowing, occur without any admixture of secondary effects or reactions of the vital force.”

Boenninghausen, with Hahnemann’s concurrence, integrated the idea of there being only one disease with the understanding that it manifested in altered sensations and functions. He generalized modalities and sensations, concluding that what is true of the part is true of the whole. Hence, local sensations are an expression of a common general sensation.

“We as homeopathists, do not yet fully appreciate the value of sensations.” Nash in Leaders in Homeopathic Therapeutics (under Sulphur)

The Sensation Approach: My idea of vital sensation is a direct progression of Boeninghausen’s Grand Generalization. There is only one disease state and all local manifestations are but an expression of it. The Sensation Approach extends this idea to the connection between mind and body, and sees them as expressions of the same disturbance. For example, we can understand, in Bryonia, the relation of the aggravation from slightest motion (physical) and desire to keep still to the mental aversion to being disturbed. Baryta carbonica has delayed development of the mind as well as the body. They are all aspects of the same experience. Hence, one is focused on coming to the common point behind mind and body. This point I call the vital sensation.

4. The Understanding of the Kingdoms

At the time of Hahnemann’s practice, there were only ninety-nine proved remedies, with very few, if any, remedies made from animal sources. And therefore, it would have been very difficult to make group generalizations. In two centuries more remedies, with their provings and clinical confirmations, have been added, so that we now have about 2500 remedies, representing a wide variety of natural sources. The increasing number of remedies provides both a greater probability of reaching the similimum and a greater practical difficulty in identifying it. In the 20th century, homoeopaths such as Farrington. Leeser , Roberts, Clarke, and Dhawale began studying remedies as groups, seeing similarities that could help narrow down the choice. With the advent of computerized repertories, the analytic ability to study groups and see common patterns, without theorizing, is made much easier and more scientific.

John Henry CLARKE, MD observed:

“This is often of importance, since there is a strong therapeutic likeness between members of the same botanical group.. The chief function of homoeopathy, it is true, is to individualise. This must be effected , with the greatest possible completeness. But when once this has been done and to effect this was one of the main objects I kept before me in compiling my Dictionary - grouping can be of the utmost value in the study and use of the materia medica…………..

When this individualizing of remedies has bee mastered, the grouping becomes of great importance in practice. Of this both Dr. Burnett and Dr. Cooper made the most brilliant use. I need only instance the working out of the Lobelias by Dr. Cooper, and of some of the Conifers by Dr. Burnett. Those how wish to follow the successes of these great therapeutists will have alight to guide them in my Repertory of Natural Relationships.”

E A Farrington remarked:

“Now, then, you will find that drugs hold certain relations to each other. You will find five relations. The first I have called the family relation, derived from their similarity in origin. When drugs belong to the same family they must of necessity have a similar action. For instance, the halogens, Chlorine, Iodine, Bromine and Fluorine, have many similitudes, because they belong to one family. So, too, with remedies derived from the vegetable kingdom. Take, for instance, the family to which Arum triphyllum belongs. There you find drugs which resemble each other from their family origin.”

The Sensation Approach: The vital sensation, affecting body and mind, manifests in expressions that are strange, rare and peculiar because they are beyond the human experience. They are expressions very closely correlating with the experiences of something else in nature. Naturalists divided the natural world into three kingdoms – mineral, plant and animal. We find these three kingdoms have distinct patterns of non-human experience that are reflected in persons and remedies.

To understand this scientifically, we collect the symptoms from the proving and rubrics of many of the remedies from the group and then see what is common to them.

“Everything that is conjectural…should be strictly excluded; everything should be the pure language of nature carefully and honestly interrogated.” – from Aphorism 144

“In acute diseases, on the other hand - except in cases of mental alienation - the subtle, unerring internal sense of the awakened life-preserving faculty determines so clearly and precisely, that the physician only requires to counsel the friends and attendants to put no obstacles in the way of this voice of nature by refusing anything the patient urgently desires in the way of food, or by trying to persuade him to partake of anything injurious.” Aph.262

Consider plant remedies like Ignatia, Pulsatilla and Staphysagria — what do people who need them have in common? We can see that they are extremely sensitive and reactive people. If we look at three mineral remedies—Natrum muriaticum, Argentum nitricum and Baryta carbonicum — what see that they have as their main issue the feeling that something is lacking or lost. In the animal remedies such as Lachesis, Lac caninum and Apis mellifica we see in common issues of jealousy, competition and hierarchy.

Thus these three patterns — sensitivity, structure and survival — correspond to what we observe in nature in plants, animals and minerals, respectively.

We are often accused of practicing the Doctrine of Signatures, but those who do so are looking at our application very superficially. Just because someone wears a striped shirt to conclude that he needs Zebra is not my teaching. The kingdom understanding is effectively applied only when the case-taking has achieved a depth whereby all the different dimensions of the disease can be understood as expressions of one inner dynamic disturbance.

The need for grouping arose from the difficulty in practice where you cannot break everything about the patient into a referable symptom. Repertorial rubrics are incomplete in their scope. For example, if a person says, “I am very orderly and planned,” how do we classify it? The rubric ‘fastidious’ would be incorrect. Yet, if you can see that it is a mineral feature, then you have a wider base of application. If a person has a fear of a sudden and surprise attack, how will you turn it into a rubric? There is no rubric so exact. But if we can understand this feeling in terms of a reptile attack or an Umbelliferae sensation, it frees us a lot and we can consider a remedy from these groups.

We sometimes also find very peculiar characteristics of the patient – for example excessive fascination with something or a specific, excessive phobia, or aversion or disgust. These are often related to the source and may not be found in a rubric.

(For me it is so interesting to see the rubric Fear of Wind and see Thuja- but rather than just prescribe on the proving symptoms or rubric it is far more relevant to me to know that conifer trees are the oldest tress on earth and often you see that many of them are hollow ( like Sequoia trees after thousands of years) and that one of the big problems for these conifers is strong winds that can blow them over since they are fragile in that way- from this I can understand the rubric better but far more I can understand that energy pattern in a patient. - Robert Gramlich)

So we understand the whole sub-group in a particular way and there is a constellation of themes. Then our way of using the patient’s information becomes much broader as we try to understand the experience. So we don’t have to worry that the rubric is absent or incomplete, because our picture is broader than the rubric.

Studying patients and remedies as Themes:

To study themes in sub-kingdoms gives a broader approach to the patient and their remedy. For example, I had a case of a man with chronic renal failure following a coronary bypass surgery. This man was always inventing. His whole job was to find creative solutions to difficult technical problems. He would struggle with them, not stopping till the solution was found. He expressed a mineral sensation. Using the themes of creativity (row five) and persistence (eighth column), I gave him Ruthenium, which significantly improved his pathology and also his obsession to be creative.

If I want to study the common qualities of the remedies in the Third Row of the periodic table, I will look at what is common between Natrum muriaticum, Phosphorus, Sulphur, Silicea, Alumina and Magnesium. One thing that can be seen is embarrassment. Nat-m is embarrassed when urinating, Sil is embarrassed on the stage, Sulphur seems to be not embarrassed (yet is the main remedy in the rubric: Embarrassment). So, we start collecting the common features of the remedies of this row, not only the physical or chemical properties. We find that their main issues are of care and nourishment, having their own identity and choice, comfort with familiarity and other related issues. From this collection of common features we can see a pattern in these remedies. Another way of doing it is to study which rubrics in the repertory represent a very high percentage of remedies from the third row. This also shows a pattern.

Otto LEESER’s “A Chemist’s outlook on the homeopathic materia medica” covers the chemical and mineral remedies, i.e. the alkalis (natrums, kalis), the halogens (iodine, bromine, etc.), and the sulphur, nitrogen, carbon, heavy metal and other groups. Shows similar symptoms for remedies that are chemically related, like the cold sensitivity of the alkali compounds. Presents materia medica in conformity with the science of chemistry.

Using the kingdom and sub-kingdom approach comes with certain risks, but if we discard the idea, it is like throwing out the baby with the bath water. Obviously at this level there can be false leads. One has to use these ideas with much training and great caution and be aware of the risks involved. I very strongly reiterate that they should never be taught or practiced as a substitute or alternative. They are only a development of classical homoeopathy. We have to learn the fundamentals of the Organon, Materia Medica and Repertory, and use these ideas on the base of those.

But now you have a choice. You can start with rubrics and come to a remedy and see if it is in the patient’s kingdom and sub-kingdom. Or you can go into the depth of the patient, come to kingdom and subkingdom and also see if the proving symptoms confirm it. The two approaches namely, the traditional and sensation method are not divergent, but actually convergent. They come to the same point from two different directions.

They compliment each other, since both have lacunae a wise man would use both.

William Gutman, MD, often compared the qualities of the substance with the symptomatology. Here are some examples:

“Remembering the function of silica in the outer world as well as in the inner world of man, where it shapes and builds, strengthens and defends, we will now attempt to picture, only with the help of this image, the individual whose silica power is poor or disorganized.”

“Gold, potentized, seems to impart to body and mind when afflicted through disease symptoms, which in strong doses it is able to produce itself, all the qualities which are associated with the metal, indestructibility, which it gives to the mind to resist its urge for self-destruction and to restore the healthy urge for self-preservation.

“Integrated with the human life process, through proving and as a remedy, the life force of the plant expresses itself, as it were, through the " language of the organs", and through mind and emotion as mental symptoms.”

Speaking on Lachesis , Dr L R Twentyman commented:

“So far we have attempted to sketch the relation of the Lachesis drug picture to the serpent archetype, using as a help the essential features revealed by biology and mythology. It is perhaps surprising how far this can go, especially when we consider that the remedy is prepared from the venom rather than from the snake itself. It does seem that the mental and general symptoms and modalities are more understandable in terms of the characterization of the serpent as a whole than in terms of the chemistry of the venom and the acute symptoms of snake bite.”

H A Roberts penned these words:

“We know less of the personal habits of the snakes than of some of the other animals from which we derive remedies. However, it is characteristic of all the snake venoms that in the provings there is the excessive sensitiveness to touch. The snake is an antagonist of every living creature; he avoids all contacts with other creatures, except for food, when his is the offensive attitude. The snake does not coil to strike at haphazard; there is a regularity to this posture in may snakes. The provings of the remedies prepared from the snake venoms invariably develop in the direction of the symptoms, the same direction as the snake takes in coiling. For instance, the Lachesis always coils from left to right; Lachesis symptoms, in the provings, start on the left side and move toward the right, with the aggravation usually on the left.”

Roberts wrote in Homeopathy 1936 :

“It is characteristic of the snake venoms, in their provings, that there is always the element of fear - the fear of enemies, suspicion. Lachesis fears that someone is behind her, and dreads siting so that someone might injure her in the back; she cannot endure having her back toward anyone else in the room. Crotalus horridus, the rattlesnake, imagines himself surrounded by enemies. Elaps has a fear of being alone, but does not wish to be spoken to. Cenchris has such a nervous apprehension that it causes the patient to tremble and the teeth to chatter, with the belief that his enemies are plotting against him.

Even as each patient presents to us individual characteristics, so each remedy has a personality of its own which is delineated in the symptomatology produced through careful provings. Just as each person's individuality is most clearly shown by his metal reactions, or by his habits and eccentricities which reflect his mental attitude, so the raising of any animal substance to a potency form reflects the true spirits of the creature from which it was derived, and allows us to compare these symptomatic findings of the racial peculiarities of the creature with the metal symptoms developed in our patients.

This is a field which has yielded but a small part of its possibilities. If we could know more of the habits of these creatures from which our animal remedies are derived, we would use them with far greater accuracy, for we might then known better the individual peculiarities which we often see reflected in our sick patients. If, on the other hand, many of these animal remedies were better or more completely proved, we might well infer from the symptoms produced much more of the natural history of these creatures who have so great a part in the healing art.”

As early as Sept 1896, William Boericke (A Compend of the Principles of Homoeopathy) said, “Family relation, such as belongs to the same, or allied botanical family, or chemical group; thus similarity in origin is its claim. In a very broad way, drugs may be divided, according as they belong, to one of the three kingdoms of nature, thus drugs from the animal kingdom, vegetable or mineral.

•It is not difficult to note certain great features, common to drugs, belonging to one kingdom; but similarity of effects is more marked as different members of a botanical family, or chemical group, are examined. Thus the Ranunculaceae family, comprising drugs like Aconite, Pulsatilla, Cimicifuga, etc, show certain symptoms of marked similarity—a family likeness not to be mistaken. This is sometimes so great as to seem identical.”

5. Levels of Experience

“When a person falls ill…it is only the vital principle, deranged to such an abnormal state, that can furnish the organism with its disagreeable sensations…for, as a power invisible in itself and only cognizable by its effects on the organism, its morbid derangement only makes itself known by the manifestation of disease in the sensations and functions of those parts of the organism exposed to the senses of the observer and physician, that is, by morbid symptoms.” – from Aphorism 11

We understand from this that there is one disease which deranges the vital force and manifests in abnormal sensations, functions and symptoms. There are then several ways to examine the deranged vital force. One can list the variety of symptoms and choose the most peculiar, or one can go deeper and try to see a unifying connection in them. We find that as we ask the patient to describe the problem in finer detail, one comes to a point where one can see the entire pattern of the one disease, the one deranged state. It is as if each expression is a hologram of the whole disease.

I perceived different levels in the experience and expression of the state, which ranged from the most superficial to the deepest. The levels inward are from pathology to local, from local to general, from general to vital.

Level 1 – Name – diagnosis – pathology

Level 2 – Fact – local symptoms

Level 3 – Emotional and psychosomatic correlations

Level 4 – Delusion – general symptoms and perception alterations

Level 5 – Vital sensation - which relates the mind and body in one experience

Level 6 – Energy – the dynamic disturbance of the vital force

Level 7 –Seventh – the level of the unprejudiced observer.

I believe that potency selection has been unconsciously based upon the levels of experience. When there is 6, then 30, and then a jump to 200 and 1M in the centesimal scale, we are already recognizing that there are different levels at which the disease state manifests itself. The levels from pathology to mind were already known. It has been commonly accepted that the lowest potencies like 6 and 30 are useful in pathological and local expressions, whereas 200 and 1M when more emotional symptoms are found, and 10M when the characteristic symptoms of the remedy are found with much intensity.

A clearer understanding of the levels of experience can give a concrete solution to the vexed question of how to choose the potency. We are now able to define exactly what the criteria of choosing a particular potency, which is the level at which the patient is living their everyday life.

6. Case-taking

In case taking, Hahnemann directed specific attention to the importance of the peculiar and characteristic symptoms of the patient.

“The more striking, singular, uncommon and peculiar (characteristic) signs and symptoms of the case of disease are chiefly and most solely to be kept in view; for it is more particularly these that very similar ones in the…selected medicine must correspond to.” – from Aphorism 153

He counseled the physician, in aphorisms 84 to 90, to enquire further and further for a more precise understanding of symptoms.

“When the patient (for it is on him we have chiefly to rely for a description of his sensations…) has by these details, given of his own accord and in answer to inquiries, furnished the requisite information and traced a tolerably perfect picture of the disease, the physician is at liberty and obliged (if he feels he has not yet gained all the information he needs) to ask more precise, more special questions.” – from Aphorism 89

The Sensation Approach: The individualizing examination of a case is a process of eliciting what is most characteristic and peculiar in the patient. It is, simultaneously, a search for the one disease and the source of the single remedy.

What are the ways in which we can find out what is peculiar?

1. Asking questions.

2. Observing the patient’s behavior and expressions

By following the most troubling symptom and asking the patient to describe more and more about it, we can go deeper more easily. We keep the focus on the sensation and ask more about it, excluding our own conjectures and interpretations, only asking for the description of the subjective experience. And when the patient goes into his experience and observes it he expresses his visualizations which are very strange as far as a human being is concerned. But they are fully explainable and understandable in context of something in nature. So we start hearing the pure language of nature, the language of the source.

As we observe the patient we can also see the way he moves his hands, his body gestures. This is remarkable and very peculiar to the individual case. It comes from the subconscious mind, and therefore must be even more characteristic. We found that making the patient focus on the gesture helped him reach an even deeper level of experience of the vital sensation. At that level, his physical and mental expressions seem to come to one point.

So we use every possible means to come to the understanding of the inner state, knowing that it corresponds with that of the source.

Other windows to the peculiar and characteristic

Doodles and spontaneous art

Each one makes a completely individual pattern or doodle. Instead of interpreting it, we simply ask the patient to focus on his own doodle and observe his own experience. Hence we use the doodle as a tool for the patient to observe himself. We found it highly effective. Similarly we make children do some form of art work and ask them to talk about it. Since children usually speak spontaneously, their innermost experiences can be revealed.

Music provings

“He knows with the greatest certainty the things he has experienced in his own person.” – from Aphorism 141

You know by experiencing, not by theorizing. This principle is universal in application. I considered using music as a dynamic influence, since it is known to have therapeutic effects. Each person must be having a music that is healing for him. So could we identify the specific effect of a type of music on the human being?

I took a standardized melody in Indian music – the raaga. It is made of notes in a specified pattern. I played this music to audiences in three continents on different occasions. I asked them to experience what happens within them when they hear the music. Indeed a particular raaga elicited a very specific state in people though their backgrounds were diverse. Interestingly I found that the state of a particular raga was close to a particular remedy. For example the Raaga Darbari produces a state close to that of Aurum metallicum. I could then use that Raaga as an auxiliary mode of treatment in patients who needed Aurum.

The same principle which applies to music can probably also be applied to other art forms – art, literature, movies etc.

I am sure we can find many more tools helpful in our endeavour to reach the depth of the patient and to perceive his individuality and to treat them on the Homeopathic principle.

Defining Sensation Homeopathy :

Sensation Homeopathy recognizes a level of core experience within a person that is deeper than his expression of symptoms through his mind or body. This is the level where Sensation is exerienced and expressed.

The core experience of an individual is a reflection of a 'source' in the natural world. It is as if the song of something in nature is within the individual and its pattern can be seen in all aspects of the person's expression in the world.

The individual’s pattern of expression can be perceived more clearly when understood as a part of a larger order in nature. That order has been classified into kingdoms such as the mineral, animal or plant kingdoms, and then further into subkingdoms reflecting the different elements and species in the natural world.

Similarly homeopathic remedies reflect the pattern of the source from which they are derived. Remedies are not only perceived as individual entities, but as belonging to groups, so they share the features of the group as well as their individual characteristics. Remedies may also be mapped into the kingdoms of the natural order, such as the mineral, animal or plant kingdoms, and then further into subkingdoms. The common features of any given group will be evolved through rigorous and careful study of the provings, rubrics and clinical information of each member of the group. A well-researched scientific study of the disciplines of chemistry, botany, and zoology, supplements the study of the common features of a given group and the differentiating features of its individual members.

Sensation homoeopathy evolves by establishing a body of knowledge that is not only grounded in homeopathic information from provings and clincial experience, but builds on the similarity to information derived from the study of nature through the disciplines of chemistry, botany, and zoology. This knowledge will eliminate any guess work or work based on the so-called doctrine of signatures, where similarity in appearance or some other such superficial attributes are used as the reason for selecting the remedy. It also removes guess work and general knowledge in knowing the features of a given kingdom, subkingdom or group.

A map of the miasms is another way of understanding that is useful in classifying remedies and patients. Sensation homeopathy defines miasm as an indicator of the pace and depth of the experience as perceived by the patient. It now recognizes 10 miasms, each one representing a specific pace and degree of desperation, and each one equating to a pattern of a well-known infectious disease (the exception being Cancer).

In Sensation homeopathy case-taking will be directed to perceiving the core sensation of the patient, as well as eliciting his characteristic symptoms. In actual fact this core sensation is often the most characteristic and individualizing of the patient’s symptoms.

Our results will be more accurate and and act more deeply in our patients if we are able to reach this level in case-taking, although this may not always be possible due to a variety of reasons. Even if this level is not reached in case-taking, it is still necessary to see the patient’s characteristic symptoms match the kingdom and subkingdom. In the case of a well-proven remedy the patient’s characteristic symptoms must also be seen in that remedy.

Sensation homoeopathy encourages provings and highly values the Materia Medica and the Repertory. But it is possible that there may be only a partial proving or no proving at all for a remedy needed by the patient. If the patient’s core expression and most characteristic symptoms do not fit into a known remedy, one could use a map of the kingdoms, subkingdoms, and miasms to come to a remedy.

Sensation homoeopathy leaves the practitioner flexibile to choose a method and technique in case-taking as long as he is clear about the goal, i.e., uncovering the core experience of the patient that underlies all his expressions of symptoms in both mind and body. The method used in case-taking will be the one that suits the individual patient.

Sensation homeopathy recognizes the core experience of the patient, the common point between mind and body, as vital sensation. In understanding vital sensation in the context of human experience in the world, Sensation homeopathy perceives seven levels of experience, namely, name, fact, feeling, delusion, sensation, energy and the seventh level. Ideally the homeopath would take the case to the seventh level and use energy patterns such as hand gestures to uncover the sensation in the case. However this may not be possible with all patients.

 

Concepts
The Sensation Method Approach
What is Non-Human Specific
New Approach to Casetaking
Dr.Sankaran's Concept of Miasms
Dr.Sankaran's Concept of Levels
Books by Rajan Sankaran

Resources
Vital Quest 4.0 - Sankaran's System
Wednesdays by Rajan - Online Forum
Insight Alliance Homoeopatic - A Web Group
Pay Per Day - Online Videos

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