| The second aphorism states:
The highest ideal of cure is rapid, gentle
and permanent restoration of the health, or removal and annihilation
of the disease in its whole extent, in the shortest, most reliable,
and most harmless way, on easily comprehensible principles.
or
The highest ideal of cure is the rapid,
gentle and permanent restoration of the health; that is, the lifting
and annihilation of the disease in its entire extent in the shortest,
most reliable, and least disadvantageous way, according to clearly
realizable principles.
In the first aphorism, Hahnemann discussed the mission of a physician
(to cure) and at the same time gave a very brief but to-the-point
definition of cure (restore the sick to health). In the second aphorism,
Hahnemann moves forward and goes on to qualify the best possible
cure. He was not satisfied by just telling us what the cure is.
In the second aphorism he very clearly states that the ideal
cure should be rapid, gentle and permanent. But again, there
is more to these words than what meets the eye. I always tell my
students that Hahnemann writes pages in words! That is why it is
not uncommon for me to lecture for three to five hours on explaining
even the first or second aphorism. And this will become clear to
everyone as we continue our discourse on Hahnemann's aphorisms.
We have already discussed in aphorism one that only when there
is restoration of health, can we call it cure. Now let us
discuss the 'qualifiers' for an 'ideal cure'.
The first qualifier is 'rapid'. The ideal cure
should be rapid. As an adjective 'rapid' means - Moving, acting,
or occurring with great speed. It is synonymous with 'fast'.
So the ideal cure should come fast. The ideal cure should take the
least possible time. But what is the time frame for a cure to be
called 'ideal'? A day or two for acutes? A few weeks for chronic
cases? No, there is no 'ideal time' for an 'ideal cure'. It depends
upon the individual case. In an acute, still in the bud, a few minutes
or a few hours, might be the ideal time. In an acute that is full
blown, a few days might be the ideal time. In a functional chronic
case of not much duration and having no acute miasms, a few weeks
or few months might be an ideal time. In cases with fully developed
pathologies, active miasmatic states, annually recurring diseases,
or with significant problems at mental and emotional planes, the
healing period may run into many years. It is not for us to decide
what would be the 'ideal time' for curing a particular case. Our
efforts should be directed towards curing the patient as early as
possible. The less time it takes to cure the case the better!
We now move on to the next qualifier, 'gentle'.
The ideal cure should take the least possible time but it is the
second qualifier (gentle) which puts a limit to the first qualifier.
Gentle means 'Not harsh or severe; mild and soft'. So the
ideal cure should not just be rapid, it should also not be harsh
or damaging in any way. Let me give you an example:
Suppose you have to go from place A to place B, say 100 km's apart.
There are many ways/modes to reach B from A. You can go by foot
and it will probably take more than two days. Your joints are also
going to hurt a lot. You
can use a cycle and you will cover the distance in a day or more.
Again there is lot of physical labour - it's not easy (comfortable)
for most of us to ride a cycle for 100 km's. You can chose a scooter
or a bike and you will cover the distance in 2 hours. You can chose
a car and you will cover the distance in less than 2 hours. But
the cost of the car and the fuel consumption would be significantly
higher as compared to the scooter. You can chose a helicopter or
a private jet. You will be there in minutes but the cost is going
to be exorbitant. Then you can even tie yourself to a missile and
you will get there in minutes! Although not in one piece!!
So we see that the quickest way (the missile) is also the most
damaging. Going by foot and cycle is slow (not rapid enough) and
taxing (not gentle). So the choice lies between the bike and the
car. Both are good enough but the bike is ideal because of its better
fuel efficiency (financially less taxing). It is both 'fast enough'
and 'gentle enough'. The 'bike' here is the simillimum
that will give just the needed thrust to the vital force to heal
itself. If the progress is very slow, it's not ideal because the
patient is suffering all the time. And it is our duty to relieve
him of his sufferings as soon as possible. Similarly, in an effort
to cure the patient quickly, if the patient suffers in any way (strong
homeopathic aggravation, new medicinal symptoms or suppression),
even then the condition is not 'ideal'. So for a cure to be ideal
there has to be a balance between the rapidity and the gentleness.
But even when you have the simillimum (the bike), you might not
be 'rapid enough' or 'gentle enough'. How? Say the bike gives the
best average when driven at 60 mph. If you drive too slowly (potency
lower then required, repetition more infrequent then desired), you
are not going to reach B as rapidly as is possible and also it is
going to be more taxing (more fuel consumption). Same way, if you
drive at 100 mph (potency higher then required, too much repetition),
you will reach early but the fuel consumption is going to be higher
(not gentle enough) plus there is going to be more wear and tear
of the engine (homeopathic aggravation?). And there is even an increased
risk of accident (idiosyncratic reaction to the remedy or life-long
imprints of medicinal symptoms)!
So your work does not stop at choosing
the simillimum. You have to select the right potency and then manage
the case properly to affect an ideal cure - which is 'rapid enough'
and 'gentle enough'.
At this point, I remember my first eczema case. A lady in her late
thirties came to my clinic with weeping eczema on her right leg.
It had been there for the last 15 years and she had used every possible
treatment. I took the whole case and every detail of the patient,
(not just the eczema) matched Graphites perfectly. I gave her just
one dose of Graphites 30CH with Sac lac for 2 weeks. On the next
visit the lady came to me, nearly jumping with joy. She was very
excited and told me that the eczema is already very much less and
that she feels great. Nothing had ever done this to her. I was also
very happy. I gave her Sac lac for another 2 weeks after which the
lady said that the eczema had reduced further but not as much as
the previous time. I again gave her Sac Lac for 2 weeks after which
the lady came and said that this medicine is not doing much work
because the eczema was not clearing as fast as it did in the first
2 weeks. The eczema was disappearing gradually but the lady started
becoming restless because she was looking for 'magic'. As a young
practitioner I was not experienced enough to decide about how long
I should wait before repeating. Giving in to the patient's pressure
and to speed up the cure, I repeated the medicine. Next time when
the patient came, I was shocked to see that the eczema was increasing
again. I didn't know what to do. I gave Graphites 200CH, the eczema
increased further. With no mentor well versed in classical homeopathy,
I was totally confused. I tried this, then that ...but to no avail.
A couple of months later, I lost the patient. In hindsight, I think
if I had waited for a couple of weeks or months more, the case could
have progressed to cure. Haste does make waste!
Then we come back to the next qualifier - 'permanent'.
The restoration of health has to be permanent for it to be called
a cure. Permanent means 'Lasting or remaining without essential
change; something that if forever'. So once you restore the
health, there should be no relapse of the condition. If you relieve
the patient of all the complaints but the complaints come back after
some time in varying degrees, then it is 'palliation' not 'cure'.
The whole conventional medicine is geared towards palliation and
suppression and this focus on cure alone puts homeopathy in a different
league. But what do you mean by a permanent restoration of
health? Does it mean that once you cure a person he/she will never
fall sick again? Once you cure a person with depression or ovarian
cysts, he will never catch a flu again? Or once you cure a flu in
a person, he will never get the flu again in his life? No, even
after you 'cure' a person, the person may come down with occasional
acutes because even relatively healthy people can catch a flu or
a bug at times. However they usually resolve quickly without any
complications.
Another related question is - Is the 'permanent' cure unconditional?
To answer this, we first need to understand the difference between
a 'relapse' and a 'recurrence'. If a disease condition comes back
soon (or annually) after stopping the treatment, then it is most
likely a relapse. If a patient says - 'Doctor, I was better while
was taking your medicines, I even stayed well for a few days after
I stopped the medicine but now I again seem to be getting my old
symptoms back' - it usually means that the medicine just palliated
and the cure was not complete, therefore it is a relapse. But if
while under treatment, the patient improves physically, mentally
and emotionally and stays that way for a very long time, it is usually
an indicator of a cure. If you cure a person with Malaria or Typhoid
and the next year the person comes down with it again, it does not
mean that your cure was not complete (unless there is an annual
recurrence). Many people say that if your vital force is healthy,
you will never catch a bug but I personally feel that it's not true.
An acute infection usually depends not only on the vitality of the
person but also on the virulence of the affecting organism. If a
virus or bacteria is too virulent, anyone (even a healthy person)
can come down with a sickness. Same goes for chronic illness. Chronic
illnesses are usually precipitated (the tendency usually
preexists) from chronic stress (either physical, mental or emotional).
After you cure a person, it is the person's responsibility to maintain
his health. If the person again starts taking an unhealthy diet,
adopts an unhealthy lifestyle or comes under similar mental emotional
influences which initiated the disease process initially, he/she
may have a 'recurrence' of a similar condition. So the 'cure' is
not unconditional. Once the health has been restored, it is the
patients responsibility to ensure that the state is maintained.
Let me give you another example to clarify this -
Suppose you own a nice car and you meet with an accident because
you were driving rashly (the pre-existing tendency) or someone hit
you even though you were driving alright (the virulence of the bug/circumstance).
Having met with the accident, you now take the car to a mechanic
(the homeopath). The mechanic sets everything right, removes the
dents, paints all the scratches, polishes everything and the car
is now (apparently) as good as new (the cure!). But
once the mechanic hands you the car again, is it his responsibility
that you do not meet with an accident again? No! If you drive carelessly
again, you can still meet with an accident, someone can still hit
you even if you have done nothing wrong yourself. With every recurrence,
it becomes difficult for the mechanic to bring the car back in its
original state. The repair work starts showing! Plus with long use,
there is going to be wear and tear of the parts (age related problems).
If you do not use the car for long periods (no exercise - physical
as well as mental), the battery is going to die and there is going
to be some problem in starting the car every time. If you do not
get the car serviced regularly, put in good quality oil and water
on time (the importance of diet and nutrition), there is going to
be more wear and tear on your car. So be it the health of your car
or your body, it depends upon you not just your physician. The 'cure'
is never unconditional!
Now we move on to the next part - 'annihilation of the
disease'. Many people will say - 'Hey! Hahnemann is speaking
about treating diseases. What happened to the holistic approach
and the individualization?' But Hahnemann always puts qualifiers
at just the right places for such people. Here also he says 'annihilation
of the disease in its whole extent'. What is this 'whole
extent'? For Hahnemann 'disease' was not an entity, it was a process.
And curing a disease means, reversing the whole process in such
a way that not just the infection or the pathology disappears but
the patient gets back to his/her optimum health.
Hahnemann has used another set of words to drill down the idea
of the ideal cure - shortest, reliable and harmless. Shortest is
synonymous with 'rapid' and as such needs no further explanation.
'Most harmless' or 'least disadvantageous' stands as a clarification
for 'gentle'. But the words 'most reliable' seem to be different.
What does reliable mean? Reliable means 'trustworthy, dependable'.
When does a person or an object become reliable? When you know that
it will not fail easily. In homeopathic terms it means that a cure
will be reliable if there is no relapse. So reliable is also used
in a sense similar to 'permanent'. But reliable has another dictionary
meaning too - Yielding the same or compatible results in different
clinical experiments or statistical trials. So if we extend
the definition of reliable here, we come to the conclusion that
the cure should not just be permanent, it should be done through
a mode, in a way, which is reproducible too.
Now we come to the tricky part of this aphorism - 'on easily
comprehensible principles' or 'according to clearly realizable
principles'. What was the need for this? Here Hahnemann was not
just thinking about curing a patient. Here
he has widened the scope of his words to cover all patients. His
last words of this aphorism reflect his thoughts about homeopathy
as a 'system'. For him, medicine in general, and homeopathy in particular,
was not just an art but also a science. And every science is based
on certain rules, laws and principles. Without any set of rules,
there can be no uniformity, no standards. There can be no reliability.
Hahnemann wanted that the benefits of the real medicine should reach
each and every patient and for this to happen there has to be some
set of rules that everyone can follow to achieve cure. But why should
these principles be 'easily comprehensible'. Think of it this way
- if there were as few doctors in the world as there are astronauts,
astrophysicists, marine biologists or nuclear scientists, what would
be the state of our medical system? Would medicine and cure be within
the reach of everyone. I guess no. The principles have to be such
that they are easy to understand. Only then they will mass proliferate
and the benefit of homeopathy will reach each and every human being.
So we are now done with all the qualifiers but we are not done
yet! I have left the beginning for the end. The highest
ideal of cure. Homeopathy students often take the definition
of ideal cure to heart, often so much that they start believing
that every cure has to be rapid, gentle and permanent. But please
remember that here Hahnemann is talking about the 'ideal'. Ideal
means 'perfect; model' - something that's worth emulating or following.
But in real practice, not every cure is going to be ideal. There
will be cases which will be incurable, there will be times when
you will miss the simillimum, when you won't be able to get the
right potency or patients, who do not work on their health. Our
aim should always be to attain the ideal but we will not succeed
in every case. That should not disappoint us as the 'ideals' are
set to give a direction and we should be grateful that Hahnemann
has set for us such high and noble standards. Homeopathy is not
just a set of rules. Principles can be learned in a classroom but
practicing homeopathy is an art, a skill. And as your experience
grows, you become more skillful in curing your patients. And when
you do see those ideals in practice, you feel the magic of homeopathy
- the real cures - that keep all of us hooked to homeopathy!
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Dr. Manish Bhatia
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