With the exception that Hahnemann transgressed his own rule in professing to have discovered the essential nature of certain diseases, viz., the chronic diseases, of which mention has been made in the last two lectures, and that he founded thereon a peculiar mode of treatment by antipsorics, and antisyphilitics, and antisycotics–with this exception I say, we must admit that Hahnemann rendered an important service to practical medicine when he pointed out the in utility for therapeutic purposes of all investigations regarding the proximate cause of diseases, and when he asserted the vanity of all transcendental speculations, and declared as false and untrustworthy every indication based upon the undiscoverable essential nature of the disease. He regarded the morbid phenomena cognizable by the senses as completed facts, the cause of which it was not incumbent on the practitioner to know or to search for.
Hahnemann, with that clear and critical spirit for which he was pre-eminently remarkable, could not fail to perceive that it was this metaphysical or speculative method of viewing diseases, of regarding them as something separate and distinct from the living whole, of conjecturing their peculiar nature, that had in all ages led physicians astray, and given rise to all those contradictory methods of treatment that have prevailed in medicine since it was cultivated as a science, and his object in limiting practitioners to take cognizance only of what was manifest and unmistakable in diseases, viz., their ostensible symptoms, was to remove the indication for treatment out of the region of hypothesis and place it once more within the domain of fact and of nature. His effort was to bring back medicine from the meta physical to the purely physical
This would of course place him at once in direct antagonism with the whole body of the so-called philosophical medical men, whose delight was to infer from the phenomena present the proximate cause and the essential nature of the disease; and the partisans of the various theoretical sects could not brook to be told that their ingenious theories as to whether the disease depended on spasm, inflammation, congestion, infarctus, and the like, or whether it was primarily a disease of the liver, the stomach, the brain, or the kidneys, did not help them a bit in their treatment of the commonest maladies. Accordingly we find even the sharpest intellects among them disputing with the greatest zeal these plain and common-sense views of Hahnemann’s, and even a Hufeland, (Die homoeopathie.) gravely alleging that Hahnemann’s system would only remove the symptoms but leave the disease, and that homoeopathy, if it ever came to be generally adopted, would prove “the grave of science,” a sentiment which has been re-echoed of late years by the Hufeland of England, Sir John Forbes. (Brit. and For. Medorrhinum Rev., vol. xxi., art. Hahnemann and Henderson, or Homoeopathy, Allopathy, and Young Physic.)
But if Hahnemann ran counter to the philosophical sect of physicians, he offended also in equal if not greater degree the pathological school, who, by their investigations and post-mortem examinations, thought they had discovered in the structural changes they observed on the dissecting-table, assisted by microscopical observations and the aids of improved chemical analysis, the real nature of many diseases. That their painful and minute investigations should be held utterly valueless, as far as treatment was concerned, was more than they could patiently bear to hear, and accordingly the congenial schools of pathological anatomy and organic chemistry, represented by Andral, Rokitansky, and Liebig, at once set their faces against a system that disparaged their discoveries, and trusted solely to the mere alternations in the patient’s feelings, which were scarcely deemed by them worthy of a thought.
And yet, in order to convince ourselves that all the speculations of the philosophical sects and the investigations of the iatro-chemical and pathological anatomical schools have not advanced the art of therapeutics by a hair’s breadth, we need only glance at the miserable success that has attended all the methods of treatment founded on the learned theories of the medical school.
Hahnemann’s system professes to aid therapeutics by a process the very reverse of all those founded on theoretical fancies, pathological or chemical. It leaves no margin for anything like theory. The effects of a number of medicines on the healthy human body having been duly registered, and the symptoms of the disease we have to treat being carefully noted, the practical rule was, as Hahnemann expresses it in the 147th paragraph of the Organon,- “Whichever of these medicines we find to contain, in the symptoms observed from its use, the greatest similarity to the collective symptoms of the natural disease, this medicine will and must be its most suitable, its most certain homoeopathic remedy.”
The sum therefore of the practitioner’s duties, in regard to the selection of the remedy, according to Hahnemann, resolves itself into a purely empirical act, an almost mechanical comparison of the drug-symptoms with the disease-symptoms, and the medicine found to present the greatest similarity in respect of its symptoms with those of the disease is the most appropriate, the most homoeopathic remedy. But it is not all symptoms that, according to Hahnemann, are of equal importance in guiding our selection, for he tells us, in Aphorism 153, that it is the more striking, singular, uncommon, peculiar, or characteristic symptoms of the disease that are to be kept chiefly or almost solely in view; it is for analogues to these that we must search through the lists of medicinal symptoms. “The more general and undefined symptoms,” says Hahnemann, “such as loss of appetite, headache, debility, restless sleep, discomfort, and so-forth, demand but little attention, as symptoms of such a general nature are observed in almost every disease and from almost every drug.”
Now this appears a sufficiently plain and common-sense rule, but unfortunately Hahnemann seems to take for granted that we can tell intuitively what are these characteristic symptoms of diseases and of medicines, and many homoeopathists seem also to take it for granted that they can. This pretension on their part has given rise to some most extravagant and ridiculous propositions on the part of some of Hahnemann’s followers, who have set themselves up as competent guides. A favourite achievement of these learned gentlemen on both sides of the Atlantic is to cull from Jahr’s Manual all the symptoms that diligent compiler has distinguished by italics, and in this way make books, the size to whose pages makes them serviceable for shaving-paper, but for no other purpose that I wont of.
When I say that Hahnemann has not told us how to distinguish the characteristic symptoms of diseases, I do not mean to say that he has entirely omitted to mention this subject in his minute directions to us as to how we are to take down and study our cases, which will be found in the Organon, Aphorism 84 to 99 inclusive, but what he does say there upon the subject does not go a great way to illume our previous darkness. In Aphorism 95, for instance, he says, talking of the mode we should pursue in investigating chronic diseases, “the most minute peculiarities must be attended to, because in these diseases they are the most characteristic, and least resemble those of acute diseases, and if a cure is to be effected they cannot be too accurately noted.”
Again, as regards epidemic diseases, he tell us what we are to consider their characteristic symptoms. One case of epidemic disease, he says, will not enable us to learn them; it is only from the careful observation of several that we can do this. “In writing down the symptoms of several cases,” he says, (Organon, Aphorism 102.) “the sketch of the morbid picture becomes ever more and more complete, not more extended and spun out, but more significant, more characteristic, and more comprehensive, as regards the peculiarities of this collective disease. On the one hand, the general symptoms (e.g. loss of appetite, sleeplessness, etc.) become particularly and exactly defined, and on the other, the more marked and special symptoms, which are peculiar to but few diseases and of rarer occurrence, at least in the same combination, become prominent and constitute what is characteristic of this malady.”
Now, as far as we can gather from this rather obscure passage, it would appear that, contrary to what we would anticipate, all the characteristic symptoms of the epidemic disease are not met with in one case, but that it requires the observation of several to enable us to fill up the characteristic portrait. In other words, the minute shades of symptoms observed in several cases go to constitute the characteristic features of the disease. We should rather have thought that the characteristic symptoms of an epidemic disease should be met with in every individual case of the disease. Again, you will remember that, in his Organon (Aphorism 235, etc.), Hahnemann enters at great length into the treatment of intermittent fevers, and he tells us that the chief characteristic indications for the remedy are to be learned from “the symptoms of the patient’s health during the intervals when he is free from fever.” (I take this opportunity to correct a typographical error in my published translation of the Organon, p.281, line x., where “free from fever” has been printed by mistake “free from pain”).
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.