Obstacles To Cure

Introduction

A living organism has an inherent power to adjust itself to inner conditions and outer environment, but within certain limits. If this limit is exceeded, the deviation from the normal state of health may be adjusted and restored to its previous healthy condition by suitable dietetic and hygienic measures (indisposition, §150). But in the event of disease proper, the deviation from the healthy state of the organism is too far gone to be adjusted by the aforesaid measures. Now comes the time and occasion to apply some stimulus in the form of a specific drug energy to restore the sick to health. (§151). The condition precedent to successful application of a needed drug stimulus is the knowledge of dietetic, hygienic, pathology, bacteriology etc.

Dr Hahnemann says in §1 of Organon of Medicine, that, “THE physician’s high and only mission is to restore the sick to health, to cure, as it is termed.” But there are certain factors which hinder cure by obstructing the effect of a properly selected medicine inspite of a suitable dose and repetition. About this, Hahnemann writes in §3, that, “…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…” ¹ So, a true physician must have the knowledge of the factors which may act as an obstacle to cure in each particular case, in order to bring about a permanent cure.

Knowledge of obstacles to recovery and their removal (§3, §5, §7)

The physician should have the knowledge of all the dietetic, hygienic and other factors that pose an obstacle to the recovery:

• Exciting causes(Causa Occasionalis) 
• Maintaining causes
• Fundamental cause (Miasm)

He should know how to remove all these obstacles to bring about a cure.

Exciting cause- In acute diseases, the most probable exciting cause (§5) has to be determined. Exciting cause is the stimulus which arouses or brings about a state of disequilibrium in the health of a susceptible person, causing the onset of an acute disease or the acute state (exacerbation) of the chronic disease. This exciting factor has to be investigated in every case of an acute disease, although it can never be ascertained with full certainty. There can only be a probability of such a link between cause and the effect (i.e., disease). Therefore, only the most probable exciting cause can be found. In this search for the exciting cause, certain Accessory circumstances (§5) have to be taken into consideration. Any manifest exciting cause has to be removed where it exists (§7). By removing the exciting cause, the indisposition generally ceases spontaneously and the original healthy state is restored. Hahnemann has given some examples in footnote to §7, of such exciting causes (causa occasionalis), whose removal results in cessation of the diseased condition:

• Removal from the room strong smelling flowers, which have a tendency to cause syncope & hysterical sufferings.
• Extract from the cornea the foreign body that excites inflammation of the eye.
• Extract foreign substances that may have got into the orifices of the body (nose, gullet, ears, urethra, rectum, vagina)
• Some examples of such exciting causes which Hahnemann gave in Medicine of Experience are –

• Deficiency of pure, open air
• Excess or deficiency of sun’s light; of both kinds of electricity
• Constriction of various parts of body by different articles of dress
• Excessive quantities of food or drink, e.g., wine, spirits, beer etc.

After removal of such manifest exciting (& maintaining) causes only, the totality of symptoms can be formed, which is the sole guide to the selection of the suitable remedy. Knowledge of such exciting causes will help to prevent an exposure to them, hence preserving health.

Maintaining Cause- Maintaining causes are the ones, which are responsible for continuation of the diseased state of the body. These pose an obstacle to cure in any disease. Hahnemann has given many examples in footnote to §7, of the conditions, which when present, pose as an obstacle to the recovery in such cases:

• Over-tight bandage on a wounded limb, that threatens to cause mortification
• Ligature on a wounded artery that produces fainting.
• Belladonna berries, which are swallowed.
• Vesical calculus
• Imperforate anus of newborn infant.

Unless these conditions, which maintain the disease (causa occasionalis) are removed, the disease will continue and recovery is not possible. Therefore, all such maintaining causes have to be ascertained and removed. By doing so, the indispositions will cease spontaneously and recovery will ensue. After removal of the maintaining (& exciting) causes, whatever morbid symptoms remain, will form the totality of symptoms, which call for a suitable remedy. Maintaining causes are the avoidable noxious influences which are only responsible for the production of Pseudo-chronic diseases – inappropriately named chronic diseases (§77). For example:

• Habit of indulging in injurious liquors
• Prolonged abstinence from things that are necessary for the support of life.
• Persons residing in unhealthy localities, especially marshy districts
• Prolonged deprivation of exercise or open air
• Over exertion of body or mind etc.

i.e. state of ill-health disappears spontaneously when such maintaining factors are removed (provided no chronic miasm lurks in the body)

Fundamental cause- Fundamental cause is the basic/ primary/original cause, for each case of disease. Three types of fundamental causes are responsible for each type of chronic disease – the three Chronic Miasms – Psora, Syphilis, Sycosis. They produce dynamic derangements in the basic substance or ‘soil’ of the person and create a morbid susceptibility for diseases. For discovering the Fundamental cause of a chronic disease, the physician has to gain a knowledge of the condition of patient during the most significant points in the whole history of this chronic disease (§5) – period of conception, intrauterine life, during delivery (moment of birth), dentition, puberty (menses/ spermatorrhoea), marriage, pregnancy, menopause. While searching for the fundamental cause, Accessory circumstances (§5) are to be considered – which are the supplementary conditions, affording aid to the development of a disease. Until fundamental causes are removed by a proper similimum (anti-miasmatic remedy), the chronic diseases can never be cured.

Accessory Circumstances

These are the Physiological and emotional status/ Constitutional Configuration of an individual and the impact of the environment in which the patient as a person lives. Accessory circumstances hold a practical importance during various stages of cure. They help in the choice of remedy (§5, 7, 18, 24) and also work as obstacles to cure.

Accessory circumstances work as obstacle to cure in the following aspects:

• Regimen
• Environment: Patients especially with respiratory diseases will not be cured if they live in smoky, dusty areas and in damp basement and cellars in spite of proper dose and repetition of the indicated similar medicine. At present the industrial growth has given rise to the problem of environmental pollution by industrial wastes. Such increasing environmental pollution hinders cure vigorously.
• Diet: A person is being treated for his chronic diarrhea. The correct similar medicine in suitable dose has been administered. But there is no cure. On further investigation, it was found that there is some error in his diet. He is taking such a diet which is not suitable to his disease. Hence the patient will not be cured until this error is corrected.
• Objects of anger, grief or vexation (§260)
• Mental or bodily overexertion
• Avoidance of any emotional shock
• Other medicines

Diet And Regimen Acting As Obstacles To Cure

• Proper hygienic and dietetic measures must be taken recourse to before administration of remedial drugs which are used as specific stimuli to rouse the vital force to react against the morbific agents and overcome their noxious influences.
• During the treatment everything must be removed from the diet and regimen which can have any medicinal irritant. (§259)
• In § 260 Hahnemann says, “Hence the careful investigation into such obstacles to cure is so much the more necessary in the case of patients affected by chronic diseases, as their diseases are usually aggravated by such noxious influences and other disease-causing errors in the diet and regimen, which often pass unnoticed”.
• In footnote to §260 Hahnemann talks about the recommended regimen for chronic diseases and talks about the various factors in the diet and regimen which act as obstacles to cure.
• Dr BK Sarkar writes in his book of Organon of Medicine, that, in Chronic Diseases we have got to be more careful in dietetic and hygienic matters as they may easily upset the patient in a suspicious manner. The following things are to be avoided: (§ 260, Footnote)

• Coffee; fine Chinese and other herb teas; beer prepared with medicinal substances; liquors; all kinds of punch; spiced chocolate; odorous waters and perfumes of many of kinds; strong scented flowers in the room; both powders and essences etc.; highly spiced dishes and sauces; spiced cakes and ices; crude medicinal vegetables for soups; dishes of herbs, roots and stalks of plants possessing medicinal properties; asparagus and all vegetables possessing medicinal qualities, celery, onions; old cheese, and meats in a state of decomposition, etc.
• Excesses in food and in the use of sugar and salt and spirituous drinks.
• Heated rooms, woolen clothing next the skin
•  A sedentary life in closed apartments or frequent indulgence in passive exercise (such as riding, driving or swinging), prolonged suckling, taking a long sleep in a recumbent posture in bed, sitting up long at night
• Uncleanliness, unnatural debauchery enervation by reading obscene books, reading while lying down.
• Onanism or imperfect or suppressed intercourse in order to prevent conception
• Subjects of anger, grief or vexation, a passion for play, overexertion of mind or body, especially after meals.
• Dwelling in marshy districts, damp rooms, poor living etc.

N.B. Even during Hahnemann’s time his followers wanted to outdo him in their strictness in dietetic and hygienic matters to which he wrote: “some of my disciples seem needlessly to increase the difficulties of the patient’s dietary by forbidding the use of many more, tolerably indifferent things which is not to be commended.”

• The most suitable regimen during the treatment of chronic diseases consists in: (§261)

• Removal of the above-mentioned obstacles to recovery;
• Supplying where necessary the reverse;
• Innocent moral and intellectual recreation;
• Acute exercise in the open air in almost all kinds of weather; e.g., daily walks, slight physical labour etc.
• Suitable, nutritious, unmedicinal food and drinks etc.

Pathological Causes

• The various aspects of a physician’s mission (§1) are:

• To cure incurable cases
• To palliate in incurable cases
• To preserve health

In cases, where pathology is so advanced so as to become irreversible, the physician can only give a soothing effect with the medicines.

• Disease per se is the morbid process of functioning of the life-principle; if this process is unchecked, it eventually leads to structural changes. These structural changes might be of two types viz., reversible and irreversible: they are the end-results of morbid vital process and act as obstacles to restoration of the abnormal vital process to its previously healthy condition
• The more the pathological changes are of severe degree and of irreversible type, the less the chances are for recovery. Hence, the pathological state of the patient is certainly one of the factors impeding recovery and its knowledge is therefore essential for a physician-therapeutist.
• Stuart close in the chapter Cure and Recovery in his Lectures and Essays on Homeopathic Philosophy, says….

“The tangible, physical results of disease as thus defined may and often do disappear spontaneously when the internal dynamic disturbance is removed’ by curative medication, but they are not primarily the object of homœopathic treatment. It may be necessary eventually, to remove them mechanically by surgical art. Surgical or mechanical measures become necessary when the tangible products of disease are so far advanced or so highly developed that they become secondary causes of disease and obstacles to cure. In all cases in which disease has unlimited in organic or tissue changes which have progressed to a point where surgical interference is necessary, homœopathic dynamical treatment should precede and follow operation; bearing in mind always that such changes are the direct result of preceding and accompanying morbid functional changes, and that the patient is not cured unless normal functioning is restored.”

• Dr. H.A. Roberts in his book The Principles and Art of Cure by Homoeopathy has also detailed various obstacles to cure in the Chapter XXXIV – ‘The Deflected Current’.

Miasmatic Cause

• Even after administration of similimum, Hahnemann observed a continuous relapse or recurrence of the symptoms occurred at variable intervals and there by no complete cure. This made him think about the obstacles for complete cure and this led him to the discovery of the nature of chronic diseases, which led him to the theory of 3 chronic miasms – Psora, Sycosis and Syphilis.
• So, in a chronic miasmatic disease, the miasm may act as an obstacle in the way of cure. Such miasm will have to be removed by the proper anti-miasmatic treatment in order to cure the patient permanently. 

One Sided Diseases

• One sided diseases may act as an obstacle to the cure of the patient due to:

• The nature of these diseases being manifested by a scarcity of the symptoms
• Their chronic nature

Cases Lacking In Vital Organs

• In cases where the patient is lacking in any vital organs, e.g. a patient whose spleen has already been removed surgically, for such patients a complete cure is impossible.

Life Style

• In the current scenario of disintegrating familial structures, technological advancements, globalization, consumerism, substance abuse, competitive working styles etc., lifestyle gives rise to/ maintains a plethora of illnesses.
• Life style diseases belong to the category of preventable non-communicable chronic diseases (since the onset of these lifestyle diseases is insidious, they take years to develop, and once encountered do not lend themselves easily to cure, Hahnemann named them ‘inappropriately named chronic diseases’ (§77).
• In various aphorisms of his Organon we can see that Hahnemann has emphasized on the role of life-style factors of the patient playing a role in acting as obstacles to cure….

• In § 208 Hahnemann tells that “The age of the patient, his mode of living and diet, his occupation, his domestic position, his social relation and so forth, must next be taken into consideration, in order to ascertain whether these things have tended to increase his malady, or in how far they may favor or hinder the treatment. In like manner the state of his disposition and mind must be attended to, to learn whether that presents any obstacles to the treatment, or requires to be directed, encouraged or modified.”
• In § 252 Hahnemann tells that “But should we find, during the employment of the other medicines in chronic (psoric) diseases, that the best selected homoeopathic (antipsoric) medicine in the suitable (minutest) dose does not affect an improvement, this is a sure sign that the cause that keeps up the disease still persists, and that there is some circumstances in the mode of life of the patient or in the situation in which he is placed, that must be removed in order that a permanent cure may ensue.

Modern Drug And Its Influence 

(Iatrogenic Diseases – §74, §75, §76)

• At present, the patients are used to taking allopathic drugs haphazardly for their relief without knowing their evil consequences. The prolonged use of such violent drugs in ever-increasing doses may produce artificial chronic diseases which weaken the vital force severely. 
• It has also been found from clinical experience that prolonged and indiscriminate administration of potentized medicines (especially of high potency) may also complicate the cases.
• Hence indiscriminate use of drugs even homoeopathic (especially of high potency) also act as obstacles to cure.

With this understanding about the various obstacles to cure, we understand that, when we realize that something can be an obstacle to cure, then we must try to remove it in the best way possible so that healing can progress.