A friend of mine has symptoms of several miasms - cancerous and tuberculous are dominant. There is a mixture of miasms in his family:
Grandmother myocardial infarction, father myocard. inf. and tuberculosis, cancer of the colon, mother atheroma, severe pneumonia in early childhood, chronic nose bleeding, metrorrhagia causing abort, skin cancer, herpes, one sister cancer of breast, the other cancer of skin.

It is difficult to decide, which nosode should come first. He is in good physical condition and denies to have any disease. His general physical symptoms, modalities are very similar to Lycopodium: better movement in fresh air, warm rooms aggr, sitting still aggr, very restless.

He is always in motion, even when sitting he bites nails or the skin of his hands or jigs his feet. Easily irritated, destructive, physical workaholic, strong desire to travel.

His colon is as irritable as his mind. Urge to stool many times a day with much flatulence, sometimes bleeding, some yrs ago a coloscopia was made - two pieces of tissue (polypous?) were excised, but harmless. From child on nose bleeding, last few years only during flue, herpes during flue. Likes milk, but causes flatulence/cramps. 2 small brown warts at neck.

I simply don't know with which to start.

Hi Helmut,

Usually for deciding on the miasm, one take into account what is the predominant expression in the patient himself.
This patient seems to have a predominant Tubercular miasm, both mentally and in the physical expression of his complaints. (Restlessness, Bleeding tendency, Irritability)

Having said that, I don't think he should be given a specific "antimiasmatic" remedy unless it also covers his consitutional picture, or rather is the similimum. Most remedies are manifestations fo combined misams as well, though one may be predominant.

COnsidering the sympotms you've given us, several other remedies could be considered as well, to differentiate with Lyc - Merc, Tub, Iod or a salt of it, Aurum, etc .
So it would help to go a little more deeper and understand his issues and what is really most important to him. Is there a problem with confidence to confirm Lyco?

There is an idea here in India of "opening" a case with Tuberculinum when there is a strong Tubercular miasm in the history, or Sulphur when there is a chronic psoric manifestation.
I don't think that is necessary.

Hope this helps,
doctorleela

[ 02. January 2003, 18:46: Message edited by: doctorleela ]

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http://www.homeopathy2health.com

I totally agree with the wonderful and fabulous Dr. Leela! Don't start the case with Carc. or Tub. just because you see the diseases in the history or the miasms in the history. Give the remedy that speaks to the patient's presenting picture. I agree that it looks like the Tubercular miasm, and if the picture looks like Tuberculinum, fine, feel free, but we don't have to give a remedy just because there's something in the history that suggests it, it's what's presenting that matters. Do you want to fill out our Questionnaire?

Snoopy

[ 02. January 2003, 19:06: Message edited by: Snoopy ]

Dear Dr. Leela and Snoopy,
thanks for your answers.
Re Lycopodium
His physical symptoms are very similar and in acute diseases he responds good to it, e.g. in a simple flue: Last time he was through with it in 3 days including Herpes.
But his mind symptoms are different. He is much more aggressive, violent and he has not the lyco-problems in dealing with people, nearness etc.

Re questionnaire
yes, I would like to fill in the questionnaire - the one posted above? How does it work afterwords?
Excuse my English (I'm really much better in German ...)

Hi Helmut,

YEs Snoopy is suggesting that you fill out more details with the help of the questionnaire so we could help you find a closer similimum. You could post here itself.

Lyco does seem to be partial.

All the best.
doctorleela

__________________
http://www.homeopathy2health.com

Helmut,

The questionnaire is on the topic page, where your topic is located.

Snoopy

Dear Helmut

Strive for the remedy which covers the totality of symptoms the closest. If Lycopodium does not resemble the totality and especially not the mind symptoms refrain from using it. If Lycopodium is very close but not spot on check out the complementary remedies.Let go of any preconceptions and start afresh without limiting yourself to this or that remedy. Where is the gravity of your case? Can you find an etiological reason why your friend is in his current condition? Create structure in your case. Make sure you appreciate the high value of the given mental symptoms and generals.Consider Carc or Tub when they resemble the totality not before. Miasmatic blockages can occur, but basically any chronic condition is a miasmatic blockage and any similimum will be helpful.Carc and Tub are wonderful friends if indicated. To assess the strength of a miasm in a patient look at the totality of symptoms and analyse the overwhelming tendency in the patient manifest at the present time. The miasmatic tendency in siblings is a good indicator but no proof, then assess parents, grandparents and other relatives. I think the biggest problem in finding the similimum is the limitation of our mind which tends to prejudge the case and allocate a remedy even before the case is fully taken. You may write to me in German if you want to.

My friend's wife and I have joined forces to fill in the questionnaire. Answers are rather long to avoid misunderstandings.

First Name:
Age: 50
Height:185
Weight:85 kg

1. What is your chief complaint (CC)? Tell as much about it as you can, including what is the worst part of it and why it's the worst: the sensations, the kind of pain, the location, how your energy has been affected (for example, has the complaint made you restless, weak, nervous, anxious, irritable, hypersensitive, effected your thirst and appetite, your body temperature, and so on). In other words, how you are different since you became sick?

The persistent complaint is in the intestines (the patient himself denies ist, says he has it under control and doesn't want to speak about it. There is sometimes blood on the stool - formerly often. He has also haemorrhoides. 8 years ago a coloscopy was done, tissue was excised but declared harmless. Doctor didn't say what it was and patient didn't ask. Borborygmus often in sleep. Much flatulence. Tearing pain in abdomen. Much noisy flatus with stool. Amount scanty. Goes to toilet many times a day.

2. When did this problem begin? What happened in
your life around that time? What do you think
caused it?

His wife says he suffered from obstipation when she first knew him (beginning twenties). He used laxatives. He was a student then, did many additional jobs as he had no financial support from his parents. When the current complaints began is not known. Maybe it's heredited - father cancer of colon, a nephew blood stool.

3. What aggravates the CC and what brings it on?(for example, certain types of food or weather, movement, light, noise, company, talking,
heat/cold, or anything else that you can think
of; please be specific) and what makes the CC better (for example hot or cold, massage, eating, lying still, music, company...)? In other words, what does it make you do to try to feel better, to cope?

Worse: chocolate (blood and pain and he doesn't feel good generally the next day). In former years he couldn't resist, since abt 5 yrs he has restrained himself and pays much attention to healthy food.
Onions, pulse, cabbage cause pain and cannot sleep after eating them. Milk (no problem as a child), still likes it but also causes pain.
Better: exercise in open air

4. At what time of the day or night is the CC the
worst? Specify an hour if you can. ---
5. What symptoms can you identify that accompany
the CC (whether directly related or not; for example, headache with nausea; or menstrual cramps with diarrhea; a cold with irritability and anger)?

headache, pulsating , in forehead as a prodromal symptom, sickly look. Face white, yellowish, dark rings under eyes, irritable, sleeps bad, awakes too early, sometimes from urge to stool

GENERAL QUESTIONS
6. Environment: With regard to the seasons, weather, outdoor temperature, indoor temperature, drafts, air quality, airconditioning, ocean air, mountain air, humidity, the sun/rain/thunderstorms/clouds/fog, etc.: what environmental factors give you comfort and relief, and which ones cause discomfort and distress? Try to give examples.

can't stand sultry heat, hot sticky room air (must take off clothing), heat at nape of neck (can cause nose bleeding), no roll collar or scarf, back pain from getting cold there through draught or getting wet.
Gets headache, feels dazed, tired, has stitching, tearing pain in an old scar when a low-pressure area is drawing near
better fresh air, likes heat of sun (ameliorates back pain), quickly gets a dark tan

7. What position is most uncomfortable for you?
being forced to sit still in a hot room

8. a)Do you tend to be chilly or warm? Are there parts of your body that are colder or warmer than the rest of you? Is there a special time of day or night when they are colder or warmer? b) Do you perspire a great deal? If so, when? And where on the body? (feet, head, hair, chest, armpits, etc) Does it leave a stain of a particular color? Is there a particular odor?

He is warm. He rolls up the legs of his trousers in the evening (when watching TV). Perspiration normal.

9. Describe what your tongue looks like.
Didn't dare ask.

MENTAL/EMOTIONAL
10. What do you worry about? How do you deal with
worries?
In young yrs thrifty. Thinks carefully about how to invest or spend money but buys luxurious gifts and equipment for the household. But no reason for worries. Tends to expect always the worst even in trifles.

11. How do you keep your house/your desk/your room/your study/your bathroom?

All tidy, does a lot of work, repair to keep everything in good order or to make improvements. Fastidious. Garment must be clean, but doesn't care about fashion or style or colour (red-green blind). Likes to have his home beautiful, puts candles on the table even when eating alone

12. How easily do you cry? In what situations? ---
13. When you are upset, what do you do to help yourself feel better?

exercise or work in the open air

14. What makes you angry? What do you do when you're angry?

other people working or reacting slowly (driving!), doing unprecise work, bad organisation.
Waiting in a queue. When something he is working on doesn't function as it should.
Throws things about, breaks them, kicks. Example: he hit the parkometer with his car, got out to look at the damage and multiplied it by giving the hood a violent kick. Or bangs the door so violently that it falls from the hinges. (all worse when drunken) Does not admit that such behaviour is stupid, but ssays it was due to provocation or he was under strain. Afterwards he repairs everything he has damaged before.

15. Do you have an emotion that predominates; such as anger, depression, irritability, anxiety, jealousy, joy...or possibly two emotions that tend to alternate predictably?

Impatience, harshness, irritability - by every word, slightest contradiction, takes even mild jokes in bad part. Such periods alternate with days of loving care of wife and family, brings flowers, carefully selected gifts, helpful wherever he can.

16. What fears do you have?
to get a severe disease that makes it impossible to move about, to work, with his brain injured - that things might happen without being able to control them.
3 yrs ago he went to the doctor who diagnosed high blood pressure and gave him a beta blocker. He warned him that he should reduce overweight. That really made him anxious. He immediately began a strict slimming diet and lost 15 kgs within a year. Bloo pressure normal since then.
in general: events that he cannot control, wants to be armed against all possible occurrences. Example:
watched report on a snow catastrophy on TV. The next day he bought an electricity generator just as a precaution.

17. What have been the most difficult circumstances in your life? How did you cope?
The worst event was a dangerous biking accident. For a long time afterwards he was concerned about what could have happened, no fear of death, but of having his head damaged. Nevertheless he continued biking, but from then on with a helmet.
Seeing his father in hospital with the mark of death. (He cared lovingly for him until his death.)

18. What are the greatest joys you have had in
your life?
His wedding (this answer came totally unexpected and make his wife happy).
Having concluded his studies with a diploma.

19. What was your childhood like?
normal, harmonious

20. What bothers you most in other people? How,
if at all, do you express it?
people being all thumbs, stupidity, careless work, not punctual, smokers (formerly smoked himself).
He frankly says what bothers him - varying from calmly teaching them how to act to harsh criticism.

21. What causes the most problems in your relationships?
His harshness - most of what he says sounds simply harsh, even if it is not meant so.

22. Do you have any recurring dreams? What are they about?
Cannot remember

23. What would you need to feel happy?
One thing might perhaps be more sex, to judge from his wife's statement.

24. What do you do for work? Ideally, what would
you like to do?
likes his work and would want no other

25. If you were made President for a day, what would you change?

26. When people have criticized you, what were they complaining about? Similarly, when people have praised you, what did you receive praise for?
harshness, impatience
Praised: reliability, good work, organisation talent, humorous dealing with problems and subordinates. Although he does not yield, has his own way.

27. What would you like to change most about
yourself?
in his own words: to be friendlier, more conciliatory but " a leopard cannot change his spots"

FOOD
28. How do you feel before, during and after
meals? How do you feel if you go without a
meal?
29. What would you most like to eat (if you did
not have to consider calories, fat, anything
you've read about the right way to eat)?

sweets, chocolate, nuts, smoked bacon (every day), spicy food, formerly salted much

30. What foods do you dislike and refuse to eat?
What foods do you react badly to, and in what
way?
abdominal pain after milk, chocolate, cabbage, pulse, onions

31. How much do you drink in a day? Include
sodas, juice, coffee, tea, milk, and
alcoholic beverages as well as water. How
thirsty do you tend to get? What temperature would you like your drinks to be?
Thirst is ok, drinks enough, cold but not icy. Drinks too much wine in the evening. 1 bottle a day, tendency increasing.

SLEEP
32. How is your sleep? Mostly deep, see 31. Bad only with abdominal disorder.

33. Do you do anything during sleep? (speak,
laugh, shriek, toss about, grind your teeth, drool, snore, walk, talk, etc.)
talks and snores, shrieks sometimes

34. Do you have trouble falling asleep? What keeps you awake? Do you wake always at a certain time? What causes you to wake up? What position do you sleep in?
sleeps on back or either side

WOMEN
35. Number of pregnancies, number of children,
number of miscarriages, number of abortions
36. At what age did your menses begin? If you
have gone through menopause, at what age?
37. How frequently do they (or did they) come?
38. What about their duration, abundance, colour,
time of day when flow is greatest; any odour
or clots?
39. How do you (did you) feel before, during and
after menses?

HEALTH HISTORY
40. What medications are you taking at present? None
41. How frequently do you get colds and flus? 5 times a year
42. Have you had any childhood illnesses twice,
or in a very severe form, or after puberty? no
43. Have you had any vaccinations since the
standard childhood ones? Tetanus, Cholera
Have you ever had an
adverse or unusual reaction to a vaccination? after pox some days ill with fever
44. Have you had any surgery? What and when? At 20 when he nearly cut off his thumb with a circular saw. He got a penicilline allergy thereafter. The scar hurts sometimes when a low-pressure area approaches. The skin of the inner hand has been hard, horny and scaly since then.
45. Have you had at any time (mention year):
warts, cysts, Polyps, or tumors? Where were they located? How were they treated?
Kind of juvenile warts on the left hand, two yrs ago, treated with tincture.

46. Do you tend to have any discharges (nasal,
vaginal, etc.)? What is the color, consistency?

SENSITIVITY
47. a) Do you tend to need a smaller dose of
medications than most other people?
b) Do you need less anaesthesia than others,
or have a hard time coming out of it? Feels sick and dazed afterwards, even after injection for tooth extraction.
c) Do you tend to react to vitamins and herbs
and/or need hypoallergenic vitamins?
d) Are you sensitive to paint fumes, exhuast,
dry cleaning fluid, fragrances etc.? Headache from paint fumes.

48. Family history: Mention diseases, causes
and ages of deaths of father, mother,
sisters, brothers and grandparents on both
sides.

grandmother myocard infarction died at 80, father tuberculosis lungs after having been wounded in war, hypertension , myocard infarction. embolie of lungs, cancer of colon died at 82, mother severe pneumonia as a child, atheroma and frequent nose bleeding (both was in the family), abortus due to metrorrhagia, afterwards sterilization (total extirpation) followed by heavy swellings of the whole body (happened after birth of patient) cancer of skin. Sister cancer of skin. Half-sister cancer of breast.
49. Construct a time line: Mention from birth
on to the present day, all IMPORTANT events
(emotional and physical traumas,
heartbreaks, divorces, work-related events,
diseases or traumas your mother had while
being pregnant with you, family stress,
death in the family or of friends,
disappointment, etc.) Mention the symptoms
experienced at those moments or which you
can date to those traumas. No related symptoms known. Except as under 17
50. When you stand in line at the bank or supermarket, how do you feel? angry, impatient
51. When your family member was last sick, what did you do? Everything to help, caring lovingly
52. How is your sexual energy? good
53. How do you react to consolation violent "let me alone!"
54. What part of your life do you have the most difficulty coping with.
55. What are your hobbies? Travelling (strong desire), biking, natural science, computer
56. Habits: bites nails and skin of hand, always in motion

The urge to movement existed in childhood already according to his mother. About outbreaks of temper she wouldn't talk, she adores him.

Thanks for filling out the questionnaire, I hope we can help you. I'll be reading it over tonight.

Thanks again,
Snoopy

Helmut,

This case is soooo Tuberculinum, right down to the shrieking in sleep! I'll get back to you later with some potency ideas, right now I gotta run. Talk to you soon,

Snoopy