Shared pathos: Epistemological reflections on the concept of similitude

Alberto Panza

 

In one of the fundamental works of 20th century thought, Martin Heidegger wrote that the merits of a discipline can be assessed by its capacity to tolerate, without dissolving, periodical revision of its fundamental concepts. This flexibility is necessary of course given that the epistemological frame upon which it rests is itself constantly changing.

Under the pressure of inescapable epistemological change, such a discipline (or for that matter, an individual) can reach a state of crisis manifesting typically along two lines:

  • • Loss of heuristic potential and collapsing of the discipline’s frame
  • • Resistance to change and retreat into a rigid and uncritical defense of fundamental concepts which thereby they lose their character as paradigms and become dogmas

This chapter focuses upon the central paradigm of homeopathic medical thought, the concept of similitude, not from the perspective of clinical efficacy—this is discussed elsewhere in the present volume—but in response to current epistemology, particularly complexity theory.

Every therapeutic act, according to Francois Laplantine, depends upon a search for correspondence. Both in traditional medicine and scientific medicine, there is a constant effort to establish a connection between what scientists call a ‘pathological complex’ (which can mean the ill person or a functional limit) and a ‘therapeutic complex’ (the combination of certain acts and instruments which characterize adequate treatment).

The well-known Hahnemannian formula similia similibus curentur designates a type of natural correspondence, a profound solidarity between the cure and the cured. A synthetic formula, it is elegant and suggestive while also enigmatic. From which perspective should we consider similitude? Similar to what? As Massimo Mangialavori states “The principle of similitude can be applied at various levels.”

The most superficial (or mere phenomenological) level is seeking analogy through an isomorphism of emergent symptoms. Correlation is sought, for example, between a patient’s symptoms and those produced by a healthy person during a proving. Configuring this as a ‘homeotherapeutic’ model, the fundamental idea is to induce a controlled therapeutic crisis which acts in the same direction as the disease. The term ‘homeotherapy’—to which homeopathic medicine is not limited—evokes a sense of shared pathos, a resonance based on the principle of sympathy between two organized systems defined respectively as ‘remedy’ and ‘patient’.

A similar theme of secret correspondence between man and ‘other’, that is, an ‘ultra-specific entity’ present in the biome is a well-known anthropological concept. By ‘ultra-specific’ is meant a one-to-one correspondence that is highly individualized: for each person there is a signified other and the two manifest a powerful resonance. This correspondence, referred to as ‘participation’ by the ethnologist Lucien Lévy-Bruhl, is fundamental to most rites and magical practices. The complex of beliefs known as totemism provides one obvious example among countless others. Totemism is founded on the idea of an intimate connection between an individual (or clan) and an animal, plant, or object from the natural world. It is precisely through such highly individualized correspondence that a protective and therapeutic effect is achieved. (For the contemporary observer, a vision quest can facilitate discovery of one’s own totem.)

In traditional societies the principle of similitude is not limited to ritual but operates in various ways as a principle of true knowledge. Giorgio Raimondo Cardona, one of the better-known sages of ethnoscience, emphasizes how the principle of similitude inspires amazingly accurate and specific knowledge of the natural world. This occurs both in larger cultural complexes and smaller tribes. Such material, if amassed into one collection, would be considerable. It would afford a quite refined articulation of taxonomy organized through “systems of coherent thoughts characterized by correspondences between elements at various levels.”

Unfortunately this rich inheritance from traditional cultures is too often denatured and deprived of its heuristic potential in two (opposite) ways: confined to a mere intellectual curiosity or employed as a means to demonstrate and validate a concept or principle. To illustrate the latter, one could make analogy to the rich repository of an individual’s personal mythologies. Taken as a psychosocial data, it does not by itself demonstrate anything. However, with the application of critical intelligence to this data, a number of suggestive possibilities present themselves. Upon further elaboration they serve as excellent representations of key (enigmatic) elements of human existence.

The information offered by traditional cultures is often too isolated, reduced and schematized (if not also trivialized) to give rise to suggestive possibilities. Consider the case of the BaMbuti and the Bantu. The representative horizon of the pygmy BaMbuti of the Ituri forest (central Africa) is the forest from which they gain protection and support. The forest, however, is also the source of myriad evil phenomena such as disease, suffering and death. This occurs not from a malicious intent but because of a momentary lack: when the forest goes to sleep at night, men lose the forest’s support and protection and are therefore exposed to evil attack. To avoid this, the forest must be woken up at sunset with a sweet droning song so as to reestablish beneficial contact. Meanwhile, for the neighboring population of Bantu, evil originates from a malevolent deity which is called “the one who makes siege.” This divinity stands on the shoulder of every man like the Greek daimon, invisible to the subject but inseparable from his destiny. This example underlines how seemingly arbitrary, far afield, and therefore unique two traditional cultural beliefs can be. Because these two cultures are in longstanding communication, one might assume some level of influence on one another regarding the fundamental concern: the origin of sickness and suffering. Yet their concepts are nearly opposite. In other words, their two views are not only dissimilar but hard to reconcile within a simple comprehensive scheme despite their having lived adjacent to one another over a quite extended period of time. This suggests that intelligent inquiry should follow open horizons of association rather than delimited frames of conformation, i.e., the assumption that neighboring tribes automatically demonstrate confluence in significant areas of their respective cultures.

In models of therapeutic action, just as in the anthropology of disease, we encounter more opposites: adorcism and exorcism; addition and subtraction; excitation and sedation; homeopathy and allopathy. (It is interesting to note that exorcism, a common element in many magical ritual therapeutic techniques which involves an invasion of evil or attack by an enemy combatant, bears some resemblance to biomedicine’s attempts to eradicate certain ills through hypertechnological means.) As with the example from Central Africa, such opposite views tend to defy easy generalization or schematization.

The BaMbuti culture’s image of waking the forest at night is compelling, suggestive and poetic. It expresses the idea of a link between the survival of evil and the lack of cohesion and contact between few parts and the totality, as when a disharmonic condition arises between the individual and the grand breath of physis. Meanwhile the Bantu culture’s concept reminds us that entropy is nestled into the very heart of our (provisionally) aggregate corporality. The physis/forest is the great cradle of all that is living; and man exists through continuous recombination or, better yet, through cycles of organization, disorganization and reorganization. In the long-term no forest is able to protect one from the destiny already written inside the corpus (“he who hovers near”), the destiny to which even the forest must eventually submit.

Is it necessary to choose one of these battle lines? Instead of seeking evidence in the anthropological record for this or that thesis, it seems preferable to seek open horizons regarding what is proposed rather than succumbing to the prejudicial binary code of true/false—the origin of all reductionism.

The mere fact that the concept of similitude is so broadly diffused throughout the anthropological record should by itself provide some confirmation of its reliability. The argument against this assertion cannot be proven merely on the grounds that these cultures are traditional.

One could argue that this concept, despite its pervasiveness, is nevertheless nothing but a fascinating and persuasive confabulation, a persistent animist fantasy which ill fits the coordinates of our current episteme. From this vantage point, it is a ‘super-stition’ in the etymological sense: that which is ‘super’ (over) and ‘stition’ from ‘stare’ (stay, stands), hence ‘overstays’ or survives like an empty shell, having lost its referent context.

Even here, however, one may ask how such survival occurs. What lends it support? Many answers can be considered, from the most trite and banal to the most poetic. Perhaps the difficulty is rather our own narrow context. As a refined theoretical psychoanalyst once commented, our tendency to confine the experience of the self to the psychosomatic perimeter of the individual is a fairly recent development. The more extended precedent was to experiment with self-identity via the other (whether human or non-human).

Should the principle of similitude be seen as merely a simple metaphor (where the subject is represented through other in contradistinction to self)? First of all, we may wish to challenge the supposed simplicity of metaphor given the current perspective that metaphors are not mere ornaments, but rather essential instruments, of thought. In this way, elements of the ‘real’, i.e., the literality of life, which are innately difficult to understand gain expository representation.

Secondly, we can observe that, according to homeopathic medical thought, the remedy is not just a metaphor by which a person is represented; rather, the therapeutic effect depends upon a series of correspondences which are structural and dynamic. These close correspondences between the patient-system and the remedy-system allow the former to be receptive to the therapeutic action of the latter. The homeopathic symptoms not only describe those pathological processes from which one can derive and define a semiotic; most importantly, they describe the function of the living system. In other words, they point not only to the disease but to the well state; not only to the defensive mechanism but to the compensatory and reparative; not only to the vulnerable core but to one’s dominant emotional tones.

All this material allows us to configure (without pretending to an exhaustive synthesis) some fundamental trends in the way one inhabits one’s body and the space-environment. As such, the homeopathic remedy serves as a prefigured ‘anthropological model’ which can be recognized as it occurs in the concrete lived experience of the patient-system.

Even so, one might ask whether it is possible for disenchanted post-modern man, living in a technological world, in a universe devoid of the sacred, to continue thinking in terms of correspondences and attunements with ultra-specific entities from the natural world.

Is not the disappearance—or deep metamorphosis—of the landscape in 20th century figurative art an indication of an irreversible distance from the world of nature and its replacement by a technosphere, the new kind of habitat? In the context of a resolute anti-naturalism, the principle of similitude becomes nothing more than a naïve anthropomorphism whereby human traits are projected onto a non-human fabulation in the manner of a Disney cartoon.

We cannot afford to indulge in such simplistic generalizations and narrow-minded approaches. This is the orientation dictated by technology—the attendant risks of which are to become self-referential and self-celebratory. This is not the only direction of current epistemological thought. We should ask ourselves whether, according to contemporary science and its neo-positivist paradigm, many illegitimate criteria (or those considered non-scientific) can still be considered viable.

It is important in this regard to remember how in the second half of the 20th century there was a radical and profound change in paradigms—a true epistemological break—in the natural sciences. The inception of this break was general systems theory, followed by dynamic systems theory and chaos, arriving at the science of complexity. Within our current discourse, there is not sufficient space to describe this epic shift; it will suffice to say that the new paradigms of the biological and physical sciences allow us, as described by Ilya Prirogine, “to be able to speak of a new dialogue between man and nature.”  This dialogue avails itself of what the scientists define as “a new scientific vocabulary: the vocabulary of complexity.”  The expressive potential of this new lexicon permits us to overcome the classical distinction between systems which are simple and complex; open and closed; random and organized.

This dichotomous opposition is replaced by a pluralistic vision of the physical world where entropy and negentropy, determinism and stochastics, closely coexist in all types of systems. This opens up enormous possibilities in the confrontation and connection between different entities and states in the physical world. Obviously, this does not ignore the potentially big differences between systems, but such differences do not constitute antithesis. The common problem here is the tendency to dichotomize, to transform what is different into dualistic opposites: anthroposphere/biosphere; organic/inorganic; thought/instinct; mind/body. Dichotomizing seems to come less from a deficiency in thought than from a suffering in thought. It represents the difficulty to ‘com-prehend’ in the etymological sense: ‘com’ (together) and ‘prehend’ from ‘prendere’ (to take). From this perspective, dualism represents a difficulty of relating to the real world without nullifying it. In the end, dualism does not represent the assumption of difference but its negation; it is an attempt to eliminate and exorcize the disturbing idea that opposites belong to each other.

Complexity theory is a relatively recent discovery whose ideas have not yet fully permeated our established way of thinking and the reflex ways by which we relate to various manifestations of nature. Even so, it’s not especially difficult, according to Prigogine, to conceive of our financial system, our language, the mammal’s brain, or even the most humble of bacteria as complex systems. He goes on to suggest an interesting example: a cubic centimeter of gas or liquid, which with slight variation of scale, is quickly apprehended as an astounding aggregation of complexity. We know that at the pressure of 760 mm of mercury and at the temperature of 0 celsius, a mole of any kind of gas contains an equal number of molecules according to Avogadro’s number, (6.02 x1023), which are moving in every possible direction and constantly colliding against each other. “Is it enough to say that this is a complex system?” asks Prigogine. One could say that such a microsystem (or macrosystem, depending on the point of view) manifests a disorganized and irregular behavior, random and mechanical. Physicists, referring to the absence of any coordinated activity, call it molecular chaos. But it’s enough to produce a thermal dishomogeneity and assist the emergence of an organized complexity: the appearance of a harmonic arboreal structure (a snow flake). The scientist concludes that the difference between simple and complex, between randomized and organized, is less clear than one would think.

The theory of autopoietic systems, coming from the fields of biology and neurobiology, constituted the next important paradigmatic shift. This theory revealed that living systems are based on the net relationships of which they are composed: “the relationship is the tissue of a system,” so wrote Humberto Maturana and Francisco Varela in their best-known work, Autopoeisis and Cognition. There they state that the traditional approach of biological sciences, which is based on increasingly finer degrees of discrimination (and division), ends up ignoring the most fundamental characteristic of living systems: that they are interactive.

All such living systems depend upon the maintenance of an organized functional structure in order to survive. This depends in turn on an ability to self-observe so as to contend against eventual disturbances which threaten to disorganize the system. If disorganization passes a certain threshold, however, the system can no longer maintain its usual structure and function. At this point it ‘de-structures,’ and component parts enter into a cycle of reorganization whereby they are “at play” and aggregate in newly complex ways. To summarize, self-organization operates within a plastic, dynamic, cohesive structure until certain limits are passed; then the system evolves/devolves a new structure and organization. In essence, such a process demonstrates the two fundamental aspects of living beings: continuity and discontinuity.

This discussion recalls the work of Gregory Bateson in the field of psycho-anthropology, namely his expanding the semantic conception of mind. Relying on various complex perspectives offered by anthropological theory, Bateson emphatically affirmed how the term ‘mind’ could be extended to define the ability for organization, and especially self-organization, within every living system. From this perspective, limiting the concept of mind to Cartesian cogitation seemed not only restrictive but implausible. In other words, mind, within this broader definition, can and should be attributed to plants and animals as occurs in the great majority of traditional cultures. This view exposes our tendency toward anthropocentric colonialism, a tendency which leads to self-attribution—as if by divine right or absolute monarchy—and a belief in the exclusivity of mind as a means to justify the predatory supremacy of our species.

The so-called ontological solitude of man—which could be considered as either a privilege or a curse (or both)—and his radical incomparability with other living beings have recently been reconsidered from the perspective of a new scientific discipline called anthropozoology. This field first appeared in Europe and the United States at the end of the 1980s. After developing a more precise approach in the first years of the new millennium, it became redefined as post-humanism. The post-humanist perspective proposes a radical critique of anthropocentric dominion and isolationist principles; meanwhile, it promotes overcoming our essentialist purity and the autarchy of the anthroposphere (seen as separate and in opposition to other realms of the biome).

Ontological autarchy corresponds to epistemological anthropocentrism which strove to consider illegal or senseless any attempt to presuppose a relationship—which was not just an instrumental partnership—between man and other ultra-specific entities.  Post-humanism, by contrast, underlines the concepts of hybridization (not used in the usual negative sense of the term) and ‘other-reference’. As Roberto Marchesini wrote: “Understanding hybridization means going all the way in evaluating the debts humanity has contracted toward what is not human; acknowledging that, far from being an autonomous fruit, man constructed his history through trade with non-human references, importing and writing the genetics of this ‘other’ inside his own genetic code.”

It is important here to underline that post-humanism is not anti-humanism. Naturally the critique of anthropocentrism should not be read as a disputation of human beings’ extraordinary complexity or a proposed return to simplistic biological reductionism. Rather, it represents an opening to a conjugated and pluralistic logic, capable of assuming the presence of ‘other’ as a constitutive element of identity. According to the post-humanist perspective, man is defined as “a transitional ‘other-referring’ being.”

This transformation is not of little consequence. All those aforementioned areas of thought, to which we can now add the astounding conclusions derived from genome mapping, have significantly contributed to reducing the split which separated human from non-human, removing man from an autoreferential ontology, a real autarchic cage which disallowed dialogue with the ‘other’. This radical change of paradigms afforded a batting down of fences between disciplines, helping to realize the hope of Adolf Portmann to: “overcome the barriers which separate the natural from the human sciences.”

Great turning points in art and science are not simply epistemological breaks, wiping the slate clean of what came before; rather, something already known is conjoined to something just now being told. The old is seen in a different light based on the apical change in perspective; it is made afresh through its recombination with the new. The work of the poet Giovanni Pascoli is a particularly appropriate example here. Therefore, the principle of similitude need not be dismissed as unscientific, nor embraced, following the homeopathic adepts, as a religious article of faith. Rather, it can be viewed within its rich anthropological and historical contexts, and through the new epistemological lens of complexity theory.

A particular danger regarding the principle of similitude, and another reason why it has sometimes been dismissed by science, is its superficial application on the level of morphology and behavior. Such can lead to rather simplistic conclusions and caricatures as when a patient might be given Limulus (butterfly) for ‘walking on tiptoe’ (i.e., ‘fluttering’) or Helix (ivy) for ‘grasping’ at things. The principle is effective when it operates at the level of system organization following the definition offered by autopoiesis: the identity of a system coincides precisely with its modes of organization. This concept was clearly expressed by Maturana and Varela in a foundational passage which is worth quoting in its entirety:

The organization of a system…specifies the identity of a system class, and must remain unchanged so that the identity of the system class remains unchanged. If the organization of a system changes, then its identity changes and becomes a unity of another type. Nevertheless, given that a particular organization can be realized by systems with various structures, the identity of a system can remain unchanged while its structure changes within certain limits determined by its organization. If those limits are exceeded, that is to say, if the structure of a system changes in such a way that its organization can no longer be realized, the system loses its identity, and the entity becomes something else, a unity defined by another organization.

Superficial isomorphism is not very helpful in studying the principle of similitude, whereas deeper structural analogies and system processes are essential. From this perspective, it is important to underline the characteristic autopoietic processes of a system, distinguishing chance variables from those which must not be excluded. This is true for both the patient-system and the remedy-system.

In terms of organization, every living system presents:

  • • a particular morphology, with some changeable elements (to a certain limit)
  • • a particular structural arrangement which takes form (‘emerges’) amidst the vicissitudes of life
  • • a certain degree of cohesion
  • • a differential degree of plasticity or rigidity
  • • specific modes of accrescence and decline (aspects of entropy and negentropy)

Every living system develops its shape in a context. It grows within a habitat that is more or less favorable. It shows particular strategies to use its internal resources (and to access external resources) for nutrition, reproduction, and defense against antagonists. Every system, from the perspective of autopoiesis, is distinguished not only by its structural qualities but also by a series of ethological characteristics which describe:

  • • a way to live in the space-environment and to enter into relations with environmental resources
  • • a way to relate (or to avoid relating) with other beings of the same species and with antagonistic species
  • • a way to manage peculiar areas of vulnerability
  • • a way to modify his own structural characteristics so as to effectively utilize resources, to curb entropic tendencies, and to confront threats from the environment

Discussing similitude based on structural organization and processes is easier with living systems such as plants and animals than minerals or other inanimate substances. Even so, such substances do evidence differential modes of aggregation or disaggregation, qualities of compatibility or incompatibility (in relation to other substances), and characteristic points of vulnerability or fragility. We should not forget that few substances are in a pure state unless they are created or isolated in a laboratory. Nearly all substances are hybrids, that is, a combination of constituent parts brought together and formed into a unity. This process of formation occurs within a specific context. To identify potential analogies for a substance, one needs to ask oneself two questions: 1) in which larger system does it appear?; and 2) what function does it serve within the aggregation of which it is a component part? According to the theory of autopoiesis, the identity of a system consists in its organization. To understand a remedy-system, therefore, one must do more than simply index a list of symptoms: a complex inferential procedure is required.

A decisive step in this direction is the suggestion, presented in this book by Mangialavori and Marotta, to substitute the old term ‘homeopathic symptom’ with ‘homeopathic theme’, along with a reorganization of material which more easily affords thematic inquiry and analysis. Fashioning themes confers visibility and concreteness to the holistic orientation (shared by homeopathic medicine with other therapies) but which often remains a mere petition of principle rather than a principle believed and adhered to. Articulating an analogical relationship through comparison of organizational systems permits one to make explicit the corner stones and nodal points by which the interwoven web of a holistic approach can be concretely configured.

One of the problems with the homeopathic hermeneutic is the innate ambiguity of the term ‘symptom’. Different meanings refer to different phenomenological areas, leading to many misunderstandings. The proclivity for listing mental symptoms, for example, can inadvertently lead the practitioner down the path of rigid determinism, whereby the entire psychical life of a person (hopes, fears, projects, disappointments, anxieties, desires, dreams and fantasies) is reduced to mere epiphenomena (of the remedy)—strange approach for a discipline which claims to be respectful of the whole person. If one is not careful, the approach can further devolve from symptomatic to hyper-symptomatic, whereby all possible expressive modalities or experiences of the psychophysical self are reduced to mere symptoms.

This shadow-like effect is made worse by the severe approximation in some rubrics. A typical example is the conflation within the rubric ‘delusions’ of real hallucinations (with clear evidence of altered perception by the subject) and false hallucinations (where the subject knows that the experience does not reflect objective reality—as in reveries, fantasies, and open-eyed dreams). Obviously, these experiences are quite different and point to two very separate patterns of organizations, namely, the presence or lack of awareness that an experience is hallucinatory.

This brings us back to the fertile suggestion to reorganize registers and research around themes. Currently, despite impressive progress in recent years, computerized repertories are still unable to satisfactorily render the palpable experience of the clinical consultation into intelligible therapeutic terms. Attempting to do so recalls the anguish of a student translating a difficult, enigmatic text from another language, clinging to the dictionary in the hope of finding, among the examples listed, a phrase from the text that one is trying to translate. This hope is most often disappointed since the dictionary, like the repertory, is more suited to creating text than matching it. This higher-level function would depend upon a much more sophisticated elaboration as well as a multi-nodal reorganization of the material.

The WEB has made us familiar with the challenges presented by vast amounts of dyshomogeneous data. Hypertrophic information without hypertextual organization, as communication theorists are well aware, leads to disinformation. This type of organization is accomplished by building networks of connections woven together with nodal points. In this way usable navigation paths can be made inside the sea of available information.

In terms of homeopathic medicine, an organization of material through various thematic registries is quite different from the mere categorical classification of various themes (as in current repertories). A hypertextual approach would employ particular nodal points (characteristic themes, fundamental themes and motifs) which, when taken together, do not simply inform but meta-inform; that is to say, the very way in which the material is organized implicitly illustrates the criteria.

A text is more than a mere list of words. The etymology of the term points to the essential feature: ‘text’ is related to the word ‘textile’ (weaving). A text therefore is a woven network of associative meanings which, when considered together, i.e., in ‘con-text’, are multi-layered. In other words, a text is a net of instituted and reinstituted, hence ‘woven’, connections.

Similarly the practitioner, when applying the principle of similitude, must weave together the various elements conveyed by the patient. This requires a step beyond mere reorganization of material from the repertory. Participation within a therapeutic field immerses the practitioner inside the material. Here he is exposed to apparently disorganized and fragmentary elements which, when apprehended through an open, associative posture of mind, allow a weaving together of the most relevant themes in the life of the patient.

The problem of what to include as themes and how to coordinate them is relatively less emphasized in evidence-based medicine. In this context, themes tend to be linear and singular: identification or exclusion of pathological processes. The approach may be called ‘symptomatic emergency’ whereby one naturally relies upon a broad (if not exhaustive), detailed nosography. In essence, biomechanical medicine ‘sections’ the field, organizing what the patient said according to this singular theme, while all other aspects (functional or dysfunctional as they may be) are declared outside this scope and therefore irrelevant. To resolve a symptom with sure efficiency, it is perfectly legitimate to ‘cut’ the hermeneutic in this way. Homeopathic medicine, by comparison, endeavors to encompass the whole which includes, of necessity, more diverse, heterogeneous aspects. This creates a different set of possibilities and problems.

To adequately identify similitude requires comprehension of two preliminary operations: the autopoietic characteristics of the remedy-system and the fundamental manner of living in the patient-system. Then these two areas are compared. This is the moment when the principle of similitude takes shape and identifies a potential therapeutic nexus.  It is a complex process which puts into play the therapist’s capacity to conjecture, infer, but above all, empathize—empathy here means entering, through participatory listening, the world of the patient. The process is creative, not mechanical, and rarely works if approached as a grid or flowchart.

The heuristic potential of the similitude concept is drastically reduced if applied through simple and reductive transposition of A (remedy-system) to B (patient-system) or vice versa. The principle of similitude is not a datum but a hermeneutic operation; a path to travel, not a shortcut. The map is not the territory, and the anthropological model is not the living anthropos. This obvious but often disregarded point can help one to avoid the trap of reductionism. Too often the practitioner pours too many assumptions into the space between description and prescription, believing that one can deduce from repertory symptoms (for a particular remedy) all the virtual aspects of the patient-system.

Analogy is not identity, and patients do not appear in the prepackaged form that schemes typically guide one to look for. Though the remedy-system is prefigured, the patient is not; and so each time, the analogy must in a certain sense be reinvented. The most one can do is to orient oneself, through thematic organization of the repertory material, toward what the patient conveys. Such contributions, realized within the therapeutic field (and therefore not delegable), are what most guide our understanding of the ‘anthropological model’ of the remedy.

The principle of similitude takes its form through a constant interplay between ‘stored or inherited knowledge’ and ‘knowledge through experience’ which occurs only as a result of the therapeutic encounter. From this perspective, we could speak of an anthropological groundwork in homeopathic medicine. Whereas biomechanic medicine’s place for inspiration and verification is the laboratory; for homeopathic medicine, as with psychoanalysis, it is in the field. This work is similar to that of the anthropologist who, with only a guiding hypothesis in his field bag, ventures forth, putting his theory to the test. Invariably, he must continually modify both his hypothesis and his tools as a result of his ongoing encounter with ‘other’.

The principle of similitude permits one to gather together under one banner many scattered fragments (thoughts and mere sketches of thoughts) presented by the patient. It allows one to orient the therapeutic field under the guidance of a hypothesis so that it can be coordinated with fundamental themes derived from the unique organization of the selected remedy-system. On the other hand, clinical experience helps one put into the correct order the enormous amount of reportorial symptoms, whereby privilege can be given to some promising possibilities which can later be confirmed on follow-up.

Encouraging such relations, though not in an oversimplified way, is the heart of the hermeneutic adventure: searching for the similitude. This project entails, newly in every instance, the weaving together of two elements, the warp and weft of remedy-system and patient-system, but also repertory and clinic. In this way, the conjectural form becomes reified through evidentiary experience. In so doing, each element within each polarity is reciprocally illuminated by the other simultaneously. This circular rather than linear process is a recursive operation whereby the element to be defined is itself, at one moment of the elliptical orbit, the operator of the definition. Here similitude appears like the Virgin Mother in Dante’s Paradiso, who is welcomed by the poet as the daughter of her son.

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