Back From Mumbai - Recent Trends In Homeopathy

17 years it took for me to get back there. And, from the moment of arrival, engulfed by the fetid smells and damp heat of the city, I started to ask myself, “Why did I wait so long?” It felt like I had come home. It is said that a visitor either loves or hates India, that there is little room for an indifferent attitude. Life unfolds unadulterated in front of you; extremes of order and chaos, wealth and poverty, the sublime and the base, the attractive and the repugnant, of joy and suffering exist in a proximity to each other that is at odds with our experience. Certainly, it is not everyone’s cup of tea.

I found myself immediately enthralled, invigorated and also quite comfortable. The streets of Mumbai (formerly known as “Bombay”) - like those of most Indian cities - are teeming with life. They were a source ceaseless source of curiosity and stimulation.

Groups of children handsomely dressed in uniforms on their way to school and filthy urchins pulling at your sleeves to beg for a rupee. Smart looking youths wearing the latest fashions forever talking on their cell phones. Merchants hawking their wares. Taxi drivers and three wheeled auto-rickshaws vying for customers and space amongst the pedestrians and buses - ceaselessly honking their horns, swerving back and forth. The leper, the cripple, the aged and infirm sitting by the side of the road, calling out or passively waiting for the passerby to drop a coin into their cup. A cow aimlessly wanders by - the object of outstretched hands which first touch and then bless this symbol of the divine. Mangy dogs and cats scamper in and out of the alleyways, feeding on the scraps and staying out of harm’s way. The pungent smells of delicious curries hang in the air - as do the putrid smells of decay and waste.

It occurred to me that as a society time itself has a different meaning there. For the most part, we perceive our world as moving forward from one moment to the next, from one year to the next. Constantly we progress from point to point, from last year’s model to this year’s, leaving behind the newly old, the out of fashion, the antiquated.

But in India, it feels like things don’t progress as much as they accrue. The ancient survives alongside the modern. There are people living lives much the same as their ancestors hundreds - or thousands - of years ago. There are people living lives contemporary with any civilization on earth. It runs the gamut - not only from the ancient to the modern, but from the primitive to the sophisticated. One can look into the eyes of a soul that seems unimaginably downtrodden and ignorant one moment, then strike up a conversation with someone of equally impressive brilliance and insight the next.

It never ceases to fascinates. But what is the point?

Out of this phantasmagoria and apparent chaos, India has developed into a nation of incredible diversity. There is a unique form of acceptance based on the ethnic, linguistic, cultural, and religious diversity of its people. It is a philosophical perspective that seems to incorporate rather than exclude.

Certainly, this does not make it a utopia by any means. Intolerance, violence, greed and fear - all the foibles of humankind - are found in India like anywhere else. But alongside these, there is a perception that dissimilar ways of life and thought can stand alongside each other.

A primary example is the Indian medical system. Although conventional allopathic medicine - what we might think of as “modern” medicine - is the dominant school which receives by far the greatest amount of resources, other schools of medicine are officially recognized, sanctioned, funded and taught. An aspiring physician can pursue studies at recognized medical schools that offer training in one of a number of systems: allopath, homeopathy, ayurveda (traditional herbal medicine), unani ( a medical system dating back to the Greeks that was introduced to India in 1351 AD by Arabs), siddha (similar to ayurveda, but practiced mainly by the Tamil peoples of the south) or naturopathy.

The contrast between the fortunes of homeopathy in the United States and India is particularly instructive. In the 19th century, this country developed the richest homeopathic tradition in the world. But allopath emerged as the dominant force at the beginning of the twentieth century. As the allopaths solidified their position atop the American medical establishment, they did so to the exclusion of other traditions, such as homeopathy and naturopathic medicine.

Philosophically, it was objectionable to our western perspective that more than one system of medical thought be recognized as true. Subsequently, as official recognition, financial support and educational opportunities were withdrawn, these systems all but disappeared within a single generation.

In India, homeopathy, like the English language, was part of the legacy of British colonization. Despite these foreign origins, its value as an effective medical modality was recognized and it was subsequently incorporated into the national healthcare system. Today, with over one hundred thousand (or one “lakh” in Indian english) practitioners, numerous medical schools, and many of the worlds leading practitioners, homeopathy flourishes in India perhaps more than anywhere else in the world.

It was this rich homeopathic culture and the teaching of one particular practitioner that enticed me to travel to Mumbai late last year.


Part 2

From all around the world, fifty homeopaths had come to Mumbai for 2 weeks of intensive study with a remarkably gifted homeopath. Each morning the participants watched him at work as he consulted a patient. Afterward, the teacher would lead a discussion about what we had observed during consultation, analyzing its essential aspects and coming to a conclusion as to the proper prescription for the patient. This process took anywhere from 3 to 5 hours.

Provided one could stay awake and alert after a huge and delectable buffet spread, the afternoons were filled with more case presentations, this time on video, along with discourses on homeopathic theory. We would close as the sun set in deep oranges and purples over the Arabian Ocean outside.

How is it that a single homeopathic case, the consultation and decision making process, might take so long? Well, the short answer is that it doesn’t have to. It is possible and sometimes necessary to work with greater speed, perhaps only a few minutes in some cases, to speak with and prescribe for a patient. Certainly, the homeopathic physicians working at government clinics and hospitals throughout India, where a days work might entail attending to the needs of a hundred or more patients, are quite adept at working very fast.

But, there are many levels at which a homeopathic can prescribe a remedy. A world of difference lies between the action of a remedy quickly chosen to relieve symptoms, and the action of a remedy carefully selected to address the deepest levels of illness at a causal level. Indeed, it was this teacher’s unique, groundbreaking methodology in search of deeply acting prescriptions which drew this international contingent of homeopaths.

Perhaps originally homeopathy was not such a complicated endeavor. In these early stages, experimentation and clinical experience led to a set of some one hundred medicines, give or take, whose curative action was well known. Around the turn of the 19th century, the illnesses with which patients presented were less chronic and complicated (though no less lethal). Homeopaths of that era became masters at using these medicines to handle their patient’s infirmities, especially the deadly infectious diseases that the other medical systems of that day dealt with so ineffectively.

As we entered the modern era, changes in the nature of society as well as the effects of the industrial revolution and postindustrial technology corresponded with the development of ever more complex and chronic degenerative illness.

Homeopathy, too, evolved. The number of remedies available to practitioners grew from one hundred to several hundreds to several thousands. The range of potencies of remedies increased as well. Reference materials based on ongoing experimentation, clinical experience and theoretical developments also. The advent of computer technology and the development of homeopathic databases and related programs accelerated this process many times over.

As a result of these two trends, the increase in chronic disease and the proliferation of homeopathic information, the practice of the homeopathy has in some ways become more complex and more of a challenge than it was initially. It was to meet these challenges that leading modern homeopathic thinkers and practitioners, our teacher included, endeavored to advance its theoretical principles and practical applications.

This new work has not been universally embraced by the homeopathic community. Always a diverse and fractious group, homeopaths have a history of internecine feuding almost as destructive as their struggles with the allopathic or conventional medical community.

True to this tradition, there are a considerable number of homeopaths who are loath to view these new ideas as anything less than heresy. The most vituperative amongst them accuse the proponents as apostates who have turned their back on the teachings of the founder and have deviated from the basic principles that lie at the foundation of homeopathy.

At the heart of this controversy is an issue about the way remedies are selected for patients and their incorporation into the homeopathic materia medica (the total set of all remedies at the disposal of a practitioner). Classically, before a remedy is used in homeopathy it is the subject of one or more experiments, known as “provings”.

A proving is executed by administering a dose of a particular remedy to a group of persons, then carefully observing, recording and collating the reactions the individuals in this group experience over an extended period of time. This process provides a window into the action of a remedy and establishes the range of its curative possibilities. Without a well done proving, it can be difficult to understand how a remedy acts and when to prescribe it. Thus, the use of remedies not fully proven in a clinical situation is seen as not only unorthodox, but also unscientific procedure.

But recent theoretical developments along with the application of computer technology have made it possible for homeopaths to understand the action of remedies which have not been proven and to successfully prescribe them. From the perspective of these innovative thinkers, this new methodology does not disregard the orthodox principles so much as extrapolate on them.

As in any realm of human endeavor, be it scientific, religious, or social, there is always a tension between those who hold different perspectives, especially between those who place utmost value in the preservation of a tradition or maintenance of orthodoxy and those who believe that it is only through creative development and innovation that any ongoing undertaking can remain vital.

In the world of homeopathy, their is value in both points of view. Both the preservation of tradition and the advancement of understanding are essential if our science is to remain dynamic and relevant. If only both sides could recognize their mutual value...


Part 3

You’re driving down the highway and see a vehicle on the other side of the divider, heading in the opposite direction. When you first notice it, the make and model of the car isn’t very obvious. Perhaps you think to yourself, “ Oh, that must be a SUV, but there are so many on the road these days, it’s impossible to tell which one it might be unless I get close enough to read its name”.

Or, in another scenario, it might a car you recognize immediately. “I’d recognize a VW Beetle from a mile away!” Then again, you might see the vehicle and think, “Wow, I’m not even sure what kind of a car that is... Maybe it is one of those new crossover station wagon-SUV things.” Another possibility is that you know what make the car is, but aren’t sure of the model. “I can tell it is a Volvo, but which one?”

Once it wasn’t so complicated. There just weren’t that many different types of cars out there. A few manufacturers with a few models each - and if you were interested in cars at all, it was easy to pretty much know everything that hit the road. Now, it is much more of a challenge to recognize the profusion ever evolving automobile models.

This situation in many ways parallels the practice of homeopathy. First, homeopathy is essentially a matching game, predicated on the practitioner’s ability to elicit and recognize patterns related to the patient’s state of well being. Once the pattern is perceived, it is matched to a homeopathic remedy that shares the same pattern.

Secondly, as the knowledge base and precepts of homeopathy have evolved over the last two centuries, what was once a matter of matching a number of straight forward symptoms to one out of relatively small set of 100 or so remedies, has become elaborate. Today, we literally have thousands of remedies at our disposal - with new ones being added to our ‘materia medica’ (a general term for all substances used as curative agents in any given system of medicine).

In order to handle this proliferation of remedies and knowledge accumulated over the last 200 years, homeopaths have been greatly assisted by two developments, one technological and the other theoretical.

The technological innovation is the use of computer programs that allow homeopaths to organize, access and analyze information in ways that were once impossible. Computer technology also has in part facilitated a theoretical evolution in homeopathic thinking - the classification of both homeopathic remedies and patients into various groups or families which share certain characteristics.

The categories of classification closely parallels the organization of organic and non-organic substances in the natural sciences. The largest and most fundamental division is into the three kingdoms - plant, animal and mineral - that encompass all existent matter.

Each of the three kingdoms has its own distinctive nature and the task of the homeopath is to perceive to which kingdom the patient belongs. A plant remedy, and by extension, a person in need of a plant remedy, is characterized by great sensitivity and reactivity. This person experiences strong sensations and reacts to them accordingly. Structure and maintaining the integrity of structure are the concepts that define a mineral remedy and person. Finally, competition and the struggle for survival characterize animal remedies and the people who need them. This idea is best understood through an example. In order to truly understand the nature of a patient and the remedy he or she needs, it is essential for a homeopath to understand the feelings and attitudes underlying the information related by a patient. Only then is it possible to understand to which kingdom the patient belongs.

For instance, we might imagine a person seeking homeopathic treatment with the chief complaint of recurring headaches. When asked what is the worst thing about the headaches, a person in need of a plant remedy will tell of the terrible pain: how it, for example, feels like a tight band or like an unendurable pounding in the temples or like a knife stabbing behind the eye. The sensation of the pain and attempts to accommodate or relieve the pain will occupy the patient’s attention.

A “mineral patient” who experiences a similar type of headache, when asked to describe the worst aspect of the symptoms, might mention the sensation of the pain, but will eventually turn his attention to how the pain makes it impossible to work or difficult to support his family. The mineral patient might say something about the pain making it difficult to concentrate which results in he lacks confidence to make appropriate decisions at work or home.

In other words, the headache brings out in the mineral patient a basic issue or concerns about his capacity to function, to perform adequately or otherwise maintain the structural integrity of his life. Depending on which particular mineral remedy is needed, the specific issues related to capacity and structure will vary.

In contrast to these two, animal remedy patients respond quite differently. First, the manner of response often will be the first clue. They tend to be - no pun intended - more animated with gestures and descriptions; their speech, in general, more florid. They may use terms like “the pain is killing me” or sprinkle their speech with similar words like “torture” or “murder”.

In effect, patients in need of an animal remedy will convey the feeling that the symptoms or the disease are doing something to them, that they are victims. Stories about their lives, whether concerned with family, work or friendship, most often detail how someone or something is doing something to someone else - most often to themselves.

The division of remedies and patients into the kingdoms is the most basic and general form of categorization. Once the kingdom is determined, further questioning and analysis will assist the practitioner to find out to which plant family, what area of the periodic table, or what type of animal the patient belongs. Again, on determining the family, the next step is to understand which specific plant, mineral or animal the patient needs.

This method is quite different from the standard or ‘classical’ approach to homeopathic where the patient’s symptoms are matched directly to a remedy without any classification process.

While not universally accepted by all classical homeopaths, the method of categorization can give a unique perspective on the energetic state of a patient while also making it possible for the practitioner to utilize a wider number of homeopathic remedies.


Part 4

A woman came for a consultation the other day complaining of chronic sinus and intestinal problems. I asked her to tell me which symptoms troubled her the most. She replied that it was her facial pain from the sinuses. Asking her to describe the pains further, she said that it felt like her head was stuffed, and that something was pressing outward from her face, especially from her eyeballs.

I persisted with the same line of questioning, requesting her to tell me more about the pressing sensation she was experiencing. “It’s a pressing, like a bubble that wants to burst...” Pointing to the bridge of her nose, she continued, “I can feel it right here. It’s heavy, like a weight.”

At this point, I could see the sheen of moisture in her eyes and knew what was next. I encouraged her to tell me more about how it felt. “That heaviness, I’m carrying it in my head. The pressing is like a release, releasing that heaviness and becoming light.” Her eyes were brimming over with tears. “I have no idea why I’m crying... I’m carrying all this in my head and it doesn’t feel good.”

Again, I asked her to tell me about the bubble. “It is contained. Its a mass, very dense, full...I’m carrying that extra weight. It is weighing me down.” “And the opposite of that feeling would be what?” “Light, buoyant. I’d have better energy. That weightiness gets in the way of doing more. I feel sluggish, burdened in an insidious way, like I’m carrying something extra. I feel heavier than I actually am. It is tiring.” And again there were tears.

What had happened? Why had she burst into tears when describing the way her sinus problems felt? Because what she was expressing was not just a symptom, but the way in which she experiences her problem. In fact, it isn’t limited to how she experiences her sinus problem - it is the way she experiences all her problems, it is the way she experiences life.

When she was asked about her intestinal problems, she related the way it felt as “bloating and distention. I feel a pressure, a heaviness. It is like there is an inner tube around my stomach. It is tight with a pressure inside pushing. Very dense, heavy, full.” And the opposite of that? “To push it our. It would be a relief; it’d feel calm, empty and weightless. It would be lighter”.

Although a totally different problem in a different part of the body, it is experienced in the same way: pressure, weight, full, wanting to push it out.

She even experiences the same sensation - or actually their exact opposite - in her dreams.

She has a recurring dream of being at a gathering in a large house. There are people everywhere, and it is a good time. She is wandering from room to room. She feels good, but is somewhat overwhelmed by the vastness of the house and confused by all the rooms and people. When asked to describe her feelings more, she replies, “I’m not in control; I’m lost - but not frightened. It is a very fluid situation, rushing from room to room. I’m bouncing, leaping from space to space. Actually, it feels quite fun, almost playful. I’m weightless, not tied down to the earth. There is no resistance. I feel buoyant.”

Her other consistently recurring dreams are of flying. “I’m out west some place. It’s very open, with canyons and chasms...What a great dream! I feel so joyful and free, powerful and controlled. I feel part of everything and weightless, flying over shiny dazzling water”.

Wherever we turn in the case, there is the feeling of weight or weightlessness, heaviness or buoyancy. This sensation that permeates every aspect of a case is called the “Vital Sensation”, but actually signifies more than just a sensation. It is the way she experiences her life, the filter through which she perceives her physical, emotional and mental reality. In this sense, it may be more accurate to name it the Vital Reaction.

Her spontaneous and totally unexpected tears came at the point in the consultation when she consciously first started identifying the Vital Sensation and expressing how it felt. It was a powerful experience precisely because it was a point at which her subconscious and conscious being connected.

Previously, I have discussed the categorization of remedies - and patients - into the mineral, plant and animal kingdom. Each of these 3 kingdoms will have a characteristic Vital Reaction. The plant remedy/patient is characterized by a Reaction that is literally a physical sensation - as in the case in described above, and is thus a true Vital Sensation. Each family of plants will have its own distinctive sensation, which usually is expressed a pair of opposites: heavy/light, contracted/expanded, connected/detached, etc.

The mineral remedies experience the Vital Reaction in relation to a sense integrity of the structure of some aspect of life: to form relationships, to provide for themselves, to take responsibility for others, amongst other things. Their Reaction is often expressed in terms of capacity, confidence, competence or the lack thereof.

The Vital Reaction of an animal remedy and patient is expressed in terms of survival in a competitive world. There are feelings of attacking or being attacked, winning or losing, freedom or confinement, sexuality and attraction.

The concept of the Vital Reaction in homeopathy is a relatively new development and as such is still neither well known nor universally accepted in the field. But an appreciation of its significance opens the way to new ways of perceiving the underlying disturbances that cause disease and treating them.


Part 5

Since its inception over 200 years ago, there have been many innovations in the principles and practice of homeopathy. Some of these have been wholesale variations that challenge the fundamental tenets of the classical system as developed by its founder, Samuel Hahnemann. Others have been evolutionary developments firmly rooted in the classical tradition that adhere to its underlying theory.

An example of the former is the use of “polypharmacy”, or mixtures of several remedies in one solution. This clearly is inconsistent with the Hahnemannian axiom of prescribing single remedies. An example of the latter is Hering’s “Law of Cure”, which is less of a scientific law than a rule based on clinical observations on how symptoms evolve under the action of a curative remedy.

This rule, as enunciated by Dr. Constantine Hering, one of Hahnemann’s closest disciples, states that the curative response to a homeopathic medicine is often not the immediate cessation of symptoms, but a shift in their nature and position. Under the action of the remedy, the symptoms experienced by the patient will disappear first from the center of the organism progressing toward the circumference or surface of the body, from the upper parts of the body proceeding downward, or from more important organs to less important ones, and from the head to the hands and feet.

The significance of this rule is twofold. First, it signifies that the restoration of health is not simply the elimination of a symptoms or group of symptoms. It is a process that takes place over time - either quickly or slowly - by which the vital energies of the body regain a healthy equilibrium.

Secondly, Hering’s Law is a clinical guide to the practitioner, allowing him to better determine whether the patient’s condition is improving or not. For instance, if the chief complaint is asthma, and after the remedy the asthma disappears but a skin rash develops, this is a positive response: the symptoms have moved form the center (the lungs) to the periphery (the skin).

If, on the other hand, an initial complaint of arthritis in the knees disappears along with the appearance of headaches, this would be a cause for concern: the symptoms have shifted from the lower part of the body upwards and from a less important part (the joints) to a more important one (the head). (All too often, the action of conventional allopathic medicines or symptomatic remedies of any sort will have this type of non-curative shift in symptomatology.)

Similar to the postulates of Hering over 150 years ago, in the last decade the groundbreaking work of Dr. Rajan Sankaran of Mumbai, India, along with a group of his colleagues informally known as the “Bombay Group”, has also advanced both the theoretical and clinical aspects of classical homeopathy over the last decade .

This work has been the source of much controversy within the profession. While some homeopaths have been vituperative in their criticism of Dr. Sankaran as a homeopathic heretic, others believe that his far reaching insights are firmly routed in the spirit of the Hahnemannian tradition.

Previously, I have introduced two of these ideas: the categorization of patients and remedies into the three kingdoms, families or various other groups, and the concept of a Vital Sensation or Vital Reaction that characterizes the way in which a person (or any sentient organism) experiences life.

A third theoretical development is the delineation of different ways in which people perceive, interpret and communicate experience. Known simply as the “Levels”, this concept is broadly applicable not only to homeopathic or medical situations, but to just about any human experience.

Dr. Sankaran has differentiated 7 Levels which follow one after the other: Name Fact Feeling Delusion Sensation Energy Seventh (No name)

As an example, when we listen to a piece of music, we relate to it or experience it through a mixture of the Levels. Most superficially, we use a name to signify it. Then we might describe it by how long the piece is, what instruments are used, when it was written and many other facts related to it. At the next level, we are moved by it because it evokes certain emotions in us. At the “delusion” level, our imagination takes over and we become transported by the music to a scene either real or imagined. We actually feel a physical sensation at the 5th level, such as a warm flush on the skin or increased beating of the heart. The 6th level is more rarefied and abstract, where we relate to the music directly through patterns of light and sound or other energetic phenomena. The final level - one that has not been given a name - is a transcendent experience that defies description.

In the field of medicine, especially homeopathy, people relate to their condition through the various Levels: Level 1. Name. I have a headache. Level 2. Fact. It is in my temples and begins after I wake in the morning Level 3. Emotions. I feel irritable and don’t want to talk with anyone when I have it. Level 4. Delusions. It is like someone is stabbing me with an ice pick Level 5. Sensation. The pain is sharp, piercing deep into my skull. Level 6. Energy: The pain is a quick, narrow force that I experience as a blue color. (There is no application of the 7th Level here.)

Depending on the nature of the person, they will relate to their headache focusing on one level more than another. For instance, one person will describe in great detail how the pain actual feels, while the next person talks more about how irritable it makes him feel.

One of the fundamental differences between homeopathy and conventional medicine is that they systems also focus on different levels. Conventional medicine is focused on the first two: the name or diagnosis and the symptoms or facts. Without clear information about them, it is impossible to offer any treatment.

While they both are important for the homeopath, the deeper levels are often of greater significance in finding a truly curative remedy. Especially at the 5th or sensation level where the mental and the physical aspects of the body most directly connect, the Vital Sensation expresses itself as reliable reflection of the vital force. This manifestation of the vital force at provides a deep insight both into the nature of the illness and the curative remedy.