Pathological basis of Homoeopathy



The effect of extremes of temperature in producing diseases is well-known; and, indeed, accepting as true the commonly-received notion that heat is direct stimulant, and cold a direct sedative, it is worth while pausing for a moment to consider the probable mode of action of these two agents upon the organism for, with some necessary modifications, the action of all other exciting cause of disease may burned under one or other of these two classes, direct stimulant and direct sedative. An inquiry into the mode of action of these two agents as far as that is possible, will give us the necessary insight into the most probable proximate causes of disease, and thus assist us in our proposed task of giving therapeutics a rational pathological basis.

In this attempt I shall not claim for myself the merit of originality, nor shall I attempt to adduce, for the purpose of refuting them, all the other opinions of learned authorities on the subject. To those who are curious upon the subject, I would recommend the writings of one who, not himself an experimental physiologist, has brought the keenest wit and the most philosophical acumen to bear upon the subject of physiology and pathology of any modern author with those works I am acquainted. I mean the works of the late John Fletcher of Edinburgh, which I would earnestly advise all homoeopathists to study.

The first effect of a direct stimulant, such as heat is, upon the capillaries, is to cause them to contract. This contraction represents increased action in the capillaries themselves The application of a red-hot iron to the skin is observed to be followed at first by a deathly paleness of the part, and the alternation in the calibre of the capillaries has been observed, microscopically, in the foot-web of the frog and the transparent omentum or other animals, by Spallanzani, Thomson, Philip, Hastings, Burdach, Wedemeyer, Koch, and many others. During this contraction the motion of the fluid in the capillaries is quickened, as noticed by the increased rapidity of the passage of the blood-globules. After a longer or shorter interval, the capillaries become dilated, sometimes to double their normal state; this dilatation indicates diminishes action in the capillaries, and is accompanied by accumulation, tardy circulation, and even stagnation in the circulation of the fluid contained in the capillaries. This constitutes inflammation; and though we are not in a position to deny that there may be some other change in the capillaries not cognizable by the senses, such as loss or alteration of some, perhaps electrical, property in the capillaries which causes the blood-globules to stick to the sides of the vessels in the marvellous way in which they have been noticed, yet so much seems to be evident, that inflammation does not consist essentially in a spasm or increased action of the capillaries, as supposed by Stahl, Van Helmont, Hoffmann, Cullen, and others, but in a dilatation or diminished action of them, as first advanced by Vacca Berlinghieri, and subsequently taught by many of the best physiologists.

We may suppose that the contraction and dilatation of he capillaries may occur within certain limits, without compromising health. The primary paleness, followed by the blush that attends certain mental emotions, is a familiar instance of this.

After the manner of John Brown, we might illustrate this subject by figures. Thus, supposing the medium or quiescent state of he capillaries to be represented by O, the range of healthy action might be said to be between plus 5 and -5, while that of morbid stimulation and subsequent depression ranged between plus 5 to _5 to 10; the consecutive depression bearing an exact proportion to the previous over-action.

Thus, consistently will health, the vessel will contract and expand thin a d cretin limited range, in obedience to the natural stimuli; but of a stimulus of too great power be applied, it will contract, first inordinately, and again expand to such a degree as that it shall be incapable of recovering its natural calibre immediately, perhaps at all, without the application of a fresh stimulus. the actual cause of this is supposed to the that the increased irritation causes a proportionate exhaustion of irritable matter and therefore of irritability, and consequently the usual stimuli (of the circulating fluids, etc.) cause less than usual irritation; hence, as we see, the vessels do not resume their healthy contraction, or do so but slowly.

The morbific effect of a direct sedative, such as cold is supposed to be, is in the end of the same as that of a direct stimulant, only the sedative acts at two removes. At first, there is dilatation beyond the healthy degree, then contraction also beyond the healthy degree, followed in its turn by more or less permanent dilation, constituting the morbid state, inflammation, etc.;-or, as this process has been explained, the direct sedative causes primarily diminished irritation in the part on which it acts, this diminished irritation from stimuli be increased), and this again is followed by a proportionate exhaustion.

It is, however, doubtful to my mind whether cold is a direct sedative. Many facts induce me to believe that it is often, if not always, a direct stimulant; at the events, extremes of cold seem to act as stimulants, though I am not prepared to deny that a minor degree of cold may act as a direct seductive. Perhaps heat acts as an irritation more on the arterial capillaries, cold on the venous, or vice versa, which would account for the different effects of their application.

In the first stage of this inflammation it will be evident, the capillaries in which the operations of secretion and excretions are performed being contracted, these functions will be diminished. when, on the contrary, the capillaries are dilated, more blood pouring into hem, these functions should be increased and we find this to be the case, as shown by the effusions (or rather secretions) of lymph, serum, etc. There are as many kinds of inflammations as there are different structure of the body; and the products of inflammation not only differ to an equal degree, but are moreover wonderfully modified by the diathesis, dyscrasias, or peculiar condition of the organism and its fluids. This has been beautifully illustrated by the observations of the Vienna pathologists, to which I have already referred.

Though we are unable to prove that all morbid actions are analogous to inflammation, it is highly probable that a very great number of them are so, and it is also highly probable that the division of diseases into structural and functional is incorrect; for we have good reason to believe that all functional diseases, so called, must depend on some change of structure somewhere; and we know that structural disease, commonly so called, are accompanied by alternation of function.

An agent that must never be lost sight of in considering morbid action is sympathy. This term implies the transmission of an irritation or stimulation from one part of the system to another. To give illustrations of it in healthy action, I may refer to the obvious connection by this agent of the skin and kidneys, of the larynx and testicles, the uterus and mammae, etc., etc. In pathology we observe this property still more markedly displayed. I shall only cite a few instances. Orchitis in the male, and mastitis is the female, are a frequent effect of cynanche parotidea; the eyes are apt to be sympathetically inflamed in gonorrhea. It has been said that such results and the effects of poisons are owing to absorption; but the same cannot be said of such instance as the ulceration of the duodenum following extensive burns, the irritation of the nose attendant on morbid action in the rectum, etc.

That this property of sympathy plays an important part in the production and cure of disease cannot be denied. It is not, however, requisite that we should inquire into its essential nature, or ascertain precisely what is the particular organ or structure which gives rise to it. It is sufficient to know that it pervades the whole system, and is in constant operation. Sympathy, then, implies that property of the organism whereby an irritation applied to one part is propagated to another, where there is a specific susceptibility for its reception The symptomatic fever accompanying inflammation is an instance of sympathy. While inflammation may be defined as the action of a morbific irritation on a definite spot, fever may be considered as the action of an irritation on the whole capillary system of the skin.

The first effect, corresponding to the contraction of the capillaries in inflammation proper is exhibited by the coldness, paleness, and shivering. The second, corresponding to the dilatation of the capillaries, is represented by the heat and redness of the skin, and this is followed by the increased secretion from the capillaries, in the form of sweat.
It is by the principle of sympathy that we explain those phenomena that occur in the course of many disease, viz., metastasis and metaschematismus. The return of the capillaries to a healthy state indicates an increase in their irritation; this irritation is propagated by sympathy to another parts and there gives risen to the morbid phenomena designated by those appellations.

R.E. Dudgeon
Robert Ellis Dudgeon 1820 – 1904 Licentiate of the Royal College of Surgeons in Edinburgh in 1839, Robert Ellis Dudgeon studied in Paris and Vienna before graduating as a doctor. Robert Ellis Dudgeon then became the editor of the British Journal of Homeopathy and he held this post for forty years.
Robert Ellis Dudgeon practiced at the London Homeopathic Hospital and specialised in Optics.
Robert Ellis Dudgeon wrote Pathogenetic Cyclopaedia 1839, Cure of Pannus by Innoculation, London and Edinburgh Journal of Medical Science 1844, Hahnemann’s Organon, 1849, Lectures on the Theory & Practice of Homeopathy, 1853, Homeopathic Treatment and Prevention of Asiatic Cholera 1847, Hahnemann’s Therapeutic Hints 1847, On Subaqueous Vision, Philosophical Magazine, 1871, The Influence of Homeopathy on General Medical Practice Since the Death of Hahnemann 1874, Repertory of the Homeopathic Materia Medica, 2 vols 1878-81, The Human Eye Its Optical Construction, 1878, Hahnemann’s Materia Medica Pura, 1880, The Sphygmograph, 1882, Materia Medica: Physiological and Applied 1884, Hahnemann the Founder of Scientific Therapeutics 1882, Hahnemann’s Organon 1893 5th Edition, Prolongation of Life 1900, Hahnemann’s Lesser Writing.