Patient Evaluations at One Month
The following descriptions and diagrams are not designed to cover every eventuality. Nevertheless, if they are studied thoughtfully, the student will perceive the basic principles underlying the interpretation. They should not be learned by memory—to be applied in a routine manner. Rather, they should be studied meditatively in order to arrive at the inner principles underlying them. Only in this way will the reader gain a true understanding of the single direction in which cure proceeds. These descriptions and diagrams, although often oversimplistic in themselves, bring to bear all of the laws and principles which have been described thus far.
One word of caution in interpreting the diagrams: the figures included in this chapter describe on the vertical axis the intensity of symptoms, and on the horizontal axis, time. To be truly accurate from the point of view of homeopathy, I would have to present the diagrams in terms of the overall health of the patient; in this way, I would show an improvement as moving higher on the graph rather than lower (declining intensity of symptoms) as is shown. It is presented in this manner because the patient is most likely to describe symptoms in this way. Even though it is somewhat incorrect in terms of the activity of the defense mechanism, patients do measure health in terms of presence or absence of symptoms. For this reason, this convention will be followed in these diagrams.
Another point to emphasize in interpreting the diagrams is that the lines shown are purposely not shown as straight lines. All patients show some degree of variation in symptoms from day to day. If symptoms are observed over time intervals which are too short, i.e., hours or days, the overall progress of the patient can easily be misinterpreted. On any given day, it can appear that a significant aggravation or amelioration is occurring, whereas in reality the changes are merely due to random daily fluctuations.
Patient: "I feel better, but still have problems."
Case: Major symptoms ameliorated after an aggravation, while minor symptoms are unchanged.
Interpretation: Correct remedy. Good prognosis.
This situation is less clear in its interpretation. The patient reports an improvement in terms of the chief complaint, the mental/emotional state, and the energy, but some of the less important homeopathic symptoms (say, warmbloodedness, craving for sweets, sensitivity to noise, constipation, etc.) show no change. This situation is encountered in perhaps the majority of cured cases.
It is here that an overly perfectionistic homeopath can do a lot of harm. The prognosis in this circumstance is very good because all three of the major symptoms show a dramatic improvement following an aggravation. Treatment of the minor symptoms at this point must be avoided. If the prescriber is impatient, however, and gives another remedy based upon the remaining minor symptoms, the case may become disrupted.
The best course in such a case is to reassure the patient about the good response, and then to wait for a long time. Very likely, the minor homeopathic symptoms will gradually disappear over a period of three months or longer. They should not be prescribed upon at the moment. In case these minor symptoms remain with the patient after a long time, and if they are annoying, the homeopath should retake the case; most probably it will be found that one of the complementary remedies is then indicated.
Patient: "I feel better, but I have a few new symptoms."
Case: Definite aggravation followed by amelioration, but some new symptoms develop which are characteristic of the remedy given.
Interpretation: Correct remedy, with "false proving." Good prognosis.
Prescription: Wait. New symptoms will disappear.
This is another situation which is commonly encountered, and it represents another instance in which the homeopath is quite liable to make a serious mistake. The patient reports a dramatic improvement of all major symptoms, and further questioning reveals that there was an aggravation within the first few days. However, the patient reports new symptoms which are very characteristic of the remedy given.
For example, the patient may have initially complained of a lack of energy, recurrent aphthae, and herpetic skin eruptions. After taking the full case, Natrum muriaticum is prescribed. After one month, the patient says, "Boy, that is powerful stuff! Within a few days, I felt wiped out and all of my aphthae and herpes were much worse! However, since then they have disappeared. I have felt great, better than I have for twenty years! Now, though, I seem to get headaches at 10 A.M. several days of the week. Strange. I have never had headaches prior to taking this remedy." It is immediately realized that 10 A.M. headaches are very characteristic of Natrum muriaticum. The general state is improved, but a new symptom corresponding to the remedy is present.
This must not be misinterpreted as being a proving which should be antidoted. In fact, it confirms very nicely that the prescription was exact; the recommendation therefore must be, "Wait!" The new symptom is merely a manifestation of the remedy, and it will pass within a few weeks at the latest, leaving the patient feeling very well. This interpretation of the appearance of a new and characteristic symptom, however, is valid only when the general condition of the patient has been simultaneously ameliorated.
Patient: "My original problem is better, but now I have another one."
Case: Chief complaint better without aggravation, while new and deeper problem has emerged. No change in energy or mental-emotional state.
Interpretation: Suppressive and disruptive effect of medicine.
1) Study again the original case to discover the correct remedy in the first place.
2) If no remedy is apparent, antidote with allopathic drugs, coffee, or camphor, and thenwait for new clear image to emerge.
Here, we have a circumstance which is somewhat unusual, but by no means unheard of, especially in the first years of prescribing. The patient reports no significant change in energy or mental/emotional symptoms, and the chief complaint has diminished quite a bit, but some intense new symptoms have replaced it.
If the information is truly reliable, then we have suppressed one symptom and another has come up in its place. If, with this new symptom, there has not formed a new picture of another remedy and the case seems confused, then study again the original case to see if you can find a better remedy.
If no better medicine can be found from the original case, the best choice is to wait until the new symptoms subside and the image returns to its original state, provided the severity of the patient's condition allows it. If, however, the new state is causing a great deal of suffering, the best policy would be to try to antidote the action of the first remedy. This can best be done by giving ordinary allopathic drugs for palliation, or by having the patient drink significant amounts of coffee (or even by trying to rub large amounts of camphor into the skin). After a period of two or three weeks of allopathic treatment or coffee, stop the palliative or antidoting process and wait for one week to allow the system to settle into a new image. Then re-take the case and prescribe once again.
In such suppressed cases, it is very important not to try to give a new remedy based upon the changed newimage. This would likely lead to even further disordering of the case. It is also advisable not to try to antidote the remedy by another homeopathic medicine; any homeopathic remedy which can have an antidoting effect upon the system is likely to be close enough to the resonant frequency of the organism to cause further disturbance. It is much more desirable simply to simply allow time to produce a better image upon which to prescribe.
In Appendix B, Prog Vithoulkas describes twenty-two responses to a homeopathic remedy. The above are just three of those.