PROGNOSIS A= FTER OBSERVING THE ACTION OF THE REMEDY

KENT’S 12 OBSERVATIONS

After a prescription has been made, it is important to observe what happens in consequence to the prescription. Not being conversa= nt as to what may happen will result in wrong prescriptions. If the homoeopath= ic physician is not an accurate observer, his observation will be indefinite; = and if his observations are indefinite, his prescribing is indefinite.

It is to be understood that after a prescription is made= , it has acted. If a medicine is acting, it starts immediately to affect changes= in the patient, and these changes are indicated through signs and symptoms. If= a prescription is not related to the case, waiting is loss of time, and that should be taken into account among the observations.

The remedy is known to act by the changing of the sympto= ms. The disappearance of symptoms, the increase of symptoms, the amelioration of symptoms, the order of the symptoms and duration are all changes from the remedy, and these changes are to be studied.

Among the commonest things that remedies do is to aggravate or ameliorate.

The aggravation is of two kinds; aggravation of disease, in which the patient grows worse; or aggravation of symptoms, in which= the patient grows better. An aggravation of the disease means that the patient = is growing weaker, the symptoms are growing stronger, but the homoeopathic aggravation, which is the aggravation of the symptoms of the patient while = the patient is growing better, is something that the physician observes after a true homoeopathic prescription.

The patient should be the aim of the physician, to deter= mine whether he is improving or declining.

First observation – Prolonged aggravation and final decli= ne of the patient

· = This is seen in an incurable case, where the antipsoric administered was too deep, and it has established destruction. There is reversal of order of cure.

· = The patient steadily declines. The symptoms take = on an internal phase – vital organs are affected. In this state, vital r= eaction was impossible.

· In incurable and doubtful cases give no higher th= an the 30^th or 200^th potency, and observe whether the aggravation is going to be too deep or too prolonged. Begin, in such cases, with a moderately low potency, and the 30^th is low enough for anybody or anything. Otherwise, the deep acting remedy in high potency resu= lts in a killer’s aggravation.

ILLUSTRATION –

A stoop-shouldered patient, with a chronic hack= ing cough reports for treatment. His face is sickly, he is lean and anxious, he is careworn and poor. An antip= soric seems indicated. Tuberculosis is diagnosed and the patient is steadily declining. On prescribing the antipsoric - he c= omes back in a few days with quite a sharp aggravation of the symptoms – increased cough, night sweat, and more weakness. this patient returns in a week, and the aggravation is still present and increased - coughing is wors= e, expectoration is more troublesome, night sweats have been going on; he comes back at the end of the second week and he is still worse, and all the sympt= oms have been worse since he took that medicine. He was comparatively comfortab= le before he took that medicine, but at the end of the fourth week he is stead= ily growing worse. There has been no amelioration following this aggravation, a= nd he is evidently declining – PROLONGED AGGRAVATION AND FINAL DECLINE.<= o:p>

Second observation – Long aggravation, but final and slow improvement

· = Seen in cases that are not so advanced, with not = so profound a disturbance – on administration of a high potency.

· = The aggravation is long and severe and may last f= or many weeks, yet there is a final amelioration - a slow but sure improvement= .

· = It shows that the disease has not progressed quit= e so far; the changes have not become quite so marked.

· = It is always well in doubtful cases to go to the lower potencies, and in this way go cautiously prepared to antidote the medicine if it takes the wrong course.

· = If, at the end of a few weeks, he is a little bet= ter and his symptoms are a little better than when he took the dose, there is s= ome hope that finally the symptoms may have an outward manifestation whereby he will attain final recovery, but for many years you may go along with prolon= ged aggravations.

Third observation – Aggravation is quick, short and strong with rapid improvement of patient

· = Seen in cases where there is no structural change= of vital organs or superficial structural changes of less vital organs.

· = Aggravation, that comes quickly, is short, and has been more or less vigorous, then improvement of = the patient will be long.

· = Reaction of the economy is vigorous. There is a difference between organic changes that take place in the organs that are vital, that carry on the work of the economy, and organic changes that take place in structures of the body that are not essential to life. =

· = An aggravation that is quick, short and strong is= one that is to be wished for and is followed by quick improvement. Such is the slight aggravation of the symptoms that occurs in the first hours after the remedy in an acute sickness, or during the first few days in a chronic case= .

Fourth observation - No aggravation, with recovery of patient

· = These are cases with very satisfactory cures, whe= re the administration of the remedy is followed by no aggravation whatever.

· = There is no organic disease, and no tendency to organic disease. The chronic condition itself to which the remedy is suitab= le is not of great depth, belongs to the functions of nerves rather than to threatened changes in tissues.

· = If there is no aggravation the potency just exact= ly fitted the case. In cures without any aggravation, the potency is suitable,= and the remedy is the curative remedy, provided that the symptoms go off and the patient returns to health in an orderly way.

· = It is the highest order of cure in acute affectio= ns, yet the physician sometimes will be more satisfied if in the beginning of h= is prescribing he notices a slight aggravation of the symptoms.

Fifth observation - Amelioration comes first and the aggravation comes afterwards

· = The patient says he is better, and the symptoms s= eem to be better; but at the end of a week or four or five days all the symptoms are worse than when the patient first came.

· = (a) = Either the remedy was only a superficial remedy, and could only act as a palliativ= e, or

= (b)&= nbsp; The patient was incurable and the remedy was some= what suitable.

· = One of these two conclusions must be arrived at, = and this can only be done by a re-examination of the patient and by finding out whether the symptoms relate to that remedy.

· = The remedy could have been an error. A further st= udy of the case shows that the remedy was only similar to the most grievous symptoms, that it did not cover the whole case, that it did not affect the constitutional state of the patient, and that the patient is incurable and = the selection was an unfavorable one.

· = It is the best thing for the patient if the sympt= oms come back exactly as they were, but very often they come back changed, and = then one needs to wait through grievous suffering for the picture.

Sixth observation - Too short relief of symptoms

· = When a high and right potency acts in curable case – the remedy acts at once and establishes a condition of order, after which there is no need in giving medicine. This order may continue a considerable length of time, sometimes several months. The patient gets alo= ng without any medicine. But, the patient may come back at the end of the firs= t, second and third week and says he has done well, that he has been improving= all the time, but at the end of the fourth week he returns back with suffering.=

· = This could be due to some obstacle - something th= at has spoiled the action of medicine. This condition is an unfavorable one. <= o:p>

· = If relief after the constitutional remedy does not last long enough, it is because of some condition that interferes with the action of the remedy; it may be unconscious on the part of the patient, or = it may be intentional. A quick rebound means everything in the remedy, means t= hat it is well chosen, that the vital economy is in a good state, and if everyt= hing goes well, recovery take place.

· = In acute= cases, when there is too short amelioration of the symptoms, the remedy has= to be repeated. If it is too short an amelioration in acute cases, it is becau= se high grade inflammatory action is present and that organs are threatened by= the rapid processes going on.

· = If it is too short amelioration in chronic diseases, it means that t= here are structural changes and organs are destroyed or being destroyed.

Seventh observation - Full time amelioration of the sympt= oms, yet no special relief of the patient

· = There are conditions in patients that prevent improvement beyond a certain stage.

· = A patient with one kidney can only improve to a certain degree; patient with fibrinous structur= al change in certain places, tubercles that have become encysted and lungs cap= able of doing only limited work are examples of such cases.

· = These cases have symptoms, and these symptoms are ameliorated from time to time with remedies, but the patient is only curabl= e to a certain extent; he cannot go beyond and rise above such a state.

· = After several medicines have been administered – the amelioration of the case has existed= the full length of time. But the patient has not risen above his own pitch in t= his length of time.

· = The remedies act favorably, but the patient is no= t cured, and never can be cured. The patient is palliated in this instance, and it i= s a suitable palliation for homoeopathic remedies.

Eighth observation – Patients prove every remedy they get

· = Patients maybe hysterical, oversensitive to all things.

· = The patient is said to have an idiosyncrasy to everything, and these oversensitive patients are often incurable.

· = When administered a dose of a high potency, they = go on and prove that medicine, and while under the influence of that medicine = they are not under the influence of anything else. Such patients are good provers, they will prove the highest potencies.

· = For such patients, go back to the 30^th= and 200^th potencies. Many of them are born with this sensitivity and they will die with it.

Ninth observation – Action of the medicines upon provers

· = Healthy provers are a= lways benefited by provings, if they are properly conducted.

· = It is well to observe carefully the constitutional states of an individual about to become a prover, and to write these down and subtract them from the proving. <= /p>

· = These symptoms will not very commonly appear duri= ng the proving; if they do, note the change in them.

Tenth observation – New symptoms appearing after the reme= dy

· = If a great number of new symptoms appear after the administration of a remedy, the prescription will generally prove an unfavorable one.

· = Now and then the coming of a new symptom will sim= ply be an old symptom coming up that the patient has not observed, and thinks i= t a new one.

· = The greater the array of new symptoms coming out after the administration of a remedy, the more doubt there is thrown upon t= he prescription. The probability is, after these new symptoms have passed away, the patient will settle down to the original state and no improvement takes place. It did not sustain a true homoeopathic relation.

Eleventh observation – Is when old symptoms are observed to reappear

· = In proportion as old symptoms that have long been away return just in that proportion the disease is curable.

· = They disappeared because newer ones have come up.= It is quite a common thing for old symptoms to appear after the aggravation has come, and hence we see the symptoms disappearing in the reverse order of th= eir coming.

· = Those symptoms that are present subside, and old symptoms keep coming up.

· = Old symptoms often come back and go off without a= ny change of medicine. It indicates that the medicine must be let alone. If the old symptoms come bac= k to stay then a repetition of the dose is often necessary.

Twelfth observation - Symptoms take the wrong direction

· = If a medicine is prescribed for rheumatism of the joints and relief takes place at once, but the patient now suffers form vio= lent internal distress of the heart, or centers in the spine, there is a transference from circumference to center, and the remedy must be antidoted at once, otherwise structural change will t= ake place in that new site.

· = Most gouty patients get along best when their fin= gers and toes are in the worst condition. To prescribe for this, and see the hea= rt symptoms grow worse is not favorable.

· = There is a danger in selecting a remedy on extern= al symptoms alone, i.e., selecting a remedy that corresponds only to the skin = and ignoring all the symptoms and general state of the patient; because it is t= rue that the remedy that is related to the skin alone may drive in that skin disease and cause it to appear while the patient himself is not cured. Such= a patient will remain sick until that eruption comes back again, or locates in another place.

DR. SUMIT GOEL

M.D. (Hom)

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