This section is from the book "A Compend Of The Principles Of Homoeopathy", by William Boericke. Also available from Amazon: A Compend of the Principles of Homoeopathy as Taught by Hahnemann.
A knowledge of the pathology of disease (not mere passing, pathological theories, against which Hahnemann so justly protested,) is necessary to interpret the symptomatology obtained and prescribe the truly indicated remedy, and not merely one externally homoeopathic. The true meaning of any symptom is reached not by considering it alone, but by viewing it in relation to all the rest, and thus placing it in its proper relative position. We must learn to view symptoms in perspective. The natural history of diseases must be learned, as well as their different stages and characteristic signs accompanying them.
* S. Kimball.
The use of pathology in interpreting the symptoms is seen in the treatment of a case of typhoid fever, where the fever, restlessness, etc., might call to mind Aconite as a remedy; but a little closer examination would show this to be but a partial and apparent homoeopathic relationship. Pathology would interpret the fever and restlessness of the typhoid patient and associate them with the coming prostration, the septic condition, the asthenia - conditions wholly foreign to Aconite, which can deal only with sthenic inflammations and healthy blood.
Some symptoms are primary, others reflex. After an organic disease has become established, secondary modifications of health take place, which do not offer valuable symptoms for purposes of prescribing the curative remedy. Really valuable guiding symptoms, if found at all, will be in the earlier state of the patient before the organic changes have taken place; thus, in the treatment of an organic kidney disease, a curative remedy would be more likely to be found in the earlier symptoms that preceded the development of the dropsy, anemia, etc., characteristic of the later stages.
Pathology also teaches the important difference between the absolute, pathognomonic symptoms and the contingent or peculiar symptoms of a given case of disease.
General Or Absolute Symptoms are those which are common to all patients suffering from the same disease and they are essential for purposes of diagnosis. Thus the fever, sore throat and rash are general or absolute symptoms of Scarlatina, while again, the fever, cough, physical signs and bloody sputa are absolute symptoms of Pneumonia.
Contingent Or Peculiar Symptoms are those which vary with the individual and are not essentially pathognomonic of the disease, but always of the individual' patient. They are therefore the characteristic symptoms of the patient's totality of symptoms, and hence most essential in selecting the remedy. Hence the rule:
The greater the value of a symptom for purposes of diagnosis, the less its value for the selection of the homoeopathic remedy and vice versa.
The seemingly unimportant, peculiar, contingent symptoms of the patient, though valueless for purposes of diagnosis, are the chief guiding symptoms for the selection of the homoeopathic remedy.
Totality of quality rather than of quantity, is the basis for homoeopathic prescribing. In any case of disease it is necessary to discover in what way, that is, by what peculiar symptoms, does one case of illness differ from every other of the same disease. How does this patient's typhoid or rheumatism differ from the typhoid or rheumatism of every other patient. This special totality of quality, or of characteristics will unerringly lead to the curative homoeopathic remedy. This is the Hahnemannian Similarity. It exists between the characteristic symptoms of the patient and the characteristic symptoms of the drug, and we must individualize each case in order to arrive at this desirable goal, for the selection of the hemoeopathic remedy. This differs from the mere Pathological Similarity which consists in matching diseased conditions or pathological processes as determined by pathological anatomy. It adapts the remedy to a disease rather than to the individual patient.
Thus, in the treatment of pneumonia, a remedy would be given that actually produces lesions similar to the pneumonic process. Phosphorus has actually produced hepatization of the lungs in animals poisoned by it; hence, it should be the curative similar, as it is undoubtedly the pathological similar. So Arsenic produces a gastro-enteritis and ultimate lesions just like cholera, and should, therefore, be the curative remedy in this disease, since it is the pathological similar. But experience denies this deduction. To be curative, a remedy must correspond to the characteristic symptoms, whether these are based upon the ultimate patho-logico-anatomical lesion or not. Unquestionably, the similarity in pathological process or lesion is one of the most important factors in the totality, but not the determining one in every case.