Fear of death you must treat in the same way. The repertory would be endless, if dissected still further into its finest shades. One can always, under each drug, turn up the materia medica, and see exactly what the fear; produced by any of the drugs, actually means.
As to claustrophobia, Dr. Tyler in one of her repertory cards has massed all the small rubrics that go to form this condition, such as: – Restlessness, faintness, weeping, fear & unconsciousness in closed room, crowded room &warm room.
Or it might be a fear of suffocation.
(See Kent’s Repertory, pp. 48, 74, 90, 91, 763, 764, 766, 1321, 1323)
In regard to “better and worse for company”, one must combine the rubrics `Worse for company’ and `better alone’; and the rubrics `Better for company’ and `worse alone’. The latter very often means fear alone.
He says: “A case has gone to such extreme end-results and all guiding symptoms, if they ever existed, are absent. It is impossible to make one’s prescription on symptoms which may have existed in early life. There is nothing in the case but the pathological result. How are we to find the remedy?”
He quotes a case: “A lady (50), cirrhosis of liver, abdomen requires tapping weekly. Twenty pints of clear ascitic fluid are withdrawn each time. Wassermann negative. No history of alcoholism. The most probable cause: Jaundice following measles years ago.
“How can one hope to find a remedy for such a case?”
Where a patient cannot put up symptoms, you have nothing to guide you to the Homoeopathic remedy. In such a case Organ remedies will sometimes come in, remedies that profoundly affect certain organs, and by inducing pathological changes in them, lead to such trains of symptoms. We know that quinine will produce ague-cake; alcohol, cirrhosis of liver with consequent ascites. And lately we have been told that poisoning by colloidal silica will produce fibrosis of liver and kidneys.
Burnett, following Rademacher, a contemporary of Hahnemann, made great play with some of these organ remedies such as Chelidonium, Spiritus glandium quercus (acorn tincture), Ceanothus, Cholesterinum, and a number of others.
He asks further: “If during treatment of a chronic case-
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patient has an intercurrent illness such as influenza, must you immediately afterwards repeat your chronic remedy?”
Not necessarily. If after waiting a week or so, the patient is less well in the old ways, you must repeat.
Dr. “K” wants impressions of Types of Various Drugs. Once he gets the impression, finds he can better understand a drug in materia medica. It might be a good suggestion if sometimes we could get several men to describe a drug, as it appears to them, and in that way get a more complete and striking picture than any single individual can give. In the busy life of a general practitioner, when there is no time to work out the exact symptoms of a case, if the patient’s constitutional drug can be spotted, the patient will improve in health and gradually lose the symptoms that have brought him for help. A more superficial remedy, covering the exact symptoms complained of, might have sooner wiped them out: but the effect on health will be greater and more permanent from the slower and deeper acting drug.
PITFALLS
Absence of an expected symptom does not cut out a drug. For instance, a desire for pork does not rule out Pulsatilla, if other symptoms, and especially mental symptoms appeal for that drug. One of my own best Pulsatilla cases was a man with a craving for fat. On the other hand, a loathing of fat DOES suggest Pulsatilla as one of the remedies to be thought of. This is a positive symptom.
Negative symptoms are of less importance than positive. That a patient is not restless, does not necessarily cut out Arsenicum That a patient does not put her feet out of bed, and does not go into raptures over rags and rubbish, does not cut out Sulph. That a patient is not loquacious, does not mean that Lachesis cannot help her. That she is not indifferent may not cut Sepia and Phosphorus That she is indifferent is of the greatest importance, and carries you a long away towards Sepia and Phosphorus and few others. That her soles burn, at night and refuse to stay in bed is very suggestive of Sulph., Pulsatilla and two or three other remedies. Her great loquacity puts up an almost irresistible plea for Lachesis That she loathes fat, puts Pulsatilla, Cina, Ptelea trifoliata, in court. These are positive symptoms. Negative symptoms are dangerous, and cannot be used to exclude remedies. Even in the proving of drugs, only a proportion of provers put up certain symptoms. It is the positive symptoms, strongly marked, that you cannot get away from, on which you must base your prescription. On the other hand, in a choice between several drugs, all exhibiting these same positive symptoms, the general aspect of the patient will decide, or as we have said, a glance into the materia medica, at the sections that deal with the patient’s immediate distress, will reveal to you, without doubt, your drug. A child with ulcerated nostrils may be easily cured by Aurum, when Sulph. had failed to improve. But the child is not suicidal! The strong negative symptom that comes into your picture of Aurum is wanting. No matter! Your business is with what the child does exhibit; not with what he fails to put up, even though it should enter into your conception of the drug.
It is a great help, often, to be able to spot your drug early; but there is a danger in spotting your drugs as the patient enters, and making all your questions tend towards that drug. Some patients are absolutely atypical, and you may exclude the right drug, instead of spotting it. It is the same danger as throwing out your drug on negative symptoms.
The temptation of working from a small rubric, to the exclusion of drugs not there. One must remember that the repertory, though monumental, is not and cannot be, perfect. Our 1,000 drugs cannot be all equally well represented all through the repertory, into the smallest rubrics. If all were equally well proven, and equally well represented, in a perfect repertory, homoeopathic prescribing would be a mechanical art, relegated to the paid drudge. Where as it demands insight, vision, deduction, experience, constant effort, and affords everlasting interest, and even excitement. On the other hand, small rubrics may be wonderfully suggestive, and lead to the best work. Many a drug appears only in one small rubric, probably in the highest type. A small rubric with one unusual drug in the highest type may put you on to a drug whose very name you have never heard, yet which, when turned up in the materia medica, absolutely fits your case.
A doctor had been long treating, a woman with a very large goitre of many years standing. This doctor hated cats, and when this patient came in, there was often a yowl from the corner, and the patient would say, “Oh, it is only a poor little starved kitten. I always carry a bag, and I pick them up, poor little things, and take them to be destroyed. People are so inhuman; they neglect them and let them starve. I can’t bear to see them suffer.” Once she produced her letter to a local paper on subject of cruelty to animals and cats. “People would go off for a holiday, and leave the cat in the street to starve,” she said. One day the doctor, glancing down the small rubrics under “Sensitive”, suddenly saw a one drug rubric in big type, “Sensitive when hearing of cruelties”, and Calcarea only, in the highest type. Next time the cat-woman came, she got that remedy, high. Next time, the goitre was smaller, the patient looked amazingly flourishing; and when the doctor asked about the cats, he was told, “Oh, people are not so inhuman now!” And the woman persists in this belief, the cat-bag is discarded, and she no longer hunts the streets looking for starved kittens for the lethal chamber.
Dr. Tyler tells me that she was treating a child, sharp enough, but at the age of three unable to speak a word. She turned up “Talk….. slow in learning to ” and found one unexpected remedy only in the highest type, Natrum muriaticum She gave it…Other more likely things had not helped. In a month the mother volunteered that the day after the new medicine the child began saying words.
Then the danger of prescribing without a careful examination of patient. One very keen doctor, a most sound man, tells me that he was recently almost betrayed into that error. He was on the point of prescribing Phosphorus We must never be led away by enthusiasm for prescribing into the neglect of the most exact diagnosis possible to us. Do not treat irregular haemorrhages from the vagina without making sure that you have not polyps, fibroid, or carcinoma to deal with. You may have this even in quite young women. It will not do you much good if your patient, failing to get relief from homoeopathy, goes elsewhere to be told the cause of the trouble…inoperable carcinoma.
DISCUSSION
Mr. Pritchard felt sure that all would agree that Dr. Weir had given them a most interesting and exhaustive disquisition. Dr. Weir had said, when starting, that he would be very pleased if any member would ask him questions. Mr. Pritchard said he came to the meeting with one or two questions to ask, but these had already been answered by Dr. Weir in replying to various other written questions that had been sent in. Mr. Pritchard said he was pleased to hear. Dr. Weir wind up his paper with a strong request that the thorough examination of a patient should not be forgotten. In the course of his experience. Mr. Pritchard had seen a few patients whose troubles had been passed over in this way. Only a few months ago he was called to Turnbridge Wells to see a lady who had been under treatment for two years for bladder trouble. The practitioner in charge of the case was a M.D., F.R.C.S., who ought to have known better, but directly Mr. Pritchard saw the patient, her mere appearance denoted some malignant trouble. Upon examination it was at once apparent that there was malignant disease of the uterus, too far gone for operation. Mr. Pritchard always remembered the advise of one of his first lecturers at Guy’s, which was, “Always thoroughly examine your patient. Put your finger in, and you won’t put your foot in”. There was one type of patient that Dr. Weir had omitted to mention. Mr. Pritchard said that when he first took over his practice twenty-three or four years ago, there was one lady – a relict of his predecessor – whom he treated for three months without being able to do anything for her. He tried his very best and went over her symptoms many a time. At the end of three months she complained that she was no better, although she had been attended by Mr. Pritchard all that time, and indicated that she was not satisfied. Mr. Pritchard told her that he had done his best and refused to treat her further. The following day he received a letter saying she was really bad, and would he go to see her, and the next day he received a message, “I am very ill, please come.” Mr. Pritchard relented and went to see her again, spending a long time with her and prescribing for her symptoms, and from that day he never had any more trouble with her. A similar case was that of a lady who was looked after by his partner during Mr. Pritchard’s holiday. Upon his return this patient said, “I am so pleased to see you back again. The other doctor’s medicine did me no good at all”. Mr. Pritchard inquired from his partner what he had been giving and found that he himself would have prescribed in exactly the same way, and he now continued the treatment. The patient at once reported improvement, whereupon Mr. Pritchard said to her, “Whilst I have been away my partner has been giving you the same medicine which you say did you no good. When I came back I gave you the same medicine and you at once report improvement. Aren’t you ashamed of yourself?” This was certainly a type of patient difficult to treat.
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