Aphorism 161-170

§ 161 Sixth Edition
When I here limit the so-called homoeopathic aggravation, or rather the primary action of the homoeopathic medicine that seems to increase somewhat the symptoms of the original disease, to the first or few hours, this is certainly true with respect to diseases of a more acute character and of recent origin, but where medicines of long action have to combat a malady of, considerable or of very long standing, where no such apparent increase of the original disease ought to appear during treatment and it does not so appear if the accurately chosen medicine was given in proper small, gradually higher doses, each somewhat modified with renewed dynamization (§ 247). Such increase of the original symptoms of a chronic disease can appear only at the end of treatment when the cure is almost or quite finished.

§ 162
Sometimes happens, owing to the moderate number of medicines yet known with respect to their true, pure action , that but a portion of the symptoms of the disease under treatment are to be met with in the list of symptoms of the most appropriate medicine, consequently this imperfect medicinal morbific agent must be employed for lack of a more perfect one.

§ 163
In this case we cannot indeed expect from this medicine a complete, untroubled cure; for during its use some symptoms appear which were not previously observable in the disease, accessory symptoms of the not perfectly appropriate remedy. This does by no means prevent a considerable part of the disease (the symptoms of the disease that resemble those of the medicine) from being eradicated by this medicine, thereby establishing a fair commencement of the cure, but still this does not take place without those accessory symptoms, which are, however, always moderate when the dose of the medicine is sufficiently minute.

§ 164
The small number of homoeopathic symptoms present in the best selected medicine is no obstacle to the cure in cases where these few medicinal symptoms are chiefly of an uncommon kind and such as are peculiarly distinctive (characteristic) of the disease; the cure takes place under such circumstances without any particular disturbance.

§ 165
If, however, among the symptoms of the remedy selected, there be none that accurately resemble the distinctive (characteristic), peculiar, uncommon symptoms of the case of disease, and if the remedy correspond to the disease only in the general, vaguely described, indefinite states (nausea, debility, headache, and so forth), and if there be among the known medicines none more homoeopathically appropriate, in that case the physician cannot promise himself any immediate favorable result from the employment of this unhomoeopathic medicine.

§ 166
Such a case is, however, very rare, owing to the increased number of medicines whose pure effects are now known, and the bad effects resulting from it, when they do occur, are diminished whenever a subsequent medicine, of more accurate resemblance, can be selected.

§ 167
Thus if there occur, during the use of this imperfectly homoeopathic remedy first employed, accessory symptoms of some moment, then, in the case of acute diseases, we do not allow this first dose to exhaust its action, nor leave the patient to the full duration of the action of the remedy, but we investigate afresh the morbid state in its now altered condition, and add the remainder of the original symptoms to those newly developed in tracing a new picture of the disease.

§ 168
We shall then be able much more readily to discover, among the known medicines, an analogue to the morbid state before us, a single dose of which, if it do not entirely destroy the disease, will advance it considerably on the way to be cured. And thus we go on, if even this medicine be not quite sufficient to effect the restoration of health, examining again and again the morbid state that still remains, and selecting a homoeopathic medicine as suitable as possible for it, until our object, namely, putting the patient in the possession of perfect health, is accomplished.

§ 169 fifth Edition
If, on the first examination of a disease and the first selection of a medicine, we should find that the totality of the symptoms of the disease would not be effectually covered by the disease elements of a single medicine – owing to the insufficient number of known medicines, – but that two medicines contend for the preference in point of appropriateness, one of which is more homoeopathically suitable for one part, the other for another part of the symptoms of the disease, it is not advisable, after the employment of the more suitable of the two medicines, to administer the other without fresh examination, for the medicine that seemed to be the next best would not, under the change of circumstances that has in the meantime taken place, be suitable for the rest of the symptoms that then remain; in which case, consequently, a more appropriate homoeopathic remedy must be selected in place of the second medicine for the set of symptoms as they appear on a new inspection.

§ 169 Sixth Edition
If, on the first examination of a disease and the first selection of a medicine, we should find that the totality of the symptoms of the disease would not be effectually covered by the disease elements of a single medicine – owing to the insufficient number of known medicines, – but that two medicines contend for the preference in point of appropriateness, one of which is more homoeopathically suitable for one part, the other for another part of the symptoms of the disease, it is not advisable, after the employment of the more suitable of the two medicines, to administer the other without fresh examination, and much less to give both together (§ 272, note) for the medicine that seemed to be the next best would not, under the change of circumstances that has in the meantime taken place, be suitable for the rest of the symptoms that then remain; in which case, consequently, a more appropriate homoeopathic remedy must be selected in place of the second medicine for the set of symptoms as they appear on a new inspection.

§ 170
Hence in this as in every case where a change of the morbid state has occurred, the remaining set of symptoms now present must be inquired into, and (without paying any attention to the medicine which at first appeared to be the next in point of suitableness) another homoeopathic medicine, as appropriate as possible to the new state now before us, must be selected. If it should so happen, as is not often the case, that the medicine which at first appeared to be the next best seems still to be well adapted for the morbid state that remains, so much the more will it merit our confidence, and deserve to be employed in preference to another.

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I have now, after eighteen months of work, finished the sixth edition of my Organon, the most nearly perfect of all.

Samuel Hahnemann