Aphorism 40:
The Law of Complication: Aphorism 40 and the Formation of Complex Diseases
In Aphorism 40, Samuel Hahnemann describes the third and most problematic outcome that occurs when two dissimilar diseases meet in the same person. Building on the previous principles of repulsion (§ 36) and suspension (§ 38), he now examines what happens when a new disease acts on the organism for a long time without being able to displace the old one.
The Principle of Complication
Hahnemann explains that if a new dissimilar disease is allowed to persist alongside an existing one, the two eventually join together to form a complex or “double” disease. In this scenario:
- No Neutralization: Neither of the two dissimilar diseases removes or cures the other.
- Spatial Distribution: Each disease “occupies a particular locality in the organism,” taking possession of the organs and systems peculiarly adapted to it and leaving the remaining parts to the other disease.
- Coexistence: The two (or sometimes three) diseases remain separate but simultaneous within the same body without disparaging the “unity of life”.
The Example of Syphilis and Psora
The most frequent example provided in the sources is the combination of syphilis and psora.
- Initially, the venereal symptoms may be suspended or kept in abeyance when a psoric eruption appears.
- In time, because both are strong chronic miasms, they join together.
- The patient is rendered “more diseased and more difficult to cure” because they are now fighting two distinct internal derangements at once.
Simultaneous Acute Diseases
Hahnemann notes that while the one disease usually suspends the other in acute cases, there are rare instances where two dissimilar acute infectious diseases (such as smallpox and measles) have occurred simultaneously and “combined, as it were, with each other” for a short duration.
Clinical Implications and Treatment
Aphorism 40 highlights a significant challenge for the physician. When a complex disease is formed, the patient’s state becomes far more entangled. Hahnemann clarifies in a footnote that there is no real “amalgamation” of the diseases; they simply exist side-by-side.
For treatment, he recommends a judicious alternation of the best specific remedies for each disease (for instance, alternating mercurial preparations for syphilis with specific antipsorics for psora), administered in the most suitable dose and form.
Conclusion: The Penalty of Dissimilarity
Aphorism 40 serves as a final proof that dissimilarity is the enemy of a cure. Whether through natural progression or inappropriate allopathic treatment (§ 41), adding a dissimilar disease to the body only leads to increased suffering and complexity. This reinforces the necessity of the Homoeopathic Law—that only a similar force can truly annihilate an existing disease and restore the vital force to harmony.
