The peculiarities of chronic treatment

- BENERJEE.P

"patience" for the patient and "patience" for the physician. 

There are many peculiarities in the treatment of chronic cases. They are patience, time, and correct selection of the medicine and its potency, and last of all-observation. But, of all "patience" is the most important-"patience" for the patient and "patience" for the physician.
 There are also some obstacles in the way of chronic treatment, and of them the ignorance of the mass is the main. This is almost an insurmountable obstacle and it can only be mitigated by a gradual educating of the people, and unless this can be done, the great gift of Hahnemann, the true method of treatment of chronic diseases will go untasted and unused. People only know that the treatment of a case may take 10, 15 or 20 days, and they are unable to conceive how Homœopathy should take years and years. They are ignorant of the fact that the effect of Homœopathic treatment of a chronic case is "Cure" while that of Allopathic treatment is "Suppression"-a disappearance of the disease symptoms only. They are ignorant of the fact that in the Allopathic method there is nothing for such a far reaching course of treatment-a course of treatment that touches the very principle of life, and not a treatment that deals with the physical expressions of that principle. Unless all these mysteries are explained to the ignorant people, they can not possibly be in a position to understand why the Homœopathic course of treatment of a chronic disease is so lengthy. It has therefore been my policy always to explain the method to the patient and his guardian before taking up his case. And if I find that there is not the required patience on their part, I do not take up the case at all. This of course means some loss to the physician. But the fact is that the physician who makes money his object cannot treat chronic cases. "Cure" must always be his object-hard labour and cure. Of course there are cases in which the physician is adequately rewarded for his hard labour. However, to the point. In the treatment of chronic cases, "patience" both for the physician and for the patient is an indispensably necessary condition.

 But why are so much time and patience necessary in this kind of treatment?-The first thing is the preparation of the record. Hahnemann has laid special stress on the necessity as also on the method of preparing the record. And it consists in recording the symptoms so as to make out a picture. It is by no means a mere clerical work. Just as the painter draws the sketch of his subject with some lines, similarly, the Homœopathic physician also will have to paint the picture of his patient with the symptoms. The lines are the language of the painter and the symptoms are the language of the Homœopathic physician. The painter must have an art so that the sketch he draws may indicate his subject. Similarly, the physician also must have his art so that the record of symptoms he prepares, may indicate his patient and none else. If he simply records a catalogue of symptoms, it may be the picture of a patient, but it may not be the picture of the patient whom he wants to represent in his record. It is this that constitutes his art, and it is essential in preparing the record. Unless this art is there, unless the record prepared indicates the particular patient whose symptoms have been recorded, it is no record at all, though ten or even twenty pages of symptoms may have been recorded. Now, imagine what amount of time and patience are necessary for preparing such a record. The preparation of the record is no clerical work. It is the art of an artist.

 The second thing is the selection of the medicine. This is also a very very difficult business, and it demands a thorough knowledge of the Materia Medica. Not only this, but also an unprejudiced mind, so that it may be possible to make a correct selection free from all bias.

 The third thing is the selection of the potency and it is even more difficult than the selection of the medicine. I have seen many Homœopaths who keep only two or three different potencies in their boxes. But I wonder, how they can manage their cases with such poor equipments. In my humble opinion, every true Homœopath who ventures to take up chronic cases must have at least the following potencies:-30; 200; 500; 1,000; 10,000; 50,000; and c.m.
 And yet there may be cases which would require potencies even higher than these. However, let us now see, by the way, if there is any method which can be followed for determining the potency. It is admitted by all that there is none. But this cannot be so. Some method there must be, though it is difficult to explain and still more difficult to understand that, because a generalisation in the matter of selection of potency is not possible, each individual case being its own standard for ascertaining the same. Yet, some idea as to how the potency in a given case is ascertained has to be given, particularly for initiating the new learner into this difficult part of Homœopathic treatment. Unless some broad hints for selection of potency are laid down, it is not possible for a new learner to undertake this work with accuracy and precision. I will, therefore, try some hints below, though it must be understood that they are by no means to be followed with rigidity. The prescriber must gradually understand this difficult work from a study of each individual case he may take up.

 (1) In cases where the patient is sensitive physically or mentally (e.g. , where he is easily vexed or agitated in mind, or is subjected to some illness on the slightest provocation), low potencies, should always be used whether in acute or in chronic ailments. For acute ailments 6th, 12th, and 30th are low potencies here, and for the chronic, 30th, 200th or 1,000th at the most are low potencies.
 (2) Where however, the patient is not sensitive as above, the 30th potency and not below this, should be used in acute cases. Neither should potencies above the 200th be used. It is safe to begin the treatment of acute illnesses of such patients with the 30th and to gradually go up to the 200th. In chronic cases of the patients of this type, potencies below the 200th, should never be used. Treatment of such chronic cases should almost always be begun with the 200th, and the potency should only be gradually increased to 1,000th, 10,000th, 50,000th, and c.m.  etc, as demanded by the circumstances of the cases.
 (3) Really homœopathic action of drugs is seldom available from potencies below the 200th. It is only in very rare cases that such action is available from the 30th potencies. As however our business is only a homœopathic fitting of the drug to the case, every endeavour should be made to begin chronic cases with the 200th potency and not lower than this. That is to say, that unless there is anything positive to point to a lower potency, either in the shape of the sensitiveness of the patient or in the shape of lack of vitality, the 200th and not any other lower potency should be preferred for beginning the case.

 (4) In extreme cases, where the vitality of the patient may be very low, it is safe to begin with potencies as low as 6th or 12th. In such cases, potencies higher than these should be used with caution and gradually only.
 (5) In cases of suppression, e.g. , of some discharge or some eruption, and where these have to be brought back for effecting a cure of the patient, the 6th or 12th potencies are worse than useless, because no suppressed eruption or discharge can be brought back with them. The 30th also is useful in very rare cases. The 200th generally may bring back such suppressions. But when the case of suppression is a very old one, e.g. , a gonorrhœal discharge of long standing, the 200th even is a low potency. Only potencies like 1,000th, 10,000th, 50,000th and higher may bring back suppressed conditions. The potency in such cases is always in proportion to the chronicity of the case. The older the suppression, the higher is the potency required for bringing it back.
 (6) In incurable cases, which have therefore to be palliated only, very low potencies should be used. The 6th and 12th only are generally suitable in such cases, and the 30th even should not be resorted to in most cases.

 (7) If any medicine is required to be given to pregnant ladies with the object of freeing the child in the womb from the miasmatic affection of the parents, it should not be given below the c.m.  potency, provided the condition of the mother's health does not indicate otherwise.