Baltimore Homeopathic Study Group

Boenninghausen Seminar Taught by Luc de Schepper

Kim Elia introduced Dr. Luc De Schepper. He said, "I volunteered to introduce Luc. I've been doing homeopathy for 18 years. I wish I knew Luc when I started learning homeopathy because I would have saved a lot of time. He's going to be coming out with a new book, Achieving and Maintaining the Similimum on July 25th."

Luc began by saying, "My goal today and tomorrow is to see that you can apply Boenninghausen's method in practice. I wish I knew this thirty years ago. It is extremely valuable, as you will see. I teach five different methods of repertorization. It's important to have a choice. This is probably the easiest method  and the only one I can teach in a weekend. Whatever method I teach, will only be the theory. You will need to follow it up with practice. You can get lucky and get the similimum without using any method of repertorization. But you want to increase the chances. The art of case management in homeopathy is the most important skill, but it most seldom taught. Even Kent asked why so many practitioners get the first prescription right and then get lost in the second prescription.

"The Boenninghausen method is the easy method, the short cut. Most times the short cut homeopaths use is palliation. Prescribing on the keynote is also not good. Knowing the whole materia medica is difficult Hahnemann approved of Boenninghausen's repertory and used it. What I have asked you to use is for this seminar is Boger's Repertory, which is not the same as Boenninghausen's Therapeutic Pocketbook."

"What kind of diseases can you use this method on? Some people think Boenninghausen's method is only good for acute diseases. When should you use an acute intercurrent remedy? Many homeopaths don't believe in them, they think they will disrupt a chronic case. Other homeopaths think a single remedy should work for both chronic and acute cases. That makes no sense. According to the Organon, the stronger disease suspends the older one (aphorism 38). When the acute is gone, the chronic condition comes back. Emotional problems can also suspend chronic diseases. If you apply the chronic remedy to the acute disease, it will be dissimilar to it. You will add symptoms of the chronic remedy and create a complex disease. You will add accessory symptoms. It's important to recognize complex diseases when treating patients. Kent said in Lecture 26 that it's important to distinguish between chronic and acute symptoms. "These two things must be separated." You'd be surprised how difficult it is to find acute remedies. Coughs are hard to treat. When there is a change in symptoms of the patient, you treat. Some homeopaths say they never treat acutes. I hope they come down with diarrhea when they are in India and then see what they do. But that doesn't mean you treat every little thing. If an acute is not treated properly there is the possibility of it creating a complex disease. Each can effect a different organ symptom. Complex diseases are often created by allopathic treatment. If you are lucky the acute will subside with no further problems even if it is not treated. This happens quite often."

Luc continued, "Another case for using Boenninghausen's method is a one sided disease. For example a lupus patient will have the threat of kidney failure. It is a one sided disease at that point. The whole disease picture is aimed at one organ. The vital force is overwhelmed. Another case is acute tuberculosis. If you treat it miasmatically, you will kill your patient. It's too much for the patient. This is one of the few cases where you don't need to take a miasmatic analysis. You will use Boenninghausen for very serious acute diseases like gangrene. This method is perfect. This woman had gangrene from a tick bite and she emailed me a picture of her foot from her hospital. I prescribed Lachesis 1M and  the foot got better. When someone presents with mainly a physical problem, Boenninghausen is useful. In a case like ADD you usually use another method. But sometimes I do a Boenninghausen analysis and I'm surprised how right it is. If starts as an acute and was never cured, you can use Boenninghausen's method. For example, a belladonna headache can stay on the physical level for many years."

Luc said, "There are different levels of suppression. If a disease is suppressed it moves from the skin and joints, to the internal organs, then the central nervous system. Then there are emotional symptoms like jealousy, forsaken feelings , anger, and so forth. At the deepest level of suppression the disease moves to the mind and will. The patient is suicidal, forgetful of recent events, and shows confusion. If the disease moves to an even deeper level the patient is forgetful of old events and has delusions. I had a patient who was treated allopathically for eczema and then became delusional after 'successful' treatment of the eczema. Another patient of mine was delusional. As she became better she showed emotional problems. So I changed the remedy. Then she got eczema around the ankles. I changed the remedy again. And after that she was cured. Fixing eczema and replacing it with asthma is a classic problem in allopathy.  I asked a mother whose son had seizures when the symptoms started. She said when his asthma got better. I told her I will cure his epilepsy and give him his asthma back, and then his eczema. Mental and emotional problems can also be treated by Boenninghausen's method. If someone with emotional problems comes in complaining of a headache, the remedy that Boenninghausen's method suggests will also cover the emotional problem."

Luc continued, "Boenninghausen's method is useful when patients make no connection between their physical and emotional symptoms. These are down to earth patients with no time to investigate their feelings. They are goal oriented and do not introspect. They want to keep a very tight control over their emotions. If they are anxious, it is about money. They also hoard things. If you analyze patients using Jungian types, then the thinking types are sulfur, aurum, lachesis, lycopodium, and china. According to Jung, thinking and feeling are opposed types and you can't be both. The feeling types are the silver remedies and phosphorous. When feeling people start thinking it manifests as delusions. The sulfur man marries the phosphorous woman and thinks he is in control but really isn't. The phosphorous wife complains her husband is insensitive. It's because her husband is not a feeling type. Bryonia peoples' greatest fear is poverty. It's almost a fixed idea. No other remedy has a greater fear. Anything they do is in relation to this fear. They are driven away from home in order to work. They won't come complaining of this fear, but instead of physical problems. A Boenninghausen analysis will find the proper remedy from the physical symptoms. Then you can think of the complementary remedy, such as natrum muriaticum or phosphorous. Sepia people don't reveal their emotional problems unless they are down and out and come in and cry. Instead they will complain about physical symptoms such as dizziness, fainting, lower back pains, and leucorrhea. If you ask about psychological symptoms they will feel insulted and shut down. So you treat them based on their physical symptoms. The Kali family are extremely down to earth. They won't tell you how they terrorize their families with rules. They do this because they are anxious. They are rigid, stiff people. Their symptoms will spill over into the physical level with stiff joints. So the kali carb will come to you with physical symptoms. Carbon people are on level two of the periodic table. This level includes lithium, beryllium, boron, carbon, nitrogen, oxygen, and fluorine. The pure carbon person makes a nuisance of themselves about everything. They complain about every little thing. They think they're going to die and sometimes you wish they would. This whole level has a problem with individuation. Lithium carb never will present with an emotional problem because they aren't aware of them. It is the only bold type remedy for hemiopia. They are half blind on the physical and the emotional level. They have to hang onto someone. The nitric acid patient is pissed, a pest, pessimistic, and never pleased. They are always engaged in a lawsuit, because they like to fight. A nitric acid patient of mine was driving past two people who were fighting and jumped out and joined the fight."

"Then the are patients with suppressed and repressed emotions. They are the natrums. They go through different stages. Singing and laughing all day long can be natrum muriaticum. They laugh immoderately. One patient of mine couldn't go to funerals because he would laugh. At first natrums have a need to connect. Then they go into the second phase when they get into a bad relationship. Then at the third phase they give up on relationships. They are afraid to be hurt. The pathology of natrum muriaticum is in the central nervous system because it can't sink deeper. There are many multiple sclerosis cases who need it. Their symptoms are paralysis and numbness. The remedy you will confuse with natrum muriaticum is platina. They also have relationship problems, but for different reasons. The platina patient will look for the perfect spouse. They are highly sexed but also very spiritual and this combination is hard to find. Other remedies are looking for sex only. The magnesiums also repressed. According to Kent magnesium carbonicum is 'the orphan of the materia medica'. Adopted children often need magnesium carbonicum. They are the most irritable patients in the materia medica. They fight for their life, because they feel this is dangerous world. They feel all alone. They dream they are lost in the forest. They are down to earth people. In contrast, magnesium muriaticum patients are twelve or thirteen when their parents divorce. They become hysterical. Magnesium carbonicum can't afford to be hysterical. Magnesium muriaticum has delusions and fixed ideas. Their dreams give them away."

"Hypochondriacal remedies like calcarea carbonicum, nitric acidum, arsenicum, argentum nitricum, and cannabis indica can be repertorized with the Boenninghausen method. Arsenicum and argentum nitricum are very similar remedies. They come with a litany of symptoms. They have many chief complaints.  You ask yourself which one do I focus on.  The first kind to focus on is permanent and stabilized symptoms. They have the same symptoms for twenty five years. The next is the most recently appearing symptoms. If a moderate to severe acute disease occurs you prescribe on its symptoms. For example, you may have a case with severe cough with gagging and constriction. In Kenya I treated the son of a doctor who had suffered from a cough for the past fourteen days, day and night. I can assure you that coughs are difficult to treat. Thank God he was a phosphorous and intelligent [so he could explain his symptoms]. It was an ipecac cough and I cured it in two doses. You also look at the concomitant symptoms. Literally it means 'going together with'. For example, a cough associated with total absence of thirst. Or you can prescribe ona change in the disposition and temperament.  After the acute disease resolves. Hahnemann says the chronic condition will return modified to some extent. So you need to retake the case. See if the previously indicated remedy is still needed. Ask when the patient returns if the symptom picture is unaltered. If it is, you don't need to take the case. A patient may come back and say I've never been well since I came down with a cold. It means there is an underlying miasmatic disease. Puberty or menopause can also wake up a miasm. A child who died from the whooping cough really died from the underlying miasmatic disease that was woken up. The other thing you should look at is the modalities. What makes it better or worse? Often these persist over time and the patient knows them well. But avoid treating allopathic drug symptoms! A patient of mine with severe arthritis got injections causing severe water retention. You don't prescribe on this. She lost fifteen pounds after stopping the injections."

Luc explained, "The Boger Boenninghausen Repertory enlarges on Boenninghausen's Therapeutic Pocketbook. Hahnemann's Materia Medica Pura is based on provings on himself [and his associates]. Boenninghausen noticed that it didn't contain details like sensations and modalities. I invite you to read Boenninghausen's Lesser Writings. It's great. It gives you a good idea about his practice. He changed remedies quickly, not because he alternated remedies, but because the symptom picture changed. He liked to use olfaction of remedies. For example, for trigeminal neuralgia olfaction works extremely quickly. Boenninghausen said that the conditions of amelioration and aggravation don't belong to a part of the body, they apply to the whole person. He was criticized for this because sometimes a remedy will have a modality for a region that differs from the modality for the rest of the person. For this reason Boger added particular modalities to his repertory. It almost becomes like Kent. But you shouldn't mix symptoms from the Boger Boenninghausen repertory with rubrics from Kent or Synthesis."

"The Boger Boenninghausen Repertory is based on aphorism 95 of the Organon. 'Chronic patients become so accustomed to prolonged suffering that they no longer pay much attention to their symptoms. They have nearly forgotten how health really feels. It hardly occurs to them that these less troublesome symptoms which are greater or lesser deviations from health are the key to choosing the remedy.' In the Boger Boenninghausen method mental and emotional changes are the last to be taken into account. With the Kentian method, the better psychologist you are, the better homeopath you are. In the Boger Boenninghausen method when you have narrowed it down to one or two remedies you use the mental and emotional symptoms to differentiate. In the Boger Boenninghausen repertory, the section on mental and emotional symptoms is much smaller than in Kent."

Luc said, "When repertorizing the chief complaint comes first. In other methods of case analysis, you don't use the chief complaint. If there is more than one complaint, ask which is worst. The modalities of the chief complaint are the most important. It is such a decisive factor that if you have a remedy with the concomitants, sensations, and dreams of the patient but not the modality, you must reject it. A remedy the ranks very high in the modalities is the one you choose. If there is a recognizable never well since or etiology it comes first among the modalities. Concomitant symptoms are symptoms that go together with the chief complaint. The less often it typically goes with the complaint, the more important it is. For example, diarrhea with headache is a concomitant. The concomitant also has modalities. For example, asthma with increased urination. If there is an aggravation of the concomitant that is the same as of the chief complaint, it has increased value. For example, eczema on the head and white stools where both are aggravated by milk. This is extremely important. I have one more thing to say about mental and emotional symptoms. Sometimes the patient unconsciously projects something onto the therapist. It's especially problematic if it's something in the unconscious of the therapist. It's dangerous because then we can put too much emphasis on these symptoms."

Luc explained the structure of the repertory. "The first part of the Boger Boenninghausen repertory is a materia medica. It's okay, but you won't need it. The repertory starts with the mind section on page 191. It's limited, but has good information. You go here for never well since symptoms like jealousy. When using the Boger Boenninghausen Repertory we like big rubrics. The small subrubrics are used for differentiating remedies. There are four grades. Black type is three. Large caps are a four. Italics are a two and plain type is a one. Four means a remedy is found in most of the provers and clinically confirmed. One means the rubric is only clinical. Page 203 has the important rubric 'grief, sorrow, and care'. Page 210 has Love, unfortunate, a 'never well since' rubric. Page 213 has 'persecuted feels' (paranoia). Page 221 is 'vexation', another never well since symptom. On page 222 are the time modalities and on page 223 is the start of the aggravations. The particular aggravations were added by Boger. On page 230 there is a cross reference. 'Head, internal' means headaches. First Boger gives the location. Then he follows with sides (left and right). On page 281 there are the conditions of aggravation and amelioration. Page 302 is hair. At the beginning of each section Boger gives abbreviations for each of the principal symptoms. Food cravings are under appetite, on page 472.  The first sticker should go on page 678, concomitants before menses. Put the next sticker at page 805, the start of the extremities section."

"Page 885 has the rubric 'gait', which is useful. Page 881 has sensations and complaints in general. This should get a sticker and is an important section. It contains pathological symptoms, like apoplexy. 'Carphology' means picking at the clothes. Page 890 has convulsive movements, spasms. Page 892 has direction of pain, which is not in the other repertories. It should get a sticker. Page 902 has 'Infants, affections of' along with subrubrics. It deserves a sticker. Infants means below two years old. On page 907 you have 'lassitude, physical', which contains remedies for fatigue. On page 919 is the rubric, side, symptoms on one On page 935 is the rubric 'weakness, exhaustion, prostration, infirmity'. On page 1020 you have 'chill and fever'. The most important section starts on page 1105, and is deserving a sticker. It is conditions of aggravation and amelioration in general. It is the very first section you go to when repertorizing a case. Page 1103 has time modalities. It takes precedence over the modalities in the various sections. Page 1116 is totally hidden and deserves a sticker. 'Emotions aggravate'. It is the same as stress. Page 1119 has the food and drink aggravations. Page 1126 has 'lifting and overlifting aggravates'. Page 1154 has the concordances. When you are successful with a remedy and you need another remedy to complete the case, you look at this section. Remedy Relationships by by Thomas Blasig and Peter Vint is useful as well. Page 1132 has a rubric not in Kent: 'aggravations by phases of the moon'. Page 358 has various causes of deafness."

Luc then told us, "Here are the tips in using Boenninghausen's method":

"The first case is a case of convulsions reported in the Journal of Homeopathic medicine and worked out with Kent's Repertory. I also wanted to see if Boenninghausen gave the same result."

His convulsions started with an aura always in the left extremity and presented as shocks or thrusts. His face became dark and dusky. It was always worse during sleep, and at new moon and triggered by fright. His convulsions started at the feet and continued upwards to the hands and arms. He was a very loquacious individual otherwise.

"How we are going to work it.? Fill out the sheet. with the rubrics:"

Chief Complaint
Convulsions

Modalities
1: Triggered by fright, page 1116
2: Worse during sleep, page 1141
3: Worse at new moon, page 1132

Concomitant Symptoms with their modalities
Dark, dusky face, page 394

Sensation
4: Shocks or thrusts, page 930

Locality
5: Start at feet and continue upwards to hands, page 892
6: Aura, extremities in, page 883
7: Symptoms all on left side, page 921

Pathology
8: Spasms, convulsions in general, page 921

M/E changes
9: Loquacious, page 210

The first rubric we use the fours and threes, since is is larger than an inch. Go to the first rubric and write down the fours first. Then write down the threes. Take the second rubric.. Only consider remedies in the third and fourth degrees, all others are eliminated. Score the remedies you have now first. Then eliminate any remedy that doesn't add to seven. Score the remaining remedies for the remaining rubrics. The highest scoring remedies are cuprum, belladonna, and silica. Belladonna doesn't score high in the modalities, so it is eliminated.

Aco 4 3 - - 3 2 2 2 2 18/7
Ign 4 3 - - 1 4 1 3 - 16/6
Op 4 3 - 2 - - - 3 2 14/5
Pul 4 4 - - 1 2 1 3 - 15/6
Bel 3 4 - - 2 4 1 4 3 21/7
Sil 3 4 4 - 1 4 - - - 16/5
Cup 3 2 3 2 2 1 2 4 4 23/9
Caus 3 2 3 - 2 - 1 - - 11/5

Luc said, "Most likely cuprum is the acute and silica is the chronic remedy. I call cuprum, argentum, and aurum the three metals of the Olympic games. Only one person can get the gold. To know the essence of a remedy you go to the delusions. Cuprum has the delusion they are a general, a sense of haughtiness. But he has only reached an ordinary position. But they lack a sense of imagination, they are prosaic. Allopathic doctors are cuprum, homeopathic doctors are silver. But silver has a lot of illusions. A lot of expectations are placed on homeopaths. A gold is a person who gives and the person he gives to also becomes a giver. The cuprum is a cramped individual because they hang onto what they have very strongly."

Q: What happens if you give the chronic remedy when an acute is required?

A: During an acute episode you need to give the acute, otherwise you risk getting a complex disease. You treat with the acute first and follow up with the chronic. If attacks occur again, I give the acute as an intercurrent.

Q: How should you evaluate the time symptoms are worse and extending to?

A: Time symptoms are worse are scored as modalities and extending to are scored as locations.

"If you only have three or fewer modalities, you should take the 4, 3, and 2 so that you don't lose the remedy. If you don't have a lot of rubrics, you can take all the rubrics that seem to apply. With Boenninghausen's method even when you get the wrong remedy, it will be a close similimum.  In this case 7 of 10 symptoms will disappear and 2 or 3 new symptoms will be added. The's are the symptoms of the remedy. You can bring the case to a cure with the 5th or 6th Organon methods."

"Use the fifth edition posology for 100% of your acute cases. For a normal sensitive person without skin condition, take a 4 oz bottle and put one pellet of the 6C potency. Put 20 drops of alcohol. Succuss it 8 times, then take one teaspoon, put it in four ounce cup, stir, take one spoonful. Hear from the patient the next day. Look for a great response (striking response) If you get that, don't repeat. Otherwise repeat every day or every other day while the patient is improving. Succuss each dose. The biggest mistake is to give the wrong potency and too frequently."

Luc de Schepper
2004 NCH Summer School