During my journey as a Homeopath the last eleven years, whenever I have prescribed on Single Symptom Totality, I always felt thankful and grateful to my materia medica teachers. They always stressed one thing:
“Always remember that characteristic, unusual, peculiar symptoms are the most important of all in prescribing. Characteristic symptoms distinguish that individual remedy from other similar remedies. A symptom becomes characteristic in many ways. For instance, a common looking symptom becomes a characteristic feature of that remedy when it is studied in reference to its causation, location, sensation and modality. This is called Symptom Totality – A symptom in its total form…..”
Many times I have seen that just one such characteristic symptom, in its total form, describes the whole totality of that drug. It is possible to pin point that drug as a remedy of choice on that symptom’s presence in the patient. It can be called a Keynote Symptom of that remedy. Discovering one such keynote symptom in the patient, the remedy may just fit the remaining whole case. Single Symptom Totality itself becomes The Totality of Symptoms for that particular case, indicating that particular remedy. Let’s look at some cases examples to illustrate this:
“Doctor, after the head injury, I feel like I am a small child of 4-5 years, and I feel like doing mischief like them. I do not like being with or talking with elders and guys of my age; I feel shy. I do not feel like behaving like a grown up. I feel good being in the company of small children and playing with them. Along with this, my speech has become slurred and my right hand has become paralyzed. Absolutely no grip and power in my right hand. Cannot even hold pen, ball, or bread and cannot eat with right hand…….”
This seventeen year old boy had fallen from a fast moving train and remained unconscious for a month in the hospital. He regained consciousness, but with his right upper limb paralyzed, speech slurred and a change in his mental attitude and behavior. The feeling of being a child along with causative modality of head injury and concomitant symptom of paralysis was a symptom in its total form. As I already knew about the injury group of drugs like Arnica, Ledum pal, Calendula, Cicuta, Nat. sulph, Symphytum, Ruta etc., I wanted some reference for the feeling of being a child. I checked in Synthesis Repertory and in the Mind section I found something relevant.
Mind – Delusion – child: he is a child:
acts like a child; Cic, plut-n, symp
Cicuta and Symphytum are two well known injury drugs. Symphytum’s main sphere of action is on bones, facilitating the reunion of fractured bones. I selected Cicuta of course. Cicuta virosa 200, a single dose, brought about exteriorisation of the disease in the form of severe itchy eruptions all over the back, neck and scalp, fifteen days after the dose. The eruptions persisted for about two weeks, along with progressive improvement in the right hand paralysis, in speech and also in his mental attitude and behavior. The feeling that he is a child disappeared completely and he started behaving like an adult. The parents also commented that he no longer behaved like a child. After a month, Cicuta was repeated and physiotherapy was suggested. By the next month he resumed his duties.
Another example is a case of a huge Chocolate cyst ( Haemorrhagic cyst ) nearly 7 inches in diameter in the right ovary in a young, very lean, unmarried, over-sensitive girl, cured on the same basis of Single Symptom Totality.
Memory poor and forgetful especially for the well known streets and places. Dry mouth  with marked thirstlessness. Tongue felt like dry cotton and would adhere or stick to the roof of the mouth. Aversion to water. Would drink only to moisten the mouth and then spit it out.
Dryness of the mucus membrane to the extent that tongue feels like dry cotton and sticks to the roof of the mouth along with concomitants like thirstlessness and aversion to water; drinks only to wet the mouth and then spits it out – Reference from Synthesis Repertory pointed out only and only to Nux.mosh. All the other characteristics of the case automatically fit.
Two doses of Nux.mosh 200 at the interval of fifteen days cleared the cyst completely and permanently. Rapid, gentle and permanent restoration of sick to health, as stated by the Great Dr.Samuel Hahnemann. Also, the girl who was under weight put on nearly 7 kgs. in next 2-3 months and looked more beautiful.
Moral of the story is – always try to complete any symptom in its total form, i.e. causation, location, sensation, modality and concomitant. You may discover keynotes pointing to the remedy like this. If not one single then, maximum three such keynotes are more than sufficient to select the remedy. Certainly by doing this, a physician’s high and only mission – to restore the sick back to health, becomes easier.
Editor’s note: Below is the whole case of chocolate cyst, enabling you to see the full symptom picture and how everything was covered :
A Case of Chocolate Cyst
Name: Ms. A. S.
Age: 25 yrs.
Date of first consultation: 12/15/2004
A 25 year old unmarried woman came to my clinic with her parents. They were worried because the patient had been advised by a gynecologist and surgeon to remove her ovaries. Her ovaries had been damaged due to hemorrhagic cysts. She had been warned about some of the complications from this problem such as relapse, infertility, and malignancy. The family was worried because the woman was still unmarried. Though the cyst had been growing larger and filling with blood with each menstrual cycle (725 ml blood had collected within 10 months), the patient was not ready to have surgery. The diagnosis happened accidentally when one day the patient felt a lump in her pelvis on her right side. She went to a gynecologist and did a pelvic sonogram. Prior to this time, she had not had any pain or any disturbance in her menstrual cycle. The sonography report follows.
USG Abdomen and Pelvis:
A huge right ovarian cyst  approximately 15 cm in diameter was present and retained approximately 725 ml of blood. The left ovary showed multiple small cysts retaining blood. The cysts are known as hemorrhagic or “chocolate” cysts. The rest of the abdominal and pelvic organs were normal and there was no free fluid seen in the abdomino-pelvic cavity. There was no evidence of malignancy.
It had been 10 months since she was diagnosed and she had been treated unsuccessfully by another homeopath. She was advised to go for aspiration at Nanavati Hospital, Vile Parle to review the case again and to find the correct simillimum. She underwent aspiration as advised and continued with homeopathic treatment for two months but the cysts started filling up with blood and showed no sign of improvement. She came to me at this time and the case follows.
• No pain, no tenderness on touch and superficial palpation.
• A large lump was felt on deep palpation on the right side of the pelvis which was painless.
• Left side of pelvis felt normal on palpation.
30 days normal menstrual cycle with little pain and discomfort. Flow was intermittent. Spotting for first 3 days followed by flow of bright red blood with dark red clots. Gushing flow at times running down her heels. Fast staining blood difficult to wash off. Stringy and ropy clots. Stringy and ropy leucorrhoea in mid-cycle for 3-4 days suggesting ovulation. Irritable, angry, sad and depressed during period of ovulation and menses.
Hypersensitive to external impressions like noise. Disturbed and irritable from loud noise and if questioned repeatedly. Can’t tolerate injustice done to herself or anybody else. Fights for justice. Rebels against injustice and untruth. Feeling of being cheated, feeling of betrayal by those who don’t do their duties properly and are unfaithful to their work and responsibilities. Very duty conscious. Conscientious about trifles. Feels guilty if she has neglected her duties.
Anxious, worrying, caring and sympathetic to others. Would bear the pain herself to help others. Goes beyond her limit to help others. Worries about others’ health. Strong sense of idealism and duty consciousness. Faithful and loyal to her work and employers. Fastidious. Wants everything neat, clean and tidy, and wants things to be in their place. Irritable on seeing dirt and mess. Punctual. Anxious about time. Hurried to be on time. Anxious about meeting an engagement. Anticipating anxieties before exams. Stage fright. Nervous diarrhea before exams and stage performance. Anxiety about talking in public, but settles once started and performs well.
Memory is poor about places. Forgets well known streets. Cannot recognize known and familiar streets or places where she has been many times before. Gets confused and has to ask for directions. Memory is poor for certain names and terminologies. Mixes and confounds them.
Thirst – Absolute thirstlessness. Aversion to drinking water. Lips become dry, tongue adheres to roof of mouth but does not feel like drinking water. Drinks a sip to wet the mouth or holds water in mouth and then spits it out.
Appetite – Poor. Gas, constipation, and heaviness in the stomach and abdomen all the time. Does not feel like eating and does not feel hungry.
Craving – Spicy food and fruit juices.
Stool – Very sticky stool. Stools stick to the surface of commode, despite pouring water on it.
Menses – Stains remain on clothes in spite of hard washing.
Thermal state – Cannot bear cold drafts. Must wear thin covering on upper extremities. Bathes with warm water except in hot summer.
Father suffered from 3rd stage tuberculosis in his youth. Sister also suffered from tuberculosis in her youth.
Slow and progressive cystic pathology and collection of blood, together suggest activities of sycotic and tubercular miasms. Sticky stools, staining menses, gas, etc., as well as dullness of memory also suggest strong activity of the sycotic miasm. Family history of tuberculosis in father and sister suggests tubercular diathesis in background. Hypersensitive, irritable, emotional nature is a feature of psoric or tubercular miasms.
• Memory weak for well known and familiar streets
• Thirstlessness with dryness of mouth
• Tongue adheres to roof of mouth
• Staining of menses
• Sticky stools
Evaluation of Case:
I understood this patient as tough and strong looking on the outside but sensitive, emotional, and sympathetic on the inside. The pathology is similar in nature – a huge tough shell collecting ample amounts of liquid inside without showing any pain or discomfort for months at a time. This case needed a remedy which was tough on the outside but soft on the inside. A remedy with the combination of irritability, diligence, fighting for justice, punctual, neat and tidy as well as emotional, sympathetic, conscientious, worrying and caring for others. The remedy had to have poor memory for familiar streets, thirstlessness with dry mouth, and a love of spicy food.
Totality of Symptoms:
Memory weak for well known streets
Thirstlessness with dryness of mouth
Tongue adheres to roof of mouth
Menses difficult to wash off
Craving for spicy foods
Applied Materia Medica:
When the symptoms mentioned above are repertorized, remedies like Nux moschata, Nux vomica, and Pulsatilla prominently appear. Pulsatilla can be ruled out because its changeable, weepy, timid, yielding nature is not seen in this case. Nux vomica is extremely bitter, poisonous, irritable and hypersensitive. This case is missing the extreme level of irritability of Nux vomica. Nux moschata seems to fit perfectly on the basis of its thirstlessness with dry mouth and weakness of memory for familiar and well known streets. These two symptoms are the keynote symptoms of Nux moschata and both symptoms are intensely present in this patient. Nux moschata was chosen as the prescription.
Nux moschata 200 c
200 c potency was selected keeping the patient’s sycotic pathology in mind as well as the presence of two keynote characteristic symptoms in the case and remedy.
Within 48 hours:
Patient came to clinic saying that she could palpate the cyst in her abdomen. Patient was examined by the doctor.
On superficial palpation, no mass was palpable.
On deep palpation, a small mass was palpable.
Cyst showed remarkable decrease in size and volume.
After 15 days:
Dose was repeated for the persistent cyst and other symptoms of gas, etc.
In 2 months:
Gas, flatulence reduced
Patient gained 6 kg weight
Thirst improved. Patient started liking water. Dryness of mouth disappeared.
Both ovaries normal.
After 6 yrs:
No relapse. Patient is absolutely fine. She got married and is settled in her life.