What the Physician Must Perceive – Curability

A discussion the third aphorism dealing with the knowledge a physician must have to cure the sick. This includes knowledge of disease, knowledge of medicinal powers of drug substances and the knowledge of laws to apply the later to former….

Organon Section 3. If the physician clearly perceives what is to be cured in diseases, that is to say, in every individual case of disease: if he clearly perceives what is curative in medicines that is to say, in each individual medicine; 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 recovery must ensure-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, as also in respect to the exact mode of preparation and quantity of it required, 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.

The translator has correctly used here the word “perceive.” which is to see into, not merely to look upon with the external eye, but to clearly understand, to apprehend with the mind and understanding. If Hahnemann had said “see ” instead of perceive,” it might have been taken to mean seeing with the eye a tumor to be cut or by opening the abdomen, to see the diseased kidney, or, by examination of the urine, to see that there is albumen or sugar present, by removing which in some mysterious way the patient would be cured.

It is evident by this Hahnemann did not look upon pathological change or morbid anatomy as that which in disease constitutes the curative indication. The physician must perceive in the disease that which is to be cured, and the curative indication in each particular case of disease is the totality of the symptoms, i.e., the disease is represented or expressed by the totality of the symptoms, and this totality (which is the speech of nature) is not itself the ease of the disease, it only represents the disorder in the internal economy. This totality, which is really external, a manifestation in the tissues, will arrange itself into form to present, as it were, to the physician the internal disorder.

The first thing to be considered in a case is, What are the curative indications in this case? What signs and symptoms call the physician’s attention as curative signs and symptoms? This means not every manifestation is a curative indication. The results of disease occurring in the tissues, in chronic diseases, such as cancerous changes, tumors, etc., are of such a character that they cannot constitute curative signs; but those things which are curable, which are capable of change, which can be materially affected by the administration of remedies, the physician must know, they are the curative indications.

The physicians ought to have a well-grounded idea of government and law to which there are no exceptions; he ought to see the cause of disease action to be from centre to circumference, from the innermost of the man to his outermost. If law and government are present, then law directs every act taking place in the human system. Every government is from the centre to the circumference. Look at it politically. Whenever the system of central political government is not bowed to, anarchy and loss of confidence prevail. There are also commercial centres. We must recognize London, Paris, and New York as centres of commercial government in their different spheres.

Even the spider entrenches himself in his web and governs his universe, from the centre. There cannot be two governments; such would lead to confusion. There is but one unit in every standard. In man the centre of government is in the cerebrum and from it every nerve cell is governed. From it all actions take place for good or evil, for order or disorder; from it disease begins the healing process. It is not from external things that man becomes sick, not from bacteria nor environment, but from causes in himself. If the homoeopath does not see this, he cannot have a true perception of disease. Disorder in the vital economy is the primary state of affairs, and this disorder manifests itself by signs and symptoms.

In perceiving what is to be cured in disease one must proceed from generals to particulars, study disease in its most general features, not as seen upon one particular individual, but upon the whole human race. We will endeavour to bring this idea before the mind by taking as an example one of the acute miasms, not for the purpose of diagnosis, as this is easy, but to arrange it for a therapeutic examination. Let us take an epidemic, say, of scarlet fever, or grippe, or measles, or cholera.

If the epidemic is entirely different from anything that has hitherto appeared in the neighbourhood it is at first confusing. From the first few cases the physicians has a very vague idea of this disease, for he sees only a fragment of it, and gets only a portion of its symptoms. But the epidemic spreads and many patients are visited, and twenty individuals have perhaps been closely observed.

Now if the physician will write down all the symptoms that have been present in each case in a schematic form, arranging the mind symptoms of the different patients under “mind” and the head symptoms under “head”, and so on, following Hahnemann’s method, they-considered collectively-will present one image, as if one man had expressed all the symptoms, and in this way he will have that particular disease in schematic form. If he places opposite each symptom a number corresponding to the number of patients in which that symptom occured, he will find out the essential features of the epidemic.

For example, twenty patients had aching in the bones, and at once he sees that that symptom is a part of this epidemic. All the patients had catarrhal affections of the eye, and a measly rash, and these also must be recorded as pathognomonic symptoms. And so by taking the entire scheme and studying it as a whole, as if one patient had experienced all the symptoms, he is able to perceive how this new disease, this contagious disease, affects the human race, and each particular patient, and he is able to predicate of it what is general and what is particular. Every new patient has a few new symptoms; he has put his own stamp on that disease. Those symptoms that run through all are the pathognomonic symptoms; those which are rare are the peculiarities of the different people. This totality represents to the human mind, as nearly as possible, the nature of this sickness, and it is this nature that the therapeutist must have in mind.

Now let him take the next step, which is to find in general the remedies that correspond to this epidemic. By the aid of a repertory he will write after each one of these symptoms all the remedies that have produced that symptom. Having in this way gone through the entire schema, he can then begin to eliminate for practical purpose, and he will see that six or seven remedies run through the picture, and, therefore, are related to the epidemic, corresponding to its whole nature. This may be called the group of epidemic remedies for that particular epidemic, and with these he will manage to cure nearly all his cases.

The question now arises, which one is the remedy for each individual case? When he has worked out the half dozen remedies he can go through the Materia Medica and get their individual pictures so fixed in his head that he can use them successfully. Thus he proceeds from generals to particulars and there is no other way to proceed in homoeopathy. He is called to a family with half a dozen patients in bed from this epidemic, and he finds a little difference in each case so that one remedy is indicated in one patient and another remedy in another patient. There is no such thing in homoeopathy as administering one of these remedies to all in the family because of a diagnostic name.

Now, while one of the remedies in the epidemic group will most likely be indicated in many cases, yet if none of these should fit the patient, the physician must return to his original anamnesis to see which one of the other remedies is suitable. Very rarely will a patient demand a remedy not in the anamnesis. Every remedy has in itself a certain state of peculiarities that identifies it as an individual remedy, and the patient has also a certain state of peculiarities that identifies him as an individual patient, and so the remedy is fitted to the patient.

No remedy must be given because it is in the list, for the list has only been made as a means of facilitating the study of that epidemic. Things can only be made easy by an immense amount of hard work, and if you do the drudgery in the beginning of an epidemic, the prescribing for your cases will be rapid, and you will find you remedies abort cases of sickness, make malignant cases simple, so simplify scarlet fever that classification would be impossible, stop the course of typhoids in a week, and cure remittent fevers in a day.

If the physician does not work this scheme out on paper he must do it in the mind, but if he becomes very busy and sees a large number of cases it will be too much to carry in the mind. You will be astonished to find that if you put an epidemic on paper you will forever be able to carry the knowledge of it in mind. I have done this, and have been surprised to find that after a dozen references to it I did not need it any more.

Now you may say, how is this in regard to typhoid fever? It is not a new disease, it is an old form. The old practitioner has unconsciously made an anamnesis of his typhoid cases, he has unconsciously written it out in his mind and carries it around. It is nor difficult to work out the group of typhoid remedies, and from this group he works. The same is true with regard to measles, certain remedies correspond to the nature of measles, i.e., when studied by its symptoms and not by name.

Of course, every now and then will come up a rare and singular case, which will compel you to go outside of the usual group. Never allow yourself to be so cramped that you cannot go outside of the medicines that you have settled upon as medicine, say, for measles. All your nondescript cases of course will get Pulsatilla, because it is so similar to the nature of measles, but it does not do to be too limited or routine, but be sure in administering a remedy that the indications are clear. Every busy practitioner thinks of Ailanthus, Apis, Belladonna and Sulphur for malignant cases of scarlet fever, and yet he has often to go outside of that group.

So the physician perceives in the disease what it is that constitutes the curative indication.

This presents itself to his mind only when he is clearly conversant with the nature of the sickness, as, for instance, with the nature of scarlet fever, of measles, of typhoid fever,- the zymosis the blood changes, etc., so that when they arrive he is not surprised; when the typhoid state progresses he expects the tympanitic abdomen, the diarrhoea, the continued fever, the rash, the delirium and unconsciousness. These things stand out as the nature of typhoid.

When, therefore, he goes to the Materia Medica he at once calls up before his mind this nature of typhoid, and so is able to pick out the remedies that have such a nature. He sees in Phosphorus, Rhus, Bryonia, Baptisia, Arsenicum, etc., low forms of fever, corresponding to the typhoid condition. But when the patient jumps away out of the ordinary group of remedies, then it is that he has to go outside of the beaten track and find another remedy that also corresponds to the nature of typhoid fever.

By these remarks I am endeavouring to hold up before you that the physician regards as the curative indications of disease. First he sees the disease in general as to its nature, and then when an individual has this disease this individual will present in his own peculiarities the peculiar features of that disease. The homoeopath is in the habit of studying the slightest shades of difference between patients, the little things that point to the remedy. If we looked upon disease only as the old-school physician sees it we would have no means of distinction, but it is because of the little peculiarities manifested by every individual patient, through his inner life, through everything he thinks, that the homoeopath is enabled to individualize.

“If the physician clearly perceives what is curative in medicines, that is to say, in each individual medicine.” Here again he progresses from general to particulars. He cannot become acquainted clearly with the action of medicines individually until he becomes acquainted with the action of medicines collectively, proceeding from a collective study to a particular. This is to be done by studying provings.

Suppose we were to start out in this class and make a proving of some unknown drug. It would be expected that you would all bring out the same symptoms, but the same general features would run through this class of provers; each individual would have his own peculiarities. NO 1 might bring out the symptoms of the mind more clearly than NO.2; No. 2 might bring out the symptoms of the bowels more clearly than No.1; No.3 might bring out heal symptoms very strongly, etc., Now if these were collected together as if one man had proved the medicine, we would then have an image of that medicine. If we had a hundred provers we would go through the whole nature of this remedy and perceive how it affected the human race, how it acted as a unit.

What I have said before about studying the nature of disease must be applied the study of the nature a remedy.

A remedy is in condition to be studied as a whole it is on paper, the mind symptoms under one head the symptoms of the scalp under another, and so on throughout the centre of the body in accordance with Hahnemann’s schema We may go on adding to it, developing it, nothing which of the symptoms or groups of symptoms are the most prominent.

A remedy is not fully proved until it has permeated and made sick all regions of the body. When it has done this it is ready for study and for use. Many of our provings are only fragments and are given in the books for what they are worth. Hahnemann followed up in full all the remedies that he handed down to us; in these the symptoms have been brought out upon the entire man. Each individual medicine must be studied in that way, as to how it changes the human race.

To understand the nature of the chronic miasms, psora, syphilis and sycosis, the homoeopath must proceed in identically the same way as with the acute. Hahnemann has put on paper an image of psora. For eleven years he collected the symptoms of those patients who were undoubtedly psoric and arranged them in schematic form until the nature of this great miasm became apparent. Following upon that he published antipsoric remedies which in their nature have a similarity to psora. To be a really successful physician the homoeopath must proceed along the same lines in regard to syphilis and sycosis.

Now, when the physician sees, as it were, in an image, the nature of disease, when he is acquainted with every disease to which we are subject and when he sees the nature of the remedies in common use, just as clearly as he perceives disease, then on listening to the symptoms of a sick man he knows instantly the remedies that have produced upon healthy man symptoms similar to these. This is what paragraph 3 teaches; it looks towards making the homoeopathic physician so intelligent that when he goes to the bedside of a patient he can clearly perceive the nature of disease and the nature of the remedy. It is a matter of perception; he sees with his understanding. When a physician understands the nature of disease and of remedies, then it is that he will be skilful.

James Tyler Kent
James Tyler Kent (1849–1916) was an American physician. Prior to his involvement with homeopathy, Kent had practiced conventional medicine in St. Louis, Missouri. He discovered and "converted" to homeopathy as a result of his wife's recovery from a serious ailment using homeopathic methods.
In 1881, Kent accepted a position as professor of anatomy at the Homeopathic College of Missouri, an institution with which he remained affiliated until 1888. In 1890, Kent moved to Pennsylvania to take a position as Dean of Professors at the Post-Graduate Homeopathic Medical School of Philadelphia. In 1897 Kent published his magnum opus, Repertory of the Homœopathic Materia Medica. Kent moved to Chicago in 1903, where he taught at Hahnemann Medical College.