Having thus shown our belief that the alternation which Dr. Drysdale defends, for the purposes of “meeting complications,” and of “awakening susceptibility”, is not alternation a priori, not alternation properly so called, but is compatible with sound doctrine, although explained by the use of unsound pathological hypotheses, we shall pass, next, to the two general principles on which alternation, properly so called, is really based and defended.
Before proceeding further in the discussion of the subject of Alternation, let us briefly recapitulate the positions already taken.
1. We have assumed that the propriety of Alternation can be argued about only by those who regard the practice of medicine as an art based upon scientific principles, by reference to which it is to be regulated and exercised. We have not considered it possible to discuss the questions with those who make their practice a series of repetitions of individual experiences, without the intervention of general principles based on and inferred from a large number of individual instances.
No discussion can be sustained with this class of practitioners, for the reason that arguments involves, in its very nature, an appeal to principle and the exercise of reason. When, consequently, and advocate of Alternation objections to our condemnation of his method, that he regards the subject from a practical point of view, while we persist in ignoring the practical, and in looking only at the question as one of science, we feel driven to the conclusion that, if excluded from the ground of scientific principle, we have no ground left on which to stand for the discussion of this or of any question of medical practice; and further than this we have nothing to say.
2. We have stated our belief that many writers have defended, under the name of ALTERNATION, modes of practice which are, in our opinion, not properly called Alternation, and which certainly are not open to the objections that we entertain to what we have defined as ALTERNATION, properly so called.
3. Defining Alternation, as we understand it, we have taken occasion to state requirements of a sound homoeopathic prescription, requirements, which cannot be met by the process of Alternation.
We come now, in conclusion, to consider certain statements of principles by which Alternation, as we define it has been sought to be justified and defended.
DR. Coe (1 American Homoeopathic Review, vol.v., p.447) “It is an established principle in Homoeopathy, demonstrated by drug-proving and clinical experience, that each drug has its own specific sphere and manner of action, hence that each remedy acts in a particular manner upon a particular organ or tissue, or upon a particular set of organs or tissues. Another recognized principle in Homoeopathy is, that attenuated remedies act on the system only by virtue of their homoeopathy to the disease by which the system if at the time affected hence they are inert when taken by persons in health.” (One of our best provings of Natrum muriaticum on the healthy was made by Dr. Wurmb with the 30th decimal dilution!) ** “But supposing I find no single remedy that will complete the picture (corresponding to the picture of the disease); some part is still defective- it either wants a head, a body, or a limb, what am I to do? What I do is this: I finish out the picture with something that will complete it. If the head symptoms are unmistakably Aconite symptoms, and nothing else, the chest symptoms unmistakably Bryonia symptoms, and nothing else, and the symptoms of the lower limbs unmistakably Rhus symptoms, and nothing else, (1 Humano capiti cervicem pictor equinam Jungere si velit, et varias inducere plumas Undique collatis membris, ut turpiter atrum Desinat in piscem mulier formost superne, Spectatum admissi risum teneatis, amici?) I can finish my picture in no other way, nor can any one else. ** But the single remedy objector says, one of my medicines will modify the action of the other in such a manner that I cannot rely upon their doing what their pathogenesis would indicate. I think he is mistaken. If attenuated medicines only act homoeopathically, as we all hold, only act upon those organs and tissues which are affected by disease in a manner similar to the drug affection, then my Aconite, Bryonia and Rhus each goes, to its own place, and performs it own office, without interfering or being interfered with by the others.”
Dr. Drsdale appears to agree with Dr. coe, for the says; (2 Annals of British Hom. Society, xvii., 375). “There are, therefore, no a priori physiological grounds for doubting that two medicines, whose physiological spheres are sufficiently dissimilar, can display their effects without interference, when given at intervals. Let us apply this to the treatment of complications in disease, and by this we may chiefly understand those symptoms or morbid states that are not necessarily dependent on one common proximate cause, but are connected merely by their happening to co-exist in the same individual.” (We protest against this cool assumption that two or more “morbid states may co- exist in the same individual,” connected merely by their accidental co- existence!) “After exposure to cold we may be attacked with inflammation of the nasal, tracheal or bronchial mucous membrane, or parenchyma of the lungs or the pleura or the parietes of the chest or the liver or peritoneum, etc., according to the specific susceptibility of the tissues attacked; and each of these diseases may exist separately, and be attended with the appropriate essential and sympathetic symptoms of the case. In such cases we ought properly to rely on one medicine, which may be reasonably expected to meet the specific susceptibility of the part primarily affected. But, on the other hand, from exposure to the same cause, inflammation may be set up in several of those tissues at the same time, and thus several trains of morbid symptoms set up that have no necessary (would the author have better expressed his real meaning if he had said, ‘pathologico-anatomical?’) connection, except that of occurring in the same individual. In that case, how can any one medicine be homoeopathic to the case which does not show its specific relation to all those different tissues in health?
“dr. Cate also brings forward inflammation of the mucous coat of the colon. When it extends to the peritoneal coat of the gut, he gives Mercurius corrosivus in alternation with Sulphur, corresponding to their specific action on their (these) different tissues. Also in inflammation of the membranes of the brain, threatening effusion, he finds Bryonia, alternated with Hellebore, more efficacious than either singly. But this is already recognized in Homoeopathy, without stepping into the doubtful regions of pathology.”
In discussing these statements we desire to use great moderation of expression, conceding freely that they involve questions of pathology and Pathogenesy, of which our knowledge is only, and perhaps can be only, proximative, and concerning which, instead of absolute facts, we have only probabilities.
Among those who discuss questions of medical philosophy may be distinguished two characters of mind, corresponding to similar classes among intellectual philosophers-the analytic and the synthetic.
The tendency of the one class is to divide an independent group of phenomena, such as a sick man or a drug-proving presents, into elements each one of which it inclines to regard as independent of the others. To the researches of this character of mind owe our knowledge of Histology, both physiological and pathological, and much else that is of inestimable value in medical science. The same disposition being carried into clinical investigation, the symptoms of the sick man have been analyzed into the perversions of function of the various organs, and the alterations of the different tissues of the body, as well as the formation of tissues not found in the healthy body. As a result, we have the precious sciences of Pathology and Pathological Anatomy.
Based, as these analyses are, upon material changes of structure and of product, the danger to which those who engage in them are liable is this: that having their attention exclusively directed to material changes, or to visible and tangible results of material changes, they overlook two points to which it is equally important that observations should be directed.
1st. That inasmuch as healthy tissues exist, and healthy functions are performed, by virtue of an imponderable force called for lack of a better name. “Vital force,” and which is inherent in each tissue, and gives to it its specific properties, there must have been a change in this force preceding every material change.
2d. That this force, though it seem to impart to each tissue and organ a susceptibility to stimulus peculiar to that tissue, yet so pervades and vivifies the entire organism, as to give rise to what is known as sympathy-a property of living organisms, by virtue of which there results, from the serious modification of any function or alteration of any tissue, a corresponding and definite modification of most if not all of the functions of the body, and an alteration of at least many of the tissues. It is by virtue of this property that each individual man is a living unit, and not a collection of independent monads, which merely chance to co-exist in one human form.
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'.