Medical Essays, 1842-1882 Part 3

The line, then, has been drawn by the champions of the new doctrine; they have lifted the lance, they have sounded the charge, and are responsible for any little skirmishing which may happen.

But, independently of any such grounds of active resistance, the subject involves interests so disproportioned to its intrinsic claims, that it is no more than an act of humanity to give it a public examination. If the new doctrine is not truth, it is a dangerous, a deadly error. If it is a mere illusion, and acquires the same degree of influence that we have often seen obtained by other illusions, there is not one of my audience who may not have occasion to deplore the fatal credulity which listened to its promises.

I shall therefore undertake a sober examination of its principles, its facts, and some points of its history. The limited time at my disposal requires me to condense as much as possible what I have to say, but I shall endeavor to be plain and direct in expressing it. Not one statement shall be made which cannot be supported by unimpeachable reference: not one word shall be uttered which I am not as willing to print as to speak. I have no quibbles to utter, and I shall stoop to answer none; but, with full faith in the sufficiency of a plain statement of facts and reasons, I submit the subject to the discernment of my audience.

The question may be asked in the outset,--Have you submitted the doctrines you are professing to examine to the test of long-repeated and careful experiment; have you tried to see whether they were true or not?

To this I answer, that it is abundantly evident, from what has often happened, that it would be of no manner of use for me to allege the results of any experiments I might have inst.i.tuted. Again and again have the most explicit statements been made by the most competent persons of the utter failure of all their trials, and there were the same abundant explanations offered as used to be for the Unguentum Armarium and the Metallic Tractors. I could by no possibility perform any experiments the result of which could not be easily explained away so as to be of no conclusive significance. Besides, as arguments in favor of h.o.m.oeopathy are constantly addressed to the public in journals, pamphlets, and even lectures, by inexperienced dilettanti, the same channel must be open to all its opponents.

It is necessary, for the sake of those to whom the whole subject may be new, to give in the smallest possible compa.s.s the substance of the h.o.m.oeopathic Doctrine. Samuel Hahnemann, its founder, is a German physician, now living in Paris, [Hahnemann died in 1843.] at the age of eighty-seven years. In 1796 he published the first paper containing his peculiar notions; in 1805 his first work on the subject; in 1810 his somewhat famous "Organon of the Healing Art;" the next year what he called the "Pure Materia Medica;" and in 1828 his last work, the "Treatise on Chronic Diseases." He has therefore been writing at intervals on his favorite subject for nearly half a century.

The one great doctrine which const.i.tutes the basis of h.o.m.oeopathy as a system is expressed by the Latin aphorism,

"SIMILIA SIBILIBUS CURANTUR,"

or like cures like, that is, diseases are cured by agents capable of producing symptoms resembling those found in the disease under treatment. A disease for Hahnemann consists essentially in a group of symptoms. The proper medicine for any disease is the one which is capable of producing a similar group of symptoms when given to a healthy person.

It is of course necessary to know what are the trains of symptoms excited by different substances, when administered to persons in health, if any such can be shown to exist. Hahnemann and his disciples give catalogues of the symptoms which they affirm were produced upon themselves or others by a large number of drugs which they submitted to experiment.

The second great fact which Hahnemann professes to have established is the efficacy of medicinal substances reduced to a wonderful degree of minuteness or dilution. The following account of his mode of preparing his medicines is from his work on Chronic Diseases, which has not, I believe, yet been translated into English. A grain of the substance, if it is solid, a drop if it is liquid, is to be added to about a third part of one hundred grains of sugar of milk in an unglazed porcelain capsule which has had the polish removed from the lower part of its cavity by rubbing it with wet sand; they are to be mingled for an instant with a bone or horn spatula, and then rubbed together for six minutes; then the ma.s.s is to be sc.r.a.ped together from the mortar and pestle, which is to take four minutes; then to be again rubbed for six minutes. Four minutes are then to be devoted to sc.r.a.ping the powder into a heap, and the second third of the hundred grains of sugar of milk to be added. Then they are to be stirred an instant and rubbed six minutes,--again to be sc.r.a.ped together four minutes and forcibly rubbed six; once more sc.r.a.ped together for four minutes, when the last third of the hundred grains of sugar of milk is to be added and mingled by stirring with the spatula; six minutes of forcible rubbing, four of sc.r.a.ping together, and six more (positively the last six) of rubbing, finish this part of the process.

Every grain of this powder contains the hundredth of a grain of the medicinal substance mingled with the sugar of milk. If, therefore, a grain of the powder just prepared is mingled with another hundred grains of sugar of milk, and the process just described repeated, we shall have a powder of which every grain contains the hundredth of the hundredth, or the ten thousandth part of a grain of the medicinal substance. Repeat the same process with the same quant.i.ty of fresh sugar of milk, and every grain of your powder will contain the millionth of a grain of the medicinal substance. When the powder is of this strength, it is ready to employ in the further solutions and dilutions to be made use of in practice.

A grain of the powder is to be taken, a hundred drops of alcohol are to be poured on it, the vial is to be slowly turned for a few minutes, until the powder is dissolved, and two shakes are to be given to it. On this point I will quote Hahnemann's own words. "A long experience and multiplied observations upon the sick lead me within the last few years to prefer giving only two shakes to medicinal liquids, whereas I formerly used to give ten." The process of dilution is carried on in the same way as the attenuation of the powder was done; each successive dilution with alcohol reducing the medicine to a hundredth part of the quant.i.ty of that which preceded it. In this way the dilution of the original millionth of a grain of medicine contained in the grain of powder operated on is carried successively to the billionth, trillionth, quadrillionth, quintillionth, and very often much higher fractional divisions. A dose of any of these medicines is a minute fraction of a drop, obtained by moistening with them one or more little globules of sugar, of which Hahnemann says it takes about two hundred to weigh a grain.

As an instance of the strength of the medicines prescribed by Hahnemann, I will mention carbonate of lime. He does not employ common chalk, but prefers a little portion of the friable part of an oystersh.e.l.l. Of this substance, carried to the s.e.xtillionth degree, so much as one or two globules of the size mentioned can convey is a common dose. But for persons of very delicate nerves it is proper that the dilution should be carried to the decillionth degree. That is, an important medicinal effect is to be expected from the two hundredth or hundredth part of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of a grain of oyster-sh.e.l.l. This is only the tenth degree of potency, but some of his disciples profess to have obtained palpable effects from "much higher dilutions."

The third great doctrine of Hahnemann is the following. Seven eighths at least of all chronic diseases are produced by the existence in the system of that infectious disorder known in the language of science by the appellation of PSORA, but to the less refined portion of the community by the name of ITCH. In the words of Hahnemann's "Organon,"

"This Psora is the sole true and fundamental cause that produces all the other countless forms of disease, which, under the names of nervous debility, hysteria, hypochondriasis, insanity, melancholy, idiocy, madness, epilepsy, and spasms of all kinds, softening of the bones, or rickets, scoliosis and cyphosis, caries, cancer, fungua haematodes, gout,--yellow jaundice and cyanosis, dropsy,--"

["The degrees of DILUTION must not be confounded with those of POTENCY.

Their relations may be seen by this table:

lst dilution,--One hundredth of a drop or grain.

2d " One ten thousandth.

3d " One millionth, marked I.

4th " One hundred millionth.

5th " One ten thousand millionth.

6th " One million millionth, or one billionth, marked II.

7th " One hundred billionth.

8th " One ten thousand billionth.

9th " One million billionth, or one trillionth, marked III.

10th " One hundred trillionth.

11th " One ten thousand trillionth.

12th " One million trillionth, or one quadrillionth, marked IV.,--and so on indefinitely.

The large figures denote the degrees of POTENCY.]

"gastralgia, epistaxis, haemoptysis,--asthma and suppuration of the lungs,--megrim, deafness, cataract and amaurosis,--paralysis, loss of sense, pains of every kind, etc., appear in our pathology as so many peculiar, distinct, and independent diseases."

For the last three centuries, if the same authority may be trusted, under the influence of the more refined personal habits which have prevailed, and the application of various external remedies which repel the affection from the skin; Psora has revealed itself in these numerous forms of internal disease, instead of appearing, as in former periods, under the aspect of an external malady.

These are the three cardinal doctrines of Hahnemann, as laid down in those standard works of h.o.m.oeopathy, the "Organon" and the "Treatise on Chronic Diseases."

Several other principles may be added, upon all of which he insists with great force, and which are very generally received by his disciples.

1. Very little power is allowed to the curative efforts of nature.

Hahnemann goes so far as to say that no one has ever seen the simple efforts of nature effect the durable recovery of a patient from a chronic disease. In general, the h.o.m.oeopathist calls every recovery which happens under his treatment a cure.

2. Every medicinal substance must be administered in a state of the most perfect purity, and uncombined with any other. The union of several remedies in a single prescription destroys its utility, and, according to the "Organon," frequently adds a new disease.

3. A large number of substances commonly thought to be inert develop great medicinal powers when prepared in the manner already described; and a great proportion of them are ascertained to have specific antidotes in case their excessive effects require to be neutralized.

4. Diseases should be recognized, as far as possible, not by any of the common names imposed upon them, as fever or epilepsy, but as individual collections of symptoms, each of which differs from every other collection.

5. The symptoms of any complaint must be described with the most minute exactness, and so far as possible in the patient's own words. To ill.u.s.trate the kind of circ.u.mstances the patient is expected to record, I will mention one or two from the 313th page of the "Treatise on Chronic Diseases,"--being the first one at which I opened accidentally.

"After dinner, disposition to sleep; the patient winks."

"After dinner, prostration and feeling of weakness (nine days after taking the remedy)."

This remedy was that same oyster-sh.e.l.l which is to be prescribed "fractions of the s.e.xtillionth or decillionth degree." According to Hahnemann, the action of a single dose of the size mentioned does not fully display itself in some cases until twenty-four or even thirty days after it is taken, and in such instances has not exhausted its good effects until towards the fortieth or fiftieth day,--before which time it would be absurd and injurious to administer a new remedy.

So much for the doctrines of Hahnemann, which have been stated without comment, or exaggeration of any of their features, very much as any adherent of his opinions might have stated them, if obliged to compress them into so narrow a s.p.a.ce.

Does Hahnemann himself represent h.o.m.oeopathy as it now exists? He certainly ought to be its best representative, after having created it, and devoted his life to it for half a century. He is spoken of as the great physician of the time, in most, if not all h.o.m.oeopathic works. If he is not authority on the subject of his own doctrines, who is? So far as I am aware, not one tangible discovery in the so-called science has ever been ascribed to any other observer; at least, no general principle or law, of consequence enough to claim any prominence in h.o.m.oeopathic works, has ever been pretended to have originated with any of his ill.u.s.trious disciples. He is one of the only two h.o.m.oeopathic writers with whom, as I shall mention, the Paris publisher will have anything to do upon his own account. The other is Jahr, whose Manual is little more than a catalogue of symptoms and remedies. If any persons choose to reject Hahnemann as not in the main representing h.o.m.oeopathy, if they strike at his authority, if they wink out of sight his deliberate and formally announced results, it is an act of suicidal rashness; for upon his sagacity and powers of observation, and experience, as embodied in his works, and especially in his Materia Medica, repose the foundations of h.o.m.oeopathy as a practical system.

So far as I can learn from the conflicting statements made upon the subject, the following is the present condition of belief.

1. All of any note agree that the law Similia similibus is the only fundamental principle in medicine. Of course if any man does not agree to this the name h.o.m.oeopathist can no longer be applied to him with propriety.

2. The belief in and employment of the infinitesimal doses is general, and in some places universal, among the advocates of h.o.m.oeopathy; but a distinct movement has been made in Germany to get rid of any restriction to the use of these doses, and to employ medicines with the same license as other pract.i.tioners.

3. The doctrine of the origin of most chronic diseases in Psora, notwithstanding Hahnemann says it cost him twelve years of study and research to establish the fact and its practical consequences, has met with great neglect and even opposition from very many of his own disciples.

It is true, notwithstanding, that, throughout most of their writings which I have seen, there runs a prevailing tone of great deference to Hahnemann's opinions, a constant reference to his authority, a general agreement with the minor points of his belief, and a pretence of harmonious union in a common faith. [Those who will take the trouble to look over Hull's Translation of Jahr's Manual may observe how little comparative s.p.a.ce is given to remedies resting upon any other authority than that of Hahnemann.]

Many persons, and most physicians and scientific men, would be satisfied with the statement of these doctrines, and examine them no further.

They would consider it vastly more probable that any observer in so fallacious and difficult a field of inquiry as medicine had been led into error, or walked into it of his own accord, than that such numerous and extraordinary facts had really just come to light. They would feel a right to exercise the same obduracy towards them as the French Inst.i.tute is in the habit of displaying when memoirs or models are offered to it relating to the squaring of the circle or perpetual motion; which it is the rule to pa.s.s over without notice. They would feel as astronomers and natural philosophers must have felt when, some half a dozen years ago, an unknown man came forward, and asked for an opportunity to demonstrate to Arago and his colleagues that the moon and planets were at a distance of a little more than a hundred miles from the earth. And so they would not even look into h.o.m.oeopathy, though all its advocates should exclaim in the words of Mr. Benjamin Dougla.s.s Perkins, vender of the Metallic Tractors, that "On all discoveries there are persons who, without descending to any inquiry into the truth, pretend to know, as it were by intuition, that newly a.s.serted facts are founded in the grossest errors." And they would lay their heads upon their pillows with a perfectly clear conscience, although they were a.s.sured that they were behaving in the same way that people of old did towards Harvey, Galileo, and Copernicus, the identical great names which were invoked by Mr.