Me thinks Hahnemann himself would delight in these were he with us, and would insist that our drug-provings be perfected by like means, that our selections might be more and more precise. No one more than he has valued positive objective demonstration of morbid alterations, but in his day this way sadly restricted by the limitations of general knowledge. Let our future prescribing intelligently reflect our present advantages!.
“Treat Patient not the Disease.” This dictum of the pioneers, now classic, is distinctive of pure Homoeopathy; which, however practical exigencies may seem to cause any to depart fro it, is the only possible “point of departure,” as navigators phrase it and it is ever in view, also, as “the returning point,” as rhetoricians say.
It is justified in two ways: Firstly, be the fact that “totality of symptoms” means the whole man-nothing less. Secondly, that, like a derelict householder, the man is the sustainer of a nuisance called disease. A municipality does not itself, usually, abate a nuisance, but calls upon the householder himself to do so. Homoeopathic solicitation of the living organism, or its “vital principle,” does the same thing as to every particular disease. The attack upon disease, per se, savors of surgical coercion.
This may, indeed, be needful at times, but should never be confounded with medical practice proper. It is wholly exceptional. The pure medical idea, we repeat, is purely Homoeopathic.
The Medical Idea, in the Treatment of Tumors; of Intestinal Worms; and of Parasitic Skin Diseases.
This is largely a matter of “treating the patient,” rather than the disease; for, although local sensations and objective appearances have much influence in drug selection, nevertheless, these are still only emphasized voice in which we hear that of the suffering vital principle, as Hahnemann would say; the witnesses of the error of the whole living man. These, together with the “generalities” and mental symptoms, can point out to us the lines on which “Homoeopathic solicitation of the imperial vital principle” may be offered, and by which nature’s curative reaction may be received.
In a word, our business is, to make the living soil so healthy and resistant that it will not longer afford a nidus for the tumor or the parasite. In all germ diseases, likewise, this is the aim, and this the successful practice, of the genuine Homoeopathic physician.
Our surgeons, in the old days, realized of wounds, accidental or operative, and of “surgical diseases,” so-called; and the excellent work of Dr. J. G. Gilchrist, entitled Surgical Therapeutics, illustrated their practice. To day, however, it must be confessed with shame that surgical therapeutics is the same, almost, in both schools, and that, often, our surgeons mildly resent, to the detriment of their patients and of their statistics, all suggestions of “homoeopathic purity,” and, particularly, of Hahnemannian individualization.
The sources of surgical progress in the old world are, also, the tyrants of surgical therapeutics, and their dicta are, by both schools more or less, regarded as final. The remedy for this lapse, on our part, is to establish, in all our surgical hospitals, a rule of therapeutic consultations, in all cases, with competent exponents of sound Homoeopathy.
Contra-indications of Remedies.
Drugs may be deleterious to the organism, even in homoeopathic doses. It follows that in certain cases, where the chances of life are already very slight, that use of an unsuitable drug may even prove lethal. It is important, therefore, to study this matter well. .
1. Too great persistence in giving the right remedy, also too material doses, impose too much of the “primary effect” thereof upon the living body. High potencies may overdo, in the general sphere of the organism, and in the nervous system.
2. Persistence with one potency beyond the show of vital reaction may retard this; whereas a change of potency, higher or lower, may revive it.
3. Giving a drug suitable to the leading local symptoms, but unsuited to the temperament, often does harm. This in a fever, with drowsiness, suffused eyes, slow motions, crimson color of the whole face to the hair and the ears, Gelsemium is indicated, not Aconite, nor Belladonna; and both of these are contra- indicated.
And if the patient is anxious, restless, thirsty, sure speedy death, etc., neither Gelsemium, nor Belladonna, but Aconite is suitable.
Or if he is hasty, audacious, maniacal, with sudden notions, and dry, threat, all but Belladonna are contra-indicated.
4. Some drugs are contra-indicated by the nature of the existing morbid process. Thus blood-poisoning, typhoid or other, has little in common with the sthenic Aconite, but calls for Gels., Bapt., Rhus., Bryonia or Arsenic, asthenic drugs. The first is, hence, usually contra-indicated in the height of typhoid fever. Teste points out that drugs are likely to suit best the temperament and the diseases of mankind, in their own habitat. Aconite is a mountain drug; Gelsemium growing in low, damp, warm, and malarial districts.
5. Symptomatic antipathy, of course, is always a contraindication.
6. Inimical drugs are such as do not follow each other well- as, Apis and Rhus; Phosphorus and Causticum-and exert, thus bad effects, and so are contra-indicated. (See a pamphlet on this subject by Charles Mohr, M.D.).
Dosage.-As an addendum to this part it is needful to refer briefly to the question of dosage. The “minimum dose’ of Hahnemann is a relative measurement only, and means “the smallest dose sufficient to cure;” and this measurement must be determined by each physician for himself and for each individual case separately. In general, we may accept the empirical formula, viz., “all drugs have double and opposite properties and effects, according as the doses are large or small,” and admit that the former show dominant primary or “physiological” effects, the latter dominant secondary or opposite effects. From this vantage ground we may consider the neutral point between these and both extremes.
Management of Remedies and Dosage.-A few detailed suggestions on these matters, as seen in daily practice, will, doubtless, be acceptable. And in the first place, it should be said that in acute diseases both high and low attenuations are effectual; but that the more extensive the anatomical lesion the more solid the affected organ, and the greater the degree of tissue alteration the greater the tolerance of the low and even of the lowest. On the other hand, the less extensive the lesion the less solid the tissue affected, and the less the tissue- change-in short, the more purely functional is the malady the more needful are the highly attenuated preparations. Also, the personal sensitiveness is a leading reason for corresponding dosage. A plus of this demands the higher; a minus, lower.
Recent intermittent fever does well on low attenuations, as of Gelsemium. Confirmed cases demand the higher, e.g., the thirtieth centesimal and upward of Bry., Nux v., Natr.m., Ars., etc. The lower attenuations (1x to 6x) are usually repeated in hyperacute disease very rapidly, say, five to twenty minutes. In common acute cases hourly or oftener, “until an impression is made,” i.e., until distinct and positive improvement is noted; then, less and less frequently-“tapering off,” as it has been called, as the lesion subsides with the symptoms.
But if, instead, an “impression” of aggravation sets in, due to the drug, a higher potency is given, provided the symptoms still indicate it; but if these have changed, and a new drug are in order. If every prescription aggravates the symptoms and the lesion be in abeyance, and if, besides, the vitality be better, all drugs should be stopped and a placebo or else nothing be given; permitting, now, the ‘secondary vital reaction” to occur, without the least interference, so long as improvement continues. “Improvement” recognized, even when it is as yet limited to the psychic sphere, the physical is sure to follow, duly.
In subacute diseases the doses are given about three times a day for a week; although some physicians repeat much oftener if the system tolerate it, even in chronic cases. Change of symptoms is met by change of the drug.
Low attenuations in chronic diseases are repeated once, twice, three or more times per week. Sometimes, if counterbalanced by obstinate lesions in similarity with the drug every three hours has been borne, e.g., Rhus tax. 6, in cutaneous syphilis, continued some months, with Bryonia as an intercurrent remedy for “muscular pains.”.
High potencies (attenuations) are usually given more sparingly. IN collapse, after exhausting disease, one dose only can be endured. Per contra, in early cholera, etc., every five minutes to twenty minutes. In acute diseases, sometimes, a single dose will carry the case to the curative reaction. But better work is likely to be done in such cases by some repetition; e.g., three doses, one hour apart; or four doses, two hours apart, and if, after an improvement, exacerbation occur, repeat and give six hours apart.
