Main * A * B * C *
D * E
* F * G
* H * I
* J * K
* L * M
* N * O
* P * Q
* R * S
* T * U
* V * W
* Y * ZPreface. *
Introduction : How to practise homeopathy –
Case-taking – The plan of the Prescriber and how to use it – List of remedies, abbreviations and signs
* Toothache : Repertory and Reversed Repertory.
INTRODUCTION TO THE
PRESCRIBER.
PART I. – HOW TO PRACTISE HOMEOPATHY.
1. Necessary Implements.
2. Comparative Value of Symptoms. The Prescriber and Clinical
Repertory. Cases in point.
3. The Dictionary
of Practical Materia Medica.
4. Bśnninghausen’s Pocket Book.
5. The Scope of Clinical Repertories.
6. Kinds and Degrees of Similarity.
7. Hahnemann’s Doctrine
of Chronic Diseases.
8. The Genius
Epidemicus.
9. The Homśopathic
Materia Medica.
10. Symptom Repertories.
11. Various Materia Medicas.
1. NECESSARY IMPLEMENTS.
THE completion of my Dictionary of Practical Materia Medica and of
its Clinical Repertory since the
sixth edition of The Prescriber appeared, enables me to give more full
directions to my readers than I could before as to the best way to
approach the study and practice of homśopathy. I have therefore decided
to add to the former introductory portion of The
Prescriber a separate essay, which I think will prove useful
alike to the student who is desirous of acquiring the homśopathic art
and to the practitioner who has had to be content hitherto with
fragmentary implements.
The Prescriber
was originally designed to put into convenient and accessible shape all
the more salient indications for the use of homśopathic remedies from
the clinical point of view. This is
the approach which naturally first invites those who have been drilled
in the practice of the ordinary schools. But homśopathy can never be
properly practised by means of a clinical Index or Repertory (such as The Prescriber is in essence) unaided by
other works. The homśopath must have his foundation authority always
ready for instant reference. This authority is the Homśopathic Materia
Medica.It is of the greatest
importance that a clear conception should be formed at the outset as to
what the Homśopathic Materia Medica is. It is so unlike anything known
as Materia Medica in the old school, that it is a pity, as I have
pointed out below, that a different name could not have been found for
it. The homśopathic materia medica consists of a Register of Symptoms. It is the Semiology of Drugs. For the practice of homśopathy
we must know the symptoms which each drug has produced, and we must have
these so arranged that they can be found instantly for any required
region of the body. Hahnemann arranged them, for each of the remedies he
tested, in a definite anatomical order, and this arrangement is the
foundation of the order in which the symptoms are given in all works on
the subject compiled since his day. This is named technically in
homeopathy “The Hahnemannian Schema.”The homśopathic
materia medica thus consists of a schematic
arrangement of the symptoms produced by each drug, together
with amplifications from the observed action of remedies in practice.
When I
commenced the practice of homśopathy I found no little difficulty in
the fact that the works on Materia Medica were too numerous and too
scattered to be readily accessible. The only book which gave a
comprehensive idea of the remedies contained in the homśopathic materia
medica was Dr. Hughes’s Pharmacodynamics ; but this work, whilst
giving much information about homśopathic remedies, is in no real sense
a homśopathic materia medica at all : it contains no Symptom Register of the remedies it speaks
about, and yet, for better or worse, it has had to do duty for a materia
medica for many practitioners ; and as its form is like that of the
materia medicas of the old school, it has appealed very strongly to new
converts.It was the
consciousness that something more was needed that impelled me to
undertake the compilation of my Dictionary of
Practical Materia Medica, which after sixteen years of labour
saw the light. In this work I have given, as Hahnemann has done, the
Symptom Register (or Schema) of each drug, which is the foundation of
the work. In addition, I have given an introductory essay on each drug
which enables the reader to apprehend its main characteristics. At the
head of each remedy, under the heading, “CLINICAL,” I have
given a list of the principal diseases in which it has been used in
practice. At this point I have linked the work to The Prescriber. Among the names of diseases
given under this heading in the Dictionary, I have printed in italics
those under which, in The Prescriber,
the indications for this remedy will be found.In the introductory
article prefixed to the Symptom Register, or Schema, of each remedy, I
have been able to condense the history of the work it has accomplished.
In this way the Dictionary illustrates and illuminates the Schema and
makes the study of the individual symptoms much more easy and
interesting than it otherwise might be. Thus it comes about that the Dictionary comprises a whole library of
clinical experiences which could only be reached otherwise by the
expenditure of much time, labour, and research. Moreover, a great deal
of it could not be found at all ; since it was gathered by myself
in conversations from the great clinicians whom it was my privilege to
know.It has been a source of
very great satisfaction to me that the work was immediately recognised
on its appearance, by those best able to judge, as filling a place that
had long remained unoccupied. On the other hand, the force of old habit
is so strong that many who had contentedly settled down within the
limits of older works have not seen the necessity of enlarging their
borders and accepting the liberty which is within their reach. This is
one reason why at this juncture I think it essential to draw attention
to the way in which the study and practice of homśopathy may and should
be approached.There are many ways in
which the practice of homśopathy may be approached ; some find one
way more suited to their genius, some another. But I am writing now
primarily for those who use The Prescriber,
and will therefore take the approach by way of a Clinical Repertory.I will suppose that my
reader is one who has become convinced of the truth of Hahnemann’s law,
and of the efficacy of his method, and who wishes to avail himself of
the power it puts into the hands of one who can use it ; and I will
suppose, further, that The Prescriber
has been put into his hands a, a ready instrument by means of which he
can put its precepts to the test. With this book at his elbow he will be
able to find, in a case of any disease, the remedies that are most
generally appropriate, with their differential indications. In most
cases he will be able to find a remedy which fits with tolerable
closeness of similarity the case it question, and will thus be enabled
to prescribe. But it will sometimes happen that the differential
symptoms named in The Prescriber are
not sufficient to enable a choice to be made with due certainty. In that
case if reference is made to the Materia Medica, the actual symptoms of
the different remedies can be studied in full, and compared with each
other.At this point it is
necessary to mention the Clinical Repertory to
the Dictionary of Materia Medica. This is a
“Clinical” Repertory and much more besides, as I shall explain
later. But it is different from The Prescriber
in two respects : it names far more remedies under each heading,
and it gives no differential indications. In the Clinical Repertory, under each rubric, the
remedies mentioned in The Prescriber
will be found printed in italics, and those not mentioned therein, in
Roman type. It is thus a complement of The
Prescriber, giving a greatly extended list of remedies under
each rubric, and reference to the Dictionary of
Materia Medica will supply the necessary information to
enable the practitioner to make a choice among them. The Prescriber and the Clinical Repertory together provide as
complete an approach as is possible, I think, to homśopathic practice,
from the clinical aspect.But, after all, this is
only a limited approach-that is, it is an approach to a limited area of
the field. It is the glory of Hahnemann that he liberated medical
practice from its bondage to the names of diseases. Every case of
disease is a problem in itself -presenting a new combination of morbid
phenomena ; the symptom-lists of the homśopathic materia medica
presenting the possibility of finding similar combinations under one or
other of the remedies named. Clinical repertories form one out of many
of the means of fitting the remedy to the case.
2. THE COMPARATIVE VALUE OF SYMPTOMS. “THE
PRESCRIBER” AND THE “CLINICAL STORY.” CASES IN POINT.Before proceeding
farther it will be well to make clear that some symptoms or
disease-manifestations are of much more value than others from the point
of view of selecting the remedy ; and it often happens that those
symptoms which are of the greatest value in correctly naming the
disease, are of the smallest value in diagnosing the remedy. It will be
noted throughout The Prescriber that
in distinguishing one remedy from another great attention is paid to the
Times and Conditions
under which the various symptoms are better or worse–ameliorated or
aggravated. (The sign “>” is used to indicate amelioration,
and the sign “<” aggravation.) This point is often of more
consequence than the actual symptom itself. And yet these
characteristics would give little or no help in the diagnosis of the disease.Perhaps it may help in
understanding the differential value of symptoms and their Conditions or
modalities if I instance a case. Miss T., 60, consulted me on October 7,
1908, about a pain which had troubled her more or less for twenty-five
years. It affects the right side of
the head and right cheek. In the temple are violent sharp shoots of
pain. In the cheek it is a sudden pain, burning as if on fire. It is worst while eating ; worse by touch ; better after eating. It
is worst if the patient is chilled ;
and is sometimes worse at night.In dealing with a case
like this it does not assist us much whether we name the affection
“neuralgia”, “neuritis,” or “Tic
douloureux” -we must deal with it on the strength of its
characteristic symptoms.The first point of
importance to note is the locality
of the pain -it is one-sided, the
side affected being the right.The next point is -it
is a sudden pain- violent, sharp,
shooting, and burning. In this instance the nature of the pain is of
importance on account of the peculiarity of suddenness.The next point is the condition -aggravation by chewing, by the least movement or touch ;
and the last point -aggravated at night.If this patient had
applied to an old-school practitioner all these details would have been
useless to him ; all he would have needed to base his prescription
on would have been the word “neuralgia.” It would have
signified nothing, so far as his prescription went, whether it was right
side, left side, or both sides. It would not have mattered what made it
better or what made it worse, or at what time of day it came on. To the
homśopath these are everything.Turning to The Prescriber, under the heading of
“Neuralgia” will be found a number of remedies affecting the
right side of the head and face, and among them this : “Sudden
pains, especially of right side of the head and face, < by the least
movement or touch, eating or speaking ; < 4 to 8 p.m., Lyc.” Lycopodium
200 was prescribed, and two months later the patient wrote to say
“the pain was relieved in a most wonderful way.”There are other ways in
which this remedy might have been found besides consulting The Prescriber : it could have been
found by the ordinary symptom repertories, and it could have been found
by reference to the Materia Medica itself. The fact that the pain was on
the right side of the head and face
was enough to make any one but slightly acquainted with the homśopathic
Materia Medica look up Lycopodium ;
and a reference to the headings HEAD, FACE and TEETH would quickly
reveal its appropriateness. It is impossible to carry all the symptoms
of the Materia in one’s head, but it is quite possible to remember a
very large number of the characteristic symptoms and modalities (or
Conditions) of the chief remedies. And after all, the best repertory any
one can have is in his own memory. Only it must be possible to
supplement it whenever required. Every remedy has a c umber of symptoms
and modalities which are GENERAL in respect to it. That is to say, they
qualify a very large proportion of its manifestations. So that when the
practitioner meets with them in a patient he will be able to select the
remedy even if the particular
symptoms are not in precise correspondence.And it is the same with
patients. Many patients have GENERAL conditions which belong rather to
themselves than to the particular complaint they may be suffering from,
and when these am present they are often of greater importance from the
prescribing standpoint than the actual symptoms of the disease. For
instance, if the cardinal symptoms of Sulphur
crop up in a patient-sinking at the pit of the stomach at 11 a.m. ;
aggravation of the symptoms at night in bed ; hot hands and feet,
burning on the soles, must put them out of bed to find a cool place –Sulphur will be the remedy for the patient,
no matter what the nature of the disease may be.Under the heading
“CHRONIC DISEASES” in The Prescriber,
I have indicated how this knowledge may be made use of in selecting
remedies. In this way The Prescriber is something more than a mere clinical repertory -it is a repertory of
localities. Under the different
organs and parts of the body named will be found the remedies which have
a specific relationship to them. Further, under the heading MIND will be
found some leading mental symptoms and states, the presence of which,
complicating bodily diseases-or, “concomitant” with them, as
it is technically called in homeopathy-will point to the remedy to be
selected.I will now relate
another case in illustration. J. P., 58, a coachman, was sent to me by
his master on May 10, 1910. He had had severe domestic trouble, and was
suffering from great mental depression, and, in addition, there was pain
in the head. The pain was situated in the vertex, and was greatly
aggravated if he was in the least worried.The second of the five
sections into which the Clinical Repertory to
the Dictionary of Materia Medica is divided is a repertory of
CAUSATION. It is often of great importance to know the cause in which
every state has originated. The effects of a chill, physical injury or
mental shock correspond to different remedies, and the knowledge of the cause is often an important guide in finding
the remedy. On turning to this part of the Clinical
Repertory, under the heading “Worry” will be found
among the remedies Ignatia. As this
patient had had much worry and as his complaint was aggravated by worry,
Ignatia 30 was given. But it did no
good. The reason of this failure was this -although worry was an
exciting factor in the case it was not the fundamental cause. The
complaint belonged to the patient himself. The condition now was ;
head bad ; pain at vertex ; comes any time ; feels it for
a time after getting into bed ; very low spirited. Hands and feet
warm and moist.On referring to the
description of different constitutions under CHRONIC DISEASES in The Prescriber, it will be found that this
patient corresponds to Sulphur in
some of these characteristics : hot, perspiring hands and feet ;
low spirits ; night aggravation. On referring to. Sulphur in the Materia Medica, under section
HEAD it will be found that Sulphur
has numerous pains referred to the vertex. On these indications Sulphur 30 was prescribed, with very speedy
relief to all the symptoms.But the improvement
only went a certain way and then ceased. What next ? There is a
section of the CLINICAL. REPERTORY which I think I use more than any
other, and which I fear most of my readers have not learned to use, or
feel the want of it is the section Of CLINICAL RELATIONSHIPS.In the olden days when
homśopaths had fewer remedies to commit to memory, each remedy was
known much more intimately than it is at present. It was not only known
as an entity in itself-it was known in its relations to its friends. For
example, if Belladonna had relieved
a case of inflammatory or congestive trouble and then ceased to help,
the old homśopaths would know that one of the nearest relations to Bell., and one of its best friends, is Mercurius. And they would naturally think of Mercurius before any other to prescribe in
the case. In mm Repertory of CLINICAL RELATIONSHIPS I have given in
tabular form a list of all the relations of remedies so far as recorded.
This shows at a glance which remedy follows any remedy well -which are
followed well by it, which are compatible, which are complementary,
which inimical, and which antidotal. These lists are not to be regarded
as complete or exclusive, but as far as they go I find them most helpful
and suggestive. And whenever I meet an instance in which one remedy
helps out the action of another in a marked way I enter it on my list
for future use, and this I advise my readers to do likewise.This by the way. My
patient now remarked that although he was much better in himself, he
still had the pain in his head and it was worse
when he had his hat on.Referring now to The Prescriber under HEADACHE, it will be
found that Lycopodium has a headache
at the vertex which is worse when covered.
Turning now to the CLINICAL RELATIONSHIPS of the CLINICAL REPERTORY it
will be found that Lycopodium is one
of the remedies which is compatible with Sulphur. Lycopodium 30 was now given, with complete
relief of these symptoms. The patient’s livery hat was heavy, so it was
particularly trying in his employment.The relief in this case
continued for several months, when an attack of influenza brought back
the old trouble. When the influenza was cured, the old head pain
remained and Lycopodium only
partially relieved it. What was next to be done ? Turn once more to
the Repertory of CLINICAL RELATIONSHIPS under the reference, LYCOPODIUM.
Among the remedies given as “complementary” -that is to say
most closely related in action and helping out each other- is Chelidonium. A reference to the Materia
Medica will show a dose similarity between the two remedies in their
symptoms and Conditions. Chelid. 30
was given, and this completely relieved the patient.Returning now to the
former patient, Miss T., who suffered from neuralgia. In her case also Lycopodium failed on one occasion to control
the pain, and here again the complementary remedy, Chelidonium, came to its aid and removed the
whole trouble, and further illustrated the use of a repertory of
Clinical Relationships.In each of these cases pressure was a condition of aggravation. It
is necessary to be able to reduce to its common denomination on the
instant any symptom which a patient presents to you. Patients must not
be expected to describe their sensations in the bald language of the
repertories. A patient will be more likely to say “The pain is much
worse when my hat is on,” than he will to say “The pain is
aggravated by pressure.” In the same way a patient with right-sided
sciatica will be more likely to say, “I can’t bear to lie on my
right side,” than he will say. “The pain is aggravated by
pressure.” But it comes to the same thing, and many a case of
right-sided sciatica with this modality have I cured with Lycopodium.When The Prescriber fails to indicate the remedy
required for any case, on turning to the same heading in the Clinical Repertory a large number of remedies
not mentioned in The Prescriber will
in most instances be found. For their special indications it will be
necessary to turn to the Materia Medica and compare them one with
another. In compiling the Materia Medica I was able to save much space,
and consequently save my readers much trouble, by placing at the head of
each article a list of the diseases to whose symptoms the drug
corresponds. The necessity for much repetition was thus avoided, since
the leading indications for any remedy are available in any disease,
whatever may be its name, when these are prominent in a patient. But the
list, nevertheless, gives a, good idea of the range of the drug’s action ;
and when the whole of these lists came to be indexed, as it is in the Clinical Repertory, it afforded at once a
valuable approach to the Materia Medica from the clinical side and a
greatly enlarged clinical instrument as compared with The Prescriber. It would be beyond the scope
of the work to attempt to give the differential indications for each
remedy in the Clinical Repertory as
is done in The Prescriber ;
just as it would be beyond the scope of The
Prescriber to have included all the remedies named in the Clinical Repertory. But the lack of
differential indications in the latter is no real loss, since the
Materia Medica supplies them for ready reference and the study of the
Materia Medica entailed in the use of it is pure gain. There is no road to the practice of homśopathy
-whether it is the clinical road or the symptomatic road- which does not entail close and constant study of the
Materia Medica.I have already referred
to the CLINICAL RELATIONSHIPS section of the Repertory
and some of its uses. In homśopathic practice it is often necessary to
modify or arrest the action of a remedy which has been administered. The
means of doing this will be found in the Antidote
column of this section. When more antidotes than one are given, the one
which corresponds most closely to the symptoms of the case which it is
desired to put an end to will be selected.
The late Dr. R. T. Cooper
found great assistance in his practice from utilising the natural
relationship of remedies. For instance, when he had given with good
effect a remedy belonging to a certain botanical species and the good
action came to an end, his next choice was often a remedy from an allied
species, which would carry on the action. In the Repertory these will be found for instant
reference under the section of Natural
Relationships.The Repertory of Causation I have already mentioned ;
this may be also used as a limited Repertory of Aggravation. Causation
and Aggravation are not identical, but they frequently overlap.The other section of
the Clinical Repertory is the
Repertory of Temperaments, Age, and Sex.
In the selection of a remedy it often makes a great difference whether a
patient is young or old, stout or spare, male or female, fair or dark,
nervous or lymphatic. In this section of the Repertory all these points
will be found indexed for ready reference.I may mention a
practical point which I have found a great time-saver. Wherever possible
I block out on the front edges of my Repertories the different sections.
In this way I am able to find with great ease the part I want to refer
to without great turning over of pages.
3. THE DICTIONARY OF PRACTICAL MATERIA MEDICA.
I should like to
add here a few words in regard to my Dictionary
of Practical Materia Medica. I do not offer it to the
exclusion of any other author’s work, but I do offer it as the most
complete and perfect presentment of the homśopathic Materia Medica for
the student and practitioner. It is the fruit of years of labour to
combine within the compass of a single work the material needed for
daily practice, arranged in such a form that all the sections of the
information included are readily accessible and do not obscure each
other. In my work it will not be found that one “cannot see the
forest on account of the trees.” The introductory part of each
article gives the reader in the shortest compass possible, a picture of
the whole drug with the history of the work it has done. So that the
work is just as useful for the student as it is for the practitioner. I
have seen it stated in lists of works recommended for students that my
Materia Medica is a valuable book of “reference” -meaning by
this that it is a book to be referred to now and then. It is more than
that : it is a book for reference every hour of the working day ;
it is a book for the study and the prescribing desk. It was compiled,
first and foremost, for my own personal needs in practice -just as The Prescriber was- and I offer it as the
greatest labour-saving and labour-rewarding materia medica for student
and practitioner which we possess at the present day. With the Dictionary of Materia Medica, the Clinical Repertory, and The Prescriber it is possible too practise
homśopathy -with works which only describe
remedies without giving their actual symptoms this is not possible.
4. BŚNNINGHAUSEN’S “POCKET BOOK.”
The above-named three works I
offer as a minimum stock in trade for the practitioner who wishes to do
justice to his work. But I no less strongly urge on him to obtain other
works as soon as ever he is able to introduce them into his
armamentarium. And first among these is von Bśnninghausen’s famous
Pocket Book. The full title of this work is Therapeutic Pocket Book for
Homśopathic Physicians to use at the Bedside and in the Study of the
Materia Medica. This is, in a sense, the parent of all our Repertories
and an analysis of the Materia Medica. The most convenient edition is
Dr. T. F. Allen’s, for it is in reality a “pocket” book.* [*
Dr. Boger’s large work, Bśnninghausen’s
Characteristics and Repertory, contains Bśnninghausen’s
characteristic Materia Medica as well as the repertories of all his
works combined into one. It is a most valuable compilation, but it has
not the portability and compactness of the Pocket Book.] This work
carries analysis and generalisation as far as these can be carried, and
forms a symptom index of the Materia Medica that is beyond price. My
work has been to approach practice from the clinical side. Bśnninghausen’s
work approaches it from the symptomatic side. His Repertories of
“Sensations” and of Aggravations and Ameliorations have been
of enormous service to many generations of homśopathic practitioners
and will be to many yet to be born. I urgently advise every reader to
procure a copy and to read and reread Bśnninghausen’s Preface -and, incidentally, I may say the
same in respect to the prefaces of my own works to those who possess
them. I will take the liberty of quoting here a passage of Bśnninghausen’s
Preface, which may give my readers a stimulus in their study of the
Materia Medica ;-
“In using
the Pocket Book at the
bedside,” says Bśnninghausen, “much depends upon whether one
is entirely a beginner, or is already somewhat skilled in homśopathy.
But he who knows nothing whatever must, indeed, make a most careful
search for everything without exception. The more he knows, the less he
has to look for, and, finally only to use it here and there to help his
memory. This may be best shown by an example : this I have taken
for the purpose from my most recent practice, wherein the choice of the
remedy was not difficult, and at first seemed very easy, though, through
lack of attention a mistake might very easily have been made. This case
may serve for a beginner in homśopathy to try his own skill.E. N. of L., a man of
about 50 years, of a blooming, almost florid complexion, usually
cheerful, but during his more violent paroxysms inclined to outbreaks of
anger with decided nervous excitement, had suffered for a few months
with a peculiar kind of violent pain in the right leg after the previous
dispersion allopathically of a so-called rheumatic pain in the right
orbit by external remedies, which could not be found out ; this
last pain attacked the muscles of the posterior part of the leg,
especially from the calf down to the heel, but did not involve the knee
or ankle-joint. The pain itself he described as extremely acute,
cramping, jerking, tearing, frequently interrupted by stitches extending
from within outward ; but in the morning hours, when the pain was
generally more endurable, it was a dull burrowing with a bruised
feeling. The pain became worse towards evening and during rest,
especially after previous motion, while sitting or standing,
particularly if he did it during a walk in the open air. While walking
the pain jumped suddenly from the right calf into the left upper arm, if
he put his hand into his coat pocket or his breast and kept the arm
quiet, which was relieved by moving the arm, and then the pain suddenly
jumped back son into the right calf. The greatest relief was experienced
while walking up and down the roam and rubbing the affected part. The
concomitant symptoms were sleeplessness before midnight, frequently
recurring attacks in the evening of sudden flushes of heat with thirst
without previous chill, a disagreeable fatty taste in the mouth, with
nausea in the throat, and an almost constant pressing pain in the lower
part of the chest and pit of the stomach as if something there was
forcing itself outward.No skilful homśopathist
who is perfectly familiar with the action of his remedies will long
remain in doubt as to the correct remedy in this case, with so complete
and accurate a picture of the disease, for all these symptoms together
correspond to a single one, which is thoroughly homśopathic ; but
the beginner will be obliged to look for nearly every symptom and only
after long search will he find the one most fit among the concurrent
remedies. Between these two extremes of knowing and not knowing, lie
many degrees of partial knowledge, which require a more or less frequent
consultation of the book.One person, for
example, knows that the pains repeatedly changing from place to place,
with the fatty taste in the mouth, the sleeplessness before midnight,
and others of the symptoms mentioned belong especially to the action of Pulsatilla, but he is not sure whether the
remaining symptoms also belong to it, and he will not, if he acts
conscientiously, spare the trouble to compare these latter ; but he
will soon see that Pulsatilla is not
the correct homśopathic remedy, because, in addition to the mental
symptoms there are others which are not similar, but, indeed, are
directly contradictory to it.Another person who has
studied more the peculiarities of the pains distinctly remembers that China corresponds to the paralytic and
bruised pains as well as to the jerking tearings, and the stitches from
within outward and to the pains jumping from place to place. In
addition, he believes that also symptoms like sleeplessness before
midnight, the aggravation during rest, as well as the relief from motion
and rubbing, together with the flushes of heat with thirst, correspond
to this drug, but because he does not know, he also must consult the
books ; and he will soon meet with contradictions, just as the
previous one did, and he will see clearly the unfitness of China for the case.Neither of these two,
however, ever think of administering to the patient a remedy whose
curative power in this case is so improbable ; but as conscientious
homśopathic physicians they will look further and compare, and by the
help of this book they will soon find, without great difficulty, the
only really indicated homśopathic remedy.But even a third
physician, educated in homśopathy, one who recognises the
contra-indications of Pulsatilla, China, and other concurrent remedies, does
not know sufficiently that Valeriana
corresponds to the chief symptoms, and in order to be perfectly sure
about this rather infrequently used remedy, he will quickly look up the
few doubtful symptoms, and convince himself that this drug among all the
known medicines, is the best adapted to this case, as was proved by the
result ; for after a single very small dose exhibited in a high
potency in water, the whole trouble, with all the concomitant symptoms,
was completely removed in three days.”I leave my readers,
after perusing this case, to make up their minds as to which of Bśnninghausen’s
degrees of knowing and not knowing they consider that they belong.In conclusion, I will
repeat that there is only one road by which success in homśopathic
practice may be attained, and the name of this road is -Work. It is only
hard application, intelligent and unremitting, that can ensure success
in the mastery of the infinity of details comprised in the homśopathic
materia medica. The result is worth all the labour and very much more
besides ; but I would seriously warn off at the outset all who
think they will find in homśopathy an easy road to the cure of the
sick. It is possible by the improvement of our instruments to make the
practice of homśopathy less arduous than it is at present, but like
every other great and good work it can never be made easy.
5. THE SCOPE OF CLINICAL REPERTORIES.
The Prescriber
was designed primarily for the beginner in homśopathic practice by one
who had felt the need of a work of the kind when he became convinced of
the truth of the homśopathic law. As all British homśopaths receive
their training in allopathic schools, it is inevitable that allopathic
ways of looking at things should to a large extent prevail for some time
after their graduation or conversion. In the old-school text-books
remedies are considered in relation to diseases :
in homśopathy remedies are considered first and foremost in relation to
individuals. In homśopathy when the
cardinal symptoms of a remedy are marked in any case, the name of the
disease the patient may be suffering from is of no weight whatever in
determining either for or against the selection ; the remedy which
corresponds to the symptoms of the patient must be given, and if the
case is curable it will cure. To give an example, I may relate a case as
it was told to me. A patient suffering from pneumonia had gone from bad
to worse under homśopathic treatment based on nosological lines, when
it was decided to call in further help. The consultant on entering the
room observed the patient shrink away from him in great fear. He found
him collapsed and cold, with cold sweat on his forehead. He said to the
other attendants that he would take their word for all the rest of the
patients symptoms ; there was one medicine that would cure the
patient and one only, and that was Veratrum
album ; and Veratrum album
very speedily did. Veratrum had not
been given in the case before because it was not recognised by those in
attendance as a pneumonia remedy. In a very severe case of
pleuro-pneumonia of my own I rapidly cleared up all the dangerous
symptoms with Stramonium, to which I
was led by the delirium of the patient, in which he saw animals about
his bed, and especially a large black dog. The patient was a youth and
there was no question of alcoholism in the case. One of the best cures
of rheumatic fever I ever made was with Ignatia,
which was given because of the mental concomitants in the case :I mention these
instances to show that however valuable a clinical repertory may be, it
can never be paramount in homśopathy ; and whilst The Prescriber may seem to justify the
allopathic arrangement of medicines as remedies for diseases, I only
offer it as one, and that the most elementary, of the methods by which
the similar, that is to say, the homśopathic remedy may be found. For a
clinical or nosological repertory is perfectly justifiable from a homśopathic
point of view, provided its limits are clearly understood. Names of
diseases correspond to well-defined groups on the symptom-record of
various medicines. The Prescriber
shows at a glance what these medicines are, and how they are to be
distinguished from each other. Thus in a very large number of cases a
closely similar, if not the most similar remedy may be found.
But whilst
offering The Prescriber as the most
natural step in homśopathic practice to an allopathically trained mind,
and as a convenient remembrancer to older homśopaths, I wish most
strongly to insist that readers shall make themselves superior to it and
independent of it by a thorough acquaintance with the materia medica and
by making themselves proficient in the use of symptom repertories.
Classical works like those of Bell on Diarrhśa,
H. C. Allen on Intermittent Fever,
Minton on Uterine Therapeutics, all
give elaborate and detailed repertories of symptoms compiled on a
clinical basis, enabling the reader to find by their means the most
similar remedy. The scope of The Prescriber
does not permit of my doing this in respect to all diseases, but I have
adapted from Hering his excellent repertory to Toothache
(which has often enabled me to find the remedy), and I give this in its
proper place as an example of the kind, and as an exercise for junior
homśopaths in the use of the more advanced methods. Although primarily
arranged as a repertory for Toothache
it is equally available for neuralgic pains affecting the face and head
whether connected with diseases of the teeth or not.
6. KINDS AND DEGREES OF SIMILARITY.
A homśopathic
practitioner must perforce be original if he is to achieve any great
measure of success. No two cases are exactly alike, and he must be
prepared to adapt his means to any case that may arise, and happily
there is in homśopathy scope for the exercise of a great variety of
talent. In most cases there are more remedies than one that will benefit ;
and if the exact simillimum is not found, the next or the next to that
will give a measure of help ; so the beginner need not abandon the
ideal as too difficult of attainment. Then there are many different kinds of similarity,
as well as of degrees, and every
kind is available for the prescriber’s use. There is similarity between
drug anti disease in organ-affinity ; in tissue-affinity ;
there is similarity of diathesis ; similarity of sensations and
conditions-all these and other kinds of like-ness
are available for the prescriber to find his correspondence in :
and he is no friend of Hahnemann, or of Hahnemann’s system who would tie
up practitioners to any one of them.
7. HAHNEMANN’S DOCTRINE OF CHRONIC DISEASES.
Hahnemann’s discovery
of the nature of chronic diseases is evidence that his mind was not
closed to further progress, as it well might have been, by the
transcendent importance of his discovery of the homśopathic law.
Finding that certain cases were only temporarily benefited by remedies
which seemed to correspond accurately with the apparent symptoms, he was
led to note that there were points of importance in the cam to which
they failed to correspond. In the cases referred to there was the fact
that the disease manifestations, though taking the form, it might be, of
an ordinary acute illness, were really only one event in a series ;
and it was necessary to find remedies corresponding to the series, if a cure was to be affected. For
instance, an attack of asthma may look, and generally does look, like an
isolated event in a patient’s history. But inquiry will probably
discover that the same patient has at a former period suffered from a
skin eruption, a diarrhśa, or some other affection. All these are not
many diseases, but varied expressions of one morbid taint. In the case
of syphilis a sequence of disease-manifestations was known to exist.
Hahnemann added to this two others-“sycosis,” or the
“miasm” whose keynote manifestation is the appearance of
fig-warts, and the origin of which is often traceable to constitutional
gonorrhśa ; and, chiefly, the “miasm” which he called
“Psora,” whose keynote is the appearance at some period of the
patient’s history of an itch-like eruption. Without going into the
question of how far Hahnemann was right or wrong in his explanation of
the genesis of this miasm, there can be little doubt (in my mind there
is none whatever) that he was right in the main fact. Old-school
medicine has confirmed his observation in respect to the constitutional
nature of gonorrhśa, and the “herpetic diathesis” of French
writers is only Psora doctrine in another form.And I may here point
out that it is necessary to bear in mind the particular meaning attached
to the word “chronic” by Hahnemann in the phrase “chronic
diseases.” He did not use it in the ordinary sense of
“long-lasting” ; he meant a disease which was due to a
poison (or “miasm,” as he called it) which had a chronic evolution, just as the poison of
scarlatina, for example, has an acute evolution.
Syphilis is a “chronic disease,” in his sense whether the
manifestations are acute or whether they are long-lasting.
“Psora,” is a chronic disease in the same way, though
sometimes its manifestations are intensely acute. Another difference
between an acute and a chronic miasm is that the acute naturally ends in
complete recovery or in death ; whereas a “chronic” miasm
continues to act in varying or alternating ways throughout life unless
it is cured by proper treatment.Having discovered the
existence of a chronically operating poison in the essential character
of certain diseases, it was necessary for Hahnemann to find remedies
which had corresponding chronic action in order to obtain complete
similarity. These he found in the remedies named by him anti-sycotic,
anti-syphilitic, and chiefly, and-psoric. Since Hahnemann’s day much has
been done in tracing out the lie-history of morbid diatheses, and there
is no necessity to limit the number of chronic diseases to the three he
described. It is open to original minds to find other miasms and their
similars. The use of the nosodes in homśopathy, and the use of
“vaccines” and “serums” in allopathic imitations of
homśopathy are instances of possible developments on these lines.But no matter what may
be the plane on which the points of similarity are sought and obtained,
the individual symptoms of each case must in the last resort determine
the choice of the remedy. It is not a matter of giving an
“antipsoric” for a case of psora ; if the case is indeed
a psoric case, though some good may be done with a medicine whose
disease-making action is not of the psoric order, the case will not be
cured. The division of remedies into antipsoric and non-antipsoric is a
convenience for narrowing down the choice, as the “chronicity”
is the most important feature to be matched ; but the choice of the
particular medicine of the group is determined by the individual
symptoms of each case. Hahnemann’s doctrine of chronic diseases is from
first to last one of practical
import.
8. THE GENIUS EPIDEMICUS.
The doctrine of genius epidemicus is another practical aid in
prescribing. Just as one proving gives only a partial idea of a drug, so
one case of an epidemic disease gives only a partial idea of the
disease. It is perfectly legitimate homśopathy to take a number of
cases and having found the drug disease which corresponds most closely
to the disease in all its developments, to give that drug in a routine
fashion to all cases which do not manifestly call for some other drug.
The use of Baptisia in this way in
the influenza epidemics has saved me a great deal of brain-work and has
cut short, often in a few hours, many an attack of the, disease. That
does not mean that I have given no other remedy, on the contrary, I have
had to use in some case or other almost every remedy in the materia
medica ; but the knowledge of the doctrine of the genius epidemicus has saved a vast amount of
trouble, nevertheless.
9. THE HOMŚOPATHIC MATERIA MEDICA.
The last court of
appeal, when the choice of a remedy is not clear, is the Homśopathic
Materia Medica. In the homśopathic materia medica, as I have already
shewn, the symptoms belonging to each remedy are arranged in a certain
order, namely, under the headings of the different anatomical sections
in which they have occurred, so that the practitioner can find at once
any symptom which has occurred in any particular part of the body. All
the Eye symptoms, for example, are given in the section “Eyes” ;
all the Stomach symptoms in section “Stomach,” etc. There are
some who regret that Hahnemann did not keep his provers’ day-books and
publish them instead of this classified list of symptoms (which is known
in homśopathy as The Schema). This regret would be justified if the
symptoms were not available in their individual capacity and did not
admit of re-combination to an infinite extent. But a definite symptom is
available for its value, just as a definite coin is, independently of
the particular mint from which it may have been issued. It is this which
renders homśopathy the flexible and adaptable instrument that it is ;
and it is this which makes the Symptom Register
the essential of the homśopathic materia medica.Furthermore, the
symptoms are not only available in their individual capacity, they will
bear reducing to their elements and still be available, just as the
symptoms of a patient will bear the same reducing. For instance : a
patient complains that he was seized with violent pains in the back
immediately on stepping out of a bath. The bath here was evidently the
determining condition. But the bath is not the essential
of the symptom, the essential is the wetting.
On referring to a repertory, it is under the heading, “Aggravation
by wetting,” that the corresponding remedy will be found and
probably not under bath. In this
case Rhus was the remedy.
Conversely, take the example of Aloe,
which has this symptom : “Just before getting into bed, sudden
explosion and clashing in l. ear, as from breaking of glass ; the
clash of the glass was heard at the bottom of the head, and extended
thence towards r. ear.” If that symptom were met with in a patient,
or any symptom closely resembling it, Aloe
alone would cure ; but the symptom may be generalised and utilised
(and I have so utilised it) for sensations of explosions in the head, or
a noise as of something breaking. Should a symptom like this occur when
the remaining symptoms seem to indicate Aloe
equally with other remedies, its presence would determine the choice.
10. SYMPTOM REPERTORIES.
This brings me to speak
of Symptom Repertories, and among them Bśnninghausen’s Pocket Book, as I have already said, holds a
place of very great importance. Bśnninghausen realised and demonstrated
the legitimacy and the utility of paraphrasing and generalising symptoms
and their Conditions, and his lists of Conditions of Aggravation and
Amelioration, of Sensations, of Desires and Aversions are invaluable.It frequently happens
in practice that a symptom is wanted with some peculiar Condition of
aggravation or amelioration. Several medicines are found having the
symptom, but not one with the Condition. On referring to Bśnninghausen,
one of them is found in the list of remedies having that particular
Condition, though it had not been noted in connection with the symptom
in question ; but that does not destroy its appropriateness. Bśnninghausen
showed that when a medicine manifested any symptom occurring under any
peculiar Condition, that Condition might, and probably would, indicate
the medicine when the same Condition appeared qualifying any other
symptom. At any rate it would determine the choice of one of several
remedies, all of which had the symptom but only one the Condition.It is the same with
peculiar sensations : the sensation may have bean experienced in
one part of the body in the prover, but that does not destroy the
remedy’s appropriateness should the identical sensation appear in a
different part in the patient Hence the utility of Bśnninghausen’s list
of Sensations.The Totality of
Symptoms insisted on by Hahnemann as the basis of correspondence does
not refer only to their numerical sum, but to their relative importance.
It is not every sensation of a patient that constitutes a symptom from
the prescribing point of view. In every case the practitioner has to ask
himself what the points are on which he intends to base his
prescription. It has been said that if three leading characters of a
case are found under a given remedy, there is a “three-legged
stool” on which a prescription may be based with every chance of
success.There are some classes
of symptoms which are more important than others to be matched, and it
may be useful to indicate some. Without attaching much significance to
the order, I should name these as of especial importance : (1)
Mental concomitants with bodily diseases. (2) Very peculiar symptoms and
very peculiar combinations of symptoms. (3) Precise localities. (4)
Course and direction of pains and sensations. (5) Alternating symptoms.
(6) Conditions of Time : Periodicity and the occurrence of symptoms
at particular times of the day or night, or phases of the moon or year.
(7) Conditions of Temperature, sensitiveness to heat and cold, and
aggravation or amelioration by change of temperature, and at the various
seasons.
The use of
repertories is in itself an art which the homśopathist must diligently
cultivate. I cannot say that I find any one entirely satisfactory. The
plan of the Cipher Repertory
(excluding the cipher) is to my thinking the best ; but this is not
complete, and many of the completed portions are long out of date.
Gentry’s Repertory is the easiest to
use, and I should be sorry to be without it. Kent’s great Repertory is the fullest and most
satisfactory. Among other repertories, Lippe’s, that of Curie’s Jahr, and Winterburn’s Pocket Repertory may be named. The Index to Allen’s Encyclopćdia
is indispensable to those who possess that work. There is also a Repertory to Hering’s Guiding Symptoms.
11. VARIOUS MATERIA MEDICAS.
Among materia medicas,
all who can should possess Allen’s Encyclopćdia
and Hering’s Guiding Symptoms. The
former contains all the symptoms of the Materia
Medica Pura and of the Chronic Diseases of Hahnemann.
Dudgeon’s translation of the former is the best in the English language.
Among works about the materia
medica, Farrington’s Clinical Materia Medica
and Dunham’s Lectures on Materia and
Kent’s Lectures are admirable works.
Dudgeon’s translation of the Organon
should be in every library. The want of a full materia medica, giving a
full Schema and an explanatory introduction had been long apparent to
me, and I endeavoured to supply the want by my Dictionary
of Practical Materia Medica. A thorough knowledge of the
materia medica is only to be gained by persistently
using it ; by persevering search for the most similar
remedy for every case which arses, whenever the remedy is not at first
obvious to the prescriber. The search will not always be crowned with
success, but let not the practitioner be disheartened by this ; the
search itself is of use to him as it will have helped to make him
familiar with his instruments, the materia medica and the repertories.The knowledge of
remedies in homśopathy is like the knowledge of words in speaking a
foreign language. The beginner in homśopathic practice should, in the
first instance, make himself absolute master of some dozen of the most
widely useful remedies, with all their characteristics and
peculiarities, of the conditions under which their symptoms appear and
cease, and of their special times of occurrence, if they have any. The
following is a list I recommend, the medicines being named in the order
of what I regard as their importance : –Sulphur,
Lycopodium, Calcarea,
Arsenicum, Thuja,
Aconitum, Nux
vomica, Pulsatilla, Silica, Hepar,
China, Belladonna,
Bryonia. An accurate knowledge of
the symptomatology of these drugs will enable the practitioner to deal
successfully with the majority of cases he meets. But it will also do
more than this for him ; it will give him a solid basis on which to
build up a knowledge of the rest of the materia medica.
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