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| Hpathy Ezine - January, 2007 | ||||
Understanding Aphorism One-- Dr. Manish Bhatia |
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| Listen To The Audio Lecture of Aphorism One (4.98 MB) | ||||
| The first aphorism states: The high and only mission of a physician is to restore the sick to health, to cure, as it is termed. or The physician's highest and only calling is to make the sick healthy, to cure, as it is called. Footnote to Aph. 1: The physician's calling is not to spin so-called systems from empty conceits and hypothesis concerning the inner wesen (nature) of the life process and the origins of disease in the invisible interior of the organism (on which so many physicians mongering for fame have hitherto wasted their time and energy). The physician's calling is not to make countless attempts at explanation regarding appearances and their proximate cause (which must ever remain concealed) holding forth in unintelligible words or abstract and pompous expressions in order to appear very learned and astonish the ignorant, while a sick world sighs in vain for help. Of such learned fanaticism (to which the name theoretical medicinal art is given and for which special professorships are instituted) we have had quite enough. It is high time for all those who call themselves physicians, once and for all, to stop deceiving suffering humanity with idle talk, and to begin now to act, that is to really help and to cure. The first aphorism states the most fundamental purpose of being a doctor. The statement in itself looks very simple. A physician is supposed to cure the sick, so what’s the big deal? But there is more to this aphorism then what meets the eyes. Every word in this one line is pregnant with meaning and the choice of words has its own significance. Let us first see what options Hahnemann had while phrasing this aphorism. He could have said –
They all look very similar. What difference does it make if a word is changed or removed? But Hahnemann was a perfectionist. He knew what he wanted to write, what he wanted to convey and he did not want any ambiguity in his words. Let us begin our exploration of this aphorism with the word ‘mission’ or ‘calling’. Hahnemann had seen struggle, suffering and death from close quarters – not just in his patients, but in his own life and in his family too. Those who have suffered themselves and have a compassionate heart can understand the commitment Hahnemann had towards his sick patients. And he wants the same level of commitment from every physician. Here he is not talking about the ‘work’ of a physician. The ‘work’ is ‘to treat’. But he is stating the ‘aim’ or the purpose of the treatment. The treatment should be done with the aim of curing the patient. You might say – “So what’s the big deal? Every doctor tries to cure his patients.” But is it really true? During Hahnemann’s time the medical system was at the mercy of the whims and fancies of its practitioners. With treatments like blood-letting, purging, diaphoretic, diuretics and other unproved medicines, the certainty of suffering and death was greater after treatment. Hahnemann knew that very few physicians were actually aware of the real ‘cure’. And even after 200 years the world has not changed much. We still ‘treat’ the hypertension, the thyroid, the cardiac problems, the renal problems. And the treatment is often life-long with its own set of side-effects. The worst part is that a lot of the ‘treatment’ is not even justified or is out rightly wrong. For majority of viral ottitis media and sore throats, allopaths still continue to prescribe antibiotics. The ‘medicines’ are still one of the biggest cause of death. That is why Hahnemann made it very clear that while your work is to treat, your aim should be to cure the patient. There is a difference in the level of commitment between your ‘work’ and your ‘mission’. People can be sloppy or careless about their work. They may not fulfill their ‘duty’. But when the commitment comes from within, when it becomes your mission, you will really do what is in the best interest of your patient. And that is what Hahnemann wanted each one of us to do. Having said that, what was the need of adding the adjectives ‘high and only’ to the word ‘mission’? If you ask people what is their mission in life, you might hear answers like ‘I want to be a good doctor’ or ‘I want to earn a lot of money’ or ‘I want to lead a happy and stable family life’ or "I want to be famous’. People often confuse their ‘wants’, ‘desires’, ‘needs’, ‘wishes’, and ‘work’ with their mission. If you are a doctor, it is your ‘work’ to treat the patient; it is your ‘duty’ to treat him in the best possible manner. To earn a lot of money or to be a good doctor are your ‘wishes’. Similarly you have your duties towards your family, your parents and the society you live in. Even though physicians are supposed to serve, they also have their financial, emotional and social needs. There is nothing wrong in fulfilling your duties and your wishes. But you have to set your priorities right. Your wishes should not cause you to deviate from the ‘real’ purpose of being a physician. As H. A. Roberts puts it –
So while you may have many wishes and duties, your highest priority should be the well being of your patients. And while you can have many wishes and many duties, you can not have many ‘missions’ in your life. Practice of homeopathy needs a single minded devotion. Hence the use of words ‘high and only’. Another thing worth noticing here is the use of the word ‘physician’. He could have used the word ‘homeopath’ instead of physician. But Hahnemann did not change this word even after homeopathy was fully established and even when he faced bitter opposition from his allopathic brethren. The reason is that it does not matter what form of medicine we practice – Homeopathy, Allopathy, Ayuerveda, TCM or anything else, the intent or the purpose of treatment can not differ from pathy to pathy or from physician to physician. When Hahnemann wrote the Organon, his intention was not to start a new school of medicine; he never wanted homeopaths to be a separate class of ‘physicians’. In fact he believed that he had found a universal truth and that sooner or later everyone in the medical community would accept the Law of Similia. Now we move on to the next part and that is ‘cure’. I have already discussed above the difference between your work and your mission as a physician. Hahnemann has made it very clear that while our work is to treat the patient, our mission should be to cure the patient. And he has given a very brief and very precise definition of cure so that there is no room left for any wrong interpretation of the word ‘cure’. People often confuse ‘removal of symptoms’ or ‘removal of disease’ or ‘removal of pathology’ with cure. People often do not even know the difference between palliation, suppression and cure. How common it is to see patients treated with antibiotics for a cold, coming in for treatment of otitis media; how common it is to see patients taking antibiotics for acute cold coming in for treatment of dry cough that often lasts for months, how common it is to see patients with allergic rhinitis taking anti-allergic drugs developing allergic bronchitis and asthma. If the conventional treatment was geared towards cure, why are there so many sequalae of treatment? You get appendicitis, they remove the appendix, you get tonsillitis, they remove the tonsils; you get inflamed adenoids, they remove the adenoids; you get uterine fibroids, they remove the whole uterus – and then call it a ‘cure’! Hahnemann was very clear about the meaning of cure. He has clearly said that once the treatment is complete, the person should be ‘restored’ to the original state of health. If the patient develops more but different problems afterwards, it is suppression. If you remove the organ with pathology, you are not curing your patient, you are not removing the diseased state - you are just creating another compensated state. When you cure a patient, the symptoms and the pathology should disappear and at the same time the person’s general feeling of well being should improve. There should be no relapse of the chronic complaints and the number and intensity of acutes should also go down. Only when the patient returns to his/her optimum physical, mental and emotional health can we call it a true cure. The last point of focus of this aphorism is the word ‘sick’. Hahnemann knew what it is that we are supposed to cure. Is it the symptoms, the pathology or the disease? No! There is more to a sick human being than the symptoms and the disease. Hahnemann knew that the process of a disease starts much before the symptoms and the pathology appear. And the process varies from person to person – even if they seem to suffer from the same pathology. And if we have to cure a person, we have to unwind the whole process; we have to answer the underlying susceptibility. Otherwise we will just be palliating our patients. It is not the disease alone that we have to address, it is the ‘person’ who has the disease – the sick individual - that should be our object of treatment. And the objective of treatment should be to restore the sick to health. In aphorism 1, Hahnemann has kept the focus on what needs to be done. But at the same time he also wanted to make clear - what should not be done by the physician. To explain this Hahnemann has added a footnote to the first aphorism. In this footnote he reflects upon the status of the medicine in his times, when there was too much medical jargon and too little respite for the patients. He amused at the false pride and the learned reveries of the physicians and medical professors of his times, esp. when they had so little to offer to the sick humanity. Hahnemann very clearly that the physicians should keep their focus on helping the sick and should refrain from projecting hypotheses about the cause and mode of diseases. The 'search' for the 'unknown' should not come at the cost of your duty towards your patients. Hahnemann's words are still very apt. Most doctors still have ample false pride; with success they still behave like demiGods; rudeness and 'I know all' attitude is still rampant in medical fraternity. Hahnemann cautioned us against such behaviour. He wanted us to be humble enough to accept our ignorance of things we are unaware of, and to use what we know well for serving our patients. I really wish that all of us will have the humility to accept our limitations and failures, will have courage to support the truth and will have the commitment to really serve the sick humanity through this beautiful healing art that Hahnemann has gifted us. |
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