Symptomatic vs. Pathologic Prescribing.
Continuing our account of the views of early homoeopaths on the theory and practice of homoeopathy, we come to Gottlieb Rau (1779-1840), who practiced allopathy for twenty years before he adopted the new method of healing. Like Hahnemann, he advocated the use of the simplest remedies and gave free play to the healing power of nature. In all doubtful cases he preferred as far as possible to let nature take its course without the use of medicines. His one stumbling-block to complete acceptance was the smallness of the dose.
However, by careful experimentation, at first in cases not serious, he was convinced of the power of infinitesimals and became a most zealous defender of the new doctrine. Through his unusual ability and great personal charm his reputation spread far and wide.
Rau sets forth his interpretation of the theory and practice of homoeopathy in his “Organon of the Healing Art.” This excellent book remained on a shelf in my liberty for many years before I even opened it. I took for granted that it was a plagiarism of Hahnemanns work bearing the same title. The perusal of a few paragraphs changed my opinion. While Rau differs from Hahnemann upon many important issues, in the main he has written a very creditable exposition of homoeopathic philosophy and method.
In fact, he goes into some phases of the philosophy of cure more deeply than did Hahnemann, and quotes many authorities for and against his contentions. In the preface he states that he was induced to devote himself “for seventeen years to the study of propagation of the new doctrine by an intense conviction of its high worth.” He says: “My gratitude to Samuel Hahnemann, the author of the new doctrine, has not allowed me, however, to close my eyes to its existing imperfections.
I have called this work Organon, not because I considered it the last development of homoeopathy, but simply because it is a record of my own experience. I am convinced that homoeopathy is capable of progress and consider it as anybodys right to proclaim his honest and earnest meditations.” Space forbids more than a brief account of the authors most striking statements and a few instances wherein he is at variance with the teachings of Hahnemann.
Rau declares that similia represents the only true healing principle. He teaches that disease is not an entity but an internal dynamic alteration of the vital force, “which manifests itself to our senses by symptoms, which ought not to be confounded with the proximate cause.” Since the vital force cannot be divided, there can be no local disease. He queries, “Has nosology been so far of any real use in the treatment of disease? I should rather say no.” However, he believes that it would be useful to divide disease into genera, species and varieties according to their general differences; such as, sthenic, asthenic, etc.,
But attempts to treat diseases upon this basis alone have resulted in “enormous mistakes. The great use of pathological anatomy,: he says, “cannot be doubted; we should guard, however, against attaching too much importance to it.” He believes that the physician should study pathology and symptomatology in what he calls their true relations. To make his meaning clear, he describes the difference between aconite and belladonna in their action on the circulation.
Yet, he says, there are many pathologic conditions which cannot be explained; as for instance, shuddering in the pit of the stomach as ice-cold water were poured over it, a characteristic of phosphoric acid; forgetfulness with ischias, coldness of the parts affected with rheumatic pains which were cured by cocculus indicus. It is his opinion that the term “specific” treatment is preferable to “homoeopathic” and that Hahnemann was wrong in designating the old school systems of medicine by the collective name of “allopathy.” “The revulsive method is similar to the homoeopathic, inasmuch as its object is, in many cases, to excite similar affections, though in different parts of the organism.”
But he is convinced that the combination of the old and the new schools would constitute “a miserable abortion.” Still, he thinks that “the idea of antipathic treatment should not be rejected generally as has been done by some vehement members of the specific method. It is not difficult to understand that a disease might be cured antipathically, provided we knew its proximate cause, but a treatment which is directed only against isolated symptoms, is always incomplete and frequently pernicious.
Moreover, the antipathic method cannot be applied in every case because we do not know the contrarium of every anomalous condition of the organism, particularly in disturbances of the sensitive sphere and a majority of the dyscrasias. We may state it as our opinion that the appellation of specific doctrine appealing would have secured a larger number of converts.” The remedy should not be selected simply “because it is capable of producing symptoms similar to the disease, but because the general state of the organism arising from the action of the drug is similar to the general character of the disease.”.
Rau is willing to concede that cures have been made without a correct diagnosis, but this is only by a mere chance. By studying the symptoms in conjunction with nosography or pathology, the science of diagnosis is elevated to a higher rank. “Homoeopaths should be at least as careful diagnosticians as are their opponents.”.
The writer is aware of the evil effects which result from the suppression of scabies and other cutaneous eruptions, and adduces a number of illustrations from the writings of ancient and contemporary authors as well as from his own experience. He recognizes latent syphilis and psora and the fact that a large number of disease conditions result from psora, syphilis and sycosis, and adds that the obstinacy of chronic diseases cannot be accounted for except by the presence of a chronic miasm.
He thinks that Hahnemanns conception of psora is too inclusive but is to a certain extent true. His remarks concerning the relative value and importance of symptoms agree with Hahnemanns teachings on this subject. He points out that so-called accidental symptoms are frequently of the greatest value as indications for a remedy and gives some excellent illustrations of this, concluding the paragraph with others in which the pathology could not be explained.
Several paragraphs of this work are devoted to isopathy. The author relates several cures of drug diseases by high potencies of the drug itself; of the cure of snake bites by parts of the reptile, the amelioration of smallpox by its vaccine; of malignant pustule by its virus, and of the itch with psorin.
While he condemns indiscriminate venesection, he argues that bloodletting in certain cases of congestion of the noble organs, as for instance of the brain threatening apoplexy, may avert a crisis. The remaining symptoms may then be treated homoeopathically.
In general, he disapproves of cathartics, moxas, setons and other palliative measures as they frequently do great harm. “Homoeopathic palliatives are vastly superior to the usual antipathic anodynes.” Nevertheless, he deems useful the application of a “sinapism” when the eruption of measles fails to appear, or in a case of suppressed tinea capitis.
Rau believes that the “lowest as well as the highest preparations” of the remedy are two extremes which are “condemnable. It is likewise false that any dose, were it ever so small, is yet powerful enough to overcome the morbific influence.” Age, constitution, sex, the nature of the disease or its location, and inherent power of the remedy must be taken into consideration in determining the dose to be employed. Thus he says, “Belladonna, nux vomica, lachesis, phosphorus or arsenicum are still efficacious in the 20th or 30th potency; whereas the higher potencies of other drugs such as euphrasia and taraxacum would be of very little use.”.
The ideas of von Grauvogl received wide attention throughout Germany and other European countries in the late sixties, and in the United States with the publication of the English translation of his textbook of homoeopathy by Shipman in 1870. This scholarly work of over 450 pages is now out of print and considered out of date even by those who are aware of its existence. Yet it inaugurated a dispute among the members of the homoeopathic profession which lasted for several years.
The subject is treated from a philosophic standpoint and with much cold logic. In fact, this work comes nearer to placing homoeopathy on a truly scientific basis than any other in homoeopathic literature, but despite the clearness and soundness of the writers discussion of principles, and the masterly way in which he shows the absurdity of the theories of methods of the physiologic school of medicine, as he terms it, he too has his own pet theories, some of which might be held untenable even by his confreres of the natural scientific movement, as for example his theory of three general constitutions which he terms hydrogenoid, oxygenoid and carbo- nitrogenoid which received attention on the chapter on psora (JOURNAL of the A.I.H., January, 1939). Puhlman (1) Translation by Shipman of von Grauvogls Text Book of Homoeopathy. (2) Translations Worlds Homoeopathic Congress, 1876. Vol. II. -The Journal of the American Institute of Homoeopathy Vol. XXXIII. No. 7. believes that Grauvogl in formulating these three constitutions was endeavouring to combine Rademachers idea of three universal remedies and Hahnemanns three chronic miasms.
Nosologic names, Grauvogl calls mere empty words. Diagnosis in his opinion has its place in medicine but is of minor importance as an aid to prescribing since it fails to individualize the case. The homoeopath by high intimate knowledge of symptomatology is able to define the essential indications for remedy selection. His masterly analysis of the potency question will appear in a future article on that subject.