Hpathy Ezine - January, 2009

What Holds A Human Being Together From The Innermost

The Revision of Homeopathy by Masi-Elizade

Part I

-- Susanne Studer, Esther Ostermünchner

Translated by SiegFried Letzel

The “post Masi“ era has long since begun. Masi-Elizalde hasn’t left any publications and his system has proven to be brilliant at some points and worthy of debate at others.  Today therefore,  it is only possible to declare one’s own approach to this so-called method, and to describe it as precisely as possible. In the articles which will follow, we try to portray our approach to Masi-Elizalde and the developments which follow from it, in order to make it comprehensible for “Non-Masians”.

The law of similars, which had been formulated by Samuel Hahnemann in 1790, is still the basis of every classical homeopathic treatment today. All homeopaths agree that like cures alike. But each of them will soon experience, through their own practical work, that this basic premise doesn’t suffice to prescribe an effective remedy in each and every case.

In order to be able to therapeutically touch and cure a patient in his deepest being, we need an idea about where his innermost and individual problems lie. We need remedies which have also been examined regarding their individual uniqueness. Only when a prescription – whatever way it is achieved – causes these deep layers to resonate with each other, can true cure be accomplished.

Masi-Elizalde’s most important revision of homeopathy is focused on the production of a “cure with the quantum leap”, i. e.  in tracking a person’s existential improvement, his physical and mental health and his social behaviour. Masi observed that such cures sometimes happen in all homeopathic schools, but they cannot be explained or repeated. He hoped that through more meticulous study, such a cure could be made predictable, so that it may be open to every patient in the future [8]. This goal he wanted to achieve via the insights about a “core of being” within the remedy and the patient. A universally valid system of reference should define the concept and make it comprehensible.

The Way to Individualization: Revision of the remedies

The methodology of the Argentinian physician Dr. Alfonso Masi-Elizalde, created for the first time a systematic analysis of remedies and case histories. It confirmed the demand for a logical individualization, and soon lead away from so-called polychrest-homeopathy. Furthermore, this methodology offered an understanding of how the miasm-theory can be understood and practiced from a contemporary point of view. As users of the models which have been postulated by Masi, we can gain a lot in the improvement of the study of remedies, in the anamnestic techniques and in the observation of the course of treatment.

We hope that through our more practical approach, “non-miasmatic” homeopaths will gain access to the positive developments introduced by.Masi-Elizalde.

The first step in the revision of a remedy is the making of a so-called list of subjects. For it, a part of the original proving-symptoms are arranged according to certain criteria.

List of Subjects: Selection of Symptoms

Which symptoms are considered in a list of subjects?

All mind-symptoms: General mental reactions like sadness for the whole day, timidity or a cheerful nature are of low priority. Much more crucial are the contents of the symptoms, e.g. fear and being afraid that something terrible will happen or forgetting about all the pain when with a group of people, but she feels worse the next day; attaching great importance to the opinion of others; likes it when getting the good  opinion of  others (Palladium).

•         All dream contents or delusions.

•         Somatic symptoms which are marked with a share of mind-symptoms, e.g. fear associated with a certain pain, grief when perspiring. Sexuality, in this context, always is given its own subject.

•         Conspicuous somatic symptoms, localization and modalities.

•         As-if-symptoms

General qualities of pain like e.g. stabbing, burning, tearing, drawing usually are of minor importance for the development of the hypothesis.

Next, the subjects are arranged according to their thematic message.  Under an individual theme, the corresponding mind-symptoms, dreams, as-if-sensations etc. can be summarized. On the other hand, it is possible that an individual symptom contains two or more thematic contents and therefore it will appear repeatedly in the list of subjects.

The list of subjects alone can be helpful in gaining an overview of the essential contents of a remedy, and for a differential diagnosis. Leafing through several lists of subjects, one after the other, one will recognize that some general areas of life will show up in most of the remedies: work, relationship to other persons, their own body, health, disease, death, intellect, learning, etc. To bring out the nuance of a remedy, there is need for a continued questioning.

List of Subjects: Arrangement of the Symptoms according to a Miasmatic Point of View

In a second revisionary step, the prearranged symptoms in the list of subjects will be sorted according to new criteria. In order to understand in which manner it is done, requires a short excursion to the history and philosophy of homeopathy: In “The Chronic Diseases”, Hahnemann postulates in his miasm-theory a fundamental disease of the human condition, the so-called Psora. This idea of a “primary cause” for disease and suffering is also known in other philosophic or religious systems, such as the Christian Original Sin. Later, Hahnemann added two more miasms, Sycosis and Syphilis, and other homeopaths have proposed a tubercular- and respectively a cancer-miasm, etc.

Miasm as a Dynamic Category

A lack of clarity in the discussion about miasms surely comes from the idea that no other “Falls of Man” can be added to the “fundamental disease Psora”, (the causal original sin, which causes illness in the human being). As we can see now, the other miasms are well suited well to describe the courses of disease. It is known that “sycotic” or “syphilitic” symptoms describe a dynamic development of a diseases’ progress: It changes from the functional disorder (Psora) to proliferation (Sycosis) and finally to lesion (Syphilis).

Mental Dynamics of Miasms

Masi-Elizalde’s great contribution is the discovery that comparable dynamics take place on the mental level of the human being. The patient counters a “primal guilt” (the so-called primary Psora) in a first reaction phase, with fear (secondary Psora). As this condition is not comfortable in the long run, he compensates for fear in a next phase (tertiary Psora) with distension (egotrophy = Sycosis), flight (egolysis = Syphilis) or attack (alterolysis = Syphilis).

This action can be reconstructed with the symptoms of every sufficiently proven remedy. There are no more “psoric”, “sycotic” or “syphilitic” remedies, but corresponding phases within each collection of symptoms. This dynamic development is going to be explained in the folowing chapters.

Miasmatic Dynamics: Secondary Psora

First, we collect the symptoms expressing an individual complaint: e.g. fear, grief, easily scared in dreams, frightening fantasies. From this we try to draw conclusions about the core-essence of the remedy and patient respectively.

A considerable feature of the secondary Psora is, that the patient is still capable of countering his fears, expressing his complaints  overcoming them in different ways – e.g. with temporary, compensatory attitudes of the tertiary Psora.

Miasmatic Dynamics: Tertiary Psora

In order not to live a life with fear, and not to remain in the diseased condition of secondary Psora, every patient develops different compensation-mechanisms. As long a change is possible between different attitudes, he gains a mental equilibrium and we consider him a relatively healthy person. In daily life, it is appropriate to have fear occasionally, and to take an egotrophic attitude in order to tackle a particular work, or to react to a sad incident with dejection. Aggression, too, is needed to a certain extent in our relationship to our fellow human beings.

But when such a compensatory strategy becomes firmly established and the person remains in a particular attitude, then we call it tertiary Psora.

Tertiary Psora includes the following three possibilities: egotrophy, egolysis, alterolysis.

Egotrophy (Distension)

Distension, “Sycotization“ or hypertrophy of the ego: The person tries to suppress his complaint as he raises it to his individual life-philosophy,  a kind of imagination of perfection. Exactly where his strongest susceptibility lies, there he will develop the highest demands. Like the “Little Haewelman” in the children’s story by Theodor Sturm, he wants “more and more” from a particular area of his life. We should be careful not to judge such an attitude as reprehensible, as it might correspond to the old Christian or newer esoteric thinking, but rather understand it as valueless and as a design for the life of the particular individual.

A wonderful illustration for an unrealizable, boundless demand to the destiny or to an imagination of perfection (primary Psora), we find in the children’s story “The Little Haewelman” by Theodor Sturm, which we summarize in a shortend version:

The Little Haewelman

“Once upon a time there was a little boy, his name was Haewelman. During the night, he slept in a bed with wheels,  but when he wasn’t tired, his mother had to drive him around in the room, he couldn’t get enough of it. Now, little Haewelman was lying in his bed one night and he couldn’t fall asleep; but the mother was already sleeping in her large four-poster bed for a considerable period of time. “Mother”, little Haewelman called, “I want to be driven!” And while still asleep, mother reached her arm out of bed and rolled the little bed back and forth, and when her arm was about to get weary, little Haewelman shouted, “More, more!” and the rolling started afresh. Finally she completely fell asleep; and as much as Haewelman cried, she didn’t hear it; it was over. It didn’t take long time until the moon had a look through the window, the good old moon, and what he saw was so cute, that he first had to brush his fur sleeve across his face to wipe the sleep from his eyes: There, little Haewelman was lying in his bed with his eyes open and he held up one of his tiny legs like a mast. He had taken of his little nightshirt and had fixed it like a sail at his little toe; then he took one end of his shirt into each hand and began to blow with both of his cheeks. And gradually, quietly, quietly, the bed began to roll over the floor, then up the wall, then head first along the ceiling and then down the other wall. “More, more!” Haewelman cried when he had returned to the floor.  After he made his journey three times, suddenly the moon looked into his face. “Boy”, the moon said, “you don’t have enough yet?”

„No!“ cried Haewelman, „more, more! Open the door! I want to drive through the town; all the people shall see me driving.” “I can’t do that”, said good old moon; but he had a long ray going through the keyhole; and on it, little Haewelman drove out of the house. ”

This way, the story continues. Again and again the moon asked “Boy, still you don’t have enough?” and always Haewelman cries “More, more!” He rolled up to the sky, finally coming into conflict with the moon, stars and finally the sun, which in the end threw him into the ocean. The story ends with the section: “Yes, and then? Don’t you know anything more? If I and you wouldn’t have passed by and taken little Haewelman into the boat, then easily he could have drowned!”

We can see a hypertrophic claim, which never can be satisfied and finally it is restricted from the outside. Haewelman’s claim for perfection is being trimmed to a human level.

Another form of egotrophy is compensation for the experience of loss (this will be explained further in the section about “primary Psora”). Here, the patient says to himself that there is no inadequacy, and switches off his complaint by denying or not taking note of it. The famous fable about the fox and the grapes by Karl Wilhelm Ramler (1725-1798) perfectly illustrates this attitude.

The Fox and the Grapes

A fox which went hunting, found a grape vine full with black grapes hanging at a high wall. They appeared to him to be delicious, but difficult to pick. The fox crept around peering for the closest access to the grapes, bit in vain. No leap could be found. So as not to be ashamed in front of the birds sitting in the trees, the fox turned around and said, while contemptously contorting its face, “Why should I take the trouble? They are dry and are no good.”

Egolysis (Flight)

Another form of compensation for human suffering is flight or retreat. In syphilitic lysis we meet a “dissolution of the ego”, i.e. symptoms like depression, deep rooted resignation and finally suicide. If during the phases of secondary Psora and egotrophy we find colourful individual symptoms, the remedy picture becomes more and more gloomy, uniform and difficult to distinguish.

Alterolysis (Attack)

In the third variety of the tertiary Psora, the human being goes over to lay the blame on his fellow men. He turns aggressive, scolds, fights and even can go so far as to destroy a part of his outside world in order to get rid of his problems.

Central Theme: Primary Psora or what the individuality of a human being is made of -

Up to now, we have done some new arrangement of known symptoms (list of subjects) and we have accomplished a classification according to a dynamic mental process (miasmatic dynamics). In order to emerge a core idea from the existing material, we move to the level of primary Psora, to the intellectual world of the Primal Sin or – to say it in a less Christian-moral way – to the search for the individual “blindness, fad”.

We assume that every human being has a somewhat distorted perception of his being. This makes it impossible for him to judge himself and his environment objectively and completely. The distortion  unique for each  person, so people are completely different from each other in their way of thinking, susceptibilities, fears, dreams, etc. Once we understand the primary Psora of a patient (and  relate it to the core idea of the remedy) this uniqueness helps us  prescribe a multi-layered remedy.

Statements about primary Psora lie on a meta-level: here we can draw conclusions, work out a thesis and make suppositions. But it is impossible to perceive a patient directly in this deepened manner. Admittedly there are symptoms clearly illustrating the primary Psora, e.g. dreams, delusions, or as-if-sensations. But in order to get the central theme, to develop the fundamental issue of a remedy, we need to ask further questions:

•         Which “Conditio humana” does this person decline? Where does he want perfection?

•         Where does he experience insufficiency, a loss?

•         What does he experience as threat or punishment following rejection?

•         What is the focus of the internal attention?

•         How could a conscious handling with the fundamental problem show up?

Which “Conditio humana“ does this human being reject? In which aspects does he seek perfection?

Each person has a large number of responsibilities and restrictions imposed on him: The clash with the body, daily work, worries about the family, relationship to fellow men, questions about the meaning of life, disease and death, etc. will keep him in suspense.

There, where the human being rises against his fate to be entrusted with this task, his rejection hides: This human condition he doesn’t want to accept.

On the other side, he has an image of perfection of the same area. Inside he carries the idea of a more perfect world; he knows from deep within how he would improve his being if he had the opportunity. Egotrophic symptoms often display this wishful thinking pictorially, and they show from which aspects this person wants “more, more!”

In which aspects does he experience a non-sufficiency?

The logical consequence of these perfectionist ideas about a particular area of life, is a feeling of loss. Whatever the person strives for, how ever hard he ever tries – the result will never seem perfect, and he can never experience final satisfaction at this particular area.

Especially valuable in the search for the fundamental problem of the patient’s remedy are loss-perceptions, which do not correspond to reality.

A person think he’ll never find the perfect partner – but when we investigate further, we find out that he is married quite satisfactorily. Another patient believes he is not to be able to speak correctly, and complains about struggling for the correct words. But during the anamnesis we perceive him as quite eloquent. In a later (egolytic) phase of pathology there will be an increase of real losses or dysfunctions exactly where one wishes “more, more!”. These conditions are not individually distinctive – often the senses fail, thoughts tangle up, coping with daily life doesn’t succeed anymore, etc.

What does he perceive as threat or punishment following rejection?

It is imprinted deeply in the human psyche – at least for the western race - about other cultures no comments can be given – that it expects punishment for its hubris, its claim for perfection. Let us assume somebody seeks for a perfect love affair. This person wants something he cannot receive and, logically, he always experiences frustration in this area, or as mentioned before, a feeling of loss. Now we can investigate further which fears he experiences at this point. In our example, the patient would be afraid to approach other people, or he would be afraid he is not attractive enough, has an inadequate body, or he might be worried so much about the loss of his partner, that he prefers not to admit to a partnership. Both the individual perception of loss and the concrete fears for punishment, allow us to draw conclusions about the claim for perfection, and with this the core idea.

What is the focus of the internal attentiveness?

If we picture the “fad” to ourselves, like at the following graphic, we can see that in this area, where the “internal searchlight” shines, there is an especially highly developed attention. Here we find the most susceptible spot. Here the person reacts hypersensitively and always feels immediately affected, hurt and deeply moved.

To remain at the above example: A person wishing the perfect love affair for example, reacts for the first time during adolescence, then again with each rejection or disappointment, maybe even when reading cheap novels. Incidents, which may appear minor to other people affect him (perhaps make him physically sick, because his primary Psora has been irritated).

How could a conscious coping with the fundamental, problematic nature, be displayed?

In the course of our work we became aware that not all manifestations of a remedy are covered, when describing only pathologic behaviour.  So we try to imagine for each remedy picture, how a person who is (as far as possible) aware of his Psora and who has discovered how to deal creatively with it, may seek  – “for the higher purpose of our existence” as Hahnemann writes in the “Organon”. The subtle nuances towards egotrophy are sometimes is gossamerly thin. It needs to be emphasized that this chapter exclusively relates to the study of remedies. The thought of what a “cured patient” would look like, would correspond with a homeopath’s hubris!

Interpretation of individual themes or symptoms

In a last process of the study of remedies we will once more browse all significant symptoms and see if they can be explained within the light of the hypothesis. This also serves to identify whether or not an important aspect has been missed or “bent into shape”, or been misunderstood. Frequently, the results show highly interesting connections between the hypothesis on one side and mythology, symbolism, etymology, philosophy, fairy tales, etc. on the other side.

-- Part II -->

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