Editorial Remarks On Alternation



3. But there is another view of this matter from the practical stand-point. Dr. H. says: “Grant that in a given case of the use of two remedies, some one remedy might have been found that would as well, or better have answered the purpose ** the question is not, Could some other person have done better than I, but Have I done the best I could? Undoubtedly, yes! And, so far as the prescriber’s own conscience is concerned, this answer exonerates him, even though his prescription were a faulty one. And in so far, from the practical point of view, alternation may be justifiable. But will his question, ‘Have I done the best I could?” if affirmatively answered, always justify the prescriber? The practitioner of one year’s experience may commit a sad blunder and yet be fully justified, because being inexperienced and young, bad though his error was, he did ‘the best he could.’ Would this plea justify the same blunder ten years later? Obviously it would not. Yet is it not the tendency of this plea to satisfy a man with the knowledge he has and with the methods he pursues, and thus to blunt his zeal for greater knowledge and better methods? Remonstrate with the allopathist for murdering patients with lancet and purge; he replies, “I act according to my light’ I do the best I can.’ And so through all degrees of error and imperfect knowledge. It is a dangerous plea, unless its complement be always added, ‘I have done the best I can, but please God, I will do better next time!'”

And here we see the advantage of a sound “theory,” which our friend holds in so light esteem.

Suppose a practitioner driven, as Dr. H. was driven, to alternate. The patient recovers. He has, nevertheless, a conviction that drugs modify each other’s action in a way that we cannot foretell, and that the action of the entire organism is so harmonious that “two morbid states cannot co-exist independently,” and that, therefore, the morbid state being essentially one, there must be a possibility of one similar drug-disease to oppose it. A sound theory compels him to the belief that alternation is not justifiable nor defensible on scientific grounds, and that it can do nothing to advance our knowledge of Therapeutics, but rather confuses it. He enters in his mind a protest against the practice to which the necessities of practical duty and his limited knowledge of the materia medica have constrained him, and turns with redoubled vigor to the study of materia medica, smarting a little with shame that the exigencies of practice have found him unprepared, and have compelled him to a resort which, though successful, his reason condemns, and determined that the next time he will, if possible, be equally if not more successful, and by a method which shall commend itself to his reason, and shall add to his stock of knowledge for future use.

And if, while “doing the best they can,” as each case presents itself, practitioners will earnestly and systematically study the materia medica, determined to do better and better the next time, we shall have no word of reproach to utter against their temporary expedient of alternating drugs. With broader knowledge they will alternate less and less, and we are very sure that they will see, as we have done, how, in case after case in which they had alternated, the recovery was in truth retarded by the mutual reaction of the drug; and how the careful individualization of the case, and the painstaking selection of the single drug in the manner that Hahnemann advised, will be in their hands the means to a success far beyond any ever reached through alternation. For, though we have admitted and do admit that success is the object of all our labors,” we are nevertheless convinced, through our own experience, for we have alternated in our day, that a much larger measures of success is obtained by adherence to the rule of administering single remedies, and that closer study of the materia medica and sharper investigation of cases will preserve us from those dilemmas in which we are tempted or compelled to resort to alternation.

4. And if we appeal to the experience of Hahnemann, let it be understood that we appeal to the man who both knew materia Medica better than any other man ever knew it, and who had more practical experience than any of us has had. Let us not indulge in the fallacy of supposing that, because we are now practicing in the fifty-ninth year since the Organon was published, we have had fifty-nine years’ experience in homoeopathic practice, and have been studying materia medica fifty-nine years. On the contrary, our own experience is measured only by the actual number of years we have practice; since in this matter of assimilating to one’s own mind the facts of the materia medica, and of seeing the correspondence between these and the facts of the disease, we can borrow but little from the experience of others.

If then we, from our little experience of fifteen, or ten, or five years, appeal to Hahnemann with his venerable experience of more than fifty years of active practice, with his unapproachable knowledge of the materia medica, of which he might justly say like Aeneas, “magna pars fui,” with his unrivalled powers of observation and discrimination; if we appeal to him as “authority” on this question, at once practical and scientific, can it justly be said, that we are seeking some “authority outside of and beyond our own reason?” Our colleague appeals to collections of “facts.” Is not Hahnemann’s statement of his practical conclusions a most stupendous “collection of facts?” Who ever observed so many of them? Who ever observed so well as he? Facts must be received on testimony; who ever reported more graphically and more faithfully than Hahnemann? If we doubt his ability, his capacity, his candor, what are we doing with his materia medica, on the truth of which we risk our patients’ lives?

This outcry against “swearing in the words of the master” has come to have a very different meaning from that of the ancient original protest. It was never meant to intimate that the opinion and testimony of him whose abilities had crowned him “kind of men” should not have a royal weight of influence.

EDITORIAL REMARKS ON ALTERNATION.

(1 Suggested by a contribution by Dr. C. to the American Homoeopathic Review, vol. v., April, 1865.)

II.

This article very justly afirms that the question of alternation, being a practical one, “must be decided by experience;” that no dogmatism will satisfy those differing in opinion. The writer then straightway proceeds to dogmatize on the basis of two assumptions, which he claims to be “established principles in Homoeopathy,” but which very few will concede in the terms in which he has expressed them.

Having referred the question to experience, he makes no appeal to experience, whether his own or his neighbor’s. If he have experience which can throw light on this question, it ought to be comparative experience. He ought to be able to say: “For a certain period of times I avoided alternation, selecting may remedies as Hahnemann directs; then, for a period I alternated. My success under the latter method was the greater.” Such a statement as this would carry weight. But we gather from this article that the author has always practiced alternation, deriving his ideas of its propriety and necessity from the assumed :”established principles” upon which he bases his arguments, and upon the assumed imperfections of the materia medica.

If our conjecture be correct, then his experience, being confined to the practice of alteration and not bearing upon the opposite method, can have only a negative value. It merely shows that a measure of success does attend this faulty form practice, a point which was freely conceded to Dr., H.(2 See previous paper) But inasmuch as no advocate of alternation claims invariable success, the question remains, “Might not the success have been greater if alternation had been avoided?” Not having any comparative experience by the light of which to answer this question, the alternator ab initio, could not reply.

Our editorial note to Dr. H.’s paper expressly referred to Hahnemann’s experience, and to the experience of the writer, as being of this comparative character, and as, therefore, bearing on this question, and as showing, so far as they go, that the results of adherence to the single remedy are more satisfactory than those of alternation.

Some of the points touched by Dr. C. are too important to be treated in this annotation. They will be discussed in a future number of the Review. (1 See “Alternation of Remedies,” Nos. 1 and 2)

Suffice it now to say that, when he states that “the only reason why he practices alternation is the want of perfection of the materia medica,” he concedes (if he will allow us to add one other analogous reason, viz., “want of perfection in the knowledge possessed by practitioners of the materia medica which we already have”) all that the opponents of alternation contend for. For this position admits that alternation is wrong in principle, and is only necessitated by a temporary emergency. We contend that the emergency, instead of being common, is rare, if not altogether imaginary, and we appeal to our practice.

Carroll Dunham
Dr. Carroll Dunham M.D. (1828-1877)
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'.