Now, to the production of morbid action I have stated that the morbific agency acts by inducing over-irritation of the part on which it acts, causing increased vital action, which is followed at a greater or less distance of time by diminished vital action, which gives rise to those phenomena we call disease. The morbific agents, then natural and medicinal, are both primarily irritant, and cause increased vital action. When a case of disease presents itself to us, we have before us an instance of diminished vital action, in order to remedy which, by the method under consideration, we must apply an irritant capable of stimulating the diseased part up to the healthy level. Now, the medicine that will cause the same morbid symptoms as the disease in question must in its primary action be an irritant that acts on the same part or parts as those diseased, and obviously this medicine will be the remedial agent for this disease, if we can so regulate its power as to cause it to do no more than stimulate the diseased part up to the normal level, when of course the disease will be extinguished and healthy action restored. A priori reasoning will throw little light on this subject beyond leading us to infer that the quantity of the medicine requisite for this purpose must be less than what is required to produce the over-irritation necessary to cause morbid action in the healthy; but if, in addition to this, we reflect on the fact that the susceptibility of a diseased part for its specific irritant is much greater than that part in health, (For some excellent remarks on the subject of the increased susceptibility in disease, I must refer the reader to Hahnemann’s “Lesser Writings,” pp. 445, 528. It is curious to note that at a subsequent period Hahnemann seems almost to discard the notion of an increased susceptibility in disease, and in a paper published in 1827 expressly to account for the action of small doses (Opium cit., p. 817), he attributes their effects solely to the wonderful increase of power they obtain by means of the processes of trituration and succussion to which they are subjected, and he does not once allude to any increased susceptibility in disease), we shall be satisfied that the quantity required must be much less. However, it is to experience we must appeal for the final verdict in the matter of the dose of the medicine; and experience teaches us that it should be much less than we might have expected, even taking the two foregoing considerations into account.
If this attempt to explain the curative action of medicinal agents be the correct one, it will be obvious that, with respect to that method which I have termed direct irritation, or the medication by specific or homoeopathic medicinal agents, whilst the law similia similibus, or, as Hahnemann expresses it, “to effect a mild, rapid certain, and permanent cure, choose, in every case of disease, a medicine which can itself produce an affection similar to that sought to be cured”–whilst this, I say, expresses only the rule for the selection of the remedy, the actual curative process is rather contraria contrariis, for the impression we effect with our remedial agent is the opposite of the existing condition of the diseased part. This is the view taken by Dr.John Fletcher of the subject, and I cannot do better than read a portion of what he says regarding homoeopathy, as it is an evidence of his philosophical spirit, enlarged views, and unprejudiced judgment, such as we look for in vain among the other writers of the old school in this country who have touched upon homoeopathy.
“Hahnemann’s general notion (although he has obviously at times a glimmering of the truth, which is not easily reconcilable with this notion) is, that such substances (homoeopathic remedies) operate in producing a stronger impression, and thus superseding the weaker; but this is nothing more than the old axiom of Hippocrates. It is not in this way that homoeopathic remedies operate, but by stimulating to increased action the seat of disease. With respect to diarrhoea, piles, gonorrhoea, and catarrh of the bladder, diaphoresis, intermittent fever, laryngitis, iritis, ptyalism, and burns, the essence of all is inflammation; and how readily the same substance which at one time may produce at another time may cure it, will easily be perceived. It is unnecessary to speak of the action in producing and curing the same diseases of those substances which act directly; but let us take, as somewhat less obvious, that of some indirect agent in the same way, as that of mercury, one of the most generally admitted among the above-mentioned examples, in at one time producing and at another curing iritis. In the healthy state of the capillary vessels of the iris their calibre is natural, because the stimuli acting on their irritability are neither deficient nor excessive; but the irritation produced in certain parts of the body by mercury is a new stimulus, specifically adapted to the irritability of those vessels (in common with those of many other organs), so that, conveyed to these by sympathy, it excites there a secondary mordant irritation or contraction, followed sooner or later by a proportionate collapse, in which the inflammation consists. Now, what substance should we, a priori, conceive would be best adapted to bring up the vessels to their ordinary degree of contraction, and thus to discuss the inflammation? Any revulsive remedy (as we cannot get at the part directly) may be presumed capable of doing this to a greater or less degree; but, unquestionably, that will be most efficacious which has already evinced a specific power of exciting in one part such an irritation, as, conveyed by sympathy to the vessels of the iris, could excite them to inflammation, and which, as it produced, while they were healthy, a preternaturally increased action, followed of course by collapse, will, now that they are acting below par, bring this action to the healthy standard, from which they will have no tendency afterwards, to recede. Hahnemann is quite aware of this two fold action of medicines, and it is to ensure their primary, without fear of their secondary action, that he inculcates the expediency of giving them in inconceivably small doses. But it is absurd to say, as he at the same time does, that medicines in such doses operate by producing a stronger impression than that produced by the disease. They cure it, not by the stronger but by the opposite impression which they make; so that homoeopathic medicines, after all, operate on the antipathic principle. If we choose to represent the ordinary irritation of the vessels of the iris by a line, say an inch high, it is easy to conceive certain substances capable of raising it to an inch and a half; but this height, as it cannot be maintained, after a time is reduced spontaneously through double the space that it has been raised, i.e., falls as much below an inch as it had been before raised above it, or to half an inch; and what are the substances now called on to effect, but what they effected at first, namely, to raise the line of action half an inch, the result of which is now health, as it was before disease? We must remember that it is in the secondary or depressing effects of exciting causes in general that inflammatory diseases, at the time we are called upon to treat them, consist; and there is surely nothing absurd, but, on the contrary, everything reasonable, in the presumption that the same exciting causes applied in such a manner or at such a time as to ensure their primary or exciting effects, will act as the best remedies of those diseases which, under other circumstances, they may have occasioned. (Fletcher’s Pathology, pp. 489-91.)
I was much gratified to observe in an essay by Dr. Clotar Muller of leipzic, (Allg. Hom, Ztg., xxix.49.) that he takes a very similar view of the curative process to that I have just given. He takes the inflammatory process as his theme of illustration, and after showing that inflammation consists in a kind of partial paralysis of the nerves of the capillaries, he asserts that the medicine cures by the stimulation it applies to these paralysed nerves, by virtue of its primary action; that its action, in fact, is the opposite of the actual condition of the diseased part; and that the principle similia similibus is merely our guide to the selection of a remedy, but that it by no means expresses the part that remedy performs in relation to the disease. Apropos of this explanation, I may mention a remark of J. Hunter’s, which is strikingly corroborative of these views. “If,” says he, “we had medicines which were endowed with the power of making the capillary vessels contract, such, I apprehend, would be the proper medicines in inflammation;” and such, undoubtedly, are our homoeopathic remedies in their primary action.
In the explanation I have offered of the curative process, I have considered only the simplest form of disease curable by a single medicine; but the complex nature of the organism and the multifarious varieties of morbific causes may give rise to complicated forms of disease, which may not be remediable by one medicinal agent, but which may require to be dislodged from the system, bit by bit as it were, by a long-continued succession of remedies.
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.