The Genius of Homeopathy

Lectures and Essays on

Homeopathic Philosophy
By Dr Stuart M. CLOSE

Chapter X
Indispositions and the Second
Best Remedy
  Not every case which presents itself to the
physician requires medicine.
 It may only require the searching out and
correcting of some bad habit,
 some error in the mode of living, such as faulty
diet, unsanitary surroundings, non-observance
of ordinary hygienic requirements in regard to
breathing, exercise, sleeping, etc.
 In APH. 4 of the Organon, 
 Hahnemann says: "He (the physician) is likewise
a preserver of health if he knows the things that
derange health and cause disease, and how to
remove them from persons in health."
  In Aph.5
 The physician is enjoined to search out "the
most probable exciting cause of the acute
disease,
 as also the most significant points in the whole
history of the chronic disease to enable him to
discover its fundamental cause, which is
generally due to a chronic miasm."
  In making these investigations he directs our
attention to "the physical constitution of the
patient, his moral and intellectual character, his
occupation, mode of living and habits, his social
and domestic relations, his age, sexual
functions, etc."
 But this line of investigation is equally fruitful
and necessary in dealing with the indispositions
of which I am particularly speaking
 Hahnemann says: "As a matter of course every
sensible physician will remove such causes at
first, after which the indisposition will generally
cease spontaneously."
 By way of illustration he goes on to say:
 "He will remove from the room strong smelling
flowers, which have a tendency to cause
syncope and hysterical sufferings;
 "extract from the cornea the foreign body that
excites inflammation of the eye;
 loosen the over-tight bandage on a wounded
limb,
 ligature the wounded artery,
 promote the expulsion of poisonous ingesta by
vomiting
 extract foreign substances from the orifices of
the body,
 crush or remove vesical calculi,
 open the imperforate anus of the new born
infant, etc."
 In short, Hahnemann has done his best to
make it clear that the use of
common sense is not incompatible with
homœopathic practice,
 Consider , then, that class of cases which require only
the correction of faulty habits and the removal of
exciting causes.
 It requires much wisdom, skill, good judgment and tact
to perform this function as it does to prescribe medicine;
indeed, it often requires more.
 It is NOT EASIER to deal without out medicine and
dismiss the patient,
 and to make a-careful investigation of the habits and
circumstances of a patient who probably does not need
medicine at all, but only wise and kindly advice on how
to live.
 Having discovered such a case and determined that it
does not require medication, the question arises, how is
such a case to be managed?
 At first sight it would seem to be a very simple matter;
merely to tell the patient bluntly that he does not need
medicine, but only to mend his life and correct his habits
according to the advice and instruction which you have
given or will give.
 This view of the matter does not take into consideration
the peculiarities of human nature as formed by ages and
generations of habit and custom. 
 Only occasionally do we meet a patient to whom we can
give ideal advice and treatment.
 The average patient who goes to the doctor, expects to
get medicine.
 If he is so far advanced in his ideas as to believe in the
no-drug theory he will probably not go to the doctor at
all, but will seek out the osteopath or the Christian
science healer.
 The patient who believes in drugs and goes to a doctor
for treatment will be very un likely to listen to your
advice and will tell his friends , that he thought you were
a doctor, but he found that you were only a half-baked
Christian scientist after all, or something to that effect. 
 To direct his attention to his errors of living and order
him to correct them is to put the burden of cure upon
him, and that is not what he wants at all.
 He expects us to bear that burden. That is what he
comes to us for.
 There is a large class of people today-selfish, pleasure-
seeking, luxury-loving, dissipating creatures, male and
female-who demand of the physician relief from the
pains and penalties of their hygienic sins, but are not
willing to do their necessary part toward bringing this
about. They want to "eat their cake and have it too."
 We cannot afford to antagonize this class, either for
their sakes or our own.
 We owe them a duty as well as ourselves, and few of us
can afford to pick our patients. We must take them as
they come and adjust ourselves to their individual needs
and peculiarities.
 These in general are some of the cases which require
tact in management. "You can catch more flies with
molasses than with vinegar.“
 We can gradually lead some of these people into better
ways of life and thought and cure them of both their
sickness and their sins,
  It is in dealing with such cases-the
indispositions and habit disorders-that
the "second best remedy in the materia
medica" so often comes into use.
 In order to fully appreciate the value of
the second best remedy, we must first clearly
understand what is the best remedy in the
materia medica
 There cannot be any doubt. It is the indicated
remedy
 You also know that having once been
found, the best remedy IT must be
given time to act, and that its action must
not be interfered with by other drugs or
influences until it has accomplished all of
which it is capable.
 You also know, that too many doses of
the best remedy may spoil the case.
  One of the distinguishing characteristics of a
great painter is that he knows when to stop.
  Many a painting which would have been great,
if the artist had known when to stop, has been
weakened and spoiled by over-finishing.
 In his anxiety to perfect a few insignificant
details he robs his work of, its vitality-kills it.
 It is the same in treating a case. The problem is
to give just enough medicine and not too much.
 Too many doses may spoil the case.
 There are class of people who expect and
demand medicine, and are not satisfied unless they get
it, until they have been taught better.
 Now just here comes in the second best remedy without
which no good homœopathist could long practice
medicine.
 Its technical name is saccharum lactis officinalis;
abbreviated sac. lac. or s.l.
 Just plain sugar of milk!
 The young homœopath's best friend,
 The old doctor's reliance and
 a "very present help in time of trouble!"
 The doctrine of placebo, from the Latin placere, to
please-, future, placebo "I shall please," is as old as
medicine itself.
 Its psychological value is commensurate with the
frailties and peculiarities of human nature.
 The traditional "breadpill" of our medical ancestors has
given place,
 The powder of virginal white, pure sugar of milk; or to
the seductive little vial of sugar pills or tablets,
 Artistically labeled and bestowed with impressive
directions as to the exact number of pills for a dose and
the precise hours of taking, with confident assurances of
the happy effects to be expected, if directions are
faithfully followed!
 Marvelous are the results witnessed from this
remedy in cases where it is indicated.
 I have seen it bring sleep to the "insomniac,"
when even morphine had failed.
 I have heard patients declare that it was the
most effective cathartic that i had ever taken
 It is indeed too powerful and too useful a
remedy to be held 'lightly, or to be lightly used. 
 The knowledge of its use is too dangerous
to be disseminated among the laity.
 It should be as jealously guarded as a
"trade-secret" worth millions.
 Never admit its use to any but the
initiated, if you value your influence and
reputation, but never fail to use it when
your judgment dictates it.
  Let us glance at a few of the
practical uses of the placebo

 You are called to a new case.

 You see the patient and make your
examination.
 You decide that it is a case for medication.
 You have written down your symptom-findings
and glanced over the record.
 The case is difficult and you are not able to
decide offhand what remedy is indicated.
 You must have time and opportunity to study it
up
 The patient and friends want something done at
once.
 Rapidly you run over the case in your mind. This
patient is seriously ill.
 To make a mistake in the first prescription
might be fatal.
 Your reputation in the new family will depend
upon your success.
 You must retain the confidence of the patient
but you must have time and make no mistake.
 This is where your knowledge of the
second best remedy comes into use.
 Calmly and confidently you prepare and
administer a generous "s. l." powder,
 leave explicit directions for the use of as
many subsequent doses as you deem
judicious,
 Make an appointment to see the patient
again in an hour or two, or three
 Then you proceed to apply your
knowledge of how to study the case and
find the remedy according to the principles
of the Organon.
 When you have worked out your case and
found the remedy, you return.
 Then you enter as  THE MASTER OF THE
 SITUATION.
 Does anybody consider that lost time?
 Thousands of cases might have been
saved and many a professional reputation,
by following such a course,
 Instead of yielding to the silly panic-
impulse to "do something quick," which
almost invariably results in doing the
wrong thing.
 Patients do not usually die in a minute.
There is always plenty of time to do the
right thing, always, at the right time.
 If you know what the right thing is without
reflection and study, do it at once.
 Give your remedy at once if you are sure
of it, but not otherwise.
 If you are not sure, give sac. lac.
  If the case is really pressing and demands
immediate medication, GO to another room with
your repertory then and there
 The very greatest of our prescribers like
Bœnninghausen, Hering, Lippe, Wells, Biegler,
and almost all our expert prescribers of today,
do not fail to carry their repertory with them to
all cases,
 Nor hesitate to use it in the presence of the
patient if necessary.
 Instead of arousing distrust on the part of
the patients, as you might think, it
awakens confidence.
 To see -a physician making a thorough
examination, studying, "taking pains,"
showing a real interest in the case and a
determination to do his best at the
"psychological moment", is calculated to
inspire confidence at all times,
 Another use for the second best remedy is
as a supplement to the indicated remedy.
 Experience shows that Hahnemann was
right when he advised that the remedy
should be stopped as soon as signs of
improvement appear, and the curative
reaction be allowed to go on without
further repetition of doses as long as it will.
 This, of course, refers to the cases where
repeated doses are given from the beginning.
When improvement begins and you desire to
cease medication, you will simply substitute sac.
lac. for the remedy and watch your case.
 The same course is pursued when treatment is
begun with the single dose, by which method
many of the most brilliant cures are made.
 We may give enough sac. lac. powders to last
during the interval between visits, or
 a vial of blank tablets or pellets;
 but be sure to moisten the tablets and pellets
with alcohol, or put some unmedicated pellets in
the sac. lac. powders.
 The medicine case should always contain a vial
of blank pellets properly labeled for such use
 These are some of the ways to use the
second best remedy.
 If you follow the right course you will find
more and more use.
 The use of placebo is simply a very
powerful form of therapeutic suggestion;
or, psycho-therapy.
  Objection has been made to this mode of
dealing with cases, on the ground that it was
not strictly honest!
 To practice even such a mild deception upon
patients would violate their fine sense of honor!
Besides, it tended to engender in patients
a habit of dependence upon sac. lac., and to
demoralize the physician who followed the
practice!
 He who said that, anointed the eyes of a blind
man with "clay mixed with spittle," bade him go
and wash in the pool of Siloam, and he
recovered his sight-healed by faith; awakened
by the therapeutic suggestion of a clay
placebo and an order to take a bath!
      Any harmless measure which tends to arouse
the curative reaction of the organism through
the awakening of faith and confident
expectation, is not only right but legitimate and
sometimes indispensable.