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Jun 19, 2020

The Highest Ideal of Cure

Hahnemann's Organon: A Plain Discussion

By
Dr Rajeev Khanna
Dr Ravindra Singh Mann



The Highest Ideal of Cure

Before we start discussion on this topic, we want to share two examples from the history to understand the nature of medical environment and treatment methods before and during Hahnemann.

Example-1. 

Louis-13th was King of France from 1610 to 1643, after the death of his father, he became king when he was just 9 years old. Louis-13th  died of Crohn's disease and tuberculosis in 1643. James Bouvard was physician to King Louis-13th of France.

James Bouvard, the physician, ordered 47 bleeding, 215 emetics or purgatives, and 312 enemas during the period of one year, for his health problems.

Louis XIII died in Paris on 14 May 1643. 

According to his biographer A. Lloyd Moote, "his intestines were inflamed and ulcerated, making digestion virtually impossible; tuberculosis had spread to his lungs, accompanied by habitual cough. Either of these major ailments, or the accumulation of minor problems, may have killed him, not to mention physiological weaknesses that made him prone to disease or his doctors' remedies of enemas and bleedings, which continued right to his death."

Example-2.

George Washington, first president of USA died on 14 December 1799 at his home after a brief illness. Modern medical experts says that the illness as diagnosed by his physicians isn’t one of those serious illnesses that may likely cause to death. 

On December 12, 1799, two days before his death he was absolutely healthy, he went to inspect his farms on horseback in snowing and cold weather. He returned home late for dinner, When he returned he was wet but he refused to change out of his wet clothes, because he didn’t want to keep his guests waiting. Next day he had little sore throat but again went out in freezing, snowy weather for his work. 

That night, Washington woke his wife Martha to say he was feeling very sick, and that he could hardly breathe or talk on his own. The former President asked his overseer, Albin Rawlins, to bleed him. (To draw nearly a pint of his blood, bloodletting being a common practice of the time.) His family called Doctors James Craik, Gustavus Richard Brown, and Elisha C. Dick for blood-letting.


Dr. Brown thought Washington had quinsy (an accumulation of pus due to an infection behind the tonsil); 

Dr. Dick thought it is more serious "violent inflammation of the throat". 

They continued the process of blood-letting and bled him four more times over the next eight hours, approximately five pints blood was drawn ( One Pint = 473.18 ml), with a total blood loss of 40 percent. But Washington's condition deteriorated further. He was having difficulty in breathing and cough.

Washington also gargled with a mixture of molasses, vinegar and butter; he inhaled a steam of vinegar and hot water; and his throat also was swabbed with a salve and a preparation of dried beetles.

Dr. Dick proposed tracheotomy, but the others doctors disapproved. And in a 21-hour period Washington died On December 14, 1799.

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After reading above two examples you might understand that at the time of Hahnemann, medicine was in state of chaos. Physicians were speculating the medical theory as a product of imagination. Each one was contradicting the other. All were engaged in finding a basis for treatment of diseases in speculations about interior states, the invisible, internal changes in organs of the body and without knowing the cause of diseases.

During Hahnemann's time leeching, cauterisation, blistering, and other torturesome practices were common in day to day practice. Methods of treatment were more painful than original disease in many cases. We can conclude, from examples above, that death was equally possible from methods of treatment as from natural disease.

So, just after declaring the very object of Physician in first aphorism, Hahnemann outlined clearly 'The Highest Ideal of Cure' in second aphorism.

"The highest ideal of cure is rapid, gentle, permanent restoration of the health, or removal and anihilation of the disease in it's whole extent, in the shortest, most reliable and most harmless way, on easily comprehensible principles".

Again in this aphorism many words have been used, let’s have look on them :

highest ideal of cure 
rapid and gentle, 
permanent restoration of the health, 
or removal and annihilation of the disease in it's              whole extent, 
shortest, most reliable and most harmless way, 
on easily comprehensible principles".

This aphorism indicate many indirect meanings:-

1. A diseased person is already suffering a lot. So the cure must be rapid and shortest. Sooner a person get treated, it is better for him. The shortest method of treatment is the ideal method of treatment. 

2. Method of treatment must be gentle and harmless. As we learned from the examples at the beginning of discussion, the prevalent methods of treatment, at the time of Hahnemann were more torturous than disease itself.  

Leeching, bleeding, strong purgatives and emetics cannot be called as easy, gentle methods of treatment they are more painful methods, and to add such a method of treatment to already suffering person is not a wise idea.

Nothing could be better to the patient if a painless method of treatment could be discovered. And this is certainly one of the factors of 'the highest ideal of cure'. The use of words 'gentle' and 'harmless' by Hahnemann in second aphorism, emphasize his idea of empathy and responsibility towards patient's sufferings.

3. In state of health a person is in a condition of ease or comfort. But disease loses this equilibrium and person start to face sufferings. Cure means to alter from sufferings, again to state of ease, comfort and health.  

The cure is a condition to regain the same equilibrium again which was lost earlier by disease. A partial restoration of health in which few sign and symptoms are recovered, or a temporary restoration of health in which after a short recovery, person again face the suffering or disease, can not be termed a Cure.
Palliation or suppression of symptoms should not be our ideal.

4. Hahnemann propagate the holistic conception of the organism while defining the Ideal of Cure. He emphasize that only complete annihilation of sign and symptoms of original disease can be termed as cure. 

A suffering may be manifested as many symptoms, of which some may be more painful than others. But every symptom indicates a deviation from health, so each and every symptom have got to be removed to cure the disease in its whole extent.

5. At Hahnemannian time, medical theories were based on emperical guesswork, imaginations of physician, ages old unscientific hypothesises of Galen and some other ancient physicians. Hahnemann proposed that practice of medicine must be based on scientific principles, deduced from observations, generalisations and experimental verifications. These scientific principles based on observations and verifications must be organised and developed as a Therapeutic Law. And treatment methods need to be based on this therapeutic law.   
 
As per Hahnemann's view, the Therapeutic Law discovered by such scientific methods will be the 'Most Reliable' and 'Easily Comprehensible'.


On these terms, Hahnemann coined the idea of 'the Highest ideal of Cure'. 

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