"Dr. Ihm of Philadelphia, cured a child affected with dropsy, by the use of Bryonia and Pulsatilla , repeated by turns, and at proper intervals: a great many similar cases might also be cited.
"Frequently a remedy will prove extremely successful when taken after the use of some other medicine, especially when the remedy is apsoric or of short action, and is prescribed after an anti-psoric medicine, as frequently happens, on prescribing Aconitum after Sulphur ; Hepar sulphuris , after Silicea or Zincum ; Nux vomica , after Arsenicum , having no intention to destroy the action of the medicine previously administered.
"In many cases of chronic disease, I have prescribed on anti-psoric remedy, shortly after having prescribed another, when each of the medicines applied only to a part of the symptoms. For instance, to a patient labouring under a liver complaint, I first administered Kali carbonium , and a few day afterwards, Carbo vegetabilis , which was followed by the most favourable result.
"In all these cases, neither of the medicines, if it had been given without the other, would have affected a cure.
"Up to the present time, I have usually prescribed anti-psoric medicines of short action, after anti-psorics of longer action. Thus Carbo vegetabilis , Aurum , Argentum, Platina , Capsicum , Conium , Colocynthis , Dulcamara , Belladonna , Rhus , Clematis , Anacardium , Staphisagria , Thuja , Sabina , Sabadilla , Moschus , were prescribed after Causticum , Phosphorus , Natrum muriaticum , Kali carb. , Natrum carbonicum , Calcarea, Alumina , Magnesia , Silicea , Agaricus , Bovista , Lycopodium , Sepia. But the diagnostic alone affords the most precise rules on the subject.
Similarity of symptoms is to be considered in repeating two medicines, one after the other, at a short interval, or in the continuous use of several remedies after their action has subsided. Frequent confirmation has also been given to the precept, which prescribes the choice of similar remedies amongst those which belong to different kingdoms, families, or classes. But in the present state of the art, this is a point not yet determined.
In certain cases of chronic disease, in which sulphur is deemed necessary, and in which it is foreseen that eight, nine or ten doses will be required, it is better, instead of giving them in a continuous series, to interrupt them at the third dose, and replace this remedy with some other, if considered particularly homoeopathic to the symptoms and circumstances of the complaint. This intermediate remedy should be left to act eight, nine, or twelve days, and then sulphur should be resumed.
When other anti-psoric remedies are indicated, it is not necessary to give so many doses as of sulphur, and at the same intervals, before taking an intermediate remedy, when it is homoeopathically pointed out: Phosphorus alone may be excepted.
As soon as any new symptoms of importance appear, the rule is to administer immediately another medicine better adapted, and especially corresponding with the new symptoms.
"It is proper," says Hering, "to mention the alternation of a remedy with its antidote.
"I used if for the first time, in order to diminish the effects of Colocynthis , prescribed for dry-bellyache, the dreadful colic peculiar to the West Indies. Every case of it, which fell under my notice, was speedily and permanently cured, with the same medicine, partially modified, according to the greater or less severity of the case; and that without any relapse, notwithstanding its tendency to re-appear, and without palsy in the hands or arms, or the almost incurable diarrhoea which follows it, and which produces death in a few years to most of those who have been once attacked by it, - which also changes into leprosy, as I witnessed on one occasion, after the use of sulphuric baths.
"I administered the remedy at the thirtieth dilution, as in other chronic diseases; and in spite of the minuteness of the globules, which are no bigger than a poppy-seed, about one hundred to a grain, the aggravation which immediately ensued was excessive. I prescribed Coffee directly, to be taken in spoonfuls until the pain began to subside. Then after an interval of six, twelve, or twenty-four hours, I repeated the use of Colocynthis.
"It was in general necessary to have recourse to Coffee , an hour after taking the medicine; though I could easily perceive that, after the second dose, the exacerbation became less violent, besides being delayed in its advent, and a smaller dose of Coffee was sufficient to moderate its action. After a longer interval than the first, as soon as the attack returned, I repeated the same dose a third time. In the greater number of cases, I had nothing more to do to complete the treatment; the disorder disappeared altogether; and the patients speedily recovered their health and strength. Not one of them has ever had a relapse. I was very seldom obliged to give a fourth dose.
"The rule in such cases is to repeat the medicine, at intervals more and more distant, and after each dose to administer the antidote, till the increased pain shall gradually subside. By this method of treating the disease, from 1828 to 1833, I always found it give way in three or four days, without leaving behind any secondary symptom.
"The same manner of administering the medicines in other maladies is confirmed for Conium alternated with Coffee ; Sepia with vinegar; and probably Phosphorus with Opium. Much may be done with this method, in violent rheumatic fits.
"In explanation of this mode of practice, it must be observed that there is no known antidote, which either destroys or completely annihilates the action of a remedy. The most powerful medicine continues to act in spite of another weaker application subsequently employed; for antidotes are but means serving to moderate the action of medicaments.
"Camphor is seldom to be given in the same manner, though at first it abates the power of most medicines. Nitric ether (spr. nit. dulc.) appears to assuage the pains caused by remedies, only by directing the action of the medicine to the skin."
Now, in every one of these cases, Hahnemann would very justly say - Diminish your doses.
We have already said that the homoeopathic materia medica is distinguished from the old one, not only by the far better known effects of its components, but also by the indication of antidotes to these medicaments. It is undoubtedly a great advantage to be able to arrest, or at least to qualify the action of each remedy, especially when an unskillful hand has misapplied certain substances, such as mercury, sulphur, quinquina, iron, iodine, &c.; for without the assistance of antidotes, it would be almost impossible to effect a cure in such cases. In dispensing antidotes, the practitioner has to follow the same principles as those which govern the general conduct.
In a well-directed treatment, indeed, it is not often required to make use of antidotes to homoeopathic medicines, unless they are administered comfortably with the method of Hering, when that has been found more useful than the mere diminution of the doses. In truth, in a treatment skillfully conducted, the aggravations are so mild, that they do not need to be soothed. Thus it often happens that in acute disorders, a little while after the taking of the remedy, a mild and comforting sleep, of greater or less continuance, overcomes the patient, which announces that he is already relieved, and he feels that the cure has commenced. These phenomena are of most frequent occurrence among children.
One of the most valuable medicines in chronic diseases, is Sulphur , which often, without any auxiliary, completely masters a complaint, and at other times brings the cure half-way to its term.
Cases arise, however, which will not permit the use of several consecutive doses of Sulphur. This happens when the accidental symptoms of the sulphur begin to disturb the cure. Then, it will be proper to give a dose of Nux vomica or of Pulsatilla , according to circumstances - which, after a few days' operation, will dispose the system again to receive a favourable influence from Sulphur.
Patients just arrived from the waters of Aix-la-Chapelle, and who had taken them for several successive years, have been treated with sulphur; and, in spite of the different states in which they were, all of them were either entirely cured or very much relieved by a few doses of Pulsatilla , repeated once in seven days.
Several days after dispensation of this substance, Aegidi observed nocturnal sweatings, attended with a strong smell of sulpureous hydrogen, which kept pace with the patient's cure.
Unfortunately, this valuable remedy is too frequently abused, by giving it in disproportionate doses in allopathic mixtures. But this must not prevent its use when it is apparently pointed out.
Doctor Griesselich, I may observe, of Carlsrue, has been so fortunate as to discover the means of counteracting the mischievous consequences of an inconsiderate use of Sulphur. This means consist in making the patient take a dose of metallic mercury, and to allow this dose to operate several days, in order to induce the vital strength to receive a favourable influence from the Sulphur. This discovery is a very useful one; for we often meet patients, who have misapplied Sulphur , and, were it not for this relief, we should, in a great measure, be deprived of the valuable assistance of this remedy.
The repetition of the medicament is entirely grounded, as we see, on the observation of the phenomena which are revealed in the patient, and the better to appreciate these phenomena, and consequently to learn how to apply the repetition of this medicament, we must rightly understand by what signs we are to judge.
1st. Of the aggravation produced by the remedy.
2d. Of the aggravation of the malady itself.
Jahr says, that an attentive observer will perceive, by the following circumstances, that the aggravation is factitious - that is, what I have distinguished as aggravation of symptoms.
1st. The aggravation takes place without a prior improvement, almost always suddenly, after the space of half an hour, three quarters of an hour, or an hour, in acute and violent diseases; of six, eight or twelve hours, in those which are less severe; and of several days in chronic diseases.
2d. This aggravation is usually attended with accessory characteristic phenomena, which belong exclusively to the remedy dispensed.
3d. If often happens that the phenomena present a continual variation, disappearing as suddenly as they had shown themselves, and lasting altogether but a very short time; that is to say, that they do not endure above one, two, three, or six hours, from their breaking out in acute diseases; and not above three or four hours in chronic diseases.
The natural return of the disease, or what I have distinguished as the aggravation of the disease, is almost always announced in the following manner:
1st. It succeeds an improvement which, for the most part, has declared itself immediately after the remedy, and it usually takes place slowly, after the lapse of half an hour or an hour, in violent acute disorders; of twenty-four or thirty-six hours, in those which are less severe; and from eight to fifteen days in chronic diseases. (Footnote: "Whenever an aggravation," says Hering, "may proceed to a rapid abatement of the symptoms, that effect is generally called the palliative effect, whereas it is, in fact, a transient curative effect, and therefore not palliative according to the meaning of the old school. It is also incorrect to consider as palliative a transient cure of chronic diseases with remedies of short action. Medicines act as palliatives only in large doses, when their primitive action is opposed to the illness. The action of Opium itself, in several species of colic, is not palliative, for it is a positive fact that Opium produces them in its primitive action.)
2d. The return of the disease is accompanied by phenomena of a pathognomonic character of the disease, and frequently signalizing a period already gone by.
3d. The revival of the disease not only persists for a greater length of time, without any change perceptible in its phenomena, but, moreover, it increases daily and hourly.
These remarks are rigidly correct. They have been attested and confirmed by many observers. For my own part, I have experienced them on myself many times, and have had occasion to prove their exactness on a great number of patients.
The importance of these remarks in the action of remedies and the natural progress of the disease, will be felt in proportion as the practitioner shall better understand the necessity of taking for his guide, in repeating the medicament, the observance of the phenomena which occur when the patient is subjected to the influence of any remedy whatever.
The cure of a malady may be interrupted by a particular cause; and this is the place to explain the conduct which the practitioner should in that case adopt. I shall therefore point out the intermediate medicaments in chronic diseases, and examine the circumstances which may trouble their course.
(Boenninghausen, Repertorium de Homoeopathischen Arzneien.)
Coffee. - When there exists too much sensibility, increase of pain in the diseased parts, internal uneasiness, want of sleep.
Hepar Sulph. - Alternately with Nitric acid , in case of over-excitement, after abuse of mercury.
[Magnes. Aret.] - When there exists too much irritability, accompanied with tremor, agitation of the limbs, swellings of the belly, scrupulous anxiety, moral apprehension, and great weakness of the nerves.
Nux Vomica. - When there exists susceptibility or irritability in the nervous system, extreme impressibility on the organs, fear, timidity, a desire to keep one's bed, dread of the open air; violent, peevish, crabbed temper; in find, too quick or too continuous menstruation.
Opium - For cases of nervous insensibility, and a want of reaction on the vital force. Sometimes, also, in these circumstances, may be employed Carbo v. , Lauro corasus, Moschus , Nitric acid , and Sulphur.
Pulsatilla. - In some cases, at proper intervals, taken alternately with Nux to reduce the excess of irritability.
Sometimes, but not often, in this extreme impressibility, use is made of Asarum , Chamomile , China , Ignatia , Teucrium , Valerean, accordingly as either of these remedies happens to be best suited to the entire condition of the patient.
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