Difficulties in Prescribing

A paper read to the British Homoeopathic Society, June 7, 1923. Reprinted from The British Homoeopathic Journal 1923 by Sir John weir. he discussed the difficulties one can face in practicing Homeopathy….

A paper read to the British Homoeopathic Society, June 7, 1923. Reprinted from The British Homoeopathic Journal 1923.

In opening this discussion on the difficulties in homoeopathic prescribing I must, of course, presuppose agreement with the fundamental principles underlying the homoeopathic Law of Cure – so it is like preaching to the converted. But few, if any, pass a single day in practice without being confronted with difficulties as to how to proceed next. We know what homoeopathy can do curatively, and all the more we feel the responsibility of our next prescription – indeed, the future of the patient lies in our hands in a way that does not happen in other methods of treatment. Somehow, lately, we have had very little opportunity of discussing our difficulties; except perhaps in the short time at the end of our meetings. The latest additions to our ranks are faced with the problems that confront those who enter fresh fields of research, with, perhaps, a short apprenticeship. Yet they feel their responsibilities equally with those sojourn has been longer. They are consulted by patients who have had the benefit of experienced prescribers, and very definite results are expected from them. Homoeopathic doctors are often isolated units, deprived of the benefits of conferring with their neighbours, and hence their difficulties have to be shouldered.

Their risk is very great, of getting into wrong ways, and continuing in them, for want of opportunities to discuss their problems. We can all learn from each other; the oldest from the youngest, as well as the other way. It is with this object – mutual helpfulness that I suggested such a meeting as this; where we can all frankly speak of our difficulties, and perhaps get some help as to our future. I thought that the best plan to find out what were the chief difficulties was to invite suggestions, but unfortunately very few replies have come to hand, so that I am rather in the dark as to how to treat the subject. One has written and spoken so often on the subject of Homoeopathic Philosophy that it is impossible to offer anything new. But there are Laws of Cure which must be obeyed.

Hahnemann says: “Unless the physician imitates my method, he cannot expect to solve the highest problems of medical science, that of curing those important chronic diseases, which have remained uncured until I discovered their true character, and proper treatment” (Chr. Dis., p. 156).

“If physicians do not carefully practise which I teach, let them not boast of being my followers, and above all, let them not expect to be successful in their treatment.” (Ibid).

“This doctrine appeals not only chiefly, but solely to the verdict of experience – `repeat the experiments’, it cries aloud, `repeat them carefully and accurately, and you will find the doctrine confirmed at every step’ – and it does what no medical doctrine, no system of physic, no so-called therapeutics ever did or could do, it insists upon being `judged by the results’.” (M.M.P., vol. ii, p. 2).

There are errors of commission more disastrous than those of omission. “It is better to do nothing, than to do something wrong.”

One of our greatest difficulties in homoeopathic prescribing is time – lack of it. And if we are hurried or flurried, that is fatal to good work. The best time-saver is to take your case well the first time. The time thus spent will save much time and worry on subsequent visits. We can all realize, when the patient comes the second time, the mood we were in on his first visit. If the first prescription was good, the second and probably the third should be very easy. On the contrary, if you have missed your first shot, the whole thing has to be reconsidered, and time is lost.

Confidence, born of knowledge and experience, on the part of the doctor, must be unconsciously communicated to the patient; so it behooves us all to do our best, and thus acquire this assurance.

Dr. “A” raises what he calls “The Eternal Question, the choice of Potency”.

The question of potency is an extremely difficult one, so far as dogmatism is concerned.

Men have obtained good results from high, low and medium potencies, provided that the right remedy has been chosen.

You may cure a “Baptisia pneumonia” with a few doses of Baptisia in the mother tincture, or with the highest potency. This is the case in acute disease.

In provings it is found that a crude drug is apt to produce the coarser animal symptoms; and that violent efforts at elimination may put an end to the proving.

That the finer, and especially the mental symptoms of a drug have come out best when the proving started with the higher potencies.

It is matter of experience that in using the lower potencies (the 30th and under) one seldom sees, except in susceptibles, such phenomena as the homoeopathic aggravation, the return of old symptoms, the long amelioration after the initial stimulus. These of course are of great import in the conduct of the case, and in prognosis.

Again, Hahnemann worked up, Kent worked up, Nash worked up – with fear. Nash relates, in his “Leaders”, under Colchicum, how he had carried a case of 200s, given to him by Carroll Dunham, for whole year in his carriage without daring to test them. On one occasion a patient of his was dying of diarrhoeic and bloody stools (she had sixty in the twenty-four hours, and was far through). He searched for a remedy having her very marked symptom, terrible aggravation from the smell of cooking. Colchicum had it, and fitted the case. But he had no Colchicum, except in 200th potency in that case of Carrol Dunham’s. He fetched it from his carriage, put a few globules into a half- tumbler of water, and directed, “Give her a sip after each stool.”

Twice he stopped his carriage, after leaving, feeling that he must go back and give that poor woman something! But went on.

Next day he found a cheery patient. She had only needed two doses! It was thus that Nash became a high potency man.

Probably, to do the highest curative work in chronic diseases, the high, the highest, potencies are necessary. But each individual is probably most susceptible, at any time, to some particular potency. Happy if we find it.

In severe acute sickness of healthy people, high and highest potencies may cure, and may be safely used.

In advanced stages of such diseases as phthisis and cancer, with profound tissue changes and destructions, the reaction induced by a high potency may be fatal.

When the Emanometer has got beyond its experimental stage, it may have a great deal to teach us in regard to potency. It is still in its childhood – most interesting but not yet convincing.

Dr. “B” asks: “What time must elapse before concluding that a remedy or a potency has failed to act altogether?”

Each drug has, according to repeated observations, its normal length of action, varying, however, according to reactive powers of the patient and the acuteness or chronicity of the disease.

In one’s experience, drugs of long action, like Sepia, may in chronic cases fail to show much or any improvement for periods up to five or six weeks; and one has been so sure of the prescription that one had waited, and been thankful to have waited, because of the sudden, marked improvement.

One has seen Sulphur in the same way hang fire for four to five weeks, and then suddenly got the desired results.

Experience with other polychrests has often been much the same, where patients are irresponsive and exhibit poor reaction.

Hahnemann, on the contrary, says: “If the antipsoric treatment be properly conducted, the strength of the patient ought to increase from the very beginning of the treatment.” Of course where the patient says : “Symptoms the same, but I feel better,” one would not dream of interfering. Reaction is initiated. In acute cases one expects some result almost instantaneously when one has hit the remedy.

In a case of pleurodynia Arnica gave instant relief after many remedies had failed. The patient had hardly swallowed it when she exclaimed: “That’s the first breath I have been able to draw all night,” and promptly fell asleep.

Another case, one of bilious headache, where the patient, a doctor, was so prostrate after twenty-four hours of suffering, in whom remedy after remedy had failed to touch, that he could just crawl to a bottle of Chelidonium; this gave relief in ten minutes.

Another case of pneumonia, after a dose of Phosphorus 200, got such relief of suffering that he was found sitting up in bed reading a newspaper, though temperature was still 103 degree F., and the lung, of course, unresolved. Here the prompt response of the patient proved the correctness of the remedy, which in due course cured.

Hahnemann says: “The condition of the mind and the general behaviour of the patient are among the most certain signs of incipient improvement, or of aggravation, in all diseases, especially in acute ones.

“Incipient improvement, however slight, is indicated by increased sense of comfort; greater tranquillity and freedom of mind; heightened courage and a return of naturalness in the feelings of patient.

John Weir
Sir John Weir (1879 – 1971), FFHom 1943. John Weir was the first modern homeopath by Royal appointment, from 1918 onwards. John Weir was Consultant Physician at the London Homeopathic Hospital in 1910, and he was appointed the Compton Burnett Professor of Materia Medica in 1911. He was President of the Faculty of Homeopathy in 1923.
Weir received his medical education first at Glasgow University MB ChB 1907, and then on a sabbatical year in Chicago under the tutelage of Dr James Tyler Kent of Hering Medical College during 1908-9. Weir reputedly first learned of homeopathy through his contact with Dr Robert Gibson Miller.
John Weir wrote- Some of the Outstanding Homeopathic Remedies for Acute Conditions with Margaret Tyler, Homeopathy and its Importance in Treatment of Chronic Disease, The Trend of Modern Medicine, The Science and Art of Homeopathy, Brit Homeo Jnl, The Present Day Attitude of the Medical Profession Towards Homeopathy, Brit Homeo Jnl XVI, 1926, p.212ff, Homeopathy: a System of Therapeutics, The Hahnemann Convalescent Home, Bournemouth, Brit Homeo Jnl 20, 1931, 200-201, Homeopathy an Explanation of its Principles, British Homeopathy During the Last 100 Years, Brit Homeo Jnl 23, 1932: etc