Most of the time we found that after studying various theories of stalwarts of homoeopathy and our master Hahnemann's guidelines for selection of homeopathic similimum and case taking that we get little bit confused and does not understand how to apply it in practical practice of homoeopathy. This occurs you know why? Because of lack of knowledge regarding the depth of the subject and logical application of various theories according to the case i.e. for example if a case comes to you with prominent mental symptoms you should use Kent's approach, if the case is having more prominent generals apply Boenninghausen's approach, if the case is having only few symptoms again apply Boger-Boenninghausen's approach etc are the examples of these various approaches they adopted to satisfy the principle of "totality of symptoms". In order to find the similimum, it is time now to seek that how to apply their teachings in the practice.

A careful study of what all of them have said will take us to the conclusion that it is the "striking, singular, uncommom and peculiar (characteristic) signs and symptoms of the case of disease which should chiefly and almost solely be kept in view" for the purpose in view irrespective of whether these singular, unusual and peculiar symptoms which characterize the patient(not the disease) pertain to his mind and disposition, or his bodily functions, his personal or family history of infection or even the peculiar symptoms of pathology. Hahnemann even went to the extent of saying (Aph 164) that the "small number" of such uncommon and peculiarly distinctive symptoms in the best selected remedy it no obstacle to the cure. In the early days of homoeopathy when there were no detailed repertories, the masters had to wade through the vast symptomatology of remedies. It is in this situation that Guernsey and others hit upon the brilliant idea of " Keynotes" which could guide one to the remedy. Guided by the keynote one had only to check up if that remedy has the other characteristic also of the case in hand. The only condition for a keynote to be used legitimately in a case is that it should not lead to a remedy whose generals do not conform to the case. In other words, the test whether a remedy selected on the basis of keynote is the true similimum lies in the fact that it should also cover at least some of the other leading characteristics of the patient.

Let us turn to what Dr. Erastus Case says about the symptoms that guide, in his book "Some Clinical Experiences". Dr Case was a truly gifted clinician with a rare ability to clearly perceive his patients and prescribe the curative remedy. His book contains 212 clinical reports of ninety different diseases treated mostly with the highest potencies in a single dose of remedies selected on the basis of Peculiar characteristics, the keynotes. Dr. Case describes his method of arriving at his conclusions, thus:

"I follow two methods in my work: One is to pick out the uncommon or peculiar symptoms and find the remedies that have them; then hunt up the one that has the rest of the case in its pathogenesis. The other way is to take the locations and corner the remedy down by the modalities usually by means of the Boenninghausen's Slips".

Dr. Case lays down four Rules for the choice of the remedy:

• Other things being equal, give the preference to a mental symptoms rather than to a bodily one. E.g.: A case of Lyco. Which may be arrived at by the rather long process of elimination if several physical general symptoms are taken, but Lyco. Could be arrived at straight away when peculiar weakness of mind (memory) was given the highest value.
• If there is no peculiar mental symptom, use the most peculiar bodily one. E.g. A boy of 12 years, a haemophilllic, who would bleed to death from slight cut unless pressure was applied, is the patient. Six weeks ago he received a bruise a bruise upon the left buttock. The blood escaped into the cellular tissues until the thigh was enormously distended. He has been lying in bed awaiting the absorption of the blood. He is deeply jaundiced with itching skin. Bowels constipated and stools composed of small, white, round balls. Profuse hemorrhage with the urine, both fresh and coagulated blood. Stitches between the scapulae upon every attempt to swallow, so that he abstains from food and drink. Since a chill yesterday he has high fever with sleepless, restlessness, and white coated tongue.

The symptoms of skin, stool and urine and knee have been present several days, one would scarcely expect to suffer pain between the shoulders from the action of deglutition. So far as ascertained, that symptom belongs to only one remedy, Rhustox. The jaundiced skin and white stools are pathological, and neither belongs to Rhus. The hemorrhagic diathesis, haematuria and white swelling of the knee do not belong to it. Although one symptom only calls strongly for Rhus, it is so VERY PECULIAR THAT IT OUTWEIGHS ALL THE OTHERS COMBINED.

• A common symptom by concomitance may become characteristic E.g. A dry, tickling, spasmodic cough at night, relieved by sitting up, pointed to Hyos. Which cured immediately.
• In subsequent prescription, when the same remedy is not indicated, follow the latest symptoms which have appeared.----

E.g: A complicated case suggested Arsenic, Lyco. And Nux vom. To antidote drugging with allopathic medicines. Six days after Nux vom 30 the patient presented symptoms of Lyco which cured the symptoms and brought back symptoms of asthma (suppressed) nine years back. Arsenic cured fully.

I feel there could not be a CRUCIAL symptoms viz. that the choice should depend upon the nature of the MOST PECULIAR symptoms we have been able to elicit in each individual case, and at each stage.

HOW TO IDENTIFY THE UNCOMMON, PECULIAR SYMPTOMS:

This is a question of crucial importance. Naturally, as KENT has so clearly put it, all the symptoms of the patient minus those pertaining to the disease he is suffering from, are the uncommon symptoms which characterize the patient.

It is these uncommon, unusual and peculiar symptoms which guide us easily to the remedy.

The problem of identifying peculiar symptoms is not different from that of identifying a person (even a well known actor) or a certain make of a car. The eyes do not see, nor the ears hear (perceive, recognize) what the mind does not know.

ANALYSIS OF THE CASE:-

After taking the case in detail, the prescriber has to decide, on the basis of the data before him:

1. Whether the patient's health has been affected some event (mental or physical) which has left a "LIFETIME EFFECT" on him. This includes the long term, submerged latent effects of some chronic infection (Miasm) arising from history or history of his personal illnesses.
2. Where the patient has "never been well since" (Ailments from) as identifiable causative factor including suppression of a skin affection, or emotional shock, grief, disappointment, fright or serious attacks of jaundice, typhoid, tuberculosis, surgery, diphtheria, measles etc.
3. Whether the physician has been able to clearly understand the patient's state of mind and disposition - and if not, whether he has at least identified the outstanding symptoms of the mind and disposition.
4. Whether he has been able to elicit at least a few strange, rare, unusual and peculiar symptoms.
5. Whether he has noted the outstanding physical generals with their modalities etc.
6. Finally, whether he has identified at least some Particular symptoms complete with their location, sensation, modalities, causation, and concomitants.