Address, delivered at the semi-annual meeting of the Homoeopathic Medical Society of the State of New-York, Albany, February 10, 1863.
Gentlemen of the Society :
By the request of your president and other officers, I appear before you to perform that duty which, on such an occasion as this, devolves upon the president of the Society, but which the special engagements of that officer, at this season of the year, in New-York, have prevented his fulfilling.
The session of this evening brings to a close the first regular meeting of the Homoeopathic Medical Society of the State of New-York.
The object of this Society is declared to be "the advancement of the science of medicine."
In these days, when the value of associated labor is so well understood, one might certainly ask, with surprise, "Can it be that, prior to this year, there has existed in the State of New-York no central organization for the advancement of the science of medicine ?"
The fact is, there has been a State Medical Society in active operation since 1806. Its object is the same as that of our Society ; its organization and its mode of operation are identical with ours.
What, then, is the necessity for a second Society ? Why should men of the same profession, engaged in similar labors, for a common object, divide their forces, and thereby diminish their efficiency ? What is the nature of the antagonism which this division implies, and what is the necessity for its perpetuation ? Candid and exhaustive replies to these questions will explain and justify our position of separation from the Old School of medicine.
They will, at the same time, sharply define the outlines of that branch of medical science to which we have especially devoted ourselves, and will give us a clear view of the labors which devolve upon us for its advancement and development.
I propose, therefore, to discuss this antagonism,—first from a historic and then from a philosophical point of view.
Samuel Hahnemann, the great reformer of medicine, was a regularly educated physician, of great learning and very uncommon general culture and literary attainments. In the words of Sir John Forbes, who surely cannot be accused of any partiality for the founder of Homoeopathy :
"No candid observer of his actions, or candid reader of his writings, can hesitate for a moment to admit that he was a very extraordinary man, — one whose name will descend to posterity as the exclusive excogitator and founder of an original system of medicine, as ingenious as many that preceded it, and destined, probably, to be the remote, if not the immediate, cause of more important fundamental changes in the practice of the healing art than have resulted from any promulgated since the days of Galen himself ; he was undoubtedly a man of genius, and a scholar ; a man of indefatigable industry and of dauntless energy. [ British and Foreign Medical Review, XLI., 1846. ]
"' Hufeland, the Nestor of orthodox medicine in Germany, in calling attention to an essay published by Hahnemann, in his Journal, in 1801, speaks of him as "one of the most distinguished physicians in Germany."
This being the estimate in which Hahnemann was held by his most distinguished contemporary (Hufeland) and by his most learned critic (Forbes), both of whom, be it observed, were opposed to the medical "reform which he had instituted, let us glance at his professional career.
After practicing in various localities and positions, with such success and acceptance as to acquire the reputation which. Hufeland records of being "one of the most distinguished physicians in Germany,"
Hahnemann tells the profession, in several essays on medical subjects, that he has become so deeply convinced of the uncertainty of medical practice, and of the positive injurious effects of many methods in common use among physicians at that day, that at length he really "doubts whether his patients would not, in many cases, have thriven as well, or better, without his aid as with it."
This conviction of the uncertainty of medicine, this suspicion of the injury which it sometimes inflicts on the patients, were not peculiar to Hahnemann.
Girtanner and several others, before his day, expressed them.
Sir John Forbes, from whom we have already quoted, says, in 1846, of the medical methods of our own time, "In a considerable proportion of diseases it would fare as well, or better, with patients, in the actual condition of the medical art, as more generally practiced, if all remedies, at least all active remedies, especially drugs, were abandoned."
"Things [in medicine] have arrived at such a pitch, that they cannot be worse ; they must mend or end." [ British and Foreign Medical Review, XLI., 1846.]
Such views have been repeatedly expressed by members of the medical profession in this country.
Hahnemann has said nothing more severe nor more sweeping than this condemnation of practical medicine, by the late had of the profession in England.
But what did Hahnemann do when he had become convinced of the inutility and mischievousness of the current medical methods ? Did he continue a routine practice for the sake of "making a living ?"
No ! like a noble, honest man, he refused to make a pretense of curing where he believed he did not cure. He relinquished the practice of medicine and devoted himself to the collateral science of chemistry and to literary labors. But his mind was ever at work on the great question of the improvement of the practice of medicine, for he was "sure that the Creator had not left His creatures without a means of succor from the pangs and ravages of disease."
Thus intent on this subject, he could not fail to remark that although the prevailing treatment of diseases was, in general, blind and at least ineffectual to cure, yet there were certain remedies which were used in the case of certain diseases with almost uniformly happy results — or at least with such results as left no room for doubting that in these cases, at least, real cures were effected.
This he had observed to be the result of the use of mercury in certain cases, not un frequently encountered by medical men ; but his attention was especially called to the fact in connection with Peruvian bark, the febrifuge properties of which had, during the latter part of the preceding century, become well established and highly prized on the continent.
"If," he thought to himself, "if the number of these specific remedies could be vastly increased, and if some system could be discovered in accordance with which we could ascertain their exact properties and could know beforehand in what cases of disease they would be applicable, then indeed would the uncertainties of medical practice be removed, then might we anticipate as great success in the treatment of all diseases as we now attain in the treatment of a few for which we have specifics."
This desire for specifics was not original with Hahnemann. It had been expressed before his day by Bacon and by Boyle. Sydenham had longed for them in expressions almost pathetic in their hopelessness.
But Hahnemann, with his "dauntless energy and indefatigable industry," went to work to discover this system.
A casual observation in Cullen's Materia Medica gave him the clue to his discovery, as the falling apple did to Newton, and the swinging chandelier in the church at Pisa, to Galileo.
From this observation it occurred to him that provings of drugs upon healthy persons might furnish a knowledge of their specific properties, and that the administration of drugs in cases presenting symptoms similar to those which the drug produces in the healthy subject, might be the law of the application of specifics.
He sought throughout the whole medical literature of ancient and modern times for instances bearing upon this subject, and he collected a large mass of evidence corroborating his speculations.
He then proceeded to verify his theory by actual experiment. First upon himself and then upon all healthy persons who would join him in these self-sacrificing labors, he proved the effects of a number of drugs.
Then, cautiously, first in his own family, and then, little by little, in his general practice, which he had now resumed, he gave, as occasion offered, the drugs which he had proved, in cases of disease that presented symptoms similar to those produced by the drugs.
From 1790 to 1805, fifteen years of the prime of his life were devoted to constant, exhausting labors of this nature, during which time he proved on his own person more than sixty drugs ; "for," said he, "when we have to do with an art whose end is the saving of human life, any neglect to make ourselves masters of it becomes a crime !" [ Dudgeon, Hahnemann's Lesser Writings ]
At the end of this period, sure of the truth of the great principle he had discovered, — with all the incidental testimony of history to support it — with the positive results of a long experience to confirm it,— he presented his views and the results of his labors to the profession in an essay of wonderful logical power, of the utmost moderation in expression, full of almost tender persuasion and of the noblest enthusiasm [ Medicine of Experience. ] ; and he published at the same time the first part of his Materia Medica [ Frag. de Vir. Med. pos. ]
Five years later appeared the more elaborate exposition, the "Organon."
This was the turning-point of Hahnemann's career. Let us see what was his relation to the profession at this time.
He had, by universal consent, attained a position in the profession which justified him in assuming to criticize pre
vailing methods and to suggest improvements. He had shown the need of improvements, and he had borne testimony to his honesty in this exposition, by retiring from a lucrative practice.
He now came before the profession saying, "I believe I have discovered a system which will render the practice of medicine certain, and its success brilliant. I have labored fifteen years to test my discovery.
My own experiments and the testimony furnished by the records of medicine convince me of its truth. I lay it and them before you, my colleagues, and I conjure you in the name of truth, by the interests of humanity, to investigate it candidly and without prejudice."
"If," he says in his letter to Hufeland on this occasion, "if experience should show you that my method is the best, then make use of it for the benefit of mankind, and give God the glory !"
How were this exposition and appeal received by the medical men of the day ?
In 1811, appeared the Anti-Organon of Prof. Hecker — a work full of the most bitter aspersions upon Hahnemann's
personal character, whereas, in fact, the question had relation to principles and not to persons; abounding in the most concentrated contempt and scorn of the system which Hahnemann had unfolded; and without a single suggestion to investigate, by practical experiment, the practical method which Hahnemann had stated to have been attended, in his hands, with such brilliant practical success !
And from that day to the present, all the utterances of the Old School, whether from the press, the council, the professor's chair, or in the forum of the academy, have been hitter personal denunciations and aspersions of the character and motives of Hahnemann, and of all who have adopted or have even shown a disposition to investigate his method.
But many a scientific discoverer has met with opposition and calumny at the hands of his colleagues. Not to go beyond the ranks of medicine, Harvey was denounced as a quack, because he demonstrated the circulation of the blood ! Jenner was scandalized with most persistent violence because he introduced vaccination.
To Hahnemann, however, persecution came nearer home. After he had satisfied himself of the value of his discovery of the true method of medical practice, he resumed the exercise of his profession. His success was more brilliant than it had ever been. His fame as a practitioner grew rapidly, and patients began to come to him from considerable distances.
This good fortune excited the envy of his colleagues in Konigslutter, where he then resided. At their instigation, the apothecaries of the place brought a prosecution against him for infringement of the law which forbids to practitioners of medicine the compounding and sale of the remedies they prescribe. For, it must be observed, that, as an inevitable corollary to his new system of practice, Hahnemann had come to prescribe only a single drug at a time, and that he used simple preparations such as could not be obtained in the requisite purity at the apothecaries.
In vain it was urged that the spirit of the law was not infringed, since Hahnemann himself was an expert apothecary and chemist, and since his remedies were not "compounded," but simples, and not "sold," but dispensed gratuitously. The opposition was too strong. He was forbidden to practice, save in accordance with the law alluded to.
Rather than yield in a matter which he considered essential to the freedom of the physician and to the purity and certainty of his practice, Hahnemann determined to leave Konigslutter ; and accordingly, to the delight of his colleagues and of the apothecaries, and to the regret of the citizens, who were loath to lose their benefactor, and a cortege of whom attended his carriage far beyond the gates of the town, he removed to Hamburg.
Here, as he became known and appreciated, the same persecution was revived, and with the same result. He removed to Altona.
In this way, during a period of twenty-two years, from 1799 to 1821, Hahnemann was constrained, by the persecution of his colleagues, under cover of the law, to change his abode at least eleven times. The last place from which he was driven in this manner was Leipsic — a city for which he had a peculiar affection.
Here he had pursued his earliest medical studies and met with his first successes. Here he had, in later years, established a college of Homoeopathy, and had lectured to large audiences. In the shady walks and groves that surround the city, he had been wont to spend the evening of each day in social converse with his family and with the students whom he had gathered about him and who took part in his labors of proving drugs.
From this city of his love, the scientific capital of his fatherland, he was now, in the sixty-sixth year of his laborious life, driven away to an asylum offered him in the tiny capital of the tiny Duchy of Anhalt-Coethen !
No wonder that he who for so many years had followed the injunction, "When they persecute you in one city, flee ye to another," — that he who, like the Divine Healer, had gone "about from place to place doing good and healing all manner of sickness and disease among the people" — no wonder that he forgot, under the, pressure of this last indignity, that other injunction of the Divine Teacher, to "love them that hate you, and pray for them that despitefully use you and persecute you," and that, like Luther, he now bared his hitherto sheathed weapons of satire and invective against those who had striven to hinder his usefulness — who had so cruelly marred his peace and happiness — all save that peace which can never be taken from the man who has within himself the "mens sibi conscia recti” !
If in this he erred and came short of the Divine example, let him among men who is "pure," cast the first stone at him !
Time brings its sweet revenges. After a career of honor and usefulness at Coethen, where his ever-increasing fame brought him throngs of patients from all parts of Europe, and a subsequent residence in Paris, where his reputation extorted from the government a license to practice as he pleased, Hahnemann died at Paris in 1843, full of years and honors.
Eight years afterward, in 1851, the town council of Leipsic appropriated a beautiful plot of ground as a site ,for his monument, and the council celebrated officially the uncovering of a costly and beautiful bronze statue of that man, as one of Saxony's most illustrious sons, whom thirty years before the same council had ignominiously chased from their borders as an unauthorized and illegal prescriber !
Before we leave this branch of our subject, let us draw one lesson from the story of Hahnemann's persecutions. All his sufferings might have been avoided, he might have lived in peace and affluence, enjoying consideration among his colleagues and making plenty of money, had he been willing to "yield a little," to waive the right of dispensing his own medicines, to accommodate his system in various points to suit the notions of his time.
The temptation to do this might, by some, be supposed to have been great, for Hahnemann's family was large, he suffered during his wanderings from the pinchings of cruel poverty, and this took from him the leisure so necessary for his studies.
But Hahnemann was not made of the stuff that could compromise, for personal ease and prosperity, the charter that God had given him for the benefit of the race. He refused to give up one particle of anything which he deemed essential to the purity and perfectness of his system, and so he has left it to us, pure and perfect !
Let us remember his example when prospects of ease and consideration, and of the cessation of strife for the truth, tempt us to compromise unworthily with any portion of the Old School of medicine.
For there are those among us, as there are men in other walks of life, who, for the sake of what they call peace and union, would join hands with what they know to be false ! aye, even though to do it, they should have to "cut off the fanatics," who adhere strictly to Hahnemann, — to leave the "brains" of their system "out in the cold."
This is the origin and the personal history of the antagonism, between Homoeopathy and the dominant school of medicine. Hahnemann showed the imperfections of the current methods. Nobody disproved what he said. Everybody agreed with him and everybody sighed for something better. He discovered something better and offered it to his colleagues, with demonstrations of its value ; he begged them to investigate it; and in case they should find it better than the old method, to use it for the good of mankind, and give God the glory !
Then, with one accord, they denounced him as a vile imposter, and chased him from their midst, nor have they yet ceased to heap ignominy on his name !
It may be objected that I have not stated the whole grounds of the opposition of the Old School to Homoeopathy, inasmuch as I have said nothing about the "little doses."
If this were true, it would not alter the bearings of the case, because the doctrine of the "little doses," like all the rest of Hahnemann's method, was offered to the profession, to be by them submitted to the test of experience, by which, like all the rest, it should stand or fall.
But, in point of fact, Hahnemann came very slowly to see the necessity of giving small doses when he prescribed according to the law of Homoeopathy ; and he did not express himself authoritatively upon this subject until long after the, opposition to him and the prosecutions in the name of the apothecaries were in full blast ! Therefore, this opposition could not have originated in the doctrine of the dose.
Nor is the question of the dose at all essential to the experiments which Hahnemann invited his professional brethren to make for the purpose of testing his system. Intelligent experiments with doses of ordinary size would convince any physician of the truth of the Homoeopathic law ; and if he continued the experiments, the inconveniences that he would find to result from the use of such doses would inevitably lead the experimenter, as they led Hahnemann, to continually diminish the dose, until he should become convinced of the truth of Hahnemann's dogma on this subject also.
This has been the uniform experience of all physicians who have become convinced, through experiment, of the truth of Homoeopathy, and have adopted the method in practice. And the more strictly they conform to Hahnemann's method in prescribing, the more exactly do they agree with him respecting the dose. The number of these witnesses amounts to day to many thousands, and their concurrent testimony does not admit of dispute.
Let us now consider this antagonism from a philosophical point of view.
As I have already said, Hahnemann perceived that the prevailing method of treating disease comprised two processes.
One of these processes was what was then, and is still called the "Rational." It involves a theory of the cause and essential nature of the disease, and the resort to some expedient which would be likely to remove this supposed cause of the disease, and to bring about a contrary state, and so conduce to health. Of this kind was Galen's method, which divided diseases into hot, cold, moist and dry ; made a similar classification of remedies, and applied to each disease a remedy from a class of the contrary nature.
Less glaringly absurd, but in no way different in nature, are the theories which hold that certain diseases, for example, are caused by accumulation of the blood in certain organs, and are to be cured by abstraction of blood ; that others depend upon what is imagined to be want of tone, and are to be cured by remedies which are assumed to be tonics ; that others are due to a languid state of the "animal spirits," and are to be encountered by the administration of "stimulants," etc.
That these were the grounds upon which the prevalent methods, in the generation preceding Hahnemann, were based, is shown by Cullen's theory of the action of bark, and also by the following passage from "Sydenham on Pleurisy :"
"After attentively considering the various phenomena of this disease, I think it is a fever originating in a proper and peculiar inflammation of the blood, — an inflammation by means of which nature deposits the peccant matter in the pleurae. In my treatment, I have the following aim in view : to repress the inflammation of the blood, and to divert those inflamed particles which have made an onset on the lining membrane of the ribs (and which have lit up so much mischief) into their proper outlets. For this reason, my sheet-anchor is blood-letting."
A modification of this process is that which is known as the Hippocratic method of observing and following the indications of nature ; in the words of Sydenham, "watching what method Nature might take, with the intention of subduing symptoms by following in her footsteps." According to this method, if, in any disease, recovery was preceded by a critical evacuation, — such as a copious sweat, — this was assumed to be nature's method, and sudorifics were -accordingly resorted to in similar cases.
Now, independently of the fatal objection, that this method would confine our curative power to such diseases as Nature herself is wont to cure by critical discharge, etc., — the very diseases, therefore, in which medical aid could be best dispensed with, — while it makes no provision at all for such diseases as rarely or never get well of themselves, — such as nature never cures by critical discharges, — the very cases, therefore, in which there is 'most need of the intervention of art, — Sydenham tells us that the "found that spontaneous sweats often did good." "But these," he says, "were very different things from forced ones."
And Hahnemann showed that "in such cases the critical discharges and the recovery were simultaneous ; that the discharge was the consequence and announcement rather than the cause of the recovery ; and that to infer from such a state of things that we could bring about a cure by inducing an artificial sweat, would be like ringing bells and lighting bonfires to secure a victory instead of a announce one.'" [ Russell, History and Heroes of the Art of Medicine. — "Sydenham."]
The other process, which Hahnemann perceived to be comprised in the prevailing methods of treatment, was — administering, in the case of a very few diseases, of which fever from marsh miasma may be taken as the most illustrious example, certain remedies which had been discovered to possess, in some unexplained way, a power to cure these diseases. Such remedies had been discovered by the merest accident. No method was known by which others could be discovered : no method had been suggested by which it could be more clearly ascertained and defined for what particular varieties of the diseases in question these "specifics," as they were called, were especially appropriate.
Hahnemann showed the fallacy of the philosophy on which the "Rational" method was based. He showed that, even admitting that accumulations of blood do exist as the "proximate cause" in certain diseased conditions, yet these -accumulations cannot be regarded as the essential. cause of the disease. On the contrary, that cause must be sought in that force which regulates the circulation and preserves its equilibrium. This force must have been set into abnormal action, in order that an accumulation could take place in any particular organs ; and, therefore, in the accumulations we see, not the essential cause of the disease, but only one of the results of that cause.
To undertake, then, by abstraction of blood to remove a result of the cause, is not to cure the disease by removing the cause, but only to seek to palliate it by carrying away some of its products. He showed, further, that this abnormal condition of one of the dynamic forces, the action of which constitutes the life of the body, is beyond the sphere of our observation. Like the healthy action of these same forces — in a word, like life — it is an ultimate fact, behind which we cannot penetrate, and which, therefore, we cannot study as a cause of disease and seek to remove by direct rational means.
But Hahnemann went farther, and showed that, although we cannot investigate the ultimate nature and causes of those modifications of the dynamic forces of the organism, which are the essential causes of diseased action, and then remove them, as a "rational" method would propose to do, yet that if, while a disease is in full vigor, we administer a remedy which causes a sudden cessation of the morbid action without any abstraction of the fluids or any derivative action whatever, we are then justified in concluding that the remedy we have given has, in some way or other peculiar to itself, reached that force which was in a state of abnormal action, and has so modified it as to bring it back to a condition of normal action ; that this remedy has a "specific" effect upon that force under certain conditions ; and we draw this conclusion upon the general principle that when an effect ceases we may conclude that the cause has ceased to act.
And Hahnemann showed, farther, that if we could discover substances having such a specific action,, and a law by which we should know just when to apply them, we should have accomplished the much needed reform in medical science.
He appreciated so highly the value of the specifics of which medicine was already in possession, that he consecrated his life to the task of discovering a method of increasing their number and of reducing their use to a system.
In this appreciation of the direction in which alone improvement in the curing of diseases was to be looked for, Hahnemann was anticipated, as I have said, by Bacon, Boyle and Sydenham.
Thus Bacon, in the "Advancement of Learning," after a sweeping condemnation of the unphilosophical method of Galen, says : "A work is wanting upon the cures of reputedly incurable diseases, that physicians of eminence and resolution may be excited and encouraged to pursue the matter as far as the nature of things will permit ; since to pronounce diseases to be incurable is to exhibit ignorance and carelessness, as it were,, and to screen ignorance from reproach."
And again, "I find a deficiency in receipts of propriety respecting the cure of particular diseases."
Again, : They have no particular medicines which, by a. specific property, are adapted to particular diseases. I remember a learned Jew physician who used to say, 'Your European physicians are like bishops ; they have the keys of binding and loosing — nothing more !'
It would be of great consequence if physicians eminent for learning and practical skill would compile a work of approved and experienced medicines in particular diseases."
The learned Boyle, the father of chemistry, who had devoted much time to the study of medicine, says : "I cannot forbear to wish that divers learned physicians were more concerned than they seem to be to advance the curative part of their profession, without which, three at least, of four other parts, may prove indeed delightful and beneficial to the physician, but will be of very little use to the patient, whose relief is yet the principal end of physic. I had much rather that the physician of any friend of mine should keep his patient, by powerful medicines, from dying, than tell me punctually when he shall die, or show me in the opened carcass why, it is supposed, he lived no longer."
Again he says, when speaking of the need of specifics` : "Finding at every turn that the main thing which does prevail with learned physicians to reject specifics is, that they cannot conceive the distinct manner of the specifics' working, and think it utterly improbable that such a medicine, which must pass through digestions in the body and be whirled about by the mass of the blood to all the parts, should, respecting the rest, show itself friendly to the brain, for instance, or the kidneys, or fall upon this or that juice or humor rather than any other.
"First, I would demand of these objectors a clear and satisfactory, or at least an intelligible explication, of the manner of working of divers other medicaments that do not pass for specifics. For I confess that to me, even many of the vulgar operations of common drugs seem not to have been hitherto intelligibly explained by physicians, who have yet, for aught I have observed, to seek for an account of the manner of how diuretics, sudorifics, etc., perform their operations, etc.
"The same objection that is urged to prove that a specific cannot befriend the kidneys, for example, or the throat rather than any other parts of the body, lies against the obnoxiousness of poisons to this or that determinate part ; yet experience manifests that some poisons do respect particular parts of the body without equally or at all sensibly offending the rest ; and we see that cantharides, in a certain dose, are noxious to the kidneys and bladder, and quicksilver to the throat and glandules thereabout, stramonium to the brain and opium to the animal spirits and genus nervosum."
[ Russell, History and Heroes of the Art of Medicine, vol. II. p. 101 ; art. "Robert Boyle." ]
Sydenham expresses himself on this subject with his accustomed brevity and directness.
Speaking of intermittent fever, he says :
"We must do one of two things ; we must, by careful and anxious observations of the process by which nature relieves herself of this disease, draw indications as to the manner by which the incipient fermentation may be promoted and the patient restored to health, or else we must discover a specific. By the latter method, we shall attack the malady directly."
It may be observed that Sydenham did not hesitate to choose the latter method so soon as the specific virtues of Peruvian bark in intermittent fever were recognized,, and that he was the chief means of making the value of this great specific known in England ; nor have the profession generally, since his day, been disposed to hesitate in their choice between the Hippocratic and the specific methods of treating this disease, — the two alternatives which Sydenham so clearly lays down.
He continues : "By no means do I wish to express myself as if wise and learned physicians were to despair ; as if they were to think out no better modes of treatment, and as if they were to throw away the hope of discovering nobler and more potent medicines for accelerating the cure of diseases. So far am I from this that I do not despair of finding out, even myself, some such medicines and some such method of curing."
These things which Bacon, Boyle and Sydenham point out so forcibly as the desiderata of Medicine, which Sydenham did not despair of finding out, yet died without discovering — these "specific medicines," and this "methodus medendi," were offered to the profession one hundred years later by Hahnemann.
Dr. Lettson tells us, "the great Sydenham, for all his labors, only gained the sad and unjust recompense of calumny and ignominy, and that from emulation of some of his collegiate brethren and others, whose indignation at length arose to that height that they endeavored to banish him from that illustrious society (the Royal College of Physicians), as guilty of medicinal heresy."
And yet Sydenham only longed for, and looked forward to, the discovery of specifics and of the law of their employment. He was the Moses of the specific method. It was, therefore, in the regular course of historic sequence that Hahnemann, the Joshua of that method, who led the hosts of Aesculapius into the promised land of which the Moses had a glorious vision, should be unsparingly denounced as a heretic and actually banished from every well regulated society !
This, then, is the antagonism. Hahnemann shows that specifics are to be discovered by ascertaining the effects of drugs upon healthy persons ; that they are to be applied by giving to a sick person such a drug as would produce, in the healthy subject, symptoms similar to those of the sick person.
He presents this discovery to the profession as something in advance of present knowledge. They refuse to accept or even to test it, and they denounce him for offering it. On Which side lies the onus of the antagonism ?
But it may be said, however true these statements are as regards the age for which Hahnemann wrote, the scientific progress of the last fifty years has changed all that. It has changed the names of things and little besides in therapeutics. We hear no more ; it is true, of "temperaments" and "humors," of the "animal spirits," of the "Arcoehus," but instead, the talk is now of "the dyscrasias," of "diatheses," of the "cellular pathology," of "analogies" and "heterologies."
There is the same endeavor to draw from a theory of the essential nature of the disease a rational indication of cure, of which Hahnemann exposed the fallacy and impossibility. Indeed, Sir John Forbes affirms, in 1846, "The progress of therapeutics (the cure of diseases) during all the centuries that have elapsed since the days of Hippocrates, has been less than that achieved by the elementary sciences of medicine during the last fifty years. This department of medicine must indeed be regarded as yet in its merest infancy."
It should be clearly understood, and I state it most emphatically, that all expositions of the insufficiency and the chaotic state of the prevalent system of medicine — whether by the outspoken leaders of the Old School, like Forbes, or by Hahnemann and his followers — refer exclusively to the department of therapeutics, the science and art of curing diseases by medicines. In the development of the natural history of the healthy and of the diseased body, that is to say, in the science of physiology and physiological anatomy, and of pathology and pathological anatomy, as well as in the departments of hygiene, surgery, obstetrics and medical chemistry, medicine has fully kept peace with the wonderful progress of scientific knowledge in our day.
We profit by the labors of our colleagues in these branches, and accord them full recognition and admiration. But the great end and object of all these things is to cure diseases. If they afford no facilities for this, they are profitless to mankind. Now, if the same men who have brought these collateral sciences to such perfection have been unable to bring therapeutics out of what Forbes calls its present chaos of "merest infancy," is not the conclusion irresistible that they have not yet got hold of the right clue — of the true philosophy of the science ?
There is even a greater indisposition in our day, than in the time of Boyle, to admit the value and to stimulate the discovery of specifics. Nor is this wonderful ; for specifics obstinately refuse to range themselves under any rational hypothesis. They exert a peculiar, inscrutable action upon certain, organs when in certain conditions, and more than this nobody can say of them.
And yet, notwithstanding their philosophical aversion to them, the practical sagacity of our colleagues, with which they keep their philosophy strangely at variance, leads them to seize eagerly upon specifics whenever these are presented to their notice. Witness the avidity with which they have availed themselves of Iodine, Ergot, God Liver Oil, the Hypothosphities, Iron, Veratrum viride, as well as of Nickel and Oxalate of Cerium which the Houdin of orthodox medicine has lately introduced to them.
Nay, people do say that our learned friends of the Old School make frequent use, "upon the sly," of Aconite as a specific in fever, and of Nux vomica and of Pulsatilla as specifics in gastrodynia and dysmenorrhea, etc., etc., — remedies of the specific properties of which their only knowledge is derived from the labors of Hahnemann.
It is true, they undertake to give a "rational" theory of the action of these specific remedies, but with as little success as Cullen met with when he attempted to explain the febrifuge action of Peruvian bark. It is all comprised in the doggerel explication that Moliere gives of the hypnotic effects of opium.
"Domandatur causam et rationem quare
Opium facit dormire,
A quoi respondeo,
Quia est in eo
Virtus dormitiva,
Cujus est natura
Sensus assoupire."
Now, as in the days of Hahnemann, there is an antagonism between the Homoeopathists and the Old School. The former hold out to the latter what they believe to be that method which has ever been a desideratum in medicine, The latter refuse even to examine it, and expel the Homoeopathists from all associations over which they hold control, We cannot unite with them in any associated labors without ignoring and disavowing what we believe to be the true theory and practice of the all-important part of medical science — the science of therapeutics. They will not unite with us in associated labors for the development of this science.
Had Hahnemann done nothing more than devise a method of discovering and using specifics in the gross and wholesale sense in which the term was and is understood and used by the Old School of medicine, he would still have been entitled to the gratitude of mankind. He did far more.
He perceived that, in the dominant school, a specific was set apart as adapted to any individual member, indiscriminately, of a large nosological group [of diseases] ; that bark, for example, was held to be the specific for malarious fevers, in general, and that no account was taken of individual deviations within the limits of this group.
Whereas, in point of fact, he perceived what is well known within the profession and without it, that although bark is really the specific for many, indeed for the majority of malarious fevers, it is not so for all ; since many cases cannot be cured or even improved by its use.
Now, this wholesale way of regarding diseases, in groups, was the logical and inevitable consequence of the Old School theories of diseases and of the method of cure. When Galen propounded the doctrine that all diseases depend upon one of four, conditions, heat, cold, dryness, moisture, it was an inevitable consequence that he should disregard every phenomenon presented by his patients, except such as served to indicate that the case belonged to one of the above categories, and that he should have but four classes of remedial agents appropriate to these categories.
And when, in our day, physicians assume to ascribe diseases to certain pathologico-anatomical states as their essential causes, it is manifest that whatever varieties the case of each one of a dozen patients may present, must be disregarded, provided the pathologico-anatomical condition be the same in all, for they are group on the basis of this condition, and the indication for the cure is drawn from the existence of this condition, and must necessarily be the same for all.
Now, just as any spot upon the surface of the globe may be approached by an almost infinite number of roads, and yet, when the traveler has reached the spot, there shall be nothing in the mere fact of his presence there to indicate with certainly the road by which he has come thither, so the same pathologico-anatomical result may issue from the most multifarious pathological processes, which processes, however, leave no sign in the result. It then, the mode of treatment be based on the result, it can take no account of this variety in the processes.
A wholesale generalization, then, of diseases and of remedies is inevitable from the philosophy of the "Rational" method.
The common experience of the community teaches men that diseases to which the same name is given may present
in different persons an entirely different aspect.
John Doe and Richard Roe both have rheumatism, but their symptoms and whole condition are so entirely different that no one would have imagined them to have the same disease, if the doctor had not said so.
The pathologico-anatomical condition, however, is the same in both (viz., the altered condition of the blood), and consequently the rational indications for the cure are identical in the two cases.
If the doctor be true to the philosophy of his method, he treats them alike, notwithstanding the difference in their symptoms and apparent condition.
But I call your attention to the fact which is familiar to every one, that every sagacious and long-headed physician of the Old School pays the less regard to the rules of his art the more experience he acquires at the bedside.
In treating disease he "feels his way," as the saying is ; he relies on his "practical tact and experience," and often deviates widely from the rules of practice as they are deduced in the books from the theory of the art ; he trusts less and less implicitly to a pathologico-anatomical basis of treatment, and more and more to "general indications," by which he means the sum of the symptoms of each individual case. In truth, experience has taught him the fallacy of the science of therapeutics, as founded on the "Rational" basis.
Now, if this were a true science, would not experience rather confirm the practitioner's faith in it, and add to his skill in applying it ?
When on the other hand we cast aside all endeavors to base a method of treatment upon a theory of disease ; when we give over all attempts to discover the inscrutable, essential nature and cause of diseases, and confine our observations to the phenomena of morbid action, whether these be material or functional, then we can take into account the pathological processes as well as the pathologico-anatomical result. We are then in condition to give due weight to the peculiarities of each individual case of disease, to study it, as under other circumstances groups are studied, and to give due attention to the modifying idiosyncrasies of the individual.
Hence, under our method alone is an absolute individualization of disease possible. Such a method of studying disease, however, would be barren under the Old School method off treatment, even with specific. For the properties of specifics were known to the Old School only with reference to large and ill-defined groups of diseases.
By us, on the other hand, specifics are studied in the effects which they produce upon the healthy subject, precisely as diseases are studied in the effects which morbific causes produce upon the sick. The same strict individualization, then, is practicable with regard to specifics that we have seen to be necessary in the study of diseases. It is not only practicable — it is fruitful of the richest returns.
The case, therefore, is not half stated when we say that Hahnemann discovered the method of specifics. He taught us how to discover and apply, and showed us the necessity of applying, an individual specific to each individual case of disease, as studied in the totality of its phenomena and without regard to the nosological group to which, for purposes of classification, the case might be assignable.
As a necessary consequence of this individualization, Hahnemann taught the value of subjective symptoms. By these, we mean those symptoms of which the physician becomes cognizant through the sensibilities of the patient.
Among them are all the varieties of pains and abnormal sensations which accompany disease. These symptoms were previously disregarded and are still considered as of no value by the “rational” or “physiological” school of medicine.
Thus, Professor Bock, of Leipsic, in his work on Diagnosis (1853) says : "Only the objective symptoms — of which the practitioner derives a knowledge by the use of his own five senses, by sight, touch, hearing, mensuration, percussion, and by rniscroscopic and chemical examinations — are of any value to the physician. The subjective symptoms are in the highest degree uncertain and treacherous." In other words, the disease is to be studied in all cases just as the phenomena of an inanimate plant or mineral are studied ; the case of an intelligent and self-possessed patient, just as that of a patient whose intelligence is dormant under the cloud of a typhoid fever !
Now, everybody knows that pains and various sensations different from those of health, make up a large and important part in every case of illness. And what are these sensations ? Unquestionably they are the results of abnormal action of the sentient nerves, or else they are evidences. conveyed by the sentient nerves of abnormal action in some of the organs of the body.
It is in the highest degree unphilosophical to arbitrarily disregard and cast aside any of the phenomena of disease. If they find no place in our system of medicine, why, so much the worse for our system ! If they cannot be made available under our method of treating disease, this fact is prima facie evidence that our method is defective !
Furthermore, every physician and every intelligent person knows, by observation and experience, that pains and abnormal sensations almost always precede any material or organic evidence of disease. Common sense teaches every man the value, in medical treatment, of the maxim, "Obsta principiist" .
Diseases should come under treatment at the earliest possible moment. Some that are curable at early period are well known to be incurable by our present resources, if allowed, to establish themselves firmly. But the first evidence of nearly all diseases consist of subjective symptoms. A method, therefore, which does not provide for the employment of these symptoms in the determination-of the treatment, cannot furnish means for encountering disease at the very outset.
And, appealing again to the experience of the community to bear me out, I say that honest and candid practitioners of the Old School often say to their patients, “Wait a little until your disease shall have become developed, — at present I know not what to do." Why does he not know what to do ?
This question touches the weak point in the philosophy of the physiological school. It is because the patient, as yet, presents only "subjective symptoms," which are evidence of "dynamic changes" only, — because he cannot from a theory of the cause of the disease until the disease has progressed far enough to furnish him with some material results of these dynamic changes, in a word, with objective symptoms. This instance is another evidence of the insufficiency of the Old School philosophy of medicine, while at the same time it shows that, so long as they accept this ; philosophy, the physiological school are consistent and logical in excluding subjective symptoms from consideration.
Not a few diseases — the neuroses, for example — consist almost entirely of subjective symptoms. In these, the physiological physician admits his inability to institute a rational treatment, and he resorts at once to specifics. But if the specific method of treatment is available against diseases for which the physiological method fails, as well as for all other cases, is it not confessedly the universal method ?
Hahnemann's method, which avails itself of. all the phenomena which the patient presents, — holding that all together, make up the disease, — sets a true value upon subjective symptoms, Not requiring a theory- of the nature and cause of the disease as a preliminary to the treatment, but basing the treatment directly upon the phenomena which the patient presents, it can proceed to cure a patient who presents only subjective symptoms as readily and as surely as one in whom these have given place to objective symptoms.
More than this, Hahnemann showed the value of subjective symptoms in the aid which they afford us in individualizing cases of disease, and thereby enabling us to select a specific for each individual case with more absolute precision. Indeed, he showed that it is only by means of subjective symptoms that the application of individual specifics is possible. It has already been remarked that the material or organic changes in the tissues of the body, which furnish the objective symptoms, may have resulted from any one of a number of pathological process or abnormal alterations of function, and that they give us in themselves no means of knowing from what particular abnormal process they resulted. Now, unless we know this, we cannot apply specifics with exactness.
The physiological school have no means of knowing it, and therefore they, very logically, do not undertake to apply specifics with exactness to individualize cases of disease. But the subjective symptoms enable us to take cognizance of these pathological processes, these abnormal changes of function, and hence the value of these symptoms. To Hahnemann belongs the honor of having demonstrated this value, and of having shown us how to avail ourselves of it.
To Hahnemann, again, belongs the credit of having insisted upon the propriety of using only one remedy at a time. As this, however, was clearly expressed by Boyle, and is admitted by Sir John Forbes, I shall content myself with quoting their words. Boyle says (1654) : "It seems a great impediment to the further discovery of the virtues of simples, to confound so many of them in compositions ; for in a mixture of a great number of ingredients, it is hard to know what is the operation of each or any of them, so that
I fear there will scarce, in a long time,, be any progress made in the discovery of the virtues of simple drugs, till they either be oftener employed singly or be but few of them employed in a single remedy." And Forbes says, in 1846 : "Our system here is greatly and radically wrong. Our officinal formulae are already most absurdly complex, and our fashion is to double and redouble the existing complexities. This system is a most serious impediment in the way of ascertaining the precise and peculiar powers (if any) of the individual drugs, and thus interferes in the most important manner with the progress of therapeutics."
And, finally, Hahnemann demonstrated these facts :
1st. That the curative power of a specific remedy is not in the direct ratio of its material quantity. This had been suspected by his predecessor Sydenham, with respect to bark.
2d. That a drug exerts a more powerful effect on those, organs for which it has a specific affinity when these organs are sick than when they are healthy ; whence it follows that smaller doses of the same drug are required to cure diseases for which it is the specific remedy, than would be needed to produce their symptoms in the healthy person.
3d. That not only are smaller doses of specifics required to cure diseases than to produce their symptoms in the healthy, but that, when the symptoms of the diseased organism are similar to those produced in the healthy subject by a given drug, then this drug will act curatively on that organism in doses so small that they would hardly produce any effect whatever on the healthy organism.
But how small ? That is the practical question. A priori, Hahnemann said, "The smaller the better,, provided they only cure the disease in the quickest and surest manner:" He experimented for the purpose .of reaching definite conclusions, and out of these facts and experiments came the doctrine and practice of the little doses. And I repeat that those who follow Hahnemann most closely, individualize their cases most strictly, and select the individual specific with most exactness, will surely arrive, as all such have done, at the conclusion, on this subject, to which Hahnemann came.
It is remarkable that the first and second facts I mentioned respecting the dose of specifics did not escape the acute mind of Robert Boyle. He says: "To show you that a distempered body is an engine disposed to receive alterations under such impressions as will make none upon a sound body, let me put you in mind that those subtle streams that wander through the air before considerable changes of weather disclose themselves ; are wont to be painfully felt by :many sickly persons, and more constantly by men that have had great bruises or wounds, in the parts that have been so hurt, — though neither are healthy men at all incommoded thereby, nor do those themselves that have been hurt feel anything in their sound parts whose tone or texture has not been altered or enfeebled by outward violence."
If quantity be accepted as the measure of power, then the .question of the dose must be resolved by the well-known laws of physics.
But so soon as it is admitted that the power of a drug is not determined by its quantity alone, but also by 'its form, and still more by the condition of the patient and by the relation of the specific properties of the drug to the diseased condition against which it is administered, then the whole question is withdrawn from the domain of physics and is left open to be settled by experiment.
Now, it is admitted by all medical men, that some drugs at least, exert their specific influence more speedily and more powerfully when given in smell doses than when given in large doses, as, for example, Mercury, and according to Dr. Christison, Oxalic acid, which shows that there is not always a direct ratio between power and quantity.
Moreover, all medical men agree that in certain morbid states, the body is much more sensitive to the specific action of certain remedies than it is, in certain other morbid states, to the same remedies. The phrase that "such or such a disease does not bear Mercury well," is familiar to the professional ear. This shows that the condition of the patient has something to do in determining the power with which a certain dose of a specific shall manifest its action, and conversely that this condition should be taken into consideration in determining the dose.
These two facts show that the whole question of the, dose was, at the time of Hahnemann's writing, an open one, to be settled by experiment alone.
And, as Hahnemann showed that those morbid conditions of the system in which a specific exerts the most power in small doses, — in which, in other words, the susceptibility of the system to the specific is the greatest, — are precisely those in which the symptoms are similar to those which the same drug would produce in a healthy person, it follows that no experiment can be valid on the subject of the dose which does not take into consideration the condition of the patient the time, and which does not require, as preliminary conditions, first, that the subject of the experiment shall be sick, and second, that the symptoms of the sickness shall be similar to those which the drug with which the experiment is made would produce on the healthy subject.
In none of the experiments on which our opponents base their objections to the dose of Homoeopathy have these conditions been observed.
In no case in which they have been observed has the result been adverse to that at which Hahnemann arrived.
But, in truth, these objections depend in general not so much on the result of experiments as on what is called the a priori improbability, and upon the seeming simplicity and triviality of the means employed in proportion to the end sought to be attained.
The improbability exists only in the minds of those who reckon respecting the living organism as they reckon respecting an inanimate machine, employing the rules of physics.
Let me quote again from Boyle : "Whereas," he says, "it is objected that so small a quantity of the matter of a specific As is able to retain its nature, when it arrives at the part it should work on, must have little or no power to relieve it ; this difficulty will not stagger those who know how unsafe it is to measure the power that natural agents may have to work upon such an engine as the human body by their bulk, rather than by their subtlety and activity."
And as concerns the relative simplicity and triviality of the dose, listen to the practical Sydenham.
Speaking of the success of his new plan of treating rheumatism with whey, instead of by blood-letting, he says : "Should any one despise this method for its simplicity, I would have him to know that weak minds only, scorn things for being clear and plain. * * *
The usual pomp of medicine exhibited over dying patients is like the garlands of a beast at the sacrifice." [ Russell, History and Heroes of the Art of Medicine. ]
Gentlemen of the Society : In the torch-races of ancient Greece the participants ran with lighted torches, each striving to preserve the flame alive, and to hand his torch unextinguished to his successor. If the light went out in his hands he was dishonored. This was done in memory of Prometheus, who first brought fire from heaven for the benefit of men.
We have received froth the generation of the pupils and successors of Hahnemann the blazing torch which the Prometheus of our system lighted at the alter of Eternal Truth. Our honor depends on the care with which we cherish it, and the state in which we, in turn, transmit it to those who shall follow us.
The especial direction which our labors should take is determined by the peculiarities of our method.
We are to increase the number of specific remedies. We are to labor diligently, as our predecessors have done, to increase our Materia Medica, until we shall have ascertained the specific remedial properties of all substances capable of being used in treating diseases.
But more especially are we to labor to make the knowledge we thus acquire of new specifics, and the knowledge we already possess of such as we now use, more exact and definite; until we shall possess an exhaustive knowledge of each remedy, and also such a differential knowledge as shall put us in possession of all the points of resemblance and difference between each of our remedies and all the rest.
And it is in this particular province that there is the greatest present need of labor. Our Materia Medica is being filled with the names of drugs of which a few general properties are loosely recorded, but respecting which no exact or exhaustive knowledge has been attempted to be gained. All this must be changed if we would establish and maintain a reputation at all commensurate with the demands of modern science.
Finally, we must bring to bear upon our study of Materia Medica and of symptomatology all that is useful in the labors of the physiological school of medicine, in the department of the collateral medical sciences of physiology, pathology, chemistry and physical diagnosis.
For, Chaotic as are the therapeutics of this school, and based on a false philosophy, we must not suffer this fact to blind us to the wonderful progress made by it in these collateral sciences, and which are as valuable to us as to it.
They supply the means of exact observation. We need, then, in part, to reprove our Materia Medica, availing ourselves of these improved means of observation; and we must employ the same in our examination of the sick.
We are called also to give ourselves to the study of subjective symptoms. This is our especial province, because the physiological school discards these symptoms. Prof. Bock says they are "difficult to understand and apt to deceive."
I have yet to learn that a study is to be avoided because it is difficult ! or that a precious tool should be cast aside because it requires a skillful hand to use it.
The import of subjective symptoms, their connection with each other, their physiological and pathological significance; are all matters which it is indispensably necessary for us to elaborate and master.
And, last of all, the still open question of the dose demands our earnest study.
Conscientious, untiring labor in these departments will enable us to hold with honor our place in the great race, and to hand our torch, still blazing, to our successors.
We shall thus do our part toward making good the confident expectation of our master respecting his system.
"Our art," says he, "needs no political lever, no worldly badges of honor, in order to become something. Amid all the rank and unsightly weeds that flourish round about it, it grows gradually from a small acorn to a slender tree; already its lofty summit overtops the rank vegetation around it.
Only have patience ! It strikes its roots deep underground, gains strength imperceptibly, but all the more certainly, and in due time it will grow up to a lofty God's oak, stretching its great arms, that no longer bend to the storm, far away into all the regions of the earth; and mankind, -who have hitherto been tormented, will be refreshed under its beneficent shadows."
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