This tendency is very marked in the study of medicine and the general public is apt to place great confidence in a physician who is considered-or considers himself-a specialist in some one field, because he has given a good deal of time to the study of that subject.

In all departments of knowledge nowadays there are students who devote themselves to some one aspect of the subject-matter and thus gain a deeper-if a narrower-insight into the subject in hand.

This tendency is very marked in the study of medicine and the general public is apt to place great confidence in a physician who is considered-or considers himself-a specialist in some one field, because he has given a good deal of time to the study of that subject.

The special knowledge is most valuable date consultation of such a specialist may be all to the good, of it does not lean to a one-sided view of the case in hand, the paying attention to one set of symptoms only, instead of to the general condition of the patient. Homoeopathy teaches the necessity of getting the symptoms of the whole patient in order to find the curative remedy for the existing disease.

This is no easy thing, especially wit a new patient-one not accustomed to homoeopathic treatment. Such a person will often resent the physician’s careful questioning about his general condition, saying that the special trouble for which he sought relief is all that matters. The physician is wise who sees, and is able to make his patient see, the need for general investigation.

Hahnemann, in the Organon, given very careful directions for such questioning, beginning with paragraph 82 and going on to paragraph 104. He makes a distinction between acute and chronic cases in the matter of examination in paragraph 82-last part.

In this investigation some difference is to be made when the affection is an acute and rapidly developed disease and when it is a chronic one, seeing that, in acute disease, the chief symptoms strike us and become evident to the senses more quickly, and hence much less time is requisite for tracing the picture of the disease and much fewer questions are required to be asked, as almost everything is self-evident, than in a chronic disease which has been progressing for several years, in which the symptoms are much more difficult to be ascertained.

The paragraphs that follow, giving directions for the Presented for I.H.A. Bureau of Homoeopathic Philosophy, 1943.

“taking of the case” are so full of sound common sense that a physician should read them frequently in order to test his own performance in that direction.

In taking the case, the physician lists the subjective symptoms as given him by the patient but at the same time and late by physical examination, notes the objective symptoms-the expression and manner of the patient, his color, general nutrition, the condition of the tissues, blood vessels, and organs. This physical examination is essential, not only for the diagnosis of the patient’s condition, but also for the choice of the remedy. The drug chosen should be on that has produced the same general condition in the provers.

As an illustration of the need for a correct diagnosis in order to make a really accurate prescription, consider the symptom of oppressed breathing. If the cause is a weak or otherwise abnormal heart, the remedy will be one that affected the heart of the prover. Or, if the lungs themselves are a t fault, another remedy would probably he indicated. In case the cause was a general weakness, due, perhaps, to anaemia, still other symptoms would especially help in making the choice.

Mental symptoms which are most important in getting the totality may be both subjective and objective. Often a patient is

unconscious of some peculiarity, as irritability, hesitancy, tendency to repeat, etc., and very few would confess to pride, selfishness or self-assertiveness. People are apt to take themselves for granted and not to realize any departure from the normal.

Getting the totality of the symptoms demands time, patients, and persistence with the ordinary practitioner, but Hahnemann would make it seem easy in paragraph 83:

This individualizing examination of a case of disease demands of the physician nothing but freedom prejudices and sound senses, attention in observing and fidelity n tracing the picture of the disease. NORTHAMPTON, MASS.


DR. PLUMB BROWN: Dr. Stevens’ paper with quotation is most lucid and complete. There is little left for me to say, simply thank you, Dr. Stevens, for reminding me of my besetting sin and tendency of neglecting my daily opportunity as well as duty of gaining inspiration, wisdom and strength from great men and good books, especially the Organon.

If we prescribe for the whole patient, homoeopathically, is pathology ever a real and reliable and in selecting the similimum?.

Dr. MOORE: Having given our attention through the years to eye, ear, and throat, one can appreciate the solid truth back of what Dr. Stevens says.

A case in point”.

Mrs. S., 51. Unable to read more then ten or fifteen minutes. Cannot see to sew for three years. No helpful change could be made in the glasses the wears. Considering general symptoms we unearthed much digestive disturbance. For a long time fruit gives a severe upset. An outstanding symptoms.

We went back to the century before this to an article in the I.H.A. Transaction showing the advantage of fruit itself in such a case. A dose of Succus Fruit 1M. potency. Six weeks later reported she could eat fruit and enjoy it, also the eyes were again normal. She was now making a dress.

Another brief case defending the much maligned specialist.

M.J., 35. On lifting a heavy object “something gave way in the back of the head, ” six days ago. Since then very nervous (quite unusual), cannot sleep, much vertigo, suggestions possible cerebral bleeding. Examination shows small occipital spot tender on pressure, also the right ear solid full of cerumen. We figured the strain of lifting had dislocated the cerumen against the drum.

Removal of cerumen it all. {Prescribing could not have done it. Emphasizing the worth of physical examination.

Furthermore, stimulated by Dr.Stevens’ paper, we have again gone over paragraphs 84-104 of that outstanding guide to drug

therapy-The Organon of Samuel Hahnemann.

DR. DIXON: Dr. Stevens’ paper is a fine dissertation for every homoeopathic physician.

Her stressing the careful case taking, and her reference to the Organon, are commented on by the discussants preceding me. I approve of all she (and they) have said, and only want to add my especial applause to what she says in regard to the “specialists” who so frequently lose sight of the individual who is sick, in frantically attempting to cure a pathological condition regardless of the personality of the sick man.

DR.HAYES : To bring this discipline forward again was a good thought. Personally, it sent me back to Sections 82-104 after forty years or so. It was gratifying to realize that certain seasoned modes of my own were really (probably the forgotten) teaching of Hahnemann.

Referring to Section, 83, he says in substance: “The physician is to being a fresh line for every new circumstance so that the symptoms may all be ranged separately one below the other. He can then connect to any on of the additions or modifications as they may be developed.” This is of prime importance if the prescriber’s object is to get a stamp of the patient’s sensorium. The voluntary “confession” of the patient is the crucial part of the interview. It is the birth stamp and pattern of the patient’s medicinal need.

Thus he feels free from everything personal and takes advantage of the cue to tell all; and he usually does. To one direction of Hahnemann, in Section 84, I positively object; that is, to the request to speak slowly. This is a check on spontaneity and spontaneity is the essence of the value of the record. If the physician cannot write as fast as any patient can talk, or nearly so, let him take a course in write as fast as any patient can talk, or nearly so, let him take a course in abbreviation or make a system for himself. I repeat, no personal influence of the physician should intrude at this time. The issue is too critical.

In this way I almost never find it difficult to obtain a willing disclosure either then or in the question and answer period. And to top it all, the patient not infrequently is inspired to express succinately some vital point that comes to mind, even as he departs.

DR. SUTHERLAND: If Dr. Stevens’ paper doses nothing more than arouse the desire to review paragraphs 82-104 in the Organon, it will have accomplished a useful purpose. Hahnemann’s directions for case-taking mark a new advance in the patient- physician relationship which was necessitated by the very nature of homoeopathy itself. How closely one adheres to these rules marks the difference between an adequate and a poor prescriber. In these busy times a review of the paragraphs mentioned will serve to keep our steps from deviating from the path that leads to successful prescribing.

Grace Stevens