Taking the Case (1909)


The diagnosis should be as accurate as the fitting of the remedy. We must not only diagnose sickness in its larger sense but the comprehension of its picture will most certainly limit our grasp of the remedies from which a choice may be made….


The proficiency of the physician’s daily work, rather than the flash of genius which makes an occasional brilliant cure, is the final measure of the successful practitioner. His abilities will very largely depend upon the powers of observation and proficiency in details.

No branch of medical research will enhance this more than the exhaustive study of physical diagnosis, for it bears a’ close and many sided relationship to our symptomatology. In a sense therapeutics and physical diagnosis are mutually interdependent, the one helping to interpret and define the other. It therefore follows that the diagnosis should be as accurate as the fitting of the remedy. We must not only diagnose sickness in its larger sense but the comprehension of its picture will most certainly limit our grasp of the remedies from which a choice may be made. This is especially true of localized affections.

THE LOCATION

Different drugs affect different parts, tissues and functions of the organism, but the final reason why one depresses and another excites, or one either heightens or lowers activity according to dose and circumstances, remains substantially unknown in spite of researches into drug. affinity which seemingly push it further and further into obscurity. The study of regions implies a discovery of the seat of the disease and of the remedies related thereto. A large number of drugs are known principally by their regional effects; many of them are imperfectly proven and crudely applied because their drug image is not well rounded out.

They are often prescribed for specific, antipathic, palliative or suppressive effects. This is especially although not exclusively, true of the use of low potencies or crude drugs. In a general way drugs which affect the same or similar tissues bear a certain relation to each other and are differentiated through the mental sphere and the modalities. Each holds some other as its acute or chronic counterpart; the mental state of the one being generally the opposite to that of the other. Baryta carb, in common with Apis affects the lymphatic system, but their respective mental states are almost diametrically opposite. While the former stamps its dyscrasic character upon the mind and countenance, the latter is its acute complement. The Baryta carb.·constitution takes on Apis symptoms when the lymphatics show the presence of a blood infection. Similarly the chronic Sepia patient displays Lachesis symptoms in the presence of alcoholism.

THE ORIGIN

In ordinary parlance we speak of the aetiology of disease, but for us these old school ideas are far too narrow because the radius from which we draw our information is wide and may include any influence whatsoever. Things, in themselves apparently very trivial may become of the greatest import when related to the beginnings of disease. Sickness arises from extrinsic as well as autogenetic causes. The former are in a general way more accessible and therefore more accurately defined. They embrace the susceptibility to certain external influences which pervert the vital force, injuries, the state of the weather, heat, cold, dampness, physical exertion, etc.

TAKlNG THE CASE

Autogenetic causes often have mental states as their starting point; the effects of grief, worry or fright are good examples. Emotional states may be the beginning of a long train of untoward manifestations for which the similimum can not be perceived until they are given a proper place in the pedigree of the disease and as the mind does not always readily disclose such things they may be difficult to discover.

Whether the causes come from without or arise from within, the homeopathic similimum cannot be chosen with safety without taking them fully into account. The great miasms belong to this class.

THE MODALITY

Closely related to the cause, are the circumstances under which disease, and the conditions which modify it, makes its appearance. These are commonly known as the modalities; they individualise and define every sickness as well as every drug, hence the most suitable medicine can not be chosen while they remain unknown. They include such modifying agents as the effect of posture, the different kinds of motion, the various forms of heat and cold, the effects of the weather, of bathing, washing, getting wet or any modifying agent whatsoever. Many odd or strange modifying influences also occur; they belong to but few remedies and are not often seen in practice, but possess the highest value.A striking instance of this kind is found under Clematis which has an eczema which is moist during the increasing moon but dries up during the waning moon. We now know that this modality belongs almost exclusively to Clematis and that any symptoms having it will almost certainly belong to this great antisycotic, whether it be a skin eruption or a goitre. Conditions which modify or excite mental symptoms are not exceeded in importance by any others. To these belong the influence of the emotions, of fright, grief, solitude or company, thinking of the disease, consolation, vexation, etc., on the mind, “Pain which excites to anger” is an excellent example.

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