After all the symptoms of a patient have been written out the Homeopathy Repertory should be taken up. The beginner should not attempt to abbreviate the anamnesis, but should write out the full general rubric for exercise, if nothing more. If melancholy be the word, the remedies set to the word should be written down with all the graduations. If the melancholy appear only before the menses let a sub- rubric be placed in a manner to show at a glance the number of remedies of the general class having the special period of aggravation. Many of the most brilliant cures are made from the general rubric when the special does not help, and, in careful notes of ten years, would bring down many of the general rubric symptoms, and furnish the best of clinical verifications. The longer this is done the more can the busy doctor abbreviate his case-notes.
The special aggravation is a great help, but such observations are often wanting, and the general rubric must be pressed into service.
Again, we have to work by analogy. In this method Boenninghausen’s Pocket Repertory is of the greatest service.
Take Minton’s most excellent work, and we find menstrual agonies are ameliorated by heat, peculiar to Arsenicum and Nux., and by moist heat, to Nux-m. But the symptoms of one case are not like either of these remedies, and we must go farther into the materia medica. We can there form the anamnesis by analogy and make use of the general rubric, taking all the remedies known to be generally ameliorated by heat and warmth applied.
To be methodical, the general rubric should appear in the notes of the prescriber and the special below it. If this plan be carefully carried out, a comparison of ten years’ work would be a most instructive perusal. What is true of a remedy generally may often be true in particular, especially so in the absence of a contra-indicating exception, well established.
If this plan be followed by beginners, always reading up the Materia Medica with the anamnesis, by the time business becomes plenty the work becomes easy and rapid. A young man can prescribe for a few patients a day and take careful homoeopathic cures, and he can gain speed enough to prescribe for twenty or thirty a day after a few years. Any man who desires to avoid this careful method should not pretend to be a homoeopathic physician, as the right way is not in him, as the desire must precede the act.
The patient does not always express the symptom in the language that would best indicate the real nature of the symptom. Then it is that judgment is required, that the physician may gain a correct appreciation of the symptoms. So often is this true that the young man and often the old is led from the true expressions of nature, and he will make an inappropriate prescription. The task of taking symptoms is often a most difficult one. It is sometimes possible to abbreviate the anamnesis by selecting one symptom that is very peculiar containing the key to the case. A young man cannot often detect this peculiarity, and he should seldom attempt it. It is often convenient to abbreviate by taking a group of three or four essentials in a given case, making a summary of these, and eliminating all remedies not found in all the essential symptoms. A man with considerable experience may cut short the work in this way. I have frequently known young men to mistake a modality for a symptom. This is fatal to a correct result. The symptom is the sensation or condition, and the modality is only a modification. The symptom often becomes peculiar or characteristic through its modality.
When a sensation is looked up in the Repertory, all the remedies belonging to it should be written out, and individualization began by modalities.
I am frequently asked what is understood by peculiar as applied to case. A little thought should lead each man to the solution.
A high temperature, a fever without thirst, is in a measure peculiar. A hard chill with thirst for cold water is peculiar. Thirst with a fever, with the heat, is not peculiar, because you can safely say it is common to find heat without thirst, and uncommon to find heat without thirst. That which is common to any given disease is never peculiar. This may seem too simple to demand an explanation, but let him who knows it go to the next page. Pathognomonic symptoms are not used to individualize by, and are never peculiar in the sense asked for.
I am asked what I mean when I say to beginners; treat the patient and not the disease. My answer always is about as follows: The symptom that is seldom found in a given disease is one not peculiar to the disease, but peculiar to the patient, therefore the peculiarities of the patient have made the disease differ from all the members of its class and from all others in the class, and make this disease, as affecting this patient, an individuality by itself, and can only be treated as an individual. This individuality in the patient manifests itself by peculiar symptoms nearly always prominent, and always looked for by the true healer. The man who gives Acon, for fever knows nothing of the spirit of the law or the duties of the physician. The same is true of Colocynth for colic, Arsenicum for chill, etc.
“What shall we do when we find several peculiarities in the same patient and one remedy does not cover them all?” Here is where the astute physician will pick up his Repertory and commence the search for a remedy most similar to all, and if he has been a student for a few years he need not go about asking foolish questions. The lazy man has spent his days in the folly of pleasures, and the man of limited belief has shot out so many valuable things that he is constantly up in public asking foolish questions and reporting cases with symptoms so badly taken that he reveals the whereabouts of his past life. He has not made use of the Repertory, and shows a complete ignorance of the rubrics and the usual formality of taking symptoms as taught by Hahnemann. It is a blessed thing that they are not responsible for all their ignorance. Where shall the responsibility rest, and who shall “throw the first stone?”
It is so easy to wink at the sins that we ourselves are guilty of that is seems impossible to find judge or jury before whom to arraign the first law-breaker.
The cry for liberty has been a grievous error, as liberty is and has been most shamefully abused. It means a license to violate law, and only a modest elasticity is necessary and full eclecticism is the product. It is liberty that has driven out of use, or limited the use of, the Repertory that all the old healers so much consulted. If Boenninghausen used a Repertory with the limited remedies there proved, how much more do we need to consult it.