You may perhaps have had from time to time those little tracts thrust surreptitiously into your hand, bearing a double title such as “The Bent Hair-Pin” or “How Little Nellie saved the Night Express.”.
Similarly I might suggest as an alternative title to this paper “The Foresight of Hahnemann” or “The Longest Way Round is the shortest way Home.”.
With this old adage, Dr. Julian ended a lecture on Homoeopathy in this room not so many months ago, and if I may be permitted to follow in his footsteps, I should like to take up the thread of his discourse and use it as a text to this introductory lecture.
The history of medicine is very much a history of attempted short cuts.
In our passion for arriving at our destination ahead of schedule, it seems to be a deeply rooted instinct to take the first promising turning off the main road, in spite of the fact that previous experience should have warned us that all such hopes of short cuts are snares and delusions.
One of the first short cuts was invented by a Frenchman. Dr. Crookshank has described how de Sauvages in 1731 hit on the notion of classifying illnesses into diseases, and published a small book entitled the “Classification of Illnesses.” Diseases were to be classified into certain determinate kinds just as the botanists classified plants. The idea was accepted with enthusiasm, and as Dr. Crookshank states, the mischief was done, the medical profession started on a career of fitting square pegs, the patients into round holes, the diseases.
The standardisation of disease led to standardisation of treatment and medicine has suffered to this day from this tendency.
As Dr. Crookshank writes: “It seems as if Academic Medicine, with its formal nomenclature of diseases, is becoming regarded by the public and by no means the least intelligent section thereof as analogous to Heralds College, with its Tables of Precedence and the like”.
One of the most promising short cuts that diverted the progress of medicine was the discovery of bacteria. At once it appeared that further investigation into the nature of the organisms responsible for disease would necessarily lead to the cure of disease, and immediately a large number of workers devoted themselves to the isolation of the various organisms associated with various illnesses.
Having discovered the organism responsible for the illness the next step was to stamp it out.
Ehrlich evolved his famous idea of the sterilising dose, which should wipe out the invading bacteria.
And then the bacteriologists found themselves against an obstacle an agent which killed micro-organisms in vitro was practically valueless in vivo, unless used in such concentrations as were dangerous to the host. An immense amount of research was carried out in the hope of finding a drug which would annihilate the infecting organism without damaging the issues of the host Salvarsan was the 606th substance investigated in Ehrlichs laboratory. Gradually, Ehrlichs dream has been reluctantly abandoned, and it is being slowly recognised that all three factors in this eternal triangle must be taken into consideration the patient, the infecting organism and the remedy.
It is no good concentrating on the invading germ or on the antiseptic drug alone the tissues of the host must be respected as well. More and more, it is recognised that such drugs as antimony in bilharziasis, salvarsan in syphilis, the gold salts in tuberculosis, mercurochrome in septicaemia, do not act directly on the various micro-organisms concerned but through the agency of the tissues and fluids of the human body.
The late Professor Dixon admitted that bacteriological tests were no guide in assessing the curative values of these drugs. He reminded us that Ehrlich found atoxyl useful in syphilis after he had proved it had no lethal action on the protozoa in the concentrations used. So also Mercurochrome has cured gonorrhoea in concentrations well below the theoretical sterilising dose. Now investigators talk about the chemo-immuno-therapeutic properties of these drugs. That is to say they consider that these drugs, by altering in some manner, the chemistry of the body, stimulate the natural forces of recovery.
This however, is but a restatement of one of Hahnemanns fundamental points. Hahnemann wrote more than a hundred years ago: “Diseases are nothing more than alterations in the state of health of the healthy individual which express themselves by morbid signs, and cure is only possible by a change to the healthy condition of the state of health of the diseased individual.” Hahnemann claimed that medicines only act by stimulating the natural recuperative powers of the body the patient cures himself the drugs administered do not effect a cure except in so far as they set in motion the natural defence reactions of the body. As Dr. Todd said last year, “we know the cause of tuberculosis now and can reproduce the disease, but most of us have stopped trying to treat the disease, we treat the patient instead to his benefit”.