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WHAT’S A SYMPTOM?

Dr. M. A. Usmani

Usmani Resource Page

Copyright 2011-13/All rights reserved © Dr Usmani 
Contact author for permission to use

 

Some 25 years ago, (Feb. 5, 1988), I was confronted with a hard choice to opt either for the 10 volumes of Hering’s Guiding Symptoms or 12 volumes of T. F. Allen’s Encyclopedia of Pure Materia Medica. Hering’s was an attractive book, with beautiful get-up and paper quality. So naturally I started perusing and skipping through the pages of this book randomly from one volume to the other. I was marveled to see that many symptoms did not seem to me symptoms at all. What was between two full-stops, could hardly qualify as a symptom.  I was reminded of the Microsoft’s Word Processor, now called Microsoft Office Word. The text between two full-stops must grammatically be a sentence. When the sentence is incomplete, or grammatically incorrect, the Processor would underline it with a faded line. That line doesn’t let you take rest unless you correct the syntax.  There was no such gadget in homeopathy that could tell the writer that the matter which he is putting between two full-stops, does not qualify as a symptom: i.e. with Location, Sensations, and Conditions; the latter as to its genesis or causation, activation, modes and times (or occasions) of amelioration and aggravation. So I decided to buy Allen’s Encyclopedia. I had already The Condensed Materia Medica of Hering.

 

The concept of symptom is very complicated and varied in meaning and importance. A symptom to be a symptom, homeopathically speaking, must have at least three conditions fulfilled. It must have a definite and determinable location, or seat of discomfort. It must have definite expression of relating the discomfort, which technically we call Sensations. Further it must have Conditions of modification, as modes of relief and intensification of complaints of the morbid sensations, or conditions of Aggravation or Amelioration of pain. The Conditions can also include Cause of Aggravation or regeneration of painful sensations.

 

Then there are further some nuances which give validity to a syntactically perfect symptom. Which means that a perfect symptom, with it location, sensations and conditions well defined may not still qualify as a therapeutic necessity. For example you have started a chronic case. On the next visit the patient tells you many fleeting symptoms during the week that appeared and stayed for moment and disappeared to oblivion. But every symptom that the patient reports you as having occurred to him was a perfect symptom with all its structural conditions. What you advise to the patient is: ‘worry not, gentleman, let the waves pass, as they would, because your disease has entered into a flux now, and only note that symptom that sticks and does not buzz off.’  

 

One time happening can never becomes a symptom, unless it recurs or stays unchanged for a time. Even such a drastic happening as for example, a six years old lad, having spent a day picnicking in the sun; when coming home suddenly becomes erratic and does not recognize his siblings and the parents. You call a doctor, and by the time the doctor reaches, the child has already returned to his real self. Worried, you discuss with the doctor, and he comforts you by telling that the possible cause might be the long exposure to the sun, etc. But the fact is that that child is now 27 years old, and had no repetition of the symptoms and nothing unusual otherwise. So one time’s symptoms should not be prescribed upon, but be kept under observation of a caring doctor.

 

Confusing Sensations:

 

There are lot of confusing symptoms in materia medicas, and lot of confusing rubrics in every repertory. A full exposé is impossible here. I give one or two examples here. 

 

Differences between the sensations of ‘raw’ ‘sore’ and ‘scrapy’ is very difficult to make. Let us discuss it with reference to chest.

 

a)     Raw pain in chest on coughing: does not have Bell. and Bry; but has Carb.v.

b)    Sore pain in chest on coughing: has Bell. (in Italics); BRY. (in Black or capital letters);

c)     Scraping can be found under Larynx and Trachea.

d)    Rawness in trachea when coughing: Bell. and Bry. are missing. Carb.v. is present.

 

Ridiculous Symptoms:

 

In the Chapter on Extremities, in Kent’s Repertory, p.1077, there is a rubric:

Pain in Calves:

            1) Morning: Calc-p

                        Stairs, on going down: Rhus-t.

                        Waking, on: Gels.

            [How can you choose? What flimsy differences!]

           

            2) Afternoon: Rhus-t

                        4 p.m., lying on back with legs flexed: Nat-m.

            [What a symptom? Lying at 4 p.m.! If the same symptom occurs at 2 p.m. would not Nat-m. cure? Or if he is flexing his legs and is not lying on back, but on side, then what?   Murphy has ditto copied it. A brainless symptom indeed!]

 

 

It reminds me of an episode. A patient of mine, a lady, complained that she suffered severe knee pain during intercourse. I asked her to send her husband to me. After enquiring the detail I advised him a change of posture for intercourse. Our busy-bee homeopaths, wherever they find a semblance of a symptom, it is a pure nectar to them, and avidly suck it and hastily infuse it into the hive—their repertory.  So they would have entered this symptom in the repertory; and as the lady was cured by Benzoic Acid, they would have entered the rubric: ‘Knee pain, excruciating, (in a woman) during coition’. And have written Benzoic Acid in italic or in black letters. What a great (voluptuous) addition it would prove to be to our Repertory!

 

Again, there are more gems. In Murphy, p.1121

 

Aching in Calves: Walking, while: Myrica

                              Walking in Open Air:  Fagopyrum

Now what’s the difference in ‘Walking’ and ‘Walking in open air’ for a pain in calves? Moreover when only one remedy is mentioned against a rubric, one expects it to be a sure shot, which, I’m sorry, it is not.

 

Examples can be multiplied in hundreds which one doesn’t intend, nor has time thereto. Everyone should try to make homeopathy scientific in its all aspects, because the challenge is great and the survival hard-fought.

 

 

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Comment by David Kempson on June 20, 2013 at 10:29pm

An interesting article. I agree with many of your points - I think that the use of symptoms should be done intelligently, never mechanically, and whenever one takes a case you should examine everything to see if it is relevant or useful. There are many minor symptoms that come and go but have no value when trying to establish the overall pattern of the disease, and trying to prescribe on all of these is a sure path to failure. It has also been my observation that many little symptoms appear and disappear without changing the basic chronic picture.

However, in provings, I don't believe it is prudent to be deciding which symptoms should be recorded and which should not. Personally, I have no idea what kind of philosophy or techniques the supervisors and co-ordinators use when assessing the value of symptoms, so I would not like to think they are making the decision at that point as to which symptoms we should be told about. While I also believe it is important to do an overall assessment of the proving to pull out reoccurring themes (sensations, modalities etc), it might be that some of those symptoms that first appear to be fairly useless, when combined with further provings of the same remedy, or other research, could in fact paint for us an unknown aspect of it. In fact, I often wonder at how much useful information might be already filtered out of a proving because of a practitioner's personal beliefs.

Our repertories are certainly a mixed bag, that is for sure. I know that I often think the same thing as you - 'what a useless symptom, how could anyone use that?'. And yet, I have heard that said about symptoms that I use to prescribe, and seen practitioners successfully use information I might think would lead me nowhere near a suitable prescription. We are a diverse bunch, many artists amongst us who can thread unlikely snippets of information together to form maps to remedies. Rather than eliminating that information, the real onus lies on each practitioner to apply the best principles of case-taking and analysis. I think no matter how you try to lead someone through the difficult process of dissecting a case and establishing a totality, there will always be people who do not want to think to hard about it, who want the easy road.

Comment by Dr. M. A. Usmani on June 19, 2013 at 1:39am

Thanks doctor for your complements.

 My thinking is always not to be complacent with our knowledge. We must always try to make it stand the test of science and logic. What does not pass this test must be thrown into limbo for further queries. No knowledge can be bolstered up by faith and superstition. Our comparison is not with quacks, but with the most scientific brains and finest sensibilities in the world of health and medicine. Let’s purge our books from what’s drab and rubbish.

Thanking you again.  

Comment by Debby Bruck on June 18, 2013 at 9:02pm
Have a wonderful summer. Hope you are finding ways to stay cool.
Comment by Dr. M. A. Usmani on June 18, 2013 at 4:27am

Dearest Debby,

Very pleasing, refreshing, hilarious and, and, and... juvenile remarks!!! Thanks!

Comment by Debby Bruck on June 18, 2013 at 1:40am

ahhahahahahahahaha. I love to read your entries. It makes us think we are fools. 

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