Miasmatic: this represents the inherited or acquired terrain of the client with predisposition to specific patterns of disease (psora, sycosis, syphilitic, tubercular, cancer miasms). Eizayaga taught that this aspect of the case could be addressed by nosodes or remedies with strong miasmatic affinity.
Eizayaga strongly advised that the initial engagement with the client must address the organic (lesional) disease. The remedy selection for the lesional disease may agree with the constitutional or fundamental symptom pictures, but if there is not similarity, Eizayaga directed the practitioner to begin the case with the similia for the lesional aspect. Once the case has begun in this way, the dialogue of the vital force will bring about changes in symptoms that direct the further remedy selections. He taught that after the lesional disease burden has been lifted from the body, the vital force is more able to engage other aspects.
As I began to work with this approach, the clinical results my clients experienced improved substantially. While the aspects Eizayaga defined were clearly identifiable in my clients, and helpful to consider, they did not cover all of the circumstances presented by my clients: the woman with no menstrual period in the three years since a contraceptive depo-provera injection, the child unwell since a DPT vaccination, the Nevada client with very high uranium levels, the triathlete who had disrupted his kidneys when he became severely dehydrated in a competition held in a remote desert location. Eventually, I added the three exterior boxes to Eizayaga’s initial four, to include the voices of a weakened organ, the sequelae of medical therapeutics, and the effects of body burden and lifestyle impacts in the case.
Deconstructing the Client Report
For our example client, Jane, we can look at her case as all one cloth, and attempt to choose a remedy that covers all of it. This is what I would have done in my early years of practice. Eizayaga’s approach directs me to consider it differently, looking at the various aspects:
|Fundamental||The bone spur with needle like pain on motion, and easy dislocation of left shoulder suggest flouric constitution|
|Constitutional||Her fears, recurrent dream, desire for open air and disturbances of sensorium such as the light sensitivity / lachrymation are current indicators of her state. Her past eating disorder as a coping strategy in the ‘out of control’ time after her father left the family is characteristic.|
|Miasmatic||The family history of cancer and diabetes, along with her personal history of mono indicate a cancer terrain in the case|
|Lesional||Her hormonal function is disrupted; she had a concussion/head injury about a year and a half ago, and menses stopped 18 months ago. Sequelae of head injury can include symptoms that mimic pituitary tumor, such as amenorrhea, even when there are no physical findings of pituitary abnormality.|
She is still having headaches with the same nature of pain as after she had the concussion – more seldom but still there.
|Iatrogenic||Her menses stopped after she stopped taking oral contraceptives. Unclear if this is related to the rx or the head injury since they both happened about the same time.|
|Organ||Ovarian insufficiency can arise as a sequelae of anorexia. She may or may not have been ovulating while she was on oral contraceptives – unclear because she did not test it in the past.|
|Environmental||Her work schedule disrupts normal sleep (maintaining cause?)|
Eizayaga advises engaging with the lesional aspect of the case first. In this case, the etiology of her menstrual cessation was unclear (medications? head injury?). However, she is still having headaches since her concussion. Based on this, I chose to give Jane a 1M dose of Arnica. Three days later, she called to report that she experienced a typical headache the next day for about 30 minutes, then started her menstrual period the next day after that.
This strategy of deconstructing the symptoms into aspects of the case, allowing for the opportunity to identify a similia for each aspect rather than looking at all the symptoms together, brings forward therapeutic options that would not have been considered when I was looking for one constitutional remedy to address the state of the client. Once a remedy has been given, careful attention is paid to the change in symptom pattern when the client returns for a follow up. The dialogue of the vital force through the symptom changes indicates the next step at each consult. Eventually the client ends up with a deep constitutional remedy. It has been interesting to me how many times I have worked with a client in this way, and eventually been led by the symptoms to give a remedy that I had tried as a constitutional remedy at the beginning (while there was still a variety of lesional disease) with no result, only to see that it acts deeply when given later in the process of healing.
Listening for the Voice of the Client
Over time, I have come to listen to clients with the nuanced ear of Eizayaga, hearing the dominant voice of any of these aspects in each consult. As I sit across from a client, I consider the case taking to be an event similar to a dinner party. At the table, each aspect of the case has a voice. While several of the voices may make an entrance into any given consult, it is notable when one voice comes strongly forward. For example, over a series of consults, our example client, Jane, may focus strongly on one specific aspect in her symptom report. She may describe the miasmatic pattern in one consult, as if the vital force is calling for the related nosode or a remedy with a strong miasmatic affinity. She might speak through the voice of a constrained organ or body system. She could come in and describe her experiential dilemma in her way of dealing with life that would call for a constitutional remedy choice.
My experience of working with Eizayaga’s strategies has shown me that there is benefit in assessing the case by looking at each aspect, and that addressing the lesional aspect of the case often opens the door to healing more reliably than working continually with a constitutional remedy choice. Certainly a deep constitutional remedy is the goal so that the client experiences greater health overall. This approach gives me a steady path to get there.
More information about Dr Eizayaga’s concepts and strategies can be gleaned from his book, Treatise on Homeopathic Medicine.