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.
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!
Dr. Manish Bhatia