Dr Jeena Aslam
Philosophy of materia medica depends on the use, to be made of the knowledge gained.
In prescribing a similimum, in accordance with the homoeopathic law, we select a remedy whose pathogenic effects are similar to the symptoms of the individual case of disease. For making this selection, we always do a comparative study of various drugs, in our materia medica.
Hahnemann gave us a detailed description of materia medica in aphorism 143. He says, ‘Materia medica is a collection of real, pure, reliable, mode of action of single medicinal substances, a volume of the book of nature where is recorded a considerable array of the peculiar changes of the health and symptoms ascertained to belong to each of powerful medicines as they were revealed to the attention of the observer in which the likeness of the ( homoeopathic) disease elements of many natural disease to be hereafter cured by them are present, which in a word contain artificial morbid states that furnish for the similar natural morbid states the only true homoeopathic that is to say, specific therapeutic instrument for effecting their certain and permanent cure’.
Thus our study requires strict individualization of both disease and the remedy. To individualize means ‘treat separately and in detail’. The word individuality is derived from the Latin root “individus”- in means not, dividus means divisible. So every individual as a distinct and indivisible entity – unit of intrinsic form, cause, purpose and action. Totality of symptom is the basis of prescription in homoeopathy. It is the nature’s cry for the remedy that is capable of giving relief or sufferings. They are general and individual as well as diagnostic and therapeutic.
The more general, the less the individual.
The nature in her endless reproduction never produces two things alike. No two healthy or sick human beings express themselves alike. Therefore a remedy should never be selected on loose generalization. Our materia medica contains pure language of nature, brought on by a careful and faithful research on human beings. For strict individualization the characteristic symptom is essential.
Characteristic symptom is nothing but “more striking, singular, uncommon, and peculiar signs and symptoms” (aphorism 153). It is best illustrated by Boger. In his view the characteristic symptom comprises the following points.
1. Changes in the personality and temperament
2. Peculiarity of disease as well as drugs
3. Seat of the disease
i. The periodical return of symptoms after a short or long period of quiescence.
ii. The hour of the day when they are better or worse
According to C. Dunham the characteristic symptom is that which is possessed by the individual drug of which it is predicated and therefore gives its individual character. These symptoms are precious to the therapeutist. But have no pathological value. In physiological point of view they seem to be trivial and unimportant. Without the characteristic there can be no individualization. Without individualization there is no homoeopathic prescription.
While studying the proving of the drugs it could be seen that certain groups of drugs present certain symptoms which made them a member of the class to which they belong mean while they also possess certain characteristic symptoms by which each of them could be differentiating from another member of the same class. Our study of materia medica is hence both synthetic and analytic. The study of materia medica is complete only if various drugs are compared by the way of correspondence and differences to other drugs. Thus the study of one drug is the study of whole materia medica.
We could get the original knowledge of materia medica from the original publication of Hahnemann’s materia medica pura and chronic disease, in the proving of Staff’s Archive and Austrian and other journals. Now clinical, physiological and pathological materia medica is also available.
Study of the materia medica:-
Dr. C. Dunham divides the characteristic symptom under 3 heads
1. Characteristic of the disease
2. Characteristic of the drug
3. Characteristic of the individual.
Characteristic of the individual need not be a definite symptom; instead it can be referred to time, circumstances and concomitants.
The study of materia medica has been unsatisfactory all through the growth of homoeopathy. No attempt has been made to trace any pathological connection between symptoms, to give physiological explanation or to distinguish between the characteristic and generic symptoms.
This defect is also found in Hahnemann’s materia medica also inspite of the fact that Hahnemann was well aware of this as it is evident from ‘essay on the power of small doses’ published in hufeland’s journal.
This error could be justified by the fact that theories of pathology and physiology is ever changing. If Hahnemann had based the origin of symptoms upon the bases of these variables theories, he would actually mixed up these constants with variables and accordingly and as times rolled on the variables get discarded, along with that these constants also. So the proving of all these becomes in vain.
Hence it is the duty of the homoeopathic student of today’s to enrich Hahnemann’s materia medica by referring to the latest advance in physiology and pathology. For this purpose it is better to refer Hahnemann’s materia medica pura and chronic diseases rather than going for the manual.
Defect of the manual:-
Phraseology of the prover has been altered. Symptoms as said by the prover have been fragmented and these fragments are scattered throughout the records. Clinical symptoms have been included. Many of the arrangement of symptom have been altered and abbreviations have been introduced.
Initial materia medica was in German language and the English translation by Dr. Hempel suffers from error of omission and translation. There is lack of moral capacity and of intellectual and professional requirements.
Hence the study of materia medica should begin from original proving, i.e. from daily records of prover or in the Hahnemann’s anatomical scheme. First student has to make a general analysis of the drugs. The general analysis helps to place the drug along with several others in one or other groups. The points included under general analysis are
1. Sphere of action of the drug: -
Each drug has some particular affinity to certain organs, tissues or systems more decidedly than others. E.g. pulsatilla affects more on the vegetative system, organs of reproduction and this has least affection on bones, skin and glands. This will help to group the drug.
2. The extends to which organic substances are affected:-
In some proving organic substances are slightly affected, while others the affection in general. In some others the affection of organic substance and irritation of nervous system are equal in degree. It can be detected by complexion, color and temperature of the skin, colour and character of the congesting fluid, dyscracia of various variety etc.E.g: pulsatilla has a hydraemic dyscracia characterized by abundant serous or thin mucous discharge from secreting glands and surfaces.
3. The action of drug on vital powers: -
The affection of the nervous system. It is explained under 5 heads
a) The sensorium—- Symptoms of these are found under head and
b) General sensibility
c) General mobility- General symptoms with reference to movement
d) Specific sensibility- symptoms of organs of special senses
e) Sympathetic system- Symptoms referring to organs containing involuntary muscle. E.g. intestinal tract
4. General sensations:-
There were difficulties arising from inaccuracy of the prover, all description of sensations being closed in figurative language. He imagination of different provers suggest to them different mode of expression. The wealth of German language in synonyms has not diminished this difficulty
E.g. Bryonia and squilla are distinguished by sticking pain.
5. Periodicity: -
Clock like periodicity of cedron.
6. Peculiarities: -
Which constitutes conditions of time, place, circumstances aggravations and concomitants? E.g. Tearing pain in the hip of pulsatilla occurs in the afternoon- Conditions of time; It is aggravated in a warm room—Conditions of place; It is aggravated by repose, conditions of circumstances. The concomitants are those symptoms which always accompany any symptom or groups of symptoms. E.g. absence of thirst is a concomitant symptom of pulsatilla.
Which include the study of action of drug in each organ? In this anatomical order is followed.
1. Organic changes- This comprises all objective and material phenomenon
2. Sensations- Nature, locality, directions
3. Conditions of time, place and circumstances
There are certain symptoms found in the individual organs or systems which might be contradictory to the symptom found in the general analysis. E.g. generally arsenic is relieved by warmth, but head is relieved by cold. This is evident only in partial analysis.
After completing such a study of the drug the next step is to ascertain what drug resembles it and in what feature they are alike and how they differ. For this knowledge of repertory is essential.
Limitations of such study:-
Limitation is that certain drugs are incompletely proved. In this condition what we can do is expect a ‘lucky hit’.
Errors committed during study:-
Two errors commonly committed are as follows
1. Prescribing based on general analysis without considering the individualistic features
2. Prescribing based on characteristics without considering the general effect of the drug.
A. Scheme of study of materia medica:-
A. General analysis
1. Action on the vital power-
as exhibited in the action of the remedy upon (a) sensorium, (b) Special senses, (c) Sphincters (d) the other involuntary muscles (e) the power of locomotion
2. Action on the organic substance:-
b. the evacuations
c. Ulcer if any which previously existed are modified by the remedy or if any are produced by the remedy
e. General affections of dyscracia nature such as dropsy, uberculosis etc.
3. The sphere of action of the remedy:-
What organs or systems of the body are affected in a general way and in what order they are affected
What kind of sensations predominate in the proving and what reaction, if any appear to exist between certain varities of sensations and certain classes of organs and tissues
If there be any periodicity in the symptoms it is to be particularly noted and its character defined
6. Peculiarities: -
These peculiarities constitute the conditions of time
Circumstances, aggravations and concomitants which are attached to the symptom.
7. Resume of the characteristics of the remedy:-
This will include everything in the above analysis, and everything in particular the conditions of time, circumstances, aggravations and concomitants and the periods of the day at which the actions of the drug is most marked.
B- SPECIAL ANALYSIS
a. Sensorium comprising the subdivision: 1. Vertigo; 2. Intelligence; 3. Memory;4.Illusions. Each of these subdivision is to be studied in respect of sensations in far as they can be predicated of it; periodicity; of conditions of time, circumstances, aggravation, and ameliorations; and of concomitants. And under the latter rubric it is to be especially inquired what symptoms affecting other organs, or systems, occur simultaneously in evident physiological connection with the symptom under consideration
b. Headache. The points to be investigated are: 1. the location of the pain if it be stationary- its course if it moves; 2. the sensations; 3. the conditions of time, circumstance, aggravation and amelioration, as above explained in detail; 4. Concomitants
c. Organic changes. These affect the material substances and tissues of the head, and comprise all deviations from a normal material condition of which we can in anyway become cognizant-affections, for example, of the skin, glands, vessels, organs of special sense, etc.
a, The orbit. 1. Location; 2. Sensations; 3. Conditions; 4. Concomitants;
5. Organic changes. These subdivisions here and throughout the scheme, wherever used, are to be understood and studied as early explained in general analysis and under the title “head”.
b. Lids. 1. Location; 2. Sensations; 3. Conditions;
c. Conjunctiva. 1. Location; 2. Sensations; 3. Conditions; 4. Concomitants; 5. Organic changes
d. Globe. 1. Location; 2. Sensations; 3. Conditions; 4. Concomitants; 5. Organic changes
e. Secretions 1. Character, as regards color, acridity, quantity, etc; 2. Conditions; 3. Concomitants.
f. Special senses. 1. Vision, altered, intensified, diminished, or perverted 2.
Conditions attached to such alteration; 3. Concomitants.
a. External Ear. 1. Location; 2. Sensations; 3. Conditions 4. Concomitants; 5. Organic changes
b. Internal Ear. 1. Location; 2. Sensations; 3.Conditions;4. Concomitants; 5.Organic changes and their conditions
c. Special senses. 1. Deviations, whether intensified, diminished or perverted; 2. Conditions; 3. Concomitants
1. Location; 2.Sensations; 3.Organic changes, including secretions. with reference to the each of the above, observe,
a. the conditions; b. the concomitants Special sense of smell. 1. Deviation from a normal condition;
2. Conditions; 3. Concomitants
1. Location; 2. Complexions 3. Sensations; 4.Temperature; 5. Organic changes; as regards each of these subdivisions, study, a. the conditions; b.The concomitance
1. Location; 2. Aspect; 3sensations 4. temperature; 5. Organic changes; as regards each of these subdivisions, study, a. the conditions; b.The concomitance
7. Gums and teeth.
1. Location; 2. Sensations; 3. Organic changes. Of these, a. the conditions; b.The concomitance
1. Location; 2. Sensations; 3. Organic changes; of these, a. the conditions; b.The concomitance
1. Deviations from normal state. , a. the conditions; b.The concomitance
1. Location; 2. Sensations; 3. aspect ; 4. Organic changes. Of these, a. the conditions; b.The concomitance
11. Throat and fauces. 1
1.Location; 2. Sensations; 3. aspect ; 4. Organic changes. Of these , a. the conditions; b.The concomitance
1. Location; 2. Sensations; 3. Organic changes; 4. Special function. Of these, a. the conditions; b.The concomitance
1.Location; 2. Sensations; 3.Organic changes ; 4. Special function modified, as respects, a. appetite; b.thirst; and these modifications may be exaltation, diminution or perversion; c. Nausea; d. Vomitting. Of these, a. the conditions; b.The concomitance
1. Right, 2. Left. As regards each, study 1. Location; 2. Sensations;
3.Organic changes. as regards each of these subdivisions, study, a. the conditions; b.The concomitance
1. Lesions with appreciation of the organs involved; 2. Sensations;
3. Organic changes; as regards each of these subdivisions, study, a. the conditions; b.The concomitance
1. Sensations, their character, location and course, a. Before stool;
b. During stool; c. After stool. as regards each of these subdivisions, study, a. the conditions; b.The concomitance. 2. Organic phenomenon, viz, color, odor, consistence, Composition, e.g. – digested or not- consisting of feces alone or combined, etc.
17. Anus and Rectum.
1. Location; 2. Sensations; 3. Organic changes (including secretions, tumors, condylomata, etc. as regards each of these subdivisions, study, a. the conditions; b.The concomitance
18. Urinary organs.
a. Bladder.1. Location; 2. Sensations; 3. Organic changes
b, Urethra.1. Location; 2. Sensations; 3. Organic changes
c, Kidneys .1. Location; 2. Sensations; 3. Organic changes
d, Ureters .1. Location; 2. Sensations; 3. Organic changes
as regards each of these subdivisions, study, a. the conditions; b.The concomitance
e, Urine. 1. Quantity; 2. Color- physical properties; 3. Odor; 4. Deposits
f, Micturation. 1. Frequency; 2.Sensations.Note, , a. the conditions; b.The concomitance
19. Genital organs—- Male.
a, penis. 1. Location; 2. Sensations; 3. Organic changes
b, Testes.1. Location; 2. Sensations; 3. Organic changes
c, Special function. 1. Modifications, as regards exaltations, diminution, or perversion; 2. Sensations, as regards each of these subdivisions, study, a. the conditions; b.The concomitance
d.Secretions.1.Quantity;2.Quality,admixture,etc.; 3.mode of evacuations.
a. the conditions; b.The concomitance
20. Genital organs—- Female
a. Vulva. 1. Location; 2. Sensations; 3. Organic changes
b. Vagina. 1. Location; 2. Sensations; 3. Organic changes; 4.Secretion, considered as regards a. character; b. Quantity; c. Colour
c. Uterus. 1. Location; 2. Sensations; 3. Organic changes; 4.Secretion, considered as regards a. character; b. Quantity; c. Colour
d. Ovaries. 1. Sensations; 2. Organic changes. Under these note a. the conditions; b. the concomitants, attaching to each
e. menstruation. 1.sensation; 2. Periodicity; 3. Quantity; 4. Color; 5. Consistence; 6.Duration. under these , a. the conditions; b. the concomitants
21. Respiratory organs.
a. Nasal mucous membrane. 1. Location; 2. Sensations; 3. Organic changes; 4.secretions, as regards quantity and quality. Under these a. the conditions; b.The concomitance
b. Larynx and Trachea. 1. Location; 2. Sensations; 3. Organic changes; 4. secretions, as regards quantity and quality. Under these a. the conditions; b.The concomitants.
i. Cough. (a) its sound,( b)Its character, as paroxysmal or otherwise, dry or loose; (c) locations of sensation which provokes it; (d) Conditions; (e) Concomitants.
ii. Sputa. (a) Character; (b) Consistence (c) color (d) smell(e) Taste(f) Locality from which it appears to come (g) mode of evacuations(h)Sensations which precede and follow its evacuations; (i) Conditions (j) Concomitants.
c. Thorax- internal. 1. Location; 2. Sensations; 3. Organic changes. (a) conditions; (b) Concomitants.
— External. 1. Location; 2. Sensations; 3. Organic changes. 4. secretions. Respecting the above, (a) Conditions;(b) concomitants.
d, Respiration. 1. Sensations; 2. Organic action; 3.Breath, its odour, temperature, Volume. Regarding these, (a) Conditions; (b) concomitants.
a. Subjective. 1. Location; 2. Sensations
b. Objective. 1. Location 2. Organic changes as shown by position, sounds, magnitude and by rational signs; 3. Pulsations. Respecting the above, (a) Conditions; (b) Concomitants.
1. Location; 2. Sensations; 3. Organic changes. Regarding these (a) Conditions; (b) Concomitants
24. Upper extremities.
Right and Left. Respecting each study
1. Articulations. 1. Location; 2. Sensations; 3. Organic changes
2. Interarticular region. 1. Location; 2. Sensations; 3. Organic changes. Regarding these, (a) Conditions; (b) Concomitants
25. Lower extremities.
Right and Left. Studied in all respects under upper extremities.
Note sensations with their course if they be wandering; e.g. a right upper, to a left lower extremity
1. Character; 2. Periods; 3. Preceded by 4. Succeeded by; 5. Concomitants
a. Dreams ;( a) Conditions; (b) Concomitants
As a paroxysm made up of stages
Incomplete paroxysm consists of only one or of two stages.
1. Their order; 2. Relative severity and duration; 3. Antecedents;
4. Sequelae; 5.Conditions; 6.Concomitants
2. Complete paroxysm. 1. Order of the stages; 2. Their relation to each other. Separate stages; e.g.:
a. Chill. 1. Character; 2. Precursor; 3. Succeeded by, (a) Conditions; (b) Concomitants
b.Fever. Heat. 1. Character; 2. Precursor; 3. Suceeded by ,(a) Conditions; (b) Concomitants
C. Sweat. 1. Character; 2. Precursor; 3. Suceeded by ,(a) Conditions; (b) Concomitants
Between chill and heat, heat and sweat, study the interval.
1. Character; 2.Sensations; 3.Conditions; 4.Concomittants
After the paroxysm. ; 1.Sensations; 2.Conditions; 3..Concomitants
Pulse. 1. quantity; 2. frequency; 3. Conditions.
1.General. . 1.Sensations; 2. organic changes; 3.Conditions; 4.Concomittants
2.Special. 1. Localities affected; 2. Sensations; 3. organic changes; 4.Conditions; 5. Concomitants
3. Organic changes: Under these
1. Eruptions. 1. Aspect; 2. Color; 3. Sensations; 4. Secretions. A. their color; b. consistence c. odor; d. Quality 5. Scabs – a. quality b. tenacity; c. color;.d. odor; e.Conditions of subjacent tissues or secretions.
2 Ulcers. To be studied as eruptions
1. Warts ,,
2. Tumors. 1. Physical properties; 2. Sensations; 3.Conditions; 4. Concomitants
1. Faculties modified. 1. Exalted; 2. Depressed. 3. Perverted; under these a. conditions b. concomitants
1. Memory. As under faculties
1. Quality; 2. Conditions; 3. Concomitance
Dr.Jeena Aslam BHMS,MD(Hom)
Medical Officer,Govt. of Kerala