DIFFERENT WAYS OF FINDING A REMEDY In Homoeopathy, the REMEDY is the thing. Potencies and administration are the questions that divide us- are matters of personal experience.
Brilliant work has been done by people of widely different range of potencies and administration, provided that they had found the remedy. Without that the magic refuses to work.
We are here to consider DIFFERENT WAYS OF FINDING THE REMEDY, because the essential thing, for a homoeopathic prescription (and on this we are all agreed), is A LIKE REMEDY FOR A LIKE ABNORMAL CONDITION But, in order to get the “like” remedy, one must get accurately the disease-picture that has to be matched. And perhaps the most difficult thing of all is taking the case.
Somebody said the other day, “If the case is well taken, it is impossible to find it.
Pathological case-cause-taking will not help. Symptoms that go to make up the diagnosis, we must have, but they will seldom lead to the curative drug.
This may point to a group of remedies, useful in such a disease. They will not pick out the one remedy demanded by the symptoms of THIS patient.
Dr. Drysdale laid it down that “The greater the value of a symptom for diagnoses, the less its value in the selection of the remedy.” This does not mean that we must not or need not diagnose! We must!-of only to discount symptoms common to the disease, and not peculiar to this patient with the disease; or symptoms dependent on disease ultimates, mechanical perhaps, and not expressive of the patient. Also for prognosis; and for information as to what range of potencies it is wise to employ.
Again, in sheet self-defense. Failure to diagnose may wreck the physician, while “Diagnosis, without the remedy is poor consolation for the patient.”… “These ought to have done, and not to have left the other undone.
As a matter of fact, homeopathic case-taking, is merely a big addition to ordinary case taking, it never supersedes it. Just as homoeopathic materia medica is a huge addition to the materia medica of the schools. The homoeopathic doctor is all that the others are-and then MORE.
First, then, briefly to consider taking the case. It is all Hahnemann. But, instead of quoting. I will try to cut it down.
Begin by writing down the patient’s statement in the patient’s own words.
Why? To avoid errors and misconceptions, but especially for purposes of comparison.
The materia medica consists of the statements of simple people, in simple language. The match.
This has been a reproach to homoeopathy. Its facts are not recorded in the scientific terms of our day.
And yet it is just this simplicity of truth that has saved homoeopathy, and made it available for all times and for all peoples. Had it been done into the scientific jargon of a hundred years ago, it would be long obsolete. The science of one generation is often the nonsense of the next. And conversely in this instance. For what, in homoeopathy, has been decried as nonsense for a century, is now being recognized as the latest would in science. TRUTH IS GREAT, AND HAS A WAY OF PREVAILING IN THE LONG RUN You have recorded the patient’s story. Now you start on the quest of the “strange, rare and peculiar.” That is to say, you take him through it again, and make him amplify and qualify his statements. By this means you may stumble upon one or two invaluable symptoms, peculiar to himself, and not merely diagnostic of the disease. The fact that he is breathless-in asthma-will not go far. It is part of the programme, and common to all asthmatics.
But the fact that he can only breathe when lying flat or in the knee-elbow position, may be peculiar to THIS case, and highly diagnostic of one or two or three remedies. You will underline that. If you are so skillful, or lucky, as to get two or three invaluable symptoms, your work may end here. For turning up the drugs that have caused these symptoms, you may find in one of them, a complete picture of the patent’s case, disease and all. This seems to have been a common method of finding the remedy with Dr. Erastus Case, and it led him to brilliant results with many rare remedies that would not “work out” by more tedious repertory methods. His little book is well worth study-stuffed full, as it is, with instructive cases.
Next, you try to extract anything definite and well-marked in the general symptoms of the patient: his (especially) altered reactions to environment, mental and physical. The effect on him of temperature, humidity, thunder, foods, light, noise, smells; his cravings and aversions, with delicate probings for mental symptoms, especially where these denote change from his normal.
You may get help from nurse, from friends or relations (who will often lie, by the way, if the patient is present). And all the time you are using your own observation to check, to confirm, and to note the things that you are not told.
Dr. Burnett used to say, “With children. lunatics and liars, you have to use your own observation.” He seemed to imply that this was pretty well always.
For there are the persons who “pile it on”-hypochondriacs-or in hysteria. And the persons who conceal; from shyness, from shame; and invariably what is most important.
Remember leading questions evoke misleading answers. Make the patient consider. Never ask a question that can be answered by yes or no. Only record what is considered and definite.
In our earlier days we ask a good many questions, and we write down a great deal. Later on we ask many more questions and record much less.
In complicated and chronic cases get the patient’s PAST HISTORY. He many not remember it the first time; for example that eruption when a small body. He will tell you more after thinking things over the asking people who know.
FAMILY HISTORY is often of the great greatest importance. And what about VACCINATIONS?-frequent-perhaps successful. We will go into that later, with Dr. Burnett’s work.
SMALL-POX is one of the things that may hit you in the eye. It has branded its victim.
And with variolinum you can amazingly improve the health, physical and even mental, of persons who have had small pox. One has seen case, after case where the facial deformity has yielded to what would seem an impossible extent: and that after 40 years! the skin smoothing out and resuming normal coloring after a few doses at long intervals of variolinum 200.
But, may this not be the case with other acute disease and their virtues? Then old malaria or quinine. Here, again, Burnett comes in with his brilliant little monograph, which made the case for Natrum muriaticum.
Look out for T.B. manifestations, scars in neck, T.B. family history. Here you have a legitimate short cut to such drugs as Tuberculinum or Drosera, which raise resistance to tubercle, besides a group of the polychrests, Phosphorous, Psorinum, Calcarea, etc., according to symptoms.
Then Hahnemann’s chronic Miasms-psora, syphilis, gonorrhoea.
If these are not prescribed for, especially in chronic disease, you will not permanently benefit your patient-so Hahnemann says, and such is our experience.
You may cover the superficial drug-picture, but you will have to go, ultimately, for the deep disturbing cause before you can get maximum results. This, as I will show you, is Hahnemann.
Prolonged dosing with any drug will give you that drug’s disease- picture muddled up with the patient’s own symptoms; or it may be the whole case.
The same drug in high potency can antidote itself in crude preparation. But any drug, of course, having the same symptoms, will antidote.
It is always a question of matching symptoms. Among drug- symptoms, many arise from toothpastes, douches, gargles, etc.
A septic tooth may be poisoning the patient. But what about a septic pessary?-foul, very often, and indescribably offensive.
And now THE CASE HAS BEEN TAKEN The patient’s story has been recorded and the common symptoms with which it abounds, qualified, and out of these (unless otherwise, for prescribing) some things “strange, rare and peculiar” have been called and underlined.
Mental symptoms, most precious of all, if marked and true, have been angled for, and, where definite and reliable, recorded.
Where these deviate from the patient’s normal, they are of the highest importance. they may be used as eliminating symptoms, to throw out drugs by the dozen, in whose pathogenesis they do not appear.
And now we have the patient’s disease-picture complete i, e, his deviation from his normal. How are we to match with a drug disease picture? In other words, how are we to find the remedy? How did Hahnemann solve the problem?
Hahnemann and his immediate followers had great advantages over
They had fewer remedies to choose from. They knew them better, and could recognize them more easily in their patients.
For years, for half a lifetime, they had been “proving” drug after drug, and suffering its effects in their own minds and bodies. Naturally, they had less difficulty in recognizing a personally-experienced drug-picture in a patient. It had been branded on their memories by suffering.
Every personal suffering makes the doctor better able to recognize, sympathize with and help such suffering in another. The greatest ability to help is achieved ever at the greatest cost.
No great work has ever been done without great effort and great self-sacrifice. Homoeopathy is no art for the lazy and the dullard.
But our immensely wider range of medicines is compensated by fuller repertories. And the problem is, how to use them to best effect.
And here the amount of time and labor involved in finding the remedy by means of the repertory may be immensely lightened if we realize the GRADING OF SYMPTOMS; that is, their relative value. This is the key.
Even in laboriously “working out” a case by aid of the repertory, the three hours’ dreary plodding-with often doubtful results-of the uninitiated, resolves itself into ten or fifteen minutes’ work for the practiced physician.
Or, where he knows his remedies, and has gained experience and confidence, it is often no matter of working out at all He may spot the remedy at the glance, and a few questions prove that he has got it. Typical Sulphur, Calcarea, Sepia patients can hardly be missed. This makes heavy out-patient work possible.
Hahnemann speaks- and we are apt to talk glibly of the TOTALITY OF THE SYMPTOMS. What do we mean by this? Does it mean that every little symptom, and every symptom dependent on some gross pathological lesion, has to be covered? Endless work, with poor results.
You do not recognize our friends by counting up their fingers and toes, by the things personal to themselves only of all mankind.
Their totality, as it appeals to you, lies in sex, stature, coloring, voice, expression, mind; not in what is common to men, but in what differentiates.
In the same way a drug picture, to be complete, does not consist of strings of little symptoms, but of broad outlines of mental and peculiar symptoms; peculiar, that is, to one drug, and distinguishing it from all others.
As Hahnemann puts it, “The symptoms which determine the choice of the remedy are mostly peculiar to that remedy, and of marked similitude to those of the disease.”
Hosts of symptoms are common to a thousand drugs, and therefore diagnostic of none. If you give undue prominence to these, you might as well toss for the remedy.
“Each medicine differs in effect from all others” It is the differences, not the correspondences that concern us.
Hahnemann says of indefinite symptoms, loss of appetite, of sleep, weakness, etc., that they are useless, as “common to every drug, and to almost every disease”.
Hahnemann says, “In comparing the disease-symptoms with lists of symptoms of proved drugs, the more prominent and peculiar (characteristic ) features of the case are specially and almost similitude to the symptoms of the desired medicine, if is to cure.” And again, “The state of the patient’s mind and temperament is often of the most decisive importance in the selection of the remedy.” And again, Hahnemann speaks of “the totality of the characteristic symptoms” Let us realize them that the TOTALITY means the CHARACTERISTIC TOTALITY, and cause counting fingers and toes.
KENT was one of those who went back to Hahnemann and did great work. Here is what Kent wrote to me in1912:
“The methods you use are hard and arduous, and differ decidedly from mine. You do an enormously greater amount of work than I do in my cases.
“When looking over a list of symptoms, first discover 3,4,5, or 6, or as many symptoms as exist that are `strange,. rare and peculiar.’ “These are the highest generals, because `strange, rare and peculiar’ must apply to the patient himself.
When you have settled on 3 or 4 or 6 remedies that have those first generals, then find out which of them is most like the rest of the patient’s symptoms, common and particular.
“When you have taken a case on paper you must settle the symptoms that CANNOT be omitted, in each individual.
“Do not except a remedy that has the generals must have all the little symptoms. It is a waste of time to run out all the little symptoms, if the remedy has the generals.
“Get the strong, strange, peculiar symptoms and then SEE TO IT THAT THERE ARE NO GENERALS IN THE CASE THAT OPPOSE OF CONTRADICT.
“If you see the keynotes of Arsenicum see that the patient is chilly, fearful, restless, weak, pale, must have the pictures on the wall hung straight-and Arsenicum will cure.
“Or the keynotes look like Pulsatilla. See to it that she is NOT Chilly, likes windows open, wants cool air, to walk in open air, is better from motion, thirstless, tearful, gentle.
“The trouble with keynotes is that they are abused. They are often characteristic symptoms. But if keynotes are taken as final and the generals do not conform, then will come the failures.” Among ways of finding the remedy is the elaborate repertory way, which yields excellent results in the majority of cases, By working through the case on mental and general symptoms, with due regard to their relative importance one gets the remedy, provided it shall have been : (a) well proved; (b) well represented in the repertory, which is the case with a very large but, of curse, limited number of drugs.
It means labor, but less and less as one gains experience. It means grit.
But, unless you are careful not to take such symptoms too easily, it will lead you every time to well proved drugs, well represented in the repertory-the “polychrests.” But what about the valuable remedies, only half-proved, and even so, inadequately represented in the repertory? You may need one or other of these only once in half-a-dozen years, but when you do need it, nothing will take its place.
Accidental poisonings have supplied the data regarding some of these drugs. Or again, serpent bites or insect stings.
They may appear in only one rubric in the whole repertory-but there in black type.
Take heed to any rare, black-type remedy that has the salient symptoms of a patient. Go straight to materia medica and see whether it does not perhaps fit the case through and through. A remedy so learnt is never forgotten. You have one more arrow in your quiver to speed at suffering and disease.
Here is an instance. A case of melancholia, with an insane fear of insanity. Pulsatilla more or less came through, as did Ignatia, but she got steadily worse. She was smileless, sat apart, neglected everything, could neither eat nor sleep, lost color and flesh, thought of nothing but her TERROR.
Mancinella covered the case and quickly cured. Mancinella does not appear more than a couple of times in the repertory, but it stands in black type for her one overwhelming mental symptom-fear of insanity.
She got two or three doses only, at long intervals for `slight threatenings of relapse that melted away, since when she has been well for a dozen years.
Latrodectus mactans for angina pectoris is another such ill- proved, ill-represented remedy. Black type in the one rubric,”Pain, heart, extending down left arm,” should send you straight to materia medica to find the most perfect picture of the terrible condition. And it works.
Many drugs can be got only by reading and studying their genus. One of the veterans used to lay down his own law. “Read a drug a day, and two on Sundays.”
But mark or underline, as you read, the strong, rare and characteristic symptoms of each drug. You can afterwards easily run through your markings and get a drug-picture that will stick to you.
In reading any drug not also:
Its LOCAL actions.
The TISSUES and ORGANS it especially affects. (Burnett, following Rademacher, made great use of organ remedies, as well;l as the polychrests).
Also, its peculiar sensations, mental and physical. In Clarke’s Dictionary special stress is laid on these, in the remarks that preface every drug.
Nash’s LEADERS, Allen’s KEYNOTES, Boger’s SYNOPSIS, are all based on drug characteristics, and these books are immensely helpful.
If you have Allen’s Cyclopaedia you can do happy and useful reading even here, provided that you run through his black type symptoms, and his symptoms in italics. You get an extraordinary insight into remedies this way. And even in the ordinary type you may find strange symptoms; underline them.
Where in a case there is a strongly marked mental symptoms which you feel must be matched. You may lighten your work by using that as an eliminating symptom. And, in going through the rubrics of the other symptoms, record only those that have this mental symptom.
In the many cases where you have to work solidly through the marked symptoms of the patient, from mentals to generals, in their order of importance, you may, in my experience, lighten your labor thus:- Remembering the general symptoms, reactions to temperature and whether, to foods. to environment generally, must be very definitely marked in the patient to be used at all, and that, if so marked and definite, they should correspond in importance of type with the drugs in their rubrics:-
Therefore, in strong, general symptoms, it is generally enough to write down only the drugs in black type and italics. And this is really, even in long rubrics, not such a terrible task.
There is a limit to the amount of work one can put into a case. And, as a matter of fact, the more you put in, i a heavy mechanical, painstaking way, the more you are likely to be landed with a big choice of remedies, and the less likely you are to find the one. Homoeopathy has to be mixed with brains.
But Hahnemann discovered, as we all discover sooner or alter, that there are cases were the most careful symptoms covering does not carry us through. Patient improves again and again, but health is not re-established.
In a simple pneumonia you cover the symptoms and abort the case, or, if it is more advanced, you carry it through with a minimum of distress, to early resolution.
Whereas other case, even of such an acute disease as pneumonia, hang fire. Why is this? Does not out experience teaches us that there are patients that cannot throw off even a pneumonia without one of Hahnemann’s “antipsorics”-Sulphur Lycopodium, Calcarea-or where there is a T.B, history Tuberculinum.
Much more is the case with chronic disease; that is to say, with those who, year out, are ailing; who improve only to slip back.
Hahnemann got to work on this problem, and involved from it his CHRONIC DISEASES.
I doubt, if any of us pay enough attention to this part of Hahnemann’s work and teaching. We are apt to be more than content when the miracle works in simple cases, and to classify the rest as old chronics, as if thereby all has been said.
Not so with the wise old healer. He had not been content with old school medicine. He has not content with homoeopathy if in some cases, it failed to completely restore patient.
“For years he had been employed, day and night to discover why such homoeopathic remedies as were then known did not effect a true cure of certain chronic miasmatic disease.” He says, “All chronic miasmatic diseases are so inveterate, after they have become developed in the system, that unless thoroughly cured by art, they continue to increase in intensity till death. They never disappear of themselves, are never diminished, much less conquered by vigorous constitution, regular mode of life, strictest diet.
“All chronic diseases, “he says”, are based upon fixed chronic miasms, which enable their parasitical ramifications to spread through the human organism, and to grow without end”.
“The chronic miasms are semi-vital, morbid miasms of a parasitical nature.” And he says that, in his opinion “miasmatic infection, in acute as well as in chronic disease, takes place in a moment, provided the moment is favourable to the contagious influence.” For “miasms,” read “micro-organism” and see how Hahnemann was on the spot 100 years ago, (“The Chronic diseases” was published in 1828).
Hahnemann realized, then, that there are life-long conditions following some acute disease of long ago, even of centuries ago, that may have to be taken into account in prescribing.