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Date posted: December 25, 2012

Dr Satheesh Kumar.P.K  BHMS,MD(Hom)
Medical Officer,Dept. of  Homoeopathy, Govt. of Kerala

Guiding symptoms of our materia medica ”is a monumental work of ten volume by Dr. Constantine Hering. This work is a collection of cured symptoms and hence it is a complement to all other works in our materia medica. According to author it is an attempt to give our materia medica in such a form that it will help the selection of a curative medicine in any given case as easy as possible.

About the author:
Dr. Constantine Hering was born at Oschath in Saxony on 1.1.1800, and lived till the age of 80.
He wrote the “Domestic physician” and the “Guiding symptoms”- a monumental work of ten volume. He was the chief editor of North American Homoeopathic Journal, The Homoeopathic News and American Journal of Homoeopathic Materia Medica
He proved some drugs, out of which the following ones are most important
1. Lachesis
2. Gelsemium.
3. Iodum
4. Apis mellifica.
He enunciated the law of direction of cure which is known as Hering’s law of cure.

Mode of construction of the book:
First volume start with a preface by author. In addition to elaborate preface to the first volume, short prefaces are given for the third, fourth, fifth, sixth ninth and tenth volume. But there were no preface for Second, seventh and eight volume. Preface of the final volume was given by Therese Hering.

As the author died suddenly, he couldn’t complete the third volume. The remaining part of the third volume and the rest of the volumes might have been completed by either his colleagues or his heirs under the editorial board of Charles G. Raue, Calvin. B Knerr and Charles Mohr.

Hering had a premonition that he wouldn’t be able to complete his work which he expressed in these words a few weeks before his death. “ Perhaps, from my place in heaven, I may peep through a little hole and see that my work is well done”.
The third volume is specially dedicated to Dr.P.P.Wells who was one of his oldest and dearest friends.

In fourth volume they have added one new feature. At the head of each drug will be found a clinical index, giving a list of authorities and designating the publication in which the full report of each case with its cured symptom may be found.
Eg:- Under Chelidonium– Mental disturbances—Buchman B.J.H. Vol. 25
Sick head ache — R. Hughs B.J.H. 1870 Page 796
Spasms glottis — Buchman B.J.H. Vol 25 page 69.
Sixth volume contains Lachesis trignocephalus the pet child of Dr.Hering

The preface of volume 1 deals with two important things.
1. Hahnemannean view of examination of the sick ( Organon – aphorism 95, 101, 102 104 and 153 )
2. the arrangement of symptoms with their markings.

Hahnemann view of examination of the sick:
Here he says that in chronic diseases all the symptoms of the case has to be considered in the minutest detail and the search for a remedy consists in the comparison of the totality of the sick with the symptoms of our proved drugs. In making this comparison the characteristic features ( more prominent, uncommon and peculiar) of the case are more important. More general and indefinite symptoms such as want of appetite, head ache. Weakness, sleep, restless etc unless more clearly defined, deserve less important on account of their vagueness.
He criticize the selection of medicines according to the loose generalization and pathological symptoms.

The arrangement :
The arrangement is the same as that in the “ Analytical therapeutics” and in the “ Condensed material medica”.
To facilitate the study of the relative value of symptoms, four marks of distinction have been adopted. I, II, I and II which correspond to the 4 degrees in Boenninghausen’s repertory.
“ I” is the lowest and designated as occasionally confirmed symptoms. It is omitted in most cases and is sometimes used to mark a difference    in the same line.
“ II” – symptoms more frequently confirmed.
I ” symptoms verified by cures.
II” symptoms repeatedly verified .

Indicates an approved characteristic. But is seldom used by reason of our not wishing to appear authoritative. It is to be hoped that the combined experience of many practitioners, solicited from all sides will enable us in future edition to designate many more symptoms with this mark.
“ q ” The Greek letter “ theta” stands between the cured symptoms and pathological condition or physiological general state. Eg :- pregnancy. Climacteric years etc. .
. Observations from old school ( or the new as are worthy of our consideration) .
“ t ” Toxicological
“ r ” Right
“ l ” Left
<  Increase or aggravation or worse.
> Decrease or amelioration or better.
p – The Greek “ pi ” – Symptoms observed only on the sick.

In each volume medicines are arranged according to the alphabetical order of their name.  

General representation of a medicine is as follows:
Begins with the name of medicine with common name and family ( natural order) .
Then there is a brief introduction about the remedy which include the name of prover, source of remedy, it’s empirical use (uses in other school of medicine) and it’s important clinical condition for which it is used in Homoeopathy.
Symptoms of the drug has been grouped under separate headings and numbered from 1 to 48 begins from mind and ends with drug relationship.

Arrangement of symptoms under the following headings
Mind.
Sensorium.
Inner head.
Outer head.
Sight and eyes
Hearing and ears
Smell and nose
Face.
Lower part of the face
Teeth and gums
Taste, speech, Tongue
Inner mouth
Palate ant throat
Appetite, thirst and desires
Eating and drinking
Hiccough , nausea and vomiting
Scrobiculum and stomach
Hypochondria
Abdomen and loins
20. Stools and rectum
Urinary organs
Male sexual organs
Female sexual organs
Pregnancy and parturition
Voice, larynx and trachea
Respiration
Cough
Inner chest and lungs
Heart, pulse and circulation
30. Outer chest
Neck and back
Upper limb
Lower limb
Limbs in general
Rest position and motion
Nerves
Sleep
Time
Temperature and weather
Fever
Attacks , periodicity.
Location ( Locality and direction)
Sensations
Tissues
Touch, passive motion, injuries
Skin
Stages of life, constitution
Relations

Examples for each markings:
I  - Occasionally confirmed  Eg:- Abies nigra — Mind :
I . very low spirited  1 Belching and vomiting:
I. Belching
I. Acid eructation
I. Frequent vomiting of food
Anacardium   __ Hearing and ears :
I. Hearing at times very weak, at other very acute.
Armoracea sativa — Inner chest and lungs:
I. After violent cough hemorrhage and apparent death

II — More frequently confirmed
Eg :- Abies  nigra –Scrobiculum and stomach:
II. Distressing pain in stomach extending to left side.
Absinthium – Tissues:
II. Paralysis of inner organs
Acetic acid — Appetite, thirst, desires and aversion
II. No thirst with fever
Attacks :
II. Lethargic paroxysm
Skin :
II – Tetter like eruptions
I — Verified by cures
Eg:- Abrotanum – Mind:
I. The child is cross and depressed
Absinthium –Stages of life :
I. Especially younger patients
Aconite — Hearing and ears:
I.  Noise intolarable
Face:
I. Red and pale alternately
Agaricus — Neck and back :
I. Spine sensitive to touch < morning
I. Pain along spinal column < when stooping.
I I – Repeatedly verified
Eg:- Amylenum nitrosum – Upper face:
I I. Face flushes at slightest emotion
Anti crudum — mind :
I I. Loathing of life
I I. Child is fretful and peevish, turns itself away and   Cries when touched .
Anti tart — Tissues :
I I. Phlebitis.
q – stands between the cured symptoms and pathological condition
Eg:- Agaricus—Upper limbs :
Trembling of hands  q Typhus
Actea racemosa –Fever :
Night sweats, diarrhoea q Tuberculosis of lungs
Anti tart — sensorium :
Vertigo with dimness of vision   and a pressing head ache
Pneumonia.

Observations from old school  ·
Eg : – Alumen — Lower limb : . . — Ingrowing toe nail
Cough : .  — Phthisis
Pregnancy, parturition, lactation : — Cancer of mammae. .
Abrotanum — Rectum and stool : .
Worms especially ascarides.                                      .

t -Toxicological
Eg:- Anti tart — Scrobiculum and stomach :
Unpleasant feeling of warmth in region of stomach followed by violent pain in fore head and in back part of throat.  t
Aethusa cynapium — Appetite, thirst, desires, aversion :
Burning thirst t.
Hypochonria :
Liver hard, yellowish, spleen livid, tongue black  t
Pregnancy, parturition, lactation :
Violent stinging pain in mammae t .
Heart, pulse and circulation :
Anxiety in precodium t .
Palpitation with head ache, with vertigo with weakness and
Exaltation t.
Indicates an approved characteristic    Aconite — Mind:
Fear of death during pregnancy or confinement ; with prolapsus uteri; with great loquacity or anxiety in region of heart.

Symptoms observed only in the sick
Eg:- Aurum met – Skin :
p- Violent itching first in soles of feet then over whole body from evening till mid night.
Atropinum sulphuricum – Teeth and gum :
Teeth ceased to ache in two hours.
Taste and tongue :
Pappy taste.
Difficult articulation
Furred tongue; 3 rd day.
Took fluid food next day.
Arnica –Mind :
Naturally very sensitive, his keen sensitiveness of mind become greatly exaggerated.
Belladonna –Mind :
Became crazy; got one leg over the window, to kill himself, had tobe tied down; died next day, within two hours, two doses.  consumption.

Merits of “ Guiding symptoms”
1.It is a collection cured symptoms and hence it is a complement to all other works in our materia medica.
2.Symptoms of each drug is grouped under 48 headings and hence the search of particular symptom is more easy.
3.Medicines are arranged in alphabetical order
4.Separate markings are given for each symptoms according to their relative importance. This will help in the selection of similimum.
5.The fourth volume onwards provide authoritative clinical index which add validity to each symptoms

Demerits of “ Guiding symptoms” 
1.There is no index. For this work.
2.Approved characteristic very limited in number. No approved characteristic even in fully proved polychrest like Nux vom, Sulphur, Pulsatilla etc.
3.variolinum and vaccinum are given under a single heading with symptoms are in a mixed up manner.
4.The first three volume lacks authoritative clinical index. So the source of symptoms obtained are unknown

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