Module Title 9 Symptomatology And Evlauation Of Symptoms
In this module, we will learn about the ways through which homeopathy triggers the body’s natural ability to heal. This module teaches us about the benefits of using homeopathy and the scope of remedies for treating ailments in a gentle way. Sources of homoeopathic drugs are also explained. It also explains the qualities required to be a good practitioner and the need of philosophy. Branches of medicine and its basic principles are also explained. Vital force theory, disease, heredity, lifestyle hygiene and mind is also explained. Different approaches required in different cases are also discussed. Acute diseases and different conditions in which they affect the human body are explained along with chronic diseases and the fundamental cause is also explained.
In this module, we will be learning about brief biography of Hahnemann, achievements of Hahnemann and criticism of the practice of his time. As a child Hahnemann showed remarkable aptitude for study. He had an exceptional talent for languages. Samuel Hahnemann, in full Christian Friedrich Samuel Hahnemann, (born April 10, 1755, Meissen, Saxony [now in Germany]—died July 2, 1843, Paris, France), German physician, founder of the system of therapeutics known as homeopathy.
Hahnemann studied medicine at Leipzig and Vienna, taking the degree of M.D. at Erlangen in 1779. After practicing in various places, he settled in Dresden in 1784 and then moved to Leipzig in 1789. In the following year, while translating William Cullen’s Lectures on the Materia medica into German, he was struck by the fact that the symptoms produced by quinine on the healthy body were similar to those of the disordered states that quinine was used to cure. This observation led him to assert the theory that “likes are cured by likes,” similia similibus curantur; i.e., diseases are cured (or should be treated) by those drugs that produce in healthy person’s symptoms similar to the diseases. He promulgated his principle in a paper published in 1796; and, four years later, convinced that drugs in small doses effectively exerted their curative powers, he advanced his doctrine of their “potentization of dynamization.” His chief work, Organon der rationellen Heilkunst (1810; “Organon of Rational Medicine”), contains an exposition of his system, which he called homeopathy. He detailed the symptoms produced by “proving” a large number of drugs—i.e., by systematically administering them to healthy subjects.
In this module we will be learning about the cardinal principles of homoeopathy. The cardinal principles are law of similia, law of simplex, theory of vital force, law if minimum, doctrine of drug proving, theory of chronic disease and doctrine of drug dynamization. The cardinal principles are well explained. Brief explanation of miasms, as the fundamental cause of disease is well explained. Nature’s law of cure is that a weaker dynamic affection is permanently extinguished in the living organism by a stronger one, if the latter (whilst differing in kind) is very similar to the former in its manifestations. Both weaker and the stronger affections are dynamic in nature and similar. There is difference between homoeopathy and isopathy as homoeopathy uses the similar potentised substances whereas the isopathy uses the same potentised substances for medication. The qualities of physician are that he should have moral character, he must be honest, hardworking and free from complexes, regular and punctual, polite, sympathetic and dutiful towards sick, must know his limitations, should be faithful and unprejudiced observer of all facts so that he can grasp the conditions quickly and correctly. Physician should not be lazy, proud, greedy and crazy for fame and must possess the optimistic view towards life. The mission of physician is to restore the sick to health that is to cure by following the highest ideal of cure that is rapid, gentle and permanent restoration of health. The relation between the vital force and the disease is well explained.
In this module, we will learn interpretation of the sick, disease and vital force with emphasis on human as a single entity. The difference between allopathic and homoeopathic principles are highlighted. Homoeopathy perceives that there is always something prior to pathological changes of the human body. The simple substance of the human body is the vital principle that keeps all the functions of human body in harmony. The investigation of the cause of the disease is very much important before taking the case as nothing exists without a cause. Diseases are nothing but collection of certain signs and symptoms which cause disturbance in the human body and diminishes strength. Man becomes sick first at the mental plane and then the disease shifts to the physical body that is on skin, hairs, nails and other vital organs.
There are apparent diseases which are not really diseases but merely disturbed states of health which may be called as indispositions. They are also known as mimicking sickness. A psoric individual has periods of indispositions from external cause but these external causes do not inflict psora on an individual. Such a patient may disorder his stomach from abusing it and thus create an indisposition. Indispositions from external causes mimic the miasms, i.e., their group of symptoms is an imitation of a miasmatic manifestation, but the removal of the external cause is likely to restore the patient to health. True knowledge consists in becoming acquainted with and understanding the nature and quality of a remedy, its appearance, its image and its relation to man in his sickness; then by studying the nature of sickness in the human family to compare that sickness with symptoms of the Materia Medica. By this means we become acquainted with the law of cure and all that it leads to, and formulate doctrines by which the law may be applied and made use of, by arranging the truth in form to be perceived by the human mind. Hahnemann says, “In a word, the totality of the symptoms must be the principal, indeed the only thing the physician has to take note of in every case of disease, and to remove by means of his art, in order that it shall be cured and transformed into health.”
In Homeopathy susceptibility is considered as the general quality or capability of the living organism of receiving impressions; the power to react to stimuli. Every real medicine, namely, acts at all times, under all circumstances, on every living human being, and produces in him its peculiar symptoms (distinctly perceptible if the dose be large enough) so that evidently every human organism is liable to be affected, and, as it were, inoculated with the medical disease, at all times and absolutely (unconditionally), which, is by no means the case with the natural disease. In contagion (and consequently in cure) there is practically but one dose administered, or at least that which is sufficient to cause a suspension of influx. When cause ceases to flow in a particular direction it is because resistance is offered for causes flow only in the direction of least resistance and so when resistance appears influx cease the cause no longer flows in. The cause of disease and of cure exists within the primitive substance and not in ultimate material form, although the immaterial cause of disease continues in disease ultimates.
The immaterial vital principle, i.e., simple substance, everywhere pervades the organism, and in disease this disorder everywhere pervades the organism, it pervades every cell and every portion of the human economy. We will see in course of time that the change in form of a cell is the result first of disorder, that the derangement of the immaterial vital principle is the very beginning of the disorder, and that with this beginning there are changes in sensation by which man may know this beginning, which occurs long before there is any visible change in the material substance of the body. The material organism, without the vital force, is capable of no sensation, no function and no self-preservation. It derives all sensation and performs all the functions of life mainly by means of the immaterial being (the vital force) which animates the material organism in health and in disease. It is clear that Hahnemann wishes to teach that it is a disorder of the activities of the internal man, a lack of harmony or lack of balance, which gives forth the signs and symptoms by which we recognize disease. To call a group of symptoms a disease of one part, and another group of symptoms a disease of another part is a great heresy and leads to errors in prescribing that can never be corrected. Organic change is the result of disease. Materialism has greatly increased in the modern era. The materialist refuses to believe anything that does not conforms to the laws of time and space. It must be measured, it must be weighed, it must occupy space, or he has no idea of it, and will distinctly affirm that without this it is nothing and has no existence.
In Homeopathy, remedies are selected on the basis of Totality of symptom. The most appropriate remedy suitable to the patient is called similimum. When such a similimum is given to the patient, at times a temporary intensification of the symptoms may occur to the patient. This aggravation shall be mild and usually last only for a short period. Such an effect sometimes occurs following the first dose of the remedy or when the remedy has been taken more often than needed or if the person is unusually sensitive. The homeopathic aggravation after the administration of the curative remedy is the reaction of the organism, as it responds to the gently stimulating action of the medicine. This aggravation may only be a slight worsening of symptoms and may hardly be noticed by the patient. As Hahnemann said in aphorism 158 of Organon of Medicine, a slight homoeopathic aggravation in the first hours is a good indication that the acute disease will probably be cured. If aggravation is marked, or if it persists, this may because the patient is proving the remedy, because a remedy that is poorly matched may actually induce new symptoms in the patient. An aggravation caused by the smallest possible dose will be easily overcome by the vital force and does not prevent cure. It is often not perceptible in patients unless they are oversensitive. The intensity and duration of the similar aggravation gives us a clue about the correctness of the chosen remedy, the patient’s vital force, prognosis, and for case management.
A detailed explanation of the following kents 12 observations have been made in this module-
- A prolonged aggravation, and final decline of the patient
- Prolonged aggravation, then very slow improvement
- The aggravation is quick, short and strong with rapid improvement of the patient
- Recovery without any aggravation
- The amelioration comes first, then comes the aggravation
- Too short relief of the symptoms
- A full time amelioration of the symptoms, yet no special relief of the patient
- Some patient proves every remedy they get
- Action of the medicines upon provers
- New symptoms appear after the remedy
- Old symptoms are observed to reappear
- Symptoms take the wrong direction
The vital energy is that force which animates each individual. Every individual is a unique individual and everyone has a particular essence that is not found in any other person that divides his individuality from all others. In our thesis, homoeopathy is fundamental, scientific and based on natural law of Similia. In taking the case, the homoeopathic physician has two objects in view-
- First, there is the object of Diagnosis .
- Second and greater object in taking the case is to select the true symptoms of the patient .
The homoeopathic physician can have no other object in making a diagnosis than to classify the symptoms under a group head, since he never uses his diagnosis for therapeutic purposes. In this, he differs from the ordinary school of medicine, which uses the diagnosis as a guide to the desired therapy. In analysis of the case, the value of symptoms must be taken into consideration on several points. So, what we are doing here is we are giving value to the symptoms. The first point that is of importance is the personality, the individuality of the patient, must stand out pre-eminently in the picture. Palliation happens when we give a treatment, the clinical symptoms go, and the patient generally feels much better. With suppression, one or more symptoms disappear permanently, either quickly or slowly. The medicine need not be continued or repeated. The patient may continue to have other symptoms, or generally does not feel better.
Some of the external features that may suppress the normal functions of the vital force, and through the vital force the normal functioning of the body are shell-shock, fright, fear, excessive joy, intense unsatisfied longing for mate or offspring, unrequited love, extreme fatigue or exhaustion; all these forces have an influence upon the vital energy, and so suppress its natural functioning. In the chapter, ‘Deflected current’ Dr.H.A Roberts explains some common obstacles that interfere the smooth curative process of homoeopathic indicated remedies. In incurable cases, or seemingly incurable cases, we must not put a limitation on the possibilities of the similar remedy, for in many seemingly incurable conditions the similimum will so completely meet the situation as to obliterate the symptomatology of disease and the pathology, and will restore the patient to health. In some cases, one must know the obstacle to cure if he is to be able to serve the patient with any degree of real assistance; although it is one of the greatest boons of homoeopathy that so many of our remedies have in themselves the power to antidote massive drugs, and so release the vital power inherent in the patient himself, with the corresponding response towards cure.
The Philosophy of Homoeopathy rests upon the following general interpretations of the system of nature which science universally recognizes as fundamental.
- The laws and ways of Nature are uniform and harmonious.
- Effects follow causes in unbroken succession.
- To every action there is an equal and opposite reaction.
- Action and reaction are ceaseless, equivalent and reciprocal
- Motion is ceaseless and transformation continuous.
- Matter is indestructible and infinitely divisible.
- Force is persistent and indestructible.
- The quantity of action necessary to effect any change in nature is the least possible.
Homoeopathy an Experimental Science. -Like chemistry or physics, homoeopathy is established under the principles of the inductive method in science. Considered as a science, it consists of two series of phenomena, independently observed, collected and studied, connected by an underlying law or principle of nature. Its elements are: 1, The phenomena of disease; 2, the phenomena produced by drugs when administered to healthy persons; and 3, the general law of mutual action, otherwise known as Newton’s Third Law of Motion and as the Law of Similars, which connects the two series of phenomena. The phenomena of disease constitute its pathology, the experimentally derived phenomena of drugs, its materia medica and the application of its materia medica under the law its therapeutics.
The various schools of philosophy may be broadly classified as materialistic, idealistic and substantialistic.
Materialism.-The doctrine that the facts of experience are all to be explained by reference to the reality, activities and laws of physical or material substance. In psychology this doctrine denies the reality of the soul as psychical being; in cosmology, it denies the need of assuming the being of God as Absolute Spirit or of any other spiritual ground or first principle; opposed to spiritualism. Materialistic theories have varied from the first, but the most widely accepted form regards all species of sentiment and mental life as products of organism, and the universe itself as resolvable into terms of physical elements and their motions.
Idealism.-That system of reflective thinking which would interpret and explain the whole universe, things and minds and their relations, as the realization of a system of ideas. It takes various forms as determined by the view of what the idea or the ideal is, and of how we become aware of it.
Substantialism.-The doctrine that substantial existences or real beings are the sources or underlying ground of all phenomena, mental and material; especially the doctrine which denies that the conception of material substance can be resolved into mere centres of force.
Human pathology is the science which treats of diseased or abnormal conditions of living human beings. It is customary to divide the subject into general pathology and special pathology. Special pathology is divided into medical pathology, dealing with internal morbid conditions, and surgical pathology, which deals with external conditions. General pathology bears the same relation to special pathology that philosophy bears to the special sciences. It is the synthesis of the analyses made by special pathology. It deals with principles, theories, explanations and classifications of facts. Homoeopathy is based, essentially, upon the law of antidotes, which is found by observation, experiment and clinical demonstration to be the law of mutual action or attraction, expressing the equality and contrariety of action and reaction, as manifested in the living organism by similarity of symptoms, and resulting in physiological and chemical assimilation or neutralization.
Antidotes are commonly divided into three classes, according to their mode of action: 1. Physiological or dynamical; 2, chemical, and 3, mechanical.
By posology (from the Greek, posos, how much) we mean the science or doctrine of dosage. A physiological dose means a dose of a drug, empirically selected, of sufficient quantity and strength to produce a definite, predetermined effect or group of symptoms. Practically it amounts to the maximum dose consistent with safety. A physiological dose of Atropine or Belladonna, for example, is one sufficient to produce dilatation of the pupils, dryness of the mucous membranes and flushing or turgescence of the skin. Every living organism is endowed with an inherent, automatic power of reaction to stimuli. By means of this power the organism offers resistance to everything which tends to injure or destroy its integrity or disturb its normal functioning. Resistance is manifested by suffering, pain, fever, inflammation, changed secretions and excretions, etc. This power is displayed when drugs are administered because drugs are inimical to health, in proportion to their power and the size of the dose. When the similar or homoeopathic drug is administered in disease, little or no resistance is encountered, because the sphere of its action has already been invaded and its resistance overcome by the similarly acting disease producing agent.
Constitution is defined as the structure, composition, physical make up or nature of a person, comprising inherited qualities and modified by the environment. In homoeopathy, the choice of remedy is based on a consideration of the totality of an individual’s symptoms and circumstances, including personality, behaviours, fears, responses to the physical environment, food preferences and so on. Von Grauvogl classified constitution as Oxygenoid, Carbo–nitrogenoid and Hydrogenoid. A diathesis is constitutional predisposition towards a particular state or condition. It is recognizable by certain psycho-physical characteristics, by a group of diseases encountered in the ancestors and by a number of associated disorders. Homoeopathy being a “SCIENCE OF INDIVIDUALIZATION” is based strongly on the premise that no two humans are alike. Each individual is a separate entity altogether. We all are made of the same flesh and blood but have different sensitivities, different tendencies and accordingly we react to the situations.
Dr Samuel Hahnemann classifies diseases into following great divisions-
- Diseases due to mechanical and external sources
- Diseases due to indisposition
- Acute diseases
- Chronic diseases
One sided disease are chronic diseases with one or two principle symptoms which obscure all the symptoms. Hence, they are less amenable to cure. Chronic diseases which are having too few symptoms are called one sided disease. The availability of symptoms are less in number in such diseases, as a result of construction of totality becomes difficult. Hence they are difficult to cure.
Types of one-sided diseases-
- One-sided disease with internal complaint
- One-sided disease with external complaint
Dr. Hahnemann gave description and treatment of “Mental Diseases” in Aphorism 210 to 230 in the “Organon of Medicine”.
- Mental diseases are a class of disease not separated from other diseases as in so called physical diseases; mental condition of the patient is always altered in physical sickness (Aphorism 210).
- Mental diseases are like other diseases where both the symptoms of body and mind are present but while the physical symptoms have declined; the symptoms of mind and disposition have increased till they appear one sided disease of mind and disposition (Aphorism 215).
- To trace an accurate picture of the so called one-sided mental diseases and treat it successfully with homoeopathy; the physician must note the individual disposition of the patient along with the totality of the symptoms (Aphorism 210, 211).
- Dr. Hahnemann criticised medical men of his time for cruel methods and physically punishing mentally ill patients. He says that such violent methods have no place in Homoeopathy (Footnote to aphorism 228).
Miasms may be defined as an invisible, inimical, dynamic principle which permeates into the system of a living creature, creating a groove or stigma in the constitution which can only be eradicated by a suitable anti-miasmatic treatment. If effective anti-miasmatic treatment does not take place, then the miasm will persist throughout the life of the person and will be transmitted to the next generation.
All the diseases of man are built upon psora; hence it is the foundation of sickness; all other sickness came afterwards. Psora is the underlying cause, and is the primitive or primary disorder of the human race.
The main mode of transmission of Syphilitic miasm is through impure coition. The only primary manifestation i.e., chancre appears seven to fourteen days after impure coition. First appears as little pustule, which changes into an impure ulcer with raised borders and stinging pains.
The word sycosis has been derived from the Greek word “sykon” which means a fig. sycosis is a venereal chronic miasm developed due to suppression of gonorrhoea and is primarily manifested externally by the cauliflower-like excrescences on the genitals.
The word symptom has been derived from the word `symptoma’ which means ` anything that happens’. A symptom can be defined as an external expression of the internally deranged vital force.
Evaluation of symptoms is a process of grading the symptoms according to their value and priority in order to individualise the patient, so that the physician can match them with the drug symptoms and select the similimum remedy.
Symptoms are the sole expression of the internal disturbance. It is a complex entity, as complex and differentiated as the man himself. It is only by the proper understanding of these expressions in disease and their proper classification and evaluation, that we can apply our guiding law, similia similibus curentur, intelligently and for the benefit of our patients.
Evaluation of symptoms requires
1.Maturity of mind.
2. Knowledge of medicine including normal and abnormal structure, function and psychology.
3. Knowledge of homoeopathic philosophy.
4. Knowledge of homoeopathic repertories and their philosophical background.