Samuel Hahnemann (1755-1843)

Dr Samuel HAHNEMANN (1755-1843)
Dr Samuel Hahnemann (1755-1843)

While Homoeopathy itself is a perfect science, its truth is only partially known.

The truth itself relates to the Divine, the knowledge relates to man.

It will require a long time before physicians become genuine masters in this truth.

In Switzerland the children have been raised for centuries to the knowledge that it is necessary to make watches perfectly, they have been raised, as it were, in the watch factories.

Now, when Homoeopathy is hundreds of years old, and little ones grow up into the knowledge of it and observe and practise it, our successors will acquire knowledge that we do not possess now.

Things will grow brighter as minds are brought together and men think harmoniously.

The more we keep together the better, and the more we think as one the better.

It is a pity that differences should arise among us when we have so perfect a truth to bind us together.

It is very rarely the case that among the provings of our remedies not one is to be found which corresponds to the characteristic features of a case.

It was rarely so in Hahnemann’s day, and it is certainly very rarely the case with our voluminous Materia Medica.

Beginners, of course, are obliged to rely very largely upon the repertories.

This one thing you can depend upon, the image of the patient’s illness becomes more simple when you have done your best to prescribe one remedy after another.

In these difficult cases, when you have zigzagged the patient for a number of years, you will find his symptoms become more definite and striking and more clearly understood.

Sometimes when I have worked patiently upon a patient for a long time, and I have given several remedies, and the patient has partially improved, she has become disappointed and run off to somebody else, but would come back again and say I had done more for her than anyone else and she would try again.

I have found in such instances that time has done much, and that I had little trouble then to grasp the case and make rapid progress.

In addition to that, she comes back with a patient state of mind, which is more helpful to the physician than to her.

The confidence of the patient helps the physician to find the right remedy.

His mind works much better when he feels he is trusted; the confidence of the patient sharpens his intelligence.

Closely analogous to these cases are what may be called alternating complaints and one-sided complaints, those that show but one side.

It is not uncommon for a patient’s malady to have two sides – one side being manifested when the other side is not.

Eye symptoms may be present when the stomach symptoms are absent.

You may find that Euphrasia is more sharply related to the eye symptoms than the antipsoric that fits the whole case, and that Pulsatilla fits the stomach symptoms much better than the antipsoric that fits the whole case, but remember that there is one antipsoric that is more similar to the whole patient than these special remedies, because it is better fitted to the generals.

The oftener you prescribe for different groups of symptoms the worse it is for your patient, because it tends to rivet the constitutional state upon the patient and to make him incurable.

Do not prescribe until you have found the remedy that is similar to the whole case, even although it is clear in your mind that one remedy may be more similar to one particular group of symptoms and another remedy to another group.

Very often a remedy that will go to the very centre and restore order to the economy will cause quite a turmoil.

These alternating and one-sided complaints are sometimes dreadful to manage, and when everything is thrown to the surface or the extremities, e.g., when gouty and rheumatic symptoms have an outward tendency, the patient will run off and leave you.

Incurable complaints – and you meet many – will trouble any physician.

The allopath has the means of putting the patients under the influence of strong drugs and making them imagine that something is being done to their benefit, whereas injury is being done whenever they are patched tip by strong drugs.

It is unaccountable, therefore, that some of our homoeopathic practitioners make use of palliatives that are so detrimental to the patient.

The physician who applies the single remedy in potentized form under the Law of Cure any length of time will easily be convinced that there is no other way of palliation that holds out any permanent hope for the patient.

Opium will sometimes relieve pain, stop diarrhoea, and mitigate cough, but woe to the patient.

It so annuls reaction that there is no possible development of the symptoms that are necessary to indicate what homoeopathic remedy the patient needs, and while the pain is stopped the patient is not cured.

What has been said of Opium is as true of all drugs given to relieve pain.

When an opiate must be given, let it be clearly understood that a cure of this patient is abandoned.

What thoughtful physician will abandon the hope of a cure during painful sicknesses so long as life endures.

In consumption and cancer and wasting sickness the remedy that is most similar to the painful groups of symptoms will ever give the most relief and it is a forlorn hope that tempts its abandonment.

Dr Samuel HAHNEMANN (1755-1843)

Dr Samuel HAHNEMANN (1755-1843)
Dr Samuel HAHNEMANN (1755-1843)

While Homoeopathy itself is a perfect science, its truth is only partially known.

The truth itself relates to the Divine, the knowledge relates to man.

It will require a long time before physicians become genuine masters in this truth.

In Switzerland the children have been raised for centuries to the knowledge that it is necessary to make watches perfectly, they have been raised, as it were, in the watch factories.

Now, when Homoeopathy is hundreds of years old, and little ones grow up into the knowledge of it and observe and practise it, our successors will acquire knowledge that we do not possess now.

Things will grow brighter as minds are brought together and men think harmoniously.

The more we keep together the better, and the more we think as one the better.

It is a pity that differences should arise among us when we have so perfect a truth to bind us together.

It is very rarely the case that among the provings of our remedies not one is to be found which corresponds to the characteristic features of a case.

It was rarely so in Hahnemann’s day, and it is certainly very rarely the case with our voluminous Materia Medica.

Beginners, of course, are obliged to rely very largely upon the repertories.

This one thing you can depend upon, the image of the patient’s illness becomes more simple when you have done your best to prescribe one remedy after another.

In these difficult cases, when you have zigzagged the patient for a number of years, you will find his symptoms become more definite and striking and more clearly understood.

Sometimes when I have worked patiently upon a patient for a long time, and I have given several remedies, and the patient has partially improved, she has become disappointed and run off to somebody else, but would come back again and say I had done more for her than anyone else and she would try again.

I have found in such instances that time has done much, and that I had little trouble then to grasp the case and make rapid progress.

In addition to that, she comes back with a patient state of mind, which is more helpful to the physician than to her.

The confidence of the patient helps the physician to find the right remedy.

His mind works much better when he feels he is trusted; the confidence of the patient sharpens his intelligence.

Closely analogous to these cases are what may be called alternating complaints and one-sided complaints, those that show but one side.

It is not uncommon for a patient’s malady to have two sides – one side being manifested when the other side is not.

Eye symptoms may be present when the stomach symptoms are absent.

You may find that Euphrasia is more sharply related to the eye symptoms than the antipsoric that fits the whole case, and that Pulsatilla fits the stomach symptoms much better than the antipsoric that fits the whole case, but remember that there is one antipsoric that is more similar to the whole patient than these special remedies, because it is better fitted to the generals.

The oftener you prescribe for different groups of symptoms the worse it is for your patient, because it tends to rivet the constitutional state upon the patient and to make him incurable.

Do not prescribe until you have found the remedy that is similar to the whole case, even although it is clear in your mind that one remedy may be more similar to one particular group of symptoms and another remedy to another group.

Very often a remedy that will go to the very centre and restore order to the economy will cause quite a turmoil.

These alternating and one-sided complaints are sometimes dreadful to manage, and when everything is thrown to the surface or the extremities, e.g., when gouty and rheumatic symptoms have an outward tendency, the patient will run off and leave you.

Incurable complaints – and you meet many – will trouble any physician.

The allopath has the means of putting the patients under the influence of strong drugs and making them imagine that something is being done to their benefit, whereas injury is being done whenever they are patched tip by strong drugs.

It is unaccountable, therefore, that some of our homoeopathic practitioners make use of palliatives that are so detrimental to the patient.

The physician who applies the single remedy in potentized form under the Law of Cure any length of time will easily be convinced that there is no other way of palliation that holds out any permanent hope for the patient.

Opium will sometimes relieve pain, stop diarrhoea, and mitigate cough, but woe to the patient.

It so annuls reaction that there is no possible development of the symptoms that are necessary to indicate what homoeopathic remedy the patient needs, and while the pain is stopped the patient is not cured.

What has been said of Opium is as true of all drugs given to relieve pain.

When an opiate must be given, let it be clearly understood that a cure of this patient is abandoned.

What thoughtful physician will abandon the hope of a cure during painful sicknesses so long as life endures.

In consumption and cancer and wasting sickness the remedy that is most similar to the painful groups of symptoms will ever give the most relief and it is a forlorn hope that tempts its abandonment.

LECTURE 36 : The second prescription

Dr Samuel HAHNEMANN (1755-1843)
Dr Samuel HAHNEMANN (1755-1843)

The second prescription may be a repetition of the first, or it may be an antidote or a complement ; but none of these things can be considered unless the record has been again fully studied, unless the first examination, and all the things that have since arisen, have been carefully restudied that they may be brought again to the mind of the physician.

This is one of the difficulties to contend with when patients change doctors, and one of the reasons why patients do not do well after such a change.

The strict homoeopathic physician knows the importance of this and will try to ascertain the first prescription.

If the former physician is strictly a homoeopathic physician, he is most competent of all others to make the second prescription.

It is often a hardship for a patient to fall into the hands of a second doctor, no matter how much Materia Medica he may know.

The medicine that has partly cured the case can often finish it, and that medicine should not be changed until there are good reasons for changing it.

It is a very common thing for patients to come to me from the hands of good prescribers.

I tell them to stay with their own doctor. I do not want them.

Such changing is often a detriment to the patient, unless he brings a full record, and this is especially true in relation to a case that has been partially cured, where the remedy has acted properly.

If the patient has no reasonable excuse to leave the doctor, it is really a matter of detriment to the patient for a physician to take another’s patients at such a moment.

It is not so much a question of ethics, it is not so much a question of the relation of one doctor to another because friends can stand all that, but it is only after a tedious inspection of all the symptoms that an intelligent physician is capable of making a second prescription.

As a general thing, if the first prescription has been beneficial it ought not to be left until it has done all that it can do.

How is the second physician to know that ?

Then the duty of the physician is first to the patient, and to persuade the patient to return to his first doctor.

The rule is, after the first correction and homoeopathic prescription, the striking features for which that remedy was administered have been removed, a change has come, and the guiding symptoms of the case have been taken out, and only the common and trivial symptoms remain.

It is true if the physician would wait long enough he would see the return of those symptoms, but usually when a patient walks into a doctor’s office the doctor is in a hurry to make a prescription and does not wait until the proper time.

He at once prescribes on the symptoms that are left, and this is one of the dangers to be avoided, a hurried second prescription.

The patients are to be pitied that fall into the hands of such homoeopaths.

Many patients are wonderfully benefited by the first prescription ; they have said to me :

” Dr. So and So benefited me wonderfully for a while, and then he did not seem to be able to do me any good.”

The fact was that the first prescription was a correct one, having been properly chosen, and after that first prescription the doctor administered his medicine so hastily and so indiscriminately that nothing more was accomplished in the case.

The trouble was that he did not wait long enough.

It makes no difference whether the physician is so extremely conscientious that he does not want to give Sac. lac., or whether he is so ignorant that he does not know how to give it, the result is the same.

The early repetition of the medicine and the continued giving of the same medicine, will prevent anything like an opportunity for the making of a second prescription.

If the doctor administers a well-chosen remedy, and repeats it too soon, he never gives the symptoms a chance to come back and call for a second prescription ; but they become intermingled with drug symptoms, so that the rational second prescription cannot be made.

The second prescription presupposes that the first one has been a correct one, that it has acted, and that it has been let alone.

If the first prescription has not acted curatively, or has not been permitted to act the full time, it is impossible to get a second observation.

The second observation is made when the case comes to a standstill, for after the first prescription has been made changes occur ; there is a coming and going of symptoms, and while these changes are occurring no rational observation can be made of the case ; if a second prescription be made during this time, it will be likely to spoil the whole case.

If the patient is not given a perfect rest, if medicines are not kept out of the case, we will have no opportunity to make a rational second prescription.

But if these precautions are observed, then we can really make an observation upon the return of the original symptoms, which is the first thing to be considered.

Perhaps they are not so marked, but that is always the first thing to be looked for, the return of the original symptoms.

While the confusion is going on after the administration of the remedy, while internal order is being established in the economy, we do not have the return of the original symptoms.

This may be a matter of days, or weeks, or months, but if the return of symptoms is not observed what is there to be done ?

Without symptoms what can the homoeopathic physician do ?

No matter what state the patient is in, what can the physician do without symptoms ?

There is no earthly guide to the remedy except by signs and symptoms.

So that it is the duty of the physician to wait for the return of the original symptoms.

If the symptoms return somewhat as they were, differing slightly in their intensity, increased or decreased, it is good.

If the patient has not had these present symptoms for some time, if there has been a relief caused by the first prescription, and then the symptoms return somewhat as in the original, this is one of the reasons for believing. that the first prescription was a good one.

If, after an interval of two or more months, the original symptoms return, we need very little information beyond this to know that the first prescription was a good one.

In such a case when the symptoms return, when the patient has the same generals and particulars as formerly, it means that the first prescription was a good one, that the case is curable, and that the second prescription must be a repetition of the former.

Another reason for making a second prescription is the appearance of a lot of new symptoms taking the place of the old symptoms ; the old symptoms do not return, but new symptoms come in their place.

The patient says :

“Well, doctor, you have cured me of those symptoms I had, but now I have these.”

The doctor, after examining carefully these new symptoms, immediately looks up the pathogenesis, and it is possible that he will find these symptoms in the drug that he has administered and then it looks like a proving.

He asks the patient if he ever had these symptoms before.

“Never to my recollection, doctor.”

Cross-examine him carefully to see if he is not mistaken, until it seems that they are really new symptoms.

If so, the remedy has not acted properly.

It was not homoeopathic to the case ; and yet it was an unfortunate prescription, because it has caused the disease to progress in another direction, developing another group of symptoms.

This coming up of new symptoms means that they must be antidoted, if it is posssible.

The new symptoms combining with the old ones must be again studied and the second remedy must correspond more particularly to the new than to the old.

It may cause the new symptoms to disappear and possibly have an effect upon the old ones.

Any subsequent prescription takes into account all the things that have preceded it, all the conditions that have arisen, and, the third, fourth, fifth or sixth prescriptions have the same difficulties to surmount that are to be surmounted in the second.

If the first prescription was an unfortunate one, then all the others are made with difficulty and fear.

It is rarely the case that a new prescription becomes necessary when the case merely comes to a standstill.

The first prescription has been made and the symptoms commence to change in an orderly way ; they change and interchange and new symptoms come up, but finally the symptoms go back to their original state, not marked enough to be of any importance, without any special suffering to the patient, and the patient has arrived at a state of standstill.

The patient says :

“I have no symptoms, yet I am not improving ; I seemed to have come to a standstill position.”

He says this as to himself, not as to the symptoms. He has come to a standstill.

It is the duty of the physician then to wait, and wait a long time, but if after many months no outward symptoms have appeared, no external tendency of the disease, it is true that another dose of the same medicine will not do harm and the same remedy is the only one that can be considered.

A new one cannot be entertained, because there is no guide to it ; but another dose of the same medicine can cause the patient to be jogged along the way of feeling better, but there should never be any haste about it.

Wait a long time when patients come to a standstill ; but when, as in the first instance, the return of the original symptoms is observed, then you have some guide to the administration of the medicine.

The second prescription, then, technically speaking, is the prescription after the one that has acted.

You may administer a dozen remedies without having any effect upon the economy, and yet no prescription has been administered that has been specific.

You may fool away much time in administering remedies that are not related to the case.

The result is the same.

Consider the first prescription the one that has acted, that one has effected changes, and subsequent to that the next prescription is the second.

The next thing we have to consider is the change of the remedy in a second prescription.

Under what circumstances must we change the remedy ?

One instance I have mentioned, when striking new symptoms appear, and there is an entire change of base in the symptoms, so that the headache, perhaps, which has lasted a long time, disappears.

After the administration of the medicine, when a new group of symptoms appears somewhere in the body relative to the patient, such as the patient has never had, this new group of symptoms means that a new remedy must be considered, and under such circumstances the change of the remedy will be the second prescription, and the second prescription in this case calls for a change of remedy.

We will suppose another instance where the remedy must be changed.

A patient has been for years under treatment for a constitutional chronic disorder, and you have gone through the potencies ranging from the lowest to the highest, and they have acted curatively.

You have administered the different potencies, repeating the same potency until it would not act any longer, and then going higher, until you have gone through the whole range of potencies.

You can repeat that remedy many times on a paucity of symptoms, when you cannot give another remedy, simply because it has demonstrated itself to be the patient’s constitutional remedy.

This remedy should not be changed so long as the curative action can be maintained.

Even if the symptoms have been changed do not change the remedy, provided the patient has continuously improved.

If the patient says he has improved continuously, and though it would be impossible for you, at this date, from the present symptoms, to select that remedy, hold on to that remedy, so long as you can secure improvement and good from it, though the symptoms have changed.

Many physicians say :

“If the symptoms change, I change the remedy.”

That is one of the most detrimental things that can be done.

Change the remedy if the symptoms have changed, providing the patient has not improved ; but if the patient has improved, though the symptoms have changed, continue that remedy so long as the patient improves.

Very often the patients are giving forth symptoms long forgotten.

The patient has not heard them, or has not felt them because he has become accustomed to them, like the ticking or the striking of the clock on the wall.

Many of the symptoms that appear, and the slightest changes that occur, are old symptoms coming back.

The patient is not always able to say that they are old symptoms returning, but finally the daughter or somebody in the house will delight you by saying that her mother had these things years ago and she has forgotten them.

This is likely to be the case whenever a patient is proving.

So long as curative action can be obtained, and even though the symptoms have changed, provided the patient is improving, hands off.

Whenever in doubt, wait. It is a rule after you have gone through a series of potencies, never to leave that remedy until one or more dose of a higher potency has been given and tested.

But when this dose of a higher potency has been given and tested, without effect, that is the only means you have of knowing that this remedy has done all the good it can for this patient and that a change is necessary.

There is another instance to be spoken of and that is when the second prescription becomes a complementary one.

A second prescription is sometimes necessary to complement the former and this is always a change of remedy.

Suppose a little four or five year old child, a large-headed, bright, blueeyed boy, is subject to taking cold, and every cold settles in the head with flushed face and throbbing carotids, etc., you say give him Belladonna and Belladonna relieves, but it does not act as a constitutional remedy.

He continues to have these headaches, which are due to a psoric constitution, and the time comes when Belladonna will not relieve them ; but upon a thorough study of the case, you find that when his symptoms are not acute, when he does not have this cold and fever, he does not have the headache and you see an entirely different remedy indicated.

You study over the flabby muscles, and you find his glands are enlarged ; that he takes cold with every change in the weather, like enough he craves eggs, and you decide that the case calls for Calcarea.

The fact that Belladonna was so closely related to him and only acted as a palliative further emphasizes it.

It is a loss of time to treat more than the first or second acute paroxysm.

Do not give Calcarea during the paroxysm, but after the wire edge has been rubbed off by Belladdonna, give him that constitutional remedy that is complementary to Belladonna, which is Calcarea.

Many remedies associate after this fashion.

Then there are series of remedies, as, for instance, Sulphur, Calcarea and Lycopodium.

A medicine always leads to one of its own cognates, and we find that the cognates are closely related to each other, like Sepia and Nux Vomica.

A bilious fever in a Sepia constitution is likely to call for Nux, and as soon as that bilious fever or remittent fever has subsided the symptoms of Sepia come out immediately, showing the complementary relation of Nux and Sepia.

If the patient has been under the influence of Sepia some time, and comes down with some acute inflammatory attack, he is very likely to run towards Nux or another of its cognates.

The whole Materia Medica abounds with these complementary and cognate relationships.

The second prescription also takes into consideration the change of plan of treatment.

The plan of treatment consists in assuming that the case is a psoric one, if looming up before the eyes, all the symptoms in the case and its history indicate psora.

The treatment has probably consisted of Sulphur, Graphites and such medicines as are well-known to be anti-psorics.

The symptoms have run to these remedies ; but, behold, after you have made the patient wonderfully well, and you have effected marked changes in his system, so that the psoric symptoms have disappeared, he comes into your office with an ulcerated sore throat, with dreadful head pains and with the constitutional state and appearance that will lead you to say,

“My dear sir, did you ever have syphilis ?”

“Yes, twenty or thirty years ago, and it was cured with Mercury.”

Now, the psoric condition has been subdued and this old syphilitic condition has come up.

This, then indicates a second prescription.

You have to adjust your remedies to an entirely new state of things.

So it is also with regard to sycosis ; these states may alternate with each other.

When one is uppermost, the other is quiet, so you have to change your plan of treatment according to the state of the patient.

No prescription can be made for any patient except after a careful and prolonged study of the case, to know what it promises in the symptoms, and everything that has existed previously.

That is the important thing.

Always restudy your cases.

Do not administer a medicine without knowing the constitution of the patient, because it is a hazardous and dangerous thing to do.

LECTURE 35 : Prognosis after observing the action of the remedy

Dr Samuel HAHNEMANN (1755-1843)
Dr Samuel HAHNEMANN (1755-1843)

After a prescription has been made the physician commences to make observations.

The whole future of the patient may depend upon the conclusions that the physician arrives at from these observations, for his action depends very much upon his observations, and upon his action depends the good of the patient.

If he is not conversant with the import of what he sees, he will undertake to do wrong things, he will make wrong prescriptions, he will change his medicines and do things to the detriment of the patient.

There is absolutely but one way, and nothing can take the place of intelligence.

If you talk with a great many physicians concerning the observations you have made after giving the remedy you will find that the majority of them have only whims or notions on this subject and see nothing after the prescription is made.

These observations I am going to give you have grown out of much watchfulness, long waiting and watching.

If the homoeopathic physician is not an accurate observer, his observations will be indefinite ; and if his observations are indefinite, his prescribing is indefinite.

It is taken for granted after a prescription has been made, and it is an accurate prescription, that it has acted,.

Now, if a medicine is acting it commences immediately to affect changes in the patient,

and these changes are shown by signs and symptoms.

The inner nature of the disease appears to the physician through the symptoms, and it is like watching the hands upon the clock.

This watching and waiting and observing has to be done by the physician in order that he may judge by the changes what to do, and what not to do.

It is true that the homoeopath is not long in doubt in many instances what not to do.

There is always an index that tells him what not to do.

If he is a sharp and vigilant observer, he will see the index for every case.

Of course, if a prescription is not related to the case, if it is a prescription that effects no changes, it does not take long to. see what to do ; much patient waiting for a foolish prescription is but loss of time, and that should be taken into account among the observations.

The observations taken after a specific remedy has been given sufficiently related to the case to cause changes in the symptoms are those of value.

The changes are beginning, what are they like, what do they mean, to what do they amount ?

The physician must know when he listens to the reports of the patient what is going on.

The remedy is known to act by the changing of the symptoms.

The disappearance of symptoms, the increase of symptoms, the amelioration of symptoms, the order of the symptoms, are all changes from the remedy, and these changes are to be studied.

Among the commonest things that remedies do is to aggravate or ameliorate.

The aggravation is of two kinds ; we may have an aggravation which is an aggravation of the disease, in which the patient is growing worse, or we may have an aggravation of the symptoms, in which the patient is growing better.

An aggravation of the disease means that the patient is growing weaker, the symptoms are growing stronger ; but the homoeopathic aggravation, which is the aggravation of the symptoms of the patient while the patient is growing better, is something, that the physician observes after a true homoeopathic prescription.

The true homoeopathic aggravation, I say, is when the symptoms are worse, but the patient says, “I feel better.”

We must now go into the particulars concerning these states, as to the time and place, as to how the aggravation occurs, as to how the amelioration occurs, as to duration, etc.

The aggravations and ameliorations, the directions of symptoms and many other things have to come up, and be observed and judgment has to be passed upon them.

First of all, the patient should be the aim of the physician, his whole idea should be centred upon the patient to determine whether he is improving or declining.

We have to judge by the symptoms to know that this is taking place.

Very often the patient will say, “I am growing weaker,” and yet you may know that what he says is not true ; so certainly can you rely upon the symptoms and their story, which is more faithful than the patient’s opinion.

Many times the patient will say, “Doctor, I am so much worse ” ; and yet you examine into his symptoms and you find that he is really doing very well.

Just the moment that he finds out that you are encouraged, he feels better and rouses up and wants to eat.

By the symptoms, also, you can tell when the patient is really weaker, and if the symptoms are taking an inward rather than an outward course you will know, even if he is encouraged, that there is no encouragement for him.

We have in the symptoms that which we can rely upon. In the old school we have nothing but the information of the patient.

This is of little account after making a homoeopathic prescription.

The symptoms themselves must be corroborated.

The patient’s opinion must be corroborated by the symptoms.

The symptoms do corroborate what the patients say in many instances, but the symptoms are the physician’s most satisfactory evidence.

Another general remark needs to be made, namely, that we should know by the symptoms if the changes occurring are sufficiently interior. if the changes that are occurring are exterior, the physician must be acquainted with the meaning of them, so that he will know by that whether the disease is being healed from the innermost or whether the symptoms have merely changed according to their superficial nature.

Incurable diseases will very often be palliated by mild medicines that act only superficially, act upon the sensorium, act upon the senses, and though the hidden and deep-seated trouble goes on and progresses, and is sometimes made worse, yet the patient is made comfortable.

So that by the symptoms we can know whether the changes that are occurring are of sufficient depth, so that the patient may recover.

The direction that the symptoms are taking is sufficient to tell that, especially in chronic disease.

A patient walks into the clinic, somewhat stoop-shouldered, with a hacking cough that he has had for a good many years.

You judge by his looks that he has been sick a good while ; his face is sickly, he is lean and anxious, he is careworn, he is suffering from poverty and poor clothing and scanty food.

Now, you examine all of his symptoms, and they clearly indicate that he needs an antipsoric, for the symptoms are covered by an antipsoric, and from the history of the case you know he has needed it a good while.

Upon prolonged examination, the antipsoric you have in mind is strengthened.

You now examine his chest, and discover he has not the expansion that he ought to have, and you detect the presence of tuberculosis, and by feeble pulse and many other corroborating symptoms you ascertain that the patient has been steadily declining.

You give the medicine and he comes back in a few days with quite a sharp aggravation of the symptoms ; he has an increased cough, he has a night sweat and he is more feeble.

Now, the homoeopathic physician likes to hear that ; he likes to hear of an exacerbation of the symptoms ; but this patient comes back in a week, and the aggravation is still present, and is somewhat on the increase, the patient is coughing worse, and the expectoration is more troublesome than ever, his night sweats have been going on ; he comes back at the end of the second week and he is still worse, and all the symptoms have been worse since he took that medicine.

He was comparatively comfortable before he took that medicine, but at the end of the fourth week he is steadily growing worse.

There has been no amelioration following this aggravation, and he is evidently declining ; he now cannot come to the office for he is so weak.

This, then, will be the first observation – a prolonged aggravation and final decline of the patient.

What have we done ?

It has been a mistake, the antipsoric was too deep, it has established destruction.

In this state the vital reaction was impossible, he was an incurable case.,

The question immediately comes up, what are you to do ?

Are you not going to give the homoeopathic remedy in such cases ?

The patient steadily declines.

If you are in doubt about such action of the remedies and making the patient worse, you will probably have an undertaker’s certificate to sign before long.

In incurable and doubtful cases give no higher than the 30th or 200th potency, and observe whether the aggravation is going to be too deep or too prolonged.

There are many signs in the chest in such cases to make a physician doubt whether he will give a deep remedy when organic disease is present.

Of course this does not apply when things are only threatening, when you have fear of their coming, but when you are sure of their being present.

In the instance given the probability is that the remedy has been too late, and it has attempted to arouse his economy, but turned to destruction his whole organism.

Then begin, in such cases, with a moderately low potency, and the 30th is low enough for anybody or anything.

When the patient does not seem to be quite so bad as the one I have just described, you get him a little earlier in his history before the trouble has gone quite so far, and then if you administer this same very high potency in the same way you will make a second observation.

Though the aggravation is long and severe, yet you have a final reaction, or amelioration.

The aggravation lasts for many weeks, perhaps, and then his feeble economy seems to react, and there is a slow but sure improvement.

It shows that the disease has not progressed quite so far ; the changes have not become quite so marked.

At the end of three months he is prepared for another dose of medicine, and you see a repetition of the same thing, and you may know then that that man was on the border land and had he gone further, cure would have been impossible.

It is always well in doubtful cases to go to the lower potencies, and in this way go cautiously prepared to antidote the medicine if it takes the wrong course.

Then the second observation is, the long aggravation, but final and slow improvement.

If at the end of a few weeks, he is a little better and his symptoms are a little better than when he took the dose, there is some hope that finally the symptoms may have an outward manifestation whereby he will attain final recovery, but for many years you may go along with prolonged aggravations.

You will find in such a patient there was the beginning of some very marked tissue change in some organ.

We may know by observing the action of a remedy what state the tissues are in, as well as know something about the prognosis for the patient.

The third observation after administering the homoeopathic remedy is, where the aggravation is quick, short and strong with rapid improvement of the patient.

Whenever you find an aggravation comes quickly, is short, and has been more or less vigorous, then you will find improvement of the patient will be long.

Improvement will be marked, the reaction of the economy is vigorous, and there is no tendency to any structural change in the vital organs.

Any structural change that may be present will be found on the surface, in organs that are not vital ; abscesses will form and often glands that can be done without will suppurate in regions that are not important to the life of the patient.

Such organic changes are surface changes, and are not like the changes that take place in the liver, in the kidneys, in the heart and in the brain.

Make a difference in your mind between organic changes that take place in the organs that are vital, that carry on the work of the economy, and organic changes that take place in structures of the body that are not essential to life.

An aggravation quick, short and strong is one that is to be wished for and is followed by quick improvement.

Such is the slight aggravation of the symptoms that occurs in the first hours after the remedy in an acute sickness, or during the first few days in a chronic case.

Under the fourth observation, you will notice a class of cases wherein you will find very satisfactory cures, where the administration of the remedy is followed by no aggravation whatever tendency to organic disease.

There is no organic disease and no tendency to organic disease

The chronic condition itself to which the remedy is suitable is not of great depth, belongs to the functions of nerves rather than to threatened changes in tissues.

You must realize that there are changes in tissues so marked that the vital force is disturbed in flowing through the economy, and yet so slight that man with all of his instruments of precision cannot observe them.

Under such circumstances we may have sharp sufferings, but cures may come about without any aggravation.

We know then that if there is no aggravation the potency just exactly fitted the case, but here you have a course of things that you need not always expect.

Though there is nothing but a true nervous change in the economy after a potency that is not suitable, either too crude, or too high, for that patient, you will have an aggravated state of the symptoms.

In cures without any aggravation we know that the potency is suitable, and the remedy, the curative remedy, provided that the symptoms go off and the patient returns to health in an orderly way.

It is the highest order of cure in acute affections, yet the physician sometimes will be more satisfied if in the beginning of his prescribing he notices a slight aggravation of the symptoms.

The fourth observation then relates to cases in which we have no aggravation, with recovery of patient.

The amelioration comes first and the aggravation comes after observation.

At times you will see sickly patients, fully as sick as the one I mentioned in the first or second instance, walk into your office and after long study you administer a remedy.

The patient comes back in a few days telling you how much better he was immediately after taking the medicine, and now he has three or four days of what appears to be a decided improvement, a prompt action of the remedy.

The patient says he is better, and the symptoms seem to be better ; but wait, and at the end of a week or four or five days all the symptoms are worse than when he first came to you.

It is not a very uncommon thing in severe cases, in cases of a good many symptoms, to have an amelioration of the remedy come at once ; but whatever you may say, the condition is unfavourable.

Either the remedy was only a superficial remedy, and could only act as a palliative, or the patient was incurable and the remedy was somewhat suitable.

One of these two conclusions must be arrived at, and this can only be done by a re-examination of the patient and by finding out whether the symptoms relate to that remedy.

Sometimes you will discover that the remedy was an error ; a further study of the case shows that the remedy was only similar to the most grievous symptoms, that it did not cover the whole case, that it did not affect the constitutional state of the patient, and then you will see that the patient is an incurable one and the selection was an unfavourable one.

It is the best thing for the patient if the symptoms come back exactly as they were, but very often they come back changed, and then you must wait through grievous suffering for the picture ; and the patient will wait better if the doctor confesses on the spot that the selection was not what it ought to be, and he hopes to do better next time.

It is a strange thing how the patients will have an increase of confidence if the doctor will tell the truth.

The acknowledgement of one’s own ignorance begets confidence in an intelligent patient.

The higher and highest potencies will act in curable cases a long time.

When I say act, I only speak from appearance ; I should say they appear to act a long time, for the remedy acts at once and establishes a condition of order upon the patient, after which there is no use in giving medicine.

This order will continue a considerable length of time, sometimes several months.

The patient will get along just as well without any medicine, and get along better without that medicine that helped him than with it.

In curable cases, whose prospects are good, they will go along for a long time, and become very much relieved of their symptoms.

Now, if the patient comes back at the end of the first, second and third week and says he has done well, that he has been improving all the time from the cm. of Sulphur, but at the end of the fourth week he comes back and says,

“I have been running down,” the physician must then pass judgment.

Has this patient done something to spoil the action of this medicine ?

Has he been on a drink ?

Has he handled chemicals ?

Has he been in the fumes of Ammonia ?

No, he has done none of these things.

This condition is really an unfavourable one.

To have a medicine act but a few weeks, whereas it ought to act for months thereafter, will make you suspicious of that patient.

If nothing has taken place to interfere with this medicine in his economy you may be suspicious of this case.

This sixth observation is too short relief of symptoms.

The relief after the constitutional remedy does not last as long enough, does not last as long as it ought to be.

If you examine the third observation you find that there you have the quick aggravation followed by long amelioration ; but in this, the sixth, you have the amelioration, but of too short duration.

In instances where you have an aggravation immediately after, and then a quick rebound, you will never see, absolutely never see, too short an action of that remedy ; or, in other words, too short an amelioration of the remedy.

If there is a quick rebound, that amelioration should last ; if it does not last, it is because of some condition that interferes with the action of the remedy ; it may be unconscious on the part of the patient, or it may be intentional.

A quick rebound means everything in the remedy, means that it is well chosen, that the vital economy is in a good state, and if everything goes well, recovery will take place.

In acute cases we may see this too short amelioration of the symptoms ; for instance, a dose of medicine given in a most violent inflammation of the brain may remove all the symptoms for an hour, and the remedy have to be repeated, and at the end of that repetition we find only an amelioration of thirty minutes.

You may make up your mind, then, that that patient is in a desperate condition, it is too short an amelioration.

The action of Belladonna in some very acute red-faced conditions is instantaneous.

In five minutes I have noticed the amelioration come, but the best kind of an amelioration is that which comes gradually at the end of an hour or two hours, as it is likely to remain.

If it is too short an amelioration in acute cases, it is because such high grade inflammatory action is present that organs are threatened by the rapid processes going on.

It is too short amelioration in chronic diseases, it means that there are structural changes and organs are destroyed or being destroyed or in a very precarious condition.

These changes cannot always be diagnosed in life, but they are present, and an acute observer, who has been working earnestly for years, will often be able to diagnose the meaning of symptoms without any physical examination whatever, so that be can prophesy as to the patient.

Such experiences of an intelligent physician in a family will cause them to look upon him as wiser than anyone else, for he knows all about their constitutions.

This he acquires by studying their symptoms, the action of remedies upon them, and their symptoms after the medicines have been given.

This enables him to know the reaction of a given patient, whether slow or quick, and how remedies affect each member of that family.

This belongs to the physician, and he should be intelligent enough to know something about them when he has been treating them a little while.

The old physician is in possession of this knowledge, while the student and the new physician have it all to learn.

Once in a while you will see a full time amelioration of the symptoms, yet no special relief of the patient, which is the seventh observation.

There are certain patients that only gain about so much, there are latent conditions, or latent existing organic conditions, in such patients that prevent improvement beyond a certain stage.

A patient with one kidney can only improve to a certain degree ; patients with fibrinous structural change in certain places, tubercles that have become encysted and lungs capable of doing only limited work, will have symptoms, and these symptoms will be ameliorated from time to time with remedies, but the patient is only curable to a certain extent ; he cannot go beyond and rise above such a state.

Remember this after several medicines have been administered, and the amelioration of the case has existed often the full length of time of the remedies, but the patient has not risen above his own pitch in this length of time.

The remedies act favourably, but the patient is not cured, and never can be cured.

The patient is palliated in this instance, and it is a suitable palliation for homoeopathic remedies.

Observation eight.

Some patients prove every remedy they get ; patients inclined to be hysterical, overwrought, oversensitive to all things.

The patient is said to have an idiosyncrasy to everything, and these oversensitive patients are often incurable.

You administer a dose of a high potency, and they will go on and prove that medicine, and while under the influence of that medicine they are not under the influence of anything else.

It takes possession of them, and acts as a disease does ; the remedy has its prodromal period, its period of progress and its period of decline.

Such patients are provers, they will prove the highest potencies.

When you find a patient that proves everything you give in the higher potencies go back to the 30th and 200th potencies.

Such patients are most annoying.

You will often cure their acute diseases by giving them the 30th and 200th, and you will relieve their chronic diseases by giving them the 30th, 200th and 500th potencies.

Many of them are born with this sensitivity and they will die with it ; they are not capable of rising above this over-irritable and overwrought state.

Such oversensitive patients are very useful to the homoeopathic physician.

After they get out of one proving they are quite ready to repeat it or go into another.

The ninth observation is the action of the medicine upon provers .

Healthy provers are always benefited by provings, if they axe properly conducted.

It is well to observe carefully the constitutional states of an individual about to become a prover, and to write these down and subtract them from the proving.

These symptoms will not very commonly appear during the proving ; if they do, note the change in them.

The tenth observation relates to new symptoms appearing after the remedy.

If a great number of new symptoms appear after the administration of a remedy, the prescription will generally prove an unfavorable one.

Now and then the coming of a new symptom will simply be an old symptom coming up that the patient has not observed, and thinks it a new one.

The greater the array of new symptoms coming out after the administration of a remedy, the more doubt there is thrown upon the prescription.

The probability is, after these new symptoms have passed away, the patient will settle down to the original state and no improvement take place.

It did not sustain a true homoeopathic relation.

The eleventh observation is when old symptoms are observed to reappear.

In proportion as old symptoms that have long been away return just in that proportion the disease is curable.

They have only disappeared because newer ones have come up.

It is quite a common thing for old symptoms to appear after the aggravation has come, and hence we see the symptoms disappearing in the reverse order of their coming.

Those symptoms that are present subside, and old symptoms keep coming up.

The physician must know himself that the patient is on the road to recovery, and it is well to say to the patient that this is encouraging ; that diseases get well from above downwards, etc.

Old symptoms often come back and go off without any change of medicine.

It indicates that the medicine must be let alone.

If the old symptoms come back to stay then a repetition of the dose is often necessary.

The twelfth observation.

We will notice sometimes that symptoms take the wrong direction.

For instance, if you prescribe for a rheumatism if the knees or feet or for a rheumatism of the

hands, and relief takes place at once in the rheumatism of the extremities, but the patient is taken down with violent internal distress that settles in the region of the heart, or centres in the spine, you see at once a transference has taken place from circumference to centre, and the remedy must be antidoted at once, otherwise structural change will take place in that new site.

When diseases go from centre to circumference, going out from the centres of life, out from the heart, lungs, brain and spine, out from the interiors, upon the extremities, it is well.

So it is that we find most gouty patients get along best when their fingers and toes are in the worst condition.

To prescribe for this, and see the heart symptoms grow worse is a most uncomfortable state of affairs, for it is attended with a gradual downward tendency.

Eruptions upon the skin and affections in the extremities are good signs.

I remember one time I was discharged from a violent old woman. with quite a considerable amount of Billingsgate, who told me that when she called me in she could walk about, and now her ankles were swelled up with rheumatism so that she could not move.

That patient got another doctor, but soon died.

There is a great danger in selecting a remedy on external symptoms alone, i.e., selecting a remedy that corresponds only to the skin and ignoring all the symptoms that the patient may have, ignoring the whole economy and general state of the patient ; because it is true that that remedy that is related to the skin alone may drive in that skin disease and cause it to disappear while the patient himself is not cured.

Such a patient will remain sick until that eruption comes back again, or locates in another place.

LECTURE 34 : The homoeopathic aggravation

Dr Samuel HAHNEMANN (1755-1843)
Dr Samuel HAHNEMANN (1755-1843)

Organon 154 (Last clause).

“A disease that is of no very long standing ordinarily yields without any great degree of suffering to the first dose of this remedy,”

which is to say that in acute disease we seldom see anything like striking aggravation unless the acute disease has drawn near death’s door, or is very severe, unless it has lasted many days, and breaking down of blood and tissue is threatened, or has taken place.

Then we will see sharp aggravations, great prostration, violent sweating, exhaustion, vomiting and purging following the action of the remedy.

I have seen most severe reaction which seemed to be necessary to recovery.

Such a state in acute disease where it has gone many days without a remedy and a great threatening is present will be to an acute disease what many years would be to a chronic disease of long standing.

Long standing means as a matter of progress ; if we say a disease of much progress, or of considerable ultimates, we understand it better.

If the disease has ultimated itself in change of tissue, then you see striking aggravations, even aggravations that cannot be recovered from, such as we find in the advanced forms of tissue change, e.g., where the kidneys are destroyed or the liver destroyed, or. in phthisis, where the lungs are destroyed.

A disease ought always to be well considered as to whether it is acute or chronic.

Where there are no tissue changes, where no ultimates are present, then you may expect the remedy to cure the patient without any serious aggravation, or without any sharp suffering, for there is no necessity of reacting from a serious structural change.

Where there is a deep-seated septic condition, where pyaemia must be the result, you will find sometimes vomiting and purging.

As a reaction of the vital force of the economy when order is established, this order, which is attended by reaction, as it were, commences a process of house cleaning.

It does it itself, the drug does not do it ; if a crude substance is used it is the action of the drug, of course, but the action of the dynamic drug is to turn the economy into order.

So it is with chronic disease.

When the chronic disease has not ultimated itself in tissue changes, you may get no aggravation at all, unless, perhaps, it be a very light exacerbation of the symptoms, and that slight exacerbation of the symptoms is of a different character.

It is the establishment of the remedy as a new disease upon the economy instead of the reaction which corresponds to a process of house cleaning.

Elimination must take place, as we know, probably from the bowels, or stomach, by vomiting,

by expectoration, or by the kidneys, in those cases where everything has been suppressed.

It may look like an aggravation when you have had for years a limb paralyzed from a neuritis.

Suppose, after you administer a remedy that goes right to the spot, that is in the very highest sense homoeopathic, or truly specific, that paralyzed limb commences to tingle and creep like the crawling interiorly of ants, tingling sometimes from which he cannot sleep for days and nights.

This is due to the reaction of the nerves of the part.

They are called into new life, into activity.

I have seen this in paralysis.

You take, for instance, a child who has lain in a stupor for a long time, from inaction of the brain, the tingling that comes in the scalp, in the fingers and toes is dreadful, the child turns and twists and screeches and cries, and it requires an iron hand on the part of the doctor to hold that mother from doing something to hush that cry, for just so sure as that is done that child will go back into death.

That is a reaction, so that all over the benumbed parts, or where the blood begins to flow into parts where the circulation has been feeble, where the nerves take on sensation again, we have reaction, which is but the result of that turning into order.

That part has been benumbed and dead, and when circulation takes place in the part in order to repair its tissue we have reaction, which is attended with distress.

If the physician cannot look upon that and bear it, he will have trouble.

If he thinks it is an indication for another remedy he will spoil his case.

We must discriminate between that which is reaction and that which calls for a remedy.

These things are only seen in Homoeopathy, never in any other practice.

Sometimes the physician will be driven to his wits’ end in dealing with these reactions.

It is sometime a dreadful thing to look upon, and the physician may be turned out of doors.

Let him meet it as a man ; let him be patient with it, because the ignorance of the *mother or the friends can be no excuse for his violation of principle, even once.

A disease of very long standing sometimes fails to yield without this aggravation and disturbance and turmoil in the economy, and the deeper it is the more tissue change you have to contend with, and the more wonderful and distressing and painful is this reaction.

When a patient comes back after every dose of medicine with violent reaction, with violent aggravation of the disease, with violent aggravation of the symptoms, you know then that there is some deep-seated trouble.

There is a difference between the ultimates of disease and absolute weakness of the vital force.

There is such a state as weakness of the economy, and there is such a state as activity of the economy, with much tissue change. In feeble patients you may expect feeble reactions, or none at all after your remedy, but in the feeble cases they are of such character that you have few symptoms, and you can very seldom find a remedy truly specific.

For example, say you get a patient that is destined to go into consumption, a merely suspicious case.

You administer the right remedy and a violent reaction comes, a foreshadowing of what he will go through years from now if he is not cured by the remedy.

A shocking condition will come upon him ; he may be frightened and come back and tell you that that was an awful dose of medicine, poison, etc.

That is the remedy disease, those are the symptoms of the remedy foreshadowing the future of that case, because if that remedy was not similar enough to him it could not do such things, and it is because of the similitude of his state ; and he may only have those symptoms in shadow.

But the remedy cannot give him symptoms that he has not.

It cannot give him symptoms that are not related to him except in those cases that are called oversensitives.

Oversensitives, you know, are such as are capable of proving everything that comes along.

You must know whether the patient is oversensitive and proving the drug, or whether he has a vigorous constitution and is getting an aggravation.

The remedy will be exaggerated in oversensitives and sometimes in those of weakly constitution, especially those with a very narrow receding chin, those who have sunken eyes, those who have senility marked in the eyes.

The next paragraph continues this one to a certain extent.

Organon Par. 155.

“I say without any degree of suffering, because when a perfect homoeopathic remedy acts upon the body, it is nothing more than symptoms analogous to those of the disease laboring to surmount and annihilate these latter by usurping their place.”

This is only speaking from experience.

Whenever Hahnemann makes such a remark he does not place any great value upon it, because it is a matter of opinion.

You will find as a general thing in acute diseases, that if a slight aggravation of the symptoms comes in a few minutes, you will hardly ever think of giving another dose.

The remedy is so similar and searches so thoroughly that it is hardly ever necessary to repeat it.

Now there are circumstances when it is necessary to repeat, but this is so difficult to teach, and so difficult to lay down rules for, that the only safe plan is to begin cases without repetition, to give a single dose and wait, and watch its effects.

I very commonly give in vigorous, typhoid fever patients medicine in water, because it is a continued fever ; but I watch and wait, giving it several days, and the slighest sign of the action of the remedy causes me to stop. it always. I never vary from that. In a fever where the patient is feeble, to gain an immediate reaction that should never be done.

In a remittent fever the reaction may come in a very few hours, and the one dose should be the rule, while in a typhoid the reaction will seldom come in a few hours.

It is a matter of a few days, and hence the repetition is admissible.

In typhoids that are somewhat delicate never do such a thing.

The more vigor there is in a constitution the more the remedy can co-operate with that vigor to bring about a safe and quick action.

The more feeble the patient the more cautious you should be about using the smallest dose you can give.

In many chronic diseases it is possible to bring about a reaction in the first night, hence the danger of repeating the remedy.

If the delirium subsides, or a moisture comes upon the skin, and he slumbers placidly, the medicine should never be given beyond such a state.

There are times in diphtheria when the repetition of the remedy will kill, and there are times when repetition will save life.

I hope some day to be able to discover the principles.

Organon § 158.

“This trifling homoeopathic aggravation of the malady during the first few hours, the happy omen which announces that the acute disease will soon be cured, and that it will, for the most part, yield to a first dose.”

That a natural disease can destroy another by exceeding it in power and intensity, but above all things by its similarity, is the whole truth and nothing but the truth.

So that when this slight aggravation occurs you will seldom, if ever, have to give another dose in an acute disease.

When this aggravation does not come, when there is not the slighest aggravation of the symptoms, and the patient appears to be gradually better after the remedy, then it is that the remedy shows that is has not acted upon the same depth ; and that relief may cease in the case of an acute disease, and when that relief ceases the reaction has ceased and then another dose of medicine is correct practice.

Relief that begins without any aggravation of the symptoms, does not last so long in an acute disease as when an aggravation has taken place.

A slight action of the remedy over and above the disease is a good sign.

Again, you will find if your remedy was not perfectly similar you will not get an aggravation except in oversensitive patients, and then it is a medicinal aggravation.

When you find that you get no aggravation of the symptoms in a good vigorous constitution, none at all, very often your remedy has been only partially similar and it may require two or three of such partially similar remedies to finish the case.

If you will observe the work of ordinary physicians, you will notice they give two or three remedies to get their patients through where a master gives but one.

Organon § 159.

“The smaller the dose of the homoeopathic remedy, the slighter the apparent aggravation of the disease, and it is proportionately of shorter duration.”

This was written at the time of Hahnemann’s experience with what might be called small doses, ranging from the lower potencies to the 30th and seldom much higher.

He had had ample experience with the 30th, and occasionally with the 60th, but not with the tremendous turmoil that comes from the very highest attenuations.

It reads in the correct translation of it (this is incorrect here) :

“The smaller the dose is of the homoeopathic medicine, the less and the shorter is the aggravation in the first hours.”

It might be considered to mean an apparent aggravation, or an apparent aggravation of the disease.

Now Hahnemann observes, as you will find amongst several of his writings, that the disease itself is actually intensified and made worse by the remedy, if the remedy be precisely similar, but if we pass away from the crudity of the medicines, ranging up towards the 30th potency, we get a milder action, and it has a deeper curative action, and the smaller the dose of the homoeopathic medicine the less and the shorter is the aggravation.

The idea is that there is an aggravation in the first hours ; that is a matter that the paragraph itself admits, and it is this aggravation that Hahnemann is talking about.

It is sometimes true that after the third or fourth potencies of Belladonna in a violent congestion of the brain, the aggravation is violent, and if the medicine is not discontinued the child will die.

The disease itself appears to be aggravated, the child seems to be so susceptible to Belladonna that it appears as it were to be added to the disease, but with the 30th potency, as Hahnemann observes, this aggravation is slight and of short duration.

Now, in this we get an outside aggravation.

It is the drug disease of the remedy added to the natural disease, an aggravated state of the disease caused by the drug.

It is true sometimes, in spite of this aggravation, that the patient says somehow or other he feels better.

This aggravation is unnecessarily prolonged by giving too low potencies ; it is also prolonged by a repetition of the dose.

I recently observed a state that occurred from repetition.

I sent a very robust young woman, twenty years old, a dose of Bryonia, to be taken dry on the tongue.

However, she dissolved it in water, and was taking it at the end of the second day, when I was sent for, at which time she seemed to be going into pneumonia.

She had a dry, harsh cough.

“What is the matter with my daughter, doctor, is she going to die ?”

She was proving Bryonia.

I stopped the Bryonia, and next morning she was well.

This has been seen a great many times when the medicine was similar.

If the medicine is not very similar, only partially similar it yet may be similar enough to cure, but you will not see the results that I am now speaking of ; but when you make accurate prescriptions, and are doing your best work, you will see these things in the very best constitutions.

Of course, the explanation is that the patient is as sensitive to the medicine that will cure her as to the disease that she has.

Diseased states, then, are made worse by unnecessary repetition and by the dose not being small enough, that is, by the dose being very crude.

The third, fourth and sixth are dangerous potencies, if you are a good prescriber.

If you are a poor prescriber, you will demonstrate but little of anything.

You will naturally go to the higher and higher potencies for the purpose of departing from what seems to be a poisonous dose.

This action differs from the aggravation of a c.m. potency, during the latter the patient feels decidedly better.

It is short, it is decisive, and only the characteristic symptoms of the disease are aggravated.

The disease itself is not aggravated ; the disease itself is not added to, and is not intensified, but the symptoms of the disease stand out sharply and the patient says,

“I am getting better.”

The symptoms sometimes are a little alarming, but intermingled with this is a ray of light that convinces the patient from his innermost feelings that he is getting better.

“I feel much better this morning,”

says the patient, though the symptoms may have been sharpened up.

Organon § 160.

We are accused nowadays of having departed from Hahnemann.

Hahnemann wrote of the 30th potency in one of the stages of his life, as sufficiently high and sufficiently low.

We can easily see that it was in the earlier period of his investigations that he made the remark that potentizing must end somewhere.

We are accused of departing from Hahnemann, because we give different doses from what Hahnemann gave.

Now I want to show you that this is not so.

Read paragraph 279 :

“It has been fully proved by pure experiments that when a disease does not evidently depend upon the impaired state of an important organ the dose of the homoeopathic remedy can never be sufficiently small so as to be inferior to the power of the natural disease which it can, at least, partially extinguish and cure, provided it be capable of producing only a small increase of symptom immediately after it is administered.”

Now, if we go to the 200th potency and find that that will aggravate, if we go to the 50m. and find that that will aggravate, if we go to the cm., the mm., etc., and find that they will aggravate, that they still have the power to intensify the symptoms, the remedy has just the same curative power in it.

If we have the potency so high that it is not capable of producing an aggravation of the symptoms, we may then be sure that there is no medicinal power left.

We are up to the 13 mm. and the end is not yet.

Now we have never made the claim that every potency will suit everybody.

The potency must correspond to the state of the patient.

If we ever find a person who will be aggravated in his symptoms in the most positive and definite fashion, that potency will be verified.

We have not departed from Hahnemann, but have acted in accordance with his doctrines.

Organon § 280.

“This incontrovertible axiom, founded upon experience, will serve as a rule by which the doses of all homoeopathic medicines, without exception, are to be attenuated to such a degree, that after being introduced into the body they shall merely produce an almost insensible aggravation of the disease.

It is of little importance whether the attenuation goes so far as to appear almost impossible to ordinary physicians whose minds feed on no other ideas but what are gross and material.

All these arguments and vain assertions will be of little avail when opposed to the doctrines of unerring experience.”

Now, can there be any doubt of what Hahnemann meant when he speaks of the smallest dose ?

Can there be any doubt but that he means attenuation, and attenuation up and up until we reach that point in the attenuation that we do not observe a slight aggravation of the symptoms ?

In the note to paragraph 249, he says,

“All experience teaches us that scarcely any homoeopathic medicine can be prepared in too minute a dose to produce perceptible benefit in a disease to which it is adapted.

Hence, it would be an improper and an injurious practice when the medicine produces no good effect or an inconsiderable aggravation of the symptoms, after the manner of the old school to repeat or increase the dose under the idea that it cannot prove serviceable on account of its minuteness.”

So the senses have no relation whatever to the minuteness of the dose.

The medical man is inclined to measure doses from the standard of a poisonous dose.

He will measure off a little less than that which would poison, and call that a dose.

It must be seen, it must yet be visible.

This is not the test that Hahnemann offers.

He offers the test of the dose as one capable of producing a slight aggravation of the symptoms.

We see he does not limit attenuation, but he practically teaches it is unlimited, and the end has never been found.

There is a generally prevailing idea all over, not among strict Hahnemannians, but among modern homoeopaths in general, that the dose of medicine laid down by Hahnemann is too small to cure.

It is a fatal error.

An increase of the dose cannot make it more homoeopathic.

The similarity of the remedy is first, and the dose is second.

But that the dose of medicine laid down by Hahnemann is too small to cure is a fatal error.

We must see by the experience in the clinics, and by considering the wonderful things that we have gone over in the doctrines, that we have really very little to do with the dose, that there is a wonderful latitude in dosage, and that we cannot lay down any fixed rule as to the best potency to use.

It ought to be distinctly felt, from all we have gone over, that the 30th potency is low enough to begin business with in any acute or chronic disease, but where the limit is no mortal can see.

We want to follow up the series, so that we may got the very internal states that exist in degrees in the medicine.

The different potencies are distinct from each other, some are very far apart, yet invariably connected.

It is a mistake for any homoeopath to start out with the idea that the dose of medicine laid down by Hahnemann is too small to cure.

It shows that his mind is of material mould, that it is inelastic and cannot yield to the higher observations, and not capable of observing and following higher and higher as true experience would lead.

Unless man has truth in his mind his experiences are false.

Truth in the mind is first and then experiences are good.

If his mind is in a state of truth, experiences are true.

You cannot trust the experiences of men who do not know what is true, neither can they be led into truth by these fallacious experiences.

Dr Samuel HAHNEMANN (1755-1843)

Dr Samuel HAHNEMANN (1755-1843)
Dr Samuel HAHNEMANN (1755-1843)

It is very important that you should understand what is meant general, common and particular symptoms and so I will repeat somewhat.

The generals are sometimes made up of particulars.

If you examine any part alone, you are only examining the particulars.

If you examine the liver symptoms alone, you are examining particulars.

If you are examining the eye symptoms, or the symptoms of any other region considered apart from the whole man, you are examining particular symptoms.

But after you have gathered the particulars of every region of the body, and you see there are certain symptoms running through the particulars, those symptoms that run through the particulars have become generals, as well as particulars.

Things that apply to all the organs may be predicated of the person himself.

Things that modify all parts of the organism are those that relate to the general state.

Anything that the individual predicates of himself is also general.

There are things that an individual might say of himself that might relate to only one organ, but of course that becomes a particular ; but most of the things that the man predicates of himself are general.

Consider for instance, the symptoms of sleep.

You might at first think that they related to the brain, but the brain does not sleep any more than the whole man.

“I was wakeful last night.”

he is predicating something of himself and hence it is general. or, he says,

“I dreamed.”

Well it is true that the whole man really dreamed.

You might say that the mind merely dreamed, but the mind is the man and therefore, we see how important sleep and dreams become in the anamnesis of a case.

Scarcely more important is what the woman says of her menstruation ; menstruation so closely relates to the whole woman that it becomes most important.

The special senses also are so closely related to the whole man that the smells that are grateful and the smells that are disagreeable become general.

LECTURE 32 : The value of symptoms

Dr Samuel HAHNEMANN (1755-1843)
Dr Samuel HAHNEMANN (1755-1843)

Nature of Symptoms:
          General
          Common
          Particular

Grades of symptoms
          General
                    First Grade
                    Second Grade
                    Third Grade
          Common
                    First Grade
                    Second Grade
                    Third Grade
          Particular
                    First Grade
                    Second Grade
                    Third Grade

§ 153 is the one that teaches more particularly how the process of individualization or discrimination shall be carried out.

It treats of characteristics, it treats of grades.

The homoeopathic physician may think he has his case written out very well, but he does not know whether he has or not until he has mastered the idea of this paragraph.

He may have page after page of symptoms, and not know what the remedy is, and if he takes the record to a master the master will say :

“You have no case !”

“Why, I have plenty of symptoms.”

“But you have no case. You have left your case out ; you have left the image of the sickness out, because you have fated to get anything that characterizes it. You have plenty of symptoms, but have not anything characteristic. You have not taken your case properly.”

Now, after you have mastered this paragraph you will know whether you have taken your case properly, you will know whether you have something to present to a master, a likeness of something.

The lack of this knowledge is the cause of non-success with the majority homoeopathic physicians.

There are a great many homoeopathic physicians that prescribe and tinker a long time with their cases, and will ask you what a characteristic is, and if it is some one peculiar thing that guides to a remedy.

The idea of a keynote comes to the mind of many.

I do not mean that all or any part of what you have written is useless, but it is necessary to have individualizing characteristics to enable you to classify that which you have, to perceive the value of symptoms, and, if you must settle down to a few remedies, to ascertain which of these is more important than another, or most important of all.

You cannot individualize unless you have that which characterizes.

The things that characterize are things to make you hesitate, to make you meditate.

Suppose that you have been acquainted with a large number of cases of measles, for instance, but along comes one of which you say to yourself,

“That is strange ; I never saw such a thing as that before in a case of whooping cough. It is peculiar.”

You hesitate, you meditate, and at once recognize it as something individual, because it is strange and rare and peculiar.

You say, I do not know what remedy has that symptom.

Then you commence to search your repertory, or consult those of more experience, and you find in the repertory, or upon consultation, that such a medicine has that thing as a strong feature, as a high grade symptom, and it is as peculiar in the remedy as in your patient, though you have never seen it before.

You may have seen a hundred cases of measles without seeing that very thing.

That peculiar thing that you see in measles relates to the patient and not to the disease, and as the sole duty of the physician is to heal the sick that peculiar thing will open the whole case to the remedy.

When you find that the remedy has that symptom, along with the other symptoms, you must attach some importance to it, and when there are two or three of these peculiar symptoms they form the characteristic features.

What would you think would constitute a common symptom ?

We shall at once see that the common symptoms are those that appear in all cases of measles, that you would expect to find in measles.

It would be strange to have measles without any rash ; that would be peculiar.

We know that the absence of rash is a striking state of affairs and means trouble, and is peculiar.

Either it is not measles, or the absence of the rash is a serious state.

Suppose it is a fever. The patient has intense beat, an ordinary fever, coming in the afternoon and running through the night, with hot hands and feet, high temperature, dry tongue, etc.

What would you say concerning the presence or absence of thirst ?

You would say it is common if he has thirst, because almost anybody who has fever would want water.

Nothing is so natural to put fire out with as water, and the absence of thirst in a fever is strange, is rare and uncommon, peculiar and striking.

You would ask yourself at once, is it not strange that he does not have thirst with such a high temperature ?

You at once strike to the remedies that are thirstless.

You would not think of hunting up a remedy that has thirst.

So the absence of the striking features of disease constitutes a peculiarity that relates to the patient.

Well, then, that which is pathognomonic is common, because it is common in that disease, but an absence of the pathognomonic characterizes that particular disease in that patient, and therefore means the patient, and in proportion as you have that class of symptoms just in that proportion you have things that characterize the patient, and the specific remedy for the patient will be the simillimum.

It is necessary to know sicknesses, not from pathology, not from physical diagnosis, no matter how important these branches are, but by symptoms, the language of nature.

A true homoeopathic prescription cannot be made on pathology, on morbid anatomy ; because provings have never been pushed in that direction.

Pathology gives us the results of disease, and not the language of nature appealing to the intelligent physician.

Symptomatology is the true subject to know.

No man, who is only conversant with morbid anatomy and pathognomonic symptoms, can make homoeopathic prescriptions.

In addition to diagnostic ability he must have a peculiar knowledge ; that is, he must be acquainted with the manner of expression of each and every disease.

He must know just how each disease expresses itself in language and appearance and sensations.

He must know just how every remedy affects mankind in the memory and understanding and will, because there are no other things that the remedy can act upon as to the mind, and he must know how the remedy affects functions, because there are no other ways in which the remedy affects the body of man.

Now, if he knows bow diseases express themselves in signs and symptoms, then he knows what constitutes an individual disease a little different from all others.

It is the peculiar way that the same disease affects different patients that makes the symptoms strange, peculiar and rare.

That which is pathognomonic in the remedy is that which you will study out most, because it is that which is related to the patient.

Such is the state of mind that the homoeopathic physicians must keep themselves in order to begin this study, and when they have begun to think in this way they can then study the symptoms of the disease as to grade.

The symptoms of the remedies must be studied especially with respect to order on grade.

To look upon them as all alike, because they appear to be all on the same level, is to be unable to make .distinctions.

One symptom with some physicians is as good as another. It is a fact that symptoms, to a great extent, are upon a ,sliding scale.

What is peculiar in one remedy is not in any degree peculiar in another.

While it may be peculiar in a chronic case to have thirst, it is not so in a fever.

That which is true in many respects in a chronic state may be the very opposite in an acute case.

The chronic miasms are the very opposite in their character and order to the acute miasms, and this is a fact that the homoeopathic physician must know.

If you had a striking case of inflammation of the parotid gland, the patient says :

“Do not press upon it, because it is very sore,”

how would you classify that, as common or strange ?

If you think but a moment, you will see that it would be a very strange thing for a highly inflamed gland not to be sue, and that soreness upon pressure is not something to be prescribed for, but something to be known, to be taken into the general view of the case, and the remedy indicated in the case would be suitable if it have inflammation and soreness of the gland ; there is nothing striking in that : quite a group of remedies have produced hardness, soreness and tenderness of the gland ; it may be one of those, or it may be one which has never produced these things, if it have the characterizing features of the patient.

In sicknesses the symptoms that cannot be explained are often very peculiar ; the things that can be accounted for are not so often peculiar ; peculiar things are less known to man.

For instance, a patient can sit only with his feet up on the desk, or with his feet elevated ; he is a great sufferer, and because of this suffering he is compelled to put his feet up.

The symptoms hence will be put down, worse from letting the feet hang down.

“Well, what do you mean by that ? Why, if I let my feet hang down, I find I bring the nates down upon the chair, and there is a sore place there.”

Now that is quite a different thing.

You may find if it is an old man that he has a large prostate gland, which is very painful at times and very sore, and when he lets the feet hang down the gland comes in contact with the chair.

So we see that the real summing up of the case is that this enlarged and sore prostate gland is worse from pressure, and all you have learned from that symptom is that the gland is sensitive to touch, which is a common symptom.

There are instances, however, where by letting the feet hang down the patient is ameliorated ; for instance, you take a periostitis and the pain is relieved by letting the limbs hang.

No one can tell why that limb is better when hanging over the bed.

He lies across the bed with the foot hanging over the side, and why it is that he cannot lie upon his back nobody can figure out.

Now that condition is found in Conium, and you will not be astonished after you know that Conium has that symptom to find all the symptoms of your patient, say Conium.

All the rest of them perhaps, are common.

Now, when you think along this line of science, it will not take you long to get into the habit of estimating among the symptoms that appear in a record the things that are common, the things that you would expect, and the things that are strange.

Again, we see that there are certain symptoms in the remedies that are general and on the other hand the symptoms that are general must also be taken into account in order to examine any record.

All the things that are predicated of the patient himself are things that are general ; all the things that are predicated of any given organ are things in particular.

So we see how there are things in general, and things common, and things particular ; some times it may be a condition or state, sometimes it may be a symptom.

We have said that what the patient predicates of himself will generally appear to you to be at once something in general.

When the patient says, “I am thirsty,” as a matter of fact, although he feels that thirst in the mouth, yet it is his whole economy that craves the water.

The things of which he says, “I feel,” are apt to be generals.

The patient says, “I have so much burning,” and if you examine him, you find that his head burns, that the skin burns, that there is burning in the anus, burning in the urine, and whatever region is affected burns.

You find the word burning is a general feature that modifies all his sickness.

If it were only in one organ, it would be a particular, but these things that relate to the whole of the man are things in general.

Again, when the patient tells things of his affections, he gives us things that are most general.

When he speaks of his desires and aversions, we have those things that relate so closely to the man himself that the changes in these things will be marked by changes in his very ultimates.

When the man arrives at that state that he has an aversion to life, we see that that is a general symptom and that premeates his economy ; that symptom qualifies all the symptoms and is the very centre of all his states and conditions.

When he has a desire to commit suicide, which is the loss of the love of his life, we see that that is very innermost.

Medicines affect man primarily by disturbing his affections, by disturbing his aversions and desires.

The things that he loved to do are changed, and now he craves strange things.

Or the remedy changes his ability to comprehend, and turns his life into a state of contention and disturbance ; it disturbs his will and may bring upon him troublesome dreams, which are really mental states.

Dreams are so closely allied to the mental state that he may well say,

“I dreamed last night;”

that is a general state.

The things that lie closest to man and big life, and his vital force, are the things that are strictly general, and as they become less intimately related to man they become less and less general, until they become particular.

The menstrual period gives us a state which we may call general.

The woman says, “I menstruate,” so and so ; she does not attribute it to her ovaries or to her uterus ; her state is, as a rule, different when she is menstruating.

So the things that are predicated of self, of the ego, the things described as

“I do so and so,”

“Dr., I feel so and so,”

“I have so much thirst,”

“I am so chilly in every change of the weather,”

“I suffocate in a warm room,” etc.,

these are all general.

The things that are general are the first in importance.

After these have been gathered, you may go on taking up each organ, and ascertaining what is true of each organ.

Many times you will find that the modalities of each organ conform to the generals.

Sometimes, however, there may be modalities of the organs, which are particular that are opposed to the general.

Hence we find in remedies that appear to have in one subject one thing, and in another subject the very opposite of that thing.

In one it will be a general, and in another it will be a particular.