A fifth element is the knack of ferreting out causes of symptoms; for instance, a patient once struck by lightening is timid to a subsequent fear of electric storms, as is a child frightened by a timid nurse, whereas an adult without unpleasant experience who fears them has a true symptom. A sixth factor unpleasant experience who fears them has a true symptom. A sixth factor is the capacity for weeding out psychological causes for symptoms due to definitely traceable influence.
Dr. Spalding has, we feel, covered the ground admirably. The two points that we would comment on are his omission of the “ailments from” class of symptoms, for which even good prescriber so often fail to search, and his cursory regard for particular symptoms. In this latter connection it must never be forgotten that though generals are the frame, and the picture must go into it, many remedies may coincide by and large with both the mentals and physical generals and yet not be the similimum, but if the individualizing, strange particulars, especially as regards vital functions, fits, our outline is clearer, and our remedy clinched.
One of our wise prescribers suggest that we select always one mental- if available-one pathological-if it represents a definite tendency of the vital force-and one objective-which cannot lie-as well as our all important generals and salient particulars. Especially did we like Dr. Spaldings summary that “a totality is not a total list of the complaints”. We have seen a list of rubrics chosen, not one of which was mentioned by the patient consciously, which, notwithstanding, led to a brilliant cure.
Dr. E. UNDERHILL, JR.: I think the question of totality of symptoms has been a stumbling block, to a great many homoeopathists. Just what is meant by the term “totality”? There are two ways of taking that. One is the numerical total which would include every possible symptom of every kind and description that could include every possible symptom of every kind and description that could be elicited in given case. The other would be an artistic totality which could be gathered from the numerical totality if one went about it correctly.
I have used the illustration of a photograph as compared with a portrait. the photographic lens will make an imprint on the film of every defect and every line that is exposed to it, whereas a good artist can sketch in with a few lines an exact likeness that will do the person just as much justice as the photograph, perhaps more. That would be an artistic totality. Personally I like to have a case taken as completely as possible, and I like to have it all typed before I go over it. I dont like to go over hand-writing because it annoys me. With each symptom typed on a line by itself I will take a pencil or a pen, and as I read down the typewritten page I check each symptom that I intend to use. It doesnt matter then how large a symptom list you have. You can have a numerical totality if you want it and I am glad to have it, and from that you can select the artistic totality, which will include the essential generals of the case, and from which you can select your remedy.
Dr. R.E.S. HAUES: some years ago I read a short article before this Association. The title was Totality versus Personality. For my own benefit I used the phrase “personality of symptoms” in preference to “totality.” I dont know whether or not that is suggestive to anyone else.
Dr. B.C. WOODBURY: When is a totality not a totality? I notice that Dr. Spalding hasnt mentioned the subject of key-note symptoms. Key-note symptom is more or less identical, I think, with what Dr. Hubbard mentioned as having used in a cursory way. Most key-notes are of particular symptoms, but they have a very strong relation to the case.
I have a very definite recollection of hearing my father tell the story of Dr. Guernsey, of Philadelphia, who is supposed to have been the originator of the key-note symptom, although I think Lippe was fully as much so as Guernsey. In fact, he was an older teacher than Guernsey. Guernsey used it as a basis for a collection of very definite symptoms that could be used in prescribing. My father told of having been in Dr. Guernseys house one time. Dr. Guernsey has two sons, as you will recall, William Jefferson Guernsey and Joseph C. Guernsey. One of these little boys was on the rack, and his father was teaching him key- notes. I cant recall which of the boys it was, but one of the boy stuttered.
The boy who stuttered came into the room when my father was there, and his father said, “Have you learned anything today?” He said, “Yes, I have learned two key-notes today.” so that Guernsey evidently put his boys to work early on that key- note method. Key-notes are all right if they are not used to the exclusion of general symptoms. I think that the proper evaluation of symptoms cannot be too strongly stressed, whether they be key- note symptoms, so-called, or whether they be just the general symptoms, mental or environments or temperature reaction, whatever they may be.
DR. H.A ROBERTS: I think Dr. Spalding has produced a wonderful paper, and I wonder if it isnt an answers to the idea that you can learn homoeopathy from symptoms alone. I think the philosophy that goes with the teaching of homoeopathy is just as important as the materia medica and the knowledge of it. Unless we have that we are lost, and when we get that as Dr. SPALDING has presented it in ths admirable article, I look upon it with considerable pleasure, for the reason that although article, I look upon it with considerable pleasure, for the reason that although Dr. Spalding was a pretty good student or homoeopathy before last summer, I think he got a considerable amount of homoeopathy at the post-graduate school. There are several other here who also got work along the philosophical lines that helps so much in our prescribing, and helps us to evaluate symptoms and to make our prescribing more as it should be.
DR. C.M. BOGER: This very thoughtful paper deserves only admiration. However, I wish to stress ideas that were only faintly touched upon. We should try as much as possible to trace out the origin of all symptoms with which we have to deal. Sometime that is a very deep program. For instance, the young lady who has been repressed from the time she was big enough to talk until now, repressed in this direction and in that direction and in the other direction, until a few years after having reached young womanhood an explosion takes place.
She begins to realize what she has missed, what has been done to her, and she goes off on a tangent and perhaps lands in an insane asylum because she was repressed, because her mentality was held done, her mentality was warped and turned to one side. We dont always suppress symptoms by rubbing on salves and doing other devilish tricks like that. You can suppress symptoms and suppress nature by mental processes. If you treat that kind of a case and do not take into consideration the origin of the symptoms you will fail utterly and ridiculously.
I have a case of that kind on my mind now. I promised a girl that I would cure her in two or three years perhaps, that I would work away all of these repressions. She has had attacks of acute mania a number of times, but she is slowly improving. As proof that she is improving a wart that she had burned off with a Roentgen ray, or, or some other way, I have forgotten how now, has started to come back. She has only had Lachesis and Belladonna.
The point I want to stress is that you have to unload that kind to burden. You must get rid of the burden that is there. That will decide whether your remedy is the proper kind, or whether the unloading has cured the patient and brought about a reaction. It is quite hard to make a certain decision, but personally i think a patient needs both. She needs an unloading and a remedy. She needs an unloading to place her on a footing with the rest of us, and she needs a remedy to harmonize her mental and her physical nature.
DR. R. W. SPALDING: There is really noting more that I can add. I appreciate the discussion given the paper. My object wasnt to limit the particular symptoms as Dr. Hubbard suggested. I was trying more particularly to get a little more reaction for myself, through the discussion, in regard to strange, rare, and peculiar symptoms. Evidently my paper has emphasized totality more than the paragraph I really wished to emphasize, but that is a personal matter.
I am glad to express my appreciation of the post-graduate school of Boston. I am sure it did me a great deal of good last summer.
In closing I would ask that sometime some one elucidate more particularly on paragraph 153 of the Organon, not for the experienced prescriber but so that the beginner will understand it, the student, perhaps, in the school. I think often times there has been rather a large order to fill as opposed to the so- called key-note characteristics and then the totality as well.
