If it were the last, according to the old- fashioned notions and theories, you must now prescribe for Bright’s disease; you would not think that remedy which you figured out two years before fitted his case perfectly then and is what he must have now. But he needed that remedy from his childhood, and you were able to figure it out from the symptoms of his change of state pure and simple, without tissue changes. Do you suppose because the disease has now progressed into tissue change, the organs are breaking down and the man is going to die, that this has changed that primitive state?
The man needs the same course of treatment that he has needed from his babyhood. The same idea of his disease must prevail now that prevailed before he had the tissue changes. Bright’s disease is not a disease, it is simply the ultimate or organic condition which has followed the progress of the original change of state. Under other circumstances that change of state might have affected his liver or his lungs.
Tissue changes do no indicate the remedy, and so as physicians we must learn to examine symptoms which are prior to morbid anatomy, to go back to the very beginning. Such a patient as I have described must be looked upon as when he was in the simple change of state before matters were complicated. Besides this there is no manner of treatment for Bright’s disease or any other organic change. Our remedies appeal to man before his state has changed into disease ultimates, and these remedies do not change because morbid anatomy has come on, they appeal as much after tissue changes as before it. If we do not know what the beginnings are we cannot in an intelligent way treat the endings.
In a footnote Hahnemann says, “I know not therefore how it was possible for physician at the sick-bed to allow themselves to suppose that, without most carefully attending to the symptoms and being guided by them in the treatment, they ought to seek and could discover only the hidden and unknown interior what there was to be cured in the disease, etc.” The learned man in the old school today would say, “Oh, I do not care anything about your symptoms. I do not care if you are forgetful or irritable. If you do not sleep I will give you something to make you sleep. But I must sound your liver, for that is the cause of all your trouble, and I will prescribe for that.”
He supposes the liver is the cause of all the trouble, and believes that when that is corrected he has cured his patient. What a false idea! His mind is upon mere theory. It is common, when they do not know what has Killed a man, to make a post-mortem in order to discover the cause, and by this they find out certain pathological conditions; but the aim of the physician is to discover in his patient that just these conditions are present.
It is true, on the other hand, that the post-mortem affords the physician the means for a general study of the results of disease, which I would not, under any circumstances, prevent. Indeed, there are times when I would strongly encourage the study of morbid anatomy. The physician cannot know too much about the endings of disease; he should become thoroughly acquainted with the tissues in all conditions; but to study these with the idea that he is going thereby to cure sick folks, or that the things he picks up at such times are going to be applied in making prescriptions, is a great folly. It is astonishing that physicians should expect to find out by post-mortem and examinations of organs what to do for sick folks.
Physical diagnosis is very important in its own place. By means of physical diagnosis the physician may find out the changes in organs, how far the disease has progressed, and determine if the patient is incurable. It is necessary also in supplying information to Boards of Health. It may also decide whether you should give curative or palliative treatments. But the study of pathology is a separate and distinct thing from the study of Materia Medica.
In many instances foolish examinations are made. In the colleges women are examined with the speculum before a symptom is given, and if the mucous membrane is red the patient gets Hamamelis, and so on in a routine way through five or six remedies which cover all the complaints of women. Half a dozen remedies constitute the armamentarium of many of the eminent gynaecologists. Such a practice as that does not cure, does not even benefit temporarily, it is simply an outrage. But bad thought it is, perhaps it is not so great an outrage as is perpetrated when the physician imagines the disease is local, and that when he has cauterized it the woman is well, not realizing for one moment that these things come from a cause and that curing that cause should be his aim. Yet such is the teaching of the old school.
Now while the signs and symptoms are the only things that can tell the physician what the patient needs, and while those signs and symptoms relate to change of state and not to change of tissue, still there are signs that relate to tissue changes, and one who is acquainted with symptoms may consider these as indicating a change of state. For example, there are signs that indicate that pus is forming, there are appearances that will lead the experienced physician to know that the results of disease are coming; these are not valuable things in hunting for the remedy, but simply indicate certain conditions. The physician must learn to distinguish these from the symptoms that portray the state of the patient.
We are now prepared to see that if the patient is cured from cause to effect he must remain cured; that is, if the true inner disorder is turned into order he will remain cured, because this order, which is of the innermost, will cause to flow into order that which is of the outermost and finally the function of the body to become orderly. The vital order will cause tissue order, because the vital order extends into the very outermost of the tissues, and tissue government an order is a vital order; so if the cure is from cause to effect, or from within out, the patient will remain cured. In incurable cases the effects may be removed temporarily or palliated, but the patient himself has not been cured as to the cause. and owing to the fact that the patient cannot be cured the old changes will return and grow stronger because it is in the nature of chronic cases to increase or progress.
Certain results of disease which remain after the patient is cured can be removed if necessary, but it is not well to remove them before the patient is cured. If a patient has a disease of the foot bones after a bad injury and the foot cannot be cured, first cure the patient, and then if the foot is so clumsy and useless that he would rather have a wooden one remove the foot.
If you have to deal with a worthless honey-combed knee joint, first cure, the patient and then if the knee can never be useful and the limb is cold and the muscles are flabby consider the question of replacing it with an artificial one. If the economy after being turned into health cannot cure the knee nothing that can be done to the knee can cure it, Do not say that the patient is sick because he has a white swelling, but that the white swelling is there because the patient is sick.
In 1881, Kent accepted a position as professor of anatomy at the Homeopathic College of Missouri, an institution with which he remained affiliated until 1888. In 1890, Kent moved to Pennsylvania to take a position as Dean of Professors at the Post-Graduate Homeopathic Medical School of Philadelphia. In 1897 Kent published his magnum opus, Repertory of the Homœopathic Materia Medica. Kent moved to Chicago in 1903, where he taught at Hahnemann Medical College.