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Lecture 4 for the Public: “How to judge the response to the first intake of your remedy? (and the consequent doses)”


A correct interpretation to the first response of the patient to his first remedy dose is essential for the future success of the case. Even when the homeopath has selected the right remedy on the first consultation, the most difficult work is still to be done: “How to judge the response? Was it a good response indicating a true cure has started, or was it rather an improvement of a local problem, possible notifying a suppression of the symptoms, which only guarantees a worsening of the future natural disease?” This is the topic of this lesson: I want to empower the patient to first of all know what to expect and not to take some fantasy answers for a fact, and secondly, it will empower the patient to assist his homeopath more efficiently towards the cure of his illness.

The answer to this question remains the same, if your practitioner uses the 4th (dry doses), the 5th or 6th edition of the Organon. The previous lectures already have shown the great advantages of the watery doses, but the issue here is to know if the first step has been made towards cure rather than suppression or palliation (suppressing symptoms where a cure is possible).

After the first dose, the patient has to ask himself the following questions?

  • Was there an improvement according to A253: “The very beginning of improvement is indicated by a sense of greater ease, composure, mental freedom, and higher spirits?” And I would add: “A sense of well being and a better sleep, often more sleep required? Or as a first sign we may see a change in the topic of dreams: going from nightmares with killing to a dream with festivities, traveling, meeting people, connecting to dead people?” If so, then the remedy was chosen well (dose, potency included) and even if the chief complaint might not be improved at all (especially when of physical nature) the cure is set into movement. The test dose (see lesson 3) will determine the repetition of your remedy, so it is truly individually tailored to you the patient.
  • Here is the true question the patient (and the homeopath) needs to ask himself: “Did the picture, once the action of this first dose has ceased, come back unaltered or unchanged?” What exactly does this mean? Homeopaths and patients must ask themselves this question because if you can answer yes to this question, then you have initiated your cure with the right remedy, dose and potency. When I say “unchanged” this means not that nothing changed: the chief complaint, let’s say a chronic headache might have decreased in intensity and frequency, but with “unchanged” we mean no other symptoms have been added to the chief complaint. We will discuss further what “other symptoms” mean. The first thing we can see here, as mentioned in lesson 3, is that the advanced 5th and 6th edition prescriber already assesses this answer on the third day where the 4th edition prescriber (dry doses) will do so only after 3 or 4 weeks! Much can go wrong in 4 weeks, not much can go wrong in three days! Correcting a situation the third day or the 4th week makes all the difference in the world.
  • Did the picture remain the same with an aggravation of the existing symptoms? This is called a similar aggravation which leads to unnecessary suffering. A 4th edition prescriber wants to see this aggravation as it confirms the choice of his remedy but Hahnemann limited and did away completely with this similar aggravation in the 5th and 6th edition of the Organon. The watery doses allow the homeopath to choose very carefully the minimum dose and the potency which is now tailored to each patient. If there is any similar aggravation it is very minimal and again discovered the third day with the advanced methods, and only later in the 4th edition method. Of course even if the 4th edition prescriber hears about the aggravation, he will say, “great we are going to cure the case.” Curing maybe but it will be a tough road and absolutely not necessary! What if the child wants to kill his father to marry his mother (true case)? So we aggravate him and he might just do it! This is one of the reasons to prescribe with the advanced watery methods: “you don’t have to get worse before you get better!”

What if the picture of your disease comes back changed after the first visit?
There are different options and each one is followed by a different action to be taken.

  • First option: the patient comes back after the first dose of the remedy with new symptoms, which he had never before! One word of caution here: often the patient has a defective memory about previous symptoms, so make sure to check with other family members. But if they are truly new symptoms, creating much discomfort, then the remedy is wrong and the case needs to be retaken! There are exceptions: if you see discharges from any opening in the body or rashes appear after the remedy and you never had such symptoms, it is a sign of cure as the disease is pushed outwards (exteriorization). So never suppress these symptoms with creams or suppositories as you will work against the good work of the remedy and Nature!
  • There are one or two new symptoms but in a low degree of intensity while the other symptoms are getting some relief and the A253 symptoms (see before in this text) are present. The homeopath must immediately check if these new symptoms, are belonging to the remedy he has given. We call these symptoms accessory symptoms. What to do with these accessory symptoms is explained further!
  • Old symptoms are returning: symptoms that were present before can now reappear again simply because they were suspended by later and stronger symptoms. This is A38, where a stronger disease suspends the weaker one (not cure it): see lesson 1 and 2. Always ask yourself: “Did I ever have these symptoms in the past?” If so, you are on your way to cure and the remedy should not be changed! There is only one possibility that the dose and/or potency have to be adjusted (not a change in remedy): when the returning symptoms are too strong and too frequent. Here again the watery solutions are easily adjusted and this is not the case with the dry doses again!

The problem of accessory symptoms
They can take two forms.

  • The first one: A253 is followed and only one or two symptoms belonging to the remedy are present in a low intensity while many of the original symptoms have improved: this is called a close simile (almost the simillimum) and in that case nothing needs to be changed as it will not impede the cure! (A163). So this will happen: suppose you had initially 10 symptoms and after the first prescription, 5 improve and one new symptom, belonging to the prescribed remedy appears, then you are on the right track! No changes needed!
  • The second option is called the distant simile and a total different matter. It means maybe 2 of the ten initial symptoms improve (and the two might even include your chief complaint) but now 5 new symptoms belonging to your remedy appear: your case must be retaken as the wrong remedy was prescribed. If such remedy is repeated, your initial disease will now be replaced entirely with a disease made up of symptoms of the prescribed remedy, symptoms you never had! So in other words you got a worse disease! Do not think this is not possible, I have seen it enough!

What else can you see after the first prescription (and the next ones)?
If mental symptoms are now replaced by emotional ones and later emotional by physical ones. Let’s take a case of an autistic child I saw. Before he always said no to everything (contradictory) now he readily agrees to doing things and behaving better towards his sister. Before he runs away when someone wants to take a picture of him, now he likes it. He is friendly, walks now the dog (before indifferent), etc…All this while his eczema comes more out! This is a shift from the emotional plane towards the physical plane and counts as the direction of cure. He is on his way to a cure because all the rules we need to observe in homeopathy are followed. On the other hand, if a physical symptom disappears (for instance eczema) and now the child exhibits emotional or mental symptoms: wrong remedy!! Needs to be stopped and case must be retaken!

I hope this lesson helps you understanding your case follow up of that of your loved one. In the next lesson I will explain what information is important to communicate to your homeopath and what is not important. I also will touch on the integration of other modalities (psychology, Traditional Chinese Medicine, allopathy, vitamins) with homeopathy. A special approach will be taken in account for the ASD children.