Introduction – Remedy Selection

After having secured our symptoms, arranged them, grouped them, studied them singly or combined as a drug or remedy, and having “taken the case,” i. e., secured the symptoms of each individual patient, the homoeopathic physician has to select one remedy to administer. …


After having secured our symptoms, arranged them, grouped them, studied them singly or combined as a drug or remedy, and having “taken the case,” i. e., secured the symptoms of each individual patient, which the most important part of the work of the homoeopathic physician is to selected the one remedy of the class administer it. The administration includes the potency, the size of the dose, the frequency of repetition when to discontinue and when to resume taking. Also through what channels it is to be administered, the care of the channel, the medium in which it is to be administered, i. e., oil, water, alcohol, etc., etc. and last, but not by any means least, the auxiliary treatment, such as diet, exercise, bathing, clothing, change of climate, etc.

Our subject is naturally divided into two parts, first, how to select; second, how to administer the indicated remedy. The four former chapters on How to Secure and Arrange Symptoms for the Purpose of Grouping and Ranking Them; How to Study a Symptom; How to Study a Drug, and How to Take the Case, have been four steps leading up to our subject.

Always keep in mind to select the remedy for the patient never for the disease, the condition, with which the patient is suffering. For this arduous, difficult and yet most vital task we are in the habit of being guided by the following rules :

1st, The make-up of the patient.

2nd, The tissue or organ involved.

3rd, Whether the involved tissue or organ be irritated, inflamed, functionally changes or structurally changed.

4th, The personal history.

5th, The family history.

6th, The modalities of the symptoms.

7th, “The Totality of Symptoms” as determined by the six foregoing findings.

By make -up of the patient we mean his personality – his physical, intellectual, spiritual self. To ascertain this, the physician’s office should be so arranged that a good light (natural, if possible) is thrown upon the patient so that the color of the skin and mucous membrane, as well as the expression of the face and eyes may be ascertained at a glance. The indicated remedy has often been determined by me from the walk, the color of the skin, and expression of the face of the patient as he entered our office for the first time.

After the patient is seated, ascertain and write down his name, age, residence, occupation, etc. After this let him state his complaint, the reason for his coming to you, in his own words, which will usually be, “I am so nervous,” I cannot sleep,” “My stomach is out of order,” I have a cough, ” etc. Should the statement be insomnia, get the particulars, e.g., the time of night, whether sleepy or wide-awake, or whether from pain, excitement or worry.

Note whether the patient is given to exaggeration or the opposite. All of the above is included under the heading make-up.

The tissue or organs involved may be determined by studying the patient’s subjective and objective symptoms, e. g., a sharp, shooting, darting pain along the course of a nerve, without soreness and aching-inflammation. A throbbing, pulsating sensation in any part of the body indicates congestion or inflammation, or both, of some encapsulated organ; or pus or other fluid in muscular tissue or between fascia. Burning or smarting usually indicates denudation or ulceration of the skin or mucous membrane.

Functional changes show abnormal conditions of the excretions or secretions of the body. Structural changes include atrophy and hypertrophy, broken bones, abscesses, tumors, etc.

Take time and care in getting both the personal and family history. Should the patient say, “Father died of dropsy,” the organ whose abnormal functioning caused the “dropsy” and whether the patient means effusion, oedema or something as insurance companies require, are very important.

Much stress should be placed on the modalities, the time of day, the time before and after eating or drinking; the seasons; the climate, etc.

Great care should be taken in cross-examination the patient to avoid suggestions.

To the above, careful and complete tests, chemical, electrical and all other laboratory tests should be added.

Such a “Taking of the Case” should present to the experienced Homoeopathist not more than three remedies from which to make his final selection.

To determine which of two or even three remedies has the greater “Totality of Symptoms” and should be administered is a task which requires all the skill, ingenuity, training, and experience of the best prescribers.

It is at this point that the mediocre or even fairly good prescriber does the foolish trick of alternating two or rotating three or more remedies. It is better to prescribe a single remedy though inferior in similarity than two superior in similarity or one superior and one inferior, because the two are liable to be inimical, if not antidotal, to each other. Experience has demonstrated that the nearer alike two remedies are the more inimical they are to each other if given at the same time. Many a time we have been called in consultation when Belladonna and Bryonia, or Aconite and Belladonna were being given in alteration for a fever group and had the patient immediately improving by dropping one of the two and continuing the other in the same potency and dose.

My method of selecting one of two remedies of apparently equal rank is to choose the one which has the greater elective affinity for the tissue or organ presenting the group of symptoms. We always keep in mind the fact that the numerical totality is not necessarily the real totality of symptoms. Next to the elective affinity of the drug we place idiosyncrasy of the patient, i.e., his individuality. And for the third in rank the patient’s desires and aversions.

George Royal
George Royal M. D, born July 15, 1853, graduated New York Homœopathic Medical College 1882, served as president of the American Institute of Homœopathy, professor of materia medica and therapeutics, and also dean of the College of Homœopathic Medicine of the State University of Iowa.