The epitome of homoeopathic philosophy

-WRITE HUBBARD.E,
Homoeopathic philosophy may be divided into three sections, the theoretical, dealing with how and why remedies act, which is so abstruse that it can best be dealt with by the more advanced student; the didactic, meaning the rules and tenets; and the practical, which comprised the art of applying the rules in prescribing for the actual patient, understanding the results, and following through the subsequent prescriptions to cure.
First, let us take a bird's eye view of the didactic aspect. Health, to the homoeopath, is a state of harmony between the parts of the body and also between the person as a whole and the cosmos. In real health the as yet unexplained life force in each person is vigorous. It is usually spoken of as the vital force, which in disease is the true curative power. The object of giving the similar remedy is to stimulate the vital force. The object of hygiene and mechanical intervention is to clear it path of obstructions. No remedy can cure disease, it can only at best enable the vital force to function properly again.
Disease, to the homoeopath, is a state of disharmony involving at least three different factors, some morbific influence, the susceptibility of the person affected,; and the individuality of the patient modifying the form the disease takes. Homoeopaths do not try to cure the morbific influenced but to cure the patient himself. In order to cure the patient the most similar remedy must be given.
Symptoms, to the homoeopaths, are the language of the body expressing its disharmony and calling for the similar remedy. For prescribing one must take the totality of the symptoms, which includes the mental symptoms; the "generals", predicated of the patient as a whole, which include his reaction to meteorological conditions, time, bodily functions, food, etc.; the particulars, predicated of any part of the patient, and the "modalities" of these (that is, what aggravates or ameliorates), and especially such particulars as are "rare, strange or peculiar"; the causative factors, such as ailments from grief, wetting, riding in a cold wind, suppression of menses, etc.; and the pathological symptoms, indicating the elective affinity of the remedy for certain tissues or organs.
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Homoeopathy regards acute disease as an eliminative explosion,; which, if handled in the proper homoeopathic manner leaves the body in a healthier condition. This does not mean that the acute disease should be allowed to run its course, for if the symptoms are met at this inception by the simillimum the disease will be aborted and yet the economy will be purified. No acute case under homoeopathic treatment from the beginning should die, and there should be no permanent sequelae. Acute epidemic diseases often run to one or two epidemic remedies which vary as the disease shifts geographically. In this connection the epidemic remedy is an admirable prophylactic, although the chronic constitutional remedy is always the best preventive. Sequelae following acute diseases are not strictly speaking part of the acute trouble but are flare ups of chronic disease aroused by the acute condition.
Chronic disease is not self limited and shows no tendency to ultimate recovery if untreated. This is the unique sphere of homoeopathy. Practically every one has some symptoms of latent chronic disease, and to the homoeopath chronic disease is the basis of susceptibility. By taking the totality of the symptoms from birth on, a deep-acting, chronic constitutional remedy can be chosen which will aid in fending off future acute disease and remove may inherited and acquired encumbrances to the vital force. Hahnemann divided chronic diseases into three main categories or "miasms", psora, syphilis and sycosis. These may appear singly or in combination with each other or with drug disease engrafted by improper treatment. This matter of the miasms is the most difficult and moot question in homoeopathy but the fundamental thesis of the importance of chronic disease in general is essential.
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Having prescribed for chronic disease, if you have given the true simillimum, the symptoms are cured in accordance with Hering's three laws of direction : From within outward, from above downward, and in the reverse order of their appearance. This is never the case in chronic diseases untreated by homoeopathy, therefore when observed one can be sure that it is the remedy which is curing and that the correct remedy has been found. Hering's laws are so important that we will give an example : A rheumatic fever case, where the joint symptoms have disappeared and the heart is affected receives the simillimum. The heart improves, pains return in the shoulders and elbows, these disappear and the knees and ankles are involved, these in turn pass off and the patient entirely recovers. The symptoms went fro within outward (heart to joints), from above downward (shoulders to knees), and in the reverse order of their appearance (heart to limbs instead of limbs to heart). If the symptoms do not go in this order the remedy is wrong. When a patient on a chronic remedy develops a different symptom search back in your record or question your patient rigorously to determine whether this is the recurrence of an old symptom (a good sign, in which case no further remedy should be given). If it is not an old symptom search the pathogenesis of the remedy given. IF the symptom appears in the proving give nothing, if not, the choice of the remedy must be revised.
These laws of cure may or may not apply in acute disease, usually they do not. If the picture of a chronic disease includes a suppression, especially if the suppression is due to crude drugging, the chronic remedy acting according to the third law of cure will sometimes restore the original discharge or eruption. The percentage of cases in which this return is from the original channel is relatively low. With good prescribing, however, some exteriorization takes place even though this may only be a diarrhoea or a coryza. One of the times when any practitioner most needs a thorough knowledge of homoeopathic philosophy is when, after chronic prescribing he is faced with such a discharge having more or less acute symptoms. He must then decide whether this is a return of an old trouble in its original form, or a compensatory vent or a new acute disturbance, or an aggravation. If it is the first he should wait and give Placebo, explaining the process to sustain the patient's morale. If it is the second he should attempt to do the same. If, one the other hand it is the third, or the second is too annoying to the patient or even dangerous, one should prescribe an acute remedy and give it in low potency (thirtieth or even the twelfth, surely not above the two hundredth). After this the action of the chronic may not even have been disturbed. Often the acute remedy called for will be found among the acute complements of the chronic remedy. If, in the fourth case, the disturbance is merely an increase in one of the patient's complaints, or is found under the pathogenesis of the chronic remedy given, it can be classed as an aggravation and should receive no medicine, except Placebo, unless dangerous as above. If it is so serious as to threaten life, owing to the chronic having been given in to high a potency, an antidote may be in order. The selection of the antidote will be taken up in a later lecture. The great point is not to mix up your case and spoil it by giving unnecessary remedies.
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In addition to acute and chronic diseases there are, of course, diseases due to drugging, or to bad hygiene and there are diseases which have ultimately themselves in pathology calling for surgery, and also troubles which are primarily surgical like foreign bodies, fractures, extra-uterine pregnancy, etc.
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A word should be said her about pathology and surgery. From the homoeopathic standpoint much of pathology is protective, abscesses, ulcers, tumors are an effort on the part of the vital force at localization and extrusion. Such pathology should not be removed by surgery until after the sick constitution which produced such pathology has been cured. Often in the course of cure the pathology will shrink or be absorbed. If not, it remains as a foreign body and is a subject for surgery. Its removal before the cure of the constitution simply means that, balked at that outlet, the vital force will seek another one, either by recurrence in the same form or by more deep seated trouble. As to surgery, some of the orthodox homoeopaths hold that any surgery that is not merely a mechanical adjustment (such as ventral suspension of the uterus) is a definite bar to cure, the idea being that in the unravelling of the disease it gets back to where the knot was cut by surgery and can go no further. It requires the keenest judgement to decide when a case has gone to far to be relieved by remedies, and emergency surgery is indicated in a crisis. The homoeopathic remedy should always be resumed after the surgery.
In any of these classes of disease where they have been wrongly treated one should include the symptoms of the patient before the incorrect treatment, in other words original symptoms, in the totality.
Having glimpsed the didactic aspect we must run over practical philosophy. The unique law which is the basis of all homoeopathy is similia similibus curentur. How we arrive at this equation, the actual studying of drugs and patients is the province of later lectures. The actual handling of case after the first remedy has been selected is the more difficult part of homoeopathy. First is the necessity of giving the single remedy. This precludes the use of compound tablets, alternation of remedies, unhomoeopathic adjuvants such as cathartics and anodynes, etc. In a case where the miasms are mixed it may be impossible to cover the totality of the symptoms with one remedy. In such a case observed which miasm is, so to speak, on top and prescribed for the totality of symptoms of that miasm, and when these symptoms are cleared off the layer beneath, representing, by a single remedy. Sometimes the remedy indicated may be one which has power over all the miasms, as for instance, Nitric acid. The single remedy does not mean that only one remedy should be sued throughout a case, although that is the desideratum, but simply one remedy at a time. It cannot be too often stated that one must not give a remedy lightly nor change it frequently. In acute diseases the single remedy at a time still holds although the remedy may have to be changed as the case develops, in which case some of our master prescribers hold that the original remedy may be indicated again at the close of the cycle to complete the case. Further details on the single remedy will come up in the lecture on prescribing.
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Next in importance to the selection of the single similar remedy is the question of dosage. The classic rule is "the minimum dose". We prefer the term the optimum potency meaning the potency on a plane most similar to that of the patient at the moment in question. Hahnemann's original choice of the word minimum served two purposes, first, to discourage the enormous crude drugging of his time, and secondly, to point out that the high potencies have a different action from crude drugs. The whole potency question will be discussed in a later lecture in full.
The question of repeating the dose is the next in importance. As a simple rule for beginners high potencies should be given in one dose with Placebo, the low potencies, 30th, and under may need repetition. After giving the single dose of the single similar remedy the student must watch and wait. The duration of action of remedies and the factors influencing it will be discussed later. The general rule is to give nothing more than Placebo while improvement continues, in other words as long as the patient himself feels increasingly better regardless of the accentuation of certain symptoms. The beginner must learn not to try to make a good thing better by repetition as this defeats itself. According to the case, the potency and the remedy, the need for repetition may occur in from a few hours in acute disease (or a few minutes in desperate cases) to weeks, months and even a year or more in chronic cases, although waiting is perhaps the most difficult lesson for the eager homoeopath. He must wait with knowledge or valuable time will be wasted. How is he to know whether the remedy is the right one or is till acting? In acute cases the general well being of the patient should be apparent in from a few moments to two or three days. In chronic cases it varies from a few hours to several weeks sometimes, indeed, it is only apparent after the second dose. In chronic cases Hering's law of cure mentioned earlier in this paper, will show you whether you are on the right track. It is at this point, while watching the action of your remedy, that you must understand the subject of homoeopathic aggravations. An aggravation is not necessary to improvement, but it often occurs even with master prescribers. The usual cause of severe aggravation is an error in the potency or the presence of marked pathology. Aggravations are of two kinds, disease aggravation and remedy aggravation. The first of these is merely the natural progress of the disease and does not concern us her. The second or remedy aggravation, which is a sort of house cleaning, is indicative of the prognosis of the case, and has about twelve recognizable forms which will be discussed later. Due allowance for aggravation must be made before considering repetition of the dose. A general rule is that even during aggravation, the patient, as a whole, in himself, feels better.
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The subject of the second subsequent prescriptions, one of the most important in the subject homoeopathic philosophy, will be better understood in connection with prescribing later on.
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Another very vital point in the homoeopathic philosophy is that of suppressions. The causation of suppressions are dependent on so many factors; the results of suppression untreated so dire, and frequently unrecognized; and the results treated so brilliant, that a complete lecture will be devoted to this subject.
To present homoeopathic philosophy lucidly and logically to a novice is well nigh impossible. The student is urged to read and re-read the appended list of books.
reading list
Lectures on Homoeopathic Philosophy by James Tyler Kent, M.D.
The Genius of Homoeopathy by Stuart Close, M.D.
A Synopsis of Homoeopathic Philosophy by R. Gibson Miller, M.D.
The Organon by Samuel Hahnemann, M.D.
Homoeopathy the Science of Therapeutics by Carroll Dunham, M.D.
Manual of Pharmacodynamics by Richard Hughes, M.D.