Portraits of Homoeopathic Medicines: Psychophysical Analyses of Selected Constitutional Types v.1

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This book review is reprinted with the permission of the American Institute of Homeopathy

Reviewed by George Guess, M.D., D.Ht.

As a preface to this review, if I may ask the reader's indulgence, I should like to consider an issue which has come up several times in discussions with some of my homeopathic colleagues about Coulter's book. That issue is the reliability of basing the prescription of a homeopathic remedy upon psychological symptoms. It seems that some homeopathic precribers have misconstrued Coulter's intention in writing her book, overlooking her own expressed cautioning about prescribing totally upon the personality of a patient. She herself states that thorough and proper remedy selection should be based upon the physical, pathological indicators plus the psychological symptoms.

It is my suspicion that a major cause of this misinterpretation and of the current tendency of some American homeopaths to ignore psychological profiles is a misunderstanding Of, and consequent over reaction to, the teachings of two of our most significant current contributors to homeopathic knowledge - George Vithoulkas and Dr. Francisco Eizayaga.

Vithoulkas' teaching has, for various reasons too complex to consider here, often been grossly misunderstood. His early presentations of remedv "essences" captivated homeopathic audiences, but many listeners made the mistake of assuming that the essence was the sole criterion used by Vithoulkas for remedy selection. When these prescribers took this new information back to their practices and attempted to apply it in this mistaken manner, they met with much disappointment. Subsequently, I feel, they came to disregard Vithoulkas' teaching and at the same time to question the value of the symptom hierarchy postulated by Kent.

In fact, Vithoulkas' criteria of remedy selection are multifactorial and flexible, varying with the nature of the clinical case in question. Essence, totality, keynotes, peculiarities, physical pathology, family history, miasmatic considerations - all of these parameters, and more, are involved in remedy selection, the weight of each again varying with the nature of each case.

Kent, himself, in a rather obscure little essay entitled "Remedies Related to Pathological Tissue Changes," written later in his career, stated that physical pathology was very important in directing the choice of the similimum. In so doing, however, he didn't refute his earlier emphasis on mental, emotional and general indicators of the remedy; rather, his message was that the selection of the remedy should be based upon a marriage of all of the above factors.

Eizayaga has come upon the American scene with a highly systematic method of case analysis and a sequential mode of treatment, progressing from the lesional level to the functional, then miasmatic (soil), and lastly, the constitutional level. It is critically important to bear in mind when evaluating the teaching of Eizayaga that he repeatedly emphasizes the need to ultimately treat the patient. Despite his initial consideration of only the "disease" symptoms and signs of the case, he states that any therapeutic effort that does not take into consideration the entire patient is incomplete. Further, he states that when lesional remedies and functional/constitutional remedies correspond in a case, the prescriber has that much more justification for the prescription of a given indicated remedy and can prognosticate a very favorable response.

Essentially, of the major contributors to homeopathic thought in the United States, old and new agree that a consideration of the psychology of the patient is of great importance. It is similarly obvious that the nature of the patient's pathology and the specific symptomatology is extremely important. Whether the method of homeopathic treatment attempts to meld the two, or considers them separately and in a sequential fashion, the value of psychology still remains acknowledged by both schools of thought. Consequently, it is attendant upon all homeopathic prescribers to become as conversant with "homeopathic psychology" as they can.

In Portraits of Homoeopathic Medicines Coulter offers deeply penetrating accounts of the psychological profiles of nine homeopathic polychrests. Of special interest is the fact that Coulter has provided us with a number of observations of the personality characteristics of the remedies that are much subtler than anything previously noted. In fact, many of the qualities she identifies can be considered "normal" - nonpathological, She seems to contend that even normal characteristics, if sufficiently distinct, can be of value in remedy selection. This point is one which can quite appropriately be debated. Before dismissing Coulter's contention, however, it is important to note the context in which she utilizes these normal but distinct qualities when confronted with a difficult choice between two or more remedies because of an inadequacy of symptoms, the nature of the personality is used as the final determinant. In this sense, "normal" personality characteristics may well be of value clinically.

In addition to many fascinating references to the subtle traits of the remedies covered in her book, Coulter provides us with uniquely conceived depictions of the psychological pathology of these nine polychrests: Phospho-rus, Calcarea carbonica, Lycopodium, Sepia, Sulphur, Pulsatilla, Arsenicum album, Lachesis, and Natrum muriaticum. In addition to her own observations garnered from her long homeopathic career, she has resurrected many overlooked observations of some of the old masters.

Her writing is precise and elegantly styled. The prose alone makes the book pleasurable and worthwhile reading, but the information contained therein makes the work a very valuable addition to any homeopathic practitioner's library. Remedy personalities are brought to life through the combined use of case anecdotes and numerous literary references that serve to illustrate specific remedy characteristics. Coulter's clinical obervations are splendidly correlated with those of our earlier masters (e.g., Kent, Hering, Boger); she then goes on to offer valuable contemporary examples of these observations, painting written images in far richer and more varied colors than previously available in our literature . Further, she employs frequent helpful references to repertory rubrics, providing in the process some of her own suggestions for repertory additions. The book is very well organized. Each chapter includes several sub-headings that, taken together, provide a useful summary of the salient characteristics of each remedy. Having astutely identified a theme of a remedy, Coulter then proceeds to artistically weave a tapestry of images and examples that portrays the many, varied expressions of that theme in daily life.

Topics are covered thoroughly. For example, when discussing Lachesis, all expressions of the Lachesis sexuality are portrayed. The heightened sexual drive and obsession with sexual matters of Lachesis are well-known; less familiar to many, however, are the results of Lachesis sexual repression: prudish disapproval of sexual expression, coupled with an exaggerated concern for the sexual mores of others, and the confusion of religion and sex.

In other remedies, Coulter also offers observations of the polarities of remedy characteristics. Two examples are: the effervescent, sparkling side of Phosphorus contrasting with the shadow side characterized by despondency, the indolence of Calcarea contrasting with industriousness. These polarities - the usual remedy characteristic and its polar opposite - are very important for homeopaths to recognize. Too little is known today of the various polarities that no doubt exist; thus, Coulter's contributions are quite valuable.

As Coulter acknowledges in the book, it was her intention to portray the less pathological characteristics of the remedies, and, indeed, she has done this admirably. Consequently, her book is best considered a supplemental materia medica of the mind. Homeopathic students should refer to other materia medicas, most particularly Kent's, to achieve an accurate understanding of the more pathological extremes of remedy psychology.

I can personally attest to the accuracy of one of Coulter's observations. After reading her account of the Sepia male in which she mentions the possibility of his developing an unexpected concern for domestic, household matters, I chanced to see a male patient suffering from asthma. During the interview he happened to mention just such a new interest in domestic duties. This isolated finding caused me to pursue Sepia as a possible remedy. On reflection, it seemed a reasonable choice, and indeed it was!

I could mention many other such intriguing observations, but would hate to deprive the interested reader of discovering them on his or her own. Let me summarize by saying that Portraits of Homeopathic Medicines is a valuable, entertaining, and brilliantly written addition to our homeopathic literature. While not sufficient of itself in detailing the full range of psychological pathology of each remedy, the observations provided of the less extreme personality conflicts of the remedies are very useful. This book is by far the most enjoyable materia medica I have read. It reads like a fascinating biography. Despite its length (the chapters average forty-plus pages), it is never laborious. I highly recommend it to all serious students and practitioners of homeopathy. No doubt, even those casually interested in homeopathy will find it of interest as well.

JAIH Vol. 80, Number 1 MARCH 1987