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“Things which
matter most, must never be
at the mercy of things which matter least.” -Goethe
Introduction
Multi-dimensional
aspects of a human medicine i.e. homoeopathy, involve
utilization of homoeopathic remedies on the basis of Similia. As
the collective and selective approach has to be implemented in
an individual instance, keeping at the core the tenet of
individualization, homoeopathy envisages a lot of avenues - the
prescribing methodologies. It is therefore imperative for a
physician to perceive them completely before applying them.
Out of several
methods of finding the similimum, the Keynote system of
prescribing has assumed its own place in Homoeopathic practice.
It has won both, laurels and invited failures. A thorough
understanding of its base and surroundings will help utilize
this wonderful system in a better way.
Meaning
A.
THE WORD “KEY” has several meanings. Relevant to the
Homoeopathic theme are the following:
-
An implement
designed to open a lock
-
Any means of
control or possession
-
An essential
ingredient or requisite
-
An explanation of
a set of symbols or abbreviations
-
A set of answers
to a test or puzzle
-
Anything that
serves to explain or interpret
7. In (or out of)
key: In (or out of) tune with other factors
-
To bring into tune
or harmony; coordinate.
-
THE WORD “KEYNOTE”
-
Prime or crucial
element
-
An underlying or
prevailing tone, spirit or idea.
3. A
significant word or quality.
Based on these
meanings, selection of the drug is based on a prime or
crucial element available in the data of the case. That
crucial element includes the core, the nucleus or the essence of
the case and it will unlock it.
The data elicited
during case taking in its raw form is a sort of pot pourri
of various incongruous components or symptoms. The data will
have to be re-organized in a logical sequence to refine the data
so as to be useful for prescribing. The nucleus of the case
should be the main coordinator around which the rest of the data
is attached.
C.
THE WHOLE AND ITS
PARTS
Homoeopathy
propounds the concept of Totality. To perceive the totality, one
requires the vision of wholeness of the case. This is not merely
a quantitative approach. We have to define ‘quality’ in the
data. The problem is that we are swayed by the parts very
easily. If some parts are influencing, we hold on to them. These
could be dominant factors but not essentially crucial factors.
Dominant factors can be subjective and hence these could lead to
wrong or inadequate perception. The crucial factors, on the
other hand, are related to hard facts and hence significant and
without them you can’t go for a synthetic view.
When we consider
totality, there is one ‘organizing principle’ structured within
it. This principle binds all components together; it defines the
interrelations present in the data. We are able to perceive
clearly, then, all the attributes of the data, the cause-effect
relationship and the phenomenon. The whole can’t be without
parts, but whole is not merely parts together. The vision of
wholeness makes every part, every component alive! We are able
to see the universality and the commonality that exist in
various parts and beyond these parts there is something
subtle, something imperceptible that can’t be put in words.
It is
through the process of ego loss that one can achieve the
perception of wholeness. This is a very intricate problem of
human beings. How one can go for ego loss? I think that the
‘unprejudiced observer’ as the demand of Hahnemann has basically
to deal with ego loss. In ego loss, we do not add anything of
our own. We are just passively active spectators trying to dig
out the expressions, trying to look at the expressions through
synthesis, and trying to develop a portrait.
-
THE WORD ‘SYSTEM’
It is used in
many contexts, basically denotes “a whole composed of related
parts.”
This definition,
however, raises many questions:
1. Can something be
regarded more or less a whole or as a whole for some purposes
but not for others?
2. Can a whole be
also part of another whole or even of several other wholes?
Regarding relation
between whole and its parts, can we debate whether -
3. Could a ‘whole’
be more than the sum of its ‘parts’ and if so how?
4. Is it apparent
that every whole must necessarily be both more and less than the
sum of its parts? It is less because its parts are constrained
by being organized. This then, relates wholeness with
organization. The whole has to be so organized that it is able
to act as a whole on its surround. For it is composed of parts,
which may or may not be willing and able to combine in joint
action, to act “as a whole.” The parts lose their quality in
their unorganized state. To cite an example, the constituents of
a dead body are free to combine in other forms, once the
discipline of the living organism is relaxed. But they are also
more than the sum, because when organized they can do what they
could not do alone or as an unorganized
aggregate.
The prime requisite
hence is to make the data ‘organized’; bringing into play
complex, artistic part of Homoeopathy.
E.
Ultimately, the system consists of relationships. Parts /
components / objects / entities support these relationships; but
one has to understand that relationships are basic than the
entities. Rather there are entities in the system to be related.
Are they elusive to a physician?
Attaching labels to
‘entities’ and thus exaggerating them may pose a problem. It is
important to draw a distinction between the (internal)
relations, which enable any assembly to sustain its form and
those, which enable it to acts a whole on its surround.
SYNTHESIS AND DESIGN
Synthesis, however, goes beyond mere assembly, for the parts may
be integrated with each other to make a ‘functioning’ whole.
“Human synthesis in human design for a human purpose” is the
very basis of Homoeopathic science. Design and synthesis involve
doing something or making something happen. At the end of which
something is produced which was not there at the beginning.
Synthesis and design overlap in this matter. There has to be a
desired purpose, and if the matter is dealt with thoroughly
and logically with reasoning faculty, the purpose is served.
PATTERNS
Most of our thinking
is concerned with fitting things into the patterns, which we
create and continue to use. Fitting wrong things into right
patterns or right things into wrong patterns result in failures.
As a matter of fact, if we have perfect fit between what we want
and what we get, we do not bother about priorities. The
priorities are obviously included in the perfect fit. However,
it is worthwhile to check out the priorities, as the human mind
is easily carried away by the temptation. In the other words,
once perception has triggered emotion then emotion leads to
perception.
Perception is the
trickiest and the most fascinating aspect of mind. The brain
acts as a superb pattern-making system, which allows experience
to organize itself into patterns. Once the patterns are formed
they direct attention and organize the perception of the
present. Awareness of the rigidity of the pattern and the
perception is essential especially to a Homoeopathic physician
in view of the need of flexibility. Or we can become trapped by
our dexterity!
STRUCTURE
Whether the
structure is making things more difficult than they need be?
Whether the fault lies with the structure? If the structure is
evolved with reference to one part rather than the whole, the
operating thrust of different parts of the structure will not be
aligned. To be truly effective the structure needs to be
designed to cope with a wide range of data. It should be
flexible, not in ability to change but in being broad enough to
channel different types of data in the required direction. After
all, one designs the structure for success. Needless to say that
for a Homoeopathic physician, total design is much more
satisfying than tinkering.
EXTRACT -
REDUCTIONISM VS TOTALITARIAN APPROACH
A large amount of
our thinking and information – exploration is concerned with
linking things together. We come across isolated pieces of
information and link them to already existing data in the brain.
To link things, we have to act on the information, rather than
wait for the information to act on us. Significance is by no
means obvious. It has to be ‘squeezed’ out of isolated items.
The ‘squeezing’ out
of only isolated components is not the keynote system of
prescribing; the squeezing has to be in the form of extract
which has to be gleaned through the totality. Extract is not
like picking a brick out of a wall but of creating the shape of
a brick in a concrete wall. Extraction is thus pattern
recognition but with the ability to cut across interfering
patterns.
The ability to
extract is rare and it is here that the problems of a
Homoeopathic physician are maximum - to pick out the important
keys from the flak. He has to think a priori, a posteriori and
in concreto.
CONCLUSION
The keynote system
of prescribing is a skillful art. To reduce this wonderful
methodology to a mere workout of the manifestations (and not of
the state) is an injustice. The substance that this system
carries, is lost if we approach the data from the reductionist
point of view.
With right analysis
and synthesis, a Homoeopathic physician will be able to process
the data and derive the extract. In the course of analytical
activity, the mind advances from the complex to the simple, from
the fortuitous to the necessary, from multiformity to identity
and unity. The purpose of analysis is cognition, breaking-down
of the parts to basic elements of a complex whole. Whereas
Synthesis is the process of uniting into a single whole, parts,
properties and relations isolated by means of analysis. Going
from the identical, the essential, to the different and varied,
synthesis combines the common and the individual, unity and
variety, into a concrete living whole. Synthesis complements
analysis and is in indissoluble unity with it.
Reductionism is
favored out of favoritism, temptation, with a pecuniary accent
and involves no brain-fag. But it invites failures and poses a
problem as to the assessment of ‘movement’ that occurs after the
administration of the remedy. The keynote system affects the
follow-up in a negative way, creates the confusion as to the
next prescription and creates a zig-zag path, unlikely to reach
Hahnemannian cure, if vision used is narrow.
Keynote through
totality is the need, and is the right path.
“We are, what we repeatedly
do. Excellence, then, is not an act, but a habit”
wrote Aristotle. Each physician has to introspect where he
stands. |
