Praxis: A New Approach to Homeopathic Medicine: Method of Complexity:The Search for Coherence in Clinical Phenomena, Vols. I and II

By Massimo Mangialavori, MD, edited by John Sobraske, MA, LMHC, LMFT
Vol. I, Methodology, 298 pp.; Vol. II, Drug Family I, 284 pp.
Published by Matrix Editrice, 2010, $110.00, ISBN 978-88-88799-14-8

Reviewed by Sybil Ihrig, L.Ac., HMA, CCH (Cand)

What is the true Holy Grail for us classical homeopaths? Is it finding the Simillimum for a given patient? Or could it be something even more recondite—a soulful depth of insight into remedies so penetrating that it verges on the mystical?

Over the past two decades, this quest for profound insight has led a succession of international homeopaths to develop elegant, meaningful new systems for understanding remedies and classifying groups of remedies into families. As notable examples, we’ve seen the Sensation method from Rajan Sankaran and the periodic table classification system from Jan Scholten.

Another homeopath who has made equally significant, yet less widely recognized, contributions to our knowledge base is Dr. Massimo Mangialavori of Italy. Massimo (as he is known by colleagues) has been teaching internationally for a long time and semiannually in the U.S. for more than a decade, but until recently, publication of his findings in English has been piecemeal and not always of the highest quality. Dr. Betty Wood (New England Homeopathic Academy) and a group of close associates took over the publication efforts several years ago, and since that time, the professionalism of the resulting work has been increasing steadily.

Now, after nearly three years of work, Massimo’s long-awaited magnum opus is finally seeing daylight in English. Praxis presents, in the first two volumes of what will likely become a four- or five-volume set, a comprehensive overview of the conceptual methodology that underlies Massimo’s practice and teaching.

Massimo has long been known for his emphasis on clinical cases—the live patient—as the most stable foundation for enlarging our knowledge of homeopathy. His body of work also enlarges our understanding of many “small” remedies that polychrest prescribers seldom hear about or use. Such “small” remedies are probably better characterized as “underrepresented.” Historically, he maintains, our repertories were developed in such an inconsistent fashion that rubrics rarely represent either the symptom grade or the “phase” (the evolutionary point on the compensated-decompensated continuum) of a given remedy reliably. Further, the decontextualized organization of most repertories tends to encourage a misleading reductionism in our clinical thinking. Rather than trying to simplify homeopathy, we should include in our sights the enriching perspectives of natural history, traditional medical uses, myths and legends, toxicology, and pharmacology, among others.

Some of the methodological concepts that are clearly elucidated for the first time in Praxis, Vol. I, include:

  • Symptoms—Symptoms are phenomena that can be expressed either verbally or nonverbally, subjectively or objectively. Massimo differentiates among several categories of symptoms and their relative usefulness in case analysis. Not all symptoms recorded in the repertory are coherent in terms of a given remedy’s core themes. The most important types of symptoms are structural symptoms, which reflect the core structure and adaptive strategy of the patient. Structural symptoms may or may not correspond with the traditionally known “strange, rare, and peculiar” symptoms in our literature; in any case, they go deeper than SRPs.
  • Structure, corpus—The term structure as used by Massimo reflects his construct of the corpus as the full body-mind complex of a human being, which cannot be dichotomized neatly into “Mind” symptoms vs. physical ones. To better understand the idea of the corpus, consider the distribution of symptoms found for a remedy such as Colocynthis; we see relatively few Mind symptoms, but a great preponderance of Abdomen and Extremities symptoms. Does this mean that the Colocynthis patient has no emotions or thoughts? Hardly. Rather, it suggests that for patients needing this remedy, the corpus expresses the mind through other body systems. This brings into question our assumptions that Mind symptoms must always be given precedence in repertorization. Is that heresy according to Hahnemann? Not necessarily so.
  • Themes—Massimo feels that themes are a more reliable basis for remedy classification than symptoms. He differentiates between characteristic themes, which are often present in a case as a polarity (e.g., cold/heat) depending on whether a patient is compensated or decompensated, and fundamental themes, which are strongly reflective of a remedy’s adaptive strategy (the way in which a person interacts with the challenges of her or his environment) and persist over time in any remedy phase.
  • Homeopathic families—Unlike his colleagues Sankaran and Scholten, Massimo’s concept of homeopathic families crosses genus and even kingdom boundaries. (I recently took a case for which Rhus glabra was curative. The chief differentials were between Rhus glabra and Lac caninum, a comparison that would have made no sense using Sensation method but which made perfect sense using concepts derived from Massimo’s thematic approach.) Volume II of Praxis comprises case studies of “Drug family” remedies (Anhalonium, Psilocybe, Agaricus, Bovista, Convolvulus, and Nabalus), which come from different botanical plant families but share similar characteristic and fundamental themes linking them together. A future volume of Praxis will contain case studies of Drug family remedies from other kingdoms as well.

The full title of the Praxis series gives us a hint that these tomes are no light bedtime reading for the faint of heart: “Complexity” in the subtitle refers both to the complexity theory and systems thinking that inform Massimo’s understanding of homeopathic similitude and to the full-on encounter with real, complex human beings that we must encourage in order to understand remedies in clinical context. That being said, Praxis is a treasure trove of key concepts that will greatly enrich any homeopath’s understanding of the depths to which our art/science can reach.

For more information on Massimo’s seminars and publications, e-mail Dr. Betty Wood at NEHA,