Homeopathic Education

Review

This book review is reprinted from Volume 103, Number 2 Summer 2010 Edition, with permission from American Journal of Homeopathic Medicine.

Reviewed by George Guess, MD, DHt

Ms. Coulter has yet again penned another elegantly written book, Homoeopathic Education: The Unfolding of Experience. Forgetting for a moment the meaty contents of this work, and focusing solely on the author's writing style, please allow me a moment to comment about her use of language, which as editor of the American Journal of Homeopathic Medicine, I've come to greatly appreciate and savor. Not only is her writing precise and thorough, it flows melodically, almost poetically from page to page. She is, I think, at her best when recounting patients' clinical histories, as well as when illustrating a point of materia medica with an allusion to a character from classic literature, Charles Dickens's work her seeming favorite source. Surely, she is one of the very few within our homeopathic ranks deserving of the appellation "Homeopoet Laureate."

The book's intention is to detail what Ms. Coulter believes to be the optimal homeopathic educational experience, or, in other words, how to 'grow' a homeopathic practitioner. Her preferred method - after completing introductory didactic courses in homeopathy and after, and while, reading the classic homeopathic literature - the clinical preceptorship.

Her contention is that nothing so prepares the young professional for homeopathic life so well, so thoroughly, and so realistically as the actual observation of and participation in an actual, living clinical homeopathic practice. Class work alone is too defined, too limited, and too subject to the whims, bias, and limitations of the teacher. Reading the literature alone can never prepare the student for the vast variety of clinical experiences that await him or her - the multiplicity of presentations that any given remedy can present; the occasional concessions that must be made to clinical realities, situations that seem to pit theoretical concerns against overall patient safety and expediency. Then too, only through direct clinical experience can many of the seeming myths of homeopathic practice be confronted and subsequently verified or refuted (and Coulter details and dispels many such myths of practice). Let me here quote the author as she succinctly describes the cultivation of a homeopath via the preceptorship:

"Having journeyed through the various stages in the making of a homeopath, from the enthusiasm and excitement of the initial stage, through the exhilarating sense of discovery of the expansion stage, followed by the difficulties and disappointments that are entailed in the hard work required during the strengthening stage-which, however, so often turn out to be the precursors of the rewarding deepening stage; having indicated the different educational challenges confronting the aspiring homeopath and the way in which he can arrive at a stage of competence and independent thinking, one now finds the full-fledged practitioner well and truly poised to investigate the reach of homeopathy: to extract from the science an expanded understanding of the natural laws beyond its strictly healing parameters and explore the answers it unfolds for the ever questing human spirit." [page 277]

Not only does she present quite thoroughly the many advantages and challenges the homeopathic preceptee faces, but also the satisfaction, challenges and difficulties the preceptor will encounter, if he or she chooses to offer this service. Precepting a student is a major responsibility and not to be taken lightly.

As the author progresses chapter by chapter through the dynamics of the preceptorship, she reveals her own understanding of much of homeopathic philosophy, case management, case taking, material medica, posology, etc. Herein lies a wealth of information for neophyte and seasoned homeopath alike. A few assertions will prove controversial, of course, given the variety of ways homeopaths practice. Nonetheless, in this reviewer's opinion as a whole they are insightful, solid, well-reasoned, and backed by the classic literature. Following are examples of some of these assertions.

The concept of the 'triangular' pattern of remedy presentations in patients; i.e., isosceles, equilateral and inverted triangular patterns. These all correspond to instances when the patient's symptomatology appears to coincide with not one, but a few different remedies. Much akin to Hering's cure by 'zig-zag' approach, in such instances, the perceived remedies are prescribed in sequence, often in a rotational order, as dictated by prevailing circumstances. Where some homeopaths might seek instead one single remedy, possibly a smaller one, that, as close as possible, covers all the presenting aspects of the case, Ms. Coulter contends that this triangular approach of remedy rotation/alternation has proved highly effective. Furthermore, she contends that when such varied remedy 'layers' are present in a case, it matters not the order in which the indicated remedies are prescribed; salutary effects will follow each prescription as the patient's health, coaxed along by each remedy in the prescribing sequence, is progressively restored. [In the reviewer's opinion, while this latter assertion might well be often true, there are clearly instances when the prescription order is all important. One recalls the case of a patient with hypothyroidism who had many Calcarea carbonica symptoms, as well as indications for Magnesia muriatica. Calcarea carbonica was prescribed initially, with no effect; then Magnesia muriatica was prescribed, which quickly removed those symptoms for which it was indicated, incrementally improved her thyroid function, and which, after waiting a suitable amount of time and administering additional doses in higher potency, eventually stalled. At this point Calcarea carbonica was again prescribed in the original potency; this time its effect was profound, eventually curing her hypothyroidism. ]

She discounts in-depth psychoanalysis in homeopathy, fearing that such a practice could well bog the practitioner down in confusing and often irrelevant psychological labyrinths. She rather views the organism as a whole, where mental-emotional disturbances will find their parallel on the physical level, there for the homeopath to perceive without ambiguity. This is not to say that the author ignores psychological symptoms or personality characteristics; her many published material medica profiles attest to that.

A few of the commonly-held beliefs of homeopaths she discounts. For example, she believes that many homeopaths' fears of repeating a remedy too soon are groundless; similarly, she does not caution against some homeopaths' wariness of treating acute illnesses while a patient is undergoing chronic treatment. She denies the potential danger of homeopathic suppression of illness, asserting that Hahnemann's references to suppression pertained only to that wrought by conventional allopathic contrary treatment. Precepting offers unparalleled advantages over other methods of training homeopaths, teaching effective case taking methods, flexibility in treatment approach, posology, follow-up care (ie, the second and subsequent prescriptions), flexible and realistic application of various homeopathic tenets (e.g, the hierarchical prioritization of symptoms, the evaluation of remedy effect, the decision as to when to change remedies, how healing occurs, etc.), not to mention how to run a practice.

One criticism Ms. Coulter levels at the homeopathic community is the seemingly ever-present predilection of many homeopaths for theoretical speculation. The preceptorship, she contends, is the perfect foil for such notions: "In fact, that which drives a homoeopath to excessive theorization is generally the lack of opportunity to practice really thorough classical homoeopathy: the lack of a sturdy, common sense, down-to-earth experiential approach that leaves few openings for abstract speculation. Consequently, for prescribing purposes, most of the post-Hahnemannian theories or doctrines are either irrelevant or confusing. Without necessarily being 'wrong' per se, they tend, as was pointed out earlier (p.110) to obfuscate homoeopathic practice rather than clarify, and can hinder a sound understanding of the homoeopathic experience." [p. 184]

Despite this reviewer's admiration for this book, and Ms. Coulter's work in general, two of her assertions in this book, neither of which can really be put to the test of objective verification, themselves smack of theoretical fantasy - the concept of "nationality remedies" and the possibility of planetary influences interfering with patients' responsiveness to homeopathic treatment and would have been better omitted from this book.

Ms. Coulter peppers the text throughout with delightful vignettes of several homeopathic remedies and illustrative clinical case histories. A couple of times she offers far more detailed materia medica, such as of Baryta carbonica and, especially, Argentum nitricum, to which an entire chapter is devoted. Both of these descriptions offer very interesting new insights into the remedies, or rather I should say, refreshed insights. For often as she conveys some seemingly newly discovered remedy characteristic, she parenthetically provides an original reference from such unassailable sources as Hahnemann or Hering that succinctly describes that feature, though in far less vivid and recognizable detail than does Ms. Coulter. Such command and recall of the classic literature is impressive. In taking note of many of the less striking proving symptoms that past masters have catalogued and further developing them through the lens of clinical appraisal, she fleshes out the remedy, adding to the subtleties of its appearance and giving the remedy a richer, deeper picture.

Homoeopathic Education is an exemplary, informative, and thought-provoking work. Ms. Coulter is to be applauded for the effort, and homeopaths, be they educators, novices or old hands, will benefit nom its reading. She has in her long career accumulated a wealth of experience and rich insights into both materia medica and the mechanics of homeopathic practice. However, that is not the limit of her understanding; homeopathy has informed and enriched her world view, her cosmology, if you will, as attested to by this final quotation with which I will end: "A healing system which holds that the strongest poisons of plants, animals, metals, minerals, chemical compounds, and diseased tissue bring about the strongest cures (where the venom of the serpent, for instance, no longer a purely deadly substance, can be turned into a powerful force for physical well-being, mental growth, and even spiritual regeneration... nourishes faith in a meaningful universe: a universe where nothing has been created in vain. In attesting (by means of provings) to the healing power of all created matter-and thereby, to nature's original 'goodness'-homoeopathy, in its higher synthesis, offers a resolution to the dualism of this world, and holds forth the possibility that mankind can be restored to the state of harmony and peace with Nature that, according to world myth, existed before man's fall nom grace." [p.279]

About the Reviewer: George Guess, MD, DHt, practices homeopathy in Crozet, Virginia. (Charlottesville area) He is editor of the American Journal of Homeopathic Medicine and Vice-President of the American Board of Homeotherapeutics.

This book review is reprinted with the permission from the Summer 2009 Edition of The Homeopath.

Reviewed by Annie Batchelor

I came to this latest Coulter publication with enthusiasm, enjoying her scholarly approach in revealing the material medica from her classical homeopathic view. Those of you who are familiar with her writing will also recognise the quietly assertive authorial voice and confident referencing to her own experience.

This work takes the form of three parts: 'Homeopathic Knowledge' is a description of the path to becoming a practitioner, the basic knowledge required and suggested approaches to establishing the knowledge learnt by practicing; 'The Educational Scene' is a critique of current pedagogy; the last - Individual Growth or deepening, continues to demonstrate her approach by a thorough evaluation of Argentum nitricum. She concludes with her thoughts on the way forward for us all.

Catherine Coulter has facilitated homeopathy instruction of medical doctors using the model of 'clinical preceptorship' since 1972. This is founded on an in-depth reading and understanding of The Organon and Lesser Writings, and Kent's essays and commentaries on philosophy and material medica. Apart from Boericke and Boger, both chosen for their useful repertories, there is a stunning absence of referred texts. But this is not a mindless exhortation but a passionate and well-reasoned exegesis of the value of our founding fathers. It follows patient and selfless encouragement of learning and has much to offer us all; it is, in sum, a plea for a return to the apprenticeship as a learning model.

In the second part 'The Educational Scene' the review of methodologies of teaching includes insights into the advantages and disadvantages of the preceptor model. The polemic emerges here with a gentle but firm finger-wagging at those in danger of straying too far from the fold. I found myself agreeing with much of it! This second part may convey her heart's desire. All of which leaves me in a quandary. Like so many texts published there is the appeal to 'everyman', yet this second part is Coulter's personal critique of other authors and methodologies in all but name.

This new Coulter contribution to our literature falls into a tradition of sound writing from a personal perspective. I am thinking here of Margaret Tyler and Phyllis Speight (will some kind publisher please re-print her wonderful Introduction to Homeopathy?). These authors have flair and call on their own practices to illustrate by example. This book is not of the ilk of the uber-referenced, academic studies; the bibliography is spare, there are no website or research papers to refer to. But in summary, I think the educators among us will enjoy its reach and the student homeopath will enjoy her knowledge and confidence. Personally, I would wish for a text edited with the profession more in mind, and this is its major drawback.