It is on the last of these points only that I can touch here; for the rest I must refer to the work itself. Hahnemann’s treatment of the subject of dose had not had justice done to it, in consequence of our knowing only the Fifth Edition of the `Organon’. In the year 1829, after the publication of the Fourth Edition, he unfortunately determined to secure uniformity in Homoeopathic usage by having one dilution for all medicines, and this the decillionth the 30th of the centesimal scale.
Our present `Organon’ represents this view; but the first four edition make no such determination, and are entirely moderate and reasonable in the principle of posology they lay down. The dose of a Homoeopathically selected remedy, they say, must obviously be smaller than one intended to act antipathically or Allopathically. If too large, it will excite needless aggravation and collateral suffering. It should be so reduced, that its primary aggravation (which Hahnemann supposed a necessary result) should be hardly perceptible, and very short-lasting.
How far this must be, varies with the medicine used; and for suggestion on this point he refers to his MATERIA MEDICA PURA, where the dosage recommended ranges from the mother-tincture upwards, the 30th being a dilution of exceptional height. He alleges experience alone as having led him to attenuate as far as he has; but argues the reasonableness of so doing from the increased sensitiveness of the diseased body, pointing out that dilution does not diminish the power of a substance in proportion to the reduction of its bulk. Excluding the specific doses mentioned in the other work referred to, which are simply matters of fact and experience, there is nothing in this part of the `Organon’ in its essential structure to which fair exception could be taken.
I wish I could have stopped here; that there had been in the volume I am now expounding nothing more difficult to defend than what has gone before. In its first three editions i.e., up to 1824 there is not. Almost everything in Hahnemann’s work during the first quarter of this century is of enduring worth; it is positive, experimental, sound. But from this time onwards we see a change. The active and public life he had led at leipzic, with the free breath of the world blowing through his thoughts, had been exchanged, since his exile to Coethen in 1821, for solitude, isolation, narrowness.
The reign of hypothesis began in his mind hypothesis Physiological, Pathological, Pharmacological. The theories he was led to form in all these branches of thought found their way into the later editions of the `Organon’, and so demand some consideration from us here. But let it be remembered throughout that they are not of the essence of its argument; that its structure and substance were complete before they appeared, and in the judgment of many of us are rather injured by their interpolation. Without them, all is inductive reasoning or avowedly tentative explanation; they, dogmatically asserted but all unproven, introduce a new and questionable element, they constitute what Drs. Jousset and Gailliard have well called the “romance of Homoeopathy.”
The first of these hypotheses is that of a VITAL FORCE, as being the source of all the phenomena of life, and the sphere in which disease begins and medicines act. Hahnemann would probably at all times have called himself a vitalist, in distinction alike from the animism of Stahl (which made the immortal soul the principle of life), and from the views of those who would bring all vital phenomena under the laws of Physics and Chemistry. He early, moreover, employed the term “dynamic” to denote the sphere in which true diseases took its origin and those effects of drugs which require vitality for their production.
Disease has its “materies morbi” and organic changes; but all these may be Hahnemann would have it always were secondary products and effects, the primary derangement being invisible and intangible, manifest only in altered sensations and functions. Drugs, again, produce many of them chemical and mechanical effects; but these might occur in the dead as in the living body. The exclusively vital reactions they set up in the crucible of the organism belong to another sphere; they correspond with the beginnings of disease, like them are revealed by altered sensations and functions, like them are to be characterized as “dynamic.”
Had he gone no further all would have been well. It is easy to read into his language the present protoplasmic doctrine of life; while the frequent commencement of disease in molecular rather than molar changes, (Hahnemann himself would have allowed this “frequent” to be more correct than “invariable”; for he considered Cholera due to the invasion of a cloud of minute organisms, and on this ground advised Camphor to be used so freely for it (see Lesser Writings, p. 851, 854). He is thus granting, IN PRINCIPLE, the germ-theory of infectious disease, and the propriety of parasiticide treatment in them.) and the dynamic as distinct from the mechanical and the chemical action of drugs, are recognised by all. But in his later years Hahnemann advanced from this thoroughly tenable position into one far less easy to maintain.
He adopted the view that vitality was a “force,” analogous to the physical agencies so called, without which the material organism would lack sensation and functional activity, which animates and energies it during life and leaves it at death. It is this “vital force” (LEBENSKRAFT) which is primarily deranged in illness, and on which morbific potencies both natural and medicinal act through the sensory nerves. Its behaviour under medicinal influence is ingeniously imagined and elaborately described (aphorism 127); and in the Fifth Edition of `Organon’ it is frequently mentioned as the actor or sufferer where previously the author had been content to speak of the organism (as in aphorism 148).
Now Hahnemann can hardly be thought the worse of for entertaining this view, since, in some form or other, it was almost universally prevalent in his day. If the advice of the present Pope has been taken, it is still the teaching of all Roman Catholic colleges; for it is simply the Thomist doctrine itself derived from Aristotle under another name. But the tendency of recent science is to regard the organism as no monarchy, wherein some “archaeus” lives and rules, but as a republic in which every part is equally alive and independently active, the unity of the whole being secured only by the common circulation and the universal telegraphic system of nerves. It is unfortunate, therefore, that Hahnemann should have committed himself and his work to another conception. Either or neither may be wholly true; but one would have been glad if the `Organon’ had kept itself clear of such questions, and had occupied only the solid ground of observation and experiment.
And now of the PSORA-THEORY. This is far too large a subject for justice to be done it here. It has been fully handled elsewhere; (See Dudgeon’s LECTURES ON HOMOEOPATHY, IX and X and my own PHARMACO-DYNAMICS, pp. 87, 90 and 839. A thoughtful paper on the subject was presented to our International Congress of 1896 by Dr. Goldsborough; and, with the discussions following, may be read in its Transactions. Dr.Goldsborough differs from me as to the range of cutaneous disease covered by the name “Psora” in Hahnemann’s writings, and indeed so extends it as to include itching eruptions of all kinds.
He makes him explicity contained for a doctrine of “herpetism” which I have viewed as only implicitly contained in his thought. He is thus unable to agree with me that Hahnemann “based the logical superstructure of his Psora-theory upon the distinct entity Scabies,” I have carefully weighed what my able colleague has written, but am unable to modify the judgment expressed in the text, and in the references given in this note.) and any one who would desire to deal fairly with Hahnemann on the point has abundant material for so doing. I can only say a few words as to what it purports to be and what it really is.
It is sometimes averred by Hahnemann’s critics that he made all Chronic Disease or at least seven-eighths of it originate in from the category of true chronic maladies those which arise from unhealthy surroundings, noxious habits, and depressing influences (aphorism 77) for these, he says, disappear spontaneously when the LOEDENTIA are removed. Neither will he allow the name to the medicinal affections which the heroic treatment of his day made so common (aphorism 74-6), and which he regards as incurable by art. True Chronic Disease consists of such profound disorders as Asthma, Phthisis, Diabetes, Hypochondriasis, and the like disorders insusceptible of cure by Hygiene, and tending to permanent stay and even increase.
A certain proportion of the affections so characterized were traceable to venereal infection Syphilitic or “Sycotic” (i.e., Gonorrhoeal); and it seemed to him that the remaining seven-eighths (it is here that these figures come in) must have some analogous “miasmatic” origin. In the medical literature of his day he found numerous observations (he cites ninety-seven of them) of the supervention of such diseases upon the suppressing of cutaneous eruptions among which Scabies then very prevalent held a prominent place. In this last he had found the “Miasm” he wanted. It resembled Syphilis in its communication by contact, its stage of incubation, and its local development, while it was far more general. He thereupon propounded it as together with the other contagious skin affections, the Tineae, etc., which he regarded as varieties of it the source of the non-specific Chronic Diseases, understood as defined.
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.