DIAGNOSTIC AND THERAPEUTIC TOTALITY


That disease is primarily a morbid disturbance or disorderly action of the vital force, represented by the totality of the symptoms of the patient. It is purely a dynamical disturbance of the vital powers and functions which may or may not ultimate in gross tissue changes. The tissue changes are no essential part of the disease, but only the products of the disease which as such are not the objects of treatment by medication.


In the latter half of the Seventeenth century Syndenham, who revived Hippocrates method of observation and experience, stated, “that disease was a developmental process running a regular course with a natural history of its own. A vigorous effort of nature to throw off morbific matter, and thus to recover the patient”. Lippencot states that a cure is a medicine able to remove the disease; he also says that vital principle is the unknown cause of life.

Hahnemann teaches “that disease is the suffering of the dynamis or life principle of the organism”.

The symptoms by which this suffering is made known, are in themselves all there is to be removed in effecting the cure. He says that when every perceptible symptom of disease or suffering of the vital force has been removed, the patient is cured. If the patients vitality has been too much exhausted, the “end product” of his disease may not be removed, just the same as a scar is left after a wound is perfectly healed. After the patient is perfectly cured of his disease, or suffering of the vital force, the “end products” such as tumors, obstructions, or effusions, may be safely removed by the skilled surgeon. Close states:.

That disease is primarily a morbid disturbance or disorderly action of the vital force, represented by the totality of the symptoms of the patient. It is purely a dynamical disturbance of the vital powers and functions which may or may not ultimate in gross tissue changes. The tissue changes are no essential part of the disease, but only the products of the disease which as such are not the objects of treatment by medication.

Cure from the homoeopathic point of view consists in the speedy, permanent, restitution on health, or alleviation and obliteration of disease. We thus note the cause of disease among original observers of both schools were very similar.

“When studying a case from the diagnostic standpoint certain symptoms are selected as having a known pathological relation to each other, and upon these is based the diagnosis”.

Hahnemann writes, “the totality of symptoms is the only guide to the selection of a remedy”.

“the curative power of medicines depends upon the symptoms they have similar to the disease”. “The totality is the image or picture reflecting outwardly the internal essence of the disease, i.e., of the suffering of the life force”.

Close remarks:.

The word picture is significant and suggestive. A picture is a work of art which appeals to our aesthetic sense as well as intellect. Its elements are form, color, light, shade, tone, harmony and perspective. As a composition it expresses an idea, it may be of sentiment or fact; but it does this by the harmonious combination of its elements into a whole-a totality.

In a well balanced picture each element is given its full value and its right relation to all the other elements. So is the symptom picture which is technically called the totality. The totality must express an idea. The elements which go to make the therapeutic totality must be as definitely and logically related and consistent as are the elements which go to make up the diagnostic totality. The numerical totality must be distinguished from the related or logical totality.

Hahnemann taught “that most attention should be paid to the peculiar and characteristic symptoms”.

A “keynote” in music is the fundamental note or tone of which the whole piece is accommodated. Keynote is the new name Dr. Guernsey invented for Hahnemanns idea of “peculiar and characteristic symptoms”.

In diagnosis we have the pathognomonic symptoms or the symptoms by which the disease is surely known.

Organon, paragraph 6, says:.

The ensemble or totality of these available signs or symptoms represent in its full extent the disease itself: that is they constitute the true and only form of which the mind is capable of conceiving. The expression has a two fold meaning. It represents the disease and it also represents the remedy, as language represents thought. The totality of the symptoms means first the totality of each individual symptom. A single symptom is more than a single fact; it is a fact that with its history, its origin, its location, its progress or direction and its condition.

Every complete symptom has three essential elements; location, sensation, and modality. By location is meant the part, organ, tissue, or function of body or mind in which the symptom appears. By sensation is meant the impression or consciousness of an impression on the central system, through the medium of the sensory or afferent nerves, or through one of the organs of senses. A feeling or a state of consciousness products by an external stimulus, or by some change in the internal state of the body. A sensation may also be a purely mental or physical reaction, such as fright, fear, anger, grief or jealously.

By modality we refer to the circumstances and conditions that affect or modify a symptoms of which the conditions of aggravation and amelioration are the most important. By aggravation is meant an increase or intensification of already existing symptoms, by some appreciable circumstance or condition. Amelioration is technically used to symptoms or in the state of the patient as a whole by medication or by the influence of any agency circumstance or condition.

To know the aggravation and amelioration of a drug is similar to knowing the symptoms by which a disease is known. The totality of the symptoms means all the symptoms of the case which are capable of being logically combined into a harmonious whole, having formed, coherency and individuality.

The physician must known what a symptom is and how to elicit; he must known what the totality of symptoms means and how to construct it; he must perceive that potentization is a physical process by which the dynamic energy, latent in crude substances, is liberated, developed and modified for use as medicines. The physician must make a complete examination, including all necessary pathological investigations. Having all the facts in hand he can determine what features of the case are medical, what are surgical, what are psychological, what are the case are medical, what are surgical, what are psychological, what are hygienic, what are sanitary, etc. Every disease has its symptomatic likeness in the materia medica.

And thus we observe a diagnostic totality goes hand in hand with a therapeutic even though the disease is not named by the observer. A complete symptom complex as a rule is required for a proper diagnosis, as well as for a proper remedy. A diagnostic ability increases a physicians armamentarium, increases his patients confidence, and aids materially in the treatment of the case.

Report of three hospital cases which have nearly the same symptoms of which only similar symptoms are given. The diagnostic totality decides the treatment.

CASE A-Face distressed, anxious, livid, sunken eyes, cold sweat. Diagnosis, croup. Remedy, Spongia.

CASE B- Face distressed, anxious, livid, sunken eyes, cold sweat. Diagnosis, cardiac trouble. No characteristic symptoms. Cannot select remedy.

CASE C- Face distressed, anxious, livid, sunken eyes, cold sweat. Diagnosis, no pathology discernible. Remedy, Arsenic.

Another set of cases requiring the same remedy:.

CASE D- Nausea, anxiety, thinks he is dying, covered with urticaria from head to foot, he stings and burns, rolls and tosses as if he would tear himself to pieces. Diagnosis, sting of honey bee. Given antidote, Carbolic acid.

CASE E-Fainting, and insensibility lasting for hours, prickling like needles over body, tonic spasm, arms flexed, offensive discharges. Diagnosis, no pathology discernible. Remedy, Carbolic acid.

CASE F- Excessive percentages of H. Cl. in gastric juice during digestion, epigastric pain, acid eructations, vomiting, constipation, “afraid to eat.” Diagnosis, nervous dyspepsia. Remedy, Carbolic acid.

“The trained examiner patiently and skillfully analyzes and completes the statements, brings out details, connects the whole case and constructs the case logically and scientifically, giving it a typical form according to a preconceived idea. That is art and true art is always scientific.

DISCUSSION.

DR. JULIA M. GREEN: Dr. Neiswanders paper shows that he is a good student of homoeopathic philosophy. I think his diffidence prevents him from expressing in his own words instead of quoting from one author after another. However, he has given us the idea has tried to clinch it with the illustration of cases.

It brings up the whole question of presenting the philosophy of medicine to a student. A good many people nowadays say we can not give our homoeopathic philosophy to the present-day student because his preliminary education has prevented him from ability to take it in the words which are familiar to us.

Dr. Lynn J. Boyd, you know, is head of the Clinical Medicine Department in New York College, and he says medical students nowadays are “from Missouri”; they must be shown. They come to study medicine from a great deal of preparation in laboratory work, and therefore, in order to make them good homoeopathic doctors, we must take them from where they left off and keep on with the laboratory method of teaching, gradually instilling into their minds the idea of dynamics.

It seems to me that many of the best practitioners we have come over from that kind of teaching into our dynamic philosophy, without any trouble at all. Dr. Neiswander himself is a good example of it. His paper does not sound as if he had to be introduced through the modern laboratory method of study.

I want to compliment him on his paper as an example of the possibility of teaching homoeopathic philosophy, from the very beginning, in our own way.

DR. A.H. GRIMMER: I wonder if Dr. Green could find out how many mental symptoms Dr. Boyd got in his experiments, to bring the old school men to the idea of dynamics.

DR. C.M. BOGER: Practically, there must be some bridge for the ordinary student to come to study homoeopathy in homoeopathic colleges. There must be a bridge somewhere. The bridge is not found in the organ. There is a midstep somewhere which the student is not able to make. Practically speaking, I have found that bridge to consist of pure philosophy, mixed up with the teaching, or stepping up to that from the teaching of evolution, to somehow show how evolution, its teachings and conclusions, are all based on pure philosophy. That is the bridge that I have followed, and I believe successfully.

DR. W.J.S. POWERS: I might say, from my experience with the students, that the bridge is the intelligence of the individual who is to be taught, his ability to appreciate truths when they are shown to him. It is a mistake for a person who is trying to teach homoeopathy to contaminate his philosophy with the philosophy of the old school, which we known is the wrong philosophy. The only thing for us to do is to stand firmly on our philosophy, and not admit for a moment that it can be bridged from one to the other. It is the one or the other, and it is for the individual student to be able to grasp that from an intelligent point of view.

DR. EVELINE B. LYLE: It seems to me there is something back, even before that, and that is the personality of the person who is studying and later practicing medicine. If the person is a real healer, it doesnt make any difference whether he belongs to the old school or the new school. The idea is exactly the same. Hahnemann did it for the same reason. He wrote that I think in the first two or three lines in the Organon. I am of the old school myself. I am also a homoeopath. My idea was to heal in the easiest and quickest, the best and most permanent manner, under the old school, as under the homoeopathic.

When you have been in practice long enough, it doesnt make the slightest difference what your training is. If you are a young doctor and cure a lot of measles and scarlet fever, you pat yourself on the back and think you have done a wonderful thing. But in chronic work you come to the point, if you are a real physician, where you fail under the old school. I was so dissatisfied with medicine that I wound have been perfectly willing to go out and scrub floor, because I knew I could do it better. I was not healing a large number of people. There were complaints and I could not find out what the trouble was, but the patients were sick.

If your doctor has the knowledge of failure, he will hunt until he finds the bridge, and you wont have to lead him up to it. He will be perfectly willing to be shown, and he will be perfectly willing to learn, and he will understand your words, he will understand what you are talking about, and he will be a good homoeopath, better than many of those who are now being trained.

DR. W. J.S. POWERS: I think Dr. Lyle has proven exactly what I said.

DR. E.B. LYLE: Exactly! That is why I said it.

The power of disturbing the functional integrity of the organism clearly shows Clematis medicinally to be the embodiment of a malign and obstructive force, interfering with the flow of orderly life from nerve centres to circumference, from more vital organs to the outskirts of the body. By means of the operation of our law for the selection of a remedy, we make use of these very disturbing and obstructive possibilities of the drug and concert them to perform useful service for the restoration of health whenever the vis medicatrix naturae is found to working harmoniously with these efforts of nature and aid therefore the vital reaction of the suffering body and the remedy in this way tends to restore health.

The conversion of a malignant or hurtful force to benign and useful service is expressed by Mephistopheles and constantly illustrated by the practice of homoeopathy. “I am the force that ever seeks to do the wrong and is forced to do the right.” WM. BOERICKE, M.D., 1899.

H A Neiswander