2006 February

Constitutional remedy or constitutional treatment?

by Ai-Ling Makewell
The term constitutional remedy has been a point of irritation for many homeopaths, though it is not serious in
its misgivings. It has been problematic for me ever since my student days because the very concept of a
constitutional remedy conveys the idea that there is one and only one remedy for an individual throughout his
or her life. And this one and only remedy is going to take care of all of a person’s ills and symptoms as the
word “constitutional,” according to the English dictionary means, “intrinsic, fundamental, deep-seated,
indigenous, and inherent, etc."

While for many people one remedy may suffice for whatever symptoms they are exhibiting at the time of a
homeopathic consultation and may be repeated again and again. Many other cases may require one remedy
then and another to address the presenting symptoms at another time. Life is not static, as life unfolds there
are other manifestations such as environmental impact and life experiences that may change one’s mental,
emotional and physical expressions in terms of (dis-ease) symptoms. Vithoulkas’ idea of “layers” may be one
way of considering the emerging symptoms on the physical, mental or emotional level. These on the
continuum of life’s process can be considered as life’s “turning points.” In that each layer may be markers of
life changing events that have made an impact on an individual’s developmental process. In this context I
propose to take the phrase “constitutional treatment” instead of “constitutional remedy” to be more appropriate
in describing each of the homeopathic consultations and the remedy given to a patient is only appropriate at
that time.

Constitutional treatment connotes the process of healing the entirety of the individual in that particular time
frame of a person’s life, whereas constitutional remedy implies a remedy that is intrinsic to the individual being
treated. The problem with the latter definition further relates to the meaning that a person can be defined as a
remedy (Scholten, 1996). When we begin to look at a patient in terms of remedy picture or their psychological
profiles, we risk defining him by the remedy he requires, rather than a person in his own right, complex and
three dimensional. In this, what we are not dealing with is the bigger issue that "a person cannot be cramped
into a remedy, but a remedy can fit an individual's healing requirement at that time in his life." In other words,
an individual person is much broader and more complex than a remedy can ever hope to encompass.

The problem with the concept of constitutional remedy is that we have the tendency to conjure up certain
psychological drug picture when relating to the person if, for example, the individual happens to have Sepia as
a “constitutional remedy.” I sometimes hear other homeopaths discuss an individual in terms of “Oh! She is
not Sepia, she is more like a …” At its best, this way of considering a case is simplistic, and at its worst, we
type cast our patients as “Sepia” or “Natrum muriaticum, etc.” – a depersonalization that prevents a
homeopath to gain deeper insight into the individual who exhibits certain symptoms.

The individual is not the remedy, rather the remedy given at that time of a person’s life may be a
representation of a core issue or a problem that has manifested itself in terms of symptoms in the process of
self-healing. In this respect all the presenting symptoms, whether these are on the mental, emotional, or
physical level in an individual, are the language of the soul showing that the time for healing something deep
is at hand. Hence, for most of us we probably need more than one remedy to address certain symptoms
presenting themselves at different stages of life.
However, each remedy prescribed by a homeopath throughout the course of a patient’s treatment is a form of
constitutional treatment because during each stage of healing the entirety of the individual is being
considered. Therefore, my proposal of the term “constitutional treatment” conveys the idea of seeing the
patient as an evolving individual having certain problem or disease symptoms at this particular stage of life
process rather than seeing them as a “psychological type” devoid of further possibility or even lacking the
capacity to change and grow.

The cases in the articles, "A Case of Magnesium Carbonicum and Sepia" and A Case of Magnesium
Flouratum, Tilia Europaea and Sandium", will demonstrate my view in favor of the phrase “constitutional
treatment” rather than “constitutional remedy.”

2006 February
Magnesium Fluoratum, Tilia Europaea and Scandium, _A case of
by Ai-Ling Makewell
Case 1 – Magnesium Fluoratum, Tilia Europaea, Scandium

A man aged 41 of medium built came to consult with me in 4/2003. He looks older than his age and came in
with overalls on covered with white paint. He is a painter by trade and owns his own business.
The main problem he is having includes a general lack of energy, not sleeping well, feeling tired and profuse
perspiration. He could easily doze off after dinner, or “go out like a light” at three o’clock in the afternoon.
While he was on holiday, he slept all the time during the first week there. “Generally I just don’t feel 100%,
eyes are tired, wake up 2-3 in the morning without having had a deep sleep. There is also bowel problem with
haemorrhoids that lead to bleeding.”
He also smokes (10 cigarettes a day), likes to drink one beer a day, sometimes spirit. Although he enjoys his
drink, the symptoms are worse after taking in alcohol.
Other symptoms include: blood in the spit (saliva), varicose veins in the legs (1 1/2 inches in diameter, like
bruises), hiatus hernia (< alcohol), bad sweats (profuse perspiration creates a lot of body heat), sweats easily
(did not use to in the past), cramps in legs when surfing in cold water, sore right shoulder, and chronic
snoring.

History: Born with one testicle, tonsils were taken out at age six, hernia operation last year, and is allergic to
Penicillin.
He is not affected by temperature changes and is warm blooded, sleeps on sides. He does not dream a lot,
but when he does it is about work and he talks about work in sleep. He loves salads, hot chilli, spicy food, fish,
chicken, fruit, strong coffee, sweets and cakes. Not very keen on red meat or Brussels sprouts. As a child he
used to like milk a lot, but not very fond of it anymore. He drinks six glasses of water a day plus juice and cups
of tea.
He further related that making money used to be something really important to him. His father was like that
and instilled in him that he must be successful and making a lot of money. Making money has been an
important goal ever since he was a child. He wanted to own his own house – “I am doing well. I have my own
house and own my business, but family is now more important, also having more friends in life. These were
important, but they were on the back burner before and now there is a yearning for those.” He also says that
his sex life is very important and can have sex ten times a day if he could. He goes on to say that “when I get
stressed out, I tend to lose the plot which leads to more stress, and I end up yelling, just can not let it go, can
not deal with the problems rationally."
He also says that he lacked confidence when younger, now that he is financially secure he feels more
confident, he used to apologise for everything. Additionally, he is not able to take criticism with the tendency to
become very defensive and is self-critical.
His parents were divorced when he was very young. He says that his father only married his mother for her
money. His parents’ divorce has affected him badly, he then has to take on the role of being “man of the
house.” His step father came on the scene when he was ten years old, but they were not wanted by the step
father. As such, he felt that he and his siblings didn’t really have a home anymore, which caused him to cry for
days at a time, not a happy childhood. These childhood experiences left him with a sense of lacking in control.
He can also be very aggressive, volatile, and cranky.

Prescription: Magnesium Fluoratum 1M, 1 dose

Analysis
The central theme of this case is his place in the family structure. There was no room for him after his parents’
divorce and especially so when his step father came on the scene. There was a lack of certainty about where
his place is in the family. This theme belongs to the Silicium series. It is the stage two of this series,
Magnesium. Other Magnesium characteristics include aggression, fear of criticism, lack of confidence, feeling
forsaken. His food desires also indicate the choice of magnesium such as a desire for salad, fruit, sweets and
meat.
My choice for Fluoratum as a combination with Magnesium is based on the theme of his strong desire to
make money and strong sexual drive. Other symptoms indicating Fluoratum include desire for alcohol, spicy
food, and being warm blooded.

Follow-up (5/2003)
His return visit was a month later. He related that there is a deep sense of inner peace and felt content for a
few days. All the symptoms were better for a short time, but they returned. The Magnesium Fluoratum
touched him on the mental and emotional level deeply, but did not have much of an effect on his physical
symptoms.
The symptoms he has now include night sweats, feeling really tired, cranky over little things, body feels heavy,
and feeling overwhelmed by his daily work demands. He needed to push himself in order to get his work
done.

Retake the case.

He again related to me about his childhood experiences. He was unhappy, parents divorced, mother had to
struggle to keep the children going during the first few years after divorce. During that time they saw their
father on holidays only because he remarried. When at age ten his step father came on the scene and never
he felt that he belonged there and could not wait to leave home. As such, he had to make a choice to whether
to live with his father or mother, he felt emotionally torn. Each time when he went from one parent to the other
he felt a feeling of being torn apart because he developed attachment for one parent then had to leave and go
to the other parent so the attachment was broken again and reformed with the other parent.
This situation went on for sometime while he was growing up. Resulting from this he just couldn’t wait to grow
up and felt very insecure as a kid, “did everything by myself, felt sad.” He further relates that this situation
created a lot of resentment within him, as they were left to their own devices, and never felt a part of a family.
Prescription: Tilia Europaea 200C, 1 dose.

Analysis
The reason for choosing Tilia is based on his feeling of being torn apart every time when visited one parent
then had to go to another. This situation created a sense of forming attachment with one parent and then
being forcibly detached and separated when he had to leave and go to live with the other parent. This sense
of attachment is between parent and child, which belong to the Malvales family. It is the sycosis miasm
because of his feeling being stuck and unable to do anything about his childhood situation. This brings to the
remedy Tilia Europaea.

Follow-up (8/8/2003): Had factures in the teeth because of grinds teeth in sleep awoke with sore jaws. His
profuse perspiration is much less and feels normal most of the times. He is now having thoughts of slowing
down on his work commitments, though a bit scared of not having anything to do and is feeling rather restless.
He says that he has trouble getting satisfaction out of anything especially money, which was something of
importance to him in the past. Now, he feels that his family and music and friendships are far more important
to him and he also feels a lot more confident.

Prescription: Tilia Europaea 1M 1 dose. At the same time, the bowel nosode Sycotic Co. 12C, 3 doses were
given (one a day for three days) for reason that he still having occasional perspiration and grinds his teeth in
sleep and feeling restlessness.

Follow-up (19/12/2003)
Although emotionally he is feeling low and fed up with everything his tendency to perspire profusely has totally
disappeared. After the last remedy he did feel much more relaxed and felt good. He still grinds teeth a bit not
as much as before. He is now thinking about a career change which causes anxiety. At the moment, he has
trouble making decisions about changing his career (going into Real Estate) though he is normally quite
decisive. He is lacking in energy. When gets up in the morning he doesn’t feel refreshed and his worry about
having to lay off his staff tend to drain his energy. It is a big weight on his shoulders because he feels
responsible for their welfare. Additionally, though he still wants to make a lot of money and achieve more, he
feels that he is at a cross roads in life and questions the validity of his goals. This “confusion” makes him very
indecisive.

Prescription: Scandium metallicum 200C, 1dose.

As soon as after taking the remedy, he felt much less tired and his sore eyes are also better, not as sore as
before when he first came into the room.

Analysis
This man’s concern at present is about his work (Ferrum series). He is thinking about changing careers, but
has trouble making decisions because of worry over whether it is the right thing to do as he has wife and a
daughter to support. Also he feels responsible for his employees and what they will do if he closes down his
business.
As his main concern is about work it belongs to the theme of Ferrum series. It is stage three which has to do
with comparing, scanning, and investigating the possibilities in changing his career. Because of the
uncertainty of the future in what he is trying to do there generated a lot of doubt and he therefore hesitates in
making a firm decision as what to do. As such, his internal conflict causes a lot of confusion and
indecisiveness. The essence of Scandium metallicum is “not knowing which task to choose” (Scholten,
1996:336).

Follow-up (17/3/2004)
Two weeks after the remedy Scandium metallicum, he made a decision to go on holiday, then the change of
career came. “All of my employees completed their job last week and I have 3-4 weeks before I start my new
job in the Real Estate.”
Now he is feeling a bit lost. He has given up a reasonably successful business and is unsure about his future
which makes him feel frustrated, angry and confused. He feels that people let him down and is feeling angry
inside and unsettled at the moment. There is perspiration from time to time which wakes him up during sleep.
Tiredness returned and he feels he can always lay down for a snooze.
Prescription: Tilia Europaea 10M, 2 doses (one to take home).

Follow-up (23/3/2005)
Now it is a year later from his last visit. He still works very hard, but is not as stressed out as before although
the job (Real Estate Agent) is quite stressful. He says that he is not nearly as angry as before and is much
more confident. He feels much better and dresses better since he changed job. The reason for this visit is
because he is a bit under the weather.
Prescription: Tilia Europaea 10M, 2 doses. As far as I know he is well.

Categories: Remedies
Keywords: Magnesium Fluoratum, Tilia Europaea, Scandium
Remedies:

2006 February
Magnesium carbonicum and Sepia,_A case of
by Ai-Ling Makewell
Case
A woman of twenty five years of age came to see me in 10/2004. Her main complaints were fatigue and
genital herpes. Her left eye has been twitching for the last six months. She had gotten genital herpes back in
1996 from her first boyfriend. At first it comes and goes for a while, she did not have any symptoms of blisters,
only discomfort and slight pain and tingling sensation in thighs when sitting down on toilet. In 2000 it got worse
and worse as time went on. She had blisters and tingling pain in her thigh so she went to the medical Doctor
and was diagnosed with genital herpes. The Doctor put her on medication (Marvelon), however, her condition
got worse. She had attacks every two to three months. There would be a break out with blisters and sores
(red blisters start on one side then to the other with yellow pus) when she feels stressed out at work.
Her chronic fatigue started in 1998 during her university years. At times, she needed two extra hours of sleep
in the afternoon. Then during 2002, she became depressed over work and personal reasons. She had to go to
sleep right away after work and had to struggle to get up in the morning. Because of the fatigue condition she
is ready to go to sleep at three in the afternoon. Although now her chronic fatigue is not as bad as it was, the
energy level is below what she should be feeling (had flu in 2002 and 2003). Now she has a lingering cough
since catching the cold last week and can not stop coughing after talking for a while.
She is now on contraceptive pills, her menstrual flow was worse at night before the pills.
Food desires: loves Italian food, chocolate, junk food, pumpkin, sweet potatoes, strawberries, mango, lettuce,
roast and vegetables and warm food.
Food aversions: cauliflower, broccoli, parsnip, apples and bananas.
She feels the cold, but does not cope well with heat either.

She had an argument with her father eighteen months ago that resulted in a stand off situation and left home
without resolution. Much later, her father apologised to her and now they are back in contact.
When younger she was easy going, playful, could adapt to any situation, but she becomes aware of other
people’s judgment as she got older and therefore, tried to fit in. She says that she is quite conservative,
worries a lot about whether she is making the right decision or not or what others think about her. Externally, “I
put up a good front and thought if that person really knew me, he would think that I am boring.” She continues:
“If I want someone to like me, then, I am concerned about how they think of me – may be I am too narrow or
conservative for them.”
Her security and family are really important to her though she does not spend enough time with them (living in
different states). Also feeling content and happy is important too. Additionally, she feels that she doesn’t really
belong in the family though comfortable with immediate family not with relatives (parents got divorced during
her teens). She also relates: “I get angry a lot, but cannot express it towards anyone (tears running down).
Sometimes I can express it through dancing.” At this stage I ask: “What sort of things makes you angry?”
Reply: “When people show a lack of respect for others can make me really angry. Also, I get angry when
someone won’t let me have an opinion or when feel quite alone and having to rely on myself.”
Her fears include fear of rejection, making wrong decisions, people who can’t control themselves (on drugs),
which can be unpredictable.

Prescription: Magnesium carbonicum 1M, 1 dose. Feeling much more relaxed soon after taking the remedy.

Analysis
The central issue for this young woman has to do with her feeling of not belonging to her family which is the
theme of Silicium series. Her lack in confidence, concerned about what other people think of her (she
criticises herself for others – her own imagination of what others would say about her), the tendency to adapt
(fit in) to a social situation, and feeling passive and powerless (unable to express anger), etc. belong to the
second stage. This brings to the remedy Magnesium. I chose carbonicum as a combination for reason that the
issue of respect, value, self-worth and the father are of concern to her. Hence, the choice of remedy is
Magnesium carbonicum.

Follow-up (12/11/2004)
She reported that she has been really well, changed diet (cut out chips and chocolate), and was able to throw
a tantrum towards her partner. She was grumpy when feeling hungry. Her left eye does not twitch as much as
before. The genital herpes showed a tingling sensation for one day only and she is not feeling sleepy
anymore. Generally, there is more energy and her persistent cough cleared up three days later.
She became assertive with her partner immediately on the day she came to see me. She feels really good
about her new found ability to express herself more, though still a little hesitant to do so at work. Everything
has been positive.
Prescription: Magnesium carbonicum 1M, 2 doses.

Follow-up (12/1/2005
She is feeling very low (a bit depressed) ever since mid December 2004 (took the other Mag-c 1M on
12/12/2004). After taking the magnesium-carbonicum, she became really grumpy, irritable, lost the motivation
to do things, and needing more sleep. Obviously, Magnesium carbonicum has served its purpose and is no
long applicable. Retake the case.

“Dancing makes me feel better, I love rain. I have trouble breathing in, really constipated, feeling fatigued.”
She goes on to say that “I have no headache for a while, no eye twitch either, no cold, no chest pain
(apparently she used to get chest pain when tired). Herpes has been good without any eruptions. I am starting
to look for another job because feeling as if at a dead end. I cry in the shower and feel I do more work than
others at work which gives me a sense of being not valued.”
Her menstrual blood is quite light the last few days, no more pain. Exercising always make her feel better
otherwise feels like a blob. She has no sex drive, it is a real effort for her to have sex with partner. Tears are
running down her face when she started telling me about her health and personal problems. Her health has
not been good since puberty. She has a tendency to keep her problems to herself. It only makes things worse
when others try to console her when upset. As I questioned more, she says that she loves thunderstorms.

Prescription: Sepia 200C, 1 dose.

She has a reaction straight away after taking the remedy; tingling sensations around the shoulders, feeling a
bit dizzy – light headedness with a desire to cry. Feeling more relaxed.

Analysis
Magnesium carbonicum has done its job on one level, therefore it did not bear to be repeated again. Other
symptoms come to the fore. The central theme at this time is showing Sepia is needed. During the first
consultation, she said that as a child she was lively and playful without feeling self-conscious, which together
with loss of sex drive, love of thunderstorm and dancing, and cries when telling symptoms form the central
theme of Sepia. Also “never well since puberty” is another prominent Sepia symptom.

Follow-up (19/11/2005)
She reports that she has not had any herpes eruption during the last ten months until this week. She had the
eruptions twice because of emotional stress, she is feeling emotionally torn between two men and not
knowing what to do. She feels fatigued and always tired because often she goes without proper meals as her
work becomes busy (changed job which is much more satisfactory).
Prescription: Sepia 1M, 2 doses (one to take home).

Report (24/1/2006)
There was a great deal of things going on in life, she made the decision to separate from her partner. The
house they jointly owned is put on the market. Although there is change she is feeling happy and now
meditates regularly. In this, she is not only able to sit with her emotions, pains, and feelings, and feel the
changes all around her, but also with an optimistic outlook towards the future.
This case is ongoing. The ten months gap between her previous visit and this recent one showed that Sepia
as a remedy could work well for her. The idea that Magnesium carbonicum could have been a remedy that
was needed to take off one “layer” of which may have resulted from her experience during the time of her
parents’ divorce (during her late teenage years). Parents’ divorce for a child (whether at an early age or in
their teens) is till a major turning point in one’s life that could have a profound impact on one’s emotional,
mental and physical development. As a consequence, now another remedy, Sepia, perhaps may work well for
her for sometime to come.

Reference
Scholten, J. (1996), Homoeopathy and the Elements, Utrecht, The Netherlands.
http://www.interhomeopathy.org/constitutional_remedy_or_constitutional_tretament