List of Themes

In the first step we group the statements of the patient into themes.

1. Connection, Chains, Disruptions

•         As a baby and when going to sleep, one had to hold her hand.

•         Likes doing fine work: knitting, doing embroidery, making chains.

•         Fantasy, she could create all kind of pearls to make her chains on her own.

•         Prefers cursive writing (not block letters).

•         She cares for her friendships for years.

•         She gets angry when father and mother stop telling her something.

•         She gets angry when the lining of her bicycle chain falls off. Then I have to fix it again and again. (Her drawing consists of sheer scattered organ-parts @ picture 1)

•         Problem with the skin, organ of contact.

2. Afraid of War, soldiers came across the field, they all where carrying weapons.

3. Vampires, Masks

•         People are vampires, mum and dad too, only me, I’m not.

•         Afraid that the parents are not the true ones, bit wearing masks which look like them.

4. News, Changes

•         Does not want tips and guidance with new things.

•         Always wants to walk the same path to school.

•         Didn’t want to go to Kindergarten at first.

•         Didn’t at all want to play flute.

5. Prefers drawing girls, princesses, fairies, almost never she draws boys.

6. The “Wawuschels” have glowing hair, so they don’t need any light.

7. Reading, Language

•         She was dying to learn reading.

•         She gets angry when her father and mother stop telling stories.

•         She wants thick books to be read to her.

8. Does not like tips and advice on new things.

9. Ambition, Mistakes

•         Does not like writing block letters, does not write such nice letters.

•         She is very ambitious. In school she is among the best students.

•         She gets annoyed about her own mistakes.

•         She’s always been well-behaved, conformistic.

10. Sometimes she is a little bit clumsy, awkwardly walking.

Classification according to Miasmatic Dynamics

In the second step we examine the list of themes according to the following symptoms:

•         Symptoms of the disease (secondary Psora)

•         Symptoms of compensation (Egotrophy).

•         Symptoms of retreat (Egolysis).

•         Symptoms of the attack (Alterolysis).

Also, we search for primary-psoric hints, for symptoms with metaphorical content, which cannot be readily classified according to the other miasmatic phases. For example “as-if-symptoms” or dreams without emotional reaction. They must be explained at the end of the remedy or case-analysis based on the “blindness” [distorted perception] of the patient.

Primary Psora

The drawing with the single, scattered organs has to be evaluated as the most immediate expression of her individuality (@ pict. 1).

Secondary Psora

In which symptoms can we find the disease of this child?

•         People are vampires, mum and dad, too, only me, I’m not.

•         Afraid, that her parents are not the real parents, that they wear masks which only look like them.

•         Does not like to play flute, does not want to go to the Kindergarten, does not like changes.

•         Afraid of war. Soldiers came across the field, they all were carrying weapons.

•         Has to hold the hands of her parents when going to sleep.

•         Does not like to write block letters (prefers cursive writing).

Tertiary Psora

Egotrophy (Distension)

With which attitudes does Laura compensate her disease? How does she try to become superior to the problem?

•         She likes to make fine things: knotting, doing embroidery, making chains.

•         Illusion, she could create all kinds of pearls to make her chains on her own.

•         Prefers cursive writing (not block letters).

•         She cares for her friendships for years.

•         Prefers drawing girls, princesses and fairies, hardly she draws any boys.

•         Does not like to get any tips and advices.

•         The “Wawuschels” don’t need any light, because their hair is glowing.

•         Ambitious, she doesn’t want to make mistakes.

•         Reads with very young age and much.

•         She always walks the same path to school.

Egolysis (Flight)

Egolytic symptoms are not present in this case history.

Alterolysis (Attack)

How does Laura make her environment responsible for her disease?

•         She is annoyed when mum and dad stop telling stories.

•         She is annoyed when the lining of her bicycle falls off. Then I’ve got to fix it again and again.

Central Theme – Primary Psora or what is the Individuality of a Person?

Which “conditio humana” does Laura reject? In what does she seek perfection?

Laura suffers, when she has to let go of her parents’ hands, when she writes block letters, when she is confronted with new things. And in her illusion she feels being cut off from the parents and from the other people around her. It seems there exists a rejection in the areas of letting go and changes.

However, the egotrophic compensation may point to what a person wishes more than can ever be achieved in his real being. For Laura, there seems to be a demand for “closeness” and autonomy.

The illusion, in which she creates pearls on her own in order to make chains expresses this: I want to make bondings on my own, that is I want to experience myself in closest connection with my environment and I want to decide about it by myself.

The theme bondings and interruptions passes through all miasmatic phases:

•         She suffers, when her parents stop the flow of words and she compensates it alterolytically: If you would not stop talking, then I won’t need to get angry.

•         She suffers from changes, from the interruption of what is accustomed. She compensates it egotrophically: I always want to walk the same path to school, this way I can escape from unexpected influences and from interruptions.

Laura also rejects starting anew again and again, to meet new influences and to experience herself as an individual person who is all alone. Admittedly, she can have new associations, she can feel closeness, but this is never a lasting condition.

Because of that, how does Laura experience insufficiency, a loss?

The experience of loss can happen in all areas where she experiences interruption. The insufficiency – which the patient rarely is aware of, but which is presented on the analytical meta-level – would mean: I cannot be in association sufficiently. Therefore she feels being cut off or being alone in situations which would not cause any reaction in other people.

Following rejection, what does the patient experience as threat or as punishment?

The greatest threat is the interruption of the bonds between parents and child. The parents are wearing masks, and they pretend as if they were her parents, or they transform to vampires. She is left behind without any ties to them.

She has daydreams of war and soldiers, which can be seen as a picture of destruction and interruption of a whole, connected structure.

What is the Focus of her Inner Attention?

Therefore, the focus of Laura’s inner attention lies in themes like closeness, distance and continuity, that is, the breaking up and interruptions. An expression is presented with her drawing (@ picture 1).

The Search for the most suitable Remedy

Also with the “work by Masi”, in most cases we make use of a repertorization. Often, individual mental symptoms cannot be repertorized, because the mind-rubrics are too general, or because small rubrics have not been added. Therefore we try to refer to the most accurate clinical rubrics. In the history of Laura this is limited to the symptoms of the skin and with the exception of polychrests, we would hardly achieve any interesting results.

When choosing the remedy I was mainly led by the impressive drawing of the child. For me, it was a high-quality aphorism 153-symptom. I knew about Baptisia, that such chopping up-feelings can happen.

Baptisia believes that the bond, which ties together the different parts to an integrated and coherent thing would be too inconsistent. For Baptisia, the whole thing is nothing else than the sum of its parts. He is afraid of disintegration of the unity which holds together an existing thing [9]. The following symptoms we find from Hering: He thinks that his legs would make conversation. He thinks that his gouty toe would have a nice chat with his gouty thumb. He feels his being scattered all over the place and he turns around quickly to get together the different parts.

Like any other remedy, Baptisia also has main symptoms. However, the correspondence with Laura’s eczema was poor. Nevertheless, I prescribed this remedy because I didn’t know any other remedy which would cover the mental part any better.

Prescription (Mid-January 1999): Baptisia Q 1, once a day.

Follow-up two months after Baptisia Q 1

March 1999: No amelioration. The only change was some aggravation of the skin, sometimes more – sometimes less.

Prescription: I see some resonance with the remedy because of the aggravation of the skin. Therefore I raise the potency to Q 3.

Follow-up three months after Baptisia Q 3

June 1999: It works fine with these drops. The skin has healed. But Laura expresses that she doesn’t want at all to be healthy, then she wouldn’t be the same Laura anymore. Recently she has also been quite aggressive, and she literally devours books. I advise to wait and see, and to proceed with the remedy if necessary.

Already here I should have been sitting up and taking notice, because this statement does not fit to a real cure. The aggression and the intensive reading speaks in favour of a shift to tertiary Psora. With this, she compensates her disease, which means that the skin eruption is being suppressed.

Prescription: Baptisia Q 3, as required.

Follow-up four months after Baptisia Q 3

End of July 1999: The new intake of the drops didn’t help at all. The eczema is more visible again, she also has spots on her face, she also had a fever and since then the skin has got quite in a muddle. With this report it was clear that the process of recovery went into the wrong direction. Aside from the psychological refusal of a recovery, against Hering’s rule, we observe on her body a migration of the eczema in an upward direction.

Differential Diagnosis: Niccolum

I’ve been searching for a differential-diagnostic remedy to Baptisia, and I found in the repertory by Guy Loutan [7] under the term “composition”: Ferr-p., Nicc., Kali-s., Bapt., Sabad, Anac., Thuj., Ham., Viol-o., Puls. Aside from the theme “interruption”, I also established priority to her demand of autonomy. This theme is common in different nuances in most metals, therefore I had a closer look at Niccolum.

•         The comparison between the focus of the inner attention of the patient and of Niccolum shows interesting correspondences: In Niccolum, it is directed towards the being as a part of a compound. Everything that reminds of it, provokes the psoric sensitivity: Mingling or purity, continuity or interruption, distance or closeness. The other people continuously remember Niccolum about their being as a part. Niccolum feels threatened by them, it experiences them as obstacles. It wants the total autonomy of its activities [9].

•         On the level of the symptoms we find the following dreams with Niccolum:

•         Dream; that she saw a man coming whom she knew, whom initially she thought to be the devil, whom she recognized again shortly after, what made her happy in the same way as it had been threatening her before.

-        A transformation resembling Laura’s masks and vampires.

-        A terrible dream: she saw the head of a relative being cut off (…) or a dream about squabbles when they were out for murder and manslaughter; she wanted to chop off the fingers of a relative, but she couldn’t achieve it in spite of all the efforts she was taking.

-        Illusions in a dream which reflect the theme of a physical chopping up.

•         The main symptoms of Niccolum show a clear agreement with the skin of the patient. There are skin eruptions on the face and on the extremities as well as many symptoms of itching. It is not a specific remedy for the skin, but all the allergic redness is well known which nickel based metal parts like ear studs or jeans buttons can provoke on the skin.

Prescription (beginning of September 1999): Niccolum Q 3, once a day.

Follow-up one month after Niccolum Q 3

Mid-October 1999: The eruption on the eyes ameliorated within 10 days, after this there was improvement at the inner elbow, and at her feet it is still flickering a little bit. At the same time her mind calmed down together with the facial eruptions. Laura takes the drops independently by herself, she says that they are good for her.

Prescription: Continuation with Q 3, report when the bottle is empty.

Follow-up four months after Niccolum Q 3

Early January 2000: Never has it been grave again, but also never completely well. She keeps on scratching somewhere on her body, but one can’t see anything. In the hollow of the knees, it is slightly cicatrized. The face looks pretty nice. She has become a glowing child, doesn’t have such an elderly skin anymore.

Prescription: Niccolum Q 6

Follow-up three and a half and eight months after Niccolum Q 6

Mid-April 2000: She is fine now. Since February her skin is fine. We are very happy. Before, the winter had always been a hard time. Sometimes, for 1-2 days, she has some redness which then vanishes on its own.

Early August 2000: Again an eruption at the inner elbows, at her wrists and she has very sensitive eyelids. Many spots where the eczema had been violent before, now, in the summer sun, they remain white. Since the beginning of July she took the drops again, but they didn’t help her. What has happened? We went on holiday, Laura never wants to go on holiday.

Prescription: She’s been confronted with many new things. Changes irritate her Psora. Niccolum C 200.

Follow-up six weeks after Niccolum C 200

Mid-October 2000: The eczema sometimes is at the wrist and forearm, sometimes at the eye, it can flare up for one day and vanish again. In the hollow of her knees she always has a dry skin, but it is not irritated at the moment. The spots which have healed up now are brown again. The irritability of her skin has started in summer when she was confronted with her unloved holidays and I realize that she has moved to upper school according to her age.

Prescription: Thus, she is continuously confronted with the theme of changes. Niccolum XM

Follow-ups after Niccolum XM

End of November 2000: Very satisfied with the skin. No irritable spots anymore.

Mid-April 2002: She’s doing fine with her skin. Now she complains about pain at the finger tips of both hands. It is as if writing on the blackboard with a chalk. Otherwise she feels good. She is “in bloom”.

Prescription: Niccolum XM

Early June 2002: The annoying feeling at the finger tips has gone. Ten days ago it has started with the skin again at the thighs and at the buttocks, then it has vanished again and now it has started at the lower legs. At the thighs, the skin is pretty okay again. Wait and see. The eczema at the lower legs vanished a few days later.

Early September 2002: Since summer holiday a red border around her eyes, as if the skin were salty, it itches violently. The same sensation at the angle corners of the mouth. She never wants to go to holiday. Before the holidays began, we told the children that we are going to move to another place next spring. Laura doesn’t want that.
Prescription: Niccolum XM

Inquiry in August 2004: She never had any problems with her skin. It is somewhat dry, she always has to put cream on it. Isolated flaring up every now and then and under her protectors of her shinbones when playing soccer.

Since I have moved my private clinic to another place resulting in a longer distance to the place of residence of the patient,  direct contact with her was made more difficult. Unfortunately I had no opportunity to follow-up her mental development according to the hypothesis of Niccolum.

Evaluation of the Method by Masi Elizalde

By Thomas Ade -

Most of the “Post-Masians” today don’t use Thomism as a pattern of reference, but they try to grasp the central idea of a remedy without this restriction within a single philosophical system. The following thoughts and experiences were implemented in the Revised Materia Medica which was published by us: the reduction to one philosophy and one set pattern of terms works for so long, as we stick to a limited number of remedies! Thirty, fourty remedies can be dealt with easily following strict guidelines. But if the number of remedies increases, suddenly unwanted overlapping of terms occur, greater differentiation becomes difficult and it partly appears to be far-fetched.

Also the transfer of case histories to a philosophical fundamental concept presents many severe difficulties. We always run the risk of presuming an interpretation of other people’s life histories which goes far beyond what is therapeutically meaningful. Many case histories also do not offer the appropriate material. For example, when someone has no dreams or hardly any mind-symptoms or thoughts about their own life, we cannot practically “put the philosophical superstructure on them”. In our daily practice, it has also been quite difficult to put “typical” feminine topics into the Thomistic pattern. For obvious reasons, feminine topics practically are not present for Thomas von Aquin.

For all those reasons, in the first years of our examination of the revision by Masi, we were facing difficult problems in translating modern questions of being human according to this philosophy. A further difficulty was with the Christian-patriarchal language with all those moral codes of sin and punishment, which, according to our opinion, only clouds the question about disease and cure of the human being, instead of shedding light on it.

The last – and probably the most important argument against Thomism as a dianoetic basis of homeopathy lies in the assumption, which can be traced back to Aristotle, that a materializing soul administers and governs the body, that is, always in the direction from soul to body, never the other way. This idea Hahnemann would have accepted as consistent, for he writes in aphorism 9 of the Organon about the spiritual vital force, which animates the material body and retains it in harmonious vital operation. Today we know that influence in the opposite way is also conceivable, namely, that a change in the body may lead to a change of the inner-mental experience. Imagine a person who has suffered from pain for years and who suddenly gets rid of it: an intensification of his zest for life, of optimism, social good nature etc. would not astonish us. Even modern encephalic research likes to define “mental”, as neurological functions of certain areas of the brain or as hormonal processes. Consequently, today we have to know how to handle the conception that there is an intimate cross-linking and interaction between the different parts of human existence (body, psyche, social environment etc.), and that we, in homeopathy, for a long time have not finished thinking over, where our remedies influence exactly what and in which direction.

Therefore it is necessary, if we want to come from one single basic concept, one central theme for the description of a remedy – to formulate them close to the present time, close to the social-cultural and linguistic reality. Otherwise, the linguistic conglomerates of remedies and patient cannot be brought together to a relationship of similarity.

What remains of Masi?

The search for a keyword which can stand synonymously for the problematic nature of the primary Psora, still makes a lot of sense to us. Looking for it means a well-disciplined handling of the complexity of a remedy proving, or a case anamnesis. In the work “according to Masi”, this means profiting greatly in structure and clarity.

The most important insight by Masi-Elizalde relates to the two homeopathies of Hahnemann: the a-psorical, pre-psorical homeopathy of the early years, and the antipsorical homeopathy following the development according to the Chronic Diseases, that is to say, after 1816. In this late phase, the Psora is the real target of treatment by Hahnemann. Today, thanks to the preliminary work by Masi-Elizalde, we can follow in these footsteps and proceed researching, where there existed nothing but a conceptional chaos before [8].

The discovery of the miasmatic phases by Masi-Elizalde as dynamics of a physical and mental development (see the theoretical part), surely exerts the most persistent influence on our concrete work with the remedy and with the patient. By the use of miasms in such a logical way, for the first time, we get a concrete and comprehensible connection to our work in daily practice – without following the oversimplifying pattern which divides remedies just into “psoric”, “sycotic” or “syphilitic” remedies.

Today, in the European area, we have several groups which, in their intellectual approach, follow Masi-Elizalde, without following strictly any dogma. They all take on single or several efforts and discoveries in their work. But an integrated and common opinion surely cannot be given. In 2005, for the first time, we had an international meeting, where we exchanged and compared study results.

Status of the commonly valid System of Reference

Homeopathy – like any other medical discipline – is far from being an accurate science. Our material always is the living human being in a dynamic process. Therefore, results never can be repeated or reduced to commonly valid statements.
Our theoretical thoughts today also are directed towards the question of whether a quantum leap in the development can happen at all.

For the time being we came to the conclusion, that a patient, who takes pleasure in being relatively healthy (see theoretical part), and who has a rather simple request to homeopathy, cannot undergo any sudden development! Those who independently deal with the problems of their lives and who, according to the circumstances, are first anxious, then egotrophic, then depressed – those who perceive their mental reactions and remember their dreams – cannot become still “healthier” or more independent. They already are close to their secondary Psora and cannot develop more “to the left” in the direction of the core of their nature – except in the sense of a wisdom, which is gained spiritually or by old age.

The primary Psora is a matter which is an epistemological matter of homeopathy and it cannot be “erased” with any remedy.

But in cases, when the patient is focused on reaction patterns of the tertiary Psora (Egotrophy, Egolysis, Alterolysis), there can be a very dramatic development in several areas of life by means of a well chosen remedy. In this case, we first encounter a psoric crisis, and then a clear shift in direction to secondary Psora, and finally to a more liberate attitude towards “the higher purpose of being”.

Only one Remedy for the whole Life?

Masi-Elizalde’s postulate, that a single remedy has to suffice for the whole life of the patient, we cannot judge conclusively at present. The opinions about this are divided within the community of the successors of Masi.

The demand for finding the simillimum for each and every human being fails for different reasons:  There are too few sufficiently proven remedies. We only have a few of them at our disposal in the revised form. The access with the help of indexes and repertories needs improvement, even in the era of computers. But it is very crucial that in the end, cure is beyond our will and predictability.

When we find the rare cases, where we experience that a single remedy works for a patient to the satisfaction of everyone for many years, and has triggered a real development, we are exceptionally satisfied and motivated again and again in order to proceed our research in this direction.

Now it is appropriate to comment about the time needed for case taking.  Critics of the method by Masi like to say that the time needed to work on a case history is excessively long. But if we succeed in prescribing a very well fitting remedy – in order to avoid saying the unfortunate term “Simillimum” – it will accompany the patient for a long period of time, in all kinds of acute diseases, stressful situations, etc. In all these therapeutical contacts with the patients we do not need to find a new remedy – which is extremely time-saving and it justifies the two to four hours of time reworking the case after the initial anamnesis.

Ressources:

[1]     Allen T.F., The Encyclopedia of pure Materia Medica, New Delhi 1988

[2]     Association Française de l’Approfondissement: De la recherche Homoeopathique

[3]     Chevalier/Gheerbrandt, Dictionnaire des Symboles, Laffont, Paris 1982

[4]     Clarke, Der Neue Clarke, Bielefeld 1990

[5]     Forschungsinitiative zur Revision der Materia medica e.V. www.form-homoeopathie.de

[6]     Hering Constantin, The Guiding Symptoms of our Materia Medica, New Delhi 1989

[7]     Loutan Guy, Répertoire de Thèmes et de Matière Médicale Dynamique, 8. ed. Genf 1997

[8]     Masi-Elizalde Alfonso, Ãœberarbeitung der Lehre, Materia Medica und Technik der Homoeopathie, Preis Stefan, Seminar zur Sicht der Homoeopathie nach Dr. Masi-ELizalde, Hoehr-Grenzhausen, 1993

[9]     Preis Stefan, Mattmann Peter, Weihe Christoph, Studer Susanne, Weiss Karl:, Materia Medica Homoeopathica – revidiert nach Dr. Alfonso Masi-Elizalde, Luzern 1996/97

[10]    Studer Susanne, Ostermünchner Esther, Revidierte Materia Medica Homoeopathica Band 1, HIZ, Hägglingen 2002

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– Susanne Studer, Esther Ostermünchner

Translated by SiegFried Letzel