After these opinions we will be able to agree with Emil Schlegel of Tubingen when he says in his “Reform of Medical Science” (1903):
It is almost remarkable how the enlightened leaders of the modern movement of natural sciences unconsciously extend their hand to the long misunderstood genius.
And his prophetic word indeed seems near it fulfilment:
This time has now come when a thorough understanding of Hahnemann will be easier and more possible, when his honest and well described observations will also find scientific acceptance and when it will begin to be of extreme advantages to represent the teachings of that great German physician, in order to divert them into the stream of recognition and life.
HAHNEMANN’S ATTITUDE TO PATHOLOGY.
In the essay, “On the Value of the Speculative Systems of Medicine,” etc., published in “Hufeland’s Journal,” 1808, No. 263, Hahnemann writes:
But though all the component parts of the human body are to be found in other parts of nature (with the exception perhaps of zoonic acid and uric acid), yet they all act together in this organic combination for the full development of life, and for the discharge of the other functions of man, in so peculiar and anomalous a manner (which can only be defined by the term vitality) that this peculiar (vital) relation of the parts to one another and the external world, cannot be judged of and explained by any other rule than that which it supplies itself; therefore by none of the known laws of mechanics, statics or chemistry.
Yet in spite of these innumerable deceptions physiologists and pathologists would still return to this old leaven;because they tried, chiefly for the sake of their own pride, to explain much, even the inexplicable in the essence of medical science. They considered it impossible to treat the abnormal state of the human body (diseases) scientifically without possessing a tangible idea of the fundamental laws of the normal and abnormal conditions of the human organism. This was the first and great deception which they practised on themselves and on the world. This was the unhappy conceit which, from Galen’s days down to our own, made medical science a stage for the display of the most fantastic, often the most self-contradictory hypotheses, explanations demonstrations, conjectures, dogmas and systems, whose evil consequences cannot be overlooked.
Therefore it was a fight against all the system which resolved and contradicted each other! Derived from the system of experience and not from an external system! This was Hahnemann’s standpoint when he continued:
I pass on to pathology, a science in which that same love of system has upset the mental balance of the metaphysical physiologist, and has caused a similar degeneration of the intellect, in the attempt to fathom the essential nature of diseases, that process by which affections of the organism become diseases. This they term the first internal cause.
No mortal an form a clear conception of what is here aimed at, to say nothing of the impossibility of any intelligence, even in imagination, finding a road to an intimate view of what constitutes the essence of disease: and yet hosts of sophists with important looks, have affected to play the seer’s part in the matter.
Also in the Introduction to the “Organon,” page 3, he rejects the old pathology with its love of systems, which tries to force individual diseases into definite disease categories, for the purpose of treatment. He says:
The old school of medicine flattered themselves that they could justly claim for it alone the title of ” rational medicine” because they alone sought for and strove to remove the cause of disease, and followed the method employed by nature in diseases. They only fancied that they could discover the cause of disease: they did not discover it, however, as it is not perceptible and not discoverable. The great majority of diseases being of dynamic (spiritual) origin and dynamic (spiritual) nature, their cause is not perceptible to the senses; they therefore exerted themselves to imagine one, and from a survey of the parts of the normal inanimate human body (anatomy), compared with the visible changes of the same internal parts in persons who have died of disease (pathological anatomy), as also from what they could deduce from a comparison of the phenomena and functions in healthy life (physiology) with their endless alterations in the innumerable morbid states (pathology, semeiotics), they drew conclusions relative to the invisible process whereby the changes which take place in the inward being of man, when diseased are affected-a dim picture of the imagination.
In another passage (page 136) Hahnemann condemns the old pathology with its multitudinous variety of names of diseases which were erroneously considered to stand by themselves, and in a footnote to this he enumerated diseased conditions which differed very widely from each other frequently only having one isolated sign of similarity.
And further: All the diseases which nature produces in human beings exposed to a thousand different kinds of conditions forming an endless variety of changes which can never be defined in advance, pathology has split up to such an extent that they are reduced to a mere handful of artificially formed diseases.
THE OBJECT OF DIAGNOSIS.
According to the “Organon, ” 81 (Annotation I, page 171, 6th Edition):
The true physician knows that he has to consider and to cure disease, not according to the similarity of the name of a single one of their symptoms, but according to the totality of the signs of the individual state of each particular patient.
And in 82, page 172 (6th Edition):
as no real cure of this (the chronic diseases- R.H.) or of other disease. He had already pointed this out in his translation “Treasury of Medicine or Collection of Chosen Prescriptions” (“Thesaurus Medicaminum,” 1800) when he said: I regret that the different kinds of dropsy are not differentiated, and that the same kind of dropsy is always mentioned. The division into leucophlegmatic and inflammatory is not sufficient, just as little as a distinction in mental diseases between mania and melancholia. What would we think of a botanist who had no other divisions for vegetation than plants and herbs?
In 5 of the “Organon” we read: The particulars of the most probable exciting cause of the acute disease are useful to the physician in assisting him to cure them, as also are the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm.
And in 7, he says: as in disease we can perceive nothing but the morbid symptoms, the totality of these symptoms of this outwardly reflected picture of the internal essence of the disease, that is, of the affection of the vital force. must be the principle, or the sole means, whereby the disease can make known what remedy it requires.
AUSCULTATION AND PERCUSSION.
Auscultation, invented by Laennec in 1816, is that important branch of medical art which determines sounds and noises in the inner part of the body by applying the ear to the body of the patient, or by placing a listening tube (stethoscope) between the physician’s ear and the patient’s body (over the heart. lungs, pleura, large blood vessels and edges of fractures). Auscultation which requires a keen ear, good tuition and continued practice, was first adopted in France for general use, later the medical schools of Vienna and Prague followed and then through Skoda’s perfecting it, it gradually came into use in Germany.
Percussion stands in close relation to auscultation; it is a method of tapping on the surface of a patient’s body by means of the finger tips or by means of a special hammer. As the organs in the human body, from their construction and position, emit different sounds from the body cavity in which they are enclosed, these different sounds enable us to estimate the condition of the inner organs of the human body. It was first recommended by Auenbrugger (in the year 1761) and it was once more the French who perfected it (Rosiere de la Chassagne, Corvisart, and the above mentioned Laennec). After Skoda had further improved it, he introduced it into Germany. Yet it took more than the first quarter of the Nineteenth Century to secure its adoption.
That is why one of the best known clinicians of his time in Germany, Professor Schonlein of Wurzburg, still made his diagnosis in 1820 almost entirely by basing them upon the symptom picture. Empyema, for instance (a collection of pus in the pleural cavity) was to be recognised from the numbness of the arm, and although the dull sound obtained when percussing with the finger or percussion hammer on the chest wall is a very much better sign, it was unknown to Schonlein, and he, therefore, does not mention it.