Homoeopathy has not as yet given prominence and emphatic utterance to the fact that the decisive symptoms, in diseases and drug-provings, are, in many respects, insignificant indeed very insignificant and trifling. Nevertheless Homoeopathy has not been unaware of this fact; she has only not expressed it in sharp, clear words and thereby given a full currency to the importance and to the apparent unusual nature of this circumstance. For, when we are taught that, in examining a patient, we must go to, work in a sharp and thorough fashion, and must investigate with indefatigable zeal until we find out the peculiar phenomena which give us our rule of action, it is clearly implied in this very teaching, that often these peculiar phenomena do not present themselves obviously in the foreground, but are, on the contrary, insignificant and apparently trifling.
And when, further, we are taught how to conduct ourselves when proving a drug, in order to allow the symptoms to develop themselves and not to pervert and cloak them by accidental phenomena, as well as to take cognizance of them undisturbed, the conclusion, in like manner, follows from this teaching that the decisive, instructive and important symptoms do not always stand, fair and square, full before the eyes.
In truth, it has been seen and felt that the determining symptoms present themselves in many respects insensibly. But everybody has, timidly as it were, kept this fact to himself and not given prominence to it, as the experience which furnishes the rule; we have silently accorded to it an importance which we have not been willing to express publicly, aloud, clearly and boldly.
And we have been timid in this matter, because we have regarded it as a token of incompleteness and of unripeness, that we are obliged in many ways to avail ourselves of so insignificant and trifling symptoms. But he who has been initiated into this open secret, that the very determining symptoms are often insignificant, and has been in the habit of profiting by it – he has ever distinguished himself by an especial practical ability. Yet in doing so he might fall into the opposite danger, viz.: of taking these insignificant phenomena in a subtler sense than the progress of science up to the present day enables us to do and justifies our doing — misfortune which, where the investigations were truthfully made, may indeed damage the individual, but can only benefit the science.
Let us then say it – emphatically, loud and frankly – that the determining symptoms appear in many respects to be insignificant and unimportant, and let us proclaim it to be a requisite condition, that in proving drugs and in examining patients, the insignificant symptoms are not to be neglected, but even to be noted and regarded with especial care.
A slight sticking or digging pain in the teeth, when proving a drug, a slighter increase of heart-beat, an inconsiderable pain in the throat, a somewhat unpleasant taste, which recurs only at long intervals, a slight change in the stool, a somewhat restless night, a slightly more abundant sweating, a somewhat depressed or a somewhat exalted state of mind, etc., etc. – these phenomena are to be taken notice of; and it is, in good part, only when these are reckoned in, that the entire picture of the disease or of the drug-action is made out.
And has not also the diagnosis of diseases its difficulties and its subleties? Is the diagnosis of iritis always so dazzlingly obvious; the diagnosis of pneumonia always so rudely palpable; the distinction between diphtheritis and catarrh always so striking, as it seems to be in very well developed cases?
Where no dazzling facts present themselves, the examination, the investigation must keep to the insignificant circumstances, and it lies in the nature of the thing, that these occur more frequently than the striking indications and are often even more important than the latter.
And if the grosser changes in and upon the tissues are often but little developed, how much more may this be the case in regard to such phenomena as present themselves only as the subjective expression of excited tissue-functions? For the insignificant and apparently unimportant phenomena, on which often so very much depends, are manifestations of the tissue activity – also manifestations which are as yet pretty much undisturbed and not yet covered over and concealed by the results of the excited pr perverted tissue functions. They are initial-phenomena and they may easily be lacking there, where a process has become developed in its full extent; they are lacking, for example, in a fully developed pneumonia, whereas at the beginning of the same they may be still present and may indicate the peculiar character of the existing irritation.
The “peculiar,” the “characteristic” symptoms – these are to be regarded as the determining ones; but we must, at the same time, never forget, and we must always say emphatically, that these symptoms may be very insignificant ones and that we have to seek them, for the most part, in the series of little and unimpressive phenomena. Accordingly, free from all feelings of timidity, we receive these seemingly insignificant phenomena within our field of investigation. What microscopic research is, in the case of small objects, the same, in semeiotics, is the scientific investigation of the trifling, unimportant, subjective and objective phenomena of disease, and he, who cannot labor in this field of the small ane the few, can never be a master in either department of science. The riper spirit adventures into the depths, whose limits are immeasurable and whose products may indeed, to the uninitiated, seem insignificant, unimportant, trifling and profitless. D.
|The American Homoeopathic Review Vol. 05 No. 01, 1864, pages 07-10
|errors only; interlinks; formatting