Aphorism 3 and 4: how to cure people and prevent relapse
Outline:
Aphorism 3 serves as an outline for the rest of the book, and covers what a healthcare practitioner needs to know in order to create the kind of cure he praised in previous aphorism. At the end of aphorism 3, he brings up the topic of hygiene. Aphorism 4 continues with the idea of using lifestyle as a way to prevent relapses.
Background:
The first aphorism basically states that the number one job a medical professional should be concerned with is making people better. The second aphorism states that the best way to do that is with a quick, safe and permanent cure that is based on a sound philosophy (philosophy makes it replicable and teachable!). Both the first and second aphorisms, like this one, set a very general stage. He’s not talking about homeopathy (yet), he’s talking about what medicine should be in general. This will form the basis for his argument as to why homeopathy is the best medicine, but that argument won’t happen for a while.
Aphorism 3, deconstructed:
This aphorism can appear wordy, but it's structure is pretty basic. Here is the aphorism deconstructed in point form.
To treat with judgment, reason or logic, you need:
Discernment of disease (also written as understanding or perceiving indications of disease/what needs to be cured):
Diseases in general
Each individual case before you
Medicinal knowledge
Medicines in general
Each individual medicine
Know how to match the two:
Prepare the remedy correctly
Dose the remedy correctly
Finally, make sure it’s permanent:
Know obstacles to recovery
Know how to remove those obstacles
Aphorism 3 is often considered an outline of the whole Organon. Indeed, the order of this aphorism roughly follow the order of topics in the rest of the book, and the major sections of the book are accounted for here in this aphorism. Below, you can see the aphorism in point form again, with the corresponding aphorisms, so you can see for yourself that the aphorisms do indeed follow in this rough order.
To treat with judgment, reason or logic, you need:
Discernment of disease (also written as understanding what are indications of disease, or perceive what needs to be cured):
Diseases in general
Types of disease: Aphorisms 72-81
Chronic miasms: 204-209
Mental/emotional: 210-230
intermittent diseases: 231-244
Each individual case before you (case taking): 82-104
Medicinal knowledge (summary: acquiring a knowledge of medicines 105-145)
Medicines in general
Provings: 105-145
Each individual medicine
I understand this to be a knowledge of materia medica, the study of which does not have a separate section in the Organon
Know how to match the two:
Which philosophy should drive a prescription: 1-71
homeopathic treatment of diseases: 146-203
Prepare the remedy correctly
Making a remedy: 264-271
Dose the remedy correctly
Administration of medicines: 272-285
Finally, make sure it’s permanent:
Know obstacles to recovery
Know how to remove those obstacles
This idea of lifestyle counselling scattered throughout, but the largest section could be considered 259-263. Aphorisms 5, 77, 81, and others are of note, however.
What does it mean to “know” disease and remedies?
Depending on the translation you read, the words used are realize, understand, perceive, or know diseases and remedies. If you have the Decker and O’Reilly version of the Organon, in the glossary you will see a long discussion on the words “knowledge, discernment and realize”. They will also refer you to the word “participation”. In the discussion on the word knowledge, Decker notes that the form of knowledge referred to in aphorism 3 has an experiential component:
“To know: kennen [to ken]. To have deep personal knowledge, such as that based on life experience, specifically that part of life experience that cannot be conveyed to another person through teaching or demonstration. For example, the difference between … knowing about water from reading about it and studying it scientifically versus knowing from having dived into lakes, waded in streams and walked in the rain” (pp 321-322).
In most translations the word “perceive” is also used frequently, although in Decker/O’Reilly’s version realize is used. Meaning you need to clearly perceive what is diseased, or realize what is clearly diseased. Perceiving/Realizing here does not necessarily mean you understand the mechanism or know how to diagnose the condition before you, but it means you need to take note of or become aware of what signs constitute disease. Decker does have a discussion on realize here, which notes that realize is to clearly see the nature of something. I do not interpret that to mean that we need to understand the inner working of disease or symptoms, but rather that we need to be able to know whether what we are looking at is a symptom, is it unique, is it a variation of normal human experience, is it due to lifestyle only (and therefore does not need a remedy) or is it a dynamic symptom, etc. Kent in his Lectures on Homeopathic Philosophy takes this to mean that we need to be able to "see into, not merely look upon [symptoms]...to understand, apprehend [them] with the mind" (pp33-34) but I do not agree. Symptoms, to Hahnemann, are simply changes in feeling or function (aphorism 6, 7) and as such, we do not have to "understand" them, but note that they exist.
Matching a remedy and a disease:
We already get a bit of foreshadowing of the idea of matching symptoms to symptoms. In Homeopathy, we match the symptoms of the disease to the symptoms created by a medicine. We need to understand how to match what is unique in the patient to what is unique in the medicine. But we also need to understand how to generally match a disease to a medicine. He continually points to the importance of knowing the general and the specific in medicine.
Obstacles to Cure: Aphorism 4 and the end of aphorism 3:
At the end of aphorism 3, he notes that in order to make cure permanent, you need to be able to recognize obstacles to cure and remove them. So any cure you make with a medicine may not be permanent if you don’t remove something in someone’s life that can create disease. This could be stress, poor living conditions, or a poor diet.
In aphorism 4, he says that you are a sustainer of health if you know and can remove things that create disease.
The way he words these however, clearly sets a hierarchy. First, you cure sick people (ala aphorism 1), then if you want to preserve or sustain health, you tackle obstacles.
Causes of disease?
Depending on the translation, your version may say that you need to remove the things that cause of disease. The idea of “causes” can get confusing because sometime he will rail against the allopaths for trying to know what causes disease (which he says are unknowable), and then sometimes he says we need to find the cause of disease and remove it. So what gives?
In the introduction and some earlier editions of the Organon, he explains his idea of causes a bit more clearly. Hahnemann believed that something may create disease but that once a disease has been brought into being, it needs to be treated. If you remove the cause of disease, you do not cure the disease. Because the disease now lives on its own! At the time Hahnemann was writing, allopaths believed the cause of disease was a physical thing that could be removed. When the physical entity was removed, then the disease would go away. It’s a lot like the idea of detoxing today – we say there are “toxins” in the body, that once removed will cure the disease. But instead of a juice cleanse like today, back in Hahnemann’s time you were subjected to bloodletting or fistulas. So when Hahnemann complained about the allopaths removing the cause, he was referring to the speculation about a possible physical entity to be removed, and the idea that removing the cause would cure the disease.
However! If you are now thinking of all kinds of diseases that are cured by lifestyle, then know that Hahnemann didn’t consider a pure lifestyle problem to be a true disease. So if someone is overweight only because they overeat, then Hahnemann wouldn’t consider that a true disease. And if someone has diabetes only because they eat a lot of simple carbohydrates, then that is not a true disease to Hahnemann. This can of course be debated; I am not saying this because it’s an indisputable fact. The point is what Hahnemann meant when he talked about removing the cause of disease. His point, I believe, was that there are things in life that make us more likely to be ill (like overeating or eating too much of a certain kind of food, or being in an abusive relationship). Removing those from our life where possible will protect our health. These are the “causes” he is talking about in aphorism 3 and 4. But again, he's not saying that removing these will cure a "true" disease.
These aphorisms in a nutshell: Know what needs to be cured (in general and in each individual case), know your medicines (and how to dose and prepare them) and match disease to medicines. Protect health with lifestyle. Done! Easy! (Ha!)