In the last session of the Post-Graduate School of the American Foundation for Homoeopathy there was considerable discussion among the students over the elimination of certain symptoms in case analyses, on the grounds that they were explainable and therefore could not be used in finding the remedy. It would be illuminating to hear the matter discussed by this body. It often happened that there were not enough symptoms left to find a remedy after the case had been analyzed. Some of the symptoms eliminated seemed to be good guides to a remedy.
Such a state of affairs would indicate but two things, namely, that some symptoms, that could be explained could be used in the remedy picture, or, that the case was poorly taken. With the latter, of course, we have nothing to do here.
It seems rather trite to mention again the much discussed totality of symptoms, but it is necessary to do so as there are in reality two totalities which may be called the gross and the net. The gross includes every symptoms and sign of the malady, both explainable and non-explainable. The net includes only the symptoms on which we prescribe and is arrived at only after careful deliberation. It should be so synthesized as to make a picture that will indicate a remedy. The question is: May a symptom, even though it may be explained as due to the pathology if sufficiently marked and characteristic be included in the net totality.
Here are a few things to be taken into consideration:
Kent taught us that there were many features of a disease that had to be taken into consideration besides the symptoms the patient gives, such as mode of onset, type of fever, etc. Many of these things we now believe to be explainable; at least there are hypotheses for them. Not the pathology so much as the type of fever, etc. Many of these things we now believe to be explainable; at least there are hypotheses for them. Not the pathology so much as the type of pathology, e.g. Silica in schirrus conditions. I believe Kent gave more weight to disease than we usually think but his great skill may lay in that he prescribed on a full picture which was clear to his perception and not on a symptoms list.
Explanation is a very relative procedure and is it possible that many things now regarded as explainable might later be found to be as mysterious as those which we now consider to be non- explainable? In our present ignorance of both pathology and physiology might it not develop that later much of what seems strange to us now might be as clear as day? Supposing we stood in that Utopian land where knowledge is complete and everything is thoroughly understood, would homoeopathy cease to function because there would be no more strange, rare, and peculiar symptoms left? It would not, and I believe this for the following reason.
If every drug could be thoroughly and completely proved the complete reaction produced in the individual would be as distinctly typical of it alone as it appears to be in the partially proved state. It is not a few symptoms alone which point to the remedy but the sum of many, so arranged as to make a picture. Several might run very close but there would be a feature added that would cause them to separate. So, in the end, we will know better how to synthesize our picture and not have to spend our time worrying over whether this or that symptoms can be explained.
The problem of the so-called key-note will be solved. This term is a misnomer and should be key as it merely unlocks and does not give the tone of the remedy. At the stage of which I speak we will have practically no use for such symptoms except as a part of the whole picture.
In the net totality we may find any type of symptom, mental, physiological or pathological, as long as it is difficult characteristic. I do not plead for pathological prescribing. It depends on the type of symptom holding back the case, or perhaps as its root. The case of pulmonary tuberculosis which Dr.Stearns told of being cured by Ignatia is a warning against stressing any type of symptom, and it depends on exceedingly good judgment to know where to throw the most weight.
Burnett made some very remarkable cures by understanding the pathology and yet knowing but little of the strange, rare and peculiar symptoms of the drugs he used.
To know what is curable in disease, what is curative in the remedy and how to apply the two is, in the last analysis, very much of an art, and in the handling of the collected symptoms allows great freedom. Dr.Rabe said in one of his editorials, we are sometimes compelled to look cock-eyed in order to see the picture. It is this freedom and lack of empiricism that is homoeopathys strong fort. It affords us many angle or avenues of approach to the indicated remedy and we should therefore set down no prescribed method of approach. TOLEDO, OHIO.
DR.PULFORD: I dont think that any symptom should be eliminated. In the majority of cases, the case taking has not led to a particular remedy. What is necessary is to take into consideration all symptoms, for many symptoms, such as clinical ones, appear on top of other conditions. A remedy not producing the symptom itself, but that symptom being brought about by other conditions, will point clearly to the indicated remedy, and the consequences are that none of these symptoms should be eliminated.
DR. KRICHBAUM: Why certainly explainable symptoms are necessary at times. A man sprains his ankle, and he has a sharp pain when he does it. I have been unable to get a definite statement in all cases whether there is an aggravation from motion and a relief from exercise. If a man had a syphilitic condition complicating his other symptoms, certainly, in my opinion, it would have a bearing on our prescription. Personally, I cant see how we can separate an explainable symptom from our picture complex.
PRESIDENT WILSON: When I came into the room this afternoon, our steno-typist said, “Doctor, I have a pain in the back of my shoulder”, and went to explain about it. I dont know why one shouldnt take her explainable symptoms as to the cause of her pain in her shoulder as a basis for prescribing. She came by train and sat near the open window. We see many such cases. I certainly think that her symptom is explainable.
DR.ROYAL: I think if we are not going to use the faculties that we have to get at an explanation of the symptoms and now we are going to reject the best class of homoeopaths would be those that didnt have brains enough to understand anything.
DR.WRIGHT: I was just going to say that this brings up the whole subject of eliminative symptoms, and it seems to me in regard to explainable symptoms, that very often we need to know some of those so-called diagnostic, well-explainable symptoms, because we must use real remedies which have it in their power to produce the sort of disease that the diagnosis may cover. For instance, if we have an inflammation of a serous membrane, we must use a remedy which has it in its power to excite and inflame serous membranes.
DR.FARR : If there is anything in the individuality of the patient and of the remedy, it seems to me that the explainable symptoms are the ones that would show the individuality.
DR. STEVENS: I didnt hear the paper, but the remarks that I have heard would suggest that many of the explainable symptoms simply lead us to the cause and that certainly is one of the things we have to consider in prescribing.
DR. PULFORD: I want to thank all of you. I didnt really write the paper as a final thing, but to raise the question and have the matter discussed, and I think it has accomplished its purpose, and that will be all.