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A Quest For Simillimum - Stages and Miasms

by Shilpa Bhouraskar

listed in homeopathy

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The Quest for Similllimum, by Shilpa Bhouraskar, is a two part online book: the first part, An Overview, is free when you register on her website; and the second part is Stages and Miasms.

These online books came about when Shilpa found that homeopathy practitioners used different techniques for finding a remedy. Shilpa decided she didn’t want to rely on just one technique but wanted to understand several tools so she could choose a particular style for a patient rather than one style for all patients; after all, homeopathy is about individualizing.

Shilpa, a homeopath and tutor originally from India, moved to Australia where she exposed students to different styles of working. She found that the huge network of support and extensive possibilities for practical experience found in India were not available in Australia. Today about 67% of Indians use homeopathy, making India one of the largest users of homeopathy in the world. The practice of homeopathy elsewhere continues to be a challenging process.

Shilpa’s books, based on her vast experience, offer a template that incorporates Classical and non-classical strategies of repetorisation and  analysis which can work in different situations.


In the first book, she looks at the evolution of homeopathy in four stages, using Cinchona as an example. The first stage is the discovery of homeopathy by Hahnemann, with Cinchona and remedy prescription based on the name or diagnosis of a disease.

In the second stage, any disease with Cinchona -like fever could be treated with the remedy.  The third stage was the differentiation of symptoms of fevers where all symptoms may not subscribe to Cinchona. This is when individualizing came into its own.

Shilpa acknowledges that this stage came from Hahnemann but was revolutionized by Boenninghausen and Kent. While Kent gave top priority to mental symptoms, Boenninghausen’s use of concomitants individualized the case. Patients were seen as having individual personalities and expressions. So Cinchona needed to come with a remedy picture - a particular personality and physical symptoms to qualify. Kentian style homeopathy was highly influential and continues to be so all over the world today.

Stage Four is where modern homeopathy sees disturbance in the vital force, expressing itself in signs and symptoms. This is the vital sensation method of Rajan Sankaran . At this stage, a Cinchona (China) remedy picture will display feelings of being stuck, unable to fulfil desires and attacked from time to time. This understanding comes from studying the themes of the various kingdoms.

“This is disease expression never assessed before, a level beyond just the man and his constitution,” says Shilpa. In this method, the practitioner attempts to find the connection between the source within the patient and the source of remedy. She says that accuracy comes from practising at the higher stages but incorporating all stages in the understanding of the case.

Shilpa gives a case of Psoriasis where the woman felt persecuted and abandoned by family. Analysed according to the Sankaran method, she displayed the need for structure in her life, with a family unit, and an imbalance as a result of losing the structure - indicative of a mineral remedy. Her sense of being betrayed and let down led to the remedy Nat Mur. Here the remedy is classed as a malarial miasm - between Syosis and Acute.

Repetorising the case from a Kentian perspective, Shilpa looks at the mental symptoms alongside generals and physicals, and emerges with Nat Mur again. Constitutionally and physically, her case shows a syotic miasm.

At Stages one and two, the disease psoriasis points to Nat Mur. The patient does well on the remedy 200 C to 1M over a ten month period. Shilpa concludes that while Nat Mur would have come up in Stage 3 alone,  the multiple approaches confirm the accuracy of the remedy.

The idea here is that working with different methods helps practitioners enhance their practice. One method alone is not the ideal. The fourth stage is not always applicable to all cases and hence the need to fall back on the previous stages.

Stages one and two are suitable for pathological cases with no characteristic symptoms - in babies, animals, and for people who are unable or unwilling to talk in depth about their condition.

In Stages three and four, the homeopath looks beyond the disease and this suits patients who are happy to be interrogated about their lives, minds and emotions.

Shilpa concludes that patients can get to this level with trust. She suggests that patients should be allowed to set the tone for the consultation, allowing the homeopath to go as deep as they want to go.

Miasms and Stages is the second book. Here, Shilpa elaborates on the different approaches to suit different patients.

Stages one and two are better suited to allopathic doctors turned homeopaths. Good medical diagnostic skills and the ability to distinguish between diseases, symptoms and the peculiarities are required. Resources such as Compton Bennet’s Organopathy or Tissue Salts are more suited at these stage.

Stage 3, largely popularized by Kent, is the more common method used by the vast majority of practitioners. Here, the person along with his physical symptoms is considered. Stage 4 is the latest in the homeopathic evolution which includes understanding the man beyond the physical and mental symptoms, examining the vital force and energy at greater depths.

Shilpa discusses the skills required to analysis cases in each of the stages. For instance, “The sensation method requires insight, dissociation and keen observation. Someone who just wants to experience the phenomenon and provide that space for the patient to express that energy.”

The Miasms are discussed from Hahnemann to the present. Miasms were incorporated into case analysis, looking at suppressors and family history with non-miasmatic remedies being used to treat acute exacerbations of chronic diseases. While Hahnemann’s theory of miasms determined a connection between diseases in a patient’s life time, his classifications of remedies were not totally clear.

In practice, practitioners need to work out the interplay between individual miasms and disease miasms. Remedies have multi-miasmatic patterns. For instance, a case of psoric sulphur can be cleared to reveal a syphilitic sulphur and later might change to a syphilitic complementary like Pulsatilla.

No new miasms can be discussed without mentioning Sankaran. Shilpa devotes a section to Sankaran’s contribution to the miasms. His model perceives the origin of disease as stemming from past histories and generations forming delusional roots in susceptible patients, resulting in “disease state as a form of survival response”. Sankaran elicits sensations, a level deeper than symptoms and delusions, and miasms are used to differentiate between remedies from the same family.

Sensation and miasms go hand and in hand. At the 4th stage of analysis, the practitioner determines the kingdom; at the miasmatic level identifies the depth of pathology and experience and perception of the patient; and the responses: psoric (hopeful), sychotic (acceptance) and syphilitic (beyond repair).

An absence of sensation but only a miasm denotes a nosode. Awareness of sensation gives a lasting cure, the sensation being deeper at the psoric level, and faster cure.

The book concludes with five cases analyzed at all stages, using Kent, Boenninghausen and the Complete Repertory. While it inspires a practitioner to attempt different models of analysis and reaching accuracy, it is not a step-by-step guide to repetorisation or analysing cases. 

Shilpa’s books provokes an homeopath to think differently about the way one practises. Quite a few homeopaths, such as Luc Schepper, repetorise cases using different systems. Only those trained under the Sensation Method with knowledge of Sankaran’s schema, can confidently take cases at Stage 4. Other homeopaths such as Dinesh have also contributed hugely to the sensation method and their works are worth studying. Scholten, Mangalvorie and a few others have published  works on the kingdoms. 

Shilpa has recently produced a video course on her stages concept. For more details visit her website

Further Information

Register for free book :

Purchase Stages and Miasms: 

The author may be contacted via

Prasanna Probyn
E-Book. Free Download for Registered Members
$25; £15.70 approx. for second book

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