First of all, results of first prescription are NOT the same as completely curing the case. But the first prescription has to match the disease state and effect the change that is curative in direction. I take my stance for matching the disease from aphorism 6 in the Organon 5th and 6th edition: viz::
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.
This means an accurate tracing of the disease state, and prescribing based on the totality of the symptoms that are presented before him. Further reading of the Organon and of the case notes of Hahnemann in his Case books, has revealed the comprehension that Hahnemann had in understanding that the prevailing presentation of symptoms, need to be dealt with, as they are the picture of the “disease”. In simple terms, if a patient presents with Eczema, and on the way across the street gets hit by a car, which do you treat FIRST? obviously the present and maintaining disorder caused by vehicular impact. Its a different disease state.
This crude explanation of a methodology, shows that the understanding of “WHAT” constitutes a single MAINTAINING disease state, is vital in treating.
How many times has a patient presented with mental and physical symptoms, and in repertorising the case, we have not been able to come to a single remedy that covers all the expressions of the disease? The answer is simple, IT IS NOT ONE DISEASE!
Hahnemann went on to explain that he would then treat the PRESENTING symptoms until the presentation of the disease state for the one disease he was treating ameliorated or CHANGED in a large way, and then he would swap remedies to treat that other disease state…based only on the symptoms presented as a totality. These symptoms can and WILL switch between states necessitating following them with the appropriate remedy when required.
He did stress that the body could not hold similar disease states, BUT different one could co-exist happily.
Given that is the case, careful evaluation of the presentation of the symptoms before you, and extraction of the main PRESENTING ones that are affecting the patient, and are deviations from his normal state..BE IT THAT THE NORMAL STATE for the patient is also perhaps diseased… the presenting symptoms need to be removed and then treat each complete disease picture as it is presented. Sometimes the presenting disease state is the whole disease and treatment will remove it in its entirety by focusing on the presentation of symptoms.
Another example is that a patient presents with a heavy bronchial infection, and we know has a history of allopathically treated gonorrhea (with no symptoms) We would, according to Hahnemann treat the presenting symptoms first, (the bronchial affection) and then treat the STD appropriately as and when or if, symptoms possibly arise.. EXCEPT.. where the presenting symptoms do not ameliorate to the application of remedies, and the STD is the maintaining cause of the lack of reaction to the application of correctly prescribed remedies.
There is so much information to be gleaned from his case books. At first when I read them, I did not comprehend why it took so long for him to cure patients in some cases. As I started to compare cases together, and in reading Chronic diseases again, I finally understood his ability to see disease states as separate entities, and then the reason for his work on miasms came clear. Even within the infecting agents of PSORA, there can be DIFFERENT infecting agents. For this we need different remedies, differential diagnosis for disease STATES.
Modern medicine confirms Hahnemann’s observations regarding layers of infection and reaction.
On this methodology, which is Hahnemanns, I claim a 75-80% success rate for careful first prescription in starting to remove the disease OR DISEASES and will work through the presentations of symptoms as they arise, for the complete removal of a single disease state, or the alternation of separate disease states in the patient utilising different remedies as required.
Aphorism 5 gives credence to this.
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.