HAHNEMANN’S THERAPEUTIC HINTS by R.E. DUDGEON
IT has always been a matter of regret to his disciples that Hahnemann did not publish any systematic work on his therapeutics. His unrivalled powers of observation, his intimate acquaintance with the actions of medicines and his vast experience would have enabled him to produce a manual of inestimable value to the practitioner. But though Hahnemann has not written any complete work on his clinical experience his writings are by no means destitute of valuable indications for the remedial employment of many of the medicines whose pathogenic he had investigated. The greatest number of these indications is to be found in the introductory observations prefixed to most of the pathogenic of the medicines contained in the Chronic Diseases. In introducing these indications he usually remarks that the medicine was most serviceable when some of the conditions or symptoms enumerated were present. In the first part of this work, and again in a note to Alumina, he deprecates the use of these indications as a substitute for a careful comparison of medicinal and morbid symptoms in the treatment of diseases. They should not, he says be solely relied upon in order to determine our choice of the remedy, but should rather serve to corroborate the correctness of that choice, which must always depend on similarity of symptoms of drug and disease. Besides these hints in the Chronic Diseases there are to be found scattered throughout Hahnemann’s published works and letters, many clinical observations from the experience of himself and other’s which are of great service in assisting the practitioner to choose the right remedy for many affections. Among these I have included the illustrations given in the four first editions of the Organon of the homoeopathic use of medicines by writers of old school, as Hahnemann had satisfied himself that these were genuine examples of homoeopathic cures. A considerable number of the symptoms of the pathogeneses in the Materia Medica Pura are stated to be “curative”, but few of these are available for my purpose, as they seldom really deserve that appellation, being mostly transient effects of an opposite character to the normal state of the prover, such as “longer sight” in a myope, “cheerfulness” in a person naturally melancholic, etc. In the absence of access to Hahnemann’s case books, the material I have collected and arranged in repertorial form may be regarded as Hahnemann’s own selection of therapeutic instruction from the vast stores of his own experience.
Hahnemann has left few records of cases treated by himself. I shall here give a condensed report of those we possess.
(1) A man employed in a printing establishment, aet. 24, had been working at the press for eighteen months, when he was suddenly attacked by pain in the left side, which obliged him to keep his bed. After a few days this subsided but left a permanent dull pain in left hypochondrium. Some months later a dietetic error he had a violent fit of colic. When this passed off he found that he could not bear certain kinds of food, more especially carrots, cabbage and all sorts of fruit, particularly pears. Any of these articles brought on an attack of the following character: Four or five hours after eating such food, he felt a movement in the umbilical region, then a pinching of the most intolerable kind for a half or one minute, each time suddenly departing with borborygmus extending to caecum. In the worst attacks these symptoms were almost constant. There occurred a sensation of contraction above and below, so that flatus would not pass either up or down. The abdomen swelled and was painful to touch. There was inclination to vomit, constriction of chest short, laboured breathing, cold sweat, a kind of stupefaction, and complete exhaustion. He could not swallow a morsel of food or a drop of liquid. He lay stupefied and unconscious, with swollen face and protruded eyes and without sleep: the attack of spasmodic colic gradually subsided, the pain diminished, wind escaped up and down, and thus the attack went off, having lasted from 16 to 24 hours. The strength returned after 3 or 4 days, and nothing remained but the dull, fixed pain in hypochondrium before described, and weakness with sickly appearance. He had to leave his work at the printing press and become a compositer. He had been subjected to all sorts of medicinal treatment for these attacks, but without benefit. At last the idea occurred to Hahnemann to give him a medicine which produced very similar symptoms. This was Veratrum Album. He got four powders each containing four grains, with the injunction to take one powder daily. But he took instead two powders daily and had finished the whole 16 grains in a couple of days. This caused the most violent colic, cold sweat and feeling of suffocation, so that he thought he must die. When he recovered from this artificial colic he was and remained quite well, the pain in the hypochondrium having also disappeared (Lesser Writings, p. 353 anno 1797). The date shows that this case was treated in the year following his enunciation of the homoeopathic therapeutic rule.
(2) A washer-woman, aet. above 40, had been laid up for more than three weeks with the following symptoms: On any movement, especially at every step, and worst on making a false step, she has a shoot in the pit of the stomach, coming from the left side. When she lies she feels free from pain. She cannot sleep after 3 A.M. She relishes her food, but after eating a little feels, sick, the saliva collects in her mouth like water-brash; empty eructations after every meal. Her temper is passionate, she is easily excited to anger. When the pain is severe she is covered with sweat. Prescription, one drop of pure Bryonia juice. The next days she was quite well and could resume her washing. (L.W. p. 864, anno 1815).
(3) A man aet. 42, whose business kept him constantly at his desk, had been ill for five days. His symptoms were: The first evening he became sick and giddy, with much eructation, without known cause. The following night, sour vomiting. The subsequent night much eructation. To-day, nausea eructations of foetid and sour taste. The food seems to lie undigested in stomach. Empty, hollow and confused head, sensitive to the least noise. Disposition mild, soft, patient. He got Pulsatilla 12, half a drop, and next day was quite well (Ibid p. 866, anno 1815). These two cases show Hahnemann’s treatment five years after the publication of the first edition of the Organon.
(4). A country girl aet. 14, not yet menstruated, was seen 12th September, 1842. A month previously and had slept in the sun. Four days afterwards she imagined she saw a wolf, and six days afterwards she felt as if she had received a blow on the head. She spoke nonsense, became maniacal, wept much, had sometimes dyspnoea, spat white phlegm, was unable to describe her sensations. She got Belladonna (dilution not stated], a dose every morning. 16th-Somewhat quieter; can blow her nose, which she could not do during her madness; still talks much nonsense, but does not make so many grimaces when talking; wept much last night; good motion; tolerable sleep; still very restless; eyes injected; has a pain in nape; medicine continued. 20th -Much better; speaks more rationally; weeps a little; recognises and names the doctor; wishes to kiss a lady present; she begins to show her amorous propensities; is easily put in a passion and takes things in bad part; sleeps well; weeps often; gets angry about trifles; eats, more than usual, when she comes to her senses like to play in a childish way. The Belladonna was continued, a dose every morning to 28th. From 22nd to 24th.-Much excited day and night; great lasciviousness in actions and words; pulls off her clothes and tries to touch the genitals of others; readily gets into a rage and beats everyone. Hyoscyamus 30, a dose every morning. 5th October.-For 5 days would eat nothing; complains of belly-ache; for the last few days has been less malicious and less lascivious; stools rather loose; itching all over body especially in genitals; sleeps well. Sacch. lactis for seven days. 10th-On the 7th fit of extreme anger, sought to strike everyone. On the 8th, attacks of fright; fear of an imaginary wolf; fear lest she should be burnt. Since then has been quiet, talks rationally and has shown no indecency for two days. Sacch. lactis 14th.-Quite good and sensible. 18th,.-Severe headache; drowsiness by day; less cheerful. Sulphur (dilution not stated, probably 600, a dose every morning. 22nd. -Very well; very little headache. Sulphur continued to November, at which time was healthy, rational and sensible. L.W., p. 869.
(5 ) An actor, aet, 33 14th January, 1843. For several years had been frequently subject to sore throat. Has had it now for a month. The previous one lasted six weeks. Pricking on swallowing saliva; feeling of contraction and excoriation. When he has not sore throat he suffers from a pressure in anus with violent excoriative pain; the anus is then inflamed, swollen and constricted. It is only with great effort he can pass the motion, when the swollen haemorrhoidal vessels protrude. January 15th.- Took before breakfast a dose of Belladonna 30; in the evening his sore throat was aggravated. 16th-Sore throat gone. The affection of anus returned as above described; there was an open fissure with excoriative pain, inflammation, swelling, throbbing pain and constriction; in the evening a painful stool. He confessed having had a chancre eight years previously, which had been, as usual destroyed by caustics, after which all the above affections had appeared. 18th.-Mercurius vivus, one globule of the lowest new dynamisation I (whatever that may mean], a dose every morning (and afternoon?] 20th.-Throat nearly well; anus better but still has excoriative pain after stool, but no more throbbing, swelling, inflammation or contraction. A dose of Mercurius viv. (potency not indicated ] every morning. 25th.-Throat almost well, in anus raw pain and severe shootings; great pain in anus after stool; contraction and heat there. 30th.-To-day in afternoon last dose of the Mercurius On the 28th the anus was better but the sore throat has returned; severe excoriative pain there. One globule in milk sugar for seven days (?]. February 7th.- Severe ulcerative pain in throat; belly-ache but good stools, several in succession, with great thirst; anus all right. Sulphur 2 Percent in seven tablespoonfuls as above. 13th-Had ulcerative pain in throat, especially when swallowing saliva, of which he has now a large quantity especially copious on 11th and 12th some contractions of anus, especially since yesterday. Merc by olfaction and in solution, a dose every morning (?] 20th. -Throat better since 18th; has suffered much in anus; stool painful to pass; less thirst. Sacch. lactis. March 3rd.-No more sore throat. When at stool a bloodless haemorrhoidal lamp comes down: this used to cause burning and sore pain, now itching only. Olfaction of Nitric acid (dilutions not stated] thereafter milk sugar, 20th.-Hardly any pain after stool; yesterday passed some blood with the motion (an old symptom); throat well, only somewhat sensitive to cold drinks. Olfaction of Nitric acid. (Olfaction is performed by smelling for one or two seconds at a small vial containing half an ounce of alcohol or brandy in which a globule of the medicine has been dissolved). He remained permanently well. (L.W., p. 870).
These last two cases illustrate Hahnemann’s practice in the last years of his life.
It is a pity we have not a large collection of cases from Hahnemann’s carefully kept case-book, but the above are all I can discover. And again it is unfortunate that it is only the remedies contained in the Chronic Diseases, the so-called “anti- psorics,” and not all of these, for which he has furnished the indications ab usu. However, I have been able to glean from his other writings many hints for the employment of other remedies, and I believe the practitioner will find this little work of immense use in helping him to the selection of the appropriate remedy. All the recorded symptoms being derived from the extensive experience of the greatest therapeutist of this and all other times, cannot indeed be regarded as “key-notes” to the remedial virtues of the medicines, but certainly as valuable hints to the selection of the remedy.
The repertory form in which I have arranged the symptoms is founded on the Hahnemannian schema. The arrangement under each heading is seldom alphabetical. I have endeavoured to group the symptoms together in a rational order, and with regard to the pains I have followed the classification adopted in the Cypher Repertory. The abbreviations of the medicines are also nearly the same as in that work. To save space I have frequently employed the letters “m., n., e., d.,” instead of “morning, night, evening, day”.