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.”
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.
Explanation of Aphorism One
When we read this aphorism (paragraph), it appears as if the meaning of this sentence is very simple. It seems that Dr. Hahnemann is writing the obvious. But if we look at it carefully, the deeper meaning of each word will become clearer. There are certain words in this aphorism that have deeper meaning.
The first such word is “mission”.
MISSION:
The dictionary meaning of “mission” is “selfless work” or “a strongly felt aim or calling”. The original German word used by Dr. Hahnemann is “beruf”. When Dr. Hahnemann says, “only mission”, he means that the physicians must keep curing the patients as their only objective. Nothing else in the world matters for him. Money, fame, publicity, etc. will follow automatically once you achieve your “mission” of curing the patients. If you concentrate on money, fame, etc., your focus of attention of curing the patient is diverted and you achieve neither money nor fame or publicity. Worse, you will also not be able to cure the patients.
THE SICK:
Dr. Kent has very nicely described this concept in the first chapter of his “lectures on Homeopathic Philosophy”. He says that “SICK” IS A PERSON WHOSE VITAL FORCE IS DERANGED. The micro-organisms like the bacteria, viruses, etc. are NOT responsible for sickness. They are NOT the causative agents. In fact, they are the end products of the disease process.
Dr. Kent also says that in Homeopathy, we consider the person as a whole is affected. It is the man who is sick and not the parts or the organs. We can never say that a part is not connected with the rest of the organism. All parts and organs are always connected with each other.
Dr. Kent says, “Tissue changes are the end result of the disease and not the disease.” Tissue changes come in the end of the disease process. The actual sickness starts long before the tissue changes occur. It is a common experience that when a patient goes to a physician for his complaints, the physician examines the patient and investigations are carried out in the laboratory. The reports say there is “nothing abnormal detected”. But still the patient is suffering. How can this happen? This means that the sickness/illness has already started, but the tissue changes have not yet developed. Dr. Kent says, “It is nonsense to say that a person was not sick before the localization of the disease”. That is, the person has been sick long. before the pathological changes have taken place. The Old School (that is, the allopathic method of treatment) takes into consideration only the pathological changes that can be seen with the eye or the microscope. They want to “see” the disease. That is, they consider only the end results of the disease. They do this because they want to find out the diagnosis of the disease.
But in Homeopathy, we don’t need the diagnosis of the disease. What we need are the symptoms of the patient and not of the disease.
As seen earlier, the symptoms develop long before the tissue changes have taken place. So, as Homeopaths, we are at an advantage to treat patients in the beginning of the disease process and not let the disease progress till the tissue changes to take place.
The man is prior to the organs. That is, the mind is first affected – the tissue changes at the physical level come very late in the disease process. Dr. Kent gives a good example of this concept. A child is suffering from wild dreams, nervous excitement, twitching muscles, restless sleep, etc. hen he is examined physically, there is “nothing abnormal detected”. But still the child is suffering. After many years of suffering, tissue changes set in. The allopathic physician now finds something “abnormal” at the physical level and only now he considers the person as “sick”. Only now he will say the person is sick – that is, only after the tissue changes are actually “seen” with the eye or the microscope. Till then he (allopathic physician) never considered the person sick.
So, according to Dr. Kent, it is the deviation (or alteration) in the “will” and the “understanding” which the inner man is, and THIS DEVIATION is the point at which the sickness starts according to Homeopathy.
Dr. Hahnemann says, “There are no diseases, but sick individuals.” It is practically impossible to ‘see’ the disease separately.
FOOTNOTE: In the times of Dr. Hahnemann, the treatment with medicines was not based on any fixed principles. There were only theories and speculations (guesswork). They used to only imagine what might be wrong with the patient. Every physician created his own theory. Based on these theories, he used to decide the treatment for his patients. But as there were no principles, the treatment never helped all patients. Frequently the treatment made the patients worse than before. So a new theory was created, followed by a different treatment. This went on for years. E.g. treatment for eczema (a type of skin disease) was purgatives or the treatment for hypertension (high blood pressure) was blood-letting (bleeding), etc. Since the treatment was based only on theories, Dr. Hahnemann called this
“THEORETIC MEDICINE”, and strongly criticized such a harmful method of treatment in the footnote no. 1 to this aphorism.
Dr. Hahnemann says that the physician should not speculate and create such theories. He says that it is long enough that we have been creating theories. It is time to act and see to it that the patient is cured and not remain satisfied in creating theories. Theories don’t help, actions help the patient.
According to M.P Arya….. Aphorism 1 Explains
The Physician
Physician is one who has acquired knowledge and skills to practice medicine by undergoing training and who is recognized and competent as such, by the authorities of the land, by possessing a valid license to examine and care for the sick. This definition is sufficient as far as the law and common perception goes. However, a physician is much more than this. Let us examine more closely the scope of medicine as a whole and what role the physician has to play in it.
Medicine is a learned profession, deeply rooted in a number of sciences and entrusted with the obligation to apply them for the benefit of mankind. Medicine applies its knowledge and skills for the preservation of health, prevention of diseases, cure of diseases and the amelioration of the sufferings of mind and body. Medicine is not only a science but an art as well. Here, not only the scientific principles are applied for some biological aberration in order to have uniformity in its approach and consistency in its interventional outcome, but also its focus is on the patient, whose welfare is its continuous purpose and aim.
Patient is not a repository of diseased organs but a living human being in distress, who needs medical help and assistance. As long as medicine is an art, its chief and characteristic instrument must be the human faculty. Practice of medicine requires not only deep knowledge and skills, but also human understanding and sound judgment. Competence in medical practice is based on
continuing pursuit of acquiring and refining these skills, updating the knowledge and an understanding of human nature. A physician must be quite familiar with disease in all its manifestations and guises. But in this medical art, he is also an advocate of the patient first and an adversary of the disease next. It is the patient who is personified and not the disease. These finer aspects of the medical art do not occur spontaneously but could be acquired with patience, right practice and experience.
Medical art is the most difficult of all the arts. It requires an independent thinking, indefatigable work culture, correct discrimination and conscientiousness in work on the part of the physician. It is a reflective or an intellectual exercise every time the physician treats a case. Higher functioning of human intellect, unfettered judgment and valid reasoning of selection and determination are the essential mental qualities one should possess to enter the field of medicine. Above all, the physician should possess empathy towards the sick, a compassion for the welfare of human beings and a positive attitude and passion of service above self.
Each physician, like each patient, is unique with innate strengths and weaknesses and cannot be passively molded into the medical professional. A physician enters this profession with established values and traditions of ethical conduct and responsibilities of human life that is at stake. In order to meet the needs and expectations of the patients and profession, the new entrant must imbibe these standards for himself or herself.
The qualities of an ideal physician are easy to state but difficult to attain. Compassion, sincere interest in the welfare of fellow human beings, knowledge of human nature, tact, equanimity, sustained scholarship, curiosity and high ethical standards are some of the basic traits a physician must possess, including physical and mental vigor.
Practice of medicine is arduous and demanding. Hence, this profession is certainly not for people who love indolence, and are languid and disengaged. That is why Hahnemann writes elsewhere that, “When we have to do with an art whose end is the saving of human life, any neglect to make ourselves thorough masters of it becomes a crime.” Medicine is both a humbling and exhilarating profession to those who pursue it as a career. He who makes this his role model is a true physician.
The physician should never use any medicine on his patients, whose effects, on the healthy human body have not been previously known through careful experiments on healthy human beings (proving). Also, use only a single medicine, in a minimum doses, at one time according to its indications in the patient, in other words, he has to use just sufficient and correct medicine to arouse the defense mechanism of the body, to take over the curative processes. He should never prescribe any medicine, on mere conjecture of some possible usefulness in a disease or from hearsay that that remedy has helped in such and such disease. A true homoeopathic physician is one who never acts without correct fundamental principles, never gambles with the life of the patient entrusted to him. This distinguishes a homoeopathic physician from every physician of all older schools of medicine.
Mission
The word ‘mission’ here means an objective or an aim. It should not be taken in its literal meaning or given some politico-religious tone or color. Different translators have given different meaning to the term Beruf used by Hahnemann. William Boericke has naturally adopted Dr. R. E. Dudgeon’s excellent translation of the word as ‘mission’. Dudgeon also uses it interchangeably with the word ‘aim’. This appears correct as Dr. C. W. Wheeler, in his translation of the first edition of the Organon had translated the first aphorism thus – ‘The physician has no higher aim than to make sick folk well, to pursue what is called the Art of Healing’. However, from the second edition onwards, Dr. Hahnemann has revised this aphorism and used the term “beruf”, as mentioned above. This has landed the aphorism into many an interpretations by its many translators and commentators. However reading the 3rd, 4th and 5th Aphorisms makes matter abundantly clear and allows no further room for any misunderstanding.
The monitory gains in this profession are secondary. The satisfaction felt at the end of job, which is well done is its real reward. Besides being a competent physician, who is the bedrock of medicine, one should love their fellow human beings and have compassion for the one who is in difficulty.
Further, in his professional life, a physician will come across all the virtues and vices to which mankind is heir. The physician need not be morally neutral in personal judgments but these must be stringently excluded from his professional activities. The response of the physician to human frailty and fallibility should be that of compassion rather than cynicism. He should evince a keen interest in the infinite variety of human experience rather than repulsion from its aberrations. Physician is a humanist at work, who works in a non- judgmental manner.
Physician’s Objective or Aim
We find that Hahnemann takes a very practical view of medicine. He, at the very outset defines the purpose and role of the practicing physician. A practicing physician must never forget that his primary and traditional objective is utilitarian, that is, giving aid to his patients. In other words, he has to relieve his patient from mental and physical sufferings and cure his patient.
A practicing physician’s prime concern or the only concern should be to utilize all his medical knowledge and skills to bring back the lost state of health in his patient and restore normalcy as quickly as possible. The whole endeavor of a practicing physician should be to focus his attention on his patient and his complaints. The patient’s welfare and interest should be upper most in his mind.
Hahnemann, therefore, rightly insists that a treating physician should refrain from indulging on the various secondary issues, though important and interesting academically, such as interest in internal operations that maintains life processes, nature and development of disease processes in the invisible interior, etc., and not waste his time and talent in speculating and proposing various hypotheses about them, while his patient is in an urgent need of his help and assistance.
Hahnemann also warns that a practicing physician should resist the temptation of trying to impress his patients with the use of high sounding medical terminologies, to explain the phenomenon of sickness or its immediate causes, etc. in order to give them the impression that he knows quite well about the disease that his patient has. As these attempts are of little practical help to his patient in getting relief from his sufferings, the only thing that would be of help to his patient would be, that he should act and apply his medical knowledge and skills to cure him and give him relief from his sufferings, rather than merely engage him with his impressive talks. The patient is not concerned with these highly technical issues. The patient’s prime concern is getting quick relief and recovery from his sufferings and that is all he expects from his physician and that is what a practicing physician should carry out without delay.
Hahnemann was aware of the inadequacies in understanding the operation of life processes and in the phenomenon of sickness and their primary causes during that point of time. He appealed to the physicians to pay attention to the manifestations of disease alone. With all our advances in knowledge at the present time, many years after him, we still do not know many things about life, health and disease, which we ought to know. We should concentrate on the signs and symptoms of disease alone.
Hahnemann was also concerned about the fact that in spite of the works of many talented physicians on these issues, it has yielded no concrete or tangible explanation so far. Instead what actually resulted in these studies was only a web of theories and conjunctures, without any sound basis and consistency on which one could depend in practice. Hahnemann gave the name—theoretical medicine to these hypotheses. He, therefore, was quite right in cautioning the physicians not to waste their time and energies in trying to unfold these mysteries, but to concentrate on applying their learned medical skills and knowledge in giving aid to their patients and cure them from their sicknesses.
Hahnemann was not averse to enquiries in these areas, as many would believe or blame him for, for he himself was a great enquirer. He was conscious of the nature of such enquiries in difficult areas like, dealing with nature of life processes phenomenon of sickness, etc., which were bound to be painfully slow and of long drawn nature, and also because these were required to be carried out with complete circumspection.
Therefore, if the practicing physician realizes at the very outset that the true object of his mission consists, not in engaging himself in this, but in giving aid to the sick, he has then understood his whole existence of being in the medical profession. One who is conscious of this role, alone can take charge of his patient effectively.
The Sick
A simple, straight forward description of the sick is simply, a fellow human being in need of attention and help; who comes to the physician seeking help or is brought to him because of a problem relating to his or her health.
This subjective judgment on his part carries with it many disquieting concerns, which may not be expressed by the patient. These may not be even real or reasonable. For example, even a very brave and strong person in sickness can become anxious. Sometimes this anxiety, fear and worry is reasonable and real as in diseases like cancer or AIDS, because of their implied meaning namely, death. At other times, in other diseases, it may even be baseless and unreal like loosing a job, failure to meet the family’s needs and obligations, financially ruining, or loss of an independence, loss of respect and love of dear ones, fear of leading a life of invalidism, loosing the life of dignity, etc. In order to cure the patient, these aspects are also to be taken care of and solved by the physician as a friend, philosopher and guide to his patient, in all chronic and prolonged illnesses.
Each human being is unique with a life that is enormously complex—in heredity, early experiences, cultural, social, economical, political, religion and psychological environment, education, opportunities, successes, failures, fantasies, commitments, motivations, etc. In making adjustments to and in compromising with them, he or she may be crippled in his or her life or these things make him or her mature and brave. Living, therefore, is in final analysis, a personal encounter system. These factors also play a crucial role in genesis of diseases and their maintenance, especially the chronic and prolonged illnesses. This interacting person on so many fronts, behind the sickness has to be taken care of when dealing with treatment of chronic diseases, unless we, as physicians, spend time and listen to him attentively without interruption, will fail to grasp his or her fears, anxieties and predicaments real or unreal.
Health and Cure
Hahnemann, here uses two terms, cure and health. We should be clear in our mind as to their significance and understand their complete meaning.
Cure is eradication of all the symptoms and signs of the disease, and to bring back the original healthy state of the patient, which comprises of the physical, psychological, social and spiritual well-being. Cure is not merely relieving the isolated annoying symptom or group of symptoms of the patient here and there, or suppressing or masking his troublesome symptoms, or substituting his disease with another drug induced disease. Nor does it consist of administering him or doing anything to him which adds to his suffering and discomfort in any way. To cure is to do every thing possible, which brings back the lasting original healthy state, as quickly as possible, without adding any further discomfort to the patient.
Here the aim is to cure the patient, as a person As Hahnemann explains in the next aphorism, cure should be achieved on some fixed principles or basis, on which others could also relay to achieve similar results in future, if they follow strictly those principles or basis. The basis should be uniform and logical, which is understood easily by all. A competent physician through his art, from outside only, can deliver a cure to a diseased person. Spontaneous cure without the help of outside medicine is termed as recovery, seen in acute or self- limiting diseases sometimes. It is not possible in chronic diseases.
Health
Health and disease are two opposite and interchangeable states of the human life, like the swings of a pendulum. One is normal and usually a stable state that we call health. While the other is an unstable and abnormal state which we know as disease. Disease requires outside intervention by a competent physician, before it can be brought back to a healthy state.
State of health remains, as long as there is equilibrium, both internal as well as external (milieu internal and milieu external – the environments), which in turn results in harmonious functioning of the body and mind. In this state of health, we experience no abnormal sensations and disturbed functioning (symptoms) of our body and mind; there is an overall ease. We are, not conscious of its existence or presence till it is lost from us. It is a natural, normal and only earthly blessings, all living persons are endowed with. Hence, it becomes mandatory to do every thing possible to preserve and maintain it, at all times.
Disease is the opposite state where this equilibrium is disturbed. This in turn causes disharmonious functioning of the body and mind. This is an abnormal state of the human beings in which the ease is replaced or substituted by dis-ease or disease, and we experience a train of abnormal feelings and functioning of— mind and body, through the symptoms (sensations and complaints) and signs (abnormal changes), the significance of which can only be known by a competent physician. A practicing physician’s objective is, therefore, to assist the patient in restoring this disturbed equilibrium.
Coming back to the first aphorism, it is this part of the physician’s duty, in which the physicians of Hahemann’s time had failed, and therefore, his first preoccupation was to point that out in the very beginning. Thus, in brief, a physician should find himself with his medical knowledge and skills, responsible and accountable for the welfare of his patients. He should only concentrate on bringing back the patient’s lost health and to cure him as it is called.
Here the word mission means an objective or an aim, that is all. It should not be taken in its literal meaning or given some politico- religious tone or color to it. Read the 3rd, 4th and 5th aphorisms, which makes matter clear.
Hahnemann has explained how a physician can restore the sick to health or cure him, in the aphorisms 7, 8, 17, 22, 50, 51, 53 and 61, which follow. The first aphorism should, therefore, be read in conjunction with them in order to get its fuller implication and meaning.
In the rest of the teachings of Organon, Hahnemann tells us about the steps that are necessary to fulfill this objective. In brief these steps are:
1. Paying utmost attention to the symptomatology—manifestations of disease.
2. Selecting the medicine based on the totality of symptoms and,
3. Annihilation of these symptoms by means of the medical art.
Annihilation of the symptomatology means transforming disease into health.
Through his repeated experiments and long experience, Hahnemann concludes—Cure by Symptom Similarity—the indisputable Therapeutic Law of Nature is the basis of his new system of medicine—Homoeopathy. This fact will be unfolded to us as we read the Organon further.
