THE TOTALITY OF THE SYMPTOMS
As our sole guide in the choice of the curative remedy is the totality of the symptoms, it is necessary to inquire what is meant by the totality.
In acute disease every symptom experienced by the patient or observable by others is to be included in the totality; also any cause, such as wetting, fright, etc., and circumstances aggravating and ameliorating.
As an acute disease never forms a complex with a chronic one, the latter being suppressed until the former one has run its course, care must be taken when ascertaining the symptoms of the acute disease not to take into account old symptoms which belong to the chronic disease. But in some cases of acute disease, SYMPTOMS of the chronic disease remain, and are active during the acute disease: such chronic symptoms are peculiar because they have not disappeared, and very often are guiding to the cure of the acute disease; while the remedy will have no relation to the chronic disease, yet that peculiar symptom will stand out and guide you to the remedy that will cure the acute disease; such symptoms are peculiar to the patient. (Kent, Medical Advance, January 1890.)
In chronic: disease the totality includes all symptoms experienced by the patient since birth, excluding those arising during acute disease. While theoretically it is proper to include all such symptoms, yet great caution must be used. (1) Some other chronic miasm may have been acquired during life or (2) the symptoms may have been so perverted by inappropriate treatment that they do not truly represent the disease.- (Kent, Journal of Homoeopathics, July 1899.) When the symptoms have been much perverted by inappropriate treatment we can sometimes get a sure foundation on which to base a prescription by taking the symptoms as experienced by the patient before this inappropriate treatment was commenced.
This investigation into the former symptoms of the patient is frequently of great service when the presently existing symptoms do not point clearly to any remedy. For example, in an adult with neuralgia of the limbs, where present symptoms are not guiding, if we find that in infancy he had scald-head like that of Mezereum, and we now examine the neuralgias produced by that remedy, it will often be found that they bear a close resemblance to that of the patient, and it will probably prove curative and reproduce the original eruption.
It frequently happens that, when we search for the totality of the symptoms, we find they have been so perverted or suppressed by inappropriate treatment that these now present do not present a true picture of the internal disease. For example take a case of gonorrhoea suppressed by Argentum nit., and on examination there will be found a pretty full picture of Medorrhinum and a partial one of Argentum nit., and probably Natr. mur.
(In all such cases we must prescribe upon the symptoms is possible, but if the case foes not respond and the suppressing drug is known, it is sometimes advisable to select a remedy competing which has an antidotal relationship.-K.)
In determinating the totality, especially with regard to former symptoms in chronic disease, it is also necessary to ascertain whether one or more miasms are present, as it is useless to attempt to find a remedy for all the symptoms when there is more than one. In such cases, as a rule, only one miasm is active at a time, and the treatment must be directed against that one. When two or more miasms form a complex, we must endeavour to separate them.
(The symptom are the only guide to the separating of the miasms. The road to death is by more complexity, and any remedy that improves the patient will cause a simplification or separation of the miasms.-K.).
