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Now you may ask what  if there are changes in pathology is  present ? 

There is nothing in the nature of diseased tissue to direct to a remedy; it is only a effect of disease. Suppose there is an  a tumor of the mammary gland  there is nothing in the fact that it is a tumor or in the aspect of the tumor that would lead you to the nature of the change of state. The tissue changes are least important but what you comprehend in the patient himself, how he moves and acts, his functions and sensations, are manifestations of what is going on in the internal economy. Kent says "A state of disorder represents its nature to man by signs and symptoms, and these are things to be prescribed upon. Take a case which as yet has no pathological changes, no morbid anatomy, one that has only functional changes; the collection of signs and symptoms presents to the intelligent physician the nature of the state and he is clear as to the remedy. But if the patient does not receive that remedy, what will happen ?The case will go on for a while, perhaps for two or three years, and when he returns to you on examination you will find that he has cavities in his lungs or an abscess in his liver, or albumin in the urine, etc. If it were the last, according to the old-fashioned notions and theories, you must now prescribe for Bright's disease; you would not think that remedy which you figured out two years before fitted his case perfectly then and is what he must have now. But he needed that remedy from his childhood, and you were able to figure it out from the symptoms of his change of state pure and simple, without tissue changes. Do you suppose because the disease has now progressed into tissue change, the organs are breaking down and the man is going to die, that this has changed that primitive state ?The man needs the same course of treatment that he has needed from his babyhood. The same idea of his disease must prevail now that prevailed before he had the tissue changes. Bright's disease is not a disease, it is simply the ultimate or organic condition which has followed the progress of the original change of state. Under other circumstances that change of state might have affected his liver or his lungs. Tissue changes do not indicate the remedy, and so as physicians we must learn to examine symptoms which are prior to morbid anatomy, to go back to the very beginning.' Such a patient as I have described must be looked upon as when he was in the simple change of state before matters were complicated. Besides this, there is no manner of treatment for Bright's disease or any other organic change."

You have gone through kents descriptions which have confused you more. Let us imagine   a case of tumor in abdomen of a 30 year old women. Just imagine that patient came to you before ten years say at age of 20 when she did not have the tumor. She presented to you typical symptoms of arsenic album.

AT AGE OF 20 PATIENT PRESENTED THE FOLLOWING SYMPTOMS OF ARSENICUM ALBUM     

She didn't get her treatment as all her symptoms were mild. After 10 years she developed abdominal tumor. After 10 years only mild change of basic symptoms are present she can now tolerate fruit. Had she taken her Arsencum album for her minor ailments she would have never got abdominal tumor after 10 years

AFTER 10 YEARS SAY AT AGE OF 30 SHE DEVELOP TUMOR

Here the remedy will be same  for tumor in abdomen, that is arsenicum album. Her mind, her desires were all present even before the tumor came into existence. All her basics desires, mind etc remain same now and before she developed tumor. And so arsenicum album is her remedy. NOTE : that if you refer repertory ARSENIC do not have any  tumor  in abdomen , yet that is the remedy. When Hahneman says  that "he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease." is just simply illustration of above.

Allopathic physician is not bothered about his patients symptoms, he does not care if his patient is forgetful, uneasy .If he finds that his patient is not sleeping he may put the patient to sleep, but he will say that he  must sound the stomach which is the cause of all the trouble and his prescription is based on that. He believe that stomach is all the cause of the trouble and correcting that patient is 'cured'. This is his theory. A false impression carried out from generation after generation. When some one die it is not uncommon to make a post-mortem in order to discover  the cause, and by this they find out certain pathological conditions ; but the aim of the physician is to discover in his patient that just these conditions are present. It is true, on the other hand that the post-mortem affords the physician the means for a general study of' the results of disease which is essential some times.

The study of morbid anatomy

Morbid anatomy is useful in postmartum to know what caused the death- disease, accidents, homicidal or suicidal etc.

It is useful when foul play is suspected as the cause of death

The physician cannot know too much about the endings of disease ; he should become thoroughly acquainted with the tissues in all conditions ; 

Pathology cannot be applied in treating an individual for curing a sickness

But to study these with the idea that he is going thereby to cure sick people, or that the things he picks up at such times are going to be applied in making prescriptions, is a great folly. 

By now you might have come to the notion that, Physical diagnosis is not important. Never. Physical diagnosis is very important in its own place.

IMPORTANCE OF DIAGNOSIS

(1)PROGNOSIS OF DISEASE.

Prognosis is  forecast of the course and probable outcome of a disease. It is useful in predicting the course or outcome of a disease or abnormality. It helps in predicting the likely outcome of a disease based on the condition of the patient and the action of the disease. You can tell  a person now what is likely to happen in the future because of having a disease. Kent says 'By means of physical diagnosis the physician may find out the changes in organs, how far the disease has progressed, and determine if the patient is incurable. It is necessary also in supplying information to Boards of Health.' It may also decide whether you should give curative or palliative treatments."

Example : you may treat for diabetics (which is a pathology). You can say that the patient is cured only  if you have examined the blood of the patient. But totality is not based upon diagnosis. The study of pathology is a separate and distinct thing from the study of Materia Medica. Kent gives examples "In many instances foolish examinations are made. In the colleges women are examined with the speculum before a symptom is given, and if the mucous membrane is red the patient gets Hamamelis, and so on in a routine way through five or six remedies which cover all the complaints of women." Half a dozen remedies constitute the armamentariurn of many of the eminent gynecologists. Such a practice as that does not cure, does not even benefit temporarily, it is simply an outrage. But bad though it is, perhaps it is not so great an outrage as is perpetrated when the physician imagines the disease is local, and that when he has cauterized it the woman is well, not realizing for one moment that these things come from a cause and that curing that cause should be his aim. Yet such is the teaching of the old school."

The unprejudiced observer - True homoeopathic physican

Now while the signs and symptoms are the only things that can indicate  the physician what the patient needs, and while those signs and symptoms relate to change of state and not to change of tissue, still there are signs that relate to tissue changes, and one who is acquainted with symptoms may consider these as indicating a change of state.

For example, there are signs that indicate that pus is forming, there are appearances that will lead the experienced physician to know that the results of disease are coming ; these are not valuable things in selecting the remedy, but simply indicate certain conditions. The physician must learn to distinguish these from the symptoms that portray the state of the patient.

We are now organized to see that if the patient is cured from cause to effect he must remain cured ; that is, if the true inner disorder is turned into order he will remain cured, because this order, which is of the innermost, will cause to flow into order that which is of the outermost and finally the function of the body to become orderly.

The  order in the centre (vital force) will cause tissue order, because the vital order broadens into the very outermost of the tissues; so if the cure is from cause to effect, or from within out, the patient will remain cured.  

Incurable cases

In incurable cases the effects (pathology) may be removed temporarily or palliated, but the patient himself has not been cured as to the cause, and owing to the fact that the patient cannot be cured the old changes will come back and grow stronger because it is in the nature of chronic cases to increase or progress.

Certain results (pathology) of disease which remain after the patient is cured  can be removed if necessary, but it is not well to remove them before the patient is cured.

kent says an example "If a patient has a disease of the foot bones after a bad injury and the foot cannot be cured, first cure the patient, and then if the foot is so clumsy and useless that he would rather have a wooden one remove the foot. If you have to deal with a worthless honey-combed knee joint, first cure the patient and then if the knee can never be useful and the limb is cold and the muscles are flabby consider the question of replacing it with an artificial one. If the economy after being turned into health cannot cure the knee nothing that can be done to the knee can cure it. Do not say that the patient is sick because he has a white swelling, but that the white swelling is there because the patient is sick."

let me conclude. In aphorism six he tells us, that in each individual case we are to Observe only what is outwardly observable through the senses; that this consists of changes in the sensorial condition of health of body and mind revealed to our senses by abnormal signs or symptoms and that these morbid signs or symptoms, in their entirely, represent the disease in its full extent; that they constitute the true and only conceivable form or picture of the disease.