Boenninghausen classified the characteristic
symptoms into seven categories. They are:
1. Quis (Personality of the Patient)
2. Quid (Peculiarity of Complaints)
3. Ubi (Seat of Disease)
4. Quibus Auxilus (Concomitant Symptoms)
5. Cur (Causations)
6. Quomodo (Modalities of Circumstances)
7. Quando (Modalities of Time).
BOENNINGHAUSEN Clemens von states-
“The seven rubrics designated in this maxim seem to contain all the
essential momenta which are required in the list of the complete image
of a disease. May I be allowed, therefore, to attach my remarks to this
scheme with the desire that this hexameter, which was formerly used
only by theologians, may now be also impressed on the memory of
homoeopaths and be put to use by them.
1.
Quis?-As a matter of course the personality,
the individuality of the patient, must stand at the head
of the image of the disease, for the natural disposition rests on it.
To
this belongs first of all the sex and the age; then the bodily
constitution and the temperament; both if possible, separated,
according to his sick and his well days i. e., in so far as an
appreciable difference has appeared in them. In all these peculiarities
whatever differs little or not at all from the usual natural state
needs little attention; but everything that differs in a striking or
rare way therefrom deserves a proportionate notice. The greatest and
most important variations are here found mostly in the states of the
mind and spirit, which must be scanned all the more carefully, if they
are not only sharply distinct, but also of rare occurrence and,
therefore, correspond to only few remedies. In all such cases we have
all the more cause to fathom these states with all possible exactness,
as in them frequently the bodily ailments recede to the background, and
for this very reason offer but few points for our grasp, so that we may
be able to make a sure selection among the remedies which compete.
Paragraph
104 of the Organon makes it the duty of the homoeopath to make a
written scheme of the image of the disease, and whoever has once
acquired a certain facility in this will easily know how to satisfy
this requirement and gradually acquire a certain specializing
penetration, which will prove to him of ever increasing usefulness. For
as every man presents an individual nature different from every other
one, and as every medicine must be exactly adapted to this
individuality, in agreement with the symptoms, which it is able to
produce in the total man, so, at once, at this first investigation as
to the Quis? A great number of medicines are thrust aside, just because
they do not correspond to the personality of the patient.
The
spiritual and dispositional individuality of the patient here gives the
most important, often almost the only deciding points for the selection
of the remedy, where the disease involved is one of the mind or spirit,
and generally the two disturbances present themselves so conjoined into
one that the signs of the one only receive their full and definite
character from the other. Hahnemann, indeed, recognized the importance
of this two momenta from the beginning, but the necessity of weighing
the two in their connection with one another he only recognized later
on in its full measure; and he then placed the symptoms proper to the
two, which in the first provings had been separated, one making the
beginning and the other the end, in the "Chronic Disease" immediately
one after the other, an improved arrangement, which we also find in the
best works on Materia Medica Pura of later times.
Many
other things belonging to this rubric, but concerning the bodily
individuality and presenting, as it were, the chief features in the
portrait of the patient, are contained in those books under the heading
of "general." It would be desirable and would greatly facilitate the
use if everything not pertaining thereto should be excluded, and the
former be brought under a particular rubric denominated either
"Individual" or "Personal," in such a way that the corporeal would
present a separate picture, as has been done with respect to the
spiritual and mental.
2.
Quid?-Of course this question refers to the disease,
i. e., to its nature and peculiarity.
It
may be unquestionably received as an axiom that we must first know an
evil accurately before we are able to give any effectual aid against
it. That occasionally relief may be given, without having first
recognized the nature of the evil, as little refutes this axiom as the
fact that an unexpected event occurs frequently which lies outside of
our computation, and which either leads to good or evil, while neither
the good will, nor the knowledge of the physician have the least to do
with it.
But
this axiom must be associated with another, which is no less true and
no less important, namely this: That we must also know and possess the
means which are able to relieve the evil when it is recognized. Where
these are lacking, the former are of course of no avail.
Since
the times of Hippocrates, thus since more than two thousand years, very
much has been done with respect to the first point, and we have
especially enjoyed a great progress and enlightenment within the last
century and up to modern times. The path of pure observation and
experience, which for a time had been pretty much forsaken, and on
which that ancient Father of the healing art had gathered his valuable
material, has again been entered upon. At the same time our
contemporaries possess and use the great advantage ensuring to them
from the fact that they stand on the shoulders of their predecessors,
and can thus view a greater circle of vision and, more especially, that
astonishing progress has been made in all the subsidiary sciences,
especially in chemistry and anatomy; so also they have had the
advantage offered them by many physical instruments, which it must be
confessed they have used with industry and care. By these means the
modern physiological school, and, at the same time, the diagnostics of
diseases, have reached an excellence not attained in earlier times.
The
only thing of which every Homoeopath has to complain in this matter, is
that things are conducted in too general a manner for his doctrine, and
that almost universally diseases are described and treated of under the
same name, which differ essentially in their nature, and require for
their cure very different medicines.
An
immediate result of this failing is, that Homoeopaths can make only a
very limited use of the great advance made by the dominant school in
diagnostics, since their generality excludes every special direction as
to the suitable remedy.
Now
since the modern Materia Medica of allopathy, as well as the older one,
moves in the same generality, the conclusion follows almost inevitably
that even the most cultivated allopath often stands undecided when he
is to make a choice of remedies, so that almost every one of them will
order something different, and that he is usually compelled to mix many
things together in order to cover the various indications.
More
about this will be found in the course of this short treatise in a more
suitable place, where the other questions are also discussed. Here I
can only say so much about it.
a.
That the most penetrating and most indubitable diagnostic as offered by
the best allopathic manuals is rarely if ever sufficient for the
Homoeopath, so as to enable him to make a sure selection of the remedy,
and that
b.
Such a diagnostic at most, and even then not always, may serve to
exclude all those remedies from the competition which do not correspond
with the common genius of the disease, but seem to act chiefly on other
parts of the organism.
3.
Ubi? - The seat of the disease really
makes a part of the former question, but it nevertheless deserves to be
more particularly emphasized, as it frequently furnishes a
characteristic symptom, since almost every medicine acts more and also
more decidedly on certain particular parts of the living organism.
These
differences not only enter into consideration in certain so-called
local diseases, but also in those diseases which are called by more
general names, as affecting the whole body, e. g., gout and rheumatism.
For it is probably never or very rarely the case that all parts of the
body are affected in the same degree; even if it should be merely the
case that the right side is more affected than the left or the reverse.
But the examination of the parts affected is most necessary and most
required when the whole to which they belong is larger, and is
described merely in that general way which allopath seem to delight in.
Such names as headache, eyeache, toothache, colic and the like can in
no way contribute to a rational choice of a remedy, not even when also
the kind of pain is indicated.
Of
course, the exact individualization of the ubi is most necessary in
local ailments. Every Homoeopath knows from experience how necessary it
is, e. g., in treating toothache, to select a remedy which in
accordance with its provings on healthy persons has shown its action on
the especial tooth to be treated. Among the most striking and decisive
phenomena in this respect we should especially number the sores on the
upper side of the joints of fingers and toes, which under allopathic
treatment frequently prove very obstinate, and not unfrequently become
malignant, and necessitate an amputation, and, as I had an opportunity
of witnessing here in two cases, may even have a fatal result. Every
Homoeopath knows the efficacy of Sepia in these ulcers of the joints,
which have no otherwise distinguishable features when this remedy is
taken internally; without any external medication it will have a sure
effect. Medicines which correspond to similar ulcers on other parts of
the body in such cases are utterly useless.
If
the practice of auscultation and percussion, as well as the use of the
stethoscope, the plessimeter, etc., had been as well known to Hahnemann
and his pupils as to our young physicians, they would no doubt have
made the most extended use of the same for gaining a more exact
knowledge and delimitation of interior ailments. They would have found
out in lung troubles, e. g., definite local signs pointing to the use
of certain remedies, and would have indicated them more accurately, and
would not have limited themselves to defining them as being on the left
or on the right side or at the top or below. To bring up to date and to
specify more closely might be one of the chief duties for those who
make additional provings at the present time, and might serve to an
important and essential enrichment and completion of our Materia Medica
more than a whole mass of confirmations of older symptoms or the
finding out of new ones, which mostly have a lack of individuality.
At
the same time it will be conceded from the allopathic side that the
closer delimitation of the part affected, even though it may be of
moment in the completion of the diagnosis, will be of no use to
allopathic therapy, because this school is unacquainted with the
peculiarities of the various medicines. No allopathic Materia Medica
gives any information that the one remedy, e. g., corresponds more to
the anterior or the posterior lobe of the liver, more to the upper or
the lower part of the lungs, on the right or the left side, according
to which the choice of the remedy may be made. Even if we Homoeopaths
do not as yet know this as to all remedies, we do know it with respect
to many of them, and for what is lacking we find a substitute in other
signs, since, as is well known, all of these correspond to the remedy
to be selected, at least they must not be opposed to it. Thence it may
be seen that these new inventions, the value of which I am not in any
way inclined to undervalue, have far less value in a therapeutic
direction than in prognosis, where they show the extent and the
dangerous nature of the malady.
Finally,
we must yet consider in this question that neither the internal
changes, which can be determined by these instruments, nor the material
external changes, which manifest themselves openly to our notice, ever
present the dynamic disease itself, but are only its products, and are
only developed in the course of the disease. When, therefore, these
first beginnings are checked by the suitable remedy before those
disorganizations take place, then these latter would not come to be
developed, and it would be an inexcusable procedure to allow these
sufferings to advance to a point where these material changes can be
recognized in an artificial manner. It was necessary to mention this,
in passing, in order that it may be shown how Homoeopathy proceeds, and
to deny most decidedly the objection sometimes made that Homoeopathy is
merely an expectative method, which allows the disease to develop
without hindrance until it is too late to help. On the contrary,
Homoeopathy knows and uses in infectious diseases sure prophylactic
remedies, which are always and exclusively such as have the power to
heal the disease itself, and they never omit their use for the
protection of those around the patient.
4.
Quibus Auxiliis?-If
the hexameter which we are following had been originally written for
our doctrine, probably a more suitable expression would have been used
in this instance, e. g., quibus sociis or quibus comitibus? Still the
name does not matter, and it is manifest that it must refer to the accompanying
symptoms.
Now
since in Homoeopathy the chief aim consists in ascertaining the remedy
which most completely corresponds to the totality of the symptoms, it
is evident that this point is of the greatest importance and deserves
the most careful consideration.
For
every disease presents in its recognizable phenomena a more or less
numerous group of symptoms, and it is only their totality which
presents its complete image. This image may be compared to a portrait,
which can only then claim to be a striking likeness when all the
features of the original are faithfully presented in it. It is not
sufficient that mouth, nose, eyes, ears, etc., should be presented in
such a manner as characterizes man, and distinguishes him from the
monkey and other animals but as every human physiognomy possesses its
peculiarities and is distinguished from every other, so also here the
more or less strongly pronounced abnormalities must most carefully and
with the greatest faithfulness and truthfulness be presented and given
their prominence. If, therefore, retaining our former comparison, the
nose should have a most peculiar form, color or size, it would not be
sufficient to present this alone, though it should be most lifelike,
and to add all the rest according to fancy, but also the secondary
parts, which, as it were, form the back-ground, must present a whole,
such as it exists in reality, in order to give a perfect likeness.
It is from
this point of view that the concomitant ailments are
to be regarded when we select a remedy according to the motto: Similia
similibus.
Thence it is evident that the rare, striking and peculiar symptoms
which present themselves demand a more prominent place than the common
ones, because on them chiefly though not exclusively the similitude
depends.
From
this it naturally follows that the value of such concomitant symptoms
for the purpose intended varies widely. But it would too far transcend
the purpose of this contribution if I should adduce and explain all the
many categories of value. I shall therefore limit myself to the
presentation of a few of the most important points here involved:
First
of all, those symptoms which are found in almost all diseases may be
left out of our count, unless they manifest themselves in a striking
manner.
The same
obtains as to those ailments which are wont to appear as constant
concomitants or at least as usual in the disease under consideration,
unless they should be distinguished by some rare peculiarity and in
this respect offer something characteristic.
On the other
hand, all those attendant symptoms should be carefully noted which (a)
rarely appear in connection with the leading disease, and are,
therefore, also found rarely among the provings; (b)
those which belong to another sphere of disease than the chief ailment,
and (c)
lastly, those which have more or less of the characteristic signs of
one of the medicines, even in case they have not before been noticed in
the present juxtaposition.
Now
if besides this among the last mentioned concomitant symptoms there
should be one or another in which the genius of one of the remedies
should be plainly and definitely portrayed, so that it would be plainly
pointed out, this one symptom thereby would acquire such an importance
that it would even outweigh those of the chief ailment, and may then be
at once considered as the most suitable. Such a symptom would be
included among those which Hahnemann calls "striking, strange, unusual
and peculiar (characteristic) signs," and which are then "almost alone
to be considered" because they preeminently give to the whole disease
its individual character.
One
circumstance deserves to be particularly mentioned here which
particularly shows the importance and value of concomitant symptoms,
namely, that several very efficient and in part specific remedies in
certain diseases were discovered almost exclusively through them, the
other symptoms indicating the main disease not having pointed in that
direction, nor indeed could they have given such an indication, because
the noticeable proximate signs could not sufficiently indicate the real
peculiarity of the disease. This same system of concomitant symptoms
also gives to Homoeopathy a much greater sureness in the treatment of
diseases as compared with Allopathy, which first constructs for itself
a frequently deceptive diagnosis of the disease, which at most only
points out the genus of this disease, and where there are important
attendant symptoms it endeavors to help itself by adding to the leading
remedy given for the genus of the disease one or another additional
remedy to cover the concomitant ailments.
5.
Cur?-Why? The causes of the disease play
a prominent part in pathological books, and justly. But a large part of
this amounts only to guesses and attempts at explanation, which mostly
have only a very subordinate value or none at all in the proper therapy
of the disease, and which are too remote for our doctrine which is
directed merely to the practical.
The causes of
diseases are most generally and, indeed, very properly divided into
external and internal.
The
internal causes properly refer only to the general natural disposition,
which in some cases amounts to a peculiar supersensitiveness
(idiosyncrasy). The external causes or occasional causes embrace
everything which, where there is such an internal disposition to
disease, may produce disease.
The
general natural disposition which is also called the proximate cause,
really belongs to the first question (Quis?) which respects the
individuality of the patient. It only belongs here in so far as the
consequences of a former disease may have modified the original natural
disposition, and thus it deserves mention.
The
occasional cause, however, is the matter with which the present
question occupies itself and which deserves to be more closely
considered. As to the natural disposition notified through previous
diseases, this either depends on the miasmatic-chronic nature of those
diseases as yet unexterminated, among which in agreement with the
teachings of Hahnemann many homoeopaths even at this day count psora,
syphilis and sycosis, or it is derived from the remains and
after-effects of acute diseases, which when, they do not belong to the
former, as is frequently the case, constitute the numerous class of
medicinal diseases or poisonings. Not unfrequently, however, we meet
with cases where both these momenta have cooperated to undermine the
natural health, thus producing a monster of a disease which is even
more deeply inrooted and more difficult to combat.
As
to the recognition and treatment of the first mentioned miasmatic
diseases and their complications, Hahnemann himself in his masterly
work on the Chronic Diseases left us the most complete directions,
founded on many years' experience. The much disputed division of
medicines into antipsorics and non-antipsorics need not be considered
here. It is enough to know that the former far excel the latter in
their effectiveness in chronic diseases, and that their originator has
nowhere excluded them from use in acute diseases. Later experience has
also taught us that additional medicines from our medical treasury
should be numbered in this category which have not been thus treated of
in that excellent work. I am only sorry that Hahnemann has not been
able to fulfill the promise which he give me in writing, that he would
treat as thoroughly and completely the images of syphilis and sycosis
with his accustomed mastership as he had done in the above mentioned
work (Vol. I, p. 58 ff. of the Second Ed.) with respect to latent and
re-awakened psora. Whether we may believe in what many somewhat
derisively call Hahnemann's Psora-theory, or reject the same, the
attentive practitioner must frequently have found cases where even the
remedy chosen with perfect correctness, in some acute disease, did not
unfold its proper and decided effect before one of the so much
criticised antipsorics-frequently Sulphur-had first been used, when
psora had been involved, or an antisyphilitic or antisycotic when
syphilis or sycosis had been present before and had remained uncured.
It must, however, be confessed to be one of the most difficult tasks of
the physician to always make the most suitable choice among the
antipsoric remedies, as most of them have almost the same symptoms and
very few truly characteristic symptoms are found with the different
remedies. The more necessary is it for the homoeopath to study with
continuous industry these lists of symptoms and to compare them with
each other in order that he may pick up the scattered grains of gold
for his use.
Poisonings
and medicinal diseases are in one line and it makes no difference by
whose hand any one has been deprived of his health by means of a
substance injurious to his organism; among these substances medicines
as will as poisons find their place. Of course, it is always of the
greatest importance to know in every case the medicines or poisons, in
order that they may be met by the proper well-known antidotes. The
simple poisons may be pretty easily and surely recognized by their
effects! It would have required but one case of poisoning occurring
before the eyes of a Homoeopath for him to have recognized the effects
of Arsenic, which yet remained unknown to all the allopathic
physicians, in the case of the thirty murders of Gessina Timme in
Bremen, until the facts were obtained. In the medicinal diseases this
is much more difficult, because seldom or never is one medicine given
by itself, but always mixed with others; it can not, therefore, yield a
clear and definite image. With these, therefore, it is necessary, as in
the other case it is desirable, and it facilitates the treatment, if we
can have a reliable account of what has preceded, and to be able to
look over the prescriptions. Since this may be of use even later on, as
the treatment proceeds, the journals of many Homoeopaths have a special
rubric reserved for this subject. We must consider these symptoms,
called anamnestic, as being of special importance in this question.
Although the ordinary consequences of such morbiferous circumstances
and events are mostly already contained in the lists of symptoms of the
medicines proved on healthy people, yet homoeopathic practice has long
ago shortened and made sure the tedious and troublesome path of such
investigations, and indicated for most of these cases the remedies
which are foremost in their usefulness in such cases. This is e. g.,
very much simplified in cases of contusions, sprains, burns and the
like. In other cases, e. g., in colds, the matter is already somewhat
more complicated, since the kind of a cold and the part of the body
affected offer differences which again point to different remedies.
Thus there is a great difference in this respect as to whether the
person has been simply exposed to the cold, or whether this took place
while the body was in a perspiration, or if he at the same time got wet
through. So also it is well known that different remedies are indicated
when internal parts (stomach, abdomen, chest) have been exposed, or
merely external parts (head, feet, back), and this must be carefully
weighed in every case. All this, as before said, is found among the
symptoms in the Materia Medica; but when once it is known that a cold
in the head from exposure to cold air, after previously being in a
heated room, or after having the hair cut, points to Belladonna or
Sepia; after taking cold in the feet, to Baryta or Silicea, and when at
the same time there has been a wetting, to certain other remedies, then
the attention will first of all be directed to these, and only
comparison be made with others which are also occasionally indicated
when the first are not sufficiently suitable.
Finally
we must yet add a word under this question about infectious diseases,
about which in pathological manuals we read so much that is
contradictory and unreliable; the influence of which teachings is,
however, much more far reaching than is generally supposed. To meet
these diseases, which often spread until they become a real calamity,
Homoeopathy has the most sure and approved prophylactics, and these,
indeed, are the very same which have the power of healing those
diseases when they have developed. Therefore, when we find in a family
a case of infectious typhoid fever, there the same remedy, which has
been given the patient in accordance with his symptoms, will also be
sure to, protect those in the house from infection, as it destroys the
natural disposition thereto, and it will even in the shortest time
restore those with whom there may have already been apparent the
beginning of the disease. This last fact is the more important, as
these first beginnings are usually so poor in symptoms that no certain
choice can be founded on them; but the known occasional cause fully
makes up for what is lacking. Of course, such a cure is not so
brilliant as when the patient has been at the verge of the grave, but
the gain for him and the consciousness of the physician is his
sufficient reward.
6.
Quomodo?-From
its etymology, this preposition excellently describes the essence and
the scope of the question before us. For the word Modus in the old
classics not only refers to the manner and mode in
general,
but also to all the modifications which can take place in anything,
thus the measure, the rule, the aim, the relations, changes, etc.; thus
whatever, with the exception of time, which is included
in our
last question (Quando), possesses the ability to produce a
modification, aggravation or improvement with the patient, naturally
belongs, according to the usage of the language, to this rubric. This
question has a double importance to Homoeopathy, first, because it was
first discovered and developed by Homoeopaths, and is, therefore, their
indisputable and exclusive property, and secondly, because all the
results of provings and of experience, without exception, belong to the
more or less characteristic signs, of which no one is a matter of
indifference, not even those of a negative kind.
Allopathy
has never given any general attention, which might have been of use to
therapy, to this moment. At least its manuals on Pathology, Therapy and
Materia Medica contain nothing of importance on this subject.
Homoeopathy, on the other hand, soon after its discovery, recognized
its great therapeutic value, and we find the first but already clear
traces of it in Hahnemann's "Fragmenta de viribus medicamentorum
positivis," which appeared in the year 1805. But during the progressive
development of our science its importance appeared more manifest, and
it was soon declared to be indispensable, so that in the later provings
the attention was more and more directed upon it. On this account the
latter provings are the more complete, with the exception of those made
by Hahnemann in the Materia Medica Pura, which were elaborated with
especial industry and on account of their constant use accompanied with
copious notes.
If
we compare the lists of symptoms of the medicines which have been
proved somewhat fully, even a superficial survey will show that we find
in almost every one of them the general indications of almost every
disease; headache, colic, pain in the chest, diarrhoea, constipation,
as well as dyspnoea, pains in the limbs, fever and cutaneous ailments,
etc., are in no case quite absent. But if we study these indications
somewhat more closely, with respect to the special parts of the body
and the different sensations, then, indeed, differences will appear,
and we frequently discover symptoms which appear more or less
frequently in one remedy and are totally lacking in another. But the
number continues too large to bring the decision to a sure and
indubitable point, and we soon feel the need of securing additional
points in order that we may find the true and suitable simile among the
competing medicines. But the Quomodo with the Quando generally solves
the riddle in the most satisfactory manner, and not only removes every
doubt, but also furnishes the proof for the solution which we may have
before supposed to be the right one. That in such investigations and
comparisons we must also, as in what precedes, occupy the especial
standpoint, is a matter of course. It is not sufficient, e. g., to
merely consider motion in general in contrast with rest in the body, or
in the part affected, we must also consider incipient and continuous
motion, as well as the different kinds and degrees of motion. The same
applies to lying down, we must not only consider the kind of position
(on the back, on the side, doubled up, horizontal, etc.), but also
aggravation or improvement in the parts affected by lying on the
painful part, or the part not painful; all this is to be found out
accurately and adapted to the remedy.
Quite
a prominent part in this rubric is occupied by the partaking of food
and drink, and this not only in diseases of the digestive organs, but
also in fevers and other internal and external affections. Here it is
not so much the amount of appetite, or thirst, to which also allopathy
in some cases gives a proper importance, but especially the dislike or
the desire for particular kinds of food and drink, and more especially
also the change of condition after partaking of one or another article
of food that often gives the most important hints as to the medicine to
be selected. All experienced Homoeopaths have therefore always given
the greatest attention to this subject, and it is very much to be
desired that whatever different persons have discovered in this
direction should be collected and published.
It
was mentioned above, in passing, that even negative signs, so far as
they belong to this rubric, should not be neglected. An example will
show best what is meant by this: when a patient, for whose condition
Pulsatilla seems suitable according to the five preceding questions,
feels best while at rest in a warm room, while he feels uncomfortable
in the open cool air, and also is fond of fat foods and bears them
well, or offers other peculiarities which are in conflict with the
characteristics of Pulsatilla, this would give an urgent cause to doubt
the applicability of it to his case and to look for another remedy
which also in these points corresponds with the symptoms.
I
am sorry that the space for these contributions, which anyways may seem
to have been already greatly exceeded, does not permit me to enter more
in detail on one and another matter belonging to this division, as I
may openly confess that I consider the indications obtained from this
and the following question as the most important, indubitable, and
therefore the decisive ones for therapeutical purposes. Even the
numerous class of reflex actions, almost all of which fall into these
two rubrics, do not by their internal contradictions diminish this
importance, as soon as we know their mutual value, and are, therefore,
enabled to estimate properly the worth of each.
7.
Quando?-This last question concerns the time
of the appearance, of the aggravation or the improvement of
the ailments, and follows in natural order after the preceding, and is
hardly of less importance in therapy than the last one.
From
the time of Hippocrates and his commentators up to our times great
attention has been bestowed on the periods of time in the various
phases and stadia of the disease. The endeavor has been made to fix the
period and continuance of the beginning, of the increase, the acme, the
decrease and of the end of the disease. This would, indeed, make a
useful contribution to the recognition and the characterization of the
disease. But only in case it should be left altogether to itself and
not be modified by medical interference. But on the other hand it can
not be denied that this cannot give the least aid in the selection of
the remedy, if only owing to the fact that the medicines cause
disturbances in the natural course of the disease, which frequently lie
altogether outside of all computation. Least of all can they be of any
advantage to allopathic therapy, because it lacks all criteria from
which to indicate the one or the other. I hope that I may not here hear
the objection that, e. g., the periodical return of a fever points to
an actual or a disguised intermittent fever and therefore indicates
Quinine in its various preparations; for we are not likely to find a
homoeopath who has not in his practice had to treat numerous victims of
this error.
Homoeopathy
intends something quite different in this question, having nothing in
common with what precedes. But it is concerned with two momenta which
have an immediate effect on the choice of the remedies, namely: (a),
the periodical return of morbid symptoms after a longer or shorter
cessation, and (b), the aggravations and alleviations depending on the
time of the day. These two will require but a few words.
The
periodical return of morbid phenomena often coincides with periods of
time which carry with them particular occasional causes. Among these
are to be numbered the menstrual ailments, as well as those which ate
conditioned by the seasons, the weather, etc. Where such definite
secondary causes cannot be discovered, and where as is mostly the case,
the attacks are not closely bound to any sharply defined periods, they
have no therapeutic value for homoeopaths as they lack the quality of a
useful indication.
But
of the greater importance are the aggravations and alleviations at
particular times of the day, and this with respect to those which refer
to single symptoms as well as those that refer to the general health.
In this respect Homoeopathy possesses a great and valuable treasury of
well prove experiences which are being more and more enlarged by
careful observations. For there is hardly any disease, from the
malignant internal fevers down to local ailments, in which during the
different times of the day there does not manifest itself a more or
less decided and distinct aggravation or alleviation. Now since
homoeopaths have learned these peculiarities also in the various
medicines during their provings on healthy persons, they are enable to
make extensive and blessed use of this peculiarity in their
therapeutics, and they are obliged to do this in order that they may
satisfy the rule Similia similibus also
in this respect.
To
demonstrate the preceding with some special facts, I will only adduce
here the importance which the time of the day has on coughs with
respect to the expectoration, as well with respect to the greater ease
with which it is discharged, as also the consistence and the taste.
Something similar we know about the stools, and although most of the
remedies have diarrhoea among their indications, we so far know only of
two (Conium and Kali carb.) where this takes place only by day and not
by night.
With
respect to the ailments which have a typical return, independent of
other causes, we have a considerable series of remedies corresponding
to this, without on that account excluding others, when they are
indubitably indicated by their symptoms. Only in cases where this
return is sharply and definitely pronounced, as for example in the
evening from 4 to 8 o'clock (Helleborus and Lycopodium), or exactly at
the same hour (Antimon. crud, Ignatia and Sabadilla), we should give it
a special importance and only be careful that there may be no
contra-indications.”
[Source:
A contribution to the judgement concerning the
characteristic value of symptoms, BOENNINGHAUSEN
Clemens von, (allg.
hom. zeit., vol. 60, p. 73 ff.)]
“The
teaching of the Organon in this matter really contains the proper, true
kernel of the answer, and this, of course, deserves to be first
premised. It is found in the great Paragraph No. 153 (5th Ed.) and is
as follows:
"In
seeking for the specific homoeopathic remedy, i. e., in this
juxtaposition of the phenomena of the natural disease and the list of
symptoms of the medicines, in order to discover a morbid potency
corresponding in similitude to the evil to be cured, the more striking,
particular, unusual and peculiar (characteristic) signs and symptoms of
the case should especially and almost solely be kept in view; for there
must especially be some symptoms in the list of the medicine sought for
corresponding to this, if the remedy should be the one most suitable to
effect the cure. The more general and indefinite symptoms, such as lack
of appetite, headache, weariness, disturbed sleep, uncomfortableness,
etc., in their generalness and undefinedness deserve but little
attention, unless they are more especially pronounced, as something of
such a general nature is seen in almost every disease and in almost
every medicine."”
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