When the attending physician has “taken the case” of the patient for whom he must prescribe and has chosen the remedy, how shall he decide on the potency to be used? Shall it be a matter of routine? Because he generally gives the two hundredth or the thousandth shall be begin with that? Shall he not rather consider how acute the condition is and how the patient is reaching to the attack?.
If the condition is chronic and the suffering not too great, would it not seem wise to begin with the two hundredth potency and watch its action? Even here, however, the remedy itself must be taken into consideration because some drugs act so much more quickly than others and some do better in a higher, some in a lower potency.
Suppose the physician has given the two hundredth potency with good results, but finally improvement seems at a standstill and the same remedy is still indicated. Shall the same potency be repeated or is it better to go higher to the five hundredth or one thousandth?.
Again, it seems to me that circumstances must decide. If the reaction to the first dose has been prompt and very decided, it would seem probable that the same potency might well be repeated; but if the reaction to the remedy was rather show in the first page, the second dose should be in a higher potency.
Supposing that the same remedy has been repeated several times in ascending potencies and now a new remedy is indicated, what potency of that should be used? If A was last given in the ten thousandth, should one feel that the patients system has been brought to the level of that potency and would react best to that in the new remedy, B, or would it be better to begin lower again, hoping in that ways to interfere less with what had already been accomplished?
Is it not possible that a remedy acting on a different place from the last one given might reach symptoms or conditions that the former had not touched?.
Here we come up against the theory of the similimum which, of course, should fit the patient in every detail and require neither repetition nor change, but so many times we cannot attain to such perfection and have to do as well as we can with a similar.
Far be it from me even to suggest alternation of remedies, but I have one patient who has occasional attacks of gas which make it exceedingly hard for her to breathe. Lycopodium, Kali carb. and Sulphur given for the totality of symptoms have all served to put her in better condition and lessen the frequency of attacks; but when one comes, if it does not yield to drinking hot water, she has permission to take one tablet of Carbo veg. 12x., which generally relieves her in the or fifteen minutes and the improvement lasts for some time.
It seems inexcusable that I havent found a remedy to cure the condition entirely. Carbo veg. in high potency does not do it. The patient is elderly and takes life rather hard, two reasons which make prescribing more difficult.
Another question of potency: Mr. A is treated for an acute condition – say a sore throat, a coryza or on acute sinus-and responds promptly to a remedy in a certain potency. Later, perhaps in two or three years, he comes back with the same symptoms and apparently needing the same remedy. Should it be prescribed in the same potency as before? I think it would be logical to go higher, although sometimes the same potency works well. Can we make any rule about it?.
These ordinary problems must be faced every day and answers decided on. I should be grateful for a discussion of them.
NORTHAMPTON, MASS.
DISCUSSION.
DR. HUBBARD: We cannot let great silence follow the potency question.
I would like to ask Dr. Stevens if she feels, when she has a patient on chronic high potency of 50M., if some condition comes in where she has to give acute remedy, that she should carefully keep as far away as possible from the constitutional remedies. DR. GRIMMER: I am sorry I missed hearing the paper; I just came in. But there is one thing; she spoke about alternation. There is a broad law or manner of approach that Dr.Kent mentions in his philosophy about remedies that have to be given in a complementary series.
Where there is a mixture of miasms in chronic conditions, very often one remedy, an antipsoric, for instance, will act favorable for quite a while, and then, in spite of change of potency or anything else, there is a deadlock and you come to a stone wall. In that case the remedy that corresponds to the complicating miasms will act well for a while, and then will come up the other group of remedies and an antipsoric or antisycotic, whichever it may be. There have been many cases that required that procedure in order to effect a cure.
DR. SAGER : I would like to ask a question. Dr. STevens is giving a high potency and here comes an acute conditions, and she given another remedy. Is that going to interfere with the action of the high potency?.
DR. QUACKENBUSH: To me the question that Dr. Stevens has brought up is a question of judgment. That is the thing which distinguishes the homoeopathic physician, let us say, from the amateur prescriber. We all hark back to first principles, and having been taught that the high potency is the activator, the thing which carries the chronic case along, and that if an acute condition really requires something more than a placebo, it would seem better to give the low, as Dr.Stevens has done in her 12x.
The interruption-that is, the change in the sequence-is almost infinitesimal, because we have another fundamental chronic thing, which is recognized by all the masters. Hering particularly states the law again is that in acute condition the chronic symptoms remain in abeyance, and w hen the acute condition subsides, aided and abetted materially by the low potency, back again comes your chronic condition, and you are able to judge and carry on with you high potency as before.
DR. BOND: I remember reading in the Recorder some time ago an article along that same line by Dr. Underhill. I wonder if he would mind reviewing that a little for us.
DR. UNDERHILL, JR.: As a rule, in chronic conditions I attempt to treat whatever symptoms are uppermost at the time that I see the patient, the first contact with the case. The patient who has never been seen before needs perhaps to be sold on homoeopathy, and I have not started anything as far as chronic trouble is concerned. Therefore, if he has a cold or acute digestive upset, I feel it is perfectly justifiable to attack that directly.
However, if he has come for a chronic condition, or if, after such a patient has been placed on a chronic remedy, he been comes with an acute condition,
I try to determine whether or not it is going to run away with him. If it does not, we will let it ride with placebo, and the arousing effect of the constitutional remedy on his vitality will in all probability see him through.
Once in a while however, threatening conditions do arise, and then it is a problem just what to do. There comes in your point of the discrimination, and I do not know that I can give a final word as to what procedure is best. I have tired both ways, doing as Dr. Stevens has done, giving a relatively low potency for the acute condition, but have been, on the average, more disappointed in its action than I have when I have stepped in with a high potency of the acute remedy.
After the acute condition has worn off, the plan is to wait as long as possible before repeating or stepping in again with a chronic remedy and before doing so being careful to look over the case very critically to see whether or not the same remedy or some other remedy is indicated.
DR. MOORE: Dr. Underhill, about what potency would you use ordinarily, on the average, at the start in an acute case?.
DR. UNDERHILL: I usually try to give a different potency from what I give in the chronic case.
DR. MOORE: If there has been no chronic, do you run lower, and about what do you mean by low potency?.
DR. UNDERHILL: Anything above the thirtieth centesimal we consider high. Anything below the 30th is low potency. We usually start with about the 200th in acute conditions, and when the remedy on longer holds after sufficient amelioration to demonstrate the homoeopathicity of the drug, we then step it up to the 1M. potency.
DR. DIXON: That brings up a little remark that was put to me since we assembled this morning. A party who is on a high potency dose complained about a cough, that the cough was distressing and it was thought something ought to be done for the cough. Something like that comes up so often, and I always try to evade braking out on another remedy. I talk philosophy to those people. I say, “Get an idea of values.
When you have a chronic remedy to cure a chronic condition, it seems futile to break in on a big program like that just to give relief from a cough or a cold or a runny nose or something of the sort.” It is surprising how many people you can carry through a distressing aggravation of some acute trouble if you just spread a little philosophy there and show them what real values are. It will often work. Those acute conditions will subside. They may be distressing or aggravating for a while, but if you evaluate real values, I think it is well worth while to go through it, rather than to break in on a well- selected chronic remedy.
