Hello all,

The question of stages and degrees is an interesting area of study so I thought I would comment on the subject. Understanding the 4 stages of pathology offers insights into the nature the disease and its corresponding remedies. This includes functional and organic pathological states as well as stages and degrees of pathology. A function disorder only incudes changes in the functions of system, organs and tissues. These changes produce dynamic symptoms but as of yet there is no organic pathology. This is associated with the earlier stages of pathology.

An pathological state includes organic tissue changes in systems, organs and tissues. This is considered part of the later stages of disease. These two major states also have fours stages that included different degrees. These types complaints cannot be approach in the same manner. The nature, degree and stage of the disease have relevance to the choice of remedy (acute, chronic, anti-miasmic, intercurrent, alternation, etc), the size of the dose (small, medium. large), the delivery system (dry, liquid, oral, olfaction), the potency system (C or LM), the potency degree (low, medium, high) and the repetition (single dose, split-dose, timing of the intervals) The four stages of physical pathology are:

1. Irritation and inflammation
2. Infiltration, induration and swelling
3. Suppuration, scarification, bleeding
4. Ulceration and necrosis

These four stages are found in both acute and chronic diseases. For example, in the first stage of a acute cold, flu and other infections there is usually redness, heat, irritation, and inflammation of mucus tissue. In the second stage the is usually swelling and a clear or white discharge. In the third stage there is sacrifice of white cells and the production of pus at the inflammatory barricade with mucus discharges of yellow to yellow green color sometimes tinged with blood. In the forth stage their is usually sores and ulceration of the mucus membranes with the discharge of foul, yellow-green to brownish -to to blackish mucus.

This signs show the stages and degrees of the pathology and come with corresponding concomitant systemic symptoms. For example, the first stage may have prodromal chill and malaise then remittent fever and irritability; the second continuous fever, sweats, weakness, moodiness, etc.; the third chill, heat, sweat, hectic fever with high spikes, restlessness, etc; and the fourth with high fever, coldness, depression and collapse. These are only illustrative ideas of a process rather than fixed examples witnessed in each and every case.

The same pattern is noted in chronic diseases. They also start with irritation and inflammation and progress with infiltration and indurations,that tend to suppurate, bleed and scar and end in ulceration and necrosis. For example, the diseased blood vessels first become inflamed and irritated; then thickened and occluded; then hemorrhagic and scared; then degenerative and necrotic; and THEN .the patient is dead!

The development of the miasms also has four stages and differing degrees of pathology. These are the prodrome period, the primary symptoms, the latent states and secondary or tertiary stage..Each of these stages has unique symptoms that progress from early functional to early pathological to moderate pathological to advanced pathological states. The road to cure is the reversal of the advanced pathology to moderate pathology to early pathology to functional stages to the state of health. This is part of Hahnemann's direction of cure commonly called "Hering's laws".

The late, great Dr, Dhawlae MD pointed out many years ago that the four stages of pathology correspond to the four major characteristics of miasms, psora, sycosis, pseudopsora TB and syphilis. Psora is exemplified by irritation and inflammation; Sycosis by induration, infiltration, and over growth; Pseudospora TB by suppuration, scarification, and bleeding; and syphilis by ulceration and necrosis. The non venereal miasms like psora and pseudopsora TB involve heat, inflammation, suppuration, bleeding, scarification, etc., while the venereal diseases like sycosis and syphilis are more prone to infiltration, induration, swelling, over growth, degeneration, ulceration and necrosis. This show the different in infections spread by skin contact the droplets and those passed by sexual intercourse.

As the miasms progress from 1 to 4 they also tend to include some of the symptoms of the previous miasms. For example, pseudopsora is an intensification of some of the symptoms of the psora. Syphilis is an intensification of some of the symptoms of sycosis. An illustration of this is that pseduospora starts with inflammation similar to psora but then moves to quickly to easy suppuration, bleeding and scaring and systemic syphilis first starts with an over growth called gumma which is similar to sycosis but it quickly breaks down into necrosis and ulcerations. HIV/AIDS has all of these symptoms in various degrees and aids in the proliferation of psora and TB. There are many such relationships.

Chronic remedies and anti-miasmic medicines also have different stages and degrees of disease that reflect these four areas. Some remedies like Aconite reflect mostly in the first phase of inflammation and acute diseases while others like Mercury have all stages in differing degrees but has very marked ulceration and necrosis. Some remedies are more adapted to a single physical type of constitution, temperament and miasma. Others suit several different types of patients due to their broad action over human constitutions, chronic diseases and complex miasms. Nevertheless, each remedy has a characteristic pattern in which its own stages, degrees, adaptability and anti-miasmic actions are predominate.

The four stages of pathology also show up on the psychological level. This is also a very interesting and gratifying area of study. The four major stages are:

1. This is the early functional stage. This involves of coping mechanisms, compensation, and other methods of control used to repress complexes while maintaining the appearance of normality.
2. This is the late functional and early pathological stages. This involves the breakdown of coping mechanisms and the temporary or intermittent loss of control over the complexes.
2. This is the establishment of the full pathological stage with neurotic states. This is where the complexes are exerting control over the patient.
4. This is the advanced pathological stags with psychotic states. This is when the complexes have complete control over the patient.

Persons in the first stage are controlling their emotions through coping mechanisms and compensation. For the most part they appear "normal" but it is a contrived state in which the persona puts on a good face but the shadow will react by showing opposite states sooner or later. A person with repressed anger will speak very softly in an effort to control their emotions but there is stiff masking of the facial expressions and corresponding body postures. It is impossible to keep up this front forever because there is a need for problem solving. There will be moment of uncharacteristic moods accompanied by "Freudian slips" combined with automatic actions, rigid body posturing, and obvious inner tensions. The anger will leak out and others will wonder "what has gotten into them?". It is not what got into them. It is what is coming out of them. This will be noticed by those close to the person as they are often part of the triggering mechanism or a convenient target of the "kicking the dog" syndrome . This corresponds to the state of inflammation or irritation.

The second states begins when the coping mechanisms begin to break down and the emotions can not longer be compensated or totally repressed. The anger will now be expressed and the symbolic powers of the word association, tone and setting will now begin to take over. Certain situations will trigger inappropriate actions in which the patient appears to be overreacting to others. The energy of the undigested archetypes and the complexes in the personal unconscious begin to activate and take control of the persona and the mask begins to fall off. At this time the patient alternates between control and coping and loss of control and troubling moods. The signs of mood affective disorders like depression and mood swings begin to show themselves. The patient is obviously trouble but as of yet they are for the most part still in control of their emotions. This corresponds to the stage of infiltration or induration.

In the third stage the patient begins to take on neurotic behavior which is noticed by the patient and those around them. This is when anxiety, hysterical, obsessive compulsive and hypochondriacal neuroses and paranoid disorders begin to take shape. The undigested archetypes and complexes in the personal unconscious now control the action of the patient and the coping mechanisms no longer work. Mood affective disorders like simple depression takes on the signs of clinical depression and mood swings become manic depressive bipolar states. The patient begins to suffer all the classical symptom of full melancholia. The patient life becomes a drama of symbolic actions and the power of the undigested archetypes rule that person's actions. Mood, setting and situations trigger stronger reactions that the patient cannot control and they begin to avoid certain persons, places and things. Paranoid disorders with fear and phobias increase. There may be fits of violence toward self and others and suicidal behavior may be noted. This is corresponds to the stage of suppuration and scarification.

The fourth stage the patient begins to lose contact with reality and their delusions, projections and hallucinations are taken as the sole reality. They no longer see their own behavior as inharmonious and lose self awareness of their actions. They believe that their actions and thoughts are rational and the actions of others are irrational and perverse. At this point, the energy of the undigested archetypes takes the patient over completely and they act out their complexes on the stage of the delusions and believe that this is the real world. Now the neurosis gives way to psychosis and schizophrenia and the patient is considered truly insane. This corresponds to the stage of ulceration and necrosis.

Many times the concomitant physical symptom will correspond the mental pathology. The body becomes inflamed, infiltrated, suppurated and necrotic as the psyche becomes more irritated, indurated, scared and ulcerated. The systems, organs and tissues become targets for related psychosomatic disorders and conversions diseases. The psyche and soma become mirror images and the brain will take on chemical imbalances that affect the nervous system and endocrine glands. This is very common in mood affective disorders, neuroses, and paranoid diseases.

In some cases, however, the former physical disorders are transferred to the psyche and the body will remain relatively normal. This is occasionally witnessed in psychosis and schizophrenia. The patient may appear strong and healthy although they are seriously compromised mentally. Mental diseases that start with organic degenerations often have more serious physical symptoms than those that start at the level of psychic then target the body. The physical symptoms that original in the psyche are often transferred back and forth depending on the situation. There are many potential manifestations of these states so each situation must be individualized according to its causes, symptoms and attendant circumstances.

If one analysis the remedy with these four stages in mind it become very easy to see the layers and strata within the proving symptoms and their clinical confirmations. Our remedies are extremely multi-faceted and multi-polar. This includes both the physical and psychological symptoms. That is why not one single essence or theme can complex cover the entire Gestalt pattern of a homeopathic remedy. They have phase in which their symptoms are the opposite of other phases. This makes it impossible to pigeon hole the remedies into one signal keynote. Trying to categorized remedies in simple categories like hot or cold is impossible. There are few remedies that are completely hot or cold. One can call Sulphur a "hot remedy" but it also is a 3 for lack of vital heat! This multifaceted nature is true with most of the deep acting chronic remedies. Looking at the remedies in stages helps to clarify why a remedy is hot at one stage, has mixed thermals at another, and is cold in the end.

Stages and degrees also explains how to use symptoms that might appear "healthy" like cheerfulness. In the first stage cheerfulness is often a coping mechanism to cover up sadness by compensations that are not natural. When someone is too cheerful bordering on hysterical laughter this is not a healthy state. One can almost here them crying in the tone of their laughter! When so-called healthy states are presented are part of persona mask it is a form of compensation not healthy conditions. Excessive of normal beneficial emotions are also diseases. Pride is good but the pride of Platina is pathological because it involves ego-inflation and delusions of being royal, precious and better than all others.

Stages and degrees also shows one how contradictory symptoms fall into place. For example, a keynote of Natrum Muriaticum is said to be sadness, depression, and a closed grief stricken state where the patient is unable to cry, etc. This, however, only relates to Natrum Muriaticum in the 3rd stage of mental pathology. In the first stage Natrum Muriaticum is cheerful, open, romantic, hopeful and cries fairly easily. In the second stage they suffer mood swings in which they are sometimes cheerful and sometimes sad and sometimes they laugh and sometimes they cry, etc. In the third stage they become depressed, emotionally rigid, hopeless, suicidal and never cry or show much emotion. In the fourth stage their complexes take over and they act out there undigested archetypes and express their complexes in a manner that is complete psychotic. These could manifest as an extreme form of any of the symptoms of the previous stages. They now become what people call insane because they are completely out of touch with reality.

This same analysis in stages and degrees can be applied to diseases, patients and remedies. Nevertheless, one should realize that any system of analysis can only function relative to the time and circumstances to which it is applied and has it exceptions. The observer is always part of the observation and should not think that reality is easily place in neat, little boxes. I hope this helps elucidate the stages and degrees of illness as well as the multifaceted nature of our remedies.

Similia Minimus
Sincerely, David Little

---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000

Hello,

Thanks for this posting. I was trying to understand stages recently.

In short, can we categorize these stages in:-

Inflamations

Indurations

Supprations

Degenerations

__________________
Homeopathic & Biochemic system existed because Drs.Hahnemann & Schuessler thought differently.
Successful people don't do different things, they do things differently..S.Kh.

Quote:

Originally Posted by David The late, great Dr, Dhawlae MD pointed out many years ago that the four stages of pathology correspond to the four major characteristics of miasms, psora, sycosis, pseudopsora TB and syphilis. Psora is exemplified by irritation and inflammation; Sycosis by induration, infiltration, and over growth; Pseudospora TB by suppuration, scarification, and bleeding; and syphilis by ulceration and necrosis.

Hello David,

Thanks for this valuable contribution.
Isn't this close to what Vijayakar is teaching?
Vijayakar is regarding the relations of the miasm as a part of the timeline and a part of Herings rules. Everybody will start with a acute/psoric reaction, but i.e. someone with a syphylic constitution will progess rapidly to a syphilic state.

Quote:

Originally Posted by David If one analysis the remedy with these four stages in mind it become very easy to see the layers and strata within the proving symptoms and their clinical confirmations. Our remedies are extremely multi-faceted and multi-polar. This includes both the physical and psychological symptoms. That is why not one single essence or theme can complex cover the entire Gestalt pattern of a homeopathic remedy. They have phase in which their symptoms are the opposite of other phases. This makes it impossible to pigeon hole the remedies into one signal keynote.

Isn't this depending how deep you look?
When we look at the secondary expressions, this is correct, but when we look at the primary core of the disease this is not true. All expression even though sometimes opposites, express the same archetypical issue. The secondary expression are depending of the miasms involved, the circumstances, stage of disease, constitution, age, education , etc. But the underlying susceptibility will remain the same, on this level the remedies are not multi-faceted, but represent their true fixed essence?

Just some thoughts,

Kind regards,
Piet

David,

Thank you very much for posting this message. I am very interested in the outline of the four stages of pathology on the psychological level. Is this an outline that you developed yourself? Please tell me how I can learn more about using this understanding of remedies in treating psychological problems.

Thank you,

Karen

Dear Karen,

Nothing I do is completely developed by myself as it is based on the work of several generations of the homeopaths. If was for not Hahnemann and the lineage of practitioners, I would know nothing. The arrangement of the four degrees of psychological symptoms is a schemata I made in line with what I have observed in the clinic. One cannot treat a patient's psyche separate from the soma anymore than on can treat the soma as something separate from the psyche. As a homeopath we work with the essential nature of the totality of the symptoms of the body and soul as this is the only true presentation of the Gestalt of the disease. Nevertheless, it is important for homeopaths to understand the Maps of Consciousness so that we understand the psychological aspects of patients and remedies more completely. Therefore, a study of psychology is very important to the homeopath.

.. Please understand that this fourfold analysis does not cover all the possible symptoms of our remedies and how they interlock with each other. It is just a way of viewing patients and symptoms that is not a waste of time and often very useful. One must study the nature of the disease state in terms of stages and degrees to find the correct remedy, dose, potency and case management strategy. It also helps us understand the direction of cure. For example, many patients will work there way back through the stages 4, 3, 2, 1.

A 4th stage patient believes that their delusions are real. The always think nothing is wrong with them and project their inner complexes on others. This is the essential nature of a psychotic state. When the patient realizes that their is something wrong with them and the way they are perceiving reality the move to the 3rd stage. Now they being to struggle with their mood affective disorders, neurosis, phobias, etc. When they get partial control over their neurotic states they move to the second stage where sometimes they are in control and sometimes they are not but they know what is happening to them and the path toward cure. Now they begin to function better and the complexes no longer completely control their lives.

When they are able to cope and compensate for the remaining complexes they appear as healthy as anyone else but the healing it not done. Just coping and compensating is not a true state of health. This is not a state of naturalness and spontaneity. Once the individual is able to deal with the causes that underlie their moods, feeling and actions they are able to remove them. Once problem solving moves to the state of resolution they not longer need to use coping mechanisms and compensation to function. Their moods and feeling will still have their highs and lows as this is part of human nature but they will be expressed naturally in a healthy manner in which they stay true to themselves while adapting to society as needed. This is the psychological equivalent of the physiological direction of cure.

As Hahnemann said, all diseases are "initially" a derangement of the vital force. This functional derangement moves through 4 stages until it become extremely pathological. On the physical level this is called organic pathology while oh the mental level it is called psychopathology. The return to health is the path back through the time-line by which the disease developed and the release of unresolved causations. The homeopathic remedy makes this process much, much easier because it assist the patient in the process almost effortlessly. Nevertheless, psychological counseling and problem solving is, as Hahnemann called it, food for the soul and a great aid. Hahnemann was as much a psychologist, philosopher and counselor as a prescriber of remedies. We should seek to be likewise.

I will try in the next days to put up a portrait of remedies based on stages and degrees.

Sincerely, David Little

David wrote;

Quote:

Not all Natrum Muriaticum patients demonstrate the same archetypal complexes no matter how deep one looks. No two Natrum mur patients shows the exact same constitution, temperament, causes, conditioning, signs and symptoms, etc. To bring Natrum mur down to a single keynote that covers every patient every time under every circumstance is in line with clinical reality. We choose remedies by the essential nature of the totality of the symptoms for this very reason. No one symptom is complete in itself by itself. This makes it impossible to pigeon hole our deep acting remedies into one signal keynote! That is my clinical opinion.

Quote:

Yes, opposites states may express the same archetype. Complementary opposite and functional polarities are part of nature.

Hello David,

You seem to miss my point here.
What you're saying is refering to the patient, not to the remedy. In one case the prescription is more close to the center, then in another case. It is not that opposites states of the same remedy MAY express the same archetype, they ALWAYS do. All I'm saying that opposite or different states of the same remedy have one level in common.

The essence of a remedy is not the same as the expression of a patient, but where the expression comes from. Every mineral, plant, animal, human is created with its unique pattern and meaning. Our remedies, derived from those kingdoms, represent this essence. This doesn't mean we are able to catch this in one word, I never said that, but it still is a universal transcendental pattern. When we prescribe the simillimum for a patient, our remedy must basically acts on this level, not on the symptoms, which are only expressions of this deeper level. When we prescribe for different/ opposite Natrum Muriaticum patients, our pills still comes from the same vial (source)?


Kind regards, Piet

Quote:

Originally Posted by David I will try in the next days to put up a portrait of remedies based on stages and degrees.

I look forward to this!!!

One "stage" issue I've been intrigued with, is recognizing early stages of some of the "deep" remedies, such as syphilinum, lyssin, or any of the others that are first thought of for dramatic sorts of pathology.

And any others!
Thanks so much, as always!

Shannon

When same remedy shows symptoms of different miasms, how it can be prescribed? Is it to be decieded in different potencies i.e. lower potency for earlier stages & higher for later stages?

In this respect it may be useful to understand it:-inflammatory/degenerative stages of any disease & action of any chemical.

Ca, Mg, Cu, Cr: Inflamatoty in low amount(may mean defficiency) and degenerative in high amounts.

K, Fe, Mn, Zn : Degenerative in low amount( may mean deficiency) and inflamatory in high amounts.

This site may be useful.

http://www.acu-cell.com/dis-ost.html

__________________
Homeopathic & Biochemic system existed because Drs.Hahnemann & Schuessler thought differently.
Successful people don't do different things, they do things differently..S.Kh.

Hi Piet,
I"m sorry I ahven't been following this thread closely as I"m jsut back from a holiday.
But I have written an artile in the May issue of the hapthy ezine and will post the link sometime today as soon as it is out.
I have outlined the basis of these stages as explained by the Dhawle's symposium which is what I was also taught in medical college.

Yes it is quite similar to what Vijaykar talks about with a few points of difference. Vijaykar described this process based on (genetic) Embyrological development, which I think is a brilliant perception. This will be my next article in June Ezine (and I"d be happy for your comments on both) where I will explain VIjaykar's perception and parallel it with the ICR Symposium's perception of Disease Evolution.

Please do read these series of articles (as I post the links) and I"d be happy for feedback.
thanks,
dr. leela
www.homeopathy2health.com

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http://www.homeopathy2health.com

Hi Peit, I meant to say below, I'm writing a "series of articles on MIASMS" in the hpathy ezine (April issue onwards) and I'd be glad for your (and anyone elses) interest/comments.
thanks,
dr. leela

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http://www.homeopathy2health.com