Once it is clearly stated that there are peculiar specifics for pure individual diseases according to how they are described (in a general-pure way) in the pathology books and that there are also specifics for the different expressions of the individual disease, we will start from the fact that the information in the elaboration of the anamnesis is intended, among other things, to establish a timeline between the different problems that the patient may have and the pathological relationship that they may have with the main symptom, and these as a whole in turn with the various spheres of action of the remedies (§ 22 & FN-25 Sixth Edition). It is perhaps at this point where concomitant symptoms become more relevant.
Since it is Hahnemann himself who expresses that the reactivated Psora results in pathologies with their different names, I understand that the different psoric symptomatic expressions are clearly defined by well-delimited symptomatic complexes for each of those specific pathologies connected to each other within a single great general pathology; Psora, which is the great base infection that reconfigures our immune system to predispose us to inflammatory, infectious, degenerative, neoplastic, vascular, etc. pathologies.
This implies that during the anamnesis of concomitant symptoms, they have an incidence with the main symptom in its timeline through their morbid activity (preface, § 69-70 Sixth Edition), that is, their peculiar and characteristic activity with the main symptom so that together they can, or at least try to do, match with the sphere of action of the remedy at the most optimal level. Which would avoid many selection problems. (§ 169 Sixth Edition)
Having said that, I dare to say that the concomitant symptoms are those that accompany the main symptom in its timeline, and that they may or may not be in connection with the specific pathology suggested by the chief ailment. These can be considered according to several slopes:
Encopresis due to fear / anxiety
Nephrolithiasis due to physical exertion
Epilepsy by milk crust suppression: Case of Boenninghausen narrated by Carroll Dunham, in which the Baron seems to have prescribed Viol-T based on the suppressed crusta lactea. PHILADELPHIA JOURNAL OF HOMOEOPATHY. VOL. IV. NOVEMBER, 1855. Num. VIII, Pages: 449-458 LETTER OF C. DUNHAM, M.D. WILDBAD, OCTOBER 6, 1855.
Deafness due to suppression of tinea capitis: Case of Carroll Dunham. Taken from Homeopathy the Science of Therapeutics.
* Rarity: “Rarely appear in connection with the leading disease, and are, therefore, also found rarely among the provings.” But they really are in connection with the main pathology. Examples:
As to the pathology:
Leukonychia during hypertension.
Orchitis during mumps
Virchow ganglion in stomach cancer.
As to the proving: symptoms that are rarely generated by a remedy or that when generated are only produced by a small group of remedies. What would define them not as extraordinary, rare or uncommon symptoms per se, but by the few remedies that produces them during a pathogenesis. Examples:
Squil and Rheum bubbling sensation.
Nausea and vomiting with the smell of food from Colch and Ars.
* Allen: “those which belong to another sphere of disease than the chief ailment” that at least appear constant or alternating (§ 232 fn) in the timeline of the disease under consideration. Examples:
Cough with diarrhea (Rumex)
Anal fissure with pharyngitis (See case Monsignor Varlet: P 154/155 Df 14)
* Well characterized: “those which have more or less of the characteristic signs of one of the medicines, even in case they have not before been noticed in the present juxtaposition.”
A symptom that does not belong to the pathology that the chief ailment indicates, but is so well characterized that it points better to a more appropriate remedy. It is not concomitant as such, but it becomes into a main symptom. A matter of focus.