The word symptom is as grossly misunderstood in the abstract as it is misapplied in the concrete and this ignorance is painfully evident in all schools of healing.
Ask a number of physicians to define the word and you will get about as many answers as it is possible for differing minds to concoct and they are all of them, characterized by luck of philosophical or practical comprehension. In our own school we speak learnedly, or otherwise of “generals” “particulars “characteristics” and other subdivisions of symptomatology, and yet when we fall back to the basic question “What is a symptom?” we find that we have taken much for granted. The writer had, sometime ago, the opportunity to ask a physician of another school to define disease and in perfect conformity to the edicts of his cult he answered: “Disease is the abnormal condition of one or more organs of the body.” Very well doctor, if that be true then what is a symptom?.
He hesitated a moment and then replied. “Why sir, you cough to know that disease and symptoms are the same thing.” The writer was prompted by this statement to wonder whether a four years course in a medical college offers sufficient time for some minds to grasp the rudiments of medical knowledge.
At the same time it is not the stupidity of this type that prompts the high brows to question the thoroughness of our academic instructions because that very answer would “Pass master” in many of the college that have escaped the adverse criticism of this coterie of self – appointed, self annointed censors.
Again, who has not heard a symptom defined as “A manifestation of an abnormal condition.” and how many of you have observed this interpretation given in some of our books of reference.
To be sure, that definition is of the toothsome type, and goes unmolested till the dissenter advances the question whether a normal condition might not also be manifest by symptoms, and then it is that a symptom assumes larger proportions than had formerly been assigned to it.
The healthy man has symptoms of health as much as the diseased man has symptoms of disease and the basis of intelligent practice must ever be a definite understanding of the difference in these manifestations on one hand and their relationship on the other.
The student of medicine is urged at the outset to learn physiology and the only serviceable result from this study is that he learns the symptoms of health, then later he is promoted to the vague but interesting wrestle with pathology, wherein he learns the symptoms of disease (sometimes getting no further than the ridiculous conclusion that they are identical) then finally he reaches the realm of practice, wherein he attempts to supplant disease with health and his success or failure he determines by symptoms.
If his inclination be toward progress he soon learns that he may banish certain symptoms of disease without eradicating the disease itself- while the reverse is true, that if, when guided by the symptoms, he eradicates the disease, he need not have further concern of the symptoms, since with the elimination of their causes they must disappear. Also, he is just as sure to learn that the healthy man does not under any circumstances offer indications for medication.
Let him first learn however that a symptom is simply a manifestation of a condition, and the remainder of his medical accomplishments will not be so difficult of attainment.
DISCUSSION
C.M. Boger:- Symptoms are such elusive things that much must be left to the judgment of the man who uses them. The interpretation of a symptom depends upon the accuracy of the patients expression and also upon the doctors ability to correlate them and give each its due importance, and not to put undue importance upon any one that does not deserve it.
The relative value of symptoms is of great importance, many times we are confused by the great multiplicity of symptoms. The proper interpretation of the symptoms of a case depends upon our ability to grasp the case as a whole, the symptoms are natures representation of a diseased state and we should grasp them as one thing- an entity. The whole complex of symptoms is natures field in which she needs help, and by means of the homoeopathic law she indicates very plainly what she needs. She always puts the important symptoms – that is, important to the doctor-at the last. There are the latest or the most recent to develop.
That is a point that many of us are apt to overlook. That should never be forgotten; the most recent symptoms become the most important guides or leaders as it were.
We have been taught to expect symptoms to come in a certain order and this is true but it is not always practical. The point that I lay more emphasis upon is this; every symptom is one part or detail of a whale complex, just as each think in a painting is a part of the whole painting. The complex of symptoms is a natures expression of the disease, and from this point of view it matters not what the disease may be called. We must grasp that idea and look at the remedy rather than through the eyes of the disease. The patient has the sickness; he has it in peculiar way; we should prescribe for him not from the standpoint of the disease or diagnosis, and the we are prescribing thought the eye of the remedy. The more thoroughly we can do that, regardless of the name of the disease the quickly will we cure.
J. Stewart Smith:- Does not Hahnemann teach that the sum of the symptoms is the disease.? Is it correct to teach that we are to look upon the symptoms simply as the manifestation of an entity.? I think that we are taught very distinctly that we are to look upon them as the disease, and when they are removed the disease is gone. Therefore in prescribing it is not the question what disease the patient has but what symptoms does be present. The whole problem is to discover the characteristic symptoms of the patient and to match them with a remedy, irrespective of the name of the disease that the patient may have. When the symptoms are removed the patient is cured, and that is all that there is to it.
There is a tendency and a very strong one to make symptoms simply the guiding points to a diagnosis. We ask, what is the matter with the man, and answer it by a name. The real question is not what is the matter with the man but are the characteristic symptoms which be presents characteristic of him rather than of the disease. In what form does nature manifest his ill-health? Then match the state or sum of the symptoms with a remedy and the man is cured.
I recently read a paper by Dr. Royal which gave an entirely wrong conception of what a homoeopathic prescription is. We are in continual danger of falling into pathological prescribing. The tendency that way is very strong and we are should be continually on our guard against it.
J.B.S King:- It seems to me on a single hearing of this paper that the old school doctor who answered Dr. Crutchers question was right and Dr. Crutcher wrong, although he adopts an attitude of scorn towards his answer. He tries to make out that symptoms and disease are different things; theoretically they may be out practically, actually, and for our work they are identically the same. I regard Dr. Crutchers distinction, therefore, as a superfluity.
T.H. Hudson:- I always try to get hold of Dr. Crutchers papers and read them over carefully beforehand. Then I could talk a week. Dr. Smith has voiced my sentiments exactly, and I think that it is a true expression of what Hahnemann taught in regard to symptom. As prescribers we should be regardless of the classification of disease into certain diagnoses. I have had two cases of pneumonia in which one patient needed an alkali and the other an acid and yet both cases were inflammation of the lungs.
I like Dr. Bogers idea of seeing the symptoms through the eyes of the remedy. I think that I have always tried to do that. I think of the remedy most prominently and not so much of the disease. When I have found a characteristic symptom or a key-note as it is called, I generally find that the other symptoms cluster around and show very clearly what the remedy is.
L.P. Crutcher:- I think that the only criticism to answer is that of Dr. Smith. His statement is correct as he presented it, but might lead to a misunderstanding. The simple statement that when you banish the symptoms the patient is cured is not quite true. You many banish a pain with an opiate but the patient may be not the least bit better. The significance of that statement to me is that we should know the disease by the symptoms and cure by the symptoms, but we do not cure the patient simply by eliminating the symptoms. That is more like old school practice. It is possible to eliminate symptoms without eradicating the disease. We use the symptoms without as our guide to the remedy that will cure, but we do not simply eliminate symptoms.
