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§251
There are some medicines (e.g., ignatia, also bryonia and rhus,
and sometimes belladonna) whose power of altering man’s health consists
chiefly in alternating actions - a kind of primary-action symptoms
that are in part opposed to each other. Should the practitioner
find, on prescribing one of these, selected on strict homoeopathic
principles, that no improvement follows, he will in most cases soon
effect his object by giving (in acute diseases, even within a few
hours) a fresh and equally small dose of the same medicine.1
1 As I have more particularly described in the introduction
to “Ignatia” (in the first volume of the Materia Medica Pura).
§ 252
But should we find, during the employment of the other medicines
in chronic (psoric) diseases, that the best selected homoeopathic
(antipsoric) medicine in the suitable (minutest) dose does not effect
an improvement, this is a sure sign that the cause that keeps up
the disease still persists, and that there is some circumstances
in the mode of life of the patient or in the situation in which
he is placed, that must be removed in order that a permanent cure
may ensue.
§ 253
Among the signs that, in all diseases, especially in such as are
of an acute nature, inform us of a slight commencement of amelioration
or aggravation that is not perceptible to every one, the state of
mind and the whole demeanor of the patient are the most certain
and instructive. In the case of ever so slight an improvement we
observe a greater degree of comfort, increased calmness and freedom
of the mind, higher spirits - a kind of return of the natural state.
In the case of ever so small a commencement of aggravation we have,
on the contrary, the exact opposite of this: a constrained helpless,
pitiable state of the disposition, of the mind, of the whole demeanor,
and of all gestures, postures and actions, which may be easily perceived
on close observation, but cannot be described in words.1
1 The signs of improvement in the disposition and mind,
however, may be expected only soon after the medicine has been taken
when the dose has been sufficiently minute (i.e., as small as possible),
an unnecessary large dose of even the most suitable homoeopathic
medicine acts too violently, and at first produces too great and
too lasting a disturbance of the mind and disposition to allow us
soon to perceive the improvement in them. I must here observe that
this so essential rule is chiefly transgressed by presumptuous tryos
in homoeopathy, and by physicians who are converted to homoeopathy
from the ranks of the old school. From old prejudices these persons
abhor the smallest doses of the lowest dilutions of medicine in
such cases, and hence they fail to experience the great advantages
and blessings of that mode of proceeding which a thousandfold experience
has shown to be the most salutary; they cannot effect all that homoeopathy
is capable of doing, and hence they have no claim to be considered
its adherents.
§ 254
The other new or increased symptoms or, on the contrary, the diminution
of the original ones without any addition of new ones, will soon
dispel all doubts from the mind of the attentively observing and
investigating practitioner with regard to the aggravation or amelioration;
though there are among patients persons who are either incapable
of giving an account of this amelioration or aggravation, or are
unwilling to confess it.
§ 255 Fifth Edition
But even with such individuals we may convince ourselves on this
point by going with them through all the symptoms enumerated in
our notes of the disease one by one, and finding that they complain
of no new unusual symptoms in addition to these, and that none of
the old symptoms are worse. If this be the case, and if an improvement
in the disposition and mind have already been observed, the medicine
must have effected positive diminution of the disease, or, if sufficient
time have not yet elapsed for this, it will soon effect it. Now,
supposing the remedy is perfectly appropriate, if the improvement
delay too long in making its appearance, this depends either on
some error of conduct on the part of the patient, or on the homoeopathic
aggravation produced by medicine lasting too long (§ 157), consequently
on the dose not being small enough.
§ 255 Sixth Edition
But even with such individuals we may convince ourselves on this
point by going with them through all the symptoms enumerated in
our notes of the disease one by one, and finding that they complain
of no new unusual symptoms in addition to these, and that none of
the old symptoms are worse. If this be the case, and if an improvement
in the disposition and mind have already been observed, the medicine
must have effected positive diminution of the disease, or, if sufficient
time have not yet elapsed for this, it will soon effect it. Now,
supposing the remedy is perfectly appropriate, if the improvement
delay too long in making its appearance, this depends either on
some error of conduct on the part of the patient, or on other interfering
circumstances.
§ 256 Fifth Edition
On the other hand, if the patient mention the occurrence of some
fresh accidents and symptoms of importance - signs that the medicine
chosen has not been strictly homoeopathic - even though he should
good-naturedly assure us that he feels better, we must not believe
this assurance, but regard his state as aggravated as it will soon
be perfectly apparent it is.
§ 256 Sixth Edition
On the other hand, if the patient mention the occurrence of some
fresh accidents and symptoms of importance - signs that the medicine
chosen has not been strictly homoeopathic - even though he should
good-naturedly assure us that he feels better, as is not infrequently
the case in phthisical patients with lung abscess, we must not believe
this assurance, but regard his state as aggravated as it will soon
be perfectly apparent it is.
§ 257
The true physician will take care to avoid making favorite remedies
of medicines, the employment of which he has, by chance, perhaps
found often useful, and which he has had opportunities of using
with good effect. If he do so, some remedies or rarer use, which
would have been more homoeopathically suitable, consequently more
serviceable, will often be neglected.
§ 258
The true practitioner, moreover, will not in his practice with
mistrustful weakness neglect the employment of those remedies that
he may now and then have employed with bad effects, owing to an
erroneous selection (from his own fault, therefore), or avoid them
for other (false) reasons, as that they were unhomoeopathic for
the case of disease before him; he must bear in mind the truth,
that of medicinal agents that one alone invariably deserves the
preference in every case of disease which correspond most accurately
by similarity to the totality of the characteristic symptoms, and
that no paltry prejudices should interfere with this serious choice.
§ 259
Considering the minuteness of the doses necessary and proper in
homoeopathic treatment, we can easily understand that during the
treatment everything must be removed from the diet and regimen which
can have any medicinal action, in order that the small dose may
not be overwhelmed and extinguished or disturbed by any foreign
medicinal irritant.1
1 The softest tones of a distant flute that in the still
midnight hours would inspire a tender heart with exalted feelings
and dissolve it in religious ecstasy, are inaudible and powerless
amid discordant cries and the noise of day.
§ 260 Fifth Edition
Hence the careful investigation into such obstacles to cure is
so much the more necessary in the case of patients affected by chronic
diseases, as their diseases are usually aggravated by such noxious
influences and other disease-causing errors in the diet and regimen,
which often pass unnoticed.1
1 Coffee; fine Chinese and other herb teas; beer prepared
with medicinal vegetable substances unsuitable for the patient’s
state; so-called fine liquors made with medicinal spices; all kinds
of punch; spiced chocolate; odorous waters and perfumes of many
kinds; strong-scented flowers in the apartment; tooth powders and
essences and perfumed sachets compounded of drugs; highly spiced
dishes and sauces; spiced cakes and ices; crude medicinal vegetables
for soups; dishes of herbs, roots and stalks of plants possessing
medicinal qualities; old cheese, and meats that are in a state of
decomposition, or that passes medicinal properties (as the flesh
and fat of pork, ducks and geese, or veal that is too young and
sour viands), ought just as certainly to be kept from patients as
they should avoid all excesses in food, and in the use of sugar
and salt, as also spirituous drinks, heated rooms, woollen clothing
next the skin, a sedentary life in close apartments, or the frequent
indulgence in mere passive exercise (such as riding, driving or
swinging), prolonged suckling, taking a long siesta in a recumbent
posture in bed, sitting up long at night, uncleanliness, unnatural
debauchery, enervation by reading obscene books, subjects of anger,
grief or vexation, a passion for play, over-exertion of the mind
or body, especially after meals, dwelling in marshy districts, damp
rooms, penurious living, etc. All these things must be as far as
possible avoided or removed, in order that the cure may not be obstructed
or rendered impossible. Some of my disciples seem needlessly to
increase the difficulties of the patient’s dietary by forbidding
the use of many more, tolerably indifferent things, which is not
to be commended.
§ 260 Sixth Edition
Hence the careful investigation into such obstacles to cure is
so much the more necessary in the case of patients affected by chronic
diseases, as their diseases are usually aggravated by such noxious
influences and other disease-causing errors in the diet and regimen,
which often pass unnoticed.1
1 Coffee; fine Chinese and other herb teas; beer prepared
with medicinal vegetable substances unsuitable for the patient’s
state; so-called fine liquors made with medicinal spices; all kinds
of punch; spiced chocolate; odorous waters and perfumes of many
kinds; strong-scented flowers in the apartment; tooth powders and
essences and perfumed sachets compounded of drugs; highly spiced
dishes and sauces; spiced cakes and ices; crude medicinal vegetables
for soups; dishes of herbs, roots and stalks of plants possessing
medicinal qualities; asparagus with long green tips, hops, and all
vegetables possessing medicinal properties, celery, onions; old
cheese, and meats that are in a state of decomposition, or that
passes medicinal properties (as the flesh and fat of pork, ducks
and geese, or veal that is too young and sour viands), ought just
as certainly to be kept from patients as they should avoid all excesses
in food, and in the use of sugar and salt, as also spirituous drinks,
undiluted with water, heated rooms, woollen clothing next the skin,
a sedentary life in close apartments, or the frequent indulgence
in mere passive exercise (such as riding, driving or swinging),
prolonged suckling, taking a long siesta in a recumbent posture
in bed, sitting up long at night, uncleanliness, unnatural debauchery,
enervation by reading obscene books, reading while lying down, Onanism
or imperfect or suppressed intercourse in order to prevent conception,
subjects of anger, grief or vexation, a passion for play, over-exertion
of the mind or body, especially after meals, dwelling in marshy
districts, damp rooms, penurious living, etc. All these things must
be as far as possible avoided or removed, in order that the cure
may not be obstructed or rendered impossible. Some of my disciples
seem needlessly to increase the difficulties of the patient’s dietary
by forbidding the use of many more, tolerably indifferent things,
which is not to be commended.
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