Hahnemann Revisited by LUC DE SCHEPPER, MD, PhD
[From HOMEOPATHY TODAY Volume 20, Number 4, April 2000]
This book review is reprinted with the permission of the National Center for Homeopathy
Hahnemann Revisited: A Textbook of Classical Homeopathy for the Professional by Luc De Schepper, MD, PhD, CHom, DIHom, LicAc
1999, hardback, 576 pages
Reviewed by Julian Winston
Dr. Luc De Schepper received his medical degree in Belgium in 1971. He began studying homeopathy as part of a PhD program in acupuncture. He moved to the U.S. in 1981 and has been using homeopathy exclusively since 1991. He is in private practice in San Diego, CA.
When Dr. De Schepper titles this 576-page book A Textbook of Classical Homeopathy for the Professional he is very serious. This is a book for practitioners. It is not for beginners. Many of the concepts discussed within it could easily be misunderstood by them, or worse, misused.
The author says, “I believe he [Hahnemann] has answers and guidance highly relevant for us today, although sometimes inaccessible because they are couched in old-fashioned language.” Cautioning that the book is designed for the practicing professional, the author describes it as an “exposition” of Hahnemann’s system.
The book is divided into four parts: The Foundation, The Healing Process, The Chronic Miasms, and the Appendices.
Part One, The Foundation, discusses the basic principles of the system. There is a good discussion about provings. “Hering’s Law” is discussed, although there is confusion here about the details of when Hering’s Law was first published.
There is a discussion about what makes a remedy homeopathic, and the author says it must be based on the totality of symptoms- mental, emotional, and physical; it must be a single remedy; and it can never have a “material substantial dose.” This is not actually what Hahnemann says. Hahnemann speaks of considering the totality of the characteristic symptoms of the disease. Mental, emotional, and physical indications may be used if they are characteristic.
Considering that Hahnemann, Gram and others did good homeopathy with drop doses of tincture, I wonder about the inclusion of “never have a material substantial dose” without further qualification as to what “substantial dose” means.
There is a good discussion about the place of pathology in homeopathy with quotes from Grimmer, Hering, Farrington, and Nash, and there is a good exposition of the development of potencies-including the LMs.
There is a listing of recommended usages for some common potencies, based on writings from “old masters” and, says De Schepper, “confirmed by my own experience.” This is followed by specific variations such as, “In sports injuries to a basically healthy person, 30C, then four hours later a 200, then four hours later a 1M, in each case 3 pellets dry”-a posology used by the late Pierre Schmidt.
Following that is a discussion about frequency of administration, specific application of centesimal potencies (acute cases, chronic cases, constitutional remedies, nosodes, epidemic prescribing), adjusting the remedy, adjusting the potency, the distinction between dose and potency, and 13 pages about LM potencies.
In describing the process of case taking, De Schepper lapses into “homeopathic shorthand” and gives hints that are, to my thinking, exactly what Hahnemann cautions against when he talks of “freedom of prejudice” in Paragraph 83 of The Organon. De Schepper says: “When you meet the patient in the waiting room, one patient will be calmly waiting for you, reading a book or knitting some socks for Christmas (Calcarea). Another one will be fuming at you for being five minutes late, telling you in no uncertain terms that you are wasting his precious time (Sulphuric acid the ‘time is money’ guy)…”
These judgments continue throughout the chapter-the “dogmatic and rigid Kali carb person,” the “know it all” Sulphur the “non-trusting” Lachesis, “the elegant and subtle colors [of clothing] of Carcinosin, the black, white or purple of Nat mur” He describes patients who were so environmentally sensitive that they came to the office wearing masks: “I immediately knew what remedy to prescribe (Phosphorus or Arsenicum) … ” Says De Schepper, “What jewels for your prescription. You have hardly asked the first question and you have an abundance of information … ”
Yes. But this information can easily be misused by someone beginning in homeopathy. I wish the author had expressed more qualification about this kind of thinking (e.g., “these are hints I have found through my years of practice”) rather than putting it out with such unfailing certainty I know of two cases of environmental sensitivity that responded to Sepia-based upon the unique symptoms of the case. Had the prescribers immediately “known what to prescribe” they would have missed the remedy that was curative.
De Schepper suggests the use of a written intake form (which is described in full in the appendix). He gives brief mention to the practice of “underlining” (as taught by Vithoulkas) without describing it fully. He encourages the physical exam specifically looking at the tongue and examining the skin in eczema cases.
When taking an acute case, he suggests the use of Boenninghausen’s seven levels of case-taking: quis (who-the details of the patient), quid (what-the etiology), ubi (where-the location of the complaint), quibus auxiliis (with what-concomitant symptoms), cur (why-modalities), quomodo (how-how did it manifest?), quando (when-time modalities).
In discussing pediatric case taking, De Schepper discusses questions to ask the parent, for example: How is the child with affection? What is the child’s reaction to music? What are the food cravings and aversions? He again makes the leap of describing remedies for behaviors …”Does the child watch every gesture you make (Calcarea)? Does the child jump around and destroy things (Tuberculinum)?”
Chapter eight, “Constitution, timeline, and temperament,” contains some interesting ideas. He uses the word “constitution” to mean the innate “stuff” of which the person is made and not necessarily the curative remedy for the persn’s chronic condition. This is very like the thinking of Argentinean homeopath Francisco Eizayaga. According to De Schepper there are only seven possible innate constitutions-Sulphur, Phosphorus, Calcarea, Calc phos, Silica, Lycopodium, and Baryta carbonicum. The case usually consists of the building of further layers on top of the constitution, and this can be understood by viewing a time-line of the patient.
An interesting diagram on page 150 shows “the road not traveled”-a constitutional Phosphorus has a detour through a “Natrum muriaticum” event (loss of parent, move, etc) and through the childhood years exists in a Nat mur state, moving to a young adulthood characterized by unsuitable partners and heartbreak. This leads to a Sepia state of indifference to loved ones, unhappy relationships, and infertility. In later life the person becomes a “crusader”-the Phosphorus constitution with the Natrum mur personality.
The chapter is followed by an 11-page discussion of the Hippocratic temperaments (Sanguine, Choleric, Phlegmatic, Melancholic) and how they relate to both Chinese medicine and homeopathy.
Part Two, The Healing Process, is about the process of prescribing. De Schepper presents his own clinical method based on the selection of ten rubrics. He says that, given this method, the homeopath will have “a consistent chance of finding the curative remedy,” and that when he uses this method with his homeopathy classes, the students can select the correct remedy. These are “solid principles for finding the simillimum in a logical, orderly way,” and “derive from the works of the old masters, starting with Hahnemann.”
After a brief discussion of the difference between the simile (the almost correct remedy) and the simillimum, he presents his methodology which begins with the prioritizing of the symptoms, in this order of importance:
1. Strange, Rare, or Peculiar symptoms (including delusions and strong keynotes)
2. Never well since
5. Food cravings and aversions
6. Sleep and sexuality
7 The chief complaint with location, sensation, modalities, and concomitants.
De Schepper presents an example grid to fill in, but I found the instructions, without an example, to be confusing and hard to follow. Examples, however, do exist in the appendix, but only result, to me, in many unanswered questions. In the first case there were 28 possible selected rubrics. To fit them into the schema, 10 rubrics are to be selected. Although De Schepper offers the guideline that one should choose “medium sized” rubrics, the 10 he selects for the case are described as “my 10 favorite rubrics.” Should one have “favorites”? Or should the rubric selection be based on some understandable criteria? What are the criteria for selection? What does he know that he is not stating clearly?
The second sample case contains 55 possible rubrics. The 10 rubrics used are seemingly selected by looking at the “essence” of the case and drawing conclusions about the patient’s personality There is a discussion of the possible remedies that might be of use. De Schepper says, “Let’s see where these remedies are in our repertorizing. With so many rubrics available, we want to choose the ones that reflect this patient the best.” This sounds like the remedy is being decided first and rubrics that support that choice are there selected.
If that is the feeling I get from this section, then the process of selection has not been well explained.
After discussing “Golden Rules and Special Forms of Prescribing,” which include a list of remedies in series (gleaned from old literature) and a list of acute and chronic relationships, De Schepper urges one to “start with a polychrest remedy” Saying that he has been to many conferences where the presenter “tries to impress the participants with a small remedy that matches the case in only a few specific symptoms,” he suggests the use of the larger remedies. “I would advise in 99% of cases starting with a polychrest.” He then outlines a series of exceptions to the rule.
He urges prescribing by symptom, not by symbolism (e.g., he quotes a case where Lac leoninum [lion’s milk] was prescribed because a cat came to the prescriber’s door when she was puzzling over the case) and decries this type of practice-reminding us of Hahnemann’s exhortation against “supersensible speculations which are not borne out by experience.”
There is a whole chapter discussing how delusions manifest some remedies. It includes lists of some of the delusions De Schepper has seen in practice and how they were manifested in the case.
After discussing aggravation, healing crisis, suppression, and obstacles to cure, De Schepper presents 12 possible scenarios of reactions to the first prescription (similar to those which Vithoulkas presented in The Science of Homeopathy), and some management tips from the old masters. He also discusses the second prescription, that is, when and how to change the remedy or potency This is followed by advice about palliation and incurable diseases, remedies for the dying patient, and a discussion of the nosodes and indications for use, including a full discussion of the bowel nosodes of Bach and Wheeler.
Part Three discusses the “chronic miasms” including the tubercular and cancer miasms. De Schepper discusses the “central idea” of each-a construct of the mental symptoms that are obviously valuable to him in his prescribing.
The final chapter is a discussion of the treatment of cancer with homeopathy and includes a number of cases from homeopathic literature.
Part Four, the appendices includes the “intake forms,” a listing of remedies “Never Well Since” and “Ailments From,” a 24-page listing of symptoms and their miasms, and the solutions to several of the cases within the text. Included are cases from the “Cancer” chapter, three of which were taken from the experience of Edmund Carleton, MD, who practiced at the turn of the century Since Carleton only spoke of the remedies he prescribed, the repertorizations and reasonings for his choices are retrospective as interpreted by De Schepper. The fourth case is described in the text as one which “shows how to prescribe for advanced pathology for the one-sided disease that has over-powered the vital force.” But when the case is looked at in the appendix, there is only the suggestion that “No doubt a dose of Arsenicum album is required… Aurum may be the next remedy coming up…” but no remedy is given and no follow up reported.
The fifth appendix is a 16-page discussion of the similarities between homeopathy and traditional Chinese medicine.
This is a book intended to be of help to the practicing homeopath. The format is full letter size (8 1/2 by 11 inches). It is well bound and has a number of excellent diagrams that are useful to those who are visually rather than verbally oriented. I had a problem reading the text because of a consistent lack of the use of a space between a comma/period and the next letter-causing all the sentences to seemingly “run-on.”
There are a few strange typos like Hippocrates being Hippolates and “next” being “neai.” On page 213 (food desires and aversions), the last few words on the page are “Ask a question like,’if you didn’t have to think..'” and there is no continuation on the next page which starts the section “Breastfeeding and infants.”
In the Cancer chapter, one case is footnoted in the text as “16,” but the footnotes for the chapter end at “15.”
While discussing the Genus Epidemicus, there is mention that the Spanish Flu of 1918 responded mainly to Baptisia. I am curious as to the source of this information, since there is no reference given in the bibliography. In all the reading I have done about the Flu of 1918, the prime remedies were Gelsemium and Bryonia.
My reservations about the work have been outlined above. While the book contains a plethora of information, much of never before found in one place, the information on “the method” is very thin and, in my opinion, poorly justified. De Schepper writes with a certainty about things that are not so black and white in my observation.
I am sure that most practitioners with a few years under their belt would find useful information within these pages the “Aha! I never looked at it like that.” But much of the advice is, for me, too pat and too cut and dry While the author decries prescribing on “symbolism,” a number of his suggestions found in the case taking chapter are, in my opinion, very close to that edge, and run the risk of having one who is a novice fall into the “clammy handshake equals Calcarea” syndrome, without looking further afield. These ideas are based on the experience of the author and should have been clearly identified as such rather than presented as “the way”-as they differ from the experiences in practice of other homeopaths I know.