You should endeavor to have a good knowledge of both the acute and chronic miasms.
First of all the image of psora should be studied from all the symptoms that we can gather, and especially from the symptoms that Hahnemann has given, in the Chronic Diseases.
Next we have to make out a similar anamnesis of syphilis, which can be done from books, from clinics, from observation, and all other possible sources, and then an anamnesis has to be made of sycosis.
These are things most general, and will bring before the mind, in one, two or three images, a grand picture of all the chronic diseases of the human race.
Take psora first for that is the very foundation of human sickness.
It would appear that the human race is one enormous leper.
Now, add to that the state of syphilis and we have a bad matter made worse ; then add to that the state of sycosis and we will see the extent of human sickness.
We then have to advance and carefully study each of the acute miasms from the books, from observation, and from every source of information, carefully arranging it on paper so that it can appear before the mind as an image.
Smallpox has few features and it can be made to appear as an image before the mind, and so with all the acute miasms, infectious diseases, cholera, yellow fever, etc., the diseases that have heretobefore appeared in epidemic or endemic form.
These have all to appear before the mind as images.
It may be said of them that they are all true diseases seen by the examination of the totality of the symptoms.
No physician can know too much about the image of a given sickness, studied from the symptomatology, and this is the best information that can be obtained.
Now-a-days patients are not permitted to tell their story in the language of nature.
The physician says,
"I do not want to hear that."
Talk on the part of the patient interferes with his prescription writing.
There is no writing down of the case.
Now take, for instance, one of the clinics here. How would you remember from day to day, and from week to week, what had been given to each patient ?
There is no importance attached to that in the old school.
It is simply their object to give the patient a big dose of medicine.
It may not have occurred to you that there are several reasons of importance for keeping records, and of constantly referring to them ; even the regular clinicians here may not have seen the full importance of it.
But suppose a patient that I have been considering for three years is partially cured, and she has done remarkably well, has been restored from an invalid to a good wife and mother, but is not yet cured.
Now for some reason she goes into the hands of another homoeopath.
What can he do without ascertaining what I have done for her ?
It is important for the patient when living in the same town to be faithful and true to the physician who has done her the most good.
A conscientious physician will not feel like taking another doctor's practice in that way.
I am not so conceited that I should feel like taking up the work of another doctor who is able to do good work.
Men who think more of getting money than anything else will jump in and prescribe for your patients.
"The physician ought ever after to have this image before the eyes to serve as a basis to the treatment, especially where the disease is chronic."
Without records, you are at sea without compass or rudder.
With a record, Hahnemann says,
"He can then study it in all its parts, and draw from it the cbaracteristic marks,"
that is, you have the nature of the disease continuously in mind.
When the image of the disease has passed from mind its very nature is gone.
Here a point comes in you must know about.
After your first prescription has been made, you may have an aggravation.
It is well to know the date of this, and about how long it lasted, and to keep watch of it.
If no change has occurred the same image may continue to appear before the mind, but if changes have occurred and are continuously appearing in the symptoms you will readily see that no medicine can be administered.
The symptoms that come and go could not guide anybody as to what to do.
Now a commotion has taken place, you cannot prescribe while this commotion is going on, the symptoms are changing place, they are coming and going, for perhaps one to three weeks after that prescription.
You have to watch and wait.
Notice when the symptoms begin to roll into order ; then another dose of medicine is needed.
These things take place only after the administration of a remedy that was pretty high, high enough to take hold, and the case falls into order only when the patient needs another dose.
Suppose a patient has been sick three to four years with a train of symptoms, and on the way to visit you from a long distance ; the patient is taken worse, and a homoeopathic physician is called in.
The patient gets a dose of medicine and improves wonderfully, now what are you going to do ?
You do not know what it was and you write to the physician, but he has forgotten what it was.
What a confusing state that is, is it not ?
Well, that is just the state you would be in without your records.
There is, I have been led to feel, too great carelessness often among our best men in transferring cases from one town to another, from one physician to another.
A habit that has existed between another Hahnemannian and myself has been pleasing to us both.
When one of his patients has been transferred from his care to my care he has told me what remedy the patient was on, and I in the same way when sending patients to him have mentioned the remedy the patient was on.
It is the duty of the physician to furnish such information when a patient leaves the city to go under the care of another physician.
It is the duty of the physician to transfer such a patient to good hands, if there are any good hands to transfer him to.
This subject is preliminary to the observation of Organon § 105, which leads to the second step of practical Homoeopathy.
by James Tyler Kent