There is a third class of mental symptoms which one has to take into consideration and which one can, for convenience, call disturbances of the Understanding or Intellect. Under this heading one would consider disturbances such as illusions or delusions, or symptoms occurring in delirium. Also under the same heading one tends to place constantly recurring dreams.
Lastly under the mental section one gives consideration to symptoms indicative of general mental capacity, such as power of concentration, capacity for work, difficulty in finding the appropriate words or phrases, and disturbances of memory.
Mental symptoms as a whole, when found, are the deciding factors in the choice of the appropriate remedy, and under the heading of mental symptoms the degrees of importance are first the character, second the disturbance of the primary instincts, third disturbances of the under-standing or intellect, and lastly disturbances of general mental capacity and memory.
Passing now to the physical symptoms complained of by the patient, from the prescribing point of view one again grades them as of different degrees of importance. One considers that the most important physical symptoms are those which refer to the patient as a whole, as opposed to symptoms referring to one or other organ or part. These one considers the Physical Generals, meaning to imply that the patient generally, or as a whole, is better or worse under certain circumstances, or that he has a general feeling as opposed to a sensation felt in some particular part.
In practice if has been found that these general symptoms are again not all of equal value, with the result that there has been a tendency over the years to group them under different headings according to their degree of importance, Looked at from the point of view, one considers that the general symptoms which express physical desires and aversions are of the greatest importance. By physical desires and aversions one tires to express first of all any sexual disturbances, and secondly any aversions to or cravings for any particular articles of food or drink.
Of second degree of importance one considers the patients reactions as a whole to external stimuli, that is to say, their response to heat and cold, fresh air or stuffiness, wet or dry, thunder or snow, and so on. In addition to that one brings under this heading any tendency to periodicity in their complaints. And finally one places under this heading any foods which disagree and any marked allergic manifestations.
There is a third group of general symptoms which are most easily described as the General Sensations or Reactions of the patient in response to specific action, or in response to definite physiological states, for example, whether the patient is better when in motion or at rest, whether he is better or worse from sleep, better or worse when fasting or after eating, always provided these reactions are general and expressed by the patient’s saying that he himself feels better or worse. Under the heading of physiological stares one places the feeling of well being or illness in such conditions as after stool, during menstruation, after sexual intercourse, in other words the response to any normal physical activity.
There are some other general symptoms which one places as of the same degree of importance, although not quiet covered by the heading that I have already given you. These consist of symptoms which are general to the patient, for instance, if all the pains are of the same character, no matter where felt, one considers that there is a general governing factor and that weight must be given to this point when prescribing. Again, if a patient is suffering from a painful condition and the pains tend to develop or depart in the same manner on all occasions, that one considers a matter of general importance. Or again, if all the patient’s complaints tend to be entirely, or predominantly, confined to one side of the body, that one-sidedness one considered to be of great importance.
Next one takes into account anything in the patient’s past medical history which may have a bearing on the present disturbance, and one gives the same degree of weight to that in deciding on the remedial measures to be taken. Under this heading one finally places anything in the family history which may indicate a family tendency or a hereditary dyscrasia.
Of less importance, but what one considers still as general in character, are the symptoms referring to haemorrhages and discharges, provided the haemorrhages and discharged, no matter from what part of the anatomy, are constant in character.
The foregoing embraces all the general symptoms, and the degrees of value from a drug selection point of view are in the following order, first disturbances of the physical appetites, second general responses to external stimuli, third general reactions in response to physical activity or physiological states, coupled with pains of a general character, past personal history and family history, and of least importance haemorrhages and discharges.
Finally, one takes up symptoms which are-referred to one or other organ or system, in other words, the symptoms of which the patient usually complains in the first instance. Again, from the prescribing point of view, one does not consider all these symptoms as of the same degree of importance. One considers that where a symptom refers to a vital organ it is of more importance than where it refers to a superficial organ or the skin. Symptoms referring to a superficial organ or the skin. Symptoms referring to the heart, lungs, digestive tract and central nervous system and considers of the greatest importance. Symptoms referring to the subcutaneous tissue or the skin one considers of least importance of all.
In a small proportion of cases one comes across instances where the symptoms, or a particular symptoms, complained of by the patient strike one as peculiar. The peculiarity may be dependent on the fact that in one’s experience of the disease form which the patient is suffering one would expect that the patient’s complaint would be the opposite of what it is. For instance, where one has an obviously red, inflamed joint one’s experience is that joint is sensitive to pressure and to movement; if however, one comes across a case in which the opposite occurs, that is to say, the affected joint is relieved by manipulation and pressure, one considers that peculiarity must be taken into account in the choice of the appropriate medicine. Another type of oddity which one sometimes comes across is the case in which a perfectly ordinary and common symptoms appears only under peculiar and restricted circumstances. For instance, it is quite common to meet with patient suffering from diarrhoea, but where that diarrhoea is brought on by anticipation of any unusual activity that fact has to be taken into account. Or, for instance the opposite, constipation, is all to common these days, but where one comes across a case in which the patient is unable to defecate in the presence of the nurse in attendance that, again, is a symptoms of which one would have to take note. Or there is the more common instance still in which difficulty of micturition is felt only when there is someone in the immediate vicinity. Where one comes across these odd symptoms they should always be carefully noted and an endeavour made to cover them by the medicine which is administered. In many cases it is possible to be led direct to the most appropriate remedy by a consideration of these odd symptoms alone, but great care has to be taken in this as the record of the production of these odd symptoms is by no means complete, and further, where the mental or well-marked general symptoms produce by the drug are at variance with the mental or well-marked general symptoms of the individual patient exhibiting these odd peculiar symptoms no curative result will follow the administration of the apparently indicated medicine.
In other words, these peculiar symptoms, although sometimes of the greatest possible help when there are no contra- indications cannot be held to override all other considerations.
Having a clear picture of the relative values of the symptoms from the point of view of homoeopathic prescribing, one has then to approach the problem of how one cab be certain of obtaining of obtaining all the necessary information about any particular case. One finds that, taking a case from the ordinary medical standpoint, one will have a record of all the relevant features which enable one to make a diagnosis. In many cases, however, the diagnosis will not help in the choice of a remedy. This will be determined almost entirely by the symptoms which the patient gives indicating that he is out of health, in other words, that he has departed from his normal.
The whole of one’s success in the art of homoeopathic prescribing depends on one’s power of individualizing every case which one has to treat. With this object in view, what one is always endeavouring to do is to find in what way any symptom of which the patient complains is modified by any external circumstance, or any action on the part of the patient, or is in any way influenced by time. For instance, it is a common experience that a patient will come along with some indefinite rheumatic symptoms, consisting of a certain amount of stiffness, pain, difficulty in movement. These symptoms will help in no way in the selection of your drug as they might well be covered by a hundred or more different remedies.