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SIGNIFICANCE OF CAUSATION

IN HOMOEOPATHIC PRESCRIBING
DR. ANJU JETHANI, M.D. (Hom.)
Senior Medical Officer, Medical Center, High Court of Delhi &
Sr. Lecturer, Department of Organon of Medicine,
Nehru Homoeopathic Medical College & Hospital, New Delhi.
E-mail: dranjujethani@gmail.com
ABSTRACT: We have often heard the notion in homoeopathic
parlance that the symptoms of an illness are everything and a
homoeopathic physician just needs to perceive the effects of
disease, while turning a blind eye to the concept of cause of
disease. In fact the concept of cause of disease has been the
QUESTIO VEXATA of homoeopathic philosophy. Let us understand
this cause-effect axis in light of modern works of science and
establish their correlation with homoeopathic philosophy.
INTRODUCTION: Every effect has underlying causation(s) and
appreciating the fundamental concept of causation is essential in
the study of life sciences. Each and every stream of medical
science dealing with therapeutic interventional approach has to
be very unambiguous in its understanding of cause-effect axis. In
fact, perception of the causes of disease is important in health
not only for prevention, but also for diagnosis and the application
of appropriate therapeutic regimen.
In homoeopathic system of therapeutics too, the same holds
good. As highlighted above, there is a prevalent view that
believes in perceiving totality of symptoms (i.e. EFFECT) and
completely turns a blind eye towards the concept of causation.
However, this is a myopic perception of philosophy of the great
philanthropist,
Samuel
Hahnemann
who
gave
due
consideration to the concept of causation, albeit in different light
than the accepted allopathic norm. This can be deciphered from
5 of his magnum opus work Organon of Art of Healing
where he precisely states that:

Useful to the physician in assisting him to cure are the


particulars of the most probable exciting cause of the acute
disease, as also the most significant points in the whole history of
the chronic disease, to enable him to discover its fundamental
cause, which is generally due to a chronic miasm 1
Besides this, in aphorisms 93, 207 & 208; Hahnemann has
extolled the significance of perceiving causations in a given case
of sickness. In light of these facts, let us evolve our approach to
the understanding of etio-pathogenesis of sickness and its
significance in prescribing.
To start with, let us glean through the two different models of
causations:
MODELS OF DISEASE CAUSATION
LINEAR MODEL
NON LINEAR MODEL
LINEAR MODEL OF CAUSATION emphasizes upon the fact that
cause produce effects in a known, discernible linear manner and
the effect is proportional to cause.
NON LINEAR THEORY OF CAUSATION states that a minor
change in the initial conditions can lead to a major deviation in
the result and a major change may result in a minor deviation. In
fact, the Non linear system of equations emphasizes that effects
are not proportional to their causes. Aside from the complex
abstraction of mathematics, the concept of a nonlinear
relationship is often seen simply as a cycle, or feedback loop. 2
Since the linear model of disease causation believes in the fact
that cause produce effects in a linear, known pattern; therefore
the cause may be discernible from the known effects. It has been
the application of this very concept that is the edifice of
allopathic system of medicine where the symptoms of the patient
demand hearing as long as they are directive towards some form
of causation, which then becomes the central theme of
treatment. For instance, a patient presenting with the symptoms
of typhoid fever will be in accordance to the linear model lead on

to the sole cause of salmonella typhi. This in turns becomes the


core issue of treatment in the form of antibiotic. Now this may
still hold good for directly traceable infectious diseases, yet how
will this model work in the chronic disease of modern era NON
COMMUNICABLE DISEASES or the LIFE STYLE DISORDERS.
The non-linear model stresses upon the fact that interactions
between psychosocial and biological factors in the etiology and
progression of illness and disease are varied and form a web of
causality. How an individual interprets and responds to the
environment determines responses to stress, influences health
behaviour, contributes to the neuro-endocrine and immune
response, and may ultimately affect health outcomes.
In fact, it is important to comprehend that in spite of the great
triumphs of molecular biology, biologists still know very little
about how we breathe or how a wound heals or how an embryo
develops into an organism.
This concept is also beautifully highlighted in the works of Stuart
Close when he talks of MULTI-FACTORIAL CAUSATION of sickness,
where a complex network of causes, some known and some
unknown are at work in non-linear pattern to produce multitude
of effects. 3
It is the appreciation of this very concept that is central to our
understanding of homoeopathic methodology of treatment. Let us
acknowledge and accept that the diseases are mediated by
numerous
etiological
factors
such
as
environmental,
bacteriological, socio-cultural, so and so forth and appropriately
adopt remedial measures where they can be removed through
the modification of accessory circumstances.
However, on account of inability of human reasoning to decipher
the whole host of causations, let us rely on the effects, that
encompass the cause, as the basis of logical prescription. To
clarify this point further, let me quote the famous philosopher,
Henri Bergson who said that:
The present contains nothing more than the past, and what is
found in the effect was already in the cause; it is just the matter
what was perceptible and what was not. 4

This does not any way demean the importance of taking


causation in consideration but emphasizes that cause is
important as along as it is perceptible and the effect produced by
the cause (in the form of concomitant symptoms) provides logical
basis of prescribing the similimum. The very fact that such a
cause produced effect through subtle, non linear pattern and
therefore its mechanism of action was inexplicable does not
decry its connotation. In actuality, it had to be inexplicable due
the very fact that the perceptible cause is just one of the causes
involved in the web of causations.
Let us clarify this point further. Any case of illness tracing its
origin to h/o grief (which was one of the causes yet the only one
perceptible) does not automatically warrant a prescription of
Ignatia or Nat. mur. but in case of such patient developing the
concomitant symptom of involuntary sighing, the prescription of
Ignatia becomes logical; irrespective of the lack of reasoning of
this cause-effect axis.
It is for this reason that most faithful follower and ardent disciple
of Hahnemann, Boenninghausen introduced a case taking
schemata that included the seven aspects most important to the
homoeopath when forming a complete symptom image in which
CUR or perceptible etiological aspect of illness was one of the
chief factor.5
Before we conclude this discussion, let us throw light on the
following statement mentioned by H.R. Wulf in the much talked
about journal of the present day Lancet:
This, then is my vision of what will happen to our scientific
perception of disease during the next century: we shall realise the
wisdom of the ancient Aristotelian approach to the study of
nature, which means that we shall no longer regard disease as a
mechanical fault in the human machine but as a disturbed life
process.
We shall apply the theories of open systems and non-linear
dynamics to medical problems, and we shall reach a fuller
understanding of the development of disease. 6

REFERENCES
1. Hahnemann, Samuel. Organon of Medicine, Translated
from 5th edition with an appendix by R.E. Dudgeon; with
Additions & Alterations as per Sixth edition translated by
William Boericke, B. Jain Publishers Pvt. Ltd., New Delhi.
2. Benet, William Rose. The Readers Encyclopedia, 3rd
edition, A & C Black Publications, London.
3. Close, Stuart. The Genius of Homoeopathy, Indian Books
& Periodical Publishers, New Delhi
4. Stanford Encyclopedia of Philosophy, The Metaphysics
Research Lab Stanford University.
5.

Boenninghausen, C.M.F. von. The Lesser Writings of


C.M.F. von Boenninghausen, Compiled by T.L .Bradford,
B. Jain Publishers (Pvt.) Ltd., New Delhi.

6. Wulff H.R. The concept of disease: from Newton back


to Aristotle. Lancet 1999; 354 (suppl):50.

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