But before citing authorities, let us point out how far DR. Russell’s argument, even allowing it full force, comes short of being a defense of alternation, as it is actually practiced here and in England! Dr. Russell allows it where “two distinct, specific forms of disease” co-exist, such as scarlet fever or small- pox and typhus- a phenomenon that no physician in ordinary family practice is likely to observe more than once a week! Yet how many times a day do a majority of our colleagues alternate? It is safe to say that, with very many, the giving a single remedy is the infrequent exception! Their case is exactly met by the following remarks of Dr. Russell, one of the champions of alternation”
“The objection usually urged against alternation is that it leads to laxity of practice. True, if we give two medicines instead of one and let the system take its choice, as it were, to which it shall submit-if, in a given case, for example, we find two medicines pretty nearly indicated, and, instead of ourselves selecting the one and rejecting the other, we toes them, both in, trusting that the right one will act, and the other be a nonentity or negative quantity. NO ONE WHO DEALS CONSCIENTIOUSLY WITH HIMSELF WILL DELIBERATELY APPROVE OF SO SIMPLE A METHOD OF EVADING THE DIFFICULTY OF CHOICE.”
A few instances and citations may serve to recall to the minds of practitioners of medicine, the frequent instances in which two varieties of disease, co- existing, modify each other. A young person whose parents died of consumption, and who has himself had abscesses of the cervical glands and eruptions of the face and who takes cold readily-is feeble and pale-who, in short, has scrofulosis and is a predestined victim of consumption, gets an attack of enteritis or of pneumonia. Is it not notorious that the joint action and reaction upon each other, of this chronic scrofulosis and the acute affections running the short and sharp course which they would follow in a robust subject, they will almost surely degenerate into tuberculosis of the mesenteric glands with colliquative diarrhoea, and of the lungs, respectively? And would any one dream of treating these acute affections in such a subject just as they would treat them in a subject otherwise and previously healthy?
But why not? Because the previously existing disease modified and (so far as symptoms are concerned) blended with the acute attacks. No doubt one single remedy will cover this blended case.
When a patient has suffered from paroxysms of intermittent fever, and on the cessation of their regular recurrence he is still sallow, feeble, dyspeptic and full of malaise, there can be no question that he still suffers from the disease-the result of marsh miasm. If now this this patient get a pneumonia or a neuralgia, here will be a second and a distinct and dissimilar disease co- existing with the former. So different, however, will be its course from what it would have been in a patient not laboring under miasmatic disease, so blended will it be from the beginning, with the latter, that, though a wholly distinct “pathological form” of disease, it will require the identical treatment of miasmatic disease and will yield to nothing else. The same thing is eminently true of syphilis in the system.
Bonchut says; (1 Pathologie Generale, p. 269) “Syphilis, herpetism, scrofula, the marsh miasmatic disease, etc., often appear under forms not habitual. **
We imagine that we are dealing with acute or chronic inflammations, and we treat them as such until, some day, changing our method, we see them recover, one under Mercury, another under Sulphur, another under Sulphate of quinine, another under Iodine, etc. Is there anything stranger than those observations in marshy countries, where pneumonia, fever, encephalo-meningitis, are cured by Quinine rather than by blood-lettings and by antiphlogistics?”
Another instance of the modifying power of two morbid influences co-operating on the same individual is furnished by the fact that when an epidemic prevails not only are almost all healthy persons, to some extent, affected by the epidemic influence, but the maladies of all sick persons, whatever, their nature may be, are modified and changed into a greater or less conformity with the epidemic, whatever it may be.
Dr. David Hosack uses these words: (2 Copland’s Dict. Pract.Medorrhinum, 2, 404, note) “The fact stated by Sydenham and other writers on epidemics, that the prevailing disease swallows up all other disorders; that, is, that during the prevalence of an epidemic plague, typhus, dysentery or other diseases of this class, every indisposition of a febrile sort readily assumes the character f the prevailing disorder. We know this to be experienced in the diseases of other countries, and we see it daily exemplified in our own.”
Homoeopathicians especially, since their observations are finer and are less exposed to fallacy from drug-poisonings, have opportunity to make observations of this, kind, and they have often noticed how, at one season and under one epidemic, a single drug or group of drugs corresponds to the most diverse pathological forms of disease, while at other season and under other epidemic influences, very different groups of remedies are indicated by the same pathological forms of disease.
And we believe that most Homoeopathicians who have dealt much with chronic cases, must have fallen in with patients who labor under such a constitutional affection as herpes or cancer, and which, under favorable circumstances, is kept in a latent conditions by the occasional use of some clearly indicated remedy. If these patients get an acute disease of whatever kind, this disease is almost sure to present, at an early period, symptoms which indicate this same remedy that suits their chronic malady. Does not this argument a posteriori show that these two independent, co-existent maladies blend and modify other, at least in the view of the therapeutist?
The entire homoeopathic doctrine doctrine of chronic diseases, and the use and necessity of so-called antipsoric remedies, are based upon this same idea of mutually modifying influence of two-existent maladies.
Hahnemann says he found that in some persons acute disorders did not yield promptly to remedies which seemed indicated and which quickly cured them in others. On examining closely he found these patients presented, in the present or in the past, symptoms indicating their infection by certain miasms which he reduced (whether rightly or no is immaterial) to three miasms-psora, syphilis and sycosis. He sought for remedies which would meet the indications of these chronic miasms and the acute affections combined, and this led him to prove and use the remedies known as the antipsorics. Our success with those remedies might be taken as another a posteriori proof of the blending of two co-existing diseases.
Dr. Drysdale, apologizing for the practice of alternation, says:
“We have not a few examples where the patient has, through ignorance or design, unknown to us, taken large doses of heterogeneous drugs, such as Quinine or Opium or purgatives, and yet our higher dilutions have taken effect notwithstanding. On this subject Trinks confirms Kampfer’s remarks, that, in chronic diseases which have been long treated with excessive doses of allopathic medicines, we often find a great susceptibility to the action of homoeopathic medicine.”
Are these writers to be understood as maintaining that chronic drug-poisonings, such as the mercurial, the Sulphur, the iodine, the quinine, the iron or the opium chachexy, do not cause acute disease to be most difficult of cure? The contrary is notoriously the case, as the literature of physicians of every school abundantly shows. How can this be, unless the artificial chronic disease, viz., the cachexy, blend with, and modify, the supervening to great length disease!
These remarks might be extended to great length by multiplied instances. They suffice, however, to show distinctly the practical conclusions to which, what we conceive to be sound principles, as well as accurate observation, have led us. With them we conclude what we have to say concerning the alternation of remedies, taking our leave of the subject in the spirit of Bishop Chillingworth’s declaration:
“I will take no man’s liberty of judgment from him; neither shall any man take mine from me. I will think no man the worse man, I will love no man the less for differing in opinion from me. And what measure I mete to others I expect from them again”.
Dr. Dunham graduated from Columbia University with Honours in 1847. In 1850 he received M.D. degree at the College of Physicians and Surgeons of New York. While in Dublin, he received a dissecting wound that nearly killed him, but with the aid of homoeopathy he cured himself with Lachesis. He visited various homoeopathic hospitals in Europe and then went to Munster where he stayed with Dr. Boenninghausen and studied the methods of that great master. His works include 'Lectures on Materia Medica' and 'Homoeopathy - Science of Therapeutics'.