I thought I would add something else to this, and that is that I am not advocating stopping the search for the similimum. In many cases, I believe it may take hard work and some time to reach the deepest part of the disturbance. It is often some time before the patient will tell you what you need to know to really heal them. But we should never stop looking, as long as the patient is happy to keep talking.

David

I'm one of those people who believes that "close-enough-icum" remedies push the patient further into his/her state--they very effectively open up the totality so that you can see what the similimum is. I have seen suppression result from remedy use, but the danger of suppression seems to come more from an inability to "manage the case" than an ability to take the case and prescribe "the similimum" right off the bat. Prescribing routinely, using the wrong potencies, and dosing far too frequently cause way more damage than giving, for example, arsenicum to a patient who is afraid of vomitting, rather than asafoetida, the similimum.

Once again, the difference between doing harm and curing can depend solely on your ability to observe, listen to, and respond to the patient, as well as the action of the remedy. It is a difficult thing to "wait and watch" while the body responds to the remedy's force, and to know the "good signs" from the "bad ones". It is harder still to be patient and continue to wait. I know this must have prompted Hahnemann back to the lab so he could devise the LMs, and who could blame him? The potential for unnecessarily complicating the case is monumental. But in the cases where doses are given and waiting is involved some of the most spectacular ameliorations happen just when you are about to give up on the remedy you last gave, because it looks like things aren't going anywhere (I've just learned this lesson again this past weekend, when one of my patients called to tell me she'd experienced something close to a breakthrough after a pretty painful day earlier in the week...and I was all ready to give up on what I'd prescribed, and had a new remedy all picked out!).

It is very true that nothing works as curatively as the similimum--the right remedy given in precisely the right potency (Sunny's thread on the vomitting phobia patient is a great example of that), but giving a well chosen remedy that palliates and partially acts is also a valuable act--not suppressive and "dangerous". I honestly believe just from watching my patients that palliation has a strengthening effect, and this allows the patient to bring up the symptoms which will point you in the right direction to cure. Whether you give the similimum or not, the trek back to health is always a process for both the practitioner and the patient--its not about giving the similimum every time, but it is about giving the remedies required for the patient's own healing abilities to work their own magic. You can only prescribe on what you see--nothing more. That is why a bunch of homeopaths all taking the same case can all come up with valid considerations for remedy prescriptions.

Divina

[This message has been edited by Divina (edited 24 January 2001).]