Francisco X. Eizayaga and the Layer Approach to Homeopathy

2) Physical agents : mechanical trauma, extreme temperatures, changes in the atmospheric pressure, radiation, electric shocks.

3) Chemical agents: all the varieties of poisons.

4) Biological agents: virus and rickettsias cause endocellular lesions. Just as the bacilli of diphtheria, bacteria act by means of exotoxins which inhibit oxidation phenomena and protein synthesis within the cells. Gram negative bacteria act by means of endotoxins which are released when dying. Others, like the bacillus of Koch, awaken an allergic reaction in the host.

5) Disturbances in immune mechanisms: immune reactions against exogenous and endogenous antigens, like the anaphylactic reaction against an alien protein or an autoimmune reaction, are cause of cell lesions.

6) Genetic alterations: diseases such a congenital malformations, genetic mutations, lack of enzymes.

7) Malnulrition: protein and vitamin deficiencies, just as nutritional excesses, can cause serious diseases and death.



Diseases classified from a clinical viewpoint and from an anatomo-pathological viewpoint into two large groups: functional disturbances and lesional diseases.

A)    Functional perturbations may be:

Psychic: e.g., anxiety, fears, excitement, irritability.

General: e.g., insomnia, tiredness, lack of appetite, sweat.

Local: internal organic sensations, tremors, contractures, pain, etc.

The clinical and anatomo-pathological characteristic is that the process is always in one of these three stages: cell irritation, dysfunction, inflammation with “restitutio ad integrum”. In these cases, the cell’s anatomic structure has not been destroyed; it has only suffered a temporary transformation.

B)    Lesional diseases: those conditions which produce structural and microchemical changes in the cell. These changes depend on the specific noxious agent, its toxicity and its capacity to produce the injury; also its type and the degree of differentiation of the cell, as well as the cells metabolic activity, and state of health. The first manifestation of cell damage generally is a change in the mitochondria and in the plasmatic membrane. Afterwards, deep mitochondrial changes take place in the endoplasmic reticulum and in the polyribosomes, with damage to the cellular capacity of oxidative phosphorylation and protein synthesis. When cells are incapable of conserving ionic and liquid homeostasis, tumefaction, dropsical vacuolation and fat metamorphosis appear. Up to then, the cellular lesion is reversible, i.e., capable to regenerating and recovering its function.

a) Lesional reversible diseases are those in which, notwithstanding the structural alteration they produce, may draw back until cell “ad integrum” restitution as well as functional recovery are complete. This restitution is complete and spontaneous in acute diseases; in chronic diseases restoration cannot be produced spontaneously but after an adequate homeopathic treatment. lt is also true that diverse acute diseases, and some chronic ones, go through a preliminary period during which they are reversible and curable, becoming irreversible afterwards, despite treatment. For example, schizophrenia, multiple sclerosis and numerous chronic infections.

1)     Lesional reversible mental diseases: deliria, disturbances of judgement due to cerebral lesions, delusions, etc.

2)     Lesional general reversible diseases: some nutrition diseases, septicemia, etc.

3)     Lesional local reversible diseases affect an organic system, and can be localized or diffuse. They are localized when the anatomo-pathological alteration comprises a circumscribed area; eg., follicular tonsillitis, a wound in the skin, localized glomerulonephritis etc.

They are diffuse when the anatomo-pathological alteration comprises the whole system or Organ; eg., acute hepatitis, acute encephalitis, enteritis, diffuse glomeruIonephritis, etc.

All these conditions are curable by means of the dynamized, diluted (in any potency) medicine, except for especially particular cases which require a certain potency. As a general rule, we can affirm that any individual sensitive to a given medicine is sensitive to any potency and dilution; there exist, nevertheless, degrees of efficacy for each potency in each particular case.

b) Lesional irreversible diseases provoke deep cellular changes, to the point that these alterations cannot be either anatomically or functionally restored; in other words, they do not heal. In these cases no treatment, neither homoeopathic nor allopathic, can obtain real cure. Symptoms can only be relieved. An explanation is necessary here: focal irreversible lesions may be cured clinically be means of scarring, but they cannot be cured histologically because there is no “ad integrum” restitution. Irreversible diffuse lesions, instead, comprise the whole organ and are really incurable, as the scarring of the whole lesion would mean the total annulment of the organ and, therefore, of its function. This cellular death of parenchymatous tissue may be quick, like in an embolism or a traumatism, or slow, like in cirrhosis or chronic nephrosclerosis.

But there exists an unquestionable fact proven by many years of experience: the homoeopathic medicine dynamized beyond Avogadro’s number, without matter, does not act on diffuse or incurable irreversible lesions. From here stemns the fundamental importance of a clinical, anatomo-pathological correct diagnosis before prescription, not only of the medicine, but also of the appropriate dilution.

Thus, here is another irrefutable fact: in order to act therapeutically on irreversible and incurable lesions, the patient must be given a medicine that is active in its natural state, according to a lesional similarity, modalized and individualized, covering most of the pathological symptomatology and will always be administered in dynamized, low material dilutions, taking advantage of the reversible therapeutic effect, according to the Arndt-Schulz’s rule. In all remaining cases of curable lesions, reversible or not, and of course, in functional disturbances, medium, high or very high potencies can be most successfully employed.

Another problem appears in the special case of irreversible and incurable lesions: When must the remedy based on similitude will be taken? Before the fundamental medicine, simultaneously with it or after it? In our opinion, it is very difficult to advise an inflexible rule for all possible cases as the patient’s individuality will always be present. In the future, the best pattern to follow will only be found by properly collected statistics. In the meantime, each physician must use his common sense and his clinical criterion to solve each individual case.

Conclusion: we can maintain with certainty that the therapeutic field of homoeopathy will be remarkably enlarged by putting these fundamental notions into practice during our everyday medical work. With this, an unusual efficacy of homoeopathy as regards diseases considered to be incurable or as regards diseases, for which there was not even a palliative resort according to the classical homoeopathic method, will be added to its well known, familiar effect on a multitude of patients and diseases.

However, as it is very often impossible to discern whether a pathological process is curable or not. Whenever the physician feels he is not forced to act with urgency he must try a treatment with dynamized medicines, and he will very often verify that what was considered totally incurable is curable will the homoeopathic medicine.

Examples of irreversible, incurable diseases: hepatic cirrhosis, malignant nephrosclerosis, advanced multiple sclerosis, cerebral softening due to arteriosclerosis, paralysis, malignant hypertension, cardiac insufficiency, blocked branch bundle of His, ovarian cysts, kidney cysts, fibromatosis, cancer in general, benignant tumors (some types).

Therapeutic conclusion


Any curable disease, including local irreversible ones with compensative function, may be treated with medicines dynamized at any potency. On the contrary, incurable local diseases with a non-compensative function or diffuse diseases must be treated with medicines in mother tincture or in low dynamized dilutions. We are not only looking for a dynamic but also a chemical action, always on the similitude basis and using the Arndt- Schulz’s rule.


The fact that homoeopathy is an excellent therapeutic for psychosomatic patients and diseases is universally accepted. lt is also similarly admitted that during their functionally reversible stage, patients with emotional disturbances and perturbations of judgment are usually curable by homoeopathy with relative ease.

Great homoeopathic teachers claimed official medicine to be clearly superior for treatments of all kinds of organic diseases, leaving homoeopathy aside only for the field of psychosomatic and functional diseases. According to this way of thinking, they practically divided diseases into functional and lesional diseases, admitting that homoeopahy achieved good results within the first group, but allopathy was more successful in the second one. This is the reason that prominent homoeopaths thought of the three following therapeutic possibilities:

1) With inert medicines in their natural state but active once they are dynamized e.g., Silicea, Calcarea carbonica, Natrum mur. With these medicines, psychosomatic, funtional and inflammatory reversible diseases could be cured.

2) With scarcely toxic medicines in their natural state(e.g. Pulsatilla, Belladonna etc.) somewhat deeper diseases and more severe inflammations could be cured besides the psychosomatic condition.

3) With very toxic medicines in their natural state, capable of producing deep, destructive tissue lesions (e.g. Phosphorus, Arsenicum, Mercurius sol, etc.) a much larger variety of diseases, from the psychic ones to the severe organic lesions, could be cured.

lt is true that no pathogenesis with dynamized medicines can produce the destruction of tissues, which is only observed in authentic toxications, whose pathologic descriptions are added to the corresponding pathogenesis. In theory, this therapeutic systematization into three possibilities looks very attractive. A fourth possibility could be added: toxic medicines of not known mental symptoms which could be exclusively used on account of their physiopathologic modalized local action.

However, such systematization runs the risk of being far too schematic and a priori.

In our practical experience, however, we have found that curing a case does not depend on the toxic nature of the medicine as much as it depends on the origin of the disease.


Let us see a few demonstrative clinical histories, divided into two therapeutic groups for lesional patients.

A)    Patients treated with the similar remedy, i.e., that which covers the lesional pathology.

Case No. 1. Mr. B.R. (R 301), 50 years old. He consults on 10-15-63 on account of an enormous tumor which covers the right half of his bladder, and which, by means of cystoscopy and biopsy, is verified to be a papilloma. Total hematuria, without clots, practically black blood, with a tickling sensation in his left iliac region, painful lumbar tiredness and premature ejaculation. His father and his wife died from cancer. Without going into too many details so as to be brief, two well defined situations are found.

a) Repertorization of the present lesional condition: bladder polyp; hematuria; balanitis; a desire for acid foods; he dreams he is falling, he dreams of dead people; Thuja constitutional type, with excrescences, warts, telangiectasiae, etc., Medicine: Thuja.

b) Simillimum repertorization: inconsolable; aggravated from consolation; sympathetic; craving for vinegar; premature ejaculation; blood does not coagulate. Medicine should be Natrum mur. The treatment starts with the similar medicine, i.e., Thuja 200, and in a few days there is a great improvement, with elimination of dead tissue. The treatment went on for six years, always with Thuja and intercalating the Medorrhinum and Carcinosin nosodes now and again, with the patient’s total recovery. Bladder was controlled cystoscopically. The tumor disappeared in less than two years. During the 5th year an eczema, which had been suppressed with cortisone reappeared, and it also disappeared. During the 6th year the cured patient ends his treatment and reappears in our consulting room on 12-23-77, now suffering a prostate adenoma, with retention of urine. The present condition corresponds to Apis.

Case No.2. Mr. J.E.R. (R 40), 56 years old, consults on 10-01-54 on account of his prostate adenoma already diagnosed by the urologist, who prescribed immediate surgery. Frequent micturition by night and by day; urging to urinate, must hurry up or the urine will escape. As antecedents he reported pulmonary tuberculosis on the right vertex when he was 23 years old, followed by a similar lesion in the left knee. The prescription is based on the following present symptoms: enlarged prostate, dysuria, frequent micturition; imperious urging to urinate; Thuja constitutional type. Medicine prescribed: Thuja, which he took as his principal medicine during several years, intercalating other medicines now and again; periodically controlled. Ort 07-29-61 a urologic examination reveals a normal prostate and all his conditions have improved. To date, the patient has undergone 34 years of a periodical treatment; he is 93 years old and his psychic and physical conditions are excellent. He is a lawyer and still continues working in his profession.


Case No.3, Mr. E. R. (R 378), 47 years old. single. He was assisted 11 years before, when Natrum mur was discovered as his simillimum. Ort 02-28-77 he consults on account of great ascites, elephantiac edema of genitals and lower limbs, venous collateral abdominal circulation, emaciation, anorexia. Two 5 cm worms with Schistosoma characteristics had been eliminated via urethra in the middle of a hematuria shortly before. There being no characteristic symptoms, we prescribed his simillimum, Natrum mur, obtaining no results. Due to his anxiety, his nervousness, his fear of death, brown, dehydrated tongue, frequent thirst for small quantities and need to sip liquid, he was treated with Arsenicum 30 C, noticing quite an improvement which kept going on with consecutive potencies. After 3 months, the process remained stationary, and a subcutaneous edema which covered the whole left hemi-thorax and arm appeared later on. We put together new symptoms: edema and tissue infiltration; pale, wax-like, transparent, sensitive edema; oliguria; lack of thirst; brown tongue; putrid breath; dry mouth without thirst; aggravated from heat. The effect was spectacular with Apis 30 C. The edema quickly disappeared from above to below. His analysis and his general condition improved and he went back to work in a short time.

B) Patients treated with the simillimum

Case No.4. Mr. C.A.C. (C 886),40 years old. Cavitary lung tuberculosis 4 cm wide and pleurodiaphragmatic adhesions. Started with family annoyances and personal frustrations, repeated hemoptysis from lung cavity, fever and night sweats, emaciation. We repertorized the following symptoms: forsaken feeling, slowness, anxiety about his health; night sweats while in bed; apprehension in stomach; bright-red colored hemoptysis; desires sea food. Calcarea carbonica 30 C brought on an immediate recovery. X-ray control shows a remarkable scarring about the 2nd month. X-ray image of the lung lesion disappeared during the 5th month, with complete recovery, due to successive potencies.

Case No.5. Miss D.A. (A 585), 31 years old. She consults on 8-13-76 on account of Lung Aspergilosis (Aspergillus fremigotus) which appeared a year after a tuberculous lesion in both lung vertexes. She was treated with Riferin, Nicotibin, etc., and the lesion was discovered due to a scanty expectoration and hemoptysis. The test of complement fixation was positive at 1/32. She underwent X-ray and endoscopic studies, as well as with nebulization treatment which had no result at all, and was prescribed surgical extirpation of the affected zone. She presents some pinkish, bloody expectoration, thick during the morning, two hemoptysis having been registered during the last month. The following symptoms are repertorized: pulmonary tuberculosis, hemoptysis; presenting a sympathetic, mild, sweet-mannered personality; she expresses anxiety about her health; she is sad and weeps before menstruation; she wants to die, even more so when she wakes up and is aggravated before storms; desires farinaceous and salty food. She was treated with Natrum mur, starting with a 30 C potency in repeated doses, with her condition improving progressively; other potencies were used later on, until 50 M was reached during the 9th month, with practically total clinical and serological recovery. A month treatment with an autonosode made of sputum, totally negativized the complement fixation. The cure was completed in 19 months time.

Case No.6. Miss V.S. (S 905), 22 years old. She consults on account of diffuse hyperthyroid exophthalmic goitre, with a 68-85-69 iodine captivation. Presents exophtalmia, goiter, hand tremors, photophobia, cramps, watery coryza, occipital and nape migraine, loss of weight. She was advised to undergo an operation. lt all started with a love disappointment she suffered due to her father’s behavior. Repertorization: Symptoms of disease: exophthalmic goiter; trembling hands; cramps in calves, photophobia; watery coryza; occipital and nape of neck pain; stitching pain in eyes. Symptoms of the patient: disappointed love, malicious; anger with indignation; sympathetic; contemptuous; aggravated from consolation; sensitive to music. The whole picture was covered by Natrum mur, which was prescribed at the 30C potency, and higher potencies afterwards until 50 M was reached, with great improvement. Goiter, exophthalmia and her psycosomatic state were cured within 9 months.

Case No.7. Mr. A.F. (P470). He consults on 3-15-77 on account of a duodenal ulcer which was radiographically and endoscopically confirmed. Very violent spasmodic pains in his epigastrium and left hypochondrium, swollen abdomen; with ups and downs which are now permanent. He bends double during pain, with cold sweat. He gets worse at 6 pm and before having lunch; he gets better while drinking. Constipation alternates with diarrhea. The epigastric pain extends to the back, it gets better when drinking and eating, and it gets worse when drinking alcohol. Tachycardia, arrythmia, hypertension (16-10). Antecedents: his father died from leukemia; his mother died from stomach cancer. The following symptoms were repertorized: Disease symptoms: Ulcer (Stomach-Abdomen); gastric cramping pain; abdominal distension; cold perspiration from pain; drinking ameliorates; must bend double; stomach pain extending to back; tachycardia; irregular pulse. Patient’s symptoms: forsaken feeling; horrible things affect him; conscientious; perspiration of the neck at night; perspiration from cold air; burning in soles (uncovers feet at night); desires for salt, farinaceous and sea food. He was immediately relieved with Calcarea carbonica. With successive potencies, his psychosomatic cure was complete.

So as to be brief, we shall only mention here special cardiac insufficiency cases in which simillimum is unable to normalize the heart function and it is necessary to resort to the complementary cardiotonic, or those infectious cases in which the corresponding nosode is indispensable.

Conclusions. Cases 1,2 and 3 correspond to lesional diseases which evolve naturally and which develop the patient’s hereditary morbid diathesis. Cases 4, 5, 6 and 7 correspond to organic processes which follow emotional disturbances. Those of the first group were cured with a lesional or similar medicine; the ones of the second group were cured with the simillimum medicine which covered the lesion as well. We could present many cases resembling these. A possible therapeutic pattern is hereby posed:

1)     In severe and organic cases, when the remedy for the disease (similar) and the remedy for the patient (simillimum) are different, one should prescribe the similar first.

2) When the remedy for the disease and the remedy for the patient are the same, this ideal simillimum must be prescribed.



1.Dr.Gattari.. “Experiences with Ledum and Hypericum in the prevention of tetanus”, Homeopatia.Nov.Dec.1960, Buenos Aires.

2.Dr.C.W.Eaton. “Vacunacion antivariolica y homeopatia”, “Homeopatia”, 1962, page 35. Buenos Aires.

*Stanley L.Robbins. “Structural and Functional Pathology”. Interamericana Edit.Mexico, page 23 and following ones.


Francisco X. Eizayaga, Treatise on Homeopathic Medicine, Ediciones Marecel, Buenos Aires, 1991

Luc de Schepper, Achieving and maintaining the simillimum, B.Jain Publishers, New Delhi, 2006

Luc de Schepper, Hahnemann revisited, B.Jain Publishers, New Delhi, 2006

Samuel Hahnemann, Organon der Heilkunst. 6.Auflage, Barthel & Barthel, Nendeln, 1999

James Tyler Kent, The art and science of homeopathic medicine, Dover Publications, New York, 2002

James Tyler Kent, Lesser writings, Clinical cases, New remedies, aphorisms and precepts, B.Jain Publishers, new Delhi, 2004


[1] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.256

[2] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.256

[3] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 256

[4] see Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.68

[5] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.292

[6] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.134

[7] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.257

[8] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 81

[9] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.149

[10] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 133

[11] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.247

[12] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 260

[13] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 261

[14] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.133

[15] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 260

[16] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 229

[17] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.133

[18] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 65

[19] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.157

[20] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 69

[21] J.T.Kent, The art and science of homeopathic medicine

[22] S.Hahnemann, Organon, §7 Organon

[23] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p.229

[24] see Luc de Schepper, Achieving and maintaining the simillimum, p.178, and

[25] see

[26] Luc de Schepper, Hahnemann revisited, p.143

[27] Luc de Schepper, Hahnemann revisited, p.143

[28] Francisco X. Eizayaga, Treatise on Homeopathic Medicine, p. 292

[29] see the interview Lynn Amara by Jilda Helinga:

[30] Reprinted from private correspondence with Jose Eizayaga



Photograph Francisco Eizayaga

Graphic layer approach by Katja Schütt

Synoptic table reprinted from Eizayaga’s book with permission of Jose Eizayaga

About the author

Katja Schuett

Katja Schuett

Katja Schutt, Msc, HP, DHM, PGHom, DVetHom, has studied homeopathy with several schools, amongst which David Little’s advanced course stands out as it offers a really deep insight into homeopathic philosophy and materia medica ( Her current focus lies in working with animals and studying history, the old masters, and research.


  • You wrote :
    Although Hahnemann mentions the importance of the constitution, it was only later homeopaths who developed the concept of constitutional prescribing. Based on observation, Hahnemann mentioned in the Materia Medica Pura that Pulsatilla and Nux vomica are most likely to benefit in persons with certain constitutional and temperamental features. However, he did not define constitutional features as a prescribing rule for curative treatment, these are definitely the totality of signs and symptoms.

    This is factually not correct. Hahnemann very clearly mentioned that the mental disposition of the patient must be considered without which no cure can be expected vide aph#213 and its footnote. The totality of signs and symptoms makes a useless and meaningless exercise if it does not include the mental and emotional changes in ALL cases of disease, including acutes. vide aph #213

  • Dear V T Yekkirala,
    thanks for your comments. I would like to mention that prescribing on mentals, or including them, is not the same as “constitutional prescribing”. Of course, the (morbid) state of mind is most important and often reveals § 153 symptoms, thus contributing to the total symptom picture which is used for homeopathic precribing. (Amongst others) These symptoms have been derived from provings which constitute the most reliable source for knowing a-priori which remedy is going to cure – provided it covers the totality of characteristic symptoms of the patient. Constitutional features (as it is refered to usually), however, refer to features which do not change during lifetime and which have been worked out from clinical experience, i.e. these are features which have been observed in patients in which certain remedies have been seen to work the best, like the blond-haired Pulsatilla subject. Blond hair or a dark complexion, however, neither constitute morbid symptoms nor can they been brought out in provings, hence they were never adivsed by Hahnemann for prescribing. As written, the concstitutional approach with constitutional drug “pictures” have only been elaborated by later homeopath like Kent, Tyler, Blackie. BUT, they all emphasized that it is finally the symptom picture that decides for the remedy. In practice, much controversies arise from the fact that the obviously identified constitutional drug picture of the patient does not seem to be identical with the remedy that seemingly covers his totality of symptoms. Practitioners use to solve this problem by using appropriate potencies, ie. higher potencies for identified constitutions, and lower/medium potencies if the symptom picture predominates and does not agree with the basic constitution of the patient, what lead to the development of the layer approach in prescribing (which should finally arrive at the basic constitution). As outlined in the article, there are different concepts of constitutional prescribing which finally determine the different procedures of homeopathic practitioners. But, no matter which definition you prefer, Hahnemann clearly outlined in § 169 Organon how to proceed if two similes are seen in the patient’s case. If confronted with the dilemma of perceiving two different remedies, he advised us to select the remedy which is more homeopathic to the case… for which the totality of the strange, rare, uncommon and characteristic symptoms are crucial, and which, of course, includes mental symptoms as the state of mind is always altered in a disease subject, and as the mentals often held the key for prescribing homeopathically.

Leave a Comment