Specific Medicine and attempts at a Theory of Cure

An intense discussion about the use of specific remedies in homeopathy. Can we have fixed remedies or specifics for fixed ailments? or do we need to individualize in every case?…

Hahnemann’s original name for homoeopathy was the doctrine of specifies-He always considered his remedies specifies-Difference betwixt homoeopathic and old-school specifies-Difference betwixt homoeopathic specifickers and purists- Names proposed for homoeopathy-Is homoeopathy the doctrine of specifies? – Sydenham on specifies-Bacon-Kopp- Stieglitz-Hufeland-Stapf-Arnold-Kurtz- Roth-Schron-Goullon-Wolf-Rapou-Dufresne-Watzke-Black-Homoeopathy is specific medicine-Explanations of the curative process- Hahnemann’s idea that the stronger disease over come the weaker- His first attempt at an explanation of what takes place-Fallacies of this explanation-Medicines act conditionally, not absolutely- Instances of insensibility to medicinal action-Medicinal action not stronger than disease-Cures effected by weaker, not by stronger irritations-Examples from Hahnemann-Irrelevancy of Hahnemann’s illustrations-His second attempt at an explanation of the curative process-Extravagance of this attempt-Refutation of it-Hahnemann conscious of the weakness of his theory-Rau’s polar theory-Attomyr’s botanic theory-Eschenmeyer’s latitudinarianism- Jahn’s increased reaction theory-Schron reaction theory- Hufeland’s similar theory-Theorie of the worshippers of the vis medicatrix nature-Dr. Sangrado.

In my last lecture I attempted to show you that the homoeopathic therapeutic law discovered by Hahnemann, in other words, the maxim that in order to cure diseases in the best possible manner we must select agents that possess an inherent power to excite in the healthy economy morbid states similar to those produced by the diseases we have to cure, was the logical deduction from the most generally received and satisfactory pathological hypothesis of modern times, and it is my intention in this and the next lecture to consider the chief explanations that have been offered of the mode of action of the curative medicinal agent when opposed to the disease in the organism. I shall commence by stating Hahnemann’s views, and follow with an account of the most plausible or popular explanations that have been given by his disciples.

But before entering upon this subject, I may advert to the name originally bestowed by Hahnemann on his system, viz., the doctrine of specifics, and inquire what he meant by that term.

We find that from 1796 to 1808 he employed almost exclusively the word specific to designate his system, and after the latter date meet with the term homoeopathic, but often in combination with specific, as specific-homoeopathic, or homoeopathic- specific.

The term specific, as applied by him to disease, has not the broad signification given to it by the older writers. Thus he says, in the Essay on a New Principle, etc., published in 1796, “I do not believe there can be a thoroughly specific remedy for any disease of such and such a name, laden with all the ramifications, concomitant affections and variations, which in pathological works are so often inconsiderately detailed as essential to its character, and as invariably pertaining to it.”

Thus he rejects the term as applied by the older writers to such diseases or names of disease a scrofula, gout, syphilis, ague, etc., for which names, as they include manifold varieties of disease, he does not admit there are absolute specifies. On the contrary, he states his belief that there are as many specifies as there are different states of individual diseases i.e., that there are peculiar specifies for the pure disease, and others for its varieties, and for other abnormal states of the system. (Lesser Writings, p. 306). Even in the last edition of the Organon (Aphorism 147) he talks of the homoeopathic remedy being the specific for the cure of disease.

Still, notwithstanding what Hahnemann had written in 1796, he does not seem to have been altogether guided by his own rules in the treatment of certain continued and remittent fevers and other typical maladies in 1789, (*See a paper published in they year in the Lesser Writings, p.382, et seq.) when he seems to have groped about, not without much fumbling and stumbling, until he discovered the proper specific remedies for these disease, very much after fashion of the specific-hunters of the old school, to which he still virtually belonged. Although I cannot be certain of the fact, yet it seems to me highly probable that it was not till after this period (1798)–consequently more than eight after his notable experiments with bark-that he commenced methodically to prove medicines in order to ascertain their curative powers; up to this period I should say his knowledge of medicines was entirely derived from the records of poisoning in allopathic literature, and a few desultory and unmethodical experiments on himself and friends.

I consider it necessary to enter at some length on the question of the specific character of homoeopathic remedies, because the employment of the term specific medicine by some of Hahnemann’s followers has given rise to the accusation, on the part of others, that they meant thereby to deny the law of cure similia similibus, and sought to bring back homoeopathy to the generalizing specific practice so-called of former times. But this is nothing more than one of those false accusations so apt to be engendered in the heat of controversy, and its absurdity becomes apparent when it is considered that the only way in which those who use the term specific medicine in preference to homoeopathy profess to discover the specific for this or for that case of disease is by experimentation on the healthy, and by the analogy of the symptoms so produced with those of the disease-a proceeding which removes them at once from the vague uncertainty and happy-go-lucky method (if method that could be called which was most unmethodical) employed by the old physicians for the discovery of their febrifuges, their anti-spasmodics, anti- rheumatics, antarthritics, and so forth, which each gained its reputation from having cured at one time a case or two of some disease which was sufficiently precise and definite as to be referrible to a class and species in the nosological table; but as the name is not nearly sufficient to give the indication for the employment of a drug, it usually happened that on the next occasion when it was tried, the case not being precisely of the kind in which it was serviceable before, though bearing the same nosological, appellation, the vaunted specific belied the expectations raised concerning it, and speedily fell into disrepute; and such is, in fact, the history of all the fashionable medicines of the cold school. It could not but happen in those experimental times, when everything was tired for every disease, that amid such blind and indiscriminate striking the right nail was occasionally hit upon the head, and a rapid and notable cure was effected.

If the lucky cure happened to be effected with a single remedy, or, as more frequently happened, a compound prescription, the fortunate practitioner, under whose judicious treatment the cure took place, made speed to acquaint his brethren that such a drug or such a mixture, pill, or draught was a wonderful remedy for such a disease. Now, the probabilities were that this feat could not be repeated from this description, for the chances were that in other’s hands the drug, and still more the complex prescription, could not be prepared nor administered in exactly the same way; and another circumstance that greatly tended to diminish the chance of a successful repetition of the cure was, that under every name of a disease were included many different varieties of diseases, for only one of which was the remedy suitable. The consequence of all this was, that though perhaps a few striking cures were actually made by the new remedy, so many failures took place that the once-vaunted specific gradually fell into disfavour and disuse We can scarcely mention a drug or a formula that has not had its daub of reputation, to which its night of neglect bears the same proportion as in northern regions the long night hears to the transient glimpses of sunshine in mid-winter.

Not of the character of such specific-hunters, but the very reverse of such, are those who have been derisively termed specifickers by their opponents, who usually arrogate to themselves the title of pures or Hahnemannians. Some difference there must be between the specifickers and the pures, else had they not formed themselves into two different schools. The difference does not, I believe, consist in any want of that spirit of individualization so necessary for the selection of the appropriate drug on the part of the so-called specifickers, but rather that they endeavour more than their rivals to bring the light of modern pathology to bear on the investigation of the morbid case, and seek to refer, when possible, the array of symptoms to the derangement of some particular organ or system; in other words, they endeavour to arrive at the pathology of the disease, natural or artificial.

The term specific, as applied to homoeopathy, is, as I have shown, quite Hahnemannic, and might be adopted just as well as any of the other terms that have at various times been proposed by those who have taken objection to the term homoeopathy. Thus we find one proposing for our adoption the term homoeosympathy; another, Dr. Weiss, suggests, homoeodynamics; Dr. Perussel prefers homoeo-organics; Dr. Arnold has written a work on homoeopathy, terming it the idiopathic method of treatment. Dynamopathy and homoeotherapeia have each their advocates; and hahnemannism has been suggested by some, out of compliment to its founder, though Dr. Hering of Philadelphia would apply this term to express the power that is supposed to be added to medicines by the processes of succession and trituration, and which he conceived to be analogous to galvanism and mesmerism, and therefore to demand a similar etymology.

Griesselich says, if we will have the correct them we must not stick at trifles, but accommodate our mouths to the pronunciation of this euphonious word, homoeopharmacopathy; and an anonymous writer in the ninth vol. of the British Journal of Homoeopathy, conceiving homoeopathic cures to be guided by the rules of Reichenbach’s od, proposes for our adoption the term homoeodylism. From our opponents our systems has received various titles; thus Trousseau, who partially believes in the truth of the law, offers us a name founded on his hypothetical explanation of the mode of action of our drugs, medicine substitutive; and our bright and trenchant foe, the Lancet, looking at one of our remarkable technicalities, has denominated our system globulism, just as though we, looking at the prominent practices of the old school, should dub it pillulism, blisterism, or complex- prescriptionism.

But though our homoeopathy throws little or no light upon the doctrine it represents, and though had we the christening of it anew we might select a more explicit appellation, yet now that it has been consecrated by time and the thing it represents is sufficiently under-stood, we shall not presume to turn anabaptists with regard to it, but be content to let it remain at it is.

Now to return to the question of homoeopathy being the medicine of specifics, we find that a great deal has been written on this point by homoeopathists, and some-what also by allopathists.

In order to be able to determine if homoeopathy be the doctrine of specifics, we must inquire what is meant by the latter term. If we accept, for instance, the definition most current in the old school, viz., that a specific is already capable of always curing a certain disease, we must confess that this is far too vague for the homoeopathist, because if we inquire into what is meant by a certain disease, we shall find that it signifies some species of disease in the ordinary nosological system, if species of disease in the ordinary nosological system, if it do not stand for a whole class of morbid system, if it not stand for a whole class of morbid affections which have no relation to each other besides the fanciful one assigned to them by nosologists.

Thus we shall find that whereas at one time, under the term of the same disease are included all the varieties of morbid states included in the terms gout, scrofula, etc., for which no specifics ever have been or ever could be discovered, at another time the term same decease is applied to the more definite affections, small-pox, measles, scarlet fever, etc., the different cases of which have a strong bond of connection between them; but still they are subject to such variations that it would be in vain to seek for a specific that should be adapted to the cure of all cases of any of these diseases; nor does homoeopathy propose to furnish such specifics.

Sydenham, without pretending to define what a specific is, seeks to inform us that a specific does, viz., it cures a disease without evacuation. Mercury, he says, which only cures syphilis by an evacuation, to wit, salivation, is not a true specific to the disease, but is only specific to the evacuation, which is the agent that effects the cure. “There is a vide difference,” he says, “betwixt medicines that specifically answer to the indications of treatment and medicines that specifically cure diseases.” The only true specific he knows is Peruvian bark for intermittent. Nevertheless he expresses his belief that nature has provided remedies of a specific character for the cure of the more serious maladies that afflict humanity, and that near at hand and in every country-if we but knew them. p (Long before Sydenham, the sagacious Bacon had perceived and lamented that want of specific medicines, and had endeavoured to point out the mode in which such medicines might be obtained, indicating at the same time the fatal obstacle to gaining a knowledge of specifics that existed in the mode of practice of the physicians of his day. The objections he then urged and the advice he then gave apply with equal force to the old-school practitioner of our own day, many of whom profess such admiration for Bacon, but none of our own day, many of whom profess such admiration for Bacon, but none of whom have profited by the wise counsel he gives in the following passage:- “We generally find,” says he, “this deficiency in the cures of diseases, that though the present physicians tolerably pursue the general intentions of cures, yet they have no particular medicines which, by a specific property, regard particular diseases; for they lose the benefit of traditions and approved experience by their authoritative procedure in adding, taking away, and changing the ingredients of their receipts at pleasure, after the manner of apothecaries substituting one thing for another, and thus haughtily commanding medicine, so that medicine can no longer command the disease. For, except Venice treacle, mithridate, diascoridium, the confection of alkermes, and a few more, they commonly the themselves strictly to no certain receipts; the other saleable preparations of the shops being in readiness rather for general purposes than accommodated to any particular cures, for they do not principally regard some one disease, but have a general virtue of opening obstructions, promoting concoctions, etc., and hence it generally proceeds, that empirics and women are often more successful in their cures than learned physicians, because the former keep strictly and invariably to the use of experienced medicines without altering their compositions.

I remember a famous Jew physicians in England would say, `Your European physicians are indeed men of learning, but hey know nothing of particular cures for diseases.’ And he would sometimes jest a little innocently and say, `Our physicians were like bishops, that had the keys of binding and loosing, but no more.’ To be serious, it might be of great consequence if some physicians, eminent for learning and practice, would compile a work of approved and experienced medicines in particular disease; for though one might speciously pretend that a learned physicians should rather suit his medicines occasionally, as the constitution of the patient, his age, customs, seasons, etc., require, than rest upon any certain prescriptions; yet this is a fallacious opinion the under-rates experience and over-rates human judgment. Therefore this part of physic which treats of positive and authentic remedies, we note as defective; but the business of supplying it is to undertaken wit great judgment, and as by a committee of physicians chosen for that purpose.” (Advancement of Learning, book iv. chap. 2.) He cannot imagine that such will be wound in the animal and mineral kingdoms, but only in the vegetable kingdom. (Sydenham, Obs. Medorrhinum cica Morb. Acut. Hist. et Cur., Praef. edit. tert., Aphorism 21, 22, 23, 24. Sydenham’s views specifics will therefore not assist us much in our inquiry).

Kopp, (Denkwurdigkeiten, ii.), who condescended to dally a little with homoeopathy and patronise it, gives this definition of a specific:- “A medicament which effects alternations principally in one organ in the healthy and diseased state, acts specifically upon that organ.” Now, though homoeopathists are perfectly willing to admit that all their remedies act especially on particular organs in health and in disease, the above definition is much too vague for their notion of a homoeopathic specific remedy, for it avails not to say the medicine produces alterations, but the exact character of such alternations, as shown by the phenomena they give rise to, must be stated. The simple fact of a medicine acting on this or that organ will not suffice; we require to know also the how and the when. A specific, according to Kopp’s definition, might or might not have a homoeopathic relation to the disease of the organ on which it is presumed to act, for every organ is capable of being acted on by many medicine; but each medicine produces its own peculiar alterations, and that medicine only is the homoeopathic specific which produces an alteration similar to that caused by disease. Kopp’s specifics correspond very closely with the organ-remedies of Rademacher and his followers.

Stieglitz, (Die homoeopathie. Hannov., 1835.) who wrote against homoeopathy, understands by the term specific-1. A medicine which, when properly employed, certainly cures a disease in all its stages and degrees, to a certain extent without our being able to tell how; and, 2, one that acts decidedly upon an organ without our being able to tell why. If such be the correct definition of specific, then we may certainly say that homoeopathy is not the doctrine of specifics; and we may also say that there are few, if any, such specifics as those indicated by Stieglitz’s first definition.

The great Hufeland, who wrote both for and against the homoeopathic principle of his friend Hahnemann, considers that by means of specifics a cure is effected by attacking the internal alternations of the vitality on which the disease depends, which is indeed the disease itself, and changing in into the normal state; and he further says, the knowledge of medicines which produce in a healthy state symptoms similar to the disease (similia similibus curantur) may be very well profited of, in order to discover specifics. (Enchiridion, pp. 72, 73). In another place he says: “The aim of homoeopathy is to find specifics for individual forms of disease; and by so doing it may render great service to medicine.(Hufeland’s Journal, 1822, 2nd part, p.64).

Stapf (Archiv, i.1.) attempted to define specifics, and to show not so much that homoeopathy was the doctrine of specifics as that the ancient practice with specifics was a sort of crypto- homoeopathy-that specifics so-called were indeed homoeopathic remedies. Specificity he defines to be the relationship of powers among themselves, as also of disease with the agencies that act upon them. He shows that the idea of specifics in old medicine was of much too general a character; but that this idea, indefinite as it was, contained the germ of a better specific doctrine, which admitted of a much more scientific development and foundation. Homoeopathy alone, he alleges, offers a rational mode of of discovering specific remedies for every case of disease.

J.W. Arnold at one time (Hygea, ii.250) condemned the application of specific to homoeopathy. Afterwards,(Hyg. xviii. 237; and Idiop. Heilverfahren.) however, he sought to define accurately the term specific, and to apply it to the homoeopathic method; and his name is one of the most prominent among those of the so-called specific school. Whilst acknowledging the value of individualization in respect to diseases, he would confine that within certain limits, for he contends that it is the reverse of scientific to carry it as far as Hahnemann has advised. The scientific physician has more to do than merely to note the individual phenomena of the case of disease before him; he has to investigate the focus of the phenomena, the kernel, as it were, of the morbid picture, the seat of the disease in fact, in order at once to restore unity to the scattered features of the morbid picture, and to get a substantial point d’ appui for the treatment; a very excellent thing, no doubt, if attainable, but the success that has attended the efforts to attain it have not hitherto been so great as to encourage us to hope that we shall soon be able, from the ensemble of the symptoms of a case of disease, to make deductions which shall be anything like mathematically correct as to the particular organ that is the actual seat of the disease, the primum movens in the cycle of morbid phenomena.

In order to this, we must presuppose a perfection of diagnosis to which we have not yet attained; but at the same time we must admit that we have made wonderful progress of late years towards it, and it is by no means improbable that we shall make still greater progress, as our means of diagnosis and attainments in pathological science advance. Of course it is to be understood that the same deductions that are to be applied to diseases must likewise be brought to bear on the pathogenetic actions of drugs, otherwise and their seat would not guide us in the slightest degree to a better mode of treatment; and for this purpose, I fear our whole collection of the pathogenetic actions of medicines would avail us but little, and a through re-proving of all would be indispensable.

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.