History
of Homœopathy : Its Origin ; Its Conflicts.
by Wilhelm
Ameke, M. D.
Presented by Dr
Robert Séror.
Hahnemann,
as a Physician.
State of medicine when he commenced practice.
In order to judge of
Hahnemann’s
achievements in the field of medicine, it is necessary to glance at the
condition of medicine at the commencement of his career, when no Such
method of investigation, founded on natural laws, as we have to-day, was
as yet in existence.The conceptions of the phenomena presented by the healthy and the
sick, were forced into systems, deduced from scanty observations by
individual authors, and altered from time to time to suit the views of
the period and new discoveries by them.Thus, L.
Hoffmann
(1721-1807),
found that most diseases were produced by impure and acid humors which
were to be expelled from the body, or ameliorated by ” antiseptic
” or ” dulcifying ” remedies.
Medical theories of the period.
Stoll
(1742-1788)
taught that diseases arose from the influence of a predominant
constitution which was deter-mined ” by the prevailing weather and
epidemic fevers.”In all diseases the physician had to pay the greatest attention to
the condition of the ” primae viae ” ; most illnesses resulted
from gastric impurities, especially bile. The removal of these matters
by emetics and purgatives was the principal means resorted to.If signs of bile were absent in the evacuations, in the appearance,
and in the taste of the patient, it was a case of latent bile ”
bilis latens.”Purgatives and emetics demonstrated the truth of these theories. At
the same time, ” latent inflammations” had to be contended
against, wherein lay a great danger in many diseases.According to the testimony of A. F.
Hecker,
[Die Heilkunde auf ihren Wegen,
Erfurt and Gotha, 1819.]this
doctrine was regarded as one of the most brilliant advances in the
medical art, and doctors betook themselves to Vienna from all parts of
Europe to learn ” the successful Stoll method.”Another physician writes :
[Medicin.
Literat. f prakt . Aerzte. von Schlegel. Leipzig, 1787,
XII., p. 99.]”
Stoll
is the greatest living physician. He stands, as he deserves, in a
position of great repute, and all intelligent persons in Vienna are
attended by him.”
Kampf
(1726-1789)
alleged that most diseases have their seat in the abdomen, and are due
to “infarcts.”” By infarctus, I understand an unnatural condition of the blood
vessels, especially of the portal veins and larger blood vessels, in
which they are plugged and distended in various places by ill-concocted,
variously degenerated, fluid-bereft, inspissated, viscid, bilious,
polypous and coagulated blood, tarrying and eventually sticking in the
circulation, or in which the inspissated serum in the blood, in the
glands, in the cellular tissue, together with the above-mentioned
blood-dregs, collects, corrupts, dries, and takes on various forms of
degeneration in the digestive pas-sages …… “.
”
These infarctus
spare no age, sex, or temperament ; even infants are not free from them.
I can think of very few diseases or accidents which do not arise
originally from infarctus.” He gives as instances, epilepsy, grey
and black cataract, deafness, consumption, abdominal diseases, bladder
affections, all kinds of exanthemata, cancer, scurvy, fever, tympanites,
dropsy, jaundice, &c.”Clysters consisting of taraxicum, rad. graminis, saponaria, card.
bened., fumaria, marrub. alb., millefol., chamomill., verbasc., rye- and
wheat-bran ; to which various “appropriate” drugs were added,
all being made into extracts by means of rain or lime-water, were
employed to disperse these infarctus.” Without detriment to the health, two to three clysters can be
taken daily for as many years…. Often the
labours of a Hercules are required to cleanse such an astoundingly
laden, old, intractable bog, and to overcome the stony, and as it were
wedged-in degeneration of the blood.”
[Joh. Kampf, Oberhofrath, erster. Leibarzt, &c., für Aerzte und
Kranke bestimmte Abhandlung von einer neuen Methode, die hartnäckigsten
Krankheiten, &c., 2nd
Aufl., Leipzig, 1786,
p. 576.]A physician wrote
[Bei G. W. C.
Müller, Joh. Kampf, Abhandl. &c., Leipzig, 1788,
p. 86.]
: “I have treated many sick persons who have taken more than five
thousand clysters before they entirely got rid of the infarctus.”
Kampf
also recommends his
method for prolonging life. He found a great number of followers among
physicians, who expressed their approbation and gratitude for this
discovery. ” Here again is an achievement of which Germans may be
proud….. let me offer my heartfelt thanks to the author.” [Medicin.
Literat. von Schlegel. Leipzig, 1785,
p. 34.]Another
[Neue literar.
Nachrichten für Aerzte, &c. Halle, 1787,
p. 319.]
says : ” Kampf’s
method has too many generally acknowledged advantages ever to lose, at
all events, with sensible people, its well-earned reputation…This universally-read book.” At the same time, the number of its
mutilated reprints and spurious’ editions was complained of.[Medic.
lour., von Baldinger, 1787,
XI., p. 25.
]
Hecker, l. c.,
testifies
that many patients used thousands l of such clysters, and the method of
treatment by clysters was in much vogue among physicians, patients and
even healthy persons, for many years.” Stases, stoppages and obstructions ” in all manner of
organs figured as the chief cause of many diseases, so that ; a
homoeopath could write, many years later, perhaps with a little
exaggeration :[Die Allööpathie,
1834,
No. 19.]” By the belief in the existence of stoppages, obstructions,
&c., we can understand why among ten prescriptions nine contain
senna, spirits of wine, dandelion, rhubarb, sal-ammoniac, mercury, dog’s
grass and antimony ; for these drugs were originally suggested because
they were supposed to cleanse the tubes and passages of, the human body
from their foul accumulations like brooms, scrubbing brushes and
clearing rods.Whether the patient be red or pale, fat or thin, consumptive or
dropsical, whether he have lost his appetite or suffer from ravenous
hunger, be constipated or have diarrhoea, it is all one ; he has
obstructions and stoppages, and must be sweated and purged, puked, bled
and salivated.If you see a physicians pausing in meditation, believe me, if he is
not thinking of’ ` inflammation,’ he is thinking of stasis.’ “To illustrate this a well-known writer,
Scheidemantel,
[ Die Leidenschaften als
Heilmittel betrachtet, Hildburghausen, 1787.]
is quoted.He says that a student was cured of melancholy through being greatly
frightened during a sea voyage by a collision between two ships.Explanation : ” Perhaps the, melancholy student had obstruction
of the bowels which’ was removed when his ship struck against the other,
and thereby shook him severely.”Towards the end of
1790,
the system of the Scotchman, John
Brown (1736-1788),
began to spread over Germany.
Brown
was possessed of
great assurance. In his own opinion he first raised medicine to the
position of a true science to which the name of ” the Science of
Nature ” was soon given.
According to this every human being possesses a greater or less
degree of irritability. Health depends upon the possession of just the
right amount of irritation. Disease is produced either by two much
irritation (sthenia) or want of irritation (asthenia).The task of the physician was simply to moderate the excess of
irritation, or to strengthen the too weak irritation. Thus all diseases
were divided into two classes and also all remedies, these were ”
sthenic ” and ” asthenic.” In affections depending upon
too much strength, “irritation diminishing” drugs were
employed, which in the order of their efficiency, were bleeding, cold,
emetics, purgatives, diaphoretics.In the asthenic forms of disease, sthenic remedies were employed,
which, in the order of their efficiency, were meat, heat, prevention of
vomiting, purging and sweating, by meat diet, spices, wine, exercise ;
in the more severe cases of disease, volatile stimulants : musk,
ammonia, camphor, ether and opium.[Comp.
B. Hirschel, Geschichte des Brown’schen Systems. Dresden and Leipzig, 1846,
p. 37.]Cinchona was first added by the followers of
Brown.
Knowledge of the structure and functions of the organism was only of
minor importance, for everything depended on the irritants and the
degree of irritability. ” So great,” saysBrown,
” is the simplicity to which medicine can be reduced, that a
physician when he comes to the sick-bed will only have to elicit three
things.First, whether the disease is general or local ; secondly, if
general, whether sthenic or asthenic ; thirdly, in what stage of
irritation it is.When he has satisfied himself on these three points, nothing remains
but to settle his indications and plan of treatment, and carry it out by
means of the corresponding remedies.”[K.
Sprengel, Geschichte der Heilkunde. Halle, 1828,
V. I., p. 455
]The diagnosis was only of minor importance.
Contemporaneously with
Brown,
the natural philosophy founded by Schelling
[First edition of his System der
Naturphilosophie, Jena u. Leipzig 1799.]
made its appearance and quickly
distanced all inferior conceptions.
It grappled with and explained all phenomena by the absolute. We may
form some conception of its influence on medicine by reading the
following sentences :” The mouth masticates and the stomach digests by the same
process of vegetation ; the difference of these phenomena is only the
result of their different mechanism.”” Living matter is a print or picture of absolute nature ; and,
again, absolute nature her-self is absolute life, and the prototype of
the organism.”” Life is cause ; phenomenon and existence are its results. Life
as cause is immortal, for immortal cause is life.”” Life is the infinite, disease the finite, and the cure is to
be considered as the synthesis of both (the third power).”” Contagion is the magnetic moment of the dynamic process
reigning in the organism.”After the statement that the essence lay in the conception of the
magnet, “which is connected with the identical pole,” it is
further said : ” Only in this way do we get a true idea of
contagion, and come to a true explanation of this long misunderstood
process.”[Comp. Hecker,
l.c.]
Henrich SteffensOne of the most prominent natural philosophers was Henrich
Steffens,
” a deep and scientific thinker.” [Hecker’s
Annalen, II., p. 353.]In
Oken’s
periodical, Isis (1822,
p. 123),
he is put on a level with Aristotle,
Humboldt, Goethe, Treviranus, Oken, and others.
He wrote a book,
Elements of
Natural Philosophy, Berlin, 1806.This work, was ” a spring H out of which arose a series of
philosophical works,” and gave the following information, pages189-191
:” Feeling is the identity of external oscillation and internal
being, consequently, identity of the nervous and muscular systems.,
Unity of the internal factor and difference of the external gives
sensation ; difference of the internal and unity of the external
sensation of warmth.” Hearing is the identity of the relative anorganic of the
organization and its internal being ; consequently, identity of the
nervous and osseous systems.
Influence of Natural Philosophy.
” Hunger is internal tension of the assimilation under the
influence of the mass opposed to external, hence the feeling of hunger
at the cardiac orifice of the stomach.”And further, page
186
:“Animalization is identical with the internal becoming
objective. The manifestation of the internal is sensation. There is no
animalization without sensation. Sensation under the influence of the
universal is feeling ; sensation under the influence of individuality is
consciousness.”Steffens dedicated his work to the ” Delphic Temple of Higher
Poetry,” and in fact most of these persons moved almost entirely in
the higher regions of the clouds, and the human being with whom their
investigations had to do remained on the earth, but they up there
enjoyed a heavenly existence.They were far above all controversy. “True natural
philosophy,” says Steffens, “puts an end to all contradiction
and all controversy of opinions and hypotheses with other opinions and
hypotheses, and can, therefore,. have no opponent.” ” A true
saying,” remarks a critic.[Hecker’s Annalen, II., p. 444.]
True natural philosophy knew everything and explained everything.
“Natural philosophy has the priority of know-ledge, for it is the
knowledge of knowledge, and must be regarded as potentized
knowledge.”[Steffens, l.c.,
p. 16.
]It is astonishing the assurance with which every phenomenon was
explained without hesitation. ” Magnetism is the conversion of
oxygen and hydrogen into carbon and nitrogen,” saysSteffens,
page 91,
and Schelling knew [L.c., p. 248.]
that oxygen is the principle of
electricity.The whirligig of Natural Philosophy took possession of the heads of
the majority of German savants and the most prominent physicians.Very few escaped it, as
Hufeland,
A. v. Humboldt, Blumenbach, Treviranus, Sommering, Wedekind.
There was, however, no system which could be generally followed.
There were, indeed, men who knew the direction the medical accessory
sciences should take, but they could not obtain a hearing because they
were suffering from the spirit of the age.
Reil
, in his doctrine of
fevers and in his Archiv fur
Physiologie, brought
prominently forward the doctrine that disease was not to be conceived as
a foreign thing, but depended upon the altered form and composition of
the animal substance ; health also depended upon certain rule of form
and composition.Disease was departure from normal form and composition, that is,
anatomical and chemical change.In what condition was physiological chemistry in those days ?
To what conclusions did its appreciation lead Let us take an instance
from the advanced year1810
: About this time a book which had newly appeared entitled, The
Complete Description and Examination of Spontaneous Combustion was
reviewed in Hecker’s Annalen.”
[II., p. 547]This disease manifests itself,” so it says, “by the sudden
ignition of the human organism and its ‘combustion with the appearance
of flames, so that only ashes or coal, in one case only a spot of grease
remained of the whole body.”[Comp.
Justus Liebig On the Spontaneous Combustion of the Human Body,
Heidelberg, 1850,
p. 31.
By this work the ghosts of forty-eight spontaneous combustions were
laid.]We are chiefly interested in the chemical explanation of this
phenomenon as given in the work quoted :1
. ” The whole body of the
consumed persons was penetrated through all its cells by hydrogen gas,
at least in sufficient quantities to suffice for its first ignition and
the’ maintenance of the fire.”2
. “An excess of other
inflammable matters, as sulphur, and phosphorus, was. simultaneously
present.”3
. ” The body, thus in a
high degree inflammable, was not ignited by external fire, but by an
electric explosion , in its interior ; the electric spark quickly
permeated the body filled with inflammable matter.”On this
Hecker
remarks : ” This theory of spontaneous combustion is certainly as
satisfactory a one as can be given in the present state of our knowledge
and with the imperfectly observed facts.”
A. von
Humboldt
with others opposed the ” disease-matter” theory. ”
Disease-matter is really the whole living matter itself, so far as its
form and composition are changed and the balance of its elements is
disturbed.” [Versuche über
die gereizte Muskel and Nervenfaser nebst Vermuthungen über den chem.
Process des Lebens. Posen and Berlin, 1797,
II., P. 359.]Medical men were too impatient to utilise this theory, they wanted to
reap when they had barely finished sowing.The immense progress made by chemistry through the discoveries of
Lavoisier,
especially the newly discovered knowledge of the significance of oxygen,
caused researchers to utilise this advance also for medicine.So, according to
Humboldt
(l.c.), want or excess of oxygen is the proximate cause of disease,
” because oxygen combines with phosphorus, sulphur, nitrogen,
carbon and hydrogen, and produces acids which diminish the energy of the
nerves, thereby deranging the functions of the secreting organs.”In
Humboldt’s
famous work, which was abreast of the knowledge of the day, we read that
hydrogen is contained in plumbago and similar views. Although Humboldt
opposed the ” disease-matter ” and ” acid-acridities
” theories, he nevertheless held that ” an acid is at work in
the production of scrofula,” and with Haller discussed the question
” whether in convulsions alkaline or acid acridities were
irritating the spinal marrow.” [Ib.,
II., pp. 360
and 379.]It was indeed very tempting to utilise the great chemical discoveries
in the treatment of disease. About the middle of the eighteenth centuryHaller
thus described the blood : ” The blood consists of equal parts, is
coagulable and all the redder the better the animal is nourished ; in a
weak hungry animal it is yellowish. The white sometimes mixed with it
generally comes from the chyle.”
Johann Friedrich Blumenbach (1752-1840)In
1789,
about thirty years later, J. F. Blumenbach,
the famous Gottingen professor, teaches : [Anfangsgründe
der Physiologie, Vienna, 1789,
§ 6.]” Blood is a peculiar fluid of a well-known colour, sometimes
lighter, sometimes darker, viscid to the touch and warm, and as it
cannot be imitated by art, it must be considered as one of the secrets
of nature.” In all this time no progress seemed to have been made.
Chemical
treatment of Disease.In
1803
this was taught : [F. Kapp,
System. Darstellung der durch die neuere Chemie in der Heilkunde
bewirkten Veränderungen and Verbesserungen. Hof, 1805,
P. 31.]
” Blood consists of nine ingredients : odoriferous matter,
fibrinous parts, albumen, sulphur, gelatine, iron, potash, soda, and
lastly water… the elements of the blood are : hydrogen, carbon,
potassium, chlorine, phosphorus, sulphur, oxygen, calcium and
iron.”Thus physiological chemistry had made great progress, and this
excited so much admiration that an attempt was made to utilise these
discoveries.
Garnett
recommended
sulphuret of potash, sulphate of lime and wood charcoal, in consumption.
The sulphuret of potash produced sulphuretted hydrogen, the hydrogen of
this combined with the oxygen of the blood and the inflammatory action
of the latter was paralysed.J. J.
Busch
recommends sulphur and hepar sulphures in pulmonary consumption ; this
produced ” a mephitic vapour” in the ulcerated lung, and
thereby impeded the destructive action of the oxygen.
Girtanner
, of Gottingen,
followed in the wake of the Englishman Beddoes,
in whose method of treatment various gases, nitrogen, hydrogen, &c.,
were inhaled by means of a special apparatus (an improvement of Menzies’s)
as a remedy for phthisis, the process being minutely described and
illustrated in Hufeland’s
Journal, 1795,
I., p. 199.Others prescribed chlorate of potash in scurvy, syphilis and nervous
fever, in order that the oxygen of this salt might be liberated in the
body. Alkalies were recommended in dysentery to extinguish the ”
septic acids ; ” carbonate of potash was indicated in puerperal
fever to neutralise the ” excessive acidity ” which was the
cause of this complaint.In diabetes, oxygen preponderated ; ” all the fluids of the body
were saturated with oxygen.” Hence the good effects of an animal
diet, of milk, of meat, of sulphuretted hydrogen and of limewater.
Reich
considered oxygen the
only sure remedy for the febrile state, which he considered dependent
upon the un-due development and accumulation of nitrogen, carbon,
hydrogen, sulphur, and phosphorus. He was professor of medicine in
Erlangen and Berlin ; in various journals, and in a special work, [G.
C. Reich, Beschreibung der mit seinen neuen Mittel behandelten
Krankheitsfälle. Nürnberg, 1800.]
he recommended a secret remedy for
fever which he would only reveal for a large sum of money.This remedy would in a short time, or even at once, cut short a
fever. A committee of four doctors instituted experiments in the Berlin
Charite Hospital, and considered its action proved in a number of cases.After the report of this commission the professor was decreed ”
an annual pension of500
thalers, free of tax and stamp duty” by the King of Prussia for the
publication of his secret ; in case of his death half of it went to his
widow. [Med. Chir. Ztd. Salzburg, 1800,
III., 315.]This became known before the great remedy against fever was revealed
and it was eagerly awaited. Curiosity was at length gratified in the
autumn of1800.
It consisted of sulphuric and muriatic acid ; nitric acid was also good
in certain conditions. [Ib., 1799,
IV., 189
; 1800,
I., 25,
and IV. 292.]
Baumes, Girtanner
and other
others founded a system. Most diseases were explained and cured in a
chemical way. They arose from excess or want of oxygen, hydrogen,
nitrogen and phosphorus.Accordingly there were ” oxygenous ” remedies : —
antimony, mercury, iron, lead, gold, silver, cinchona, acids, camphor,
ether, alcohol, narcotics — ” hydrogenous ” remedies :
oleagineous bodies, sedentary habits, fat meat, fish — ”
nitrogenous” remedies : meat, and ” deoxidizing ” agents
; lastly, ” phosphoric ” remedies : fish, phosphates of lime
and soda, phosphoric acid.Electricity was treated in a similar manner.
According to
Schelling,
as has been said, oxygen was “the principle of electricity.” Juch
was quite certain that oxygen played the chief role in electricity,
while Erxleben
considered it to consist of oxygen, hydrogen and heat. Leiner
believed it to be composed of hydrogen and oxygen. [Comp.
Kapp. i.e.]
Instability of Medical
Theories.These various views and systems, and other ones besides, reigned
almost simultaneously in Germany at the end of the last and the
beginning of this century. And even if one theory was superseded by
another, still something of each stuck in people’s heads. Each tried to
discover what best suited his views. Many went over from one theory to
another.
Wedekind
, [Ueber
den Werth der Heilkunde. Darmstadt, 1812,
p. 212,]
ex-professor of clinical medicine
at Mainz, thus pictures a doctor of that period : ” I know a
physician who at one time adopted the heating and sweating method.How much essentia alexipharmica, mistura simplex and composita
Stahlii
did he not daily prescribe !He was also a great partisan of bleeding, and I do I not doubt that
he often by it counteracted the baneful effects of his heating remedies
andvice versa.
But the triumvirate of
Boërhaave,
Stahl
and Fr. Hoffmann
was drawing to an end.
Tissot
had become the
leading authority. Our practitioner now advocated the cooling method.
Tamarinds, cream of tartar, saltpetre, oxymel, and barley-water were his
favourite remedies. He forbade healthy people to smoke, because Tissot
had asserted that all
tobacco-smokers must die in their prime of apoplexy.
”
When Stoll
became the leading authority among physicians, we find tartar emetic and
ipecac. in most of their prescriptions. They were, of course, devoted to
the administration of clysters when Kampf
was in vogue.C. L.
Hoffmann
was called to occupy the place that had been held by this physician.
Accustomed to follow the spirit of the age, they now exaggerated what
this great thinker taught concerning antiseptic remedies. How can
fashionable practitioners understand the meaning of an author ?Enough, our physicians did not observe how the functions of their
patients were carried on, in order to ascertain how far these were
injurious or advantageous to the maintenance of the body, but they
proceeded forthwith to cure every disease by means of antiseptics.A few years later
Brown
became dictator in medicine, and `Methodism’ ruled the fashion.
Remedies made to fit Theories.
Our practitioners now called those physicians who devoted themselves
to remedy vices in the fluids of the body, or to procure evacuation of
depraved humors, murderers ; for to believe in such vices showed the
greatest ignorance.Their practice was summed up in four words — sthenia, asthenia,
sthenic influence, asthenic vices. Very few of their prescriptions were
without naptha, laudanum, ether, musk, or sal-ammoniac.They were now as much in favour of wine, brandy, and meat diet, as
they had been against them at the time whenTissot
was the ruling deity. Now they returned to purging in order to cure
local affections, and tried to unite all these different modes of
treatment.Therefore, they now refused to be called Brownians, and insisted upon
being called eclectics.”The therapeutic text-books for students and physicians were as
variously coloured as maps. ” Ontology,” the idea that a
disease is a foreign thing carrying on its evil ends in the system, has
met with wide acceptance from the days ofGalen.
Hence the evacuant method was supreme. Further, there was a
stimulating, a strengthening, a weakening, a softening, an antagonistic,
a restorative (not to be confounded with the strengthening), an
astringent which increased the cohesion, a relaxing which diminished the
cohesion, a derivative and a resolving method, and also a specific,
antimiasmatic, antiseptic and antigastric method.[See
Hufeland, System der prakt. Heilkunde. Jena, 1818,
and others.]The various remedies were fitted on to these methods ; thus there
were demulcent, diluent, dissolving, inspissating, blood-cleansing,
cooling, evacuating and expectorant, &c., drugs.To order a simple remedy was not the custom. We still find the idea
that it is necessary that a prescription should contain a basis, a
constituens, an adjuvans, a corrigens and a dirigens.Complex prescriptions containing
8,
to, or more drugs were in daily use. There were so-called “magistral-formulas,” complex mixtures composed by “authorities
” as remedies for certain diseases, and sanctioned by ”
experience.”
They were kept ready made by the apothecaries, and no one dared to
alter them.These prescriptions were changed every day in acute diseases, in
chronic every two or three days, as the cases reported in the medical
journals show ; and what incredible quantities of drugs were poured into
the sick man’s body.
All the various systems out-did one another in this practice.
The Brownians, e.g., gave in typhus fever, together with] other
remedies,10–12
drops of opium every quarter o an hour till sleep was induced, when the
dose was to be doubled, and was then to be gradually increased ”
till the health of the patient could be maintained by less powerful
stimulants.”In “indirect debility,”
150
drops of laudanum which means 0.70
grammes of pure opium, were to be given at once, and in the sequel the
necessary doses gradually diminished till the desired result was
attained.In difficult labours, the ordinary cause of which was recognised to
be ” weakness,” the parturient woman, according toBrowns
was to be supported with wine, and if the labour was tedious and
difficult, with opium. Opium (later all cinchona) was with this school
the best remedy in all diseases depending on weakness.There were physicians who, according to their own statement,
prescribed several pounds of pure opium in the year. ” Thousands
oft sick persons, and among them the most hopeful young subjects, were
sacrificed to the rage for opium,” asHufeland
said later. [Hufeland’s Journ.,
XXXII., St. 2,
p. 16.]Similar results were produced by the ” antiphlogistic)
method,” which was employed by many physicians in inflammations and
inflammatory fevers.Bleeding, saltpetre, calomel in large doses till the teeth were
loosened, and energetic salivation were the ” matadors ” of
the antiphlogistic school, supplemented often by evacuating agents,)
such as emetics and purgatives.Many physicians troubled themselves little about the local affection
in ” general debility ; ” for this they prescribed simply
iron, cinchona, and a number of other bitter drugs. There are few
diseases in the treatment of which one can say that the physicians of
that day did no harm.
Pathological anatomy was little cultivated in Germany. The Brownians
did not require it for their therapeutics. Those among the remainder who
relied upon the results of post mortem examinations allowed themselves
to be misled by crude conceptions.If they found congestion of blood in the organs, or even
mortification, this confirmed the indication for bleeding and the other
antiphlogistic means of treatment. Accumulations of bile, depraved
humours and mucus, indicated the employment of evacuating agents.
Exudations required derivatives, &c.Did physicians feel satisfied with such a condition of the healing
art ?Most seemed satisfied with themselves. There were, however, severe
critics who were not much better hands at treatment than the others.
Marcus Herz (1747-1803)Marcus
Herz,
for instance, 1795
(in Hufeland’s Journal) ;
Girtanner, 1798
[Ausführliche Darstellung des
Brown’schen Systems. Gottingen, 1798,
II., pp. 608-610.]
; Wedekind,
1812
(l.c.) ; Kieser,
1819,
[System der Medicin. 1819.]
and others.
Girtanner
, who helped to
complete the confusion by spreading the Brownian and chemical theories,
exclaims : “As the healing art has no fixed principles, as nothing
is demonstrated clearly in it, as there is little certain and reliable
experience in it, every physician has the right to follow his own
opinion.When there is no question of real knowledge, where everyone is only
guessing, one opinion is as good as another.In the dense Egyptian darkness of ignorance in which physicians are
groping their way, not even the faintest ray of light has penetrated by
means of which they can steer their course. I don’t care if anyone feels
offended by what I say.My object is not to give offence, but to maintain the truth. If any
practitioner is not satisfied with my opinions, let him examine his own
conscience and ascertain of how many medical truths he is certain. He
who can point out to me certainty in medicine may throw the first stone
at me.”
These critics, however, did not themselves sec the deeper lying
causes of this confusion. Physicians did not know how to observe.Instead of collecting only facts and drawing no further inferences
from them than they warranted, they fastened upon single observations,
made comparisons, created theories, and cooked the facts so as to suit
these theories.The science of natural philosophy lent these speculations wings, and
they were raised completely out of ‘ the regions of actuality into the
blue ether.At the same time with the majority of physicians, the desire for
knowledge was very limited. Many complaints were made of this. ProfessorBaldinger
lamented that not only many physicians, but even many professors showed
little zeal for study.” I know one professor of medicine, who will not admit more then
nineteen books into his library. If a twentieth volume were dedicated to
him, and sent to him carriage paid, bound in morocco, he at once sells
it to the library of his university.”[Medic.
Journ. v. Baldinger, 1790,
St. 23,
p. 16.
]Of universities, indeed, there was no dearth ; at the end of the last
and in the first decade of the present century there were not less than40
universities where German was the language spoken, among which, however,
only a part were able to provide their medical courses with clinical
instruction.The state of professional amenity corresponded to the condition of
medical knowledge. ” A savage partisan spirit,” writes
ProfessorRoose,
in 1803,
[Horn’s Archiv f. med. Erf., III.,
p. I.] ” has taken possession
of many minds and seems to be spreading universally.Physicians split into sects, every one of which embitters the others
by violent and often unfounded contradiction, and so prevents all
possibility of doing good.Dogmatism and a persecuting spirit are becoming commoner and commoner
among physicians, and they are only distinguished from the dogmatism and
persecution of enraged religious sects of former times by being
fortunately powerless to arm the secular authorities with fire and sword
against their adversaries.
Quarin’s influence on
Hahnemann.If the spirit of the age permitted the establishment of a revealed
medical art with us as with the Asiatics, there would undoubtedly be a
Catholic and a Protestant confession, and there would not be wanting
either a pope for the one or a chief pastor for the other.”
Dr Joseph Von
QUARIN (1733-1814)The more uncertain a physician feels of his own skill the more loudly
he calls to the State for assistance against the quack and charlatan. It
was so in those days.
Wedekind
(l.c., p. 38)
describes a debate among physicians who espoused the reigning opinions ;
one of them shouted out : ” The scientific physician will be ruined
unless he is favoured in every way by the Government.”A sad condition for the said “science” to be in, but which
accounts for the embittered disputes related in the course of this work.
Hahnemann
‘s Services to
Medicine.What instruction had
Hahnemann
in the art of medicine ?It cannot be proved that any physician exercised a special influence
over him and gave him a particular bent. He himself indeed speaks with
great reverence ofQuarin.
He writes, in
1791,
“I owe to him whatever there is of physician in me.”It nevertheless seems as if the feeling of a debt of gratitude to
Quarin
for favours received (see below) was not without influence in inducing
him to make this statement.
Dr Joseph von Quarin (1733-1814)
Freiherr von Quarin,
born
in 1733,
was body physician to Maria Theresa and the Emperor Joseph ; he filled
six times the post of rector of the university of Vienna.He died in
1812
of “debility.”His medical works did not meet with general acceptance among the
profession.[Under other auspices
the General Hospital of Vienna would gain more,” was said of Quarin
in the Medic. Litteratur für prakt. Aerzte, von Schlegel. Leipzig, 1787,
XII., p. 94.]Several of his works t exist, which will well repay careful study if
we wish to decide how farQuarin’s
influence over Hahnemann
extended. [Heilmethode der
Entzündungen. Aus d. Lat. von J. Zadig de Metza, Copenhagen, 1776.
Heilmethode der Fieber. Aus d. Lat. vom Vorigen, Copenhagen, 1777.
Animadversions practicoe in diversos morbos, II. vols., Vienna, 1786.
Praktische Bemerkungen ueber versch. Krankheiten. Aus d. Lat., Vienna.
De curandis febribus et inflamationibus, Vienna, 1786.
Ueber den Nutzen und Schaden der Insecten. Ueber die Verschiedenheit der
Salze u. ihren Gebrauch. Versuche ueber die Cicuta virosa.]
Hahnemann’s
first Medical Work.That
Quarin
was an advocate of bleeding till the day of his death (1812)
appears certain.The first considerable medical work of
Hahnemann
appeared in 1784,
Guide to the Radical Cure of
Old Sores and Foul Ulcers.”
[Translated in Brit. Jour. of Hom., XLII., p. 101,
et seq.]Old ulcers of the leg and fistulae were specially meant.
In the preface he says :
The majority of physicians would have nothing to do with them, but
left them to the bath man, the shepherd and the hangman, more from
ignorance than disgust.The fame of practising such heroic treatment smells much worse than
the foetid discharge.The mode of treatment of ordinary physicians and surgeons consisted
in ” purification of the blood,” bleeding, cupping, sweating
and purging.The chief external remedies used were the lead preparations,
especially lead ointments and plasters.Hahnemann
even when a young physician seems to have been unaffected by the
prevalent belief in authority.The finishing stroke to the treatment of such cases is generally
given by old wives, the hangman, the farrier, the shepherd and death.
For all that I am not too proud to confess that horse and cow doctors
are frequently more successful, that is to say, more skilful in curing
old sores than the most learned professor and member of all the
academies.Let this not be denounced as mere empiricism ; I would like to
possess their workmanlike expedients which are founded on experience,
often, it is true, gained in the treatment of animals, but which I would
willingly exchange for many medical folios, if they were to be had at
that price.But, on the other hand, far be it from me to draw from them general
rules for my treatment or to prefer irrational quackery to the
well-considered medical theories deduced from the observations and
experience of illustrious and honest men. I know the limits of both.The want of any principle for the discovery of the curative powers of
drugs was even then a cause of complaint with him.
Thus much, however, is true, and it may make us more modest, that
almost all our knowledge of the curative powers of simple and natural as
well as artificial substances is mainly derived from the rude and
automatic procedures of the common people, and that the wise physician
often draws conclusions from the effects of the so-called domestic
remedies which are of inestimable importance to him, and their value
leads him to adopt simple natural means to the great advantage of his
patients. I will spare my readers proofs of this.In pages
43
and 180,
he alludes to several shepherds and quacks who were thoroughly rational
and obtained good results. If we read this work we shall in many cases
see Hahnemann’s
independent mode of excogitating medical subjects.Naturally he still adhered to the old treatment.
In women about the climacteric he still recommended bleeding, as he
did in fever under certain circumstances and with caution (p.79)
; he, however, blames the usual excessive blood-letting, and commends
the action of cinchona in fever “even in severe cases” (p. 69).He was a great enemy to coffee (p.
78),
but a great advocate of exercise and open air, and also of the
beneficial action of change of climate and residence at the seaside, all
things which were then little spoken of in medical works.Next to nourishment, exercise is what is most important for the
animal machine, by it the clockwork is wound up. These delicate
creatures should not be confined to needlework, nor allowed to loiter
over the toilet table, to play cards, to pay tedious visits or to read
enervating books, whereby they would be reduced to the condition of
colourless plants grown in a cellar.Exercise and wholesome air alone suffice to determine all the juices
of our body to their proper place, compel the excretory organs to throw
off their accumulated moisture, give strength to the muscles,
communicate to the blood its highest degree of redness, attenuate the
humours so that they can readily penetrate the remotest capillary
vessels, strengthen the heart’s beats, establish healthy digestion, and
are the best means for obtaining repose and sleep, whereby refreshment
and renewal of the vital spirits are secured (p.76).
Strengthening diet, wholesome air and exercise, together with
amusement to the mind, are indispensable, and everyone knows their power
and can employ them. Nourishment suited to the body in appropriate
quantity is the only thing required to ensure healthy digestion and to
eliminate the bad juices from the prima via ; exercise promotes the
appetite, strengthens the digestion, and better than all purgatives
expels the excess of evil humours by the natural outlets of the body
every movement of the limbs conduces to the strengthening of the
circulation of the blood and to the completeness of the assimilation of
the nutritive fluids — there can be no health without exercise.
Where is the remedy that can more agreeably and more certainly remove
the decomposing ferment in our blood-vessels that always tends to
destroy our machine than pure air ? With every breath we draw a quantity
of it into our lungs, its purest etherial part, the source of our
corporeal heat, penetrates by means of the exhalent vessels of the
innumerable arteries of these organs into the mass of the blood and
expels the unwholesome spoilt air, the air we expire. It is only in the
pure open air that we feel refreshed by breathing ; in cellars and close
rooms full of living creatures we become weak, faint and die, often in a
few hours if the air is much spoilt by the breath of many persons. These
different effects of the air we breathe convince us that life and health
are not to be expected without pure air (p.94).
Further on he discusses the habits of life, the occupation, the
division of the day and the conditions of the dwellings in a short,
concise and convincing manner. How seldom was hygiene considered in a
therapeutic work in those days ? How many books on therapeutics were
written which contained no mention of hygiene ! We do not even meet with
theword hygiene
in its present sense. There were as yet no precautions taken for
preserving health.If we consult Hufeland’s
journal,
which was founded 11
years later, and in which the most eminent practitioners wrote, we shall
have to search through all its numbers till the year 1830
to be able to extract as much concerning hygiene in several decennia of
this much later period as Hahnemann
has scattered through his work of 192
small octavo pages on a surgical complaint.Even in the year
1828,
the allopaths were reproached by an opponent of Hahnemann’s
for the small amount of trouble they gave themselves about these
important matters compared with him. There were very few exceptions, as,
for instance, Hufeland,
as his Macrobiotik, which
appeared 12
years later (1796),
shows, though we see from his neglect of diet and hygienic measures in
his journal that
he had not grasped their importance. Hahnemann
prescribes exactly what should be the diet and occupation, the position
of the sitting and bedrooms, and frequency of the renewal of their air
(p. 98,
et seq.).
Amusement is necessary ;
I
do not approve of solitary forced labour and exercise. Consequently,
I always endeavour, whenever possible, to bring my patients into a state
of disposition free from care and worry, whereby alone, as I believe,
the wearing friction which the mind and body exercise on one another in
our organism may be lessened.
Advocacy of cold-water Treatment.
Varied, agreeable society, with occasional music, is the best thing
for cheering the human soul that is not depressed to the condition of an
insensible lump, and even should we meet with persons sunk so low among
our patients, they must at first be forced to go into society, just as
we force the child to swallow the healing draught. They should even
accustom themselves to social converse at the sacrifice of more
remunerative occupations, until they acquire a taste for it, especially
when morality, temperance, and exercise can be combined with it. How
else can we get rid of care or acquire a hopeful view of life except
amid a happy throng of our like-minded fellow creatures, amongst whom we
can cast off the burdens of life, and mutually bestrew our paths with
flowers ?The strictest cleanliness in dress and in the whole mode of life must
be maintained, along with exercise, open air, and recreation.
Cleanliness is the spice of all the operations of life, and without it
the most costly dainties and the finest clothes excite only disgust.
Johann
Siegmund Hahn (1696-1773)Upon the employment of cold water, which, in spite of the efforts of
Hahn
(died 1773),
was greatly neglected, and for the systematic employment of which there
was no enthusiasm, Hahnemann
writes at length (pages 108
to 126),
and gives exact instructions.If there is such a thing as a universal remedy, it is undoubtedly
water. [The temperature, duration, and time of day of its employment are
given in detail.] I can never cease to marvel how our most eminent
physicians, when prescribing a strengthening treatment, have been so
remiss in laying down precise directions for the use of the cold bath.
They content themselves with telling the patient to take a half or a
whole bath in the morning and sometimes also in the afternoon. No word
respecting the degree of temperature of the water, the exact duration of
the bath, and the other particulars concerning it so necessary for the
patient to know. We cease to wonder that injury to the health is often
caused by cold baths, when we consider how very improperly the cold
water may often be used when the physician gives such meagre, maimed and
laconic directions respecting its use.If a weak, delicate patient remain for hours in snow-water, in order
to comply heroically with the loose directions of his eminent physician,
it is probable that he will be taken out of it in a fainting state,
doubled up with convulsions, struck down by apoplexy, or chilled into a
low fever, or perhaps stiff and stark dead. Can we find fault with the
useful knife with which the infant wounded itself ; should we not rather
blame the negligence of its nurse ?In our directions for the use of powerful remedies we cannot be too
precise and explicit : patients are only too apt to err on the side of
doing less rather than more than we prescribe.
This want of precision on the part of physicians is the cause of the
great prejudice against cold water ; we meet great numbers of people who
regard the cold bath as the most pernicious weapon in the medical
armamentarium, who dread it more than death.But the rank and file of medical practitioners who slavishly imitate
their betters have brought the cold bath into disrepute by their
senseless ways of carrying out the careless prescriptions of our Hippocrateses.He then proceeds to tell us what unintelligible instructions were
usually given by physicians.Hahnemann
writes exact directions concerning the conditions of the bath and the
frictions, &c., in and after it.When
Hahnemann
was once convinced of a thing, he enunciated it with the greatest
precision, and did not easily allow himself to be turned from it. ”
I am,” he says at the end of this chapter, ” borne out by the
most extensive experience, and I claim unlimited confidence on this
point.”His medical treatment of ulcers was
as
follows :— Internally he gave in suitable cases decoctions of woods,
therefore compound medicines (p.86),
but he also gave the medicines
singly, though in large doses. He completely banished the customary lead
plaster and ointment.As the local application he used alcohol (p.
44),
solution of corrosive sublimate (p. 40,
44,
153,
171),
lunar caustic (p. 148),
solution of arsenic — the latter in the proportion of 1 to 30,000
[Comp. Kennzeichen der Gute,
&c., p 223.]
(p. 149,
181),
and balsam of Peru [This he
repeatedly recommends, 1791.
Trans. of Monro, II., p. 123.]
(p. 149),
each remedy singly and in accurately indicated cases.Where necessary, he recommends energetic treatment. At page
44.
he relates a case of caries of the metatarsal bone of the great toe,
with burrowing fistulae and unhealthy pus.” I was called in. I enlarged the wound, dressed it a few days
with digestive (a mixture of Peruvian balsam, or balsam of copaiba, with
two to three parts of the yolk of eggs), I scraped the carious bone
clean out, and removed all the dead part, dressed it with alcohol, and
watched the result.”Later he applied alternately dressings of corrosive sublimate and
digestive.
Reception of his novel methods.
Internally he gave tonics, and the patient gradually began to mend.
The scraping out of the carious bone is looked upon now-a-days as an
achievement of modern surgery.Thus
Hahnemann,
in his treatment of wounds and ulcers, proved himself an excellent
surgeon, and was far in advance of his contemporaries. He was not wrong
in saying of himself at the conclusion of his book :I cannot be blamed for insisting on such a generally applicable
treatment of old malignant ulcers, and in preferring it with certain
limitations to all others ; the most careful and extensive experience is
on my side. Anyone who has had the opportunity to make so many
observations in such cases as I have made, who is actuated by such a
desire to do good to his fellow creatures as I feel that I am, who so
thoroughly hates the prejudices and prepossessions in favour of the old
over the new, who has as little respect for the authority of a great
name as I have, and who as zealously endeavours to think and act for
himself as I do, will, I imagine, not easily hit on another and better
treatment of old ulcers, he will consequently be able to obtain the same
excellent results of his efforts as I have obtained, which is the
highest reward that a conscientious physician can expect, results which
have hardly ever disappointed me, whereas the different treatment of
others has almost always belied their expectations.
Baldinger
, professor in
Jena, Gottingen and Marburg,
the instructor of Blumenbach,
the younger Meckel,
Reil,
&c., thus criticises Hahnemann’s
book : [ Medic. Journ. von
Baldinger. Gottingen, 1785,
p. 23.]“The author has treated his subject very thoroughly and well. He
shows how mistaken the previous and most usual treatment has been —
and teaches a better. The book is written in such a thoroughly practical
manner that we cannot sufficiently hope that it will be widely
read.”Instructions
to Surgeons concerning the Treatment of Venereal Diseases” [Translated
in Hahnemann’s
Lesser Writings, pp. 1
to 187.]
which appeared in 1789,
received an equally favourable reception.
Baldinger
writes : [Med.
u. Phys. Journ., 1790,
St. 14,
p. 76.]” This work is profound and clear.” Immediately after a
work on the same subject by ProfessorFritze,
of Berlin, is criticised :” This book, like the other one, also contains much that is
good. Both authors have thought for themselves, and written not only profoundly, but also
comprehensively and clearly.”
Appreciation of
Hahnemann’s
labours.Kurt
Sprengel
writes the following criticism : [Geschichte
der Arzneikunde. Halle, 1828,
V., Part 2,
p. 591.]
Hunter’s
ideas are the
foundation of the theoretical part of a very good book by Samuel Hahnemann.
He here recommends his mercurius solubilis, a mild and excellent
preparation whose admirable effects have since been verified.The first important writer, who highly commended this remedy, was
Joh. Fr. Fritze, Prof. in Berlin, in a work[Handb
über die vener. Krankh. Berlin, 1990.]
which is good, though it contains
little that is new, nevertheless it has been approved of in foreign
countries in its translations.Another critic writes :
[Neue
Litterar. Nachrichten f. Aerzte, &c. Halle, 1789,
p. 785.]Our
readers will see from the extracts given that this is no ordinary work,
but is written with an unusual degree of knowledge, reflection and
original thought. The special methods of treatment recommended and the
maxims laid down deserve trial and attention.In the
Medic. chir. Zeitung [Edited
by Prof. Hartenkeil. Salzburg, 1790,
III., p. 345.
] we read :The book is, however, not merely the work of a man of intelligence
and learning, but is written with an aphoristic brevity to which they
learned medical reader will only find a parallel in Hunter, Swediaur
, André, &c.It is a book that will be of great use for academical lectures,
though the author did not design it for that purpose, Sc.Soon after
A. R. Vetter’s
book on syphilis appeared :
A New Method of Treatment of all Venereal Diseases after Hunter,
Girtanner andHahnemann.
[Vienna, 1793.]Medic.
chir. Zeitung [1791,
I., pp. 117
and 231.]
writes concerning his translation
of Cullen’s
Materia Medica:
Herr
Hahnemann
has made this translation most carefully, in spite of the obscurity of
the original…. The comments of the translator are generally very
learned, and he has also enhanced the value of this important work by
his numerous corrections of the author’s errors.
Orthodox treatment of the Insane.
The way in which mental diseases were formerly treated (one need not
go so far back asHahnemann’s
time) is known to every physician.Physicians treated excitable and refractory maniacal patients like
wild animals ; it was thought necessary to cow and terrify them.Corporal chastisement and nauseating medicines were ordinary means
used.Furious maniacs were strapped down on a horizontal board which could
be quickly turned on an axis to a vertical position, or put in the
so-called rotating chair. “A well fitted up madhouse was, in certain respects, not unlike a
torture-chamber,” saysWestphal.
[Psychiatrie und psychiatrischer Unterricht. Berlin, 1880.]This method of treatment was adopted by Ernest
Horn
in 1806
in the insane department of the Berlin Charite, then the largest
madhouse in Prussia.He also invented the ” closed sack,” in which maniacs were
tied up, and which compelled them, according toWestphal,
to remain lying wherever they were placed. ”It is shameful to have to confess,” says
Westphal
in 1880,
” what a short time has elapsed since the insane were shown to the
Sunday visitors of hospitals and work-houses as a kind of sport, and
teased in order to amuse the visitors.”As the treatment of the insane depends upon the state of culture, we
shall here quote as an illustration of the degree of refinement of the
physicians of that day, some remarks from theMedicinische
Bibliothek of the celebrated
Gottingen professor, J. Fr. Blumenbach.He is speaking of a work on medical jurisprudence of repute in which
it is stated that in Baden a parricide could not be brought to confess
because torture had been abolished.The critic thereupon remarks
[Vol.
III., St. 2,
p. 282.]
(in the year 1789)
:The most innocuous and at the same time the most efficacious mode of
torture which can be retained without hesitation is, in our opinion, to
apply only such a degree of torture to the accused as will set up a
slight traumatic fever, and, after this has been set up, to threaten him
with it again. The depression of mind, the loss of self-control,
produced by the traumatic fever, will bring even the most hardened
ruffian to confess.We have more than once found in dealings with criminals, that men who
are able to support a severe first application of torture, if they are
again tortured after a few days when suffering from traumatic fever,
become quite faint-hearted and spiritless and they confess everything.
Hahnemann’s
treatment of the Insane.Hahnemann
‘s principle in his
treatment of insanity was this :“I never allow an insane person to be punished either by blows
or any other kind of corporal chastisement, because there is no
punishment where there is no responsibility, and because these sufferers
deserve only pity and are always rendered worse by such rough treatment
and never improved.”[Deutsche
Monatschrift, February, 1796.
Lesser Writings, p. 293,
note.]He treated and cured in this way in
1792,
the Chancellery Secretary Klockenbring
of Hanover, a man well known to literature, who had become deranged.After hit complete cure from madness this sufferer showed his
deliverer, “often with tears in his eyes, the marks of the blow and
stripes his former keepers had employed to keep hire in order.”Hahnemann
, therefore, was a
long way ahead of his cone temporaries in the treatment of the insane.That he at first employed bleeding is natural enough, but we always
see him apply it cautiously, and even as early as1784
he contended as has been shown, against excessive bleeding.In
1832
Hahnemann
writes, in a letter to M. Müller,
[Lesser Writings, p. 373.]
that he had given up bleeding,
emetics and purging more than thirty years ago.He still bled in
1797,
as appears from a paper in Hufeland’s
Journal, [Arzneischatz,
aus dem Engl. übers. von Hahnemann.
Leipzig 1800,
p. 171.]
and in 1800
he was not an absolute opponent of it. ” In acute sthenic maladies,
bleeding an the removal of all kinds of irritants do more good than
watery drinks.”Some indications of the treatment resorted to in typhus or nervous
fever in those days have already been given.
Johann Peter FrankLets us hear one of the greatest physicians of the time, J. P.
Frank
on the subject, in his work De
Curandis Hominum Morbis which
was completed in 1821
: [Translated in 1832
by Sobernheim, with commendatory preface by Hufeland.]“We should be cautious about blood-letting, but “an
inflammatory nervous fever’ is a very different matter.”
Hahnemann’s
early treatment of Typhoid Fever.“When by venesection we have once succeeded in reducing the
complaint to a simple nervous fever.”“In gastric nervous fever we must give emetics, because
otherwise obstinate diarrhoea is apt to set in towards the end of the
illness.” ” Indeed, sometimes an emetic given even at a later
stage is of service.” Then comes a chapter on ” the treatment
of symptoms.”For each single symptom there is a different remedy.
For diarrhoea : “China, canella, red wine, calumba,
contrayerva, catechu, alum, fresh milk, theriac (a brew containing40
to 60
drugs and 0.25
parts of opium to every 30
parts of fluid), and diascordium, introduced by the mouth or the
anus.”” For violent abdominal pains following true inflammation,
general or local bleeding,” besides blisters, baths, ”
fomentations, anodynes and repeated enemata.”In ” putrefying crudities” in the bowels : tamarinds,
rhubarb and cinchona.In “spastic” affections of the brain : wine and opium ; but
for congestive cerebral affections : ” leeches and cupping in the
region of the temples and occiput or behind the ears.”” In profuse, purely symptomatic hemorrhages : cinchona and
alum, externally and internally, mineral acids with cold water,
fomentations of snow or ice, and also sometimes wine and opium.”Imagine a medical man sitting with the book of this great authority
before him, a book which was translated in1832
with a commendatory preface by Hufeland,
as though it were something very excellent. What prescriptions would
result from such instruction ?Concerning
Hahnemann’s
treatment of typhoid fever we learn the following in the year 1790
— that is thirty or forty years earlier : [Translation
of Cullen, II., pp. 125,
267.]” In nervous fever (the symptoms of which
Hahnemann
describes minutely), antiphlogistic remedies — refrigerating and
laxative salts, watery drinks, and bleeding act as poisons. Emetics and
blisters do harm. Bark and strong wine in large quantities, I have
seldom found to fail if I have been called in early enough.”Besides repose of body and mind, he orders more especially fresh air.
Hahnemann’s
early views on Itch.At page
126,
he repeats that in nervous fever cinchona
and wine are ” the only good remedies,” and on page 267
he again speaks of the benefit
of bark in large doses with wine, and against the highly commended and
usually employed opium.
Brown
and his treatment,
which reminds one of Hahnemann’s,
were at that time not known in Germany.
Hufeland
[Hufeland’s
Journ. V., Intelligenzblatt, No. 1,
p. 1.]
is of opinion that in 1792
“neither he nor anyone else in Germany had seen any of Brown’s
writings.”With regard to the itch,
Hahnemann
took a very ” advanced ” view, which he, however, completely
changed thirty years later.With the exception of some hints by older authors,
Bonomo,
of Leghorn, was the first who correctly described the itch-insect in 1683,
on which account Wichmann [Aetiologie
der Krätze, von J. E. Wichmann, Kgl. Grossbritt. Hofmedicus zu
Hannover. Hannover, 1786,
with four plates of the itch acarus copied from Bonomo, 2nd
edition, 1791.]
justly styles him the founder of
the itch theory.
Bonomo
admits that he
received his knowledge from poor women and slaves in Leghorn, who were
in the habit of mutually removing each other’s itch-insects with
needles.The parasitic doctrine was, nevertheless, little regarded till
Linnaeus, in1757
(Exanthemata viva), and
the above-mentioned Wichmann,
in 1786,
drew attention to it.
Wichmann
, in his work, held
the views of to-day. In England itch was already generally treated as a
” living eruption ; ” in France the medical faculty still
warned people against the external remedies there used by the common
people for this malady. [Wichmann,
l.c., p. 118.]It was much the same in Germany.
Wichmann
was disregarded, and the view prevailed that the itch-insect was the
result and not the cause of the affection.Thus Job. Jak. Bernhard
[Handbuch
der allgem. und besond. Contagienlehre. Erfurt bei Henning, 1815,
also under the title Ueber die Natur &c. des Spitaltyphus and der
ansteckenden Krankheiten überhaupt.] did
not consider the itch-insect and ” the microscopic animalcules in
other contagious diseases ” the contagium itself.
Supposed Sequelae of Itch,
consequent on its suppression.He, however, considered them as important constituents of the
infecting material, ” like the animalcules in semen and
vaccine-lymph.” Also, similar animalcules might be produced without
being capable of conveying contagion, as, for example, the louse disease
[phthiriasis].
Friedrich
Jahn,
1817,
vehemently disputed the truth of the parasitic theory of the itch.”
[Klinik der chron. Krankheiten.
Erfurt, 1817,
II., p. 614.]He asserts on the contrary the ” undeniable truth of
itch-metastases,” and he finally pronounces : “We may,
therefore, consider the whole of this theory as unfounded.”
De Curandis HominumJ. P.
Frank
entered the lists as a most determined advocate of the causa
viva in his book, De
Curandis Hominum Morbis, completed
in 1821.hhhHe recommended killing the itch-insect at the commencement of the
infection, but after the itch had existed some time he thought ”
reckless suppression ” very dangerous. He distinguishes13
kinds of “symptomatic itch,” as, for instance, a scorbutic, a
hypochondriacal, a critical, a plethoric, &c. ; ” also a
“psora neogamorum,” a variety which affected newly married
persons.
Ferdinand
Jahn,
a talented disciple of Heusinger
and Schonlein,
a partisan of the natural historical school, held the following views in
1828
: [Ahnungen einer allgem.
Naturgeschichte der Krankheiten. Eisenach, 1828,
p. 201.]“Chronic eruptions arc usually the outward manifestations of
dyscrasias which arc deeply rooted in the interior of the organism…..
Itch deprived of its cutaneous blossoms develops its roots that are
present in the interior of the organism more strongly, so that those
manifestations which are known under the name of itch-metastases
ensue.”In judging such views, we must remember that in those days itch
eruptions with numerous pustules all over the body and extensive
cutaneous ulcerations were no rarity.
Autenrieth
, known to be a
pupil of J. P. Frank,
writes under the title, Sequelae
which follow the suppression of
Itch,
in 1808
: [Versuche für die prakt.
Heilkunde aus den klin. Annalen von Tübingen, 1808.
Griesselich, Kleine Frescgemülde. Carlsruhe, 1836,
I., p. 88.]The most terrible and the most frequent sources of chronic diseases
of adults in our neighbourhood are the psoric or itch eruptions which
have been wrongly treated with sulphur ointment and fatty outward
applications.I have so frequently seen die evil results among the lower classes
and those who lead a sedentary life that arise from the suppression of
the itch, and see them still every day in such a variety of sad
forms, that I do not hesitate a moment to assert that it is a subject
that deserves the attention of every physician, and of even every
employer of labour who has the welfare of those under him at heart.According to
Autenrieth,
the sequelae of ” suppressed itch ” are : ulcers of the leg,
pulmonary consumption, a kind of hysterical chlorosis, white swelling of
the knee, effusion into the joints, amaurosis with obscuration of the
cornea, glaucoma with amaurosis, mental alienation, paralysis, apoplexy,
wry neck, &c.In spite of all this,
Autenrieth
held the parasitic theory to an extent which was uncommon for his time.
He even maintained that the itch-insect was the vehicle of a poison
which must not be driven by ointments from the surface of the body into
the interior, and that, on the other hand, the itch might be the product
of an internal disease driven outwards on to the skin.
Hufeland
shows that he held
this view : [Enchiridion Medicum,
Vermächtniss einer 50
jähr. Praxis. St. Gallen, 1839,
2nd
edit., p. 293,
et seq.]But the itch may also appear as a product and symptom of internal
diseases — scabies spuria. Here, indeed, it is only a form of another
disease, but here also a contagium may develop, and so it may become
infectious. To this variety belongs the syphilitic, scrofulous,
arthritic, and scorbutic itch, and also the critical, an itch-like
eruption by which the critical resolution of both acute and chronic
maladies is effectedThe mites found in pustules are not the cause but the effect —
parasites of the itch….. But in connexion with this (that is to say
the treatment) many difficulties and important considerations come into
play.Thus we can suppress the diseased action of the skin by a mere local
application of the specific, but the contagium itself, which has already
penetrated deeper, is not thereby destroyed, and the result is either
that the itch always reappears or, what is worse, is thrown on internal
parts, and often produces very dangerous and obstinate metastases.
Consumption, lung-itch, dropsy, cramps of the stomach, stomach-itch,
epilepsy, and all kinds of nervous diseases may ensue. The result is
still more serious if the itch is complicated with another disease or is
a product or crisis of another disease.
Hahnemann’s
early acquaintance with the Acarus scabieiIn
1835
the learned Rau
[Ueber den Werth des hom.
Heilverfahrens, 2
nd edit. Heidelberg and Leipzig, p. 33.]wrote as follows :
The assertion a well-known writer (Krüger Hansen ?)
has recently made, that no evil results are to be feared from quickly
suppressing the itch, is confuted by such numerous observations that it
is unnecessary to argue against it.We must at the same time bear in mind that in those days the
diagnosis of skin diseases was very faulty, that scabies, eczema,
impetigo, prurigo, &c., were not yet distinguished from one another,
and were thought various degrees of intensity of the same disease.Did
Hahnemann
know the existence of the itch-insect ? and at what period did he become
acquainted with it ? In his translation of Monro’s
Materia Medica, 1791,
Hahnemann
says in a foot-note (II. 49)If, in a recent case of itch, we make the patient wash himself
several times daily with a saturated solution of sulphuretted hydrogen,
and get his linen dipped in the same solution, the affection disappears
in a few days, and does not return except with re-infection.But would not it return if it was caused by acridity of the humours ?
I have often observed this, and agree with those who attribute the
disease to a living cause. All insects [among which the itch-mite was at
that time included] and worms are killed by sulphuretted hydrogen.Further on in the same work, in another note (II.
441),
he maintains that itch is a ” living eruption.”In
1795
a treatise by Hahnemann,
On Crusta Lactea, appeared
in J. N. Blumenbach’s
Medicinischee Bibliothek .
[III. St. 4,
Gottingen, 1795.
Translated in B. Jour. of Hom., XLII., p. 209.]This periodical did not appear in any regular order. Articles which
had been written as early as1793
are found in this volume.Hahnemann
has put no date to
his essay, so that we cannot exactly determine the date at which it was
written. He, however, remarks in it that he was in the country when it
was written. From 1794
to 1796
he lived at Pyrmont and Brunswick ; from 1792
to 1794
in Gotha. To the last-named period, therefore, belong the following
remarks.In the village (probably Molschleben),
”
where my children enjoyed
perfect health,” there were a great many children affected with
so-called milk-crust, and to an unusual degree.As
Hahnemann
thought he had seen instances of this complaint being communicated, h
attempted to prevent intercourse between his own and the infected
children belonging to the village. One of the boys thus affected,
however, succeeded in gaining access to them. ” I saw him playing
in close contact with them, I sent him away, but the infection had
already taken place.”The boy had kissed
Hahnemann’s
children. The complaint began first in the child kissed, and then spread
to the other three) children.“I poured warm water over dry hepar sulphuris (powdered oyster
shells mixed with equal parts of sulphur and kept) for ten minutes at a
white heat), and thus made a weak solution. I painted the faces of the
two who had the eruption worst with this every hour for two consecutive
days.After the first application the complaint was arrested and gradually
got well.” He pursued the same course with the other children with
the same success.The remedy when applied to the skin becomes gradually decomposed by
the action of the air, and sulphuretted hydrogen is developed
with a foetid smell, which, as we know, is rapidly fatal to most
insects.Is not crusta lactea a cutaneous disease caused solely by infection ?
does not the infecting matter contain very small animalcules as a miasm
?I hardly expect to meet in practice with such another opportunity of
answering these questions positively in the affirmative as this, which
was so completely within my cognisance. My children got no purgatives
nor any other medicine, as they were otherwise quite well and well they
remained.In a note he says :
I relate here the following case because of its similarity. A servant
girl (infected by a servant newly arrived), had had the itch for six
days ; one arm and hand were covered with it, and the eruption made its
appearance on the other hand between the fingers. I made her wash both
arms thrice daily for two days with the above-mentioned solution ; she
got well without sequelae ; the girl who communicated it was treated in
the same manner, and was cured in eight days. If this complaint is
produced by insects in the skin, what harm can it do to kill them
provided we do so with medicines that possess no power
in themselves to do harm to the body ?Physicians have been all too ready to ascribe to the suppression of
certain skin diseases effects which were the result of some cachexia,
&c., which was coexistent, and which remained uncured !
From what follows it appears that he was not free from the opinion
that a virus penetrates the whole organism from the itch-insect.” An old case of bone-disease began to heal quickly as soon as I
had ascertained that it was complicated with itch. I dressed the sore as
usual, but washed the whole body with the above-mentioned lotion.”In
1791,
he narrates (Monro
I. 76)
that he had cured itch by internal remedies only, which shows that in
those days the term ” itch ” had a much wider signification
than now.He treats the subject of the therapeutic employment of electricity,
clearly and intelligently, and he could not conceive how the Academy of
Rouen could adjudge a prize to a work ofMara
which denied to electricity almost all remedial power (Arzenikvergiftund,
p. 163).He taught the proper use of many drugs whose actions were little or
imperfectly known, and described accurately their sphere of action,
which he was better able to ascertain than others, because he always
gave only one remedy at a time, and carefully watched its effects.We shall here only mention aconite, belladonna, hyoscyamus,
stramonium, conium maculatum, ipecacuanha, Peruvian balsam and arsenic.His numerous articles in
Hufeland’s
journal, his
terse and frequent annotations in his translations of Cullen,
Monro,
the Edinburgh Dispensatory and
the Thesaurus medicaminum, as
well as casual (observations in the Apothekerlexicon,
prove what we have said.With regard to
Hahnemann’s
reputation as a practical physician of his day, let us hear his
contemporaries.
Brunnow
relates : [Ein
Blick auf Hahnemann,
Leipzig, 1844,
p. 6.
Translated by Norton.]” In fact, even in the beginning of his career as a physician,
he succeeded in achieving many splendid cures by his simple method of
treatment, and wherever he went he carried with him the reputation of a
careful and successful practitioner.”
Laudatory notices of
Hahnemann.The
Medic. char. Zeitung (1799,
II. 411)
writes : ” Hahnemann
has made himself a name in Germany as a capable physician.”In the same periodical
[Ergänzungsheft,
VII., p. 307.]
he is described as a physician
” to whom we are indebted for many good contributions to the
perfection of our science.”In the
Allg med. Annalen des
19
Jahrh. in the number for
November, 1810,
Hahnemann
is called a man, ” who has been known as a thinking physician and
good observer for more than twenty years, and at the same time has
continually increased his reputation as a clever and successful
practitioner.”
Hufeland
, in 1798,
[Huf. Jour., VI., St. 2.
Note. ] calls him a man ”
whose services to our art are sufficiently important,” and further [Ib.
V., St. 2,
p. 52.
] ” one of the most
distinguished physicians of Germany ” ” a physician of matured
experience and reflection.”In
1800
Daniels
[Ib. IX., St. 4,
P. 153.]
speaks of ” Hahnemann,
a man rendered famous by his writings.”In the same year
Bernstein
writes in the Pract. Handbuck
fiir Wundärzte :
”
Samuel Hahnemann,
a very meritorious physician, is known for his excellent preparation of
mercury, namely, mercurius solubilis, and also for his wine test and his
chemical and pharmaceutical writings.He has also deserved the gratitude of surgeons.
He published for them
Guide
to the cure of old sores and ulcers, 1784,
and Instruction to Surgeons for
the treatment of venereal diseases. Leipzig,
1786.”
In the year
1791,
the Leipzig Economic Society elected him a member, he was next elected a
member of the Electoral Academy of Sciences of Mainz, and later of the
Physical and Medical Society of Erlangen.In
1798
we read this notice in the Medic.
chir. Zeitung (IV. 192).“
Mietau
: it is intended to erect a temporary university here. It is said that
it is intended that the medical faculty shall consist of Dr. Samuel Hahnemann
of Konigslutter, Dr. Samuel Naumberg
of Erfurt, and Dr. Frank
of Mühlhausen.”
Hahnemann
as a Medical Reformer.Let us now pass from
Hahnemann’s
capacity and acquirements in medicine to his achievements in the way of medical
reform.
He was not fashioned out of soft wood, hence his words often seem
hard and harsh, and even bitter. We shall see how, with penetrating
glance and great store of knowledge, he saw more and more clearly the
utter worthlessness of the therapeutics of the day, and the disastrous
methods of procedure of physicians.Amidst the confusion of hypotheses and speculations, a weak voice
would not have been listened to. He had a strong, sturdy and healthy
body and a lively temperament. Such natures do not creep about in felt
slippers when they have to combat the widely spread follies of their
time ; the question whetherHahnemann
would have been more prudent if he had written in a more conciliatory
tone, does not concern us here.As early as
1784,
as we have seen, he speaks contemptuously of ” fashionable
physicians.” In 1786
he inveighs in his book on Arsenic
against the wretched state of
medicine at that time, against “that most fruitful cause of death,
the bungling of physicians,” who, among other things, powdered
ulcers over with arsenic, thus often causing the death of the patients,
and who gave this drug in poisonous doses in intermittent fever.In
1791,
in his translation of Monro,
he came across the statement that cantharides eliminated morbid humours
; Hahnemann
there-upon remarks (II. 248),
” this is the common delusion that the sores produced by vesicating
agents only remove the morbid fluids.When we consider that the mass of the blood during its circulation is
of uniform composition throughout, that the exhalents of the
blood-vessels give off no great variety of matter under otherwise
identical conditions ; no rational physiologist will be able to conceive
how a vesicating agent can select, collect and remove only the injurious
part of the humours.
His estimate of the Practice
of his days.In fact the blister under the plaster is only filled with a part of
the common blood serum, just like that which separates from the blood
when it is drawn from a vein.But, according to the insane idea of these short-sighted doctors,
venesection, too, draws off the bad blood only, and continued purging
evacuates only the depraved humours ! It is terrible to contemplate the
mischief which such universally-held foolish ideas have caused.”In another place (
Monro,
I. 265)
Monro speaks of corrosive sublimate as an ” alterative.” Hahnemann
thereupon re- i marks : ” I do not know what our author means
thereby, though he uses the language of his and my contemporaries.If an alterative is something which does good here, why does he not
say so ? But no, an alterative seems to be only a half-and-half sort of
remedy. Such a remedy is not required in the whole range of
medicine.” Further (I.246).
“Alterative is a scholastic term ; it is unpardonable in a medical
author to use such a vague expression.”In the same way,
Hahnemann
in many places takes occasion to direct the attention of his
fellow-practitioners to the many absurdities of the day, from which he
used the most earnest efforts gradually to emancipate himself.In
1790,
he attacked the teachers of materia medica of the clay (Cullen,
I. 58).
” The old teachers of materia medica with their puerilities,
vagaries, old wives’ tales and falsities, are venerated as authorities,
even in the most recent times — with a few exceptions — and neither
the originators nor their weak disciples deserve to be spared.We must forcibly sever ourselves from these deified oracles if we
wish to shake off the yoke of ignorance and credulity in the most
important department of practical medicine. It is high time to do
so.”To ascertain the truth in the wilderness of “observations ”
and ” experiences,” he soon hit upon the plan which all great
physicians have followed ; he ceased from the fussy interference
practised at the sick-bed by his contemporaries, and urged his
mixture-loving fellow practitioners to adopt instead.
His denunciations of Polypharmacy.
Simple Prescriptions.Worthily to appreciate this, we must remember that in those days it
was taught that a properly constructed prescription should consist of
several parts.Hahnemann
was of course taught
this, and later he admits that the method of treatment by mixtures
” clung to him more obstinately than the miasma of any
disease.”If then we see him in the first few years of his practice, sometimes
giving mixtures, generally containing only two drugs, we see on the
other hand, that he was gradually emancipating himself from this bad
system.As early as
1784,
[Anleitung alte Schäden, &c.,
p. 165.
B. J. of H. XLII, p. 165.]
he advocates a simple method of
treatment ” instead of the farrago of contradictory
prescriptions.”In
1791,
he asks, when Munro
has been recommending a complicated mode of treatment for sclerosis of
the liver (Munro, II. 288)
:” What was it that really did good ? ….. As long as we do not
accustom ourselves to use simple remedies throughout and carefully to
consider in each case the accompanying circumstances, habits of life,
&c., our therapeutics will remain a combination of guess-work, truth
and poetry.”In the year
1796,
Hahnemann
writes in Hufeland’s
Journal : [Versuch
caber ein neues Princip, &c., II., St. 3.
Hahnemann’s
Lesser Writings, p. 310,
note.]The strangest circumstance connected with this specification of the
virtues of single drugs is, that in the days of these men the habit that
still prevails in medicine, of mixing together several different
medicines in one prescription, was carried to such an extent that I defy
Oedipus himself to tell what was the exact action of a single
ingredient of the hotch-potch.The prescription of a single remedy at a time was in those days
almost rarer than it is now-a-days. How was it possible in such a
complicated practice to differentiate the powers of individual medicines
?Hahnemann
, in his treatise Are
the obstacles to certainty and simplicity in practical medicine
insurmountable ? which
appeared in the year 1797,
[Hufeland’s Journal 1
V., St. 4.
Lesser Writings, p. 358.]
pronounces ” simplicity the
first law of the physician,” and further on :
His
scorn of complex prescriptions.How near was this great man (Hippocrates) to the philosopher’s
stone of physicians — simplicity ! and to think that after more than2,000
years we should not have advanced one single step nearer the mark, on
the contrary, have rather receded from it !Did he only write books ? or did he write much less than he actually
cured ? Did he do this as circuitously as we ?It was owing to the simplicity of his treatment of diseases alone,
that he saw all that he did see, and whereat we marvel….. Here the
question arises : Is it well to mix various drugs in a single
prescription, to administer baths, clysters, bleeding, blistering,
fomentations and inunctions all at once or in rapid succession, if we
wish to raise therapeutics to perfection, effect cures, and know with
certainty in every case what the remedy has done in order to be able to
employ it in similar cases with still greater, or at least with equal
success ?The mind can only grasp one thing at a time and can rarely assign to
each of two powers acting at the same time on one object its due
proportion of influence in bringing about the result ; how can we attain
to greater certainty in therapeutics if we deliberately set a large
number of different forces to act against a morbid condition of the
system, while we are often ill-acquainted with the nature of the latter,
and are but indifferently conversant with the separate action of the
component parts of the former, much less with their combined action ?Who knows whether the adjuvans or the corrigens may not act as basis
in the complex prescription, or whether the excipiens does not give an
entirely different action to the whole ? Does the chief ingredient if it
be the right one require an adjuvans ? Does not the idea that it
requires assistance reflect severely on its suitability ? or should a
dirigens also be necessary ? I thought I would complete the motley list,
and thereby satisfy the requirements of the schools.I think I may venture to assert that a mixture of two drugs almost
never produces the effects of each in the human body, but an effect
almost always different from the action of both separately — an
inter-mediate action, a neutralisation, if I may borrow an expression
from chemistry.The more complex our prescriptions are, the darker is the condition
of therapeutics.That our prescriptions contain fewer ingredients than those of the
Portuguese Amatus will help us just as little as the fact that Andromachus
wrote still bulkier prescriptions will help him. Are our prescriptions
simple because both these wrote more complicated ones ?How can we complain of the obscurity and intricacy of our art, when
we ourselves render it obscure and intricate ? I, too, at one time
suffered from this infirmity ; the schools had infected me. This miasma,
clung to me before it came to a crisis, more obstinately than the miasma
of any other mental malady.
His plea for simple prescriptions.
Are we in earnest in our art ? Very well then ! What would be more
like Columbus’s egg than to make a brotherly compact to give only
one simple remedy at a time in every single malady, without making any
important change in the surroundings of the patient, and then let us see
with our own eyes what the drug does, how far it helps and how far it
does not help ?Would it really be more learned to prescribe from the apothecary’s
shop numerous and variously mixed medicines for one disease (often in
one day), than, like Hippocrates, to treat the whole course of a
disease with one or two enemata, and perhaps a little oxymel and nothing
else ? I thought it was the masterpiece of art to give the right
medicine, not the most complex.
Hippocrates chose the simplest out of a class of diseases ; these
he watched closely and described minutely. In these simplest maladies he
gave single simple remedies out of the store of existing drugs which was
then small.Thus it was possible for him to see what he saw and to do what he
did.It will I hope not be contrary to good taste, to proceed as simply in
the treatment of diseases as this great man did.If any one sees me give one remedy one day, another the next and so
on, he may conclude that I am wavering in my treatment (for I too am a
weak mortal) ; but if he sees me mix two or three drugs in the same
prescription (and ere now this has sometimes been done), he would at
once say : ” The man is at a loss, he does not rightly know what he
would be at, he is bungling ; if he were certain that one was the right
remedy he would not give a second, and still less a third !”What could I answer ? I could only hold my tongue. If I were asked
what is the mode of action of bark in all known diseases ? I would
confess that I know little about it, though I have so often given it
alone and uncombined.But if I were asked what cinchona would do if administered along with
saltpetre, or still more with a third substance, I should have to
confess my benighted ignorance and would worship any one who could tell
me.Dare I confess that for many years I have never given anything but a
single remedy at a time, and have never repeated it till the first dose
had exhausted its action, bleeding alone, an emetic or purgative alone
— and always a simple never a complex medicine — and never a second
till I was quite clean as to the effect of the first ?Dare I confess that in this manner I have been very successful and
satisfactorily cured my patients, and seen things which otherwise I
never would have seen ?If I did not know that there are around me several of the best men
who in simple earnestness are striving after the noblest of aims, who by
a similar method of treatment have corroborated my maxims, I should
indeed not have dared to avow this heresy. Who knows that I should not
in Galileo’s circumstances have denied that the earth went round
the sun.But the day is beginning to dawn !
His ridicule of complex prescriptions.
In the year
1798,
in his translation of the Edinburgh Dispensatory,
he inveighs against ” the
physicians who love prescriptions containing many ingredients ”
(II. 340).
” What god could decide what good effects would result from the
admixture of three strong things very unlike in their actions (castor
oil and preparations of lead and mercury externally applied in cancer)
……The height of empiricism is the employment of mixtures of strong
medicines ” (II.605).
Further on (p. 606),
where compounds are again recommended, he observes : ” We cannot a
priori say what are the powers
of a compound remedy. Every drug has its peculiar action. Which way
would several balls of different sizes, thrown in different directions
and with different degrees of force and striking together, go ? Who
could tell beforehand ? ”The less successful he was in converting his contemporaries to the
employment of simple medical treatment, the more loudly he raised his
voice.In
1800,
he translated Thesaurus
Medicaminum, a new collection of medical prescriptions, from
the English. The translation was published anonymously, the notes being
signed ” Y.”He wished to prove by his criticisms how the complicated formulas
acted in a manner directly opposed to the attainment of the cure desired
and of instruction.In the preface
[Translated in
Lesser Writings, p. 398.]
we find the following emphatic words :Even the best formulas (I should like to convince my countrymen of
it) are unsatisfactory and unnatural and act conflictingly and contrary
to the object intended ; a truth, which in our time when formulas are so
much in vogue, we should preach from the housetops. When shall I see
this folly extirpated ? When will it be recognised that the cure of
diseases is better effected by simpler but properly selected remedies ?
Must we always have to endure the ridicule of Arcesilases ?Shall we never cease to mix a number of drugs in the same
prescriptions, the effect of each of which is only half known or not
known at all by even the greatest physicians ? Though Jones, of
London, used300
pounds of bark every year, what do we know of the actual, individual
action of this drug ? Little ! What do we know of the pure and specific
action of that powerful drug Mercury, the immense use of which by
physicians would seem to imply an accurate knowledge of its effects on
our body.
He shows the absurdity of the complex formulae
of high medical authorities.If so great an obscurity reigns with regard to these single drugs,
how useless must be the phenomena which appear after the indiscriminate
administration of several such unknown drugs together. It seems to me
like throwing together a number of various shaped balls with one’s eyes
shut on to a billiard table of unknown form and many cushions, and
attempting to prophesy what effect they will have together, what
position each ball will take, and where it will eventually come to a
standstill after repeated rebounds and unforseen collisions !Further, he describes sarcastically the statements which the
prescription writers of the day made as to the effects of their basis,
their adjuvans, their constituens, dirigens and corrigens.Unfortunately it is not possible to quote all the characteristic
passages ofHahnemann’s
writings. Further on he says : ” Nature works according to eternal
laws, without asking anyone’s permission ; she loves simplicity, and
effects a great deal with one remedy ; you effect little with many
remedies.Imitate nature ! To prescribe many drugs mixed, and sometimes even
several prescriptions daily, is the height of empiricism ; to give
single remedies and not to change them till the time of their action has
expired, this is to take the straight road towards the inner holy place
of art.”In the
412
pages of this work he proves by numerous examples how irrational it is
to mix drugs.Here are a few examples :
PAGE 33
: —
If the remedy already consists of five ingredients, each of considerable
strength, why should not the whole materia medica be included ? That
would be better still. O, how little is the true action of each one of
these ingredients known ! What action do we expect from them when they
act simultaneously on the body ? How shall we attain the knowledge of
simple drugs when we only give them mixed ? It seems to me that we are
ashamed to know accurately the action of each drug, and that we mix
several up together in order, in the resulting confusion, to keep before
our eyes the fog we love so dearly.PAGE 39
: —
A qualified doctor is, of course, at liberty to give any-thing he likes,
Nature must submit out of respect for his diploma.PAGE 66
: —
Is it not wise to mix a substance like aloes which only acts after
twelve or sixteen hours, and then only produces a small, soft stool
(given in large doses as a purgative, it produces few stools but causes
a great deal of griping) with another substance, such for instance as
colocynth which acts in a couple of hours ! It is quite un-known what
time scammony takes to purge, and what are the peculiarities of its
action. But all the better ! the more unknown the drugs are, the more
scientific is the mixture !PAGE 74
: —
A formula suffering from an unwholesome mixture of ingredients !
Heating, cooling, purging and other remedies all mixed together. Now we
shall know the effects of oxymel of colchicum which we have not been
able to ascertain from its use by itself since the days of Dioscorides
! Alas !PAGE
81
: — In true dysentery we should
avoid such things (senna boiled with rhubarb and tamarinds), and in
other cases we can easily find less disgusting compounds, if the evil
spirit of mixing will no leave us in peace.PAGE
86
: — I have observed in all these
secundem artem formulae that the authors jealously omit to explain why
they mix rhubarb with saffron, gentian, serpentary and aloes, why senna
leaves with jalap root ?Did they know that each of all these things had a different effect ?
Did they think that their combination would produce an intermediate
action when we only imperfectly know the effects of each singly, and
still less in combination ?Or did all their wisdom eventuate in the itch for compounding, which
is an epidemic disease among our physicians ? But sometimes I almost
think that higher considerations have influenced them in making these
mixtures, for they mix rhubarb and aloes with liquorice.A splendid idea ! they will thus be sweetened, and the bitter taste
taken away.Difficile est satyram non scribere.
PAGE
91
: — We cannot believe the
formula writers when they say, for instance, that the more numerous the
diuretics in a mixture the more efficacious is it for the elimination of
urine ! The fools ! Usually it is just the opposite, one often hinders
the other. Why do they, then, mix so many ingredients ? Because they
look upon treatment like investing in a lottery.If I place my money on enough numbers, thinks the weak-minded
gambler, I must win ! Too dear a way, my friend, of attaining your
object. If you were right, Zacutus Lusitanus, with his
fifty ingredients in one prescription, must have been a matador among
physicians.PAGE
97
: — Obstructions of the liver
are more easily guessed at than diagnosed, and there are kinds of
jaundice which disappear of them-selves in a few days. This explains how
such an indigestible brew could have obtained its reputation in such
diseases.Of what use was sulphate of potash if dandelion alone would have
effected the object desired ? or would the first have been sufficient
alone ? or must we give both ? and why both ? If it is the result of
experience that both must be used in order to do good, then give us the
details of your experience where there was no doubt as to the nature of
the disease or the good effects of the mixture. An intelligent man must
have a reason for each step of his procedure.PAGE
100
: — To the ordinary
practitioner, a simple prescription is like a thorn in the eye ! Hippocrates,
with his simple drugs, must have been a bungler who should have bought a
modern book on the art of prescribing.
No useful experience of medicinal action can
be obtained from medicinal mixtures.PAGE
106
: — In these seven consecutive
formula, we shall see squills united with eight different drugs. Was
squills alone not sufficient ?What assistance did it receive from its fellow-ingredients ? If the
added ingredients were all useful in an equal degree, why so many
changes ? If they were not, why are we not told which were the useful
ones and which the useless and in what cases ? This should be done if we
are not to think that changing about is recommended merely for the sake
of changing, or even coeco instinctu.But no ! we find many famous physicians recommending prescriptions
containing an immense number of ingredients in dropsy, with the excuse :
that many substances only excite their full power if mixed together in
certain proportions. Then what is the full power ?Occasionally the water is removed, but in what cases ? They cannot
tell us this any more than they can tell us when cream of tartar, when
potash, preparations of squills, colchicum, juniper, parsley and
foxglove are especially indicated.If they cannot even determine the right cases in which to give simple
remedies, all of which in certain cases prove useful singly and remove
the water, why do they recommend mixtures and complicated mixtures
which, if each simple drug is good for its special kind of disease, must
have a still narrower sphere of action and must be suitable in a still
more individual case of disease on account of the complicated character
of the mixture, in which each ingredient has a new direction and limit.The physician who is intimately acquainted with drugs, knows how
difficult it is to get only fifty simple drugs in equally good condition
; the condition of the leaves, roots and barks is so much influenced by
the habitat of the plant, the time of gathering, the maturity of growth,
removal of the damaged parts, the period of drying which varies from a
few hours to several weeks, the restricted or unrestricted access of
air, and the warmth or dampness of the places where they are kept. What
differences are produced by even the modes of preparation, the infusion
in hot or cold water, strong or weak alcohol, for a few minutes or for
several weeks !He further points out the mistakes made in preparing extracts (by
boiling) and the negligent mode in which they are kept in apothecaries’
shops.If we have always such difficulty in getting from them simple drugs
and preparations in equally good condition — if, in one word, it is so
unusual to get for our patients simple drugs of uniform quality, what
madness is it to expect to have the most improbable of imaginable
things, viz. : — medicines consisting of many ingredients always
identical in character, many of which have undergone complicated
processes (subject to defects and accidents) in their preparation !Who will consider an uncertain, never uniform mixture of
7,
8,
10
or 15
ingredients a reliable remedy ?Only one who knows nothing about the subject.
If you send the prescription to ten different respectable
apothecaries you will get ten preparations differing in taste,
appearance and smell (to say nothing of medicinal properties !).But if you have a single remedy you can judge of its quality and
increase the dose if it is weak. What will you do, if in a complicated
mixture one ingredient is100
times stronger, another 10
times weaker than you have been accustomed to, without your being able
to detect it ?PAGE
112
: So one contradicts another, and
neither knows how far he is right and the other wrong. They do not
sufficiently distinguish their cases and they seek their remedy in
mixtures, thus converting even the little light they had into utter
darkness. Is this the royal road to the temple of truth ?PAGE
118
: This mixture can hardly be
compounded without the precipitation of part of the saltpetre, but what
does our hero care for chemistry in compounding his mixtures ? If only
grotesque enough things are heaped together so as to seem learned, only
the stomach of the patient will suffer.PAGE
142
: In what kinds of intermittent
fevers ? and how are they distinguished from those which are cured by
bark ? What part was taken by the antimony, what by the potash, and what
by the chamomile flowers ? Behold ! ” The earth was without form
and void, and darkness was upon the face of the deep.”PAGE
352
: I call that a sauce au
dernier gout made out of thirteen piquant ingredients which partly
neutralise each other’s action. This is now (since the banishment of
common sense) the highest fashion ! Poor Hippocrates ! with his
simple remedies, how ignorant he appears in comparison. We are now in
possession of the true savoir faire, of the highest
culture. God have mercy on the poor souls driven out of their
methodically treated bodies !With similar remarks
Hahnemann
accompanies the author on every page through the whole book, proving
thereby how earnest was his striving after truth and how great his
anxiety for the improvement of therapeutics, and how far he surpassed
his mixture-loving contemporaries in the gifts of observation and
investigation.A year after, in
1801,
he writes in Treatment of
Scarlet Fever, page 12
: [Lesser Writings, p. 431.]
” Here we often see the nec
plus ultra of the grossest
empiricism ; for each separate symptom a particular drug in the
complicated formula ; a sight that cannot fail to inspire the
unprejudiced observer with feelings at once of pity and indignation
!”
Hahnemann the first advocate of
Simplicity in Therapeutics.At the same time he attacked
Brown
on this question in Hufeland’s
journal. [Vol.
II., St. 4,
p. 3
and 4.
Lesser Writings, p. 618.]
Brown
recommended the
employment of several drugs at once, never of one at a time.
On this Hahnemann
remarks :” This is the true sign of charlatanism. Quackery always goes
hand in hand with complicated mixtures, and any one who can recommend
(not merely tolerate) them is far removed from the simple ways and laws
of nature.”In the following years he was never weary of urging on his
mixture-loving colleagues that the ” chief law for the physician
” was simplicity of treatment.In
1805
in Medicine of Experience [Lesser
Writings, p. 534.]
he again writes :” A single simple remedy is
always
calculated to produce the most
beneficial effects, without any additional means, provided it be the
best selected, the most appropriate and in the proper dose. It is never
necessary to give two at
once.”” If we wish to perceive clearly what the remedy effects in a
disease and what still remains to be done, we must only give one single
simple substance at a time. Every addition of a second or a third only
deranges the object we have in view.”In the same year he writes in.
Esculapius
in the balance : [Lesser
Writings, p. 488,
note.]This is the general, but most unjustifiable procedure of our
physicians : to prescribe nothing by itself — no ! always in
combination with several other things in one artistic prescription.
“No prescription can properly be termed such,” says Hofrath Gamer
in his Art of Prescribing, “which does not contain several
ingredients at once.” You might as well put out your eyes in order
to see more clearly.In
1808
we read in The Value of the
Speculative Systems of Medicine : [Lesser
Writings, p. 567.]But the case is worse still and the proceeding more reprehensible
(the prescription of mixtures) when we consider that the action of each
or at any rate of most of the ingredients thus huddled together is
individually great and yet unascertained.Now, to mix in a prescription a number of such strong disordering
substances, whose separate action is often unknown and only guessed and
arbitrarily assumed, and then, forthwith, at a venture, to administer
this mixture, and many more besides without letting a single one do its
work out on the patient, whose complaint and abnormal state of body has
only been viewed through illusive theories and through the spectacles of
manufactured systems — if this is medical art, if this is not hurtful
irrationality, I do not know what we are to understand by an art, nor
what is hurtful or irrationalThis motley mixing system is nothing but a convenient shift for one,
who having but a slender acquaintance with the properties of a single
sub-stance, flatters himself, though he cannot find any one simple
suitable remedy to remove the complaint, that by heaping a great many
together there may be one amongst them that by a happy chance shall hit
the mark.Towards the end of the above-named essay he again breaks out : ”
Further, let us reflect how extremely pre-carious and, I might say,
blind, such a system of administering drugs must be which fights against
diseases, themselves misunderstood from being viewed through glasses
tinged with ideal systems, with almost unknown drugs assembled in one or
several such formula ! “No physician has preached this important truth with such energy and
such conviction asHahnemann.
No physician has so consistently employed simple prescriptions, and he
could with truth assert in 1805
that :” No physician on the face of the earth, neither the founders of
systems nor their disciples, is accustomed to give in diseases only one
single simple drug at a time and to wait till its action is exhausted
before giving another.”The
Organon appeared
in 1810,
and it is scarcely necessary to mention that in it he advocates
simplicity of treatment, as did also later his followers in numerous
periodicals and other works.
Hahnemann’s
attacks on the Therapeutics of his time.We have already shown how
Hahnemann
attacked deference to authority in therapeutics, as early as 1786
and 1790.
He had already pronounced against bleeding in nervous fever.
Hahnemann’s
criticism of the medical treatment of the Emperor Leopold.In the same work (Cullen, II.
18)
in 1790
he complains, “Bleeding, antiphlogistics, tepid baths, diluent
drinks, low diet, blood purifiers and ever-lasting purgatives and
enemata are the vicious circle in which the ordinary run of German
physicians are always revolving.”According to
Hahnemann
there are few exceptions. He even took occasion to attack his
blood-thirsty colleagues in a case which attracted great attention.Two years later the Emperor Leopold II, of Austria, died unexpectedly
(early in the year1792).
[It was a time of political
fermentation. Much anxiety was felt respecting France, which threatened
Germany with invasion to punish the émigrés. Leopold, in the short
period of his reign from 1790
as German Emperor, warded off apparently inevitable war by his prudence
and love of peace. All hopes were centred in him ; consequently the news
of his sudden unexpected death came like a thunder-clap, and filled all
hearts with apprehension. Hahnemann
at that time resided in Gotha, where Der
Anzeiger, a newspaper often
used for discussions among physicians and for communications from
physicians to one another, was published. It appeared afterwards under
the title Allgemeiner Anzeiger
der Deutschen. Hahnemann
was acquainted with the editor, Dr. Becker,
to whom he had most likely communicated his views, and was probably
invited by him to take this step in order to clear up matters. The
sudden death had already given rise to all sorts of curious rumours.]The post-mortem
[Der Anzeiger, 1792,
No. 137
and 138.]
revealed among other things a
” semi-purulent ” exudation about a pound in weight in the
left pleura.In No.
78
(l.c. 31
March, 1792),
Hahnemann
thus criticises the treatment of the physicians :” The report states ` his physician,
Lagusius,
observed high fever and swelling of the abdomen early on February 28
‘ ; he combated the malady by venesection, and as this produced no
amelioration, three more venesections were performed without relief.Science must ask why a second venesection was ordered when the first
had produced no amelioration ? How could he order a third, and good
Heavens ! how a fourth when there had been no amelioration after the
preceding ones ?How could he tap the vital fluid four times in twenty-four hours,
always without relief, from a debilitated man who had been worn out by
anxiety of mind and long continued diarrhoea ?Science is aghast ! “
Lagusius
(alias
Hasenöhrl) had called
Professors Storck
and Schreiber
in consultation.” The clinical record of the physician in ordinary
Lagusius
says :The monarch was on the
28th
February attacked with rheumatic fever [what symptoms of a rheumatic
character had he ?] and a chest affection [which of the numerous chest
affections, very few of which are able to stand bleeding ? let us note
that he does not say it was pleurisy, which he would have done to excuse
the copious venesections if he had been convinced that it was this
affection] and we immediately tried to mitigate the violence of the
malady by bleeding and other needful remedies [Germany — Europe —
has a right to ask : which ?]On the
29th
the fever increased [after the bleeding ! and yet] three more
venesections were effected, whereupon some [other reports say distinctly
— no] improvement followed, but the ensuing night was very restless
and weakened the monarch [just think ! it was the night and not the four
bleedings which so weakened the monarch, and Herr Lagusius
was able to assert this positively], who on the 1
st of March began to vomit with violent retching and threw up all he
took [nevertheless his doctors left him, so that no one was present at
his death, and indeed after this one of them pronounced him out of
danger].At
3.30
in the afternoon he expired, while vomiting, in presence of the
empress.'”Hahnemann
challenged the
physicians to justify them-selves. This attack of Hahnemann’s
was certainly a violent one.On the other hand, if a case with such important issues depending
upon it, were to occur nowadays, how the physicians would be blamed !Hahnemann
plainly saw the
perniciousness of the medical treatment. Why should he not do what
now-a-days many would do ? Fear was unknown to him, and he was not
wanting in knowledge of all branches of science. Moreover, he in this
case expressed the general opinion.Before the emperor’s physicians answered
Hahnemann’s
challenge, a discussion arose among other physicians in the same
journal.The physician to the Court of Saxony, Dr.
Stoller,
[L.c., No. 103,
30
th April] pronounced Hahnemann’s
attack improper, unfair and useless, perhaps written for the purpose of
making himself known, and stated that he had been convinced by optical
evidence of the weakness and ailing condition of the emperor during his
sojourn at Pillnitz and had said so.
Opinions of contemporary physicians on
Hahnemann’s
criticism.He exclaims : ” Good Herr
Hahnemann,
it was just because the first and second bleeding did not do what was
intended that it was repeated ! ”He maintains that the doctors left the patient at the command of the
empress, which explains their absence at the time of his death.In conclusion, he asserts his impartiality, for he knows Herr
Lagusius
” by his writings under the name of Hasenöhrl, “and Herr Hahnemann” also only by his excellent works, especially that on arsenical
poisoning, and from what he heard of him in Dresden.”A physician who in thirty years’ practice “had never had a
quarrel with a colleague either at the bed-side or else-where,”
gives his opinion.[L.c., No. 119,
18
th May.]He deprecates this dispute between two physicians, “who are both
to be highly honoured for their literary reputation “It is difficult to believe that Herr
Hahnemann
had the intention of making himself more famous than he already is.Herr
Hahnemann
is already so much respected and renowned for his valuable services that
he certainly does not require to make himself more popular with the
German public by getting up a quarrel with Herr Lagusius,
who is himself not better known.”He blames the personal character of
Hahnemann’s
attack, but not its publicity, which only serves to further the cause of
truth. ”That court physicians are fallible, is sufficiently proved by those
of Louis XIV., who slaughtered half his family by bleeding in
influenza.”He defends the venesections, but would rather have seen them limited
to two. Further it was to be remarked that physicians of the older
Vienna school ” think fevers in the highest degree inflammatory
which were perhaps only gastric, as was evidently the case with the
emperor,” although many patients recovered without bleeding.The author mentions a pertinent article by Dr.
Lenhardt,
which had been noticed shortly before in the Anzeiger
[No. 112,
10
th May.] to whose therapeutic
views he inclined.These were that the emperor was suffering from ” inflammatory
matters,” ” impure fermenting substances,”
“acridities” and “degenerated bile” in theprimae
viae, which substances should
have been energetically evacuated, and thereby his life would have been
saved.This having been neglected, the inflammation so quickly got the upper
hand that it turned to gangrene. From this article we also learn that
two and-a-half hours before his death the doctors gave such a reassuring
prognosis that his son Francis II., left the bed-side.
Lagusius
, according to Lenhardt,
was quietly sitting at a gentleman’s dinner table, when he received the
news of the emperor’s death, which must have shocked him not a little.The author then returns to
Hahnemann’s
article and says :Nevertheless I do not maintain with Herr Stoller that Herr
Hahnemann’s
article is unfair, improper and useless.Not unfair, because in the domain of science every thinking
man has a right to judge openly and fearlessly all subjects relating to
his science.Herr
Hahnemann
is ` doctor’ and what is more a learned man and may, in this character,
just as well take the imperial physicians to task as of yore Dr. Luther,
relying on his diploma of doctor, did the Roman curia.
Not improper,
for every intelligent man may speak his mind on
every subject of human knowledge unless he thinks it more politic to
hold his tongue. Posterity, however will not do so, and if all
contemporary physicians are silent, it will certainly ask the question,
why the emperor Leopold died so quickly ? What was the cause of his
death ? How was his malady treated ? Why should a learned man who found
himself in a position to speak freely not do so ? Is not every
intelligent, unprejudiced, cool and impartial observer a representative
or, if you prefer it, a precursor of posterity as the morning star is of
the sun ?Not useless, if the opinion
1
. That a too energetic mode of
treatment is a common cause of serious metastases, and also2
. That the highest criterion
of practical skill and prudence — the ability to foresee and avert
metastases — can be thereby made to penetrate the minds of physicians
more than hitherto. Not useless,3
. If from this incident the
difference between true and inflammatory-like fevers can be more plainly
distinguished, and the latter treated more by attending to the prime
vice than by bleeding and resolvents, and thereby many valuable
lives may be saved.
Post-mortem examination of the Emperor
Leopold.” Attention to the
prima
vice” was a euphuism for
emetics and purgatives.Meanwhile on the
11
th of June [L.c., No. 137.]
the emperor’s physicians explain :” That the morbid condition was quite different from that which
Hahnemann
had represented on the re-port of ignorant journalists.” (Hahnemann
had founded his attack on the report of Dr. Lagusius
himself.) Further, we must have a poor idea of Hahnemann’s
medical know-ledge ” if he maintains that a second bleeding should
never be undertaken if the first has not given relief” ”His majesty when he was taken ill, was not the least in an exhausted
condition,” (Stoller
and also Lenhardt
maintained the contrary), ” but was very strong, and thus was in a
condition to be attacked by violent inflammation in both the pleural and
peritoneal cavities, and this was best combated by venesection.It was not thought to be pleurisy, because no cough was present, but
a rheumatic inflammatory fever which was then very prevalent in Vienna.
Vomiting came on only at the last because neither flatus nor anything
else could be removed by clysters from the distended abdomen,”They subjoined the following report of the autopsy :
Nec thoracis cavitates vitio immunes erant, quippe pulmo dexter nimis
flaccidus erat, et cavum pectoris sinistrum continuit serum
extravasatum, semipurulentum ad lb.1.
Superior pulmonis lobus inflammatus.
Pleura eo in loco, ubi dolor acutissimus sentiebatur, sponda :
membrana obtecta erat.Cor transversim sectum sanum erat attamen nimis flaccidum.
Ex quibus descriptis pronum est concludere, acutissimam
inflammationem optimum Monarchum inter paucos dies e medio sustulisse.So the emperor died from an attack of inflammation of the chest with
sero-purulent exudation, and the foremost physicians of Vienna diagnosed
” rheumatic inflammatory fever.” Even the autopsy did not put
them on the right track, the diagnosis remained ” a very violent
inflammation ” of the peritoneal and pleural cavities.The ” signs of inflammation ” which they found in the
abdominal viscera are omitted for the sake of brevity. The bowel seems
not have been opened, of the condition of its mucous membrane we are
told nothing in spite of the chronic diarrhoea which was present.The article concludes : ” The medicines which the inquisitive
doctor wishes to know consisted of antiphlogistic nitrous remedies and
enemata. They were given to arrest the violent inflammation which was
clearly shown to have existed by the autopsy, as is shown in the
report.”Lastly, a minute report was promised by the physician in ordinary
Lagusius.
Hahnemann
on June 14th
(No. 140)
declared : –1
– That the reply of the
emperor’s physicians was made with less calmness than the occasion
required and that it answered nothing.2
– That Herr von Lagusius
should produce the full report of ” this remarkable disease ”
which had been expected for ten weeks. ”He will not refuse our request and will tell his ignorant
contemporaries the weighty authorities according to whom a patient
should be bled a second, third and fourth time, if the previous
bleedings produce no amelioration. He will present us with a history of
the case which in pragmatic exactitude, lucid description and veracious
fidelity will breathe the spirit of the Asclepiades of Cos.”Kurt
Sprengel
[Kritische Uebersicht des
Zustandes der Arzneykzznde im letzen Jahrzehend, Halle, 1801,
p. 139]calls this attack of
Hahnemann’s”
fanatical,” without finding any further fault with it.The defence of the emperor’s physicians he calls ” very
unsatisfactory ” and informs us that the promised full history of
the casedid not appear.
That it was not
Hahnemann’s
intention to be-little his adversaries is shown by his defending Storck
in 1791
against other physicians, [Translation
of Monro II., p. 324.]
and pronouncing him one of the
greatest physicians ; though his true should be carefully separated from
his false opinions ; also in Hufeland’ journal
(1806,
3,
p. 49)
he declares him worthy of a statue.
His reductio ad absurdum of the
Therapeutics of his time.In the year
1806
Hahnemann
gave utterance to the following sally : [Aesculapius
in the Balance. Lesser Writings, p. 488.]With the exception of what a few distinguished men, to wit, Conrad
Gesner, Storck, Cullen, Alexander, Coste and Willemet have done, by
administering simile medicines alone and uncombined in certain
diseases, or to persons in health, the rest is nothing but opinion,
illusion, deception.In
1808
he sharply and truly criticises the actual condition of therapeutics, [On
the present want of foreign medicines, Allg. Anz. d. Deutschen No. 207.
Lesser Writings, 553.]
and at the same time enumerates
the modes of treatment employed by the older and younger practitioners
of the time :The method of treating most diseases by scouring out the stomach and
bowels : — the method of treatment which aims its medicinal darts at
imaginary acridities and impurities in the blood and other humours, at
cancerous, rachitic, scrofulous, gouty, herpetic and scorbutic
acridities — the method of treatment that presupposes in most diseases
a species of fundamental morbid action, such as dentition or
derangements of the biliary system, or hemorrhoids, or infarctus, or
obstructions in the mesenteric glands, or worms, and directs the
treatment against these — the method which imagines it has always to
do with debility, and conceives it is bound to stimulate, and
re-stimulate (which they call strengthen) — the method
which regards the diseased body as a mere chemically decomposed mass
which must be restored to the proper chemical condition by chemical
(nitrogenous, oxygenous, hydrogenous) antidotes : — another method
that supposes diseases to have no other originating cause but mucosities
— another that sees only inspissation of the juices– another that
sees nought but acids — and yet another that thinks it has only to
combat putridity, &c.Imagine the embarrassment in which a physician must be placed, when
he comes to the sick-bed, as to whether he should follow this method or
the other, in what perplexity he must be when neither the one nor the
other mode of treatment avails him : how he, misled now by this, now by
that view, feels himself constrained to prescribe now one, now another
medicinal formula, again to abandon them and administer something
totally different and, finding that none will suit the case, he thinks
to effect, by the strength of the doses of most powerful and costly
medicines, that cure which he knows not(nor
any of his colleagues either) how to bring about mildly by means of
small, rare doses of the simple but appropriate medicine.In the same year
1808
he says in his treatise, On the
value of the speculative systems of medicine : [Allg.
Anz. d. D. Lesser Writings, p. 561.]I pass on to pathology, a science in which that same love of
system, which has crazed the brains of the metaphysical physiologists,
has caused a like misapplication of intellect in the attempt to search
into the internal essence of diseases, in order to discover what it is
that causes diseases of the organism to become diseases. This they
called the proximate internal cause…….After humoral pathology (that conceit, which took especially with the
vulgar, of considering the diseased body as a vessel full of impurities
of all sorts, and of acridities with Greek names which were supposed to
cause the obstruction and vitiation of the fluids and solids,
putrefaction, fever, everything, in short, whereof the patient
complained, and which they fancied they could overcome by sweetening,
diluting, purifying, loosening, thickening, cooling and evacuating
measures) had, now under a gross, now under a more refined form, lasted
through many ages, with occasional interludes of many lesser and greater
systems — (to wit, the mechanical origin of diseases, the doctrine
which derives diseases from the original form of the parts, that which
ascribes them to spasms and paralysis, the solid and the nerve
pathology,[Nerve pathology was
the doctrine that attributed disease to a reaction of the nerves against
unusual irritations.] the chemical
pathology, &c.) the seer Brown appeared, who, as though he
had explored the pent secrets of Nature, stepped forward with amazing
assurance, assumed one primary principle of life (irritability), would
have it to be quantatively increased and diminished, accumulated and
exhausted in diseases, and made no account of any other source of
disease, but ascribed all diseases to want or excess of strength.He gained the adherence of the whole German medical world, a sure
proof that their previous medical notions had never convinced and
satisfied their minds, and had only floated before them in dim and
flickering forms. They caught eagerly at this one-sidedness, which they
persuaded themselves into believing was genuine simplicity……And what was, after all, his one-sided irritability ?
Could he attach any definite and intelligible idea to it ?
Did he not mystify us with a flood of words destitute of meaning ?
Did he not draw us into a treatment of disease, which, while it
answers in but few instances, and then imperfectly, could not but in the
preponderating remainder give rise to an aggravation or speedy death.Nevertheless
Hahnemann
was not blind to the services of others. He shows this with regard to Brown
in his excellent essay : Observations
on the three current modes of treatment.
[Hufeland’s Journal XI., St. 4,
1809.
Lesser Writings, p. 623.
]
His appreciation of Brown’s
system.But let us do him justice ! whilst we see that the glory which was to
constitute the apotheosis of his original head vanishes, whilst the
Titan who sought aimlessly to heap Pelion on Ossa, quietly descends from
the rank of heroes — whilst we see that his colossal plan to turn
everything topsy-turvy in the domain of Aesculapius is dashed to pieces,
and that the myriads of special diseases cannot be referred by him to
one or two causes, or what is the same thing, be decreed by him to
consist of two or three identical diseases differing from one another
only in degree, nor their infinite varieties be cured by two or three
stimulants or non-stimulants — whilst we consign all these arabesque
eccentricities to the domain of fable, let us not forget to do him the
justice to acknowledge that with a powerful arm he routed the whole gang
of humoral, acridity and saburral physicians who, with lancet, tepid
drinks, miserable diet, emetics, purgatives and all the nameless
varieties of resolvents, threatened to destroy our generation, or at
least to deteriorate it radically and reduce it to the lowest possible
condition ; that he reduced the number of diseases requiring
antiphlogistic treatment to three per cent. of their former amount ;
that he determined more accurately the influence of the six so-called
non-natural things on our health ; that he refuted the imaginary
advantage of vegetable over animal diet to the advantage of mankind ;
that he restored to the rank of a remedial agent a judicious regimen,
and that he reintroduced the old distinction between diseases from
defect of stimulus and those from excess of stimulus, and taught with
some degree of truth the difference of their treatment in a general way.This may reconcile us with his manes !
Very few physicians — perhaps none — saw as clearly as
Hahnemann
in those days ; it was his strong hand which first succeeded in putting
down the mob of bleeding and purging doctors.Our author continues his criticism :
[Lesser
Writings, p. 562.]The transcendental school repudiated the idea of having but one
fundamental vital force. The reign of dualism commenced.Now we were fooled by the natural philosophers. For of such seers
there was no lack, each devised a new view of things, each wove a
different system, having nothing in common but the morbid propensity not
only to evolve from their inner consciousness an exact a priori account
of the nature and universal constitution of things, but actually to look
on themselves as the creators of the whole, and to construct it out of
their heads each according to his own fashion.
Criticism of Contemporary Materia Medica.
All the utterances they maundered forth respecting life in the
abstract and the essential nature of man were — like their whole
conception — so unintelligible, so hollow and unmeaning, that no clear
sense could be drawn from them.Human speech, which is only fitted to convey the impressions of sense
and the ideas immediately flowing from them refused to express their
conceits, their extravagant fantastic visions ; and, therefore, they had
to babble them forth in new-fangled, high-sounding words, superlunary
locutions, eccentric rhapsodies and unheard of phrases without any
sense, and get involved in such gossamer subtleties, that one felt at a
loss to know which was the most appropriate — a satire on such a
misdirection of mental energy or an elegy on its ill success.We have to thank natural philosophy for the disorder and dislocation
of many a young doctor’s understanding.Moreover, their self-conceit was yet too much inflated for them to
trouble themselves with the study of diseases or their cure ; they were
content to prate about their dualism, their polarization, their
representation, their reflex, their differentiation and
indifferentiation, their potentiation and depotentiation.This natural philosophy still lives and flourishes in a far-fetched
doctrine of the spiritualization of matter, and in ecstatic
hallucinations concerning the creation and order of the universe and its
microcosm — man.After describing the natural philosophical doctrine of sensibility,
irritability and reproduction, and characterising it as a playing with
empty words, he continues :[Lesser
Writings, p. 564.]How impossible is it by all these barren a priori’s to obtain
such a just view of the different maladies as shall enable us to find
the remedy suited to each — which ought to be the sole aim of the
healing art How can one justify to a sound judgment the seeking to make
these speculative subtleties, which can never be made concrete and
applicable, the chief study of the practical physician ?In the above-mentioned treatise he also criticises the materia
medicas of his time :[Lesser
Writings, p. 569.]And whence do these authorities on materia medica draw their data ?
Surely not from an immediate revelation ?
In truth, one would almost be induced to believe they must have
flowed to them from direct inspiration, for they cannot be derived from
the practice of physicians, who, it is well known, hold it beneath their
dignity to prescribe one single, simple medicament and nothing more in a
disease, and would let the patient die and the medical art ever remain
as a no art, sooner than part with their learned prerogative of writing artistically
compounded prescriptions.
Most of the imputed virtues of the simple drugs have, in the first
place, obtained a footing in domestic practice and been brought into
vogue by the vulgar and non-professional.Barren information of this sort was collected by the old herbalists,
Mattholi, Tabernaemontanus, Gesner, Fuchs, Lonicer, Ray, Tournefort,
Bock, Lobel, Thurneisser, Clusius, Bauhin, &.c., very briefly,
superficially and confusedly, and interwoven with baseless and
superstitious conjectures, intermingled with that which the unciting Dioscorides
had in a similar manner collected, and from this unsifted catalogue was
our learned-looking materia medica supplied.One authority copied another down to our own times. Such is its not
very trust-worthy origin.The few books that form an exception to this (Bergius and Cullen),
are all the more meagre in data respecting the properties of the
medicine ; consequently, as they for the most part, the latter
especially, reject the vague and doubtful, we can gain little
positive knowledge from them.Similar opinions respecting the allopathic materia medica we
frequently find in more recent literature ; we might fill a volume with
them.But in
Hahnemann’s
time such attacks were unheard of, “audacious” as the
allopaths maintained.No physician since
Paracelsus
had dared to expose with such frankness and boldness the miserable
condition ofthe medical treatment of the period.
In an anonymous article,
[Allg.
Anz. d. D., No. 207.
Lesser Writings, p. 573.]
in the year 1808,
after he had for twenty years
past been calling the attention of his contemporary physicians to the
evils wrought by the healing art he
writes :It must some time or other be loudly and publicly said, so let it now
be boldly and frankly said before the whole world, that our art requires
a thorough reform from top to bottom.What should not be done is done, and what is essential is utterly
neglected. The evil has come to such a pitch that the well-meant
mildness of a John Huss is no longer of any use, but the fiery
zeal of a stalwart Martin Luther is required to clear away this
monstrous leaven.No other science or art, or even handicraft, has advanced so little
with the progress of time, no art is so behindhand in its radical
imperfection as the medical art.Sometimes one fashion is followed, sometimes another, first one
theory then another, and when the new does not seem to answer, the old
is again tried (which was found to be inadequate before).
Provings of Drug in former times.
Treatment is always guided, not by conviction, but by opinion, each
new mode of treatment was the more artistic and learned the less it
succeeded, so that we are reduced to the wretched and hopeless choice of
one of the numerous methods, almost all equally impotent, and have no
fixed therapeutic principles of acknowledged value.Each follows the teaching of his own school and what his imagination
suggests to him, and everyone finds in the immense magazine of opinions,
authorities to which he can refer for confirmation.At the conclusion of his treatise
On
the value of the speculative systems of medicine, he
exclaims : [Lesser Writings, p. 573.]Such is the fearful but too true condition of the medical art
hitherto, which, under the treacherous promise of recovery and health,
has been gnawing at the life of so many of the inhabitants of earth.Oh ! that it were mine to direct the better portion of the
medical world, who can feel for the sufferings of their fellow
creatures, and long to know how they may relieve them, to those purer
principles which lead directly to the desired goal.
The proving of
drugs on the healthy organism.It is true that in all ages drugs were proved, and that on the
healthy body.
On this point Hahnemann
says : [Organon, 5
Edit. Dudgeon’s trans. p. 16.]But in all the works on Materia Medica, from Dioscorides
down to the latest books on this subject, there is almost nothing said
about the special peculiar action of individual medicines ; but, besides
an account of their supposed utility in various nosological names of
diseases, it is merely stated whether they promote the secretion of
urine, perspiration, expectoration or menstruation, and more
particularly whether they produce evacuation of the stomach and bowels
upwards or downwards ; because all the aspirations and efforts of the
practitioner have ever been chiefly directed to cause the expulsion of a
material morbific matter, and of sundry (fictitious) acridities, on
which it was imagined diseases depended.There were a few exceptions to this, as
Hahnemann
admits, for instance, Conrad
Gesner, Storck, Cullen, Alexander, Coste and Willemet.
Haller
also is honourably
mentioned by Hahnemann
on account of his proposal to ascertain the effects of medicines by
provings on the human organism.But even these men only proved medicines
in
isolated cases, none of them
proceeded systematically.
Hahnemann’s
early Provings of Medicines.Hahnemann
was the first who
made the proving of medicines a system.As early as
1790
we see Hahnemann
experimenting with drugs upon himself.In
1796
he writes in Hufeland’s
journal [II,
St. 3,
p. 465.
Lesser Writings, 309
et. seq.] that
the search for specific remedies [In
this place we may observe that the word specific
has a different meaning in homoeopathy to what it has among allopathic
therapeutists. The latter understand by specific remedies such as are
employed for a certain disease ; thus for them quinine is a specific for
ague, mercury for syphilis, &c. The physician who seeks for one
medicine for a form of disease, falls into routine practice.
Homoeopathists understand by specific remedies such as are capable of
influencing under certain conditions, certain organs and tissues, these
and none other.] was the most
desirable and praiseworthy undertaking, but he laments the utter want of
any principle for discovering them ; hitherto experience only has been
the doubtful guide.
“Nothing then remains for us but to test the medicines on our
own bodies.The necessity of this has been perceived in all ages, but a false way
was generally followed, inasmuch as they were only employed empirically
and capriciously in diseases.” In this way, he continues, no
certain results could be gathered, more especially as medicines were
given mixed together.” The true physician whose sole aim is to perfect his art can
make use of no other information concerning medicines , than :” First, what is the pure action of each by itself on the
healthy human body.” Secondly, what do observations of their action in various
simple or complicated maladies teach us ?”In order to ascertain the actions of drugs on the healthy body, he
recommends proving on ourselves and the study of records of poisoning.” A complete collection of this kind of information with
estimation of the degree of reliance to be placed on their reporters
would be, if I am not very much mistaken, the foundation stone of a
materia medica, the sacred book of its revelation…. “He zealously occupied himself and others who devoted themselves to it
with the proving of medicines, the collection of cases of poisoning and
the formation from the results thus arrived at of a materia medica which
should be free from all assumptions and founded only on experiment.His great endeavour was to found a physiological materia medica.
His first essay of this kind was called,
Fragments
de viribus medicamentorum positivis, Lipsiae , 1805,
wherein he arranged systematically the results of his provings and of
his studies.He himself says of it in the preface :
”
Nemo me melius novit,
quam manca sint et tenua.”
Nevertheless a merely superficial glance at this collection will show
with what devoted diligence and earnestness of conviction he worked at
it.The book consists of two parts, of which the first contains
269,
the second with the repertory of the first, 470
pages.The drugs in this work whose effects he partly proved on himself and
partly gleaned from the toxicological observations of others, are the
following in their order :Aconitum napellus, tinctura acris (
Hahnemann’s
causticum),
Arnica,
Belladonna,
Camphor,
Lytta vesicatoria (cantharides),
Capsicum annuum,
Chamomilla,
China,
Cocculus,
Cuprum vitriolatum,
Digitalis,
Hyoscyamus,
Ignatia,
Ipecacuanha,
Ledum palustre,
Helleborus niger,
Mezereum,
Nux vomica,
Opium,
Pulsatilla,
Rheum,
Stramonium,
Valeriana,
Veratrum album.In the same year,
1805,
he says in his Medicine of
Experience : [Lesser Writings,
p. 514.]
”
those substances
which we term medicines are unnatural irritants, only calculated to
disturb the health of our body, our life and the functions of our
organs, and to excite disagreeable sensations, in one word to render the
healthy — sick.There is no medicine whatever which does not possess this tendency,
and no substance is medicinal which does not possess it.”Therefore he required the most exact proving of drugs on the human
body in order to ascertain their powers.
Substitutes for foreign drugs.
In the following year,
1806,
Hahnemann
contributed another essay on drug provings and minute individualization
to Hufeland’s
Journal.
[On Substitutes for China, XXIII. St. 4,
p. 27.
British Journal of Homeopathy, XLII. 212.]Two years later he discourses
[All.
Anz. d. D., No. 237.
Lesser Writings, p. 574.]
in his article
On substitutes for foreign
drugs and on the recent announcement of their superfluousness, in
the following manner :Let us only teach physicians principles of universal applicability
according to which the powers of drugs may be ascertained and tested
with certainty, as to what each is incontrovertibly useful and suitable
for, to what cases of disease each is unexceptionably adapted, and what
is the proper dose……But we are by a long way not so far advanced as this.
No principles are yet universally recognised, according to which the
curative powers of medicines (even of such as have never yet been
employed at the sick bed) can with certainty be ascertained a priori,
without first subjecting them to the infinitely tedious process of
testing them in haphazard fashion at the sick bed, which is almost
never convincing and is usually attended with injurious effects.This obscure mode ab effectu in morbis whereby little or
nothing is determined, has, moreover, the cruel and unpardonable
disadvantage that the individual, naturally so irritable when diseased,
is apt to be made worse by so many blindly instituted experiments, and
may even fall a victim to them, especially since the recent fashion of
prescribing large doses of powerful medicines has been adopted.But as long as the former better method is not established in the
State, and the latter mode only is so, which has been from the beginning
acknowledged to be unserviceable and insufficient — so long will
contradictory opinions of physicians relative to the curative powers of
medicines continue.A glaring instance of these ” contradictory opinions of
physicians ” had just been given : the Vienna medical faculty had
pronounced cascarilla quite superfluous,[In
consequence of the continental blockade there occurred a sensible
deficiency of foreign drugs, particularly for the immoderate doses of
medicine then in vogue. That most keenly felt by physicians was the want
of cinchona bark, for which a vast number of substitutes, mostly
complicated mixtures of bitter drugs, was proposed. (Hahnemann
repeatedly declared that there could be no surrogates in the sense
attached to the word by his colleagues, and in 1808
advised as the best help out of the difficulty that it should be noted
that when the medicine was suitable such large doses were not required).
Difficulties were also experienced from the failure of the supply of
other drugs which the Vienna Faculty sought to overcome by publishing in
the Allg. Anz. d. Deutschen, 1808,
10.
305,
a list of foreign medicines which they alleged to be ” quite
superuous,” as for instance Peruvian balsam, copaiba, cina,
colocynth, sarsaparilla, senega, tamarinds, &c.] while
the well-known Professor Hecker,
of Berlin, in No. 221
of the Allgemeiner Anzeiger der
Deutschen maintained —
” Cascarilla is not only equally efficacious with cinchona bark in
intermittent fever, but is even preferable.”Hahnemann
showed that this was
an unwarrantable assumption, because Hecker
never employed cascarilla alone, nor does he mention in what kind of
intermittent fever he gave it.
Mode of Action of Bark in Ague.
Similia Similibus.
In order to learn what that ” better method ” referred to
is we most go back some years.In the
Instruction to
surgeons concerning venereal diseases,” 1789,
[Lesser Writings, p. 97.]
Hahnemann
speaks of the moot : of action of mercury, which he alleged to be a
counter-irritant action on the body, gave a description of in its most
developed form, and called ” mercurial fever.”He had thus already left the beaten track, for it was the fashion to
believe that it acted by removing the ” miasma ” by means of
salivation, sweat, diarrhoea or urinary secretion.Hahnemann
considered the
production of his ” mercurial fever” necessary for the cure of
syphilis.In the following year,
1790,
Hahnemann
translated Cullen’s
Materia Medica. Cullen
(II. 108)
explains the efficacy of cinchona in intermittent fever by the ”
strengthening power it exerts on the stomach,” and adds, ”
that he has never met with anything in any book which made him doubt the
truth of his view.”Hahnemann
rejects this
explanation in a note, and adds :Let us consider the following : — Substances such as strong coffee,
pepper, arnica, ignatia am arsenic, which cause a kind of fever,
extinguish the periodicity of intermittent fevers.
Hahnemann’s
first proving of Bark.For the sake of experiment, I took for several days four drachms of
good cinchona bark twice a day ;my feet, finger tips, &c., first grew cold, I became exhausted
and sleepy ; then my heart began to palpitate, my pulse became hard and
rapid ; I had intolerable anxiety, trembling (but not rigor),
prostration in all my limbs ; then throbbing in the head, flushing of
the cheeks, thirst, and in short all the ordinary symptoms of
intermittent fever [Hahnemann
had suffered from ague in Erlangen, Monro, II, 396]
appeared one after another, but without actual febrile rigor.In a word, even the special characteristic symptoms of intermittent
fever, dullness of the senses, a kind of stiffness of all the joints,
and in particular the disagreeable numb sensation which seemed to be
located in the periosteal covering of all the bones of the body, made
their appearance.This paroxysm lasted two to three hours each time and returned when I
repeated the dose, otherwise not. On leaving off the drug I was soon
quite well.On page
115
he mentions that a kind of artificial fever must be produced by
ipecacuanha in order to cure certain forms of intermittent fever.In
1791
his translation of Monro
appeared (1794,
a second unaltered edition).Here, also, he holds the view (II.
333)
that “in insidious fevers from unknown causes in which the vital
force is sluggish, a new, strengthening and efficacious fever” must
be excited.In the chapter on cinchona, he again declares against “its tonic
action ” as the cause of its febrifuge property. (II. ;78)
”If, however, we accept the view given at length in my note in
Cullen’s
Mat. Medica, that
bark in addition to its tonic action, overpowers and suppresses the
intermittent fever chiefly by exciting a fever of short duration of its
own, it will not be difficult to explain this paradox.All other substances capable of exciting counter irritation and
artificial fever, given shortly before the paroxysm, check intermittent
fever quite as specifically, but they cannot be relied upon with such
certainty.””
Similia similibus”
had not been pronounced, though he remarks (II. 181)
that the mercurial disease resembled that of syphilis, without making
any application of the resemblance.He started with the idea of aiding the inherent recuperative power by
a medicina excitant acting directly on the part affected, while his
contemporaries were talking of resolving obstructions, expelling
acridities and evil humours, removing the ” morbid over-produced,
accumulated inflammatory blood” from organs, remedying poverty of
blood, counter-irritating, altering, strengthening, astringing, giving
tone, &c.
Contraria contrariis curentur.
As a therapeutic axiom, he first alludes to the
simile
in the year 1796,
in the well-known article in Hufeland’s
Journal : Essay on a new
principle for discovering the curative power of drugs. [Lesser
Writings, p. 295.]In the first place he speaks of the several ways adopted in practical
medicine for treating the pathological changes of the body.
The first way, to remove or destroy the fundamental cause of the
disease,was the most elevated
it could follow. All the imaginings and aspirations of the best
physicians in all ages were directed to this object, the most worthy of
the dignity of our art.Further on he speaks of this method as above all criticism, but says
that the drugs chosen were not always those best adapted for the
purpose.I shall now take leave of this royal road, and examine the other two
ways of applying medicines.The author then mentions the drugs which act according to the
principlecontraria contrarily,
for instance, purgatives in
constipation, venesection, cold and saltpetre in inflammations, alkalies
in acidity of the stomach, opium in neuralgia.In acute diseases, which, if we remove the obstacles to recovery for
but a few days, Nature will herself generally conquer, or if we cannot
do so, succumb ; in acute diseases, I repeat, this application of
remedies is proper, to the purpose and sufficient, as long as we do not
possess the above-mentioned philosopher’s stone (the knowledge of the
fundamental cause of each disease, and the means of its removal), or as
long as we have no rapidly acting specific.In chronic diseases, he contends, the mode of treatment according to
contraria
contraries must be rejected ;
it is improper to treat constipation by purgatives, the excited
circulation of hysterical, cachectic and hypochondriacal patients by
venesection, acid eructations by alkalies, chronic pains by opium,
&c.And although the great majority of my medical brethren still adhere
to this method, I do not fear to call it palliative, injurious
and destructive.
I beseech my colleagues to abandon this method (contraria
contraries) in chronic diseases, and in such acute diseases as tend
to assume a chronic character ; it is the deceitful bye-path in the dark
forest that leads to the fatal swamp.The vain empiric imagines it to be the beaten highway, and plumes
himself on the wretched power of giving a few hours’ ease, unconcerned
if, during this specious calm, the disease plant its roots still deeper.But I am not singular in warning against this fatal practice.
The better, more discerning and conscientious physicians have from
time to time sought for remedies (the third way) for chronic
diseases and acute diseases tending to chronic, which should not cloak
the symptoms, but which should remove the disease radically, in one word
for specific remedies…..But what guided them, what principle induced them to try such
remedies ?Alas ! only a precedent from the empirical game of hazard, from
domestic practice, chance cases in which these substances were
accidentally found useful in this or that disease, often only in
peculiar unmentioned combinations, which might perhaps never again occur
; sometimes in pure simple diseases.It were deplorable indeed if only chance and empirical hap-hazard
could be considered as our guides in the discovery and application of
the proper, the true remedies for chronic diseases, which certainly
constitute the major portion of human ills.In order to ascertain the actions of remedial agents, for the purpose
of applying them to the relief of human suffering, we should trust as
little as possible to chance, but go to work as rationally and as
methodically as possible.He then demands provings of drugs on the healthy organism, as he had
already mentioned.By them alone can the true nature, the real action of medicinal
sub-stances be methodically discovered ; from them alone can we
learn in what cases of disease they may be employed with success and
certainty.But as the key for this is still wanting, perhaps I am so fortunate
as to be able to point out the principle under the guidance of which the
lacunae in medicine may be filled up, and the science perfected by the
gradual discovery and application on rational principles of a
suitable specific remedy for each, more especially for each chronic
disease, among the hitherto known (and among still unknown) medicines.It is contained I may say in the following axioms.
Every powerful medicinal substance’ produces in the human body a
peculiar kind of disease, the more powerful the medicine, the more
peculiar, marked and violent the disease.We should imitate nature,
which sometimes cures a chronic disease
by superadding another, and employ in the (especially chronic) disease
we wish to cure, that medicine which is able to produce another very
similar artificial disease, and the former will be cured ; similia
similibus.
Different modes of Drug-Action.
We only require to know, on the one hand, the diseases of the human
frame accurately in their essential characteristics and their accidental
complications, and on the other hand, the pure effects of drugs, that
is, the essential characteristics of the specific artificial disease and
attendant symptoms caused by difference of dose, form, &c., and by
choosing a remedy for a given natural disease that is capable of
producing a very similar artificial disease, we shall be able to cure
the most severe diseases.This axiom has, I confess, so much the appearance of a barren,
analytical formula that I must hasten to illustrate it synthetically.Before he enters upon this he makes a few more remarks on the mode of
action of medicines.Most medicines have more than one action ; the first a direct action,
which gradually changes into the second (which I call the indirect
secondary action).The latter is generally a state exactly the opposite of the former.
In this way most vegetable substances act.But few medicines are exceptions to this rule, continuing their
primary action uninterruptedly, but of the same kind, though always
diminishing in degree, until after some time no trace of their action
can be detected, and the natural condition of the organism is restored.Of this kind are the metallic (and other mineral ?) medicines, e.g.,
arsenic, mercury, lead.If, in a case of chronic disease, a medicine be given whose direct
primary action corresponds to the disease, the indirect secondary action
is sometimes exactly the state of the body sought to be brought about.Palliative remedies do so much harm in chronic diseases, and render
them more obstinate, probably because after their first antagonistic
action they are followed by a secondary action, which is similar to the
disease itself.In the ” elucidation by examples ” of his therapeutic
principle, he cites a number of drugs.Hahnemann
here commits a great error, the greatest possible under the
circumstances.He leaves the method by induction too soon, and assumes the truth of
many effects of drugs which he should first have tested.Various hypotheses are quoted instead of evidence, while other
examples are very unsatisfactory.If he had only made use of unassailable demonstrations as he did with
belladonna, mercury, arsenic, aconite,. veratrum album, ipecacuanha,
rhus, and discarded all doubtful matter, he would have much better
served his cause.
Examples
of Homoeopathic medication.We shall here quote some of
Hahnemann’s
evidence, we must, however, not forget that he was a child of his times
and could not have the knowledge of our day.Belladonna excites mania and convulsions, therefore it is effectual
in certain cases of insanity and epilepsy. ” Its great tendency to
paralyze the optic nerve, renders it, as a similarly acting substance,
an important remedy in amaurosis, in which I have myself seen very good
results.”It produces a kind of sleeplessness and cures it. Belladonna has been
found useful in serous apoplexy, and it produces similar states.Hyoscyamus produces and cures a certain kind of mania. It excites
convulsions and is, therefore, beneficial in epilepsy.For similar reasons it sometimes cures chronic sleeplessness.
Mercury produces rodent ulcers and caries of the bones ; ”
experience has confirmed the usefulness of this specific.”Arsenic, according to
Hahnemann’s
own experience, is very apt to excite febrile rigors and a paroxysm
recurring daily, each time weaker.It is there-fore a curative drug in intermittent fever.
Hufeland
remarks thereupon
in a note : ” I must here remark with all due deference to the
author, that I cannot yet accept the internal use of arsenic in
intermittent fever.”Arsenic causes many chronic skin eruptions and also cures them under
certain conditions.Rhus causes erysipelatous skin eruptions and can heal them.
Rheum causes diarrhoea and cures certain kinds.
Every physician who studies
Hahnemann’s
writings in an impartial spirit, must come to the conclusion that with
many faults he was honestly anxious to find in the mighty chaos of
assumptions, guesses, theoretical speculations and bewildering variety
of experience, a firm footing on the ground of natural science for the
foundation of medicine.From some remarks of
Hahnemann
in the following years, we see that he was quietly and incessantly
occupied with the construction of a therapeutics according to his
principles. In 1799
he remarks in his Apothekerlexicon
(in which he gives
observations on the action of single drugs) with regard to sabina, that
the leaves and oil of this plant have the power of exciting hemorrhages
especially from the uterus, and may be successfully employed in such
affections under certain circumstances.
Also
apropos of
hyoscyamus he alleges that its toxic effects greatly resemble diseases
which can be cured by it. In the following year he recommends belladonna
in scarlet fever on the same therapeutic principle.In
1805
the Medicine of Experience appeared,
in which Hahnemann
pursues the following train of thought. [Lesser
Writings, p. 510.]Every disease is owing to some abnormal irritation of a
peculiar character, which deranges the functions and healthy state of
our organs.To this main maxim he adds two ” maxims of experience ” :
First maxim of experience.
When two abnormal irritations act simultaneously on the body,
if
the two be dissimilar, then
the action of the
one (the weaker) irritation will be suppressed and suppressed for some
time by the other (the stronger).
Second maxim of experience.
When the two irritations greatly resemble each other,
then
the one (the weaker) irritation, together with its effects, will be
completely extinguished and annihilated
by the analogous power of
the other (the stronger).He supports these axioms by examples from daily practice and
concludes :In order therefore to be able to cure, we shall only require to
oppose to the existing abnormal irritation of the disease an appropriate
medicine, that is to say, another morbific power whose elect is
very similar to that the disease displays.Further on he says :
It is only by this properly of producing in the healthy body a series
of specific morbid symptoms, that medicine can cure diseases, that is to
say, remove and extinguish the morbid irritation by a suitable
counter-irritation.Every simple medicinal substance, like the specific morbific miasmata
(small-pox, measles, the venomof
vipers, the saliva of
rabid animals, &c.) causes
a peculiar specific disease — a series of determinate’ symptoms, which
is not produced precisely in the same way by any other medicine in the
world.
In order to follow still further this natural guide, and to penetrate
more profoundly into this source of knowledge, we administer these
medicines experimentally, the weaker as well as the stronger, each
singly and uncombined, to healthy individuals with caution and
care-fully removing all accessory circumstances capable of exercising an
influence ; we note down the symptoms they occasion precisely in the
order in which they occur, and thus we obtain the pure result of the
form of disease that each of these medicinal substances is capable of
producing, absolutely and by itself, in the human body.In this way we must obtain a knowledge of a sufficient supply of
artificial morbific agents (medicines) for curative implements, so that
we may be able to make a selection from among them. My Fragmenta de
viribus medicamentorum are something of this sort.From this method of employing drugs he distinguishes the palliative
method, according to which purgatives are given in constipation, opium
in pain, cold in inflammation, &c.We cannot refrain from quoting the following paragraphs, though we
may be accused of repetition.If we observe attentively we shall perceive that wise nature produces
the greatest effects with simple, often with small means. To imitate her
in this should be the highest aim of the reflecting mind. But the
greater the number of means and appliances we heap together in order to
attain a single object, the farther do we stray from the precepts of our
great instructress, and the more miserable will be our work.With a few simple remedies, used singly one after the other, more
frequently however with one alone, we may restore to normal harmony the
greatest derangements of the diseased body, we may change the most
chronic, apparently incurable diseases (not unfrequently in the shortest
space of time) into health — whereas we may, by the employment of a
heap of ill-selected and composite remedies, see the most insignificant
ailments degenerate into the greatest, most formidable and most
incurable diseases.Which of these two methods will the professor of the healing art, who
strives after perfection, choose ? A single simple remedy is always calculated
to produce the most beneficial effects, without any additional means ;
provided it be the best selected, the most appropriate, and in the
proper dose. It is never requisite to mix two of them together.We administer a medicine in order if possible to remove the whole
disease by this single substance, or if this be not completely
practicable, to observe from the effect of the medicine what still
remains to be cured. One, two, or at the most three simple medicines are
sufficient for the removal of the greatest disease and if this result
does not follow, the fault lies with us. ; it is not nature, nor the
disease, that is to blame.[Lesser
Writings, p. 533.]
Now, as in every case, only a single simple medicinal substance is
necessary, no true physician would ever think of degrading himself and
his art and defeating his own object, by giving a mixture of medicines.It will rather he a sign that he is certain of his subject if we find
him prescribing only a single medicinal substance.[Lesser
Writings, p. 536.]In this work he attempts to support his therapeutic principle by
quotations from the writings of the older physicians.Occasionally, however, physicians suspected that it was that property
of medicines (now confirmed by innumerable observations) of exciting
(positive) symptoms analogous to the disease, by virtue of a tendency
inherent in them, which enabled them to effect real cures.But this ray of truth, I confess, seldom penetrated the spirit of our
schools, enshrouded as they were in a cloud of systems.He adds the names of
Detharding,
Major, Brendelius, Dankwerts,
and in the Organon he
also mentions Bertholon,
Thoury, Störck and the Dane Stahl.In Hufeland’s
journal[Vol.
XXVI., St. 2,
pp. 5
and 6.
] he
says in 1807
:Though here and there a wise man was found who had the courage to
oppose the general ideas and to advocate ” similia similibus,”
this proposition did not find general acceptation.Hahnemann
adds later on in the Organon
: [Dudgeon’s translation, p. 106.]I do not bring forward the following passages from authors who had a
presentiment of homeopathy as proofs in support of this doctrine, which
is firmly established on its own merits, but in order to avoid the
imputation of having suppressed these foreshadowings with the view of
securing for myself the credit of the priority of the idea.He might well say, however :
[Organon,
1st
edit., p. 5.]” None has as yet
taught this homoeopathic
therapeutic doctrine ; ” emphasis being placed on the word ”
taught.”
Contempt for symptomatic treatment.
In the year
1807,
in Hufeland’s ,journal, he
attempts to support his therapeutic principle by very numerous
quotations of the observations of earlier physicians, [Fingerzeige
auf den homöopathischen Gebrauch der Arzneien in der bisherigen Praxis,
vol. XXVI., St. 2,
p. 5-43.
This is given in Dudgeon’s translation of the Organon.] in
addition to his former instances.But here again he allowed himself to be carried away by his zeal ;
the selection of his evidence was not sufficiently careful, so that his
opponents in many cases easily discovered inaccuracies.
Hahnemann’s
views respecting disease and his examination of the patient.As early as in
1786
Hahnemann
blames the treatment of single symptoms of a disease instead of the
disease itself, the ” white-washing ” of symptoms as he calls
it (Preface to Arsenical
Poisoning).
He speaks to the same effect in various other places, as e.g., in
1800,
in the preface to the Arzneischatz
. [Lesser Writings, p. 402.]And thus as though they were independent beings endowed with free
volition, each ingredient in a complete prescription has its task
allotted to it, vel invitissima Minerva Hygeiaque, and many other
things are expected of it ; for there are many learned considerations in
a regular classical prescription.This indication and that one must be fulfilled, three, four and more
symptoms must be met by as many different remedies.Consider Arcesilas ! how many remedies must be artistically combined
in order to make the attack at once from all points. Something for the
tendency to vomit, something else for the diarrhœa, something else for
the evening fever and night sweats.And as the patient is so weak, tonic medicines must be added, and not
one alone, but several, in order that what the one cannot do (which we
don’t know) the other may…..
But what if all the symptoms proceeded from one cause, as is almost
always the case, and there were one single drug that would meet all
these symptoms.In order, however, to obtain an accurate picture of the disease, he
insisted on a minute examination of the patient and all his symptoms.He thus writes in
1805
in Medicine of Experience : [Lesser
Writings, p. 505.]
The internal essential nature of every malady, of every individual
case of disease, as far as it is necessary for us to know it for the
purpose of curing it, expresses itself by the symptoms as they
present themselves to the investigations of the true observer in their
whole extent, connexion and succession.When the physician has discovered all the observable symptoms of
disease that exist, he has discovered the disease itself, he has
attained the complete conception of it requisite for the cure.To enable us to perform a cure, we require to have a faithful picture
of the disease with all its manifestations, and in addition, when this
can be obtained, a knowledge of its predisposing and exciting causes, in
order, after effecting the cure by means of medicines, to enable us to
remove these also, by means of an improved regimen, and so prevent a
relapseThe patient relates the history of his ailments, those about hint
describe what they have observed in him, the physician sees, hears,
feels, &c., all that there is of an altered or unusual character
about him, and notes down each particular in its order, so that he may
form an accurate picture of the disease.In the following pages he gives ample instructions as to what
questions should be asked the patient and how he should be examined. He
himself kept a very minute record of the cases of his patients. In each
case he noted exactly the history and course of the disease down to the
very minutest symptoms and deviations from health. For this purpose he
often spent hours examining his patient.He also informed himself of the hygienic conditions of the abode,
mode of life, preparation of food, occupation of his time, &c. ;[Comp.
Hahnemann’s
Leben von Albrecht, Leipzig, 1875,
p. 90,
also Elias, Hom. Gurkenmonate, Halle, 1827,
p. 29.]
all this at a time when
physicians, with few exceptions, limited their energies to writing
prescriptions.These investigations of the disease were more and more minutely
conducted by him as he became more and more convinced in the course of
time that every disease had a special individual character.We very soon find him an enemy to all classifications and
generalisations as the reader is already aware from his own words.[Comp.
Apothekerlexicon, II, p. 88
; then II., part 2,
pp. 62,
99,
tom, 123,
151,
152.
“The physician who for every pain, every cough, every diarrhoea,
has recourse to opium, is an out and out quack,” pp. 2206,
244,
282,
327,
330,
350,
356,
358,
364,
393,
399,
432,
450,
469.]
Criticism of the ordinary practice
of giving mixtures of unknown drugs.Here we may quote a few of
Hahnemann’s
characteristic remarks in the Arzneischatz,
of 1800,
in which he insists upon the exact diagnosis and investigation of
individual varieties of disease :” I think it a pity that no distinction has been made between
the many varieties of dropsy, and that only one dropsy is spoken of. The
division into leucophlegmatic and inflammatory is not nearly adequate,
any more than that of insanity into mania and melancholia. What should
we think of a botanist who recognised no division of plants except into
trees and herbs ?” (page71)
When pareira root is recommended,
Hahnemann
exclaims :” Must it then be given in all cases of renal and vesical
disease without exception ? What a noble remedy it must be if it can
cure them all ! ” (page227.)
Cinchona bark is recommended in a particular minutely described case.
Hahnemann
says :
— ” A single accurate description of a case, such as this, in
which a drug should be employed, is worth a whole bulky volume of
empirically jumbled prescriptions, though compondedsecundum
artem.” (p. 202).The time of administration and the duration of the action of cinchona
are spoken of, and the contradictory views of the best physicians,Cullen,
Werlhof, Morton, Talbor,
&c., given.On this
Hahnemann
says :” How exact must have been the observations of the physicians
who after their employment of one of the most extensively used
medicines,bark, for
more than 160
years in a disease marked by characteristic symptoms of the most
well-defined kind, neither knew the proper time for its administration
nor how long its action lasted. (I found that its action ended twenty
hours after its administration.) How can they presume to give reliable
instruction with regard to the action of more rarely employed drugs in
less characteristically defined diseases ?” (p. 245)A mixture of chamomile, myrrh and potash is recommended in ague.
Hahnemann
:” These one-sided modes of procedure cannot lead us to the
discovery of the truth. In the empiric powder described above, chamomile
flowers were by far the most powerful ingredient, and they possess a far
greater febrifuge power than myrrh, especially in those kinds of
intermittent fever in which a febrile rigor is coincident with internal
and external heat. As long as they do not recognise exact symptomatic
distinctions, our physicians will be no better than learned-looking
quacks.” (p.258)
Apropos
of a ”
bolus,” composed of ammonio-muriate of iron and sal-ammoniac, of
each eight grains, oxide of iron, 3
grains, and extract of gentian, co grains, to be taken twice a day in
ague, Hahnemann
says :“We should be told exactly in what kind of intermittent fever
this wonderful mixture was of use. Why precisely so many grains of each
ingredient ? Did the Delphic oracle ordain those proportions, which are
therefore to be regarded as a revelation ?If an unfavourable condition is excited in a patient by this mixture,
to which ingredient is it to be attributed ? And why must
ammonio-muriate of iron be given specially when the sal ammoniac and
oxide of iron already form ammonio-muriate of iron — that is muriate
of iron and ammonia in the stomach ? No explanation is offered on these
points.We must give it exactly as it is in every kind of intermittent fever
!Sic bene placitum. Blessed
are those who believe without reasoning.” (p. 265)The receipt for a ” mild, agreeable and cheap ” stomachic
is given.Hahnemann
:” We cannot imagine anything more empirical than the unqualified
recommendation of one remedy as a stomachic in all cases. More general
and empirical were not the recommendations ofNicander,
Dioscorides, Largus, Macer or
the Salernitan school.Will the day ever dawn ? I doubt it.” (p.
278)
In the preface (IV. note)
Hahnemann
writes :“Indolent ignorance has always tried to find specifics, that is,
remedies which would cure a whole class of diseases, e.g., intermittent
fevers in general, without regard to special cases.There can, however, from the very nature of things be no such
remedies any more than there can be one universally applicable process
for extracting copper in the most perfect manner from all different
kinds of ore, in whatever variety of combinations the metal may exist in
nature.
Objection to nosological
classification.There can be no such general remedies.
But for each single case of disease, there is a particular remedy,
created so to speak by nature for the purpose, which better deserves the
name of a specific.”[Comp.
ib., 184,
241,
253,
268,
275,
291,
293,
302.
].In
1808,
in Medicine of Experience ,
[Lesser Writings, p. 502.]
Hahnemann
asserts the following :Hence it happens that with the exception of those few diseases that
are always the same, all others are dissimilar and innumerable,
and so different that each of them occurs scarcely more than once in
the world, and each case of disease that presents itself must be
regarded (and treated) as an individual malady that never before
occurred in the same manner and under the same circumstances as in the
case before us, and will never again happen precisely in the same way.This conception evidently is pushed too far, and even
Hahnemann
himself does not rigorously follow it. He even wished to see the names
of diseases abolished, though he makes the following observation :We observe a few diseases that always arise from one and the same cause,
e.g., the miasmatic maladies [no distinction was made in those days
between miasma and contagium], hydrophobia, the venereal disease, the
plague of the Levant, yellow fever, small-pox, cow-pox, the measles and
some others which bear upon them the distinctive mark of always
remaining diseases of a peculiar character ; and because they
arise from a contagious principle that always remains the same, they
also always retain the same character and pursue the same course,
excepting as regards some accidental concomitant circumstances, which,
however, do not alter their essential character.This observation does not accord with what was previously advanced,
but the imperfect state of diagnosis in those days must be remembered.But putting aside this,
Hahnemann
deserves the credit of having insisted upon the strictest
individualization of diseases, and he showed its necessity more
conclusively than any other physician.Classification is so convenient and easy that most medical men
incline to it.Hahnemann
always advocated individualization, and taught it systematically in his
numerous works.
Large doses originally prescribed.
Hahnemann’s
method of preparing medicine.Hahnemann
‘s homoeopathic method
of preparing medicine distinguished him more than anything else from all
other physicians of all times. We will here trace its evolution.At the commencement of his practice he naturally gave the usual
doses.In
1784,
[Guide to the Radical Cure,
&c. B. J. of H. XLII., p. 132.]
e.g., he recommends for purifying
the blood, five to fifty grains of crude powdered antimony to be taken
daily, but “only when the body possesses sufficient, I might almost
say a superfluity of strength,” in such cases he gave, “if
necessary, but not frequently, a purgative of twenty to seventy grains
of jalap root once a week.”He taught, in
1787,
that good results could only be expected from conium maculatum if it is
given in sufficient doses to cause giddiness, a feeling as if the eyes
were pushed out of the head, slight nausea, trembling of the body, and
one or several loose stools, ” all signs of a full dose.”
” This varies with the quality of the extract and other
circum-stances. Commonly we pass from four grains a day to several
drachms.”Twelve to fifteen grains of the powdered leaves and root of
belladonna were to be givenevery
other day. ” Some
giddiness should follow the administration of this powerful drug if it
is to do any good.”It is the same with aconite, ” of which the root seems to be the
most powerful part of the whole plant.” The ex-tract prepared from
the juice of the whole plant was to be given in doses from “half a
grain to several grains” several times a day. The “ordinary
dose” of digitalis is half to one spoonful of the freshly expressed
juice of the leaves twice a day.Hyoscyamus was to be given in the form of The extract, ” at
first one grain several times a day, to be increased up to thirty grains
a day,” six to twenty grains of the seeds were to be given.[Kennzeichen
der Güte, &c., pp. 92,
96,
98,
101.]
Hahnemann’s
gradual adoption of small doses of medicine.In
1790,
he gives, in ” nervous fever,” one and a half to two and a
half ounces of cinchona bark (cort. chin. fusc.) in twenty-four hours,
then pauses until its action has ceased.
Cullen
does not notice
aconitum napellus in his therapeutics, he does not even enumerate it
among his “sedatives.”Hahnemann
makes the following
remarks :Aconite is not mentioned. I may remind my readers that it belongs to
the class of acrid narcotic plants, and has a very powerful action.My experience with the extract does not allow me to pass it over in
silence. In chronic erratic gout I have applied some of the
well-prepared extract with the result of speedily relieving pain.Its efficacy is most palpable and striking in chronic rheumatism and
erratic gout, when given internally in sufficient dose to produce its
characteristic symptoms.These characteristic symptoms were ” giddiness, restlessness,
and perspiration.”The first dose which produced this effect should be the last. He
usually gave it for three or four evenings ; the first dose was one
grain, the second two, the third four grains. ” If the third had no
effect, I gave a fourth dose of eight grains.”He then states that he has come across badly prepared extract, of
which one scruple could be taken “without marked effects ;[Comp.
Monro, II, p. 267.]
the cause of its powerlessness was
the way in which it had been prepared.The fresh juice evaporated over a water bath yields the only reliable
extract of aconite, conium, hyoscyamus, belladonna, &c.” (Cullen,
320).In
1791
(Monro,
I. 260),
he holds the same views as in 1789
about the dose of mercury to be given in certain forms of syphilis.
” The ordinary dose for an adult is a half to one grain (of his
merc. solubilis) the first day, the dose to be increased daily by half a
grain, up to the 5th
to 7th
day (not exceeding five grains),” till the so-called mercurial
fever is set up, when it must be discontinued.That he was at this time greatly in favour of powerfully acting
medicines is shown by the following note (Monro
had been saying that fomentations were often sprinkled over with spirit
of camphor before being applied). ” Such feeble prescriptions, of
which contemporary practice can show many instances, we should abandon
to the busy, do nothing practice of the common herd of practitioners.Spirit of camphor should be applied where it is necessary, and
emollient fomentations where they are required.”(ib.
II. 115).
Monro
goes on to say that
he has given cinchona ” in very small doses” for some time in
obstinate fevers.Hahnemann
thereupon remarks,
” This is, indeed, a per-verse manner of administering bark, which
if followed would not give very good results.” (I. 199)
Monro
mentions that people
who had taken eight to ten ounces of cinchona bark in the course of a
month without result, were afterwards cured by taking two to three
ounces daily for two or three days. Hahnemann
:” Even this quantity is not necessary ; we will not over-load
our patient and will attain our object in regular agues as well if we
give, shortly before the expected attack, one or two good doses, say one
and a half to two drachms or more of good bark two hours and one hour
before the commencement of the paroxysm.All doses given long before the attack are of little or no use. If
the attack does occur, a similar dose is given just before the second,
half as much before the third expected paroxysm, and so on.” In
certain cases he was in the habit of employing a ” nauseating
treatment ” by means of small doses of ipecacuanha, in order to
” over-power” some other complaints, such as intermittent
fever, diarrhoea, &c.We shall only mention one other out of the number of examples of
Hahnemannian
posology in this work. Monro writes : ” Hyoscyamus is not used in
England, because the trials with it have been unsuccessful.”Hahnemann
:
” Or because the drug was powerless, not having been properly
prepared or used in suitable cases. I may here remark and insist that
heroic drugs should be given in very small but continually increasing
doses, till some severe symptoms manifest themselves, such as are
produced by the drug given in a rather too large dose.If this is not done, neither hyoscyamus, aconite, belladonna nor
conium can yield valuable results.”
His further advance in
Microposology.In
1792,
he gave Klockenbring,
who was suffering from an attack of mania, twenty-five grains of
tartrate of antimony, a dose ” which only caused him usually to
vomit moderately three times, sometimes even less frequently.”
[Lesser Writings, p. 290,
note.]In the following year he still gave this remedy in doses of five to
twenty grains,[Apothekerlexicon,
I., p. 158.]
and indeed, considered that under certain circumstances this dose was
necessary to save life, ” where ordinary physicians with their
trumpery remedies are slumbering while their patient is dying —
occidit qui non servat.”He considers ambra a good analeptic, but in larger doses than are
ordinarily given. ” Thirty grains must he given according to
Boswell, before the nerves and blood-vessels are agreeably excited ;
smaller doses of the remedy in solution probably suffice.”In
1795,
in cases of fever in which cinchona aggravated, he gave with good
results powdered ignatia ” in large doses : to children
three-quarters of a year to three years old a half to two-thirds of a
grain ; to four to six years old children, one to one and a half grains
; to seven to ten years old children, two to three grains every twelve
hours.”About the same time in an ” epidemic fever,” which he
describes minutely, he gave adults fifteen to sixteen grains of camphor
in the twenty-four hours, “but I soon found that I must give thirty
grains to weak, and forty grains to strong subjects in twenty-four hours
if I wished to produce rapid amelioration.”In more than
100
cases he says he only met with one in which this dose of camphor
produced disagreeable effects, and these were removed by the
administration of half a grain of opium. [Hufeland’s
Journal, V., St. 1,
1797.]In
1798
(Edinb. Disp., II.
362),
he recommended sarsaparilla to be given in ” large doses of a good,
strong decoction.”These few examples of the doses given by
Hahnemann,
selected from a great number of observations and detailed clinical
records, will suffice to show that Hahnemann
at first gave quite as large doses as most, and in some instances even
larger.From this time forth his doses become gradually smaller, but not
uniformly so with all drugs. In1800
(Arzneischatz : , p. 25),
he agrees with Bell’s
opinion that a more powerful action on the system is obtained in
syphilis, if an equal quantity of mercury is given in a shorter time
than when employed for six months as an ” alterative.” Mercury
in syphilis is the only instance after 1799
in which he recommends stronger doses.If we
examine
his prescriptions more narrowly, we sec that, apart from his laudable
endeavours to attain to simplicity of treatment, he often, especially in
the case of powerful drugs, did not give successive large doses for a
considerable time, but began with small ones and gradually increased
them up to the point of slight toxic action, and then discontinued and
waited the results. In these cases the dose was not repeated till the
action of the previous closes was exhausted.In this we see the practical therapeutist who knew what he was aiming
at, the zealous, careful observer, the conscientious physician.Even in chronic diseases in which it was the common practice to give
powerful drugs not previously carefully proved upon the sensitive
organism, and to continue to give them for weeks and months, he
frequently only gave three or four doses, and then observed the changes
effected by them in the diseased organism, and noted accurately the
duration of their action.This practice was peculiar to him, and distinguished him from all his
colleagues, before and of his time.While, on the one hand, he was in favour of vigorous treatment, we
see that he very soon, on the other hand, began to employ some remedies
in small doses, and gradually increased the number of these remedies,
though at first he did not raise the smallness of the dose to a general
therapeutical principle. He first only accumulated experiences and
carefully conducted observations. These labours remind us of his
chemical researches, in which it was his constant endeavour to ascertain
the limits of the action of substances.
His doses of Arsenic, and of the
Narcotic Medicines.He advises caution in the use of drugs in various places, for
example, inCullen
(II., 265)
: ” Though I have above remarked that I thought the smallness of my
doses was the cause of the unfortunate result, this ,must not induce
beginners to give unusually large doses of opium in such cases.”Further on (II.,
496)
he warns us against Cullen’s
practice, who ” was firmly convinced that mercury acts against
syphilis by increasing the amount of the evacuations, whereby the poison
is removed from the body,” and his consequent recommendation of
“the long-continued and ample administration of mercury.”He repeats this warning in
Monro
(I. 335),
and in the Edinburgh
Dispensatory (I.,
440).His employment of what was considered in those days an unusually
small dose, is seen as early as1787
(Kennzeichen der Güte, &c., p.
223),
with regard to arsenic, which he recommends as a good external
application in “indolent ulcers,” in a solution containing one
part in 30,000
of water.Glauber salt ” in small doses is a diuretic, the merits of which
have not yet been sufficiently appreciated.” (ib., p.279)
In
1790
(Cullen,
II., 289),
in a woman seventy-six years old, he rapidly cured “a violent
vomiting uncomplicated with indigestion, probably caused by a
chill,” by means of a piece of linen rag soaked in laudanum laid on
the pit of the stomach.In
1791
(Monro,
II., 326),
he recommended to commence giving narcotic vegetable medicines
“invariably in very small doses.”In
1793
he speaks of the employment of arsenic, which was then occasionally
given in doses of half to one grain with disastrous results, so that Hufeland,
in 1796,
contended against its employment at all in medicine, and almost all the
physicians of the day agreed with him.As early as
1787,
Hahnemann
had written : [Kennzeichen der
Güte., &c., p. 223
; comp. also his work on Arsenical Poisoning , 1786,
p. 38.]” For several centuries timid attempts have been made to employ
its powerful action in medicine.”He then details his method of treating ulcers, and continues : ”
I will not speak of the attempts to cure ague with it, for fear lest a
disastrous abuse of it should ensue.” So the therapeutic use of
arsenic lay under a ban from whichHahnemann
released it for ever.In
1793
(Apothekerlexicon, Part I.) he
recommended a dose of one-tenth to one eighth gr. of arsenic instead of
the usual dose of three to five times that quantity. ”In future times, when we may expect physicians to be more
conscientious, clear-sighted and circumspect, this extremely violent
poison will be converted into an extremely useful remedy for the most
desperate ailments of suffering humanity.”In the treatise from which tie have several times quoted,
On
a new principle, &c., in Hufeland’s
Journal, 1796,
p. 434,
[Lesser Writings, p. 312,
note.] he advises the
administration of the drug selected according to his therapeutic
principle only in a dose just strong enough to produce a scarcely
perceptible indication of the expected artificial malady.He says of belladonna
[Lesser
Writings, p. 322.]
that its action lasts 12,
24
to 48
hours. ” The dose should therefore not be repeated till the lapse
of two days.” Opium in certain cases should only be given every
twelve to twenty-four hours, arsenic seldomer, every two days, in doses
of one-tenth to, at the outside, one-fifth of a grain, in hectic fever
only one-twelfth grain ; the duration of the action of aconite is seven
to eight hours in certain cases ; camphor should only be given every
thirty-six to forty-eight hours, veratrum album every five to ten hours,
agaricus musc. twelve to sixteen hours. ” Rhubarb is efficacious
even in the smallest doses in certain cases of diarrhœa.”In
1797
(Edinburgh Disp. I.,
239)
he recommends belladonna half a grain in two days for adults, and
considers ” one to two grains of good squills a full dose in most
cases,” in contrast to the Edinburgh
Disp. (I. 519),
which prescribes four to ten grains, mixed with twice that quantity of
saltpetre.In the same place stramonium is recommended in doses of ten grains in
“insanity.”
His doses of Nitrate of Silver,
Hyoscyamus, Hellebore, Lead.Hahnemann
thereupon remarks :
” The varieties of insanity are very numerous, so also are its
remedies. This remedy is only useful in some cases, but ten grains is
much too large a quantity to give of a good extract.” (I. 541)In
1798
he insists upon nitrate of silver being given internally only in
solution and very dilute. The Edinb.
Disp., on the contrary, quotes
the authority of Boërhaave
for its administration in doses of two grains, in pills composed of
bread crumbs and sugar (II. 230).It further speaks of the drugs which will destroy the poisonous
qualities of opium without interfering with its medicinal action.Hahnemann
: ” If we wish to deprive strong drugs of their noxiousness, we
must only employ them in suitable cases and in the proper dose. This is
their great corrigens, and there is no other besides this.”In
1799
in the Apothekerlexicon he
expresses the opinion that sabina does good service in certain
conditions even ” in very small doses.”Hyoscyamus was efficacious in certain accurately described morbid
conditions ” in very small doses of one-sixtieth to one-thirtieth
of a grain of the extract prepared according to my method and given in
solution.”One-hundredth and even one-thousandth part of a grain of the
inspissated juice of stramonium, if it was of good quality, usually
sufficed.With regard to veratrum album, he says that the ancients performed
grand treatments with it, but that the moderns avoided it on account of
its dangerous effects ; the truth lay between the two, for this drug
given in doses one thousand times smaller than those in which it was
administered by the ancients, is one of the most valuable remedies.In
1800,
in the
Arzneischatz (p.
56),
he gives rhubarb in one-third
to one-fourth of a grain in the form pf tincture.The English author speaks of an infusion of a drachm of digitalis in
half a pound of water, a tablespoonful to be taken two or three times a
day.Hahnemann
: ” This is too
venturesome. As the duration of the action of digitalis is at. least two
to three days, we should not repeat the dose before the lapse of three
days. If we give the same dose every eight hours for three days the
action of the digitalis will have became nine times as dangerous.If its action is of longer duration, as my experience leads me to
believe, the danger will increase in a greater degree with each fresh
administration.”(ib., S. 125)
When a teaspoonful of tincture of helleborus niger twice a day is
recommended,Hahnemann
remarks : ” This enormous dose should assuredly be diminished to a
twentieth part. Two drops of the strong properly pre-pared tincture of
black hellebore are enough to act power-fully on an adult, and will do
all that is possible to be done in cases where the tincture is
indicated, and if it is not indicated so large a dose will cause
irreparable damage.” (ib., p. 169)
The author recommends an electuary containing cinchona bark. “An
electuary is one of the most inefficacious and disagreeable forms in
which cinchona can be administered,” saysHahnemann.
”We should not seek to introduce the greatest possible number of drugs
into the stomach, but should rather bring them in the most soluble and
efficacious form possible in contact with the nerves of the stomach and
intestines ; then a very small quantity will be found necessary.”(ib.,
S. 197)
The English author recommends pills of sugar of lead and opium ; we
may go up as high as one and a half grain of lead, and “some
patients” may even be given one grain or one and a half to begin
with ; ” it is, however, best to begin with the smaller dose.”Hahnemann
: ‘ ” How undecided is the author in a matter of so much importance
! Sometimes we can begin at once with one and a half grain ; sometimes
it is better to commence with the smallest dose.Indeed, it would be much safer never to give this powerful metal
either in powder or in pill, but always in solution ; neither should we
ever administer it in the form of sugar of lead, for it is at once
precipitated in the stomach.Chloride of lead dissolved in
100
parts of boiling water is better, as it is not precipitated by muriatic
or carbonic acid. We shall find that one or two drops of this for a dose
will do all that can be expected from lead preparations.
His doses of Copper, Mezereum,
Squills, Conium, Arsenic.If they arc not indicated, of what use is the empirical
administration of such large doses as are here recommended ? They must
do harm !” (ib., p.217)
Ammoniaco-sulphate of copper is recommended in the form of pills, at
first one, to be increased to ” as much as the stomach will
tolerate.”Hahnemann
: ” The writer
of this, is convinced that we should never venture to introduce so
powerful a metal into the stomach unless in the dry form, for if given
in solution as sulphate of copper it will almost instantaneously affect
the whole nervous system in a dose 100
times smaller than the pills here advised.” (ib., p.
259)
Apropos
of another
prescription (three drachms of simaruba bark ” if the stomach will
tolerate it “), he says :” Must the doses administered by physicians be so large that
they are almost on the point of being rejected when taken ? Such
veterinary practice applied to human beings, such crude and coarse
methods of treating the delicate human organism, prove the degraded
state of medical practice. The proper drug will be found efficacious in
incredibly small quantities without causing violent commotion.”(ib., p.
279)
In syphilitic periostitis, half a pound daily of the following
preparation is to be drunk : half an ounce of daphne mezereum boiled
with six pounds of water down to four – pounds. The author of this
prescription even prefers a stronger dose.Hahnemann
: ” And this
dose is already six times too large. Do not, please, let us each
prescribe according to our own pleasure, but let us first fairly consult
nature and experience.We must, of course, not use the bark of the root which has been kept
a number of years in coarse powder ; but how can the medical man bother
him-self about everything ? how can he know everything ? It is quite
enough that he leaves this to the apothecary, who leaves it to his
dispenser, to his apprentice, or to his pounder — it is quite enough
that he leaves it to the tender conscience of one of these hired
menials.” (p.321)
À propos
of pills of
conium extract, &c., Hahnemann
:” We must not blame the stomach ; the fault is with the
physician, who is ignorant that a solution of the inspissated juice, in
doses one hundred times smaller ought to be given,and this does as much as these
many hundred times less powerful pills.” (p. 371)Further on we read : ” Our author does not seem to know what an
incredibly small quantity of squills is able to produce remarkably good
effects.”Hahnemann
has two notes, with
regard to the dose of arsenic : ” Two drops of Fowler’s solution
contain about one-sixtieth grain of arsenic, and therefore twenty drops
one-sixth grain, in every case much too large a dose for old or young,
especially as it is recommended to be repeated two or three times in
twenty-four hours, which multiplied experience will not allow me to
advise.” (p. 393)
And further, it having been remarked that arsenic, as a remedy for
intermittent fever, is worse than the disease, Hahnemann
: ” Perhaps so, in the rough hands of the ordinary physician.
Baker
is quite right there.
Apart from this, however, the unqualified recommendation of arsenic in
undefined intermittent fevers is just as wrong as its unqualified
condemnation.Even
a priori, one
may be thoroughly convinced that a powerful substance which can be
diminished in solution to every variety of dose, might be the most
suitable, most innocuous remedy in certain well-defined morbid
conditions. Our physicians of today, however, will not ascertain these
conditions and give the ten-millionth part of a drug, therefore arsenic
should not be used by our contemporaries.” (ib., p. 396)Thus, in the course of years, the number of drugs which he had proved
continually increased, and the results of the zealous and careful
researches of our genial investigator forced upon him more and more the
conviction that the doses hitherto accepted as the normal ones, were
much too large.History records no instance, books give no example of a physician
ever having attempted to determine the question of the suitable dose
with such zealous endeavour as the clear-sighted, indefatigable and
thoughtfulHahnemann.
He remarked from his own experience that those drugs which were
selected according to his principle, consequently in a specific relation
to the affected parts, were therefore calculated to influence them in a
special degree, and sometimes seemed even to act in very small doses
more strongly than was desirable.
Preparation of medicinal
dilutions.He, therefore, proceeded still further in the diminution of the dose.
Here, however, a question of the greatest importance arises : How did
he set about it ? Did he take, say, the ten-millionth part of a grain on
the point of a needle and deposit it on the tongue of his patient ? Did
he, with some kind of instrument, re-divide this particle into a hundred
parts and take a single one of them as the dose to be administered ?His method was as follows : He took one part of a drug and mixed it
intimately with a certain quantity of a suitable vehicle, as sugar of
milk, water or alcohol. Of this preparation he took a fraction and mixed
it, by careful trituration or succussion, with a new quantity of sugar
of milk, alcohol, &c. Of this preparation, he again triturated or
succussed a part with the suitable vehicle, &c.In the year
1801,
[Cure and prevention of scarlet
fever. Lesser Writings s, p. 432.]
he recommends tincture of opium in
certain cerebral symptoms in scarlet fever, and directs that this should
be prepared in the following way : One part of this tincture is shaken
up with 500
parts of alcohol, and a drop of this intimately mixed with 500
drops of alcohol.The patient is to take drop doses of this preparation. We may as well
here state thatHahnemann
later regulated this method systematically by triturating or succussing
one part of the drug with ninety-nine parts of sugar of milk or alcohol
; of this preparation he again took one part and mixed it with
ninety-nine of the vehicle, and so on.These were called the first, second and third trituration or dilution
respectively, or as he termed it afterwards ” potency.”He did not use medicines prepared in this way for the same purposes
as others physicians. He did not advocate their administration to
produce emesis, purgation, or narcosis ; neither did he employ them to
” cleanse the blood of acridities,” or to “combine with
the excess of oxygen present in inflammatory blood.” He did not aim
at ” cutting the phlegm,” ” resolving obstructions,”
” softening indurations,” or destroying parasites.
“
He had discovered that with medicines, selected according to his rule
and which therefore were not meant to effect a revolution in the body,
such preparations influenced favourably the curative process. At first
he himself was astounded at his discovery which he speaks of as unheard
of,” and ” incredible.”He was therefore, all the more anxious to make sure of his ground as
he proceeded, and was not only able to confirm, but even , to extend his
remarkable discovery. In the first years of this discovery he dwelt
emphatically on theweight of
the drug contained in his preparations, and recounted to the astonished
world the results obtained by a millionth, billionth, &c., part of a
grain of medicine.In
1801,
Hahnemann
recommended belladonna in scarlet fever, in doses corresponding to the
third or fourth dilution, and chamomilla in the same way in certain
conditions. [Cure and prevention
of scarlet fever. Lesser Writings, p. 442.
]In
1805,
in his Medicine of Experience, he
says :None but the careful observer can have any idea of the height to
which the sensitiveness of the human body to medicines is increased in
disease. It transcends all belief when the disease has attained a great
intensity……On the other hand it is as true as it is wonderful, that even the
most robust individuals when affected by a chronic disease,
notwithstanding their corporeal strength …… yet as soon as the
medicinal substance positively appropriate to their chronic disease is
administered to them, they experience from the smallest possible dose as
great an impression as if they were infants at the breast.[Lesser
Writings, pp. 528,
529.
]In the year
1806,
he wrote in Hufeland’s
Journal (St.
3,
p. 40),
an article entitled : What are
poisons ? What are medicines ? [Trans.
in Brit. Jour. of Hom., XLII., p. 222.]For the proper comprehension of this article it must be explained
thatHahnemann
had been reproached by Hecker
in 1796
and others for using as medicines dangerous poisons such as the
narcotics introduced by Storck,
and therefore the public should be warned against employing him, as we
shall see more particularly when we come to the chapter on the ”
opposition to homoeopathy.”
As we know,
Storck
introduced into medical practice, aconite, belladonna, hyoscyamus,
colchicum, stramonium, conium and pulsatillain the sixtieth year of the last century, and afterwards found in
Hahnemann
his most active supporter.In
1810,
an author writes in Hufeland’s
Journal (St.
9,
p. 80),
” The practices of Storck,
Hahnemann
and others have the ill-repute of being more hazardous
experiments.”Hahnemann
thereupon writes :
Has the Creator ever laid it down as a law that a scruple or a
grain should be considered the smallest and most appropriate dose
for all medicines, even the most powerful ?Has He not bestowed on us means and knowledge whereby we may diminish
the more and most powerful substances into small and the very smallest
doses and administer them in the tenth of a grain, the more powerful in
the hundredth, the thousandth of a grain, the most powerful in the
millionth, billionth, aye, even the trillionth, quadrillionth and
quintillionth of a grain ?Who prevents us doing this and regulating our doses thus (wisely)
according to the strength of the different medicines ?The circumstance that medicines are only suitable remedies for the
human body in different doses, can furnish the sensible man with no
excuse for branding the more powerful drugs, that is to say those that
can only be used in the smaller doses, with the popular name of poison,
and therefore for spurning these great gifts of God, the very remedies
which are indispensable for the cure of many of the most serious
diseases.But as we can diminish the doses of medicines when they are of
the more powerful kind to any desired fraction of a grain, indeed to the
very smallest fraction, just as easily as we can increase the
doses of medicines of the weaker sort to more than a grain, a scruple, a
drachm, what hinders us from according at least as much respect to those
more powerful medicines as we do to the less powerful ones ? Thus we
shall get rid of the disgrace of having so long echoed the common folk
in their denunciations as poisons of the most powerful instruments for
preserving health and life, and of having so long deprived ourselves and
others of their beneficial use.I confess I have often felt deeply grieved at reading the hard words
applied by many so-called physicians to the valuable labours of Baron
Anton von Storck : ” we protest against this poisoning
practice.”Was not this praiseworthy attempt to furnish us with remedies which
we did not possess, and which could never be replaced by other
substances, was not this philanthropic, highly successful, heroic
attempt worthy of a triple civic crown, of a splendid monument to his
honour ? He struck out the path and we must thank him — by
making use of his gifts, by imitating him, but (as nothing is perfect at
a first attempt) with more cautious doses and a more careful selection
of the , cases of disease for which these powerful plants are suited…..
No sensible man who can lay claim to the character of a scientific
unprejudiced physician should ever again so far forget himself as to
brand with the name of poison substances whose power to alter the human
organism is notorious, and whose medicinal power consequently is beyond
doubt, and by so doing prevent many blessings and set his own miserable
ignorance above these medicinal powers.Where the common folk think they see only objects of horror, there
the wise man sees objects of the deepest veneration and makes use of
them with thankfulness to the Eternal Source of love.
Sapere aude !
This is the first time he makes use of the proud motto which he so
appropriately chose.Subsequently
Hahnemann
discovered that the action of a drug was not proportional to its
quantity, that, e.g, twice
or three times the quantity did not produce twice or three times the
effect ; the diminution of the
action of the drug was not proportionate to the diminution of its
quantity.
Further, he found that with the above mentioned mode of preparation
the efficacy of many drugs, instead of diminishing, increased ; that
medicines so prepared gave results which could not be obtained with the
crude substances. Also the astounding fact became evident that medicines
could be so diluted that neither physics nor chemistry could discover
any medicinal matter in them, and yet they possessed great healing
power.Highly poisonous substances could thus be converted into beneficent
and innocuous remedies, and substances which were easily decomposed, and
therefore tending to become inefficacious, could be converted into a
form in which they were not liable to decomposition, and thereby became
powerful remedial agents in the hands of a skilful physician.This is
Hahnemann’s
greatest discovery, one of the most momentous discoveries ever brought
to light by human research. By this discovery alone he became one of the
greatest benefactors of the human species ; it must inevitably work a
complete revolution in the science of therapeutics, and will make its
way for the weal of suffering humanity in spite of the keen opposition
of university faculties and their unreflecting followers.
Hahnemann’s
discovery of the uselessness of Chemistry and Physics to Therapeutics.No doubt in time the possibility of the action of such medicinal
preparations will be explained by natural science.
Hahnemann’s
attitude towards the sciences auxiliary to medicine and his conception
of disease.That
Hahnemann
was not a contemner of natural science and chemistry he has sufficiently
proved ; he, in fact, overtopped all his contemporaries in his knowledge
of these sciences, as is completely proved by his own writings, without
appealing to Hufeland’s
testimony, who considered him the best chemist among the physicians of
his day.He was not slow to utilize these auxiliaries in the treatment of
disease, as is seen in several places in his writings ; he even
instituted experiments on this subject as his articleOn
Bile and Biliary Calculi,
[Crell’s Chem. Annalen, 1788,
Vol. II., St. 10.]
which we have already quoted,
shows.He took out the liver and gall-bladder of a man, who had just been
shot, and ascertained the action of various reagents on the bile in
order to decide whether these reagents could be usefully employed in
affections of the liver.His attempts to utilize the teachings of the allied sciences in
disease very soon convinced him of the uselessness of efforts in this
direction ; scientific investigation had found no firm foundation to
work upon, and assumptions and speculations overshadowed real knowledge.It is important to enquire : what was his opinion concerning the
influence of natural science and chemistry on the development of
medicine ?On this point he gives the following answer in
Hufeland’s
journal : [1801,
XI. St. 4.
Lesser Writings, p. 615.].“We must go still higher,” insists a celebrated teacher of
dynamology,[Reil seems to be
alluded to here. Comp. his Erkenntniss und Kur der Fieber, Halle und
Berlin, 5
vols. 1799-1815
; also his Archiv für Physiologic, Halle, 1796-1815.]
who has been reared on the etherial milk of critical philosophy, ”
we must mount up to the original source of diseases, the altered
composition and form of matter.”This ontological maxim, however near to the truth it may appear a
priori to the thinker conversant with natural science in general,
and with the probable arrangement of our organism, is entirely useless
to the practitioner ; it cannot be applied to the treatment of
individual diseases.In like manner what Bruce says of the remotest source of the
Nile is of no practical utility at its Delta. Still this teacher of
natural science has approximated much more closely than we might have
expected to what pure experience teaches, in his special views relative
to diseases and particular fevers, and given much less scope to mere
probabilities than his dogmatical and credulous predecessors.Though a love of system guides all his steps, he always honestly
points out where his deductions run counter to the maxims of experience,
and has a wise respect for the latter. The medical thinker may educate
himself under him, but when he is at the sick-bed, let him not forget
that these views are mere individual ideas, mere hints, and that from
them no remedial means can be deduced.Leaving out of sight the unfortunate comparison with the Nile,
Hahnemann
has most ably criticised Reil’s
teachings in these few words. His practical sense, in strong contrast
with the speculative spirit of almost all his con-temporaries,
recognised the value of Reil’s
inductive method, but at the same time saw how his steps were hampered
by natural philosophy. Very few of his contemporaries arrived at so
accurate an estimate of Reil
as Hahnemann.On the other hand he pronounced :
That the practical physician can make no use of this knowledge……
It will not lead to the discovery of a single remedy.” He was right
with regard to those days ; but was he so with regard to the future ?This is a question which will determine the whole direction of
investigation, the basis of all medicine.We will allow
Hahnemann
to answer in his own words, and describe the fundamental lines of his
efforts. This he does in the Organon
(2nd
edition, preface). We must premise that ” experience ” is
equivalent to investigation, “sciences of experience” are the
same as what are now called the ” inductive sciences.” What we
call ” experience ” to-day used to be called ”
empiricism.” We must at the same time recall to mind the various
medical systems, all of which were founded on the imaginings of
physicians and the teachings of natural philosophy then in its most
flourishing state.
Preface to the Second Edition of the
” Organon.”Physicians are my fellow-creatures ; I have no feeling against them
personally. The medical art is my subject. We must ascertain whether
therapeutics as hitherto taught, has been evolved out of physicians’
heads, out of illusion and caprice, or is derived from nature. If it is
only the achievement of speculative refinements, arbitrary axioms,
traditional observance and dogmatic assumptions deduced from dubious
appearances, it is, and must remain a nullity, even though it may date
from thousands of years back and show title-deeds conferred on it by all
the emperors and kings that ever lived.True medicine is from its very nature a pure science of experience,
and should therefore rest only upon pure facts, and the sensible
phenomena belonging to its sphere of action, for all the subjects with
which it is concerned are distinctly and sufficiently indicated to its
sensible appreciation by experience ; knowledge of the disease to be
treated and of the action of drugs and also the mode in which the
ascertained actions of medicines are to be used in curing diseases, can
only be learnt by experience ; its subjects can only be derived from
pure experience and observation, and our science should not venture a
single step beyond the sphere of pure carefully observed experience and
experiment if it wishes to escape degenerating into mere jugglery and
nullity.The following few irrefragable considerations will show that the
whole art of medicine up to this date, though millions of
well-intentioned physicians have adhered to it through two and a half
thousand years for want of a better, is nevertheless in all its parts an
utterly irrational and useless art. The intellect alone can (a
priori) evolve from itself alone no conception of the essential
nature of things, of cause and effect ; there must always be sensible
perceptions for every one of its dicta concerning the actual. Facts and
experience must be at the root of all revelations of truth.If we take a single step outside the region of observation we shall
find ourselves in the infinite kingdom of fantasy and of arbitrary
assumptions, the parent of disastrous delusion and of absolute
nothingness.In the real sciences of experience, in physics, chemistry and
therapeutics, speculative reason therefore can have no voice ; for if it
act alone, thereby becoming the victim to empty assumption and
imagination, it can only produce fantastic hypotheses, which in millions
of cases, are, and from their very nature must be, only delusions and
falsities.Such were the magnificent conjuring games of so-called theoretical
medicine, in which a priori conceptions and assumptions had
erected many imposing scholastic edifices which only showed what their
architects imagined about things they could know nothing of, and which
were not necessary for the art of healing.Medical practice found nothing of any use to it in these sublime
systems which soared a long way above all experience. It went boldly its
own way at the sick-bed, according to the traditional instructions of
its text-books, treating diseases as they had been hitherto treated by
practical authorities, heedless, like its predecessors, of the teachings
of experience, indifferent about having any real grounds for its
practices, quite content with that key to routine treatment — the
prescription manual.A sound, unbiassed judgment of this monstrosity easily discerns that
what has hitherto been called the art of medicine was only a
pseudo-scientific jumble, which, like Gellert’s hat in the fable,
underwent periodical revolutions, in consonance with the fashion of the
day, but in its essential character of a system of treatment always
remained the same blind irrational procedure. There was no such thing as
a true healing art founded on experience ; everything in traditional
medicine was only artifice and imagination in the guise of probability,
but altogether opposed to nature and experience.The disease to be treated was arbitrarily excogitated by pathology.
The number, form and kind of diseases there ought to be, were
dogmatically fixed ; just consider ! all the diseases which are produced
by nature in infinite variety in human beings under thou-sands of
different conditions and in multifarious forms that can never be
foreseen are cut down by the pathologist into a mere handful of
nosological names.Diseases were with superfine subtlety defined a priori, and
hypothetical substrata attributed to them that had no foundation in
experience (how, indeed, could distinct, pure experience lend any
support to such fantastic dreams ?) ; no ! on the contrary, reliance was
placed upon a supposed insight into the inner nature of things and the
invisible vital processes (which, however, is denied to mortals).Also in order to establish something definite in respect to remedies,
they inferred the properties of the individual drugs of the materia
medica from their physical and chemical and other extraneous qualities,
also from their smell, taste and appearance, and especially from their
very impure experience at the sick-bed, where in the tumult of morbid
symptoms only composite prescriptions were used in imperfectly described
cases of disease ; the dynamic spiritual power to alter the health of
human beings, invisibly hidden in the inner essence of medicines, and
never revealed in a pure and true manner save when tested on the healthy
individual, were arbitrarily assumed without the medicines having ever
been interrogated in this way.What had been excogitated, imagined and guessed about medicines,
therapeutics now taught how to apply to the assumed fundamental cause of
disease, or to single symptoms of it, on the principle of contraries (contraria
contraries), according to the doctrine of the hypothesis-framer,
Galen, and contrary to nature, and this doctrine was considered amply
proved if only sufficiently illustrious authorities could be quoted in
favour of it.All these unnatural dicta of man, interwoven with all manner of
illogical and false conclusions were forced into agreement with their
artificial divisions, subdivisions and tabulations, and behold ! that
elaborate house of cards, the art of medicine, was the result ; a thing
altogether opposed to nature and experience, a tissue of guesses and
assumptions, a mere nullity, a pitiful self-delusion calculated to
endanger men’s lives by its blind, unsuitable treatment, which has been
incessantly ridiculed by the wisest men of all ages and which labours
under the curse that it is not what it pretends to be and cannot perform
what it promises !Sober, unprejudiced reflection will convince us that correct views
respecting every case of disease to be treated, the determination of the
true properties of drugs, their adaptation to every morbid condition and
their appropriate dose — in short, the whole true healing art should
never be the work of self-satisfied ratiocination and fallacious
suppositions, but that its requirements, the materials as well as the
rules for its practice, are to be diligently sought in visible nature,
in careful, honest observations and pure experimentation, and in these
alone, without the adulterating admixture of arbitrary dogmas.Only thus shall we be acting in a manner worthy of our object — the
preservation of the precious lives of our fellow-men.I leave it to others to decide whether my conscientious endeavours in
this direction have been successful in discovering the true healing art.
Hahnemann’s
doctrine of the Dynamic nature of disease.The great difference between
Hahnemann
and the later natural-historical school is expressed by himself in one
small word of three letters : “and.” Hahnemann
speaks of ” chemistry, physics and
medical science ; ” they
said : medical science is applied chemistry and physics, and founded
medicine on these two sciences.Hahnemann
stood in still
greater contrast to this school by his “dynamism.”In the first decades of his work and research, starting from purely
material conceptions, he gradually arrived at dynamic views, and indeed,
these occurred to him as a consequence of his pharmaceutical doctrine.Chemical and physical morbid changes were in his opinion dependent
upon the morbid modification of the vital force. “Diseases must be
considered as dynamic derangements of the vital ‘character of our
organism, they must therefore be cured by agents capable of causing
dynamic change.”Further : ” Diseases depend upon no substance, no acridity, that
is upon no materies morbi, but they are solely spiritual derangements of
the spiritual vital force which animates the human body.)[Organon,
Preface, p. X. (Dudgeon’s translation).].Again : ” Therefore a disease (which does not come within the
province of operative surgery) considered as a thing separate from the
living whole, from the organism and its vivifying vital force and hidden
in the interior, be it of ever so subtle a character, is an
absurdity.”[Ib., § 13.]
Force apart from matter is inconceivable. The vital force inhabiting
the organism, must therefore be united with a substance though no doubt
the latter is in a state of infinitely minute division.In the second decade of this century a solution of the problem was
enunciated by the medical investigators of France, which twenty years
later was gradually re-echoed in Germany. “We must localize
diseases,” look for their seat !Hahnemann
considered that most diseases were general affections. So the general
current of opinion, to which we owe much, ran contrary to his views.But to complete this separation of his views from the general bias of
opinion, hisChronic Diseases,
their Peculiar Nature and Homeopathic Treatment, appeared
in 1828.Hahnemann
had for years, as he
says, been incessantly occupied with the endeavour to ascertain the
cause of the heredity of diseases, why one person was subject to a skin
complaint, another to pulmonary, nervous, dyspeptic, &c., disease,
and why chronic diseases so frequently obstinately resisted the
apparently best selected remedies.The habits of life give no satisfactory explanation. The empty
expressions ” it is inherited,” ” it is the
predisposition to disease,” with which the majority of physicians
were, and still are satisfied, did not content his inquiring mind. He
wished to substitute something reliable in their place ; and this was
certainly a praiseworthy endeavour. We have already seen what was the
opinion then prevalent with regard to the ” itch ” and its
consequences.
” Itch ” was a diagnosis which covered many other
affections besides the one now known as ” scabies ” or ”
itch.”Hahnemann
was very fond of the
history of medicine and liked to study medical authors. In the course of
these studies he was struck with the fact that the most frequent cause
of chronic diseases was ” psora,” the “itch
dyscrasia,” and he fills thirteen pages with quotations supporting
this view from the following authors :
Fr. Hoffmann, Morgagni, J. Fr. Gmelin, Hundertmark, L. Ch. Juncker,
Sauvages, E. Hagendorn, Lentilius, Reiland many others, who had observed that almost all chronic diseases were
sequelae of psora.”He was therefore gradually forced to the conclusion that in cutaneous
diseases there was a ” something” which was capable of
producing other diseases, and which, transmitted from generation to
generation, was the remote cause of many diseases.Besides this ” psora ” there were other fundamental causes,
viz., ” sycosis,” the phenomena connected with gonorrhoea, and
” syphilis.” Though there may have been some substratum of
truth in these views,Hahnemann,
nevertheless, far transcended the limits of probability and fell into a
great error.Hahnemann
soon found the most
vehement opposition from his own followers.
Griesselich
writes as
follows, in January, 1836
: [Frescogemälde, I., p. 92.]
”I have questioned all the homoeopaths I know, whether they consider
psora such a fundamental cause of disease, and I must confess that I
cannot remember a single one who thought so.”The Central Congress of Homoeopathists in Frankfort-on-the-Main in
1837,
under the presidence of Dr. Rau,
rejected this doctrine. [Schmidt’s
Jahrbücher XVI I., p. 383.]But the efficacy of
Hahnemann’s
so-called anti-psoric remedies was not therefore denied.Evidently
Hahnemann
— as we have repeatedly said together with his great achievements had
also his weaknesses like every other human being and all geniuses.
Hahnemann’s
services to Pharmacy.Such reformers, endowed with unusual strength, have erratically
formed heads and rugged characters, and whoever attacks their asperities
with the intention of destroying them, may expect the fate which befell
the gnat in the fable who thought it had killed a sleeping lion, but
while it was singing its song of victory, he rose up and went for his
tiny adversary.
Hahnemann
and the Apothecaries.
Hahnemann
‘s labours for the
improvement of pharmacy show his high estimation of this branch of
know-ledge, and how important it appeared to him that the physician
should have the best possible curative instruments at command. Thus he
writes in the Apothekerlexicon (I.
52,
53)
:” Simple drugs collected at the proper seasons in all their
power, and simple preparations made and preserved in the highest degree
of perfection, are the greatest ornaments of a good drug store ; it is
necessary and quite fair to ask the public to pay the full price for
such drugs ; but to sell stale, powerless or even spurious drugs and
preparations badly made, or mayhap converted into poisons in the process
of preparation, at even half-price, is to act the usurer’s part, in many
cases to deprive the suffering of relief, and in some cases even to rob
and murder him — a shameful, criminal action.”In
Trommsdorff’s
Journal der Pharmacie,
[1795,
III., pp. 62
and 63.]
this passage is cited as ”
true, well-expressed and laudable.”What was the state of the drug stores in those days ?
In the preface to
Kennzeichen
der Güte und Verfälschung der Arzneimittel, Hahnemann
quotes a work of Gilbert’s
which draws a vivid picture of the wholesale adulterations of drugs
which was at that time practised in the great seats of commerce, such as
Marseilles, and Hahnemann
adds that the Dutch were not much better for they competed with one
another in supplying adulterated drugs in order to bring down their
price.
The universal adulteration
of Medicines.” German importers,” says
Hahnemann
, “must be armed
with invincible conscientiousness, principles scarcely compatible with
the commercial spirit, if they are to resist the flattering cheapness of
these wares which they buy on trust. They know that their customers, the
shop-keepers and small apothecaries, have to deal with an
indiscriminating public who must take their wares over the counter
without examination, if they only bear the name of the true article ;
and the custom-house authorities are convinced of their genuineness if
only the full duty is paid.” (According to Hahnemann
a few excellent establishments in Prussia and Russia were praiseworthy
exceptions to this mode of trading).Thus the planters of the East and West Indies, in conjunction with
the Dutch manufacturers, through a ring of greedy tradesmen united only
by the craving for high profits, have the welfare of Europe at
their mercy ; and as to the articles they provide us with, after they
have passed through the last hand, we are at a loss which to admire
most, their enhanced prices or the skill displayed in their
adulterations……If we really wish to obtain genuine drugs, the poor apothecary should
not be compelled by elaborate pharmacopoeias to keep all manner of crude
and composite medicines, which not even Galen, Myrepsus
and Zwolfer could preserve from fermentation, mould and vermin.His ability should be tested by competent men, the wholesale dealer
in drugs should surpass his customers the apothecaries if possible in
uprightness, knowledge of his wares and chemical science; the
adulterator of drugs should be punished even more severely than the
coiner ; the inspector of drug stores should bring to his task a greater
amount of knowledge, and the quack who dispenses his own medicines
should be compelled to swallow them himself ; but the man who has the
courage and skill to restore to the Fatherland this branch of trade,
which was taken from us first by the Venetians and then by the Dutch,
should be honoured and rewarded.Certainly there is much to be done before the best medicines can be
placed in the hands of the physician, who sometimes wants nothing more
to enable him to relieve the sufferings of his fellow creatures but that
trifle — reliable instruments.As it was thus often impossible even for an honest apothecary to
procure good wares, little confidence could be felt in the druggists’
shops. In small places especially they were often combined with general
goods’ shops, and not infrequently in the same room.Frequent complaints were made of the ignorance of their owners, who
were even accused of selling drugs which they knew to be spurious.[Crell’s
Chem. Annalen, 1792,
I., p. 259.]If such practices were openly complained of, they must have been of
frequent occurrence.If the apothecary went on a journey in order to purchase drugs —
and this was necessary in those days — he abandoned the making up of
prescriptions and the sale of medicines to his ” apprentice,”
who often knew little or nothing of the art.Even in good, well-supplied neighbourhoods, shops are described where
the drugs stood about covered with dust, in no order and in unsuitable
vessels.[Berlinisches Jahrb. der
Pharmacie, 1795,
p. 197.
]Professor
Trommsdorff
who was himself the owner of a well-known drug-store in Erfurt, still in
existence, narrates [Jour. d.
Pharmacie, 1796,
III., St. 2,
p. 78.]
that he found in many shops the evil practice of using cinchona bark and
rhubarb root over and over again to make decoctions, and other injurious
abuses.Similar and worse practices were reported and lamented in
Crell’s
Annalen. [1792,
I., P. 257.]” We might reasonably suppose that apothecaries who had kept
shops for a number of years would at last become more careful and
skilful in their practice, but in vain ! they will not be weaned from
old ways and routine.”This description is illustrated by a number of examples ” whose
names could be given if required ; ” among them we find (besides
the above-mentioned conscious adulteration of drugs) the following :” An apothecary once asked me what I paid for boracic acid and
saccharic acid, and what they were? Two substances not often asked for,.
and which I imagine are only known to one in ten. It was a disgrace to
any apothecary not to know all about such trifling matters.”
Faulty modes of preparing Extracts of
Narcotic Plants.Many physicians at that time complained of the unreliable quality of
drugs ; especially blame-worthy was the mode of preparing the narcotics
: aconite, belladonna, conium, hyoscyamus, &c., which were usually
only administered in the form of extracts.They differed as much as five or ten times in strength according to
the time they were boiled or the way in which they were kept ; the most
pernicious results sometimes followed their administration, and many
medical men did not dare to prescribe them.Scruple and drachm doses of these poisonous substances were sometimes
given without injury, if the extract was bad, a fact which could not be
known to the physician ; on other occasions, the extract happened to be
good, and a fatal issue was almost inevitable.
Monro
(II. 270)
writes that he had repeatedly seen an ounce of extract of hyoscyamus
given in twenty-four hours. Hahnemann
thereupon directs attention to the boiling of the extract, whereby it
would be rendered as harmless as extract of lettuce.In another place he warns us
(Arzneischatz.
, p. 30)
: ” If we wish to spoil myrrh, an active and unknown drug, we in
Germany make an extract of it. We do not care and, indeed, cannot
estimate how much of the strength of the drug is lost, or how much it is
burnt during its preparation.All the better for us — it is now all the more
secundum
artem ! ”Hahnemann
says (Monro,
II., 222)
that he has seen extract of aconite which could be given in scruple
doses without effect, while three grains of a good preparation would be
a very strong dose.On another occasion he says (Monro, II.,
267),
that if the extract is prepared by boiling — ” and this is the
almost universal practice” — it may be taken almost like a food.
”The medical man — this is my well-founded opinion — should either
make his extracts himself after the afore-said manner (theHahnemannian),
or see that the apothecary does so.”Hahnemann
repeatedly complains
of the untrustworthiness of druggists’ shops :” I know capital towns in which there is not a single apothecary
who knows hemlock ” (ib.) — ” Many drugs are not properly
prepared in many druggists’ shops”(Edinb.
Disp. I, 312)
— ”We cannot even now count upon the accurate measurement by
apothecaries of such small doses as half to a quarter grain”(ib.
p. 361.)
In another place, he deplores the careless way in which the work is done
in many, (ib. II.,
492)
also that his preparation of mercury ” is usually so carelessly and
imperfectly prepared.” [Ib.
II., 247
and 371.]Further :
” How many different roots have druggists used instead of black
Christmas rose root (helleborus niger), almost every kind except the
right one.Ten distinct roots have been introduced into apothecaries’ shops
under this name, and the helpless practitioner relies upon the officinal
extract. helleb. nigri ! wretched man ! “An author laments the absence of results from the administration of
extract of aconite.Hahnemann
: ” The inspissated juice was worthless. That is the solution of
this constantly recurring mystery.”No single critic has proved the falseness of these strictures upon
the pharmaceutists of that time.Hahnemann
, who was
theoretically and practically so skilful an expert in the apothecary’s
art that few equalled or surpassed him, usually gave the patients who
entrusted their health to his care, his own medicines, thus trenching,
on the privileges of the apothecaries.” How much lower will the servile spirit of the physician’ bend
under the despotism of the monopolising apothecary ?” exclaimsHahnemann,
when again discussing they unreliability of a preparation. (Arzneischatz,
p. 160)There was a time when a medical man who allowed his’ drugs to be
prepared by anyone else was looked down upon. But when the mixing of
drugs came more and more into vogue, he could no longer prepare the
complicated brews himself, and the apothecaries thereupon gradually came
into existence in Germany in the XV th century (in Prague and Nürnberg
as early as the XIV th century).The apothecary was, therefore, only a means to an end, and he was
only required by those practitioners who would not or could not prepare
their own medicines. No one ever thought of compelling the physician to
have his medicines prepared by a third person.
Origin of the Apothecaries’
Guild.The encroaching guild of apothecaries contrived to have a law passed
at the end of the XVII th and beginning of the XVIII th Century in
Prussia forbidding physicians to dispense their own medicines ; it being
expressly added, ” that they may not thereby do detriment to the
apothecaries.[The
medicinal edicts in question will be found in detail in Sorge’s Dispensirfreiheit
der Aerzte, Berlin, Dümmler, 1877,
p. 31
; a work that well deserves to be read.]This did not meet with a proper opposition from physicians, because
they had gradually accustomed themselves to abandon the preparation of
their instruments of healing to a third person, and had not themselves
sufficient time, inclination, or knowledge to collect the drugs,
ascertain their purity, and finally to compound the mixtures.This is the cause of the origin of the privileges of apothecaries,
who have taken from physicians through their own fault their natural,
original, and inherent right of preparing the drugs discovered and
introduced by themselves and not by the apothecaries, whereby they might
be sure of the purity of the remedies they prescribed.Hahnemann
demanded, in
opposition to this unnatural condition, the restoration of their
original right, and tried to induce physicians to concern themselves
more with the purity of their drugs and reminded them of their ancient
rights, and many of them demanded back their rights.How important was the preparation and dispensing of his medicines by
himself is self-evident.Hahnemann
would never have made
his great discoveries concerning the actions of drugs had he not
dispensed his own medicines.Hahnemann
has deserved the
gratitude of both the apothecary and the physician for having attacked
with a strong arm abuses existing in the druggists’ shops, whereby he
effected a beneficent reform in this sphere, though his manly intrepid
assault has not always been welcomed by the apothecaries.
Complete List of
Hahnemann’s
Works. Hahnemann’s Writings arranged
in the order of their publication.1777
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(<>).
Translation of Nugent’s Essay on Hydrophobia, Leipzig. I. G. Müller.
From the Engl. 150
p.1777
Trans. of Stedman’s
Physiological Essays and Observations, with plates. Leipzig. I. G.
Müller. From the Engl. 134
p.1777
Trans. of Falconer’s Essay
on Waters commonly used at Bath. Leipzig bei Hilscher. From the Engl. 2
pts. 355
p. and 439
p.
Dr William
FALCONER (1744-1824)1777
Trans. of Ball’s Modern
Practice of Physic. Leipzig 1777
and 1780,
with Notes under the name Spohr. From the Engl.Dissertatio inaugur. medic : Conspectus affectuum spasmodicorum
aetiologicus et therapeuticus. Erlangae 1779.
4.
20
p.The
first small Medical Essays in Medicinische
Beobachtungen von Krebs,
Quedlinburg. 1782
Heft 2.In the
Sammlung der auserlesenen und neuesten Abhandlungen für Wundärzte,
Leipzig, Weygand, are several articles by Hahnemann.
1783,
1784,
1787.Trans.
of Demachy’s Procédés Chimiques. Leipzig bei Crusius. 2
vols. 302
p. and 396
p. From the French, with additions and plates. 2nd
Edit. 1801.1784
Guide to the Treatment of
Old Wounds and Indolent Ulcers. Leipzig bei Crusius. 192
p. (trans. in Brit. Jour. of
Hom. XLII.)Trans.
of Demachy’s L’Art du Distillateur Liquoriste. Leipzig. 2
pts. From the French, with additions. 332
p. and 284
p.On
Arsenical Poisoning ; its Treatment and judicial Detection. Leipzig.
Lebrecht Crusius. 276
p.Trans.
of Demachy’s L’Art du Vinaigrier. Leipzig bei Crusius. From the French,
with Additions and an Appendix. 176
p.1787
The Signs of the Purity
and Adulteration of Drugs, by B. v. d. Sande, Apothecary in Brussels,
and Hahnemann.
Dresden bei Walther. 350
p.1787
Prejudice against Coal
Fuel, the Way to Improve this Combustible, etc., with 2
plates. Dresden. Walther.1787
On the Difficulty of
Preparing Soda by Potash and Kitchen Salt. Crell’s chem.
Annalen, II. St.
11.
Pp. 387-396.Influence of some kinds of Gases on the Fermentation of Wine, ib.
I.
St. 2.
Pp. 141-142.1788
On the Wine Test for Iron
and Lead, ib. I.
St. 4.
Pp. 291–306.
1788
On Bile and Gall-stones, ib. II.
St. to. Pp. 296-299.1788
An Uncommonly Powerful
Remedy for Putrefaction, ib. II.
St. 12.
Pp. 485-486,
trans. into French by Cruet.1788
Instructions for Surgeons
respecting the Venereal Disease. Leipzig bei Crusius XIV. u 292
p. (trans. in Lesser Writings I).Unsuccessful Experiments with some New Discoveries, ib.
I. St. 3.
Pp. 202-207.1789
Letter to Crell on Baryta,
ib. II,
St. 8.
pp. 143-144.1789
Discovery of a New
Constituent in Plumbago, ib. II.
St. 10.
pp. 291-298.1789
On the Principium
adstringens of Plants. Beitrage zu d. Chem.
Annal. Vol. IV. St. 4,
pp. 419-420.1789
Trans. of the History of
Abelard and Heloisa, by Sir J. Barrington. From the Engl. Leipzig. 17
sheets.Remedy
for the Salivation and Destructive Effects of Mercury, J. Fr.
Blumenbach’s Medic. Bibliothek,
Vol. 3.
pp. 543-548.1790
Smaller Articles on
Various Subjects. Crell’s Annal.
I. St. 3.
pp. 256-257.1790
Complete Mode of Preparing
the Soluble Mercury, ib. II. St.
1.
pp. 22-28.1790
Trans. of Ryan’s Inquiry
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Weygand. From the Engl. 164
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Trans. of Fabbroni’s Dell’
arte di fare il Vino ragionamente. Leipzig. 278
p. From the Italian, with Additions.1790
Trans.
of Arth. Young’s Annals of Agriculture, &c. Leipzig bei Crusius. 2
vols. From the Engl. 290
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Trans. of Cullen’s Materia
Medica. Leipzig. Schwickert. 2
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of Grigg’s Advice to the Female Sex in general. Leipzig. Weygand. From
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Trans. of Monro’s Materia
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p. and 472
p. From the Engl., with Notes. 2nd
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Trans. of De la Metherie’s
Essai Analytique sur l’air pur. Leipzig bei Crusius. 2
vols. 450
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p. From the French.1791
Trans. of Rigby’s Chem.
Observations on Sugar. Dresden bei C. C. Richter. From the Engl., with
Notes. 82
p.1791
Insolubility of some
Metals, and their Oxides in Caustic Ammonia. Crell’s Annalen,
II. St. 8.
pp. 117-123.Contributions to the Art of Testing Wine. Scherf’s Beitrage zum Archiv
der Medic. Polizei, Leipzig.
Vol. 3.1792
On the Production of
Glauber Salt according to Ballen’s Method. Crell’s Annalen,
I. St.
1.
pp. 22-33.1792
Friend of Health.
Frankfurt. Fleischer. Pt. 1.
100
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189).Apothekerlexicon. Leipzig b. Crusius. Theil I (A — E), 280
p.1793
Something about the
Wirtemberg and Hahnemann’s
Wine Test. Intelligenzblatt der Allgem.
Liter. Zeitung, No. 79,
p. 630.1793
Preparation of Cassel
Yellow. Erfurt 4.On the
new Wine Test and the new Liq. probat. fort. Crell’s Annalen,
I. St. 12.
pp. 104
— 111.On
Crusta Lactea. J. Fr. Blumenbach’s Medic.
Bibliothek, Vol. 3.
pp. 701
— 705
(trans. in B. J. of H. XLII.)1795
Apothekerlexikon (F — K)
244
p.1795
Friend of Health. Leipzig
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6
sheets (trans. in Lesser
Writings, 240)Trans.
of J. J. Rousseau : Sur l’éducation des enfants, under the title
Mother’s Manual. Leipzig bei Fleischer. From French.1796
Description of
Klockenbring during his Insanity. Deutsche
Monatschrift, Februarheft
(trans. in Lesser writings, 287)1796
Essay on a New Principle
for Ascertaining the Curative Power of Drugs. Hufeland’s Journal.
Vol. 2.
St. 3
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pp. 391
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Something about the Pulverization of Ignatia Beans. Trommsdorff’s Journal
der Pharmacie, vol. 5.
St. 1.
pp. 38
— 40.1797
Case of Rapidly Cured
Colicodynia. Hufeland’s Journ. Vol.
3
St. 1.
pp. 138
— 147
(trans. in Lesser Writings, 353).
1797
Are the Obstacles to Certainty and Simplicity in Practical Medicine
Insurmountable ? ib. vol.
4.
St. 4.
pp. 727
— 762
(trans. in Lesser Writings, 358).1797
Trans. of Taplin’s
Equerry, or Modern Veterinary Medicine Pt. 1.
Leipzig. From the Engl. 387
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Trans. of the New
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plates. Pt. 1.
583
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of Taplin, Pt. 2.
304
p.1798
N. Edinburgh Disp. Pt. 2.
628
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Apothekerlexikon (L — P)
259
p. with 3
plates.1798
Antidotes to some Heroic
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Vol. 5.
St. 1,
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(trans. in Lesser Writings, 374)
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Some kinds of Continued
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Bd. 5.
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(Lesser Writings, 382.)1798
Some Periodical and
Hebdomadal Diseases, ib. Bd.
5.
St. I. p. 45
— 59.
(Lesser Writings, 395.)Apothekerlexikon (Q — Z) 498
p.Trans.
of Thesaurus Medicaminum, a new collection of medical prescriptions.
Leipzig bei G. Fleischer d. J. From the Engl. 412
p. with a preface by the translator and notes signed “Y.’) (The
preface trans. in Lesser
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Trans. of Home’s Pract.
Observations on the Cure of Strictures of the Urethra by Caustics.
Leipzig bei G. Fleischer d. J. 147
p. From the Engl., with Notes.Cure
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p.1801
Fragmentary Observations
on Brown’s Elements of Medicine. Hufeland’s Journal,
Vol. 12,
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(Lesser Writings, 405.)1801
On the Power of Small
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Vol. 13.
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(Lesser Writings, 443.)1801
Observations on the Three
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Vol. 11.
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(Lesser Writings, 592.)1801
View of Professional
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32.
(Lesser Writings, 417).
On the
Effects of Coffee. Leipzig bei Steinacker, 56
p. (Lesser Writings, 450.)1803
On a Proposed Remedy for
Hydrophobia Reichsanzeiger , No.
71.
(Lesser Writings, 447.)Aesculapius in the Balance. Leipzig bei Steinacker. 70
p. (Lesser Writings, 470.)
1805
Fragmenta de viribus
medicamentorum positivis sive in sano corpore observatis. Lipsiae, sumtu
J. A. Barthii. 2
pts. VIII. and 269
p. — V I. and 470
p.On
Substitutes for Cinchona. Hufeland’s Journal
Vol. 23.
St. 4.
S. 27
— 47
(trans. in B. J. of H., XLII.)
1806
Scarlet Fever and Purpura
Miliaris two Quite Distinct Diseases. ib.
Vol. 24.
St. 1.
pp. 139
— 146
(trans. in B. J. of H. XLII.)1806
What are Poisons ? What
are Medicines ? ib. Vol. 24.
St. 3.
pp. 40
— 57
(trans. in B. J. of H. XLII.)1806
Objections to Proposed
Substitute for Cinchona and to Succedanea in General. Reichsanzeiger,
No 57.
(Lesser Writings, 542)1806
Medicine of Experience.
Hufeland’s Journ. Bd.
22.
St. 3.
p. 5
— 99.
(Lesser Writings, 497.)1806
. Trans. of Albrecht v.
Haller’s Materia Medica. Leipzig.Indications of the Homeopathic Employment of Medicines in Ordinary
Practice. Hufeland’s Journ. Vol.
26.
St. 2.
pp. 5
— 43,
afterwards in the three first editions of the Organon
(in Dudgeon’s trans. of the Organon)On the
Present Want of Foreign Medicines. Allg.
Anzeig. d. Deutschen, No. 297.
(Lesser Writings, 551.)1808
On Substitutes for Foreign
Drugs. lb. No.
327.
(Lesser Writings, 574.)1808
On the Value of the
Speculative Systems of Medicine, ib.
No. 263.
(Lesser Writings, 556.)1808
Extract from a Letter to a
Physician of high standing on the great Necessity of a Regeneration of
Medicine, lb. No. 343.
(Lesser Writings, 581.)1808
Observations on the
Scarlet Fever. ib. No. 160.
(Lesser Writings, 546.)1808
Reply to a Question about
the Prophylactic for Scarlet Fever. Huf. Journ.
Vol. 27.
St. 4.
pp. 153
— 156.
(Trans. in B. J. of H. XLII.)To a
Candidate for the Degree of M.D. Allg.
Anz. der Deutschen, No. 227.
(Lesser Writings, 625.)1809
On the Prevailing Fever, ib.
No. 261.
(Lesser Writings, 528.)
1809
Signs of the Times in the
Ordinary System of Medicine, ib.
No. 326.
(Lesser Writings, 640.)Organon of Rational Medicine. Dresden bei Arnold. 1810.
222
pp. — 2.
Edit. 1819,
with the title : Organon of Medicine, 371
pp. — 3.
Edit. 1824.
XXIV. and 281
pp. — 4.
Edit. 1829.
XVI. and 307
pp. — 5.
Edit. 1833.
XXII. and 304
pp. (This last edition trans. by Dudgeon, 1849.)Materia Medica Pura, Pt. 1.
Dresden 1811.
248
pp. — 2.
Enlarged Edit. 1823.
— 3.
Enlarged Edit. 1830
(trans. by Dudgeon, 1883.)Dissertatio historico-medica de Helleborismo Veterum, quam defendet
auctor Samuel Hahnemann,
med. et chirurg. Doctor, academ. Mogunt. scient. ut societ. physic. med.
Erlang. , et societ. reg. oeconom., quae Lipsiae floret, Sodal. honor.
Lipsiae. Tauchnitz. 86
pp. (trans. in Lesser Writings,
644)Spirit
of the New Medical Doctrine. Allgem.
Anz. d. H. March. Pp. 626
(afterwards in more complete form in the second part of the M.
M. P. (Lesser Writings, 696,
and in Dudgeon’s trans. of the M.
M. P.)
Treatment of the Typhus or Hospital Fever at present Prevailing. Allg.
A. d. D. No. 6.
(Lesser Writings, 712.)On the
Venereal Disease and its ordinary Improper Treatment, ib.
No. 211.
(Lesser Writings, 728.)1816
On the Treatment of Burns,
ib. No.
156
and 204.
(Lesser Writings, 716.)1816
Materia Medica Pura. Pt.
II. 396
pp. — 2nd.
Edit. 1824.
— 3rd.
Edit. 1833.
— Pt. III. 288
pp. — 2nd.
enlarged Edit. 1825
(trans. by Dudgeon, 1883.)The
Same, Pt. IV. 284
pp. — 2nd.
enlarged Edit. 1825
(trans. by Dudgeon, 1883.)The
Same, Pt. V. 306
pp. — 2nd.
enlarged Edit. 1826
(trans. by Dudgeon,
1883.)1819
On the Uncharitableness
towards Suicides. Allg. A. d.
D. No. 144.
(Lesser writings, 781.)On the
Preparation and Dispensing of Medicines by Hom. Physicians Themselves. (Lesser
Writings, 783.)
Treatment of Purpura Miliaris. Allg.
A. d. D.
No. 26.
(Lesser Writings, 782.)
1821
Materia Medica Pura. Pt.
VI. 255
pp. — 2nd.
enlarged Edit. 1826
(trans. by Dudgeon, 1883.)How
may Homeopathy be most certainly eradicated ? Allg.
A. d. D. No. 26.
(Lesser Writings, 793.)
1825
Information for the
Truth-seeker in No. 165
of the Allg. A. d. D. ib. No.
194.
(Expanded and altered in the Mat.
Med. Pura, Vol. 6,
under the title ” How can small doses of such very attenuated
Medicines as Homoeopathy employs still possess Great Power ?” Lesser
Writings, p. 817
and Dudgeon’s trans. of Mat.
Med. Pura, II., p. 43.
The L. W. gives
the article as originally written in 1825,
the M. M. P. as
altered in 1827.)The
Chronic Diseases, their Peculiar Nature and Homoeopathic Treatment.
Dresden b. Arnold. Pt. I. VI. and 241
pp. — Pt. II. 362
pp. — 2nd.
enlarged Edit., 835.
— Pt. III. 312
pp. 2nd.
enlarged Edit. Düsseldorf b. Schaub. 1837.The
Same, Pt. IV. 407
p. — 2nd.
enlarged Edit. Düsseldorf bei Schaub. 1838.1830
The Same, Pt. V. — 2nd.
enlarged Edit. 1839.
(Trans. by Hempel)Allopathy ; a Word of Warning to all Sick Persons. Leipzig bei
Baumgärtner. 32
p. (Lesser Writings, 827.)1831
Appeal to Thinking
Philanthropists on the Mode of Infection of Asiatic Cholera. Leipzig bei
Berger. 20
p. (Lesser Writings,
849).1831
Cure and Prevention of
Asiatic Cholera. Cöthen bei Aue. (Lesser
Writings, 845).1831
Letter about the Cure of
Cholera. Berlin bei Aug. Hirschwald 15
p.Cure
of Cholera, with an Appendix. Nürnberg bei Stein. 1832.1832
Remarks on the extreme
attenuation of Homeopathic Medicines. Arch.
f. hom. Heilk. Vols. 11
and 12.
(Lesser Writings, 857.)Copyright
© Robert Séror 2006.
