Theorie Repertorisieren

Repertoriensammlung.

Repertorisieren und Krebs.

[Elaine Lewis]

Characteristic Symptoms

The symptom is BIZARRE. It’s WEIRD. It makes you turn around and say, “Huh? What did you just say? Could you repeat that please?” Also, a symptom that’s RECENT is characteristic.

A recent symptom is very reliable, it hasn’t had a chance to be corrupted by time, drugs, bad habits and so on. You know that Hering’s Law says that healing takes place in reverse order, right?

So the most recent symptom in a case will be the first to go, so matching that symptom is essential.

The symptom is PECULIAR or strange in the disease. For example, it’s normal to have thirst during a fever, we wouldn’t pay any attention to that. But if a person had no thirst…that would

be very characteristic and we would surely want to look up “thirstless during fever”.

The symptom is normal but EXCESSIVE. What if a person had thirst during fever but he was pouring glass after glass of water and never feeling satisfied; we would surely have to look up “thirst with fever”.

Symptoms that you’d expect to be there but aren’t there; or they’re there only in the smallest way. Let’s say a person has a very bad sore throat by all appearances but reports no or very little pain! That would really be strange! And what remedy has that? “Painless sore throat”: Baptisia.

The symptom is a keynote of a remedy! Robin Murphy always says, “If you see a keynote of a remedy, give the remedy!” That means the example in #3 should be given Phosphorus right away without a moment’s hesitation.

The symptom is characteristic by its concomitant. What does that mean? You might have a common symptom, such as vomiting in a stomach flu, there wouldn’t be much we could do with a symptom like that; but, if the patient had diarrhea at the same time? A concomitant diarrhea? That would be very peculiar; we would surely repertorize that! The rubric is “Stomach: vomiting, diarrhea, during” and the two main remedies are Ars. and Verat.

Two symptoms alternate: as one goes away, the other one comes back.

Sensation, location and modalities! A symptom means nothing to us without its sensation, location and modalities! You can’t even find it in the Repertory if you don’t know these things!

We saw in “Repertory Round-Up part 3”, the Vertigo case, the patient said she had a headache on her vertex (top of her head) but we couldn’t do anything with that symptom because it’s not

in the Headache chapter! That’s because the sensation is listed first and the location second! So you would have to look it up as “aching pain, vertex” or “shooting pain, vertex”. We didn’t have

any sensation information. And as for modalities–the factors that make the complaint better or worse, including the time of day or night–you might have a very common symptom in your case;

by all rights, a useless symptom; but, attach a modality to it, and you might be down to just a few remedies! For example, “Cough: coughing agg.” That means that instead of feeling temporarily

> after coughing, as is usually the case, coughing makes the cough worse! There are only 12 remedies in that rubric, and only 4 that are either in bold or italics. So, you add a modality to a symptom and suddenly you’re down to just a few remedies; that’s how important modalities are!

MENTALS / EMOTIONALS We all know how important they are, I don’t have to tell you. BUT! They have to be peculiar! If they make sense, they’re not symptoms! If I say, “I hurt my

knee and now I’m depressed,” is that a symptom? We’d all be depressed if that happened to us! And another thing, you really have to use your powers of discernment when a patient is talking

to you. He might say, “I don’t want any company, I want to be alone.” That sounds like a really good symptom, doesn’t it? “Company aggravates” or “aversion to company”. But is that really true? Find out! In the vertigo case we mentioned, the patient was aggravated by the company that was THERE–namely, her kids!!!! That’s why she wanted to be alone, because her kids were not helpful! So what seemed like a great symptom was actually not a symptom at all!

ETIOLOGY! The famous etiology I’m always talking about! It’s expressed as “ailments from” in our Repertory. Etiology is at the top of the hierarchy of symptoms. And since I brought that up, this would be a good time to segue into Part-B of our discussion, namely…

The Hierarchy Of Symptoms

Etiology (“Ailments From” or “Never Well Since” a certain trauma, event or illness)

Diagnosis (the name of the condition):

We have to know what disease or condition you have so we can go to that rubric and see which of the remedies there have the characteristic symptoms of our case. Measles? Heart disease? PMS? Arthritis? Gallstones? Kidney stones? Ovarian cyst? A stomach virus? Some of you are going to say, “Isn’t this allopathy?” If I don’t know what you have, I could be giving you a measles remedy for poison ivy! You know, that’s the thing about symptoms, they cover a lot of diseases, and you can’t seriously think that you get the same remedy regardless of what the diagnosis is! Really? Think about that! Take a symptom like diarrhea, so many illnesses have it: Food poisoning, Crohns Disease, Stage fright…do they all get Ars.? The food poisoning patient might need Ars., but the stage fright patient might need Gels., the Crohns Disease patient might need Nit-ac. and so on; so, knowing the symptom isn’t enough, we have to know what’s wrong with you!

Sudden Onset

A sudden onset might trump everything in the case and lead to an immediate consideration of Aconite or Belladonna and maybe even Baptisia in septic states.

Delusions and Strange/Rare and Peculiar symptoms including the most recent symptom in the case.

Mentals (symptoms like confusion, forgetfulness, poor concentration, stupor.)

Emotionals (fear, crying, yelling, whining, making unreasonable demands, throwing things, etc.)

Physical Generals–symptoms that start with the word “I” (“I’m thirsty”, “I’m cold”, “I want to sleep”, “I’m nauseous”, “I want ice”, “I want the lights out”, etc.)

Local symptoms–symptoms that start with the word “my” (“My leg hurts”, “My eye itches”, “My throat is sore”, “My nose is stopped up,” “My feet are cold”.)

Now, to help us out, let’s look to this month’s Quiz Answer as an example: “Revisiting: A Mrs. Rosie O’Donnell From Fort Lynn, NJ writes…”. As you may remember, Rosie had a very complicated case; she seemed to have a million things wrong with her! My quiz respondents dutifully repertorized all of Rosie’s symptoms, giving equal weight to the local symptoms and the strange/rare/peculiars, etc. The “cold feet” Rosie complained of, and her hang-nails got the same value as her most recent symptoms: aversion to cheese and her day-long crying spell–which was just “weird” in my opinion.

Checking with our hierarchy of symptoms, was there an aetiology in this case? No. Was there a diagnosis? No. Was there Sudden Onset? No. Strange/Rare and Peculiar? Yes!!!! Two things:

A newly acquired aversion to cheese and a desire to cry for no reason.

So now, I want you to picture the Hierarchy of Symptoms as a chest of drawers and imagine that each drawer is labelled.

The top drawer says “Aetiology”, the 2nd drawer says Diagnosis, the 3rd drawer says Sudden Onset, the 4th drawer says Delusions and Strange/Rare/Peculiar, and so on. Now, pay close attention. What happens when you pull open the top drawer and look inside? ALL THE OTHER DRAWERS DISAPPEAR!

[Joy Lucas]

Case taking is all about extracting symptoms and symptoms have to have a quality to them and be the FACTS of the case. The aim is to get a minimum number of symptoms with the maximum importance and relevance to the case. Not so few that they become too exclusive but not so many as to be confusing - I like to aim for a maximum of 10.

Confining yourself to:-

Location

Sensation

Extension

Modalities

Causation

Concomitants

should suffice for all cases.

Taking the totality of the case doesn¹t mean including every single detail of the person¹s life, it merely means the totality of the signs and symptoms pertaining to the diseased state.

Sometimes this will include a fusion or borderline states between what is healthy and what is diseased - what some call constitutional prescribing. Although being able to rank symptoms properly hasn’t much to do with how to take a case, it is still relevant to say that the case taking has to be good so that the case analysis can be good and case analysis has to include the ranking of symptoms.

There are various methods of doing this but separating symptoms into the following categories is extremely valuable and practical. Some homeopaths create graphs, or columns, or shapes for these symptoms, some do it in their heads:

1) Physical Generals - if the case has physical symptoms and they are part of the presenting complaint then these are very important in my opinion and often not given enough consideration.

2) Mental and Emotional Generals - if these are strong and dominate a case then obviously they are important but emotional symptoms often present an extremely grey area for some prescribers.

3) Particulars are the symptoms that are important to the client, those that are prefixed by “My…”. These symptoms can be very meaningful because the client will be relating to them intimately and are often the symptoms they will talk most about. I place a lot of emphasis on these symptoms because of this and they often lead you into the inner sanctum of a case, where all the intriguing symptoms are.

4) Strange, rare and peculiar (most important symptoms of all). Striking, uncommon and peculiar symptoms can appear absolutely anywhere within the case. It might be the modalities of a case, the sensations, the location (if not generalised but specific). They can be cravings or aversions, dreams or fears.

They might appear as seemingly small symptoms but nonetheless significant. For example, a burning sensation which is >>> heat; a dry mouth that has no thirst; nausea which is NOT >>> for vomiting; a fever that has no thirst, etc. Likewise, a single characteristic symptom can dominate a case to such a degree it virtually leads the case easily to the simillimum. For example, hands covered in warts; cold hands # cold feet; a pain in the heart only in the late afternoon; a weakness of memory for dates only, etc.

How you recognise these strange symptoms is largely common sense because their oddity factor should shine through but you can’t always depend on the client offering all this on a plate - you have to ask questions and follow through on all information offered.

Unfortunately, what sometimes happens, is that the prescriber turns a relatively ordinary symptom into a strange one, giving it the wrong ranking and letting it define a case so it is necessary that one learns how to see the 3 main dimensions to a symptom:

The degree of peculiarity

The location in the hierarchy of the organism

The intensity of the symptom as expressed by the client.

5) General and undefined symptoms or vague and indefinite symptoms should not be included directly in the case but put to one side. These types of symptoms might be

indications of a deeper layer or less active miasmatic influence, they might also be meaningless, they might even be the symptoms which develop after the first prescription which

in turn will shed light on the case, but initially they should be left to one side.

6) Confusing symptoms, due to drugs, poorly elicited because of the client¹s state, damaged by previous remedies or suppression in some way should also be put to one side.

7) Symptoms that are common to any specific disease diagnosis also need to be put into a context. If such a common symptom exists but it completely dominates a case then this symptom gains importance, e.g. the debilitating and aching bones throughout the body that one often experiences with ‘flu, or flaking skin in an eczema case - common enough but if it dominates then it is important.

As you proceed through a case the client will either spontaneously offer information or will answer through pertinent questions. Either way there will be a natural intensity to all symptoms within a case and you need to find a way of grading these symptoms as you go through the case. Some use an underlining system, others a numerical system - thus:-

4 underlines = volunteered information which has intensity and emphasis

3 underlines = the perception of the client of their own condition

2 underlines = volunteered information but that which doesn’t have so much intensity or emphasis

1 underline = information that is even more vague but still distinct enough to be called a symptom

No underlines = vague information probably from direct questioning - “sometimes”, “I don’t really know”, too far back in the past and not relevant now, etc etc. If you ask someone if they are scared of spiders and they have to think about it but finally say “yes”, forget it, you just cannot include information like that.

I tend to think that the presenting complaint of any case is a metaphor for the whole case and thus I place a lot of importance on the presenting complaint - it represents the facts of the case, the point at which the client has come to see you, it is the point of no return. It is here you find the most vital symptom that have the highest ranking and that relate outwards towards the rest of the case but the further outwards you go the lower the ranking gets for most symptom.

Always be guided by what needs to be cured.

Excerpt from a Forum:

hi elaine,

[I'm] not finding the same remedy in all the rubrics. seems like this must happen a lot when assembling a case? or does this happen in only the “difficult” cases?

You’ve asked a profound question. This is why homeopathy is so difficult!

We say we take the totality of symptoms, but as you’ve pointed out, if you go to the Repertory (our main reference book) and look for the symptoms in the case, you rarely find that there is one remedy shared by all.

For example, if you have a runny nose and sore throat that extends to the ear, with amelioration (improvement) from thunder and lightning storms, you may see that you can’t find a single remedy that covers the whole case. So, how, under the circumstances, does one pick a remedy? It seems to suggest that you have to disregard some of the symptoms as being “irrelevant” and that’s exactly what you have to do!

The symptom with the most value in this particular case is “Thunder and Lightning ameliorate”! Why? It’s because it’s so unusual! It’s so peculiar! Here’s a person who’s sick with a cold and feels better in a storm! It’s weird!

It doesn’t occur to the average person that we all have colds differently! And it’s how we’re different, in homeopathy, that leads to the correct remedy.

Think of it as looking into a microscope to identify the kind of bacteria present, the only ones you can see are out on the fringe-they’re waving a big red flag, “Look at me! Look at me!” The others are all huddled in a ball, so, you’re looking out on the fringe where you can see! The only thing I “see” in this case is someone whose symptoms go away in a storm! Everything else is like everyone else’s cold! Indistinguishable!

This is how homeopathy works-it’s the peculiar symptom, it’s the striking symptom that you can’t ignore, which seems to have nothing to do with the complaint, that makes it so you can find a remedy. So, in this case, you’d check the Repertory for “Environment: > thunderstorms.” (Murphy’s Repertory) and there’s only about 4 remedies, and then you’d check to see which of the 4 most closely fits your case.

Here’s the problem with the Repertory:

1. Some remedies were very extensively “proven” -tested on volunteers- and have hundreds of years of clinical use, and are, consequently, over-represented. Remedies like Sulphur may show up in almost every rubric from Bloating to Vertigo, and so a strict repertorization will almost always show Sulphur as the “winner” every time!

2. Other remedies are “under-proven”, under-used, and are poorly represented in the Repertory and will never “win” in a strict repertorization.

3. There are numerous symptoms in the Materia Medica (our other “Big Book”) that were never entered into the Repertory! For instance, the remedy Chocolate isn’t in the rubric “Abandons/Forsakes His Own Children”, and clearly it should be there. (Simillimum, summer 2003, p. 48)

So we can see that we have to have some other strategies going for us other than strict repertorization when solving a case.

What might those strategies be? Well, different homeopaths have lots of tricks up their sleeves, but here’s a few I think we would all agree upon:

1. The most recent symptom takes precedence. The most recent symptom in a case can’t be ignored in favor of the ones we find more interesting. It might be that before you can get to the heart of the case, a recent “boring” symptom may block your way if you don’t knock it off first! For instance, a patient who’s had arthritis for years and has just fallen and bumped his head, needs Arnica -our injury remedy- even though the arthritis has been around longer and represents a deeper problem.

2. SUFFERING in the case takes precedence. If someone has pain, you have to take the case of the pain, even though you may suspect that your patient is constitutionally a Sulphur or a Calc. When you see a person with, for example, a Bryonia pain-sharp, stitching pain, < slightest motion - you have to give Bryonia right away, it doesn’t matter that he sticks his feet out of the covers, is messy, doesn’t like to bathe, and other symptoms associated with Sulphur.

3. Find the worst thing! When there seems to be a million symptoms in the case, and there usually are, ask your patient, “What’s the worst thing that’s the matter with you? What symptom do you want to go away first?” Then take the case of whatever that is. He may say, “If I didn’t have insomnia, a lot of my other problems would go away.” So, the case then becomes one of insomnia-you’d ask him to describe it, what does he think about while lying awake, does he wake at a certain time each night, what may have caused it, and so on.

4. Look for what’s excessive in the case: Too much talking, too much sweating, too much dryness, too much…whatever.

5. Find the over-sensitivity: Look to see what the person is overly sensitive to: Criticism? Rainy weather? Music? Sunlight?

6. The patient’s response to stress - is there a pattern? You may find that this is a person who cries about everything, or over-reacts violently to everything, or feels that he can’t ask for help, despite having these stresses in his life. The RESPONSE to stress is more significant than having a stress, per se.

7. The cause. Very often if we know the cause, we can pack up our bags and go home! The cause determines many or possibly even most of our prescriptions! “You’ve had this since the accident? Oh, why didn’t you say so?

8. The remedy’s Arnica!” “You had this since your boyfriend broke up with you? Why didn’t you say so! The remedy’s Nat-m.” “You’ve had this since the flu? Why didn’t you say so? The remedy’s Gels.!” (I’m over-simplifying to make a point.)

In general, when confronted with symptoms which don’t fall neatly under the umbrella of one remedy, THROW OUT THE COMMON SYMPTOMS right away-symptoms like “Depression”, “Headache”, “Runny Nose”-symptoms which could be any one of 500 remedies, forget about them!

THROW OUT EVERYTHING THAT’S NOT INTENSE.

Look for what’s PECULIAR.

Look at what’s RECENT.

Look for SUFFERING.

Look at what’s STRIKING.

Look for a THEME (always crying, always talking about birds, etc.)

Ask what’s the WORST THING in the case (generally, pathology on the MENTAL/EMOTIONAL plane, if intense, tends to be the worst thing-fears and delusions, for example, can cripple a person < than a broken leg).

Look at how the person RESPONDS to his complaint.

Find out what he’s HYPERSENSITIVE to.

Look to see what he’s doing OVER AND OVER again; look to see what he’s SAYING over and over again.

See if you can separate the symptoms into acute and chronic and treat acutes first.

Look for the CAUSE.

In the final analysis, instead of 20 symptoms in the case, you may find that you’re down to 4 or 5!

So, for example, in a Chocolate case, regardless of the diagnosis-arthritis, or menstrual cramps, etc.-the rubrics or symptoms you might finally decide upon may look like this:

Desires chocolate (theme, over and over again, excessive)

> in the countryside (unusual in that most people don’t need to be in the country to feel better)

> by curling up in a ball (response to the complaint, odd, striking)

< by the presence of her children (overly sensitive to her children, odd, striking)

Desires to travel/escape (response to the complaint)

(These really are Chocolate symptoms, I’m not making this up!)

So, it’s what’s unusual in the case, it’s what’s excessive, it’s the response, it’s what’s repetitive, it’s what’s striking and remember to treat the suffering first and look for etiologies (causes).

If there are “layers” in a case, each layer will begin with a CAUSE, an event, which will shift a person over to a new remedy picture-or, it might take him deeper into his own constitutional state;

For example, there’s the Healthy Sulphur who’s ambitious, pursuing a career, getting good grades, warm, loves the outdoors, extroverted, active, etc.;

The very sick Sulphur, who’s become a recluse, stays indoors, is chilly, and has become lazy and has stopped trying. A healthy Sulphur, after failing repeatedly in business, for example, will take on this new state, but it’s still Sulphur.

Try to see what the critical “events” in the person’s life were. There are a set of remedies that correspond to each event-remedies for the flu, remedies for loss of a loved one, remedies for injury, remedies for business failure, etc.

If you see that a person has never been the same since a significant event, the symptoms themselves become less significant and the CAUSE becomes paramount, and you would want to try to match a remedy in the CAUSAL rubric to your case.

“Unable-to-sit-through-a-rambling-explanation”. I’m thinking Sulphur!

[Massimo Mangialavori]

In meine Sprechstunde kommt Altero, 36 Jahre, ein Mann von kräftigem Körperbau, aber dennoch agil. Man kann sich leicht vorstellen, dass er früher Sportarten betrieb, die viele Körperübungen zum Aufbau von Muskelmasse erfordern. Gleichwohl bewegt er sich leicht und geschmeidig. Er ist dezent und zugleich sehr vornehm gekleidet.

Er trägt einen wunderschönen Kaschmirpullover, Designerhosen und -schuhe, und sogar seine Unterwäsche ist von sehr teurer Marke. Sein stark gerötetes Gesicht, dessen Farbe sprechend noch intensiver wird, verrät eine gewisse Aufregung, die Altero wohl lieber vor mir verbergen würde.

Zunächst redet er sehr förmlich, wohl um zu zeigen wie gebildet er ist. Doch als ich versuche, Themen anzusprechen, die ihn vermutlich innerlich mehr bewegen, beginnt Altero zu murmeln, dann über seine Worte zu stolpern und schließlich gar zu stottern.

Abgesehen von seiner Art zu sprechen, scheint es klar zu sein, dass Altero sich als eine selbstbewusste, kompetente Person darstellen möchte, die vielseitig interessiert ist. Aber sein Wissen auf all diesen unterschiedlichen Gebieten, das er so geschickt zur Schau stellt, scheint nicht sehr tief zu sein.

Altero hat etliche dunkle Flecken nahezu über seinen ganzen Oberkörper verteilt, für die er sich schämt und die er nicht erwähnt, bis ich ihn untersuche. Dann gibt er zu, dass er seit vielen Jahren unter Mykosen leidet, was er als Makel in seiner Erscheinung empfindet.

Altero sagt: „Ich habe Netzhautblutungen aufgrund einer starken Kurzsichtigkeit. Mehrere Leute empfahlen mir, hierher zu kommen, nachdem ich die Topspezialisten auf diesem Gebiet aufgesucht hatte… Sie seien der Beste, nicht nur in Italien. Seit kurzem ist es sehr viel schlimmer geworden und angeblich kann man nichts dagegen machen. Wenn mein Auge anfängt zu bluten, soll ich einfach abwarten, bis es wieder absorbiert ist…“

Wann fingen diese Blutungen an?

„Vor vier Jahren trat es zum ersten Mal auf. Es beginnt immer mit einem schwarzen Fleck in meinem Blickfeld und ich kann dann in dem Bereich nicht gut sehen.

Welches Auge ist betroffen?

„Die letzten Male war es hauptsächlich das rechte Auge.“

Wie lange dauert es an?

„Es dauert zwei bis drei Monate, bis man nichts mehr davon merkt und sieht und bis das Blut wieder vollständig absorbiert ist.“

Wie ist es dann mit Ihrem Sehen?

„Wenn es sehr hell ist, erscheinen die Dinge verzerrt… Bei Dämmerlicht sehe ich einen schwarzen Schein und ich kann überhaupt nichts sehen an dieser bestimmten Stelle…“ [nur nach den Blutungen]

Was hat Sie bewegt, zu mir zu kommen? Sie haben das ja schon länger...

„Anfangs machte ich mir nur wenig Sorgen, doch inzwischen bin ich extrem beunruhigt, denn jetzt tauchen sie in allen möglichen Situationen auf. Aber es scheint keinen besonderen Grund dafür zu geben und niemand hat mir gesagt, ob es etwas gibt was ich tun oder lassen sollte… Sie können während des Schlafs auftreten, oder während des Lernens oder während der Arbeit… Ich kann mich in keinerlei Weise dagegen schützen… Es gibt keine Ursache und keinen speziellen Zusammenhang mit irgendetwas. Ich bin ziemlich verzweifelt, wenn es wieder anfängt zu bluten… Ich habe Angst, es könnte doch auf lange Sicht Schaden anrichten.“

Hatten Sie immer schon Probleme mit Ihren Augen?

„Mit drei Jahren begann meine Kurzsichtigkeit, es war schon ziemlich fortgeschritten… ich musste die Seiten beim Lesen sehr dicht vor die Augen halten.“

Ist das immer noch so?

„In den letzten Jahren ist es sehr viel schlimmer geworden. In den letzten zehn Jahren habe ich Kontaktlinsen getragen und kann auch gut damit sehen. Meine Sehkraft scheint sich zu stabilisieren. Aber mir wurde gesagt, dass das viele Lesen die Situation noch verschlimmern könnte…“

Kam das mit den Netzhautblutungen sehr plötzlich oder...

„Ich glaube, es war ein schleichender Prozess… Vielleicht deutlicher spürbar während der Pubertät, aber damals habe ich wohl zu viel Hochleistungssport betrieben.

Ich praktizierte verschiedene Arten des Ringens, angefangen von Freistil über griechisch-römisches Ringen und dann Judo. Die anderen Kampfsportarten interessierten mich nicht so sehr, weil es nicht so viel körperlichen Kontakt gibt… Und ich mag es, den Schweiß meines Gegners zu riechen… Es stößt mich ab und erregt mich gleichzeitig, so als wäre ich ein Tier. Aber ich will den Faden nicht verlieren… Mir scheint, ich kann nachts nicht gut sehen… Ich traue mich nicht nachts Auto zu fahren und empfinde entgegenkommende Scheinwerfer sehr störend. Sie blenden mich… Ich trage gerne eine Sonnenbrille… sogar nachts. Ich trage eine Sonnenbrille wie Aristoteles Onassis und fühle mich damit viel besser, wie mit einer Maske. Schließlich kann ich Ihnen auch erzählen, dass ich eine leichte Lähmung des Gesichtsnervs hatte, das begann ebenfalls in meiner Jugend. Man behauptete, es sei durch eine Erkältung entstanden, doch das glaube ich nicht. Einige Ärzte können nicht über die eigene Nasenspitze hinaussehen. Die eine Gesichtshälfte war völlig in Ordnung, und wenn man meinen Kopf im Profil sah, konnte man nichts erkennen…

Es gab da einen unangenehmen Zeitpunkt, als ich aufhörte, in ein bestimmtes Fitnessstudio zu gehen…

Einige Jahre zuvor war mein Trainer gestorben und ich ging eine äußerst enge Verbindung mit seinem Assistenten ein. Aber wir begannen sehr stark miteinander zu konkurrieren, und schließlich musste ich mich von ihm trennen…

Etwa zur gleichen Zeit verließ mich meine damalige Freundin und begann mit ihm auszugehen, und das war’s dann …

Ich zog mir eine Erkältung zu, als ich im Winter ohne Helm Motorrad fuhr…

Aber ich habe das x-mal in meinem Leben gemacht, davor und danach und jetzt, und nie ist etwas passiert.“

Was geschah dann?

„Als ich zuhause ankam, war mein Gesicht verzerrt und ich konnte nicht einmal mehr mein rechtes Auge bewegen…“

Was taten Sie dann?

„Ich blieb zuhause bis alles wieder vollkommen in Ordnung war… Es dauerte Monate und ich brauchte sehr viel Kortison. Jahrelang hatte ich Schmerzen im Kiefergelenk, bis ein Zahnarzt es behandelte, angeblich gäbe es keinen Zusammenhang, aber das glaube ich nicht … Denn zuvor hatte ich nie Probleme damit gehabt… In kritischen Situationen hielt ich meinen Mund geschlossen.“

An diesem Punkt wollte Altero offensichtlich gerne das Thema wechseln.

„Ich habe ein strukturelles Problem und wüsste gerne, ob die Homöopathie mir dabei helfen kann. Seit fünf Jahren ist mein diastolischer Blutdruck zu hoch. Das hatte ich vorher nie, aber meine Cholesterin- und Triglyceridwerte waren immer schon ein bisschen zu hoch. Ich bin um meinen Blutdruck besorgt… der diastolische Wert ist stark gestiegen. Nachts höre ich oft mein Herz unregelmäßig schlagen und meine Herzfrequenz ist beschleunigt…

Ich kann das wirklich hören, es ist ganz deutlich und es ängstigt mich etwas… Es würde mir nichts ausmachen, wenn ich wüsste, dass es nur ein funktionelles Problem ist…

Das sagten sie mir auch, aber wenn es kommt, tut meine Brust weh, und ich fühle einen Schmerz im Herzen. Obwohl mir die Ärzte sagten, dass das unmöglich sei.

Es scheint in keinem Zusammenhang mit irgendetwas Bestimmtem zu stehen… Wie soll ich es beschreiben… ein Gefühl von Fülle in der Brust… als ob da plötzlich zu viel Blut sei… Und dann fühle ich, wie es sich zusammenzieht…

Und ich möchte nicht so tun, als würde mir das keine Angst einjagen.“

Was genau macht Ihnen Angst?

„Ich kann dieses Gefühl eingeschnürt zu sein nicht ertragen… Zum Beispiel trage ich trotz meiner beruflichen Position auch bei der Arbeit nie, wirklich niemals eine Krawatte und ich trage nur extrem bequeme Kleidung.

Das ist nicht nur eine Sache der Bequemlichkeit… Es hat auch etwas mit meinem Lebensstil und meinen Überzeugungen zu tun.“

Was sind Ihre Überzeugungen?

„Seit einigen Jahren verfolge ich einen spirituellen Weg und -abgesehen von meiner Arbeit als Unternehmer- leite ich einen kleinen Verlag, der nur eine bestimmte Art von Büchern veröffentlicht, ein Nischen-Bereich, nur für jene, die es verstehen können. Seit ich die Verantwortung übernommen habe, sind wir stark gewachsen, und darauf bin ich echt stolz, obwohl wir viele Gegner haben.“

Wieso Gegner?

„Weder ‚Gegner’ noch ‚Konkurrenten’ ist die wirklich richtige Bezeichnung. Genau genommen sind es Feinde, denn sie benutzen die hinterhältigsten Tricks, um für ihr eigenes Material zu werben und unseren Verlag in Misskredit zu bringen.“

Was sind das für Bücher, die Sie herausgeben?

„Wir veröffentlichen die Werke einiger großer Meister der Vergangenheit, aus verschiedenen Kulturen… Mein Ziel ist es zu zeigen, dass zwar Kultur, Geschichte, und Zeiten verschieden sind… aber dass die Botschaft dieser Menschen letztendlich dieselbe ist,... obgleich man es auf unterschiedliche Art und Weise darstellen muss, damit es auch von den einfachsten Leuten verstanden wird.“

Und damit verdienen Sie Geld?

„Nein. Das mit dem Verlag ist eine Art Mission für mich, ich werde nicht dafür bezahlt… Meine Motive sind völlig anders. Früher war es eine größere Verlagsgruppe, aber es kam zu einer Spaltung und man bat mich, die Leitung unserer Gruppe zu übernehmen. Ich entschied dann, einen unabhängigen kleinen Verlag zu gründen, damit wir von niemandem abhängig sind und alles selbst machen können. Haben Sie gewusst, dass alle großen Verlagsgesellschaften auf die gleiche Weise begonnen haben?“

Ist es wichtig für Sie, dass Sie diese Arbeit unentgeltlich machen?

„Ja, vielleicht. Ich glaube, dass es in vielen so genannten Religionen und Sekten eine Menge Vorurteile gegenüber Geld gibt. Darüber will ich mich jetzt nicht weiter auslassen, aber ich versuche nicht, mich durch etwas zu bereichern,was der wichtigste Teil meines Lebens ist. Wenn eine Religion dich in Unwissenheit lässt, dann ist das eine Sache, die wirkliche Wahrheit ist etwas anderes… Jene, die vorgeben das Armutsgelübde abgelegt zu haben oder die sagen, sie seien nicht daran interessiert ihre gesellschaftliche Stellung zu verbessern, bringen mich nur zum Lachen. Das ist reine Heuchelei, eine der offensichtlichsten Unwahrheiten in den so genannten Religionen. Ich bin in dieser Sache extrem ehrlich. Gewisse Mittel sind nicht bloß notwendig, sie sind einfach essentiell… Aber es ist ein Unterschied, ob man sie benutzt, um ein Ideal zu pflegen oder um sie auf persönliche Weise und aus rein egoistischem Vergnügen zu genießen.“

Was haben Sie sonst noch für Beschwerden, außer den Problemen mit den Augen?

„Oft leide ich an Schlaflosigkeit und das führt dann zum Kollaps, oder ich schlafe einige Nächte, aber nicht sehr tief. Das geht jetzt so seit einigen Jahren. Drei Jahre lang machte meine Tochter kaum ein Auge zu und seitdem ist mein Schlaf nicht mehr wie früher. Es ist zwar etwas besser geworden, aber in letzter Zeit kann ich kaum eine Nacht durchschlafen.“

Was genau sind Ihre Schlafprobleme?

„Ich kann schwer einschlafen. Ich fange an, über Dinge nachzudenken und dann beginnt das Gedankenkarussell… Spezielle Dinge im Zusammenhang mit meiner Arbeit. Da ich ein selbständiger Unternehmer bin, gab es ja immer viele Dinge über die ich nachdenken musste.“

Gibt es wiederkehrende Träume?

„An die meisten meiner Träume erinnere ich mich nicht, mit Ausnahme von einem, wo ich eingesperrt bin und alles zerschlagen muss, um herauszukommen…

Es endet immer schlecht, weil ich immer der erste bin, der verletzt wird, wenn ich Dinge zertrümmere… Ich weiß nicht, wie ich es besser erklären soll… Ich bringe die Ketten zum Reißen und die Eisenglieder zerbersten, sie fliegen hoch und schlagen mir ins Gesicht und verletzen mich… Oder meine Haut wird dabei zerfetzt und zurück bleiben eine Menge Narben.“

Noch weitere Träume?

„Als ich jung war, hatte ich einen sehr schönen Traum, worin ich einer Gruppe von Feinden gegenüberstand. Meistens wurde ich direkt von einer Kanonenkugel getroffen, so dass ich in tausend kleine Stücke zerbrach, die alle kleine Versionen meines Selbst wurden… Eine Art Armee von wütenden kleinen Klonen… kennen Sie Walt Disneys Fantasia… die Episode mit dem Zaubererlehrling, der den Besen in eine Menge Stücke zerbricht?“

Wie ist Ihr beruflicher Werdegang?

„Nachdem ich die Schule verließ, begann ich zu arbeiten und hatte eine große Verantwortung auf meinen Schultern zu tragen. Zwischen achtzehn und dreiunddreißig war es sehr schwer für mich. Ich arbeitete pausenlos, denn ich hatte das Geschäftliche ganz allein zu erledigen.“

Wie meinen Sie das?

„Mein Vater verließ uns und hinterließ ein kleines Familienunternehmen… und ich musste mich allein um alles kümmern. Und dann lernte ich alles über Finanzen, denn mir gefiel es nicht, wie unsere zwei Sparkonten geführt wurden.“

Sie haben sehr viel gearbeitet?

„Ich bin nicht jemand, der weiß, wann man eine Pause einlegen muss…“

Gibt es Krankenhausaufenthalte?

„Ich war einmal im Krankenhaus, weil ich mir das Schienbein gebrochen hatte, nachdem ich mit meinem Fahrrad einen ziemlich schlimmen Unfall hatte. Einer meiner Freunde schnitt mich in einer Kurve…

Der Bruch war sehr schlimm, man konnte den Knochen hervorstehen sehen… Ich bekam eine Entzündung und während meiner Genesung kam eine Thrombose hinzu und eine leichte Lungenembolie… aber ich habe ein dickes Fell…

Ich wurde auch noch an den Hämorrhoiden operiert, weil sie sehr stark bluteten und es so nicht mehr weiter ging. Auch in der Nase wurde ich operiert. Ich weiß nicht mehr an welchem Nasenloch,

aber als ich klein war, habe ich eines kauterisiert bekommen, weil ich so oft Blut auf dem Kopfkissen hatte…“

Was ist in diesem Fall klinisch wichtig?

• Konkurrenzgefühl oder Angriff und Verteidigung

- „Ich kann mich nicht selbst verteidigen“ / „Sie sind meine Feinde“ / „Ich rieche gerne den Schweiß meiner Gegner.“ In seinem Traum wird er zu vielen kleinen

Versionen seines Selbst und tritt so seinen Feinden entgegen

• Blutungsneigung / Blutandrang / Kongestion

- „Als wäre da auf einmal zu viel Blut.“ / Kurzsichtigkeit / Nasenbluten / Hämorrhoiden / Thrombose / Gesichtsröte

• Gefühl der Beengung

- kann enge Kleidung nicht ertragen / etwas muss herauskommen

• Vorstellung von Lähmung / Pilz / Designerkleidung / reagiert sehr empfindlich auf Bilder / kurzsichtig ab dem Alter von drei Jahren / Er will edel, perfekt und fast

aristokratisch wirken

• Träumt davon, in einem Käfig eingesperrt zu sein

• Spiritualität / Religiosität

- Es ist eine Art Mission für mich“

• Physisches gegen Metaphysisches / versteckt seine Instinkte hinter einer geistigen Maske

• Verstecken

- versteckt dunkle Hautflecken

• Überheblichkeit

• Zwei Seiten / Dualität

• Widersprüchlichkeit / Scheinheiligkeit

• Traum von Klonen? Er braucht niemand anderen um zu existieren oder in der Welt zu überleben

• Isoliertheit

• Sehprobleme / Probleme mit den Augen

In jedem von uns steckt ein gewisser Narzissmus. Das Problem ist nicht, ob wir narzisstisch sind oder nicht, sondern was wir damit machen. Wie drücken wir es aus? Wenn man kein bisschen selbstverliebt ist, dann kann man vieles nicht tun - z.B. auf einer Bühne stehen, ein Orchester dirigieren etc. Es gibt einen positiven Narzissmus und einen negativen. Es ist ein „guter“ Narzissmus’, wenn jemand ihn nutzt, um sich weiterzuentwickeln oder anderen Menschen zu helfen - man denke z.B. an einen Lehrer am Podium, der sein Wissen weitergibt. Das ist weder nutzlos, schlecht noch egozentrisch. Diese Menschen stehen im Mittelpunkt, aber im positiven Sinne. Sie bringen Sich selbst in eine angesehene Position und können dadurch anderen Menschen etwas mitteilen. Wahrscheinlich würden sich der Einzelne oder auch die Gesellschaft ohne solche narzisstische Persönlichkeiten nicht verbessern. Gandhi gehörte zu dieser Kategorie.

Bei negativem Narzissmus ist die Person total auf sich selbst fixiert und nur daran interessiert, die eigenen Fähigkeiten zu verbessern. Selbstverliebt in die eigene schöne Gestalt. Oder, im schlimmsten Fall, nutzt so jemand andere Menschen aus, um sich selbst zu verbessern. Al Capone gehört zu dieser Kategorie. Narzissmus ist also nicht zwangsläufig eine schlechte Gesinnung. Doch welche Seite wird hier ausgelebt?

Verlauf: - Ein bis drei Monate später

Er nahm als Potenz Q1, die nach zwei Wochen abgesetzt werden musste wegen Kopfschmerz und Nasenbluten. Daraufhin nahm er zwei Mal die Woche ein paar Tropfen und später einmal die Woche.

Dieses Mal sieht er anders aus, viel normaler und sein Verhalten ist nicht so bombastisch und extrem egoistisch und wirkt nicht so verführerisch.

Altero erzählt:

„Ich vergaß letztes Mal zu erzählen, dass ich vor Jahren Labyrinthitis hatte mit Schwindel. Nach Ihrem Medikament kamen diese Episoden wieder und es ging mir jedes Mal sehr schlecht. Als es vor Jahren ein letztes Mal auftauchte, sah man als Ursache ein Kreislaufproblem und ich erhielt dafür Medikamente. Ab dem Zeitpunkt begann mein Bluthochdruck.

Ich habe immer noch Momente mit fahrigen Gedanken. Es ist für mich nicht leicht, die richtigen Worte zu finden.“

Erzählen Sie mir mehr darüber...

„Was mir zu anderen Zeiten ganz natürlich erscheint, wird plötzlich verbindungslos. Ich kann mich nicht genau daran erinnern, was ich gerade dachte und fühle mich dann verloren, obwohl es mir wenige Minuten zuvor alles noch ganz klar war.“

Haben Sie das schon länger?

„Ja. Ich musste lernen, mit meinen Emotionen umzugehen und sie zu verstecken. Anders ging es nicht, denn so wurde ich von meinen Eltern erzogen.“

Was ist mit dem Schwindel?

„Eines Tages wollte ich morgens aufstehen, doch als ich aus dem Bett sprang, wurde mir schwindelig und ich wusste nicht mehr, wo ich mich befand. Ich musste ganz still halten, ohne zu denken. Vollkommen still. Ich konnte meinen Kopf nur nach rechts drehen, nicht nach links. Seitdem habe ich immer ein komisches Gefühl, wenn ich mich vorwärts beuge. Wenn mir bei der Arbeit, z.B. während einer Konferenz, mein Füllhalter zu Boden fällt, gerate ich in Panik. Ich muss ihn aufheben und was könnte dabei geschehen? Meine Hauptsorge ist, dass die Leute vielleicht merken könnten, was in mir vorgeht.“

Was geht denn in Ihnen vor?

„In bestimmten Augenblicken habe ich das Gefühl, dass irgendetwas die Ketten durchbricht.“

Wann kommt dieses Gefühl?

„Das passiert meistens, wenn es sehr kalt ist. Es kommt viel häufiger im Winter als im Sommer. Ich habe Probleme mit der Wärmeregulation. Wenn ich sehr müde bin, fröstelt es mich leicht. Und ich leide unter heißem Wetter, weil dann meine Energie nicht groß ist.“

Gibt es sonst noch etwas zu berichten?

„Beim letzten Mal vergaß ich zu erzählen, dass ich auch schon einmal Nierenkoliken hatte. Ich sollte viel trinken und drei Jahre lang keinerlei Milchprodukte essen. Eines Tages kam ein Kalziumstein heraus. Beim letzten Mal hatte ich nur etwas Sand in den Nieren und man hat mir mehrmals ein starkes Schmerzmittel gespritzt.“

Wann haben Sie diese Nierenbeschwerden?

„Das passiert zu bestimmten Zeiten. Ich schwitze dann ganz extrem und habe doch keinen Durst. Und ich leide an Mangelernährung.

In den letzten Wochen hatte ich häufig brennende Schmerzen im Magen. Da hilft mir am besten viel frischer Orangensaft. Das Problem ist geringer, wenn ich keinerlei Tomaten esse. Doch ansonsten habe ich einen starken Magen. Ich kann sogar Steine verdauen. Aber wenn ich wirklich krank bin, fällt es mir sogar schwer, etwas Wasser zu trinken.“

Was können Sie mir über Ihren Gemütszustand sagen?

„Ich habe so eine Tendenz, zu emotional zu sein. Und was mir wirklich fehlt, ist, irgendetwas zu starten. Ich genieße die Gefühle bei einem Start, wie beim Start eines

Wettkampfes oder Rennens. Diese Art von Emotion fehlt mir. Nicht den Wettkampf vermisse ich, sondern den Adrenalinschuss im Blut. Solange ich noch Wettkämpfe bestritt, habe ich teilweise sechs Kilo an einem Wochenende verloren. Aber ich bevorzuge ganz klar Einzelsportarten wie Skilaufen, Motorsport oder Tennis - keinen Mannschaftssport. Ich konnte noch nie einen Mannschaftssport ausüben.“

Warum?

„Ich bin nicht so dumm, um nicht zu verstehen, wann meine Probleme anfangen. Es fällt mir schwer, ihnen das zu gestehen. Meine eigentlichen Krisen entstehen immer dann, wenn ich sehr enttäuscht worden bin. Wie beispielsweise bei einem Verrat.“

Wer hat Sie verraten?

„Es begann damit, als ich erkannte, dass mein Vater eine Art Krimineller ist. Er machte viel Geld auf illegale Weise. Dann starb mein Judotrainer (mein Idol), weil er betrunken einen Autounfall hatte. Und zu guter Letzt nahm mir der andere Trainer meine Freundin weg. Und jetzt interessiert sich meine Geliebte für einen anderen Mann.“

Ihre Geliebte...?

„Ja, sie ist nicht meine Frau.“ (Seine Geliebte hatte eine Affäre mit einem anderen Mann.). „Das ist immer wieder das Gleiche. Ich habe oft Affären mit meinen Sekretärinnen oder Angestellten im Unternehmen. Der Erotikkult beschäftigt mich sehr. Ich habe mich mehrere Jahre lang mit tantrischem Sex befasst und es mit viel Erfolg praktiziert. Meine Frau allerdings hat sich niemals für diese Dinge interessiert, und ich wiederum könnte nicht mit diesen Frauen zusammenleben. Denn ich bin überzeugt davon, dass diese Sache nichts mit der Ehe zu tun hat, weil es etwas völlig anderes ist.“

Haben Sie schon einmal mit einem Psychologen darüber gesprochen?

(Er begann, laut zu schreien.) „Erzählen Sie mir nur nichts über Psychologen! Das ist nur ein Haufen unkompetenter Halunken, die die wahre menschliche Psyche nicht verstehen. Weil sie niemals eine wirklich spirituelle Schulung hatten. Wahre Psychologie ist die Psychologie, die schon seit alters her existiert. Der Rest ist bloß oberflächlicher Mist. Verstehen Sie? Ach, ich rede dauernd über andere Dinge und jetzt habe ich Ihre Frage vergessen.

Auf meinem spirituellen Pfad folgte ich jemandem, einer Frau, die mich wirklich inspirierte. Aber auch durch sie erfuhr ich eine ernsthafte Enttäuschung. Es war nicht das erste Mal, dass ich mit Frauen aus meinem Unternehmen eine Affäre hatte. Ich habe immer viel mit ihnen unternommen, denn ich bin ein sehr guter Mann, der sich immer um menschliche Angelegenheiten kümmert. Dabei geht es mir nicht nur um den rein physischen Geschlechtsverkehr.“

[Wenn er bei einer Person (Frau) Probleme sieht, ist sein Verhalten der eines Meisters, der permanent gibt. Er wird niemals eine Beziehung mit jemandem eingehen, weil er die Oberhand behalten will. Wie in Pygmäleon - er erkennt, dass eine Frau Probleme hat und will ihr helfen].

„Denn Sex mit einer sehr schönen Frau haben, das kann jeder. Aber die wahre Essenz von Erotik beinhaltet, ein echtes Gefühl der Vereinigung zwischen zwei Menschen zu spüren.“

Haben Sie das in Ihren Beziehungen erreicht?

„Mehr oder weniger endeten sie alle auf die gleiche Weise. Am Ende wollte jede Frau immer mehr. Trotz meiner Anstrengungen konnte ich bisher keine Frau finden, die fähig war, mit solch einer Beziehung richtig umzugehen.“

Und Ihre Frau...?

„Meine Frau entdeckte es dieses Mal, weil diese andere Frau bei mir zuhause anrief. Aber ich hatte schon beschlossen, meine Frau zu verlassen. Nachdem wir unsere Tochter bekommen hatten, schwand bei mir auch noch jegliches intellektuelle Interesse an meiner Frau. Sie war immer eine unsichere Person und doch wie ein Anker auf meinem physischen Weg. Wir trafen uns, weil wir beide sehr interessiert an Literatur waren. Aber sie verstand nie richtig, was ich gerne lese.“

Warum haben Sie sie geheiratet?

„Sie wurde schwanger.“ (Er will keine weiteren Aussagen zu diesem Thema machen.)

Wie geht es in Ihrem Beruf und mit der Arbeit?

„Bei der Arbeit ist alles in Ordnung, aber ich glaube, dass ich das Unternehmen wechseln werde. Ich werde alle meine Aktien zurückgeben und in ein anderes besseres Unternehmen einsteigen.“

(Ich fand später heraus, dass das nicht stimmte. Er war ein Angestellter auf hoher Ebene, aber kein Teilhaber. Sie kündigten ihm wegen seiner Affäre mit einer Kollegin.)

Erzählen Sie mir noch ein wenig über Ihre Beziehung zu Ihrem Vater....

„Ich spreche nicht gerne über meinen Vater, denn ich fühlte mich nie von ihm geliebt. Er bewertete mich danach, was ich tun oder nicht tun konnte. Dabei war ich immer der Beste und fühle mich auch verantwortlich für die Entscheidungen in meinem Leben. Schlimm war für mich, als ich entdeckte, wie er zu seinem Geld kam… doch das ist zu persönlich, um es zu erzählen.“

Was empfinden Sie bei dem Gedanken an ihn?

„Gegenüber meinen Eltern empfinde ich einen starkes und tiefes Gefühl des Zorns. Wann immer ich an meine Eltern denke, werde ich zornig. Ich denke, dass Wut eine Emotion ist wie jede andere, nichts besonderes. Ich bin einer der wenigen Menschen, die sich ein tiefes Gefühl des Zorns zugestehen. So etwas würde nach katholischer Moral als Sünde gelten. Ich glaube, dass die katholische Kirche uns einfach ignorant halten wollte. Wir sollen nichts verstehen und nicht wachsen können. Ich will als Mann vollkommen sein, das ist das Hauptziel meiner Existenz. Diese Erfahrung auf unserem Planeten ist nicht irgendein blöder Quatsch. Da gibt es Heilige und Krieger und sogar Krieger, die Heilige sind. Meine Schlaflosigkeit ist jetzt viel schlimmer geworden. Selbst Pillen und Kräuter helfen nicht. Ich habe noch nie einen guten Schlaf gehabt. Es fällt mir schwer einzuschlafen, ich wache häufig wieder auf und liege ruhelos im Bett. Ich denke, das hat viele verschiedene Ursachen. Da gibt es eine Art Frustration, die ich nicht erklären kann. Ich gebe mir wirklich Mühe, erst ins Bett zu gehen, wenn ich richtig müde bin.“

Er erwähnte nicht ein einziges Mal seine Blutungen wie in der ersten Konsultation.

Auf Nachfrage:

„Die Blutungen, ach ja… daran habe ich gar nicht mehr gedacht. Es sind jetzt so viele andere Gedanken in meinem Kopf, dass ich geistig ganz woanders bin.“

Offensichtlich beunruhigt es ihn dieses Mal nicht so sehr wie bei der ersten Konsultation.

Er soll mit dem gleichen Mittel fortfahren in der Q3.

Nach vier Monaten

Dieses Mal erschien er in einer eher niedergedrückten Haltung, nicht gerade deprimiert, aber in keiner guten Stimmung. Die Scheidung stand kurz bevor. Aber er bemühte sich nicht mehr so sehr, seine Probleme zu verstecken oder als gewitzte, brillante Person zu gelten. Er war offener, seine Probleme zuzugeben und eher bereit, sich ihnen zu stellen und sie zu lösen.

Altero sagt mir:

„Immer wieder erlebe ich Momente eines schnellen Wechsels zwischen Euphorie und Depression. Ich glaube, dass ich übersensibel bin. Wenn irgendetwas passiert, dann beschäftigt mich das Problem zu sehr. Ich fühle mich auch bei der Arbeit nicht wohl. Damit ich nicht zu viel daran denken muss, treibe ich viel Sport. Vielleicht wäre es besser gewesen in einem solchen Umfeld zu arbeiten, denn ich bin eine sehr sportliche Person.

Wenn man so etwas als Beruf betreibt, muss man an Wettbewerben teilnehmen, das gehört nun mal dazu (Auch im Geschäft will er eine solche Konkurrenzhaltung beibehalten, nur ist es da nicht so offensichtlich.). Aber das ist eine Welt der Haie, die sich gegenseitig heimlich umbringen. Und ich brauche das Geld schließlich zum Überleben.“

Wie ist die Situation mit Ihrer Frau?

„Es ist wirklich schlimm. Meine Frau ist dabei, mich finanziell völlig zu ruinieren.“

(In anderen Fällen dieses Mittels gibt es oft eine lange Vorgeschichte, wo sich der Patient Opfer eines ernsthaften Verrats fühlt, oft im Zusammenhang mit Menschen, die ihm sehr nahe stehen). „Eines der Hauptprobleme ist, dass aus steuerlichen Gründen nichts auf meinem Namen eingetragen war. Folglich gehört meiner Frau alles.“ (Er musste öffentlich eine Bankrotterklärung abgeben, was seinem Ruf schadete.)

Gibt es weitere Beschwerden?

„Seit kurzem bin ich etwas besorgt um meine Augen. Obgleich ich kaum Energiereserven habe, bin ich sehr engagiert bei meiner Arbeit. Wenn ich im Stress bin, habe ich das Gefühl, dass meine Augen geschwollen sind und weh tun, aber ohne dass ich Blutungen hätte. Ich vergaß zu erzählen, dass ich seit Jahren im Frühling allergisch auf mehrere Pflanzen reagiere. Es begann mit häufigem Augentränen, da war ich ungefähr 16 Jahre, und ich musste in dieser Zeit eine Menge Nasenspray benutzen. Jetzt ist es das erste Mal in meinem Leben, dass ich keinerlei Allergien habe. Ich kann sogar gut atmen und habe keine Schmerzen mehr in der Brust.

Und erfreulicherweise ist auch mein Blutdruck in Ordnung. Die Blutungen haben aufgehört, doch beunruhigen mich diese Augenschmerzen. Ich war bei einem Augenarzt, doch er meinte, dass meine Augen in Ordnung seien.

Manchmal wird mir auch leicht schwindelig. Ich habe das Gefühl, als ob jemand mir mit einem Stock auf den Nacken schlägt.“ (Wieder wird das Problem projiziert, als wenn jemand anderes ihm Leid antun will.)

„Ich weiß, ich habe ein starkes Ego. Ich investiere eine Menge Energie, nur um mein Bestes zu geben und immer der Erste zu sein. Weil ich meine andere Arbeit (die Druckerei) aufgeben musste, wollte ich mehr über Psychologie lesen... Selbst in diesem Verein beschäftigt man sich theoretisch mit Philosophie und Religion, doch der Ex-Vorsitzende bemühte sich nach allen Kräften, mir meinen Job wegzunehmen.“

Haben Sie eine neue Beziehung?

„Ja, ich bin jetzt mit einer anderen Frau zusammen. Sie hat mir eine Menge über ihre Erfahrungen mit einer Psychotherapeutin erzählt. Ihre Psychotherapeutin hatte auch eine spirituelle Schulung. Ich glaube, so etwas würde ich gerne auch probieren. Mit ihr habe ich sehr intensiven Sex. Aber eins ist mir noch nie im Leben passiert. Ich konnte früher stundenlang Sex haben und es war in Ordnung, aber mit dieser neuen Frau ist alles nach wenigen Minuten vorbei. Doch sie ist sehr glücklich, und ich will nicht dauernd mit derselben alten Technik weitermachen. Glauben Sie, dass ich damit auf dem richtigen Weg bin?“

Dann geht es Ihnen ganz gut soweit?

„Es stimmt, ich habe nicht mehr so viele körperliche Probleme. Aber ich habe jetzt so viele emotionale Schwierigkeiten.“

Altero rief wegen einer Grippe an mit hohem Fieber. Er nahm eine Wiederholungsgabe des gleichen Mittels und es ging ihm nach wenigen Stunden schon besser. Danach studierte er vier Jahre lang Psychotherapie.

Ich begleitete ihn noch weitere sechs Jahre, und nur noch wenige Male musste das gleiche Mittel als Wiederholungsgabe gegeben werden. Jedes Mal wegen Schlaflosigkeit.

Repertorisieren

Erste Mitteln

Klein - groß.

Cure takes Time

A constitution cannot be radically changed for the better in a week or a month. Hahnemann demanded at least two years for the cure of a chronic case. When such a case comes for treatment, refuse to take it unless the patient will promise all the time required. A patient may be told that his immediate condition may be ameliorated, but he must not consider himself cured and may experience a return of symptoms. The Prescriber - J.H. Clarke MD

Hering’s laws:

From above downwards.

From within outwards.

From a more important organ to a less important one.

In the reverse order of their coming.

Sankaran has outlined 6 basic levels that should be traced during a homoeopathic case taking:

Level 1: Pathological (The main complaint or diagnosis)

Level 2: Symptomatic (Description of actual symptoms, such as local symptoms, modalities and location)

Level 3: Emotional (What does it feel like? What is the emotional state of the patient whilst experiencing the symptoms?)

Level 4: Delusion (What does the patient feel like? Symptoms of the neuro-endocine-immune axis)

Level 5: Sensation (The sensation felt in the body when exploring the symptoms)

Level 6: Energy (Background pattern, movements and patterns observed or evoked by the interview experience)

[Dr. Margaret Lucy Tyler and Sir John Weir] presented by Sylvain Cazalet

Success in Repertorising depends on ability to deal with symptoms; and this has to be taught; it is not innate (= immanent). People all the world over are wasting their lives, working out

cases at enormous expenditure of time and minutest care, for comparatively poor results: and all for want of a little initial help. The key to the enigma, which they lack, is

GRADING of SYMPTOMS... The grading of symptoms in such-wise as to economise labour without compromising results; and, in the cases where all the more-or-less-indicated remedies lack some symptom or other of the totality, to know which symptoms are of vital importance to the correct prescription; and which are of less importance, and may therefore probably be neglected; and also which may be safely used as eliminating symptoms, to throw out remedies by the dozen from the very start; and which cannot be safely used to throw out any remedies at all, on pain of perhaps losing the very drug one is in search of - the curative simillimum.

To begin with, symptoms are of two orders:

a) those general to the patient as a whole (Kent's GENERALS),

b) those particular, not to the patient as a whole, but to some part of him (Kent's PARTICULARS).

Repertorisieren in Akute:

Elaine, my daughter had swine flu! I wish I could write it up for you but I wasn’t able to help her much. I tried maybe 8 different remedies during the course of the illness but nothing really helped.

My sister had the same symptoms when she stayed with me the month before. Poor thing was sooo sick- she’s still talking about it! I tried many remedies to no avail.

After she left, I bought 2 remedies that I thought would have helped her (that I didn’t have) just in case one of us came down with it. But, none of them helped my daughter.

I wondered what others have found helpful for this flu because:

* Gels.

* Bry.

* Ars.

* Acon.

* Eup-per.

and a bunch of others did nothing.

The symptoms were (in order) sore throat, high (104° F) fever, severe body aches, severe chilliness, pounding headache.

Now Kelly, as you know, none of the symptoms you just mentioned mean anything to the homeopath!

What?

And why do I say that? Because the Repertory rubrics for these designations (fever, sore throat, etc.) are so large, so huge, so generic that virtually every homeopathic remedy in the Materia Medica covers them!!! Homeopathy is a system of “peculiars”. What’s peculiar about your fever? What’s strange about your sore throat? That’s what we have to know! This is the only way we can find a remedy. Towards that end always remember: The Big 4!

The Big 4?

Yes, the Big 4: Sensation, Location, Modalities, Concomitants

Oh my God! You’re right! It’s a little tricky, I gotta admit; but, I think you’ve got something going there! So, I think you better tell everyone what the Modalities are.

Kelly, modalities are REALLY important to us; if we don’t get the modalities in a case, we may not be able to solve it! Modalities are all the factors that exert an influence on the complaint! For example, you have the flu, let’s say; and believe it or not, there will be factors that will make it better or worse and we need to know what these things are; you may be better for cold drinks, or, worse from fresh air, or better for hot bathing or hot drinks like tea, or better from hand-holding and sympathy, or worse from all company and conversation. These little details could not possibly be more important to the homeopath! Try and think of EVERYTHING that makes your complaint better or worse!

And what about concomitants, what are they?

Concomitants are the adjunctive symptoms in the case. “Additional symptoms”. They are highly valued because they are often the striking, strange, rare or peculiar ones which Hahnemann says we need to know or the likelihood of cure is rather slim. Take for example, menstrual cramps with burping. What does burping have to do with menstrual cramps? Nothing, that’s what makes it the concomitant! I need a remedy that burps and hopefully also has cramps! When Shana had menstrual cramps one time and started burping, I went right for the Carb-v. (our major burping remedy) I didn’t even stop to think about it! It worked too!

Observing the patient is very important and can often give you the concomitant. Observe what the patient is doing and saying. This is so important, it’s part of my questionnaire: What are you doing? What are you saying?

Sometimes body language tells us what we need to know. Bryonia patients are lying perfectly still and won’t answer your questions (because the slightest movement aggravates - even talking).

Colocynth and Mag-p. patients are bent over double. Gels. patients answer every question with “Huh…?” because they’re in a semi-stupor. Nux-v. is rudely making demands (“I’m still waiting for the glass of water I asked for two seconds ago!”). Ars. beggs you not to leave! (“Can’t you just stay one minute more?”)

Do you need to know anything else besides the Big 4?

Which, again, are?

OK, singing now: Sensation-Location, Modalities-Concomitants/Sensation-location, modalities-concomitants!

Very good Kelly! Yes, yes it would help to know more; three more things:

1. Is there a time issue? Is the patient < in the evening? < 219 h.? < at midnight, etc.? Think of this as the Time Modality.

2. Did the complaint come on suddenly or gradually? Complaints that come on suddenly are often covered by just two remedies! Acon. and Bell.!

Really?

Sometimes Bapt., if the case is septic.

And what does that mean?

Sepsis is characterized by bad odors, stuporousness, confusion, etc. If a septic condition comes on suddenly, think of Bapt. Bapt. is thought of as a “worse” Gelsemium with the addition of thirst; plus, stuporous presentation, apathy and inclination to sleep.

3. I’m leaving the best for last.

What’s that?

3. Etiology!

That means the cause! Am I right?

Yes. You have to know this! The remedy must cover it! Unless the etiology is something vague, like, “germs” or something really common, it alone could be so valuable as to solve the case for you! How often has this happened? You’ve taken the case, it looks really good for a certain remedy, like Bell.: the patient is red, full of heat, burning; you’re just about to give Bell. when you ask, “When did it start, after what?” And the patient says, “Oh! Allergy to peanuts!” Allergic???? That’s not Bell., that’s Apis! See, when you know the cause, it changes everything!

Ladies and Gentlemen, take note: Etiology Over-rules Symptomatology!

We seldom need to know any details, such is the importance of etiology.

So, getting back to your daughter’s flu, when you say “sore throat”, I would say:

What was the sensation?

What makes it better or worse?

Where in the throat is it, right side? left side? the whole thing?

We need to do this for every symptom. A properly delivered symptom would sound something like this:

I have constipation with no urging which is chronic and causes much abdominal pain which causes me to bend over double and rub as hard

And why do I say that? Because the Repertory rubrics for these designations (fever, sore throat, etc.) are so large, so huge, so generic that virtually every homeopathic remedy in the Materia Medica covers them!!! Homeopathy is a system of “peculiars”. What’s peculiar about your fever? What’s strange about your sore throat? That’s what we have to know! This is the only way we can find a remedy. Towards that end always remember: The Big 4!

Anything else you need to know in taking an acute case?

WHAT’S WRONG!

WHEN DID IT START, AND, DID IT COME ON SUDDENLY or GRADUALLY?

DO YOU KNOW WHAT CAUSED IT?

(Don’t forget to observe the patient; what’s he doing, what’s he saying, what does he look like?)

WHAT MAKES YOU BETTER OR WORSE IN GENERAL?

(this includes time of day when person is better or worse) Plus, all the “I” symptoms.

THE LOCAL SYMPTOMS with THE BIG 4: sensation, location, modalities, concomitants

(You need to know this for each local symptom that’s part of the case! Don’t tell your homeopath, “My leg hurts! My scalp itches!” Say, “My leg hurts in the calf area, I got it from over-stretching, it’s better from rubbing.” “My scalp itches. Scratching makes it worse! Very hot water makes it stop.”)

Remember that Concomitants are any symptoms that are unexpected or just curious. They may be “normal” but out of place, or in excess, or less than what you’d expect like lack of thirst during fever.

IF THE CASE HAS A MENTAL/EMOTIONAL CONCOMITANT, THE REMEDY MUST MATCH THAT (unless it’s vague or common)!

Is there a hierarchy of symptoms?

It happens there is! We’ve already said that etiology overrules symptomatology, and that Generals are more valuable than Particulars in terms of remedy matching. So, here it goes:

Diagnosis/name of the condition-aka, “The Chief Complaint” (ask patient to describe in his own words)

Onset-sudden or gradual

Etiology (what caused the complaint, and when)

The Appearance-what does the patient look like? What does he ”say” and “do”? (He may say things like, “I’m doomed!” or “Bring me some ice!” all clues to the remedy; he may be tossing and turning; or, conversely, lying perfectly still; all important information.)

Generals

Particulars (the big 4, which are, again?)

Are you askin’ me? Are you talkin’ to me?

So now you’re Robert DeNiro all of a sudden? Let’s move on to discharges. If there are discharges, you’ll want to know their color, odor and consistency. You’ll also want to know if they create a sensation - like burning, irritation or itching, etc.

Plus, for heaven’s sake, don’t mix up acute and chronic symptoms! Don’t tell the homeopath you’re thirsty if you’re ALWAYS thirsty! Don’t tell him you’re irritable if you’re ALWAYS irritable!!

By knowing how to solve acute cases, you can stop a complaint from going chronic! You can save a life! You can stop a person’s suffering! Even people with chronic disease develop acutes of one kind or another; this is why we have to treat chronic disease in a manner that allows us to stop the chronic remedy during an acute, give the acute remedy, and resume chronic treatment when the acute resolves. Obviously high-potency, one-dose chronic prescribing does not lend itself to this! We can’t let people suffer, they’ll leave homeopathy and go right to their doctor!

Patients must not be expected to describe their sensations in the bald language of the repertory. A patient will more likely say, “The pain is worse when my hat is on”, than he will say, means “The pain is aggravated by pressure”.

Do not go against the modalities: [Elaine Lewis]

Modalities are the things that make the complaint better or worse. (itchy rash isn’t better for hot applications, don’t give Rhus-t! Rash isn’t aggravated by hot bathing, don’t give Sulph.! If a person is better for a good night’s sleep, don’t give Lach.! If a person says, “I love warm, stuffy rooms”, don’t give Puls. your first choice! It’s hard to imagine what could be more important in a case than the modalities (except finding the cause)! Be sure and ask for them. When someone tells you their complaints first try to find out the cause, what caused it, because you may be able to use an “ailments from” rubric to solve the case, which might make the symptoms, themselves, irrelevant; then, if discovering the cause does not open up the case for you, ask them, “What makes it better or worse?” I don’t care what they say is wrong with them. Sometimes we can be overwhelmed when we hear a case! So much is wrong! It sounds so serious! Just remember to say, “What caused it?” Then, “What makes it better? What makes it worse?” Give examples: heat, cold, motion, cold drinks, hot drinks, lying down, hot or cold applications, sympathy/company, massage, pressure, sleep, etc. There’s almost nothing you can do if all you have is the name of the illness! But for example, if someone says, “I have a headache that’s better for hard pressure,” that could be Bry.! Now, try to think of a remedy that’s WORSE for hard pressure-that’s the remedy NOT to give!

Acute Case Taking in a Nutshell:

Here are the basics questions to be answered:

What changed since you got sick?

When did it start?

Do you know what caused the problem?

What are the symptoms? (physical and mental)

Do they extend from one place?

What are the sensations? (burning, aching, stinging, itching etc.)

What are the locations of the symptoms?

What are the modalities? (What makes it better or worse?)

What are the concomittments? (What symptoms occur together?)

Prescribing on Causation

Some remedies associated with specific causes. For example, Colocynth is effective for internal spasms caused by anger.

Dehydration: Chin. Carb-v.

Grief or loss: Ign. Nat-m., Caus.;

Vaccination: Thuj. Sil.;

Head injuries: Arn. Nat-s. Hyper.

Humiliation: Staph. Ign. Lyc.

Sexual abstinence: Con.

Repertorisieren for Chronic Ailments:

Look for:

Excesses, Deficiencies, Blockages, Loss of vital fluid. Also, sensitivities to noise, weather, etc. What do they over-react to?

Motivation: What’s their motivation for doing whatever it is they say they’re doing? For example, Nux-v. is ambitious. Ars. feels vulnerable and insecure so he is motivated to accumulate more money than he actually needs and to cultivate a support network of people who are dependent on him so they can never leave. Phos. is motivated to make friends in order to counter the delusion that he is alone, isolated on some distant island.

What is the focus of their time/energy/attention? What is dissipating their energy? Is there suffering? Treat any suffering first. Look for keynotes of remedies.

See if there is a compelling etiology. For example if everything happened after a head injury, that fact is more important than the totality of symptoms. The rubric would be ”Head: injuries, ailments from”.

The top layer is a chronic disease with X or Y acutes. You’ll need a remedy for the disease and an intercurrent remedy for the acute/s.

Determine the “essence” remedy underneath the disease. Finally, determine the constitutional remedy-the healthy state the person was born with. It could be calc-carb, sulphur, etc. For example: Disease: cancer- remedy-conium. Essence remedy underneath: Nat-m. Constitutional remedy under Nat-m.: Phosphorus. How would you know? The cancerous tumor is hard/indurated with a concomitant of vertigo on turning the head - Con. The Patient began her life as an out-going, sociable person, extroverted, tall and thin; then was put into foster care after losing her parents and became Nat-m. (Nat-m. has a relationship with Con. according to Robin Murphy.)

Regarding Aggravations: If a remedy aggravates with no amelioration, it could mean: right remedy, but out of order. You may be overlooking a recent layer; may have prescribed “too deep”. Look for suffering in the case which needs to be cleared first; such as, pain or infection or disease/pathology. Try the remedy again after you have cleared the top layer and it might work then.

THE GRADING OF SYMPTOMS

1^st grade: MENTAL SYMPTOMS if well marked. These take the highest rank; and a strongly marked mental symptom will always rule out any number of poorly-marked symptoms of lesser grade. (For these may never have appeared in the drug-pathogenesis - perhaps for lack of a sufficiently drastic proving; and yet, time and again, the drug will clear them up). The mental symptoms, always provided that they are very definite and well-marked, are the most important symptoms of the case.

But for the mental symptoms particularly, it is well to go constantly through the Repertory (Mind-section), and to master all that is presents; and to make cross references; and to be sure that you get the correct rubric; and often combine two rubrics that practically amount to the same thing, and yet do not give quite the same list of drugs. As, for instance, aversion to company and better alone may not be quite the same thing; and yet it is often difficult to sort them. Again, worse in the dark, and fear of darkness are difficult to fix correctly in many cases, while the elements fear of robbers, fear of ghosts - of apparitions, etc., may come in: so here you have at least 4 rubrics which you may have to combine on pain of missing something. Many of the rubrics must be considered in company, and all with intelligence and some elasticity, or there is great danger of eliminating the very drug you are in search of. And - the better you know your Repertory, the more rapid your work will be, and the better your results. Never grudge turning its pages!

2^nd grade, after the mental symptoms, and his reactions to mental environment, come, if well marked, such general symtoms of the patient as his reactions, as a whole, to bodily environment: - to times and seasons, to heat and cold, to damp and dry, to storm and tempest, to position, pressure, motion, jar, touch, etc. But they have got to be in capitals or in italics in the patient as well as in the Repertory, to take this rank; or to be safely used, some of them, as eliminating symptoms. ("Some of them", because there are perhaps only half-a-dozen symptoms which it is at all safe to use in this way; and then only, of course, if strongly marked).

And, once again, be sure that you have your very rubric; and if necessary combine two rubrics that work out practically as synonyms, and yet do not present quite the same list of drugs. A doctor was driven to despair over a case of melancholia by using better for open air instead of desire for open air. The symptom was so intensely marked that it was used without hesitation as an eliminating symptom, ruling out Sulphur (which has desire for open air), but which had every other big symptom of the case in capitals and which promptly cured. You have got to know your Repertory from cover to cover, if you are to have the best results: and you have got to use it with brains and imagination.

3^rd grade general symptoms are CRAVINGS and AVERSIONS. But to be elevated to such rank, they must not be mere likes and dislikes, but longings and loathings: in big types in the Repertory, and in the patient - in corresponding types, anyhow !

In corresponding types everywhere and all through: and this is most important. As, for instance, if your patient is only a little restless, Ars. and Rhus-t., superlatively restless remedies, will, of course, be rather contra-indicated. Big types in the Repertory will never help you, unless the symptoms are big type in the patient too. In first taking the case, it is well to vary the type as you set down the symptoms; to put those poorly marked in brackets, and to underline the intensely marked symptoms: for that will help you to match them correctly.

4^th in women, the MENSTRUAL STATE, i.e., general aggravation of symptoms before, during and after the menses. Of lower rank comes the question of menses early, late, and excessive - and this last of course only where there is nothing such a polypus, fibroid, menopause, to account for it.

5^th PARTICULARS - the symptoms that bulk so largely for the patient, and for which he is as a matter of fact, actually consulting you. You will have taken them down first, with the utmost care and detail, listening to his story, and interrupting as little as possible; but you will consider them last: for these symptoms are really of minor importance from your point of view (certainly in chronic cases) because they are general to the patient as a living whole, but only particulars to some part of him. In a great railway system, for instance, a strike that raises the price of fuel for a few weeks, an accident on the line that means compensation to the repair of few yards of permanent way, are less vital to the Company than the brain quality of its General Manager, of the force, competence and activity of the Chairman and Board of Directors. Make the executive of the Company efficient, and it will deal in the best way with details. In like manner, put your patient, as a whole, in order, and he will straighten out the disorder of his parts. You have got to get at him; and you can only get at him through his general and mental symptoms. Start for the Particulars, and see where they land you! In the body politic, where the executive is not sound, you deal with lax discipline here, with peculation there, with incompetence, and disorder, and slackness, and inefficiency. There is rottenness at the core; and you will find that as fast as you clear up one mess; the system breaks down at a new part. Go for the Management; put that right; and let it act. So with your work: - start treating an eczema, per se, and "cure" it, to find yourself confronted with - say asthma; prescribe for that, and the wretched patient comes back presently with a brand-new disease - Rheuma: tinker with that - and the heart gives out. Go for the executive - for the patient himself; - the patient who was all along capable of eczema - asthma - rheumatism: go for the patient as a live entity, revealed by his general and mental symptoms in chief; deal with him according to the Law of Similars, and he will do the rest. Always provided that the thing has not gone too far, that the tissue changes are not too gross, he will even undo the rest, step by step backwards, to the reproduction of the initial lesion on the skin. The whole is greater than its part. Never juggle with "Particulars" at the expense of the life of the whole.

But, in their right position of secondary importance, you must go into the particulars all the same, and with great care (if only to confirm your choice of the drug); and it will amaze you to find how they fall into line, when the choice is correct. More than that, when the drug has been chosen on general grounds, the patient will return and tell you, not only "I'm better", and that the trouble for which he consulted you is better, but he will volunteer, "My knees are better too, all the swelling has gone"; and referring to your notes you discover that you had never heard of his knees before ! and he will go on and tell you that his back (of which you hear now for the first time) is much less painful: and the constipation, which he had not previously mentioned, is a thing of the pasts. (This was a Nit-ac. case!).

Among the PARTICULARS, your first-grade symptoms will always be anything peculiar, or unusual, or unexpected, or unaccountable. You now want to know not only how your patient, as a whole, reacts to environment, but how his head, his stomach, his lungs, his muscles and joints stand heat and cold, damp weather and dry, react to stuffy atmosphere or draughts, desire or resent movement and jar. You will find one headache being banged against the wall; while another has to be nursed with such extreme care that the sufferer dare not move a finger, and would swear, if the movement of his lips were not agony, when you clumsily lurch against his bed. Or another headache will demand a bolt-upright position; while for a fourth the only thing is to kneel up, while it is pressed low into the pillow, or against the floor.

Now, to get the terms clearly

A GENERAL SYMPTOM, OR A GENERAL, IS ONE THAT REFERS TO THE PATIENT HIMSELF, AS A WHOLE, AND OF WHICH HE CAN SAY "I", instead of "My". "I feel the cold frightfully: " "I dare not move hand or foot in a thunderstorm; and I simply couldn't be alone." "This heat is knocking me all to pieces - I just can't stand it!" - these are Generals. In these the patient expresses himself. Remember, he is the sum of many lives, building up many tissues, and organs of diverse function. Through the Generals the Dweller-in-the-House speaks -

through the Mentals and Generals: - the Life which is the sum of the lives, and something beyond that: - the Life "in which they live and move and have their being"; and with whom, whatever their individual life and vigour, they perish. Truly the whole is greater than its part. Surely it is scientific to deal with the whole first, as a Whole?

But where your patient says "My" instead of "I", there you have a Particular. "My headache is awful in the house: the only thing for it is to go out and walk about. It often drives me out of bed at 2 or 3 h., to walk the Common for hours." (These are not exaggerated statements: we are giving you, all through, actual words of actual patients; and the magic drug for the last was Puls.).

But the Generals and the Particulars may not only be quite different, but they may be flatly contradictory in the same patient: so you see how imperative it is to get them clearly, and to know what value to give to each. Arsenicum is worse from cold: Ars. stands in the list of "predominantly cold remedies" in capitals. And yet the headache of Arsenicum is better from cold. Ars. has been described as only comfortable when "rolled in blankets up to his chin, with his head out of the window." Lycopodium is a warm remedy in the main, and often cannot stand heat: yet his stomach symptoms, which are a great feature of the drug, are ameliorated by hot food and drinks. Of these the patient says not "I", but "My", therefore they are particulars. He may say, "I cannot stand heat", (a General of the highest importance, and one of the most safe and useful of eliminating symptoms - if strongly marked !) - "I cannot stand heat, but my indigestion" (a particular of the greatest importance to the patient, and on which he lays the greatest stress) "is better for hot food and drinks. Cold things always disagree with me", (meaning his stomach). Again, Phosphorus stands in capitals as a very cold person -

If you are to be a good prescriber, by the way, your drugs have got to be people for you, with whims, fancies and terrrors; with tempers and idiosyncrasies and characteristics: you have got to see them stalking about the world, speaking and moving and halting, with the bodies-minds-souls of men. You have got to travel with them in tram or train, and they will betray themselves, buttoned up and shrinking together, or loose and jolly and open; fidgety, restless, fearful; dull and inert; quarrelling for an open window, growing at the draught with windows closed. You have got to dine with them, and they will reveal themselves in their relation to food and drink, and in the mental revelations such convivial moments of relaxation call forth. You may spot them, standing for preference, or sinking always into the nearest seat; stoop shouldered and drooping, or erect and full of "go"; depressed and querulous; restless and anxious, as their deeply lined faces testify; smooth and smug; dirty complexioned and careless of appearance; chalky faced and flabby of superlative tissue: compact and hard as nails; fault-finding - affectionate and mild - responsive to every wave of sentiment and emotion - dull and indifferent. Look for them everywhere, and learn them, and they will betray themselves at every turn; and you will often save yourselves hours of solid work, by spotting them as they enter your consulting room.

5^th PECULIARS. So, to hark back... Phos.: a very cold person, but his stomach is > cold drinks. When that is sick he craves for cold water, which is vomited, so soon as it gets warm in the stomach.

This is a particular, true, but a priceless one, because it is peculiar to Phos. And here we have a new term - a "PECULIAR" symptom, strongly diagnostic of one drug. These peculiar symptoms are especially useful in acute diseases where you are more likely to meet them, and where they often provide a brilliant short-cut to the drug, saving time and toil. And see how these peculiar unaccountable, contradictory symptoms help you - how unexpected they are, and how diagnostic ! here you have the superlatively chilly Phosphorus: and yet his pains are often of the most intensely-burning description: and though, as a whole, he cannot tolerate cold, yet his sick stomach craves for icy drinks, which it cannot even retain when they get warm ! Take your Generals and Particulars mixed-up and awry and just-anyhow, and you might land in giving such a patient Lycopodium; for both are worse for heat, and worse for cold; only the Generals and Particulars are exactly reversed ! For Lycopodium is in the main, intolerant of heat, which his stomach craves; while Phosphorus detests the cold which his sick stomach demands with vehemence. See how all-important it is to get your Generals and Particulars right! This is where we fail, and blame Homœpathy.

6^th Then, besides Kent's Generals and Particulars, you have COMMON SYMPTOMS. A symptom may be common to all cases of a certain disease, and therefore of no great use in picking out the individual remedy for a particular case of that disease; or it may be common to a very great number of drugs, and therefore indicate one of a large group of remedies only; and so of very little use in repertorising. Take thirst, a general symptom of the patient, though in the Repertory relegated to the section "Stomach": - "I'm terribly thirsty." If there is nothing to account for the thirst, it may be an important symptom; though common to a great number of drugs! But if the patient is running a high temperature, or suffering from diabetes, or if his work keeps him in the heat of a bakehouse or an engine-room, or if the weather is suddenly and unusually hot, the symptom becomes a Common symptom, and almost valueless. Don't waste life in writing down that awful list of remedies "Thirsty". Absence of thirst under conditions where you would expect it, on the contrary, becomes a very important symptom, as absence of thirst with a very high temperature - Kent has a rubric for that.

Remember - THE MORE UNCOMMON A SYMPTOM IS, THE MORE VALUABLE: THE LESS YOU CAN ACCOUNT FOR A SYMPTOM AND THE MORE INTENSELY PERSONAL IT IS, THE MORE IMPORTANT. In inflammation, for instance, worse from pressure is what one would expect, and of little value - so many drugs and most inflammations have it ! But better from pressure, under these circumstances, is priceless, and leads you to a small group of drugs, such a Bry. Frequent micturition with a fibroid impacted in the pelvis is not a symptom that will help you in working out your case; it is a Common symptom and amply accounted for... and this leads one to insist on the absolute necessity for correct diagnosis before you even open your Repertory. Remember, the priceless symptoms for success are the strange, the rare, the unaccountable ones; those that flatly contradict preconceived ideas, and head off straight for a limited number of drugs.

6^th "ELIMINATING" SYMPTOMS

This is a new word, but expresses what we all desire in repertorising, and what we have got be very cautious of using too rigidly, lest we lose the remedy we are looking for.

Instances best reveal meanings. Take one. Say your patient complains of dyspepsia, with burning pain in the stomach, and the frequent vomiting of sour fluid. He pours you out particulars, which he has at his finger-tips; since they are just the symptoms that impress a man's memory, by intruding themselves on his consciousness in a very realistic way. You jot them down till you have got the case as fully as most people go, with all its modalities (i.e. the conditions as to heat and cold, movement and rest, position, hours of day and night, relation to food and drink, etc., of the stomach condition complained of). You have assured yourself, by careful examination, as to whether the trouble is likely to be organic or functional; or whether some of the symptoms have got to be discounted, as secondary to some gross lesion. And now it is your turn. You have to elicit the general symptoms of your patient; you have got to switch him off the siding "my", and on to the main line "I". And you now find that he cannot stand heat - whatever his stomach may do; that he is ill if long out in the sun: that he wants a cool room, prefers cold weather and a cold climate: that he never goes near the fire: and you noticed when he came in that, though the weather was cold, he was not buttoned up, or thickly clothed. It is not closeness or stuffiness so much that affects him (you have got to be careful between these!) but heat. He is one of Dr. G. Miller's "predominantly hot-remedy people". There is an eliminating symptom for you! You know at once, whatever his stomach condition may be (its particular symptoms might perhaps be equally well-met by Ars., Phos., Nux-v. Lyc. Nat-m. or a host of others); but with that temperament, that warm personality, it would be useless for deep and curative work to think of giving him Ars., Phos., Nux or Sep. He is a hot patient, and these are predominantly cold remedies. You can strike them out at once. For even if one of them, aptly fitting the exact stomach symptoms only, gave temporary relief to the immediate condition, the patient would relapse again and again. It could not hold. It would act as a palliative, not a curative drug. It might provide a temporary organ-stimulus: it could never be the stimulus of the organism. And here you see well the difference between deep and superficial work - between curative and palliative. The people who get their honest triumphs in similars, and see at least brilliant temporary results in superficial and acute conditions, and believe honestly that these are the very best attainable by medicine, scout the idea of the lasting triumphs of the simillimum. They know well, from years of experience, their own limitations; and it seems to them outrageous that other people should make larger claims. As a matter of fact, when you get the real simillimum, the odds are that, instead of palliating the stomach condition, you will aggravate it a thousandfold - for the moment; aggravate it, once and for all, to cure. And if you do not know your work, you will think that you have got the wrong medicine and antidote or change it; and your patient will be, so far as you are concerned, incurable. But it may be your ignorance only that makes him so!

So now, down all the rubrics, mental, general, and particular, you will carry that great eliminating symptom, WORSE FROM HEAT, and ruthlessly cut out all the remedies that are chilly, and therefore deeply help chilly people. None of these you need write down at all. Using Dr. G. Miller's list, which we will give in a moment, you can go on to any other General, and especially to any marked mental symptom, and often get a pretty correct idea of the exact remedy before you ever start to tackle the particular and immediate suffering for which the patient comes to you. Now supposing you discover that he is liable to fits of depression, and yet cannot endure any attempt at consolation; that he becomes a very fiend if anyone attempts to cheer him up - even to enquire what is amiss: the people have learnt to let him severely alone, when his moods are upon him; why, with these two important symptoms alone, worse from heat, and worse from consolation, which have got to be in equal type, remember, in the patient and in the drug, you have reduced your area of search to Lil-t., Nat-m., and Plat. (for Lyc. and Merc. come through the "< consolation test" in the lowest type only, which is hardly good enough for such a marked loathing of consolation as this !) Or, if your patient had been as predominantly chilly and worse for cold as this one was for heat, and the aggravation from consolation test came out as strongly, you would have found yourself at the start of your work with Ars., Bell., Calc-p., Ign., Nit-ac., Sep. and Sil., with two or three others to play with in brackets - lowest type. If you can get such marked eliminating symptoms to begin with, see what a comparatively small number of drugs you have to carry down through all the rubrics, and how much easier and quicker it is to get your remedy, and how much greater confidence you have in the result of your search. You will generally find, as you work down, that one drug stands out more and more pre-eminently: - it may not be in all the rubrics, but it has got to be in all the important ones, i.e., those best marked in the patient, and of highest grade. And presently you throw down your pen: you are convinced; and it is a mere waste of time to go further.

Now take the same case and start, instead, on the marked symptoms complained of by the patient - the Particulars, and just see what work you have cut out for you! Begin with the rubric Vomiting, and write it out for the last time, and see what it entails. And write all the drugs, in all the types, lest you should miss any. Take his particular symptoms, one by one, and write, and write, and write.

Vomiting, 162 drugs.

Vomiting water, 108 drugs.

Vomiting sour, 89 drugs.

Burning pain in the stomach, 186 drugs.

Pain in the stomach p.c., 110 drugs, etc.

It may be easily such a list, of which this is but the merest beginning: - no wonder that people get "Repertory funk!" - for remember that people are actually doing this, at this moment, in all quarters of the world: for they are sending us their beautifully-neat, conscientious and exhaustive work to show, as they ask for a better way: and it is their cry for help that has caused this article to be compiled. Sheets and sheets of paper you will cover. One that lies before us now has all the drugs in forty-nine different rubrics, some if immense length, as Stools offensive, Burning urine, Stools pasty, Yellow stools. Why, before you ever come down to such symptoms, you should have three of four drugs only in hand: - and they are symptoms of the lowest grade, and Common symptoms; hardly worth glancing through for confirmation of the drug. Moreover, there is the possibility that you may accidentally omit the very drug you want from some of the long lists you are so slavishly copying: and the odds are, that when they are all complete, without the aid of eliminating symptoms some half-a-dozen drugs will come out pretty near one another when you count up at the end, and that your travaux d'Hercule will leave you unconvinced and still in doubt.

A pathognomic symptom is the distinguishing symptom of a disease or condition, e.g., the peculiar rash and odor of measles, the primary and secondary fever of smallpox, etc.

A characteristic symptom is the distinguishing symptom of a drug. It is to the drug what the pathognomic symptom is to the disease, e, g,, agg. of all the symptoms by means of sleep under Lachesis.

Which Symptoms are Important?

Functional symptoms in an organ are of much less value than symptoms which occur in other parts during the function of that organ. Burning pain in the urethra, during or after micturition, is of little value in gonorrhoea, for it is usually present; but pain in the testicles, thighs, or abdomen during or after micturition, or symptoms of some other part not immediately concerned in that function, would be more important. So, also, pain in the stomach after eating, in indigestion, is not of as much value as vertigo or headache after eating would be in the same attack.

Problems confronting one when first attempting to prescribe homœopathically.

[Dr Elizabeth Wright Hubbard] Presented by Sylvain Cazalet]

Dr. Underhill has told you most graphically and humorously how he was led into homœopathy so I will omit my initiation except to say that after working at the “Allgemeine Krankenhaus” in Vienna in the usual way, I was apprenticed for nine months to a homœopathic physician in Geneva where I studied, literally, from 12 to 16 hours daily.

Before he was willing to take me as a pupil, he gave me a stiff examination in ordinary medicine, including Anatomy, fractures, surgical diagnosis, pathology, bacteriology, and chemistry, and gave me slides to diagnose under the microscope, etc. He then asked me certain questions as to what I thought life was about, why I went into the practice of medicine, what were the chief duties of a physician

and so on. These questions perplexed me, as I did not then understand their bearing on the philosophy of homœopathy. It was, "What do homœopaths give for rheumatism?" Having read somewhat in homœopathic literature. I answered that homœopaths do not give a remedy for rheumatism or for any disease name or diagnosis (although, of course, certain remedies are more frequently indicated in rheumatic conditions). They give a remedy on the symptoms of the patient who has the disease, in other words on the reaction of the individual in question to any given disease entity. This defines one

of the fundamental differences between the homœopathic approach and regular medicine.

Until the physician's mind has compassed the differences between the viewpoints of ordinary medical training and Homœopathy he cannot even begin to prescribe homœopathically. Let me enumerate,

for clarity, wherein these differences lie.

1^st as above mentioned, he must grasp the principle of individualization. Modem medicine lays a good foundation for this through its interest in endocrinology and psychiatry, but except for obvious glandular imbalances it offers, as yet, no therapy commensurate with the refinements of differentiation. What does individualization mean to the homœopath and how does he arrive at it ? It involves a subsidiary new method of case-taking. After you have your classical history, elicited largely by asking questions, you can often make a diagnosis but rarely a homœopathic prescription. For the latter you need to know the mental state of your patient, and what the homœopaths call his "generals", which mean the things which apply to the patient as a whole-his reaction to heat and cold, wet and dry weather and storms, motion, position, food, etc.

You need to know how these same factors affect the specific complaints of your patient, in other words the modalities of his particular disease symptoms-whether his headache is better from hot or cold applications, from motion or rest, from lying or walking, from pressure, or food, and at what time of day it is worse. ("Modalities", in other words, mean aggravations or ameliorations of specific symptoms, just as "generals" mean aggravations and ameliorations of the patient as a whole). There is a fourth type of thing that you must know about your patient in order to prescribe homœopathically and that is his rare, peculiar, or characteristic particular symptoms. These often appear trivial idiosyncrasies to the patient, things that he has always had, or that no doctor to whom he has told them, has ever been interested in. These often serve as Keynotes to guide to a remedy. But of what use is all this additional information about your patient ? How does this picture of his personality aid you ? You have individualized, but of what use is such differentiation, if you have only a standard treatment for the condition that you have diagnosed ?

2^nd This brings us to the second great difference between homœopathy and regular medicine. The law on which homœopathy is based, or, if you prefer, the hypothesis, is to be found in the statement of Hippocrates, "similia similibus curantur." which Hahnemann revived and amplified. Dr. Sterns has told you how Hahnemann came to apply this law and made the first so-called "proving" of quinine.

A "proving", in the homœopathic sense, is experimenting with a drug in minute doses on a relatively healthy human being. The record of symptoms so produced, on a large number of provers of different ages and sexes, constitutes the basis of our homœopathic materia medica. The object of proving a drug is to delineate the drug personality.

Each of our remedies is to us a living individual, they are like friends whom one recognizes whenever seen, not only by their grand characteristics but also by their mannerisms and tricks. We now have on the one hand, the drug personalities, and on the other the picture of our patient in his present state. It follows, if like cures like that we must match pictures and fit the personality of a drug to our patient, administer it, and watch the results. After one has grasped this ingenious theory and learned to put it into practice, it remains only to see it work. I, for one, being a natural septic, was slow to believe that evidence of my senses. Could the astonishing improvements and cures have been coincidence, or suggestion, or faulty diagnosis ?

There are certain controls which one can use. Put the patient on the proper regimen including diet, etc., and see what that alone does for your condition. Then give Placebo, with your best manner. In my experience, in nine cases out of ten, the patient will report no progress. When they are discouraged by this unsuccessful first prescription, give them the remedy you have chosen, the simillimum. If you feel reasonably certain that the drug-picture fits your patient ; and you have the simillimum, in most cases you will see a swift and beautiful result. But these are not the only possible methods of control. There are laws of remedy action which are contrary to anything you could expect in an untreated case. When you see these, you know that your remedy is taking hold.

3^rd? They were formulated by Constantine Hering, one of the pioneers of Homœopathy in this country, and are as follows: The curative remedy acts from within outward, from above downward, and in the reverse order of the symptoms.

Take, as an illustration, a case of rheumatic fever in which, after the customary salicylate dosing, the joints appear to have cleared up but a heart condition develops. Give such a patient the similar remedy and he will complain that his joints are worse again, but he himself feels better and you find that his heart is clearing up. You explain to him that the remedy is working from within outward, the more vital organ, the heart, is getting well first, and the peripheral organs, the joints, are again involved. Give him nothing but Placebo. Shortly he will tell you that his shoulders and wrists are clearing up but that the pain is now in his knees or ankles. Again you see the law of cure in action, from above downward, and you wait. You observe that his symptoms are disappearing in the reverse order of their appearance, the heart condition which came last, going first. If you trust your remedy under these conditions, your patient will make a real recovery without the annoying recurrences. (If, on the contrary, you found that the joints in the lower extremities cleared up and those of the upper extremities became involved, you would know you were on the wrong track and had not found the simillimum).

One of the knottiest problems for the beginner is the different concept of pathology and bacteriology. Homœopaths accept the facts of these branches of medicine. The difference lies in the interpretation. Pathology is an end result of some morbid process. The homœopath is not nearly as interested in the diseased tonsil, the hæmorrhoid, the ovarian cyst, the cancer, the tapeworm, or the psoriasis, as he is in the constitutional dyscrasia behind these. He is not eager to remove the ultimates of disease at once, but rather to cure the underlying cause. In the course of this cure the ultimate will often disappear, as in the case of diseased cervical glands or fibroids. If not, it can be removed when it has become merely a foreign body, and when the constitution is so changed that it will not ultimate itself in further pathology in a more deep seated organ. Similarly one is taught to consider that bacteria cause disease.

The homœopath is more interested in the individual's susceptibility, than in the bacteria themselves. Instead of poisoning the malarial plasmodia with quinine or the syphilitic spirochætæ with salvarsan, the homœopath prefers to stimulate the body to make itself uninhabitable for these organisms, and he does this by means of the similar remedy. To give another instance, instead of killing off head lice with delphinium and leaving the patient susceptible to further invasions, the homœopath gives chronic constitutional remedy which removes the susceptibility and the lice seek better pasturage.

4^th stumbling-block for the medical mind is the question of suppression. Discharges and eruptions are ordinarily classed with pathology as something to be gotten rid of by local measures. We are taught

to use argyrol in coryza, to paint cervices with mercurochrome in leucorrhœa, to stop a gonorrhœal discharge with protargol, to check a diarrhœa with opium or bismuth, to clear up skin eruptions with ammoniated mercury or sulphur ointment or other applications. The homœopath holds that this is suppression, and not cure, that these outward manifestations ate not primarily local but an expression of deep disease, the body trying to throw off impurities. They have watched the incidence of more deep-seated troubles following such "suppression". The chronic constitutional homœopathic remedy given to a case which has been so treated, will offer bring back the original eruption or discharge with concomitant relief of recent grave symptoms and ultimate clearing up from within of the original discharge or eruption. Let me illustrate with a case from my practice recently.

A women of 45, came to see me for suicidal depression, for which she could give no emotional cause. She dated her mental symptoms definitely from the time when she had had a foul, lumpy, green leucorrhœa "cured" by local vaginal applications, a few months before. I gave her a dose of Sepia (a remedy made from cuttlefish ink) on her mental symptoms. A week later she returned exuberant, all the depression for which she had been doctoring being gone, and said, "By the way, doctor. I have that awful discharge back again, just as it was before". I was delighted, warned her against suppressing it a second time, and gave Placebo. The discharge has since lessened and improved in character and she continues, as her husband says, a changed woman. So much for the fundamental differences.

Another problem which confronted me was whether the homœopathic remedy could influence definite chronic pathology. A girl of 19 came to me for severe intermenstrual bleeding. On examination I found a nodular fibroid bigger than my fist. A well-known New York specialist, she told me later, had diagnosed it and advised merely general health measures, as he did not want to x-ray so young a girl. Her chronic case worked out on mental and general symptoms to Phosphorus, which happens to be one of the main remedies useful in fibroids. Three months after I gave her this, I sent her to be checked up by the same specialist. He was amazed at the decrease in size of the fibroid and asked her what she had been doing. Six months later he pronounced her normal and sanctioned her marrying.

A further difficulty I experienced was in believing the current statement that homœopathic remedies can do no harm. THEY CAN !

Another problem which one frequently meets in general practice is that of prophylaxis. Strict homœopaths believe that vaccines and inoculations are harmful. It took considerable experience for me to be convinced that the chronic constitutional remedy is the best prophylactic. The whole subject of the chronic constitutional remedy is a fascinating one, but beyond the scope of this paper.

As a last problem comes the practical one which is such a stumbling-block to students, as to whether one can make a living on homœopathic general practice. Certainty more than half of my patients were not believing in Homœopathy, many of them dead against it, but I have found that by up-to-date examination and laboratory procedures, by the actual accomplishment of the remedies, and by adroitly "selling" to the patient the principles of homœopathy without the name, they are intrigued, send you their friends, and become staunch believers in the method.

To all of the puzzling problems outlined above, a satisfactory solution can be found, if one is willing to do the hard work involved in learning enough to get results. I am completely "sold" to Homœopathy. When I fail I know that the failure is mine and not homeopathy's and when I can see a similar remedy for a case, I have, even before giving it, a perfect certainty that good results will be forthcoming.

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