THE
Medical Advance
A Homoeopathic Magazine
Vol.
XXXI CHICAGO
*SYMPOSIUM OF HOMOEOPATHIC PRESCRIBING
THE REPETITION OF THE DOSE
CLARENCE WILLARD BUTLER, MONTCLAIR , N.J.
Edited By: Dr. Ravinder S. Mann
Part 2
(For Part 1 Click Here)
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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