Aphorism 2: The ideal cure

The first aphorism focused on the person, the physician, and what their most important role or duty is. But the second is focused on the ideal therapy.

So it reads:
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.

Let’s rearrange this a little bit to see the structure here.

The highest ideal of cure is rapid, gentle, and permanent restoration of the health [based] on easily comprehensible principles. I.e. the removal and annihilation of the disease in its whole extent, in the shortest, most reliable, and most harmless way.

So there’s a couple of points here.

First notice the structure. We have:
A perfect cure = one that is based on easily comprehensible principles and happens rapidly, gently, and permanently.

Then he repeats himself essentially.

A rapid gentle permanent restoration of health = removing the disease in the whole extent in a short, reliable, harmless way.

So we can see that a cure is equivalent to restoring health and equivalent to removing the entire disease, not just a few symptoms. For the cure to be “ideal” or “perfect” it should happen quickly, without ill effects of its own and permanently. I think for most of us this makes intuitive sense. None of us want to cure someone by causing more suffering, or giving them something that will take two years to work. This is a bit vague (how fast is fast?), but based on his writing in ME, I think he is at least looking for something that is faster and gentler than nature does on its own.

However, you could also argue that the vagueness (how fast is fast? How gentle is gentle?) allows this aphorism to be applied differently depending on context. In other words, in an acute situation where you are bleeding out, you may want a therapy that is less gentle, not very permanent, but works very fast (like a tourniquet). In a chronic situation, maybe speed is not very important, but the gentleness and permanence is. And different patients are going to prioritize different things.
On permanence: we can never know if what we do is truly permanent; we really only know that something hasn’t relapsed yet. But again, as an ideal, this is exactly what we want. We want a therapy that will last for as long as possible.

Where’s the homeopathy?

Homeopathy still has not been mentioned. Nor will it be mentioned for a while. So he is not saying (yet) that homeopathy is best because it meets these criteria, but that these are the criteria by which we should judge everything. This makes sense if you think of this part of the Organon as a long argument. The conclusion he reaches at the end of the 71 aphorisms on philosophy is that homeopathy is the best medicine. But he gets there by first establishing the ideal medicine and cure, and then shows why other methods don’t live up to that ideal medicine and argues that homeopathy does. So here, and in the first aphorism, he is establishing these ideals by which we should measure everything.

I also think, although I do not know, that this was part of why Hahnemann became so dissatisfied with the medicine of his time. He repeats a version of this aphorism constantly throughout the Organon and the Medicine of Experience, and this aphorism was barely changed from edition 1 through to edition 6. Meaning he was incredibly steadfast in his belief of this ideal cure for many decades. And his critique of medicine continually centers around the fact that either cure is not focused on enough (see aphorism 1) and/or that the medicines used are harmful, can create long lasting suffering and the relief they do create is short lived (meaning they do not live up to the ideal of this aphorism).

Now this evaluation of medicine is actually not original to Hahnemann. A physician born in 124 BCE named Asclepiades was famous for the saying "the duty of the physician is to treat safely, quickly, and pleasantly;" Note that this is very similar to Hahnemann’s summary of the first and second aphorisms together “The only calling of the physician is to cure rapidly, gently, and permanently”. So Hahnemann has essentially split Asclepiades’ saying in two, and goes into slightly more detail about the physician in aphorism 1 and slightly more detail about cure in aphorism 2.

Clear principles and being reliable.

To a certain extent if something works, it doesn’t really matter why. However, clear principles give a profession, as it has given homeopathy, the ability to create multiple, reproducible (ie reliable) cures. If Hahnemann just had a “gift” for curing people, then the multitude of cures that came after him, based on the principles of homeopathy, would not have occurred. Therefore, in no individual case of cure are the principles of cure necessarily important (because on an individual level, if the individual gets better nothing else matters), but when it comes to multiplying this success in practice, we need principles to guide us to make results replicable. Mixtures of medicines similarly theoretically could work, but if they work, we don’t know which medicine worked or didn’t work, so we don’t know how to apply our results to the next person. Except to try the same thing again, and if it doesn’t work the second time, we have to go back to the drawing board. Same issue with prescribing based on disease category or traditional diagnosis (psoriasis, eczema, etc). It’s fine when it works but if it doesn’t work, we don’t know what didn’t work and therefore how to proceed. Clear principles allow us a way out of these issues.

Translations:
In this aphorism, the translations are mostly congruent with each other. However in the Wenda Brewster O’Reilly and Steven Decker translation, the glossary does explain this idea of clear principles a bit more thoroughly. They clarify that it means “To see into the true nature of something and comprehend it completely. Clearly realizable or inseeable principles ( §2 ) are principles that are so lucid that it is easy to grasp their full nature. Nothing is obscure or incomprehensibly complex.” So this whole Organon, should, theoretically be laying down clear principles where nothing is incomprehensibly complex. Not sure Hahnemann really achieved his goal there. This book is generally not known for its entertaining manner, readability or clarity.

Conclusion:

This aphorism and possibly aphorism 1 were based on an aphorism by Asclepiades and it basically means that the best cure is one that removes the entire disease, is based on easily understood principles and happens quickly, gently and permanently. Hahnemann repeats this idea multiple times throughout the whole Organon, as well as in some other writings, so this was clearly a big deal to him.
However, he has left a lot of questions still to be answered – namely how in the world do we cure this way. What’s the “entire disease” exactly, and what’s “restoration of health” even look like. So stay tuned, because those are the questions answered in the next few aphorisms.
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