No physical research can detect this vital force, nor reveal the nature or modus operandi of this function of sympathy, and hence it happens that those whose minds incline to rest upon the data of physical analysis are prone to overlook them, or, even though they admit them in their philosophy, yet to practically ignore or underestimate them. From this tendency results a disposition to regard the proximate cause of disease-that is to say, the material change of tissue and product-as the essence of the disease, forgetting the modification of vital force, which must have preceded and been the occasion of this proximate cause, and a further disposition to look upon the the alteration of function and tissue of each organ or system of the body as a separate disease, thus easily admitting the idea of the co-existence of several independent diseases and of complicating diseases without number.
From the stand-point of this class of mind it is not easy to perceive the mutual relations and interdependencies of apparently remote groups of symptoms- such, for example, as ulceration of the cervix uteri and chronic conjunctivitis, which, if they co-exist in any patient, would be likely to be regarded as independent diseases, and to be treated by independent courses of medication; whereas, in fact, they are so intimately connected that they are best treated by a single remedy.
Nothing is farther from our purpose than to make light of Pathology, which, as an aid in the investigation of disease, is of inestimable value. It is evident, however, that Hahnemann was right in warning his disciples against making it the basis of medical practice. Its investigations cannot, in the nature of things, go beyond material changes. Yet disease begins in dynamic changes; and the connections of different groups of symptoms are dynamic, and beyond the reach of physical research.
And then, even where the subject is material and amenable to physical research, to base the prescription upon a determination of the organ or tissue affected by the drug and by the disease, is to go backward from the certainty afforded by a comparison of the symptoms to the uncertainty of a double hypothesis. For, as in the cases supposed by Dr. Drysdale, we have first to assume that the symptoms produced on the healthy subject by Mercurius corrosivus and by Sulphur respectively, show that the one of these drugs acts especially on the mucous membrane of the colon, and the other on serous covering of it; and, secondly, we must assume that, in the patient before us, the inflammation which began in the mucous membrane has extended to the serous membrane; and on this double assumption our alternation is to be based and defended. Suppose, that in its progress from within outward, the disease also affected the muscular coat-should we give Nux vomica also? Or the glands likewise-shall we give a fourth remedy, say, Rhus Then the vascular system of the gut is probably simultaneously affected-would this call for Hamamelis, or for Aconite for the arteries and Hamamelis for the veins? Here we should have six remedies to be alternated, the selection of each being based upon its “specific relation to the tissue” affected, etc. Now, what is all this but a revival of the old method, against which Hahnemann so earnestly protested, or prescribing upon the basis of an hypothesis of the nature and seat of the disease-an utter throwing overboard of the whole system of Inductive Philosophy, as so logically and so successfully applied to medical practice by Hahnemann?
It may be worth our while to dwell for a few moments longer on this very important branch of the subject, for it is a point on which very many practitioners have gone astray. Indeed, we have seen an attempt to reconstruct our entire Materia Medica Pura, on the basis of the specific action of the drugs respectively upon certain organs and tissues of the body-almost all symptoms not anatomically explicable being excluded (the so-called “American Materia Medica”).
The statement of a “general principle,” which we quoted, viz., “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 particular manner upon a particular organ or tissue, or upon a particular set of organs or tissues,” contains, it seems to us, a fallacy. While we admit, of course, that each drug has its own specific sphere and manner of action it does not seem to us that this is equivalent to saying that each drug acts in its peculiar way on “a particular organ or tissue, or a particular set of organs and tissues,” leaving (for this is implied in the statement, as the rest of the article from which we quote shows) leaving the other organs and tissues of the body wholly unaffected by the action of the drug of disease, as the case may be. Yet it is necessary to assume this fallacy, in order to justify the practice of alternation.
On the contrary, we have never met with, and we do not believe in the possible existence of, a case of sickness in which, as adduced by Dr. Coe, the head could be affected in one way, so as to unmistakably call for Aconite, and yet no organ of the body show Aconite symptoms; while at the same time the chest presented exclusively Bryonia symptoms, and the extremities Rhus symptoms. The uniform tendency of our own practical experience goes to satisfy us that, if any concrete case should present clear characteristic Aconite symptoms in any portion of the body, then not only would symptoms of disease be found in most of the other important organs or systems, but not these system would present more or less well defined characteristics of Aconite: or even should they not present characteristics which we recognize as those of Aconite, the symptoms would nevertheless speedily disappear under the use of Aconite, if that drug were clearly indicated by characteristic symptoms in the other organs. So abundantly has our experience confirmed this view, that if we find clear characteristics of any drug in the symptoms of any organ of the body, no matter what symptoms may be presented by other parts of the body, and no matter how little these latter symptoms may seem to indicate this same drug, we never dream of alternating remedies. We are confident that a remedy which is clearly indicated by characteristic symptoms, though they be but few in number, will cover the whole case, and will remove the entire disease. Nor do we, as is assumed by the alternators, expect to accomplish by “succession” what they aim to effect by Alternation. We so thoroughly believe in the unity of disease as to be confident, that, in however many organs and tissues morbid symptoms may present themselves, they still spring from and depend upon the and the same unknown and inscrutable cause, just as the multifarious symptoms of a drug-proving depend upon one cause, viz., the drug; and that though the characteristic symptoms which furnish the indication for the remedy may be observed only in the symptoms of one organ or system, yet the symptoms of the rest of the body will be equally controlled by the action of this remedy. It is remarkable, however, to how great an extent, if we observe carefully and intelligently, we may recognize, in the various groups of symptoms affecting the various organs of the patient, the characteristic mode of action, and the conditions of that remedy, the characteristic indications for which we find in some one organ alone of the patient!
The tendency of the second of the classes of minds into which we divided medical philosophy is to synthesis. They are, perhaps, in danger of underestimating those material changes of tissue which are the proximate cause of disease, because they are intent upon observing and tracing out that perversion of the vital force which must have preceded and induced all the organic and material changes which the case presents, and which perversion they regard as essentially the disease itself. They study this perversion in its various manifestations, viz., the symptoms. They do not seek to analyze these groups of symptoms, for the purpose of forming a theory respecting the tissues affected, so as to select a remedy which affects, as they suppose, identical tissues, and in the same way. They do not thus admit hypothesis into their method. They study the groups of symptoms to get at their peculiarities and conditions. Profoundly impressed with the intimate connection of all parts of the body, through the all-pervading Vital Force (whatever it may be), and with
the fact, observed every day, that change of function in one part of the body speedily brings about corresponding changes in almost every other part, they seek, by the light of one group of symptoms, to find in the patient other and corresponding groups. In these investigation Physiology and Pathology, which teach the relations and mutual dependencies of different organs, are of inestimable value, enabling the student to find in remote organs parallel groups of symptoms; the characteristic which determines his choice of a remedy being often in an organ very remote from that to which his attention was first called as being the seat of disease. Having thus been led, by his philosophy, to collect the various groups of symptoms presented by the entire body, as constituting one single disease, the practitioner surveys this collection in search of the characteristic symptoms, or group of symptoms might be found among many remedies, or group of symptoms which shall point to this remedy. Ninety of the symptoms might be found among many remedies, ten perhaps may be peculiar to, and characteristic of, a single drug. This he selects, without hesitation, as his remedy for the entire malady of that patient.
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'.