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NOTE

THE CURRENT SYMPTOMS OF ILLNESS ARE THE SUREST POINTERS TO THE APPROPRIATE REMEDY.

In § 7, Hahnemann⁹ writes: “Thus, in a word, the totality of symptoms must be the most important, indeed the only thing in every case of disease, that the medical-art practitioner has to discern and to clear away, by means of his art, so that the disease shall be cured and transformed into health.” Here Hahnemann is talking about the case of illness, not about the set of symptoms that the patient had but which has now disappeared. We need to know about these symptoms when treating cases of chronic illness in order to assess the course of the illness and – for example – to judge whether old symptoms have reappeared during the course of healing. But old symptoms are not included in the repertorisation. Symptoms are (according to § 6) “alterations in the condition of the body and soul … which are outwardly discernible through the senses. That is, … the deviations from the former healthy state of the now sick patient”. Accordingly, symptoms do not include character traits or characteristics of a patient that are also found in the healthy state. This distinction is crucial since, if we ignore it, we may choose the wrong remedy. For example, if a patient is very irritable when healthy, yet noticeably placid when ill, we must take the placidity as the symptom, not the irritability.

NOTE

SYMPTOMS ARE DEVIATIONS FROM THE ORIGINAL HEALTHY STATE – ALTERATIONS IN THE STATE OF HEALTH DURING ILLNESS.

The emphases above are of practical importance since we must ask ourselves when taking every case whether the symptoms belong to the current case of illness or whether they existed prior to the illness. If the latter is true, we must not include those symptoms in the repertorisation. This is especially important if old symptoms contradict current ones. For example, if a patient with an acute febrile illness says she has heat with a dislike of being uncovered, yet in terms of her pre-existing menopausal flushes she feels heat with the desire to uncover herself, we must only use the symptom heat with a dislike of being uncovered when treating the acute febrile illness. In addition, the separation of illness symptoms from the patient’s characteristics is of decisive importance for the choice of remedy: if the desire for fresh air found in a case of illness is also found in the healthy state, it must not be included in the repertorisation.

According to Hering, a complete symptom consists of the five elements location, sensation, clinical findings, modalities, as well as concomitants and extent. When taking the case we should attempt to elicit complete symptoms whenever possible.