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Totality of symptoms
Notes on Totality of symptoms

Let’s have short discussion of totality of symptoms.  Let us see what it means in a simple comprehensible way. Totality of symptoms are nothing but symptoms presented by the patient. In aphorism 7 of organon of medicine Hahnemann saysthe totality of these its symptoms, of this outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force. The disease is caused by internal change in vital principle that animates our body. But this internal change can only be known by its symptoms produced by the patient. The removal of the totality of the symptoms is actually the removal of the cause of internal change in vital principle which is the aim of every physician.

Stuart Close, in The Genius of Homoeopathy, says: “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 formed, coherency and individuality. Technically, the totality is more (and may be less) than the mere numerical totality of the symptoms”

From above two definitions of masters it is clear that totality of symptoms is actually the symptoms presented by the patient and it need not be numerical totality.

 Four pillars on which totality of each of the symptoms of the patient is based are:

1.      Locality of symptoms: location of the complaint –is meant the part, organ, tissue or function of body or mind in which the symptom occurs.eg-left sided frontal headache

2.      Sensation of symptoms: is meant the impression, or consciousness of an impression upon the central system through the medium of the sensory or afferent nerves. In short what you feel of the disease for example pain.

3.      Modalities of symptoms: Anything that increases or decreases a symptom or group of symptoms. Two types of modality are present

Ø  AGGRAVATION is meant an increase or intensification of already existing symptoms by some appreciable circumstance or condition. For example: getting fever every winter.

Ø  AMELIORATION is technically used to express the modification of relief, or diminution of intensity in any of the symptoms, or in the state of the patient as a whole, by medication, or by the influence of any agency, circumstance or condition. For example: pain in extremity better by standing still.

4.      Concomitants: symptom that co exist with main symptoms without any pathological and physiological relationship with main symptoms. For example headache and pain in extremity (say lower limb) same time. Both do not have any relationship with each other even though both occur simultaneously.

 

Let discuss three other masters’ concept of totality

 

1.      BOENNINGHAUSEN’S HAS FOLLOWING CONCEPT OF TOTALITY OF SYMPTOMS

According to Boenninghausen totality of symptoms are based on following seven factors
 Quis –Personality,the individuality
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 Quid –Disease, its nature and pecularity
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 Ubi – Seat of the disease
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 Quibus auxilis –Accompanying symptom
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 Cur –Cause of disease
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 Quomodo- Modification agg and amel.
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 Quando- Time
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2.      BOGER’S HAS FOLLOWING CONCEPT OF TOTALITY OF SYMPTOMS

According to Boger totality of symptoms are based on following seven factors
 Changes of personality and temperament
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 Peculiarities of disease
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 The seat of disease
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 Concomitants
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 The cause
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 Modalities
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 Time
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3.      KENT’S HAS FOLLOWING CONCEPT OF TOTALITY OF SYMPTOMS

According to Kent totality of symptoms are based on following three major factors: (a) mind (b) physical (c) particulars
MIND
 Will.
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 Perversion of understanding/Intellect.
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 Perversion of memory/memory.
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PHYSICAL
1- Perversion of sexual sphere including menstrual symptoms; general agg, before, during, after menses; effects of coition.
2- Symptoms pertaining to appetite, food desires and aversions and thirst.
3- Things affecting the entire body- Weather and temprature,food,positions, motions, etc.
4- Symptoms of special senses

PARTICULARS
 Symptoms related to the parts (characteristics)
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1- Symptom that cannot be explained
2- Symptom with clear modalities

 

We have discussed what different masters have said about totality of symptoms. From above concepts of our masters we have drawn clear picture of totality of symptoms of a disease which is based on wholistic concept of man as whole. Wholistic concept of a disease (totality of symptoms) treatment  includes:

*      MAIN SYMPTOMS: which include   Location, sensation, modality, and Concomitants.

*      Appetite, including likes and dislikes in food and drinks.

*      Mental sphere of  the patient  which include interpersonal relationship between family members, interpersonal relationship between spouses and children, interpersonal relationship between his or her friends, relatives and others in his work/school(if schoolchildren).It also  include stress, anxiety, phobia etc. This also includes psychic symptoms of a patient.

*      We have to consider modification of symptoms by Weather and temperature, food, positions, motions, etc.

Sexual sphere of the patient including menses of the female patients

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