The amelioration comes first and the aggravation comes afterwards is the fifth observation. At times you will see sickly patients, fully as sick as the one I mentioned in the first or second instance, walk into your office and after long study you administer a remedy. The patient comes back in a few days telling you how much better he was immediately after taking the medicine, and now he has three or four days of what appears to be decided improvement, a prompt action of the remedy.
The patient says he is better, and the symptoms seem to be better; but wait, and at the end of a week or four or five days all the symptoms are worse than when he first came to you. It is not a very uncommon thing in severe cases, in cases of a good many symptoms, to have an amelioration of the remedy come at once; but whatever you may say, the condition is unfavorable.
Either the remedy was only a superficial remedy, and could only act as a palliative, or the patient was incurable and the remedy was somewhat suitable. One of these two conclusions must be arrived at, and this can only be done by a re-examination of the patient and by finding out whether the symptoms relate to that remedy. Sometimes you will discover that the remedy was an error; a further study of the case shows that the remedy was only similar to the most grievous symptoms, that it did not cover the whole case, that it did not affect the constitutional state of the patient, and then you will see that the patient is an incurable one and the selection was an unfavorable one.
It is the best thing for the patient if the symptoms come back exactly as they were, but very often they come back changed, and then you must wait through grievous suffering for the picture; and the patient will wait better if the doctor confesses on the spot that the selection was not what it ought to be, and he has to do better next time. It is a strange thing how the patients will have an increase of confidence if the doctor will tell the truth. The acknowledgment of one’s own ignorance begets confidence in an intelligent patient.