To some it may appear presumptions that I should thus venture to dispute the assertions of Hahnemann on points connected with his own doctrines, as though he was not a far better observer of all these things that he brings forward as facts than any of his disciples can possibly be, but I believe we shall best consult the interests of homoeopathy as a science by inquiring critically into every part of the system and ascertaining and carefully distinguishing what are really facts from what are mere assertions, and refusing credence to the latter until we have carefully sifted the evidence on which they rest, or if none is brought forward in their support, by subjecting them to a strict logical inquisition.
Now it so happens that Hahnemann’s theory of homoeopathic aggravation is a theory only. The cases he has recorded afford no evidence of its truth, and the only thing it has to rest upon is Hahnemann’s theory of the mode of action of homoeopathic agents, from which it is the necessary deduction. Now as I have, I think, shown the untenableness of Hahnemann’s explanation of the curative process, I think I am justified in rejecting this deduction from it, and in seeking to explain those occasional phenomena, that have been considered to be proofs of it, in some other way, as I have already done and as has been done by many other homoeopathists of greater experience and scientific acquirements than I can boast of.
It is often alleged by our adversaries that if we believe in homoeopathy we are bound to accept all the doctrines of Hahnemann, but nothing can be more preposterous. Because we believe in the phenomena of galvanism, are we bound to believe in the hypothesis by which Galvani attempted to explain them? because we believe in the utility and indeed the indispensableness of Dalton’s atomic theory, are we therefore bound to accept Dalton’s idea of ultimate atoms and elementary substances? The facts observed by Sydenham and the practical deductions he drew from those facts have still their value, whilst the theories he held are obsolete and absurd. The phenomena of mesmerism are undeniable, but who is to swallow all the reveries of Mesmer? Hahnemann was a great man, but not a prophet; his works are full of wisdom, but they are not revelations. And yet there are some of his disciples who hold it to be almost blasphemy to dispute any one of his sayings; there are some who think to overwhelm us with confusion when we advocate this or that practice, by saying triumphantly–“that is contrary to the doctrines of Hahnemann”.
I think the best homoeopathist is not he who is always prating about what Hahnemann did or was supposed to do, and who would try all practice by the Hahnemannic test, but he who boldly approaches the doctrines and precepts of Hahnemann in a spirit of enlightened scepticism, who refuses his credence to every tenet that will not bear the light of a searching criticism, and who who hesitates to accept even Hahnemann’s practical rules, without subjecting them to the scrutiny of reason guided by experience.
It is in this spirit I have examined the question of homoeopathic aggravations and found it defective, and it was in this spirit I investigated Hahnemann’s theory of the mode of action of homoeopathic remedies. This spirit has influenced me in accepting the law of similia similibus as the grand therapeutic rule, and in rejecting Hahnemann’s hypothesis to explain it and his doctrine of homoeopathic aggravations. Pursuing the same plan with regard to the other doctrines agglomerated round the homoeopathic law, I trust I shall succeed in proving to your satisfaction that whilst there is a vast deal that is of immense practical value connected with these doctrines, many of the theoretical views linked together with homoeopathy, which have excited the mistrust if not the derision of scientific inquirers, are non-essential to the truth of the healing law, and that if the real truths connected with homoeopathy be carefully picked out from amongst the crowd of hypothesis in which they are smothered, the whole system therefrom resulting will offer a more strictly scientific, logical, and rational character than it assumes in the writings of Hahnemann, and will carry more conviction to the minds of the majority of the profession.
My chief aims therefore will be to demonstrate the rationality of the essentials of the homoeopathic system, and to divest it of those non-essentials which have hitherto only served to retard its progress. Among the latter I consider the homoeopathic aggravation holds a prominent place.
There are, however, some phenomena connected with the favourable march of diseases and with the curative effects of medicines in disease that might, on a superficial view of the matter, seem to afford some countenance to the doctrine of homoeopathic aggravations, when observed only in connection with the curative action of the remedial agent. It is well known that some acute exanthematous diseases present unfavourable symptoms as long as the exanthema remains imperfectly developed, and that these unfavourable symptoms subside simultaneously with the full development of the eruption. This occurs sometimes spontaneously, but very frequently in consequence of the administration of the appropriate remedy; but though, as far as the mere eruption is concerned, this effect of the medicine is an aggravation, in respect of the whole disease it is a decided amelioration. It is commonly said that in such a case the morbid process is transferred from the internal vital organs to the external skin; but whatever be the proper explanation of the fact, its promotion by means of a proper curative agent cannot be regarded as an aggravation, but on the contrary, as a restoration of the disease to its normal mild course.
In like manner it often happens with chronic diseases that their termination is marked by the appearance of some exanthema, the development of which is often promoted by the homoeopathic remedy; and in the case of skin diseases, properly so called, it is no unusual thing for the homoeopathist to observe during his treatment the great spread and extension of the cutaneous malady. This may seem very like the homoeopathic aggravation of Hahnemann, but it is no aggravation at all, being precisely analogous to the similar result that occurs with the acute exanthemata before mentioned. Thus it almost invariably happens that however much the patient may complain of being worse, of the great increase of his cutaneous discomfort, etc., we shall find that some internal symptoms, some headache, gastralgia, dyspeptic or other symptoms, are decidedly relieved, if not altogether gone.
Now it is obvious that this occurrence cannot be held to be the homoeopathic aggravation of Hahnemann, for the most important features of the disease are relieved, and only the least important increased. Nor is it a sign that the dose administered has been needlessly large, and that it is requisite to discontinue the medicine; on the contrary, the phenomena will be produced by the very smallest doses that are curative, and it is good practice to repeat or even to increase the dose, as tending to the more effectual bringing out of this kind of crisis, and consequently to the speedier cure of the whole disease, to which this cutaneous efflorescence bears the same relation that the flowers do to the whole plant.
Every homoeopathic practitioner must have noticed this primary increase of the cutaneous malady before its final cure, an increase, be it observed, that we have some difficulty in persuading our patients can be of any advantage to them hereafter, and instances must be familiar to most practitioners of the serious detriment to the health that often attends the local suppression of cutaneous diseases by astringent or caustic applications.
I have seen cases, and the records of similar ones are to be found in our homoeopathic literature, where an eczematous or other eruption, that had lasted for years in a moderate form, has increased so as almost to occupy the whole surface under the homoeopathic treatment before it finally disappeared, and the only thing that could induce the patient to continue the homoeopathic treatment was the marked improvement that he observed in some head, stomachic, or other symptoms. I have also met with cases where, in the treatment of some gastric or other chronic affection, on the subsidence of these symptoms a cutaneous affection of a most disagreeable and extensive character has appeared; and when the patient, alarmed at the occurrence of this disagreeable symptom, has resorted to other treatment and had the eruption removed by local means, the internal affection has almost immediately returned.
The rationale of the increase or fresh occurrence of the cutaneous symptoms on the cessation of the internal morbid signs, and vice versa, seems to be, agreeably to the pathological doctrines I laid down in my previous lectures, the following:- The return of the diseased part to the healthy state acts as a stimulus to the other part with which it is in sympathetic connection, and produces there the over-irritation which is followed by exhaustion of vital action or disease.
It is probable that the differences observable among cutaneous diseases depend upon their different anatomical seat in the dermoid structures, and possibly careful observation will teach us, if not the particular structure that is in sympathetic connection with each particular organ, at all events the particular character and general locality of the cutaneous affection that is in this relation with each particular internal disease. This subject has indeed already engaged to a limited extent the attention of some practitioners, and we can easily believe that its investigation must be fraught with great advantages not only to pathology and diagnosis but also to therapeutics.
This subject, however, I must leave until I come to treat of that remarkable doctrine which Hahnemann enunciated in 1828, viz., the so-called psora theory or doctrine of chronic diseases.