The Examination of the Patient

This is the idea, get the original from of the malady. To do this, at times we have to trace through a mass of difficulties and conditions to get back to the original form of the trouble, but you must get there because you will see that in the beginning this malady, in accordance with all laws of Divine Providence, must have conformed to some remedy that had been created for its cure. The symptoms at that time stood out indicating this medicine, but since then there has been nothing but confusion, nothing that can be tied to, nothing that can be examined; it appears to have no relation to anything.

Very often we can take up the thread and get back to the remedy that was clearly indicated, even twenty years before. If that remedy was indicated then, and was not given the cure that was possible by that remedy or a similar one is the only thing to be considered; that is the only remedy in the case. Since that time the patient has been in continued turmoil from the action of drugs. Because it was twenty years ago there is no reason that you should not think of that drug. The patient’s disease has not been cured, it has only been changed and modified; but it is the same patient, and the same sickness and requires the same medicine. If the disease has been complicated by drugs, however, you cannot always get the action of that medicine which the patient needs for the disease per se, but after the drugs have been antidoted you will have to give that very medicine that you figured out and he will be cured.

It is necessary also to observe the changes all along the line of progress, to know the disease at its beginnings, it earlier manifestations, its symptoms and its endings. You find, say, most violent neuralgic pains along the course of nerves in an adult patient, and for these you administer remedies until you are tired and get only temporary relief; but you discover that in his childhood he had an eczema, and you will find it looks like Mezereum, and see its violent neuralgias are similar to those of your patient. The administration of Mezereum cures this neuralgia and brings back the eruptions that he had his babyhood, and he goes on to recovery. Without getting that view of the old scald head, you would not have thought of Mezereum.

Or, instead of Mezereum, Sepia may have had the likeness of that scald head, and he may now have the most striking and characteristic symptoms of Sepia; for behold the little things that have been put into such a turmoil by a bad drugging are under Sepia, and you put your patient on Sepia, and these last appearing symptoms go first and the eruption comes back upon the head and behind the ears, and Sepia has cured him. When these things are seen one after another in everyday practice the physician must begin to wonder if there is not some truth in it all. And as sure as you live, if you practice faithfully, carefully studying yours cases at great length, gathering in everything that was in the beginning, your cures will be so striking that the multitude will come to you to be healed. You cannot place too much importance upon the masking of a patient’s symptoms by medicines, by improper repetitions and by dosing carelessly.

s 94. “On inquiry into a state of chronic disease it is required to weigh the particular circumstances in which the patient may be placed in regard to ordinary occupation, mode of life and domestic situation.” etc. Almost everything in life is circumstantial. All of the activities of life are circumstantial, i.e., there are no activities that are not governed by circumstance. There is not business that is not governed by circumstance. The circumstances of a man’s life govern his actions and reactions, symptoms and the development of symptoms.

The body is associated with circumstances, every function is related to circumstance, and awe may say all the natural functions of life are connected with circumstances. Without these we would have nothing to prescribe upon, we would have nothing a ascertain images by, we would have nothing to form the symptoms, hence the circumstances of life and habit must be studied with a view to going into the slightest particulars. To illustrate that more particularly, and to bring it down to a practical basis, we may say that the examination of every woman relates to her eating, her stool, her menstruation, her bathing, her dress, because these are the things natural to her. These are the circumstances in which her symptoms may come or may not come.

Until the woman is educated to it she does not understand. “What do you mean, Doctor?” she says. Then I may say, “You have given me these symptoms; you say you have headache, stomachache, etc. Now will you proceed to relate to me under what circumstances this headache appears, how it is affected by your changes in dress, by the changes in weather, how it is affected before, during or after your monthly indisposition and so on.” Now, these are the natural circumstances.

In addition to these another group of circumstances comes up, a group of circumstances somewhat different, in relation to ordinary occupation. Every person will have circumstances more particular than those in general. Occupation will make changes in the circumstances of young women. She may be standing upon the floor of Wanamaker’s store all day, and this has produced a condition of prolapsus; or she may lead a sedentary life at her work as seamstress, or she may be at some other occupation, the circumstance of which will develop her psoric manifestations. Modes of life mean a great many different things. They come in as supernumeraries over and above the natural conditions and circumstances of life. The natural functions and circumstances of life have to be considered in relation to the mode of life. The mode of life comes in as the exciting cause of disease, whereby psora which is in the economy is developed in a certain peculiar direction.

The domestic is often the cause of trouble in the woman; there may be marriage to a man who is intemperate with her sexually; she may have a domestic situation that cannot be cured, and it must be examined as to its permanency and the prospect of removing it. Things that cannot be removed will develop psora, in a peculiar direction. “All these circumstances ought to be examined to discover if there is anything that could give birth to and keep up the disease, so that by its removal the cure may be facilitated.”

s 92. The patients generally call attention to the commonest things, while it is the strange and peculiar things that guide to a remedy. The symptoms most covered up from the observation of the physician are often the things guiding to the remedy, but finally they leak out in some way. The symptom is of such a character that the patient says of it. “I have always has it and did not suppose that had anything to do with my disease.” When asked “Why did you not tell me that before?” she says, “I did not suppose that amounted to anything, it is so trivial.”

The physician often hazards a remedy. He feels he must make a prescription, but has no reasonable grounds for thinking he has found the remedy because the patient’s story has been so confusing, and the symptoms that he has obtained are so common and ordinary, such as all remedies possess. With such a foundation he cannot have any assurance that he has the remedy, and, although he may have hazarded several remedies, in the case, the patient comes back uncared, month after month, and year after year. These symptoms that are withheld and seem to be so obscure, and so difficult to obtain, are the very ones that the patient thinks do not amount to anything. What seems to him to be the little symptoms are very often characteristic of the disease, and necessary for the choice of the remedy. Let me illustrate it.

A patient comes along with a pallid face, a rather sickly countenance, tired and weary, subject to headaches, disorders of the bladder and disturbances of digestion; and in spite of all your questioning, you fail to get anything that is peculiar. You set the patient to thinking and to writing down symptoms, and she comes back month after month and give her Sulphur, Lycopodium and a good medicines. You can sometimes find out whether she is a chilly or hot-blooded patient, and thus you can get a little closer among the common remedies; but the patient says a one says one day, “Doctor, it seems strange that urine smells so queer, it smells like that of horse.” Now at once you know that is Nitric acid. “How long have you had this?” “Oh, I have always had it, I did not think it amounted to anything.” If you examine the common things belonging to Nitric acid you will find that it possesses all the features of the case.

This is how a guiding symptom can be used. Nitric acid has a keynote “urine smelling strong like that of a horse;” but if you should give it upon that alone and the general symptoms were not there, you would probably remove the particular symptoms only, and they would come back after a while. Use a keynote to examine the remedy to see if it has all the other symptoms that the patient has. What I have described to you is a hypothetical case. In a busy day you will have several of these cases that you have been working at for months, and the patients have spent a lot of money of to no account.

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.