Early in the history of the case the Arnica or the Aconite would probably have acted and the miasm would have been overthrown but those remedies not having been used and the miasm of the patient having had time to work, an entirely different set of remedies must be considered. That is one of the important points in this paper.
Harvey Farrington: I was struck with the statement that the most important symptoms are in the emotional sphere; if we start with the proposition that the patient is to be prescribed for and not the disease, it follows as a corrollary that the mental or emotional symptoms are the most important because these apply to the individual alone. The mental faculties are the centre of every patient and the others are secondary The doctor in his paper made the dogmatic statement that the art of prescribing is the art of reading between the lines. But the art of prescribing is rather the art of sifting a case and analysing the symptoms out of many, which indicate the remedy. that will cure. Given a case in which the symptoms are clear you do not have to read between the lines or to do any sifting but such are exceptional. The mixed and chronic cases are the ones where the analysing and sifting has to be done.
In respect to a chronic case, the mental symptoms art of the greatest relative value and the most peculiar to the patient and from them we can descend to- the various tissues, always remembering that those are of the greatest relative value which express some characteristic or peculiarity of the individual. The statement that the miasm may continue a case after the exciting cause has been left behind and lost sight of is no doubt true but nevertheless the exciting cause is one important feature of a case and often leads to the remedy.
P. E. Krichbaum: Before we try to read between the lines, we must be able to read the lines themselves; we must study the materia medica and have a menta1 picture of the remedy. Without the repertory, if the case needed some unusua1 remedy I should be apt to miss it. A certain kind of study is needed; for instance I could not tell the characteristic features of my father although I am supposed to know him so well. But if you were to read out his characteristics to me when you had read out a certain number, I would say, that is my father. I have been very much interested in a patient that I have been treating lately because she has been under the care of Dr. Allen, Dr. Carleton and Dr. Kent for several years without being cured. I did as well as they did until I told her to drink buttermilk and then I did much better. She has a movement every day since then.
R. F. Rabe: How do you know that it is not a mere chemica1 action?
P. E. Krichbaum: I do not.
E. A. Taylor: Dr. Boger makes some startling statements in his paper. I supposed that the totality of the symptoms was the only guide to the use of a remedy and yet that is practically what he condemns as symptom-covering unless by symptom-covering he means with no regard to the relative value of symptoms. If he means to say that there is something mystical, or hidden or something beside the symptoms for us to consider, then I say that that is beyond what Hahnemann taught us and beyond Homoeopathy. It is admitted by all good homeopaths that we must see and consider the sick man without regard to diagnosis but then a good many go farther and say that we must also know about the miasm that effects the patient now I would like to know what a miasm is but a diagnosis. When you determine that a man has syphilis, have you not made a diagnosis? Now if you prescribe for the syphilis are you not prescribing on the diagnosis?
A. P. Bowie: The great and distinguishing characteristic of Hahnemann was that he was a marvellous observer and just as we excel in observing we will become successful practitioners. This paper to my mind is too much concerned with philosophy and not enough with materia medica. We can theorise as much as we please and we can entertain various opinions but there is our record of materia medica to go by and unless we stick to that as a guide and observe the symptoms, objective and subjective of the patients, we are sure to be all at sea so far as practical work goes. It does not much matter what theories we have if we stick to that. I do not want anybody’s opinion about the remedy or about how it works. Nor do I care a penny about what Dr. Waring esteems so highly, the connection between the vital force and the pathological result. The proof of the correctness of a prescription is the results that follow. If I get the results I know that I am right and if I do not, I know that I have made a mistake and must try again.
C. M. Boger: I do not feel that any of these criticisms need answering; careful reading of the paper itself will show that all these questions are answered in the paper. One point I will try to make a little clearer; you cannot cure cases by exclusive symptom-covering or by exclusive individualisation. The true reflection of a disease is a single thing; it is one thing. Why do you not cure with Lilium tigrinum unless the sexual sphere is involved? Or why do you, not cure with Aconite unless the mental sphere is involved? Every remedy expresses a single concrete entity and proper study will enable you to recognise it just as you recognise the letter A when you see it. Every patient presents also a distinct entity—a group of symptoms that you must rook at as a one. It is your business as physicians to find out how closely you can fit your patient with curative remedies.
In order to do that, you must use repertories, but you must not use them merely to cover the symptoms of the case and nothing else. Suppose the repertory shows that Sulphur stands at the head of the list in a certain case and yet you know that it is not a case for Sulphur and that there is no use in giving Sulphur to the patient. That shows at once that you can not do good prescribing by machine work or by the force of numbers. Judgement and knowledge both of humanity and of materia medica must be used.
Suppose that a case has few symptoms, and Hahnemann tells us that these are the most difficult cases to deal with, how are you to determine the remedy when perhaps the repertory shows that several have those few symptoms, unless you use your knowledge both of patients and materia medica? A lady came to me with profuse nose-breed, she said “doctor, my nose does not bleed unless I touch it.” Worse from touch, in that location; four remedies have it, three in the repertory and one in manuscript. I looked up every one of those four before I could decide which was the one. It was not because of the aggravation from touch alone but because the mental condition revealed to me that the remedy was Niccolum and Niccolum cured her promptly. The remedy should be a true reflection of every thing in the patient’s body. A man stubs his toe and he either swears or cries. It discloses his mental state when he does that without thinking; it is an involuntary act and hence genuine.
E. A. Taylor: These points you speak of are only symptoms. What would you have in addition to the symptoms? That is what I am trying to get at.
C. M. Boger: The way the patient talks; the modes of expression all show the operation of his mind.
H. S. Llewerllyn: Why are not those very things symptoms?
C. M. Boger: Every operation of the mind has its own peculiar.
E. A. Taylor: Was the woman’s mind operating in that way when her nose began to bleed?
C. M. Boger: Such thing cannot be found in the materia medica as symptoms but they are there if you can read between the lines. You will find the deciding touch to a case in these mental states when you get into a tight place.
The way the mind operates picks out the one remedy out of the twenty that have the symptom that you are looking for.
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