NON-LINEARITY Straightens PRESCRIBING

SIGNIFICANCE OF CAUSATION

IN HOMOEOPATHIC PRESCRIBINGDR. 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.comABSTRACT: 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 1Besides 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. 2Since 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. 3It 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. 4This 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.5Before we conclude this discussion, let us throw light on the following statement mentioned by H.R. Wulff 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. 6REFERENCES1. 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.