Each disease, each individual case of disease and each symptom of disease has its totality or individual form.

If the “day books” or records of a good proving are examined it will be seen that the symptoms of each prover are set down chronologically in the order of their occurrence; that each symptom is as complete as possible in its elements of locality, sensation and modality; that the symptoms are stated mostly in the vernacular, the plain simple language of the layman, who describes phenomena as they appear to him, simply, graphically, or by analogy or homely comparison. The record of these facts with the remarks and observations of the director of the proving constitutes a “proving,” in which exists the elements from which the Materia Medica is constructed.

*The Day Books of the provers are not the Materia Medica. Not until this mass of material has been analyzed, sifted, classified according to its anatomical, physiological and pathological relations and had its general and particular characteristics logically deduced, does it become materia medica for practical use. Many things in a proving must be interpreted in the light of anatomy, physiology, pathology, or psychology before they are available for therapeutic use, just as the statements of patient in regard to his sufferings must be interpreted in making a diagnosis or in making a prescription.

The true Totality, therefore, is a Work of Art, formed by the mind of the artist from the crude materials at his command, which are derived from a proving or from a clinical examination of the patient.

It is important that these points should be understood, because, otherwise, there is liability to err in several directions.

1. Error may arise in placing too much emphasis upon a single symptom, or perhaps actually prescribing on a single symptom as many thoughtless do.

2. Error may arise in attempting to fit a remedy to a mass of indefinite, unrelated or fragmentary symptoms by a mechanical comparison of symptom with symptom, by which the prescriber becomes a mere superficial “symptom coverer.”

3. Failing in both these ways the prescriber may fall to the level of the so-called “pathological prescribers,” who empirically base their treatment upon a theoretical pathological diagnosis and end in prescribing unnecessary and injurious sedatives, stimulants, combination tablets, and other crude mixtures of common practice.

The physician who known what a symptom is from the homoeopathic standpoint and how to elicit it; who knows what the totality of the symptoms means and how to construct it, and who has the intelligence, the patience and the honesty to study his case until he finds it will not be guilty of such practice.

Characteristics and Keynotes.- In paragraph 153 of the Organon, Hahnemann says that in comparing the collective symptoms of the natural disease with drug symptoms for the purpose of finding the specific curative remedy, “the more striking, singular, uncommon and peculiar (*characteristic) signs and symptoms of the case are *chiefly and almost solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure. The more general (common) and undefined symptoms; loss of appetite, headache, debility, etc., demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and drug.”

This seems a sufficiently clear description of what Hahnemann meant by “characteristic” symptoms; and yet the term has been the subject of much discussion and many have differed as to what constitutes a “characteristic.”

Confusion arose and still exists through the inability on the part of many to reconcile the teaching of this paragraph with the apparently conflicting doctrine of The Totality of the Symptoms as the only basis of a true homoeopathic prescription. These have taken refuge either in the mechanical “symptom covering” already referred to, as fulfilling their conception of the “totality;” or in what is knows as “keynote prescribing,” which, as they practice it, means prescribing on some single symptom which they (perhaps whimsically) regard as the “keynote” of the case.

The fundamental mistake here has been in the failure to distinguish between the *numerical totality and the related or logical totality, as already explained.

Both of these misapprehensions should be recognized and corrected.

The real “keynote system,” as taught and practiced by the late Dr. Henry N. Guernsey (but perverted by many) does not conflict with the doctrine of the totality of the symptoms, nor does it fall short of complying with Hahnemann’s injunction to pay most attention to the peculiar and characteristic symptoms of the case. It is, in fact, strictly Hahnemannian. The truth is that Dr. Guernsey simply invented a new name for the old Hahnemannian idea.

A synopsis of Dr. Guernsey’s keynote method will be of value in this connection.

The term “keynote” is merely suggestive as used in this connection. The reference being to the analogy between materia medica and music. This analogy is shown in the use of other musical terms in medicine, as when the patient speaks of being “out of tune,” or the physician speaks of the “tone” of the organism. Disease is correctly defined as a loss of *harmony in function and sensation.

The keynote in music is defined as “the fundamental note or tone of which the whole piece is accommodated.” In pathology the term “pathognomonic symptom” expresses what might be called the keynote of the disease, or that which differentiates it from other diseases of a similar character.

In comparing the symptoms of medicines we find that each medicine presents peculiar differences from all other medicine. These differences from all other medicine. These differences by which one remedy is distinguished from an other, are the “keynotes” of the remedy, according to Dr. Guernsey.

It does not mean that the keynote of the case alone is to be met by the keynote of the remedy alone and that the other features of the case or remedy are to be ignored. The keynote is simply the predominating symptom or feature which directs attention to the totality. Its function is merely suggestive. A prescription is not based upon a keynote, considered as one symptom, no matter how “peculiar” it may seem. Its utility lies in this: that when the prescriber has become familiar with these “keynotes” or “characteristics” of remedies he will be able more quickly to find the remedy in a given case because the field of selection has been narrowed. When he recognize such a keynote in the symptoms of a case it suggests or recalls to mind a medicine, or medicines, having a similar keynote. Reference to the repertory and materia medica will verify and complete the comparison. There is usually something peculiar in the case, some prominent feature or striking combination of symptoms that directs the attention to a certain drug, and this is what Dr. Guernsey called a keynote.

The misunderstanding and abuse of this method has caused it to fall somewhat into discredit. But considering Guernsey’s “keynotes” and Hahnemann’s “characteristics” as synonymous terms, which they are, and making legitimate use of Guernsey’s method, it has value.

*A characteristic or keynote symptom is a generalization drawn from the particular symptoms by logical deduction. Evidently the characteristic or peculiar symptoms of a case cannot be determined until a complete examination has elicited *all the symptoms of the case (the numerical totality) for purposes of comparison. This having been done there are various ways of selecting the characteristics.

Dr. Adolph Lippe illustrated his method in this way: ” In many cases,” he says, “the characteristic symptoms will consist in the result obtained by deducting all the symptoms generally pertaining to the disease with which the patient suffers, from those elicited by a through examination *of the case.” In other words *the characteristic symptoms are the symptoms peculiar to the individual patient, rather than the symptoms common to the disease.

He illustrated this by a case, as follows: “The patient was attacked by cholera. All the characteristic symptoms of cholera were present; but in this individual case there was (1) an unusual noise in the intestines, as if a fluid were being emptied out of a bottle. (2) The discharge came away *with a gush. Of what pathological value these symptoms were we know not. Still they formed part of the totality which we must cover. Deducting from the (numerical) totality of the symptoms those common to the disease, we were in possession of the characteristic symptoms of the patient.

“We found that those two symptoms are also characteristic of *Jatropha curcas, and that this remedy, at the same time, has caused symptoms corresponding with the general pathological condition.” Jatropha promptly cured the case.

Stuart Close
Stuart M. Close (1860-1929)
Dr. Close was born November 24, 1860 and came to study homeopathy after the death of his father in 1879. His mother remarried a homoeopathic physician who turned Close's interests from law to medicine.

His stepfather helped him study the Organon and he attended medical school in California for two years. Finishing his studies at New York Homeopathic College he graduated in 1885. Completing his homeopathic education. Close preceptored with B. Fincke and P. P. Wells.

Setting up practice in Brooklyn, Dr. Close went on to found the Brooklyn Homoeopathic Union in 1897. This group devoted itself to the study of pure Hahnemannian homeopathy.

In 1905 Dr. Close was elected president of the International Hahnemannian Association. He was also the editor of the Department of Homeopathic Philosophy for the Homeopathic Recorder. Dr. Close taught homeopathic philosophy at New York Homeopathic Medical College from 1909-1913.

Dr. Close's lectures at New York Homeopathic were first published in the Homeopathic Recorder and later formed the basis for his masterpiece on homeopathic philosophy, The Genius of Homeopathy.

Dr. Close passed away on June 26, 1929 after a full and productive career in homeopathy.