REVIEW OF THE AIMS & METHOD OF INTERNAL MEDICINE



There are very few medical schools that do that. We have been called sectarian by some, but actually we are more catholic, as far as our methods of therapy are concerned, than most medical schools that I am familiar with.

For some years I happened to be Physician-in-Chief of a large hospital near Philadelphia where we had medical interns from almost all the medical schools in this Country, and I was surprised to learn how limited was their knowledge of medical therapeutics. For example, I recall one day having a case of influenza in the Ward. I said to the intern, who happened to be a graduate of a Class A medical school, “I think we ought to give this man gelsemium.”

He replied, “Whats that, doctor ?” I said, Did you ever go to a medical school ?” “Oh, yes, for four years, but I never heard of gelsemium.” I said, “Dont you know that the Pennsylvania Board of Health, a few years ago during the great epidemic of 1918-1919, sent a letter to all the doctors in this State, asking them if they would not prescribe gelsemium for cases of influenza instead of aspirin and codeine ?” He said, “I heard of that.” I said, “You dont even know what that medicine is ?”

He said, “No.” I said, “If I had a student in my class who didnt know what digitalis was or who didnt know what morphine was, Id feel very much abashed; and yet when you learn of a drug that the State Board of Health has asked the doctors of this State to administer to people because of its curative value, you dont even know what it is !”.

The essence of sectarianism is that a physician has one method which he tries to apply to every form of disease. There is no one method of treatment that applies to everybody, and the best doctor is not the man who takes pride in the fact that he knows only one method of treating people, but is the man who has the widest knowledge of various therapeutic measures and applies each when it is indicated.

If we begin with drug therapy, and that is, of course, an important part of medicine, it is common knowledge that there are various methods of drug therapy. First, I want to refer to what is known as the antipathic method. The antipathic method is the administration of a drug which has an effect that is the opposite to that of the disease. For example, if a man is suffering from constipation, we give him Epsom salts, because Epsom salts produces diarrhoea; if he has diarrhoea, we give him opium, because opium has the effect of producing constipation.

This is what we know as the antipathic method, a method that is very old and at times a very effective method of treating illness. It, of course, has great limitations. For example, what is the opposite, of a headache ? The fact that you dont have a headache isnt the opposite of a headache. And what is the opposite of a pain from a gallstone? Well, there is no opposite. So it is a method which has very definite limitations not only because there are no opposites for many symptoms but also because the production of the opposite condition may not be helpful to the patient.

For example, if a patient has a diarrhoea that is the result of uremia and I give him opium to constipate him. I stop the diarrhoea, but I may kill the patient. If the patient has typhoid fever with a temperature of 104 degrees and I give him phenacetin. I many reduce his temperature to 97, but the patient will probably die. So you see there are a great many limitations to this method of therapy, valuable as it may be under certain conditions.

Next we have what is frequently spoken of as the allopathic method. Now the law of the State of Pennsylvania provides for homoeopathic, electropathic, and allopathic representatives on the State Medical Board, but if you want to get the graduate of the average medical college mad, just refer to his method of prescribing drug as “allopathic.” It is very much like flaunting a red flag in the face of the proverbial bull. There are a few words that offend the average doctor, “Homoeopathic” is one and “Allopathic” is another. There is no scientific basis for such an attitude as they are both perfectly proper and scientific terms by which to designate certain types of drug therapy.

The allopathic method is the administration of a drug, chiefly for its palliative action, without any definite known relationship existing between the effect of the drug, and the disease to be treated. For example, for many years the Peruvian Indians found that if they gave Cinchona bark to people who had malarial fever they got well. They did not know anything about quinine or about malarial parasites. They just knew if you swallowed this bark, a certain percentage of the people got well of the disease.

To-day when a person has syphilitic gumma of the brain and shows certain types of paralysis, we give him potassium iodide; the gumma in the brain is absorbed and the paralysis disappears. We dont know why; we simply know that it does. There is no particular physiological action of potassium iodide that would suggest to you that if a man had gumma in his brain or liver it would disappear under the administration of potassium iodide. This is what we call the allopathic method. It is more or less empirical–a method of trial and error.

This method has often proved to be of great value in therapeutics. It is a method that has been used in medicine for many hundred of years; and we have some very effective drugs that are applied in accordance with this method. Some of them are curative, but mostly they are palliative.

Now we come to another method–the use of what we know as antipathogens. Antipathogens are medicinal agents that are used for the destruction or the elimination of the cause of disease. The other methods of treatment that I have referred to are largely palliative. For example, you have a cough, and I give you a half grain of codeine. That relieves the cough, but it doesnt cure the bronchitis that causes the cough. Or you have a boil on your neck, and I give you a hypodermic injection of morphine. I relieve the pain, but that doesnt cure the boil.

There are a number of antipathogens, and first I wish to discuss is the homoeopathically indicated remedy. The homoeopathic method is based upon the conception that the administration of an agent capable of producing symptoms similar to those from which the patient is suffering, will bring about in the cells of the body a vital reaction which will result in the production of antibodies or substances antagonistic to the disease.

Probably the simplest and best known example of this method is the use of vaccination against small-pox. Here we take a minute particle of the cow-pox vaccine, inoculate the skin and there is produced in the body a cellular reaction resulting in the formation of antibodies that protect the patient against small-pox.

You can readily see that the drop of material that we put on the patients arm does not stimulate his heart, or his liver, or his kidneys, or his nervous system, nor does it circulate around in the blood for the next fifteen years and kill the germs of small-pox that may come along. That is inconceivable, but we do know that the minute quantity of cow-pox virus produces in the living cells of the body a curative or protective reaction, and the curative or protective substances are formed by the living cells. So we have what we call a dynamic or vitalistic reaction.

Now homoeopathy is not limited, as many people imagine, to the administration of sugar pills. Homoeopathic remedies can be given on sugar pills, or in powders, or in liquid, or by hypodermic injections, or intravenous methods. There are a variety of ways by which it can be given, but the basic principle of homoeopathy is the stimulation of living cells to curative reactions; and such reactions can only be induced in accordance with the principle of “similars”.

For example, if I want to protect you against small-pox, I cannot use organisms of typhoid fever, I must use the virus of small-pox itself or of cow-pox, which is a very similar disease. If I want to produce antibodies against the organism of pneumonia and its toxins, I must start by inoculating with the pneumococcus and not with the diphtheria bacillus. In other words, I must proceed on the principle of similars, and the basis of all vaccine and serum therapy is pure and simple homoeopathy.

Another important method of antipathogenic therapy is chemotherapy. By chemotherapy we mean the introduction into the body of certain chemical substances that will inhibit the growth of organisms or antidote their toxins. Of course the most brilliant example of chemotherapy we have today is the sulfanol compounds, certain concentrations of which in the blood will destroy or inhibit the growth of the pneumococcus, the streptococcus and other bacteria. In this type of therapy the living cells play no part.

If we could get all the pneumococci that are in the body of a man who has pneumonia, in a test tube and pour the sulphopyridine solution on them, it would be the ideal way to kill them. This is in direct contrast to the homoeopathic method, where we depend upon the reactive power of the living cell to produce the curative substances. In chemotherapy, the curative substance is introduced into the body already formed and the cell plays no particular part in the process.

G Harlan Wells