Key note prescribing in Homoeopathy – relevance & features

Dr  Smitha Brahmachari
Dept. of Repertory, National Institute of Homoeopathy.

“I keep six honest serving men; they taught me all I know, Their names are what, why, when, how, where and who.” Park’s textbook of Preventive and Social Medicine.

Abstract
The vast collection of symptoms of which the Materia Medica is composed is incomprehensible without an understanding of the principles upon which it is based, along with meaning of symptoms, their method of classification and interpretation.

At this juncture comes keynotes whose objective is to aid the practitioner that which is guiding and characteristic in the individuality of each remedy and thus utilize more readily the symptomatology of the vast Homoeopathic materia medica with great certainty and ease.

KEY WORDS – Keynotes ; Homoeopathic treatment.

Introduction

The first book – Keynotes of Hom. Mat. Med. By H C Allen.

The life work of the student of homoeopathy is one of constant comparison and differentiation. He must compare the pathogenesis of a remedy with the recorded anamnesis of the patient.

Knowledge of the individuality of the remedy in the pathogenesis – Peculiar/ Uncommon/ Characteristic/ the red strand of the rope and the central modality or principle of the remedy.

Ex – Aggravation from motion of Bryonia, the amelioration of Rhus tox, vicious delirium of Belladonna or the apathetic indifference of Phos acid.

Totality of symptoms in and through which an individual case is expressed.

Paragraph 153 of the Organon; ‘The more striking, singular and uncommon and peculiar (characteristic) signs and symptoms of the case of disease are chiefly and must solely to be kept in view; for it more peculiarly, these very similar ones in the list of symptoms of selected medicine must correspond in order to constitute it most suitable foe effecting the cure. The more general and undefined symptoms; loss of appetite, headache, debility, demand but little attention when if that vague and indefinite character; symptoms of general nature observed in every disease and drug’

Historical consideration

The real “Keynote system” was taught and practiced by the late Dr. Henry Newell Guernsey M.D.(1817 – 1855AD)

He simply invented a new name for the old Hahnemannian idea.

Diagnosed as having tubercular infection.

Professor of Mat Med in Hahnemann medical college, Philadelphia (1871) – Delivered lectures of a medicine based on leading character which gives the physician the direction toward the proper remedy.

Synopsis of his lectures was published in American Homoeopathic medical journal, later as mat med in 2 parts.

1882/83, 3 yrs before his death, a copy of Boenninghausen’s therapeutic pocket book with edition of confirmation, by Boenninghausen himself was published.

His Keynotes idea had meaningful use of practical application.

Seriously criticized by Kent, who says “the great trouble with keynotes is that they are misused. The keynotes are often the characteristic symptoms; but if the keynotes are taken as final, and the generals do not confirm, then will come the failures”

Kent has given some characteristic in lectures of Mat med himself for example:

• Phosphorus – patient in low fever want to be mesmerized, they are starving for vital energy. Sometimes calcarea.
• Lycopodium – deep furrows in forehead and face with flapping nostrils in pneumonia or bronchitis.
• Camphor – vomiting and purging with cold, blue, dry skin.
• Cuprum – sudden blindness followed by convulsions. Etc…

Meaning of keynote

An instrument by which something serves to disclose or open or solve something.

It also helps to perceive the level of intensity or artistic execution.

The term “keynote” is merely suggestive, the reference being to analogy between mat med and music.

1. Music has seven ‘sur’ / tones – SA RE GA MA PA DHA NI – arrangement gives a melodious music. There is only one keynote to any piece of music however complicated and that governs all the various parts of the whole music.
2. Disease is the loss of harmony in function and sensation. ‘Pathognomonic symptom’ expresses what might be called the keynote of the disease.
3. Symptoms of medicines present peculiar differences from all other medicines. During proving each one show peculiar, characteristic symptoms. There is a similarity and a difference evident upon the close comparison.
4. In the like manner diseases and all other external influences affect different individuals differently, yet similarly.

Characteristic of keynote

1. The keynote is a predominating symptom/ feature which directs attention to the totality.
2. When the prescriber becomes familiar with these keynotes or characteristic of remedies he will be able to find more quickly the remedy in a given case because the field of selection has been narrowed.
3. When he recognizes such a keynote in the symptom of a case it suggests or recalls to mind a medicine having a similar keynote. Reference to repertory and MM will verify and complete the comparison.
4. There is usually something peculiar in the case, some striking combination of symptoms that directs the attention to certain drug and this is what Dr. Guernsey called a keynote. It’s synonymous with Hahnemann’s characteristics.
5. A characteristic/ keynote is a generalization drawn from the peculiar symptoms by logical deduction. So they cannot be determined until a complete examination of all the symptoms of the case (numerical totality) for the purpose of comparison.
6. The keynote generally falls under following categories:

1. Very peculiar symptom
2. Mental concomitant with bodily disease.
3. Precise locality
4. Course and direction of pain and sensation
5. Alternative symptoms
6. Modalities

Examples of keynote books:

1. Keynotes and characteristics with comparisons of some of the leading remedies of the MM with some of the nosodes, by H C Allen.
2. A synoptic key of MM, by C M Boger.
3. A primer of MM by T F Allen
4. Characteristic MM by W H Burt.
5. Keynotes and redline symptoms of MM by A V Lippe.
6. Characteristic of Homoeopathic MM by M E Douglass. 

Examples of keynotes

Actea rac. – lancinating, electric like pains.

Chamomilla – pain with numbness.

Backache – > emission – zincum met.

                   < emission – cobalt. Etc….

Case
Dr. Adolph Lippe – A case of cholera,

Cholera with an unusual noise in the intestines as if a fluid were emptied out of a bottle and the discharge came away with a gush – Jatropha.

Conclusion
The modern school of medicine accept in disease only what is general (common) to all those affected by it; in medicinal provings they accept only that which is experienced by many provers.

But Homoeopathic school accepts all the symptoms experienced by the differently constituted provers, they consider as peculiarly characteristic the individual symptom of the patient those not generally experienced by others suffering from a similar form of disease.

Dr. Charles G Raue – Characteristic symptoms individualize both disease and the drug. It belongs exclusively to a single remedy and cautioned not to diagnose a remedy on one symptom only, be it ever so characteristic. They define the circle of remedies out of which we must select.

Dr. C Hering – Every stool must have at least 3 legs, if it is to stand alone. – Select at least 3 keynotes as the basis of prescription. But it is wise to give the symptomatic stool a broad base and as many legs as possible.

So keynotes seems indispensable to enable us to intelligently and successfully use our voluminous symptomatology. But correct prescribing will always remain an art.