Medical Essays, 1842-1882 Part 4

Benjamin Dougla.s.s Perkins.

But experience has shown that the character of these a.s.sertions is not sufficient to deter many, from examining their claims to belief.

I therefore lean but very slightly on the extravagance and extreme apparent singularity of their pretensions. I might have omitted them, but on the whole it seemed more just to the claims of my argument to suggest the vast complication of improbabilities involved in the statements enumerated. Every one must of course judge for himself as to the weight of these objections, which are by no means brought forward as a proof of the extravagance of h.o.m.oeopathy, but simply as ent.i.tled to a brief consideration before the facts of the case are submitted to our scrutiny.

The three great a.s.serted discoveries of Hahnemann are entirely unconnected with and independent of each other. Were there any natural relation between them it would seem probable enough that the discovery of the first would have led to that of the others. But a.s.suming it to be a fact that diseases are cured by remedies capable of producing symptoms like their own, no manifest relation exists between this fact and the next a.s.sertion, namely, the power of the infinitesimal doses. And allowing both these to be true, neither has the remotest affinity to the third new doctrine, that which declares seven eighths of all chronic diseases to be owing to Psora.

This want of any obvious relation between Hahnemann's three cardinal doctrines appears to be self-evident upon inspection. But if, as is often true with his disciples, they prefer the authority of one of their own number, I will refer them to Dr. Trinks's paper on the present state of h.o.m.oeopathy in Europe, with which, of course, they are familiar, as his name is mentioned as one of the most prominent champions of their faith, in their American official organ. It would be a fact without a parallel in the history, not merely of medicine, but of science, that three such unconnected and astonishing discoveries, each of them a complete revolution of all that ages of the most varied experience had been taught to believe, should spring full formed from the brain of a single individual.

Let us look a moment at the first of his doctrines. Improbable though it may seem to some, there is no essential absurdity involved in the proposition that diseases yield to remedies capable of producing like symptoms. There are, on the other hand, some a.n.a.logies which lend a degree of plausibility to the statement. There are well-ascertained facts, known from the earliest periods of medicine, showing that, under certain circ.u.mstances, the very medicine which, from its known effects, one would expect to aggravate the disease, may contribute to its relief.

I may be permitted to allude, in the most general way, to the case in which the spontaneous efforts of an overtasked stomach are quieted by the agency of a drug which that organ refuses to entertain upon any terms. But that every cure ever performed by medicine should have been founded upon this principle, although without the knowledge of a physician; that the h.o.m.oeopathic axiom is, as Hahnemann a.s.serts, "the sole law of nature in therapeutics," a law of which nothing more than a transient glimpse ever presented itself to the innumerable host of medical observers, is a dogma of such sweeping extent, and pregnant novelty, that it demands a corresponding breadth and depth of unquestionable facts to cover its vast pretensions.

So much ridicule has been thrown upon the pretended powers of the minute doses that I shall only touch upon this point for the purpose of conveying, by ill.u.s.trations, some shadow of ideas far transcending the powers of the imagination to realize. It must be remembered that these comparisons are not matters susceptible of dispute, being founded on simple arithmetical computations, level to the capacity of any intelligent schoolboy. A person who once wrote a very small pamphlet made some show of objecting to calculations of thus kind, on the ground that the highest dilutions could easily be made with a few ounces of alcohol. But he should have remembered that at every successive dilution he lays aside or throws away ninety-nine hundredths of the fluid on which he is operating, and that, although he begins with a drop, he only prepares a millionth, billionth, trillionth, and similar fractions of it, all of which, added together, would const.i.tute but a vastly minute portion of the drop with which he began. But now let us suppose we take one single drop of the Tincture of Camomile, and that the whole of this were to be carried through the common series of dilutions.

A calculation nearly like the following was made by Dr. Panvini, and may be readily followed in its essential particulars by any one who chooses.

For the first dilution it would take 100 drops of alcohol.

For the second dilution it would take 10;000 drops, or about a pint.

For the third dilution it would take 100 pints.

For the fourth dilution it would take 10,000 pints, or more than 1,000 gallons, and so on to the ninth dilution, which would take ten billion gallons, which he computed would fill the basin of Lake Agnano, a body of water two miles in circ.u.mference. The twelfth dilution would of course fill a million such lakes. By the time the seventeenth degree of dilution should be reached, the alcohol required would equal in quant.i.ty the waters of ten thousand Adriatic seas. Trifling errors must be expected, but they are as likely to be on one side as the other, and any little matter like Lake Superior or the Caspian would be but a drop in the bucket.

Swallowers of globules, one of your little pellets, moistened in the mingled waves of one million lakes of alcohol, each two miles in circ.u.mference, with which had been blended that one drop of Tincture of Camomile, would be of precisely the strength recommended for that medicine in your favorite Jahr's Manual, "against the most sudden, frightful, and fatal diseases!" [In the French edition of 1834, the proper doses of the medicines are mentioned, and Camomile is marked IV. Why are the doses omitted in Hull's Translation, except in three instances out of the whole two hundred remedies, notwithstanding the promise in the preface that "some remarks upon the doses used may be found at the head of each medicine"? Possibly because it makes no difference whether they are employed in one h.o.m.oeopathic dose or another; but then it is very singular that such precise directions were formerly given in the same work, and that Hahnemann's "experience"

should have led him to draw the nice distinctions we have seen in a former part of this Lecture (p. 44).]

And proceeding on the common data, I have just made a calculation which shows that this single drop of Tincture of Camomile, given in the quant.i.ty ordered by Jahr's Manual, would have supplied every individual of the whole human family, past and present, with more than five billion doses each, the action of each dose lasting about four days.

Yet this is given only at the quadrillionth, or fourth degree of potency, and various substances are frequently administered at the decillionth or tenth degree, and occasionally at still higher attenuations with professed medicinal results. Is there not in this as great an exception to all the hitherto received laws of nature as in the miracle of the loaves and fishes? Ask this question of a h.o.m.oeopathist, and he will answer by referring to the effects produced by a very minute portion of vaccine matter, or the extraordinary diffusion of odors. But the vaccine matter is one of those substances called morbid poisons, of which it is a peculiar character to multiply themselves, when introduced into the system, as a seed does in the soil. Therefore the hundredth part of a grain of the vaccine matter, if no more than this is employed, soon increases in quant.i.ty, until, in the course of about a week, it is a grain or more, and can be removed in considerable drops. And what is a very curious ill.u.s.tration of h.o.m.oeopathy, it does not produce its most.

characteristic effects until it is already in sufficient quant.i.ty not merely to be visible, but to be collected for further use. The thoughtlessness which can allow an inference to be extended from a product of disease possessing this susceptibility of multiplication when conveyed into the living body, to substances of inorganic origin, such as silex or sulphur, would be capable of arguing that a pebble may produce a mountain, because an acorn can become a forest.

As to the a.n.a.logy to be found between the alleged action of the infinitely attenuated doses, and the effects of some odorous substances which possess the extraordinary power of diffusing their imponderable emanations through a very wide s.p.a.ce, however it may be abused in argument, and rapidly as it evaporates on examination, it is not like that just mentioned, wholly without meaning. The fact of the vast diffusion of some odors, as that of musk or the rose, for instance, has long been cited as the most remarkable ill.u.s.tration of the divisibility of matter, and the nicety of the senses. And if this were compared with the effects of a very minute dose of morphia on the whole system, or the sudden and fatal impression of a single drop of prussic acid, or, with what comes still nearer, the poisonous influence of an atmosphere impregnated with invisible malaria, we should find in each of these examples an evidence of the degree to which nature, in some few instances, concentrates powerful qualities in minute or subtile forms of matter. But if a man comes to me with a pestle and mortar in his hand, and tells me that he will take a little speck of some substance which n.o.body ever thought to have any smell at all, as, for instance, a grain of chalk or of charcoal, and that he will, after an hour or two of rubbing and sc.r.a.ping, develop in a portion of it an odor which, if the whole grain were used, would be capable of pervading an apartment, a house, a village, a province, an empire, nay, the entire atmosphere of this broad planet upon which we tread; and that from each of fifty or sixty substances he can in this way develop a distinct and hitherto unknown odor: and if he tries to show that all this is rendered quite reasonable by the a.n.a.logy of musk and roses, I shall certainly be justified in considering him incapable of reasoning, and beyond the reach of my argument. What if, instead of this, he professes to develop new and wonderful medicinal powers from the same speck of chalk or charcoal, in such proportions as would impregnate every pond, lake, river, sea, and ocean of our globe, and appeals to the same a.n.a.logy in favor of the probability of his a.s.sertion.

All this may be true, notwithstanding these considerations. But so extraordinary would be the fact, that a single atom of substances which a child might swallow without harm by the teaspoonful could, by an easy mechanical process, be made to develop such inconceivable powers, that nothing but the strictest agreement of the most cautious experimenters, secured by every guaranty that they were honest and faithful, appealing to repeated experiments in public, with every precaution to guard against error, and with the most plain and peremptory results, should induce us to lend any credence to such pretensions.

The third doctrine, that Psora, the other name of which you remember, is the cause of the great majority of chronic diseases, is a startling one, to say the least. That an affection always recognized as a very unpleasant personal companion, but generally regarded as a mere temporary incommodity, readily yielding to treatment in those unfortunate enough to suffer from it, and hardly known among the better cla.s.ses of society, should be all at once found out by a German physician to be the great scourge of mankind, the cause of their severest bodily and mental calamities, cancer and consumption, idiocy and madness, must excite our unqualified surprise. And when the originator of this singular truth ascribes, as in the page now open before me, the declining health of a disgraced courtier, the chronic malady of a bereaved mother, even the melancholy of the love-sick and slighted maiden, to nothing more nor less than the insignificant, unseemly, and almost unmentionable ITCH, does it not seem as if the very soil upon which we stand were dissolving into chaos, over the earthquake-heaving of discovery?

And when one man claims to have established these three independent truths, which are about as remote from each other as the discovery of the law of gravitation, the invention of printing, and that of the mariner's compa.s.s, unless the facts in their favor are overwhelming and unanimous, the question naturally arises, Is not this man deceiving himself, or trying to deceive others?

I proceed to examine the proofs of the leading ideas of Hahnemann and his school.

In order to show the axiom, similia similibus curantur (or like is cured by like), to be the basis of the healing art,--"the sole law of nature in therapeutics,"--it is necessary,

1. That the symptoms produced by drugs in healthy persons should be faithfully studied and recorded.

2. That drugs should be shown to be always capable of curing those diseases most like their own symptoms.

3. That remedies should be shown not to cure diseases when they do not produce symptoms resembling those presented in these diseases.

1. The effects of drugs upon healthy persons have been studied by Hahnemann and his a.s.sociates. Their results were made known in his Materia Medica, a work in three large volumes in the French translation, published about eight years ago. The mode of experimentation appears to have been, to take the substance on trial, either in common or minute doses, and then to set down every little sensation, every little movement of mind or body, which occurred within many succeeding hours or days, as being produced solely by the substance employed. When I have enumerated some of the symptoms attributed to the power of the drugs taken, you will be able to judge how much value is to be ascribed to the a.s.sertions of such observers.

The following list was taken literally from the Materia Medica of Hahnemann, by my friend M. Vernois, for whose accuracy I am willing to be responsible. He has given seven pages of these symptoms, not selected, but taken at hazard from the French translation of the work. I shall be very brief in my citations.

"After stooping some time, sense of painful weight about the head upon resuming the erect posture."

"An itching, tickling sensation at the outer edge of the palm of the left hand, which obliges the person to scratch." The medicine was acetate of lime, and as the action of the globule taken is said to last twenty-eight days, you may judge how many such symptoms as the last might be supposed to happen.

Among the symptoms attributed to muriatic acid are these: a catarrh, sighing, pimples; "after having written a long time with the back a little bent over, violent pain in the back and shoulder-blades, as if from a strain,"--"dreams which are not remembered,--disposition to mental dejection,--wakefulness before and after midnight."

I might extend this catalogue almost indefinitely. I have not cited these specimens with any view to exciting a sense of the ridiculous, which many others of those mentioned would not fail to do, but to show that the common accidents of sensation, the little bodily inconveniences to which all of us are subject, are seriously and systematically ascribed to whatever medicine may have been exhibited, even in the minute doses I have mentioned, whole days or weeks previously.

To these are added all the symptoms ever said by anybody, whether deserving confidence or not, as I shall hereafter ill.u.s.trate, to be produced by the substance in question.

The effects of sixty-four medicinal substances, ascertained by one or both of these methods, are enumerated in the Materia Medica of Hahnemann, which may be considered as the basis of practical h.o.m.oeopathy. In the Manual of Jahr, which is the common guide, so far as I know, of those who practise h.o.m.oeopathy in these regions, two hundred remedies are enumerated, many of which, however, have never been employed in practice. In at least one edition there were no means of distinguishing those which had been tried upon the sick from the others.

It is true that marks have been added in the edition employed here, which serve to distinguish them; but what are we to think of a standard practical author on Materia Medica, who at one time omits to designate the proper doses of his remedies, and at another to let us have any means of knowing whether a remedy has ever been tried or not, while he is recommending its employment in the most critical and threatening diseases?

I think that, from what I have shown of the character of Hahnemann's experiments, it would be a satisfaction to any candid inquirer to know whether other persons, to whose a.s.sertions he could look with confidence, confirm these pretended facts. Now there are many individuals, long and well known to the scientific world, who have tried these experiments upon healthy subjects, and utterly deny that their effects have at all corresponded to Hahnemann's a.s.sertions.

I will take, for instance, the statements of Andral (and I am not referring to his well-known public experiments in his hospital) as to the result of his own trials. This distinguished physician is Professor of Medicine in the School of Paris, and one of the most widely known and valued authors upon practical and theoretical subjects the profession can claim in any country. He is a man of great kindness of character, a most liberal eclectic by nature and habit, of unquestioned integrity, and is called, in the leading article of the first number of the "h.o.m.oepathic Examiner," "an eminent and very enlightened allopathist."

a.s.sisted by a number of other persons in good health, he experimented on the effects of cinchona, aconite, sulphur, arnica, and the other most highly extolled remedies. His experiments lasted a year, and he stated publicly to the Academy of Medicine that they never produced the slightest appearance of the symptoms attributed to them. The results of a man like this, so extensively known as one of the most philosophical and candid, as well as brilliant of instructors, and whose admirable abilities and signal liberality are generally conceded, ought to be of great weight in deciding the question.

M. Double, a well-known medical writer and a physician of high standing in Paris, had occasion so long ago as 1801, before he had heard of h.o.m.oeopathy, to make experiments upon Cinchona, or Peruvian bark. He and several others took the drug in every kind of dose for four months, and the fever it is pretended by Hahnemann to excite never was produced.

M. Bonnet, President of the Royal Society of Medicine of Bordeaux, had occasion to observe many soldiers during the Peninsular War, who made use of Cinchona as a preservative against different diseases, but he never found it to produce the pretended paroxysms.

If any objection were made to evidence of this kind, I would refer to the express experiments on many of the h.o.m.oeopathic substances, which were given to healthy persons with every precaution as to diet and regimen, by M. Louis Fleury, without being followed by the slightest of the pretended consequences. And let me mention as a curious fact, that the same quant.i.ty of a.r.s.enic given to one animal in the common form of the unprepared powder, and to another after having been rubbed up into six hundred globules, offered no particular difference of activity in the two cases.

This is a strange contradiction to the doctrine of the development of what they call dynamic power, by means of friction and subdivision.

In 1835 a public challenge was offered to the best known h.o.m.oeopathic physician in Paris to select any ten substances a.s.serted to produce the most striking effects; to prepare them himself; to choose one by lot without knowing which of them he had taken, and try it upon himself or any intelligent and devoted h.o.m.oeopathist, and, waiting his own time, to come forward and tell what substance had been employed. The challenge was at first accepted, but the acceptance retracted before the time of trial arrived.

From all this I think it fair to conclude that the catalogues of symptoms attributed in h.o.m.oeopathic works to the influence of various drugs upon healthy persons are not ent.i.tled to any confidence.

2. It is necessary to show, in the next place, that medicinal substances are always capable of curing diseases most like their own symptoms.

For facts relating to this question we must look to two sources; the recorded experience of the medical profession in general, and the results of trials made according to h.o.m.oeopathic principles, and capable of testing the truth of the doctrine.

No person, that I am aware of, has ever denied that in some cases there exists a resemblance between the effects of a remedy and the symptoms of diseases in which it is beneficial. This has been recognized, as Hahnemann himself has shown, from the time of Hippocrates. But according to the records of the medical profession, as they have been hitherto interpreted, this is true of only a very small proportion of useful remedies. Nor has it ever been considered as an established truth that the efficacy of even these few remedies was in any definite ratio to their power of producing symptoms more or less like those they cured.

Such was the state of opinion when Hahnemann came forward with the proposition that all the cases of successful treatment found in the works of all preceding medical writers were to be ascribed solely to the operation of the h.o.m.oeopathic principle, which had effected the cure, although without the physician's knowledge that this was the real secret. And strange as it may seem, he was enabled to give such a degree of plausibility to this a.s.sertion, that any person not acquainted somewhat with medical literature, not quite familiar, I should rather say, with the relative value of medical evidence, according to the sources whence it is derived, would be almost frightened into the belief, at seeing the pages upon pages of Latin names he has summoned as his witnesses.

It has. .h.i.therto been customary, when examining the writings of authors of preceding ages, upon subjects as to which they were less enlightened than ourselves, and which they were very liable to misrepresent, to exercise some little discretion; to discriminate, in some measure, between writers deserving confidence and those not ent.i.tled to it. But there is not the least appearance of any such delicacy on the part of Hahnemann. A large majority of the names of old authors he cites are wholly unknown to science. With some of them I have been long acquainted, and I know that their accounts of diseases are no more to be trusted than their contemporary Ambroise Pare's stories of mermen, and similar absurdities. But if my judgment is rejected, as being a prejudiced one, I can refer to Cullen, who mentioned three of Hahnemann's authors in one sentence, as being "not necessarily bad authorities; but certainly such when they delivered very improbable events;" and as this was said more than half a century ago, it could not have had any reference to Hahnemann. But although not the slightest sign of discrimination is visible in his quotations,--although for him a handful of chaff from Schenck is all the same thing as a measure of wheat from Morgagni,--there is a formidable display of authorities, and an abundant proof of ingenious researches to be found in each of the great works of Hahnemann with which I am familiar. [Some painful surmises might arise as to the erudition of Hahnemann's English Translator, who makes two individuals of "Zacutus, Lucita.n.u.s," as well as respecting that of the conductors of an American h.o.m.oeopathic periodical, who suffer the name of the world-renowned Carda.n.u.s to be spelt Cardamus in at least three places, were not this gross ignorance of course attributable only to the printer.]

It is stated by Dr. Leo-Wolf, that Professor Joerg, of Leipsic, has proved many of Hahnemann's quotations from old authors to be adulterate and false. What particular instances he has pointed out I have no means of learning. And it is probably wholly impossible on this side of the Atlantic, and even in most of the public libraries of Europe, to find anything more than a small fraction of the innumerable obscure publications which the neglect of grocers and trunkmakers has spared to be ransacked by the all-devouring genius of h.o.m.oeopathy. I have endeavored to verify such pa.s.sages as my own library afforded me the means of doing. For some I have looked in vain, for want, as I am willing to believe, of more exact references. But this I am able to affirm, that, out of the very small number which I have been able, to trace back to their original authors, I have found two to be wrongly quoted, one of them being a gross misrepresentation.

The first is from the ancient Roman author, Caelius Aurelia.n.u.s; the second from the venerable folio of Forestus. Hahnemann uses the following expressions,--if he is not misrepresented in the English Translation of the 'Organon': "Asclepiades on one occasion cured an inflammation of the brain by administering a small quant.i.ty of wine."

After correcting the erroneous reference of the Translator, I can find no such case alluded to in the chapter. But Caelius Aurelia.n.u.s mentions two modes of treatment employed by Asclepiades, into both of which the use of wine entered, as being "in the highest degree irrational and dangerous." [Caelius Aurel. De Morb. Acut. et Chron. lib. I. cap. xv.

not xvi. Amsterdam. Wetstein, 1755.]

In speaking of the oil of anise-seed, Hahnemann says that Forestus observed violent colic caused by its administration. But, as the author tells the story, a young man took, by the counsel of a surgeon, an acrid and virulent medicine, the name of which is not given, which brought on a most cruel fit of the gripes and colic. After this another surgeon was called, who gave him oil of anise-seed and wine, "which increased his suffering." [Observ. et Curat. Med. lib. XXI obs. xiii. Frankfort, 1614.] Now if this was the h.o.m.oeopathic remedy, as Hahnemann pretends, it might be a fair question why the young man was not cured by it. But it is a much graver question why a man who has shrewdness and learning enough to go so far after his facts, should think it right to treat them with such astonishing negligence or such artful unfairness.