Homeopathy Papers

Francisco X. Eizayaga and the Layer Approach to Homeopathy

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Francisco X. Eizayaga and the Layer Approach to Homeopathy

Francisco Xavier Eizayaga

Dr. Francisco Xavier Eizayaga is an Argentine homeopath whose contributions to homeopathy rapidly achieved international recognition. He was born on January 23, 1923, in the province of Santa Fe, Argentina.

Francisco Eizayaga studied medicine at the Medical University of Buenos Aires. He worked as an urologist with Professor A. Astraldi in the Hospital de Clinicas, in the Hospital Ramos Mejia and in the Urology Department of the Hospital Municipal de Vicente Lopez, province of Buenos Aires.

From 1949 to 1950 he studied homeopathy at the Asociacion Medica Homeopatica Argentina (AMHA). There he became an associate professor in 1954, and a full professor in 1964. He was the president of the Asociacion Medica Homeopatica Argentina for 14 years.

Dr.Francisco Eizayaga worked as a classical homeopath in his practice since 1952.

In 1988 he established the Instituto Superior de Homeopatia Clinica de la Fundacion HOMEOS in Buenos Aires. Its aim was teaching and investigating homeopathy, as well as its expanding it to support medical care through homeopathy clinics, and  training courses for physicians.

From 1951 he regularly taught clinical homeopathy in Argentina, primarily at the AMHA, and since 1989 at the Instituto Superior de Homeopatia Clinica de la Fundacion HOMEOS, Buenos Aires. He also lectured on homeopathy worldwide, including Brazil, USA, Mexico, Colombia, Uruguay, Venezuela, Chile, UK, Spain and Canada. He taught the first complete homeopathy course in San Pablo, Brazil, from 1976-1977, and gave more than 350 seminars.

Francisco Eizayaga was married to Berta Amalia Klein, and they had eight children and nineteen grandchildren. Three of his children also became homeopathic physicians. The family was united by a strong affection and they lived by the highest principles. His son Dr. Jose Enrique Eizayaga is a well known homeopath who also graduated as a homeopathic physician at the Asociacion Medica Homeopatica Argentina (AMHA) and lectures at the Universidad Maimonides in Buenos Aires, Argentina.

Francisco Eizayaga passed away on June 25, 2001, in Olivos, province of Buenos Aires, Argentina.

Dr. Francisco Xavier Eizayaga held the following positions during his life:

  • For 14 years he was the president of the Argentine Medical Homoeopathic Association (AMHA)
  • Director and Honorary professor of the School for Graduates of the AMHA
  • Editor of the journal Homeopatia of the AMHA
  • Honorary member of the Instituto Hahnemanniano do Brasil, Asociacao Paulista de Homeopatia, and Academia Homeopatica Barcelona
  • Co-founded the Organizacion Medica Homeopatica Internacional (OMHI), Geneva, and was its president until 1996
  • Vice-President of the Liga Medica Homoeopathica Internationalis for Argentina
  • Deputy of the French Boiron Institute (Lyon) in Argentina
  • Established the Instituto Superior de Homeopatia Clinica de la Fundacion HOMEOS, Buenos Aires, in 1988

He has published numerous articles on homeopathy and the following books:

  • Tratado De Medicina Homeopática (Treatise on Homeopathic Medicine)
  • El Moderno Repertorio De Kent (Kent’s Modern Repertory)
  • Clinical Homeopathic Algorithms (Edited by Lynn Amara)
  • Enfermedades agudas febriles (Acute febrile diseases)

His books, Treatise on Homeopathic Medicine and Kent’s Modern Repertory are included in the curriculum in almost every Spanish Homeopathy School in the world.

Dr.Francisco Xavier Eizayaga is considered internationally as one of the great masters of homeopathy and known as a homeopathic physician with absolute moral integrity and an exceptional dedication to teaching. He conveyed optimism and confidence about homeopathy, based on his results in clinical practice. He passed on his knowledge unconditionally to new generations of young disciples and inspired many homeopaths on their path to learning. One of them is Dr. Eugenio Candegabe, another famous Argentine homeopath. Francisco put him in contact with homeopathy for the first time when they were working at the External Consultation Services of the Department of Urology at the Hospital de Vicente Lopez. Eugenio Candegabe appreciated Francisco Eizayaga as a physician with a passion for his profession, and secure in his knowledge of prescribing. Among Eizayaga’s great contributions to homeopathy, Dr. Candegabe points to his enormous capacity for teaching, his  special skills as a practitioner, and his book, Kent’s Modern Repertory, which was the first translation of Kent’s book into the Spanish language. Many other homeopaths report having the good fortune to meet Francisco Eizayaga and called him a “Master Par Excellence”.

Francisco Eizayaga’s Layer Approach

Eizayaga opines that the different evolutionary states of the disease and their degrees of seriousness require different clinical and therapeutic criteria. Treating  different kinds of similitude’s requires knowledge of the pathological process and the evolutionary stage, as well as an exact clinical and pathological diagnosis of the disease, and distinguishing between the symptoms of the patient and the symptoms of the disease.

He points out that whereas allopathy only focuses on the lesional disease, and has no answer for the preceding stages, the therapeutic possibilities of homeopathy also include the preceding stages, as well as severe infectious, lesional, and tumorous diseases.

Francisco Eizayaga’s model is based on the following assumptions:

  1. Disease is an expression of the disturbed vital force. It always progresses from functional disturbances in the individual’s psyche and the general functions, to structural changes in local parts, and from slight to deep pathological manifestations. This is expressed in the following sequence:

a)     Illness in its first stage is only emotional-affective and easy to cure by returning the lost equilibrium. Within this stage ailments of the emotional and affective sphere, sensorium, coenesthetic sensations, and central nervous system occur.

b)     In the second stage the illness also involves the general state of being. General symptoms which refer to the totality of the organism, indicate the involvement of the whole economy and the homeostatic alteration.

c)      In the third stage local symptoms appear, due to the affection of organs and organ systems. Organic manifestations in acute as well as chronic diseases appear according to the known sequence of pathological stages: irritation, inflammation and dysfunction, followed by reversible and irreversible organic or tissue lesions, indicating a growing severity in the vital imbalance. The illness may have emotional-affective, general, local, only general, or only local manifestations.

2.   Based on the different evolutionary stages of the disease progress, Eizayaga distinguished between different “layers”:

a)     Morbid trends and predispositions of the constitution, no pathology

b)     Morbid trends expressed in the miasmatic terrain, no pathology

c)      The Fundamental disease with psychosomatic and general symptoms. This relates to the first and second stage of the disease.

d)     The Lesional disease with local pathology or clinical entity, which is seen as the “disease” itself. This relates to the third stage of the disease.

3.   Eizayaga classified diseases from the clinical, anatomo-pathological viewpoint as follows:

  • Functional disturbances: These comprise the first and second stage of the disease, i.e. the fundamental disease.
  • Lesional diseases: The third stage of the disease.

4.   He clearly differentiated between the treatment of the patient and the treatment of the disease, based on distinguishing between “the patient’s symptoms which precede the disease from the symptoms of the disease itself”. The treatment of the constitution and the fundamental disease comprises the treatment of the patient. The treatment of the lesional disease constitutes the treatment of the actual disease.

5.   Based on this concept he suggested treating the patient in “layers” according to their state: Treatment of the constitution, the miasmatic terrain, the fundamental disease, and the lesional disease. Treatment has to begin with the outmost layer, progressing deeper inwards with each prescription. It has to proceed in the following sequence:

  • Lesional disease: Treatment of the disease with the lesional, similar remedy.
  • Fundamental disease: Treatment of the patient with the fundamental remedy, the simillimum, to restore the psychosomatic balance.
  • Morbid terrain: Miasmatic treatment with the corresponding nosode(s) to eliminate morbid trends.
  • Constitution: Constitutional treatment with the constitutional remedy to prevent further diseases.

Constitutional layer

Eizayaga distinguished between the genotypical constitutional and phenotypical constitutional diagnosis. The genotypical constitution refers to the “way of being” of a person and their normal individual features. We are born with hereditary genetic and constitutional characteristics and certain organic structures and functions of the organs, which depend on the genotype. These may move and oscillate within a certain range, but are considered to be normal and not pathological.

Characterological features are not real symptoms, “but just psychic characteristics which pre-exist in the individual before any pathogenesis and must not be considered abnormal either, even though they are taken into consideration for the prescription“.[1] Certain characteristics and symptoms help us in prescribing the constitutional remedy because they are the differentiating, individualizing factor between patients. Even if they are not pathological symptoms in themselves, they help us to individualize the patient and remedy. Eizayaga opines that, if characterological features are found in the materia medica and repertory, besides the really pathogenetic symptoms, “this is due to the proven fact that certain individuals who possess the same psychic characteristics of certain medicines are especially stimulated by them“.[2]

The constitutional remedy is prescribed to prevent the development of diseases and future ailments that the patient may develop otherwise. It does not cure anything. It is to prescribe once the lesional and fundamental diseases have been cured and the morbid terrain has been cleared.

Eizayaga identified four normal genetic constitutions: Sulphur, Calcarea carbonica, Calcarea phosphorica, and Calcarea fluorica.

The phenotypical constitutional diagnosis relates to the fundamental disease.

Miasmatic layer

Miasms constitute the morbid terrain and determine the diathetic pathological trends of all individuals. “All human constitutions have a morbid predisposition implicit in them or, in other words, they are inclined to certain illnesses, depending to a great extent on their diathesis or active miasm.”[3]

Morbid tendencies develop slowly and according to a chronology which practically repeats itself in the majority of cases. Francisco Eizayaga identified five miasms: Psora, Sycosis, Syphilis, Tubercular and the Cancer Miasm.

When writing on What must be cured in diseases Eizayaga clearly suggests that  miasmatic treatment requires prescribing the diathetic or miasmatic nosode or nosodes to eliminate the individual’s morbid trend. Nosodes must be customarily administered in high potencies.

In another chapter of his book Eizayaga does not limit miasmatic treatment to the application of nosodes, but points out the anti-miasmatic properties of other remedies and their indications: The morbid process which arises due to the active miasm may prevent the indicated remedy from acting efficaciously, and requires application of the remedy or the nosode that corresponds to this miasm. Each miasm has its typical remedies like Sulphur and Psorinum for Psora, Thuja, Medorrhinum and Nitricum acidum for Sycosis, and Mercurius, Aurum and Syphilinum for Syphilis [4]. Regarding miasmatic treatment he states:

Ever since homeopathy has existed, right from Hahnemann up to today including the most traditional authors like Kent, miasmatic treatment has been achieved by employing the Law of Similitude through the Materia Medica and the repertory.”[5]

He also admits that acute exacerbations of the chronic miasm are effectively prevented with constitutional and fundamental treatment.

Fundamental layer

The phenotypical constitutional diagnosis relates to the fundamental disease and emerges from the pathological sufferings. It comprises the psychophysical constitution and is not measured by the patient’s skeleton, nor by the circulating humors or the predominant metabolic type. It is “measured by the dynamic dysequilibrium of a subject expressed in psychical, general and local symptoms liberated by traumatic circumstances in a predisposed, susceptible person“.[6] This constitutes the fundamental disease.

The functional disturbances occurring within this fundamental layer, may manifest on the psychic and sensitive, general or local organic level. As there is no cell destruction, but only a temporary transformation of cell structure, the pathological stages are limited to irritation, inflammation and dysfunction, with the possibility of “restitutio ad integrum”.

The psychosomatic symptoms are considered to be the symptoms of the patient and precede the symptoms of the disease itself. “They are revealing a pathological alteration of the phenotypical constitution which must be treated with the so-called fundamental remedy or simillimum with which we shall not only cause the disturbed individual to recover but also we will prevent the future evolution and organic localization of the progressing disease“.[7]

The prescription of the fundamental remedy, which is called the simillimum, is based on the patient’s characteristic, psychic modalities, general and local symptoms. “In chronic patients, not only symptoms of the current illness should be taken into account, but rather, and most principally, the chronic and pathobiographic symptoms of the patient, in order to find the profound temperamental and constitutional motivations that have lead to his present state.“[8] “The top hierarchical symptoms to base the prescription on are always those extracted from the pathobiographical history, i.e., the phenotypical constitutional symptoms, those which express the individual psychophysical temperament of the patient when faced with his personal, familial and social reality.”[9]

In functional disturbances as occurring within the fundamental layer, medium, high or very high potencies can be prescribed.

Lesional layer

Within this stage the patient develops lesional pathology due to structural and microchemical changes in the cell. The localization of the pathological process provides us with local symptoms, i.e. particular symptoms localized in organs or systems, which are common or pathognomonic. The case is curable if superficial organs are affected, even if some superficial lesion may persist. The affection of a vital organ transforms the disease into an incurable case.

Lesional diseases are classified as:

  1. 1. Lesional reversible diseases
  2. 2. Lesional irreversible diseases
    1. In lesional reversible diseases the structural alterations that occur on account of functional or organic disturbances, can be cured with “restitutio ad integrum” and complete functional recovery. They are localized when comprising a localized area, or diffuse, when comprising a whole organ or system. They may manifest as lesional reversible mental, general or local disease.

 

  1. In lesional irreversible diseases, cellular changes cannot be restored ad integrum, because cells have reached a no-return point in the pathological process. One can distinguish between focal and diffuse irreversible lesions. They are localized or focal when comprising a localized area, or diffuse, when comprising a whole organ or system.

Francisco Eizayaga differentiates irreversible diseases according to their curability and gives the following explanation: “Focal irreversible lesions may be cured clinically by means of scarring, but they cannot be cured histologically because there is no “restitutio ad integrum”. 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“.[10]

That is, lesional diseases can be grouped according to their curability into:

a)     Reversible and curable diseases.

b)     Irreversible but semi-curable diseases. This occurs in focal lesions that cannot be cured histologically but only clinically, always provided function can be restored or compensated.

c)      Irreversible and really incurable diseases. If the irreversible lesion comprises a whole vital organ only palliation will be possible. If however it comprises a non-vital organ, it will be without general repercussion.

In all these cases homeopathy offers an excellent option for treatment.

Local lesions are chronologically the last to appear and are called the “actual disease” of the individual. “The morbid localizations indicate “the illness the patient has” “, and from thence the treatment must begin.[11] In lesional diseases in which there is a clinical entity, treatment must be directed first at this organic aspect of the disease, “because it is the most serious and the one which must be aided by us first. The prescription must be based on modalized local symptoms, placing the strictly pathological or organic symptoms in a pre-eminent position “.[12]

“It is true that when a clinical disease level and a constitutional or miasmatic fundamental condition coexist, in said case the disease must be treated first and then the patient.”

F.Eizayaga, Treatise on Homoeopathic Medicine, p.292

 

To choose the remedy only the actual symptoms with their characteristic modalities have to be considered, leading to the prescription of the “similar” remedy. That is, the remedy must cover the pathological symptomatology, yet it must be individualized and modalities considered. Eizayaga emphasized that the common symptoms do not interest us as such, but that the modified symptoms with concomitants and alternating and subjective symptoms, and the rare or peculiar, characteristic symptoms are important for the homeopath. Only these give the strictly individual symptoms. He advised us to make use of all symptoms of the local disease including its modalities and concomitants, and those psychiatric symptoms that “appeared or were exacerbated right from the beginning of the disease and that are not chronic symptoms of the patient which preceded this disease“.[13]

Eizayaga also suggests investigating the fundamental remedy: “The chronic patient, who is to be found in the background of the “actual illness“, presents mental and general symptoms with their corresponding modalities of aggravation and amelioration and his desires and aversions for food. In these symptoms may be found the image of a “patient who suffers the illness“, reinforced and completed by the image that the personal history gives.”[14]

The therapeutic ideal is when the fundamental remedy (simillimum) also covers the symptoms of the clinical entity, i.e. agrees with the lesional remedy (similar), as this gives more certainty regarding success. In this case the simillimum is to be prescribed.

Eizayaga’s comments on how to proceed when the lesional and fundamental remedy do not agree, are somewhat contradictory.

He advises, that in “cases in which there is a clinical entity… what must draw our attention first is this organic aspect of the disease, because it is the most serious and the one which must be aided by us first.” [15] The prescribed remedy has to cover the active pathology by all means. Therefore, he concludes that when the investigation of the fundamental remedy reveals it does not agree with the lesional remedy, treatment should be started with the lesional remedy. Referring to the seriousness of pathology, he advises that the similar remedy for the disease should be prescribed in severe and organic cases, if this differs from the patient’s simillimum. He also advises, that in incurable cases it is “not adequate to use the simillimum remedy, but the one which covers the present sufferings“.[16]

However, in another chapter of his book he writes that the patient’s individuality will always be present and that no strict rule can be given as to whether the lesional remedy is to be taken before the fundamental remedy, simultaneously with it or after it. Each case is to be solve individually.

Eizayaga emphasizes the therapeutic limitation of the similar remedy, which merely aims at curing the “present disease”. Only the simillimum treats the individual as a person, hence the lesional remedy is to be followed by the patient’s fundamental remedy, and then by miasmatic and genotypical constitutional treatment.

Therapeutic hints from Eizayaga

Francisco Eizayaga writes that although the patient is sensitive to any potency of the indicated remedy, there are degrees of efficacy of each potency. The similitude may correspond to low, medium and high potencies, according to the susceptibility of each patient. Certain cases however, may require a particular potency for cure, and there are special cases where the patient will only react to certain potencies. The homeopath will only tap homeopathy’s full therapeutic potential if low and high potencies are used.

Eizayaga writes that any curable disease can be treated with remedies at any potencies. These include functional disturbances, lesional reversible diseases, and semi-curable lesional irreversible diseases with compensative function. Also in the treatment of curable lesions, reversible or not, medium, high or very high potencies can be prescribed.

It is therapeutically important to consider that higher potencies, diluted beyond the Avogadro’s number, do not act on diffuse or incurable irreversible lesions. Therefore, incurable focal diseases with a non-compensatory function and incurable diffuse lesional diseases must be treated with remedies applied in mother tinctures or low potencies, as only these are appropriate to their lesional similarity.

Eizayaga distinguished lesional irreversible diseases according to their curability with dynamized medicines as follows:

–         A focal lesion with compensatory function is curable with a dynamized medicine.

–         A focal lesion with non-compensatory function is incurable with dynamized medicine.

–         A diffuse lesion with destruction of a whole non-vital organ is incurable but without general repercussion.

–         A diffuse lesion, comprising a whole vital organ is incurable with a dynamized medicine.

He mentions, that it is not always possible to determine the curability of a pathological process, so that the homeopath should try treatment with dynamized medicines and will often cure what was not considered to be curable.

Acute diseases are to be treated with the acute intercurrent remedy, considering first the “pathological symptoms as the ones of greatest repertorial value for the prescription“. Eizayaga states that the remedy has to cover the most serious organic pathology and recent ailments. Psychic and causative symptoms only have to be considered secondly.

 

 

Discussion

The patient or the disease

Francisco Eizayaga’s ideas deviate in many respects from Hahnemann’s teachings. The most profound discrepancy arises from his viewpoint that the patient and the disease itself, which he views as the lesional pathology, have to be treated separately.

Hahnemann clearly points out in the Organon that it is always the whole being who is ill and that there are no local diseases.

“It is the morbidly affected vital force alone that produces disease. Therefore disease is not to be considered as an inwardly hidden wesen separate from the living whole, from the organism and its enliving dynamis, even if it is thought to be very subtle. Such a phantom can be conceived only by materialistic minds.”

§12 and §13 Organon

The disease constitutes the derangement of the dynamic vital force, which comprises the whole patient. Hence, there are no such things as “diseases” in the abstract to treat, only diseased person.

The indicated remedy, chosen according to the totality of symptoms, balances the vital force. Through this stimulus, a vital reaction is started and homeostasis reestablished. If signs and symptoms are removed, the totality of the disease with all its manifestations, is removed. Therefore, rebalancing the vital force means cure of the patient with their disease. The patient and their disease cannot be separated, but are one. This implies that there cannot be two different remedies indicated at the same time, one for the patient and the other for the disease.

When Hahnemann was searching for the “specific” remedy he referred to the individual remedy indicated in a given case. Each patient suffers from his/her own “individual” disease, which never before appeared in the same manner. Hence no true cure can take place without strict individualization. In each case, we find besides the common and pathognomonic symptoms, some characteristics that give the case its individuality and cause it to differ from all other cases. By considering the individual reaction of each patient through strange, rare, peculiar and characteristic symptoms, we treat the patient with their disease.

To view local manifestations as the disease itself rather seems to adhere to the allopathic concept, which views all diseases as local and of the cells, and disease manifestations as self-contained entities. In homeopathy the disease manifestations in one part are considered in their relation to the whole man, and the only means of cure is to treat the whole patient. Homeopathy is primarily concerned with the primary, dynamic aspect of the disease, not its pathological manifestations, which are but the results of disease, and not in any sense the disease itself. In homeopathy the human is not only considered as an individual, but also as a complete unit in himself. Kent warned us, that:

“He who considers disease results to be the disease itself, and expects to do away with these as disease, is insane. Most of the conditions of the human economy that are called diseases in the books are not diseases, but the results of disease. All that we can possibly know of “Disease” is expressed in symptoms only.”

J.T.Kent, lectures on Homoeopathic philosophy

The fundamental and the lesional disease

 

In Eizayaga’s layer model the fundamental and lesional diseases are treated separately based on the assumption that the local pathology is a self contained entity.

Hahnemann elucidates the purpose of local manifestations in chronic diseases:

It is evident that man’s vital force, when encumbered with a chronic disease which it is unable to overcome by its own powers instinctively, adopts the plan of developing a local malady on some external part, solely for this object, that by making and keeping in a diseased state this part which is not indispensable to human life, it may thereby silence the internal disease, which otherwise threatens to destroy the vital organs (and to deprive the patient of life), and that it may thereby, so to speak, transfer the internal disease to the vicarious local affection and, as it were, draw it thither. The presence of the local affection thus silences, for a time, the internal disease, though without being able either to cure it or to diminish it materially. The local affection, however, is never anything else than a part of the general disease, but a part of it increased all in one direction by the organic vital force, and transferred to a less dangerous (external) part of the body, in order to allay the internal ailment.

§201 Organon

Local manifestations in chronic diseases serve the purpose of alleviating the internal malady, yet they express and still belong to the same dynamic disease.

“The organs are not the man. The man is prior to the organs. From first to last is the order of sickness as well as the order of cure – from man to his organs and not from the organs to the man.”

J.T.Kent, Lectures on Homoeopathic Philosophy

Regarding their treatment, Eizayaga writes that local symptoms represent themselves by modalities of aggravation and amelioration, sensations, concomitants and alternating symptoms. As these do not always coincide with the modalities of the general symptoms, “it is possible that one single remedy is unable to cover the totality of mental, local, and general symptoms, where the “similar” of the local picture is one remedy, and that of the psychical and general symptoms is another“. [17]

If all manifestations belong to the same disease it is practically impossible to separate the symptom picture into different entities. By prescribing for isolated symptoms one misses the general review of the whole case as an entity. Hahnemann clearly stated that the patient’s symptoms should be taken as a totality and a remedy chosen that covers the whole.

“From this indubitable truth, that besides the totality of the symptoms with consideration of the accompanying circumstances nothing can by any means be discovered in disease wherewith they could express their need of aid, it follows undeniably that the sum of all the symptoms and conditions in each individual case of disease must be the sole indication, the sole guide to direct us in the choice of a remedy.”

§18 Organon


“The physician should never lose sight of this great truth, that of all known remedies there is but one that merits a preference above all others, viz.: that whose symptoms bear the closest resemblance to the totality of those which characterize the malady.”

S. Hahnemann, Organon

Eizayaga’s rationale is that it usually occurs, in most cases, “that the symptoms of the patient do not correspond, in their characteristic’s, to the fundamental remedy. These symptoms may be local, general, and even mental, and are those that express the recent pathological activity of the patient. These symptoms correspond to a medicine proper to the actual state and take the name of similar medicine“.[18]

So even if he individualizes the symptoms of the lesional disease by using modalities and concomitants, he still does not consider the true totality of the case and will necessarily fail with the prescription, unless the taken symptoms are strange, rare, peculiar or uncommon, and thereby truly individualizing. The symptoms of location may furnish characteristic symptoms, yet are most often the characteristic general symptoms which held the key to the case. Kent reminded us:

“The physician spoils his case when he prescribes for the local symptoms and neglects the patient. Localization is at all times a secondary state or the result of disease, while changed feelings are the primary manifestations.”

J.T.Kent, New remedies

That the patient’s simillimum does not cover the local symptomatology does not necessarily mean it will not cure. Kent also addresses this subject when writing on The value of symptoms:

 

“In ninety-nine cases of a hundred you can leave out the particulars, for the particulars are usually contained within the generals. If there be but one remedy that has the numerous generals, and covers those generals absolutely and clearly and strongly, that will be the remedy that will cure the case. There may be a lot of little particulars that may appear to contra-indicate, but they cannot; for nothing in particulars can contra-indicate generals.”

J.T.Kent, The Art and Science of Homeopathic Medicine, p.210

I would like to point out, that even if Kent evaluated the case from generals to particulars, he still considered the strange, rare and peculiar symptoms as the most important in prescribing. These may occur among mentals, generals, or particulars and must therefore be of varying importance and rank !

In § 169 Organon Hahnemann also gives us guidance on 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, and to retake the case after its beneficial action has ceased, and not to give the other remedy automatically.

Eizayaga’s prescribing procedure for cases with lesional pathology agrees with the prescribing procedure for acute cases, in which merely the actual symptoms are taken into account:

In chronic lesional cases and in the acute cases the disease is repertorized with the modalities of the individual himself in order to treat the disease independently of the chronic patient.”[19]

He suggests for lesional diseases, that “the past and not present symptoms (at the moment of registering a case) must be taken into account only after the prescription based on the present symptoms have been tried and have failed“.[20]

Again Kent gives us clear guidance as how to approach the case: “Examine the image of the case where the order was lost because that is where the image must be found… The patient’s disease has not been cured, it has only been changed and modified; but it is the same patient, and the same sickness, and requires the same medicine.“[21]

Rectifying the application of the “fragmentary” similar remedy, Eizayaga refers to §162 Organon where Hahnemann writes:

“Sometimes happens, owing to the moderate number of medicines yet known with respect to their true, pure action, that but a portion of the symptoms of the disease under treatment are to be met with in the list of symptoms of the most appropriate medicine, consequently this imperfect medicinal morbific agent must be employed for lack of a more perfect one.”

§ 162 Organon

Both argue that it may be admissible to apply partially indicated remedies, yet their rationale is completely different.

For Hahnemann it may be necessary to apply a partially indicated remedy due to the lack of remedies, and in one-sided diseases due to lack of symptoms. One-sided diseases display only one or two principal symptoms which obscure almost all the others. The principal symptom can either be an internal complaint, or a more external complaint. If the principal symptom is an internal complaint, the defective symptom picture often occurs due to the inattentiveness of the observer ! Also, local manifestations have their origin in the internal disease and arise or grow worse because the patient is inwardly ill and the entire organism involved.

“Among the one-sided disease an important place is occupied by the so-called local maladies, by which term is signified those changes and ailments that appear on the external parts of the body. Till now the idea prevalent in the schools was that these parts were alone morbidly affected, and that the rest of the body did not participate in the disease – a theoretical, absurd doctrine, which has led to the most disastrous medical treatment.”

§185 Organon

To treat one-sided diseases successfully one chooses the remedy that, based on these few symptoms, is the most homeopathically indicated. Cure is likely to happen when these few morbid symptoms are strange, rare, uncommon, peculiar or characteristic. A incompletely homeopathic remedy may not cure, but it will serve the purpose of completing the display of the symptoms of the disease, and in this way facilitates the discovery of a second, more accurately suitable, homeopathic medicine.

Eizayaga however is prescribing a “fragmentary” remedy due to limiting a-priori the prescription on a fragmentary symptom picture, which can necessarily never reflect the totality of symptoms. But Hahnemann required us always to evaluate the whole case and to base the prescription on the totality of symptoms, not fragments. It is clear that if we only consider fragments of the case we will only get a fragmentary symptom picture and a remedy that that will only partially cover the case.

“So it is the totality of symptoms, the outer image expressing the inner essence of the disease, i.e. of the disturbed vital force, that must be the main, even the only, means by which the disease allows us to find the necessary remedy, the only one that can decide the appropriate choice. Briefly, in every individual case of disease the totality of the symptoms must be the physician’s principal concern, the only object of his attention, the only thing to be removed by his intervention in order to cure, i.e. to transform the disease into health.”

§7 Organon

Hahnemann generally condemned all treatment methods which focus only on one of many symptoms that diseases present, and reminds us, that “a single symptom is no more the whole disease than a single foot a whole man“.[22]

Eizayaga further refers to §163 Organon in which Hahnemann writes:

“In this case we cannot indeed expect from this medicine a complete, untroubled cure; for during its use some symptoms appear which were not previously observable in the disease, accessory symptoms of the not perfectly appropriate remedy. This does by no means prevent a considerable part of the disease (the symptoms of the disease that resemble those of the medicine) from being eradicated by this medicine, thereby establishing a fair commencement of the cure, but still this does not take place without those accessory symptoms, which are, however, always moderate when the dose of the medicine is sufficiently minute.”

§163 Organon

After applying a simile no complete cure can be expected. Kent expressed this best with the following sentence:

“Power comes in the direction of similitude, not of intensity, and gains power only in proportion, as it is similar.”

That means, in a case where a close simile is given, some light accessory symptoms may appear which pass without undue suffering and do not prevent the cure.

“The small number of homoeopathic symptoms present in the best selected medicine is no obstacle to the cure in cases where these few medicinal symptoms are chiefly of an uncommon kind and such as are peculiarly distinctive (characteristic) of the disease; the cure takes place under such circumstances without any particular disturbance.”

§164 Organon

 

But no favorable results can be expected from a distant simile that is unhomeopathic to the case, as this will not improve the patient on the deeper planes, and tends to change the symptom picture by bringing out new increasing and persisting symptoms. The greater the dissimilarities between the symptoms of the remedy and patient, the more distant the remedy gets from the simillimum, and the more unhomeopathic symptoms will appear after its application and combine with the symptoms of the progressing natural disease.

“If, however, among the symptoms of the remedy selected, there be none that accurately resemble the distinctive (characteristic), peculiar, uncommon symptoms of the case of disease, and if the remedy correspond to the disease only in the general, vaguely described, indefinite states (nausea, debility, headache, and so forth), and if there be among the known medicines none more homeopathically appropriate, in that case the physician cannot promise himself any immediate favorable result from the employment of this unhomeopathic medicine.”

§165 Organon

The simillimum is the best indicated remedy and will cure rapidly, gently and permanently, so nothing should motivate us to limit ourselves in the choice of the remedy by prescribing on fragmentary symptom patterns. However, Hahnemann stated that it is impossible to find a remedy that fits the patient’s symptom picture exactly. Therefore, it is theoretically impossible to apply a remedy without any accessory symptoms. But if the true simillimum is applied and taken in a small enough dose, these will be hardly noticeable.

This means, the lesional remedy will only provide a true cure if the considered symptoms were truly individualizing, and the selected remedy resembles the characteristic, peculiar, uncommon symptoms of the case. In this case it must be supposed to be the patient’s simillimum.

It is clear that Eizayaga has to consider the therapeutic limitation of the similar remedy which merely aims at curing the “present disease” without treating the individual as a person. For this the patient’s simillimum has to be applied.

Eizayaga advises that in incurable cases it is “not adequate to use the simillimum remedy, but the one which covers the present sufferings“[23], and that the constitutional or fundamental remedy may provoke serious reactions in patients lacking vitality.  This agrees with the often pronounced warning that a deep acting constitutional or miasmatically chosen remedy should not be applied in advanced pathology, as this could weaken or overwhelm the vital force.

Even in advanced pathology the local malady does not exist without participation of the whole organism and relationship to other organs, and arises or grows worse because the patient is inwardly ill and the entire organism involved.

In practice two different therapeutic approaches are being used: Some homeopaths find they are more successful with constitutional prescribing even in advanced pathology, and include in their prescription the past symptoms if no current totality can be found. Others, like Luc de Schepper and David Little, suggest using a layered approach in cases that have advanced pathology, vital organ pathological changes or present with one-sided pathology. Here one should restore the function and vitality of the organ first, and work the patient backward from the one-sided state in the vital organs by reversing the symptoms until the disease returns to a more constitutional condition. As the symptoms are reversed over time one introduces deeper acting remedies and follows up with more constitutional remedies later. That is, the more active lesional layer should not be treated with a deep acting or miasmatically acting remedy. Only when the one-sided disease is subdued and the older chronic disease reappears, should it be addressed with a deeper acting, miasmatically chosen remedy. This approach allows the vital force to recuperate so it will now be able to encounter and tolerate deeper-acting remedies with a positive curative response.[24]

If advanced pathology is suspected, treatment needs to begin with the very low potencies in judiciously given doses (usually 6C), working one’s way up with increasing potencies, and preferably LM’s. This latter “layer” approach differs from Eizayaga insofar as it focuses on advanced pathology and a too weak vital force, instead of including all lesional diseases in general.

In truly incurable cases the natural disease has overpowered the vital force which is therefore unable to generate symptoms. Only palliation is possible. Acute prescribing is necessary for the more superficial symptoms with preferably vegetable remedies which act less deeply than animal or mineral remedies and are easier for the vital force to handle. These patients can only improve to a certain point, but can never be cured, only palliated during acute outbursts according to the changing symptom picture. It is best to use Hahnemann’s advanced methods of applying the remedy in water, because the dose can be readily adjusted to the sensitivity of the patient.

Boenninghausen and Boger’s repertorization methods are worth mentioning as being especially suited to one-sided cases with paucity of symptoms. Boger’s method is also suited for cases rich in particulars with marked modalities and concomitants, pathological generals, clinical symptoms, objective symptoms and pathological symptoms with absence of characteristic symptoms, and cases without many mental symptoms. Boenninghausen’s method is best to use for cases representing complete symptoms, prominent concomitants, marked sensations and modalities, when generals are lacking or strongly marked mentals are not available, in cases having suffering in few parts but no modalities for all the suffering parts, or scattered modalities.[25] Based on a different conception of the Totality of Symptoms there are different repertorization methods, each of them emphasizing different aspects to form the totality of a case, yet they all have their origin in the Organon. It is important for a homeopath to be familiar with these subtle differences so that one may apply them depending upon the prescribing data elicited from the patient.

 

 

Constitutional prescribing

 

The word constitution comes from the Latin word constituere or constitute and means to form, establish or make up.

There are different concepts of constitutional prescribing depending on the definition:

  1. Some homeopaths refer to the constitutional remedy as the remedy that covers the patient’s individual type and which is unchangeable for life.
  2. Other homeopaths refer to the remedy that covers the patient’s totality of symptoms for a chronic condition, with particular emphasis on personality and temperament.
  3. For others it relates to the innate constitution.  Depending on the layers that form on top of the innate constitution, the patient may need another remedy for his current condition.

Eizayaga’s concept agrees with the third definition. He distinguishes between the genotypical and phenotypical constitution. The genotypical constitution relates to the innate constitution, whereas the phenotypical constitution relates to the layer that forms on top of the genotypical constitution, and is called the fundamental disease by Eizayaga.

The innate constitution is the sum total of an individual’s characteristics as they are potentially determined at the moment of fertilization. It displays an inherent tendency to respond along predetermined individual characteristic patterns, and has lifelong characteristics which do not change and which are not considered morbid symptoms. The innate constitution and temperament are the major conditioning factors in the experience of suffering, they condition signs and symptoms and the development of disease. Paracelsus has written:

All man’s diseases originate in his constitution.”

 

The constitutional prescription is based on the argument that a particular person with a particular constitution and temperament has the tendency to develop certain pathological symptoms, and therefore has a particular affinity for a particular remedy and responds positively to it. All constitutional types contain healthy and positive qualities, but are also prone to certain unbalanced and negative tendencies that may develop depending on the life experiences and the influences which act upon it. Most homeopaths argue that patients who respond to the same constitutional remedy all their lives and which also covers their innate constitution, are rare today. This would mean for Eizayaga’s concept that the genotypical and phenotypical constitution agree, that is, that the remedy that covers the traits of the constitution is also the therapeutic remedy for the patients fundamental disease.

However, the genotypical and phenotypical constitutional remedy may be different. When determining the fundamental remedy of the phenotypical constitution, the homeopath has to differentiate between the features belonging to the patient’s innate constitution and the layer of the fundamental disease, reflecting those ailments and symptoms that date from the time this layer started.

When all layers are treated and the miasmatic terrain is cleared, the patient receives the remedy that relates to the innate, genotypical constitution. This is to strengthen the patient and to prevent further diseases. Luc de Schepper states that it helps “polish the diamond, by bringing out the best qualities of the constitution and minimizing any weaknesses”. [26]

 

Eizayaga distinguished the four possible genetic constitutions Sulphur, Calcarea carbonica, Calcarea phosphorica, and Calcarea fluorica.

Other homeopaths like Luc de Schepper opine that there are seven possible innate constitutions at the time of conception, with any number of possible remedy states imposed on them. He names Sulphur, Phosphorus, Calcarea carbonica, Calcarea phosphorica, Silicea, Lycopodium, and Baryta carbonica. Most of these are minerals involved in basic physiological processes, or plants which contain a high percentage of minerals.[27]

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.

Miasms

 

Miasms are like an invisible substance that overpowers the vital force and creates a weakness in the patient and a tendency to suffer from particular diseases. If not eradicated with antimiasmatic treatment they persist throughout life and are transmitted to subsequent generations.

Hahnemann clearly points out in the Organon, that knowledge of the miasms will help the physician to bring about a cure (§5 Organon), and that the indicated remedy has to cover the totality of symptoms as well as the active miasm:

“Since one may know a disease only by its symptoms, when there is no obvious exciting or sustaining cause to be removed, it is evident that only the symptoms, together with any possible miasm and additional circumstances, must guide the choice of the appropriate, curative remedy.”

§ 7 Organon

All true chronic diseases arise from a miasm. Hence miasms and constitution are closely related, and chronic treatment should include miasmatic treatment at any point of prescription.

Eizayaga’s comments that the action of the indicated remedy may be prevented due to a miasmatic block, is a well-known fact and has been confirmed in practice. In these cases the corresponding nosode needs to clear the terrain before the indicated chronic remedy can work. However, to treat miasms as a separate layer, rather seems to be escapist. His comments on miasmatic treatment are somewhat contradictory, stating at one point that they have to be treated with the corresponding nosode(s), and on another occasion he requires applying the remedy or the nosode that corresponds to the miasm to solve the case, and points out that all miasms have their typical remedies.

When analyzing his cases he rather seems to adhere to the latter alternative, which agrees with Hahnemann’s concept of miasmatic prescribing as outlined in §78-82 Organon and The Chronic Diseases.

At the time Hahnemann was investigating miasms, he distinguished Psora, Sycosis and Syphilis. Eizayaga also considers Cancer and Tuberculosis.

Case analysis

Francisco Eizayaga demonstrates the treatment of patients with the lesional, fundamental and constitutional remedy with case studies (see appendix). He emphasizes: “In all cases, absolutely in all, the constitutional underlying condition, or miasmatic or susceptible latent condition must be treated“.[28] Yet, when analyzing the described cases it is obvious, that chronic cases are presented as having been cured without the application of nosodes or the genotypical constitutional remedy.

Patients with lesional diseases:

  1. Case no.1.Repertorization of the present lesional condition: Thuja constitutional type; Simillimum repertorization: Natrum mur; prescription: Thuja, intercalating Med and Carc; years later Apis. Note by the author: The patient was “cured” although the repertorized simillimum was never prescribed. It is unclear how Thuja can be the constitutional type and Natrum mur the simillimum as both refer to the fundamental disease according to Eizayaga’s terminology (Thuja is not a genotypical constitutional remedy).
  2. Case no.2. Prescription based on present symptoms: Thuja constitutional type; intercalating other remedies now and again. Note by the author: All conditions improved without prescribing a nosode. Thuja is considered as the fundamental, phenotypical constitutional remedy that also covered the lesional disease. No nosode or genotypical constitutional remedy was administered.
  3. Case no.3. Natrum mur has been the patient’s simillimum years before and was prescribed, but without results; Ars and Apis ameliorated. Note by the author: No nosode or genotypical remedy was applied.

Patients with fundamental diseases:

  1. Case no.4. Calcarea carbonica was repertorized and prescribed.
  2. Case no.5. Natrum muriaticum was repertorized and prescribed; the autonosode made of the sputum was also applied.
  3. Case no.6. Natrum muriaticum.
  4. Case no.7. Calcarea carbonica.

In these cases no nosode were prescribed. In the where case Calcarea carbonica was applied, no information was provided as to whether the fundamental, phenotypical remedy possibly agreed with the genotypical remedy.

Eizayaga also mentions certain chronic states which could only be solved based on past constitutional symptoms which the patient had previous to the present pathology, but which are not present in the patient’s actual state. These especially applied to cases in which the “illness” in terms of pathology was cured, but certain aspects of the patient’s personality did not change. Note of the author: As the remedy only ameliorated partially (and possibly against Hering’s law) it must be seen as a simile that did not cover the whole case. However, whether the first applied remedy was truly curative and had to be followed by a complementary remedy to complete the cure, or whether the first prescription was merely palliative and caused a dissimilar aggravation that called for the application of the truly indicated remedy, cannot be judged due to missing details about the cases.

Eizayaga provides food for thought and raises many questions with his perceptions and case studies. To understand his way of thinking it is best to read his book entirely. Unfortunately, there are several contradictory comments which make it a difficult read, so that I would definitely not recommend it to the newcomer in the field of homeopathy.

Lynn Amara, who has studied and worked with Francisco Eizayaga, commented on his approach, that “it is a mistake for homeopaths to interpret his work as saying to treat the Lesional layer first. He encouraged treating as deeply as you could. It is as if the client comes with a pocket full of change, some pennies, nickels, dimes and quarters. The pennies are the Lesional, the nickels are the Fundamental, the dimes are Miasms and the quarters are the Constitution. We would like to find the constitutional remedy right from the beginning, but what if all that is brought to you are pennies from a car accident. You may need to prescribe on the Lesional layer and treat the sequelae of the car accident. But if someone brings you 25 pennies, well then, do consider how that came about and treat as deeply as you can.”[29]

Jose Eizayaga points out, that some points in the book Treatise on Homeopathy “do not agree with Francisco Eizayaga’s way of thinking at the end of his life, but represent antiquated ideas which do not agree with the reality.”[30] Unfortunately, till now no further writings have been published or provided to evaluate his further thinking and amendments.

Although the book Treatise on homoeopathic medicine contains some misrepresented facts and contradictory comments, it is still full of gems and insights of a dedicated homeopath. My advice for every homeopathy student and practitioner is: Read and study as much as you can, and gain as much practical experience as possible, to arrive at your own conclusions !

Katja Schütt

Appendix

Copyright: This article is reprinted from Dr.Francisco Xavier Eizayaga’s book Treatise on homoeopathic medicine with friendly permission of Jose Eizayaga.

DISEASES ACCORDING TO THEIR DEGREE OF SEVERITY

Dr. Francisco Xavier Eizayaga

Homoeopathic action has been traditionally confined to certain diseases, predominantly psychical, psychosomatic, functional, such as allergies, rheumatism and others, while the possibilities of efficacy of homoeopathic medicines for severe, infectious, lesional, tumorous illnesses have been denied. This somewhat light and precipitate concept was maintained by renowned authors. In our opinion, this is an error that, on one hand, comes from a narrow view of the therapeutic possibilities of different homoeopathic dilutions and medicinal potencies and, on the other hand, from a lack of proper knowledge of the disease as considered according to the different evolutive stages. The so called “unicists” homoeopaths, followers of Kent, adhere to high potencies and disdain material dilutions which are below Avogadro‘s number.

The “organicists“, in contrast, generally prescribe only low material dilutions. lt is therefore evident that both groups will thus have fragmentary or incomplete viewpoints of homoeopathic therapeutics and, consequently, of its real possibilities. Not having a clear idea about the kind of disease and of the degree of the tissue lesion pertaining to the disease, leads to regrettable mistakes and confusion, more so when bearing in mind the diverse kinds of similitudes which the homoeopaths must handle (see Chapter IX).

CLASSIFICATION OF DISEASES ACCORDING TO THEIR DEGREE OF LESION

 

In general, diseases which affect human beings follow a familiar evolution which goes from the slightest to the deepest pathological conditions. Thus, disease as an expression of lack of harmony of the vital force, starts by showing disturbances proper of each patient, corresponding to his emotional and affective sphere, his sensorium, his coenesthetic sensations, his central nervous system, his peripheral nervous system -the latter two being his means of communication par excellence. The general symptoms which indicate that the individual’s whole state is disturbed, appear later: tonism, temperature, appetite, thirst, sleep, sweat, reveal a homoeostatic alteration, i.e., an alteration of the process of physiological autoregulation of the internal medium and of the body temperature. In the process of aggravation of the morbid condition, later on, the organic systems or the organs in themselves are affected. Progress of morbid mechanisms leads to an organic localization of the disease in which the four classical pathological stages occur: irritation, inflammation, dysfunction and tissue lesion (see Chapter XII).

This sequence generality takes place both in a chronic disease as in an acute one, with the difference being the time it takes to develop. As regards the causes of cell lesions and cell death, these may be classified in the following general groups: 1) hypoxia: 2) physical lesions; 3) surgical lesions 4) biological agents;

5) immunologic mechanisms; 6) genetic defects; 7) malnutrition; 8) aging.

1) Cellular Hypoxia: the most frequent mechanism is due to a decrease of oxygen in the bloodstream (ischemia), whether due to primary arterial occlusion (arteriosclerosis), or to intravascular clots (thrombosis or embolisms). For instance, myocardial infarction, cerebral apoplexy, kidney infarction, etc. Other times it is due to an incapacity of transporting oxygen in the erythrocytes (anaemia, poisoning due to carbon monoxide).

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.

ANATOMO-PATHOLOGICAL CLASSIFICATION OF DISEASES

 

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.

TREATMENT OF LESIONAL DISEASES

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.

DEMONSTRATIVE CLINICAL HISTORIES

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.

Bibliography

 

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.

References

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

Footnotes

[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 https://hpathy.com/homeopathy-interviews/david-little-interview-1-2/

[25] see https://hpathy.com/homeopathy-repertory/repertorization-methods-kent-boenninghausen-boger-an-overview/

[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: Hpathy.com

[30] Reprinted from private correspondence with Jose Eizayaga

Websites

http://www.lanacion.com.ar/nota.asp?nota_id=315346

http://www.homeopatia.org/index.php?option=com_content&task=view&id=212&Itemid=42

https://hpathy.com/homeopathy-interviews/dr-eugenio-f-candegabe/

https://hpathy.com/past-present/history-of-homeopathy-in-argentina/

http://www.simillimum.com/education/little-library/the-works-of-great-homoeopaths/pdghgjahr/article.php

https://hpathy.com/homeopathy-interviews/david-little-interview-1-2/

https://hpathy.com/homeopathy-repertory/repertorization-methods-kent-boenninghausen-boger-an-overview/

Images

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 (simillimum.com). Her current focus lies in working with animals and studying history, the old masters, and research.

3 Comments

  • 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.

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