Presented for the I.H.A., Bureau of Homoeopathic Philosophy, June, 1943.
AN APPEAL TO HOMOEOPATHIC PHILOSOPHERS.
Kindly bear with me and be a little more explicit, than to say that the Organon answers all of my queries for wisdom. No man ever creates anything. All that any man can do is to make new combinations and distributions of material already existing.
Please draw the line between the similar remedy and the similimum. Does the similar remedy ever cure or does it simply remove the symptoms or the totality of symptoms for which it was given, while the similimum completely cures the whole case?.
Many remedies have been added since Hahnemann’s time and many remedies are still unknown. Have we at out command the similimum for every case that presents itself?.
As illustrative of my quandary of mind may I ask your aid in interpreting a personal experience. For five consecutive years I have had a series of unpleasant symptoms each fall; in late October or early November I have had the following cycle. In the night I would be awakened suddenly by a severe sore throat, centrally located, most painful, dry, hot, rough, and raw with mouth full of saliva. I was most uncomfortable and the one thing most to be desired was relief. I took one dose of Mercurius 1M. I dropped off to sleep in a few minutes and awoke in about an hour greatly relieved, throat very much easier. When I awoke in the morning my throat was about normal. I went about my work as usual.
In the morning of the second day I was awakened by an active “cold in the head,” profuse acrid discharge from nostrils, the nares and upper lip very red and painfully sore. I took one dose of Arum triph. 1M.; the relief was most prompt and gave me the assurance of a cure. However, the following morning I was conscious of a severe cold in the head, nose dry but full, with occasional dropping through post nares, some sneezing with persistent tickling in throat and larynx causing a very irritating cough.
I succeeded in getting some relief by blowing some hard scabs from both nostrils but the cough with painful pressure at the bifurcation of the bronchi was increasing, accompanied by much wheezing and expectoration of a tough, ropy mucus.
I took one dose of Kali bi. 1M. which gave a prompt relief lasting for three days. This was followed by a persistent cough which lasted for several weeks in spite of any remedy.
I related my experience, of which I am no too proud, to four good Hahnemannian physicians. To quote from them: “You did not start right, for you did not have your similimum, the next time the Lachesis or Hepar sulph. or other suggested possible remedies”.
For five consecutive years I had the same experience: marked temporary relief of symptoms for which the remedy was given, but one stage followed the other always sending in a persistent cough from which I was unable to get relief for several months. Last fall in desperation I took one dose of sulfathiazole, with immediate relief of all symptoms. The pulse dropped fifteen beats the first forty minutes following the taking of the sulfathiazole. It was about two weeks before my heart action was normal but I have had no recurrence of the cycle of miseries since and I have had the longest continuous period of relief and comfort that I have experienced for six years.
Two more cases and then I will submit to your judgment Mrs. B. a case of severe asthma. Her case had been carefully taken, thoroughly analyzed and the remedy selected by a Hahnemannian, the latchet of whose shoes as a homoeopathic prescriber, I am unworthy to unlatch. Lycopodium was given in the 1M. potency with absolutely no result. I took the case very carefully and Lycopodium came out as the head of the list. I too prescribed Lycopodium with no result. I later gave Lycopodium 30X. in broken dose of two hour intervals with most gratifying results. Was Lycopodium simply the similar remedy?.
Mrs. S. consulted me about wakeful nights; sleep well the first of the night but unable to sleep after 2 a.m. After carefully taking the case I prescribed Kali carb.; for two nights she slept well, after that her nights were worse than ever. Was the taking of the remedy coincidental, similar, or what? True, three swallows do not make a spring.
I am at the mercy of you as judges and as Dr. Frank Kraft of Cleveland used to say “Hew to the line, let the chips fall where they will”.
Please give me of your wisdom– similar, similimum or simply coincidental and an illustration of poor case taking and poor selection of remedy in improper dose.
Prove all things, hold fast to that which is good. SPRINGFIELD, MASS.
DR. ROBERTS: To answer Dr. Brown’s inquiry in some detail, we shall begin by saying that although we may all know the answers that are in the Organon we are not always clear-sighted enough to apply the wisdom in our prescribing. This applies to us all.
The similar remedy often palliates for a longer or shorter period, and a succession of similar remedies may help the patient on to a cure, depending on the validity of the individual and the relationship of the remedies chosen to such problems as the miasmatic tendencies, chronicity, etc.
The similimum cures.
We have not the similimum for every case because only a small portion of our resources for cure, according to Divine beneficence, has been tapped. But more to the point, we do not begin to comprehend the potentials of even well-used and fairly common remedies. In other words, we have limitless powers at the disposal of our very limited abilities for their application, through our own restricted powers of observation and comprehension.
In the first case cited, one of the pertinent symptoms was the annual periodicity. It was not possible to comprehend this the first year, possibly not the second. By the third year the repetition of the cycle should have been recognized. It is always somewhat dangerous for a physician to prescribe for himself because he must of necessity take the short-range view. On the basis of the symptoms reported it seems that the similimum was Lachesis.
In the second case we may remark that the question of potency in its relation to the individual has never been successfully solved. However, as a matter of my own, experience especially in asthma and hay fever, it has been true that the 1M. potency of even a carefully selected remedy is comparatively useless. My experience has been very satisfactory with the 9M. potency, but the 200th has served better than the 1M. Lycopodium was undoubtedly the similimum, but the potency was not the similimum for the dynamis of the patient.
In the third case we observe that the report is like that given by patients who have homoeopathic kits in their homes–an initial amelioration and subsequent aggravation, or perhaps just a return to the earlier state. We feel that in their cases this is usually due to an inadequate symptom basis for the prescription–prescribing on one or two symptoms, as the novice so often does. This is not the case with a veteran prescriber, but it brings out a point worth considering; the stimulation of the potency, as manifest in these transient reactions, without regard to the similarity of the remedy.
In every day life we see such reactions from tea, coffee, cocoa, the vitamins, and other frequently used stimulants, in various degrees of “potency.” We know too little about the energy of the potencies we use in our remedies.
In this case we can only say, specifically, that Kali carb. could not have been the similimum, or there would not have been an initial amelioration which failed to hold, which is contrary to the laws of cure.
DR. STEVENS: Anyone who thinks it is easy to practice good homoeopathy has never half tried it. This paper is written by a physician with a very large practice who nevertheless takes time to choose his remedies carefully and his patients respond to them. In this paper he poses a question that must always be more or less difficult to answer.
Ideally, of course, the similimum should cover all the patient’s symptoms, acute and chronic, general and local, the general and mental symptoms being especially important. In many acute cases, however, the local symptoms stand out so sharply that one instinctively prescribes on these, without stopping but only a similar. This error is especially easy to make if one is prescribing for oneself.
In the first case presented it would seem that the remedies taken reached the most prominent symptoms promptly and effectively but that they may also have brought out new symptoms–as if the patient were really proving the remedy. This sequence of symptoms, I confess with regret, is not unknown in my own prescribing. IF the Mercury which relieved the sore throat continued to act and caUsed the acute coryza which followed, would the coryza have disappeared soon if it had been let alone?
I don’t know.
Arum triphyllum is a remedy I use less frequently than many others and I was surprised on reviewing it in the materia medica, to find how many Mercury and Kali bi. symptoms it had– not only the acrid coryza, but the very sore throat and excess of saliva of Mercury and the stringy mucus of Kali bi. If it had been given first, would it have cleared the case?.
This case has puzzled me a great deal. I once took the symptoms as carefully as I could and worked it out by repertory, with the result that Alumina appeared to be the remedy. The 1M. relieved the sore, scabby nose, but did nothing for the cough which followed. Since sulfathiazole removed the symptoms present at the time of administration and prevented those that usually followed, it would seem that it really was the similimum. I believe, however, that if it had been given in potency, the effect on the heart would have been less trying and that on the nose and throat quite as good.
The second case in which Lycopodium high did nothing, but the 30X. relieved, illustrates, I think, the fact that a remedy to be the similimum must fit the patient not only as to symptoms, but also as to potency. Some patients respond quickly to high potencies and hardly at all the lower ones, while with others it is just the reverse. It is often difficult to decide which potency will be most effective and one has to experiment.
Could case three be an example of early amelioration followed by a belated aggravation?.
Or was the patient in such a broken-down state that no remedy would hold more than a few days? The latter condition is common enough and is most discouraging. Few remedies have sleeplessness after 2 a.m. and in Kent’s Repertory only two are given in the largest type, Kali carb. and Nitric acid. We would be glad to know the other symptoms of the patient in order to judge more accurately. Possibly another potency would have continued the action.
In our search for the similimum the old adage holds good– “Keeping everlastingly at it brings success”.
DR. HAYES: Dr. Brown must have had a jocular smile up his sleeve when he put down these queries for discussion. Well he knows that these difficulties in homotherapy are common experience. What prescriber always has the correct answer or does the right thing at the right time every time?.
These anxious questions show that the doctor cherishes that ideal of the physician’s “high and only mission, which is to cure the sick.: That itself is a rare qualification in these days of a hundred things to do inside, outside and all around the patient instead of looking toward dynamic cure. That qualification even in a homoeopathic tyro is most hopeful for physician and patient.
As to the doctor’s personal experience, to jump over his other questions for a moment, sulfathiazole was undoubtedly a lucky perspiration for his condition. Provings and potentization of the sulfa variations, if this desideratum is ever undertaken, should provide a timely addition to our materia medica. I say timely because these potentized drugs may contain a quality antidotal to the two or three generations of cell and circulatory deterioration caused by coal tar derivatives and other degenerating drugs.
The aggravation that preceded the curative “phase” is significant. One purpose of potentization, though a lesser one, is to prevent unpleasant or dangerous provings. The doctor was lucky to escape without lasting drug imposition and disease suppression.
As to whether we have at our command the similimum for every “case,” that is a question that will never be answered with finality.
To go toward a solution one must first ask what is meant by the word “case.” If by “case” is meant the symptomatic scheme as collected by the doctor one might answer “perhaps.” There are already more resources in the homoeopathic materia medica than any one prescriber can use. How can one tell, in the doctor’s adventure, for instance, whether some other remedy than sulfathiazole might not have done as well?.
Then as to similimum. Neither the limits of the term nor the limits of its action have ever been satisfactorily defined. Similimum is an arbitrary term applied to a condition of flux. Even similimum veri connotes but a degree of similarity. Even the idem cannot be identical; and less so in relation to impressionable vital energy in its material environment of variable states. “Similimum” as an ideal is a practical term but as a agent of eternal cure is as far away as immortality,and really may be related to it.
Furthermore, one must ask, what is the so called similimum supposed to equal in practice, a nosological entity, the entire future of the patient or to some period of five, ten or fifteen years of life?.
Also when the similimum has acted how can one tell whether the cure was effected because of the selection alone or because of the patient’s capacity to react? Some patients have more power of reaction than others, so why not give due credit to the patient’s reserve power? In practice, cure depends as much on individual native organization as on the efforts of the prescriber to discover the best remedy.
Vitality is an elastic quantity, sometimes an evasive one, and that often without apparent tissue change. The best selected remedy may act perfectly with incurables, but soon the vitality slips from under. The time element has not been mastered. With slower pace and more subtle design this shadow dogs our footsteps evermore. It will continue to do so until desire, will and mind are perfected and the miasms banished from life.
DR. SUTHERLAND: Dr. Brown in his paper has asked for wisdom. Being a neophyte in the art of homoeopathy, I do not feel myself entirely competent to discuss this interesting paper.
In respect to the first case cited, which was the Doctor’s own experience, I have the feeling that the similimum
was not prescribed. I believe it is difficult for any physician to prescribe accurately for himself–certainly it is for me. He cannot have the detached and impartial attitude towards his discomforts that is so necessary in the homoeopathic handling of patients.
The apparently miraculous cure following the use of sulfathiazole poses a question, the answer to which in any man’s guess. As far as I know sulfathiazole has not been proved. Perhaps it will be some day, and it is quite possible that the symptom picture described by Dr. Brown may develop in the proving. I would suggest that by empirical methods Dr. Brown prescribed the similimum for his condition.
Referring now to the case for which Lycopodium was prescribed, Dr. Brown asked the question, “Was Lycopodium simply the similar remedy?” Since Lycopodium was chosen independently by two excellent prescribers, we may presume that Lycopodium was the similimum, but to my mind the similimum requires the use not only of the most similar remedy but also of the most similar potency. In this particular instances, I believe that the remedy was correctly chosen but that the potency was unsuitable to the patient, and hence no result was obtained. That there is evidence to support this contention is shown by the subsequent good result obtained by the use of the 30X.
DR. BROWN: Most appreciatively do I thank Drs. Stevens, Roberts and Hays for their very gracious discussion of my appeal.
I feel that it behooves us to stop occasionally and in patient silence regain poise, wisdom and strength to press on and triumph over our mistakes as well as to laud our successes.
All of the criticisms and suggestions are just, timely and greatly appreciated. We are mortal beings made in the image of God but not infallible.
Our goal is to cure unfortunates to prevent misfortune and to gain wisdom and strength by united effort.
Our daily problem is: what is curable, what is curative and how, how to adapt the two in the surest way. Both Dr. Stevens and Dr. Roberts suggest the choice of the similimum in potency as well as in the choice of the remedy; is experience our only teacher?.
In my personal case, cited, Lachesis was given but without beneficial effect; as yet I have experienced no return of the unpleasant cycle, but in case I do I plan unless you disprove, to take a high potency of Sulfathiazole.
The asthmatic case is enjoying a period of apparent cure following the 30X. potency of Lycopodium.
In the third case Kali carb. may not have been the remedy, but a dose of the CM. potency did the work.
Let us help each other.
A light-haired boy of nine years has had quotidian chills for three days.
He wakes early in the morning very thirsty.
Chill begins in the spine at 6 a.m., and lasts until 10, with thirst and aching in his bones.
Two hours of fever follow with headache, ending with nausea.
The headache persists after the fever, but there is no sweat. 1894, Aug. 14. Eupatorium perfoliatum CM. Fincke, one powder.
Dec. 4. He has had no more chills until today, when one came of the same character as those in August.
Eupatorium perfoliatum CM. Fincke, one powder.
That was the last chill, although he has resided during the thirteen years since then in one of the worst malarial section of the state.–Clinical Experiences, ERASTUS E. CASE.