BHA

Patient-centred healthcare

Making sense of health and illness part 3

by Bob Leckridge MBChB FFHom

The homeopathic approach, the whole understanding of health, of illness and of human beings which has developed from Hahnemann’s first principles into our present day level of understanding, has great potential to teach us how to stay healthy and how best to deal with illness. This series considers some of the basic principles of homeopathy, focusing on making sense of health and of illness. These insights will enable the reader to take practical steps to be more able to experience better health, to understand that our solutions are in our own hands. We can actively enhance our self-healing.

This pull-out and keep series includes:

Causes and courses of disease
Samuel Hahnemann, who devised homeopathy, wrote down his main ideas in a book known as the Organon. It isn’t a very easy book to understand and I wouldn’t recommend it to the casual reader, but it is full of remarkable insights into health and disease.

It was written at a time when there was a very lively struggle between “vitalists” and “materialists”. The “materialists”, spurred on by the discoveries from human dissection and the developments of instruments like microscopes, believed that all disease was material in nature. Initially they said disease was what was seen in organs and tissues at dissection and later refined that to say it was due to malfunctions in cells. This way of thinking is still dominant today although it has developed much greater complexity in the light of modern scientific discoveries.

Hahnemann adhered to the other school of thought – the “vitalists”. These people maintained that human beings were more than their material parts. They maintained that non-material elements like the soul, or spirit, or “spirit-like” forces also existed and were, in fact, more important than the material parts of a human being. Hahnemann adopted the concept of “the vital force” from this school of thought. The hypothesis was that health was maintained by a “life principle” or “vital force” and that when diseases attacked or damaged this force, then it reacted to try to repair itself. The reactions were manifested as symptoms.

This is an interesting concept and although no such entity has ever been isolated the idea is still a useful and quite intuitive one. We often use the word “energy” today without really being very clear exactly what an “energy” is. However, we can all make a statement about our physical energy, our mental energy and our emotional energy at any particular moment. These “energies” are fundamentally the same concept as Hahnemann’s “vital force”. Similarly, we find it quite straightforward to comment on our overall “well-being” even though such a quality is hard to define and impossible to identify with medical instruments. However, what is the value of this vital force concept and how does it help us to understand sickness and health?

Causes of illness
Well, let’s begin by thinking about causation. When we become sick, after all, isn’t one of our first questions “why me?” It’s not a question which ever produces definitive answers but the homeopathic principles can make some suggestions as to possibilities.

In paragraph five of the Organon, Hahnemann says it is useful to identify the “exciting” or “fundamental” causes of the sickness. In other words, can we identify the probable causes? He goes on to clarify that such causes might be found in the physical, emotional, social or environmental dimensions of a person’s life. This is a very holistic way of understanding illness. It’s frequently useful, therefore, to ask a patient “when were you last completely well?” and then to ask what was happening in life prior to becoming unwell.

It amazes me how often a patient will then identify for the first time that their illness began the year a relative died, or the year they gave birth, or started a new job, or lost a job, or whatever. Until asked these questions people often have completely failed to notice that some major change occurred in their lives prior to the illness – a change that may well have impacted adversely on their health.

I have countless examples of this but let me mention two. One was a man with multiple sclerosis (MS) whose first symptoms appeared the day after he was involved in a multiple vehicle accident on a motorway in the wintertime. He said he had wondered if that accident had had anything to do with his MS but that a neurologist had told him there was no evidence that accidents could cause MS. So, just a coincidence then? Taking a homeopathic approach, instead of presuming that the accident wasn’t important we can assume that it was. This allowed the selection of a homeopathic remedy on the basis of “ailments from injury” which then produced an improvement in the patient’s health.

Another example – a young nurse with inflammatory bowel disease (Crohn’s disease) which began the day she started in her first ward as a student and the sister yelled at her from the other end of the ward reducing her to tears of humiliation. Could that be a cause? Or a coincidence? Taking the homeopathic approach I assumed it could be a cause and selected a remedy based on this experience of humiliation and her reaction to it. Staphysagria soon helped her to get better.

What’s the point of this? Well, the point is that anything which challenges us, anything which makes an impact on us, anything which forces us to adapt to changed circumstances, can have a negative impact on our health. In other words, instead of simply adapting, sometimes we fail to adapt completely and so we become damaged somehow. Once damage occurs we need to try to repair that damage, and even if we do manage a repair, we may be left with scars.

Before we go any further, let me clarify that I am not saying that any change is damaging. It is true that if we fail to adapt to changes then we might sustain damage somewhere. However, it is also through change and adaptation that we grow and develop. If we don’t stretch ourselves, if we don’t challenge ourselves, if we don’t push beyond our “comfort zones”, then we don’t grow, and like all other forms of life our options are only between growing and shrinking. We cannot stay the same. We either develop, or we degenerate. Scary thought? I suppose it is, because when things feel OK we tend to want them to stay that way forever. Change, however, is a fundamental quality of life. It’s the one thing that never goes away!

So let’s consider some origins. Here is another exercise you can do. Do you suffer from any chronic complaints? If so, then ask yourself, when did you last feel completely well? Then ask yourself what was happening in your life prior to this chronic problem commencing? You need to think back over the 12 months prior to the onset as modern research has revealed that major life events can have an impact on health up to 12 months later. In fact, some doctors have even produced a scoring system for life events. Moving house, death of a relative, marriage, divorce, starting a new job, losing a job all score 100 – the most powerful factors. The higher the life event score, the greater the chances of developing some kind of illness within 12 months.

As you do this exercise, remember that these are all exercises in understanding. We are not interested in judging or blaming. We are simply trying to understand ourselves better. If you don’t have any chronic illnesses, you will still be thinking back over the last year and listing your life events. Don’t let this be a cause for concern. Even if there have been a significant number of life events recently, this does not mean that you are bound to become ill soon. It does mean you are more at risk, so now is as good a time as any to pay attention to your health and do your best to maintain it.

Courses of disease
The observations of homeopathic doctors since Hahnemann have confirmed that diseases develop according to certain patterns. For instance, when we first become unwell, we become so in a very vague way. We “just don’t feel right”. Then we start to develop some general symptoms – maybe feeling a bit too hot or too cold, maybe developing a disturbance of our appetite or becoming thirsty. It’s only after this that we start to produce “symptoms” – such as a rash, a swelling, or a pain in part of our body. This can be understood as an example of how we first become unwell in our “vitality” (or “vital force”), then we produce symptoms as our healing system tries to rectify the problem.

However, doctors usually try to cure by suppressing symptoms or by removing damaged tissue. The homeopathic approach comes at the problem from the other direction – what can we do to enable the body to do what it does best? –that is to heal, or to cure. In fact, doctors don’t actually cure anything, they can only support the body while it goes about curing itself! Think about that for a minute. It means that you don’t have to go searching for a magic answer to your problems somewhere. Your body can, and will do its best to, heal itself. What you need are actions and interventions, which support these natural processes.

Dr Hering, another early homeopathic doctor, described how the body seems to demonstrate an “intelligence” in its healing. Here is what he described: the body always heals the most important part first, it heals problems inside the body before it heals problems on the surface, it heals from head to toe (not toe to head), and as the body heals it deals with the most recent symptoms first, then moves on to heal the older ones.

Understanding the healing process
How does this help us understand our healing processes? Well, first of all it means that the first stages of getting better might not involve much change on the surface. For example, if a person is suffering from asthma and eczema, it is likely that the asthma will be dealt with first, and only after that, the eczema. It also means that as the body heals the more recent problems, then there can be a temporary re-appearance of older problems, so, for example, sometimes a patient might get a reoccurrence of a skin problem, which hasn’t troubled them for a few years.

Knowing about these observations helps us to understand not only the processes by which we became ill, but also the processes by which we will recover. Most importantly, this teaches us that diseases are probably not localised, but that the outward appearances of disease may look localised. We don’t get better only in our joints, for example, but in our whole selves (of which our joints are only a part).

All health, and all illness, is holistic. Even if you are not a poetry fan, I recommend you read a poem by Roger McGough, called “Bits of me”. It’s a great, and very funny, illustration of this point.

Another remarkable principle of Hahnemann’s is that the environment is fundamentally important to health. In his book, he doesn’t only highlight potential causes of ill health from the environment but he describes something he called “obstacles to cure”. What he means by this is that if there are adverse circumstances in the environment then the body’s capacity to heal itself may be inhibited. It also means that unless these environmental influences are addressed and modified, then it will be very difficult for the patient to get better.

What kinds of potentially harmful factors can we discover in our environments? Mainly, Hahnemann identified excesses of any sort – dietary, physical, sexual, mental and so on. The concept of “stress” is a more modern one, but it is, in many ways, the same as Hahnemann’s concept of “exciting” or “fundamental” causes. Anything in the environment, which can make an impact on human beings, has the potential to be both an initial cause and a maintaining cause in an illness.

Monitoring your environment
You’ve probably done a couple of exercises from this series where you’ve used a notebook or journal. The first one was an exercise in self-observation, the second was one in observation of others. Now let’s do an exercise in becoming aware of our environments. Your testing device is your self – your body and your mind. For a few days use your notebook again to record your observations about the reactions of your body or your mind to different circumstances – to food, to position, to activities, to noise, light and weather, to other people and to particular behaviours. Picking up the changes you experience will allow you to identify the kinds of influences to which you, in particular, are most sensitive.

You should look out for factors which are not good for you, as well as factors which are good for you. This is because Hahnemann’s observation that things in the environment have the potential to do harm was the starting point for an even more useful discovery – things in the environment can also help. In homeopathy, a key term is “modalities”. The homeopathic doctor is very keen to hear about the things that influence your symptoms. Those things, which make it worse are known as “aggravating modalities” and those things which make it better are “ameliorating modalities”. Without “modalities”, homeopathic doctors say a symptom is not “complete”.

There is a strange thing about human awareness – we seem to be more aware of “aggravating modalities” than “ameliorating” ones. Maybe that is because our first instinct is to defend ourselves, so we pay special attention to potential harms before we become aware of the things, which promote well-being. Whatever the reason, as you do this observation, try, in particular to note not only the things which aggravate but also those which ameliorate. The former are the things you have to avoid or learn how to protect yourself against. The latter are the very things, which maintain your health and act in your interests to promote recovery.

Dr Bob Leckridge graduated from Edinburgh University in 1978 and worked as a GP until 1995 since when he has worked full-time as a Specialist in Homeopathic Medicine at Glasgow Homoeopathic Hospital. He teaches homeopathy internationally and is the author of Homeopathy in Primary Care. He became President of the Faculty of Homeopathy in 1998.