The physician who aims to be something more than a mere dispenser of palliatives, pills, and piffle, will never lack opportunities to magnify his profession and become a power for righteousness in his community, as well as a healer of its diseases. It is in dealing with such cases – the indispositions and habit disorders – that the *”second best remedy in the materia medica” so often comes into use. Of course you all know what the second best remedy is. No? I am surprised that your education has been so neglected! But I am glad it is to be my privilege to teach you something you do not know. There are so few things that the average young doctor does not know!
In order to fully appreciate the value of the second best remedy we must first clearly understand what is the best remedy in the materia medica. There cannot be any doubt in your minds as to that, I am sure. It is the *indicated remedy. You also know that having once been found, the best remedy must be given time to act, and that its action must not be interfered with by other drugs or influences until it has accomplished all of which it is capable. You also know, or, if you do not, you will learn (if you keep your eyes open and your wits about you ) that too many doses of the best remedy may spoil the case.
One of the distinguishing characteristics of a great painter is that he *knows when to stop. Many a painting which would have been great, if the artist had known when to stop, has been weakened and spoiled by over-finishing. In his anxiety to perfect a few insignificant details he robs his work of its vitality- kills it. It is the same in treating a case. The problem is to give just enough medicine and not too much. Too many doses may spoil the case. I have referred to the class of people who expect and demand *medicine, and are not satisfied unless they get it, until they have been taught better.
Now just here comes in the *second best remedy, without which no good homoeopathist could long practice medicine. Its technical name is *saccharum lactis officinalis; abbreviated sac. lac. or s. 1.; just plain sugar of milk! The young homoeopath’s best friend, the old doctor’s reliance and a “very present help in time of trouble!”
The doctrine of *placebo, from the Latin *placere, to please; future, *placebo “I shall please,” is as old as medicine itself. Its psychological value is commensurate with the frailties and peculiarities of human nature. The traditional “breadpill” of our medical ancestors has given place, in the march of scientific progress, to the more elegant powder of virginal white, pure sugar of milk; or to the seductive little vial of sugar pills or tablets, artistically labelled and bestowed with impressive directions as to the exact number of pills for a dose and the precise hours of taking, with confident assurances of the happy effects to be expected, if directions are faithfully followed!
Marvellous are the results witnessed from the resort to this remedy in cases where it is indicated. I have seen it bring sleep to the “insomniac,” when even morphine had failed. I have heard patients declare that it was the most effective cathartic they had ever taken and ever taken and beg for a generous supply for future use; which supply I have usually refused on the ground that it was too powerful a remedy to be entrusted to the hands of the unskilled. It is indeed too powerful and too useful a remedy to be held lightly, or to be lightly used. The knowledge of its use is too dangerous to be disseminated among the laity. It should be as jealously guarded as a “trade-secret” worth millions. Never admit its use to any but the initiated, if you value your influence and reputation, but never fail to use it when your judgment dictates it.
Let us glance at a few of the practical uses of the placebo. You are called to a new case. You see the patient and make your examination. You decide that it is a case for medication. You have written down your symptom-findings and glanced over the record.The case is difficult and you are not able to decide off – hand what remedy is indicated. You must have time and opportunity to study it up. The patient and friends want something done at once. Rapidly you run over the case in your mind. this patient is seriously ill. To make a mistake in the first prescription might be fatal, or it might prejudice the case by confusing it so that a quick and satisfactory cure would be impossible. Your reputation in the new family will depend upon your success. You must retain the confidence of the patient, but you must *have time and make no mistake.
This is where your knowledge of the second best remedy comes into use. Calmly and confidently you prepare and administer a generous “s. 1.” powder, leave explicit directions for the use of as many subsequent doses as you deem judicious, make an appointment to see the patient again in an hour or two, or three, and then hie you to the seclusion of your library, where you proceed to apply your knowledge of how to study the case and find the remedy according to the principles of the Organon.
When you have worked out your case and found the remedy, you return. Then you enter the patient’s presence as *master of the situation. – unless the Master of Destiny has ordained otherwise
Does anybody consider that lost time? It is a pity that more time is not lost in that way! Thousands of cases might have been saved and many a professional reputation, by following such a course, instead of yielding to the silly panic-impulse to “do something quick,” which almost invariably results in doing the wrong thing.
Patients do not usually die in a minute. There is always plenty of time to *do the right thing. always, at the right time. If you *know what the right thing is without reflection and study, do it at once. Give your remedy at once if you are sure of it, but not otherwise. If you are not sure, give sac. lac.
If the case is *really pressing and demands immediate medication, retire to another room with your repertory then and there.
The very greatest of our prescriber – men like Boenninghausen, Hering, Lippe, Wells, Biegler, of those who are gone, and almost all our expert prescriber of today, do not fail to carry their repertory with them to all cases, nor hesitate to use it the presence of the patient if necessary. Instead to arousing distrust on the part of the patients, as you might think, it awakens confidence. To see a physician making a through examination, studying, “taking pains,” showing a real interest in the case and a determination to do his best at the “psychological moment” (which is always the *present moment with the man who is suffering), is calculated to inspire confidence at all times- except with fools, whom no physician wants for patients and who ought to be permitted to get off the earth as soon as possible for the benefit of posterity anyway.
Another use for the second best remedy is as a supplement to the indicated remedy. Experience shows that Hahnemann was right when he advised that *the remedy should be stopped as soon as signs of improvement appear, and the curative reaction be allowed to go on without further repetition of doses as long as it will. This, of course, refers to the cases where repeated doses are given from the beginning. When improvement begins and you desire to cease medication, you will simply substitute sac. lac. for the remedy and watch your case.
The same course is pursued when treatment is begun with the *single dose, by which method many of the most brilliant cures are made.
We may give enough sac. lac. powders to last during the interval between visits, or a vial of blank tablets or pellets; but be sure to moisten the tablets and pellets with alcohol, or put some unmedicated pellets in the sac. lac. powders. Patients have a way of investigating powders sometimes and counting the pellets. If they find no pellets they may become suspicious.
The medicine case should always contain a vial of blank pellets property labelled for such use. One friend of mine always carries a duplicate case of vials containing black pellets, but labelled as medicines to disarm suspicion.
These are some of the ways to use the second best remedy. If you follow the right course you will find more and more use for it, except with a few rare patients whom you can gradually educate up to the point where they come to realize that but little medicine and few doses are necessary, when a case is skill fully conducted.All this is quite in line with the most up-to-date teaching and thinking on therapeutic subjects. The use of placebo is simply one form, and a very powerful form of therapeutic suggestion; or, to use the still more recent term, psycho- therapy. In the habitual, systematic and judicious use of the harmless little powder of sac. lac. the homoeopathist antedated all the modern cults of drugless healing, and even they have devised no more powerful nor efficient measure.
We are not under the necessity of sending our patients away, as Dr. Wm. Gilman Thompson, of Cornell University Medical College, had to do. He was holding a medical clinic before the senior class. To this clinic came a woman whose case was diagnosed as neurasthenia. Among the multitude of complaints she poured forth, she laid most stress upon *constipation; but declared that she *could and *would not take any more cathartics.
Dr. Close was born November 24, 1860 and came to study homeopathy after the death of his father in 1879. His mother remarried a homoeopathic physician who turned Close's interests from law to medicine.
His stepfather helped him study the Organon and he attended medical school in California for two years. Finishing his studies at New York Homeopathic College he graduated in 1885. Completing his homeopathic education. Close preceptored with B. Fincke and P. P. Wells.
Setting up practice in Brooklyn, Dr. Close went on to found the Brooklyn Homoeopathic Union in 1897. This group devoted itself to the study of pure Hahnemannian homeopathy.
In 1905 Dr. Close was elected president of the International Hahnemannian Association. He was also the editor of the Department of Homeopathic Philosophy for the Homeopathic Recorder. Dr. Close taught homeopathic philosophy at New York Homeopathic Medical College from 1909-1913.
Dr. Close's lectures at New York Homeopathic were first published in the Homeopathic Recorder and later formed the basis for his masterpiece on homeopathic philosophy, The Genius of Homeopathy.
Dr. Close passed away on June 26, 1929 after a full and productive career in homeopathy.