After a prescription has been made the physician commences to make observations. The whole future of the patient may depend upon the conclusions that the physician arrives at from these observations, for his action depends very much upon his observations, and upon his action depends the good of the patient.
If he is not conversant with the import of what he sees, he will undertake to do wrong things, he will make wrong prescriptions, he will change his medicines and do things to detriment of the patient. There is absolutely but one way, and nothing can take the place of intelligence.
If you talk with a great many physicians concerning the observations you have made after giving the remedy you will find that the majority of them have only whims or notions on this subject and see nothing after the prescription is made.
These observations I am going to give you have grown out of much watchfulness, long waiting and watching. If the homoeopathic physician is not an accurate observer, his observation will be indefinite; and if his observations are indefinite, his prescribing is indefinite.
It is taken for granted after a prescription has been made, and it is an accurate prescription, that it has acted. Now, if a medicine is acting it commences immediately to affect changes in the patient, and these changes are shown by signs and symptoms.
The inner nature of the disease appears to the physician through the symptoms, and it is like watching the hands upon the clock. This watching and waiting and observing has to be done by the physician in order that he may judge by the changes what to do, and what not to do. It is true that the homoeopath is not long in doubt in many instances what not to do.
There is always an index that tells him what not to do. If he is sharp and vigilant observer, he will see the index for every case. Of course, if a prescription is not related to the case, if it is a prescription that effects no changes, it does not take long to see that to do; much patient waiting for a foolish prescription is but loss of time, and that should be taken into account among the observations. The observations taken after a specific remedy has been given sufficiently related to the case to cause changes in the symptoms are those of value.
The changes are beginning, what are they like, what do they mean, to what do they amount? The physician must know what he listens to the reports of the patient what is going on. The remedy is known to act by the changing of the symptoms. The disappearance of symptoms, the increase of symptoms, the amelioration of symptoms, the order of the symptoms, are all changes from the remedy, and these changes are to be studied.
Among the commonest things that remedies do is to aggravate or ameliorate. The aggravation is of two kinds; we may have an aggravation which is an aggravation of the disease, in which the patient is growing worse, or we may have an aggravation of the symptoms, in which the patient is growing better.
An aggravation of the disease means that the patient is growing weaker, the symptoms are growing stronger, but the homoeopathic aggravation, which is the aggravation of the symptoms of the patient while the patient is growing better, is something that the physician observes after a true homoeopathic prescription. The true homoeopathic aggravation, I say, is when the symptoms are worse, but the patient says, “I feel better.”
We must now go into the particulars concerning these states, as to the time and place, as to how the aggravation occurs, as to how the amelioration occurs, as to duration, etc. The aggravations and amelioration, the directions of symptoms and many other things have to come up, and be observed and judgment has to be passed upon them.
First of all, the patient should be the aim of the physician, his whole idea should be centred upon the patient to determine whether he is improving or declining. We have to judge by the symptoms to know that this is taking place. Very often the patient will say, “I am growing weaker,” and yet you may know that what he says is not true; so certainly can you rely upon the symptoms and their story, which is more faithful than the patient’s opinion. Many times the patient will say, “Doctor I am growing much worse;” and yet you examine into his symptoms and you find that he is really doing well. Just the moment the he finds out that you are encouraged, he feels better and rouses up and wants to eat.
By the symptoms, also, you can tell when the patient is really weaker, and if the symptoms are taking an inward rather than an outward course you will know, even if he is encouraged, that there is no encouragement for him. We have in the symptoms that which we can rely upon. In the old school we have nothing but the information of the patient. This is of little account after making a homoeopathic prescription. The symptoms themselves must be corroborated. The patient’s opinion must be corroborated by the symptoms. The symptoms do corroborate what the patients say in many instances, but the symptoms are the physician’s most satisfactory evidence.
Another general remark needs to be made, namely, that we should know by the symptoms if the changes occurring are sufficiently interior. If the changes that are occurring are exterior, the physician must be acquainted with the meaning of them, so that he will know by that whether the disease is being healed from the innermost or whether the symptoms have merely changed according to their superficial nature.
Incurable diseases will very often be palliated by mild medicines that act only superficially, act upon the sensorium, act upon the senses, and, though the hidden and deep-seated trouble goes on and progresses, and is sometimes made worse, yet the patient is made comfortable. So that by the symptoms we can know whether the changes that are occurring are of sufficient depth, so that the patient may recover. The direction that the symptoms are taking is sufficient to tell that, especially in chronic disease.
A patient walks into the clinic, somewhat stoop-shouldered, with a hacking cough that he has had for a good many years. You judge by his looks that he has been sick a good while; his face is sickly, he is lean and anxious, he is careworn, he is suffering from poverty and poor clothing and scanty food. Now, you examine all his symptoms, and they clearly indicate that he needs an antipsoric, for the symptoms are covered by an antipsoric, and from the history of the case you know he has needed it a good while.
Upon prolonged examination, the antipsoric you have in mind is strengthened. You now examine his chest, and discover he has not the expansion that he ought to have, and you detect the presence of tuberculosis, and by feeble pulse and many other corroborating symptoms you ascertain that the patient has been steadily declining.