Prescribing on the Basis of Totality of Characteristic Symptoms

In aphorism 7 of Organon of Medicine Dr. Hahnemann says "Now, as in a disease, from which no manifest exciting or maintaining cause has to be removed, we can perceive nothing but the morbid symptoms, it must be the symptoms alone by which the disease demands and points to the remedy suited to relieve it, and moreover, the totality of the symptoms, of this outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force must be the principle, or the sole means, whereby the disease can make known what remedy it requires- the only thing that can determine the choice of the most appropriate remedy- and thus in a word, the totality of symptoms must be the principle, indeed the only thing the physician has to take note of in every case of disease and to remove by means of his art, in order  that the disease shall be cured and transformed into health."

Totality of Symptoms consists of:

1. Quantitative or numerical totality of symptoms

2. Qualitative totality or totality of characteristic symptoms

The numerical totality of symptoms is not so important as the totality of characteristic symptoms for the selection of the Simillimum. The task of finding out the totality of characteristic symptoms and their peculiar nature was taken up by Dr. Von Boenninghausen. In his lesser writings Boenninghausen gives the following seven types of symptoms which makeup the totality of characteristic symptoms:

1. Quis-meaning makeup of the patient.

2. Quid-meaning peculiar sensations of the patient.

3. Ubi-meaning peculiar locations of the disease.

4. Cur-meaning cause of the disease.

5. Quamodo-meaning modality of time.

6. Quanto-meaning modality of circumstances.

7. Quibus Auxilus- meaning concomitant symptoms.

Totality of characteristic symptoms as given by Boenninghausen were accepted by Dr. Hahnemann an other homoeopaths.

To elaborate the concept here are few examples from the stalwarts of homoeopathy.

Quis: Case Example by Dr. Kent

Infantile Paralysis: A nine year old child reported fever followed by paralysis. Paralysis left deltoid; left arm and leg. The limbs jerk in sleep and weaken her. Chillness; complains much of cold. Feet burning sensation; puts them out of bed. Restless. Excited when playing and hands are constantly in motion. Tearful when can't have her own way. Tired from walking any distance.

Causticum 10M was given and the child was reported cured. The selection of Causticum was made on the basis of the following characteristic symptoms:

1. Paralysis of single parts

2. Restlessness: must move constantly but motion does not relieve

3. Chilliness complains much of cold.

Quid: Case Example by Dr. E.T Balch

A 10 yrs old girl fell forward and hurt her chest. She was brought to me by her mother with the complaint that she has no desire to play, her sleep is disturbed by frightful dreams. She is so afraid that she piteously begs her mother to take her somewhere. She feels as though snakes are on her back.

Lac Can 50M one dose was given on the basis of the sensation that she has snakes on her back. The child was reported normal within 24 hrs.

Ubi: Case Example by Dr. Kent

A woman of 53 yrs of age came to me with complaint of sore throat of six weeks, and scarcely able to go outdoors. She was under the treatment of old-school since six weeks. The main complaint was soreness in the pharynx. It started from left side and extended to right side, aggravation by swallowing solids and ameliorated by warm liquids. Desires cold drinks but cold aggravated the throat. She has chronic constipation.

On the basis of the location Left Side - Extending to Right Side, with the exception of the aggravation from warmth all symptoms are indicating Lachesis. As such Lachesis 10M was given. 

After the dose her Left Sided throat pain became worse. She had aggravation by cold water, burning sensation at night from cold air, thirst constant for cold water, bowels now normal for the first time, and pulsating headache, cracking sensation at the base of skull when turning head. Sach Lac. was given. All throat symptoms ceased at the end of 7 days. The favorable action of the remedy was evident in the aggravation occurring on the first day and improvement in the rectal evacuation.

Lachesis was selected on the basis of characteristic location and extension of the drug which has an affinity for the throat and modality of the extension from Left to Right.

Cur: Almost all remedies have a relation of all kind to the various accidents and conditions of ordinary life. Their symptoms are made worse or better by heat or cold, rest or motion, by night or day, or other circumstances or conditions. Many remedies are related to the effects of certain conditions. This is not the same as aggravation, though allied to it and sometimes identical with it. For Example, Arnica removes morbid conditions caused by false, Ruta relieves the effect of bruised bones. It is not correct in either case to describe these as aggravations. Although causations and aggravations are not the same their are closely allied. Following are the few examples of  Causation:

Washing clothes causes ill effects  to which certain remedies corresponds. Phosphorus corresponds to headache resulting from washing clothes. Belladonna corresponds to headache after hair cut. Pyrogenum corresponds to sewerage gas poisoning. Allium Cepa corresponds to post operative ciliary neuralgia.

Quamodo: Case Example by Dr. Nash

A 14 yrs old girl having postural eruptions on the left leg extending from the ankle to the hip was reported for treatment. When the eruptions were broken and discharged  they left a red raw, sore surface. The pain, itching and burning were all greatly aggravated in the warmth of bed and night. Merc. Sol 2M  promptly relieved the sufferings in a few days.

Quanto: Case Example by Dr. Clarke

A girl aged 18 having the complaint of headache, beginning in the occipit, going over forehead, comes on sunrise, gets worse towards noon and ameliorates at sunset. She was cured with Kalmia 2X. 

Quibus Auxilus: Case Example by Dr. Burnett

Cancer of lip, with painful cracks in the corners of mouth with Condurango.

Dr. Nash has recorded a cured case of diabetes with rheumatic fever with Lactic Acid.