The second case that I will give will show you how not to use the repertory.
This method of trying to find a remedy which will cover every symptom of the
patient is the one most of you try to use and it is one that is discouraging not
only from the fact that it takes so much time, but as well as the fact that many
times the repertory will not give the particular rubric for which you may be
looking. I selected this case for the reason that each of the symptoms can be
found in the repertory and that one remedy covers them all.
Case 2. – Mrs. H. S. came to me 2-12-’07 with the following
symptoms which I will give in her own language: “I am so nervous; am afraid
I shall kill some of my people, as I go all to pieces and can’t control myself.
Thinking about killing, I dream of killing my little girl. If I do not get
better soon I shall commit murder. Every afternoon I have pain over my eyes as
if burned. Can’t read at night, as there are sharp pains going through my eyes;
if I persist in reading dark points appear on the page so I cannot see the
print. Hungry most of the time; in morning when I awaken there is burning pain
in my stomach which grows worse until I get up, when it goes away. Always have
to take pills to move my bowels; before they move there is a sharp cutting pain
in the rectum and many times the bowels come out while at stool. If I drink beer
will have piles for two or three days. My menses have been too often since my
last child, three years ago, and for a week before I am sick have whites each
morning, which are much worse walking. There is not much flow, and it only lasts
two or three days and smells sour as vinegar. Can’t sew for past month, as there
are stitching pains in the back of my neck when bending my head forward. Feet
cold as ice every afternoon and cramps in my calves keep me awake nearly all
night. Do not shop, as I feel so badly when I have to stand long.”
Repertory Analysis
Fear of killing people. – [Absin], Ars.
a., Nux v. , Rhus
t. , Sulph.
Dreams of committing murder. – Rhus t.
, Sulph.
Burning pains over the eyes, worse afternoon. – Sulph.
Sharp shooting pains at night, on reading. – Phyto.
, Sulph.
Followed by dark points. – Con. , Sulph.
Burning pains in stomach on waking, better rising. – Sulph.
Cutting pain in rectum before stool., – Asar.
, Sep. , Sulph.
Prolapsus recti during stool. – Ign. , Lyc.
, Podo. , Rhus
t. , Sulph.
Leucorrhoea mornings, worse walking. – Nat.
m. , Bov. , Sarsa.
, Sep. , Sulph.
Menses scanty, short duration. – Amm. c.
, Lach. , Puls.
, Sulph.
Menses smell sour. – Carbo v. , Sulph.
Stitching pain in neck from bending head forward. – Sulph.
Feet cold afternoon. – Nux v. , Sulph.
Cramps in calves while in bed. – Ars.
a., Caust. , Ign.
, Sulph.
Worse standing – Con. , Cycl., Lil.
t. , Puls. , Sep.
, Sulph. , Valer.
Here we see that Sulphur covers each
symptom, but with a good knowledge of the arrangement of the repertory it took
me some time to work it out. Now to demonstrate how much more rapidly we can
arrive at the same results by working from the generals to particulars, we will
start with a general rubric:
Menses scanty, short duration. – We find the following nineteen remedies that
have this symptom in the first and second grades: Alum.
, Am. c. , Asaf.
, Bar. c. , Cocc.
, Con. , Dulc.
, Graph. , Lach. , Mang.
, Merc. , Nat.
m. , Nux v. , Phos.
, Plat. , Puls.
, Sepia. , Sulph. , Thuj.
Now among this group of nineteen remedies will be found one which will cover
the totality of our case. If we were to give a remedy upon this one symptom
alone we might give any one of the above, for they all have this condition in a
high degree; but if we did not give the right one we should not cure the case.
We must individualize our case [still] further, so we will use another general.
Worse standing. – In consulting the repertory we find that of the first
nineteen there are only the following seven which have the symptom in the first
and second grade: Con. , Cocc.
, Phos. , Plat.
, Puls. , Sepia.
, Sulph.
But [still] we have seven remedies, any one of which may be the remedy so
far, and we must individualize [still] further by another symptom. We will take
the general, better in open air. Here we find that we have only four remedies of
our previous group which will have this symptom in the first and second grade – Con.
, Phos. , Puls.
, Sulph.
We have now worked our list down to four remedies and we will individualize
again by taking another general, fear of committing murder. This gives us Sulphur
, the only remedy which covers all of the symptoms we have taken so far. Now if
the logic of our reasoning be correct, if the technique of selection be without
a flaw, Sulphur must be the mathematically correct
remedy, and reference to the pathogenesis of the remedy shows that Sulphur
not only covers these four symptoms we have used, but it also contains all the
other particular and common symptoms of the case. The proof of the pudding is in
the eating, so we will turn to our record and we find the patient was discharged
7-7’07; that all symptoms had disappeared, bowels move naturally. Says never
felt better in her life.
Case 3. – Boy, age 14; epileptic attacks for three years.
First attack followed fright caused by other boys’ make believe to hang him.
Attacks increasing in frequency until at this time they occur every two weeks.
The following symptoms were given: Attacks begin by running round in circle, the
falls down unconscious. Attacks are more frequent in cold dry weather and during
new moon. Involuntary urination during the attack. Boy complains of always being
cold; wants to keep warm both summer and winter. He is very touchy; everything
makes him cry; seems depressed all the time. Appetite either ravenous or
wanting. Aversion to all kinds of sweets, of which he was previously very fond.
Repertory Analysis. – Under complaint caused by fright we
find thirty-six remedies. Of these the following twenty-one have the symptoms in
the first and second grade: Acon. , Apis
, Arg. n. , Art. v., Aur.
, Bell. , Caust.
, Coff. , Cupr., Gels.
, Glon. , Hyos.
, Ign. , Lach. ,
Lyc. , Nat.
m. , Nux v. , Op.
, Plat. , Puls.
, Rhus t.
Sadness and depressed. – Acon. , Arg.
n. , Aur. , Bell.
, Caust. , Gels.
, Ign. , Lach. ,
Nat. m. , Plat.
, Puls.
Worse cold dry weather. – Acon. , Caust.
Aversion to sweets. – Causticum .
We have arrived at the solution of the case by four steps and have used all
general symptoms. Now you may ask, why did we start with the rubric complaints
caused by fright? First: this is a general symptom and we are working from the
generals to particulars. Second: This condition was caused in this boy by
fright. This mental shock was so profound that it caused the whole condition of
this patient to be changed. It not only produced the epileptic seizure, but
affected his desires as well. One of the remedies found under this rubric will
be the one which will cover the totality of the case.
The second symptom we will take is another general – sadness and depression.
We take this rubric from the fact that it is a mental condition produced by a
derangement of the patient’s most internal condition, the mind. Now if we hope
to cure this case we must have a remedy which has produced this symptom in the
provers, so among our first twenty-one we find eleven with this symptom in the
first and second grade.
Another general condition is the modality that attacks are worse in cold dry
weather. Among the eleven remedies found in the first two rubrics we find only
two which are worse in cold dry weather.
In order to decide which of these two will cover our case we will take the
general aversion to sweets. Here we find that Causticum
must be the mathematically correct remedy, and turning to our materia
medica we find that the pathogenesis of Causticum
not only contains the rubrics we have used in our analysis, but the
remaining symptoms of our case as well.
Therefore, Causticum is the remedy we
will give. Our records show that two doses of this remedy were administered with
the following results: The attacks lessened during the first month to one; the
second attack, a very slight one, did not follow for seven weeks, and now, after
an interval of a year and a half, there has been no sign of a return, so we may
safely say the boy is cured.
Case 4. – Mrs. A. S., aet. 28; married four years; menses
have always been irregular, but during the first year of married life were more
regular but always profuse. The third year married gave birth to a seven-pound
child; labor normal, no lacerations. Since labor has never been well; the menses
would appear every two weeks; then every five or six weeks, with no regularity.
The would be profuse and weakening. Had had curettages and various treatments
without relief. The condition of the patient at the time of first prescription
was as follows: Menses irregular and profuse; great weakness when walking; the
walk from the car to office completely exhausted her. Cannot sleep; what sleep
she gets is unrefreshing. No appetite; does not want to think of eating. Craves
beer, of which she had never tasted but once, and then it was repulsive. Sweats
easily; is in a perspiration most of the time and has to be very careful about
getting in a draft, as when she becomes chilly she is nauseated.
Repertory Analysis. – Menses irregular and profuse – Apis
, Arg. n. , Art. v., Benz.
ac. , Calc. c. , Carb.
ac. , Caust. , Cimi.
, Cocc. , Con.
, Dig. , Ign.
, Iod. , Ip. , Iris.,
Kreos. , Lyc.
, Murex , Nux v.
, Nux m. , Secale
, Sepia , Staph. , Sulph.
, Tuberc.
Worse from warmth – Arg. n. , Calc.
c. , Cocc. , Con.
, Ign. , Iod. , Ip.
, Lyc. , Nux
m. , Sulph.
Extreme weakness from walking – Calc. c.
, Cocc. , Con.
, Iod. , Lyc.
, Nux m. , Sulph.
Great desire for beer. – Calc. , Cocc.
, Sulph.
Nauseated when chilly. – Cocculus .
Just a word of explanation of our selection of rubrics in this case. Why did
we start with the symptom, menses irregular and profuse? In the first place, it
is a general symptom; then it is the symptom above all others that has proved
the change in the patient’s general condition; it we expect to cure this case we
must have a remedy that has in its symptomatology this condition. On the other
hand, if we took any of the remedies we find in the first and second grades
under this rubric we would have a remedy for this local condition that so many
and various lines of treatment had been used upon with no results; so not only
must we take this symptom, but must take the other symptoms, which make this
case of irregular and profuse menses different from every other case of the same
condition; in other words, that makes of it an individual case. Therefore, we
proceed with the other symptoms.
One word more, about our fourth rubric – great desire of beer. Ordinarily
this symptom would be of little vale, but we find a patient that before she was
affected with this change of internal conditions did not like beer; in fact, she
had never tasted it but once and then it was repulsive to her, but now she is
sick; some change in her desires has produced a condition of her economy whereby
she has a craving for beer. Now the condition has changed ans a symptom which in
other cases would be of little or no value deserves a prominent place in our
record analysis.
This case also has another interesting peculiarity, in that if the keynote
prescribers had been working at it they might have reached a correct solution,
for in this case we find that the particular symptom, nauseated when chilly, is
found under only one remedy, Cocculus .
Our selection of Cocculus in this
case was justified, for the case was cured. The menses became regular and
normal; the weakness disappeared; the craving for beer vanished; the excessive
perspiration and nausea left, until after four months she was discharged stating
that she never felt so well in her life.
There are some cases where we cannot individualize closely enough to work our
case down to less than two or three remedies. When this occurs we take the
remedy which has the symptoms in the highest grade and if the pathogenesis of
the drug justifies we give that. To illustrate, I will give the analysis of a
case without the history.
Menses copious and dark. – Am. c. , Am.
m. , Ant. c. , Ars.
a., BELL. , Bism.
, Bov. , Bry. , Calc.
c. , Calc. p. , Carbo
a., CHAM. , China
, Cimic. , Cocc.
, CROC. , Cycl., Ferr.
, Graph. , Ign.
Kali n. , Kreos.
, Lach. , Lil. t.
, Mag. c. , Nit.
ac. , NUX M. , Nux
v. , Phos. ac. , PLAT.
, PULS. , Sabin.
, Sec. , Sep. , Sulph.
Worse riding in a wagon. – COCC. , Ign.
, Nux m. , SEPIA , Sulph.
Worse before menses. – Nux m. , SEPIA
, SULPH.
Aversion to milk. – Sepia , Sulph.
Sadness in evening. – SEPIA , Sulph.
Vertigo looking down. – Sepia , SULPH.
Here we find by giving a numerical value of two to those of the first grade
and of one to the second grade that we have Sepia
having a value of nine and Sulphur a
value of eight.
Absolute reliance cannot be place on numerical superiority on points for any
one remedy; that is, a remedy not having so many points as another will yet have
a better correspondence with the vital features of the symptom picture, and be
the curative drug to select. This selection must be made from a final comparison
of the drug’s pathogenesis as given in a complete materia medica.
In closing the cases for analysis I wish to conclude with the following case
to illustrate two points. 1st. That, as regards our prescription, diagnosis has
little or nothing to do. 2d. That if we could all forget our diagnosis while
taking our case for a prescription we should all be able to do better work. This
case will be given as taken by a young lady who had never studied medicine; in
fact, all she knew concerning that subject was that when she or her friends were
sick she wanted a homoeopathic remedy to make them well. I have never this case
personally, but know she is well from reports that I have received through the
mail.
Mrs. H. C., aet. 42; widow. Has eruption on legs, which burns and itches, and
is worse from warmth of bed. She cannot keep her legs quiet at night. Is worse
from warmth of stove, which causes creeping sensation over whole body. Feet are
icy cold during day, but soles burn at night in bed.
Lameness of left shoulder, which has lasted since rheumatism four years ago;
this is worse when lying on it. The hands go to sleep and feel numb, more
specially the left one. The wrist pains as if sprained when awakening. All pains
are of burning character and change locality often and suddenly.
Sometimes, there are small ulcers on inner side of left thigh, from which
there is a thin offensive discharge; walking will cause them to smart, become
red and puffy. Stiffness in small of back on bending or beginning to move. The
pains go down the thigh. She has dry cough, which is worse after sleep and is
caused by a tickling in the throat. This cough has always come the last of March
or the first of April, and would last until real hot weather had come; with this
cough she is quite hoarse and has sensation of lump in the throat. Menstruation
is dark and scanty and offensive; has not been regular since last child, twelve
years ago; she says all her aches and pains are better during her flow, and she
never feels so well as when flowing freely, although it is sometimes accompanied
by a painful diarrhoea. At other times she is always constipated; has to to
closet and try several times before she has stool. There is sensation of weight
and pressure in bowels with much rumbling of gas. Abdomen is sensitive in the
morning on awakening. Complains of burning, stitching pains in left ovary when
constipated. Appetite one time is good, then she may have none at all. She says
she cannot get enough to drink; has constant thirst and drinks a great deal of
coffee. The mouth and tongue are dry; has feeling as if the skin was peeling
from the roof of mouth. Sour taste in mouth all the time; tongue cracked, brown
center and red tip.
Does not sleep well; has had work to get to sleep before midnight and then
she wakens frequently with shock in pit of the stomach and a tight suffocating
feeling in the chest. Lately she has complained that her heart feels too large
for her chest when she walks fast. This oppressive pain is sometimes relieved by
belching. For past few weeks face and lips are bluish; has flushes of heat, but
only one cheek gets red; the other is pale. For last year her hearing has been
failing; she complains of noise like a tea kettle boiling. There has been
scarcely any wax, and what there was would be hard and white. Riding in the cold
has always given her earache. She fears to go to bed during this last attack, as
she thinks she may die, and she says she dreads to die so much.
There has always been more or less headache, at different times, but the one
which has been most troublesome is one that begins on the right side of head and
goes through to the left until it aches all around. With this there is a drawing
in the back of neck and burning pains back of the eyes; some dizziness with
sensation as if she were going to fall to the left side. She has an irritable
disposition and everything seems to be worse in the morning when she awakens.
Now what is the diagnosis in this case? I do not know. Have never made one.
We do no care about the diagnosis, as it is not a disease we wish to treat, but
rather this sick woman we are going to try and cure. We have a well taken case,
and from this mass of symptoms we must select some that will individualize this
case and make it different from all others. Let us look at the record and see
which symptoms we will select for our repertory analysis. We find the following
general symptoms: Worse after sleep, thirsty, burning pains, left side and
better during flow. Making a repertory analysis of these we find under:
Worse after sleep. – Acon. , Apis
, Arn. , Ars. , Camp.
, Carb. s., Carb. v. , Caust.
, Chel. , Cocc.
, Con. , Euph.
, Ferr. , Hep.
, LACH. , Lyc.
, Op. , Phos. ac.
, Puls. , Rheum
, Sabad. , SEL. , Sep.
, Spong. , Staph.
, STRAM. , SULPH. , Verat.
Thirsty. – ACON. , Arn.
, ARS. , Camp.
, Carb. v. , Chel.
, Cocc. , Con.
, Hep. , Lach.
, OP. , PHOS. , STRAM.
, Sulph.
Burning pains. – Acon. , Arn.
, ARS. , Carb.
v. , Con. , Lach.
, Op. , PHOS. , SULPH.
Left side. – Arn. , LACH.
, PHOS. , SULPH.
Relieved during flow. – LACHESIS.
Here you see we have worked our long case down to one remedy with five
rubrics. We will now turn to the pathogenesis of Lachesis
and see if our selection has been justified. In the Guiding Symptoms
we find under Lachesis not only the five
symptoms we have used, but also each and every one of the other symptoms; so
this remedy must be homoeopathic to the case.
Lachesis , two powders, was sent with
the following results: For thirty-six hours after the administration there was
an aggravation of all the symptoms, which was followed by rapid improvement that
has continued ever since until the last report, when she wrote that every
symptom had disappeared and that she felt as well as she had ever been in her
life.
Let us look at the analysis of constipation, the great bug-bear of our
prescribers, who say that constipation cannot be affected by the homoeopathic
remedy. The reason for this statement is that constipation, in the common, per
se, cannot be cured, for we have no one remedy for the disease condition.
Even when we bring our case of constipation down one step in
individualization we are no better off; taking for example, constipation with
hard stool, under this common general we find eighty-three remedies listed under
this rubric (page 635, second edition, Kent); any one of these remedies might be
curative in such a general condition, but if we do not have something to
individualize our case further we are at sea. Taking the character of stool as:
Stool Dry (page 634). – We narrow our list to thirty-one
remedies, which are as follows: Aesc. , Amm.
c. , Arg. m. , Arg.
n. , BRY. , Calc.
c. , Cimex., Con.
, Cupr., Ham. , Hep.
, Kali bi. , Kali
c. , Kali s. , LAC.
D. , LYC. , Nat.
m. , NIT. AC. , NUX
V. , OP. , PHOS.
, Plat. , Plb.
, Podo. , [Prun.], Sanic.
, SIL. , Stann.
, Sulph. , ZINC.
With this condition is often associated inactivity of rectum, i. e., not
having a desire for stool for three or four days.
Inactivity of Rectum (page 619). – We find fourteen of the
above thirty-one remedies, in the first and second grade, which allows us to
narrow our group of curative remedies to the following: BRY.
, Calc. c. , KALI
C. , Lyc. , NAT.
M. , NUX V. , OP.
, PHOS. , Plat.
, PLB. , Podo. , SANIC.
, SIL. , Sulph.
The stool may crumble, and if such is the case it will help you to further
particularize the above fourteen remedies in order to find the one curative
remedy in this individual case.
Crumbling (page 634). – This rubric gives us only five out
of the above fourteen which have crumbling stool, and are as follows: Nat.
m. , Op. , Plat.
, Podo. , Sulph.
The best we have been able to do with the symptoms that refer to the
constipation, per se, has been to narrow down to five remedies, and one
of these five will be curative. You say we might give all five at once in a
gun-shot prescription, and that is what some men do, and then say that
Homoeopathy will never cure constipation. Or that you might give first one and
then the other in rotation, but you would never cure the case that way, although
one of these five remedies will be curative if given alone. We must look for
other symptoms of the patient, and you will always be able to find some in every
case that will help us to individualize this patient so we may find the one
remedy.
Suppose Burning pain after stool. (p. 624). We find that
this rubric only contains Natrum mur , and Sulphur
of the above five remedies. We are now down to two remedies either one of which
may be curative. Look at the tongue, and see if you cannot find some symptom
there which will help you out. Let us suppose that this patient had a heavily
coated tongue, but along the edges there were spots which were clean. This would
be known as mapped tongue. Look under this rubric, Tongue mapped in
circles on sides (page 411). We find that of our two remedies only Natrum
mur , has this symptom, so if you have no marked generals to rule out
Natrum mur , it would be the remedy and
would cure the case, unless there was some tissue change or growth which from
pressure was causing an occlusion of the bowel. In taking these old cases of
constipation do not expect to give one dose, or a dozen doses, in rapid
succession, and expect the constipation to disappear over night or in a week.
These cases are usually long standing, they all have the constipation habit, and
most of them the cathartic habit, and have to be carried along with your
remedies in series, mayhap for several months, before a cure will be
established.
In order to cure your case you must insist upon the cathartics being stopped
at once, and until your remedy has changed conditions so as to establish a
normal stool you must depend upon diet and an enema of warm water to empty the
lower bowel.