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- Dean crothers md, nick nossaman md, robert schore md, jennifer jacobs md (past member)
Interviewed by lucy vaughters, pa-c. cch
Until this interview, all I knew was that this was "Rhus tox weekend", and that these men were doing "extractions." -L. Vaughters
AH: So tell me the history of this group.
DC: We started in 1985. The founding group consisted of Dean Crothers, Jennifer Jacobs, Nick Nossaman, Robert Schore, and Jackie Wilson. Jacques Imberechts founded Homeopatia Europea back in the early '80s and it was an umbrella organization for a group of study groups around Europe, like this one, and each study group had a group of doctors and three or four things that they were supposed to do. Meeting for usually four days at a time, usually four times a year, and they would study materia medica, present and discuss cases, discuss homeopathic theory, and make additions to materia medica.
One of the things back then that each person who joined a study group was expected to do was to do what they called an extraction. That was before computers. The extraction meant that you chose a remedy and you went through the Repertory and you listed-you typed or you wrote down by hand, or whatever-every rubric in the Repertory that contained that remedy. You put it together as a document, as an extraction of that remedy from the Repertory.
NN: This would be typewritten-pages and pages and pages and pages.
DC: But each person chose a remedy and did that process. The extraction was for a document that was to be submitted to the whole group so that anybody could look through the paper and see all the Repertory rubrics in which that medicine appeared. Now you could do it in about a minute and a half on the computer, with any remedy. The other thing to do, based on the extraction, was to go through that remedy as a group, divide it up into sections, and divide it up in terms of authors of different materia medicae, and that person would read through every symptom in the materia medica and look it up in the Repertory. If it wasn't in the Repertory, if they couldn't find it referenced some place, then he or she was to make a list of proposed additions to the Repertory representing that remedy. Then we would get together three months later and go through everybody's list and either reject or accept the proposed additions of the group.
AH: What would be a basis for rejection?
DC: If you found it was actually referenced someplace else in the Repertory, the person just hadn't thought about how it should be. We could give you some examples, from what we've done today. In fact, Nick had proposed "stomach pain": a "sore pain on touch."
AH: So you're working on one remedy right now?
DC: Yes, Petroleum. He found that "stomach pain, sore on touch" was not referenced for Petroleum in the Repertory. We decided not to do that because if it's a "sore pain", then it is tender to the touch, so that's redundant. The Repertory has some errors by doing that, but we decided rather than perpetuate that inconsistency, we'd just leave that proposed addition out.
AH: OK, so is what you do today the very same?
DC: That part is the same except that we've computerized it. I wrote a computer program, and it's pretty slick! We've got the materia medica, the Repertory and a database in the computer. We just flip between the three programs, look in the materia medica, look at symptoms, flip over to the Repertory, find that symptom and if we can't find it, we highlight the symptom and copy and paste it right into the database. Then we go to the Repertory and propose where it should be and put that in our database. So then we have a database of all the proposed additions. We do that individually and then we come back with our disks after this meeting and we put it all under one file. For example here's our next symptom that we're going to do. This is for Petroleum, it's Allen's Encyclopedia. So it's "pain as from a sprain in the first joint of the toes on stepping." It's in the extremities chapter of the Repertory and it's "pain, sprained, toes, stepping," and it's a grade one. That's the proposal I'm making for an addition. So what we'll do is look up in the Repertory and see if we can find a better place to put it, or see if it's already represented, or not represented, or if it's straightforward which degree to make it and then we'll make the addition in the Repertory. The Repertory is set up now so that we can add that directly to the Repertory, in Synthesis.
AH: Is it just the one Repertory you're making changes in?
RS: Yes, Synthesis.
NN: Although, we have attempted a number of times to communicate with the people at the other repertories because we'd like to submit it to them, too, but we haven't had any answer.
AH: Oh, really?
NN: Isn't that right?
DC: Yes. I've sent them in the earlier version, but I think that the technology was just way too difficult. We sent them earlier versions of databases of our additions. It was on disk, which they would then have the option if they wanted to, to take those additions and put them into MacRepertory, but I don't think they've done it, I'm not sure. But this has become much easier now, it's much more time efficient the way we're doing it now.
NN: It's in exactly the format that it can just be basically merged into Synthesis with the push of a button. There isn't any sort of additional work. It's in such a form that it's just ready to be merged.
AH: Tell me more about the Homeopatia Europea?
DC: It was the original umbrella group of Jacques' study groups. Each study group was named after the first remedy that it studied.
AH: So you guys studied Rhus tox first. I thought maybe you chose the name because it was your favorite remedy, or you were just really restless guys?
DC: There was the Coca group in France, the Lycopodium group, and the Kali carbonicum group in Boston at one time.
AH: Is it all work and no play? What do you get out of it, other than enormous glory?
DC: Oh, right, we get lots of glory (laughs). We don't really get anything out of it.
AH: Is it not fun any more?
DC: It is fun.
NN: I think it's a great question, because we ask ourselves that, too, because it is a lot of work! Part of it is, well, satisfaction; it's in a quote from Jacques Imbrechts, the originator, about "the satisfaction of feeding the cow that feeds us." In other words, it's kind of like doing our bit for the database. Some people do provings, some people do whatever, besides just the day-to-day work in the trenches that we all do. There's also the satisfaction in just sort of hanging out with these guys for a few days.
AH: It seems like Dean looks forward to this weekend.
NN: I do too. Very much.
AH: It looks grueling. I come in here and there's this tangle of cords, piles of books, and six monitors going at one time!
DC: And we're debating. We debate over the details about whether this should be the wording or was this an interpretation based upon the translation, which was incorrect for whatever, or is this even worthwhile? You know, what's the clinical relevance to what we're doing at this moment in time. We try to keep bringing it back to that.
RS: One of the things that was very obvious this morning was how many of the modern-day authors have taken credit for additions to the Repertory that were made by Allen and Hahnemann and Hering.
AH: Oh, really?
NN: Oh, tons. A lot of the additions are attributed, in the Synthesis, to modern authors.
DC: Phatak, Vithoulkas, Pierre Schmidt.
RS: They created the illusion that additions to the Repertory or original proving symptoms, formerly made by other authors, were their own. Hering, and also several modern authors upgraded some of the symptoms from the provings, e.g. , from grade 1 to 2, based on repeated clinical confirmation. But there are a lot of people reinventing the wheel and taking credit for it. Many modern authors translate these symptoms into psychological jargon, and I think over-interpret a lot of what's been done. Much of the original information is distorted.
NN: It's funny to see provings these days compared with provings 100 years ago, which we are looking at. These are detailed about the nature of the pains for example, and extensions of the pains and very much on the physical level of things, with incredible kind of details, like 3 adjectives; "stitching," "itching," "burning" type pains in the right lateral malleolus extending to the big toe,' kind of stuff. In the provings these days, the emphasis is on the psychological experience of the medicine and so on; it's really an interesting kind of difference! I'm sure people are having physical experiences from these, but really the vogue now is to think psychologically about things, and not really add to the database on all levels, on the physical level as well as on the intellectual and cognitive and emotional levels.
AH: Do you use any material from contemporary provings?
NN: Well, we haven't, just because our goal has been to go back and sweep up the last bits of old provings not included in the Repertory because this is probably going to be the last time anybody goes through to catch all the little residuals that have been left behind. One of the interesting things about that, you can say to yourself, well, geez, big deal, somebody's recorded all this stuff, I mean, what are these little scraps all about? Are they of any use? Just an example, I think, of one that was really left behind, was on Ferrum Metallicum. The symptom was exophthalmic goiter (Graves disease) as a result of suppression of the menses. This was an addition of the 3rd degree from Ferrum, and it wasn't in the Repertory. Which was pretty significant clinically, and has the potential for being significant clinically. So it's not just little bits of trivia.
DC: We usually end up with 3 or 4 or 5. ..
DC: Big things like that.
AH: So you take all this work and you send it to the Synthesis people, and then ...your group's work is notated somehow?
AH: It's not?
NN: Because it's the original authors, so if it goes in there, it will have Hering's or Allen's subscript next to it.
AH: So it's virtually without glory.
NN: Oh yeah. Actually, the 2 of them are in there for additions, I guess, that you guys have made, right?
DC: I haven't made any additions, but...
NN: But they're listed as authors in Synthesis.
DC: Actually, it was nice in the book version in Synthesis, Schroyens did mention...I don't know if he mentioned us as a group, I know he mentioned me, I think he might have mentioned Bob. Nick had been kind of the silent partner in our group.
[O]ur goal has been to go back and sweep up the last bits of old provings not included in the Repertory because this is probably going to be the last time anybody goes through to catch all the little residuals that have been left behind. (Dr. Nick Nossaman)
NN: You guys are listed individually, and then Rhus tox group is listed as an entity.
DC: Right. So it was sort of acknowledgment or thank you for contributing.
AH: Are you all the last remaining group, or are there other ones still active?
DC: I don't know. Jacques, who was the leader for a lot of the European groups, those study groups began to dissipate. The leadership went away. Jacques became much more involved in the LIGA. So in the last, probably, 6 or 7 years, he's removed himself from what he used to do. He would travel around the world. He would go to the study group meetings. He came to our group here, in Seattle, probably 10 times? Or more?
NN: Quite a few. He got us going and then moved on to other things.
DC: He would come back and spend the weekend with us, and help guide us in the process that we were doing, and encourage us and criticize us, and whatever else. So when he quit the leadership and cohesiveness sort of fell away. The Lycopodium group is one that I know of in Italy. Their interest went off into computers, and they developed what's called the CHIP. It's the Computerized Homeopathic Information Program. It's a whole patient database, kind of like HOMER that we use here in the office. Somewhat like a follow-up database, only it's a much more sophisticated Windows based, integrated with RADAR patient database, clinical database, with remedies, with follow up, all that kind of stuff.
NN: Tell her about the functional health index.
DC: We developed that as a group.
NN: That was one of our projects.
AH: The functional health index is very useful-we use it here at Evergreen, and I like it a lot. Can you review it for a moment?
DC: We came together as a think tank, with this idea of developing the functional health index, and we videotaped the whole meeting! It was funny. We were trying to set up an APGAR score. [Named from Dr. Virginia Apgar, APGAR uses five observations on a newborn baby at one and five minutes after birth to determine basic vitality-Appearance, Pulse, Grimace, Activity, and Respiration]. A simple way to look at a new patient, to say how healthy or sick the person is functionally.... I think we've all used it.
NN: You know, it's interesting, not only from the totals, (note: referring to the total "score" patient is given on this "Functional Health Index"; patients are scored from 0-2 on the parameters of mental, emotional, energy, social, and physical functioning, with a total score of between 8-10 indicating a relatively healthy person, and so forth)-of whether they're a 7 or an 8 or a 9 or whatever; but also the different terrains that you see. For example, many people are multilevel; they may be a "1" socially, yet a "2" on the other levels. It would be interesting to do a computer analysis of people. We've always talked about that, of doing "before and after" type stuff, but haven't gotten around to doing that.
DC: I don't know if I told you this or not, but we did that ...we were testing the functional health index, we would ...present a case, discuss it, and then each individually create his or her own functional health index, to compare. And they were remarkably similar. We then would do a follow-up, there would be a discussion of the remedy that was prescribed, and then a follow-up of the case.
AH: Jennifer, what do you remember about this group? What was valuable to you about it when you were in it?
JJ: One thing I valued a lot was the reading of the Organon and the related materials, discussing them in depth. Because I hadn't looked at that stuff since I originally started homeopathy, and the viewpoint that you have about the Organon and Kent's Lectures and all of that is much different after you have 10 or 15 years of experience, compared to when you're a neophyte. So I think it was good to kind of validate what we're doing, and remind ourselves of the basic principals, because I'm not sure a lot of people really read the Organon as an ongoing exercise.
What I remember was the fellowship of getting together intensely for three days with other homeopaths, and doing nothing but talk about cases and philosophy and remedies and sharing our own...there's a lot that goes on outside the formal meeting in terms of sharing our own experiences with patients and difficult cases, and observations and discussions about the state of homeopathy and the political aspects, and I guess I remember the dinner table conversations more fondly than the actual study group. Luckily I'm still privy to that part of the study group, the dinner table conversations.
AH: Anything else?
JJ: One thing I remember that we researched, and which has been a revelation to me, is the word "herpes" in the Repertory, that it means just something is "spreading", like a snake, as opposed to "herpes" as we think now. I'm sure a lot of people use the word "herpes" now in the Repertory to mean something like herpes genitalis or simplex; but that's not what they meant. Do you have an addition that you haven't talked about yet? Maybe you should just do one so she can get an idea of what you do.
DC: We spent quite a bit of time yesterday on "hectic fever". What is a "hectic" fever? So we looked in the dictionary, we looked up "hectic," and see the derivation of it where "hectic" came from, and how it pertains to fever.
AH: What is a hectic fever?
DC: A hectic fever is a continuous, variable fever related to tuberculosis; consumptive fever. It's a low-grade fever.
JJ: I would have thought it had to do with malaria.
RS: "Related to or being a fever that fluctuates during the days as in tuberculosis or septicemia, consuming or emaciating fever."
JJ: Could it be malaria too?
DC: No, it's not that spiky, it's more of a low-grade fever. It's funny, because the word "hectic", as we think of it, is more frantic.
As I was thinking of it, a synonym for hectic is "feverish." So it may come from that .
JJ: So in analyzing "hectic fever" you go into the derivations of the word "hectic" and what that means.
DC: It helps us in deciding ...where it should be added, and whether it should be added or not.
RS: Then you realize that we rarely see patients with these fevers. Patients are suffering from suppression of fevers. Are we seeing chronic inflammatory instead of acute infectious diseases?
DC: Yes, we're getting gastritis and ulcers, instead of fevers.
RS: And we're seeing more auto-immune diseases, degenerative diseases, cancers, and complex illnesses, unlike what occurred 100 year ago. And yet, homeopathy has its roots in the eighteenth and nineteenth centuries. The roots have not changed. This homeopathic process keeps me grounded. There's something nice and old-fashioned about it.
DC: You should see Bob, when we start the meeting, every time-I have to bring him back down and get him grounded again! So this is also from Allen, "rectum, pain, stitching, bending forward ameliorates."
NN: This is the symptom that Dean got out of Allen and then he extracted from this symptom in Repertory language that he's proposing to be an addition to the Repertory.
RS: And it may or may not be a rubric already. We'll see.
AH: And then the next step would be-oh, you're doing it right now.
DC: Yes. "Pain, stitching, bending forward ameliorates."
RS: And here's a symptom: "Pain, stitching, rectum, when the body is erect." Petroleum is in the third degree.
DC: When the body is erect. And this says, "pressing pain in the rectum two days before the menses. She was obliged to lie forward...That's it! So that's the significance of that rubric, is the fact it comes on when she's standing upright.
RS: There's another thing we didn't see. Let's do an extraction for Petroleum and just look at the remedies in the third and fourth degree. There are 189 symptoms that have Petroleum only in the third and fourth degree. Look at these symptoms and you'll see the flavor of the remedy eliminating that psychological interpretation that's imposed by the modern authors. You don't get distracted by the way in which various authors change original symptoms.
DC: Well, I think, related to what you're saying in terms of modern authors, I don't have anything, really, against modern authors, it's just that nobody can have all experience. I think that Vithoulkas or someone else, Herscu, who writes a psychological description of a remedy is writing about the kinds of patients that he has seen that fit that remedy. But there are others that he hasn't seen, and perhaps his own personality attracts certain kinds of people to his practice that present a certain psychological picture of the remedy. So I think it's fine, but it may be risky to think that that's the only kind of picture you'd see of a remedy, a certain psychological picture. Whereas, the provings are more...
NN: You don't hear people at case conferences talk about that they were led to the remedy by a peculiar physical symptom. You just don't hear that mentioned these days.
RS: It was really common knowledge in Europe...Pierre Schmidt, Künzli and the people that taught Jacques. Those things were given a lot of weight.
DC: Yes, the peculiar symptoms.
RS: Modern methodology has gotten away from that.
RS: Here, I just randomly picked some of these symptoms here, like somebody has catarrh in the eustachian tube and an ulcer on the leg and a ravenous appetite with emaciation. Repertorize those three symptoms and you come up with Petroleum. The tendency nowadays is for people to say, "well, what is the psychological makeup of this person? However, if it's normal, then you can base the prescription on these symptoms. That's a kind of foreign concept to a lot of people. There is a tendency for practitioners not to prescribe without mental or emotional symptoms.
JJ: I was just going to say that the other thing is that when you go back and you read about the provings and how they were done, and how many people did them, it's kind of scary. Some of these provings were done on two people. And we're basing our whole practice on this, so I'm not so sure the provings are the gold standard. In modern provings that they're doing-double-blind, placebo-controlled provings-they're finding a lot of the symptoms, well, that's a whole other subject, but a lot of symptoms, they're finding, that the placebo people get are the same as the provers, and they're throwing a lot of those symptoms out. So there's a lot of talk, at least in Europe, about how valid are the provings, and how should they be conducted, and how were Hahnemann's provings conducted.
RS: I remember a case of a man who had severe, chronic constipation, who was so concerned about his wife that if his wife improved, he would improve. So I gave him placebo as a first prescription. And he had an immediate, classical aggravation, followed by relief. You'd have thought it was a remedy. So how do you explain that?
AH: How do you explain that?
RS: I think that if you follow the method as outlined by Hahnemann, pay very close attention to it, concentrate on it ...dedicate to it, resonating with it, and pay close attention to the patient, you no longer can separate yourself from the patient. The patient, the doctor, the interview, and the effect of the remedy become one and the same thing. That group has a homeopathic curative effect.
JJ: Or how somebody who has been doing a proving of something all of a sudden sees two cases of that remedy in their office in the next six months, and it works.
RS: There's another dimension to the healing process, an energetic or psychic level.
AH: So, for instance, the patients in the double-blind studies that you were talking about who were receiving placebo and having symptoms the same as the other people, there's something else that may be going on there, energetically?
JJ: There's something else going on.
DC: I'm not sure if I agree with throwing out those symptoms, because they might be just as bad.
JJ: Well, you've got the whole idea of morphic resonance and all that kind of stuff.
AH: What kind of resonance?
JJ: Morphic resonance. It's like when you go to a South Sea island and you teach a bunch of children English nursery rhymes, and then you go to another island, completely separate, and teach children English nursery rhymes, they learn it twice as fast as the first group because there's something going on.
DC: Because that learning has taken place before.
JJ: That learning has taken place. It all has to do with chaos theory, I believe, doesn't it?
RS: I think the homeopathic process is one entrance into that dimension. If you follow its rules, it will take you into that dimension, and once you're there, a different set of rules applies.
AH: It's what we all aspire to, right?
RS: Yes. Homeopathy has taught me about healing. I believe that a student should learn from his teacher then add to that understanding. Homeopathy has taught me about energy medicine and the non-material nature of healing.
AH: But what is placebo effect? Something real?
JJ: Right, the self-healing capacity of the body, and it's very powerful.
RS: It's a pattern that can be perceived and worked with and studied. Yes.
JJ: Well, I know I talked with Dr. Wayne Jonas about it, he felt that just thinking about the right remedy for the patient even without giving the remedy, was enough.
JJ: Yes, he would talk to someone on the phone and decide on a remedy and mail it, but they would start getting better even before it got there.
DC: Bill Gray talked about it years ago, about having that experience of talking to the patient on the phone and figuring out the remedy and forgetting to mail it.
RS: Then you have people that use kinesiology or various ways of testing the remedy, hold the remedy and get an effect. Well, what happens with all the remedies in our remedy cabinet? Why don't they antidote each other, cross-contaminate each other?
JJ: You know, I've always thought it would be great if you could sneak into some homeopath's office, and replace all of their remedies with placebo and let them practice for a year, and see what happens.
RS: That's a great idea!
AH: You'll have to get a grant to do that study!
RS: I think the homeopathic process is a method that is understood by the western culture, and it's one of many healing paths.
DC: Which we don't know. We don't know what that is yet.
AH: I'm sure Bob has some theories.
RS: In paragraphs 288 and 289of the Organon Hahnemann discusses animal magnetism or mesmerism, and the effects of positive and negative passes of the healer's hands over the patient. Hahnemann offered some interesting ideas about subtle life energies. From my study and practice of Cranial Osteopathy I have learned how to pass my hands over patients and create the same or similar effect as a homeopathic remedy. The point I am trying to make is that my study and practice of classical homeopathy helped me to learn how to employ subtle healing energies with or without homeopathic remedies.
I've always thought it would be great if you could sneak into some homeopath's office, and replace all of their remedies with placebo and let them practice for a year, and see what happens. (Dr. Jennifer Jacobs)
AH: And that's why you need the extractions, to ground you, when you don't follow the rules anymore?
RS: Yes, if I get too esoteric or bogged down in fanciful explanations of remedy essences, using the Repertory prevents me from overlooking seemingly uninteresting symptoms like warts, discharges, and tongue shapes, which may be peculiar enough to lead to the selection of the curative remedy. This is what I mean by grounding-finding the connection between psychic and physical symptoms. Some physical symptoms are so striking and peculiar that they guide the homeopath to the curative remedy as surely as would a clear mental symptom. Grounding in this sense keeps one from developing fantastic emotional essences of remedies which are easily misunderstood. In addition to the conventional paths of communication such as nerves, fascia, blood vessels, and hormones, physical and emotional levels communicate by means of esoteric pathways which resonate at very different frequencies. Some call these esoteric circuits. Conventional medicine is more material oriented. An acupuncture student first learns to feel the indentation in the physical body demarcating an acupuncture point. A master acupuncturist (sometimes called a Chi master) can feel the indentation in the field over an acupuncture point. The energy fields surrounding the physical body, after proper training, are palpable. Frequently they do not follow the course of a nerve, vessel, or muscle. Sometimes the field surrounding the temperature centers of the brain are directly linked to the energy field around an ingrowing toenail. It's possible that this correlates, for example, with the increased vital heat, hot feet, and in-growing toenails seen in patients cured with Sulphur in homeopathic potency. The homeopathic remedy "touches" the energy field of the patient. Similarly, a "magnetic" pass by a healer can have the same effect.
AH: Do you ever find the homeopathic process cumbersome, or do you require that tedious process in order to get to that point as a healer?
RS: The homeopathic process is, for me, very cumbersome, when the patient isn't paying attention. If I have a patient who's focused, it's easy. If the patient's attention is elsewhere, it's impossible.
AH: If their attention is elsewhere, meaning they're not in touch with themselves?
RS: No, being in touch with oneself may be misleading. A patient who is paying attention may be doing so unconsciously. In order to be well, the patient must be committed to the healing process, to getting well. Some patient's say they want to be well, but their energetic field "says" otherwise. Some patients are very skeptical and improve very quickly because their subtle energies are ready to heal. I think that the non-material vital energy speaks more accurately than the intellect which is prone to make too many mistakes.
AH: Just one more question. Vithoulkas' Essences had such a big impact on a generation on homeopaths, and I'm just wondering, do you feel that that took us away from the gist of homeopathy? You're nodding your head yes. Do you agree?
NN: It has contributed greatly in one sense, and led to some imbalance in other respects. I think everybody's trying to emulate one aspect of what Vithoulkas has taught, be more esoteric and give a constitutional case of some obscure remedy based on a psychological "essence" they develop from a few cases. This is not all bad, but I think it's sort of tipping the balance, and forgetting important physical and general symptoms. I think it is important to pay attention to mental symptoms, and really do good quality work in that regard, but I think if it neglects the whole picture, then it is unbalanced. So on the one hand, we have him to thank for the enthusiasm he's generated in all of us, and on the other hand, I'd like to see us looking at a remedy in a balanced fashion, in all its aspects.
Dean Crothers, MD, a graduate of the University of Washington School of Medicine, studied homeopathy with George Vithoulkas. Past President of the American Institute of Homeopathy, former editor of Resonance, Dr. Crothers is currently medical director of the Evergreen Center for Homeopathic Medicine, which he founded with his wife Jennifer Jacobs, MD, MPH.
Nick Nossaman, MD, DHt. Graduate of University of Colorado School of Medicine. Past President of the National Center for homeopath and American Institute of Homeopathy, has been practicing homeopathy in Denver since 1976. Robert Schore, MD, DHt, graduated from The University of Michigan Medical School in 1969, studied homeopathy primarily with Dr. Jost Künzli in Switzerland, and has practiced classical homeopathy since 1974. His was a former editor of Homeotherapy, and has a private practice in Seattle. He can be contacted at emailDoctorSchore. com.
Jennifer Jacobs, MD, MPH received her MD degree from Wayne State University and a Masters in Public Health at the University of Washington. She studied homeopathy with George Vithoulkas, is a Past-President of the International Foundation for Homeopathy, and is currently the President- Elect of the American Institute of Homeopathy. She is also clinical assistant professor of Epidemiology at the University of Washington School of Public Health where she conducts research on the use of homeopathic medicines in primary care.