What has changed? And what has stayed the same? How is the patient in health and how does he change in sickness? How do we reconcile “take note of nothing…except the deviations from the former healthy state” (Aphorism 6), with “the most significant points in the whole history of the chronic disease” (Aphorism 5)?
Let’s look at them… (text taken from 6th edition)
Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.
The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.
So – which one is it? If the information described in Aphorism 5 is what is needed to make an accurate homoeopathic prescription, we can understand the Kentian-style intake, lasting hours and sometimes even days. We can also understand how Kent – with a little push from Swedenborg, ok, a hefty shove – came to the concept of the constitutional remedy. A remedy which encompasses the patient’s entire soul and psyche, in this life and – depending on your beliefs – in all those that came before and will come after…
Since Kent’s time, homeopaths have worshipped at the altar of the Constitutional Remedy, the simple substance – a Swedenborgian, not Hahnemannian concept – and this is what most non-homoeopaths and homoeopaths alike believe Classical Homoeopathy to be.
But then what do we do about Aphorism 6? This Aphorism and its instructions have been swept under the constitutional carpets of so-called Classical Homoeopathy for so long that the simple clarity of focus and objective has been lost to many.
Hahnemann’s language in Aphorism 6 is very clear. “Take note of nothing but the changes in the health of the body and the mind”. How on earth is it possible to ignore that? But it is ignored.
The thing is – this is not an “either/or” situation. Both Aphorisms are essential, but they serve different purposes. We cannot take what has changed (Aphorism 6), if we don’t know what was before (Aphorism 5). We cannot assess those changes and prioritize them if we don’t know whether there is an exciting cause, a maintaining cause, a miasmatic origin (or something that is harming the patient’s health and can be removed – see Aphorism 4) – if we don’t do the work set out in Aphorism 5.
But the central focus, the torch that has to guide us through the often labyrinthine nature of a complex case has to be Aphorism 6. So many patients today are subjected to never-ending sessions where they are asked to disclose their most intimate thoughts, dreams and fantasies, their sexual urges, their emotional relationships past present and future, their failed expectations and unexpected successes. The process is usually emotionally draining, hugely time-consuming, potentially harmful in terms of the patient-practitioner relationship, and without the context set out in Aphorism 6, of no use whatsoever and potentially hinders us from finding the best homoeopathic prescription for the patient.