The Five Level Diagram To help visualize this concept I use a diagram with five levels.

Its probable that a person has more than five subtle bodies but for homeopathic purposes, I think we can limit ourselves to five and prescribe on that vital level, or the disturbed Dynamis as Hahnemann instructed. Besides being in line with Hahnemanns stipulation, an advantage of this Five Level Diagram is that it shows that homeopathy is not an energy medicine as such. Of course a disturbance on Level 5 will express itself on Level 2 but we would not consider Level 2 the source or cause of the disease. The term energy is used for a lot of different phenomena, which can cause confusion. Stating that everything is energy might have a basic truth somewhere, but a statement that is always true is meaningless in itself. Not everything that is invisible is the same nor can it be defined by calling it energy. The five level Russian doll model of concentric circles enveloping each other, helps to convey the idea that as we evolve from one to five we move to increasing individuality. In our most subtle body we are most unique while the expressions in ever-denser levels are increasingly general and common. This scheme can also help to guide us through the case taking and to evaluate from which level the information comes from. Every person has a body and a mind. Both of them incorporate two aspects: Level 1: The Physical Body This is the only visible and tangible part of the person. It is the material body; it can be touched, looked at, examined, measured, tested, and scanned from the inside and the outside. If the person is disturbed, in many instances his physical body will show all kinds of expressions. In acute diseases for example, he may have fever, weakness, cough, pains, and evacuations. Usually the invading virus or bacteria will be considered the cause of the disease and the treatment will be concentrated on destroying the pathogens. In the case of a chronic disease the physical signs and symptoms are usually considered the result of genetic makeup combined with life style and bad luck. The treatment is aimed at easing the expressions of the disease, at diminishing the symptoms. Medicine, still deeply rooted in the positivistic belief that reality is defined by what is observed from the outside by a neutral observer and can be predicted and repeated, is only concerned with the physical body. Although the effect of the emotions on the physical body are recognized (and called psychosomatic), these effects are not to be compared with real diseases. The former are cases for psychologists while the latter belong in the hands of a medical doctor. Most people, even when confronted with the limitations of this belief, are so immersed in it that they find it hard to think of the pathogens as the result of the disease and not the cause. The tendency in recent decades has been to consider even the sufferings of the

heart and soul the result of dysfunctional brain chemistry and to treat them with medication. Treating Level 1 can be done with toxic or non-toxic substances. Most of the allopathic medication is known to be toxic and to have side effects. Since these medications dont touch the origin of the disease but only suppress its expression, it is clear that the disturbed Dynamis will try harder to express the same symptoms or will find another, and deeper, level. The majority of natural healing systems are aimed at treating the physical body as well, using non-toxic substances from natural sources, for instance phytotherapy, herbal medicine, supplements, clay treatment, cleansing therapies, etc. Similarly diets are aimed at enhancing the health of the physical body using the basic adage: you are what you eat. As undeniable as it is that diet and life style influence all levels of the person, the basic axiom from the homeopathic point of view is quite contrary to that. That is to say: the health store will provide all that is necessary for a strong and healthy body/ level one, and believe that as a consequence all the other levels will benefit, while the homeopath treats level five knowing that all other levels will benefit. Its the way up versus the way down. Level 2: The Energetic or Ethereal Body Level 2 represents the energetic aspect of the physical body; whereas Level 1 is measurable and thus quantitative, Level 2 is qualitative. It represents the vitality of the person and although the language might lead to confusion- it is not to be confounded with the vital level or Level 5. The energetic body is not individualized as Level 5 is; everybody has more or less vitality. Also the possible disturbances at this level are relatively limited to disturbances in the amount, the nature or the distribution of the energy. When there is a lack of energy, one feels tired, listless, depleted. There is insufficient supply of energy to wake up refreshed, to feel full of energy to do whatever one wants to do during the day: to move, work, play, create, relate, to function. The automatic functions of the body are slow, lacking, and inadequate. Hahnemann called this psora. When there is an uneven distribution of energy then the functions swing from one extreme to the other: there is hyperactivity or over functioning followed by exhaustion. The balance is lost and there is no middle point of regularity. Hahnemann called this sycosis. In both cases the disturbed energy body, which in health resonates with the second dimension, (read more about this is in the chapter on nosodes) will allow viruses and bacteria to multiply and cause physical illnesses. When the nature of the energy is distorted, the energy body can turn against itself and cause autoimmune diseases. Like the physical body, the energetic body needs to be fed: it needs to take in energy. It can be charged by clean air and water, sunlight, earth, exercise and all therapies that use these elements (water therapies, bathing, breathing exercises, sauna, infra red treatment,

certain sports), by touch, massage, osteopathy, acupuncture, aromatherapy, fresh food. One should not forget that in food there is an energetic aspect as well as a material one. The material is what can be seen, touched, weighed and measured: the constituents in terms of calories, proteins, and carbohydrates for example l. This doesnt indicate anything about the quality of the food: when it is processed it loses quality, and may be essentially dead. This can be detected for instance in Kirlian photography. Level 3: The Emotional Body or The Astral Body This level can be considered the container of all the emotions we have had and have: anger, grief, fright, guilt, shame, mortification, fear, anxiety, insecurity, doubt, suspicion, hope, jealousy, hatred, envy etc. They are common to all humans although the amount and the mix differ a lot. This has more to do with personality, upbringing, social and cultural background than with the vital disturbance. Nevertheless, when the dynamis is out of tune the emotions will be troubled as well. Whereas the physical body is individual and personal in the same way that the vital body is, the energetic, emotional and mental levels have a collective facet in that they are influenced by other people and by the ideas and emotions of the collective. Everybody has experienced the effect of another persons energetic body: if it is strong, vital and full of life we probably get energized by the company of those people. When a person has a weak, needy and withering energy body we can feel completely drained by them feeding on our energy body. In the same way we can be influenced by the strong emotions of another person, even when they are not literally expressed: we can feel sad around another persons grief or irritated by somebodys irritation. If the feeling is collective it is all the stronger: a protest can infect everybody with anger and violence, a football game evokes enthusiasm and exuberance, a show, pop concert, or any group happening will multiply the feelings of the participants. For homeopathic purposes the emotional level in itself is not a basis for prescription, since it is too common and too easily the object of interpretation. We tend to understand or explain the emotions and to qualify them as unpleasant/pleasant or unwanted/wanted or even positive/negative. The patient also usually tries to explain why he has a particular emotion and gives us a psychological analysis. But in homeopathy, although we take note of those emotions, we dont make those kinds of interpretations. It is the what of the disturbance not the why we are looking for. Disagreeable emotions are expressions of the vital disturbance in the same way eczema or sleeplessness. They are not the source of the problem but the result. Level 4: The Mental or Causal Body Together with the previous level, the mental level forms the mind part of the organism and has an individual and a collective aspect. Dominant and widespread ideas can influence individual ideas and convictions and this fact is used by advertisers of all kind, be it political or commercial.

Some people seem to suffer from individual diseases while others seem to live out the collective disturbance. The reason for this is probably not to be found on this level but on the choices of the soul. Even when we cannot give a reasonable answer to the question of why a person is the way he is nor why he suffers from a particular disturbance, the observation that the disease is an individual or respectively a collective one, might have repercussions for the treatment. One could call Level also the psyche. We can determine healthy psychological functioning (psychology) and unhealthy psychological functioning (psycho pathology), very much in the same way we have healthy physical functioning (physiology) and unhealthy physical functioning (physical pathology). The psyche has further levels within itself: the conscious, subconscious and unconscious mind. The conscious mind is the tip of the iceberg: its where our rationality resides, where we think, calculate and make logical thought processes. The subconscious, a much larger and more important layer that we want to explore during case taking, contains all our unwanted, unbearable, forbidden or too painful thoughts, desires, wishes, experiences etc. Because they are not allowed to exist or to be expressed, they are suppressed and denied and disappear under the surface. There they live an underground life and influence the persons thoughts and acts, without him or her being aware of it. Since feeling, admitting or expressing these feelings and ideas was or is taboo and thus life threatening, it is difficult to get them to the surface. Certain psychotherapies try this in order to make them conscious and integrate them into the personality, but this is a long and painful process that is met with a lot of resistance. In the homeopathic consultation we have techniques to inquire into the subconscious level without being too invasive. Our questioning is then directed at the exploration of the areas or instances of least control: fears and phobias, dreams, intensely stressful events, fascinations, hobbies etc. The unconscious level is similar to the collective unconscious: it contains the memory of the whole history of the human race. On that level we have symbols, myths, allegories, fairy tales, legends, and fables etc. They are universal and reflect the main themes in human life: birth and death, the after life, initiation rites, parenthood, burial, power, and love for example. In the patient they will often show up as dreams or as an unexplainable fascination. Everybody has a mind, even a baby or a child, I dont think there is any doubt about that, but not every case is a mental case. We talk about a mental case when the focus of the disease expression is on the mental level and shows serious derangements. But in every patient we explore the mental level because as we go up the levels, the more individualized a person becomes. If we want to know how he perceives himself and the world, we will have to ask him. Level is also called (Sankaran et al) the delusional level. Sankaran understood that since everybody has his own version of reality, everybody lives in his or her delusional world. A

delusion is then defined as a distorted perception of reality, not being in the here and now but living in the memories of the past or the anxieties for the future. Both reflect the actual state in the past and the future. This is by the way, an answer to the question of whether we should prescribe on the actual state the patient is in when we see him, or if we should prescribe for his entire history. When one understands that the memory is flexible and will always rewrite the biography according to the present state and understanding, than we see that the past or the biography of the patient contains only projections of the present in the past. There is only the eternal now. We cant prescribe on the past and we cant prescribe on the future. As a consequence of living in a delusion, we all make our conditions OK. In reality everybody is unconditioned OK and perfect, but since we dont experience it that way, we are disturbed. Part of this disturbance is expressed in our ideas about how we need to be or what we need to do. This leads to compulsive thoughts, actions and reactions and restricts our freedom. These conditions and restrictions are excellent pointers to the remedy we have to prescribe in order to resolve them. Level 5: The Vital Level This level beyond mind and body could be interpreted as the cross point between this aspect of us that is a sparkle of the spirit and the individual and unique organism that we are. Because we try to prescribe in line with Hahnemann on basis of the most possible similarity of the picture of the disturbance, we try to prescribe on the vital level. Time and again Hahnemann writes that disease is nothing but a dynamic derangement in our spirit like vital body which shows itself in the sensations and functions of the mind and body. He also states that when all these expressions of mind and body have been removed nothing of the disease remains since it was immaterial in the first place. Level 5 is also called the sensation level (Sankaran et al): it is the level of the deepest awareness of one self. It is not a thought, for that would be a product of the psyche (Level) but it shapes thoughts and emotions, energy and physical functions and actions. Level 5 is the realm of the individuality. It is the blueprint of the person and it contains the experience of the self. Because it is so intimate and so obvious, so natural to the person, it never needs to be verbalized and when asked to, many people struggle to make it explicit. Again: we have techniques for that and I will go into them in the chapter on case taking. The unique emergence of a person is composed of many aspects, it is like an orchestra and in the healthy state they all play harmoniously together. They provide an instrument that can be used for the higher purposes of our existence, described so well in aphorism 9. We are born with this vital sensation and it remains as an integral part of us throughout our lifetime. This is a fact. In the same way that our set of parents (genetic), our place and date

of birth (astrological), gender, place in the family, (nurture), constitution (miasm), family history (family constellation), will never change: these are the facts of our life. From this it follows that everybody has a vital level. Is everybody disturbed or diseased then? Obviously there are gradations. We all have a vital sensation but can feel happy and free and enjoying good physical health and energy. In that case the vital level seems quite undisturbed and doesn't produce signs and symptoms in the mind and body. If so it is a sure sign that there is some disturbance on the vital level expressing itself on order to be helped. From this point of view disease symptoms are our chance to be healed. Some people however aren't capable of describing this vital experience, babies and small children can't talk and for most children under 12, it will be difficult for them to give enough nuance in their speech for the homeopath to be able to clearly discern the vital sensation. What to do? The answer to this question can be found by using the scheme and the knowledge that expressions are always to be found. All Levels All of the Time The vital sensation expresses itself on all levels all of the time. The skill of the homeopath is to differentiate these expressions from the bulk of information we get from the patient. How do we know which information is useful and reliable (because it is vital) and which information is not? In general: information that only covers one level is local, be it on Level 1, 2, 3 or 4. When coming from the vital level the information makes a coherent pattern throughout different levels. The focus of the symptomatology may be on just one level, but even this must pervade other levels and somehow connect. For instance: the main rubrics point to the same remedy, the dream is the tailpiece that gives sense to all other symptoms in the case, the vital sensation is backed up by the proving symptoms etc. In the best cases: all different ways of approaching the case will lead to the same conclusion/remedy. In these cases we know we are making a solid prescription. The levels of experience in each person allow us to determine the image or pattern of their vital disturbance. Let's take the levels in more detail to know how to differentiate vital information from common information: Level 1: The way the pathology is experienced On Level 1 we take into account all symptoms that don't belong to, or are not common for, the physical pathology. When symptoms don't belong to the pathology they belong to the patient. For instance: a patient says his vomiting is better at the seaside. Or he gets migraine from potatoes. This is uncommon and must be a symptom of the patient. If a patient says he can't stand the light and wants to lie down in a dark room, it belongs to the pathology.

From this it follows that the common symptoms of the pathology won't help us in prescribing a vital remedy because they are not sufficiently individualized. Level 2: The disturbances in the nature, amount and distribution of the energy of the patient When this level is healthy: energy is abundant, vitality is at a maximum and all the functions of the patient are smooth, easy and unnoticed by them. The appetite, digestion, circulation, sleep, menstruation, breathing, temperature, motion, etc cause no problems. In homeopathic jargon these are covered by the generalities. If there is disturbance in sleep, digestion, evacuations, accommodation, etc, if the patient is tired, weary, listless, joyless, burnt out, depleted, restless, never sleeps enough, is hyperactive etc., these are expressions of the vital disturbance on the energy level. Level 3: The way the story/emotions are experienced We are on level three when the person expands the topic from my disturbance to me; and in the process he generalizes what he is talking about. When he makes this leap spontaneously and naturally, which frequently happens during consultation if we can keep quiet and not interrupt his account with too early questioning, we go from local to general. Often the patient starts the case by describing his pains and sufferings and at a certain point he admits that the way he feels about the problem, he feels on other occasions too. Or he gives the circumstances in his life that, according to him, caused triggered or aggravated the problem. Or he starts telling the homeopath about his thoughts, feelings and worries concerning the problem. All these are emotionally charged and this is what the homeopath means by patient stories. The patient starts to tell the story of his life, or at least what he considers to be meaningful regarding his symptoms. To prescribe on that level would be most dubious. The majority of these feelings will be common human feelings, and in that sense they are normal and are no basis for a prescription. Even when the patient starts crying and feels he is uncertain, always failing, never good enough, not accepted, not understood, and not loved enough we know these are all common human worries. Until we are healthy we all need to be seen, appreciated, accepted, loved and cared for. When we are healthy, we have an abundance of appreciation, acceptance, compassion, love and care to give to others, knowing that everything given is ten times returned to us. Prescribing on this level therefore contains the danger of prescribing on the projection of the emotions of the homeopath, or prescribing for the patient based on superficial psychology. It carries the risk of giving advice about how to live and what to feel. But the homeopath is not an advisor or a consultant: this would assume that the homeopath knows and the patient doesnt know. The contrary is true: the patient is the only one who knows how it feels to be him. The homeopath cant know until he questions and understand the patient fully, on a vital level, and not on a superficial emotional level l. An advisor is the one who is supposed to know better and to tell the other what to do. In homeopathy, we dont know what is good for the patient and how he should live. We are not on the comfortable side of the knowers and the patient on the suffering side of the not-knowers: we are all in the same boat. The human condition is for all humans and we all have a vital experience of how it is to be us.

During case taking the homeopath is fully present, without thinking or judging, to get to know this unique vital experience. Emotions can be a stepping-stone to the next level or they can be part of the vital expression when they are: not in proportion; unsuitable; unexpected; repetitive; unexplainable; exaggerated or in short, strange, rare and peculiar. Although this part of the consultation can take a long time, there is always a reason why the patient tells a particular story or anecdote. We dont prescribe on the story itself but because the patient picked out this particular example, it must be meaningful: there is a message in the story. Mostly the patient gives the message as a conclusion at the end of the story, if not: we can ask for it. We do this is an indirect way, not bluntly asking: Yes, I see and what is the message in your story? Rather we take the leap to the next level and ask how he experiences being in the situation that he just described. Very often he will compare it to another situation where he felt the same. Then we know we are on the right track: since the patient feels the same in different circumstances or situations or levels: it must be an expression of the vital sensation. A healthy person has all emotions at his disposal but doesn't sail on every emotional current. Most emotions are triggered by underlying psychological difficulties and are an obstacle in communication. As a result, they can be triggered by ego hurt and defensiveness. When a similimum is given and the vital disturbance settles, we observe the vulnerability in terms of threats to the ego reduce dramatically. The person begins to consider himself in general as OK the way he is. As a result he considers other people as also OK, because the outside world is nothing but a reflection of the inside world. When a person experiences himself as basically OK, he is no longer in need of appreciation, reassurance, presence, or care from others. He has no need to defend himself when others attack: he can see the attacks are coming from the outside and that they are not his problem. As a result he feels calm, full of self-confidence, carefree. As his thoughts are not crowded with worries, he has little to think about. His mind becomes free to do what he likes to do, to become creative, enjoy whatever he in his freedom chooses to do or to be. Level 4: The basic delusion On the psychic level we have the conscious, subconscious and unconscious mind. With the conscious mind we think rational and logical thoughts. We can reflect on events and on ourselves, analyze study, calculate, remember, understand things. But it doesn't help us when it comes to the vital disturbance. Some patients want to know the remedy that is given to them and the reason why; they want the whole explanation in order to understand what their problem is and to learn about it. Apart from the fact that the name of the remedy is bound to provoke conscious or unconscious images, associations and thoughts, I don't believe that the vital remedy/disturbance is something to be explained or understood. Though the curiosity of the patient is understandable, discussion of the remedy is disadvantageous. Would anybody want to discuss where the needles of the acupuncturist can be put or where and how the surgeon is allowed to cut?

The homeopathic cure is not a process of insight and awareness, it is unlike psychotherapy where the patient goes through the suffering, relives it, analyses it and gives it a place. A similimum takes away the suffering in the way the snow is melting in the sun: quiet, unobserved, effortless. That's why many people going through a total transformation, obvious to all bystanders, can declare that they haven't noticed any changes after the remedy. They are right! The similimum acts unnoticed by the patient. It's like an aspirin taking away the pain. It happened unnoticed but when questioned one suddenly realizes the pain has indeed gone! If the remedy is discussed: the follow up becomes unreliable. The patient will willingly or unconsciously influence his report of what happened after the remedy, and there is a risk that by changing the remedy, the similimum may be lost forever! If the patient is convinced that the remedy discussed is not his similimum and the homeopath changes it, he will never agree to go back to it. Even when the patient visits another homeopath he will tell them the remedies he took that didnt help. In this way, the next homeopath will also not repeat that remedy. I can demonstrate with many cases of cured patients at their first follow up when they bluntly stated: your remedy hasnt done anything. Or: this wasnt the right remedy. Would they have repeated the same remedy if they had known what they had taken? Basically, not discussing the remedy with the patient is to protect the patient and to increase the chance of a cure. The potential of classical homeopathy is total transformation but it is a subtle treatment and takes a skilled practitioner to manage the process. Of course later on the patient can be told what remedy has been effective. The purpose of the homeopathic treatment is to make people independent, not to create dependence on the physician. People will want to give the homeopath their ideas about their suffering, and this is fine, but it is no basis for the prescription. At the emotional level the story contains the message, the ideas might also convey a message. They may point to the delusions. Delusions by definition are unconscious. The person probably translated them as logical thoughts and conclusions but we can perceive that he is emphasizing one aspect of reality. A person can and will probably have more than one delusion. Remember, we define delusion as a false perception of reality that is projected onto the outside world. Only this little part of the whole reality is noticed while the rest is disregarded. Ask five people how their holiday in Italy was and one will say the food was absolutely fabulous, a second that the country is full of thieves and pickpockets, a third enjoyed the beautiful weather and landscapes, the fourth cant stop talking about the art and historical remains, while number five admired the fashionably dressed people. All of these are part of a bigger true reality and we cant tell which one is real because they all are. But we can perceive in others where their focus of attention lies. This is what they resonate with. If the one talking about thieves goes to another place he will see thieves there as well. When he listen to the news or reads a newspaper he will only reconfirm his idea that the world is full of thieves. He will install an alarm in his house because he knows about burglaries in the neighborhood. He probably has some anecdotes in his life where he was robbed This

is what we call a basic delusion: the basic conviction underlying the other ideas and beliefs. It is the one thought to which all the others can be reduced. Level 5: The vital expression The other four levels are expressions of what is disturbed on Level 5 On Level 5 we are not looking for a thought or conviction but for an experience. Strange as it may sound, it is the way the person experiences himself and thus the outside world. Because the medium of homeopathy is language we have to convey this by words and language is a faculty of the brain. In other words: we have to use Level measures. Even when the patient uses hand gestures or body language in general, is still is language and has to be translated in words, in order to make explicit what the patient has shown us. The vital disturbance can be expressed in many ways: by singing, dancing, drawing, art, movements etc., but homeopathy is based on communication through language: it is a therapeutic system using observation and talking. We know for sure we touched the vital disturbance when we hear it on different levels: the same thing expressed in mind and body, albeitin a coded form. The same thing can be literally the same sensation (for instance the body feels injured and the mind feels hurt) or important rubrics on different levels pointing to the same remedy. Its possible to make a vital prescription with symptoms on only one level but we usually have many remedies listed in our repertories and we know they are, no matter how detailed the repertory, still incomplete. If we want to make a prescription that is not in our known remedies, we first have to understand the vital disturbance and then look for the similar remedy picture. This is where we can find tremendous help by analyzing according to large groups before we come down to subgroups and species. The same story and even the same thoughts about the story can be experienced in different ways. For example: breaking up a relationship which may be considered as an insult by the other person, can be perceived as a crumbling away from security, stability, role or status in the community by the patient. In that case we would suspect a mineral remedy. It may be experienced as a sudden unexpected shock by which the person is totally scattered: a sensation from the plant family. Or it may be experienced as a defeat, a lost fight in which the person is victimized by the other persons cruelty and we would look for an animal remedy. These experiences are not thought but are one level deeper and they will pervade any circumstance, domain, anecdote, story, dream, and pathology in the persons life. Only on the vital level can we discern the kingdom and miasm. Kingdoms The vital sensation is the way the person experiences himself, it is how he is, what it is like to be him, hence his individual being or his uniqueness. There are of course many features in this uniqueness, many of them unconscious and operating autonomously. It can be compared to a whole orchestra with the vital disturbance being one instrument that is out

of tune, spoiling the entire performance. Many of the instruments will be in tune though, since many facets of the patient are healthy, balanced or functional but since there is one loud, false note, the music of the person will sound distorted. If the similimum then tunes this instrument, the person can start to play his own song in a harmonious way. But first, a few words about symbols. In my understanding (and as explained in The Charm of Homeopathy) Our remedy pictures are symbolic One of the main differences between men and mammals (with whom we share the physical body) is the capacity man has to symbolize. Animals may have a rudimental ability for it but people do it most of the time. A child at age one is capable of understanding that an object that is out of sight still exists. This means he can grasp the idea of absent things and people and he can even recognize abstract images of it. A toddler can look at a picture, an image, a drawing, a TV play and recognize the rabbit, be it two dimensional, big or small, in any color, speaking or moving, talking or being dressed up, in whatever material it is made. He even can use a symbolic sound to point to that rabbit and knows it is the same thing as his cuddly toy or the animal in the garden. To be precise: it is not the same but it is similar enough to be recognized as belonging to the same category. We know that nothing is ever the same, there are no two identical snowflakes, but to make communication possible, we use the same symbol for things that are similar enough to be considered as belonging to the same category, symbol or word. For us it is such a normal phase in evolution that we dont notice how absolutely incredible this is. A small child, hardly capable of walking and feeding himself, already has the mind power to understand such complex processes and learns with amazing speed to fill his inner map with symbols. This is what we call education: the symbols are exchanged and communicated. This means we agree on a certain version of reality. We learn how to be human among humans. If a child is left with wolves, it will grow up to be a wolf. The potential to be human is there but when unformed in the growing up phase, or rather replaced by another formation of the inner map, it becomes impossible to correct later in life. The wolf children never managed to learn to speak if they missed this development at an early age. Of importance for us now is the observation that we recognize representations or symbols of a thing or an idea on the basis of similarity. As long as the representation carries enough characteristics, we identify it as the image of a certain object or phenomenon. With enough characteristics we mean with minimum and meaningful characteristics. A tree can be depicted with two parallel vertical lines and a circle on the upper part of this: symbols for the stem and the crown. Even a small child will draw a tree like this or recognize the symbol, yet in reality it has little to do with the complexity of the real tree or the enormous variety in trees. The symbol is not much but it is enough. Another example is the representation of a man: a few lines with a circle on top will do: two lines for the arms, two for the legs and one in the middle for the body. This carries enough meaningful characteristics to represent or symbolize a human being with its enormous complexity!

This is the way we use symbols and in this way we make groups. All categorizing is based on enough similarity to put related phenomena into a group. This is done in science. This is what we also do in homeopathy. The peculiarity with homeopathy is that the body of knowledge first started with the detailed data and later developed larger categories, whereas in science the domain is first divided into large groups or areas and then into subgroups and finally into species. Its possible that the reason for this may be the fact that science is based on the outer gaze of the objective observer looking at what the phenomenon looks like and does, while homeopathy is based on the inner experience of what the phenomenon feels like and means. The larger groups in homeopathy are founded upon proving symptoms and rubrics. The last three decades homeopathy took a quantum leap due to the understanding of inspiring teachers and the new possibilities afforded by computer software. As all progress starts with the right questions, some homeopaths asked themselves whether homeopathic remedies that belong to the same chemical groups or biological families have similar drug pictures. The answer was that they do: the kingdoms proved to have common characteristics, as well as miasms. The first observation was that remedies belonging to the three main kingdoms: plants, animal and minerals show common characteristics. The other kingdoms: Monera, Fungi and Imponderables were examined and common traits also found. It is often impossible to find these characteristics reflected in the separate rubrics: kingdoms are only to be determined on the fifth level: they are rooted in the experience of the self, hence the vital sensation. This means that the same event can be felt in a different way according to the kingdom to which the person belongs. It is clear that this as a tremendous help in finding the similimum: once the kingdom is clear, only remedies from this group need be considered. But as these kingdoms in themselves are not yet listed in the repertory rubrics, the homeopath must put the right questions to the patient and understand the kingdom before he refers to the repertory. Then the search may be limited to the kingdom to which the person belongs. It is clear that this means the search for the remedy is directed and is based on the pattern of disturbance of the patient, instead of being based on the amount of remedies that the homeopath masters. In the first case the outcome can be any remedy, (known or unknown to the homeopath), in the latter the patient is fitted into the boxes, which the homeopath has at his disposal. This clearly makes a fundamental difference in solving a case. Lets say the homeopath knows 30 polychrests. Probably he claims he can help 80 % of all his patients. Which is absolutely true. If he had only 9 remedies, he would also be able to help 80% of his patients. We can make our categories as large or as small as we want: people will always fit in. The two first categories are the gender: only two. Then for instance we

can divide according to astrological sign: 12 possibilities. Or according to the types from the Enneagram: 9 boxes plus combinations. Or in Psychological Types: 8 basic types with combination pictures. Or in 12 polychrests: archetypical images. We all fit in many boxes and all those characteristics are part of our overall make up. But in homeopathy our aim is to prescribe for the individuality of the patient. In its logical consequence this means we should give a different remedy to each patient. Of course this is impossible to accomplish and the topic is covered in my book The Charm of Homeopathy. The homeopath who works very hard can master more than 100 remedies, he can familiarize himself with a few hundred maybe, but still it is a very limited number of the remedies listed to date (some 13.000) and it is impossible to keep up with the new remedies and provings that appear every day. Even though having a vast knowledge of remedies is a huge help in solving cases, it still takes a good method to know what will fit the patient. It is like having an enormous vocabulary and no grammar to make sense of it or on the other hand, having a thorough knowledge of the grammar and a poor vocabulary makes the outcome very limited and impersonal. Ill go into more detail on the patient based search in the chapter on anamnesis and analysis. Mineral Kingdom It is no surprise that the systematizing of the homeopathic remedies started with the grouping of the mineral remedies. In the late 80s, homeopaths taught remedies in groups like the Natriums, the Kalis, the Magnesiums, the Ammoniums, the Aurums, the Ferrums and so on. The compound remedies had characteristics of either element and they had a signature of their own. Sankaran noticed that Precious Metals like Palladium, Argentum, Platina and Aurum shared a lot of symptoms and characteristics and were neighbors on the Periodic Table. Could this mean that we could draw conclusions from the position of an element on this table and these shared characteristics? It was clear from these well known remedies that these metals shared the need to perform exceedingly well, to be in the limelight, to be on stage, doing supernatural deeds, being haughty and above others. What about other metals? We had enough well proven metals like: Ferrum, Zincum, Cuprum, Cobaltum, Niccolum to know that they also share qualities. Little by little the whole Periodic Table was examined by Scholten and others who did group-provings. Meanwhile elements that were so far unknown were proven, elements like: Hydrogen, Helium, Ozone, Plutonium, Germanium, Neon, Crypton, etc. (Sherr at al). During the last two decades the general themes from the mineral kingdom were formulated. I found the vital sensation of the element is the feeling of being empty. It is an existential emptiness of Level 5, not the energetic emptiness of Level 2. In the latter it is a matter of having no energy, because of expending a lot (in sports for instance or by overwork) or having chronic fatigue syndrome or a related problem. In the former the experience is of being fundamentally empty, which, by the way, is the truth. Elements are as proved by quantum physics- not the little building blocks of matter they were thought to be but are empty in themselves. In a human experience this emptiness results in a need, a lack, a missing or losing something that the person needs in order to exist.

This means that the case of a person needing a mineral remedy will revolve around his existence, not his life or his survival, as it would in a plant or animal kingdom case. In order to exist the mineral patient misses something, he needs, lacks or loses something, what we call his condition to be OK. This something is the fundament, the basis on which his existence is built. When you hear the patient using these words: emptiness, fundament, missing, lacking, losing, building, basis: those words are watertight pointers to the mineral kingdom. Remember: the kingdom is only discerned at Level 5. Of course it always depends from which level the information is coming. In the beginning of a consultation a lot of patients sound like minerals: the language is fact like, a bit distant and the words chosen are like official language. This can be the phase of testing the homeopath. But even then the patient might introduce his complaint in a mineral way. Not so much in a logical mathematical sequence of telling his symptoms, because this only means the patient is orderly and well organized. It is clear that also plant remedies and animal remedies can be controlled, logical and well organized. These are aspects of a persons personality and we are not prescribing on personality but on the vital experience. Personality is the result of inherited traits, education, intelligence, social background, family situation and temperament. But a vital sensation can persist regardless of those conditions. That is why we can rely on the vital sensation to prescribe no matter the gender, age, profession, constitution or circumstances of the patient. If we base our prescription on the pictures of one possible expression (for instance the Nux vomica workaholic, the tearful blond Pulsatilla, the menopausal Lachesis), we risk not recognizing the vital sensation when it shows up in a totally different expression. (The five year old Nux vomica girl, the bald 60 year old Pulsatilla man, the young Lachesis guy). Expressions are limitless. It is very risky to prescribe on them as the same expression could as well result from a different vital expression. A workaholic can belong to any kingdom and miasm because it is a personality trait rather than a vital question. Back to our minerals. The underlying experience in their life is of missing, losing, needing, lacking something they need in order to exist. The basic requirements in order to be OK depend on the issue of the horizontal row of the Periodic Table. The degree of dependence is reflected in the vertical column: well go into that in detail when we discuss rows and columns. The mineral patient will talk about his capacity and for that uses words so common that we can easily overlook them. He talks about what he (cant) do, what he (doesnt) manage, in which he (doesnt) succeed. He feels he lacks strength or stamina; he doesnt have enough energy, balance, power, security, support, stability. This may accompany the report of his chief complaint. For instance: he has a low back pain and therefore feels unstable. Or he may conclude a whole report of a chronic complaint and all the treatment he underwent by saying that the situation is more or less stable for the moment. A patient put it this way: my health since the stomach ulcer is still a bit shaky. Very often they use the words support: I had no support from, I needed a bit of support from him, who is going to support me now my father has died?, this idea supported me

They are wanting, needing, lacking or losing the support they need. It can be expressed like something to hold on to, something to base yourself on. This accounts for the first 9 columns while the columns from 11 to 18 feel they lose their grip; things are sliding away under their feet, or crumbling down or collapsing altogether. They experience the hardships of life as a threat to their very basic fundament. It is the structure, the frame that they have built their life on. If things go wrong it is experienced as touching them in the deepest part of their core; sometimes they even use the word nucleus. Often mineral patients talk about parts or pieces of themselves, as if they were made up from bits and pieces. As they feel something is lacking they feel incomplete and are looking for this completeness in order to be OK. This again is common to all humans: to look for the thing that gives fulfillment. But the mineral person feels something in him is lacking, missing or getting lost, while a plant will suffer from his specific sensitivity. Theres nothing missing or insufficient, if only he didnt always feel so, lets say injured. In the animal kingdom nothing is wrong or missing with him, it is the other who borrows trouble. In the nosode kingdom the person feels he is weak and abnormal because he is always sick in circumstances where others are healthy. The mineral person feels dependent on this particular condition he needs to fulfill in order to exist and strives to become independent from it. But the more his structure or fundament is unstable the more dependent he will be. It is said in the beginning of the categorizing that the mineral patient is well structured and although this is basically correct it can lead to many misinterpretations. The most common mistake is to go for the words and disregard the context in which the word is said. This makes all the difference in the world and it is well demonstrated by the Vital Approach Scheme. If the information doesnt come from the fifth level, the kingdom cant be discerned. Now if a patient talks about my structure and Im a well structured person and the structure in my life is lost since I quit working, he may well be talking about this personality trait of him: being a person with discipline and a tight schedule. This is something completely different to a vital sensation. A plant can be very busy (Bryonia and Nux vomica are well known examples), an animal remedy can be industrious and well organized and a nosode can plan his agenda meticulously. This is Level 3 information: it is the level of the story, the biography, the personality and might contain Level 5 information (the vital sensation is all levels all of the time) but is not to be confused with it. Level 5 or vital is what persists regardless of age, gender, situation, background, education, intelligence, mood, situations Homeopaths are sometimes at a loss when the patient comes with a certain story one consultation, and brings a whole different story and mood at the next one. Which is true and on which one must the prescription be based? It is exactly here that the value of the Vital Approach is well demonstrated. No matter what the patient comes with, we probe deeper to find the vital experience in it. And we will not be surprised to find that it always leads to the same thing. It has to. There is only one vital sensation in a patient and it is the source of disturbance. This is why a patient will always come back to it. It doesnt disappear after the similimum because it belongs to his individuality, how could it vanish? His name or face wont vanish either after the similimum! But it will be silently in the background and wont prevent the maximum harmonious functioning of the person on all levels.

This basis, this foundation that the mineral person is talking about is not a real material construction, it is the way the person experiences his life and himself. It is the foundation of his being and hence the case will evolve around meaning, sense, use, value, purpose, role in life. This means if the patient talks about a difficulty at his job, for instance he feels surpassed by a colleague and suffers from injustice, we have to keep asking. The story is not sufficient to prescribe on, neither is the feeling of injustice (Level 3) Not only is it a common human feeling and, according to aphorism 153, we shouldnt prescribe on the common but on the strange rare and peculiar, on top of that it is too superficial. We cant even distinguish a kingdom on this level, because the feeling of being treated unjustly belongs to all kingdoms. If the patient would answer your question about how it is for him to be in such unjust situation, with a feeling of inferiority, being a loser, surpassed by better and stronger ones, his career and so he is finished, he obviously needs an animal remedy. If he feels traumatized by it, like being beaten black and blue, he needs a plant remedy from the Compositeae family. But if he feels his security is shaky, unsteady, his financial future unsure, no law and order to fall back on, having lost his grip on his life, feeling useless now that what he built up is breaking down, he surely needs a mineral remedy. In general the mineral case focuses around just one theme. There is one main problem or main issue to be discussed and the whole case will only explore this one thing. Animal kingdom: A person who belongs to the animal kingdom has the sensation that life is a fight, a struggle for survival. Everybody wants to live or to stay alive, but people from the animal kingdom experience everything in their life as a survival issue. It is about to live or to be killed, while a mineral talks about existence and people belonging to the plant kingdom die, their life ends, they dont get killed. The survival is a matter of eating or being eaten, kill or being killed. They can use all kinds of synonyms like slaughter, murder, execute, slay, exterminate, and finish one off. The idea always is that somebody is doing this to another. In the animal kingdom somebody else is the problem, not some thing. During anamnesis one will hear the patient talk about the others who are the enemy: they threaten him, look down upon him, dominate him, betray him etc. Hence the message in the story is: who is the problem, rather than what. This can make the main differential diagnosis in an animal case where the aggression and violence is not so much in the foreground, because the animal is the prey, not the predator. Still there will be somebody else doing something to the patient and that is experienced as the main problem. Its not enough that the patient talks about quarrels or fights: everybody clashes now and then with others. It is the fact that the quarrel or clash is experienced as a fight and in this fight the thing at stake is survival, is what makes it an animal case. Only one can win: there is always a winner and a loser. For the winner it is survival, victory, power, being the best, on top, the first, the conqueror. For the loser it feels like being finished, hes dead, the victim, loser, the prey, eaten, defeated. There is no win-win possibility. One is the victim and one is the aggressor, one is the weaker and one is the stronger. There can only be one winner: there is no room for both. Its you or me. The fight can be for a person, a position or a contest for example, but for a person in the animal realm everything is conceived as a fight or a threat to his survival. Even when he

takes the bus he will have the feeling he has to fight to find a place to sit or others will take it from him. In his house he might feel the threat of being attacked and burgled; at his job in the office he feels every word of criticism as an attack to his person, in a relationship he can be very defensive. It is either attack or defense. What a person feels is done to him, he will do to others. The person belonging to the animal kingdom is the victim or the aggressor: when he feels attacked and victimized he might complain about the aggression of the others and is always in the defense, when he is the aggressor he might feels he is treated with violence and reacts in the same way. The world is a harsh place. One has to fight his way to the top. The winner takes it all. Female animal remedies often display attractive behavior, or rather attention seeking behavior. They give a lot of importance to their looks, even when it is not so obvious for others. Often the homeopath gets more animated in animal cases, more charmed or amused, but this depends on the subkingdom and whether it is a prey or predator in front of us. Since there is aggression and a desire to dominate, or a fear of being dominated, power is a big issue. Power is often expressed as competitiveness or ambition. In itself this is not a pointer to the animal kingdom, but the competition here has the flavor of survival: it is a matter of life and death. It is you or me. There can only be one winner. There can only be one at the top, only one can be the best, the first, the fastest, the winner. The competition is always in a comparison: how am I doing compared to the others? Even in a case where the animal features are suppressed or compensated, the person will compare himself to others. It can be quite subtle and presented in little extra remarks intertwined in the story, which might be overloaded with rationalizations. But when they are there, they are not to be denied. The patient is perhaps troubled by some symptom (like hair loss, skin symptoms, being overweight) that makes him less attractive than others. He may have physical pathology that makes it impossible to do sports like other people of his age. He may feel inferior because his diploma is lower than the others at the office. He may feel others get more, are more charming, faster, dance better, whatever, but the overall idea is that they will always make the comparison. A mother will ask herself is she is as good or better than other mothers, even a client in the therapists office wants to be the best client. There is never an equal relationship: there is always somebody higher and somebody lower. Or the patient has the idea he is higher than another in one aspect and lower in other aspects. The superior/inferior issue will be present in a straightforward or more disguised way but it will be there. Because the feeling of being inferior is so unbearable it might be heavily compensated with for instance, an attempt to be religious or humble and then of course the most religious or humble of all! The opposition or quarrel sometimes is expressed in one and the same patient: its like two tendencies in himself have a fight for supremacy. In the proving symptoms we see this reflected in the rubrics; antagonism with self and two wills. There is a split in the person and a conflict within. Or his symptoms are experienced as doing something to him. This throat pain is killing me.

When there is no compensation, the power issue will be at the forefront with arrogant, intimidating, domineering, haughty, proud or even menacing behavior. There can be violence in the language with cursing and swearing and desire to kill somebody. The patient might not be able to control his anger and violence, and may start fights with, or beat up people whom he feels are attacking him. He can get enraged and out of control and this may be his chief complaint. At the other end of the spectrum: the victim of such an aggressive person who is beaten, abused, threatened and manipulated, may need an animal remedy too. Sometimes this is the actual story, and sometimes the person feels like this even with relatively minor fights but it is always their experience that counts. Often we see huge anger in animal cases, be it on the side of the victim or the aggressor. The anger can easily flare up or be suppressed, because the person feels he might kill if he loses control. There might be triggers like jealousy or an attack from outside, but the anger slumbers in the person, if not in his daily life, it can come up in dreams or in a love for violent movies. Sometimes it is expressed the other way around: when, violence done to animals, which are not able to defend themselves provokes indignation, anger or a desire to pay back the evil doers. There are cases where the patient is feeling especially touched by the violence done to a particular animal and it is wise then to probe deeper into the matter, as it might lead to the source. People who need an animal remedy often talk about humans as a group they dont belong to. They make remarks like: humans are not to be trusted, humans are cruel, I dont understand humans, humans always create rules and values etc . It is as if they distance themselves from humans, they are looking from the outside t, they are not talking about we but about them. This can be a pointer to an animal remedy. Not surprisingly sex, procreation and territory, in fact all the instinctive features in a person, are prominent in an animal case. Again: all humans have these features but in a person belonging to the animal kingdom they are in the foreground and will be important issues in the case. In plant or mineral cases they might not even be mentioned as the problem lies elsewhere. In animal cases the fact that the patient is male and the homeopath female, or the other way around, can be more or less subtlety mentioned by the patient. He can just casually make remarks that are inappropriate for the homeopathic setting. They remind the homeopath that the patient is from the opposite sex and that the need to do that comes from the patients animal-like awareness of gender. Sometimes the sexual issue slips into the case spontaneously and as always: when a statement of the patient seems to be unnecessary or out of place, it is doubly important and it is most likely coming from the vital level. Procreation features are seldom mentioned as such but problems often start with pregnancy, lactation, conceiving children, in the male or the female animal patient. The territory issue can come up in many different ways, but it is good to remember as a general rule that animals have their specific habitat. This means they feel best in a particular environment and they will defend what they consider to be theirs. Depending on the subkingdom the features will be different and we will go into more detail into this later.

We should listen carefully to the special words referring to animals like: hierarchy, go hunting, herd mentality, my nest, poisoned, decoy in a trap, poison me, cub, fur, catch, claw etc. They can all be pieces of the puzzle and part of the coherent pattern. In animal cases it is not so much in the repetition of the same thing but in the building up of the pattern that we come to our conclusion. The fears in the animal kingdom are about survival as well: being chased, caught, imprisoned, killed, eaten, slaughtered. There can be a tremendous threat and a sensation of danger, which can be vague but nevertheless life threatening. The patient finds many expressions for this: fear of suffocation, being taken by surprise, being raped, overpowered, beaten, injured. It is important in the case taking to insist on being exact and to ask all details of this fear. Id even suggest repeating the question more than once in different forms, asking for images, or for a description of the worst case scenario. A fear that in the beginning sounded quite general like fear of persecution or fear of high places sometimes turns out to be a very specific fear of being chased, hunted, thrown in a deep well, being taken and drowned, body parts being bitten off and so on. The patient might give an image of a predator hunting and bringing down a prey and then biting it to death or devouring it or slowly, slowly suffocating it. The pictures he gives can be in dreams and that is just as useful: dreams come from the subconscious part of the psyche but they contain Level information as well. Not every dream is valuable: it depends on the common sense of the homeopath to know when and how to use dreams. The archetypical dreams come from the unconscious and are the classical dreams many people have: like being unprepared for an exam or being late for an appointment, refer to the broad sensation of needing to perform. Children dream of being chased or eaten by the wolf or a witch, yet they dont all need Belladonna. Those dreams belong to normal childhood fears and the images are given in the stories and fairytales we tell our children. In the same way people use images of happenings during their day or what theyve seen on television that night, in their dream but the feeling in the dream is theirs. It pays to persist in asking them to describe the dream in all its detail. Maybe the patient will say: it is not exactly a fear but disgust. Disgust is a general feature in animal cases. It may be scenes they are disgusted by, or smells or behavior. Often they feel disgust for other people or loathe themselves. The contempt, loathing, disgust, feeling of being dirty, are themes of animal remedies in general and it doesnt matter if they are interwoven in a story about themselves or somebody else. There is nobody out there, remember. All we see is a reflection of ourselves. Therefore what we tell about somebody else, we tell about ourselves. Because the overall feeling of the animal kingdom seems to be a feeling of disgust and of being dirty, it led many to the conclusion that the miasm must be leprosy. In my understanding this is a confusion between sensation and miasm. The disgust is a sensation and belongs to all animals and the miasm seems to be unclear in animal cases. The reason for this is, as far as I have observed in my cases, that the same remedy is represented by different patients in different ways and intensities. We should keep in mind that homeopathy is based on symbolic representations of a vital experience. The instrument of homeopathy is mainly language. Even if we observe the

patient and the way he behaves and expresses himself, we translate this body language into words: we are still in the realm of language, and therefore symbols. Animals are rich and strong symbols. We tend to project a lot of identifications and qualifications on them, we use them as totems, or in ritual or shamanistic practices. Many patients therefore will identify with a particular animal but this does not mean they need an animal remedy. Projection comes from Level . It is a product of the imagination or in a broader perspective, the psyche. In most cases it has to do with the wishes or the longings of the patient. Even when he needs an animal remedy the identification with a certain animal might very well be the opposite of what he needs: maybe he identifies with the eagle and needs the mouse. A good tip then is to look for what it is in the picture of the animal that the patient describes, which doesnt fit. For instance an 11 year old girl was asked to describe the horse she loved so much. She said: it is so beautiful and sweet, you can comb it and brush it and take care of it, it knows who you are and is always welcoming you. It has such a beautiful body and when it runs the mane waves in the wind. Well, the depiction of the looks of the horse might be right and realistic but the sweet, welcoming, loving and taking care of doesnt belong to the horse. This means it must belong to the girl. (In her case she needed a mineral from the third row) In the proving we usually see only one aspect of the remedy, for instance the proving of Lac Leoninum gives a picture of the male lion (Talks with an air of comment, wants to fight) But if a woman needs Lac Leo she most likely will show another side of the same remedy. Her role is completely different and we expect to see a complete focus on the children. Again a little boy or girl needing Lac Leo will display different aspects altogether. Which is then the miasm? This is even more prominent in domesticated animals. Dogs, cats, horses, goats, cows, etc. come in so many various breeds, and we use them for so many purposes, that they sometimes hardly look like the wild version of themselves. Can we can rely on the proving of one particular dog to represent the whole range of possible dogs? Again when we remind ourselves of the symbolic nature of homeopathy, it is clear that there is sufficient dogness in every dog, because this is exactly what got them into that category: a minimum set of meaningful characteristics. But in the patient it is not so much the question which dog he is (pit bull or a schnauzer) but rather which dog quality is represented in the patient. Ive seen patients who feel themselves second class, a very typical dog-expression. What is conveyed is the idea that even though they live with humans, they will never get the same status or be treated at the same level. Another dog case can focus on loyalty, the desire to do a good job, to perform well in order to please the boss. In yet another dog case the center of attention might be the (fight for ) the place in the hierarchy/family. It is hard to define the miasm that pervades all these cases. Ive seen bird cases where the patient was experiencing the bird coming out of the egg into a new world, while another talked about the hindrance, the trap versus the freedom, and again another example of the same bird gave a very detailed picture of how she was flying during her dreams and the utter bliss she felt while doing it. Could all these cases belong to the same miasm? But now comes the good news: we dont really need to know the miasm in an animal case. I agree it would help if it pointed to certain remedies and excluded others but thus far we dont seem to have attained that knowledge.

Maybe the miasms dont even make much sense in animal cases. If the issues are a feeling of inferiority, a fight for power and supremacy, a threat of being killed and eaten: how can one cope with this? Are there coping mechanisms we could imagine in those situations? Can one even think that the inferiority is a crisis that one has to overcome? Is it logical to accept the fact that there is a threat that one will be killed? Isnt it a bit odd to feel unfortunate because of a power clash? For those reasons my conclusion so far is that the miasms in animal cases are unclear, unreliable, unknown, confused with sensations and incomplete, and as a consequence cannot be relied upon to help analyze a case. Plant remedies Plant remedies have certain particular sensitivities that are repetitive and aimed at the opposite. It is said that plants are sensitive and even though it is true, the statement is confusing. Everybody is sensitive to his own problem, no matter what kingdom he belongs to. And the emotionality of Level 3, for example grief and sadness, is often mistaken for sensitivity. Partially this is a language matter: we use the words feeling, sensing and experiencing for Levels 3, 4 and 5. The patient doesnt know what we are looking for and it is better not to explain too much or patients who like to keep control, will influence the answer with their rational mind. This makes their answers worth less. When asked for the experience and the patient answers with: I feel sad, we know it is Level 3. We can prompt the patient to tell us more and most likely he will go into Level and give ideas, delusions or images: it hurts in my heart, its like a wound there, as if somebody stabbed me with a knife etc. The leap to Level 5 is to ask directly for the experience: to be hurt and stabbed in the heart, how is it for you?. If the patient needs a plant remedy hell give a plant sensation: it is like being burned to the third degree, like scalded, like your skin is raw, it is very, very painful (Ranunculacea). If it were an animal remedy the sensation would be that somebody tried to kill me, wanted to finish me, hated me so much that he wanted to murder me to get rid of me etc. The aggressor would come into the foreground. In the plant kingdom the sensation of what it does, comes to the fore. To know for sure whether we are dealing with a local sensation or a vital sensation, we have to wait during case taking for the same sensation to be repeated. If it doesnt, it means it applies only to one situation, or one level or one complaint. Until the contrary is proven we cant use it as a basis for the prescription. For instance, a person has a stiff and painful joint and he cant move freely. When questioned about this, he says he feels stuck. This is a sensation belonging to the Anacardiaceae, but it is also a quite common sensation with that kind of complaint. If the stuck feeling is not repeated anywhere in the case, it probably was a local sensation. In another example: a patient has a quarrel with her mother-in-law. She feels the mother-in-law doesnt accept her, treats her like a stranger though she makes all possible effort to be recognized. Still she feels shes not part of the family, she doesnt belong, she is not wanted and is ultimately alone. This doesnt necessarily mean that she needs a plant from the Lily family: a feeling of being excluded and forced out. If this same feeling is not repetitive in the patient, then it belongs to the situation, to the story and not to the vital disturbance. It can be a more or less realistic depiction of what is going on and the feelings might well be in proportion to her actual situation.

In order to be sure that the sensation is repetitive, it must come up spontaneously. This is why it is so important to ask very open questions and to follow the patient where he is taking us in the first part of the consultation. If we start to ask questions about a sensation too soon, we emphasize it before we even know if it is a vital sensation. The patient will get the impression that for some reason this is important, and we making a case instead of receiving a case. To spot the repetitive sensation, the full attention of the homeopath is required. The patient may use different words for the same sensation. For instance the sensation of the Solanaceae is catastrophe. But there are many expressions of that one sensation: war, violence, explosions, fire, bombing, earthquakes, tsunamis, volcanoes, natural disaster, plain crash, and so on. The main idea is of a violent event with many deaths and the action the person wants to is to escape from the place of danger. Even when the patient doesnt use the word catastrophe, we have to spot the idea of a calamity of this kind. It will be the underlying feeling or message in every story or example that he gives. On the other hand, when a patient does use the word catastrophe we cannot be sure that he needs a plant from the Solanacea family. First we have to ascertain for ourselves that it is not a common expression from the third level but a vital sensation from the fifth. And then we must listen carefully to discover whether the sensation is general and is repetitive. The third aspect is the opposite of the sensation: again this must come spontaneously. Asking the patient who complains of feeling stuck what the opposite would feel like, is an ineffective question. The answer is too predictable and loses all impact. Sometimes the patient only gives you the opposite polarity since it is the compensation for the sensation. It is what the patient is aiming at in order to avoid his sensation. For instance the Umbellifereae sensation is that of a sudden and unexpected blow. The way to avoid this is to be prepared for everything, to expect the unexpected so to speak. Hence these patients will stand out because they stress over and over how well prepared they always are, in any situation. Then one starts to wonder who needs to have this condition fulfilled in order to be OK and then we understand the sensation behind it. A patient needing a remedy from the Papaveraceae family is sensitive to unbearable pain and torture. Since they perceive in the world around them only cruelty and pain, they may spend their time and effort on spiritual practices to gain a sensation of calmness and bliss, the state of the Buddha. A patient needing a member from the Solanaceae family will probably describe fight or flight reactions or adrenaline and that he wants to sit near to an exit to be able to escape. Even if he doesn't talk about the catastrophe he feels lurking in every corner, by describing the opposite we understand what it is that he wants to avoid. Any sensation that a person has can show itself in different ways: the straightforward sensation, the way the patient copes up with it or the compensation. The coping up points to the conditions he needs to be OK. In reality everybody is OK. Wouldn't it be a blasphemy to accuse our Creator of doing a sloppy job? Is it man who decides what is perfect and what is not? Is the eagle perfect and not the crow? Is the buttercup perfect but not the daisy? Are there perfect and imperfect beings? Such an idea is unimaginable except in a limited or distorted point of view. This is what we call disease. We can't see the love and perfection in all creation but qualify things as good or bad according to our morals, philosophy or likes and dislikes. Because of that we feel there are conditions that need to be fulfilled in order to be OK, lovable, worth our existence and maybe to earn a place in heaven.

The general kingdom hint for plants is this specific sensitivity and an overall tendency to react to the environment. Plant patients are lively and alert, vivacious and easily touched and they react before they can think. They are quick, swift, attentive, and make connection with everything and everybody around them. They have an eye for the surroundings, for beauty and harmony, colors, smells, proportions, tissues, sounds, anything. This also means they can startle easily, get carried away by music, love to dance or watch dancers, be sensitive to perfume, get readily disturbed by messy things, feel in their bodies what is happening around them. For instance they listen to the evening news on TV and all the violence and the disasters give them the feeling of being fragile. Then they tell an anecdote in their life of a relationship that ended and they feel that this split in the family can never be mended. And their main complaint happens to be inflamed joints, which give them the feeling that they can fall easily and break something. The feeling in mind and body is the same: fragility (Conifers) They can talk at length about their connection with animals or favorite pets, they love flowers or gardening, cooking, decorating, they have alert senses in general. Most of them will love to be in nature, enjoy landscapes, forests, trees, desert, mountains, and the seaside: the fresh air and the sun. And not surprisingly, the majority have all kinds of modalities. This means they are easily affected/influenced by outer circumstances. Of course they react to other people as well, in close or more remote relationships. Everything that happens, that is said or done, makes a deep impression. The consequence is that plant cases give an abundance of symptoms, a lot of modalities, sensations, anecdotes, stories and examples. Often when the homeopath can't see the wood for the trees it's because he is in the plant kingdom. Because they have a vivid way of talking the plant case can be confused with animal remedies. But in plants it is rather a matter of stimulation of ideas, excitement or exhilaration; in the drug remedies this goes as far as euphoria. Because of their intense feelings they can use strong language, but again this is not an animal quality as such. A plant can have an intense fight with somebody and be enraged or full of hatred. They can be intensely jealous (Hyoscyamus for instance) or express forthright violence (Solanacea) but this is merely an emotional reaction to what they experience. And in plant remedies the miasm determines how the patient is coping up with his vital sensation. Let's take the example of a patient belonging to the Cruciferae family: they feel the natural flow is stopped and dammed. The continuity is stopped by something in the way, the flow has come to a standstill. Depending on the miasm this can be experienced in different ways.

Anamnesis

It is always said that case taking is at least half of the work and it is true. When an interview is well done, the vital disturbance should be clear or at least the expressions of the disturbance should give a coherent pattern. In an ideal situation only one or a few remedies are left to prescribe.

Although every homeopath has his personal style, there are nevertheless some guidelines to help the homeopath navigate the interview. When we are focused on the vital disturbance, our questioning should be aimed at getting us to Level Five, if possible. If this is not possible, then we should be able to perceive expressions of the Level Five disturbance on all the other levels. If the homeopath knows exactly what he is looking for, he wont get lost on the way. With the Vital Approach it is always possible to determine on which level we are, and whether we have information relating to the kingdom or miasm. Before the Vital Approach, the homeopath often got lost in the sheer bulk of information. It was difficult to determine which information was qualitative and which was more quantitative. In that situation there is a tendency to refer to keynotes or important features. The disadvantage of this is that we all have many characteristics, which are covered by many remedies. These remedies will all affect the expression or symptoms but which wont cure the source of the problem. Every patient is different but there are some general rules that should be followed. Long experience in practice has led me to conclude that the patient will always take you where the treasure is hidden. Id like to stress this because it is so important. The patient will define the territory and all the homeopath must do is dig there for the right remedy. If we ask questions and by doing so direct the patient, then weve lost this crucial help. We will define the topics and the patient will answer our questions because he thinks this is the information we need to know in order to prescribe. As a result we will have collected information that suits our prejudices and we will have made a case instead of receiving one. The first method almost always leads to remedies we know and feel comfortable with, the latter can lead us anywhere! We can trust and follow the path the patient is taking us, because we know he will lead us precisely where we need to go. This is so important that I cannot repeat it enough. The patient leads us by the choice of topics and the way that he reveals them to us. All we have to do is willingly follow him in any direction he is taking us. In this way he defines the territory and we can be absolutely sure it is there that we will find the remedy; we dont need to inquire about any other area! We might so inquire at the end to confirm the remedy (or kingdom/miasm/source) but it will only be confirmation. Having said that: Step 1: Define the Territory By define the territory I mean that whatever the patient talks about at the beginning of the interview, answering the homeopaths general question (like: What brings you here? What can I do for you?) is a marker of the territory. This especially applies to his spontaneous remarks or questions: (what a nice office you have! Should I start at the beginning? I used to work there and there but because of the system I changed to etc.), all are important and meaningful. A patient never says anything haphazardly and certainly not at the beginning of the consultation. These spontaneous remarks are also important throughout the whole consultation, and even if the homeopath misses a few, the patient will repeat them more than once. Some patients may answer a simple question with just one line while others may take three quarters of an hour to answer the same question. In the first case the homeopath will need to help the patient, they may be shy or be unsure about how much time they can take. The questions must be as general as possible, for example: Can you tell me more

about this? Can you tell me even more?, Can you give me some details about this? Anything else? The first thing we need to do is determine the Chief Complaint. This may be anything. A patient might start the interview with a clear physical complaint and medical diagnosis, or have seven minor complaints, distributed on different levels. When the patient names more than one complaint, we must ask: What complaint is troubling you most? The answer may be a confirmation or a total surprise! Sometimes the patient comes up with a whole new and unexpected subject. As a homeopath, never assume that we know something. We dont! We know how the world looks from our point of view and we have our definitions and understandings of words, meanings and context, but the patient has a whole different experience of the world. In fact it is exactly this different experience of the world that we are trying to unveil during the interview. Every time we are not asking for clarification because we assume we know what the patient meant or we know what a word means, we risk missing the point. Some homeopaths might find it uncomfortable to not know during case taking, but its important to remember that we are not sitting there in a meditative state, somewhere in the clouds, trying to blank out our minds or doing something vaguely spiritual. On the contrary: we are sitting there with full attention, and with full trust in the technique we are using (because it works!) with interest and a determination to understand the uniqueness of the person in front of us. How this uniqueness looks in each case we dont know, we will explore it during case taking. How we are going to get there, we have a fairly good idea because we use an established strategy. We studied the theory, we practiced the tools, weve seen it demonstrated many times and we ourselves have done it many times. It is like solving a puzzle: even when you know how to do it, each puzzle is a new challenge. You know what to do but you dont know the outcome. This not knowing doesnt need to be uncomfortable; one can be a super expert at solving puzzles/riddles and still not know what the outcome might be of any individual puzzle. The not knowing therefore means that we dont know how the patient will express his vital experience until we questioned him carefully. Subjects are chosen by the patient The questions we ask at the beginning of the case-taking invite the patient to respond:: Can you describe what it feels like?, How is the tiredness/ restlessness/ stress (etc.)?, Is there anything else that troubles you? Very often, after summing up the chief complaints and minor complaints, the patient will give some reason or explanation for his troubles. He might think they are due to a weak immune system, to a shocking event, a loss or stress of any kind. He might give a medical explanation or he may have visited alternative healers before and tells the homeopath what their conclusions were. Patients have often already been through psychotherapy or read books and attended workshops to come to terms with their sufferings and will share their ideas with the homeopath. Although they may sound like rationalizations, they are still important. Mans mind works in mysterious ways! The homeopath needs to listen very carefully to the patients conclusion about his sufferings. What does the complaint prevent the patient from doing or how does it affect him? How does he feel about this complaint? How does he cope with it?

We must first try to identify the symptoms, which are incongruent with the patients pathology.. In the beginning we may get hints of the vital sensation when the patient reveals, often between the lines, what the complaint does to him: make him less attractive; make him less capable; produces a certain feeling; makes him conclude that he is not normal, etc. We repeat our question, anything else? until the patient himself agrees that there is nothing more. We should ask a question two, three or more times until we are sure we have all the information possible! In fact during consultation, when the homeopath perceives there must be more underneath, any question may be repeated. In order to make it sound more natural to the patient, the question can be rephrased, although the patient is often not even aware if the question is literally repeated. In the first part of the interview where there is minimal intervention by the homeopath, the spontaneous emotions of the patient become important. Any spontaneous remark by the patient is considered twice as important. Or conversely: any answer to a question by the homeopath is of less importance. We risk getting what weve asked for and very often that is not what the patient was going to tell us. By spontaneous emotions I mean: those kind of extra lines that the patient offers during their report: what I found difficult, I was shocked by, this head ache makes me irritated, Im afraid this spot will spread, this really knocked me down, the blocked nose is hindering me, etc. In the first part of the case taking we get sensations and feelings interwoven with the symptoms given by the patient. Many of those sensations might be common, many will be local, and some might be vital. This is what we need to discover during the consultation. But first we must give the patient the space to tell whatever he thinks is important, we will for clarification later. It is always better not to direct anything at all, not to ask anything at all in the beginning, lest we decide the direction of the case! We do not know. The patient is the only one who knows, even though he may not be aware of it. Who besides the patient can tell us how it is to be him or her? How it is to experience the world and himself? The patient is the only one who knows. When he tells us, we are allowed to understand and to see the pattern. This process of seeing what something is, is very different from understanding why. It is almost like looking at a picture in a 3D modus: it is necessary to look a in a special way, almost looking behind the picture, and then all of a sudden the image, always there but previously invisible, becomes clear. Once seen, its hard to imagine how we could not see the image before! It is not a matter of interpretation, understanding why the house or the tree is in the picture, nor is it a question of the house being good and the tree being bad. The judgment we make must be about what is a piece of the pattern, not what is desirable or not. Step 2: Questions for details When the patient defines the territory we must ensure that we precisely determine the borders, and therefore ask questions about the topics that the patient just discussed. If he said he has three problems, well ask anything we can think of about these three problems. Keep in mind that those questions should be as general as possible, they should not to lead or guide the patient in any direction. General questions mean questions

without any suggestion or interpretation. When the patient said: This knee is causing trouble, the question should be: Can you tell me more about the trouble? not: What kind of pain do you have?. This way of questioning the patient is very different from that used in other therapeutic modalities and the homeopathic student needs to become familiar with it.. The focus of the case-taking should be on helping the patient describe what is experienced, not explaining why the problem is there. When the patient has told the homeopath everything about the what, the how, the when and the where of the problem, very frequently he makes the topic broader and moves from my problem to me. At this point, the patient will give the homeopath his own concerns, anxieties, worries, ideas how and why it started and previous similar events or feelings. In this way we seamless go from the complaint to the patient and are given parts of his life story. Even if we dont ask many questions, this part of the consultation tends to be loaded with so many stories that it can be hard to discern the qualitative from the quantitative information. It requires the homeopaths full attention because, as mentioned before, there is always a reason why the patient chose just that example out of the million other things that have happened in his life. The art is to spot the particular way of telling this story and the spontaneous remarks that come with it. Examples of this might be: a common expression but in the wrong place; a sequence of words with one illogical one, not fitting or repetitive; or an odd word or an unexpected, even wrong expression. In short: all those things that would not have been said by anyone else, and which means that they are the signature of the patient: his frequency pattern. The homeopath at this point should restrain himself from jumping to conclusions when he hears something familiar: a rubric, keynote, a hint he recognizes as belonging to a certain remedy. All patients will give you many if the consultation is long enough! But these are nothing but attributes that we all have in abundance, without having connection to the vital disturbance: they are just local phenomena. We cant go on giving everybody who prefers soft boiled eggs, Calcarea carb., can we? On the other hand we should not ignore hints to remedies, not at all! They must be registered somewhere in the back of our mind and if more rubrics are added as the case unfolds, then of course we can give the remedy. But we should avoid getting fixed on a remedy as soon we hear a keynote, because then our mind tends to delete everything which the patient says that doesnt fit our idea and only hear what will confirm it. A good method to dispense with a fixed idea of a remedy is to put that remedy to the test. As an example: a woman came for an intake in the Master Class for severe cramps all over her body. She was talking about her job and how much stress she always had. As a teacher she was given a difficult schedule, she had quarrels with the director, started a case with the union and felt wronged by everybody. But she was firm and defensive and fought for her rights. It was difficult not to think about Cuprum in her case. Instead of asking more about Cuprum topics like: What about finance?, Can you tell me more about the importance of work? or What does this health problem mean for you?, which would all lead to predictable answers in light of the topics just discussed, I tried something completely different. When noting down her personal information, she told me that she had two children and that the oldest boy was handicapped. Since she didnt mention him in the consultation so far, I asked her about him. She answered that since she is a perfectionist, it was difficult for her to accept. She gave a few more sentences, and then

somehow made an association in her mind and started talking about the neighbors. Their garden bordered on the patients garden and the neighbors gas tank spoiled their view. She wrote letters to the municipality and even took a lawyer. Within a moment of being asked about her handicapped son she was giving me another image of a bossy person, vigorously fighting for what she thinks is right and should be forced by the law upon others. She spoke hardly a word about the boy! Well, this was strange, rare and peculiar for a mother and confirmed Cuprum. The difference was that now we were sure it was Cuprum, whereas when we ask Cuprum questions we will never know whether we made the case ourselves or not. In this part of the consultation, we encourage the patient to tell us about the topics he began with, but we dont choose other areas. If he doesnt go there we dont have to go there. The encouraging questions are all aimed at Level 5: How did you experience this? It shouldnt always be put literally in these words because it might sound quite artificial, better to use as few words as possible and to make your question as broad as possible: How was it?, Can you tell a bit more?, Can you describe this?, When you say: grief what do you mean?. One can repeat a question more than once. Many beginning homeopaths dont dare to do so because they are afraid they may look stupid. They think the patient will think they didnt listen or they dont understand the simplest thing. Sometimes they are afraid a patient will lose his patience or will never come back. To avoid this it might be wise to introduce the repetition of the question with a little explanation: I know you told me this before but could you describe once more how it was for you when your daughter left home? Every time you tell me something, some new words or expressions might come up and I want to have the picture as complete as possible. When a patient says: I dont know, it is a good idea to give him a little time to think: often it is nothing but an introduction to the answer. With children Id even press a little bit and say: Well, think a bit then. The middle part of the interview mostly gathers information: the patient tells you part of his life story or at least some events that left an impression on him. The fact that he chose to bring up these topics means they have something to do with the vital sensation. It is always the patient who links everything together. We shouldn't use our imagination to connect parts of the story together because we risk making a creative prescription that has nothing to do with the patient. For instance: we feel the patient behaves like a frog: he loves nature and moist weather, he has big eyes and a big mouth, he is kind of jumpy in his narration and he burps like a frog. This may all be true, but if the patient didn't give kingdom and subkingdom words or even better, proving symptoms, we have to be very careful with such prescriptions. That is why I recommend asking questions that are as general as possible, checking the answer three times and putting the idea to the test at another point in the consultation. Also: never assume you know what the patient means: you don't until the patient has told you. If he uses the word emptiness, what does he mean? You have to ask! Silly as it may seem at the beginning, the value will soon be obvious Just ask three patients who used the word injustice what they meant by this; the answers will be completely different. When a patient talks about tension, stress, difficulty, problem, being depressed, always ask: What do you mean? If you ask how they feel about something and the answer is bad, you can ask: I understand this makes you feel bad but how is it that? If they say: It is difficult, then the homeopath can ask: This bad and difficult feeling: can you describe it a bit

more?. It is necessary to keep asking until you feel the answer is authentic and personal, and not something that everybody says. It may be a word, an example, a comparison, an expression, as long as it expresses the deepest feeling if the patient. Another very important reason to inquire deeply is to see if the word the patient chose to use 'holds'. For instance, the patient says: I have an empty feeling inside. We could stop here and with great self-confidence prescribe a mineral remedy, but if we ask what the patient means by emptiness and the answer is something like: It's a feeling of being left alone in a dark wood, then we have to go on asking: And how is that?. Let's say the patient answers: Scary, then this is Level 3, and we have just double-checked whether the emptiness was a Level 5 sensation. When we first asked we may have been given an image on Level 4, but when we asked again, something else came up. Now suppose we go on and ask: This left alone, scary and empty feeling, how is this for you?, and the patient says: I feel completely lost and bewildered, we must conclude that the emptiness doesn't hold and our questioning has led to something else. Lost and bewildered sounds like a deeper experience and we must check during consultation if this experience is repeated. It is another reason why consultations take time: to be sure we must check, otherwise we will simply be guessing, going by the words without knowing exactly what the patient meant by them, and furthermore we will not have the context in which the words were said. Some cases are time consuming because the patient is loquacious and describes every event in his life in all its detail. Or he may have read a book on homeopathy where it was stated that the homeopath needs to know all about his character and preferences. This can lead to what I would call horizontal information: more of the same. A homeopath needs to go vertically through the levels. A good way to switch from this horizontal information is to take the first opportunity to say: I understood this and this and that happened and you were feeling such and such, can you tell me how it is for you to be in those situations?. The homeopath can precise what the patient told him and then make the leap to Level 5. Its a direct question but it is based the story told, not on a single word. Sometimes the patient jumps from one subject to another but certain words are repeated.. Then the homeopath can pick out the repeated word and ask the patient to define it, but the word needs to have come up at least three times. Lets say the patient mentions the words doubt, which is very common. This could be triggered by his chief complaint, for instance vertigo. If the word pops up again, for instance in a relationship problem, it means it is also felt on a completely different level and in different circumstances. If the patient then tells another anecdote where the final conclusion is doubt, for instance doubting his capacity to financially manage on his own, then we can ask: when you say doubt, what do you mean?. If it wasnt clear by then, the kingdom will probably be revealed by the patients answer to this question. In general, the kingdom, miasm and often the subkingdom, are clear when the second part of the consultation is done, usually after approximately an hour and a half of case-taking. Step 3: Confirmation By the time the territory is defined by the patient and the topics in it fully explored by the homeopath, stuffed with all the patients anecdotes and examples, the homeopath usually

has a good idea where the treasure is hidden. He doesn't know what he is going to find but he knows where he needs to dig. The third step of the consultation is mainly for confirmation. The homeopath can begin to ask more direct questions, for example: There are a few words I'd like you to clarify, in the beginning if the interview you said, or: I noticed you used the word pressurized a few times, can you talk a bit more about pressurized?, or: Your pains in the legs are unbearable, you said, can you say a bit more about unbearable pains?. Now is also the moment to ask about the patients fears and anxieties, even if the patient has already talked about them, it is important to check. The homeopath can ask: Is there anything you are afraid of?. If during the consultation the patient has already talked about his fears, he will come back to it and that provides a good confirmation. If the patient has not already been specific about his fears, he might link them to the Chief complaint anyway. Psychoanalysts describe dreams as the highway to the subconscious, but the homeopath uses them in a completely different way. The homeopath doesn't try to interpret the dream at all, but takes the facts and the feelings in the dream as important features. For instance: somebody may dream of being in a boat on the water. When asked what the feeling is, the patient may say: very calm and pleasant, or extremely scary, it was like a threat came from the deep water etc. The image alone is not enough to understand the patients experience. On the other hand, many dreams seem to belong to daily human activity: dreams of coming unprepared for exams; having to hurry to catch a train or plane'; going out into the street half dressed; being persecuted; trying to escape but the legs won't move; teeth falling out; dreams of flying and so on. Although these dreams are common, we must still ask for the individual patients feeling in the dream and how often they have had it. Whether we take the dreams into account depends somewhat on the intensity and the frequency of the dreams. The same applies to children's dreams. It is quite common for children to dream about a ghost or a monster, but if the child has frequent nightmares about them and the child wakes up terrified, then it becomes a problem. Very often an attitude or a feeling in itself is not strange, rare and peculiar, but rather the fact that it is recurrent, or inappropriate, or out of proportion. If at this point in the interview we do not already have a good idea of the delusions in the case, we can often discover them by exploring the fears and dreams. Also the things that the patient cant stand are discussed. It is up to the patient to give meaning to cant stand. This may be anything, from the smell of eggs to people who abuse animals. It may be a sensitivity or an irritation, an aversion or disgust. A little reminder here: when the patient says: Im sensitive to, does not automatically indicate the Plant kingdom, everybody is sensitive to a particular thing, that is the definition of their problem. Mineral or Animal or Nosode patients are also sensitive; it is what they are sensitive to that points to their remedy! Sometimes it is in the last part of the consultation that everything falls into place and it is only then that we have the aha feeling of now I understand, rather than it confirming what we already knew. This is just as well. Some cases evolve in a step by step manner, where one statement builds on another, while other cases seem to be only unconnected bits and

pieces of information that the homeopath cant bring together. It may be compared to working on a puzzle. If the homeopath has the main picture with pieces fitting together, he is able to see the picture quite early in the consultation. However, sometimes the homeopath has a piece here and a few pieces there and it is only at the end of the consultation that the missing piece that links all the others together is revealed. It can be more uncomfortable for the homeopath since he must stay in the not knowing mode for a longer, but the end result is the same. If at the end of the consultation things are still not clear, we can ask the patient what events, people, times, situations or circumstances in his life had the biggest impact. Often this leads to some conclusive statement from the patient. To finalize the case we can talk about the things the patients likes to do best. Does he have any hobbies? Where or what does he likes best? What were the moments in his life he had a really good time? What would he like to do if he had the time and money? Normally if the vital sensation is understood at this point, the homeopath is not surprised to see it expressed in everything the patient says and does, even in his hobbies or fascinations and in his likes and dislikes. It is also advantageous to end the consultation on a lighter topic. To send the patient home once the fears and worries or deepest disgust has been investigated seems a rather odd thing to do. To discuss positive aspects of the patients life makes the atmosphere more natural and eases the transition to common conversation (Level 1, 2 or 3). When an anamnesis is well done, the vital sensation is clear and two possibilities present themselves: the similimum (the remedy with a similar vital sensation) is known, or we know what remedy we need to look for. If this is a remedy that is unknown to us, we have software at our disposal to help us find it.

Kingdoms The vital sensation is the way the person experiences himself, it is how he is, what it is like to be him, hence his individual being or his uniqueness. There are of course many features in this uniqueness, many of them unconscious and operating autonomously. It can be compared to a whole orchestra with the vital disturbance being one instrument that is out of tune, spoiling the entire performance. Many of the instruments will be in tune though, since many facets of the patient are healthy, balanced or functional but since there is one loud, false note, the music of the person will sound distorted. If the similimum then tunes this instrument, the person can start to play his own song in a harmonious way. But first, a few words about symbols. In my understanding (and as explained in The Charm of Homeopathy) Our remedy pictures are symbolic One of the main differences between men and mammals (with whom we share the physical body) is the capacity man has to symbolize. Animals may have a rudimental ability for it

but people do it most of the time. A child at age one is capable of understanding that an object that is out of sight still exists. This means he can grasp the idea of absent things and people and he can even recognize abstract images of it. A toddler can look at a picture, an image, a drawing, a TV play and recognize the rabbit, be it two dimensional, big or small, in any color, speaking or moving, talking or being dressed up, in whatever material it is made. He even can use a symbolic sound to point to that rabbit and knows it is the same thing as his cuddly toy or the animal in the garden. To be precise: it is not the same but it is similar enough to be recognized as belonging to the same category. We know that nothing is ever the same, there are no two identical snowflakes, but to make communication possible, we use the same symbol for things that are similar enough to be considered as belonging to the same category, symbol or word. For us it is such a normal phase in evolution that we dont notice how absolutely incredible this is. A small child, hardly capable of walking and feeding himself, already has the mind power to understand such complex processes and learns with amazing speed to fill his inner map with symbols. This is what we call education: the symbols are exchanged and communicated. This means we agree on a certain version of reality. We learn how to be human among humans. If a child is left with wolves, it will grow up to be a wolf. The potential to be human is there but when unformed in the growing up phase, or rather replaced by another formation of the inner map, it becomes impossible to correct later in life. The wolf children never managed to learn to speak if they missed this development at an early age. Of importance for us now is the observation that we recognize representations or symbols of a thing or an idea on the basis of similarity. As long as the representation carries enough characteristics, we identify it as the image of a certain object or phenomenon. With enough characteristics we mean with minimum and meaningful characteristics. A tree can be depicted with two parallel vertical lines and a circle on the upper part of this: symbols for the stem and the crown. Even a small child will draw a tree like this or recognize the symbol, yet in reality it has little to do with the complexity of the real tree or the enormous variety in trees. The symbol is not much but it is enough. Another example is the representation of a man: a few lines with a circle on top will do: two lines for the arms, two for the legs and one in the middle for the body. This carries enough meaningful characteristics to represent or symbolize a human being with its enormous complexity! This is the way we use symbols and in this way we make groups. All categorizing is based on enough similarity to put related phenomena into a group. This is done in science. This is what we also do in homeopathy. The peculiarity with homeopathy is that the body of knowledge first started with the detailed data and later developed larger categories, whereas in science the domain is first divided into large groups or areas and then into subgroups and finally into species. Its possible that the reason for this may be the fact that science is based on the outer gaze of the objective observer looking at what the phenomenon looks like and does, while homeopathy is based on the inner experience of what the phenomenon feels like and means.

The larger groups in homeopathy are founded upon proving symptoms and rubrics. The last three decades homeopathy took a quantum leap due to the understanding of inspiring teachers and the new possibilities afforded by computer software. As all progress starts with the right questions, some homeopaths asked themselves whether homeopathic remedies that belong to the same chemical groups or biological families have similar drug pictures. The answer was that they do: the kingdoms proved to have common characteristics, as well as miasms. The first observation was that remedies belonging to the three main kingdoms: plants, animal and minerals show common characteristics. The other kingdoms: Monera, Fungi and Imponderables were examined and common traits also found. It is often impossible to find these characteristics reflected in the separate rubrics: kingdoms are only to be determined on the fifth level: they are rooted in the experience of the self, hence the vital sensation. This means that the same event can be felt in a different way according to the kingdom to which the person belongs. It is clear that this as a tremendous help in finding the similimum: once the kingdom is clear, only remedies from this group need be considered. But as these kingdoms in themselves are not yet listed in the repertory rubrics, the homeopath must put the right questions to the patient and understand the kingdom before he refers to the repertory. Then the search may be limited to the kingdom to which the person belongs. It is clear that this means the search for the remedy is directed and is based on the pattern of disturbance of the patient, instead of being based on the amount of remedies that the homeopath masters. In the first case the outcome can be any remedy, (known or unknown to the homeopath), in the latter the patient is fitted into the boxes, which the homeopath has at his disposal. This clearly makes a fundamental difference in solving a case. Lets say the homeopath knows 30 polychrests. Probably he claims he can help 80 % of all his patients. Which is absolutely true. If he had only 9 remedies, he would also be able to help 80% of his patients. We can make our categories as large or as small as we want: people will always fit in. The two first categories are the gender: only two. Then for instance we can divide according to astrological sign: 12 possibilities. Or according to the types from the Enneagram: 9 boxes plus combinations. Or in Psychological Types: 8 basic types with combination pictures. Or in 12 polychrests: archetypical images. We all fit in many boxes and all those characteristics are part of our overall make up. But in homeopathy our aim is to prescribe for the individuality of the patient. In its logical consequence this means we should give a different remedy to each patient. Of course this is impossible to accomplish and the topic is covered in my book The Charm of Homeopathy. The homeopath who works very hard can master more than 100 remedies, he can familiarize himself with a few hundred maybe, but still it is a very limited number of the remedies listed to date (some 13.000) and it is impossible to keep up with the new remedies and provings that appear every day. Even though having a vast knowledge of remedies is a

huge help in solving cases, it still takes a good method to know what will fit the patient. It is like having an enormous vocabulary and no grammar to make sense of it or on the other hand, having a thorough knowledge of the grammar and a poor vocabulary makes the outcome very limited and impersonal. Ill go into more detail on the patient based search in the chapter on anamnesis and analysis. Mineral Kingdom It is no surprise that the systematizing of the homeopathic remedies started with the grouping of the mineral remedies. In the late 80s, homeopaths taught remedies in groups like the Natriums, the Kalis, the Magnesiums, the Ammoniums, the Aurums, the Ferrums and so on. The compound remedies had characteristics of either element and they had a signature of their own. Sankaran noticed that Precious Metals like Palladium, Argentum, Platina and Aurum shared a lot of symptoms and characteristics and were neighbors on the Periodic Table. Could this mean that we could draw conclusions from the position of an element on this table and these shared characteristics? It was clear from these well known remedies that these metals shared the need to perform exceedingly well, to be in the limelight, to be on stage, doing supernatural deeds, being haughty and above others. What about other metals? We had enough well proven metals like: Ferrum, Zincum, Cuprum, Cobaltum, Niccolum to know that they also share qualities. Little by little the whole Periodic Table was examined by Scholten and others who did group-provings. Meanwhile elements that were so far unknown were proven, elements like: Hydrogen, Helium, Ozone, Plutonium, Germanium, Neon, Crypton, etc. (Sherr at al). During the last two decades the general themes from the mineral kingdom were formulated. I found the vital sensation of the element is the feeling of being empty. It is an existential emptiness of Level 5, not the energetic emptiness of Level 2. In the latter it is a matter of having no energy, because of expending a lot (in sports for instance or by overwork) or having chronic fatigue syndrome or a related problem. In the former the experience is of being fundamentally empty, which, by the way, is the truth. Elements are as proved by quantum physics- not the little building blocks of matter they were thought to be but are empty in themselves. In a human experience this emptiness results in a need, a lack, a missing or losing something that the person needs in order to exist. This means that the case of a person needing a mineral remedy will revolve around his existence, not his life or his survival, as it would in a plant or animal kingdom case. In order to exist the mineral patient misses something, he needs, lacks or loses something, what we call his condition to be OK. This something is the fundament, the basis on which his existence is built. When you hear the patient using these words: emptiness, fundament, missing, lacking, losing, building, basis: those words are watertight pointers to the mineral kingdom. Remember: the kingdom is only discerned at Level 5. Of course it always depends from which level the information is coming. In the beginning of a consultation a lot of patients sound like minerals: the language is fact like, a bit distant and the words chosen are like official language. This can be the phase of testing the homeopath. But even then the patient might introduce his complaint in a mineral way.

Not so much in a logical mathematical sequence of telling his symptoms, because this only means the patient is orderly and well organized. It is clear that also plant remedies and animal remedies can be controlled, logical and well organized. These are aspects of a persons personality and we are not prescribing on personality but on the vital experience. Personality is the result of inherited traits, education, intelligence, social background, family situation and temperament. But a vital sensation can persist regardless of those conditions. That is why we can rely on the vital sensation to prescribe no matter the gender, age, profession, constitution or circumstances of the patient. If we base our prescription on the pictures of one possible expression (for instance the Nux vomica workaholic, the tearful blond Pulsatilla, the menopausal Lachesis), we risk not recognizing the vital sensation when it shows up in a totally different expression. (The five year old Nux vomica girl, the bald 60 year old Pulsatilla man, the young Lachesis guy). Expressions are limitless. It is very risky to prescribe on them as the same expression could as well result from a different vital expression. A workaholic can belong to any kingdom and miasm because it is a personality trait rather than a vital question. Back to our minerals. The underlying experience in their life is of missing, losing, needing, lacking something they need in order to exist. The basic requirements in order to be OK depend on the issue of the horizontal row of the Periodic Table. The degree of dependence is reflected in the vertical column: well go into that in detail when we discuss rows and columns. The mineral patient will talk about his capacity and for that uses words so common that we can easily overlook them. He talks about what he (cant) do, what he (doesnt) manage, in which he (doesnt) succeed. He feels he lacks strength or stamina; he doesnt have enough energy, balance, power, security, support, stability. This may accompany the report of his chief complaint. For instance: he has a low back pain and therefore feels unstable. Or he may conclude a whole report of a chronic complaint and all the treatment he underwent by saying that the situation is more or less stable for the moment. A patient put it this way: my health since the stomach ulcer is still a bit shaky. Very often they use the words support: I had no support from, I needed a bit of support from him, who is going to support me now my father has died?, this idea supported me They are wanting, needing, lacking or losing the support they need. It can be expressed like something to hold on to, something to base yourself on. This accounts for the first 9 columns while the columns from 11 to 18 feel they lose their grip; things are sliding away under their feet, or crumbling down or collapsing altogether. They experience the hardships of life as a threat to their very basic fundament. It is the structure, the frame that they have built their life on. If things go wrong it is experienced as touching them in the deepest part of their core; sometimes they even use the word nucleus. Often mineral patients talk about parts or pieces of themselves, as if they were made up from bits and pieces. As they feel something is lacking they feel incomplete and are looking for this completeness in order to be OK. This again is common to all humans: to look for the thing that gives fulfillment. But the mineral person feels something in him is lacking, missing or getting lost, while a plant will suffer from his specific sensitivity. Theres nothing missing or insufficient, if only he didnt always

feel so, lets say injured. In the animal kingdom nothing is wrong or missing with him, it is the other who borrows trouble. In the nosode kingdom the person feels he is weak and abnormal because he is always sick in circumstances where others are healthy. The mineral person feels dependent on this particular condition he needs to fulfill in order to exist and strives to become independent from it. But the more his structure or fundament is unstable the more dependent he will be. It is said in the beginning of the categorizing that the mineral patient is well structured and although this is basically correct it can lead to many misinterpretations. The most common mistake is to go for the words and disregard the context in which the word is said. This makes all the difference in the world and it is well demonstrated by the Vital Approach Scheme. If the information doesnt come from the fifth level, the kingdom cant be discerned. Now if a patient talks about my structure and Im a well structured person and the structure in my life is lost since I quit working, he may well be talking about this personality trait of him: being a person with discipline and a tight schedule. This is something completely different to a vital sensation. A plant can be very busy (Bryonia and Nux vomica are well known examples), an animal remedy can be industrious and well organized and a nosode can plan his agenda meticulously. This is Level 3 information: it is the level of the story, the biography, the personality and might contain Level 5 information (the vital sensation is all levels all of the time) but is not to be confused with it. Level 5 or vital is what persists regardless of age, gender, situation, background, education, intelligence, mood, situations Homeopaths are sometimes at a loss when the patient comes with a certain story one consultation, and brings a whole different story and mood at the next one. Which is true and on which one must the prescription be based? It is exactly here that the value of the Vital Approach is well demonstrated. No matter what the patient comes with, we probe deeper to find the vital experience in it. And we will not be surprised to find that it always leads to the same thing. It has to. There is only one vital sensation in a patient and it is the source of disturbance. This is why a patient will always come back to it. It doesnt disappear after the similimum because it belongs to his individuality, how could it vanish? His name or face wont vanish either after the similimum! But it will be silently in the background and wont prevent the maximum harmonious functioning of the person on all levels. This basis, this foundation that the mineral person is talking about is not a real material construction, it is the way the person experiences his life and himself. It is the foundation of his being and hence the case will evolve around meaning, sense, use, value, purpose, role in life. This means if the patient talks about a difficulty at his job, for instance he feels surpassed by a colleague and suffers from injustice, we have to keep asking. The story is not sufficient to prescribe on, neither is the feeling of injustice (Level 3) Not only is it a common human feeling and, according to aphorism 153, we shouldnt prescribe on the common but on the strange rare and peculiar, on top of that it is too superficial. We cant even distinguish a kingdom on this level, because the feeling of being treated unjustly belongs to all kingdoms. If the patient would answer your question about how it is for him to be in such unjust situation, with a feeling of inferiority, being a loser, surpassed by better and stronger ones, his career and so he is finished, he obviously needs an animal remedy. If he feels

traumatized by it, like being beaten black and blue, he needs a plant remedy from the Compositeae family. But if he feels his security is shaky, unsteady, his financial future unsure, no law and order to fall back on, having lost his grip on his life, feeling useless now that what he built up is breaking down, he surely needs a mineral remedy. In general the mineral case focuses around just one theme. There is one main problem or main issue to be discussed and the whole case will only explore this one thing. Animal kingdom: A person who belongs to the animal kingdom has the sensation that life is a fight, a struggle for survival. Everybody wants to live or to stay alive, but people from the animal kingdom experience everything in their life as a survival issue. It is about to live or to be killed, while a mineral talks about existence and people belonging to the plant kingdom die, their life ends, they dont get killed. The survival is a matter of eating or being eaten, kill or being killed. They can use all kinds of synonyms like slaughter, murder, execute, slay, exterminate, and finish one off. The idea always is that somebody is doing this to another. In the animal kingdom somebody else is the problem, not some thing. During anamnesis one will hear the patient talk about the others who are the enemy: they threaten him, look down upon him, dominate him, betray him etc. Hence the message in the story is: who is the problem, rather than what. This can make the main differential diagnosis in an animal case where the aggression and violence is not so much in the foreground, because the animal is the prey, not the predator. Still there will be somebody else doing something to the patient and that is experienced as the main problem. Its not enough that the patient talks about quarrels or fights: everybody clashes now and then with others. It is the fact that the quarrel or clash is experienced as a fight and in this fight the thing at stake is survival, is what makes it an animal case. Only one can win: there is always a winner and a loser. For the winner it is survival, victory, power, being the best, on top, the first, the conqueror. For the loser it feels like being finished, hes dead, the victim, loser, the prey, eaten, defeated. There is no win-win possibility. One is the victim and one is the aggressor, one is the weaker and one is the stronger. There can only be one winner: there is no room for both. Its you or me. The fight can be for a person, a position or a contest for example, but for a person in the animal realm everything is conceived as a fight or a threat to his survival. Even when he takes the bus he will have the feeling he has to fight to find a place to sit or others will take it from him. In his house he might feel the threat of being attacked and burgled; at his job in the office he feels every word of criticism as an attack to his person, in a relationship he can be very defensive. It is either attack or defense. What a person feels is done to him, he will do to others. The person belonging to the animal kingdom is the victim or the aggressor: when he feels attacked and victimized he might complain about the aggression of the others and is always in the defense, when he is the aggressor he might feels he is treated with violence and reacts in the same way. The world is a harsh place. One has to fight his way to the top. The winner takes it all. Female animal remedies often display attractive behavior, or rather attention seeking behavior. They give a lot of importance to their looks, even when it is not so obvious for others. Often the homeopath gets more animated in animal cases, more charmed or

amused, but this depends on the subkingdom and whether it is a prey or predator in front of us. Since there is aggression and a desire to dominate, or a fear of being dominated, power is a big issue. Power is often expressed as competitiveness or ambition. In itself this is not a pointer to the animal kingdom, but the competition here has the flavor of survival: it is a matter of life and death. It is you or me. There can only be one winner. There can only be one at the top, only one can be the best, the first, the fastest, the winner. The competition is always in a comparison: how am I doing compared to the others? Even in a case where the animal features are suppressed or compensated, the person will compare himself to others. It can be quite subtle and presented in little extra remarks intertwined in the story, which might be overloaded with rationalizations. But when they are there, they are not to be denied. The patient is perhaps troubled by some symptom (like hair loss, skin symptoms, being overweight) that makes him less attractive than others. He may have physical pathology that makes it impossible to do sports like other people of his age. He may feel inferior because his diploma is lower than the others at the office. He may feel others get more, are more charming, faster, dance better, whatever, but the overall idea is that they will always make the comparison. A mother will ask herself is she is as good or better than other mothers, even a client in the therapists office wants to be the best client. There is never an equal relationship: there is always somebody higher and somebody lower. Or the patient has the idea he is higher than another in one aspect and lower in other aspects. The superior/inferior issue will be present in a straightforward or more disguised way but it will be there. Because the feeling of being inferior is so unbearable it might be heavily compensated with for instance, an attempt to be religious or humble and then of course the most religious or humble of all! The opposition or quarrel sometimes is expressed in one and the same patient: its like two tendencies in himself have a fight for supremacy. In the proving symptoms we see this reflected in the rubrics; antagonism with self and two wills. There is a split in the person and a conflict within. Or his symptoms are experienced as doing something to him. This throat pain is killing me. When there is no compensation, the power issue will be at the forefront with arrogant, intimidating, domineering, haughty, proud or even menacing behavior. There can be violence in the language with cursing and swearing and desire to kill somebody. The patient might not be able to control his anger and violence, and may start fights with, or beat up people whom he feels are attacking him. He can get enraged and out of control and this may be his chief complaint. At the other end of the spectrum: the victim of such an aggressive person who is beaten, abused, threatened and manipulated, may need an animal remedy too. Sometimes this is the actual story, and sometimes the person feels like this even with relatively minor fights but it is always their experience that counts. Often we see huge anger in animal cases, be it on the side of the victim or the aggressor. The anger can easily flare up or be suppressed, because the person feels he might kill if he loses control. There might be triggers like jealousy or an attack from outside, but the anger slumbers in the person, if not in his daily life, it can come up in dreams or in a love for violent movies.

Sometimes it is expressed the other way around: when, violence done to animals, which are not able to defend themselves provokes indignation, anger or a desire to pay back the evil doers. There are cases where the patient is feeling especially touched by the violence done to a particular animal and it is wise then to probe deeper into the matter, as it might lead to the source. People who need an animal remedy often talk about humans as a group they dont belong to. They make remarks like: humans are not to be trusted, humans are cruel, I dont understand humans, humans always create rules and values etc . It is as if they distance themselves from humans, they are looking from the outside t, they are not talking about we but about them. This can be a pointer to an animal remedy. Not surprisingly sex, procreation and territory, in fact all the instinctive features in a person, are prominent in an animal case. Again: all humans have these features but in a person belonging to the animal kingdom they are in the foreground and will be important issues in the case. In plant or mineral cases they might not even be mentioned as the problem lies elsewhere. In animal cases the fact that the patient is male and the homeopath female, or the other way around, can be more or less subtlety mentioned by the patient. He can just casually make remarks that are inappropriate for the homeopathic setting. They remind the homeopath that the patient is from the opposite sex and that the need to do that comes from the patients animal-like awareness of gender. Sometimes the sexual issue slips into the case spontaneously and as always: when a statement of the patient seems to be unnecessary or out of place, it is doubly important and it is most likely coming from the vital level. Procreation features are seldom mentioned as such but problems often start with pregnancy, lactation, conceiving children, in the male or the female animal patient. The territory issue can come up in many different ways, but it is good to remember as a general rule that animals have their specific habitat. This means they feel best in a particular environment and they will defend what they consider to be theirs. Depending on the subkingdom the features will be different and we will go into more detail into this later. We should listen carefully to the special words referring to animals like: hierarchy, go hunting, herd mentality, my nest, poisoned, decoy in a trap, poison me, cub, fur, catch, claw etc. They can all be pieces of the puzzle and part of the coherent pattern. In animal cases it is not so much in the repetition of the same thing but in the building up of the pattern that we come to our conclusion. The fears in the animal kingdom are about survival as well: being chased, caught, imprisoned, killed, eaten, slaughtered. There can be a tremendous threat and a sensation of danger, which can be vague but nevertheless life threatening. The patient finds many expressions for this: fear of suffocation, being taken by surprise, being raped, overpowered, beaten, injured. It is important in the case taking to insist on being exact and to ask all details of this fear. Id even suggest repeating the question more than once in different forms, asking for images, or for a description of the worst case scenario. A fear that in the beginning sounded quite general like fear of persecution or fear of high places

sometimes turns out to be a very specific fear of being chased, hunted, thrown in a deep well, being taken and drowned, body parts being bitten off and so on. The patient might give an image of a predator hunting and bringing down a prey and then biting it to death or devouring it or slowly, slowly suffocating it. The pictures he gives can be in dreams and that is just as useful: dreams come from the subconscious part of the psyche but they contain Level information as well. Not every dream is valuable: it depends on the common sense of the homeopath to know when and how to use dreams. The archetypical dreams come from the unconscious and are the classical dreams many people have: like being unprepared for an exam or being late for an appointment, refer to the broad sensation of needing to perform. Children dream of being chased or eaten by the wolf or a witch, yet they dont all need Belladonna. Those dreams belong to normal childhood fears and the images are given in the stories and fairytales we tell our children. In the same way people use images of happenings during their day or what theyve seen on television that night, in their dream but the feeling in the dream is theirs. It pays to persist in asking them to describe the dream in all its detail. Maybe the patient will say: it is not exactly a fear but disgust. Disgust is a general feature in animal cases. It may be scenes they are disgusted by, or smells or behavior. Often they feel disgust for other people or loathe themselves. The contempt, loathing, disgust, feeling of being dirty, are themes of animal remedies in general and it doesnt matter if they are interwoven in a story about themselves or somebody else. There is nobody out there, remember. All we see is a reflection of ourselves. Therefore what we tell about somebody else, we tell about ourselves. Because the overall feeling of the animal kingdom seems to be a feeling of disgust and of being dirty, it led many to the conclusion that the miasm must be leprosy. In my understanding this is a confusion between sensation and miasm. The disgust is a sensation and belongs to all animals and the miasm seems to be unclear in animal cases. The reason for this is, as far as I have observed in my cases, that the same remedy is represented by different patients in different ways and intensities. We should keep in mind that homeopathy is based on symbolic representations of a vital experience. The instrument of homeopathy is mainly language. Even if we observe the patient and the way he behaves and expresses himself, we translate this body language into words: we are still in the realm of language, and therefore symbols. Animals are rich and strong symbols. We tend to project a lot of identifications and qualifications on them, we use them as totems, or in ritual or shamanistic practices. Many patients therefore will identify with a particular animal but this does not mean they need an animal remedy. Projection comes from Level . It is a product of the imagination or in a broader perspective, the psyche. In most cases it has to do with the wishes or the longings of the patient. Even when he needs an animal remedy the identification with a certain animal might very well be the opposite of what he needs: maybe he identifies with the eagle and needs the mouse. A good tip then is to look for what it is in the picture of the animal that the patient describes, which doesnt fit. For instance an 11 year old girl was asked to describe the horse she loved so much. She said: it is so beautiful and sweet, you can comb it and brush it and take care of it, it knows who you are and is always welcoming you. It has such a beautiful body and when it runs the

mane waves in the wind. Well, the depiction of the looks of the horse might be right and realistic but the sweet, welcoming, loving and taking care of doesnt belong to the horse. This means it must belong to the girl. (In her case she needed a mineral from the third row) In the proving we usually see only one aspect of the remedy, for instance the proving of Lac Leoninum gives a picture of the male lion (Talks with an air of comment, wants to fight) But if a woman needs Lac Leo she most likely will show another side of the same remedy. Her role is completely different and we expect to see a complete focus on the children. Again a little boy or girl needing Lac Leo will display different aspects altogether. Which is then the miasm? This is even more prominent in domesticated animals. Dogs, cats, horses, goats, cows, etc. come in so many various breeds, and we use them for so many purposes, that they sometimes hardly look like the wild version of themselves. Can we can rely on the proving of one particular dog to represent the whole range of possible dogs? Again when we remind ourselves of the symbolic nature of homeopathy, it is clear that there is sufficient dogness in every dog, because this is exactly what got them into that category: a minimum set of meaningful characteristics. But in the patient it is not so much the question which dog he is (pit bull or a schnauzer) but rather which dog quality is represented in the patient. Ive seen patients who feel themselves second class, a very typical dog-expression. What is conveyed is the idea that even though they live with humans, they will never get the same status or be treated at the same level. Another dog case can focus on loyalty, the desire to do a good job, to perform well in order to please the boss. In yet another dog case the center of attention might be the (fight for ) the place in the hierarchy/family. It is hard to define the miasm that pervades all these cases. Ive seen bird cases where the patient was experiencing the bird coming out of the egg into a new world, while another talked about the hindrance, the trap versus the freedom, and again another example of the same bird gave a very detailed picture of how she was flying during her dreams and the utter bliss she felt while doing it. Could all these cases belong to the same miasm? But now comes the good news: we dont really need to know the miasm in an animal case. I agree it would help if it pointed to certain remedies and excluded others but thus far we dont seem to have attained that knowledge. Maybe the miasms dont even make much sense in animal cases. If the issues are a feeling of inferiority, a fight for power and supremacy, a threat of being killed and eaten: how can one cope with this? Are there coping mechanisms we could imagine in those situations? Can one even think that the inferiority is a crisis that one has to overcome? Is it logical to accept the fact that there is a threat that one will be killed? Isnt it a bit odd to feel unfortunate because of a power clash? For those reasons my conclusion so far is that the miasms in animal cases are unclear, unreliable, unknown, confused with sensations and incomplete, and as a consequence cannot be relied upon to help analyze a case. Plant remedies Plant remedies have certain particular sensitivities that are repetitive and aimed at the opposite. It is said that plants are sensitive and even though it is true, the statement is confusing. Everybody is sensitive to his own problem, no matter what kingdom he belongs to. And the emotionality of Level 3, for example grief and sadness, is often mistaken for

sensitivity. Partially this is a language matter: we use the words feeling, sensing and experiencing for Levels 3, 4 and 5. The patient doesnt know what we are looking for and it is better not to explain too much or patients who like to keep control, will influence the answer with their rational mind. This makes their answers worth less. When asked for the experience and the patient answers with: I feel sad, we know it is Level 3. We can prompt the patient to tell us more and most likely he will go into Level and give ideas, delusions or images: it hurts in my heart, its like a wound there, as if somebody stabbed me with a knife etc. The leap to Level 5 is to ask directly for the experience: to be hurt and stabbed in the heart, how is it for you?. If the patient needs a plant remedy hell give a plant sensation: it is like being burned to the third degree, like scalded, like your skin is raw, it is very, very painful (Ranunculacea). If it were an animal remedy the sensation would be that somebody tried to kill me, wanted to finish me, hated me so much that he wanted to murder me to get rid of me etc. The aggressor would come into the foreground. In the plant kingdom the sensation of what it does, comes to the fore. To know for sure whether we are dealing with a local sensation or a vital sensation, we have to wait during case taking for the same sensation to be repeated. If it doesnt, it means it applies only to one situation, or one level or one complaint. Until the contrary is proven we cant use it as a basis for the prescription. For instance, a person has a stiff and painful joint and he cant move freely. When questioned about this, he says he feels stuck. This is a sensation belonging to the Anacardiaceae, but it is also a quite common sensation with that kind of complaint. If the stuck feeling is not repeated anywhere in the case, it probably was a local sensation. In another example: a patient has a quarrel with her mother-in-law. She feels the mother-in-law doesnt accept her, treats her like a stranger though she makes all possible effort to be recognized. Still she feels shes not part of the family, she doesnt belong, she is not wanted and is ultimately alone. This doesnt necessarily mean that she needs a plant from the Lily family: a feeling of being excluded and forced out. If this same feeling is not repetitive in the patient, then it belongs to the situation, to the story and not to the vital disturbance. It can be a more or less realistic depiction of what is going on and the feelings might well be in proportion to her actual situation. In order to be sure that the sensation is repetitive, it must come up spontaneously. This is why it is so important to ask very open questions and to follow the patient where he is taking us in the first part of the consultation. If we start to ask questions about a sensation too soon, we emphasize it before we even know if it is a vital sensation. The patient will get the impression that for some reason this is important, and we making a case instead of receiving a case. To spot the repetitive sensation, the full attention of the homeopath is required. The patient may use different words for the same sensation. For instance the sensation of the Solanaceae is catastrophe. But there are many expressions of that one sensation: war, violence, explosions, fire, bombing, earthquakes, tsunamis, volcanoes, natural disaster, plain crash, and so on. The main idea is of a violent event with many deaths and the action the person wants to is to escape from the place of danger. Even when the patient doesnt use the word catastrophe, we have to spot the idea of a calamity of this kind. It will be the underlying feeling or message in every story or example that he gives. On the other hand, when a patient does use the word catastrophe we cannot be sure that he needs a plant

from the Solanacea family. First we have to ascertain for ourselves that it is not a common expression from the third level but a vital sensation from the fifth. And then we must listen carefully to discover whether the sensation is general and is repetitive. The third aspect is the opposite of the sensation: again this must come spontaneously. Asking the patient who complains of feeling stuck what the opposite would feel like, is an ineffective question. The answer is too predictable and loses all impact. Sometimes the patient only gives you the opposite polarity since it is the compensation for the sensation. It is what the patient is aiming at in order to avoid his sensation. For instance the Umbellifereae sensation is that of a sudden and unexpected blow. The way to avoid this is to be prepared for everything, to expect the unexpected so to speak. Hence these patients will stand out because they stress over and over how well prepared they always are, in any situation. Then one starts to wonder who needs to have this condition fulfilled in order to be OK and then we understand the sensation behind it. A patient needing a remedy from the Papaveraceae family is sensitive to unbearable pain and torture. Since they perceive in the world around them only cruelty and pain, they may spend their time and effort on spiritual practices to gain a sensation of calmness and bliss, the state of the Buddha. A patient needing a member from the Solanaceae family will probably describe fight or flight reactions or adrenaline and that he wants to sit near to an exit to be able to escape. Even if he doesn't talk about the catastrophe he feels lurking in every corner, by describing the opposite we understand what it is that he wants to avoid. Any sensation that a person has can show itself in different ways: the straightforward sensation, the way the patient copes up with it or the compensation. The coping up points to the conditions he needs to be OK. In reality everybody is OK. Wouldn't it be a blasphemy to accuse our Creator of doing a sloppy job? Is it man who decides what is perfect and what is not? Is the eagle perfect and not the crow? Is the buttercup perfect but not the daisy? Are there perfect and imperfect beings? Such an idea is unimaginable except in a limited or distorted point of view. This is what we call disease. We can't see the love and perfection in all creation but qualify things as good or bad according to our morals, philosophy or likes and dislikes. Because of that we feel there are conditions that need to be fulfilled in order to be OK, lovable, worth our existence and maybe to earn a place in heaven. The general kingdom hint for plants is this specific sensitivity and an overall tendency to react to the environment. Plant patients are lively and alert, vivacious and easily touched and they react before they can think. They are quick, swift, attentive, and make connection with everything and everybody around them. They have an eye for the surroundings, for beauty and harmony, colors, smells, proportions, tissues, sounds, anything. This also means they can startle easily, get carried away by music, love to dance or watch dancers, be sensitive to perfume, get readily disturbed by messy things, feel in their bodies what is happening around them. For instance they listen to the evening news on TV and all the violence and the disasters give them the feeling of being fragile. Then they tell an anecdote in their life of a relationship that ended and they feel that this split in the family can never be mended. And their main complaint happens to be inflamed joints, which give them the feeling that they can fall easily and break something. The feeling in mind and body is the same: fragility (Conifers)

They can talk at length about their connection with animals or favorite pets, they love flowers or gardening, cooking, decorating, they have alert senses in general. Most of them will love to be in nature, enjoy landscapes, forests, trees, desert, mountains, and the seaside: the fresh air and the sun. And not surprisingly, the majority have all kinds of modalities. This means they are easily affected/influenced by outer circumstances. Of course they react to other people as well, in close or more remote relationships. Everything that happens, that is said or done, makes a deep impression. The consequence is that plant cases give an abundance of symptoms, a lot of modalities, sensations, anecdotes, stories and examples. Often when the homeopath can't see the wood for the trees it's because he is in the plant kingdom. Because they have a vivid way of talking the plant case can be confused with animal remedies. But in plants it is rather a matter of stimulation of ideas, excitement or exhilaration; in the drug remedies this goes as far as euphoria. Because of their intense feelings they can use strong language, but again this is not an animal quality as such. A plant can have an intense fight with somebody and be enraged or full of hatred. They can be intensely jealous (Hyoscyamus for instance) or express forthright violence (Solanacea) but this is merely an emotional reaction to what they experience. And in plant remedies the miasm determines how the patient is coping up with his vital sensation. Let's take the example of a patient belonging to the Cruciferae family: they feel the natural flow is stopped and dammed. The continuity is stopped by something in the way, the flow has come to a standstill. Depending on the miasm this can be experienced in different ways.

Anamnesis

It is always said that case taking is at least half of the work and it is true. When an interview is well done, the vital disturbance should be clear or at least the expressions of the disturbance should give a coherent pattern. In an ideal situation only one or a few remedies are left to prescribe. Although every homeopath has his personal style, there are nevertheless some guidelines to help the homeopath navigate the interview. When we are focused on the vital disturbance, our questioning should be aimed at getting us to Level Five, if possible. If this is not possible, then we should be able to perceive expressions of the Level Five disturbance on all the other levels. If the homeopath knows exactly what he is looking for, he wont get lost on the way. With the Vital Approach it is always possible to determine on which level we are, and whether we have information relating to the kingdom or miasm. Before the Vital Approach, the homeopath often got lost in the sheer bulk of information. It was difficult to determine which information was qualitative and which was more quantitative. In that situation there is a tendency to refer to keynotes or important features. The disadvantage of this is that we all have many characteristics, which are covered by many remedies. These remedies will all affect the expression or symptoms but which wont cure the source of the problem.

Every patient is different but there are some general rules that should be followed. Long experience in practice has led me to conclude that the patient will always take you where the treasure is hidden. Id like to stress this because it is so important. The patient will define the territory and all the homeopath must do is dig there for the right remedy. If we ask questions and by doing so direct the patient, then weve lost this crucial help. We will define the topics and the patient will answer our questions because he thinks this is the information we need to know in order to prescribe. As a result we will have collected information that suits our prejudices and we will have made a case instead of receiving one. The first method almost always leads to remedies we know and feel comfortable with, the latter can lead us anywhere! We can trust and follow the path the patient is taking us, because we know he will lead us precisely where we need to go. This is so important that I cannot repeat it enough. The patient leads us by the choice of topics and the way that he reveals them to us. All we have to do is willingly follow him in any direction he is taking us. In this way he defines the territory and we can be absolutely sure it is there that we will find the remedy; we dont need to inquire about any other area! We might so inquire at the end to confirm the remedy (or kingdom/miasm/source) but it will only be confirmation. Having said that: Step 1: Define the Territory By define the territory I mean that whatever the patient talks about at the beginning of the interview, answering the homeopaths general question (like: What brings you here? What can I do for you?) is a marker of the territory. This especially applies to his spontaneous remarks or questions: (what a nice office you have! Should I start at the beginning? I used to work there and there but because of the system I changed to etc.), all are important and meaningful. A patient never says anything haphazardly and certainly not at the beginning of the consultation. These spontaneous remarks are also important throughout the whole consultation, and even if the homeopath misses a few, the patient will repeat them more than once. Some patients may answer a simple question with just one line while others may take three quarters of an hour to answer the same question. In the first case the homeopath will need to help the patient, they may be shy or be unsure about how much time they can take. The questions must be as general as possible, for example: Can you tell me more about this? Can you tell me even more?, Can you give me some details about this? Anything else? The first thing we need to do is determine the Chief Complaint. This may be anything. A patient might start the interview with a clear physical complaint and medical diagnosis, or have seven minor complaints, distributed on different levels. When the patient names more than one complaint, we must ask: What complaint is troubling you most? The answer may be a confirmation or a total surprise! Sometimes the patient comes up with a whole new and unexpected subject. As a homeopath, never assume that we know something. We dont! We know how the world looks from our point of view and we have our definitions and understandings of words, meanings and context, but the patient has a whole different experience of the world. In fact it is exactly this different experience of the world that we are trying to unveil during

the interview. Every time we are not asking for clarification because we assume we know what the patient meant or we know what a word means, we risk missing the point. Some homeopaths might find it uncomfortable to not know during case taking, but its important to remember that we are not sitting there in a meditative state, somewhere in the clouds, trying to blank out our minds or doing something vaguely spiritual. On the contrary: we are sitting there with full attention, and with full trust in the technique we are using (because it works!) with interest and a determination to understand the uniqueness of the person in front of us. How this uniqueness looks in each case we dont know, we will explore it during case taking. How we are going to get there, we have a fairly good idea because we use an established strategy. We studied the theory, we practiced the tools, weve seen it demonstrated many times and we ourselves have done it many times. It is like solving a puzzle: even when you know how to do it, each puzzle is a new challenge. You know what to do but you dont know the outcome. This not knowing doesnt need to be uncomfortable; one can be a super expert at solving puzzles/riddles and still not know what the outcome might be of any individual puzzle. The not knowing therefore means that we dont know how the patient will express his vital experience until we questioned him carefully. Subjects are chosen by the patient The questions we ask at the beginning of the case-taking invite the patient to respond:: Can you describe what it feels like?, How is the tiredness/ restlessness/ stress (etc.)?, Is there anything else that troubles you? Very often, after summing up the chief complaints and minor complaints, the patient will give some reason or explanation for his troubles. He might think they are due to a weak immune system, to a shocking event, a loss or stress of any kind. He might give a medical explanation or he may have visited alternative healers before and tells the homeopath what their conclusions were. Patients have often already been through psychotherapy or read books and attended workshops to come to terms with their sufferings and will share their ideas with the homeopath. Although they may sound like rationalizations, they are still important. Mans mind works in mysterious ways! The homeopath needs to listen very carefully to the patients conclusion about his sufferings. What does the complaint prevent the patient from doing or how does it affect him? How does he feel about this complaint? How does he cope with it? We must first try to identify the symptoms, which are incongruent with the patients pathology.. In the beginning we may get hints of the vital sensation when the patient reveals, often between the lines, what the complaint does to him: make him less attractive; make him less capable; produces a certain feeling; makes him conclude that he is not normal, etc. We repeat our question, anything else? until the patient himself agrees that there is nothing more. We should ask a question two, three or more times until we are sure we have all the information possible! In fact during consultation, when the homeopath perceives there must be more underneath, any question may be repeated. In order to make it sound more natural to the patient, the question can be rephrased, although the patient is often not even aware if the question is literally repeated.

In the first part of the interview where there is minimal intervention by the homeopath, the spontaneous emotions of the patient become important. Any spontaneous remark by the patient is considered twice as important. Or conversely: any answer to a question by the homeopath is of less importance. We risk getting what weve asked for and very often that is not what the patient was going to tell us. By spontaneous emotions I mean: those kind of extra lines that the patient offers during their report: what I found difficult, I was shocked by, this head ache makes me irritated, Im afraid this spot will spread, this really knocked me down, the blocked nose is hindering me, etc. In the first part of the case taking we get sensations and feelings interwoven with the symptoms given by the patient. Many of those sensations might be common, many will be local, and some might be vital. This is what we need to discover during the consultation. But first we must give the patient the space to tell whatever he thinks is important, we will for clarification later. It is always better not to direct anything at all, not to ask anything at all in the beginning, lest we decide the direction of the case! We do not know. The patient is the only one who knows, even though he may not be aware of it. Who besides the patient can tell us how it is to be him or her? How it is to experience the world and himself? The patient is the only one who knows. When he tells us, we are allowed to understand and to see the pattern. This process of seeing what something is, is very different from understanding why. It is almost like looking at a picture in a 3D modus: it is necessary to look a in a special way, almost looking behind the picture, and then all of a sudden the image, always there but previously invisible, becomes clear. Once seen, its hard to imagine how we could not see the image before! It is not a matter of interpretation, understanding why the house or the tree is in the picture, nor is it a question of the house being good and the tree being bad. The judgment we make must be about what is a piece of the pattern, not what is desirable or not. Step 2: Questions for details When the patient defines the territory we must ensure that we precisely determine the borders, and therefore ask questions about the topics that the patient just discussed. If he said he has three problems, well ask anything we can think of about these three problems. Keep in mind that those questions should be as general as possible, they should not to lead or guide the patient in any direction. General questions mean questions without any suggestion or interpretation. When the patient said: This knee is causing trouble, the question should be: Can you tell me more about the trouble? not: What kind of pain do you have?. This way of questioning the patient is very different from that used in other therapeutic modalities and the homeopathic student needs to become familiar with it.. The focus of the case-taking should be on helping the patient describe what is experienced, not explaining why the problem is there. When the patient has told the homeopath everything about the what, the how, the when and the where of the problem, very frequently he makes the topic broader and moves from my problem to me. At this point, the patient will give the homeopath his own concerns, anxieties, worries, ideas how and why it started and previous similar events or feelings. In this way we seamless go from the complaint to the patient and are given parts of his life story.

Even if we dont ask many questions, this part of the consultation tends to be loaded with so many stories that it can be hard to discern the qualitative from the quantitative information. It requires the homeopaths full attention because, as mentioned before, there is always a reason why the patient chose just that example out of the million other things that have happened in his life. The art is to spot the particular way of telling this story and the spontaneous remarks that come with it. Examples of this might be: a common expression but in the wrong place; a sequence of words with one illogical one, not fitting or repetitive; or an odd word or an unexpected, even wrong expression. In short: all those things that would not have been said by anyone else, and which means that they are the signature of the patient: his frequency pattern. The homeopath at this point should restrain himself from jumping to conclusions when he hears something familiar: a rubric, keynote, a hint he recognizes as belonging to a certain remedy. All patients will give you many if the consultation is long enough! But these are nothing but attributes that we all have in abundance, without having connection to the vital disturbance: they are just local phenomena. We cant go on giving everybody who prefers soft boiled eggs, Calcarea carb., can we? On the other hand we should not ignore hints to remedies, not at all! They must be registered somewhere in the back of our mind and if more rubrics are added as the case unfolds, then of course we can give the remedy. But we should avoid getting fixed on a remedy as soon we hear a keynote, because then our mind tends to delete everything which the patient says that doesnt fit our idea and only hear what will confirm it. A good method to dispense with a fixed idea of a remedy is to put that remedy to the test. As an example: a woman came for an intake in the Master Class for severe cramps all over her body. She was talking about her job and how much stress she always had. As a teacher she was given a difficult schedule, she had quarrels with the director, started a case with the union and felt wronged by everybody. But she was firm and defensive and fought for her rights. It was difficult not to think about Cuprum in her case. Instead of asking more about Cuprum topics like: What about finance?, Can you tell me more about the importance of work? or What does this health problem mean for you?, which would all lead to predictable answers in light of the topics just discussed, I tried something completely different. When noting down her personal information, she told me that she had two children and that the oldest boy was handicapped. Since she didnt mention him in the consultation so far, I asked her about him. She answered that since she is a perfectionist, it was difficult for her to accept. She gave a few more sentences, and then somehow made an association in her mind and started talking about the neighbors. Their garden bordered on the patients garden and the neighbors gas tank spoiled their view. She wrote letters to the municipality and even took a lawyer. Within a moment of being asked about her handicapped son she was giving me another image of a bossy person, vigorously fighting for what she thinks is right and should be forced by the law upon others. She spoke hardly a word about the boy! Well, this was strange, rare and peculiar for a mother and confirmed Cuprum. The difference was that now we were sure it was Cuprum, whereas when we ask Cuprum questions we will never know whether we made the case ourselves or not. In this part of the consultation, we encourage the patient to tell us about the topics he began with, but we dont choose other areas. If he doesnt go there we dont have to go there.

The encouraging questions are all aimed at Level 5: How did you experience this? It shouldnt always be put literally in these words because it might sound quite artificial, better to use as few words as possible and to make your question as broad as possible: How was it?, Can you tell a bit more?, Can you describe this?, When you say: grief what do you mean?. One can repeat a question more than once. Many beginning homeopaths dont dare to do so because they are afraid they may look stupid. They think the patient will think they didnt listen or they dont understand the simplest thing. Sometimes they are afraid a patient will lose his patience or will never come back. To avoid this it might be wise to introduce the repetition of the question with a little explanation: I know you told me this before but could you describe once more how it was for you when your daughter left home? Every time you tell me something, some new words or expressions might come up and I want to have the picture as complete as possible. When a patient says: I dont know, it is a good idea to give him a little time to think: often it is nothing but an introduction to the answer. With children Id even press a little bit and say: Well, think a bit then. The middle part of the interview mostly gathers information: the patient tells you part of his life story or at least some events that left an impression on him. The fact that he chose to bring up these topics means they have something to do with the vital sensation. It is always the patient who links everything together. We shouldn't use our imagination to connect parts of the story together because we risk making a creative prescription that has nothing to do with the patient. For instance: we feel the patient behaves like a frog: he loves nature and moist weather, he has big eyes and a big mouth, he is kind of jumpy in his narration and he burps like a frog. This may all be true, but if the patient didn't give kingdom and subkingdom words or even better, proving symptoms, we have to be very careful with such prescriptions. That is why I recommend asking questions that are as general as possible, checking the answer three times and putting the idea to the test at another point in the consultation. Also: never assume you know what the patient means: you don't until the patient has told you. If he uses the word emptiness, what does he mean? You have to ask! Silly as it may seem at the beginning, the value will soon be obvious Just ask three patients who used the word injustice what they meant by this; the answers will be completely different. When a patient talks about tension, stress, difficulty, problem, being depressed, always ask: What do you mean? If you ask how they feel about something and the answer is bad, you can ask: I understand this makes you feel bad but how is it that? If they say: It is difficult, then the homeopath can ask: This bad and difficult feeling: can you describe it a bit more?. It is necessary to keep asking until you feel the answer is authentic and personal, and not something that everybody says. It may be a word, an example, a comparison, an expression, as long as it expresses the deepest feeling if the patient. Another very important reason to inquire deeply is to see if the word the patient chose to use 'holds'. For instance, the patient says: I have an empty feeling inside. We could stop here and with great self-confidence prescribe a mineral remedy, but if we ask what the patient means by emptiness and the answer is something like: It's a feeling of being left alone in a dark wood, then we have to go on asking: And how is that?. Let's say the patient answers: Scary, then this is Level 3, and we have just double-checked whether the emptiness was a Level 5 sensation. When we first asked we may have been given an image on Level 4, but when we asked again, something else came up. Now suppose we go on and

ask: This left alone, scary and empty feeling, how is this for you?, and the patient says: I feel completely lost and bewildered, we must conclude that the emptiness doesn't hold and our questioning has led to something else. Lost and bewildered sounds like a deeper experience and we must check during consultation if this experience is repeated. It is another reason why consultations take time: to be sure we must check, otherwise we will simply be guessing, going by the words without knowing exactly what the patient meant by them, and furthermore we will not have the context in which the words were said. Some cases are time consuming because the patient is loquacious and describes every event in his life in all its detail. Or he may have read a book on homeopathy where it was stated that the homeopath needs to know all about his character and preferences. This can lead to what I would call horizontal information: more of the same. A homeopath needs to go vertically through the levels. A good way to switch from this horizontal information is to take the first opportunity to say: I understood this and this and that happened and you were feeling such and such, can you tell me how it is for you to be in those situations?. The homeopath can precise what the patient told him and then make the leap to Level 5. Its a direct question but it is based the story told, not on a single word. Sometimes the patient jumps from one subject to another but certain words are repeated.. Then the homeopath can pick out the repeated word and ask the patient to define it, but the word needs to have come up at least three times. Lets say the patient mentions the words doubt, which is very common. This could be triggered by his chief complaint, for instance vertigo. If the word pops up again, for instance in a relationship problem, it means it is also felt on a completely different level and in different circumstances. If the patient then tells another anecdote where the final conclusion is doubt, for instance doubting his capacity to financially manage on his own, then we can ask: when you say doubt, what do you mean?. If it wasnt clear by then, the kingdom will probably be revealed by the patients answer to this question. In general, the kingdom, miasm and often the subkingdom, are clear when the second part of the consultation is done, usually after approximately an hour and a half of case-taking. Step 3: Confirmation By the time the territory is defined by the patient and the topics in it fully explored by the homeopath, stuffed with all the patients anecdotes and examples, the homeopath usually has a good idea where the treasure is hidden. He doesn't know what he is going to find but he knows where he needs to dig. The third step of the consultation is mainly for confirmation. The homeopath can begin to ask more direct questions, for example: There are a few words I'd like you to clarify, in the beginning if the interview you said, or: I noticed you used the word pressurized a few times, can you talk a bit more about pressurized?, or: Your pains in the legs are unbearable, you said, can you say a bit more about unbearable pains?. Now is also the moment to ask about the patients fears and anxieties, even if the patient has already talked about them, it is important to check. The homeopath can ask: Is there anything you are afraid of?. If during the consultation the patient has already talked about his fears, he will come back to it and that provides a good confirmation. If the patient has

not already been specific about his fears, he might link them to the Chief complaint anyway. Psychoanalysts describe dreams as the highway to the subconscious, but the homeopath uses them in a completely different way. The homeopath doesn't try to interpret the dream at all, but takes the facts and the feelings in the dream as important features. For instance: somebody may dream of being in a boat on the water. When asked what the feeling is, the patient may say: very calm and pleasant, or extremely scary, it was like a threat came from the deep water etc. The image alone is not enough to understand the patients experience. On the other hand, many dreams seem to belong to daily human activity: dreams of coming unprepared for exams; having to hurry to catch a train or plane'; going out into the street half dressed; being persecuted; trying to escape but the legs won't move; teeth falling out; dreams of flying and so on. Although these dreams are common, we must still ask for the individual patients feeling in the dream and how often they have had it. Whether we take the dreams into account depends somewhat on the intensity and the frequency of the dreams. The same applies to children's dreams. It is quite common for children to dream about a ghost or a monster, but if the child has frequent nightmares about them and the child wakes up terrified, then it becomes a problem. Very often an attitude or a feeling in itself is not strange, rare and peculiar, but rather the fact that it is recurrent, or inappropriate, or out of proportion. If at this point in the interview we do not already have a good idea of the delusions in the case, we can often discover them by exploring the fears and dreams. Also the things that the patient cant stand are discussed. It is up to the patient to give meaning to cant stand. This may be anything, from the smell of eggs to people who abuse animals. It may be a sensitivity or an irritation, an aversion or disgust. A little reminder here: when the patient says: Im sensitive to, does not automatically indicate the Plant kingdom, everybody is sensitive to a particular thing, that is the definition of their problem. Mineral or Animal or Nosode patients are also sensitive; it is what they are sensitive to that points to their remedy! Sometimes it is in the last part of the consultation that everything falls into place and it is only then that we have the aha feeling of now I understand, rather than it confirming what we already knew. This is just as well. Some cases evolve in a step by step manner, where one statement builds on another, while other cases seem to be only unconnected bits and pieces of information that the homeopath cant bring together. It may be compared to working on a puzzle. If the homeopath has the main picture with pieces fitting together, he is able to see the picture quite early in the consultation. However, sometimes the homeopath has a piece here and a few pieces there and it is only at the end of the consultation that the missing piece that links all the others together is revealed. It can be more uncomfortable for the homeopath since he must stay in the not knowing mode for a longer, but the end result is the same. If at the end of the consultation things are still not clear, we can ask the patient what events, people, times, situations or circumstances in his life had the biggest impact. Often this leads to some conclusive statement from the patient.

To finalize the case we can talk about the things the patients likes to do best. Does he have any hobbies? Where or what does he likes best? What were the moments in his life he had a really good time? What would he like to do if he had the time and money? Normally if the vital sensation is understood at this point, the homeopath is not surprised to see it expressed in everything the patient says and does, even in his hobbies or fascinations and in his likes and dislikes. It is also advantageous to end the consultation on a lighter topic. To send the patient home once the fears and worries or deepest disgust has been investigated seems a rather odd thing to do. To discuss positive aspects of the patients life makes the atmosphere more natural and eases the transition to common conversation (Level 1, 2 or 3). When an anamnesis is well done, the vital sensation is clear and two possibilities present themselves: the similimum (the remedy with a similar vital sensation) is known, or we know what remedy we need to look for. If this is a remedy that is unknown to us, we have software at our disposal to help us find it.