In 1998 VCCH commenced a project using the principles of Homeopathy and miasms (genetic inheritance) to further the understanding of chronic disease. This project has involved thousands of hours of research and highlights the role of miasms and how they can be effectively utilised in the clinic.

As the project developed it became clear that facial features play an important role in recognizing a patients' dominant miasm. All these findings, including an understanding of miasms and how to utilise them in clinical practice, have now been published in "Appearance and Circumstance" and "Homœopathic Facial Analysis" by Grant Bentley.





By Grant Bentley and Louise Barton


Homœopathic Facial Analysis (HFA) is the most straightforward and accurate way of determining a patient’s miasm.  It allows for the selection of a remedy that will act in a constitutional way to enhance a patient’s health. It reduces and removes symptoms for long periods of time, using only one or in some cases a few miasmatic remedies given one at a time.


The following nine step plan demonstrates how to incorporate miasmatic prescribing using facial analysis into clinical application.






1 – Case taking

3 – Choosing rubrics

5 – Homœopathic software

7 – Potency and frequency of dose

2 – Taking photos

4 – Choosing the miasm

6- Digital camera

8 - Outcome




9 – Maintaining health




A step by step example of the process of HFA



*      Case is taken

*      Photos taken

*      Symptoms charted

*      Rubrics chosen from chart

*      Miasm selected from photos

*      Rubrics repertorised

*      Remedy selected from miasmatic group

*      Potency and frequency of dose chosen



Symptoms analysed


1          Good outcome – continue treatment as required


2          Poor outcome – repeat the following steps

*      Check photos to validate miasm

*      Take new photos if first set are unclear

*      Check rubrics

*      Re repertorise

*      Change remedy



This method has been used on all patients presenting with chronic disease over an eight year period by a number of practitioners in Melbourne Australia.  Using a small number of remedies (about 50 polychrests) results have improved dramatically.  This has been even more so in the last few years as the method has become more streamlined.  The following steps are how we practice.




The aim of case taking is to get the totality of the patient’s symptoms.  It is not about psychoanalysis or putting the patient through a deeply reflective process.  It is about finding a simillimum that will bring about better health. 


General classical Homœopathic concepts apply –


*      Listening

*      Removing judgement

*      Observing patterns

*      Understanding the main complaint – what, when, how

*      Checking from top to toe for all physical complaints – current and history

*      Ensuring all generals are covered – sleep, appetite, thirst, food (cravings, aversions, aggravations), bowels/urination, menses, perspiration, environmental sensitivity, positions and time factors


Special care must be taken when using mental rubrics.  There are two ways ‘mentals’ can be used and they must be chosen very carefully as this is the area where judgment by the practitioner will lead to errors of rubric choice.


Emotional responses – use sparingly and only when they are very clear – for example weeping, anger, jealousy are usually very easy to see and can be used as a firm rubric choice


Circumstances – asking the patient to give you a biography of their life with an emphasis on important moments is a solid way of determining the energy pattern of their life.  It is not about what they think of themselves or how they would like to be but about what actually happened.  Being factual means the practitioner is working on solid ground.  Examples would be a history of violence (Mind – Violence), a strong concentration on business (Mind – Business or Mind – Dreams of business) or people who spend much of their time alone (Mind – Company aversion to).


Another way circumstances provide mental rubrics is by using the emotional state of the people around the patient.  For example a patient who has had three jealous partners – even though they are not jealous themselves, are attracting jealousy to them therefore jealousy becomes an important theme in their life (Mind – Jealousy).  Another example is a patient who tells of a family who is always fighting, (Mind – Quarrelsome).




Photos are taken after the case taking is completed but prior to the analysis.  This is a good time for the patient too as you have gained their confidence through the case taking process.  Detailed instructions for taking photos can be found in Homœopathic Facial Analysis by Grant Bentley. 


*      Tell the patient about why you are taking photos before the consultation begins

*      Have a set way of explaining the purpose of taking the photos

*      Use simple terms like group or genetics rather than miasms

*      Do not use pathologies when describing miasms


Five photos are required –


1.      Straight on – relaxed mouth

2.      Straight on – broad smile

3.      Straight on – hair pulled back

4.      Profile left

5.      Profile right


*      Each image must show the patient holding their head as straight as possible

*      All images must be in focus and must fill the screen – ie so the patient isn’t too far away

*      The five photos must clearly show the following aspects of the face -  hairline, forehead, eyes, bridge of nose, mouth, teeth, smile, chin and ears




After taking the case and photos we do a case analysis.  Symptoms are categorized into a chart as follows





Fearful ++

Jealousy themes ++

Dreams – vivid +

Likes friends +


< night ++

> rest

Des coffee +++

Av milk +

Burning pains +++

Right sided ++

< summer

Constipation - occasional


Sinus – pain, discharge – yellow - occasional

Headaches – frontal ++

Knee pain +

Skin – eruption itchy – on chin




It is easier to determine which rubrics to choose when the whole case is clearly laid out in front of you.  It is important to observe patterns, intensity of symptoms and what is unusual.  Our aim for the repertorisation is to choose between five and eight rubrics that meet the following criteria


*      The symptom is frequent

*      The symptom is intense or distinctive

*      The symptom is unusual





1-2 rubrics

3-5 rubrics

1-2 rubrics



By ensuring that each of these three areas has some representation (with the majority being generals) the remedies coming through will be certain to cover the case.  Note that general rubrics are always the most important and if your case is mostly mental or physical, it will be more difficult to find the correct remedy. 


So in our example above we might choose


*      MIND; JEALOUSY (65)

*      MIND; FRIGHTENED easily (162)

*      GENERALITIES; NIGHT, nine pm. - five am.; agg. (262)

*      GENERALITIES; FOOD and drinks; coffee; desires (51)

*      GENERALITIES; PAIN; burning; internally (195)

*      GENERALITIES; SIDE; right (225)

*      HEAD PAIN; LOCALIZATION; Forehead (430)


Note that we try to use rubrics with 40-500 remedies in them.  Even though this will bring us more remedies to choose from we can feel certain that the one remedy we need will be amongst the group.  In the example above fourteen remedies will repertorise.  Once we know our patients miasm our choice will become much smaller.




*      Facial analysis will always determine the miasm accurately

*      Pathology is a poor indicator of miasms

*      Psora, sycosis and syphilis are the base of all miasmatic prescribing

*      Essence pictures of psora, sycosis and syphilis are incomplete

*      All miasms are equal in their potential for destruction



Each facial feature is influenced by psora, sycosis or syphilis or a combination of two or more miasms. Some facial features are within normal range and will not rate.  Categorised features (about seventy in total) are detailed in both books on HFA


Appearance and Circumstance – photos

Homœopathic Facial Analysis – sketches

There are fifteen feature areas on each face


  1. Hairline
  2. Forehead
  3. Bridge of nose
  4. Eyes
  5. Nose
  6. Cheeks
  7. Mouth
  8. Lips
  9. Smile
  10. Teeth
  11. Chin
  12. Ears
  13. Lines
  14. Skin
  15. Asymmetry



These features and their miasmatic classifications come from more than eight years of observation and analysis from thousands of patients – they have been clinically verified and form the basis of HFA.


Learning to apply HFA


*      Practice on at least fifty faces before expecting to be competent

*      Use family, friends, patients, television and movies

*      Practice taking photos

*      Use the HFA book to help in defining parameters

*      Chart your results


It is important to take your time and judge carefully.  Use the HFA book as a desktop guide – soon you will remember the features well and know when to allocate them and when to leave them out.  Make a simple chart like the following and place the patient’s features in them.  Not every feature is rated as some fall within “normal” parameters. 


PSORA (Yellow)



Down-turned nose

Close set eyes

Two lines

Thin lips

Two front teeth

Chin – receding

Ears – sloped


7 features

Wide nose

Teeth – straight







2 features

Hairline – high

Asymmetry – nose, eyes







3 features


The patient in this example will need a psoric remedy as their psoric features dominate over their sycotic and syphilitic features.




Are used to describe the miasms – see Appearance and Circumstance for detailed description


*      Pathology is not an accurate way to determine a miasm

*      Colours are non-judgemental

*      Colours are easy to remember


For example patients who are dominated by the tubercular miasm can get cancer and patients dominated by the cancer miasm can get tuberculosis.  By removing the pathological tags we remove the disease name from our minds and focus on the true nature of the miasm.




Provides the following benefits


*      Large rubrics are very useful – they cast a wide net and will draw our remedy to us

*      Cases can be looked at from more than one perspective

*      Saves time


We use MacRepertory Complete but any Homœopathic software will be adequate.  The package you choose must contain all the generals as grouped by Boenninghausen and Kent including modern updates.




*      Give instant images

*      More accurate than the naked eye

*      Catch the patient in the best position

*      Allow for many extra images until the information is fully provided




2.2 to 7.2 megapixels


The higher the megapixels the more definition.  Definition is helpful for zooming in on teeth or hairlines. 




Everyone in Homœopathy has different ideas about posology.  We commenced our clinics using Kentian prescribing but have developed the following guidelines from ongoing clinical experience.  We find daily doses of 6C or 30C satisfactory for many patients and can give daily doses for one, two or more months without any aggravations provided there is continuous or sustained improvement. However there are still cases that are given a single dose of 200C or 1M with occasional repeats as required.


What about aggravations?

When choosing a remedy from within the patient’s miasm few aggravations are encountered as long as the remedy matches the totality and the potency is low enough to suit the patients sensitivity.





6C daily

30C daily

200C sd

1M sd

10M sd

Structural pathology – long term or very bad






Structural pathology – less severe






Functional signs and symptoms – daily occurence






Functional signs and symptoms - intermittent






Allergies – all ages






Child - sensitive






Child – first remedy  (no structural pathology)






Child – second remedy or later (no structural pathology)






Mental symptoms dominant (no sp or strong fss)






Mentals with structural pathology






Mentals with functional signs and symptoms






Elderly – structural pathology – long term/very bad






Elderly – structural pathology – less severe






Elderly – functional signs and symptoms






Elderly – mental symptoms only (no sp or fss)






Mental illness – no sp or strong fss







sp = structural pathology (changes to body – skin, joints, organs)

fss – functional signs and symptoms (sleep, pains, digestion with no test results indicating structural changes)

Sd = single dose


Where more than two potencies are shown always commence at the lowest potency



6C or 30C daily – commence with a daily dose from two weeks to one month or until their next visit.  When the problem is 90% or greater fixed and all auxiliary symptoms have settled withdraw the remedy.  Commence again if and when symptoms decline, if returning symptoms are different search for a different remedy.


200C, 1M, 10M – single dose.  Give one dose only.  Repeat the single dose only when the action of the remedy is slipping backwards.  If a patient slips back for one or two days still wait as people are always changing and re-establishing a state of balance and they may get better without a further dose.  If the slip back continues for longer than a few days it is time for another dose. When the potency no longer brings about the depth of response or the length of response consider going up the scale.




A well chosen Homœopathic remedy should provide the following for our patients


70-100% improvement of the presenting complaint AND

Improvement in auxiliary symptoms such as


*      Sleep

*      Other pathologies

*      Well being

*      Energy


Repetition of the remedy will depend on


*      The state of the patient

*      The type of pathology

*      External stresses


External stresses deserve a special mention.  They are almost always the cause and the continuance of chronic disease.  External stress can be


*      Removed (best outcome for patient)

*      Adjusted

*      Put up with


Where external stress continues it is reasonable to expect that the remedy will hold for lesser periods than when it has been removed.


Areas that result in energy being drained from the patient include


1.      Worry

2.      Tension and stress

3.      Overwork

4.      Poor nutrition

5.      Negative self belief

6.      Emotional trauma

7.      Physical trauma including childbirth and accidents


It is important to remember that our remedies are medicines – they are not people themselves and although we have painted caricatures to help us learn materia medica these pictures are not always true of every patient that needs that remedy.  The remedy is a set of potentials waiting to replace an existing state of energy imbalance using the law of similars as an agent for removal of those symptoms.  It is nothing more and cannot change the soul or the personality of the patient.


This chart is a guideline for what can be expected from the application of a well chosen miasmatic remedy




Functional symptoms


Reduced in frequency – 70% or more

Reduced in intensity – 70% or more

Structural symptoms

Completely gone (rare)

Partially gone

Reduction of pain – 70% or more

No further advancement of symptoms

Negative emotions


Reduced – 70% or more

Only triggered by far greater stress than previously

Patient takes control more quickly

Positive emotions

Will remain the same – they are not to be “fixed” and are not part of the problem


Belongs to the patient for life and to be used only as a guide for remedy selection if at all



*We regard the removal of symptoms as a “quelling” of symptoms. 


A remedy that is Homœopathic to the patient and their symptoms, gives them the extra energy required to quell those symptoms.


Increased energy = health


Energy down = signs and symptoms


Humans are homeostatic beings and designed to react to stress.  Pathology is the result of wrong thinking that came about due to stress either imposed externally or from within.  There are no guarantees in life that this will not occur again in the future.  It is up to the practitioner to explain to the patient that it is possible that these symptoms or other symptoms may occur again in time.




*      Use miasmatic Homœopathic remedies as required

*      Eat natural, whole foods

*      Exercise regularly in fresh air

*      Keep company with people you love and  like

*      Choose an activity that you find joyful – indulge in it regularly


ND Dip Hom Grad Dip Psych. Th Prof Memb AHA AROH reg ATMS ANPA

Principal of the Victorian College of Classical Homeopathy since 1995, Grant has enthusiastically taught and researched Homeopathy during that time. He first studied Naturopathy and Psychotherapy but on discovering Homeopathy recognised the depth of understanding Homeopathy brings to the therapist when dealing with ill health.

Determined to understand the underlying factors, he was fascinated with Hahnemann's last great work The Chronic Miasms and subsequent work done later by Allen and Roberts. This saw him embark on a personal research project regarding the miasms that has led to a remarkable link between our appearance, our circumstances and our health. His first book Appearance and Circumstance was published in 2003 followed by Homœopathic Facial Analysis in 2006.

He is currently writing his third book showing how miasms are reflected in all aspects of structure, behaviour, life events and time. Grant considers himself a Hahnemannian Homœopath, using facial analysis as a modern technique in conjunction with traditional Homœopathic principles.

Dip Hom Prof Memb AHA AROH regd

Louise Barton has been in clinical practice since graduating in 1996. She was involved in the Australian Homoeopathic Association (Vic) from 2001, both organising seminars and as President from 2002 - 2004.

She teaches at the Victorian College of Classical Homœopathy and has been involved with miasmatic research and the production of her partner Grant Bentley's book Appearance and Circumstance and Homœopathic Facial Analysis.



"Homoeopathic Facial Analysis" by Grant Bentley

Hundreds of photos and sketches with detailed parameters to aid in the miasmatic analysis of faces. This book is the complete visual guide to facial analysis and combined with Appearance and Circumstance will allow homoeopaths from student level to practitioner to make an accurate miasmatic diagnosis before a remedy is chosen.



"Appearance and Circumstance" by Grant Bentley

After 12 years of research, Hahnemann presented his theory regarding the origins of chronic disease - the miasms. Psora, Sycosis and Syphilis were triumphs in Homœopathic understanding.

Extending on Hahnemann's original idea of three primary miasms, Appearance and Circumstance details the development of the complex miasms - Tubercular, Syco-Psoric, Syco-Syphilitic and Cancer, as well as the three primary miasms.

Knowing that miasms are genetically inherited influences, the author discusses how each miasm will dominate physical structure, pathology and mental outlook. Recognizing the lifetime influence of a miasm helps to explain the events and circumstances that surround us.

Understanding that every individual is dominated by one of the miasms, facial features have been identified and matched to each group, and can be used as clinical aids. Themes together with facial features enable a practitioner to recognize the dominant miasm of the patient.

This book contains explanations and facial charts to aid the Homœopath in utilising these concepts. Facial feature identification can be incorporated into any current case-taking method.

By the end of his life Hahnemann regarded himself as a miasmatic prescriber and made a clear distinction between this method and symptom prescribing only. The further he examined the miasm theory, the more convinced he became that miasms are the key to understanding chronic disease and unlocking a case. Appearance and Circumstance continues this work.

Appearance and Circumstance has been welcomed by homœopaths around the world as being a fresh and innovative way of using miasmatic understanding to find better remedies for our patients. The knowledge (gained from patients) of the themes and behaviours within these miasms has again validated why homœopathy is not only a true medicine of natural law but also a medicine covering all human experience. The understanding of human behaviour provided by the miasms has been an extraordinary journey of richness and clarity. It is a journey that continues to unfold the mysteries of human nature and delight both patients and practitioners alike with improvements in health and wellbeing.

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