Carcinosin

By Don Webley

Carcinosin is a remedy that, in my experience, is one of the great polychrests of the homeopathic Materia Medica. It is frequently used by European and Latin American homeopaths, but much less so by American practitioners. Frankly, I do not understand why this is the case. Cancer is more widespread here than elsewhere, and common sense would suggest that the miasmatic nosode of this disease would be frequently indicated.

Indeed it is, and I assume that its under-application is due to lack of familiarity with the remedy and perhaps also to a prejudice that goes along with such unfamiliarity. I hope that this article will help practitioners to feel a little better equipped and more inspired to search for this remedy. It will never work out in the repertorization; one does have to look for it. But it will resolve a good number of those cases that seem to make only fair progress under a "perfectly indicated" remedy. I deliberately chose to have this manuscript in essentially completed form before consulting other published works on the subject, so that, for better or worse, it is my personal experience that is reflected here. It was, however, instructive for me to read the proceedings of the Hechtel conference on Carcinosin, as well as Jonathan Shore's valuable presentation to the 1989 IFH Professional Case Conference. I saw observations that I had recorded verified in the experience of others. I also saw one or more authors take agnostic positions on indications that are leading indicators in my experience. Of course, I also saw indications with which I had been unfamiliar. This article does not purport to be the final source on Carcinosin. Much material that is either my own experience or part of the general body of knowledge on the remedy is not represented here. I do hope eventually, however, to publish a definitive work on this nosode. Therefore, I actively solicit responses and cured cases, for I do not feel I have plumbed the depths of this remedy.

The Carcinosin remedy picture is difficult to summarize in a single all-encompassing keyword. There is no cowardice, as in Lycopodium, or fear of the universe, as in Arsenicum. It is also difficult to make any categorical assertion about the remedy, for the opposite of anything said about it might just as well be true. Perhaps more than any other in our homeopathic armamentarium, Carcinosin is a remedy of polar opposites. I have very often had a disbelieving mother walk out in a state of more than a little doubt because I gave her mild-mannered, introverted child the same remedy that I gave to her obstinate, hyperactive brat who bounces off the walls. Yet this very amorphousness and this bipolar character suggest the image of Carcinosin.

It is commonly stated that the epidemic of cancer that now plagues the industrialized world is directly related to the suppression of tuberculosis. It would be difficult to prove this thesis beyond doubt, but a number of observations point strongly in this direction. First of all, one of the factors that alerts one to a possible need for the cancer nosode is tuberculosis in the family history. Carcinosin shares some noteworthy symptoms with Tuberculinum, for instance, the hair on the spine, blue sclerae, genupectoral sleep position, and the desire for travel. I have also observed the perspiration on the head during sleep with sufficient frequency to add it to the repertory.

I have had the opportunity to treat the parents of many children who have benefited from this nosode and have found more often than not the remedy has not been indicated in these people. What one typically observes is a very suggestive history on one side - usually the mother's - and a somewhat less tainted past on the other side. Often neither parent needs the nosode, even though it may be indicated in one or more of their children. It is as if the number of suggestive illnesses in the family tree needs to rise to a certain "critical mass" before the cancer miasm explodes into being. Thus a child will be a Carcinosin type, while the parents take other remedies. Significantly as well, I have rarely seen a case where parents need Carcinosin and the children do not. Taken together, these facts do not augur well for the future of humankind. We are, as it were, witnessing the unleashing of a new horseman of the apocalypse upon the world in this generation. We have seen this reflected in the steep increase in the occurrence of cancer over this same period, but the fact that the nosode is appearing, ex nihilo, as it were, in this generation, suggests that we have perhaps glimpsed the tip of this monstrous miasmatic iceberg. Carcinosin is destined to be the nosode of the age in much the same way that Tuberculinum-bovine was the star of Kent's day. There are shadows of Medorrhinum in this nosode, also. We see the hyperactivity in children, increased sexual desire, amelioration by the ocean, genupectoral sleep position, desire for salt, sweets and fats, and insomnia.

The other chief components of the Carcinosin picture come from the Natrum-muriaticum and Sepia family. We see the fastidiousness and a desire for salt indicative of Natrum- muriaticum, the worse with consolation (although the opposite is as often present), sensitivity to sea air, desire for chocolate, and aversion to fats and milk of both remedies. We see the love of dancing of Sepia, as well as its childhood hyperactivity. Like both remedies, it is very easily offended. Cancer has been called the great masquerader, and so it is with its nosode. One often sees a symptom picture which is a perfect example of, say, Tuberculinum-bovinum, like case B.J.S. at the end of this article, but which has one or two symptoms that don't quite fit. As I have indicated, these "sore thumb" symptoms, and the family history, often lead to the use of Carcinosin.

Sometimes one sees a case which seems to have, for example, a Phosphorus symptom group. Then a Sepia aspect and finally a Natrum-muriaticum set of symptoms. Knowing this remedy, one sees its aspect as the unifying thread running through the case. Such an instance is patient C.D., whose case is quoted later on. Whitmont calls cancer, "The penalty for the unlived life," and Wilhelm Reich referred to it as the end result of the "Carcinomatous Shrinking Biopathy." Natrum-muriaticum and Sepia reflect these tendencies perhaps more than any other remedies, and it is significant that they should be so closely related to this nosode. The tubercular and gonorrheal tendencies provide the groundwork or, perhaps more accurately, the miasmatic sod upon which the poisonous seeds may germinate into the cancer miasm. It is for this reason that Carcinosin has all these remedies hinted at in its picture. Unless one has a clear feeling for the essential process occurring in Carcinosin, one will tend to be confused, because the remedy appears as one type then another, and then yet another. Consider the disease itself, for a moment. Cancer may manifest in any organ, and, as a result, show itself by a wide variety of symptoms. Yet what is common to all cancers is unrestrained, chaotic growth, wherein the limitless generative energy that animates the life of the body and its cells is freed from the normal controls and results in the chaotic growth and spread of a malignant and consuming tumor throughout the affected system. Here we begin to see the process that underlies the remedy.

Rudolf Steiner once characterized cancer as having two phases, that of fever, heat, or inflammation, and that of tumor formation. This heat, this intensity, this fire kept barely within check, suggests something of the essence of Carcinosin. Carcinosin is the name we give to the pathological picture that arises when the life force itself, present in an individual with great intensity, is thwarted and turns upon its host organism, consuming it in its mad search for outflow and resolution. The Carcinosin child, therefore, has frequent and often very high fevers, is often hyperactive, and has a difficult time going to sleep and staying asleep. He has "exceedingly strong food cravings which often alternate with aversions," so that frequently one hears, "I used to LOVE eggs, but now I hate them." In the Carcinosin family history, and in the personal history of the patient, this intensity is also present as addiction to alcohol, or to drugs, cigarettes, and particularly to caffeine, and great sensitivity to foods. It likewise manifests as great passion and sexual intensity, beginning often at a young age, love of dancing and music, desire for travel, and exhilaration in a thunderstorm. I have also observed very early eruption of both deciduous and permanent teeth in a number of cases. It would, of course, be very difficult to add this to the repertory, as, by its very nature, it is not a symptom that can be cured. But I have seen it on a few occasions. This chaotic energy also sometimes manifests as alternation of symptoms from one side of the body to the other. I have seen this in a sore throat, but it is not a symptom that I can otherwise vouch for from experience, although others make much of it.

How then do we distinguish the Carcinosin energy and intensity from that of Medorrhinum or Tuberculinum? In cancer, no poison or foreign principle causes the cells to begin their destructive and unrestrained growth. What is occurring is simply a stepped up, if chaotic, version of the growth process of normal tissue. In the gonorrheal and tubercular miasms on the other hand, there is the introduction of a foreign principle which intensifies, but also perverts, the energy. Cruelty and hardness are everywhere manifest in these remedies, the result, if you will, of this perverse external principle. Thus, the Tuberculinum or Medorrhinum child is often cruel, or mean, though sensitivity to reprimand and to others is not foreign to some Medorrhinum children. A full-blown or typical adult belonging to either of these types is not someone with whom you would easily leave your children and pets for a weekend. There is a darkness about the energy of both these types that is completely absent in Carcinosin. About the only categorical assertion one can make about this type is that it will never manifest malicious cruelty. Two very important facts to bear in mind about the Carcinosin picture is that the remedy is listed under "sympathetic" and "anxiety for others" in second type in the Synthetic Repertory. Concern and regard for others is fundamental to these cases, and, as we will see, is the source of some of its pathology. Thus, even the obstinate kid whose mother says has a terrible temper and hits his brothers and sisters walks into the office looking so sweet and pleasant you can hardly believe that she is speaking of the one who sits in front of you. One is immediately drawn to the Carcinosin child, and likewise to the adult, before onset of deep pathology. There is something attractive and magnetic about their energy. It is light and warmth without the dark shadow of the other two nosodes.

In the young adult case - "young" really referring to an early stage of pathology - this energy is often tangibly sexual: Carcinosin takes a back seat to few remedies as regards the intensity of its libido. A recent female patient, when asked about how often she and her lover engaged in sexual intimacy replied: "Once a week, but that's down from the first year we were married, when we made love three times a day." One sometimes finds a history of promiscuity, but just as often a few long-term relationships, characterized as well by this same intensity. The Carcinosin patient's relationship to sexuality is emotional rather than genital, more refined and less coarse, and less emotionally complicated than that of Medorrhinum or Lachesis, for example. The sexual urge is simply the adult manifestation of the energetic intensity with which the patient has lived since childhood. Eventually, therefore, the individual realizes that casual sex is not what he or she really wants. Thus the promiscuity tends to develop into a long-term commitment, or becomes complicated by coffee, drugs, and chocolate to ease the pain of disappointment. Therefore, although one feels the sexual intensity of the Carcinosin patient sitting across the table, it is not the kind of energy that puts one on guard. Although the intensity is evident, one does not feel that the patient is going to make a proposition. As evidence that the high sexual drive is usually non-pathological, it rarely declines after a prescription.

A third fundamental aspect of the Carcinosin picture is the fastidiousness. The Synthetic Repertory gives Carcinosin as a black type remedy, and this is my experience. It is much more basic to the being than, for example, the fastidiousness of the Natrum-muriaticum patient, which it resembles; it is usually for order, rather than for dirt. Though the latter is seen, the Natrum-muriaticum relationship to punctuality is only rarely present. Even though outwardly the Carcinosin patient is not necessarily more persnickety than the Natrum-muriaticum, it is the part in his life that this tendency plays that we must examine. It seems to me that it is the result of a rigidity, a need to control that stems from the patient's knowledge that he or she is sitting upon a wildfire which is potentially all- consuming if not strictly contained. It is the same sensation that generates a fearful reaction when sickness arises, or that is the root of the fear of cancer. Patient K.A., whose case is quoted here, always felt that she would die young. Deep down, the patient knows that there is a pathological time-bomb ticking inside. The fastidiousness is an attempt to control it. Put another way, the fastidiousness is a valiant effort to keep mortality at bay. Somehow the Carcinosin subject feels that if she can keep her environment perfect, or her figure perfect, then she just might live forever. Case K.A. illustrates something fundamental about the remedy in this regard. She always has exercised religiously, owns a health food store, and has been addicted to all the products that she sold. She looks several years younger than her age, but has always planned to have a face lift at age forty-five. She is terrified of aging. She takes meticulous care of her body, at least its appearance, and her environment. When she was raped a couple of years ago, she did not tell her son (she is a single mother) because she did not want him to be concerned. Another patient presented with herpes as her chief complaint. She had other symptoms, like constipation and sleeplessness, but the herpes, which in her case appeared in rather mild form, threw her for a loop. "I feel diseased. Why is this happening to me. I wasn't born to do a trip like this." She felt unclean, and became extremely agitated when even the tiniest lesion would appear. She was the kind of person who "loves things to be nailed down." Mortality is the real issue here, and the anxiety upon the appearance of the herpetic lesions is just a proxy for the dread upon the appearance of the specter of death. It is fundamentally true that all fear is, when fully inspected, only fear of death. Yet all remedies do not have fear of death, and some remedies fear certain things while others have other terrors. Arsenicum is one of the remedies whose very fabric is woven upon a fear of death. Carcinosin is likewise. I would not add it to the repertory for this symptom, and indeed, I have never seen it frankly manifested in a Carcinosin patient. Yet the same mortal news that, in an Arsenicum patient leads to stark fear and insecurity, is manifested in Carcinosin as WORRY and ANTICIPATION. Essentially, the Carcinosin patient fervently hopes that, with planning, and organization, and by staying on top of things that, just maybe, she will not die.

The difference between Arsenicum's fastidiousness and Carcinosin's neurosis is best illustrated as follows: Two girls are leaving on a cross-country trip; anxious mothers stand on either side of the car, bidding tearful farewells to their "little girls." The Arsenicum is the one saying, "Honey, drive carefully! I've heard awful things about how they drive in Ohio. Make sure you fasten your seatbelt, and don't sit on any toilet seats, and make sure you don't talk to strangers. Oh! your hair needs some work, the part is crooked. Make sure to call me every night. Yes, it's fine to call at 1:00 a.m., I can never sleep then anyway." The Carcinosin mother whispers softy to her daughter, "Sweetie, take care of yourself, and make sure you always wear clean underpants. What if you had an accident, and they brought you to the hospital with dirty underwear on?"

A little bit of a caricature, but not much! I have seen it suggested in print that perhaps the Carcinosin fastidiousness is not primary, that it stems from a desire to please. This is most definitely not so in my experience, and this point would distinguish Carcinosin from Staphisagria, which is not fastidious. Nevertheless, the desire to please is there, and because this remedy is so sensitive to reprimand and sympathetic, the Carcinosin patient is often quite adept at conforming his or her life to the expectations of those around. Case K.A. expresses this perfectly. In the second follow-up, quoted below, she says, "My masks are gone, I don't have to perform any more. I always figured things out and performed, so that I would not have to deal with the fear."

This issue of fastidiousness leads into the matter of control, a core issue in the pathogenesis of Carcinosin. Foubister gives a history of fright and prolonged unhappiness as features in the history that suggest Carcinosin. These are in fact often present: the Carcinosin pathology arises when the boundless centripetal life energy and great sensitivity to and concern for others are constricted, confined, and traumatized by the cold and brutal facts of life. Thus one often hears a life story of extensive sexual abuse and horrors that tests one's credulity. This is the essential process occurring in the pathogenesis of Carcinosin, and if one grasps it, one will find the remedy where it is hidden to others. Yet it is true that Carcinosin is as hard to pin down as the color of a chameleon. This is because, depending on which of its component characteristics is present to the greatest degree, the remedy may mimic Natrum-muriaticum, or Medorrhinum, or Staphisagria, or Phosphorus, or Sepia, or Tuberculinum, or Calcarea-carbonica, or yet some other (Pulsatilla too). Thus a woman with high sexual energy, very social, sympathetic, and clairvoyant may resemble a Phosphorus and share its food desires. One may be at the point of giving it until she mentions how much she likes to drink tea, and no, she never drinks cold water. Or a fastidious, pathologically responsible woman who loves chocolate and salt, but does not care for sex, and is not very receptive to consolation, may be about to receive Natrum- muriaticum until it is realized that she loves to sit in her car in the sun with the window rolled up, and likes soft, gooey fat on meat. Control by rigid, almost sadistic parents or spouses is a form of unhappiness often found in these cases. Case K.A., discussed later, is such an example. She describes herself as having been raised by a "Nazi mother" who tolerated nothing short of perfection. Her first husband was an evangelical Christian (he also womanized extensively on the side, and was heavily into pornography) who was even more suffocating. He could not stand to hear people breathe or chew, so that she had to feed the children before he came home. He would never touch a woman, so their "sex life" consisted of her fellating him while he smoked cigarettes sitting in a chair. Nevertheless, one should not feel that Carcinosin is contraindicated if there is no history of brutalization. Life's ordinary traumas are often sufficient suffering. Even in the face of such extraordinary suffering, however, the Carcinosin patient seems not to resist. In this is a resemblance to Staphisagria. Even as a child, the Carcinosin patient is extremely sensitive to reprimands. It is hard to distinguish between the two. The distinction, it seems to me, is that Staphisagria resists confrontation because the organism is simply too sensitive to tolerate the anger of others and does everything to avoid situations where that might arise. The Staphisagria child will not show the ebullient energy of the Carcinosin child, and the outbursts to which he or she is sometimes prone. Carcinosin, by contrast, remains with the alcoholic husbands out of something resembling, but not entirely identical to, a sense of responsibility. It is rather that if she can somehow keep it together on the home front, it will help stave off the fear of mortality and disorder lurking beyond. We need to return to the Carcinosin patient's anxiety about others and its sympathetic quality. A certain kind of Carcinosin patient will present herself very like a Phosphorus, will sit on the edge of the chair, and lean toward you, and be very much affected by other people. At times the distinction can be very hard to make, because this remedy shows all the sensitivity of Phosphorus, feeling the emotions of others, and also being prone to visions and psychic phenomena. If a distinction can be made it is that this patient is more "solid" or and less amorphous than the Phosphorus patient. One clinician at the Hechtel conference expressed it quite well: "Phosphorus," he said, "is like a chameleon, and has no skin, that is to say, no boundaries." But it is not always an easy distinction to make. More usually, however, there is anxiety about others, and a desire to help, without the loss of boundary between self and other. In such cases, guilt is often part of the complex, again deriving from the patient's feeling somehow responsible and obliged to take care of, and protect all around, from mortality. One patient expressed it quite poignantly: "My middle name is guilt," she said. This is perhaps as good a place as any to amplify my quick reference to the fact that almost anything said about Carcinosin, though sometimes false, will at other times be true. I have just contrasted the energetic, outgoing, intense, Carcinosin child with the more sensitive and retiring Staphisagria. It is true that this is the more common manifestation of Carcinosin in children. It is also true that the complete opposite is sometimes seen. Carcinosin children can be quiet, shy, depressed, and pathologically sensitive in much the same way as Staphisagria subjects of the same age. Even in this type, however, there will usually be the identifying keynotes: the food cravings, the constipation, the sleeplessness, and the high fevers suggestive of intense energy lurking beneath the tranquil surface. I think of such children as cases where the pathological development has been accelerated so that the implosion or introversion of energy that occurs only later with the more common type is the case from an early age.

Generally speaking, however, the depressed, collapsed stage is seen only later, though not necessarily in a very old person. In taking the history, it will be observed that the patient was once outgoing, energetic, sexually vital. Sometimes, especially in cases of sexual abuse, this is not the case; there will be indifference to sex. I don't believe that I have ever seen true aversion to sex in a Carcinosin patient. Even such women are not truly frigid, and their lack of sexual response is situational; they will sometimes speak of a brief interlude between bad marriages, or a particular relationship, where their sexuality flowered. The typical childhood history is also present. Now she is exceedingly depressed, to the point of attempting suicide. The guilt has become a profound sense of failure. In these individuals, the history of pain and abuse is often marked. Sometimes it is astonishing. There will often be alcoholic parents and a history of sexual abuse. Another patient, a child of dysfunctional alcoholic parents, and a woman who herself struggled with addiction to alcohol and cigarettes, confessed to great feelings of worthlessness, and had suffered bouts of depression in the past. She hit the nail on the head when she said: "As a child I never was taught how to take care of myself."

How to Look for Carcinosin

In spite of what you have read here, you will need to make a deliberate effort to discover the Carcinosin cases in your practice, at least initially. I can now recognize them as easily as Natrum-muriaticum or Sulphur or Ignatia, or any of the other polychrests, but that was not always the case. The primary difficulty is that the case will never repertorize out to Carcinosin if you use Kent's Repertory. I myself always use the Synthetic Repertory first, and Jost Kunzli von Fimmelberg's Repertorium Generale for the particulars. The Synthetic Repertory contains the distillation of Pierre Schmidt's vast wisdom, and he evidently used Carcinosin quite a bit, because there are a number of Carcinosin additions in that Repertory with a "7" superscript identifying him as their source. Nevertheless, even these do not provide a complete enough representation of the remedy to have it come out in a repertorization. Rather, you have to know its hiding places and how to recognize its tracks. The first thing that will make you think of this remedy is a case that seems like a perfect Natrum-muriaticum, except that the patient tells you how she loves to sit in the sun or how much she loves the juicy fat on pork chops, or you discover that she loves consolation. The same could be said of Pulsatilla, Sepia, Phosphorus, Lycopodium, Medorrhinum, Calcarea, and a number of other remedies, but I find that the majority of Carcinosin cases are either slightly kinky Natrum-muriaticum or Sepia cases or Medorrhinum with a twist: a little too gentle and without the edge, and maybe with an aversion to salt instead of a desire, and no amelioration at night. Natrum-muriaticum bears the same special relationship to the cancer miasm that Mercury does to syphilis, or Thuja to gonorrhea. At least this is my observation. When you suspect that something is cooking, pay careful attention to the family history. Look for cancer, diabetes, alcoholism, drug addiction, insanity. You will occasionally find tuberculosis in the history. Foubister says that pernicious anemia is also suggestive, but I have never found this in any patient's history. I think it tends to be the kind of thing that one's descendants don't know about; it is not as patently obvious as cancer or a heart attack. I have in recent times begun to suspect that severe asthma and hay fever in the ancestry is indicative, but I am not certain enough of this to assert it. I throw it out so that others may consider that possibility and report it to our fellows. Foubister says that the maternal history is more important This is true in my experience, but this should not suggest that the paternal history is insignificant. It is not necessary to have all four grandparents die of cancer or diabetes. When that is the case, then I have to be quite convinced that some other remedy is indicated before I will give it. You will, however, find Carcinosin cases when half the ancestors have a suggestive history.

Sometimes there are fewer tainted forebears but all five of the patient's siblings are alcoholics. It is not a cut-and-dried matter. Nevertheless, you will rarely use Carcinosin when there is no suggestive history at all. But you sometimes will. I wrote in the first draft of this manuscript that I had done so only once. On looking over some cases, I realized that I had been mistaken: I have used the remedy a few times - not often, but more than once - on its indications alone. This is not surprising. Who only uses Medorrhinum when there is a clear gonorrheal history? Next, examine the patient's own history. Constipation and insomnia from childhood are strongly suggestive, as are high or frequent fevers as a child. A patient of mine had, as a child, the highest temperature ever recorded at Providence Hospital, in excess of 108 degrees Fahrenheit. Another child would run about and play outside with a 106 degree fever. These fevers often accompany earaches or tonsillitis. Hay fever as a child is also a strong indication. Foubister gives a history of pneumonia and whooping cough as suggestive. I have seen these, but less frequently. Even rarer, in my practice, are individuals who have had childhood diseases more than once. Foubister does give this indication. He also writes that Carcinosin is suggested when there is unusually severe reaction to vaccination. I mention these for the sake of completeness, but cannot confirm them from my own experience. Carcinosin children characteristically have very high energy as children. The sleeplessness and fevers are just manifestations of this.

Then there are the symptoms associated with the remedy itself. Carcinosin, as we have discussed, is pre-eminent among fastidious remedies. It loves to dance and travel, and is affected one way or another by the ocean. Carcinosin is said to be exhilarated by thunderstorms. To be honest, however, as a western Oregonian, I cannot vouch for relationship to thunderstorms. Where I live, asking people about how they react to thunderstorms is usually only slightly more fruitful than asking Eskimos if they are afraid of elephants. Carcinosin is strongly moved by music. They tend to like classical music, though others will like rock. I have observed an aversion to jazz in several patients. There seems to be real aversion to this kind of music. My theory, and it is entirely the kind of idle speculation condemned by our illustrious founder, is that the syncopation offends their sense of order and propriety. In small children, you will find head-sweats during sleep. This is a very important rubric in treating children. Kunzli gives it a black dot in his Repertory, a sign that it is a symptom this is often a dispositive symptom in his experience. He gives the following remedies for head-sweats during sleep: Bry., Calc., Calc.-p, Cham. Cic., Lyc., Merc., Podo., Sanic., Sep., Sil. To this list I add from my own experience: Tub., and Carcinosin. Often this single symptom, in conjunction with the genupectoral sleep position, also present in Carcinosin, gives the case away. This symptom is of little significance in infants, as it is common in the first year or so of life. The Synthetic Repertory gives the following remedies in this rubric: Calc.-p, Carcinosin, Con, Euphorbium, Lyc., Med., Phos., Sep., Tub. I have found these indications to have the force of generals of high rank: they are proxies for something very deep in the life of the child. Thus, in a small child, these symptoms must be present in the pathogenesis of the simillimum. For example, then, if there are both genupectoral sleep and head-sweats, the field is immediately narrowed to five remedies of all the entire Materia Medica. Anyone who has treated children, and wondered how to choose a remedy based on no symptoms at all will appreciate the value of these indications. It should be mentioned that Carcinosin also often sleeps spread-eagled, arms and legs outstretched. This is not at all uncommon in small children, but I mention it so that its presence does not dissuade one from using Carcinosin. One often finds the blue sclerae otherwise associated with Tuberculinum, and the cafe-au-lait appearance. The moles often mentioned as indicative of Carcinosin are of a very specific type. They are round, dark-brown macules. Carcinosin, like Medorrhinum, is suggested by a hairy spine and neck, and by unusual amounts of arm or leg hair, especially in children and women. Many writers have reported Carcinosin as being worse with warmth. I have seen this, but I have seen the opposite perhaps more often. When there is a history of prolonged suffering, think of Carcinosin. This does not mean a broken heart or a disappointing date. K.A.'s case, quoted in this article in its entirety, gives a picture of what I mean by prolonged suffering. Foubister gives severe fright as another precipitating cause. I have no reason to doubt him, but cannot attest to it from my own experience. Unusually restrictive and suppressive parents or spouses point to this remedy also. When the history is parental, we may surmise that it is likely to have been causative. When, on the other hand, it is seen in a series of spouses, it is, rather, a pathological symptom. In other words, only a Carcinosin, or perhaps a Staphisagria, would, as an adult, put up with the abuse K.A. endured from her husband. George Vithoulkas gives as a keynote, "burning pain in the ascending colon." I have seen it only once. I suspect it is like the Thuja keynote of "nose runs at stool," dispositive but rare, at least in my experience. One individual reading this article is likely to recognize this latter symptom, since I was guided to Thuja in his case; but I have not seen it again. The food cravings are very important guiding symptoms to this remedy. Foubister says that an aversion or desire for any of the following foods is suggestive of Carcinosin: meat fat, sweets, salt, fruit, milk, and eggs. My own experience confirms this. What I will add to this is that a particular characteristic of the Carcinosin type is an alternation, often over periods of years, between aversion and desire for one or more of these items. The remedy tends to have a lot of aversions and desires, and that needs to be present for one to really consider this remedy on the basis of its cravings. Thus a desire for meat fat and salt and a neutral feeling about the other items would lead one away from Carcinosin. There is often also a sensitivity or allergic reaction to some of these items.

I have saved what I consider to be the most important food desire for the last: chocolate. Schmidt give it as second type. I believe he understates the case: I feel that it should certainly be black type. Nevertheless, you will occasionally see an aggravation from chocolate, and I think I may even have seen an aversion to it on occasion. The remedy type also desires onions and garlic. It has a strong relationship to coffee, but then again, this is the addictive remedy nonpareil, so that should be expected. I have observed, however, that it is also particularly sensitive to coffee. In one of the cases quoted in this article, the patient, after marked improvement, took some coffee to stay awake on a transcontinental trip. She noticed her uterine symptoms returning before she had finished half the cup. Fortunately, she had the presence of mind to throw the rest away, and suffered no lasting harm. When this manuscript was essentially complete, I scanned CARCINOSIN, the record of a symposium on Carcinosin in Hechtel, Belgium. Several of the practitioners mentioned desire for soup as being of cardinal importance in Carcinosin, second only to desire for chocolate as food craving. I did not know this, but the writers all gave ample evidence of a clear understanding of the remedy. This should therefore be taken as authoritative, and I also will take pains to inquire about soup in suspected Carcinosin cases. The following case sketch is of a "pseudo-Staphisagria" woman. The prescription would easily have been missed had I not known what to look for.

Her chief complaint was exhausting (3) menstrual cramps (2). She also had cramps at ovulation. The patient, M.E., is intimidated by anger (2), and NEVER expressed anger toward her husbands. She was introduced to abuse early. She recounts that at age 2 or 3, she lost all her hair. The diagnosis was "stress"; she now feels that she lost her hair because she would not cry out, of fear of her father, an alcoholic, who later left her mother, and died of metastasized stomach cancer. Her stepfather would ejaculate in her mouth, then beat her and threaten her with more serious harm if she ever told anyone. Later, at 11, it was an uncle fondling her, and a couple of years after that, a cousin forcing vaginal intercourse on her. She proceeded to become involved in successive abusive marriages. Both were to black men.

Why did I make a note of this? Prejudice aside, it is a matter of my observation that in the United States, whereas the decision to enter into an inter-racial relationship signifies nothing of interest to a homeopath, the decision on the part of a white woman to choose only black men as her sexual partners is noteworthy. Often it suggests the existence of a Staphisagria-like, or in this case, Carcinosin-like tendency. Before any readers who do not know the author of this piece cry "Racism!", such individuals should know that the author himself is a black man - one, moreover, who is married to a white woman, who, incidentally, is neither a Staphisagria nor a Carcinosin.

The first husband was an unregenerate adulterer, nineteen years older than she. He would even bring women back to the house and copulate with them while his wife cried in the next room. Her second husband was an alcoholic who beat her, and with whom she had sexual intercourse two or three times a day on weekends, but only out of duty, as she had little interest herself.

Why did I not give her Staphisagria? This might have been the logical choice. She had all the food cravings of Natrum-muriaticum, however: chocolate (2) [at the menses (2)], salt (1), garlic (1); she also loved the ocean (2) and was fastidious about time (1) and claustrophobic(1). Perhaps she was a Natrum-muriaticum, but she was not worse with sunshine, and was not worse from consolation (2). That ruled Natrum-muriaticum out. I observed that she disliked jazz (2), desired onions (2), and was worse from coffee (2). There was also a suggestive history: Her father was an alcoholic who died of cancer; his parent's history was unavailable, the mother had no remarkable history, but the maternal grandmother had DM, and asthma, and died of a CVA. The MGF was a severe alcoholic and died of cerebral hemorrhage in his 40's. With all pieces of the puzzle in place, Carcinosin was a much better fit than either Natrum-muriaticum or Staphisagria.

Case of C. C., 11 months, DOB 23 Nov. 82, male

10 Dec. 83: I believe this was my first Carcinosin case. I have had the opportunity to follow his progress for nearly ten years. It has been one of the singular and most gratifying joys of my years of practice to see this child rescued from a life of desperate suffering, ill health, and almost certainly, early death, and restored to vibrant good health. This child presented a truly frightening demeanor, I had never seen a child look so ill before. Anyone of more discretion and certainly anyone with a license to lose would have refused to see him. It was apparent that he would die on my hands. Nevertheless, I proceeded: Chief complaint of epileptic seizures (3). Onset during teething at 4 months - 1st tooth; diagnosed as stroke by neurologist. Had been on Phenobarbital, then changed to Gemonil, 200 mg/day. He changed in character around the time of onset: used to be exuberant. Now, especially since Gemonil, clingy, crying. No health problem before the stroke. Mother tried to take him off drug a couple of months ago - couldn't. Onset: left arm twitching, then left leg, then both became limp. Was a week before function returned. Frightened of people (2). Used to sweat on head during sleep (front of head) (1), better with Zinc supplement. Easily startled (2), hair on spine (2), doesn't eat but an obese child (2). Non-stop ear infection, colds, pneumococcus, high fevers to 104ºF (3), 20 times last six months. Acts as if genitals sensitive. Worse with Mom eating cheese, milk - redness on cheek (1). Sleeps badly (2) last 2 months, since onset of congestion. Alarming congestion (3) - I had never seen a child breath like that. Blue sclerae. Discovered, months later, C.C. had teeth at 4.5 to 5 months. Father's history: ex-heroin addict, PGF, PGM, both DM. Mother: healthy, MGM, died at 47 of liver CA. MGGM died in mid-fifties of breast CA. MGGF died of cardiac symptoms. MGF had tuberculoma which required surgery. A mental breakdown followed, for which he required shock treatment. PGGM and PGGF were living reasonably healthy. Assessment: Vital force rating 4-5; head sweats, obesity, convulsions on dentition. Plan: Calcarea-carbonica 200C, t.i.d. until aggravation then discontinue Gemonil gradually. 21 Dec. 83: No change, Calc.-c incorrect remedy. Family history of cancer, diabetes, tubercular diathesis, mental disturbance. Plan: Carcinosin 200C, t.i.d. until aggravation, then discontinue Gemonil.

3 Jan 84: C.C. had a reaction 4 days ago. I was not called and Mom continued to give Carcinosin. He is now coughing (2), vomiting (2), having neurological activity on left side around mouth. Assessment: therapeutic aggravation. Plan: Gemonil 200 mg/day, then 175 mg/day.

4 Jan 84: Cough (2): Mom thinks it is pneumonia.

5 Jan 84: Had fever (2) last night, over 102ºF in axilla. Coughing, but no vomiting last night. Congestion better last few days. No neurological activity. Fever 8-9 p.m. until 3-4 a.m. (2). Vomiting had been worse from 5 am on (2).

Assessment: still aggravation.

Plan: Wait. Gemonil 175, then 150 mg/day.

8 Jan. 84: Fevers on last few days start p.m., 104ºF rectal. Threw up postprandially on Jan.

6 , 7, not today. Coughing the same.

Plan: Gemonil 150, then 125 mg/day.

11 Jan. 84: Much better. For the first time since aggravation he has smiled, played, kissed Mom, slept by himself, etc. Fever 104ºF or so in evening last few days. Threw up after bad coughing spell; had redness on cheek - old symptom from when he started Gemonil.

Assessment: proceeding according to plan.

Plan: Gemonil 100 mg/day.

22 Jan. 84: Yesterday was final day on allopathic medication. C.C. has, for the last few days, had slight twitching with some disorientation, then vomiting, one attack almost always at 6 p.m., sometimes also in morning.

26 Jan. 84: No neurological activity of any kind for three days. Plays all day; happy as before all this. In the past he had convulsions when Gemonil was reduced to 150 mg/day.

Assessment: correct remedy.

Plan: wait.

28 Feb. 84: Bumps on face, chest, diaper rash. Restless sleep (1), wakes every 1-2 hours. Mild cough/cold for a week, getting canines. No redness on cheek from milk, cheese, no sensitivity on genitals. Appetite increased (3). My observation: the difference is like day and night. No congestion, child is happy, relates well to me. No convulsions or any other problems.

Assessment: one could not ask for a better result; absolutely curative response.

Plan: wait.

18 May 84: Left side of face acted paralyzed, then he turned blue today. Mom had coffee off and on during the last two weeks. Last dose 1-1.5 weeks ago. Took a bad fall yesterday, hit head. Can't stand now (2). Drooling (2) because of teething, diarrhea (2). No head sweats. Sleep starts out in genupectoral position then goes back.

Assessment: relapse as a result of fall.

Plan: Arnica 1M

19 May 84: No change after Arnica. Mom did coffee on 14 May, C.C. has loose stools since. Mom has used facial clay with mentholatum for one month. First drank coffee one month ago - "He's better, so it won't hurt." Two weeks ago she noticed that on being reprimanded he would get upset (2), hold breath (2), turn purple (2).

Assessment: I was foolish not to inquire in more depth. The situation is

that his remedy has been antidoted by the coffee and/or the clay ointment.

Plan: Give Carcinosin 200C to take home.

20 May 84: I was out of town. Mom called and talked to Ray Wood, N.D., with whom I shared a practice at that time. She was hysterical. C.C. had many seizures. Ray wanted to hospitalize but I decided against it. By 3 p.m. the seizures had calmed down.

Assessment: relapse.

Plan: Carcinosin 200C.

21 May 84: Several minor seizures the next day, was back to normal in a week.

11 July 84: Had been in bad auto wreck about three weeks ago. He received Arnica at that time, which helped the bruises, etc. His mother weaned him suddenly and she was in the hospital for three days without him. Restless night (2), cries (2), screaming (2), goes to sleep at 9 p.m., then wakes at 12, screaming. Rash around mouth (2), congestion (2) last two weeks, wheezing audibly (1), coughing at night (1), fear of falling (2), appetite down (1), more irritable (1). Didn't cry all the time when Mom was in hospital. When she came home he asked to nurse and screamed (2) for one hour, inconsolably. Tantrums bad (2), every two days. Bad diaper rash (2). Mom thinks that left side is somewhat neurologically active. Displaying a lot of anger (2).

Assessment: Perhaps a remedy is indicated but, bearing the gravity of the case in mind, we will wait.

14 July 84: Fever, 104.6ºF rectally, since yesterday. Ornery that day, several tantrums. Worse 2:30-3 p.m. (1). Grinds teeth in sleep after wreck (2). Thirstier (1). Restless sleep (1). Shouts during sleep (1). Acts "shaky" when he wants something. Does not look sick, however.

Assessment: probably the mere fact that he has an acute illness together with what has transpired suggests a new prescription.

Plan: Give Ignatia 1M because of sudden weaning, after acute, taken 19 July.

20 July 84: Sneezed immediately after taking the remedy. Threw up. Slept that night, woke up his former self. Much better, no tantrums.

Assessment: Ignatia was correct remedy.

Plan: wait.

I have prescribed occasionally for chief complaints over the years, but he has not had a full-blown seizure in eight years. His last constitutional prescription was Carcinosin 50M, on 21 Mar. 87, when he had some neurological symptoms. He now complains about things of such gravity as athlete's foot.

Case of K. A., DOB 10 Mar. 48, female

14 May 92: The impression that this patient gives is of a yuppie who exercises a lot and takes meticulous care of her appearance, and who will do anything to avoid getting old. She drives a stylish BMW with a license plate customized with her name. There is something quintessential Carcinosin about her; perhaps it is the muted fire in her eyes, peering out from behind a veil of pain and disappointment. In any case, I knew the remedy without asking, and thought of asking only enough questions to get a confirmation of my intuition and provide a basis for follow-ups. But this is, after all, a cancer case. It turned out that this decision was not mine to make. As soon as I asked her: "What is the matter", then everything flowed out. I should mention something about how I came to this case that says a lot about the patient and the remedy. She owns a health-food store in a small town that I visit periodically to see patients. Several of my patients had spoken of me to her, and vice- versa. I would hear, through the grapevine, that she had intended to see me this month but couldn't for this reason, and next month for another reason. Acting upon the pleas of my friends and patients, I decided to help matters along. I went into the store, ostensibly to buy a rice-dream bar, and let it slip who I was. She immediately poured out her life story to me, and told me that she was determined to avoid orthodox medical treatment, and intended to come and see me, and that she would work it out with her schedule, and it might not be this month but perhaps next month. I explained to her that this was a disease that would terminate in only one possible way unless we did something about it, and quickly. By the time I had walked the few blocks to my office, she had called, wanting to see me that day. Carcinosin is very much into keeping death away by planning and activity. This strategy had begun to fail for her, but she could not accept mortality, the ultimate imperfection. Therefore, she simply hid her head in the sand.

Chief complaint breast cancer. Six months ago she had lost a lot of weight, discovered a hard, mobile, painless, nut-like lump in her left breast. Diagnosis from biopsy was malignant breast tumor. Since the biopsy heaviness (1), pulling (1) deep in breast and aching in left axilla (1). Migraines (3) with blindness (3) and vomiting (3) since age 16, when she was married; every three months, used to be every six weeks. Aborts them with Cafergot which makes her high (3) and cold (2). Depression (3) off and on all her life. Has attempted suicide several times in last few years. Manic (2) all along. Low energy (2). Always felt she would die young (2). Drinks too much alcohol (2), 2-3 drinks a day.

I recount her personal history in great detail here because it is a clear pointer in the direction of this remedy, and includes many elements to be found in the typical Carcinosin history. "I was raised by a Nazi woman. She was a perfectionist (23), who would only give you one chance to Fuqua up." When she did, her mother would grab her by the hair and pull her down the stairs. As a result, "I spent all my life trying to be perfect (3)." Adored (3) and feared (3) her mother. Her father was a soft-spoken "good ol' boy," whom the mother left when K.A. was 13 years old. At 11 she was raped by a relative. Upon hearing of it, her mother pushed her down the stairs saying, "There is two kinds of dirt, one you can get clean from, and one you can't." She became reclusive from this point on, spending time by herself and with her horse, and became, during teenage years, a "prick-teaser." She slept with a boy at 14 and married him at 16, a man "like Jimmy Swaggart." One day he would be a religious fanatic, the next his fanaticism was for pornography. Nevertheless, she dedicated herself to being the perfect mother. She became strict and narrow as befitted the wife of a fundamentalist Christian. When she found out that he had been unfaithful, she left him. Sex was a duty with this man; there were no emotions or feeling. She married him because he was the first boy she had slept with, and therefore she felt that he owned her. He yelled constantly and controlled her thereby. He could not stand to hear people eat or breathe, therefore she would feed the children before he got home so that he would not have to hear them eat. As soon as she left her husband, she "went to town," was a "16 year-old in a 34 year-old body." She had a couple of major relationships and many one- night stands. She had a hysterectomy at this point and several abortions, she didn't really know about birth control. She also had some questionable Pap smears, was told to "take it out," and did so unquestioningly. She had what appeared to have been peritonitis, with high fever (3), vomiting bile. More surgery, collapsed intestines. She failed to respond to any treatment. Finally, her M.D. said, "You are dying and I don't know why." She woke up, realized the gravity of the situation, checked herself out of the hospital, and promptly recovered. After this she became the "kept woman" of a powerful and dominant attorney, who later was killed in a terrible car accident. She had a five-year relationship, just ending, with an alcoholic/workaholic. A small, Napoleonic, dominant man who would often try to get her to have sexual intercourse with his friends, and who would boast to her about his lovers. He would never touch her. "Sex" consisted of fellatio while he sat in a chair and smoked. She has slept with perhaps 50 men in her life but cannot reach orgasm (2), except by masturbation. The one exception was a young artist who whimpered and cried during sex but was very attentive to her, and with whom she lived for a while. He left her because he wanted children and a younger woman. At a certain point she found herself in a prostitution situation. She had a friend who had a large rain forest project. K.A. agreed to sleep with the rich man who would, in exchange, be easily persuaded to make a large donation to her friend's cause. It turned out to be more than she bargained for. He was impotent and had an implant. In lieu of his own performance he tried to get her to have sex with his dog. He urinated on her and attempted to beat her up. It was shortly after this when she discovered the cancer. Always had trouble with relationships (2). Doesn't trust men (3), afraid of them (3). "Says no to nobody, for anything" (3). Never refused a man sexually in her life (3) until a year and a half ago, when she had a migraine, was going blind and vomited. He then raped her. She felt this was the story of her life. She did not report the rape; she did not want her son to know. She became depressed, tried suicide twice, was treated with Prozac, Wellbutrin, Chlorophen. She remains on them, though on reduced dosage. Has tried to get off them, unsuccessfully. She began smoking at this point. Hates herself for it, is contrary to every thing she believes in. Also began to gain weight at this point. Looking at her I didn't take this latter too seriously. She had been a foster mother for abused children for twenty years. The rape brought her own abuse into consciousness. "Part of me feels that I will die, commit suicide" (3). Breaks down in tears at this point and at many others.

Bloating digestion (3), frequent urination (2), fastidious (2), for disorder. When depressed goes off by herself (2) to cry. Consolation leads to shame (2); she does not want to be a problem. Loves the sun (2), water (2). Fear of heights (1). Takes herbs and supplements too numerous to mention. Loves to dance (2). As a child she slept well but sweated in bed (2). Had delusions of head expanding, body shrinking or vice versa. At these times vertigo (2), worse rising from seat (2). Desires coffee (3), which gives her a high followed by a manic state. Chocolate (3). Had never eaten salt, now craves sesame salt (3), butter (3), onions (1), garlic (2), milk (3) which makes her worse. Tends to sore throat (1). Aversions to eggs (2) except on croissants, fruit (2), usually salt (2). Family history on mother's side: MGF violent, abusive, unbalanced; his father was clinically insane. MGM: "sexually promiscuous," "the town whore," married ten times. Father's side: F: healthy; MGM: has been hospitalized long-term for nervous breakdown; MGF: 93, healthy.

Assessment: To me there was no question. The only other possibility was Staphisagria, and I would undoubtedly have used it if I didn't know Carcinosin. I would have assumed that the symptoms not covered by this remedy were representative of another layer. However, the food cravings are here in spades, she is fastidious, there are digestive difficulties, and there is cancer, although there is not much in the ancestral history. She also has migraines and had a preference for animals (her horse), as a youngster - a symptom which other writers have mentioned. As importantly, she had the unmistakable essence of this remedy written all over her.

Plan: Carcinosin 200C, daily, until aggravation, then gradually discontinue allopathic medications, 14 May 92. Get her to wean herself off cigarettes and alcohol.

19 May 92: K.A. called, crying (3), hysterical (3): "Everything I ever did bad is coming back." (3) Nausea (3), chills (3), fever (3). Memories of past traumas (2), including feelings about abuse. Pain in the breast (3) as if it would explode. Took a couple of all medications today, had been off a couple of days. Migraine (3).

Assessment: Good reaction! Aggravation.

Plan: Continue remedy for a while until I am sure she is totally off all medications.

23 May 92: (phone) "Migraine calmed down yesterday. I feel great (2), better than I have felt in a long time."

Assessment: Short, quick aggravation followed by a rapid rebound. It appears we have a curable case here.

Plan: Discontinue homeopathic remedy.

16 June 92: She thinks she antidoted with coffee; she now has dark circles under her eyes.

I cannot say that they weren't there before. Before the remedy she had been utterly depressed, confused, now she is grounded, still clear, although tired (2) and emotionally exhausted (2) from having to deal with people in her store who always inquire after her health and give her advice. But emotionally clear! Eating lots of chocolate (2), put on 10 pounds (she can stand to put on some more). No headaches until a couple of days ago. Then she had two drinks and became sick (3) as during the aggravation. This has passed, though. Slept better. Personal life is better. She is in a positive relationship now, both are committed, allowing herself to be open and vulnerable and loved for the first time in her life. Breast sore (1) first left, then right. Bloated (!). Fungus in toenails, cracks between toes. Episodes of coldness (1), was cold (2) with the headache after drinking. More grounded now, can say "No!" but feels fragile in this equilibrium. Urinates less, but no longer consumes alcohol and coffee. After coffee she became despondent with circles under her eyes and fullness in breasts. She had been riding her bicycle again, now she can't.

Assessment: She had been drinking coffee every other day since she stopped taking the remedy. There is no evidence of antidoting, but we shall see. Perhaps there will be some effect from the alcohol.

Plan: Wait.

21 July 92: Running every day, working, but one day feels energetic, playful, then used up by the end of the day, "on reserve." Wishes she were beyond the point of constant focus on the possibility of relapse. "My body is falling apart." What she means by that is that her hair is dry (2), fingernails peeling (2). "No muscle tone." Brown liver spots all over, especially on legs. Started taking Mesostrate supplements. Thinks she feels better. Has had a few headaches, no migraines. Pulling sensation in area where lump had been biopsied. Has had some coffee over the last month. Not depressed but "used up" (1), tired (1). Relationship is healthy; only healthy one she has ever had. She describes the recovery from her fever during the aggravation: all men in her life - lovers and sons - were there; she felt healed of so much fear of men. "I always figured things out and performed, so that I would not have to deal with the fear." "There has been a softening of the crust of pain in my life." "A lot more secure in who I am. I can say 'no'." Spends a lot less time evaluating when the next crisis will be and how to avoid it. Enjoys sex; good, six times per week. Urination normal. Bloating (1) off and on. Not eating so much chocolate. Still worse for consolation (2). Recently her son remarked that the smell of DMSO was coming out of her pores. He noticed it because he had hated the smell when she used it in the past. Also noticed other odors, perhaps from other drugs. At times she is tired (2). Very up last week, tired this week.

Assessment: Doing well in spite of coffee. I gave her a stern rap about coffee, asked her if she liked it enough to die for it.

Plan: Return to clinic in 1 month.