The Art of Interrogation

By SCHMIDT Pierre

The art of interrogation

In choosing a subject, I have
taken as my theme one after
which so many beginners are
sighing and to which I have, in
fact, found really no sufficient
and useful references in our
homoeopathic literature,
however extensive.
On the other hand, I have
learned through frequenting
homoeopathic dispensaries and
hospitals how very rarely
indeed did the practitioners
really know how to apply
exactly the teachings
recommended by the Master,
concerning the interrogation of
the sick and homoeopathic
semiology; for, must we, after
having listened to the patient,
direct the interrogation in a
given direction, either on the
side of a presumed pathological
diagnosis or toward a remedy
suggested by the first recital
made by the patient ?
Or must we, against all we
were taught in our studies,
interrogate without any
consideration whatever
concerning either remedy or
diagnosis, but make what we
may call a systematic
interrogation ?
On the other hand, we all know
the theoretical principles, but
how many apply them really
fully ?
Is this question of
interrogation simply a thing of
theoretical interest or is it a
matter of practical application
?
Is it only a simple vue de
l'esprit ?
Is there real accord between
theory and practice ?

Now that homoeopathy is

developing and growing, and
this especially in our Latin
countries, France, Switzerland,
Spain, Italy and South America,
everywhere we hear young
practitioners asking : "But how
to question the patient ?"
"What are the most useful and
indispensable questions to ask
?" What is the difference
between the allopathic and the
homoeopathic consultation ?"
Theoretically speaking, we
have certainly many precious
practical suggestions
concerning the questionnaire ;
Hahnemann, in his Organon,
devotes more than sixtythree
paragraphs 1 where he speaks
about the examination of the
patient. Von Boenninghausen
gives us excellent advice how
to take the case. Jahr furnishes
also a questionnaire, as well as
others like Mure, Perussel,
Molinari, Landry, Claude, then,
more recently, Close and Kent,
this last the only one who gives
us a full questionnaire
comprising more than thirty-
two pages, entitled "What the
Doctor Needs to Know in order
to Make a Successful
Prescription."
Finally, there is that of Dr.
Margaret Tyler.
But I bear in mind also the
famous lecture of Constantine
Hering, published in 1833 in
the "Bibliothéque
Homoeopathique de Genève," in
which he sets forth the theme
how to trace the picture of the
disease, his rules being
summed up in four words : -
To listen, to write, to question,
to co-ordinate.
It will not be my task this
evening to develop
theoretically these four
precepts, my purpose being
essentially to aim at the most
useful and exclusively practical
side of the question in general.
Consequently, I will not
discuss the art of listening to
the patient, not the best way to
write one's observations, nor
yet the technique of the study
and the co-ordination of the
symptoms, or the question of
the physical examination. We
will take up this evening only
with the third precept, the
questioning, or examination,
strictly speaking.

I will neither enter into long

theoretical details about this
question, or propose to you the
large ideal questionnaire, which
would be the most complete
and the most perfect. I have
compiled a questionnaire of
that kind after years of the
study of my chronic cases, but
as it covers more than thirty-
six pages, I obviously cannot
discuss it here.
The main purpose of the
allopathic consultation is to
establish a pathological
diagnosis, to label the disease
in the most modern nosological
fashion. It is said and taught
everywhere that without it no
treatment should be attempted.
For the old school, the
investigation of objective
pathological symptoms is
absolutely essential. In this
research the interrogation
plays rather a secondary role,
the allopathic consultation
being always more occupied by
examinations with a more or
less complicated array of
physical instruments or
chemical analysis, but one
moment of reflection only will
show us that all these
procedures only aim at
determining the one or the
many organs which are affected
and to determine how far they
are involved.
It is the hunting after end-
products, after the results of
disease.
If these results are not still
manifested in a precise
objective manner, and if the
sick person suffers from
functional troubles only, or
even if these are not yet
present and the patient is only
complaining of subjective
troubles, his case is arbitrarily
decided. It is a nervous,
psychic, imaginary case !
But in the homoeopathic
consultation, we are not at all
satisfied with this investigation
only. Its object is to establish
how a given morbid affection
has developed itself in a given
subject, and to explore all the
possible details of the evolution
of such a disease in an
individual, and how precisely
this patient differs from all the
others bearing the same
diagnosis.
 For example, an allopath, after
having examined the throat of
a patient, remarks that it is
inflamed and covered with
membranes from which he may
take a part for laboratory
examination. And, if the result
of this examination be
diphtheria, he will give an
injection of serum. If it is said
to be a simple infection, he will
give an antiseptic gargle and a
throat-paint.
If he has ten patients following
the same diagnosis, the ten will
be treatment just the same.
(Which reminds me à propos of
an amusing story a minister
told me the other day. He used
to wait outside the surgery for
a certain doctor friend of his,
to whom he ventured to make
the remark it was always
interesting to note how many
of the patients came out with
bottles of the same coloured
medicine. To this remark the
only answer forthcoming was a
look of rather confused
embarrassment !)
On the contrary, a
homoeopath will inquire into
all details which differentiate
this particular patient from the
ten others; one would have the
membranes on the right side
another on the left, and
another on the velum of the
palate. The appearance of the
membrane may vary in colour
from green to yellow, black or
white, according to the case; in
others the consistency may,
however, change, but especially
interesting for the homoeopath
are the functional and
subjective troubles of the
patient. One may have burning
or shooting pains, or may
complain of dryness or
rawness. Certain patients may
alleviate their pain by drinking
cold water or warm, or by
eating solid food. The
extension of the trouble from
left to right or vice versa, or
from the throat to the larynx or
to the nose, all these
differences may lead to a
different homoeopathic
remedy.
Many details, forsooth
seemingly of secondary
importance, if not quite useless
for the allopath, pathologically
observed, which will however
permit not only of precise
diagnosis of the disease but
especially the diagnosis of this
given patient, and the
homoeopathic physician will be
able to find his own and
particular remedy, I mean the
remedy adapting itself
precisely to all the different
characteristics and
peculiarities of the case.

There exist more than fifty-six

remedies for diphtheria, but
there is a very small number
corresponding really to all the
symptoms pertaining to this
particular patient. And this is
where the task of the
homoeopath begins.
To know well how to observe,
how exactly to interrogate, is
the first step in this
indispensable inquiry, and one
which leads to the real remedy
to be found.
This is, Mr. President, Ladies
and Gentlemen, why I will take
this evening in consideration
the best questionnaire to be
utilized by the physician in his
current daily practice. A
questionnaire which will satisfy
the following desiderata : -
(1) The minimum of the best
questions to be asked a patient
when the time is limited.
(2) Most important and most
necesary those questions to
discover, not the pathological
diagnosis but the therapeutic
diagnosis, the general remedy
corresponding to the patient.
(3) The questions to be asked,
those for which we are sure to
find a correspondence in our
repertories and materia
medica.
The interrogation, above all,
must be methodical.
Of course, it goes without
saying that the questions asked
must be according to the
purest principles of
homoeopathy, i.e. , : -
(a) To avoid direct question,
for we know, if the patient
answers with yes or no, the
question is badly formed.

(b) Never to ask a question

putting an answer, so to say,
into the patient's mouth, thus
making sure not to bias his
answer.
(c) To avoid all questions
where the patient is obliged to
choose between two different
alternatives, and respect the
sacred rule to leave the patient
always his own choice.
Of course, the physician must
put himself, as Dr. Kent says,
on the level of language
comprehended by his patient.
His attitude of seriousness and
benevolence must help to
stimulate the confidence of his
patient.
On the other hand, he must
know sufficiently his materia
medica, so that his questions
will be adapted to the
comparison he will have to
make further on. "Store up your
materia medica so as to use it,
and it will flow out as your
language flows," in the well-
known words of Kent.
The physician, by his manner
of interrogation and general
questions, must do everything
not to determine, but to let the
patient himself characterize
the particular facts. "Say as
little as you can, but keep the
patient talking and help him to
come close to the line and keep
to the point."
Never allow yourself to hurry a
patient, established a fixed
habit of examination that will
stay with you. It is only when
you keep up the most careful
kind of work that you can set
up your reputation and fulfil
your highest use (Kent).
We can never sufficiently bear
in mind how difficult is the art
of interrogation, and all the
importance that should be
given to it. "One can learn very
much from Socrates," observes
Hering, "and the study of Plato
is as important for us as
Hippocrates."
To avoid all ambiguity, I will
first give you some questions
that in the course of your own
practice you also will have
frequently heard,
demonstrating that many
physicians show by the
questions they ask that they
have not grasped the thought
of individualization; for
example : -

(1) Direct questions : (a) Are

you thirsty ? (b) Are you
irritable ? (c) Have you pain in
the stomach ?
(2) Suggestive questions : (a)
You do not stand the cold very
well, do you ? (b) You surely
prefer to be consoled ? (c) I
suppose that you don't like too
greasy and too rich food ?
 (3) Questions where the
patient must choose : (a) Do
you prefer dry or wet weather ?
(b) Do you dream about sad or
cheerful things ? (c) Are your
menses dark or light ?
About the direct questions, it
is quite frequent that a patient
would say "Yes, I am thirsty,"
because he thinks about his
morning coffee and his soup at
noon but really does not drink
anything besides. Or another
would say "No," because he
thinks that drinking tea, wine,
lemon squash and soda do not
mean thirst, this being
reserved for ordinary water
only.
Then, about the greasy or rich
food, he will say that he does
not like them because the
doctor has said "Too greasy."
And about the menses, you will
hear that they are dark, being
really absolutely red, because a
timid patient, having no choice
between dark or light, will reply
one or the other colour in order
to get rid of the question.
I think it unnecessary to
discuss every possible answer
or error which will result by
doing so, my purpose being to
give you a list of questions
avoiding precisely these errors,
to present them to the
criterium of your long
experience and to submit it to
your considered criticism. Of
course you are aware of the
considerable advantage a
beginner in homoeopathy
would have if he had not to
wait for forty years, but be at
once able to ask just the best
and most exact questions
aiming at a practical result,
and to the answer of which he
would be able to find a similar
correspondence in our
pathogenesis.

What would be really the use of

a question about which we
know no corresponding remedy
? Of course, everything is
useful, but I repeat that we are
working here for practical
results and not for theoretical
purposes. We must adapt
ourselves to the pathogenetic
pictures of our materia medica,
pictures which are very rich
and precious.
To finish with this
introduction, I cannot
sufficiently criticize the
method quoted in the book
recently published, "La doctrine
de l'Homoeopathic francaise"
where the physician, after a
short physical examination,
asks the patient about the
symptoms of Sepia suggested
by a yellow saddle he has
observed on her nose, or those
of Lycopodium on an irritable
man complaining of his liver.
This we may call the "torpedo
method," in French "le
torpillage." Because a patient
has red lips you would ask him
: "Have you not an empty, all-
gone sensation in the stomach
before noon ?" "Do you not find
it disagreeable to be in a
standing position quite a while
?" "Are you not obliged to put
your feet out of the bed at
night because they are
burning." "You probably drink
much and eat little, and c. ...
..."
Those two torpillage methods,
the last one based only on
direct and suggestive
questions, the former one on
two external symptoms, are
most dangerous, especially for
the beginner, as almost
invariably a suggestionable
patient impressed by the
physician, will find present all
the symptoms about which he
is asked.
One may feel why such
physicians do need to give
drainage remedies in addition
to four or five others, to be able
to obtain something we will call
a result.
It is blunderbuss shooting,
ladies and gentlemen, for
beginners of course a strong
temptation, may be even an
amusing method, even perhaps
a necessary stage to something
better. But the practitioner
who is not afraid to work his
materia medica, to study his
repertories and to understand
his Organon, will be able with a
single shot-may I say, after the
manner of my own fellow-
countryman, Wilhem Tell, "with
one arrow" -to obtain the
desired results, because his
methodical and serious
interrogation will give him a
full picture of the disease,
about which he will be able to
consider what represents really
the patient on the whole.
 I will consider this matter later
on.
We have classified our work in
the following way : -
(a) What are the bases of
interrogation ? (That is, on
what basis are the questions to
be asked ?)
(b) What is the best
classification to adopt in
interrogation ?
(c) How to formulate the
questions, in which way to be
formulated ?
(d) How are we to know if
questions are well asked, and
consequently well answered ?
 I say again that I will not
present here a full
questionnaire, but the best and
shortest questionnaire
calculated to obtain the
maximum results, the time
being limited. And this will
constitute the current
questionnaire of the physician
having at his disposal twenty to
thirty minutes for the
interrogation and examination
of his patient.
What are the bases of
interrogation ?
That is on what basis are the
questions to be asked ?
 To this, I will answer that
those questions must be ruled
by the homoeopathic semiology
concerning the value of
symptoms, considering always
the patient in general, on the
whole, to see the patient in his
totality and not in his parts;
not the disease, not the
pathology, not the diagnosis,
but the patient, living feeling
and thinking.
Of course, I will not consider
the anamnesis, the part
concerning hereditary and
personal antecedents; all
references which are a part,
evidently, of the interrogation
of every patient, but not
necessary to develop, as they
offer absolutely no difficulties
to the physician in comparison
with the active interrogation,
after the patient has exposed
freely all his feelings and
symptoms to his physician.
Everyone should be very
conversant with the masterly
exposition given by Kent in his
23-26 lectures on his
Homoeopathic Philosophy.
What classification is to be
adopted ?
On one side, we have the
counsel given by Hahnemann in
his Organon, then the
remarkable study of Kent in his
32-33 chapters concerning the
value of symptoms, then the
numerous classifications
established by Grimmer,
Gladwin, Green, Loos, Margaret
Tyler, Del Mas, Stearns, to
quote only those worthy of
notice. It is impossible to
discuss here every one of the
proposed classifications, the
broad lines of which,
nevertheless, converge in the
same direction : First mental
symptoms, then general
symptoms, then cravings and
aversions, then sexual
symptoms, including M.P. , and
finally sleep and dreams.
After this list come the local
symptoms related to the
organs.
But if, theoretically, this
classification seems the most
acceptable, practically, it is not
so; and about this experience
has proved to me precious
teachings.
In my early days of practice, I
used always first to ask the
mental symptoms, but very
soon I came to see I was
mistaken.
In fact, an unknown patient,
knowing nothing whatever
about homoeopathy, feels hurt
or resents this interrogation
about his character when he
comes to see you for a
headache, a stye or an
enlargement of his prostate.
Very often too, he imagines
that you are mistaking him for
a mental case, and that you are
making a disguised
psychoanalysis. Very shortly,
the physician sees by the
patient's way of answering, his
attitude and his look, the error
the himself is committing.

On the other hand, to make

the interrogation of the mental
symptoms at the end of the
questionnaire is also a mistake.
Because then the patient is
tired and has his mind on the
fact that those questions have
nothing to do with his disease,
and have no relation whatever
to it. Thus he answers shortly,
curtly, badly, manifesting very
soon his impatience and his
desire to get rid of the inquiry.
This is why experience has
taught us that it is preferable
to begin with the general
symptoms, then to ask the
questions related to the
mentality, explaining rapidly to
the patient the difference here
between homoeopathy and
allopathy, the former being able
to compare these symptoms
with those obtained on the man
in health, because of
homoeopathic experimentation
only supposed to be made on
the healthy man, and not, as
the ordinary school does, on
animals.
Then come the aversions and
alimentary cravings, then the
symptoms related to the sleep
and dreams, and finally, for
ladies, those concerning the
menses if it is possible to do so.
The questions related to the
sexual sphere can almost never
be asked in the first
consultation, especially in a
short one. Sometimes it can be
touched on when one is asking
about heredity or personal
history.
To close with, it is good to
reconsider some of the
symptoms predicated by the
patient, especially those
considered as rare, peculiar and
striking, strange or uncommon,
and to examine their
modalities in order to see if
really they deserve important
consideration.
Here is the list of symptoms to
be taken into consideration : -
(1) General Symptoms. -
Horary aggravation, periodical
season aggravation; by the
weather : dry, wet, cold, hot,
fog, sun, wind. Changes of
weather : snow, storms;
aggravation of temperature,
draughts of air; tendency to
take cold, desire or aggravation
by the air : aggravation of
position, by motion or by
repose, riding in cars, sailing,
prandial aggravation, appetite
and thirst, aggravation by
certain foods, wine, tobacco,
drugs, vaccinations, cold or hot
baths, seashore or mountain,
clothing, wounds slow to heal,
haemorrhages, fainting in
rooms full of people, laterality
(side affected).

(2) Mental Symptoms. - The

mental state of a human being
can, on the whole, be resolved
into four or five essential
points : life or death, emotions,
fears, irritability and sadness;
and all these under hyper or
hypo-manifestations.
The theoretical classification
would be thus : -
(a) Symptoms relating to the
instinct of self-preservation
(death, suicide, and c.).
(b) Ailments from grief,
vexation, mortification,
indignation, anger, bad news,
disappointed love, and c.
(c) Fear, anguish, anxiety.
(d) Irritability, anger, violence,
impatience, hastiness.
(e) Sadness, weeping, despair,
effect of consolation.
Then, certain symptoms
having no relation to these
categories as, for example,
jealousy, absent-mindedness,
concentration, mania of
scruples and as to trifles;
modifications of the character
before, during and after
menses.
Instead of followed this
questionnaire in the above-
given order, it would be better
to follow it in the reverse order;
because one must begin with
symptoms rather superficial
and which do not go too deep
into the mind of the patient,
which latter is ultimately to be
discovered.
For the practitioner who has
his eyes open as well as his
understanding, there are
numerous mental symptoms
that can be observed without
saying one single word, as for
example : timidity, loquacity,
egotism, easily offended,
embarrassed, exhilarated,
easily startled, haughty,
needless, suspicious, laughing
immoderately, even some
memory troubles, quiet or
hurrying disposition, sighing
patients, restless, weeping
when speaking about certain
symptoms; also, there are
certain symptoms of which
there is no need to ask the
patient because he will tell
them himself, either because
he came for this purpose, or
suffers really very much on
account of it. Very often, also,
friends or relatives may have
written of those symptoms to
you before the consultation, if
they are sufficiently striking,
as, for example, the refusal to
eat, the desire to escape,
sometimes even fear of suicide,
and c.
(3) Aversions and Alimentary
Cravings. - (a) Sweets, pastry,
delicacies; (b) salty things : (c)
sour, strong and spiced food;
(d) greasy and rich foods,
butter; (e) bread, fruits, fish,
meat; (f) milk, coffee, wine,
beer; (g) state of thirst and
appetite.
(4) Sleep and Dreams. - (a)
Position of the body, head and
extremities during sleep : (b)
what the patient is doing
during sleep : laughs, starts,
talks, shrieks, weeps, is afraid,
grinds his teeth, keeps eyes or
mouth open, and c.; (c) quality
of the sleep : hours and causes
of wakings, of sleeplessness and
sleepiness; (d) all about dreams.
(5) Symptoms Concerning the
Menses and the Sexual Sphere.
- (a) M. P. too late, duration,
abundance, colour, quality,
consistence, more day or night,
influence of the character or
other particular symptoms
before, during and after the M.
P., shortly all about what we
call the "Molimen."
(6) Rare, strange and peculiar
symptoms indicated by the
patient, with their modalities
and related phenomena and the
making more precise of the
main symptoms for which the
consultations was made.
Now, let us see this theoretical
list of questions realized in a
practical way, according to the
Hahnemannian principles. I
have just purposely chosen
questions corresponding to
repertory rubrics, which are of
a middle size and containing,
when possible, two or three
degrees of remedies (italic and
heavy type) and avoided the
longer paragraphs like those of
sadness, night aggravation,
thirst, and c... which contain
almost all the remedies.

Here is now the real

questionnaire to be submitted
to your criticism : -
How to formulate the questions
It is not a bad procedure to say
to the patient at this time : "I
have listened to you until now
without interrupting you, now
we will change the role, and
please don't be astonished if I
seemingly stop you while
answering, to ask you the next
question, because this will
mean that the answer I was
waiting for is obtained. Do not
believe that by so doing, I
under-estimate your answer,
but this only signifies that a
longer explanation will bring
neither useful nor new details
in the case."
General symptoms
(1) At what time in the twenty-
four hours do you feel worst ?
(2) In which season do you feel
less well ?
(3) How do you stand the cold,
hot, dry, wet weather ?
 (4) How does fog affect you ?
(5) What do you feel when
exposed to the sun ?
(6) How does change of
weather affect you ?
(7) What about snow ?
(8) What kind of climate is
objectionable to you, and where
would you choose to spend
your vacation ?
(9) How do you feel before,
during and after a storm ?
(10) What are your reactions to
north wind, south wind, to the
wind in general ?
(11) What about draughts of air
and changes of temperature ?
 (12) What about warmth in
general, warmth of the bed, of
the room, of the stove ?
PAGE 15
(13) How do you react to
extremes of temperature ?
(14) What difference do you
make in your clothing in winter
?
(15) What about taking colds in
winter and in other seasons ?
(16) How do you keep your
window at night ?
(17) What position do you like
best-sitting, standing, lying ?
(18) How do you feel standing a
while, or kneeling in church ?
 You remark that this question
of the standing position comes
again. You will find this way of
repeating it is intentional here
and there in the questionnaire.
It is a very useful and
necessary procedure for
verification.
(19) What sports do you engage
in ?
(20) What about riding in cars
or sailing ?
(21) How do you feel before,
during and after meals ?
(22) What about your appetite,
how do you feel if you go
without a meal ?
 It will be often answered to
you : "I can easily go without a
meal but I never can stand a
big dinner or banquet." A
question that you did not ask,
but which demonstrates that
the question was well
formulated as it made the
patient talk and left him his
own choice.
(23) What quantity and what
do you drink ? What about
thirst ?
(24) What are the foods that
make you sick, and why ?
(If the patient does not answer
after a while, just ask looking
closely at him : sweets, salty
things, sour, greasy food, eggs,
meat, pork, bread, butter,
vegetables, cabbages, onions,
fruits ?)
(25) What about wine, beer,
coffee, tea, milk, vinegar ?
PAGE 16
(26) How much do you smoke
in a day, and how do you feel
after smoking ?
(27) What are the drugs to
which you are very sensitive or
which make you sick ?
(28) What are the vaccinations
you have had, and the results
from them ?
 (29) What about cold or warm
baths, sea baths ?
(30) How do you feel at the the
seaside, or on high mountains
?
(31) How do collars, belts and
tight clothing affect you ?
(32) How long are your wounds
in healing, how long in bleeding
?
(33) In what circumstances
have you felt like fainting.
Mental symptoms
(34) What are the the greatest
griefs that you have gone
through in your life ?
(Quite often the the patient
will lower the head and look
quite moved, and a kind word
of the doctor will be needed. It
is why, as soon as the extra-
version or self-expression has
been made, this following
question will make the patient
look at you again in an
astonished way, and sometimes
with a happy smile) :
(35) What are the greatest joys
you have had in life ?
These two questions are very
important and, when asked at
the right moment, will pave the
way for the coming questions.
(36) At what time in the
twenty-four hours do you feel
in the blues, depressed, sad,
pessimistic ?
(37) How do you stand worries
?
(38) On what occasions do you
weep ?
(If the patient cannot answer,
we will just ask-not losing for
one second his expression-
music, at reproaches, at which
time of the day ? Certain
people can refrain from
weeping, some others cannot).
(39) What effect has
consolation on you ?
If the answer is : "It depends
by whom," you may say : "Just
by people you like," because
very often people say they do
not like to be comforted
because they think of members
of their family they hate.
(40) On what occasions do you
feel despair ?
(41) In what circumstances
have you ever felt jealous ?
(42) When and on what
occasions do you feel
frightened or anxious ?
(If the patient does not answer,
ask : Some people are afraid of
the night, of darkness, to be
alone, of robbers, of certain
animals, of death, of certain
diseases, of ghosts, to lose
their reason, of noises at night,
of poverty, of storm, of water.
According to the way of
answering, you will at once see
the real fears, and be able to
discriminate those which are
not to be taken into
consideration.)
(43) How do you feel in a room
full of people, at church, at a
lecture ?
(44) Do you go red or white
when you are angry, and how
do you feel afterwards ?
(45) How do you stand waiting
?
(If he does not answer, just
question him about
impatience.)
(46) How rapidly do you walk,
eat, talk, write ?
(47) What have been the
complaints or effects following
chagrin, grief, disappointed
love, vexation, mortification,
indignation, bad news, fright ?
(48) In time of depression, how
do you look at death ?
Certain patients have
presentiments of death,
thoughts of death, even desire
to die; others have tendencies
or desires of suicide, some
would be courageous enough to
do it, others are afraid, in spite
of desiring it.
(49) Tell me all about over-
conscientiousness and
overscrupulousness, about
trifles; some people do not care
about too much details and too
much order.
(50) What about your character
before, during and after menses
?
During all these questions, the
physician must by king words
put his patient at ease, but
must watch him very closely,
without the patient's noticing
it.
Food cravings and aversions
(a) What is the kind of food for
which you have a marked
craving or aversion, or what are
those that make you sick or
you cannot eat ?
Here also, it is very important
to watch very carefully the
expression of the patient,
because it is very easy to read
on the face by observing the
corners of the mouth coming
down if the patient is
disgusted, or on the contrary
coming up with big shining
eyes if the craving or a strong
alimentary attraction is felt.
Then, one can add, for example
:-
(b) What about pastry and
sweets ?
(c) What about sour or spiced
food ?
(d) What about rich or greasy
food ?
(e) How much salt do you need
for you taste ?
(f) What about thirst and what
do you drink ?
Coffee, wine, beer, and c. ...
Of course, all those questions
have been already asked in the
beginning of the questionnaire,
but by asking them again, you
are able, by doing some cross
questioning, to determine if
they have been answered well
the first time or not.
Sleep
(a) In which position do you
sleep, and since when that
position ? Where do you put
your arms, and how do you like
to have your head ?
(b) What are you doing during
sleep ?
(If the patient does not answer,
you add : Some people speak,
laugh, shriek, weep, are
restless, are afraid, grind their
teeth, have their mouth or
their eyes open.)
(c) At what time do you wake
up, or when are you sleepy ?
What makes you restless or
sleepy ?
(d) What about dreams ?
For ladies, menses
(a) At what age did they begin
?
(b) How frequently do they
come ?
(c) What about their duration,
abundance, colour, odour, what
about clots, and c.
(d) At what time in the twenty-
four hours do they flow most ?
(e) How do you feel before,
during and after menses ?
Retaking the case
It is necessary to take through
again the symptoms told by the
patient, those which were
strange, rare and peculiar, for
example : Sensation of a nail in
the head; feeling of a string
drawing back the eyeballs,
feeling of a lump in the throat,
a griping feeling in the heart,
feeling of a construction like a
bandage around the knees.
All those must be carefully
noted, in order that the
physician may ascertain
himself that there are no
occasional causes provoking
them.
Then, about some other
outstanding symptoms; it is
important to take the
modalities concerning the
aggravation or amelioration by
motion, repose, heat or cold, in
or outdoors, position, eating,
pressure, and c.
How now, to know if the
questions are well asked and,
consequently, well answered ?
There are two ways of knowing
:-
 (1) During all the
interrogation, the physician
must carefully watch his
patient and observe the way he
answers. An in La Fontaine's
fable, the "ramage" must accord
with the "plumage", i.e. , the
intonation of his voice, the
play and expression of his
physiognomy, especially in
mouth and eyes, must be
carefully observed and grasped.

A patient who says, "Yes, I like

meat, but I don't drink milk
with pleasure" without change
of expression indicates no
symptom at all. But if he says,
"Oh, I cannot do without meat,
and I hate milk," saying this
with a happy face and an
enlargement of the eyes
regarding meat, but regarding
milk with a wry face, while
turning the head to the side,
you then know you have good
symptoms.
Of course, beside the question
of useful and useless
symptoms, in the useful
symptoms there is still a
gradation : There are very
marked-and also less important
ones-but this comes into
consideration only if we have
quite a number of them. On the
occasion of the first
interrogation, we will have
little to do with this
consideration, and be happy to
have only a sufficient number
of symptoms.
(2) During the interrogation,
the physician is carefully
noting in writing all the
answers of his patient. He
underlines or marks with a
cross those which are of
importance to be further cross-
questioned or verified in order
to be assured that the patient
has really well understood and
well answered the question.
This is to put it to the proof.
Then, we have seriously to
consider making quite a
number of cross-questions. For
example : -
If the patient has told you that
he feels worse after meals, you
may ask him : "If you have an
important matter to decide or a
delicate letter to write, or some
important call to make, would
you do it at 2 p.m. ?"
If he told you that he was
sleeping with his hands
outstretched over his head, you
may ask him : "During sleep,
would the warmth of the bed
clothes cause your hands to
perspire ?"

If he tells you that he hates

greasy food : "Do you prefer the
fish with sauce, or fried, or in
black butter ? And how do you
like bacon ?"
If he says that pity or
consolation aggravate him, ask
him if he has a friend to whom
he gives his confidence when
he is worried.
Should he assert he is never
angry, ask him if he is red or
white when angry. Very often,
the answer will be : "Red, but it
passes rapidly away."
To be certain that some
symptoms are to be retained
and good, these few above-
mentioned examples will
suggest you to know how to ask
these questions.
Very often, a patient says that
he is very impatient, but you
can observe that, after having
sat for half an hour in your
waiting room, he walks calmly
into your consulting room and
responds most calmly to your
questions.
 Another will tell you that he is
even-tempered, but you learn
that he is divorced or that he
has left his family because of
incompatibility of character.
If one, two or more remedies
come to your mind after such
an examination, and you are
hesitating between this one and
and the other, that is the only
occasion where one is
authorized to ask some
questions, always based on the
same principles, but relative to
the symptoms characteristic of
the remedy suggested, always,
obviously trying to avoid direct
questions and the torpillage
methods already referred to.
Very often, it would be better
and more prudent to give S.L. ,
rather than to administer a
remedy that is not absolutely
indicated, about which we are
not sure, and have the courage
to await the second
consultation in order to
complete the picture of the
disease.
The purpose of this paper is
not to examine what is to be
done with the symptoms thus
obtained or how to classify
them, or how to find the
corresponding similimum in
the materia medica. If one
follows this classification, the
second part of the work, the
grading and classification of
symptoms would be nearly
completed for the physician.

I observed that certain

questions are always answered
in the same way, by almost
everybody, and consequently I
consider those bad questions.
Sometimes, too, the patient
indicates some symptoms
which seem very important,
and which he has not in reality.
He will inform you that he has
some abilities or qualities, and
you observe just the contrary.
That is why I think that a
questionnaire established with
method and reflection is
indispensable, and that is why I
have submitted it to you this
evening, desiring to know your
own experiences and what are
the questions to suppress, to
develop, or in which order to
ask them.
I always try to practise the
advice of my esteemed teacher,
Dr. Austin of New York, who
told me that a good physician
should be able in the first
consultation to make his
patient laugh or cry, and so
doing, he was assured that the
contact was made, as he was
able to put in vibration the
living human being who was
asking for help.
If, in the allopathic
consultation, as we were told
and taught in our allopathic
studies, one must not believe
his patient, must ask the
fewest questions possible and
believe only what could be
observed by the physician
himself, this is quite different
in homoeopathic consultation,
because the homoeopathic
physician must do his best to
create around him an
atmosphere of confidence and
benevolence, and try to
comprehend especially the
human being who comes to be
helped. The most important
task in homoeopathy is to
individualize and to
discriminate, but
individualization and
comparison are inseparable,
and there is a difference in the
nature of things most similar, a
point that must be carefully
considered.

The substitution of one

remedy for another cannot be
thought of or entertained in
homoeopathy, and Kent repeats
what Hahnemann says : "In
homoeopathy, medicines can
never replace each other nor be
as good as another."
One cannot repeat enough that
if the first examination is well
established, well made, well
realized and well interpreted,
the search after the remedy
will be but a le thing, and if the
case has been well taken and
the remedy based really on the
most important symptoms, all
this being rightly done at the
first consultation, the work for
the physician will be
considerably easier because he
has found the thread and has
only to follow it. On the
contrary, these treatments
based on local examination or
insufficient interrogation will
oblige you to zigzag perpetually
and, instead of feeling your
prescription based on an edifice
with large foundations, you
have the impression of a cork
floating on the ocean.
 Nothing is more culpable than
to say, "Thuja is your remedy,
because I see that you are
perspiring on your upper lip !"
(the repertory has seven
remedies for this sole
symptom) or, "You are Lachesis
because your lips are blue and
varnished," or "You are a case
of Condurango because you
have cracks in the corners of
the mouth."
If I speak here about
Condurango, it is to confess my
mea culpa.
Eleven years ago, when I came
to the London Homoeopathic
Hospital for the first time, I
was very kindly authorized to
follow the visiting physician
round the wards. It happened
to be the day of Sir J. Weir. I
did not know him; was he a
good or a bad homoeopath ?
Did he know anything about it
? Very soon I would be able to
decide for myself.
Just arrived from Geneva,
after having studied
homoeopathy in the
"Catechism of Dr. Dewey" and
the "Organon of Hahnemann," I
thought I had the whole of
homoeopathic knowledge and
wisdom. This was all the more
so as I had already treated
some cases with success,
having received the benefit of
the experience of a physician
who had given me advice in
some rather more difficult
cases.

After having seen some

patients, we stopped before a
bed where a new patient had
just come, and I still remember
and can see Sir John Weir, his
head bending towards the
patient, asking innumerable
questions. As soon as one was
answered, another was quickly
formulated.
In the beginning, this
impressed me, but I rapidly saw
that the patient had quite a red
patch on the right corner of her
mouth with a deep crack.
This reminded me of a similar
case where I was puzzled about
the indicated remedy and
where a homoeopath told me :
"It is a plain Condurango case."
As soon as Sir John Weir was
through, feeling the marked
superiority of my knowledge
and seeing that after this long
and elaborate interrogation he
had not mentioned any
remedy, I told him, "Don't you
see that it is a plain case of
Condurango ?" Very kindly he
turned his head and, without
irony or reproach but bowing
his head, he said very politely :
"I thank you, Sir; we will
discuss this later on." Everyone
around turned on me with an
appreciative look at my
cleverness.
After the visit we went down,
and I then had my bad quarter
of an hour-(mauvais quart
d'heure)-my cold touch.
"Well," said Sir John, "why is it
a case of Condurango ? "Simply
because of this crack in the
corners of the mouth." But,"
said he, "what about all her
other symptoms ?"
"Oh, they are of no
importance. If you look
carefully at her tongue, you
surely will find some denuded
areas and also some gastric
symptoms and this will confirm
and prove your Condurango."
"Well, well," said Sir John, "let
us see." He simply opened a
large book like the Bible and
asked me if I knew it. "No." said
I; "have homoeopaths written
such large books ?" "It is the
Repertory of Kent," he replied,
"and see here that twenty-two
remedies stand beside
Condurango for cracks in the
mouth."

With kindness but persuasion

he very rapidly pulled to pieces
all my illusions and my
assurance.
He convinced me that this was
a case of Sepia, explaining to
me patiently why among the
many symptoms there was a
discrimination to be made, how
interesting and of the utmost
importance a hierarchic
classification was to be made
and that rules and principles
were to be followed for such a
study, why Sepia was the
remedy for this patient and not
Condurango. It was the most
beautiful lesson in modesty
that I ever received.
I shrivelled inside and
perspired outside. I had
brilliantly demonstrated my
deep and profound ignorance
and unveiled my incapacity.
But I probably was still not
baptized, as when I went to
New York, Dr. Austin at my
first interview asked me which
were the homoeopathic
remedies for rheumatism and,
after I had spoken about Rhus
and Bryonia, he gave me the
last blow to my knowledge,
saying simply : -
"Well, my brother, I think it
will be necessary to study
homoeopathy."
Thus I learned to live out this
famous sentence of the
philosopher : "All I know is,
that I know nothing !"
In the same way, if your
interrogation is not based on
the essential principles of the
homoeopathic doctrine, if you
are led by your caprice or fancy
only and interrogate just about
the symptoms the patient is
complaining of, you will make
only patchwork and end in
failure. This failure would only
demonstrate your own
ignorance.
If a patient presents herself to
you with varicose veins and
pain in the lower limbs and you
give her Fluoric acid Calcarea
fluorica or Hamamelis, you will
have treated only the vascular
walls, but not all the varicose
patient. This is only a travesty
of homoeopathy. It is the
application of a remedy to a
diagnosis, it is allopathic
prescribing with homoeopathic
remedies.

If the patient adds that she

has agglutinated eyes in the
morning and that her hairs are
falling away, you would think
at once of Graphites or
Sulphur. But if she adds still
further that she is bleeding
from the nose, is very thirsty
and craving acids, you will turn
your preference to Phosphorus.
You may then ask if she feels
an empty sensation at the
stomach and suffers from
heartburn, in order to confirm
Phosphorus in your mind. But
at the next consultation, she
will confess that she is
suffering from a very distended
abdomen, that she is
constipated, her sleep is
unrefreshing, liking better to be
outdoors, so you will say : "Now
it is clear, it is Lycopodium,"
and so on, continually. Like the
wandering Jew, you err in this
labyrinth, losing your head and
often your patience. Why ?
Because you have not made a
systematic and methodical
examination, established
according to the rules formerly
given.
If you go through the short,
but quite full interrogation
given before, you will learn that
this patient has her menses
more at night, and the study of
this case will show you very
rapidly and clear as water that
only one remedy covers all
these symptoms, except the
varicose veins, it is true, and
here the remedy is Magnesia
carbonica, not for or against
the varicose veins, but for the
patient who will be cured, and
the varicose veins besides.
I described this case en
passant because it is precisely
one of my successful cures of
varicose veins. The patient was
cured, her varicose veins
disappeared, like all the other
miseries : gastritis, epistaxis,
and .... You will not be
astonished to know that this
depressed patient is now
cheerful and enterprising, and
that the beautiful mass of her
black hair justifies her
legitimate pride.
 The homoeopathic
interrogatory includes, as you
see, rules to be followed and a
technique to be observed.
This interrogation, made
according to the suggestions
given in the beginning of this
paper, will permit of the
physician individualizing his
case after an interrogation well
made, a precious stone in the
walls of the therapeutic edifice.
Physicians cannot sufficiently
avoid every partiality to
influence the patient from
whom be has to elicit
symptoms, related to remedies
of which he may think, and
which come to his mind by the
first answer given by the
patient. "He has a key to the
patient and examines the
patient by the key, that is, as
Kent says, by the drug, a bad
practice and never to be
resorted to except as a dernier
ressort and in stupid patients."
Doing so, we are on the wrong
track which will end only in
pitfalls.
The more objective the
symptoms, the more they are
to be observed of the patient
dead, in his coffin, the less
value have they. On the
contrary, the more they
express the living, feeling,
thinking human being, the
more important they are.
To establish a questionnaire
really useful to the busy
physician for his daily practice,
a questionnaire based on the
pure doctrine of homoeopathy,
such has been my purpose this
evening. My endeavour will be
more than fully rewarded and
compensated if I may be told
what further to add, to take
away, to modify or to render it
more perfect.
 Knowing the valued knowledge
and opinions of the members of
your Society, I submit this
most important question to
your esteemed consideration.

Pharmacopollaxy
This term is derived from the
Greek pharmacon, remedy, and
pollaxis, many times, and
means really, repetition of the
remedy.
It is not my purpose to develop
here all the modalities
concerning this controversed
question, which has been also
applied so differently, but to
place myself to a higher point
of view, and here I will put the
question in those terms : What
do we mean by the repetition of
the remedy ?
At first, it seems that this
question is very simple and
clear, nevertheless it has been
so much obscured that one
could find commonly in our
school this too frequently used
expression : the repetition of
the dose. What signifies this
locution ? Dr. Jahr asserts that
the administration of the
remedy in watery solution does
not constitute a repetition, of
the dose. This is really the way
to darken and complicate this
subject. No, the fact of giving a
remedy in a successive manner,
no matter in which form, is not
- homoeopathically speaking - a
fraction of this remedy, but
really the repetition of the very
remedy each time it is given.
This is why Hahnemann, in his
first volume of the Materia
Medica, in the French edition,
stipulates in his eighth
paragraph this very question,
writing as the title of his
chapter :
On the repetition of
homoeopathic medicaments.
The master could have said in
this title : the repetition of the
doses, if it had been his
opinion. So it seems clear that
in his very thoughts, every
time one is repeating a dose he
is repeating the remedy and
the whole remedy. This chapter
begins with those words :
In the Organon I have insisted
on the necessity never to give
at the same time but one single
dose of a well chosen
homoeopathic medicament,
and to let it have all the
necessary time to develop its
action.
Evidently here the words
single dose signify a remedy
given at one single time. Of
course, if one repeats many
times this dose, he repeats as
frequently this remedy.

One gives each time what

represents the whole of the
remedy, and not a fraction of
it. Moreover in the chronic
diseases, when we repeat the
"dose at long intervals, do we
not give each time the remedy
?
A little further in this chapter,
Hahnemann says again :
Thus, a primitive psoric
eruption, on a patient which is
not too much weakened, even if
it has invaded the whole body,
can be perfectly cured through
one dose of Tinct. Sulph. Xe
(30th dil.) repeated every seven
days in the course of ten to
twelve weeks (consequently
with 10 to 12 globules).
This term consequently, in
this parenthesis explains the
thought of the master. Those
who know and understand the
writings of Hahnemann know
very well that for him each
globule contains the remedy on
the whole.
Here are again some very
intelligible and explicit words
about it :
But if the physician has to give
a same substance more than
one time, what is indispensable
in order to cure serious chronic
diseases, he should be careful
to change each time the degree
of dynamization, even very
slightly, the vital force of the
patient can support the same
medicament even at short
intervals an incredible number
of times, one after another, and
this with the greatest
success....
Dr. Mure, in his Doctrine of
Rio, is still clearer and more
precise :
One single globule dissolved in
a glass of water and taken by
spoonfuls, every twelve hours,
constitutes as many doses as
the number of spoonfuls taken.
In homoeopathy nothing will
increase the energy or
intensity and the rapidity of
actions of remedy by
augmenting or multiplying its
quantity.
At last, the spirit of our
doctrine teaches us that in the
series of potentization, each
vial contains the remedy on the
whole, and every one of the
hundred drops of the vial
contains the whole remedy, to
this degree in the series.
We must never forget, as has
been said already by Granier, a
French homoeopath, that our
remedies are not the so-called
infinitely smalls, and we must
forever let this faulty locution
disappear. Our remedies are
dynamic agents, like the
miasms, and ought to be called
miasmoid. The presence of
matter is here absolutely out of
the question.
*The Chronic Diseases, IId
French ed., preface, p. V.

The doctrine of the repetition

of the remedy is virtually
contained in the following
sentence taken from the
writings of our master :
It goes without saying that
before the physician permits
himself to repeat the dose of a
medicament, he should be
absolutely convinced that it
was perfectly well chosen and
homoeopathically indicated.
 One should never more say
repetition of the dose, but we
should say repetition of the
remedy.
Every time Hahnemann speaks
about the repetition of the
doses, it is only a negligence of
language, also every time he
speaks of a medicament
instead of a remedy. In fact,
the medicament, through
experimentation or proving,
produces the phenomena and
pertains to pathology. The
remedy on the contrary,
through experiments
neutralizes the symptoms and
pertains to nosology. To the old
school, the remedy is a remedy
a priori, without anything prior
to it, but for our school the
remedy is considered as such
only a posteriori, having as its
starting point its study on the
healthy man. To the
homoeopathic school, every
remedy before its application
must have been a medicament.
Of course, it is not our purpose
on this occasion to give all the
wise advices resulting from the
vast experience of the master
concerning the repetition of
the remedy. For those who
have taken the time to read
carefully and to study the
preface of the Chronic
Diseases, the Lesser Writings,
the preface of each volume of
the Materia Medica Pura and
the Organon, it is very clear to
understand that our master has
said almost everything
touching the pharmacopollaxy.
In conclusion, we can say that
:
1. The ideal to be realized, as
Hahnemann said, would be to
treat every disease with one
single remedy and one single
dose. Of course, this supposes a
very careful study and quite
perfect correspondence of the
remedy to the sick patient.
2. The repetition of the
remedy requires positive and
strong reasons. The principal
reason of the repetition of the
remedy must be based on the
vital reception, on the
individual reaction which is
called susceptibility of the
patient, the less sensitive is
the patient, the more one is
permitted to repeat.
3. The repetition of the
remedy depends also on the
nature of the remedy.
 4. The repetition of the
remedy must be submitted to
the nature of the disease as
well as to the nature of the
remedy.
5. The repetition of the
remedy depends on the
duration of the action of the
remedy. Everyone knows that
Calcarea has a longer duration
of action than Ignatia.
6. The repetition of the
remedy depends on its
dynamization (potency).
7. In chronic diseases one
must be very careful with the
repetition and you will never
regret to repeat at long
intervals, rather than too
shortly.
8. In acute diseases experience
teaches us that the repetition
can be done more frequently.
Nevertheless many beautiful
cases have been cured with one
single dose of a few doses.
(High fever, great pain, great
fear, strong fits of anger or
emotional excitement shorten
the action of a remedy and
indicate repetition.)
9. Hahnemann has repeated :
And nothing is more guilty
than to repeat blindly and
routinarily a remedy, one must
be guided always by the
reaction of the patient and
observe carefully the direction
and course of the symptoms,...
One must be very careful not to
use prevision in the indications
of the homoeopathic remedies
and should always base his
prescription on the actual
totality; it is impossible to
prescribe different remedies in
advance, either mixed or
alternated, for this is a practice
absolutely aside from the
principles of our doctrine, it is
only empiricism, and the work
of the most pitiful routine....
The homoeopathic physician
ought to examine the
symptoms every time he
prescribes; otherwise he cannot
know whether the same remedy
is indicated a second time, or
whether a medicine is at all
appropriate 2.
10. The most important thing
about the repetition is the
careful observation of the
patient and disease, so as to
ascertain precisely which is
which, pertains to the one or
the other. More harm has been
done by repeating doses than
by giving too rarely a remedy.
One is amazed to observe all
the possibilities of the single
dose when the field for its
action is free and no
interference perturbs its
possibilities. There are great
forces that we still do not
dream of, and one impulse, as
small as it seems to be, has its
place in the right moment,
according to the law of nature,
and can bring results which are
really extraordinary.
11. We must add, as
Hahnemann says; There are
exceptions to the rule, which it
is, however, not the business of
every beginner to discover.
The repetition of the remedy is
one of the most important
things after the careful
selection of this remedy and its
careful prescription. It needs
not a worried, nervous or
restless physician; but very
careful observation, patience,
knowledge and also courage are
the qualities required for a
master in prescribing. The
homoeopathic physician is
surely the one who must be
most careful about this
question and who is able to
learn very much if he knows
how to watch and wait, after
having given his remedy. No
routine must preside to the
decision of such a
homoeopathician, for he must
act only according to law and
principles, as Kent beautifully
describes it in his chapter
concerning the second
prescription :
No repetition is to be
considered unless the record
has been again fully studied,
unless the first examination,
and all the things that have
since arisen, have been
carefully restudied that they
may be brought again to the
mind of the physician 3.