The question of proper exercise would seem to lie within the province of the physician. We recall one case, however, where the patient, a woman past middle life, was instructed to get out of the house, into the open, and cultivate her interest in wild flowers, thus getting her interests outside herself along with fresh air and sunshine. We supposed the prescription was being filled, as we were greeted with fresh wild flowers every call we made, but she did not seem to gain in strength nor did her colour improve. Some time later (after she left us for a more sympathetic physician) we found that her husband faithfully went to the fields and gathered fresh flowers for the vases, while she rested from the prospect of his endeavours in her behalf.
There are patients who cannot take strenuous exercise because of pathological obstacles. There are patients who are so restricted by circumstances that they get little opportunity for exercise in the open air. But such patients are usually chronics with a long history and a poor prognosis; we usually accept the situation and do the best we can toward homoeopathic palliation, and surprising as it may be to us, we sometimes approach cure in spite of the difficulties. But the patient who can co-operate, but will not, and perhaps even leads us to believe she has made the attempt, herself deflects the current of cure at its very source. Then we question the value of our prescription and wonder why the indicated remedy failed to work.
One of our hardest problems is the patient who cannot seem to rally-the old chronic, with a long but seemingly not overwhelming history, and with a clear picture of a remedy. Some where here there is an obstacle to cure and we must plumb the history- physical, mental, emotional-to remove that obstacle or measure it, and to measure as well our remedy and its potency, to determine whether it is the *simillimum in likeness of symptomatology and energy.
Another obstacle to cure is the ease with which the physician’s judgment may be overbalanced in favour of the patient’s favourite symptom. This may seem a trifling matter, but frequent repetition of a trouble some symptom may so warp the true picture of the case that the symptomatology seems to reflect an entirely different remedy than those true, but less conspicuous indications, that are actually present. The patient does this unconsciously by remembering the most troublesome factors and forgetting the seemingly minor items that should furnish the clue to the remedy.
We have discussed some of the obstacles to cure as they affect the patient or the physician. Let us discuss the other side of the problem: the remedy.
Here our first problem is the source of the remedy itself. How close to Hahnemann’s standard did the source of our remedy approach? In other words, how carefully did the homoeopathic pharmacist identify the source of his supply? Is the plant identical with the botanical source of our proving? We cannot expect a *Rhus tox. case, for instance, to be cured with some other member of the family, if we have depended upon the proving of *Rhus tox. as our guide. Here we enter the field of similars instead of the *simillimum. Was the original supply fresh and in good condition? Substances of inferior quality cannot provide a good potency. With what degree of thoroughness did the pharmacist follow Hahnemann’s instructions for potentization? With what degree of thoroughness did the provers follow instructions?
We must be able to depend absolutely upon the sources of our remedies, and if there has been carelessness in gathering the original substance, in any part of the process of making the potency, in contamination in handling the potency or in discrepancies in recording the provings, then we cannot but expect that the current of cure will be deflected. All these details are known to the homoeopathic prescriber, but we cannot refrain from pointing out that these details may spell the difference between life and death, certainly between cure and failure, in many of our cases where there seems to be no reason to expect a deflection of the current of cure.
We question whether the provings were made under proper control. How many entered into the proving? How accurately was the substance, the origin of the potency, labelled? Inaccurate labelling might be the difference in possible cure or deflection by an insurmountable obstacle.
Weighing the symptoms of the patient against those of the remedy is one of our major problems; but an even more important problem is the weighing of symptoms of the proving itself. How great value, we ask ourselves, shall we place upon those symptoms occasionally or rarely produced in a proving? We are told, for instance, that the time aggravation which is almost a keynote of *Kali carb. appeared in only one prover, yet it has been clinically confirmed so frequently that we often think of it as one of the leading symptoms of *Kali carb.- or when we think of the 3 a.m. aggravation we immediately think of *Kali carb., in spite of the fact that Kent’s *Repertory lists a number of remedies with this modality.
It is important that we use every means within our power to determine whether or not the occasional symptom comes from the individuality of the remedy or whether it is a deflection of the remedy’s dynamis through idiosyncrasies of the patient or through something the patient may do or may use that distorts the reaction. Here is patient, for instance, who cannot take *Hepar sulph. without producing a symptom not appearing in any of our *Hepar provings-a sensation as if a finger and thumb were pressing either side of the larynx. Is this a valuable symptom or is it an individual reaction of no value?
Hahnemann gave us very clear directions for making provings, and instructed us that in every case the usual habits and diet of the prover remain at ordinary level during the proving, so that we might know whether or not the symptoms were produced by the remedy or by changes in the prover’s habits. However, it is conceivable that such things as diet, etc., even if the patient had become accustomed to them, might deflect the current of symptoms in like degree to the disturbing element in the dietary. We reflect that such articles of diet as coffee, which we are taught affects the action of certain remedies when prescribed for curative purposes, might in like degree modify the reaction of the remedy in its proving, either to completely nullify part of the symptomatology or to modify it to an entirely different picture. Thus we must use every care in adopting casual provings. In the case of Hahnemann’s provings, he reduced them to what approaches a mathematical formula. He carefully weighed the habits, diet and general state of health as manifested by symptomatic reaction of each prover before such prover was accepted for service. This data was subtracted, as it were, from such symptomatology as appeared during the course of the proving or within reasonable time thereafter, and the remaining symptoms were credited to the remedy action. Moreover, this procedure was well controlled by the number of provers for each remedy. These details were watched with the precision characteristic of Hahnemann.
A word about keynotes as a possible obstacle to cure is not out of place. Keynote symptoms have proved themselves as of almost equal degree a bane or a blessing. With out vast array of remedies the average homoeopathic physician learns well the polycrests; thereafter, depending upon their relationship to his practice, he tends to depend upon memorizing a more or less brief outline of remedies. Many remedies he knows only by keynotes. If these key notes are used as a reference to materia medica study they serve well, but they are very dangerous for a basis in prescribing. If he prescribes solely on the keynote he may, and often does, remove the conspicuous symptoms; but this may serve only as an obstacle to cure by deflecting the current of symptomatology and thus distorting the picture of the patient himself.
“The physician should distinctly understand the following conditions; what is curable in diseases in general, and in each individual case in particular… He should clearly comprehend what is curative in drugs in general, and in each drug in particular….He should be governed by distinct reasons, in order to insure recovery, by adapting what is curative in medicines to what he has recognized as undoubtedly morbid in a patient…Finally, when the physician knows in each case the obstacles in the way of recovery, and how to remove them, he is prepared to act thoroughly, and to the purpose, as a true master of the art of healing”.
