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Gleanings from Homeotherapeutics, Fourth Dimension In Prescribing

Gleanings from Homeotherapeutics


Fourth Dimension in Prescribing


Dr. M. A. Usmani


Before Boenninghausen a complete symptom was three directional, viz.,


1)    Location in the body;

2)    Sensations, that the patient feels;

3)    Conditions of aggravation and amelioration.


Boenninghausen added another direction to make the prescription more secure: and that was the concomitant. A concomitant is a symptom that occurs concomitantly with the major complaint, and has no apparent physio-pathologic bearing on the major complaint. (More about concomitants will be discussed further below).  


Traditionally there were three methods by which a homeopathic physician used to prescribe: viz. on the basis of:


  1. The totality of the symptoms; and every symptom is considered complete in its own right, having location, sensation and conditions of <>


  1. Keynotes Prescribing: on which many great masters have done excellent work. 


  1. Clinical Prescribing, or Pathologic Specifics. Here Clarke and Boericke have done admirable work, and also it is Burnett’s choicest field. And Cowperthwaite has paved the way to this end.  


Among all the three methods, the first was the real classical way of the Master. Prescribing by the concomitants, a la Boenninghausen, and on the basis of gleanings of homeopathic literature, is the fourth dimension, which I will discuss here, as the method for the last resort, when the above three methods could not help; this dimension should be tried.


Now let’s clear our concept about





The dictionary meaning of ‘concomitant’ is ‘occurring and existing concurrently’. Boenninghausen was the first master who found and mentioned these symptoms. He was also the first who methodically incorporated them in his works.


The meaning of this term has variously been defined by the subsequent authorities. E.g.


  • “The word ‘concomitant’ means ‘existing and occurring together’; also known as ‘associated symptom’”.


  • “The symptoms that accompany the chief complaint are called concomitant symptoms.”


  • “The concomitant bears no relation to the chief complaint than the time association. When these symptoms cannot be explained by pathology, they become the characteristic symptoms.”


  • “The concomitants arise from the inherent constitutional aspect, and tend to remain constant with the patient irrespective of the nature of the disease.”


Dr.C.M. Boger developed the idea fully in his “Boenninghausen’s Characteristic and Repertory, with Additions and Modifications”.


According to him:


  • Concomitants mean accompanying or co-existing. The more they belongs to another sphere of the patient’s health than the chief complaint_ they become unreasonable attendants


  • The peculiar, strange and rare symptoms are indeed concomitants.  They cannot be explained pathologically, yet they occur at the same time with the chief complaint.


  • When a marked peculiar symptom belonging to the disease proper, makes the choice of the remedy difficult, a concomitant will decidedly indicate the drug.


  • Concomitants may far outrank the other symptoms of the chief complaint; such symptoms tend individuality to the totality. 


  • Totality being the sum-total of the characteristic symptoms, due attention to concomitants help in finding the similimum more easily, and with an assurance of accuracy. So concomitants are characteristic symptoms peculiar to the individual patient; (Boger infers).


  • A concomitant having the same modality as the grand symptom, presents a high characteristic feature of the remedy and is of great importance.


  • Mental concomitant in physical ailments and physical concomitants in mental ailments are an unfailing guide to the similimum. 


All are valid observations, solidly based on experience. But when incorporated in the body of their works, one finds their boundaries hazy, mingled up, and totally confusing. Most of the symptoms which Boenninghausen (or Boger) mentions as concomitants do not qualify as such. They are, at best, the modalities of the leading symptom or complaint; or a complementary part of the same symptom; or a consequential condition of the same (the major) complaint. Take, for example, the topic ‘Concomitants after stool’ (pp. 599ff.). Note the following entries: 


i)               ‘Pain; colic; griping; cutting; soreness; weakness in abdomen,’ after stool; are just common symptoms in dysentery. But Boenninghausen (or Boger) has mentioned them as concomitants. They are not even symptoms. They are the qualifying conditions of the main symptom. Similarly

ii)             ‘Burning; cutting; dragging; pressing; or prolapse like feeling; smarting, and bruised feeling; straining in anus after stool, are again common symptoms of dysentery. Boger mentions them separately, with their indicated remedies, as concomitants. A quite uncalled for division.

iii)            Again, the discharges of blood, and mucus like symptoms, have the same common status as the extension and qualifying conditions of the pathology. They cannot be called concomitants by any stretch of imagination.


Symptoms like ‘headache after stool’, or ‘hunger after stool’, or ‘palpitation after stool’ can be taken as concomitants, without hesitation. 


According to the above discussion, one feels that almost three-fourth of the concomitants, mentioned in ‘Boger’s Boenninghausen’ can be rejected as not passing the test. Boericke’s concept of concomitants is much clearer than that of Boenninghausen. A large body of symptoms, mentioned by Boericke, in his Repertory, under the main rubric of ‘concomitants’, however, are not concomitants. Some of them are sequential symptoms, some are modalities, and some are mere causative symptoms.


Under the Chapter of ‘Palpitation’ (p.856ff), for example,  the concomitants he mentions are:


‘with anguish, restlessness’, (he gives 16 remedies); but we know that anguish can both be the ‘cause of’ and ‘be caused by’ the palpitation; hence it’s not a concomitant.

with dyspnoea’ (14 remedies); dyspnoea  we know is a common symptom with palpitation.


Twenty-four symptoms are mentioned by Boericke as concomitants under Palpitation, out of which 6 to 7 can be accepted as true concomitants. Symptoms related to the organ (here the Heart), as e.g. ‘with labored heart’ or ‘with praecordial pain’ can be predicated to the organ itself, and qualify the symptom ‘palpitation’.


Under the Chapter ‘Rheumatism’ (pp.880ff), he gives 19 concomitants, which mostly are valuable; so are under ‘Asthma’ (pp.883ff), where he gives 18 concomitants, which more or less are correct and valuable.


Under Uticaria, in Skin Chapter, (pp.916ff), he has very ably distinguished between causative and concomitant symptoms.


So we come to the conclusion that the concept of concomitants is clearer in the mind of Boericke than Boenninghausen. In the final analysis we understand by CONCOMITANTS those symptoms or complaints that occur with the leading complaint, but not following, or bearing any causal or consequential connection with that leading complaint. A few examples I give as under:


Rheumatism with urticarial eruption’: Urtica Urens  (Bericke, p.881). This proved to be such a strong concomitant relation that Dr. Burnett ventured to employ Urtica Urens for rheumatism as a specific remedy, and with singular success.


Sciatica with gastric symptoms and eructations’: Veratrum Alb. And Verbascum.


‘Sciatica with lachrymation’: Chel. ,Mez., Puls., Rhus-t. (both, Boericke, p.949).


Locomotor Ataxia with enuresis’: Equis. H., Berb.V.,


Frequent sneezing with itching in the ears’: Cyclamen.


Megrim with menstrual irregularities’: Cyclamen.


‘Erections during toothache’; or ‘toothache with erections’:  Daph. Ind.


‘Jaundice with heart trouble’: Dig.


‘Edema Pedum with heartburning’: Zinc.


‘Palpitation with Aphthae’: Illicium. Etc., etc



These Gleanings will contain a rich harvest of concomitants and vast practical knowledge of world’s good literature, garnered during some 40 years’ practice and study. When a case is not settled by a careful taking of the history, and the presenting complaints of the patient, and repertorization of the same on the general or/and clinical repertories, and a help from Keynotes, a careful perusal of the relevant topic in these Gleanings would be insightful with dividends. This would be a sort of fourth dimension in prescribing.


From the name of this program (verily Gleanings is a continuous enrichment program) it is evident that it is never complete, and every careful precriber has the right and perhaps duty, to contribute to the sum-total of the subjects, by adding more and more practically tested concomitants and other practical hints.


In addition to concomitants, I have included many kinds of other symptoms, such as:


  • Alternating states of symptoms, as
    • diarrhea alt. with constipation, esp. in old-age;
    • Skin eruptions alt. with dysentery, or diarrhea;
    •  Skin eruptions alt. with chest symptoms;
    • Skin eruptions alt. with asthma or other chest problems;
    • Respiratory ailments alt. with gout or skin or sick headache;


  • Sometimes alternating states occur according to weather: as one set of symptoms in summer alternating with a set of other kind of symptoms, in some other part of body, in winter; or such alternation with regard to spring and autumn. These alternating states become very peculiar and give birth to characteristic symptoms, coveted by any keen prescriber.


  • Sometimes for a very common symptom a very uncommon or unusual medicine is mentioned, that too becomes an occasion for its inclusion in the Gleanings.   


I claim no originality in this regard, and wherever my own notion in mentioned, that would be in parenthesis. I acknowledge the gratitude from all the masters and other authors whose knowledge I have appropriated. The following authors were specially consulted, and quoted, with the abbreviations mentioned against their celebrated names:


CMM for Clinical Materia Medica Dr. Farrington

Ph. D for Pharmacodynamics Dr. R. Hughes

Dic. Pr. for Dictionary of Pr. Mat. Med Dr, Clarke

Cl. Th. for Clinical Therapeutic Dr.T, s. Hoyne

BK for Boericke Mat.Med Dr. W. Boericke

CB for Books of Dr. Burnett

FD for Books of Dr. Faiz-ud-Din

Usmani Resource Page

Copyright 2011-12/All rights reserved © Dr Usmani
Contact author for permission to use


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Comment by sajjadakram on September 7, 2011 at 8:48am
Well explained. In support, I wish you post some of your cases. Not only experienced homeopath will be benefitted, the fresh will also gain much knowledge.
Best wishes.
Comment by Debby Bruck on September 3, 2011 at 5:02pm
Always matter worth reading and bookmarking. Thank you so much. I tweeted to the twitterverse. This helps make clear that concomitants are "WITH" another symptom as in "ACCOMPANY" rather than a causal factor or a response to a symptom. I will study up some more of your examples.

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