Later he was put under ginseng tincture. Within forty-eight hours to our great amazement he began to develop the most striking combination of belladonna symptoms imaginable-flushed face; injected sclera; sore throat, worse on the right side; throbbing headache; throbbing carotids, etc. So striking was the picture that three members of the faculty, not knowing that he was under the influence of a drug, made a diagnosis of acute tonsillitis, prescribed belladonna and ordered him to bed. These instructions were, of course, not followed. Ginseng? Yes, for they were subsequently reproduced in detail with the 3d, and again with the 6th potency.
I repeat, and desire to emphasize, that this experience has very great significance, and I am convinced that if what is suggested were fully developed that a great deal of light would be thrown on the problem of the materia medica. What this suggests to me is, that the symptoms complex of a drug by itself is wholly inadequate with the action of a drug when we have committed a certain number of symptoms to memory is an absurdity.
What science demanded was that we explain the reason for this unusual and unexpected reaction to these drugs; tell what was in the chemical and morphological makeup of this young man which made him unresponsive to belladonna and susceptible to ginseng and made him produce a combination of symptoms strikingly similar to those produced by others under the influence of belladonna. Had we been able to do this then we should have been able to scientifically differentiate the one drug from the other and scientifically account for everything that occurred. But this we were unable to do; we stood convicted of incompetence, which is what we all stand convicted of when we come to this matter of drug pathogenesis.
I realize that I am now expected to point out just how the subject of Human Morphology and drug pathogenesis are related and how a knowledge of the former can at once be applied in the study of the latter. I am sorry I shall have to disappoint such expectations. Before anyone shall be able to do this a great deal of diligent work in drug proving will have to be done, proving then with an eye to the problem of the morphology of the subjects used in the provings.
However, it may be possible for me to throw some light on the matter by telling you a little about an experience I had when I first began practice in the Hawaiian Islands some years ago.
One of the surprises i had immediately after I began my work was the regularity with which Belladonna failed me. With no drug did I believe myself better acquainted, and none was chosen with greater care; but always the results were nil. After many failures I began to give ferrum phos. for what were clearly belladonna symptoms, and to my surprise, with excellent results. The flushed face; red, shining eyes; injected sclera; throbbing headache; throbbing carotids; hot steamy body; very full pulse; dry mouth and throat, etc., were always there. Let me say in passing that in the tropics the people are invariably lymphatic and phlegmatic.
One day I discovered that the pulse of belladonna is invariably firm as well as full and that of ferrum phos. always soft and easily compressed. This I thought a rather flimsy basis on which to make a differentiation, but having nothing better it has to serve. Later I discovered something which gave me a broader and firmer basis, and which fully accounted for the character of the pulse of the two drugs as well as for other things. When compared morphologically we find the two types similar in two things and no more. First, we find that they have the same coloring, both being blondes, with fair skin, blue eyes, light or light-brown hair; and second, we find that they have an equally well-developed pulmonary, cardiac and arterial systems.
Hence the great similarity in the inflammatory symptoms. But when we come to study them further we find that the belladonna individual has combined with this pulmonary, cardiac and arterial development a strong development of the nervous system, while the Ferrum phos. individual has relatively strong development of the lymphatic system. Hence the conspicuous nervous symptoms- restlessness, excitability, wild delirium, etc. of the one, and the soft, flabby, relaxed suppurative tendency of the other. A knowledge of these morphological differences has served me wonderfully well through the years.
During my last fifteen years in ear work I never once had to do a paracentesis of the drum membrane nor did a single case of otitis media develop once I attribute to the fact that I never trusted to belladonna in any case where the lymphatic elements were strongly in evidence in the individual makeup; and these are always conspicuous where the inflammatory processes have a suppurative tendency. Belladonna is not a suppurative remedy, that is, a remedy indicated in the presuppurative stage of any inflammatory process. But ferrum phos. is distinctly so. Ferrum phos. is the acute to hepar and to calcarea carb.
Ginseng is differentiated from belladonna on the same ground as is ferrum phos., and from the latter it is differentiated on the ground of color; it is as distinctly brunette as ferrum phos. is blonde. The young man who made the splendid proving had hair and eyes as black as jet; a rather coarse but clear skin; a fairly heavy skeleton; well-developed muscles; full, round chest; a little more than full abdominal development. He was only a moderately good student, being rather lazy, good-natured and easy-going. As we were just beginning our morphological researches, it is not possible for me to describe these different types as fully as I should like. But this much is suggestive at least.
It will be granted, I am sure, that it is not possible to present in anything like a comprehensive manner the modern theory of human morphology in the time allowed me. Nor is it possible for me to describe the morphological method of examination adequately, give the measurements, the reasons for taking them, and tell how the data are interpreted. However, I trust I have succeeded in showing that the subject is one of fundamental importance; that it is directly related to the study of materia medica. I trust, too, that I have made the fact a little clearer that the unhappy situation the School is in at the present time is due to our utter inability to understand the materia medica and, therefore, to teach it.
The morphological method I am firmly convinced offers our only hope of not only improving the condition of the School but of really saving it from utter extinction. As Professor De Giovanni says, in speaking of this method: “It is necessary and cannot be substituted by any other.” Unfortunately, few as yet realize this. WE have tried to substitute another, and we have failed. We now find ourselves in a position that is, to say the least, discreditable.
To again quote Professor De Giovanni, while speaking of the medical situation in general: “The laity, as well as the students and the learned of the science, have grave doubts concerning the general medical clinic-doubts that are confined to no country, because they are met everywhere, and are almost sanctioned even by practitioners of medicine, who for this reason are the cause of the prejudices and errors which contrast with the progress of general culture”.
