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How Not to Do It
By Margaret Tyler
Presented by Sylvain Cazalet

          Dr. Kent, Dr. Gibson Miller, and others, can tell you, from
long years of successful work and experience, how to do it. I feel
that I am equally well qualified, from some years of poor
prescribing and much failure, to tell you how not to do it. I used to
get brilliant flashes of light and joy - when I hit the drug - and that
was just often enough to keep up the enthusiasm of an optimist like
myself; but, take it all around, it was failure; and, because it may
help some of you, I will try to tell you why.

          Homœopathy, as you and I know, would work, and did

work. But I had not properly mastered it; my ideas were too crude,
my methods too lawless and untrained, for it would work only
fitfully for me. The power was there, right enough, for the
illuminating flash testified to its presence; but I could not draw on
it with confidence at all times, or make it work quietly and surely -
as power will work for those who understand the forces they
harness, and can recognize their laws and limitations, and the
peculiarities of their manifestations.In short, I had not learned my
philosophy .... to tell you the truth, I did not know that there was
any philosophy to learn. And, without its philosophy, one may use
homoeopathic medicines, even homoeopathically, but one is no
homoeopath, and one will never get uniform nor satisfactory
results. One will never even recognize the significance of the
results one does get, nor know how to deal with them.

*
Margaret Lucy TYLER (1857-1943)

TO MASTER THE FIRST THING IS TO OBEY

          Remember that the one thing that power exacts is obedience.
Electricity is a great power; no man has doubted its existence; for
the roar that has followed the flash since the dawn of time has
proved too much for the stoutest skeptic. But, to utilize this power,
man must court it in its own way, obediently, guiding it through its
own channels, conforming to its idiosyncrasies one by one, as he
makes its better acquaintance and discovers them. It is only by
faithful obedience to the master-power that it may be bent to work
for man, obediently, as his slave. So with homœopathy. There are
no rough-and-ready methods. A child can stroke a cat's back and
get sparks; but for a steady, useful current, to drive engines, or
light a city, or girdle the earth, it requires rigid conformance to all
the known laws. No great power works without definite laws and
limitations; and with these we have to reckon, or fail. And in
homceopathy, as in electricity, you have either something - or
nothing! Both are giddily intangible - only to be recognized by
results. And in both there are no half measures. All has to be in
order with your method if the steady current of healing is to flow.
A spark here and there - even evastating - is not business. It is
convincing in its way, and may even hold a promise of better
things if you can better your methods of dealing with it.

PRESCRIBING FOR THE DISEASE

          For a homoeopath, I suppose the often fatal first step is to

label diseases, and then to label drugs to match.
To ticket Rhus and Bryonia "rheumatic remedies", and practically
make your choice between them, and to fling it in the teeth of
homœopathy when they fail to cure a case that required Sulphur or
Tuberculinum, or - the dentist;
To regard Sulphur and Graphites as "skin medicines", and utterly
fail in the cases (and they are not few) that demand Pulsatilla;
To set Sepia aside as "a remedy for women's complaints", and
scorn the person who dares to give it to babies.
Whereas, if you are to work your homceopathy for all it is worth,
you will have to cure individual cases
Of tubercular dactylitis with Sepia, of all medicines!
Of goitre, even with a mass in the right lobe - not even the left -
with Sepia (I showed such cases recently to the British
Homoeopathic Society);
Constipation with Rhus, or Variolinum (as did Dr. Burnett);
Or (as did one of our men recently) a nocturnal gastralgia
accompanied by wasting with a single dose of Syphillinum.
          If you are to do it, and to do it often, you just have to let the
disease alone and go for the patient. You have to say, not "this is a
case of rheumatism, and I might try Rhus, because Rhus is a very
good medicine for rheumatism", but "this is a Sepia patient, and,
whatever ails her, it is Sepia she needs, and no other medicine".
My goodness! if I had known that from the beginning.

          And, for your own sake, don't be too ready to say, "I tried
homoeopathy for such a case, and it failed". Remember, it was you
who failed; and the very fact that you failed proves that, whatever
it was, it was not homceopathy. The power was there all the time,
only you failed to apply it. Say this to some one who knows, and
he regards you pensively. You have merely betrayed your own
limitations.

TOO FREQUENT REPETITION

          Now, the second fatal stumbling-block is the cabalistic sign

"t. d. s." - ter die sumendum (which the knowing ones reserve for
Placebo). I suppose that that has blighted more brilliant
homoeopaths in the bud than one can imagine. And next to that, in
its self-stultifying mischief, comes the atrocious formula, of those
who fondly imagine that they are doing high class homœopathy
indeed, "once weekly". When I started on my career of failure and
bad prescribing, I saw every one giving drugs "t. d. s." - for
chronic cases anyway; think of it ! And, never having learned to
prescribe, I fell headlong into the pit. In vain my mother protested -
she had learned good homceopathy in the early days of better
work.

          "It is quite wrong", she said, "to give medicines like that, and
for weeks at a time. It is not homœopathy at all. Directly there is
improvement, you must stop; and only repeat later, if the
symptoms return unchanged".

          But "t. d. s." was everywhere the rule, on which I proceeded
to improve. For, knowing that potencies worked, I gave 30s and
200s thrice daily - or once or three times a week, as the spirit
moved me; not divining that, if one must play the "t. d. s." game, it
is well to employ the drug in its highest state of im-potency -
perhaps about the 3x, where you have not enough quantity for
crude effects, or enough penetrating power for deep and lasting
mischief. Men do get excellent results in some superficial cases, in
this way.
          Worse than all, I led others into the same error, inducing
them to try the high potencies. I was always thrown back on
myself to wonder why, when I had made a good prescription, the
patient, after a few days' splendid betterment "Why, I thought I
was cured for the first three days" - relapsed and came back worse
than ever, or with new tales of woe, for which a new prescription
went down - with like result. Always better - and then worse,
perhaps in a new way; but never, never, never cured.

          Gentlemen, you can go on in this way for years, curing your
patients till they die. They will forgive you the relapse each time
for the good hope of the first three days. In fact, that will go down
to your credit, and the rest to the credit of the disease. You can ring
the changes with a regular sequence of amelioration; drug effect;
new prescription - symptoms wiped out; new drug symptom; new
drug to meet them - fresh amelioration; fresh mischief; and again
another remedy of like symptoms which, like all its predecessors,
ameliorates promptly, and then proceeds (if persisted in in this
idiotic way) to set up its own train of symptoms, for which you
again drearily prescribe - while homœopathy sinks lower and
lower in your estimation, and the younger men wonder that you
have lost all enthusiasm for its cause. Even in those days of little
knowledge, I could often have done brilliant work had I used my
mother's words, and adjured the patient: "Directly you are better
you have to leave off your medicine, and never touch it again,
unless you are really worse".

          I am afraid I spoiled several men's work by inducing them to

try the higher and highest potencies. I know that I am giving
myself away badly, but perhaps that is necessary. For, gentlemen,
every evil that I have done in my ignorant flounderings after better
things lives on in some corner of L.H.H., and I am always meeting
my sins at odd moments and around unexpected corners - "hinc
illce lachrymoe!"

          I have seen Calc. carb. CM prescribed thrice daily for a

month by a man who was, as he expressed it, "giving the high
dilutions a trial". And my evil suggestions as to giving
Tuberculinum weekly, while one gave, say, Silica 30 t. d. s. (Silica,
that deep-acting drug of 40-60 days' action ! ), are still haunting the
place like evil spirits, to lay which it will take more of the holy
waters of repentance and confession than I can manage this
afternoon.

 
USE OF REPERTORY

          But it was not all imagination and daring experiment. I did
try to work out my cases, believing that when I failed it was
because I had the wrong drug - which by no means follows. I did
try to work out cases, with hours and hours of labor - generally in
vain ! For I had never been trained.

          Till our first scholars came back from America, no one had
ever taught me how to recognize the few symptoms of inestimable
value in the equation. NO one had ever shown me how to eliminate
drugs and minimize labor by starting with certain general
symptoms well marked in the patient. I had no faintest idea how to
work economically as regards labor.

          I would start by writing down that terrific list of drugs

producing constipation - if the patient complained of that trouble;
and so on through all his symptoms, important or unimportant,
even mechanical, and probably altogether misleading, giving to
each drug its value according to type, and never once considering
(what is most important) whether the type coincided in patient and
drug; then rounding up with an arithmetical calculation.
Sometimes the drug came out: but the labor was hideous,
monotonous, and not even remunerative in results.

          I was not easily beaten; if there was anything in

repertorizing, I was determined to master it, and more, to make it
practical with a minimum of labor; for I went so far as to devise a
card-trick system, every card a symptom, and all drugs that
produced that symptom punched out. I deafened myself punching
one thousand such cards. I have them still, a great cabinet full. But
even this could not help, because the system was wrong.

          When one knows how to repertorize, a choice from some 80

cards of "general" symptoms in a small portfolio is all that is
needed to start a case - often to work it out in five minutes with a
glance at the materia medica - had I known ! But I have learned
one thing from all this, and that I am competent to teach any one,
viz., how not to do it.

          Another way to insure failure, in some cases, is to start your

repertorizing (by way of weeding out useless drugs and lightening
labor) not with generals, but with some list of drugs that has the
patient's ailment. Say it was my case of goitre, where Sepia cured -
one dose of Sepia.
          In my days of fruitless repertorizing, I should have begun
work on a case like that by writing down all the drugs that have
been found useful in goitre; then, as there was a mass in the right
lobe, I should have eliminated all the drugs, by the help of another
list, that did not affect the right side of the body, or neck. And I
should have failed - absolutely and inevitably have failed; because
Sepia is in no list of drugs known to affect the thyroid gland. And
again, though Sepia is among the drugs that pick out one side of
the body, it happens to choose the left side for its operations, in the
general way; so, again, I should have inevitably missed it. She
received Sepia because she looked, and was, a typical Sepia
patient, with Sepia symptoms, and because I simply could not give
her anything else - then; my absurd intention being to cure her first
and then to tackle her goitre.

          But if (and it is a large if) you cure your patient, the odds are
that there will not be anything left to cure. Your business is to cure
her; the rest is her affair. Make her normal, and she will have no
further use for acquired abnormalities. Healthy nature makes short
work with superfluous details; for she can waste, as well as
develop. Given the irritant, and she will sprout "ultimates", and in
vain you prune them away. Put her right, and she starts clearing
them off and setting her house in order. Be well assured that
8nothing continues to exist without cause! And learn a lesson from
the tadpole's tail; it has taught me much. I used to think it dropped
off ! We have a great deal to learn about absorption !

HASTY PRESCRIBING

          Another way not to do it is to be too ready with your

prescription. If you take a lot of trouble with a case (when you
know how), it will give you very little trouble afterwards.
Conversely, if you take a very little trouble to begin with, it will
give you endless trouble, many times repeated. You have fouled
the clear waters with a wrong prescription, and how are you going
to peer into the depths? You no longer have a true disease picture
to match. One bad prescription leads to several, perhaps to a
hopeless mixing-up of the case. "Curses and chickens (and bad
prescriptions) come home to roost". If you are not sure give a
Placebo and wait. Hahnemann says, "A week's Placebo to start
with, anyway" !

 
PRESCRIBING DURING AMELIORATION

          And when you have worked it out, and actually found your
drug, there are still several ways of how not to do it. One of the
most catastrophous and heart-breaking is to repeat while
amelioration holds. Two cases have bitten into my memory,
though hardly understood at first; and yet I go on doing the same
thing again and again, for it is the hardest lesson in the world to
learn, to hold your hand and do nothing. One catches at the excuse
of any little recurrence of symptoms to repeat, and often spoils the
case - pro tem., anyway.

          A glaring instance, which in those early days I did not even
understand, was a chronic typical Aloes-diarrhea. (I have hunted in
vain for the notes so speak from vivid memory only). He got Aloes
CM (either one dose or two at a week's interval). He came back so
much better, practically cured, that I hugged myself, and hugged
homceopathy as a very wonderful thing. I had found his remedy
right enough, and I would keep him on it for a bit, lest he should
relapse! Of course, he came back less well. Then I gave it more
often (it was the right remedy, for the first dose had been magic). I
piled it on - homceopathy was a less wonderful thing (my
homoeopathy, that is, which ought to have been written in inverted
commas); and presently he came no more.

          That case has rankled ever since. I came to the conclusion, at
that time, that the first prescription was a comparatively easy
matter; but what to do with patients when they came back better
was beyond me! The very obvious "do nothing" was also beyond
me for ages.

          That is where the philosophy comes in. That is where, in

homceopathy, we perish for lack of knowledge. That is where the
young men, who have been trained score. They will never know so
much about "how not to do it"; but they have been taught when not
to do it ! For there is one rule, and one only, that meets the case:So
long as amelioration holds, let it be;.and only repeat, or reconsider
the case, when you are sure that it is quite at an end.

          Why, Wright has proved that recently, under the microscope,
for Tuberculinum; though Hahnemann laid down the law more
than a hundred years ago. And we who call ourselves his followers
sneer at "the eternal Hahnemann'', and do not even take the trouble
to master his teachings.
          Never repeat while amelioration holds. It will be from
minutes to hours (Hahnemann says so) in acute cases, and from
days to weeks or months, according to drug and case, in chronic
diseases. But, unless you want to see your work always going back
on you, unless you want to be one of those who have "tried
homceopathy and failed", let your ameliorations severely alone,
and keep your enthusiasm for scientific medicine.

London
Homeopathic
Hospital
          The other sharp lesson was a case of heart failure in a
woman of 29, mitral incompetence, etc., that I got permission to
treat after admission to the L. H. H. Here I have the house
physician's notes and measurements. She worked out Arsenicum,
and I gave a dose of Ars. CM two days running (as she had been
given a dose of Spig. low in the intervening night, and it might
have interrupted). The effect was magical. Three days later (only
four days after admission):

          The heart had contracted, and was now only one inch,
instead of two, to right of the sternal margin. The liver had also
contracted, and now, in the nipple line, measured 6 1/4 inches
instead of 8 3/4 inches.One hundred heart beats out of one hundred
and forty-four now reached the wrist, instead of sixty-two out of
one hundred and sixty.

          She was sleeping quietly at night, instead of the suffocating

spells when she dozed, and the frequent vomitings all night that
had been a feature of the case.

          She felt very much better. Every one was amazed at the
improvement, and, in my joy and desire to hasten matters yet more,
I gave her, a week later, another dose of Ars. CM. And that ended
the case - in all senses! She grew worse. Lyc. was given, and failed
to relieve. All her fearful restlessness returned; she could stay
nowhere. She demanded to go home, where she died very soon
after.

          You who know realize that it was risky even to give a CM to
such a case, but that it was madness to repeat it while the patient
was doing so well. You see that it is not enough to spot your drug;
it is not enough to make a successful prescription, even. You need
all the philosophy if you are to carry your work through every
time, if you are to get nearly all there is to be got out of
homoeopathy. I was like an electrician who, having proper wires
and a lamp of just sufficient resistance to glow its brightest,
wantonly doubles the current, fuses the filament, and earns
darkness. The greater the power, the more carefully must it be
handled, to avoid disaster.

HIGH POTENCIES IN ADVANCED CASES

          Another way not to do it., a case that emphasized the fearful
risk of giving a high potency of the indicated remedy to advanced
disease, was a case of malignant tumor of the breast. The woman
had been doing well on unit doses of Scrof. nod., had lost pain and
swelling of the arm, and inconveniences of the disease, though it
was steadily progressing. She was a healthy looking, robust old
woman of masculine appearance.

          I worked her out and gave Lach. 200, and then a dose of
Lach CM. This was promptly followed by alarming collapse,
hemorrhage, rapid greenish fungations, and intolerable odor (all
relieved, by the way, by a dose of Ornithogalum a few weeks
before she died). This Lach. CM aggravation pleased me, rather
than otherwise - showed that I had hit the drug. A second dose,
later was followed in half an hour by collapse; and, again, a
horrible aggravation of all symptoms. But I still fondly hoped that
the reaction might carry her a long way toward clearing up the
case. It never came. And I have learned my lesson now.

          In advanced disease, malignant or tuberculous, with much

tissue change or lowered vitality, philosophy teaches that the most
terrible that you can give your patient is the indicated remedy in
high potency. Give her anything but that!

          Some of you are fidgeting with impatience, not believing

this, or vowing that if you did believe it you would quit
homceopathy. But others in the discussion, by and by, will more
than confirm it from their own experience. You will find that it is
the men who know their work, and can handle their power, and get
results, who are not only the most keen and enthusiastic, but who
develop at times a positive terror of their drugs - in the potencies;
for they know how potent they may be for evil as well as for good;
that when the disease mass is large, or the reaction poor, the most
harmful drug you can give to a patient is the simillimum unless
very cautiously and low.

INTERFERENCE

          Another brilliant way not to do it (you see that I have tried
them all) is to have your cases in common, and to work with some
one who knows little, and cares less, for the philosophy of
prescribing. It is late; there are a heap of patients to be got away in
a short time. He sees a case on which you have expended much
labor and thought; hears a tale of woe - a medicinal aggravation
perhaps (your poor prescriber does not believe in aggravations, for
in the nature of things he gets few, and never spots one when he
does get it ! ); or old symptoms returned; or a diarrhea or rash or
excessive sweating that may be critical, mean a sharp leap towards
the cure of some serious condition, if left alone; or even symptoms
worse and patient better (if he inquired), which should call a halt.
But, at the first word, down goes a new drug; and the case is off at
a tangent - perhaps beyond recovery.This is how not to do it, with
a vengeance! For this is to throw your very life, your energy, and
your success, to the moles and the bats - and without
compensation. You and your patient have both suffered for the
victory that has been snatched from you, and suffered in vain! We
all have plenty of chances, unless we walk warily, of spoiling
another's work.

          But enough of how not to do it! There has been plenty of
that in the past; but the past is beyond our reach. Old things are
passing way, rapidly! Our concern is with the present; and the
future, living or dying, is ours! Let us only diligently train the
younger men, and the great cause is safe in their hands Those who
can wield power can be trusted never to betray it. And to you who
have learned your homceopathy under a master; who know its
philosophy by heart; who have been trained to work out your
cases, to respect and fear your potentized drugs and to use them
only safely; who have learned to recognize and understand and
deal with results - to you I would say:Be patient, be gentle and
 courteous, be tolerant and forbearing. You have no idea how those
who have not had your advantages have struggled and do struggle,
in a heart sickening way, and without your results to buoy them up
and reward their labors. They can look back, many of them, to the
time when their enthusiasm was as great as yours; when they knew
their drugs, from diligent study, as well as you do, and with far
more labor than you have bestowed, who have had them presented
to you in an attractive way - who have been taught.

          And, above all, be good stewards of the gift that was given
to you, and be ready to impart. Each one of us, working by himself
and for himself, has only a limited life work, a limited fund of
hours and energy, and then comes the "whisper out of the
darkness" that says "the end is forbidden"; that says, "thy use is
fulfilled'' - and then, silence. But think how enormously we can
multiply our life work, our influence, the sphere of our energy and
usefulness, by helping and inspiring others. What an enormous
mass of work may at last be laid to our account. Think of the work
that Dr. Kent is doing in the world today, through his scholars,
through the men he has kindled and inspired, and taught, and the
men that they, in their turn, have taught and are teaching. Believe
it, there is no greatness in the world but through service.

          He that would be great among you, let him serve. Teach!
Help! Strengthen! Hearten! Inspire! Freely we have received freely
give - and of the best that is in you.

Dr Margaret Lucy Tyler

The Homoeopathician, February 1912;
reprinted in the Homoeopathic Recorder, October 1929.

Copyright © Margaret Tyler 1912

Mise en page et arrangements Copyright © Sylvain Cazalet 1999
* Photograph courtesy of Peter Morrell

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