Theory of the Chronic Diseases. – Human pathology is the science which treats of diseased or abnormal conditions of living human beings. It is customary to divide the subject into general pathology and special pathology. *Special pathology is divided into *medical pathology, dealing with internal morbid conditions, and *surgical pathology, which deals with external conditions. *General pathology bears the same relation to special pathology that philosophy bears to the special sciences. It is the synthesis of the analyses made by special pathology. It deals with principles, theories, explanations and classifications of facts.
While the findings and conclusions of modern pathology are accepted in large part by all schools of medicine, and serve as the common basis of the therapeutic art, there are enough variations and differences, particularly in general pathology, arising from contemplation of the subject from the homoeopathic point of view to justify the creation of a special field or department, called Homoeopathic General Pathology, especially as it is concerned with *Chronic Diseases.
Homoeopathy differs with regular medicine in its interpretation and application of several fundamental principles of science. It is these differences of interpretation and the practice growing out of them which give homoeopathy its individuality and continue its existence as a distinct school of medicine.
These differences are primarily philosophical. They have to do mainly with the interpretation or explanation of facts upon which all are agreed, and which all accept. These differing interpretations arise from differing viewpoints. Modern science in general, and medical science in particular, regards the facts of the universe from a materialistic standpoint. It endeavors to reduce all things to the terms of *matter and motion. No valid objection could be raised to this if its definitions of these terms were broad enough to include all the facts.But failing in this, and deliberately closing its eyes and refusing to see certain great, fundamental facts which are not covered by its definitions and of which, therefore, no explanation can be made, medical science formulates systems and methods of practice which are not only inefficient, but often positively harmful.
Homoeopathic medical science views the facts of the universe in general, and medical facts in particular, from a vitalistic sub- stantialistic standpoint; that is, from the standpoint of the substantial philosophy, which regards all things and forces, *including life and mind, as substantial entities, having a real, objective existence. In homoeopathic philosophy life and mind are the fundamental verities of the universe.
Upon the recognition of this basic fact rests Hahnemann’s doctrine of the ” Vital Force” as set forth in the Organon, about which there has been so much discussion. All doubt as to Hahnemann’s position is removed and the subject is placed beyond controversy so far as he is concerned by the final sixth revised edition of the Organon, which is at last accessible to the profession. In this edition Hahnemann invariably uses the term, *Vital Principle instead of Vital Force, even speaking in one place of *”the vital force of the Vital Principle,” thus making it clear that he holds firmly to the substantialistic view of life-that is, that Life is a substantial, objective entity; a primary, originating power or principle and not a mere condition or mode of motion. From this conception arises the dynamical theory of disease upon which is based the Hahnemann pathology, *viz.: that disease is always primarily a morbid dynamical or functional disturbance of the vital principle; and upon this is reared the entire edifice of therapeutic medication, governed by the law of *Similia as a selective principle.
As this view leads to a radically different method of practice, the necessity for a special consideration of general pathology in its various departments is evident.
In formulating his “Theory of the Chronic Miasms, ” Hahnemann did for pathology what he had already done for therapeutics: he reduced a great mass of unsystematized data to order by making a classification based upon general principles.
This classification of the phenomena of disease led to the broadest generalization in pathology and etiology that has ever been made, and greatly simplified and elucidated the whole subject.
Hahnemann’s generalization was based upon his new and far- reaching discovery: *the existence of living, specific, infectious micro-organisms as the cause of the greater part of all true diseases.
The history of the progress of natural history shows how men first approached nature; how the facts have been collected, and how these facts have been converted into science by successively broader and broader generalizations leading to the discovery of basic laws of nature.
The work of Hahnemann in pathology may be compared to that of Cuvier in zoology, who reduced the entire animal kingdom to four fundamental classes, based upon the general characteristics of their internal structure : Vertebrates, Mollusks, Articulates and Radiates. Until Cuvier’s time there was no great principle of classification. Facts were accumulated and more or less systematized, but they were not arranged according to law.
Hahnemann reduced all the phenomena of chronic disease according to their causes to four fundamental classes, Occupational or drug diseases, Psora, Syphilis and Sycosis.
Taking the entire mass of morbid phenomena, he first eliminated all of the numerous symptoms and so-called diseases which are merely local, temporary and functional, in persons otherwise healthy, due to non-specific causes, such as indiscretions in diet or regimen, mechanical injuries, undue exertions or indulgences, emotional excesses, etc. Such conditions are not true diseases, but mere indispositions, which disappear of themselves under ordinary circumstances when the cause is removed, or yield easily to corrective hygienic, dietetic, moral or mechanical measures. They ordinarily require no medicine. In this class of cases are included many of the so-called occupational diseases, caused by exposure of healthy persons to noxious influences incidental to environment or vocation, such as unsanitary dwellings, exposure to fumes and emanations from chemicals, absorption of minerals such as lead or copper, etc.
The treatment of such conditions involves merely the removal of the cause, and, in some cases, antidoting the poisons, chemically or dynamically.
This removed a large part of the mass of phenomena from the category of diseases and cleared the way for further new classification of the remainder.
The next step consisted in collecting into a class all the phenomena known to be due to those ancient, widespread and malignant scourges of mankind, the venereal diseases. Syphilis, already recognized as the fundamental cause of a large number of symptoms and as a complicating factor in many diseases, had been studied quite extensively. A careful review and collection of all the known phenomena of syphilis was made, greatly enlarging its scope.
Gonorrhoea as a constitutional disease was but little known, but Hahnemann’s keen mind had detected its relation to many evil consequences following the suppression of the primary discharge by local treatment. He had also observed the evils arising from the topical and mechanical treatment of the anomalous venereal condition variously known as *Sycosis, or the ” fig wart disease,” condylomata, ficus marisca, atrices and warts. (London Medical Dictionary, 1819.)
Certain forms of condylomata were regarded by some authorities as due to syphilis. Although it was known that the tumors were sometimes of venereal origin and accompanied by a kind of gonorrhoeal discharge from the genital passages or the rectum, they were not recognized as the manifestations of a distinct disease, differing in many important respects from syphilis, nor were they necessarily connected with gonorrhoea.
Condylomata were not regarded as having any connection with the large number of peculiar constitutional symptoms which are present in many cases. Hahnemann made extensive researches in the phenomena presenting in such cases and came to the conclusion, first, that they constituted a definite and distinct infectious, constitutional venereal disease, clearly distinguishable from syphilis on the one hand, and the simple, non-specific urethritis on the other; and second, that it was due to the presence of specific, living micro-organisms.
To this newly recognized pathological from the applied the generic name *Sycosis, using the Greek term commonly employed in his day to designate the typical physical manifestation, the “fig wart.” His researches in the general subject of syphilis and gonorrhoea, conducted by the inductive method in science, resulted in throwing a flood of light upon a previously obscure subject, more clearly defining and greatly broadening not only the sphere of the venereal diseases, but the scope of all subsequent research. He was thus the precursor by more than fifty years of Noeggerath, who called attention anew to the importance of gonorrhoea as a constitutional disease and demonstrated the gonococcus as its specific proximate cause.
There still remained the vast number of symptoms constituting the non-venereal diseases, acute and chronic, which afflict man- kind. These for the most part had been or were being classified in the most arbitrary and whimsical manner.
Classifications and nomenclature were being changed constantly according to the varying opinions and theories of individuals, none of whom were guided by any general principle. The situation was exactly like that which confronted Cuvier in natural history and Linnaeus in botany.
Into this wilderness of conflicting names, theories and classifications Hahnemann began to blaze his way, guided by the compass of logic encased in the inductive method of Bacon. His search was now directed to the discovery of the fundamental causes of the non-venereal diseases. Having found that so large a number of symptoms and diseases had a venereal origin in syphilis and sycosis, it occurred to him that it might be possible to find a common, general or primary cause for all, or at least a great part of the remaining symptoms of disease, and thus to make a final generalization. To this end he directed his efforts. Rejecting existing classifications; searching, collecting, comparing, grouping similar and naturally related symptoms in the light of history, logic and experience; tracing the relations between similar diseases and their antecedents, and tracing recognized proximate causes to their antecedent causes as far back as possible, he gradually narrowed the field of general causation until he arrived at one primary cause, which accounted for and explained the greater part, if not all of the phenomena with which he was working.
The determination of a primary cause opened the way for a consistent reclassification of the secondary causes, and the correction of many errors of grouping and nomenclature of diseases. It obliterated at one stroke a large number of fictitious diseases which were in reality named from merely single symptoms. (Hydrocephalus, fever, diarrhoea, hydrophobia, jaundice, diabetes, anaemia, chlorosis, pyorrhoea, otorrhoea, catarrh, eczema, etc., all of which belong to the general class of infections.)
As Cuvier’s work showed that the animal kingdom was built on four different structural plans, so, by singular coincidence, Hahnemann’s work showed that diseases were built, as it were, on four different plans, according as they arose from four different causes; namely, Occupational or Drug diseases, Syphilis, Sycosis and Psora.
Relation of Bacteriology to Homoeopathy :- This brings us to a consideration of Hahnemann’s epoch-making discovery of specific, living micro-organisms as the cause of infectious diseases such as cholera and the venereal diseases, and of the relation of bacteriology to homoeopathy.
The great practical value of Hahnemann’s Theory of the Chronic Diseases has never been fully appreciated because it has never been fully understood.
Hahnemann was so far ahead of his time that is teaching, in its higher phases, could not be fully understood until science in its slower advance had elucidated and corroborated the facts upon which he based it; and this science has done in a remarkable manner. For the suggestion of bacteriology as the basis of a rational modern interpretation of Hahnemann’s Theory of the Chronic Diseases we are indebted to the late Dr. Thomas G. McConkey, of San Francisco. His paper, “Psora, Sycosis and Syphilis,” published in the December, 1908, number of *The North American Journal of Homoeopathy, laid the profession under a deep obligation to him. The critical insight, originality, open- mindedness and evident comprehension of the deep significance of the facts of the case displayed in that brief but suggestive paper add poignancy to our regrets that he did not live to work out a fuller exposition of the subject himself.
It is perhaps less important that Hahnemann should be accorded the just recognition due him for his remarkable contribution to medical science, than that the world should be given the benefit of the practical teaching included in his Theory of the Chronic Diseases.
Modern bacteriological science, by long independent research, slowly arrived at the goal Hahnemann reached more than half a century before in regard to the nature and causes of certain forms of disease. It has accomplished much in the way of prophylaxis, sanitation and hygiene through the use of that knowledge; but the profession at large has failed to follow his logical and practical deductions in regard to the *cure of these diseases, or to discover a means of cure for itself. In this respect modern medicine is no further advanced that it was in Hahnemann’s day. It is obliged to confess and does confess, when driven to the wall, that it has no reliable cure for any disease.
Vaccine treatment, for example, the latest, most general and most widely adopted theory and practice growing out of bacteriology is now acknowledged by the highest representative authority of regular medicine to be a failure.
The *Journal of the American Medical Association (No. 21, 1916), presents, as the leading article of that issue, a paper by Dr. Ludwig Hektoen, on “Vaccine Treatment,” and devotes to it a page of editorial comment.
The editorial opens as follows :
“Looking backward over the development of active immunization by vaccines during the last fifteen years, we appear to be at the termination of one epoch in the therapeutics of infectious disease. In this issue Hektoen traces the stages by which vaccines which were first employed with attempted scientific control have come into indiscriminate and unrestrained use, with no guide beyond the statements which commercial vaccine makers are pleased to furnish with their wares. Already most physicians are realizing that the many claims made for vaccines are not borne out by facts, and that judging from practical results there is something fundamentally wrong with the method as at present so widely practiced. As clearly shown by Hektoen, ‘the simple fact is that we have no reliable evidence to show that vaccines, as used commonly, have the uniformly prompt and specific curative effects proclaimed by optimistic enthusiasts and especially by certain vaccine makes, who manifestly have not been safe guides to the principles of successful and rational therapeutics.”
It is not fair, and certainly not ingenuous, as that keen critic, Dr. E.P. Anshutz, then editor of The Homoeopathic Recorder, pointed out, to put the blame for this failure upon the manufacturer, since *”Vaccine therapy was born in the innermost chamber of laboratory science.”
The editorial concludes as follows:
“The fact that much time and effort of the past ten years appear now to have been wasted, so far as positive results go, should make us doubly cautious in accepting a new and somewhat similar procedure until opportunity has been afforded for its verification under conditions favorable for scientific control.”
Confronted with demonstrations of cure by homoeopathic medication in such bacterial diseases as cholera, typhoid, typhus and yellow fever, croup, diphtheria, pneumonia, rheumatism and even tuberculosis and cancer, the dominant school of medicine has thus far declined to consider them, denied both the cures and the principles upon which they are accomplished, and continued to follow its traditional course. it still pursues the ancient “will o’ the wisp” “specifies for diseases,” ever failing and refusing to see that cure is always *individual, in the *concrete case or patient, never in the generalized disease; and that such a thing as a specific cure for a disease does not, and, in the nature of things, cannot exist, since no two cases, even of the same disease, are ever the same. Realization of such failures, and bacteriological confirmation of the teaching of Hahnemann in respect to the nature and cause of certain diseases, taken together, should at least create a presumption in favor of the truth of his teaching in regard to the cure of those diseases and lead to a scientific investigation of his method.
Dr. McConkey, viewing Hahnemann’s theory from the standpoint of bacteriology, pointed out, first, that we have inherited from preceding generations a false and misleading interpretation of what Hahnemann really taught in regard to *Psora as the cause of chronic non-venereal diseases.
The primary error consisted in regarding psora merely as a *dyscrasia or diathesis, which is directly opposed to what Hahnemann taught as we now understand it. Instead of regarding psora as a dyscrasia Hahnemann *included several of the dyscrasia among the morbid conditions and diseases *caused by psora.
Such an error could only have arisen in minds already prejudiced by the current erroneous teaching of the day, and not yet enlightened by knowledge which was soon to come as a result of original research in the field of bacteriology. On this ground it is conceivable how the error arose and spread. New truth, quickly grasped by a few alert and open minds, penetrates the average mind slowly. Original investigators themselves, absorbed in their own pursuit, are often reluctant to consider their work in its relation to the work of preceding investigators, even if they are philosophically competent to do so, which, as a rule, they are not.
The exceptional work of an individual forerunner, therefore, may easily be overlooked for a time; but eventually the truth discovered by him will be recognized, as it now has been in the case of Hahnemann.
Hahnemann was the first to perceive and teach the *parasitical nature of infectious or contagious diseases, including syphilis, gonorrhoea, leprosy, tuberculosis, cholera, typhus and typhoid fevers; and the *chronic diseases in general, other than occupational diseases and those produced by drugs and unhygienic living, the so-called drug diseases.
Hahnemann held that all chronic diseases are derived from *three primary, infectious, parasitic sources. “All chronic diseases,” he says, “show such a constancy and perseverance * * * as soon as they have developed and have not been healed by the medical art, that they evermore increase with the years and during the whole of man’s lifetime; and they cannot be diminished by the strength (resistance) belonging even to the most robust constitutions. Still less can they be overcome and extinguished. Thus they never pass away by themselves, but increase and are aggravated even until death. They must therefore have for their origin and foundation *constant chronic miasms, whereby their *parasitical existence in the human organism is enabled to continually *rise and *grow.” (*Only living beings grow.)
A misunderstanding of the sense in which Hahnemann uses the word “miasm” has deceived many. It was the word loosely used in his time to express the morbific emanations from putrescent organic matter, animal or vegetable, and sometimes the effluvia arising from the bodies of those affected by certain diseases, some of which were regarded as infectious and others not.
A misleading distinction was also made between miasma and contagion and between contagion and infection.
Parr’s Medical Dictionary, London, 1819, now a very rare book, but the highest authority of that time, article, “Miasma,” says: “In the more strict pathological investigation of modern authors they are distinguished from contagion, which is confined to the effluvia from the human body, when subject to disease; yet the contagion, when it does not proceed immediately from the body, but has been for some time confined in clothes, is sometimes styled *miasma. Another kind of miasma (see contagion) is putrid vegetable matter, and indeed everything of this kind which appears *in the form of air. Miasma, then, strictly speaking, *is an aerial fluid, *combined with atmospheric air, and not dangerous unless the air be loaded with it. * * *
“Each infectious disease had its own variety, *diffused around the person which it has attacked, and liable to convey the disease at different distances, according to the nature of the complaint, or to the predisposition of the object exposed to it.”
Under “Contagion or Infection” the same authority says: “It has been lately attempted to distinguish these two words, though not with a happy discrimination. We should approach more nearly to common language if we employed the adjective ‘infectious’ to *disease communicated by contact; for we infect a lancet and we catch a fever by contagion. * * * Contagion then exists *in the atmosphere, and we know distinctly but one kind, *viz.: Marsh- miasmata, which probably consists of *inflammable air.”
The yellow fever of America, epidemic catarrhs, plague, dysentery, scarlatina, Egyptian ophthalmia, jail, hospital and other fevers, smallpox, measles, ulcerated throat, whooping cough, the itch, venereal diseases and the yaws, are mentioned as examples of miasmatic diseases, some of which are regarded as “infectious,” and others not. “Other complaints supposed to be infectious are apparently so from their being the offspring of *contagion (that is, ‘aerial fluids, combined with atmospheric air’) only.”
“People are very variously susceptible to infection. The slightest breath will sometimes induce the disease, while others will daily breathe the poisonous atmosphere without injury.”
“Infection is indeed more often taken than is supported. * * * It is generally *received with the air in breathing.”
This shows the confused state of medical opinion at the time when Hahnemann was conducting his investigations of the subject, which were to result in his propounding the most startling, revolutionary and far-reaching theory in the history of medicine, namely, the *parasitical nature of infections and chronic diseases.