In the Essay I have mentioned he shows, that as Physiology takes cognisance, not of life, but of the results of life, so that with which Pathology is concerned is the result of the abnormal and perverted life which we call disease. The products of disease Pathology sees, hears, or infers: It knows nothing of disease itself. Hence, to base Therapeutics upon Pathology alone is to make the former merely palliative a pumping out a leaking ship instead of stopping the leak. It may be said that we do not know where the leak the primary disturbance is, and that if we knew we could not reach it to stop it.
But by the proving of medicines we obtain agents which their powers to cause similar inundations, and therefore presumably, similar breaches, which upon the principle SIMILIA SIMILIBUS it is the hypothesis that they can repair. If then, the comparison between the results of disease and of drug-influence be thoroughly and accurately made, the parallelism of action must reach also to that which originates either. “And here,” Dr. Dunham writes, “I cannot refrain from tendering homage to the wonderful provision of genius by which, in an age when Pathology, as we understand it, was unknown. Samuel Hahnemann anticipated all that we have said, and all that the most advanced thinkers of our day have taught, respecting the scope and influence of Pathology in relation to Therapeutics.
The symptoms of the urinary organs in connection with the discharge of morbid urine would at one time have been regarded as the proper subject of treatment. But Pathology has now taught us to trace these symptoms back to the kidneys and beyond the kidneys to the blood, and beyond the blood to the nutrition and the destruction of all the organised tissues. As Dr. Carpenter remarks, `When, for example, the urine presents a particular sediment, our enquiries are directed not so much to the sediment itself, as to the constitutional state which causes an undue amount of the substance in question to be carried off by the urinary excretion, or which prevents it from being (as usual) dissolved in the fluid.’ To confine the attention, therefore, in prescribing for a given cause, to the immediate organ the perversion of whose functions is most obviously pointed out by the prominent symptoms, is to disregard the clearest indications of Pathology.
We must analyse these prominent symptoms, and must include their remotest elements in our indications. Nay, these remotest elements the constitutional disturbances of which Carpenter speaks are even more important indications for treatment than the more obvious and objective symptoms. But how can we analyse these more obvious symptoms, and ascertain those `constitutional disturbances’ in which they have their origin? In no other way than by a study of the functions of the entire organism in what way and to what extent they are performed in an abnormal manner.
And this brings us at once to that rule on which Hahnemann so strongly insisted, that the entire organism of the patient should be examined in every possible way, and that the `totality of symptoms’ should be made the basis of the prescription; nay, that the constitutional, general symptoms are often more conclusive as to the proper treatment than the more obvious local symptoms. The grand old master reached at a single bound the same conclusions to which the labours of a half century of able Pathologists have at last, with infinite research, brought the medical profession.”
All this time we have been dealing with general principles: but let us look at special forms of disease, and see whether or not the Hahnemannian mode of regarding them is sufficient for their treatment.
1. The FEVERS constitute a group which plays a large part in daily practice. They are maladies in which morbid increase of temperature exists prior or out of proportion to any local inflammation which may be present. The theory of this state is still a moot one. According to some Pathologists it depends upon excessive heat-production; according to others upon deficient heat-radiation; while yet another class (with whom I venture to think the truth resides) believe that both factors operate at one time or another in the process. (See my “Knowledge of the Physician,” Lecture V.) But whatever be the genesis of fever, it remains a positive fact a clinical entity, with which we have to deal.
Upon the Homoeopathic principle, we have to treat it with drugs capable of producing fever. How they do so, we may not know; but our ignorance of the process matters little if we are sure about the result, “An infinitesimal quantity of Atropia a mere atom,” writes Dr. John Harely “as soon as it enters the blood, originates an action which is closely allied to, if it be not identical with, that which induces the circulatory and nervous phenomena accompanying Enteric or Typhus Fever.” This is sufficient; and as soon as we learn it to be a fact from Hahnemann’s proving of Belladonna (made, I may add, before Dr. Harely was born), yet minuter quantities of Atropia (in the form of the juice of its mother plant) became in our hands trusted remedies for these very fevers.
Again, the classification of fevers of which we have already spoken, so necessary for science and so valuable for general purposes, has but the smallest influence upon drug-selection. The old divisions of Synocha, Synochus, and Typhus (the last with its “nervous” and “putridus”), worthless as they are from a scientific point of view, are much more useful for our practice than those of Typhus, Typhoid, Relapsing, and Ephemeral. They denote the KIND of fever with which we have to do, its quality and mode of life; and to us it is all important that our drugs, next to being really febrigenic, should correspond in their action to the kind of fever present. They can hardly set up a whole Typhoid, in its complete evolution; but the febrile state they develop is certainly either a Synocha, a Synochus, a Typhus nervosus versatilis or stupidus, or a Typhus putridus; and if we find these states existing, in the essential fevers, the exanthemata, or elsewhere, in them we shall have our remedial means.
2. After FEVERS, the most important group of disease consists of the INFLAMMATIONS. To the Pathology of this morbid process many pages are devoted at the commencement of every treatise on Medicine or Surgery. Whether, after all that has been written, we know much about it in its essence, may well be doubted; but even if we do, of what avail is our knowledge for treatment at any rate for medicinal treatment? The old phenomenal signs, DOLOR, PALOR, RUBOR, TURGOR, still for all practical purposes constitute INFLAMMATION, when externally manifested and when it is internal, and so invisible, the facts which lead us to infer its presence and seat are no less of the symptomatic order, as I have already argued. To treat Inflammation Homoeopathically, it is only necessary to find a drug capable of setting it up, at the same spot and in the same manner, as evidenced by the symptoms.
3. The NEUROSES, of which I would in the third place speak, are still as Libermeister says symptomatic groups. Their unity is one neither of cause nor of lesion; it is clinical only. It is of much interest to know what is the seat and process of the Epileptic paroxysm; but our choice of Anti-epileptic remedies must be determined mainly by the power they have of inducing similar paroxysm in the healthy subject, explain it or not as we can. In like manner is it with Cholera and Tetanus and Hysteria; no conceivable knowledge we can gain as to their intimate nature would make us better able to fit Homoeopathic remedies to them than we should be, if we possessed their symptomatic analogues in drugs.
It thus appears that of the three elements which exist in all knowledge phenomena, laws, and causes, it is the first which for positive therapeutic action, chiefly concerns us in disease. Not that the other two are worthless to us, even for this end. Our laws here are classification the recognition in morbid states of genera, species and varieties analogous to those of animated nature. These enable us to form groups of remedies associated with them, instead of having to wander through the whole Materia Medica for each prescription: They also give a continuity to medicinal treatment, without which the USUS IN MORBIS were of no avail.
Hahnemann led the way here, by constantly insisting on the existence of fixed and definite types of disease, to which standing remedies should be applied; and by giving us group of “Antipsorics.” I fear, however, that he must be considered as having rejected all enquiry into causes I mean proximate causes, the noumena of the phenomena in this sphere. In so doing we need not follow him. His ground for taking symptoms as the element of parallelism between disease and drug-action was that they only were surely known in his day this was true, and his selection of them was most prudent.
But to maintain that they alone were knowable was unwarrantably to bar the progress of science. His stricter followers have acted on the DICTUM, and have looked askance on the positive Pathology of the present day, with its physical diagnosis and post-mortem confirmations. They have always been a decade or more behind hand in their recognition of such distinction as those between Typhus and Typhoid, between Chancre and Chancroid, and in their use of such means as auscultation and thermometry. Now this is altogether wrong. An inference from symptoms, if sure, is as good a basis for treatment as symptoms themselves. This sureness is assumed in the prognosis given and the general management instituted: Why should it not be also for purposes of drug-selection? By proceeding upon it we secure another route to the SIMILE we desiderate.
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.