- Email: [email protected]
The patient's experience and the homœopathic drug picture
The patient's experience and the homoeopathic drug picture E. K. LEDERMANN,
M.D., F.F.HOM.
Homoeopathic medicine depends for its survival on being related to medical thought in general. Each generation of homceopathic physicians is under an obligation to bring the principles of Homceopathy into line with the principles of medicine as conceived at the particular time. The present paper is intended to serve the cause of integration by demonstrating the relationship between Hahnemann's approach and the approach of a certain school of psychiatry. Before this psychiatric view is explained, the prevalent view in medical science will be discussed. THE OBJECTIVE APPROACH
Tile traditional approach of medical science is objective in two respects. First it treats the patient as an object and secondly it develops an objective body of knowledge. Homoeopathy shares in both forms of scientific objectivity. First the patient is examined and diagnosed objectively as is customary in medicine and secondly is assessed objectively from the homceopathic point of view in terms of the homoeopathic drug picture. The science of Homceopathy is embodied in the materia medica and in the relationship between the phenomena seen in the patients and in the drug pictures. This second form of objectivity is related to pharmacology and toxicology as taught in the medical schools but differs fundamentally from these disciplines because it does not consider quantity as a vital factor in the effectiveness of its remedies. The qualitative element remains the common feature of classical and homceopathie pharmacology. The objectifying concepts which guide the homceopathic prescriber are the stimulus of the drug and, as the corresponding concept, the patient's sensitivity to the medicinal stimulus. 1 THE SUBJECTIVE APPROACH A homceopathie prescription promotes the patient's recovery by taking into account his subjectivity, his personal world of experience. Subjectivity is manifest by the emphasis on modalities, the patient's reactions to temperature, to climate and to different positions of the body. There is the stress laid on the mental characteristics such as fear, irritability, cravings for sympathy, desires for certain foods or dislikes of others and the importance attached to delusional states: e.g. as if body and mind were separated, as ff some parts of the b o d y were abnormally long, short, or brittle, etc. Although physicians in general are not taught to investigate the subjective world of the patient, certain psychiatrists have for some time paid attention to this world.
76
THE
BRITISH
HOM(EOPATHIC
JOURNAL
In his book General Psychopathology2 Karl Jaspers devotes one chapter to a discussion of the subjective experience of the patient, to a description of the phenomena which comprise the patient's inner world. He speaks of the serf which becomes aware of objects and in particular of the way in which it relates these to space, time, the body and to reality. Through establishing such connexions, man's mind orientates itself. Jaspers follows his description of the nature of these phenomena by an account of certain abnormalities of consciousness, of sensations which are distorted with regard to intensity of vision, hearing and smell. He quotes several examples: a schizophrenic patient who experienced the rays of the sun as losing their intensity, hysterical people who are insensitive to pain and depressed patients who complain that everything tastes insipid. The homceopathic prescriber pays attention to all the phenomena mentioned in Jaspers' book. The interesting fact is that he often discovers the abnormal phenomena in people who are not suffering from a mental illness, but who are physically ill. They are helped in their illness by the homceopathic remedy chosen on the grounds of these abnormal states of mind. With regard to distortion of space, Berberis, Camphora, Drosera, Kreosote, Nitric acid and Sulphur are listed in Kent's Repertory under "things seem longer", while Glonoine is mentioned as an example of a spatial, abnormal experience affecting the patient's body ("chin seems too long"), time experience is disturbed in the drug pictures which are characterized by the feeling that time passes too slowly, the main remedies being Alumina, Argentum nitricum, Cannabis indica, Cannabis sativa, Cencheris contortrix (copperhead snake), Glonoine, Medorrhinum, Mercurius, Nux moschata and Nux vomica, while the feeling that time passes too quickly is found in the remedies Cocculus and Theridion. The homceopathic materia medica contains many references to distorted body images, e.g. "divided into two parts": Baptisia, Thuja; left side of body smaller: Cinnamomum; scrotum feels swollen: Sabadilla. A misconception of reality resulting in delusions is a feature of the drugs which poison the brain: Hyoscyamus, Lachesis, Belladonna, Stramonium are amongst them. The Repertory gives also examples of specific hallucinations: Belladonna and Opium patients may see faces, Belladonna and Calcarea carbonica patients may imagine figures to be present. These examples demonstrate the importance of abnormal states of consciousness in homceopathic medicine. Jaspers went beyond the mere static approach and introduced a phenomenological dynamic conception into psychiatry. He followed the philosophers Dflthey and Husserl who had replaced conceptual explanation of mental life by intuitive understanding. Dilthey formulated the difference between the two approaches as follows: "We explain by means of purely intellectual processes, but we understand by means of co-operation of all the powers of the mind in apprehension. And in understanding we start from the system as a whole, which is given to us as a living reality, to make the particular intelligible to ourselves in terms of it. ''a According to Dilthey, "the experienced system of mental life must remain the foundation of psychology, safely grounded on immediate lived experience". 4 Following Jaspers, the psychiatrist must intuitively enter into the whole structure of his patient's subjective work and must create in his own imagination the phenomena which the patient has created in his world of phantasy. I t is possible to grasp the origin of another person's emotions. Jaspers calls this mode of understanding which takes the genesis of mental life into account,
"genetic".
PATIENT
AND
HOM(EOPATHIC
DRUG
PICTURE
77
Psychiatrists, following this intuitive approach, have described the worlds of the schizophrenic, the manic, the depressed, the obsessional. 5 The homceopathic physician must develop his intuitive power in order to grasp the wholeness of the patient in relation to the drug pictures. He is helpe d b y authors who have described "genetically", in terms of homoeopathic understanding psychology, how different types of people experience the world. K e n t was a master in the art of apprehending the salient features of the drug picture in a dynamic way. Take his account of Sepia for instance: 6 the tragedy of unfulfilled love leading to excitability, to suicidal depression, to indifference and to spitefulness. We see the picture of a woman who has been disappointed and who has lost the ability to feel for her family and for others; at the same time she cannot feel for herself. K e n t observes rightly: " I t will be seen t h a t the love itself cannot be so changed, but the affections can be as they are the expression of love. ''r I n the Silica picture we re-live the strain and the exhaustion which follows prolonged effort, made more strenuous b y the fear of failure. K e n t quotes a typical case: "A young man who has studied for years and is now nearing the end of his course. He dreads the final examinations but he goes through them all right, then a fatigue comes upon him and for years he is unable to enter his profession. He has this dread of undertaking anything."s He who experiences life as frightening is liable to develop psychosomatic symptoms. The Phosphorus patient is in this predicament. He is sensitive to all impressions, noise, touch and odours. He thus becomes subject to headaches which are made worse b y a warm room, suffers from digestive upsets which are ameliorated temporarily by cold drinks, from palpitations which are aggravated b y motion, and from restless sleep--being kept awake b y anxious thoughts. Sepia, Silica and Phosphorus can help m a n y people who suffer from psychosomatic illnesses. The psychosomatic condition is not merely functional, but organic lesions result from psychic disturbances. There is a vicious circle, for instance in those whose coronary arteries go into spasm because of some emotional strain, who are terrified of the anginal pain, and who therefore develop further attacks. Cactus grandifloris helps the "functional" as well as the "organic" case, it relieves the fear and the spasm and can thus, if given in time, prevent heart muscle damage. The angina pectoris patient's experience is not only on the level of consciousness, his fear of death enters into the unconscious; it accompanies him in his daily activities. The homceopathic prescriber can relieve this anxiety b y such remedies as Aconite or Arsenic. The depth of the unconscious cannot be fathomed. No physician can measure the full force of disappointments and frustrations. Staphysagria m a y help such a sufferer and m a y prevent manifestations of ill-health. Menorrhagia, not caused b y organic uterine disease or b y endocrine disturbance, is an example of a disturbance which affects the inner core of a woman's being. Depth psychology can often reveal the serf-destructive nature of such excessive bleeding which is an expression of a woman's disappointment. The homceopathic remedy which I have found helpful in such cases is Ustilago maidis, given in tincture form or in low potencies. Pruritus ani and pruritus vulvae are indications of sexual unconscious conflicts in m a n y cases. Caladium seguinum in low potency helps some of these patients, Natrum muriaticum in high potency benefits others.
78 SYMBOLIC
THE
BRITISH
HOM(EOPATHIC
JOURNAL
EXPERIENCE
Scratching does not just relieve irritation, it also provides pleasure and pain. The pain can be punishment for pleasure which the mind experiences as forbidden pleasure. Scratching can be symbolic of self-destruction and can, in fact, be disfiguring and thus socially harmful. Such acts directed against the serf can be explained b y reference to the body-image which every human being carries in the unconscious mind. Paul Schilder has examined this symbolic activity from a psychiatric point of view. 9 According to this author, "we build the picture of our body again and again . . . . these are forces of hatred scattering the picture of our own body and forces of love putting it together. ''1~ Schilder has pointed out t h a t the body-image is influenced b y the opinion which is conveyed to a person from his surroundings and represents the standards accepted by him. One of m y women patients, for instance, could think of her body only as light; the explanation was t h a t heaviness meant to her sexuality which she had denied herself. The symbolism sexuality indicating heaviness was valid only for this particular patient. There are, however, some associations which are universally recognized as meaningful. Openness, narrowness, width, and other similar physical qualities stand for certain attitudes of mind. The homceopathic prescriber can make use of this symbolism for such bodily experience, as the following four cases illustrate: Case 1 Mrs. K.L., aged 34. Diagnosis: ulcerative colitis. The condition had been present for ten years and had responded to cortisone treatment and psychotherapy, carried out b y other practitioners, only temporarily. There were m a n y psychological features in this case. One of them was hurry. The patient felt always in a hurry, her food hurried along in the digestive tract and diarrhoea was the result. Thus the disturbed function of her bowel reflected her restless attitude to life. Kent's Repertory lists a number of remedies which are characterized b y hurry in general, hurry in various occupations and in mental work. Tarentula is one of these remedies and helped this patient. Case 2 Mrs. O.I., aged 47. This patient suffered from a duodenal ulcer in 1961. The ulcer healed, but a state of intense tension causing abdominal pain and nausea followed. The tension was so severe t h a t she could not settle down and follow her m a n y interests. The tension was thus a general feature which manifested itself in her attitude and in her digestive organs. From the homceopathie point of view, the bowel nosode Dysentery co. covered both aspects and she improved after a few doses of the 12th potency. Case 3 Miss F.R., aged 60. Main complaint: weariness. Her limbs felt heavy, and t h a t heaviness was symbolic of life as it appeared to her. Sepia lifted her out of her state of depression (of being pressed down). Case 4 Miss F.P., aged 35. Anxiety symptoms which had been present for several years, not relieved b y psychotherapy which she had received from another psychiatrist. She felt "hemmed in" as a person and could not stand restricting clothes around her neck. She felt relieved when passing stool or when her menstrual flow was established. These excretory functions helped her temporarily as they symbolized a freedom of expression. Unconsciously she wanted to throw off her restricting anxious outlook on life. She was given Lachesis which gave relief.
PATIENT THE EXISTENTIAL
AND HOMG~OPATHIC
DRUG PICTURE
79
ATTITUDE
The bodily complaints of these patients reflected their faulty attitude to life. Their recovery thus depended on their ability to change their attitude, a task for the self which becomes aware of such need and which has the freedom to change. The self experiences a life spent in illness as a wasted life. These four patients came to recognize their attitudes as futile, they accepted the challenge felt by their selves and they found the strength to adopt a different outlook, The patient whose restlessness had caused the symptoms of ulcerative colitis recognized the fact t h a t she had escaped into illness because she had been afraid to be an adult person, a wife and a mother, the woman who had been so tense t h a t she had become an invalid through spasms inside her abdomen became aware of her task to come to terms with an unsatisfactory marriage. The third patient had to face a lonely old age and the fourth had to understand her feeling of restriction as an outlook on marriage which her mother, who had been made unhappy b y an alcoholic husband, had conveyed to her. After having been confronted with their particular situations, these people found the strength to cope with their situations through adopting a new attitude. The four patients did not only receive the appropriate homeeopathic medicine; they also had existential psychotherapy which means t h a t they were encouraged to find a new existence. "To exist is to take leave of what one is (ex) in order to establish oneself (sistere) on the level of that which formerly was only possible."11 THE ISSUE OF EXISTENCE The physician who understands his patients' ethical struggle for a new existence understands contemporary man's most vital issue. We have to find a new orientation, which involves defining the rightful place of science within our lives. Medical science is the subject in which doctors are trained. They learn to look upon their patients as bearers of disease, and disease becomes defined as certain processes which are interpreted as part of nature. Treatment is directed against disease. Homceopathie treatment is given in the form of remedies which correspond to the patient's whole personality. The spiritual struggle of man, the struggle for meaning in life, is of supreme importance for the personality. Many of the homceopathic drug pictures are characterized by feelings of anxiety and tension which result from being anxious. The examples chosen in this paper illustrate the significance of anxiety as an important element of a patient's experience. Existential philosophers, Sartre, Heidegger and others, have described the anxiety which man must face when confronted with the need to choose, when trying to find values and faith. Existential psychiatrists have applied the insight gained from the writings of existential philosophers in the treatment of the neurotic and psychotic patient. Homceopathic physicians who have been trained to consider the whole patient must join the ranks of existential therapists. I n t h a t way they can prove t h a t they are alive to man's greatest needs.
REFERENCES 1 Ledermann, E. K., "Fundamentals of Medicine, A critical review of O. Leeser's conception". Br~L Hor~. J., 55, 76. April 1966. Jaspers, Karl, General Psychopathology, Engl. transl. Manchester University Press 1963.
80
THE
BRITISH
HOM(EOPATHIC
JOURNAL
a Dilthey, Wilhelm, Ideas concerning a Descriptive and Analytical Psychology, G. S. Teubner~ Leipzig and Berlin 1924, V. p. 172. English transl, in H. A. Hodges, Wilhelm Dilthsy, Kegan Paul, Trench, Trubner & Co., Ltd., London 1944, p. 136. Ibid.
a Some of these descriptions can be found in Existence, A New Dimension in Psychiatry and Psychology. Ed. Rollo May, Ernest Angel and Henri F. Ellenberger, Basic Books Inc., New York 1958. a Kent, Lectures on Homveopathic Materia Medica, fourth edition, p. 880-890. Boericke & Tafel, Philadelphia 1932. 7 Ibld., p. 881. s Ibid., p. 891. a Schilder, Paul, The Image and Appearance of the H u m a n Body, Kegan Paul, Trench, Trubner & Co. 1935. lo Ibid., p. 166. 11 Foulqul6, Paul, Existentialism, p. 49. Dennis Dobson Ltd., London 1948.
My introduction to Homoeopathy DR. G. CHARETTE,
Nantes
L a d i e s a n d Gentlemen, F i r s t o f all I h a v e a confession to m a k e , v e r y a n n o y i n g for me. B u t i t will n o t surprise those who k n o w m e well, as for instance, m y friend Dr. N a v e a u , who h a s seen m e l e a v e b e h i n d in m y p a t i e n t s ' houses so m a n y w a l k i n g sticks, gloves a n d umbrellas, t h a t he has labelled m e A ~ a c a r d i u m . This is m y excuse t h a t I h a v e forgotten t h e well d o c u m e n t e d p a p e r I m e a n t t o r e a d t o y o u t o d a y . B u t d o n ' t c o n g r a t u l a t e yourselves too soon. Y o u w o n ' t g e t off so easily as all t h a t . W h e n I h o l d t h e p l a t f o r m , I defend i t a g a i n s t all comers! Dr. Pag6s, professor a t t h e F a c u l t y o f Montpellier, should h a v e t o l d us t o d a y how he was b r o u g h t t o H o m c e o p a t h y . I f y o u h a d h e a r d him, y o u would h a v e l e a r n t h o w a n e m i n e n t professor was c o n v e r t e d to our teaching. B u t in his absence, I a m going t o r e c o u n t how one o f t h e m o s t m o d e s t s t u d e n t s o f t h a t F a c u ] t y , myself, has followed in his footsteps. Besides, i t is a quite edifying a n d m o r a l little story, where you will recognize in m y person, v i r t u e r e w a r d e d - - a n d in t h e process I shall h a v e t h e o p p o r t u n i t y o f bringing before y o u t h e personalities o f t h e h o m c e o p a t h s who h a v e i n s t r u c t e d m e in t h e m e t h o d s o f t t a h n e m a n n , a n d t o w a r d s w h o m I can n e v e r be t o o grateful. I t will be a n o p p o r t u n i t y to t h a n k t h e m in public, a n d t h a t will be v e r y p l e a s a n t for me. I h a d t h e honour, a t t h e beginning, to be a c o u n t r y doctor. I s a y i t w i t h o u t A paper read at the International Congress of Homo~opathy, Paris 1932. Translated by Frank Bodman.
M.D., F.F.HOM.
Homoeopathic medicine depends for its survival on being related to medical thought in general. Each generation of homceopathic physicians is under an obligation to bring the principles of Homceopathy into line with the principles of medicine as conceived at the particular time. The present paper is intended to serve the cause of integration by demonstrating the relationship between Hahnemann's approach and the approach of a certain school of psychiatry. Before this psychiatric view is explained, the prevalent view in medical science will be discussed. THE OBJECTIVE APPROACH
Tile traditional approach of medical science is objective in two respects. First it treats the patient as an object and secondly it develops an objective body of knowledge. Homoeopathy shares in both forms of scientific objectivity. First the patient is examined and diagnosed objectively as is customary in medicine and secondly is assessed objectively from the homceopathic point of view in terms of the homoeopathic drug picture. The science of Homceopathy is embodied in the materia medica and in the relationship between the phenomena seen in the patients and in the drug pictures. This second form of objectivity is related to pharmacology and toxicology as taught in the medical schools but differs fundamentally from these disciplines because it does not consider quantity as a vital factor in the effectiveness of its remedies. The qualitative element remains the common feature of classical and homceopathie pharmacology. The objectifying concepts which guide the homceopathic prescriber are the stimulus of the drug and, as the corresponding concept, the patient's sensitivity to the medicinal stimulus. 1 THE SUBJECTIVE APPROACH A homceopathie prescription promotes the patient's recovery by taking into account his subjectivity, his personal world of experience. Subjectivity is manifest by the emphasis on modalities, the patient's reactions to temperature, to climate and to different positions of the body. There is the stress laid on the mental characteristics such as fear, irritability, cravings for sympathy, desires for certain foods or dislikes of others and the importance attached to delusional states: e.g. as if body and mind were separated, as ff some parts of the b o d y were abnormally long, short, or brittle, etc. Although physicians in general are not taught to investigate the subjective world of the patient, certain psychiatrists have for some time paid attention to this world.
76
THE
BRITISH
HOM(EOPATHIC
JOURNAL
In his book General Psychopathology2 Karl Jaspers devotes one chapter to a discussion of the subjective experience of the patient, to a description of the phenomena which comprise the patient's inner world. He speaks of the serf which becomes aware of objects and in particular of the way in which it relates these to space, time, the body and to reality. Through establishing such connexions, man's mind orientates itself. Jaspers follows his description of the nature of these phenomena by an account of certain abnormalities of consciousness, of sensations which are distorted with regard to intensity of vision, hearing and smell. He quotes several examples: a schizophrenic patient who experienced the rays of the sun as losing their intensity, hysterical people who are insensitive to pain and depressed patients who complain that everything tastes insipid. The homceopathic prescriber pays attention to all the phenomena mentioned in Jaspers' book. The interesting fact is that he often discovers the abnormal phenomena in people who are not suffering from a mental illness, but who are physically ill. They are helped in their illness by the homceopathic remedy chosen on the grounds of these abnormal states of mind. With regard to distortion of space, Berberis, Camphora, Drosera, Kreosote, Nitric acid and Sulphur are listed in Kent's Repertory under "things seem longer", while Glonoine is mentioned as an example of a spatial, abnormal experience affecting the patient's body ("chin seems too long"), time experience is disturbed in the drug pictures which are characterized by the feeling that time passes too slowly, the main remedies being Alumina, Argentum nitricum, Cannabis indica, Cannabis sativa, Cencheris contortrix (copperhead snake), Glonoine, Medorrhinum, Mercurius, Nux moschata and Nux vomica, while the feeling that time passes too quickly is found in the remedies Cocculus and Theridion. The homceopathic materia medica contains many references to distorted body images, e.g. "divided into two parts": Baptisia, Thuja; left side of body smaller: Cinnamomum; scrotum feels swollen: Sabadilla. A misconception of reality resulting in delusions is a feature of the drugs which poison the brain: Hyoscyamus, Lachesis, Belladonna, Stramonium are amongst them. The Repertory gives also examples of specific hallucinations: Belladonna and Opium patients may see faces, Belladonna and Calcarea carbonica patients may imagine figures to be present. These examples demonstrate the importance of abnormal states of consciousness in homceopathic medicine. Jaspers went beyond the mere static approach and introduced a phenomenological dynamic conception into psychiatry. He followed the philosophers Dflthey and Husserl who had replaced conceptual explanation of mental life by intuitive understanding. Dilthey formulated the difference between the two approaches as follows: "We explain by means of purely intellectual processes, but we understand by means of co-operation of all the powers of the mind in apprehension. And in understanding we start from the system as a whole, which is given to us as a living reality, to make the particular intelligible to ourselves in terms of it. ''a According to Dilthey, "the experienced system of mental life must remain the foundation of psychology, safely grounded on immediate lived experience". 4 Following Jaspers, the psychiatrist must intuitively enter into the whole structure of his patient's subjective work and must create in his own imagination the phenomena which the patient has created in his world of phantasy. I t is possible to grasp the origin of another person's emotions. Jaspers calls this mode of understanding which takes the genesis of mental life into account,
"genetic".
PATIENT
AND
HOM(EOPATHIC
DRUG
PICTURE
77
Psychiatrists, following this intuitive approach, have described the worlds of the schizophrenic, the manic, the depressed, the obsessional. 5 The homceopathic physician must develop his intuitive power in order to grasp the wholeness of the patient in relation to the drug pictures. He is helpe d b y authors who have described "genetically", in terms of homoeopathic understanding psychology, how different types of people experience the world. K e n t was a master in the art of apprehending the salient features of the drug picture in a dynamic way. Take his account of Sepia for instance: 6 the tragedy of unfulfilled love leading to excitability, to suicidal depression, to indifference and to spitefulness. We see the picture of a woman who has been disappointed and who has lost the ability to feel for her family and for others; at the same time she cannot feel for herself. K e n t observes rightly: " I t will be seen t h a t the love itself cannot be so changed, but the affections can be as they are the expression of love. ''r I n the Silica picture we re-live the strain and the exhaustion which follows prolonged effort, made more strenuous b y the fear of failure. K e n t quotes a typical case: "A young man who has studied for years and is now nearing the end of his course. He dreads the final examinations but he goes through them all right, then a fatigue comes upon him and for years he is unable to enter his profession. He has this dread of undertaking anything."s He who experiences life as frightening is liable to develop psychosomatic symptoms. The Phosphorus patient is in this predicament. He is sensitive to all impressions, noise, touch and odours. He thus becomes subject to headaches which are made worse b y a warm room, suffers from digestive upsets which are ameliorated temporarily by cold drinks, from palpitations which are aggravated b y motion, and from restless sleep--being kept awake b y anxious thoughts. Sepia, Silica and Phosphorus can help m a n y people who suffer from psychosomatic illnesses. The psychosomatic condition is not merely functional, but organic lesions result from psychic disturbances. There is a vicious circle, for instance in those whose coronary arteries go into spasm because of some emotional strain, who are terrified of the anginal pain, and who therefore develop further attacks. Cactus grandifloris helps the "functional" as well as the "organic" case, it relieves the fear and the spasm and can thus, if given in time, prevent heart muscle damage. The angina pectoris patient's experience is not only on the level of consciousness, his fear of death enters into the unconscious; it accompanies him in his daily activities. The homceopathic prescriber can relieve this anxiety b y such remedies as Aconite or Arsenic. The depth of the unconscious cannot be fathomed. No physician can measure the full force of disappointments and frustrations. Staphysagria m a y help such a sufferer and m a y prevent manifestations of ill-health. Menorrhagia, not caused b y organic uterine disease or b y endocrine disturbance, is an example of a disturbance which affects the inner core of a woman's being. Depth psychology can often reveal the serf-destructive nature of such excessive bleeding which is an expression of a woman's disappointment. The homceopathic remedy which I have found helpful in such cases is Ustilago maidis, given in tincture form or in low potencies. Pruritus ani and pruritus vulvae are indications of sexual unconscious conflicts in m a n y cases. Caladium seguinum in low potency helps some of these patients, Natrum muriaticum in high potency benefits others.
78 SYMBOLIC
THE
BRITISH
HOM(EOPATHIC
JOURNAL
EXPERIENCE
Scratching does not just relieve irritation, it also provides pleasure and pain. The pain can be punishment for pleasure which the mind experiences as forbidden pleasure. Scratching can be symbolic of self-destruction and can, in fact, be disfiguring and thus socially harmful. Such acts directed against the serf can be explained b y reference to the body-image which every human being carries in the unconscious mind. Paul Schilder has examined this symbolic activity from a psychiatric point of view. 9 According to this author, "we build the picture of our body again and again . . . . these are forces of hatred scattering the picture of our own body and forces of love putting it together. ''1~ Schilder has pointed out t h a t the body-image is influenced b y the opinion which is conveyed to a person from his surroundings and represents the standards accepted by him. One of m y women patients, for instance, could think of her body only as light; the explanation was t h a t heaviness meant to her sexuality which she had denied herself. The symbolism sexuality indicating heaviness was valid only for this particular patient. There are, however, some associations which are universally recognized as meaningful. Openness, narrowness, width, and other similar physical qualities stand for certain attitudes of mind. The homceopathic prescriber can make use of this symbolism for such bodily experience, as the following four cases illustrate: Case 1 Mrs. K.L., aged 34. Diagnosis: ulcerative colitis. The condition had been present for ten years and had responded to cortisone treatment and psychotherapy, carried out b y other practitioners, only temporarily. There were m a n y psychological features in this case. One of them was hurry. The patient felt always in a hurry, her food hurried along in the digestive tract and diarrhoea was the result. Thus the disturbed function of her bowel reflected her restless attitude to life. Kent's Repertory lists a number of remedies which are characterized b y hurry in general, hurry in various occupations and in mental work. Tarentula is one of these remedies and helped this patient. Case 2 Mrs. O.I., aged 47. This patient suffered from a duodenal ulcer in 1961. The ulcer healed, but a state of intense tension causing abdominal pain and nausea followed. The tension was so severe t h a t she could not settle down and follow her m a n y interests. The tension was thus a general feature which manifested itself in her attitude and in her digestive organs. From the homceopathie point of view, the bowel nosode Dysentery co. covered both aspects and she improved after a few doses of the 12th potency. Case 3 Miss F.R., aged 60. Main complaint: weariness. Her limbs felt heavy, and t h a t heaviness was symbolic of life as it appeared to her. Sepia lifted her out of her state of depression (of being pressed down). Case 4 Miss F.P., aged 35. Anxiety symptoms which had been present for several years, not relieved b y psychotherapy which she had received from another psychiatrist. She felt "hemmed in" as a person and could not stand restricting clothes around her neck. She felt relieved when passing stool or when her menstrual flow was established. These excretory functions helped her temporarily as they symbolized a freedom of expression. Unconsciously she wanted to throw off her restricting anxious outlook on life. She was given Lachesis which gave relief.
PATIENT THE EXISTENTIAL
AND HOMG~OPATHIC
DRUG PICTURE
79
ATTITUDE
The bodily complaints of these patients reflected their faulty attitude to life. Their recovery thus depended on their ability to change their attitude, a task for the self which becomes aware of such need and which has the freedom to change. The self experiences a life spent in illness as a wasted life. These four patients came to recognize their attitudes as futile, they accepted the challenge felt by their selves and they found the strength to adopt a different outlook, The patient whose restlessness had caused the symptoms of ulcerative colitis recognized the fact t h a t she had escaped into illness because she had been afraid to be an adult person, a wife and a mother, the woman who had been so tense t h a t she had become an invalid through spasms inside her abdomen became aware of her task to come to terms with an unsatisfactory marriage. The third patient had to face a lonely old age and the fourth had to understand her feeling of restriction as an outlook on marriage which her mother, who had been made unhappy b y an alcoholic husband, had conveyed to her. After having been confronted with their particular situations, these people found the strength to cope with their situations through adopting a new attitude. The four patients did not only receive the appropriate homeeopathic medicine; they also had existential psychotherapy which means t h a t they were encouraged to find a new existence. "To exist is to take leave of what one is (ex) in order to establish oneself (sistere) on the level of that which formerly was only possible."11 THE ISSUE OF EXISTENCE The physician who understands his patients' ethical struggle for a new existence understands contemporary man's most vital issue. We have to find a new orientation, which involves defining the rightful place of science within our lives. Medical science is the subject in which doctors are trained. They learn to look upon their patients as bearers of disease, and disease becomes defined as certain processes which are interpreted as part of nature. Treatment is directed against disease. Homceopathie treatment is given in the form of remedies which correspond to the patient's whole personality. The spiritual struggle of man, the struggle for meaning in life, is of supreme importance for the personality. Many of the homceopathic drug pictures are characterized by feelings of anxiety and tension which result from being anxious. The examples chosen in this paper illustrate the significance of anxiety as an important element of a patient's experience. Existential philosophers, Sartre, Heidegger and others, have described the anxiety which man must face when confronted with the need to choose, when trying to find values and faith. Existential psychiatrists have applied the insight gained from the writings of existential philosophers in the treatment of the neurotic and psychotic patient. Homceopathic physicians who have been trained to consider the whole patient must join the ranks of existential therapists. I n t h a t way they can prove t h a t they are alive to man's greatest needs.
REFERENCES 1 Ledermann, E. K., "Fundamentals of Medicine, A critical review of O. Leeser's conception". Br~L Hor~. J., 55, 76. April 1966. Jaspers, Karl, General Psychopathology, Engl. transl. Manchester University Press 1963.
80
THE
BRITISH
HOM(EOPATHIC
JOURNAL
a Dilthey, Wilhelm, Ideas concerning a Descriptive and Analytical Psychology, G. S. Teubner~ Leipzig and Berlin 1924, V. p. 172. English transl, in H. A. Hodges, Wilhelm Dilthsy, Kegan Paul, Trench, Trubner & Co., Ltd., London 1944, p. 136. Ibid.
a Some of these descriptions can be found in Existence, A New Dimension in Psychiatry and Psychology. Ed. Rollo May, Ernest Angel and Henri F. Ellenberger, Basic Books Inc., New York 1958. a Kent, Lectures on Homveopathic Materia Medica, fourth edition, p. 880-890. Boericke & Tafel, Philadelphia 1932. 7 Ibld., p. 881. s Ibid., p. 891. a Schilder, Paul, The Image and Appearance of the H u m a n Body, Kegan Paul, Trench, Trubner & Co. 1935. lo Ibid., p. 166. 11 Foulqul6, Paul, Existentialism, p. 49. Dennis Dobson Ltd., London 1948.
My introduction to Homoeopathy DR. G. CHARETTE,
Nantes
L a d i e s a n d Gentlemen, F i r s t o f all I h a v e a confession to m a k e , v e r y a n n o y i n g for me. B u t i t will n o t surprise those who k n o w m e well, as for instance, m y friend Dr. N a v e a u , who h a s seen m e l e a v e b e h i n d in m y p a t i e n t s ' houses so m a n y w a l k i n g sticks, gloves a n d umbrellas, t h a t he has labelled m e A ~ a c a r d i u m . This is m y excuse t h a t I h a v e forgotten t h e well d o c u m e n t e d p a p e r I m e a n t t o r e a d t o y o u t o d a y . B u t d o n ' t c o n g r a t u l a t e yourselves too soon. Y o u w o n ' t g e t off so easily as all t h a t . W h e n I h o l d t h e p l a t f o r m , I defend i t a g a i n s t all comers! Dr. Pag6s, professor a t t h e F a c u l t y o f Montpellier, should h a v e t o l d us t o d a y how he was b r o u g h t t o H o m c e o p a t h y . I f y o u h a d h e a r d him, y o u would h a v e l e a r n t h o w a n e m i n e n t professor was c o n v e r t e d to our teaching. B u t in his absence, I a m going t o r e c o u n t how one o f t h e m o s t m o d e s t s t u d e n t s o f t h a t F a c u ] t y , myself, has followed in his footsteps. Besides, i t is a quite edifying a n d m o r a l little story, where you will recognize in m y person, v i r t u e r e w a r d e d - - a n d in t h e process I shall h a v e t h e o p p o r t u n i t y o f bringing before y o u t h e personalities o f t h e h o m c e o p a t h s who h a v e i n s t r u c t e d m e in t h e m e t h o d s o f t t a h n e m a n n , a n d t o w a r d s w h o m I can n e v e r be t o o grateful. I t will be a n o p p o r t u n i t y to t h a n k t h e m in public, a n d t h a t will be v e r y p l e a s a n t for me. I h a d t h e honour, a t t h e beginning, to be a c o u n t r y doctor. I s a y i t w i t h o u t A paper read at the International Congress of Homo~opathy, Paris 1932. Translated by Frank Bodman.