EVALUATION OF SYMPTOMS
The word meaning of “evaluation” is to “judge” or “to determine the quality”. So in short, the evaluation of symptoms means “to determine or to judge the quality of the symptoms.
A general truth is the aggregate of the particular truths, a comprehensive expression by which an indefinite number of individual facts are affirmed or denied
Evaluation of symptoms is a process of grading the symptoms according to their value and priority in order to individualize the patient so that the physician can match them with the drug symptoms and select the similimum remedy.
Once the case taking is over, the physician finds himself in the accumulated mass of symptoms. To make the patient’s suffering clear, he has to classify these collected symptoms according to their importance in the selection of remedies. Constructing the essence of the disease is not a simple task. One remedy in materia medica seems to be suitable for one group of symptoms and the other remedy for the other.
To overcome this problem, pioneers have designed and developed the process of evaluation of symptoms. This is the result of their years of clinical experience with the practicality of the law of similia. The evaluation of symptoms has to be done according to the accepted terms and conditions advocated by the pioneers.
Dr. Kent recommends a method that will be useful in using Kent’s repertory and Boenninghausen recommends one evaluation process which is helpful in sorting out the case with the help of his repertory. Every homeopath has to strictly adhere to these rules and guidelines in order to make the best use of each repertory.
§ 153 explains, “In this search for a homeopathic specific remedy, “the more striking, singular, uncommon and peculiar (characteristic) symptoms of the case of disease are chiefly and most solely to be kept in view for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to the more general and undefined symptoms like loss of appetite, headache, debility, restless sleep, discomfort, and so forth demand but little attention”.
Hahnemann broadly classified the symptoms into
- 1. General symptoms.
- 2. Uncommon symptoms.
These symptoms are common to many diseases as well as many medicines. These general symptoms of Hahnemann are equal to Kent’s common symptoms.
Example: loss of appetite, headache, debility, restless sleep, discomfort, fevers, etc. They do not bear any importance in homeopathic prescribing.
Those symptoms which are unexplainable, either on pathological or physiological grounds and those are peculiar to the patient alone are called the uncommon symptoms. These are found in a few patients and in a few provers. They are very valuable and important for the prescription of a remedy.
Example: Burning pain relieved by hot application, fever without thirst, coryza relieved by cold bath, etc. Evaluation Hahnemann’s evaluation is a laborious and cumbersome process. Every symptom has to be arranged manually and referred to the materia medica at every step to arrive at a similimum.
Hence, in the footnote to § 148 Hahnemann says, “This laborious, sometimes very laborious, search for and selection of the homeopathic remedy most suitable in every respect to each morbid state is an operation which, not withstanding all the admirable books for facilitating it, still demands the study of the original sources themselves.”
That medicine that covers the most “uncommon symptoms” of the patient is the indicated remedy. Though Hahnemann’s evaluation is not practiced today as is all other methods originated the Hahnemann’s process only.
Kent’s Evaluations of Symptoms
Kent’s method of evaluation is the practical and the most widely used one. Kent reduced the process of evaluation to the mere matching of “diseased personality” to “drug personality”. Kent had a view that the medicine which covered the mental symptoms of the patient supported primarily by the physical generals and secondarily by particular symptoms will be the suitable remedy.
The more the medicine symptom individualizes the patient’s personal features, the higher the place it occupies in the evaluation gradation, because it characterizes the individuality of the diseased person. “The true homeopathic prescription cannot be made on pathology, because provings have never been pushed in that direction. No man who is only conversant with morbid anatomy and pathognomic symptoms can make homeopathic prescriptions”.
To arrive at the disease personality, Kent had grouped to the totality of symptoms into 3 headings:
- General symptoms
- Common symptoms
- Particular symptoms
Learn more about these symptoms:
Grading of symptoms according to Kent
While prescribing the remedy a physician may suspect the reliability of the symptom that is mentioned in materia medica. Hence, to assure the physician and to make his prescription more confident, Kent classified and graded the symptoms present in the materia medica into 3 grades. The clinical and practical value of each general, common and particular symptom has been classified according to their reliability in the selection of the remedy.
The common “criteria” adopted for the grading of symptoms is whether the symptom is:
1. Proved and recorded during drug proving
2. Reproved or confirmed
3. Clinically verified successfully by prescribing to the sick All these criteria have to be fulfilled by any symptom before including it into the materia medica. To make the evaluation more accurate and to aid the physician in this process
Kent ranked each variety of symptoms into 3 grades.
- i. First grade
- ii. Second grade
- iii. Third grade
i. First Grade Symptoms
The first-grade symptoms fulfill the above-mentioned three criteria. That is before including these symptoms into materia medica.
a. These symptoms have appeared in all the provers during drug proving
b. During reproving also they appeared
c. These symptoms have been clinically verified on the sick
ii. Second Grade Symptoms
The second-grade symptoms fulfill the criteria but are not up to the level of the first-grade symptoms.
a. These symptoms have appeared in only a few provers during drug proving
b. They are confirmed by reproving
c. They are only occasionally verified by clinically administering to the sick.
iii. Third Grade Symptoms
Third-grade symptoms do not fulfill all the criteria, but they
a. Occasionally appeared in one or two provers
b. Are not confirmed by reproving
c. Have been clinically verified as having the power to cure the sick J.T.Kent’s “Repertory of Homeopathic Materia Medica” contains these 3 grades of symptoms in rubric form.
The first-grade symptoms are shown in “bold” letters, the second-grade symptoms are shown in “italics” and the third-grade symptoms are shown in “common” fonts. They have been graded based on the criteria of “Proved, Reproved and Clinically Verified”. Those symptoms printed in bold letters are the most reliable ones because they are proven, reproved, and clinically verified. Those symptoms mentioned in italics are reliable but not to the level of bold, because they are proven, either reproved or clinically verified, but not both. Finally, those printed in common type are not reliable ones, as they fulfill only one criterion and not all the three criteria.
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- How to do Analysis in Homeopathic Case Taking?
- Brief History Of Homeopathy in India
- What is Prophylaxis in Homeopathy?
Boenninghausen was a greater follower of Hahnemann. According to Boenninghausen:
1. The totality represents the sum total of the characteristic features of the case. This would differentiate individual patients from the group suffering from the same complaint.
2. A remedy cannot be selected by a single indicating symptom, even if the symptom is very peculiar in nature. But, the indicated remedy has to be selected based on the characteristic totality.
Garth Boericke’s Evaluations
Garth Boericke evaluated the symptoms into 2 major headings:
1. Basic or absolute symptoms
2. Determinative symptoms
1. Basic Symptoms: They are those that appear in every proof and in most diseases. They are usually of diagnostic importance and have little value in the homeopathic selection of the remedy. Example: headache, anorexia, fever, weakness, etc.
2. Determinative Symptoms: They are the individual, personal, characteristic, keynote, or guiding symptoms of a drug personality. They help in distinguishing or individualizing a patient and hence help in homeopathic prescription. Example: the mental symptoms, characteristic modalities, strange, rare, peculiar symptoms