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| Index to Boger's Lesser Writings | Index to Historical Archives | ||||
The Repetition of the Dose-- C. M. Boger |
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| Not many papers have appeared on this subject, perhaps the best one is by Dr. Lippe, which was first published in the Organon, and later reprinted in the Medical Advance. The object of giving a remedy is to temporarily incite a similar action in order that a dissimilar permanent reaction may ensue; this lies at the basis of all cure, and is self-evident. While all cures follow their lines and are more quickly and certainly made by giving the most similar remedy, it does not imply that potencies are absolutely essential thereto; for crude medicines and extra-medicinal methods may and frequently do cure after the same manner; to this we should not be blind. Such cures however are of their very nature generally partial and finally need a deep acting antipsoric to perfect them. In many cases the delicate poise of the life force reflects like a mirror, more or less of the image of every remedy given; these are very difficult to cure, a complete picture, the single dose and a long wait being absolutely essential to success; here we need all our tact, to hold the patient until the proper response appears, a single mistake will surely ruin the whole case. Another class is masked by insusceptibility and slow reaction, these may require a frequent repetition of the remedy until a decided _ movement is inaugurated, which will then be powerfully carried forward to its termination by the life force which then acts slowly but surely. Every case is a new study, requiring a determination of the character of the vital reaction, hence the practical utility of the single dose is most apparent; it enables us to feel the pulse of the whole organism, as it were, and thereby judge what manner of man we have to deal with. A slow and gentle cure is the acme of our ambition, failing in this, it enables us to feel our way and estimate our surroundings preparatory to the next move. The second prescription is always of the greatest importance, too often we are apt to look for a different remedy, when in fact the new symptom complex is only a variation of the older image, and requires repetition of the former remedy in a different potency; having carefully made up our mind as to the indicated remedy we should be slow to change, always thoroughly testing the chosen medicine in the scale of potencies as well as in the repetition of the dose, before abandoning it for another. Remedies typify patients and phases of disease, hence to speak of specifics is harmful in the highest degree. We all know that when the constitutional remedy for a given patient has once been finally worked out, it will cure almost any disease which may attack him, even although these later symptoms may seemingly be the opposite of those previously removed, for it must be remembered that these later manifestations are also in all likelihood alternate effects of the drug already in use; it were therefore folly to change the prescription, such a course will only end in confusion and defeat. A great danger lurks in the hasty prescription, it is a great troublemaker and mixes up our cases, hence the watchword is wait, wait until the full picture appears, then prescribe and your success will be pronounced and permanent. Many men learn this slowly or not at all, they also never cure any one. The pace of remedies and the combined organs which they affect, is one of the greatest importance, some act quickly and run a rapid course like Aconite, Glonoin, Belladonna, etc., others develop their effects slowly and act deeply like Calc. c. and Sulphur, they dip deep down into the tissue building processes and modify every cell action; these have been aptly called antipsorics and are doubly suitable to chronic diseases, although acute ones may also demand them; snake venoms and some acids act rapidly and disintegrate the affected parts, this is especially true of Crotalus and Sulphuric acid. DISCUSSlON H. C. Allen, M.D.: Here is one of the most important topics for all of us:. the repetition of the remedy. I think that, as a rule, we make more mistakes in this than in any other part of the practica1 act of curing. We frequently fail by a too frequent repetition of the dose. To know when to repeat and how to repeat requires a master in the aft. Dr. Lippe once made a statement in my hearing that I thought the most audacious I had ever heard. He said that if he could visit a case of diphtheria the first time, before anybody had had a chance to spoil it, and make the first prescription, he would generarly cure the case with one remedy and often with one dose. .I went to Philadelphia and stayed there a month to see Dr. Lippe do it. At that time I was giving two, three or four remedies at a time or in alternation. I saw Dr. Lippe clear up serious cases of illness over and over again in pneumonia, bronchitis and so on with a single prescription. Not always, but often. The secret is first to find the remedy and then to know when to repeat and when to refrain from repeating. It is in this, that skill is manifested; this is the work that marks the difference between the artist and the bungler. J. H. Allen, M.D.: That is where the majority of Homoeopaths stand; they can prescribe properly as far as the first prescription is concerned, but they know nothing of action and reaction; the very things that must take place in order to effect a cure. The man who selects a remedy on the symptoms and then after giving it, knows how to wait and to watch intelligently is a master both in prognosis and in curing. But it is not the individua1 that S doing it; it S the law that does the work. If we understand this, we will not meddle and interfere with the working of the law bur will stand aside and give the law a chance to effect its miracles. If we will but prescribe the right remedy and wait long enough, we can do wonders in those old chronic cases that are the despair of any but the proper therapeutics. There is no more beautiful thing than to watch the slow unfolding of a cure in a chronic case. Wm. P. Wesselhoeft, M.D.: I think that the physician who takes the time and care to make the first prescription right, and who selects the remedy only after sufficient study, will always be inclined to respect the pains that he has taken, and not be likely to spoil all that he has done through too frequent repetition or by change of remedy. It is almost the universal mistake of beginners. They inherit from the old school and from materialistic science, the idea that we must pepper our patients every two hours with medicine. It seems to be that every one has to learn the lesson for him or herself and nobody can give it to another. Pretty much all young prescribers have to go through the same experience and suffer the same disappointments before they learn to do better. I have frequently tried to impress young men with the idea that it is necessary to give the medicine time to work but I do not believe that it does much good; they have to learn it from bitter experience. It is one of the hardest things to do to keep the fingers away from the bottles. As our experience grows wider it becomes less and less necessary to repeat the dose. |
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