The same principle of letting the drug act as long as possible applies in every case. In the subacute one finds that the duration or improvement will be materially less than in the chronic, lasting only a week or two at the outside, whereas in acute disease the duration of action, again, is very much shortened, the length of time during which the action will continue being proportional to the acuteness of the disease from which the patient is suffering. In the average acute febrile condition one finds that one has to repeat every hour or two hours, to begin with, increasing the interval as the curative reaction improves. In very acute conditions, such as biliary or renal colic, one may have to repeat every ten or fifteen minutes; in cases such as acute ptomaine poisoning one may have to repeat at first, every quarter of an-hour, or every half-hour, then as the duration of action lengthens one spaces out one’s administration. In all these cases it is obvious that one is working on the same principle, of letting the drug act as long as possible.
There is one other practical point which is of great importance, namely, what to do when the action of the first dose in coming to an end in a chronic case. In my experience it is in advisable to change the potency of the drug at the time of the second administration. If the symptoms of the case are still covered by the original prescription one should repeat the same drug in the same potency. A very important practical point arises here. If a patient comes back and reports that he is suffering from some fresh symptoms which have not been noted in the original case record and if these symptoms which are covered by the original drug, even if they have not been present at the time of the first prescription, the indications are that the original drug was correct, and is still acting so no further medication is required. Of course, where the symptoms have changed entirely a fresh prescription will have to be made. In the event of the indications still pointing to the same drug, how often one can with benefit repeat the same potency depends very largely on the time over which the drug is acting. Kent says that one can repeat once only without changing the potency. In my experience, if the drug is holding for a long time one can repeat much of tener than once and each time the same potency holds longer and longer, If a repetition of the same potency does not produce such a marked improvement as the first prescription, or it the duration of the improvement is tending to lessen, then it is advisable to raise the potency.
My experience of prescribing for local pathological conditions with low potencies is very limited, the reason being that it is only in a very small minority of cases that one is unable to find any symptoms in addition to those of the local condition on which to prescribe. In the vast majority of cases the local pathological lesion is covered by the remedy which is selected on general principles and will respond to the administration of the remedy. From such experience as I have had of pathological prescribing I conclude that one has to administer several doses over some days and then stop. It would appear that where one is prescribing in this way there is not a general symptom similarity and that by the administration of several doses over a length of time one sensitizing the patient to this action of the drug, very much as the insensitive prover eventually produces symptoms if the drug administration is kept up long enough. The difference is that in cases requiring treatment one particular organs has been rendered to some extent sensitive by the disease processes, therefore the drug tends to pick out this sensitized organ before it begins to produce constitutional symptoms.
As I said at the beginning of my paper, the practice of Homoeopathy is a combination of art and science. There are certain fixed rules which govern homoeopathic practice. The application of these rules to practice is an art. Just as there are certain laws which govern all musical production and yet the playing of any musical instrument is an art which can be acquired and developed only by practice, so it is with Homoeopathy. I have tried to show how, over the years, I have come to employ the tools of Homoeopathy ad to use them in accordance with the homoeopathic principles. It has been said that ” There are nine and sixty ways of constructing tribal lays, and every single one of them is right” so I am sure that every one of you has his or her own method of putting into practice the principles on which we are all agreed.
The British Homoeopathic Journal.