Selection of the Remedy



In his preface to his Manual of Homoeopathic Therapeutics (I quote from Laurie’s edition). after observing that the choice of the medicament frequently depends on the condition of the aggravation or amelioration, he gives us the following illustrative case:-“My friend Dr. Lutherbeck (to whom I always intrust my practice in my absence) gave to one of my patients for some sequelae of a case of deeply-rooted tubercular phthisis of which I had cured him (amongst which a disagreeable smoothness, with a thick coating of mucus on the teeth, formed the predominant symptom, and invariably became aggravated for two consecutive days every time he shaved), carb. anim. 30, with the most successful results, although the only symptom on the skin of the face (152) noticed by Dr. Adams was not present.” On turning to the symptom in question in Hahnemann’s Chronic Diseases, we find it be as follows:-“The skin of the face smarts, especially on the cheeks, about the mouth, and the chin (after shaving).” Now, I believe this symptom to be altogether unimportant in itself, and probably attributable to anything but the medicine swallowed. Dr. Adams resided in Russia, and probably the day on which he observed this wonderful symptoms was rather cold, which would cause his face to smart after shaving; or it might be he had used some coarser soap than usual; or possibly his razor was not quite in order or was not “a well-tempered blade;” for does not the poet (I mean Mr. Mechi’s of Leadenhall-street) not only notice this fact but propose the remedy, in the following lines?-

“Most people complain that shaving’s a bore.

Each day’s painful scrape only chafes an old sore;

Choose the cutler who stands at the head of the trade-

Half the better depends on a well-tempered blade-

In the front of these lines his name is displayed.”

Dr. Adams, however, leaves us in blissful ignorance of all these matters, and our self-constituted doctor Boenninghausen accepts his symptom as a genuine medicinal action, the only important point of which to him is the parenthetical observation “(after shaving).” For, be it observed, the state of the teeth has nothing whatever to do with this operation as far as carbo animals is concerned; indeed, carb- anim. nowhere offers a state of the teeth at all resembling that of Dr.Lutherbeck’s patient, either after or before, or independent of shaving; and Dr. Lutherbeck’s patient had no smarting of the face whatsoever. All the resemblance between the patient and the prover is that something was observed by each after shaving; but though there is an obvious connection of the prover’s symptoms with the operation of shaving, there is none as regards the patient’s symptom, unless it be that the patient probably made faces in the glass as many do after shaving, and then first observed the mucus on his teeth. The circumstance of the symptom occurring invariably for two successive days is no doubt very remarkable, and has its due weight with us; but what most interests us is the new light thrown by Boenninghausen on homoeopathy, whence it would seem that in the selection of our remedy it is quite immaterial whether or no the symptom be among its pathogenesy, provided only any symptom is noted as occurring under a condition analogous to that under which any symptom of the disease occurs. Thus it would have answered Boenninghausen’s purpose equally well, if the symptom recorded by Dr. Adams had been, in place of what it is, “inclination to wipe the face after shaving,” a circumstance almost as likely to occur as the smarting of the face after that operation, the “after shaving” being, test Boenninghausen, the sole thing of importance in the matter.

I would not have deemed it necessary to occupy your time with the exposure of such extravagant absurdities, were it not that of late we have seen Boenninghausen held up to our admiration as the greatest living authority on homoeopathy, whereas he is nothing but a useful repertory-maker and enthusiastic dilettante practitioner, who, not having had any medical education and having taken to homoeopathy late in life, is not at all qualified to give an opinion on points which require a thorough acquaintance with many of the auxiliary branches of medicine, and, above all, the mental discipline and qualifications for forming a correct judgment on medical subjects, only attainable by a thorough medical education. (Here von Boenninghausen has evidently no mean estimate of himself as an exponent of the homoeopathic system, and often censures very severely some whom we are inclined to consider as the most learned and scientific of our body. This is by no means an uncommon habit with dilettanti homoeopathists, homoeopathists, even in our own country. These doctors Dei gratia, seem disposed to put in a claim for the exclusive title of Fidei Defensores, to judge by the rating they occasionally administer to us for our deviations from what they are pleased to set forth as the true homoeopathic doctrines.)

Dr. Mure, in his book upon the Homoeopathic School of Rio, talks indeed about characteristic symptoms as determining the choice of the remedy; but the specimens he gives of his practice exhibit nothing of the sort, nothing but a mechanical reckoning of the symptoms of the disease and of those of the drugs corresponding best with it, drug that presents the greatest number of the symptoms of the disease without any regard to their quality or character, being that he fixes on. No doubt, by this mechanical reckoning up of the symptoms of drug and disease, a lucky hit is often made, just as the most irrational empirics often make lucky hits, and the most ignorant peasant sometimes succeeds in curing a disease that has baffled the skill of the most learned professors; but the perfection of medicine does not consist in making lucky hits, but in being able to select our remedy with the greatest possible amount of certainty; for this, some other method than the arithmetical process is required.

In the selection of the remedy, says, Dr. Griesselich, Handbuch, 164 we must keep in view-

1. The individuality of the patient in its whole extent. as regards predisposition, etc.

2. The symptoms, from their commencement until their present state, as regards duration, connection, intensity, etc.

3. The ascertainable cause that acted on the patient, as a consequence of which the predisposition to the disease burst forth in flames; the external noxious influences.

Consequently we must pay attention to the aetiology, semiology, and diagnosis of the disease. But, continues he, as our object is to oppose to the disease a medicine resembling it, and that in its characteristic symptoms, we require to attend to the same points as for the investigation of the disease, we require to diagnose the medicinal just as we do the natural disease. Hence it is requisite to estimate the value of the symptoms. It is only by the exercise of our reasoning faculties that we are able to raise phenomenology and symptomatology to a higher rank.

The certainty and rapidity, continues Griesselich, with which we are able to recognise a disease from its symptoms, and to employ for it the appropriately similar medicine, depends upon the actual state of our objective and subjective pathological and pharmaco-dynamical knowledge. This explains why there are so many cases of disease that we cannot do any good to, partly because the medical art is not omnipotent and never will be so, partly, because every physician is not able to make himself master of all the resources the art affords, or to have them always in readiness to apply at the proper moment. It must therefore happen that a false selection of remedies is occasionally made, and the most skilful is not he who never makes a false selection, but he who does this least frequently. After showing that other circumstances formerly detailed guide us in the selection of the remedy, he observes that homoeopathy is a causal and rational mode of treatment in the best sense of those terms, although among homoeopathists there are certainly some more coverers of symptoms.

Dr. Trinks (Handbuch, Introd., p. xxx.) says truly that the most appropriate and specific remedy for every case of disease is that one whose positive peculiar effects on the healthy human organism present the greatest similarity to the peculiar and essential phenomena of the disease to be cured. By this similarity the medicine betrays its direct action on and relation to the disease to be cured, and the organs and systems of the organism where it has its seat. It may happen that several medicines offer this similarity to a case we have to treat, whereby there will be some difficulty in selecting the best remedy; but this may generally be done by ascertaining which of the remedies resembles the disease, not only in its most essential but also in its less essential symptoms. If, notwithstanding what may appear to be a proper selection of the medicine, the practitioner should not see the expected full and perfect cure, he must endeavour to ascertain-1st, if his choice of the medicine was appropriate; 2nd, if the disease has not undergone some essential change in its phenomena, character and course, by the action of the medicine was given in the proper dose. In the first case, he will have to make another and more careful selection. In the second case, the remedy will not do to be repeated; it will be requisite to have recourse to another, which shall resemble the disease in its now modified and altered form. If, after the administration of the well-selected remedy, the disease undergoes a change in the quantity but not in the quality of its essential symptoms, we may infer that the dose administered has not been sufficient, though the choice was correct. It will never be requisite to give two remedies at the same time in a disease. Even when two acute disease occur in the same individual at one and the same time, it will not be necessary to give two remedies at once; we must direct our attention to the cure of the most dangerous disease first, and when that is past we can then set about curing the other. In like manner, where an acute disease occurs in the course of a chronic one, we must neglect the latter until we have subdued the former. In other respects, Dr. Trinks’s advice does not differ from Hahnemann’s and he does not inform us how we are to distinguish the characteristic essential symptoms of drug and natural disease.

R.E. Dudgeon
Robert Ellis Dudgeon 1820 – 1904 Licentiate of the Royal College of Surgeons in Edinburgh in 1839, Robert Ellis Dudgeon studied in Paris and Vienna before graduating as a doctor. Robert Ellis Dudgeon then became the editor of the British Journal of Homeopathy and he held this post for forty years.
Robert Ellis Dudgeon practiced at the London Homeopathic Hospital and specialised in Optics.
Robert Ellis Dudgeon wrote Pathogenetic Cyclopaedia 1839, Cure of Pannus by Innoculation, London and Edinburgh Journal of Medical Science 1844, Hahnemann’s Organon, 1849, Lectures on the Theory & Practice of Homeopathy, 1853, Homeopathic Treatment and Prevention of Asiatic Cholera 1847, Hahnemann’s Therapeutic Hints 1847, On Subaqueous Vision, Philosophical Magazine, 1871, The Influence of Homeopathy on General Medical Practice Since the Death of Hahnemann 1874, Repertory of the Homeopathic Materia Medica, 2 vols 1878-81, The Human Eye Its Optical Construction, 1878, Hahnemann’s Materia Medica Pura, 1880, The Sphygmograph, 1882, Materia Medica: Physiological and Applied 1884, Hahnemann the Founder of Scientific Therapeutics 1882, Hahnemann’s Organon 1893 5th Edition, Prolongation of Life 1900, Hahnemann’s Lesser Writing.