THE “KEY-NOTE” SYSTEM – BY HENRY N. GUERNSEY

THE “KEY-NOTE” SYSTEM
Read before the Philadelphia County Medical Society.
BY HENRY N. GUERNSEY, M.D.

[Taken from: The Hahnemannian Monthly, Vol. III (1868),
No.12, pp. 561-569.
With a few annotations by Stefan Reis.]
www.dynamis-schule.de

Introduction:

“The keynote system
has done more mischief than anything else, although keynotes are not to be ignored, but until
the relation of the generals and particulars is understood it is no matter how much you
memorize about it.” Thus wrote James Tyler Kent (1849-1916) in Vol.2 (1899) of his Journal of Homoeopathics (p.444f.). For Kent is regarded as one of
the best Homoeopathic teachers and practitioners ever, one is prone to accept this proposition
without forming an own opinion. Therefore, let us listen to the inaugurator of the term
“key-note” – Henry Newell Guernsey himself. We will see, that also Kent was not free
from misunderstandings. That any method of treatment must be applied correctly, is
unquestioned. If any Homoeopathist has misapplied the key-note system, by ignoring the
doctrines of genuine Homoeopathy, the fault is not to be found in the method itself. So Kent’s
repertory, too, is not immune against incorrect application.

Stefan Reis
www.dynamis-schule.de

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Henry N. GUERNSEY

In view of the fact that numerous inquiries
have been made of me regarding the principle of Homoeopathic practice attempted to be
expressed in the term “Key-note system”, and as much attention has been attracted to
the subject, recently, in Journals and otherwise, I have deemed it eminently proper to place
before the members of our Societey, a correct exposition, as far as I am able to make it, of
the scope and utility of the method expressed by that term, as a part of practical
Homoeopathy.

The term “key-note” is not to be
regarded as in itself definitive, nor did I, in first using it, wish or intend it to be taken
as a piece of scientific nomenclature. It occurred to me as being in a very great degree
expressive of a fact in medicine, and as such alone is it to be accepted. The term
“key-note” is therefore

suggestive, and merely provisional; to be continued in use only until its scientific successor
is duly chosen and qualified by general acceptance.

But while it is true that the term is nothing
more than an illustration, an analogue and a hint, its immense significance is not thereby
diminished. It is still the expression of a fact, a truth, central and fundamental; the
knowledge of which, in Homoeopathic theory and practice, is necessary to the full and complete
comprehension and the most extended use of the law of the similars.

The key-note, in music, is defined to be
“the fundamental note or tone to which the whole piece is accommodated”; and the
key-note of music finds, by analogy – through which things most remote and unlike
superficially are connected in the closest relationship – its likeness everywhere. The
key-note of Religion is God’s existence. By it every one of the innumerable theologic tones,
however apparently discordant, are harmonized. Gravitation is the key-note of the order that
governs the myriad spheres that plough their way through space. Progress is the key-note to
which the wonderful political, social and industrial movements of the day are attuned. [1] The
key-note of the Church – is faith; of the true household – love.

Thus has been given suggestively, and perhaps
with sufficient clearness, the meaning, force and true application of the term as I have used
it in medicine, and with the feeling that suggestion is often more lucid than direct
expression, I hesitate to give a more exact definition.

When a man tells us he is “out of
tune”, or when a medical author speaks of the depressed or improved “tone”, or
want of “tone” of the system, we scarcely require an explanation of the meaning of
the terms thus used, and more is conveyed to our minds, perhaps, than could be made clear by a
laborious attempt to express in other words the same thing. It is thus with the term
“key-note”. It is intended to be expressive of a truth that could not be expressed
in any shorter or more compact sentence; and as conveying or rather suggesting to the mind the
whole truth itself.

A casual observer, viewing the fair field of
our Materia Medica, would say that the flowers are all alike; so similar and so common as to
be utterly valueless; and, indeed, without the principle involved in the term I have used,
this would appear to be the truth. In Materia Medica and Pathology we have before us, vast
heaps of apparently inharmonious, confused and unrelated facts, and these continually
accumulating, with the prospect that the higher faculties – upon the unincumbered and vigorous
action of which depends all real achievement – would eventually become hopelessly bewildered,
were it not that the guiding principle, the one fundamental characterizing power, the

key-note, in fact, is struck, and every
tone and feature and expression is attuned to it and by it, modulated and harmonized.

The “key-note system” is not only
applicable to the array of symptoms constituting the pathogenesis of our Materia Medica, but
as well to the array of symptoms and conditions constituting disease. In Pathology, the term
pathognomonic symptom is intended to express, in very many instances, what might be termed the
key-note of a given disease, and yet while this is true so far as it goes, it does not go far
enough to cover the whole ground; to embrace the whole category of diseases; or to mark the
distinctive features that characterize one case of the same disease from another. Now the
Homoeopathic Physician does not profess to treat disease,

per se; but rather patients; and thus from the very
nature of things, even the erudite generalizing of the Allopathic School cannot be received by
us.

Although the chief features of a disease are
present and similar in all persons attacked by the malady, and even those symptoms which
perhaps have furnished it with its name, yet we must all confess that we are able to detect
some sign or symptom, some all-pervading condition, some characterizing circumstance that
gives that case its individualitiy, and causes it to differ, if ever so slightly, from all
other cases. Thus we may be said to have first – the expressions that evidence disease; then
the special markings that distinguish classes and orders; the conditions or symptoms by which
each class or order is subdivided and each subdivision furnished with a specific name; and
finally, the

characteristic
features which serve to distinguish each case of the same diesease from all other cases: as in
the human family we find first the broad and ever-present features of the race; then the
distinctive marks of nationality; then the peculiarities of family; and lastly, the
lineaments, deeply or faintly traced, which characterize the individual.

This, now, is what we would call the key-note
system, as carried into the study of disease. It is

comparative Pathology in its most extended sense. You are, perhaps, ready to tell me that this
is nothing new. I am well aware of it. Hahnemann laid it down as distinctly as it was possible
to give utterance to truth, and while it is not true simply because Hahnemann gave utterance
to it, it is true because
the experience of thousands of Homoeopathists have confirmed it as the true system of
diagnosis; the truly practical method of distinguishing between one case and another, or in
other words, of individualizing. Alas, that it should be so often lost sight of in the fascinating whirlpool of
generalization.

Let us now turn to the store-house from
whence is to be drawn the agencies that are to prove curative for these multifarious forms of
disease, and see how the “key-note system” is to be applied there and with what
effect.

From the “provings” of Aconite;
from its numerous toxicological effects; and from the revelations of its scope furnished us by
its use in disease, a vast tissue of symptoms might be accumulated, that it is not
exaggeration to say would fill a large volume; and to these we might add the results of new
provings, on different individuals,

ad infinitum. How very many of these symptoms are very similar to, or apparently identical with,
those produced through the provings of other drugs? Truly the flowers appear all alike. Yet
there is something within
that pathogenesis, indicative of Aconite alone; embodying in expression its one characteristic, unfailing, predominant effect,
which makes it to differ from all other drugs, and which persuades all its other effects with
more or less predominance. This symptom or condition, these symptoms or conditions form the
key-note or key-notes of Aconite as a medicine, and furnishes the key to its indications in
disease. Thus, in instituting comparisons between medicines, by taking all the symptoms and
comparing them carefully, we will find that each one presents, besides the fundamental similarity to all the others, peculiar differences from all the others; and these
invariable points of peculiar difference are the “key-notes” in a comparison of such
remedies.

Here, then, we have the characteristic
peculiarity in the disease that individualizes that case, and we are enabled to call up from
the store-house of the Materia Medica and place in apposition with it that medicine which
possesses in its pathogenesis a corresponding similar characteristic, peculiarity or
“key-note”, and which will prove to be the curative agent for that case of disease.

It is charged against the key-note system
that it is in conflict with the doctrine that teaches the necessitiy of meeting the totality
of the symptoms, or in other words, the doctrine of true Homoeopathy. This is by no means
true. It is claimed, – not that the key-note in the case is to be alone met by the key-note of
the remedy; nor that the whole case is to be met by the key-note alone, – but simply that the
predominant symptom or condition of the case that individualizes it and constitutes its
key-note, suggests to the mind a medicine having a corresponding predominant symptom,
condition or key-note, and that if there has been no error committed either in viewing the
key-note of the diesease, or of subsequently selecting just that remedy having the
corresponding feature, there will then be found in the pages of a

symptomen codex [2], under the heading of that
particular remedy, the remaining features, symptoms and conditions of the patient, or in other
words the “totality”. Thus the “key-note” as before explained, is simply
suggestive; suggesting by the shortest, surest and most practical method, a remedy; separating
and isolating it from all other medicines as having, first: the characteristic symptom or
condition or “key-note” in a marked degree [3]; secondly, and consequently, the
remaining symptoms or conditions; these constituting together the totality of a case. As a medical friend expresses it
in a recent letter, “the key-note gives us the pitch of the tune, but it is not the tune.”

After all, it is in this way that true
Homoeopathists have ever prescribed. It is not the totality that biases the mind, so to speak,
or directs the attention to a certain remedy. It is always something peculiar in the case,
some prominent feature, or marked symptom that directs to a certain drug, and the totality
afterwards confirms or disapproves the choice. I again repeat, therefore, that the
“key-note system” does not in any way interfere with the doctrine of “the
totality”: it insists, on the contrary, upon the essentiality of that doctrine, and is
the guide to its being properly and practically carried out.

In my recent work on Obstetrics, &c. [4];
I have endeavored to carry out this key-note system to a practical determination, so far as
my, at present, limited knowledge has permitted. I have not attempted to set down under the
head of each remedy in each disease, the catalogue of symptoms that

might be present, but to give the characteristic
peculiarities or key-notes of the remedies – such only as had been, in my experience and that
of others, “tried, proved and chosen”, – so that the mind might be directed at once
in the true direction, the choice to be confirmed by the totality of the symptoms; so that the
true key-note being struck
all the other tones would be harmonized with it. It is in this way that I desire to be
understood, and those gentlemen who have done me the honor to review my book will bear in mind
that this is the true interpretation of the plan I have set forth; and if they will give it
their attention, and carefully and conscientiously experiment at every fitting opportunity,
they will, ere long, be ready to say yea! and amen! to all I have written on the subject.

A few examples, by way of illustration, may
not at this juncture, be misplaced.

Being called in consultation recently, in a
case of dysmenorrhoea, where a great variety of symptoms presented themselves, I was much
struck with the

devout, beseeching, earnest and ceaseless talking of the patient, and at once suggested to the attending Physician the exhibition of Stramonium. Upon comparing symptoms he
replied that all her symptoms were not under the head of that remedy, but agreed to the use of
Stram., as he could suggest nothing else, adding that if it cured her, “he would cease to
believe in the doctrine of totality”. I replied that Stram. was undoubtedly the remedy,
and if it were properly proven and on every variety of temperament and condition, all of her symptoms would be found in the
record of its pathogenesis. Stramonium 2c was given and it quieted her at once, and all her
other symptoms speedily vanished, inversely as they had appeared. Her peculiar talking was the last symptom to manifest itself
and the first to disappear, and when present in disease in either sex is a key-note to Stramonium.

In case of hemorrhage, where the blood forms
itself into a resemblance to long black strings hanging from the bleeding orifice,

Crocus will be the remedy; not for the
hemorrhage alone, but for the whole chain of symptoms presented by the patient. The hemorrhage
being last to appear will be the first to be removed, and by not now interfering with the
curative action in progress, giving no other medicine, and allowing a sufficient time for the
action of the dose, the remaining symptoms, constituting the whole condition that has led up
to the hemorrhage with its characteristic peculiarity, will be dissipated, inversely as they
have appeared.

When, in colicky children, an appearance of
red sand is discerned in the diaper, we know that

Lycopodium is indicated. By the action of that remedy the whole disordered condition of the
little one will be removed; the whole chain of disordered action that culminated in this
phenomena of the urine. The urine indicates Lycopodium; is the key-note in the case for that
remedy, and the balance of the little patient’s symptoms will be found under it and be removed
by it.

I am permitted to refer to the following
case, extracted from one of the numerous letters sent me on this subject. In a case of typhoid
fever; the last and worst of a malignant epidemic, where the disease had resisted the action
of all the medicines given, and the attending and consulting physicians despaired of saving
the boy, – a previously healthy, robust lad of sixteen years, – he was restored to his former
rugged condition through the action of a remedy suggested solely by a “key-note”
symptom. My friend writes, “as I went to his bedside one evening, I noticed a peculiar
convulsive movement of the head, such as I had not before noticed in this or any other case,
viz.;

the head jerked itself clear of the pillow and
then fell immediately back; this being constantly repeated. I at
once recalled your key-note for Stramonium. I went to my office and on comparing the symptoms of the case with the
symptomatology of that remedy I was struck with the wonderful correspondence.

I then gave repeated doses of the 3d
dilution, acting on my colleagues advice, but in twenty-four hours saw no improvement. The
30th was then given with no favorable result. I then gave a single dose of Stram. 2c at night
and was delighted to see a smile on the face of the anxious mother when I called next morning;
‘Henry became quiet’, she said, ‘very soon after taking the medicine, and has for the first
time slept quietly.’ His convalescence was steady from this period. I gave no other medicine
for ten or twelve days. Stramonium saved him, and your ‘key-note’ given me in the class, was
my only guide to it.”

The few examples thus cited are sufficient to
point out the practical workings of the key-note system. Through it alone, I hold, can the art
of prescribing Homoeopathically be simplified and rendered exact. By it Stapf [5] was enabled
to prescribe correctly, in the presence of an expectant and admiring class, without asking a
question, for the objective key-note, revealed in the countenance of the patient, gave him
full knowlegde that under Cantharis the whole condition and symptoms would be found; and by it
hosts of Homoeopathic physicians since his day have been safely and quickly guided to the
truly-healing medium that might have been missed if sought through more complicated channels.
The force and truth of Hahnemann’s idea that the symptoms of the disease are cured inversely
as they appear, is beautifully demonstrated if viewed from the stand-point of the key-note
system. Through this system the complex and difficult text of the Materia Medica is rendered
pure and clear, and every shadow uplifted from its pages; by it Pathology – the servant of
Homoeopathy – is brought into fullest and most vigorous usefulness, and Diagnosis made exact
and availing. As in the hands of an Agassiz or a Leidy, a few bones or teeth, or the scale of
a fish, are sufficient to unfold a whole chapter in the book of natural history, so in
Homoeopathic practice, by the characteristic key-note emphasized by the patient, the
practitioner is enabled to individualize his case and draw to his aid, thus revealed, the
corresponding similar remedy having the totality of the case, and able,

coeteris paribus, to cure it.

I have thus attempted to demonstrate the
meaning, truth and utility of the “key-note system”. Without any attempt at fine
writing or display I have endeavored, in moments of leisure stolen from hours of toil, to set
forth with clearness and exactness what I believe to be, not a new doctrine, but a true one in
Homoeopathy; and if, by reason of this paper or the discussion that may follow it, or any
inquiry that may be set on foot through its publication, we may be led still farther into what
I conceive to be a true path to the correct system of Homoeopathic therapeutics, I shall feel
myself amply rewarded.

Henry N. GUERNSEY

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Annotations (by Stefan Reis):

[1] Remember: this was written in 1868!

[2] With this term, Guernsey makes a hint to G.H.G. Jahr’s Materia Medica: Ausführlicher
Symptomen-Kodex

der Homöopathischen Arzneimittellehre. Erster Band: Gedrängte Total-Ubersicht aller zur
Zeit eingeführten Homöopathischen Heilmittel, in der Gesammtheit ihrer bekannten
Esrtwirkungen und Heilanzeigen, Leipzig 1848.

[3] Not only “among others”!

[4] The application of the principles and practice of Homoeopathy to obstetrics, 1st ed.,
Philadelphia, Boericke, 1867. From this edition the Indian reprints of to-day are made, but
originally it was followed by two improved editions in 1873 and 1878. For illustration: the
first edition having 752 pages was enlarged up to finally 1004 pages (3rd. ed.).

[5] Johann Ernst Stapf (1788-1860), editor of the first Homoeopathic journal, Archiv für
die homöopathische Heilkunst. The case Guernsey refers to could not be found yet.

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Recommended writings for further study on this
subject:

Guernsey, Henry N.:

The
genius of our remedies and the genius of disease compared, in: Transactions of the
Homoeopathic Medical Society of the state of Pennsylvania, 1870-1871, Philadelphia 1871, pp.
181-185.

Guernsey, Henry N.:

Uterine
haemorrhage treated by internal remedies, in: Transactions of the American
Institute of Homoeopathy, Chicago 1871, pp. 507-509.

Kent, James Tyler:

The
basis of future observations in the Materia Medica, or how to study the Materia Medica,
in: Journal of Homoeopathics, Vol.II, Lancaster 1899, pp.441-449.

Reis, Stefan:

Das
Keynote-System und seine korrekte Anwendung, in: Archiv für Homöopathik, Band 2
(1993), III, S. 105-109.

Reis, Stefan:

Keynotes
zur Materia Medica, 2., überarbeitete Auflage, Haug Verlag, Heidelberg 1999,
darin: Vorwort des Übersetzers (S. 9-12), Kurzbiographie H.N.Guernsey (S.291-294), Das
Keynote-System (S.295-307).

Copyright © Stefan Reis1999
Photo et mise en page Copyright © Sylvain
Cazalet 1999

H.I.