In chronic diseases the investigation of the signs of disease above mentioned, and of all others, must be pursued as carefully and circumstantially as possible, and the most minute peculiarities must be attended to , partly because in these diseases they are the most characteristic and least resemble those of acute diseases, and if a cure is to be effected they cannot be too accurately noted; partly because the patients become so used to their long sufferings that they pay little or no heed to the lesser accessory symptoms, which are often very pregnant with meaning (characteristic) — often very useful in determining the choice of the remedy–and regard them almost as a necessary part of their condition, almost as health, the real feeling of which they have well-nigh forgotten in their sometimes fifteen or twenty years of suffering, and they can scarcely bring themselves to believe that these accessory symptoms, these greater or lesser deviations from the healthy state, can have any connection with their principal malady.
One of the major issues with case taking and analysis is the mistake of thinking a symptom comprises of:
This is not the reality. a COMPLETED symptom comprises only of:
On this basis then, a CONCOMITANT is a complete symptom which itself comprises of these three parts. It is this/these symptom/s that is present during/with/alternating) with the main complaint which often determines the choice of remedy/ies to consider during an analysis and OFTEN is the key to the prescription. Use of a concomitant determines the CASE.
Aphorism 95 makes this very clear.