Is it suggested that Hahnemann meant to intimate that these groups of symptoms might co-exist in the patient at the same time and might make a “totality of symptoms” that would require these two remedies to cover it? But these groups are pathologically incompatible. No one conversant with the phenomena of sickness could conceive of a patient presenting, at one and the same time, “heat, increasing restlessness and agonizing anxiety,” and likewise oversensibility to pain and a disposition to weep and despond. No! patient in a waxing fever often swear; but they seldom pine and weep; they feel general anguish but make light of specific pains. But when the fever has waned, there often succeeds it a stage of over-sensibility and of proneness to weep; and this succession may be repeated again and again, and we suppose Hahnemann recommended these remedies to correspond to this succession. We cannot comprehend his words in the sense attached to them by the London Review. In the signification in which we have understood them, they correspond precisely to all of his other directions, which have been quoted as favoring “alternation.”
But, now, suppose it conceded that, while Hahnemann’s practical deductions from scientific principles were opposed to “alternation,” his practice sanctioned it. Is the argument from his practice all powerful against his principles? This reminds us of what the Chairman of the British Society calls Dr. Drysdale’s Socratic irony “-you all object to alternation, and, yet, you all alternate.” We have seen that Dr. Drysdale’s definition of alternation is such as to cover almost every actual case of treatment and is different from that of every other writer. But, the argument from the universality of a practice, in favor of its propriety, is a dangerous one to play with. Place it in the mouth of a theologian and see how it reads: You all condemn sin, and yet, you are all sinners!”
Does the weight of this argument lie on the side of sin or on the side of the condemnation of sin! Does propriety necessarily follow from universality? Are the majority always right, just because they are the majority? Is so, all hail, Allopathy!
The conditions of a true and defensible homoeopathic prescription require, in our opinion, that the symptoms of the patient, at the time of prescribers, shall be collected and compared with the provings in the Materia Medica, and that the drug whose symptoms correspond most closely with those of the patient shall be selected. Perhaps no Homoeopathician would object to this statement. But let us see what it requires.
First. It requires that before every prescription, the symptoms of the patient shall be studied anew. In some way or other, whether it be done by the physician or by a provisional deputy specially instructed for the case (as we have explained that the nurse may be), more or less perfectly, this must be done. We have seen that in the ordinary method of alternation (a priori) this is not attempted to be done and cannot be done; it is not proposed to do it.
Second. It requires that the aggregate of the symptoms presented by the patient be regarded in the malady, for which an analogue is to be found in the Materia Medica. We have no authority in science for arbitrarily dividing this aggregate of symptoms into groups, for each of which we are to find an analogue in the Materia Medica, and then giving these analogues, in combination, or in alternation. This requirement is perhaps the most difficult of all to fulfill. In collecting the symptoms, our utmost sharpness of insight and our deepest and most extensive learning in every department of physiological, psychological and pathological science will be tasked to construct, from the patient’ history and from his present condition, a complete picture of the morbid phenomena which he presents, from which the physiological idiosyncrasies of his peculiar temperament and personality shall all have been eliminated, and in which his symptoms shall be duly arranged with regard to their mutual relations and dependencies. Then, furthermore, inasmuch as we cannot hope to find, in the proving of any drug, a duplicate symptom for every symptom of the patient, the rarest judgment and most extensive knowledge of semiology are required to analyze the patient’s symptoms and to detect those which are truly characteristic of that individual case, and for which an analogue must be found in the proving; and to set these characteristics apart from the other symptoms, the analogue of which it may be less imperatively necessary to discover. It is here, undoubtedly, that the greatest knowledge and ability are required of the physician and here that failure are most frequently made. It is, probably, from failures in this analysis of symptoms, that the supposed necessity of alternation most frequently arises.
Third. It requires that a drug shall be selected which has produced on the healthy subject, symptoms very similar to those of the patient. The substance given must have been proved in the same form (not necessarily the same dose) as that in which it is proposed to be given. If Hepar sulphuris calcareum correspond to the case, this requirement is, by no means, fulfilled if we give Sulphur and Calcarea carbonica combined or alternated, on the ground that these substances are the constituents of Hepar sulphuris calcareum. For, this involves the assumption that the Sulphur and the Calcarea carbonica have undergone no changes during the process which made, out of them, that third substance-Hepar sulphuris. No! Hepar sulphuris was proved as such. If we select it, for the reason that the symptoms which it produced correspond to those of the patient, then we must give Hepar Sulphuris, the very substance that was proved. Otherwise we plunge into a sea of speculation and hypothesis and forfeit that certainty which it was the sole object of our science (as of ever science0 to attain. In like manner, if the Iodide of Mercury had been proved on the healthy subject and its symptoms were most similar to those of our patient, it would not be a compliance with the demands of our science should we give, instead of Iodide of Mercury the very substance that produced these symptoms, the Mercurious vivus and the tincture of Iodine, assuming that, because Iodide of Mercury is a compound of these two substances, therefore the conjoined or alternate action of the elements from whose union it sprang must be identical with its own. From instances like these, it is clearly to be seen that we may not, consistently with the principles of our science, prescribe drugs in any other from or combination than that in which they were proved. If drugs had been proved in alternation, we might then with propriety, perhaps, prescribe them in alternation. Until this is done, the method is a hap-hazard, chance operation- successful, no doubt, at times, but in such a way that success could never be foreseen or insured, nor could the experience of the practitioner in any way serve to establish or confirm any principle of medical science.
A homoeopathic prescription, as we have defined it, is a deduction from a generalization, which has been established by induction from a multitude of instance. This is the law SIMILIA SIMILIBUS CURANTUR, in accordance with which the remedy is selected, under the three requirements that we have specified. So well established is this law of nature, that if we are so fortunate as to be able, in any given case of disease, to comply closely with those requirements, and particularly with the second, we may with certainty predict, and in confidence await, the favorable result of our prescriptions. Such certainty of foresight and such confidence it is our great object to attain, and nothing but a scientific method can afford them.
But we have shown that alternation, as we use the term, and as we have described the process, is incompatible with this scientific method. It does not meet the requirements of the law. It does not take the aggregate of the symptoms as the single basis of prescription. It does not give the remedy, single and simple, such as it was used in the proving. But it permits itself to act on two assumptions-that the aggregate of the symptoms may be arbitrarily divided and separately prescribed for; and that two or more drugs which have been proved independently of each other may be used conjointly as a sort of composite analogue to the aggregate of the symptoms; and all this with equally good and sure result. These two assumptions are not even alleged to be based on any collection of facts. Their introduction deprives the proceeding of all claim to a strictly scientific process.
The advocates and defenders of alternation are naturally divided into two classes. The one frankly disavow any pretension that alternation is a scientific deduction from a general principle, and defend it on the simple ground of experience. They have alternated successfully in a case or cases like the present, and therefore they do it 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'.