Dear friends, today we have with us in our Hot-Seat, the famous ‘facial-analysis’ couple, Grant Bentley and Louise Barton. Grant is the Principal of the Victorian College of Classical Homeopathy in Melbourne, Australia. Both Grant and his partner Louise have done intensive research into miasms and their influence on facial features. This research has been applied clinically since 1999 and is now a recognized diagnostic method to determine a patient’s miasm.

Dr. Bhatia – So Grant and Louise, before we start the serious discussion on miasms and facial analysis, let’s start on a lighter note. Tell us something more about yourself, how you got interested in homeopathy, and what the journey has been like?

Grant

In my twenties I started studying Naturopathy which would be the most common introduction to Homoeopathy for Australian Homoeopaths.  I had already qualified and was practicing Psychotherapy but felt I needed something more to complete my practice.  My first book was Classical Homoeopathy by Margery Blackie and I became an instant convert on my first read.  I was fascinated with Homoeopathy and its structure, something I thought was sadly lacking in Naturopathy and appreciated the quality of its author.  By the time I had finished the book I knew that’s what I wanted to do and I began studying Homoeopathy the next year.  The journey has been an interesting one.  After graduating and practice I began teaching and soon afterwards was offered the position of principal at the Victorian College of Classical Homoeopathy(VCCH), a position I still hold nearly fifteen years later. 

Because my wife Louise is also in practice and is co-administrator of the college, Homoeopathy is more than a job, it is a common bond we both share.  The college training I received was grounded and thorough.  The patron of the college was Dr Subrata Banerjea who helped the original founder Denise Carrington-Smith, formulate a curriculum grounded in the classics.  This stood me well and gave me the foundation I needed to understand Homoeopathy in a practical and clinical way.  I now look on this training I received as invaluable and I consider myself fortunate to have had such teachers.  Modern Homoeopathy in the west can be extremely interpretive and I feel blessed that my training was based on the solid unshakable platform supplied by Hahnemann, Kent, Allen, Roberts and the teachers I just spoke about.

Louise

I got started later than Grant.  Like many other students in Australia I had already started working in a different field – personnel management.  After ten years I wanted to expand my horizons – luckily I came to Homoeopathy straight away and not via any other modality – I didn’t have any unlearning to do!  I had been seeing a Homoeopath and was impressed with the results and the philosophy behind it.  I read a few Homoeopathic books, left my job and signed up for training.  In the early nineties there wasn’t much choice in regard to Homoeopathic training in Melbourne – only naturopathic colleges with Homoeopathy as an elective.  In retrospect I am so glad I chose VCCH as although it was small it was dedicated to Homoeopathy and quickly I became a passionate convert. As part of my training I went to India in 1995 and spent some time studying with Dr Subrata Banerjea who always made such a point of using miasmatic knowledge in prescribing. After I graduated in the mid nineties, I set up my own clinic and later began working at VCCH in an administrative role.  Soon I was helping Grant with his research, running the student clinic and doing some first year training in Homoeopathy.  By the late nineties we were partners, had a blended family and our own son was on the way.  Somehow we still had time to talk about Homoeopathy and what became Grant’s major interest – the miasms.

Dr. Bhatia – You both have had very interesting lives and it’s great to see that your work has only flourished more after the two of you came together. My wife, Manisha, is also a homeopath and I don’t have enough words to tell how helpful it becomes at times to have a life partner who understands your work, passion and eccentricities! Do you think your work on miasms would have been any different if the two of you were not partners in work and life?

Grant

Yes it would have been vastly different if Louise had not been involved.  When I was developing this system, I thought about it, spoke about it and wrote about it 24 hours a day.  I would even wake up dreaming questions to ask myself!  If I didn’t have anyone to bounce these ideas off, particularly someone as skilled as Louise there is no way this system would have developed as quickly and perhaps it may not have developed at all. 

Louise

There is no doubt that this work is Grant’s work but I feel proud to have been involved and if I can claim anything it is that I asked challenging questions!  We both belong to opposite miasms and bring different qualities to the work.  Grant is more abstract in his thinking whilst I am more linear.  He thinks and writes about broad concepts while I streamlined the system.  I suggested that each feature should get one point to help determine dominance and I came up with the triangle.  I like to see things visually and like systems, so that helped to pull it all together.  There is no doubt that the passion we both have for Homeopathy brought us together and has fuelled the rapid development of Homeopathic Facial Analysis (HFA).  We are both amazed that it has come to this point and we are happy that so many practitioners are beginning to use it in their clinics.

Dr. Bhatia – Today you teach about miasms to everyone, but how did you learn about this very controversial theory of Hahnemann? Who were your teachers and what was your initial impression about this theory?

Grant

While Hahnemann’s work on the miasms was a stroke of genius, it can also be very difficult to work with.  In fact I must confess that I was like a number of people who during their training found the miasms so complicated and to some degree so unnecessary, that I contented myself to drop all thought of them and to concentrate my focus on finding the simillimum.  After all the simillimum represented the underlying miasm anyway, therefore to focus on one was to focus on the other.  This is not the case but I did not know that then.  In the years following my graduation I had more failures than successes but enough successes to keep me going.  Like many Homoeopaths I adopted essence prescribing as my principle method of achieving greater constitutional results.  My focus on constitutional prescribing was necessary because chronic disease did and continues to make up more than ninety percent of my practice.  Unfortunately essence prescribing is rooted in the belief that extremely subtle differences between remedies exists.  Therefore the focus was entirely on materia medica and the extraction of how the indignation of Staphysagria is slightly different than the indignation of Nat Mur, which is different than the indignation of Calc Carb.  Because I’d already done Psychotherapy I found this area fascinating and seductive.  Later I was to learn that even though it sounds good the results never reached expectation. 

One of the good things about teaching undergraduates was that I got to reread the Organon every year.  And each time I picked up a little bit more valuable information.  Around 1998 when I was reading the Organon once again, I was struck by Hahnemann’s conviction regarding the miasms.  Of course I had heard this story a number of times before – I had read it nearly ten times myself, but for some reason this time I was really taken by it.  His conviction and his willingness to stake his reputation on the truth of the miasms convinced me that I should not be giving it the lip service I had been doing in the past.  Nobody knows Homoeopathy like its founder and if Hahnemann says that the miasms should be central to every chronic disease prescription, then that’s what should happen.  So I guess that’s how it started - by believing in Hahnemann’s belief yet at the same time acknowledging that I had no way of applying it.

Dr. Bhatia – Your comment about results never reaching expectations with the essence theory is interesting. But I will come back to that later. So Louise, what about your initial experiences with the theory of miasms?

Louise

As part of our studies we had to do a lot of research on the miasms and write an essay on the topic.  After reading Chronic Diseases, Allen, Roberts, Ortega, etc., I remember feeling really confused and decided (like Hering) that it really didn’t matter which miasm it was as long as the totality was covered.  When Grant mentioned that he really wanted to understand what Hahnemann meant and reread every book on the subject I was thinking – oh miasms are boring!

Dr. Bhatia – When and how were you convinced that the theory of miasms is still relevant but needs more work for clinical application?

Grant

One of the reasons miasms remain so controversial was because of the way Hahnemann himself explained them.  Obviously he knew what he was talking about, but to take such a large abstract concept and try and put it into words for everyone to understand can be an extremely difficult task, and I’m not sure he did this successfully.  My understanding of Hahnemann’s miasms really didn’t take shape because of Hahnemann but because of the writings of Allen and Roberts.  For example if I read and try to make sense of psora the way that Hahnemann wrote about it,  I fail to pick up any patterns and put the book down with the belief that it can cause anything and everything but that’s not really individualizing.  Allen and Roberts on the other hand are the authors that begin to categorize Hahnemann’s three miasms into more easily recognizable groups.  These authors talk about the hypo function of psora, the hyper function of sycosis and the dysfunction and degeneration of syphilis.  Now I can see trends forming and now I can see differences and how each miasm is a dissimilar disease in its own right. 

Louise

Grant has always considered that everything Hahnemann did had to have some importance.  It was really Grant’s personal mission to try and understand why Hahnemann spent twelve years on the topic and why mostly since that time miasms have only been given lip service. 

Dr. Bhatia – This is very strange! Allen and Roberts had access to exactly the same texts from Hahnemann as we all do. Then how were they able to give a structure to the theory of miasms while we see a chaos with 90% of the problems ending up in Psora? Does that mean that Allen and Roberts have not merely interpreted Hahnemann’s work, they have given their own version of it? That will make the theory even more controversial. Do you have any idea on what basis early homeopaths like Allen and Roberts were able to classify the miasms in the way in which most of us understand them today?

Grant

No I don’t and I look forward to the day, where I have a little more time, so I can begin an historical research to try to find out how Allen developed the construct he did.  So far I have not seen any previous author that has been the “missing link” between Hahnemann and Allen but if anyone reading this knows more about this subject and would like to share it with me, I would eagerly await their reply. I know that Roberts followed Allen but perhaps we underestimate the genius of Allen to be able to restructure and interpret Hahnemann where nobody else could.  In my mind Allen is one of Homeopathy’s most unsung heroes.  Most of what we understand about psora, sycosis and syphilis, even the tubercular miasm comes from Allen.  So he must have been able to see trends and patterns in chronic disease.  Is it controversial?  No I don’t believe so. The reason for this is because historically it has stood the test of time.  Many practitioners have made successful prescriptions based on the foundations that Roberts and Allen have put into place.  Nothing proves truth like success.  Allen’s observations may have begun their life as interpretations, but their continuing and repeated success raises them above controversy.  

Dr. Bhatia – But don’t you think that the interpretation of later homeopaths varies from that of Hahnemann? If you read ten different books on miasms, you will get a difference in either the classification or in interpretation of ‘what miasms are’ or in symptom classification. How do you find a common working ground in all that?

Grant

Dr Bhatia that is the best question I have been asked in years.  I make the claim that facial analysis is based on Hahnemann’s concept of the miasms but in truth this is only partially accurate.  Hahnemann’s concept of the miasms included psora, sycosis and syphilis and he stated in the Organon the foundations of natural law that would allow the joining of miasms to create complex groups.  However Hahnemann’s interpretation of the miasms is for all intents and purposes almost unusable.  Take psora for instance, if 94% (I think that’s what he claims) of the world’s population is psoric and psora accounts for the vast majority of chronic disease regardless of form, where does that leave us?  And how do we use it?  I think it would be fair to say that while the foundation of HFA is Hahnemann, it is Allen and Roberts who create the working model through their understanding.  For example Hahnemann never mentions that psora is about hypo-function, nor does he say that sycosis is inflammation and hyper function predominantly.  These observations are first purported by Allen and developed even further by Roberts and it is this in which HFA is based.  Hahnemann made no reference to facial structure as best I understand it. Allen is the first to do this.  The trouble with Hahnemann’s miasms is that while he himself understood them in theory, he couldn’t teach that theory in any meaningful way to other Homeopaths.  We know this because of the lack of miasmatic application that runs through early Homeopathic history.  The only reason miasms are such a hot topic now is because Allen and Roberts made them clear.  If they could take Hahnemann’s work and see the patterns running through it and successfully utilize them, then Allen and Roberts should be the base and following their lead has proved immensely successful for me.  Kent says that miasms are the inherited predisposition towards disease, at least psora is.  Allen makes the further claim that both sycosis and syphilis are predispositions rather than actual diseases.  The problem for Hahnemann was that he was still seeing it in a physical sense rather than a vital predisposition.  He saw psora as the consequence of suppressed and mistreated leprosy rather than an inherited predisposition that we would today call genetics.  Allen and Roberts believe the miasms are genetically linked. Otherwise they could not talk about miasms, pathology, character and facial structure as all one and the same thing.

In regard to symptom classification I have not found pathology to be either credible or reliable indicators of the underlying miasm.  Boenninghausen, Hahnemann’s greatest supporter, states himself how poor pathology is as a miasmatic indicator.  In developing HFA the focus was always on facial features, never on pathology.  It is true that we have seen certain pathological trends such as allergies and psora, reproductive problems and sycosis and bone pain and syphilis, but none of these are exclusive.  What we have found is that the generals laid down by Hahnemann, Allen and Roberts have been far better indicators than pathology.  For instance the worse at night of syphilis is a better indicator than pathology itself. 

Dr. Bhatia – OK, let me now ask you the Big question – What is a Miasm? Hahnemann gave three; J. H. Allen added the fourth one, after which people have added Cancer, Typhoid, Ringworm, Chickenpox, Malaria and Leprosy according to their own understanding. Miasms have been called a predisposition, genetic susceptibility, suppressed and maltreated infections, a sin, reaction to a situation and what not! What do YOU understand by the word ‘Miasm’?

Grant

In a way this is the ultimate question.  When Homeopathy first started Hahnemann was trying to treat acute diseases and fevers, which he did successfully.  When it came to the treatment of chronic disease he was not so successful.  Hence the study into why - which became Chronic Diseases.  Hahnemann believes the miasms to be infectious agents of microbial origin, leprosy, gonorrhea and syphilis.  I understand why he would believe this.  After all Hahnemann must have treated more than one generation of families over his 88 years.  He saw children of syphilitic parents being born with traits and characteristics similar to the infected parent.  If syphilis as a miasm, that is a tendency, was passed on to future generations and had a microbial origin, then the other miasms would also.  The fact is that when we are dealing with chronic disease we are dealing with far more than infection. Hahnemann’s continuance of the belief that miasms belong to micro-organisms has not been fruitful in the treatment of chronic disease, therefore I question its validity.  As I said earlier the easiest thing to prove is the truth because the truth is what is provable.  The fact that miasms are so controversial and confusing, is because the truth behind the miasms is not as accurate as it should be.  Personally, I have come to believe that miasms are something totally different to how Hahnemann interpreted them, and find myself at odds with contemporary theory.  In a nut-shell this is my understanding of the miasms.

The miasm is the way we describe the workings of the immune system we inherit – essentially there are three primary ways our immune systems cope with stress and disease.  Firstly it can meet the germ head on, by attempting to create an impassable barrier forbidding the germ’s entrance into the body.  This is the psoric miasm and when in balance, it is effective at protecting its host.  Out of balance however, it will begin to reject everything as foreign thereby creating allergies and reactions so typically seen in psoric patients.  Secondly an immune system can choose to conserve energy by not meeting force with force but rather encapsulating and imprisoning any invading microbe, thereby restricting it’s impact and stopping it from becoming systemic.  This is the sycotic miasm and it accounts for the tumors, cysts, warts and fibroids it characteristically is known for.  Thirdly is the submissive immune system that conserves energy by monitoring a microbe’s progress through the system, and allowing it to pass through unimpeded thereby limiting its impact.  If however the microbe or infection gets out of control, it will draw on its reserves of energy to fight.  This is the syphilitic miasm and accounts for why syphilis traditionally is the miasm that has pathology more deeply imbedded and central than the others.

However, even here we are still talking about infection and response, but chronic disease extends into the individual and this means that miasms must also influence the general make-up and character of the individual.  Let me explain what I mean.  To me a miasm is another term for a survival instinct and we apply the same pattern to microbes as we do to human beings in social circumstances.  Remember as Hahnemann said, the vital force cannot tell the difference between stresses so all stress is treated as the same stress, he writes this in the Organon, in reference to disease and drugs and how the vital force cannot tell the difference.  A survival instinct is how we protect ourselves and what we project on to the world around us in order to acquire the things we value and need to keep us safe.  If we take psora for example, the psoric immune system is confrontational and competitive.  When we look at the major psoric remedies such as Sulphur and Lycopodium, it should come as no surprise to find they have a dictatorial and dominating nature.  This means they survive by out competing those around them.  Have a look at which remedies are involved in business and power and you will see that most of them such as Sulphur, Lycopodium, and Bryonia are all traditionally psoric.  Sycosis on the other hand has fixed ideas.  Sycosis feels trapped and imprisoned just like their immune response and this also means that sycotic people will have a controlling element in their character, because taking charge of situations is how they become needed.  This makes them protected because others need them around. The need to feel secure is the outward expression of the internal securing of infection. Syphilis on the other hand is submissive.  Their survival instinct makes them lenient and yielding by nature and this protects them because they are so well liked that others are willing to act in their defense should the situation arise. 

I do not believe in the contemporary model that each miasm is a step further downward from the one it leaves behind.  That is, that sycosis is worse than psora and syphilis is worse than sycosis.  It is not a downward progression but rather a difference.  Life is built around diversity, the miasms just show that human beings also have this same diversity. 

Much is made of progressing back up through the miasmatic scale after appropriate homeopathic remedies have been given, but the truth is that people under stress always revert back to their weakest point.  Stress if it is strong enough, will throw people back into positions they thought they left behind years before.  I have had patients that will claim after a break-up of a marriage or a business failure or something equally as distressing, that they begin to suffer complaints such as migraines or asthma for the first time in twenty years.  Does this mean they have suddenly acquired the same layer of infection they had twenty years ago?  Of course not.  It simply means that under a certain amount of pressure, migraines or asthma will present themselves in this person, but they have been absent because the person has not been under enough pressure to elicit them until recently.  This opens up a whole new paradigm of prescribing.  The base line is that I do not believe even under the best homeopathic remedy that cure means the eradication of all previous symptoms forever. Rather, I see cure as a balance between stress and response.  Homeopathic remedies build a buffer zone between how much stress a person can endure before the same response begins again. 

Louise

This makes absolute sense to me now, that there can only be seven miasms or seven responses.  Using the three basic ways that a person or immune system can respond, that is outwardly, inwardly or sticking to a fixed position (psora, syphilis and sycosis), only four other miasms can exist alongside those primary miasms.  When two dissimilar diseases of equal strength join together – tubercular (psora & syphilis), syco-psora, syco-syphilis and cancer (psora, sycosis and syphilis of equal strength) from the three primary responses come a total of seven.  It is just simple math.  We have taken pathologies out of the equation so typhoid, malaria, chickenpox, etc., just can’t exist as miasms in their own right.  They may be illnesses that occur but they don’t describe a miasm as an independent response state. 

Grant worked backwards to get to this point but when a system is true it will explain everything; and put simply, our world is three dimensional, there are three particles (electrons, neutrons and protons). There are the three forces of outward, fixed and inward and the three measurements of height, width and depth. Psora, sycosis and syphilis represent the Homeopathic view of this natural construct. These same forces shape our facial structure – they shape every part of who we are, how we see life, how we respond to stress, how we look, absolutely everything. Homeopathy is so clever and yet so simple!

Dr. Bhatia – Grant, I can not help asking you this now. In your book ‘Appearance and Circumstances’, there is a small passage, where you write –

“What is the difference between miasms and karma? The short answer is, there is no difference at all. Miasmatic knowledge is nothing more than the age-old laws of karma with a medicinal application.”

I am unable to relate this with the immune-response approach that you just mentioned. The Encyclopedia Britannica summarizes the concept of Karma as –

“In Indian philosophy, the influence of an individual's past actions on his future lives or reincarnations. It is based on the conviction that the present life is only one in a chain of lives. The accumulated moral energy of a person's life determines his or her character, class status, and disposition in the next life. The process is automatic, and no interference by the gods is possible. In the course of a chain of lives, people can perfect themselves and reach the level of Brahma (God), or they can degrade themselves to the extent that they return to life as animals. The concept of karma, basic to Hinduism, was also incorporated into Buddhism and Jainism.”

How do you explain the passage in your book?

Grant

When I talk about Karma I am talking about the laws of the non-material universe.  As we know through Homeopathy, the non-material ‘energy’ universe is governed by laws opposite to those that govern our material one.  The infinitesimal dose where less means more as well as the law of similars are great examples of this.  In the physical world, it is opposites that attract and similars that repel, look what happens for example when two protons meet, but in the non-material world it is the opposite that is true.  The more we concentrate on something through thought (energy) the more it manifests and the more similar energy is attracted toward it.  With Karma we learn by circumstance what energy resides within us.  If negative things keep happening then it is because negativity is within us, we get what we cause.  Constitutionally, karma is a life theme and life themes are rubrics.  As your question states, karma is a chain of events.  If a patient has an abusive upbringing and then becomes involved with an abusive spouse, spiritually one would say that abuse is their karma, homeopathically we say abuse is their constitutional life theme and because it is causing so much damage and impact – a kind of never been well since effect – it is what is draining their energy and allowing chronic disease to develop. Violence is an important rubric in the repertorisation of this patient.  Karma is our make-up and that means it is our constitution, who we are, what we love and what we hate.  These are all the things Kent stated we need to know if we are to successfully treat and understand patients with chronic disease.

Karma means being caught in captivity by negative thoughts and deeds that secure us to the earth in the endless cycle of birth and rebirth.  After good constitutional treatment, many patients become stronger in what they need for themselves, they become less angry, less jealous and less domineering.  These are the traits that keep us earth bound and the traits karma tells us we must overcome.  If we must move away from domination to find our own inner strength, that is our karma – our life lesson.  Domination or abuse will be drawn toward us not as punishment but as something to overcome so we become stronger.  Using constitutional remedies also achieves this and the causative circumstances and trends cease.  This is why I say the law of karmic attraction and the law of similars are the same.  

Dr. Bhatia - When and how did the idea of using facial features for assessment of miasms strike you?

Grant

Allen and Roberts not only made Hahnemann’s concept of the miasms clearer, these two authors also mention facial features as indicators to the miasm.  It was these books, Allen’s Chronic Diseases and Roberts Art and Principles of Cure that got the ball rolling.  I was fascinated by the idea that internal miasms would be represented by and influence external facial features.  Later by reading other authors such as Donald Foubister and his account of the Carcinosin appearance, I began to understand that if miasms are inherited and influence all physical structure which they have to do to create specific disease processes; they would also influence physical make-up including facial structure.  It is crazy to think that psora for instance can stamp its own unique mark on pathology as well as on the mind but not on the appearance.  That is contrary to holism which is the basis of constitutional prescribing.  So I began a private research project in 1999 to see whether I could extend upon the work of Allen and Roberts to create an observable diagnostic system by the miasmatic determination of facial features.

Louise

Yes it was very fortunate that Grant focused on the facial features.  In the early days we just looked at everyone’s faces and tried to see the link between features and their pathology.  We were stuck in the whole idea of “essence” prescribing and had ideas that perhaps faces would have “types” too.  After a rocky start we discovered this couldn’t possibly be true.  Once we had more than half the features categorized it became obvious that nearly every patient had at least one feature from each of the primary miasms.  So they all belonged to the Cancer miasm!  Of course this couldn’t be true so we sat down and thought about this long and hard and decided to try the idea of dominance.  Within weeks we were convinced that this was the way to go and we haven’t looked back since.  Now as we see the whole picture and how each part operates we know it couldn’t be any other way but everything is easier in retrospect.

Dr. Bhatia – Tell us about your findings related to the use of facial features for identification of miasms in detail.

Grant

At first the project consisted of information gathering and so findings were limited as all beginnings are. Information gathering consisted of analyzing the facial features of successful constitutional cases with remedies well known to represent a specific miasm.  For instance if a patient had a successful result with Sulphur, photographs of his face were taken and kept for future reference.  When other successful cases with Sulphur came through, the clinic photographs of all these patients were then compared to find the common features relating to all.  When you are dealing with the miasms you are dealing with a genus epidemicus, so our job is not to find the unique, but it is to find the generic.  After analyzing patients over a five year period a comprehensive system of determining the dominant miasm in a patient by their facial features had developed.  For the last three years we have not added anything significant to the model as we believe it to be complete.  There are always going to be small details and fine tuning that needs to be done on a regular basis, but the model itself is reliable, sound and effective.  What both Louise and myself have found is how successful Homeopathy can be.  What I mean by this is previously to HFA, I imposed restrictions on how far a remedy could go.  In the past with a condition like epilepsy or cancer I would have imposed guides on myself that limited what I believe could be achieved with the Homeopathic remedy.  If a condition was serious I viewed my role as secondary and believed for many years that while Homeopathy could offer valuable service it could not necessarily be the primary medicine to complete cure without any outside adjunct.  HFA has shown me that by matching the remedy to the miasm, that my previous outlook was naïve.  Rather than becoming more “realistic” about the potential of our remedies, I have learned to open myself to the “unrealistic” because I have seen that anything is possible.  Cancer for instance was a disease that I thought was difficult to treat constitutionally because of my previous limited success and therefore treated most cases by organo-therapy.  This is no longer the case; all chronic disease is constitutional including cancer and should always be treated in the same manner.  The problem was not the system, it was simply – as it always is – my choice of remedy.  We offer open clinics to both students and practitioners here in Melbourne to encourage people unfamiliar with HFA to see first hand what Homeopathy is capable of.  For years I practiced in the traditional sense without HFA and so know the difference between the two when it comes to results.

Louise

Yes it was the same for me.  Now I couldn’t imagine practicing without doing a facial analysis every time.  It is such an important piece of information and makes choosing remedies so much easier.  Remedies can look alike – especially when you first start practicing and the subtle differences aren’t clear.  Even now I have come to realize that although an “essence” picture may be true of some patients there are other patients who seem quite different but still need the same remedy.   We have gone back to repertorising every chronic case, using rubrics that represent the generals like Boenninghausen suggested and being very careful when choosing mental rubrics and always working out the miasm using facial analysis.  Our current students are really lucky as we decided to only teach them how to take a case, how to repertorise, how to choose the miasm and then accept the remedies that were delivered to them as part of this process.  If they have more than one remedy to choose from then it is back to checking the materia medica for the final decision.  They are doing some very good cases using this method and are far more advanced in their confidence and outcomes than we were at the same level. 

We found it quite incredible when patients of the same miasm started describing life stories of great similarity.  We came to see these stories as “themes” and still can’t get over how the case story and the face will lock and key. 

Grant also made an amazing link when he started applying the findings of this model to trends in history and disease.  There is a clear link between epidemics and social history that fits perfectly into the seven colour miasm model.  These same social themes fit the stories of the patients with corresponding faces.  Of course anyone who has studied metaphysics knows these things but seeing universal patterns in action is constantly exciting.  His current book explores all of these issues with a particular emphasis on the dual nature of humans, the role of the miasm, the vital force and what will probably be controversial – that Homoeopathy can be completely explained using Newtonian physics rather than Quantum physics.  We have had many discussions with each other and our students and believe this work will be of great importance to Homeopathy.

Dr. Bhatia – That’s great! But how do you analyze a face? What are the features that you focus on and how do you differentiate between subtle differences in the facial features?

Grant

The inference of both Allen and Roberts is that miasms influence facial structure in accordance to their own design.  For example, we know that sycosis is hyper-function which means accumulation.  Excessive inflammation, mucous or fatty tissue, tumors, fibroids and cysts are all results of the sycotic tendency to accumulation.  If excess occurs internally, and facial features are formed by the internal miasm, then larger or excessive features also represent sycosis.  This is a conclusion that was formed from successful cases.  I did not set out to prove that excess internally, would be excess externally, but when I saw it by examining the photographs of successful sycotic patients, it became obvious that it could be no other way.  It also became obvious with the syphilitic inward miasm why so many successful syphilitic patients had facial features such as deep set eyes, dimples and inward pointing teeth.  This is cutting a long story very short but it gives you an idea of the philosophy of the system.  In practice we take the photographs of every patient after concluding their consultation.  These photographs are then examined and each facial feature is assessed in accordance to hyper, hypo and inward structure.  Each individual facial feature once assessed is allocated into its miasmatic group.  The rest is based on Hahnemannian theory and simple addition.

Hahnemannian theory is that two dissimilar diseases cannot live in the same body at the same time, the stronger will dominate the weaker.  If the diseases are of equal strength they will join to form a complex miasm such as the tubercular miasm (psora and syphilis).  The addition is simply adding all the facial features influenced by each miasm in a chart, to determine which is the stronger disease (miasm).  If a person has far more syphilitic features than sycotic or psoric, then syphilis would be the stronger disease, therefore a syphilitic medicine must be chosen.  Hahnemann stated in Chronic Diseases that the treatment of chronic disease must consist of the miasm and the totality not just totality alone.  Up until now we have had no real definitive way of recognizing the stronger internal miasm.  What HFA has provenn is the miasm that is strong enough to influence the majority of facial features is also the miasm that is strong enough to dominate the rest of the body, therefore it is the stronger disease and the one we must treat.

Louise

We are writing an on-line course with Pioneer University in Dubai to help practitioners to develop their skills and apply HFA.  Some faces are definitely easier to analyze than others.  In the same way as some cases are easier to analyze than others.  However with practice everyone’s results improve.  Our students study it for 18 months and after about nine months most of them are getting the correct miasm.  It is all about learning to see size and shape and structure.  Once you know what to look for it becomes easier.  We recommend studying at least fifty faces before you will really feel some confidence.  It isn’t that hard to do – your family, friends, movie stars, people in restaurants – there are faces everywhere.  Once you get started you will be seeing noses and ears and hairlines and knowing straight away which miasm is dominating that feature.  Then it is just a matter of adding up all the features to see the totality and where the dominance lies.

Dr. Bhatia – Does being male or female affects this analysis? The differences in the male and female skull and facial features are quite easy to recognize.

Grant

No, being male or female makes no difference whatsoever.  We are only comparing each facial feature against other features and the overall size of that person’s face.   Women can have inward teeth and men can have inward teeth (syphilis).  Men can have a down-turned nose (psora) and women can have a down-turned nose.  It is not about overall looks and it is not about beauty.  This is about shape and size, nothing more. 

Louise

Everyone is individual regardless of their sex or race. Facial analysis is about looking at all the parts and adding up the totality – really the same as case analysis. So while, for example, sycotic features tend to be seen more in females than males there is no exclusivity. We see all miasms that include both sexes. Once you really look at the features you will see this is true. There are more than seventy different features – this is why there are nearly six billion different faces (a bit less due to identical twins of course); but having the three core miasms and then seeing their impact on the majority of facial features on each single face allows for a multitude of outcomes – our individuality. So one psoric person will look quite different than another and the same is true of each of the miasms. After a while you start to recognize similar combinations that add up to the same miasm but even then the variety of placement of features can allow for a completely different look. Say for example two people are of the same miasm and they both have similar hairlines, eyes, foreheads, ears and mouths but one of them has much larger teeth and a broader smile whilst the other has a broad nose – all of a sudden they will look quite different. However when each feature is rated and the totality is decided upon they still come up the same miasm. Whether or not they need the same remedy depends on the case – sometimes yes, sometimes no. In the end it is just a diagnostic tool but a fascinating one that’s for sure.

Dr. Bhatia – And what about the facial features of various races? Does that have any effect on the facial analysis?

Grant

Yes certain miasmatic features do seem to be more dominant amongst some races.  However to suggest that everybody from a particular race will belong to one miasm is nonsense.  In an interview with a Chinese migrant on a Melbourne radio station, the Chinese man laughed when he said that all us round eyes look alike! Everyone from a different race becomes overwhelmed at first by the similarity of a new race.  But after only a few days of being amongst a new culture, variation becomes obvious.  By the end of the week there is as much variation in the new culture as there is in the old.

Louise

Yes we get many people asking about race.  Because Australia is so multi-cultural we are used to seeing many races although still predominantly Caucasian.  People are so sensitive about equality that they point out differences even between individuals, let alone whole groups – however this is what Homeopathy is all about!  So yes racial features are often asked about.  No matter what race the patient, each feature still tells the same story – if it is distinctive, it will be either psoric, sycotic or syphilitic. Whilst some races have common features – e.g. the recessed lids of Asians, the wider nose of Africans, the lower hairline of Arabs, the down-turned nose of Europeans, the dominance for each patient within a race can (and does) vary enormously. 

Dr. Bhatia - You have said that your results have been significantly better after you started using facial analysis. Have you ever quantified the difference in success? What changes have you found in your clinical practice and the success rate after using facial analysis?

Grant

I have quantified the success of HFA by checking a one year period of patients, examining the result of each case and placing them into a category of unsuccessful, partially successful or successful. Unsuccessful is self explanatory, partially successful means an improvement of between 50-80%. Successful means that the main problem is dramatically alleviated as well as an improvement of energy and well being with no or few minor ailments remaining. For example if a patient suffers from depression, insomnia and panic attacks as well as gastric reflux and has two warts, if all their complaints are ameliorated to a level of more than 80% but the two warts remain I would still regard this as a success. Patients whose symptoms have ameliorated between 50% - 80% are placed in the partial success group. Patients who have had no benefit or discontinued treatment within two visits were placed in the unsuccessful group. Obviously at a personal level I believe if I had been given more time, this unsuccessful group would have a much lower percentage. However for the sake of statistics, I must accept this result. The number of constitutional patients who achieved a better than 80% success rate on all levels regardless of the multi-factorial nature of their complaint was 64%. The number of people who reached a 50 – 80% amelioration of their complaints, therefore qualifying as a partial success, was 12.5%. 23.5% were rated as unsuccessful. Of partial and successful cases most were achieved within four visits. This means statistically that 76.5% of patients will achieve within four visits a 50% or greater improvement of their health regardless of the nature of their pathology. This is important as there is no specialization in the clinic and the chronic diseases treated ranges from suicidal depression to cancer, to panic attacks, to rheumatoid arthritis. Chronic conditions also include allergies, asthma and pneumonia.

Louise

I saw Miranda Castro when she came to Australia and recommended doing a self audit to determine how well you were doing as a practitioner. It is a daunting task especially with chronic cases. I wasn’t too happy as the really successful cases were few and far between. However many of the patients who didn’t get the wonderful outcome got peripheral improvement for periods of time and so they kept coming back. It is interesting that most of the long timers have got extremely good remedies (finally) after applying HFA – mostly in the last few years. Like Grant, close to 60% get a remedy that really turns them around and partial successes account for another 15 - 20%. The other 20% leave or I am still trying. These are the cases where a polychrest just won’t do and with those patients that persevere we try to get results with smaller remedies – knowing their miasm through facial features means we will be able to confirm more remedies once a positive outcome occurs.

I really like knowing that I am in the ball park with most patients. The facial features are absolutely essential for gaining this confidence. If my patient for example is tubercular or dominantly cancer miasm, in most cases a major polychrest will help them very quickly. Repertorising is essential (did I mention this?) and we use much larger rubrics than before knowing that this process only draws in possibilities – the miasm will determine which three or four remedies to look at.

I now expect that all aspects of the patient will improve, especially their energy and well being and of course always the presenting pathology. So even if they come for one pathology – say hay-fever and the remedy I chose in the past helped that condition but then I find they suffer with anxiety attacks too, I won’t consider the result a success until both conditions are under control. I no longer look at the patient in a layers model but as a whole person who expects to get better in a whole way with single remedy treatment or in some cases a series of remedies, but always one at a time. Another area in which I fully I fully expect an outcome is in the amount of time it takes to get a solid result. Solid improvement should commence within a couple of weeks to a month – if nothing has happened then I know there is a better remedy. Obviously the depth and longevity of the pathology has to be taken into account but using miasmatic remedies means the simillimum is so close that the healing commences quite quickly. This came as a surprise to us as we were trained to be patient and cautious especially with long standing complaints. But when you regard the action of the remedy as rebalancing the vital force rather than curing the condition you come to expect that the patient will quickly see changes. I didn’t practice like this in the past – there was a lot more waiting and expecting aggravations. Now when working with the miasm the reaction to the remedy is often very fast and far more holistic in the outcome. So it becomes an expectation and I am far happier with the results. Also results hold well in most cases – it is just far better all round. And easier. It has been a pleasure to teach the method and see our students do so well so quickly.

So we really want to see all Homeopaths using HFA – for obvious reasons. We all want to do the best for ourselves and our patients as quickly and deeply as possible.

Dr. Bhatia – Many homeopaths have focused on the concept that the true simillimum should not just cover the symptoms but also the underlying miasm. So the concept is not new. But so far, homeopaths have relied on symptom classification and pathology to identify the underlying miasm.  Have you ever compared the results of miasm identification through symptoms and through facial analysis? If so, are the results similar with both approaches?

Grant

I suppose if I had found the traditional model of miasms, that is the allocation of pathology into a miasmatic group successful, then the need to develop another model would not have arisen.  I think one of the reasons there are so many different and often opposing views of how to apply the miasms, is because the traditional model fails in its attempt to clarify.  There is simply no way we can say that Hahnemann’s legacy of the miasms and how to apply them in clinical day to day practice has been successful, and yet we know at the same time, that Hahnemann was the greatest medical mind the world has ever seen.  So if he stakes his reputation on stating that the medicine chosen for a patient must be based on the totality of their symptoms, as well as their miasm, then we must listen.  Miasmatic symptom prescribing yielded no results above symptom totality alone, at least not for me.  In the end I disregarded miasms altogether as many practitioners do, and based my prescriptions entirely on presenting symptoms – exactly what Chronic Disease says NOT to do.  In short my answer to your question is yes, I have tried them both and my conclusion is miasmatic symptomology does not yield results, and historically this would also prove to be the case for the profession, however facial analysis (HFA) has been a rich vein of success.

Dr. Bhatia – You have said earlier that with essence prescribing ‘results never reached expectation’ and also ‘Modern homeopathy in the west can be extremely interpretive’. Can you elaborate on this further? Do you think that the excessive focus on subjective symptoms and interpretation of dreams, delusions, and sensations is making homeopathy less productive? Do you think we should stick to the age old tried and tested methods of symptom repertorization (no interpretation) and finding the miasm? What is your opinion on these modern developments and what is the future of homeopathy in your opinion?

Grant

In western Homeopathy there is a strong focus on seeing remedies as distinct and individual personalities in the same way as we see people.  Much of this has arisen because of the works of Kent and Tyler.  Hahnemann did not view medicines in this same way and one look at Materia Medica Pura will clarify that he saw medicines as medicines.  In Aphorism 9, Hahnemann states that there is a distinct difference between the predictable vital force and the more unique and individual characteristic soul of an individual.  The vital force according to Hahnemann is a program designed for our well being but distinctly separate from our mind and character.  Because Homeopathic remedies work on our vital force they work on a preordained program not our personality, or our individuality.  If remedies had to be specific to the most characteristic parts of our personality there would be no such thing as a polychrest.  A polychrest is a drug of many uses but it can only have many uses because it fits many types of conditions in many types of people.  Most of the contemporary understanding regarding medicines as unique and distinct personalities has been attributed to Kent and yet Kent himself advises against this, and chastised Tyler for doing so in Drug Pictures.  For any who doubt this I would suggest they read Kent’s Lesser Writings and look at the cases he presents at the end of the book.  It soon becomes noticeable that while Kent talks theoretically about individualization and character, his prescriptions are based on pathology and physical generals.  The idea that Homeopathic remedies touch or alter the immortal soul is absolutely wrong.  Remedies interact with the vital force but as Hahnemann has pointed out the vital force is NOT the soul.  Therefore remedies do not have to be individualized to suit the person, but need to be individual enough to suit the way that person’s vital force is responding to stress. 

Let me point this out by example: a patient attends the clinic with conditions such as arthritis and irritability and also has a personality that is artistic and generous. After the successful administration of a remedy, that person’s arthritis and irritability have gone, but their artistic talent and generous nature remain. This is because talent belongs to the soul, while arthritis and irritability belong to the vital force because they are stress responses. Remedies never make a happy person less happy or a talented person less talented. In fact remedies cannot touch this aspect of character at all. We have all seen this and we have all heard patient’s who state, after good constitutional treatment, that the way they feel now is the way they used to feel twenty years ago. This is a return to an unstressed state; it does not mean they have moved to a “higher” plane. Therefore in my opinion, to focus on character and personality is to focus on the soul and that is not the domain of the remedy. A remedy is for the vital force - not the soul. Generals and emotions are great indicators of the vital force. Repertorisation is essential but it cannot be based on interpretation. Repertorisation is simply a program – the accuracy of the information that comes out is equal to the accuracy of the input. So in this case speculative input creates speculative output. If you merely think your patient is guilt ridden, but you know that their complaints are both right sided and worse at night, then only these two generals should go into the repertorisation.

Too many attempts at personalizing medicines have been done. Also, the focus on one particular aspect of a remedy at the expense of more comprehensive symptoms has also taken place. For example, in the proving of Nat Mur far more provers wept openly and publicly than those retiring to their rooms to weep privately. And yet in most materia medicas, at least western ones, a whole personality profile has been based on the martyrdom of Nat Mur, presented by their inability to cry in public as the central key. This occurs even though the majority of provers were otherwise. Personality profiles are not wrong, they are just very, very limited.

The future of western Homeopathy is precarious. We are in the unfortunate situation in which we have gone from a position that rivaled conventional medicine to a current position below chiropractors, osteopaths, naturopaths and in some countries kinesiologists. For many western Homeopaths in order to study Homeopathy one must also study one of the other modalities.

In the recent past, one came to Homeopathy via other modalities, then focused on homeopathy entirely. Now we seem ill-content with Homeopathy and feel the need to be both Homeopaths as well as psychologists or psychotherapists. Because I came from psychotherapy to Homeopathy, I cannot comprehend why so many Homeopaths want to be psychotherapists. My only conclusion is that contemporary western Homeopaths are confusing the parameters between the vital force and the mind. The remedy influences the vital force, which is the emotional responses and general reactivity to stress. Character change seen after a remedy is the patient returning to an unstressed state. To confuse this as anything deeper is to miss the point of Homeopathy entirely.

In regards to the future, I believe Homeopaths – at least western ones, need to decide whether they are going to be psychotherapists or Homeopaths. At this point, most seem to think that they are one and the same but I can assure you they are not. Hahnemann understood that the mind and vital force were separate entities and contemporary Homeopaths would be advised to do the same.

Where homoeopathy goes from here is dependent on the success of our achievements. Patients turn to Homeopathy, particularly in chronic disease, because we offer them hope. Homeopathy can do what no other western medicine can, therefore we have a niche. However society at present has an abundance of psychologists, psychotherapists and counselors and does not need more of the same even if we offer a pill at the end. While I think the current trend to be counselors and spiritual advisors as well as Homeopaths will be unfruitful, if we return to the roots that made us great in the first place, that is, the re- energizing of the constitution and the treatment of disease, there is no reason why Homeopathy should not retake its allotted place as a respected and effective medical alternative. Like the patient returning to their unstressed state, the position for Homeopathy to return to already exists.

Louise

We have discussed this for years and at one point I got pulled into the type of model Grant is referring to (this was before facial analysis).  I didn’t get good results and found the process difficult for myself and the patient.  I am just so grateful to have been brought back to Homeopathy the way it was intended to be; my results and confidence in the clinic reflect this, most particularly because of using facial analysis.  HFA has given me a deeper understanding of what Homeopathy is and has made me proud to be a Homeopath without feeling the need to be something else as well. 

Dr. Bhatia - All this is very thought provoking and I hope our readers will understand the depth of your words and enjoy this fruitful discourse. Gant and Louise, it has been a wonderful experience to have you among us in our Hot-Seat. I have enjoyed your answers very much and I am sure everyone out there is going to find this discussion interesting. Thank you for your time and patience!