Comparative Materia Medica using a Thematic Categorization of Symptoms

Abstract: One way to recognize the image of a remedy and the depth of its action is to categorize symptoms according to different levels of expression within its total symptom picture.  Many remedies often look alike, making the art of remedy comparison challenging and so recognizing the depth and sphere of action of a remedy is a key part of homeopathic study. Many remedies can be said to have three levels of expression, which can be classified as the following levels: Intrinsic, Compensated and Decompensated states, each matching the miasmatic categorizations of Psora, Sycosis and Syphilis. The miasmatic categorization can be seen as a form of thematic expression and in so doing it can be helpful in recognizing the unique picture of a remedy. Examples are shown of how this model offers an efficent new way to compare remedies.

Every remedy has a sphere of action, revealing its breadth and depth of action. This is revealed in both physical and mental symptomatology. Some remedies are much better known than others and especially with the polychrest remedies, it can be said that we know virtually everything that there is to know about their action. However, even in such situations, person will only produce a small number of symptoms of a remedy and the challenge is to be able to identify the remedy using the unique combination of symptoms in any given case.

One way to understand the development of the image of a remedy and the depth of its action is to categorize symptoms according to different levels of expression. Every remedy has a sphere of action that determines the quality and intensity of its symptoms and also a unique pathological affinity and expression. Understanding this can be very important in distinguishing between remedies. Symptoms can often look alike when making comparisons and recognizing the depth and sphere of action of any remedy is a key part of homeopathic study.

One way to recognize the depth of action of a remedy is to use the three basic miasmatic themes as a model of developmental structure or theme of a remedy. If we use the three miasms as metaphorical themes rather than merely connected to the traditional disease states, then many remedies can be said to have three levels of expression, which I have classified as the following: Intrinsic, Compensated and Decompensated states, each matching the miasmatic categorizations of Psora, Sycosis and Syphilis. The idea of remedies having different stages of action is not new and has been described by many homeopaths, using similar or different descriptive terms. The purpose here is to connect it to the idea of constitution and also to use it as a means to help differentiate remedies.

Some of the older textbooks tended to focus on the decompensated levels of the remedy, whereas this information has since been complemented with a wider comprehension of the developments that lead up to this. For example, reading Causticum, Staphysagria and Nitric acid in Kent’s Lectures on Materia Medica, one gets very specific ideas of each remedy, but these are not always seen in practice: some people needing these remedies will not show symptoms at that developmental stage, which is more in the decompensated stage. We need to be able to identify a remedy before it has reached this stage and understand the movement toward the end stages of a remedy. This has been an important development in our understanding of materia medica

The following descriptions develop this idea and give an analysis of our materia medica based on three levels and phases of action of a remedy.

Intrinsic level: (psora)
The intrinsic level belongs to what is often termed the “constitutional” state. The term constitution is used in different ways but the way it’s being used here is to describe intrinsic, fundamental or basic states of the person that don’t necessarily change. In many of the images of well-known remedies, aspects of the “personality” of the remedy are described in terms that describe the basic nature, the soil or the essence of a person, and information of this sort includes basic personality qualities – loves, hates, inspirations, work choices, temperamental qualities, even basic fears and anxieties. It also includes basic sleep and dream patterns, food desires and aversions, weather likes and dislikes and basic physiological qualities such as skin, hair and nails and characteristic eruptions, stool, urination, perspiration etc. Even though these things are basic to the person and may not change, we often use some of this information to help us find the indicated remedy. Also, when using this information to choose a remedy one can often presume that the remedy chosen is the constitutional “soil” remedy for the person, and not a “layer” or more superficial remedy. It is addressing the basic biological function and and psycho/dynamic features of the person. In this way, the intrinsic layer can be identified with the psoric miasm.

The issues of the psoric miasm are those concerning the basic identity and purpose of the person and address the core ideas and motivations of a person’s life. We have the most information of this sort with polychrest remedies, and especially the mineral remedies which are often connected to the psoric miasm. The most psoric remedies are those minerals found as part of basic biological functioning such as Calcium, Potassium, Magnesium, Manganese, Natrum, Ferrum, Phosphorus, Silicea and Sulphur. The other element that most clearly is seen as part of the psoric dynamic is Carbon and its connection to many of our remedies, e.g., Calcarea carbonica, Graphites, Kali carbonicum etc. The psoric mineral remedies are predominantly found in the lighter elements in the periodic table – even though other minerals and metals do play a significant physiological role in the body and many of the remedies in the mineral and metal kingdom address fundamental constitutional issues. However, those elements found closer to the surface level of the earth’s crust were integrated into the food cycle by plants and animals over millions of years and then into the evolution of human biology. With these remedies and others, we have a clear idea of the personality types that often need these remedies and a clear idea of their biological and chemical function, which allows us to understand their sphere of action as remedies. With many of these remedies we also have a clear idea of their compensated (sycotic) and decompensated (syphilitic states). This knowledge comes from provings, (including accidental or deliberate overdosing or poisoning), which gives information as to the depth of physiological action of any substance. As importantly, it comes from clinical experience, where the physiological and psychological expressions of a remedy action are revealed.

As the elements become heavier, their basic function in normal physiology becomes less. We still have a clear picture of their homeopathic image but the issues they address tend to be less about basic identity and purpose and are focused more intensely on certain psychological and physical areas. There is a more extreme expression in life and in disease symptoms. Their relationships to others becomes more intense and driven. Their needs seem greater. As such they address both the sycotic and syphilitic miasms, which are identified with the compensated and decompensated levels, respectively. The remedy Mercurius is an example of this. We have a clear understanding of its homeopathic action, including a personality type for the person, but its predominant syphilitic action means that a large portion of its mental and physical picture is in the decompensated or syphilitic stage. That is in contrast to remedies like Calcarea carbonica or Sulphur, that most generally express most of their symptoms in the intrinsic or compensated stages.

It can be considered that everybody might need a mineral remedy at some point, that there is a basic constitutional affinity for a mineral remedy to address basic issues. As our body is formed from mineral constituents and we are of the earth and will return to the earth, it makes sense that we can all potentially need a remedy from the mineral kingdom. That doesn’t mean that we should always start a case with a mineral remedy, a “deep acting anti-psoric” as the books describe. Giving a deep acting mineral/metal remedy too early in a case when there are other issues going on can be a mistake and Hahnemann was clear in his ideas of giving remedies to cover the sycotic and syphilitic miasms first. As a rule of thumb, the deeper the pathology is, the further it is away from the constitution and the more it has to be considered as an unique image riding on top of the constitutional image.

Compensated level: (sycosis)
The compensated level is often seen as an exaggeration of what is natural, a distortion of the basic state. It is seen in both physical and mental symptomatology. Most information for giving a remedy is taken from information in the compensated state. It is, after all, what motivates most people to see a homeopath. However, when giving psoric-based polychrest remedies, information from the intrinsic level is often used to help justify the remedy. What was the person like before the current situation arose? What is the overall context of a person’s life? What has happened to them in their life; what dynamic influences have they been exposed to or been influenced by? Therefore, in chronic prescribing, most prescriptions are made using a combination of the intrinsic and compensated states, the deviations from the norm giving the context for the type of prescription made. However, in more sycotic states, there is less information given of the basic state, most of the energy is given to the aberration from health. It feels more like a fixed state of being, an identity with what is wrong and that which is different from the basic state.

In most of the large polychrest remedies, one mostly gets a clear mixture of constitutional information that relates to both the intrinsic and compensated state. In remedies already mentioned, such as Natrums, Calciums, Magnesiums, Kalis, Silicea, Phosphorus and Sulphur one can use information taken from both levels. However, in other well-known remedies such as Argentums, Platinum, Aurum etc, the information given is often more weighted to the compensated and decompensated state; not in every case but that is the pattern. Also, as symptoms move toward a compensated state, there is more of an external focus on how the person is dealing with situations in the world and how they are seen in the world. It is more egoic and less to do with basic issues of survival, food, work, job, identity etc. There is more exteriorization.

Many plant remedies present symptoms in the compensated or sycotic state. They are stuck in a strategic reactionary pose to some idea or fault they perceive they have experienced or that is in their nature. There is often a clear emotional state given in plant remedies, one that is not necessarily connected to any other situation. It is not referenced to anything else in life, but is experienced directly whereas in mineral remedies, an emotional state is often related to some other aspect of their life – work, relationships, ego issues etc. There is a larger context in which the emotional state is referenced to.

Also, there can often be a distinct etiology indicating a plant remedy, whether it’s shock, fright, fear or grief. If one sees a clear etiology and then a clear emotional image as a result, especially if there are no physical concomitants, then one is often looking at a plant remedy. The term fixed is often used to describe the sycotic miasm, characterized most clearly in the remedy Thuja, the king of the sycotic miasm remedies. Thuja is seen as having fixed ideas, a rigidity and fixedness of thinking. However, many plant remedies have a similar expression. It is not so much fixed ideas as seen expressed in Thuja but more of a fixed emotional/mental pattern that dominates their consciousness. Also, individual plants cannot move much. They are fixed in place so their consciousness and reality reflects a fixed attitude. Their strategies are consequently restricted. Therefore, most plant remedies express themselves in a compensated state. Attention is not given to their basic identity and function in life. Even Nux vomica is mostly caught up in its emotional state. They are more concerned with their feelings, their anger and frustration than what their work will do for their basic ego. Their reference points are their feelings or their stomach or sleep and not to do with what people will think of them or where they belong in life. If they do make reference to these things, it is still secondary to their feelings, their fixed emotional state. This can help in differentiating remedies, for example, between Nux vomica and Sulphur. In some cases, both remedies may be needed in the same person, but it’s important to know the most important symptoms to prescribe on at the beginning and to see which symptoms belong to which remedy.

In some cases, there may already be two remedy images being revealed, one for the intrinsic symptom picture and the other for the compensated state. These may often be complementary remedies, such as Nux vomica and Sulphur, Pulsatilla and Graphites, Belladonna and Sulphur or Calcarea carbonica etc. Often it may be seen that one complementary remedy is a mineral while the other is a plant.

However, as stated, the information found in the compensated state is often the most important information we prescribe on, and we may or may not use information from the intrinsic state to confirm the prescription.

Decompensated level: (syphilis)
This level reveals the more broken down and pathological states within a remedy. It shows the depth of action a remedy can go to. In some remedies this is the majority of information given. The heavy metals in our materia medica are an example of this. However, even with the more psoric remedies in the materia medica, there exists the pathological limits of how far the remedy can go. The difference is that a larger part of the complete symptom picture does not involve significant mental or physical pathology. As is well known, the mental state in the syphilitic condition is much more dark and desperate than is seen in the psoric or sycotic states.

The decompensated states are revealed in some of the old materia medica where the conditions being treated were often extreme. As mentioned, Kent’s Lectures on Materia Medica has many descriptions of these states. Descriptions of more advanced physical pathology and general degenerative conditions are mostly described, which are now seldom seen by many homeopaths. These states tended to be seen more in the 19th century and in developing countries today. It is a reflection of the changes in homeopathic understanding of our materia medica that we have broadened our knowledge especially in the psychological and dynamic areas of a remedy picture and it these issues which people often consult homeopaths today. In general our current culture is more psychologically oriented than in past centuries.

However, understanding the depth of action of a remedy is important in recognizing the key themes of a remedy and also how that may help in identifying the remedy when a person is expressing a much less intense picture. It can be a good way to analyze a remedy, by looking at its extremes or polarities as a way of understanding its essential themes.

Some plant remedies express a clear decompensated or syphilitic state. There are more destructive physical and mental qualities in their picture. Therefore, the emphasis in the case will be even further from the basic, intrinsic level and will generally be within the compensated and decompensated levels. Plant remedies that express more syphilitic or decompensated levels include Stramonium, Hyoscyamus, Belladonna, Opium, Cannabis indica, Conium, Nux vomica and Aconite. In fact, most of the plant remedies that have toxic qualities to them will be found in the decompensated or syphilitic state where what is found is a combination of physical or mental intensity and destructive processes. Some plant remedies are given more intrinsic, constitutional images, e.g., Pulsatilla and Lycopodium, but it is somewhat questionable that all the characteristics given to them are actually accurate. These two examples especially seem to have courted favor with homeopaths of old, making one wonder if their reputation perpetuated their ubiquity more than anything fundamental about their healing action. Therefore, with most plant remedies, the predominance of symptoms will not have to do with issues of basic identity and position in life. Non-toxic plants tend not to have such deep-seated symptoms, physically or psychologically although if they are the constitutionally indicated remedy, they will work on that level accordingly.

Animal remedies also tend to predominate in the compensated or decompensated states. Their concern, depending on the remedy, is much more concerned with survival, life and death, competition, sexuality, violence, extremely negative self-image, activity and movement, and physically there are often distinct functional and structural pathologies that are seen along with mental states. It is not always easy to distinguish between some plant and animal remedies, e.g., Hyoscyamus and Lachesis and sometimes between animal and mineral remedies, e.g., Phosphorus and Crotalus horridus, Lachesis and Platina etc. As with any remedy distinction, the whole case has to be taken into account before concluding which family the case belongs to. Animal remedies that have venom tend to have strong destructive qualities to them, e.g., snakes, spiders and some insects, and therefore are often useful in destructive physical conditions with more advanced pathologies. A study of the snake remedies, for example, with their respective venom action reveals much important information of the conditions they will treat – predominantly blood, heart and nerve related pathologies, all expressing to a great extent decompensated physical states.

When a person needs an animal remedy, especially from the poisonous realms, it is possible they had an experience that mimics the experience of the animal they need, especially if there is clear mental picture. This may be an inherited memory or acquired in life but some kind of intense experience has happened.

With snake, spider and insect remedies the time of susceptibility is often when very young, when an upset in the normal mammalian development has occurred. Perhaps there was an abrupt or continued conflict with the relationship with the mother, often accompanied by acute danger and threat. This latter quality is often seen in insect and spider remedies more than snake remedies. In the snake remedies, the general character and personality of the person tends to be more evolved, mature and integrated. In spider and insect remedies, there is often an immaturity and lack of emotional integration. This is because the consciousness of the person needing these remedies has had to focus on survival and the immediate needs of life. They have not had time to think. They are always needing to react, and therefore express in the compensated and decompensated states. In these cases, there is not so much concern with issues identified with the intrinsic stage – one’s meaning, identity and purpose in life. Much more energy goes to the reactive impulses of an often-unconscious pattern of ideas. A person may not be aware of these ideas yet acts out of them nevertheless. In homeopathy, it is this reactive behavior that gives us key information for a remedy choice. In these examples, it also indicates why many animal remedies express symptoms in the compensated and decompensated states; they are further away from the intrinsic nature of human consciousness, although one could argue that the intrinsic nature of a mineral is far away from human consciousness!

Creating a clear delineation of intrinsic, compensated and decompensated layers is therefore much clearer for polychrest mineral remedies than for less well-known remedies and for animal and plant remedies, which as mentioned relate more to the compensated and decompensated realms. Therefore this classification is done partly to reveal the breadth and depth of action of remedies and partly to allow a more complete comparison of remedies at each stage of expression. Certain remedies will be compared with one another only at the intrinsic expression of their expression, whereas some will be compared more in the decompensated stage. Also, categorizing symptoms according to these three stages helps clarify the fact that any person will only present with a limited number of symptoms of a remedy, often predominantly in one stage or another. One of the biggest mistakes that beginning homeopaths make is eliminating a possible remedy based on what is NOT there in the case, what they expect to always find in a remedy, not understanding that at different stages only a portion of the totality will ever be present. This is important in being able to identify a remedy based on only a select portion of symptoms in any case.

The following examples are of two remedies taken from my book Comparative Materia Medica: Integrating New and Old Remedies to show how remedies are classified according to the levels described above. It should be noted that even though each stage is described as a distinct phase, considerable overlap can occur and of course is subject to the interpretations of different homeopaths.

Causticum
Idea: My survival is dependent on my ability to maintain my passion and connection to the truth.

Keynotes:
Sensitivity.
Sympathy, injustice, fairness.
Anxiety, fear.
Optimism, cynicism, anger.
Worn out.
Sadness, despair, anguish.
Rawness, skin, throat.
Throat, larynx, trachea.
Joints.
Bladder.
Nerves, muscles, paralysis, numbness.
Skin, warts, eczema, psoriasis.
Worse cold and dry, wind, drafts.

Intrinsic stage:
Idealistic, optimistic, passionate, caring.
Sympathetic, Serious. Dutiful.
Responsive, reactive, excitable.
Emotionally sensitive and open, but only to a point.
Sensitive to cold, cold, dry wind. Feels better in humid weather.
Larynx and trachea.
Food: desires smoky, spicy, salty food. Averse to sweets.
Skin: warts, fingers, edge of nails.

Compare: Kali carbonicum, Kali phosphoricum, Lycopodium, Natrum muriaticum, Phosphorus.

Compensated stage:
Idealism mixed with rigidity.
Too sympathetic. Emotional rawness.
Too excitable, over sensitive, stammering.
Fanaticism, strong ideas, easily disappointed. Too responsible.
Anger, indignation, righteousness. Injustice.
Closed, hard, suspicious
Grief.
Anxieties, fears, < dusk, something horrible will happen.
Worries, full of cares.
Physical rawness, especially larynx, trachea, digestion, skin.
Warts, growths.
Joints agg, arthritis < damp, cold > heat and humidity.
Bladder, weakness, involuntary urination. Paralysis.
Tendons feel too short, desire to stretch.
< cold, dry winds – Cough, arthritis, losing voice etc.

Compare: Cobaltum, Conium, Dysentery co., Kali phosphoricum, Lachesis, Manganum, Mercurius, Niccolum, Natrum muriaticum, Nux vomica, Phosphorus, Platina, Rhus tox, Staphysagria, Sulphur, Thuja.

Decompensated stage:
Exhausted, depleted, broken down.
Cynical, despairing, hopelessness.
Depression, deep sadness. Suicidal ideation.
Profound worries, about everything. Checks things many times.
Fears something horrible will happen, of death, full of fearful anticipation.
Crippling arthritis. Arthritic deformities. Contracture of joints.
Multiple sclerosis, Parkinson’s. Polio. Paralysis.
Bell’s palsy.

Compare: Arsenicum album, Aurum, Conium, Lathyrus sativus, Manganum, Phosphorus, Platina, Plumbum, Stannum, Thallium.

Progression:
Idealistic, passionate and sensitive, the initial optimism of life is mixed with a sensitive, sympathetic nature, but which becomes more like a wound to the soul as the suffering of humanity and life itself becomes too much. Greater cynicism, doubt and fears arise as the concerns and worries take over, leading to a mental and physical breakdown, with paralysis of organs and joints, chronic arthritis and degeneration.

Nux Vomica
Idea: My survival is dependent on my being free to be active to achieve whatever I want and not to be restricted in any way.

Keynotes:
Sensitivity – to stimuli – noise, smell, drugs, smoke, all input.
Idealistic, Zealous, Excitable, Sympathetic, Enthusiastic.
Activity – Ambition, Industrious, Headstrong.
Impatience, impetuous.
Anger, impulsivity, touchy. < slight causes.
Aggravated by noise, anger, odors, touch.
Shock, fright, grief.
Violence, rage, striking, desire to kill.
Exhaustion. Weakness, depleted, nervousness.
Sleep – insomnia. < on waking – anger, touchy.
Constrictions, spasms – constipation, ineffectual urging.
Chill, coldness.
Digestion, stomach, sensitivity. Liver, gallbladder, intestines.
Food – craving stimulants, alcohol, coffee, drugs.
Nausea, vomiting, retching.
Nervous system – wound up, spasms, convulsions, Paralysis, numbness.
Mental fatigue.
Tobacco – desire and aversion.
Aggravate by cold, wind, drafts.
Aggravated by heat, covering.

Intrinsic/Compensated stage:
Industrious, busy, active, ambitious.
Idealistic zeal. Fanaticism.
Outgoing, sympathetic, expansive, over the top.
Censorious, over mentalized.
Impatient, easily frustrated. Anger.
Indulgent, craving stimulants.
Sensitive to all stimuli – food, drugs, alcohol, tobacco.
Chilly.
Cramps.
Stomach issues.
Sleep problems.

Compare: Adrenalinum, Causticum, Chamomilla, Coffea, Histaminum, Ignatia, Iodum, Lycopodium, Medorrhinum, Proteus, Strychninum, Sulphur, Sycotic co.

Decompensated stage:
Anger, rage, out of control. Mania. Impulsive.
Desire to kill.
Insomnia,
Exhaustion, depletion, worn out.
Over stimulated, can’t let go.
Depression, despair, anguish, suicidal thoughts.
Spasms, cramps.
Neurological conditions. Painful states of nerves, paralysis, Multiple Sclerosis.
Stomach conditions, ulcers, cancer.
Addictions. Destructive habits.
Extremely chilly. Can´t warm up.

Compare: Anacardium, Aurum, Causticum, Hepar sulph, Iodum, Kali iodatum, Kali phosphoricum, Mercurius, Sepia.

Progression:
In the intrinsic and compensated stage, the key qualities seen are a need to be active and busy, along with a great sensitivity, a touchy mental quality. There is a need to express themselves and not be interfered with too much. Both body and mind are sensitive, with a desire for strong stimulants to keep them going. Anger often is not far away, and as the compensation becomes stronger, anger and intolerance become greater, often aggravated by the craving for stimulants and an increasingly wound up state. Spasms in the body can be felt, increasing chilliness and an inability to relax and let go. Insomnia and constipation are often seen. As the state becomes more decompensated, there is increasing weakness, collapse and neurological conditions. There is great oversensitivity to everything. Mentally there can be violent impulses, homicidal inclinations and rages. The digestive system is easily upset with spasmodic pains and contractions, intense constipation, peristaltic problems and paralysis of organs and nervous system.

These two examples show how for many remedies one can use the three levels described as a means to categorize complex symptom pictures and is a way to see the progression of a remedy from a relatively healthy state to its ultimate pathological expression. It enables one to make more accurate comparisons between remedies at each different level and can ideally give us a clearer understanding of the unique image for many of our well known and lesser known remedies.

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