Proving symptomatology and clinical results

58th CONGRESS OF THE LMHI – April 22-26 2003, Graz, Austria
P. Gulia, G. Pitari, G. Dominici


Etna lava was prepared as homeopathic remedy from 2001 sicilian volcano eruption. The proving occurred from October 2001 to March 2002, including 3 prover groups, 3 supervisors and 1 coordinator. The rules of classical hahnemannian proving have been followed, using 30 CH potency and subsequently 200 K. 27% placebo was included. More than 300 symptomatological notes have been registered; the repetition of unusual general and mental symptoms has been observed. The present paper shows: the symptomatology of the double-blind multicentrum proving compared to previous reported data, new prover descriptions of the remedy and some clinical results.


Etna lava – Homeopathic new remedy – Classical hahnemannian proving – Double blind – Placebo – Clinical results


Etna is the largest active volcano in Europe and one of the largest in the world.
Many of Etna’s eruptions have occurred through fissures that have opened in the volcano’s sides, although one of the numerous vents in the central crater is almost always active, emitting lava or puffs of gas and ash.
Etna’s ample structure has formed through phases of activity and periods of dormancy and erosion. The magma’s conduits have shifted over time, giving the volcano its current irregular shape.
Etna’s structure was formed in a relatively recent geological period somewhere between 150,000 and 80,000 years ago. Its most important eruptions during the last 2,500 years are well documented, whilst nearly all the eruptions occurring in the last 500 years have been recorded.
Etna’s eruptions are prevalently effusive i.e. with lava flows running like rivers down its slopes, thereby increasing its dimensions.
Magma is a very hot natural substance composed of a heterogeneous system formed by liquid, solid and gaseous phases of variable duration. The composition of the liquid is often silicated but rarely carbonatite. Other elements present in the magma are Al, Fe, P (which, together with Si, are called the “structural components”) and Na, K, Mg, Fe Ca and Ti, defined as “structural modifiers” insofar as they modify the magma’s viscosity by interrupting the silicated chains and saturating the oxygen valence. The principal volatile components present in magma in significant quantities are H2O and CO2.
The summer of 2001 saw Etna fully active once again: from 18th July to 7/8th August. The explosions were concentrated around an altitude of 2,550 metres whilst, at lower altitudes, a single vent at 2,100 metres proved to be active and its eruptions threatened the village of Nicolosi several times. Etna’s activity then continued in successive stages for the greater part of 2002 and early 2003.


The lava samples were taken at an altitude of 2,550 metres from the crater of Monte S. Leo. Upon analysis, they gave the following composition:

SiO2: 47,18 – CaO: 10,64
TiO2: 1,71 – Na2O: 3,36
Al2O3: 16,24 – K2O: 1,92
Fe2O3 tot: 11,33 – P2O5: 0,49
MnO: 0.17
MgO: 6,21 – Tot. 99,25

The samples were delivered in September 2001 to the Unda Laboratories at Grumo Nevano (in the province of Naples) which saw to the trituration and preparation of the remedy in 30Ch and 2000K potencies in both liquid and granular form.
At the same time, the Unda Laboratories prepared other dynamized substances from amongst which the remedy to undergo experimentation was randomly chosen.
The experimentation team was composed of:
1 co-ordinator, 3 supervisors and 11 provers.
A phial containing placebo was introduced into each of the three groups of provers. The number of placebos and how they were distributed was known by the co-ordinator alone.


Rome: 5 Provers (2 males / 3 females)
Naples: 3 Provers (1 male / 2 females)
Catania: 3 Provers (1 male / 2 females)

As a whole, the composition of the groups was 36% male and 64% female. The group of provers that received the remedy was 37.5% male and 62.5% female. The placebo group was 33% male and 67% female.
Of the 11 experimenters, 6 were doctors, 2 were pharmacists, 1 was a biologist and 2 did not practise a medical profession or have any particular knowledge of homeopathy. Thus the ICCH guidelines regarding the number of provers, their profession and the placebo percentage were respected.
Proving began at the end of October 2001 and the length of the observation period was fixed for at least two months from the day the remedy was first taken. Indeed, previous data had highlighted how symptoms caused by the remedy can arise or continue even several weeks after the first administration. Within hours of administration, all the provers developed symptoms varying in number and intensity according to their particular personal sensitivity to the remedy (§134 Organon) and this lasted for a period varying from three to four weeks. One prover (no. 3) continued to produce symptoms after the two months were over and to such an extent that it became necessary to give an antidote: another prover (no. 9) continued to experience symptoms arising during the experimentation for more than four months and these disappeared after a further administration of the remedy (§131). Another prover (no. 1) produced symptoms for approximately 20 days and then saw the initial symptoms reappear accompanied by other, completely new ones (experimental symptoms insofar as they also appeared in other provers) just when she considered her experience had ended.

Method of administration

a) First intake in the evening. To be repeated (in the absence of symptoms) every six hours up to a maximum of 6 subsequent intakes (ICCH Guidelines). Administration was to be suspended:
1) when symptoms appeared;
2) 48 hours after the first dose.
During the first phase, the 30CH potency was used in drop form: 10 drops taken directly under the tongue for every intake, with the obligation of succussion at every administration after the first one by striking the remedy energetically against a hard surface or the palm of a hand at least 10 times.

Criteria for recording the symptoms (§ 139 Organon)

a) A notebook was provided for noting the symptoms as soon as possible after they were perceived. The symptoms were then transferred to a computer, defined precisely and completed.
b) Every prover was given a personal code together with the number of the corresponding phial. The code and number were recorded beside every symptom.
c) As well as giving his/her code, every prover had to indicate the time and day/s of the symptom’s appearance; e.g. 1st, 2nd, 4th and 7th day..
d) The symptoms had to be transcribed, listed and numbered following the chronological order of their appearance.
e) Technical or medical terms, psychologisms, overly succinct language or elaborate attempts at explanations were all avoided. The provers were asked to be as spontaneous and direct as possible.

Symptoms classification
Every significant symptom had to be recorded and classified within one of the following groups:
1) Common symptom, but of increased intensity.
2) Cured symptom, disappeared.
3) Previous symptom, reappeared.
4) New symptom.
5) Exceptional symptom, in terms of novelty and intensity.

“Previous symptom” is to be understood as a symptom experienced by the experimenter months or years before the start of proving (§ 138 Organon).
“Exceptional symptom” is to be understood as a new symptom with marked and totally unusual characteristics.

The frequency of contact between supervisors and provers was established at one direct meeting every week and more regularly by other channels of communication, whereas that between co-ordinator and supervisor was fixed at a minimum of every 15-20 days.

In the case that a prover suffered a deterioration considered unbearable on account of its intensity or persistence, the co-ordinator and supervisor, acting in agreement, would arrange for the suspension of the experimentation and the administration of an antidote.

Volcano lava in homeopathy – toxicological data

The use of volcano lava in homeopathy is not new: the remedy Hekla lava is well known. Taken from the lava and ash of the Icelandic volcano of the same name, its clinical applications are significant but it would merit a fuller homeopathic experimentation (“In this imperfect pathogenesy we have undoubtedly symptoms pointing to diseases of teeth and bone” – Hering in “Guiding Symptoms”).
Ash from the volcano Popocatepetl and the remedy known as Cinis popo underwent experimentation in Mexico a few years ago.
Lastly, Dr. Gaetano Arena has conducted experimentation with Etna lava in Catania. A comparative assessment of the results of that experimentation has enabled us to highlight many important data in common, both regarding the general and mental symptoms and the local, physical ones, thus constituting a valuable confirmation of shared experimental results.
As regards the toxicology on volcanic eruptions, some data concerning volcanoes in different situations can be found in publications. For example, some toxicological effects were reported immediately after the eruption of Popocatepetl, Mexico’s most famous active volcano. Both physical symptoms (respiratory problems, above all) and mental ones (depression, nightmares and anxiety) are reported in this work; it is nevertheless necessary to emphasise that, apart from the different geographical region and the probably different type of eruption and eruptive material, gases are also emitted into the atmosphere during a volcanic eruption. When inhaled along with the particulates, these gases can have very clear effects which the lava (being solid and lacking those gases) could not cause on its own.
These particulates contain Silicium monoxide which can provoke acute or chronic silicosis in man. Silicia particles generally provoke pulmonary fibrosis.
Titanium dioxide, one of the components of Etna lava, is a compound widely used in the manufacture of plastics and dyes. It is used as a food additive or in cosmetics.
It is very resistant to corrosion and for this reason also has an application in metallurgy as well as in the capacity of a component for surgical implants and prostheses. It is also present in drinking water. It is considered inert and the percentage absorbed after oral administration is approximately 3%. What is absorbed is then excreted in urine. If inhaled, it tends to remain in the lungs. In massive doses, it is classified as a “mildly troublesome” compound, given that only mild cases of pulmonary fibrosis have been observed in patients who have inhaled massive quantities by accident.
Lava’s other components may be considered inert, although some of them are known to be toxic in massive doses. Indeed, phosphoric anhydride is considered corrosive. It is also necessary to consider that the toxic effects of individual components are not found in mixtures similar in composition to volcano lava: preparations of this kind are considered inert and can be widely used in surgery and dentistry.


The 8 “verum” provers described over 300 symptoms. These symptoms were checked, discussed and validated by all three supervisors with each prover and, subsequently, by each supervisor and the coordinator.
The importance paid to the preliminary meetings of the coordinator with the supervisors and the provers to establish a simple, accurate and correct language, that would describe precisely what the prover had felt, has to be standardized.
The frequent direct meetings between the supervisors and provers during proving is another point of importance. In this way symptoms – such as complexion, facial expression, tone of voice – could be noted and introduced into the diary by supervisors. These symptoms are symptoms of the substance, in other words proving symptoms; they could be missed if not described by provers or without strict and repeated contacts with the supervisors. Hahnemann himself recommends recording signs or objective symptoms (par. 108).
The duration of proving must be underlined. According to ICCH recommended Guidelines for Good Proving, it was established that the duration of the supervision would be two months. A following third month of observation before judging ended the experience because of the absence of new or repeated symptoms and before administering 200K to one or more provers. Most provers, indeed, confirmed the reliability of the choice: only one of them continued producing symptoms – or, more precisely, the same pain in right forearm – for 3 months.
Among the more than 300 validated and recorded symptoms, 37 are “repeated symptoms”, that is each of them was recorded by at least a prover for 2 or more days. 24 of the total are “crossed symptoms”1, that is recorded by at least 2 provers. In fact many of them were “repeated and crossed” symptoms simultaneously. Furthermore they were all very intense and classified as “new” or “extraordinary” by the provers and they lasted for several days.
These symptoms are the base for this synthetic report on the pathogenesis of Etna lava. Our firm conviction is that the proof of a good proving is not to record hundreds or thousands of symptoms from every part of the body but to record 10-20-30 symptoms which are certain and reliable and which draw a clear picture of the proved substance.

General symptoms

1) Chilliness, coldness.
2) Weakness, weariness, heaviness.
3) “Wateriness”

Chilliness is highly characteristic: it is an actual lack of vital heat. It will be illustrated better by means of provers’ notes.

Prover 1 – “I felt cold during the night, I had to wear a pair of socks! And I became chillier during the following day, too.”
“I had to wear two pairs of trousers and two sweaters – one over the other – because of the intense cold I felt. I have not got the courage to undress and wash myself. “
“I feel my body as cold, as anaesthetized because of the cold; it doesn’t sweat; it is as if dead, without signs of life; I don’t even feel any sexual desire; I have got so many warm clothes on that I don’t feel signs from my body; I don’t even smell its scent.”
“I felt so cold I had to go out and be heated by the sun, like a lizard; in spite of my dislike for strong sunlight and strong sunny heat. I felt only an unbearable heat on my face but my body kept on feeling cold.”

These symptoms are valuable as:
– they went on for two weeks from the early beginning of the proving (30 CH);
– Prover 1 was described as a warm-blooded in her prior case study (written by her
supervisor); she dislikes warm weather, warm rooms, warmth in general and
tolerates cold weather very well;
– the proving started at the end of October 2001; from that time till half of November
a very strange warm fall was recorded in Rome ;
– correctly the prover classified the symptoms as “extraordinary”.

Prover 9 – “I feel cold over my shoulders and my arms. I had supper in a wind-cheater: I think it is very strange as my husband and sons had supper wearing T-shirts! Chilliness in the arms; unusual for me as I always feel warm!”
The prover lives in Sicily, near Catania which is near Etna, and November 2001 was hot!

Tiredness, weakness, heaviness
Prover 1 – “I feel heavy, I drag my legs; my belly is blown up and I am constipated.” “My temples are heavy as if my head is stuffed.”
“I am tired, heavy, I don’t go to work, stay in bed all day.”
All these symptoms kept on for 15 days after a 200K dose.
“Wateriness” is a neologism invented by a prover. It accurately describes a group of symptoms characterized by profuse thin discharge, such as water, from the nose, the eyes and the bladder.
Prover 9 – “I have urinated a lot. It has never before happened to me except when I was pregnant….clear, profuse, odourless urine….also last night I got up twice to urinate: it has become an habit but I drink as usual!”
New and extraordinary symptoms, appeared from the third day of proving and kept on for 11 days.

Prover 1 – “2nd and 3rd day: I have urinated a lot. It was as if profuse water was flowing out of me. I kept on urinating a lot all day.” New symptom.
Prover 2 – “During a walk (it was very cold) a very violent crisis of sneezing with unbearable itching of the nose and profuse watery discharge from the nose. NOTE: I have not had such a crisis for the last 10 years, at least.”
He classifies the symptoms as “extraordinary” because of:
– its intensity;
– it occurred at the end of November, completely out of the season (May-June) when he used to suffer allergic rhinitis in the past;
– he had not suffered from allergies following a cure ten years previously.
Other provers described an analogous situation.
Prover 1 – “Profuse watering of the eyes in the sunlight, without stopping, but without burning just like water flowing from eyes, water not tears. Profuse “watery” tears simply appearing.”
These symptoms, on the 2nd day of proving, were classified as “current but intensified”.
“I feel as if water was inside the nose root, I need to sniff all the times, like a sort of tic. It is not a cold.” From 2nd to 4th day; new symptoms.

Mental symptoms

1) Calmness
2) Cheerfulness. 3) Resolution
4) Anger
5) Exaltation
6) Powerlessness
7) Nostalgia

Feeling of calm, a good and cheerful mood and resolution.
A note, written by Prover 1 on the 22nd day, is an exact picture of it.
Prover 1 – “I still feel cheerful and strong; I sleep less; I do a lot of things, more than usual…This cheerful mood is strange. I am not upset in spite of many troubles….I am not upset as if it’s not worth taking such things to heart…”

Prover 9 – I heard upsetting news and I flew into a rage (as usual); instead of feeling hurt and brooding over it I called and confronted the people who had offended me. It was unusual: I prefer to let it go. Resolution in facing trouble (9th day).”
“I get angry but I don’t submit, I react, other than usual.” (31st day).

Prover 6 – She is a quick-tempered woman, usually; yet, 30 days from the beginning of the proving she notes: “I am still feeling very calm. I shout much less than usual, I think; I don’t fly into a rage; I face trouble quietly. As if I can look at the world more serenely. I don’t know what it comes from! The consequence is an huge improvement in my family relationships, above all with my daughters, with whom I have a deep stream of affection.”

The three last described symptoms have to be considered as cured symptoms.

Resolution reaches a sort of exaltation:
Two provers (n.1 – n.3) express themselves in this synthetic way: “My feeling was: I can do everything!”
And Prover 3 adds: “I felt resolute; facing trouble I felt clearly I was superior to the trouble. I felt the same way facing people, my conviction was: I can subdue him!.”

It is interesting to note that a prover wrote she could face and work out problems during proving she had not had the courage to face for many years before Etna lava.

Prover 5 – He wrote on 5th day: “In the morning, before getting up, I have a deep feeling of well-being with self-confidence: I feel myself “ a world master”, everything smiles at me, I don’t see the dark side, nothing worries me, bothers me, makes me feel anxious or fearful, nearly an exaltation…” This symptom is absolutely “new” for him.

As often happens during a proving, opposite mental symptoms come out: calm and anger; resolution and helplessness; cheerfulness and sadness. It is not strange neither unusual. (See Organon par. 115 and the introduction to Nux vomica in Hahnemann’s Materia Medica Pura).

Prover 1 – “I feel insecure, I cannot say No! I say Yes to proposals I don’t like, I stay dull, blank, I grow confused. Then I feel anguished in doing things I don’t want to do…” “Hopeless and weary” – “I can’t stop crying!” – “I wish I could get away.”
“Anger against everyone; I can’t bear people, I find pretexts for quarrelling. “
“I quarrel with many people without feeling sorry.”

All these symptoms were classified as “extraordinary” except the initial one, which had appeared in the past.
Besides, the prover produced all these symptoms in the second phase of the proving after having taken Etna lava 200K. The above described symptoms are diametrically opposed to those she had proved taking Etna lava 30 CH (see above): a sort of reverse result which stemming from the potency?
This consideration seems confirmed by Prover 3, the other one who took 200K (see below).

A supervisor, after a meeting with a prover, wrote the following note: “She conveys the feeling of being compressed, she is about to blow up like someone who is restraining herself hardly…”
Therefore, the compressed anger seems to be one of the main items of Etna lava: unexpressed anger, a submerged feeling which has to find an outlet.
A consideration, arising from the proving symptoms, which needs to be confirmed by other provings of Etna lava, is that the submerged anger would seem to rise and to hold – anyway, felt – against family members or people held dear.
A Prover wrote: “I have turned my man out of the house, I felt choked.”
Another Prover: “I haven’t yet spoken (30th day of proving – Note of Coordinator) to my mother, I quarreled with her without feeling sorry as I used to do in the past. For the first time I forced her to give in.”

Nostalgia – Prover 2 – “I feel constantly nostalgic these days. I don’t feel depressed nor anxious nor euphoric but I feel nostalgic; nostalgia for my son, my family, my old house, my friends. Usually I don’t feel nostalgic. On the contrary I live for the future and the doubts and choices it involves. I think it is an important distinction.”
The same Prover, having taken 200K four months later, wrote: “I felt nostalgic, this was the main feeling after having taken 30 CH. Now, after 200K, I feel calm although I have a very full work schedule.”
It is the same reverse result reported above.

To recapitulate some highly descriptive mental syndromes of Etna lava are reported: Prover 5 – “Good mood with more resolution to do things. But it faded away a few days later as if it was like an external covering which was hiding a very deep irritability; I myself was not aware of its presence but the irritability suddenly came out at a small contradiction. I could easily get back to my prior mood.”
“A sort of euphoria, almost an exaltation of short duration but under it irritability was present, ill-feeling, almost harshness, almost malice, hard-hearted.”

Prover 6 – “I feel very active, on the line between cheerfulness and anger.”

On the opposite side:
Prover 1 – “I felt heavy, my head was rumbling, I didn’t want to do anything, I wanted to stay at home, stay alone, to sleep, not to work anymore. I ate and slept and then a lot of anger came out, against everyone and everything. Against me and my relatives. I have broken with the past: I have thrown away many things reminding me of the past.”

Physical symptoms

A few characteristic physical symptoms are reported. They are all “new” or “extraordinary”, unless otherwise stated. Furthermore, they started on the first days of proving, unless otherwise stated.
It must be remembered that “old symptoms” mean symptoms which have not occured for at least one year before the proving.

– Heavy and blocked head (Pr.1 – for 15 days)
– Awful headache, as if the head is blocked. (Pr. 1)
– I first felt as if my head was about to burst; now it is blocked and heavy. The head
is awfully heavy. (Pr.1 – after having taken 200K).
– Heavy head with a fainting feeling. (Pr. 3 – for 2 d.)

Eyes – Nose
See General Symptoms for watering from the eyes and from the nose. Prover 1- 2 –-3 recorded symptoms like an hay-fever.

– Burning in the pit of the stomach, frequent belching (P.2 – for 21 d. – old symptom) Prover 2 and Prover 3 recorded nausea and belching. The Prover 3 recorded burning pain and a dilated stomach, both of which got worse during the three menses that followed the beginning of the proving.

– I had trouble defecating. Dry, small, hard stool. (Pr. 2 – for 6 d. – old symptom)
– An anal fissure, present for a month before the proving, disappeared completely.
(Pr. 3 – on 4th d. – cured symptoms).
– Frequent flatulence. Stinking flatus. (Pr. 9 – for 5 d.).
– I had trouble defecating. (Pr. 9 ).

– See above: General symptoms, “Wateriness”
– Pr. 1, 3, 5, 9 recorded frequent micturition and profuse urination lasting many days.

Female genitals
– Regular menses, without premenstrual depression, nor pains nor complaints. (Pr.1 – first menses 8 days after the proving began – cured symptoms).
– Sudden but short improvement of menstrual pains. The pain is usually like a blade which cuts my uterus in two. This pain extends to the loins, more intense in the right side, and to the internal parts of my thighs. (Pr. 3 – 1st menses one day after the beginning of the proving – cured symptom).
– The menses only lasted 4 days: usually they last 7. (Pr.3 – 1st menses)
– The menses appeared before the proper time (an advance of 7 days): without pain; lighter, pinky menstrual blood. Usually my menstrual blood is darker. The menses lasted 5 days instead of the usual 3 days; the menstruation was more copious than
usual. (Pr. 9 – 1st menses).
– Menses early 2 days (2nd menses) – Menses early 11 d.( 3rd menses) – (Pr.9)
– Leucorrhoea: white, thick but not copious discharge. (Pr. 10 – for 13 d.)

– Violent cough, racking cough! Deep, hollow, racking cough; violent fits of coughing. The paroxysm ends in a sound like a gasp as if I have got whooping cough. Then I retch violently and I throw up mucus. The cough tears my chest, my heart. I am expelling a lot of catarrh and tears as if I can’t get rid of anything. (Pr. 1 – for 2 d. after having taken 200K).
– Cough and white-yellowish scanty catarrh, at waking up. (Pr. 2 – for 2 d.)
– Strange, very loose cough; bloody strings in the catarrh. (Pr. 7 – for 5 d.)

– Pain in the lumbar region when standing for a long time (Pr. 1 – for 10 d. – old symptom).
– Sharp muscular pain in the loins on right. It gets worse while standing up or arching. Sometimes the front part of my right thigh hurts a lot, too. The backache is getting worse and worse (Pr. 3 – from 56th to 60th day of proving. Owing to the intensity of the pain, which left the prover immobile, the coordinator and her supervisor decided to antidote the remedy. The improvement was very quick.)
– Strange lumbar pain, like an electric shock, when I try to stretch my back. The pain is so violent that it takes my breath away; luckily it doesn’t last long, only a few seconds. The pain doesn’t go down along the sciatic nerve, as usual, but it spreads up the spine. This is strange and new. (Pr. 9 – 2 d.)

– I woke up feeling an intense pain in my right elbow down to the fingers tips. The pain is like a twist. My right hand fingers have gone numb; I have to open and to close my hand and then I feel a light feeling of tingling in my fingers. I get up and I move the arm for a while and the pain gets better. I lie down but the complaints and the pain quickly come back. It is difficult for me to use a computer: my fingers hurt and they have gone numb……I feel my right middle finger as if it is dead but painful; it is a deep pain which spreads up to the elbow…..I feel my right middle finger as if it is made of wood….(Pr. 9 – for 100 d.! – all these symptoms lasted periodically over three months. In fact, every two weeks they appeared again and lasted few days. When they become unbearable the supervisor advised the prover to repeat Etna lava 30 CH: 5 drops every 4 hours for two days. The painful syndrome disappeared on the 2nd day. Note of the Coordinator).
– I woke up at 6:50 a.m. My hands had gone numb, more on the right side. The complaint lasted 15 minutes (Pr.10 – on the 1st day of the proving – old symptom).

The provers recorded 37 dreams. Prover 3 described dreams characterized by a lot of water (the “wateriness” again): heavy rain; water spouting out of a factory chimney and changed into soot. Other dream themes are: red colours (red cities, red houses, a red throne, very red sunset); feelings of anger and resolution.

Five provers among the eight “verum” provers developed skin symptoms from the first days of proving. The skin eruptions were different in types and long-lasting; they located in different areas of the body.
– Pr. 1 : red unbearably itching small spots on the body. Acne on the face.
– Pr. 2: violent itching on the head and on the thighs; improvement of dandruff; a
reddish itching with large spot on the neck.
– Pr. 3 : pimples on the face and on the thighs; rash on the thighs and on the sacrum.
It didn’t itch unless touched.
– Pr. 5 : desquamating spots on the neck and on the external angle of the left eye.
– Pr. 9: rash on the face with boils on the chin. This eruption was red, dry, not itching,
desquamating like dandruff, long-lasting, worsening during menses.


A careful study of the characteristic symptoms noted by the provers allows us to construct
a first, succinct picture of the Etna lava patient who:
a. is lacking in vital warmth and wraps up well without getting warm. He suffers from hot flushes;
b. feels tired,heavy and lacking in strengt hand drags himself about;
c. has a heavy, watery discharge from the nose and eyes; has a deep, hollow, rasping, racking cough that manifests in violent fits;
d. has a strong and frequent urge to urinate, both during the day and at night; the urine is copious and as clear as water;
e. suffers from constant nausea, a burning sensation in the stomach, regurgitation and eructation.
f. has widespread, itchy rashes;
g. is elated almost to the point of euphoria, enjoying great energy and the sensation of being able to do anything;
h. feels calm but easily become sangry;
i. suffers an intense and impotent rage; a repressed rage that leaves him feeling as if he is about to explode;
j. is resentful and unfeeling. He is unrepentantly furious with members of his family;
k. feels nostalgia for his family and children;
l. has unrestrainable tears that come flooding out like water.

Clinical case no. 1
A 57-year old woman. Acute case.
– Vertigo syndrome
– Acute rhinitis

First examination – 14th March 2002
The patient is overweight, hypersensitive, affected in her mode of self-expression and hot- tempered. She has long been receiving treatment for recurring dizziness (cause unknown) without recovering. Actea racemosa and Conium maculatum have been her main remedies.
Approximately 20 days earlier and after an incubation period of irritability and general malaise, she had a high temperature, dizziness, pharyngitis and rhinitis. The worst symptoms have now disappeared but some troubles will not respond to any remedy. Her current symptoms are as follows:

3) I have a bad cold on my left hand side; my eye is weeping, my ear is terribly itchy and my tonsil is really hurting!! (She is very theatrical as she describes her symptoms).
4) Sometimes I have something that feels like a plug in my nose which drives me crazy, and here as well (she indicates her maxillary sinuses). Then, my nose drips water like a tap.
5) I often have to rub my forehead which seems to be burning and then I know that the dizziness is coming.
6) Then it’s as if a bomb is exploding…. It starts with my eyes itching and then the cold explodes along with a great general malaise.
7) I feel black, unmanageable….. before all this happens, above all.

At this point she begins to rail against her mother who is constantly pissing her off. She seems to be intolerant of everyone, her husband, her employer etc. and full of insults.

An objective examination revealed pharyngeal tonsillitis with a marked swelling of the tonsils, the left one in particular. There was a wax plug in the right ear.

The patient’s words seem to describe the dynamics of a volcano: a dark, profound malaise followed by an angry explosion producing copious material i.e. the nasal discharge in this case. Singular, too, are those expressions a plug in my nose and I feel black; like the completely black Mount Etna.
Etna lava 200K – a few granules by mouth at the end of the examination.
A few seconds afterwards, while the patient is still dissolving the granules in her mouth, her face goes red, her left eye begins to weep and trouble her and she rubs it violently. She wrinkles up her nose and, rather alarmed, asks what is happening. She says that the catarrh has suddenly started to come down from behind.
Her recovery was very quick and her symptoms disappeared completely.

Clinical case no. 2
A 59-year old man
– Polyuria
– Invertebral disc prolapse (L5/S1)
– Arterial hypertension
– Paroxysmal coughing

First examination – 1st July 2002
The patient is a business manager. He has consulted many doctors without success. He has been treated (first with Aurum, then Plumbum and Glonoinum) for roughly a year by now but has not benefited greatly. He is a person who appears to be very calm and self-controlled, expressing himself slowly and with great precision. As he talks, he reveals a great frustration and feeiling of impotence caused by events experienced as a form of injustice. He lives under constant stress and harbours a terrible repressed rage which he lives on an exclusively internal level. The examination is difficult, slow and very hard work. He currently has the following symptoms:
1. I feel a strong itching in my urethra which forces me to urinate very frequently, every two hours during the day (sometimes even every half hour). At night I have to get up at least three times, but it can be as many as eight times. Every time there is a lot of clear urine. I have never had any infections.
2. I am living in a constant state of stress; I react really strongly at times and have to contain myself: with my family, for example, or the other managers and the bank managers….Sometimes I have the urge to hit someone… I am putting up with abuse and insults.
f) I have become very aggressive: I’ve reached my limits.
g) I get angry on the inside but outwardly I’m impotent. I’m forced to accept certain
situations that I cannot change (Note: he becomes pale, livid with rage).
h) I feel a strong sense of impotence; I’m always fighting losing battles!!
i) When my blood pressure rises I get hot in the face, particularly the ears, and my legs
feel very cold. I generally feel the cold a great deal and wear tights for a good part of the year.
j) Sometimes I get a very bad, violent cough which lasts for 15/20 days. Nothing will
make it go and it won’t let me sleep. It’s a very deep cough which comes in violent fits and I have to go outside; I can’t lie down.
k) I often suffer from a lack of air. I don’t like being indoors and I always feel better
outside, particularly in the mountains, skiing or doing some other sport.

The patient then begins to recount numerous episodes confirming his conclusions. He does so extremely calmly and slowly with a wealth of detail.
Blood pressure: 160/100 mm/Hg.
Etna lava 200K + Placebo twice a day for 30 days.

Second examination – 24th September 2002
I am amazed that I have not heard from my patient for almost three months and all the more amazed when he arrives smiling. This had never happened before. Furthermore, he is much more open and his face is more expressive.
I have even been quite well!
I get up once or twice at night to urinate…. I don’t have time during the day as I’m very busy! My blood pressure is fairly good.
Blood pressure: 145/85
As the patient is about to begin a very demanding period at work, I prescribe:
Etna lava MK + Placebo twice a day for 60 days.

23rd October – Telephone consultation
The patient’s wife calls me. She is very worried because her husband is sleeping “too deeply” at night and isn’t getting up to urinate. I feel curious.
I later talk to the patient who tells me he is very well. He never wakes up and his blood pressure is good. All this is so strange that his wife was worried!

27th December 2002 – Telephone consultation
The cough has come back, as it does every year; I’m losing my voice.
Etna lava MK.

Third Examination – 7th January 2003
The patient looks well. He is friendly, open and calm.
After taking the medicine, I needed to urinate frequently for two days but the urge was less bothersome than it has been in the past.
Three days ago, I had a bad pain in my left gluteus and thigh. It lessened the following day and then disappeared.
My cough is less frequent but very violent and I’m producing a lot of catarrh.
My temperature is 36.5 ̊C which is like having a fever for me: my body temperature is usually 35 ̊C (!).
Blood pressure 160/90 mm/Hg

The fact that the polyuria was brought into prominence during the first two days and that an old pain returned (the patient suffers from an invertebral disc prolapse) is to be noted and confirms Hering’s Law. His low body temperature is characteristic: we could say, “as cold as a volcano!”. His mood is steadily better, his cough is improving and producing catarrh that is detoxifying him. Prescription:
Placebo twice a day for 30 days.

Clinical case no. 3
A 46-year old man
– Arterial hypertension
– Obesity
– Recurring bronchitis
– Widespread rheumatic pain

First examination – 4th April 2002
The patient has been undergoing treatment for a few years. He suffers from arterial hypertension and attacks of acute bronchitis with bronchospasm. He is obese. He appears cheerful, almost oblivious of everything, like a person who manages to take everything lightly. He is confused and disjointed when he talks about himself and so it is difficult to grasp the useful symptoms. He was prescribed Acidum fluoricum MK about eight months ago, with good results. He currently has the following symptoms:

6) I feel rage. I’m frightened I can’t controli it. I’m only angry when I’m at home. (Note: he is visibly fuming).
7) It’s like there’s something that wants to come out and makes me violent. I’m always angry and fed up in bed in the evenings; I’d like to sleep alone.
8) I have the urge to hit someone: the dog, my daughter….
9) My wife irritates me. She never listens to me and is always trivializing everything.
She’s like a Egyptian mummy, there’s no dialogue…. (His playful, somewhat childlike
face changes and becomes dark, cold, pale and livid with rage).
10) When I go home in the evenings I feel irritated by the house and my family.
11) My backache never leaves me. It’s worse if I keep still. It creaks on the right and the
left. I feel pain in the soles of my feet. Also in my elbows, first the left one and then
the right.
12) My teeth are hypersensitive. My bottom lip is cracking at the centre.
13) I lose things.
14) My stomach burns. Constipation is followed by diarrhoea.
15) I have dreams about war and that I’m escaping”. Blood pressure 160/100mm/Hg. Weight: 98 Kg
Etna lava 200K + Placebo twice a day for 30 days.

Second visit – 17th April 2002
His face is visibly softer and more relaxed: ready to really joke.
I was worse at the beginning, very tired indeed. My malleoli hurt me; for about eight days. Now I feel sleepy but I’m sleeping well at night.
My left shoulder feels as if it has gone to sleep; I feel numbness and a pain in my elbow. I can hear crepitus in my back.
My mood is OK, I feel better. I don’t keep quiet any more. I don’t let myself pass for a fool but say what I think. I can see that the rage I feel is not my wife’s fault but, rather, something I’ve always had. It’s something very old. Who knows when it started!
Blood pressure 135/90 mm/Hg
Placebo twice a day for 30 days.

Third examination – 10th May 2002
I feel weary and have pains in the joints of my feet and my back…. My mood is tolerably good. I get irritated but not badly. My irritability is no longer like it was before, when I was afraid I couldn’t contain it; even my concentration has improved.
There are many things I would like to do but I don’t have the strength when I start…. I feel uncomfortable just going up the stairs. Blood pressure: 130/80 mm/Hg.
Etna lava 200K + Placebo twice a day for 30 days.

Fourth examination – 29th May 2002
I’m sleeping very well and I wake up feeling rested; but I’m sluggish and have little desire to do things. I have pains in my joints and in my right elbow…. A tendinous cyst that appeared in my left wrist a year ago has come back. I have a bit of a headache after I’ve woken up but then it goes.
There’s always something irritating me. I get cross easily but only superficially. I’m often bad-tempered. I’d like to eat masses!
I feel exhausted after making love. It’s been like that for ages!

Blood pressure: 130/85 mm/Hg. Weight: 97 Kg. The patient doesn’t remember ever having such a normal, stable blood pressure.
Etna lava MK + Placebo twice a day for 60 days.

Fifth examination – 4th July 2002
The patient appears particularly cheerful. He is in a good mood and jokes.
Straight after the single dose, the pains in my elbows and left wrist suddenly disappeared. The pain in my feet is still there, more in the right foot. It torments me at night sometimes. The tendinous cyst in my wrist has also disappeared. I still have a bit of backache, with a lot of creaking.
My mood is OK. So is my desire to do things but I get tired easily, even just having to go up stairs. I don’t hold anything back any more. Particularly with my wife. I tell her what I think!
Everything started there, with that feeling of impotence…

The patient’s blood pressure is, incredibly, 120/78 mm/Hg, a level hitherto never recorded.
No prescription

Sixth examination – 18th November 2002

I’ve been well but for about the last month I have less interest in my activities…. I get tired easily.
I have lots of aches and pains in my tibial malleoli, on the left side of my back and in other places. I toss and turn in bed at night. I’m tired and weary.

Note: he talks at length about his arguments with his wife. Blood pressure 140/95 mm/Hg.
Etna lava MK

Seventh examination – 17th December 2002
I feel generally well, but then at certain moments…. I don’t know what’s wrong with me! Particularly in the evening I have a vague malaise, a sense of emptiness.
I suffer less from headaches. I have much more energy and many fewer pains.
My thoughts are rather chaotic. I can’t organise them properly.
My rage is still lasting too long.
Blood pressure: 130/90


The clinical cases presented here are the result of the first prescriptions made using this remedy. The material gathered must be studied, confirmed and extended until a precise definition of the Ena lava picture can be given and thus one of the patients and pathologies it can heal. The prescription has always been given to patients who have been treated homoeopathically for years and have benefited from the treatments to date but who had not been cured. This is the broadest category in every homeopath’s case histories. Every new remedy that is carefully tried out and studied can fill a defined vacuum, substituting prescriptions that are imprecise and therefore not very effective.


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