Organon of Medicine

APHORISM 7:

Now, as in a disease, from which no manifest exciting or maintaining cause (causa occasionaliss) has to be removed1, we can perceive nothing but the morbid symptoms, it must (regard being had to the possibility of a miasm, and attention paid to the accessory circumstances, § 5) be the symptoms alone by which the disease demands and points to the remedy suited to relieve it – and, moreover, the totality of these its symptoms, of this outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force, must be the principal, or the sole means, whereby the disease can make known what remedy it requires – the only thing that can determine the choice of the most appropriate remedy – and thus, in a word, the totality2 of the symptoms must be the principal, indeed the only thing the physician has to take note of in every case of disease and to remove by means of his art, in order that it shall be cured and transformed into health.

1 It is not necessary to say that every intelligent physician would first remove this where it exists; the indisposition thereupon generally ceases spontaneously. He will remove from the room strong-smelling flowers, which have a tendency to cause syncope and hysterical sufferings; extract from the cornea the foreign body that excites inflammation of the eye; loosen the over-tight bandage on a wounded limb that threatens to cause mortification, and apply a more suitable one; lay bare and put ligature on the wounded artery that produces fainting; endeavor to promote the expulsion by vomiting of belladonna berries etc., that may have been swallowed; extract foreign substances that may have got into the orifices of the body (the nose, gullet, ears, urethra, rectum, vagina); crush the vesical calculus; open the imperforate anus of the newborn infant, etc.

2 In all times, the old school physicians, not knowing how else to give relief, have sought to combat and if possible to suppress by medicines, here and there, a single symptom from among a number in diseases – a one-sided procedure, which, under the name of symptomatic treatment, has justly excited universal contempt, because by it, not only was nothing gained, but much harm was inflicted. A single one of the symptoms present is no more the disease itself than a foot is the man himself. This procedure was so much the more reprehensible, that such a single symptom was only treated by an antagonistic remedy (therefore only in an enantiopathic and palliative manner), whereby, after a slight alleviation, it was subsequently only rendered all the worse.

Dr Prasad Rasal:

After explaining the Importance of the Unprejudiced Observation & Portrait of the Disease, Dr Samuel Hahnemann explain about the Importance of the Causa Occasionalis or the Maintaining Cause and Totality of the Symptoms.
The things which maintains the disease are called as the Maintaining Causes which are responsible to produce the False Chronic Diseases. Removal of the maintaining cause removes the false disease. Dr Hahnemann explained the number of examples of the Maintaining causes in the first foot note to this paragraph as, “It is not necessary to say that every intelligent physician would first remove this where it exists; the indisposition thereupon generally ceases spontaneously. He will remove from the room strong-smelling flowers, which have a tendency to cause syncope and hysterical sufferings; extract from the cornea the foreign body that excites inflammation of the eye; loosen the over-tight bandage on a wounded limb that threatens to cause mortification, and apply a more suitable one; lay bare and put ligature on the wounded artery that produces fainting; endeavor to promote the expulsion by vomiting of belladonna berries etc., that may have been swallowed; extract foreign substances that may have got into the orifices of the body (the nose, gullet, ears, urethra, rectum, vagina); crush the vesical calculus; open the imperforate anus of the newborn infant, etc.”
If there is no Maintaining Cause in the case, the external manifestations i.e. symptoms indicates the internal dynamic derangement of the disease. Dr Hahnemann labels it by Totality of the Symptoms. He defines it as an outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force. Totality of the Symptoms is the only important tool to find out the Similimum. He further says that it is the only thing that can determine the choice of the most appropriate remedy – and thus, in a word, the totality of the symptoms must be the principal, indeed the only thing the physician has to take note of in every case of disease and to remove by means of his art, in order that it shall be cured and transformed into health.
Here, he has used the words “by means of his art”. In fact, He has explained in short that Homoeopathy is not only the Science but also an Art. Finding out Characteristic Totality in a case is an Art. Every Homeopath has to develop this Art in himself for finding a Similimum. Let me share one example. One of my student came to me after finishing the case of a 5-6 years girl & told me that, “Sir, she is perfectly Baryata. She is totally shy, not uttered a single word, never answered a single question, never looked at me during case taking. Whatever data I got is from her mother.” I turned towards the girl & offered her sweet globules. She liked them & asked for more. Then I asked her name, her school’s name, address & she started talking very freely. The shyness vanished & similarly the Baryata picture. So, it’s really an Art along with Scientific base.
In the 2nd foot note to this paragraph, He has compared the Homoeopathic aspect of Totality of the Symptoms with the Antipathic aspect of using Single Symptom from the group of symptoms. He criticized this aspect of Single symptom because it never denotes the Individuality & the antipathic prescription based on this Single Symptom is unable to remove the disease in its whole extent. A single one of the symptoms present is no more the disease itself than a foot is the man himself. It acts as a palliative mode of treatment & original disease reappears with greater intensity after finishing the palliative effect of this Antipathic Medicine.