How to Take the Case (1920)

In daily clinical work it has always seemed best to first get a pretty full life history of the case in hand, then look over the objective appearances, and lastly find out what the patient thinks and feels. …

Prof. Tyndall has shown the necessary elements of a science to be the observation of facts, the induction of laws from these facts and the constant verification of the laws by practical experience.

When Hahnemann read that Cinchona Bark, the great empirical remedy for ague, had actually caused symptoms like the ones it had been curing, it was too striking to be passed over and he began to search medical lore for other cures seemingly based upon the similar action of drugs. He found a number, but the accounts were not conclusive enough to clearly confirm his induction, hence he began those experiments in drug action which were destined to end in what we now call provings, and to finally have a more profound effect upon medical science than any one thing that has happened since the days of Hermetic medicine, more than fifteen hundred years before our era.

As his work went on and drug effects were verified again and again he was troubled by the frequent overaction of the remedy, which he sought to remove by steadily decreasing his dosage, and was thereby insensibly led into potentization, which is after all Hahnemann’s real and greatest discovery Daily experience with potencies gradually evolved the practical details of the law, all of which was incorporated in the Organon as we know it today. We may well believe that our innumerable verifications of the law will, in time, raise medicine more nearly to the plane of a true science, like that of mathematics, which advances from certain fixed and self evident truths, while all the others draw conclusions from evidence, by deduction,, through reason, etc., all from premises which are in themselves of a variable import.

Our vision transmits impressions by means of light with consider-able fidelity, but as we descend into matter each successive sense using lower rates of vibration reports with less and less accuracy, so that by the time we reach subjective sensation, interpretation is needed. In other words, in proportion as things are not self-evident, they must be and are defined, by comparison, essentially a very flexible method, which uses the striking and unusual as points of departure.

The larger part of sickness is composed of morbid feelings and sensations, which necessarily bear the impress of the sufferer, which also holds true of drug symptoms. A partial or one sided array of symptoms of either sort, is perhaps common enough, but unless marked by very striking features, is to be greatly distrusted. Here is the weak point in most of the minor remedies, as well as the difficulty in many clinical cases.

In daily clinical work it has always seemed best to first get a pretty full life history of the case in hand, then look over the objective appearances, and lastly find out what the patient thinks and feels. These factors are then carefully built into a mental picture of what seems to be wrong. For sufficient reasons all of its features can not usually be elicited at the first interview.

Hahnemann repeatedly pointed to the peculiar symptoms, as being the real indicators for the curative remedy, and the successful prescriber is he who can pick them out and without losing touch with the essential diagnostic features assign them to their proper places in the symptom picture. He links together and combines the essentials with the singularities present in such a way as to produce an harmonious whole. This is perhaps, not easy to learn, but it can be done, by avoiding a false start and persistence, even to the point of seeming to be intuitional.

The number of such possible combinations, is of course, unlimited, but we find that certain ones actually occur with relative frequency, giving rise to the idea of specifics, organ remedies, epidemic remedies, etc., etc., all delightfully indefinite terms, full of danger and lacking in the accuracy which makes for correct and radically curative homeopathic work. In learning this art it is needful to divest oneself of all speculative opinions as to the origin of such odd manifestations. These things belong to the obscurities of diagnosis, nor does this mean that a diagnostic symptom can never be a major indication, as witness the marked aggravation from motion, equally prominent in pleurisy and the provings of Bryonia or the 2 A. M. aggravation, frequent in both duodenal ulcer and the effects of Kali bichromicum.

It is the striking nature of the systemic effect that determines the value of a given symptom; a manifestation that is prone to occur without any obvious connection with the disease itself. In chronic cases it is very apt to be a concomitant, while in acute ones it often stands out like a freshly painted guide post. The physician must know how to give it the right value. It is an especially dangerous mistake not to ascertain the relative age of such symptoms. A few clinical cases will illustrate some of these points.

C.M. Boger
Cyrus Maxwell Boger 5/ 13/ 1861 "“ 9/ 2/ 1935
Born in Western Pennsylvania, he graduated from the Philadelphia College of Pharmacy and subsequently Hahnemann Medical College of Philadelphia. He moved to Parkersburg, W. Va., in 1888, practicing there, but also consulting worldwide. He gave lectures at the Pulte Medical College in Cincinnati and taught philosophy, materia medica, and repertory at the American Foundation for Homoeopathy Postgraduate School. Boger brought BÅ“nninghausen's Characteristics and Repertory into the English Language in 1905. His publications include :
Boenninghausen's Characteristics and Repertory
Boenninghausen's Antipsorics
Boger's Diphtheria, (The Homoeopathic Therapeutics of)
A Synoptic Key of the Materia Medica, 1915
General Analysis with Card Index, 1931
Samarskite-A Proving
The Times Which Characterize the Appearance and Aggravation of the Symptoms and their Remedies