An Interview with Massimo Mangialavori, M.D.


[Tim Shannon]

A parting note about Massimo Mangialavori’s teaching:

I’ve been studying with Massimo Mangialavori since 1998. He talks about studying materia medica via cured cases. This has become a growing and profound reality for me. Of course learning from the provings and repertory are always important. However, I was never able to read materia medica and understand symptoms and how it might apply to a patient. But once one has seen a cured case, whether someone else’s or one’s own, that is the beginning of understanding a Rx. By extension, this also helps to learn the family of the symptoms.

Another fundamental teaching is that of learning to see the greater themes or trends in a patient rather than just symptoms. He also talks a lot about understanding symptoms and people by looking

at the underlying strategy of the patient - how they are getting their needs met as constrained by their pathology. These lessons have particularly helped with autistic patients, unwilling teens, and some delusional patients. Often these patients won’t give us some of the deeper symptoms we prefer. Using themes, and patient strategies has helped to solve some very difficult cases where the patient was unable or unwilling to disclose deeper details.

As examples, I currently have two autistic boys who were unable to speak. One case is doing wonderful on Lac Felinum, the other on Coca. I also have a paranoid delusional patient who was adamantly claiming she had no problems or complaints– physical or mental. She was brought in by her daughter, who in a separate interview revealed some very intractable paranoid delusions.

That patient is doing wonderful on Thea. The above cases were solved using the larger themes and strategies of the patients rather than looking for symptoms that were simply not available.

Using Massimo’s specific theory of families was also fundamental to solving these cases as well as many others.

Massimo also uses a lot of contemporary psychology to elucidate a more contemporary understanding of the psyche. Besides teaching with his long term cures, he also shows his deeper understanding of the patient and symptoms from many different angles. This has helped me to truly understand Rx’s, instead of just seeing a Rx as a list of symptoms. It is hard to use words to convey how profoundly this teaching has impacted the accuracy and ease now common in my practice.

In the beginning as a student, one needs to borrow other good prescribers knowledge by studying their long term cured cases. But as I’ve seen good cures of many families of symptoms, rare as well as common symptoms, it has completely altered my perception. It is common now for me to give a symptoms that works well and deeply right from the initial intake, doing all the repertorization and differential during the initial intake (mine are 2 hours or less).

As my working body of knowledge has expanded I’ve seen more and more cures with a full range of symptoms. I mostly credit this to Massimo’s grounded clinical knowledge as well as my own growing database of long term cured cases. Massimo’s teaching is about learning how to fish for oneself. It has helped me to grow and express my love of homeopathy via beautiful and growing success with my patients.


Interviewed by: Heather Knox American Homeopath; 1999, Vol. 5, p4

Looking at an oak tree, we can describe it as:

A large piece of wood reaching toward the sky

A  mixture  of  acorns  and  strange  leaves  with  large  indentations  around  the  edges

attached to heavy branches

A gigantic and immobile creature which is noisy on windy days

A future winter without heating problems.

All these symptoms  are  somewhat useless  and  confusing if one  does not understand

the basic concept of a tree.  Once this is known it is relatively easy to accommodate

more  detail.    So  too  with  homoeopathic  medicine.    If  described  out  of  context,  the

symptom  appears  like  a  lost  fragment;  it  is  meaningless.    On  the  other  hand,  if contextualised  and  anchored  to  a  larger  conceptual

framework  (i.e.    a  tree),  it becomes meaningful and can be understood

(Mangialavori, 2010: 35)


AH: One of the things I am inspired by is your knowledge of the homeopathic materia medica. Can you tell me how you learn about a remedy?

Mangialavori: I have learned the most important things about remedies from my own cases. What I like most is to have a living picture of a remedy. The material we have in our books and in the repertories is mostly very "cold" and not so instructive, at least apart from the socalled polychrests. When I was first learning, most teachers gave just their opinions, which often were mere repetitions of repetitions of repetitions. Very few teachers were able to deliver authentic and reliable information, which I believe are necessary steps to a deeper understanding of a remedy picture.

I was astonished to see how little connected to the reality of cured cases the teaching could be. I have been to many seminars where people had very strange ideas about certain remedies. They were able to speak in an amazing, brilliant and fantastic way about these ideas but mostly what they taught was not attached to the reality of cured patients. I insist that it is more important to have good cures than to have brilliant ideas. These cures should be documented. This is what Hahnemann taught us.

I consider a well-documented case to be the story of the patient, the patient's suffering and the patient's healing process, reported over a long time (at least one to two years), in the patient's own words and not simply the connection of symptoms. I am very disturbed when I read case reports that are nothing but a list of symptoms. I totally disagree with this. I think that this is allopathic, not homeopathic thinking. We criticize the allopaths for making their diagnosis only on some pathological symptoms; but it is exactly the same attitude when you come to a homeopathic remedy by saying this patient has a fear of thunderstorms, a desire for salt and a desire for ice cream and therefore it is a case of Phosphorus. It is like saying "there is this or that amount of red blood cells, protein, sodium, etc." It is exactly the same as allopathic thinking. From this you cannot derive any understanding of the patient. I believe the only way to get a vivid experience of a remedy picture

is to collect well-documented cured cases. Until you have seen a cure from a remedy, using all your senses to see what was really healed -what the process was- how can you have a clear experience of such a remedy? This is the only way in which everyone of us can develop a clear experience with a remedy.

So, to come back to your question, I have collected those of my cases, where the remedy had worked in both the patient's chronic and acute conditions, and for a long time. Then I studied this material thoroughly for a better (and more often for a first) understanding of a remedy. I tried to find out what was common in the cases and in the stories of the patients, in the irwords, explanations and descriptions of their state and the history of this state. This, I believe, is crucial and absolutely necessary if you want to develop as a homeopath rather than relying on very dry second-hand information. Your own work is your best teacher.


AH: You have spoken about the importance of studying well documented cases. You mentioned that you are working on the Delphi Project?

Mangialavori: Yes, it is something I am seriously involved with because I have to say that I am really fed up with this mass of material that we have and which contains just copies of copies of copies of other books. I think this is totally useless. I don't understand why homeopaths need to write books on remedies that don't belong to their own range of experience. It's stupid and it is also risky.

If you have good ideas and good experiences about some remedies, it is better to write about them and nothing else. Thus, much good old information becomes diluted and further diluted until it's just a watery soup. In our Delphi Project, which is still in its initial phase, we are collecting cured cases where both the case report and the follow-ups are carefully documented. What our time needs most is authentic and valid information about experiences with remedies in cured people. After a certain number of cases have been collected the aim is to review them and to publish the essentials or themes which could be derived from such cases. This alone can be the material of a real materia medica viva.


AH: You talked about developing a vivid picture to learn remedies. What would you suggest to students for studying materia medica?

Mangialavori: The best way to study materia medica is to study well-taken and well-treated cases. You can call yourself lucky if you find a teacher who follows this very practical model of teaching.

2nd suggestion it is very useful to have an idea what the remedy substance is. I don't think you can use Aurum successfully without knowing that Aurum is gold; you can't use Bufo without knowing that Bufo is a toad.

Unfortunately, our homeopathic literature gives very little information about the substances, therefore you have to find sources yourself. We do have a lot of very useful biological, chemical, physiological, pharmacological and -what is also very important- anthropological and medical historical information about the relation of all these minerals, plants and animals with human life. All this information is of the utmost interest to us and can very often lead directly to the center of a much deeper understanding for the use of a homeopathic remedy. These studies must include all relevant material wherever it may come from and without any prejudice. Old mythological narration and fairy tales which center around a plant, for example, can be very instructive. Very often you can detect an essential focus of a remedy in the history of its use or in its name.

You might get very precious information about indications for a snake remedy through studying the life of these animals.

3rd suggestion concerns our homeopathic materia medica itself. When studying remedies, we have two problems. Very often, when remedies are well known, we have too much information.

On the other hand, when remedies are not well known we have too little information. The challenge is to gather the information in such a way that you either enrich or reduce it by grouping it as "themes." By themes I mean collecting a group of symptoms that have something in common, in which there is a connection, which can help you to understand the remedy. The most important reason for using themes is to arrive at a level of information that is very characteristic for this substance. Here you have two classes of symptoms in a remedy: those symptoms, belonging to the central "themes" and the others that don't. A symptom which can be connected to a central theme is more likely to be of value in prescribing that remedy than any other symptom because it is closer to the core of that remedy. My approach to studying remedies -and to make these studies more vivid- is therefore a threefold one: to use both homeopathic and non-homeopathic material and to study well cured cases. I think our model of thinking is a very complex one and if you focus only on the proving-symptoms and nothing else it becomes one-sided and much less efficient.


AH: I think you have made studying the remedies very fun.

Mangialavori: [laughing] Yes. If I don't have fun I can't practice anything; it is an essential part of life. If you don't have pleasure in what you are doing it becomes senseless.


AH: What do you think is the biggest weakness in the way homeopathy is practiced today?

Mangialavori: I think there are many.

1st I have the general impression that the difficulty of practicing homeopathy is widely underestimated and many in the field are mere amateurs and poorly prepared to do the job. This is mainly

due to inappropriate teaching.

2nd many focus on psychological analyses of cases, patients and remedy-pictures with very little professional experience. We are flooded with ready-made, self-created, homeo-psychological interpretations. Psychology, like medicine, is a science that has to be studied. The psychological and medical handling of a patient is a very difficult matter for which you have to be thoroughly trained. This is even more true if you do it in a homeopathic way.

Another big threat to our profession is the carelessness and irresponsible attitude with which quite a few publications present remedy-pictures or provings. Without presenting their sources, without any sufficiently observed and documented cases, the authors claim to detect cores, essences and whatsoever of the newest and latest remedies as if they were partaking in a race. In these discussions I am missing the patience as well as the patients.


AH: Do you think homeopathy is in a transition right now?

Mangialavori: Homeopathy has been developing for more than 200 years and has always been in transition. Now we have to consider how to practice it in a contemporary and very professional way, using the tremendous knowledge coming out of other scientific fields and finally realizing our possibilities of individualizing have been used far beyond the method's borders.

A good step forward has been that most of us no longer believe it is possible to cure 80% of the diseases with a dozen remedies, as some homeopaths once taught. But instead of proving one new remedy after the other, I would prefer to increase and concentrate our work on elaborating information about the 1500 "known" remedies, most of which, in my view, are more unknown than known.


AH: Do you think we are doing too many provings?

Mangialavori: I don't think we should stop doing provings as they are very interesting and are the basis of our work. But instead of constantly inventing new remedies we also need to discover more things about those we already have.

This feeling that we don't have enough, that we have to have more all the time is a disease, the real pathology, of our era. The results, at this moment, don't show a better quality of understanding of our cases. I would prefer to go deeper with what we have.


AH: How does a student make studying the plants as interesting as studying the animals?

Mangialavori: There is no principal difference between the study of a plant or the study of an animal if you know how to find material. There is certainly more material about snakes or spiders than about some rare plants; but on the other hand we have such wonderful plants as the Solanaceae which deliver a huge amount of detailed anthropological and historical and pharmacological (toxicological) information. Read the book Plants of the Gods and you will be cured of your doubts that the study of plants might be boring.


AH: Recently people have been concerned about a school of thought that is teaching that there is not only one simillimum. How do you feel about that?

Mangialavori: This discussion has been going on since the time of Hahnemann. It is a typically senseless theoretical dispute. Similarity means similarity and not identity. Life is an individual phenomenon unless you clone an organism. Therefore, it is very clear that similarity can be something more or less, from this view or that view, and there is no precise method to judge similarity in homeopathic terms in any other way than to give a remedy to the suffering organism and see how the vital force reacts. The law of similars is a law that exists not in reality but as simile (a possible remedy in terms of similarity) as well as the simillimum (the best possible remedy in terms of similarity); both are theoretical constructs or hypotheses referring to a diseased state and not existing in reality until you can demonstrate a cure. The quality of the cure can be judged best by the patient who will say "I am better" or "I feel cured." This is the difference between the simile and the simillimum.


AH: So you think there is one simillimum and that the other remedies are on the way to it?

Mangialavori: Again, nobody can say, how many similes and how many simillimums a disturbed vital force can theoretically respond to in nature. This idea of the simillimum is a theoretical concept; it is something you fix your attention on. You look where the arrow is pointed. The simillimum is both the center of your target and your arrow. But there are other targets and other arrows. The simillimum happens when you are able to shoot your arrow close to the center. Sometimes it happens but not in the majority of our prescriptions.


AH: So ultimately you do believe in the simillimum?

Mangialavori: I believe the simillimum is a workinghypothesis we use to get close to a cure.


AH: What impressions do you have of homeopathy in North America?

Mangialavori: It is very difficult to say. I sense people are lively, enthusiastic and open minded. This is my first impression. But I also feel that the cultural background, the education is very

different from my own. In fact, I cannot really judge what is happening here and I would like to have more time to observe.


AH: Do you have any words of advice for a new student?

Mangialavori: First, do not be too impressed by big names and old men's talk because many old teachers in homeopathy are very dogmatic and could easily make you give up your sensitivity and critical attitude in front of their authority. Especially from S. America there is a dogmatism which is a mixture of religious narrow-mindedness and the pretension "to know what Hahnemann really thought." This approach is absolutely lifeless and counterproductive. I can say this because I fell amongst those teachers in my beginning and it was an awful waste of time. Endless discussions about miasms, a theory Hahnemann developed but which nobody has ever really understood in its practical value. I don't like the approach about miasms because it is mere theory and does not have much to do with today's reality.


AH: So don't study miasms?

Mangialavori: No, I wouldn't go that far. But I would like to warn students to avoid becoming fixed in this kind of theoretical study and discussion. It's nothing but a possible explanation, an historical model of understanding. I don't want to give you the impression that I totally reject these thoughts of Hahnemann but I believe we have other and better knowledge today that renders this approach quite unnecessary.


AH. Did you just finish a book?

Mangialavori: I am very lazy about this. This first book, I should have finished four years ago. I have rewritten it four times.


AH: Is it published?

Mangialavori: No, not yet, it should be finished by the end of this year. I hope. It is a book about spiders in homeopathy. It will be published in English and German first.


AH: Good! What is your next book?

Mangialavori: Probably a book about what we can call, in homeopathic terms, the Solanaceae family. It will be about the remedies close to Belladonna but not only plants from the botanical Solanaceae family. My idea about families is something larger and not exactly the same as in biology and botany. I have often been misunderstood. In my beginning teaching I presented coherent biological groups like the spiders or snakes and people thought a biological relation alone would suffice to make a homeopathic relationship. This is sometimes but not always true. A true homeopathic family integrates members from other kingdoms if their themes are related. For example, Lyssinum is a nosode from the saliva of a dog with rabies, but from its homeopathic materia medica themes,

it belongs definitely to the Solanaceae family. This is underlined by the fact that Belladonna, Hyoscyamus and Stramonium are well known for their healing properties in the rabies disease.


AH: Do you have other books brewing?

Mangialavori: I have enough material for quite a few books. The snakes around Lachesis, the spiders around Tarantula, the sea remedies around Sepia, the Umbelliferae around Conium, the Compositae around Arnica, the Coniferae around Thuja and not to forget the so-called drugs like Cannabis, Opium, Anhalonium - substances that were traditionally used as drugs in different cultures. Each world culture has its own special drugs: Coca in S. America, Anhalonium in mid-America, Cannabis in North Africa, Opium in the Middle East, Agaricus in Siberia, Kava-Kava in Polynesia. These drugs are very interesting because these substances were originally used to alter consciousness, to discover one's relationship with God. The idea of God is different all over the world and each culture uses a different substance and a different approach although they also have many important features in common. I have researched this material and have good cases too and

I would like to work more on it.


AH: How do you find time to write?

Mangialavori: This indeed is a problem, considering that I have a family. And then there are my two horses and some other animals too. It is absolutely necessary to protect your private life and to have time for yourself to recover and recreate your energy. In the beginning when I decided to give seminars it was just for fun and because I wanted to share some experiences. I did not feel like

a teacher. Since then teaching has become an important part of my work, and I can even say of my life, and it takes many, many weekends. Sometimes it has become a burden because I receive so many invitations and I have a hard time saying "no!" to somebody. Therefore I have had to learn to use my time in a more economical way, giving breaks to myself, and enjoying freedom from too much responsibility.


AH: You were telling me that in the morning you shovel manure and contemplate life. Tell me about this...

Mangialavori: It is true, I have two horses, a male and a female of course, and I have to take care of them. They are Pintos, spotted white and black and I chose these horses, because they are not well known and not so much appreciated in Italy. I live in the countryside in northern Italy. I bought an old farmhouse there but I did not imagine how much time, energy and money would be needed to restore it!


AH: You have two children?

Mangialavori: Yes, the girl, Magdalena is 10 and the boy, Samuel is 8. They are the most important things in my life. I assisted at their births. They were born in my house. I am very close to them.

I like that they are in contact with animals: dogs, cats, horses. I was in Milan until I was 8 years old and I had no contact with nature. To me this was a disaster. I suffered a lot for this. So I wanted to offer this to my kids. This is the reason why I moved to the countryside.


AH: So the manure in the morning?

Mangialavori: Ah, the manure in the morning! If you have a horse you have to clean the stable. It is very nice, because you remain very attached to the ground and to the manure of your animals.

I can think for half an hour while I use my hands and I even have a product, something I can use for my garden, which is very good for the ground I am living on. I believe it is a good exercise,

a kind of meditation, and it is good for your physical body, too. And finally, it reminds you of what you are doing here on earth.


Die „ kleinen Mittel“

Fragen an Dr. Massimo Mangialavori

Dr. Mangialavoris Erkenntnisse beruhen zum großen Teil auf eigenen Beobachtungen, die er mit großer Ruhe und Geduld vermitteln kann. Das nachfolgende Gespräch über „kleine Mittel“ hilft auch dem erfahrenen Homöopathen, die Möglichkeiten seiner Heilkunst auszudehnen und Perspektiven zu erweitern.

Dr. Mangialavori lebt in Solignano (Norditalien).

Seine ureigenen Seminare finden alljährlich auf Capri statt, er lehrt jedoch auch in Amerika, Deutschland, Israel, Holland und Großbritannien.


Rainer Ginolas: Dr. Mangialavori, was verstehen Sie unter dem Begrifff „kleine Mittel?“

Dr. Massimo Mangialavori: Ich mag den Begriff „kleine Mittel“ nicht sehr, ich denke, er ist nicht korrekt. Ich hege die Ansicht, daß in unseren Repertorien und Arzneimittellehren eine Anzahl Mittel präsentiert werden, die wir besser kennen als andere. Einige kennen wir wenig, einige zu wenig, andere hingegen sind gut bekannt, werden aber nicht mehr genutzt. Und wieder andere sind gut bekannt, wurden aber nie nach ihren tatsächlichen Möglichkeiten genutzt. Wenige von diesen Arzneien, eigentlich sehr wenige, haben mit der Zeit aus verschiedenen Gründen den Teil der Mittel übernommen, die zu häufig und auch unkorrekt angewendet werden - die Polychreste. Von diesen meinen wir, vielleicht genug zu wissen und haben eine Vielfalt klinischer Informationen; und trotzdem, diese Mittel werden in einer Art und Weise verabreicht, die sehr vage und nicht akkurrat ist.


Rainer Ginolas: Der Begriff „kleine Mittel“ heißt also nicht etwa, daß wir über ein Gruppe von Mitteln reden, die klein in ihrer Wirkung sind?

Dr. Massimo Mangialavori: In der Tat glaube ich das nicht. Ich denke, es gibt viele Gründe, die einige Kollegen im Lauf der Zeit dazu geführt haben, eine derartige Hypothese zu erstellen. Vor allem hat sich seit dem Zeitalter der Aufklärung ein großer Teil des medizinischen Denkens weiter und weiter abgekehrt, hin zu einem „reduzierten Modell“. Viele Homöopathen haben sich dieser Gedankenrichtung angepaßt und gelangten so zu einer derzeit stark reduzierten und gefilterten Anzahl an Arzneimitteln.

Es ist ohne Zweifel offensichtlich einfacher, Hypothesen aufzustellen, die darauf abzielen, zu zeigen, warum eine bestimmte Therapie nicht wirkt, als einzugestehen, das das Verschreiben eines bestimmten Mittels vielleicht nicht das Bestmögliche war. Außerdem sind wir davon ab, die Homöopathie wie früher zu praktizieren, als nur wenige Mittel gebräuchlich waren und nur ein begrenztes Repertorium zur Verfügung stand. Das Repertorium wurde mittlerweile durch ständige Nutzung und Anwendung erweitert.

Das erlaubt den Homöopathen, weitere Möglichkeiten auf der Basis der beobachteten Symptome zu nutzen, an statt sich nur auf die eigene Erfahrung zu beschränken.

Eine andere Begrenzung lag, vielleicht nicht ganz bewußt, in der geringen Anzahl von Arzneimitteln, die sich in den meisten Fällen, in der Apotheke der Homöopathen befanden. Ich glaube, daß auch das dazu beigetragen haben könnnte, das man sich auf einen kleinen Teil der Mittel beschränkte, insbesondere bei den Verschreibungen in akuten Fällen. Diese letzte Beobachtung halte ich für besonders wichtig bei der Bewertung des häufigen Gebrauchs einiger Mittel, die in akuten Fällen verschrieben werden. In der Tat hat auch das Übermaß der repertorialen Symptome dazu beigetragen, die Polychreste mißzuverstehen, wie es auch dazu beigetragen hat, die Mittel, deren Symptome im Verhältnis zu den weniger bekannten Mitteln gut vertreten sind, überzubewerten.


Rainer Ginolas: Dann würde der Begriff „kleine Mittel“ auch nicht heißen, das die Wirkungsweise eher lokal begrenzt ist?

Dr. Massimo Mangialavori: Auch dieses glaube ich nicht. Zumindest entspricht das nicht meiner Erfahrung. Seit 15 Jahren arbeite ich so, als ob alle Mittel gleich wichtig und effizient sind. Und ich glaube, daß der einzige Unterschied darin besteht, daß einige Mittel mehr oder weniger bekannt sind und in der Praxis mehr oder weniger Anwendung finden. Zu Anfang meiner homöopathischen Praxis habe ich viele Kollegen und anerkannte Lehrer gehört, die genau das behaupten, aber ich muß Dir gestehen, dass mich das nie überzeugt hat. Es erschien mir immer als Widerspruch, daß auf der einen Seite die umfangreiche Arbeit steht, die Suche nach den Anwendungsmöglichkeiten der Mittel ( =Arzneimittelprüfung) und auf der anderen Seite dagegen das Einschränken der Möglichkeiten auf wenige Substanzen. Für mein Dafürhalten ist es jedenfalls tröstlich, daß bei einigen interessanten Verläufen die sogenannten „Kleinen Mittel“ in eher schweren Fällen verschrieben wurden, wohingegen nach meiner Ansicht, und der anderer Kollegen, ein Polychrest weniger gute Resultate erzielt hätte. Meine Erfahrungen und Erkenntnisse waren mir sehr hilfreich und haben

mich dahin gebracht, eine Methode des Studiums homöopathischer Mittel zu entwickeln, die es mir erlaubt, bei der Verordnung präziser sein zu können. Ich arbeite immer ausgehend von der Voraussetzung, daß grundsätzlich jedes Mittel verschrieben werden kann, ohne mich von Anfang an darauf zu beschränken, nur wenige Substanzen nutzen zu können. Ich forsche noch weiter in diese Richtung und denke, daß ich noch einen langen Weg vor mir habe. Doch ich bin zufrieden mit den Ergebnissen, die ich erziele. Auch bestärkt es mich darin, weiter zu forschen und zu beobachten, daß viele Kollegen, die einigen meiner Ansichten folgen, sehr ermutigende Ergebnisse hervorbringen.


Rainer Ginolas: Dann bedeutet der Begriff „ kleine Mittel“ demnach eigentlich „nicht gut bekannte Mittel?“

Dr. Massimo Mangialavori: Genau! Das Problem ist, nach welcher Strategie man eigentlich vorgehen soll, wenn man im praktischen klinischen Alltag zu verordnen hat.

Ausgehend von der Prämisse, daß tatsächlich alle Mittel effizient sind, müssen wir eine angemessene Forschungsmethode finden, ein Modell, das uns erlaubt, die Forschungsergebnisse geeignet auszuwerten. Ohne Zweifel ist die weitere Forschung sehr wichtig und auch hier haben wir noch einen weiten Weg vor uns. Ich meine, daß auch der beste praktische Versuch nicht die einzige Möglichkeit ist, gute Informationen über die Effizienz einer Sache zu erhalten. So habe ich in den letzten Jahren versucht, Hypothesen zu erstellen, die mir erlauben, Mittel aufgrund derjenigen Informationen zu verschreiben, die mir bis dato vorliegen. Denn wenn man auf die Prüfungsergebnisse aller Substanzen, die zur Auswahl stehen, warten würde, müßte man sicher weit länger leben, als einem möglich ist. Ich meine, es ist in keiner Wissenschaft verboten, Hypothesen aufzustellen. Das wichtigste dabei ist, diese anhand von Ergebnissen zu belegen. Deswegen habe ich nützlicher Forschung, die unerläßlich ist, bei der Erforschung von Symtomen, wie wir es in der Homöopathie machen. Aber ich glaube auch, daß jede gute Prüfung bis zur klinischen Bestätigung der Symptome, die sie hervorgebracht hat, eben nur eine Prüfung bleibt. Es scheint mir logisch, daß eine beliebige Substanz nicht als „Heilmittel“ angesehen werden kann, solange sie nicht mit guten Ergebnissen in der Klinik angewendet worden ist. Meiner Ansicht nach ist die Prüfung ein „Gesichtspunkt“, ein grundlegender Gesichtspunkt für den Homöopathen, aber ich persönlich ziehe es vor, nicht dabei stehenzubleiben. Nicht zufällig sind die ersten Prüfungen homöopathischer Arzneimitteln fast alle von bereits vorhandenen Vorkenntnissen über die betreffende Substanz ausgegangen. Und diese Kenntnisse kamen aus den unterschiedlichsten Wissensgebieten. Die gedankliche Vorstellung, und manchmal auch die Intuition, die zu der Vermutung führt, daß eine bestimmte Substanz zu einem Heilmittel werden könnte, entsprang aus Kenntnissen der Toxikologie und Pharmakologie, aus der Anwendung von Heilpflanzen oder verschiedenen Medizinen schon in der Antike - aus der Tradition, manchmal aus Mythen, dem Volksglauben oder anthropologisch zu bewertenden Phänomenen.

Im Falle der Tarantula zum Beispiel hat man jahrhundertelang geglaubt, daß eine bestimmte Art von Krankheit, Choreomanie (Tanzwut) genannt, durch das Gift einer Spinne verursacht würde,

und daß diese Krankheit nur durch ein bestimmtes Ritual geheilt werden könne, das hauptsächlich aus einer bestimmten Art von Musik bestand. Die Quellen, aus denen wir unser Material entnommen haben, sind äußerst unterschiedlicher Natur, und es ist ganz und gar nicht einfach, eine plausible Erklärung für die Bedeutung dieser Beziehung zwischen Mensch und Natur zu geben, ohne in Diskussionen magischer oder philosophischer Natur hineinzugeraten, die heute leider sehr weit entfernt von der akademischen medizinischen Wissenschaft zu sein scheinen.

Am Anfang meiner Untersuchungen war ich praktisch gezwungen, außerhalb unserer homöopathischen Literatur zu forschen. Ich empfand das Bedürfnis, mehr über die Arzneimittel zu erfahren,

die nicht ausreichend experimentell erprobt waren und infolgedessen in der Klinik nicht verwendet wurden. Zu meiner großen Überraschung habe ich festgestellt, daß es eine „Kohärenz“ in den unterschiedlichen „Beschreibungen“ gibt, die der Mensch von den verschiedenen Substanzen, die wir als Heilmittel verwenden, geliefert hat. Es ist faszinierend zu sehen, wie wir das, was ich die „Hintergrundthemen“ eines jeden Heilmittels nenne, in der Toxikologie, in der Pharmakologie, in der traditionellen Anwendung, ja sogar in den Volksmythen wiederfinden können.

Der Mensch hat versucht, seine Beziehung zur Natur, in der er lebt, auf die unterschiedlichsten Arten zu beschreiben -von der Poesie bis zur wissenschaftlichen Forschung- und oft treffen am Ende dieselben Auffassungen wieder zusammen. Das ist der Zusammenhang, den ich suche, wenn ich ein homöopathisches Arzneimittel erforsche.

Jede Substanz muß, um in unseren Augen als solche zu gelten, in einer Art „Struktur“ aufgebaut sein. Diese Struktur und die Umwelt, die sie umgibt, beeinflussen sich gegenseitig auf dynamische Weise vermittels einer Reihe von Strategien, die angewandt werden, um diese Substanz, so wie sie ist, zu erhalten. Die Homöopathie mißt den endogenen Mechanismen für ein System, die dazu dienen, dieses System im bestmöglichen Gleichgewicht zu halten, eine vorrangige Bedeutung zu. Ein gutes Heilmittel stimuliert diese Mechanismen und wir sagen, daß es „heilt“. Die Erforschung dieser Strategien in der Physiologie einer Substanz scheint mir den Strategien, die in der Pathologie eines Systems angewandt werden, das mit dieser Substanz geheilt wird, sehr ähnlich zu sein.

Im Grunde sind genau das die Phänomene, die wir während einer Arzneimittelprüfung und während der klinischen Anwendung beobachten.

Unser Problem, auch angesichts einer gut durchgeführten Prüfung, ist immer der Versuch, zu verstehen, was wirklich wichtig ist bei der Betrachtung, sonst bleibt auch die beste Arzneimittelprüfung nichts anderes als eine Auflistung von Symptomen, ohne jede Logik, ohne jede Organisation und ohne Seele. Auf dasselbe Problem stoßen wir angesichts einer ähnlichen Liste von Symptomen, die wir durch die Klinik bestätigt finden können.

Das große Problem bei den Polychresten ist, die Untersuchung von tausenden von Symptomen vorzunehmen und eine vernünftige Synthese herzustellen. Im Falle der sogenannten „kleinen Heilmittel“ ist das große Problem genau umgekehrt. Mein Untersuchungsmodell beruht auf einer vertieften und erweiterten Erforschung der Substanzen, die wir für die Herstellung eines homöopathischen Heilmittels verwenden. Natürlich messe ich der Tatsache, daß die Symptome der Prüfungen durch die Klinik bestätigt werden, allergrößte Wichtigkeit bei, aber ich suche immer womöglich auch nach Informationen außerhalb der Homöopathie. Meine Absicht ist es, zu einer Synthese zu gelangen, die mir entweder hilft, die Vielfalt an nutzlosem Material bei den Polychresten zu reduzieren, oder die Kenntnisse über die weniger bekannten Heilmittel zu erweitern und zu präzisieren.

Ich möchte nochmals unterstreichen, daß am Ende dieses Prozesses die Bestätigung dieser Hypothesen durch eine beträchtliche Anzahl erfolgreich behandelter klinischer Fälle stehen muß. Andernfalls wage ich nicht, von einem Heilmittel zu sprechen und nehme auch keine Ergänzungen zu meinem Repertorium vor.


Rainer Ginolas: Könnte es ein Hinweis für die Richtigkeit des Mittels sein, wenn jemand eine auffällige Abneigung, oder umgekehrt, eine starke Sympathie für Schlangen oder Spinnen aufweist?

Dr. Massimo Mangialavori: Das glaube ich eigentlich nicht. Ich halte das für einen sehr oberflächlichen Ansatz. Es stimmt zwar, daß ein Patient, der gut auf ein Arzneimittel reagiert, das von einer Spinne stammt, eine enge Beziehung zu diesem Tier hat, aber das trifft auch für viele andere Heilmittel zu. Ich glaube, Hahnemann hatte Recht, als er gegen die oberflächliche und ungeeignete Verwendung der „Kennzeichnungen“ zu Felde zog, wie sie zu seiner Zeit üblich war. Aber bis heute scheinen sich die Dinge leider nicht sehr geändert zu haben.

Ich persönlich meine, daß die analoge Beziehung zwischen dem Menschen und der Natur, in der er lebt, von wesentlicher Bedeutung ist, sonst könnten wir uns nicht erklären, wie es möglich war,

den therapeutischen Nutzen so vieler Pflanzen zu kennen, ohne irgendwelche Kenntnisse von Chemie oder Pharmakologie zu haben. Heute leben wir in einem Zeitalter der Wiederentdeckung und der Aufwertung der Bedeutung von Analogien, die ich persönlich ohne Einschränkung teile. Aber eine Analogbeziehung ist eine Erfahrung, per definitionem ist es etwas, das man mit Worten nicht beschreiben kann, ohne daß es in erschreckendem Umfang an Bedeutung verlöre. Es ist kein Zufall, daß die Kulturen, die sich auf eine analoge und „magische“ Annäherung an die Natur stützen, diese Kenntnisse überliefert haben, ohne sich der Schriftform zu bedienen, sondern vielmehr der Verwendung von Symbolen den Vorzug gaben. Ich glaube, daß es sehr riskant ist, den Begriff der Kennzeichnung auf dermaßen banale Beziehungen zu reduzieren.


Rainer Ginolas: Es gibt viele gut bekannte Mittel, die in bestimmten Fällen ziemlich zuverlässig helfen - Arnica bei Verletzungen, Cantharis bei Sonnenbrand, Apis bei Bienenstichen usw.

Gibt es Beschwerden, bei denen man „kleine“ oder unbekannte Mittel mit derselben Wirksamkeit einsetzen könnte?

Dr. Massimo Mangialavori: Das Beispiel, das Sie anführen, bezieht sich auf die akute und symptomatische Anwendung einiger Arzneimittel für einige Beschwerden, die wir meiner Meinung nach nicht als Krankheiten bezeichnen können. Außerdem beschäftigt sich der homöopathische Ansatz per definitionem mit den Kranken in ihrer komplexen Gesamtheit. Dieses ungeachtet gibt es verschiedene, wenig bekannte Arzneimittel, die ich in akuten und sehr genau beschriebenen Situationen für wirkungsvoll halte. Mir kommt Bellis perennis in den Sinn, das ich bei Brüchen oder Eingriffen am Uterus, auch bei Tieren, mit besseren Ergebnissen einsetze als Arnica.

Phellandrium und Medusa, um die Milchproduktion zu stimulieren.

Buthus australis bei akuten Lebensmittelhepatitiden und gleichzeitigem Ikterus.

Pituitaria anterioris bei beginnenden Nickelallergien.

Chininum sulphuricum in der Malariaprophylaxe. Und viele andere, aber ich muß Ihnen gestehen, daß ich stets eher zurückhaltend bin, mit der Nennung von Beispielen dieser Art.


Rainer Ginolas: Behandeln Sie Hauterkrankungen, wie z. B. Neurodermitis, ebenfalls mit kleinen Mitteln?

Dr. Massimo Mangialavori: Ich halte die Unterscheidung zwischen einem Polychrest und einem weniger bekannten Heilmittel für sinnlos, sowohl unter einem mehr theoretischen Gesichtspunkt als auch unter dem Aspekt meiner täglichen Praxis; es handelt sich hier um eine rein numerische Frage. Vielleicht scheint es Ihnen selbstverständlich, aber ich suche immer dasjenige homöopathische Arzneimittel, das mir am geeignetsten erscheint. Ich habe die Angewohnheit, jedes Jahr eine Überprüfung der Mittel vorzunehmen, die ich am häufigsten verschreibe, und natürlich gibt es Unterschiede auf der Grundlage dessen, was ich untersuche und besser zu kennen glaube. Im wesentlichen sind mehr als 70% meiner Verschreibungen keine Polychreste, und die Mehrheit der Patienten, die ich behandele, leidet unter schweren chronischen Krankheiten.


Rainer Ginolas: Welche Bedeutung messen Sie Symptomen zu, die auf der Haut erscheinen, z.B. „blutend, nach Kratzen“ oder „Absonderungen, gelb, honigartig“? Haben diese Symptome Gewicht, oder beachten Sie sie weniger, weil sie auf der Haut erscheinen?

Dr. Massimo Mangialavori: Ich glaube, daß alle Symptome potentiell wichtig sind, auch solche, die noch nicht im Repertorium enthalten sind, da sie ausgezeichnete Informationen für eventuelle Erweiterungen desselben darstellen, wenn sie klinisch bestätigt sind. Die Bewertung eines Symptoms der Haut als weniger wichtig gegenüber einem tieferliegenden Symptom ist etwas, mit dem ich nicht einverstanden bin. Die „Tiefe“, mit der Sie ein Symptom bewerten, ist lediglich eine Frage des Beobachtungsmusters, das Sie anwenden. Offensichtlich ist es weniger schwerwiegend, an Juckreiz zu leiden als an einer Depression, aber es gibt zahlreiche Fälle, in denen ein Symptom auf der Haut das einzig mögliche sichtbare Anzeichen für ein Leiden bei einem Menschen ist. Wie tiefliegend dieses Leiden ist, ist nicht so einfach und unmittelbar zu bewerten. Und oft, auch nach mehr als einer Konsultation, gibt es Dinge, die nicht zutage treten, und das kann vielerlei Gründe haben. Das geht von der Beziehung zum Arzt bis hin zur Typologie dieses bestimmten Patienten, dem vielleicht die Worte fehlen, um sein „Übel“ zu beschreiben. Vor allem, wenn Du kleine Kinder, Tiere oder Patienten behandelst, bei denen sich sehr früh ein großes Trauma ereignet hat, zu einem Zeitpunkt nämlich, an dem es nicht möglich ist, verbal auszudrücken, was passiert, zu einem Zeitpunkt, an dem das Bewußtsein nicht in der Lage ist, etwas anderes herauszuarbeiten - dann kann ein Symptom der Haut eine sehr großes Gewicht haben.

Die Charakteristika eines bestimmten Symptoms auf der Haut können bei der Hervorbringung von Symptomen, die ein komplexeres Leiden des Systems ausdrücken, sehr hilfreich sein und sind

eben nicht nur das oberflächliche Bild eines isolierten Symptoms. Ich glaube aber trotzdem, daß dies sehr schwer zu verallgemeinern ist, jeder Fall ist eine Geschichte für sich.


Rainer Ginolas: Was ist der wichtigste Punkt, den Sie während Ihrer Praxisarbeit lernen mußten?

Dr. Massimo Mangialavori: Ich glaube, daß ich dem Studium der Homöopathie zuviel Bedeutung beigemessen habe in bezug auf die Zeit, die ich dazu aufgewendet habe, um mich hinsichtlich der Beziehung zu meinen Patienten auszubilden. Gewiß zwingt mich die Leidenschaft für die Medizin und die Homöopathie jeden Tag zur Konfrontation mit meiner eigenen Unwissenheit. Angesichts dieses Fasses ohne Boden scheint das, was ich lerne und zu kennen glaube, nie genug zu sein. Im Laufe der Zeit denke ich anders über meine Mißerfolge, und meiner Meinung nach ist es nicht möglich, ein ganzes Leben lang zu meinen, es handele sich nur um die Frage, das „beste Arzneimittel“ zu kennen, und einfach nur noch mehr lernen zu müssen.

In der Geschichte der Menschheit bis heute hat es so viele unterschiedliche Auffassungen von der Medizin und der Kunst des Heilens gegeben, und noch viele weitere werden dazukommen.

Der einzige gemeinsame Nenner all dieser Arten von Medizin, die oft Kriterien aufweisen, die sich in augenscheinlichem Gegensatz zueinander befinden, ist die Tatsache, daß es da jemanden gibt, der um Hilfe bittet, und einen anderen, der glaubt, ihm diese Hilfe geben zu können. Was zwischen diesen beiden Personen passiert, ist etwas sehr Komplexes, das wir noch nicht erforscht haben, und das meiner Meinung nach bis aufs Letzte sehr schwer zu verstehen ist. Nach meiner Ansicht hat sich die Homöopathie niemals ausreichend für dieses Problem interessiert, und auch heute noch, zweihundert Jahre nach ihrer Entstehung, und ein Jahrhundert nach den sonstigen grundlegenden Entdeckungen auf dem Gebiet der

Wissenschaft, der Medizin und Psychologie scheint es immer noch so, als wäre das Höchste an Wissenschaftlichkeit bei unseren Forschungen, zu überprüfen, ob die Arzneimittel auf isoliertes Gewebe wirken oder ob es möglich ist, dieselben Kriterien der statistischen Untersuchung anzuwenden wie die konventionelle Medizin.

Ich glaube, wir müssen hier noch sehr viel mehr tun und uns wirklich einem ensthafteren und wissenschaftlicheren epistemologischen Modell zuwenden.

Was ich in all den Jahren gelernt habe ist, daß es zu vieles gibt, was ich nicht weiß, und daß ich nicht alle Patienten heilen kann, die mich um Hilfe bitten. Anfangs hat mich das sehr deprimiert, jetzt empfinde ich das mehr als einen Anreiz, weiterzumachen, ohne zu denken, einfach nur mehr lernen zu müssen. Ich habe mir viele Gedanken gemacht um das, was ich nicht wußte, jetzt akzeptiere ich mit weniger Unbehagen, daß ich trotz allem mein ganzes Leben lang vor einem Geheimnis stehen werde.


Rainer Ginolas: Dr. Mangialavori, ich danke Ihnen für dieses Gespräch.


[Richard Moskowitz]

“Method of Complexity, The Search for Coherence in Clinical Phenomena”

Because of limited time and space, I will simply highlight a few of the items that caught my fancy along the way. I love the fact that he begins with the Doctrine of Signatures and even seems to agree with the fundamentalists that such trivial resemblances as the yellow color of Chelidonium and that of the bile, for example, fall short of a genuine affinity. But that is only because he is interested in the deepest levels of meaning, precisely what the old school insists on steering clear of, arising from the core of each remedy as a unique system of adaptation to its natural habitat, and including both physicochemical and mythic realms, as indicated by their time-honored uses in folklore and medicine.

At times these multi-layered resonances can seem almost spooky. Ever since my first course in homeopathy, for example, I've often reflected on the fact that our greatest snake remedy was named for Lachesis, one of the three Greek goddesses who fix the span of life, and the unlikely circumstance that Hering, who first proved the venom in 1828, died on the 52nd anniversary of that event, almost to the day. Signatures of this sort are heavy with meaning, because they probe deeply into the history of our culture, and weave what first seem like unrelated details into a tapestry that becomes cogent and persuasive.

Massimo's "Method of Complexity" is so named because it encompasses fields as diverse as anthropology, folk medicine, physiology, biochemistry, toxicology, classical homeopathy, and the art of clinical medicine, which ties them all together and arises from acquaintance with human nature more than book learning. He differs from other teachers chiefly in this multi-systems approach, his quest for resonance and corroboration on so many levels, and his insistence that no one method of case-taking or remedy study will work every time, that homeopathy is an art to be experienced a new with every case, and is never complete.

Contrary to sacred truths we've all been taught, H. first great heresy is that provings are not the best source for materia medica study, because they yield long lists of detailed symptom-information, whereas the student mainly needs to know how important each symptom is for prescribing the remedy. Reliable remedy information adequate for prescribing on thus requires some system for organizing and prioritizing the data. More than any other leading teacher today, Massimo prefers cured cases for this purpose, because they alone provide sufficient richness and context to display

the whole of the remedy in the whole of the patient, to connect the threads that led him to prescribe it, and to grasp the analogy with other patients needing the same remedy. These connections he calls "themes," and from them he builds his materia medica.

Arising from the clinical experience of every homeopath, but rarely spoken out loud, this little iconoclasm reminds me of my home birth years, when I often wracked my brains over Cimicifuga and

its disembodied rubric "Fear of insanity," which never seemed to fit my cases. But when one of my patients carried to 42 weeks without going into labor, the threat of hospitalization prompted her

to tell me about her previous miscarriage and D&C, the most traumatic experience of her life, and the frightful premonition that the more intense pain of labor would "unhinge" her wits, and push her "over the edge" into a state of disintegration from which she would never return. A few days later, she appeared at my office already well along in labor, looking wild-eyed and out of control, just as she had foreseen: her speech was fragmented, her movements abrupt and unpredictable, and her mood pitiable. In that instant I understood not only the rubric, and why she'd been so reluctant to confide in me, but also many physical symptoms of the remedy in relation to it, so that I too was alarmed for her sanity. Although remaining clinically psychotic throughout the labor, she progressed rapidly on two or three doses of Cimicifuga 200, gave birth normally, and made a full recovery, on the strength of which I learned to prescribe the remedy to a variety of patients and with splendid results.

Massimo's criteria for a "cured" case are so strict that many of the successes we love to report at conferences would fall far short of satisfying them. For chronic conditions, he accepts a remedy as simillimum only after a follow-up of at least two years, and preferably longer, during which the remedy has continued to act in a curative manner, and has been effective in overcoming seemingly unrelated acute conditions developing in the interim, even injuries and other common domestic ailments, in lieu of the usual first-aid remedies.

Themes emerging from cured cases also provide the ideal framework for organizing the proving data, which can then be used to confirm, refute, or modify the themes. Materia medica study is thus

an ongoing process of integration, not a rôte memory exercise. The end result is rewriting and re-organizing the Repertory itself on thematic grounds, a monumental task that will require the collaborative efforts of at least a whole generation of dedicated homeopaths.

I especially loved his case of the patient with a passion for toy trains, cured with the help of Allium sativum, whom he uses to illustrate how to clarify a symptom, that is, to give it meaning by deriving it from or redefining it as a theme. To render this patient's hobby in symptom-language, rubrics like "Passion for model making" or "Plays with toy trains before supper" at first seemed

likely candidates, since they disappeared after the remedy, along with his other disabling pathologies, and were precisely the kind of quasi-objective, "value-neutral" observations that our Repertories are filled with. Yet in the end he found them misleading by giving too much detail, and thus obscuring the deeper meanings that could suggest useful analogies for similar cases, a consideration that persuaded him to add the remedy to the rubric "Childish," in effect upgrading it to a theme, and to identify and cure several other patients with equally consuming hobbies.     

For me another fascinating highlight was how he defined and distinguished the themes themselves. What he calls "characteristic" themes are distinctive of the remedy and often present, but not always, because they are limited either to certain stages, such as acute inflammation for Belladonna (childhood) or to polar opposites, depending on whether the patient is in a compensated or decompensated state. "Fundamental" themes, on the other hand, are essential structural components that must be present, although not always easy to spot, and provide the core or ultimate basis

of similitude. Thus the theme of "Isolation" in Camphora turns out to be fundamental to all the "Drug" remedies, whereas "Sensitivity to cold," its most famous keynote, is only characteristic of

its most extreme or decompensated cases, so that a more typical, compensated patient would be more likely to defy the cold.

This kind of nitty-gritty scholarship is to be found in every chapter, and it is a thing of beauty. His elucidation of themes is likewise masterful and easy to grasp, although he makes their actual discovery look a lot easier than it is for someone trying out the idea for the first time. In any case, it is obvious that the Repertory extractions on which they were based were made possible by MacRepertory and Reference Works, the computer software he uses, and to which he pays frequent and well-deserved tribute.

The method culminates in his concept of the Homeopathic Family, which is precisely the point where his method comes closest to that of Sankaran and Scholten, and where he also most clearly diverges from them. Whereas Sankaran and Scholten identify homeopathic remedy "families" taxonomically, according to their place in Nature, Massimo insists on a classification based solely on

the homeopathic characteristics of the remedies themselves. Often he begins taxonomically, based on a suspicion, such as might arise from a treatment failure involving the best-known representative

of a natural biological or chemical grouping, usually a polycrest, like Lachesis for the snakes. But the next step, extending the analysis to a few others taxonomically related to it, like Crotalus, Naja, and Bothrops, insists on a purely homeopathic definition, based on the fundamental themes that all of them have in common. Eventually, identifying them makes it possible to add other remedies

that are taxonomically unrelated, often "small" or at least unfamiliar and underrepresented in the literature.    

The same idea has fruitful applications for the "second prescription," where one remedy has acted curatively for a period of years, but then stops working, and therefore needs to be changed. In my earlier training, based on the work of Kent and his successors, this was a clear signal for retaking the case and prescribing a new remedy, perhaps but not necessarily complementary to it. But if the major themes are still at work in the patient, as one would expect them to be from the length and strength of the curative reaction, Massimo's family concept argues strongly for choosing a different remedy from the same family, a strategy he has evidently employed with great success.

In Volume II, I marvel at how he gets his patients to confide in him as they do, to blurt out their deep inner truths, in the absence of which we often substitute a Review of Systems for no better reason than that's all we can think of to fill up the time. This is the mystery of case-taking, which is what distinguishes great homeopaths from merely competent ones, and ultimately it can't really

be taught in a discursive fashion, because it involves the subjective experience of the homeopath as a human being, not just a doctor, scientist, or healer.

The Method of Complexity aims to identify the patient's adaptive strategies, and finds them in physical symptoms no less than mental, so that even the distinction between them tends to disappear. The idea is to encourage a free-flowing narrative, by tolerating the silences, trusting patients to tell what they have to tell without trying to force them in a certain direction, and finding the themes and thus the whole story wherever the patient leads us, rather than by our default setting of simply amassing as much data as possible.

The cases in Volume II are beautifully presented, and a pleasure to read. Each remedy is introduced with a brief but scholarly essay on its natural history, its uses in folk medicine, and its pharmacological, toxicological, and homeopathic characteristics, such that the cases seem to materialize out of this background. These little gems are materia medica writing at its finest. The cases

are sensitively taken and full of deep confidences from real people that bring to life the method that Massimo has outlined and elaborated. Many are followed by commentary as Dr. Giovanni Marotta, Massimo's long-time collaborator, mentor, and friend, almost an alter ego, whose more reflective style is nevertheless perfectly attuned to the method that they both created and developed, and thus adds a further richness to the work that in no way detracts or distracts from its mission.

I wish I could say the same for some of the contributions of other authors. The concluding section of Volume I, Chapter 1, for example, is a learned essay by Professor Alberto Panza, an academic colleague of Massimo's who sought to identify themes in modern European philosophy, science, and culture that are congruent with homeopathic teachings, an eminently worthy project. I couldn't help feeling a bit disappointed and let down that the writing, the translation, and even some of the sources cited revolved around highly technical terminology that are difficult to translate, unfamiliar to most readers, and too abstruse for them to understand.

Another example was the last chapter of Volume I, the longest in the book, which was a summary of the main teachings of modern psychology for homeopaths. For the English edition, this important task was undertaken by John Sobraske, the General Editor, and carried out with thoroughness; but in comparison with Massimo's engaged, incisive, and goal-oriented style, it often seemed an overlong and tedious digression that lacked sufficient relevance to the work as a whole. On the other hand, Sobraske's Introduction to Volume II, a brief summary of Volume I, is excellent, thoroughly competent, and easy to read. My only question was, why do a shortcut for people choosing to omit Volume I, which contains some of the finest writing on homeopathy that I have ever read and would thus be a great pity and a huge mistake to skip over?

In addition, there were a sizeable number of translators and editors, including such dedicated homeopaths as Betty Wood, Krista Heron, Bill Gray, and Maria Kingdon in North America, and several others in the UK and Europe; and their work certainly deserves hearty commendation. But their task was made almost superfluous by Massimo's own excellent command of English, on the one hand, and almost impossibly difficult by Prof. Panza's much greater need and unfamiliar subject matter, on the other.

All of these, of course, are but minor quibbles. My main reason for recommending these volumes is my belief that they will change and ultimately improve how homeopathy is taught and practic



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