Hahnemann, in Organon, II 104, 152, of the Organon, gives explicit directions for its selection; he tells us how the choice should be made from among the drugs which exhibit effects simulating those of the whole disease picture at hand and shows how the final differentiation depends upon the individualistic or peculiar symptoms. A truly scientific procedure.
The interpretations of what constitutes a striking or singular symptom, except as pointed out in 86 and the following seven considerations: 1. Changes of personality and temperament are particularly to be noted, especially when striking alternations, even if rare, occur; the latter often supplant or by their prominence may obscure the physical manifestations and consequently correspond to but few remedies. Taking written notes II of every case gradually drills the mind into recognizing types (personalities) and their corresponding remedies.
The expressions of the intellectual and moral proclivities are inter-dependent and their combined character affords the best and almost sole indication in the choice of remedies for mental affections.
2. It is self evident that the nature and peculiarities of disease, as well as the virtues of drugs, must be thoroughly known before we can hope to give practical aid in sickness. The homoeopath soon realizes that for him everything in medicine is generalized too much; the most diverse diseases needing quite different remedies are designated by a common title which excludes every precise indication that might lead to the most suitable remedy, hence he can make only a limited use of diagnosis. For the same reason every allopath orders a different medicine or mixes his drugs to cover the various indications.
The most accurate and indubitable diagnosis of a disease form as depicted in pathological (allopathic) treaties can seldom or never suffice for the sure selection of the similar (homoeopathic) remedy in a concrete case. It can, at most, but not invariably, severe to exclude from the comparison all medicines which do not correspond to the comparison all medicines which do not correspond to the nature of the disease, but which on the contrary seem to expend themselves upon other parts of the living organism.
3. The seat of the disease frequently points to the decisive indications for almost every drug acts more definitely upon certain parts of the organism, the whole body seldom being affected equally, even in kind; differences occur in the so- called local disease, as well as in the affections designated as general; such are gout and rheumatism. At times the right, then again the left side suffers more, or the pains may appear diagonally, etc., etc.
The amount of attention to be given to the affected part is necessarily proportioned to the magnitude of the general illness of which it is a portion. Such general terms, therefore, as headache, toothache, bellyache, etc., every when the nature of a the pains is expressed, cannot contribute even the least towards a rational choice of the remedy.
It is essential to ascertain the seat of the local disease with accuracy; for every experienced homoeopath knows how, in toothache for instance, it is necessary to select the remedy which in its provings has repeatedly acted upon the very tooth that suffers. The specific curative power of Sepia in those stubborn and sometimes fatal joint abscesses of the fingers and toes is extraordinarily conclusive evidence upon this point, for they differ from similar gatherings in location only, while the remedies so suitable for abscess elsewhere remain ineffectual here.
Had the niceties of physical diagnosis of our times been known during the age of Hahnemann he would doubtless have localized his remedies more accurately than merely giving such vague designations, as above, below, right or left, etc., It would become our contemporaries infinitely better to fill up these gaps than to keep on repeating well known symptoms or discovering others which are almost invariably of no importance.
In the treatment of disease the value of modern methods is far less therapeutic than prognostic. The internal physical signs and and objective material changes never represent the dynamic disease, but are its product, developing as it progresses. when, as is often possible, such disorganizations can be nipped in the bud by well selected remedies it is unpardonable to await their appreciable ravages. This equally true of homoeopathic prophylaxis.
4. In finding the similimum for the whole case the concomitants, above all, demand the most thorough examination. While carefully elucidated characteristics strikingly portray the leading features of a case they are always modified by the peculiarities of the relief before the picture can be said to be accurate. Common-place or well known accompaniments are unimportant unless they are present in an extraordinary degree or appear in a singular manner.
We must, therefore, examine carefully all those accessory symptoms which are:
(A) Rarely found combined with the main affection, hence also infrequent under the same conditions in the provings.
(B) All those belonging to another sphere of disease than that of the main one.
(C) Finally those which bear the distinctive marks of some drug, even if they have nerve before been noted in the preceding relation A concomitant may so distinctly and decidedly depict the nature of a drug, and consequently indicate it, as to acquire an importance far outranking the symptoms of the main disease; it then points to the most suitable medicine. Such symptoms above all others evidently belong to those which Hahnemann called striking, extraordinary, and peculiar (characteristic)_and are to receive our almost exclusive attention because they lend their individuality to the totality. A number of efficient and partly specific remedies for various disorders are almost solely discoverable from among them because the disease symptoms proper, for lack of peculiarities, offer no possible assistance in the choice. The system of con concomitants also makes Homoeopathy distinctly safer, rendering it less dependent upon a previously constructed diagnosis which is often deceptive.
5. The cause. Pathological explanations and speculations are too far removed from our entirely practical method to have any great value in a therapy and cure Diseases are logically divided into internal and external. The former arise from the natural disposition, which is sometimes highly susceptible (idiosyncrasy). The latter can excite disease principally by means of external impressions when there is already a natural predisposition thereto.
The modified natural tendency to disease depends according to Hahnemann, upon the uneradicated miasms of psora, syphilis and sycosis. When it does not originate in these it is mostly composed of remnants and sequels of the acute affections which so largely go to make up drug diseases and poisonings; but we not infrequently see both factors combine to undermine the health, thus presenting a proportionately deeper rooted disease just that much harder to combat. In such cases antipsoric remedies very much excel all others in efficacy. (The scrofulous diathesis- psora-is constantly being extended by the practice of vaccination; our view of the matter receives confirmation from the fact that in very many cases of such diseases which are essentially acute antipsoric remedies that rapid and durable cures can be effected). Preface to Whooping Cough.
Whether or not we believe the psoric theory, the fact remains that the best selected remedy is often ineffectual unless preceded by the proper antipsoric, antisycotic or antisyphilitic, as the case may be, but because of their almost identical symptom lists, it is generally chosen with difficulty by differentiating and searching out the few true characteristics.
Drug diseases and poisoning do not differ in their health destroying power. The drug given should be ascertained and properly antidoted. Simple poisons are easily detected by their effects, but a drug disease is generally a compound result which fails to show a clear and accurate picture, hence a knowledge of the contents of former prescriptions taken is a necessity and lightens the labor.
Practice has extracted and rendered the anamnesic symptoms easy of access, thus greatly restricting the list from which the selection is to be made, so that attention to but a few characteristics quickly determines an accurate choice. This is especially true of sprains, bruises, burns, etc. Colds are more complicated, because of the diverse manner in which they are contracted and the different parts which they affect point to different remedies; for instance, it makes a great difference whether they are contracted while sweating by exposure of a part, being drenched all over or partly, etc. Various remedies must be considered according to whether the symptoms localize themselves internally (stomach, chest, abdomen, etc.), or externally (head, feet, back, etc.). Such remedies are not to be too readily thrown aside unless certainly found dissimilar in other respects-So much depends upon a knowledge of the cause (Anamnesis) of disease, that without it the choice of a homoeopathic remedy cannot be made with safety: Aphorisms Hippocrates VII., 12.
Homoeopathic prophylactics are tested and sure. The very remedies which cure the fully developed diseases will protect exposed persons. This is very important for the reason that incipient diseases are generally very lacking in the characteristic which determine the choice.
6.The modalities are the proper and most decisive modifiers of the characteristics, not one of which is utterly worthless, not even the negative ones. They have developed in importance with the growth of Homoeopathy.
A superficial examination of any completely proven drug will reveal the common symptoms of all diseases, such as headache, bellyache diarrhoea, eruptions, etc., etc. A little closer inspection of their sensations and relations to the different parts of the body establishes undoubted differences in the manner of their appearance, the modality. All experienced homoeopaths pay great attention to this point. It is self evident that the modality must be specialized: it is not sufficient, for instance, to note the general effect of motion in a given case, but the various kinds of motion, and whether they arise during continued or at the start of movement must be known. Likewise, the general effect of position, such as lying on the side, back, crosswise, horizontally, etc, as well as the special discomfort or ease caused from lying on the painful or painless side, must be elicited in order to apply the most suitable remedy.
The cravings and aversions to various foods furnish some of the most important points in deciding upon the remedy.
when the symptoms seem to point out a particular remedy with which the modalities, however, do not agree it is only negatively indicated and the physician has the most urgent reasons to doubt its fitness; he should, therefore, seek for another having the same symptoms.
7. The time is hardly less important than the aggravation and amelioration itself and could be of great use were the different stages of disease left undisfigured by drug influences, for they constantly produce the most devious effects upon the natural course of disease. I hope no one will say that periodicity necessarily indicates Cinchona (Quinine), for there is hardly a single homoeopath who has not treated numerous victims of this error. This homoeopathic objective concerns two points which have a direct bearing upon the choice of the remedy.
A. The periodical return of the symptoms after a shorter or longer period of quiescence.
B. The hour of the day when they are better or worse.
The former coincides with epochs having special, accidental causes, such as menstrual disturbances, all seasonal or temperatural influences, etc. Where it is impossible to discover such secondary causes, or where, as is usually the case, their time of recurrence is not more accurately designated they have no value for homoeopaths because they are lacking in precise indications.
The general or special modalities referable to the time of day are of much greater importance, for hardly any disease lacks this feature and the provings supply the same peculiarity, qualifying them for the best and most comprehensive uses. To illustrate this we need only refer to influences which the time of day exerts upon coughs, diarrhoeas, etc. A considerable list of remedies exhibit typically recurrent effects; unless these are clear and decided (like Hell, and Lycopod. at 4.8 P.M.), or return at exactly the same hour (Ant.c., Ignatia, Saba.), they are unimportant.
(In general, the tyro in Homoeopathy cannot too earnestly take to heart the caution to avoid the great error of regarding a numerically large mass of symptoms that are general in their character, but do not individualize the case, as a sufficient guide in choosing the remedy. The keen perception and appreciation of those symptoms, which, that the same time, correspond to the nature of the diseases and also designate the remedy which is exclusively or at least most decidedly indicated- this alone betokens the master mind.
For it is easier-very much easier-to select the right remedy after a picture of the disease, complete in every respect and fully meeting all requirements, has been drawn up, than to obtain the materials for such a picture and construct it for oneself.)- (From the Preface of the Whooping Cough).
THE REPETITION OF THE DOSE
Medicines, by proper (higher) potentization, develop a continually widening, quicker and more radical sphere of action which stretches far beyond all pathological forms but never out outgrows their own true characteristics. This should however, not lead us into straining at conclusions and making blind applications of this postulate.
A single dose of the properly selected homoeopathic remedy will in a short time to transform the character of a disease as to cause it to show indications for a different remedy. The common experience that the continued thoughtless and injudicious use of the same medicine often does more harm than good, and that two very similar remedies do not follow each other well, has its origin in this fact.
The primary and secondary action of many drugs repeats itself alternately, hence, as long as this happens, the one (first) dose has not exhausted its action.
In diseases like small-pox, scarlet fever, etc., which generally attack man only once, every repetition, particularly of the higher dynamizations, only tend to prejudice or retard the cure, whereas, in other diseases it regulates itself by the extent of their liability to recur.
In every attack, one minute dose of the rightly chosen remedy, if allowed to quietly expend itself not only accomplishes everything to be expected of medicine, but when the same drug is, after a long time, again given, as evidently the most applicable remedy even for another disease, it disappoints us, and will only act after a sufficient time has elapsed for the former dose to have finished its work.
In chronic disease the action of the truly legitimate (similar) remedy must be left undisturbed if we wish to attain success.
External manifestations are in noway indispensable to the existence of chronic disease, on the contrary, the more the external (vicarious) symptoms are disturbed or repressed, the deeper do they take root and flourish internally. It follows from the dynamic nature and constitution of every real disease that it is never purely local, but always finds its genesis in the immaterial life force, therefore in the whole living organism, and can only be rooted out as fast as the increasing vital reaction displaces the primary drug action; most rapidly towards the end. Abstracted from the Aphorisms of Hippocrates, VII., 12.
In conclusion it may not be useless to call to memory, in an abridged form, what my worthy friend, Dr. J. Aegidi, says in the?Archive of Homeopathy (XII., I., 121), which coincides entirely with my own experience. After the administration of the carefully selected (according to the similarity of the symptoms) remedy, as early, at the latest, as after the lapse of eight days (in acute sickness often already after a few hours), one of two events certainly follows either.
A. The state of the illness is changed, or
B. It remains the same.
A change in the sick condition embraces three events, either.
Ist.The condition is ameliorated,
2nd. It is aggravated, or,
3rd. The disease alters its symptom complex.
In the first case one sees the medicine’s beneficial action penetrating deeply and it is, therefore, hasty not to wait the fullest extent of the amelioration. Here, at least haste is useless, mostly harmful, and only then, when the improvement comes to a visible standstill, is it advisable to give a second, third or fourth dose of the same remedy, especially however, only as long as a lessening, but not essentially changed symptom complex still points to it.
In the second event we see the state of the sickness becoming worse; particularly do the characteristic symptoms heighten their intensity without changing or transposing themselves, the so-called homoeopathic aggravation. Here the remedy has overcome the affection in its essence and for a whole nothing further is to be done unless perhaps entirely too important complaints make the application of a proper antidote necessary, which on most occasions is found in a second, and, if possible, still smaller dose of the same medicine.
The third instance concerns an alteration of the symptom complex and is evidence when this happens that the remedy was not fittingly chosen and must be exchanged for a suitable one as soon as possible.
When, notwithstanding, the carefully chosen remedy and the patient’s faultless diet, the sick condition, on the contrary, is not at all changed, as in the case mentioned under B, the cause usually lies in want of receptivity, which we must seek to remove either by repeated small doses or by medicines recommended for deficient reaction.
By following these rules we have the pleasure of assisting the sick to recovery in an incomparably shorter time than has commonly been possible under the former evil treatment where the physician lacked a fixed rule of practice.-From the Preface of the Antipsoric Repertory.
The repetition of the dose is determined by the nature and force of the response elicited; this response reveals the actual states of the patient in proportion to the accuracy of the prescription. The speed of the reaction is naturally governed by the course of the individual affection plus the vital reactive power of he individual. Hence, it follows that a quick relief in chronic disease bodes no good, if the remedy has been properly chosen.
No second dose should be given as long as the relief progresses, even though slightly. The amelioration is apt to show itself in the mental state first; the mind becomes more tranquil and the suffering is more easily borne although its intensity may as yet not be lessened.
In a real cure the symptoms recede from above down ward, from within outward and in the reverse order of their coming; all other ways are irregular and open to the suspicion of being mere palliations calculated to destroy the natural symmetry of the manifestations, hence to complicate and render the disease intractible.