True homoeopathic treatment and its success depend on three things:
1. The diagnosis of the Patient.
2. The diagnosis of the Disease.
3. The diagnosis of the Remedy.
In each case there are several causes which may lead us to make errors. The object of this book is to set down some general principles which will safeguard the new as well as the old from making errors in diagnosing the patient, the disease and the remedy.
The first part of the book is purely a translation of the article of Dr. Bernoville mentioned in the References. The second part of this book is a summary of ideas about the diagnosis of the patient by the help of morphology so long put forth in different journals of France by the French homoeopathic doctors and specially by Dr. Leon Vannier in his books referred in the References.
The illustrations are tracing from Dr. Vanniers books for which he has very kindly given authorisation.
I hope that my colleagues of India will surely find something new and interesting in this book which will, I am sure, be helpful in their practice.
Last of all my thanks to the publisher who has very kindly financed the publication of the book.
THE HOMOEOPATHIC MEDICINES
The result obtained in Homoeopathic therapeutics are extremely variable according to the method of application of remedies. The medical science is an art with two principles: The principle of prescription and the principle of practice. The same is the case with Homoeopathy as well as in other science of medicine. We must know that the results may be excellent or on the contrary negative or inexistant or even replaced by violent aggravations if we do some errors about the:
3. Repetition of doses.
4. Time of the application of doses.
5. And last of all there are some particular cases for some particular medicines.
1. THE TINCTURES
The part played by a Homoeopathic doctor does not consist alone in treating the patient. He should at the same time control the value of the fabrication of medicines supplied to him by the pharmacists from different laboratories. One error which one can do in this regard is the result of the ignorance of the origin of a remedy and this is very important. It is then necessary that we must know how the Homoeopathic medicines should be manufactured. Hahnemann gave a solution of the problem in a very simple manner during his time. He completely ignored the part which a pharmacist can play in the preparation of medicines.
He himself used to prepare his medicines and even now there are a number of homoeopaths in different countries who, faithful to the principle of their master, prepare their medicines themselves and directly apply these medicines to their patients. This is no doubt illegal and moreover it is not a progress. We must call it a regression because it is not possible for us to have all the up-to-date machines and all the personnel employed for the preparation of two to three thousands of medicines that we require.
It is however, necessary that we know how the homoeopathic medicines are prepared, if not we may be victims of a wrong preparation. It is for this reason the homoeopaths in France have in the beginning decided that the homoeopathic medicines are to be prepared by the specialised homoeopathic pharmacists. But the doctors as well as the specialised homoeopathic pharmacists ought to know how to prepare the homoeopathic medicines.
THE MINERAL KINGDOM
As regards the MINERAL KINGDOM the control is easy. A mineral substance should be taken as a remedy. You may say that it should be taken pure and well prepared. But this is not all and neither it is true. When Hahnemann and others obtained a pathogenesis departing from a substance, it is necessary that we should depart from the same substance, even if it not purified, while the pharmacist, obsessed by the principles of modern chemistry, tries for purifying in an absolute manner their substances of mineral origin, though sometimes they find that these substances are less active.
A classical example: Hahnemann prepared Calcarea Carbonica from the shell of the egg of ostrich-from the portion which is found in between the external and the internal surfaces of the egg shell. It is no doubt Carbonate of Lime but it also contains trace so other minerals and marine substances. Therefore, it is not necessary to use the absolutely purified Carbonate of Lime but the egg-shell of ostrich itself for the preparation of Calcarea Carbonica. This may be considered as a general rule for all substances of mineral origin. It is preferable to depart from the mineral substances in their natural state.
The mineral substances are valuable medicines in the form as they are found in the natural state. They act generally better in the living organism. On the contrary the chemical substances are, for some medicines of secondary importance. Why? This requires no explanation. If we wish to use some dilutions of Pyramidon or Arseno-benzol we will find that they are rarely useful. But there are exceptions. As for example the Arsenic Compound of Bayer 205, has been very successfully used in dilutions of 200 and 1000,in azotemia – at least in some cases of Azotemia (The dilutions of Penicillin are also now used in France with very interesting results).
It should therefore, be a principle that we must not have our mind haunted by the idea of absolutely purity. There are some homoeopaths who go further and say that when water is used it should be used as it is in the place of distilled or bi-distilled water. It should also be decided whether for some products, the water from the source containing Carbonate of Calcium should be used instead of bi-distilled water. Some researches are to be made in this regard.
From the point of view of the mineral kingdom we have yet another rule which requires elucidations. It is the FREQUENT NECESSITY OF REPLACING THE PURE METAL BY ITS OXIDE. It seems that Cuprum Oxide is more interesting than Cuprum itself both having the same indications. The former is more active.
The case is the same with Bromides. Mr. Berne has shown that when we depart from a metal fro the fabrication of some medicines, we can not be absolutely sure whether the substance will remain pure in course of the preparation. Thus Zincum Metallicum will transform itself into Zinc Oxide in the process of preparation. The same thing may be said of Alluminium, Iron, and for all the metals (neither gold nor platinum).
Besides, except the very heavy metals, there is hardly any difference between the metal oxide and metal pure. For this reason it is better to oxidise the metal before preparing a medicine from it. In practice, take for example when you use a remedy having for its origin Cuprum Metallicum, which has not given expected results, you must try Cuprum Oxide which may prove to be more active having the same indications as that of Cuprum Metallicum.
Sometimes it is necessary to prefer some salts to others. This is not a rule in Homoeopathy; it is a rule of chemotherapy. In Homoeopathy we have two such examples. A classical example: Argentum Nitricum, the Nitrate of Silver – a remedy having an action though different to that of Silver metal, yet more deep and much more important. For this reason this remedy is very frequently used. There is another example which, as I have very often pointed out, is that of Plumbum Aceticum.
Since two or three years I have replaced my prescription of Lead Plumbum Aceticum which is much more active. Lead is a metal whose action is very well known to us. The pathogenesis of plumbum and of all its salts have been enriched by vocational in-toxications. On the other hand we also know marvellously well the anatomy and pathology of the lesions caused by the lead. But when we apply our knowledge to Homoeopathy we very often meet with some failures even when
Plumbum is indicated, while plumbum Aceticum has at least a much more interesting action in muscular atrophies of neuritis and poly-neuritis. Plumbum Metallicum does not act well in these cases. The Acetates of metal provokes some pains and some other acute phenomena which its metal cannot. Can we explain this fact by the help of chemical reaction? This is also a case of research.
On the other hand the simple acids are not the remedies of first importance in Homoeopathy. They are less important than the metalloids. Phosphoric Acid is not as valuable as Phosphorus. Sulphuric Acid has very much the less value than sulphur. The acids have for themselves some common indications which are primary to all acids. As for example the general symptom, the DEBILITY.
Some cases of debility may be covered by Muriatic Acid as well as by the Sulphuric Acid. Thus you will get amelioration of pains resulting out of hyperacidity by applying Muriatic Acid, Sulphuric Acid and Nitric Acid. Sulphuric Acid acts longer but it should be remembered that you may apply the one or the other but their action is secondary and functional which will ameliorate hyperacidity but will not cure it.
It is necessary that we maintain a link between us and the chemist. The difficulty lies in the fact that chemistry is a practical Science where there is no place for general consideration. Take a book on chemistry and you will find that it is a book of pure experience and that chemist acts always tentatively. They have no general rule. When they make new experiment they have no ideas well founded by reasoning. We, doctors, on the contrary, try to lay down some general rules.
THE VEGETABLE KINGDOM
As regards the Vegetable Kingdom there are two important guiding principles. The first is that the plants should be taken IN THEIR MILIEU i.e. to say in their wild state. Take care of the plants grown in gardens for using in the preparation of tinctures. It is possible that such plants may give results, but it is an error of a priori because the plants should be collected in their milieu.
The second rule is the following. We must begin with tinctures made in alcohol and not with tinctures i.e. to say with tinctures made from fresh plants. This is easy to realise for indigenous plants but for plants growing in hot countries it is very often difficult to be certain of its origin. The rule for the fresh plants has its value. In a word the alcoholature, in order that it may be of any value, should begin as much as possible on the spot of collection of the plant itself.
As for example an exotic plant sent in France in dried condition may not have any action. It is necessary that the person who collects them should make the alcoholic tincture on the spot and send it to another place, otherwise the originals may not have equal value. (The time of collection has also some importance. The general rule of phytotherapy is that the plants should be collected in blooming state. There are plants that grow in shade and there are others that grow in open. The degree of insolation must have some influence of the quantity and the quality of the juice of the plant).
(That question of freshness has some importance for the active organs having intense metabolism but for the grains and the skins it has very little importance).
Our perfection in the practice of Homoeopathy has no value if we are not sure of the originals which we use for the preparation of our medicines. If we do not get the desired effect of a medicine we prescribe, we do not apply it any more thinking that the medicine is deceptive while perhaps it has not given desired effect because it is not prepared from a good original. Let us then be absolutely sure that the originals are good in order that we may not accuse the medicine for being ineffective. We should, on the contrary accuse ourselves because we have failed to make the proper choice. This is of course a difficult question.
It may be noted here that when we apply the globules dissolved in water mixing it with a spoon for 5 to 10 minutes we get much more rapid results.*
There are some laboratories that have replaced Psorinum of Hahnemann which is a scraping of the itch, by scrapings of eczema. This is an error because Hahnemann established the pathogenesis of Psorinum preparing it from the scrapings of itch.
Similar is the case with Hydrophobinum. It should be made from the saliva of a rapid dog, and not from the marrow of a rapid dog. The remedy prepared by the Pasteur Institute may be interesting but it is not Hydrophobinum which contains other organic substances, found in the saliva.
THE ANIMAL KINGDOM.
In the Animal kingdom there are other rules. Hahnemann, as for example formulated the rule that the entire body of the animal is to be used. For the serpents and other big animals only the venom is used but for the the small insects the whole is to be used to start with.
However as regards the serpents we must know that the venom of the animal has no value if the animal is not caught in its country of origin and if possible in liberty. The venom of the serpents kept in captivity in Europe has not as much value. When these animals are not in freedom, but are in conditions comparable to those of a free state, we may get some results. This is the rule for all the venoms of serpents kept in captivity in the antivenomous Institute of Rio de Janeiro. The institutes of this kind are famous in Brazil. There the serpents lives as if in liberty in gardens and for preparing the Antivenomous serums the venoms are gathered during the time of the year when they are more active.
The case of Apis is interesting. Sometimes Apium Virum acts better in oedema than Apis. In this case also we must be sure of the origin used by the pharmacists. The Germans have found out the active principle of Apium Virus which they have isolated in the form of Apisine. You may use it in subcutaneous injections in 6x. This 6x dilution of Apisine is much more active than Apium Virus in rheumatism.
We must be very careful for Apis. Many Homoeopaths very easily get the idea that Apis acts in all cases of oedema. This is one of the causes of failures with Apis because the oedema of Apis is painfully rosy, hot and inflammatory. It is for this reason oedema of Cardio-renal origin does not come within the sphere of Apis.
The question of the origin of medicines is very important and very delicate to deal with because finally it leads us to the question of the “Mark”. This question arises in Homoeopathy and it also arises in pharmacology. We are forced to apply Digitalis of such and such “mark” because the action of Digitaline is variable according to the region where it is produced. But the question is more grave and more delicate in Homoeopathy for the very reason that we have no means of control.
We can control the efficacy of a Homoeopathic medicine only by its application to our patients. Our question is always a relative one. We may think (and the anti-homoeopaths actually thinks) that it is a coincidence if we have an amelioration and naturally we may always about the value of our medicines. A particular case does signify nothing. We cannot be sure until and unless we have experience of the effect of a drug in several thousands of cases. In a word we may say that we have to have a certain confidence in our suppliers.
The case is the same with Opotherapy where the question of “mark” is also very important.
This is all about the origins of our medicines from which we should depart. There are many errors that we may make in selecting the drug to start with for preparing further dilutions.
(Lastly we may say that in our colleges, with the teaching of the different branches of Homoeopathic medicine, we must also have a course of Pharmacology. We must not forget that in India we cannot accept in to the rules laid down in the foreign pharmacopias. We must try to establish our own pharmacopia always with special consideration of our Indian herbs growing in a climate which is so different to that of other lands. Secondly it is also necessary that we have our own materia medica for the very reason that the drug action is variable according to the climate of its origin. In other words we, Indian Homoeopaths, must have our own Materia Medica and our own Homoeopathic Pharmacopia).
The question of the Homoeopathic dose is our next problem. We may make many mistakes in this case. We should know the cases where high dilutions are to be used and where to apply the lower dilutions. We must also know how to repeat the Homoeopathic doses. The repetition of doses is a very important problem.
The laws regarding the dilutions are not yet accepted by all Homoeopaths. They should be considered in an open mind. However most of the Homoeopaths agree on the point that the lower dilutions act soon; superficially and for a short time; the high dilutions act slowly, deeply and for a long time. It seems that the laws relating to the homoeopathic dose are rather some corollaries of the law relating to the intensity of excitations caused in the living organism.
In practice this is very important and should be considered with a supple mind because the excitations differ according to the remedies. But we must insist on the point that while diluting the medicines the Homoeopaths have discovered a capital principle which is the duration of the action of Homoeopathic medicines. This is what make Homoeopaths for more superior to other therapeutists. We know at least approximately the duration of the action of our medicines.
In general medicine one does not know it. Hahnemann had discovered that in diluting and dynamising a substance, imparting to it some more medicinal energy, the duration of action augments and in reading the works of Hahnemann we find that he proved as for example. Causticum is capable in high dilution to act from 60 to 100 days. He found that in certain dilutions the period of action may last up to 120 days. When the dilutions are increased up to 100,000 Korasakow,* or still higher, it may be active for a much more long duration. Every remedy has its duration of action but this duration of action may be increased in course of treatment. when you treat a patient with a high dilution the duration of its action is not very long.
Take for example: you apply Lachesis 200 to a patient who has never been treated or who is having a homoeopathic treatment for the first time. In such a case the duration will not be more than 7 or 8 days. The negative phase is 24 hours; the positive phase begins on the 2nd day: amelioration continues for 6 days and from the 6th day the amelioration begins to fall and the patient feels less better.
You repeat the dose and as gradually you go on repeating the dose even in the same dilution the duration of its action will increase. If instead of giving Lachesis 200 you apply 1000, the duration of action will be 15 days of positive phase and next you will have one month with another dose of M and you will obtain a positive action for 2 to 3 months with Lachesis 10,000 Korsakow.
The duration of action varies according as the patient has only begun the treatment or he is having a treatment for a long time. But there are so frequent exceptions to this rule that in reality it can only be learnt by individual practice.
Here we have an excellent argument for propaganda of Homoeopathy to other doctors who never busy themselves with the question of the duration of the action of their medicines. The official school busy themselves only in case of preventive vaccinations as regards the duration of action.
As regards the lower dilutions, they are to be applied rather in acute case because they act superficially and for a short period. On the other hand for the drainage of a chronic case we must get a real hierarchy of actions by giving a high dilution which acts for a long time, followed by some functional remedies which are repeated every day or at an interval of two days for the reason that their action is short lasting.
Very recently Cahis of Barcelona and Dr. Nabel have used some mixtures of dilutions and it has been seen that by mixing dilutions an action is obtained which is intermediary between a high and a low dilution and that the action is very deep because of the high dilution, acting at the same time very rapidly (because there is a lower dilution) and that the duration of action is intermediary. The mixtures of dilutions act soon, deeply and their duration is medium.
In summary we may say: while the high dilutions have a negative phase of aggravation for one or two days followed by a slow amelioration continuing for a long time, the lower the dilution acts for a short time, it acts superficially and it should be often repeated. The mixture of the two kinds of dilution give a result intermediary between the two.