In many places of his writings Hahnemann denounces trusting to the usus in morbis, in other words, the experience of the good effects of a medicine in one disease as a guide for the employment of the same drug in what we may suppose to be a similar case–a curious paradox indeed, that the system he introduced to the medical world as the “Medicine of Experience” should dispense altogether with experience! for to that it amounts. We observe, however, that in the prefaces to the provings of many of his medicines, especially his later ones, he gives long lists of the morbid states for which the medicine has proved useful; but fearful apparently that this proceeding might be taken to indicate a connivance at that pernicious custom of the old school of being guided to the employment of a medicine by the usus in morbus, he adds a note to the first list of this kind in the Chronic Diseases, which is too characteristic to be passed over.
He there regrets that these enumerations of the symptoms that have disappeared under the use of the medicine have been misunderstood, and stated to be conditions that might determine us in the selection of medicines in our treatment–indications– which they are not in the very least; “such illusions,” he adds, “we leave now as heretofore to our allopathic step-brethren.” And precisely the same idea occurs in the first part of the Chronic Diseases, at page 150. (Curiously enough it happens that the name Hahnemann adopted for his system, homoeopathy, is derived from the motto of the empirical school, ouolov=aoos, ouolov Oapuakov, which means that similar diseases should be treated similarly, in other words, experience of past diseases should be our guide in the treatment of present ones. This motto has frequently been used as the formula of the homoeopathic system, improperly as I cannot help thinking. It appears to me far from improbable that, in the early part of his career, Hahnemann had the idea of reviving the empirical system of treating diseases, if I may judge from his writings previous to 1805, and this seems also to be the impression of the author of an essay, published at Berlin in 1834, entitled Franc. Frid. Brisken, diss. Philinus et Hahnemannus, seu veteris sectae empiricae cum hodierna secta homoeopathica comparatio. It is singular therefore to find Hahnemann in his later days denouncing experience as a guide for treatment.
It is difficult to see what other use these lists could possibly be put to than to aid us in the selection of the remedy. They constitute Hahnemann’s experience of its curative action, and are of the same kind of value as the histories of cases successfully treated, and the fact that Hahnemann gives us such lists is a proof to my mind that he latterly altered his notions respecting the utility of records of cases, though he could not bring himself so far to eat his own words as to give regular details of cases treated by him; but in these lists he gives us the next best substitute for such histories, in the morbid states he succeeded in curing with the various medicines; while at the same time, to preserve his own character for consistency, which I very much fear was impossible, as I think I have in former lectures shown he had lost it long ago, he gives a fling at the vile allopathic custom of seeking for an indication ab usu in morbis.
But Hahnemann has himself furnished us with other guides to the selection of some remedies which could never have been obtained from a mere mechanical or arithmetical comparison of symptoms, and the value of these hints or indications is so great that we only regret the number of the remedies is so few for the employment of which he has furnished us with such admirable guides. Thus of nux vomica he says, the experience of a long practice has taught him that this medicine is particularly adapted for persons who are of a very anxious, zealous, fiery, or violent character, or where the disposition is malicious, wicked, or disposed to anger. It is suitable for the morbid symptoms remaining after the catamenia, when that function comes on some days too soon and the discharge is somewhat too copious.
It is also useful for those affections caused by drinking too much coffee or wine, and especially such as arise from a prolonged sedentary life in close apartments; likewise for those that arise from too prolonged mental exertion. As regards pulsatilla, he gives some indications for its use that could only have been obtained from clinical experience, as we would scarcely have discovered them from ever so careful a study of its pathogenesy. Thus, he says, it is especially adapted to women whose catamenia are retarded by a few days, and for the effects of eating pork, when it disagrees, neither of which symptoms do we meet with in its pathogenesy. Again, he says it is peculiarly adapted to persons of bashful disposition, disposed to tearfulness, and subjects of secret sorrow and vexation, or, at all events, to persons of a mild and yielding disposition, if in their days of health they were good-humoured and gentle (or frivolous and good-natured). It is also adapted to those of a slow phlegmatic temperament, but not at all to persons of rapid resolve and lively movements, but who are at the same time not good- tempered.
I believe it will be generally conceded that Hahnemann’s recommendation of arnica as specific for the effects of falls, blows, knocks, bruises, sprains, or lacerations of the solid parts was owing more to its ancient repute as a vulnerary among the common people than to the pathogenetic effects he observed from its administration.
It was, as he himself tells us, experience that convinced him of the efficacy of rhus in the effects of sprains, inordinate muscular exertion, and bruises.
In like manner, the utility of opium in removing the torpor of the sensitive nerves, which in many cases renders it impossible for the patient to perceive and to detail accurately his morbid symptoms, is a gain of experience.
In the Chronic Diseases (vol.i. p. 163) he gives a list of a number of indications for remedies which we should scarcely have discovered in a search through their pathogeneses. “Overloading of the stomach,” he observes, ” is best removed by hunger (i.e. some weak broth in place of the usual dinner) and a small quantity of coffee; derangement of the stomach by means of fatty substances, especially pork, by pulsatilla and hunger; derangement of the stomach, which causes eructations with taste of the food, by highly potentized antimon. crudum; a chill of the stomach from eating fruit, by smelling at arsenic; derangement of the stomach with spirituous liquors, by nux vomica; derangement of the stomach, with gastric fever, chills and rigor, by bryonia; a fright, when it can be given immediately, and especially if it have produced fear, by opium; but where we are only called in after the lapse of a considerable time, or where vexation is also combined with the fright, by aconite; but if grief is the effect of the fright, by ignatia; annoyance that has produced anger, violence, heat, and vexation, by chamomilla, but if besides the vexation there is chilliness and coldness of the body, by bryonia; annoyance, with indignation, profound inward vexation, and throwing things away that he may have in his hand, by staphysagria; indignation, with silent inward vexation, by colocynth; unfortunate love, with silent melancholy, by ignatia; unfortunate love, with jealousy, by hyoscyamus; a severe chill, besides confinement to the house, the room, or the bed, by nux vomica; if diarrhoea have resulted from it, by dulcamara; or if pains are its effect, by raw coffee; if, however, fever and heat are the consequences, by aconite; a chill, followed by attacks of suffocation, by ipecacuanha; a chill, followed by pains, with lachrymose disposition, by crude coffee; a chill, followed by coryza, with loss of smell and taste by pulsatilla; a sprain or dislocation, in some cases by arnica, but most certainly by rhus; contusions and wounds by blunt instruments, by arnica; burns of the skin, by compresses of water mixed with highly potentized arsenic, or the continual application for hours of alcohol, heated by immersion in very hot water; weakness from loss of humours or blood, by china; homesickness, with redness of the cheeks, by capsicum.
Many other passages might be brought forward from Hahnemann’s writing where he gives indications for the use of remedies that could not have been suggested to him by their pathogenetic effects solely, but those I have already adduced will suffice for the present.
Whilst, then, Hahnemann professedly pointed to the comparison of the symptoms of disease and drug as the sole indication for the choice of the remedy, he in fact, gave homoeopathy a much wider basis. In the first place he tacitly admitted that we must exercise some discrimination and reasoning power, when he stated that it was the characteristic symptoms of disease and drug that should guide us, for we must exercise our judgment and selection in determining what symptoms are characteristic, and this, again, cannot be done without a thorough acquaintance with pathology. Again, when he introduced into his system his theory of chronic diseases, and insisted on its value to therapeutics, he therein encouraged a search for the (proximate) cause of the malady, a search that in its issue should influence us in the selection of some medicines in preference to others, the preference not depending on the similarity to symptoms present, but on the supposed or ascertained antecedents of the disease. This was a concession in favour of aetiology, as determining the choice of the remedy, which his disciples are justified in improving upon.
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.