Homeopathy Papers

The Second Prescription

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Dr. William Boericke, one of our great physicians, outlines the principles for determining the second prescription.

William Boericke – 1849-1929

The Second Prescription 1In the treatment of chronic diseases, Hahnemann’s instructions to write out the symptoms and arrange them according to the rules given, is an absolute necessity to attain accuracy of knowledge of the possible indicated drugs and the selection of the most similar remedy. This procedure ensures also a ready selection of the second prescription, since the record will answer all of the necessary questions and determine the right course to be pursued. The prescriber’s attitude after the first prescription, in the treatment of chronic diseases especially, ought to be passive. The first and foremost rule is to wait and watch further developments. The selected homoeopathic remedy simply stimulates the vital forces to reaction, and we must await results. No further interference is called for when any one of the following conditions presents itself:

1. Short aggravation of the Symptoms.
This is a curative effect of the remedy. Do not interfere with it unless the aggravation continues and the general state of the patient is worse, in which case an antidote, i.e. a homoeopathic remedy for the latest symptoms is indicated. Usually one dose of such an antidote is all that is required to modify the condition, and then the case can progress without further interruption.

2. General Amelioration of the Symptoms.
It is self evident that such a condition should not be disturbed by further medication, on the principle of letting well enough alone. If the disease gets better from within outward, from above downward, from more vital to less vital parts, the improvement is permanent and radical. So an improved mental state is always a favorable indication of a well chosen remedy.

3. Reappearance of old Symptoms.
The return of some of the older symptoms, if not too severe, indicates a curative action of the remedy administered, if they appear in the reverse order of their development, i.e.,if the latest symptoms disappear first.

4. Appearance of new symptoms.
If such come on after the administration of a remedy, they may be clinical symptoms of the remedy, and if there is at the same time general improvement, they need not be considered, as they will disappear. If they persist, the homoeopathic antidote will soon rectify the passing increase of the morbid phenomena.

Under all these conditions, no further medication is required.So long as improvement is thus progressing, it is folly to change the remedy, and it is not advisable even to repeat the dose.

Other Favorable Symptoms

In acute disease, it is a favorable symptom if the patient falls asleep soon after taking the remedy; also, if he feels generally better, though the local symptoms may not show any improvement. The improvement here is probably largely psychical, and will soon be followed by the necessarily slower improvement on the physical plane.

The mental condition and general behavior of the patient, if more tranquil and natural, are among the most certain and intelligible signs of incipient improvement, especially in acute diseases.

Should this progressive evolution of the symptoms towards health cease:

A further review of the case is required, and a new remedy is to be chosen when:
(1) The mental state shows an embarrassed, helpless state instead of the tranquility of improvement.

(2) When no change of any kind follows the first prescription, after waiting long enough for reaction, which is, however, a variable matter, according to the chronicity of the case and character of the remedy chosen, the shortest period to be allowed in a chronic disease being one week, and preferably a longer time.

(3) When new and important symptoms and old modalities, especially aggravations that persist, characterize the case, proving that the remedy was not homoeopathic to the case, and acted only as a pathogenetic agent in producing new symptoms. This is the danger of selecting a remedy only remotely similar instead of the similimum. The second remedy will often be found a complementary drug of the first.

Three Precautionary Rules of Hahnemann

The author of Homoeopathy, in his work on “The Chronic Diseases”, has established three precautionary rules, which he has impressed in the most urgent manner upon the minds of his disciples, and which no homoeopathic physician can violate without committing the greatest faults in practice. They are the following:

1. To suppose that the doses which he had recommended for every anti-psoric remedy, and which experience had taught him to be the proper doses, are too small.

2. The improper selection of a drug.

3. The too great haste in administering a new dose.

Precautionary Rule No. 1. Smallness of dose. The debates relative to the smallness of doses are far from being closed. The more that has been written on that subject for some years past, the more contradiction has been heaped upon contradiction. What is a truly remarkable circumstance in this discussion a circumstance which is by no means creditable to the opponents of small doses, is the fact that the manner in which Hahnemann gradually arrived at the introduction of the small doses in practice, in consequence of repeated trials, observations, experience, seems either to have been forgotten or entirely ignored.

It is experience, and nothing else, which led the carefully-observing author of that immortal text-book to that minuteness of doses which has now become an object of derision. In the second edition of “Chronic Diseases,” after having spoken of homoeopathic aggravations, Hahnemann continues thus: “If the original symptoms of the disease continue with the same intensity in the succeeding days as in the beginning, or if this intensity increases, this is a sure sign that, although the remedy may be homoeopathic, yet the magnitude of the dose will make the cure impossible. The remedial agent, by its powerful disproportionate action, not only neutralizes its genuine homoeopathic effects, but established, moreover, in the system, a medicinal disease by the side of the natural disturbance, which is even strengthened by the medicine.”

That portion of the preceding quotation, which is printed in italics, embodies a great truth which has never been denied, which has been abundantly confirmed by the numerous results of the allopathic treatment of chronic diseases, and is, therefore, well worthy of attentive and serious consideration. Such results

are even witnessed in the comparatively easy treatment of syphilis, from the abuse of mercury, which is then secondary syphilis.

Hahnemann continues afterwards: “This pernicious effect of too large a dose may be observed already in the first sixteen, eighteen or twenty days of its action. In such a case it becomes necessary either to give an antidote, or if the antidote should not be known, to administer a very small dose of such antipsoric as corresponds most homceopathically to the symptoms of both

the natural and the artificial disease. If one antipsoric should not be sufficient, another, of course, ought to be given, after having been selected with the same care.”

How little an excessive dose is capable of displaying its full curative powers may be seen from the following remarks of the author of homoeopathy: “The excessive action of the otherwise homoeopathic remedial agent having been subdued by the proper antidote or by antipsoric remedies, the same agent may then be exhibited again, but of a much higher potency, and in a more minute dose.” But this agent would have no effect, if a first powerful dose of it had not accomplished in the beginning all the good that the agent is capable of doing.

Finally, Hahnemann observes: “Nothing is lost by giving even smaller doses than those which I have indicated. The doses can be scarcely too much reduced, provided the effects of the remedy are not disturbed by improper food. The remedial agent will act even in the smallest quantity, provided it corresponds perfectly to all the symptoms of the disease, and its action is not interfered with by improper diet. The advantage of giving the smallest dose is this, that it is an easy matter to neutralize their effects in case the medicine should not have been chosen with the necessary exactitude. This being done, a more suitable antipsoric may be administered.”

This advice ought to be carefully considered, especially by the beginners, together with the warning which Hahnemann has expressed in the preface to his work on “Chronic Diseases.” ” What would they have risked, if they had first followed my indications and then employed small doses ? The worst which would have befallen them was, that those doses would have

been of no avail. It was impossible that they should do any harm. But instead of exhibiting small doses, they employed, from a want of sense and of their own accord, large doses for homeopathic use, thus exposing the lives of their patients, and arriving at truth by that circuitous route which I had traveled upon before them with trembling hesitation, but the end of which I had just reached with success. Nevertheless, after having done much mischief, and after having squandered the best period of their lives, they were obliged, when they were really desirous of curing a disease, to resort to the only true method which I had demonstrated to them a long while ago. *

Diet and Regimen during Homoeopathic Treatment

Hahnemann and the early homoeopathists laid great stress on a strict diet; but this is a field that has been greatly neglected in modern times, largely because it was found that the power and efficacy of the well-chosen remedy were able to manifest themselves, notwithstanding great license in diet and hygiene.

Nevertheless, a return to Hahnemann’s careful restrictions may be advisable in many cases. His teachings, in this regard, are as follows:

“The minuteness of the dose required in homoeopathic practice, makes it necessary that every other kind of medicinal influence that might cause a disturbance should be avoided in the diet and regimen of patients, in order that the highly rarified dose may not be counteracted, overpowered, or disturbed by extraneous, medicinal influences. In chronic cases, therefore, it is especially necessary to remove all obstacles of this nature with the greatest care, since they exercise a deleterious effect.”

Regimen in Acute Diseases

Here the instinct of the patient usually guides him aright, and his cravings can be judiciously gratified.(Von Boenninghausen).

“The food and drink most commonly craved by patients suffering from acute diseases is generally of a palliative and soothing kind, and not properly of a medicinal nature, but merely adapted to the gratification of a certain longing.”

“In acute diseases, the temperature of the room and the quantity of covering should be regulated entirely according to the wishes of the patient, while every kind of mental exertion and emotional disturbance is to be carefully avoided.”

For further study, read:”Organon,” $$253-263.

“The Second Prescription,” by Dr. J. T. Kent, in Proceedings of the Hahnemannian Association, 1888, page 71.

“Practical Hints on the Management of Chronic Cases. “by

W. P. Wesselhoeft, M.D., in Transactions of Hahnemannian Association, 1889, page 8.

“Procedure in the Treatment of Inactive, Progressive Chronic Diseases,” by T. J. Kent, in Hahnemannian Advocate, July, 1896.

From: A Compendium of the Principles of Homoeopathy as Taught By Hahnemann, and Verified by a Century of Clinical Application

Wm. Boericke, MD 1896

About the author

William Boericke

William Boericke, M.D., was born in Austria, in 1849. He graduated from Hahnemann Medical College in 1880 and was later co-owner of the renowned homeopathic pharmaceutical firm of Boericke & Tafel, in Philadelphia. Dr. Boericke was one of the incorporators of the Hahnemann College of San Francisco, and served as professor of Materia Medica and Therapeutics. He was a member of the California State Homeopathic Society, and of the American Institute of Homeopathy. He was also the founder of the California Homeopath, which he established in 1882. Dr. Boericke was one of the board of trustees of Hahnemann Hospital College. He authored the well known Pocket Manual of Materia Medica.

3 Comments

  • I like this article as there are lots of things to learn for a beginner homeopath. It will be very helpful in practice. I will try my best as it is a great honour for me to be a homeopath.

  • DEAR DR,
    AFTER READING THIS ARTICLE, IT APPEARS THAT HOMEOPATHIC TREATMENT IS A RESEARCH FOR TREATING EACH CASE. EVEN THE STALWART HOMEOPATHS ARE NOT SURE OF REMEDY, ITS POTECY, ITS DOSE AND DIETRY CONTROL IN GENERAL OR IN PARTICULAR WITH REFERENCE TO PARTICULAR REMEDY. THANKS FOR SUGGESTIONS
    DR SHEKHAR

  • this kind of articles enlighten me and strict me not to deviate from the homeo track,since 1986. -healer sambath.

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