Abstract– Homoeopathic case taking is a very elaborate and a very different approach than conventional case taking, because the prime objective of homoeopathic case taking is INDIVIDUALISATION. One important step of case taking is, evaluation of symptoms because all the symptoms which you receive are not of equal importance and hence a grading of symptoms is required to select the similimum. This article is an attempt to elaborate the importance of evaluation of symptoms in homoeopathic prescription.
Keywords– Gradation, Symptoms, Homoeopathy, Case taking
Introduction- Homoeopathy being holistic in approach considers each and every aspect of the diseased individual. Hence, homoeopathic case taking is a very elaborate and a very different approach than conventional case taking, because the prime objective of homoeopathic case taking is INDIVIDUALISATION. Homoeopathic case taking focuses on the “ the sick”, rather than the diseases parts or organs. Homoeopathic case taking involves few steps, evaluation of symptoms being one of the most important steps for the formation of a portrait of disease which leads to the selection of the similimum. The word meaning “ Evaluation” is to “judge” or “ to determine the quality”. So, the evaluation of symptoms means” to determine “ or to judge the quality of symptoms”.
Definition– Evaluation of symptoms means grading of symptoms as per their merit or their importance for the purpose of formation of individual picture of disease, which can be matched with drug symptoms and similimum can be selected.
Once you are done with case taking, you get an ocean of symptoms , all of which are not equally important and hence, a grading or evaluation of these symptoms is required. There are various methods adopted by different pioneers of Homoeopathy for the evaluation of symptoms, which are as follows:
- Hahnemann’s Evaluation of symptoms
- Kent’s Evaluation of symptoms
- Boenninghausen’s Evaluation of symptoms
- Garth Boericke’s Evaluation of symptoms
Hahnemann’s Evaluation of symptoms
Dr Hahnemann in § 153 states , “In this search for a homeopathic specific remedy, “the more striking, singular, uncommon and peculiar (characteristic) symptoms of the case of disease are chiefly and most solely to be kept in view for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to the more general and undefined symptoms like loss of appetite, headache, debility, restless sleep, discomfort, and so forth demand but little attention”.
Hahnemann’s classifies the symptoms into:
- General symptoms- General symptoms are common symptoms of diseases , which we find in many diseases and many medicines. These are equal to Kent’s common symptoms. Because these are found in many diseases , hence are of no help in Individualisation.
For example: Fever, headache, loss of appetite, debility etc.
- Uncommon symptoms- Uncommon symptoms are not related to the disease but they are peculiar to the patient . These symptoms are found in only a few patients and in few proverbs. Hence, they are very important in individualising the patient and in Homoeopathic prescribing.
For example: Fever without thirst, burning pain relieved by hot application.
Kent’s Evaluation of symptoms
“The true homeopathic prescription cannot be made on pathology, because provings have never been pushed in that direction. No man who is only conversant with morbid anatomy and pathognomic symptoms can make homeopathic prescriptions”.
Kent classifies the symptoms into:
- General symptoms- General symptoms according to Dr. Kent are those symptoms which the patient explains by using the prefix “I” ,they depict the patient as a whole. Hence , these symptoms are of prime importance in selection of similimum.
For example : I am hungry , I am restless etc.
General symptoms can be broadly classified into 2 groups:
- Mental generals- Mental generals are further classified into:
Will- Love, fear, anger, depression, suspicion, greed, hate, conscientiousness, jealousy etc .
Understanding- Confusion, illusion, delusion, hallucination etc.
Intellect- Memory, concentration, comprehension etc.
- Physical generals- Physical generals are further classified into:
Thirst, hunger, appetite, desire and aversions, urine, stool, perspiration, sleep, dreams , thermal reaction, pathological conditions, subjective sensations, periodicity- in relation to time, sides of the body, weather etc.
Common symptoms- Common symptoms are common to many diseases and many drugs and hence they are not important in the process of individualisation. Kent’s common symptoms are equal to Hahnemann’s general symptoms.
For example: bearing down sensation is common symptoms of uterine prolapse.
Particular symptoms- Particular symptoms correspond with the particular anatomical part of the body. He uses the pronoun “ My” to express these symptoms,
For example- my head is bursting, my leg is aching etc.
Kent further grades symptoms found in proving into three grades:
- First grade- appeared and recorded in majority of proverbs during drug proving, and verified clinically on the sick.
- Second Grade- appeared in only a few proverbs during drug proving and confirmed by reproving.
- Third Grade- appeared occasionally in one or two provers, are not confirmed by reproving and sometimes found clinically on treating certain ailments.
Boenninghausen’s Evaluation of symptoms
Boenninghausen emphasized on the totality of symptoms and his evaluation consists of following seven points:
- QUIS : Personality of an individual, age , sex, constitution and temperament
- QUID: Nature of the disease
- UBI : Location of the disease
- QUIBIS AUXILUS : Concomitant symptoms
- CUR : Why? Cause of the disease
- QUOMODO : Modifying factor
- QUANDO : Modalities , the time of appearance of aggravation and amelioration
Garth Boericke’s Evaluation of symptoms
Garth Boericke’s classifies the symptoms into :
- Basic/ Absolute Symptoms -Basic or absolute symptoms are those that appear in every drug proving and in most diseases . They play a very important role in diagnosis.
For example : debility, anorexia etc.
- Determinative Symptoms -determinative symptoms are the symptoms that are the characteristic symptoms of the patient and the drug. They help in individualising the patient and are guiding symptoms of the medicine.
For example: characteristic modalities
Conclusion- Evaluation of symptoms is the crucial step of case taking because it helps in forming the portrait of disease with which the symptoms of the medicine can be matched and similimum can be selected. Different pioneers had different opinions regarding the gradation of symptoms on the basis of which they had developed their evaluation of symptoms. Once you are done with case taking, you get an ocean of symptoms , all of which are not equally important and hence, a grading or evaluation of these symptoms is required.
- Hahnemann S. Organon of medicine. 6th ed. New Delhi: B Jain Publishers; 2012.
- Kent J.T. Lectures on homoeopathic philosophy. 18th impression. Noida: B. Jain Publishers (P) Ltd; 2018
- Nagendra Babu. G. Comprehensive Study of Organon an Attempt to Understand the Organon of Medicine as a Scientific Treatise. B. Jain Publishers (P) Ltd. First Edition: 2009.
About the Author
Dr. Varsha Manchanda, Dr. Shubhangi Tiwari
MD Scholar ,Department of Organon of Medicine and Homoeopathic Philosophy, Government Homoeopathic Medical College, Bhopal