MEDICINE BEFORE HAHNEMANN



At all events the Hippocratean tenets lead to a materialistic or realistic theory of disease and maladies originating from lesser factors than divine maledictions could be dealt with in a direct manner. Like all new truths non-essential, irrelevant and even erroneous corollaries were attached and it was unfortunate that disease became a something to be purged, drained, “let,” or sweat out of the body, for it has taken centuries to evaluate this “something”.

Beginning as a premature generalization, possessing considerable truth and resulting in improvement in treatment or at least an attenuation in the severity of disease, the practice of medicine was based upon the assumption that disease was a something added to the body which could be cured by elimination through natural or artificial openings. Centuries have come, each bringing varied methods having as their goal the removal of hypothetical toxins. Centuries have gone, each writing Tekel to many of these practices until one by one they have gradually become obsolete and archaic. Of the panaceas, bleeding and emesis have practically disappeared and because of a natural reaction to their frequent failure are now avoided, even when indicated. Of the ancient tripod of cure, purges remain partly as a verity, mostly as a heritage.

This materialistic concept of disease is more important in a consideration of the origin of homoeopathy than the discovery by Hippocrates that like may be treated by like. In one of the works usually attributed to Hippocrates entitled “On the Places of Man,” the author makes the admission that although the general rule of practice is contraria contraris, the opposite rule also holds good in some instances, that is, similia similibus curentur. He illustrates this statement by several examples among which are the following: Substances which cause strangury, cough, vomiting or diarrhoea will generally cure these same diseases. Warm water which when drunk generally excites vomiting, will also put a stop to it by removing the cause.

“Give the patient a draught from the root of mandrake in a smaller dose than will induce mania,” he well counselled for the treatment of suicidal mania. The author of De Morbus Popularibus (Hippocrates?) gave us the following formula, “dolor dolorem solvit,” which may be rendered, one pain cures another. In the 46th aphorism we note “of two pains occurring together, not in the same part of the body, the stronger weakens the other”; also that “the cold stomach delights in the cold things.” In one place he states that cold water causes convulsions, tetanus and rigor (Aphorisms, v. 17), while in another that cold water in tetanus will restore natural warmth. In aphorism 21 we note that cold things such as snow and ice cause haemorrhages, yet cold water is curative in haemorrhages.

In De Internis Affectionibus we read that in the summer after a long walk dropsy is produced by the hasty drinking of stagnant or rain water, still the best remedy is for the patient to drink himself full of the same water for this increases the stools and urine. In De Morbo Sacro he states that most epilepsies are curable by the same means as caused them. A homoeopathic morsel can be found in the Epistles of Hippocrates “Hellebore given to the sane pours darkness on the mind, but it is wont greatly to benefit the insane.” It is therefore quite reasonable to assume that Hippocrates was well aware of the existence of more than a single therapeutic rule and that among others he thought and taught the dogma of similia. How different this concept is from Hahnemanns but still an inkling of a general therapeutic method! As a matter of record the writer should state that he is not prepared to defend the accuracy of all of Hippocrates views.

The Dogmatists should be mentioned as the successors to Hippocrates. Believing that physicians should be philosophers they indulged in endless and largely useless speculations, yet with the idea that progress in medicine rested in physiology and understanding of disease in “perverted vital function” they might have made noteworthy advances had it not been for the court physicians and the philosophy of Plato.

The Empirics of Heraclides represented a reaction against the Dogmatists. This school had for their main proposition the idea that the chief duty of the physician consisted in discovering what particular drugs will remove particular symptoms. This removal was accomplished as the result of.

1. Observation, experiments, autopsy;

2. Learning from contemporaries;

3. Analogy;

4. Epilogism inferring preceding events from the present.

Before leaving Greek medicine and passing on to a brief consideration of Roman medicine one more interesting, though at present hackneyed quotation, may be cited:.

“Take the hair, it is written

Of the dog by which you are bitten.

Work off one wine by his brother,

And one labor with another”.

-Antiphanes, 401, B.C.

In considering Roman medicine we may profitably omit mention of Cato the Censor, whose panacea was cabbage, and arrive at Asclepiades of Prusa. Utilizing the atomic theory of Democritus and Epicurus, this reformer taught that the body was composed of atoms between which were pores. Disease was due to alternations in the relationship between the atoms, especially blocking of the latter. His treatment may be summarized in the statement that he did not believe the function of the physician was to amuse the patient while Nature cured the disease, but that Nature was capable of doing harm.

Among his followers was Themison who conceived the idea of abolishing all the conflicting theories of medicine by combining the good features of each. His eclecticism is clearly displayed by the desire to supplant the practice of distinguishing diseases by their symptoms (Empirics) and searching for the causes of disease (Dogmatists) by merely observing what symptoms diseases had in common. The observer would then discern that all ailments were manifested by either an increase or diminution of secretions depending upon variations in the size of the pores, that is to say, constriction or relaxation (Asclepiades).

Treatment was based upon the principle of contraria contrariis, that is, astringents or laxatives. The greatest of the latter class was bleeding. After an interval the tenets of this self-styled Methodic school were perfected by Thessaulus of Tralles by the introduction of the alterative method of treatment, an idea which remains, somewhat modified, in medicine today. The great importance of this school from the standpoint of our discussion is that it followed a single therapeutic rule or guide contraria contrariis curentur which with the Brunonian doctrine, forms a replica of Hahnemanns similars.

Before presenting Galen to our readers, we owe a few lines to Nicander who recognized the homoeopathic or isopathic principle in his poetical materia medica. The treatment of viper bites consisted of the head of the viper or the liver of the reptile macerated in wine or river water. The cooked flesh of frogs was recommended in the therapeutics of toad poisoning. Even Xenocrates, flourishing long before Galen, was tinctured with a sort of homoeopathy in advising the use of goats blood in the treatment of hemoptysis. Ecchymosis of the eyes was best treated by the local application of pigeons blood according to this authority. Other therapeutic gems were the treatment of asthma by pulverized frogs lungs, affections of the liver by dried wolf liver, diseases of the spleen by roasted bullock spleen, hydrophobia by the saliva found under the tongue of a rabid dog, or by the internal use of its liver. Varro advised a patient bitten by an asp to drink his own urine.

Galen, the most prolific of ancient writers, was the next great figure in medicine. To him the foundations of medicine rested upon two pillars, anatomy and physiology, while Diseases were of three kinds-.

1. Those affecting simple tissues, as muscles.

2. Those affecting compound tissues as liver.

3. Those affecting the body generally, but especially the four humours.

The third are the dyscrasiae in contrast to eucrasia, the normal harmonious mixture of humours. Even in eucrasia there may be a preponderance of some humour resulting in particular temperaments as sanguine, bilious, phlegmatic, and melancholic.

The causes of disease are three.

1. Procatartic or exciting.

2. Proegumenic or predisposing.

3. Synergestic or proximate.

Symptoms are of three classes

1. Altered functions (actions leases).

2. Vitiated qualities (qualities vitiatas).

3. The results of both of those especially morbid excretions and retentions.

His therapeutic doctrine is best exemplified by “indication,” meaning whatever enables us to draw conclusions as to treatment apart from experience. His first indication is to remove the cause of disease or prevent its action. A second class arises from symptoms. If these are against Nature treat by contraries, but if they are in accordance with Nature treat by similars. Other indications which need no discussion are the temperament of the patient, the seasons of the year, dreams, etc. Some drugs are specifics, i.e., purgatives, but they must act through one of the elementary qualities heat, cold, dryness and moisture. Each of these is divisible into degrees according to its intensity. Thus Opium is cold to the fourth degree and pepper hot to a similar extent, a division carried to a ridiculous degree in the subsequent centuries. A few homoeopathic ideas found in Galen are mentioned here.

Linn J. Boyd