He asks further, “Must I take all mental symptoms without reference to attending circumstances, i.e., a girl with intense fear of thunder, whose mother has also fear of thunder, and hides during a storm. Am I to include fear of thunder?”
All the more! You do not refuse to take phthisis into consideration, because her mother or her grandmother had died of it. On the contrary, very often the same peculiarities and the same drugs run in families.
And once again: “Patient has had certain mental symptoms for years before the development of physical illness… am I to take that symptom?”
Organon (par. 213) says, “We must pay attention to the change that has taken place in mind and body”.
Whilst all symptoms must be taken into consideration in a case, yet the last appearing or more recent symptoms are the most important for the first prescription.
Dr. “G” writes: “My greatest difficulty is myself, how to get proper knowledge of materia medica”. KNOWLEDGE OF MATERIA MEDICA
Read a drug a day in different books, so as to get different presentments by men of different minds, and different experiences. Some can tell you about one drug, some about another. Read such books as give briefly the characteristics of drugs. You do not need all the small details – the symptoms common to innumerable drugs. You want the broad, characteristic outline – the peculiarities – the strange mentalities For quick work, you want to know especially, what makes this drug quite unlike all others, say “Allen’s Keynotes” or “Nash’s Leaders” if you are too rushed or tired for “Kent”. Or read the black type and italics in “Allen’s Cyclopaedia,” or the black type of “Hahnemann’s Materia Medica Pura”. These give you a wonderful perception of drugs.
Also, when you have worked out a case, glance through your drug in the materia medica before prescribing, to see that it not only fits the patient as a whole (several drugs may seem to do this) but that it is also on the spot with what the patient complains of. In this way you learn your drugs far better than in merely working them out; it will also save you from tediously working through small particulars, which may not be well represented in the repertory.
For instance, Sepia, Nitric acid. and Natrum mur. might work out more or less. But if the patient is complaining of uterine symptoms, probably, if you turn up Sepia, you will find a picture of the whole trouble;if it is anal or buccal, you might possibly find your picture detailed in the provings of Nitric acid, or the headache complained of may be absolutely Natrum mur. There is not only the general and mental picture to be dealt with; but also the regional. We sometimes forget this. Prescribers say that Kent rather neglected the regional. But it is a fact that drugs pick out each its own locality or tissue, as Silicea,, connective tissue; Arnica, Carbo veg., Lachesis, Pulsatilla veins; Chelidonium, Podophyllum,, liver; Bryonia, Ruta,, serous tissues.
He says, “two types worry me”.
Patient “who has a respect for doctors, and tells you plenty. When he has gone, you find nothing but an impenetrable verbal forest.”
You will get gradually to know what Clarke calls “good symptoms”, that is, symptoms valuable in the finding of drugs, also symptoms that you feel must form a part of the case. Underline these with red pencil, as you read through what you have written, or as the patient gives the symptoms. They will then stand out in their order of importance, and save you much work.
Hahnemann suffered from just the same difficulty. For he says, “observe and discount the temperament of your patient. Some, “he says, “particularly hypochondriacs, and other sensitive and intolerant persons, are apt to represent their complaints in too strong a light, hoping thereby to induce the physician to redouble his efforts.
“But the shy, the modest, or timid and bashful will state their case in obscure terms; or may consider many of their symptoms too insignificant to mention.” (Org. p. 1, 6.)
Again, “Patient with chronic complaint, doing well, has had a recent repeat, and comes in with an acute condition…(?) not related to the chronic one”.
Here Hahnemann says…”The physician must be on his guard against interrupting the action of the antipsoric remedy which he has given to the patient. Let him not exhibit an intermediate remedy on account of a little headache which may perhaps come the day after the remedy was given; or another remedy for a sore throat, or diarrhoea, or a little pain, The rule is that the carefully selected homoeopathic remedy should act until it has completed its effect.” (Chr,. Dis., p. 150.)
Dr. “H”, referring to the treatment of mental cases, says:
“I am up against the difficulty of working on a scarcity of material facts.
“I must judge by the patient’s expression and what he chooses to tell me, which consists mostly of delusions.
“I have come to the conclusion that to prescribe on delusions or delirium or mania in this type of case is hopeless”.
Dr. Burnett used to say: “With infants, lunatics, and liars you have to form your own judgment” re: choice of remedy.
The patient may be unable to give symptoms by word of mouth, or may lie when giving them. But there are other even more sure of ways of arriving at what you want.
Your observation, expression of face may help you, especially in cases of insanity, where, perhaps, the one idea has stamped itself upon the patient. You may see pictured anxiety, fear, suspicion, the lineless face of Sepia, the deeply-lined face of Arsenic. The face may express stupidity, foolishness, may be old-looking, sickly, suffering. Kent has rubrics for these under “Face” (Repertory, pp. 378, 379 besides the rubrics in mentals. You will observe the behaviour of the patient – restlessness; ceaseless movement of hands or feet; desire to escape, Or dull, phlegmatic appearance.
The reports of attendants are invaluable. The patient may be sly, spiteful, cruel, weeping, shrieking. His appetite – hungry or greedy; aversion to food; refusal of food. Aversion to or desire for different foods. Unnatural cravings. May eat lime, earth, his own excrement. His fears – alone, in the dark, of people. Symptoms of paranoia or megalomania. Dr. Tyler has more or less grouped these into two of her repertory cards, “delusions of persecution” and “delusions of grandeur”. Very important, too, are the reports of friends as to changes of disposition. You may find, on inquiry, that a kindly person has become cruel; that there are cravings for things once loathed, or a loathing of things once craved; that there is indifference to, or hatred of persons once loved. All these things are of the utmost importance in dealing with insanity. Never forget the nosodes in mental diseases and maldevelopments.
Tuberculinum is wonderful mental remedy or stimulus. Apart from its symptoms, the indication is a family history of tuberculosis, or previous T.B. history of patient, or, as Allen puts it, “when the best indicated remedies have failed to produce improvement.”
Also Syphilinum : one would think of this where the patient is sleepless, or when his sufferings, mental or physical, are always worse at night. Queer things have been cured by this drug, on that nightly aggravation indication, where other symptoms have not been available, or have not helped (as a case of nightly vomiting). Incessantly washing the hands is one of the peculiar symptoms of Syphilinum, and has been verified clinically. And there is a mental symptom – dreads the night.
Also Medorrhinum. This has some very insane mental symptoms. Far-away sensations; seems to herself to make wrong statements; thinks someone behind her; hears whispering; sees faces peer at her from behind furniture; sees large rats running; large people in the room, feels a delicate hand smoothing her head; all life seems unreal; sure she is going to die; wild and desperate feeling, as of incipient insanity; suicidal; feels matters before they occur, and generally correctly; fear in the dark; has committed the unpardonable sin and is going to hell. A useful symptom, “likes to lie on abdomen”.
Do not forget the effects of blows and fall on head and neck. Arnica, Hypericum, Cicuta, must be here thought of. In America they are said to be doing a great work on asylum patients with manipulations of neck.
Dr. “J” considers fear one of the most important of the guiding symptoms. But fear of this and that is seldom shown in any new and marked degree in chronic illness.
In chronic illness why should not the fears be chronic too?
In recent illness, acute or chronic, people do often get new fears. One is told, “I used not to be afraid in the dark – or alone. I am now!” And after treatment patients often say, “No I am not so nervous now, have lost such and such fears.”
He asks: “Does fear of thunder mean noise, lightning, death, or what?”
It may mean any or all these things, or the effect in persons sensitive thereto, of electrical tension. They are all massed together under fear of, or worse during, storm. It is as well to take these rubrics together. Whatever they are, they are all intensified during a thunderstorm.
Weir received his medical education first at Glasgow University MB ChB 1907, and then on a sabbatical year in Chicago under the tutelage of Dr James Tyler Kent of Hering Medical College during 1908-9. Weir reputedly first learned of homeopathy through his contact with Dr Robert Gibson Miller.
John Weir wrote- Some of the Outstanding Homeopathic Remedies for Acute Conditions with Margaret Tyler, Homeopathy and its Importance in Treatment of Chronic Disease, The Trend of Modern Medicine, The Science and Art of Homeopathy, Brit Homeo Jnl, The Present Day Attitude of the Medical Profession Towards Homeopathy, Brit Homeo Jnl XVI, 1926, p.212ff, Homeopathy: a System of Therapeutics, The Hahnemann Convalescent Home, Bournemouth, Brit Homeo Jnl 20, 1931, 200-201, Homeopathy an Explanation of its Principles, British Homeopathy During the Last 100 Years, Brit Homeo Jnl 23, 1932: etc