It is the impossible for nay mind to remember every symptom of every drug or even every symptom of any single drug in our materia medica, but it is absolutely necessary that the successful physician should have an acquaintance with as many drugs as is humanly possible, and, above all, a knowledge of how to approach and study each and every proven remedy. No teacher can teach one materia medica, the very best that they can do for us is to teach us how best to approach and study it, and it is to this end that we shall attempt to take up this task.
First of all it is necessary, if possible, to find the essential symptom or symptoms which must be present in EVERY case requiring the remedy under consideration. This, or these, when found, will be easily remembered. If this cannot be done our next step will be to find that group of symptoms which is characteristic of the drug under consideration, which symptoms form the skeleton of the drug upon which the rest of the symptoms are built.
Then we must find as many symptoms as possible of undoubted reliability which appear under no other known remedy than the one under consideration, and lastly, all those symptoms for which the remedy under consideration is the undisputed leader. In this way one studies from the center or heart of the remedy to its circumstance or from its most important to its least important symptoms. For the rest of the less important symptoms the repertory will be of the greatest importance.
In prescribing intelligently and accurately the first and most important consideration is a knowledge of how to approach and study the patient to accurately elicit such symptoms as are absolutely necessary for the proper selection of THE indicated remedy. This is erroneously styled “how to take the case”.
We are going to take up our task today by introducing Aconitum napellus, the common Aconite, monks-hood or wolf;s- bane. Aconite, which is a deadly poison to the human, has been eaten by elephants with impunity, showing that animal experiments with drugs for the purpose of prescribing for the human is useless and of no avail whatever.
The leading symptom which is a constant companion and requisite to an Aconite case is AGONIZED TOSSING ABOUT. According to the late DR.T.F.Allen this is essential to a case requiring Aconite and therefore should always be present when Aconite is indicated and prescribed. It is the characteristics, the red strand that runs all through the cases requiring, Aconite. These characteristics or red strands should ever be prescribed upon alone, unless they occur under no other known remedy or in a case with a paucity of symptoms, but they will serve in an emergency to point to the rubric in the repertory to confirm you finding. If it is not the ONLY remedy mentioned the rubric will give you the most logical list of selected remedies with which to compare.
Our next step is to get a list of those prominent symptoms which are the most constant from which to form a skeleton, just as one would take the common constant symptoms in a disease to form a diagnosis.
Under Aconite the skeleton symptoms would be: Agonized tossing about intense anxiety and restlessness, feat, especially of a crowd or of death, expression of fear and anxiety, dry mouth bitter taste, great thirst for cold water, full, bounding, hard, rapid pulse, and a dry hot skin, even during the chill the head and face are hot. Thus we get a skeleton of Aconite easy to remember.
In relation to other remedies having anguish, anxiety and restlessness, Aconite is one of degree of intensity just as Mercurius cor. is one of degree of intensity in tenesmus. The expression of fear is only equaled by that of Stramonium. The fear of a crowd is equaled by no other remedy. So we note from this, then, that if Aconite removes only the restlessness, the other symptoms remaining, it is time to stop the Aconite at once and look for some other remedy for that particular case. Also, when Aconite has caused the dry hot skin to perspire, it should be stopped at once. A peculiar thing about Aconite is, that while its taste is bitter to all things, water becomes an exception. Aconite and Stannum metallicum are the only two known remedies having bitter taste to everything except water.
Now that we have gotten the red strand and skeleton of the remedy let us take a glance at those symptoms that are covered by Aconite alone, found under no other known remedy, so that in cases with a paucity of symptoms we may get a strong clue to the remedy needed.
We have fear of death in pregnancy; pain in the forehead above the eyes from cold, dry wind; inflammation of the eyes from the same source; sensitiveness of eyelids to cold air; tearing pain in teeth aggravated after going to bed; inflammation of the stomach after cold things; pain in the abdomen extending to the chest during stool; burning pain in region of umbilicus; involuntary urination with thirst and fear; cutting pain in the chest after the chill; sense of boiling water poured into the chest; tingling of the foot extending upward; fever with one check red and hot, the other pale and cold.
The above group of symptoms, as far as known, belong to Aconite alone and are of the highest grade and therefore characteristic of the drug. We do not remember of their eve having been stressed or especially mentioned by any one, but whenever and whenever they occur they are final so far as the remedy goes, as well as important, but they are only final or prescribing purposes when there is a paucity of symptoms. In such cases a knowledge of them is very important, also they are important deciding factors when they occur in cases where two remedies run close together.
Our next group in enlarging the sphere of Aconite will be the symptoms for which Aconite is THE leading remedy. they are: Delusion that one is about to die; nervous excitement; fear of death, predicts the day; vertigo, sways to the right; boiling sensation in the head; stitching pain in eyes from motion; redness of eyes from injuries; sensitiveness of the eyes to cold air; face fees enlarged; pain in sound teeth; in teeth in raw, or cold dry wind; blood oozing in the throat; stools looking like chopped spinach; tension in the bladder; ineffectual urging to urinate in children; inflammation of the ovaries from suddenly checked menstrual flow; sharp pain in the uterus; palpitation after fright; sensation of hot water in chest; coldness of the toes; numbness of the left forearm, of the legs on sitting; fever alternating with chill at night. A knowledge of this group is quite important, especially in the absence of an available repertory, and very important, when a repertory is available, as a guide to the proper rubric where other remedies may be found for comparison.
It is, also, a deciding factor when in doubt about two apparently similar remedies, as a group of symptoms in which one of the remedies has the most leaders would undoubtedly fix the choice on that remedy.
The outline of this remedy is by no means final but it is a means of enabling one to find the proper lead into the heart of the remedy, and it gives the student a proper clue to the gateway of the path that will lead him intelligently to the goal he seeks.
In the absence of the above knowledge the repertory will be an important factor in the forget for one moment that the repertory is intensely mechanical and that you get out of it exactly what you put into it. It cannot sort out and classify your symptoms for you. Many collect a mass of symptoms, put them through the repertory for their failure. It is just as necessary to have accurate symptoms to put through the repertory as it is to be able to prescribe without it.
After the student has learned how to approach and study the materia medica, his next and most important step is how to approach and study the patient in order to be enabled to elicit those symptoms peculiar to the patient and his ailment. This is erroneously refered to as “taking the case”. You have already taken the case when you have accepted the patient, therefore “taking the case” does not mean anything and is a misnomer.
The greatest factors, then, in the science and art of to prescribing are, first and greatest, how to approach the patient to study him and elicit only that which bears on his individual case, in the absence of which knowledge the rest is useless; second, a knowledge of how to approach and study the materia medica, which is equally as important as the preceding; and lastly, how to use the repertory. It is our opinion that this latter has been a little overly stressed, especially to the student early in his career. The majority of the rubrics are too lean to give any degree of accuracy, therefore more stress should be laid on the materia medica in order to get a better foundation of the drugs.
A word as to the term similimum. The term similimum to us, does not really mean anything. It is simply the Latin for MOST SIMILAR. Any remedy may mean to many minds the most similar whether it be THE indicated remedy or hot, or, in the language of Pope, “Tis with our judgment as with our watches, none go just alike yet each believes his own”. So it is with those who prescribe, each is positives he has found the similimum (the most similar remedy) yet Nature fails too often to verify their judgment. We would like to suggest to this body that they cast aside blind precedent and coin the word SIMILIMUM as a changed form of the English word SIMILAR and defined as THE INDICATED remedy, which admits of no comparison, and which includes the correct potency.
