TOTALITY OF SYMPTOMS:

 Totality is not sum total of symptoms but it is logical combination of the symptoms, which characterize the person as well as individualizes the problem. Thus, all the symptoms which are classified and evaluated, do not form a working totality of the case.

 In aphorism 7 Hahnemann states that the totality of symptoms which are outwardly reflected picture of the internal essence of the disease ,that is, of the affection of the vital force.

 Staurt close defines ‘the totality of symptoms means all the symptoms of the case which are capable of logically combined into a harmonious and consistent whole,having form, coherency and individuality.Technically, the totality is more than mere, numerical totality of the symptoms. It includes the ‘concomitants’ or form in which symptoms are grouped.

 “The totality is that concrete form which the symptoms take when they are logically related to each other and stand forth as individuality, recognizable by anyone who is familiar with the symptomatic forms and lineaments of drugs and disease.(H.A.Roberts).

 “Totality of the symptoms is to therapeutist, the disease.”(Richard hughes)
 Boenninghausen says totality of symptoms not only sum total of symptoms but one grand symptom, the symptom of the patient. In totality 3 factors must be present.
 1. Locality
 2. Sensation
 3. Modality
 In addition Boenninghausen emphasized the special value of concomitants in the selection of similar remedy.

The concomitant symptom is to the totality what the condition of aggravation or amelioration is to the single symptom. It is the differentiating factor.
“The totality” is not therefore, a mere haphazard, fortuitous jumble of symptoms thrown together without rhyme or reason.Totality should express the individuality of the case

BOENNINGHAUSEN’S CONCEPT OF TOTALITY
 Quis –Personality,the individuality
 Quid –Disease, its nature and pecularity
 Ubi – Seat of the disease
 Quibus auxilis –Accompanying symptom
 Cur –Cause of disease
 Quomodo- Modification agg and amel.
 Quando- Time

BOGER’S CONCEPT OF TOTALITY
 Changes of personality and temperament
 Peculiarities of disease
 The seat of disease
 Concomitants
 The cause
 Modalities
 Time

 Kent says “the totality of symptoms means a great deal . It is wonderfully a broad thing……


 It is all that enables the physician to individualize between the disease and between the remedies; the entire representation of disease is the totality of symptoms and entire representation of drug is the totality of symptoms.

KENT’S CONCEPT OF TOTALITY
MIND
 Will.
 Perversion of understanding/Intellect.
 Perversion of memory/memory.

PHYSICAL
1- Perversion of sexual sphere including menstrual symptoms; general agg, before, during, after menses; effects of coition.
2- Symptoms pertaining to appetite, food desires and aversions and thirst.
3- Things affecting the entire body- Weather and temprature,food,positions, motions, etc.
4- Symptoms of special senses

PARTICULARS
 Symptoms related to the parts (characteristics)
1- Symptom that cannot be explained
2- Symptom with clear modalities

 Totality of symptoms would vary under various circumstances. It would mean one thing in acute case and another in a chronic case. Acute totality includes the recent symptoms.A patient is suffering from a chronic disease if he develops an acute disease he needs an acute remedy fitting to the acute condition.
 A patient in chronic disease requires to interrogate about his mental states,physical generals,past history,family history etc.,but it would not be needed in acute case. so “totality of symptoms” in acute condition is entirely different from chronic condition.

“TOTALITY OF SYMPTOMS” IN A PATIENT.

“TOTALITY OF SYMPTOMS”IN A DRUG.

 “Totality of symptoms” is equal to the new phrase coined by Dr.Castro “Essential total of the symptoms.” After deleting the common symptom of a case, the symptoms left over is the “Essential total of symptoms.”
 Case receiving, case perceiving, evaluation of symptoms are pre-requisite conditions for erecting the “Totality of symptoms.”

UTILITY OF TOTALITY OF SYMPTOMS
 Helps in building of portrait of disease
 Helps in Repertorisation of the case
 Helps in selection of similimum
 Helps in better grasp of drug picture