3. We pass now to the third division of the “vocation of the true physician,” as conceived by Hahnemann. How is he to use his knowledge of drug-action in the treatment of disease? How is he to wield the potencies the former gives him for the favourable modification of the latter?.
To the answer to these questions are devoted forty-eight aphorisms (aphorism 22-69) of the first and a hundred-and-forty-seven (aphorism 146-292) of the second division of the `Organon.’ Hahnemann argues that there are only three conceivable relations between the Physiological effects of a drug and the symptoms of disease, and therefore only three possible ways of applying the one to the other.
The two may be altogether diverse and heterogeneous, as the action of a purgative and a congestive headache; and if you use the former to relieve the latter, you are employing a foreign remedy you are practising Allopathy. Or the may be directly opposite, as the influence of a Bromide and the sleeplessness of mental excitement; then to give Bromide of Potassium to induce slumber is to act upon the enantiopathic or anti-pathic principle. Or thirdly, they may be similar, as Strychnine- poisoning to TETANUS or that of Corrosive sublimate to DYSENTERY.
If such drugs are used for their corresponding disorders, you are evidently Homoeopathizing. Now of these, Allopathic medication must be condemned, both on the ground of its uncertainty, and on that of the positive injury it does by disordering healthy parts and by flooding the system with the large doses of drugs necessary to produce the desired effects. Antipathic treatment is certainly and rapidly palliative; but the inevitable reaction which follows, lead to a return of the evil, often in greater force. It can rarely moreover, deal with more than a single symptom at a time; and even then its capabilities are limited by the very few really opposite states which exist between natural disease and drug-action.
Antipathy may do tolerably well for immediate needs and temporary troubles; but it is not competent to deal with complex, persistent or recurrent maladies. For these we are shut up to the Homoeopathic method, if we are to make any rational use of drugs in disease at all. This operates “without injury to another part and without weakening the patient.” It is of inexhaustible fertility, for the analogies between natural and medicinal disorders are endless. It is complete, for the one order of things may cover the other in its totality.
It is gentle, for no large and perturbing dosage is required for its carrying out. It is, lastly, permanent; for the law of action and reaction, which makes the secondary effects of antipathic palliatives injurious, here operates beneficially. The primary influence of the drug being in the same direction as the morbid process, the secondary and more lasting recoil will after (it may be) a slight aggravation directly oppose and extinguish it. It is thus that Hahnemann explains the benefit wrought by Homoeopathic remedies thus, and also by the theory (aphorism 28-52) of the substitution of the medicinal for the actual disease, of which he cites parallels in nature.
Here again we pause to ask what objections have been taken to Hahnemann’s position. His doctrine of the three relations between drug-action and disease seems too simple for certain minds. One (Anstie) calls it Metaphysical; another (Ross) Geometrical; a third exclaims “how curious, how ingenious, how interesting!” and seems to think that in so designating it he excludes the possibility of its conformity to Nature. But why should it not have these features and yet be true? What other alternative is possible? What fourth term of comparison can be found between (be it remembered) the effects of drugs on the healthy and the symptoms of disease? If you use the one for the other, you must do so Allopathically, antipathically, or Homoeopathically.
Medical men seem very fond now-a-days for disclaiming any system in their practice, and announcing themselves as altogether lawless and empirical. But they can no more help practising upon one or other of these principles than M. Jourdain could help speaking prose unless he launched into verse. If they would only analyse their own thoughts, they would see that as soon as they learn the Physiological action of a drug, they consider what morbid states it can indirectly modify or directly oppose.
These are two of the members of Hahnemann’s triad; and the difference between us and them is that our first thought seeks out what disorders the drug phenomena most resemble. We would not neglect the other two directions in which the medicine might be utilised, if we had reason to think it advantageous to follow them; and our complaint is that the profession at large do neglect and ignore the third, to the great loss of their patients.
Why should they do so? Some have answered that the method is really practicable, that real parallels between disease and drug- action are rare. To speak thus, however, implies a very deficient knowledge of Pharmacodynamics. Others have expressed a more general and natural objection when they have argued that medicines which are truly similar must aggravates rather than benefit, if they act at all. It would seem so; and it is not surprising that in the older works on Materia Medica morbid states analogous to the action of drugs are set down as contra- indicating their employment.
But this difficulty SOLVITUR AMBULANDO. Let any one take an obvious instance of such a contra- indication condition a sick stomach for Ipecacuanha, a congested brain for Opium, a dry febrile tongue for Belladonna. If he gives a quantity capable of exciting such states in the healthy, he may undoubtedly aggravate. But let him reduce his dose somewhat below this point, and he will get nothing but benefit. This has been tested again and again and no one has reported adversely to it: on the contrary, uses of medicines derived from the method are now becoming as popular in general practice as they have long been in ours.
Why should this benefit result? We have heard Hahnemann’s explanation, that such remedies work by substitution and by exciting reaction. It is one in which it is not difficult to pick holes, and he himself says, in propounding it, that he does not attach much importance to it (aphorism 28). Any discredit, however, resulting from its disapproval must attach equally, as regards substitution, to Bretonneau and Trousseau; as regards reaction, to more than one ingenious thinker of our own country, as Fletchers, Ross, Rabagliati. (See MONTHLY HOM. REVIEW, xxiii, 600-2.)
More recently, the hypothesis has been advanced, that medicines have, even in health, an opposite action in large and small quantities, so that the reduction of dose necessary to avoid aggravation gives you a remedy acting in a direction contrary, to that of the disorder, while its choice by similarity secures practicability and complete embracement. I myself feel great difficulty in acceding to this theory as a general account of Homoeopathic cure; but there is no justification for representing its adoption as an abandonment of the Homoeopathic position. It is an attempt at explanation, that is all: the fact that likes are cured by likes is the all important thing, account for it how we may. So Hahnemann said, and so all we Homoeopathists believe.
The side of Hahnemann’s position on which he is most vulnerable is his exclusiveness; in which he maintains his method to be applicable to all non-surgical diseases, and to render all other ways of employing medicines superfluous and hurtful. This led him, as has been fairly urged, to regard intestinal worms as product of the organism, and to ignore the acarus as the exciting cause of Scabies; it has resulted among his followers in a denial of palliatives to their patients by which much suffering might have been spared.
In the first matter, however, he erred in common with most of his contemporaries; and in the second he is not responsible for the excess of disciples who are often more Wilkesite than himself. The rational Homoeopathist recognises, indeed, the inferior value and limited scope of antipathic palliation. He knows that it is only properly applicable to temporary troubles; but in these he makes full use of it. He does not allow his patients to endure the agonies of Angina pectoris, when he knows, that Amyl nitrite will relieve them: he does not refuse them Chloroform during the passage of a calculus any more than during that of a foetus. Hahnemann’s exclusiveness is not to be justified; but it may fairly claim excuse as the enthusiasm of a discoverer, full of the sense of the power of his new method, and naturally led to apply it everywhere and to esteem it without rival.
The treatment of his subject in the second part of the `Organon’ is purely practical. It gives instructions for the selection of remedies upon the Homoeopathic principle, and for their judicious employment when selected. It enquires what should be done when only imperfect similarity can be obtained, when more than one medicine seems indicated, and when the symptoms are too few to guide to a satisfactory choice. It considers the treatment on the new method of local diseases (so called), of mental disorders, and for the great class of Intermittent affections. It gives directions for diet and regimen; for the preparation of medicines; for the repetition of doses, and for their size.
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.