Reviews of the Herscu Letter
THE HERSCU LETTER:
Teaching Exceptional Homeopathy
Over The Internet
Gregory Pais, ND, DHANP
Originally published Fall 2000 Volume XIII No. 3 SIMILLIMUM – The Journal of the Homeopathic Academy of Naturopathic Physicians
The Herscu Letter; produced by Paul Herscu ND, DHANP, is a bi-weekly publication that presents a methodical approach to the practice of homeopathy. It comes to you, not by way of the mailman, but by the flow of electrons across the internet. All you need is an e-mail address and $19.00 per month to access this distillation of Dr. Herscu’s 20 years of homeopathic practice.
What makes Dr. Herscu’s instruction unique is his step-by-step construction of a practical homeopathic model, one that encompasses all aspects of homeopathy: provings, materia medica, casetaking, case analysis, repertorization, and follow-up. I find seminar experiences exciting, as you see case after cured case. What’s often missing is the cohesive homeopathic thought process that takes you to the curative remedy. One teacher’s perceptual prowess or psychoanalytic skill may appear clear when the case is presented. But transferring that success to one’s own clinic is not always viable. This is where the Herscu Letter comes in, offering homeopathic education, rooted in the fundamentals, encompassing the full scope of practice. Each Letter comprehensively addresses a specific topic, with theory, examples, and a “hands-on” section. This problem-based learning style creates the infrastructure for finding the simillimum.
The Pathology of the Patient:
The first II issues of the Letter (there have been 22 so far) address the fundamental topic of how homeopathy looks at symptoms, the pathology of the patient. Herscu maps the evolution of this primary thought process from Hahnemann to Boenninghausen. As homeopaths, we match the symptoms of the patient to those cured by a particular remedy. From the beginning the question has been, “Which symptoms do we choose?” Whenever one takes a case, there are dozens of symptoms. How does the homeopath determine which ones to prescribe upon? In aphorism 153 of the Organon, Hahnemann states that “the more striking, strange, unusual, peculiar (characteristic) signs and symptoms in the case are especially, almost exclusively, the ones to which close attention should be given.”
Taking Hahnemann’s directions as a starting point, Henry Guernsey developed the idea of the keynote. As Herscu describes it, these “were supposed to be unique features of any particular remedy, or unique features of a particular patient. There is usually something peculiar in the case, some prominent feature or striking combination of symptoms that directs the attention to a certain drug, and this is what Dr. Guernsey called a keynote.” Constantine Hering drew characteristics from localities, sensations, modalities, and concomitants. We may assume that three characteristics should be sufficient to make a cure very probable.” Adolphus Lippe focused on the characteristic symptoms unique to the patient. The symptoms that were common to the disease were the least worthy of attention.
Keynotes are a subset of characteristic symptoms. They are symptoms brought on by a few remedies, in a few patients. Dr. Herscu states, “A keynote is a symptom that so strongly speaks to a strong, common quality of a remedy that one assigns to them a higher value than other symptoms within that remedy and even within that quality.” When taking a case however, seldom will a patient express all the keynotes of one remedy. Often they will have keynotes of several remedies. The “Aha!” for me here was the following point. Herscu iterates that some people need “one of those remedies because their general state is well exemplified by that symptom. Others will not need one of those remedies because their general state has little to do with that symptom.” In other words, we need to determine whether the keynote symptom we are looking at is truly characteristic of the patient. Otherwise one reels through the maze of symptoms, not knowing whether the next one is a dead end or not.
The next stage of symptom assessment comes from Baron von Boenninghausen. In his article, A Contribution to the Judgment Concerning the Characteristic Value of Symptoms, the Baron looks to the individuality of the patient. The mentals, dreams, emotions, generals, sleep, etc. These indicators point to the pathology of the whole, what needs to be cured. But these symptoms are often fragmented. You may have a sensation without modalities, a location without a sensation. “In reality the patient is not expressing many symptoms, but only parts of a very few complete symptoms, which the examiner must bring together and complete.” If the whole patient is sick, and not the part, then the symptom of the part relates to the whole. “Just as each particular symptom is made up of locality, sensation, and conditions of aggravation and amelioration, so the totality is made up of general characteristics of the particular symptoms.” Boenninghausen would take a modality from one part of the patientâ€™s picture, a sensation from another, until he had a complete symptom. Dr. Herscu views the Baron’s analysis as a progenitor to his own work. “The application of this article IS homeopathy. In short, what Boenninghausen attempts to do is to articulate the casetaking and which symptoms to pay attention to and the theoretical reason for paying attention to those symptoms.”
“If we look at any patient we will find that the long symptom list, according to Hahnemann, is actually comprised of some few characteristics, according to Boenninghausen. Now if you look at those characteristics, you will see that some of those characteristics actually belong together. They express the same idea. This is the first realization of my model. This is in fact very easily demonstrated. For example, a person may be bleeding from several places. Boenninghausen introduced the concept that the idea of bleeding should be looked at rather then just the individual places; that bleeding has a higher level of organization than any of the locations by themselves AND a higher level of understanding then just simply adding the locations together. The concept that we are trying to find is bleeding. This is a Boenninghausen characteristic symptom.”
“In this same patient one may find that the patient is vomiting and has diarrhea and is perspiring. My innovation is to say that all these characteristics will add up to one Grand characteristic which is intense fluid loss, occurring through the loss of blood, and through vomiting and diarrhea. The main benefit of this innovation is that it allows us to be able to place more symptoms of the patient into a coherent picture of the disease, thereby allowing us to better understand what truly ails the patient. This allows us to be able to place any new symptom into the already existing framework.”
“The second innovation is to clearly describe the relationship between different characteristic segments. We add a major breakthrough that adds a great deal to our understanding of disease. Once the segments are developed for any patient or for any remedy, it becomes clear that they are related to each other. One can often put the segments in an order that forms a circle. In this order, any segment naturally leads to the next segment, which then leads to the next, finally returning to the first segment mentioned.”
Here is the dynamic process of disease expressed through the symptoms of the patient. By using this relationship of symptoms to each other, of segments completing a cycle, the homeopath has an ending point for the case interview. “The interview is directed by the concept, is informed by the model. We know what we are searching for and we have a clear destination. This means that the analysis and the interview become one and the same thing.”
“We now have a description of disease that is clear enough to accomplish the following: First it more clearly gives us a picture of what we are looking for. Second it allows us the possibility to take all the symptoms and organize them. Third, the organizing process happens during the case interview, which means that it helps you understand where you need to focus, helps you understand what you need to ask and find. Fourth, it makes it possible to get the whole first part of the work to the point all the way up to the repertorizing process done with the patient there.”
The succeeding issues of the Herscu Letter have further developed this model of health and disease. They show its application to materia medica study, repertorization, and provings. Space considerations prevent me from providing further detail. I’ve tried to illustrate the value of this work by offering a snapshot of the insightful thought process Dr. Herscu conveys. If I’ve succeeded, you’ll want to join this online homeopathic university. When you do, you’ll be rewarded by an excellent educational experience.
The foundation of the Herscu method can be found in the first two chapters of his book, Stramonium with an Introduction to Analysis Through Cycles and Segments and in Volume 8, Numbers 1 & 2, of the New England Journal of Homeopathy.
What Subscribers are Saying:
“Your writings on “Specifics and Therapeutics” have been GREAT – thanks. The focus on therapeutics with your approach to case taking, analysis and learning has once again been settling to me, to not feel so overwhelmed with how information is presented (in texts, and cases) and then interpreted. I also really appreciated your writing and analysis of the 5 cases – consistency, focus on where the energy is being spent, how the chief complaint affects the whole, – they will continue to guide me as I develop my skills.”
– Holly Manoogian, New Hampshire
“I received Herscu Letter #2 with great anticipation! Not only did I look forward to more theory and practice, I was excited to find out the remedies for the first case! Now that I look over my repertorizing of case #401 I can see Nux-vomica emerge clearly, but this is in hindsight. I am hopeful some foresight will eventually come through a firm foundation in homeopathic thinking that you’re helping us to build. Just a note of appreciation for the Herscu Letter – Dr. Herscu has presented a brilliant exposition of the historical ground upon which we stand, as well as the innovations he has made as evolving from Boenninghausen -beautiful!!! My heart felt thanks for the wonderful gift you’ve offered to students of homeopathy, and the subsequent cures of the sick to be realized. Please keep me informed of any other opportunities for studying with you in the future.”
– Steve Cobb, Massachusetts
“Many thanks for this last letter. They are so good and although I do not have a lot of time, when I sit down to read these letters I feel so touched by the depth and clarity of explanation.”
– Margit Jacob, California
“I have been meaning to tell you how much I enjoy the Herscu Letters, and how much I appreciate your dedication to getting it “right”, your thoroughness and deep insights and thoughts and the wonderful system you have created with cycles and segments.”
– Jeanette Primost, Israel
“I would like to pass on my appreciation for the Herscu letters. I feel my practice improving since starting the Herscu letters.
In particular, I really like the method of clarifying really what you are looking for in doing the cycle and segment chart. I rarely get the whole case looking like a good complete story, but it really helps to see the different areas grouped and then you can look for all the rubrics in each segment. I have good software to combine rubrics in a flash and have had more success doing this lately. Somehow I feel that my perception is improving of what is important and what is not and getting the correct context of the whole case.
I would like to thank Dr. Herscu for the very clear way he explains his methods and sharing them with me. I find his letters extremely full of sense and backed up by a lot of hard study into the pioneers and his own extensive practice. His further clarification on the materia medica is so needed.
Homeopathy is one of the hardest things I have ever studied, even though I found school and nursing college relatively easy. I may not have studied homeopathy if I knew how difficult it was. Living at the bottom of New Zealand is also very isolating and these letters are just great.”
– G.T., Herscu Letter subscriber from New Zealand