LEAVING APART the rishis of Ayurveda and mandarins of China, in the orient, in the Western world, the idea of placing medical practice on semeiology and deciding the line of treatment on some general principles related with semeiology (law of similia/contraria) first occurred to Hippocrates, who is called the father of scientific medicine for that. But very unfortunately Hippocrates failed to evolve out all the aspects and technicalities involved in the practical application of the principles, for example, how to elicit the semeiology of drugs to be matched with the semeiology of patients, how to decide the dose, how to follow the action of remedy, what is the difference between the curative and palliative action of the remedy based on the principle of similia and contraria respectively, and so on. That is why, soon after his demise, medicine again reverted to an art, based on various forms of speculations and notions, where it remained for about two thousand and five hundred years. Thereafter it fell to the lot of Hahnemann to to rehabilitate medicine again on the solid foundation of semeiology detailing out all the aspects and technicalities related with it, based on irrefutable principles, to wit, how to elicit the required semeiological data of the individual patients, how to evoke the pathogenetic symptomatology of individual drugs, how to match the symptomatology of the patient with that of a single drug on the basis of the sole principle of curative therapeutics founded on the natural law, similia similibus curantur, how to observe the movement of symptoms in order to assess the process of cure or otherwise, how to fathom the obstacles to cure (including the maintaining and fundamental causes), how to adjust the regimen congenial with the requirements of the semeiology of the individual case and so on
But the efficient apprehension and practical application of these teachings of the great master essentially prenecessitates intensive use of certain basic faculties on the part of the practitioner; the most important ones of which are mentioned here:
- The faculty of observation: This faculty must be clearly distinguished from simple seeing or even watching. Observation necessitates the deepest and most circumspective use of not only the sense of vision, but all the five sense of higher animals, and over and above these, of the sixth sense, given only to man, which Hahnemann mentions as “other senses”(apho 84). Proper use of these six senses enables the observer to ferret out all the required data in each case, correctly interpret them and assess their value and dimensions in the proper background and perspective.
Every normal human being is born with this faculty entails life-long exercise. This exercise is conducted in voluntarily by each member of the homo sapiens (the intelligent species of the genus Homo) since birth to ripe age in acquiring knowledge and experience and then at ripe age, correlating, deepening and extending the acquired knowledge (wisdom).
But an individual who has voluntarily taken the responsibility of taking care of the most precious property of man, viz. life and health, cannot conscientiously afford to depend upon the spontaneous development of the faculty of observation. He has to perpetually persevere in developing this faculty throughout his life. And the highway for this purpose has been laid down by Hahnemann in the Organon and further developed immensely by his followers like Boenninghausen, Hering, the three Allens, Dunham, Kent, Boger, Roberts and many others. If we seriously want to enhance and imporve our natural faculty of observation we have no way other than to go deeper and deeper into the teachings of these masters, all from most critical and practical point of view. Simply committing them to memory and vomiting them here and there per mouth or paper will serve no purpose other than tiring the auditory system of others or overflowing the dust-bin of rubbish.
One important basic fact should be reminded here: our eyes do not see what our mind does not know or seek to know. In the beginning of our homoeopathic practice we very often got wonder-struck at the talent of some of our seniors in observing at a glance a very important guiding hint in many a case which escaped our notice for pretty long time and thus baffled all our attempts to do any good to those particular cases.
And at this fag end of our life we realise that our power of observation gradually increased, more and more as our grasp on materia medica increased. This applies particularly to modalities, causative relations and concomitants. Until we came to know how strange, peculiar and guiding these apparently most insignificant phenomena might be, we were baffled in our attempts to do any good to many of our cases. But when we came to know from materia medica that, such petty features like raising up or hanging down of legs could modify the symptoms, sweating induced only by closing or opening the eyes; or characteristic concomitance of symptoms of cystitis with those of pleurisy or of diarrhea with those of nephritis depicted in certain drugs; detection and observation of those phenomena in different patients became more and more easy.
Similarly we spoiled many of our cases before we came to know how to observe the movements of symptoms after our medication, by acquainting ourselves with Hering’s laws of cure and Kent’s twelve observations.
Thus, what to observe and how to observe can never be learned and assimilated and utilised in practice without sufficient grasp on materia medica and the basic principles of Homoeopathy as given by Hahnemann in his Organon and Chronic Diseases and various writings of his sincere followers.
- Faculty of interpretation: Our observation may very often betrary us if the facts presented by our sense of vision, hearing etc. are not properly assessed, understood and interpreted in their respective background and perspective. A few examples will make these points clear: you offer a dish to your friend. Actually he may be very hungry or even greedy for the dish. But the way or the circumstances in which you offered it might not be liked by your friend. Thus many a no may actually be interpreted as a strong yes, if only we have sufficient degree of circumspection and sympathetic mind. Similarly a mother throwing her child into fire may not be an act of hatred but of extreme love.
This task of interpretation very often creates nearly insuperable difficulty in eliciting symptom-picture of the patient, i.e. case taking, and also in following up the case. We know, homoeopathic treatment and management depends almost solely on the expression of the patient. But any expression of the patient without proper verification, by cross examination and deeper observation in correlation with other data may lead us astray. Again we give some instances: one lady patient when asked about regularity of her bowels, replied, “Oh yes, it moves regularly”. But during examination we found a large number of hard masses along her whole colon appearing to be so many tumors. Then we asked her, “Did your bowels move today?” She said, “No” “Yesterday?” “No”. Day before that?” “No. “When did it move?” One taciturn patient, when asked what were his complaints? Answered “Nothing particular”. “Why have you come to me then?” “Because my wife wants it”. Actually we obtained only a few vague symptoms from his wife. And all the while the patient, was sitting with a frowning attitude for his wife making a fuss with him. But, during examinations, his face was found to wince a bit, when palpating his appendicular region. Actually he was suffering from subacute appendicitis. We leave apart the linguistic deficiency of most of our patients and their attendants.
Similar difficulty arises in following up the case. Very often it so happens, when asked on a subsequent visit, “How are you feeling?”, we get a reply “Oh, very bad.” But on scrutinising the recorded symptoms we find that most of them have considerably abated. When that is told to the patient, he retorts, “Don’t you see that my old ‘cured’ urethral discharge has reappeared, and I am not being able to go to my wife?” If we are not constantly conscious about Hering’s laws of cure we may spoil the case by trying to ‘cure’ the discharge again.
Thus, we can never accept the statements of the patient or his attendants on their face value and must make all efforts to realise the precise meaning of those statements and to scan them in their proper perspective and actually perceive the real condition.
- The faculty of perception: Perception is nothing but capacity for thorough and precise understanding or comprehension. Without proper exercise of this faculty most of our observations will remain lifeless, superficial and often lead to erroneous interpretation. This faculty entails some degree of intelligence with a sympathetic bent of mind on the part of the observer, taking his charge as his own near relation. We have already cited many instances, how the exercise of this faculty turns many a no into yes, apparent cruelty into extreme affection, tranquility or even gayfulness covering extremely painful conditions.
- Faculty of expression: Deficiency of this faculty is of course most commonly found in the patients even of educated society, but none the less in the practitioners also. If this deficiency is not made good by the practitioner he will be handicapped at every step, namely, in recording the case history, studying materia medica, matching the symptom- totality of the patient with those of materia medica, using the repertory, and following up of his case.
Every homoeopath must strive by all means to improve these four natural faculties inherent in himself, if he wants to improve his proficiency in homoeopathic practice.
Dr. J.N. Kanjilal