Up to this time we have been studying principles that relate to the knowledge of Homoeopathy. At this point Hahnemann arrives at three important conclusions as to what we have been studying in application to practice. There are three steps to be surveyed:
1st. “By what means is the physician to arrive at the necessary information relative to a disease, in order to be able to undertake the cure?” Of course that relates to the disease in general, and the patient in particular. In going over the 3rd paragraph, we gathered together the means of studying an epidemic and each man in particular.
We shall now proceed to study disease in general and the patient in particular, from now on to the end of this course. All the rest of the study is of such a character. There are a great many questions that arise in this problem that must be studied in detail, the study of the nature of acute miasms and the study of the nature of chronic miasms; the study of such changes as show there are two distinct classes of sickness. Each one is to be studied in its most general way, and each person as a particular entity.
2d. “How is he to discover the morbific powers of medicines; that is to say, of the instruments destined to cure natural disease?” This constitutes a study of the Materia Medica and a knowledge of how it is built, which is by provings, by recorded facts.
3d. “What is the best mode of applying these morbific powers (medicines) in the cure of diseases?” This involves the study of all methods and settling upon that which is best.
To proceed in the study of these in a rational, scientific and careful manner is the object of the future study of this book. It leads from now on, from the science of Homoeopathy to the art of healing. We see that we have now gone over the principal part of that which is merely science, the science of Homoeopathy. We have none of the enormous classifications in the study of Homoeopathy that are resorted to in traditional medicine; they should not appear in the study of applied Homoeopathy.
The study of the classification of diseases as is done in traditional medicine is useful, because we come in contact with the world. As the Boards of Health require us to state what particular disease, according to classification, a patient died from, classified in accordance with old school nosology, we have therefore, to go into the study of diagnosis. In Homoeopathy, diagnosis cuts very little figure in the treatment; but all the ultimates in the case must be brought forward and described by name.
We want the use of adjectives, we want the use of large language, we want descriptive power, in order that the nature of the sickness, which is all that man can know about the disease, may be brought out on paper, and thereby caused to appear at any time thereafter to the mind of the physician. If the physician were simply to make a study of the disease, and after studying it were to give it a name and let that name constitute the record, no future prescription could be made. And the physician, thereafter, in referring to this record, would know nothing about its nature. The name conveys no idea of the nature of the sickness, only its place in a general classification. A knowledge of the nature of individual sickness is necessary for a prescription, and this depends upon the ascertainment of the details.
The very first of this study is to prove and realize that there are two classes of diseases, acute and chronic. The general classification of all diseases is made in this way; the acute are thrown into one group and studied as acute diseases, and so with the chronic.
An acute miasm is one that comes upon the economy, passes through its regular prodromal period, longer or shorter, has its period of progress and period of decline, and in which there is a tendency to recovery. A chronic miasm is one that has its period of prodrome, period of progress and no period of decline; it is continuous, never ending, except with the death of the patient.
The acute diseases need much less study than the chronic. They are all such as are contagious or infectious, such as have a miasmatic character and are capable of running a definite course. When man disorders his stomach and has an attack of vomiting, and from which he has no after trouble, he has suffered merely from an indisposition. Such conditions from external causes are not miasms.
Things that go through the mouth into the stomach and thereby produce sickness act either as rousers up of some old trouble or as mechanical causes of disturbance. The pure disease, on the other hand, whether acquired or inherited, are those that flow from the innermost to the outermost while making man sick. These causes that make man sick are influx of simple substance and they run a fixed distinct course. Each one has its own time of prodrome, its own period of progress, whereby the traditional school of medicine has fixed what it calls pathognomonic symptoms. It is well to know these symptoms, not for the purpose of naming merely, but for the purpose of association.
The study of disease should not be for the purpose of naming; if it is so, the name does harm. When you think of a child suffering from measles, the idea of measles may go out of mind, but the character of the sickness of that particular child must remain in the mind. At first you will not be able to see what is meant by that, especially if you have been in the habit of studying cases for the purpose of diagnosis.
I do not say this to throw a cloud upon diagnosis, but to show that the study of diagnosis is not for the purpose of making a prescription. The more you dwell upon diagnostic symptoms, the more you will becloud the ideas entering the mind that lead toward a prescription. You might go into the room and work an hour individualizing a case, deciding whether it were measles or scarlet fever (there are some confusing cases in the beginning). Well, you might say, it is measles, and must now have Pulsatilla, or scarlet fever and must have Belladonna.
You will really see that such a state of affairs is misleading to the mind. If you are in an epidemic, where it is necessary in order to save the neighbourhood, to know, for instance, whether a certain case is of cholera or not, then it becomes necessary to do the two things. The family and the surrounding families are entitled to the safety that a correct knowledge would give and that protection, isolation or quarantine would afford. There are two kinds of study, one with a bearing toward the classification that the disease belongs to, and one with reference to the remedy that the patient needs; but I prefer to settle the patient first as to the remedy he needs, and this has very little to do with the classification, except in a general way.
After a remedy has been decided upon that clearly covers the symptoms and the patient receives his dose of medicine, the next point is, what step is necessary to take in order to protect the people if this is a contagious disease. Diagnosis is something that a physician cannot afford to be foolish about, he cannot afford to be a blunderer, he cannot afford to go around calling scarlet fever measles, and measles scarlet fever.
He must know enough about the general nature of diseases that after the prescription has been made and the patient settled as to that, and the mother wants to know what is the matter with the child, to tell her, for, in that instance, she has a perfect right to know; that is, a case where the family must be protected, where outsiders must be protected; the physician must decide whether it is proper for the child to go to school, or whether it is not proper.
There are some conditions of chronic diseases which closely resemble acute diseases; for instance, these mimicking acute attacks that come on regularly as periodical headaches. One attack, singled out, might have the appearance of an acute miasm, yet the tendency to progress and not to recovery shows that it belongs to the chronic class. Those disorders that come form debauchery and drinking and overeating, from immediate circumstances that are periodical, are things that arise from the latent psoric condition; they are momentary sickness, and if it were not for the fact that man suffers from chronic miasms he would not have these; these attacks would not form a sickness, would not have an appearance of acute sickness. It is due to chronic miasms that man has these little recurring attacks. These do not come with a prodromal period. a progressive period and a period of decline; they may have an attack and decline, but not a prodrome. The acute miasms like the chronic have the prodromal period.
Par. 72 says: “Relative to the first point, it will be necessary for us to enter here into some general considerations. The diseases of man resolve themselves into two classes,” etc. Remember that the acute diseases always tend to recovery; the chronic diseases have no tendency whatever to recovery, but a continuous progressive tendency; they are far deeper miasms.
There are three of these chronic miasms that belong to the human family–psora, syphilis and sycosis–and these we will take up and study. The worst cases are those wherein the three chronic miasms, or some parts of the three, have been complicated by drugs. When the effect of drugs has been removed then we may begin to study the pure miasms themselves, but the miasms are complicated at the present day in most men, for whenever we come in contact with chronic sickness we come in contact also with chronic drugging and its effect upon the vital force.
I am of the opinion, perhaps I am wrong, that when blood-letting was in vogue, when violent cathartics were thrown in, when emetics and sweating were prescribed, as in the olden times, when all these violent things were resorted to, the human race was not torn to pieces as rapidly as at the present day. The enormous doses of Jalap and Calomel rushed through the intestines and cleaned out the patient, and he felt better afterwards, and probably did not carry to his grave the internal results of that cleaning out.
He did not carry the internal results of the emetics and sudorifics, but at the present day small doses of concentrated drugs are administered, which have an insidious effect upon the economy and develop their chronic symptoms very slowly. From the continued taking of old school products, the alkaloids, etc., we have the most dreadful state that has ever occured in the history of medicine coming on. The aim is to get small doses, to get an insidious, effect. The milder preparations, like Sulphonal, require months to develop their chronic tendencies, and are most vicious and troublesome drugs.
These slow and subtle preparations are now being manufactured, and though seeming to produce a mild primary effect have secondary effects or after-effects which are very severe. Hahnemann said, in his time, the most troublesome chronic diseases were those that had been complicated with drugs. If that were true then it is ten times so now. The little headache compounds, the catarrh cures, etc., are milder as to the first effects, but more violent as to the last effects. They are prepared to imitate the palatable form of homoeopathic remedies.