practice

from Stuart Close, The Genius of Homeopathy, chapter XI, Symptomatology:

Totality of the Symptoms.-"Totality of the Symptoms" is an expression peculiar to homoeopathy which requires special attention. It is highly important to understand exactly what it means and involves, because the totality of the symptoms is the true and only basis for every homoeopathic prescription.

Hahnemann (Org., Par. 6) says:-"The ensemble or totality of these available signs or symptoms, represents in its full extent the disease itself; that is, they constitute the true and only form of which the mind is capable of conceiving." The expression has a two-fold meaning. It represents the disease and it also represents the remedy, as language represents thought.

1. The Totality of the Symptoms means, first, the totality of each individual symptom.
A single symptom is more than a single fact; it is a fact, with its history, its origin, its location, its progress or direction, and its conditions.
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2. The Totality of the Symptoms means all the symptoms of the case which are capable of being logically combined into a harmonious and consistent whole, having form, coherency and individuality. Technically, the totality is more (and may be less) than the mere numerical totality of the symptoms. It includes the "concomitance" or form in which symptoms are grouped.
Hahnemann (Org., Par. 7) calls the totality, "this image (or picture) reflecting outwardly the internal essence of the disease, i. e., of the suffering life force."

The word used is significant and suggestive. A picture is a work of art, which appeals to our esthetic sense as well as to our intellect. Its elements are form, color, light, shade, tone, harmony, and perspective. As a composition it expresses an idea, it may be of sentiment or fact; but it does this by the harmonious combination of its elements into a whole-a totality. In a well balanced picture each element is given its full value and its right relation to all the other elements.

So it is in the symptom picture which is technically called the Totality. The totality must express an idea. When studying a case from the diagnostic standpoint, for example, certain symptoms are selected as having a known pathological relation to each other, and upon these is based the diagnosis. The classification of symptoms thus made represents the diagnostic idea. Just so the "totality of the symptoms," considered as the basis of a homoeopathic prescription, represents the therapeutic idea. These two groups may be and often are different. The elements which go to make up the therapeutic totality must be as definitely and logically related and consistent as are the elements which go to make up the diagnostic totality.

The "totality" is not, therefore, a mere haphazard, fortuitous jumble of symptoms thrown together without rhyme or reason, any more than a similar haphazard collection of pathogenetic symptoms in a proving constitutes Materia Medica.

The Totality means the sum of the aggregate of the symptoms: Not merely the numerical aggregate-the entire number of the symptoms as particulars or single symptoms-but their sum total, their organic whole as an individuality. As a machine set up complete and in perfect working order is more than a numerical aggregate of its single dissociated parts, so the Totality is more than the mere aggregate of its constituent symptoms. It is the numerical aggregate plus the idea or plan which unites them in a special manner to give them its characteristic form. As the parts of a machine cannot be thrown together in any haphazard manner, but each part must be fitted to each other part in a certain definite relation according to the preconceived plan or design-"assembled," as the mechanics say-so the symptoms of a case must be "assembled" in such a manner that they constitute an identity, an individuality, which may be seen and recognized as we recognize the personality of a friend.

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The true Totality, therefore, is a Work of Art, formed by the mind of the artist from the crude materials at his command, which are derived from a proving or from a clinical examination of the patient.

It is important that these points should be understood, because, otherwise, there is liability to err in several directions.

1. Error may arise in placing too much emphasis upon a single symptom, or perhaps actually prescribing on a single symptom as many thoughtlessly do.

2. Error may arise in attempting to fit a remedy to a mass of indefinite, unrelated or fragmentary symptoms by a mechanical comparison of symptom with symptom, by which the prescriber becomes a mere superficial "symptom coverer."

3. Failing in both these ways the prescriber may fall to the level of the so-called "pathological prescribers," who empirically base their treatment upon a theoretical pathological diagnosis and end in prescribing unnecessary and injurious sedatives, stimulants, combination tablets, and other crude mixtures of common practice.

The physician who knows what a symptom is from the homoeopathic standpoint and how to elicit it; who knows what the totality of the symptoms means and how to construct it, and who has the intelligence, the patience and the honesty to study his case until he finds it will not be guilty of such practice.