Repertory Analysis, Dosage and Repetition.
After the longest and most difficult part of your task, that of
individualizing your symptoms, has been completed
the remaining portion, that of selecting your remedy with the repertory,
is quickly done and is a simple mathematical
proposition. Like all other mathematical problems we must start
with the right premises and follow certain axioms in
order to arrive at the correct solution. Thus if the logic of our
symptom analysis is correct, if the technique of
selection be without a flaw, the choice of the remedy must be mathematically
certain.
Before giving the demonstration of the repertory analysis I wish
to say a few words concerning the administration
of the remedy after we have found the one which covers our individualized
symptom picture. One of the most
difficult things to comprehend is when to repeat the dose. You will
find as a general thing in acute cases that if a
slight aggravation of the symptoms comes in a short time you will
not think of giving another dose, for your
patient will get along better without more medicine; but there are
conditions when it is necessary to repeat the
dose. For this there is no clear-cut rule that can be laid down,
and it is very difficult thing to teach and to understand;
rather it can only come by experience and by using powers of observation.
The safe rule to follow is, never repeat the dose after
reaction begins.
If more than one dose is necessary repeat the dose until there
is improvement and then stop; more doses will
only retard the cure. When reaction is taking place never repeat
the remedy; when reaction ceases or improvement
stops, the remedy may be repeated.
Many good homoeopathic prescriptions are spoiled by too oft repeated
doses of the right remedy. We are often
treating the effects of too many doses of the remedy when we think
we are treating the disease.
I do not like to bring the question of potency up in this place,
but it
is one thing I wish to emphasize; that is, when the dilution of
the
right remedy will carry your case part way to health, and you are
sure
you have the right remedy, increase the strength of the remedy rather
than change to another unsuitable one. In this way you will find
your
cases being carried on to a complete cure.
We find certain rules given us for the repetition of the remedy
in Chronic Diseases and Hahnemann discusses these on pages
209-213, in speaking of the third mistake in the treatment of diseases.
Quoting in part, we find, on page 209: “The third leading
mistake that the Homoeopathic physician cannot too carefully or
steadfastly avoid is in hastily and thoughtlessly giving some other
medicine ... but if once a medicine ... is acting well and usefully,
which is seen by the eight or tenth day, then an hour or even half
a day may come when a modern homoeopathic aggravation again takes
place. The good results may not appear in their best light before
the twenty-fourth or thirtieth day. The dose will probably have
then exhausted its favorable action about the fortieth or fiftieth
day, and before that time it would be injudicious and an obstruction
to the progress of the cure to give any other medicine. Experience
teaches that a cure cannot be accomplished more quickly and surely
than by allowing the suitable antipsoric to continue its action
so long as improvement continues ... Whoever can restrain his impatience
as to this point will reach his object the more surely and the more
certainly ... periods of aggravation will occur, but so long as
only the original ailments are renewed and no new, severe symptoms
present themselves, they show a continuing improvement, being homoeopathic
aggravations which do not hinder but advance the cure. The physician
must; therefore, in chronic diseases, allow all antipsoric remedies
to act thirty, forty or even fifty and more days by themselves,
so long as they continue to improve the diseased state perceptibly
to the acute observer, even though gradually; for so long the good
effects continue with the indicated doses and these must not be
disturbed and checked by any new remedy.”
In footnote, page 212, we find: “But he who will not allow
himself to be convinced of this and imitate what I now
teach, he who is not willing to imitate it exactly, can leave the
most important chronic diseases uncured.”
This third step of our Trinity is of equal importance with the
first two, for no matter how well you have done the
first and second parts of your task all your efforts can be spoiled
by the wrong administration of the remedy.
When we have given our remedy on the above formula we may expect
certain things to happen. In all curable cases
we will expect a cure to take place or at least to be started. We
may know that this cure is taking place by certain
signs of nature which are given to us in the symptoms of the patient,
and the way these signs or symptoms disappear
will tell us if we are going to make a cure. If we are to cure the
symptoms must disappear from above downward,
from within outward and in the reverse order in which they came.
From the study of the Organon and the Chronic Diseases, we learn
that there are certain other things that we may
expect after the prescription has been made. Kent gives these observations
as eleven in number. I will simply give
them without further comment, as an explanation may be found in
Kent’s Lectures on Homoeopathic
Philosophy, or in a paper on the subject by myself, published in
a late number of the North American Journal of
Homoeopathy.
Following the dose one of the following results is to be expected:
1st. A rapid cure will take place with no aggravation of symptoms.
2d. The aggravation will be rapid, short and strong, and is followed
by rapid improvement of the patient.
3d. A long aggravation with final and slow improvement of patient.
4th. A long aggravation with final decline of patient.
5th. Full time amelioration of symptoms with no special relief
of patient.
6th. Amelioration comes first and aggravation come afterward.
7th. Too short relief of symptoms.
8th. Old symptoms are seen to appear.
9th. New symptoms appearing after the remedy is given.
10th. Patients who prove every remedy given.
11th. That symptoms take the wrong direction.
The first case used will be an illustration of repertory analysis,
working through the two divisions of Mental
and Physical Generals. (Many are partial to this method, and it
is well to use it in the beginning, as it trains you in
the repertory arrangement.)
My examples, as further cases illustrated will show, does not
follow this method and has laid me open to
criticism (from some sources) of being too mathematical in my methods
and of the liability of securing erroneous
results. This criticism might be sustained if one depended upon
the repertory as the final deciding factor for the
remedy; but taking the pathogenesis of the remedy, as given in a
complete materia medica, as the court of last resort
I am at a loss to see where the criticism is justifiable. To me,
at least, my method of taking the most prominent
general, be it mental or physical, as a starting point and eliminating
remedies from the group thus reached is
much more comprehendable and more easily followed. In advocating
this method I assume the physician to be
familiar with the arrangement of his repertory and a master of the
art of individualization of cases. |