Now, everybody knows that pains and various sensations different from those of health, make up a large and important part in every case of illness. And what are these sensation? Unquestionably they are the results of abnormal action of the sentient nerves, r else they are evidences conveyed by the sentient nerves of abnormal action in some of the organs of the body.
It is in highest degree unphilosophical to arbitrarily disregard and cast aside any of the phenomena of disease. If they find no place in our system of medicine, why, so much the worse for our system!? If they cannot be made available under our method of treating disease, this fact is prima facie evidence that our method is defective! Furthermore, every physician and every intelligent person know, by observation and experience, that pains and abnormal sensations almost always precede any material or organic evidence of disease. Common sense teaches every man the value, in medical treatment, of the maxim, “Obsta principiis!” Diseases should come under treatment at the earliest possible moment. Some that are curable at an early period are well known to be incurable by our present resources, if allowed to establish themselves firmly. But the first evidence of nearly all diseases consist of subjective symptoms. A method, therefore, which does not provide for the employment of these symptoms in the determination of the treatment, cannot furnish means for encountering disease at the very outset.
And, appealing again to the experience of the community to bear me out, I say that honest and candid practitioners of the Old School often say to their patients, “Wait a little until your disease shall have become developed, at present I know not what to do.” Why does he not know what to do? This question touches the weak point in the philosophy of the physiological school. It is because the patient, as yet, presents only “subjective” only, because he cannot from a theory of the cause of the disease until he cannot from a theory of the cause of the disease until the disease has progressed far enough to furnish him with some material results of these dynamic changes, in a word, with objective symptoms. This instance is another evidence of the insufficiency of the Old School philosophy of medicine, while at the same time it shows that, so long as they accept this philosophy, the physiological school are consistent and logical in excluding subjective symptoms from consideration.
Not a few diseases-the neuroses, for example-consist almost entirely of subjective symptoms. In these, the physiological physician admits his inability to institute a rational treatment, and he resorts at once to specifics. But if the specific method of treatment is available against diseases for which the physiological method fails, as well as for all other cases, is it not confessedly the universal method?
Hahnemann’s method, which avails itself of all the phenomena which the patient presents, holding that all together, make up the disease, sets a true value upon subjective symptoms. Not requiring a theory of the nature and cause of the disease as a preliminary to the treatment, but basing the treatment directly upon the phenomena which the patient presents, it can proceed to cure a patient who presents only subjective symptoms as readily and as surely as one in whom these have given place to objective symptoms.
More than this, Hahnemann showed the value of subjective symptoms in the aid which they afford us in individualizing cases of disease, and thereby enabling us to select a specific for each individual case with more absolute precision. Indeed, he showed that it is only by means of subjective symptoms that the application of individual specifics is possible. It has already been remarked that the material or organic changes in the tissues of the body, which furnish the objective symptoms, may have resulted from any one of a number of pathological process or abnormal alterations of function, and that they give us in themselves no means of knowing from what particular abnormal process they resulted. Now, unless we know this, we cannot apply specifics with exactness. The physiological school have no means of knowing it, and therefore they, very logically, do not undertake to apply specifics with exactness to individualize cases of disease. But the subjective symptoms enable us to take cognizance of these pathological processes, these abnormal changes of function, and hence the value of these symptoms. To Hahnemann belongs the honor of having demonstrated this value, and of having shown us how to avail ourselves of it.
To Hahnemann, again, belongs the credit of having insisted upon the propriety of using only one remedy at a time. As this, however, was clearly expressed by Boyle, and is admitted by Sir John Forbes, I shall content myself with quoting their words. Boyle says (1654): “It seems a great impediment to the further discovery of the virtues of simples, to confound so many of them in compositions; for in a mixture of a great number of ingredients, it is hard to know what is the operation of each or any of them, so that I fear there will scarce, in a long time, be any progress made in the discovery of the virtues of simple drugs, till they either be oftener employed singly or be but few of them employed in a single remedy.” And Forbes says, in 1846: “Our system here is greatly and radically wrong. Our officinal formulae are already most absurdly complex, and our fashion is to double and redouble the existing complexities. This system is a most serious impediment in the way of ascertaining the precise and peculiar powers (if any) of the individual drugs, and thus interferes in the most importance manner with the progress of therapeutics.”
And, finally, Hahnemann demonstrated these facts:
1st. That the curative power of a specific remedy is not in the direct ratio of its material quantity. This had been suspected by his predecessor Sydenham, with respect to bark.
2d. That a drug exerts a more powerful effect on those organs for which it has a specific affinity when these organs are sick than when they are healthy; whence it follows that smaller doses of the same drug are required to cure diseases for which it is the specific remedy, than would be needed to produce their symptoms in the healthy person.
3rd. That not only are smaller doses of specifics required to cure diseases than to produce their symptoms in the healthy, but that, when the symptoms of the diseased organism are similar to those produced in the healthy subject by a given drug, then this drug will act curatively on that organism in doses so small that they would hardly produce any effect whatever on the healthy organism.
But how small? That is the practical question. A priori, Hahnemann said, “The smaller the better, provided they only cure the disease in the quickest and surest manner.” He experimented for the purpose of reaching definite conclusions, and out of these facts and experiments came the doctrine and practice of the little doses. And I repeat that those who follow Hahnemann most closely, individualize their cases most strictly, and select the individual specific with most exactness, will surely arrive, as all such have done, at the conclusion, on this subject, to which Hahnemann came.
It is remarkable that the first and second facts I mentioned respecting the dose of specifics did to escape the acute mind of Robert Boyle. He says: “To show you that a distempered body is an engine disposed to receive alterations under such impressions as will make none upon a sound body, let me put you in mind that those subtle streams that wander through the air before considerable changes of weather disclose themselves, are wont to be painfully felt by many sickly persons, and more constantly by men that have had great bruises or wounds, in the parts that have been so hurt, though neither are healthy men at all incommoded thereby, nor do those themselves that have been hurt feel anything in their sound parts whose tone or texture has not been altered or enfeebled by outward violence.”
If quantity be accepted as the measure of power, then the question of the dose must be resolved by the well-known laws of physics.
But so soon as it is admitted that the power of a drug is not determined by its quantity alone, but also by its form, and still more by the condition of the patient and by the relation of the specific properties of the drug to the diseased condition against which it is administered, then the whole question is withdrawn from the domain of physics and is left open to be settled by experiment.
Now, it is admitted by all medical men, that some drugs at least, exert their specific influence more speedily and more powerfully when given in small doses than when given in large doses, as for example, Mercury, and according to Dr. Christison, Oxalic acid, which shows that there is not always a direct ratio between power and quantity.
Moreover, all medical men agree that in certain morbid states, the body is much more sensitive to the specific action of certain remedies than it is, in certain other morbid states, to the same remedies. The phrase that “such or such a disease does not bear Mercury well,” is familiar to the professional ear. This shows that the condition of the patient has something to do in determining the power with which a certain dose of a specific shall manifest its action, and conversely that this conditions should be taken into consideration in determining the dose.
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'.