Analysis & Evaluation of Symptoms in Homoeopathy

mansoor (1240)Word meaning ” examine in order to learn what the separate parts are”

According to Castro ”  The act of resolving or reducing or breaking the whole in to pieces or groups is called analysis”.

In analysis of the case the value of symptoms must be taken in to consideration on several points. First the personality ,the individuality of the patient must stand out in the picture.

Secondly they should be categorized under subjective, objective, general, common & uncommon symptoms.

Purpose of analysis
To identify the prescribing symptoms in a given case.

Hahnemannian concept
In aphorism 153 Hahnemann described two group of symptoms in a given case. They are more striking, singular, uncommon & peculiar (characteristics ) symptoms and the” more general & undefined symptoms.”

Kentian method
Kent divided the symptoms in to

  • General
  • Particular
  • Common

Boenninghausen’s method
In Boenninghausen’s method the individual symptoms are not important but groups are more important. According to Boenninghausen the patients symptoms are to be considered from the group aspect of

  • Location
  • Sensation
  • Modality
  • Concomitants

In Kent’s method both symptoms & remedies are graded, while in Boenninghausen’s method only remedies are graded and evaluated in therapeutic pocket book.

Dr. P.Sankaran
Analyzed the symptoms in to
Path gnomic
Non path gnomic

Garth boerick 
Divided the symptoms in to Basic & Determinative symptoms.
Basic or absolute symptoms are similar to Hahnemann’s more general & undefined symptoms.

Boger’s method
According to Boger analysis is assembling of symptoms in to those of the patient & those of the disease – means Path gnomic & non path gnomic symptoms.
The final analysis of every case therefore resolves itself in to the assembling of the individualistic symptoms in to one group and collecting the disease manifestation in to another “.  (Study of MM by Boger)

Dr.N.Ghatak
Divided the symptoms in to Subjective & Objective symptoms. The subjective symptoms again classified in to personal ( relating to the patient as a whole) and local symptoms (relating to localities ).

Most of the authors divided the symptoms in to
General _ Characteristics (Rare, uncommon, peculiar, strange)
Particular

Evaluation of symptom implies the principles of grading or ranking of different kinds of symptoms in order of priority, which are to be  matched with the drug symptoms in order to cover the characteristic totality in a natural disease condition with that of drug disease.

Proper evaluation of symptom is the most important step next to case taking in Homoeopathy.In evaluation of case the value of symptom must be taken in to consideration on several points.

Basically symptoms are ranked according to their intensity, how deeply they reach in to the organism ( mental will & emotional symptoms are considered most important ) and according to their degree of peculiarity.
According to Kent ” all symptoms of will and affections including desires and aversions are the most important as they relate to the innermost of the man. Of less value are those relating to intellect ,while those of memory are to be ranked lowest.

But according to Elizebeth wright ” on the other hand just because the physician knows that mental symptoms are most important he should not hunt in the haystack for a tiny mental, with which to open his case. The symptom should have the same importance the same weigh or mass ,in the patients case as is assigned to them in the symptom hierarchy.

Need for evaluation
A case is full of symptoms of which all are not of same importants and value.Therefor in order to reach the similimum the symptoms have to arranged accordingly.
The evaluation of symptoms is based on the basis of operating schools of philosophy.

Rules to be followed
The generals always rules the first
The general symptom must be strong and well marked
A number of strong particulars may not be ignored on account of one or more week generals
Symptoms related to the vital organs are of more importance  than those relating to less vital parts.
Common particulars may in certain condition assumes a comparative high rank
By virtue of their appearance at 2 or more sites
As the last appearing symptoms of the case
In mental diseases bodily symptoms have to considered as concomitants, while mental in case of physical illness are for the final differentiation of the medicines.
Mental symptoms < or > by physical generals are of the highest rank
Take minimum symptoms of maximum importance.
Low grade mental symptoms < or > physical general symptoms are of higher value or grade than common mental symptoms
Eg. Menses <or>,weather <or>
Particular symptoms having < or > by any mental general symptoms or physical general symptoms are of higher grade than particulars only and same goes with commons Eg. Anger after, pain in stomach
All physical generals <or> by mental generals are of higher  value than only physical generals Eg. appetite wanting ,vexation after
Predisposing causes are of greater value in c/c precribing.but precipitating causes are of greater value in acute prescribing.

Different methods of evaluation

Kentian maethod
Kent was the first to introduce the scheme of analysis, evaluation & gradation of symptom to reach the similimum. Kent has given highest emphasis to mental generals reflecting the inner most of the patient.

Kentian features of evaluation
Prime importance to mental generals
Limited generalization
Physical generals including modalities
Characteristic particulars for final stage of differentiation

Scheme of evaluation
1. General symptoms
a) Mental general

1st grade mental _ will, love & hates
2nd grade – Emotions
3rd grade _ Intellect / understanding
4th grade – Memory
b) Physical generals
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 beused as eliminating symptoms. Eg. weather, climate ,bathing etc.

2. Common syptoms

This 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.

Importance
This symptoms tend to disturb the patient most and he seek consultation for them only .Thus the prescription of acute necessity will be based on this particulars.
The generals help in the delineation of out line 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 peculier,uncommon.uncompeted & un accountable
Eg. Inflammation with out pain
2nd grade particular
articulars with marked modality
3rd grade particulars
Common particulars without any appreciative  modality, having diagnostic value only

Hahnemannian method
Categorized the symptoms in to
Generals & Uncommon

G.Boerick method
Basic or absolute
Determinative symptoms

Boenninghausen’s method

  • Quis _ Peculier constitution & temperament
  • Quid _ Nature of disease
  • Ubi _ Seat of disease
  • Qiubis axillus _ Concomitatnts
  • Cur _ Cause of the disease
  • Quomodo _ Modalities of circumstances
  • Quando _ Time modalities

Spalding
Mental generals, physical generals, dream , special senese, desires & aversions, modalities, strange rare peculiers, particulars, objective or pathology.

E. Hubbard.
Physical general & mental general

Whitman
Mental general
Physical general with modalities
Food, desires & aversions
Menses
Strange rare peculiars
Particulars

MARGERET TYLER
1. Mentals _ Will, understanding, memory
2. Strange, rare, peculiar  –   May occur among mentals, generals or particulars
3. Physical _ sexual perversions –  Stomach related
4. Physical generals _ Relating to climate   Position etc.
5. Character of discharges
6. Particulars

Dr. WEIR & M.L.TYLER
Mental general
Physical general as a whole
Cravings & aversions
Menstrual state
Particulars

References
Hahnemann Organon of medicine
Patel The art of case taking…
Mohanty Text book of repertory
Elizebeth.W A brief study course in Homoeopathy
Ritu Study of repertory
Sivaraman Analysis and evaluation of symptoms

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