Vikariation und Metaschematismus

"Vicariation and metaschematism, representative – vicarious – symptoms and the transformation of disease processes, these are terms of a bygone medical epoch (18th and 19th centuries). Samuel Hahnemann (1755 – 1834), the founder of modern homeopathy, tried to use them to open up the dialectical relationship between illness and symptom. After decades of research into infectious chronic diseases (miasms), especially syphilis, he observed that if peripheral persistent symptoms are suppressed, the disease situation inside the organism can develop into more severe symptoms.

From this he concluded that the peripheral local symptom has a representative (vicarious) function for the whole central disease. It is thereby appeased and its progress stopped. Its elimination leads to metaschematism (change of shape) of the symptomatology in the sense of aggravation of pathology. It is therefore necessary to treat the whole pathological context, not just the symptom. From then on, this is exactly the basis of that homeopathy, which is called classical and refers strictly to Hahnemann. Hahnemann's approach makes the pars-pro-toto-relation fruitful for medicine. Symptoms are more than just the expression of the disease. For medical practice, the central problem of therapeutic symptom suppression and its often fatal consequences opens up.

The vicariation principle is Hahnemann's real innovative discovery. The other principles, the law of similarity (Analogy or Simile principle) and the potentiation principle, are based on the old tradition of the hermetic microcosm-macrocosm equivalent respectively alchemy. Through Hahnemann's drug testing on healthy people, they were just empirically justified and confirmed. Only the vicariation principle is based on the intellectual life of Hahnemann's time.

Pars-pro-toto-consciousness has been represented in all areas of cultural life since Leibniz's influential Monadology. First and foremost: The discovery of the hermeneutical circle of understanding acquired by Friedrich Ast. It implies the ability to conduct analytical and synthetic research at the same time, inductively and deductively, and to come to intuition. Goethe called this „anschauende Urteilskraft“ in reference to Kant.

Since there is no term for pars-pro-toto-relations in dynamic life processes, the term panenchy respectively panenchial is introduced. The whole (gr. pan) is preserved in the appearance of the part. The Aristotelian concept of entelechy is modified in the sense of a mereological teleology of the living. Hahnemann's panenchial concept of the vicarious symptom comes much closer to the Greek original meaning of gr. symptoma (sym-piptein: coincide) than the conventional symptom term. The symptom is not only a sign or indication, but in symptoma there is a collapse of a disturbed connection in itself.

For Hahnemann, vicariation is always connected with the dimension of the transcendental life force, “Lebenskraft”. For him, vicariation is an expression of the powerlessness of the life force, it can do no more than just appease. This shows the contrast between the Enlightenment and the romantic view of the world. Hahnemann was not a romantic, he was a free spirit and follower of Deism. The physiological life force has been divinely established, but in pathology it must fail, according to the plan of the deistically conceived “watchmaker God”. The enlightened doctor as His creative representative must come to its aid. That is the final meaning of the symptom.

There was no conscious reception and assimilation and yet the whole development of classical homeopathy from Hering's rule (reverse metaschematism) to Vithoulka's hierarchical layer model is characterized by the doctrine of vicariation and metaschematism. Most – even classical – homeopaths reject the principle of vicariation as untimely. They assume that the evident standard of modern homeopathy criticism is conventional medicine with the results of natural science. But that`s hermeneutically inadmissible. Thinking in dialectical contexts is not typical of modern medicine, which tends to think in terms of causality. However, vicariation is an acausal phenomenon.

There are two points of contact to anthroposophical medicine:

1. The idea of dislocation. It says: The right thing – the physiological process – shifts to a wrong – unphysiological – place, it is dislocated. But this thought lacks the dimension of meaning: Why does something shift, what does the organism want to achieve?

2. The therapeutic vicariation idea: The homeopathic remedy vicariates the patient's symptoms. The symptomatology becomes superfluous by the vicarious similar means, the organism can free itself. Hahnemann also thought this way at times to explain the principle of similarity. The homeopathic remedy continues the insufficient vicarious efforts of the organism, replaces those that are similar, and completes them. Healing then is the vicariation of the vicariation."