thx to israeli homoeopath

No one could give a yes or no unless the whole case was on here.

This doesn't make a lot of sense to me.

Firstly, why are you using a CM potency? This is a potency reserved for the deepest psychological disorders, not for physical pathology. If you are only treating urethritis with it (for which Thuja is a well-known pathological remedy) then you should be using 6-12c. What else in the case calls for such a high potency? I would expect an extremely high level of peculiarity in terms of symptoms, and a high level of repression in the mental symptoms, to justify CM.

Even then, I can count the times I have used such a potency on one hand in my 20 years in homoeopathic practice. It is an unusual situation that calls for it I think. How deeply 'Thuja' is this patient?

Frankly, I would expect such a potency to cure the case - completely, as much as any single remedy can. To give such a potency in the first place it should suit the person 'top to bottom' so to speak, and should address all the important issues in the person's life. It should also address the miasm (sycotic for Thuja).

Of course some cases require more than one remedy over time. The higher the potency used, in chronic cases, the longer the time between doses, and the more time that will pass before a new remedy is needed (a completely new state shows itself). There is no set time for this, you prescribe the new remedy when the STATE CHANGES. In my experience with high potencies (even only as high as 1M) this is months, and sometimes years before another remedy is needed. Sometimes even before another dose is needed of that same remedy.

It is important not to prescribe purely on the basis of your perception changing or being incomplete. The patient needs to actually change in state to justify a new remedy prescription. I am uncomfortable with the 'layers' theory because it seems to promote the idea of dividing a single case into components and treating them separately, instead of trying to uncover the totality for the whole case.

I would also be extremely cautious about changing remedies too quickly. This is another thing that the 'layers' theory promotes - impatience to get to the next part of the case (which to me seems to actually reflect a lack of confidence in the first prescription more than any genuine ability to see into the future).

I am wondering what it means when you say 'has woken up'? What exactly is the change you have seen? What aspect of healing does this waking up represent? How has the case changed after the Thuja?

I also wonder how you know what remedy is next? How can you see two pictures at once? Either a patient is Thuja or they are Carcinosin or they are Nux-vomica. The three remedies belong to different miasms (Sycotic versus C-ancer versus Typhoid). In terms of treatment history, Tuberculinum is Tubercular and Sulphur is Psoric. What is the link with all these very different remedies? It suggests to me that the core part of the case remains unclear.
[message edited by Evocationer on Tue, 01 Jul 2014 01:25:56 BST]

I am enjoying the opportunity to discuss case-taking and remedies in this way. It doesn't happen too often on this site anymore. It used to happen a lot when more homoeopaths frequented the forum.

Firstly I would be confident in your choice if Thuja really suits the case. Do not be quick to change the medicine. You would expect dramatic and deep changes in the person in response to a remedy. Watch for Direction of Cure to judge whether the remedy is really curing them. Direction of Cure is the best and most reliable guide for homoeopaths, and the case should be scrutinized carefully to be sure that things really are moving in the right direction and in the correct order.

Part of Direction of Cure can indeed be to move back to a previous state (reoccurance of old symptoms) however this frequently responds to the same remedy, so the best course of action is to wait to see if it resolves on its own, if the patient processes the issue on their own with the support of the changes the remedy has made. If not, the first step would always be to repeat the same remedy in the same potency but slightly altered in dosage (as per the guidelines in the 6th edition of the Organon). Do not repeat high potencies too soon though.

I don't really recognize those aspects you mentioned as being characteristics of Thuja. Specifically. Without seeing the case I don't really know what it is your prescribing on.

The core of Thuja (when prescribing at high potencies 1M and above) would be:

Fragile, broken, brittle.
Disconnected (from themselves, inside disconnected from the outside)
Weakness
Emptiness
Cut-off
Fragmented

The Sycotic response is to hide this from others, as their internal state is experienced as a flaw or weakness which cannot be fixed, but must instead be adapted to or obscured from sight. The Sycotic complaint is one that can be lived with as long as strict condition are imposed on the person's life to avoid bringing it to light or allowing it to cause a problem. The Sycotic patient tends to live 'around' their problem, avoiding anything that might aggravate or uncover it.

The reason Thuja is often such a powerful tool to use against Sycosis is because this internal core sensation (broken, weak, fragile) resonates extremely closely to the Sycotic sensation itself (an internal flaw or weakness).

I am not sure of all those terms you are using - 'milk and champagne in the same glass unmixed' isn't an expression I understand in relation to Thuja. It is an interesting term but I haven't seen it used in the literature. Where is the reference for this?

The important thing with any case is to make sure that the patient is directly describing the core state of the remedy to you, and that you are not trying to perceive it yourself. It is only the patient's perception that matters. Any patient can seem to be 'a complex person with contradictions of character'. Such a description is always about the observer, not the one being observed, so it cannot be used to make decisions. Such an observation would provoke a deeper examination of the patient to uncover the source of their 'complexity'.

In relation to Carcinosin, it has its own well-developed individual picture, which I agree can look superficially like other remedies. This is true of EVERY remedy - they can all look like something else. This is again related to the observer, not the patient - this happens because we see only the outside, and must work hard to understand how the patient experiences their disease on the inside.

I actually think that Carc and Thuja could resemble each other in some ways - in fact I believe I have mistaken one remedy for the other in the past, so I think as a differentiation it is quite suitable. Underneath there is a very different picture (the true picture).

I have used Carcinosin a lot over the years, and when looking at the core state what I always see is CONTROL. This is a nosode, and as a nosode it sits in the exact centre of the miasm. It represents the miasm exactly. Any patient who needs a nosode will show the miasm in all aspects of their life/disease. ORDER, DOMINATION, CONTROL, CHAOS, SUBMISSION, INVASION, REPRESSION, SUPPRESSION are the main themes.

Also there are the themes of Nosodes generally which is to feel the presence of a disease pattern throughout every aspect of their life. They often refer to the qualities of the disease the nosode is made from, when talking about things unrelated to any actual disease. Carsinonsin patients will use terms relating to c-ancer when discussing their life, or when discussing symptoms that normally would not have those qualities (including their views or feelings about the symptoms). The basic sensation in such a case is a sensation of sickness, of disease, and how they experience this is directly related to the specific disease the nosode is made from.

I do not believe you can have two pictures at once, and I definitely do not believe you have two miasms at once. I do believe that we as practitioners can be confused as to what we see. I know that happens to me fairly often in clinic. I know that in terms of miasm we may not have enough of the big picture to really see the pattern, or we can mix the core state of the remedy up with the miasm. I also believe that in the past the use of only 3 miasms actually created more confusion. The more recent addition of further miasmatic patterns show us that it was not 2 miasms a patient was expressing, but a single miasm that had qualities of both but was actually something separate and unique.

Ok 10M certainly is more reasonable, although still quite high. Much of what I have said still applies to it, but I do think that 10M bears a little more repeating than CM does.

Are you mixing potencies together? This is definitely not the right thing to be doing. You do not know what kind of medicine you are creating by doing this. Potency, like remedy, must be single, so that you can assess the results properly and manage the case over the long term more rationally.

It is also dangerous to be giving frequent doses of 10M (if it still is 10M when mixed with 30c - I am not sure what potency that would end up being). One dose should last the patient a long time if it is the simillimum - months or years generally, although in the beginning some people do seem to need an extra dose. This seems to be related to the amount of tissue change in the patient or the amount of medical suppression that has occurred.

Carcinosin people do not tend to dominate others, or at least do not perceive it that way. They are dominated and controlled, and suffer greatly from this. They may fight, or rebel against it, but their sensitivity to being dominated would make it difficult for them to be in the position of the dominator.

The animal remedies tend to talk about domination and control a lot too, and I often find I am differentiating with animal remedies and Carc.

It might be that the other characteristics could represent that remedy. Without the whole case it is hard to offer any valuable opinion in that regards.

I think we have very different training. I was taught from 6th edition Organon of Medicine, so there are a number of things you have been taught that don't agree with my own approach. If it works for you then that is fine. I find adjusting dosage works quite well for modifying possible aggravation so I don't need to play around with mixing potencies or remedies. What potency do you have when you mix 10M and 30? How do you go up or down from there, without knowing that?