“Whatever the emphasis or valuation put on any special symptom or group of symptoms, it first must be fundamentally agreed that the totality alone is essential to the selection of a remedy homoeopathic to the diseased state of the patient. No detail is too insignificant. Scrupulous and painstaking care in case taking is paramount. No values must be written into the record, nor over emphasis placed on any division of the symptom total; the mind kept open until all the evidence carefully weighed is in. To possess actual value symptoms must be reliable and definite, of the very warp and woof, unaffected by their appearance or use in other cases; in short, symptoms that clearly individualize the case under consideration- a totality that sets the case apart from any other previously observed. Until this totality is on paper before us there can be no ranking or ascribing of values. Hence the need, however tedious, of sound case taking, for it is fundamental and not to be compromised by bias or past clinical experience.
In order to match the genius of the disease with the genius of the remedy we then seek to rearrange and rank individual symptoms to better discern the remedial agent. Of the symptoms related or observed many may not particularly distinguish. What are some of these?
Pathological symptoms, so-called, indicative of the results of disease were described as ultimates by Kent. These evidences of tissue changes are helpful in diagnosis or prognosis, but because they are effects, not causes, they do not become of primary importance in pointing to a curative remedy. All processes have an origin, and it is their beginnings to which a similar drug pathogenesy may be comparable. Likewise in epilepsy, the remedy is not seem in the actual seizure, but rather in what has preceded perhaps long before.
Symptoms common to all cases of a certain disease are little indicative of a similar remedy. There is nothing here to be found individual and compelling our choice. Symptoms common to many drugs likewise do not stand out in the selection of a similar drug picture.
Symptoms due to drugging, or improperly chosen remedies, or too early repetition do not present the individual nature of the disease as manifested in the changed state and hinder differentiation. Again the long list given by a hysterical patient is difficult to value.
The predominating “my” symptoms in reference to particular parts of the body also belong in the class of lesser values, unless these are striking, or becoming general because they are similarly evidenced throughout the various parts of the patient. Particulars rarely distinguish the individual and to that extent are weak in value.
So are common symptoms, such as loss of appetite, headache, exhaustion, discomfort, etc., often indefinite and therefore not to be emphasized unless qualified further to really individualize the case.
What symptoms, then, stand forth, compelling and of major rank, pointing more directly toward what is essential for cure? A consideration of homoeopathic philosophy antedates proper symptom valuation. Very briefly, it is not the body of man that expresses disease, but the reaction of his vital force against invasion. Nature’s response is in the way of symptoms experienced through sensation, etc. Individualization means the reaction to any morbific agent as evidenced in the patient under our care. When this is clear to the prescriber, there is no thought of remedies based other than on the patient himself. Not the present symptoms alone, but those detectable from birth, show the conflict which has harassed the inner real life in its bid for mortal existence.
Ray W. Spalding MD