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A theory of tumour development
stage is like watching another person demolishing a wall with a sledge hammer and then rushing out to buy one for our own use. The remedies are increasingly being presented as disease-specific, often appealing to the prescriber who has little time to study the patient or remedy. The clinical proof of the remedy is necessary, but only in giving substance to our understanding and application of the tools of our trade. One quite infamous pathological prescriber was Dr Crippen who sold a number of remedies and remedy mixtures as disease-specific. We each have our own personal approach to these three stages and to some of us one stage is more important than the others. This undoubtedly reflects in our practice as well as our teaching of the subject and can present an inconsistency to both patients and pupils of homo~opathy. We must try to overcome this inconsistency by attempting to balance all three aspects in our own approach. Otherwise we are likely to select the wrong tool for the job necessary. There are many ways of presenting information about homoeopathic remedies. Unfortunately to the newcomer this variety of approaches can lead to confusion and conflict, calling on the one hand for the most pragmatic of minds and on the other a fluidity and artistry which is eventually difficult to express in concrete terms, so making it difficult to express to some of our allopathic colleagues. In teaching about the remedies we must bear in mind a need to understand them, to teach them in a fashion which facilitates their learning and we must in the most practical of ways demonstrate their effectiveness. REFERENCES 1 TwentymanLR. Stannum. Br Horn J 1984; 73:22. 2 ShuttleworthVS. Parts per Million. Br Horn J 1984; 73"51. 3 Julian OA. Pathogenesis of Platinum 1980.Br Hom J 1983; 72"31.
A theory of tumour development ANNE CLOVER, DPM, FFHOM
This paper is the first of a trilogy relating to the place of homoeopathic concepts in the understanding and therapy of cancer. The aim in this first part is to review some of Hahnemann's theories relevant to carcinogenesis. It will consider the way in which he assesses the contribution of factors as various as chronic poisoning, subtle psychological determinants and hereditary traits. Today there are Volume 73, Number 4, October 1984
18 7
increasing references to a wide range of factors said to be causes of cancer. Physical carcinogens as well as emotional, ideological and other similarly subtle factors and hereditary patterns relevant to tumour development are being researched. It may be argued that in many ways Hahnemann has also spanned this spectrum of causes in his writings, referring to the role of the latent, and many would say hereditary, trait that he termed "psora", as well as to its provocation by contemporary irritants of various forms. As in so many other situations, the role of distinct physical factors is more easily considered than that of psychological energies. But if we pursue Hahnemann's approach we will look as closely as possible at all aspects of the relevant processes. Hahnemann is by no means one of the first to express insights concerning subtle determinants of tumours. As early as the second century Galen expressed the opinion that women of a "melancholic" temperament were more likely to develop breast cancer than those described as "sanguine". This might suggest that those who suffered such problems passively were more liable to tumour development than those who readily expressed their emotions. Such references to an association between breast cancer and psychological disorders increased in the 18th and 19th centuries, and even more so in the present era. Recent examples have included a s t u d y published by Green and Miller in 1958 reporting an association between cancer and preceeding personal loss, ~ and by Green and Swisher in 1969 on three sets of monozygotic twins discordant for leukaemia with prior major personal psychological stress in the affected twin. z Other studies published in the 1960s showed a correlation between prior depressive illness and subsequent cancer development. Since then further studies of such an interrelation between malignant disease and prior psychological stress have appeared to give contradictory results. But many workers in this field still argue firmly in support of the association from their personal experience of patients' reports, whilst also pointing out the difficulty of adequately assaying the frequency or role of such effects. But as Hahnemann reminds us many times, empirical experience is on its own not enough to formulate or dismiss a theory. Rational deduction, particularly when applied to careful observation of patient's reports, is a more reliable guide. Today, science has clearly shown that all matter is energy behaving in an apparently substantial manner. The idea of solid entities or uncuttable atoms has long been exploded. It is only inertic thought that holds to an erroneous dualism between supposed immaterial forces and so-called material atoms. We are now in an era when thought is having to catch up with science and dynamize its interpretations. Since the physical body is a dynamic form it follows logically that the energies of thought and feeling are in continuous kinetic interaction with the apparently physical aspects of beings. Freud and Jung are well known exponents of such theories. It is less often acknowledged that the interaction had been stated long before them by Samuel Hahnemann. Hahnemann's many writings show a progressive understanding on his part of a hierarchy of causes of chronic diseases, one form of which he says is cancer. He recurrently emphasized the need to look at all aspects in a spectrum of causes and 188
The British Homoeopathic Journal
warned against a blind prejudice on one hand, or empty speculation on the other. 3 Blind prejudice, he says, is opinion-biased according to a person's particular training. In other words, someone who is inappropriately tied down to their previous experience and ideas. Empty speculation is an opposite type of error, that is, hypothesis inadequately tested in experience. In colloquial terms, one is seeing no further than the end of a nose, the other is a flight of fancy or phantasy. The way to avoid these errors, according to Hahnemann, is through careful scrutiny of all relevant factors. This hierarchy of causes described by Hahnemann ranges from spiritual, or initiatory forms, to diet and dampness. Although he was writing long before public health was a common concern, he firmly argued the need for care in this dimension. Today it is easy to take such measures for granted. But in his day, Hahnemann was again showing a pioneer attitude when he emphasized their importance to health or disease. His advice on diet was similarly practical. He advocated a fresh, well balanced diet, avoiding excesses or substances difficult to assimilate. In a similar vein he argues against the abuse of drugs and for appropriate regimes of exercise. All such obvious physical factors, he argues, can play a fundamental role in determining human health or disease. They are the basic modalities in his hierarchy of causes of chronic disease in general, or tumours in particular. 4 All through his writings Hahnemann consistently argues the similar importance of psychological factors for health or disease. Clearly to him the physical performance was a type of end product revealing the effect of progressively finer influences. His assessment is constantly non-dualistic, emphasizing the interaction of the subtle and gross determinants. Amongst such subtle factors he differentiates emotions, selective or trained thoughts, a higher mind or understanding and ultimately the volition or will. Often such modalities appear to be considered together when he refers to the "vital force". This term, though unfamiliar today, was widely used in the time of Hahnemann for factors that would now be termed psychological. In expanding his understanding of this aspect of human function, Hahnemann differentiates such factors that in his opinion contribute to malignant disease. Examples that he lists are training in formative years, moral conflict, sexual difficulties, family problems, jealousy, resentment and fear. 5 His list is wide-ranging, but can be summarized in today's terminology as referring to emotional imprinting and intellectual conditioning. Today it is widely acknowledged that the physical organism holds dynamic imprints of prior experience, such as perceived sensations, emotional reactions and ideological training. Clearly these serve a useful purpose when they facilitate useful training, but become a problem when they strongly bias a person to repeat experience remembered by them as pleasurable and restrictively to avoid pain or threat. Such restriction can easily conflict with personal creativity and become a factor in the development of disease. Summarizing his hierarchy so far, Hahnemann has referred to the role in tumour development of three modalities that today could be termed physical, emotional and ideological. But his hierarchy of factors contributing to chronic disease such as cancer does not stop here. He Volume 73, Number 4, October 1984
189
also refers to even more subtle vectors when he writes of spiritual essences and the higher mind. 6 He appears to imply that the higher mind is an understanding that extends beyond the individual empirical training and intellect to include an awareness that might be described as cosmic.7, 8 Many philsophers and other thinkers have referred to an inherent intelligence and ultimate order in the universe. Various religious, philosophical or psychological terms have been pursued for this, examples are the Christian Logos, the Buddhist field of formal-voidity, the Platonic realm of ideas, and the Jungian collective unconscious. They all imply an immediate, innate consciousness within creative power of its own processes. Hahnemann appears to refer to such an awareness and the possibility of it informing the individual thinker when he writes of the higher mind or the reason-gifted consciousness. It implies an understanding reaching far beyond the limits of ordinary egoic training. He then appears to develop and apply this awareness in relation to chronic disease when he implies that a personal disregard of its information accompanies empirical bias and contributes to interpersonal conflict. Closely associated with such concepts are references to spiritual or initiatory essences.7, 8 Hahnemann's writings imply his progressive understanding of an informed initiation, a term also translated as a spiritual essence, that is, the prime mover of any creative process. It could be called an ultimate cause, answerable only to itself. Logical deduction implies that such an initiation would be a primary cause of an act, the free will referred to in various ways by philosophers, psychologists, religious thinkers or similar researchers in all ages. In other words, Hahnemann appears to be saying, like many other thinkers have done, that the primary cause appears qualitatively in its effect. Hahnemann's use of the term "initiatory essence" implies this. It denotes a quality essential to the form and not an imposed directive. One way of illustrating such concepts is to liken the initiatory essence to the pattern in an acorn that determines its development, given appropriate resources, into an oak tree. The term "conceptual essence" is a very interesting one, implying the dual aspects of the will to act in this way and the form expressing it. Hahnemann argues that such a subtle form is the prime mover of any extant structure and deduces that just as such influences can sustain health, their imbalance c a n contribute to disease. Such initiatory derangements, he argues, need a similar form of corrective. That is, an initiatory imbalance needs a change of initiative for its correction. In relation to these concepts he argues that potentization gradually releases such intiatory forms and presents them in a manner that can facilitate an appropriate re-orientation in a disturbed energy field. Here then are two more aspects, which, added to the three of thought, feeling and drive previously described, make a five-fold hierarchy. It begins with the will, or essential initiation, moves to a comprehensive understanding or higher mind, then refers to conditioned temporalized thought or opinion, after this to emotional conditioning and finally to diet, damp, drugs or other similarly gross physical factors..The activity of all these aspects, Hahnemann argues, is revealed in the gross physical form, a dynamic construct that reflects the whole series. All aspects, he says, are in continual interfunction and all therefore contribute all the time to health or disease. 190
The British Hornoeopathic Journal
In relation to chronic disease, including tumours, Hahnemann argues that such influences accrue during the lifetime of an individual, then interact with a latent trait. M a n y have interpreted his writings on psora as implying a hereditary trait that is vulnerable to reactivation by contemporary effects. Hahnemann relates the origins of psora to a chronic irritation developed in the dawn of civilization and o f which leprosy m a y be a long-standing sign, contemporary VD a more recent manifestation) But whatever its origins he argues that this trait is liable to reactivation by the other factors named as contributing to chronic disease. TM He is therefore describing a dual action of the latent trait and a stimulus that provokes its activation. It is a theory that bears close comparison with contemporary expressions of the combined effects of hereditary factors as well as personal psychology or exposure to carcinogens which in combination can produce a malignant disease. Although Hahnemann firmly argues that such a latent trait is the c o m m o n property o f mankind, he still emphasizes the individuality of diseases with which it is associated. The basic trait m a y be shared but the provoking factors are unique. Hence he says we need to remember that in each patient we are seeing not "cancer" but a "type of cancer". 11 It is a point taken up again by Clarke when he emphasizes that " h o m e o p a t h y is the art o f individualizing". Hahnemann's theories therefore imply a thoroughly dynamic understanding of tumour development. In all his writings H a h n e m a n n consistently deduced a theory first, then applied this in a rational therapy. The second paper in this series will discuss how these insights can be applied today in the treatment of malignant disease. REFERENCES 1 Greeve WA, Miller. Psychological factors and reticulo-endothelial disease. Psychosom Med 1958; 20:124-44. 2 Greeve WA, Swisher SN. Psychological and somatic variables associated with the development and course of monozygotic twins discordant for leukaemia. Ann N Y Acad Sci 1969; 164:394-408. 3 Hahnemann S. Organon. Pretace 2nd ed. 4 Ibid., Paragraph 77.6th ed. 5 Ibid., Paragraphs 81A, 93.6th ed. 6 Ibid., Introduction and paragraphs 62, 63.6th ed. Trans. Dudgeon. RPH 196t. 7 Ibid., Paragraphs 15-20 and 269, 270.6th ed. 8 Hahnemann S. Chronic Diseases. Prefaces to vol. IV and V. Delhi: Jain. 9 Ibid., p. 48. 10 Ibid., p. 10. 11 Hahnemann S. Organon. Paragraph 81.6th ed.
Volume 73, Number 4, October 1984
19 1
A theory of tumour development ANNE CLOVER, DPM, FFHOM
This paper is the first of a trilogy relating to the place of homoeopathic concepts in the understanding and therapy of cancer. The aim in this first part is to review some of Hahnemann's theories relevant to carcinogenesis. It will consider the way in which he assesses the contribution of factors as various as chronic poisoning, subtle psychological determinants and hereditary traits. Today there are Volume 73, Number 4, October 1984
18 7
increasing references to a wide range of factors said to be causes of cancer. Physical carcinogens as well as emotional, ideological and other similarly subtle factors and hereditary patterns relevant to tumour development are being researched. It may be argued that in many ways Hahnemann has also spanned this spectrum of causes in his writings, referring to the role of the latent, and many would say hereditary, trait that he termed "psora", as well as to its provocation by contemporary irritants of various forms. As in so many other situations, the role of distinct physical factors is more easily considered than that of psychological energies. But if we pursue Hahnemann's approach we will look as closely as possible at all aspects of the relevant processes. Hahnemann is by no means one of the first to express insights concerning subtle determinants of tumours. As early as the second century Galen expressed the opinion that women of a "melancholic" temperament were more likely to develop breast cancer than those described as "sanguine". This might suggest that those who suffered such problems passively were more liable to tumour development than those who readily expressed their emotions. Such references to an association between breast cancer and psychological disorders increased in the 18th and 19th centuries, and even more so in the present era. Recent examples have included a s t u d y published by Green and Miller in 1958 reporting an association between cancer and preceeding personal loss, ~ and by Green and Swisher in 1969 on three sets of monozygotic twins discordant for leukaemia with prior major personal psychological stress in the affected twin. z Other studies published in the 1960s showed a correlation between prior depressive illness and subsequent cancer development. Since then further studies of such an interrelation between malignant disease and prior psychological stress have appeared to give contradictory results. But many workers in this field still argue firmly in support of the association from their personal experience of patients' reports, whilst also pointing out the difficulty of adequately assaying the frequency or role of such effects. But as Hahnemann reminds us many times, empirical experience is on its own not enough to formulate or dismiss a theory. Rational deduction, particularly when applied to careful observation of patient's reports, is a more reliable guide. Today, science has clearly shown that all matter is energy behaving in an apparently substantial manner. The idea of solid entities or uncuttable atoms has long been exploded. It is only inertic thought that holds to an erroneous dualism between supposed immaterial forces and so-called material atoms. We are now in an era when thought is having to catch up with science and dynamize its interpretations. Since the physical body is a dynamic form it follows logically that the energies of thought and feeling are in continuous kinetic interaction with the apparently physical aspects of beings. Freud and Jung are well known exponents of such theories. It is less often acknowledged that the interaction had been stated long before them by Samuel Hahnemann. Hahnemann's many writings show a progressive understanding on his part of a hierarchy of causes of chronic diseases, one form of which he says is cancer. He recurrently emphasized the need to look at all aspects in a spectrum of causes and 188
The British Homoeopathic Journal
warned against a blind prejudice on one hand, or empty speculation on the other. 3 Blind prejudice, he says, is opinion-biased according to a person's particular training. In other words, someone who is inappropriately tied down to their previous experience and ideas. Empty speculation is an opposite type of error, that is, hypothesis inadequately tested in experience. In colloquial terms, one is seeing no further than the end of a nose, the other is a flight of fancy or phantasy. The way to avoid these errors, according to Hahnemann, is through careful scrutiny of all relevant factors. This hierarchy of causes described by Hahnemann ranges from spiritual, or initiatory forms, to diet and dampness. Although he was writing long before public health was a common concern, he firmly argued the need for care in this dimension. Today it is easy to take such measures for granted. But in his day, Hahnemann was again showing a pioneer attitude when he emphasized their importance to health or disease. His advice on diet was similarly practical. He advocated a fresh, well balanced diet, avoiding excesses or substances difficult to assimilate. In a similar vein he argues against the abuse of drugs and for appropriate regimes of exercise. All such obvious physical factors, he argues, can play a fundamental role in determining human health or disease. They are the basic modalities in his hierarchy of causes of chronic disease in general, or tumours in particular. 4 All through his writings Hahnemann consistently argues the similar importance of psychological factors for health or disease. Clearly to him the physical performance was a type of end product revealing the effect of progressively finer influences. His assessment is constantly non-dualistic, emphasizing the interaction of the subtle and gross determinants. Amongst such subtle factors he differentiates emotions, selective or trained thoughts, a higher mind or understanding and ultimately the volition or will. Often such modalities appear to be considered together when he refers to the "vital force". This term, though unfamiliar today, was widely used in the time of Hahnemann for factors that would now be termed psychological. In expanding his understanding of this aspect of human function, Hahnemann differentiates such factors that in his opinion contribute to malignant disease. Examples that he lists are training in formative years, moral conflict, sexual difficulties, family problems, jealousy, resentment and fear. 5 His list is wide-ranging, but can be summarized in today's terminology as referring to emotional imprinting and intellectual conditioning. Today it is widely acknowledged that the physical organism holds dynamic imprints of prior experience, such as perceived sensations, emotional reactions and ideological training. Clearly these serve a useful purpose when they facilitate useful training, but become a problem when they strongly bias a person to repeat experience remembered by them as pleasurable and restrictively to avoid pain or threat. Such restriction can easily conflict with personal creativity and become a factor in the development of disease. Summarizing his hierarchy so far, Hahnemann has referred to the role in tumour development of three modalities that today could be termed physical, emotional and ideological. But his hierarchy of factors contributing to chronic disease such as cancer does not stop here. He Volume 73, Number 4, October 1984
189
also refers to even more subtle vectors when he writes of spiritual essences and the higher mind. 6 He appears to imply that the higher mind is an understanding that extends beyond the individual empirical training and intellect to include an awareness that might be described as cosmic.7, 8 Many philsophers and other thinkers have referred to an inherent intelligence and ultimate order in the universe. Various religious, philosophical or psychological terms have been pursued for this, examples are the Christian Logos, the Buddhist field of formal-voidity, the Platonic realm of ideas, and the Jungian collective unconscious. They all imply an immediate, innate consciousness within creative power of its own processes. Hahnemann appears to refer to such an awareness and the possibility of it informing the individual thinker when he writes of the higher mind or the reason-gifted consciousness. It implies an understanding reaching far beyond the limits of ordinary egoic training. He then appears to develop and apply this awareness in relation to chronic disease when he implies that a personal disregard of its information accompanies empirical bias and contributes to interpersonal conflict. Closely associated with such concepts are references to spiritual or initiatory essences.7, 8 Hahnemann's writings imply his progressive understanding of an informed initiation, a term also translated as a spiritual essence, that is, the prime mover of any creative process. It could be called an ultimate cause, answerable only to itself. Logical deduction implies that such an initiation would be a primary cause of an act, the free will referred to in various ways by philosophers, psychologists, religious thinkers or similar researchers in all ages. In other words, Hahnemann appears to be saying, like many other thinkers have done, that the primary cause appears qualitatively in its effect. Hahnemann's use of the term "initiatory essence" implies this. It denotes a quality essential to the form and not an imposed directive. One way of illustrating such concepts is to liken the initiatory essence to the pattern in an acorn that determines its development, given appropriate resources, into an oak tree. The term "conceptual essence" is a very interesting one, implying the dual aspects of the will to act in this way and the form expressing it. Hahnemann argues that such a subtle form is the prime mover of any extant structure and deduces that just as such influences can sustain health, their imbalance c a n contribute to disease. Such initiatory derangements, he argues, need a similar form of corrective. That is, an initiatory imbalance needs a change of initiative for its correction. In relation to these concepts he argues that potentization gradually releases such intiatory forms and presents them in a manner that can facilitate an appropriate re-orientation in a disturbed energy field. Here then are two more aspects, which, added to the three of thought, feeling and drive previously described, make a five-fold hierarchy. It begins with the will, or essential initiation, moves to a comprehensive understanding or higher mind, then refers to conditioned temporalized thought or opinion, after this to emotional conditioning and finally to diet, damp, drugs or other similarly gross physical factors..The activity of all these aspects, Hahnemann argues, is revealed in the gross physical form, a dynamic construct that reflects the whole series. All aspects, he says, are in continual interfunction and all therefore contribute all the time to health or disease. 190
The British Hornoeopathic Journal
In relation to chronic disease, including tumours, Hahnemann argues that such influences accrue during the lifetime of an individual, then interact with a latent trait. M a n y have interpreted his writings on psora as implying a hereditary trait that is vulnerable to reactivation by contemporary effects. Hahnemann relates the origins of psora to a chronic irritation developed in the dawn of civilization and o f which leprosy m a y be a long-standing sign, contemporary VD a more recent manifestation) But whatever its origins he argues that this trait is liable to reactivation by the other factors named as contributing to chronic disease. TM He is therefore describing a dual action of the latent trait and a stimulus that provokes its activation. It is a theory that bears close comparison with contemporary expressions of the combined effects of hereditary factors as well as personal psychology or exposure to carcinogens which in combination can produce a malignant disease. Although Hahnemann firmly argues that such a latent trait is the c o m m o n property o f mankind, he still emphasizes the individuality of diseases with which it is associated. The basic trait m a y be shared but the provoking factors are unique. Hence he says we need to remember that in each patient we are seeing not "cancer" but a "type of cancer". 11 It is a point taken up again by Clarke when he emphasizes that " h o m e o p a t h y is the art o f individualizing". Hahnemann's theories therefore imply a thoroughly dynamic understanding of tumour development. In all his writings H a h n e m a n n consistently deduced a theory first, then applied this in a rational therapy. The second paper in this series will discuss how these insights can be applied today in the treatment of malignant disease. REFERENCES 1 Greeve WA, Miller. Psychological factors and reticulo-endothelial disease. Psychosom Med 1958; 20:124-44. 2 Greeve WA, Swisher SN. Psychological and somatic variables associated with the development and course of monozygotic twins discordant for leukaemia. Ann N Y Acad Sci 1969; 164:394-408. 3 Hahnemann S. Organon. Pretace 2nd ed. 4 Ibid., Paragraph 77.6th ed. 5 Ibid., Paragraphs 81A, 93.6th ed. 6 Ibid., Introduction and paragraphs 62, 63.6th ed. Trans. Dudgeon. RPH 196t. 7 Ibid., Paragraphs 15-20 and 269, 270.6th ed. 8 Hahnemann S. Chronic Diseases. Prefaces to vol. IV and V. Delhi: Jain. 9 Ibid., p. 48. 10 Ibid., p. 10. 11 Hahnemann S. Organon. Paragraph 81.6th ed.
Volume 73, Number 4, October 1984
19 1