§ 89

When the patient (for it is on him we have chiefly to rely for a description of his sensations, except in the case of feigned diseases) has by these details, given of his own accord and in answer to inquiries, furnished the requisite information and traced a tolerably perfect picture of the disease, the physician is at liberty and obliged (if he feels he has not yet gained all the information he needs) to ask more precise, more special questions.1

1 For example, how often are his bowels moved? What is the exact character of the stools? Did the whitish evacuation consist of mucus or faeces? Had he or had he not pains during the evacuation? What was their exact character, and where were they seated? What did the patient vomit? Is the bad taste in the mouth putrid, or bitter, or sour, or what? before or after eating, or during the repast? At what period of the day was it worst? What is the taste of what is eructated? Does the urine only become turbid on standing, or is it turbid when first discharged? What is its color when first emitted? Of what color is the sediment? How does he behave during sleep? Does he whine, moan, talk or cry out in his sleep? Does he start during sleep? Does he snore during inspiration, or during expiration? Does he lie only on his back, or on which side? Does he cover himself well up, or can he not bear the clothes on him? Does he easily awake, or does he sleep too soundly? How often does this or that symptom occur? What is the cause that produces it each time it occurs? does it come on whilst sitting, lying, standing, or when in motion? only when fasting, or in the morning, or only in the evening, or only after a meal, or when does it usually appear? When did the rigor come on? was it merely a chilly sensation, or was he actually cold at the same time? if so, in what parts? or while feeling chilly, was he actually warm to the touch? was it merely a sensation of cold, without shivering? was he hot without redness of the face? what parts of him were hot to the touch? or did he complain of heat without being hot to the touch? How long did the chilliness last? how long the hot stage? When did the thirst come on - during the cold stage? during the heat? or previous to it? or subsequent to it? How great was the thirst, and what was the beverage desired? When did the sweat come on - at the beginning or the end of the heat? or how many hours after the heat? when asleep or when awake? How great was the sweat? was it warm or cold? on what parts? how did it smell? What does he complain of before or during the cold stage? what during the hot stage? what after it? what during or after the sweating stage?

(Added to the Sixth Edition)

In women, note the character of menstruation and other discharges, etc.

§ 90

When the physician has finished writing down these particulars, he then makes a note of what he himself observes in the patient1, and ascertains how much of that was peculiar to the patient in his healthy state.

1 For example, how the patient behaved during the visit - whether he was morose, quarrelsome, hasty, lachrymose, anxious, despairing or sad, or hopeful, calm etc. Whether he was in a drowsy state or in any way dull of comprehension; whether he spoke hoarsely, or in a low tone, or incoherently, or how other wise did he talk? what was the color of his face and eyes, and of his skin generally? what degree of liveliness and power was there in his expression and eyes? what was the state of his tongue, his breathing, the smell from his mouth, and his hearing? were his pupils dilated or contracted? how rapidly and to what extent did they alter in the dark and in the light? what was the character of the pulse? what was the condition of the abdomen? how moist or hot, how cold or dry to the touch, was the skin of this or that part or generally? whether he lay with head thrown back, with mouth half or wholly open, with the arms placed above the head, on his back, or in what other position? what effort did he make to raise himself? and anything else in him that may strike the physician as being remarkable.

§ 91

The symptoms and feelings of the patient during a previous course of medicine do not furnish the pure picture of the disease; but on the other hand, those symptoms and ailments which he suffered from before the use of the medicines, or after they had been discontinued for several days, give the true fundamental idea of the original form of the disease, and these especially the physician must take note of. When the disease is of a chronic character, and the patient has been taking medicine up to the time he is seen, the physician may with advantage leave him some days quite without medicine, or in the meantime administer something of an unmedicinal nature and defer to a subsequent period the more precise scrutiny of the morbid symptoms, in order to be able to grasp in their purity the permanent uncontaminated symptoms of the old affection and to form a faithful picture of the disease.

§ 92

But if it be a disease of a rapid course, and if its serious character admit of no delay, the physician must content himself with observing the morbid condition, altered though it may be by medicines, if he cannot ascertain what symptoms were present before the employment of the medicines, - in order that he may at least form a just apprehension of the complete picture of the disease in its actual condition, that is to say, of the conjoint malady formed by the medicinal and original diseases, which from the use of inappropriate drugs is generally more serious and dangerous than was the original disease, and hence demands prompt and efficient aid; and by thus tracing out the complete picture of the disease he will be enabled to combat it with a suitable homœopathic remedy, so that the patient shall not fall a sacrifice to the injurious drugs he was swallowed.