Saturday, 6 August 2011

Organon of medicine

The physician's high and only mission is to restore the sick to health, to cure, as it is termed.1
1 His mission is not, however, to construct so-called systems, by interweaving empty speculations and hypotheses concerning the internal essential nature of the vital processes and the mode in which diseases originate in the interior of the organism, (whereon so many physicians have hitherto ambitiously wasted their talents and their time); nor is it to attempt to give countless explanations regarding the phenomena in diseases and their proximate cause (which must ever remain concealed), wrapped in unintelligible words and an inflated abstract mode of expression, which should sound very learned in order to astonish the ignorant - whilst sick humanity sighs in vain for aid. Of such learned reveries (to which the name of theoretic medicine is given, and for which special professorships are instituted) we have had quite enough, and it is now high time that all who call themselves physicians should at length cease to deceive suffering mankind with mere talk, and begin now, instead, for once to act, that is, really to help and to cure.

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.

If the physician clearly perceives what is to be cured in diseases, that is to say, in every individual case of disease (knowledge of disease, indication), if he clearly perceives what is curative in medicines, that is to say, in each individual medicine (knowledge of medical powers), and if he knows how to adapt, according to clearly defined principles, what is curative in medicines to what he has discovered to be undoubtedly morbid in the patient, so that the recovery must ensue - to adapt it, as well in respect to the suitability of the medicine most appropriate according to its mode of action to the case before him (choice of the remedy, the medicine indicated), as also in respect to the exact mode of preparation and quantity of it required (proper dose), and the proper period for repeating the dose; - if, finally, he knows the obstacles to recovery in each case and is aware how to remove them, so that the restoration may be permanent, then he understands how to treat judiciously and rationally, and he is a true practitioner of the healing art.

He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health.

Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.

§ 6 Fifth Edition
The unprejudiced observer - well aware of the futility of transcendental speculations which can receive no confirmation from experience - be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.1

1 I know not, therefore, how it was possible for physicians at the sick-bed to allow themselves to suppose that, without most carefully attending to the symptoms and being guided by them in the treatment, they ought to seek and could discover, only in the hidden and unknown interior, what there was to be cured in the disease, arrogantly and ludicrously pretending that they could, without paying much attention to the symptoms, discover the alteration that had occurred in the invisible interior, and set it to rights with (unknown!) medicines, and that such a procedure as this could alone be called radical and rational treatment.
Is not, then, that which is cognizable by the senses in diseases through the phenomena it displays, the disease itself in the eyes of the physician, since he never can see the spiritual being that produces the disease, the vital force? nor is it necessary that he should see it, but only that he should ascertain its morbid actions, in order that he may thereby be enabled to cure the disease. What else will the old school search for in the hidden interior of the organism, as a prima causa morbi, whilst they reject as an object of cure and contemptuously despise the sensible and manifest representation of the disease, the symptoms, that so plainly address themselves to us? What else do they wish to cure in disease but these?*
* The physician whose researches are directed towards the hidden relations in the interior of the organism, may daily err; but the homoeopathist who grasps with requisite carefulness the whole group of symptoms, possesses a sure guide; and if he succeed in removing the whole group of symptoms he has likewise most assuredly destroyed the internal, hidden cause of the disease.

§ 6 Sixth Edition
The unprejudiced observer - well aware of the futility of transcendental speculations which can receive no confirmation from experience - be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.1
1 I know not, therefore, how it was possible for physicians at the sick-bed to allow themselves to suppose that, without most carefully attending to the symptoms and being guided by them in the treatment, they ought to seek and could discover, only in the hidden and unknown interior, what there was to be cured in the disease, arrogantly and ludicrously pretending that they could, without paying much attention to the symptoms, discover the alteration that had occurred in the invisible interior, and set it to rights with (unknown!) medicines, and that such a procedure as this could alone be called radical and rational treatment.
Is not, then, that which is cognizable by the senses in diseases through the phenomena it displays, the disease itself in the eyes of the physician, since he never can see the spiritual being that produces the disease, the vital force? nor is it necessary that he should see it, but only that he should ascertain its morbid actions, in order that he may thereby be enabled to cure the disease. What else will the old school search for in the hidden interior of the organism, as a prima causa morbi, whilst they reject as an object of cure and contemptuously despise the sensible and manifest representation of the disease, the symptoms, that so plainly address themselves to us? What else do they wish to cure in disease but these?

Now, as in a disease, from which no manifest exciting or maintaining cause (causa occasionalis) has to be removed1, we can perceive nothing but the morbid symptoms, it must (regard being had to the possibility of a miasm, and attention paid to the accessory circumstances, § 5) be the symptoms alone by which the disease demands and points to the remedy suited to relieve it - and, moreover, the totality of these its symptoms, of this outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force, must be the principal, or the sole means, whereby the disease can make known what remedy it requires - the only thing that can determine the choice of the most appropriate remedy - and thus, in a word, the totality2 of the symptoms must be the principal, indeed the only thing the physician has to take note of in every case of disease and to remove by means of his art, in order that it shall be cured and transformed into health.
1 It is not necessary to say that every intelligent physician would first remove this where it exists; the indisposition thereupon generally ceases spontaneously. He will remove from the room strong-smelling flowers, which have a tendency to cause syncope and hysterical sufferings; extract from the cornea the foreign body that excites inflammation of the eye; loosen the over-tight bandage on a wounded limb that threatens to cause mortification, and apply a more suitable one; lay bare and put ligature on the wounded artery that produces fainting; endeavour to promote the expulsion by vomiting of belladonna berries etc., that may have been swallowed; extract foreign substances that may have got into the orifices of the body (the nose, gullet, ears, urethra, rectum, vagina); crush the vesical calculus; open the imperforate anus of the newborn infant, etc.
2 In all times, the old school physicians, not knowing how else to give relief, have sought to combat and if possible to suppress by medicines, here and there, a single symptom from among a number in diseases - a one-sided procedure, which, under the name of symptomatic treatment, has justly excited universal contempt, because by it, not only was nothing gained, but much harm was inflicted. A single one of the symptoms present is no more the disease itself than a foot is the man himself. This procedure was so much the more reprehensible, that such a single symptom was only treated by an antagonistic remedy (therefore only in an enantiopathic and palliative manner), whereby, after a slight alleviation, it was subsequently only rendered all the worse.

It is not conceivable, not can it be proved by any experience in the world, that, after removal of all the symptoms of the disease and of the entire collection of the perceptible phenomena, there should or could remain anything else besides health, or that the morbid alteration in the interior could remain uneradicated.1
1 When a patient has been cured of his disease by a true physician, in such a manner that no trace of the disease, no morbid symptom, remains, and all the signs of health have permanently returned, how can anyone, without offering an insult to common sense, affirm in such an individual the whole bodily disease still remains interior? And yet the chief of the old school, Hufeland, asserts this in the following words: Homoeopathy can remove symptoms, but the disease remains. (Vide Homoopathie, p.27, 1, 19.) This he maintains partly from mortification at the progress made by homoeopathy to the benefits of mankind, partly because he still holds thoroughly material notions respecting disease, which he is still unable to regard as a state of being of the organism wherein it is dynamically altered by the morbidly deranged vital force, as an altered state of health, but he views the disease as a something material, which after the cure is completed, may still remain lurking in some corner in the interior of the body, in order, some day during the most vigorous health, to burst forth at its pleasure with its material presence! So dreadful is still the blindness of the old pathology! No wonder that it could only produce a system of therapeutics which is solely occupied with scouring out the poor patient.

In the healthy condition of man, the spiritual vital force (autocracy), the dynamis that animates the material body (organism), rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purpose of our existence.

§ 10 Fifth Edition
The material organism, without the vital force, is capable of no sensation, no function, no self-preservation1, it derives all sensation and performs all the functions of life solely by means of the immaterial being (the vital force) which animates the material organism in health and in disease.
1 It is dead, and only subject to the power of the external physical world; it decays, and is again resolved into its chemical constituents.

§ 10 Sixth Edition
The material organism, without the vital force, is capable of no sensation, no function, no self-preservation1, it derives all sensation and performs all the functions of life solely by means of the immaterial being (the vital principle) which animates the material organism in health and in disease.
1 It is dead, and only subject to the power of the external physical world; it decays, and is again resolved into its chemical constituents.

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