I would start by writing down that terrific list of drugs producing constipation-if the patient complained of that trouble; an so on through all this symptoms, important or unimportant, even mechanical, and probably altogether misleading, giving to each drug its value according to type, and never once considering (what is most important) whether the type coincided in patient and drug; then rounding up with an arithmetical calculations. Sometimes the drug came out; but the labour was hideous, monotonous, and not even remunerative in results.
I was not easily beaten; if there was anything in repertorizing, I was determined to master it, and more, to make it practical with a minimum of labour; for I went so far as to devise a card- trick system, every card a symptom, and all drugs that produced that symptom punched out. I deafened myself punching one thousand such cards. I have them still, a great cabinet full. But even this could not help, because the system was wrong.
When one knows how to repertorize, a choice from some 80 cards of “general” symptoms in a small portfolio is all that is needed to start a case-often to work it out in five minutes with a glance at the materia medica-had I known! But I have learned one thing from all this, and that I am competent to teach any one, viz., how not to do it.
Another way to insure failure, in some cases, is to start your repertorizing (by way of weeding out useless drugs and lightening labour) not with generals, but with some list of drugs that has the patient’s ailment. Say it was my case of goitre, where Sepia cured-one dose of Sepia.
In my days of fruitless repertorizing, I should have begun work on a case like that by writing down all the drugs that have been found useful in goitre; then, as there was a in the right lobe, I should have eliminated all the drugs, by the help of another list, that did not affect the right side of the body, or neck. And I should have failed-absolutely and inevitably have failed; because Sepia is in no list of drugs known to affect the thyroid gland. And again, though Sepia is among the drugs that pick out one side of the body, it happens to choose the left side for its operations, in the general way; so, again, I should have inevitably missed it.
She received Sepia because she looked, and was, a typical Sepia patient with Sepia symptoms, and because I simply could not give her anything else-then; my absurd intention being to cure her first and then to tackle her goitre.
But if (and it is a large if) you cure your patient, the odds are that there will not be anything left to cure. Your business is to cure her; the rest is her affair. Make her normal, and she will have no further use for acquired abnormalities. Healthy nature makes short work with superfluous details; for she can waste, as well as develop. Given the irritant, and she will sprout “ultimates”, and in vain you prune them away. Put her right, and she starts clearing them off and setting her house in order.
Be well assured that nothing continues to exist without cause! And learn a lesson from the tadpole’s tail; it has taught me much. I used to think it dropped off! We have a great deal to learn about absorption!
HASTY PRESCRIBING
Another way not to do it is to be too ready with your prescription. If you take a lot of trouble with a case (when you know how), it will give you very little trouble afterwards. Conversely, if you take a very little trouble to begin with, it will give you endless trouble, many times repeated. You have fouled the clear waters with a wrong prescription, and how are you going to peer into the depths? You no longer have a true disease- picture to match. One bad prescription leads to several, perhaps to a hopeless mixing up of the case. “Curses and chickens (and bad prescriptions) come home to roost”.
If you are not sure give a Placebo and wait. Hahnemann says, “A week’s Placebo to start with, anyway”!
PRESCRIBING DURING AMELIORATION
And when you have worked it out, and actually found your drug, there are still several ways of how not to do it. One of the most catastrophous and heart-breaking is to repeat while amelioration holds. Two cases have bitten into my memory, though hardly understood at first; and yet I go on doing the same thing again and again, for it is the hardest lesson in the world to learn, to hold your hand and do nothing. One catches at the excuse of any little recurrence of symptoms to repeat, and often spoils the case-pro tem., anyway.
A glaring instance, which in those early days I did not even understand, was a chronic typical Aloes-diarrhoea. (I have hunted in vain for the notes so speak from vivid memory only). He got Aloes CM (either one dose or two a t a week’s interval.) He came back so much better, practically cured, that I hugged myself, and hugged homoeopathy as a very wonderful thing. I had found his remedy right enough, and I would keep him on it for a bit, lest he should relapse! Of course, he came back less well. Then I gave it more often (it was the right remedy, for the first dose had been magic). I piled it on-homoeopathy was a less wonderful thing (my homoeopathy, that is, which ought to have been written in inverted commas); and presently he came no more.
That case has rankled ever since. I came to the conclusion, at that time, that the first prescription was a comparatively easy matter; but what to do with patients when they came back was beyond me! The very obvious “do nothing” was also beyond me for ages.
That is where the philosophy comes in. That is where, in homoeopathy, we perish for lach of knowledge. That is where the young men, who have been trained score. They will never know so much about “how not to do it”; but they have been taught when not to do it! For there is one rule, and one only, that meets the case:
So long as amelioration holds, let it be; and only repeat, or reconsider the case, when you are sure that it is quite at an end.
Why, Wright has proved that recently, under the microscope, for Tuberculinum; through Hahnemann laid down the law more than a hundred years ago. And we who call ourselves his followers sneer at “the eternal Hahnemann”, an do not even take the trouble to master his teachings.
Never repeat while amelioration holds. It will be from minutes to hours (Hahnemann says so) in acute cases, and from days to weeks or months, according to drug and case, in chronic diseases. But, unless you want to see your work always going back on you, unless you want to be one of those who have “tried homoeopathy and failed”, let your amelioration severely alone, and keep your enthusiasm for scientific medicine.
The other sharp lesson was a case of heart failure in a woman of 29, mitral incompetence, etc., that I got permission to treat after admission to the L.H.H. Here I have the house physician’s notes and measurements. She worked out Arsenicum, and I gave a dose of Arsenicum CM two days running (as she had been given a dose of Spigelia low in the intervening night, and it might have interrupted).
The effect was magical. Three days later (only four days after admission):
The heart had contracted, and was now only one inch, instead of two, to right of the sternal margin.
The liver had also contracted, and now, in the nipple line, measured 6 1-4 inches instead of 8 3-4 inches.
One hundred heart beats out of one hundred and forty-four now reached he wrist, instead of sixty-two out of one hundred and sixty.
She was sleeping quietly at night, instead of the suffocating spells when she dozed, and the frequent vomitings all night that had been a feature of the case.
She felt very much better. Every one was amazed at the improvement, and, in my joy and desire to hasten matters yet more, I gave her, a week later, another dose of Arsenicum CM. And that ended the case-in all senses! She grew worse. Lycopodium was given, and failed to relieve. All her fearful restlessness returned; she could stay nowhere. She demanded to go home, where she died very soon after.
You who know realize that it was risky even to give a CM to such a case, but that it was madness to repeat it while the patient was doing so well. You see that it not enough to spot your drug; it is not enough to make a successful prescription, even. You need all the philosophy if you are to carry your work through every time, if you are to get nearly all there is to be got out of homoeopathy. I was like an electrician who, having proper wires and a lamp of just sufficient resistance to glow its brightest, wantonly doubles the current, fuses the filament, and earns darkness. The greater the power, the more carefully must it be handled, to avoid disaster.
HIGH POTENCIES IN ADVANCED CASES
Another way not to do it, a case that emphasized the fearful risk of giving a high potency of the indicated remedy to advanced disease, was a case of malignant tumour of the breast. The woman had been doing well on unit doses of Scrof. nod., had lost pain and swelling of the arm, and inconveniences of the disease, though it was steadily progressing. She was a healthy looking, robust old woman of masculine appearance.
