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� Leela D’Souza-

francisco

� Christine Lauterbach

� Matthias Strelow

� Boenninghausen

Boger

� Essences

Keynotes

� Scholten

Vijayakar

Therapeutic Strategies

through TOTALITY

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BOENNINGHAUSEN’S

METHODOLOGYby Leela D’Souza-francisco

� Boenninghausen’sTOTALITY (1843):ONE complete, GRAND symptom categorized into L,S,M,C of presenting symptoms.

� Therapeutic Pocket Book: Grading of remedies in FIVE levels based on provings and clinical cure. Similimum choice guided by TPB, dependant on grading.

� TOTALITY based on Doctrine of Concomitance:Importance of ‘attending circumstances’, no direct relationship to the Chief Complaint

� Doctrine of Analogy: Valid inference that characteristic sensation and/or modalities in one area, can complete a missing part of grand symptom in a different area of disease.

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BOENNINGHAUSEN TOTALITY:

FOUR COMPONENTS

� L0CATION: The part, ORGAN, TISSUE

� SENSATION: DESCRIPTION OF FEELING or pain

� MODALITY: Includes CAUSATIONS

� CONCOMITANT: Includes MENTAL STATE.

� LIMITATIONS/Criticisms:1) Mental State and complete proving symptoms not well represented in TPB (Hering)2) Overgeneralization with loss of individuality if characteristics not carefully obtained (Kent)3) TPB confirmed only 129 remedies (TF Allen added 229 more)

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BOGER’S

METHODOLOGY

� Boger(1915) said: The "GENIUS“ or “general expression” of the remedy is a strain or pattern in every pathogenetic symptom complex.

� PATHOGENESIS of the Symptom Complexdevelops in both remedy and patient, and includesPhysiological & Pathological scope, Modality, Mind, Sensation, Location, OBSERVATIONS

� Changes in FORM and STRUCTURE of disease (mental and physical) in TIME is the basis of remedy choice

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BOGER TOTALITY :

FIVE COMPONENTS

� A) MODALITIES: Includes Causation, DischargesB) MENTAL STATE: Detailed evaluationC) SENSATIONS: Includes ThirstD) LOCATION: Includes sides of the body

� E) OBJECTIVE OBSERVATIONS:1. Demeanour 2. Restlessness/ Torpor 3. Nervous Excitability/ Sensibility 4. Facial Expression 5. Secretions 6. Colour 7. Odour

� LIMITATIONS:1) Medical knowledge or paramedical training required for diagnosis of pathology2) Application of Theory of Miasms necessary for management

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CLINICAL ADVANTAGES

� BOENNINGHAUSEN: 1) Logical approach of analogy and remedy grading 2) History, analysis & remedy choice within 15 mins.3) Concordance of remedy relationships in TPB assists long-term clinical management

� BOGER:1) Objective observations : EMERGENCIES; serious pathology; infants/children2) Perception of pathogenesis of disease for HOPSITAL PROTOCOL1. State: Health � Diathesis � Disease2. Phase: Prodrome � Functional � Structural3. Miasm: Psora � Sycosis � Syphilis

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ESSENCESby Christine Lauterbach

� Essence definitions:

� Roger Morrison (1989): It offers us a very deep understanding of a remedy It reflects the „taste“ of the remedy

� Jonathan Shore (1999)The central thread that brings unity to the diversity of manifestationsBut: We cannot experience the essence of a thing directly.

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ESSENCES: Advantages

� Patient offers her/ his symptoms in a more DESCRIPTIVE way

� ABSENT pathologic symptoms in the body level:

FUNCTIONAL cases

� Reinforces a deep understanding of the patient and

a WIDE and DEEP case-taking

� For students: Easier to learn a whole CONTEXTUAL remedy picture

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ESSENCES: Limitations

� Patient offers No Essence or discriptive symptoms/ one-sided pathology on the body- level

� Cannot be used in emergency cases/ acute illness

� BEGINNERS could be restricted by the Essence picture of a remedy

� Essence is missing in SMALL REMEDIES

� Can it be transferred to other countries (different social, cultural, religious, gender, etc. context)? Who determines what an Essence is?

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KEYNOTES

� Guernsey (1868) was first to introduce concept of Keynotes as „suggestive and merely provisorial“.

� „Remedy has to be confirmed by TOTALITY...

� ... the key-note of music finds, by analogy –through which things most remote and unlike superficially are connected in the closest relationship – its likeness everywhere. .“

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KEYNOTES: Advantages

� Cases with STRIKING symptoms (Peculiar, Rare, Queer Symptoms – PQRS)

� GENIUS EPIDEMICUS

� ACUTE Diseases and EMERGENCYSituations

� While LEARNING or teaching it offers a good and LOGICAL STRUCTURE

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KEYNOTES: Limitations

� Cannot be used in cases without

outstanding symptoms (Peculiar, Rare,

Queer Symptoms – PQRS)

� In cases where the KEYNOTE points to a

different remedy than the remedy of the

Totality

� It is easily Misunderstood as a Shortcut

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SCHOLTEN VIJAYAKAR

by Matthias Strelow

A Comparison – Flexibility vs Clear Rules

� SCHOLTEN links homeopathy with Modern Science through:STRUCTURAL analysis of “created disease” based on PERIODIC TABLE of Elements

� He has a flexible, OPEN MINDED VIEW on disease, analysis.

� His view seems to be founded partly in Buddhist Philosophy,indicated on his web-site.

� VIJAYAKAR links homeopathy with Modern Science through: Relating 3 classical MIASMS to Cellular Defences; HERING’S LAW to germinal layers in EMBRYOLOGY

� His work is based on Kent, JH Allen, Boenninghausen.

� He relates himself to his Indian Hindu Philosophy background

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SCHOLTEN VIJAYAKAR

Case Analysis

� Several THEMES form TOTALITY of disease

� Preference for MENTAL STATE in analysis

� STRUCTURAL analysis of the “created disease”

� NO MIASM CLASSIFICATION except observation in remedy selection

� “GENETIC SIMILIMUM” is the TOTALITY of “genetic disposition”

� Balance of MIND AND BODY with the help of physical generals; CHARACTER analysis of life long symptoms

� MIASM CLASSIFICATIONessential for analysis, prognosis and management of case

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SCHOLTEN VIJAYAKAR

Remedy Response

� Amelioration in mind is evaluated based on THEME analysed

� Hering`s law mostly as reversal of symptoms

� General amelioration evaluated in %

� Disappearance of part of symptoms without complete healing is not characterised as suppression

� Hering`s law is guided by 3 GERMINAL tissue-development; explains direction of cure

� If disease progression UPWARDS in Vijayakar’s 7 layer hierarchy, remedy is suppressive.

� MENTAL amelioration may be indicative of suppression,

in advanced pathologies.

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SCHOLTEN VIJAYAKAR

Case Management

� Repetition is quite frequent if indicated

� Remaining state of

symptom picture

indicates another remedy

� Hardly any placebo

� Repetition very occasional, except in

sycotic miasm

� Change of remedy

indicated when cure not

in Miasmatic and Hering’s directions

� Daily placebo

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SCHOLTEN VIJAYAKAR

Each Strategy at 2 POLES of Clinical Practice

CRITIQUE

� Scholten is too FLEXIBILE with the disadvantage of UNCLEAR expectations on follow up and DIRECTION of disease undetermined; too many remedy changes

� Vijayakar is too IDEALISTIC; offers STRICT GUIDELINES(Miasmatic and Hering’s); may not easily accommodateindividual, exceptional developments in cure; case static

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CONCLUSION:

Strategy Applications

� Boenninghausen: Obscure cases; When TIME LIMITED for patient; Totality with more physical characteristics; Acute disease; Genus Epidemicus; Research strategies

� Boger: Emergency cases; Pathological cases; Cases where Subjective history impossible; Research Strategies

� Essences: Functional or psychological cases that need a deep understanding of the patient and his suffering.

� Keynotes: Genius Epidemicus; Acute Disease; Chronic cases with PQRS; Research strategies

� Scholten: Mental State predominant; Supportive Analysis to other Totality Methods

� Vijayakar: All types of Cases; Homeopathic Rules for Research Methodology Analysis

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THANK YOU!

� From us in the

THERAPEUTIC STRATEGY GROUP

� Matthias, Christine & Leela