COMMENT BY DEBRA:
In Aphorism 4, Hahnemann is still discussing the "Trinity of Homeopathy" and saying that one must know what is curative with regards to medicines (remedies) and be able to adapt the remedy to the disease to affect a cure. He is not merely talking of physical remedies, but also 'dynamic' or invisible remedies. As well, one must also know what will create disease, and know how to 'get rid of it' For instance, removing an 'obstacle to cure' could be an example of this. If I, as the homeopath see an obstacle to cure in an individual, I must work with that individual to remove it. One must decide what is to be cured in the disease, such as: smoking, drug abuse, improper nutrition, emotional problems, past trauma, a chronic miasm, or any number of things. I see it as any kind of blockade that is in place to prevent the individual from achieving health. Once the cause of disease is removed, the vital force is unencumbered and free to heal itself.

For example: A patient comes to me with a liver problem. This person also drinks a lot. of alcohol. The alcohol, in this case, is an obstacle to cure. The person must quit, or cut down on their alcohol consumption to be 'cured'. That is the 'easy' part.

However, I should also be looking into and trying to help this person as far as exploring why they are drinking heavily. Why is this person self-medicating themselves? Is it an unhappy/unhealthy relationship? Is it a self-esteem problem? Are they in constant physical and/or emotional pain? I, as their healthcare provider must explore all the possibilities and determine how best to help this person remove these things from their life. Probably, in this situation, I would also suggest going to AA.

COMMENT BY PAUL:
The key is determine what is an obstacle. We have to assess carefully. A person has several food allergies eg. milk, wheat and egg. Do we exclude these from the diet. If so how do we determine the effectiveness of our remedy. If not, what effect will that have on our remedy?

AND

And no doubt this information would play a vital role in your choice of remedy. The correct remedy would also lead to the patient giving up alcohol because the need is no longer there.

COMMENTS BY GABY:
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Aph. 4
Er ist zugleich ein Gesundheit-Erhalter, wenn er die Gesundheit störenden und Krankheit erzeugenden und unterhaltenden Dinge kennt und sie von den gesunden Menschen zu entfernen weiss.

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[.....if he knows the things that derange health and cause and maintain disease...]

COMMENT BY JOYCE:
A few comments on Aph 4:

He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health.

Even someone who is healthy, can be strengthened. With strengthening of our vital force/lessening the susceptibilities that we do have, improving our lifestyle/diet, we will be able to withstand much more interaction with our environment.

Most people do not realize that having small "dysfunctions" like certain cravings, a dislike of warm stuffy rooms, and are only able to sleep on their abdomen, etc. are the possible beginning very slight signs of imbalance, which could lead to further imbalance down the road if the organism is stressed enough. Taking care of these slight functional imbalances early is good preventative medicine. Eileen has written about giving babies their "constitutional" after birth. A wonderful start in the world, as they will be strengthened in their response to their environment.

Joyce Laidlaw