How the Physician is a Remedy for the Patient (part one)

In his Organon, Dr. Hahnemann makes some very earnest comments about the proper conduct of the physician towards the patient. The text which I have excerpted below is derived from Hahnemann’s experience with working with patients in mental institutions, however the principles contained are applicable to all patients, regardless of whether or not they are in such an extreme state of mental illness.

228.1 In psychic diseases arisen by means of somatic disease, which are only to be cured by homeopathic medicine directed against the internal miasm along with carefully adapted regimen, a seemly psychical conduct towards the patient as an auxiliary soul-diet must indeed also be carefully observed on the part of the relations and the physician.

In this first sentence alone, he has already alluded to the three jurisdictions of Heilkunst treatmentmedicine (“..which are only to be cured by homeopathic medicine directed against the internal miasm…”), regimen (“…along with carefully adapted regimen…”), as well as therapeutic education (“…as an auxiliary soul-diet must indeed also be carefully observed…”).

228.2 To raging insanity must be opposed quiet intrepidness and firm, cold-blooded will — to awkward, plaintive lamentation, mute regret in looks and gestures — to nonsensical prattle, not quite inattentive silence — to a disgusting and atrocious behavior and similar chatter, complete inattentiveness.

Here is a point where Cesar Millan and Dr. Hahnemann could become quick friends — the “calm, assertive energy” which Millan constantly reinforces in his rehabilitation of dog owners is the same thing Hahnemann is recommending to the physician in their treatment of their mentally unwell patients. As soon as the physician, or dog owner becomes rattled, and dragged into the emotional drama of the patient, everyone has been reduced to the lowest common denominator, and no progress can be made.

228.3 Only let there be safeguards against property damages, preventing them without reproaching the patient about them, arranging everything so that all corporal punishment and torment [In a lengthy footnote here, Hahnemann describes the disaster precipitated by the typically cruel and unprincipled behavior of doctors in mental institutions.] are thoroughly abolished.

This is similar to the general principle of parenting, of keeping the child safe from overt danger, without becoming unnecessarily restrictive of their movment and exploration of the world. As in the general impulse of homeopathic medcine, Hahnemann is suggesting that the impulse from the physician needs to be just enough to produce the desired effect, without being over the top, and therefore suppressive.

228.4 This is all the more easily effected since in the homeopathic administration of medicine — the only case in which compulsion could be justified as an excuse — the small doses of helpful medicine are never conspicuous to the taste and can therefore be given wholly unawares to the patient in his drink, so that all compulsion becomes unnecessary.

Free will, and informed consent are always the highest ideals to bear in mind in healthcare. There are cases, other than such conditions in the mental institutions which Hahnemann describes here, where a deceptive administration of medicine may be appropriate in a given family dynamic, and where one or more of the family members are sufficiently “out of their minds” due to their state of disease, and would become a harm to the rest of the family if left untreated. I mention this, but bear in mind that a very high level of consideration needs to be undertaken into the dynamics and ethics before applying such treatment in any given case.

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