(From vol. iii, 2nd edit., 1825.)
(The alcoholic tincture of the thin tubular as well as the royal bark, Cinchona officinalis.)
Excepting opium I know no medicine that has been more and oftener misused in diseases, and employed to the injury of mankind, than cinchona bark. It was regarded not only as perfectly innocuous, but as a wholesome and universally beneficial medicine in almost all morbid states particularly where debility was observed, and was often prescribed in large doses several times a day for many weeks, and even months, together.
In so acting the ordinary physicians were guided by an utterly false principle, and they confirmed the reproach I have already frequently made against them to the more sensible portion of the public, that they have hitherto sought in traditional opinions, in guesses prompted by false lights in theoretical maxims and chance ideas what they could and should find only by impartial observation, clear experience, and pure experiment, in a pure science of experience such as medicine from its nature must only be.
Setting aside all guess-work and all traditional unproved opinions, I adopted the latter method, and I found, as with the other medicines, so especially with cinchona bark, by testing its dynamical powers on the healthy human being, that has certainly as it extremely curative in some cases of disease, so surely can it also develop the most morbid symptoms of a special kind in the healthy human body; symptoms often of great intensity and long duration, as shown by the following true observations and experiments.
Thereby, first of all, the prevailing delusion as to the harmlessness, the child-like mildness and the all-wholesome character of cinchona bark is refuted. (As long ago as the year 1790 (See W. CULLEN’s Materia Medica, Leipzig, bei Schwickert, ii, p. 109, note) I made the first pure trial with cinchona bark upon myself, in reference to its power of exciting intermittent fever. With this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy. This is a truth so incontrovertible, so absolutely without exception, that all the venom poured out on it by the members of the medical guild, blinded by their thousand-years old prejudices, is powerless to extinguish it; as powerless as were the vituperations launched against HARVEY’s immortal discovery of the greater circulation in the human body by RIOLAN and his crew to destroy the truth revealed by HARVEY. These opponents of an inextinguishable truth fought with the same despicable weapons as do to-day the adversaries of the homoeopathic medical doctrine. Like their modern congeners they also refrained from repeating his experiments in a true, careful manner, (for fear lest they might be confused by facts), and confined themselves to abuse, appealing to the great antiquity of their error (for GALEN’s predecessors and GALEN himself had arbitrarily decided that the arteries contained only spiritual air, and that the source of the blood was not in the heart but in the liver), and they cried out: Malo cum Galeno errare cum Harveyo esse circulator! This blindness, this obstinate appeal to the extreme antiquity of their delusion (it was only after thirty years and more that HARVEY had the satisfaction of seeing his true doctrine universally adopted), was in those days not more stupid than the blindness of to-day, and the present aimless rancour against homoeopathy which exposes the pernicious rubbish talked about ancient and modern arbitrary maxims and unjustifiable practices, and teaches that it is only by the responses given by nature when questioned that we can with sure perscience change diseases into health rapidly, gently, and permanently. )
But equally evident is it, from the symptoms of disease produced by cinchona bark in healthy observers recorded below, that the numerous unhappy results of the treatment by this bark occurring in the practice of ordinary physicians, and the frequently incurable aggravations of disease developed where bark in long continued and large doses was the main remedy in the prescriptions were owing solely to the noxious character of this drug when employed in unsuitable cases, and in too frequent and too large doses. This noxious character is demonstrated by the medicinal symptoms recorded below, which physicians till now were not aware of, and which they made no effort to ascertain. On the contrary, they innocently ascribed these aggravations to the natural course of the disease itself.
But I refrain from blaming these physicians, whose judgement is biassed by the prejudices of their schools, on this account, (their conscience will doubtless reproach them for it) I will content myself with expressing my own convictions in a few remarks.
1.Cinchona bark is one of the most powerful vegetable medicines. When it is accurately indicated as a remedy, and when the patient is seriously and intensely affected by a disease that china is capable of removing, I find that one drop of a diluted tincture of cinchona bark, which contains a quadrillionth (1/ 1000000,000000,000000,000000, th) of a grain of china-power, is a strong (often a too strong) dose, (Compare this with the large doses of this drug given in ordinary practice!) , which can accomplish and cure all alone all that china is capable of doing in the case before us; generally without it being necessary to repeat this dose in order to effect a cure; a second dose being rarely, very rarely, required. In the case neither of this nor of any other medicine did a preconcieved opinion or an eccentric fancy lead me to this minuteness of dose. No, multiplied experience and faithful observation led me to reduce the dose to such an extent. Led by experience and observations I clearly saw that larger doses, even where they did good, acted much more powerfully than was needed for the cure. Hence the smaller doses; and as I repeatedly observed from these the same effects though in a less degree, I gave still smaller, and the very smallest doses. These proved sufficient to effect a complete cure, and they did not display the violence of larger doses, which tends to delay the cure.
2. A very small dose of china acts for but a short time, hardly a couple of days, but a large dose, such as is employed in the practice of every day, often acts for several weeks if it be not got rid of by vomiting or diarrhoea, and thus ejected from the organism. From this we may judge how excellent the ordinary practice is of giving every day several and moreover large doses of bark!
3. If the homoeopathic law be right – as it incontestably is right without any exception, and its derived from a pure observation of nature – that medicines can easily rapidly, and permanently cure cases of disease only when the latter are made up of symptoms similar to the medicinal symptoms observed from the administration of the former to healthy persons; then we find, on a consideration of the symptoms of china, that this medicine is adapted for but few diseases, but that where it is accurately indicated, owing to the immense power of its action, one single very small dose will often effect a marvellous its action, one single very small dose will often effect a marvellous cure.
I say cure, and by this I mean a “recovery undisturbed by after-sufferings”. Or have practitioners of this ordinary stamp another, to me unknown, idea of what constitutes a cure? Will they, for instance, call cures the suppression by this drug of agues for which bark is unsuited? I know full well that almost all periodic diseases, and almost all agus, even such as are not suited for china, must be suppressed and lose their periodic character by this powerful drug, administered as it usually is in enormous and oft-repeated doses; but are the poor sufferers thereby really cured? Has nottheir pervious disease only undergone a transformation into another and worse disease, though it may no longer manifest itself in intermittent attacks recurring periodically, but has become a continued and, we may say, a more insidious disease by this very powerful and, in this case, insuitable medicine? True, they can no longer complain that the paroxysm of their original disease reappears on certain days and at certain hours; but note the earthy complexion of their puffy faces, the dulness of their eyes! See how oppressed is their breathing, how hard and distented is their epigastrium, how tensely swollen their loins, how miserable their appetite, how perverted their taste, how oppressed and painful their stomachs by all food, how indigested and abnormal their faecal evacuations, how anxious, dreamful, and unrefreshing their sleep! Look how weary, how joyless, how dejected, how irritably sensitive or stupid they are as they drag themselves about, tormented by a much greater number of ailments than afflicted them in their ague! And how long does not such a china-cachexy often last, in comparison with which death itself were often preferable!
Is this health? It is not ague, that I readily, that I readily admit; but confess – and no one can deny it – it is certainly not health. It is rather another, but a worse, disease than ague. It is the china-disease, which must be more severe than the ague otherwise it could not overcome and suppress (suspend) the latter.
Should the organism, as it sometimes will, recover from this china disease after many weeks, then the ague, which has till now remained suspended by the superior force of the dissimilar china-disease, returns in an aggravated form, because the organism has been so much deteriorated by the improper treatment.
If the attack be now renewed in a still more energetic manner with cinchona bark, and continued for a longer time in order, as it is said, to ward off the fits, there then occurs a chronic china-cachexy, a faint picture of which will be found in the symptoms recorded below.
Such are most of the bark treatments of our physicians, because they know not what are the cases for which bark is suited. They are suppressions of the original affection by the production of a stronger china-disease, which is mistaken for a manifestation of the obstinacy of the original disease, the development of new symptoms being attributed to its peculiar malignity; because it is not known that these ailments are due to china, because it is not recognised what they are, namely, artificially induced china-disease.
The following symptoms caused solely by bark acting on the healthy body, will open the eyes of physicians on this subject, those of them at least who have not yet acquired the faculty of silencing their consciences, and in whose bosoms a warm heart for the welfare of their fellow creatures still beats.
Most intolerable and unjustifiable, however, is the monstrous abuse made by the dominant school of medicine, which plumes itself on being the only rational school, of this powerful drug in all kinds of debility.
There is no disease which is attended by weakness (as almost every one is naturally), or which physicians by their unsuitable allopathic medicinal mixtures have reduced to exhaustion of vital powers – where they did not consider it necessary to give this bark in large doses in order to strengthen as they call it; no patient prostrated, ruined and enfeebled by improper drugs to a condition of complicated cachexy whom they have not endevoured to set up and restore to a healthy condition by tonic potions of infusion, decoction, extract, electuary of china, or by the same drug in powder. He is stuffed and tortured with it for weeks and months under the pretence that it will do him good. Of the consequence of such treatment I would prefer to say nothing. If the death-rolls could speak, they would most eloquently speak the praises of this abuse of bark; and so also would the crowds of the living victims of asthmatic, dropsical, and icteric diseases, and those other unfortunates who remain affected with neuralgic os spasmodic maladie, or with malignant growths, abdominal sufferings or lingering fever, if they but knew what mischief had been done to them.
I would appeal to the common sense of these practitioners and ask them how, without being guilty of the most unpardonable slipshod practice, they can venture to administer bark in all those infinitely various diseases, which of themselves, as also especially in consequence of the traditional medical treatment, must necessarily medical be attended by weakness? How can they ever imagine that they can strengthen a sick person whilst he is still suffering from his disease, the source of his weakness? Have they ever seen a patient rapidly cured of his disease by appropriate remedies who failed to recover his strength in the very process of the removal of his disease? If, however, as is natural, it is only by the cure of the disease that the weakness of the patient can cease and give place to strength and activity, and if, on the other hand, there can be no question of a removal of the weakness as long as its source is not dried up, that is to say, as long as the disease on which it depends is not cured, what a perverse treatment must not that be, which seeks to make strong and active by the administration of china (and wine) a patient at whose vitals the disease is still gnawing! These practitioners cannot cure diseases, but they can attempt to strengthen these uncured patients with cinchona-bark. How can such a stupid idea ever enter their heads? If bark is to make all sick persons strong, active and cheerful, it must needs be the universal panacea which shall at once deliver all patients from all their maladies, from all morbid sensations and abnormal functions, that is to say, make them in all their ailments in every respect well and free from disease! For so long as the plague of disease deranges the whole man, consumes his forces and robs him of every feeling of well-being, it is a childish, foolish, self-contradictory undertaking to attempt to give such an uncured person strength and activity.
That cinchona-bark is no panacea for all diseases, we are taught by the sad experience of the ordinary practice; but its symptoms show that it can be an appropriate, real remedy for only a few cases of disease.
It is no doubt true that by the first doses of bark the strength of the patient, be he ever so ill, is increased for a few hours; he is able to raise himself up in bed all alone, as if by a miracle; he wants to get out of bed and put on his clothes; all at once he speaks in a stronger more resolute manner, venturing to walk alone, and grows animated, eagerly desires to eat this or that,- but a careful accurate observer easily sees that this excitation is only an unnatural tension (see below the note to § 895). A few hours pass and the patient sinks back, sinks deeper down into his disease, and the fatal result is often accelerated.
Do not these gentlemen perceive that no one can become well (truly strong and active) as long as his disease lasts?
No! the always suspicious semblance of strength communicated to the patient for a few hours by bark is invariably attended by the saddest results, and this will ever be so, except in those rare cases where cinchona-bark is at the same time the right remedy for the disease on which the weakness depends. In such cases the patient’s weakness ceases immediately with the disease. But, as I have said, such cases are rare, for cinchona-bark is the true remedy (which relieves rapidly, permanently, and without after-ailments) for but few diseases. In all the many other cases bark, as a medicine and so-called tonic, must to harm, and the more so the stronger its medicinal power (injuring when given improperly) is. For all medicines, without exception, can do no good when unsuitable for the case of disease, and must inflict so much the more injury the greater their medicinal strength (and the larger the doses in which they are given).
Hence, physicians should first learn the peculiar power oaction of cinchona-bark, and exactly what particular alterations in the health of human beings it is capable of causing, before they presume to undertake the cure of diseases, and consequently the morbid weakness, with this powerful medicinal agent. They should first know the symptoms of china before attempting to determine for what collection of morbid symptoms, that is, for what case of disease it may be curative; it can be curative for none but those whose symptoms are to be found in similarity among the symptoms of china, he who falls to do this will always commit mistakes, and do infinitely more harm than good to the patient.
When china has been selected according to conscientious homoeopathic conviction (but not as hitherto, according to theoretical views, deceptive names of diseases, or the misleading authority of equally blind predecessors), and is consequently the truly appropriate remedy of the case of disease to be treated, in such a case, and for that very reason, it also the true strengthening remedy. It strengthens in as much as it removes the disease, for it is only the organism free from disease that restores the defective strength; strength cannot be materially poured into it by a decoction of china (or by wine).
There are no doubt cases where the disease itself consists of weakness, and in such cases bark is at once the most appropriate curative and strengthening remedy. Such a case is that where the sufferings of the patient are solely or chiefly owing to weakness from loss of humours, from great loss of blood (also from repeated venesections), great loss of milk in nursing women, loss of saliva, frequent seminal losses, profuse suppurations (profuse sweats), and weakening by frequent purgatives, where almost all the other ailments of the patient are wont to correspond in similarity with the china symptoms (see notes to 837 and 860). If, then, there is here no other disease in the background to produce dynamically or to keep up the loss of humours, then for the cure of this peculiar weakness (from loss of humours), which has here become the disease, one or two doses as small as those above mentioned, (Here as elsewhere I insist on the sufficiency and efficiency of such small doses. And yet the vulgar herd can never understand me, for they know nothing of the pure treatment with one single simple medicinal substance to the exclusion of all other sorts of medicinal irritants, and their thoughts are enchained in the mazes of their old routine. Even when the ordinary physicians now and then constrain themselves to give in some (acute) disease one single medicine, they never have the heart to refrain from using at the same time several other things possessing medicinal power, which, however, they regard as of no consequence, and to which they apply the trivial name of domestic remedies.) They must always use simultaneously either a poultice of so-called aromatic or solvent herbs applied to the most painful part(just as though these could have no effect on the patient through his olfactory nerves, nor act as a heterogeneous medicine through the skin!), or they must rub in some medicinal ointment, or give a medicinal vapour-bath, or a medicinal gargle, or apply a blister or sinapism, or prescribe several half, whole or foot-baths, or order clysters of valerian, camomile, &c. (just as though all these were a mere nothing and did not act on the human system as heterogeneous powerful medicine through the skin, the mouth, the rectum, the colon, &c.!), or they must administer simultaneously a tea of mint camomile, elder-flower, so-called pectoral herbs, &c. (Just as though a handful of such herbs or flowers infused in boiling water counted for nothing!). In such an onslaught with heterogeneous drugs, which, although ignorance looks upon them as innocuous domestic remedies, are to all intents and purposes medicines, and some of them very powerful medicines, in this accessory quackery, I say, even a large dose of medicine of another kind can, of a truth, never display its peculiar action, and such an uncommonly small dose as homoeopathy requires is completely powerless; it will be instaneously overpowered and aniihilated. No! in the language of rational men that alone can be called giving a single medicine in a disease, when, excepting this one, all other medicinal influences aer excluded from the patient and carefully kept away from the patient and carefully kept away from him. But he who will do this must know what things brought in contact with the human body act medicinally on it. So long as he does not know this it must be ascribed to his ignorance that he considers as nothing, as not at all medicinal, such things as herb-teas and clysters, poultices and baths of herbs and salts, and the other things just mentioned, and continues to use them thoughtlessly under the name of domestic remedies during the employment of medicine internally. Still more heedlessly in this respect is the treatment of chronic maladies conducted; for, in addition to what the patient takes from medicine chests and bottles, and the external applications and so-called domestic remedies that are usually administered to the patient, lots of superfluous hurtful things are allowed, and even prescribed, which are also regarded as indifferent matters in spite of the disturbing effects they may exercise on the patient’s health, and of the confusion they may cause in the treatment. Besides the internal and external use of medicines the patient is allowed, for example, to take (fro breakfast) mulled beer, vanilla chocolate, also (even several times a day) strong coffee or black and green tea, not unfrequently – to strengthen the stomach (?) – claret-cup, liqueurs containing strong spices, seasonings of all sorts in the food, and especially in sauces (made of soy, cayenne pepper, mustard, &c.) – these things are supposed merely to increase the appetite and promote digestion, but to possess no hurtful medicinal quality! – moreover, quantities of uncooked herbs cut small and sprinkled over the soup – which are regarded as supremely wholesome, but are really medicinal – also various sorts of wine – one of the main reliances of ordinary practice – must not be forgotten. Besides all these there are tooth-powders, tooth-tinctures, and tooth-washes – also composed of medicinal ingredients, and yet considered innocuous because for-sooth they are not swallowed; just as though medicines only taken into the mouth or their exhalations drawn into the nose did not as surely act on the whole organism through its living sensitive fibres as when they are swallowed! And then the various kinds of perfumes and washes (musk, ambergris peppermint drops, oil of bergamot and cedar, neroli, eau-de-Cologne, eau-de-luce, lavender water, &c.), besides perfumed sachets, smelling bottles, scented soaps, powders and pomades, pot-pouri, and any other noxious articles de luxe the patient may desire. In such an ocean of medicinal influences the otherwise adequate homoeopathic dose of medicine would be drowned and extinguished. But is such a medley of medicinal luxury necessary and useful for the life and well-being or compatible with the recovery of the patient? It is injurious; and yet, perhaps, it has been invented by physicians themselves for the upper classes in order to please, to stimulate and to keep them ill.but even though physicians may not directly recommend it, it is sufficiently sad that they not know the medicinal noxiousness of all this luxury, and that they do not prohibit it to their chronic patients, This hotch-potch of noxious influences, due partly to the luxurious habits of the patient himself, partly to the simultaneous use of domestic remedies ordered or permitted by the doctor, is so much the rule, so universally pervalent, that the ordinary practitioner cannot think of treatment without such a simultaneous medical confusion, and hence, under these circumstances, he is unable to promise any decided effect from the internal administration of a single medicinal substance in a disease, even when it is given in a large dose, far less from a very small dose of medihomeopathically employed! CONRADI was acquainted with no other treatment than such as is constructed amid such a confused medley of medicinal influences, as is evident when he says (Grunariss der Pathologie and therapie, Marburg, 1801, p. 335), that the action ascribed by me to such small doses is beyond all belief. Here, not to dwell upon the trifling circumstance that the determination of the action of medicinal doses is hardly a matter of belief, but rather of experience, he seems no more than other ordinary practitioners to have either the slightest conception or the slightest experience of the action of a small dose of appropriate medicine in a patient completely excluded from the simultaneous irritation of all other kinds of medicinal substances, otherwise he would have spoken in a different manner. A pure treatment with a single homoeopathic medicine, all counter-acting medicinal contaminations being removed (for it is only of such I speak and only such I teach), never is seen or dreamt os in routine practice. But the difference is enormous and incredible.