SYMPTOMATOLOGY

AMRUTHA MAHESAN
1ST MD
 SYMPTOM ?
 The word symptom has been derived from the word ‘symptoma’
which means ‘anything that happen’.
 Symptoms are outward reflections of an internal derangement of the
vital force.
 These are the evidences of the disease.
 Morbid derangement makes itself known only by its manifestation,
at first, in the form of altered sensations and functions and later,
in structural or organic dysfunctions
According to Hahnemann(§ 6),
symptoms are 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.
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.
Dr. Kent : “Every symptom is the indicative of a
deviation from the normal state of health”.

Dr. Stuart Close: “In general, a symptom is any

evidence of a disease or a change of state of
health”.
 Dr. Dewey: “A symptom is the expression of disturbance
in a healthy body produced by a drug or some morbid
agents”.

 Dr. Wright: “Symptoms to the Homeopath are the

language of the body expressing its disharmony and
calling for a similar remedy”.
 USES OF SYMPTOMS
• To understand the disease one must be able to distinguish the
variations in healthy expressions, from an actual deviation.
• Symptoms help us to understand the changes that have occurred
an departures from the former state of health.
• Knowledge of the true nature of symptoms, constitution of
symptoms and their classification is necessary in proving
medicine, in the examination of a patient, in the study of MM and
in the selection and prescription of the indicated remedy.
• Knowledge of types of symptoms and their value are essential for
repertorizing a case.
SIGN
These are the alterations from the state of health observed or detected
by the physician or attendants. All the objective evidence of the disease
is identified with the term Sign. The signs are of great importance as
they are the only available evidence of disease of infants, comatose
patients, insane persons, etc. The patient may not be aware of the
existence of this entity.

SYNDROME
A group of symptoms and signs suggestive of particular type of disease
or in other words represent a disease.
Elements of a Symptom
Location
Sensation
Character/ color/ odor
Aggravation
Amelioration
Concomitants
Causation
Duration
Extension
Alternation
 Classification of symptoms
Dr. HAHNEMANN Dr. KENT
Characteristics §153 General symptom
General & undefined symptom §153 Particular symptom
Lesser accessory symptoms §95 Common symptom
Accessory symptoms §181
Dr. STUART CLOSE Dr. H A ROBERTS
Subjective symptom Chief complaint/Leading symptom
Objective symptom Auxiliary symptom/Concomitant symptom
Keynote symptom Subjective symptom
Negative symptom Diagnostic symptom
Contradictory symptom
Alternating symptom
Dr. E. WRIGHT Dr. GARTH BOERICKE
Common symptom Basic symptom
Mental symptom Determinative symptom
General symptom Clinical symptom
Objective symptom
Pathological generals
SUBJECTIVE SYMPTOM
 Subjective symptoms are those, which are felt by the patient himself.
 The deviations and the alterations at the level of sensations and
functions, indicate a primitive stage of the disease which the patient
alone can feel.
 Available much before the actual disease localizes itself in a particular
system or organ.
 Stuart Close writes that subjective symptoms constitute the only direct
avenue of approach to the inner sphere, which must otherwise remain
closed to our investigation.
 All types of pain, discomfort, various sensations and mental symptoms
come under the domain of subjective symptoms.
 Ranked highest among during evaluation of symptoms as they belong
to psychic and mental sphere. Perceiving the subjective symptom
incase of hysterical patients, young children and old people are
difficult.

Rubrics :
HEAD- PAIN- stitching – forehead
MIND – FEAR- Falling of
MIND- CONFUSION of
VERTIGO – CLOSING eyes, on.
SKIN- ITCHING- Scratching agg
EXTREMITIES – NUMBNESS - fingers
OBJECTIVE SYMPTOM

Objective symptoms are those which are perceptible to the

patient, bystanders and physician. They are known as signs.
These perceptible changes are sure signs of disease and do
not mislead the physician. Can be perceived by the physician
by his sound senses while interrogating or examining the
patient or by laboratory findings. They become the most
important guide in infants, unconscious patients, insane, deaf
and dumb patients, patients with a different language and
even in un-co-operative patients.
Rubrics:
SKIN- DISCOLORATION- yellow , jaundice
- new born children( physiological jaundice)
GENERALITIES – CYANOSIS- infants in (asphyxia neonatorum)
FACE- DISCOLORATION- Pale - lips
FACE – ERUPTIONS – Impetigo
SKIN- ERUPTIONS- Chicken-pox
GENERALITIES- EMACIATION- Children(marasmus)
ABDOMEN- HERNIA, inguinal
Common Symptoms
Objective symptoms are those which are present in many
persons suffering from the same ailment.
For example breathlessness is a common symptom in an acute
exacerbation of asthma, headache and body ache are common
symptoms in a case of fever etc.
These symptoms are very much helpful in diagnosis of a case.
They do not help in individualizing a person hence they are not very
important for prescribing in the homoeopathic system of medicine,
unless they are further qualified.
However, they help us to arrive at a group of medicines.
Common symptoms help us to know the uncommon
symptoms.
Common symptoms become useful when they are:
Absent
Intense
Associated with other symptoms
Present in a group
Traceable to indicate origin, duration and progress.
Common symptoms must be considered last in the
hierarchy of symptoms and study of repertory, be they
general or particular, mental or physical.
Rubrics:

RESPIRATION – DIFFICULT – Night, during.

CHEST – PALPITAION- Heart, region of
THROAT – PAIN-inflammation – Swallowing on
HEAD- PAIN- Sides
FACE – SWELLING – Parotid gland – right.
EAR – DISCHARGES- purulent
STOMACH – PAIN- Eating- after
Pathogenic Common Symptoms
 Symptom that is common to a medicine
 They form the bulk of the drug pathogenesis
 They do not help in remedy selection when found in isolation.
 Important when they are found in harmonious groups or when they are
very intense in their expression

Pathognomonic Common Symptoms

 Symptom that is common to a disease state.
 They may not be of any relationships, they are commonly found in
many related disease states
 Helpful in differential diagnosis
Uncommon Symptoms
Uncommon symptoms are those which draw our attention because they
stand out in a group of symptoms.
Also known as characteristic symptoms.
Help in individualizing a person since they are the expressions of the
person and they have little to do with the existing pathology and disease.
Have little importance in arriving at a diagnosis.
Help the physician to understand the constitutional qualities of the
individual and also the differentiation of remedies to reach a similimum.
Rank very high. The qualities of symptoms described by Hahnemann as
striking, singular and peculiar – all belong to this category of symptoms.
Rubrics:

RESPIRATION – DIFFICULT – Fanned, want to be

CHEST – PALPITATION- Heart, Menses before
HEAD- PAIN- Sides- milk, from.(Brom)
NOSE – CORYZA – Eating after (Nux vom)
STOMACH – VOMITING- Drinking – as soon as water
becomes warm in Stomach (Phos)
GENERAL SYMPTOMS
All the symptoms that are predicted of the patient himself are called general.
These symptoms give information pertaining to the whole of the patient.
The things of which the patient says “I feel” are apt to be generals.
For example:
I am thirsty
I feel hot etc.
Generals are expressions of the whole person at a physical and mental level.
Generals are sometimes also made up of particulars.
When a certain symptom runs through all the particulars, it becomes a general.
A common sensation found at two or more than two locations also becomes a
general.
Generals can be mental or physical.
MENTAL GENERALS
This includes expressions available at an emotional and intellectual level.
One should note that emotions provide greater force to an individual and any change
in the emotional sphere is considered as the most important symptom of the person.
This relates so intimately to the man himself.
While considering the mental symptoms, the symptoms of emotions and intellect
should both be taken into consideration in the following order-

Will
Perversion of understanding
Perversion of memory
Will – Perversion of
Ailments from anger understanding – Perversion of
bad news Delusions, memory –
Grief Hallucinations Memory loss of
Love Illusions Absent-
Joy Thoughts mindedness, etc.
Reproach Absorbed
Hatred Clairvoyance
Irritability Confusion
Jealousy Comprehension
Love Excitement
Hate Imbecility
Anxiety mental activity
Fear Ailments from mental exertion
Rubrics:

MIND- ANXIETY – future about

MIND- DELUSIONS –Animals, of.
MIND – IRRITABILITY – Headache during
MIND- MEMORY – Weakness – said, for what has
MIND- ABSENT-MINDED – Reading while
MIND – THINKING, Complaints of, agg.
MIND – FEAR- People of.
MIND- CONFUSION- Mental exertion, from.
PHYSICAL GENERALS
Symptoms involving the whole person at a bodily level are to be considered in the
following order.
Perversion of the sexual sphere, including symptoms in relation to
menstruation.
Ailments from
Food – craving and aversions.
Appetite and thirst
Sleep and its disturbances
Weather and climatic influences
General modalities – position, motion, periodicity, moon phases, etc
Of these symptoms, the expressions which have a pathological basis are called
Pathological Generals. Eg. Tumors, warts, etc.
Rubrics:
GENITALIA FEMALE- MENSES –Painful, dysmenorrhea
STOMACH – DESIRES – Cold drinks / milk / alcoholic drinks
STOMACH – AVERSION - food, hunger with
STOMACH – APPETITE – Ravenous – marasmus with
STOMACH – THIRST – Large quantities for- long intervals at.(Bry)
SLEEP- SLEEPLESSNESS- Waking after
GENERALITIES - WARM- Becoming, in open air, agg
PARTICULAR SYMPTOMS
Symptoms that are related to a part of the body.
They are symptoms, which pertain to the part and do not represent the whole person.
The presenting complaints are usually particular symptom that compel the patient to
seek the physician as they seem to disturb him frequently.
They become important when they are qualified or marked with intensity or when
they are found in unusual situations. Modalities make a particular symptom
important. Undoubtedly they are very important while dealing with acute
complaints. Characteristic particulars do help in final differentiation of the remedy in
a well defined group of remedies. They also acts as keynote-prescribing symptoms
when generals are lacking in a case.
Rubrics:
TEETH- PAIN- Eating after
STOMACH- ERUCTATION- Food(regurgitation)
ABDOMEN – PAIN- Umbilical, region of.
RECTUM- HAEMMORHAGE- stool during
BACK- STIFFNESS, Cervical region
CHARACTERISTIC SYMPTOMS
The symptom that enable the physician can individualize the case or
characterize the case and by which he can differentiate the remedies are called
Characteristic symptom.
These symptom have little value in the diagnostic point of view.
It can be characteristic general or particular, or a characteristic symptom of a
patient or a remedy, all represent the symptom which are rarely seen, which are
the sole indication in the selection of remedy.
As it is peculiar to patient, it is also known as Peculiar Symptom or Contingent
Symptom.
E.g: head sweat profusely while sleeping, wetting pillow far around – Calc Carb
Haemorrhoids- blue like bunch of grapes – Aloe socotrina
PECULIAR, QUEER, RARE & STRANGE (PQRS) SYMPTOMS
These are also characteristic symptom which are rarely seen among the
patients.
Symptoms are defined by this term to denote intensity of its uniqueness,
which are peculiar to few remedies and few patients suffering from
similar diseases.
These symptoms drag the attention of the physician as they are abnormal
E.g: burning pain ameliorated by warm application
Difficulty in breathing ameliorated by cold exposure
KEYNOTE SYMPTOM
The symptoms, which are peculiar in a case and help to find out a
small group of remedies, are called keynote symptoms.
They should be at least three keynote symptoms in order to make a
correct homoeopathic prescription (the three-legged stool of Hering).
It was Dr. Guernsey who highlighted the importance of these
symptoms in homoeopathic practice.
Later, many other great prescribers like Dr. Lippe, P.P. Wells, H.C.
Allen, etc. gave importance to keynote prescribing.
Keynote prescribing was more in practice before the advent of
reliable repertories.
In fact, all keynote symptoms cover a good number of remedies and
should refer to repertories to verify the prescription.
COMPLETE SYMPTOM
A symptom with all the 3 essential components i.e elements of
location, sensation and modalities are called a Complete Symptom
The idea of a complete symptom was first introduced by
Boenninghausen who while going through the MMP and Chronic
diseases noticed that a majority of symptoms did not have
modalities. Therefore, it is necessary that all the elements should be
looked for and noted down while case taking. It is found that, very
often, it is the modality especially the element of amelioration,
which is lacking in description. Complete symptoms not only help in
the understanding of a case but also help in repertorization by
Boenninghausen’s approach.
Rubrics:
EXTREMITIES- PAIN- aching – knee – morning- walking
HEAD- PAIN – Shooting – temples – extending from temple to temple
CHEST – FULLNESS – Heart – night – while lying on left side
LARYNX & TRACHEA – PAIN – Pressing – Larynx – coughing from
BACK- PAIN- Aching – Cervical region – bending head back amel
ABDOMEN – FULLNESS sensation of – hypochondria – eating after
INCOMPLETE SYMPTOM

 Incomplete symptoms are those which lack any one of more of the three
elements (location, sensation and modalities) of a symptom.
 Boenninghausen had devised a method to overcome this deficiency in a
symptom.
 He has advocated that if one element is missing in a symptom, it can be
taken from another symptom to complete it i.e. one modality or sensation
could be applicable to all the parts or to the whole person.
 This idea is known as the principle of grand generalization.
CHIEF SYMPTOM
 Chief symptoms are those which compel a patient to seek the
help of a physician.
 Patient mentions if first in a case taking session.
 In a majority of the cases, chief symptoms are described in
detail and physicians do not face any problem in detecting them.
 Most of the time these symptoms are common symptoms and
they help the physician in diagnosis of a case.
 Chief symptoms are also known as presenting symptoms/
leading symptoms.
 Sometimes there can be more than one chief symptom in a case.
CONCOMITANT SYMPTOM
 Concomitant symptoms are those which accompany or are associated with
the chief complaints. Also called as Auxiliary Symptoms.
 In majority of cases, it is noticed that patients do not mention these
symptoms, considering them insignificant.
 Except in relation to time, the presence of concomitant symptoms can not be
explained since they do not have any pathological relation with the chief
complaint.
 These symptoms occur at the same time, before, or after the occurrence of
the chief complaint.
 These symptoms represent the individuality of the patient and hence assume
an important place in constructing the totality.
 They play a very important role in repertorization.
Rubrics:

EXTREMITIES – COLDNESS – foot – urination during

CHILL- CHILLINESS - Urination – Before
TEETH – PAIN- Menses before
EXTREMITIES – COLDNESS- Foot – anxiety during
EAR – NOISES- Humming - menses during
RECENT SYMPTOMS

Recent symptoms are those which have surfaced or are available as a later
development in a chronic case.
This division is done on the basis of time and progress in a chronic disease
of long standing.
Recent symptoms indicate the trend and direction of the forward
movement of the disease and therefore, they should be given due
importance while selecting a similimum
Rubric: MIND – MEMORY – Weakness of memory- recent facts of
MIND – AILMENTS FROM – Grief -recent
CORROBORATIVE SYMPTOMS
Concomitants which have no direct pathological or physiological
association to the chief symptoms are called corroborative
symptom.
Corroborative symptom forms the part of the concomitant symptom
E.g. For headache from excitement relived by bilious vomiting, the
medicine is Arg. Nitricum. But the evidence of argentum nitricum
symptom in any other region of the case strengthen our selection. It
may be desire for sweets or may be fear that ranks high
BASIC SYMPTOM
Symptoms which are essential for understanding the disease condition i.e the
diagnosis and are found in almost all provers without any characteristics are called
basic symptoms.
They are equivalent to common symptoms.
They are also known as Absolute symptoms.

DETERMINATIVE SYMPTOM
Symptoms which help to find out or select finally an indicated remedy, are called
determinative symptoms.
The term was used by Dr. Garth Boericke.
Boericke’s determinative symptoms are equivalent to Hahnemann’s characteristic
symptoms.
CLINICAL SYMPTOMS
Dr. Boericke has defined Clinical symptoms as one which doesnot appear in the
proving of a drug, yet nevertheless has been inadvertently relived by that same drug
given for another purpose. Eg. Stitching pain in the chest are constantly relived by
Bryonia which failed during proving.
These are the symptoms which could not be ascertained and included in drug
pathogenesis while proving of a drug but always relieved the same symptom when
encountered in a patient.

SPURIOUS SYMPTOMS
These are the vague symptoms, also known as the common symptoms of the disease
present in the proving of all most all the medicines.
They are of no use either for the purpose of prescribing or for the purpose of diagnosis
of disease.
DIAGNOSTIC SYMPTOMS
Symptoms which are important for diagnosing a case, are called
diagnostic symptoms. These symptoms are the product of a disease and
not very helpful in homoeopathic prescribing. These are of value in
differentiating the common/uncommon symptoms or the symptom of the
patient from that of the disease.
PATHGNOMONIC SYMPTOMS
Specific and characteristic symptoms of a given disease or clinical
condition are called pathognomonic symptoms.
They are also known as pathognostic symptoms.
Example: Aschoff bodies in rheumatic carditis.
koplik spot in measles.
keyser-fischer ring in Wilson’s disease
ALTERNATING SYMPTOMS
Symptoms, which manifest the partial picture of a chronic disease in one
phase and are replaced by some other manifestations later, are called
alternating symptoms.
Knowledge of these symptoms helps us to obtain the complete picture of a
chronic disease.
Eg. Diarrhoea alternating with constipation, diarrhoea alternating with
rheumatism, asthma alternating with eruption, etc.
Rubrics:
SKIN- ERUPTIONS- alternating with respiratory symptoms
RECTUM – CONSTIPATION – alternating with diarrhea
SKIN- ERUPTION- urticaria – alternating with rhematism
NEGATIVE SYMPTOMS
Symptoms which are expected to be present in a case but remain absent are
called negative symptoms. They become valuable by their conspicuous
absence
Ex. absence of thirst in fever, absence of pain in inflammation, etc, absence
of eruption in measles.
Rubrics:
STOMACH- THIRSTLESS- heat during
MOUTH- DRYNESS –tongue, thirst without
ACCESSORY SYMPTOMS
Accessory symptom of disease
Certain symptoms, being long standing, the patient become used to it and
consider them as a part of their life. This may be an uncommon symptom, but the
patient may ignore it, as they find no relation with their disease.
Hahnemann explained about these symptoms in §95 as Lesser accessory
symptom. These are important symptoms for a homoeopathic prescription.
Eg. Urge for stool after taking food
anxiety followed by diarrhea
Rubrics: RECTUM – URGING - eating after
RECTUM – DIARRHOEA- anxiety after
Accessory symptom of medicine

The new symptoms that appear after treating a case with partially suitable
homeopathic remedy that the patient never observed these symptoms in his
life before are called accessory symptom of medicine §181.
If the accessory symptom of medicine is so severe, then the physician should
select a new remedy based on the new totality considering both the already
existing symptom and the newly appeared accessory symptom of medicine
RECURRENT
RECURRENT SYMPTOMS
SYMPTOMS
Symptoms
Symptomswhich whichreturn
returnat atfrequent
frequentintervals,
intervals,arearecalled
calledrecurrent
recurrent
symptoms.These
symptoms. indicate the tendencies and constitutional dyscrasias of
theThese
individual.
indicate the tendencies and constitutional dyscrasias of the
Rubrics:
individual.
STOMACH
Rubrics: – PAIN- recurrent
THROAT
STOMACH – INFLAMMATION
– PAIN- recurrent– Tonsils – recurrent
EYE-
THROAT
STYES – INFLAMMATION
– recurrent – Tonsils – recurrent
BLADDER
EYE- STYES – INFLAMMATION-
– recurrent recurrent
MOUTH-
BLADDER APHTHAE-
– INFLAMMATION-
Children; in infants,
recurrent
recurrent
MOUTH- APHTHAE- Children; in infants, recurrent
PERIODICAL SYMPTOMS
Symptoms
RECURRENT whichSYMPTOMS
return at a fixed interval, are called periodical symptoms.
These symptoms
Symptoms are helpful
which return inat finding
frequent outintervals,
an indicated
areremedy.
called recurrent
They are given a good
symptoms.These representation
indicate in most
the tendencies andofconstitutional
the repertories.
dyscrasias of
the individual.
Rubrics:
Rubrics:
HEAD-
STOMACH PAIN-– periodic headache – every seven days
PAIN- recurrent
GENERALITIES- PERIODICITY
THROAT – INFLAMMATION – neuralgia
– Tonsils everyday at same hour : Kali-bi
– recurrent
GENERALITIES – PERIODICITY – 14th day
EYE- STYES – recurrent
STOMACH
BLADDER––PAIN – Periodical; 3rdrecurrent
INFLAMMATION- day, every
VERTIGO
MOUTH- –APHTHAE-
PERIODICAL – Every
Children; in 2infants,
weeks recurrent
 PARADOXICAL SYMPTOMS
RECURRENT SYMPTOMS
Symptoms which are self-contradictory and opposite in nature, but
Symptoms which return at frequent intervals, are called recurrent
found together, are called paradoxical symptoms.
symptoms.These indicate the tendencies and constitutional dyscrasias of
For example – sleepy but can not sleep, throat pain better by
the individual.
swallowing solid food, dry tongue with thirstlessness, etc.
Rubrics:
These are also known as contradictory symptoms.
STOMACH – PAIN- recurrent
THROAT – INFLAMMATION – Tonsils – recurrent
Rubrics:
EYE- STYES – recurrent
SLEEP –SLEEPLESSNESS- Sleepiness with.
BLADDER – INFLAMMATION- recurrent
STOMACH – THIRSTLESS – Desire to drink with
MOUTH- APHTHAE- Children; in infants, recurrent
MOUTH – DRYNESS – Tongue- Thirst, without
THROAT – PAIN – Swallowing, on – solids amel(M)
PATHOGENETIC OR AETIOLOGICAL SYMPTOMS
The symptom pertaining to the aetiological or exciting
feature of the disease.
Eg. Coryza from exposure to dry cold air
Cough from getting wet in rain

Rubrics: NOSE – CORYZA- Air, from draft of

COUGH- WET, getting.
ACUTE SYMPTOMS
Symptoms usually of short duration with severity and sharpness.

Rubrics :
CHEST – PAIN – Heart, region of – acute
CHEST – PTHISIS PULMONALIS – Acute
EXTREMITIES – PAIN – Stitching- Hip – acute
EYE – INFLAMMATION- Acute
CHRONIC SYMPTOMS
Symptoms occurring in an individual for a long duration/period of time as in
c/c diseases.

Rubrics:
NOSE – CORYZA- Chronic, long continued
RECTUM – HAEMORRHOIDS – Chronic
COUGH – DRY – Chronic, dry cough
THROAT INTERNAL – INFLAMMATION- Chronic
HEREDITARY SYMPTOMS
Symptoms that is present as a part of hereditary disease which are
present both in parents and off-springs.

Rubrics:
GENERALS- FAMILY HISTORY OF- Apoplexy(S)
GENERALS – FAMILY HISTORY OF – Cancer
GENERALS – FAMILY HISTORY OF - Tuberculosis
ACCIDENTAL SYMPTOMS
Symptoms which are found prominently in a person but do not
fit into the totality, are known as accidental symptoms.
These are present by chance and do not help either in
understanding the phenomena of disease or in forming a totality.
It is safe to ignore these symptoms after weighing them properly.

FUNCTIONAL SYMPTOM
It indicate the symptoms which are produced before the
structural damage is affected.
Usually indicative of symptoms produced during early bio-
physical or bio-chemical changes.
SCHEIN SYMPTOMS
These are the apparent symptoms caused by the excessive Homeopathic
medicines as a result of frequent repetition. The dose in that case must be
reduced and repeated at longer intervals and possibly stopped several days.

GENERIC SYMPTOMS
These symptoms are produced by the dynamic generic action of the drug.
These symptoms are common to many drugs of a particular genesis or class.
Eg., all the medicines of Ophidian group have hemorrhagic tendency
Medicines of Halogen group have action on enlargement and induration of
glands
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