The viewpoint of the modern physiologist reflects the theory that the vast majority of human ills are traceable to dysfunction of the glandular system; that most growth problems (over-and under- development of the whole body or parts) and many maladjustments of the child to its environments, and even of the adult to his relationships and problems, are related in some degree to endocrine imbalance.
The modern student of homoeopathy may have learned to scoff at the philosophy of Hahnemann, yet how close the endocrinologists findings are to the teachings of Hahnemann that the human being is a unit, mind, body and spirit and that these are so correlated as to act freely and without impediment when the vital principle, the spirit-like force or dynamis, is in equilibrium; yet if this equilibrium of health be thrown out of balance by the dysfunction of one member (or if this imbalance be manifest by the dysfunction principally of one organ) the whole is affected to a greater or less degree.
So it is, also, that the function of some of the ductless glands is to secrete a minute quantity of specialized product into the system, a secretion that has a vital bearing on the health of the whole constitution. In many cases this secretion of a normal gland is so minute that it approaches the homoeopathic attenuation.
With this concept of the importance of the endocrine glands in maintaining normal health, and with the almost infinitesimal amount of some of these glandular secretions, we can hardly fail to see the important relationship the homoeopathic remedy may hold to the manifestations of endocrine dysfunction and to the balance of the ductless glands themselves.
In considering this vast subject it is apropos to quote from the recent book by August A. Werner, M.D., F.A.C.P., entitled Endocrinology (Lea & Febiger, 1937):.
There has been much complaint from physicians in general that the literature on endocrinology is technical and difficult to understand. There are several reasons for these seeming difficulties, among which may be mentioned (1) the newness of the subject; (2) the lack of definite information as to the possible number of hormones and their functions; (3) the intricate interrelationship of the secretions of the ductless glands. (4) the difficulty in application of the results of animal experimentation to the human, which, aside from the scientific value of such work, is the ultimate object of these investigations; (5) the variation of potency of the hormonal preparations used, and (6) the difficulty of determining individual dosage, which is influenced by the degree of function of the glands of the patient, the individual susceptibility of the patient, cellular receptivity, interaction of other endocrine secretions, and the effect of general metabolic factors and disease processes in each individual.
To be a good clinical endocrinologist, one must first be a good internist, and the time is not far distant when, in order to be a good internist, one must be a good endocrinologist.
It is necessary to have:.
1. A thorough knowledge of the anatomical structure and arrangement of the autonomic nervous system. Its division into two parts, viz., the parasympathetic and the sympathetic; a knowledge of the function of these two divisions which are diametrically opposed to each other when stimulated.
2. Comprehension of the function of the endocrine glands, in so far as this has been definitely or reasonably established.
3. The recognition that the intricate vital life processes of the body over which we have no control, such as the regulation of normal growth and development, the digestion, absorption, and assimilation of food and its release from the storehouses, such as the liver and muscles for the production of energy, the continuation of cardiac action and respiration at a normal rate, our sense of well-being; all these and more, depend in great part upon the maintenance of a delicate equilibrium between the two divisions of the autonomic nervous system.
4. A knowledge that the maintenance of this functional balance between the parasympathetic and sympathetic divisions of the autonomic nervous system is markedly influenced by the internal secretions of the ductless glands which act as governors over it.
There is a great clamor from the medical profession for information on treatment of endocrine conditions. Before we can treat any abnormal condition successfully we must first have knowledge of the syndrome and its etiology (here speaks the viewpoint of the orthodox school- H.A.R.) and secondly, we must have potent preparations for treatment. Many endocrine syndromes have been recognized in the past before active principles were available for treatment. This condition still exists and the possession of active hormones does not always insure that relief can be given, for obvious reasons. With the desire and urge to alleviate these endocrine syndromes, all manner of glandular preparations have been utilized, many of which are inert, especially when administered orally.
In closing his Preface Dr. Werner gives credit to various members of the profession who have been of great help to him, and speaks of one member with the following significant tribute:.
Where an understanding of the fundamentals of endocrinology was acquired, and the lesson was inculcated to study the patients condition with every conceivable relationship to disease in mind and not as an aggregation of glands.
In his first chapter the author cites the influence of emotions, as well as the reaction of various drugs, on various functions, with the reflex action on the glands through the nervous system. His comments on the organs in sickness and health recall Hahnemanns observations, but in this 1937 observation Dr. Werner does not achieve the practical application of Hahnemanns logic and philosophy which seems so plain to us.
However, even a brief survey of his work astonishes us with the wide range of syndromes which Dr. Werner suggests are caused by glandular dysfunctions or are influenced by glandular preparations. These conditions range from acne to hemophilia, from anaemia to deformed and distorted skeletal formation in children or developing in adult life. This implies that a vast array, if not the majority, of constitutional afflictions are due to glandular dysfunction, and therefore we may assume that the constitutional homoeopathic remedy will have its usefulness here in the light of modern knowledge just as it has had in the past when we did not realize the importance of a knowledge of endocrinology, but trusted to the totality of symptoms as our sure guide in prescribing.
There is little doubt that the majority of cases of over-and under-development of tissues or organs such as adiposis, obesity, inhibition or precocious development of sex characteristics (whether traceable to the pineal, pituitary or thyroid glands or the gonads), and changes in the skeleton formation such as may come from dysfunction of the parathyroid, are, in the language of Hahnemann, manifestations of the miasms, either inherited or acquired. It may be circumstantial evidence for the miasm theory that certain types of manifestations are found among certain peoples, just as those types of glandular obesity which are found largely in the Hebrew race; for one might argue with equal weight that centuries of prescribed diet might have had their influence. Nevertheless, in many cases of glandular dysfunction we are able to trace like tendencies through a family history. Sometimes in cases where no such evidence is available we may find history, or definite evidence, of venereal infection, very often reported as cured by scientific treatment.
To the Hahnemannian homoeopath, the lack of laboratory corroboration has little weight because he realizes that the miasm may persist after the microorganism has been suppressed, diminished or destroyed by treatments in the infected individual or by passing through successive generations.
In any case, while the orthodox school works on the basis of the objective symptoms, merely recognizing as concomitant the subjective symptoms which to them are extraneous for clinical purposes (even while they acknowledge their theoretically correct glandular extracts as inert!) the homoeopathic school fixes its attention on the individuals subjective manifestations in accordance with Hahnemanns logical development of the therapeutic principle.
Such a book as Dr. Werners offers us the most up-to-the-minute discussions on the pathology, etiology and diagnosis of these conditions, but there is little real help here in the therapeutic field. Let us turn to such a book for such information as we may glean from modern authors and research workers, but let us turn to a study of our rich fund of materia medica and philosophy when we wish to help the patient toward cure.
As an index to our cumbersome materia medica let us turn to our repertories with the constitutional symptoms of the sick individual in mind. Here we are not forced to trace the organ supposedly responsible for the manifestations in the patient; instead, we note the symptoms peculiar to the patient symptoms mental and physical and by meeting the symptoms of the individual with the corresponding symptoms of the indicated remedy we shall be able to meet like with like, and with reasonable assurance we can test the homoeopathic principle in these as in other cases.
Of course it is necessary in these cases, as in all others, to consider the possibility of cure, just as Hahnemann taught. This is well summed up in the concluding paragraph of an editorial in the October 1938 issue of the British Homoeopathic Journal, which we quote:.
In estimating the possibility of successful homoeopathic treatment of deficiency disease we must, of course, recognize that the action of drugs is by eliciting a response from a living cell; they cannot do this from those that are dead or restore them to life. It is of no use to attempt the impossible. But we should also recognize that no organ or tissue becomes suddenly destroyed, unless it be by trauma, and that there are all degrees of failure of function, and if the failure has not gone too far it should be, and we believe it is, possible to restore it to the normal by the giving of the similimum.
To this end we need a deeper acquaintance with our remedies. We are using practically the same materia medica that we did fifty or more years ago. It requires no alteration, but it does need to be added to, not by the addition of more remedies, but by fresh provings to pursue the action of our drugs into the realm of modern physiological research, and especially their action on the endocrine organs. If we do not increase our knowledge of the capabilities of our drugs our homoeopathic art will become static. It will make no progress.
It was our purpose to suggest several rubrics from both the Kent and Boenninghausen repertories that are peculiarly pertinent to the conditions we are studying, but when we were brought face to face with the widely varying array of functional symptoms manifested by these patients, it seems we can do no more than comment to you the repertories themselves, and advise the physician who wishes to cure his patient not to neglect these valuable adjuncts to successful prescribing.
In other words, when a cursory glance at a modern work on endocrine dysfunction covers such a wide range of symptoms, it is impossible to limit the possible symptoms in even a few syndromes. Again and again we are faced with the conviction that we are dealing with what we have already long since learned to know as constitutional symptoms, and we cannot think of a few rubrics that might be useful without omitting others even more valuable. So we can only repeat: LEARN THE VALUE OF YOUR REPERTORY FOR REFERENCE WORK, AND YOU WILL BE WELL REPAID FOR THE TIME EXPENDED.
Nor can we, in one brief evening, begin to consider the syndromes which we meet in daily practice, and which we recognize as having endocrine relationships. We may only sketch a few of these conditions with a very restricted consideration of suitable therapeutic measures; and we may briefly outline a few outstanding remedies having general influence on glandular structure.
Probably the type of glandular imbalance we meet most frequently is diabetes mellitus. The accepted therapy is insulin, and it has a definite influence on the sugar output; yet few physicians pause to consider whether this treatment is curative or merely palliative a substitution therapy. Recent experiments indicate that continued massive doses of insulin may result in an increase of sugar following an initial decrease; and that it may remain at a fairly high level so long as the insulin therapy is pushed.
A case recently observed provided the interesting phenomenon of a marked decrease of sugar output when the patient was forced to do without her insulin for a few days; and that when she returned to a decreased insulin dosage the amount of sugar remained at a much lower level than while she was receiving massive doses. A series of observations on patients under homoeopathic care would be valuable.
We must remember that once insulin therapy is established, it tends to become necessary to the patient and there is little hope of establishing normal balance. Therefore it is more practical to begin treatment by the use of the homoeopathic remedy, for we can always go to insulin latter if this is necessary. We find suitable remedies for Sugar in Urine in the repertories, and most of the remedies listed are deep in action or are closely related to emotional states. The diabetic patient usually presents subjective symptoms that clearly indicate the similimum; or he may be able to give a history of emotional shock preceding his present affliction that will point the way to the remedy.
It is possible that his symptoms are so clearly marked that the indications for a constitutional remedy cannot be overlooked, even though his indicated remedy has not been proved to produce the sugar imbalance. In such case, if the patient improves on the indicated remedy, we are justified in adding it to those already listed, giving it a tentative clinical rating. If the general level of health is raised, even though the low sugar threshold remains the same, we may safely rely on the remedy which maintains general improvement, and not be too anxious over the sugar output.
Recent research work has indicated the influence of the pancreas in peptic ulcer. There is probably no surgical condition which yields so readily to the homoeopathic remedy and proper diet, if it is discovered before surgery is necessary to save life. These conditions usually present enough subjective symptoms to define the similimum from the list of suitable remedies Kent gives; in this list, too, we find the polychrests to the fore, probably with the Kalis, Lycopodium and Phosphorus leading.
It is frequently the case that in exploratory operations the close prescriber finds evidence of ulcers healed under his earlier prescriptions in other words, homoeopathic prescribing has left its signature on diseased tissues.
Another frequent exhibition of endocrine imbalance is in the disturbance of the menopause. These patients give us a wealth of subjective symptoms. In fact, many of these woman are so valuable that we cannot overlook that great leader among the many indicated remedies for this particular condition Lachesis. But a well rounded symptom analysis may show us some other remedy to have greater applicability.
Hyperemesis gravidarum is a serious condition we meet occasionally. If this condition is met early enough and we can find the indicated remedy, neither surgery nor yet endocrine preparations will be required. In the July 1938 Homoeopathic Recorder Dr. Allan D. Sutherland gives us the distinguishing characteristics for a few of our remedies in these conditions. His article is worth study.
We all know the indications for Ars., Bry., Cocc., Colch., Kali c. (the sudden nausea coming on while walking and the sudden over powering sleepiness after eating a mouthful or two); Nat. mur., Petr., Phos., Sulph., Verat. a. Many of us do not think so often of Aletris farinosa with its muscular atony and chlorotic history. We would add to Dr. Sutherlands list the nosodes, Medorrhinum, Psorinum, Syphilinum and Tuberculinum for consideration. Dr. Sutherland is careful to point out that this is but a brief list of the possibilities; but it is valuable as a suggestion of help in critical conditions.
One of the most distressing conditions we have to deal with (and one we fortunately rarely meet) is enlarged thymus. In his discussion of this condition, Werner states his conviction that it is not the enlargement of the gland itself which causes the sudden death, but that this condition is concomitant to the influence of the vagus nerve on the heart.
This indicates even more strongly the necessity for the constitutional remedy for the small child, and the physician must be keen in watching his development; for all too often the child is in apparently good health until attacked suddenly and without warning. Where cyanosis, suffocative attacks or other symptoms occur, however slight, a remedy may be found that will carry the child through to normal health. If the symptoms take an asthmatic tendency we have more assurance in selecting the constitutional remedy.
In general practice we frequently meet children who are backward in mind and body. Here is a field where we are able to do remarkably good work with our remedies. The Barium salts are not sufficiently appreciated for such work, but the Calcarea group, Silica or Sulphur (to mention but a few) may be more clearly indicated. Even the Kalis and the Natrums are surprisingly successful when indicated. When the constitutional remedy is found, it is surprising how those children under developed, dull, stupid, unable to learn, perhaps nervous and high strung react to normal development.
Often these children are deceitful as well as backward; then we add Arg. nit. and perhaps Bufo to our list; and if they are convulsive children these remedies may be even more strongly indicated.
A consideration of the mental and emotional states is our best indication for the similimum. This is not as simple as to feed glandular preparations, perhaps, but it is less apt to throw other glandular secretions out of proportion, and the results seem to be generally better. And no man who has watched the action of our potencies can doubt their efficacy.
To a large extent the remedies which come to mind as constitutional remedies of sufficient depth to influence these glandular conditions with their structural and nervous concomitants are our great polychrests, and many of these are from the same chemical base as the elements of the physical body Sulphur, Silica, Phosphorus, Kali, Natrum, the Carbons. Then we find such remedies as Lycopodium, Nitric acid, and the major nosodes, of great use in these conditions. It is impossible, as well as dangerous practice, to name leading remedies for any pathological condition, and still less for any functional disturbance; yet there are valuable remedies which have a wide range and frequent usage in our daily practice that are not so valuable in these conditions.
In running over suitable rubrics for glandular conditions we find Pulsatilla conspicuous by its absence in many rubrics, and when it occurs, it is in the lower ratings. On the other hand, we find Lycopodium as a leader. Lycopodium is one of the very few survivors from the first era of plant life, and it has changed very little in appearance. It has survived because of the basic qualities inherent in the development of all life, and probably, therefore, has a greater potential influence on organic symptoms.
There is hardly an organ or function that is not influenced by that greatest of all polychrests, Sulphur. Even Hering noted its influence on such glandular conditions as were then recognized. We have spoken of its value in developing backward children. It is classical for its use in deep-seated affections resulting from the suppression of superficial symptoms.
It has proved its usefulness in diabetes mellitus. We all know the classical indications for Sulphur; but in passing it briefly, we mention one function of Sulphur we may have occasion to invoke: that of stirring the organism to reaction when other seemingly indicated remedies fail to act, especially if there are recurrences of acute or subacute manifestations where the patient moves toward recovery only to slip back repeatedly.
Phosphorus resembles Sulphur in its fields of usefulness as in many of its symptoms, while being quite different in its classical constitution. Where Sulphur is indolent, Phosphorus is over excitable erotic in many manifestations and erratic in most symptoms related to the sexual functions. These manifestations range from insanity or lascivious ideas to vicarious menstruation, impotence and abnormal labor.
Phosphorus affects the development of the physical body in the child, his ability to concentrate his mental efforts, and the normal functioning of the adult, just as in Sulphur. Prostrated energies from loss of fluids and from emotional and physical strain are characteristic of Phosphorus, as against the general lack of energy of Sulphur.
Both Phosphorus and Phosphorus acid are to be considered in glycosuria, as well as other glandular difficulties.
Nitric acid has a powerful action on glandular dysfunctions, especially of syphilitic origin, although it is antipsoric and antisycotic as well. Sensitiveness is a keynote of this remedy of the head or of the affected parts, to touch jars, sudden motion or sudden change in tempo of motion; to cold, to changes in the weather; tendency to take cold.
There is great disturbance of the circulation; the fingers and toes appear livid, pale, cold or dead at times. The characteristic sensation as of a splinter in the affected parts, particularly in such tissues as the tonsils, is found also in Arg. nit. and Hepar. In Nitric acid the disturbance of the sexual organs and functions rivals Phosphorus, and sometimes there is almost as much lasciviousness. In general the sensitiveness and excitability is uppermost, but they tire quickly; old people calling for this remedy manifest excessive prostration.