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Analysis of Case for Repertorization


Homeopathic Journal :: Volume: 2, Issue: 2, Dec 2008 (General Theme)   -   from Homeorizon.com
Author : Dr. Anoop Kumar Srivastava, BHMS (Gold Medalist), MD(Hom), Director www.homeorizon.com, Consultant, Homeopathic Hospital, Government of U.P. (India)
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Article Updated: Oct 18, 2009


The word Analysis originates from the Greek word, analusis meaning "breaking up or dissolving". Its literal meaning is the process of breaking up of a complex topic into constitutional parts to gain a better understanding of the subject. This method of systematic study has long been used by Descartes, Galileo, Newton as a practical method of physical discovery.

According to Dr. Castro, "The act of resolving or reducing or breaking the whole into pieces or groups is called analysis".

Analysis of Symptoms is important for homeopaths as it helps us in understanding the case. We understand health and disease as a Gestalt concept and not just the haphazard conglomeration of symptoms. The study of constituents and their inter-relationships help us in understanding the concept of "WHOLE" - a vital aspect in the understanding of homeopathy.

After a thorough case taking a physician is in possession of a large number of symptoms which if selected and arranged properly could help in forming a complete picture of the case. Also it includes the most important task of assessing the relative value of each part of the case alone and in relation to the whole. Therefore, Analysis of Case is the logical dismemberment of the case recorded into viable units which help in perfect synthesis. This process is not mechanical but an artistic pursuit with a logical mind. It is like extracting of 24 carat gold from its ore; a sort of carving out the perfect sculpture of Madonna from the large marble block.

But, yes it needs the art and expertise of Michelangelo.

Proper analysis needs a keen and analytical mind. The physician should be able to analyze every symptom in depth and to arrange it logically. The physician is required to be unprejudiced, observant of details and with analytical approach.

But as important it may seem it is the step where one very frequently errs. A slight error on the part of physician can mislead the whole case leading to improper selection of medicine. As it all depends on his discretion alone about the separation and arrangement of each symptom which help in synthesizing the complete picture.

Different stalwarts with different philosophies have their views about analyzing of case but the underlying theory remains the same.

Hahnemanian Viewpoint: Dr. Hahnemann in his Organon stated the importance of characteristic symptom. According to him a case presents with symptoms, most of which are general and undefined whereas some are more striking, singular, uncommon and peculiar (characteristic). It is these characteristics which are given higher priority while analysis of case. "The more general and undefined symptoms: loss of appetite, headache, debility, restless sleep, discomfort, and so forth, demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and from almost every drug."

Kentian School: Dr. J.T.Kent analysed the sum total of case into General symptoms, Particular symptoms and the particular symptoms.

The General symptom is the one which is experienced by the patient as a whole while the particular symptom is the one that pertains to a part. "The things that lie closest to man and big life, and his vital force, are the things that are strictly general, and as they become less intimately related to man they become less and less general, until they become particular."

Common symptoms are experienced by a large number of patients or provers and are of little value in remedy selection.
Dr. R. G. Miller in his booklet - On the Comparative Value of Symptoms categorically states that both generals and particulars may either be characteristic and particular" and vice versa.

Boenninghausian School: It was Dr. Boenninghausen who worked a great deal on the concept of Analysis of Symptoms. He gave clear directions as to how the physician should dismember the patient language into the complete symptom. He also contributed the "Doctrine of Analogy" to assist the physician in completing the symptoms. He advocated on giving priority to complete symptoms, which consists of: In

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. Boger's View:  Dr. Boger held the view that the case should be scrutinized for the disease symptoms and the individual symptoms. It is these individual symptoms which hold a higher priority as they focus on the response of the vital force to the disease, thus characterizing the symptoms of the person. "The final analysis of every case, therefore, resolves itself into the assembling of the individualistic symptoms into one group and collecting the disease manifestations into another, then finding the remedy which runs through both, while placing the greater emphasis on the former."

Dr. Sankaran's View: He classified symptoms into:

Pathognomonic Symptoms: Symptoms of the disease; helpful for diagnosing the case.

Non-Pathognomonic Symptoms: Symptoms of the patient which help us to select proper Homeopathic medicine.

The greater the value of a symptom in a diagnostic sense, the less its value in therapeutic sense.

Dr. Garth Boericke's View: Classification of symptoms into Basic (Common and Diagnostic) and Determinative (Characteristic and Guiding)

Basic or Absolute Symptoms or Pathognomonic Symptoms: Symptoms that appear in every proving and diseases and are important for diagnosis.

Determinative or Non-pathognomonic symptoms: These are strange, rare or peculiar symptoms of the patient, they are characteristic of an individual and are important for prescription.

It must be remembered that Dr, Boericke uses the term Basic Symptoms and Determinative Symptoms to denote Common and Uncommon symptoms respectively; and Dr. Boenninghausen often uses the terms Primary Symptoms and Secondary Symptoms to express the same order meanings.

Dr. N. Ghatak's View: Dr. Ghatak divided the symptoms into Subjective and Objective symptoms. . The subjective symptoms again classified in to personal ( relating to the patient as a whole) and local symptoms (relating to localities ).

Dr. G.I.Bidwell  divides all symptoms from innermost to outermost, from mind to skin, from generals to particulars into two divisions

(a) strange, rare, peculiar and uncommon symptoms; and

(b) the common symptoms

Though all may seem different yet the essence of all their teachings remains the same. Going through all the above views the student should not let himself get confused over which path to tread, for irrespective of the road he chooses he is bound to reach the Similimum safely provided he understands the underlying concept. To further simplify the intricacies of analysis I wholeheartedly support Dr. Roberts usage of words of famous detective character of Arthur Canon Doyle, Sherlock Holmes about acting as a scientific detective, "That which is out of the common is usually a guide rather than a hindrance." Thus it is the uncommon which should be given more preference while analyzing the case. The final outcome of analysis should help the physician to extract the following information:

Causation: Ailments from, physical and emotional factors.

General modalities: Aggravations and ameliorations, relations to heat and cold.

Characteristic particulars (modalities, etc.)

Rare, peculiar and striking symptoms.

Concomitants.

Common symptoms with location, sensation and modalities.

 Analysis and Evaluation

While Analysis is breaking up of the case recorded into viable constituents; Evaluation is the hierarchal enlisting of these units according to importance.

Analysis (Breaking up of Whole into Parts)

 

Evaluation (Enlisting of the parts according to importance)

Synthesis of Case (Construction of Case)

Repertorisation

Prescribing Similimum

 Cure

One thing to remember is that Analysis and Evaluation are always done based on certain school of philosophy. The process of analysis and evaluation is in fact, a sieving up of the case recorded in order to procure a complete ripe case which can be helpful in Repertorisation.

If the logic of our symptom analysis be correct, if the technique of selection be without a flaw, the choice of the remedy must be mathematically certain.


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