[Read by title before I.H.A., Bureau of Clinical Medicine, July, 27, 1939.].
W. W. YOUNG, M.D.
Since that time, well over a century ago, when Hahnemann delivered himself of the against all experimentation except that conducted upon the human, in short the provings, it has become a generally accepted rule that der Fuebrer of the homoeopathic school was not to be questioned, that his word was of the nature of a Solomonic law.
Of recent years there has risen a group of homoeopathically trained men are not so willing to accept this teaching as an immutable law but to regard it as a doctrine which, with the change of time, might well be modified. They are aware that such research as there was being conducted in the days of Hahnemann was of a very crude sort, the doses used in the experiments were poisonous or just sublethal, that instruments were crude and that the endeavor was essentially to determine a single characteristic action of or effect of a drug so that it might be classified as to that effect of a drug so that it might be classified as to that effect, i.e., whether it was a diuretic, a sedative, a cathartic.
Even later when a half century of progress had been made and instruments had been improved, does had been tremendously reduced and studies were being made upon isolated tissues and organs the aim was to discover certain chemical or irritative, spasmodic or relaxing effects of a drug. There was very good reason why, under such circumstances, Hahnemann should have sensed the obvious fallacy of such procedures and the conclusions drawn therefrom so that those who subscribed to his opinion in condemnation were more than justified in taking that stand.
Indeed today no progressive research worker would do otherwise than likewise agree that conclusions drawn from experiments on animal with sublethal doses of drugs, or experiments conducted on isolated tissues and organs with physiological doses can or do contribute little or nothing to our knowledge of the curative reactions elicited in tissues and organs by drugs given in small or smallest doses for their curative, immunological or antigenic effect.
But there has been a tremendous though little appreciated change in the method of conducting animal experimentations with drugs. Sublethal doses have been discarded. Isolated tissue experiments are considered passe. The modern pharmacologist is becoming acutely aware of drugs on the body and reactions of the cells to drugs. This realization has made it imperative for him to evolve a totally different method of drug testing. No longer is he content to demonstrate that a certain amount of a drug per body weight will in a certain number of instances modify a particular body function in a more or less characteristic manner.
He has learned that drugs are tools that can be employed in several different ways and that among those is that which the homoeopath has utilized for six generations, namely, that of the symptom specific antigen. Indeed only in the last two decades do we find it explicitly stated in orthodox textbooks of bacteriology and immunology that drugs possess antigenic properties.
Unfortunately it has been the habit of homoeopaths to condemn those who do not see eye to eye with him, who refuses to accept our tenets on faith alone or on the basis of clinical experience, condemn those who demand that the truth of our contention be proven in an indisputable way free from the controlling influences of the clinic, the factors of personality, human weakness and a large number of criticisms too many to mention here, known to all trained investigators.
It would have been much better had we turned our efforts to meeting those just demands. We certainly ought not to fail to mention that there were a bare handful of our best minds who did essay to subject the homoeopathic tenets to the cool, critical test of the laboratory, but they either failed because of lack of opportunity and assistance or went about the solution in the wrong way. The attack on the problem demanded the evolution of a new strategy, pharmacologically speaking; inventive genius was required. None of the accepted procedures were adaptable.
Any protocol for this newer type of animal research must of necessity take due regard of not a single functional change but the animals totality, must consider the question of minimal dose, must not forget the single remedy, the time factor, the question of cellular reaction and means of measuring it, in fact must neglect nothing short of the psychic which still cannot be duplicated in the laboratory.
There arose the necessity for a technique in animal experimentation which would meet the demands of the homoeopathic thesis. Arndt and Schulz with their law of small and large dosages illustrate a step in the right direction. Kotschau went one step further. Walbum evolved a technique that answered another aspect of the problem. But none covered the field so well as has been done by the type of research that I wish to discuss.
Credit for evolving this technique must go, as paradoxical as it may seem, to one who had no homoeopathic training, one Leroy Gardner of the Saranac Laboratory for the Study of Tuberculosis, Saranac Lake, New York. The article quoted is to be found on page 13 of the American Journal of Pathology for the year 1937.
Here is reported an animal “proving”, conducted with the utmost care and precision and under rigorously controlled conditions. Actually there were two provings running simultaneously and under identical circumstances. The experimentor employs two antigens, or, in the terms of the older homoeopathic terminology, two remedies; one from the animal kingdom, the tubercle bacillus, and the other from the mineral kingdom, silica. The experiments were conducted upon a variety of animals; cats, rabbits, guineapigs, rats, mice.
Under favorable conditions the tubercle bacillus elicited a cellular response with which you are all familiar, namely the disease named for that bacillus in all the stages and manifestations from the early to the last and the experimentor subjected the animals at various stages to autopsy and histological examination, made frequent and periodic tests and observations throughout.
Under identical conditions he simultaneously subjected similar series of animals to the administration of silica, subjecting these groups to the same kind of rigorous checks and tests. Since the outcome of this second set of experiments is not so well known to you it is this that we shall go into in more detail. It should be kept in mind that there is not even a most remote relationship chemically between these two totally alien antigens and yet, in the words of the author, we find that:.
It is remarkable that a simple inorganic compound such as the dioxide of silicon can set in motion a complicated series of cellular reactions comparable to those produced by a living organism made up of proteins, carbohydrates and lipoids. The lesions of silicosis and tuberculosis are essentially similar. It will be shown that silica can cause every type of cellular response found in tuberculosis.
So far I will ask you not the use of a phrase which is becoming more and more frequent in the field of drug research and that is tissue or cellular response, a phrase which is gradually taking the place of the antiquated and highly misleading one, drug action. It has taken us many years to realize that drugs are essentially inert substances, possessing of themselves no histrionic ability.
We are becoming more acutely aware of the fact that what occurs when an essentially inert substance is brought into contact with living irritable cells and tissues is determined by the reactive potentialities of the host and the characteristics of that reaction will be determined by the interpretation that hosts organs and tissues give to the reaction, and that, too, is conditioned by definite controllable factors. Among these are the avenue of administration, chemical state of, particle size of, etc., of the irritant.
Granting so much the author of this article places particle size as the most important of these factors, and for the following reason. A fragment of quartz weighing 2.5 grams was imbedded in the tissues of a pig for one year and during all that time led to the development of only a few mononuclear cells along its borders. Smaller particles of the same material measuring 10-12 microns in diameter, merely a foreign body type of reaction that progresses very little in a year or two, a reaction that exhibits no individuality, is definitely local and extremely mild. Yet particles of still smaller size, say 1-3 microns in diameter, provoke rapidly progressive tissue changes.
If one utilizes an even smaller particle, less than one micron, in a dose of 0.2 grams, there is an even more acute reaction with death in from one to eight months. Gye and Purdy some years ago demonstrated that the use of still smaller particles of silica was almost instantly fatal. Or, as Gardner puts it, “The rate of reaction to quartz is inversely proportional to particle size”.
Here, with a distinct vengeance, is homoeopathic research, the like of which has not been produced by our school in its more than one hundred years of existence and of this we have no right to be proud. From it we learn certain things. One is that the drug possesses no divine power to “act”, to alter tissues, in short it has no “potency”. Whatever dynamic power is manifested in the reaction of a living organism to an irritant is an essential ingredient of the organism itself.
Hahnemann succinately stated that the mild dose was the strong dose and, lacking demonstrable proof of this assertion such as is given here, he himself wavered during his lifetime from the use of the high potency to the tincture in material doses and back again. Time and time again we have been embarrassed by the necessity to explain how such a common condiment as Natrum mur. could, in the infinitesimal dose, give rise to systemic reactions or how an inert spore like Lycopodium could lead to such therapeutic results as we have all witnessed. Here at last we have light showing us the way out of that darkness.
I know it to be a fact that the high potentist has been inclined to hide himself from his fellows, jealously guarding his faith in his therapeutic approach. More of such research as this will permit him to come out of his shell and substitute indisputable proof for abiding faith. And what is more important, others who have not felt free to proceed upon faith alone will have some justifiable reason for using the imponderable.
Not only is it true that the severity of the reaction to the antigen is inversely proportional to the size of the dose but the smaller the dose the more rapid that reaction. Here then is laid another criticism of the small dose, one almost universally employed as an excuse by our weaker sisters to use the handy and brain saving opiate or hypnotic or sedative in lieu of a well chosen symptom specific antigen. How many times have you heard that alibi which goes something like this? “She had a Belladonna headache but I gave her some aspirin instead because she had to have immediate relief.”
You know, as I know, that had it been a Belladonna headache (and of course the speaker was not exactly confident that it was) Belladonna would have given as rapid results as aspirin, granted, of course, that the prescriber gave a small enough dose. At least, if there is any truth in advanced research this we are given to believe.
Another conclusion that can be drawn from this experiment is this, that with the large dose there is not individuality to the cellular reaction. Thus a particle of silica 10 microns in diameter evokes a reaction that is characteristic of any foreign body, be it wood, lead, chalk, tin or what not. But as soon as one reached the realm of the micron or less than micron diameter the bodys reaction takes on character and distinction. This is not exactly a new observation but nonetheless it is highly important because here the observation is made under rigorously controlled conditions with exact serological and histological follow-up, essential research technique which is utterly impossible in human experimentation.
Those who have engaged in provings have all been impressed with the difference in the results of such experiments conducted with the high potencies. In the former there will be a high percentage of takes but the symptoms will be nondescript, often vague, present few modalities and fewer subjective symptoms. Provings with the high potency, on the other hand, often lead to violent reactions, give a low number of takes, result in distinctive, often startling symptomatologies with many subjective symptoms. Reactions to low potencies are short lived. Those to high potencies, once initiated, frequently continue for weeks or months. Thus the newer technique in pharmacology, as illustrated in this experiment, harmonizes once again with the homoeopathic thesis.
But we should not lose sight of the fact that the animals used in this experiment were normal and healthy hosts, carefully selected, housed and fed, weighed and observed, a state of affairs that is impossible to achieve when working with human beings. Yet these animals were sensitive and reacted to the infinitesimal dose. I hardly need say that it is a well established fact today that disease sensitizes tissues and cells to irritants to which they ordinarily would not react or will heighten a sensitivity already present, comparable to an allergy.
Therefore we might well ask the question, if these animals reacted so violently to silica when they were healthy what would be the acuity, the severity, the rapidity, the violence of that reaction and to how small a dose if they were previously conditioned by disease? That question is not answered in this experiment but it certainly points the way for further investigation.
But to return to the original article. Here we are presented with a wealth of histological specimens, serological and haematological data all going to prove that “Silica is capable of exciting every tissue response that can be produced by the complex living organism”. Certainly I do not have to recall to you the text of our materia medica where it is said that Silica is to be used in tuberculosis of all kinds and in all stages but that its use here is to be indulged in with caution and especially so if the high potencies are to be used. Nor do I have to wonder if you have had the truth of that text brought home to you.
And so I draw near the end of my paper, the purpose of which has been to bring out certain salient points, of which I might well tabulate a few. First of all I wish to lay the ghost of the antipathy of the homoeopath toward animal research, research of the kind sponsored by Walbum, Kotschau, Schultz and Gardner. Indeed, I would even essay to go further, to encourage our school to stimulate such research but in doing that to so adapt and improve on the technique that subsequent experiments will be even more fertile than the one quoted here. In advocating this I would strongly urge that such experimentation be employed in conjunction with, but never be allowed to subordinate or take the place of, human “provings”.
How richly we will be rewarded can be readily appreciated when we summarize some of the lessons learned from his single excursion into the newer pharmacology. First we are given reason to know that antigens from widely alien sources can produce essentially similar lesions. Next that a single dose of the antigen will elicit a response that will last for months, lead to inflammation, exudation, proliferation, necrosis, even death. Next that the smaller the dose or the more minutely divided the antigen the greater the reaction in respect to extent (local, focal, systemic), acuity, severity, longevity.
Next that the smaller the dose the more distinctive and characteristic the reaction. Again, the reaction is a function of the host and not of the agent itself. In addition to all this other lines of investigation are suggested. And note you, gentlemen, is not all this essentially homoeopathic in tone?.
And so, in closing, let me make this earnest plea and perhaps a prophecy. Subsidize, encourage, even demand more such research for in this way you will stimulate the recrudescence of the homoeopathic school. Failing to do so will result in a well deserved degeneration. Homoeopathy is not a thing apart from the rest of general medicine, but must be regarded as an essential part of the whole. If, as we give others to believe, there is any truth in our teachings, then we should be only too anxious to have those teachings subjected to the cold scrutiny of exact investigation and, as you have seen here, you may be assured that it will gain by that critique. Fail to do so and in another hundred years it will remain, as it is now, something misunderstood and mistrusted and so avoided by sincere minds who quite properly look upon us, and that which we profess, with misgivings.