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The passage discusses the 12 observations made by physicians like Kent and Hahnemann after administering remedies to patients. These observations help determine the correct remedy and management of the patient's condition.

There are three types of aggravations discussed - disease aggravation, homoeopathic aggravation, and medicinal aggravation. Disease aggravation means the symptoms are worsening and the patient is declining. Homoeopathic aggravation means the symptoms are worse but the patient feels better. Medicinal aggravation means new symptoms appear belonging to the remedy and the patient declines.

If old symptoms that the patient had forgotten reappear after administering a remedy, it indicates the patient is on the right path to recovery according to Herring's law of cure. The remedy should not be disturbed in this case.

twelve

OBSERVATIONS

SUBMITTED
BY
V.ABIRAMI
 Kent described about the 12 observations
in his
LECTURES On
HOMEOPATHIC
PHILOSOPHY in
LECTURE ėėėĕ
Under the topic ,
PROGNOSIS
AFTER OBSERVING
THE ACTION OF THE REMEDY.
H A Robert described about this
observations in his
THE PRINCIPLES
AND ART OF CURE
BY HOMOEOPATHY in
CHAPTER ΧΙV
under the topic
REMEDY REACTION
INTRODUCTION
• After a prescription has been made the
Physician commences to make observations.
• These observations only help in the Second
and following prescriptions.
• These observations have grown out of much
watchfulness, long waiting and watching.
• KENT says “ If the Homoeopathic Physician is
not an accurate observer, his observations will
be indefinite, his prescribing is indefinite”.
 If a medicine is prescribed to the patient, the
medicine starts to affect changes in the patient.
These changes are shown by signs and
symptoms.
 The Physician observes these changes and judge
what to do and what not to do.
 KENT INTERPRETS as “Watching the hands
upon the clock”.
 The remedy is known to act by changing the
symptoms either,
Disappearance of symptoms (or)
Increase in symptoms (or) Amelioration of
symptoms (or) Change in order of symptoms.
 Among the changes Aggravation and Amelioration
are the common changes.
 Aggravation is of three kinds
1.Disease Aggravation
2.Homoeopathic Aggravation
3.Medicinal Aggravation
 Disease aggravation - symptoms are growing
stronger, and the patient is growing weaker.
 Homoeopathic aggravation – aggravation of
symptoms will be there but the patient is growing
better. It is observed after true homoeopathic
prescription.
 MEDICINAL AGGRAVATION- there is
appearance of newer symptoms which belongs to
the medicine and patient is becoming weaker.
 KENT says ‘The true homoeopathic aggravation is
when the symptoms are worse , but the patient
says “I Feel Better”’ and in same condition H A
ROBERT says ‘In homoeopathic aggravation the
patient says “I feel better, Doctor, but such and
such symptoms are worse”’.
 In aggravation and amelioration-
time, duration, how it occurs, direction of
symptoms.
 After observing this only the judgement has to
be passed.
 PATIENT – Declining or Improving.
 SYMPTOMS- Taking inward or outward course.
1ST OBSERVATION
CASE CHANGES: Patient- stoop shoulders, hacking
cough for many years, lean, anxious, looks very sick,
suffering from poverty, poor clothing, scanty food.
 After the examination of chest ,we detect the
presence of Tuberculosis with feeble pulse.
 ANTIPSORIC medicine is given.
 After few days – sharp agg of the symptoms.
 After a week –agg is still present and somewhat
increased.
 At the end of 2nd week- all symptoms are still
worse.
 At the end of 4th week- steadily growing worse and
become weak and no amelioration.

OBSERVATION: A prolonged aggravation and final


decline of the patient .
WHAT IT INTERPRETS: The antipsoric was too
deep.
 The remedy has been too late,
it attempted to arouse his
economy- but turned to
destruction of the whole organism.
 The vital force was impossible to react, he was an
incurable and doubtful case. Prognosis is bad .
MANAGEMENT: Decrease the potency.Palliate and
do not aim at cure.
WHAT IT TEACHES: In Incurable and Doubtful
cases- Not give more than 30th or 200th potency.
 30th potency is low enough for anybody.
 Observe whether the aggravation is going to be too
deep or too prolonged.
 Deep acting medicines should not be given.
H.A. ROBERT’S VIEW
 PROLONGED AGGRAVATION AND FINAL DECLINE
OF THE PATIENT
 WHAT IT INTERPRETS: the administered remedy is
deep, an antipsoric. It has set in motion the vital energy
and developed a destructive process. In this state of
incurables the vital reaction towards cure is impossible and
we can assure that the case is incurable. It is illustrated in
case of tuberculosis.
 MANAGEMENT: Antidote and give low potency.
 WHAT IT TEACHES:
 avoid giving high potency in profound incurable
conditions.
 We can administer lower potency and go on until later it
may possibly react favorably to a higher potency.
 HAHNEMANN said in Aphorism :255,276.
 APHORISM 255 –We convince ourselves by going with
them through all the symptoms enumerated in our
notes of the disease one by one, and finding that they
complaint of no new unusual symptoms in addition to
these and that none of the old symptoms worse. Now
supposing the remedy is perfectly appropriate, if the
improvement delay too long in making its appearance,
this depends either on some error of conduct on the
part of the patient or on the homeopathic aggravation
produced by the medicine lasting too long,
consequently on the dose not being small enough.
 APHORISM 276- Even though it may be
homoeopathically suited to the case of
disease , does harm in every dose that is too
large, the more harm larger the greater its
homoeopathicity and the higher the potency
selected, and it does much more injury than
any equally large dose of a medicine that is
unhomoeopathic.
2 ND OBSERVATION
CASE CHANGES : Patient does not seem to
quite so bad as in the 1st instance, you get him a
little earlier in his history before the trouble has
gone quite so far. If you give high potency -
aggravation is long and severe for many weeks.
Then his feeble economy seems to react .
There is a slow but sure improvement.
OBSERVATION: A long aggravation
but final and slow improvement.
WHAT IT INTERPRETS:
 The disease is still in curable state
but in a feeble constituition.
 The disease has not progressed
quite so far.
 The changes have not become quite so marked
 The patient was in a border line and had he gone further,
cure would have been impossible.
 Beginning of some marked tissue in some organ.
 The Vital Force is still REACTIVE in this stage.
MANAGEMENT: Need not antidote.Keep him on low
potency. Case is Curable.
WHAT IT TEACHES:
In doubtful cases - always go for Lower potencies
(or) be prepared to antidote the medicine if it takes the
wrong course.
H.A. ROBERT’S VIEW
 LONG AGGRAVATION BUT FINAL ALTHOUGH
SLOW IMPROVEMENT.

 WHAT IT INTERPRETS: in cases where there is


not so profound a disturbance, after the remedy has
been administered, the aggravation may be long and
severe, yet the final reaction and amelioration comes.
There comes a slow but sure recovery.
 In this borderline cases there is already established some
marked organic changes and pathological changes have
actually taken place, there is a longer period of
aggravation.
 But the general improvement in health will severely
manifest.
 MANAGEMENT: Keep them in low potency.
 WHAT IT TEACHES: In doubtful and borderline
cases give low potency.
HAHNEMANN said in Aphorism :276.
APHORISM 276: Even though it may be
homeopathically suited to the case of disease, does
harm in every dose that is too large, the more harm
larger the greater its homoeopathicity and the higher
the potency selected, and it does much more injury
than any equally large dose of a medicine that is
unhomoeopathic.
3 RD OBSERVATION
CASE CHANGES : After prescribing medicine-
there is an immediate aggravation which is more
or less vigorous, short and quick.
Followed by improvement which lasts for long
period.
Acute cases – First few hours.
Chronic cases – First few days.
OBSERVATION: Aggravation is quick,
short and strong with rapid
improvement of the patient
WHAT IT INTERPRETS:
 Vital force reacts vigorously.
 No tendency to any structural
damage vital organs.
 If present it is only on the surface and not in
the vital organs which are important to life of
patient - heart, liver, brain, kidneys.
MANAGEMENT: Case progresses in good
condition.Ideal reaction.Do not intervene Wait
and Watch , Cure takes place.
WHAT IT TEACHES: It is a True
HOMOEOPATHIC AGGRAVATION. Whenever the
aggravation is quick, short and vigorous-will find
improvement of the patient will be long.
H.A. ROBERT’S VIEW
 AGGRAVATION IS QUICK AND SHORT AND
STRONG, WITH RAPID IMPROVEMENT OF THE
PATIENT.
 WHAT IT INTERPRETS: when you find such a
reaction to the remedy you will always find rapid
improvement. The reaction is vigorous and there is no
structural changes in vital organs. Only it is superficial
in nature and near the surface such as furunculosis or
abscess formation and are not in kidneys, heart, brain.
 MANAGEMENT: Wait and watch.
 WHAT IT TEACHES : it is well to take note of the
difference between organic changes that takes place in
the vital organs that sustains economy, which we
cannot do without and those takes place in the vital
parts that are not vital to life itself.
 HAHNEMANN said in Aphorism:157,158,159,160,161.
APHORISM 157-The homoeopathically selected remedy does, by reason
of its appropriateness and minuteness of the dose, gently remove and
annihilate the acute disease analogous to it, without manifesting its other
homoeopathic symptoms, that is to say, without the production of new,
serious disturbances, yet it usually,immediately after ingestion for the first
hour, or for a few hours-causes a kind of slight aggravation,(where the
dose has been somewhat too large)which has so much resemblance to
the original disease that it seems to the patient to be an aggravation of
his own disease. But it is, in really, nothing more than an extremely
similar medicinal disease, somewhat exceeding strength the original
affection.
APHORISM 158- the slight homoeopathic aggravation during the first- a
very good prognostic that the acute disease will most probably yield to
the first dose is quite as it ought to be, as the medicinal disease must
naturally be somewhat stronger than the malady to be cured if it is to
overpower and extinguish the latter, just as a natural disease can remove
and annihilate another one similar to it only when it is stronger than the
latter.
 APHORISM 159- The smaller the dose of the
homoeopathic remedy is, so much the slighter and
shorter is this apparent increase of the disease
during the first hours.

 APHORISM 160-But as the dose of homoeopathic


remedy can scarcely ever be made so small that it
shall not be able to relieve, overpower, indeed
completely cure and annihilate the uncomplicated
natural disease of not long standing that is
analogous to it, we can understand why a dose of
an appropriate homoeopathic medicine, not the
very smallest possible, does always, during the first
hour after its ingestion, produce a perceptible
homoeopathic aggravation of this kind.
 APHORISM 161-The so called homoeopathic agg or primary
action of the hom medicine that seems to increase some what
the symptoms of the original disease, so the first or first few
hours, this is certainly true with respect to diseases of a more
acute character and of recent origin; but where medicine of
long action have to combat a malady of considerable or of
very long standing, where one does, consequently, must
continue to act for many days, we than occasionally see,
during the first six, eight or ten days, the occurrence of some
such primary action of the medicine, some such apparent
increase of the symptoms of the original disease, whilst in the
intervening hours amel of the whole malady is perceptible.
After the lapse of these few days the amel resulting from such
primary action of the medicine proceeds almost
uninterruptedly for several days longer.
4 TH OBSERVATION
CASE CHANGES : The case were the
administration of the remedy is followed by no
aggravation whatever.
OBSERVATION: No aggravation, with
recovery of the patient.
WHAT IT INTERPRETS:
 The potency exactly fitted the case
and the remedy is the curative remedy.
 No organic disease.
 No tendency to organic disease.
 There is only nervous change in the patient.
 The patient returns to health in an orderly way.
MANAGEMENT: In acute diseases, it is very good.
In chronic cases, we must wait and watch,do
not intervene, the Cure takes place without any
aggravation.
No repetition. Do not interrupt the action of the
remedy.
WHAT IT TEACHES: Highest order of
HOMOEOPATHIC CURE.
The Physician will be more satisfied if in the
beginning of prescription he notices a slight
aggravation of symptoms.
H.A. ROBERT’S VIEW
 OBSERVATION: NO AGGRAVATION
WHATEVER.
 WHAT IT INTERPRETS: there is no organic
change and no tendency to organic disease. There
is only functional disturbance, exhibiting its effects
in the nervous manifestations .
 With all the instruments of precision we do not
observe any pathological changes.
 MANAGEMENT: In these cases the single
remedy is a moderate potency (say the 200th) will
probably and the remedy are correct.
 WHAT IT TEACHES: Ideal homoeopathic cure.
 HAHNEMANN said in Aphorism:156,253.
 APHORISM 156:There is however, almost no homoeopathic
medicine, be it so suitably chosen, that especially if it should
be given in an insufficiently minute dose, will not produce, in
very irritable and sensitive patients, at least one trifling,
unusual disturbance, some slight new symptom whilst its last;
for it next to impossible that medicine and disease should
cover one another symptomatical as excitely as two triangles
with equal sides and equal angles. but this unimportant
difference will be easily done away with by the potential
activity(energy) of the living organism, and is not perceptible
by patients not the goal of perfect recovery excessively
delicate; the restoration goes forward, not withstanding, to
the goal of perfect recovery, if it be not prevented by the
action of heterogenous medicinal influences upon the patient,
by errors of regimen or by excitement of the passions.
APHORISM 253- Among the signs that in all
diseases especially in such as are of an acute
nature, inform us of a slight commencement of
amelioration or aggravation that is not
perceptible to every one, the state of mind and
the whole demeanor of the patient of the most
certain and instructive. In the case of sight an
improvement we observe a greater degree of
comfort, calmness, freedom of mind, higher spirits,
a kind of return of the natural state. in the case of
a slight aggravation. We observe a constrained
,helpless, pitiable state of disposition of mind of
the whole demeanor and all gestures ,postures
and actions, which may be easily perceived on
close observation but cannot be described in
words.
5TH OBSERVATION
CASE CHANGES : In cases as mentioned in 1st and 2nd
instance- after a long study – administering a remedy.
Patient comes back in 3 or 4 days-says much Better
immediately after taking the medicine.
At the end of 5 days- all symptoms are Worse than he first
came to u.
OBSERVATION: The amelioration comes first and the
aggravation comes afterwards.
WHAT IT INTERPRETS:
Either the remedy – only superficial
remedy and could only act as a
palliative (or)
the patient was incurable and the remedy was somewhat
suitable or if there is any obstacle to cure.
MANAGEMENT: Re examination of the patient -
whether the symptoms relate to that remedy?
• Sometimes the remedy will be error.
• Remedy is only similar to grievous symptoms.
• Does not cover the whole case and does not affect
the constitutional state of the patient.
• Then will find the disease is incurable and it is an
unfavorable condition.
WHAT IT TEACHES: In severe cases, if the
amelioration comes first the Physician must Re
examine the case again.
• Find out the drawback in the remedy or in the
patient.
H.A. ROBERT’S VIEW
 This amelioration comes on to last usually for three
or four days. But the end of a week or 10 days . All
the symptoms are worse than when he first came
to you.
 OBSERVATION:AMELIORATION COMES FISRT
AND THE AGGRAVATION COMING
AFTERWARDS.
 WHAT IT INTERPRETS: these are usually case
that have great many symptoms. What we though at
first was a favorable reaction the ultimate
conditions is unfavorable. Either we selected too
superficial remedy, that could only act as a palliative
or the case is incurable and the remedy has been
somewhat similar but not completely so.
 Sometimes you will find the remedy was in error I.e the
remedy was similar to the most pronounced symptoms
but did not cover the whole case and did not strike at
the constitutional state of the patient I.e we missed the
essential concomitants and based our prescription on
the generals only.
 It may be that we have an incurable patient.
MANAGEMENT: we must examine the patient again and
find out whether the symptom related to the remedy or
to the disease. If it comes back exactly as they were
when you first saw the case,but the symptoms often
comes back changed.We must wait and this require
patience on the part of the Physician and co-operation
on the part of the Patient.
 WHAT IT TEACHES:In severe cases if amel comes first
rexamine the case again.
 HAHNEMANN said in Aphorism:256.

 APHORISM 256: On the other hand if the patient


mentions the occurrence of some fresh incidents
and symptoms of importance-signs that the
medicine chose has not been strictly
homoeopathic-even though he should good
naturedly assure us that he feels better(as it not
infrequently the case in pthisical patients with lung
abcess ), we must not believe this assurance, but
regard this state as aggravated as it will soon be
perfectly apparent it is.
6 TH OBSERVATION
CASE CHANGES : A medicine whose action lasts
for months but the action stops in few weeks.
There is amelioration immediately after taking
medicine and only for few hours or days or weeks.
OBSERVATION: Too short relief of symptoms.
WHAT IT INTERPRETS:
If this observation is achieved ,there is suspicion on
the patient that there is blocks to cure - had drinks,
handled chemicals, had been on the fumes of ammonia,
done something to spoil the action of medicine.
 If nothing has taken place to interfere with this
medicine –suspicion is on the case.
MANAGEMENT:
If the Obstacle is on the patient- avoid those
obstacles or remove the blocks to cure.
If the obstacle is in case- prognosis is bad as in
1st observation.
WHAT IT TEACHES:
Amelioration that comes earlier must be
suspected.
The Best Kind of amelioration is which comes
gradually at the end of an hour or two hours.
If too short an amelioration in Acute cases it
indicates a High grade inflammation in the organs.
In Chronic diseases- indicates structural changes
& organs are destroyed (or) being destroyed (or)in a
precarious condition already.
H.A.ROBERT’S VIEW
 In instances where you have a too short amelioration
immediately after the administration of the remedy.
 OBSERVATION:TOO SHORT A PERIOD OF RELIEF
FROM THE SYMPTOMS.
 WHAT IT INTERPRETS:If there is a quick rebound the
amelioration should last.If it does not last,it is because some
condition that interferes with action of remedy. May be
something that the patient is doing entirely unconsciously,or
doing deliberately and unintentionally.
 Sometimes the action of the remedy is much more quickly
exhausted.The most satisfactory amelioration in acute cases
is where amelioration comes gradually and takes an hour or
two after the administration of the remedy before it is
markedly manifest.
 MANAGEMENT: Avoid the obstacles on patient or
remedy.
HAHNEMANN said in Aphorism:250,252.
APHORISM 250- In urgent cases after the lapse of only six, eight or
twelve hours ,that we have made a bad selection in the medicine last
given, in that patient’s state is growing perceptibly, hour slightly,
worse from hour to hour, by the occurrence of new symptoms and
sufferings, it is not allowable, but, it is our duty to remedy our
mistake, by the selection and administration of a homoeopathic
medicine not merely tolerably suitable, but the most appropriate
possible for the existing state of the disease.
 APHORISM 252-But should we find during the employment of the
other medicines in chronic(psoric) disease, that the best selected
homoeopathic(anti psoric) medicine in the suitable(minutest)dose
not effect on improvement, this is a sure sign that cause that keeps
up the disease still persists, and that there is some circumstances in
the mode of life of the patient or in the situation in which he is
placed, that must be removed in order that a permanent cure may
ensue.
7 TH OBSERVATION
CASE CHANGES : Certain patients who have latent
existing organic conditions. Eg:a patient with one kidney
or whose lung capable of doing only limited work,etc...
After administering the remedy – improves only to a
certain stage, yet there is no relief of the patient.
OBSERVATION: A full time amelioration of the
symptoms, yet no special relief of the patient.

WHAT IT INTERPRETS:
 They can improve only to a certain stage will have
symptoms.
 Are ameliorated from time to time with remedies.
 Patient is incurable and palliated at this instance.
MANAGEMENT: It is a suitable palliation for
homoeopathic remedies.
 Can only palliate this case .
WHAT IT TEACHES:
 After several medicines have been
administered, and if the amelioration exists only
full length of remedies, but the patient has not
risen above – The Remedy act favorably but the
patient is not cured and never be cured.
H.A.ROBERT’S VIEW
 OBSERVATION:A FULL TIME AMELIORATION OF
THE SYMPTOMS, YET NO SPECIAL RELIEF OF
THE PATIENT.
 WHAT IT INTERPRETS: This you will encounter in
cases where you have structural changes where the
patient will improve on the remedy for sometime and
then stops.
 We meet these conditions where organs like the Liver
and Kidneys are partially involved and can function
only in part.
 MANAGEMENT: By careful repetition of the
remedy at infrequent intervals the patient may be
kept comfortable for a considerable period of time
even though you will not be justified in expecting a
cure.
 HAHNEMANN said in Aphorism:279.

 APHORISM 279 – The pure experience shows


universally,that if the disease do not manifestly depend
on a considerable deterioration of an important
viscus,and if during the treatment all other align
medicinal influences are kept away from the patient, the
dose of the homoeopathically selected remedy can
never be prepared so small that it shall not be stronger
than the natural disease, and shall not be able to
overpower, extinguish and cure it, atleast in part, as
long as it is capable of causing some,though but a slight
preponderance of its own symptoms, over these of the
disease resembling it immediately after its ingestion.
8 TH OBSERVATION
CASE CHANGES : Some patients are hysterical,
overwrought, oversensitive to all.
 If we administer a dose of High potency → they will go on
proving that medicine.
 Its takes possession of them and acts as a disease does.
 Has its prodromal period period of progress and its period
of decline
OBSERVATION: Some patients prove every
remedy they get.
WHAT IT INTERPRETS:
These patients are Idiosyncratic patients.
 They prove every remedy they get. Such patients are
provers, they will prove High potencies.
MANAGEMENT: When you find a patient that
proves everything you give in higher potencies
go back to the 30th and 200th potencies.
 Often Cure their Acute diseases – by 30th and
200th potencies .Chronic diseases- by 30th, 200th
and 500th potencies.
WHAT IT TEACHES: Many of them are born
with this sensitivity and they will die with it.
 It is difficult to Cure such patients.
 Such patients are very useful to Homoeopathic
Physicians. After they get out of one proving,
they are ready to prove another remedy.
H.A.ROBERT’S VIEW
 OBSERVATION: SOME PATIENTS PROVE EVERY
REMEDY THEY GET.
 WHAT IT INTERPRETS:They are purely
hysterical.They prove any remedy you may give them
and get an agg from it.This is because of an
idiosyncrasy for the remedy or because of too
sensitive reaction of the vital energy.
 MANAGEMENT:It is almost impossible to do
anything with them in a curative way.It is an
inestimable help in proving a remedy.
 Give lower potency and cure the cases.
 HAHNEMANN said in Aphorism:116,117.
 APHORISM 116:Some symptoms are produced by the
medicines more frequently- that is to say, in many
indivduals, other more rarely or in few persons, some only
in very few healthy bodies.

 APHORISM 117:Idiosyncrasies by which are meant


peculiar corporeal constitutions which, although
otherwise healthy, possess a disposition to be brought into
a more or less morbid state by certain things which are
seem to produce no impression and no change in many
other indivduals.For as two things are required-to wit the
inherent power of the influencing substance, and the
capability of the vital force that animates the organism to
be influenced by it-the obvious derangements of the
health so called Idiosyncrasies.
9 TH OBSERVATION
OBSERVATION: The action of the medicines
upon provers.
Healthy provers are always benefited by
provings, if they are conducted properly.
Write down the constitutional states of the
prover and subtract them from the proving.
These symptoms will not very commonly
appear during the proving.
H.A.ROBERT’S VIEW
 ACTION OF MEDICINE ON PROVERS.
 Note down the symptoms and subtract them
from the proving symptoms.

HAHNEMANN said about DRUG


PROVING in Aphorism:105-145.
10 TH OBSERVATION
CASE CHANGES : After the administration of
the remedy there is appearance of more number of
new symptoms.
OBSERVATION: New symptoms appearing
after the remedy.
WHAT IT INTERPRETS:
 It is an unfavorable
condition.Wrong prescription.
In some situations new symptoms will be an old
symptoms, that the patient has not observed
and thinks it a new one.
MANAGEMENT: Should enquire about this new
symptoms to the attendants or parents as it may
even occurred at his younger age.
 If it is new symptoms even after enquiry - an
unfavorable condition.
 Remedy must be antidoted or prescribe the
right remedy.
WHAT IT TEACHES: The First prescription has
to be made carefully based on the entire totality
of the symptoms.
H.A.ROBERT’S VIEW
 After good selection of the similimum, we may note a
reaction where a great number of new symptoms appear
after the administration of remedy.
We must re-examine the case, whether they are older
symptoms which the patient has forgotten or newer
symptoms.If they are actually a number of new symptoms
then the observation,
OBSERVATION: NEWER SYMPTOMS APPEARING
AFTER THE REMEDY.
WHAT IT INTERPRETS: It is an unfavorable sign.A
group of entirely new symptoms appearing after the
administration of a remedy is evidence that the case is in
wrong direction.We have probably mixed the case.The
newer symptoms of the medicine seems to appear.
 MANAGEMENT: Remedy must be antidoted or can
select the remedy by the present symptoms.
 HAHNEMANN said in Aphorism:167,249.

 APHORISM 167- Thus if the occur, during the use of


this imperfectly homoeopathic remedy first employed,
accessory symptoms of some moment, then, in a case
of acute diseases we do not allow this first dose to
exhaust its action, nor leave the patient to the full
duration of the action of the remedy, but we
investigate afresh the morbid state in its new altered
condition, and add the remainder of the original
symptoms to those newly developed in tracing a new
picture of the disease.
 APHORISM 249 : Every medicine prescribed for a
case of disease which,in the course of its action,
produces new and troublesome symptoms and
appertaining to the disease to be cured, is not
capable of effecting real improvement and cannot
be considered as homoeopathically selected it
must, therefore, either, if the aggravations be
considerable,be first partially neutralised as soon
as possible by an antidote before giving the next
remedy chosen more accurately according to
similarity or action;or if the troublesome
symptoms be not very violent,the next remedy
must be given immediately, in order to take the
place of the improperly selected
11 TH OBSERVATION
CASE CHANGES : The old symptoms that have
long been away returns.
OBSERVATION: When old symptoms are
observed to reappear.
WHAT IT INTERPRETS:
 The disease is curable.
 It is common thing for old symptoms to
appear after the aggravation has come.He is on
the road to recovery.
 Hence we see symptoms disappearing in the
reverse order of their coming.
 According to HERING’S LAW OF CURE
MANAGEMENT: The Physician must know the
patient is on the road to recovery.
 Encourage the patient.
 Do not disturb the action.
 If the old symptoms come back to stay, then
the repetition of the dose is necessary.
WHAT IT TEACHES: Old symptoms often
come back and go off without any change of
medicine.
 It indicates that the medicine must be let alone.
H.A .ROBERT’S VIEW
 As in last instance,if they are the return of the former
symptoms which the patient has for forgotten then
the observation,
 WHEN OLD SYMPTOMS ARE OBSERVED TO
REAPPEAR.
 WHAT IT INTERPRETS: If there are a return of the
former symptoms which the patient has forgotten ,it is
indication that the patient is on the Right road to
recovery and it is a truly homoeopathic action.I.e cure
takes place according to HERRING’S LAW OF CURE.
 MANAGEMENT: Do not disturb the action of the
medicine
HAHNEMANN said in Aphorism:280.
 APHORISM 280 in 6TH EDITION: The dose of
medicine that continues serviceable without
producing new troublesome symptoms is to be
continued while gradually ascending,so long ass
the patient with general improvment,begins to
feel in a mild degree the return of one or
several old original complaints. This indicates an
approaching cure through a gradual ascending of
the moderate doses modified each time by
succussion.
12 TH OBSERVATION
CASE CHANGES : Rheumatism of knees or feet
or hands→ prescribing medicine →Relief takes
place in Rheumatism of extremities, but goes
internally and settles in the region of Heart or
in the spine.
OBSERVATION: Symptoms take the wrong
direction.
WHAT IT INTERPRETS: The transference has
taken place from circumference to
center.Wrong remedy.
MANAGEMENT: The remedy must be antidoted at
once, otherwise structural damage will takes place
in that new site.Try again.

WHAT IT TEACHES: When the disease go from


center to circumference → from heart, lungs, brain
and spine to extremities → it is well.
 Eruptions upon skin are Good signs.
 It is a great danger in selecting a remedy on
external symptoms alone.
 The remedy that is related to skin alone may drive
in the disease and it disappears but the patient not
cured.
 Such patients will remain sick until that eruption
comes back again, or locates in another place.
H.A.ROBERT’S VIEW
 OBSERVATION:Another case there is appearance of
new symptoms after the administration of the
remedy,but in the first place these cases offered few
symptoms for an adequate prescription.
 If there has been a general improvement the 1st
remedy was homoeopathic.
 In 2nd chance the 1st remedy was probably one of a
group of similars and it served to bring to light the
other formerly hidden symptoms which were definite
part of the case.
 MANAGEMENT:In this case,the closely related
remedies to the one first administered will probably
contain among them the similimum which will assist
the complete cure.
HAHNEMANN said in Aphorism:256.
 APHORISM 256: On the other hand if the
patient mentions the occurrence of some fresh
incidents and symptoms of importance-signs
that the medicine chose has not been strictly
homoeopathic-even though he should good
naturedly assure us that he feels better, we must
not believe this assurance, but regard this state
as aggravated as it will soon be perfectly
apparent it is.

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