Book Reviews: Stramonium
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Stramonium, With an Introduction to Analysis Using Cycles and Segments by Dr. Paul Herscu, ND MPHGeorge Guess, MD, DHt – JAIH – Spring 1997Michael Dong, RS Hom David Curtin Durr Elmore & Alice Duncan Ruth Pendergrast– Resonance – March/April 1998 |
New England School of Homeopathy Press, Amherst, Massachusetts, 1996. 220 pages. Soft cover. ISBN# 0-9654004-0-9
Cost: $28.00 + shipping charges of: $7.50 USA / $18 international orders. Payment accepted in US dollars only.
Reviewed by George Guess, MD, DHt
AJIH – Spring 1997, Vol. 90, No. 1
Limitless creative energy! Capable of exhaustive clinical research in a short span of time! Able to author materia medica that is both deeply penetrating and of vast scope! Such are but a few of the accolades that can rightfully be attributed to our local Superhero on the continent, Dr. Paul Herscu. With Stramonium, Dr. Herscu has again penned a masterful work, full of original thought and original clinical observations. Stramonium herein is described thoroughly, from its profoundly disturbed mental picture to its vitiligo. His focus is the pediatric Stramonium image. Employing his highly original concept of remedy cycles (a concept he has been lecturing on for the past two years), he attempts to conceptualize the varied symptomatology of this remedy as manifest expressions of a recurring dynamic cycle (or spiral) of disease. The cycle represents a flow of events which is composed of a number of fundamental segments. Each segment is meant to describe the defensive reaction or perception pattern of the diseased individual or remedy. In the case of Stramonium the cycle proceeds as follows: fear of death or injury; vulnerability, clinginess leads to violent overreaction leads to the desire to close off leads to death and deadness; the shut down state leads to confusion over his dual state; half alive and half dead leads back to fear of death and injury, etc. It is an intriguing thesis, one which some readers, if not most, may well find useful in clinical practice.
Dr. Herscu asserts that in any given case each and every symptom should correlate to at least one of the fundamental materia medica segments. This reviewer has difficulty reconciling this assertion with what appears to be the sometimes confounding reality of the layered case wherein symptoms of more than one remedy are apparent.
Thus, assuming the concept of remedy cycles is valid, it would appear that the practitioner, though gifted with such new knowledge, would still have to face the quandary of which symptoms are most characteristic of the patient, and hence useful for prescribing.
Another stumbling block for this reviewer, who is admittedly given to more concrete than abstract thinking, is the sometimes poetic application of segment cycles to symptoms at hand, specifically physical symptoms. In the realm of psychopathology, however, the segments are much more easy to apply, though not necessarily easy to conceive.
Regardless of one’s affinity for this concept, homeopaths should make themselves aware of this process of remedy and case analysis. No doubt many practitioners will excitedly embrace it. Early in the book, Dr. Herscu also discusses his “Map of Hierarchy,” pertaining to the homeopathic treatment of children with behavior, learning and attention difficulties. This concept has been described before in this journal in a seminar report given by Michael Glass, M.D. It pertains to the sequencing of remedies in these children, and groups remedies according to severity and quality of pathology. It is an innovative and apparently trustworthy guide. Dr. Herscu just touches upon the broad subject of the treatment of these children in this section, intending to enlarge upon this topic in a later book.
Part One of this book discusses the topics above. Part Two, some 134 pages, covers Stramonium in assiduous detail. Many are familiar with the fear and violence aspects of Stramonium; though the observations on these aspects is not new, in this work we are treated to a full-spectrum description of the behavior, from the overt panic, nightmares and violence to the far more subtle expressions of the same theme in sweet children who might well tempt us to prescribe “nicer” remedies. Also, the psychodynamics of such behavior is described as never before.
Readers will especially find Dr. Herscu’s description of the introverted and autistic aspects of Stramonium of great interest. These observations I believe to be original and solidly confirmed by repeated clinical verification. Which speaks to a fine trait of Dr. Herscu’s writings, they are all so firmly footed on the soil of clinical experience. When Dr. Herscu describes so thoroughly the intricate specifics of Stramonium’s physical pathology, it is clear that this is no rehashing of textbook knowledge. His observations are clinical pearls to be gathered Q the chest oppression in bronchitis that mimics Phosphorus, the otitis that can resemble a combination of Arsenicum and Belladonna, the conjunctivitis which often leads to confusion with Sulphur, etc.
The book is well written and well bound (in paperback), the print attractive and easy to read. I often found myself wishing for more differential materia medica as Dr. Herscu described the finer points of Stramonium. In fact, there is very little differential materia medica in the book; this is in the main a total body immersion in Stramonium only. The differentials will have to wait for his later work.
Obviously, I am well pleased with this book and highly recommend it. Dr. Herscu deserves our gratitude for his ceaseless efforts to share with the homeopathic community his valuable experience in the homeopathic treatment of children.
American Institute of Homeopathy
925 E. 17th Ave
Denver, CO 80218
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Reviewed by Michael Dong, RS Hom
“The totality of these its symptoms, of this outwardly reflected image of the internal essence of the disease, that is, of the suffering of the life force. The totality of symptoms must be the principal or the only thing whereby the disease can be made discernable what remedy it requires.”
–The Organon of Medicine, Aphorism 7, Samuel Hahnemann.
This book is the second in a series by Paul Herscu. In his first book, The Homeopathic Treatment of Children: Pediatric Constitutional Types, he provides a much needed, updated materia medica of the remedies he has found to be the most commonly indicated in his practice for children. It was with much anticipation and excitement that I received his second offering, Stramonium.
Stramonium is not only a materia medica on this important remedy but provides new ideas on methods of analysis which Herscu has been developing over the years. The book is divided into two parts. The first part is titled “New Ideas Need a New Language.” In it he describes the need for a new way of looking at our methods of analysis because of the evolution of homeopathy since the days of Hahnemann.
He says: “a new model is needed, a model that reflects the new insights in homeopathy, a model that can:
– explain all the old phenomena
– incorporate and explain all the new phenomena
– predict with accuracy future phenomena
This model must help us to understand both the totality of the patient and the totality of the remedy, as well as help us decide how to approach the analysis of the patient.”
It is a common thing in homeopathy that after we have taken a patient’s case we have in front of us a whole series of symptoms. We understand that in order to repertorize and to discover what remedy will lead us to cure of the patient, we have to be able to select the appropriate symptoms which accurately show what is the disturbance in the vital force, what Stuart Close calls the “logical totality.”
What Paul Herscu suggests is that this understanding is not enough. He says in his book: “Disease is a unit. It is one disease for one person at one time. Our job is to ferret out that one disease for that one person. The vital force’s job is to help us find it, by producing signs or symptoms, that show us the pattern of the disease.”
His method of analysis is based on the idea that every remedy, every illness, every patient has a cycle or pattern within it. If we can identify or understand that cycle or pattern, then we can see how all the symptoms fit together. Each of these cycles is composed of segments, these being major themes which run through the symptoms.
Often these cycles can be found in an analogous manner on the mental, emotional and physical levels and may require some lateral thinking to connect them. He also put forward the idea of generalizing symptoms very much like Boenninghausen did when the segments or cycle of the particular case or remedy were known (i.e., remedy “x” [in the proving] has a stinging pain in the left side. Might it be generalized into “stinging pain in the side”– which would encompass the right side too?).
Through his experience and practice, he has extended this idea to the disease having a cycle as well, and that the segments are composed not only of themes but of remedies. He calls the relationship of remedies that he sees most commonly with children, the “Map of Hierarchy.” This relates to the states or remedies children go through as they progressively get worse or vice versa, as they move towards health and cure. As the child’s pathology worsens, they carry over some of the symptomatology of the previous remedy’s state, resulting in a picture which may be a combination of two. His map provides a model from which you can see this, and thus may help in the selection of the most appropriate remedy. Throughout this first section he uses the remedy Stramonium as an example to demonstrate his ideas.
The second section is devoted to Stramonium, featuring the analysis of it by cycles and segments. The resultant materia medica is clear, easy to read, and neatly sets out the themes of this remedy. The segments which he has identified involve fear, violence, attention difficulties, introversion, and, finally, autism. He closes with a conventional materia medica of the sleep and body symptoms of Stramonium. Reading this book reminded me why I enjoyed his first book so much. The information he presents is in a form which is easy to understand, and his new concepts are clear and well-defined. It is inspiring to read the work of an original thinker, someone who is prepared to try something different and then share his experiences with us. His method of analysis using cycles and segments may not suit everyone nor may we all agree with his map of hierarchy, but this book should be on the homeopath’s reading list just for the clear, modern, and up-to-date picture of Stramonium which he provides.
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Reviewed by David Curtin
British Homoeopathic Journal – January 1997
Paul Herscu is a practicing homoeopath and director of the New England School of Homoeopathy. His first book The Homoeopathic Treatment of Children, published in 1991, has been very popular in this country and I would have been surprised if his latest book was not at least as good as his first. I was curious to see that the book, running to over 200 pages, seemed to be all about a single homoeopathic medicine. Even Kent’s lecture on Sulphur only runs to 25 pages. This is certainly the most detailed account of any medicine that I have ever read.
I skipped part I of the book (as Herscu invited me to do in the author’s comments) and turned to the materia medica of Stramonium which comprises the greater part of the book (and which I thought would be the most interesting section). Here Herscu has written an in-depth psychological profile of Stramonium which is very clearly presented and reflects his obviously considerable experience and understanding of Stramonium. Many different manifestations of the well-known symptoms are described, with case examples. Much of this was familiar to me as I have taken a particular interest in Stramonium myself, and so I read with quite a critical eye. But I was impressed by what I read, though there were times when I thought there was a bit too much repetition. What I found particularly interesting was the chapter on autistic children, an area in which I have no experience. Herscu’s practice is predominantly pediatric and most of his examples are of children. Most of the information in the book also applies to adults, however. An excellent chapter on physical and general symptoms is included.
More important than the descriptions of the different symptoms is the way in which Herscu links the different parts to make a whole and explains the reasons behind the symptoms. The way he does this is quite masterly, and to grasp fully how he does this it is necessary to read part I-Cycles and The Map of the Hierarchy. This for me was the best part of the book. It is where Herscu describes how his thinking has developed; how to really understand materia and make it come alive. The ideas presented here are not new to me (many contemporary homoeopaths are thinking along similar lines), but I have not seen them so clearly expressed in print before.
Essentially three ideas are presented in section one of the book. Firstly, formulating a phrase or sentence for each remedy that will fit every symptom of that remedy, every patient we have ever seen who needed that remedy, fit every materia medica we have ever read, every lecture that we have ever heard … It must be a precise statement that sums up all that this remedy encapsulates, but also the dynamic aspect of it, how it moves from one illness to the next.
This idea has its roots in Vithoulkas’s Essence, but differs in that it attempts to incorporate all the symptoms of the medicine. A closer contemporary equivalent is Jeremy Sherr’s Blueprint. Most of Sherr’s work unfortunately is not yet in print. Herscu’s example of this for Stramonium says: Driven by confusion, fears, and vulnerability, Stramonium is engaged in an ongoing and violent battle between the conscious and the unconscious, between darkness and light, between succumbing to the death realm and yearning to exist in the life realm. Examined carefully everything about Stramonium should fit this picture.
Secondly, the idea of cycles. Here Herscu describes how a patient may move from one symptom or state to another, and finally back to the beginning again, forming a circle or cycle. From this we can understand how opposite, or seemingly contradictory symptoms of a homoeopathic medicine may appear in the same person at different times. It also enables us to draw together all the different strands of a medicine to make a coherent whole. Herscu’s materia medica of Stramonium is an example of how these models can be applied to materia medica to bring it alive and improve our understanding.
The third idea, The Map of the Hierarchy, puts medicines into groups. Some have more intense states than others. Medorrhinum is I worse’ than Lycopodium, Stramonium ‘worse’ than Medorrhinum, Hyoscyamus ‘worse’ than Stramonium. One of the practical applications of this is to help decide which should be prescribed first in a layered case with mixed symptoms.
I think this is a book which should appeal to all serious homoeopaths. It is well written and clearly presented. Though it is a paperback, binding, print and paper quality are all good. Unfortunately the price is high at present, but I think it is worth it. I thoroughly recommend it.
British Homoeopathic Journal
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London WC1N 3HT, U.K.
Tel: 0171-837 9469. Fax: 0171-278 7900
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Reviewed by Durr Elmore & Alice Duncan, editors
SIMILLIMUM / Fall 1996 Volume IX No. 3
“We are at a turning point in homeopathy, moving from the materia medicas of the past to those of the future. In the past it was the symptom that was emphasized. In the future we will be looking with more interest at the ideas behind the symptoms. Why do these particular symptoms exist in the first place? Where do they come from? What do they lead to?”
“This book is my first complete description of the totality of a remedy. Among these pages you hopefully will find answers to why the Stramonium becomes fearful or develops violence and what it leads to next.”
Ever since Paul Herscu’s The Homeopathic Treatment of Children was published, in 1991, homeopathic treatment of current day children became much easier. The book has enriched and clarified our knowledge of eight major pediatric constitutional remedies- and its up-to-date materia medica is immensely practical. Dr. Herscu writes from his own observations and experience-and the information he gives is based on real cured cases. His work enlivens our perception of these remedies, and helps us recognize and differentiate between their individual pictures.
We have waited five years for this second book, Stramonium, to be completed-and, now that we have read it, can enthusiastically attest that it is worth the wait.
Why “A Whole Book on Stramonium?” A chapter with that title answers that question.
Herscu writes: “I came to see Stramonium as an encompassing remedy: one that, like a chameleon, could appear camouflaged as either a polychrest or nosode or as one of the mania remedies. A perfect set-up for confusion and incorrect prescribing.”
This book is much more than a materia medica on Stramonium. It also serves as a blueprint and example for dear and comprehensive development of future homeopathic materia medicas, practice, and teaching. The approach is revolutionary- yet absolutely true to the principles and spirit of homeopathy.
The book is in two parts. Part One presents a new model and approach for understanding, studying, and practicing homeopathy. “We need to understand not just the symptoms of the illness, but more importantly, the way of being sick. How can we go about doing that?” Paul is searching for a way to tie together all of the homeopathic symptoms of a remedy “. . . because this kind of learning leads to understanding. Why should we settle for memorizing when we can understand?” A Herculean undertaking, yet we can see, in Stramonium, how such a way of thinking can both simplify and improve our work.
“How can we best see the message that the vital force is struggling so hard to show us? It is flashing the pathology of the whole patient at us, if only we could see it. Its message can be detected in every symptom of the patient. That is the genius of the vital force … If the vital force can say in a nutshell, ‘This is it. This is the disease,’ why can’t we? What a help it would be if we could describe with a single statement every symptom that a remedy can produce or cure … If there is only one disease, how do all the symptoms fit together? Not just most of the symptoms, not just the ones we selected, but all of the symptoms, the mental state, the sleep position, the food cravings and aversions, the common as well as the characteristic symptoms.”
He offers such a statement for Stramonium: “Driven by confusion, fears, and vulnerability, Stramonium is engaged in an ongoing and violent battle between the unconscious and the conscious, between darkness and light, between succumbing to the death realm and yearning to exist in the life realm.
Herscu describes disease (and therefore the picture of each remedy) as a cycle composed of four to six fundamental segments, each segment being a theme or major element in the case. Every symptom of each particular remedy should fit into and exemplify the theme of one of its segments. “Each segment can be identified by a word or phrase, such as yearning for comfort, violent overreactions, etc.” He gives examples of how to evaluate the symptoms: “Sensitivity to noise, aversion to touch, and fear of robbers-are these similar? Yes, they all represent fear of invasion. It is almost uncanny how much you can predict with this form of assessing. Not only can you predict symptoms you will find in the patient, but even symptoms you will find in the materia medica.”
Next he explains The Map of Hierarchy (“a predictable order of remedies that a patient may need over time”), grouping remedies into four phases, based on the depth of pathology inherent in the remedy. “It was by observing the process of healing that the Map of Hierarchy came to me, not from philosophical reflection or theorizing. In a way, it shows us Hering’s Law operating on a larger scale, with whole remedies (instead of merely symptoms) moving in a direction either toward healing or toward deeper pathology.” This map is a clear and practical aid in understanding the remedies, as well as in prescribing. Stramonium is a transition remedy in Phase 3, a remedy at a crossroads. ‘In first and second phase remedies, the new brain, the reasoning brain, keeps everyday life in some kind of balance between the conscious and the unconscious. But, in the lower fourth phase remedies, the unconscious rules, and logic gives way to old-brain passions, such as hate, lust, and uncontrolled appetites. Standing at the mid-point, Stramonium acts as something of a doorway to the unconscious and to the remedies that are ruled by it.”
Most remedies share symptoms with other remedies, and Herscu’s model helps us decide which to choose: “What if you give a remedy that was needed earlier (a healthier remedy or a remedy of an earlier phase) to someone who needs a later phase remedy? By giving the earlier phase remedy you get rid of some of the symptoms but fail to address the more serious symptoms … the colds and bronchitis are gone and what is left? Intense anger and fear and violence … Giving the remedy underneath suppressed the case.” If a patient shares symptoms with remedies of different phases, he advises us to give the remedy of the deeper phase. This will lead to cure instead of suppression.
Part One of the book lays the foundation with a model for thought, and provides us with the map. Part Two enlarges our knowledge of this remedy so readers can more accurately understand and recognize Stramonium in its details, and in its essence. From the cycle of Stramonium, to the fundamental segments of the remedy, to the polar states, we get to know this remedy. Herscu’s initial descriptions of the Stramonium state provide a context in which to place the information given here. And, as in his first book, we learn from his experiences. “The Stramonium child is very fearful; he feels alone and vulnerable and thinks that he is going to be hurt. These fears drive him to act, but his actions overshoot, producing unintended consequences-he overreacts in a violent way. Having overreacted, he now has less energy and wants to close off to protect himself and his remaining energies. But again he overshoots and closes off too much, so that parts of him feel numb, parts of him feel dead. Now images of death, feelings of deadness, and feelings of being alone come up and confuse his experience of reality. The child’s overall view of the world is warped, in that everything he experiences goes through this filter of confusion, which leads him again to more fear, self protection, overshooting, and then to becoming closed off again …
“The emotional realm of Stramonium contains a number of states … states such as fear, autism, introversion, and violence. But it is important to realize that a Stramonium child may not be violent, may not be introverted, may not be autistic-these states may simply be reactions or responses to fear, and, as such, may only last as long as the situation lasts, otherwise not playing a significant role in the child’s life … Any or all of the following responses might be seen at such times: violence, rage, and screaming; crying and depression; clinging to someone; ritualism, autism, and attempts at escape.”
Useful differential materia medica is also provided: throughout the book we find comparisons between Stramonium and other remedies, from polychrests like Sulphur and Calcarea carbonica, to “fourth phase” remedies such as Hyoscyamus and Veratrum album.
The book includes an excellent discussion of children’s attention difficulties and hyperactivity-exploring topics such as aggression, ritualistic or preservative behavior, and poor impulse control. The final section is a thorough review-of-systems that relates specific symptoms from the mind and nervous system and throughout the body, and considers their expression of the theme and cycle of Stramonium.
Herscu’s ideas are expressed in a gentle, accessible style-and the information offered is clear, insightful, and intelligent. This book is obviously the result of years of deep thought, and a true desire to solve the problems that still impede the learning and practice of homeopathy. Herscu understands the pressing need of homeopaths to be able to truly grasp the individual nature of our remedies and to recognize the various manifestations of their states-to have the skill to prescribe with accuracy, and thus be better able to help relieve the suffering of our patients.
Paul Herscu, N.D., DHANP, is the founder of the New England School of Homeopathy, and of the New England Journal of Homeopathy. He was instrumental in the resurgence of the HANP, and is a past board member. He practices in Enfield, Connecticut.
Homeopathic Academy of Naturopathic Physicians
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e-mail: hanp@igc.apc.org
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Reviewed by Ruth Pendergrast
Resonance – March/April 1998
The study of materia medica can be daunting for any serious student of homeopathy. Fortunately for our knowledge (and unfortunately for our bank balances), many new books are available to study. Some, like Vermeulen’s new Concordant Materia Medica, teach us the breadth of materia medica. Others, like Paul Herscu’s Stramonium, strive to teach us its depth.
In the book, Stramonium: With an Introduction to Analysis Using Cycles and Segments, Herscu first goes into his method of conceptualizing remedies and selecting among them; then he provides us with a detailed discussion of components of the Stramonium picture.
In a conversational tone, Herscu lays out his frustrations over his years of study, practice, and teaching, which led him to a new way of understanding materia medica, In the real world, prescribing on the totality of symptoms can lead to a confusing picture with more details than clarity. But if we leave the totality, how do we choose the “right” symptoms? If there is one disease, one central disturbance, one mistunement of the vital force, how can we understand all the symptoms as expressions of that disease? Herscu’s method involves seeing the disease as a cycle, which progresses from one segment to another in a dynamic process of reactions. The cycle includes all the symptoms generated by the vital force as it strains to return to balance, and therefore can include seemingly contradictory or opposing states in one whole.
In addition to the cycle, Herscu strives to formulate one sentence to describe each remedy, one sentence that expresses every symptom of the remedy that fits every patient who needs that remedy, regardless of where they maybe in the progression of the disease. For Stramonium, he suggests: “Driven by confusion, fears, and vulnerability, Stramonium is engaged in an ongoing and violent battle between the unconscious and the conscious, between darkness and light, between succumbing to the death realm and yearning to exist in the life realm.” (p. 8.)
The cycle of Stramonium moves from “fear of death or injury; vulnerability; clinginess” to “violent overreaction” to “the desire to close off” to “death and deadness; the shut down state” to “confusion over his dual state; half alive and half dead” and then back to “fear,” etc. Recognizing the different states which make up the Stramonium picture enables a homeopath to treat the patient who may not exemplify the stereotypical wildly violent state.
Herscu emphasizes that the cycle should be a tool for learning. In the process of differentiating between one remedy and another, we may wish to subdivide the cycle into even more segments or we may wish to simplify and condense it to fewer. His lack of absolutism was one of the strengths of this book. He wants to share a useful tool but doesn’t see it as the only valid approach.
Another tool that Herscu introduces in Stramonium is the “Map of Hierarchy.” He considers 20 remedies commonly used for children with learning, behavior, and attention problems, and divides these into four groups. Each group, or phase, represents a depth of pathology. In practice he has observed children moving from one remedy to another as they heal, and consistently sees certain remedies in more pathological states.
This idea is not without controversy in the homeopathic community, with other practitioners asserting that any remedy can manifest its symptoms at a deeply disturbing level or at a more superficial level. I don’t see the map of hierarchy to contradict that assertion, only to supplement it for those cases which do progress through layers towards cure.
The four groups of remedies are polychrests, nosodes, “transition remedies,” and finally, phase four remedies. The transition remedies stand at the doorway between the functioning conscious mind and the unconscious. Phase four remedies are for children who have passed beyond the doorway, whose behavior is characterized either by uncontrolled passions or by increasing dullness.
In casetaking, often we will find some symptoms of each phase, which confuses the picture. Herscu’s guideline is: if it’s hard to choose between two remedies, prescribe the remedy farthest in the hierarchy. The severe pathology must be addressed.
As we move into the second part of the book, Herscu elaborates on the cycle of Stramonium, and explains the different facets of the remedy which will be seen in different children. Each of these facets-such as fear, violence, attention difficulties, introversion, and autism-is considered in depth. Along with these mental and emotional symptoms, sleep and respiratory symptoms are very important in understanding Stramonium. He includes many examples from his own practice and other homeopaths.
As the children of our culture continue to be exposed to fear and violence throughout their lives, Stramonium will continue to be an important remedy to understand. Reading this book gave me the confidence to prescribe Stramonium to an eight-year-old boy whose parents had begun to fear that they would not be able to care for him in their home. His raging violence was affecting everyone in the house, and nothing seemed to help. “Hideous” was the word I often heard to describe this child. After the remedy, “delightful” is the word I’ve heard most.
I am humbled by the powerful changes homeopathic remedies can bring to desperate families, and I’m grateful to Paul Herscu for this thoughtful and thorough book.
Ruth Pendergrast is a first-year student at the Colorado Institute of Classical Homeopathy in Boulder. She lives in Fort Collins, Colorado.
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