Some estimate of the patient’s personality and temperament has probably been arrived at already but further tactful enquiry may be called for into such matters as fears, tears, temper, tidiness or otherwise, ability to relax or the reverse, response to sympathy, attitude to heights or closed spaces, interests and hobbies, and so on.
Outstanding psychological features will often provide a strong indication for the use of one or another remedy.
By careful comparison of the outstanding features of the patient’s total symptom-picture with the characteristic features of drug-pictures in the materia medica one or more similar remedies will be suggested, thus arriving at a tentative prescribing diagnosis.
The similarity may be so striking and so clear that the remedy is obvious and can be prescribed straight away. But often there will be more than one remedy indicated at this point. Further consideration is necessary before the final choice can be made.
Of immense value in this connection is a further step, to discover the typological, or constitutional, diagnosis. Individuals vary greatly in their constitutional make-up and what is important is the known relation of remedies to fairly well- defined types. There are often clearly revealed by the physical features, the mental and emotional attributes and the general reactions that have been brought to light.
Hahnemann’s Three “Miasms”.
There remains still another line of diagnosis to be followed up, namely the toxicotic. As Hahnemann emphasised more and more in his later writings the most important factor both in initiating and in maintaining disease is probably the presence in the tissues of poisons, “miasms” as he called them, toxins as we would say today.
With the limited facilities for research available in his day Hahnemann’s search for such disease-producing poisons or miasms was extremely restricted.
He postulated three main miasms as causal in initiating and prolonging disease states. These be named Psora, especially related to congestive states and cutaneous manifestations; Sycosis, especially related to catarrhal states; and Syphilis, then as now a widespread human scourge and responsible for a variety of disease manifestations.
Much is now known as to the toxicotic causation on disease, and it is realised that chronic disease may be due to residual poisoning from previous infections such as diphtheria, measles, scarlet fever, tuberculosis, typhoid fever and malaria, to say nothing of the aftermath of vaccination and various inoculations.
The reason why such knowledge is of special value to the homoeopath is that in his materia medica he possesses remedies that are specially related to the different forms of toxicosis, not only to Hahnemann’s “Big Three” but also to many others.
For instance : NATRUM MURIATICUM is related to malaria; MERCURIUS to syphilis; DROSERA to tuberculosis; and THUJA to vaccinosis.
Other remedies derived from disease tissue or from culture of specific organisms are called “nosodes” (nosos-disease).
These are of special value in prolonged disease when the apparently indicated remedy fails to clear up the case, and also in chronic disease states apparently deriving from some infective episode, perhaps many year in the past. They may also be employed prophylactically.
Nosodes are prepared by the process of attenuation and sub- division described in the next chapter. The toxicity of the original material is thus neutralised and replaced by curative power, the ability to stimulate antitoxic and restorative activity in the tissues of the body.
The exact mode of action of the remedy is still unknown. the actual presence of so-called toxins in the body is also only a partial hypothesis. It is, nevertheless, evident that much chronic disease does derive from previous infection, sometimes antenatal. The re-resulting condition of metabolic disharmony or of tissue sensitivity calls for the use of a deeply acting remedy related to the causal factor.
The foregoing may seem a somewhat formidable undertaking at first sight. The scheme may be regarded as a sort of blueprint for history-taking which can be modified according to circumstances and as the result of experience.
In an acute emergency, decision will obviously have to be reached as to treatment on a quick assessment of the immediate features of the case. But often a satisfactory line of therapy can only be decided after a full and meticulous review of all the facts, as outlined above.
For the homoeopath diagnosis is no light or easy task. In addition to the search for clues to underlying pathology, which is the obligation of every physician, he must also track down the curative similar remedy from every possible angle-causal factor, symptom-picture, constitutional type and deep-seated toxicosis, or miasm.
