Case Taking observations from Hahnemann.

 Sore throat, fissure of anus

O—–t, an actor, 33 years old, unmarried.

January 14, 1843. For several years he has had a sore throat, so now for a month. The last time his sore throat had lasted six weeks. When swallowing saliva, he feels a pricking sensation of constriction and soreness.

When he is not afflicted with this sore throat, he suffers from a fissure of the anus, with violent pain as from a chap; then the anus is inflamed, swollen and constricted, he can then discharge his stool with great exertions, while swollen haemorrhoidal veins extrude.

January 15. He took early before breakfast a coffeesponful of a solution of one pellet of Belladonna in seven tablespoonful of water, from which solution one tablespoonful was put into a tumblerful of water and stirred.

January 15. In the evening the throat was worse.

January 16. The throatache is gone, and a toothache remained. but the ailment of the anus has returned, as described, an open fissure with pain as from a chap, swelling, beating pain and constricture. Nevertheless he had a painful stool in the evening.

He acknowledged that eight years ago he had a chancre which had been as usual destroyed with a corrosive, after which all these ailments had set in.

On January 17 he received one pellet of Mercurius vivus I. of the lowest new dynamization (which contains immensely less substance than the present) prepared for being taken as before and taken as before (after shaking the bottle every time), one spoon-full in one tumblerful of water, as with the Belladonna, well stirred. 

January 20. Almost all the toothache gone. The anus is better; but he still feels a soreness there after the stools; but there is no more pulsation there, no swelling of the anus and no inflammation. Less constricted. One pellet of Mercurius viv., 2 dynamization, prepared and taken in the same manner in the morning. I did not note down whether he took the Mercurius (2) once or twice a day; usually only once early in the morning before breakfast.

January 25. The throat is almost altogether well, but in the anus there is a pain as from a chap, and severe lancinations, severe pain in the anus after stool, there is still some constriction and heat.

January 30. In the afternoon he received the last dose (one coffeespoonful). On the 28th the anus was better, the throatache had returned; severe chaps in the throat.

One pellet in sugar of milk for seven days, prepared and taken as before.

February 7. Severe pain as from ulceration in the throat. Colic, but good stools, but several times in succession, with great thirst. But everything is well at the anus. Sulphur 2-0 in seven tablespoonfuls of water as above.

February 13. He had ulcerative pains in his throat, especially when swallowing saliva of which he now has a great quantity, especially much on the 11th and 12th. Some constriction of the anus, especially since yesterday.

Now I let him smell of Mercurius and gave him Mercurius vivus 2-0, one pellet, as always in seven tablespoons, one-half spoonful of brandy and to be taken as before.

February 20. The throat is better since the 18th; he suffered much at the anus; the stool pains him when discharged; less thirst.

§-0 Sugar of milk in seven tablespoonfuls.

March 3. No more throatache. In going to the stool a haemorrhoidal vein but bloodless extrudes (formerly this caused burning and pains as from chaps), now there is only itching in that spot. I let him smell of Ac. nitr.

March 20. Hardly any more pain after the stool; yesterday some blood was discharged with the stool (an old symptom). The throat is well, only when drinking anything cold there is some sensation.

Now he is allowed to smell of A

c. nitr. The smelling is directed after opening a little vial containing half an ounce of low grade alcohol or brandy, in which one pellet with medicine is dissolved; he smells at it one or two moments.

His health was permanently restored.

In sending this case to Boenninghausen, Hahnemann was presenting the usage of LM or Q potencies. He also stated that they were not good examples for instructional use.

In saying that, some of us at the IHM have spent considerable time examining the methodology employed in the actually casetaking. It determines a number of criteria that has to be employed in EVERY case analysis. For those that have an inner determination to practice homoeopathy in the proper manner, it would be of benefit to stop listening to the modern gurus who purport to be ‘experts’ but whose words and methodology prove false to the instructions of Hahnemann.

The only way to determine if a method is Hahnemannian  is to undertake a deep study of all the writings of Hahnemann, the writings of Boenninghausen, the case examples of Hahnemann and Boenninghausen, and a critical evaluation of the cases presented in Hahnemann’s case books from Germany and Paris.

In examining this case we see that the patient presents a picture of the disease state and how it affects him. Hahnemann clearly outlined in aphorism six of the Organon the methodology based on observation to elicit the individual symptoms and reaction to the disease process that has affected the patient.

§ 6
The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease

in looking at this case we can see that the patient has two seats of affection in his organism. One is the throat and the other is the anus. At the time of taking the case, the throat symptoms were predominant and the disease state was focused on this area. The patient had had a sore throat for over a month when interviewed by Hahnemann. There are not absolute specifics regarding the symptoms taken by Hahnemann in this case, but we can assume his prescription of Belladonna was based on an accurate assessment of the current prevailing disease expression as located in the patient’s throat. The symptoms of the anal fissure were not present at this time, but were obviously noted by Hahnemann in the disease picture, but he did not prescribe for them as they were not present.

In observing this case we can see very clearly that Hahnemann, utilising the law of similars, would only prescribe on symptoms that were present at the time of consultation and predominantly dictated the expression of the disease.

So Hahnemann prescribed the Belladonna.

January 15. In the evening the throat was worse. January 16. The throatache is gone, but the ailment of the anus has returned, as described, an open fissure with pain as from a chap, swelling, beating pain and constricture. Nevertheless he had a painful stool in the evening.

So fairly immediately, the Belladonna worked successfully on the organism and moved the state from the throat to the Anus, as per the alternating condition of the patients illness.

Hahnemanns experience with both infection, remedy action and disease states, given the symptoms, would indicate that he retook the symptoms as the fissure presented itself. In tracing the picture of the disease, his experience dictated that the seat of the problem was of a chronic nature, venereal in nature and probably due to suppressive allopathic treatment of the ailment. This was confirmed by the patient. There are no notes recorded by Hahnemann as to why he prescribed Mercurius, however a general overview of Mercurius and its ability to produce symptoms similar to both syphilis and suppressed syphilis are unequalled by any other medicine in the materia Medica. We note that Hahnemann gave the Mercurius to deal with the underlying infection/suppression that was the maintaining cause and aggravating factor in producing both the throat symptoms and the anal fissure.

It is also important to note that Hahnemann was treating the disease state as expressed in the patient’s physical symptoms and syphilitic infection. Nowhere do we see mention of the patient’s mental state or condition. This is important, if not vital in understanding Kent’s incorrect assertion that the mental state is of primary importance in every prescription. The only time a symptom becomes a prescribing symptom is when it is changed and altered. A physical symptom, a local symptom, a modality, a location can all be the leading symptom for prescribing if it is changed and altered from the previous state of health and is represented as peculiar to a certain remedy which produces the same state or symptom from its substance.

Looking further into this case, who we see that Hahnemann re-dosed the patient with Mercurius a few days later. We also see that Hahnemann prescribed in the Q potency and moved from LM 1 to LM 2. He repeated the dosage a few times as the patient still had soreness of the anus. On 28 January we note that the anus was much better but that the throat symptoms had returned. At this juncture, Hahnemann decided to give placebo for seven days to see what other symptoms developed. After this period, the patient was prescribed sulphur LM2. We note that after the symptoms were collated, Hahnemann again prescribed Mercurius and then placebo  until March 3.

We note at this juncture that the throat pain had all but gone. The residual anal pain had changed from severe chapping and splitting to a haemorrhoidal vein with itching. He was prescribed Nitric Acid, and this was repeated a few times more until cure a few weeks later.

So we can learn much from this case. Firstly that there is no such thing as a constitutional remedy. Each prescription is based on the collection of changed and altered symptoms and has nothing to do with personality or personal preferences. We can see in this one presented case that it took several remedies to restore the patient to health. We can see that miasms are nothing more than infections, and that miasmatic diseases are nothing more than the results of being infected and produce their own symptom peculiarities based on that.

Homoeopathy is a medical practice and application of therapeutics. Unless the laws of similars is followed closely and the application of the therapeutics is adhered to using the scientifically observed results of being poisoned by a substance and the symptoms noted, it will not work effectively or permanently. We can see that Hahnemann did not ever promote a core delusion or a personality type for prescribing. By following Kent’s methodology it has been the undoing and spoiling of many a case where the practitioner has applied a personality or preference rather than the matching of prescribing symptoms.

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