Every personal suffering makes the doctor better able to recognize, sympathize with and help such suffering in another. The greatest ability to help is achieved ever at the greatest cost.
No great work has ever been done without great effort and great self-sacrifice. Homoeopathy is no art for the lazy and the dullard.
But our immensely wider range of medicines is compensated by fuller repertories. And the problem is, how to use them to best effect.
And here the amount of time and labor involved in finding the remedy by means of the repertory may be immensely lightened if we realize the GRADING OF SYMPTOMS; that is, their relative value. This is the key.
Even in laboriously “working out” a case by aid of the repertory, the three hours’ dreary plodding-with often doubtful results-of the uninitiated, resolves itself into ten or fifteen minutes’ work for the practiced physician.
Or, where he knows his remedies, and has gained experience and confidence, it is often no matter of working out at all He may spot the remedy at the glance, and a few questions prove that he has got it. Typical Sulphur, Calcarea, Sepia patients can hardly be missed. This makes heavy out-patient work possible.
Hahnemann speaks- and we are apt to talk glibly of the TOTALITY OF THE SYMPTOMS. What do we mean by this? Does it mean that every little symptom, and every symptom dependent on some gross pathological lesion, has to be covered? Endless work, with poor results.
You do not recognize our friends by counting up their fingers and toes, by the things personal to themselves only of all mankind.
Their totality, as it appeals to you, lies in sex, stature, coloring, voice, expression, mind; not in what is common to men, but in what differentiates.
In the same way a drug picture, to be complete, does not consist of strings of little symptoms, but of broad outlines of mental and peculiar symptoms; peculiar, that is, to one drug, and distinguishing it from all others.
As Hahnemann puts it, “The symptoms which determine the choice of the remedy are mostly peculiar to that remedy, and of marked similitude to those of the disease.”
Hosts of symptoms are common to a thousand drugs, and therefore diagnostic of none. If you give undue prominence to these, you might as well toss for the remedy.
“Each medicine differs in effect from all others” It is the differences, not the correspondences that concern us.
Hahnemann says of indefinite symptoms, loss of appetite, of sleep, weakness, etc., that they are useless, as “common to every drug, and to almost every disease”.
Hahnemann says, “In comparing the disease-symptoms with lists of symptoms of proved drugs, the more prominent and peculiar (characteristic ) features of the case are specially and almost similitude to the symptoms of the desired medicine, if is to cure.” And again, “The state of the patient’s mind and temperament is often of the most decisive importance in the selection of the remedy.” And again, Hahnemann speaks of “the totality of the characteristic symptoms” Let us realize them that the TOTALITY means the CHARACTERISTIC TOTALITY, and cause counting fingers and toes.
KENT was one of those who went back to Hahnemann and did great work. Here is what Kent wrote to me in1912:
“The methods you use are hard and arduous, and differ decidedly from mine. You do an enormously greater amount of work than I do in my cases.
“When looking over a list of symptoms, first discover 3,4,5, or 6, or as many symptoms as exist that are `strange,. rare and peculiar.’ “These are the highest generals, because `strange, rare and peculiar’ must apply to the patient himself.
When you have settled on 3 or 4 or 6 remedies that have those first generals, then find out which of them is most like the rest of the patient’s symptoms, common and particular.
“When you have taken a case on paper you must settle the symptoms that CANNOT be omitted, in each individual.
“Do not except a remedy that has the generals must have all the little symptoms. It is a waste of time to run out all the little symptoms, if the remedy has the generals.
“Get the strong, strange, peculiar symptoms and then SEE TO IT THAT THERE ARE NO GENERALS IN THE CASE THAT OPPOSE OF CONTRADICT.
“If you see the keynotes of Arsenicum see that the patient is chilly, fearful, restless, weak, pale, must have the pictures on the wall hung straight-and Arsenicum will cure.
“Or the keynotes look like Pulsatilla. See to it that she is NOT Chilly, likes windows open, wants cool air, to walk in open air, is better from motion, thirstless, tearful, gentle.
“The trouble with keynotes is that they are abused. They are often characteristic symptoms. But if keynotes are taken as final and the generals do not conform, then will come the failures.” Among ways of finding the remedy is the elaborate repertory way, which yields excellent results in the majority of cases, By working through the case on mental and general symptoms, with due regard to their relative importance one gets the remedy, provided it shall have been : (a) well proved; (b) well represented in the repertory, which is the case with a very large but, of curse, limited number of drugs.
It means labor, but less and less as one gains experience. It means grit.
But, unless you are careful not to take such symptoms too easily, it will lead you every time to well proved drugs, well represented in the repertory-the “polychrests.” But what about the valuable remedies, only half-proved, and even so, inadequately represented in the repertory? You may need one or other of these only once in half-a-dozen years, but when you do need it, nothing will take its place.
Accidental poisonings have supplied the data regarding some of these drugs. Or again, serpent bites or insect stings.
They may appear in only one rubric in the whole repertory-but there in black type.
Take heed to any rare, black-type remedy that has the salient symptoms of a patient. Go straight to materia medica and see whether it does not perhaps fit the case through and through. A remedy so learnt is never forgotten. You have one more arrow in your quiver to speed at suffering and disease.
Here is an instance. A case of melancholia, with an insane fear of insanity. Pulsatilla more or less came through, as did Ignatia, but she got steadily worse. She was smileless, sat apart, neglected everything, could neither eat nor sleep, lost color and flesh, thought of nothing but her TERROR.
Mancinella covered the case and quickly cured. Mancinella does not appear more than a couple of times in the repertory, but it stands in black type for her one overwhelming mental symptom-fear of insanity.
She got two or three doses only, at long intervals for `slight threatenings of relapse that melted away, since when she has been well for a dozen years.
Latrodectus mactans for angina pectoris is another such ill- proved, ill-represented remedy. Black type in the one rubric,”Pain, heart, extending down left arm,” should send you straight to materia medica to find the most perfect picture of the terrible condition. And it works.
Many drugs can be got only by reading and studying their genus. One of the veterans used to lay down his own law. “Read a drug a day, and two on Sundays.”
But mark or underline, as you read, the strong, rare and characteristic symptoms of each drug. You can afterwards easily run through your markings and get a drug-picture that will stick to you.
In reading any drug not also:
Its LOCAL actions.
The TISSUES and ORGANS it especially affects. (Burnett, following Rademacher, made great use of organ remedies, as well;l as the polychrests).
Also, its peculiar sensations, mental and physical. In Clarke’s Dictionary special stress is laid on these, in the remarks that preface every drug.
Nash’s LEADERS, Allen’s KEYNOTES, Boger’s SYNOPSIS, are all based on drug characteristics, and these books are immensely helpful.
If you have Allen’s Cyclopaedia you can do happy and useful reading even here, provided that you run through his black type symptoms, and his symptoms in italics. You get an extraordinary insight into remedies this way. And even in the ordinary type you may find strange symptoms; underline them.
Where in a case there is a strongly marked mental symptoms which you feel must be matched. You may lighten your work by using that as an eliminating symptom. And, in going through the rubrics of the other symptoms, record only those that have this mental symptom.
In the many cases where you have to work solidly through the marked symptoms of the patient, from mentals to generals, in their order of importance, you may, in my experience, lighten your labor thus:- Remembering the general symptoms, reactions to temperature and whether, to foods. to environment generally, must be very definitely marked in the patient to be used at all, and that, if so marked and definite, they should correspond in importance of type with the drugs in their rubrics:-
Therefore, in strong, general symptoms, it is generally enough to write down only the drugs in black type and italics. And this is really, even in long rubrics, not such a terrible task.
