When the demonstration is clear that the present remedy has done all it is capable of doing-and this demonstration can not be made until much higher potencies than usually made have been tried then the time is present for the next prescription.
To change to the next remedy becomes a ponderous problem and what shall it be.
The last appearing symptom shall be the guide to the next remedy. This is so whenever the image has been permitted to settle by watching and waiting for the shaping of the returning symptom picture. Long have I waited after exhausting the power of a remedy. While observing a few of the old symptoms returning; finally a new symptom appears. This latest symptom will appear in the anamnesis as best related to some medicine having it as a characteristic which most likely have all the rest of the symptoms.
It is not supposed that this later appearing symptom is an old symptom on its way to final departure, for so long as old symptoms re-appear and disappear it is granted that no medicine is to be thought of.
It is an error to think of a medicine when a symptom image is changing. The physician must wait for permanency or firmness in the relations of the image before making a prescription.
Some say, “I must give the patient medicine or he will go and see someone else.” I have only to say that it were better had all sick folks gone somewhere else, for these doctors seldom care but often complicate the sickness.
The acute expressions of a chronic disease have a different management from the acute disease, e. g., a child suffers from bronchitis in every change of weather. It may grow worse if treated with the remedy for the acute symptoms
The miasm that predisposes the child to recurrent attacks must be considered.
One recently under my care had received Antimonium tart., Calcarea, Sulphur, Lycopodium, etc., in such indiscriminate confusion that the child was not cured. The waiting on Sac.lac. through several attacks permitted the drug-effects to pass off, and the true image of the sickness was permitted to express itself through several of the exacerbations taken as a whole.
When western ague is complicated with a miasm, a single paroxysm does not fully express the totality, but several must be grouped and the true image will be discovered. If the acute disease be complicated with a miasm the indicated remedy will wipe it out “cito, tuto et jucunde.