Dr. B – Welcome to the Hpathy Hot-Seat! Frederik, Tell us something about how your journey into the world of homeopathy began?
FS – Yes. When I started studying medicine I was not aware of homeopathy. During the first years of medicine, classical training for MD, I was quickly disappointed about the contents, especially in successive years when I was confronted with clinical work, observing patients and understanding how the treatment was carried out and was failing. I found that patients were not being taken care of in an efficient, kind and gentle way. At the same time when this was happening, I was getting to know many different types of philosophies, cultures, situations and workshops. During this exploration, I came across homeopathy and I read about its principles, etc. These two incidents together gave me the grounding in my decision to do homeopathy.
Dr. B – But how exactly did you come in contact with homeopathy?
FS – When I was at the university, it was the end of the Sixties. It was a time when knowledge was being spread, everybody was giving lectures and workshops. As students, we were going from one to another to attend those workshops to know about all the knowledge that existed – and it just happened that in one such workshop homeopathy was mentioned. I investigated it, because I was into medicine. I investigated acupuncture; I investigated different types of diet, etc. So it was in this search that I came across homeopathy.
Dr. B – You have been the president of VSU, the largest school of homeopathy in your country. What was the experience like leading the school from the front?
FS – It was a very interesting time because it was the first school in our language area. Before that there were only schools in the French language area. So to start a school in our own language, which was Dutch, was very interesting and challenging and rewarding because there was enormous feedback and thirst for homeopathy. And it was the start for homeopathy in our part of the country.
Dr. B – What was the status of homeopathy in Belgium when you started the school?
FS – When we started there were very few homeopaths, only a few in Brussels, the capital, and in the Flemish part there were only 5 or 10 homeopaths. With our school we have increased the number to several dozens of homeopaths practicing full-time and several hundred people use homeopathy from time to time.
Dr. B – And what change do you perceive has come in the last 25 years or so?
FS – That the public is now requesting homeopathy. Very clear! From the side of the public there have been several studies and one study mentioned that at least one in three people have used homeopathy the year prior to that enquiry.
Dr. B – While homeopathy has spread in general in Europe, there have been efforts to ban or restrict the supply of homeopathic medicines, like in France. They have banned most of the nosodes and sarcodes, there has recently been a ban on Syzigium as pointed out by Gabrielle Traub in our December editorial. Many other medicines are coming into that list as well. How do you perceive this? On one hand there is demand from public and on other hand the laws, the countries, and the legal setup are crippling homeopathic practice.
FS – Yes it’s absolutely correct. While the demand is still there, the people enquiring and requiring homeopathy treatment is increasing but certain legal institutions, sometimes political, sometimes medical boards etc., are trying to enforce certain regulations to hinder and ‘cripple’, as you have very correctly used the word, the expansion of homeopathy. So we are at this time facing a very difficult situation.
Dr. B – What is being done in Europe to counter this?
FS – Well, there has been an initiative against the article in the Lancet, which you must know about. This reaction was widespread in Belgium, all over Europe, television and all newspapers, etc. We have replied to that with press releases; we have spoken to the patients, written articles in our own magazines. We are trying to give as much information from our side as possible. So on this ground work, we are involved in international politics. On the European level, it is more favorable to alternative medicine and homeopathy. We are also in touch with W.H.O. As you may know, that whole setup of Lancet was because the W.H.O. had released a preliminary report which was favorable to homeopathy!
Dr. B – Yes, I have read about it.
FS – So this was all about Lancet. So I expect that the European legislation and statements from W.H.O. will help to crush the very intolerant attitude of certain national governments and medical boards.
Dr. B – Nearly every where you go, you are asked about RADAR and Synthesis but we would like to know about you as a homeopath, your clinical practice and experiences. I would like you to share those aspects of your life with us.
FS – I started practicing in 1977. I have been practicing classical homeopathy since the beginning. I keep on practicing even though a lot of my time has to be spent in coordination of the team behind Synthesis. I keep on practicing all the time. And secondly, since June 2004, since the seminar in Alonnissos, Greece, I have started teaching again, which I had given up before. Even when teaching I present my own cases so that people know the way I practice.
Dr. B – You have worked intensively with George Vithoulkas. I would like to know what that experience has been like, working with him, working on the Vithoulkas Expert System since you were the chief coordinator for VES?
FS – That is a very interesting question because some people look at George like he is someone who suddenly finds a remedy out of the blue and say what an incredible intuition he has. George has repeatedly, as you may know, denied this and has replied that if he has a suggestion to make on a remedy, it is based on his study and his knowledge and not so much on his intuition. This means he expects homeopaths to study and not to hope for some kind of inspiration or intuition to come up. This is exactly his whole approach, which has impressed me very much while creating VES with him because it was almost just like mathematics! You do this, then you think this, and when this is happening you make an exception. Very clear and precise. First of all this confirms what he has been saying, that you have to have knowledge and not wait for an intuition. Second, it was very easy because he has a clear and mathematical perception of how his brain is functioning within those homeopathic symptoms in the case. So it was very easy to convert it into a computer module.
Dr. B – I will just go off the track since you have spoken about the word ‘intuition’. In the recent past there has been a lot of controversy about this intuitional aspect of homeopathy that many homeopaths seem to use. There was a controversy in the Links about Sher’s provings and the dream provings of Sankaran and Scholten’s approach as well. There are many other methods which are preached in the name of homeopathy, like Vega machines and hair testing, etc. George has stood against these methods but still there has been a really big divide over this in the homeopathic fraternity in general. How do you perceive this dilemma?
FS – Yes. Well I think that there are 2 areas. One area is whether it can be investigated or tried out, etc. using the set of homeopathy principles, which means that homeopathy has a certain definition and we start with that. And there is a second area which has those things that look like homeopathy but this is a different area because it is not homeopathy, and I think it creates a certain confusion in using the word homeopathy in these other areas; and apart from homeopathy and this so called homeopathic area, there are many areas where the mind is investigated; the potential of intuition is investigated, etc. That is fine. I don’t have a problem with investigation. The problem arises when people are invited to apply certain thinking or certain working methods. They must decide for themselves: Does it work or not? Can I repeat this suggestion in my practice or not? Do I get the results or not? And people should be open-minded and listen. They should try that and find out whether it is useful of not. So it is a matter of trial and error. We are in a time where just everything goes much faster, where everything is getting integrated, like physics is touching the area of religion. Everything is becoming more interwoven. So we have to face that fact in homeopathy too. But coming back to homeopathy itself, we must use the word homeopathy only when it fits the definition.
Dr. B – In homeopathy, there has been too much focus on the subjective aspect of cases. For example, remedies are being given only on delusions and dreams that are ‘interpreted’. We see such cases are presented in many conferences, where the remedy is selected based upon, not the concrete symptoms, but the interpretation of the subjective symptoms. Do you think that such subjectivity should be there in case analysis and remedy selection?
FS – First, regarding the mental symptoms, I believe that we should use them. The way to use them should be such that it can be repeated, it can be understood, that there is a method which is clear and applied. So if I say, listen, this patient has this and this and this, so for this reason I take this information, I use this repertory rubric and I think of this remedy. This method of going from the language of the patient about mental symptoms to a conclusion should be clear and repeatable. So for me the criterion is – can it be repeated? Whatever anyone says can be fine and very nice and interesting. The criterion is, can it be repeated. Because if it can be repeated it means that there is methodology behind it and it can be applied.
Dr. B – Before we start talking about the repertories, there is a step before and that is of case-taking. What are your views about case-taking? How should a case be approached? What is the proper way of case taking? How should the symptoms be evaluated?
FS – This is exactly the content of the course that I am giving here and there since almost 2 years. It is about case taking and how to go to the medicine. It is difficult to summarize it but I will just say two phrases. The case that should be taken is the case that the patient is telling you. I am interested to go where the patient leads me to the case. Therefore I repeat the words of Hahnemann – don’t interrupt and just ask, What else? I really believe this brings up important information. Secondly, as we walk towards the decision, the repertorization and remedy selection, then I believe that the natural idea is, we must have what is strong and striking. Again I relate to Hahnemann’s paragraph153, about the strange and peculiar symptoms of the case. I believe these two elements are the core elements of my approach that have stood with time.
Dr. B – There was a period when you used LM potencies exclusively. What are you views about potency selection in general?
FS – About LM potencies, I used them for acute and chronic cases for a year or more. I still use them but now I also use another scales because I feel that at some times some patients have better reaction with other scales.
Dr. B – What is the criteria for selection of scale and potency?
FS – That is very difficult to answer in short. I will give maybe one idea which I believe is also the key idea on this topic. People have different approaches for different patients. I think what one should be very carefully assessing is, what happens with that patient? One of the principles is that it has to be individualized. People say, if there is heavy pathology use low potency. This is not individualization. I will prefer other rules that are individualized. I suggest to you to look at the reaction of the patient and then decide and optimize the poslogy for each patient.
Dr. B – Now we would like to talk about the repertories in general and Synthesis in particular. You have been associated with this project since 1983. How did it happen that you started working on this project?
FS – At that time when everything was tiny and small, there were only a few homeopaths, say 10 or so who were interested in the software development and I was one of them. And so I took up the responsibility and became the coordinator of the little group and it never ended.
Dr. B – What was the experience like working on this project? That was the first time homeopathic software was being made for Windows. It was a totally new path. How did you feel trekking on it?
FS – It was sometimes very hard because I, myself, was not convinced that technology will ever be able to help in homeopathy. In fact at times, I was against the development of homeopathic software. Even after I got convinced, the first years, almost 10 years, there was lots of resistance in the homeopathic community. I was not even allowed to speak about it in certain schools when I was teaching my cases. People told me, don’t speak about computers. It was perceived as commercial! Now that has changed. Now there is no seminar in the world where people do not present the case with computerized case analysis or computerized material medica. But it was a very difficult time while there was a lot of animosity during the developmental years.
Dr. B – What was it like when you released the initial version of RADAR. What was the feedback like?
FS – First, when we printed the book, it came down to a more usable level… because it was a book, you see, and that really made a change because people said …ah! This is Kent and for this rubric I have Synthesis …it was a big difference as there were different remedies and there were different results. So that started really changing a lot of things.
Dr. B – Synthesis has come a long way …9 versions. There has been an increase in quality and quantity at the same time. In the past, there have been allegations that a lot of medicines and rubrics are being added which are not verified. I know your method now, that you first create an empty repertory with rubrics, then a second team adds the medicines and a third team cross-checks everything. But was it like this from the very beginning?
FS – No! Because, first I was almost alone, with 2 other people to do all the work. Then a few more and few more came together. The work is so enormous. We do a job and at the same time there is a request for 2 or 3 other projects. The repertory is absolutely not final. We need to do much more work to streamline it, to increase the quality of the index, it has to be done. We have now such a wide range of people using it that I believe that we will reach that level. But it is just such a tremendous job and a lot has not been done. When someone asks me why you have not added the proving of blah blah blah, I reply, Because I can only work for 48 hrs out of a 24 hour day, and because you were not helping us!
Dr. B – Primarily, when you start compiling a new repertory, you add remedies and rubrics from other sources, clinical data, provings, and other repertories from works that have already been done. How do you verify that what is written in those sources is correct? Because in many of such works also, the preferences and biases about various remedies and rubrics have crept in due to the clinical experience of the author.
FS – That is a very difficult aspect of the work and we have been doing it in the following way: When there is an author who says that Bellis-p is good for this thing, we will add it with the reference of the author. So people can first check whether this information exists in a book or an article or if it is clinical information. They can go back to this person and ask about the clinical case and verify the information. In addition, by adding the author reference, we are inviting you to verify. You will see that in many remedies in Synthesis, there is not one but 4 or 5 author references. In this way, the knowledge base is increasing and maybe in ten years, there will be a number of remedies that have gotten confirmation from the clinic and will have many references. However, there will be remedies which will never get confirmed. Then it is an aspect of confidence that remedies supported by only one source are not very useful! So, repertory becomes like a mixture of information which is very solid and confirmed by everybody and there is some information which lies there with a question mark. This indication of the references of each remedy is clear and can be used. If you want to use Synthesis with all the confirmed rubrics, you can. When you prescribe your 10 or 20 polychrests and you don’t get anywhere, you say, Show me also all the hypothetical information and you may see new remedies coming up, and then say, I might try this.
Dr. B – There has been an increase in the number of homeopathic medicines. We have now close to 4000 medicines. Do you think that there is scope for using that kind of vast information? Most of the homeopaths use less than 100 remedies in more than 95% cases. Then what is the role of those other 3500 remedies that we have? What clinical utility do these new remedies have?
FS – First of all, I think it is important to confirm that there are polychrests in homeopathy, and they are still there. So, if someone knows very well the top 100 remedies, he can do a lot. So, anyone studying homeopathy should be encouraged to master the 100 polychrests first. Secondly, I have to say that I have cases with remedies which are not polychrests. I have number of cases with very new remedies that responded in a very spectacular way and where I had been giving other remedies without success. So, I confess that it is my experience that some of the new remedies can bring about an incredible change where other remedies were failing before.
Dr. B – The percentage of new remedies that stand out as polychrests is very small compared to the work done by Hahnemann, Hering and others. Why do you think that newer remedies often do not stand out as polychrests? Do you think the provings are deficient?
FS – I think there is a problem of availability, that the information is not easily available. There is a proving in a journal; think about it. After one month, you forget a bit about it and after six months you scarcely remember it at all. So, there again, the repertory comes in as a tool. It can work as a reminder when a special symptom comes up. And if we can integrate the provings in the repertory, people may find them more easily. And there will be greater use of the newer remedies. Whether one of those new remedies will prove to be a polychrest is difficult to say. Why was Hahnemann lucky? Hahnemann also proved medicines that did not turn out to big ones. Magnets for example. Every remedy Hahnemann proved did not turn out to be a big one but you are right: Arsenicum, Belladonna all come out to be very big remedies! I think we have the same with new remedies. Some will prove–like chocolate or diamond–to be of use repeatedly and others won’t. It’s difficult to predict.
Dr. B – In the last 30 or 40 years, there has been a resurgence in the interest in writing new repertories. People were very comfortable using Kent’s or Boenninghuasen’s repertory. But after the work of Barthel (Synthetic Repertory), there have been many new repertories – Combined, Complete, Synthesis, Murphy’s, Repertorium Universale, etc. Do you see a need for these different repertories, especially when they rely on the same sources for expansion? Are they giving the same platform to the community or are they confusing? Is this race for getting more rubrics, more remedy references and more data spoiling the data itself?
FS – Yes it is a worry and a concern. I have and my team has always worked for quality with version 2, 3, 4 and 5. But then as soon as the book was published with version 5, this tendency has come up in the community that more is better. People were telling me …Listen! I don’t care if the remedy is confirmed in the rubric or not, it should be there to make me think of the remedy, it should just be there. So far teachers were saying, just put it there, put it, put it! And when this demand for quantity became stronger, we had to find a solution and the solution we have found is in Synthesis 7. We introduced the repertory views. You can look at Synthesis with all the information and also look at Synthesis with less but more reliable information. We have at that time given more stress on adding more information more quickly and you are right that there was a jump from version 5 to 6 to 7. We have given more information more quickly but only after we have provided the homeopathic community with the tool to get rid of the quantity if they wanted, to look at the Synthesis repertory view like a content view where only more confirmed, more reliable information is available.
Dr. B – But doesn’t it happen if you add a particular remedy or rubric to Synthesis which is not well confirmed, just by being part of such a work, gives the information a level of credibility/authenticity? People consider it reliable because it is there in Synthesis.
FS – Yes. That is a danger and I am happy you ask this question because this is not our purpose. Our purpose is to be an index, a synthesis of what is happening in the homeopathic community and to label it in certain way …to label it in a way, for example, we would indicate whether certain information is derived from classical provings or any other type of hypothetical proving. Then people can decide if they want to use that information or not. The solution is in making the information available as precisely as possible. The solution can not be in me deciding whether this information is reliable or not. Because wherever I will draw the line, there will be some people who will agree and some people who will disagree. So I’ll get killed either way. So the solution is not to take the authority for this big decision. The only solution I find is to be as transparent as possible, and that is possible in Synthesis.
Dr. B – What future do you see for Synthesis?
FS – Well, the version 9.1 has been released. This is a big leap, a big achievement, so version 10 is not coming up as soon as next year. We have to work a little bit further and take some more time before releasing version 10 because version 10 should be more special, and so the goals we have for the moment are mostly on the level of quality. We are collecting lot of information for correcting certain things like duplicate rubrics and clarifying language issues; because of the translations, we got a lot of demands for corrections of certain rubrics and we are having more information from reliable sources, from old sources which are not yet available in Synthesis. We are working since long but I don’t think that still all the knowledge from our classics is in Synthesis.
Dr. B – In Synthesis 9-1 you have added six works from Boenningahusen and Boger. You are also planning to add Kenbo to RADAR. What role do you see of such specialized software as Kenbo with Synthesis and RADAR?
FS – Well! Kenbo is an approach on how to proceed in the analysis of the case and offers assistance in how to bridge the gap between the language of the patient and where you need to go with your prescription, and so there is the language of the patient and there is this very big work that my team is doing and Kenbo will be using that to lead the practitioner in a more easy way towards the conclusion.
Dr. B – With version 9.1, you have generalized the rubrics a bit, like you have been bringing the sensations down and taking the locations up. Kenbo is based on Boenninghausen’s work and you are also generalizing a bit. Do you think there is a similarity in the work and if both can merge on a single software platform.
FS – We have to work on the details and it is our goal to find the best possible solution for the homeopathic community as a whole.
Dr. B – What in your view is the future of repertory in general? With thousands of new remedies being proved, do you think that the repertory will grow to an unmanageable level in the future?
FS – I don’t think so. The repertory will become more and more an index, a starting point to go somewhere, the starting point to go to material medica, like you look at a certain rubric and see that both Pulsatilla and Nux are jealous and I wonder what is the difference, and then jump off from the repertory rubric to investigate the jealousy of Nux and jealousy of Pulsatilla. If I see a small rubric and see that it is from the proving, I will move to the proving. I may see an unexpected remedy in a rubric and I see that it is from a case and I will move to the case. So the repertory will evolve like an index, a starting point to go to the source information.
Dr. B – But as the number of medicines grow, rubrics will become larger. If rubrics have 300, 400 remedies listed against them, do you think they will remain at all useful in our quest to find the simillimum?
FS – Well, if this is one rubric in the whole repertorization it can be useful because it may highlight a small remedy. The big rubrics are big, not exactly because they contain big remedies but also because they contain small remedies. Say you have taken some another small rubric of that small remedy and that remedy suddenly pops up because it is also present in your big rubric.
Dr. B – I will come back to the question of having many modern repertories. Do you think that the international homeopathic community needs to build a set of standards to create future repertories because at present everyone seems to be working on his own ideas, own interpretation of sources, of what is good and what is bad. Shouldn’t there be some basic standards on which everyone should work?
FS – Yes, First I would like to state that I and my team are not working on our own. We are very much involved with the community. We have hundreds of people who are collaborating with us and we let ourselves be influenced by whatever the people are requesting and saying. We have exchanges in many ways. It is a question of standards. They will be set mostly in a way that they did not exclude each other. If I can give the example of quality and quantity, what has to be the standard? It’s like ten years back this was a major issue. Whether we stay with quality and we see some other repertories jumping in numbers or do we add more quantity as well. The solution is choosing between 2 standards – quality and quantity. In evolving a technology where both were possible. I believe again that we must mention the technology or way. Different things are possible at the same time.
Dr. B – You have written a couple of books also. Is there any other work that you are working on at present?
FS – No my focus is still on the repertory. I feel there is still too much to be done on the repertory to increase the quality, to streamline the information, to make information more easily available. So I think for the next few years I will focus on the repertory until I feel that it has reached a certain point, then I may imagine other things but at present my focus is very much ion the repertory.
Dr. B – One last question Frederik. Compiling a repertory like Syntheis is really a big work. How does your family cope with your busy schedule?
FS – Well! Every day is not as happy as the other day, if you understand what I mean. I can tell you when the deadline is there, and we have to fit in with the desktop publishing team, which has taken 6 weeks to work, the paper has been bought, the printer has reserved the machines, we can not just stop any time. So we have to finish in time. So every time we have a deadline of any version of Synthesis, I can tell you it is a hell of a life.
Dr. B – In general, what future do you see for homeopathy in the current times?
FS – Well! You know the war is going on Europe, in US especially and my expectation in fact is that something will happen that will make this war appear to be very unnecessary. And that there will be very much greater acceptance of homeopathy in the Western health care system, like it is already the case in India. And that homeopathy will be understood to be really very important, almost first level in health care. This is my expectation.
Dr. B – Thanks you so much Frederick for this wonderful interview. It was a pleasure to meet you in person and talk to you in detail.