Book Review
NATIONAL JOURNAL OF HOMOEOPATHY 2000 May / Jun VOL II NO 3.
Reviewed by
Kasi Vishwanathan

Title: The System of Homoeopathy
Author: Dr Rajan Sankaran
Publishers: Homoeopathic Medical Publishers, 20 Station Road, Santacruz(w), Mumbai-54
Pages: 494
Price: Rs 350

This is the 3rd book in the series by Dr Rajan Sankaran after "Spirit of Homoeopathy" and "Substance of Homoeopathy", wherein he tried to explain his understanding of Homoeopathic principles and approach to case taking and prescription. This current book, he says, explains his method of case taking and analysis and hence deals with his evolution over the years in his practice. A large number of case studies with the actual interview record, detailed case analysis and remedy selection makes this book very absorbing. The follow- up seeks to demonstrate how the remedy actually worked.

To appreciate his system it is necessary to keep in mind, without prejudice, his concepts of disease and the approach. Briefly discussed in chapter 1, the main points are:

1. The disease affects first the mental and general plane and then the organs. He terms this as central disturbance, which is what has to be treated, if peripheral disturbances are to cease to exist.
   
   
2. The mental disposition is important, as per Aphorism 211 of the Organon; it is not discrete or separate but connected by a situation: the mental state, not merely mental symptoms.
   
   
3. Disease is a posture adopted by the organism for survival in his particular situation; mental state is part of this posture. If the posture is appropriate for the situation, it is not to be treated (Does it mean that the patient himself will not come for treatment?) Disease stems from roots - the impressions from situations in the past or from previous generations - that make a person adopt a posture as if he is still in that situation. In many cases the situation for which the particular posture was adopted, no longer exists. Hence disease is a delusion ie a false perception of reality. The state of being of a person can stem from a situation or delusion. To remove the state one must remove the delusion.
   
   
4. In children, there is a striking resemblance in the state of infant and the mother during pregnancy and sometimes of the father. (This is of course well accepted now.)
   
   
5. There are four stages of the disease:
   1. The delusion or the main feeling. (eg lamenting that he is not appreciated).
   2. Coping as the intensity increases (He tries to gain appreciation).
   3. Failed stage- when person is unable to cope because the delusion is very intense but yet trying his best (Hatred, quarrelling and jealous).
   d) Given up stage, where he makes no further effort to cope (sits and meditates over imaginary misfortunes)
   In stage (a) for eg, the feelings are uncompensated (represented by Calcarea-sulph)
   
   
6. Awareness of the reality is cure and health is freedom.
   
   
7. Many symptoms may be in the compensated form (covering up some elements of our nature by an act of will) and symptoms of the uncompensated state, so essential for prescribing have to be unearthed. In dreams, the feelings expressed are raw and uncompensated; therefore dreams are often the key to understanding the patient and time spent in exploring dreams pay rich dividends in remedy selection.
   
   
8. Each remedy is a STATE OF BEING.
   
   
9. The delusions are also analysed in terms of the miasms. Apart from three basic Hahnemannian miasms, he has introduced in-between miasms like Typhoid, Sub-acute, Ringworm, Malaria, Cancer and Leprosy miasms, with their corresponding remedies and Nosodes. This approach, he says, enables better understanding while helping narrow the choice of remedy.

At the end of 25 cases, the reader is fairly familiarized with the concepts. Then follows chapter 27, titled "The System" in which he outlines the CONCEPTS of case taking and case analysis A packed 48 pages! Thereafter 10 more cases are presented in which the same system is adopted.

He now describes his four levels of case taking -
1st.Level - only symptoms are gathered.
2nd Level - important hints obtained at first level, are acted on, and the line of enquiry established. Dreams are asked at the end of second level.
3rd Level - directed enquiry - going deep into these issues and feelings, including the PQRS.
4th Level - this epicenter of delusion or sensation, changes the complexion of the case as we can see it through the eyes of the patient. Connections are unearthed and the common point of the deepest mental and physical sensations surface. At this point the miasm, the kingdom of the remedy and other ideas, all converge to a sharp focus to facilitate remedy selection. The delusion or the innermost feeling is best revealed in an understanding of the patient's subconscious mind, especially his fears and dreams and thus rubrics can be substituted f one oranother. Finally he resorts to confirmatory questions about the kingdom and the remedy.

In the last chapter he discusses, with brief case illustrations and cross-references to the earlier cases, each aspect of case taking. The points he makes are:

1. The chief complaint, either alone or together with other complaints, may give an idea of the kingdom, miasm, stage of the disease and the delusion either in part or in whole.
   
   
2. The effect of the complaint on the patient is important; eg one patient with severe pain and heaviness in the abdomen did not want to move. She could neither move out nor be with the plants and trees she loved. This feeling of being restricted, as if in prison, with a feeling of having done something wrong, led to selection of Cyclamen.
   
   
3. Pathology is nothing but an expression that corresponds to the delusion, but it serves to make the delusion real. Eg: a woman felt tremendous performance pressure as she was severely restricted by her father. When he died, she developed eruptions on her fingertips making it impossible to work as a dentist, paint or sew; thus the delusion was kept alive, even after the exit of the exciting factor.
   
   
4. Unconsciously we choose situations that excite our worst feelings or pathology. The exciting factor only acts as a trigger. (of feelings and reactions from the patient's past or from his delusion..? kv possible to omit)
   
   
5. The actuality versus perception of patient are often startlingly different. Eg: in one case of Carcinosin, the child found disorder around her and felt obliged to put it into some order, but felt handicapped because she was too small. Later, when she helplessly watched her parents fighting and hitting each other, she again felt too small to intervene; and developed auto-immune vasculitis with gangrene, as a result. Another patient experienced stress associated with appearing in public. Here it was not timidity; she was so tall and masculine that she felt others looked down on her. The rubrics- Delusion, diminished, short; delusion, looked down upon and disgust for self; led to prescription of Lac-can.
   
   
6. Dreams reveal uncompensated feelings and are the most direct path to the patient's delusion. Do not ignore dreams nor interpret them. He discusses, with illustrations, this topic in great detail - what to look for in actual and virtual dreams. Actual dreams are those which occur in sleep while virtual dreams include other forms of uncompensated behaviour in the waking state- eg fears, fantasies, sensations as if, metaphors, interests and hobbies, hopes, religion and philosophy. Each is illustrated.

The doctor should explore the vocation or profession of the patient-what he chooses to do and why; recreational activities, chosen out of free will, thruely indicate the uncompensated person.

Case Analysis:
Pay close attention to the exact words of the patient. Reference to attachment to an animal or flower or nature or the type of profession chosen may point to the remedy. Trace the connection between all aspects of the case and give weightage.
For miasmatic evaluation: correlatethe words, attitude, mood, pace, pathology and past history.

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