The Second Prescription

The second prescription may be a repetition of the first, or it may be an antidote or a complement; but none of these things can be considered, unless the first examination, and all the things that have since arisen, have been carefully restudied….

The second prescription may be a repetition of the first, or it may be an antidote or a complement; but none of these things can be considered unless the record has been again fully studied, unless the first examination, and all the things that have since arisen, have been carefully restudied that they may be brought again to the mind of the physician. This is one of the difficulties to contend with when patients change doctors, and one of the reasons why patients do not do well after such a change.

The strict homoeopathic physician knows the importance of this and will try to ascertain the first prescription. If the former physician is strictly a homoeopathic physician, he is most competent of all others to make the second prescription. It is often a hardship for a patient to fall into the hands of a second doctor, no matter how much Materia Medica he may know.

The medicine that has partly cured the case can often finish it, and that medicine should not be changed until there are good reasons for changing it. It is a very common thing for patients to come to me from the hands of good prescribers. I tell them to stay with their own doctor. I do not want them. Such changing is often a detriment of the patient, unless he brings a full record, and this is especially true in relation to a case that has been partially cured, where the remedy has acted properly.

If the patient has no reasonable excuse to leave the doctor, it is really a matter of detriment to the patient for a physician to take another’s patients at such a moment. It is not so much a question of ethics, it is not so much a question of the relation of one doctor to another because friends can stand all that, but it is only after a tedious inspection of all the symptoms that an intelligent physician is capable of making a second prescription. As a general thing, if the first prescription has been beneficial it ought not to be left until it has done all that it can do. How is the second physician to know that? Then the duty of the physician is first to the patient, and to persuade the patient to return to his first doctor.

The rule is, after the first correction and homoeopathic prescription, the striking features for which that remedy was administered have been removed, a change has come, and the guiding symptoms of the case have been taken out, and only the common and trivial symptoms remain. It is true if the physician would wait long enough he would see the return of those symptoms, but usually when a patient walks into a doctor’s office the doctor is in a hurry to make a prescription and does not wait until the proper time.

He at once prescribes on the symptoms that are left, and this is one of the dangers to be avoided, a hurried second prescription. The patients are to be pitied that fall into the hands of such homoeopaths. Many patients are wonderfully benefited by the first prescription; they have said to me “Dr. So and So benefited me wonderfully for a while, and them, he did not seem to be able to do me any good.” the fact was that the first prescription was a correct one, having been properly chosen, and after that first prescription the doctor administered his medicine so hastily and so indiscriminately that nothing more was accomplished in the case.

The trouble was that he did not wait long enough. It makes no difference whether the physician is so extremely conscientious that he does not want to give Sac lac or whether he is so ignorant that he does not know how to give it, the result is the same. the early repetition of the medicine and the continued giving of the same medicine, will prevent anything like an opportunity for the making of a second prescription.

If the doctor administers a well-chosen remedy, and repeats it too soon, he never gives the symptoms a chance to come back and call for a second prescription; but they come intermingled with drug symptoms, so that the rational second prescription cannot be made. The second prescription presupposes that the first one has been a correct one, that it has acted, and that it has been let alone.

If the first prescription has not acted curatively, or has not been permitted to act the full time, it is impossible to get a second observation. The second observation is made when the case comes to a standstill, for after the first prescription has been made changes occur; there is a coming and going of symptoms, and while these changes are occurring no rational observation can be made of the case; if a second prescription be made during this time, it will be likely to spoil the whole case. If the patient is not given a perfect rest, if medicines are not kept out of the case, we will have no opportunity to make a rational second prescription.

James Tyler Kent
James Tyler Kent (1849–1916) was an American physician. Prior to his involvement with homeopathy, Kent had practiced conventional medicine in St. Louis, Missouri. He discovered and "converted" to homeopathy as a result of his wife's recovery from a serious ailment using homeopathic methods.
In 1881, Kent accepted a position as professor of anatomy at the Homeopathic College of Missouri, an institution with which he remained affiliated until 1888. In 1890, Kent moved to Pennsylvania to take a position as Dean of Professors at the Post-Graduate Homeopathic Medical School of Philadelphia. In 1897 Kent published his magnum opus, Repertory of the Homœopathic Materia Medica. Kent moved to Chicago in 1903, where he taught at Hahnemann Medical College.