A Contribution to the Judgement
Concerning the Characteristic Value of Symptoms
By Clemens Franz Maria von Boenninghausen
Presented by Sylvain CazaletIt is now over
three years since the great Homoeopathic Congress was held in Brussels, Germany being, I am
sorry to say, but little represented. In the last session of this meeting after several
propositions had been read, my resolution was adopted and a prize-question was proposed, to
answer which a period of two years was granted. This prize essay, as the Homoeopathic
journals have also made known, was intended to call out a “Treatise concerning the
greater or lesser (characteristic) value of the symptoms occurring in a disease, to aid as a
norm or basis in the therapeutical selection of the remedy.” The answer to this
question was not limited to Belgium or to France, but it was handed over to the competition
of the whole medical world, and it was thus unanimously acknowledged to be a subject of the
greatest importance. Nevertheless, this question, in spite of the daily increase of the
homoeopathic literature, has thus far remained unsolved. This silence extending far over the
time set, which was computed liberally enough, seems to justify the assumption that the
solution of the question has met with considerable difficulties, though every homoeopath
must every moment find himself in the position to ask himself this question, and to have to
answer it. It might not appear altogether proper for me, the author of the question, to also
now enter among the competition for this prize. But the old practitioner will be pardoned
for furnishing at least some contribution to the solution, and thereby again calling
attention to the question.The teaching of
the Organon in this matter really contains the proper, true kernel of the answer, and this,
of course, deserves to be first premised. It is found in the great Paragraph No. 153 (5th
Ed.) and is as follows:In seeking for the
specific homoeopathic remedy, i.e., in this juxtaposition of the phenomena of the natural
disease and the list of symptoms of the medicines, in order to discover a morbid potency
corresponding in similitude to the evil to be cured, the more striking, particular, unusual
and peculiar (characteristic) signs and symptoms of the case should especially and almost
solely be kept in view; for there must especially be some symptoms in the list of the
medicine sought for corresponding to this, if the remedy should be the one most suitable to
effect the cure. The more general and indefinite symptoms, such as lack of appetite,
headache, weariness, disturbed sleep, uncomfortableness, etc., in their generalness and
undefinedness deserve but little attention, unless they are more especially pronounced, as
something of such a general nature is seen in almost every disease and in almost every
medicine.It is seen,
however, that it is here left to the physician to judge what is understood by the “more
striking, particular, unusual and peculiar” symptoms, and it might, indeed, be
difficult to furnish a commentary to this definition, which would not be too diffuse and,
therefore, easily understood, and on the other hand would be complete enough to be properly
applied to all these cases. Whence is it that we are unable to show any such definition in
our literature? Even what Hahnemann adduces in §86, and those that follow, only contains
some examples which are given without any systematic order, and are therefore but little
suited to impress themselves on the memory, a requirement which in all such matters must
appear to be of very great importance.After looking
about in the whole of the medical writings, allopathic as well as homoeopathic, for an aid,
I remembered that in the middle ages they were accustomed to bring all such matters into the
form of verses, in order that the memory might thus be assisted. The modern learned world
knows, e.g., the diet of the Schola salernitana, dating from the beginning of the twelfth
century, drawn up in leonine verses, as is supposed, by a certain John of Milan, from which
some parts are quoted even to this day. But though I did not find here anything for the
present purpose, I yet found something which, as it seemed, might prove useful with writers
of quite a different doctrine. There is, namely, a hexameter dating from this same period
but from the theologic scholastics; this is, indeed, of a somewhat jolting construction,
nevertheless it contains briefly and completely the various momenta according to which a
moral disease is to be judged as to its peculiarity and grievousness. The verse is the
following: “Quis? quid? ubi? quibus auxiliis? cur?
quomodo? quando?“The seven rubrics
designated in this maxim seem to contain all the essential momenta which are required in the
list of the complete image of a disease. May I be allowed, therefore, to attach my remarks
to this scheme, with the desire that this hexameter, which was formerly used only by
theologians, may now be also impressed on the memory of homeopaths and be put to use by
them.As a matter of
course the personality, the individuality of the patient, must stand at the head of the
image of the disease, for the natural disposition rests on it.To this belongs
first of all the sex and the age; then the bodily constitution and the temperament; both, if
possible, separated, according to his sick and his well days i.e., in so far as an
appreciable difference has appeared in them. In all these peculiarities whatever differs
little or not at all from the usual natural state needs little attention; but everything
that differs in a striking or rare way therefrom deserves a proportionate notice. The
greatest and most important variations are here found mostly in the states of the mind and
spirit, which must by scanned all the more carefully, if they are not only sharply distinct,
but also of rare occurrence and, therefore, correspond to only few remedies. In all such
cases we have all the more cause to fathom these states with all possible exactness, as in
them frequently the bodily ailments recede to the background, and for this very reason offer
but few points for our grasp, so that we may be able to make a sure selection among the
remedies which compete.Paragraph 104 of
the Organon makes it a duty of the homoeopath to make a written scheme of the image of the
disease, and whoever has once acquired a certain facility in this will easily know how to
satisfy this requirement and gradually acquire a certain specializing penetration, which
will prove to him of ever increasing usefulness. For as every man presents an individual
nature different from every other one, and as every medicine must be exactly adapted to this
individuality, in agreement with the symptoms, which it is able to produce in the total man,
so, an once, at this first investigation as to the Quis? A great number of medicines are
thrust aside, just because they do not correspond to the personality of the patient.The spiritual and
dispositional individuality of the patient here gives the most important, often almost the
only deciding points for the selection of the remedy, where the disease involved is one of
the mind or spirit, and generally the two disturbances present themselves so conjoined into
one that the signs of the one only receive their full and definite character from the other.
Hahnemann, indeed, recognized the importance of this two momenta from the beginning, but the
necessity of weighting the two in their connection with one another he only recognized later
on it its full measure; and he then placed the symptoms proper to the two, which in the
first provings had been separated, one making the beginning and the other the end, in the
“Chronic Diseases” immediately one after the other, an improved arrangement, which
we also find in the best works on Materia Medica Pura of later times.Many other things
belonging to this rubric, but concerning the bodily individuality and presenting, as it
were, the chief features in the portrait of the patient, are contained in those books under
the heading of “general.” It would be desirable and would greatly facilitate the
use if everything not pertaining thereto should be excluded, and the former be brought under
a particular rubric denominated either “Individual” or “Personal,” in
such a way that the corporeal would present a separate picture, as has been done with
respect to the spiritual and mental.Of course this
question refers to the disease, i.e., to its nature and peculiarity.It may be
unquestionably received as an axiom that we must first know an evil accurately before we are
able to give any effectual aid against it. That occasionally relief may be given, without
having first recognized the nature of the evil, as little refutes this axiom as the fact
that an unexpected event occurs frequently which lies outside of our computation, and which
either leads to good or evil, while neither the good will, nor the knowledge of the
physician have the least to do with it.But this axiom
must be associated with another, which is no less true and no less important, namely this:
That we must also know and possess the means which are able to relieve the evil when it is
recognized. Where these are lacking, the former are of course of no avail.Since the times of
Hippocrates, thus since more than two thousand years, very much has been done with respect
to the first point, and we have especially enjoyed a great progress and enlightenment within
the last century and up to modern times. The path of pure observation and experience, which
for a time had been pretty much forsaken, and on which that ancient Father of the healing
art had gathered his valuable material, has again been entered upon. At the same time our
contemporaries possess and use the great advantage enuring to them from the fact that they
stand on the shoulders of their predecessors, and can thus view a greater circle of vision
and, more especially, that astonishing progress has been made in all the subsidiary
sciences, especially in chemistry and anatomy; so also they have had the advantage offered
them by many physical instruments, which it must be confessed they have used with industry
and care. By these means the modern physiological school, and, at the same time, the
diagnostics of diseases, have reached an excellence not attained in earlier times.The only thing of
which every Homoeopath has to complain in this matter, is that things are conducted in too
general a manner for his doctrine, and that almost universally diseases are described and
treated of under the same name, which differ essentially in their nature, and require for
their cure very different medicines.An immediate
result of this failing is, that Homoeopaths can make only a very limited use of the great
advance made by the dominant school in diagnostics, since their generality excludes every
special direction as to the suitable remedy.Now since the
modern Materia Medica of allopathy, as well as the older one, moves in the same generality,
the conclusion follows almost inevitably that even the most cultivated allopath often stands
undecided when he is to make a choice of remedies, so that almost every one of them will
order something different, and that he is usually compelled to mix many thins together in
order to cover the various indications.More about this
will be found in the course of this short treatise in a more suitable place, where the other
questions are also discussed. Here I can only say so much about it.a. That the most
penetrating and most indubitable diagnostic as offered by the best allopathic manuals is
rarely of ever sufficient for the Homoeopath, so as to enable him to make a sure selection
of the remedy, and thatb. Such a
diagnostic at most, and even then not always, may serve to exclude all those remedies from
the competition which do not correspond with the common genius of the disease, but seem to
act chiefly on other parts of the organism.The seat of the
disease really makes a part of the former question, but it nevertheless deserves to be more
particularly emphasized, as it frequently furnishes a characteristic symptom, since almost
every medicine acts more and also more decidedly on certain particular parts of the living
organism.These differences
not only enter into consideration in certain so-called local diseases, but also in those
diseases which are called by more general names, as affecting the whole body, e.g., gout and
rheumatism. For it is probably never or very rarely the case that all parts of the body are
affected in the same degree; even if it should be merely the case that the right side is
more affected than the left or the reverse. But the examination of the parts affected is
most necessary and most required when the whole to which they belong is larger, and is
described merely in that general way which allopaths seem to delight in. Such names as
headache, eyeache, toothache, colic and the like can in no way contribute to a rational
choice of a remedy, not even when also the kind of pain is indicated.Of course, the
exact individualization of the ubi is most necessary in local ailments. Every Homoeopath
knows from experience how necessary it is, e.g., in treating toothache, to select a remedy
which in accordance with its provings on healthy persons has shown its action on the
especial tooth to be treated. Among the most striking and decisive phenomena in this respect
we should especially number the sores on the upper side of the joints of fingers and toes,
which under allopathic treatment frequently prove very obstinate, and not infrequently
become malignant, and necessitate an amputation, and, as I had an opportunity of witnessing
here in two cases, may even have a fatal result. Every Homoeopath knows the efficacy of
Sepia in these ulcers of the joints, which have no otherwise distinguishable features when
this remedy is taken internally; without any external medication it will have a sure effect.
Medicines which correspond to similar ulcers on other parts of the body in such cases are
utterly useless.If the practice of
auscultation and percussion, as well as the use of the stethoscope, the plessimeter, etc.,
had been as well known to Hahnemann and his pupils as to our young physicians, they would no
doubt have made the most extended use of the same for gaining a more exact knowledge and
delimitation of interior ailments. They would have found out in lung troubles, e.g.,
definite local signs pointing to the use of certain remedies, and would have indicated them
more accurately, and would not have limited themselves to defining them as being on the left
or on the right side or at the top or below. To bring up to date and to specify more closely
might be one of the chief duties for those who make additional provings at the present time,
and might serve to an important and essential enrichment and completion of our Materia
Medica more than a whole mass of confirmations of older symptoms or the finding out of new
ones, which mostly have a lack of individuality.At the same time
it will be conceded from the allopathic side that the closer delimitation of the part
affected, even though it may be of moment in the completion of the diagnosis, will be of no
use to allopathic therapy, because this school is unacquainted with the peculiarities of the
various medicines. No allopathic Materia Medica gives any information that the one remedy,
e.g., corresponds more to the anterior or the posterior lobe of the liver, more to the upper
or the lower part of the lungs, on the right or the left side, according to which the choice
of the remedy may be made. Even if we Homoeopaths do not as yet know this as to all
remedies, we do know it with respect to many of them, and for what is lacking we find a
substitute in other signs, since, as is well known, all of these correspond to the remedy to
be selected, at least they must not be opposed to it. Thence it may be seen that these new
inventions, the value of which I am not in any way inclined to undervalue, have far less
value in a therapeutic direction than in prognosis, where they show the extent and the
dangerous nature of the malady.Finally, we must
yet consider in this question that neither the internal changes, which can be determined by
these instruments, nor the material external changes, which manifest themselves openly to
our notice, never present the dynamic disease itself, but are only its products, and are
only developed in the course of the disease. When, therefore, these first beginnings are
checked by the suitable remedy before those disorganizations take place, then these latter
would not come to be developed, and it would be an inexcusable procedure to allow these
sufferings to advance to a point where these material changes can be recognized in an
artificial manner. It was necessary to mention this, in passing, in order that it may be
shown how Homoeopathy proceeds, and to deny most decidedly the objection sometimes made that
Homoeopathy is merely an expectative method, which allows the disease to develop without
hindrance until it is too late to help. On the contrary, Homoeopathy knows and uses in
infections diseases sure prophylactic remedies, which are always and exclusively such as
have the power to heal the disease itself, and they never omit their use for the protection
of those around the patient.If the hexameter
which we are following had been originally written for our doctrine, probably a more
suitable expression would have been used in this instance, e.g., quibus sociis or quibus
comitibus? Still the name does not matter, and it is manifest that it must refer to the
accompanying symptoms.Now since in
Homoeopathy the chief aim consists in ascertaining the remedy which most completely
corresponds to the totality of the symptoms, it is evident that this point is of the
greatest importance and deserves the most careful consideration.For every disease
presents in its recognizable phenomena a more or less numerous group of symptoms, and it is
only their totality which presents its complete image. This image may be compared to a
portrait, which can only then claim to be a striking likeness when all the features of the
original are faithfully presented in it. It is not sufficient that mouth, nose, eyes, ears,
etc., should be presented in such a manner as characterizes man, and distinguishes him from
the monkey and other animals but as every human physiognomy possesses its peculiarities and
is distinguished from every other, so also here the more or less strongly pronounced
abnormalities must most carefully and with the greatest faithfulness and truthfulness be
presented and given their prominence. If therefore, retaining our former comparison, the
nose should have a most peculiar form, color or size, it would not be sufficient to present
this alone, though it should be most lifelike, and to add all the rest according to fancy,
but also the secondary parts, which, as it were, form the background, must present a whole,
such as it exists in reality, in order to give a perfect likeness.It is from this
point of view that the concomitant ailments are to be regarded when we select a remedy
according to the motto: Similia similibus. Thence it is evident that the rare, striking and
peculiar symptoms which present themselves demand a more prominent place than the common
ones, because on them chiefly though not exclusively the similitude depends.From this it
naturally follows that the value of such concomitant symptoms for the purpose intended
varies widely. But it would too far transcend the purpose of this contribution if I should
adduce and explain all the many categories of value. I shall therefore limit myself to the
presentation of a few of the most important points here involved:First of all,
those symptoms which are found in almost all diseases may be left out of our count, unless
they manifest themselves in a striking manner.The same obtains
as to those ailments which are wont to appear as constant concomitants or at least as usual
in the disease under consideration, unless they should be distinguished by some rare
peculiarity and in this respect offer something characteristic.On the other hand,
all those attendant symptoms should be carefully noted which (a) rarely appear in connection
with the leading disease, and are, therefore, also found rarely among the provings; (b)
those which belong to another sphere of disease than the chief ailment, and (c) lastly,
those which have more or less of the characteristic signs of one of the medicines, even in
case they have not before been noticed in the present juxtaposition.Now if besides
this among the last mentioned concomitant symptoms there should be one or another in which
the genius of one of the remedies should be plainly and definitely portrayed, so that it
would be plainly pointed out, this one symptom thereby would acquire such an importance that
it would even outweigh those of the chief ailment, and many then be at once considered as
the most suitable. Such a symptom would be included among those which Hahnemann calls
“striking, strange, unusual and peculiar (characteristic) signs,” and which are
then “almost alone to be considered” because they preeminently give to the whole
disease its individual character.One circumstance
deserves to be particularly mentioned here which particularly shows the importance and value
of concomitant symptoms, namely, that several very efficient and in part specific remedies
in certain diseases were discovered almost exclusively through them, the other symptoms
indicating the main disease not having pointed in that direction, nor indeed could they have
given such an indication, because the noticeable proximate signs could not sufficiently
indicate the real peculiarity of the disease. This same system of concomitant symptoms also
gives to Homoeopathy a much greater sureness in the treatment of diseases as compared with
Allopathy, which first constructs for itself a frequently deceptive diagnosis of the
disease, which at most only points out the genus of this disease, and where there are
important attendant symptoms it endeavors to help itself by adding to the leading remedy
given for the genus of the disease one or another remedy to cover the concomitant ailments.Why? The causes of
the disease play a prominent part in pathological books, and justly. But a large part of
this amounts only to guesses and attempts at explanation, which mostly have only a very
subordinate value or none at all in the proper therapy of the disease, and which are too
remote for our doctrine which is directed merely to the practical.The causes of
diseases are most generally and, indeed, very properly divided into external and internal.The internal
causes properly refer only to the general natural disposition, which in some cases amounts
to a peculiar supersensitiveness (idiosyncrasy). The external causes or occasional causes
embrace everything which, where there is such an internal disposition to disease, may
produce disease.The general
natural disposition which is also called the proximate cause, really belongs to the first
question (Quis?) which respects the individuality of the patient. It only belongs here in so
far as the consequences of a former disease may have modified the original natural
disposition, and thus it deserves mention.The occasional
cause, however, is the matter with which the present question occupies itself and which
deserves to be more closely considered. As to the natural disposition notified through
previous diseases, this either depends on the miasmatic-chronic nature of those diseases as
yet unexterminated, among which in agreement with the teachings of Hahnemann many
homoeopaths even at this day count psora, syphilis and sycosis, or it is derived from the
remains and after-effects of acute diseases, which when they do not belong to the former, as
is frequently the case, constitute the numerous class of medicinal diseases or poisonings.
Not infrequently, however, we meet with cases where both these momenta have cooperated to
undermine the natural health, thus producing a monster of a disease which is even more
deeply in-rooted and more difficult to combat.As to the
recognition and treatment of the first mentioned miasmatic diseases and their complications,
Hahnemann himself in his masterly work on the Chronic Diseases left us the most complete
directions, founded on many years’ experience. The much disputed division of medicines into
antipsorics and non-antipsorics need not be considered here. It is enough to know that the
former far excel the latter in their effectiveness in chronic diseases, and that their
originator has nowhere excluded them from use in acute diseases. Later experience has also
taught us that additional medicines from our medical treasury should be numbered in this
category which have not been thus treated of in that excellent work. I am only sorry that
Hahnemann has not been able to fulfill the promise which he gave me in writing, that he
would treat as thoroughly and completely the images of syphilis and sycosis with his
accustomed mastership as he had done in the above mentioned work (Vol. 1, p. 58 f. of the
Second Ed.) with respect to latent and re-awakened psora. Whether we may believe in what
many somewhat derisively call Hahnemann’s Psora-theory, or reject the same, the attentive
practitioner must frequently have found cases where even the remedy chosen with perfect
correctness, in some acute disease, did not unfold its proper and decided effect before one
of the so much criticized antipsorics – frequently Sulphur – had first been used, when psora
had been involved, or an antisyphilitic or antisycotic when syphilis or sycosis had been
present before and had remained uncured. It must, however, be confessed to be one of the
most difficult tasks of the physician to always make the most suitable choice among the
antipsoric remedies, as most of them have almost the same symptoms and very few truly
characteristic symptoms are found with the different remedies. The more necessary is it for
the homoeopath to study with continuous industry these lists of symptoms and to compare them
with each other in order that he may pick up the scattered grains of gold for his use.Poisonings and
medicinal diseases are in one line and it makes no difference by whose hand any one has been
deprived of his health by means of a substance injurious to his organism; among these
substances medicines as well as poisons find their place. Of course, it is always of the
greatest importance to know in every case the medicines or poisons, in order that they may
be met by the proper well-known antidotes. The simple poisons may be pretty easily and
surely recognized by their effects! It would have required but one case of poisoning
occurring before the eyes of a Homoeopath for him bo have recognized the effects of Arsenic,
which yet remained unknown to all the allopathic physicians, in the case of the thirty
murders of Gessina Timme in Bremen, until the facts were obtained. In the medicinal diseases
this is much more difficult, because seldom or never is one medicine given by itself, but
always mixed with others; it can not, therefore, yield a clear and definite image. With
these, therefore, it is necessary, as in the other case it is desirable, and it facilitates
the treatment, if we can have a reliable account of what has preceded, and to be able to
look over the prescriptions. Since this may be of use even later on, as the treatment
proceeds, the journals of many Homoeopaths have a special rubric reserved for this subject.
We must consider these symptoms, called anamnestic, as being of special importance in this
question. Although the ordinary consequences of such morbiferous circumstances and events
are mostly already contained in the lists of symptoms of the medicines proved on healthy
people, yet homoeopathic practice has long ago shortened and made sure the tedious and
troublesome path of such investigations, and indicated for most of these cases the remedies
which are foremost in their usefulness in such cases. This is e.g., very much simplified in
cases of contusions, sprains, burns and the like. In other cases, e.g., in colds, the matter
is already somewhat more complicated, since the kind of a cold and the part of the body
affected offer differences which again point to different remedies. Thus there is a great
difference in this respect as to whether the person has been simply exposed to the cold, or
whether this took place while the body was in a perspiration, or if he at the same time got
wet through. So also it is well known that different remedies are indicated when internal
parts (stomach, abdomen, chest) have been exposed, or merely external parts (head, feet,
back), and this must be carefully weighed in every case. All this, as before said, is found
among the symptoms in the Materia Medica; but when once it is known that a cold in the head
from exposure to cold air, after previously being in a heated room, or after having the hair
cut, points to Belladonna or Sepia; after taking cold in the feet, to Baryta or Silicea, and
when at the same time there has been a wetting, to certain other remedies, then the
attention will first of all be directed to these, and only comparison be made with others
which are also occasionally indicated when the first are not sufficiently suitable.Finally we must
yet add a word under this question about infectious diseases, about which in pathological
manuals we read so much that is contradictory and unreliable; the influence of which
teachings is, however, much more far reaching than is generally supposed. To meet these
diseases, which often spread until they become a real calamity, Homoeopathy has the most
sure and approved prophylactics, and these, indeed, are the very same which have the power
of healing those diseases when they have developed. Therefore, when we find in a family a
case of infectious typhoid fever, there the same remedy, which has been given the patient in
accordance with his symptoms, will also be sure to protect those in the house from
infection, as it destroys the natural disposition thereto, and it will even in the shortest
time restore those with whom there may have already been apparent the beginning of the
disease. This last fact is the more important, as these first beginnings are usually so poor
in symptoms that no certain choice can be founded on them; but the known occasional cause
fully makes up for what is lacking. Of course, such a cure is not so brilliant as when the
patient has been at the verge of the grave, but the gain for him and the consciousness of
the physician is his sufficient reward.From his
etymology, this preposition excellently describes the essence and the scope of the question
before us. For the word Modus in the old classics not only refers to the manner and mode in
general, but also to all the modifications which can take place in anything, thus the
measure, the rule, the aim, the relations, changes, etc.; thus whatever, with the exception
of time, which is included in our last question (Quando), possesses the ability to produce a
modification, aggravation or improvement with the patient, naturally belongs, according to
the usage of the language, to this rubric. This question has a double importance to
Homoeopathy, first, because it was first discovered and developed by Homoeopaths, and is,
therefore, their indisputable and exclusive property, and secondly, because all the results
of provings and experience, without exception, belong to the more or less characteristic
signs, of which no one is a matter of indifference, not even those of a negative kind.Allopathy has
never given any general attention, which might have been of use to therapy, to this momenta.
At least its manuals on Pathology, Therapy and Materia Medica contain nothing of importance
on this subject. Homoeopathy, on the other hand, soon after its discovery, recognized its
great therapeutic value, and we find the first but already clear traces of it in Hahnemann’s
“Fragmenta de viribus medicamentorum positivis,” which appeared in the year 1805.
But during the progressive development of our science its importance appeared more manifest,
and it was soon declared to be indispensable, so that in the later provings the attention
was more and more directed upon it. On this account the latter provings are the more
complete, with the exception of those made by Hahnemann in the Materia Medica Pura, which
were elaborated with especial industry and on account of their constant use accompanied with
copious notes.If we compare the
lists of symptoms of the medicines which have been proved somewhat fully, even a superficial
survey will show that we find in almost every one of them the general indications of almost
every disease; headache, colic, pain in the chest, diarrhoea, constipation, as well as
dyspnoea, pains in the limbs, fever and cutaneous ailments, etc., are in no case quite
absent. But if we study these indications somewhat more closely, with respect to the special
parts of the body and the different sensations, then, indeed, differences will appear, and
we frequently discover symptoms which appear more or less frequently in one remedy and are
totally lacking in another. But the number continues too large to bring the decision to a
sure and indubitable point, and we soon feel the need of securing additional points in order
that we may find the true and suitable simile among the competing medicines. But the Quomodo
with the Quando generally solves the riddle in the most satisfactory manner, and not only
removes every doubt, but also furnishes the proof for the solution which we may have before
supposed to be the right one. That in such investigations and comparisons we must also, as
in what precedes, occupy the especial standpoint, is a matter of course. It is not
sufficient, e.g., to merely consider motion in general in contrast with rest in the body, or
in the part affected, we must also consider incipient and continuous motion, as well as the
different kinds and degrees of motion. The same applies to lying down, we must not only
consider the kind of position (on the back, on the side, doubled up, horizontal, etc.), but
also aggravation or improvement in the parts affected by lying on the painful part, or the
part not painful; all this is to be found out accurately and adapted to the remedy.Quite a prominent
part in this rubric is occupied by the partaking of food and drink, and this not only in
diseases of the digestive organs, but also in fevers and other internal and external
affections. Here it is not so much the amount of appetite, or thirst, to which also
allopathy in some cases gives a proper importance, but especially the dislike or the desire
for particular kinds of food and drink, and more especially also the change of condition
after partaking of one or another article of food that often gives the most important hints
as to the medicine to be selected. All experienced Homoeopaths have therefore always given
the greatest attention to this subject, and it is very much to be desired that whatever
different persons have discovered in this direction should be collected and published.It was mentioned
above, in passing, that even negative signs, so far as they belong to this rubric, should
not be neglected. An example will show best what is meant by this: when a patient, for whose
condition Pulsatilla seems suitable according to the five preceding questions, feels best
while at rest in a warm room, while he feels uncomfortable in the open cool air, and also is
fond of fat foods and bears them well, or offers other peculiarities which are in conflict
with the characteristics of Pulsatilla, this would give an urgent cause to doubt the
applicability of it to his case and to look for another remedy which also in these points
corresponds with the symptoms.I am sorry that
the space for these contributions, which anyways may seem to have been already greatly
exceeded, does not permit me to enter more in detail on one and another matter belonging to
this division, as I may openly confess that I consider the indications obtained from this
and the following question as the most important, indubitable, and therefore the decisive
ones for therapeutical purposes. Even the numerous class of reflex actions, almost all of
which fall into these two rubrics, do not by their internal contradictions diminish this
importance, as soon as we know their mutual value, and are, therefore, enabled to estimate
properly the worth of each.This last question
concerns the time of the appearance, of the aggravation or the improvement of the ailments,
and follows in natural order after the preceding, and is hardly of less importance in
therapy than the last one.From the time of
Hippocrates and his commentators up to our times great attention has been bestowed on the
periods of time in the various phases and stadia of the disease. The endeavor has been made
to fix the period and continuance of the beginning, of the increase, the acme, the decrease
and of the end of the disease. This would, indeed, make a useful contribution to the
recognition and the characterization of the disease. But only in case it should be left
altogether to itself and not be modified by medical interference. But on the other hand it
can not be denied that this cannot give the least aid in the selection of the remedy, if
only owing to the fact that the medicines cause disturbances in the natural course of the
disease, which frequently lie altogether outside of all computation. Least of all can they
be of any advantage to allopathic therapy, because it lacks all criteria from which to
indicate the one or the other. I hope that I may not here hear the objection that, e.g., the
periodical return of a fever points to an actual or a disguised intermittent fever and
therefore indicates Quinine in its various preparations; for we are not likely to find a
homoeopath who has not in his practice had to treat numerous victims of this error.Homoeopathy
intends something quite different in this question, having nothing in common with what
precedes. But it is concerned with two momenta which have an immediate effect on the choice
of the remedies, namely (a), the periodical return of morbid symptoms after a longer or
shorter cessation, and (b), the aggravations and alleviations depending on the time of the
day. These two will require but a few words.The periodical
return of morbid phenomena often coincides with periods of time which carry with them
particular occasional causes. Among these are to be numbered the menstrual ailments, as well
as those which are conditioned by the seasons, the weather, etc. Where such definite
secondary causes cannot be discovered, and where as is mostly the case, the attacks are not
closely bound to any sharply defined periods, they have no therapeutic value for homoeopaths
as they lack the quality of a useful indication.But of the greater
importance are the aggravations and alleviations at particular times of the day, and this
with respect to those which refer to single symptoms as well as those that refer to the
general health. In this respect Homoeopathy possesses a great and valuable treasury of well
proven experiences which are being more and more enlarged by careful observations. For there
is hardly any disease, from the malignant internal fevers down to local ailments, in which
during the different times of the day there does not manifest itself a more or less decided
and distinct aggravation or alleviation. Now since homoeopaths have learned these
peculiarities also in the various medicines during their provings on healthy persons, they
are enabled to make extensive and blessed use of this peculiarity in their therapeutics, and
they are obliged to do this in order that they may satisfy the rule Similia similibus also
in this respect.To demonstrate the
preceding with some special facts, I will only adduce here the importance which the time of
the day has on coughs with respect to the expectoration, as well with respect to the greater
ease with which it is discharged, as also the consistence and the taste. Something similar
we know about the stools, and although most of the remedies have diarrhoea among their
indications, we so far know only of two (Conium and Kali carb.) where this takes place only
by day and not by night.With respect to
the ailments which have a typical return, independent of other causes, we have a
considerable series of remedies corresponding to this, without on that account excluding
others, when they are indubitably indicated by their symptoms. Only in cases where this
return is sharply and definitely pronounced, as for example in the evening from 4 to 8
o’clock (Helleborus and Lycopodium), or exactly at the same hour (Antimon. crud., Ignatia
and Sabadilla), we should give it a special importance and only be careful that there may be
no contraindications.I conclude these
contributions, which I have only hastily sketched down, with the hope that I may have
succeeded in putting into the true light the difference between Allopathy and Homoeopathy
and to incite my colleagues on their part to treat these important themes more at length,
even if this be done only with respect to some one of the questions indicated at a time.
Clemens Franz Maria von
Boenninghausen
Allgemeine Homoeopathische Zeitung, Vol. 60, p. 73
Translation by L.H. Tafel, 1908Copyright © Sylvain Cazalet 1999