Part 38

"The invisible substance that has undergone a morbid alteration in the interior of the human body, and the perceptible changes, which are externally developed,--in other words, symptoms,--form by their union what is called disease; but the symptoms are the only points of the malady which are accessible to the physician, the sole indication whence he can derive any intuitive notion, and the principal objects with which he ought to become acquainted to effect a cure. From this incontestable truth there is nothing discoverable in disease beyond the totality of its symptoms to guide us in the selection of our curative means."[39]

It is not to be supposed that an experienced physician, although a homoeopathist, will rest satisfied with this study of symptomatic medicine, without endeavouring to attach these effects to some cause, however occult it may appear; but such a doctrine becomes pernicious, since it bids us close the only book of truth that can reveal our errors,--_post mortem_ investigations. Surely, if a group of certain symptoms attend a disease which, when terminating fatally, shows disorganization in certain viscera, we are not only justifiable in giving to that disorganization a specific name in our scientific classification and categories, but in considering the symptoms of no other importance than as corroborative of those facts that morbid anatomy daily brings to light.

It is generally admitted that most nosologies are imperfect, and may occasionally lead the young practitioner into error. This is easily accounted for when we consider the Protean forms that the same disease assumes in different individuals; yet, without this classification, the science of medicine could not be studied. A certain arrangement is necessary to simplify all our pursuits in natural science, and to seek a variety we must know the order and the genus.

Had Hahnemann given a better system of nosology than those we possess, and with his truly praiseworthy zeal and industry enumerated the various symptoms of disease as minutely and as accurately as he has recorded the effects of medicinal substances, his labours might have proved a most valuable addition to our store of knowledge.

Let us now direct our attention to the absurdities to which these opinions have led. Solely attentive to effects, and heedless of the disorganization of various important parts of the human economy which morbid anatomy detects, Hahnemann endeavours to discover the occult causes--the original source--the germ--of the malady, which most likely are beyond the reach of our researches; and he boldly affirms that all chronic diseases spring from syphilis, a disposition to warts and the itch. Now experience has proved that such an assumption is unfounded. The most healthy subjects, those who attain the finest old age, are more liable to this disgusting affection than the wealthy and cleanly part of the community. The Irish and Scotch peasantry from their infancy, and through life, are most subject to psora; and certainly our soldiers and sailors, amongst whom the disease is common, are not more predisposed to chronic diseases than any other classes of society, of course not taking into consideration the effects of unhealthy climates.

Syphilis, it will be readily granted, has a considerable share in producing anomalous _sequelæ_, more especially when in combination with mercury. Warts, except of a syphilitic character, were never known to germinate diseases; indeed, they affect the most healthy and robust individuals. Yet to these three miasmatic causes does Hahnemann attribute nearly every disease that was ever known to afflict mankind; while he passes over in silence the predisposition to scrofula, gout, rheumatism, to which we can unfortunately trace with too much certainty the source of much human misery.

That the itch is a disease of great antiquity is a matter of doubt. It has been maintained that it is the same eruptive disorder described by Celsus under the appellation of _scabies_; yet this writer does not allude to its contagious nature, and moreover says, that in some cases it disappears completely, whereas in others it is renewed at certain periods of the year.

Celsus, moreover, includes other forms of pustular eruptions among the different species of scabies, not sufficiently distinguishing them from each other. The character of his scabies is more analogous to the lichen agrius of Willan.

Nor did the ancients consider their _psora_ as our itch. It appears to have been the scaly tetter, which they sometimes denominated _psoriasis_, at others _lepra_, a synonymous affection; but neither pustular nor vesicular. Leprosy, indeed, is a malady totally distinct from the itch in all its characters. Hahnemann asserts that the species of leprosy that afflicted the Jews, and which is described by their legislator in the 13th chapter of Leviticus, was the itch; but any one who will peruse this description will perceive that it does not bear the slightest resemblance to that disorder. It appears, on the contrary, to have been that kind of leprosy called _leucé_ by the ancients. Nor was leprosy constantly attended with itching, one of the chief characteristics of the malady, and from which sensation it derives its very name. Hippocrates mentions a leprosy that usually occasioned a prurience before rain. There are no diseases in the classification of which more obscurity exists than in cutaneous affections; and Hahnemann's ideas would tend to increase this confusion, since he tells us that he considers the _framboesia_ of America, the _sibbens_ of Norway, the _pellagra_ of Lombardy, the _plica_ of Poland, the _pseudo-syphilis_ of the English, and the _asthenia Virginiensis_ of Virginia, complications of his three miasmatic principles; and he further informs us, no doubt on the faith of some idle tradition, that _psora_ lost its external deformity on the return of the Crusaders, who brought from the Holy Land the use of linen shirts, a cleanly and salutary precaution that eradicated the disease at a period when France had no less than two thousand hospitals for the reception of _itch_ patients,--a plain proof that he confounds leprosy with itch, since the hospitals he alludes to were distinctly considered leper-houses.

It is certainly true that there does exist in our system a constant predisposition to eruptive affections of some kind or other. We are born heirs to certain exanthematic affections, such as the measles and smallpox; and it would be as difficult to find a being morally immaculate as an individual free from speck or blemish. Many of these eruptions are considered of a critical and salutary nature; and the ancients fancied that nature relieved herself by throwing upon the surface some "peccant humours." Hence their dread of the retrocession of any of these "breakings out;" and there is no doubt but that accidents frequently followed their sudden disappearance, in the same manner as drying up an issue or a blister established for some time, and become habitual, may occasion internal mischief; but to maintain that all chronic diseases arise from three eruptive principles is a most gratuitous and untenable assertion.

Enthusiastically anxious to support his doctrines, Hahnemann is frequently led into erroneous assertions. Thus he tells us that life will suddenly cease if a little water, or the mildest liquid, is injected into a vein; whereas experience has proved, in the treatment of cholera, and various other instances, that the most stimulating solutions may be thus introduced, not only with impunity, but with salutary results.

It is needless to enter more deeply into the ungracious business of pointing out errors, many of which were evident to Hahnemann himself; since, not only in the several editions of his Organon, but in various paragraphs in the same volume, he contradicts himself.

A much more gratifying and important task is now undertaken, to prove, by the evidence of facts, supported by practical reasoning, that the art of healing is more indebted to the homoeopathic doctrines than to any system that has hitherto been delivered in our schools.

That the all-bountiful Creator, in permitting, for purposes unknown to us, mankind to be visited by so many scourges, has also scattered around us means to counteract these evils, cannot be a matter of doubt. Instinct leads animals to find out these salutary agents, and various specifics have been discovered by man. The rudest savage is in possession of curative substances unknown to civilized man, and performs cures where learning and experience have proved of no avail.

To extend the limits of specifics, must therefore be considered a most desirable step towards adding to our means of relieving disease; and in this pursuit it is impossible to bestow too much praise on the homoeopathic observer. Enthusiasm--predilection to a favourite but persecuted system--may induce an ardent proselyte not only to deceive others, but unwittingly to deceive himself. It is therefore not only possible, but probable, that in the experimental investigations of the effects of medicine, Fancy, in her multifarious colours, may have depicted, with apparent fidelity, a state of body and mind that only existed in an excited imagination; but when we behold various individuals, distant from each other, and totally unconnected, observing similar results from the exhibition of various medicinal substances, we have no right to call their assertions into doubt. These assertions, moreover, are not laid down dogmatically, but are earnestly recommended to be submitted to the test of experiment. For instance, the homoeopathist has found out that certain substances, by diminishing the energy of the heart and arteries, subdue inflammatory action as effectually as venesection. This is a fact daily witnessed, and of which any practitioner may convince himself. It is not asserted, that in cases of sudden determination of blood, which require immediate revulsion and abstraction of the vital fluid, homoeopathic remedies will be found possessed of sufficient activity to afford prompt relief; but experience has fully proved that in cases which can admit of a few hours' delay, these medicines very frequently supersede the necessity of debilitating the patient by a copious loss of blood.

Dr. Paris, in his admirable work on Materia Medica, has justly observed, "that observation or experiment upon the effects of medicine is liable to a thousand fallacies, unless it be carefully repeated under the various circumstances of _health_ and _disease_, in different climates, and on different constitutions." This has been the main object of the homoeopathist; and a further quotation from the above distinguished writer will illustrate the importance of their labours. "It is impossible to cast our eyes over such multiplied groups (of medicinal substances) without being forcibly struck with the palpable absurdity of some, the disgusting and loathsome nature of others, the total want of activity in many, and the uncertain and precarious reputation of _all_, without feeling an eager curiosity to inquire, from the combination of what causes it can have happened that substances at one period in the highest esteem, and of generally acknowledged utility, have fallen into total neglect and disrepute. That such fluctuation in opinion and versatility in practice should have produced, even in the most candid and learned observer, an unfavourable impression with regard to the general efficacy of medicines can hardly excite our astonishment, much less our indignation; nor can we be surprised to find that another portion of mankind has at once arraigned physic as a fallacious art, or derided it as a composition of error and fraud. A late foreign writer, impressed with this sentiment, has given the following _flattering_ definition of our profession: _Physic is the art of amusing the patient, while Nature cures his disease_."

With such a lamentable view of the practice of medicine, can we be too thankful to those observers who strenuously endeavour to rescue it from the dark trammels in which prejudice and interested motives have bound it? In no country more than in Great Britain is such an investigation desirable. We have become proverbial from our incessant abuse of a farrago of medicinal substances; and what is usually termed an _elegant prescription_ signifies an amalgam of various drugs and preparations, which most probably, by their affinities, neutralize the expected effects of each other; for, however great and flattering may have been the discoveries of modern chemistry, many of these affinities are unknown to us. Surely when our labours cannot detect any difference in the component parts of the purest Alpine atmosphere and the deleterious air of a loathsome dungeon, we cannot expect to form a correct idea of pharmaceutic combinations.

The mere hopes of being able to relieve society from the curse of constant drugging, should lead us to hail with gratitude the homoeopathist's investigations. That many physicians, but especially apothecaries, who live by overwhelming their patients with useless and too frequently pernicious medicines, will warmly, nay furiously inveigh against any innovation of the kind, must be expected as the natural result of interested apprehension; and any man who aims at simplicity in practice will be denounced as guilty of medical heresy. Have we not seen inoculation and vaccination branded with the most opprobrious epithets, merely because their introduction tended to diminish professional lucre?

In these remarks upon medicinal combinations, it is not meant to infer, that, because they are chemically incompatible, they are ineffectual,--experience has proved the contrary; but no one will contend that, if we can attain the same beneficial results from a single ingredient, administered in small quantities and at distant periods, as from the exhibition of repeated and nauseous doses of pills, powders, draughts, potions, &c. which hang over the bed of sickness, nay, of slight derangements, like the sword of Damocles, we have not effected a most salutary reform in the practice of physic. It is related of one of these ingenious and industrious practitioners, that, having seen a prescription, that only contained half a dozen medicines, he exclaimed, "What! nothing more?" To which the prescriber replied, "If you choose, sir, we'll step over to the apothecary, and see what else he has in his shop."

Specifics may be divided into two classes; the one producing a peculiar effect upon particular organs, the other producing general results. Thus, the action of cantharides and digitalis on the urinary system, of emetics on the stomach, of certain purgatives on the small intestines, and of others on the large ones, are generally known; whereas the action of mercury and opium is still a matter of controversy. A study of these effects constitutes the chief object of the homoeopathist; and, having determined their peculiar action, these medicinal agents are given singly, and, as we have already observed, in the most minute doses.

It is this division into infinite fractions that has drawn upon the homoeopathic practice the denunciation of the allopathic physicians, as it is considered utterly impossible that such imponderable particles can produce any beneficial or prejudicial effect; and the Academy of Medicine of Paris, when officially condemning the doctrine, asserts, in support of this argument, that great danger arises from it "in frequent and serious cases of disease, where the physician may do as much injury, and cause no less mischief, by ineffectual means as by those which are prejudicial."

This is perhaps one of the most important points of the homoeopathic doctrine. If these fractional doses are inert, and yet the disease is cured, then must the successful treatment be solely ascribed to the dietetic regimen and the efforts of nature. However, experience has afforded abundant proofs that these infinite atoms do produce positive and evident effects. What appears to our feeble organs an atomic fraction may produce phenomena on the organism which we cannot comprehend, but should not therefore be denied. Let one grain of iodine be dissolved in one thousand five hundred and sixty grains of water, the solution will be limpid; let two grains of starch be dissolved in two ounces of water and added to the first solution, and the liquor will forthwith assume a blue tint. In this experiment the grain of iodine has been divided into 1/15360. Dissolve the four-hundredth part of one grain of arsenic in four hundred thousand parts of water, and the hydric-sulphite will bring it into evidence. Let a five-thousandth part of arseniate of ammonia be dissolved in five hundred thousand parts of water, and the addition of the smallest proportion of nitrate of silver will obtain a yellow precipitate. Numerous experiments of a similar nature may be daily resorted to, to prove that the most minute particles of two substances possessed of chemical affinities may be brought into action, although diluted _ad infinitum_. But the power that the smallest particle possesses in producing natural phenomena cannot be more evidently proved than by Spallanzani's experiments in fecundation. This physiologist having wrapped up a male frog in oil-silk, fecundation could not take place; but having collected on the point of a camel-hair pencil a particle of the fecundising fluid, he succeeded in vivifying thousands of eggs. Surprised at this result, he dissolved three grains of the secretion in a pound of water, and one globule of the solution was endowed with the same faculty. In this case the globule of water only contained 1/2994687500 part of one grain. This curious experiment has been tried with a similar result by Prevost and Dumas. How imponderable and impalpable must be the effluvium which enables the dog to track his master for miles! the particle of atter of roses that perfumes a whole chest of clothes! and what must the power of the aroma be which is preserved for thousands of years in some Egyptian mummies! Would the vulgar believe in the wonders of the solar and gaseous microscopes unless they were exposed to view? In these we behold in amazement myriads of individuals in one drop of fluid, each of them as perfect in organization as the mighty mammoth of old or the sagacious elephant of our days, endowed with distinct habits, destructive and reproductive propensities and faculties.

It has been advanced by the opponents of homoeopathy that the insignificant dose of three or four medicinal globules cannot possess any power, since one might swallow a thousand of them with impunity. To this it is answered, that it is only under certain morbid conditions that these medicines act by their homoeopathic affinities. Moreover, it is well known that small doses of medicinal substances will frequently produce more powerful effects than larger quantities. Tartar-emetic, sugar of lead, calomel, afford daily instances of this fact; and it is also admitted that many substances act differently upon the healthy or the sick. An individual in health can take any food without apprehension; but when his functions are deranged, the slightest imprudence in regimen may lead to serious consequences. There are primordial and inscrutable peculiarities in our constitution that cannot be accounted for; and the medicine which relieves one patient will aggravate the sufferings of others. The exhalations of the American _rhus_ are deadly to some persons, but innocuous to others; and many poisons which cause instantaneous death to some animals may be given with safety to others. Whence has arisen the controversy regarding damp sheets, which many maintain are not dangerous, simply from the fact that a healthy person with a vigorous circulation may sleep in them with impunity, when a feeble and languid subject will be exposed to some dangerous determination of blood?

A learned writer already quoted thus expresses himself on this matter:[40] "The virtues of medicines cannot be fairly nor beneficially ascertained by trying their effects on sound subjects, because the peculiar morbid condition which they are calculated to remove does not exist." It may be said that this observation militates against the homoeopathic experiments, and to a certain extent it evidently does; but it cannot be inferred that because a medicinal substance will occasionally act differently in health and in disease, that it may not frequently operate in a similar manner when the morbid condition does prevail, since it is generally admitted that medicines act in a relative manner according to the state of the system. Hence classifications of medicines are too frequently erroneous and imperfect. The doses of medicines determine their effects. Linnæus says, "Medicines differ from poisons, not in their nature, but in their dose;" and Pliny tells its aphoristically, "_Ubi virus, ibi virtus_." According to their doses, medicines will produce a general or a local effect; and Dr. Paris, whom I feel much gratification in quoting, lays down as a rule that "substances perfectly inert and useless in one dose may prove in another active and valuable." It would be foreign to my purpose to enter more fully into this most important subject; but the cases which shall be adduced will be deemed sufficient to convince the most incredulous, of the power of homoeopathic doses.

Those who have denied this property have boldly attributed homoeopathic cures to dietetic means. Admitting this statement by way of argument, surely, if any observer, by ascertaining the peculiar action of our ingesta, can so regulate the regimen as to produce salutary effects without the aid of medicine, mankind would be most essentially benefited. How many persons do we not daily meet with, who have never taken any medicine since their childhood, when maternal care strove to destroy their digestive organs with apothecary's _stuff_, and who regulate their functions by mere attention to their mode of living. I know one gentleman, a physician, who relieves constipation by green chilies; another, with cold milk; a third, with warm milk: in some habits spinach and sorrel will act as a powerful and safe aperient; in others, cheese, or a hard egg, will operate in a contrary way. Fermented and spirituous liquors all possess specific properties. Some gouty persons cannot drink Claret without bringing on a paroxysm, and others dread a glass of Champagne or Burgundy. Nay, different wines have been known to bring on arthritic attacks in particular parts; and I have known Champagne to produce gout in the wrist, and Burgundy in the knee, in subjects who under other circumstances never experienced the disorder in those articulations. Our peculiar aversion, nay, our dread, of various alimentary substances are well known. The odour of cheese, of strawberries, have occasioned fainting and convulsions; and in certain constitutions, several articles of diet bring on indigestion. In short, the study of our ingesta is one of the greatest importance; and here again the homoeopathist is entitled to our best thanks.

This investigation will moreover prompt physicians to be more attentive in inquiring into the various effects of alimentary and medicinal substances on their patients. Instead of hastily drawing out routine prescriptions for such and such a disorder, they will accurately ascertain the physical and moral condition of the subject, taking into due consideration previous habits, predispositions, and pursuits in life. Indeed, it would be desirable that practitioners followed the example of army medical men, who keep an exact register of every individual they attend, and in which is diligently recorded every circumstance connected with the disease and its treatment.