Changed and unchanged mental symptoms in prescribing

8. Are you sure the symptoms you took are symptoms of the disease?  If the patient is generally angry, this is a point you can use in differential diagnosis, but if that is not something that has changed, it is not part of the disease totality – don’t use it in your initial set of prescribing symptoms.  (vide Aphorism 6).

Dr. Marco Colla asked me to explain this point from my previous post in greater depth.

Before I begin, please make sure you’re sitting comfortably with a copy of the Organon on your lap, laptop, tablet (wax or digital) – and READ APHORISM 6!  It’s at the beginning of the Organon for a reason…

I decided to devote an article to this response because it hinges on one of the most misunderstood issues in homoeopathy today.  I feel sometimes that many homoeopaths forget basic common sense when approaching cases.  Let me transport you from the rarified atmosphere of Organon and aphorisms to a scene enacted in everyday life in millions of households worldwide – a scene which many of you will be intimately familiar with (no sexism intended, feel free to switch the roles at will):

Ma:  The child is sick – I’ll have to take her to the doctor.
Pa:  How do you know?  How do you know she’s sick?
Ma:  Can’t you see?  She’s burning up, she’s been up all night vomiting, and now she’s too weak to get out of bed.  She’s never like this!
Pa:  But she was fine yesterday when she went on the trip with the school!  She said she had a great time even though it was pouring with rain and she got soaked.

This is an acute disease state.  These are the presenting symptoms, this is the new state, what has changed as described in Aphorism 6.

How do we know we are sick?  How do we know someone else is sick?  Because they are not as they were before, something has changed.  This is true in chronic and acute illness.  As homoeopaths we are brought in to help fix something that isn’t working properly – which once worked better.

Two men in a bar (feel free to translate to “two women over a cup of coffee”):

Burt:  I really needed that pint, my mother-in-law is driving me crazy.
Fred:  Why, what’s happened?
Burt:  Well, you know she’s been living with us ever since she had that fall and broke her hip 6 months ago?
Fred:  Yeah, but she was always such a sweet old lady –
Burt:  Sweet?  (splutters over the remains of his pint) Sweet?!  Ever since this fall, she’s become a complete witch!  Sarcastic, nasty, never a please or thank you…

Get it? Changed mental state within chronic disease totality.  Here the mental state is important in the first stage of the prescribing process.  A remedy that cannot produce a malicious state in a healthy person won’t do the job here.

However – and here the mistakes occur:

Burt:  I really needed that pint, my mother-in-law is driving me crazy.
Fred:  Why, what’s happened?
Burt:  Well, you know she’s been living with us ever since she had that fall and broke her hip 6 months ago?
Fred:  Yeah, but she was always pretty awful, sarcastic, nasty, thought you were used to it…
Burt:  It’s the same as before – some things you never get used to…

Unchanged mental state within chronic disease totality.  In differential diagnosis if you have a choice between a remedy that can produce yielding pliant behaviour and one that can produce sarcastic nasty behaviour, and both are a good fit for presenting symptoms that have changed, go with the nasty one.  But this mental state has no place in the initial symptoms used to narrow down remedy options – because it is not part of what has changed.

I haven’t given all the options here, but essentially the unchanged mental state can be what Hahnemann terms as information “useful” to the case.  But the parameters of the disease state go through their primary definition within the criteria of Aphorism 6 – what has changed.  That is where certainty is to be found.

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