Remedy Selection

Last modified on February 5th, 2019

Remedy Selection

   TWO things are necessary for the successful selection of the similar remedy, a clear picture of the patient and a comprehensive knowledge of the materia medica.

Not only must careful note be taken of all the patient’s symptoms but each symptom must be investigated as to its details and modalities. It is the individual peculiarities of the symptom and its mode of responding to heat and cold and other modifying factors that provide the data for accurate symptom-matching.

If there is correspondence between the stimulus provided by the remedy and the response of the sick individual, relief of symptoms and restoration of health will result.

How this is brought about is difficult to explain, or even to theorise about. Numerous explanations have been offered and Hahnemann said that the drug-induced disease somehow annihilated the natural disease.

In practice, it is evident that the suitable remedy does stimulate the sick individual in such a way as to call forth a curative response.

The drug is usually administered in exceedingly small does so that the stimulus provided may be in the nature of “in formation”, or “instruction”, as to how the body can set about reversing the disease process, repairing damage (where this is possible), and restoring the balance of function and biochemical homoeostasis on which health and well-being depend.

The stimulus may be something in the nature of what one distinguished scientist describes as “the hypothesis of a biotonic or non-mechanistic information transmission”.

It is not necessary to wait for accurate explanations before applying a principle which has been found to give practical results in healing the sick, and the problem becomes one of how to select the suitable remedy in any particular case.

The first endeavour must be to match the symptom picture presented by the patient with a similar picture in the materia medica. The symptom may be many or few, pertinent or vague. Common symptoms such as cough, headache, rheumatic pain, skin rash and so on are of no value for accurate prescribing unless qualified.

The symptoms that must be picked out for the purpose of matching with the materia medica are those which are prominent, personal and particular; particular especially in their detail and in their modalities.

The next step is to assess the evidence from the point of view of prescribing value, to decide which symptoms and features by reason of their prominence, personal character, or peculiarity must be matched and covered by equally prominent and characteristic features in the materia medica picture.

It is of prime importance to know how to evaluate the symptoms presented by any particular patient. First and foremost it is the prominence, the marked and obvious character of a symptom, and its personal attributes in the particular individual patient that give it high value.

Further, and it is impossible to over-emphasise this, it is always necessary to study the individual patient as a whole ; physical features, general reactions and emotional and temperamental attributes all being taken into account.

Symptoms Classified.

Symptoms may be roughly classified as local, general, mental and constitutional. With regard to prescribing value the mental and emotional features are rated in the top rank, especially if of recent development or if showing a variation from the usual.

Local symptoms are of value when very marked and typical, a special kind of pain, haemorrhage of a definite variety, a distinctive type of cough, a particular form of sputum, and so

on.

Symptoms may be valuable owing to their peculiar character. There are many of these, for example :

Burning pains relieved by heat point to ARSENICUM ALBUM ;

Coldness of the affected part with relief from cold applications points to LEDUM ;

Great thirst despite a moist tongue suggests MERCURIUS ;

Fever with absence of thirst points to APIS, GELSEMIUM or PULSATILLA ;

Relief from swallowing solids accompanying a sore throat points to IGNATIA or LACHESIS ;

Prefers to lie on the painful side indicates BRYONIA ;

A complaint that his limbs seem to be scattered all over the bed, disordered body-sense, points to BAPTISIA.

Symptoms may also be evaluated according to their chronology.

Recent symptoms are indicative of active disturbance in the body and are of high prescribing value when studied in detail.

Remote symptoms are those which may have occurred in the past and are only called to mind on careful enquiry. They often prove of value in pointing to a remedy which might have been prescribed at the time and may even now be of benefit.

Recurrent symptoms are usually evidence of an underlying chronic disorder which reveals itself by occasional attacks of acute illness. Search must be made here for some infectious illness in the past from which full recovery has not been made, or perhaps for an inherited taint, a so-called miasm.

This may call for the use of a Nosode, that is a preparation of an infective agent such as DIPHTHERINUM, MORBILLINUM, TUBERCULINUM, LUETICUM and so on.

Attacks which recur periodically at regular intervals point to the possible use of such remedies as ARSENICUM ALBUM, CHINA, NATRUM MURIATICUM.

Recrudescent symptoms is a term which can be used in relation to a curious phenomenon, sometimes met with in homoeopathic prescribing. It is usually in connection with the treatment of a chronic condition, when following the administration of the apparently indicated remedy fresh symptoms appear.

These on careful investigation prove to be a recrudescence of old symptoms from which the patient suffered, perhaps some years past. They tend to appear, moreover, in reverse order chronologically to the times of their appearance in the past.

The temptation to treat such symptoms must be resisted. They are evidence of physiological reaction in response to the administration of the remedy, and such activity on the part of the body’s own resources should not be interfered with.

These recrudescent symptoms, therefore, do not call for further prescribing. They will disappear in due course, probably not to reappear again.

Reactive symptoms is a term which may be used to describe another type of response to treatment, namely an aggravation of the existing symptoms after taking a few doses, or just one single dose, of the remedy prescribed. this is most likely to occur in persons who are unusually sensitive to any form of medication.

It is recognised to be a sign that the remedy is taking effect and is usually short-lived in duration. The remedy should be discontinued, but no antidote is called for unless the aggravation proves to be unduly prolonged.

In an over-sensitive subject the administration of a homoeopathic remedy may produce not an aggravation of the symptoms already present but fresh symptoms altogether, in other words an accidental proving. In this case the treatment must be discontinued, but if the symptoms still persist a suitable remedy must be given to deal with the new situation.

It may occur that in relation to the group of symptoms presented by the patient more than one remedy is indicated. In this case it is necessary to study the case also from the point of view of typology, to find the constitutional or personal remedy which matches the personality of the patient This will enable the possible remedies to be “reviewed” ; the one which is most suitable to the particular patient can then be selected. In other words, what is matched with the materia medica is not merely the symptom picture but the patient picture, symptoms included.

Another reason for seeking the constitutional, or personal, remedy is that this will sometimes be called for when the apparently indicated remedy, prescribed on the symptom picture for an acute condition, fails to clear up the case. It may well be the remedy which covers the whole case, or it may be complementary to preceding remedies.

The search for the similar remedy must primarily be along the line of skilled symptom-matching, not neglecting to check and confirm by consideration of the general modalities and constitutional characteristics of the patient.

The search for the similar remedy in this way may at times be difficult and baffling, and sometimes the apparently indicated remedy will fail to effect the response hoped for. Experience has shown, however, that certain other lines of enquiry may on occasion prove of assistance in remedy selection.

Causal Factor.

It has been observed that complaints of one kind or another may often be precipitated by or linked with adverse factors such as emotional stress, weather changes and extremes, injuries, inoculations and so on.

Further, it can be noted in the materia medica that complaints deriving from this or that causal factor are therapeutically associated with certain remedies, which can be prescribed on this basis. For instance :

Symptoms induced by getting suddenly chilled when hot can often be controlled by DULCAMARA ;

Those resulting from exposure to damp by NATRUM SULPHURICUM ;

Those following injury, even at a remote date, by ARNICA, or, if the injury has involved concussion of the brain, by NATRUM SULPHURICUM ;

Those dating from a sudden or severe fright by ACONITUM ;

Those deriving from emotional stress or shock by IGNATIA.

In this connection it is often necessary to carry the investigation further back than the immediate precipitating factor and to make careful enquiry into disturbances of health in previous years, in infancy and childhood, or even into parental ill-health before birth.

It may transpire that the sick individual has “never been the same” since some previous and possibly quite remote disturbance of health.

Positive findings along these lines will often provide strong indications for the use of a remedy. For instance :

A history of trouble after anti-smallpox vaccination, or of repeated vaccinations, will suggest THUJA ;

Previous infection with or contact with tuberculosis will point to the use of DROSERA or of one of the TUBERCULINUM preparations;

Old malaria, possibly much-treated, will call for NATRUM MURIATICUM ;

A remote episode of fright with the sense of fear persisting will suggest OPIUM ;

A former attack of measles, diphtheria, or whooping-cough, will indicate the possible need for the corresponding Nosode.

Tissue Affinities

It sometimes happens that in a particular case their is a paucity of high value prescribing symptoms to guide in the choice of the remedy. There is, however, evidence of the involvement of some special organ or tissue.

It is recorded in the materia medica that certain remedies have a special affinity for some organ, or tissue, or system, and in the presence of disease affecting such sites the associated remedy can often be employed therapeutically. Examples of such affinities are given on page 12.

This is limited sphere of help in remedy selection. But it may be of value, and remedies prescribed on such local indications will usually be given in low potency, say 3x or 6, and in repeated doses.

Previous Clinical Experience

If a patient presents similar symptoms to those suffered from on a previous occasion it can usually be inferred that the remedy effective on the former occasion will prove the best selection in the present event.

This points to the advisability of keeping careful records not only of symptoms but also of treatment, and in detail as to potency and number of doses given.

In the event of an epidemic of, say, influenza, when a similar symptom picture is encountered in case after case, the remedy that is found effective in one case is likely to be suitable also for the others, at any rate in clearing up the acute symptoms. Follow-up treatment will call for more individual selection along normal homoeopathic lines.

Repertories

The various available works of reference and repertories linking symptoms with related remedies afford valuable help in remedy selection. But there is no substitute for that constant study of the materia medica that alone can give the physician an intimate knowledge of a remedy, its most prominent features and its inner nature, and thus enable him to sense and recognise its counterpart in the sick individual.

About the author

Robert Gibson-Miller

He was born in 1862, and was educated at Blair Lodge and the University of Glasgow, where he graduated in medicine in 1884. Early in his career he was attracted to the study of Homoeopathy, and with the object of testing the claims made for this system of medicine he undertook a visit to America. As a result of his investigations there Dr. Miller was convinced of the soundness of the homoeopathic theory. Dr. Miller did not write much, but we owe him also his Synopsis of Homoeopathic Philosophy and his small book, always at hand for reference, on Relation ship of Remedies.

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