Repertory Analysis, Dosage and Repetition

My method of taking the most prominent general, be it mental or physical, as a starting point and eliminating remedies from the group thus reached is much more comprehensible and more easily followed….

After the longest and most difficult part of your task, that of individualizing your symptoms, has been completed the remaining portion, that of selecting your remedy with the repertory, is quickly done and is a simple mathematical proposition. Like all other mathematical problems we must start with the right premises and follow certain axioms in order to arrive at the correct solution. Thus if the logic of our symptom analysis is correct, if the technique of selection be without a flaw, the choice of the remedy must be mathematically certain.

Before giving the demonstration of the repertory analysis I wish to say a few words concerning the administration of the remedy after we have found the one which covers our individualized symptom picture. One of the most difficult things to comprehend is when to repeat the dose. You will find as a general thing in acute cases that if a slight aggravation of the symptoms comes in a short time you will not think of giving another dose, for your patient will get along better without more medicine; but there are conditions when it is necessary to repeat the dose. For this there is no clear-cut rule that can be laid down, and it is very difficult thing to teach and to understand; rather it can only come by experience and by using powers of observation.

The safe rule to follow is, never repeat the dose after reaction begins.

If more than one dose is necessary repeat the dose until there is improvement and then stop; more doses will only retard the cure. When reaction is taking place never repeat the remedy; when reaction ceases or improvement stops, the remedy may be repeated.

Many good homoeopathic prescriptions are spoiled by too oft repeated doses of the right remedy. We are often treating the effects of too many doses of the remedy when we think we are treating the disease.

I do not like to bring the question of potency up in this place, but it is one thing I wish to emphasize; that is, when the dilution of the right remedy will carry your case part way to health, and you are sure you have the right remedy, increase the strength of the remedy rather than change to another unsuitable one. In this way you will find your cases being carried on to a complete cure.

We find certain rules given us for the repetition of the remedy in Chronic Diseases and Hahnemann discusses these on pages 209-213, in speaking of the third mistake in the treatment of diseases. Quoting in part, we find, on page 209: “The third leading mistake that the Homoeopathic physician cannot too carefully or steadfastly avoid is in hastily and thoughtlessly giving some other medicine… but if once a medicine… is acting well and usefully, which is seen by the eight or tenth day, then an hour or even half a day may come when a modern homoeopathic aggravation again takes place. The good results may not appear in their best light before the twenty-fourth or thirtieth day. The dose will probably have then exhausted its favorable action about the fortieth or fiftieth day, and before that time it would be injudicious and an obstruction to the progress of the cure to give any other medicine. Experience teaches that a cure cannot be accomplished more quickly and surely than by allowing the suitable antipsoric to continue its action so long as improvement continues… Whoever can restrain his impatience as to this point will reach his object the more surely and the more certainly… periods of aggravation will occur, but so long as only the original ailments are renewed and no new, severe symptoms present themselves, they show a continuing improvement, being homoeopathic aggravations which do not hinder but advance the cure. The physician must; therefore, in chronic diseases, allow all antipsoric remedies to act thirty, forty or even fifty and more days by themselves, so long as they continue to improve the diseased state perceptibly to the acute observer, even though gradually; for so long the good effects continue with the indicated doses and these must not be disturbed and checked by any new remedy.”

In footnote, page 212, we find: “But he who will not allow himself to be convinced of this and imitate what I now teach, he who is not willing to imitate it exactly, can leave the most important chronic diseases uncured.”

This third step of our Trinity is of equal importance with the first two, for no matter how well you have done the first and second parts of your task all your efforts can be spoiled by the wrong administration of the remedy.

When we have given our remedy on the above formula we may expect certain things to happen. In all curable cases we will expect a cure to take place or at least to be started. We may know that this cure is taking place by certain signs of nature which are given to us in the symptoms of the patient, and the way these signs or symptoms disappear will tell us if we are going to make a cure. If we are to cure the symptoms must disappear from above downward, from within outward and in the reverse order in which they came.

From the study of the Organon and the Chronic Diseases, we learn that there are certain other things that we may expect after the prescription has been made. Kent gives these observations as eleven in number. I will simply give them without further comment, as an explanation may be found in Kent’s Lectures on Homoeopathic Philosophy, or in a paper on the subject by myself, published in a late number of the North American Journal of Homoeopathy.

Following the dose one of the following results is to be expected:

1st. A rapid cure will take place with no aggravation of symptoms.

2d. The aggravation will be rapid, short and strong, and is followed by rapid improvement of the patient.

3d. A long aggravation with final and slow improvement of patient.

4th. A long aggravation with final decline of patient.

5th. Full time amelioration of symptoms with no special relief of patient.

6th. Amelioration comes first and aggravation come afterward.

7th. Too short relief of symptoms.

8th. Old symptoms are seen to appear.

9th. New symptoms appearing after the remedy is given.

10th. Patients who prove every remedy given.

11th. That symptoms take the wrong direction.

The first case used will be an illustration of repertory analysis, working through the two divisions of Mental and Physical Generals. (Many are partial to this method, and it is well to use it in the beginning, as it trains you in the repertory arrangement.)

My examples, as further cases illustrated will show, does not follow this method and has laid me open to criticism (from some sources) of being too mathematical in my methods and of the liability of securing erroneous results. This criticism might be sustained if one depended upon the repertory as the final deciding factor for the remedy; but taking the pathogenesis of the remedy, as given in a complete materia medica, as the court of last resort I am at a loss to see where the criticism is justifiable. To me, at least, my method of taking the most prominent general, be it mental or physical, as a starting point and eliminating remedies from the group thus reached is much more comprehendible and more easily followed. In advocating this method I assume the physician to be familiar with the arrangement of his repertory and a master of the art of individualization of cases.

Glen Irving Bidwell