Having glimpsed the didactic aspect we must run over practical philosophy. The unique law which is the basis of all homoeopathy is similia similibus curantur. How we arrive at this equation, the actual studying of drugs and patients is the province of later lectures. The actual handling of cases after the first remedy has been selected is the more difficult part of homoeopathy. First is the necessity of giving the single remedy. This precludes the use of compound tablets, alternation of remedies, unhomoeopathic adjuvants such as cathartics and anodynes, etc.
In a case where the miasms are mixed it may be impossible to cover the totality of the symptoms with one remedy. In such a case observe which miasms is, so to speak, on top and prescribe for the totality of symptoms of that miasms, and when these symptoms are cleared off the layer beneath, representing perhaps, another miasms may be prescribed for, again by a single remedy. Sometimes the remedy indicated may be one which has power over all the miasms, as for instance, Nitric Acid.
The single remedy does not mean that only one remedy should be used throughout a case, although this is the desideratum, but simply one remedy at a time. It cannot be too often stated that one must not give a remedy lightly nor change it frequently. In acute disease the single remedy at a time still holds although the remedy may have to be changed as the case develops, in which case some of our master prescribers hold that the original remedy may be indicated again at the close of the cycle to complete the case. Further details on the single remedy will come up in the lecture on prescribing.
Next in importance to the selection of the single similar remedy is the question of dosage. The classic rule is “the minimum dose.” We prefer the term the optimum potency meaning the potency on a plane most similar to that of the patient at the moment in question. Hahnemanns original choice of the word minimum served two purposes, first, to discourage the enormous crude drugging of his time, and secondly, to point out that the high potencies have a different action from crude drugs. The whole potency question will be discussed in later lecture in full.
The question of repeating the dose is the next in importance. As a simple rule for beginners high potencies should be given in one dose with Placebo; the low potencies, 30th. and under may need repetition. After giving the single dose of the single similar remedy the student must watch and wait. The duration of action of remedies and the factors influencing it will be discussed later. The general rule is to give nothing more than placebo while improvement continues, in other words as long as the patient himself feels increasingly better regardless of the accentuation of certain symptoms.
The beginner must learn not to try to make a good thing better by repetition, as this defeats itself. According to the case, the potency and the remedy, the need for repetition may occur in from a few hours in acute disease (or a few minutes in desperate cases) to weeks, months and even year or more in chronic cases, although waiting is perhaps the most difficult lesson for the eager homoeopath. He must wait with knowledge or valuable time will be wasted. How is he to know whether the remedy is the right one or is still acting?
In acute cases the general well being of the patient should be apparent in from a few moments to two or three days. In chronic cases it varies from a few hours to several weeks, sometimes, indeed, it is only apparent after the second dose. In chronic cases Herings laws of cure, mentioned earlier in this paper, will show you whether you are on the right track. It is at this point, while watching the action of your remedy, that you must understand the subject of Homoeopathic aggravations.
An aggravation is necessary to improvement, but it often occurs even with master prescribers. The usual cause of severe aggravation is an error in the potency or presence of marked pathology Aggravations are of two kinds, disease aggravations and remedy aggravation. The first of these is merely the natural progress of the disease and does not concern us her. The second or remedy aggravation, which is a sort of house cleaning, is indicative of the prognosis of the case, and has about twelve recognizable forms which will be discussed later.
Due allowance for aggravation must be made before considering repetition of the dose. A general rule is that even during aggravation the patient, as a whole, in himself, feels better.
The subject of the second and subsequent prescriptions, one of the most important in the subject homoeopathic philosophy, will be better understood in connection with prescribing later on.
Another very vital point in the homoeopathic philosophy is that of suppressions. The causation of suppressions are dependent on so many factors; the results of suppression untreated so dire, and frequently unrecognized; and the results treated so brilliant, that a complete lecture will be devoted to this subject.
To present homoeopathic philosophy lucidly and logically to a novice is well nigh impossible. The student is urged to read and re-read the appended list of books and to send in to the Carriwitchet DEpartment questions which arise.
Reading list.
Lectures on Homoeopathic Philosophy by James Tyler Kent, M.D.
The Genius of Homoeopathy by Stuart Close, M.D.
A Synopsis of Homoeopathic Philosophy by R. Gibson Miller, M.
D., Journal of Homoeopathics, Vol. iv., August, 1900, page 194.
The Organon by Samuel Hahnemann, M.D.
Homoeopathy the Science of Therapeutics by Carroll Dunham, M.D.
Manual of Pharmacodynamics by Richard Hughes, M.D.
The Homoeopathic Recorder
Vol. XLV. No. 4.
