Char

act
eri
zi
ngDi
mensi
ons

oft
heTot
ali
tyofSy
mpt
oms

Par
t1:
Dimensi
onsofaPhy
sical
Sympt
om

Whent hetot
ali
tyofthesympt omsthatspeci
all
ymarkanddist
ingui
shthecaseofdi
seaseor,i
n
otherwords,
whent hepictur
eofthedisease,
whateverbei
tski
nd, i
sonceaccur
atel
ysket
ched,
themostdiff
icul
tpartofthetaski
saccompl i
shed.

-Samuel
Hahnemann,
Organonoft
heMedi
cal
Art
,§104(
Dudgeont
ransl
ati
on)

Lastmonth'
sinstal
l
mentofthisser
iesf
ocusedont hehomoeopathi
cinter
view.Wi
ththecase
taken,
thesymptomswri
ttendownandi mpressedonourminds,we'
rereadytomatchour
coll
ect
ionofsymptomstoar emedi
alagent-orarewe?

NotethatHahnemann,i
naphori
sm 104,di
dnotstat
emer el
y"Whenthesymptomsthatspeci
all
y
markanddisti
ngui
shthecaseofdiseasearei
dent
if
ied.
.."-r
ather
,hespeci
fi
edtheneedto
i
denti
fya"tot
ali
ty(
Gesammt hei
t)ofsymptoms.
"

Hahnemannremindedust hatt
hetotal
i
tyofthemorbi
dsymptomsofacase-ast
he"out
wardl
y
r
efl
ectedpi
ctur
eoftheinternal
essenceofthedi
sease"-i
stheonl
ythi
ngwecanknowabout
t
heinter
nal
essenceofdisease:

Now, asinadi sease,from whi chnomani festexciti

ngormai ntainingcause( causaoccasi onal
is)
hastober emoved, wecanper ceiv enothingbutt hemor bidsy mpt oms, i
tmust( regardbeing
hadtot hepossibili
tyofami asm, andattent i
onpai dtotheaccessor ycir
cumst ances,§5)be
thesympt omsal onebywhi cht hedi seasedemandsandpoi ntst ot heremedysui tedtoreli
eveit
-and,mor eover,t
het otali
tyoft hesei tssympt oms, ofthisout war dlyrefl
ectedpi ctureofthe
i
nternalessenceoft hedi sease, t
hati s,oftheaf fecti
onoft hev it
al force,mustbet heprincipal
,
orthesol emeans, wher ebythedi seasecanmakeknownwhatr emedyi trequires-t heonly
thi
ngt hatcandet er
mi net hechoi ceoft hemostappr opriat
er emedy-andt hus, i
nawor d,the
tot
ali
tyoft hesympt omsmustbet heprincipal
,indeedtheonl yt hingt hephy sicianhastot ake
noteofi neverycaseofdi sease.

SamuelHahnemann,
Organonoft
heMedi
cal
Art
,§7(
Dudgeont
ransl
ati
on;
thi
saut
hor
's
emphasi
s)
Howdoesthi
stotal
i
ty,
Hahnemann'
sGesammt hei
t,di
ff
erf
rom amer
ecol
l
ect
ion-ev
ena
t
horoughcol
l
ecti
on-ofthesy
mptomsofthecase?

St
uar
tCl
ose,
inTheGeni
usofHomoeopat
hy,
tackl
edt
hisquest
ion:

TheTotali
tyoft heSympt omsmeansal l
thesymptomsofthecasewhicharecapableofbeing
l
ogical
lycombi nedintoahar moniousandconsist
entwhol
e,havingf
orm,coher
encyand
i
ndivi
duali
ty.Technicall
y,thetot
ali
tyismore(andmaybeless)thanthemerenumer i
calt
otali
ty
oft
hesy mpt oms.Itincl
udest he"concomit
ance"orf
orminwhichsymptomsar egrouped..
.

Thet
otal
i
tymustexpr
essani
dea.
..

The"tot
ali
ty"i
snot,t
her
efore,
amer ehaphazar
d, f
ort
uit
ousjumbleofsymptomsthrown
toget
herwithoutr
hymeorreason,anymorethanasimilarhaphazar
dcol
lect
ionofpathogenet
ic
symptomsinapr ovi
ngconsti
tut
esMateri
aMedi ca.

Closewentont odescri
bethetot
ali
tyasasymptom pi
ctur
eofthedi
sease-infactbor
rowi
ng
thatter
mf rom Hahnemann,"
dasBil
dderKrankhei
t"(
§104)-acomposit
ioncreat
edbythe
"
har moniouscombinati
onofit
selementsi
ntoawhole."

Thispictureoft hedisease,pai
ntedbyit
scol l
ect
edsy mptoms, needsforourpur posesnotonl
y
theinter
nal coherencyofacomposi ti
on,butalsotheindiv
idual
ityofapor t
rai
t.Thet ot
ali
ty
needst oreflecttheinneressenceofthediseaseoftheperson,withthedetailnecessaryto
dist
inguishthisindiv
idualcaseofdiseasefrom othersofsi
mi l
arnature.Hahnemannpi thi
ly
descri
bedwhatwer equirefori
ndivi
dual
izi
ngdet ai
l,i
ntheOrganon:

Inthissear chforahomoeopat hicspecif i

cremedy ,thatist osay,inthiscompar i
sonoft he
collecti
v esympt omsoft henat uraldiseasewi ththel i
stofsy mpt omsofknownmedi ci
nes,in
ordert of i
ndamongt heseanar t
ifi
cialmor bif
icagentcor respondi ngbysi mil
ar i
tytot hedisease
tobecur ed,themor est r
iki
ng,singular,uncommonandpecul i
ar(characteri
stic)signsand
sympt omsoft hecaseofdi seasear echi ef
lyandmostsol el
ytobekepti nv i
ew; foritismor e
particularl
ythesethatv erysimi l
aronesi nt heli
stofsy mpt omsoft heselectedmedi cinemust
correspondt o,i
nor dert oconst i
tut
ei tthemostsui tablef oreffectingthecure.Themor e
gener alandundef inedsy mptoms: lossofappet i
te,headache, debi l
it
y,restl
esssl eep,
discomf or
t,andsof orth,demandbutl it
tleattent
ionwhenoft hatv agueandi ndef i
nit
echar acter
,
i
ft heycannotbemor eaccur atel
ydescr ibed,assy mpt omsofsuchagener alnaturear e
obser vedinal mostev erydiseaseandf rom almostev erydr ug.
-SamuelHahnemann,
Organonoft
heMedi
cal
Art
,§153(
Dudgeon/
Boer
icket
ransl
ati
onoft
he
6thedi
ti
on)

Theappl i
cati
onofthisaphorism t
oindiv
idualsymptoms-st ri
king,si
ngul
ar,uncommonand
pecul
iar(charact
eri
sti
c)signsandsy mptoms-wi ll
betakenupi nasubsequentinst
all
mentin
thi
sseries.Fornow,I'
dli
ket ofocusonthe"iftheycannotbemor eaccur
atelydescr
ibed"por
ti
on
ofaphorism 153.Whatdower equi
reinordertohaveanot herwisegeneralandundefi
ned
symptom "mor eaccurat
elydescri
bed?"

Agai
n,f
rom St
uar
tCl
osei
nTheGeni
usofHomoeopat
hy,

Dr
.Hering,i
nhisquai
ntfashi
on,..
.sai
d:"
Everyst
oolmusthaveatleastt
hreel
egs,
ifi
tist
o
st
andalone."Headvi
sedselect
ingatl
eastthr
eechar
acter
ist
icsy
mpt omsasthebasi
sof
pr
escr
ibing.

Ami lki
ngstoolwil
l st
andupononel eg-i
fyousitonitandthusprovi
deyourownt wol egsasthe
othernecessaryprops;buteventhen,asever
yf ar
mer'sboyknowsbybi t
terexperi
ence,a
vi
ciouskick,ora"corkscrewswat"from t
heoldcow'stailmayupsettheyouthful
mi l
kerandhis
pailofmil
kandbr inghimt ogri
ef.

Soitiswisetoalwaysgivethesymptomaticmil
k-stool asbroadabaseandasmanyl egsas
possibl
e.Theyouthfulpr
escri
berwil
lgetmanyav iciouski ckf
rom r
efract
orycases.Hemaybe
knockedsprawli
ngandl osehispai
lofmilkafewt i
mes, buthewil
lbeabletoavoidthi
swhenhe
haslearnedthepeculi
ari
ti
esofhispati
entaswellasIl earnedthepeculi
ari
ti
esofmybov i
ne
ki
ckerwhenIwasaboy .

Thecharacteri
zi
ngf eatur
esofasy mptom needtostandtothesymptom li
ket hel
egsstandtoa
mil
kingstool-widely-spr
eadandsoli
dlysupporti
ng.The"5W's"ofj
ournali
sm comet omymi nd:
"Who,What, Where,When, Why"ser
vetobroadlycharact
eri
zetheevent
soft henews.What
camet oBoenninghausen'smind,wasa12t h-
centur
yv er
seusedbytheologicschol
asti
csto
deter
minethesev eri
tyofasin,onwhichhebasedhi s1860essay,AContribut
iontothe
JudgementConcer ningtheCharact
eri
sti
cValueofSy mptoms.
Inthi
sessay,Boenninghauseninvestigat
edt hechar
act
erizi
ngdimensionsofthet
otal
ityi
n
ter
msoft hedescript
ives"Quis?quid?ubi?quibusauxi
li
i
s?cur?quomodo?quando? "("Who?
What?Wher e?Associatedwithwhat ?Why ?Inwhatmanner?When? "
).Anotherwi
setoo-gener
al
symptom -e.g.
,"headpain"-assumeschar act
eri
zi
ngvaluewit
hinthetotal
i
tyofsymptoms
wheniti
sf ul
lydescri
bedacr ossthesesev eral
dimensi
onsas:

Qui
s?-agener
all
yir
ri
tabl
eandi
mpat
ientman

Qui
d?-dul
lpai
n,becomi
ngt
hrobbi
ng,
andati
tsmosti
ntensel
i
keanai
l(3)bor
ingi
ntot
hebr
ain

Ubi
?-r
ightey
e(3)
,templ
eandf
orehead

Qui
busauxi
l
ii
s?-wi
thbi
tt
erv
omi
ti
ng(
2)

Cur
?-af
tercommut
ingont
het
rai
n

Quomodo?-wor
sej
arormot
ion(
2),
wor
sel
i
ght(
2);
bet
terv
omi
ti
ng(
3)

Quando?-wor
seev
eni
ng(
2)

Heri
ngusedasi
mpl
i
fieddi
agr
am t
ogr
aphi
cal
l
yil
l
ust
rat
ethedi
mensi
onsoft
het
otal
i
tyof
symptoms:

Her
ingdi
agr
am

Thesef ourprinci
paldi
mensi onsofafull
y-
char acter
izedtotali
ty-Local
it
y,Sensati
on, Modal
it
ies,
andConcomi tant
s-serveast he4potenti
allegsofSt uartClose'
sstablemetaphoricalmil
ki
ng-
stool.[
Not ethatt
hesechar acter
izi
ngdimensionsdonotappeart oapplyaswel l
tosy mptoms
ofthement al
/emoti
onal r
ealm.Thiswasast ickingpointinBoenninghausen'
sscheme, whi
chI
willaddressinthenextinstal
lmentofthi
sser i
es].

Notev er
ysy mptom inacasei schar acter
izedbyal lfouroft hesedimensi ons.Duet o
i
nattenti
venessont hepar toft hepatient,and/oront hepar toft heinter
viewer,orduet otr
ue
one-si
dednessofdi sease, somecol l
ectedsy mptomsmaybemi ssi
ngpot enti
allycharact
eri
zing
dimensions.Awar enessofourr eli
anceont hef ul
ldimensi onalityofthetotali
tyduring
casetaki
ng( see"keepy ourey esont hepr i
ze"inthepr i
orinst all
mentoft hisseries)mayhelpus
i
npar ttoavoidsuchadef i
ciency .Howev er,iti
simpor tanttor ecognizethatwedonotr equir
e
eachofoursy mptomst obef ul l
ycharacterizedalongt heselines-itisthet ot
alityofsymptoms
thatneedstobef ullycharacterizedinasmanyoft hesedi mensi onsaspossi ble.
Boenninghausenr ecognizedthatourcases, aswellasourpr ovi
ngs, arenecessar i
lyincomplete.
Anti
ci
pat edmodal it
iesareof t
enmi ssinginbothcasesandi nprovings;sensationsar eoft
en
i
nadequat elydescri
bed.Onponder i
nghowt oadapttot hesedefici
encies,i
toccur redt ohi
mt hat
modali
t i
esandsensat i
onsof tenbelongmor etothecaseasawhol e-i.e.
,tothet otali
tyof
symptoms-t hanjusttoal ocalsympt om.[Wemi ghtreflectt
hatBur net
tsimilarlysuggestedthe
sameofl ocalit
y,i
nhi sconceptofspeci fi
cit
yofseat].Boenninghausensuggest edt hat
modali
t i
esandsensat i
onsmi ghtbeusedi ncaseanal ysisasdescr i
ptorsofthewhol e,rat
her
thanmer elyofthepar t
s,andheel evatedthem fr
om local descr
iptorstogener alsympt oms.

AstrategyIoft
enusei ncaseanal ysis,
istoorganizesymptomsforreper
torialanal
y sis
accordingtoBoenninghausen'sdimensions.UsingtheRADARr eper
torysoftware,forthe
headachecaseletabov e,Iwouldplacethe"Quis"(who)rubr
icsi
ntothefi
rstrubricclipboard;t
he
"Qui
d"( what)r
ubri
csint othesecondcl i
pboar
d; et
c.Thishel
psmet oseet hatIhaveabal ance
ofsympt omsacrosst hecharacter
izingdimensionsofthecase.

Ital
soal
lowsmetouset
heHer
scuanal
ysi
smodul
einanunor
thodoxway
.Bysel
ect
ingt
his
anal
ysi
smethod,

Her
scu

theremedieshavingatleastonesymptom i
neachdi mensionar
eemphasized.Themulti
ple
cli
pboardscanbev iewedsimult
aneouslywit
hintheHerscumoduleanal
ysi
s,andf r
om t
he
analysi
swindowi t
self,
thevari
ousremediesthatrunt
hruthedimensi
onsrepresent
edcanbe
dir
ectlycompared.

Inthetwoinstal
lmentstofoll
ow, Iwil
lextendBoenni
nghausen'sconceptofthecharact
eri
zi
ng
dimensionsofasy mptom tosy mptomsoft hemental/
emotionalr
ealm,discuss
Boenninghausen'
sconceptoft heconstructi
onofsymptomsbyanal ogy,andexaminethepros
andconsoft hepract
iceofgener al
izat
ionofmodalit
iesandsensati
ons.
Sour
ces:

Or
ganonoft
heMedi
cal
Art

Samuel
Hahnemann(
Dudgeon/
Boer
icket
ransl
ati
onoft
he5t
h/6t
hedi
ti
ons)

Germanexer
cept
sar
etakenf
rom Or
ganonderHei
l
kunst
,Text
kri
ti
scheAusgabeder6.
Auf
lage;
JosefM.

Schmi
dt,
ed.
;HaugVer
lag,
Hei
del
ber
g(1992)

TheGeni
usofHomoeopat
hy;
Lect
uresandEssay
sonHomoeopat
hicPhi
l
osophy

Stuar
tClose(Pr
ofessorofHomoeopat
hicPhi
l
osophy
,NewYor
kHomoeopat
hicMedi
cal
Col
l
ege,
1909-1913)

Rel
atedAr
ti
cle:

Bonni
nghausen'
sTher
apeut
icPocket
book

Thechall
engesmetinproduci
nganewt
ransl
ati
onoft
heBoenni
nghausenReper
tor
yforRADAR
Sof
tware,takenf
rom t
heorigi
nal
Ger
manversi
on.