Concept of Disease and Totality of Symptoms

Dr Beena Abraham

Concept of disease.
Disease is the abnormally altered state of life chactererized by a sensation of uneasiness and discomfort due to the dynamic derangement of the vital force.

In Aphorism 11,  Hahnemann defines disease as ‘’an abnormally altered state of health in which the self –acting vital force is primarily deranged by the morbific dynamic influence inimical to life .subsequently causing disagreeable sensations and functions which are exfoliated outwardly through morbid signs and symptoms, totality of which constitutes   the disease. Thus disease is not a separate entity lying in the hidden in the interior of the organism.

 According to Stuart Close:”disease is an abnormal vital process, a changed condition of life, which is inimical to the true development of the individual and tends to organic dissolution.”

And he defines health is that balanced condition of the living organism in which the integral harmonious performance of the vital functions tends to the presentation of the organism and the normal development of the individual.

Life is the invisible, substantial, intelligent, individual, co existing power and cause directing and controlling the force s involved in the production and activity of any organism processessing individuality.

Disease to a homoeopath is a disharmony involving at least 3 different factors, some morbific influence, the susceptibility of the person affected and the individuality of the patient modifying the form the disease takes.

In the state of disease, the vital force is primarily deranged, so that it is unable to control, coordinate and harmonise the different vital operations of the living organism. This inefficiency of the vital force is first reflected in the subjective plane in the form of various abnormal sensations in various locations or in the     whole self as well as in the form of disturbed condition and activities of the mind .if the disturbance is allowed to go on unchecked it soon becomes reflected in the form of abnormal functioning of different parts, organs as well as whole organism. If it is not brought to balance even at this stage it becomes manifested in the various material and structural changes.

In short in short disease may be defined as a dynamic derangement of the vital harmony of the whole organism manifested first in the sphere of sensation, then in the sphere of functions, then in the sphere of material constituents manifested in the material body as signs and symptoms .the totality of these signs and symptoms constitute the disease. 

Totality of symptoms
Concept of Dr.Samuel Hahnemann’
Totality of symptoms implies not merely a numerical aggregate of all the symptoms, but it relates to the synthetic comprehension of a concrete individual picture of the patient through logical combination of general symptoms ,particular symptoms and distinctive and individualizing peculiar symptoms and strange rare and uncommon symptoms as manifested by the patient.

Our master gave the concept of totality of symptoms through different aphorisms of Organon of medicine. 

Aphorism 7:-The totality of the symptoms is ‘Out wardly reflected picture of the internal essence of the disease ,that is of the affection of the vital force’ it must be the sole means where the disease can be make known what remedy it requires-the only thing that can determine the the choice of the most appropriate remedy. 

Aphorism 15 :- The affection of the morbidly deranged ,spirit like dynamis that animate our body in the invisible interior ,and the totality of outwardly cognizable symptoms produced by it in the organism and representing the existing malady ,constitute the whole , they are only and the same.

Aphorism 16:-After the changes in the health of the patient cognizable by our senses have revealed the disease to the carefully observing and investigating physicians as fully as was requisite in order to enable him to cure it. 

Aphorism 18:-The totality of symptoms must be the sole guide to direct in the choice of a remedy.

Aphorism 22:-For the totality of the symptoms of the disease to be cured, a medicine must be sought which has a tendency to produce similar or opposite symptoms. 

Aphorism 24:-There remains therefore, no other mode of employing medicines in disease that promises to be of service besides the homoeopathic, by means of which we seek, for the totality of the symptoms. 

Aphorism 25:-The totality of the symptoms of this morbid state, that is to say .the whole disease present.

Aphorism 27:- The curative power of medicine ,there fore depends on the symptoms ,similar but superior to it in strength, so that each individual case of disease is most surely radically, rapidly and permanently annihilated and removed only by a medicine capable of producing in the most complete manner the totality of the its symptoms , which at the same are stronger than the disease. 

Aphorism 70:- Totality is nothing but the essence of the medicine to select the similar remedy and to facilitate a cure. 

TOTALITY OF SYMPTOMS:- Boenninghausen’s view
Boenninghausen first conceived the idea of clinical completing symptoms partly by analogy and partly by observation of curative effects. He discovered that many of the modalities of a case were general in their relation.

The totality of symptoms is not only the sum total of symptoms, but is in itself one grand symptoms, the symptom of the patient.

The totality of symptoms is the disease what the man the ego, is to his organism .it is that which gives individuality and personality’’.

The characteristic symptoms can be elucidated following 7 consideration;-

  1. quis-the changes in the personality and temperament.
  2. quid-disease individualization.
  3. ubi– seat of the disease.
  4. quibus auxilis;-concomitants.
  5. cur;-prima causa morbid [cause of the disease]
  6. quomodo;modalities.
  7. quando-the time factor.

Totality of symptoms;; according to Kent.
Totality of symptom is all that is visible and represents the disease in the natural world to the eye., the touch and external understanding of man.

The characteristic image must be there to individualized the case as well as the drug Kent emphasized of detailed study of the expression of the whole person who is sick. A holistic approach to study both disease phenomenon and drug. Kent give importance to the general symptoms of the patient as it express the man himself. Pathological symptoms are only the end results.

A man consists of body mind and spirit and he is known to us by his total behavior .

Kent classified symptoms into general, particular and common to understand person ,part and disease respectively. Kent gave more emphasis on the general and uncommon peculiar symptom which characterize a person and his disease. the mental symptoms are most important as it the expression of the inner man. The loves and hates or desires and aversions are the deepest mental symptoms. 

Totality of  symptoms according to Stuart Clause
Stuart close defines it as ‘the totality of symptoms means all the symptoms of the case which are capable of being logically combined into a harmonious and consistent whole .having form ,coherency and  individuality, technically .the totality is more than the mere numerical  totality of symptoms. 

The totality means the sum of the aggregate plus the idea or plan which unites them in a special manner to give them its characteristic form,

The totality of symptom represents the therapeutic idea .the coordination of symptoms in pathological relation gives a diagnostic idea. Totality not mere the numerical aggregate, but the sum total, their organic whole as an individuality.

Symptoms of a case must be assembled in such a manner that they contribute an identity, an individuality to recognize ‘genius of the remedy’.-the essential principle of the remedy which gives its individuality. The drug pictures personified in such a way that it give the individuality so that the thieves identical to one who steal away our health and comfort can be identified from the rogues gallery’’ and bring them to justice as set a thief to catch a thief.

The true totality is there fore is a work of art, formed by the minds of the artist from the crude materials at his command, which are derived from a proving or from a clinical examination of the patient. 

Errors in taking totality

  1. Place too much emphasis upon a single symptom. or prescribing on a single symptom.
  2. Attempt to fit a remedy to a mass of indefinite unrelated or frag mentary symptoms by a mechanical comparison of symptoms with symptoms ,by which the prescriber becomes a mere superficial ‘symptom coverer’.
  3. Pathological prescription.

 Totality of symptoms Concept of  H A Robert.
According top H.A.Robert’’the totality is that concrete form which the symptoms take when they are logically related to each other and stand  forth as an individuality ,recognizable by any one who is familiar with the symptomatic forms and lineaments of drug and diseases.

It is not the common symptoms ,common to all disease syndromes ,that are of value ,but the rare ,the peculiar , the unusual that stand out by themselves .it is the concomitant symptoms ,which stands out the individuality so to be noted.

In analyzing the case ,very valuable symptoms are those pertaining to the Aggravations and ameliorations. because aggravations and ameliorations are the natural modifiers of diseased state and are the definite reaction of the man himself/

Alternating and contradictory symptoms or a very lack of symptoms are indications of high rank.

Periodic manifestation of symptom is another one to be of high evaluation. if we can find a remedy that has the ‘’none,stricking ,particular characteristic signs and symptoms of the case’ and in addition covers the chief complaints as well -a sound basis for the similimum.

Totality of symptom : Concept of Richard Hughes
The totality of the symptom is the only side of the disease turned towards the practitioner .this alone is perceptible to him that is the main thing he can know respecting the disease, and that he need to help him to cure it

The totality of symptom is to the therapeutist the disease’’ 

Totality of symptoms : Concept of  C M Boger
To get the symptom picture ,let the patient to tell his own story ,amplified the questionnaire in such a way that cause and course of the sickness and modifiers of the sickness can be elicited.boger also give importance for the 7 points to choose the characteristic symptom such as

  1. Changes in personality and temperament
  2. Peculiarities of disease
  3. The seat of disease
  4. Concomitants
  5. Cause
  6. Modalities
  7. Time

Totality of symptom – concept of Dr J N Kanjilal
Totality of symptoms does not means a conglomeration of all the symptoms of a patient or a drug ; it  really means a combination of certain groups of symptoms in definite settings with a definite background and certain individualizing characteristics set appropriately on the symptom complex ,so that it can point to the drug having similar peculiar symptom complex.

Totality of symptoms does not mean a haphazard mixture of all symptoms of a patient or a drug . it really means a combination of certain individualizing characteristic set appropriately on the symptom complex ,so that .it can point to the drug ,having similar peculiar symptom picture.

Importance of totality of symptom is it is the sole guide in the choice of the remedy. And the removal of the totality of symptoms  means the removal of disease, or totality of symptoms is to be removed in effecting the cure.

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