Then this one strong, general symptom would overrule the marked particulars that Puls. alone had, and declare plainly that Puls. could not be the remedy, notwithstanding the fact that it alone had the three strong particulars.
On the other hand, a number of strong particulars must not be neglected on account of one or even more weak generals.
Let us take another case of gastric catarrh, with.
Severe pain over the right eye.
Bitter eructations.
Pain in the stomach.
Worse from cold, and better from the drinks.
One cold and one hot food.
So far Lycopodium and Chelidonium correspond about equally to the case. If there is in addition–.
Constant pain under the inferior angle of right scapula.
A yellow -coated tongue with indented margins.
Clay-coloured tongue with indented margins.
No one would hesitate to give the preference to Chel. If, on further examining the case we find that.
The patient always feels worse all over– though not in a very marked degree after eating.
That he feels better moving about than when sitting.
These generals would be against Chel. and in favour of Lyc. but they are only weak and not strongly marked generals, and consequently should not be allowed to overrule the strong particulars that indicate Chel.
1. Amongst general symptoms is to be included the mental state, which, reflecting the condition of the inmost part of man, is bound to be of the utmost importance, and as Hahnemann so strongly insists must always, if well marked, take the highest rank in the selection of the remedy. These symptoms are naturally the most difficult to elicit, for people, as a rule,shrink from revealing their inmost thoughts and motives, their hatreds and yearnings, their evil tendencies, and their delusions, etc., and it requires the greatest tact and a full knowledge of human nature to win the confidence of our patient, and so understand his deepest thoughts.
Of course, we are all aware of the value of the more common mental states, and these influence us, consciously or unconsciously, in the choice of our remedies.
We all recognize, for example, the fastidiousness of Arsenic, ” the gentleman with the gold-headed cane”; the irritability of Bryonia, Chamomilla, and Nux vomica; the gentle, yielding, lachrymose Puls.; the ever varying moods of Ignatia; the hauteur of Platina; the lack of self-confidence of Silicea; but there are many less apparent conditions which have to be deeply probed for, though when found are invaluable.
Such are the presentiment of death of Apis; the lack of natural affection of Sepia and Phosphorus; the strange impulses to kill those dearest to them of Mercurius and Nux; the suicidal promptings of China not open and obvious like those of Natrum sulph., but hidden, shamefaced, and mixed with fear. These latter, in the early stages, few patients care to allude to, yet their value to us in inexpressible. Even amongst the mental symptoms there are various ranks and consequently they vary greatly in their value.
All symptoms of the will and affections, including desires and aversions, are the most important, as they relate to the inmost in man. Of less value are those relating to the intellect, while those of memory are to be ranked lowest of this group.
2. Amongst our other generals are the effects of sleep and dreams such as the aggravation after sleep of Lachesis, and Sulphur; the aggravation from loss of sleep of Cocculus; and the great relief from sleep of Phos. and Sepia.
Again, how often has the study of the dreams revealed the hidden key to the remedy ! For in sleep man is off his guard, and his subconscious self can assert itself, and under such circumstances the veil is often lifted a little, so that we are able to apprehend in some degree the deep and hidden mysteries of that disordered life we call disease. Of course, such dreams must be regular and persistent to make them of value, and great care must be taken to eliminate the effect of all external influence.
I recall a case of aortic aneurism, giving rise to much pain and many other pressure symptoms. The patient had not the slightest idea what his disease was, yet he dreamed night after night, of pools and seas of blood, and so distressing was this that sleep was one wild nightmare. The other symptoms were valueless so far as the selection of the remedy was concerned; but, taking the dreams as my guide I gave Solanum tuberosum oegrotans, which completely removed the dreams, and so relieved the pains that he went down to his grave in peace.
3. But one grand general, viz., the effect of different temperatures upon the patient as a whole is often of the greatest service in calling our attention to special groups of remedies and excluding other groups, so that the labour of selection is thereby greatly lessened. It is by no means always an easy general to use in fact, I am more careful in questioning patients with regard to this than with regard to anything else.
How often, in response to our question as to how they are affected by heat and cold, they will reply: “Oh ! I cant stand heat!” But, on inquiry, you discover they hate cold, but cannot stand close, stuffy place; or perhaps they may say so because they are worse in summer which is not necessarily the same as aggravation from heat, for summer, in this climate at any rate, means more than heat.
Another frequent source of error is the tendency to mistake any undue readiness to perspire as an indication that heat aggravates. On the other hand, many confuse an undue tendency to catch cold with aggravation from cold, but when we have eliminated these errors and find the patient markedly aggravated as a whole by heat or cold, we are greatly aided in our choice of remedy.
The question of temperature is often very valuable when the body as a whole is markedly affected by one temperature, and some special organ by the opposite;for example, we find a general shrinking from cold under Ammonium carb. and Carbo vegetabilis, yet their respiration is relieved by cold air. Cycl. has the same aggravation, except for its cough and some headache; China, except for its stomach symptoms; Phosphorus, except for its headache and stomach symptoms; as a patient suffering from headache and general rheumatism of the body remarked, if he could only have his body in a bath and his head in an ice-tub, he would be supremely happy.
Conversely, the general aggravation of heat of Lyc., except for its stomach and some rheumatic symptoms; of Secale, except for some headaches and neuralgias, illustrates the value of this general. The exquisite sensitiveness of the mercurial condition to both extremes of temperature, finding comfort only at a medium temperature, is doubtless known to all of us, and must often have served us in good stead when the other mercurial symptoms were absent.
5. There is little need to call attention to the general effect of the various weathers, but many a valuable hint is obtainable from them, not only in a positive but also in a negative way. In many conditions such as rheumatism, where we expect as a rule to have an aggravation from weather changes, the absence of such an aggravation becomes peculiar and characteristic, and enables us to throw out of consideration whole groups of remedies.
For example, where change of weather does not influences a rheumatism, we can safely exclude Dulcamara, Nux moschata, Phos, Ranunculus bulbosus, Rhododendron, Rhus., Sil., Tuberc.; if wet weather does not affect, we can eliminate Calc., Merc., Natrum carb., Natrum sulph., and Ruta. Such negative conditions are not sufficiently used.
While the mere absence of particular symptoms that strongly that characteristic a remedy cannot be relied on as excluding that medicine, yet when strong generals that characterize the remedy are absent we can, with a fair degree of confidence, exclude that remedy, simply because each drug is a unity, and such characteristic generals are their very web and woof.
5. Amongst the generals must be indicated the influence of the various positions, such as the strong aggravation of most symptoms by standing, of Sulphur and Valerian; the aggravation of lying on the right side, of Merc.; the peculiar aggravation of Phos., when lying on the left, yet aggravation of the head symptoms when lying on the right. To be of any value as general symptom, the patient as a whole must be markedly influenced by these, and if only one organ is so affected they take only low rank, being particulars.
6. The tendency of disease to affect particular parts of the body is often well marked, and may be a general of considerable value. Such, for example, is the semi-lateral nature of many illness that require Alumina, Kali carb., Phos. acid.; or, if the right side is mainly affected, Apis, Bell. and Lyc.; or, if left-sided, Argentum nit. Lach. and Phos. Again, how often has the oblique appearance of symptoms led to the choice of Agaricus or Asclepias tuberosa as the remedy, and even more frequently the appearance of symptoms on alternate sides has led to a cure by Lac caninum.
