In acute disease the homoeopathic aggravation is not, as a rule, marked unless the disease has been severe and dangerous.
In chronic cases without tissue changes the aggravation is usually not severe, but when there are tissue changes there is almost invariably a marked aggravation usually with elimination through some of the natural orifices of the body.
In the former the aggravation is due to the medicinal disease, whereas in the latter it is due to an effort an natures part to put matters right-a sort of house cleaning.
When the remedy does not correspond exactly to the disease symptoms we are not likely to haven an aggravation (except in over-sensitiveness where it is medicinal and not curative).
This is especially observable in feeble patients who, owing to their deficient vitality, are not able to produce any very guiding symptoms-[Kent, Journal of Homoeopathics, May 1900.]. THE REPETITION OF THE REMEDY.
The medicine must not be repeated until the action of the last dose is fully exhausted. In other words, there can be no fixed time as to when to repeat, each case must be judged on its own merits.
In acute cases it is comparatively easy to determine when the last dose has exhausted its action by means of the general appearance and mental state of the patient, and also to a less degree by the pulse and temperature.
In typhoid fever in vigorous patients Kent usually gives the remedy in water every few hours for several days, because it is a continued fever, but on the slightest sign of reaction stops the remedy.
On the other hand, he does not repeat the remedy in continued fever in feeble patient.
In remittent fever reaction will appear in a few hours, and one dose is sufficient.
But in chronic cases it is not easy, for it is the rule and not the exception to have sharp, short exacerbations interrupting the improvement, and we must be sure that the exacerbation is a permanent and not a mere passing one.
In chronic cases we know that the dose is still acting as long as old symptoms return, or, if the symptoms continue to disappear in the reverse order to that in which they originally appeared, or if they pass from internal organs to more superficial parts, or if they go from above down.
More cases are spoiled by too frequent repetition than from any other cause, and it must remembered that an acute case may show no improvement for three days and some chronic ones for sixty.
When the vitality is very low, as in collapse, it is dangerous to repeat the dose. But when there is a lack of response to the remedy after allopathic drugging, which is really due to a sluggishness and not to a want of vitality, it is necessary to repeat oftener.- [K.].
Incurable disease requires more frequent repetition of the short-acting remedies for palliation, and it is not advisable to use a higher potency than the 200th.- [Kent, Journal of Homoeopathics, Nov. 1897.].
Some antipsorics have also an acute action, and when indicated in acute diseases behave exactly like the short-acting remedies.
When the remedy corresponds very closely to the disease the symptoms, after a reasonable time, will come back exactly the same or perhaps with the omission of one or two. In such cases all we have to do is to repeat the same remedy and potency until it fails to act, when another potency must be used.
Unfortunately in chronic diseases it is rarely possible to select a remedy that corresponds with perfect accuracy to the disease, and consequently when the symptoms return they are somewhat changed; and frequent repetition of the original remedy will confuse the case, for it is possible to suppress symptoms by the too frequent use of even high potencies.
THE SECOND REMEDY.
The first remedy having done all that it can, we must proceed to choose the second one. If the symptoms came in the order a,b,c,d and e, and after a dose of an antipsoric remedy we find great improvement for 6 to 8 weeks, with the disappearance of symptoms, e,d,c, and then a and b again increase and even e returns, but d and c have permanently gone; finally a new symptom f appears, so that we now have a,b,c,f; this last appearing symptom, f, is guiding and will appear in the anamnesis as best related to some medicine which has it as a characteristic. Hering says that this new symptoms, f, will generally be found amongst the symptoms of the last given remedy, but only of low rank. It is on account of the appearance of this new symptom and the disappearance of d and e that the original remedy is now contraindicated.
The second remedy must bear a complementary relation to the first, and hence the last remedy, either homoeopathic or allopathic, that has acted, forms one of the most important guides in the choice of the second remedy.
If a case has been much drugged we are often forced to give Nux as an antidote. This giving of Nux, however, does not confine our choice of the remedy that is to follow to that 8 or 10 remedies which bear a complementary relation to Nux, for Nux has a wide range and after giving it the case will open up and you can give any remedy excepting Zinc., which would have to be avoided.
POTENCY.
The minimum dose is as essential to homoeopathy as the law of similars.
The best results are only obtained when the disease force and the remedial force are on the same plane.
This may explain why in some cases a low potency cures after the failure of a high. When a medicine needs repetition it should be given in the same potency as long as it will act.
If the remedy called for during an acute exacerbation is afterwards needed for the chronic condition it must be given in a different potency.
Very high potencies should not be used in incurable cases.
In certain oversensitives very high potencies instead of curing always cause provings, and such people do better with the 200th or 1M. When the patient has been long accustomed to the use of low potencies you do not always get good results from the higher potencies at first. Conversely the frequent proving of high potencies seems to develop a susceptibility and such provers obtain more and finer symptoms than those who have only proved low potencies.
In all periodic diseases, periodic either with regard to pain, convulsions or discharges, it is not advisable to give the remedy during the exacerbation, but immediately after it.- [Kent, Journal of Homoeopathics, Sept. 1897.].
DIRECTION OF SYMPTOMS DURING CURE.
1. From within out.
2. Usually from above downwards.
3. In the reverse order to that in which they appeared.
This process goes on until the primary manifestations of the disease appear, whether it be the chancre of syphilis, the gonorrhoea of sycosis, or the eruption of psora.
The original discharge may not come back at the original place, but from some other mucous membrane. It is also to be remembered that the miasms may be taken at any stage, and consequently if a woman takes syphilis from her husband in the sore throat stage we can only bring back the disease to that point and not to the chancre.
INIMICAL REMEDIES.
Remedies which are very similar in action either antidote one another or are inimical. This latter relation only holds good provided the fist given remedy has acted and to some extent influenced the case.
When the first remedy has taken possession, he is the proprietor, and this relation should be respected. If the first remedy has had no effect its inimical may be given with perfect safety.
Some remedies are inimical to each other in their acute sphere and others only in their chronic.- [K., Med. Adv., Jan. 9. 1895].
MANAGEMENT OF ABNORMAL CRAVINGS.
In acute disease it is advisable to yield to the cravings of the patient, but in chronic disease they must not be indulged.
It is to be noted that when a patient has by long continued use become habituated to drugs, such as morphia, tobacco, etc., the homoeopathic remedy will, at times, act in spite of the continued use of the drug; but, of course, the action is short lasting and imperfect.
CAUTIONS TO BE OBSERVED IN THE USE OF CERTAIN REMEDIES.
Certain remedies, such as Sulphur, Silicea, Phos. and Sulph. ac., owing to their power of expelling foreign bodies, are very dangerous in some diseases, as these bodies can only be got rid of by suppuration. In far advanced phthisis with tubercular deposit or where healing of the diseased part with calcareous deposit has taken place, or foreign bodies, such as bullets, are encysted near vital organs, this danger is a very real one.
There are two classes of symptoms in all advanced tubercular and suppurative lung diseases, viz., the toxaemic and constitutional, the chest pains, the hectic fever, the mental symptoms and drams being toxaemic.
If one of this group of remedies, say Silicea, only corresponds to the toxaemic symptoms and not to the constitutional ones, it will palliate by subduing the toxaemic symptoms without doing any damage.
But, if prior to the formation of the tubercle, the patient suffered from weekly headaches coming up the back of the head, offensive foot sweats, sensitiveness to cold, etc., and though these may have all disappeared even before the phthisis came on, the Silicea will prove a most dangerous remedy.-[K.,Journal of Homoeopathics, Nov. 1899.]
