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NB:  The reader is also invited to read: - How to use the Repertory by Bidwell, part of KHA's Philosophy.

Shooting pain characterises a neuralgic affection.
Burning pain shows that the mucous membrane is effected.
Cutting pain indicates that serious membranes are effected.
Drawing pain denotes the muscular and tendinous tissues.

Valuation of Symptoms  [Based on Puddephatt / Speight]

Now in every class of disease there are two classes of symptoms: -

1. Those pertaining to and characteristic of the patient.  These symptoms in homeopathic phraseology are termed generals.

2. Those that pertain to the disease.  These are termed particulars.

Generals

The first and golden rule laid down by Hahnemann was that our main reliance must always be place upon the symptoms that signify the patient and that we must pay particular attention to those symptoms that are peculiar or characteristic of the patient and NOT to those that are common to the disease.

The point we have now to consider is what do we mean by the patient.

Do we mean the individual we see before us, consisting of head, trunk, arms and legs, or is there some deeper meaning attached to this statement"  The patient that Hahnemann is referring to is the individual that is hidden inside the head, trunk, arms and legs: the real man, made up of will and intellect, the dynamic force that causes all action.

Generals Which Characterise The Patient

Mental symptoms that characterise the patient are of the very highest importance as - (First Grade)

The foxy cunning of tarentula hispanica - the lack of natural affection of sepia and phosphorus - the extreme irritability of nux vomica and byronia - the suicidal promptings of aurum and china, which the patient keeps to himself and you know nothing about them until he has committed suicide - the fastidiousness of arsenicum alb. - the presentment of death in apis - the terrible fear of aconitum - the ever changing mooods of ignatia - the extreme hauter of platina - the yeilding weepy pulsatilla - the filthy, diry, unkempt, thin, stooping suphur - and so we could to on.   But sufficient examples have been give which will characterise - mark that word well - the patient and never forget this.

All symptoms of the will and affections, including desires and aversions, are the most important, as they relate to the inmost of man.

The above symptoms ranks so high that if it be a strong and well-marked one it can over-rule any number of particulars (those symptoms  that relate to the pains and aches of the body).

Now when this real man is sick, he has the invariable habit of referring to himself as 'I' - in the first person.  He states for example: 'I feel depressed' - 'I cannot stand the cold' - 'I hate the dark' - 'I cannot stand a warm room' - 'I detest wind in any shape or form' - 'I over the heat'.  It is a case of I, I, I.  All symptoms, therefore, that relate to the patient himself will commence with 'I this' and 'I that'.  These symptoms are the first grade general symptoms: for it is when he is relating these symptoms that he 'lets the cat out of the bag' and reveals himself: the self he is always so careful to keep hidden or camouflaged.

When he states - 'I feel depressed' - he means that every part of himself is depressed.  When he states "I cannot stand the cold' - he means that the whole man is in agony from the cold and not just his hands or feet.

The "I" prefixing a symptom means that the whole man is is affected by that symptom.

Your success in obtaining these first grade general symptoms from a patient will depend entirely upon your skill and above all your tact when taking the case.

None of us likes revealing our inmost desires, thoughts and aspirations, especially when they are not quite what they should be.

If you are fortunate in obtaining a number of these first grade generals, you are indeed in luck's way: for you can prescribe with the utmost confidence, without even taking into consideration a whole host of physical symptoms appertaining to the pains and aches in the body.

When you have found the remedy that covers these first grade generals, it will not only remove all the symptoms prefixed by 'I' but all those as well prefixed by 'My', i.e., 'My rheumatism' - 'My eczema' - 'My sore throat', and so on.

Dreams (Second Grade Generals)

The next class of strong generals we have to consider are dreams, for these relate to the man himself.

Dreams only become generals when the patient repeatedly dreams about the same subject and especially when about the same subject and especially when they are ghastly, terrifying and fantastic.  for example: dreams of falling from a great heights, which are covered by thuja - dreams of snakes, covered by argentum nit and lac canium - dreams thoe world's on fire covered by rhus tox.  If you sould have any doubts as to the truth of the importance of these dream symptoms, Dr. Gibson Miller, relates one of his cases, which is as follows:

'I recall a case of Aortic Aneurysm (a dilation of the largest artery in the body called the Aorta) giving rise to much pain and many other pressure symptoms.'

'The patient hand not the slightest idea what his disease was, yet he dreamed night after night of pools and seas of blood and so distressing was this that sleep was one long nightmare.  The other symptoms were valueless so far as the selection of the remedy  was concerned; but taking the dreams as my guide I gave Solanum Tubersum Aegrotans, which completely removed the dreams, and so relieved the pains that he went down to his grave in peace.' (Italics mine.)

The reader will no doubt be interested to learn that sloanum tuberosum aegrotans is a diseased potato tincture of the affected tubers.  Those who possess Boericke's Materia can verify this extraordinary symptom if they turn up solnaum nigrum (black nightshade) and on page 598 they will find this symptom recorded at the bottom of the rubric 'Relationship'.

If you are fortunate in getting this class of symptom, it will make your search for the remedy so much easier.

Another class of general symptom that ranks high are the effects of different temperatures upon the patient himself as a whole.  It is definitely ascertained from a patient that he as a whole - mark that - loathes the cold, you can save your self all the trouble in the world when search for his remedy by throwing out all those remedies that are worse from heat: and if the patient loathes the heat, then all the remedies that are worse by cold can be dispensed with.

The same rule also applies to damp and wet weather.  So much for generals.

Particulars

These symptoms pertain to any give organ of the body, or to disease as it affects the physical body.

In this case the patient when relating his sufferings will prefix his symptoms by 'My'.  For example  'My head aches' -  'My throat feels as it it was on fire' - 'My body feels as if it was broken' - 'My inside feels as if it is dropping out'.

Now this class of symptoms relates man's body and not to himself and at their face value they are useless for prescribing.  Let us take: 'My head aches'.  Now it is quite impossible to prescribe on just this bald statement.  If we turn up Kent's Repertory under section Head and look up the rubric PAIN, headache in general', we will find something like 250 drugs which cause headache, so which of the 250 drugs are you going to give, and why?

Now if the patient says, 'My head aches', but I only get it from about 10 a.m. to about 3 p.m.' and is pretty emphatic about the time, then this particular symptom can be promoted to the general class, becuase it is definitely strange and peculiar that he always has this headache only during the hours sepcificed.  If he has also two or three other rather nondescript particular symptoms, natrum muriaticum will put everything right, for the simple reason that natrum muriaticum is the only drug that can cure a headache which comes on at 10 a.m. and disapears at 3 p.m.  

Head Pain; HEADACHE in general; forenoon; 10 a.m. to 3 p.m : Nat-m. [Kent]
Head; PAIN; Forenoon; agg.; ten am.; three pm., until : NAT-M., polyp-p. [CR09]

As this symptom has become a strong general naturm muriatium will not only cure the headache, but you will most probably find on looking up this remedy in the materia medica that the other two or three nondescript symptomks are alos covered by natrum muriaticum, and will in due course disappear.

Let us take another example:
'My throat feels as if it was on fire'.
Again if we refer to Kent's Repertory and turn up the section on Throat and study the general rubric 'Burning in' we find about 170 drugs against burning.

Obviously nothing can be done just on this symptom.  But if on further questioning the patient we find that the only relief he gets is by drinking hot drinks, then this symptoms becomes strange and peculiar; because obviously if a person has a throat that feels on fire, one would be lead to thing that cold drinks would ameliorate the burning.  No this symptom can be promoted to the general class, and there is only one drug that will do the trick and that is arsenicum album.

Throat; PAIN; burning; warm drinks amel. : ars., alum., calc-f., hep. [Kent]

For the purpose of the interested laymen enough has been said to differentiate on general and particular symptoms: and if the reader gets the point that have been stressed well into his head, he will not go very far wrong.

It must of course be appreciated that when dealing with obscure and deep-seated diseases of long standing, various other factors have to be considered, and this must be left to the experienced practitioner.

Sufficient has, however, been said for the layman to be able to deal with the everyday complaints that may come his or her way.  By quick action he may succeed in aborting a sickness which, if allowed to continue, may be develop into serious trouble.

Modalities

The word 'Modality' constantly appears in homoeopatic literature and means 'a condition qualifying a symptom'. We will give an example.  Suppose a patient has a bursting, splitting headache, which is much worse by motion and stooping.  The symptom in the case is bursting, splitting heading, and the qualifying conditions are worse by motion and stooping.

Those readers who poses Boericke's Materia will find the 'modalities' recorded at the end of each drug.

The will also find in the same work at the end of the book, page 968 to 979 a list of modalities in alphabetical order, divided into two sections,  The first section is of "aggravations, page 968 to 975 the second section 'Amelioration' from page 975 to 979.

 

This is a very useful list indeed and can be used with great effect.  The following example will show how this section should be used:- 

Suppose you have a case with quite a number of pains and ached of nondescript nature, but you ascertain quite definitely from the patient that they are all right-sied and are always very much worse from about teat to supper time, and are worse also by warmth and heat; otherwise the patient has nothing else to record.

Now the question is, what are we going to do about it:  First of all, the number of pains and aches of a nondescript nature are 'particulars' and will not help us very much,  The real points of interest are:

1. They are right sided.
2. Always much worse frokm teat to supper time.
3. They are worse by warmth and heat.

The first thing we have got to do is to find out all the remedies that are right-sided and cause pain of different kinds on the right side.

Now turn up the Section 'modalities', page 986.  On top of the page you will find the work'Aggravations' in think type; and if we follow down this list in alphabetical order we will find on page 973, at the top, 'Right side'.  Against this rubric we have: 

Now Symptom No. 2.

It's no use looking up this symptom as it is worded, for we well not find it.  now tea-time is usually about 4 p.m. and supper-time is around about  8 p.m.  By the way, don't forget Summer-time (day light saving time) as you will have to make the necessary adjustments, for remember when all these drugs were proved, Summer-time was unknown.  This is very important, for when you get strong time modalities, this must be taken into account or you will go badly adrift.  To continue - what we have got to do is find a modality that state 'Worse from 4 p.m. to 8 p.m.'  Now let us go back to our 'Aggravation' work down until we come to 'Periodically'.  If we work down a little further we find the rubric, 'Periodically, 4-8 p.m.' Lyc Sabad.

Symptom No. 3.

Worse by warmth and heat.
Once again we turn up the first section under modalities and work down until we come to the rubric. 'Warmth, heat'.  Against this rubric we have: -

So how to find the remedy.

First look at symptom No. 2.  Here we have 'Worse 4-8 p.m.', we have two remedies lyc and sab.

Lyc is mentioned under all three symptoms and sab under only two.

 N.B. Boericke's Materia Medica and Repertory are available for both MacRepertory and ReferenceWorks.

In MacRepertory they are available as extras if you have the Core Library III or as part of Library VI.

In ReferenceWorks they are available in both Library Core 3 and Full G3.

Don't forget that if you get a case without any strong generals or obvious symptoms that scream at you, you must ascertain all the modalities you possibly can, such as - the location of the trouble- time of aggravation or amelioration, if any - effects of heat, cold, wet, damp -rest and movement - position, whether worse or better by standing, lying kneeling, and so on.