When the perfect Simillimum is not working....

Homeopathy is the treatment of diseases by remedies chosen according to the Law of Similars.
All Homeopaths agree on that. Well….most of them.

But is that all?

How comes that sometimes a remedy, obviously well chosen, works poorly? And this even when the choice is checked by colleagues and teachers, and the same remedy is suggested?
How comes that a well chosen remedy sometimes gives terrible aggravations? Wrong potency, wrong dose, are we told. But is that really all?

Hahnemann, Kent and most of the contemporary Classical homeopaths advocate the use of a single remedy without any interference from any other form of treatment.
That is an ideal.
But is it always attainable? And is it always justified?

In today’s world, we are confronted not only with diseases, acute or chronic, but with a slow intoxication* and intoxination** of our organisms, a slow, subtle, insensible but all pervading and almost unavoidable poisoning: adulterated food, water polluted with the best of intentions (Cl, Fluor), polluted air, EMF from computers, TV, phones, power lines, vaccines and medications, etc,…

Our “Lebenskraft”***, Life Energy, Ki, Prana, Ruach, Vital Force, whatever you want to call it, is busy fighting the poisons and the diseases with the help of most of our organs.
To treat with Homeopathy, we introduce an artificial disease that is supposed to displace the natural disease. But it does not do that on its own; the remedy needs the involvement of the Lebenskraft and the active participation of all our organs.

What if they are too busy just maintaining life? Wouldn’t that explain why a well chosen remedy does not work?

What if the supplementary imbalance from the remedy just pushes some organs into a totally chaotic answer instead of starting the repairs? Wouldn’t that explain many unexpected aggravations?

Wouldn’t it make sense to prepare the body to heal? Isn’t it logic to optimise the function of each and every organ before the “real” treatment starts?

That is the purpose of Drainage, Detoxification and Organotherapy.

Many Classical Unicist Homeopaths claim that the Simillimum is its own draining remedy.
Yes. Maybe. Sometimes.
Are you willing to gamble on this affirmation?
I am not!
If I can avoid aggravations, complications or lack of efficiency, if I can speed up the recovery of a patient, then I will use whatever is needed.
There is no contradiction between Drainage and Hahnemanian Homeopathy.
One prepares the way for the other.
It is true that sometimes, by unblocking the function of the organism, the Lebenskraft is freed to perform its original task and produces a cure, or at least a sensible amelioration without the prescription of a Simillimum.
So what?
Isn’t that in absolute agreement with Paragraph 1 of the Organon? “The physician’s highest and only calling is to make the sick healthy, to cure, as it is called”.

When you plan a long trip in your car, don’t you check and repair it beforehand to ensure a safe trip? Why would you do that for your car and not for your body?

First some history, as indeed it appears that many other famous healers and homeopaths were thinking along the same lines.

We meet again our old friends and precursors, Paracelsus and Hippocrates.
In his “Commentariae Aphorismos Hippocrati”, Aphorism 21, Paracelsus writes: “When Nature searches for an outlet, the healer must help it find the appropriate place, for Nature is a better healer than man”.

Nebel, a Swiss Homeopath from Lausanne, is credited as the first homeopath to use drainage as such and to give it a theoretical formulation; he called the drainage remedies “channelling remedies” (Remèdes canalisateurs). [Nebel. Canalisation. Propagateur de l’Homéopathie 1915].

In an article in 1934 [Homéopathie Moderne 15 Janvier 1934], Nebel attempted to demonstrate that the use of intercurrent remedies, like Nux Vomica, during an antipsoric treatment, as Hahnemann described, is actually a kind of drainage, and by doing so, that Hahnemann used drainage during his treatments without identifying it.

Nebel was treating tuberculous patients and demonstrated that by adding drainage techniques to the homeopathic treatment, his patients had very little aggravations and were improving faster.

Rouy, a student of Nebel, made a distinction between drainage and channelling. Drainage uses remedies that are known for their physiological action on an organ, whereas channelling is the use of antidotal or complementary remedies with the Simillimum to direct and control its “excesses”, its aggravations.

Roland Zissu extended that notion into homeopathic drainage and organopathic drainage.
Homeopathic drainage uses low potencies of remedies that are complementary to the Simillimum and are selected upon the local symptoms and signs, or medium potencies of complementary remedies selected upon more general symptoms and signs, for the purpose of preparing the action of the Simillimum and prevent aggravations. [NB: for Zissu and other contemporary French homeopaths, a low potency is 3X, 5X, 3 to 5 CH, a medium potency 7-9CH].
Organopathic drainage uses remedies known, often through Herbal Medicine, to have a pharmacological action on the target organ, or remedies that have strong homeopathic signs and symptoms linked to an organ, like the scapular pain of Chelidonium used in liver drainage.

Many other authors, French in general, refined the definition and use of drainage (Fortier-Bernouville, Duprat, Allendy, Tetau, Conan Meriadec, Maury whose booklet has been translated in English, etc,…).

Drainage will cause a specific functional stimulation of the organism or of the target organ(s) through remedies specifically selected either through local or loco-regional symptoms and signs, or through known physiological activity on the targeted organ or tissue.
Channelling will control the effects of the Simillimum by modulating its action; that is why channelling remedies are complementary or antidotes to the Simillimum.
For practical purposes, if drainage has been done correctly before giving the Simillimum, there should not be any need for a channelling remedy.
Alternatively, if drainage has not been done, one or more channelling remedies should be administered in low potency with the Simillimum during its period of activity, if need be.
Draining before the Simillimum will optimise the function of the organs, draining after the Simillimum will complete the elimination and the cleansing. Channelling before or with the Simillimum will modulate its action and avoid aggravations and complications.

Drainage respects Hering’s Law: it has to go from inside out, from the most important organs to the less important ones. This means that a drainage therapy targeted towards the nervous system should show an improvement of the nervous symptoms associated with, for example, an increase in urine output, or some mild diarrhoea, or a skin eruption. But if the kidneys are drained and nervous symptoms appear, something is wrong and the situation should be reassessed.

Classical homeopaths, unicists, should not despair! There is a way to respect the single remedy mantra and to perform drainage.
First of all you must be certain of your Simillimum; then instead of going straight to a high potency, the same remedy is first given in low potency and worked up to the desired higher potency. It is not exactly a single dose, but it is still a single remedy. It respects the concept that the remedy is its own drain and the concept of using a low potency to cleanse, prepare the organs.
The use of ascending LM potencies is an example of inadvertent drainage where the remedy is its own drain. Margaret Tyler’s technique of ascending potencies (30, 200, 1M) is also akin to that way of thinking, although the purpose is not drainage.

Roland Zissu [Matière Médicale Homéopathique Constitutionnelle] introduced the notion of Miasmatic Drainage, with different remedies according to the miasm involved. This is actually another presentation of the old notion of prescribing a nosode when the properly indicated remedy is not working or removing a miasmatic block. When should it be done and why not do it in every case before, or after, the Simillimum is a totally different discussion.
According to Zissu, and as practised today, we will use different draining remedies according to the symptoms:
- localised symptoms, like the base of the lung (Chelidonium Right lung, Ranunculus Left lung)
- tissular symptoms: skin (Fumaria, Saponaria), serous membranes (Bryonia)
- organ symptoms: spleen, (Ceonanthus), kidneys (Berberis)
- biochemical symptoms, depending which product has to be removed: uric acid (Urtica), poisons, antibiotics (isopathic)

We should by now realise that drainage is the use of a localised, specific, targeted Simillimum; we use the totality of the symptoms of the organ, tissue,… with its modalities to choose a remedy, or a few remedies if need be.
There is absolutely no antagonism between unicism and drainage; these are complementary techniques based on a sound understanding of physiology and pathology.

The low potencies that are used, from tincture to 3X or 3C, induce cellular activity of short duration; the low potencies work better on cells, organs and tissues, they have a short action, quasi pharmacological, and they need repetition for their action to be sustained. Slightly higher potencies, up to 5C or 6C might be used or added if we want to act also on a cellular or tissular energetic level.

A great supporter of drainage, Dr. Michel Guillaume, wrote: “The concept of drainage in homeopathy has no other purpose than to be functional. Indeed, it has the merit of allowing the global understanding of a pathological case and to better adapt the corresponding homeopathic treatment” (free translation from Basses Dilution et Drainage en Homéopathie, Coulamy & Jousset, page 338).

Detoxication, or detoxification, meaning the removal of toxic substances, poisons that are compromising the proper function of the organism, is often used interchangeably with drainage. At the risk to appear as a nit-picker and hair-splitter, there is nevertheless a difference, and not only semantic.
Drainage prepares the excretory organs to function adequately, to remove those toxins, heavy metals, pesticides, herbicides, insecticides, that have been interfering with proper physiological functions; but are they ready to go?
When the toxic substances are localised in the organs themselves (liver, kidneys, skin, intestines), the functional stimulation of the draining remedies is often enough to trigger their elimination by resetting the physiology to normal; therefore, whatever should not be there is rejected.
But as we well know, many harmful substances are stocked in places where they can do the least harm like the fatty tissues or even the bones and joints; that is one of the reasons for many patients labelled as “arthritic” but where all the tests and radiographies are normal, keep suffering until a proper detoxification is done; the classical example of this is gout with deposits of uric acid in the joints and “gouty arthritis”; clear the uric acid, the gout is cured. Many overweight and obese patients cannot loose any weight no matter what they do; diet, exercise, treatments, everything fails; this is actually a clear warning sign of intoxication as removing fatty tissues would free the toxins and create disease or even death, therefore not fat loss will be allowed. Only after completing a full detoxication will weight loss be permitted and successful.
So how do we proceed? Clearly if we know which substance is involved, an isotherapic treatment is indicated. A low potency of the guilty compound will trigger its elimination; we have all been told the story of the patient who was dying from chronic arsenic poisoning and was given a dose of potentised Arsenicum Album with the effect of having arsenic pour out of his skin in a white powder (unfortunately, I could not find the original text); many have used potentised Petrol or the remedy Diesel Fumes to treat patients with sensitivity to gasoline; and more and more remedies like VDU and Cellphone are created and prescribed with success for the effects of electromagnetic fields. This is detoxification.
When there is no specific substance involved, or if there are too many suspects, the time honoured alternation of Sulphur 6C in the morning and Nux Vomica 6C in the evening has almost always been effective. Should that be anathema to the purist classical homeopath? Certainly not! This is not homeopathy; it is general detoxication using potentised substances.
All this is very nice and well, but what if the organs have been compromised, are not functioning properly and no matter how much stimulation is given through the drainage remedies, it isn’t working?
We need to repair the organs, and that is the field of Organotherapy.
One approach to Organotherapy is the use of herbs known as stimulating repair and growth of the organs.
Let’s look at the liver: Silybum Marianum (St Mary’s thistle) and Cynara Scolymus (artichoke) are well known for that purpose, even used in injection in conventional medicine for acute liver failure (Silybum extract); the Gemmotherapic Cedrus Libani is another one, the Homeobotanical remedy L yet another one. Almost every single organ or function has a few corresponding remedies to induce repair and growth available; we just have to learn them.
Another approach is to use the potentised organ itself: Liver 4C, Kidney 4C, any involved organ can and has been potentised and used (4C stimulating, 7C regulating and 9C depressing according to the French theory, but in practice any potency will do what is needed to stimulate repair and proper function). Potentised organs provide the template for the repair and are often if not always used with the appropriate remedies as described in the previous paragraph. The same dried and lyophilised organs can also be ingested and provide the exact amino acid profile needed as building blocks for the repair, but that becomes the field of nutrition.

As you can see, there are many ways of creating proper circumstances for your perfect Simillimum to work; but you must be aware of those obstacles and be able to use other tools to reignite your patient’s Vital Force and ability for reaction, repair and cure.

Footnotes:
* intoxication is the introduction of external harmful compounds in the organism

** intoxination is the flooding of the organism by internally produced harmful compounds, including bacterial toxins

*** I am using the German word Lebenskraft instead of Vital Force because there has been too many arguments about what Hahnemann really meant by this word, and so many different translations. I do not want to become entangled in useless semantic arguments.


Bibliography.
Drainage, Detoxification and Organotherapy: to be published in 2008 by the author of this essay.
The Organon of Medicine, 6th Edition, Samuel Hahnemann translated by Wenda O’Reilly.
Matiere Medicale Homeopathique Constitutionelle, Vol 1 & 2, Roland Zissu, Editions Boiron.
Basses Dilutions et Drainage en Homeopathie, A. Coulamy, C. Jousset, Editions Similia.
Le Drainage. Dr. Patrick Pilard. Editions Similia.
Drainage in Homeopathy. Dr. E.A. Maury. C.W. Daniel Company.
Rademacher’s Universal and Organ Remedies. Ramseyer A.A. B. Jain Publishers