Our pathogeneses, in spite of showing many features due to the provers’ idiosyncracies, the translator’s command of idioms, clinical experiences and misinterpretations, are nevertheless excellent resumes which place the key-notes in their true light as points of departure only, for their abuse distorts nature’s image and often brings disaster which ends in skepticism or mongrelism. A concise view not only includes the time and order in which symptoms arise, but also the things which modify them- the modalities.
Boenninghausen saw and corrected the tendency of Homoeopathy to pay too much attention to subjective sensation while it lacked the firm support of etiologic factors and the modalities, which afford so many objective and distinctly certain criteria. The triumphs of similia in the diseases of children and insanity certainly show how vastly important they may be, for no judgment can pay it a handsomer compliment than to speak of its special adaptability to children and old people.
From a very few provings, in which he saw but a small part of the immense circle of similia, Hahnemann predicted, its amplitude, and finally gave us the immeasurable power of potentization; a scientific demonstration which rests therapy firmly upon experiment and dispenses with learning our symptomatology by rote.
Study shows every drug to be a living, moving conception with attributes which rise, develop, expand and pass away just a diseases do; each holding its characteristics true through an ever widening scope, to its lasts expression in the highest potencies.
The homoeopathist is a true scientist, in that he spares no pains to learn the nature of this individuality; it lifts him above doing piece-meal work and the restraint of nosological ideas. Everyday practice, too often, never gets beyond the simple lessons of students life and they remain the doctor’s only resource. This is very wrong and acts as a constant handicap.
The true physician is the man who knows how to make the best cures and the most expert healer is the man who knows best how to handle his materia medica. The faculty to mastering it is not dependent upon encyclopaedic memory, but rather upon the inquisitor’s ability to pick out from among the essential embodiments of each picture the things which show how it exists, moves and has its being, as distinguished from its nearest similar. That a mental variation should be the determining factor is therefore not strange, for are not minute differences the very essence of science?
It is very useful to have an idea of the relative values of related remedies, for in essence each portrays a certain type, with variations which relate it to its complementaries, thus dovetailing into each other. The effect of material doses simulates acute diseases while the potencies bring out finer effects, although this is not an invariable rule.
A knowledge of many symptoms is of small importance on the other hand learning how to examine a patient and then to find the remedy is of the utmost importance.
The common way of eliciting well-known key-notes and prescribing accordingly is a most pernicious practice, which has earned a deserved odium and is no improvement upon the theoretical methods of the old school.
To be ruled by clinical observation and pathological guesses is a most disastrous error which limits our action and only obscures the wonderful power of which the true similimum is capable. Such reports mostly lack individuality and at best describe only end products; standing in strong contrast to those expressions which reveal the real mind, whether in actions, words or speech. The recital of cured cases only shows what can be done, but not how to do it.
To do the best work, nothing must prevent a full, free and frank presentation of the symptoms as they are, without bias, and although their comprehension necessarily involves judgment, the more clearly they follow the text, the greater is their similitude, hence usefulness. Hahnemann showed rare acumen in setting down each expression in a personal way, thus securing scientific as well as psychical accuracy.
The patient’s relative sensitiveness is a very material help in separating remedies. The alertness of drugs like Aconite or Coffea is just the reverse of the dullness of Gelsemium, Phosphoric acid and the like, and yet fright may cause the over- sensitiveness of the former as well at the depression of Opium. If stupidity be due to high temperature or an overwhelming intoxication we don’t await the development of a sense of duality, which may never come, but think of Baptisia, etc. at once.
Such an early prescription saves many a life and forestalls pathological changes.
The various cravings and aversions are highly significant, especially when combined with the patient’s behaviour toward solitude, light, noise, company or any other daily environment. The most expressive new symptom is usually the key to the whole case and directly related to all of the others, and is often expressed by a change of temper or other mental condition. Such apparent trifles reveal the inner man to the acute observer and have proven the undoing and insufficiency of liberal Homoeopathy.
We do not say however that diagnosis is of no value in choosing the remedy, for certain drugs are so often called for in some diseases as to have established a fundamental relation thereto, hence they involuntarily come to mind during treatment and deserve our careful, but never exclusive attention. A Baryta carb. patient may have adenoids; black teeth make one suspect that the patient drooled badly during dentition and the survivor of pneumonia may still carry earmarks calling loudly for Phosphorus, etc. These and many more should suggest the patient first and the disease afterward.
The past history and the way each sickness leaned is both useful and interesting, for most persons develop symptoms in a distinctive way through the most diverse affections. Such constancies are truly antipsoric and it should be your pleasure to search out the differentiating indications from among them.
While their discovery is not always easy, for it involves a recital of every past sickness, the trend of each illness and its peculiarities are a part of the sick man’s way of doing things and must be known if you wish to do the best work. They will give you a better idea of present and future prospects as well as lay a solid foundation for the prescription that will do much and reveal many things.
If we say that remedies typify patients and know that constitutions exhibit tendencies, then whey are drugs not specifics? Simply because vitality is a varying force whose mutations are always similar but never the same; it is modified by every influence and keeps itself in relative equilibrium only. The more nearly it holds one phase the more certainly will it, even with varying external manifestations, demand a particular medicine.
Under that circumstances and in what way shall we then discover this more or less constant factor? It lies in the peculiar personality of the patient, especially in the deviations of his mind from the normal. Sometimes an active mental state overshadows all else, as under Aurum, Belladonna, Ignatia, Lycopodium, Nat-c., Phosphorus, Platina, Pul. or Veratrum, according to circumstances; at others a strange mental placidity during the gravest physical danger, is a most striking guide. The facial expression may be its true index and deserves our most careful scrutiny. No effort should be spared to learn the nature of the mental change which has over taken the victim, for it epitomizes the whole patient.
Ideally no two remedies can be equally indicated although practically we find innumerable variations obscuring the choice. As students it is of the first importance to have a grasp of the type which each represents, leaving experience to master intricacies and detail. We speak of a Phosphorus, Sulphur, Sepia or a Pulsatilla type and yet this does not convey a very useful idea to the young man because he lacks the experience which rounds out the image of each drug in his mind’s eye and finally enables him to pick it put on sight. How often does the dilated pupil suggest Belladonna when accompanied by nervous erethism and dryness, while contrariwise moisture, puffiness and sluggishness make one think of Calcarea carb. Then we have the nervous irritability of a Nux vomica patient to contrast with the mildness of Pulsatilla, etc.
The treatment of coughs is a severe test for the prescriber, and yet no patient demands a more careful going over than the one who coughs. In addition to the above hints one should first carefully find out where and by what the coughing is excited. Ordinarily it is the result of an irritation starting from the throat, larynx, chest or stomach, but it is especially necessary to know the exact point of origin. Those beginning in the throat pit generally call for Belladonna, Chamomilla, Nux-v., Rumex, Sanguinaria, Sepia or Silicea. When the primary seat seems to be on the left side of the throat or larynx Baptisia, Belladonna, Conium, Hepar., Olanim. or Salicylic acid stands first, but if it is on the right side we look mostly to Dioscorea, Iris-Verbascum, Phosphorus or Stannum.