The Examination of the Patient

When the physician comes to look over the record after an examination to get the image to classify and arrange it, he will find what is peculiar, and those symptoms that are most general, and those that are but common. These three grades appear in every complete case, and in every complete proving of a remedy. Homoeopathic study and observation will enable one to pick out these grades at a glance.

Every case has common symptoms, but peculiar symptoms may be absent and you must not expect to cure when peculiar symptoms are absent. Homoeopathy is applicable in every curable case, but the great thing is to know how to apply it. The physician must sit in judgment upon the symptoms and determine whether they are peculiar or common. If the patient’s discourse is incoherent, the question arises is he intoxicated or delirious, or is there breaking down of the brain and insanity? The flash of the eye is important; it will tell things that cannot be told by the nurse.

It is important for the physician to know the value of expressions. When the patient stares with glassy eye, is he injured about the head, is he suffering from shock, intoxication or typhoid fever or some disease in which the mind is stunned? The physician immediately proceeds to ask, “How long has the patient been in bed?” If the character is above reproach, he will not suspect intoxication; if the patient has been sick for many days with fever, tongue coated, abdomen sensitive, etc., he is fully entered upon the course of typhoid fever.

The physician must know immediately upon entering the room what the state of the patient resembles: apoplexy, coma, opium poisoning, etc. A physician is supposed to set his mind to work instantly, to ascertain the condition of the patient and what relation the symptoms maintain to the Materia Medica. If an opium poisoning there must be selected an antidote; if apoplexy, a careful taking of the symptoms in relation to the cerebral clot to prevent inflammation and symptoms relative to that state, and relative to the remedy. The patient may be intoxicated and have apoplexy at the same time.

There is no symptom in the sick room without its value, especially in acute and serious cases. Children are sometimes found in a sound sleep and cannot be aroused; the mother says the child has worms and gives Cina, for Cina has all these symptoms of stupor, difficulty in arousing, falling back to sleep. But the child fails, going into coma, the nose flaps, the chest heaves, the brow is wrinkled, there is rattling in the chest, showing the child is going into cerebral congestion. The physician now must examine on every side of the case to find the nature, to know what to expect. He who neglects this is not a true homoeopathic physician; a mere superficial application of Homoeopathy is not sufficient. After all the symptoms are written out, the physician must study the character of the fever, whether it is intermittent, continued or has come on in one sudden attack; he must know sufficient of the symptoms to judge of all these.

You will learn so much about the purport and the aspect of every motion of the human being that you will place less and less reliance on diagnostic symptoms as diagnostic symptoms, and learn more the value of symptoms as symptoms. You will be astonished to find how expert you will become about diagnosis and prognosis by studying the symptoms. You can learn something from every case you have mind; but by a process of rapid exclusion, you say it is not cholera, not haemorrhage, etc., and latterly you come to the cause of this aspect.

You can tell when it is to me for cardiac compensation to be broken in Bright’s disease; a peculiar tremulous wave that belongs to the muscles of the face and neck, a tremulous jerk of the tongue, putting about half way; the pale, cold, semi-transparent skin with cold sweat. It is important to know instantly what the cause is, for the treatment will be different, but remember that it is nothing that you need to name that makes it important.

All these symptoms have respect to remedy and to diagnostic conditions. So far as there is a morbid anatomy which can account for symptoms, so much less are those symptoms worth, as indicating a remedy; if you had no other than such symptoms, you could find no remedy.

Among the many things that interfere with the examination of the patient the most important is the taking of medicines or having done something, no matter what it is, that has been capable of changing the symptoms. Very commonly, the patient will present himself in the doctor’s office, and after giving a long array of symptoms will relate a dose of Quinine, and he thinks he is no better, and now he applies to you for relief. In acute diseases this is very bad and may interfere with finding the homoeopathic remedy.

Very often the general state collectively both drug and disease symptoms, in a very acute condition must be prescribed for, but in chronic disease the plan is different. The symptoms that arise after the taking of a dose of powerful medicine are not indicative of a remedy, they are confusing, they present no true image of the disease and hence the physician has nothing to do but wait, or at most administer a well-known antidote to the drug taken. Sometimes he must wait a considerable time until the symptoms reveal themselves and express the nature of the sickness. It is just as bad where the physician himself is a bungler as it is where the patient has taken the drugs.

The confusion arising from bad prescribing is just the same as that produced by the patient’s drugging. There are physicians going about will mix up their cases and continue to prescribe for their own drug symptoms, and who never have any idea of waiting for the true image of the disease to develop itself. Drugging is only a matter of changing symptoms and masking the case. Anything that will effect a change in the symptoms, the taking of drugs, or drinking too much wine or drinking today, or great exposure, will mask case, and this mask must wear away before the intelligent physician can make a cure.

The whole aim of the physician is to secure the language of nature. If it has been masked by medicines, it cannot be secured. Any meddling will so affect the aspect of the case that the physician cannot prescribe, and the physician who does this meddling must inevitable be driven into bad methods or into allopathy. I have looked over the work of bad prescribers and have wondered what on earth they could see in Homoeopathy to attract them; they do not cure folks. They have no cures to present.

The patients cannot well be satisfied by these things. It is true that once in a while a strong vigorous, robust patient, when he gets a homoeopathic remedy, will go on getting well through a mess of symptom changing and drugging, so that in spite of this meddlesome practice he will recover. The physician in that case, knows not what remedy to attribute to it, for he has given a great many. But only the most vigorous constitution will stand such homoeopathic villainy, go on and get well in spite of their indulgence in wine, in eating, etc.; it is wonderful what their own powers will do in throwing off disease.

In ordinary cases, however, we see no such things, confusion is brought about at once if the physician administer another medicine in place of administering placebo. At times a patient will present himself, and you will be able to get a true image of the sickness by ascertaining all the things that occured up to a given date. “Upon that date,” he says. “I took some medicine, and most of my symptoms, subsided.” They lead to another image from which you can gather nothing; a scattering has taken place.

The symptoms may cover page upon page, and yet what remedy do you see? None at all; it looks as if a number of provings of drugs had been mixed up all together, intermingling symptoms here and there without any distinctness. No individualization is possible. Now up to that date the symptoms you gathered may be just all that is necessary. Up to that date the symptoms present the image of a remedy which, it administered, may yet though sometimes it will fail at first because of the confusion, but after waiting a little it will act. After the the administration of a remedy prescribed upon symptoms in the past I have known the remedy many times to go on acting.

Again I have known that remedy to fail entirely. In such a case, wait awhile and then order will begin to come and that remedy which was indicated previous to the drugging will act. Suppose a physician comes to you and says, “Up to a certain date I was able to hold this patient’s symptoms in order with Thuja; but when the symptoms seemed to change and I gave such and such medicines, and have never seen such good results in prescribing as I did up to that period.” You must give him Thuja again, and in this way take up the thread where it was lost. Examine the image of the case where the order was lost; because that is where the image must be found. “On the contrary, the symptoms and the inconvenience which exhibited themselves previous to the use of the medicine, or several days after their discontinuance, give the true fundamental notion of the original form of the malady.”

James Tyler Kent
James Tyler Kent (1849–1916) was an American physician. Prior to his involvement with homeopathy, Kent had practiced conventional medicine in St. Louis, Missouri. He discovered and "converted" to homeopathy as a result of his wife's recovery from a serious ailment using homeopathic methods.
In 1881, Kent accepted a position as professor of anatomy at the Homeopathic College of Missouri, an institution with which he remained affiliated until 1888. In 1890, Kent moved to Pennsylvania to take a position as Dean of Professors at the Post-Graduate Homeopathic Medical School of Philadelphia. In 1897 Kent published his magnum opus, Repertory of the Homœopathic Materia Medica. Kent moved to Chicago in 1903, where he taught at Hahnemann Medical College.