“Every effective remedy creates in the human body a of illness peculiar to itself; and this illness is just so much more peculiar, definite, and severe as the drug is effective.” As an annotation to this, he writes: “The most effective drugs, drugs inducing specific diseases and consequently most active therapeutically are called poisons by the laity.” And then further: “One should imitate nature in that she sometimes cures a chronic disease by means of another which is super-imposed upon the first, and should apply to the disease which is to be cured (especially a chronic one) the remedy which is able to produce, artificially, a disease resembling as much as possible the one to be healed and the letter will then be cured: similia similibus curantur (Like is cured by like)”.
A few pages before this passage, Hahnemann states his position as to the first of the two Hippocratic doctrines, i.e, “Contraria contrariis curantur” (Opposites are cured by opposites). He characterizes this doctrine as only conditionally valid. In regard to this he says on page 423 : “In acute ailments which nature herself will generally cure if we will prevent, even or a few days, all interference with recovery, but to which, if we cannot do that, she succumbs-in acute ailments, I say, the prescribing of drugs (according to the law of contraria) is correct, effective, and sufficient so long as we are not all- knowing and do of recognize the fundamental cause of every sickness nor possess the means with which to give relief; or so long as we have no effective specific”.
And further : “But if the cause of the sickness and the means of relief are plain to see and we, unmindful of this, nevertheless combat the symptoms merely with remedies of this nature, or administer them for the purpose of opposing chronic ailments, this therapeutic procedure-to fight complaints by means of drugs which physiologically produce a contrary effect-is then termed palliative and should be rejected. In chronic cases, the palliative ameliorates only at first and in consequence stronger doses become necessary, but these do not remove the real cause and so the longer they are used the more injurious they are”.
As a proof of this point of view, Hahnemann then brings forth, among their things, the treatment of chronic obstipation with cathartics; and chronic pains with the continued use of medicines derived from “the juice of the poppy” (opiates)-“And even though the greater number of my medical contemporaries were still to cling to this method, I do not hesitate to term it palliative, injurious, and pernicious.
I beg my fellow practitioners to forsake this method-Contraria contrariis curantur-in chronic cases and those acute cases that are just about to degenerate into a chronic form. It is an incorrect way, a temporary woodmans road, leading through a dark forest and ending at the edge of a precipice. The proud empiricist considers this method as the well marked road to victory and is very pleased with himself that he is able with this miserable power to give relief for a few hours, unconcerned as to the fact that the malady takes firmer root under this coat of whitewash”.
I wish to repeat here yet another sentence from page 437, in the chapter on “Palliative Medicine”: “Perhaps the palliative medicines as so injurious in chronic diseases and make them so much more persistent, for the reason that, after the first effect which tends to relieve the symptoms of the disease, they cause an after the first effect which tends to relieve the symptoms of the disease, they cause an after effect that resembles the original illness”.
In the second portion of his essay, Hahnemann produces a large number of proofs for his views in regard to he effectiveness of a therapy according to the principle of “Similia similibus.” From the long series of these, only two will he presented here. On page 465, we read: “I have in my supplement to “Cullens Materia Medica already drawn attention to the fact that Peruvian bark, given in large doses to sensitive people in normal health, will produce an attack of true fever which is very similar to an attack of intermittent fever and therefore, in all probability, overpowers the latter and so cures. Now, after a much greater experience, I wish to add: not only is this probable, but it is quite positive”.
On page 521, there is a passage concerning arsenic: “The true nature of arsenic has not yet been accurately studied. I, myself, have experienced the fact that it has a great tendency to produce spasm of the blood-vessels and a tremor of the nerves. Such attacks are called ague-fits. If one uses it in somewhat stronger doses-one sixth to one-fifth of a grain for an adult- this tremor becomes very positive. This tendency makes it a very powerful remedy against intermittent fever because of the similarity between the symptoms produced by the arsenic and those present in this type of fever.
Indeed, all the more so from the fact that it possesses the power, as I have brought forth, of producing a daily recurrence of the attack (decreasing in intensity, however), even if one discontinues the use of it. In typical ailments of every kind in periodically recurring headaches, etc.-this peculiarity of arsenic for type-production when given in small doses, one-tenth up to never more than one- sixth of a grain in solution, becomes important and may, as I foresee, become quite invaluable to our successors who will, perhaps, be still more courageous, are observant, and also more cautious than ourselves”.
This idea of using arsenic in small doses-one grain equals about five centigrams-must, at that time, have been considered a very audacious and hazardous therapeutical enterprise. Hufeland, at least, cannot resist remarking in a footnote to this passage : “I must here, with due respect to the author, confess that I am as yet not above to agree to the internal use of arsenic, especially in intermittent fever.” That, too, has changed in the course of time!. As one or the other of my readers may not be familiar with the character of Hahnemanns scientific training before he decided to enunciate his views, perhaps it might be well to give a short description of it here. As a medical practitioner, and also as a chemist, Hahnemann was held in high esteem by the contemporaries.
His publications on “Arsenical Poisoning, Its Antidotes and Legal Determination,” “Concerning Signs of Purity and Adulteration of Drugs,” his “Wine Test” under which name was known the method originally devised by Hahnemann to demonstrate, qualitatively, the presence of lead in wine, along with co- existing iron, the former being derived from sugar of lead, a substance formerly often used as an adulterant, created the same well deserved interest among experts of that time as did his communications in Crells “Chemical Annals,” and his methods of preparing the so-called Mercurius solubilis. Mention might also be made here of his “Guide to a Through Healing of Old Wounds and Indolent Ulcers”; his “Instructions for Surgeons concerning Venereal Disease”; and his method of treating carious bone conditions by scraping our the diseased portions and treating the wound with a sublimate solution.
Then in the year 1810, Hahnemann published his “Organon” in which he very clearly made known his views concerning the action of drugs, especially his attitude on the second Hippocratic doctrine, relating to the principle of the action of similars.
In paragraph 29, he says: “Whereas every ailment which does not come within the scope of surgery is due to be peculiar pathological disturbance of the functional activity of our vital force; therefore in the case of a homoeopathic cure where the restoration of the equilibrium of the vital force which has been disturbed by disease has been brought about by means of a drug- potency accurately chosen according to similarity of symptoms, an artificial ailment similar to and stronger than the natural one is induced which is, as it were, substituted for the weaker, similar, and spontaneous pathological state; so that the vital force is now contending against the drug disease alone and is impelled to an increased effort because of the greater intensity of the drug action; however as this intensity of the drug-potency is of short duration, the renewed vital energy becomes supreme and, just as in the first phase, it became free of the spontaneous pathological condition, so it has, in this latter phase, been liberated from the artificial or drug affection and is now capable of again carrying on the life of the organism in health”.
The foregoing sentence which is rather drawn out, requires a careful analysis in order to be properly understood : Disease is, according to the opinion of the present day, the expression of a disturbance of the physiological equilibrium of the organs. By the administration of a drug-potency, according to the doctrine of similia similibus curantur, a disturbance of the equilibrium as nearly as possible identical with, but stronger than the pathological state is produced. The expression, drug-potency, chosen by Hahnemann may, for the present, remain undiscussed. We will have opportunity to refer to it at another time.
