THE LAW OF PALLIATION by HERBERT A. ROBERTS, M.D.
Posted: Sun Jan 08, 2006 1:57 pm
THE LAW OF PALLIATION by HERBERT A. ROBERTS, M.D.
http://homeoint.org/books4/roberts/chapter19.htm
The principles and Art of Cure by Homœopathy
by HERBERT A. ROBERTS, M.D.
Presented by Médi-T
CHAPTER XIX
THE LAW OF PALLIATION
PHYSICIANS who have been somewhat trained along homœopathic lines
manifest more confusion in the treatment of incurable diseases than in
almost any other field of medicine. When faced with incurable cases, the
thought occurs to a great many physicians to administer palliative measures
in an effort to alleviate suffering and to attempt to hide from the patient
and from the family the real seriousness of the situation. Although they
may mean well, it is an effort expended in the wrong direction, and does
more harm than can well be estimated. There is no place in the field of
medicine where obliteration of symptoms will cause so much confusion, so
there is no possibility of accurate prescribing, as in these incurable cases.
The basis of cure is the fundamental law of similars. The law of
similars is the fundamental law also in the palliation of incurable states.
The administration of narcotics and sedatives suppresses symptoms and
destroys the power of elimination by locking up the secretions in all
states so completely that we cannot get a true picture of the condition of
the vital force and energy upon which we must evaluate our symptomatology.
The result of palliative treatment by the use of narcotics demands the
continual increase of the drugging, for as soon as the effect seems to be
subsiding, more drug must be administered. It becomes a vicious circle from
which there is no escape except to be sent to the ultimate end in a
confused and half-deadened condition, instead of being helped to live out
as many years as possible in the easiest, quietest and most gentle manner.
In his Genius of Homœopathy, page 79, Stuart Close gives us the
following admonition:
Many substances are used medically in such form, in such doses, by
such methods and upon such principles as to be distinctly depressive or
destructive of normal reactivity. They are forced upon or into the
suffering organism empirically without regard to nature's laws. So far as
their effect upon disease is concerned they are in no wise curative, but
only palliative or suppressive and the ultimate result, if it be not death,
is to leave the patient in a worse state than he was before. Existing
disease symptoms are transformed into the symptoms of an artificial drug
disease. The organism is overwhelmed by a more powerful enemy which invades
its territory, takes violent possession and sets up its own kingdom. Such
victories over disease are a hollow mockery from the standpoint of a true
therapeutics.
When we are facing these incurable conditions the administration of
the similar remedy almost always ameliorates the situation, at least for
three or four days, and usually for a longer period. Then we may have a
return of the symptoms, when the indicated remedy will be called into use
again. These conditions of impending fatality are usually accompanied by a
great many symptoms, because the whole organism is involved and a gradual
dissolution is taking place in every part of the economy and the vital
energy is so nearly overcome as to be unable to throw off these
manifestations. Sometimes one symptom or set of symptoms predominates and
becomes the annoying, troublesome, disagreeable symptom-complex. In these
conditions we must retake the case and reexamine the remedy that we have
been using, to see if it corresponds with the disease condition. If the
similarity exists in these especially troublesome manifestations, these
patients can be made much more comfortable.
For instance, a recent case of incurable cancer developed involuntary
urination with absolutely no control over the condition. Her remedy was one
of the Calcarea group. For this troublesome symptom of involuntary
urination the repertory gives us five remedies of equally prominent rank
which we may consider: Arsenicum, Natrum mur., Pulsatilla, Rhus tox, and
Causticum. With the constitutional similarity of the patient to the
Calcareas, Causticum was the only remedy to be considered, and one dose of
Causticum 200 restored complete control over this disagreeable symptom, and
made the patient more comfortable in general.
Another class of symptoms that is very troublesome and which often
falls under the use of palliatives, is composed of the patients who
complain of insomnia. These patients will yield to the law of similars with
pleasing results in their whole constitutional state, but not unless this
symptom is considered with the concomitants that point to the remedy.
Insomnia may be the outstanding irritating symptom in many varied symptom
pictures. In some cases there is general coldness, and the patient will lie
for hours awake unless he is covered with extra bed clothing, although he
may not be aware of being uncomfortably cold. Worries of a business nature
may be the cause of the accompanying symptom picture, or family
disturbances may be at the bottom of the trouble. There may be pain and
distress in certain parts. Any of these things attend a symptomatology of
which the insomnia is but a part. Does he fall asleep if his knees are
heavily covered? Is he kept awake by a rush of ideas? Is he lying awake
because he fears that something will happen to him if he drops off to
sleep? When does he lie awake-on first going to bed or after midnight? In
other words, what are the concomitants?
The insomnia may be treated with crude palliative measures so that the
patient secures sleep, but at best this is an unnatural sleep; while if the
insomnia is considered as a part of his symptomatic picture, and given its
proper place in that symptomatology and the man himself is treated-not
alone one or two symptoms-he will gain his natural, refreshing sleep and he
himself will be improved in general health.
Again, pain is one of the experiences from which human life has ever
striven to free itself. Pain in itself is a blessing in disguise, for it
brings to the patient a recognition of trouble, and to the physician the
ability to recognize the location of the trouble.
The treatment of pain as a single trouble, and the fear of pain, has
led to a winder use of narcotics than any other single factor. It is the
cause of more drug addicts than can well be estimated. The patient is in
pain, or the physician fears that the patient may be in pain, and in a
sympathetic attempt to relieve the patient from a temporary discomfort many
a physician has been led to prescribe drugs, the initial effect of which is
to relieve the suffering of the patient, but the lasting effects of which
are to produce a drug addict. Robert T. Morris, M. D., made the following
statement in 1893, and it is as true today as it was then:
1. Opium is a drug which stupefies the physician who gives it more
than it does the patient who takes it.
2. A drug which greatly relieves the distress of the physician, who,
without it, would be compelled to do something rational for the relief of
the patient who has put confidence in him.
Pain in itself is but a part of the symptom, however, for the
physician must take into consideration the location: the kind of pain,
whether steady or intermittent, and if intermittent, whether at regular
intervals or upon motion, or is it dull, cutting, blunt or sharp, pressing,
pulling, darting, cramping? Get at the type of pain as a characteristic
symptom of the disordered condition; the times and circumstances of
aggravation and amelioration, the reaction to thermic conditions, and all
the concomitant symptoms that can be found. When the symptom of the pain
itself is complete, with the location, type, and aggravations and
ameliorations, your picture is almost complete; but if in addition you can
find those concomitants (which may lie in the conditions of aggravation or
amelioration but which are often from seemingly unrelated symptoms) you
have a sound basis for the selection of a remedy which will relieve the
pain promptly, and the patient will be much more comfortable and happy in
general than with any narcotic.
One of the most difficult problems a physician has to meet, where he
has need of acumen and discernment and a complete knowledge of remedy
pictures, are such conditions as manifest an alternation of symptom
pictures in different seasons of the year, such as summer gastric
disturbances and winter rheumatic conditions, the Dr. Jekyll and Mr. Hyde
of chronic manifestations. There are a number of these conditions of
alternations of symptom groups, and then there are the alternation of
sides. When the patient presents himself to you, you may be justified in
concluding from his story that his trouble is limited to the disturbed
state of which he complains at that time; yet the remedy selected on this
group of symptoms alone will often fail to bring relief, or, if the remedy
does relieve the symptoms most marked at the time, the man's condition as a
whole may not be improved, or indeed it may even be worse, since we have
not cured but palliated a part of his symptom picture, obliterating a very
valuable part of our symptomatology. If the patient is curable and we have
thus obliterated a part of his symptom picture, we have blinded ourselves
as to his true state: whereas a complete understanding of his condition
over a period of several months would give a sound basis for a successful
remedy selection. This is especially true in such conditions as gout, and
we have remedies that have just this periodicity. Either for palliation of
incurable diseases or for the cure of the curable diseases the
symptomatology of the remedy must simulate, in so far as possible, the
disease picture in order to bring relief, and where periodicity or
alternation is a part of the symptomatology the remedy must have the
characteristic feature if we are to expect it to be effective.
It is sometimes true, when we have a case with alternating phases or
series of symptom groups and we are unable to meet the condition with a
remedy that covers all the phases (either because we do not learn of the
alternating phases from the patient in the first place or because we do not
know of a remedy to meet the condition), that by meeting the symptom groups
as they arise in the case itself as we go on, the symptomatology becomes
clearer and more distinct so that we more completely meet the conditions as
they arise and the patient's condition becomes better as a whole. This is
meeting the case by a zigzag process, removing the most pronounced and
characteristic symptoms by the remedies most similar in each state, but it
takes very careful prescribing or we are apt to hopelessly mix the case.
This may be done in emergencies or when we cannot find a better method. It
serves better as a palliative measure in incurable states than as a
curative measure in curable states, and a failure in any of one of a series
of successive prescriptions may mean the difference between possibility and
impossibility of eventual cure. There is far more satisfaction and the case
is much more complete if we can get a picture of the whole condition and of
the single remedy to meet that condition.
This may be difficult from two angles. The young physician may find it
difficult to do this work carefully because he lacks the knowledge of the
materia medica; but he has at his command a wonderful source of help in his
repertories, which will often serve his purpose by quick reference, filling
in the knowledge that he lacks of the remedy. Another possibility is that
of remedy relationship and the relationship of the various inherited
dyscrasias to the case; these are large subjects in themselves and will be
discussed elsewhere. Again, it is very possible that the remedy covering
the case has not been proved fully, or may not have been thought of by the
students of materia medica.
Here is where the limitations of man's knowledge manifests itself. The
law is correct and God-given, but no secrets of knowledge are ever given
without diligent work and observation on the part of man. Much work has
been done by our antecedents in developing an exceedingly valuable materia
medica, and they have left a glorious record in the symptomatology of the
different remedies. They have given us the weapons to meet these states; if
we fail it is not the fault of the law, nor of the weapons, but of our
failure to learn the use of our equipment. Incurable cases are a source of
great anxiety to every physician, but the physician who will follow the law
of similars with the use of the single remedy in potentized form will give
quicker relief and more sustained relief than all the massive doses of
narcotics and sedatives.
In cases of mechanical injuries where there is much pain and which
would be subject to narcotic or sedative treatment under ordinary medicine,
the homœopathic physician has a group of vulnerably remedies that will not
only allay the pain and distress incident to traumatic conditions, but will
prevent congestive, suppurative or gangrenous processes and actually will
hasten healing; whereas narcotics, while deadening the pain, invite
structural changes by slowing the natural recuperative powers. In this
class we may mention such remedies as Arnica, Hypericum, Ledum, Natrum
sulph., Rhus tox., and Ruta, each of the highest usefulness when indicated.
These remedies cannot be used successfully at random, any more than in any
other condition; but when they are similar to the condition they are of
inestimable benefit.
The homœopathic physician finds another substitute for narcotics in
surgical cases, either before or after operation. Here the indicated remedy
does excellent service, and the patient will go through the mental and
physical distress very happily. These remedies will be indicated partly by
the symptomatology of the patient and partly by the immediate causes of
distress, such as lacerated wounds, strenuous vomiting, shock and
incarcerated flatus. In other words, here also the symptoms must be complete.
These are the things that may be done to relieve suffering. The same
law applies in curable and incurable cases, and it is very essential in
curable cases that no narcotic nor hypnotic nor sedative should be used,
for the reason that these cloud the whole condition; but if the true
reflection of the symptomatology be found we have a basis for help which no
other means could offer. In incurable cases, or seemingly incurable cases,
we must not put a limitation on the possibilities of the similar remedy,
for in many seemingly incurable conditions the simillimum will so
completely meet the situation as to obliterate the symptomatology of
disease and the pathology, and will restore the patient to health.
--------------------------------------------------------------------
Sheri Nakken, R.N., MA, Hahnemannian Homeopath
Well Within & Earth Mysteries & Sacred Site Tours (worldwide)
Vaccination Information & Choice Network
http://www.nccn.net/~wwithin/vaccine.htm
http://www.nccn.net/~wwithin/homeo.htm
homeopathycures@tesco.net
ONLINE Introduction to Homeopathy Classes
ONLINE Introduction to Vaccine Dangers Classes
Voicemail US 530-740-0561 UK phone from US 011-44-1874-624-936
http://homeoint.org/books4/roberts/chapter19.htm
The principles and Art of Cure by Homœopathy
by HERBERT A. ROBERTS, M.D.
Presented by Médi-T
CHAPTER XIX
THE LAW OF PALLIATION
PHYSICIANS who have been somewhat trained along homœopathic lines
manifest more confusion in the treatment of incurable diseases than in
almost any other field of medicine. When faced with incurable cases, the
thought occurs to a great many physicians to administer palliative measures
in an effort to alleviate suffering and to attempt to hide from the patient
and from the family the real seriousness of the situation. Although they
may mean well, it is an effort expended in the wrong direction, and does
more harm than can well be estimated. There is no place in the field of
medicine where obliteration of symptoms will cause so much confusion, so
there is no possibility of accurate prescribing, as in these incurable cases.
The basis of cure is the fundamental law of similars. The law of
similars is the fundamental law also in the palliation of incurable states.
The administration of narcotics and sedatives suppresses symptoms and
destroys the power of elimination by locking up the secretions in all
states so completely that we cannot get a true picture of the condition of
the vital force and energy upon which we must evaluate our symptomatology.
The result of palliative treatment by the use of narcotics demands the
continual increase of the drugging, for as soon as the effect seems to be
subsiding, more drug must be administered. It becomes a vicious circle from
which there is no escape except to be sent to the ultimate end in a
confused and half-deadened condition, instead of being helped to live out
as many years as possible in the easiest, quietest and most gentle manner.
In his Genius of Homœopathy, page 79, Stuart Close gives us the
following admonition:
Many substances are used medically in such form, in such doses, by
such methods and upon such principles as to be distinctly depressive or
destructive of normal reactivity. They are forced upon or into the
suffering organism empirically without regard to nature's laws. So far as
their effect upon disease is concerned they are in no wise curative, but
only palliative or suppressive and the ultimate result, if it be not death,
is to leave the patient in a worse state than he was before. Existing
disease symptoms are transformed into the symptoms of an artificial drug
disease. The organism is overwhelmed by a more powerful enemy which invades
its territory, takes violent possession and sets up its own kingdom. Such
victories over disease are a hollow mockery from the standpoint of a true
therapeutics.
When we are facing these incurable conditions the administration of
the similar remedy almost always ameliorates the situation, at least for
three or four days, and usually for a longer period. Then we may have a
return of the symptoms, when the indicated remedy will be called into use
again. These conditions of impending fatality are usually accompanied by a
great many symptoms, because the whole organism is involved and a gradual
dissolution is taking place in every part of the economy and the vital
energy is so nearly overcome as to be unable to throw off these
manifestations. Sometimes one symptom or set of symptoms predominates and
becomes the annoying, troublesome, disagreeable symptom-complex. In these
conditions we must retake the case and reexamine the remedy that we have
been using, to see if it corresponds with the disease condition. If the
similarity exists in these especially troublesome manifestations, these
patients can be made much more comfortable.
For instance, a recent case of incurable cancer developed involuntary
urination with absolutely no control over the condition. Her remedy was one
of the Calcarea group. For this troublesome symptom of involuntary
urination the repertory gives us five remedies of equally prominent rank
which we may consider: Arsenicum, Natrum mur., Pulsatilla, Rhus tox, and
Causticum. With the constitutional similarity of the patient to the
Calcareas, Causticum was the only remedy to be considered, and one dose of
Causticum 200 restored complete control over this disagreeable symptom, and
made the patient more comfortable in general.
Another class of symptoms that is very troublesome and which often
falls under the use of palliatives, is composed of the patients who
complain of insomnia. These patients will yield to the law of similars with
pleasing results in their whole constitutional state, but not unless this
symptom is considered with the concomitants that point to the remedy.
Insomnia may be the outstanding irritating symptom in many varied symptom
pictures. In some cases there is general coldness, and the patient will lie
for hours awake unless he is covered with extra bed clothing, although he
may not be aware of being uncomfortably cold. Worries of a business nature
may be the cause of the accompanying symptom picture, or family
disturbances may be at the bottom of the trouble. There may be pain and
distress in certain parts. Any of these things attend a symptomatology of
which the insomnia is but a part. Does he fall asleep if his knees are
heavily covered? Is he kept awake by a rush of ideas? Is he lying awake
because he fears that something will happen to him if he drops off to
sleep? When does he lie awake-on first going to bed or after midnight? In
other words, what are the concomitants?
The insomnia may be treated with crude palliative measures so that the
patient secures sleep, but at best this is an unnatural sleep; while if the
insomnia is considered as a part of his symptomatic picture, and given its
proper place in that symptomatology and the man himself is treated-not
alone one or two symptoms-he will gain his natural, refreshing sleep and he
himself will be improved in general health.
Again, pain is one of the experiences from which human life has ever
striven to free itself. Pain in itself is a blessing in disguise, for it
brings to the patient a recognition of trouble, and to the physician the
ability to recognize the location of the trouble.
The treatment of pain as a single trouble, and the fear of pain, has
led to a winder use of narcotics than any other single factor. It is the
cause of more drug addicts than can well be estimated. The patient is in
pain, or the physician fears that the patient may be in pain, and in a
sympathetic attempt to relieve the patient from a temporary discomfort many
a physician has been led to prescribe drugs, the initial effect of which is
to relieve the suffering of the patient, but the lasting effects of which
are to produce a drug addict. Robert T. Morris, M. D., made the following
statement in 1893, and it is as true today as it was then:
1. Opium is a drug which stupefies the physician who gives it more
than it does the patient who takes it.
2. A drug which greatly relieves the distress of the physician, who,
without it, would be compelled to do something rational for the relief of
the patient who has put confidence in him.
Pain in itself is but a part of the symptom, however, for the
physician must take into consideration the location: the kind of pain,
whether steady or intermittent, and if intermittent, whether at regular
intervals or upon motion, or is it dull, cutting, blunt or sharp, pressing,
pulling, darting, cramping? Get at the type of pain as a characteristic
symptom of the disordered condition; the times and circumstances of
aggravation and amelioration, the reaction to thermic conditions, and all
the concomitant symptoms that can be found. When the symptom of the pain
itself is complete, with the location, type, and aggravations and
ameliorations, your picture is almost complete; but if in addition you can
find those concomitants (which may lie in the conditions of aggravation or
amelioration but which are often from seemingly unrelated symptoms) you
have a sound basis for the selection of a remedy which will relieve the
pain promptly, and the patient will be much more comfortable and happy in
general than with any narcotic.
One of the most difficult problems a physician has to meet, where he
has need of acumen and discernment and a complete knowledge of remedy
pictures, are such conditions as manifest an alternation of symptom
pictures in different seasons of the year, such as summer gastric
disturbances and winter rheumatic conditions, the Dr. Jekyll and Mr. Hyde
of chronic manifestations. There are a number of these conditions of
alternations of symptom groups, and then there are the alternation of
sides. When the patient presents himself to you, you may be justified in
concluding from his story that his trouble is limited to the disturbed
state of which he complains at that time; yet the remedy selected on this
group of symptoms alone will often fail to bring relief, or, if the remedy
does relieve the symptoms most marked at the time, the man's condition as a
whole may not be improved, or indeed it may even be worse, since we have
not cured but palliated a part of his symptom picture, obliterating a very
valuable part of our symptomatology. If the patient is curable and we have
thus obliterated a part of his symptom picture, we have blinded ourselves
as to his true state: whereas a complete understanding of his condition
over a period of several months would give a sound basis for a successful
remedy selection. This is especially true in such conditions as gout, and
we have remedies that have just this periodicity. Either for palliation of
incurable diseases or for the cure of the curable diseases the
symptomatology of the remedy must simulate, in so far as possible, the
disease picture in order to bring relief, and where periodicity or
alternation is a part of the symptomatology the remedy must have the
characteristic feature if we are to expect it to be effective.
It is sometimes true, when we have a case with alternating phases or
series of symptom groups and we are unable to meet the condition with a
remedy that covers all the phases (either because we do not learn of the
alternating phases from the patient in the first place or because we do not
know of a remedy to meet the condition), that by meeting the symptom groups
as they arise in the case itself as we go on, the symptomatology becomes
clearer and more distinct so that we more completely meet the conditions as
they arise and the patient's condition becomes better as a whole. This is
meeting the case by a zigzag process, removing the most pronounced and
characteristic symptoms by the remedies most similar in each state, but it
takes very careful prescribing or we are apt to hopelessly mix the case.
This may be done in emergencies or when we cannot find a better method. It
serves better as a palliative measure in incurable states than as a
curative measure in curable states, and a failure in any of one of a series
of successive prescriptions may mean the difference between possibility and
impossibility of eventual cure. There is far more satisfaction and the case
is much more complete if we can get a picture of the whole condition and of
the single remedy to meet that condition.
This may be difficult from two angles. The young physician may find it
difficult to do this work carefully because he lacks the knowledge of the
materia medica; but he has at his command a wonderful source of help in his
repertories, which will often serve his purpose by quick reference, filling
in the knowledge that he lacks of the remedy. Another possibility is that
of remedy relationship and the relationship of the various inherited
dyscrasias to the case; these are large subjects in themselves and will be
discussed elsewhere. Again, it is very possible that the remedy covering
the case has not been proved fully, or may not have been thought of by the
students of materia medica.
Here is where the limitations of man's knowledge manifests itself. The
law is correct and God-given, but no secrets of knowledge are ever given
without diligent work and observation on the part of man. Much work has
been done by our antecedents in developing an exceedingly valuable materia
medica, and they have left a glorious record in the symptomatology of the
different remedies. They have given us the weapons to meet these states; if
we fail it is not the fault of the law, nor of the weapons, but of our
failure to learn the use of our equipment. Incurable cases are a source of
great anxiety to every physician, but the physician who will follow the law
of similars with the use of the single remedy in potentized form will give
quicker relief and more sustained relief than all the massive doses of
narcotics and sedatives.
In cases of mechanical injuries where there is much pain and which
would be subject to narcotic or sedative treatment under ordinary medicine,
the homœopathic physician has a group of vulnerably remedies that will not
only allay the pain and distress incident to traumatic conditions, but will
prevent congestive, suppurative or gangrenous processes and actually will
hasten healing; whereas narcotics, while deadening the pain, invite
structural changes by slowing the natural recuperative powers. In this
class we may mention such remedies as Arnica, Hypericum, Ledum, Natrum
sulph., Rhus tox., and Ruta, each of the highest usefulness when indicated.
These remedies cannot be used successfully at random, any more than in any
other condition; but when they are similar to the condition they are of
inestimable benefit.
The homœopathic physician finds another substitute for narcotics in
surgical cases, either before or after operation. Here the indicated remedy
does excellent service, and the patient will go through the mental and
physical distress very happily. These remedies will be indicated partly by
the symptomatology of the patient and partly by the immediate causes of
distress, such as lacerated wounds, strenuous vomiting, shock and
incarcerated flatus. In other words, here also the symptoms must be complete.
These are the things that may be done to relieve suffering. The same
law applies in curable and incurable cases, and it is very essential in
curable cases that no narcotic nor hypnotic nor sedative should be used,
for the reason that these cloud the whole condition; but if the true
reflection of the symptomatology be found we have a basis for help which no
other means could offer. In incurable cases, or seemingly incurable cases,
we must not put a limitation on the possibilities of the similar remedy,
for in many seemingly incurable conditions the simillimum will so
completely meet the situation as to obliterate the symptomatology of
disease and the pathology, and will restore the patient to health.
--------------------------------------------------------------------
Sheri Nakken, R.N., MA, Hahnemannian Homeopath
Well Within & Earth Mysteries & Sacred Site Tours (worldwide)
Vaccination Information & Choice Network
http://www.nccn.net/~wwithin/vaccine.htm
http://www.nccn.net/~wwithin/homeo.htm
homeopathycures@tesco.net
ONLINE Introduction to Homeopathy Classes
ONLINE Introduction to Vaccine Dangers Classes
Voicemail US 530-740-0561 UK phone from US 011-44-1874-624-936