1. Is there anything in the etiology of the disease which would help us to select a drug?
2. Does inspection of the patient and his actions call to a mind remedy?
3. Do the complaints of the patient correspond to the characteristic sensations and modalities of any drug which we can think of offhand?
4. In a case which has “gone the rounds,” are the symptoms present due by any chance to “drugging”? This is frequently overlooked.
Probably, several drugs qualify as possible remedies at this point. We next must reinforce our choice (or eliminate it) by the following questions :
1. Does the elective affinity of the drug correspond?
2. Is this drug seemingly Homoeopathic or actually Homoeopathic? i.e., does it produce symptoms in the same manner that the disease produces symptoms in our patient?
3. Is it capable of similar functional change, similar irritation, similar pathology?
4. Does it correspond to the stage that the disease is then in?
At times, drugs are loosely spoken of as “beginning,” “mid- point,” and “end-point” drugs by which is meant that they, as a rule, are at the peak of their influence at these stages of disease. Thus, Aconite is most certainly a beginning drug-Bryonia one which comes in when disease is well-established-and Lachesis and Arsenic might be classified as essentially end – point drugs- the last stages of disease.
Having selected our drug, the next step is to decide how and when to give it. Only general suggestions are in order and the following are believed to be the crystallized experience of the majority of the school. This does not mean that it is the best, and indeed it has little resemblance to the original rules laid down by Hahnemann.
One thing is certainly true : Unless a man follows absolutely the directions for repetition, dosage, and preparation of drugs and is conversant with Homoeopathic philosophy, he has no right to say, “Such and such a remedy failed me.” It is the author’s belief that very successful Homoeopathic medicine may be practiced as outlined in this book, but he is fully aware that it falls far short of what many consider the proper teaching of Homoeopathy. No method is above challenge, and for the majority of medical cases, the following suggestion seem best :
1. Give a sub-physiological dose.
2. Improvement calls for less frequent dosage and possibly a higher potency.
3. The more clear cut the determinative symptoms, the more justified we are in using a higher potency.
There are other considerations that come up, but these are the three main principles of Homoeopathic dosage.
In general, when a drug has been carefully worked out, the tendency is to give a few doses several hours apart and await results. This is applicable to chronic ailments. It is based on the fact that we want to determine the reaction of that patient, and see whether his symptoms disappear from ” above downwards, from within outwards, and in the reverse order of sequence.”
In regard to the potency used, it will be found that the more carefully a drug is prescribed, the more often one will use a high potency. Sometimes quite definite aggravations follow a good Homoeopathic prescription when too low a potency is employed, and it goes unrecognized, the physician simply thinking that the case has become worse. All this emphasizes the fact that Homoeopathic drugs dare not to be lightly used, and their reaction is to be watched for in precisely the same manner that one would look for manifestations after giving a dose of vaccine.
During the interim, the patient’s natural anxiety in regard to medicine is to be taken care of by judicious resort to a placebo. In acute cases, much more frequent dosage is used and required. In the first place, our prescription is not so exact, being a beside one, and, therefore, aggravation is not so apt to follow. It is probably a “similar” one, but not the “simillimum.” Then, it is certainly a debatable question as to how much and how frequently the body needs this drug help or stimulus.
When the body resources are constantly being called upon to expend vital energy, it seems but logical to aid these forces as frequently as possible. The fact that it is an acute disease also accounts for more frequent changes in the remedy to meet the changing totality as the disease progresses in that patient. Constitutional treatment is particular too, and may only be accomplished by Homoeopathy.
It has a wide field in pediatric practice and is suitable to many chronic diseases. Such a course of Homoeopathic treatment is not accomplished in a week or a month, but truly astounding results accrue after a sufficient length of time has been allowed. It is preventive medicine in the best sense by which pathological discrasures are aborted or cured. All treatment of difficult cases is constitutional, and it has been found that a certain class of remedies are best for this purpose. Such drugs profoundly effect metabolism and physiologic processes, in contra-distinction to the more superficial remedies whose sphere is functional change and whose action is comparatively short.
Constitutional prescribing is never undertaken at the bedside but only after a most exhaustive examination, with due regard to history, physical examination, and laboratory findings. The method differs in nowise from that already outlined in the selection of the drug, but usually requires repertory study and its further consideration will be taken up under the chapter dealing with Chronic Disease and the Repertory.
Tissue remedies are of constitutional nature, but are often prescribed without this careful analysis, mostly on the grounds originally outlined by Schuessler who introduced them. They are especially valuable, if exhibited during the convalescent period of the disease. They also have well-marked pathological pictures which make them a favorite with men who incline to let this be the criterion of their prescriptions.
There are twelve tissue remedies. Tissue remedies are given on a “deficiency” basis. This theory teaches that an unbalanced or deficient inorganic salt content in the cells manifests itself by profound structural and functional changes to which the name of numerous diseases have been given. Dr. Schuessler, the originator of this method, when challenged as to whether this deficiency was cause or effect made answer that ” It is an effect (the nature of the disease), the cause being a foreign irritation….which can cause a deficiency of a cell salt.”
What interests Homoeopaths particularly is the fact known to us that an abundance of a certain cell salt in the blood or food does not mean that this substance is capable of assimilation-if the body is diseased. Thus, in chlorosis, iron may be given in material doses. It is not the amount but the catalytic effect. The body is perfectly capable of taking up iron from the food, if given the proper stimulus.
Incidentally, Schuessler does not recommend iron in chlorosis but Calcarea phos. This furnishes a better stimulus to take up iron than iron does itself. We know that the same conditions hold in regard to the absorption of Natrum muriaticum. Thus, a person can be taking all sorts of salt yet it requires an attenuated preparation to re-adjust the body metabolism. The same is true of Calcarea, Sulphur, and other organic medicinal agents.
We cannot enter into a discussion of the truth and falsity of Schuessler’s theory here-but simply state that the theory has caused a great deal of investigation into this class of drugs and some at least have been carefully proved. Whatever their mode o action, there is no doubt as to their therapeutic value when given on indications outlined in the Homoeopathic Materia Medica.
Clinical Remedies – This is the name given to those drugs which have had a partial or incomplete proving, but whose efficiency has been demonstrated at the bedside. Usually, their entrance into the Materia Medica has come about in this wise : A physician would start to prove an unknown drug and notice, for instance, particular symptoms in the urinary tract.
Having found out the elective affinity of the drug, he would give this to a series of renal cases and note its effect. Besides its beneficial effect in the urinary field (if present), he would observe clinical and curative symptoms which disappeared under this same drug in other parts of the body. From such data a clinical pathogenesis was constructed and, if the drug action was confirmed by other observers, it was incorporated into the Homoeopathic Materia Medica.
There are many reliable clinical remedies in the Materia Medica such as the tissue remedies and many of the drugs spoken about in Hahnemann’s “Chronic Diseases.” Clinical remedies like clinical symptoms depend on the integrity of the observer for their valve. In spite of this drawback, we personally have the greatest respect for verified clinical remedies and many of the most brilliant results from Homoeopathic treatment can be traced to the use of one of these drugs.
As a rule, clinical remedies are given in dosage corresponding to that recommended by the original investigator. In most cases, it consists of drop doses of the tincture or lower potencies.
American homeopath - Ann Arbor - Michigan.
Son of William Boericke.
Books:
A Compend of the Principles of Homeopathy.
Homoeopathy