Totality of Symptoms Sec 153-144 Organon
NATIONAL JOURNAL OF HOMOEOPATHY 1998 May / Jun VOL VII NO 4.
In section 18 of this much-neglected book, Organon, we read that the totality of the symptoms is the sole indication for the selection of remedies. This is true if we understand that in this totality are contained the symptoms which control the choice. It is not true if one understands that all the symptoms in this totality are of equal value in their control of this choice. That this is not what the author intended to teach, is made quite clear by sec 153, which may be taken as a commentary of sec 18. In this sec 153 he says "in searching after the specific remedy....we ought to be particularly and give almost exclusively attentive to the symptoms that are striking, singular, extraordinary and peculiar characteristic. For it is to these latter that similar symptom, from among those created by the medicine, ought to correspond, in order to constitute the remedy most suitable to the cure. On the other hand, the more vague and general symptoms merit little attention, because almost all diseases and medicines produce something as general.
Now in seeking the specific remedy for a given case of sickness, according to the Hom method, right understanding of sec 18 and 153 is indispensable if mistake and failure are to be avoided. To find all the symptoms of the case to be treated in a single remedy is often impossible, for the reason they are not in the record of any one so to seek for them will often be only labour lost. Natural diseases are not gotten up in patterns exactly adapted to those recorded. As the result of the action of ingested drugs the like which cures does not necessarily consist in the resemblance in its entirety. When this does obtain and can be found, the cure is for this reason the more certain assured. But if cures were limited to such cases the practical value of Hom law would be reduced far below true standard.
How then are we to reconcile these two sections when we accept them as our practical guides? One requires totality of the symptoms, while the other those most striking etc. the one seems to demand the whole, the other; but a part. We ans sec 18 teaches simply this, that we have not other guides to the selection of curatives than the symptoms of the case to be cured. Its chief intent is to exclude from this selection all abstract notions and hypothesis of whatever name. This was the more needed at the time this paragraph was written for the reason that these then constituted almost the entire furnishing of the then current school of medical practice. It is still needed for the 4 reason that the old time poverty in practical resources is still prevalent, as is the old endeavour to conceal this fact by pretences to knowledge of that which only exists in the imagination, which pretences are not more responsible because presented in terms which time and teaching have incorporated into current medical thought and practice.
"The symptoms alone are the guide" says the objector. That is just what this paragraph is intended to teach, and not that every symptom of a case is to be found in the record of its curative before it can be accepted as such. "Then, continues the objector [old school] "your treat only symptoms and not diseases at all. This has been cast at the Hom school as a reproach from the beginning and with as much of boldness and arrogance as if its opponents had really something else to treat. "We treat diseases" indeed what are these but names, often arbitrary and without significance, of which nothing is or can be known, except through manifestations to the patient or physician whom we call symptoms? Aside from these, diseases are, as to all knowledge of them, but abstract ideas of things unknown, and except through these manifestations unknowable, as object of curative endeavour. The old school pretence that a treats diseases as something distinct from these resolves itself into the very empty abstractions and hypotheses which this section was intended to antagonize.
But, how shall we understand the terms of the commentary? By the words striking, extraordinary etc? Our first remark in our endeavour to get at the true meaning of these is that by the most striking the author cannot mean that symptom which first and most forcibly seizes the attention of the physician., the patient and his friends. To make this apparent, take a case of dysentery. That which first arrests and holds the attention of all is the pain and tenesmus. But these are so general that they belong to all cases of this disease and therefore by this fact are relegated to that category of symptoms which the author assures us 'merit little attention' Without these no case is dysentery. It is evident then the (Vptill here)author does not use the word in this sense. His real meaning is better expressed by the last term employed to indicate the class of symptoms to be chiefly regarded in our search. "Peculiar" This is it. But what does he mean by the word here? Evidently that we are to give chief attention to symptoms which are "peculiar" to the case in and not necessarily to those which cause the patient most suffering. That which is peculiar to the case characterizes it as a member of a family. The general or defining symptoms declare the family to which this member belongs. Then it is the peculiar or specific symptoms, which are our chief guides in our discovery of the specific cure of the case. But it may be asked is not that peculiar to a disease which is found in which it is used here. If this were so, then in a case of dysentery, for example, we should have, under this direction, only to notice the pain, tenesmus, and the other defining symptoms which belong to this and all other cases of the class and find in the similar of these the curative under the law. We have all tried this, and have been disappointed in our expectations of the cure we supposed the law promised our expectations of the cure we supposed the law promised as the result of this proceeding. The disappointment came from our misunderstanding of the requirements of the law.
It will come in every case so treated. Success can follow only in those where the remedy chosen happened to have in its record, with those defining symptoms, those other and less obtrusive ones which individualize the case, and in which curative relationship between drugs and diseases alone resides. If the cure follows in cases so treated, in the prompt and pleasant manner a right compliance with the demands of the law assures, it is because the practitioner has been guilty of a fortunate blunder. This will be sufficiently plain if we remember that Hom prescribing is specific prescribing. That is, finding and giving to the sick the one specific medicine the cure of his case requires under the law. Hom presumes the existence of such a remedy in every case of sickness, it imposes on the physician the duty of finding it. If in any case, as may well happen, either from poverty of our resources or from lack of knowledge the one remedy cannot be found ie a remedy which in its known effects on the organisms are found the symptoms which constitute it the specific in the case, by virtue of the required similarity then that must be selected which has greater similarity to the elements of the diseased manifestation than any other . This resort to that which is less than perfect because of the above necessity is no argument against the right of the presumption of the existence of that which is perfect ie some drug in which is the power to produce symptoms with the required resemblance to constitute it the required specific. This drug may not yet have been proved or if proved and known to the physician, and hence the necessity of this resort to that which is less than perfect. Neither does the fact that this resort is followed at times by a cure, which though less prompt and complete than that from a specific remedy, is nevertheless ultimately a cure, excuse the prescriber form the utmost endeavour to find that which is perfect. This is ever to be the one object of his life work, to find the one specific; failing in this endeavour is failing in the first and most important of his duties.
That the above view of the one hundred and fifty third section which refers defining symptoms to a subordinate importance in search for the specific remedy, is the true one may be seen still more clearly if we attempt a prescription based on these as a chief guide. The impracticability of this will appear if, when we accept those as our guides, we and this that it may be such it must be in its effects on the organism that which is most like those defining symptoms of our case. The case is dysentery the defining symptoms of which are frequent discharges from the rectum of blood or mucus, or both with colicky pains, tenesmus, and fever. Now there are as to the first of these, a multitude of cases met with in practice, the discharges of which are so much alike, and so like those recorded as having resulted from the action of a multitude of remedies on the organism, that no man can tell from those in a given case which of this multitude in this particular is more like the case in hand than the others and therefore is for this case its specific cure. The discharges are smell of mucus fixed with blood, and here is all they have to tell in very many cases, and the records of the effects of may drugs tell the same story so exactly that no man can tell which of them has most resemblance to that of the case in hand. The same is true of the pains. From these alone no man can tell whether they are more like those which have resulted form one or other of the many drugs form which we have to choose in treating our case, and therefor we cannot tell whether one or the other is most like the pain in the case for which he is seeking a remedy. This he may feel sure of that that which he seeks as one of the many, but which of these? To answer this question on a better foundation than a guess will necessitate a preference to other elements of the case, and these belong evidently to that other class of symptoms which this one hundred and fifty third section commends to our chief attention - those which are the specifics of the case. These remarks are equally applicable to the other defining symptoms the tenesmus and fever.
We have said Homoeopathy is specific prescribing. Its practice is ever and only a successive finding of the one specific remedy for each succeeding case as it becomes a subject for treatment. This being found, it needs no second for its aid in the cure. If otherwise, then it fails, to fulfill the office of a specific and this is proof sufficient that in this case at least the prescriber has failed. If it be true that there are such specifics for the cure of the sick and that the finding of them is possible under the guidance of the two sections of the Organon we have been discussing, then the superfluity, to say the least of all so called adjuvant is demonstrated whether these be of external or internal application. But we may go further, and as no man can tell beforehand how this so called adjuvant is or is not to modify the action of the specific remedy, that while it is in all cases needless, in many it must by such modifications become positively injurious. This view, it will effectively disposes of the liberty which has of late been so often and so earnestly claimed, to do as one pleases in the discharge of his practical duties in this matter of adjuvant and in all others at variance with the teaching of the two sections we have been considering. If one claims this liberty and acts upon it in his clinical duties to the prejudice of the section of the specific remedy selected than there is another liberty, which, by so doing he deprives himself of the liberty to call himself afterward a Hom physician.
The view of practical law and duty which we have been presenting if admitted as authoritative will also dispose of another fashion of practice that of prescribing at the same time tow or more remedies to be given in alternation, at definite intervals of time, in the absence of all knowledge of what will be the condition of the patient at the lapse of either of these intervals and therefore not knowing whether either of the given remedies will or will not be specific for his case at the time it is directed to be given. If either of the prescribed remedies be the specific for the case in hand the other cannot be. The idea of a specific for the case, made such by the law of similar, excludes the possibility of a second in the same case., as it is impossible that each of these tow can be 'most like' One or neither of the two may be but both cannot. That which is not is at least useless, often mischievous and never homoeopathic. If to be this it is indispensable that each prescribed medicine shall be that which in its ascertained action on the living organism presents the most perfect likeness to the phenomena of the disease to be cured.
[Report from Homoeopathic Heritage, Feb 1995]
P P WELLS M.D
