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.
PATHOLOGY.
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.
CONCOMITANT SYMPTOMS.
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.
