In homeopathy prescription is done on the totality of the characteristic symptoms, as Hahnemann said in the Organon. Prescription on a single symptom while ignoring other characteristic symptoms is not good homeopathy. So what is the role of keynotes? The job of the homeopath is to find the remedy which is most similar to the symptoms of the patient. But because of the finite capacity of the mind, the homeopath can only consider a certain number of symptoms and remedies when selecting the most similar remedy. The role of keynotes is to guide the homeopath in selecting symptoms and remedies. If a symptom is clearly and strongly expressed by the patient and that symptom is a keynote of a remedy, that remedy becomes a candidate to be considered when choosing the most similar remedy. The role of the keynote is to help the homeopath to keep from being lost in a mass of details. However, the selection is only one step in choosing the remedy. The materia medica is always the final authority in choosing the remedy. So how does a symptom become a keynote of a remedy? Keynotes are based on the clinical experience of homeopaths. When a homeopath finds that a symptom is a reliable guide to a remedy it becomes a keynote of that remedy. Because this process is somewhat subjective, different homeopaths will disagree on whether a symptom is a keynote. Keynotes are a useful tool in selecting the most similar remedy. However, knowledge of the repertory and materia medica are equally important.

The keynotes here have been selected from Nash's Regional Leaders. I have selected keynotes that I hope acute prescribers will find useful.

• Aconite
• When little sharp foreign bodies have entered the eyes, before they can be removed, and after removal.
• Croupy cough, awaking in first sleep, particularly with children, after dry, cold west wind.
• Allium Cepa
• Copious, watery, acrid discharge from the nose, and watering bland discharge from the eyes.
• Constant sneezing with profuse acrid coryza, when coming into a warm room.
• Apis mellifica
• Sudden, shrill, piercing screams (awake or sleeping).
• Oedematous swelling of the throat; uvula hangs down and looks like a transparent bag filled with water.
• Arnica Montana
• Fear of being touched by persons coming towards him.
• Bad effect even in inflammations, from mechanical injuries, falls, bruises, and contusions.
• Arsenicum Album
• Very great anguish and restlessness; cannot rest anywhere, moves from place to place; wants to go from one bed to another.
• Unquenchable thirst; drinks often, but little at a time; the water disagrees.
• Belladonna
• Pulse much increased in force and frequency, with throbbing of carotid and temporal arteries.
• Skin is so hot it burns the hand to touch.
• Bryonia Alba
• Very irritable, inclined to be angry, chilly, or a red face and heat in the head.
• The great characteristic is aggravation from motion.
• Cantharis
• Tenesmus of the bladder; urine scalds and burns; passed drop by drop.
• Pain in loins, kidneys and abdomen, with such pain on urination that he could not pass a single drop without wanting to moan or scream.
• Carbo Vegetabilis
• Great suffocation; desires to be fanned; must have more air.
• Collapse, cold sweat, cold breath, cold tongue, voice lost, extreme pallor or greenish color of face.
• Chamomilla
• Whining, restlessness; child will be quiet only when carried, which seems to relieve it.
• Child wants different things, and repels them when getting them.
• Gelsemium Sempervirens
• Copious discharge of clear limpid urine > the headache.
• Fever heat with drowsiness, little thirst; feels very weak and languid; wants to lie still; trembles if he attempts to move.
• Hepar Sulphuris Calcareum
• Sensation of a splinter or fish bone sticking in the throat.
• Great sensitiveness to cold air; cannot bear to be uncovered; coughs when any part of the body is uncovered or cold air strikes him.
• Hypericum Perforatum
• Consequence of spinal concussions.
• Injuries to parts rich in sentient nerves, especially fingers, toes, and matrices of mails.
• Ignatia Amara
• Sadness and sighing with sobs and tears and will not be comforted, wants to be alone. Silent grief.
• The remedy of great contradictions (paradoxicalities)
• Ipecacuanha
• Nausea intense, persistent, nothing > during convalescence.
• Suffocation threatens from constriction in throat and chest; much mucus.
• Kali Bichromicum
• Cough with expectoration of very tough mucus, so viscid that it draws out in strings down to the feet.
• Ulceration deep as if cut out with a punch; edges irregular.
• Lachesis
• Hot flushes, metorrhagia and other troubles during the climacteric; burning on vertex.
• Great sensibility of the throat to the slightest touch, even of the collar or bed clothes; can bear nothing round the neck.
• Ledum Palustre
• Stings of insects, especially mosquitoes; punctured wounds.
• Rheumatic pains are < in warmth of bed and bed covering, only when holding feet in cold water.
• Magnesia Phosphorica
• Flatulent colic forcing the patient to bend double > from heat, rubbing; spasmodic pains generally
• Pains lightning-like coming and going.
• Mercurius Vivus
• Painful dryness of throat with salivation, when tonsils threaten to suppurate; sharp sticking pains when swallowing.
• Most complaints < in the evening or at night; from heat of bed and during perspiration.
• Nux Vomica
• Great heat; whole body burning hot, yet must be covered up, as the least uncovering or motion makes him chilly.
• Oversensitiveness to external impressions, cannot tolerate noise, talking, music, strong odors, bright light.
• Phosphorus
• Wants cold food and drink, ice cream; is > by them.
• Slight wounds bleed much.
• Pulsatilla
• Stomach disordered from cakes, pastry, rich or fat food.
• Thirstlessness with most all complaints.
• Rhus Toxicodendron
• Lumbago from sleeping on damp sheets, or ground; on getting wet while perspiring; pains, strain, etc., < while at rest; on beginning to move; > when gets in motion and by pressure.
• Pains as if sprained; ailments from spraining or straining, lifting, particularly from reaching up high for things.
• Sulphur
• Diarrhoea some hours after midnight, or driving out of bed early in the morning, 5 a. m.
• All the orifices of the body are red as if pressed full of blood.