I HAVE been asked to speak to you on this occasion regarding the “Further Improvement of our Materia Medica.” The term “further” implies that some improvement has already taken place, from which, as a resting-point we may note progress and survey the ground yet beyond us. The reference is obviously to the Cyclopedia of Drug Pathogenesy, and upon this I would say a few words at the outset.
The work in question consists-as you know-of a collection of the provings of drugs not contained in Hahnemann’s own volumes, with a selection from cases of poisoning by them and of experiments made with them upon the lower animals. These provings, poisonings and experiments have been carefully translated or transcribed from their originals, and are presented in the primary narratives wherever these are given.
The provings themselves are a selection, made upon rules approved by the two National Societies of America and England, and so framed as to exclude-as far as it is possible-all dubious matter. We thus have, in the four volumes of the Cyclopedia, pathogenesis of as many hundred medicines, [The exact number is 413.] as trustworthy as careful choice can insure, and as correct as knowledge and painstaking care can make them, with the additional advantage that, wherever practicable, they are presented in an intelligible and interesting form.
The result gained by the completion of this work is that the lamentatious over the unsatisfactory state of our Materia Medica, which for the last forty or more years have been heard from all parts of the Homoeopathic world, may now sink to silence, or rather be exchanged for gratulation. They were well warranted when Jahr’s Manual, in its various forms, was or sole collection of pathogenesy. Symptomatology was there presented in a form most incredible, unintelligible and repulsive, without ground for its statements or clue to its mazes: it was, as it has been called, “nonsense made difficult.”
Nor were the groans evoked by it altogether assuaged by the appearance of the Encyclopedia of Dr. Allen, great advance through this was. Our scattered provings were there, indeed, brought together and referred to their authors, besides being much enriched from general medical literature; but they remained unshifted, and were all broken up into the categories of the Hahnemannian schema. Our Materia Medica, even in “Allen,” continued to be dubious and unattractive.
Now it is neither. The student can read the narratives of proving, poisoning and experiment contained in the Cyclopedia of Drug Pathogenesy with as much confidence and as lively interest as if they were cases of idiopathic disease; and the practitioner can, with firm reliance, utilize them in his practice. If doubtful matter still remains, as where, with little or no information as to their origin, we merely have a list of symptom, the statements made as to their character, and (generally) the inferior type in which they are presented, will suffice to warn off from possible quicksands or quagmires.
But I must not leave the Cyclopedia without a word as to the pathogenesis given us by Hahnemann himself, to which it contents itself wit referring, evidently implying that they also should be possessed by the reader. Those of the Chronic Diseases, indeed, are still a sealed book to most from the back of an adequate and accessible version. The Materia Medica Pura, however, has been now retranslated for us by the competent hand of Dr. Dudgeon, and can be obtained by any one. There may be read the results of the master’s primal essays at drug-proving, with his own illuminative introductions and notes.
The symptoms are arranged in schema- form, indeed, and there is little information as to how they were elicited; but the latter deficiency is supplied from other sources, and many of the individual symptoms are themselves groups which have association and sequence. When I speak of our Materia Medica as we English-speaking nations have it, it must be understood that I include these two volume of Hahnemann’s as well as the four of the Cyclopedia which supplement them.
And now, from the standpoint of what has been gained, let us inquire what remains to be done towards the improvement of this Material Medica of ours. Let us clear the way be seeing what should not be done.
The first thing to be deprecated is the view that the narratives of the Cyclopaedia constitute so much “raw material” only, and must be worked up into a schematic symptoms list before they can be made available for practice. Why should this be? For readiness of reference, it is replied: when we want to know what spinal symptoms Cicuta induces, we can turn to them at once in Allen, but in the Cyclopaedia we have to hunt them through a number of records. My answer is, that this need should be p[provided for by an index, as it is in other books. We do not, in these, cut up the text into categories that individual items may be the better discovered; nor should we do so here.
Hahnemann unfortunately took this course with his own provings; and nothing, I think, has done more to rob him of his honor in the profession at large, to hinder conversion to Homoeopathy, and to drive practitioners of the system into empiricism, than the distortion which has resulted. I maintain further that symptoms placed singly, divorced from their sequence and concomitants, often convey a false idea as to the pathogenetic action of drugs: so that the schema is not only unnecessary but misleading.
[ These theses are defended to detail in a paper on “The Presentation of the Materia Medica,” read by me at the International Homoeopathic Congress of 1886, and published in the TRANSACTIONS, p. 121.] The abandonment of this mode of presenting our Materia Medica is one of the most important features of the Cyclopaedia; and it would be to “further improvement” if we were to build again that which we had destroyed.
In is under the influence of these considerations that I do not feel as sympathetic as otherwise I should be towards another plan for reconstructing our Materia Medica-that advocated from Boston by Drs. Wesselhoeft and Sutherland, and taken up (with some modifications) by the Baltimore Investigation Club. It is mainly a trying of the symptoms of our pathogenesis by the test of their recurrence in more than one subject of the drug’s influence-only those which stand the ordeal being retained.
I am not quite sure about the soundness of the method; there must be some flaw in a mode of proceeding which leads to the rejection of Cactus as inert, and to the reduction of the symptom-list of Gelsemium (upon one proposed method) to four items only. [See New England Medical Gazette for December, 1888, and North America. Journal. of Homoeopathy for June, 1889. The principle, however, is excellent; it is that upon which I am to a large extent acting in making the index to the Cyclopaedia.
I am referring only to such apparent effects of drugs as “by the force of their occurrence or the constancy of their recurrence witness to organic connection with their assumed causes.” [+ See “The Index to the Cyclopaedia” in the Monthly Hom. Review for November, 1890.] But suppose I were to write down these symptoms as I indexed them, and, casting them into the categories of a schema, were to public them as the tried residuum of our symptomatology. Genuine they might be; but a Materia medica so constituted would retain all the remaining faults of those of old; it would be as unintelligible, as repellant, as misleading as these were.
One of our journals, in noticing the Cyclopaedia, says that “it totally ignores a host of old Homoeopathic landmarks.” By this is probably meant the “clinical symptoms” which swell the bulk of so many of our Materia Medicas-meaning by this term morbid states which have (not appeared, but) disappeared while their subjects were taking certain medicines. Hahnemann made some, though sparing, use of such symptoms only, however, when they occurred in provers of drugs, [++ The symptoms list of Iodium in the Chronic Disease is the sole exception to this statement.] and always nothing that they were Heilwirkungen.
Jahr introduced them more freely, indicated their character by affixing a small circle (O) to each. So far little harm, if little good, was done. More recently, however, the practice has grown up of mixing pathogenetic and clinical symptoms, together with guesses, therapeutic suggestion, and hypothetical inference, in one indiscriminate mass, and calling this conglomerate the Homoeopathic Materia medica. men imagine that they are applying the law of similars when they work with such books, whereas they are very often practicing the merest empiricism.
I do not wish, on the present occasion, to go further into detail on this subject. I have often expressed myself upon if and always feelingly; for I deplore the procedure in question as one of the greatest calamities that has ever befallen us. My sole reason, however, for mentioning it now is to support the opposition I would make to any vitiation of our symptomatology with matter of a clinical kind. It is not that I undervalue the usus in morbis or despise therapeutic suggestion; but I would have these kept separate from the pure Pathogenesy. They may appear in prefaces and notes, as in Hahnemann’s publications; or they may occupy a separate volume, as must be in our case. There they find scope for abundant usefulness; but mixed up with the results of provings and poisonings they are confusing, illusory, destructive of all scientific thought and practice.
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.