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Aphorism 6
§6

The unprejudiced observer-well aware of the futility of transcendental speculations which can receive no confirmation from experience-be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms), which can be perceived externally by means of the senses; that it to say, 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.
Foot Note:
I know not, therefore, how it was possible for physicians at the sick-bed to allow themselves to suppose that, without most carefully attending to the symptoms and being guided by them in the treatment, they ought to seek and could discover, only in the hidden and unknown interior, what there was to be cured in the disease, arrogantly and ludicrously pretending that they could, without paying much attention to the symptoms, discover the alteration that had occurred in the invisible interior, and set it to rights with (unknown!) medicines, and that such a procedure as this could alone be called radical and rational treatment.

Is not, then, that which is cognizable by the senses in diseases through the phenomena it displays, the disease itself in the eyes of the physician, since he never can see the spiritual being that produces the disease, the vital force? Nor is it necessary that he should see it, but only that he should ascertain its morbid actions, in order that he may thereby be enabled to cure the disease. What else will the old school search for the hidden interior of the organism, as a prima causa morbi, whilst they reject as an object of cure and contemptuously despise the sensible and manifest representation of the disease, the symptoms, that so plainly address themselves to us? What else do they wish to cure in diseases, but these?

EXPLANATION
UNPREJUDICED OBSERVER
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A physician in order to treat a patient should find out what is the deviation from normal state of health of the individual. In this process speculation has no role to play. A physician should be free of bias, hence should not indulge in mere hypothesis that cannot be proved by experiments.
mann expected us to be unprejudiced. The prejudices of a physician can be at 3 levels

1. Determining the disease diagnosis.

Prior conclusion of the diagnosis based on so-called intuitions can induce the physician to make mistakes in prognosis.
E.g. diagnosing a young girl as having a migraine or hysterical headache without thoroughly examining her, one might miss out a SOL (Space Occupying Lesion) of the brain.

CASE

Once a group of resident doctors in a homoeopathic hospital were going for their breakfast to the mess early in the morning, the staff informed them that a young girl of about 18yrs had come to the hospital with some abdominal discomfort. When the doctors saw her from far she appeared to be unusually well dressed with a fine sari and jewels for that time of the day as it was yet hardly around 7.30am. So one of the residents suggested that we better have our breakfast first as they had a very busy schedule ahead and would not find any time latter on for the same. doing otherwise they consented that they should first see the patient. On examining the girl the doctor found that the patient's pulse was fast, she had fever and pain and tenderness in the abdomen in the right iliac fossa and McBurney's sign was positive. Thus confirming the diagnosis of Acute Appendicitis the patient was immediately advised surgery by the Surgeon and so was operated giving her relief and saving her life.While the patient was recuperating in the wards, she was asked why she was all dressed up so early in the morning, she told that she was on the way to attend a wedding of a family member and though she was complaining of abdominal pain she was asked to bear the same as if she was malingering the pain, as all the family members were busy with the wedding. Just to satisfy her that her pain was not very critical she was bought to the hospital while they were passing it on their way to the marriage ceremony. Thus everybody's compliance was proved to be otherwise.

2. In terms of Drug diagnosis.

Prejudging a remedy on the basis of a few signs or with one or two symptoms usually leads the physician to ask leading or pointing questions regarding the same preconceived remedy while taking the case.
E.g. a person appearing to be neat and tidy does not mean that he requires the drugs Arsenic / Nux-vom because of his fastidiousness.

3. While understanding the patient.

Predetermining the patient as being a haughty, stupid or uncooperative person can modify our case taking.A physician is not supposed to judge a patient he is expected to " receive the case during case taking ".
This also interferes in judging the intensity and characteristic nature of the patient's symptoms thereby resulting in improper individualization of the patient and incorrect medicine determination. It is no the job of a physician to be judgmental about the patient's character or his behavior while treating him.
PORTRAIT OF DISEASE
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Portrait of the disease can be formed from the following sources.

1. The Patient

The patient primarily gives details about the changes he has seen in himself from his otherwise healthy state. The complaints could be physical or mental in nature. The symptoms he narrates could be related to the diagnosis of the disease or otherwise.

2. The Relatives and Attendants

Observations made by the people who take care of the patient and information given by relatives and friends who know the patient for a long time can be considered.
E.g. The relatives can complain about the changes in the patient like

" She is more irritable / quieter than before"
" He is talking / eating faster than before"
" Child is stammering "
" He is making more mistakes in studies"

3. Observations of the Physician

The physician being a keen observer can and should be able to note subtle disturbances in the patient.
E.g. The gait, stature, or sitting posture of the patient. He should be able to judge the demeanor of the patient as he enters the chamber. He should be able to accurately observe whether the patient is sitting quietly or is he fidgety.

OBSTACLES IN FORMING THE PORTRAIT OF THE DISEASE
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The physician can face obstacles at various levels in forming the portrait of the disease.

The Patient

The patient could be either a stoic personality or a hypochondriac. A hypochondriac person has a tendency to exaggerate the symptoms, thereby misleading the physician in understanding the seriousness of the illness.
E.g. Myocardial infarction.

The Relatives and Attendants

They may have their own prejudices, which can creep into the history of the patient.
E.g. A mother-in-law / daughter-in-law syndrome can be quiet common in the subcontinent.

The Physician

The physicians own prejudices can form a block in forming the portrait of the disease. These prejudices can lead to mal-observation or non-observation on part of the physician.

In the footnote Hahnemann criticizes the old school for trying to find the primary cause of the disease in the interior of the man without actually being inspired by the symptoms of the patient. Even today many a physician is tempted to pronounce a patient fit and healthy if all the laboratory investigations are normal, even if the patient is in need of health.