In acute conditions it is not difficult to know when to repeat the remedy. If the patient takes a turn for the worse repeat at once and if the case is at all alarming step up the potency, making certain that the symptoms of the remedy still match those of the patient.
In ambulatory chronic cases it is sometimes quite a problem to know just when to repeat. The general tendency undoubtedly is to repeat too soon.
Too early repetition causes less interference if the potency is raised but it is an unnecessary extravagance in slow-paced deep- rooted chronic cases requiring perhaps years of constitutional treatment. The element of time (chronos) cannot be ignored in the treatment of chronic disease and if the remedy is frequently repeated and the potency steeped up each time we may quite possibly arrive at the jumping-off place before the patient is cured. The billionth and ten billionth potencies will undoubtedly work but this is nevertheless getting somewhat beyond the range of practically.
If the curative cycle has run down before the remedy is repeated the same potency can be successfully employed at least from three to five times. If repeated in the identical potency during the active progress of the cycle the third or even the second dose may prove disappointing.
The question of when to repeat and when to raise the potency in chronic cases is further confused by the failure of many physicians to realize the natural rhythm or periodicity which is present both in sickness and in health. No one feels the same from day to day or from month to month. Each individual has his own rhythm and when there is constitutional derangement this flux and reflux of the vital energy becomes more or less exaggerated into periods of aggravation and amelioration. The diurnal periodicity is very marked in some cases and this is reflected in such remedies as Arsenicum, Kali carb., Lycopodium and Syphilinum, all of which have conspicuous time aggravations. China reflects a forty-eight hour and a seven day periodicity. Arsenicum often has a fourteen day rhythm. Tuberculinum twenty- one days, Nux vomica and Sepia twenty-eight days. The springtime aggravation of Lachesis and other snake venoms is well known.
Probably most of those present will recall the frequency with which old patients, those on the absent list, will return again for treatment at the same season of the year, often in the same month, and sometimes almost to the very anniversary of their first visit to the office. Arsenicum and Thuja have this annual periodicity to a marked degree.
In considering repetition or change of potency wait until the general direction of the case can be clearly seen. When the pick- up is definitely lost it is time to initiate a new cycle of curative action.
DR. FARRINGTON: This paper deals with a subject that is always in our minds, one of the failures of homoeopathic technique which so few really understand or recognize. As the essayist so well says, it is often difficult, especially in chronic cases, to determine when to repeat the remedy. It is a fact that homoeopaths the world over, even those who are loyal and try to practice according to correct principles, find this difficulty. It is always surprising to me how a chronic case, or for that matter even an acute case, can improve and permanently recover when a remedy has been repeated day after day, and probably several times a day for a long period of time. I think it is only because when the remedy has acted, the patient established an immunity to its further action, or else I dont know how we could cure so many cases in this way.
It must be remembered, however, that all cases will not respond to higher potencies. We have to select as best we can the potency that seems best suited to the case. The periodicity that Dr. Underhill mentioned is also an interesting subject. He has mentioned several of the most prominent remedies of periodicity, among them the snake poisons. Snake poisons have a periodicity, some of them annual. There are many cases recorded in literature which show that symptoms return after the snake bite on the identical day of the year on which the bite occurred, both in human beings and in animals.
DR. BOGER: Some years ago I translated a paper on remedies written by Dr. Ide of Stettin. That was a very valuable paper, and ever since I did that work, the idea has been growing upon me. I have extended the paper now to quite a good-sized little book. Among the latest additions that I have made to that have been over 3,000 observations of successful prescriptions made and the days upon which they were made. In looking those cases up to find out what phase of the moon was present at that time, I find out several things. Of 134 observations on Phosphorus, but 53 prescriptions were made in the full moon week. That is only one example. Arsenicum I have carried on in the same way. The high percentage of successful Arsenicum prescriptions are made in the increase of the moon.