This is the fourth consecutive year in which I have appeared before this body as an essayist. I hope you are not growing tired of it. As I have stated here before, I love to talk; and when the opportunity presents itself to speak on any subject connected with homoeopathy, I am more than eager to seize it.
Today I present you nothing new in homoeopathy, but merely add one more bit of testimony to the never-failing efficacy of the indicated remedy. If in your practises you have seen reason to doubt the efficiency of the homoeopathic remedy, do not place the blame on homoeopathy.
Place it where it belongs — upon yourselves. For if the results you obtain from the remedies you prescribe do not justify your choice of them, then the reason for failure lies, not with the principles by which they were prescribed, but with the manner of their choice and administration. Let me direct your attention to Paragraph 3 of the Organon, a part of which I quote:.
If the physician clearly perceives what it is in disease in general and in each case of disease in particular that has to be cured. . . . if he clearly perceives what is the healing principle in medicine in particular. . . .: if in the light of clear principles he can so adapt the healing virtue of the drug to the illness that is to be cured that recovery must follow, and if he has the ability to select not only the particular remedy whose mode of action is most suitable to the case, but also to choose the exact quantity of the remedy required . . . and the fitting period for its repetition . . . and in addition recognize in every case the hindrances to lasting recovery and can remove them, then truly he knows how to build up his work on an adequate basis of reason.
This relationship between the disease, the drug, and the doctor should be uppermost in our minds whenever we are called upon to prescribe for a case of illness whether it be acute of chronic in nature.
The homoeopathic prescription is predicted, first, upon a carefully taken history, and second, upon a thorough knowledge of the actions of drugs. The former is necessary because only in this way are we able to recognize what is curable in the disease for which the prescription is intended.
The latter is need because in this way only are the curative properties of drugs manifest. Having obtained, through careful observation and skilful questioning the symptoms of the disease and having selected through our knowledge of drug action the most similar remedy, the next question to be decided is that of dosage and repetition.
One of the chief laws of homoeopathic therapeutics is expressed in Paragraph 242 of the Organon as follows:
. . . the counter-force chosen as exactly as possible for the removal of a natural disease-force should be so calculated that it will only just attain its object and will do the body no harm in any way through unnecessary strength.
The reason for this is obvious. Since the smallest quantity of medicine disturbs the organism least, we should choose the minimal dosage, provided that it is a match for the disease. Experience has shown that the very smallest doses of drugs chosen for their homoeopathicity to disease are matches for the disorder for which they are chosen.
If the disease is not accompanied by actual pathological changes in the structure of some important organ, there cannot be a dose of the homoeopathically chosen remedy so small that it will not be stronger than the condition to be overcome. Hahnemann was led to this conclusion by his observation of the effects of drugs in ponderable quantity, even when homoeopathically indicated.
So many severe aggravations appeared following the use of the indicated remedy in crude form that he was led to the procedure of dilution in an attempt to eliminate these untoward phenomena. Yet even in the higher dilutions the indicated remedy will show an accentuation of the disease manifestations, though in a mild degree, within a short while after its administration. This initial aggravation is a favorable sign for two reasons; 1. Because it indicates that the remedy has been correctly chosen. and 2. Because it shows that the remedy is capable of cure.
Now we come to the question of the repetition of the dose. One could spend the whole afternoon in the discussion of this particular phase of the prescription. I believe that this aspect of our art has been a greater impediment to the advancement of homoeopathic skill in the individual physician that almost any other, the next is the minimum dose. The general rule is that the remedy should not be repeated as long as improvement is apparent. This applies both to acute and chronic conditions.
Frequently in the acute condition, repetition will be called for rather soon because the strong and active nature of the illness will quickly exhaust the action of the remedy. Yet even here the second dose should not be given as long as the favorable action of the first is evident.
Nothing in nature is so sensitive as the diseased cell to the action of the similar remedy, hence needlessly repeated dosage may call forth not only severe aggravations but also set up symptoms that are provings of the remedy and which if not recognized as such, will further complicate and cloud the disease manifestations themselves. A clear and undimmed picture of the diseased state must be present as a basis for accurate prescribing.
Concerning repetition in chronic condition the same rule is applicable. Since the power of the remedy is less quickly exhausted in these cases, one must be still more cautious not to repeat the dose too soon. Severe aggravations are apt to be the result of over-anxiety to DO SOMETHING for the patient. It must be remembered that if the case is carefully taken and the remedy well chosen upon the indications, more is being accomplished toward the cure of the condition than with any other method of treatment.
I believe that the use of the highly potentized drug is absolutely essential to the successful chronic prescription. It is surprising over how long a period of time the higher dilutions will act. Weeks and frequently months will elapse before it becomes necessary to give a second dose of the chosen remedy. It is remarkable, too, how well these cases get along in the meantime on placebo !!
I am convinced that the use of the repertory is an indispensable aid in the choice of the remedy for these chronic cases. The condition is usually so deep-seated, so long lasting, and will present upon examination so many apparently unrelated symptoms, which may not be characteristic of any particular remedy, that it is impossible to reach any opinion as to the indicated medicine without the help of a good repertory.
Before terminating this paper I shall cite a few cases which I hope will be illustrative of the points I have discussed.
At two oclock in the morning of Friday, February 1, I was called to see an eight-year-old boy who presented the following symptoms: Late in the preceding afternoon he complained of a sore pain in the tip of the left shoulder. At bedtime his mother noticed that he was hot and feverish. He was thirsty for cold water. His sleep was disturbed by restlessness and talking.
He had a deep harsh cough < at night. His throat was red and dry. His face and body were very flushed and gave the sensation of burning heat to the examining hand. The pupils were dilated. The temperature was 104F. and the pulse was proportionately rapid. One dose of Belladonna 200 was given. I saw him again in the afternoon. At this time his temperature had dropped to 100F. His left shoulder was sore to touch, but no longer pained him.
He was coughing only occasionally. He was thirsty. He slept most of the time and sweated profusely during sleep. There was no other complaints. I felt that the case was showing favorable progress and therefore prescribed Sac. lac. The next day the lad was completely well and was allowed to return to school on the Monday following.
This was the familys first experience with homoeopathy and to say that they were both astonished at the rapidity of recovery and pleased with the lack of intensive medication is putting it mildly.
At 2 a. m. on the morning of January 30, a little boy, aged three, suddenly became delirious and feverish. He was restless and wished to be held. His face was very flushed, his ears were red. The skin was hot and burning to the touch. The mouth was dry and he was thirsty. The pupils were widely dilated. The temperature was 104F. and pulse and respiration were both rapid. A single dose of Belladonna 200 was given. Within twenty- four hours the temperature was normal and the symptoms had subsided.
A young man of 21 came to see me with the following complaints; Sore throat < on the left side, < by empty swallowing, swallowing hot drinks, swallowing food. The left side of the tongue was sore and made more so by touch and the act of chewing. There was a sensation in the throat as of a lump which could not be swallowed. There was pain in the lower molars on biting.
The throat seemed full of mucus but hawking was very painful. The eyes ached dully and were < by bright light. He was alternately chilly and sweaty, and complained of great weakness. Sleep was disturbed by anxious dreams. He felt much worse in every way after sleep.
You have probably guessed the remedy, and you are right. A single does of Lachesis 200 was given. Twenty-four hours later he was much improved and seventy-two hours after the remedy was prescribed he returned to his work.
Lachesis is frequently indicated in the sore throats of March and April. Lachesis is also a high ranking remedy for the sensation of a ball or lump internally. (Cf. Lac caninum.).
At 9:30 a. m. April 25 I was asked to see a married woman twenty-one years of age, the wife of the above patient, who gave me in the following story: Just after midnight she had a severe chill, followed by sweat, and succeeded in an hour or two by severe, cramping, labour-like pains in the lower abdomen and back, occurring every five to ten minutes and producing a desire to bear down. Accompanying the pains was a flow of bright red blood. When I saw her the pans were very severe, the flow was very dark with much clotting. She was obliged to sit up with the pains which came every three minutes. Between pains she was exhausted and very pale. Her pulse was soft and regular, and with the pains very rapid.
Examination showed a uterus enlarged to the size of a two-months pregnancy with a soft cervix dilated just about enough to admit the examining finger. High up in the cervical canal was felt a mass which was thought to be a decidua.
A single dose of Secale 200 was given this girl at 10:45. In fifteen minutes the pains were much more bearable, the patient was calmer. About 11:15 she easily expelled a large mass of tissue having the appearance of decidua, whereupon her pains ceased and a normal lochial flow appeared. During the next two days she passed several clots without pain of difficulty. Her lochia ceased on the fourth day and she made an uneventful recovery. It is evident that this remedy worked faster and more efficiently, and just as completely, than curettage could have done, and with less danger to the patient — considering the circumstances under which such procedure would have had to be carried out.
A man 38 years old came to my office one afternoon “all of a flutter” and gave me the following history: Two weeks previously while digging a ditch he was struck in the peno- scrotal junction by the handle of his pick. The only complaint following this accident was a swollen sensation at the site of the injury until two days ago when a urethral discharge developed.
The discharge was thick and creamy but not profuse. His penis feels swollen. There was a dull ache in the penis during and after urination with tenesmus, not painful during the act. This aching was made worse by an jar of by lifting. There was itching in the urethra before urination. He gave no previous history of venereal infection and — believe it or not !– no history of recent exposure. However, a smear of the urethral discharge showed that gonococci were present !!.
A single dose of Pulsatilla 200 was given. Five days later there was less discharge and the only subjective symptom present was itching during urination. He was given Sac. lac. and told to return in five days. On his third visit all symptoms had subsided, the only objective finding being shreds in the first glass of the two-glass urine test. A week later he still showed shreds in the first glass.
One month later there were still shreds in the first glass, and so the urine was centrifuged and the sediment stained according to Gram method. No gonococci were demonstrated. At this time a dose of Pulsatilla 1m. was given. Unfortunately I have not seen this man since, so I cannot say what the ultimate outcome of the case is. No local treatment of any sort was given and no medication of any sort except as described.
The cases I have so far discussed have been of the acute type. The results obtained in this class through the use of the potencies are frequently very spectacular because the contrast between sickness and health is so marked and improvement is so rapid. Yet the curative power of highly potentized drugs is just as sure and frequently as startling in chronic illnesses, though often not at all spectacular.
The return to health is slower because there are a greater number of symptoms to combat and their eradication must follow an orderly regression according to the Hahnemannian law of cure. In individuals manifesting evidence of one or more of the chronic miasms — psora, syphilis or sycosis– the progress of cure is slow and difficult, and in elderly people often is not completed before death intervenes, though improvement under the truly indicated remedy is certain.
If you will bear with me a few moments longer, I should like to present a few cases of this nature for your consideration.
A married woman of 45 came to me complaining of a blood- tinged leucorrhoea for the past two months which was made worse by intercourse, by lifting and by straining at stool. Further questioning revealed that her periods were very irregular, usually too early, lasting ten days. For the first two or three days the flow was no more than a show, later becoming very profuse, bright red and clotted. She flowed more freely on moving about. There was never any pain during the period though she complained of chilliness. About the third day of the menstruation she would develop a severe headache centering in either the right or left temple. The pain was constant and cutting in character and accompanied by nausea. Headaches < by any motion and > upon lying down and putting a hot water bottle to the head.
She said that she felt “keyed up” all the time and was constantly fearful that her menses would appear. She had no desire to do any work because everything looked too hard. There was a tendency to weep over trivial things. She imagined that she had cancer or some terrible disease was upon her. She always felt worse in the morning at 10 oclock, and better in the evening while reading in bed. She frequently had a feeling of pressure in the forehead, especially when under any nervous strain, which was > by walking in the open air. In general she felt better in warm weather. She felt no desire for intercourse.
She had had the various childhood diseases and acute nephritis when fourteen. She had delivered a normal child nineteen years ago. A year or so later she had an abortion, self-induced, from which she dates her present troubles. In April, 1933, she had had a D. & C. performed for diagnostic purposes and because she had a cervical polyp. The present symptoms she said were a recurrence of those present previous to the above operation.
Bimanual examination revealed the following conditions: A slight prolapsus, a second degree retroversion, a lacerated and eroded cervix and two small, soft, easily bleeding tumors protruding from the cervical canal, probably polypoid in character.
A repertorial study of his case was made, using Boenninghausens Pocket Book. Thirty-one rubrics were employed. Sepia was found to have thirty of the thirty-one symptoms, and on December 18 a single dose of the 1M. was given her. She reported on December 26 that she had had a slight headache December 25, beginning when she arose and lasting until 3:30 p. m. Her period began the next day and was exactly on time for the first time in three months. She was much less apprehensive, felt happier and less “keyed up”.
On March 12 Sepia 1M was repeated because of recurrence of the symptoms, though in a less aggravated form. She was last seen April 10, following her April period, when she stated that she had had less headache with this period than ever before. The flow was not profuse and there were no clots. The periods have been entirely regular since the first dose of Sepia and her nervousness and apprehension have entirely disappeared. She has had no blood-tinged leucorrhoea since her first dose of the indicated remedy.
On February 4 I gave a dose of Nux vomica 200 to an old lady of seventy who told me that four weeks before she had caught cold and now was so lame all over that she could not keep still. The cold began as a watery discharge from the right side of the nose, < after sneezing. There was now a sensation of weight in the occipital region, < on stooping, with a dull pain in the forehead and over the right eye which > by hot applications and < by putting the hands in cold water. She had pains in the joints which showed a tendency to shift from place to place. The nasal discharge was now thick and greenish.
There was a stinging prickling sensation in the skin on going into the cold so that she had to wrap up warmly, even her head. She had a loose cough, < at night, with the expectoration of thick greenish phlegm and accompanied by a scraping sensation in the chest. She was apt to be dizzy when walking. She told me that she had done nothing for her cold except take aspirin and that she had not gotten any better.
I found out that for several years have a free prosperity and a freer exchange of thought she had been in the habit of taking one or two aspirin tablets a day, just on general principles (which seems to be the way to prescribe that poison). While the above symptoms do not definitely indicate Nux vomica, I felt that this remedy was needed to clear away the suppressive effects of aspirin, hoping when that was accomplished that the true picture of her condition would be apparent.
That this line of approach was the right one is evidenced by the fact that she has shown a steady improvement to the present time. No other medication has been received except placebo– and she is NOT taking any more aspirin. I last saw her three weeks ago. A number of arthritic symptoms are beginning to appear, and I have learned that she first began to take aspirin a number of years ago for an arthritis which she thought she had cured by it. Eventually she will need some other constitutionally and deeper acting remedy which will cure the real trouble. Nux vomica in the meantime has simply been clearing the way for it.
The seven cases presented are simple run-of-the-mill types. You all meet them every day in your own work. They are brought before you, not with the idea of making Sutherland great, but with the hope of making homoeopathy greater.