The Four Remedy Reactions, Part 3, Partial Simillimums and Accessory Symptoms

[David Little]

The Signs of Partial Simillimum

Accessory Symptoms

One of the most misunderstood areas of remedy reactions is accessory
symptoms. Accessory symptoms are caused by partial simillimums that suit
one part of the case but to not possess the totality of the characteristic
symptoms. For this reason they produce side-actions that are not
homoeopathic to the individual under treatment. These are actually symptoms
of the remedy rather than the patient that have the potential to change the
natural symptom pattern. Many homoeopaths unfamiliar with accessory
symptoms think these are new symptoms, deeper layers, or new diseases in
the patient rather then the sign of a partial simillimum. If one is not
careful, they may continue to give more of partial simillimums that
continue to produce more and more accessory symptoms until the original
natural disease is so masked by medicinal symptoms that the case becomes
muddled and may become spoiled in the end.

Everyone gives a partial simillimum on occasions so one best learn the
consequences. A partial simillimum will cause an improvement in one side of
the case while producing new symptoms in another area. If the remedy is
close enough the center of the case the vital force will remove any mild
accessory symptoms without trouble. One often sees a few new symptoms of a
mild nature that fade rather quickly without causing any disruption of the
case. The therapeutic power of the remedy will increase as the mild
accessory symptoms disappear.

If the remedy is too far from the center of the case it may produce
moderate to strong accessory symptoms which become obstructive over time
rather than weaker and eventually disappearing. The therapeutic powers of
the remedy lessen and the accessory symptoms increase. This is an important
differential. This is one of the reasons it is important to give a single
test dose, or a short series of three test doses, and for stopping the
repetition of a remedy when the symptoms become changeable, and waiting and
watching for a appropriate time depending on circumstances. In the Paris
casebooks one sees Hahnemann giving placebo when he was repeating doses and
the symptom pattern became a bit confused. He would let the case settle.

When symptoms are removed and return in the same form with less
intensity during a relapse, the remedy is a simillimum. When repeating the
dose to speed the cure the symptoms under treatment should not change. If
the patient improves in one area and new symptoms appear in others, the
remedy is a partial simillimum. These changes are not the return of old
symptoms associated with Hahnemann's direction of cure. These new symptoms
are often found in the materia medica under the remedy.

Partial simillimums lead to "zig-zag prescribing" where the cure is not
a straight forward event. First the case improves in one area yet troubles
seem to appear in other areas calling for a new remedy. There are two types
of zig-zag prescribing. The first is when the accessory symptoms are not
too strong and the homeopath zigs and zags with partial simillimums until
they reach the goal. If the remedies are close enough to the center the
cure may not take place rapidly, and may not be as gentle as hoped, but it
will take place. This is called zig-zagging with honors.

An experienced homoeopath can use one or two remedies over a long
period while the inexperience may need three, four, five or more medicines
over the same period. Those homeopaths who always need many remedies to
treat a case are those that rarely give true simillimums. These
practitioners have endless rationalizations for why they "need" to give so
many remedies. In truth, the reason is that they do not take a good case in
the beginning and give remedies that suit the essential nature of the
characteristic symptoms.

A well chosen chronic remedy should be able to be repeated, if needed,
in several different potencies over a longer period of time. When a remedy
only covers one part of a case it will change other parts by producing side
actions that change the natural symptom pattern. Less changes the better -
more changes the worse. Less remedies - better prescriptions. More remedies
- worse prescriptions. I can always tell how well I understand a chronic
case by how many remedies I have used in one year.

There are, however, one-sided pathological conditions where a decent
remedy will bring out symptoms but these are either symptoms that the
patient had in the passed that became a repressed layer or they symptoms
which the individual has the potential to produce. In this case, this is a
good sign because the one-sided nature of the symptom pattern is being
broken up and the repress mistunements are surfacing. This helps the
homoeopath administered a deeper acting remedy.

The difference in a dissimilar aggravation and accessory symptoms is a
question of degrees. A dissimilar aggravation produces new and troublesome
symptoms not appertaining to the disease state under treatment. It does not
cause improvements. A partial simillimum causes improvements in one area of
the case while producing new and possibly obstructive symptoms in
another.There are three methods of dealing with accessory symptoms
depending on circumstances. These actions methods are similar to those use
when the wrong remedy produces a dissimilar aggravation.

1. If the accessory symptoms are mild the vital force will remove them
while proceeding toward the cure. There is nothing to do because the remedy
is "close enough". The homoeopath should keep an eye on any accessory
symptoms that appear. It is not uncommon for a remedy to produce a few side
actions but they should pass through quickly.

2. If the accessory symptoms becomes stronger, and the remedial powers of
the remedy lessen, the remedy should not be repeated. Sometimes, a
relatively short period of waiting and watching will allow the accessory
symptoms to fade and a new better remedy can be chosen. If there are still
some lingering accessory symptoms they should be included with the natural
symptoms in a grand totality, and a better remedy given. This should
regularize the VF and move the case forward without the production of
accessory symptoms. Such a remedy acts as an antidote to the negative
accessory symptoms and a complement if there are some positive improvements
caused by the partial simillimum.

3. If the accessory symptoms become troublesome and obstructive and what
little improvement there was disappears under their weight, the remedy may
have to be canceled in the same manner as a dissimilar aggravation. After
the symptoms settle, the case retaken. Now one must be very careful to
give a good simillimum. If the size of the dose is kept small and one is
prudent with the potency factor, antidotes should not be necessary.

When Remedies Do Not Hold.

Another difficult phenomena is when a remedy works well enough in the
beginning but then seems to no longer hold. Sometimes, it just takes a
adjustment of the size of the dose, the number of succussions given a
medicinal solution, or raising the potency to make the remedy hold for a
longer period again. A good simillimum should hold longer and longer as the
remedy is repeated and the potency is raised. Holding for shorter and
shorter periods no matter what we do is not a good sign. There can be some
reasons for this phenomena.

1.. There is an underlying fundamental cause like a classical miasms
obstructing the cure. Here one looks for miasmatic signs, symptoms and
history. This may be time when a chronic intercurrent nosode will either
make the case move forward or resensitize the vital force to the previous
remedy so it will hold.

3. There may be some hidden organic pathology blocking cure. Here one
examines the patient vital organs and systems and may need to address this
pathology directly with a better remedy.

3. The remedy is a distant partial simillimum that can not hold because an
important aspect of the case has been missed. Here on carefully retakes the
case and give a better remedy. Sometimes, Boenninghausen's Concordance
helps here because it show the most similar circle of remedies to the one
used.

Suppression and Partial Simillimums

Suppression is when some of the more superficial, one-sided or local
symptoms are ameliorated but the sense of well-being, mental state, general
symptoms, and vitality decline. This is a sign that the remedy has
suppressed symptoms of the case causing the mistuned energy to go deeper
into the organism. The signs of suppression are the opposite of the
Hahnemann's direction of cure. The symptoms move from without to within,
from less important to more important systems, and new symptoms appear.
Suppression can also be caused when the symptoms of the chronic miasms are
treated in a one-sided manner by remedies that only reflect limited facets
of the entire miasmatic syndrome. Suppression can also be caused by
treating the patient in a one-sided manner by causations or disease names
rather then the essence of the totality of the symptoms.

Suppression by homoeopathic remedies is a possibility. One must take a
complete case and follow the progress of the patient over a long period of
time. Sometimes, some of the symptoms get better in the beginning yet
slowly over time the patient declines. Suppression is the sign of a wrong
remedy. A one-sided partial simillimum can cause suppressions if they only
fit the superficial aspects of the case. The homoeopaths must always look
at the long term progress of the person and not be fooled by the immediate
improvement of one or two symptoms. The WHOLE patient must improve. If the
emotional state, intellectual capacity, the general symptoms, and vitality
decline while a discharge or local symptoms improves this is a negative
sign. Another sign of suppression is when the susceptibility to infectious
disease and environmental stress increases.

Suppression comes from not taking a complete case as suggested in
aphorism 5 and 6 of the Organon. This includes the timeline of the complete
case history, constitution, temperament, acute and chronic causes, miasms,
social and domestic situations, habit and lifestyles, sexuality, age, etc.,
as well as the totality of the signs, coincidental befallments and symptoms.
When there is suppression the homoeopath must reverse the affects of the
negative remedy.

1. The offending remedy may be cancel by a known antidote and the case
retaken. The suppressed symptoms should resurface if the vital force has
sufficient reserves to do so.

2. The second option is retaking the case with the natural symptoms and
medicinal symptoms as presented with the inclusion of those symptoms that
were suppressed. If the treatment is successful the suppressed symptoms
will come back thus restoring the natural direction of cure. If the new
remedy does not cause an over all general improvement after the removal of
the suppression the case must be retaken and a better simillimum given.

3. If the vital force does not seem to be able to reinstate the suppression
after the cancelation of a remedy by an antidote one can use option 2 to
reinstate the suppressed symptoms and get the case moving forward.

Suppression by homoeopathic remedies is something that every
homoeopaths must consider a possibility. If the homoeopath takes a complete
case, and understands the role of the chronic miasms and constitutional
disorders, suppression can be avoided. If the dose is kept small and
medicinal solution is used these negative affects can be removed without
trouble. Large numbers of dry pills of high potencies, and repeating the
wrong remedy mechanically, can seriously affect the vital force. Being
careful when taking a case in the beginning and following a patient
carefully to the end prevents such unproductive situations from arising.

Next comes a naturally healing crisis.
Sincerely, David Little
Similia Minimus,
Sincerely, David Little
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000