In many old-standing chronic cases, especially those that have been long under allopathic treatment, these peculiar and characteristic symptoms have so completely disappeared, or have been so utterly forgotten, that our difficulties are thereby increased. Nay, it is even the case at times that the characteristic symptoms may never have existed except in the patients ancestors, and under these circumstances cure is practically impossible.
It is as if, during the exploration of some old city, a coin were discovered, by which, if we could determine the year of the king during whose reign it was issued, we should be in a position to fix an important date. If the coin was well preserved, any skilled numismatist would promptly furnish us with all the information we desired; but, if it were much worn and eroded, while we might, from the shape or composition of the metal, be able to determine the dynasty under which it had been issued, it would be utterly out of his power to state the individual king, to say nothing of the year of his reign.
PECULIAR SYMPTOMS.
Let us take a few examples of the symptoms that are peculiar to the patient, as distinguished from those that are common to the disease.
The common or pathognomonic symptoms of dysentery are bloody mucous stools, pain, and tenesmus. From these alone we can determine the group of remedies that correspond in general to this disease, and in J.B. Bells classical monograph on this subject over fifty remedies are mentioned; yet, from these alone it would be impossible to discover the individual remedy for the case under treatment. If, however the patient has.
Much thirst, and. Every time he drinks he shivers, and.
Each drink is followed by a loose stool.
These symptoms, being unusual in the disease, and consequently peculiar to the patient, would guide to Capsicum as the remedy.
Dyspnoea, oedema, palpitation of the heart and albuminuria are the common symptoms of many kidney troubles, and from them alone we cannot determine the curative remedy; but if we find in addition that there is.
A strong craving for fat,.
Urine intensely strong, and.
A sensation as if the urine were cold when passed,.
Then these would be peculiar to the patient, and point to Nitric acid as the remedy.
Let us turn to characteristic modalities. In a case of spasmodic asthma, an aggravation from lying down is so common as to be valueless in the individualizing of the remedy; but, if we find there is much relief from lying down, as in Psorinum, or from assuming the knee-elbow position, as in Medorrhinum, then these, being peculiar and characteristic, will be invaluable.
In hysteria we have an illustration of the danger of prescribing for the symptoms that are common to the disease, and hence not peculiar to the patient. It seems the most natural thing to gather up all the incongruous and peculiar symptoms that characterize this disease, and to prescribe for them.
But when we realize that this incongruity is the very essence of the disease in other words, is pathognomonic of it — we then perceive that we have been prescribing for the symptoms that represent the disease, and not for those that characterise the patient. In such cases, the true guides to cure, if discoverable, are to be found in the changes of desire, the aversions, the loves and the hates; and these are particularly difficult top find, for the hysterical patient conceals her real hates and loves and relates what is not true.
In the foregoing, stress has been laid on the supreme importance of paying the greatest attention to the symptoms that are peculiar to the patient, but it would be foolish to ignore the symptoms that signify the disease. They must, indeed, be taken into consideration; but as subsequent to, and of much less value than, those that are predicated of the patient.
In a very large number of cases, no one remedy corresponds to all the peculiar symptoms, but three or four seem to have equal numbers of them, and of approximately the same value. In such a state of affairs, the remedy that has also the common symptom best marked must prevail.
It must ever be kept in mind that there must be a general correspondence between all the symptoms of the patient and those of the remedy, and that, however helpful the peculiar symptoms may be in calling attention to certain remedies, yet they are not the sole guides; for after all, it is the totality of the symptoms that determines the choice.
It is true that at times a brilliant cure has been made by a remedy that correspond only to those symptoms that were peculiar to the patient, and was not known to possess any strong resemblance to the common symptoms of the disease; but even in such a case, it is almost absolutely certain that further provings will reveal that the remedy has the common symptoms also.
RANK OF SYMPTOMS.
When using these peculiar and characteristic symptoms as the main guides in the selection of the remedy, it is important to bear in mind that they must be equally well marked in patient and in remedy. In other words, no difference how peculiar and outstanding a symptom may be, either in the patient or in the remedy, unless it be of equal grade in both, we must pay little heed to it.
For example, if a patient experiences occasional and slight heat in the soles of the feet at night in bed, this symptom would not be of much importance in selecting Sulphur as the remedy, because in that drug this symptom appears in such a vigorous and outstanding way that the provers declare that their feet burn at night as if they had been on fire.
Take a case of rheumatism, markedly aggravated in dry weather and better in damp. In such a case, the selection of Phosphorus as the remedy could not be based upon this modality, for while Phosphorus has it, it is only in the lowest degree.
Even in a case, with, let us say, ten peculiar and characteristic symptoms, of which one remedy has eight, but of a very low rank, while another has only five, but of high rank and corresponding to the rank of the symptoms as experienced by the patient, in such a case it is very improbable that the first medicine will prove to be the curative one. The second is much more likely to be so.
It is this question of rank of symptoms that is the chief objection to the numerical method of selecting the remedy. It seems to have fascinated some minds, for while it is laborious in the highest degree, it seems to promise certain and exact results; but medicine even homoeopathic is not yet an exact science, and it is extremely improbable it ever will be, even when we have perfected our armamentarium. Consequently, all such mechanical methods are to end in failure, for quality will ever be of infinitely more importance than mere quantity.
In opposition to this numerical method, some physicians have gone to the other extreme, and have been content to be guided in the selection of the remedy by one or two peculiar and outstanding symptoms, practically ignoring all the others, because they have overlooked the fact that, unless there be a general correspondence between the symptoms of the patient and those of the remedy, it is not reasonable to expect a cure.
This so-called “keynote” system of prescribing is very attractive, as it seems so easy, and saves all the laborious comparison of competing drugs that is involved in the numerical method and also because by means of it many brilliant cures have been made; but it is, from its very nature, a wrong method, and in a large majority of cases is doomed to failure, because it ranks one or two symptoms very high and practically ignores the others.
Having discussed the difference in value, so far as the selection of the remedy is concerned, between the symptoms that signify the patient and those that signify the disease, we would turn to the other great division of symptoms viz.: the generals and the particulars.
GENERALS.
The general symptoms are those that affect, the patient as a whole, and, because of this very fact, they are naturally of higher value than the particulars, which affect only a given organ.
What the patient predicates of himself is usually general, as when he says, “I am thirsty,” I am sleepy” thereby indicating that his whole being is so affected, and not merely one or two particular organs. So much higher may a general symptom rank that, if it be a strong and well-marked one, it can overrule any number of even strong particulars.
Let us take a case of gastric catarrh, with.
Semi-lateral headache.
Roaring in the ears.
Greasy taste.
Aversion to fat and butter which aggravate greatly.
Fullness and pressure of the stomach after eating.
Flatulence.
Chilliness.
Vomiting of the food.
So far Pulsatilla and Cyclamen compete equally. If we have in addition.
Diarrhoea only at night.
Nausea from hot not from cold drinks.
Palpitation when lying on the left side.
Then the balance will turn towards Puls.
If we find that–.
The patient has the greatest aversion to the cold open air,. It is always aggravated by the least cold.
