Francisco Eizayaga was a Argentinean homeopathic doctor, whose taught in the 1980s in North America and Europe He died in 2001. He gave a new insight into homeopathic theory and has developed a new view of illness and disease. His theories are to some extent at variance with the Kentian philosophy and practice as taught by George Vithoulkas and his students.
Eizayaga's ideas are explored in depth in his book Treatise on Homoeopathic Medicine . Eizayaga sees life as an triangle; at the bottom the wide base represents birth with disease layers eventually leading to the point of death being at the top , "inside out" (reversing the order of these "layers" from the above), he describes the "layers" of the individual's disharmony as
Division 1 BIRTH- the miasmatic terrain
the genetic heritage the person brings into life is as it were the soil in which disposition to diseases will grow . e.g.allergies, illness and chronic diseases later on. Remedies that affect this level are Nosodes. Sometimes this level has to be treated, sometimes not. The routine interposition of a nosode-requiring
"Miasmatic layer" or morbid terrain could introduce a routinism based on a particular image of the structure of the individual that differs from Hahnemann's empirical pragmatism. In The Chronic Diseases, Hahnemann advocates treatment and elimination of Psora as a process that might require a succession of remedies, each prescribed in the same manner to the presenting totality of characteristic symptoms as this picture shifts in the course of treatment. The "Morbid terrain" is also considered to be a miasmatic "diathesis" or predisposing susceptibility. Eizayaga gives 5 fundamental "miasmatic diatheses": the Psoric, Tuberculinic, Syphilitic, Sycotic and Cancerinic terrains. If the treatment reaches a block and seemingly appropriate remedies fail to act then consideration should be given to treating with a miasmatic nosode .He advises that this "morbid terrain" be treated specifically with the corresponding nosode when required.
The work of David Lilley and Rajan Sankaran cover this area in some (albeit controversial ) detail
The miasmatic nosodes are not distinguished fundamentally from remedies from other sources,when looking at the fundamental and constitutional levels. The presenting symptoms of Psora individual would be addressed not necessarily with Psorinum but with the remedy that emerges as the simillimum to the characteristic totality of the disharmony of the patient. Eizayaga keeps the nosodes to the terrain level and considers the miasmatic non-nosode remedies (eg calc carb , sulphur) in the constitutional layer
Division 2: The Constitution
This is what the person is when they are born. These things can't be changed-they may develop and present completely formed in adult life.- the bone structure, build, color of skin, color of eyes, hair, etc. food likes and dislikes . temperature desires – heat /cold preferences There are few remedies that work here. Most babies are fat, sweaty, and like milk. Most fit Calc carb. Some who are hot and dry may need Sulphur. Some need Phosphorus. Some need a mix - as seen in Calc phos., Calc sulph.
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"The Constitutional layer" - the physical and character features of the person which are in the individual before any pathology develops, These features are not considered abnormal. These are not treatable or curable as they are not diseases, Eizayaga says that, "We only advise to prescribe the genotype's constitutional medicine to prevent future ailments. In other words, to prevent the diseases from which human beings will fatally suffer ... This constitutional remedy does not cure anything; it just prevents disease."
work of Jan Shoelton on minerals and elements covers this to a large extent
Division 3: The Fundamental.
This is a "layer" that comes by living life. The baby whines and the mother thinks to herself, "he must learn to wait. It will be good for him to learn patience- any way I am too busy right now."
The baby thinks, "Why does mummy not respond when I cry? Does she not care? Has she abandoned me? " – and later becomes a clingy, whining Pulsatilla. These "layers" can build on each other - the loss of a friend in school may lead to the withdrawal of Nat mur, or the hysteria of Ignatia etc.
So far, none of these stages are treatable with conventional medicine yet the body is out of balance There are no diseases yet so there are no medicines. Homeopathy however helps restore balance.
The Fundamental layer" corresponds to the “ symptoms of the patient" that come before or seem otherwise unconnected "symptoms belonging to the disease."
These can be the mental/emotional symptoms of the patient with no precipitating cause but rather reflect the persons response to their illness state They also consist of vague physical general disturbances with no particular organ implicated, "the typical symptoms of the patient who will suffer from future diseases and which therefore 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." Jonathon Shore’s work is involved with this level.
Division 4a: Lesional (treatable, reversible, curable)
As things progress physical pathology appears. This point conventional medicine are employed as physicians often feel they are helping. This layer, can be cured with homeopathy to the point of the pathology being removed.
Division 4b: Lesional (treatable, non-reversible, semi-curable)
At this point we find irriversable changes to the physical body which although treatable can never be completely cured. with tuberculosis lung damage cannot be reversed, or of alcoholics with cirrhosis (severe liver damage). The process can be treated and cured, but the organic damage cannot be reversed. The patient's health is compromised.
Division 4c: Lesional (non-treatable, non-reversable, palliation)
The physical pathology is past the point of responding to treatment. homeopathy However can offer palliative care.
In the "Lesional layer" – are the symptoms and signs that spring from the disease process." Eizayaga's writings may be misunderstood. , he says (p. 257, para 5): "There is a very clear dividing line between the patient's symptoms and the symptoms of the disease. It consists in the localization of the pathological process in an organ or a system that provides us with the so-called local symptoms which Hahnemann called 'localized'." The meaning of ‘patient’s symptoms are those non- specific ones to the disease process that the patient will throw up under any illness and this is part of the constitution – eg the patient is very weepy- but she always is when she is ill no matter what the illness. A few pages later (p. 260, para 5) he says that, "In order to select this 'local' medicine, we recommend not to reject any symptom of the disease or clinical entity, its modalities and concomitants, but on the contrary, to make use of them all. The psychic symptoms of an emotional, affective, or volitive type and the mental symptoms corresponding to the intellect and to judgement (psychiatric symptoms) will be immensely important and will constitute a fundamental aid in individualizing the acute medicine, on the condition that all these symptoms appeared or were exacerbated right from the beginning of the disease and that they are not chronic symptoms of the patient which preceded this disease." One could consider two rather different definitions of a "lesional layer"; the first, more restrictive definition consisting only of the localized/regional physical symptoms; e.g.renal symptoms but excluding any psychological upsets and concomitant diseases not related to the renal symptoms and the second, more of a Hahnemannian totality of those symptoms judged relevant to the current diseased state of the individual, spread across organ systems but including the reactions also that arise from the fundamental layer and non specific to all her illnesses Neither is what I think is meant – It is rather the summation of symptoms and signs of the lesion with the person’s own response peculiar to that disease process and that process alone.. • The "lesional remedy" can either be the same or complement the "fundamental" remedy, the latter, representing a pathological alteration dependent on any underlying "fundamental" susceptibility. Adding the causative nosode (eg a bowel nosode or an auto nosode ) to the lesional remedy treats both the terrain and the causative agent and accelerates the cure 25% to 50%
Division 5 DEATH
Finally Death is the point where the body’s vital organs can no longer function nor can their decline be reversed to a point where life can be maintained
Eizayaga said it is a mistake to give the Fundamental remedy instead of the Lesional remedy.
The example he uses is that of a menstrual problems characterized by a stringy discharge.
Kentian philosophy seeks to treat at the constitutional or even the fundamental level at the first and subsequent prescriptions.
If you treat the Fundamental (i.e., Pulsatilla) she will feel better, but the discharge will remain. The Lesion MUST be treated first (Kali-bi), and then the Fundamental.
"miracle cures" happen when the Lesional and Fundamental ARE the same remedy - then *everything* gets better. If you only the Fundamental will not cure the Lesional if they are in need of different remedies.
So, first you have to cure the Lesional, then the Fundamental in their respective orders . Then, maybe the next underlying Fundamental - until you either get to the Constitutional, or you run into a block and have to go to the "Terrain" and clear that up first.
In practice there is often the need to progress through more than a single remedy to the cure the person and bring them back to health., Eizayaga and Hahnemann would be in agreement that, in cases presenting with physical pathology, there is often would likely come up with the same remedies, in much the same manner. However, they would likely disagree with their justification for this observation. Eizayaga’s method is a development of Hanneman’s work rather than a completely different system
The distinguishing features of Eizayaga's approach to analysis of cases is the search for the layers in the case. When we analyzing a case, Eizayaga suggests that we look at the patient’s disharmony as consisting of a series of concentric "layers", from the surface moving inward described as the:
• Local/regional disease
• Fundamental layer
• Morbid terrain
• Constitutional layer
He advises that we address these consecutively from the outermost layer first (lesional), progressing "inwards" through these layers with successive prescriptions as necessary.
Eizayaga notes three possible types of cases, The patient may present with each of these layers "outermost".
(1) A localized lesion or clinical entity - Local/regional disease, "symptoms of the disease" showing. i.e that which the patient is complaining
(2) Psychosomatic illness only ("patient's symptoms", preceding organic disease) no illness being present but a tendency showing through possibly coming out at times of stress but then receeding- this is fundamental layer showing. This is a fundamental case
In psychological diseases the same principle applies ; treat the lesion first. However the lesion to be considered is often a fundamental lesion ;the starting point of the condition and may be in the distant past. The fundamental lesion can be considered the specific and clearly defined start of the case
(3) No pathology, but only "morbid trends" or a condition of susceptibility expressed in the terrain or in the constitutional characteristics of the person. There are no symptoms showing however.
There are several derivations available by misinterpreting Eizeyaga’s work. Two of these are the erroneous ideas that –
(1) There is a choice, based on our belief, to prescribe
On characteristic totality of "the person" constitutional layer On the the characteristic totality of all "the diseases";past and present Fundamental (lesional layer) or for that matter, that the "characteristic totality of the person" and the "characteristic totality of the disease"( a fudge between prescribing possibly two remedies that closely fit the lesional layer and the fundamental layer and a remedy that fit each partially) at any point in time are or could possibly be different;
The principle is that you always start with the current lesional disease(s)
(2) That in addition to recognizing the lesional layer we can also see the deeper layers while the disease process is still present – the fundamental layer can only been identified when the lesional layer has been cured though hints may be there like distant mountain peaks . Similarly the constitutional layer may only be seen once the fundamental (illness ) layer has been cleared Whilst , they are multiple facets of the totality of the person in the present – that we cannot "see through the layers" to the remedy(-ies) that will be needed in the future and certainly this should not be included in the first prescription
When the lesion is repertorised one would expect the fundamental remedy to be present in the broader rubrics. E.g. if the patient presents with pain in the hand then that ‘ broad rubric’ will contain the fundamental remedy thogh this may not be the one indicated for the particular disease in question. We also have to remember that our repertories are still incomplete particularly for the strange rare and peculiar aspects of diseases.
It is for the "carefully observant physician" to tease out the characterizing aspects of the case initially and subsequently as the disease proceeds to cure.
The chapter in which Eizayaga introduces the preceding concepts of "layered" treatment is titled "What Must be Cured in Diseases." In Hahnemann's aphorism 3, "To be a genuine practitioner of the medical art, a physician must: 1. clearly realize what is to be cured in diseases, that is, in each single case of disease...the correct remedy in the correct dose and at the right repetition must be used"
\the Eiziyaga methods develops the theme found in the Organon, aphorisms 173-185
Hahnemann say in these aphorisms that, in treating these "local diseases":we should also see the bigger picture Eizeyaga says that this is a multi-stage process
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He says Hahnemann supports the idea of "layered" case but refers to them as partially covering the similitude ( in Par. 163) and this partial similitude is the lesional layer (in Treatise, p. 259) that " Hahnemann recommends a Partial remedy to be used
we may feel we are treating through "layers" of the illness, we are in fact still treating the same imbalance. By using a succession of remedies we are not "peel off layers" Rather we are clarify our view of the imbalance that has always been there .
Eizayaga's advice on how to prescribe for local diseases is the same as Hahnemann's. His reason for this method is quite different. Eizayaga says that we are to find the simillimum for the imbalance that is well-described by the local disease symptoms, and only then to follow at a later stage with remedies for the underlying pre-morbid conditions and predisposing states that allowed the body to come to these ends(fundamental layer).
Hahnemann asserts that we must try to find as close a remedy to the similimum as we can We then refine our prescription as the case changes under the action of that probably imperfect remedy Eizayaga and Hahnemann agree that we cannot predict the progression of remedies given in a case at the outset and- the case needs to be re-taken following the response to each remedy.
In aphorism 175 of the Organon, Hahnemann warns on prescribing on single lesion diseases. First, in, "Diseases with an internal main symptom that appear to be one-sided are, in fact, often not one-sided. Rather, the medical observer, due to inattentiveness, has not completely tracked down the befallments that are at hand for the completion of the outline of the disease-gestalt."
Secondly in aphorism 189, "Little cogitation is needed for it to dawn on us that no external malady (except for those that arise from particular external damages) can arise without internal causes, can persist in its place or even grow worse, without the cooperation of the entire (consequently, sick) organism. Such external maladies could not come to light at all without the concurrence of the entire rest of the condition and without the participation of the living whole ... the emergence of such an external malady will not even allow itself to be thought of apart from its being occasioned by the whole of the mistuned life, so intimately do all the parts of the organism cohere and form an indivisible whole in feelings and functions."
• • Eisayaga gives the following example of an acute case – A 3 year old boy with asthma • Lesional symptoms – Frequent status asthmaticus – Been treated with steroids & beta agonist – Agg 2-4am – Worse damp – Worse exertion – Worse seashore – Grinding teeth – Mapped tongue • Remedy suggested =Arsenicum • • Fundamental symptoms – Developed because of forsaken feeling – Fear of dark fear of alone – Desires affection – Weeping easily • Remedy suggested =Pulsatilla
• Constitutional symptoms – swollen fat abdomen – Sour perspiration when sweating – Soft flesh – sensitive to cold – Feet out of bed at night – Desire for milk eggs • Remedy suggested =Calc carb • • He had Been treated with calc carb without result • Treated with arsenicum – asthma disappeared forever • Then treated for 4-5 months with pulsatilla • Then calc carb
• teh asthmatic child is calc carb by constitution • but his asthma appears as an arsenicum picture • • You may see the constitutional picture underneath but the totality of symptoms of the acute disease is arsenicum Namely • Worse at midnight • Fear of dying • Fear of loss of control • Onset of fastidiousness • Burning in lungs • Desire for sweets • Salt • Eggs • Sour perspiration • When he was treated with calc first it brought on an aggravation
fundamental case. They have ,as it were, a ‘fundamental lesion’. Someone presents with a fear of the dark. This has been since the age of eight’ The patient discloses that this was the time when they were abused in their bed. The fundamental treatment will be the abuse remedies; fear remedies; delusion remedies (staphsaagria; opium &c) along with appropriate psychotherapeutic counseling. The homeopathic treatment will facilitate that fundamental lesional healing to take place. Then other fundamental remedies can be used – and so on. There is a caveat that these cases should only be handled by practitioners with extensive experience in this field. It can be very destructive to the patient who is forced to disclose these details for no therapeutic reason and with no appropriate back up of readily available psychological services . The patient yet again feels out of control over a very intimate aspect of their life.
• • Constitutional case • Child 8/12 • Health routine check- • Mind alternates with fright • Big head • Sweats on head • swollen fat abdomen • Sour perspiration when sweating • Soft flesh • sensitive to cold • Feet out of bed at night • Desire for milk eggs
• Treatment withCalc Carb will be preventative for the future • Eg otitis ; catarrh • 1 /week- • Prevent relapse after cured • Or nosode beginning of winter • Maintenance of health • Constitutional remedies are well known polycrests and include • Calcarea carbonica --
Lycopodium --
Medorrhinum --
Natrum muriaticum --
Phosphorus --
Pulsatilla --
Sulphur --
Tuberculinum --
(carcinosin) • (Silica) • (Tarantula) • This article takes it's inspiration from severeal sources including Will Taylor's article at http://homeopathyplanet.com/audesapere/study%20room/Library/LibraryEizayaga.htm This article compares in greater depth the work of Eizayaga and the organon of Samuel Hanneman. Also the Work of the Late Julian Wilson http://www.wholehealthnow.com/homeopathy_pro/eizayaga_layers.html
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