IJFIRH - 2024, Volume - II, Issue - III [July to September 2024]

e-ISSN No- 3048-6270

Published by Homoeopathic Chronicles

THE TOTALITY OF SYMPTOMS - AN EMPIRICAL REVIEW

Janani .S 1 , Sibin R.A 2, Sanjay Narayanan 3

1 Intern, Sarada Krishna Homoeopathic Medical College, (Affiliated to The Tamil Nadu Dr. M.G.R Medical University, Chennai), Tamil Nadu-629161

2 Department of Organon of Medicine, Sarada Krishna Homoeopathic Medical College, (Affiliated to The Tamil Nadu Dr. M.G.R Medical University, Chennai), Tamil Nadu-629161

3 Intern, Sarada Krishna Homoeopathic Medical College, (Affiliated to The Tamil Nadu Dr. M.G.R Medical University, Chennai), Tamil Nadu-629161

Article Received: 15 July 2024 - Accepted: 18 August 2024 - Article published online: 30 September 2024 

DOI: https://doi.org/10.59939/3048-6270.2024.v2.i3.3 

BACKGROUND

The concept of the totality of symptoms remains the basis of the selection of homoeopathic medicines. It is considered as the pre-requisite for arriving at the indicated medicine. The construction of totality varies according to the philosophy that a physician follows. Kent’s totality emphasizes the mental generals, physical generals, and the characteristic particulars. Likewise, the concept of totality according to Boger and Boenninghausen includes changes in personality and temperament, peculiarities of disease, the seat of disease, concomitants, the cause, modalities, and time. Whatever the method of constructing the totality, the remedy selection must be the same at the end, as the patient is same for all the philosophical concepts. Dr. Hahnemann defined the totality of symptoms in aphorism 18 as the total of all the symptoms in each case. It is important to understand that the term ‘totality of symptoms’ is the result of a peculiar internal mechanism, that takes place inside the body. The explanation for the selection of medicine cannot lie in the result (symptoms), but it should lie in the process that caused such a result. This article emphasizes the concept of the totality of symptoms, its evolution, its components, and its interaction with the microenvironment of the individual.

A BRIEF BIBLIOGRAPHY OF DR. SAMUEL HAHNEMANN

Dr. Samuel Hahnemann (1755-1843), born in Meissen, Saxony (now Germany), was a pioneering German physician best known for founding homeopathy. Educated at the University of Leipzig and the University of Erlangen, Hahnemann initially practiced conventional medicine but grew disillusioned with its methods. His translation work exposed him to new ideas, leading to his development of the "law of similars," which posits that substances causing symptoms in healthy individuals can treat similar symptoms in the sick. Central to his approach was the concept of the "totality of symptoms," which emphasizes treating the patient holistically by considering the complete set of physical, emotional, and mental symptoms rather than isolated issues. This holistic approach requires a detailed understanding of the patient's overall condition, individual responses to illness, lifestyle, environment, and emotional state, ensuring that treatment addresses the root cause rather than just alleviating individual symptoms. Hahnemann believed that the totality of symptoms represented the true nature of the patient's disease and that effective treatment must restore balance and harmony to the entire system. This principle became the foundation of homeopathy, detailed in his seminal work, "Organon of the Medical Art" (1810). Despite facing opposition from the medical community, Hahnemann continued to practice and refine his methods, eventually relocating to Paris in 1835, where he remained until his death in 1843. His contributions significantly shaped alternative medicine, and his legacy endures through numerous homeopathic institutions and continued global practice.

METHODOLOGY

A comment article emphasizes commenting on innovative conceptual understanding by referring to a concept described by different authors

DISCUSSION

EVOLUTION OF TOTALITY OF SYMPTOMS

As mentioned earlier, the totality is the result of an internal mechanism. Let us consider an example. Dyspnoea is a common symptom. Various remedies indicate breathing difficulty. At the same time, there are different reasons for breathing difficulty. Environmental factors like high altitude, pollution, and smoke inhalation can cause dyspnoea. Respiratory conditions like asthma, bronchitis, pneumonia, and emphysema can cause breathing difficulty. Obesity and lack of physical fitness superimposed with smoking habits remain as modifiable causes for dyspnoea. Hormonal fluctuations can also result in dyspnoea. The increase in progesterone levels in pregnancy can cause bronchodilation increasing the respiratory rates1,2,3. In menopause, decreased estrogen levels can lead to increased airway resistance that results in hot flushes which causes rapid breathing4,5. Many psychological issues like anxiety disorders, and panic attacks may show this symptom6,7. Thus, it can be understood that the symptom ‘breathing difficulty’ is just the result, but the internal process that resulted in breathing difficulty varies. Asthmatic breathing difficulty indicates remedies like Ars alb and Natrum sulphuricum. These remedies exhibit action on the system's immune sphere and bring an amelioration. Whereas, Antimonium arsenicosum is a remedy that is indicated for dyspnoea due to emphysema9,10. Anti-arsrnicosum may improve the recoiling capacity of the dilated alveoli and could ameliorate the symptoms. Bryonia is a catarrhal remedy that can reduce breathing difficulty due to bronchitis, producing expectoration9. Lachesis is a remedy indicated for post-menopausal syndrome10. Breathing difficulty due to hormonal causes can indicated for Lachesis. Laryngeal pathologies resulting in breathing difficulty may call for remedies like spongia9,10. Thus, it is evident that the totality of symptoms occurs due to an internal process. The medicine selection should not only be made merely out of the totality of symptoms but also the reason for such a totality should be considered.

IMPORTANCE OF LESSER ACCESSORY SYMPTOMS

As the mechanism of action of homoeopathic medicines is under research, it is practically challenging to identify the internal process that resulted in such totality in all cases. However, there will always be associated symptoms that occur as a reflection of the internal core mechanism. It might be a simple modification in the generals of the patient. Even though the internal core mechanism remains difficult to understand, the associated complaints give us an idea about the possible mechanism that had happened in the body and this can be easily perceived by the physician through proper case-taking and keen observation with sound knowledge in pathology. Unfortunately, we also have certain difficulties in doing this. The patient may fail to narrate such complaints as he might become used to it. He might also think that such complaints do not have any relation with the chief complaints. Or in worse cases, the patient may even fail to notice such a complaint. These symptoms have great value as they represent the internal mechanism that resulted in such a totality. These are termed as the lesser accessory symptoms by our master in aphorism 95 in the 6th edition of Organon8. He would have mentioned that these lesser accessory symptoms are characteristic and are often helpful in determining the choice of the remedy. As such symptoms provide the reason behind the resultant totality, they are tagged as the characteristic symptoms that guide us to the medicine selection.

COMPONENTS OF TOTALITY OF SYMPTOMS

The totality of symptoms contains common symptoms and uncommon symptoms. The common symptoms represent the pathology. In the case of arthritis, there is pain in the knee joint. This pain in the knee joint is a common symptom and it represents the pathology called inflammation. However, there are different reasons for knee joint pain. If the knee pain is caused due to joint stiffness, muscle strain, joint inflammation, synovial fluid changes, and so on, constant motion ameliorates the pain, indicating Rhus Tox9,10. If the knee pain is due to cartilage breakdown, or bone spur formation are may be due to nerve impingement, then even the slightest motion will cause severe pain. This indicates Bryonia that has, the slightest motion aggravation9. From this, we can understand that arthritis is a pathology with a common knee pain symptom. But the reason for knee pain is the uncommon peculiar symptom that indicates the remedy. As we can see there are different reasons for pain, no two arthritis are the same. When a patient has pain in joints, it could be said that the patient has a ‘kind of arthritis’. This is what has been exactly mentioned in the footnote of Aphorism 81.

INTERACTION WITH MICROENVIRONMENT

For every organism to thrive and multiply, it needs a proper environment11. The factors contributing to a living organism's proper homeostasis are called microenvironment. Whenever the microenvironment is deranged, the person becomes susceptible. Another reason for the occurrence of uncommon peculiar symptoms is due to microenvironmental changes. As every person have unique microenvironmental factors, the symptoms arising on each individual becomes peculiar to the person. This is what we do as individualization. Homoeopathic treatment impacts changes in the level of microenvironmental level of a patient providing holistic, individualistic treatment for patients.

CONCLUSION

Homoeopathic approach is claimed to be holistic and individualistic. The symptoms included in the totality of the symptoms are the effect of an internal mechanism. The basis of the selection of medicine should not be confined to the results, but the core process should be the totality. Based ‘totality of symptoms’ has remained a constant answer to the question ‘How do homoeopaths select medicine?’ This article intents to provide a more scientific explanation on the concept of totality of symptoms so that homoeopathy can survive strongly in the upcoming era of conceptual science.

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