Comparison, individualization, and difference in the nature of things most similar, are points that must be carefully considered. The substitution of one remedy for another cannot be thought of, or entertained in Homoeopathy.
The homoeopathic physician must individualize, he must discriminate. He must individualize things widely dissimilar in one way, yet similar in other ways. Take for instance the two remedies, Secale and Arsenicum; they are both chilly, but the patient wants all the covers off and wants the cold air in Secale, and he wants all things hot in Arsenicum. The two remedies thus separate at once; they are wholly dissimilar as to the general state, whilst wholly similar as to particulars.
A mere book-worm symptom hunter would see no difference between Secale and Arsenicum. You go to the bedside of a case of peritonitis, and you will find the abdomen distended, the patient restless; you will find him often vomiting blood and passing blood from the anus; you will find horrible burning with the distended abdomen, unquenchable thirst, dry, red tongue, lightning-like pulse. Well, Arsenicum and Secale have all these things equally; they both have these things in high degree; but when Secale is indicated he wants all the covers off, wants to be cold, wants cold applications, wants the windows open; cannot tolerate the heat, and the warm room makes him worse. If Arsenicum is indicated in such a case, he wants to be wrapped up warmly, even in the month of July, wants hot food and hot drinks. The whole Materia Medica is full of these things and is based upon this kind of individualization.
Without the generals of a case no man can practice Homoeopathy, for without these no man can individualize and see distinctions. After gathering all the particulars, one strong general rules out one remedy and rules in another. Physicians by the questions they ask often show that they have not been able to grasp this idea of individualization. They pick out two symptoms, or one symptom common to two remedies, and say, “Now, both of these remedies have this same symptom, how are you going to tell them apart?”
Well, if you are acquainted with the Materia Medica, with the art of individualization, you will at once easily see how to get the generals; the generals of one are so and so, and the generals of the other are so and so, and this will enable you to distinguish one of these remedies as best adapted to the constitution, when the two remedies have the one symptom in any equal degree. Now, this rules out the idea of substitution. If one does not work, they say, try all down the list alphabetically, until you hit it.
Why a remedy that has never been known to produce that symptom may cure the case, because it is more similar to the generals of that case than any other. This is the art of applying the Materia Medica. Many times a patient brings out that which is so strange and rare that it has never been found in any remedy. You have to examine the whole case and see which remedy of all remedies is most similar to the patient himself. From beginning to end, the homoeopath must study the patient. If he become conversant with symptoms apart from the patient, he will not be successful.
Par. 118 reads: “Each medicine produces particular effects in the body of man, and no other medicinal substance can create any that are precisely similar.” That is the beginning of a doctrine showing that there can be no substitution. There are cases that are so mixed that man, no matter how much he studies, cannot see the distinctions, but, remember one thing, there is one remedy that is needed in the case, whether it is known or not; it is needed in the case, and it has no substitute, for that remedy differs from all other medicines, just as this individual differs from all other individuals. It may be that we cannot see that it is needed, it may not appear to be indicated, but it is needed all the same, though the intimation may not have come to the eye or ear of the physician. That shows the necessity of waiting and watching. In Homoeopathy medicines can never replace each other, not one be as good as another.
As we hasten along with this subject, we find in Par. 122 Hahnemann says: “In circumstances of this nature on which depend the certitude of the medical art, and the welfare of future generations, it is necessary to employ only medicines that are well-known.” Purity is important, medicines as they are proved should be kept unmodified and preserved and possessed of their full energy. Now, it is important that you shall use the same substances, as nearly as possible, as were proved.