PRACTICAL HINTS IN THERAPEUTICS


Theoritically there is no difficulty in understanding the spirit of his statements but we often come across with tremendous difficulties in the actual field. He has mentioned about repetition of drugs at proper intervals both before and after the commencement of the action of a drug but he has not definitely pointed out how to know those proper intervals; how long to wait after administering the first dose of a well selected drug?


(Question of repetition of drugs)

The selection of a proper Similimum is essential and the question of repetition of the same is no less essential.

As regards the question of repetition Hahnemann in his organon points out thus.

(1) “Perceptible and continued progress of improvement in an acute or chronic disease, is a condition which as long as it lasts, counter – indicates the repetition of any medicine whatever.” (Art no. 245)

(2) ” … A speedy cure may actually be obtained by repeating the finest dose of an accurately selected medicine at proper intervals, such as are proved by experience to be most conductive to a speedy cure and timed so as to prevent an injurious and revulsive counteraction of the vital force, whose action is to be tempered and modified in accordance with the morbific power of the medicine.”

(3) “Under these conditions … medicine may be repeated at intervals of fourteen, twelve, ten, eight, or seven days. In chronic diseases assuming an acute form and demanding greater haste these spaces of time may be obliviated still more but in acute diseases the remedies may be repeated at intervals of twenty four, twelve, or four hours and in the most acute diseases of intervals varying from an hour to five minutes. These periods etc.”

(4) The dose of the same medicine is to be repeated several times if necessary but only until recovery occurs or until the remedy ceases to produce improvement.

Theoritically there is no difficulty in understanding the spirit of his statements but we often come across with tremendous difficulties in the actual field. He has mentioned about repetition of drugs at proper intervals both before and after the commencement of the action of a drug but he has not definitely pointed out how to know those proper intervals; how long to wait after administering the first dose of a well selected drug?

It has been found many a time that injudicious waiting has been, in acute diseases particularly of infectious nature, the cause of loss of life. In chronic cases however it does not matter so much if some delay is made in giving a second dose of the medicine.

Injudicious repetitions on the other hand, always interferes with the smooth action of a drug. Only the minimum administration of a drug in order to produce a “definite and tangible impression” is what is aimed at.

Under such circumstances, I always follow the following rule and almost always do get very satisfactory results if the selection of the drug is correct.

I have been observing for a long time that there is a clear relation between the time which a disease takes to develop and the time which it takes to disappear although there have been exceptions to this general rule.

This led me to think that there must be also the same kind of relation between the rate at which a disease – process progresses and the time which a well selected drug takes to produce a tangible impression in the same; that is there must be some proportionality between the two.

A chronic disease for instance, which takes, say, 10 years to assume a particular shape cannot be expected to show any impression in a few days, so in this case repetition of a drug before a fortnight will have no meaning.

Pneumonia, cholera, diphtheria and other infectious diseases form instances in which a symptom complex progresses rapidly and if a well selected drug be administered to a particular case, the rate of the symptoms to vanish may thus be expected to be equally rapid.

In these cases repetition of a drug every one or two hrs. will not be unjustified, till a definite impression is obtained. In a very very urgent case of cholera morbus a drug may have to be repeated every fifteen to thirty minutes as we have already seen in art 247.

Sanyal I B