If we review these cases and analyze the operations of the physician’s mind, we shall see that, in number one, he confesses that he has been the “accident of an accident”, and he invokes his “good luck” to stand him in stead again. He does not exercise his reasoning faculties at all. Let him pass.
In the other cases, there is, besides a thanksgiving for succus, and effort of the mind to arrange the facts which the case presents in order, along with some other facts already stored there, and to infer from the aggregate store of facts some principle or plan of action which may be profitably brought to bear on some future case. It is thus and only thus that “experience teaches.” For, since no two cases are ever met with that are in every respect precisely alike, the experience acquired in treating one case can never be available in treating another, except through the intermediate application of the reasoning powers. We hear and observe facts, collect and arrange them analyze and reflect upon them, induce principles from them, and prepare ourselves to make practical application of these principles when a new case shall for it.
Now, what is this but theorizing? When we analyze a case in such a way as to suggest to our minds its proper mode or course of action, or to infer from it any principle that might help us in a future case, we form a “theory.” We cannot think, indeed, about collecting facts without theorizing.
Yet the defenders of alternation invite us simply “to look and see,” to “establish facts. These once fixed any theory which will perfectly account for them is good.” These are Dr. Hawley’s words. (1 American Homoeopathic REview, vol. v., p. 338). And the London Homoeopathic Review, vol. ix., p. 432, quotes Dr. Hawley’s words approvingly: “The homoeopathic system of medicine,” ** says DR. Hawley, “bases itself, not on theories but on facts as they observed in the world of man. It frees its disciples from all dogmas and simply asks them to look and see.” Well, being thus invited, we “look and see.” What do we see? Why we see Dr. Hawley giving Bryonia and Sepia in alternation in one chronic case and Arsenic and China in another case, and curing both in a way which satisfied him well. This is what we see. But what does DR. Hawley see when he look at these same facts? Why he sees something which prove to him that “for him, the use of remedies in alternation is better than the use of a single remedy.” And the London Review sees in the same facts something “which proved to him (Dr. Hawley) that the alternation of medicine is not only admissible, but that cases now and then occur which CAN ONLY BE CURED BY SUCH ALTERNATION.”
Is not this “theorizing” pretty strongly and on a rather slender basis? Our friends warn us against “Theory” and yet, from two facts, Dr. Hawley concluded that, “for him, the use of remedies in alternation is better than the use of a single remedy,” From the same two facts the London Review makes Dr. Hawley conclude that “cases now and then occur, which CAN ONLY BE CURED BY SUCH ALTERNATION.” This is a broad generalization on a very narrow foundation. But Dr. Hawley admonishes us that “we have not yet any such collection of facts as will warrant any generalization.”
For ourselves, we should not feel justified in drawing any such conclusions as these from DR. Hawley’s cases or from any of the case already narrated, cured by alternation. When adduced in evidence, we accepts them as facts and give them what we consider to be their full value. They prove to us that cases may be cured by alternated remedies, but they prove no more than that. They prove that two remedies in alternation cured a case which neither of those two remedies singly had cured. Beyond this they prove nothing. Assuredly they do not prove that a physician could not have cured each case more quickly with some other remedy, given singly. How could such evidence be held by us to justify such conclusions as Dr. Hawley and his reviewer draw from it, when our daily experience furnishes case after case which had been treated ineffectually by physicians who always alternate and which yields promptly to the single remedy. Evidence of this kind whether FOR or AGAINST alternation, will not settle this question.
These remarks, extended as they are, have been made for the purpose of showing that clinical experience is available as a means of improvement in medical practice only in so far as it is analyzed, thought about, and, in fact, “therorized” about; that those who deprecate dogmatism and would put off the formation of generalizations, do, themselves, dogmatize and theorize, and from the nature of the case they must do so in the act of reasoning about the evidence they bring forward.
If this be inevitable, then, it must be allowed us likewise to theorize and in what we have to say about alternation we shall hold ourselves justified in basing our argument on generalizations from a multitude of collated facts. We hold that the argument from theory is in order. And regarding a SCIENCE as being a connected and independent series of generalizations based on an analysis of methodically arranged and collated facts, we require the advocates of alternation to rest their cause, as we do our opposition to alternation, on such a generalization. Failing to do this, they have no claim for their method as a part of the SCIENCE of Therapeutics. Failing this, the facts which seem to justify alternation can be used in no other way than in the blind, empirical way of literal imitation, in which accuracy and certainty are quite out of the question. But our whole object in study and labor, beyond the direct need of our patients, is to complete the structure of our science, such as we have defined a Science to be, a means of attaining accuracy and certainty.
Some of the advocates of alternation have failed to perceive the necessity of raising their procedures to the level of a scientific method. They still rest on the rude empirical ground of unmethodized experience. Their argument is: “I have alternated remedies which, singly, had failed, and I cured. Henceforth I shall alternate.” Or, as the London Review varies the argument (9,432), “The practice of alternation of remedies is one so widely adopted that it would appear to have the sanction of very extended practical experience. ** Experience has proved abundantly that the alternation of remedies increases the rapidity of the cure,” etc. The same argument was used by Dr. Coxe, (1 American Homoeopathic Review, iii.59) who claims to have alternated for twenty-five years, and to have been successful. As we have before remarked, the same argument may be used by Allopathists, and by the advocates of every form of practice, whether pure, mixed, or wholly vicious. The same argument may be, and is, advanced by those who oppose alternation.
Others, however, have seen the necessity of basing their advocacy of alternation on some general principles, among them particularly Dr. Drysdale (1 Annals of British Homoeopathic Society) and Dr. Coc, (2 The American Homoeopathic Review, vol. v., April, 1865) and to these statements of principles we wish to devote some attention.
But, first, let us have a clear understanding of what is properly meant by alternation of remedies.
As we have stated, the term if used in different senses.
1. Dr. J.R. Coxe (loc.cit.) seemed to think that the opponents of alternation contend that each case of sickness should be treated with one single remedy, and that, if during an illness a change in the symptoms should compel a change in the remedy, this, by whatever name it be called, is, in fact, alternation. He scouts the idea of any real distinction between alternation and succession of remedies. Well, if this be all that alternation means, we have no reason to oppose it. But, what is a case of disease in this sense? Does it comprise all that may ail a man from the time that he takes to his bed to the time that he goes to his work again? Suppose a patient sick of dysentery, and recovering finely under the single remedy Mercurius corrosivus. When just convalescent he is seized with rheumatism, and requires Rhus toxicodendron. It is, “alternating” to give it to him? And then, suppose him safely over rheumatism; but just before he goes to work again, he has a return of dysentery, requiring Mercurius corrosivus. Is it “alternating” to give it, if the symptoms require if? And if, when cured of this relapse, he gets the measles and requires Euphrasia, is it “alternating” again to give him this remedy? Why, according to this definition, if you call this all one sickness, it has been a case of alternation. If you call it four sickness, perhaps not. To the patient, certainly, it is “all one,” whatever you call it? Now, suppose the symptoms in a case to have changed just as decidedly as in the case supposed above, but yet not so definitely as to induce you to give to the changes these nosological names of dysentery, rheumatism and measles. The medicines, Mercurius, Rhus and Euphrasia will have been just as clearly indicated by these successive changes, and just as imperatively required as though the patient were regarded as having had four successive disease. Is it “alternation” to give these remedies successively just as they become clearly indicated? We think it is not, but some say it is. We are sure it is sound practice.
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'.