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Progress in acute illness can be assessed using the same criteria as those listed in section 1.7: if the patient achieves an improvement of at least 50% within two days, we wait; otherwise we administer the reserve remedy. Treatment is successful if the illness can be treated with the first or second remedy without any more consultations. Of course acute illness frequently resolves spontaneously. Healing can only safely be ascribed to the remedy in such cases when it occurs exceptionally quickly. For example, a meta-analysis by Del Mar and colleagues demonstrated that placebo treatment of acute middle -ear infection led to freedom from pain in 60% of patients within 24 hours.²³ In contrast, a study with 230 patients suffering from acute otitis media showed that 39% of the children were pain-free six hours after receiving the first homeopathic remedy, and a further 33% of the children who received a second remedy were pain-free within 12 hours.²⁴ Such improvements can be ascribed to the effect of the homeopathic treatment.

It is more straightforward to judge progress in chronic illness and multimorbid patients. We have found it useful to ask the patient to rate each complaint in terms of intensity and frequency on a scale of 1 to 10, where 10 is the worst state. This is done at the start of treatment and then at every check-up. In addition they judge their improvement, also on a scale of 1 to 10. This should ideally reflect the reduction in average symptom intensity. With the spreadsheet case log, presented in chapter 5, these patient assessments can be displayed in graphical form (see example below, figure 1).

Figure 1: Example of Graphical Progress Check (Ms D. T., 58 years old)