Minutus

Hi All-
This is an actual case and so would like to your input in this. I
would like to know what medicine you would select from a MIASMATIC
view point and why- or tell me even if it is a miasmatic disease. I
promise I would not criticize, make fun of your names or pelt stones
at any ivory towers. ( My behavior would be so exemplary you could get
to call me St.Hahnemannian, the Materialist)

This is an honest attempt to correct my ignorance - an ignorance that
has made people even question my homeopathic credentials...

Patient, in seventies, male, thin as a nail, and also as sharp, keen
eyes, respectful, accompanied by son. Interview went comfortably.
Farmer, works in the field had worked till 4 days back, heavy manual
work. Goes to work rain or shine. Wife does the same. Presents with
Bilateral inguinal hernia for past 4 years, first right and then left,
soft, no pain. When doctors had run preliminary tests before surgery,
found out that he had hydroneprosis left kidney and multiple stones in
right, elevated BP 180/110, Urea elevated; patient had reacted to the
dye injected for tests - had problem speaking and tremors of tongue in
the morning on waking for 2 days( this I found out only later).
Had never been to a doctor before that he could remember, hardly ever
fell sick, no h/o any other ailment. Had a bout of ?flu 2 months back
with some cough following that. Took home-made pepper brew for this
and not treated allopathically. Nothing significant about that that he
could remember or elaborate. No family h/o TB, diabetes, hypertension
or cancer. Parents lived upto around 90 years. No h/o any extra
marital affairs/
non-drinker, non-smoker. Sleep good. No special dreams. Normal bowel
movements, normal urine flow.

Visited his son in another town, his son took him to the doctor on his
own and not because of any complaints from the patient and these
events/ diagnoses followed.
--What do you think the miasms that are present here and what is the
most active and why do you think it is so? I did not think
miasmatically so I cannot comment.

As mentioned previously - this is for discussing and just to see what
comments come up for purely educational purposes - so no bullying or
flame-throwing or brow-beating...

Surely every case has a miasmatic recognition to it, even if well mixed
one should be able to identify the direction the case has come from and
what dominates it and where it is going.

This case seems to be mainly physical and little on the mental or
emotional although his dutiful hard work could be brought into the
equation.

I would offer it as a mixed miasmatic influence - sycotic for the over
production of stones and blocking of the ureter. Maybe add the duty
bound approach to life to this, uncomplaining - although this is also
highly kindled with a psoric influence as well. Some syphilitic
influence with the organs not functioning, breaking down.

Hernia suggests a weakness, mainly physical, from all that heavy manual
work. Hernias are 'out of place' happenings, displacement,
internalisation of external problems.

Allergic reaction to dye? Or maybe just the body rejecting a foreign
substance. If allergic then Psoric.

The tongue trembling and difficult speech is more curious - might
indicate a mental problem or the core of something of a more nervous
origin - psoric.

So over all Psoric and Sycotic influence. Lycopodium fits for me if a
remedy mention is required.

Best wishes, Joy

http://www.homeopathicmateriamedica.com
http://www.homeopathicmateriamedica.blogspot.com
[Non-text portions of this message have been removed]

Joy-
Thanks for the good elegant analysis. I would have gone that way too.
Now think about this case without analyzing using miasm theory. We
know this is a chronic condition developing over a period of time.
We know that we have nosodes etc.

1)If you were to think of some remedy that could cause this picture -
what would it be? Let us say you do not know Lycopodium to be
trimiasmatic or multimiasmatic.

2) Could this cancer miasm? Neoplasms could cause all this- could
cause hydrohephrosis when they block, could cause destruction of
tissue and might keep silent till the last moment many times as has
happened in this case.

3) Of course Syphilis and Gonorrhea can cause this. Can this also be
Tubercular miasm? TB is capable of causing all these... But there
are also a bunch of other things like Leptospirosis and other
infections ( Chlamydia etc) that could cause this, I guess some of
these might be part of sycosis.

4) One of the Differential diagnosis for any condition that could
cause hydronephrosis ( tubulo interstitial diseases) is heavy metal
poisoning - Lead etc. Could these be considered as well? Are they
miasmatic or not?

5) How about snake poisons?

6) WOuld you build a hierarchy of symptoms here in terms of newness
or old symptoms or current vs chronic symptoms etc?

Once again thanks for your comments.
--- In minutus@yahoogroups.com, Joy Lucas wrote:
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Actually I don't see my approach as being that of miasm theory, it is
just the way I look at most cases - what has influenced the case
historically and what the case might suggest for the future and this
inevitably brings into play miasmatic influence.

The case you quoted appeared to be of someone of relative good health,
very few serious illnesses, easily takes care of an acute such as 'flu
like sx, lives a life of apparently hard work and has survived into his
70's. However you could be wary of someone who hasn't been challenged
with much illness throughout life - just a like a child who doesn't get
the typical childhood illnesses - it 'can' suggest a build up for later
life. Many of this person's physical complaints could well suggest a
serious physical pathology developing - kidney stones, blocked ureter,
hernia, difficult speech, trembling tongue. That is quite a breakdown
coming at once and could well suggest a cancer diathesis, especially
when there is a mixed miasmatic influence, cancer being a mixture of
the miasms. Also if the rx required is Lycopodium we already know to
what extent this rx lends itself to cancers of varying kinds but not
everyone needing Lycopodium will develop cancer - every case will be
different and your quoted case could be a number of other rx anyway.

When you take a full homeopathic case you always include family history
and that too will give an indication as to what to expect with the
individual in front of you. There will be an inherited miasmatic trait
as well as what the individual has a susceptibility to (maybe the same
thing?)

To try and address your points below...

1) it is important to know what miasmatic influence each and every
homeopathic rx is inclined towards, whether it be singular or mixed -
why? because it is useful, it helps us understand each and every rx and
each and every individual case - you are not going to give a syphilitic
rx to a psoric person and expect it to be the simillimum (except in
your dreams)

2) yes it could be a cancer miasm - hard work with no play, blockage,
misplacement of tissues, lack of reaction generally etc and this would
be compounded if there were a f/h/o cancer, if not then it could be
viewed differently maybe such as a change of diet to reduce the
tendency to stones and gravel blockage etc, change of lifestyle to ease
the hernias. One needs to know the cause of the difficult speech and
trembling tongue (curious sx) and they need a context.

3) if Tb were at the foundation of this I would say that f/h/o would
possibly show this and likely is that the chosen rx (hopefully the
simillimum) will have an affinity to TB and if it were a cancer rx then
it will have anyway, won't it?

4) this is interesting and the possibility of toxicity should be
explored during case taking and could resolve a case quickly but even
toxicity cases will arouse only those susceptibilities within (from a
miasmatic point of view). For example, if the simillimum were to be
Lycopodium then what is the cause/link to the curious sx of the speech
and trembling tongue (other than the fact this is represented in the
proving sx). In other words why does Lycopodium have these sx? I'm not
going to write a thesis here (I'm trying to get away for the weekend)
but I would say it is something to do with the internalised fright,
fear, anticipation, even anger that this rx has. If this isn't shown in
the well known dictatorial and/or apprehensive nature so well known
with this rx then it does become very internalised to the point of
serious physical pathology (that this client has) and more specifically
to curious sx such as a trembling tongue - the trembling tongue being
the metaphor for all that internalisation instead of a more obvious
apprehension etc = no surprise, potential cancer pre-disposition.
Eventually nothing to do with toxicity but it would need to be ruled
out.

5) don't know what you mean by snake poisons, do you mean rx or has the
client been bitten by a snake, either way I do not see the typical
haemorraghic tendency in this person. Are you hinting that the
trembling tongue suggests a snake rx over and above a rx with a uric
acid diathesis ??

6) a hierarchy is just that - the totality of sx placed in a system of
ranking and grading. New sx are especially important because they often
represent the presenting complaint, that which the person has decided
to come and see you about, at which point they feel they need curing
and will also represent the progression of the diseased state. But the
totality is vital and needs the ranking/hierarchy to give shape to the
case. ALL sx should be ranked in my opinion, not only graded
individually e.g. 1,2,3,4 etc but ranked in priority of the whole case
vis what needs to be cured. For me this represents at least 50% of the
case work done - do this well and it becomes easier all round, in my
opinion anyway.

Hope useful, best wishes, have a nice weekend, Joy

http://www.homeopathicmateriamedica.com
http://www.homeopathicmateriamedica.blogspot.com
[Non-text portions of this message have been removed]

Hi Hahnemannian,
As to your question whether this represents miasmatic disease, that's
the same (in Hahnemann's terminology) as asking two things: (1)
whether it represents "chronic" disease, and (2) whether the cause of
that "disease" is from weakness in the patient's physiology, or whether
it is from external causes (toxicity, inappropriate circumstances,
etc.), or "errors of lifestyle". (I know that "miasm" is sometimes
used to refer to infectious diseases, but I'm using it just in the
sense of the major chronic miasms.)

If the "disease" results from inappropriate lifestyle or circumstances,
then Hahnemann did not class it as miasmatic disease, but called it an
"indisposition" and simply counseled the person to clean up their act.
(And acute-type remedies could be given to help the recovery, but he
seemed to say that usually that would not be necessary.)

But if there is weakness / disease / etc. in spite of a reasonable
lifestyle and circumstances, then we'd consider that a miasmatic
(chronic) disease. Altho I think most cases will be pretty clear in
this respect, there's plenty of room for "judgment call", and some
people are simply sturdier than others, which (according to what I was
taught) does not necessarily have to do with presence or absence of
"miasmatic taint".

So (below):
Sounds to me like good health thus far. Nothing yet to suggest any
miasm other than *possibility* (not certainty) of psoric.
Maybe this is sign of constitutional / miasmatic weakness, or maybe
it's just a result of long years of hard work! (If I had more medical
background I might have a different opinion...)
I'd take this as signs of miasmatic weakness (tho not much of one so
far!).
What miasm? I won't try to say at the moment. Stones-maybe either
psoric or sycotic? Hydroneprosis--"inflammation of the kidney due to a
blockage in the ureter"... I don't know, maybe again either psoric or
sycotic, but I'm only guessing.
Reacting to a dye that usually gives no problems seems like a psoric
overreactivity, I think? The other things here also suggest the
presence of some chronic / miasmatic imbalance, but that's all I could
say...
Sounds like a healthy guy.
Which makes it more likely that what weakness he *does* have, seems
psoric rather than another.

Is he having any trouble from the hernias?

I'd go with psora, and an enviably light dose of it.
Why was the poor guy injected with dye, and has he now fully recovered?
Cheers,
Shannon
[Non-text portions of this message have been removed]

Thanks Shannon for your analysis.

Yes - he did reocver after the medicine I gave- this is a case of
mine about 10 years back and I was able to get the urea and BP come
back to normal. Hopefully he is ok now. The dye was for radiological
studies...

The case is presented to find how the members feel about the case
and what miasms are seem to be active and how much of a consensus in
miasmatic approach comes up...

Do you think some of these have in terms of organ involvement and
pathology gone beyond Psora or not?

In terms of remedies have you got anything in mind - like what it
might be?

In this case what would be significant for you to prescribe on?
That he is "slightly" psoric? Or his symptoms/ signs?
--- In minutus@yahoogroups.com, Robert & Shannon Nelson
wrote:
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I saw that it is not classical miasmatic approach. The difficult
speech and trembling tongue came up only after the dye and had
resolved in 2 days. He was talking normally when he saw me. That is
why I did not know that there was a problem with this. I came to
know this only after I had given him the remedy and the next day he
woke up with the symptom recurring and the son desperately called me.
And since this had already occurred we waited and the next day this
symptom disappeared.

Family history was very unremarkable. This man is from avery
backward village and had no education to speak of.

Thanks
--- In minutus@yahoogroups.com, Joy Lucas wrote:
it is
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as 'flu
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Well...
Actually I don't know/remember enough about the "pathological"
aspects... If it were a real case for me, I'd be reading up and
soliciting doctors' and others' comments. But I'll try...

But about recovering, I wondered whether the speech and tongue problems
were transient, due to the dye, and went away on their own? Or did it
continue to cause him trouble? If it did not go away on its own, I
would give that great significance; less so, if it did. In either case
one rubric I would look at is "Generalities, Medicaments, allopathic
medicine, oversensitive to" (18 rxs).

Below:
I don't know enough about the issues to have an opinion on that, I'm
afraid. But to determine the associated miasm, from my understanding
the issue is less about how serious the pathology is, and more about
the *process* involved--inflammation, overgrowth, destruction?

How serious were those problems considered to be?
In your opinion (as someone who has both homeopathic and medical
training) was it surprising that he wasn't suffering in some way from
the conditions, or was it the sort of that that one doesn't necessarily
notice (unless / until some further point)?
"Slightly psoric" (*if* that was my conclusion, and I'm not prepared to
commit to it yet) would do nothing more than perhaps help refine my
choice of remedy. For instance if I plugged in all the sxs and one rx
that "ran thru everything" was mercurius, or Med, or some other remedy
prone to extreme states and having very little to do with psora, I
would pass it by pretty quickly, no matter how nice the "numbers"
looked. I assume you would do the same, tho for reasons other than
miasmatic thinking?

Well, I'll look again and see...

****
Patient, in seventies, male, thin as a nail, and also as sharp, keen
eyes, respectful, accompanied by son. Interview went comfortably.

Farmer, works in the field had worked till 4 days back, heavy manual
work. Goes to work rain or shine. Wife does the same.
_____
Presents with
Bilateral inguinal hernia for past 4 years, first right and then left,
soft, no pain.
know how to prescribe without more information. I'd ask about the
circumstances of each one--was it from an injury? What was he doing at
the time? What did/does it feel like, modalities, what else had
changed during that time (any changes to generals or mentals)?
________
When doctors had run preliminary tests before surgery,
found out that he had hydroneprosis left kidney and multiple stones in
right,
medically *and* how (or whether) he experiences them.
____________
elevated BP 180/110,
realize this is high, I am not sure *how* high it is considered to be,
but I think not extreme, especially for his age? (And if I'm crashing
wrong about that, I apologize... The folks I'm working with are not
offering me that sort of information, so I am rusty!)
_______________
Urea elevated;

___________
patient had reacted to the
dye injected for tests - had problem speaking and tremors of tongue in
the morning on waking for 2 days( this I found out only later).
(And again, consider the rubric re "sensitive to medications".)
__________
Had never been to a doctor before that he could remember, hardly ever
fell sick, no h/o any other ailment.
is so healthy, or is it because he is so "suppressed", or vital force
so weak? My impression from what you've said is that his situation is
the first--he simply sounds like a healthy guy, who is nonetheless
beginning to age.
__________
Had a bout of ?flu 2 months back
with some cough following that. Took home-made pepper brew for this
and not treated allopathically. Nothing significant about that that he
could remember or elaborate.
___________
No family h/o TB, diabetes, hypertension
or cancer. Parents lived upto around 90 years.
guy.
_____________
No h/o any extra
marital affairs/
non-drinker, non-smoker. Sleep good. No special dreams. Normal bowel
movements, normal urine flow.
_______________
Visited his son in another town, his son took him to the doctor on his
own and not because of any complaints from the patient and these
events/ diagnoses followed.
hernias, or ??

*************
assume I would be prescribing either an Eizayaga-type "constitutional"
(and Joy's suggestion of Lyc sounds promising to me) or else on the
basis of local symptoms (sensation, modalities, concomitants).
beginning, but only that.
The only prescribing method I have any real training in, is the
two-hour, whole enchilada, every-little-detail approach. I've been
intrigued how much some people can do, with how little (of what to me
seems necessary) information, and I really enjoy hearing how other
people approach these problems--even the ones that are "not classical",
and whether I agree (or understand!) or not. I am looking forward to
hearing what you gave, and what your indications were!

Thanks!
Shannon

He had developed hydronephrosis in one kidney and this could be due
to stones once again. Stones because heavy manual work in hot fields
and probably drinking less water... the other one was developing
stones too...

Yes the dye reaction had subsided on its own after 2 days.

You said:
But to determine the associated miasm,
about
Perhaps members or you could clarify on the miasm aspect... all of
these miasms are separate by their nature and one does not grow out
of another...and this is the classical approach

But I have seen writings where they have a different process like
yours in place inflammation for psora, sycotic overgrowths and
syphilitic destruction...to a certain extent this is what Joy had
written as well

But at the same time there are more than 3 miasms also in which case
this 3 way explanation will not be correct... And moreover if we
really go into cell level analysis it is very difficult to
differentiate in terms where one process ends and another starts and
so we would end up making all conditions trimiasmatic.

What if there are multiple pathologies in a person ( like this
patient)
There is a renal failure and on the face of it because of failure we
might think it is psoric but a lot of overgrowth and destruction has
gone on to come to this stage which means it is almost like the
second round of a cycle of psora, sycosis and syphilis- in the first
go around there were minimal changes with all three and now the next
cycle starts...
Thanks for your input.
-- In minutus@yahoogroups.com, Robert & Shannon Nelson
wrote:
problems
did it
I
case
allopathic
of
come
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consensus in
I'm
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I don't feel I can speak with any real authority about some of your
questions, but will give the best of my understanding; below:
This seems very plausible to me, and in line with the (so far as I can
see) very healthy history. (Tho I have to agree with Joy that there
*could* be elements of disorder that aren't apparent: are his few
illnesses because of good health (as it appears to me) or are they from
"lack of reaction" (which is possible, tho the description and history
don't suggest that to me). But if it's decided that the kidney issues
are simply from his lifestyle and inadequate water, then that would be
only a minor player in any prescription, but he should be instructed
very vigorously about the importance of "staying hydrated"! (Yeah,
could be tough to impress on such a person, unless he *has* actually
experienced problems with it...)
Which to me suggests unusual sensitivity (a clue toward a needed
remedy), but not *so* extreme, since he did recover promptly on his
own.
I agree with that, and I am confused by talk about e.g. psora "turning
into" sycosis and etc.
A somewhat related view that *does* make sense to me, tho, is that
problems develop at progressively deeper "levels", as the vital force
(or whatever we choose to call the mind / body's homeostatic mechanism)
begins to lose ground to the chronic disorder. Now if the VF is *not*
losing ground to it, then the disease will be acute or "half-acute",
not chronic--because the *definition* of chronic disease, which
Hahnemann describes as being caused by an external agent which
gradually overpowers the VF.

So there may be "latent" sycotic or syphilitic elements which will are
"stored away" at first, but can (according to this model, anyway)
become activated at later stages. I suppose that model and process
could look like a process of psora "turning into" sycosis.
So far as I'm aware, that represents what Hahnemann wrote.
Today people are using the term in a much broader context. Some people
are using it specifically to mean "chronic miasm", which I suppose is
sloppy speaking, and others are using it to mean any communicable
disease. And it's also been used to refer to any chronic and
inheritable condition, tho this might not be a really accurate use, I
don't know.

In any case the e-way explanation is only a general outline. The
symptom totality chosen for *prescribing* can vary according to the
approach the practitioner is taking (obviously).
Can you give me an example?
Some people have compared these three miasms / processes with
Ayurveda's three doshas. Certainly each process is involved in the
process of growth and life itself. When we see a process occupying its
proper role, that is a sign of health; when we see it expressing in a
counterproductive way (excess, deficiency, mis-timed or out-of-place),
then that is a sign of (I would say part of the definition of) disease.
You have to decide which are circumstantial (e.g. not drinking enough
water?); which will right themselves once circumstances are normalized;
and which are coming from physiological weakness or mistunement (to use
Hahnemann's term).
So you have to decide what is driving the process, and treat the
underlying imbalance rather than the individual expressions--unless the
severity or other limitations of the situation dictate a more
superficial (and less curative) approach.
What do you mean by "second round of a cycle of..."?

To my thinking (at this point anyway) the main value of miasmatic
thinking is that it can help us stay oriented to the underlying nature
and processes of the case. Sometimes that isn't an issue--if you have
a very straightforward match between remedy and case; or a clear
causation; or an acute or trauma--miasms probably wouldn't be much if
any consideration. But in a deep chronic case, you need to make sure
you're matching the deep, chronic processes. Probably one can do the
same thing by simply having good familiarity with the remedy and *know*
whether its nature (pace, tissue affinity, types of changes caused)
does or doesn't suit the case.

Thanks for the discussion!
Shannon