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.
