Polarity Analysis- A Path to Precise Prescription in Homoeopathy

Dr Namratha L 

Abstract: An attempt is made in this article to understand the utility of Dr. Heiner Frei’s Polarity Analysis (PA) as a tool for improving the precision of Homoeopathic prescriptions. The study of Boenninghausen’s Concept of Contraindication is also undertaken which served to be the source of inspiration for the birth of PA. The possible drawbacks of the PA analysis have also been enumerated to be studied for its apt and careful application.

Introduction: All potential lies in the spectrum of Polarity. 

Dr. Heiner Frei (Switzerland), after having served for several years as a Senior Physician in the Pediatric Hematology and Oncology Department at the University Children’s Hospital of Bern., decided to concentrate on his huge pediatric practice in 1987. In 2001, he realized the immense potential that lay in the latent concept of polarities of drugs and thus after further modifications based on Boenninghausen’s Concept of Contraindications developed- Polarity Analysis, a tool aimed at ensuring greater precision in Homoeopathic prescriptions.

Dr. Heiner Frei MD and the Swiss double-blind study investigating the efficacy of homeopathy in the treatment of hyperactive children

The Swiss randomized control trial for attention deficit hyperactivity disorder(ADHD) under the able guidance of Dr. Heiner Frei MD, was in itself, a pioneering effort in finding effective therapeutic effect attributable to Homoeopathic treatment of Hyperactive children. Each of its three phases yielded positive results through evidence for a specific method of homoeopathic treatment.¹

It also highlighted the weaknesses of the methodologies involved mainly due to the misleading reports of sensations and mind symptoms by the parents as well as paucity of symptoms in many cases.

Reintroduction of pathognomonic perception symptoms into repertorization resolved the issue of cases with lack of credible symptoms.¹

Polarity Analysis, a further development of the Concept of Contraindications by Dr. Boenninghausen, was also tested and introduced as a tool for a precise differential diagnosis of possible Homoeopathic medicines.

Increasing the rate of optimal prescriptions by 20%, Polarity Analysis turned out to be the most efficient modification in case analysis.¹

Boenninghausen’s Concept of Contraindications

The Concept of Contraindications is a lesser known literary gem contributed to the Homoeopathic literature by Dr. Boenninghhausen. It states that almost every Homoeopathic medicine includes a number of Polar Symptoms, which also encompass their opposite, E.g Desire to move/Aversion to move, Thirst/Thirstlessness etc. Any remedy may thus exhibit both poles though in varying intensity and grades. 

According to Boenninghausen, high grade medicines (Grades 3,4 and 5) correspond to the characteristics of the medicine. In choosing the apt similimum for a patient, the physician ought to select the one that has characteristics most similar to those of the patient in as 

high grade as possible. If in a given Polar Symptom, the opposite is covered by a particular medicine in high grade, whereas the pole exhibited by the patient occurs only in low grade, then this medicine, according to Boenninghausen, is contraindicated and will not cure the patient.

Nux vomica, for example, has aversion to movement in third grade, desire to move, however, only in first grade. Consequently, Nux-v will likely not cure a patient who exhibits a strong desire to move, even though it covers this symptom in principle. Boenninghausen used this method to check his choice of medicines.²

Polarity Analysis seeks to deal with these opposite symptoms and utilizes the difference in grades to mathematically determine a plus/minus for each specific symptom (the Polarity Difference).³ The higher the polarity difference, the more likely the medicine matches the characteristic symptoms of the patient, provided there are no contraindications. A negative polarity difference points to remedies which cover the patient symptoms in an unspecific way, i.e., do not cover all patient symptoms with their genius symptoms. Such remedies have very little chance of curing the presenting complaint in the patient.

The Polarity Analysis Methodology

• Mainly physical modalities are to be used, since they are the ones that are most reliable.
• At least 5 polar symptoms should be used.
• Characteristic symptoms during the ailment are to be used; not traits that are present even in health.
• Mental symptoms are to be left for later, when remedy coverage is checked in the Materia Medica.

                 

• The repertorization results are weighted in the following order of importance:

1. Absence of contraindications and size of polarity 

difference

2. Completeness of symptom coverage
3. Suitability of remedy in Materia Medica coverage.

Repertorization Scheme Relevant for Polarity Analysis⁵

 

                        

Polarity Analysis Of Symptoms Illustrated Through an Example¹

A patient suffering from tonsillitis with the following symptoms:

• <swallowing
• <speaking
• <cold food
• <after waking
• >after eating

Thirst increased

All these symptoms are polar and covered by 19 medicines. However, only three of those are not contraindicated according to Boenninghausen: Natrium carbonicum, Mercurius solubilis and Magnesium carbonicum. The concept of polarity difference for these three medicines is illustrated in Table below

The polarity difference is the sum of the grades of polar patient symptoms minus the sum of the grades of polar opposite symptoms.

According to the example, Nat-c exhibits the highest probability to cure, Merc the second highest.

Using this method,the best suited medicine in a repertorization containing several medicines, which cover all the patients symptoms, can be more readily identified. The algorithm of polarity analysis has been since integrated in several repertorization programs of  Boenninghausen’s Therapeutic Pocketbook.

A Critical Study on Polarity Analysis
Jamie Oskin, ND a highly trained naturopathic physician with an expertise in homœopathy and natural pediatrics,  was inspired to study the Bönninghausen repertory after hearing George Dimitriadis speak at the Joint American Homeopathic Conference in Virginia in April 2013.

He made an examination of Dr. Heiner Frei’s Polarity Analysis (PA) method of using Bönninghausen’s Therapeutic Pocketbook in 2014⁴ by comparing the PA method of Frei and the original Therapeutic Pocketbook reertorial method of Bönninghausen, using George Dimitriadis’s most accurate English translation of the Pocketbook . The critical analysis of PA included reference to homœopathic primary text sources with specific critique of repertory grading criteria and contraindications.

The following points summarize the conclusions that he drew at the end of his research:⁴

1. Polarity Analysis (PA) versus “conventional homœopathic prescribing” (CHP)

Frei proposes the PA methodology of repertorisation results in a “mathematical procedure” that leads to higher rates of successful prescriptions when compared with “conventional homeopathic methods.” Frei bases this claim on prospective outcomes studies where he has compared his results to a control group consisting of patients from pre-vious cohorts of patients he treated with a “conventional homeopathic approach to symptom selection and repertorisation” (CHP) that utilized the Boger-Bönninghausen’s Characteristics, Materia Medica and Repertory, prior to his development of the PA methodology. However, because this analysis only reviewed the results of one homœopathic prescriber, it cannot yet be generalized that PA alone is more effective than CHP until the research is expanded to include a larger number of prescribers. Frei’s term, “conventional homœopathic prescribing” (CHP), needs to be specifically defined, and examples for comparison clearly detailed.

2. Grading Criteria & Contraindications in Polarity Analysis

Because Frei is using PA in research models to docu-ment the efficacy of homœopathy in prospective outcome studies and placebo controlled trials (and PA methodology depends intimately upon the accuracy and reliability of grading within the Pocketbook), it would be prudent to do comparative studies of PA utilizing a copy of the repertory that is more accurate and faithful to Bönninghausen’s origi-nal publication from 1846 without any additions from the I-copy or from Bönninghausen’s later works. Clarifying the grading schema within the Pocketbook is contextually vital to interpreting contraindications. Hahn-emann was the first to propose that for an accurate homœo-pathic prescription, the characteristic of a remedy should not be contraindicated by a strong opposite in the patient in the footnote of aphorism 213 in the Organon.⁴  In addition to understanding that all four grades in Boenninghausen’s Pocketbook are significant and valuable remedy effects, it is the Homoeopaths task to match the most characteristic symptoms in case of disease, to the symptoms produced by a remedy via similarity, even if ‘less important and minor’ symptoms of the case are opposite of those produced by the remedy. Oskin has suggested that in the future development of PA,  there should be no absolute contraindications in the software, but only relative contraindications,which should then stimulate the homoeopath to carefully investigate the materia medica to find the best matching remedy for the case.

3. Mental/Emotional Symptoms and Small Rubrics

Frei puts a strong emphasis and recommends avoiding rubrics with less than 10 remedies and also recommends against using mental or emotional rubric, in the primary repertory analysis. Oskin however observes that it is still possible to effectively and reliably use the Pocketbook with both small rubrics and mental/emotional symptoms if they are sufficiently comprehended by the Homoeopath with the illustration of an example. 

Conclusion

Polarity Analysis is a result of a tedious search for a better way to match the characteristic patient symptoms with the “genius” symptoms of Homoeopathic remedies thereby improving the reliability of prescriptions.

The method leads to an efficient and reproducible choice of remedy and increases the precision of prescriptions as compared to a conventional homeopathic procedure.

References:

1. Frei H. Polarity Analysis, A New Approach To Increase The Precision Of Homoeopathic Prescriptions. Homoeopathy. 2009;98(1):49-55.
2. Boenninghausen Cv. Boenninghausens Therapeutisches Taschenbuch 2000. Hrsg. K.-H. Gypser. Stuttgart: Sonntag, 2000.
3. Von Ammon K, Sauter U, Thurneysen A, et al. Longtime results and cost efficiency of homeopathic treatment in children with attention deficit hyperactivity disorder.
4. Hahnemann, Samuel, Organon of Medicine, Fifth Edition, 1833, Translated by R E. Dudgeon. Aphorism 203 footnote.
5. Frei H. A Case Study Of A Masked Depression In Duchenne Muscular Dystrophy. Homœopathic Links Winter.2011, Vol. 24: 217 – 221

Dr. Namratha L.
Serigar,
Dept of Repertory,MD, Part 2
Government Homoeopathic Medical College And Hospital,, Bengaluru.