VALUE AND RANK OF SYMPTOMS IN SELECTION OF REMEDY.

01. Hahnemann advises us to base the selection of the remedy upon the totality of symptoms presented by the patient.

02. In acute disease there is little difficulty in determining the totality of the symptoms, as the deviation from health is usually sharp and well defined.

03. In acute disease it never forms a complex with a chronic one and the chronic disease being suppressed until the acute has run its course.

04. At times some symptoms of the chronic diseases may persist, and be active during the acute disease. Such symptoms are peculiar, because they have not disappeared, and are often guiding in the choice of the remedy for the acute disease.

05. In chronic diseases, we have to take into account not only the present symptoms but also consider many former symptoms that are not now active.

06. In chronic disease, while considering the old symptoms, care should be taken to eliminate the symptoms caused by bad pollution, due to abuse of drugs etc.

07. In every case of disease there are always two classes of symptoms: (1) those that pertain to the disease -that is common or pathognomonic ones; (2) those that pertain to the patient; and also another class that in all advanced cases, the symptoms pertains to the ultimates or results of disease. To attempt to select the remedy in accordance with the first and results of the disease alone is simply to court failure in the majority cases.

08. As per Dunham, that the drugs varying according to the size of the dose may produce three sets of symptoms: (i) The chemical symptoms. (2)The mechanical, or violent efforts on the part of the organism to eject from its cavities the offending substances and (iii) The dynamic, contingent on the vitality or resulting from the relation of the peculiar properties of the drug to the susceptibility of the living healthy organism. He still further subdivides the dynamic ones into the generic or those common to all members of a certain class of drugs - and the specific. As an example of the former, Arsenic, in certain doses produces vomiting, diarrhea, cold perspiration, cramps in limbs, but Cuprum, Veratrum, Ant tart, which belong to the same group, produce identical symptoms. The specific ones are those that are peculiar to one remedy and serve to distinguish it from its relatives. So, the chemical and mechanical symptoms obtained there from are of little value in the large majority of cases we are called upon to treat. Our main reliance must ever be placed upon the symptoms that signify the patient. In this context, Hahnemann directs that we should be particularly and almost exclusively attentive to those symptoms that are peculiar to or characteristic of the patient and not to those that are common to the disease.

09. In many old standing chronic cases, especially those that have been long under allopathic treatment, these peculiar and characteristic symptoms have so completely disappeared or have been so utterly forgotten by the patient. Under these circumstances cure is practically difficult.

10. In some diseases like hysteria, the common symptoms of the disease are the very essence of the disease then it is better to find the changes of desires, the aversions, the loves and the hates as possible and prescribe thereon.

11. While paying much supreme importance to the peculiar symptoms of the patient, but it would be foolish to ignore the symptoms that signify the disease. They must, indeed, be taken into consideration; but as subsequent to, and of much less value than, those that is predicated of the patient.

12. In a very large number of cases, no one remedy corresponds to all the peculiar symptoms, but three or four seem to have equal numbers of them, and of approximately the same value. In such a state of affairs, the remedy that has also the common symptoms best marked must prevail. There must be a general correspondence between all the symptoms of the patient and those of the remedy, and that, however helpful the peculiar symptoms may be in calling attention to certain remedies, yet they are not the sole guides; for after all, it is the totality of the symptoms that determines the choice.

13. When using the peculiar and characteristic symptoms as the main guides in the selection of the remedy, it is important to bear in mind that they must be equally well marked in patient and in remedy.

14. In a case where ten peculiar and characteristic symptoms, of which one remedy has eight, but of a very low rank, while another has only five, but of high rank and corresponding to the rank of the symptoms as experienced by the patient, in such a case the second remedy is much more likely to be the better selection.

15. The method of keynote prescription is, from its very nature, a wrong method and in the large majority of cases is doomed to failure, because it ranks one or two symptoms very high and practically ignores the others.

16. Apart from the symptoms that signify the patient, and those that signify the disease, there are other great division of symptoms: viz., the Generals and the Particulars.

17. The general symptoms are those that affect the patient as a whole, and because of this very fact, they are naturally of higher value than the particulars, which affect only a given organ. So much higher may a general symptom rank that, if it be a strong and well marked one, it can overrule any number of even strong particulars.

18. Amongst general symptoms is to be included the mental state, which, reflecting the condition of the inmost part of man, is bound to be of the utmost importance, and - as Hahnemann so strongly insists - must always. If well marked, take the highest rank in the selection the remedy.

19. Even amongst the mental symptoms there are various ranks and consequently they vary greatly in their value. All symptoms of the will and affections, including desires and aversions, are the most important, as they relate to the inmost in man. Of less value are those relating to the intellect, while those of memory are to be ranked lower of the this group.

20. Among other generals are the effects of sleep and dreams. The dreams must be regular and persistent to make them of value.

21. But one grand general viz., the effect of different temperature upon the patient as a whole is often calling our attention to special groups of remedies and excluding other groups, so that the labor of selection is thereby greatly lessened.

22. The effect of temperature is often very valuable when the body as a whole is markedly affected by one temperature, and some special organ by the opposite.

23. There is little need to call attention to the general effect of the various weathers, but many a valuable hint is obtainable from them, not only in a positive but also in a negative way. For instance the absence of aggravation of rheumatic pains from weather changes become peculiar and characteristic symptom and enable us to throw out of consideration whole groups of remedies.

24. Amongst the generals must be included the influence of the various positions, such as the strong aggravation of most symptoms by standing etc. Here, to be of any value as a general symptom, the patient as a whole must be markedly influenced by these positions, and if only one organ is so affected they take only low rank, being particulars.

25. The tendency of disease to affect particular parts of the body is often well marked, and may be a general of considerable value.

26. The time of symptoms aggravation regularly at particular hours or time is a valuable and great general. As well as the characterized periodical return of symptoms of the disease is also a great general.

27. The cravings for and aversions to various substances are as a rule general symptoms, for they depend upon some deep need in the body as a whole and if outstanding and definite, must always take high rank.

28. The influence of eating the patient in general is a great valuable general. If it influences only stomach then it may be considered as a particular only.

29. The special senses are often so closely related to the whole man that many of their symptoms are general.

30. On examining a series of particular organs we find that a symptom or modality runs so strongly through them all that is may be predicated of the patient himself. Here we have a general made up of a series of particulars.