Homeopathy Papers

The Choice of the Simillimum

Written by C.M. Boger

The great C.M Boger discusses prescribing and evaluating the effects of a remedy.

Excerpted from: Homoeopathic Therapeutics of Diphtheria – 1898

All sicknesses present two classes of manifestations, those by which they are determined or named, i. e., the diagnostic symptoms; and those peculiar to individuals and cases, often seemingly having no bearing upon the illness, hence called idiosyncratic symptoms. In weighing their value for the purpose of deciding upon the choice of a remedy, the latter are almost exclusively to be considered, while the diagnostic symptoms take a secondary place; this is well illustrated by the following case:

At noon on November 24th I saw Charles C, and found the following symptoms: Convulsive wing like motion of the alae nasi with every inspiration; breathing impeded, quick and with effort, the evidences of narrowing of the laryngeal lumen were positive.

On falling to sleep is aroused by suffocation.

A number of small patches of membrane on the right tonsil.

Face and neck bloated.

Pain in larynx when coughing.

Lips cracked in the right commissure.

Continually picks and bores the nose.

A diagnosis of laryngeal diphtheria was made, and Spongia 40m. was prescribed. Up to seven o’clock in the evening all the symptoms grew progressively worse.

This showed that the wrong remedy had been selected. I now did what should have been done in the first place; carefully wrote down the symptoms in tabulated form, placing the most characteristically diagnostic symptoms at the head and the idiosyncratic ones toward the foot of the page. This arrangement demonstrated at once that the prescription had been based on diagnostic symptoms. Hence the failure, and that the idiosyncratic indications pointed to Arum-triphyllum, which was now administered in the 200th of Dunham every hour. In two hours the patient felt easier and began to expectorate a watery fluid which seemed to come from the throat, gradually increasing in quantity until 3 p.m. of the next day, when he coughed up a number of pieces of membrane, bloody at the margin, with much mucus. From this time on the recovery was rapid and perfect.

Another point demanding careful consideration is THE REPETITION OF THE DOSE. In this connection it may be well to hear the voice of the fathers of Homoeopathy. Boenninghausen says : (Repertorium vol. i, P. X.):

“In conclusion it may not be useless to call to memory in an abridged form what my worthy friend Dr. J. Aegidi says which coincides entirely with my own experience.’ After the administration of the carefully selected remedy (according to the similarity of the symptoms), as early at the latest remedy as after the lapse of eight days (in acute sicknesses, often already after a few hours), one of two events certainly follows, either :

A. The state of the illness is changed, or

B. It remains the same.

A change in the sick condition embraces three events, either :

1st : The condition is ameliorated

2nd It is aggravated, or,

3rd The sickness alters its symptom complex.

In the first case one sees the medicine’s beneficial action penetrating deeply, and it were therefore, hasty not to await the fullest extent of the amelioration. Here at least haste is useless, mostly harmful. Only when improvement comes to a visible standstill, is it advisable to give a second, third or fourth dose of the same remedy, especially, however, only as long as a lessening but not essentially changed symptom complex still points to it.

In the second event we see the state of the sickness becoming worse. Particularly do the characteristic symptoms heighten their intensity without changing or transposing themselves – the so-called Homoeopathic aggravation. Here the remedy has overcome the affection in its essence and for a while nothing further is to be done, unless perhaps entirely too important complaints make the application of a proper antidote necessary, which on most occasions is found in a second and if possible still smaller dose of the same medicine.

The third instance concerns an alteration of the symptom complex, and is evidence when this happens that the remedy was not fittingly chosen and must be exchanged for a suitable one as soon as possible.

When notwithstanding the carefully chosen remedy and the patient’s faultless diet, the sick condition on the contrary is not at all changed, as in the case mentioned under B, the cause usually lies in a want of receptivity which we must seek to remove either by repeated small doses or by the medicines hereinafter recommended for deficient reaction.

By following these rules we have the pleasure of assisting the sick to recovery in an incomparably shorter time than has commonly been possible under the former evil treatment where the physician lacked a fixed rule of practice.

These are words of golden import to the Homoeopathician and can be closely followed with profit. Cases of diphtheria showing no change after a lapse of six or eight hours are evidence that either the simillimum has not been chosen, the patient shows a deficient reaction, or the dose has not been repeated frequently enough.

We should not flatter ourselves that we have cured cases running from six days to two weeks. The simillimum does not act in that way and such recoveries show but slight aid from our efforts.


About the author

C.M. Boger

Cyrus Maxwell Boger 5/ 13/ 1861 "“ 9/ 2/ 1935
Born in Western Pennsylvania, he graduated from the Philadelphia College of Pharmacy and subsequently Hahnemann Medical College of Philadelphia. He moved to Parkersburg, W. Va., in 1888, practicing there, but also consulting worldwide. He gave lectures at the Pulte Medical College in Cincinnati and taught philosophy, materia medica, and repertory at the American Foundation for Homoeopathy Postgraduate School. Boger brought BÅ“nninghausen's Characteristics and Repertory into the English Language in 1905. His publications include :
Boenninghausen's Characteristics and Repertory
Boenninghausen's Antipsorics
Boger's Diphtheria, (The Homoeopathic Therapeutics of)
A Synoptic Key of the Materia Medica, 1915
General Analysis with Card Index, 1931
Samarskite-A Proving
The Times Which Characterize the Appearance and Aggravation of the Symptoms and their Remedies

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