Feeling the necessity of having in a concise and accessible from the various sub-laws and rules of homoeopathy, I recently prepared for my own use the following arrangement of them. Dr.kent very kindly revised the manuscript and made a number of valuable additions, and also suggested that it might be of service to others if published in the journal.
CLASSIFICATION OF DISEASE.
All non-surgical diseases belong to one of the following classes: (A) Acute: (B) Chronic: (C) Those due to the use of drugs, living under unhealthy conditions, etc.
1. Acute disease are self-limited, and, provided no treatment is pursued, they ending resolution or death,.
This being so, an acute disease can have no sequelae, the so-called sequelae being manifestations of one of the chronic miasms roused into activity by the acute disease.
2. Acute diseases may be stopped at any stage by the similar remedy.
3. In acute infections diseases all infection ceases as soon as the similimum is given.
4. The best prophylactic in acute disease in the epidemic remedy.
5. When a trivial acute disease supervenes during the treatment of a chronic one, it is advisable to use the indicated remedy bin a low potency; for, if this is done, it will often be found after the acute disease has been cured, that the deep-acting remedy has not been interfered with by the short acting one, and that it still continues to act. (This is unlikely if the acute disease is severe. If it is a severe acute disease dont expect this, and give the remedy in potency- J.T.L.).
6. After the cure of the acute supervening disease it is advisable, before repeating the remedy for the chronic disease, to make sure that the chronic disease has not been modified by the treatment of the acute one, or by the acute disease itself, and not to call for a different remedy from that formerly needed.
7. When the acute disease has been modified by allopathic or inappropriate homoeopathic remedies, it is usually advisably to prescribe for the case as it now stands, rather than according to the original symptoms.
8. Acute exacerbations of active chronic disease must be treated in a different way from that of an acute supervening disease, provided any remedy is required at all. Frequently the acute complement of the deep-acting remedy, required by the chronic disease is the suitable one, but if only an antipsoric is called for it is better not to give any medicine.
9. Commonly, when the chronic disease is only partially active, as shown by the patient being apparently in good health except that slight causes give rise to frequent acute attacks of illness, the knowledge of the remedy for these acute manifestations will enable us to select its complementary deep- acting remedy, and so permit the cure of the chronic underlying disease.
1. Chronic diseases are characterized by their progressing from without inwards and from below upwards, and, that while the symptoms may vary, they never disappear in the reverse order to that in which they came.
2. So far as is at present known there are only three chronic diseases, viz., psora, syphilis and sycosis.
These disease may be active or latent.
They may be present in three ways, viz:
(a) A single miasm.
(b) Two to three miasms co-existing, but separate and only one active at a time.
(c) Two or there of the miasms may form a complex and this may be further complicated by a drug disease.
If two or more miasms form a complex, the proper remedy will dissociate them, and then the most active must be attacked; but the greatest combine, and they will never again separate. [See Carriwitchet No.12, April Recorder, and answer to same.-ED.].
3. These chronic disease often remain latent for long periods, but are apt to be roused into activity by acute diseases, unhealthy surroundings, grief, etc.
While latent their symptoms are very similar, and the patient may only feel ill in indefinite way.
The nosodes of these diseases are frequently of great service in rationalizing the symptoms of such cases, and thus enabling the appropriate remedy to be found.
4. These disease are always taken at the stage in which they exist in the already infected person. For example, the wife of a man with secondary syphilis will take the disease at the stage and not in the primary or chancre stage.- [Kent in Journal of Homoeopathics, March, 1899.].
5. A man with syphilis or sycosis may fail to infect his wife if she is suffering from some other but dissimilar, protecting, chronic diseases such as phthisis, or dissimilar diseases repel one another.
THE TOTALITY OF THE SYMPTOMS.
As our sole guide in the choice of the curative remedy is the totality of the symptoms, it is necessary to inquire what is meant by the totality.
In acute disease every symptom experienced by the patient or observable by others is to be included in the totality; also any cause, such as wetting, fright, etc., and circumstances aggravating and ameliorating.
As an acute disease never forms a complex with a chronic one, the latter being suppressed until the former one has run its course, care must be taken when ascertaining the symptoms of the acute disease not to take into account old symptoms which belong to the chronic disease.
But in some cases of acute disease, SYMPTOMS of the chronic disease remain, and are active during the acute disease; such chronic symptoms are peculiar because they have not disappeared, and very often are guiding to the cure of the acute disease; while the remedy will have no relation to the chronic disease, yet that peculiar symptom will stand out and guide you to the remedy that will cure the acute disease; such symptoms are peculiar to the patient.- [Kent, Medical Advance, January 1890.].
In chronic disease the totality includes all symptoms experienced by the patient since birth, excluding these arising during acute disease. While theoretically it is proper to include all such symptoms, yet great caution must be used. (1) Some other chronic miasm may have been acquired during life, or (2) the symptoms may have been so perverted by inappropriate treatment that they do not truly represent the disease.- [Kent, Journal of Homoeopathics, July 1899.] When the symptoms have been much perverted by inappropriate treatment we can sometimes get a sure foundation on which to base a prescription by taking the symptoms as experienced by the patient before this inappropriate treatment was commenced.
This investigation into the former symptoms of the patient is frequently of great service when the presently existing symptoms do not point clearly to any remedy. For example, in an adult with neuralgia of the limbs, where present symptoms are not guiding, if we find that in infancy he had scald-head like that of Mezereum, and we now examine the neuralgias produced by that remedy, it will often be found that they bear a close resemblance to that of the patient, and it will probably prove curative and reproduce the original eruption.
If frequently happens that, when we search for the totality of the symptoms, we find they have been so perverted or suppressed by inappropriate treatment that these now present do not present a true picture of the internal disease. For example, take a case of gonorrhoea suppressed by Arg. nit., and on examination there will be found a pretty of Med. and a partial one of Arg. nit. and probably Natr. mur.
[In all such cases we must prescribe upon the symptoms if possible, but if the case does not respond and the suppressing drug is known, it is sometimes advisable to select a remedy competing which has an antidotal relationship.- K.].
In determining the totality, especially with regard to former symptoms in chronic disease, it is also necessary to ascertain whether one or more miasms are present, as it is useless to attempt to find a remedy for all the symptoms when there is more that one. In such cases, as a rule, only one miasm is active at a time, and the treatment must be directed against that one. When two or more miasms form a complex we must endeavor to separate them.
[The symptoms are the only guide to the separating of the miasms. The road to death is by more complexity, and any remedy that improves the patient will cause a simplification or separation of the miasms.- K.].
THE SELECTION OF THE REMEDY.
Having, then, determined the totality of the symptoms, we must now search for the remedy that has produced symptoms most similar to those observed in the patient. Theoretically we endeavor to discover a remedy whose symptoms exactly correspond in character and grade to those of the patient; but this can rarely if ever be done, and accordingly Hahnemann directs than in searching for the homoeopathic specific remedy we ought to be particularly and almost exclusively attentive to the symptoms that in searching for the homoeopathic specific remedy we ought to be particularly and almost exclusively attentive to the symptoms that are striking, singular, extraordinary and peculiar (characteristic).
It is especially those symptoms that are peculiar to the patient and not to the disease that are to be our guides. For example, the characteristic of dysentery are bloody discharges, pain and tenesmus; but if fainting accompanied every stool, that would be peculiar to the patient, not to the disease, and hence guiding.
In determining that are characteristic symptoms of the case the following rules and cautions are of importance, viz:
1. The characteristic symptoms must be equally well marked, both in the patient and in the remedy. In other words, no matter how peculiar a symptom may be, either in the patient or in the remedy, unless it is distinctive and outstanding we must pay little heed to it.
2. No one symptom, however peculiar it may be, can be out true guide, for, unless there is a general correspondence between the symptoms of the patient and the remedy, failure with result. Those single peculiar symptoms are however, invaluable in suggesting special remedies as being worthy of examination.
3. General symptoms, or those that affect the whole body, are of very much higher thank than particulars which only relate to special organs; so much so that any number of particular symptoms can be overruled by one strong general.
What the patient predicated o himself is usually general, as when he says,”I am thirsty”, meaning that his whole body is so not any one special organ.
General symptoms, however, are of different grades of value. In the highest rank must be placed all mental symptoms, if at all well marked, and of these all symptoms of the will and affections, including desires and aversions, also irritability and sadness, are the most important. Of less importance are disorders of the intelligence, while those of memory rank lowest of the mental symptoms.
Amongst general symptoms are to be included those in connection with sleep, dreams, the menstrual state, also, the effects of the weather and sensitiveness of the patient to heat and cold.
The special senses are so closely related to the whole man that their symptoms are often general. For example, when a patient says the smells of food sickness him it is general symptom, whereas an imaginary bad smell in the nose should be particular.
We frequently find on examining the particular organs that some symptom or modality runs strongly though them all, and may be predicated of person himself, so that here we have a general made up of a series of particulars.
4. Care must be taken not of mistake a modality for a symptom, yet circumstances affecting many symptoms become leading characteristics of the patient and hence are important.
5. The skin being the outermost part will yield the least important symptoms.
6. In organic disease and in many affections of the female genitals we can please little reliance on the local symptoms.
7. A tumor or other pathological condition is no guide to the curative remedy; for in the first place it is not the disease itself, but its result, and in the second place provings have not been pushed far enough to produce similar conditions.
While we must ignore pathological changes when choosing the remedy, yet a knowledge of true pathology is absolutely necessary.
1. We can only thereby understand the course and progress of the case.
2. We can thereby know the symptoms that are common to that special state, and hence those that are peculiar to the patient.
3. We also thereby know in certain disease, or at certain stages of diseases, that no mater how similar the patient, yet, owing to the superficial character of their action, they cannot prove curative. For example, in pneumonia, in the stage of exudation, while the symptoms may apparently call for Acon., we know that remedy cannot produce such a condition, and closer examination will reveal that some deeper-acting remedy, such as Sulphur or Lyc., is needed.
4. Pathology enables us to decide, when new symptoms arise, whether they are due to the natural progress of the disease or to the action of the remedy.
5. We must clearly understand that it is the patient that is curable and not the disease, and without a proper understanding of pathology we are liable to err. Suppose a case of inflammation of a joint that has led to ankylosis. The suitable remedy will cure the inflammation, but will be powerless to break down the adhesions and surgical aid must be sought. The same holds good with regard to tumors, for when the patient is cured the tumor will cease to grow, and perhaps it may be absorbed, but very often it persists and must be removed by the knife.
6. Pathology also warns us that it is dangerous to attempt to cure certain conditions of disease, such as advanced tubercular phthisis, or where foreign bodies are encysted near vital organs.
In such cases nature can only cure by suppurating out such foreign substances, and the exhaustion entailed by such an operation is often fatal.
It is a mistake to suppose that a remedy can cure groups of symptoms only in the order in which they appear in the proving. Often a remedy cures a group whose component parts were observed in different provers and often in quite a different order.
While this is so, experience teaches that certain groups of symptoms are apt to appear together, and when this is so they are more characteristic of the remedy.
Hering says that the comparative value of concomitants maybe determined thus: If they are essentially concomitant, one being really the cause of the other (e.g., lachrymation due to a general catarrhal condition), then this feature of the case must be considered; but if no such relation of cause and effect is observed it may be ignored.
EFFECTS PRODUCED BY THE REMEDY.
The remedy having been given it will affect the case in one of the following ways:
1. The remedy causes no change-either the remedy or the potency is incorrect.
2. Steady rapid improvement takes place without any aggravation.
(a) In such cases the remedy and potency have been exactly similar to the disease force.
(b) It many also mean that the disease has not been deeply rooted.
N.B.: There may be almost complete removal of the symptoms, yet if the patient is not conscious of the elasticity of returning health it has been no cure, but only palliation.
3. A sharp short aggravation followed by quick improvement, and in this case the improvement is usually long lasting.
4. A long aggravated and final slow improvement.
This occurs chiefly in weakly patients, and there is great danger in repeating the remedy too soon.
5. A long aggravation, followed by slow decline of the patient.
These cases are incurable and only short-acting remedies should be used.
6. A sharp aggravation, but the improvement that follows is very short lasting, especially when a deep-acting remedy has been given.
These cases are usually incurable.
7. Rapid improvement, but soon followed by an aggravation.
If the remedy was the similimum the case is incurable, but if the remedy only corresponded superficially it may have acted palliatively.
8. The amelioration lasts a normal time, but a new group of symptoms appear and under another suitable remedy they disappear for the normal time and another new group of symptoms appear, yet, in spite of the removal of group after group, the patient steadily declines. This is especially observed in the old and feeble and such cases are incurable.
9. New symptoms appear (not the return of old ones which have been experienced long before the remedy was given).
(a) If the new symptoms belong to the pathogenesis of the remedy the remedy is the correct one, and must be allowed to act. If the new symptoms are not known to belong to the pathogenesis of the remedy and yet the case rapidly improves, it is probable that future provings will show that they really do belong to it.
(b) If the new symptoms are due to the natural development of the disease, then probably the remedy has been wrong and has produced no effect.
These new symptoms may be due, however, to a natural crisis of the disease, such as epistaxis in typhus, and must not be interfered with.
(c) If the new symptoms, though numerous and violent, do not belong to the natural development of the disease (and the patient does not improve), then the remedy is the wrong one.
10. An aggravation followed by the return of old symptoms. This is a very favorable state of affairs, and must not be interfered with, for no remedy is homoeopathic to re-action.
When the symptoms finally settle, if these old symptoms still persist, they must then be prescribed for, and are of the highest grade in the choice of the next remedy.
11. There is improvement, but it takes the wrong direction. For example, an ulcer of the leg meals up under the action of the remedy, but haemorrhage from the lugs comes on. This shows that the remedy only corresponded to part of the case, viz., the ulcer, and has really done harm.
12. In some patients we get a proving of every remedy given. They are over-sensitive and very difficult to cure. THE HOMOEOPATHIC AGGRAVATION.
In acute disease the homoeopathic aggravation is not, as a rule, marked unless the disease has been severe and dangerous.
In chronic cases without tissue changes the aggravation is usually not severe, but when there are tissue changes there is almost invariably a marked aggravation usually with elimination through some of the natural orifices of the body.
In the former the aggravation is due to the medicinal disease, whereas in the latter it is due to an effort an natures part to put matters right-a sort of house cleaning.
When the remedy does not correspond exactly to the disease symptoms we are not likely to haven an aggravation (except in over-sensitiveness where it is medicinal and not curative).
This is especially observable in feeble patients who, owing to their deficient vitality, are not able to produce any very guiding symptoms-[Kent, Journal of Homoeopathics, May 1900.]. THE REPETITION OF THE REMEDY.
The medicine must not be repeated until the action of the last dose is fully exhausted. In other words, there can be no fixed time as to when to repeat, each case must be judged on its own merits.
In acute cases it is comparatively easy to determine when the last dose has exhausted its action by means of the general appearance and mental state of the patient, and also to a less degree by the pulse and temperature.
In typhoid fever in vigorous patients Kent usually gives the remedy in water every few hours for several days, because it is a continued fever, but on the slightest sign of reaction stops the remedy.
On the other hand, he does not repeat the remedy in continued fever in feeble patient.
In remittent fever reaction will appear in a few hours, and one dose is sufficient.
But in chronic cases it is not easy, for it is the rule and not the exception to have sharp, short exacerbations interrupting the improvement, and we must be sure that the exacerbation is a permanent and not a mere passing one.
In chronic cases we know that the dose is still acting as long as old symptoms return, or, if the symptoms continue to disappear in the reverse order to that in which they originally appeared, or if they pass from internal organs to more superficial parts, or if they go from above down.
More cases are spoiled by too frequent repetition than from any other cause, and it must remembered that an acute case may show no improvement for three days and some chronic ones for sixty.
When the vitality is very low, as in collapse, it is dangerous to repeat the dose. But when there is a lack of response to the remedy after allopathic drugging, which is really due to a sluggishness and not to a want of vitality, it is necessary to repeat oftener.- [K.].
Incurable disease requires more frequent repetition of the short-acting remedies for palliation, and it is not advisable to use a higher potency than the 200th.- [Kent, Journal of Homoeopathics, Nov. 1897.].
Some antipsorics have also an acute action, and when indicated in acute diseases behave exactly like the short-acting remedies.