The Application of Alfonso Masi Elizalde’s Method In Case Taking Study of Substance through Accidents

The Application of Alfonso Masi Elizalde’s Method In Case Taking Study of Substance through Accidents

Examples with Anhalonium Lewinii and Case Report

A. Introduction:

The Application of Alfonso Masi Elizalde’s method in case taking allows us to make a hypothesis about the metaphysical origin of the patient’s disease. That is, it allows us to perceive the aspect of divinity the subject is reflecting, which in good part he manifests, and also, what he is rejecting of his human nature, and in what he is envious of his Creator.

The objectives of this work are:

Ø To propose the application of all steps of the method designed by Alfonso Masi Elizalde to the patient’s spontaneous report.

Ø To deepen one of its steps: the study of modalities, in accordance with the thoughts of Aristotle, Saint Thomas Aquinas, Hahnemann and Flora Dabbah.

The spontaneous report, an invaluable and irreplaceable resource, and place of permanent return, the source of re-readings, of the first discourse and the first impression, and possibility for future consultations, is the basis for our analysis.

The method to categorize the symptoms has the following steps:

1. Spontaneous report.

2. Construction of the themes, either by analogy or similarity of symptoms.

3. Grouping of themes.

4. Theme of the modalities (Aristotle’s categories).

5. Formulation of pillars.

6. Totality of Psora in its secondary stage (projected).

7. Totality of Psora in its tertiary stage (reactive).

8. Nuclei of suffering, nuclei of primary Psora.

  • a. transgression or guilt.
  • b. incapacity or loss
  • c. fear of punishment
  • d. nostalgia
  • e. justification
  • f. nucleus of reconciliation

9. Study of the altered function according to Aristotelian-Thomistic scheme.

10. Study of the language.

11. Hypothesis about the metaphysical origin of the disease for each medicine.

12. Symbolism, and related ideas, which are used for the confirmation of the hypothesis.

13. Repertorization of symptoms, lecture of Medical Materia.

14. Selection of the medicine.

15. Prognostic observations.

The study of modalities allows us to access the finest observation of the subject’s operations and the analysis of the totality of his sensations and alterations (the material cause), to observe how the functions are directed towards his object and intention (the final cause), and the distillation of the essence (the formal cause).

Aristotle enunciated and described the following categories:

Substance, Quantity (How much?), Quality (How?), Relation (with the other), Location (the motionless area surrounding him), Time (When?), Position (of the parts among each other), Action (What is he doing?), Passion (What is he suffering, the suffering), Habit (clothes, adornments, weapons).

In this way we can, with the specific tool for each thing, form an image before us, which reflects with great precision an important aspect of the patient’s life. There appears an image before us, which will surprise us and the patient, if we did not notice it with the naked eye.

We can use one or another scheme according to the nature of the material we obtain from the report of the patient.

We can transform themes, words, a modality, a gesture or an attitude into symptoms or into the repertory language.

We can conclude directly from the miasmatic dynamics or from the themes to the medicine.

The patient can tell us something with the anecdotes of his life, and the manner in which he bears them, about the nucleus of the loss, the nucleus of the transgression, of the fear of punishment and nostalgia.

The study of the functions of the soul can demonstrate to us the location of the lesion and guide us to one or another medicine.

We can change from one scheme to another, from the beginning to the end, supported by this plot so well thought by our wonderful teacher.

In this way, the method is an invaluable instrument for the selection of the simillimum.

Methodological clarifications:

After this short enumeration of the steps of the method follows:

B. The evolution of thoughts about modalities – concept of substance and accident

C. Examples of accidents with Anhalonium Lewinii, and from patients who have evolved with Anhalonium Lewinii.

B. Study of the modalities

Hahnemann said in the Organon: “Diseases will not cease to be dynamic aberrations of our spirit like life manifested by sensations and actions; that is, immaterial changes in our way of being ...”

In Paragraph 133 he asked the experimenters:

” On experiencing any particular sensation from the medicine, it is useful, indeed necessary, in order to determine the exact character of the symptom, to assume various positions while it lasts, and to observe whether, by moving the part affected, by walking in the room or the open air, by standing, sitting or lying the symptom is increased, diminished or removed, and whether it returns on again assuming the position in which it was first observed, – whether it is altered by eating or drinking, or by any other condition, or by speaking, coughing, sneezing or any other action of the body, and at the same time to note at what time of the day or night it usually occurs in the most marked manner, whereby what is peculiar to and characteristic of each symptom will become apparent..”

Following the idea of Hahnemann, and based on her observation of the construction of repertories and materia medicas, Flora Dabbah elaborated the following classification:

A) Symptoms of the way of being permanent, worthy of cure.

B) Characteristic symptoms, symptoms of the way of being temporary.

A) The symptoms of the way of being are fixed, and do not change dependent on circumstances.

These are the symptoms of the personality. Characteristic symptoms:

Ø Characteristics per se:

  • Illusions
  • Dreams
  • Sensations as if
  • Gestures
  • Attitudes
  • Behavior
    • Intensity
    • Frequency or alternation
    • Characteristic symptoms depend on circumstances – accidents

They answer the questions: How? When? Where?


1 – Time

frequencies – constant – day and night – periodically – alternating

2 – Weather – change of weather – seasons

open air – hot air – wet air – sun – storm – heat – moon

3 – Movement

walking – fast – in open air – ascending – descending – traveling – dancing – rocking – closing eyes – physical exertion – crossing the street – rest – etc.

4 – Occupations

mental effort – thoughts – memory – studying – concentration – reading – writing – calculating – playing piano – sewing – sedentary occupation

5 – Position and laterality

upwards – downwards – backward – outward – inward – sitting – standing – lying- bending – rising

6 – Location

streets – closed places – narrow places – high places – in the house – room – bed – darkness – crowd

7 – Others

alone – in company – conversing – talking – if interrupted – when touched – if looked at – if carried – screams – rudeness

8 – Cause

causeless – by trifles – bad news – horrible things – music – noise – drafts – nightmares

9 – Emotions

anger – sorrow – crying – depression – lamentation – mortification – reproaches – fright – excitement

10 – Functions

eating – breakfast – lunch – dinner – drinking – wine – alcohol – beer – coffee – hot drinks – cold drinks – perspiration – urination – evacuation – loss of fluids – getting wet – coitus – menstruation – pregnancy – nursing – menopause – sleeping – waking – falling asleep – when opening the eyes

Until this point it is what Flora Dabbah described.

And in Paragraph 15 Hahnemann said:

” The affection of the morbidly deranged, spirit-like dynamis (vital force) that animates our body in the invisible interior, and the totality of the outwardly cognizable symptoms produced by it in the organism and representing the existing malady, constitute a whole; they are one and the same. The organism is indeed the material instrument of the life, but it is not conceivable without the animation imparted to it by the instinctively perceiving and regulating vital force (just as the vital force is not conceivable without the organism), consequently the two together constitute a unity, although in thought our mind separates this unity into two distinct conceptions for the sake of facilitating the comprehension of it..”

This seems to respond then to Aristotle’s concept of Substance and Accident:

The Substance (from Latin: substantia, sub: under, and stare: be (estar), what’s below, the essence or entity of something

The Substance is what is called “a this” like men, animals, plants (“what is not said of a subject”)

The thing that exists in itself and not in another.

Accidents are only “ways of being this”. Accidents are the ways in which the substance manifests.

The thing which does exist in another being.

Words, if taken in isolation, express one of the following things: substance, quantity, quality, relation, location, time, position, action, habit, passion.

If, in this particular case, the word is applied to the human or animal, we can say:

These are the modalities, modes, ways, and circumstances in which any suffering or thing that happens to us men or to our animals can combine and transform into symptoms.

We could say, for example:

• Usually we all suffer hunger, thirst, sleepiness, tiredness, fear, boredom, hurry, impatience, pain.

• We all remain sitting, standing, lying, walking or running, or can bend and turn in the bed, alternately, and according to our physical ability.

• We all sometimes like to stretch the body, to lay in bed, rest.

• We all are more or less jealous, loving, bossy, orderly, meticulous, industrious, ill-humored.

• We all are affected by changes, death and financial loss, journeys, farewell.

• Sometimes, we all like to be alone, or together with friends, to get visits, to watch and be watched.

• We can all crush the finger in a door, stumble, take something forward, or fall.

• We all are more or less sleepy on waking, or drowsy after eating.

• All babies need more attention in the evening, and we are all tired at the end of the day.

• We all like to get home, to take one’s clothes and shoes off, and to have a warm shower.

• We all like to listen to music, to talk, listen, converse, and also to remain silent.

• We all perspire, suffer from heat, cold or tiredness.

Any of these situations is our life.

Isolated or combined at random does not mean anything.

United, with each other, in a fixed way, constitutes a symptom.

We give now, if possible, an example of accidents of the substance Anhalonium Lewinii for each of the classifications


Increased analytic discrimination.

The sexual desire came back dramatically at 1 p.m.

Many abundant ideas.


Aristotle divides the quality into four groups:

a) According to the effects on the subject in terms of quantity: THE FIGURE

b) According to whether the subject is capable of activities: POTENCE AND IMPOTENCE

c) According to whether the subject is susceptible to alteration: THE PASSIBLE QUALITY AND PASSION

d) In respect of whether he can be good or bad, conditioned as nature: HABIT-CAPACITY AND DISPOSITION.

a) FIGURE: The respective disposition of his different parts

b) POTENCE AND IMPOTENCE: That which the substance has immediately at it’s disposal for the operations. The immediate principle of operation. A certain way of being, in this or another way. The physical strength to execute or not. In case of impotence one refers to the potence if it is weak.

Drank much water and did not need to urinate.

The vision surpasses all mental functions.

Loss of execution because of an excessive visual sensation.

Cerebral dissociation accompanied by numbness of the limbs and tongue.

Loss of execution.

Lost mobility, the body is as if moving through thick molasses.

Feeling of impotence, sorrow and shock.

Tired legs, sensation of a weight upwards.

Extreme fatigue, did not want to do anything, dozing.


Susceptible to alteration; follows or produces a sensible alteration. The alteration is verified; sensible qualities of the matter, color, sound, odor, taste and heat, and the physical properties of bodies: solid, liquid or gaseous. The passible quality is durable, the passion is ephemeral and temporary.

Emotional action in all perceptions.

The residual image lasts all day.

Acute vision, in sunlight.

Cloudy vision with headache.

Green is experienced as taste.

The images are internalized into the ear, sound.

Hypersensitivity of senses.

Sensitivity to odors, there is an unusual ginger odor, and although it is so strong, it is not noticed by anybody, I felt I could suffocate.

Coldness, pallor. Feels cold. Pale discoloration of the cheek.

Coldness of genitals.

Partial peripheral anesthesia.

Lack of vital heat.

Blurred vision, ameliorates by warm bathing.

Dreams of pleasantly warm water.

Frontal headache, dull, like a cramp.

Dryness of the scleras, internal dryness.

Softer stool than usual, less gases.

Feels dead. Cold.

Sensation as if the heart had stopped.


To be good or bad, in being or activity. If they are close to being good, virtue; if they are far from being good, vice.

Division between the conscious and unconscious life.

Depersonalization. Loss of self conscience. Loss of feeling.

Introverted. Loss of the existential horizon. Feeling of the lost position.

Handles everything concentrated now. I feel strong, firm, capable to take charge of the world, I felt comfortable. Feet and arms could move, and I could walk there, open and balanced, I’m in my world and take charge of it well.

Cautious, firm and alert. Feels free.

Always ready, alert, conscious. Increased vibration.

Cosmic mysticism. Egotism. Flight of ideas.

Egocentric introversion. Euphoria, ecstasy, enjoyment.

Beautiful food. Full of color. Organic.

d.2 THE DISPOSITION: The dispositions change without difficulty, are changeable. They refer to the internal senses.

Detached, lonely, mistrust. Withdraw from reality, retreat.

I don’t feel so self conscious while talking to others.

Standing beside/by himself.

Desire to experiment with himself (masturbation?)

Wants to do the things in slow motion, as if the mind and body were moving through thick molasses.

Ability to draw abstract conclusions.

Spontaneous, open to expressing happiness, feel tired inside in the true sense.

RELATION ad aliud

“Orientation to another being”

Self identification with the environment.

Aversion to being touched.

Mistrust, thinks that he is laughed at, that his companions laugh at him.

Slight aroma of perfume in the air. One reminds him of his dead mother.

I say good bye to someone whom I will not see again; wanted to enjoy the moment.

Feels left aside. Family relations: I argued with my parents. Felt that I missed being closer to my family.

Fatigue: tired feeling in the evening, especially if there are other people around, easily tired by others.

Impatient with the boy.

A sister married. Secret marriage. The family is annoyed and felt left aside.

ACTION actio

From Latin: agere, to act, realize,

power – the act to act.

It is almost a sensuality, a pleasure to take care of myself. I really liked it.

Egocentric introversion. Observes himself. Pondering.

Walks through a shop, smelling the perfume his mother used. Keeps on walking back and forth, smelling it.

Sudden changes of attitudes toward the action.

Avoids decisions, irresolute.

Submerges underwater.

Handles everything concentrated now.

Feet and arms could move, and I could walk there, open and balanced, I am in my world and take charge of it well.

He goes swimming in the sea, which is unusual because he normally does not like cold water, feels very good.

There are large groups of animals in a forest. I guided kangaroos and dogs to a safe place, “I must take care”. Two giant friendly dogs, they will hurt every hunt animal.

I’m riding horses in a large field.

TIME: When?

“The time is the motion measured in successive instants, it is the measurement of movement and change”

Distention: He feels bloated after eating a little, in the morning on waking.

Rigid neck on waking.

Fatigue: tired feeling in the evening.

Aggravation at noon.

Anorexia and nausea: late in the afternoon, and early in the evening.

Irritable in the evening.

Alternations – periodicity – Sequences – concomitants – recurrence:

Waking from a dream at one o’clock in the morning, ameliorates when defecating.


“The immobile surface that surrounds the body immediately”

Increased orientation towards the environment. Feels attracted to the rocks.

Lies down besides a moss-covered rock which feels very comfortable, leaving a warm impression for the rest of the day.

Uncomfortable sensation of the environment and surroundings:

I was in ruins with a friend. Ugly sensation, we shouldn’t be there.

“No, there is plutonium all around, we shouldn’t be here, we don’t belong to this place. Ugly sensation, we shouldn’t be there. There was a very old wall, which collapsed. Ominous feelings. Only during the day. I felt anxious.

Darkness ameliorates.

I wanted to go out to feel the coldness in the face.

Lost in the middle of nowhere.


Lying ameliorates.

Restless motion of feet while lying in bed.

Gnawing pain in stomach, felt hot and did not want anything in the body, sensitive, as if there was something over the body.

Numbness of buttocks when sitting in meditation.


Self care attitude, I’m using good bathing salts, and humectants after showering, wearing comfortable clothes.


What he suffers reluctantly, what he suffers.

The ideas and visions penetrate the consciousness of the individual in a quite rapid succession; they seem to impose themselves on the individual who cannot control them. He is unable to resist them and is forced to listen and answer them verbally. This is as if the logical mind would lose control and as if the subconscious or part of the supraconscious mind would take command.

(In this case it is the passion that floods the consciousness)

Sensitivity to odors, there is an unusual ginger odor, and although it is so strong, it is not noticed by anybody, I felt I could suffocate.

Sensation as if cutting wire, or pliers, would dissect the head.

Anxiety in the heart. Constriction of the heart.

Oppression of the heart.

Hammering in the body.

Anxiety, panic, hurry.

Anxiety about death.

Throbbing pain, crushing, internal, in the skin. Sensitive nipples.

Severe cutting pain.

Color produces a metallic taste.

Pain in the occiput, the bones wanted to move, pulsations. Exploding.

Pulsations behind the eyes.

Overburdened by responsibilities, sad, as if he had done something dishonest.

A dog patient died, and although I had only been with him for some minutes, I felt sad and cried. I had a bad conscience because if I hadn’t been so selfish and had considered his urgency, the dog would be still alive.

Anxiety, slightly anxious about her son, whom she did not see for about a month, during his travels.

Euphoria, ecstasy. Enjoyment. Cosmic mysticism. Sensation of being borne by music.

Aversion to the sun. Photophobia, needed sunglasses.

Dreams: of disasters. Children in danger. The planet explodes. Women decide to kill themselves.

Necessity to go.


From all these descriptions we can say that Anhalonium has the following big themes:


1. He himself and the environment

2. Visions

3. Cosmic egotism

4. Execution capacity

5. Coldness, pallor – warm water

6. Self care, I feel very good, comfortable.

7. Disasters.

8. I must take care of, and guide animals. Overburdened by responsibility. It is as if had done something dishonest.


I. He himself and the environment

II. Visions – distortion and confusion of senses

III. Indiscrimination

Seeing the different modalities we can make a detailed analysis of the suffering and the reactive attitudes, it is enough to read them and to know:

How does he suffer ? The discrimination of the environment is missing: sensitivity to odors, I felt I could suffocate, gives us the material about how he suffers. I had a bad conscience because if I hadn’t been so selfish and had considered his urgency, the dog would be still alive. Overburdened by responsibilities, sad, as if had done something dishonest.

How does he defend himself when he flees ?

Avoids decision, irresolute.

Submerges underwater.

As in alterlysis, the modality of the relation is described is follows: aversion to being touched. Mistrust, thinks that they laugh at him.

How will he be if he assumes the attribute? He is God, (immaterial), egocentric introversion, observes himself. And he is in everything: Increased orientation toward the environment. Attracted to the rocks.

When it tries to impose: Handles everything concentrated now. Goes swimming in the sea

And conclude that: What does he think got lost.

Self identification with the environment. Loss of the existential horizon. Distortion of perceptions, shapes, space, all objects. Confounds present with eternity. Hopelessness. Anxiety about death. Loss of execution. Ceased outside activity. Lost in the middle of nowhere.

Wanted to be like God who is in all things, present and as the cause of their being.


That God is transcendent (distinct from the world, a, 1 ad 3), but is in all things because everything is subject to his power, because everything is present to his eyes (“presence”), and because he acts in everybody as a cause of their being (“essence”, a.3). Transcendence and immanence do not oppose in God, because he is distinct and intimate at once (a.1, ad 1).

This is so because God is simple (q.3) and perfect (q.4); he is not “circumscribable”, he is infinite, and therefore he can be everywhere (q.7; q, 8)

C. Example of a patient

C.E., female, 53 years old, professional, three children, two grandchildren.

She has received Anhalonium six years ago. I brought this history because this patient led us to study this medicine many years ago.

There are many symptoms that the patient brought to the consultation after taking the medicine. The patient did not consider them as such. Only when the symptoms were cured, she noticed that she liked more to live in this new way:

Seeing the reality, without feeling the need to flee. Without adapting to others indiscriminately.

Modalities – Accidents of the patient C.E.



Habit or capacity:

• Clairvoyance, premonition.

• She noticed that she is more in the reality with medication.

• She began to swim, they noticed in the “Ateneo de la Juventud” that she was swimming, walked with a swimsuit now, took the handbag, went, and made something.

• I moved to my own house.

• When I discovered that my job was useful for someone else. I made an appointment with a woman who was dead, the husband appointed her to the studio, and I suggested him to help.

• I also felt relief when I put my hands to cure, what I see is what I asked for, people cure.


• Absent-minded.

• He says that he gets dispersed from every little thing.

• Her husband does not see her.

• She adapted herself to others: They did not let her go to make gymnastics or did not bring her to the training.

• I feel something that I do not like.

• I can not verbalize what I am feeling.

This indifference always reciprocates; there are no quarrels, nothing.

• I realized that this is what happens to me: I do not notice what bothers me.

After medication:

I have to cover my eyes because it was so much that I saw in this new state.

• After medication: She did not use her glasses so often, and now she puts them on when necessary to see.

• Before she did not dream, now she dreams every day. Her dreams were strange and sometimes there were premonitions and such things, but now she dreams.

• She thinks she was better at work. For her the work is a great challenge, because she started when she was major, it made her afraid, and the fear paralyzed her. She could not do it, now she demands it herself, has done it now, and it has helped her a lot.

• I also felt relief when I put my hands to cure, what I see is what I asked for, people cure. I feel something that I do not like, I can not verbalize what I feel.

Passible quality:

• Cloudy vision with headache.

• Menses brought her pain at the back of the waist, she had to remain bending double. Felt anxiety before, did not know what to do.

• The pain in the leg is like an insensibility.

• I see that my hands and feet weaken when I’m walking, I don’t know.

• Each time when I’m nervous my hands are warmer.

• At times I feel my body revives.

• The ear ameliorated.

Potence and Impotence:

• When she is very nervous she weakens. Finally she noticed that she got to be more constipated. She noticed this last week, she was a little constipated.

• She eats everything, everything she likes, but she eats a little accelerated, swallows. She needs to eat less for the hunger. They work a lot in the studio, sometimes she skips lunch, and only asks for little things. She tries to eat food, not junk food.

• Almost breakfasts nothing, at lunch a cake, a sponge cake, and at night she eats steak with puree or a banana, or an alfajor [1] . In any case she eats little, a platter with pasta and tomato. Anhalonium p.3

• She likes water, milk and pizza, organic food. Belly full, heart happy.


• Her fears are like an obsession, and give her the impression of black waters. If it is very cold, she is terrified by a landscape of sea and dark waters.

• She did not discriminate herself from her environment, she lived the outside as if it were herself.

Now she has two new attitudes: One was to use glasses to see because she began to perceive the environment in another way, accompanied by the necessity to cover her eyes because the reality appeared to be so new and much. Before, she did not know that the environment and she were different things.

Although she lived with her family and had company at work, she was isolated, in a shell, introverted, absent-minded, enclosed in her world. With Anhalonium she could discriminate herself, and finally she broke away from her husband as well as her partner.

For many years she enjoys:

• The power to take decisions: before medication she was unable to make
these decisions.

• The ability to discriminate herself from the rest: she bought a house for herself, another for her studio.

• She takes care of others.

These are the symptoms for which I prescribed Anhalonium to h er six years ago:

1 1234 1i MIND – CLAIRVOYANCE 28

2 1234 1i MIND – PROPHESYING 7

3 1234 1i DREAMS – VISIONARY 45

4 1234 1 MIND – MISTAKES, making – localities, in 32

5 1234 1 VISION – DIM – headache – during 26

petr. nat-m. phos. sil. sulph. anh. bell. stram. nux-m. ars. lach. Nux-v.

About the author

Nora Caram

Dra. Nora Caram
Arevalo 2279 - Cap. Fed.
Tel: 54 - (11) -4771 - 2257 Cel: 54 - (11) 15 - 45320078
e-mail: [email protected]

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