Perhaps some day we shall have a definite, logical explanation of these facts!.
However this may be, it is fairly easy to prescribe, if we direct our minds to it, for the case which fully presents the essentials just touched upon. A remedy can usually be recognized, or if not, can be found by means of suitable repertory analysis. But what about the case which presents very few symptoms or none at all, of value in prescribing? Such cases are often met with and can be recognized as definite, diagnostic entities. Symptoms, whether subjective or objective, which reflect pathology only, are of great use in the making of a diagnosis, but are utterly useless as a basis for a homoeopathic prescription.
It is true, that the more pronounced pathology is seen to be, the less applicable is homoeopathy and the more incurable is the case. Pathologic end-products, as has so often been said, commonly belong to the surgeon. The law of similars is helpless, except perhaps, in a purely, palliative way. But surgery cannot, even with all its brilliant modern achievement, master all pathologic resultants. Medicinal therapy may be and usually is required. It needs a nice discrimination to determine, not only the possible incurability of the case and the extent of its pathologic change, but also how far the law of similars legitimately applies, or whether it applies at all. This is a rock upon which many a homoeopathic craft has ingloriously foundered!.
What then, shall be done with the symptomless case? If the surgeon finds no opportunity in it, shall it be permitted to drift into the great school of palliation, orthodox medicine, or shall it be allowed to serve as welcome prey to the vast horde of non-medical cults? This, in truth, is what often happens and to this extent is confidence in the medical man and his methods lost.
What homoeopathy needs more than any other thing today, is drug proving along modern laboratory lines, which will take into careful consideration, all the diagnostic aids employed in the work of blood chemistry, haematology in general, the chemistry of the gastro-intestinal tract, urine analysis, etc. The knowledge to be gained by provings of this kind, made upon humans, will explain, corroborate and strengthen much of our subjective symptomatology so abundantly presented in our existing provings and will also increase our ability to more easily and correctly apply our remedies in the symptomless case, as we now understand this designation.
It will, furthermore, aid us in more precisely defining the scope of homoeopathy and the degree to which it does or does not apply. Not for a moment to do we wish to create even the slightest suspicion that our present provings are to be cast aside, but we do desire to affirm that these provings will be greatly enhanced in value and usefulness, by following the course so briefly hinted at. Greater ability to cure will then be within our power and even the case without symptoms will become more hopeful, so far as aid and even cure are concerned.
There may be those who will object that the proving or reproving of Belladonna, under the auspices of the O. O. and L. Society many years ago, taught us little or nothing of practical value, which we did not know before. Doubtless this is true, certain it is, that no one now uses this reproving in a practical way. But, let us suppose, for example, that a reproving of Hepar sulphur calcareum, with special emphasis upon possible blood changes such as the production of an increased number of leucocytes, should show a more definite applicability to clinical states in which its use is now more or less uncertain, would we not be greatly strengthened in our powers of usefulness, by such knowledge?
Two recent cases, in partial illustration of our argument, come to mind. One was that of a middle-aged women suffering from menorrhagia. The usual remedies were applied in her case and certain improvement was noted. Phosphorus was apparently her basic remedy and did good work. But the beneficial effects proved to be of brief duration; in short, homoeopathic palliation alone, was achieved. Careful gynecologic examination now revealed multiple uterine fibroids and operation followed as a matter of course.
Here then we have a case, in which prescribing over a period of almost ten months, accomplished nothing but temporary relief, remedies being applied to such symptoms as presented from time to time and mostly themselves aroused by the underlying pathology. Even though Phosphorus, in its symptomatology, has much to commend it in haemorrhagic diseases, we do not know that it has ever caused a uterine fibroid nor even perhaps, that it has actually cured one. If it has, was the cure brought about in an early stage of the fibroid growth or not? Certain it is, that in this case at least, no cure was obtained by the remedies prescribed and that these were prescribed largely upon secondary symptoms. There were no others and thus to this extent, the case was symptomless.
To put it another way, pathology had swallowed the patients individuality and this in truth is what often happens or has happened in cases which turn out to be therapeutic failures. To be sure, homoeopathy has never contended, that in order to cure a given objective condition, it must be capable of actually causing such a condition. Yet it must be admitted that the assumption would appear to be a logical one.
The second case in illustration, somewhat puzzling from the angle of diagnosis, proved upon careful examination to be one of typhoid fever. It was a mild case and although presenting a characteristic temperature curve was otherwise provokingly symptomless. The patient, with innocent persistence, denied all discomfort and had in fact, been going about much as usual. The history of the attack that it had begun some three weeks before we had seen him, also that he had been working under unsanitary conditions and had been exposed to noxious emanations during his work in a Southern state. He was now put to bed, upon a soft diet and Pyrogen 30th was given, t. i. d. The temperature almost immediately began to descend and within ten days was normal.
No symptoms appeared, but the patients sense of well-being improved, as did his weight. Pyrogen frankly was an empirical prescription, none of its characteristic symptoms being present, not even the disproportion between the pulse rate and the temperature. The remedy was chosen on account of the causal factor, swamp odors and emanations, suggesting toxic or perhaps even septic influences. Admittedly, malaria officinalis or Echinacea might, with equal appropriateness, have been selected. However, the recovery of the patient left nothing to be desired. It is pertinent to ask, whether Pyrogen had anything to do with the case at all.
Was bed rest alone sufficient? Would the temperature curve have descended so promptly had no medicine at all been given? Practically perhaps, all this theorizing is futile and makes no difference, yet the philosophy of homoeopathy demands and impels us to seek logical explanations for the things we do and the phenomena we observe. It is, therefore, in this spirit of investigation and frank confession, that we have presented this paper for discussion. So far as Pyrogen is concerned, we do know some important things about it, but some characteristics with which this remedy has been endowed, may perhaps have been thrust upon it by enthusiastic, though none too discriminating observers.
Allan D. Sutherland was born in Northfield, Vermont in 1897, delivered by the local homeopathic physician. The son of a Canadian Episcopalian minister, his father had arrived there to lead the local parish five years earlier and met his mother, who was the daughter of the president of the University of Norwich. Four years after Allan’s birth, ministerial work lead the family first to North Carolina and then to Connecticut a few years afterward.
Starting in 1920, Sutherland began his premedical studies and a year later, he began his medical education at Hahnemann Medical School in Philadelphia.
Sutherland graduated in 1925 and went on to intern at both Children’s Homeopathic Hospital and St. Luke’s Homeopathic Hospital. He then was appointed the chief resident at Children’s. With the conclusion of his residency and 2 years of clinical experience under his belt, Sutherland opened his own practice in Philadelphia while retaining a position at Children’s in the Obstetrics and Gynecology Department.
In 1928, Sutherland decided to set up practice in Brattleboro.