NEMANN FOUNDER A 574690 ERAPEUTICS 513 H15 35 UDGEON. GOULD & SON AHNEMANN. THE FOUNDER SCIENTIFIC THERAPEUT) BY R. E. DUDGEON, MD). ARTES 1837 SCIENTIA LIBRARY VERITAS OF THE UNIVERSITY OF MICHIGAN E. PLURIBUS UNUM SI-QUAERIS PENINSULAM AMOENAM CIRCUMSPICE ༦ 挣 ​H610.9 415 85 HAHNEMANN, THE FOUNDER 67. OF SCIENTIFIC THERAPEUTICS. Being the Third Hahnemannian Lecture, 1882. RUEV BY RE. DUDGEON, M.D. = Nec fas est propius mortali attingere divum. London: E. GOULD & SON, Chemists by Appointment to the London Homeopathic Hospital, 59, MOORGATE ST., CITY, E.C. And all Homeopathic Chemists and Booksellers 1882. 1 J WRIGHT AND CO. PRINTERS, BRISTOL, En Memoriam. The London School of Homeopathy may almost be said to owe its existence to Dr. William Bayes. As its first honorary Secretary, he worked zealously and un- remittingly to place it on a sound financial basis. In this he succeeded beyond ex- pectation. His earnestness and the charm of his manner won over to the cause of the School a large number of supporters, both lay and medical, and his pre-eminent administrative faculty moulded it into its present form. The project of an annual Hahnemann lecture, and its publication for distribution among the Governors of the School, was eagerly adopted by him. While these pages are passing through the press, the sad news of his untimely death reaches me. I may be permitted to dedicate this lecture to his memory, and to the remembrance of a friendship of many years' standing, which was never inter- rupted by any differences of opinion we may have had respecting the best measures for promoting the usefulness of the School. December, 1882. HAHNEMANN, THE FOUNDER OF SCIENTIFIC THERAPEUTICS. Man, as the minister and interpreter of nature, does and understands as much as his observations on the order of nature, either with regard to things or the mind, permit him, and neither knows nor is capable of more."-Nov. Org., aph. 1. GENTLEMEN, Hahnemann has been dead nearly forty years. He now belongs to history. We occupy the position of posterity in relation to him. We can view him in perspective, and can estimate him in comparison with the great medical per- sonages of the past. We are now able I 1 2 Hahnemann, the Founder to fix accurately his place in the history of medicine. In this lecture I shall endeavour to show what that place is. To this end I must cast a retrospective glance over the past. As a preliminary, I will ask, what is the aim and object of medicine? It is the cure of disease. As Hahnemann expresses it in the first aphorism of his Organon, "The high and only mission of the physician is to restore the sick to health." It is necessary to remember this, for it has often been forgotten by some of the most illustrious names in the history of medicine. Anatomy, phy- siology, pathology, botany, chemistry. and all the other so-called collateral branches of medical science, are but the means to the end-that end being the of Scientific Therapeutics. 3 cure of disease. But the means have often been cultivated as though they were the end; and their cultivators are wont to look down on the therapeutist, as though the cure of disease was but a poor thing in comparison with the study of disease as a branch of natural history, or with physiological or anatomical re- search. It is impossible to say when or to whom the idea first occurred that dis- eases could be cured by drugs. In the first edition of the Organon, §7, Hahne- There must be in medicine mann says: a healing principle; common sense tells us this." But to the common sense of many there is no must" about the matter. Unless we had been told that medicines have a "healing principle," 4 Hahnemann, the Founder we should scarcely have suspected it. On the contrary, seeing their uncom- fortable effects when we swallow them, we might easily come to consider them, and class them among disease-producers rather than disease-removers. That, how- ever, medicines were believed to possess a healing principle from a very early age is sufficiently obvious. We may suppose the belief to have originated in this way: Primitive man seeing animals eating the herbs that grew about, would imitate these creatures. Some herbs he would find nourishing and good; others, he would observe, made him more or less uncomfortable and ill. These he would note and set aside. When attacked by disease, which he would endow with a personality or entity, as he did all the of Scientific Therapeutics. 5 forces of nature, the idea might occur to him, that as those herbs gave him a good scouring out, he might, when sick, eject his troublesome disease by taking what would make him vomit, or purge him, or give him a thorough shaking, and if his disease left him post hoc, he would ascribe it to propter hoc, and re- commend it to all his similarly affected friends. The earliest historical records we possess are probably the votive. tablets preserved in the temples of Esculapius. Pious persons who had been cured, or thought they had been cured of diseases, used to hang up tablets in their temples, recording their name, their disease, and the treatment they imagined had cured them. In this way medical facts were accumulated, 6 Hahnemann, the Founder and patients visiting these temples might, from a study of these votive tablets, be enabled to cure their own diseases by the same means. Ομοιον πάθος, ὅμοιον páрμакov, as they used to say, ie, for a like disease a like remedy, and thus an em- pirical therapeia was gradually formed. But it could hardly have led to much, there were so many chances against accuracy. The pious votary might have wrongly named his disease, or he might have been mistaken in his opinion as to what had cured him, or the patient who sought to profit by his experience might err in thinking he had the same disease, or might misapply the remedy. It is true the priests of Æsculapius were there to direct him, guided by the records of the tablets, but they would be just as of Scientific Therapeutics. 7 liable to err. So, on the whole, the gain to therapeutics from this system would be but small, and this method gradually fell into discredit, though it still survives. among the learned under the name of usus in morbis, and, with modifications, occupies the chief place in the domestic medicine of the people. When medicine came to be cultivated as a special profession, the primitive empiricism of the Esculapian priests was scorned by the race of learned phy- sicians, and hypothesis and speculation were employed to determine the nature of diseases and the virtues of medicines. Diseases were classified as dry and moist, hot and cold, and medicines were arranged in similar classes. Dry dis- eases were treated with moist remedies, 8 Hahnemann, the Founder hot diseases with cold remedies, and But this classification was vice versa. purely arbitrary and fanciful, and had no foundation in nature; and yet it lasted through many ages, and was not extinct in the end of the eighteenth century, when Hahnemann commenced his researches. With the increase of scholastic learning the simplicity of the ruder ages of medicine gave place to scientific complexity. No prescription was considered complete or secundum artem that did not contain at least a base, an adjuvant, a corrigent, and an excipient, and the greater the number of ingredients that could be introduced into the composite remedy, the better satisfied was the prescriber. As pa- thological theories changed so did pre- of Scientific Therapeutics. 9 scriptions. But it mattered little what pathological theory was in the ascendant, prescriptions remained as complex and irrational under one regime as under another. The vitalist and the humoralist found reasons equally plausible for bleed- ing, purging, and blistering, and for writing long prescriptions containing often several dozens of medicines more or less powerful, which only failed to poison the patient because the ingre- dients were mutually antagonistic, or because the prescription contained some powerful emetic or purgative that quickly swept the whole of the poisonous rubbish out of his system before it had time to do much harm. It is astonishing that the faith in drugs lasted so long among physicians as it did. Up to the date of IO Hahnemann, the Founder Hahnemann's discovery, and, indeed, long afterwards, we find the foremost representatives of medicine gravely pre- scribing these wonderful compounds, and repeating without hesitation the hypo- thetical fictions regarding the virtues of drugs that had been current since the days of Dioscorides. The prescriber's art seems to have attained the climax of complex absur- dity shortly before Hahnemann's days. A work published in 1683—¿.e., at a time not more distant from the initiation of Hahnemann's reform than the latter is from our day-gives us a detailed ac- count of the therapeutics of that time. It is entitled Doron Medicum, or a supple- ment to the New London Dispensatory; its author is William Salmon, Professor of of Scientific Therapeutics. ΙΙ Physick. We there find long lists of primary and secondary alteratives; pur- gatives, divided into choler purges, phleg- magogues, melanagogues, hydragogues, and holagogues. Then medicines are classified by their temperaments. "All medicines," we are told, "simply con- sidered in themselves, are either hot, cold, moist, dry, or temperate." Then follow lists of medicines: temperate; hot in the first degree, hot in the second degree, hot in the third degree, hot in the fourth degree; cold in the first degree, &c.; dry in the first degree, &c.; moist in the first, second, third and fourth degrees. Next, medicines are classified according to their "appropriation," as cephalicks, pectorals, cordials, stomachi- cals, hepaticals, nephriticks, spleneticals, 12 Hahnemann, the Founder hystericals, arthriticals. Then hot medi- cines are arranged into those heating the head, the breast, the stomach, the heart, the liver, spleen, bowels, veins, womb, joints. Cold medicaments are arranged into those cooling the same organs. Again, medicines are classified according to their properties, as emollients, relaxers, rarifiers, aperitives, attenuaters, astrin- gents, attractives, repercussives, discus- sives, cleansers, anodyns, narcoticks, carminatives, diaphoreticks, alexiphar- micks, pyroticks, suppuratives, sarco- ticks, glutinatives, epiloticks, diureticks, emmenagogicks, traumaticks, cosmeticks. Purging medicaments are: catharticks, emeticks, diureticks, sudorificks, pter- micks, salivaticks. They are further di- vided into medicines purging choler, of Scientific Therapeutics. 13 flegm, melancholia, water, all humours; by vomit, by urine, by sweat, by the nose, by the pallate.* The following are some of the queer remedies physicians prescribed and their patients swallowed in all faith- CC Quinta Essentia Bufonum Fabri, Faber's Quintessence of Toads.-R. Toads in great numbers in the month of June, hang them up and dry them in the sun, then calcine till the ashes are white, from which, with Carduus or Scabious water, or water of Limon-Peels, ex- tract a Salt to the highest whightness: mix, and keep this Salt with Treacle water. There are some which order this Quintessence to be made with the distillation of live Toads; but Faber affirms that water to be the highest poison, and, from its Volatile Spirit, to kill by its odour. This salt is one of the chiefest Anti- dotes against Poison, resisting all Venom to a wonder." (C Quinta Essentia Ossium Humanum Fabri. Quintessence of Mans Bones.-R. Mans bones The spelling of the original is retained. 14 Hahnemann, the Founder in gross powder (and infused in generous wine for 8 days) of which make an Oyl per descensum, which rectify by a seavenfold distillation in a Retort. The fæces or Caput Mortuum calcine in a strong fire, from which Calx, with boyling water, extract a Salt, which purify and make white; then conjoyn it with its afore-prepared Oyl, and digest, that they may be perfectly incorporated. This will be best and most effi- caciously done, at Sol his entrance into Aries, which is about the tenth day of March every Year. The same ought to be observed in making the Salt of Mans skull, with sweet Spirit of Vitriol. There is nothing in Rerum Natura more powerful than this Balsam in curing and taking away all manner of arthritick pains and torments. It speedily takes away all kinds of rottenness, and corrects every other vice of the Bones. Let it be applied warm in manner of a Balsam, with Lint, to the part affected. The Potestates Cranii Humani is a similar prepara- tion employed chiefly for the cure of Epilepsia or Falling Sickness.” I need not waste time by giving the details for the preparation of Pulvis Vi- perinus or Powder of Vipers, a specifick against Scabs, Itch, Morphew, Breakings of Scientific Therapeutics. 15 out, Erysipelas and Leprosies, and many other diseases, nor those for making the Balsamum ad Cancrum, containing, amongst other choice ingredients, Mum- my, Powder of dryed Toads, and Oyl of Soot. I shall pass on to- (C Unguentum Sympatheticum, The Sym- pathetic Oyntment. R. Bears Grease, the Brains of a Boar, Powder of washed Earth- worms, red Sanders, Mummy, Bloodstone, ana, zi; Moss of a dead Mans Skull, not buried, 3j; make an oyntment according to Art. Or thus according to Barbet (which he affirms to be the best description): B. Oyl of Roses, fine Bole, ana, 3j, Oyl of Linseed 3 ij, Moss of a dead Mans Skull, Mans Fat, ana, zij, Mummy, Mans Blood, ana, ss. Mix and make an Oyntment. All wounds are cured by this Oyntment (pro- vided the Nerves and Arteries, or some of the principal Members be not hurt) thus: Anoint the Weapon that made the Wound daily once, if there be need and the Wound be great, other- wise it will be sufficient to anoint it every other day. When note, I. That the Weapon be kept 16 Hahnemann, the Founder in clean Linnen, and in a temperate heat; for if the dust fall, or Wind blow upon it, or it be cold, the Sick will be much tormented; so also if it be kept too hot. 2. That if it be a stab, the Weapon must be anointed towards the point descending. 3. That if you want the Weapon, take Blood from the Wound upon a stick, and use it as if it were the Weapon. Thus the Tooth-ache is cured by pricking the Gums and anointing the Instrument." Many other medicines of a too dis- gusting character to be named to ears polite are described in this book, and the most marvellous healing virtues attri- buted to them.* Directions are given *As this lecture was delivered to an audience presumably consisting of medical persons and students, whose minds are case-hardened by their studies to all nastiness, I made no concealment as to the nature of these revolting remedies. But a valued friend and colleague has reminded me that the lecture, in its printed form, is for general distribution among the Governors of the School, who are not all medical men, nor yet all men, but the reverse; and that, therefore, it of Scientific Therapeutics. 17 1 for preparing amulets to protect the wearer from the plague and other ma- lignant diseases, and full particulars are given for making the Universal Medi- cine, which ought to have rendered all others superfluous. The book in which these ridiculous and often loathsome remedies are grave- ly described and seriously recommended was published thirty-seven years after the death of Bacon, twenty-five years after the death of Harvey, during the life of Sydenham and Boerhaave, and only twenty-five years before the birth of Cullen. might be as well not to call a spade a spade, but to employ some such euphemistic para- phrase as “horticultural implement.” On the whole, I think it best to omit the description of the spade altogether, for fear it might be thought to bear too great a likeness to a graip. 2 Uor M 18 Hahnemann, the Founder It may perhaps be thought that the work I have been quoting from contains. the vagaries of an eccentric, and that such filthy medicines as he describes were peculiar to himself. But this is not so. The writer was a learned phy- sician, the author of many other works on medicine, chemistry, botany and astrology. We find, besides, that almost all the objectionable ingredients of his prescriptions have formed the subjects of learned essays and dissertations by his contemporaries and successors far into the eighteenth century. Those curious in these matters will find in the great Dictionary of Materia Medica of Merat and De Lens, numerous rc- ferences to works published in all countries of Europe extolling the me- of Scientific Therapeutics. 19 dicinal virtues of the most repulsive substances. I do not suppose that these loathly and grotesque remedies were patronised by Stahl, Hoffmann, Boerhaave, Haller and Cullen, the great medical authori- ties of the eighteenth century, to which Hahnemann belonged; but medicine has never been practised solely by great men, and it was long before their half-hearted teachings of an unprincipled therapeia exercised much influence on the practice of the rank and file of the medical pro- fession, as they could give no more rea- son for the remedies they proposed than against those they denounced. Down to a very recent period some of the most repulsive remedies were employed by physicians of high standing, and though 20 Hahnemann, the Founder most of the filthy compounds I have alluded to without naming (for fear of shocking my readers) were eliminated from the published works on Materia Medica, some of them still retained their reputation among individual practitioners, even to our times. From want of a guiding principle for ascertaining the curative properties of medicines, thera- peutics had degenerated into a senseless farrago of uncleanness and absurdity, a caput mortuum of inert rubbish, a cess- pool of filthy abominations, and a tor- ture chamber of painful and noxious appliances. But though some of the grosser elements were discarded by the contemporaries of Hahnemann, the the- rapeutics of his time and for many years afterwards remained as irrational as ever. 替 ​of Scientific Therapeutics. 21 When, in 1796, he first tentatively put forward the idea that, in the treatment of chronic diseases, medicines might be given on the similia similibus principle, and when he launched his system per- fectly excogitated, in his Organon, in 1810, no sign had been given by the chiefs of the medical schools that they thought that complex prescriptions were irrational, that inflammations were not best treated by blood-letting, that fre- quent purgation was not eminently con- ducive to health, in spite of the wise saying of Sauvages "nil magis nocet quam repe- tita evacuantia," that alteratives—mean- ing thereby, generally, mercury pushed to salivation-were not scientific remedies, or that painful processes under the theo- retical name of "counter-irritants" were 22 Hahnemann, the Founder not indispensable curative agents. Ho- mœopathy was not "in the air" when Hahnemann wrote about it, nor, I may say, for many years after the Organon appeared. Thirteen years after the publication of the Organon, a new medical periodical was set up in London, and it took the title of The Lancet, as though blood-letting was the chief of remedies. The earlier editions of Sir Thomas Watson's great work on the Practice of Physic recommended blood-letting for everything inflammatory without a doubt as to its excellence. Even in 1858 he says about peritonitis, "It is of great importance that blood-letting should be performed early. After a full bleeding from the arm, such as has produced some sensible impression upon the cir- of Scientific Therapeutics. 23 culation and brought the patient to the verge of syncope, the surface of the belly should be covered with leeches- from 20 to 40 may be applied at once." But in the same edition he makes an exception in the case of pneumonia : "Years have passed by since I have met with any instance of that disease which has required blood-letting. I may say the same of inflammatory diseases in general. They have all become less tolerant of blood-letting since the cholera swept over us in 1832." It is not easy to understand how the sweeping over us of the cholera should render pneu- monia and inflammatory diseases less tolerant of blood-letting; but, as the celebrated article by Sir Daniel Sand- ford on "Homöopathie" appeared in the 24 Hahnemann, the Founder Edinburgh Review in 1830, and as, about the same period, the practice of homoeo- pathy was introduced into Britain, and began to be much talked about, it is more likely that the "sweeping over us" of homœopathic knowledge, rather than of the cholera, made patients less tolerant of blood-letting, and so doctors had to give it up; and as they found that diseases did better without it, they had to alter the teachings of their text books accordingly, and they had to in- vent some other reason for their altered practice, and the "sweeping over us of cholera," or the "change of type of dis- ease" served to save their dignity and excuse their change of front. But that was not till many years after the publi- cation of the Organon. of Scientific Therapeutics. 25 I Hahnemann gradually led up to his finished method by a careful examina- tion of all the systems of therapeutics that had previously been advocated. say, "all" the systems, but indeed, they were only two in number, viz., the treat- ment of disease by medicines having an action contrary to the disease, and that by medicines having an action different to the disease. He showed that these were irrational, futile, and when not use- less, pernicious. He demonstrated by reasoning and experimental proof that the true rule of drug selection, was to employ in a disease a medicine whose pure effects on the healthy body were similar to the phenomena of the disease to be cured. This was not a theory but a logical deduction from observed facts 26 Hahnemann, the Founder arrived at in the true experimental way. : Thus certain diseases were known to be curable by certain medicines. These medicines he tested on himself and others, and found that they caused mor- bid states, closely resembling the diseases they were known to cure. He did not jump to this conclusion from his one experiment with cinchona bark. That experiment set him thinking and led him to other experiments with other drugs. After six years of patient reflec- tion and experiment he suggested that the administration of medicines accord- ing to the rule similia similibus curentur might be the best method of treating chronic diseases-acute diseases might still be best treated by the contrary or palliative method. His suggestion fell of Scientific Therapeutics. 27 unheeded by the great and the small men of the day. They were quite con- tent with their old and traditional methods, their bleeding, blistering, purg- ing, salivation and complex prescrip- tions. Hahnemann, nothing daunted, went on with his experiments, and nine years later published a work in Latin On the Positive Effects of Medicines, partly ascertained by experiment on himself and the members of his own family—for as yet he had no disciples— partly culled from the records of poison- ing and observations of the effects of drugs in the writings of medical authors. At the same time he published that re- markable work The Medicine of Expe- rience. Fortified by his nine years of diligent experimentation with medicines, 28 Hahnemann, the Founder in order to ascertain their pathogenetic powers, and his equally long trials of the curative powers of medicines given. on the similia similibus principle, he felt himself justified in declaring this thera- peutic rule to be of general application, and the use of palliatives to be limited to tiding over temporary difficulties, such as apparent death from freezing or asphyxia, and hysterical convulsions. He was practising at Torgau, a small town on the Elbe, at this time. Five years more of reflection and experiment enabled him to perfect his system to such a degree, that he published his great work, to which he gave the title of Organon of Rational Medicine, according to Homeopathic Laws (Organon der rationellen Heilkunde, nach homöopa- of Scientific Therapeutics. 29 thischen Gesetzen). Simultaneously with the appearance of this work he came to Leipzic, and the following year he pub- lished the first volume of the Materia Medica Pura. The actual provings in this volume were made by himself alone, probably assisted by some of the mem- bers of his family. But he was now in a famous university town, where there were many medical students, some of whom he might hope to get to assist him in his gigantic undertaking, the con- struction, namely, of a materia medica which should contain nothing but the ex- perimentally ascertained positive effects on the healthy human body of the medicines treated of. Such a thing had never before been attempted, nor even suggested-unless we are to consider the 30 Hahnemann, the Founder oft-repeated quotation from Haller as a suggestion. Hahnemann felt that his own unaided provings would not suffice to furnish the ideal materia medica his therapeutic system required. The art was too long and his single life too short. for such a task. He must have the assistance of intelligent co-operators, who were convinced of the truth or at least of the reasonableness of his thera- peutic rule. How to get these zealous. co-operators was the problem. If he could become a teacher of medicine as he understood it, he might succeed in convincing a class of students of the truth of his rational therapeutics, and enlist them in his work. He applied to the authorities of the Faculty of Medicine of the University for permission to teach of Scientific Therapeutics. 31 medicine. He was informed that he would only be allowed to do this by passing an examination and defending a thesis before the Faculty of Medicine. He willingly complied with these condi- tions. He wrote a thesis on the Helle- borism of the Ancients, which was so excellent, that when he came to defend it before the Faculty, his examiners could find no fault with it, and were forced to acknowledge its superlative merits. Having thus obtained the licence to teach, he soon collected around him a class of enthusiastic young men, who entered heart and soul into his scheme, and aided him so effectually in his work of proving medicines that, between 1816 and 1821 he was enabled to publish five more volumes of his pure materia medica. 32 Hahnemann, the Founder The six volumes of this colossal work contain the positive effects of sixty- It constitutes a real four medicines. treasury of materia medica, displaying the accurately observed effects of medi- cines on the human body, without any alloy of hypothesis or conjecture. Such a materia medica had never been offered to the medical world since medicine had been cultivated as an art. It upset and rendered useless all the treatises and text books on materia medica that had hitherto passed current in medicine. These con- tained mere hypothetical or traditional accounts of the supposed virtues of medicines. Hahnemann's materia medi- ca, excluding hypothesis, recorded only the well-ascertained effects of medicines on the human body. Hahnemann's of Scientific Therapeutics. 33 provings were the necessary corollary to his therapeutic rule. Previous to his time a distinction had been made be- tween poisons and medicines. All drugs which were so powerful that they could not be given in ordinary doses without danger, were banished from the material medica, and those only that could be given in considerable quantities without much risk were allowed to be medicines. Hahnemann abolished this distinction. He said with Shakspeare, "in poison there is physic," and he might have said 'the stronger the poison the greater the physic." It will be observed that, during his stay in Leipzic, Hahnemann had no thought of separating himself from the established medical school. He qualified 3 34 Hahnemann, the Founder himself to be a teacher in that school in the usual manner. He gave lectures and formed a class of students in con- nexion with the existing Faculty of Medicine, and though the doctrines het taught were novel and original, he was quite within his legal right in teaching medicine as he understood it, and any medical teacher would do the same. During all this period he broached no theory either as to the nature of the dis- ease or the mode in which the cure was effected. He proved his medicines in substantial doses, and he reduced the dose of the medicine he administered for the treatment of disease, expressly in order to avoid the too violent effects of large doses. He varied his doses according to the nature of the medicine of Scientific Therapeutics. 35 and of the disease. When I say he broached no theory as to the curative action of medicines, I may be reminded that he held that medicines cured diseases by substituting a more powerful medi- cinal artificial disease for the weaker natural disease; but this, though appa- rently a hypothesis, was in fact a deduc- tion from what he believed he observed in every case in which a medicine acted curatively, viz: that it caused an appa- rent aggravation of the natural disease. We may believe he was mistaken in this, and probably he may have got the idea from a statement of John Hunter, as Dr. Fredault supposes; still it was a legitimate deduction from what he be- lieved to be facts-but which we now think we have found not to be facts—a 36 Hahnemann, the Founder logical inference from the premises, only we now hold these premises to have been However, this is a matter of unsound. quite secondary importance. The great central truths of Hahne- mann's teaching up to the time when he was driven from Leipzic by the hostility of his colleagues, were these: the de- monstration by reasoning and proof of the truth of the therapeutic rule similia similibus curentur-let likes be treated by likes; the necessity for ascertaining the effects of medicines on the healthy human body; the administration of medicines in disease singly and alone, and in the precise form in which they had been proved; the diminution of the dose for the purpose of avoiding its too violent action. There is nothing theo- of Scientific Therapeutics. 37 retical here, all these maxims are de- rived from observation and experience; conjecture and speculation have no part in them. No theory of disease or of medicinal action is involved in the therapeutic rule ; the reasoning employed in its discovery is strictly logical. Certain medicines are known to cure certain diseases, these medicines, when tested on the healthy human being, are found to cause morbid states similar to the diseases they cure. This is found to be the case with all medicines that have been subjected to trial; it is, therefore, so far as can be judged, a general rule that medicines that can cure diseases can produce on the healthy morbid states resembling those diseases; and, conversely, medi- 38 Hahnemann, the Founder Hence cines that can produce on the healthy certain morbid states can cure diseases resembling those morbid states. the therapeutic rule: in order to cure any disease select a medicine that can pro- duce a similar morbid condition on the healthy-similia similibus curentur—let likes be treated by likes. This is a prac- tical rule deduced from experience. Hahnemann first called his system the "Medicine of Experience." Then, as if to show its logical character, he called it "Rational Medicine," and later on simply "Medicine," or "the Healing Art," as though there were none other that de- served the name. To render it possible to apply this rule some one must undertake the heavy task of ascertaining the effects of medi- of Scientific Therapeutics. 39 cines on the healthy human body. Hahne- mann did not shrink from this herculean labour. For years and years he worked away silently and solitarily at the task of rendering the rule he had discovered of practical use. It was only after he came to Leipzic that he received any help from others. It was fortunate, in- deed, for homœopathy that he came to Leipzic, for had he lingered on in the pal- try little town of Torgau, he could never have attracted disciples around him able and willing to assist him, and homoeo- pathy might have remained in its initial stage-the revelation of the true rule for treatment, but incapable of being applied for lack of proper instruments. The single remedy was a necessity, for if medicines cured by virtue of their 40 Hahnemann, the Founder 1 power to produce certain morbid states on the healthy, they must be given in the same shape in which they had been proved to produce these morbid states. If given in combination with other medi- cines having different effects, or if given deprived of any of the constituents they possessed when they produced these mor- bid states, we could have no warranty that they would possess the power, under this new form or combination, of acting as they had acted when given singly and simply. If a chemist tells us that, ac- cording to the laws of chemistry, if we wish to produce a certain effect on a solution of carbonate of soda we must add a certain substance called tartaric acid, we would never be so foolish as to expect to obtain the same effect if we of Scientific Therapeutics. 41 I gave the tartaric acid in combination with other things, say, potash, magnesia, and nitre, even though we should learn- edly bestow on our additions the titles of adjuvant, corrigent and excipient, nor if we gave the carbonic acid alone, or the soda alone. The small dose was also a deduction from experience, which taught that the ordinary large doses act too violently. Experience taught that diseased parts of the human organism are more sensitive to the action of medicines having a particular affinity to them as evidenced by their causing effects on the healthy similar to those of the disease; just as a diseased organ is more sensitive to its ordinary stimulus than a healthy one; witness the excessive sensitiveness of 42 Hahnemann, the Founder the inflamed eye to light, of the in- flamed ear to sound, of the inflamed skin to touch. No theory, then, was required to justify small doses of the homœopathic medicine; they were the outcome of experience and observa- tion. We may say, then, that as long as Hahnemann remained in Leipzic at- tached to the Medical Faculty of the University as an extra-mural yet acade- mical lecturer and teacher of medicine, he presented his medical system in a truly logical manner, quite devoid of theory or hypothesis; indeed, in all his writings up to this time, he inveighs against theory and speculation in me- dicine. So utterly opposed was he to hypo- of Scientific Therapeutics. 43 thesis, that he ridiculed the idea of our ever obtaining a knowledge of the proxi- mate causes of disease. Thus in §§ 5 and 6 of the first edition of the Organon we read: It is allowable to think that (C every disease must depend on an altera- tion in the interior of the organism, but this can only be surmised by the reason from what the external phenomena reveal concerning it; but it is not in itself cognizable in any way whatever. The invisible morbid alteration in the interior and the observable alteration of the health in the exterior (symptom- complex) together constitute what is called disease; both make up the disease itself." This teaching is curiously empha- sized and expanded in the correspond- ing paragraphs of the second edition. 44 Hahnemann, the Founder thus: "It is allowable to think that every disease presupposes an alteration in the interior of the human organism. But this can only be dimly and delusively surmised by the reason from what the morbid symptoms reveal concerning it; but it is not in itself cognizable, still less infallibly cognizable in any way what- ever. The invisible morbid alteration in the interior and the alteration of the health of the exterior observable to our senses (symptom-complex) together con- stitute to the eye of Creative Omnipo- tence what is called disease; but the totality of the symptoms only is the side of the disease turned towards the physician; this alone is observable by him, and is the sole thing he can know, or needs to know, in order to enable of Scientific Therapeutics. 45 him to cure." We fondly think we know something more about the essence of disease now, and talk learnedly about increase and diminution of the inhibitory power of vaso-motor nerves, reflex action, cell-proliferation, bacilli, bacteria, and microbes, of which Hahnemann and his contemporaries knew nothing; but it is doubtful if we can improve on Hahne- mann's dictum, that we can only know diseases by their morbid symptoms. As our instrumental aids to diagnosis im- prove, we are able to make additions to our knowledge of symptoms; but the revelations of the stethoscope, the plexi- meter, the thermometer, the sphygmo- graph, the microscope, and chemical reagents, are merely additions to the sum of observable symptoms in disease; 46 Hahnemann, the Founder and the same methods must be applied to the investigation of the morbid states produced by medicines on the healthy, if we would keep pathogenesy abreast of pathology, and ascertain the most exact simile of the disease in the agents we employ for its cure. The more com- plete our knowledge of the artificial symptom-complex in medicinal diseases and of the natural symptom-complex in real diseases, the better shall we be able to employ medicines for the cure of diseases. Even should our improved methods enable us to determine with certainty the actual pathological changes in disease which they are far from having yet done-Hahnemann will still be right in saying that diseases are only cognizable by their observable morbid of Scientific Therapeutics. 47 symptoms, for it is only through the symptoms that we can infer the patho- logical state, or as he words it: "the invisible morbid alteration in the inte- rior." As far, then, as we are concerned the observable symptoms constitute the disease, and when we have ascertained everything about a disease by means of our senses, aided by all the instruments we can employ, we have ascertained the disease itself. This is no theory; it is a bare statement of fact. Thus, as long as Hahnemann lived in Leipzic, his teachings were free from hypothesis and speculation; he kept to the firm ground of observation and ex- perience, and made no excursions into the treacherous quicksands of conjecture. In fact, he constantly denounced specu- 48 Hahnemann, the Founder lation and hypothesis as will-o'-the-wisps leading only into the quagmires of un- certainty and self-deception. But Hahnemann was forced to leave Leipzic in 1821. He accepted from the Duke of Anhalt-Coethen an asylum in the petty capital of the petty duchy. He exchanged the pleasant and varied life in the literary and commercial capital. of the kingdom of Saxony for the dull monotony of a fifth-rate provincial town, whose inhabitants gave him no welcome, in fact, insulted him to such a degree that for years he never crossed his own threshold unless to visit his one patient, the Duke, but took the air in the narrow strip of garden attached to his house. In Leipzic he enjoyed a large and lucra- tive practice, where he had constant of Scientific Therapeutics. 49 opportunities of testing his method in all sorts of acute and chronic diseases. In Coethen he had actually no practice among the townsfolk, and never visited a patient, except his patron. The only practice he had was occasional consul- tations by letter, and a few rich patients, the subjects of chronic diseases who, at- tracted by the fame of his name, paid short visits to Coethen in order to consult him. He was no longer surrounded by the crowd of admiring disciples, whom he taught and with whom he used to work. almost every day, and who amused him every evening with cheerful conversation over pipes and small beer. He was now relegated to the society of his wife and daughters, excellent persons, no doubt, in their way, but not of much use to him 4 50 Hahnemann, the Founder in a scientific point of view. He was thus driven in upon himself, as it were, with plenty of time to cogitate on the meanness and injustice of the colleagues who had conspired to effect his ruin in Leipzic, and who would have rendered it impossible for him to earn his bread, had not the charity of an amiable prince offered him a paltry post with the mild dignity of Hofrath. Otium cum digni- tate he might now be said to possess, but the otium was torture to a man of his active mind and habits, and the dig- nitas was rather given than received by him. Deprived of his practice, torn from the society of his friends, no longer able to superintend an admiring circle of de- voted and enthusiastic fellow labourers in the construction of his indispensable of Scientific Therapeutics. 51 Ո Materia Medica, the sense of having been unjustly treated by colleagues, by whom he felt that he ought to have been honoured and respected, gnawing like a canker-worm at his heart; conscious as he was of having done more for scientific therapeutics than any physician of the past or present, of having found the way to truth in medicine and of having trodden it all alone;* in his enforced. solitude and isolation, as he grew old he took to the dangerous course of spinning hypotheses, which being uncorrected by discussion with other minds and inca- pable of being tested by experience at *"In these investigations I discovered the road to the truth, which I had to tread all alone, far away from the beaten highways of traditional medicine."-Preface to the first edition of the Organon. 52 Hahnemann, the Founder the sick-bed, he came to consider as truths of equal value with the great fundamental truth he had slowly and painfully elaborated by experiment and observation. We see this fatal tendency to speculation and dogmatism in the works and revised editions he published during his exile in this Patmos of Coethen. From a close and diligent observer of nature in the prime of his life, he became a seer of apocalyptic visions in his old age. Unmindful of what he had formerly said, that it was impossible to ascertain the pathological process that took place in the hidden interior of the organism, he now tells us that disease consists in an alteration of the vital force, which he seems to regard as a distinct entity. 7 F 53 of Scientific Therapeutics. 1 This notion of a vital force presiding over the functions of organic life is as purely a hypothesis as the archæus of Van Helmont, with which, in fact, it is iden- tical. I am far from denying the value of speculation, imagination or hypothesis in scientific matters when used to ex- plain observed facts, but there is always a danger of regarding a hypothesis as a proved truth; and if the hypothesis should be false, it will assuredly vitiate all the reasoning founded upon it. The hypothesis of a vital force is now gene- rally regarded as false, consequently a theory of disease founded on it can find no acceptance in the present day. When Hahnemann wrote, the vital-force hypo- thesis was a universal belief; so it may be said that Hahnemann was not to ! 54 Hahnemann, the Founder blame in adopting the belief. But, as a scientific man, he was to blame in adopting any belief at all. The true scientiate knows, he does not believe. He could not know that there was a vital force; he was not justified in be- lieving in the existence of what he could not know. He should have stuck to his original declaration, that what takes. place in the hidden interior of the or- ganism is unknowable, and remained faithful to his own maxim, that the phy- sician has only to do with observable and ascertainable phenomena, which in- deed is identical with the first aphorism of Bacon's Novum Organum. The idea of an immaterial vital force being the cause of diseases by its de- rangement, naturally led to the theory of Scientific Therapeutics. 55 that medicines, by the processes of tritu- ration and succussion, became divested of their material substance, and their powers thereby liberated; they became spiritual immaterial forces without a substratum of matter. And this idea he now promulgated, though he had formerly declared that, however much diluted, there must still remain some material stuff in the dilution. And the two opposite and conflicting statements stand side by side in the last edition of the Organon.* The hypothesis of the liberation of the spirit of the medicine by the phar- maceutical processes he employed, in the end suggested to Hahnemann this other * See § cclxxx, note, and § cclxxxvii, note. 56 Hahnemann, the Founder ! hypothesis that the power of the me- dicine was increased by dilution. To express this idea, "dilution" became (C dynamization," and it is curious to observe that, again side by side with this new idea of the increase of potency by dilution, the last edition of the Or- ganon retains the statement originally made in the first edition, that the power of a medicine decreases by dilution in a regular mathematical progression. In the solitude of his Coethen exile Hahnemann elaborated his wonderful theory of chronic diseases. He tells us that the subject had occupied him since the year 1816; but he never breathed a syllable of it, even to his most intimate. friends, until the year 1827, when he summoned to his side two of his most . of Scientific Therapeutics. 57 faithful disciples-Stapf and Gross-and to them he communicated his theory that all chronic diseases, excepting those produced by unhealthy surroundings, evil habits and improper medicinal treatment, were owing to three chronic miasms, sy- philis, sycosis and psora, the two former causing one-eighth, the latter seven- eighths of all chronic diseases. Similar views as regards the origin of many chronic diseases from psora had already been enunciated by Hoffmann, before. Hahnemann's birth, by Autenrieth in 1808, and by Wenzel in 1825; so the idea was not absolutely novel, and Hahnemann took it up and developed it to an extent undreamt of by his pre- decessors in this line. I will not attempt to show the plausibility of the theory, 58 Hahnemann, the Founder that has already been fully done by Henderson, in his reply to Simpson, by Dr. Hughes in this place, and by myself on a former occasion. I would only remind you that it is a mere theory, and as such inconsistent with Hahnemann's oft-repeated denunciations of patholo- gical theories and speculations. In 1828 Hahnemann published the first three volumes of his first edition of the Chronic Diseases. In the first volume this theory is set forth with great elaboration, and in the editions of the Organon published after this date, he introduced this theory of chronic diseases among his aphorisms. In the other two volumes he gave a number of pathogeneses of new medi- cines, which he termed "anti-psorics," this term involving another theory, viz.: : of Scientific Therapeutics. 59 that these medicines had a specific an- tagonism to the theoretical psora, which was again a departure from his former doctrine, that treatment should not be directed against the hypothetical cause of the disease, but against the actual dis- ease as revealed to us by its symptoms. Another innovation was introduced in the method he employed for ascertaining the pathogenetic effects of these new. medicines. They were not proved, like the former medicines in the Materia Medica Pura, by testing them on himself and his band of zealous co-operators. The symptoms recorded were all ob- tained by his own observations names of fellow-provers are mentioned. He could not and did not attempt to prove the new medicines on the healthy. no 60 Hahnemann, the Founder The symptoms he gives were those ob- served during the administration of these medicines to patients. What an uncer- tain, what an impure source this is, needs no argument to prove. It cannot be said that this mode of ascertaining the effects of drugs was exactly a novelty to Hah- nemann, for he indicates it already in the first edition of the Organon, & cxix: "But how we are able to discover the symptoms of the medicine even in dis- eases, especially chronic ones, among the symptoms of the original disease, is a subject of higher art, and should be left to masters in observation only." That he did not trust to this doubtful source for ascertaining the effects of his earlier medicines is sufficiently obvious; but we now find him employing it to the exclu- of Scientific Therapeutics. 6I sion of what in the previous paragraph he declares to be the most important method, viz.: trials of medicines on him- self by the accurately observing and unprejudiced physician. In Coethen also he fixed on the 30th di- lution as the standard dose of every ho- mœopathic medicine, for every disease, in every constitution, at every age. He says he was led to select this dose by innumer- able experiments. But as his experiments would require to be made with every di- lution, in every disease and at all ages, it is obvious that no man's life would be long enough to test even one medicine in this way; especially when it is re- membered how various are the charac- ters of every case of a disease called by a particular name, how diverse are the 62 Hahnemann, the Founder idiosyncracies of patients, what a differ- ence of sensitiveness is to be met with among them. We must therefore regard Hahnemann's dictum, that the 30th di- lution is the best in every case, as an arbitrary maxim, not founded on expe- rience, and therefore purely hypothetical. In the first edition of the Organon he laid it down as a rule for the dose that it should be so small as just to be able to cause a slight apparent aggravation of the disease. But this was evidently an impossible problem, as no one could have gone on trying all kinds of doses in a disease until he found the one that caused a very slight apparent aggrava- tion, more especially as, with all possible. attention and even expectation, there are few who have ever observed this so- of Scientific Therapeutics. 63 called "homœopathic aggravation in disease from any dose, great or small. Nor is there any reason for diluting medicines at all, if we are to accept as true what Hahnemann tells us in the last edition of the Organon, § cclxx, note, viz: that precisely the same medi- cinal power can be communicated to an undiluted medicinal solution by con- tinuous shaking for half an hour, as by diluting it up to his standard limit. “I dissolved," says he, "one grain of soda in one ounce of water mixed with alcohol in a phial which was thereby filled two- thirds full, and shook this solution con- tinuously for half an hour, and this was in dynamization and energy equal to the 30th potency." Were this so, the homœopathie pharmacy would be very Ι 64 Hahnemann, the Founder much simplified. There would be no sense in expending time and labour in making dilutions through thirty phials with accurately measured quantities of alcohol. One grain of the crude drug dissolved in an ounce of fluid and shaken continuously for half an hour would fur- nish us with a preparation precisely similar in potency to the standard 30th dilution. Unfortunately, as we cannot help per- ceiving, Hahnemann, during his residence in Coethen, was too apt to accept as truths many speculations of his own, and even some crude suggestions of others, the accuracy of which he did not suffi- ciently test. Thus we find him in 1833, when preparing for the press the last edition of the Organon, eagerly accepting of Scientific Therapeutics. 65 Ægidi's proposal to give medicines no longer singly and alone, as had hitherto taught, but in combinatòn ; and it was only owing to the remon strances of some of his oldest disciples that he refrained from adding a para- graph recommending these double-re- medies (Doppelmittel), the admission of which would have been a serious mis- fortune to homœopathy, and a complete departure from his former teachings. A careful consideration of Hahne- mann's writings during his period of banishment in Coethen forces on us the conclusion that his expulsion from Leipzic was an unmitigated misfortune for homoeopathy. It was during this period that he introduced all those sur- prising doctrines that have rendered his 5 66 Hahnemann, the Founder system so repugnant to the intelligence of educted physicians. He then aban- dond the safe and fruitful path of obser- ation and experiment for the hazardous and unprofitable way of speculation and hypothesis, the folly of which he had previously demonstrated. He adopted the hypotheses of disease being a de- rangement of the vital force; of the spirit of a medicine being liberated from the matter; of the increase of power of a medicine by trituration and succussion; of the origin of chronic diseases from three fixed miasms; of the antipsoric power of certain substances, and of a certain dilution being the appropriate dose for all medicines in all diseases. Had Hahnemann remained in Leipzic, attached as an office-bearer, a lecturer, of Scientific Therapeutics. 67 a sort of extra-mural professor in the Medical School of that city, engaged in extensive practice among patients of all sorts, surrounded by an attached circle. of intelligent students and practitioners, his mind not embittered against his me- dical brethren by their injustice and persecution, we may safely say that he would never have abandoned his original method of investigation and observation. and his Newtonian boast: "hypotheses non fingo." The hypotheses he spun out of his imagination in his solitary old age. at Coethen would probably never have occurred to him in his busy Leipzic life, or, at least, they would have been sub- jected to the wholesome criticism of a number of intelligent and independent minds, and their hollowness exposed in 68 Hahnemann, the Founder the fierce fire of discussion. The grand truths of his immortal discovery would. have been cultivated with assiduity. The evidence in favour of the excellence of his therapeutic rule would have been mul- tiplied and assured. The acquisitions of pathology and physiology would have been utilized in the reformed therapeutics, the improved methods of research would have been applied by him to both na- tural and medicinal diseases. Rational therapeutics would have been engrafted on medical science. Hypothesis and speculation would have found no place in the new therapeutics, or, at least, they would have been kept within due bounds and not elevated to a creed. The dog- matism and intolerance that are SO conspicuous in the writings of the sep- of Scientific Therapeutics. 69 tuagenarian hermit would never have been developed in the society of sharp- witted and independent companions. Homoeopathy would have remained what Hahnemann originally declared it to be, "rational medicine" par excellence, and its practitioners would not, as now, be handicapped in medical controversy by having to defend, explain away or repudiate a number of crude speculations which are not of the essence of ho- mœopathy, but which are clustered like parasites around that great therapeutic discovery, and which serve only to hide its fair proportions by their unwelcome obtrusiveness. It is no doubt true that Hahnemann insisted on his hypothetical doctrines being accepted as of equal certainty and } 70 Hahnemann, the Founder i value with his doctrines that are founded on experience and reason; but we are not bound to accept them, or to accept anything that has not been proved and is incapable of experimental proof, and is not satisfying to our reason. Now the soundness of the therapeutic rule similia similibus curentur is capable of proof, and has been experimentally proved thousands of times, and it commends itself to our reason. The proving of medicines on the healthy, the single rc- medy and the small dose are necessary corollaries to the therapeutic rule; but the homœopathic aggravation, the dyna- mization of medicines by pharmaceutic processes, the origin of seven-eighths of all chronic diseases from one miasm, the antagonism of certain drugs to the fan- of Scientific Therapeutics. 71 ciful psora, the possibility of ascertaining the pure effects of medicines by giving them in small doses to the sick, the identical dose of all medicines in all diseases-all these teachings may bear the stamp of genius and show great originality of mind, but that is not the question. We have to determine if they are true by an appeal to experience and reason, as we appealed to experience and reason in the matter of the thera- peutic rule, similia similibus; and if they do not stand the ordeal, we must reject them, even though they be Hahnemann's teachings-magis amica veritas! Hah- nemann did not submit these, his later teachings, to the ordeal of discussion and experiment. His disciples have done this, and have more or less rejected 72 Hahnemann, the Founder the hypotheses of the Coethen period. But the rejection of what is hypothe- tical in Hahnemann's teachings does not affect that which is practical and experimental. His discovery of the general thera- peutic rule, similia similibus curentur, his immense and self-denying labours to render the application of this rule pos- sible by proving medicines on himself and others, so far excel all that had previously been done for therapeutics, that the heroes of medicine of ancient and modern times sink into insignifi- cance beside him; indeed, disappear altogether from the field of therapeutics; and it is a case of Hahnemann first, the rest nowhere. What, let me enquire, have the greatest of Scientific Therapeutics. 73 physicians of the past done for practical medicine? Hippocrates, the so-called "Father of Medicine"-on the lucus a non lucendo principle, as he did almost nothing for medicine proper, and might rather be called the father of therapeutic nihilism -is hardly remembered for anything except his saying: "Art is long, life is short," which is but the weary wail of disappointment and failure. * Herophilus, whose name is indelibly inscribed on our dura mater, though he discovered that human beings had a pulse, could not find the cause thereof, though he is said to have dissected 600 living human beings; but his therapeu- * Torcular Herophili, the name of a conflu- ence of venous sinuses in that membrane. 74 Hahnemann, the Founder tical teaching was most disastrous, for it is believed that he was the author of the maxim, that diseases being compound, they required compound medicines — which was similia similibus of the wrong sort and he was thus the parent of complex prescriptions, which have been the bane of the medical art ever since. Erasistratus is now only remembered as the physician who got the largest fee on record for one prescription, nearly £25,000, which must make him an object of envy to all self-respecting physicians. Galen is credited with the enunciation of the therapeutic rule contraria contrariis curentur, which being exactly and en- tirely wrong, was, of course, held to be the ne plus ultra of medical wisdom down to Hahnemann's time. of Scientific Therapeutics. 75 Dioscorides is said to be the father of Materia Medica. He arranged medi- cines in an arbitrary classification, ac- cording to their hypothetical qualities, as hot, cold, moist, dry, which has no foundation in nature, and therefore his book remained the classic text book, and his classification of drugs was re- tained down to quite recent times, as I have shown in my quotations from the Doron Medicum. Paracelsus came very near to discover- ing the truth, but as he wrapped his doctrines in mystic language, and neg- lected altogether the true way to discover the fitting similia by testing medicines. on the healthy, preferring to trust to his imagination, the school he founded had no substantial back-bone, and was lost 76 Hahnemann, the Founder in a cloud of mazy hypotheses. Much of Paracelsus's treatment was conscious homœopathy, much of that of his pre- decessors and successors has been uncon- scious homœopathy; many a physician has been homœopath, malgre lui, or practised homoeopathy, as M. Jourdain spoke prose, sans qu'il en sût rien; but none has taught that the homœopathic was the general rule of therapeutics. Van Helmont may be looked upon as the inventor of the vital force, which he called archæus, and he thus set men's minds on a wrong track, which they persistently followed for many years. Hahnemann himself could not avoid it when he took to theorizing on the nature of disease. Van Helmont was not with- out merit in exposing the futility of the • of Scientific Therapeutics. 77 therapeutics of his day, but he was only great in destruction, and did little or nothing in the way of construction. Harvey was a great physiologist, and his grand discovery of the circulation of the blood formed a noteworthy epoch in medical history, but his contributions to therapeutics were nil. Nor was his merit. in his discovery so great as Hahne- mann's in his, for in Harvey's day some happy guesses at the truth respecting the circulation of the blood had already been made, and men's minds were prepared to receive it, whereas there was nothing. of the sort in Hahnemann's case. Sydenham is often called the English Hippocrates. While he sighed for spe- cifics, and wrote uncommon good sense about the desiderata of therapeutics, he 78 Hahnemann, the Founder bled like Sangrado, and wrote prescrip- tions containing nearly four-score in- gredients. He will be remembered as having declared: "sine opio nolo esse medicus." Stahl recast the doctrine of Van Hel- mont, altering the name of "archæus " to "animal spirits," but his therapeutics consisted mainly of bleeding and eva- cuants, and he denounced cinchona bark as a mischievous drug.* Among the works attributed to Stahl's prin- cipal disciple, Michael Alberti, I find one with the significant title, "De curatione per similia," which is said by a writer in the British and Foreign Medica-Chirurgical Review for July, 1871, to be the key-note of homœopathy. But I strongly suspect this writer never saw the work in question, and only made a guess at the subject. I believe, too, that Alberti never wrote such a work, for though I have not been able to find it in the British Museum, I have looked of Scientific Therapeutics. 79 Hoffmann defended cinchona from Stahl's depreciation of it, and accounted for its success in ague by its tonic pro- perties. The rest of his therapeutics was equally conjectural, and, indeed, he seems to have thought that diseases were best let alone, for he wrote: “fuge medicos et medicamenta si vis esse salvus;” but perhaps he only intended this as a warning against other doctors, not him- through scores of works attributed to him by Haller and the catalogue of the British Museum, and found that they were all merely inaugural theses of candidates for the degree of M.D. in the school of Halle, of which Alberti was presi- dent. It is thus that Haller has been enabled to father upon Alberti no less than 372 separate works, whereas I believe his extant writings do not amount to more than a dozen. Most of the essays falsely ascribed to him are the usual crude lucubrations of inexperienced students, and I have no doubt this one is of the same character. So Hahnemann, the Founder self; for he carried on a traffic in secret nostrums like many of his great contem- poraries and predecessors. says: Boerhaave professed the doctrine of contraria contrariis, but explained it as we have seen the rule similia similibus explained in our own time. Thus he "Contraries are removed by con- traries-not by such means as are di- rectly opposite or contrary to the disease present, but by such remedies as will afterwards manifest their effects contrary to the cause of the disease. If a hot drink produce perspiration in fever, then give a hot drink, for that will cool the body, which is what we want to do. If the primary action of opium is consti- pating and of rhubarb laxative, and the secondary the reverse, according to the of Scientific Therapeutics. SI • principle of re-action, then opium may be the remedy in constipation and rhu- barb in diarrhoea." Hahnemann him- self might almost have accepted this explanation. Haller is chiefly known to us by his recommendation to test medicines on the healthy human body, before pro- ceeding to experiment with them in diseases-but there is no record of his having carried his recommendation into practice. Cullen was great in nosology, or the classification of diseases. He was a stout defender of theory in therapeutics, and it was the unsatisfactory character of his theory to account for the curative action of bark in ague that led Hahne- mann to reject theory and consult expe- 6 82 Hahnemann, the Founder riment in order to ascertain the true rule of practice. John Hunter made no notable contri- butions to therapeutics, but, as Fredault. has pointed out, he first suggested the idea that one disease attacking the or- ganism at a point where another disease is, cures the latter. This notion was further developed by Hahnemann, and forms the basis of his attempted expla- nation of the method of cure by homœo- pathic remedies. From this germ, too, sprang Hahnemann's hypothesis of an apparent aggravation in all cases preced- ing the curative action. In Trousseau's “médicine substitutive" the same idea is apparent. John Brown constructed a complete. system of therapeutics, founded on a of Scientific Therapeutics. 83 double theory of disease and medicinal action. In spite of these merits it failed to obtain general acceptance, though its partisans in Göttingen heroically en- deavoured to get it into the heads of its opponents by cracking their skulls with cudgels. Rasori and Broussais, the contempo- raries of Hahnemann, both tried their hands at constructing systems of thera- peutics, the simplicity of which was ad- mirable, but the results of their practical application were disastrous, though they are not yet altogether abandoned in their native lands. The retrospective glance I have cast, with much aid from our Russell's admi- rable History, at the most prominent representative men of the past histo y 84 Hahnemann, the Founder nemann. of medicine, shows us not a single name among the heroes of medicine connected with any real advance in therapeutics— which is, after all, the sole object of medical science-until we come to Hah- What strikes us most is, that the homœopathic therapeutic rule was not discovered, or at least suspected to be a general rule for treatment, by any of the illustrious and thoughtful men who adorned the medical schools of the past. Now that we know it, it appears so simple and so obvious. But so did the way to make an egg stand on its end appear after Columbus had shewn. how to do it. Hahnemann's is the one name in the whole history of medicine connected with a rational, simple and efficacious system of therapeutics, based of Scientific Therapeutics. 85 on the solid foundation of impregnable facts. Hahnemann has not yet obtained a universal recognition of his true place. in medicine; but even among those who most persistently ignore his claims and who affect to treat him as a dreamer or a charlatan, the influence of his genius is conspicuous by the change he has wrought in their practice. The san- guinary and cruel treatment of disease has almost been abolished. Bleeding, whether local or general, is now rarely, very rarely, resorted to, though ominous signs of a desire to rehabilitate the long disused practice have lately appeared in the medical periodicals. Possibly, doctors have fondly imagined there has been again a "change of type" back to $6 Hahnemann, the Founder the old state of things when diseases were "tolerant of blood-letting," but since homœopathy has taught them better, they will hardly find that pa- tients have resumed their tolerance of phlebotomy. Blistering and cauteriza- tion are scarcely ever heard of. Mercu- rial salivation is only practised in holes. and corners. Complex prescriptions are generally allowed to be unscientific, though still too often written; but the pedantic jargon of base, adjuvant, corri- gent and excipient has passed away, and the true reason of the multiplication of the ingredients in the prescription is frankly acknowledged; and that reason is the same as impels the sportsman to put a number of shots in his cartridge, to wit, that if some miss others may hit. of Scientific Therapeutics. 87 Many of the most scientific physicians. practise a more than Hippocratic ni- hilism, under the euphemistic name of "expectancy." Remedies derived from the homoeopathic materia medica are furtively introduced into practice and given on homoeopathic principles in frac- tional doses. No opposition is offered to their introduction, provided the pro- poser makes no mention of the source of his inspiration, and can make it appear from some futile experiments on frogs or rabbits-which seem to furnish different results to every different experimenter— that they promote or destroy the inhibi- tory influence of some nerves, or that they retard or accelerate the movements of a heart removed from the body, or do something equally instructive. Anything 88 Hahnemann, the Founder' of this sort suffices to give a kind of physiological imprimatur to a remedy, and so render it a welcome and valued addition to the old-school thesaurus me- dicaminum, but its true source is well known to all who choose to enquire. The most popular modern works on therapeutics, such as those of Ringer and Phillips, are in the main mere ré- chauffés of homoeopathic practice. New pharmaceutical preparations are con- stantly being introduced under the names of “granules," "parvules" and "dosime- tric medicines," which homoeopathy may accept as sincerest flattery, they being a close imitation of her pharmaceutical preparations. Almost the only relics of pre-Hahnemannic therapeutics that still survive are purgatives and sedatives, and of Scientific Therapeutics. S9 the use of these, I am bound to admit, is as frequent as ever. Indeed, to invent or introduce a new purgative salt, powder, pill, water or lozenge, or a novel narcotic, is a sure way to fame and often to for- tune. The great Virchow, whose fame overtops that of every living medical scientiate, as Mont Blanc does the Alps, does not scruple to certify publicly to the "invariable and prompt success" of the purgative water called "Hunyadi Janos," which is merely a strong solution of Epsom and Glauber's salts; and at the last International Congress he had the temerity to assert that no medicine discovered by the Hahnemannian method of physiological proving on the healthy human body could be even distantly compared for therapeutic utility to chlo- 90 Hahnemann, the Founder rai hydrate, which was discovered in his laboratory by experiments on the lower animals, and which promises to be as destructive to health and life as opium itself. The vaunted success of this mode of discovering the powers of drugs by tor- turing stupid frogs and rabbits with them will hardly have the effect of convincing us of its superiority over the Hahne- mannian method of testing them on in- telligent human beings, more especially when we observe the exceeding diversity of opinion with regard to the mode of action of almost every drug arrived at by our most intelligent vivisectors. Take, for example, aconite. From a series of experiments on frogs, one observer is convinced that it acts primarily by pa- of Scientific Therapeutics. 91 ralysing the peripheries of the motor nerves; another, that it produces its effects by its action on the medulla ob- longata; another, that it paralyses the central nervous system; another, that it paralyses both central nervous and muscular systems; another, that it first augments excito-motor functions and sensations, and only paralyses them secondarily; another, that it paralyses the sympathetic nerve; another, that it paralyses the terminations of the pneu- mogastric; another, that it stimulates the inhibitory centre of the pneumogastric ; another, that it paralyses all nitrogenous tissues; another, that it first paralyses the sensory, then the motor part of the spinal cord; another, that it acts directly on the protoplasm. You may accept 92 Hahnemann, the Founder which of these conclusions you like, but will not find any of them of the slightest. use in practice. On the other hand, Hahnemann's experiments with aconite on human beings have furnished us with a series of objective and subjective symp- toms which have proved of the greatest value in enabling the practitioner to cure many of the most dangerous and fatal diseases to which humanity is subject, and which will prove equally valuable to all future generations. When we com- pare the relative value to the sick and suffering of Hahnemann's mode of in- vestigating the powers of medicines by testing them on the healthy human being, with that adopted by our modern phy- siologists by experimenting with them on tortured and mutilated reptiles, we of Scientific Therapeutics. 93 shall surely arrive at the conviction, that in order to obtain useful information with regard to medicinal agents, "the proper study of mankind is man"-not frogs. Every now and then the patient world is excited, and the medical world is flut- tered, by the announcement of some wonderful discovery in anatomy, physi- ology or natural history that, we are told, will revolutionize the art of medicine and make possible the cure of diseases. hitherto deemed incurable. The latest fad of this sort is the ingenious specula- tion of Pasteur, who, though no medical man, has propounded a new pathology which has fascinated a credulous profes- sion and a large portion of the semi- scientific public. According to him, all 94 Hahnemann, the Founder diseases are divisible into two classes, those in which a microzoon has been found, and those in which one will be found. And it was authoritatively an- nounced that the universal microzoocide was discovered in carbolic acid, which we were informed kills bacteria, vibriones, bacilli, micrococci, microbes, and all other morbific vermin, and yet, like a celebrated insect powder, is "perfectly harmless to animal life." So the logical inference was that carbolic acid was the universal re- medy. But it gradually transpired that some of these minute organisms, so far from being destroyed by carbolic acid, increased and multiplied, and enjoyed themselves amazingly under carbolic acid dressings, and that almost all their varieties could exist in the organism of Scientific Therapeutics. 95 without causing disease; and more asto- nishing still, it was shewn by Rossbach* that an inorganic chemical ferment of vegetable origin, free from foreign or- ganisms, when introduced into the blood of a healthy living animal, caused this blood to swarm with bacteria in count- less profusion in an incredibly short time; and further, it was found that carbolic acid was not so harmless to animal life" re as had been represented, for some sur- geons have had to give it up, because it poisoned not only their patients-which might be borne with equanimity, for patients are used to be poisoned, as eels are to be skinned-but even their illus- trious selves, which was intolerable. A * Medical Record, Aug. 1882, p. 311. 96 Hahnemann, the Founder recent attempt in the Paris hospitals to apply the carbolic acid treatment to the cure of typhoid fever was followed by disastrous consequences, the mortality having been something shocking even to the allopathic mind and conscience.* The "carbolic craze "} must be near its end when one of the most intelligent surgeons and successful operators can thus write of it: “I have shown in my published writings that car- bolic acid has done much more harm than good; perhaps it would have been better if we had never heard of it.”—Lawson Tait, on the Useless- ness of Vivisection. Proceedings of Birmingham Phil. Soc., vol. ii, p. 127. Another surgeon, Dr. Keith, of Edinburgh, if possible still more distinguished for successful operations, spoke thus at the International Me- dical Congress of 1881: “For some time I have not found the carbolic spray necessary, and have not used it in my last 27 cases, all of whom have recovered easily. With every possible care, the spray has not, in my hands, prevented the mildest septicemia, and its effects on the kidney were sometimes disastrous. I have fre- of Scientific Therapeutics. 97 These continual announcements, that at length something has been found that is certain to do wonders in the way of curing disease, never seem to get beyond the stage of hope or prophecy-like man, medicine "never is, but always to be, quently seen kidney hæmorrhage follow long operations, and two deaths in hospital patients were occasioned, I believe, by carbolic poison- ing. . . I have given it up, believing that, on the whole, it did more harm than good."— Trans. of the Intern. Med. Congress of 1881 vol. ii, p. 236. But the fertile genius of M. Pasteur has not rested contented with the mere cure of diseases by destroying their microbes. He conceived the grand idea of “cultivating" these microbes to harmlessness, taming or civilizing them, so to speak, and then inoculating them into the bodies of animals liable to catch the virulent disease from uncultivated microbes. In this way a mild form of the disease would be produced and the animal protected from the graver form, as vac- cinated children are protected from small-pox. This idea has been developed by an enthusiastic 7 98 Hahnemann, the Founder blest." They remind me of Mr. Snod- grass's attitude on a certain memorable occasion, when he made a feint of pulling off his coat and announced that he was just going to begin, but he never did actually begin. Medicine in the Snod- disciple to the length shown in the following quotation "Considering the results already obtained, we are justified in hoping that some day science will gain possession of the viruses of all diseases in the world, and will transform them into their own peculiar vaccines [¿.e., culti- vate and tame their microbes.] And then, in- stead of waiting for the onslaught of contagious diseases, the human and animal populations may be protected against them by anticipatory inoculations of their viruses modified by cultiva- tion into prophylactics." (Dr. Bouley, Le pro- grès en médecine par l'experimentation, p. 438.) When that time comes it will be all up with doctors both human and veterinary, so they will do well to make the most of their present opportunities before all disease-producing mi- crobes have been cultivated into innocuousness. of Scientific Therapeutics. 99 grassian attitude is not a very imposing spectacle, more particularly when some candid friend like James Johnstone whis- pers in its ear that it would have been better for the sick if the whole race of physicians and apothecaries had never existed; or like Sir Astley Cooper, who said that the art of medicine was "found- ed on conjecture and improved by mur- der;" or like Virchow, who flatly denies that we have any rational therapeutics, and that in spite of his eulogium of chloral and Hunyadi Janos; or like Osterlen, the author of a standard work on Materia Medica, who says that when physicians reflect that medicines are powerful substances which may easily become poisons, they will confine them- selves to the treatment of diseases by Uor M 100 Hahnemann, the Founder BOLW hygiene and dietetics. Thirty-six years ago Sir John Forbes wrote thus of the condition of old physic: "Things have arrived at such a pitch that they cannot be worse. They must mend or end." They have not mended-why have they not ended? Because old physic, like * some other condemned female offenders, always asserts, as a plea for a respite, that she is pregnant with some wonderful new idea. And she can always get a jury of respectable matrons impanneled, led on by Professor Tyndall or some other amicus curia, who are ready to swear that they believe her to be really in the family-way this time, and about to be delivered of a precious offspring that will be of inestimable value to the patient world. But nothing ever comes of Scientific Therapeutics. ΙΟΙ of it. The poor old creature is hopc- lessly barren, never indeed was other than an epicene monstrosity. When time, the great healer, shall have allayed the anger and prejudice of the profession against the importunate reformer who rudely routed them out of their fool's paradise of contented self- sufficiency, and dared to lay an impious hand on the cherished maxims of tra- ditional routine, and to throw doubts on the value of their methods and me- dicines; when the generation who hate Hahnemann because they are conscious of having acted unjustly towards him shall have passed away; when the bulk of the profession shall have acquired. that "lucidity," which Matthew Arnold has too flatteringly credited them with; 102 Hahnemann, the Founder when the enthusiasts who have bur- lesqued some of the most purely theo- retical speculations of his old age and foisted on our rational therapeutics their fluxion potencies and their grotesque પ *Those who call themselves Hahnemann- ists" do so apparently on the lucus-a-non-lucendo principle. Their teachings and practice are in almost every particular at complete variance with, if not the exact opposite of what Hahne- mann taught in his Organon and elsewhere. Thus, Hahnemann directs that dilutions of medi- cines shall be made with alcohol in as many separate phials as there are dilutions, each phial receiving one drop of the previous dilution in 99 drops of pure spirit, and being shaken vigorously to ensure thorough admixture. The Hahnemannists have rejected all this, and make all their dilutions with ordinary service water with all its impurities, in one single bottle, no shaking being administered, but the bottle being merely inverted at each so-called dilution. Whereas Hahnemann fixed the 30th dilution as the limit of his preparations, the Hahnemannists carry on their un-Hahnemannic processes to the of Scientific Therapeutics. 103 and often loathsome preparations, such as lac caninum, lac defloratum, saccha- rum album, syphilinium, sycotinum, go- norrhin, leucorrhin, sol, luna, nix, &c., by which they show themselves to be the lineal descendants of those who in- 10,000th, 100,000th, 1,000,000th and. even higher figures. Whilst Hahnemann by precept and example taught us to investigate the properties of substances that either have or may reasonably be expected to have a powerful action on the human frame, the Hahnemannists devote their energies to proving common articles of food, such as white sugar and skim milk, or allied nutritious substances such as milk-sugar and bitch's milk, or mystic imponderables, such as sun's or moon's rays, and diluted magnetic force. Lastly, though Hahnemann taught that the remedy was to be selected by reason of the perfect correspondence of its ascertained effects with the totality of the symptoms of the disease, the Hahnemannists teach the novel doctrine of choosing the remedy from some one arbitrarily selected peculiar symptom, which they euphe- mistically term a “key-note.” Now, all these I04 Hahnemann, the Founder troduced into ancestral medicine the aqua aurea, oleum philosophorum, album græcum and nigrum, bezoars, murderer's bones, sympathetic ointments and amu- innovations and novelties in doctrine and practice may be improvements or otherwise, but they are not what Hahnemann taught, they are in fact entirely different, I may say utterly opposed to what he taught, and it is difficult to comprehend how their authors can arrogate to themselves the title of "Hahnemannists," which to the common understanding implies that they are par excel- lence and the only true followers of Hahnemann; while they denounce as "mongrels" and un- worthy to be considered as true homoeopa- thists those who still obey Hahnemann's direc- tions in preparing their medicines, in not ex- ceeding the 30th dilution, in prescribing real medicines, and in being guided as much as pos- sible by the totality of symptoms in the selection of remedies; in short, who comply with the teach- ings of Hahnemann as long as these were de- duced from experiment and observation, though they may refuse assent to the hypothetical doc- trines of his old age. of Scientific Therapeutics. 105 lets-when these enthusiasts shall have discredited themselves by their absur- dities; when a new generation of earnest and unprejudiced enquirers shall have arisen, who will be capable of winnowing the golden grains of truth from the chaff of fanciful speculation, what position will Hahnemann occupy in the domain of medicine? He will be known to all future ages as the physician who first taught that discases must be treated by medicines. which have an elective affinity for those parts of the organism that are the seat of the morbid process;* that it is only *“There can surely be no ground for doubt- ing that, sooner or later, the pharmacologist will supply the physician with the means of affecting, in any desired sense, the functions of any physiological element of the body. It will, 106 Hahnemann, the Founder by testing medicines on the healthy that their affinities can be learned, and that they must be administered for curative purposes in disease in quantities too small to produce collateral disturbances. In one word, Hahnemann will be ac- knowledged to be the one, the sole founder of rational therapeutics, the fa- cile princeps of true physicians, whose in short, become possible to introduce into the economy a molecular mechanism, which, like a very cunningly contrived torpedo, shall find its way to some particular group of living elements, and cause an explosion among them, leaving the rest untouched." These words of Professor Huxley in his address to the International Medical Congress, 1881, convey the idea of an eminent scientific authority as to the desiderata of scientific medicine. They exactly express what homoeopathy is doing, and has to a great extent fairly accomplished. It has supplied the physician with medicines whose mode of action on the organs and functions of the body he has of Scientific Therapeutics. 107 mission it is, as he says, “to restore the sick to health." The history of medi- cine may be ransacked in vain to find any figure at all comparable to him. He stands out in bold relief as the first, the only one who brought order into the chaos of therapeutics, who transformed. medicine from a wild wilderness of hy- pothesis and caprice into a blooming, >> experimentally ascertained, and enabled him to send a "molecular mechanism to any spot in the organism where disease may be lurking, leaving all other parts and organs untouched. And yet neither old physic nor her scientific dry nurse perceive that homeopathy has done for medicine what science requires. While they talk of the right way to be pursued by the medicine of the future they fail to take notice that this right way has been followed with success for more than two generations by the despised dis- ciples of Hahnemann, whose methods they must pursue if they would place their art on the basis of scientific truth. ミ ​1 108 Hahnemann, the Founder fruitful garden of regularity and beauty It was not so much by intellectual great- ness, it was not by superhuman intuition that he accomplished his great reform, it was by his innate love of truth and abhorrence of specious falsehood, by his firm resolve to accept nothing as true that did not stand the test of experi- ment, even though it were hallowed by the tradition of millenniums. And having once discovered the clue, he pursued it with a singleness of mind, with a self- sacrificing diligence that grudged no toil and shirked no pains, and was not to be diverted from its object by any pro- mise of ease or honour, nor yet by the sneers of the heads or the persecution of the tail of the profession. The greatness of his aim, to relieve the sufferings of of Scientific Therapeutics. 109 his fellow-men, was at once his stimulus and his reward. When he found that his efforts to perfect the medical art procured him only insult, calumny and persecution at the hands of his col- leagues, he never condescended to reply to the hostile and unfair criticisms that were passed upon his work, and he offered no resistance to the machinations of his foes, even when they sought to ruin him and deprive him of his means of earning his bread. Rather than sacri- fice one jot or tittle of what he held to be necessary for the practice of his sys- tem in all its purity and integrity, he sacrificed himself. In his behaviour under persecution he displayed an an- tique heroism. He had his weaknesses and his faults, he would have been more IIO Hahnemann, the Founder than human if he had not. As Balzac well says: "Quelque grands que puissent être les grands hommes connus ou in- connus, ils ont des petitesses par les- quelles ils tiennent à l'humanité." But his weaknesses only showed themselves in his old age, and during his exile and enforced solitude. He then became too prone to accept without sufficient ex- amination any idea that occurred to himself or others that he fancied would contribute towards the development and perfection of his method. He grew in- tolerant of the criticism and opposition of his own disciples with regard to matters of minor importance. No such faults manifested themselves during his prime and when he lived in the world. They were the natural consequences of of Scientific Therapeutics. III the harsh treatment of his colleagues, of his old age and enforced solitude, when he had ample time to brood over the vast importance of his discovery and the criminal folly of those who rejected it without enquiry, and sought to discredit its author by detraction, calumny and persecution. The wonder is, not that he manifested some irritation under these circumstances, but that he showed so little. When the experience and observa- tions of intelligent and impartial en- quirers shall have purged his system of the adventitious and repulsive excres- cences that have gathered about it, the great truths he taught will come out more conspicuously and clearly, and the united voice of the profession will ac- 112 Hahnemann. knowledge that the merit of having indicated a general rule for the curative employment of medicine in disease, and of having rendered the application of this rule possible by ascertaining the true powers and qualities of medicines, is Hahnemann's and Hahnemann's only. Hahnemann told us that the true rule of therapeutics is similia similibus cu- rentur―let likes be treated by likes- when Hahnemann shall have obtained his true place in medicine, the actual practice of the medical world will be expressed by the words similia similibus curantur-likes are treated by likes. J. WRIGHT AND CO., PRINTERS, BRISTOL. BY THE SAME AUTHOR. Translations. ORGANON OF MEDICINE. By SAMUEL HAHNEMANN. Translated from the fifth German edition. LONDON: HEADLAND, 1849. THE LESSER WRITINGS OF SAMUEL HAHNEMANN. LONDON HEADLAND, 1851. : MATERIA MEDICA PURA. By SAMUEL HAHNEMANN. VOL. I, LONDON, 1880. VOL. II, LONDON, 1881. сс Original Works. LECTURES ON THE THEORY AND PRACTICE OF HOMEOPATHY, Delivered at the Hahnemann Hospital School of Homœopathy, Bloomsbury Square, London. MANCHESTER: TURNER, IS54. THE HUMAN EYE: Its Optical Construction popularly explained. LONDON: HARDWICKE BOGUE, 1878. THE SPHYGMOGRAPH: Its History and Use as an aid to Diagnosis. in ordinary practice. LONDON: BAILlière, Tindall & Co. CO-EDITOR OF THE BRITISH JOURNAL OF НОМ ЕОРАТНУ, A Quarterly Journal of Medical Science, since 1846. LONDON: TURNER. Filmed by Preservation 1990 Date Due DEC 18 1959 害 ​M1. UNIVERSITY OF MICHIGAN 3 9015 00660 7033 PLEASE SIGN ADDRESS AND PHONE NUMBER NAME, ADDR · > י