The first named is, of course, modified, in disease, by a previous a fourth agency, viz: the originating cause thereof; but the individuality is there; and if the drug be a true simile, the two forces will neutralize each other, up to the point of the “just sufficient” dosage; and cure results. If either predominate, the “symptoms” declare it.
Now, how shall we distinguish symptoms which are present because of the interaction of the drug-force with the others, and are hence is fruits (with their aid).
Firstly. If the natural history of the individuality, in the state of health, cannot duplicate a symptoms with the same environment, the third factor, the drug-force, must be the efficient cause.
Thirdly. During the treatment of disease, consider the natural history thereof; and if the new symptom or symptoms be alien to its natural history, the environment being the same, the remaining factor, the drug must be held responsible for them.
Fourthly. Changes of environment, however, will initiate a corresponding change of symptoms and “condition” (or “modalities”); but withal, even these will be also stamped, characteristically, by the modifying force of the drug-factor.
Fifthly. New psychic and mental errors, pains, altered functions, obscure chills, spasms, fevers, etc. (in “Fever Order”), are the common forms of symptoms produced during treatment of disease in the line of drug-pathogenesis or so- called “Homoeopathic drug-aggravation.” The latter phrase, however, belongs more correctly to the increase of pre-existing disease-symptoms after the administration of the drug. This following “low potencies” the drug may be pushed through such an episode; the reaction following, with more or less effort of the emunctory or secreting organs, in the way of elimination of the drug-excess. But, in using “high potencies,” experience shows that a placebo is the best answer to the same. (It may be here mentioned that a convulsion is the fair analogue of a chill, in practice.).
Supposed Sources of Fallacy in Provings.
The domination of subjective or of environment influences is not a sufficient ground for condemning a proving. The former simply announce the kind of individuality most susceptible to the other two factors when acting together; and the proper grouping of observed symptoms will depend upon making use of the subjective or personal symptoms is conjunction with those alterations which are excited by the other factors, viz., the drug plus the environment.
Again, the symptoms directly traceable to environment only, one may suppose, do not fall short of the scientific requirement, as experience shows, and, a priori, it must be, that a compound susceptibility exists; the other two factors, the individuality plus the drug, prepare the total physiology for certain responses to each kind of possible environment. (No proving is absolutely complete short of the test of all of these, as well as of all kinds of individuality.).
My own proving of Gelsemium in April, 1861, illustrates all this. Reading the telegrams from Charleston, S.C., concerning the battle at Fort Sumter, my system, in its original individuality, had been so modified by two weeks’ use of the drug that “threatening of diarrhoea” always followed, and I stopped the proving in the belief that the further record of such symptoms would be misleading that “there is the keynote of Gelsemium!” This was also the “latest symptoms.”.
What shall we do with the many striking pathogenetic symptoms often arising after the taking of a drug by the sick? These have often proved intensely characteristic of the remedy; but their use is hazardous, and cannot be approved until further cautious experiment has eliminated all chances of error. In cases where several remedies have been taken this rule is urgent indeed.
Surgical symptomatology is now so well studied that it will here suffice, in the main, to refer to the current authorities. Several points, however, closely concerning the general practitioner must be here specified.
First. Septic fever. Some rise of temperature, after shock of an injury or an operation, is only reparative and salutary; let us call it “primary fever.” But if this do not fall in a day or so, or, it having fallen, shall again rise, as shown by the thermometer, used at least twice daily, it is “secondary” or “septic fever,” and the only thought then must be to open, irrigate, and disinfect the wound-territory thoroughly. The Homoeopathic dilutions will perform their accustomed work all the same afterwards, especially the lower, but not exclusively.
Second. In peritonitis frequency of pulse is more significant than rise of temperature. Thus, the greatest of signs in universal surgical symptomatology are to be found in the temperature and the pulse.
Third, and lastly, in haemorrhage, as in chills, the temperature is the test, i.e., a fall to 97 degree F. or below.
General Pharmacodynamics.
PART IV.-Based upon the Organon, and rearrangement of provings in accordance with the type of Intermittent Fever, etc.
It has been said, by some (Dr. Dickson of LOndon, and others), that “all disease is Intermittent Fever.” Certainly, this dictum will but confirm the experience of many physicians practicing in malarial districts; for, every day, it seems to be restated by Nature. Even in non-malarial countries, so-called, close observation supplies a plenty of illustrations in the course of varied diseases.
Drug Diseases are no exception. Plainly, this must appear to every Hahnemannian; for, “every drug may cure Intermittent Fever” if duly individualized; the natural and the artificial disease alike presenting abundant variations- in proportion of stages, in sequence of the same, in concomitants of each, in conditions of aggravation and amelioration, etc. etc. Generalities of all kinds are easily assignable to “stages,” and are extremely significant.
Comparing these in detail, stage by stage, we observe:.
a. Certain general and local symptoms of every drug proving, regardless, protem, of the mere date of observed order of occurrence, assimilate with acute physiological depression; in other words, with the cold stage or “chill.” Such symptoms, whatever their date, are essentially “primary,” and represent truly the initial shock of the drug disease.
b. Another set of symptoms corresponds, accurately and thoroughly, with acute physiological exaltation, yet a minus of secretion, also irrespective of date; in other words, with the hot stage. This is still a “primary” from under Hahnemann’s nomenclature, being simply a fuller development of the morbid impression and of the vital disturbance thereby; but incipient secondary vital reaction has now begun to mingle with the primary effect.
c. A third set of symptoms, usually following the hot stage, appears in intermittent fever with a plus of secretion, the sweating stage or remission. In remittent fever it does not ripen into a full intermission; in intermittent fever this does happen; but in both cases this stage is evidence of acute physiological exhaustion; the primary effect is not quite abolished, yet it is subsiding with gradual approach of vital or curative “reaction,” which is synonymous with “secondary effect.” This is imperfect a d uncertain in remission, however, which implies important congestion or other lesion, preventing complete intermission and having an evil prognosis. Nevertheless, we may say, in general, that in both the hot and the sweating stages vital reaction approaches nearer and nearer, may, has already commenced. Corresponding symptoms of such a state in a drug proving are to be diagnosed and to be placed under this head.
d. A fourth state, with definite symptoms, is seen in a completed intermission-the “apyrexia.” The same class of symptoms, general and local, are to be sought and noted in every proving, and these being ameliorative, compared with the first three, they may be regarded as mainly “secondary.” They have, however, some residual organic lesions for their basis, and mean incomplete reaction only.
e. A fifth, more advanced state, is the stage of Sequelae, that is, the organic and functional lesions remaining after the paroxysmal stages have passed, perhaps entirely ceased. In heroic provings this may also be distinguished and should be classified as a subdivision of the secondary reaction, still blended with relies of the “primary effect”.
f. Recovery is, sixthly, perfected “secondary effect.” Its symptoms are subtle often, but negative. Practically, health is reached.
g. A seventh stage of intermittent fever must sometimes be noted, viz., that of periodic recurrence. The symptoms of the original “primary effect” reappear and are to be classed as such, not as any part of the “reaction of the vital principle” or “secondary effect.” Indeed, it is a clear testimony to organic sequelae, apparent or occult.
h. In every proving a careful study of the symptoms will enable one to distinguish their relation to the several stages of intermittent fever, and the resulting groups may then be arranged in the foregoing succession-the true perspective of the drug- disease picture, which thereby becomes luminous, continuous, natural, regardless of varying temperaments of provers, varying dosage, and dates of symptoms, and of their written or printed sequences, resulting from such empirical reasons.
