DEPARTMENT OF PRACTICAL CASE MANAGEMENT


Special placebos be used for particular complaints such as Pain, Headache, Insomnia, etc. In such case the word describing the complaint should be written boldly across the face of the drug envelope. This helps considerably in raising the potency of the prescription.


THE PLACEBO AND ITS SCIENTIFIC USE.

The indicated homoeopathic remedy is the best medicine in the world. If the placebo is “the second best remedy”, as affirmed by the late Dr. Stuart Close, its correct employment becomes a matter of real importance.

It is probably true that were all medication to be absolutely discontinued once and for all humanity would be spared a vast amount of suffering as well as relieved of a tremendous financial burden. If every prescriber and every manufacturer and vendor of drugs and biologic products would be good enough to substitute harmless placebos for their pseudo-scientific concoctions what a benefit they would confer upon the race.

A placebo may be any harmless thing given or done to please or placate the patient and his attendants. The value of a placebo is of course psychologic but it is effective in people of all ages and widely differing grades of intelligence.

Years of observation and experience have demonstrated the practical value of the following types of placebo:.

1. Powders (sac. lac.) using No. 10 pellets with granulated sugar of milk. The powders can be made up in either pink or white papers.

2. Tablet triturates (plain sugar or milk tablets).

3. Small, medium and large capsules filled with pulverized sugar of milk.

4. “Water medicine” small pellets dissolved in a specified quantity of water and given in teaspoonful doses as directed. This form of placebo is convenient and time saving when prescribing at the bedside.

We do not advise the use of any colored blank tablets as there might be a chemical effect from some of the coloring agents employed in their manufacture.

A hypodermic syringe is something we have neither owned nor borrowed for any purpose whatsoever in more than a dozen years, thus demonstrating the fact that even a hypodermic injection of sterile water is, after all, a superfluous gesture.

Certain precautions are essential in the care and dispensing of placebos. It is not good practice for a physician to inform his office nurse regarding the single dose and the use of blanks. If she puts up powders or dispenses “medicine” it is better that she do it with faith, thus augmenting the constructive vibrations instead of introducing “static” interference.

Two or more medicine cabinets containing good sized bottles of blank No. 10 pellets all neatly labelled and with corks marked covering a list of remedies from Aconite to Zinc is a most excellent investment.

If, for example, Bryonia is prescribed the physician will give the actual remedy himself. He will then write on powder paper the prescription as follows: “Smith, Bry. 21” and enclose it in the drug envelope. As interpreted by the office nurse this will mean that Mr. Smith is to receive 21 powders from the bottle or container labelled Bryonia.

The drug envelope should be simple and pleasing in appearance. The printing on its face should include the doctors name, address, telephone number and office hours. There should be ample space for the the date, the patients full name and the directions for taking the medicine. The date is important and should never be omitted. A date stamp is convenient.

The physician should write on the drug envelope the patients full name, preferably in ink, and then use a rubber stamp for the directions as for example:.

One Powder upon retiring.

One Powder upon arising.

and one upon retiring.

One Powder before each meal.

One Powder before meals and.

upon retiring.

One Powder every 3 hours.

When prescribing two kinds of placebo in powder form put one in white and the other in pink powder papers. Pellets moistened with 95 percent pure grain alcohol may be used for making up a very special placebo if desired.

the placebo bottles must be filled as necessary by the physician himself behind closed doors. This is a very solemn and sacred duty, for upon the correct use of the placebo depends much of the doctors therapeutics and economic success.

Uniformity in the matter of dosage is important. There should be nothing hit or miss in dealing with “the second best remedy”. The number of powders or other placebo dispensed should be gauged accurately to the time of the next appointment. Four doses a day for one week means exactly 28 powders and dose a day for 4 weeks means the same number and not 29 or 29 powders.

Properly handled, the placebo is the patients best protection against taking something the might interfere with the action of the homoeopathic remedy. It not only protects him against his own lay prescribing and that of relatives and friends but also against resorting to medicines prescribed by his former medical advisors and nostrum advertisers.

Special placebos be used for particular complaints such as Pain, Headache, Insomnia, etc. In such case the word describing the complaint should be written boldly across the face of the drug envelope. This helps considerably in raising the potency of the prescription.

Perhaps some physicians reading this may fear the pangs of conscience in resorting to such deceptive (?) methods. If there are any such we particularly ask that they lay aside all hypocrisy while they are about it. this may mean, not only the junking of some rather expensive therapeutic , but also the assumption of a more humble attitude before their patients than may have been their custom heretofore.

Figures it any way one will, the employment of some kind of placebo is practically inevitable, not only in the practice of medicine but in every other profession and in the majority of occupations. We are all using psychology in our contacts with the world and it is being used on us, more or less effectively, every day.

Hahnemann said that a physician should have character enough to prescribed a placebo when indicated. He also referred to it as a “divine gift of God”.

If a physician cannot accomplish anything phenomenal in the practice of his profession let him at least make certain that he is doing no harm to his patients.

Baryta carb.: Irresolute, slow making up the mind. Cannot think as fast as usual. Forgets what he is talking about, or what has just been spoken. Great mental and bodily weakness. Feels it is no use to study because he cannot remember. Feels inferior (reverse of Platina). Muddy expression, looks dull. Does not want to play or do anything. Sensation as if brain were loose. If the child avoids stooping or bending forward, then consider this remedy. Acuteness of sense of smell. Glands of neck may be swollen and sensitive. Weak digestion with swollen abdomen (compare Calc. phos.).

If these symptoms are present and appetite is voracious, then consider Baryta iod.

QUESTION AND ANSWER DEPARTMENT.

[ Send questions to DR. Eugene Underhill, Jr., 2010 Chestnut Street, Philadelphia, Penna].

Question: WHAT IS YOUR OPINION AS TO THE USE OF RADIUM AND X-RAY IN CANCER CASES?.

Answer: Both radium and the x-ray are important factors in the etiology of malignancy. If they can produce cancer they should be able to cure a percentage of cases and they undoubtedly have, according to all reports. These modalities should be employed only in small doses and only in the types of cases in which beneficial results have been consistently observed. To subject a patient to 24, 36 or 72 hours of radium is little short of criminal in most instances. Repeated and prolonged treatments by the x-ray have produced untold suffering, often worse than the cancer itself. “Homoeopathic doses”, repeated only when improvement lags, in worth considering in selected case, but who is qualified to do the selecting?.

Question: HOW MUCH DOES ALCOHOL INTERFERE WITH THE ACTION OF THE INDICATED REMEDY?.

Answer: Probably a good deal in some cases and relatively little in others. If alcoholic indulgence was an important factor in the causation of the condition then its discontinuance becomes extremely important. The quality of the liquor, the quantity taken and the frequency are all important factors to consider. If physicians could only be sure of 75 percent consistent cooperation on the part of their patients how fine it would be! The tendency is to begin with about 80 percent cooperation and to end up with 10 percent or less. Alcohol is frequently one of the serious obstacles to recovery and its importance in relation to case management must not be overlooked.

Eugene Underhill