Comments by Debra LeRoy:
In Aphorism 5, Hahnemann is talking about "taking a case." He is discussing getting the symptoms, (exciting cause of the acute disease) and 'the most significant points on the whole history of chronic disease.' This is why we always want as many symptoms as we can get from people. Each symptom is important to us, and the more information we can acquire, the better we can work with the individual. You will note how he explains the importance of looking at the 'moral and intellectual' character, occupation, lifestyle and habits, social and domestic relations, age, sex-life and so on.

This is partly the way we determine the constitution of the individual. He also mentions that chronic miasms are usually causative. Chronic miasms are something that most of us have acquired, whether through birth (inherited) or through suppressive treatments and/or lifestyle. The homeopath must therefore, identify miasms and remove them, where possible.

Example:
In an acute disease, of grief, for instance, it is very obvious what the 'most exciting probable cause' of the acute disease is. It is loss of a loved one.

However, if the person is like some people, each loss they suffer opens up all their previous wounds from loss as well. So, what you are facing is an acute disease on the surface, with a layer(s) of chronic, as well. In this case, it would be necessary to try to find out when this all started. Why does this person have such a hard time coping with loss?

I will use an example of a real case here, with the permission of the person involved. The patient came to me, devastated at the death of his dog. He was feeling suicidal, depressed, began drinking more than normal, and taking prescription tranquillizers. I am choosing to use an illustration without a chronic miasm as once we get into miasms, it becomes much more complicated, in my opinion.

After the second interview, we finally determined that the reason he was feeling this loss so deeply was that, as a child, he had been told in Sunday School that animals had no souls, therefore did not go to Heaven when they died. This man would not even allow himself the pleasure of having pets for this very reason, for many, many years.

To compound the problem, he was also told by a relative that people had no souls, either. Dead was dead...the end. There was no where to go, once you died. Shortly after that, an old uncle died, and the child was forced to go to the funeral, and was told by this same relative that the uncle wasn't really dead, and that he was going to 'come after' the boy and kill and then eat him. He began to have nightmares in which all of his dead relatives would be chasing after him, trying to 'get him.' He believed his relative who told him that the dead were very angry with him because he was still alive. And, sooner or later, they would want their revenge.

What this man chose to do, once he became older, was to to not observe death, at all. He never went to funerals, he never acknowledged death, period. In his mind's eye, nobody died, in his reality. At the death of his dog, however, he was unable to play out this fantasy. The evidence was right there, in front of him, but he did not know how to deal with it.

The death of his dog opened up all the old wounds that he had suffered as a child. Even though as an adult he knew logically that this wasn't true, his inner child still believed it. His disease was presenting, on the surface, as an acute, but there was a chronic aspect to it.

With the aid of well-chosen remedies and recommended grief counselling, the man was able to come to terms with death, realize the upside of it, and able to 'care' again for all beings, without the fear of a permanent separation, or having to endure their anger at him, for still being alive, if they died before him.

To merely treat the acute, in this case, would not have resulted in a cure.

Conclusion of Example in Aphorism 5
We also had to find a way to deal with and remove the past issues that were affecting his present quality of life. Then, it was time to work forwards and deal with the next issues, until finally, we were left with the more acute causes, namely the alcohol and tranqullizers, and the acute grief, itself. . With all these 'exciting causes' out of the way, the vital force was free to heal itself of these past wounds. Otherwise, they would have stayed there and surfaced each time the man suffered a loss, of any kind.