In the latest announcement of a former leading homoeopathic college we read:-
“The remarkable advances in medicine in the last fifty years makes sectarian division among physicians unnecessary and undesirable. The fundamental science of anatomy, physiology, chemistry, bacteriological pathology, together with the clinical branches, etiology, symptomatology, diagnosis, prognosis, and treatment constitute the medical curriculum and are essentially the same in fact and in teaching in all acceptable medical schools. So in teaching and practice all recognized schools stand on common ground.”
In unmistakable words we are thus told that the teaching and practice in this once fine homoeopathic college are now in accord with the empirical, trial and error, hit and miss methods in vogue in the colleges that fought the idea of therapeutic principle from the day it was announced by Hahnemann.
Common ground, at last ! What an achievement! What a confession to make!
But, amazing the confession is, and obvious as is the satisfaction of those who have played so active a part in bringing about the amalgamation of Homoeopathy and its traditional enemies, there is nothing in that to worry about. What these men believe is of no great importance. Principles are not affected by beliefs. What is important is to know how they came to reach this “common ground,” and how to get back onto the ground of solid therapeutic principle.
That we veered away from this principle is made clear by the records. And this began as far back as the last quarter of the previous century. While colleges were then still being started and societies organized, in most instances these were the product of spites in faculties in older colleges and controversies in older societies and not because of an increasing need for them. So while things seemed to be going well, underneath evils were brewing which in time brought into existence a number of financially weak colleges and insignificant and uninfluential societies.
From all this grew a situation that proved most appropriate for the opponents of Homoeopathy to introduce what they considered a superb plan for a reformation in medical education, a plan which would prove a boon to not only regular medicine but homoeopathic science as well.
The plan embraced two proposal. One to the effect that as pathology and bacteriology with its conjoined theory of serum therapy were established as indubitable sciences they should be assigned a strong if not the dominant position should be assigned a strong if not the dominant position in the college studies and full-time professors engaged to reach them.
The other proposal was based on the fact that as materia medica and methods of practice has not yet been so established they should be eliminated from the list of state board subjects. Both subjects should continue to be taught, but how and how extensively should be left to college authorities to decide. If any wished to have Homoeopathy taught they were privileged to do as long as the program of the new plan was carried out.
The scheme seemed innocent enough to out college and society leaders, and being given a certain amount of encouragement by the proponents to continue to teach Homoeopathy, it was endorsed and inaugurated in our colleges. And this was the beginning of the end.
From the day the plan was inaugurated homoeopathic students were not only compelled to spend more hours in he laboratories than before which, of course, left them fewer hours for the study of materia medica and homoeopathic principles, but they were also required to become proficient in a philosophy of disease that in all essentials is directly contrary to those principles.
They could not possibly pass the state board examination unless they were proficient. Furthermore, as materia medica and practice had been eliminated from state board list of subjects nothing was more natural than that these subjects would be slighted by students. And this was done, with the inevitable consequence that by the time they were ready to graduate they knew little about Homoeopathy and cared less. On the contrary, they had been prepared to accept as ne plus ultra everything the A.M.A. and the pharmaceutical establishments had to offer. In a word, the whole scheme was cleverly designed, introduced at the psychological moment, and carried through with faultless technique.
But clever and effectual as the scheme proved to be, its inauguration in our colleges cannot in truth be said to have been the prime cause of the predicament the homoeopathic institution is in. That caust lies much further back. To locate that we must, indeed, go back to the very days of Hahnemann. When at that time it was decided to build the institution on the foundation of the totality-of-the-symptoms concept the seed for its destruction was planted. Principles were then made subordinate to phenomena.
Drugs were proved for the purpose of accumulating symptoms phenomena-and for no other purpose. Patients were examined and quizzed for the same purpose, and prescribing became a task of matching the effect of drugs and disease. Reasons why difference in effects in different individuals from the same drug or disease, was a matter of no importance. The why of things was set aside for the what. A monumental mass of unexplainable effects created. Herein unquestionably lies the reason for present conditions, and nowhere else.
But while present conditions are anything but happy they do not foreshadow doom. It is entirely possible for us to develop methods that will be in strict harmony with the demands of science. We need but to recognize and comply with the direct and implied demands of the following:-
(1) The law of cause and effect is inviolate in nature.
(2) Cause implies agent and medium in which an effect is created.
(3) The same agent acting in different media produces different effects.
(4) Effects cannot be understood unless the character of composition or constitution of the media is understood.
(5) The materia medica in its present form is but a vast collection of effects produced in unknown media.
(6) The media being unknown, the effects cannot be understood.
(7) That which cannot be understood cannot be explained.
(8) That which cannot be explained cannot be taught.
This syllogism represents the problem the followers of Hahnemann are called on the solve. The several factors have not received the attention their importance merits; and for this Hahnemann himself is in no small measurer to blame; because in selecting only symptoms for his materia medica, and in arranging them in the way he did, he set the standard for all later materia medicas. Yes, in sections five, seven, and eight in the Organon he definitely points to the need of taking note of something more than symptoms, namely, “fundamental cause,” “causa occasionalis,” and “zufalle,” (section eight).
Cause and effect cannot possibly be treated as one. How the word “Zufalle” could have been translated by Hering as meaning “phenomena,” is most difficult to understand. Both terms as used definitely refer to morbid changes and effects, which is not at all the meaning of “Zufalle.” According to the latest edition of the Murret-Saunders Encyclopedic Dictionary the word “Zufalle” means causal event, or in other words, root cause, or causal factor.
Had Hahnemann meant to say changes he undoubtedly would have used the word “veranderungen,” and had he meant phenomena the word “erhrscheinungen,” the precise meaning of the words “changes” and “phenomena.” But by the time the translations were made the concept or the totality of the symptoms had become so deeply ingrained in the minds of the translators “Zufalle” had lost its true meaning.
Now, that this concept totally ignores the several factors in the foregoing syllogism is too obvious to require pointing out. But can this be ignored and its validity be defended on any but empirical grounds? This is altogether doubtful, indeed, in my judgment, utterly impossible. Its woeful lack of validity is conspiciously shown in the following case history, only one of any number that might be cited.
The patient was a college student in his early twenties. From his childhood he had been a victim of constipation in an aggravated form. Accompanying this were the usual symptoms of morning headache; dizzy spells; indigestion of various types; malnutrition; sallow complexion; hemorrhoids that had twice been operated, and at other times been treated locally; irritable, quarrelsome and fault finding disposition etc.
During his years he had been under the care of three outstanding prescribers and materia medica specialists, men whose loyalty to Hahnemann and Homoeopathy was unquestioned. Time and again he was examined in the orthodox way, diligently quizzed for symptoms on which to base a prescription. Each time the results were given most careful repertorial, study, and each time with the same result-nux was the remedy, and each time nothing was accomplished. It was tried in all kinds of potencies from 3x up to the cm.
Why the total failure when according to the totality of the symptoms nux was the clearly indicated remedy?
The answer is: The symptoms complained of and observed were not the totality and what was assumed to be the totality was only one phase of it and as later shown, not even the more important. a morphological examination was required to disclose the other; and that examination none of the physicians knew how to make or even recognized the need of making. When later one was made, what was discovered was an intestinal tract approximately 25 per cent deficient in development and that much or more deficient in functional capacity. This structural anomaly nux could not correct nor could it compensate for the functional deficiency. Yet here was the root cause of all the trouble, the “Zufalle,” the “causa occasionalis,” The symptoms were merely the end products.
No end of other failures to cure, I am certain, have occurred through the years for reasons similar to those in this case. Slavish devotion to an untenable concept kept distinguished prescribers and materia medica specialists from seeking and becoming acquainted with all the facts, led them to select the wrong remedy and to expect more from it than it was able to deliver, led them to fail, and so to have undeserved odium cast upon a great science.
But in adopting the totality-of-the-symptoms as the sole basis for a prescription greater harm has done to the cause than to lead physicians to choose the wrong remedy on occasions. The greater harm consisted in putting an effective check on all further scientific effort. Drug proving then became the one and all absorbing activity in which everyone took part and carried on with but one purpose, which was to accumulate symptoms for a materia medica. What else was implied in Similia besides symptom- similarity, why there are variations of different subjects to the same drug, were matters that interested no one.
It must, of course, be admitted that even on this imperfect and inadequate foundation the followers of Hahnemann in time succeeded in erecting a quite formidable structure. However, it was not a product of sound growth, but rather merely one of accretion, or sort of building-on process, which only required time to turn into one of disintegration. Is represented growth, but little or no development.
Suppose the original provers had known how to make a morphological study of each subject used in the provings, and had been able to determine the true character of organization of each, and able to appraise the functional value of the various organs and systems, and thus been able to account of what they constantly saw happening, namely, variation in reaction to the same drug, and had incorporated this in the pathogenetic record, isnt it reasonable to believe that materia medica would be a more complete and scientific work than is the present overwhelming mass of disconnected and unexplainable effects? Who can doubt it! And that all this could have been done had they known how, has in a small way been repeatedly proved, and can be proved again.
Effect, be it remembered, can be understood only when the character of the media in which they were produced is understood. And only such can be explained as are understood, and only such taught as can be explained.
But not knowing how to make a morphological study, and how to explain the mystery of variation, it was perfectly natural for those conducting the proving to do precisely that Cullen and his colleagues did with the mystery of variation in curative powers of quinine in the treatment of ague,-that was to ignore it. But this is not all they did, they rejected the inductive method of inquiry, which if properly conducted would have led them to cause and reasons, and adopted the deductive which led to nothing but effects. The result was that as time went by they got further and further away from the basic human factor and deeper and deeper into the maze of effects and ended by building a materia medica that is a veritable Tower of Babel.
Had the totality-of-the-symptoms concept been recognize and used as a measure and not assumed to be final method, we undoubtedly would be occupying a far more creditable position in the medical field than we do. As a measure it has proved of immense value in the past, and will do so in the future if not depended on in cases where other evidence is essential for understanding what symptoms and modalities cannot reveal.
A resurgence of Homoeopathy, sincerely desired, is a very doubtful event unless, first, the fundamental prejudice is given up that all we have to be concerned about are aches and pains and modalities;; and, second, were recognize that, while the elucidation and formulation of the Simile Principle was an outstanding achievement in medicine, it was only a first step and not a final goal. There are no final goals in science. Science is ever on the march toward broader and deeper concepts of principles. The moment a concept or method is stamped with the word finality, that moment the retrograde movement begins.
But as has been said: Our methods can be brought into harmony with the demands of science. We have only to comply with the implications of the foregoing syllogism and solve the problem they represent. The place of Similia in science is established. We have only to enlarge our understanding of it, learn how to distinguish between the primary and secondary values, and learn how to explain the mystery of human variation in reaction and incorporate this knowledge in the materia medica to have Homoeopathy. Moreover, let us do this and “common ground” will be found on which the two schools of medicine will stand, namely, the ground of Principle and not of empiricism.
-Journal of the Am. Inst. of Homoeopathy
Vol. 38, No.9.
There is in the interior of man, nothing morbid that is curable and no visible morbid alternation that is curable which does not make itself known to the accurately observing physician by means of morbid signs and symptoms-an arrangement in perfect conformity with the infinite goodness of the all wise Preserver of human life.