Analysis of symptoms

- BENERJEE.P,

Before I actually take up the matter of a detailed analysis of symptoms and prescription, I think, I should finish, in a few words, telling you about those patients (referred to at the end of the previous chapter) that are in the habit of changing their doctors too frequently. In fact, much improvement to such patients is seldom possible. Their cases are never well defined and are on the contrary full of disorder. Behind this disorder again, there are differences in different cases. In some the symptoms are almost suppressed, while in others the original symptoms have come to be substituted by newer symptoms, while in still others there are aggravations when they are on their way to cure. Suppose, for example, a patient comes to you after a long course of Allopathic treatment, and you find that almost all his symptoms have been suppressed, while some very few hazy symptoms of a really indescribable nature-such as, mental uneasiness, sleeplessness, want of appetite etc. are only still remaining. From the study of such a case, you will find that the symptoms of it have only been forced to disappear-forced by strong medicines-while the patient has not been really cured. In such a case, there is no means of curing the patient unless the suppressed symptoms are brought out, but the difficulty is that there are no indications on which to proceed to prescribe a medicine for bringing out the suppressed symptoms. Not only this, but the patient himself also does not agree to such a course of treatment, both because of the course of temporary suffering that such a process of treatment means as also of the fact that he considers himself to have been cured in all respects, except in respect of the few uneasy symptoms, such as-mental uneasiness, sleeplessness, want of appetite etc. If you tell him that a true course of curative treatment will bring back his old symptoms and then cure them, he will take you for a cheat and walk home. The fact is that he does not understand true cure, and you can not therefore help him. Suppose, a patient comes to you for some heart troubles. You take his history and find that he had rheumatism and that it was treated allopathically. There is no rheumatic pain now; but how can you cure the heart trouble, without bringing back the rheumatic pain? It is only the suppressed rheumatism that has settled on the heart. Then again, suppose another patient walks into your office. He had fever which was stopped with strong doses of quinine. He has no trouble now but he wants you to do something so that the fever may not return, because he knows that fever checked with quinine is ever in the habit of returning at the slightest provocation. Then again, suppose a third patient comes to you for having some lasting benefit done to him for some disease of which he has been cured (?) with some injections. These are really trying cases, in which you cannot do anything without bringing back the suppressed symptoms, to which however the patients are not agreeable. They have spent months after months in Allopathic treatment. They have spent purses of money. But they must have immediate cure in the Homœopath's hand. Very little time will be given to Homœopathy, very little money, and there must be no coming back of the old symptoms, but "cure" straight, after waking in the morning! If one single dose of Homœopathic medicine can not cure the case, and that in the course of a single night, what is Homœopathy worth?

 There is another class of such patients yet. They have been perhaps to Homœopaths, and as soon as some of the old symptoms have re-appeared after the medicines given by them, showing that the process of cure had begun, they have left their previous doctors and come to you. If however, all these facts are placed before you,-the name and potency of the medicine and the date of use etc-you can do the rest of the business necessary for completing the cure. But unfortunately this is never done and you have to make your way out of darkness. This is a difficult affair, and prescribing for such cases is a really weighty business. The treatment of chronic cases in our country is not in progress and the main reason is ignorance of the people, ignorance of the very fact that a really curative method of treatment of diseases is in existence.

 However, the analysis of symptoms recorded has now to be done and the prescription made. Symptoms are not all of them of the same importance and value, and some hint on this has already been given, while explaining the necessity of eliminating superfluous symptoms. It is only necessary here to study up the importance of those symptoms that make up the picture of the case. These may be divided into two classes,-(1) those felt by the patient himself-subjective, and (2) those perceived by the physician and others around the patient-objective. The subjective symptoms again are of two classes-(1) Personal or relating to the whole of the personality of the patient e.g. , "I like to sleep in the open air," "I am feeling thirsty", and (2) Local or relating to only certain localities of the patient's body, e.g. , "There is a pain in the liver", "There is a swelling in the knee" etc. Now, amongst the subjective symptoms, those that relate to the whole of the patient's personality are by far the most important. In fact subjective symptoms are all mental symptoms, and it is the mental symptoms that are most valuable. Amongst them, those that relate to the whole of the patient's personality i.e.  the personal symptoms are of greater value for purposes of prescription than those that relate only to certain parts of the patient's body i.e.  the local symptoms. Let me clear up the point still further by a tree.

 Now, for purpose of prescribing, the subjective symptoms are more important than the objective, because they (the subjective) relate to the mind. And again, amongst the subjective symptoms, the personal subjectives are more important than the local subjectives, because they (the former) relate to the whole patient. The objective symptoms are thus of the lowest class.
 
 So far, the method of selection of medicine in chronic and acute diseases is the same. I will therefore finish this subject in a few more words, and then take up that factor of difference in the two methods that makes chronic selection quite a different matter from acute selection. The main basis of selection both in chronic and acute diseases is the "totality of symptoms". But the meaning of the expression "totality of symptoms" is one in the case of acute diseases, while it is quite another in the case of chronic diseases. The totality of symptoms that suggests the remedy in an acute case does not suggest the remedy in a chronic one. The totality of symptoms in a chronic case is a different totality. But wherein dose this difference lie?-It lies in that which makes a disease chronic. And what is that?-That is the tendency to continue. Now, why has a chronic disease a tendency to continue?-Because, in it there are the miasms-Psora, Sycosis and Syphilis, which have the inherent tendency of continuing in the patient. It is these miasms that make diseases chronic and deprive them of their tendency to end and give them on the contrary, a tendency to continue. From the record of a chronic case, you have to judge out which of the miasms are there. You have to understand the difference in the manifestations of the different miasms, (these differences and the characteristic ways of expression of the three miasms will be dealt with later on), and also to make your inference as to which of the miasms are there in your case. Though you may not have direct evidences of the existence of the miasms from the history of your patient, you must discern their stamp on him-in his mind and body and in the different organs. The evidences of the existence of latent Psora have been exhaustively detailed by Hahnemann in his remarkable book "Chronic Diseases" and you have to study up the indications of latent Sycosis and Syphilis also in the same way. Unless you know that, you cannot possibly treat chronic cases, just as you cannot treat cholera or malaria without knowing the general symptoms of them. If you know the general symptoms of these acute diseases, then and then only you can be led to the remedies that have those general symptoms, and then only you can pick up the particular remedy out of them by seeing the particular symptoms of the particular case agreeing with the particular symptoms of one of those remedies. The general symptoms of cholera or malaria will suggest to you the names of all the remedies that have those general symptoms, and the particular symptoms of the case in hand will enable you to select the one particular remedy (out of all those remedies) that has those particular symptoms. Similarly, you have to know first of all the general symptoms i.e.  the very images of Psora, Sycosis and Syphilis, and unless you know this you cannot treat chronic diseases at all. The miasms have shaped your chronic patient-from his mind the finest to his body the coarsest part of him, and you must find out which of the miasms have done the shaping. And when you have ascertained this, you have to select an anti-miasmatic remedy. The difference between acute and chronic prescriptions is therefore this that, in chronic the medicine has to be miasmatic, while in acute it need not be so. If in the chronic case before you, there is a stamp of Psora, the medicine you will select must be an anti-Psoric. The stamp of Psora on your patient will suggest all the Anti-Psoric remedies, because the Psoric manifestations are general symptoms, but you will select only one out of all those anti-Psoric remedies by ascertaining the particular symptoms of your patient and finding out which one of those anti-Psorics has those particulars. Thus, the difference between acute and chronic prescriptions is that, in an acute case any medicine that agrees with the totality of the symptoms of the case can be selected, while in a chronic case, the remedy besides agreeing with the totality of the symptoms must also be anti-miasmatic i.e.  anti-Psoric, anti-Sycotic or anti-Syphilitic, as the case may be. There is no other difference between acute and chronic selections. If however, instead of Psora alone, there are some more miasms in a given case, the task of selection is much more difficult, and a special method has to be adopted there. But before I explain that method, it is necessary to say something more about the first prescription in chronic cases.