Dr Jeena Aslam
After giving the similimum we should observe the cases for further action. I.e. for prognosis. If your prescription is correct the remedy will surely produce changes. These changes are either disappearance of symptoms, increase of symptoms, amelioration of symptoms or reverse order of its appearance. The common findings are aggravation or amelioration. Aggravation is of two kinds.
(1) Disease aggravation
(2) homoeopathic aggravation. If the patient is growing worse after taking the medicine it is called disease aggravation. If the patient feels better, though the symptoms become worse, it is called homoeopathic aggravation. So only observing the change of symptom we could say whether the patient is improving or not. Change of symptom should be first on the interior. But in incurable cases changes occurs in the exterior first the symptoms are growing worse and yet the patient is made comfortable this is meant by palliation.
The important observations are:-
1. Prolonged and final decline of the patient:- Here the antipsoric given was too deep so that it causes destruction. It was an incurable case. Don’t go higher than 30th or 200th and observe whether the aggravation is going to be too deep or too prolonged. In such cases moderately low potency and 30th is low enough.
2. Long aggravation, but final slow improvement:- There was beginning of some very marked tissue changes in some organ, the man was on the borderland, it is better to start with low potencies.
3. Aggravation is quick, short, and strong with rapid improvement of the patient: – Here no tendency to structural changes in the vital organs. Any structural changes that may be present will be found on the surface that is the organ that is not vital. This aggravation occurs in the first hours after the remedy in an acute sickness or during the first few days in a chronic disease.
4. No aggravation with recovery of the patient: – No organic disease, no tendency to organic disease. It is the highest order of cure in acute affections, the potency exactly fit the case, in cures without aggravation we know that the potency is suitable and the remedy is a curative remedy.
5. Amelioration comes first and aggravation afterwards: – Here the condition is unfavorable. Here either the remedy was superficial and could only act as a palliative or the patient was incurable and the remedy was some what suitable.
6. Too short relief of symptoms: – Some condition may interfere with the action of the remedy it may be unconscious on the part of the patient or it may be intentional. In acute disease we may see too short amelioration and the remedies have to be repeated. In chronic disease it means that there are structural changes and organs are destroyed or being destroyed.
7. Full time amelioration of symptoms, yet no relief to the patient: – The remedies act favorably but the case is incurable. Hence the patient is palliated and it is a suitable palliation. E.g. Patient with one kidney can only improve to a certain degree.
8. Some patient prove every remedy they get: – The patient incline to be hysterical, patient is oversensitive to all things or patient is said to have an idiosyncrasy to everything. We administer a dose of high potency and they will go and prove that medicine. Such oversensitive patients are very useful to the homoeopathic physician. When you find a patient he proves everything we give him higher potencies, go back to 30th and 200th potencies.
9. Action of medicine upon provers: – Healthy provers are always benefited by proving if they are properly conducted. It is well to observe carefully the constitutional state of an individual about to become a prover and write these down and substract from proving.
10. New symptoms appearing after the administration of the remedy:-If a great number of new symptoms appear after the administration of remedy, the prescription will generally prove to be an unfavorable remedy.
11. When old symptoms are about to reappear:- Patient is on the road to recovery, so old symptom often come back and go off without any change of medicine indicate that medicine must be left alone, if old symptom come back to stay, repetition of the dose is often necessary.
12. Symptom take the wrong direction: – If we prescribe for the rheumatism of knees relief takes place at once in the rheumatism of the extremities, but the patient is taken down with violent internal distress, that settles in the region of the heart. Here transference has taken place from the circumference to centre and the remedy must be antidoted at once, otherwise structural changes will take place in that new site.
Views of H.A.Robert:-
His concept is same as that of Kent explained it in his book under the chapter “remedy reaction”.
Second prescription may be the repletion of the first or it may be an antidote or a compliment, but none of these things can be considered unless the record has been again fully studied. The medicine that has partly cured the case can often finish it and that medicine should not be changed until there are good reasons for changing it. So advice to be given to the patient that not to change the doctor frequently. We should not make a hurried second prescription. The early repetition of the medicine will prevent an opportunity for making a second prescription.
The Second prescription presupposes that the first one has been a correct one that it has acted and that it has been let alone, when the symptoms return then the patient has same generals and particulars as formerly it means that first prescription was a good one that the case is curable and that Second prescription must be repetition of the former.
Another reason for making a Second prescription is the appearance of a lot of new symptom taking the place of old symptoms, old symptoms do not return but new symptoms come in their place, it must be antidoted, the new symptoms combining with the old ones must again be studied and second remedy must corresponds more particularly to the new than to the old. Wait a long time , when the patient come to a stand still, if no outward symptom have appeared another dose of the same medicine can be considered, if there is return of original symptoms , then we have same guide to the administration of medicine.
Change of remedy in the Second prescription:- After administration of the remedy when a new group of symptoms appear somewhere in the body related to the patient such as the patient has never had this new group of symptoms means that the new remedy must be considered and under such circumstances, the change of remedy will be the second prescription. Even if the symptoms have been changed don’t change the remedy provided that the patient has continually improved.
Complimentary: – A good Second prescription is necessary to compliment the former and this is always a change of remedy. E.g. Calcarea follows belladonna. When there are a series of remedies sulphur, calcarea, lycopodium and the cognates are closely related.
The second prescription takes into consideration the change of plan of treatment. The plan of treatment consists in assuming that the case is a psoric one, sycosis or syphilitic. When one is uppermost, the other is quiet, so we have to change our plan of treatment according to the state of the patient.
No prescription can be made for any patient, except after a careful study of the case. Always restudy your cases, don’t administer a medicine without knowing the constitution of the patient.
Views of H.A. ROBERT are similar to that of KENT as far as Second prescription is concerned
Dr Jeena Aslam BHMS,MD(Hom)
Medical Officer, Department of Homeopathy
Government of Kerala
Download Synopsis of Kent’s Observations : www.similima.com/pdf/synopsis-kent.pdf