It has always been my idea that we “take the case” in order to enable us to arrive at two factors: A diagnosis, if possible, but more especially to arrive at the accurately indicated drug.
In looking over the second quarter of the Recorder for 1935, I find, p. 77, reprinted, an extract from Hahnemann, dated 1834, as follows:.
How can those gentlemen boast that they can attend 30 to 40 patients a day! What time it takes to find the useful remedy for one patient, when searching and consulting our manuals! They cannot possibly devote the necessary time to examine 30 to 40 patients. How they be able to find something exactly suitable to each one? Or have those gentlemen so memorized the materia medica and all the remedies in chronic diseases, etc., so well, that after enquiring into the circumstances of the patient, for which they frequently need one-half to three-quarters of an hour, they may be able to find at once a suitable remedy in their mind?.
I grant that in Hahnemanns day there was incontroversial reasons for his stand and remarks as above. But things have not stood still since then. He had to blaze the trail. That trail is more or less charted for us. Some of us are fast learning just what symptoms positively indicate the drug. Too, he had no repertory [ Hahnemann himself complied a brief repertory, in Latin, as an index to his ever-growing materia medica; but he later discarded it almost entirely to use Boenninghausens repertories, to one of which Hahnemann wrote a preface. ED] to go to in order to refresh his memory.
What we can readily turn to now, he had to keep stored up in his mind, or spend hours and days, even weeks, to find. All that consumes endless time. However, he had one advantage over his followers: his knowledge was first-hand, therefore burned deeply into his brain. But there were other things to be discovered besides the law of similars, the greatest of which is: just what constitutes the exact symptom totality, as related to the drug? Every drug has but a limited pathogenesis produced directly by the drug itself, and indicates it in preference to all other drugs.
If Hahnemann realized that it is strange that he did not mention the fact, since next to the law of similars itself, it is the most important factor in homoeopathy. That fact is the most important thing the case taker must know, if he or she expects to be successful. Dr. Harvey Farrington once remarked: “It is remarkable how that group runs down to the sevens”.
It is remarkable how much more simple and easy it is to rapidly “take a case” if one masters the keynote of the drug that distinguishes if from all others, together with its essential satellites. The mere asking of endless useless questions and writing page after page of symptoms is not necessary “case taking” and all too often leads one astray. And the repertory is the last thing on earth that would help out in such a process. The repertory, alone, would lead us to fully 90 percent of mild suppressions, rather than cures:.
It may be true that no physician could “take” 30 to 40 new cases per day, but who amongst us ever gets 30 to 40 new cases per day? During boom times I attended from 50 to 60 patients per day, but they were by no means new patients. If our work is done properly with the new patients as they do come, it should not take one but five minutes to prescribe a placebo on the second visit. And the time saved on that case can be applied on the new case.
In order to “take” a new case, and do it rapidly and successfully, one must be intimately conversant with the materia medica, and enabled to gain access to the distinguishing features of the drug and its little coterie of satellites; an expert cross-examiner; an expert analyst and an expert observer.
Here are samples of two cases that came to me a few weeks ago: Mrs. A. had been ailing for some time, and subject to splitting headaches. The one she had when she came to me had lasted three days. She came into the consulting room, dropped into a chair and asked not to be disturbed, but to be given a quick relief. She did not wish to be spoken to as it made her move and that made her worse. She put out her tongue; it was dry, as were also her lip and throat, and the tongue was thickly furred white.
Her taste was bitter. Asked if she was thirsty replied, “Not very often, but when I do drink I could drink a well dry.” If I had filled 20 pages of foolscap and spent 20 hours on that case, instead of the five minutes I did spend, I could not have improved on the remedy. In just ten minutes she left the office, her head entirely free from pain. She returned a week later to inform me that, “All my other troubles have improved, and I have not felt so well in years.” The time saved on that case can be applied on the next case.
Another case was that of a young lady, aged 23, who had suffered all her life from marasmus. Few thinner beings walk the face of the earth than she. She said she was hungry as a bear all the time, yet the more she are the thinner she seemed to get, yet was anxious if she did not eat. Her breathing was very difficult in a warm room. She was depressed and easily exhausted. Her glands enlarged. It took just ten minutes to take that case. She received a single dose of the 10M. of the drug, and was sent on her way rejoicing. Her mother reported a week later that there was marked change in her condition generally inside of 24 hours, and, under placebo, her condition has improved unabatingly.
Then, too, I have a precedent, in my own case, that the prescribing for a case of years standing, and the taking of the case can be done in 5 minutes. Our present dean of homoeopathy took my case and prescribed that universal drug, Sulphur, in that short time. However, the old adage, “Whatever we do not have in our heads we will have to have in our feet”, is equally true in “case taking”. We must make up in tedious rote what we lack in knowledge of the materia medica.
In my own humble estimation, Dr. Harvey Farrington is the only one so far who had approached the proper method of teaching materia medica. Those who follow closely his teachings will get a much better view of how to properly “take the case”, for once one understands the drug properly, one will know at once when one had reached the goal one seeks.
DR. GRIMMER: A paper like that is certainly valuable to us. It is of the needed things, for those who busy with a great many patients, and I want to confirm the doctors findings, in the main. We do waste a great deal of time, but it is necessary to teach the younger members to be a little more painstaking. It seems necessary that they should take the longer route, at least for a while, but as we get along in our work, we do learn these shortcuts that are really valuable and in no way impair the good of the work.