The interpretation of symptoms here finds a special function, of course; but a warning is required-not to spin cobweb theories therefrom unto vague pathological prescribing.
Interpretation of symptoms relates to the following subjects, viz.:.
1. The nature of the morbid process; as, hyperaemia, active or passive; cardiac tone, or atony; connective-tissue growth; parenchymatous inflammation; suppuration; reflex nervous states, etc.
2. Lesions of function.
3. Tissue-lesions, e.g., of epithelium; of nerve substance, etc.
4. Gross lesions of organs, e.g., heart, kidney, etc.
Each of these classes is, to the experienced therapeutist, at once suggestive of a group of remedies bearing pathogenetic and therapeutic relations thereto, as judged by provings and by clinical observations. Yet the physician must never be dominated by past experience, but ever push forward in fresh research.
Hahnemann’s Chronic Miasms and Modern Pathology.-A pertinent question here is, how does Hahnemann’s doctrine of Chronic Diseases appear in the light of modern pathology? Are his “three chronic miasms” thereby consigned to oblivion as the “disorderly fancies of the master’s senility?” Or do they appear therein, in a new dress, irradiating the field of current literature, and giving inspiration to current practice? First, is “repelled psora” a whim, of a grave pathological fact? Second, is constitutional syphilis a mere illusion, or a terrible reality? Third, is “sycosis,” or systemic gonorrhoea, the conceit of a narrow doctrinaire, or is it a sad fact in the history and in the pathology of modern diseases?.
One modern word will embrace the whole of these, namely, “septicaemia”; duration, or chronicity, is, then, the only thing left to question. Its prevention demands one prime condition, whatever its form, viz., absorption; and, again, this is the sure consequence of nondrainage. Add to this the local use of absorbent lotions, ointments, with frictions, plasters and all conditions of systemic poisoning are met. “Repelled eczema” (the “itch,” or “psora” of Hahnemann’s day) has, in my own experience, been immediately followed by hydrocephalus; everybody knows the syphilitic taint; and Ashhurst’s Surgery is good authority for the reality of gonorrhoeal septicaemia, or pyaemia.
All authors of our day confirm the Hahnemannian doctrine of repelled or absorbed organic poison. Advanced anatomy elucidates it. The “superficial cutaneous lymphatics” lie just beneath the epidermic cells, open between them, and communicate by perforating the cutis with the deep lymphatics, thus furnishing a direct route to the circulating blood, and to every living cell in the body.
Microbes are the elements of mischief according to modern views; but the facts, as clinically seen by Hahnemann, were just as real as now, and were the sound basis of his theory, and the perfect justification of his practice and of his advice. Even his nomenclature, antique though it may be, when technically understood, is no worse than the modern; e.g., “amyloid,” etc.
The chronicity of psora, or septicaemia, using the modern phrase, and its protean expression, to many unfortunate surgeons in our day, who have been victims of “blood-poisoning,” are indubitable facts. Certainly, such may well be Hahnemannians. General loss of vitality and susceptibility to morbid influences and processes, so graphically described by Hahnemann in volume one of the Chronic Diseases-these have since been their constant experience. See also a quotation from Reynolds by Prof. L. L. Danforth, TRANSACTIONS of the American Institute of Homoeopathy, vol., 1892, page 267, in “Antisepsis in Obstetrics”.
Some years since the writer contributed to the Transactions of our Pennsylvania State Society a paper, in which the unity of origin of all constitutional taints was considered at length from the standpoint of evolution.
Action and Reaction.-No range of doses monopolizes either the “primary” or the “secondary” effects of a drug; nor are the “double and opposite effects” ascribed to all drugs to be wholly found in the action of opposite grades of dosage, large and small. Nevertheless, it is true that large doses display the primary in a far greater measure than do the small, whilst in regard to the secondary effects the predominant display is just the reverse. Primary action is the attack of an enemy. Secondary action is the repulse of that enemy. In both are signs of battle- i,e,. symptoms.
The primary effect, in the language of Allopathy, is called “the physiological action.” This being transient, is regarded as of little or no specific individuality or significance for any given drug; yet in such quarters it is held to be the only possible medicinal action of any drug, to be maintained by ever- increasing doses, according to the surgical idea. From this point of view, the doses, as well as the specific individuality of Homoeopathic remedies, are absurd beyond description.
In taking such a position, however, they themselves necessarily commit the glaring absurdity of ignoring that great law of physics, viz., “action and reaction are equal.” Further, they ignore the added vital resistance against all things inimical; and still further, the fact that all drugs are, per se, thus inimical in their primary influence. The materialistic and the vitalistic philosophies alike, and throughout, support our view in this matter. The secondary is the permanent and final-the curative effect.
Natural law, however, as generally recognized, is rarely unconditional, and this “law of reaction” is conditioned by an important proviso, viz., that the preceding “action” be neither destructive nor disabling.
The Homoeopathic law submits to this self-same proviso, and hence it implies “the minimum dose,” with conservative repetition, according to the medical idea. So far as we know, it submits to but one other, viz., the curability of the given case. With these provisons, surely “likes are cured by likes”.
3. Diagnostic and pathognomonic symptomatology are too well valued and understood to need more than mention here, but a thorough course of instruction must specifically include them; only, the physician should be able always to distinguish drug- symptoms from those proper to the “natural history” of the disease per se.
4. Pharmacodynamic symptomatology is the capital city to which, in Homoeopathic practice, all roads lead; and the “totality” is the measure of the study. The physiological and pathological significances, previously studied, here find their higher illustration in the proving records of the materia medica. Indeed, a prover is doubly equipped for his important work if he has had this previous study; but he must avoid the error of writing down his subjective pathological opinions in pace of giving a faithful statement of the observed phenomena. Still, symptoms understood are symptoms remembered, and both prover and student should understand all that is possible. Even single symptoms, understood, illuminate the totality, as above shown.
The diagnostic powers of the mind will here find a most difficult yet most remunerative employment.
Here, again, the Repertory of Jahr and Possart affords a practical analytic handbook. Each chapter, indeed, is full of points for parallel or for consecutive study of all the subdivisions of symptomatology.
The strictly Hahnemannian and the final use of a repertory is an an index to the materia medica, where, only, the salient symptoms are found in their fulness, and thence the totality; consulting the provings proper under some one, and then others, of the several remedies therein suggested-examining the various drugs, one after the other, in the order of their apparent similarity, until the most similar is found.
These provings are the sanctum sanctorum of symptomatology.
5. Prognostic Symptomatology.-“Dealing in futures” is a business phrase which applies well to the physician’s work. It requires close study. In the evolution of disease the outcome is of absorbing interest, and this is judged by: 1. The natural tendency of the malady. 2. The intensity of the particular attack of the same. 3. THe importance of the specially affected organs and the amount of their involvement. 4. The amount of physiological error. 5. Heredity, age, sex. 6. Vital force, and the means at hand of sustaining it, by food and other hygienic conditions. (And here, be it observed, that to the followers of Hahnemann, the constitutional status is ever paramount, and its symptoms of the highest rank).
7. The environment, as a whole, is to each patient an individual factor, intensely bearing upon prognosis. This, too, has its symptoms, mainly in the sphere of “conditions” of aggravation and amelioration, and nowhere is there a wider field for interpretative study. 8. Lastly, prognosis rests, in large measure, upon the character of the treatment, a fact to which our school is fully alive.
However, the mere outcome of the disease itself is not the whole of the subject. The action of every prescription is a proper subject or scrutiny and forethought. The probabilities of aggravation and amelioration; the reasons for the same; the periods of probable occurrence; the interpretation of paroxysmal and other changes; the incidental drug-provings which may crop out, intended or not; their recognition, anticipation, and guidance, sometimes their open prediction-these are a part of our daily duty, and should be made the subject of definite study and teaching.
