The law “Similia similibus Curantur” demands that there should be a real and genuine similarity between the symptoms of the patient and the symptoms of the remedy as regards the nature, intensity, volume and velocity of the symptoms, so that the “totality” is not a mere numerical totality but a qualitative totality which is tantamount to an image with the correct emphasis on the proportion in which the symptoms are blended to form the image or the picture of the sickness as a whole. We are then to determine from our knowledge of the materia medica which remedy gives the image most similar to our patients sickness.
And just as you cannot give an identifiable description of a friend by merely saying he has got two hands, two feet, a nose, and two eyes, so you can never describe or understand a diseased state by describing the common symptoms of the disease or by its pathological state. Our main reliance must always be placed upon the symptoms which signify the patient. Hahnemann has given a clear directive that we should be particularly and almost exclusively attentive to those Symptoms that are peculiar to or characteristic of the patient, and not to those that are common to the disease.
As an illustration, dyspnoea, wheezing, inability to lie down, difficulty in raising expectoration are some of the common symptoms of asthma and can hardly lead you to prescribe a remedy, but if the dyspnoea is aggravated in damp weather, the patient gets a weak gone feeling in the chest and must hold the chest when coughing, how clearly we are helped in the selection of Natrum Sulph as a remedy. Or if our asthma patient feels marked relief by lying down, it is a strange and rare and peculiar symptom and at once decides choice in favour of Psorinum.
Having seen the value of peculiar and characteristic symptoms, we must take note of another important aspect of the matter. To be of prescriptive value, even a peculiar and characteristic symptom must be equally well marked both in the patient and in the remedy. For example, if a patient sometimes feels slight heat in the soles of feet at night, this symptom may not justify the selection of Sulphur which has got this symptom in a very strong degree, having made the provers declare that their feet burnt as if on fire.
Yet another important thing to remember is regarding the velocity of symptoms, i.e. the pace at which symptoms develop in a case of sickness and in the proving of the drug which appears related to the case. Thus, how much so ever, Aconite or Belladonna may appear to be indicated in a case of Typhoid, they are not likely to be helpful in the case as their velocity is not at all similar to Typhoid velocity. In serious conditions we cannot afford to indulge in the “trial and error” method and so a knowledge of these stages and states is essential if we want to be saved from failures and disappointments.
Thus in a case of Puerperal Septicaemia, the earlier we can control the case the better it is. Instead of hunting around among Aconite, Bryonia, Belladonna, Opium etc. which have got little or no resemblance to Septic states, study closely for Sulphur, Lycopodium, Ferrum, Pulsatilla and Pyrogenium. In a severe case of Pneumonia involving the hepatisation of a considerable portion of the lung, suppose your patient starts sinking at about 2 or 3 A.M. with the characteristic Arsenic symptoms, you may be able to tide over the crisis with the help of Arsenicum.
But do not wait too long upon it as it is not related to the stage of hepatisation and will not be able to clear up the lungs of the products of hepatisation. As soon as the patient has rallied round sufficiently from the state of sinking and collapse, he must receive a suitable remedy like Sulphur or Phosphorus if he is to be saved from fatal termination.
How we neglect considerations of velocity, stages and states will perhaps be illustrated better by an illustration. A lady of about 40 years of age got fever and abdominal pain. Considering it to be malarial, the allopathic physician gave her Quinine by mouth and injection. When this failed, he gave her Sulpha drugs despite which the fever and pain persisted and a hard mass appeared to be localising near and attached to the uterus. A course of Penicillin injections also was given by which the range of fever came down a little, but the hard mass continued to increase in size. About a month rolled by and the lady had by now grown very weak and anaemic, and the verdict of her physicians was that operation was the only thing left which she was too weak to undergo.
Her husband could see that her chances of surviving after the operation were very remote and called in a homoeopath who diagnosed an inflammation and started giving her Belladonna 30 three times a day. A two days trial found her weaker and more restless with aches and pains in the body, particularly back, with a slow pulse. Pyrogenium 200 was prescribed and two doses were given every 4 hours. She became more restful and felt considerably better. On the third day she started passing lot of pus per rectum whereupon her allopathic physician frightened them very much, warning them to be prepared for the fatal end.
I, however, asked them to boil a small handful of neem* *Azadiract Indica, a tree whose leaves possess germicidal and healing properties When used externally as a lotion. It is used as a medicine internally also. leaves in a little water and to give her low pressure enemas once a day to wash out the pus. Internally she was given placebos for four days, and finally a dose of Silica 200 to finish off the cure. It is now four years and the lady continues in excellent health.
The important point to consider in the case is that we are to treat the patient and not an inflammation, and that even if for a moment we concentrate our attention on the “inflammation” aspect of the case, we must try to visualise what remedy has in its genius inflammation of the nature and type which our patient has, coming on with the pace and speed with which it came on the case under consideration. Belladonna – inflammations have quite a fast and violent speed and are attended with a high fever, and do not take such a long time in their resolution.
We have already noticed that all symptoms are not alike but they have different values for the purposes of prescribing. A detailed exposition of the comparative prescriptive values of symptoms would be beyond the scope of the present paper. I would, however, outline a brief classification to assist in such valuation. As we have observed, symptoms most peculiar to the patient should be the first to be considered and these are valuable in proportion as they are related to the whole individual rather than to its parts. The following gradation would perhaps express their relative importance best.
GENERAL SYMPTOMS,
i.e. symptoms relating to the patient as distinguished from his parts:-
(1) Symptoms relating to desires and aversions, loves and hatreds. To illustrate: some people lose the love of their very life and want of commit suicide; some persons begin to hate their near and dear ones; their own children; some crave hot food and drinks, others desire ice-cream and cold, refreshing things. Some develop aversion to meat, others to milk or bread.
(ii) Now in importance are those relating to the mind and intellectual faculties. One patient is obstinate, head strong, quarrelsome and irritable, the other mild, gentle, yielding, inclined to feel hurt and weep over trifles. Likewise remedies too have different types of temperaments.
(iii) Thirdly come to the symptoms relating to the memory.
II. next in gradation or almost equally important are another class of symptoms including their modifying conditions, relating again to the whole individual.
(c) One group of this class are the symptoms showing the patients reaction to heat, cold, rest, motion, storm, weather, day, night and time.
(b) Second group of these is the symptoms showing the nature of the patients blood, discharges from bowels, bladder, uterus, ears, nose, ulcers, wounds, etc. Nature of the discharges means their colour, consistency, odor, acridity and blandness. The discharge show the imprint of the disease on the vital economy as much as other symptoms referred to above.
III. Lastly come the symptoms relating to the parts, with their modalities. Here also there may be strange, rare and peculiar symptoms which may be considered as guiding as those of the first two classes. In fact many cases seem to be composed only of particulars, and the generals, if any are of a vague and unimportant nature. In such cases peculiar and characteristic particulars become very important, and the selection of the remedy must be based upon them. In this connection, another point demands notice. The modalities relating to the parts may be contradictory to the modalities relating to the whole individual, and the remedy selected should be able to reconcile both.
Any remedy correctly worked out should reflect the image of the patient, and should fit him, his parts, his symptoms, and modalities. I would again emphasize that it is the rank of the symptoms which should weigh in the selection of the remedy rather than their numerical preponderance. In a case with ten peculiar and characteristic symptoms, if one remedy covers seven but of a very low rank while another remedy covers five which are of a high grade corresponding to the rank of symptoms as experienced by the patient, the second remedy is more likely to be the curative one. Also, if generals of a high rank are present, we should not worry if the particulars are not found in the remedy.
B.A., M.D.S.
Dehradun, India