Dr Simi Poulose
ABSTRACT:
Homeopathy, founded by Samuel Hahnemann, operates on the principle of “like cures like,” treating diseases by understanding symptoms and pathology. Emphasizing a holistic approach, it integrates the study of cell injury and individualized case-taking. Practitioners consider the entire person, including lifestyle, environment, and emotional state, to identify the most appropriate treatment. This approach ensures effective, personalized care, leading to sustainable and long-term health outcomes, highlighting the importance of pathology in medical practice.
KEY WORDS: Homoeopathy, pathology, case taking, repertory
INTRODUCTION:
Homeopathy, compared to other medical systems, is relatively recent, originating about 200 years ago in the 18th century. It was developed through the determination and incessant efforts of Samuel Hahnemann during a period when medicine was shifting from established norms and relying heavily on observations and inferences. The basic principle of homeopathy, however, can be traced back to ancient Greece. Hippocrates, often regarded as the father of medicine, recognized the concept when he stated, “By similar things a disease is produced, and through the application of the like, it is cured.”
Hahnemann coined the term “homeopathy,” which first appeared in print in an article he published in 1807. The word derives from the Greek ‘homios’ meaning ‘like’ or ‘similar,’ and ‘pathos’ meaning ‘suffering.’ Therefore, homeopathy is known as the ‘medicine of likes.’ It involves curing the sufferings of a diseased individual by administering remedies that can produce similar sufferings in a relatively healthy person, based on the principle of matching symptom similarity.
Pathology, a term derived from the Greek words “pathos” (suffering) and “logos” (study), is the scientific study of the structural and functional changes in the body due to disease. It encompasses the abnormalities in normal anatomy (including histology) and physiology that occur as a result of disease. Pathology provides the scientific foundation for medical practice, making it a critical area of knowledge for aspiring doctors, general practitioners, and specialists. Without an understanding of pathology, medical professionals would struggle to interpret laboratory reports accurately, which is essential for effective treatment and preventive care.
The importance of pathology in clinical medicine is succinctly captured by Sir William Osler (1849-1919), a revered physician and educator often called the ‘Father of Modern Medicine,’ who famously stated, “Your practice of medicine will be as good as is your understanding of pathology”, a sentiment that underscores the necessity of a robust knowledge base for all medical systems.
The term “internal environment” or “milieu intérieur”, Claude Bernard (1949), describes it as the state within the body where interstitial fluid and plasma maintain the normal structure and function of cells and tissues. The process that keeps this internal environment constant is known as homeostasis. Clinically, we recognize the importance of homeostasis in the onset of diseases; various hostile factors disrupt homeostasis, making organisms susceptible to certain pathologies, which manifest through altered sensations and functions.
This concept aligns with Dr. Samuel Hahnemann’s idea of the vital force in the “Organon of Medicine,” written over a century ago. According to the 9th aphorism: “In the healthy condition of man, the spiritual vital force (autocracy), the dynamis that animates the material body (organism), rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purpose of our existence.” Thus, disturbances in the vital force or homeostasis cause diseases.
In homeopathic treatment, understanding causations, signs and symptoms, and the totality of symptoms are essential for addressing any pathology. Since diseases often start with cell injury, it is crucial to understand cell injury and its consequences.
Cell injury is defined as the effect of a variety of stresses due to etiologic agents a cell encounters resulting in changes in its internal and external environment.
1.When there is increased functional demand, the cell may adapt to the changes which are expressed morphologically, which then revert back to normal after the stress is removed (cellular adaptations).
Example:
- Atrophy
- Hypertrophy
- Hyperplasia
- Metaplasia
- Dysplasia
- When the stress is mild to moderate, the injured cell may recover (reversible cell injury), while persistent and severe form of cell injury may cause cell death (irreversible cell injury).
Example
- Degenerations
- Subcellular alterations
- Intracellular accumulations
- The residual effects of reversible cell injury may persist in the cell as evidence of cell injury at subcellular level (subcellular changes), or metabolites may accumulate within the cell (intracellular accumulations).
E.g.
- Gangrene,
- calcifications
In the principles of homeopathy, diseases arise from disturbances of the dynamic vital force. According to aphorism 11 of the sixth edition of the Organon of Medicine, when a person falls ill, the morbid derangement reveals itself solely through the manifestation of disease in the sensations and functions of the parts of the organism observable by the senses of the physician and the patient—these are the morbid symptoms. Aphorism 153 underscores the importance of the striking, singular, uncommon, and peculiar (characteristic) signs and symptoms of a disease case, noting that these are often the most important indicators but are less evident in pathologically advanced cases. Such cases can be treated as one-sided diseases. Hahnemann details their treatment protocol starting from aphorism 172, emphasizing how to handle one-sided diseases presenting with only a few symptoms. One-sided diseases are of two types: Diseases with only physical symptoms like headache, diarrhoea and diseases with only mental symptoms like insanity, mania. In aphorism 177, Hahnemann reiterates that to treat such cases effectively, one must select a homoeopathic remedy guided by these “few symptoms,” which essentially reflect the pathology itself.
Pathology, a highly developed science, reveals minute tissue changes in diseases, which can be integrated into homeopathic principles. Modern cases often show a predominance of pathological symptoms. Practitioners cannot refuse treatment based on pathology alone and must be prepared to treat patients at any disease stage. When characteristic symptoms are unavailable, pathological symptoms should be considered. Every clinical symptom reflects some underlying pathology, which can serve as its cause, explanation, or concomitant. Thus, a good homeopath must also be a complete physician, understanding the type and extent of pathology.
Various philosophers have emphasized the importance of pathological generals in understanding and treating diseases. Dr H. A Roberts has highlighted the significance of the Sycotic miasm. This miasm, according to Roberts, manifests as an overgrowth of natural tissues, such as warts, polyps, and cysts. This pathological tendency reflects deeper, chronic disease processes within the body.
Roberts’ emphasis on the Sycotic miasm underscores the importance of identifying and generalizing pathological generals—fundamental disease patterns and tendencies that manifest across different individuals. By recognizing these patterns, practitioners can better understand the root causes of diseases and tailor treatments to address the underlying imbalances rather than just the superficial symptoms.
Carrol Dunham states that the science of therapeutics involves studying two series of phenomena together with their law of relation. Physicians must determine if a case requires hygienic management, therapeutic treatment, both, or if the patient is beyond help. To answer these questions, a diagnosis and prognosis are essential, and the case must be individualized to form a complete picture of the morbid phenomena.
Morbid phenomena are deviations from healthy phenomena. A thorough understanding of these symptoms requires orderly and methodical investigation, which is possible through familiarity with the relationships and sequences of morbid phenomena, known as pathology. Both physiology and pathology are indispensable to physicians, including homeopathists, despite some claims to the contrary.
Pathology helps physicians understand diseases, but only therapeutics can cure them. Even though the pathology of diseases like pneumonia, cholera, or rheumatism is well understood, it does not provide clues to their therapeutic treatment.
Dr. Richard Hughes’s approach was practical and scientific, strongly supporting the Similia principle. He believed that knowledge of disease equates to understanding its symptoms and available pathology. Influenced by the latest medical and scientific developments of his time, he had a weak belief in the dynamic cause of disease and opposed the miasmatic theory. He insisted that physicians must select medicines that address the disease’s pathology, earning him the title of a “Pathological Prescriber.” Hughes emphasized the necessity of understanding the pathology created by remedies at the organic level, stating that it is the pathology that must be treated.
Rajan Sankaran asserts that abnormal sensations and functions offer a holistic way to describe pathology, surpassing emotions, feelings, or delusions because they pertain to the entire organism. Pathological sensations are seen as the delusions of the whole person, with functions being their physical, general, or emotional responses. These sensations and functions run through all levels of the organism and can be used to correlate physical, mental, emotional realms, and the dynamic force.
In homeopathic case-taking, pathology-specific methods are integral to Boenninghausen’s Therapeutic Pocketbook (TPB). In Boenninghausen’s approach, the process involves a detailed examination of the patient’s symptoms categorized into four key elements: Location, Sensation, Modality, and Concomitant. These elements are meticulously analyzed to determine the precise “similimum,” or the most appropriate homeopathic remedy for the patient. By focusing on these aspects, practitioners can tailor their treatments to the individual’s unique manifestation of illness, aligning closely with homeopathy’s principle of “like cures like.” This structured method enhances the accuracy and effectiveness of homeopathic interventions.
The question then becomes how to translate these few symptoms into appropriate rubrics to find the similimum of the case. This is where the utility of Boger Boenninghausen’s repertory becomes invaluable. Dr Bogers Repertory includes numerous verified pathological rubrics that can signify a pathological change or a clinical condition in an advanced disease. His doctrine of pathological generals and such rubrics in his repertory are very useful.
Some of the pathological general rubrics are given below:
- Atropy
- Apoplexy
- Black external parts turn – gangrenous change
- Chlorosis – Iron Deficiency Anaemia
- Cancerous cachexia – Ulcers, cancerous
- Concussion – Jerks, Blows.
- Connective tissue: -Hard, indurated, Inflamed.
- Constitution – Carbo-nitrogenous, Dyscratic, Hydrogenoid, Lithaemic, acidosis, Neuropathic, Oxygenoid, soric, scrofulo-lymphatic, etc., Sycotic, Syphilitic
- Consumption: In general
- Contractions, narrowings, etc., (as after) inflammation
- Cyanosis: blue face
- Dropsy: oedema, of:
- Epilepsy
- Gangrene
- Hæmorrhage
- Indurations,
- Inflammation
- Jerks
- Marasmus
- Metastasis
- Mucus membranes, – affected, Bleeding etc
- Muscles: -In general etc
- Obesity, corpulency,
- Offensiveness
- Paralysis agitans
- Polypi
- Scurvy, scorbutic, symptoms
- Serous membranes
- Spasms, convulsions, etc.,
- Suppuration
- Swelling (tumour):
- Sycosis
- Syphilis
- Twitching (jerking), in joints:
- Torpidity
- Ureamia
- Uric acid diathesis
- Senility
These types of rubrics are essential in finding the similimum, which is the remedy that most closely matches the patient’s overall symptom picture. They also assist in subsequent follow-ups and contribute to achieving a cure that embodies the highest ideal of homeopathic treatment: the rapid, gentle, and permanent restoration of health and the annihilation of the disease in its entirety. This process is accomplished in the shortest, most reliable, and most harmless way, based on easily comprehensible principles.
CONCLUSION:
Understanding pathological generals allows practitioners to adopt a holistic and comprehensive approach to healthcare, considering the entire person and their unique expression of disease. This involves not only addressing specific symptoms but also understanding the underlying pathological processes at play. By taking detailed case histories and analyzing the progression of the disease from a pathological perspective, practitioners can gain a deeper insight into the nature of the illness.
This thorough understanding helps in identifying the most appropriate treatment strategies, ensuring a more effective and rapid cure. The approach emphasizes treating the whole person rather than just isolated symptoms, leading to more sustainable and long-term health outcomes. It encourages practitioners to consider various factors, including the patient’s lifestyle, environment, and emotional state, in addition to the physical symptoms, thereby promoting a more personalized and effective treatment plan.
REFERENCES
- Textbook of pathology 7th edition -Dr Harsh Mohan
- Organon of Medicine 6th edition – Dr R. E Dudgeon
- The principles and art of cure by homoeopathy – Dr H A Roberts
- Boger Boenninghausen’s Characteristics and Repertory – Dr C.M Boger
- Homoeopathy -The Science of Therapeutics – Dr Carroll Dunham
- The elements of Homoeopathy -Dr Rajan Sankaran
Dr. Simi Poulose
M.D Part I, Department of Practice of Medicine,
Under the guidance of Dr. Veerabhadrappa C.,
Professor, Department of Practice of Medicine,
Government Homoeopathic Medical College and Hospital, Bengaluru.
simipoulose22@gmail.com
