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Homeopathy is a Natural Science in its Purest Sense
Interview with Dr. Andrť Saine, D.C., N.D., F.C.A.H.

The following interview was conducted on September 13, 2001 by Drs. Ralf and Karin Vigoureux of Neunkirken-Seelscheid, Germany, at the time of their three-week visit with Dr. Saine in Montreal, Canada. Parts of this interview were originally published in German in the Zeitschrift fŁr Klassische HomŲopathie 2004; 48 (3): 117-127.

Q.: It is striking that you seldom use well-established nosodes like Tuberculinum, Medorrhinum, and others. Why is that?
Andrť Saine: It is true that I seldom prescribe nosodes, greatly because few of them have been well proven. With many nosodes, most of the symptoms are clinical with few clear and well-confirmed characteristic symptoms experienced by provers. As a rule, clinical symptoms are of much less value to reveal the true characteristics of a remedy. Take, for instance, Carcinosinum. There were only a few symptoms in Burnettís original proving. But now we have hundreds of symptoms and as many pathological indications. Where has all this information suddenly come from? As far as I know, there was no verification of the few symptoms found in the original proving, and now we have certain authors reporting countless pathologies of Carcinosinum in their materia medica without any careful documentation of it.

You say "well-established nosodes like Tuberculinum..." In fact, Swan introduced Tuberculinum with clinical cases only and without a proving. Letís examine two supposedly "well-established" symptoms of Tuberculinum, the fear of dogs and the desire to travel. The fear of dogs was reported by Burnett in a two-year-old child who was easily frightened, especially by dogs, and in whom Tuberculinum, as well as many other remedies, had been used. It is not said whether the symptoms disappeared, and if so, after which remedy. The desire to travel has been somewhat exaggerated as it was actually reported by Burnett, not as a desire to travel but in a man who would go from place to place to avoid the cold as he was susceptible to pneumonia in cold weather. Clearly, the provings of Tuberculinum and most nosodes are very meager and shaky and makes them harder and harder to prescribe over the years with much confidence.

There are, however, a few interesting aspects about nosodes that should be mentioned here. One is that, as a rule, a greater number of patients will react to nosodes than to other remedies. However, these reactions are often not complete; there are more what you would expect from similes versus remedies with a high degree of similarity. Perhaps because of this greater degree of susceptibility of the general population to nosodes, they have occasionally been found useful in homeoprophylaxis when the genius epidemicus was not yet known. Furthermore, you will find proportionally fewer long-standing chronic cases reacting for over a long duration to a nosode. Even though many react to nosodes, few will react positively for a long time.

There is another interesting observation about nosodes. Beginners, as a rule, rarely use nosodes. As practitioners become more experienced, they use them more often until they are put aside for better-proved remedies. Another remarkable fact is that accomplished prescribers like Lippe, Guernsey, or Wells rarely used nosodes. Lippe once remarked, while questioning the clinical value of nosodes, that over the years he had treated a great number of cases with gonorrhea without ever using Medorrhinum and this without a single failure. Lippe had predicted that Swanís isopathy would fail the clinical test, as it was contrary to all experience. He was right, it did fail. It is also interesting to note that Hahnemann did not publish his proving of Psorinum in Chronic Diseases because he said it was not proven well enough. In 1834, Hahnemann wrote to a French doctor in Lyon that the success obtained with the nosodes was not consistent enough and that the use of Hydrophobinum in patients with rabies was rash, as we had already many useful remedies.

In my experience, the best results obtained with nosodes are when they are prescribed like any other remedy, namely on the similarity of the symptoms of the patient with those of the provers. Since few nosodes are well proven, it is difficult to prescribe them with a high level of confidence; that is why I seldom use them. It is also noteworthy that published cases in which nosodes were used were, as a rule, prescribed on keynotes, past medical history, or family history, and rarely on close comparison with the provings. One of the golden rules of pure homeopathy is the development and use of a reliable materia medica in order to obtain the most consistent and gratifying results. Many nosodes have been introduced in homeopathy backwards, namely from clinical cases, with insufficient proving or no proving at all. So today, we are stuck with this backward legacy of Swan and Burnett. In the Lippe book, which I am presently completing, I go into this important subject in depth.

Q.: You donít apply Hahnemannís concept of chronic diseases, because in your opinion his theory about the infectious nature of chronic diseases is wrong. Could you explain this?
A.S.: This is a very complicated subject, which is hard to answer in such an interview. In fact, this question opens a real Pandoraís box. However, because of the importance of this question, I will try to tackle it by first giving an overview of Hahnemannís theory of the nature of chronic diseases.

Essentially, Hahnemann realized that he had noted little success in his patientsí long-term recovery from chronic diseases, although he achieved effective homeopathic treatment of patients with acute conditions. He started looking for the underlying factor of the "constancy and perseverance" of chronic diseases. He asked himself whether it could be due to too small a number of remedies being known. He said this explanation didnít fully satisfy him, even though in hindsight it was one of the major elements of the solution. Hahnemann said that from 1816-17, he tried to resolve this question day and night. Eleven years later, in 1827, he first communicated to close colleagues what he called his discovery of the nature of chronic diseases.

Hahnemann reported that the cause of chronic diseases was an underlying chronic infection or miasm. (1) At first glance, this makes a lot of sense as most chronic diseases evolve in a similar fashion as infectious diseasesórelentlessly progressing each time the defenses of the organism are down. Hahnemann concluded, from the evidence then available to him, that almost all chronic diseases had their origin in three underlying miasmatic or infectious diseases, namely syphilis, sycosis or what he called "the figwart disease" (genital warts), and psora (2) (scabies). He writes, "In Europe and also on the other continents so far as it is known, according to all investigations, only three chronic miasms are found, the diseases caused by which manifest themselves through local symptoms, and from which most, if not all, the chronic diseases originate; namely, first, syphilis, which I have also called the venereal chancre disease; then sycosis, or the figwart disease, and finally the chronic disease which lies at the foundation of the eruption of itch; i.e., the psora which I shall treat first as the most important." This discovery led him to search for remedies addressing what he considered to be the most important of these chronic diseases, psora or scabies. Thus, in 1828 he published the first volume of his materia medica of antipsoric remedies.

Hahnemann uses syphilis as the model disease to illustrate the evolution of chronic diseases, which incidentally was also recognized in his time as a chronic miasm by the rest of the medical community. Syphilis is the source of such a panoply of manifestations that Sir William Osler said that he "who knows syphilis, knows medicine." Hahnemann described the different stages in the evolution of syphilis, which he eventually extrapolates to the other two chronic miasms. First, he said, there is the contagion that happens at the point of contact. This is followed by a prodromal state where the entire organism is seized by the miasm. Then after a lapse of time there is the appearance of local symptoms, the chancre in the case of syphilis. Then, he says, as long the local skin manifestation remains present, the disease will not manifest itself in the interior of the organism. Therefore, it is the disappearance or suppression of the chancre that precipitates secondary syphilis. "So it, the chancre, when not expelled acts vicariously and soothingly for the syphilis within." This last point is so important that Hahnemannís entire understanding of the evolution of chronic diseases rests upon it.

Hahnemann then extrapolated these steps in regards to scabies. He writes in Chronic Diseases that "Psora (the itch disease), like syphilis, is a miasmatic chronic disease, and its original development is similar" but it is "the most contagious of all chronic miasmata," as it "needs only to touch the general skin." He explained that in scabies, as in syphilis, there is a prodromal state during which there is an absence of symptoms while the miasm invades the rest of the organism dynamically through the nervous system. Then, he says, "The diseased vital force endeavors to alleviate and to soothe the internal malady through the establishment of a suitable local symptom on the skin, the itch-vesicles. So long as this eruption continues in its normal form, the internal psora, with its secondary ailments, cannot break forth, but must remain covered, slumbering, latent and bound."

Therefore, the danger of suppressing the external manifestation of a chronic infection became the keystone of his "discovery" or understanding of the nature of chronic diseases. Without it his theory does not hold. Incidentally, he was not the first one to report the danger of suppressing the itch eruptions. He himself quotes a great number of physicians having made similar observations, and among them Autenrieth who had published in 1808 a treatise on the danger of suppressing the itch eruption. In the second edition of Chronic Diseases in 1835, Hahnemann writes that even though he was "not yet acquainted with Autenriethís" work when he wrote the first edition in 1828, he came to the same conclusion regarding the danger of suppressing the itch eruption with the use of certain ointments.

Again, for Hahnemann, the disappearance of the local skin lesions of the three chronic infectious diseases, scabies, syphilis, and genital warts paves the way for the development of almost all natural chronic diseases, thereby excluding iatrogenic, occupational, and environmental diseases, and as well those caused primarily by poor mental or physical hygiene. According to Hahnemann, those three chronic infectious diseases share in common a point of entry of these "miasms" where, after incubation, a skin lesion develops and acts vicariously to keep the internal miasm in check. But as soon as the skin lesion disappears, the chronic miasmatic disease affects the interior of the organism.

It is perhaps important to note that common treatment for scabies at the time of Hahnemann consisted in applying very toxic ointments, such as those made of mercury, lead, copper, zinc, or sulphur. Hahnemann cited many physicians who reported development of serious health conditions because of the suppression of the itch or other eruptions, while Autenrieth believed it was the toxicity of the ointments used that caused these adverse health conditions, and not the fact that scabies disappeared because of an external application. As Hahnemann observed skin eruptions making their appearance toward the end of treatment with antipsoric remedies, he concluded that they were the old suppressed scabies eruptions and saw this as another confirmatory element of his discovery.

Then, he extended this concept to the figwart disease, or sycosis, another sexually transmitted infection that has figwarts as its first symptom, and is "usually, but not always" accompanied by a thick, purulent, gonorrheal discharge. When the figwarts would disappear or be removed by local treatment, he said there would be similar excrescences that would "then break out in other parts of the body, either whitish, spongy, sensitive, flat elevations, in the cavity of the mouth, on the tongue, the palate, and the lips, or as large, raised, brown and dry tubercles in the axillś, on the neck, on the scalp, etc., or there would arise other ailments of the body, of which I shall mention the contraction of the tendons of the flexor muscles, especially the fingers."

What shall we say about his discovery and its evidence? Letís say that it is interesting to note that many of the well-known Hahnemannians such as Lippe, Hering, Guernsey and Dunham made almost no reference to Hahnemannís concept of chronic diseases. Actually, Dunham referred most often to the constitutional concept of dyscrasia and diathesis rather than to Hahnemannís concept of the contagiousness of chronic miasms as the underlying and fundamental cause of disease.

Letís now proceed to a critical analysis of Hahnemannís understanding of the nature of chronic diseases. First of all, we can say that with all the facts at hand, Hahnemann presented not only a very plausible explanation of the evolution of chronic diseases, but most importantly, he himself thought its clinical success was its best proof. Indeed, Hahnemann was so sure of the veracity of his discovery that he said that the fact the antipsoric remedies proved effective was not really needed as evidence, but in the end, really "serves only like the proof to a correctly solved mathematical problem." However, Hahnemannís theory of the nature of chronic diseases does not hold up at all in light of current knowledge in immunology, genetics, microbiology and pathology. At that time Hahnemann wrote, "In Europe and also on the other continents so far as it is known, according to all investigations Ö" but today we can say that from more thorough and accurate investigation, his discovery does not hold up anymore.

Q.: Can you give specific examples of where Hahnemann erred?
A.S.: Hahnemannís errors are too numerous to be listed here but we could look at some of the major ones.

First, Hahnemann based his theory on many observations that have now been found to be incorrect. For example, regarding the disappearance of the skin eruption which is the keystone of his discovery, he assumed that if the chancre in syphilis is not removed by local treatment or cured after internal treatment it will remain "standing on the same place during manís lifetime" and therefore "the secondary symptoms of the venereal disease, syphilis, cannot break out as long as it exists." It is now known that the primary chancre disappears spontaneously in most untreated people within two to six weeks of its appearance. It is also known that the chancre can still be present in some cases of secondary syphilis. Also, Hahnemann likely confused chancroid with syphilis, as he attributes to syphilis the chancre and its buboes being painful which, in syphilis, they are not.

Thus, Hahnemann was doubly wrong when he said that no "trace of the venereal disease breaks out, so long as the chancre remains untouched in its place Ö for it never passes away of itself;" and when he ascribed the cure of syphilis to the disappearance of the chancre after internal treatment, writing that syphilis "is not cured except when through the effect of the internal remedy alone, the chancre is cured," and also when he said that the disappearance of the chancre after "one little dose of the best mercurial remedy [is] convincing proof that the venereal malady is also fully extinguished within," or when he said "that there is on earth no chronic miasma, no chronic disease springing from a miasma, which is more curable and more easily curable than this." An interesting fact is that Lippe reported that patients he thought had been cured of syphilis would return many years later with manifestation of secondary syphilis.

Furthermore, there is no evidence whatsoever supporting the assertion that "almost all" natural chronic diseases, with the exception of those issuing from the chronic effect of syphilis and human papilloma virus infection, come originally from scabies. Hahnemann neglected to identify genetic, congenital, metabolic, nutritional, and degenerative diseases. Hahnemann also failed to differentiate or consider the dozens of diseases issuing from chronic infection, other than those issuing from infection with the spirochete Trepanoma pallidum or the human papilloma virus, such as tuberculosis, gonorrhea, genital herpes, leprosy, Lyme disease, malaria, brucellosis, histoplasmosis, treponematoses (endemic syphilis, yaws, and pinta), actinomycoses, etc.

He also mistakenly considered most skin eruptions to be manifestations of the internal itch infection, including eczema, leprosy, erysipelas, psoriasis, warts, ringworm, tinea capitis, yaws, etc., depending, as he says, on different environmental factors. We know today that scabies, or the itch, is the result of an infestation of the skin by the microscopic Sarcoptes scabiei mite. (3) The female mite digs a burrow in the skin to lay her eggs and produces a small secretion which irritates the skin and creates a similar reaction as with poison ivy: a local and systemic skin reaction characterized by vesicular erythema and great itchiness, especially at night. In a person affected with scabies, Hahnemann confused the skin infestation by the scabies mite with an internal infection. There is no evidence whatsoever to support a systemic infection beyond the skin infestation by the Sarcoptes scabiei or any other microorganism. The great majority of people now living in industrialized countries have no past history of having contracted scabies, and have at least as many chronic diseases as in the time of Hahnemann. It is perhaps important to note that in the time of Hahnemann, scabies was endemic throughout Europe: 95 percent of the population experienced it at least once in their lifetime.

For many years Hahnemann correctly attributed to a poison or a virus ("Gifte") the agent transmitted in cases of infection. This is noted in his treatise on venereal diseases of 1789, in his two articles on hydrophobia (1792 and 1803), in his article on the Genius of the Homúopathic Healing Art (1813 and 1833), in his Reminiscence (1818 and 1825), in a footnote to symptom 673 (or 622 in the German edition) of Sulphur in the Materia Medica Pura (1825) and in the Chronic Diseases (1828 and 1835). Moreover, in a pamphlet published in 1831 on the propagation of cholera, he writes "the contagious matter of cholera most probably consists" of "those excessively minute, invisible, living creatures," or "millions of those miasmatic animated beings." However, this contrasts with his later, but apparently incorrect, understanding that the transmissible influence of an infection is "invisible" and "nonmaterial." Indeed, in the sixth edition of the Organon of 1843, Hahnemann defines in a long footnote to paragraph 11 the term "dynamic influence," which begins as follows: "When man falls ill it is at first only the self-sustaining spirit-like vital force (vital principle) everywhere present in the organism which is untuned by the dynamic influence of the hostile disease agent." He defines this "dynamic influence" as an "invisible" and "nonmaterial spirit-like force" to which he ascribes the transmission of miasms similar to the way "the magnet communicates magnetic force to the needle."

Moreover, no one has ever demonstrated that when the eruption of the supposedly suppressed scabies returns it is actually the return of scabies. Hahnemann greatly neglected discussing the effect of very toxic ointments, such as the ones made of lead or mercury, used to treat the itch patient as compared to the actual danger of the suppression of the eruption of scabies.

Regarding sycosis, Hahnemann wrongly associated genital warts with gonorrhea, leukoplakia, pigmented nevi, and Dupuytrenís contracture, which have no demonstrable pathological links between each other.

We could go on and on looking at the evidence presented by Hahnemann in light of more accurate knowledge and continue to note the great discrepancies. Letís instead use our time more profitably by reviewing what we know today regarding the origin of chronic diseases. As a rule, two basic factors are required for sickness to happen. The first requirement is having a susceptible host and the second one is exposure to some precipitating factors occurring in an environment favorable for its development. Susceptibility of the host is mostly determined by genetic inheritance. Each organism uniquely demonstrates inherited and acquired susceptibility. Typically, the presence of this individual state of susceptibility is noticed by many idiosyncrasies even before the development of sickness. It is what Hahnemann called latent psora.

The other factor needed for the person to become sick is composed of different precipitating events or stressors. Hahnemann recognized this to the same degree as we do today. The individual is continually confronted with various adversarial forces and influences that threaten its integrity, i.e., physical forces such as gravity, atmospheric changes or radiation, pathogenic microbes, chemical influences in our food and environment, poor lifestyle and, above all, mental and emotional stresses. When these stressors sufficiently overwhelm our capacity for adaptation, the organism becomes disregulated to the point of sickness. This has been confirmed by all experience. Thus, one clearly does not need to have a chronic underlying infectious disease (syphilis, genital warts, or scabies) prior to becoming chronically ill. As far as we know, the majority of chronic diseases are not related to an underlying chronic infectious state and even less so to scabies, but instead to susceptibility, as the predisposing and most fundamental and determining factor for becoming sick. However, there needs to be other factors to trigger the disease, called precipitating factors. Indeed, few chronic diseases will develop without obvious precipitating factors. The equation is simple: susceptibility plus precipitating factors equals disease. This is the equation found in the great majority of diseases. Some of the exceptions would include diseases that are purely genetically determined, such as muscular dystrophy, and apparently do not require any exciting or precipitating factors for their development.

Also, from carefully listening to our patients, we can note that there are influences that seem to be transmitted from parent to child that may be other than through the genes. For example, yesterday in the clinic we saw a child with nightmares. The mother and two of her children have had the same nightmare almost every night for most of their lives. With the remedy, the nightmares disappeared quickly in all three. Were these nightmares the result of genetic expression or something else? We donít know. However, we can observe another aspect of the influence of the parent-child relationship, but this time from the fetus to the mother. From time to time, a mother will report that during a certain pregnancy she felt completely different and not herself. For instance, a number of years ago I treated successfully a little boy who was experiencing his second reoccurrence of a brain tumor. On the two previous occurrences, he had been operated on and received the conventional regimen of chemotherapy and radiation. With the third appearance of the tumor the parents opted for homeopathy. One of the very intense and strange symptoms the boy had was that from a very early age until the time I saw him at around 11 years of age, he craved ice and watermelon on an ongoing basis. Also, since birth he needed very little sleep. The most interesting point here is that the mother reported feeling "not herself" from the moment she conceived until the umbilical cord was cut off. She said she felt as if possessed by another entity and during this entire time she craved ice and watermelon and experienced the very characteristic sleeplessness that her son was later found to experience. Never before or after had she felt the way she felt during that pregnancy; she never craved ice or watermelon before or afterward, or experienced that sleeplessness. She had one other child and no such event happened during that pregnancy. In this case, it is hard to explain such an influence other than dynamic. Therefore the question arises: to what degree is inheritance dynamic in nature, rather than genetic.

Letís return to Hahnemannís theory of chronic diseases. Not everything in his theory is without value. There are important lessons which still hold. First, the fundamental cause of disease is constitutionalóit is the susceptibility to becoming ill, whether this susceptibility is inherited or acquired. Therefore, the physician must consider all the symptoms of the patient, even the old ones that are no longer present. Second, probably the most important and practical feature of Hahnemannís teaching on the nature of chronic diseases is what he identified as latent psora. The innumerable idiosyncrasies and functional symptoms of latent psora are earlier signs of an organismís state of imbalance and therefore usually provide ample indication to initiate treatment prior to the development of more advanced pathology. Third, it is contrary to good health to suppress symptoms or functions of the organism, especially skin eruptions and discharges, as well as mental and emotional expressions. Fourth, a person can be unwell ever since a former infection. We have also since learned that other incidents such as mental, emotional, or physical traumas or shock, or intoxications, such as vaccination, can also have similar long-term effects. We know that, on rare occasions, such taint can also be passed to the spouse and unborn child. Fifth, there is a direction of cureóthat is, during the curative process of a patient with a chronic disease, certain symptoms will disappear in the reverse order of their appearance. We will also observe the return of old symptoms and susceptibilities during the curative process; the last of these old symptoms to reappear is often a skin eruption. Sixth, some remedies will be more indicated in patients with chronic diseases, those Hahnemann qualified as antipsoric, or Pierre Schmidt, and perhaps more appropriately, qualified as homeopsoric. These are some of the important features that have been confirmed. Many other aspects of Hahnemannís theory are far from having been confirmed and therefore not useful as facts, but more as speculation.

It is important to clarify that pure homeopathy does not consist in following verbatim what Hahnemann said. Pure homeopathy is pure science, and absolutely not sectarianism. Our ultimate goal is to cure the patient in the most efficacious, gentle, certain, and permanent way. To accomplish this, Hahnemann developed a system based on the inductive method. Hahnemann wouldnít want us to follow his errors just because they came from him; he would be the first one to negate that. However, another important point that we have learned since Hahnemann is that many cases with long-standing chronic disease will recover their health without the use of anti-psoric remedies, but with only remedies such as Pulsatilla, Nux vomica or Staphysagria.

Lastly, we learn that the small errors made by Hahnemann led later on to incredible distortions of reality demonstrating inexcusable lack of academics, and turning homeopathy into caricatures.

Q.: Could you give some examples of these distortions of reality and caricatures?
A.S.: Letís look first at Boenninghausen who, in some ways, further opened the door to extrapolation on miasms by making, in this case, a somewhat acceptable link between smallpox, smallpox vaccination and Thuya and, consequently, with sycosis. I say acceptable because the link he made was based on his extensive and successful use of Thuya in treating patients affected with smallpox or the after-effects of smallpox vaccination. However, what follows falls almost totally in the conceptual realm with little connection to reality and sometimes into the realm of metaphysical speculation.

We start with Kent who wrote, "As long as man continued to think that which was true and held that which was good to the neighbor, that which was uprightness and justice, so long man remained upon the earth free from the susceptibility to disease, because that was the state in which he was created. So long as he remained in that state and preserved his integrity he was not susceptible to disease and he gave forth no aura that could cause contagion."

Thus, for Kent, psora "is the primitive or primary disorder of the human race. It is a disordered state of the internal economy of the human race," Ö and "if the human race had remained in a state of perfect order, psora could not have existed. The susceptibility to psora opens out a question altogether too broad to study among the sciences in a medical college. It is altogether too extensive, for it goes to the very primitive wrong of the human race, the very first sickness of the human race, that is the spiritual sickness. Ö Hence this state, the state of the human mind and the state of the human body, is a state of susceptibility to disease from willing evils, from thinking that which is false and making life one continuous heredity of false things, and this form of disease, psora." He adds that psora "is transferred, so that one in the advanced stages of psora will transfer to his good wife the psora which he has, and she takes it up and progresses with it and adds it to her own." As for syphilis, Kent says that it is the result of "impure fornication or adulteration."

Dr. J. Henry Allen, professor at the Hering Medical College and contemporary of Kent, went still further in his book entitled Chronic Miasms, writing: "We see sin to be the parent of all chronic miasms, therefore the parent of disease. It never was intended, nor can it be possible, that disease could have any other origin. Man was the disobedient one, and through his disobedience came disease. Ö Therefore, why should we blame the climate or the elements or bacteria or micro-organisms, when the creator tells us plainly that sin is behind all the ills to which man is heir?"

For Kent, "bacteria are results of disease. In the course of time we will be able to show perfectly that the microscopical little fellows are not the disease cause, but that they come after, that they are scavengers accompanying the disease, and that they are perfectly harmless in every respect." For Allen miasms "do not furnish the soil for germs, as we often hear said, but they father the germ." Allen then speculated to say that "if we have the miasm syphilis and psora combined, we have the multiplied changes and infinite destructive process known as tubercular [or "pseudo-psoric"] pathology." He added, "I think we can readily see from what has already been said concerning the action of both psora and pseudo-psora that the disease scrofula owes its origin to that malignant combination of psora and syphilis."

There was Von Grauvogl also who presented a bodily constitution for each of the three miasms, namely first, the carbo-nitrogenoid constitution associated with processes of retention of carbon and nitrogen which means decreased oxygenation and perverted nutrition corresponding to psora; second, the hydrogenoid constitution associated with processes of reduction and an excess of hydrogen and water corresponding to sycosis; third, the oxygenoid constitution associated with exalted processes of oxidation and excess oxygen corresponding to syphilis. Then there is Vannier in France who saw it a bit differently. For him, there are three constitutions, namely the carbonic constitution corresponding to vitality, originating from psora and affecting the epithelium; the phosphoric constitution corresponding to lack of vitality, originating from the tubercular miasm and affecting the serous membranes; and lastly, the fluoric constitution corresponding to instability, originating from syphilis and affecting the elastic tissues.

Later on, we had Thomas Paschero in Argentina who said that there are three directions to the pathological process, namely inflammation corresponding to excitation and therefore to psora; proliferation corresponding to inhibition and sycosis; and lastly, destruction corresponding to loss of function and syphilis.

On the other hand, in Mexico, we find Ortega who says that there are three forms of cellular alteration, namely, deficiency corresponding to inhibition of function and to psora; excess or exuberance corresponding to sycosis; and lastly, perversion corresponding to destruction of tissues and related to syphilis. He wrote, "One admirable coincidence, among the many encountered by a studious person with respect to miasms and general knowledge about them, relates to colors. There are three miasms: psora, sycosis and syphilis, and the primary colors are also three in number: blue, yellow and red. And amazingly, each of the primary colors is an incontrovertible reflection of the characteristics of one of the miasms." He pursued this association with his idea that psora is issued from thought, lack of awareness and timidity; sycosis being the product of selfishness and desire for pleasure; and syphilis the result of aggressiveness and cruelty.

I will spare the reader from further elaboration of speculative and ever more fanciful ideas about miasms, such as the association between the three chronic miasms to the oral and anal stages and the Oedipal complex, or the association with the Catholic church doctrine. Enough is enough with such speculation. The least we can say is that the homeopathic profession has been more than greatly delinquent in requesting from its professed teachers careful and meticulous observation and sound reasoning.

Q.: You mentioned that the fundamental cause of disease is constitutional. Why then donít you use the expression "constitutional remedy"?
A.S.: The expression "constitutional remedy" was rarely seen before Kent started popularizing it after about the mid 1880ís. Afterwards, others, such as Nash and H. C. Allen, also used this expression. Eventually, this expression became increasingly popular and since Roberts and Tyler, almost everyone in homeopathy has been using this expression. The expression "constitutional remedy" has now led doctors and patients to think that people can be identified by their "constitutional remedy." They assume that, just as oneís fingerprints do not change, people do not constitutionally change and that they therefore require the same remedy during their whole lifetime. As if there was a remedy out there in the universe which corresponded to each person for all time!

I have never seen any evidence supporting this notion. Basing oneís practice on this erroneous concept creates a paradigm that prevents an unobstructed perception of the patientís illness, unnecessarily complicating the practice of homeopathy and leading to much difficulty and frustration. The fact remains that the most accurate way to find the simillimum is to investigate the totality of the symptoms, past and present, even in an acute case, since very often the acute remedy is better determined if one also knows the patientís chronic symptoms. In any case, if someone is dying of pneumonia or somebody is dying of a chronic disease, you have to prescribe the remedy that is most similar to the totality of the characteristic symptoms of the disease being treated. This would include all the constitutional symptoms, namely the general symptoms such as appetite, thirst, sleep, body temperature, sensitivity, disposition, mood, behavior, etc. Therefore, in every acute and chronic case, the truly homeopathic prescription is always based on the evaluation of the whole picture of each individual disease with, at its core, the constitutional symptoms. But, as the constitutional symptoms change, different acute or chronic remedies will be required in a personís lifetime. Can you now see how the use of the common expression, "Doctor, what is my constitutional remedy?" is in reality very misleading? A better expression would be "Doctor, what is my current chronic remedy?" We might also note that, when this question was asked of Hahnemann, he answered that it was not the patientís business to know these things.

Q.: Why donít you use the expression "classical" homeopathy?
A.S.: The expression "classical homeopathy" is a newer expression that has mostly been used in the last fifty years. One would expect to find under this banner what is fundamental to homeopathy, its principles, works, and authors. In fact, this is not the case. At the very best, the term represents Kentian homeopathy which is not an advancement but a deviation from the fundamental principles of homeopathy. The fundamental principles of homeopathy canít be summarized to the use of single remedies in higher potencies.

It is assumed that Kentian homeopathy is classical. This is another instance of the blind leading the blind. One person says something and many repeat it without thinking. The same phenomenon can be witnessed with the concept of Heringís law (4). Kent first enunciated it ninety years ago, and the succeeding generations of homeopaths have kept repeating it as if it was a reality.

In truth, the word "homeopathy" should not need to be preceded by an adjective to be defined. Either you practice homeopathy according to its fundamental principles or you practice something else. Hahnemann requested that the "honorable" name of homeopathy be reserved for a practice based on very well-defined principles. This request is not only very legitimate but is supported by the overwhelming success of the Hahnemannians. However, even Hahnemann had to use an expression to identify homeopathy when it was correctly practiced. He used the expression "pure homeopathy" to differentiate it from what he called "bastardized" homeopathy. Practitioners practicing pure homeopathy are referred to as Hahnemannians. Today, we find under the banner of "classical homeopathy" people promoting eclectic approaches, such as a speculative materia medica and the doctrine of signatures, which have therefore nothing to do with the strict inductive method of Hahnemann and homeopathy, as Hahnemann developed and defined it. Let us be clear for once and for all: such approaches should stop being identified with homeopathy, even though they are practiced by a great number of professed homeopaths. To keep homeopathy pure we are left with no other options than to condemn what Hahnemann called "eclecticism," that mixing of incompatible elements into homeopathy. The practice of pure homeopathy is much more than the single remedy and the minimum dose. It includes the materia medica pura, the totality of symptoms and the need to constantly individualize, not only the remedy, but the posology and the administration of remedies. What should we then think of the expression "classical homeopathy" when some of homeopathyís fundamental principles are not followed by the majority of those who identify themselves as "classical homeopaths"? Lippe called this, "trading upon a name." In French, we have an appropriate expression: that the cowl does not make the monk.

Q.: According to your experience how many people need only one remedy in their whole life?
A.S.: If we include acute prescriptions I would say never. But if we exclude acute prescriptions, I would say that the great majority of patients when first coming to homeopathy with a chronic disease, not in a late stage, show signs that they have needed the same remedy since early childhood. However, during the course of their treatment the symptoms will change and after one or more years of correct homeopathic treatment usually another chronic remedy will become better indicated thus complementing the curative process. In my experience, rare are the cases with long-standing chronic disease requiring only one remedy for a complete recovery of health.

Q.: What signs are you referring to allow you to know that a patient has needed the same remedy since early childhood?
A.S.: Letís say you see a patient in his sixties who is new to homeopathy and you find out that some of his symptoms have been present since early childhood or even infancy, for instance, an intense intolerance to milk, aversion to bathing, aggravation from consolation, perspiration of the head in sleep, sensitiveness to draft, etc. You then notice that during treatment with one remedy all these old constitutional symptoms disappear as well as the majority of the other symptoms which had developed during his lifetime. It would be difficult not to conclude that this gentleman needed this remedy since infancy.

Let me give you an example from my practice. I once saw a 73-year-old Korean War veteran who was in the last stage of liver cancer. With only a few weeks to live, he was greatly emaciated and his liver was so enlarged that the ribs on his right side appeared dislocated. One liver enzyme was so elevated that it was outside the measurement scale. His complexion had the typical yellow-green tinge of late stage liver disease. He was very weak; just talking would exhaust him. In spite of all these signs of end-stage disease, he had some very characteristic symptoms, such as that he sweated on his head almost every night of his life from the moment he would fall asleep until the moment he would wake up. He also craved eggs since early childhood. What I recall is that the rest of his current and past symptomatology corresponded like a glove to Calcarea carbonica.

Here is a case where you cannot escape saying that this man had required Calcarea carbonica since infancy. Incidentally, he made an incredible recovery under Calcarea carbonica. However, if this man had been treated with Calcarea carbonica in infancy or childhood, no one could say whether he would still have required the same remedy later in his life and whether he would have developed liver cancer. Nobody knows, but what seems evident is that he required the same remedy all his life until treatment was started.

Because many acute conditions, including the result of indisposition and traumatic incidents, are as a rule dissimilar from the chronic state, one different remedies will be required to address these states. Take, for example, influenza. We find that in about 95 percent of the cases, the remedy is dissimilar to the chronic one. In pneumonia, it is maybe dissimilar 50 percent of the time. There are conditions that are more likely to be dissimilar, while with others it is about 50:50. For example, it is rather rare in a case of acute food poisoning that the chronic remedy would be indicated. Ninety-nine percent of the time, it is a dissimilar disease. Therefore, people will require more than one remedy during their lifetime, for various acute and incidental conditions, as well as for the different stages of disease, acute and chronic. Sometimes it takes two or three years, sometimes five or ten, but it is rare that you treat a person successfully without changing the chronic remedy.

Q.: Can you explain this? Why is it?
A.S.: I cannot explain it, but then, why not? Why should a person require the same remedy? We come from two parents and four grandparents and so on. As our susceptibility is greatly determined genetically, one must assume that each of our closest ancestors would have some bearing on our susceptibility and therefore on what remedies will be required during our lifetime. I remember once studying eleven members of a family spread over three generations and noticing a pattern in the remedies required by the different members of the family. Each parent is more dominant genetically in different aspects. When one of the parents requires a very clear remedy at the time of conception, it is very common to find the sick infant requiring the same remedy. That could be one possible answer to your question. To study that, you would have to study families over three or more generations, which as yet I have had very little experience with.

Q.: Do you need more remedies in a person with severe problems than in one who is quite healthy?
A.S.: It depends on the case. I saw a case once in which the person was dying of heart and kidney failure and was in the comatose stage of uremia. She progressed through the last stages quicklyóin hours or even minutesóbut to reach this advanced state took many years. So, here we were able to observe the evolution of a chronic disease in many of its later stages and each stage corresponded to a different remedy. It is often like this in pneumonia with its four different stages, namely congestion, infiltration, resolution, and convalescence. Each stage could present a different picture and require a different remedy. In cases of acute disease like pneumonia, you donít usually observe the reversal of the stages during recovery. For instance, a patient in the third stage of pneumonia does not go back to the second stage and then to the first stage, but just goes right into the fourth stage with the correct remedy. On the other hand, in the later stages of a chronic disease, I have observed the progression backward through the different stages during recovery. I need to emphasize that I have witnessed this only rarely in cases with very advanced pathology. However, it has been an invaluable lesson for the successful treatment of such cases. That is why it is so important to understand the phenomenon of dissimilar disease that Hahnemann discussed throughout his work.

I have also observed this when patients with cancer and leukemia experience complications. For example, one time I saw a young man in the late stage of acute lymphocytic leukemia who developed gangrene of the mouth. The remedy that he had been taking which was helping his general state did not help the rapidly progressing gangrene. I had to act quickly as within a few days he had lost the anterior third of his tongue and had numerous large, green gangrenous ulcers throughout his mouth. The biggest one was about 3 cm in diameter on his palate. I prescribed a different remedy based on this new picture. The gangrene started regressing right away. It was a complication of his leukemia, an infection that was dissimilar to the chronic state. His mouth healed up nicely and his tongue grew back completely, except for the very tip. On the other hand, in the case of the Korean War veteran mentioned earlier with cancer of the liver, in spite of his advanced state, he was prescribed the same remedy throughout his treatment.

I have observed the same phenomena in patients with full-blown case of AIDS; they can have multiple infections at the same time. Typically one infection will be dissimilar from another one and so on. And you may have to address each disease picture with a different remedy.

Hahnemann observed that during the treatment of patients with chronic diseases, not only will several antipsoric remedies often be needed to complete the cure, but that apsoric remedies will also be called on in the event of incidental acute conditions. What he observed has not changed today. People who maintain the opposite have to demonstrate it, as all evidence is to the contrary. The experience of Hahnemann is not difficult to prove as such experience is found throughout the literature of excellent prescribers. Also, I could easily find twenty consecutive cases of my own with a full-blown chronic disease who have been successfully treated for more than five years and rare will be the case where only one remedy was needed during the treatment of the chronic or incidental acute conditions. I have confirmed what the great majority has confirmed since Hahnemann, but the opposite has never been proven. I have met patients who have been to practitioners who always prescribe the same chronic remedy year after year even for acute conditions and incidental injuries and indispositions, without ever having an improvementósometimes even in their chronic condition!

For one reason or another, homeopathy tends to attract fanatics who approach homeopathy more as a belief system, religion, or cult rather than as a natural science. These people tend to espouse idolizing attitudes towards teachers who are often looked up to as guru figures, relying more on beliefs than on genuine observation and sound reasoning. But homeopathy is really as pure a natural science as can be, requiring great art, discernment, and perspicacity in its application. Any improvisation is really basing oneís practice on chance and not science. However, to master homeopathy is to master its science. The moment you remove the word science from homeopathy it loses all its virtues. Homeopathy is the science of therapeutics, and unfortunately, it is not a given that the ones who profess to practice it are at all qualified, let alone to practice it with the required rigor for its successful application.

Q.: You keep referring to the phenomenon of dissimilar disease. Could you explain further this phenomenon and its clinical importance?
A.S.: This is an interesting question. Hahnemann discussed this phenomenon as early as 1819 in the second edition of the Organon, and it can be found in paragraphs 34 to 46 of the sixth edition. However, throughout the Organon, Chronic Diseases, and his other works, Hahnemann constantly refers to two or more diseases coexisting at the same time in one individual: what he called complex diseases. It is a very important phenomenon, and interestingly, to my knowledge, no Hahnemannian has ever discussed it in any great detail since Hahnemann. In my experience, it is absolutely necessary to understand the very complex phenomenon of dissimilar disease in order to deal successfully with complex cases and patients with serious pathologies. Was this subject not further discussed because it was too obvious or because its real clinical importance had not been fully recognized? I donít know the answer but I would assume the latter.

For some reason, as young students of homeopathy, my peers and I were under the impression that someone who is sick can only have one disease at a time. I went my way with this misconception until I hit a wall when I started treating patients with serious pathologies. I awoke early to the reality I was facing and started to pay greater attention in order to better understand this phenomenon.

The great clinical importance of this phenomenon becomes apparent first in the analysis of a case. After having taken a complete case the first question that should be answered is whether the patient has more than one disease. If the answer is an obvious yes, then the totality of the symptoms is divided according the symptoms of each disease. Therefore, all the symptoms that have appeared since the onset of the last disease should be grouped together. If the answer is no, then all the symptoms related to the single natural disease form a totality. I specify here natural disease, because symptoms related to a causa occasionalis, poor lifestyle, or iatrogenicity should not be included in that totality.

Let me give you the example I often use in class to illustrate the phenomenon of dissimilar disease. Letís say a patient with a long-standing chronic disease, for example a full-blown case of rheumatoid arthritis, becomes fed up with conventional medicine, hears good things about homeopathy, and decides to consult you, a genuine homeopathic practitioner. You are quite busy and can schedule an appointment only in a few weeks. A week before the appointment the patient takes cold and develops symptoms she recognizes as symptoms of pneumonia that she had in the past: low grade fever, shortness of breath, chest congestion, rusty expectoration, weakness, night sweats, etc. As she knows from her readings that homeopathy can deal effectively with even the most severe case of pneumonia, she decides to wait to see you at the scheduled time in a couple days. However, by that time, her condition has progressed to a full-blown case of pneumonia. What is the possibility that she now needs the same remedy as four weeks ago when she first called for an appointment? Perhaps, fifty percent chance or less.

The day of the appointment there is freezing rain. Her husband drives her to the doorstep of your office before parking the car. As she climbs the three icy steps outside your office, she slips backward and lands violently right on her occiput. Her husband returns from the parking lot and finds her lying unconscious. He rings your bell and now you have a complex case. "No problem" is your answer as you are a genuine Hahnemannian. However, the question arises again, what are the chances that she now needs the same remedy for the chronic case with the rheumatoid arthritis, the full-blown pneumonia and the severe concussion? Perhaps less than one percent. It is likely she has three dissimilar diseases requiring three different remedies.

Let me give you another example of dissimilar disease. The wife of one of my best students was in an incredibly severe car accident. She suffered from multiple serious fractures and other serious injuries, such as major subdural hemorrhages, a punctured lung, a ruptured liver, etc. It was hard to believe that she was still alive, because she had fractures of almost every bone in her body, including the cranium, the pelvis, both femurs, tibias, fibulas, feet, clavicles, humeri, jaws, and numerous vertebrae and ribs. You can imagine the awful mess she was in. We gave one remedy at the time but we had to constantly change remedies to address a constantly changing picture. We changed remedies every 15 to 30 minutes over 4 to 8 hours just to keep her alive. Every state was different, one remedy was for the shock of the injury, then there was pain, then there was bleeding, then she was unconscious with stertorous breathing and losing vitality and so on. A colleague stayed around the clock at the hospital for over a week and he would call me regularly with new complications and for advice on what to do. These are some rare conditions where you have to change remedies quickly, as each succeeding state presents a different remedy picture.

The more classic example of dissimilar disease is the existence of a chronic disease with a more recent acute dissimilar condition, such as an acute infection, an acute physical trauma, an acute emotional shock, an acute mental strain, an acute poisoning, an acute indisposition, an acute exacerbation of a chronic disease, an acute periodical disease, or an acute physiological change. There are other situations beside a chronic disease followed by an acute condition in which two or more dissimilar diseases can coexist together, such as in two or more acute or chronic infections, the chronic effects of prolonged exposure to physical, emotional or mental stress, a chronic poisoning, a chronic indisposition, an advanced stage of a chronic disease, complications of a chronic disease, the different stages of certain infectious diseases, or a chronic physiological change. What is typically observed in practice is a complaint such as migraines, asthma or hay fever that doesnít respond to the chronic remedy under which the patient is improving in general. You can see how crucial it is to understand this phenomenon in order to obtain constancy in clinical success regardless of its complexity. As you can see, it is applicable in everyday practice.

The question now comes up, how shall we approach a case with two or more dissimilar diseases? The answer is very simpleóthe same way Hahnemann taught us. Dealing with the more serious, prominent, or latest one first and then with each successively and sometimes even alternatively. But letís be very clear on this, it has nothing to do with routine alternation of remedies, rather it is according to the change of picture and evolution of the case. Of course, the danger would be that the beginner does not recognize this phenomenon or the slightly more advanced practitioner separates every syndrome found in a patient and falsely identifies them as dissimilar diseases. Again, the practice of homeopathy, like medicine, demands a lot of discernment.

Q.: We saw some patients in your practice who were poisoned with mercury and you treated one of them with Mercurius. Was that not isopathy?
A.S.: Not really, as in the case you are talking about, the prescription of Mercurius solubilis was made prior to finding the high levels of mercury in her blood. If I prescribed Mercurius solubilis, it was because it was the remedy most similar to the totality of the characteristic symptoms of the disease being treated, and not because I was aware that she had high levels of mercury. Incidentally, I have treated a number of patients with toxic levels of contaminants and it is only occasionally that the same potentized substance was prescribed. I have treated a number of patients with high levels of mercury and a Mercurius remedy was rarely prescribed. With the simillimum, the patient feels better and eventually the mercury levels come down. Incidentally, with most patients who are poisoned with mercury, it is in the form of methyl mercury or mercury chloride and not the elemental mercury of Mercurius solubilis.

Q.: Often during your teaching you mention the inductive method of Hahnemann, which is at the core of the methodology of homeopathy. Could you explain that with an example?
A.S.: What is meant by the inductive method of Hahnemann should be made very clear to everyone. Essentially, the inductive method is the most direct and flawless approach used in natural science to discover or investigate phenomena. Hahnemann applied to medicine the virtues of genuine observation and sound reasoning as taught by Francis Bacon in his New Organon or True Directions Concerning the Interpretation of Nature. Hahnemann followed the inductive method of Bacon and called his textbook the Organon of the Rational Healing Art. Organon means organ or instrument of correct thinking. When homeopathy is correctly practiced, it is a natural science in its purest sense. Nature is our guide and not the other way around. We observe objectively in order to discover laws and principles and attempt to abide by them in our daily practice. How much more scientific can the practice of medicine be, especially when it is further supported by the overwhelming evidence of the constancy of its success?

We have to remember that the word physician comes from the Greek phusis, meaning nature. Therefore, the word "physician" means the one who studies and knows nature, its principles and laws as well as their application. Hahnemann taught us how to be true to our mission by practicing medicine scientifically and wisely. Practicing medicine without science or philosophy leads to failure. The inductive method is the basis of the natural sciences and consists of drawing the right conclusions but only after having carefully observed all that can be observed and without leaving anything out or adding anything that was not observed. Induction is not a matter of mere guesswork but a precise instrument of inquiry for arriving at the most plausible and best available answer. Even though it attempts to eliminate all possibilities of error, the inductive method is not completely error-free, as conclusions may change as new information is uncovered.

Maybe this will be most clear if we contrast the inductive method with the more often used deductive method, which is speculative in its origin. One has a theory, forms a hypothesis and tries to prove it. That is, one begins with a concept and tries to verify it, which is often but just an attempt to have nature fit oneís conception of it. On the other hand, the inductive method does not start with a concept or hypothesis but approaches reality differently by saying, "letís observe what is going on here." Slowly, as observations accumulate, patterns and principles emerge. When you study the history of medicine you find out how it evolved through ever changing theories concerning the origin of sickness and the properties of medicines. The history of medicine is largely the result of deductive thinking. Formulation of theories is often a reflection on how we limit and bias our investigative process. By nature, we tend to be deductive. When we donít know something we invent it. And, as a rule, when we reach a conclusion we stop observing.

There is a French historian of science who wrote a book on errors in science very appropriately entitled, Je pense donc je me trompe (I Think Therefore I Am Wrong). When Hahnemann came on the scene, he took a different approach, a more precise method of investigation based on pure observation, correct reasoning and wise reflection. Pure observation leads to true knowledge. In homeopathy, it applies to our materia medica and to the examination of the sick. First, regarding the properties of medicines, Hahnemann developed a materia medica that was based on pure observation, a materia medica pura free of theories, hypotheses and speculation. This pure materia medica is intrinsic to homeopathy. A practice devoid of this pure materia medica would be an imposture and shouldnít be identified as homeopathic. Again, it is very important to clearly specify that the speculative materia medica introduced by many modern authors is totally incompatible with and misrepresentative of homeopathy.

During a properly conducted proving, a homeopath will take a plant or other substances new to homeopathy and conduct a proving on sensitive colleagues, carefully noting all its effects. After an appropriate period of rest, the proving is conducted a second and a third time with the same provers. From the symptoms repeatedly experienced by the provers, the homeopath can tell with certainty in which disease that plant or substances will be indicated. Similarly, for an astronomer who discovers a new comet, he will be able to trace its exact speed, trajectory, distance, and when it will reappear in our sky with great accuracy from induction based on the laws which regulate the motion of these celestial bodies. For the homeopath, the astronomer, or other natural scientists, such conclusions are drawn by through the same unerring process of induction based on natureís laws. Incidentally, this is accomplished in homeopathy with great efficacy and gentleness without necessitating large facilities and insurmountable funds, or causing harm to animals or the environment.

The second aspect of the inductive method in Hahnemannís approach relates to the examination of the sick. Again, Hahnemann asked us to observe with the least inference from our mind, that is, to be pure observers of nature. This is very well described all throughout his work but especially in the Organon in paragraph 83 and on. Hahnemann says simply that the "individualizing examination of a case of disease Ö demands only impartiality, sound senses, attentive observation, and faithfulness in recording the disease picture." In the second volume of his Materia Medica Pura, Hahnemann published a most wonderful article entitled, "The Medical Observer," in which he says, "In order accurately to perceive what is to be observed in patients, we should direct all our thoughts upon the matter we have in hand, come out of ourselves, as it were, and fasten ourselves, so to speak, with all our powers of concentration upon it, in order that nothing that is actually present, that has to do with the subject, and that can be ascertained by all the senses, may escape us. Poetic fancy, fantastic wit and speculation, must for the time be suspended, and all over-strained reasoning, forced interpretation and tendency to explain away things must be suppressed. The duty of the observer is only to take notice of the phenomena and their course; his attention should be on the watch, not only that nothing actually present escape his observation, but that also what he observes be understood exactly as it is." Could it be better said?

Lastly, the physician must be rigorous in studying and abiding by the laws and principles of nature with regard to the application of our materia medica pura to each sick individual. Homeopathy is medicine of the individual. Conventional medicine, on the other hand, generalizes and also insists on prescribing drugs on principles of chemistry that are incompatible with the dynamism of the healing process.

The history of homeopathy teaches that the more conscientiously the physician approaches homeopathy, the better will be the clinical results. Today, when professed homeopathic practitioners want to introduce speculation in our materia medica they are simply ignoring the work of Hahnemann and homeopathyís key rules for success. They are misrepresenting homeopathy with their eclecticism, which consists of selecting what seems to them best or most fruitful from several sets of ideas, beliefs, or theories. The eclectics base their practice on their judgment, opinions, theories, whims, and fancies. They have no right or justification to identify such practice with homeopathy. On the contrary, the practice of homeopathy is based on pure observation and is guided in its practice by fixed laws and principles.

Q.: Many homeopaths are interested in the old American homeopathic journals where you can find contributions from and discussions of the successful homeopaths like Lippe, Wells, Nash and others. How accessible are they?
A.S.: Most of the old American literature is dispersed throughout American medical libraries. Only a very small portion of the literature has been reprinted in modern journals or software such as in the Encyclopaedia Homeopathica or ReferenceWorks. I understand that recently there is a greater interest in it and a greater effort to reclaim it. In Europe, unfortunately, you donít have much access to these journals. The best library in Europe giving public access to the old American journals is probably Pierre Schmidtís collection in St-Gallen, Switzerland. There are also a few good personal collections, but most of it will be found in America. The best of all homeopathic collections in America is found at the University of Michigan in Ann Arbor, Michigan. Then there is the Medical Library of the University of California in San Francisco, California, the National Library of Medicine in Bethesda, Maryland, the Lloydís Library in Cincinnati, Ohio, and the library of the National College of Naturopathic Medicine, my alma mater, in Portland, Oregon. There are also fair collections at Stanford University in Palo Alto, California, Harvard University in Boston, the State University of Iowa in Iowa City, the University of Chicago, the New York Academy of Medicine in New York City, the College of Physicians and Surgeons in Philadelphia and Drexel University also in Philadelphia, which absorbed the old Hahnemann University. As you can see, the literature is spread out all over the U.S. The great majority of the material has been microfilmed, but microfilm is an old technology, which is very awkward to use. You need special equipment to read the material or photocopy from it. Libraries have started to digitalize this information and that is where the future lies in terms of increased access to this greatly neglected heritage. However, even if everyone had access to the entire literature, one would be overwhelmed by the sheer amount of material. It is an exercise in itself just to know how to use this literature effectively.

For more than twenty years I have been sifting through this immense literature and collecting the best it has to offer. I have derived much education from it that greatly helped me to better understand the work of Hahnemann. Now, I am trying to return to the profession some of the treasures I have found there. Beside Lippe, there is lot to be gained from the writings of P. P. Wells, Hering, Joslin, Harvey Farrington, Pierre Schmidt, etc. For instance, Edmund Lee, one of Lippeís closest students, said that the writings of Lippe, Hering, and Dunham should be familiar to all students of homeopathy, but that no one wrote "more wisely and in such detail as our venerable friend, Dr. P. P. Wells." The next book I intend to publish after my book on the life and work of Lippe will concern P. P. Wellsí best writings. The best writings of those great homeopaths should be made available to our present and future students. People who want to master a discipline should study its masters and, by all means, avoid being misguided by pretenders. What shall we think of the state of education in homeopathy when some of our most important writings are not even available? It would be like studying quantum physics without having access to half of the most fundamental literature on the subject. This is an important factor contributing to the present state of confusion in the homeopathic profession.

Q.: In former interviews[1] (5) you have talked about the quality of training in homeopathy and necessary personal attributes of people who want to practice homeopathy. Some may feel that they are unable to meet these demands. How does your teaching provide the necessary information and training?
A.S.: When people come to me to be trained in homeopathy, I request that they have the necessary knowledge required to practice medicine. They must therefore have all the basic skills necessary to examine and diagnose a patient. I request that they already have a degree or are studying for it (MD, ND, DO, DVM, DDS, DC, NP, PA, or midwifery), and therefore have the basis required to integrate homeopathy. My duty is then to instruct them on how to practice genuine homeopathy correctly. I attempt to provide them with a systematic step-by-step training from A to Z. We start with what I consider most important, the philosophy of homeopathy. Here, we first examine all the pertinent concepts of health and disease, and the different forces and influences in nature and their potential role in the recovery of health. Then, we examine the different possibilities of therapeutics in order to eventually be able to focus on the ideal in therapeutics, which boils down to homeopathy. We then examine the possibilities and limits of homeopathy and where homeopathy fits in the general practice of medicine. Throughout their studies with me, I have students read the works of Hahnemann and of the great Hahnemannians.

Parallel to the development of a strong foundation in the philosophy of homeopathy, we study the methodology on how to practice pure homeopathy, step by step. Here we start with case taking, followed by case analysis, posology, administration of the remedy, the follow-up visit, the second prescription, resolving difficult cases, etc.

Strange as it is to say, I have met with very few practitioners who take a complete case. When colleagues consult with me on one of their patients, I can easily recognize my students from others just by looking at how completely the case has been taken. Also, when patients come to me after having been under the care of some famous teachers of homeopathy, I rarely find that the patientís case has been previously well taken. No wonder their treatment turned out to be a failure. After taking the case in a careful and thorough manner, the remedy picture often emerges clearly even for students relatively new to homeopathy observing by my side. This demonstrates that even experts will not find the simillimum when the case is incomplete and that even beginners can find the simillimum when the case is well taken.

It is not difficult to learn how to take a complete case, but few seem to have ever learned it. You canít improvise on case taking. It must be done in a very systematic way, so that all the pertinent aspects of the case are examined and at the same time nothing that is not present is invented. When I am asked by people to refer them to a genuine homeopathic practitioner in an area where I know no one, I often give them the following two-fold advice. First, show the practitioner the Organon and ask them how valuable the book is. If the answer is that it is an obsolete book, or that there are better books today in homeopathy, or that they have never read it, I suggest the patient to see another physician. The more times the physician has read the Organon, the more likely it is that the physician practices homeopathy well. The second piece of advice is to ask the physician how long it usually takes him to take the case of a new patient with a chronic disease. If the answer is less than two hours, it is likely that the doctor is not taking a complete case. I again advise them to look for another physician.

I was originally trained in school to take a case in one hour, as the examination rooms we were using in the collegeís teaching clinic could be booked for a maximum slot of one hour. When I started my private practice, I extended my case-taking to one and a half hours, then two hours, and now it takes me on average three to four hours for an adult patient with a chronic disease. A well-conducted case is more than half the work done. The class on case taking (6) is about ten days long as we review most of the questions asked and the significance of the patientsí possible responses.

Once the case has been well taken then you know that you have all the information needed to proceed to the next step, which is analyzing the information, or case analysis. You must have a deep understanding of how to analyze the case, the significance of each symptom, and especially what is most characteristic versus what is common. Here the key question that must be asked is, "what is most peculiar in this case of multiple sclerosis?" or "what is most peculiar in this case of schizophrenia?," etc.

The third step is to come up with a treatment plan, which, from the medicinal point of view, consists in prescribing the most similar remedy in the proper potency, mode of administration, quantity, and frequency. These are the three basic steps in the practice of homeopathy, whether it is for an acute or chronic case, or a new case or a follow-up. First, we gather the information (the symptomatology), then we answer the following two questions: what is the meaning of this information and what shall we do with it?

Once these three steps are well understood, then I teach students how to deal with difficult, complex, and defective cases. It has been my experience that very few of the current professed homeopaths are actually trained to practice the first three steps correctly. On the other hand, homeopathy is so simple and pleasant to practice when it is done systematically. I have often said that so far two of homeopathyís weakest points have always been an inadequate system of education and the lack of certification of qualified practitioners. If you donít follow a certain very precise path, it is impossible to practice homeopathy with excellence and obtain the expected constancy in results. Take dentistry: how could someone aspire to become a competent dentist if he would had the type of training commonly found with many professed homeopaths, through weekend seminars given by improvised teachers? You canít just improvise the training in order to learn the state-of-the-art in dentistry, and who would consult such poorly trained practitioners? The homeopathic profession has a lot of growing to do with regard to the training and certification of its physicians. There is a dire need for basic and systematic training.

Parallel to learning the philosophy and methodology of homeopathy, my students are taught how to study the materia medica and how to use the reliable books including the repertories. Also, students are exposed to live patients throughout their training. We take live cases with serious pathologies and analyze them in class. Students witness from the beginning to the end of their studies how cases are taken and analyzed and how follow-ups are conducted. Many cured paper cases are also given to students in order to develop the skills necessary to individualize and perceive what is most striking in a case, and also to help them to better understand the practical rules of case management.

Q.: What is missing when you see cases from people who are not well trained and what does it mean to take a good case?
A.S.: The cases are clearly incomplete. Taking a complete case means obtaining a complete and accurate picture of every problem and of every pertinent aspect of the person who has these problems. For instance, a patient comes to a physician with three chief complaints, letís say depression, migraines, and digestive problems. The doctor says: "Okay, tell me about your depression." And the patient starts talking about his depression, then switches to his migraine before finishing with his depression, and then changes direction by talking about his lifelong digestive problems. How many physicians will stop the patient from taking such a course, which can only confuse the physician and lead to an incomplete exploration of each chief complaint? To obtain a complete case, case taking must be done very systematically. Each chief complaint must be investigated thoroughly, one by one, and recorded in the patientís words.

Always ask very broad, open questions. For instance, when you start a case you could say, "When you say "depression", what do you mean?" And you repeatedly nod and ask for more with "anything else?" You let them talk, talk, talk as long as what they say is pertinent to the subject you are exploring. When you reach a point where no more spontaneous and pertinent information is offered, you have to fill in the blanks. You have to complete the information given spontaneously by probing more directly to obtain a complete picture of each complaint, including the history of the onset, the course, and evolution of the symptoms, treatment received and its effects, the frequency, duration, intensity, location, extension, modalities, and concomitants of each symptom and the exact sensations experienced. Also, you must write down all the information needed for diagnosis, prognosis, and treatment.

When you have a patient with a chronic disease, it is very, very rare that there are no precipitating events preceding the onset of that chronic disease, and/or clear exacerbating factors associated with the peak exacerbation of the disease. Therefore, the history of the onset and the exacerbation are usually very helpful in understanding the sensitivity and individuality of the patient, as are the concomitants. "When you have depression, is there anything else you also experience concurrently?" "When you develop a migraine what else happens concurrently?" or "What also comes with a migraine?" Very few patients will spontaneously tell you that, for instance, their appetite increases, or they pass great quantities of urine with their migraines, etc. All of these can be key symptoms to the case.

If there is a pain or a sensation that is experienced by the patient, investigate all the details of what exactly is felt. Pain is one thing, so you have to individualize it and find out all its different aspects, its exact sensations "as if," modalities, concomitants, etc. Also, in terms of location, have the patient show you exactly where the complaint is experienced. For instance, patients will commonly point to their sacroiliac region when referring to their "hip" pain. The physician must always try to get further precision with questions such as, "When you say it is sharp, what do you mean?" You investigate until you have obtained a complete and clear picture of each chief complaint with no stone left unturned. When your prescriptions fail, it is then often too late to go back and investigate what you have missed, as it is usually quite difficult to reverse your own spoiled cases.

Furthermore, you have to look at the past medical history of the patient, and you are likely to find out about more problems, for instance, seasonal allergies, cold sores, athleteís foot, recurrent sties, teeth abscesses, etc. Now, you are finding out about more complaints not originally mentioned by the patient, often because they are too familiar to them, they are not present currently, or not enough of a nuisance. You have to investigate each of these new complaints as if they were all chief complaints.

Once you have explored all the patientís problems and you are sure you have covered all the bases, then you need to find out about the patient who has all these problems. Usually I say to the patient: "We went over each problem thoroughly and I have a very good understanding of all your problems; now I need to know who is the person having these problems. Tell me more about yourself, anything that is most particular about you. What best identifies and differentiates you from your siblings, friends, or peers?" There are various approaches that can lead to a more in-depth discovery of the individual. And when they stop expressing anything else that is pertinent, then you have to investigate all the different aspects, which the patient wouldnít usually think of expressing spontaneously. You will have to probe to discover all the other idiosyncrasies and peculiarities by investigating all the physical generals, the different aspects of the personality and make-up of the patient, getting right to the core of the patient.

I inquire about the body temperature and sensitivities to different temperature and weather, peculiarities about their perspiration and body odors, energy, sleep, appetite, digestion, female or male problems, other aspects of the psyche that might not have come up such as anxieties and fears, sensitivities, temperament, disposition, reaction to various influences, etc. Towards the end, I ask them which stresses they currently have in their life that could interfere or prevent them from recovering their health. Usually, the last and often most important question deals with identifying the most traumatic events or periods of their life. The answer to this question should now form a comprehensive whole with the rest of the case. At times, something that was not said during the entire interview comes out only with this final question.

The next step is to make a careful physical examination of the patient. I tend to examine only the pertinent aspects in each patient. The key(s) to a case could be anywhere; they are sometimes found in the very last moment of such a long anamnesis. Once I had a patient where I discovered only during the physical examination that all her toenails were ingrown. Even though it was the last symptom obtained, it turned out to be the most striking symptom in her case. I looked back at the case and a totally different remedy picture emerged. This is another example of the importance of being thorough and how the choice of the remedy is not finalized until the last symptom is recorded.

Once you have gotten all this information, then the next step is to analyze the case, which is very simple in principle. To practice homeopathy well is not difficult when well trained. However, its mastery comes only after many long years of diligent study and practice. So, you have this patient complaining of depression, migraines, and digestive problems among other complaints. You have meticulously taken a complete case, and now the question is: what shall you do with all this information? You have asked whether the person has one or more diseases. Letís assume that the answer is one disease covering the entire case. Then, you ask yourself what is most striking about this case. This refers to the entire case as a whole and not only to the person or problems. You ask yourself something like this, "What is most striking in this case with depression?" If for example you have a patient with multiple sclerosis, then you would ask, "What is most striking about this case with multiple sclerosis?" Is it that the paralysis went from the extremities upwards, a characteristic found in a few remedies and particularly Conium? A definitive no, as it is a common symptom found in about 50 percent of patients with multiple sclerosis. It is, therefore, not a very useful symptom. You find a peculiar symptom, perhaps that all the symptoms of MS greatly aggravate around 11 a.m. and improve once the patient starts to eat lunch. This would be a very characteristic symptom that has nothing to do with multiple sclerosis. You have now an important key to your case.

You see, important keys can be found anywhere in the case. Another example: letís say you have a patient with schizophrenia. You would ask the question, "What is most peculiar in this case with schizophrenia?" The fact that the patient hears voices telling him what to do? No, as almost all cases with schizophrenia hear voices, and half the time these voices dictate to them what to do. However, if you find out that the patient has a strong craving for ice and, since early childhood, has had a tremendous fear of thunderstorms, you have now good individualizing symptoms to anchor your case on.

I have said many times that you have to be like Sherlock Holmes. You have to grasp the entire story from a close investigation and then pick out clues leading to the criminal. When Sherlock Holmes was asked to explain his remarkable success in untangling so many difficult cases, he responded, "It is the circumstances that seemingly confuse the case that invariably prove the best clues to its ultimate solution." This is the same process in homeopathic prescribing; we pay special attention to the unusual. You have to learn to continuously hone your skills and judgment to become a better detective. This can be achieved by reading many cured cases or by observing which clues were missed from oneís own cases that took a long time to solve. Good training is essential for achieving mastery, but in the end it is oneís own character that will determine success. If you are impatient, lazy or tend to take short cuts, no training will ever be sufficient for you to master homeopathy. Similar to growing a healthy plant, it is necessary to have a healthy seed in the right environment.

Q.: In your opinion, how many out of a hundred with good training will be able to master homeopathy?
A.S.: From my experience, I would say that with the current state of homeopathic education, out of one hundred physicians interested in studying homeopathy, maybe 30 will study it sufficiently to practice it, and only 10 or fewer will practice it very well. Out of these 10, one single physician could probably achieve mastery if put in the right circumstances. It is indeed a very small yield. It is a question of having the right person with the proper guidance. However, by providing a thorough didactic and supervised clinical training, we could considerably raise these numbers. The best situation would be to have a group of truly accomplished clinicians teaching within a homeopathic medical school offering an internship and residency program. To my knowledge, the closest we have come to such a situation was when Lippe and Hering joined Guernsey on the faculty of the Homúopathic Medical College of Pennsylvania between 1864 and1867.

Q.: What qualities are found in the "right" person, and what kind of guidance are you referring to?
A.S.: Once Hahnemann mentioned in a letter to Hering that he hoped Hering was a good person, as no one could be a good physician unless he was a good person. This right and good person is someone who is not only benevolent but has a balanced personality, is intelligent, healthy, dedicated, honest, tenacious, capable of hard work, and also wise enough to be able to make the right choices leading to success. If such a person would ask, "How can I master homeopathy?" and would follow the path to the end like all the past masters of homeopathy, success would be inevitable.

Q.: We have many different trends and teachers in homeopathy today; many claim to be true followers of Hahnemann. At the moment, there is an intense discussion going on in the American homeopathic community about the right way to practice homeopathy and about liberty in choosing different approaches to homeopathy. What is your opinion about that?
A.S.: My point of view on this subject has been very clear and well publicized. (7) It is true that over the years many have used the name of Hahnemann to identify their schools, associations, or journals. Many claim to be "classical" homeopaths. Unfortunately, those who have studied the work of Hahnemann diligently and thoroughly are the exception. As a rule, they are practicing what Hahnemann called bastardized homeopathy or eclecticism. They are fooling themselves as well as the public, similar to the blind leading the blind. This is not right. When a sick person after reading about homeopathy decides to consult a homeopathic practitioner, he expects to get the best of homeopathy. However, if instead he receives eclecticism hidden behind the facade of "classical" homeopathy he is being deceived by such misrepresentation.

Incidentally, a colleague in my office took a call from a woman who, practically in tears, told how she had just read an article of mine talking about how homeopathy should be practiced: based only on the facts ascertained, that the case-taking should be thorough and last at least two hours to obtain all pertinent information, etc. The woman told how she had spent the past many years and all her familyís savings trying to find help through homeopathy for her daughter who has inflammatory bowel disease, but to no avail. It only became clear to her after reading this article that she had never actually consulted with a genuine homeopath. Of the people she had seen, one divined the remedy from intuition, one prescribed unsuccessfully after thirty minutes of case-taking, one prescribed using a Voll machine, one mixed numerous remedies togetheróbut all called themselves homeopaths. She was so discouraged and had concluded that homeopathy was a farce. She was phoning to get a recommendation of a "real" homeopath in her area, and unfortunately, it was impossible to make one. It is in fact impossible to know what a person professing to practice homeopathy actually practices.

Unfortunately, very few professed homeopaths in the history of homeopathy have understood and applied the method of Hahnemann correctly and witnessed the promised results. The pioneers of homeopathy were more serious as a rule than each successive generation. Today, few can really claim to be true Hahnemannians. Unfortunately, in homeopathy people do claim whatever they want regardless of the truth and this without being held accountable by the profession. Let me give you an example. About 17 years ago, you could read in the advertisements of a very well-known homeopathic teacher that he was teaching in the tradition of Hahnemann, Hering, and Kent. During a seminar with this supposed very knowledgeable teacher, two other colleagues and I had the privilege to dine with him. As I was at that time collecting very interesting articles by Hering in my library research, I naively asked him what he had read of Heringís work. I was expecting that, like me, he had found these writings of Hering very instructive, so we could perhaps have had a discussion about them. He simply and bluntly said that he had never read anything by Hering. I almost fell off my chair. I became quickly disillusioned after such experiences and this made me more eager to find true homeopathy through my own research.

There is something missing nowadays in homeopathy, and that is rigor. Professed teachers can say whatever they want and students take it for granted that it is true. There is also a lack of academic honesty and too many students are naÔve. Our profession is very immature. You would expect that professional teachers and leaders of homeopathy would know their discipline. However, what Socrates said about the deception practiced by the Sophist teachers of his time also rings true in homeopathy today. On this matter, Socrates commented, "Can you name any other subject in which the professed teachers are not only recognized as teachers of others but are thought to have no understanding themselves and to be no good at the very subject they professed to teach?" We have much growing to do.

Hahnemann clearly defined homeopathy and all its underlying principles and warned us against misrepresentations. In 1832, in his fight against the "half-homúopaths" of Leipzig, Hahnemann wrote, "Should any false doctrines be taught under the honorable name of homúopathy . . . may you depend upon it that I shall raise my voice aloud, honestly and to its utmost. In all the public papers far and near I shall warn a world already weary of deceit against such treachery and degeneracy, which deserves to be branded and avoided."

Unfortunately, many serious people are prevented from achieving great success as a result of being lured by these false teachers. We come back to what we said earlier, that homeopathyís greatest weakness is its educational system and its incapacity to certify qualified practitioners.

The pioneers of homeopathy in America founded the American Institute of Homúopathy in 1844 for the following two purposes: First: "The reformation and augmentation of the Materia Medica" because the state of the materia medica was "such as imperatively to demand a more satisfactory arrangement and greater purity of observation which could only be obtained by associate action on the part of those who diligently seek for truth alone," and second: "the restraining of Physicians from pretending to be competent to practice homúopathy who have not studied it in a careful and skillful manner" because "the state of public information respecting the principles and practice of Homúopathy is so defective as to make it easy for mere pretenders to this very difficult branch of the healing art to acquire credit as proficient in the same." The American Institute of Homeopathy cannot stand up today and say job well done, as the current situation is not only not better, but much worse.

We have a great number of professed homeopaths who have no interest in being rigorous in their observation and reasoning. Many of homeopathyís professed teachers seem to be on a self-fulfilling journey. They are not interested in "what is," but instead are interested in promoting themselves and their ideas. This has nothing to do with the homeopathy of Hahnemann. The people that have helped homeopathy to progress forward are the ones who have applied themselves conscientiously. I have heard from a number of sources that a particular popular teacher has been presenting false cases and false outcomes in his follow-ups. This is unpardonable. Someone who cheats even once in medicine or as a teacher should at the very least be barred from practicing and teaching. One time is too many. The work of a person found cheating loses all reliability. Such a person would be better off writing fiction and inventing stories than cheating in the worse field, where it can do the most harm, medicine.

On the other end of the spectrum, there is a completely different caliber of person: with characters such as Hahnemann, Boenninghausen, Lippe, Hering, and Dunham. They were all scholarly minds who worked hard and conscientiously to advance homeopathy and help diminish suffering. Unfortunately, few people with scholarly minds are nowadays attracted to homeopathy. In the past, we had many scholars who not only adopted, but also dedicated their lives to homeopathy, often after having had their own life saved by it.

Q.: Why is it that homeopathy does not attract scholars?
A.S.: Homeopathy attracted many scholars in its early days, letís say, prior to about 1845. When you read the early history of homeopathy, many of the people who first came to homeopathy were among the best educated of their time. I am thinking specifically of Count des Guidi, who introduced homeopathy in France, and who was both a Doctor of Science and Medicine, Joslin in America who was a university professor of mathematics and natural philosophy, Jourdan, a Member of the French Royal Academy of Medicine, Hering, Boenninghausen, Wesselhoeft, Dunham, and so forth. In the Almanach Homúopathique of the Catellan brothers published in 1860, there is a 5 or 6 page list of names of scholarly physicians who adopted homeopathy. Many of the pioneers of homeopathy who understood homeopathy well came from the aristocracy and were therefore amongst the best educated. One canít help but think of Count zur Lippe, Baron von Boenninghausen, Count des Guidi, Marquis Nunez, and Count von Korsakoff.

That was in the earlier days, however. After this, homeopathy developed a bad name. In 1861, Jahr founded a journal in Paris which he called LíArt de Guťrir (The Art of Healing). In the foreword of the new journal, he writes that he has omitted the word homeopathy from its title as the practice of pretend-to-be homeopaths had given it such a bad reputation that its name alone had become the main obstacle to its own development by discouraging scholars and conscientious practitioners. It is likely that if homeopathy had accepted within its ranks only those who understood it, we would have had an ongoing united profession that would have grown exponentially. However, everyone knows how a few bad apples can ruin an entire crate.

Also, in the early days, the aristocracy and educated class not only used homeopathy but also were its benefactors. Many traveled from far away to see Hahnemann in Leipzig, Coethen, or Paris. To illustrate in what light homeopathy was seen then, there is the dramatic story of a thirteen-year-old Scottish boy named John Young who had been declared hopeless due to tuberculosis. He was the son of a poor weaver. A lady of wealth, who was doing business with his father, found out about the sick boy and showed great interest and sympathy toward him. After having met Hahnemann in Paris, she decided to send the boy to him. On his way from Scotland to Paris, the boy stopped for a couple weeks in London to be examined by the Queenís physician. After much examinations of the boy, he whispered to his assistant that there was not the slightest hope for recovery and that the boy would never return alive from Paris. The boy eventually reached Paris and was seen by Hahnemann who examined and auscultated the boy very carefully for an hour and a half in the wee hours of the night. Then, with a "luminous glow," Hahnemann said that he was glad the boy had been brought to him as he would be cured but it would take time. After nine months, the boy returned home cured and eventually immigrated to America. He would regularly come tell his story to the students at the Hering Medical College in Chicago some seventy years later. What is interesting to note is that during these nine months he saw Hahnemann on an almost daily basis. He reported seeing Hahnemannís waiting room full of people who had come from all over the world to consult with him. In that time, homeopathy was popular amongst all. People poor and rich, from close and far, sought homeopathy, often as their last resort. If the true potential of homeopathy were better known today, people would make the same great effort to seek genuine homeopathy.

Homeopathy slowly lost its luster when too many practitioners professing to practice homeopathy had deviated from its fundamental principles or did "not study it in a careful and skillful manner," and were therefore not able to deliver its full potential. Instead of gaining, homeopathy lost popularity by its lack of success in the hands of its professed practitioners. If the title of homeopathic physician had been limited only to those who understood and practiced genuine homeopathy, we would likely have grown by leaps and bounds and would today have official recognition. This is another example of how homeopathyís greatest nemeses have been its lack of quality education and its incapacity to certify its practitioners.

Q.: How do your foresee the resolution of this problem of quality education and certification of its practitioners resolved?
A.S.: It is obvious to me that one of the first steps to remedy the present situation would be to have Hahnemannians come together and unite with one voice. In my travels, I have met many colleagues interested in reactivating the International Hahnemannian Association (IHA). The IHA, originally founded in 1880, played an important role not only in preserving pure homeopathy but also in raising the standards of education and practice within the rest of the profession. People who understand homeopathy well and are interested in its progress forward should unite and meet on a regular basis to present and discuss their works. Also, they should have a journal in which to publish their papers, transactions, observations, and reviews. Such an association does not need to be large in number, but would be rich in the quality of its work. To my mind this would be the first step in providing a sound structure for our now very disorganized profession. It would also be the easiest and most useful example for others to follow and would assure continuity and progress forward for homeopathy.


  1. The concept of miasm is a common place in the history of medicine as a mode of transmission of infectious disease. It continued to be referred to even long time after Hahnemann. For instance, in 1894, the eminent British epidemiologist Charles Creighton favored the theory that influenza was spread over the land by a miasm rather than as a contagion from one person to the other, as it affected large population in most parts of a country almost at once and the occupant of a house simultaneously.
  2. Psora was a common word in Hahnemannís time and was often used almost indiscriminately for every type of acute and chronic skin eruptions. It comes from the Greek, psŰra, which root, psen, comes from an older Indo-european language and all mean itchiness or the itch disease or scabies. Antipsoric was a term used at least as early as 1783 to designated treatment against scabies.
  3. Incidentally, from his early writings, we know that Hahnemann was aware of this mite infestation in scabies. However, for unknown reason, he doesnít mention it in his later writings.
  4. A paper relating the history of Heringís Law can be read in the section Articles at
  5. Part I and II of the interview conducted by Drs. Gerhard Willinger and Friedrich Dellmour in 1994 and published in the LIGA journal can be read at It is also available in German as Um eine Disziplin zu beherrschen, mŁssen wir von ihren Wurzeln augehen from Grundlagen und Praxis GmbH & Co, Hamburg.
  6. This training is available of videocassettes from the Canadian Academy of Homeopathy at
  7. Again these articles can be found in the section Articles at

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