The genius of our remedies
and the genius of disease compared
BY HENRY N. GUERNSEY, M.D.
With a comment on pathognomonic symptoms, by Stefan Reis.
www.dynamis-schule.de[Guernsey’s paper taken from: Transactions of the fifth and
sixth annual sessions of the Homœopathic Medical Society of the State of Pennsylvania,
1870-1871. Philadelphia: Senseman & Son, 1871, pp 181-185.]Those of you who were present
at the last meeting of our Society, held in the city of Erie, in June last, will doubtless
remember that on that occasion I had the honor to lay before the Society my view in regard of
the individuality of action of the articles constituting our curative resources, in a paper
entitled „The Homœopathic Materia Medica”. [see: The Hahnemannian Monthly, Vol.6
(1870/71), pp 49-55.] In that paper I took the ground, that the pathogenesis of each
medicament exhibited not only many effects which closely resembled those produced by other
remedies, together with other effects bearing no resemblance to those produced by others; but,
as well, effects which constituted a prominent differentiality – and hence individuality; or, in other words, that the „action of medicines,
or their medicinality, have not only points of general resemblance and of general difference,
but points of special difference also. which presenting, are at once the means of positive
recognition.”To these features of essential
difference, many terms have been applied; amongst which „key note” and „characteristic”
are the best known and most commonly used. And, perhaps, no better terms than these can be
devised for indicating those isolated points of prominence in a pathogenesis. But a term
expressive of the combination of these prominent and peculiar conditions and symptoms of a
remedy, which, taken together, make up the totality of its individuality, will be found in the
word Genius – the Genius of the remedy.It may not be out of place at
this juncture, to define the meaning of the term „genius”. Genius
(gigno, geno) according to the best authorities means the innate nature; that which is
peculiar to anything, and constitutes its identity, its nature, disposition, peculiar
character, etc.Hence, you will perceive that
the term „genius”, as applied to a remedy, means that which is peculiar to the remedy,
and which constitutes its identity or its individuality, and distinguishes it from all others.Thus we have in our provings
pathogenetic effects produced in various constitutions, by various doses of drugs, and which
in the aggregate (where the provings are thorough and exhaustive) exhibit the whole sphere of
action of each medicament upon the human organism, or the whole field of curative
action of that remedy; then cropping out here and there we have symptoms and conditions –
apparently isolated, perhaps, – which serve as guides or landmarks in what might be otherwise
a trackless plain; and to these the terms „key notes”, „key symptoms”, „characteristics”,
etc., have been applied, as various similes for our Materia Medica have suggested themselves
to the fertile brains of authors and practitioners. Now, the aggregation of these prominent,
indicating, and, so to speak, all-pervading symptoms and conditions, presenting in the
pathogenesis of a remedy, constitutes and exhibits the peculiarities of its nature and
character; or, in other words, its genius. Hence, you will learn what, in my mind, constitutes
the genius of a remedy.Having now considered the one
side of the therapeutic problem, let us turn to the other.It is a well-known fact that,
in the various forms of disease there are many symptoms and conditions common to all or nearly
all forms; and there are other symptoms and conditions which have, by their dissimilarity,
enabled pathologists to effect classification and nosological arrangement; but beside all
these, we have, in each case of disease, as it comes before us in our business as
physicians, symptoms and conditions which give the individuality, and set it apart from all
other cases as a distinct entity; and the combination of these peculiar and characteristic
symptoms and conditions goes to make up the genius of that disease, or more properly, of that
case of disease.Every homœopathic
practitioner knows that cases of scarlet fever differ essentially
from each other, even during the same season, and in the same family or neighborhood. Whatever
may be the influence that gives origin to the disease, different effects are produced in
different individuals, even so far that each patient affected may present symptoms entirely
his or her own. I do not wish to be understood as asserting, by this, that one case of scarlet
fever differs from all other cases, for there may be
numerous similar cases coming within the range of observation of even a single practitioner;
but it does not follow that scarlet fever having made its appearance in a family or
neighborhood, all children seized by the disease will necessarily exhibit precisely same
symptoms.Thus, too, in a neighborhood
where marsh miasm abounds, the inhabitants who are attacked by intermittent fever, will
present a great variety of symptoms, and even the type of
the disease is not necessarily the same in all cases. Thus we may witness, in a single ague
region, quotidian, tertian, or quartan agues, presenting all the varied symptoms and
conditions which mark the vagaries of that intractable disorder, and render it the pest of
physicians and patients.I do not, at this time,
propose to attempt to settle the question as to whether these varying individual circumstances
of disease are due to extrinsic or intrinsic influences. It is extremely reasonable to infer,
however, that the disease-producing influence is in itself the same in each case of scarlet or
intermittent fever; but that it is modified by the peculiarities of the person receiving it,
and that the various forms of the disease are due to the predominating effect of these
peculiarities.However this may be, the fact
remains that there is an individuality pertaining to each case of disease, constituting the
genius of the disease, whether produced through the influence of internal causes or of
surrounding circumstances; and it may be remarked here en passant, that the recognition of
this individuality (or genius) of cases of disease, prominently marks the difference between
homœopathic and allopathic ideas of diagnosis and of treatment.You will now perceive that
there is, in my mind, a close correspondence existing between the drug-produced symptoms of
our Materia Medica and the disease-produced symptoms of a case of physical or mental disorder;
and this more particularly, so far as the characteristic or individual symptoms and conditions
of either are concerned. On the one hand we have the Materia Medica consisting of an
aggregation of the actions of drugs upon the organism in health, each drug presenting points
of general resemblance, of general difference, and of special or characteristic difference;
and on the other, the catalogue of diseases, presenting symptoms that are common to all,
symptoms of general difference, and symptoms of special difference in each case.We believe – in fact we know
– that upon the correspondence existing between the symptoms of the Materia Medica and those
of disease, the selection of curative agents depends; and the closer the correspondence the
more certainly will the curative effect be instituted by the selected medicament. Our Materia
Medica is truly termed a vast storehouse on remedial means, but the complaint has been, not
unjustly, made, that its very vastness constitutes the greatest drawback to its utilization.
This has led many students of the Materia Medica into the practice of cutting down its
symptomatology, to suit their own ideas of what it should be; these ideas being frequently
founded in experience, but just as frequently arbitrarily conceived. Hence we often find that
symptoms discarded as utterly worthless and unreliable, by one writer, have had their
truthfulness abundantly evinced by experiments satisfactory to the mind of another. If these
procedures were to be continued ad infinitum, the result would be that this great source of
beneficence would more closely resemble a palimpsest than anything else, the erasures and
re-writings on which would be so numerous as to complicate the whole and render it
incomprehensible.It occurs to me that the only
proper course to be pursued, in order to derive the greatest amount of good from our curative
resources is, to study the Materia Medica with a view to eliminating the characteristic
indications of each remedy it contains, in order to arrive at a knowledge of the genius of each; and these being obtained, we have numerous and
reliable marks to guide us through the labyrinth of symptoms, and aid us in arriving
ultimately at the goal we so ardently wish to reach, viz., certainty
in prescribing.Grauvogl, in his Handbook of Homœopathy, has made the point that the art of
diagnosis in the homœopathic mind carries with it indication;
by which he means to assert, that the homœopathic physician, by his method of studying a case
of disease, is not only gathering a full and perfect knowledge of the condition of his
patient, but is, at the same time, arriving at an equally complete knowledge of the remedy
adapted to the case. In no way can this perfection of diagnosis be consummated more quickly
and certainly, than by considering on the one hand the marked and characteristic symptoms of
the patient, which make up the genius of his disease, and on the other the characteristic
symptoms of the remedies of the Materia Medica, which make up the genius of each. I do not
mean that in ither case other symptoms are not to be taken into consideration, for I hold, on
the contrary, to the doctrine of Hahnemann, that the totality of the case should match the
totality of the medicine, whenever that is possible. But the primary
indication – the first knowledge of the remedy, which forms, according to
Grauvogl, a paert of the diagnosis – will be more quickly and certainly arrived at by
comparing the genius of the disease with the genius of our medicines.
A comment on the above paper and on
pathognomonic symptoms
By Stefan ReisIn this paper, Guernsey
describes his understanding of the term „genius”, applied both to the Materia medica,
and to pathology. Another essential point of this paper is the discussion on what we call „pathognomonic”
(or pathognomic) symptoms. Here, Guernsey’s standpoint seems to differ from what Hahnemann
and his students and direct followers claimed. At least, one could deduce the opinion, that
the characteristic symptoms and conditions are the only guide to the indicated remedy. Even if
Guernsey does not state this explicitely: the majority of Homoeopaths tends to this opinion.
In modern Homoeopathy it seems to be a doctrine, that the pathognomonic symptoms (those, that
indicate the disease, not the individual case) are to be left out for the choice of the
remedy. Therefore I feel that this is a point worth of discussion.What is a pathognomonic
symptom? In general it is understood to be a symptom or condition, that occurs in almost every
case of a certain disease. For example, in measles, almost every patient has the
conjunctivitis, the typical high fever, the typical exanthema. These symptoms are of high
value for the diagnosis of measles. We expect their appearance and when they fail to appear,
we probably do not identify the disease. If the above statement is true, the indicated
homoeopathic remedy does not have to cover these symptoms, but others, that appear in the
single case, and that are not common for others.If it is true, that the
pathognomonic symptoms are to be left out in homoeopathic prescribing, it seems to be strange
what Hahnemann and some others claimed in their therapeutic instructions.We all know, that Hahnemann
was the first to determine Pulsatilla as an almost specific for simple cases of measles. He
could do this only on the account of the typical measle-symptoms produced by the proving of
Pulsatilla. How could he destine Drosera to be of highest value in whooping cough? Because of
its power to produce symptoms similar to those of this disease. What enabled him to maintain
that in Kali carbonicum „patients suffering from ulceration of the lungs rarely get well
without this antipsoric” [Chronic Diseases, Vol.4]? Because Kali shows symptoms that
relate to this condition. It is the same with Belladonna in scarlet fever and with Arnica in
contusions. We all work according to these experiences.Georg Heinrich Gottlieb Jahr
(1800-1875), a close follower of Hahnemann, was one of the first who wrote something on this
subject. In his book Die Lehren und Grundsätze der gesammten
theoretischen und praktischen homöopathischen Heilkunst (Stuttgart, 1857) he
defines the pathognomonic symptoms to be those, that indicate the „choosable” remedies,
in other words: these symptoms are to be covered by the indicated remedy anyway; the remedies
resembling these symptoms form a pool, from which the really indicated one must be chosen
according to the peculiar, characteristic symptoms of the case. In whooping cough, all
remedies that are able to produce the typical kind of cough are possibly indicated. The final
choice depends on the similarity of the individual, non-pathognomonic symptoms.For generations of Homoeopaths, the heat in
the feet at night in bed was a highly individualizing symptom in homoeopathic practice.
Künzli added a red point to some of the related rubrics to stress its worth. Nowaday it is
well-known, that the „burning-feet-syndrome” is very often occuring in liver diseases,
diabetes, Vitamin B deficiency and some others. It is pathognomonic for these diseases. As
with this symptom, it is and will be with many other symptoms, too. They will be discovered to
be indicating various diseases. Special combinations of symptoms were formed to new diseases,
just because they are occuring quite often in this connection. There was produced a new
nosology of pathology, based on symptoms and conditions. For this nosological system is not
applicable to Homoeopathy, the discussion on the pathognomonic symptoms is not taking us
towards a better prescribing.To
be not misunderstood: the pathognomonic symptoms do not indicate the homoeopathic remedy
alone. As Hahnemann stresses in § 153 of the Organon (6th edition), the worth of
the peculiar etc. symptoms shall not be questioned, they are in fact the ones that decide the
choice. But it is also not true, that pathognomonic symptoms are utterly worthless. The
totality of symptoms has to be met with the indicated remedy, not only a part of them.Accepting
the pathognomonic symptoms as a part of the totality and therefore as symptoms to be covered
by the indicated remedy, too, we gain great help to solve many problems in homoeopathic
practice. Every busy practitioner knows, that cases full of individual, characteristic
symptoms are not as often as we wish. And with our profound clinical knowledge we would have
to delete more and more symptoms out of our cases, and even more in future, when medicine
reveals more and more symptoms as being pathognomonic for this or that disease. What is
peculiar today, may be common tomorrow. This is a contradiction to homoeopathic logic.Stefan Reis
for further discussion write to:
Stefan Reis
Hingbergstrasse 110
D-45470 Muelheim
email: DynamisRT@aol.comCopyright © Stefan Reis 2000
Mise en page Copyright ©
Sylvain Cazalet 2000