Dunham : Homeopathy, the Science of Therapeutics.

Dans Anglais, Organon by Edouard BroussalianLaisser un commentaire

By Carroll Dunham, M.D.

Francis Hart and Co., 63, Murray Street, New York, 1877.

dunham01IN this Work we have at once a tribute of affection to the memory of the departed, and, as it were, a voice from beyond the tomb pointing out the path of usefulness and success. The present volume is the first of a series which will contain a complete (we hope) collection of the writings of our late colleague, Carroll Dunham. We have often wondered why we have not followed the example of our Allopathic brethren in collecting into one the works of our great departed; and why, even to this day, the writings and correspondence of HAHNEMANN himself are scattered. Let us hope that the present undertaking will inaugurate, in this direction, a new era of enthusiasm and devotion.

The present volume contains “thirty-nine articles”, far more definite and infinitely more interesting than those of our National Church, while, unlike the latter, they are written so temperately that they will never acquire the sobriquet of “the forty stripes save one.” To do full justice to these valuable essays would be impossible in a review; they must be read and studied themselves; we can only touch upon the most important ones.

The first article, which gives its title to the volume itself, is a philosophical essay, which betokens a master mind. It involves the relation of Hygiene to Medicine. The first point to be decided is, What is meant by Therapeutics ? This Dunham defines to be the medicinal treatment of the sick. This by no means includes the whole duty of the physician, to whatever school he may belong. He may be called upon to decide whether a given case of disease is necessarily fatal, or whether a group of symptoms arises from a mechanical cause (e.g., a bullet), which can be removed; in both these cases a knowledge of Pathology is requisite. Or he may have to treat a case of ill-health arising from improper food, or injurious habits; and here a knowledge of Physiology teaches him how to act. All this, however, is outside the sphere of Therapeutics, and may be practised independently of it. The question then arises, What is the relation of one to the other? are the laws of Therapeutics the same as those of Hygiene? Our author replies in the negative. He says, “Can the Therapeutist act on ‘general principles,’ as the Hygienist does? Can he act on the maxim causa sublata tollitur effectus? Obviously he cannot. In so far as the cause of disease can be discovered in external influences, the treatment falls within the limits of the science of Hygiene as already discussed. In so far, however, as the cause of disease is identical with the essential cause of the modification of function or organ which we recognize as the disease, it can never be discovered, for it is the same, in its nature, as the cause of healthy functional or organic action; in other words, it is life itself, the nature of which, as of every first cause, is inscrutable. “Therefore”, he continues, “as the Therapeutist cannot construct a rational system, based upon the essential cause of the disease, as the Hygienist does, he must base it upon phenomena, according to the empirical method.”

This alone would be a clear line of demarcation between the two, but it is not all. “There are”, says our author, “two conditions to which every natural science must be subject, and which may, therefore, serve as tests of its fitness to be regarded as a ‘science.’ “

These are, (1) “a capability of infinite progress in each of its elements without detriment to its integrity as a whole”, and (2) “that it shall provide for the prediction of future events within its own domain.” The science of Optics, based upon empirical data, is an example of the first condition, for its laws have been discovered and extended without violation of the harmony of the whole, and in spite of the various changing theories of light; while the discovery of the planet Neptune, from previously known data, affords an instance of the latter condition in Astronomy. No one can say that Physiology, Pathology, and Hygiene fulfill these conditions; how often do we find persons in good health under circumstances which we should have imagined, upon general laws, must be prejudicial; how often do we find a patient crave for what we should ordinarily consider unsuitable, and rapidly improve on partaking of it; and how often is the most experienced Pathologist agreeably, or disagreeably, disappointed in his prognosis of his patient’s case. Since, then, Therapeutics must be founded, not on the rational basis of causes, like Hygiene, but on the empirical basis of phenomena, like Optics and Astronomy, and since the latter are exact sciences, and fulfill the two conditions above quoted, the science of Therapeutics must resemble them in these features also.

But which School of Medicine answers to this description? The professors of the Old School admit the uncertainty of their system, for which our author gives the following reason. The Old School Therapeutics embraces two methods. The first “bases the plan of cure upon a theory of the nature of the disease, endeavours so to study the pathology of the disease as to form a sound hypothesis of its modus operandi, and thus essays the cure upon ‘general principles.’ It undertakes, in fact, to act in Therapeutics upon what we have seen to be the true method in Hygiene.” But to this method there are four objections :

1-“the simple impossibility of arriving at a knowledge of the nature of the disease, which’ is modified life “;

2-that it is not sufficiently general, being “rather a congeries of sciences of Therapeutics, based on theories of isolated groups or types of disease, than a single all-embracing science, founded on one : comprehensive theory of disease “;

3-that “it is too general to embrace all the phenomena of each individual case “; and

4-as a natural conclusion to the above, that it is not capable of infinite progress, as is seen by the rise and fall of various Old-School systems, and of favorite remedies. The second method, the numerical, is liable to similar objections; for a system founded on 5,000 cases might be overthrown by the next 5,000; and it fails to provide for the treatment of new forms of disease. In short, the triumphs of “Rational Medicine “have been merely in the collateral sciences of Pathology and Physiology, and have resulted, solely in doing less harm than before.

Rational Medicine being, therefore, found wanting, let us see if Homœopathy will stand the test. Our author shows that it does. The empirical law of Similars, based originally upon such drug-and disease-phenomena as were then known, is not overthrown, but confirmed, by the discovery of new phenomena through the ‘stethoscope, and other recent inventions; and again the law being once established as universal, we can, on the occurrence of any new form of disease, point out, with unerring precision, what medicine will cure, as HAHNEMANN did in the case of cholera. Thus Homoeopathy is proved to be the science of Therapeutics, and, as such, universal and exclusive.

But let it be observed that it is the Homoeopathy of the Master which Dunham here upholds. To those who, in the present day, are departing from it, striving to join Allopathic theories with Homoeopathic facts, by making Pathology the basis of treatment, resorting to Symptomatology only when the former is obscure, and who say that though HAHNEMANN rejected the uncertain Pathology of his day as a basis for treatment, yet he would have accepted and used the more accurate (?) Pathology of the present day, we recommend a perusal of our author’s words at the conclusion of his essay on “The Relation of Pathology to Therapeutics”:

“Those of our School who insist upon Pathology as a basis of Therapeutics, who look upon the single objective symptom and its nearest organic origin as the subject for treatment, and who deride the notion of prescribing upon the totality of the symptoms, and claim to be more than mere symptom-coverers, in that they discover and aim to remove the cause of the disease,—these colleagues are as false in their Pathology, according to the highest Old-School authority, as they are faithless to the doctrines and impotent as to the successes of the founder of the Homoeopathic School.”

The fourth essay is on “Primary and Secondary Symptoms.” Dunham concludes that no law of dose can be based upon such a division, and utterly overthrows (by facts) Hale’s theories on the subject.

The fifth essay, “The Dose in Drug-Provings”, is especially needed at the present time, when a pretended Homoeopathic

Society has declared (contrary to HAHNEMANN’S repeated statements) that “Provings of high potencies are useless and discreditable in Homoeopathy.” In the first essay in this volume, Dunham has exposed the utter untrustworthiness of Hempel’s translations; in this he exposes his falsification of facts relative to the pathopoietic power of high potencies, and conclusively proves that they have the power of making the healthy ill.

The next four papers are on “The Alteration of Remedies”, and we advise those who adopt this form of polypharmacy to read them carefully, and they will see how utterly unscientific and injurious such practice is. Dunham shows conclusively that HAHNEMANN was opposed to it, and that the very passages in his writings which have been quoted in favor of it, really, when correctly translated, prove the reverse.

The tenth, eleventh, and twelfth essays are on the vexed question of Potencies. Our author’s brief sketch of HAHNEMANN’S progressive views thereon is not so accurate as his statements usually are. The fact is that HAHNEMANN speaks emphatically of giving “small doses” in the very first essay he ever wrote on Homoeopathy, in 1796, and we know of no reliable evidence that he ever gave the lower potencies in his old age; indeed, the evidence of Croserio and Bönninghausen, who visited and corresponded with him till the very last, is directly opposed to such a view. (See Fincke’s work on “High Potencies”, which contains the best extant historical sketch of HAHNEMANN’S teaching as to the potency and the dose.) The practical question, however, our author treats with great clearness; he simply appeals to facts, and quotes the experiments of Eidherr, in pneumonia, extending over a period of ten years. Eidherr treated in all one hundred and seven cases; for the first three years, he gave all the 30th decimal potency; during the second three years, the 6th decimal; and during the remaining four years, the 15th decimal. He found that the 30th potency cured more rapidly than the 15th, and the 15th than the 6th; even though comparative researches at other hospitals in the neighborhood showed that the first period was the most unfavorable to pneumonia, and the second the least so. So striking indeed are Eidherr’s comparative experiments, that the

Anti-Hahnemannians are usually seized with a convenient forgetfulness of them in their discussions on the subject. Dr. Dunham names many others who have borne testimony to the superior efficiency of the high potencies, even those whose previous bias had been towards the lower ones; and concludes by expressing his own decided preference for them, with which he relates some striking cures.

Nevertheless, he does not fail to inform us of certain facts which might seem to warrant at times an opposite conclusion. He quotes five cases, cured or relieved with the low potencies after the high had failed. If this is all, we may well say, Exceptio probat regulam, but we question whether even these are real exceptions at all. HAHNEMANN says that the reason why many prefer the lower potencies is because their remedies are not perfectly homoeopathic. Let us apply this test to these five cases. (1) Dr. Black relates a case of headache where Lachesis 30 only produced symptoms of nervous disturbance, while Lachesis 6 cured. But as no detailed account of the symptoms is given, we cannot tell whether the Lachesis was really indicated or not; it must have been a simile, but there is no proof that it was a simillimum. (2) The late Dr. Trinks quotes a case which, he says, he cured with the mother tincture of Rhus; after HAHNEMANN himself had in vain treated it with high potencies of Rhus for nearly two years. This is indeed an important case, and one which seriously reflects on HAHNEMANN’S skill; but we take the liberty of doubting it altogether. In the first place, we have heard it differently quoted, viz., that Trinks only imagined, from the symptoms, that HAHNEMANN had given Rhus; and, secondly, we do not consider Trinks a reliable witness. Dr. C. Hering, in the preface to his proving of Cistus Canadensis, has convicted Trinks of deliberate falsehood with regard to a portion of the Materia Medica; and this, coupled with Trinks’ well-known hatred towards HAHNEMANN’S teaching, prevents us from placing the slightest credence in any of Trinks’ statements, until confirmed by trustworthy observers. In fact, we can only class his assertion with the anonymous editorial endorsement of an anonymous writer in a professed Homoeopathic publication, that somebody (anonymous also) had told him that

HAHNEMANN, in his later years, prescribed castor-oil as a purgative!

“Somebody told me that someone said,

That somebody else had somewhere read,

In some newspaper, you were somehow dead.

‘I’ve not been dead at all,’ said Jack Robinson !”

(3) Dunham quotes a case of his own, where Glonoine 6 relieved after 200 had failed; but, as he adds a note to say that the symptoms subsequently returned and proved incurable, the case counts for nothing. (4) Arnold gives a case of psoriasis cured with Arsenic 3 decimal and 2 decimal, after 6 decimal and 4 decimal had failed. We fail, however, to find the symptoms of this case under Arsenic, in Allen’s Materia Medica, and therefore conclude that the remedy was only approximately homoeopathic to the case; hence the failure to cure, except in large doses. (5) Arnold gives a case of polypus of the nose, cured by Lime-water in large doses, after Calcarea 4 decimal and 2 decimal had failed. We are surprised to find so acute an observer as Dunham fail to notice that Calcarea (especially HAHNEMANN’S preparation thereof from the oyster-shell) is not the same chemical compound as Lime-water; therefore this cure was by a different, remedy, and not a different potency.

Our space will not permit a further detailed review of the other essays. Suffice it to say, that they are of great value, some treating on certain interesting cases, and others on remedies. We would advise the reader always to refer to the Table of Contents, and note the date at which each essay was written. By so doing, he will clearly see the progressive advance in Dunham’s mind. Thus in his “Diagnosis in Homoeopathic Practice, with Compilations from Kaspar’s Lectures”, written in 1854, we find him saying, “Neglect to distinguish between these varieties of symptoms (idiopathic and symptomatic) has led compilers of manuals to recommend Cina in hydrocephalus.” Here Dunham fell into error, being led astray by the pathological ideas of Kaspar. Cina should be given in hydrocephalus, or any other “disease”, if the symptoms of the patient indicate it. Ten years later, however, we find Dunham plainly stating that it is impossible to base Therapeutics on Pathology, and quoting with approval the dictum of an Allopathic

Professor (who had advanced far beyond some of the professed Homœopaths of the present day), “Gentlemen, we have to do with patients, and not with diseases.”

We candidly recommend this book to all; there are none, whether of the Homoeopathic or Pathological School, who may not derive benefit from its perusal. It is, moreover, a book for the people. The intelligent portion of the public are, as is evidenced by our subscription-list, investigating. Homoeopathy; to these we especially recommend this volume, not only on account of its general accuracy, but also on account of its lucid and readable style.

In conclusion, to those who forget that “liberty is slavery to law”, provided the law be true and just, and wander away from Homoeopathic certainty into Eclectic guess-work, lest they should be thought narrow-minded, we quote the following sentence from our author :

“If, then, we, from our little experience of fifteen, or ten, or five years, appeal to HAHNEMANN, with his venerable experience of more than fifty years of active practice; with his unapproachable knowledge of the Materia Medica, of which he might justly say, like .Æneas, ‘magna pars fui;’ with his unrivalled powers of observation and discrimination; if we appeal to him as authority on this question, at once practical and scientific, can it justly be said that we are seeking some ‘authority outside of and beyond our own reason’? Our colleague appeals to ‘collections of facts.’ Is not HAHNEMANN’S statement of his practical conclusions a most stupendous collection of facts.’ Who ever observed so many of them? Who ever observed so well as he? Facts must be received on testimony; who ever reported more graphically or faithfully than HAHNEMANN? If we doubt his ability, his capacity, his candor, what are we doing with his Materia Medica, on the truth of which we risk our patients’ lives? This outcry against ‘swearing in the words of the Master’ has come to have a very different meaning from that of the original ancient protest. It was never meant to intimate that the opinion and testimony of him whose abilities had crowned him king of men,’ should not have a royal weight of influence.”

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