Le système de la « key-note »

Nous avons pris la liberté de réimprimer un article remarquable écrit par notre ami le Dr Guernsey car nous pensons que la "key-note", en tant que système permettant de simplifier le choix du remède homéopathique, demeure à ce jour un outil inégalé et qui, tout en étant dans la continuité de la tradition hahnemannienne, n’a tout simplement aucun équivalent. Nous reproduisons aussi cet article car nous semblons être, du moins en Grande-Bretagne, tout à fait ignorants de la valeur et du véritable mérite de la key-note et parce que nous sommes constamment interpellés à son sujet, notamment si " nous pensons qu’elle puisse avoir un quelconque intérêt ?".

Notre réponse est la suivante: "À propos des key-notes dans la pratique, nous ne pourrions jamais réussir sans elles comme nous le faisons. Elles sont tout simplement inestimables et si l'Homéopathie veut un jour en finir avec l’Allopathie et régner en maître, cela ne sera que lorsque chacun de nous maîtrisera parfaitement les symptômes cliniques et pathogénétiques caractéristiques de nos remèdes, ce qui équivaut au système des key-notes du Professeur Guernsey. Avant de le laisser s’exprimer lui-même, nous ajouterons seulement que nous espérons bientôt être en mesure de publier un appendice à THE ORGANON, portant le nom de Characteristic Materia Medica. Dans ce travail d’envergure, nous pouvons compter sur l'aide précieuse de notre cher ami, le Dr. Simmons de Cheltenham, qui nous informe par lettre avoir souffert des "caractéristiques sur son cerveau depuis les dix dernières années." [Note de l’éditeur].

Compte tenu des nombreuses demandes qui me sont parvenues concernant le principe de la pratique homéopathique faisant référence au système des key-notes et puisque ce sujet a récemment suscité beaucoup d’attentions dans les journaux et ailleurs, j'ai cru tout à fait approprié de présenter devant les membres de notre Société un exposé exact, pour autant que je sois capable de le faire, de la portée et de l'utilité de la méthode exprimée par ce terme et ce dans le cadre de la pratique de l’Homéopathie.

Le terme "key-note" ne doit pas être considéré comme définitif en soi, et je n’ai ni le souhait ni l’intention, pour l’avoir utilisé en premier, qu’il soit considéré comme un élément à part entière de la nomenclature scientifique. Ce terme m'est apparu comme étant, à un très fort degré, l'expression d'un fait en médecine, et c’est seulement en tant que tel qu'il doit être accepté. Le terme key-note est donc suggestif et simplement provisoire, jusqu’à ce que qu’un autre terme scientifique faisant l’unanimité lui succède.

Néanmoins, s'il est vrai que le terme key-note n'est rien de plus qu'une illustration et une analogie, la valeur immense de sa signification n'en est pas diminuée pour autant. Il est toujours l'expression d'un fait et d’une vérité centrale et fondamentale. À ce titre, le terme key-note exprime la connaissance de ce qui, dans la pratique et la théorie homéopathique, est nécessaire tant à la compréhension pleine et entière, qu’à l’utilisation la plus étendue de la loi des semblables.

La key-note n’est pas unique à l’Homéopathie. Par exemple, en musique, ce même terme définit la note fondamentale ou la tonalité sur laquelle l’entièreté de la pièce est construite. La key-note de la musique trouve par analogie sa ressemblance dans tout les domaines (à travers laquelle les choses les plus éloignées et superficiellement contraires sont connectées par la plus étroite relation). La key-note de la religion est l'existence de Dieu. Par elle, chacune des innombrables tonalités théologiques, apparemment discordantes, est harmonisée. La gravitation est la key-note de l'ordre qui régit les sphères innombrables qui sillonnent chacune leur chemin à travers l'espace. Le progrès est la key-note vers laquelle les fabuleux mouvements politiques, sociaux et industriels sont synchronisés. La key-note de l'Eglise est la foi, tout comme celle de la véritable vie de famille est l'amour.

Voici donc dépeint de manière suggestive et peut-être avec assez de clarté, le sens, la force et la véritable application du terme key-note tel je l'ai utilisé en médecine. C’est avec le sentiment que la suggestion est souvent plus lucide que l'expression directe que j'hésite à donner une définition plus exacte.

Lorsqu’un homme nous dit qu'il se sent désaccordé ("out of tune", en anglais, référence à Hahnemann qui souligne que l'origine des maladies correspond à un désaccordement de l'énergie vitale. EB.), ou quand un auteur médical parle de la "tonalité du cas" qui est améliorée ou aggravée, ou du manque de "tonalité" de l'organisme, nous avons rarement besoin d'une explication concernant la signification de ces termes. Ces termes arrivent pourtant à nous communiquer peut-être bien plus que ce que ne pourront le faire aucune tentative laborieuse d'exprimer en d'autres termes la même chose. Il en est de même avec le terme key-note. Il est l'expression d'une vérité qui ne pourrait pas être exprimée par une phrase plus courte ou plus compacte. Pourtant, ce mot exprime ou plutôt suggère à l’esprit l’entièreté de la vérité elle-même.

Un observateur non averti, qui parcourt l’étendue de notre Matière Médicale, pourrait être amené à penser que l’ensemble des remèdes homéopathiques se ressemblent tellement et sont si communs dans les manifestations qu’ils génèrent sur des personnes saines, qu’ils en deviennent sans valeur. Sans le principe impliqué dans la key-note, cette pensée pourrait s'avérer exacte.

Dans la Matière Médicale et en Pathologie, nous avons devant nous quantité de faits apparemment disparates, confus, sans liens les uns avec les autres et qui s’accumulent sans cesse au point de rendre les personnes possédant pourtant les plus hautes facultés désespérément désorientées –et c'est pourtant sur elles que nous comptons pour atteindre nos objectifs. Cette situation devient toute autre lorsque le principe fondamental faisant fonction de guide, celui-là même qui caractérise l'énergie, est pris en compte et que grâce à lui chaque tonalité, chaque particularité et expression singulière est accordée, modulée et harmonisée. Ce principe fondamental n’est rien d’autre que la key-note.

Le système des key-note n'est pas seulement applicable à l'ensemble des symptômes qui constituent la pathogenèse de notre Matière Médicale. Il s’applique aussi à l'ensemble des symptômes et conditions qui constituent la maladie. En ce sens, le terme symptôme pathognomonique, tel qu’utilisé en pathologie, décrit le plus souvent ce qu'on pourrait appeler la key-note d'une maladie donnée. Toutefois, l’analogie s’arrête là car les symptômes pathognomoniques ne permettent ni de décrire l’entièreté des maladies, ni de distinguer l’expression particulière d’une même maladie chez des personnes différentes. C’est là une distinction majeure entre l’École Allopathique et Homéopathique, à savoir que le médecin homéopathe ne prétend pas traiter la maladie en tant que telle mais plutôt les patients qui en sont atteints. Ce constat amène naturellement les médecins homéopathes à ne pas se ranger derrière les généralisations provenant de l’École Allopathique, aussi réfléchies soient-elles.

Bien que les principales caractéristiques d'une maladie (y compris les symptômes qui ont servi à lui étiqueter un nom) soient présentes chez toutes les personnes atteintes par elle, nous devons cependant tous reconnaître qu'on peut déceler certains signes ou symptômes qui procurent au cas son individualité et le distingue, parfois subtilement, des autres cas. En conséquence, on peut dire qu'il y a d’abord des caractéristiques qui permettent de confirmer la présence d’une maladie, ensuite des particularités qui distinguent les classes et les ordres. Chacun de ces ordres ou classes peut à son tour être subdivisé en sous-classes ou sous-ordre auquel un nom sera attribué grâce à la prévalence de certains symptômes ou de certaines conditions. Ce n’est qu’alors qu’apparaissent les signes caractéristiques qui servent à distinguer les différents cas d’une même maladie. Par analogie, cette approche hiérarchique procède de la même manière que dans la famille humaine où l’on distingue d’abord les attributs caractéristiques et toujours présents de l'éthnie, puis viennent les signes distinctifs de la nationalité, puis ceux de la famille et enfin, les traits singuliers, profondément ou faiblement tracés, qui caractérisent l'individu.

Voici ce que nous appelons le système key-note, tel qu'on le met en œuvre dans l'étude des maladies. Ce n’est rien d’autre que de la pathologie comparative dans son sens le plus étendu. Vous êtes peut-être prêt à me dire qu’il n’y a là rien de nouveau. J’en suis bien conscient. HAHNEMANN, lui-même, avait reconnu la véracité des key-notes. Ce système n’a pas simplement acquis le statut de vérité parce que HAHNEMANN l’a déclaré ainsi mais bien parce que l’expérience de milliers d’homéopathes l’a confirmé comme étant un véritable système de diagnostic. C’est la seule méthode pratique capable de distinguer différents cas entre eux. En d’autres mots, c’est l’unique méthode permettant d’individualiser les cas. Hélas, elle est si souvent emportée par le tourbillon fascinant des généralisations.

Passons maintenant à la pratique et considérons des remèdes curatifs capables de traiter les multiples formes que peuvent prendre les maladies. Voyons à travers quelques exemples comment le système des key-notes doit être appliqué, et quel(s) effet(s) il produit.

Prenons l’exemple des provings d’Aconit, qui comme chacun sait est une plante qui a la propriété d’induire de nombreux effets toxicologiques. Son utilisation dans le traitement des maladies révèle l’étendue de ce médicament ainsi que l’importante quantité de symptôme qu’il peut provoquer. Si l’ensemble de ces symptômes étaient répertoriés dans un ouvrage unique, on peut sans exagération anticiper qu’il s’agirait d’un gros volume. À cela, nous pourrions encore ajouter les résultats provenant de nouveaux provings réalisés sur des individus différents, et continuer comme ça jusqu’à l'infini. Mais combien parmi tout ces symptômes d’Aconit sont identiques, ou apparemment similaires, à ceux que l’ont retrouve dans les provings d’autres remèdes ? À première vue, ils peuvent apparaitre tous semblables. Mais pourtant il y a quelque chose dans la pathogénésie d’Aconit qui est indicatif de ce remède, quelque chose qui fait ressortir son caractère propre et ses effets prédominants d’une manière infaillible et qui, part ce fait même, le distingue de tout les autres remèdes. De plus, ce quelque chose imprègne l'ensemble des autres effets, avec plus ou moins de prédominance. En définitif, ce quelque chose ne correspond à rien d’autre qu’au(x) symptôme(s) ou condition(s) qui constituent les key-notes d'Aconit en tant que médicament, et qui par conséquent fournit la clé de son indication dans la maladie.

Donc, en instituant des comparaisons entre les remèdes homéopathiques, en prenant tous les symptômes et en les comparant attentivement, nous trouverons que chaque remède présente, outre la similitude fondamentale qu’il partage avec tous les autres, des différences propres à chacun. Lorsqu’elles deviennent invariables, ces différences correspondent aux key-notes.

Nous avons donc d’une part le symptôme caractéristique dans la maladie qui individualise chaque cas, et d’autre part la Matière Médicale dans laquelle nous pouvons sélectionner un médicament qui contiendra dans sa pathogénésie une key-note correspondant à ce même symptôme caractéristique. Ce remède se révélera alors l'agent curatif dans ce cas précis.

Certaines personnes voient dans le système des key-notes une incompatibilité avec la véritable doctrine homéopathie, c'est-à-dire celle qui enseigne la nécessité de recouvrir la totalité des symptômes. Cette soi-disant incompatibilité n’est vraie à aucun moment.

L’application de ce système n’implique pas que la key-note du patient malade doive uniquement correspondre à la key-note du remède. L’ensemble des symptômes du patient ne doit pas non plus être couvert uniquement par les key-notes du remède. Ce système repose simplement sur le principe que les symptômes prédominants qui servent à individualiser le cas doivent guider le médecin homéopathe à sélectionner un remède recouvrant ces symptômes. S’il n'y a pas eu d'erreur commise à la fois dans l’observation des key-notes de la maladie et dans la sélection du remède, alors les autres symptômes appartenant au patient se retrouveront également dans les provings du remède. On pourra alors soutenir sans crainte que le remède couvre la "totalité" du patient.

Comme nous l'avons expliqué précédemment, la key-note est simplement suggestive. Elle suggère un médicament selon le chemin le plus court, le plus pratique et le plus sûr. Elle permet de séparer et d’isoler le médicament indiqué des autres médicaments grâce au(x)

1) symptôme(s) caractéristique(s) possédant un degré marqué ; et de surcroit

2) grâce aux autres symptômes restants. Ces deux types de symptômes couvrant ensemble la totalité du cas. Comme un ami médecin l’exprime dans une communication récente : "la key-note donne le refrain de la chanson mais elle n’est pas la chanson elle même".

Après tout, c’est de cette façon que les vrais homéopathes ont toujours prescrit. Ce n'est pas la totalité qui oriente l'attention sur un certain remède. C’est toujours quelque chose de particulier dans le cas, une caractéristique prédominante ou un symptôme marqué qui dirige le choix du médecin vers un certain médicament. Ce n’est que par la suite que la totalité confirme ou désapprouve le choix du remède. Je répète donc que le système des key-notes ne saurait en aucun cas interférer avec la doctrine de la "totalité". Ce système insiste au contraire sur ce caractère essentiel de cette dernière doctrine. Le système des key-notes n’est rien de moins que le guide qui permet à la doctrine d’être correctement et pratiquement mise en œuvre.

Dans mes récents travaux sur l'Obstétrique, je me suis efforcé, dans la mesure de mes connaissances, d’élaborer ce système des key-notes afin qu’il soit utilisable dans la pratique. Je n'ai pas essayé d’attribuer pour chaque remède et dans chaque maladie le catalogue des symptômes qui pourraient être présents, mais j’ai plutôt essayé de donner les particularités caractéristiques (=key-notes) des remèdes de sorte que l'esprit puisse être dirigé d'un seul coup dans la vrai direction. Le choix définitif du médicament doit être confirmé par la totalité des symptômes. En résumé, lorsque la vraie key-note a été identifiée, tous les autres symptômes se rangent derrière elle.

C’est de cette façon que je désire être compris et ces messieurs qui m'ont fait l'honneur d'examiner mon livre, garderont à l'esprit que c'est l'interprétation exacte du plan que j'ai énoncé. S’ils donnent leur attention à ce système et que soigneusement et en toute conscience ils l'expérimentent à la moindre occasion alors ils pourront bientôt se réjouir et dire amen à tout ce que j'ai écrit sur le sujet.

Les quelques exemples suivants permettent d’illustrer ce que je viens de décrire.

Je suis appelé en consultation récemment pour un cas de dysménorrhée qui présentait une grande variété de symptômes. Je fus frappé par la loquacité incessante de la patiente sur un ton suppliant, solennel, ce qui m’emmena à suggérer au médecin traitant Stramonium. Après avoir comparé les symptômes, il répondit que l’entièreté des symptômes de la patiente ne se retrouvait pas dans ce remède mais que, étant à court d’idée, il acceptait néanmoins l’utilisation de Stramonium. Il ajouta que si ce remède la guérissait "il cesserait de croire à la doctrine de la totalité". Je lui répondis que Stramonium était sans aucun doute le remède indiqué, et que si Stramonium avait été suffisamment expérimenté, sur toutes les variétés de tempérament et dans plus d’états différents, alors tous ses symptômes auraient été trouvés dans les détails de sa pathogénie. Stramonium 200 calma la patiente immédiatement et tous ses autres symptômes disparurent rapidement, et ce dans l’ordre inverse de leur apparition. Sa manière particulière de parler a été le dernier symptôme à se manifester et le premier à disparaître. La présence de cette caractéristique dans les maladies est une key-note de Stramonium.

En cas d'hémorragies où le sang jaillit de la plaie sous forme de longs filets noirs, Crocus sera le remède. Ce remède guérira non seulement l'hémorragie mais aussi tous les autres symptômes restants du patient. L'hémorragie, étant la dernière à paraître, sera le premier symptôme à être éliminé. Ce n’est qu’en laissant le remède agir, c'est-à-dire en n’interférant pas son action par l’utilisation d’un autre médicament, que les symptômes restants qui avaient pourtant conduit à l'hémorragie seront dissipés dans le sens inverse de leur apparition.

Lorsque chez les enfants souffrant de coliques, on observe l’apparence de sable rouge dans la couche, nous savons que Lycopodium est indiqué. Par l'action de ce remède, les autres troubles du petit qui avaient conduit à ce phénomène observable dans l’urine seront également éliminés. L’apparence de sable rouge dans l'urine indique Lycopodium et est donc la key-note de ce remède.

Voici un autre cas extrait de l'une des nombreuses lettres qui me sont envoyées à ce sujet. Dans un cas de fièvre typhoïde, le dernier et le pire d’une épidémie maligne qui avait résisté à l'action de tous les médicaments, les médecins consultés désespéraient de pouvoir sauver un garçon de 16 ans pourtant robuste et auparavant en excellente santé. Ce garçon fut entièrement rétabli grâce à l'action d'un remède qui fut suggéré uniquement par une key-note. Mon ami écrit : "en allant à son chevet un soir, j'ai remarqué un mouvement convulsif particulier de la tête que je n'avais jamais observé auparavant. Sa tête se relevait brusquement de l'oreiller, et puis tombait immédiatement en arrière. Ces mouvements se répétaient sans cesse. Je me suis rappelé immédiatement votre key-note de Stramonium.

Je suis allé à mon bureau et en comparant les symptômes du cas avec la symptomatologie de ce médicament, je fus frappé de la merveilleuse correspondance. Sur les conseils de mes collègues, j'ai alors donné des doses répétées en 3X mais après 24 heures, aucune amélioration n’était survenue. La 30c a ensuite été donnée, la encore sans aucun résultat favorable. J'ai ensuite donné une dose unique de Stramonium 200 la nuit, et j'ai été ravi de voir un sourire sur le visage de la mère le lendemain matin. 'Henry est devenu calme’, dit-elle, ‘très peu de temps après la prise du médicament et il a, pour la première fois, dormi tranquillement’. Sa convalescence a été constante depuis cette période. Je n'ai donné aucun autre médicament durant dix ou douze jours. Stramonium l’a sauvé, et votre key-note enseignée en classe a été mon seul guide vers le choix de ce remède.".

Ces quelques exemples sont suffisants pour illustrer l’utilisation du système des key-notes dans la pratique. Ce n’est que grâce à ce système que l'art de prescrire homéopathiquement peut être simplifié et rendu exact. Grâce à lui, Stapf a pu prescrire correctement Cantharis à partir d’une key-note objective révélée sur le visage du patient. Et c’est encore grâce au système des key-notes que les médecins homéopathes ont été guidés en toute sécurité et rapidement vers le bon remède. La véracité de l'idée de HAHNEMANN, à savoir que les symptômes de la maladie sont guéris dans l’ordre inverse de leur apparition, est magnifiquement démontrée si on la regarde du point de vue du système des key-notes. Grâce à ce système, le texte complexe et difficile de la Matière Médicale est rendu pur et clair. Grâce à lui, la pathologie –la servante de l'Homéopathie– acquiert sa pleine utilité et le diagnostic devient exact. Grâce à la key-note, mise en avant par le patient, le praticien homéopathe est capable d’individualiser son cas et d’identifier un remède qui guérira la totalité des symptômes.

J'ai donc essayé dans cet article de démontrer la signification, la vérité et l'utilité du système des key-notes. Sans fioritures ni recherche de style, je me suis efforcé durant des moments de loisirs volés au travail d'exposer avec clarté et exactitude ce que je crois être, non pas une nouvelle doctrine, mais plutôt une vraie doctrine en Homéopathie. Si en raison de cet article ou de la discussion qui peut en découler, nous pouvions avancer encore plus loin dans ce que je considère être un véritable chemin vers un système correct de la thérapeutique homéopathique, je me sentirai largement récompensé.


Auteur: Henry N. Guernsey, M.D., Philadelphia (USA).
Traducteur: Julien Beguin
Source: http://planete-homeo.org/2011/05/27/le-systeme-de-la-key-note/

Manifiesto de Espiritualidad SECPAL Mallorca 2011

Por una clínica que acoja la experiencia espiritual del ser humano, en el final de su vida. 

Entendiendo la espiritualidad como nuestra naturaleza esencial, que nos 
conforma como seres humanos y de la que surge nuestro anhelo inagotable 
de plenitud, que aspira a dotar nuestra vida de sentido, coherencia, armonía 
y trascendencia.  


CREEMOS 

1. En el ser humano, en su dignidad intrínseca y en su riqueza y complejidad. Un 
ser cuya naturaleza biológica, psíquica, social, moral y espiritual, le convierten 
en un regalo de la vida y para la vida. 

2. Que la experiencia de sufrimiento es claramente universal y que puede 
intensificarse en las fronteras del final de la vida. Su existencia se convierte para los 
profesionales en un desafío técnico  y en un imperativo moral, que exige no mirar 
para otro lado. 

3. Que la espiritualidad es también otro universal humano y que negar en la 
práctica nuestra naturaleza espiritual para el trabajo clínico, se convierte en un claro 
factor de deshumanización.

4. Que las distintas tradiciones espirituales ofrecen un vademecum de excepción 
todavía infrautilizado. En todas ellas, compatible con su rica diversidad, aflora una 
manera de estar -presencia-, de acoger al otro -hospitalidad- y de acción 
comprometida para aliviar su sufrimiento -compasión-.
  
5. En la capacidad del ser humano de afrontar la experiencia de muerte, no sin 
dificultades, pudiendo abordarla desde la negación, la resignación o la rabia, pero 
también desde la aceptación confiada que conduce a un nuevo espacio de 
conciencia trascendida de la realidad.


CONSIDERAMOS 

6. Que una concepción integral e integradora de la persona que reconoce su 
dignidad, fundamenta nuestra práctica desde sus inicios. No contemplar  en 
nuestros pacientes sus recursos y necesidades espirituales supone también 
traicionar los fundamentos y la metodología de trabajo de los Cuidados Paliativos. 

7. Que la atención a los recursos y necesidades espirituales no es patrimonio de los 
Cuidados Paliativos aunque debería ser especialmente cuidada en aquellos 
ámbitos en los que la experiencia de sufrimiento es muy significativa y en todos 
los escenarios de fragilidad, dependencia, cronicidad, pérdidas o la posible y 
cercana experiencia de muerte. 

8. Que la experiencia del morir es única e idiosincrática en cada ser humano. No 
obstante, las tradiciones espirituales, la experiencia clínica y -hoy cada día más- la 
investigación, nos aportan mapas que facilitan conocer y atravesar el territorio,
itinerarios posibles y comunes que el paciente pueda elegir y por los que nos pida,
desde el más profundo respeto, ser acompañado.

9. Que como la buena voluntad no es suficiente, los profesionales tenemos el apasionante 
reto de vincular ciencia y espiritualidad, rigor metodológico y creatividad, meta análisis e
inspiración a fin de ir generando estrategias y herramientas de evaluación y 
acompañamiento válidas, fiables y de utilidad clínica.

10. Que la herramienta por excelencia para la buena praxis es la propia persona del 
profesional y su competencia, compasión y compromiso para acoger la realidad del
otro- bañada en desesperación o en esperanza. El calibrado de esta herramienta y su
capacidad de mantener su ecuanimidad en el entorno del sufrimiento exige un
compromiso con el autocuidado en su personal dimensión espiritual.


APOSTAMOS

11. Por una comprensión de la espiritualidad en clave relacional, lo que nos invita a
profundizar en una mirada intrapersonal, interpersonal y transpersonal de la
condición humana y en un desarrollo más elaborado de nuestra capacidad de
introspección, de comunicación / deliberación y de contemplación.

12. Por una visión amplia y plural de la espiritualidad, que permita hacer presente las
perspectivas filosófica / existencial, axiológica, religiosa o cualquier otra que
respete la diferencia de cosmovisiones y el derecho a las mismas.

13. Por una actitud clara de no huida de la necesidad de prevenir y tratar el
sufrimiento evitable y de acompañar aquel sufrimiento que -fruto de la condición
humana o de la amenazante presencia de la muerte- no pueda ser evitado.

14. Por impulsar el compromiso de las Instituciones, Equipos y Profesionales en
incorporar explícitamente el abordaje de la dimensión espiritual en el quehacer 
clínico con las personas al final de la vida y sus familiares.

15. Por fomentar la formación de nuestros profesionales en evaluación y
acompañamiento espiritual, lo que supone un replanteamiento de conocimientos,
habilidades y actitudes y un afrontamiento del miedo -del paciente y del nuestro
propio- para un mejor aprovechamiento del encuentro clínico, una de las puertas
privilegiadas para acceder a la dimensión espiritual de aquel que sufre y del que le
acompaña.

Palma de Mallorca,  13 de Mayo de 2011.


Conclusiones presentadas en la IX Jornada Nacional de la Sociedad Española de Cuidados Paliativos (SECPAL) "La Espiritualidad en Clínica", Palma de Mallorca, 12 y 13 de Mayo de 2011, por el Grupo de Espiritualidad (GES) de la SECPAL. Drs. Enric Benito, Javier Barbero, Jacinto Bátiz.
Fuente: https://events.viajesiberiacongresos.com/ei/images/Manifiesto%20SECPAL%20Mallorca.pdf

Estudio Miasmático de Selenium

INTRODUCCIÓN
La Psora es sufrimiento puro. La Sycosis y la Syphilis constituyen intentos defensivos equivocados y, por 1111tanto, fallidos, mediante los cuales tratamos de no sufrir. La Psora es lo real en el hombre. La Syphilis y la Sycosis son lo que el hombre supone que es su realidad. La Psora es el sujeto y la condición humana en su desnudez. La Sycosis y la Syphilis son el ropaje, el personaje, en fin, la sombra, ora alargada, ora menguada que danza su ficción en el escenario del mundo. Pero no nos confundamos, el personaje es la representación, lo representado es otra cosa; detrás de la puesta en escena, detrás del personaje está el hombre real, el hombre que padece y cuando se decide a abandonar su defensa y se convierte en si mismo, aparece desolado, desprotegido, lleno de miedo y de ansiedad, de culpa y de vergüenza. Entonces y sólo entonces, puede a través de eso que Jung llamó proceso de individuación y que el simillimun es capaz de poner en vigencia, encarar la responsabilidad de su propia muerte en vida, en tanto ficción o personaje. Ahí, en la posición psórica, el hombre vive en el desasosiego que le produce la conciencia de su propia fugacidad, de su pequeñez frente a la infinita y despiadada belleza del mundo, de la inutilidad de su vida y de su impotencia para hacer “algo” que deje un rastro o al menos una huella, siquiera, de su existencia. Ahí, también, tiene una sensibilidad sin fronteras y, por lo mismo, abierta a todas las impresiones, que no discrimina, casi una hipersensibilidad de desollado; se siente vulnerable y sin embargo, se abre buscando receptivo e indeciso. ¿Qué será de este ser humano psórico? ¿Resistirá eso que sintéticamente llamamos angustia existencial o se doblegará ante la abrumadora sensación de abandono y soledad, bajo el peso de sus miedos y vergüenzas?

Humanizarse es asumir nuestra dramática condición, vulnerable y abierta, sensible y desasosegada pero que aun conserva, como promesa de redención, un cierto nivel de comunión con el alma del mundo, con la sacralidad de la vida. Pero la sombra, esa caricatura de lo real, esa si puede vivir “como si” pudiese imponerse y sojuzgar, desde su pedestal imaginario, a los demás para obtener, por esa vía, la ilusoria omnipotencia que requiere para someter y negar al otro, lo Otro, reafirmándose en su error primigenio para finalmente adormecerse en el espejismo de su supuesta inmortalidad. O, ya en el otro extremo del péndulo miasmático, “como si” pudiese prescindir del otro y huir del mundo mientras se embriaga en su veneno negándose a vivir para no tener que morir algún día. La egotrofia y la egolisis (Sycosis y Syphilis de la nomenclatura clásica) nos encadenan a la equivocación perpetua, al extrañamiento ya que estas posiciones no pueden cambiar ni reconciliar la intención psórica o “idea errada de ser” de la que hablara la doctora Bandoel y que nos obliga, como una fuerza oscura e ineludible, a una “manera equivocada de estar”.

Demos una mirada al Egotrófico: estos siempre están en la búsqueda de un plus que les de más poder, más respetabilidad, más dinero, más brillo social o académico; su obsesión es la imagen, la reputación. Parecen satisfechos de sus vidas, de sus logros, de sus opiniones; si no fuera porque la maestra vida les propina unos cuantos fracasos, nada podría desalojarlos de su rol de triunfadores, de su aparente bienestar y de su falsa bonhomía. Ellos son ejecutivos y prácticos, ambiciosos de duro corazón, gesto agresivo y mirada fría; aspiran a la constante y creciente satisfacción de sus deseos, a imponer siempre su voluntad y dominar, en suma, sin restricciones. Nada los puede afectar, excepto que se dude de su conducta o de su personalidad superior. Debemos aprender a descubrir detrás de esta caricatura, al hombre real que pretende ocultar por la vía del “hiper” su drama, su sufrimiento psórico, lo cual no es nada fácil ya que la egotrofia, franca o embozada, se parece demasiado a las actuales expectativas sociales y culturales acerca del éxito.

Miremos ahora hacia la Egolisis: estos también participan de la misma tragedia, solo que desde otra perspectiva menos apetecible y glamorosa, según la idea vigente en nuestra cultura moderna acerca de la actitud “correcta” para el éxito. Ellos están hastiados y sumamente cansados, sólo desean olvidar, fugarse y dormir. La vida es, para ellos, demasiado pesada y onerosa y si acaso pueden soportarla arrastrando el fardo de su sufrimiento, es de manera aburrida y rutinaria, por ello no les parece que merezca la pena de ser vivida. Muchos de ellos caen en el alcoholismo y la drogadicción, otros sucumben en la perversión psicosexual; en la infancia ya es notoria su crueldad con indefensos animales y su cobardía. En Alterlisis son violentos, criticones y practican todas las formas del irrespeto y la insolencia, mientras en sus sueños asesinan y cometen toda clase de vejaciones. Bebedores solitarios, desconfiados y sarcásticos van por los rincones del mundo acompañados del polvo y el olvido. Conocedores de todas las formas de suicidio: social, profesional y físico, viven vidas atribuladas y difíciles. Para ellos solo hay despecho en los amores, desaliento en la voluntad y desesperanza en el ánimo.

La clave del acto médico homeopático es la historia biopatográfica. Ella nos permite, en el marco de una relación dialógica y empática, comprender al sujeto de esa historia, para poder disolver el espejismo de esta doble defensa fallida y el paciente pueda atravesar su sombra, para finalmente descubrirse en su esencia psórica, en su humanidad. Nuestra tarea es acompañar al sujeto paciente en la lectura lúcida, solidaria y emocionada de esa historia de la desmesura, la imprevisión y lo siniestro. Ahora bien, en latencia la Psora por la acción del simillimum, el hombre dispone de la libertad necesaria para decidir si encara su “natural destino de eternidad”, en tanto hijo de estirpe divina, o no; si en vigencia la Psora, entonces carece de libertad y permanece encadenado al “espejismo de la inmortalidad”, en tanto personaje, en tanto sombra Psorosycósico o Psorosyphilítico. Ah! pero los homeópatas que aspiramos hacer homeopatía y no homeoterapia, hemos aprendido a crear las condiciones para que el paciente se abra y asuma la tarea, pero el palo en la rueda para todo aquel que acepta que lo digno de ser curado es la Psora, es que no tenemos una Materia Médica Miasmática (MMM) porque, aunque declaremos lo contrario, las Materias Médicas (MM ) existentes han sido estructuradas en torno a un modelo antropológico y hermenéutico reduccionista, inorgánico y, por tanto, profundamente materialista. Lo que sigue es un aporte a este movimiento, apenas embrionario, hacia una MMM, es decir, psórica, que nos permita alcanzar por la vía de la certeza y no del azar, el desideratum terapéutico que planteaba el sabio maestro de Meissen expresado en “sensaciones que produzcan felicidad, acciones que ensalcen la dignidad y conocimientos que abarquen el universo creado por el Dios que adoran los habitantes de todos los sistemas solares” y que sólo el simillimun permite avizorar.

JUSTIFICACIÓN
Los homeópatas del mundo solemos tener un stock de medicamentos, una pequeña farmacia en nuestros consultorios y todos sabemos cuales son aquellos, veinte o veinticinco remedios, cuyos frascos debemos renovar con rutinaria frecuencia mientras que la mayor parte del resto envejece sin que sus sellos hayan sido levantados jamás; pero siempre que me detengo a revisarlos me gritan desde su silencio ambarino que ellos también son parte del esplendente propósito de la homeopatía, de la promesa que yace allí esperando ser descubierta y aplicada. Y al igual que la mayoría de homeópatas intelectualmente honestos, somos testigos de la irregularidad de los resultados que desvían del camino del unicismo a muchos potencialmente buenos homeópatas, quienes terminan ejerciendo una especie de homeoterapia alopática, entre complejos y drenadores y sometiendo al paciente a la regadera supresora del más atroz eclecticismo “interdisciplinario”; ejercen atrapados en el tinglado de la nosografía al uso con esos escasos recursos farmacológicos. Pues bien, allí en esas potencias desconocidas también está la Psora, la Syphilis y la Sycosis, allí yace gran parte de la humanidad encerrada en esos frasquitos con sus gestos y dolores, con sus aspiraciones y temores, con su risa y su llanto. Debemos, pues, aprender a leer la novela de esos medicamentos como leemos ya la de nuestros pacientes, para que cada vez con mayor frecuencia podamos decir, después de escuchar a nuestros pacientes, esta historia ya la he leído. Demos, pues, una ojeada a esa porción del drama humano que Selenium nos relata.

MATERIA MÉDICA NOUMÉNICA
SELENIUM es un oligoelemento (OE) descubierto en 1818 por Berzelius y denominado así en honor de la Luna (Selene). En estado natural se encuentra siempre asociado al TELLURIUM. La primera experimentación patogenética fue llevada a cabo por HERING en 1834 y publicados los resultados en los Archivos Homeopáticos.

Cada día aparecen nuevas publicaciones científicas acerca de la importancia de los OE en diversos pasos metabólicos, para el adecuado funcionamiento del sistema inmune, para un normal proceso de envejecimiento y en la prevención de diversas dolencias de la nosografía convencional, como resultado de su capacidad antioxidante y nutritiva. Muchos de ellos son medicamentos homeopáticos más o menos bien experimentados desde varias décadas atrás.

Para el estudio de la Dinámica Miasmática de Selenium tomamos como fuente los síntomas mentales del mismo en el Repertorio Kent y la Materia Médica de Jahr, las Comparaciones y Key-notes de H.C.Allen y el Tratado de MM de Bernardo Vijnovsky, para un total de 35 rubros.

LOS TEMAS

1. Ailments after anger, vexation. G:1
2. Aversion, person, to certain. G: 1
3. Company, aversion to. G: 2 ; - Friends, of intimate. G: 2
4. Concentration, difficult. G: 2
5. Confusion, of mind, coition, after. G: 1
Emission, after. G: 2
6. Dipsomania, before menses. G: 3
7. Doubtful, soul’s welfare, of. G: 1 *
8. Dullness. G: 2
9. Excitement. G: 1
10. Exertion, agg, from mental. G: 3
11. Fancies, exaltation of, repulsive, when alone. G: 1
12. Fear, crowd, in a. G:1; Occupation, of. G: 1; People, of. G: 10; Work, dread of. G: 1
13- Forgetful. G: 1; Sleep, during, he remembers all he has forgotten. G: 1
14. Imbecility. G: 1
15. Indifference. G: 1
16. Irritability. G: 1; Coition, after. G: 1; Emission, after. G: 1
17. Lasciviousness. G: 2; Pensamientos con impotencia (Allen) - UR; Deseo sexual aumentado con impotencia (Kent)
18. Loquacity. G: 2; Evening. G: 1; Perspiration, during. G: 2
19. Mania a potu. G: 1
20. Memory, weakness of. G: 2; Business, for. G: 1; Labor, for mental. G: 1
21. Mistakes, speaking. G: 1; Wrong syllables. G: 1
22. Prostration, mind, of. G: 2; After emissions. G: 2
23. Religious, affections. G: 1 - Fanaticism. G: 1
24. Remorse. G: 1 *
25. Sadness, chill, during. G: 1; Perspiration, during. G: 1 *
26. Senses, dullness of. G: 1
27. Sensitive, certain persons, to. G: 1
28. Sexual, excesses, mental symptoms, from. G: 1
29. Starting, evening, on falling asleep. G: 2
30. Stupefaction. G: 1; Rouses, with difficulty. G: 1
31. Suspicious. G: 1*
32. Talking, sleep, in. G: 2
33. Theorizing. G: 2
34. Unconsciousness. G: 1; Waking on, after. G: 1
35. Weeping, chill, during the. G: 1

AGRUPACIÓN TEMÁTICA
1- Las aversiones (2-3))
2- La concentración (4-5-8-10-14-22-30)
3- La irritabilidad (1-2-3-9-16-19-31)
4- Los miedos (7-11-12-24)
5- La memoria (4-5-8-10-13-14-20-22-30)
6- La Sexualidad (5-6-16-17-22-28)
7- La imaginación (11-17-23-31-33)
8- La comunicación (15-18-21-26-27-30-31-32)

PILARES
1- Los miedos.
2- Las aversiones.
3- La sexualidad.

Antes de abordar la Dinámica Miasmática (DM) de Selenium, vale recordar que es uno de los tantos remedios considerados “chicos” y esto es así, porque de la lectura de las diversas materias médicas se concluye que sólo es dable utilizarlo con relativa seguridad, en el 2° nivel de Fisch, especialmente mediante el recurso a sus Key-notes: pensamientos sexuales con impotencia física (UR) y miedo de su ocupación. Allí el drama existencial Selenium, permanece oculto tras una cortina de síntomas apsóricos. Ahora, basado en los parámetros establecidos por el Instituto J.T. KENT, que fundara Alfonso Masi-Elizalde, intentaremos correr esos velos partiendo de la idea rectora de esta novedosa exégesis: el hombre se pone fuera del orden bien por envidia de un atributo divino y que en tanto ser creado no le corresponde, o por rechazo de un don. De modo que, los correlatos humanos de dichos atributos quedan alterados y disminuidos y esa es nuestra carencia primaria.

Lo primero que nos llama la atención es un pequeño grupo de síntomas sin justificación alguna en la interrelacion del sujeto con su medio y por tanto en relación directa con el sufrimiento puro o:

PSORA PRIMARIA
- Remordimiento: inquietud, pesar interno que queda después de una mala acción (DRAE)“Como si” hubiese cometido un crimen. (Culpa)

Duda de la salvación del alma ( temor al castigo)

Desconfiado, sospecha de todo. (la pérdida, la carencia) En el fondo este rubro pertenece al tema del Orgullo, ya que el orgulloso no es , como usualmente se cree, aquel que tiene una exagerada e irreal opinión de si mismo, que es mas bien vanidad, sino aquel que sólo confía en si mismo. Así que la carencia fundamental aquí es la pérdida de la confianza en el Creador y más concretamente en nuestra herencia divina, por ello duda de la salvación del alma y de ahí que luego observemos como este selenium orgulloso, que sólo confía en si mismo, se ve obligado a padecer, en su historia concreta y personal, de impotencia y de pérdida súbita de la fuerza y de la coherencia, en el plano del intelecto, por disminución de la memoria y agg. por trabajo mental, trastoca las silabas en las palabras, etc., y en el físico, por la imposibilidad de plasmar y concretar sus deseos por impotencia sexual, semen seroso y sin olor que no tiene capacidad generadora., estéril y sin embargo lo vemos en su mentira egotrófica chorreando semen, que escurre gota a gota, o al defecar, en un gesto que denuncia que su pretendida omnipotencia generadora, que quiere crear como sólo Dios puede, se va por la cloaca. Aquí vemos el síntoma en su función sanadora en la medida en que, a su manera teatral, pone de manifiesto nuestra mentira y por esa vía abre la posibilidad de que algún día y con la ayuda adecuada, podamos encarar y asumir nuestra verdad psórica, es decir, nuestra particularísima manera de estar fuera del orden de la creación, orden cósmico o como queramos llamarlo; reconocimiento y aceptación que son condición sine qua non para religarnos recuperando nuestra condición adánica primigenia.(Ser humano sano de la Homeopatía).

PSORA SECUNDARIA
Notamos luego el subgrupo de los temores y miedos (fobias):
-a las multitudes y aglomeraciones
-a su ocupación y/o trabajo
-a la gente

Estos constituyen un primer intento defensivo por proyección de sus fantasmas primarios en el medio concreto y temporal, es decir, que surgen de las vicisitudes de la interacción del sujeto con el medio, son síntomas propiamente históricos y problemáticos, mientras que la psora primaria es ahistórica y metaproblemática, dicho de otra manera, pertenece al orden del misterio, ese que en nuestra tradición judeo-cristiana llamamos pecado original, la mácula o mancha originaria, verdadero estigma de la raza.

PSORA TERCIARIA
Y así, de manera casi imperceptible vemos a nuestro personaje deslizarse ora a la posición Ego y Alterlítica, ora a la Egotrófica cuando al insertarse en el mundo desde su sufrimiento primario, establece su equivocada defensa frente a un medio que constantemente le está retando en su pretendida omnipotencia.

Si el péndulo de la DM asume la esquina Syphilítica lo veremos ejerciendo su aversión a ciertas personas, continuación particularizada de su temor a la gente y que, por supuesto, serán aquellos que con su modo de ser le recuerden su herida. En el mismo sentido se explica su aversión a la compañía, especialmente de sus amigos íntimos, ya que siendo los que mejor le conocen, su sola presencia le lastima la herida en la imaginación, aquello que desea negar ocultándose y huyendo o “destruyendo” a todo aquello que lo acuse. Por ello su confusión mental después del coito, ya que el ejercicio de la sexualidad es un intento por abrirse y comunicarse con el otro, en franca contraposición con su postura de huida y extrañamiento, contradicción que lo lleva al embotamiento y finalmente al agotamiento. Los demás síntomas de esta posición constituyen variaciones cuantitativas de su déficit energético vital: olvidadizo, embotamiento de los sentidos, indiferencia e imbecilidad.

La posición Sycótica se materializa con un menor número de síntomas que, en su conjunto, expresan la agresividad con la que intenta imponerse al medio dominándolo y poder reafirmarse en su sentimiento omnipotente. De aquí se desprende su irritabilidad que lo lleva a establecer respuestas adaptativas exageradas en relación a los estímulos del medio. Su irritabilidad posee, además, dos modalidades interesantes: - después del coito y después de la eyaculación. Por supuesto, ya que el abrazo sexual del egotrófico no es , precisamente, vínculo de comunicación y comunión, si no instrumento de dominación que “cosifica” al otro al convertirlo en “objeto” de su lascivia, dominación que se ve frustrada por la eyaculación precoz y/o la impotencia.

Finalmente, su locuacidad es otra expresión de su estrategia de dominación, ya que utiliza el principal instrumento de comunicación que poseemos, lo cual implica el respeto por la palabra del otro, para acallar al interlocutor, impidiendo su palabra con su locuacidad teorizadora, lenguaje huero, vacío de significación.

PSORA (HIPÓTESIS)
Selenium es esa particular manera de participar en la “caída” del orden de la creación, por la vía de la envidia de la omnipotencia creadora y que, en tanto atributo divino, no le corresponde y por lo mismo se ve forzado a padecer la disminución del correlato humano de dicho atributo, que en Selenium se expresa doblemente, por una parte lesionando su potencia o capacidad de engendrar, en el plano sexual y reproductivo (pensamientos lascivos con impotencia e infertilidad), y por otra parte en la dificultad de plasmar resultados concretos a partir de su labor o trabajo, especialmente intelectual (embotamiento, disminución de la memoria y temor de su propio trabajo).

BIBLIOGRAFÍA
Instituto de Altos Estudios Homeopáticos J.T.Kent, ACTAS
Bernardo Vijnovsky, Tratado de Materia Médica Homeopática.
G.H.G.Jahr, Manual de Materia Médica.
H.C.Allen, Comparaciones de Algunos Medicamentos y Notas Características.
James Tyler Kent, Repertory of the Homoeopathic Materia Médica.


Autor: Dr. Iván Salas-Vergara (Colombia).
Fuente: http://homeopatiasigloxxi.blogspot.com/2011/05/estudio-miasmatico-de-selenium.html

KENT'S NEW REMEDIES OR HAHNEMANN'S MEDICINE OF EXPERIENCE

This item addresses the status of the 'New Remedies' of Kent which are listed in his New Remedies and Lesser Writings. I question whether these remedies were proved or not. It touches further on many aspects about the man and his contributions to homeopathy as an exact science.

Where is the evidence that Kent actually proved the new remedies? Are they published? And why are the drug pictures so thin and generalised. In my view, our assumption that he did prove them is based upon belief, rather than knowledge. Does belief of this kind have any place in a therapy that claims to be rational and scientific?

Yes, Kent was a great homeopath, but that does not place him above the kind of criticism he was very keen to level at others.

Let us look at the remedies. There are 26 of them. Only 7 of them seem or are known to have been fully or partially proved (Kali ars, Natrum sulph, Zinc phos, Alum sil, Cenchris, Ars sulph flav and Calc sil). 7 out of 26 is about 26%, which is not very convincing evidence is it? Yet of these 7, Kali ars was never proved (Kent admits this on p.126); Natrum sulph was proved; Zincum phos may have been proved, Cenchris was certainly proved; Alum sil Kent claims to have been `proved and used clinically by the author for many years (p.15). If we look at the number of pages of these remedies and thus the number of symptoms we find an interesting picture. Only 7 of them have more than 10 pages. Most have 5-7 pages of text. Vespa was not proved and has 1 page, Wyethia was not proved and has 1/2 page, Ferrum iod was not proved and has 5 and 1/2 pages, Caulophyllum was not proved and has 1/2 page, Calendula was not proved and has 1 page, Barium iod has 3 1/2 pages and is clearly unproven, ditto Aurum iodide with 3 pages and Aletris with 1 1/2 pages The front-runners are Kali ars 11 pages, Kali sil 10 pages, Zinc phos 11 1/2 pages, Cenchris 16 pages, Ars sulph flav 12 pages, Alum sil 11 pages, Calc sil 15 1/2 pages.

Only one remedy listed (Cenchris) gives the names of the provers and the days on which certain symptoms appeared. If they were all proved then why didn't he give the same account as he did for Cenchris? Why single that out for special treatment?

Based on the above it seems quite clear that there is great uncertainty about the proving claim. It is therefore perfectly reasonable at this stage to assume that the bulk of these remedies were not proved by Kent as was previously claimed. Where he got the data from is anybody's guess and is unknown at this point with any certainty. Presumably he built them up from his own ideas and from clinical experiments. Fine. That is making homoeopathy up as you go along. But it stands in stark contrast with Kent's own advice to others on this subject. Here are some quotes from the Great Man himself on this very subject. They are all from the Lesser Writings / New Remedies (Indian edition):
'The admission of clinical data into our Materia Medica must be done with the greatest caution...and should always be marked...the hasty and inconsiderate adoption of clinical symptoms is certainly an evil; and if pursued to any great extent will render the Materia Medica unreliable.'(p.217)
Few homeopaths would disagree with these high sentiments.
'Though some of the best symptoms now in use are of clinical origin, as a general rule they cannot be considered as certain and reliable as the pathogenetic.' (Ibid)
And again, this is perfectly reasonable.
'By thorough and careful work we will some day have a complete Materia Medica whose every symptom will have been repeatedly verified. The indeed, will our art become the exact science predicted for it.' (p.218)
He appeared to show some hypocrisy in his dealings with others on this issue and yet used and recommended remedies which were not proved, but which he had built up from a 'building-block approach': it is surely no coincidence that they are all Kalis, Aluminas, Natrums and silicates, iodides and phosphates. It seems obvious that he has built them up from chemical remedies known to be important -- iodides, silicates, aluminium salts, etc.

One problem is that people tend to fervently and blindly BELIEVE Kent and that leads to an unhealthy sense of outrage when he is attacked. They refuse to accept any criticism of the man. That is a weak, foolish and indefensible position to adopt. Kent is not a sacred cow or icon. He has been elevated by 'believers' to a high status that he does not seem to deserve, and which does great harm to homeopathy. Maybe we should try to separate the myth, belief and fantasy from the facts about the man. We should be far more critical of these who have become icons of the movement.

This is what Kent has to say on this topic:
'There is nothing that destroys a man so fast in the scientific world as conceit. We see in old-fashioned science men who are puffed up and corpulent with conceit... extensive knowledge makes a man simple, makes him gentle... a little knowledge makes a fool of a man, and makes him think he knows it all..' (Lectures on Philosophy, p.184)
Again, this is perfectly reasonable. Except that it might ring less hollow if Kent himself did not appear to be as puffed up with his own certainty and self-importance in exactly the way he describes here.
'Experience has a place in science, but only a confirmatory place...experience leads to no discoveries?' (Lectures, p.40)
What on earth is he talking about? Surely experience is the root foundation of the whole of homeopathy, from Sam's time right down to the present-day? Without experiment there would be no homeopathy. In relation to dogmatism I say that Hahnemann's master was experiment. I see I am not alone in thinking this...

Aphorism 25 of the Organon praises what '...pure experience, the sole and infallible oracle of the healing art, teaches us...'. Also in the Preface to the 1st edition of the Organon he states that none of his conclusions should be '...accepted unless confirmed by experience...' (Dudgeon/Boericke translation, 1921, Organon of Medicine, combined 5th/6th edition, p. xiii).

Thus it is very clear that he regarded experience and experiment as being vastly superior to 'theoretical medicine', which he scathingly calls 'speculative ideas' in his Preface to the 2nd Organon: '...the splendid juggling of so-called theoretical medicine, in which a priori conceptions and speculative subtleties raised a number of proud schools... the art of medicine was merely a pseudo-scientific fabrication, remodelled from time to time to meet the prevailing fashion.' (ibid, p.xv).

In Aphorism 6, he bemoans the 'futility of transcendental speculations which can receive no confirmation from experience..' (ibid, p. 32)

And, as Dr Krauss candidly states in his Introduction, 'Hahnemann was, in all essentials, a flawless experimenter.' (p. xxiv). He goes on, 'The era of scientific medical experimentation begins with Hahnemann and nobody else. Scientific to the core, Hahnemann experimented scientifically for scientific observation...' (ibid, p. xxvii)

Finally, Hahnemann states in the Preface to the 2nd Organon: 'The true healing art is in its nature a pure science of experience, and can and must rest upon clear facts and on the sensible phenomena pertaining to their sphere of action.', and that it '...dares not take a single step out of the sphere of pure, well-observed experience and experiment, if it would avoid becoming a nullity, a farce.' (ibid, p. xiv)

Thus I offer these remarks as some justification for the view I presented. By using the word 'experiment' I did not mean to imply that means 'do your own thing' or 'homeopathy without principles'. But it is true that Hahnemann started out with very little in the way of principles, and those he ended up with, were entirely based upon his experiments.

I would also venture to add that Kent was either meaning something else completely, or that he was talking some weird kind of nonsense, when he said that 'experience has no place in science'.


Author: Peter Morrell, MD.
Source: http://www.homeoint.org/morrell/articles/pm_kentn.htm

SUBJECTIVITY AS A FUNDAMENTAL PRINCIPLE OF HOMOEOPATHY

PHILOSOPHICAL CONSIDERATIONS ON HOMOEOPATHY


a) The homoeopathic symptom is a symptom of the individual state of sickness, not a symptom of the “disease“:
The hidden disease as the “prima causa morbi“, about which it is only possible to speculate, but which cannot be the subject matter of a cure, is compared to the objective and subjective signs, symptoms, of this disease that are cognizable by the senses and that describe and represent the disease as a whole. The two concepts, disease and symptom, are thus distinguished from each other, only to be put on a level and identified with each other in a further step with regard to practical procedure in diagnosis and therapy. The patient‟s state of illness, discernible from the symptoms of the disease, constitutes the disease as a whole, is the expression of the disease, is the disease itself. The symptoms of the disease do not represent an underlying invisible disorder, the authentic cause of which the symptoms are only indications, but they are the disorder itself. They themselves represent the whole disease.
Assuming the common, everyday notion of disease, which underlies any concept of disease as a pre-understanding (Vorverständnis), the patient himself will always see the symptoms of his state of illness as his disease. The symptoms are those manifestations of the state of illness that are cognizable by the senses and that “tell“ the patient, that make him feel, that he is sick. It is the sensations and disturbed function that bother him in his normal life, that cause him to suffer. Symptoms are sensations and qualitative experiences of the state of disease. If we are running a temperature, it is not the measured temperature that will make us suffer, but the heat or the chilliness of our body, the shivering, the sweating, the accompanying pain in the limbs and the other physical sensations that distinguish our present state from that of health. We may also, additionally, experience restlessness, an unaccustomed need for the presence of other people, maybe even anxiety, etc. – in a state of sickness, we also experience our environment in a different way, it seems to change its face, so to speak, its meaning and its significance. The patient senses and experiences not only his inner context as altered, but also the context of his environment, his life-environment. Yet this altered way of experiencing the outside world is no more a direct portrayal of a real change of the environment than the altered experience of the inner world, of the body, is a direct portrayal of a physical change. Changes of the body or of the environment cannot be ruled out (in fact, it is virtually certain that all sensations are accompanied by physiological changes), but it is important to remember that the way the patient experiences and feels them does not provide an accurate portrait of such changes. Sensations and experience develop out of a relationship between the patient‟s perceptions and behavior and concretize themselves in the state of disease.
 It is only in a further mental step that the question of the cause for this state of suffering can be raised, or that examinations can be carried out for the purpose of obtaining results in the shape of measurable data.
It is of fundamental importance to distinguish the homoeopathic symptom as a symptom of the individual state of disease from a symptom of a disease (pathognomonic symptom) that may, under certain circumstances, even be observed empirically with the help of certain tools (such as, for instance, temperature measurements), but represents no immediate quality of sensation or experience.
However, what about the “objective“ symptoms that may be observed by others and are not necessarily subjective symptoms perceived by the patient himself – such as, for instance, his complexion? The observers‟ attention is aroused by the noticeable deviations from the healthy state of the patient. However, the perception (Wahrnehmung) that is the result of this active observation (Beobachtung) is also an activity on the part of the observer, a subjective “taking-in” of what is observed within the context of normal, day-to-day environment. Others notice that the patient looks different, behaves differently. Again, ordinary, everyday pre-understanding (Vorverständnis) will be the starting point for the realization that another, someone whom one has also known as a healthy individual, is now sick. Again, what is required is not the registration of objective data and facts, but subjective observation of the signs of disease that are noticeable in the other and that may coincide with the subjective perception of a third person and thus become “objective“, i. e., common, observation. An observer will notice the altered color of the skin, the color and form of the rash on the skin, the muscle tone, the odor of the sweat, the sound of the voice, etc. The person observing the patient will not immediately draw conclusions, he will not seek an explanation of what he has observed, but will simply perceive them, as his own impression which, seen against the background of his own pre-understanding (Vorverständnis), slowly take shape as the patient‟s symptoms .
On the other hand, clinical symptoms and findings that elude both the patient‟s and the observer‟s direct perception and observation can never be useful symptoms in a homoeopathic sense.

b) Each homoeopathically relevant symptom originates in sensory perception:
The symptom will either be perceived only by the patient himself or only by the observer, or both will perceive it, each one in his own way, either similarly or differently. The patient mainly reports on his own sensations, he describes how he perceives his own state of being sick. He reports sensations of his own body as well as sensations that concern his experience of his own environment. The therapist himself always remains in his role as an observer, who listens and takes in what he has heard, on the one hand, and on the other hand, hears and sees the patient and absorbs the atmosphere of the dialogue as a whole. The therapist himself maintains the attitude of a perceiver. He, too, perceives against the background of his own pre-understanding (Vorverständnis) of health and of his previous knowledge of the patient. His observation is not a purely intellectual process. As an observer, he is right in the middle of his own sensory perceptions:

“In order to investigate the living, it is necessary to participate in life. It is true that one can make the attempt to deduce the living from the inanimate, but this attempt has hitherto been a failure. One may also strive to deny one‟s own life in science, but this only leads to self-deception. We come upon life as living beings; it does not come into being, it is already here, it does not begin, because it already has begun. At the beginning of all life sciences, there is not the beginning of life itself; rather, science began with the awakening of questioning, right in the middle of life.“ (94)

Perception stands between the sensory, purely subjective sensations and what is already reflexive observation, concerning which memory and experience already exert an influence whenever something is perceived as something. Perception always happens within the context of other things, in a complex interrelation and interconnectedness of perceptions that also include one‟s own corporeality. It is also intertwined with active self-movement on the part of the perceiver which guides and chooses perception. Consequently, the therapist as an observer cannot stay out of what is happening, he cannot regard the patient and his narration as an object (to gawk at him, so to speak) from which he, as the observing subject, is able to distance himself entirely. As a perceiver, he is always also a participating observer.
I shall attempt, with the help of Maurice Merleau-Ponty„s “Phenomenology of Perception“ and, subsequently, with the help of Viktor v. Weizsäcker‟s “Gestaltkreis“, to describe and develop these considerations in more detail.

c) Sensation and perception in the works of Maurice Merleau-Ponty:
Maurice Merleau-Ponty starts his investigation into the phenomenology of perception (95) with the question of the concept of sensation. If sensation is to be defined as “the mode of my affection (Affizierung), the experience of a state of my self“ (96), it becomes apparent very quickly that even the simplest factual perception refers to circumstances and that we do not know anything that corresponds to pure sensation. A pure “impression“ cannot be perceived by itself; it must remain theoretical, because perception always remains bound up with experience. Gestalt psychology teaches us that a phenomenon that may be referred to as perception always appears as something within the environment, within the context of something else. (97) What we believe ourselves to sense are not immediately experienced qualities, either, because any quality only ever enters our consciousness in association with some object – or as an object. Consciousness is always consciousness of something as something. ”The alleged evidence of sensation is not based on the testimony of our consciousness, but on a prejudice. We believe that we know what “seeing“, “hearing“, “feeling“ is because perception has always given us colorful or sonorous objects.“ (98) For this reason, qualities are always found in a context of meaning, even if neither object nor meaning are as yet fully determined on the qualitative level. In the field of vision (“a unique sphere in which contradictory concepts intersect“ (99)), everything we meet presents itself to us in its relevant connection, in its own world. “The certain quality to which empirism refers for the purpose of defining sensation is a subject, not an element of consciousness, in fact, it is a subject derived from scientific consciousness. In this double sense, it can be said that its concept conceals subjectivity, rather than revealing it." (100)
Examples of optical illusions or the effect of complementary colors show that sensation cannot simply be defined objectively via the physical stimulus, but is always integrated into a a complex network of perceptions. The sensory organs are not objective instruments of transmission, either. What is perceived includes what is ambiguous, as well as such gaps as are not caused by something remaining unperceived. Perception “happens” by the perceiver‟s attaching what is perceived to its context or to the “positive indeterminate“ in it. If we want to understand sensation, we must first investigate the pre-objective area.
We see that “the exterior conditions of the sensory area by no means determine it piece by piece, but merely contribute to an independent organization – this is what Gestalt theory shows; we also notice that structuring within the organism depends on variables such as the biological sense of organization that are no longer variables of a physical type, so that the entire connection eludes detection by the known instruments of mathematical-physical analysis and demands and makes possible a new kind of insight.“ (101)

The symptom described by the patient, the sensation reported by him, is therefore always found in the context of the patient‟s own interpretation, it is a part of the state of disease that appears against the background of the relevant individual notion of health. It is ambiguous, it is found in a number of different connections and relations from which it receives its definition and meaning – and it is bound up with much that is indeterminate, that permits no unequivocal interpretation.
However, similar observations may be said to apply to the perception of the observer. For him, too, what he has heard and seen appears in its own context, is the background and horizon of its appearance.

d) Perception and motion in Viktor v. Weizsäcker‘s “Gestaltkreis“ :
In his works on the “Gestaltkreis“, Viktor v. Weizsäcker (102) examined the reciprocal interaction of perception and movement (103), sensibility and motility, the subjective and the objective. The observation of living organisms is always that of their self-movement which is a sign of their aliveness. This self-movement goes far beyond a simple connection of stimulus and reflex and is a highly complex accomplishment of the coordination of nervous functions, in which perception plays a central part. For instance, the perception of the motility (Bewegtheit) of the environment may be a ”deception“ in cases where it appears as the consequence of an unperceived self-movement. At any rate, self-movement and the apparent movement of the environment are firmly related to each other and this relationship can be traced back to the relationship between perception and self-perception. Weizsäcker points out that perception is not exclusively of a receptive nature, but that the biological act of perceiving itself already implies self-activity. “The performance of the act of perception shows an interconnection of the motor activity with the appearance of objects that it makes possible.“ (104) By moving myself, I let a perception appear and by perceiving something, I become aware of a movement. The interconnection comprises “the necessary condition that the process by which something becomes apparent to me does not become apparent itself, and that I am also active as a result of something becoming apparent to me.“ (105) By this process, the “appearance of objects is made possible [...] by a division into coherent and sacrificed objects.“ (106) The decision in favor of the object of attention is the decisive factor with regard to which perception is followed up (in a self-movement) and which will be abandoned. What remains decisive with regard to perception is the relationship with the object of perception with which one aligns oneself. Thus, movement can only happen with the help of the senses, but on the other hand, sensory perception is also dependent on movement. In this interconnection of perception and movement in which “we are connected with, in which we quasi adhere to, the environment and the objects it contains, by very particular relationships“ (107), “the sensory present takes shape anew each time“ (108), which, however, is contrary to a mathematical concept of the space in which objects could be arranged. On the other hand, totalities of “units” of simultaneous or successive events (Geschehenseinheiten) form from act to act that form the concrete whole again and again from different perspectives. “[T]here is no specific sensory energy with regard to spatiality. The connections between sensory impressions are not based on their classification within a general and absolute notion of space (Raumvorstellung), either. The interaction does not receive its uniform design from the structural and functional relationships at all; in fact, they themselves again and again interrupt, restrict and destroy this uniform design, in accordance with their own necessities of structure and function.“ (109)
At any rate, what the senses show us is not an image of the physical impulses, the merely quantitative alterations of which they translate into diverse qualities of sensation that play a constitutive part in our sensory perception of environment, even where they may be qualified as deception according to physical fact. This sensory image of our world is no “product fabricated by“ our organic functions, no effect of the sensory function or the stimuli from the environment; rather, perception and sensation “are that by which we first seize material processes.“ (110)
There is a radical contradiction between physical objectivity and concreteness of things in our perception that permits of no comparison. Perceived objects are not data entered into a spatial coordinate system or composites of individual stimuli within the organ, but realizations (Vergegenwärtigung) of perception (coherence – in coherence, the subjective quasi “adheres” to the real environment) with regard to the object or the place as such, a fact which inevitably implies the inclusion of a possible “deception“ in the physical sense. The realization of an object is only possible in relation to the past or to the future, as a conservation of the object‟s identity as a “Sehding“ throughout the changes wrought by time.
It is in the interrelations of perception and movement in self-movement, of which, as stated above, the mutual concealment of perceiving and moving is a part, that the living subject of perception, which distinguishes the object of biology from the object of physics, shows itself: “Sensation and perception cannot, after all, be discerned in any other way than as the experience of a subject.“ (111) In connection with this introduction of the subject into biology, Weizsäcker reminds us of former attempts to introduce this subject via the concepts of vital force or entelechy. However, what is subjective can never be objectified, not even by the introduction of a “stage master (Maschinenmeister) within the organism“ (Uexkuell) or other, ultimately theological, constructs of an intervention of the inexplicable and miraculous in natural processes, such as, for instance, Hahnemann‟s ”vital force“ (even if Hahnemann does not describe this as an intervention on the part of God or of the “spirit”, but as an undefined but comprehensively harmonizing “power“ of nature (112)).

As far as the considerations concerning the homoeopathic symptom are concerned, there are several consequences of this:
The homoeopathically relevant symptom is always based on sensory perception. As such, it is always part of the complexity of the subject and is never a mere portrait of physical processes. Symptoms are not images of physiological or pathological processes that they describe in a subjectivist language, either. Put differently, this also means that it is impossible to determine any immediate and constant relation between cause and effect (causality) between the physical processes of the material body and the perceptions and subjective sensations.

Among philosophers, there is still a discussion (the identity theory of philosophy of mind (113)) as to how far mental states (and thus also sensations) are identical with neuronal states or how far identical mental states can correspond to different physiological brain states (it was in this way that Hilary Putnam arrived at a description of mental states as “functional states“, each of which corresponds to a different brain state, even if they fulfill similar functions - functionalism). Since I cannot follow up these arguments any further within the scope of the present thesis, I shall focus on the aspect of sensations as phenomena of “experience in the sense of what happens to me and how I “live”, and respond to, what happens to me“ (Erlebnis) (114) and follow Weizsäcker„s line of argument, based on and developing out of the experiental unity between the “I“ and its environment (coherence), which focuses on unity and wholeness and therefore on subjectivity.
Seen from this point of view, therefore, sensory symptoms are modes of experience (as an experience of interior or exterior realities present in our environment) as holistic totalities of “units” of simultaneous or successive events (Geschehenseinheiten), for which mathematical descriptions and systematizations are necessarily inadequate.
This results in a fundamental lack of comparability between these subjective symptoms and objective findings (which are often referred to as “symptoms“ in clinical usage, although there, the term is used in a completely different sense to denote a ”sign of“. Thus, for instance, a reduction of the number of erythrocytes would be a sign of anaemia). In this sense, the homoeopathically relevant symptom is not a sign of a diasease, but is already part of the experience of being sick, to which it contributes directly. It does not indicate anything but itself.
This impossibility of comparing homoeopathic symptoms with clinical symptoms and findings also plays a large part in comparative scientific studies, which attempt to compare symptoms of different categories and are therefore destined to fail since, apart from everything else, this is contrary to the principles of logics.
The subjectivity of perception is doubly present in homoeopathic method: just as the patient can only experience his state of disease subjectively, the perception of the observing physician is a subjective one as well. He is no measuring device for physical processes in the patient that could detect and systematize the patient‟s data in an “unbiased“ and detached manner as if they were simply data. The attempt to turn him into a “mere observer“ would mean to abstract him from reference to the world (Weltbezug), from all context, and is tantamount to an attempt to blank out one‟s own self-movement and, consequently, one‟s own self-activity in the interlocking of perception and movement; however, this, too, is no more than self-deception (115).

e) The homoeopathic symptom is an expression of subjectivity:
The fact that this subjectivity of sensory perception cannot be equated either with arbitrariness or with a total relativization of the objectively pre-existing environment and its objects by what is purely psychological, is also demonstrated by Weizsäcker‟s studies on the “Gestaltkreis“: perception “is not the subjective final product, but movement of self and environment as it occurs. In this, the organic inner world is the vehicle and venue of this encounter. Those who wish to investigate it will have to face its double determinacy, i. e., the fact that it is determined by the environment on the one and by the peculiarity of the organic substrate on the other hand.“ (116) Perception ignores neither the reality of the objects nor the givens of the sensual organs, both are indispensable conditions that ensure the possibility of something appearing and being perceived. “Perception is the appearance of real things via real organs.“ (117) In a footnote to this sentence, Weizsäcker himself raises the question of the limits of the validity of this experience by pointing out that in our dreams, things appear to us that are not ”there“. However, I think that the question here is mainly one of the definition of reality, which, after all, is not limited to material existence. Although it is true that the reality of the unconscious mind cannot be comprehended as materiality, unconscious processes are also dependent on certain laws to which, among other things, the images appearing our dreams are related.
Weizsäcker shows how, in contrast to Kant„s teaching of the a priori forms of intuition (Anschauungsformen) of space and time, the correlation between perception and object “is not determined a priori“: neither from the point of view of space nor of that of time do the configurations of the objects as we experience them necessarily coincide with the actual structure of the objects; the classification in our perceptions are merely attributable to the structure of the objects as such. Linear time and physical space are fundamentally different from experienced time and from experienced distance and propinquity.

These preconditions of structure simultaneously limit the ambiguity of perception. The example of picture puzzles shows that one and the same object can be perceived in a very different way without any new impulses being added; they are an example of the ambiguity of the impulses themselves. “No perception is meant as an identity of experience and object; each perception takes hold of one particular way of seeing the object, it is predicative. And every object can be seen in different ways, each way of seeing may be suitable for several objects“ (118). The other way in which the same object may be seen is created by the fact that we decide to see it in a different way. “It is therefore not a special central or psychological function that determines different perceptions in cases of ”identical impulses” (Reizgleichheit), but it is the most common distinction between object and mode of appearance that is part of any perception, that permits to see differently in cases of “identical stimuli”. Consequently, what is special in these cases is not the fact that the same cause may produce different effects, but that we find that which appears behind the appearance, in all cases, even in those where the stimuli are identical. “Ambiguity” is due to this, not to the plurality of different subjective utilization.“ (119) This is a clear rejection of psychologistic interpretations that shift the ambiguity of perception to what is purely subjective within the individual psyche and, in this way, prevent the general applicability of statements regarding the objects also existing from an objective point of view.
This means that the ambiguity of perception lies in the appearance of that which appears, in the phenomenon, itself. In the phenomenon, that “which shows itself in or from itself“ (Heidegger (120)), its ambiguity shows itself in itself, lets itself be seen as the basis of its appearance.

Regarding the homoeopathic symptom, this means that it is ambiguous in itself since it is sensorily perceived; however, this means something fundamentally different from a random number of possibilities of interpreting it from a number of different points of view, depending on how it is evaluated and interpreted subjectively by the observer according to the latter‟s own requirements. It also means that the symptom is not in an unequivocal attribution relation to an objective, mathematical order of things, into which the symptom can be integrated as into a given space-time system. “It has indeed been an error of all classical sensory physiology that it treated the perception of things in space and time as subordinated to the mathematical scheme of space and time. In reality, though, it is only in exceptional cases that perception of what is or happens side-by-side […] or successively etc. will be the same as the perception of the fact that something is, or is happening, side-by-side […] or successively.“ (121)
Therefore, on the one hand, the contents of experience and perception – symptom – and the object of perception are always, as a matter of principle, different from each other (they only correpond roughly in exceptional cases (122)); on the other hand, they are tied up with each other, because the objects of perception and their objective systematics are conditions of the possibilities of perception that simultaneously permit the different possible arrangements of objects in perception (i. e., in the symptom).
This is also why the symptom cannot be “true“ or “false“ in itself. It is no use asking whether some pain described as having a certain quality is “true“ or “false“, right or wrong with regard to the examination of objectively existing and generally defined reality. It is not a question of the apophantic judgment of a statement divorced from any relation to the world. The symptom is found within the semantic context of a narrative intended to convey some kind of message. It is related to a reality that conditions its mode of appearance; based on this it wants to be understood and demands the taking of a suitable measure (e. g. a therapy).
The homoeopathic symptom only receives its relevance from its context, from “the whole of the symptoms” (Inbegriff der Symptome), the individual complex of symptoms expressing the individual state of disease that is the mode of appearance of the individual state of disease. For this reason, it is also impossible to treat individual symptoms homoeopathically, since they are ambiguous in themselves and do not permit an unequivocal attribution to any remedy unless they derive their significance from the context of all other symptoms of the patient as a whole.
Moreover, the individual symptom permits no unequivocal interpretation in the sense that it would be possible to explain what it means and what it stands “for”. It has no other meaning than itself, but always represents itself within its context, from which it derives its meaning as itself. From this point of view, the individual symptom is not a “part“ of a complex of symptoms composed of several symptoms as its building blocks, either, but is always simultaneously a representative of the whole, from which, however, it can never be detached or abstracted.
In the process of homoeopathic diagnosis, the patient‟s symptoms are always seen in a dual context:
One the one hand, each symptom is seen within the context of the individual patient‟s case history. Here, it is no individual sensation that more or less corresponds to historical fact, but it is embedded, in the sense described above, in a life-history context from which it derives its meaning and its significance and from the point of view of which it wants to be understood. This understanding must not be taken to signify an explanatory context (the question is not the reason why the patient has these symptoms), but as a context of meaning, from which each symptom also derives its meaning. This meaning exists within the unity of the individual with all his life concerns and finds its expression in the patient‟s life history. In this life-concern context, the individual is inescapably linked to the world that he shares with others (including the therapist) and within which he can communicate and be understood.
It is the homoeopathic therapist‟s task to extract from the jumble of symptoms appearing in the narrative context of anamnesis a complex of symptoms that stands in a relation of similarity to the anamnesis (and therefore also to the patient‟s state of disease) and reflects it in its entirety. As a result, each symptom will be found within the context of other symptoms, within a context of symptoms that is a context of meaning, corresponding to the narrative context of the case history and ready to be brought into a relation of similarity to it. Here again, it must be remembered that the individual symptom is not merely a component part of the whole, but that the addition, exchange or deletion of one symptoms alters the entire complex of meaning from which, in turn, it derives its meaning as an individual symptom.

f) The introduction of the concept of subjectivity into biology as a science in the writings of Weizsäcker:
In the assumption of a unity of perception and motion, as well as, consequently, in the unity of the “I” and the environment that it meets in the form of experience (coherence), the question of the influence of psychological factors on physical ones (and vice versa) as two different substances may, for the time being, be left out of account. “The assumption of the principle of coherence implies the assumption of the principle of experience (Principle of experience) and with this, the subject is introduced into biology.“ (123) The principle of experience is phenomenologically oriented, since, when we are experiencing something, we do not ask “what we see, but what we see“ (124). The compositional act of perception [...] has [...] the depth structure of being and appearing (Sein and Erscheinen).“ (125) However, this explodes the definiteness of perception, and to see a thing means that it appears and that it “is” for me in this appearance. But it is not only things that appear to us in this way; in the equivalence of appearance and motion, it may also be ourselves who let this phenomenon appear.”
 “Physics presupposes that in research, the perceiving subject (Erkenntnis-Ich) should be juxtaposed in opposition to an independent world as the subject matter of cognition. In biology, on the other hand, we have to learn that we are in an interdependent relationship with our subject matter and that the reason for this interdependency cannot itself be our subject matter. [...] In order to investigate the living, it is necessary to participate in life. Physics are exclusively objective, but the biologist is also subjective. Dead things are strangers to each other, while the living are sociable, even where they are hostile to each other.“ (126) The biologist‟s subject matter is an object “inhabited” by a subject.
In his “Gestaltkreis“, Weizsäcker tries to comprehend both the subjective and the objective aspect of nature as a system (as opposed to an arbitrary mixing of the two aspects). As his empirical point of departure, he takes the subjective statements made by patients as they live through crises. In a crisis, certain systematical processes are interrupted more or less suddenly. The subsequently emerging new order permits a new causal analysis, but the new situation cannot be deduced from the old one.
Each crisis is a “crisis of the subject. In it, the subject experiences the dissolution of its finite Gestalt [...]“ (127) The phenomena of crisis, such as fear, powerlessness, etc. can be comprehended from the point of view of the threatened subject. Unless the change takes place, the subject will be destroyed. The term “subject“ implies conditions such as unsteadiness, infiniteness, compulsion and destruction. Most movements of natural life present themselves as determinate if they are a result of expectation and intent, and as indeterminate if their origin is impulse, reflex and automatism.
However, the subject‟s experience of its own crisis, its existentiale, is not limited to the psychological facts or circumstances of the crisis. This is because in a crisis, more than at any other time, the psychological determination of the subjects is dissolved to a point of unconsciousness. From this, we can deduce that “psychological“ is not the same as ”subjective“. Crisis is the expression of the threatened unity of the subject. “The subject is no solid possession, it must constantly be acquired in order to enable us to possess it. The unity of the subject is the counterpart of the unity of the object. Just as objects and events in our environment can only constitute their unity in perception and action through the change of function, the unity of the subject is only constituted in its constant renewal throughout discontinuities and crises.“ (128) This constant threat to the subject is also the explanation of the fear of subjectivity. However, we must remember that without a subject, there is no object, either. It is therefore easy to understand that the diversity of objects is closely linked to the richness of subjectivity. Each shifting of the subject (Subjektsprung) (in a crisis) engenders a shifting of the object (Gegenstandssprung), “and even if the unity of the world is questionable, at least each subject collects its own environment, the objects of which it binds together into a small monadic world “ (129) Thus, the guarantee for unity appears to lie with the subject; however, subjectivity does not consist only of the psychophysical unity of all biological actions and processes, but above all creates the unity of all these actions and processes across all changes of function (“each action or process is an improvisation“ (130)). Subjectivity also achieves the “qualification of the quantitative“ (131) in the ability of differentiating in a world characterized by a relative limitlessness of quantitative differences. The individuation of the organic against its (much more diverse) environment that is rendered possible thanks to subjectivity is also important for each action and process.
As a result of the “peculiar displaceability of the limits“ between the self and its environment in perception and motion, no conscious act of thinking appears to be necessary in order to separate the self and its environment. Just like the environment, the body is also able to enter into this objectification and, like the environment, to become an “it“ in relation to the subject. “The precarious relationship between somatization and projection, as a mode of appearance of a special performance of an act, thus does, after all, lead to something new: we proceed to recognizing in the biological act a juxtaposition of “I” and “it”. The introduction of the subject leads here to a confrontation of things. The confrontation of “I“ and “it“ is, after all, the concrete example of a confrontation between man and world.“ (132) In this way, the category of the world is not established by an act of consciousness, but by the empirical findings of the displaceability of the boundary between “I” and “it” in the realm of one‟s own corporeality.
“The prerequisites for a meeting of subject and object [...] are fulfilled as soon as that which appears to be effected by the subject, i. e., motion and perception, coincides with that which appears to be effected by the object, i. e., the working of the physical laws. This happens when the organic actions and processes coincide with the exterior processes of nature and the latter fall into line with the conditions of the organism. What follows is that which biology has been referring to since Darwin‟s time as adaptation.“ (133) Seen from this point of view, the crisis is the change from one adaptation to another, new one. However, this begs the question of the nature of the continuity that is conserved from one assimilation to the next: “...where subject and object are mirror images of each other where they meet, the “I” will also be safe and secure in its environment.“ (134) Such security is therefore a result of the mirroring of the environment, which is subject to physical laws, by the self-movement of the organism.
Life is not only lived actively, it must also be suffered. The physiology of the senses also includes the physiology of pain. “Our statements concerning this do not refer to the ontic aspect alone, but to the pathic aspect. And it is obvious that we cannot speak of the pathic attribute of life as we speak of the ontic.“ (135) The pathic aspect of life cannot be mentioned in a dispassionate way. Concepts such as “intent, expectation, surprise, danger, threat, security, arbitrariness and freedom, decision and restriction“ do not appear as psychologisms any more, but emerge as a mode of existence of living beings that must be summed up under the term “pathic“. They do not concern “Dasein“, but suffering and express themselves both in the psychological and in the physical realms.
“„Gestaltkreis„ means that the biological phenomenon is not explained on the basis of an underlying causal sequence of functions from which the phenomenon in question has emerged; rather, it is a part of a self-contained act. Its unity may be described by way of the analysis of the crisis. Its specific attribute is the pathic aspect that is opposed to the ontic aspect. Its structure derives from the dialectic fragmentation of the critical decision in the subjective categories of “I want, must, can, should, may”. The internal order of these categories, in turn, cannot be described by an ontic category such as space, time, causality, but must be expressed as the social order of me and you, he and it, etc. Seen as a Gestaltkreis, a biological act is no link in a chain, no number in a sequence, but, by comparision with the previous situation, a transformation towards an “afterwards”, a revolutio.“ (136)
From a biological point of view, man experiences himself in a fundamental relationship of subjectivity, which is definitely experiencable, but the basis of which cannot itself become a subject matter. Weizsäcker„s investigations refer to this fundamental relationship as the last instance, which may be experienced as dependence or as freedom – but where one also hits the limits of linguistic means of expression, since at that point, no objectification is possible any more.
An experiencable manifestation of the fundamental relationship is the fact that life is not experienced in a steady continuity, but as a series of critical breaks and interruptions. In the various situations in which the “I“ can experience itself, it experiences its “Dasein“ as infinitely strange by comparison with its “Dasein“, particularly in the most intense moments of ecstasy.
“The only point of a contact between the intermittent ecstatic states was then in the form of the contact between living beings and environment. When the “I“ is thrown into its “being different“, such fleeting contact takes place.“ (137) “[T]he mirror image could not exist without the thing, the mirrored thing not without its image. We now see this complementation as the origin of all those merely derivative possibilities of presenting biological processes in categories of complimentarism at all.“ (138)
Perception and motion are not different locations of the function and not different biological acts, but the complementing dualism of the fundamental relationship: “The position of the life phenomenon in relation to its cause, which cannot itself take the place of the subject matter.“ (139) This insight is based on the wisdom of Parmenides: “Being itself cannot be moved and cannot show itself; but that which appears, is, after all, the unmoved being itself; movement is no more than the way it shows itself.“ (140) The experiential and causal incoherence of the sequence of acts is the expression of the link between the phenomenon and its invisible fundament.
Although life appears to proceed in time, its beginning and end lie at unknown thresholds that call time itself into question. “[W]ould the eternal recurrence of the same be timeless and yet only recurring in time?“ (141) Only in the dialectics of concepts does life become vivid and clear; not in the concepts of space, time, and logic, but in the anti-logical modes of appearance of that which is alive that remain close to the origin, “in conception, birth, growth, maturity, old age and death, memories and anticipation [...]“ (142)

g) Discussion of the approach in Weizsäcker’s “Gestaltkreis“ in the context of Homoeopathy:
I have presented Weizsäcker„s approach to subjectivity in such detail because its point of departure, i. e., crisis or the pathic aspect, accommodates the homoeopathic approach, which starts from the existential experience of being sick. The experience of life in its fragility in a state of disease, which ultimately eludes all explanation and remains, beyond all possibilities of rationalization (including all the explanations made possible by means of detailed examinations of the physiological processes and the resulting possibilities of influencing these processes) simply “as it is“, is the starting point of all homoeopathic diagnosis and therapy. The fact that man, as long as he lives, never quite breaks down in his crises, in spite of interrupted continuity and changing options of identity, warrants the unifying subjectivity that distinguishes him as participating in life. This subjectivity is most clearly shown under a critical menace (“We only really start to notice the subject when it threatens to disappear“ (143)) in a state of disease, which imposes itself on ”concealed health“ (Gadamer) and manifests itself in the “conspicuous, peculiar, unusual and unique“ symptoms of sensation and action in the patient. These symptoms are symptoms of the achievement of life itself, life in this way proceeds as a uniform process of an “I” in the world, with which this “I” within Heidegger‟s meaning is “familiar“. In this uniform accomplishment, the individual is embedded as a whole, body and soul, so to speak, and cannot be detached from this unity into objectification without being robbed of itself as a whole living being as a result. For this reason, the examination of the physical and physiological processes constitutes not only an approach to the patient from a different angle, but a dissociating approach which, in its confrontation, has already broken this uniformity of the process of achievement. This unity cannot be divided without destroying the whole, which cannot be put together again from the fragments thus created. (144)
Seen from the point of view of this unity, the – undoubtedly justified – question of the influence of physical processes on mental conditions and vice versa hardly arises at all, since this question is fundamentally different and is of no more than marginal significance with regard to the approach to the phenomena of being sick as an existential state of being. Thus, to a patient overwhelmed by pain, the question of what objectifiable findings may be ascertained of his state and of how these findings are connected to his pain will be of very minor significance as he lives the experience of his pain. On the other hand, for the scientific physician, the patient‟s manner of experiencing his pain is merely a marginal condition in connection with his medical approach to the patient‟s disease, a medical marginal condition which, however, will challenge him in his empathy to act not only as a physician, but also as a fellow human being. In this empathy, the physician is again challenged as a compassionate, and consequently participating, subject, with all the implications of his subjectivity. However, while in scientific medicine, this subjectivity is subordinated to the objective approach and more or less considered a nuisance factor because it interferes with the desired objectivity, it is implicit in Homoeopathy; in fact, it is, so to speak, the fundamental principle of its method.
The fact that the mode of existence of “Dasein“ expresses itself both psychologically and physically is regarded as a matter of course in the homoeopathic approach; the two are not separated from each other – one level may actually represent the other (a fact that, within this framework of comprehension, can be observed empirically in homoeopathic practice on a daily basis). In this way, the problem of how, seen either from the psychological or from the physical angle (or from the construct of what we describe as “psychological“ or as “physical“), this interaction of the physical and physiological processes with experience and modes of sensation actually happens, will of course, remain unsolved. However, based on the above argumentation, I want to posit at this point that the mode of existence of subjectivity requires different questions and approaches – in fact, those that examine this unity as an undivided and indivisible unity as to its mode of being. It is exactly this question regarding the mode of being of “Dasein“ in crisis (as a borderline experience and therefore a poignant experience of being) that is asked by Homoeopathy– and it raises this question in the context of healing, which opens up another horizon for this line of questioning.
I contend that healing through similarity, through “homoion pathos“, can only be understood within the scope of a concept of such unity as a uniform “experience” in the realization of a resonance (145) between the patient living his experience of being sick and “his“ remedy. In order to understand this, Weizsäcker„s differentiation of “psychological“ and “subjective“, which is a consequence of the evolvement of the principle of subjectivity from the crisis of the subject, is of decisive importance: in the subject, both the psychological and physical take effect (but they are not additive and they do not determine the subject entirely!), but this is not all there is to the subject. In unconsciousness or in unconscious processes, psychological determinacy may be suppressed completely without eliminating the subject as such, which only (consciously or unconsciously) suffers the “dissolution of its finite Gestalt“ (146) in the crisis.
The effect of the homoeopathic remedy cannot be reduced to psychological and/or physical aspects, either; the remedy meets the patient in his being as a subject, his being-in-the-world as a whole. Since this subjectivity is not bound up with consciousness, the reach and sphere of action of Homoeopathy embraces the entire cosmos of the living: the homoeopathic treatment of unconscious patients, babies and animals has always been particularly rewarding for homoeopathic physicians, which, by the way, is also a classical argument against the accusation that homoeopathic remedies merely produce placebo effects.
Hahnemann referred to this unifying principle in a very vague and speculative manner as the “vital force“ that maintains the entire healthy organism in harmony or is “deranged” in disease. Replacing this “vital force“ by subjectivity as the unifying principle, this principle, too, will point directly towards the methodology of Homoeopathy as a subjective approach to the mode of “Dasein” of being sick, with its subjective symptoms, which show themselves in the crisis of disease as peculiar symptoms. I have already hinted at the possibility that the approach towards healing through similarity may be derived precisely from this underlying structure. I shall return to this point in one of the following chapters.
In order to prevent all misunderstandings, this principle of subjectivity must once again be clearly defined and delimited in order to distinguish it from any subjectivism and psychologism. It is particularly the differentiation between the subjective and the psychological that makes it possible to delimit subjectivity against all psychological conditions that would cancel out the binding nature of existing objective reality in favor of the complete relativity of “random“, “arbitrary“ and purely subjective interpretations. Weizsäcker writes that the “correlation” (Entsprechung) between the subjective and the objective side is the “litmus test“ for his theory of the Gestaltkreis: “In moral life, we use the term “character” to describe the the ability of the subject to prove itself in an ever-changing and resisting world. In science, it is generally accepted that the equivalent of this is a correspondence of theory and observation. Observation, such as that provided by the senses, must decide whether or not a theory is correct. This suggests to me that theory is more of a subjective hypothesis, a thought, while observation guarantees an objective fact. However, this attitude, which is common to many researchers, cannot be sustained. It has been shown, for instance, that facts may “contradict“ each other. This is when the logical principle of contradiction acquires preponderance and claims that “objective facts“ must not contradict each other.

Moreover, criticism of sensory perception shows that observation may deceptive. This shows that proof is found in a lack of logical errors in the theory, as well as in confirmation through observation: the whole of a true and accurate cognitive finding is more complicated and relies both on proof for the theory through observation and on proof for the observation against the logical claims of the theory. There is no one-sided dependency, but correlation is the real nerve of proof. One cannot say, therefore, that of the two links of correlation – observation and theory – one is subjective and therefore uncertain, while the other is objective and therefore reliable. There must be another explanation of the confrontation of subject and object.“ (147) This relationship between subject and object exists in the realm of the living, that is to say, in biology, in the meeting and congruent correlation between that which “appears to be effected from the point of view of the subject, i. e., perception and movement“ (148) and the physical laws of nature in the processes that appear to be effected from the point of view of the object. This is the way in which the biological acts in natural processes coincide (149), which, in turn, adapt themselves to organic conditions, thus following a process of adaptation as described in evolutionary biology ever since Darwin. Crisis in disease is the leap from one adaptation to another, required by the changes in the environment from the ”I-in-the-world“ (in this sense, even the patient‟s own body may become the environment of the “I”, insofar as it is subject to physiological laws). The genesis of the sequence of biological acts is therefore in the processes of adaptation the unity of which is guaranteed by the subject. In this way, what is subjective becomes amenable to historic description and is once again clearly distinguished from the purely psychological aspects.
This historicity of the subject removes it, as such, from the influence the natural laws, but not from all other types of systematic structure for the description of which the physical laws are not suitable. This order, of which the subject is a part, cannot be the classifying-essentialist system of Newton‟s physics. (150) As a historic being, the subject is embedded in traditional connections that reach from those of evolution to the traditions of society, culture, family and the individual life history. On the one hand, this traditional connection creates a bridge towards the basis of all understanding, as it is ”located“ by Heidegger in the pre-philosophical familiarity in the world, and by Gadamer in “prejudice“ (Vorurteil); on the other hand, from an entirely practical point of view, this historicity of the subject leads us back to the narrative context of the life history and case history told by the patient, to anamnesis, which is an opportunity to express and describe it.

Notes
94 Weizsäcker, Viktor v., Der Gestaltkreis, Theorie der Einheit von Wahrnehmen and Bewegen (Theory of the Unity of Perception and Movement), suhrkamp taschenbuch wissenschaft 18, first edition 1973, p. 3
95 Merleau-Ponty, Maurice, Phänomenologie der Wahrnehmung (Phenomenology of Perception), German translation by Rudolf Boehm, Verlag Walter de Gruyter & Co, Berlin 1966.

96 ibid. p. 21
97 ibid. p. 22
98 ibid. p. 23
99 ibid. p. 24
100 ibid. p. 25
101 ibid, p. 30
102 In order to comply with the requirements of political correctness, it must be mentioned at this point that the work of Viktor von Weizsäcker (1886 – 1957) as the tenured professor of Neurology in Breslau during the period of National Socialism must be regarded with a critical eye because the department of Neuropathology headed by him also conducted research using the brains of victims of euthanasia. It is unknown to what extent Weizsäcker was aware of this (regarding this question, see: Hoffmann, Sven Olaf, Viktor von Weizsäcker: Arzt and Denker gegen den Strom, in: Deutsches Ärzteblatt 2006, 103(11): A672-674). However, this biographical problem should not be allowed to obliterate the merits of Weizsäcker„s work, to which tribute has been paid on an international level. Similar criticism from a biographical point of view may be mentioned in connection with the evaluation of Martin Heidegger‟s work.
103 Weizsäcker, Viktor v., Der Gestaltkreis, Theorie der Einheit von Wahrnehmen and Bewegen (Theory of the Unity of Perception and Movement), suhrkamp taschenbuch wissenschaft 18, first edition 1973. Wahrnehmung, p. 28 et seq., Der Gestaltkreis, p. 219 et seq.
104 ibid. p. 35
105 ibid. p. 49 et seq.
106 ibid. p. 35
107 ibid. p. 33
108 ibid. p. 40
109 ibid.
110 ibid. p. 43
111 ibid. p. 51
112 See the chapter on “The concepts of organism, vital force and wholeness in Hahnemann‟s works“
113 See, for instance, Place, U., Is Consciousness a Brain Process, in: British Journal of Psychology, 47/1956 (see also : Stanford Encyclopedia of Philosophy, http://plato.stanford.edu/entries/mind-identity/)
114 See Vetter, Wörterbuch der phänomenologischen Begriffe, p. 162: By extension, experience (Erlebnis) includes all experiences to be found in the stream of experiences (Erlebnisstrom), i. e., the actual and potential cogitationes as well as all other “real“ moments of this stream. Intentional experiences include sensation data and feelings.
115 Concerning this point, see also the considerations in the chapter entitled “The concept of freedom from prejudice in Hahnemann‟s works“
116 Weizsäcker, Der Gestaltkreis, p. 159
117 ibid. p. 172
118 ibid. p. 164
119 ibid.
120 Heidegger, Being and Time §7
121 Weizsäcker, Der Gestaltkreis, p.165
122 ibid. p. 163
123 Weizsäcker, Der Gestaltkreis, p. 245
124 ibid. p. 246
125 ibid. p. 247
126 ibid. p. 247 / 248
127 ibid. p. 251
128 ibid.
129 ibid.
130 ibid. p. 258
131 ibid. p. 259
132 ibid. p. 262
133 ibid.
134 ibid.
135 ibid. p. 268
136 ibid.
137 ibid. p. 275
138 ibid.
139 ibid. p. 276
140 ibid.
141 ibid. p. 277
142 ibid.; what is timeless annihilates time; but any recurrence must happen in time.
143 ibid. p. 254
144 This is not, by any means, intended to be understood as a rejection of the method of analyzing physical and physiological processes governed by the laws of nature, but only as a rejection of the use of the reductionism applicable to natural sciences led by physics for the description of living systems.
145 See the chapter on „Healing“
146 Weizsäcker, Der Gestaltkreis, p. 251
147 ibid. p. 254 / 255
148 ibid. p. 262
149 Weizsäcker gives examples of experiments in which it was shown that from the abundance of given possibilities of perception, the eye does not perceive the movement that actually took place but that which corresponds to the physical laws of nature. The motor functions usually also follows the physical minimum rule which is usually unknown to the bearer of the organ. (p. 264)
150 See Mayr, Ernst, Die Autonomie der Biologie, 2002 (http://www.biologie.uni-hamburg.de/b-online/d01_“/autonomie.htm , 15.11.06)

Author: Susanne Diez, MD.
Selected excerpts of her Diploma thesis to obtain the degree of “Magistra of Philosophy“ at the Faculty of Philosophy and Educational Sciences of the University of Vienna. January 2007.
Translated by Ulrike Vetter.