Generally the physician who has knowledge enough and grit enough to wait will see, before the patient dies, the homoeopathic remedy that will control the case. The whole community is sometimes turned into excitement because a doctor will not do this or that. Suppose the whole atmosphere is blue with effects of their wrath, what has that to do with it? The physician who will stick by the patient and let the people howl is one that will be trusted through any and every ordeal. But the doctor that will flinch and tremble at every threatening is one that will violate his conscience, is one that can be bought, can be hired to do anything, and will abandon his color in time of emergency.
It is hard work for a homoeopathic physician to settle off alone by himself where he has nobody that will stand by him in his tribulations. The attitude of the public must never furnish the physician with indications as to what he shall do. Let him study the patient and the symptoms of the patient. That which is right is protected and supported, and that which is wrong degrades. Let a man lose his self-respect a few times and he becomes a coward and a sneak, and is ready to do almost anything that is vicious and cowardly.
The physician who has done rightly by his patient can look the friends squarely in the face when the patient has died. If he has administered morphine to the patient and turned aside all the symptoms upon which he could find that remedy, it does not seem to me that he can look the friends squarely in the face. Of course, if you act according to principle in this way you suffer for it. You will be called names.
In the 63rd and 64th paragraphs Hahnemann treats of the primary and secondary actions of medicines. There is no necessity for dwelling upon this subject. The primary and secondary actions of a drug are simply the one action of that drug. Some homoeopaths have attempted to individualize between the primary and secondary action. It does not matter what the patient is suffering from, from symptoms which appeared in the primary action or from symptoms which appeared in the secondary action, that drug will cure just the same.
The symptoms that arise are the symptoms that arise from the remedy, and they often seem to oppose each other. In the earlier stages we have sometimes sleeplessness; in the last stages, sleepiness, and one state is sometimes more prominent than the other. For instance in Opium, some provers had sleeplessness first and sleepiness afterwards, from the smaller doses of Opium. It is known that Opium has both sleeplessness and sleepiness, and if the other symptoms agree it does not matter which one of the two is present. If Opium is indicated by the general state of the patient it will cure either of these conditions, and you need not stop to see if it produces one state in one place and the opposite in another. In some provers Opium produces diarrhoea in the beginning, in others constipation. If I should take today a crude dose of Opium, in six hours I would have a diarrhoea that would last for several days and then be constipated for six weeks. To know that drugs have two actions is simply knowing the nature of drugs in general. You will find another example in alcohol; watch two drunkards and you will see the double action illustrated.
There are constitutional states in patients by virtue of which they are always affected in a certain way, and these states are often left after provings, or are found in those who have been poisoned by a drug. All these patients will have alternating symptoms which will confuse the physician before he knows their constitutional state. It is an important thing to know the constitutional state of a patient before prescribing.
You will always be able to do better for your patients when you know all of their tendencies. Of course, in acute diseases symptoms sometimes stand out so sharply that an acute remedy can be administered without reference to any constitutional state. Acute cognates can be established in almost any patient. For instance, the Calcarea patient will need an acute cognate of Calcarea when he is sick with acute symptoms. The acute symptoms fit into and are established and formed by the constitutional state of the patient.