SUBJECTIVE SYMPTOMS

‘Subjective symptoms’ are the symptoms ‘felt’ or ‘experienced’ by the individual, without the involvement of sense organs. Only gross level pathological changes can be observed with sense organs, assisted or not assisted by other material means. Exact molecular errors underlying pathology cannot be observed, but can only be ‘sensed’ by the ‘consciousness of the individual. Information regarding these cascading micro-level pathological molecular errors are instantly conveyed to the related brain centers through the mediation of complex internal biochemical signaling system and neuro-endocrine system. These biochemical signals initiate certain neuro-chemical processes in the brain centers, which are ‘experienced’, ‘felt’ or ‘sensed’ by the consciousness as diverse groups of ‘subjective symptoms’.  As such, ‘subjective Symptoms’ represent the minute pathological molecular errors, and can be used as effective indicators for understanding the exact molecular processes underlying the pathological derangement.

Subjective symptoms may appear much before objective manifestations of pathology. Diseases with same objective manifestation may be accompanied with different subjective symptoms, indicting that they differ in some molecular level processes in the individual, demanding different similimum. Obviously, ‘subjective symptoms’ are the most reliable guides in our search for an appropriate similimum.

‘Objective Symptoms’ are those ‘observed’ by the patient himself, or by the onlookers, with their sense organs aided or un-aided by accessory means. Observations through physical examinations and laboratory investigations also belong to this class. ‘Objective symptoms’ also represent the ‘pathological derangements’, but only those which have advanced into gross observable magnitude. Hence, ‘objective symptoms’ cannot reflect the exact ‘molecular basis’ of pathology. In most cases, ‘objective symptoms’ may also be associated with certain ‘subjective symptoms’, which give real indications to the actual micro-level processes behind. Observing objective symptoms along with associated subjective symptoms help us to identify the exact molecular errors, which is necessary for selecting appropriate similimum. Such objective symptoms, appearing with related subjective symptom can be classified as a subjective symptom. Here lies the importance of sensations, modalities, concomitants, desires and aversions appearing in association with objective symptoms. Objective symptoms, in the absence of associated subjective symptoms are not of much importance in deciding similimum. When we observe an objective symptom, he should look out for ‘how it is felt’ by the patient.

For example, most ‘aggravations’, ‘ameliorations’, ‘sensations’, ‘desires’, ‘aversions’ and ‘concomitants’ accompanying ‘physical’ symptoms are ‘subjective’ but not ‘mental’. ‘Itching’ , ‘burning’, ‘pain’, and all such symptoms are ‘subjective physical’, not ‘mental’. ‘Aggravation by cold application’, ‘pain amel by rest’, ‘pain amel by motion’ etc are also ‘subjective physicals’.

Whatever method we use for grading of symptoms and repertorization, ‘Subjective Symptoms’ will come on top rank.

‘Subjective Symptoms’ may belong to four sub-groups: Subjective Mental General, Subjective Mental Particular, Subjective Physical General and Subjective Physical Particular.