Before we know what is the second best remedy, we must understand what is the best remedy in the materia medica. It is the indicated remedy of the case and without any doubt the best remedy must be given time to act and its action must not be interfered with by any other drugs until it has accomplished all of its action. You also know that too many doses of the best remedy may spoil the case.
The physician whose aim is high, not mere dispenser of palliatives and has power for righteousness in his community as well as a healer of the diseases. But when people who expect and demand medicine and are not satisfied unless they get it.
"One of the distinguishing characteristics of a great painter is that he knows when to stop. Many a painting which would have been great, if the artist had known when to stop, has been weakened and spoiled by over-finishing."
When the physician does not like to administer any homeopathic medicine to his patient or when there is no necessity for administering any medicine, he gives some UNMEDICATED SUBSTANCE to satisfy the patient and to create confidence that he has been using the medicine regularly. These unmedicated substances are called Placebo. An inactive substance, sometimes to provide psychological benefit to patients by allowing them to believe they are receiving treatment. The second best remedy word is used by Dr. Close.
According to Dr. Stuart Close, " Placebo is the second best remedy without which no good homeopathist could long practice medicine. The young homeopath's best friend, the old doctor's reliance and a very present help in time of trouble!"
The term 'Placebo' is derived from Latin word 'Placere' which means, 'to please or satisfy'.
According to Dictonary.com - A substance having no pharmacological effect but given merely to satisfy a patient who supposes it to be a medicine.
- Saccharum Lactis Officinalis (Sac. Lac.)
Different forms of placebo-
1- Solid :
- Sugar of milk
2- Liquid :
- Purified water
- Purified water with alcohol
According to Hahnemann-
1- Aphorism 91 (5th edition of Organon)- : "When the disease is of a chronic character, and the patient has been taking medicine up to the time he is seen, the physician may with advantage leave him some days quite without medicine, or in the meantime administer something of an unmedicinal nature".
2- Footnote to Aphorism 96 (5th edition of Organon)- : "A pure fabrication of symptoms and sufferings will never be met with in hypochondriacs, even in the most impatient of them; a comparison of the sufferings they complain of at various times when the physician gives them nothing at all, or something quite unmedicinal".
3- Aphorism 281 (6th edition of Organon)- : "In order to be convinced of this, the patient is left without any medicine for eight, ten or fifteen days, meanwhile giving him only some powders of sugar of milk".
According to Dr. J.T. Kent- : "Do not prescribe unless you find the remedy, instead prescribe placebo".
Uses of placebo- :
1- Gives time to select the medicine- It might be fatal to make a mistake in the first prescription by giving it with a prejudice. So you must have time and make no mistake and keep the confidence of the patient. It gives more time to the physician to study the case and select a medicine and thereby keep his honor and confidence in the patient.
2- Substitution- After administration of similimum, when improvement begins and you desire to discontinue medication, you will simply substitute placebo for the remedy and can easily watch the effect of your similimum.
3- Indisposition- In this condition where no medicine is required and slight alteration of health can be cured by giving placebo with some advice on diet and regime which proves beneficial than the usage of medicines.
4- Homeopathic aggravation- According to Kent's 3rd observation, when after administration of the medicine if homeopathic aggravation (not medicinal or disease aggravation) occurs, physician should not give any medicine to the patient. In the meanwhile physician should give placebo and satisfy the patient.
5- Over-drugged patient either from allopathy or homeopathy- In this condition, generally in chronic case patient does not give clear indications for the selection of remedy. We should give placebo for at least 10-15 days so that vital force can nihilate the medicinal symptoms due to over-drugging and we will get true picture of the disease.
6- Hypochondriac patient- By the usage of placebo we can identify the patient who exaggerate their complaints and also helps in accessing the susceptibility of the patient.
7- Psychological moment- Any harmless step, which tends to cause the curative reaction of the organism through the awakening of faith and confident expectation, is not only right but legitimate and sometimes indispensable.
i) "Never admit its use to any patient or to anyone. It may affect your influence and reputation, but use it without fail when your judgment dictate it."
ii)"Always sure to moisten the tablets and pellets with alcohol. Patients have a way of investigating powders or pills, they may become suspicious."