Classification of Symptoms in Homeopathy
Symptoms are the deviations from a state of health perceptible by the patient, those around him and the physician. For a homeopath, symptoms are the important pointers to understand the sickness in the patient. These symptoms could be at the physical level known as physical symptoms or at mental level, commonly called mental symptoms. In general, those symptoms that are explained by the patient are called subjective symptoms and those observed by the physician are called objective symptoms. During the examination of the patient, the physician may also elicit certain objective assessment of the patient and these are called the signs. Thus, in a diseased person, there may be subjective symptoms, objective symptoms and the signs. Therefore, the homeopath studies the signs and symptoms of the sick very carefully to understand the internal derangement of the patient. It is also necessary for the physician to understand, which symptom appeared first and what followed further. This helps him to understand the process of evolution of the disease.
After the details of the case is recorded, the symptoms of the patients are graded according to their relative value for the purpose of forming an individual picture. This process is called Evaluation of the Symptoms in Homeopathy. This is the most important process by which the totality of the patients diseases picture is elicited to match with the drug picture of a remedy to find out the Similimum.
There are different approaches of evaluation symptoms, based on the peculiarity of the case. However, in every instance, there should be an effort to get the symptoms with certain peculiarities. These are its location with radiation, the sensation or character with intensity, its modalities including aggravation and amelioration and the concomitants or associated symptoms. When all these four dimensions are available, the symptom is called a complete symptom. When there is a complete symptom, it become easier for the physician to understand the case better. Therefore, the concept of complete symptom is very important in Homeopathy.
Hahnemann advocated the following fundamental concepts in understanding a patient:
1. Nothing can be known of disease except through symptoms.
2. It is the patient who is ill and not his parts or organs.
3. Symptoms furnish the only unfailing guide for selection of remedy.
4. The remedy is hardly ever indicated by a single symptom however peculiar it may be.
5. Peculiar, characteristics, individualizing symptoms in the case and not common symptoms denote Similimum.
Evaluation of Symptom
The patient narrates his complaints, which he feels very important. Take note of all what he is telling in the first instance. Many of these symptoms may be related to his diseases or the diagnosis that he has done from elsewhere. The patient shall give priority to those complaints which are of serious concern to him. The physician, may require much more information about his likings, desires, sleep, dreams, habits, family history, past history and so on, which the patient may not feel relevant to the case. However, these are very important to individualise him from other such patients to find out the similimum, required to cure his illness. Thus, all the symptoms narrated by the patient may not be of equal importance to understand the case. The Physician shall distinguish the symptoms that are more important and those which are less important and also those related to the disease. The symptom related to the disease are less important in individualising the case, because such symptoms may be present in every patient suffering from the same illness. These symptoms may be necessary in the general management of case , but not for selection of the remedy. The process of
In Homeopathy symptoms are classified under different groups. Some of the commonly used classifications are as under:
1. Common symptom and Characterised symptom
2. Concomitant symptom and Chief Complaints
3. General symptom and Particular symptom
4. Complete and incomplete symptom
5. Recent and old symptom
Hahnemann classified symptoms into two types:
a. General symptoms
b. Uncommon symptoms
General symptoms are those which are common to the disease process. Example is fever, head ache, diarrhoea and loss of appetite in typhoid fever. These symptoms are present in almost all the cases of typhoid patients. These are less important in selection of a remedy in Homeopathy or to individualise the patient. Therefore these are called General symptoms.
Uncommon symptoms are the symptoms which are unaccountable, unexplainable to the disease process. These might be seen as absurd or paradoxical by the patient, but are very important to a Homeopath. Examples are in the typhoid patient, when he feels his bed very hard, even when lying in soft bed or answers to the question clearly and goes to coma. Such symptoms are found in the provings of certain medicines, and this symptom become the uncommon symptom for selection of that remedy for the patient with typhoid . Thus the law of Similia is applied to treat the patient. The uncommon symptoms reflect the individuality of the patient in the disease and are also great value in selection of the remedy.
This method consists of the following seven points:
Quis: Personality of the individual – age, sex, bodily constitution and temperament.
Quid: Nature and peculiarity of the disease.
Ubi: Seat of the disease.
Quibis auxilus: Associated symptoms
Cur: The cause of the disease
Quomodo: The modifying factors
Quando: The time of appearance, of aggravation and relief.
Garth Boericke’s method:
Garth Boericke method
He has divided the symptoms into two classes:
a) Basic or absolute symptoms
b) Determinative symptoms
a) Basic or absolute symptoms are those that appear in every proving and are of a general nature and are important in diagnosing the disease. Example: Malaise, headache, weakness, anorexia, eructation, fever and pain, etc. They are of little value to determine the homoeopathic drug indicated, but taken together furnishing a suggestive beginning.
b) Determinative symptoms are individual or personal ones found in a patient or a characteristic, keynote or guiding symptoms found in a drug’s pathogenesis. Determinative symptoms whether encountered in disease or in a drug proving are alike and usually consist of – modalities, mental symptoms, qualified basic or absolute symptoms, and strange, rare or peculiar symptoms as mentioned by Hahnemann. These symptoms help in the individualization of the patient and thus help in the selection of homoeopathic remedy.
Boger has classified the symptoms like following manner.
· Time dimension
· Causative modalities
· Tissue affinities
· Pathological generals
James Tyler Kent was the first to introduce the scheme of analysis, evaluation & gradation of symptom to reach the similimum. He classified symptoms into three main categories. These are:
He attributed the these three categories in both mental and physical symptoms. Kent has given highest emphasis to mental generals reflecting the inner most of the patient then importance of physical generals including modalities and characteristic particulars for final stage of differentiation.
As per Kent the scheme of evaluation of symptoms is as under:
1. General symptoms
a) Mental general
1st grade mental are those related to Will. The expressions of these symptoms shall be related to Love, hate and emotions ( suicidal, loathing of life) lasciviousness, revulsion to sex, sexual perversions, fear, greed, homicidal tendencies, suspicion
2nd grade mental symptoms are those related to Understanding Delirium, hallucinations, mental confusions, loss of time sense
3rd grade mental symptoms are those related to Intellect such as Memory, concentration
b) Physical generals
These are the symptom referring to the body as a whole with regards different physical attributes;
1st grade _ Referring to sexual sphere including menstrual general
2nd grade – Symptoms referring to appetite, desires etc.
3rd grade _ Things affecting the entire physical body, they are off greater importance and may be used as eliminating symptoms. eg. Weather, climate, bathing etc.
2. Common symptoms
These symptoms are common to a particular disease or are found in several patients as a common factor. They are usually of secondary importance and do not play much role in the selection of similimum, unless they have peculiar modalities.
3. Particular symptoms
The symptom which are related to a particular part or organ or functions of the body.
These symptoms tend to disturb the patient most and he seeks consultation for them only. Thus the prescription of acute necessity will be based on these particulars. The generals help in the delineation of outline where as particulars furnish the details to differentiate the remedies.
Strong particulars may point to a small group of remedies, this helps in a quick prescription.
Top grade particular Which are peculiar, uncommon. uncompleted & un accountable. eg. Inflammation without pain
2nd grade particular are the particular symptoms with marked modality
3rd grade particulars are the common particulars without any appreciative modality, having diagnostic value only
Spalding’s Method: He has classified the symptoms like this.
1. Mental generals
2. Physical general
5. Special senses
9. Strange, rare & peculiars
11. Objective or pathology
The uniqueness of Homoeopathy lies in the inherent character of its philosophy; it can identify the disease at the dynamic level, and give prime importance to finest alterations in sensation and functions. Its peculiarity lies in the fact that, it can not only recognize but also identify the disease at the dynamic level even, by its capacity to recognize and give prime importance to finest alterations in sensation and functions. Symp