Part 37

I have already stated that the homoeopathists conceive that the infinite dilution of their atoms of medicinal substances increase their energy; and this fact they so strenuously maintain, that they assert that accidents of a serious nature may arise when this division is carried too far; and these accidents are then to be met with the medicinal antidotes they pretend to have discovered: thus, camphor is an antidote to cocculus; opium, to the crocus sativus; camomile and camphor, to ignatia amara; and so on.

The minuteness with which the specific actions of various medicinal substances on certain organs is detailed is scarcely credible; and the following extract from the homoeopathic materia medica will give a slight idea of their industrious labours. Taking as an example phosphorus, which they affirm produces--

Vertigo, determination of blood to the head, headache in the morning, fall of the hair, difficulty in opening the eyelids, burning sensation and ulceration of the internal canthus of the eye, when exposed to the open air, lachrymation and adhesion of the palpebræ; inflammation of the eyes, with the sensation of particles of sand having been introduced; sparks and spangles floating before the eyes, a dark tinge in objects that are looked on, diurnal cecity, the appearance of a gray veil drawn before the eyes, pulsation in the ears, epistaxis, mucous discharge from the nostrils, foulness of breath, tumefaction of the throat, whiteness of the tongue, ulceration of the mouth, expectoration of glairy mucus, dryness of the mouth by night and by day, spasmodic eructation, nausea, sense of hunger after eating, anxiety after meals; in short, twenty-four octavo pages are devoted to the innumerable effects of this substance on the organism.

Of _magnesia artificialis_ three hundred and twelve symptoms are noted; six hundred and fifty of the _rhus radicans_; nine hundred and forty of _pulsatilla_; five hundred of _ignatia amara_; four hundred and sixty of _arsenic_: in short, volumes upon volumes are crowded with these observations, not only recording physical effects, but singular results on our moral faculties; such as serenity or moroseness, gaiety or sadness, a disposition to commit suicide or a fond partiality to life, courage or cowardice, a weak intellect or a vigorous conception. For instance,--common sea-salt occasions irascibility, lowness of spirits, taciturnity, melancholy, palpitation of heart, disposition to shed tears, pusillanimity, and despair; while potash gives rise to ill-temper without apparent cause at noon and in the evening, with violent paroxysms of rage in the morning, impetuous desires, furious passion, with gnashing of teeth, if all around does not yield to the patient's desires; while the vision of a bird hovering about the window produces loud shrieks of alarm, exaltation of the intellects, and a horror of the future. So innumerable, indeed, are all these singular effects attributed to various medicines thus experimented, that no memory, however retentive, could possibly bear them in recollection. The following are the directions laid down for conducting this curious inquiry:

The person upon whom medicines are tried must be free from disease; but weak substances should be given to subjects of a delicate and sensitive constitution. The medicine is to be tried in its most pure and simple state, possessing all its energies, taking special care that it is not combined with any heterogeneous substances during the day it is exhibited, and the time while its action is supposed to last. The diet must be moderate; all spices and high-seasoned food to be avoided, as well as green vegetables, roots, salads, &c. which are known to possess medicinal properties. The dose of the medicine to be similar to that which is usually prescribed by practitioners. If, at the expiration of about two hours, no effect is observed, a stronger dose is to be given. Should the first dose operate powerfully at the commencement, but gradually lose its influence, the second will be given the following morning; and a still stronger one, four times the strength of the first, be administered on the third day.

The result of these experiments being recorded, homoeopathic agents are selected to oppose morbid symptoms; and when the choice of remedies has been appropriate, an aggravation of the symptoms is observed. This aggravation is usually considered as an increase of the disorder, whereas it is solely the effect of the homoeopathic remedy. "For these phenomena," say the homoeopathists, "were frequently observed by physicians, who little thought at the time, that they were the result of the medicines they had given." Thus, when the pustules of itch became more rife after the exhibition of sulphur, it was thought that the increase of the eruption was merely the affection _coming out_ more freely; whereas, the aggravation was occasioned by sulphur. Leroy informs us that the heart's-ease, _viola tricolor_, increased an eruption in the face. Lyrons says that elm-bark aggravated cutaneous affections, which were cured by this remedy; but neither of them were aware of the nature of this homoeopathic development. For further information on this head, the Organon of Hahnemann must be consulted.

Such were his doctrines for a period of about twenty years,--doctrines which he emphatically pronounced infallible, and founded on the immutable laws of homoeopathy. In 1828, however, convinced by numerous failures in the treatment of chronic diseases, that other causes than those which he acknowledged,--such as the improper preparation of the medicine, or dietetic neglect on the part of the patient,--contributed to these disappointments, he announced that he had discovered the hidden source of the obstacles he encountered; and that, after many years of experiments and meditation, he had come to the conclusion that almost all chronic diseases originated from constitutional miasmatic affections or predispositions, which he divided into _sycosis_, _syphilis_, and _psora_, or, in plain English, the itch. To this latter affection he attributes innumerable disorders. In diseases of a syphilitic character, he had found his mode of treatment infallible; and he therefore concluded that all obstinate and rebellious affections were the result of some other constitutional predisposing circumstances. He tells us that he laboured in profound secrecy to discover this great, this sublime desideratum: his very pupils knew it not; the world was to remain in ignorance of his pursuits until he could proclaim the most inestimable gift that Divinity bestowed upon mankind. This immortal discovery was neither more nor less than the itch; to which malady, according to his views, since the days of Moses, seven-eighths of the physical and moral miseries to which flesh is heir, were to be referred. Whether rendered evident by eruptions, or latent from our cradle, it was a curse transmitted to us, by the modification and degeneration of leprosy, through myriads of constitutions, and which only disappears from the surface to fester in malignity until it bursts forth again in the multifarious forms of innumerable diseases, amongst which we find scrofula, rachitis, phthisis, hysteria, hypochondriasis, dropsy, hydrocephalus, hæmorrhage, fistula, diseases of the head and liver, ruptures, cataracts, tic-douloureux, deafness, erysipelas, cancers, aneurisms, rheumatism, gout, apoplexy, epilepsy, palsy, convulsions, stone, St. Vitus's dance, nervous affections of every description, loss of sight, of smell, of taste, stupidity and imbecility.[36] In support of this doctrine, Hahnemann adduces ninety-five cases recorded by medical writers, in which the disappearance of the itch was followed by various acute and chronic maladies.

The next miasmatic generator is _sycosis_, or the disposition to warty excrescences; but this source of disease Hahnemann does not consider so prolific as syphilis, or his favourite psora.

Such are the principal features of the homoeopathic system. I have already stated that its followers consider the most minute particles of medicine more powerful than larger doses; they therefore have recourse to infinite trituration or dilution in three vehicles which they consider free from any medicinal property,--distilled water, spirits of wine, and sugar of milk; by these means they procure a decillionth or a quintillionth fraction of a grain. One drop of their solution is considered sufficient to saturate three hundred globules of sugar of milk; and three or four of these globules are deemed a powerful medicine. To give a better idea of Hahnemann's notions on this subject, I shall quote his own words:

"By shaking a drop of medicinal liquid with one hundred drops of alcohol _once_, that is to say, by taking the phial in the hand which contains the whole, and imparting to it a rapid motion by a single stroke of the arm descending, I shall then obtain an exact mixture of them; but two or three, or ten such movements, would develop the medicinal virtues still further, making them more potent, and their action on the nerves much more penetrating. In the extenuation of powders, when it is requisite to mix one grain of a medicinal substance in one hundred grains of sugar of milk, it ought to be rubbed down with force during one hour _only_, in order that the power of the medicine may not be carried to too great an extent; medicinal substances acquiring at each division or dilution a new degree of power, as the rubbing or shaking they undergo develops that inherent virtue in medicines which was unknown until my time, and which is so energetic, that latterly I have been forced by experience to reduce the number of shakes to two."

As a further illustration of this theory, he affirms that gold is without any action in our organism in its natural state; but that when one grain of this metal is triturated according to the above process until each grain of the last triturated preparation contains a quadrillionth part of the original grain of the mineral, it will be so powerful that it will be sufficient to place this single grain in a phial, to be inspired for a moment, to produce the most amazing results, and none more so than the faculty of restoring to a melancholy individual, disposed to commit suicide, his pristine partiality to life.

Unfortunately for Hahnemann, many of these assertions are unsupported by facts or sound reasoning, and appear mere wanderings of an ardent imagination; and thus soaring in regions of fancy, he himself has struck many fatal blows to his own doctrines. For instance, what are the arguments he adduces to prove that in two similar diseases the strongest will overcome the weakest?

"Why," he exclaims, "does the splendid Jupiter disappear during the twilight of morn to the eyes of the contemplator? It is because a similar power, but possessed of greater energies, the breaking day, acts upon our organs."

This is a defective analogy. Hahnemann tells us that a stronger power banishes a weaker one in a permanent manner, whereas the bright planet he here alludes to will return with the night. Then again:--

"With what do we endeavour to relieve the olfactory nerves when offended by disagreeable odours? By snuff, which affects the nostrils in a similar but in a more powerful manner." This is not correct: when the action of snuff has ceased, the disagreeable effluvia become again offensive. In some instances his poetical vagaries are preposterous. "By what means," he adds, "do we endeavour to protect the ears of the compassionate from the lamentations of the poor wretched soldier condemned to be scourged? Is it not by the shrill notes of the fife united to the loud beat of the drum? How do we endeavour to drown the roar of distant artillery that causes terror in the heart of the soldier? By the roll of the double drum;--nor would this feeling of compassion, this sense of terror, have been checked by admonition or by splendid rewards. In the same manner our grief, our regret, subside, upon receiving the intelligence, true or false, that a more lively sorrow has affected another person." It would be idle to dwell upon the absurdity of such visions and erroneous statements.

To support his doctrines, Hahnemann should have proved, 1st, that medicinal powers do produce an artificial malady similar to the natural affection; 2nd, that the organism only remains under the influence of the medicinal disease; 3rd, that this medicinal disease is of short duration; and 4th, that all these effects can only be produced by a medicine selected according to their similarity of symptoms. Our theorist has utterly failed in his endeavours to establish these facts; therefore have his doctrines been impugned by many of his most zealous disciples, amongst whom may be mentioned Griesselich, Rau, Schroen. The aggravation which he asserts takes place after the exhibition of a homoeopathic medicine is not only unsupported by proof, but positively denied by many of their practitioners; and Hartman plainly affirms that, after a homoeopathic dose, the patient frequently experiences a state of calm, a disposition to slumber, and often falls into a profound sleep more or less prolonged, in waking from which he finds himself much relieved, if not perfectly cured. Thus several physicians who have adopted his practical views reject many of the doctrines on which they are founded; and a homoeopathist has justly compared his works to a wild virgin forest, in which we meet with a number of valuable trees and plants in the midst of arid brushwood and parasitic weeds that would check the growth of the most useful productions.

Yet, notwithstanding the many gratuitous assertions, and consequent erroneous inductions, we meet with in the _Organon_, it is probable that this system is destined to operate a gradual but material revolution in the _practice_ of medicine. As to theories, we must agree with Voltaire when he said "En fait de système, il faut toujours se reserver le droit de rire le lendemain de ses idées de la veille."

Hippocrates laid down in his Aphorisms the incontrovertible fact, "Duobus doloribus simul obortis, non tandem eâdem in parte, vehementior alterum obscurat. A. 46." To a certain degree, it was upon this assertion, which the experience of ages has confirmed, that Hahnemann founded the principal and most important point of his doctrine; but, going much farther than the father of medicine, he affirms that similar diseases effectually remove each other. For centuries practitioners have been acting homoeopathically; the exhibition of specifics, in fact, being nothing else. As we have already shown, specifics are known to produce symptoms similar to the diseases they cure. Hitherto the number of such medicines has been confined to a very few agents; and perhaps with the exception of mercury, sulphur, and bark, with their several preparations, scarcely any article in the materia medica could have claimed this peculiar property. To extend these limits, which confined in so exiguous a compass our therapeutic agents, has been the laborious and singular study of Hahnemann and his disciples. Haller had first given the example, and they arduously applied themselves to discover by experiments on the healthy subject, both upon their own persons and others, what were the peculiar effects or symptoms produced by various medicinal substances. These observations are so numerous and confused, that, on reading them, we feel plunged in a chaotic labyrinth of symptoms, without any clue to extricate ourselves from its perplexing mazes. Still, from this multifarious catalogue much important information can be collected; and it cannot be denied that the homoeopathist has not only thrown a new light on the action of many medicines which we daily prescribe, but brought into practical consideration the necessity of attending to dietetic discipline, by an investigation of the several properties of our usual _ingesta_.

It is obvious that any enthusiast who would blindly embrace the foregoing doctrines without serious and deep investigation, and boldly apply the wild theory to practice, would at once throw open the flood-gates of absurdity, and lend his aid in destroying, if possible, with one fell swoop, the result of ages of mature study and experience. Hahnemann, to fertilize the fields of science, had recourse to inundation instead of wise and cautious irrigation; and the fury with which he and his rash disciples maintained their opinions materially tended to retard their progress. Truth needeth not violence; its own lustre will beam through surrounding darkness, without being dragged into light.

The objections to Hahnemann's doctrines are glaring. The art of healing, from the dawn of science until the present day, has been more or less founded on the faculties of reasoning. We are taught, in the first instance, to observe carefully the phenomena of disease, and, by referring effects to probable causes, endeavour, however difficult the task, to trace their catenation. Many of these causes are perhaps sealed for ever in the inscrutable book of our destinies; yet, if we cannot obtain a knowledge of the origin of these disorders, still when we take into mature consideration the complication of all accidental circumstances, and from visible effects seek invisible relations, guided by our experience in anatomy, physiology, and the revelations of pathology, we may find this pursuit less difficult than it may be imagined. But the homoeopathist despises and rejects as idle, all those collateral means of diving into nature's arcana. He bids us dwell only upon evident symptoms, or, in other words, look to the effects alone, and cast away all thoughts of discovering their causes. Nothing can be more illogical than this argument; for certainly we can scarcely hope to remove effects without striking, as far as in our power lies, at their cause. To deny the existence of any specific affection because we cannot account for its origin, is absurd. As well might we reject the use of medicines known to possess specific properties, from our utter ignorance of their _modus operandi_. The exclusive consideration of symptoms would lead us into lamentable error, since the same symptoms are observable in various diseases. Similar pains, for instance, may be the symptoms of rheumatism, nephritic affections, and calculus; headaches may arise from inflammation, and from various and well-known sympathies with distant organs: yet, without seeking to ascertain these relations, the mechanical and empirical homoeopathist will prescribe such medicines as are known to occasion pains in the loins, or headaches; only bearing in mind perceptible derangements, heedless of the phenomena of organization, the state of the secretions and excretions, the history, the rise and progress of the disorder, or the idiosyncrasy of the patient. The liver is diseased; the discovery is of no importance. We have only to attend to the pain extending up the clavicle and shoulder, or the uneasiness experienced in the right hypochondrium: the pulse, the respiration, the condition of the excretions, the temperature of the skin, the appearance of the tongue, are all regarded as minor considerations. It is not _hepatitis_ that we are called upon to cure; it is to relieve a pain in the shoulder and in the hypochondrium, or a difficulty of lying on the left side.

No one will pretend to deny that our safest, perhaps our sole, guide in the study of disease is the group of symptoms, that become more and more perceptible during the course of our investigations. It was principally on the study of symptoms that the most learned practitioners of every age and country grounded their diagnosis and their prognosis; but they never viewed them either singly, or in their complexity, as unconnected with the particular diseases to which they were not only essentially united, but from which they originated, and of the existence of which they were to be considered the diagnostic signs. Therefore did the ancients classify them as principal and accessory, univocal and equivocal, characteristic or common, as they afforded more or less information in our pathological deduction; and in that light they were weighed with greater or less application, as our judgment could only be formed by the attentive consideration of the phenomena of the organism in health and in disease.

But while the homoeopathist's attention is chiefly directed to the discovery of means that can enable him to produce symptoms analogous to those of the disorder, he seems to disregard the laws of sympathy, by which our organism appears to be ruled; a mysterious agency which can only be ascertained by observation and experiment, when, to use the words of a distinguished writer,[37] "by the former we may be said to listen to nature, by the latter to interrogate her." Health depends upon the due co-operation of all these associations; and one organ in the wonderful machinery cannot be deranged in its functions without influencing others, however distant and unconnected they may appear. In this co-ordination, these vital relations have been very properly divided into mechanical, functional, and sympathetic. Their study constitutes the groundwork of all rational induction. It is not by individual or complex symptoms that we can decide where the want of equilibrium is to be traced. Various have been the theories on this most important subject, and great have been the erroneous ideas dogmatically laid down. The illustrious Bichat himself erred when he maintained that sympathies were aberrations--morbid developments of our vital properties. Sympathies, on the contrary, may be considered as constant phenomena, essential and inseparable from our organism, whether in health or in sickness; and are, if I may be pardoned the expression, co-ordinated to co-operate with each other in their mechanical, their functional, and their sympathetic associations.

An incarcerated hernia causes hiccup, nausea, vomiting. Will the homoeopathist tell us that we must seek in his catalogue of innumerable effects some substance which is known to produce similar symptoms? Surely the rupture must first call our attention. This example is adduced as referring to nearly every case in which it might be rashly attempted to separate causes from effects. The mammary glands are variously affected in uterine diseases; their impressions are reciprocal, yet the uterine affection must be the chief object of our solicitude. A peculiar pruritus is a symptom of calculus. Are we then to administer a homoeopathic dose of _cannabis_, or any other medicine which may give rise to a similar sensation? It may be objected to this observation that these are purely surgical cases, in which we need not be guided by symptoms to discover causes; but it has too frequently happened that nausea and vomiting have been attended to, while the hernia was overlooked, until fatal accidents were manifested. Moreover, a diseased liver, a diseased spleen or kidney, would be just as perceptible as hernia or calculus, if these parts could be brought into view or contact.

It may be said that an erroneous notion of Hahnemann's doctrines on this subject has been taken; it is therefore necessary to quote his own words:

"It may be easily conceived that the existence of a malady presupposes some alteration in the interior of the human organism; but our understanding can only lead us to suspect this alteration in a vague and deceitful manner, from the appearance of the morbid symptoms, the sole guide we can depend on except in surgical cases. The essence of the internal and invisible change is undiscoverable, nor have we any means of guarding against deceptive illusions."[38]