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Sep 19, 2013


Medical Advance
A Homoeopathic Magazine
Vol. XXXI          CHICAGO, March, 1894.            No. 3




Edited By: Dr. Ravinder S. Mann

Part 2

When the second prescription is a lower potency than that at first employed, or where it is necessary for any reason to again use the original potency, the remedy should be put in water and frequently repeated until effects are not obtained (Rule V).  By frequent repetition of doses I mean, even in chronic cases a dose every hour or two and continued several days if need be.

The patient must be seen at frequent intervals that any produced effect may be detected in its first manifestation and severe aggravations from cumulative action be thus avoided. Although this involves some trouble to a Physician and some expense to the patient it is imperative and the results will amply justify the means. As soon as drug action becomes evident the first business of the Physician is to determine the character of that action (Rule VI).

At times, after a prescription, symptoms peculiar to the drug exhibited will presently appear.

If these are accompanied y neither aggravation nor amelioration of the original conditions it shows that the drug was not Homoeopathic to the case. The effect is always disastrous because it grafts a new (drug) disease upon that which already obtains – is in fact a drug proving and a new and especially careful prescription becomes immediately imperative. The Therapeutist meets few conditions as complicated or as difficult to prescribe fore as this one.

Thus we see that a drug may influence the sick organism in that manner peculiar to itself and without essential modification of the morbid conditions present. But it may also exhibit evidences of a certain amount of influence over the disease present although not enough to establish directly curative action. In other words there are various degrees of the homoeopathicity of drug disease to natural disease. Now the ideal homoeopathic remedy, the similimum, in its curative action proceeds along the same lines as the disease which it annihilates, but conversely. But one less accurately chosen but still similar, while it may not be capable of effecting that immediate and direct cure confidently expected from the similmum, may and frequently does effect a change of the disease type. By disease type I mean that association of symptoms and conditions present through which the Physician recognizes the nature, trend and tendencies of the sickness. All disease being, in respect of the organism diseased, salutary – an effort of the vital energy to remove from it noxious influences, the manner in which it moves toward this end and the channels of elimination or method of annihilation would be presumably those which least seriously disturb the general system. I say presumably because within the animal economy as outside it, the direction of kinetic energy is toward the point of least resistance, and a minimum of resistance insures a minimum of those perturbations which are its direct consequence.

If now for any reason disease has assumed certain type, that accidental influences may serve to change, that type is a fact too well known to demand amplification at this time. Among the most potent factors in effecting such change are drugs, and were illustrations necessary the whole history of suppressant and revulsive treatment might be cited in evidence.

And as drugs this improperly administered may effect unfavorable change of disease type, so too, one may be given which from its partial homoeopathicity to the disease may effect a favorable change of type although it is not sufficiently similar to complete a cure.

Now is such case although the change is a favorable one, the conditions less severe and dangerous, the fact remains that the progress toward health is not such as is observed when the remedy has been accurately chosen – it is a diversion of the vital energy, happily to better avenues of activity, but not to that distinctive action which marks the homoeopathic cure, viz; the gradual disappearance of the symptoms in the reverses order of their appearance.

Indeed a new disease now presents itself i.e. a new complex of symptoms, differing in kind as well as degree from those other and for this reason demanding in kind as well as degree from those other and for this reason demanding a prescription homoeopathic to the status presens (Rule VIII). That unaided nature is usually equal to the cure of this new and milder disease is no excuse for inactivity on the part of the Physician.

All milder types of sickness will usually be cured by the vital energy without remedial aid, but the remedy is needed if the cure is to be made with a “minimum of discomfort, suffering and danger” to the patient.

I have dwelt with perhaps undue length on this subject because I am convinced that much time is lost and much suffering entailed from lack of wise discrimination as to the character of drug action manifest, - indirect aid too often mistaken for that direct curative action which characterizes the ideal homoeopathic cure, and by consequence, the immediate interference most useful in the one case, gives place to the “masterly inactivity” which is the only safe course in the other.

Neither time nor space, now serve for the discussion of the question of palliative treatment. Without argument or elaboration of the theme, I make here the bold statement that the Homoeopathic remedy is the truest, the safest, and most effectual palliative. 

This is in accord with the testimony of the greatest prescribers of our school of medicine, and, incidentally, with my own experience. Assuming the truth of this statement I proceed to the discussion of Rule IX.

Where the remedy is simply palliative in its action, evidence of its efficacy will be the same as curative action (q. v. Rule X). Now if these evidences of drug action are unmistakably present, despite which definite prognostic signs indicate that the sickness is making certain and undoubted progress toward an ultimately fatal termination, it proves conclusively that the disease is incurable by any mode of treatment.

The utmost that can be hoped for then is a reduction of the patient’s sufferings in the greatest possible degree, and in the safest and best possible manner.

Since this is most surely accomplished by the drug selected under the Homoeopathic law and since the evidence is plain that in the case postulated, this drug has been administered and has directed the vital energy to the most favorable lines of action, it follows logically, as it has been proven many times experimentally, that the best possible is already doing.   

Palliation being the utmost of your expectation, and this being already in evidence, any meddlesome interference not only will complicate conditions even now sufficiently serious, but will, too, deprive the patient of the only benefits which may be hoped for from medical aid.

As we have seen when discussing Rule VIII, remedial action may be direct or indirect – and this determined by the degree of homoeopathicity of the selected drug to the natural disease for which it is prescribed.

If indirect action is established its effect is to change the disease type, carrying the patient so to speak, a little way toward recovery and paving the way for another prescription.

No inconsiderable number of our cases are thus, to use the late Dr. C. Hering’s graphic expression, “zig-zagged” back to health. When however, there obtains close similarity between the drug action and the disease action the influence of the former will be directly curative and no change of type will follow, no new tissues will be invaded, no new lines of action be established, but gradually and in regular order will the signs of the sickness all disappear. This is the ideal cure for which every Homoeopathist strives. The first sign of this direct curative action will be either an amelioration or an aggravation of the patient’s symptoms. If it be amelioration steady and progressive, the exact object desired has been attained; the remedy proven to be homoeopathic, and the potency appropriate.

If on the other hand aggravation follows, then, too, is the drug proved to be homoeopathic but the power employed is inappropriate. I say inappropriate – not necessarily too strong.

A crowbar is not too strong to do the work of a cambric needle, but it is quite inappropriate. It will occasionally occur that aggravations thus super-induced will be so prolonged, severe and even dangerous that antidotal treatment will become necessary. In such case another similar remedy, in a potency different from the one already employed, will be found the most effectual antidote.

The inhibition of the aggravation by antidotal treatment may leave the case materially modified in original conditions and no further present interference be necessary, or the case may present itself considerably changed and a new prescription be demanded – a direct curative action having been converted into an indirect.

Care must always be exercised not to mistake complications from drug proving for aggravations from undue remedial action. The onset of symptoms belonging to the drug employed and the appearance of conditions in no way related to the natural course of the disease under treatment, will mark the former; simple exacerbation of conditions already present, the latter.

Aggravation from the Homoeopathic remedy, wisely handled in respect to repetition, are, however, usually transitory and quickly followed by material and satisfactory amelioration.

Amelioration of the disease conditions either direct or indirect because of intervening aggravations, is at once the beginning and unmistakable evidence of the establishment of curative action. If now the only effect which the remedy can have is the promotion of this curative vital motion, and this it has already done, it is obvious that further medication is superfluous, as has already been said.

But not only is it obvious that further medication is superfluous, but it is equally obvious that such medication may be obstructive even to the point of danger, for undoubtedly some new form of motion must be thereby introduced to complicate and modify that already established – to change exactly the action which is most desired at all. Accordingly it is most strenuously insisted (Rule X) that, when curative action is manifest, no interference is permissible so long as this continues.

This rule, as old as Homoeopathy, and appealing in the strongest manner to reason, would be easily followed if disease in its progression or in its retrogression was steadily uniform in its movement.

But unfortunately this is seldom, perhaps never, the case. Periods of improvement will be followed by sharp and distressing aggravations and conversely, periods of seemingly marked retrograde movement will precede most undoubted and satisfactory betterment of all conditions. These “wave like” movements in disease action must be allowed for, and it often becomes a very nice question whether certain changes are those temporary fluctuations which may be expected, or whether they indicate radical loss. To a correct solution of the question must be brought the prescriber’s calmest judgment and most conscientious care, for his action, which this will determine is of gravest importance.

If it becomes evident that curative action has ceased, reexamination will determine whether a change of remedy, of potency, or a repetition of the dose is next needed; if however, it proves to be one of those “wave like” motion of disease – a temporary exacerbation, no change or repetition is indicated. Wait patiently and confidently for reaction and when this comes it will certainly carry your patient to a much higher physical plane, and that rapidly and pleasantly.

It will be especially helpful in making this decision if it is borne always in mind that the patient not the disease, is under treatment. If on the whole your patient is better – especially in the Psychological sphere, even though his disease in its nosological classification is unimproved, you may confidently class the present condition as among the temporary aggravations incidental to all cases. Again as improvement progresses there will frequently appear certain symptoms not present or not remembered as present before, and appeal forcibly to your mind as marked indication for the use of another remedy. If however, the disease type remains unchanged, these should be ignored, at least in so far as they may influence interference on your part. The patient is getting well and no meddlesome medication will hurry nature who moves always according to fixed laws, intolerant of interference and unforgiving of mistakes.

Rule XI is but the expression of an obvious necessity and requires neither explanation nor amplification.

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