Study of Materia Medica

These characteristic symptoms, so precious to the Therapeutist, may seem to be of little or no pathological value, to those who forget that there are no accidents in Nature. They would be valueless if we did not need to individualize….

The method by which any subject may be most successfully studied must depend on the use which is to be made of the knowledge thus gained. It is proper, then, to inquire at the outset in what way the knowledge of Homeopathy Materia Medica is to be made subservient to the treatment of disease.

In accordance with the homoeopathic law, we select for the cure of each individual case of disease that remedy of which the pathogenetic effects are most similar to the symptoms of the case. In the process of making this selection we must pass in mental review the various drugs which compose the Materia Medica, take a comprehensive view of the pure effects of each, and institute a comparison between each in turn, and the case for which we are prescribing. This is the theory of the process.

Now, it is evident that, in order to select from a number of candidates one which most nearly resembles a given standard, we must be familiar, not merely with the general properties of all the candidates or of certain classes into which they may be divided, but also with certain properties more or less peculiar to each of the candidates, and which shall serve to distinguish each of them from all the others. In fact our method requires the strictest individualization of both disease and remedy. We are so to study Materia Medica as, above all, to bring into strong relief and fix firmly in memory those peculiarities of each drug which are not met with in any other, and which therefore serve to individualize and give character to the drug that produces them and which are called its “characteristic symptoms.” This term having been much and loosely used of late, it may not be unprofitable to devote a few words to the subject of characteristic symptoms.

By some writers the leading and most obvious and most frequently recurring symptoms are called characteristic. Thus Bennett calls fever a characteristic of the Exanthemata. By others the pathognomonic symptoms of a class of diseases are called characteristic, by others the Pathologico-anatomical.

Now, the signification of such a word as characteristic is not absolute. It depends on the connection in which you please to use it, and which is determined by the question, “Characteristic of what?” In the instances just adduced, the varieties of symptoms cited may indeed be called characteristic, but- characteristic of what? Of classes (the Exanthemata), of groups (nosological)- but not of individuals. But the only sense in which Homoeopathists can use the term is in its application to individuals. Hence a characteristic symptoms must mean one which is possessed by none other than the individual drug of which it is predicated, and to which therefore it gives character as an individual. In this sense it corresponds precisely to those features of a man by which his friends are enabled to distinguish him from other persons and to recognize him at a glance.

It is obvious that these characteristic symptoms so precious to the Therapeutist may seem to be of little or no pathological value, may even seem accident to those who forget that there are no accidents in Nature. They would be valueless if we did not need to individualize, but could be content with grouping our diseases and remedies.

To the Naturalist whose object it is to group his specimens, it is sufficient to know that John Doe has a vertebral column, is a mammal, has two hands, and is a Caucasian-because this enables him at once to place John Doe in the variety Caucasian of the species man, and his analysis goes no father. From this his whole physiological status follows. But these items of general knowledge would hardly enable the sheriff to recognize Jhon Doe in Broadway. It is of no importance to the Naturalist that he has such “accidental” peculiarities as an aquiline nose, black eyes and hair, and a brown mole on the left ala nasi; but these very peculiarities are all important to the sheriff, for they give him the means of detecting the object of his search upon the crowded street. It must not be forgotten, however, that the points on which the Naturalist laid stress are equally important to the sheriff; for if the latter should bear in mind only the individual peculiarities of the object of his quest and should forget that he is Caucasian, he might find the former in the person of and Indian, or, if he should forget that he is a bimanous creature, he might arrest a monkey.

To drop the figures, then, it is evident that we must seek to discover among the symptoms of every drug certain ones that are produced by no other drug, and which shall serve to distinguish it from all other drugs similar in other respects; that these symptoms will often be unimportant and trivial in a physiological point of view; furthermore, that we must, for convenience stake, when the number of drugs in our Materia Medica has become considerable, endeavour so to group them, on the basis of certain clearly defined symptoms or collections of symptoms, that for the purpose of preliminary examination and comparison, these groups may be regarded and compared as though they were individual drugs.

Let us suppose a case of uterine haemorrhage. As many as forty drugs probably produce uterine haemorrhage. On the basis of this symptoms, they form a group isolated from the three hundred and forty remaining drugs of the Materia Medica. We select this group from the Materia Medica, and now we must select a remedy from the group. It were a tedious task to consider and compare them one by one. But we group them again; ten of them produce dark-colored and ten florid haemorrhage; ten a limpid and ten a clotted discharge. Our case has a dark- colored discharge. Our choice is now restricted to ten drugs. But of the ten which produce a dark discharge, only five produce simultaneously a congestive headache. Thus we are limited to five drugs. Thus far, the distinction on which our grouping has been based (or which have been characteristic of the groups) have had a pathological significance and importance. We can find no such basis for any further subdivision into groups. But we observe in the case a peculiar subjective symptom. The patient complains “as though a living body were moving through the abdomen.” This may seem trivial. It is equally, however, a symptom produced by Crocus, which is one of the five remedies to which our choice had been restricted, and it is produced by no other drug in the Materia Medica. It is, then, a characteristic symptom of Crocus, enabling us to individualize Crocus, and to distinguish it from all the other drugs which in many other respects agree with it.

It will be observed that dark-colored uterine haemorrhage, though produced by Crocus, cannot be said to be characteristic of it. It is a characteristic symptom of a group to which Crocus belongs, but not of Crocus, for it is produced by the other members of this group as well as by Crocus.

Characteristic symptoms must of necessity be for the most part subjective and seemingly trivial phenomena. A list of them alone, if presented as the pathogenesis of a drug, would be as meaningless, and at first sight as ridiculous, as a list of the colors and marks and angles and curves by which friends recognize each other would be, if presented alone as the sum total of the properties of certain genera and species of the animate creation. As a background to the latter, there must be a series of phenomena capable of morphological and organic arrangement, and as the basis of the former we must have a series of objective and organic symptoms capable of physiological and pathological arrangement and of approximate explanation. But it must never be forgotten that without the characteristic, as we have described them, there can be no individualization, and without this there can be no be no individualization, and without this there can be no accurate homoeopathic prescription.

The truth of this is made apparent by a glance at the history of Homoeopathy. Certain of Hahnemann’s followers discarded the apparently trivial subjective phenomena from the provings of drugs, retaining only the objective, organic symptoms. They thus lost the means of distinguishing between the individual members of the groups of remedies. It was thenceforward useless for them to discriminate closely between individual cases of any one type of disease. Hence, inevitably, arose the fashion of prescribing a specific remedy for a disease, as the phrase went, putting the leading members of respective groups of drugs and diseases to represent the whole groups. These were the co-called “specifickers,” who had one or two remedies for dysentery, one for whooping-cough, one or two for scarlatina, etc. “of whom the world is weary”.

But the characteristic is not always a definite symptoms. Sometimes it is so, as in the case of Crocus, and as in the peculiar diplopia of stramonium. But sometimes it resides in a peculiar condition which attacks to some symptoms common to two or more drugs. This condition may be of time, or circumstance, or concomitance. Thus, if two drugs have the symptom “dry cough from tickling in the suprasternal fossa,” but to one is added the condition “occurring only in the evening,” this condition of time is the characteristic of that drug in so far as the dry cough is concerned; or if one have this condition of circumstance, that “the cough is aggravated by inspiring cold air,” this condition is the characteristic; or if one have the concomitant that the cough is attended by retching, this condition of concomitance is the characteristic.

Sometimes the characteristic resides in the conditions collectively. We borrow examples from Dr. Drysdale’s admirable Introduction to The British Repertory:

“Pain in the stomach in the morning under thirty-seven.

“Pain in the stomach with nausea in the morning under four only.”

Or it may reside in a concomitant

“Dry retching occurs under forty-five drugs.

“Dry retching in the morning under five.

“Dry retching with eructation under one only-Ledum.”

Every drug-proving, then, is to be studied in a two-fold way: On the one-hand, so as to enable us to attach it in our memory to certain groups of drugs to which it shows marked general resemblances; and, on the other hand, so as to bring not clearly into view those characteristic which distinguish it from all the other drugs of these groups in particular and of the Materia Medica in general. Our study will be at once synthetic and analytic.

Such a study is of necessity comparative in its nature. Each positive step in the study of a drug involves a question of the correspondence or difference of other drugs in respect of that step. An isolated study of all the remedies would not give us an available knowledge of the Materia Medica. It is not enough to know that Pulsatilla, Nux vomica and Chamomilla each produce diarrhoea of a certain kind. We must also know and fix in our minds the similarities and difference of each of these diarrhoeas to those of the two others and of all other drugs. The study of one drug is, in fact, then, the study of the whole Materia Medica. One is never so competent to thoroughly master a proving as when he has already mastered all other provings. The first effort must necessarily be the least satisfactory, the most imperfect.

This is the task to which the student of Materia Medica is invited and at which his predecessors have been laboring for fifty years. Why, he may ask, has not this been wrought out and systematized by those who have gone before? Why is the Materia Medica left in the same state in which Hahnemann placed if fifty years ago?

Our Materia Medica consists of the provings of drugs upon the healthy, made by Hahnemann and his disciples. These provings, as we have them, are, for the most part, a formal arrangement of the symptoms subjective and adjective observed by the prover or his friends. No attempt is made, with but few exceptions, to trace any pathological connection between symptoms, or to give any physiological explanations, or to distinguish between characteristic and generic symptoms. The symptoms alone are given, just as the symptoms of a case of disease would be given by an intelligent but uninstructed patient who unfolds his case to us in as plain untechnical words as he can, leaving to us the task of tracing connections and contriving explanations. There they stand, records of facts made in the plain vernacular, intelligible so long as the language shall endure.

But Hahnemann had a much higher idea of the kind of knowledge of Materia Medica which a physician requires than this statement would imply. In an essay on “The Power of Small Doses,” in Hufeland’s Journal, he describes this knowledge as follows: “What organs it (the drug) deranges functionally, what it modifies in other ways, what nerves it principally benumbs or excites, what alterations it effects in the circulation and digestive operations, how it affects the mind, how the disposition, what influence it exerts over some secretions, what modification the muscular fiber receives from it, how long its action lasts, and by what means it is rendered powerless, etc., etc.” Why, the, did he not construct his Materia Medica on this model? Unquestionably because, with a wonderful sagacity which together with his brilliant genius and his prodigious learning made him the “double-headed prodigy,” which Jean Paul Richter called him, Hahnemann clearly perceived the following truths: that positive facts with which a physician has to deal in constructing a Materia Medica are the observations of the proper recorded in plain, unfigurative, non-hypothetical language. That the construction which he saw to be so desirable must be the result of the application of the science of Physiology and Pathology to these facts. That the fact of the proving being of the nature of positive observation are enduring and unchangeable. But that the sciences of Physiology and Pathology, being incomplete and progressive, are continually undergoing change, and that their terms must therefore be ever varying in significance as the theories on which the sciences are based vary. That, consequently, a Materia Medica constructed by him out of these two elements, one constant and the other variable, would of necessity be transient, could not be enduring, would soon grow obsolete and its decline would carry out of sight the constant element also, and thus the labor of the provers would soon be lost to the world. Such a structure would have involved an intermingling of the current physiological theories with the facts derived from observation. The precise point and extent of the intermingling would soon become indistinguishable and thus a vitiated record would be transmitted to posterity such as the advance of science would soon render useless. A comparison of the present state of Physiology with that of 1800, of which the very terms are almost obsolete, makes the great wisdom of this view apparent. On the other hand, the pure records of observed facts, untainted by theoretical speculations, come to us from the Master’s hand as pure, as intelligible, as available as when first recorded.

We have the same material for the construction of a physiological theory of the drug-action that Hahnemann had, and we can construct it with the advantage in our favor of the great advance which Physiology and Pathology have made since Hahnemann’s day. This is the work which each of us must do for himself. No other can do it for him. The result of his labor may and will differ somewhat from that of every other student, for with the light of the auxiliary science he forms a judgment concerning observed facts, and the significance of a fact is measured by the capacity of the observer. (1 Lest by an omission I expose myself to misconstruction, I may say that inasmuch as advances in collateral medical sciences are affording continually new aids to observation, it is incumbent on each generation to re-prove to a certain extent the remedies of the Materia Medica so as to bring these aids to bear on the study of Pathogenesy).

The student should seek his knowledge of Materia Medica at the fountain head, in the original publications of Hahnemann’s Materia Medica Pura and Chronic Diseases in the provings in Stapf’s Archiv, and in the Austrian and other journals.

The Manuals, however convenient for reference in the hurry of practice, as not suitable for systematic study. In some of them, the phraseology of the prover has been altered. In others, the symptoms, as reported by the prover, have been arbitrarily sundered into fragments and these fragments are scattered throughout the record. Or symptoms ex usu in morbis have been introduced and the names of diseases supposed to have been cured by the drug are incorporated with the pure symptoms. In all of them the arrangement is somewhat altered. In many, attempts at abbreviation have been made, and with no better success than if one should squeeze one’s lemons the lessen the bulk of one’s luggage and yet hope to have good lemonade at the end of one’s journey; for it always happens, and must from the nature of the case, that the skins are the part retained while the juice is thrown away.

If a Manual must be employed, that of Noack and Trinks seems preferable; for it preserves the phraseology of the prover and does not to any great extent sunder groups of symptoms, while it places under distinct headings the pure symptoms, and the clinical effects of the drugs and the theoretical speculations of the compilers, so that the student is in no danger of mistaking the one for the other, a danger to which Jahr’s Manual does certainly expose him, and for which reason Jahr’s work is less desirable than that of Noack and Trinks.

We have dwelt at some length on the sources from which the student should seek his knowledge of Materia Medica- and with good reason! “For, can a bitter fountain send forth sweet waters?” “Do grapes grow on thorns, or figs on thistles?” If the student should fall among false or incompetent teachers, could the doctrine and practice he learns be true and successful? Now, it will be observed that the records and provings and the manuals of Materia Medica to which we have commended the student are all German works, while mine-tenths of our American and English practitioners and students are unacquainted with the German language. It is humiliating to us to be compelled to say that there are no trustworthy manuals in the English language and no translations of the German works which we have named on which reliance can be places. (1 This was written over fifty years ago and is no longer true-Publisher). We have translation of Hahnemann’s Materia Medica and Chronic Diseases and of Stapf’s Contributions to the Materia Medica, by Dr. Hempel. But, either (perhaps we should say both) from lack of moral capacity, or of intellectual and professional acquirements, or

from haste an carelessness, the translator has so marred these works by errors of omission and of translation, that they are to the student and practitioner what false lights on a difficult coast are to the unsuspecting mariner.

Dr. Hempel translated also Jahr’s New Manual or Symptomen Codex, and claims to have incorporated with it nearly all that is valuable in the Manual of Noack and Trinks, thus making it the most complete and perfect work of the kind in existence, and the best possible in the present state of our science. This translation was published with a preface by Dr. C. Hering and under the high sanction of his name and that of Dr. Gray, of New York. It is almost universally used in this country and in England, and the knowledge of the Materia Medica and of the true practice of Homoeopathy possessed by the rising generation of practitioners is, in the main, what this manual is capable of affording.

If now, I should say that this translation and compilation contains all the errors, omissions and perversions which rendered Dr. Hempel’s former translations untrustworthy, along with many others peculiar to this work, I should surely hear in reply that Dr. Hering has expressly in his preface commended the diligence and accuracy and zeal of the translator, and I should be referred to page six of the preface, whether Dr. Hering is made to say, “the Editor has, with extraordinary minuteness and labor, compared the two manuals and has transferred to the manual of Jahr all additional drugs and pathogenetic effects contained in Noack and Trinks’ work.” What could I say in offset to this indorsement of Dr. Hering? There is a word to say on the subject of this preface. It was unquestionably written originally by Dr. Hering in German. The English translation, by whomsoever made, seems not to have been altogether satisfactory to Dr. Hering (as well it might not be), for the German original was published by him (a “verbatim copy,” as he says) in he Allg. Hom. Zeitung. The English preface to Jahr’s New Manual differs from this German original far more widely than the license of scholarship will at all justify. In a foot-note to the original of the passage we have quoted above in commendation of the Editor and translator of Jahr’s New Manual, Dr. Hering says: (1 Vol., XI., Nos.23 and 24, February and March, 1851.) “After comparison of the translation with the original, the above indorsement is hereby altogether and completely withdrawn,” (2 Dies wird hiermit nach Vergleichung der Uebesetzung mitdem Original ganz und gar zuruckgenommen.) Thus, in an obscure foot-note in a German periodical, seen by n to more than one in a hundred of those American and English students who are induced by Dr. Herings’s commendatory preface to place confidence in Dr. Hempel’s translations and compilations, Dr. Hering vindicates his fame as a good school and a faithful champion of our science by withdrawing his commendation of Dr. Hempel.

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'.