/ - ^ REESE LIBRARY ^ UNIVERSITY OF CALIFORNIA. 'T^eceived ^^.^yrcZ^i-^ ■ , i8qo . Digitized by the Internet Archive in 2007 with funding from IVIicrosoft Corporation http://www.archive.org/details/compendofprincipOOboerrich A COMPEND OF THE Principles of Homoeopattiy AS TAUGHT BY HAHNEMANN, AND VKRIFIED BY A CENTURY OF CLINICAL APPLICATION, WIVL. BOKRICKK, M. D. Professor of Materia Medica aud Therapeutics, at the Hahnemann Hospital College of San Francisco; Associate Author of the Twelve Tissue Remedies of Sehuessler; Stepping Stone to Homoeopathy; Member of American Institute of Homoeopathy, Etc., Etc. SAN FRANCISCO: B0ERICK:E & RUNYON 1896. COPYRIGHTED 1896, BY BOERICKK & RUNYON Jos. WrNTRKBUKN CO., Printers and Ei.ectrotypers, San Francisco. PREFACE. Hahnemann's Organon is the great text-book of the homoeopathic school. It contains philosophical con- ceptions and practical directions for the establishment of a true science of therapeutics, and all genuine pro- gress towards this goal is in the direction pointed out in that work. To fix its principles clearly in the mind of the student, to faithfully apply them in practice, is the special duty and high privilege of Homoeopathy. The more this is done, the^more will this masterly book become a veritable mountain of therapeutic light to the practitioner. Hahnemann's teachings, and the therapeutic edifice erected by the homoeopathic school, are based upon two distinct factors. On the one hand, upon facts of observation and experiment obtained by strict adher- ence to the inductive methods of research, facts that can thus be verified at all times; and, on the other hand, upon new ideas resulting from the exercise of deductive reasoning, ideas belonging possibly to a larger and higher realm, and to some extent beyond the acceptance of modern scientific thought, but never- theless capable of great power in achieving curative results. Until quite recently, the tendency of modern homoe- opathy was to bend its energies perhaps too exclusively upon the acquisition of the facts yielding immediate results, while neglecting to some extent the study of iv Preface. the underlying principles. With neglect of the study of homoeopathic institutes came coquetry with old- school methods, and the alluring adoption of modern palliative and mechanical therapeutics, leading un- questionably to deterioration of our distinctive prac- tice. The reaction had to come. We are in the midst of it. A homoeopathic renaissance is upon us. Teach and study the Organon is its watchword. This little book is intended to be an introduction and an aid to a fuller study and wider acceptance of Hahnemann's doctrines. It does not pretend to be more than an attempt to elucidate the salient and vital points often abstrusely and always metaphorically treated by Hah- nemann, and thus to familiarize the student with the fundamental groundwork of our school. These essen- tial doctrines do not include the necessary acceptance of every statement of Hahnemann as of equal and ab- solute importance. Indeed, a wise discrimination is necessary, for the minor things may be instructive or obstructive, or even destructive, according to the way they are held; they may, therefore, be useful or other- wise for the mental development of the physician or the scientific evolution of the school. The author has gladly availed himself of everything published that furthered the end in view, and he hopes that the little volume will be used by the student and young practitioner as a first stepping-stone to the rich mine of deep philosophy and practical suggestion con- tained in the writings of Samuel Hahnemann. WM. BOERICKE, M. D. San Francisco, September, 1896. CONTENTS. CHAPTER I. THK THERAPEUTIC FIEI.D. Pages. Three methods of combating disease : Preventive medi- cine; Palliative medicine; Curative medicine Medic- inal therapeutics Empiricism Practice according to some pathological theory: i. Allopathy. 2. Anti- pathy, or Eantiopathy. 3. Organo-Therapy Objec- tions to Antipathetic treatment Practice based upon the Law of Cure The first promulgation of this prin- ciple The development of the homoeopathic princi- ple Homoeopathy, the science of therapeutics The great central truths of Homoeopathy Isopathic medication and its modern form of serum-therapy 1-13 CHAPTER II. PRINCIPIvES OF PHARMACOI.OGY. Materia Medica Drugs and drug-action Medicinal force is a distinct property of drugs Doctrine of Sig- natures Other methods of determining the medicinal virtues of drugs Experimental Pharmacology Physiological action of drugs The homoeopathic method by means of drug experimentation on the healthy— drug-proving Drug Pathogenesy The value of Toxicology as illustrating drug action Dif- ferent applications of drug action 14-22 CHAPTER III. THE HOMCEOPATHIC MATERIA MEDICA. The first book on drug effects Hahnemann's Materia Medica Pura Publication of the "Chronic Diseases," Sources of the Homoeopathic Materia Medica The comparative value of the three sources of symptoms. The Hahnemannian Schema The repertory or index of symptoms How to learn drug pathogenesy 23-30 vi Contents. CHAPTER IV. D R U G-P ROVING. Pages. The proving of medicines General rules for drug-prov- ing Directions for provers Dosage required for proving Female provers Repetition of doses Age and sex Temperament Re-provings Her- ing's rules lor provers How to describe symptoms obtained from a proving The three essential features of every complete symptom Primary and secondary drug effects Hahnemann's method of conducting provings 31-37 CHAPTER V. INTERPRKTATION OF DRUG PATHOGENESIS. Of general symptoms Of peculiar or characteristic symp- toms Of certain elective affinities to special organs or functions Locality, or seat, of action vSensa- tions, or kind, of action Modalities and concomi- tants Boeninghausen's method of interpreting symp- tomatology 38-44 CHAPTER VI. DRUG RKI.ATIONSHIP. Family relation, or collateral, side relation Antidotal relation Concordant, or compatible, relationship Complementary relation Inimical relation 45-48 CHAPTER VII. THE APPIylCATlON OF HOMCEOPATHY. The examination of the patient The selection of the remedy The administration of the single remedy. The dose and its repetition The totality of the symp- toms Special precautions to be observed Object- ive symptoms The totality in acute diseases The collective totality of epidemic diseases Interpretation of the totality Characteristic, or peculiar, symp- toms Mental symptoms First, or oldest, symp- toms Etiological factors Late symptoms Functional symptoms Need of pathology General, Contents. vii Pages. or absolute, symptoms Totality of equality Path- ological similarity Method of treating slight ail- ments Absence of characteristic symptoms in the totality Partial, or one-sided, diseases .....49-62 CHAPTER VIII. THE SIMir^IMUM. The indicated remedy The single remedy Alterna- tion, or rotation, of remedies 63-65 CHAPTER IX. THE SECOND PRESCRIPTION. Rules governing the second prescription Three precau- tionary rules of Hahnemann Diet and regimen dur- ing homoeopathic treatment Regimen in acute dis- eases 66-72 CHAPTER X. HAHNEMANN'S NOSOI^OGY. Acute diseases Chronic diseases Drug diseases The evolution of Hannemann's doctrine of chronic diseases Cause of recurrence of chronic diseases The skin phase of chronic diseases The underlying facts of the Psoric theory Anti-psoric remedies Hahnemann's suggestions in regard to administering anti-psoric remedies Other miasms recognized by Hahnemann Sycosis Eradicative possibilities of anti-psoric treatment Pre-natal treatment by means of anti-psoric remedies Suggestions for the treatment of chronic diseases Partial diseases and local affec- tions Objections to local application of a medicine simultaneously with its internal use The local appli- cation of non-homoeopathic remedies The local dis- ease is nature's efforts to relieve by derivation The mental state and temperament of the patient Mental diseases and their treatment Acute insanity Inter- mittent and alternating diseases 73-89 \iii Contents. CHAPTER XI. POSOI.OGY. Pages. Different effects between large and small doses Reasons for the difference in dosage between drugs chosen homoe- opathically and anti-pathically Reason why the honiceopathic dose is necessarily smaller Aggrava- tion follows sometimes even a minute homoeopathic dose. Historical development of the homcEpathic dose Repetition of doses The theory of Dynamization. Hahnemann's reasons why the skeptic ridicules these homoeopathic attenuations 90-98 CHAPTER XII. THE PREPARATION OF HOMCEOPATHIC MEDICINES. Pharmacopoeia Essential conditions for preparing homoe- pathic medicines The menstrua used in homoeopathic pharmacy Alcohol Sugar of milk Distilled water The unit of ' medicinal strength Prepara- tions of drugs Aqueous solutions Tinctures Dilutions or liquid attenuations Centesimal and Decimal scale Triturations To convert tritura- tions into liquid potencies Pellets, disks, cones, tablets, etc 99-108 CHAPTER XIII. Hahnemann's Philosophy 109-116 APPENDIX. A Catechism on Samuel Hahnemann's "Organon," and "Chronic Diseases," by the late Professor Samuel Lilienthal 117-152 A COMPEND OF THE PRINCIPLES OF HOMCEOPATHY. CHAPTER I. THE THERAPEUTIC FIELD. The aim of the art of medicine is to cure disease, and the physician's highest ideal of a cure, as Hahnemann says, Organon § 2, is the rapid, gentle and permanent restoration of health, or the removal and annihilation of disease in its whole extent, in the shortest, most reli- able and most harmless manner, and on easily com- prehensible principles, that is, with the least possible expenditure of time, money, vitality and suffering. In pursuance of this object, the physician presses into his service all agencies which tend to health. This is the part of Therapeutics [therapeuein, to attend upon]. It in- cludes all that relates to the science and art of healing, includes all agents, medicines among them, which may aid this purpose. It embraces dietetics, climate, cloth- ing, bathing, nursing, application of heat, cold, elec- tricity and all other means used by the physician for restoring health, when that is possible, or in palliating violent conditions or incurable diseases, or in prevent- ing their development. Hence there are Three methods of combating disease, of which every physician is bound to avail himself. They are: 2 A COMPEND OF THE 1. Preventive medicine. 2. Palliative medicine. 3. Curative medicine. These cover the whole field of possible therapeutic activity.* . Preventive Medicine includes the application of everything that physiology, hygiene, sanitary science, etc., can teach to lessen the development of disease according to the teaching in § 4 of the Organon. '' The physician is at the same time a preserver of health, when he knows the causes that disturb health, that produce and maintain disease, and when he knows how to remove them from healthy persons." It includes much of bacteriological knowledge, anti- septic medication, subjects that have made enormous strides in recent years. It includes as well the judi- cious use of homoeopathic remedies in preventing or modifying the development of epidemic and hereditary diseases. Palliative Medicine. Palliative medicines are of two kinds: (1) The use of drugs in their physiological dosage for their direct effects, as the use of Opium and Mor- phine for pain. This is the common method of the old school. (2) By the carefully selected Homoeopathic remedy given in minute dosage. This frequently yields bril- liant results in palliating where a cure is impossible. This latter method is to be tried in every case before drug palliation- is used. This is almost the sole resource of the old school, and consequently much abused, but in the hands of the *This was aptly and perfectly expressed by Dr. Bering to the author in the German words Rindern, Lindern, Mindern, embodying every possibility of a physician's distinctive sphere of usefulness. Principles of Homceopathy. 3 true physician who knows its subordinate place, it constitutes a legitimate method in incurable diseases, beyond the operation of the law of cure, where we can only alleviate, not radically cure. While Homoeopathy reduces the need and occasions for the use of mere pal- liatives to a small limit, yet palliation has its use in the practice of medicine, but it is always the expression on the part of the physician of his impotence to cure radically. Curative Medicine is almost exclusively occupied by Homoeopathy, for this method alone cures without subjecting the patient to new pains and discomforts; it alone fulfills the highest aim of the physician — to heal quickly, gently, radically, according to scientific and rational methods. All physicians are compelled to avail themselves of all three methods at times. As sanitarians and hygi- enists, physicians can do much to prevent zymotic and epidemic diseases; as homoeopathists, much can be done in the eradication of inherited disease tendencies and preventing their development; and as the laws that govern curative medicine are applied more fully, the need for mere palliation will correspondingly grow less. Leaving aside the large field of General Therapeutics, common to all physicians, of whatever school of medi- cine, we restrict ourselves to the consideration of the different uses of drugs as therapeutic agents. Medicinal Tlierapeutics is the application of drugs as medicines for the purpose of modifying or curing disease. Drugs are employed in the medicinal thera- peutic field either empirically, or according to the Law of Similars — i. e., scientifically, because according to fixed law. Empiricism is based upon mere experience and is practice without regard to any theory or scientific 4 A COMPEND OF THE deduction or investigation. A remedy is given which experience has shown to be effective in a similar case. It is the rule of authority and leads to mechanical routinism in practice. Certain remedies have, how- ever, obtained a permanent place in medicine that have been discovered empirically, and whose mode of action cannot be readily explained. It has been found that certain drugs act curatively against certain defi- nite diseases when given in material dosage. They are known as specifics. There are not many, but such are Quinine in malaria, Mercury in syphilis. Iodine in glandular affections. Salicylic acid in rheumatism, etc. These occupy a rather unique position, though it can be claimed that the relationship is a homoeopathic one, although it differs from the usual homoeopathic rela- tionship between remedies to disease in requiring material dosage. Practice according to some pathological theory is characteristic of the old school of medicine. It is con- stantly changing, as different views on physiology and pathology lead to corresponding therapeutic changes. It is therefore one of the most unstable of methods* At present, pathology being dominated by bacterio- logical views, the corresponding therapeutic measures are largely germicidal, anti-septic or anti-toxical. But already bacterial pathology, and as a consequence its therapeutics show signs of the inevitable displace- ment.* The use of medicines when administered according to some pathological theory is either according to allo- pathic or antipathic method. *Says Lawson Tait, that during his professional life he has learned and unlearned some four or tive theories of inflammation, and he predicts that the present prevalent theory, coccophobia he calls it, will soon go the way of the other theories. Phinciples of Homceopathy. 6 Allopathy (from Alios, other and Pathos, a disease), where the symptoms are different, the same organs and tissues being affected in a different manner, or other organs and tissues being affected in some manner; the relationship being one of indefinite diversity* Allopathy usually attacks the parts most exempt from the disease, in order to draw away the disease through them and thus to expel it, as is imagined. § 55 Organon. Antipathy, or Eailtiopathy (from Eanthios, contrary, and Pathos, disease) — where the symptoms, or condi- tions indicated by them, are opposites; the relationship being one of direct antagonism. It is a palliative method, pure and simple, wherewith the physician can appear to be most useful and can usually gain the patient's confidence by deluding him with momentary amelioration. The inefficacy and danger of this method as applied in diseases of a chronic nature is easily verified by clinical observation. Study § 56-71 Organon. '^All pure experience and exact experiment will con- vince us that persistent symptoms of disease are so imperfectly alleviated or exterminated by contrary symptoms of a drug, used according to antipathic or palliative method, that after a brief period of apparent relief, they will break forth again in a more marked degree, and visibly aggravated." Organon § 23. In this category of allopathic treatment belong the therapeutic method of Biochemistry, introduced by Dr. Schuessler of Germany, and the various forms of chem- ical treatment, such as Hensel's, etc. The former adopted from Homoeopathy its method of diminishing dosage and some of its distinctive remedies, but other- *Dake, Pathogenetic Therapeutics. 6 A COMPEND OF THE wise it has no relationship to Homoeopathy, since its therapeutic procedures are based upon a pathological theory and not upon the symptoms of the individual patient, which alone constitute the basis of homoeo- pathic therapeutics. Here also belongs Orgauo-Therapy, which is that therapeutic method which aims to supply deficiencies in the functional activity of human organs by the administration of substances derived from similar organs in animals. It has been found that the extract of Thyroid gland of animals, administered to the human organism, causes a rapid disappearance of the morbid symptoms of myxedema — a form of disease or atrophy of the thyroid, interfering with the performance of its function. The doctrine that sound organs of certain animals are useful in diseases of those organs in man so lately revived in the old school, was clearly taught by Oswald Croll, a disciple of Paracelsus. Its modern extension is unreasonable and unscientific, and a passing thera- peutic fad. Besides these special and modern tendencies of old school practice, there are certain perennial features characteristic of it. In place of the former hypothet- ical assumptions of the hidden causes of disease that proved delusive and deceptive as a basis for treatment, material causes of disease were next assumed to exist, and hence the treatment, based upon such hypotheses, consisted mostly in eliminating from the organism the supposed offending cause, therefore the list of purga- tives, emetics, sudorifics counter-irritants, surgical pro- cedures, local medication of all kinds. But though a temporary relief is frequently obtained thereby, no permanent cure is established, rather an increase in the very condition, in the case of chronic disease; or Principles of Homceopathy. 7 metastases appear sooner or later, which, however, are then looked upon as new diseases, and not as direct re- sults of ill-adapted treatment. " But in by far the greatest proportion of cases of disease, known as chronic, these impetuous, weakening, and indirect therapeutie measures of the old school scarcely ever prove to be of the least benefit. For a few days at most they suspend one or another of those troublesome manifestations of disease which return, however, as soon as nature has become inured to that counter-stimulus; and the disease will re-appear with more violence, because the vital powers have been re- duced by the pain of counter-irritation and improper evacuations." * Objections to Antipathic Treatment. (1) It is merely symptomatic treatment attacking some prominent single condition, instead of the disease as a whole, and neccosarily leads to polypharmacy in the endeavor to meet different conditions at the same time. (2) The transient amelioration is followed by an increased aggravation of the very condition to be re- moved, necessitating increasing dosage. (3) Drug diseases are established that complicate hopelessly the original disease of the patient; the pos- sibility of harm by the introduction of the necessary large dosage of drugs and foreign substances always being very evident. None of these therapeutic methods are curative in the true sense by directly modifying the vital activities of the organism. In the cases where such treatment is ultimately successful (and certain temporary beneficial results cannot be denied), the homoeopathic method is more direct, safer, more radical, and with no possible harm to the patient. * "Organon,'" Introduction. 8 A COMPEND OF THE Practice based upon the Law of Cure is the only truly scientific therapeutic method, since it alone fulfills the conditions of science and offers a medical practice true for all time and applicable to all forms of disease in men and animals. Homoeopathy is the only therapeutic method based . upon law. Siniilia Siniilibus Curantur.* Like affections are cured by their similars, expresses the law for drug selection in all curable forms of disease. By its application, the curative remedy is found in curable cases; and in incurable cases, the same law usually points to a remedy that will act palliatively in most conditions. By Law of Cure is meant the definite path along which a drug force moves to cure a diseased con- dition. This law forms the basis of Homoeopathy [from the Greek words homiios and pathos, meaning similar affections], the therapeutic method that applies the principle that any drug which is capable of pro- * There exists a misconception concerning the phraseology em- ploy ed by Hahnemann in the expression of the Law of Similars. Dr. K. E. Dudgeon, the recognized authority concerning the works of Hahnemann, writes in the appendix to his translation of the Organon, " Hahnemann always wrote the formula Similia Simili- bus Curentur, thereby giving an imperative or mandatory turn to the phrase." The translation must evidently be "Let likes be treated by likes." " Darch Beobachtung, Nachdenken und Erfahrung fand ich, dass im Gegentheile von leiztern [Erleichterungsmittel und Palliative durch die Curart contraria contrariis] die wahre, 7'khtige, hesie Heilung zufindensei in dem Satze Similia Similibua Curentur. Wr'ihle, um sanft, schnell, gerwiss und dauerhaft zu heilen, in jedem Kratikheilsfalle e'lne Argnei, welche ein aehnliches Leiden fur sich erregen kann, als sie heilen soil!" Nevertheless, Similia Simiiibus Curantur has been almost universally adopted by the homoeopathic school, and the belief and conviction have been unconsciously ex- pressed thereby that it is a laic of nature — S. S. Curantur — Likes are cured by likes; rather than a rule of art, S. S. Curentur— Let likes be treated by likes. Principles of Homceopathy. 9 ducing symptoms of disease in the healthy will remove similar symptoms, and thus cure the disease when found in the sick. The first promulgation of tliis principle was made by Hahnemann in 1796, in an essay published in Hufeland's Journal, entitled " On a new principle for ascertaining the curative properties of drugs." In this essay Hahnemann formulated his conclusions thus: " Every powerful medicinal substance produces in the human body a peculiar kind of disease, the more powerful the medicine, the more peculiar, marked and violent the disease. We should imitate nature, which sometimes cures a chronic disease by superadding another and employ in the disease we wish to cure that medicine which is able to produce another very similar artificial disease, and the former will be cured — Similia Similibus." This was six years after his first experiments with Cinchona bark, which was the first drug experimented with and which gave striking evidences of the simi- larity between the effects it is capable of producing, and those for which it had ever been employed, and which was the beginning of a rational, scientific, Materia Medica, and of a scientific therapeutics based thereon. The most characteristic feature about the development of Homoeopathy is the strict observance of the inductive method of research that Hahnemann adopted. Care- ful expeiiments were instituted, all preconceived theo- ries were ostracized, and the results and rigid deduc- tion from them were not published until years had elapsed in which to verify all the statements. The development of the homoeopathic principle began in the mind of Hahnemann with his experiments with Cinchona, which in turn led him to other experi- ments with other drugs and patient search of recorded 10 A COMPEND OF THE action and uses of drugs throughout the medical liter- ature. His first suggestions fell unheeded by the pro- fession; but he continued his experiments, and nine years later published a work in Latin ''On the Positive Effects of Medicines," and at the same time declared the principle of Similars as a law of general applica- tion. Five years more of further reflection and experi- ment enabled him to perfect his system and embody its principles in his great book, the "Organon of Rational Medicine." The following year, while a teacher at the University of Leipsic, he published vol- ume I of his "Materia Medica Pura," containing original provings made by himself and members of his family, and assisted later by some enthusiastic disciples that gathered around him at the University; and in 1821 he published the final sixth volume, containing the positive effects of sixty-four medicines. With the pub- lication of these two great works, Hahnemann provided both the theoretical and practical requirements of Homoeopathy as a distinct method of therapeutics. He was the first to apply the inductive method of research to therapeutics. He says, in the preface to the second edition of the Organon, published in 1818: " The true healing art is in its nature a pure science of experience, and can and must rest on clear facts and on the sensible phenomena pertaining to their sphere of action. Its subjects can only be derived from pure experience and observation, and it dares not take a single step out of the sphere of pure, well-observed experience and experiment." And, again, " Every one of its conclusions about the actual must always be based on sensible perceptions, facts and experiences, if it would elicit the truth." Homoeopathy, the Science of Therapeutics. Such a healing art conformable to nature and experience, a Principles of Homceopathy. 11 science of therapeutics, therefore, did not exist hefore Hahnemann. The most marked feature of the early homoeopathy was its entire freedom from all theory and hypothesis; it was a protest against all and any pathological theory as a basis of therapeutics. As taught, it was the true science of therapeutics, based upon exact observation of natural phenomena in disease and drug action, and noting the law governing their mutual relationship. On this solid ground of scientific observation, all Homoeopathists base their practice, whatever differences have arisen, date from the publication of Hahnemann's theory of chronic diseases and drug dynamization, and in not clearly distinguishing between Hahnemann's discoveries and facts on the one hand and his illustra- tions and mere theories on the other. Whatever Hahnemann published as a fact has never yet been disproved, but his theories are not proven. It is the genuine Hahnemannian spirit, as Hering says, totally to disregard all theories, even those of one's own fabri- cation, when they are in opposition to the results of pure experience. All theories and hypotheses have no positive weight whatever, only so far as they lead to new experiments and afford a better survey of the re- sults of those already made. The Great Central Truths of Homoeopathy. (1) The totality of symptoms of the patient consti- tutes the disease for the purpose of a cure. (2) Drug experimentation on the healthy, so-called drug proving, is the only reliable method to arrive at a knowledge of the effects of drugs. (3) The curative relation between these two sets of symptomatic facts is the law of similars, Similia Simil- ibus Curantur. 12 A COMPEND OF THE (4) The administration of one single remedy at a time. (5) The minimum (smallest) dose that will bring about a cure. (6) Repetition of the dose should cease when marked improvement sets in. Isopathic Medication and its modern form of Serum -Therapy. This means the employment of mor- bid products of a disease for the cure of the same dis- ease [Aequalia aequalibus]. It is of very ancient date, and of late has received renewed attention through the researches of Pasteur, Koch, and others; it necessitates the attenuation of the virus, in order to be used medic- inally; it was taught as early as 400 years b. c. by Xenocrates; it was introduced into Homoeopathy by Dr. Lux in 1823, and in part adopted by Dr. Hering. Lux taught that the toxins formed in the body, prop- erly attenuated, are capable of curing the very diseases that give rise to them — that is, every disease is sup- posed to have within itself its own antidote. In 1830 Hering proposed as a remedy for hydropho- bia the saliva of a rabid dog, properly attenuated; the very teaching and practice of Pasteur. He also pro- posed Phthisine as a remedy for tuberculosis, and forty years later it, too, received popular and scientific en- dorsement by Koch and others. As early as 1834, Dr. Stapf, one of the greatest of the early homoeopath- ists,who looked upon the subject dispassionately, says: " I do not doubt that the discovery of the curative ac- tion of morbid matters, in diseases that produced them, to be one of the most important discoveries that has been made since the beginning of our school." Nosodes is the homoeopathic designation for such morbid products, which are animal alkaloids [pto- maines], produced by the decomposition of animal sub- Principles of Homceopathy. 13 stances. At first ptomaines were restricted to alkaloids produced by cadaveric decomposition, hence the name (ptomaine, belonging to a dead body), but now they also include alkaloids of animal origin formed during life as a result of chemical changes within the organ- ism. These alkaloids have assumed great importance, by reason of their relation to the causation of disease, and it is probable that most pathogenic bacteria pro- duce their effects through their specific alkaloids. The homoeopathic nosodes are these specific alkaloids atten- uated according to homoeopathic methods and adminis- tered according to the Law of Similars. To obtain a permanent place in the Materia Medica, as Psorinum, the principal of the nosodes, has already achieved, and not be the victim of a passing therapeutic fad, as is the fate of most old-school therapeutic novelties, they must he proved on the healthy, and the pathogenetic effects thus obtained be the only guide for their therapeutic application. To apply them empirically for similar diseases corresponding to their origin as is done by the old-school with tuberculin, antitoxin is disastrous and non-homoeopathic. Study in this connection: The Organon: The Introduction, called by Hahnemann, "A Keview of Therapeutics; allopathy and palliative treatment, that have hitherto been practiced in the old-school of medicine, " together with historical intimations of Homoeopathy before Hahnemann's time. Also, Organon $ 1-6, on the Functions of the Physician. Also, Homoeopathy, the Science of Therapeutics, by Carroll Dunham. Homoeopathy, the only system of curative medicine, by Charles S. Mack. Pathogenic Therapeutics, by J. P. Dake, in his Therapeutic Methods. Hahnemann's criticism of Isopathy, in the Organon, Introduc- tion, note 34. Dr. Dudgeon's most valuable appendix to his translation and edition of the Organon, page 200. 14 A COMPEND OF THE CHAPTER II. PRINCIPLES OF PHARMACOLOGY. Pharmacology {pharmakon, a drug, logos a discourse) is a convenient term for the whole subject of Materia Medica, pharmacy and medicinal therapeutics. Speci- fically, it refers often to drug effects, as evinced from experiments on animals, and as such is the only source of modern old-school knowledge of the physiological action of drugs. Materia Medica is the study of drugs in regard to their origin, physical and chemical properties, but especially and chiefly in regard to their effects in modi- fying the health of the body. The latter is the dis- tinctive field of the Homoeopathic Materia Medica. Drugs and Drug Action. Drugs are substances taken from all the kingdoms of nature that are used as medicines. They usually produce deleterious effects upon the body when given in sufficiently large doses in health, and they modify some part, or the whole, of a morbid state when given to the sick. This property is discovered either empirically by observation of cases of poisoning, or by systematic experiments on human beings in health. Medicinal force is a distinct property of drugs, by which they modify vital activity, not by their chem- ical, physical or mechanical properties, but by their specific dynamic property, peculiar, distinctive and different in every drug. And they can be truly cura- tive only by reason of their modifying properties of the vital processes. Each medicinal substance, be it plant, mineral or animal product, has stored within its material particles, and embodies, therefore, its own par- Principles of Homceopathy. 15 ticular medicinal force, which can be brought into activity by breaking up the outward particles. The character of this specific force, or the drug's medicinal properties, can only be discovered by the vital test, made by experimenting with different doses on healthy human organisms, and to some extent on animals. The latter merely to see the ultimate lesions and or- ganic changes drugs are able to produce. At one time, and especially during the middle ages, before the introduction of modern, scientific methods, the properties of drugs were based upon the Doctrine of Signatures. External characteristics of a substance served to indicate possible therapeutic effects. Fancied or real resemblances between some part of a plant and some particular organ or fluid of the body pointed to therapeutic relationship. Thus, according to this doctrine, Digitalis must be of use in blood diseases, because its flowers are adorned with blood colored dots; Euphrasia was famous as a remedy for the eyes, because it had a black spot in its coralla, which looked like a pupil.* The lungs of a fox must be specific against asthma, because this animal has a very vigorous respiration. Hypericum having red juice ought therefore to be of use in haemorrhages. Euphorbia, having a milky juice, must be good for increasing the flow of milk. Sticta, having some likeness to the lungs, was called pulmonarius and esteemed as a remedy for pulmonary complaints. Singularly enough, in isolated instances at least, such relationship actually does exist, as has been verified by subsequent clinical application, and it is possible that an intuitively gifted race may see a relationship actu- *Grauvogl. 16 A COMPEND OF THE ally existing between outward forms and structures and inner uses. But for purposes of modern scientific ther- apeutics it is valueless. * Other methods of determining the medicinal vir- tues of drugs were by the sense of taste and of smell. Drugs with a bitter taste were held to possess tonic and stomachic virtues, hence the " Bitters " of the ordinary pharmacopoeia. Gentiana, for instance, is such a drug, and unquestionably does exert a tonic influence upon the stomach. But this virtue is probably not because it is bitter, but because it has a distinctive medicinal force wholly independent of its taste. Certain aromatic drugs were deemed to possess anti-spasmodic and stim- ulant properties, etc. Experimental Pharmacology. The modern method for arriving at a knowledge of drugs is by experiment- ation on animals, chiefly frogs, rabbits, dogs, cats, etc. But this method is objectionable on account of the difference in structure and physiology of these animals * "The soul does not perceive the external or internal physical construction of herbs and roots, but it intuitively perceives their powers and virtues and recognizes at once their signatum. This signature is a certain organic vital activity giving each natural ob- ject (in contra-distinction to artificially made objects) a certain similarity with a certain condition produced by disease, and through which health may be restored in specific diseases in the diseased part. This signatum is often expressed, even in the exterior form of things, and by observing that form we may learn something in regard to their interior qualities, even without using our interior sight. We see that the internal character of a man is often ex- pressed in his exterior appearance, even in the manner of his walk- ing, and in the sound of his voice. Likewise the hidden character of things is to a certain extent expressed in their outward forms. As long as man remained in a natural state, he recognized the sig- natures of things and knew their true character; but the more he diverged from the path of nature and the more his mind became captivated by illusive external appearances, the more this power became lost." — Paracehus. Principles of Homceopathy. 17 and the vast difference in their susceptibility to the action of medicines. Nux is most poisonous to man, yet pigs can eat it freely; Aconite is fatal to man in a small dose, yet dogs and horses can eat it with im- punity. Birds are not susceptible to the action of Opium or Atropin, etc. Again, the dynamic effects of drugs differ among animals. For instance, Ipecac and Tartar Emetic are emetics to men and dogs, but not to rabbits. Such methods of arriving at the crude drug effects may be sufficient to determine the so-called physiological effects of drugs, and the antipathic use of them based thereon, but is wholly inadequate for purposes of Homoeopathy. They have their use, also, in determining the ultimate organic lesions produced by certain drugs, whenever it is desirable to push a proving to such an extent. Physiological action of drugs. Drugs produce in the organism, when given in sufficiently large doses, certain disturbances or alterations of function, usually of a correspondingly definite character. The dosage required for this purpose is, as a rule, a fixed one within certain limits. It is the physiological dose — that is, a dose large enough to produce symptoms. Opium con- stipates the bowels, produces insensibility. For these purposes a recognized, fixed quantity is necessary, not less than one-half to one grain. This constitutes its physiological dose. Strychnia increases the reflex excitability of the spinal cord, in doses of one-twelfth to one-thirtieth of a grain. Digitalis slows the heart in ten minim doses. Now this direct, absolute action of drugs, which is constant, can be made the basis of treatment of disease, wherever this is possible. Its advantages are imme- diate results and improvement of certain conditions opposed to this direct drug action. It is, therefore, pal- 2 18 A COMPEND OF THE liative where indicated. This use of drugs is based upon the law of contraria contrariis opponenda, when an opposite result is desired, or when it is intended to produce not an opposite, but an entirely different action, as, for instance, a purgative in a case of head- ache. The objections to this direct use of drug effects, by means of physiological dosage, are the limited field to which such action is applicable and the necessity for increasing dosage, and sooner or later opposite re- actionary results that make further use of the drug useless. All physicians may make use of this direct, physiological action of certain drugs for certain condi- tions, but its usefulness is limited. Hahnemann him- self clearly defines it as follows: " I do not fail to recognize the great ability *bf palli- atives. They are often not only quite sufficient in cases appearing suddenly and developing rapidly, but they have great advantages, indeed, where aid cannot be postponed for an hour, or even a minute. Here, and here alone, are palliatives of real use." This use of drugs for their direct primary effects by means of a dosage sufficiently large and within certain limits, always definite and precise, has led to a classi- fication of drugs, according to their physiological and some ,of their therapeutic actions, and not differing materially from that introduced by Dioscorides, the father of Materia Medica. Since his time drugs have been classified into three principal classes, evacuants, alteratives and specifics. The evacuants are ag an subdivided with respect to the various routes by which nature expels the morbid matters, such as purgatives, expectorants and diaphoretics. Alteratives comprise drugs which alter the course of morbid conditions, modifying the nutritive processes while promoting waste, and thus indirectly curing some chronic diseases; Principles of Homoeopath y. 19 such are Mercury, Iodine and Arsenic. They increase metabolism. Other classes are the antipyretics, emmenagogues, styptics, anthelmintics, astringents, etc., etc. While such classification is very imperfect, and but a partial designation of the properties of drugs, for every drug may belong to several classes, and its special pro- perties in any class are at best vague and uncertain, still, there is some advantage to those who want to avail themselves of the direct drug effects, of this drug classi- fication, based on some of their more marked pathoge- netic and therapeutic effects. But it is entirely useless for homoeopathic prescribing. The homoeopathic method by means of drug ex- perimentation on the healthy, so-called drug proving. This is the only scientific and rational method of ascer- taining the action of medicines. All other methods have proved useless and misleading. The credit of first teaching the necessity of proving drugs upon the healthy belongs to Albrecht von Haller, a Swiss physi- cian. As early as 1755, in his Swiss pharmacopoeia, he distinctly taught this, but nothing came of it. It was not until Samuel Hahnemann, in 1796, practically went to work and actually experimented with drugs on himself and others that the first pure effects of drugs became known and could be rationally employed in practice. Hahnemann was thus the founder of the science of drug pathogenesy, for it is a fact that up to his tinl^no one had made any physiological experiment with any drug; it is a fact that his experiments with Peruvian Bark were the first ever made in the domain of pharmacology, and are a model to this day. The science of drug proving dates therefore from 1796, and is the beginning of a rational therapeutics. With the adoption of this principle, we have a key to unlock the 20 A COMPEND OF THE sphere of action of every substance in nature, so far as it can bear any relation to man's constitution in health and disease. It is a creative principle, universal in its application, true for all time. The introduction of it into medicine marks an epoch in the development of the healing art, before which time a science of thera- peutics was impossible. In the Organon, §§ 108-9, Hahnemann says: " There is, therefore, no other possible way in which the peculiar effects of medicine on the health of indi- viduals can be accurately ascertained; there is no aure, no more natural way of accomplishing this object than to administer the several medicines experimentally, in moderate doses, to healthy persons, in order to ascer- tain what changes, symptoms and signs of their influ- ence each individual produces on the health of the body and of the mind; that is to say, what disease ele- ments they are able and tend to produce, since, as has been demonstrated, all the curative power of medi- cines lies in the power they possess of changing the state of man's health, and is revealed by observation of the latter." Drug Pathogenesy is the record of testing drugs on the human body in varying doses, and on different individuals of both sexes, and observing all the symp- toms, subjective and objective, from the minutest dis- turbed function and mental state to the grossest organic lesion. "Simple drugs," says Hahnemann, "produce in the healthy body symptoms peculiar to themselves, but not all at once, nor in one and the same series, nor all in each experimenter." Such a method of arriving at a knowledge of drugs is universal in its application ; it includes all that can be learned from toxicology also. The value of toxicology as illustrating drug action is far inferior, however, to that of testing them in Principles of Homceopathy. 21 health by means of small doses. Still it gives the ulti- mate lesions and organic changes, and in this way- interprets many symptoms of the provings; but when- ever the organism is violently invaded by a foreign destructive agent, no matter what the poison is, there is usually much similarity of action, resulting from nature's efforts to throw it off by all possible routes outward from the body's distinctive vital centers, hence the inevitable nausea, vomiting, diarrhoea, nerve dis- turbances, convulsions, paralysis, etc., of most poison- ings. The provings with small doses avoid these crude, extreme effects, and, instead of producing them, rather indicate them by the milder disturbances produced. Different Applications of Drug-action. The knowl- edge of what drugs will do when given to a healthy subject can be utilized in two different ways, both legit- imate, and it is a mere matter of experience and obser- vation to determine which is the better. We can use a drug to produce its physiological effects. If this is desired, the drug must be given in a dose large enough to produce symptoms — that is, in a so-called physio- logical dose, differing with each drug and determined by experiment. This is the antipathic use of drugs, and has nothi7ig to do with Homoeopathy, or the law of cure. It is, moreover, very limited in its application, and objectionable on many grounds. The other method, the homoeopathic relationship, is universal in its application, and is not confined to any special dosage, provided such always is sub-physiologi- cal — i. e., less than is required to produce symptoms. Hence, drugs can act in tivo different ways when given in disease, and we can have, therefore: 1. Homoeopathic relationship — when given for con- ditions similar to those they are capable of producing. Applicable to all drugs, and universal in its extent. 22 A COMPEND OF THE (2) Antipathic or allopathic relationship — when given in physiological dosage to produce their first, direct or physiological effects. This is, as we have stated before, of but very limited application. The only difference in the application of drugs to disease with the two schools of medicine is, that the old school gives drugs solely to obtain their direct, physiological effects, and rather favors combination of remedies, while the homoeopathic school depends en- tirely upon the curative results obtained by giving the single remedy in a sub-physiological dose for symp- toms similar to those it is known to produce. For reference and further study, see Hahnemann's Essay on a New Principle for Ascertaining the Curative Powers of Drugs in his Lesser Writings, page 249. Hahnemann's Essay on the Sources of the Common Materia Medica, being Preface to Vol. II of the Materia Medica Pura. The Physiological Action of Medicines, by Wm. Sharp, in Es- says on Medicine, page 417. General Principles of Drug Action, by K. Hughes, in Pharma- codynamics; lecture IV-V. An interesting account and practical application of the Doctrine of Signatures can be found in Grauvogl's Textbook, $ 91-95. Samuel A Jones, M.D.: "The Grounds of a Homoeopath's Faith." An inspiring little work. Dudgeon. "Lectures on Homoeopathy." Lect. VI, Isopathy. Pkinciples of Homceopathy. 23 CHAPTER III. THE EVOLUTION OF THE HOMCEOPATHIC MATERIA MEDICA. The Homoeopathic Materia Medica is a record of the effects of drugs upon the healthy human organism, embodying a knowledge of what drugs actually do when brought in contact with the functional activity of the body. The sources of this knowledge are, 1. The systematic provings. 2. Observations of cases of poisoning and over-dos- ings, which Hahnemann and his disciples have gath- ered from general medical literature. The First Book on Drug Effects. The first work embodying such record is that of Hahnemann, entitled Fragmenta de ViriMis Medicamentorum Positivis. It is a Latin work, and published in Leipsic in 1805. Twenty-seven drugs are treated of, containing symp- toms Hahnemann himself had observed as effects of poisoning or from excessive dosing, and of provings on himself.* ''I have instituted experiments," he says in the preface, '^ in chief part on my own person, but also on some others whom I knew to be perfectly healthy and free from all perceptible disease." "In those experiments which have been made by myself and my disciples, every care has been taken to * It is interesting to know the names of the pioneer medicines whose pathogenic effects were first published in this work of Hah- nemann. They are Aconitum, Arnica, Belladonna, Camphora, Cantharis, Capsicum, Causticum, Chamomilla, Cinchona, Coccu- lus, Copaiva, Cuprum, Digitalis, Drosera, Helleborus, Hyoscy- amus, Ignatia, Ipecacuanha, Ledum, Mezereum, Nux vomica, Opium, Pulsatilla, Rheum, Stramonium, Valeriana, Veratrum album. Of these, Cantharis, Copaiva, and Valeriana, Hahnemann did not include in his subsequently published "Materia Medica." 24 A COMPEND OF THE secure the true and full action of the medicines. Our provings have been made upon persons in perfect health, and living in contentment and comparative ease. When an extraordinary circumstance of any kind — fright, chagrin, external injuries, the excessive enjoyment of any one pleasure, or some event of great importance — supervened during the proving, then no other symptom has been recorded after such an event, in order to prevent spurious symptoms being noted as genuine. When such circumstances were of slight importance, and could hardly be supposed to interfere with the action of the medicine, the symptoms have been placed in brackets, for the purpose of informing the reader that they could not be considered decisively genuine." Hahnemann's Materia Medica Pura. Five years now elapsed before Hahnemann pub- lished anything more in the line of drug pathogenesy. They must have been five years of intense labor and experiment. Then appeared the first volume of that great classical work, the " Materia Medica Pura," con- taining the symptomatology of twelve medicines, six of which had already appeared in the Latin treatise published before. Five years later appeared the second volume, con- taining the symptomatology of eight medicines, which was soon succeeded by the four other volumes, contain- ing in all the pathogenic effects of sixty-one drugs. It is a monumental work, the result of Hahnemann's matchless penetration, wonderful insight and accurate observation, of which he was a master. He was most ably assisted in this work by thirty-five fellow-provers, among whom the names of Franz, Gross, Hartmann, Herrmann, Hornburg, Riickert, Stapf, and Friedrich Hahnemann are the most conspicuous and deserve to be remembered by all students of Materia Medica. Principles of Homceopathy. 25 In 1822 appeared a second edition of this great work, with considerable additions to the symptomatology of all the remedies and some new medicines besides. A third and fourth edition were published after some years. Publication of the "Chronic Diseases." In 1828 Hahnemann published his ''Chronic Dis- eases," containing the symptomatology of a com- pletely new series of medicines, a series of deeply- acting drugs, like Calcarea, Sulphur, etc., the so-called Anti-psoric remedies. The symptomatology of these remedies was not wholly pathogenetic, but included observations at the bedside, so-called clinical symp- toms. A second edition, greatly enlarged and now con- taining the symptomatology of twenty-five remedies, besides the twenty-two of the first edition, appeared between 1835 and 1839. A peculiar feature of the provings in this work is that the bulk of them must have been obtained with the thirtieth potency, and often are observations when given to the sick, differing entirely, therefoi-e, from the pathogenetic effects of the Materia Medica Pura. A new English translation of this great work has just appeared in this country. Besides Hahnemann and his immediate disciples, Constantine Hering, of Philadelphia, contributed the best provings to the homoeopathic Materia Medica, some of his drugs ranking in importance with Hahne- mann's own. Of these, Lachesis, Glonoine and Apis take first rank. Another large contributor to the Materia Medica was Dr. E. M. Hale, not so much by proving as by intro- ducing American remedies that had been in use by botanic physicians, and gathering all that was known as to the therapeutic properties in one volume, called "New Remedies." We have, then, as 26 A COMPEND OF THE Sources of the Homoeopathic Materia Medica. 1. Hahnemann's Materia Medica Pura, published in 1811, containing the pathogenesis of the great poly- chrests — i. e., remedies of many uses and wide and fre- quent application. 2. Hahnemann's Chronic Diseases, published in 1828, containing the so-called Antipsoric remedies, those especially adapted to the cure of chronic diseases. 3. Dr. Jorg's Provings — a professor at the Univer- sity of Leipsic and contemporary of Hahnemann, but not one of his followers. He proved, among others. Camphor, Digitalis, Opium, Arnica, Hydrocy. acid, Ignatia. Some of his symptoms are quoted and in- cluded by Hahnemann in the second edition of his works. 4. Dr. Hering and the American Provers' Union. 5. Dr. E. M. Hale's contributions in his " New Remedies." 6. Various provings and reprovings under the aus- pices of the American Institute of Homoeopathy, vari- ous State societies and individual provings published in our journalistic literature. Also, Hartlaub and Trink's pathogeneses, Stapf's additions, provings by the Austrian Society, etc., etc. These records are at present collected in three great works: 1. "Allen's Enclycopaedia," in ten volumes. 2. ''Cyclopaedia of Drug Pathogenesy," in four vol- umes. These two works contain the symptoms obtained by provings, and from records of poisoning, i. e., patho- genetic symptoms. 3. "Hering's Guiding Symptoms," in ten volumes, which also contains clinical or curative symptoms — i. e.j observed on the sick. Principles of Homceopathy. 27 The comparative value of the three sources of symptoms, from records of toxicology, provings on healthy and observation on sick. 1. Toxicology. Violent cases of poisoning never yield a profitable symptomatology, on account of the violent invasion by foreign destructive agents. The organism throws it off by all routes outward and away from its distinctive life, hence vomiting, diarrhoea, convulsions, etc., common to all kinds of poisoning. On the other hand, the records of poisoning give us the ultimate action, the tissue and organic changes that the prov- ings can only indicate, and thus they illustrate and interpret the provings. 2. Provings on the healthy. The provings with com- paratively small doses avoid these violent, crude and extreme effects, and instead of producing them, rather indicate them by mild disturbances. We thus obtain the finer and more characteristic action, and thus a much more utilizable picture of drug effects. Fortu- nately, the bulk of the homoeopathic Materia Medica is made up from this source. The symptoms obtained from toxicological observations and from provings are also called pathogenetic symptoms^ and the full record, in the order of their development, is called the drug's pathogenesis. The "Cyclopaedia of Drug Pathogenesy" gives these in their fullest and most accurate form. 3. Drug effects observed in the sick. In the evolution of the homoeopathic Materia Medica, another class of symptoms not bearing the aristocracy of origin, charac- terizing pathogenetic symptoms, were introduced, so- called clinical or curative symptoms. This source was almost unavoidable, so long as drug provings on the healthy were limited in number and extent. The symptomatology of most of the great constitutional or anti-psoric remedies consists, in large part, of such clin- 28 A COMPEND OF THE ical symptoms. They are such symptoms as disappear after administering a remedy, and which are not found among the pathogenetic effects, so far as the provings have been made; but, wherever genuine, there can be no doubt that they are possible pathogenetic symptoms, could we have full and accurate provings. In this way the homoeopathic Materia Medica has been enlarged, not always wisely, however; for, in order to discover them amidst the symptoms of the disease in a patient, much discrimination and training are required. Hahnemann rightly says that this is a " subject for the exercise of a higher order of inductive minds, and must be left solely to masters in the art of observation." But, when found, they must be used tentatively and cautiously until verified in practice. Only then can they be admitted by the side of the true pathogenetic symptoms and form a legitimate addition to the Mate- ria Medica. Some of the greatest characteristics and guiding symptoms belong to this class. These clinical symptoms have been excluded from the "Encyclopaedia of Materia Medica" by T. F. Allen, and, of course, can- not have any place in the "Cyclopaedia of Drug Patho- genesy"; but they are included in full in Hering's " Guiding Symptoms " and in all manuals and text- books of Materia Medica. In some of these they are designated by a distinguishing mark, usually O, but in most of the later works even this caution is disre- garded. The Hahnemannian Schema. In order to bring this vast symptomatology within the ready reference of the busy practitioner, Hahnemann, himself a physi- cian of large and extensive practice, and, hence, in need of labor-saving devices, re-arranged it in anatom- ical order, which has been found so practical for every- day use, that it has been universally adopted by all Principles of Homceopathy. 29 our authors on Materia Medica. He begins with the head and first records all the symptoms of the mind, sensorium, etc.; then those of the eyes, nose, face, etc., downwards, placing together all the symptoms relating to each section. In this way the original provings were dissected, destroying the order of development of the symptoms, but greatly facilitating ready reference. The Repertory or Index of Symptoms. This is another aid that has been found necessary to facilitate the selection of the indicated remedy. It is a useful appendage to the homoeopathic Materia Medica, by means^ of which we can readily discover almost any recorded symptom of any proven drug. The secret of successful use of the " Repertory " is to get thoroughly acquainted with any one of the different repertories by constant reference to it, thus familiarizing oneself with its peculiar arrangement. The most helpful of them all, but the one requiring, also, most patient study, is Boeninghausen's " Therapeutic Pocket Book." Its arrangement is based on a practical analysis of symp- toms into their component elements of location, sensa- tion and conditions. (See Chapter V.) How to learn Drug Pathogenesy and acquire a working knowledge of the homoeopathic Materia Medica has occupied the students of Homoeopathy from the beginning of the school. Unquestionably, the proving of a drug is the truly natural and most effective method of getting a knowledge of its action, and every physi- cian and student should undertake such practical study as at least part of his study of materia medica. It is the true, modern, scientific method by appeal to nature herself. In the absence of this, and as a further aid, the study of original provings, and of records of poison- ings, will go far to give a good general outline of the action of a drug. This should be followed by the care- 30 A COMPEND OF THE ful and repeated reading of the recorded symptoma- tology, noting the parts especially involved, character of the symptoms, the conditions under which they occur, and the concomitants connected with each symp- tom. In this way the peculiar and characteristic symptoms and conditions will appear, which will be the guiding symptoms in practice. These characteris- tics, so-called key-notes, of the different remedies, must be committed to memory, they form the stock in trade of the homoeopathic prescriber, and will lead to the further and more detailed and comparative study of the remedies. For further study, consult Hughes, "Sources of the Homoe- opathic Materia Medica," in his work ou Pharmacodynamics; also published separately by Leath & Ross, London. Dr. John W. Hayward: "How to Learn Drug Pathogenesy, " with discussion, in the Journal of the British Homeopathic Society, January, 1895. The following classical papers should also be consulted: Constantine Hering: "How the Materia Medica should be Learnt," in British Journal of Homoeopathy, Vol. II. Dr. Meyer, one of Hahnemann's immediate disciples, on the same subject, in North American Journal of Homceopathy, Vol. II. Dr. Pope, in Monthly Homceopathic Review, VIII, and Vol. XXV. Dr. H. R. Madden, in same journal, Vol. XIV. Dr. R, Hughes, in same journal. Vol. XXIII, and in Hahne- mannian Monthly, Vol. XXIX. Dr. C. Wesselhoeft in JV. E. Medical Gazette, Vol. XXII. Dr. Joseph C. Guernsey, in Hahnemannian Monthly, Vol. XXIX. American Institute Report for 1894, Materia Medica Section; opinions of thirty-one members. Edited by Dr. Frank Kraft. Principles of Homceopathy. 31 CHAPTER IV. DRUG PROVING. The proving of medicines is a distinctive feature of Homoeopathy and a logical necessity for applying the law of cure; for, in order to meet morbid states with drugs corresponding to them, we must know, and therefore ascertain, what morbid states the different medicinal substances produce. It consists in the sys- tematic testing of a drug on the healthy human body, in order to ascertain the changes which it is capable of producing in the functions and organs. Hahnemann, after viewing the subject in every pos- sible light, and examining every method for ascertain- ing the action of drugs, came to the conclusion that the only efficient way was " to test the medicines singly and alone on the healthy human body." General Rules for Drug Proving. The medicinal substance which is to be proved must be tested singly, without any admixture of any foreign substance, except an inert vehicle when necessary for its administration. Nothing of a medicinal nature should be taken so long as it is desired to observe the effects of the proving. Each drug should be proved, not only in its crude form and lower material dosage, but with higher atten- uations as well. When the latter are used and symp- toms obtained, a special susceptibility on the part of the prover probably exists and some of the most important characteristics may be elicited from him. Only actu- ally observed facts should be recorded, free from all theories of drug action. Such purely positive observa- tion is for all time, and possesses the same value after the lapse of centuries as it does at the time when first 32 A COMPEND OF THE observed. If any deductions be drawn from the ob- served facts, they should not be incorporated into the text, but kept separate and distinct. For this reason, Hahnemann called his Materia Medica 'Tura" (pure), because free from all theories, only a record of observed facts. Hence, in making a proving, great precaution, control experiment, accuracy, close observation, and the strictest conscientiousness are essential. Directions for provers. The prover should not de- part in any material way from any of his ordinary habits of life, because his life is based on these habits and conformed to them, and any marked change in these must result in changes more or less important, which might be put to the account of the drug; hence, his food, drink, sleep, exercise, and habits generally must be such as he has been accustomed to. He should observe himself before beginning a proving, as every one is liable, even in the best state of health, to slight variations in his sensations and functions. Hav- ing thus discovered what symptoms he is liable to nat- urally and without any drug influence, he must avoid attributing these to the drug to be proven, unless, in- deed, they are more pronounced than ever. Dosage required for proving. As a general rule, begin with a comparatively small dose and increase it gradually till distinct symptoms make their appear- ance. The most useful doses are those that are just sufficient to produce distinct symptoms. Female provers. It is very important to test all drugs in regard to their effects on the female organism, hence women, married and unmarried, should contrib- ute to provings. '' Before beginning the record of a proving, she should inscribe in the note-book a state- ment of her age, temperament, the sicknesses which Principles of Homceopathy. 33 she has had, and those to which she has an inherited or acquired tendency; also, whatever pains or sensa- tions she may be habitually subject to; also, any pecu- liar susceptibilities she may possess to external influ- ences of any kind, or to mental, or moral, or emotional excitements, depressions or perversions. Her constitu- tional peculiarities, respecting the menstrual function, should be carefully recorded; regarding frequency, quantity, character, and whatever inconveniences or sufferings precede, accompany or follow menstruation, such as headache, backache, colic, leucorrhoea, etc., with peculiar states of mind or emotion." * Repetition of doses. No special rule can be given, but it has been the custom of most provers to repeat the dose every few hours until symptoms show them- selves. It is best to give a single, rather large, dose and watch its effects. This plan is chiefly useful with some vegetable medicines, whose sphere of action is small, and of which the first dose sometimes exhausts, for a time, the susceptibility of the system to the action of the substance. The continuous repetition of the dose is applicable, if we want to ascertain the special action of a drug on some organ or function by con- tinued dosing. Age and sex are modifying factors in drug proving, and all drugs should be tried on individuals of both sexes and different ages. Some drugs possess marked affinity for one sex, as Crocus and Platina for the female, and Nux preferably the male. Temperament. Different temperaments should be chosen, for certain medicines are especially adapted to certain temperaments, and here find the most favor- able environment for developing their specific effects. ■* Dunham, 3 S4 A COMPEND OF THE Re-pro vings. The provings should be repeated in different individuals and in the same prover. In order to avoid the admission of accidental symptoms, it is a safe rule, although not absolute, not to adopt any symptoms unless it has been found in several provers. By comparing one proving with another, and ascer- taining the constancy with which the different symp- toms appear, the characteristic symptoms are made manifest. It is to be remembered that all individuals are not alike susceptible to all the effects which a drug is capable of producing; therefore, the need of a large number of experiments is apparent, in order to obtain a complete view of the action of a drug. Heriiig's Rules for Provers. (1) Make a first experimental test with a single, moderate-sized dose. (2) If no symptoms are produced, take it every two or three hours, or change the time of the day for taking it. (3) If still no symptoms, try higher potencies, to which might be added this rational, additional rule: if still no symptoms appear, go lower in the scale of at- tenuations and give material doses, increasing size until symptoms appear. In the nature of things, some of the symptoms take time to develop, therefore the first experiments with small doses should not be hurried. The prover should learn to wait, for some of the late appearing symptoms are frequently the most characteristic. How to Describe Symptoms Obtained from a Prov- ing. The greatest minuteness and accuracy should be observed. A sensation should be described by some familiar comparison. State how the symptom is ef- fected by different circumstances, i. e., the drug's mo- dalities, as position of body, motion, rest, eating, fast- Pkinciples of Homceopathy. 35 ing, day, night, indoors, open air, weather, etc. No circumstance, however trifling, should be omitted which may in any way tend to indicate the characteristic ac- tion of the drug and so precisionize it. All such con- ditions of aggravation and amelioration should be care- fully recorded as they express the drug's individuality most clearly and universally. The sides of the body on which symptoms occur should always be stated, many remedies acting more markedly on one side than another. The times of occurence, aggravation or amelioration, are also very important, some remedies having distinct- ive morning aggravation of some or all of their symp- toms, others at night, etc. As an illustration of a per- fect description of a symptom, take the following of Hahnemann's proving of Nux: " Headache beginning some hours before dinner, increased after eating, then violent shooting pain in left temple, with nausea and very acid vomiting, all of which symptoms disappeared on lying down." The three essential features of every complete symptom are, therefore, (1) Location. (2) Sensation. (3) Condition of aggravation or amelioration (mo- dality), which is the most important, and it ought to be the aim of all provers to observe symptoms with these features well in mind. Never separate symptoms that appear in groups or with marked concomitants. Hahnemann always left together symptoms appearing in groups, if he consid- ered them really connected; for instance, he observed, forty-five minutes after taking Pulsatilla, a cramp in the legs, in the evening, after lying down, with a chill; and at another time, in the evening, an aching, draw- 36 A COMPEND OF THE ing pain in the legs up into the knee, with more chilli- ness than during the day. Primary and Secondary Drug Effects. It is a law of drug action, according to which the administration of each medicine causes, at first, certain abnormal symptoms, the so-called primary effects of medicines, but afterwards, by reaction of the organism, a condition entirely the opposite, where this is possible, of this first effect is produced — the secondary effects, for instance, narcotic substances produce primarily insensibility and secondarily pain. In order to produce the primary effects, material doses are required. In his essay, entitled "Suggestions for Ascertaining the Curative Powers of Drugs," Hahnemann says: ''Most medicines have more than one action; the first a direct action, which gradually changes into the second (which I call the indirectly secondary action). The latter is generally a state exactly the opposite of the former. In this way most vegetable drugs act. But few medicines are exceptions to this rule, i. e., metals and minerals. The thorough examination of drug provings, as in our possession at present, does not justify any division of drug-symptoms into primary and secondary. There are indeed in every proving, as Dr. Hering has shown, primary and secondary symp- toms, in the sense that some symptoms appear earlier and others later in the course of the proving, but although these may appear opposed to each other, they are all to be regarded as drug symptoms, and, as such, indi- cate the remedy. Hahnemann's method of conducting provings. Dr. Hering thus describes it: "After he had lectured to his fellow-workers on the rules of proving, he handed them the bottles with the tincture; and when they afterwards brought him their day books, he examined Principles of Homceopathy. 37 every prover carefully about every particular symp- tom, continually calling attention to the necessary accuracy in expressing the kind of feeling, the pain or the locality, the observation and mentioning of everything that influenced their feelings, the time of day, etc. When handing their papers to him, after they had been cross-examined, they had to affirm that it was the truth, and nothing but the truth, to the best of their knowledge, by offering their hands to him — the customary pledge at the universities of Germany, instead of an oath. This was the way in which our master built up his Materia Medica." For fuller study see Organon, $ 105 to 145. Dudgeon, Lectures on Homoeopathy, page 176. Lecture VII and VIII. Sharp's Tracts on Homoeopathy, Essay VII. Provingsin Health. Dunham, Science of Therapeutics: The Dose in Drug Proving, page 136. Directions for Drug Pro vers, page 350, A COMPEND OF THE CHAPTER V. INTERPRETATION OF DRUG PATHOGENESIS. The homcBopathic Materia Medica, as it is accessible at present to students, is a mass of symptomatology, arranged, as a rule, according to the Hahnemannian Schema. The " Cyclopaedia of Drug Pathogenesy " is the exception, which endeavors to give the symptoms in the order of their development; but, in order to practically utilize the provings, the anatomical ar- rangement of the symptomatology is desirable. Besides this arrangement, the bulk of the symptomatology can be analyzed and interpreted helpfully, and thus simpli- fied. All provings of drugs give a symptomatology composed (1) Of general symptoms. (2) Of peculiar or characteristic symptoms. (3) Of certain elective affinities to special organs or functions. General symptoms of drugs. These are common to all drugs and appear in every proving. They can practically be eliminated. Such are symptoms like feeling of malaise, loss of appetite, weakness, distress, headache, etc. Such general symptoms, unless ampli- fied by accompanying conditions or modalities^ are of com- paratively little value for the prescriber, because their presence does not point clearly to any one particular drug. We must find in our symptomatology, and make use of such symptoms as serve to individualize and give character to a drug, and hence these are called Characteristic Symptoms. Each drug is an entity, and can express its disease producing properties, i. e., Principles of Homceopathy. 39 pathogenetic force, in a way peculiar to itself. Those symptoms that do this most perfectly are the drug's characteristic symptoms. The ideal characteristic symptom is one which is possessed by no other than the individual drug of which it is predicated and to which it gives character as an individual. We learn to distinguish drugs very much as we learn to distin- guish men, not by their general features, which are com- mon to all, but rather by the peculiar expression and shape and habits by which we recognize the individual. It may be a small and insignificant thing and yet one that is most expressive of the person's individuality. So in drugs it is not the general effect upon the stom- ach or bowels or the general debility produced that serve to characterize it as the remedy, but rather the peculiar, characteristic uncommon, prominent symp- toms. These have also been designated as keynote * symp- toms, by Dr. Guernsey, and as guiding symptoms, by Dr. Hering. From a physiological point of view they may appear trivial and unimportant, but for purposes of prescrib- ing they are paramount in importance. These charac- teristic symptoms of drugs may be found in one of three divisions of its pathogenesis. Either * " While the keynotes, according to Dr. Guernsey, will, in each instance, form an unfailing guide, the requisite conditions and corresponding totality of the symptoms in such cases being inevit- ably present. If this doctrine is true — and in practice it has been confirmed by much experience — it is so because these so-called key- notes essentially represent a profound dyscrasia of the organic ner- vous system.', either in such sensations of pain as precede even the first functional derangements, and are intended as premonitory ad- monitions; or in such sensations as arise in connection with, and in conseqTience of, the initial disorder in these most interior organs of vegetative life. " — J. H. P. Frost in Hahnemannian Monthly, Vol. II, page 443. 40 A COMPEND OF THE 1. In the locality or tissue or organ affected. 2. In the sensations. 3. In the modalities and concomitants. These are the three grand divisions around which the symptomatology of drugs can be grouped, or into which they can be divided for practical study. Locality or seat of action. Every drug affects some organ or system of organs or tissue or region more de- cidedly than others, and there especially or primarily expends its power. This is not a local action merely, but a localization of the drug^s specific nature. It ap- pears, no matter by what avenue the drug is introduced into the body. A drug may come into direct contact with the blood, and thereby with every part of the or- ganism, and yet only certain tissues or organs will be affected by it— that is, only these tissues or organs will react against the foreign element. This specific localiza- tion, or specificity of seat of a drug, is known as its elec- tive affinity, by which it preferably chooses certain cells, tissues or organs, to manifest its action. In a general way, we see that Belladonna affects principally the brain as its arena for action, and this organ, therefore, has a preferred relationship to Belladonna. So, in the same way, Aconite affects the heart, Ergot the uterus, Bryonia the serous membranes, Podophyllum the duo- denum, Rhus the skin; Tellurium, the tympanum; Glonoin the vaso-motor centre in the brain; Phosphor, the periosteum. This elective affinity cannot be explained, but it ex- ists. It was recognized even before Hahnemann and homoeopathic provings, and has been made the founda- tion of a system of practice by Rademacher, a German physician and contemporary of Hahnemann, who him- self traces the thought to Paracelsus. AVhile each drug has a preferred locality, based on Peinciples of Homceopathy. 41 its elective affinity, still it must not be forgotten that the whole organism — the whole man, mentally and physically, — is affected. This is so, because the var- ious functions and organs are not independent instru- ments, but wonderfully bound together by nerves and blood vessels, and parts most remote are in direct nerve communication with each other. Diseases are produced and continued along these lines of network, when once they have found a foothold, and drugs act in a similar manner along these tracks. We ought to get a mental picture of a drug as a whole — the drug personified, and thus the typical patient corresponding to the drug. Such study gives a reality and practical utility to the Materia Medica. Sensations, or kind of Action. While the special seat of action is the first marked fact about the patho- genetic properties of drugs, the special kind of action is the second fact. This may be seen in the sensations and modalities of a drug. Thus the burning pains of Arsenic, the coldness of Camphor and Veratrum, the sticking pains of Bryonia, the stinging pains of Apis and Theridion, the plug sensations of Anacardium, the soreness of Arnica and Hamamelis, are all characteris- tic. Frequently the character of these pains indicates the seat of the action, and thus points to the elective affinity of the drug, as burning pains in general indicate the mucous membranes; dull, boring, gnawing pains, the bones; sticking, cutting pains, serous membranes; etc. In many drugs these conditions may be so expres- sive of their special character, that we nearly always expect them to be present when they are the homoeo- pathically indicated, and, therefore, prove to be the curative remedy. Such characteristic conditions are the restlessness and anxiety of Aconite and Arsenic, the chilliness of Pulsatilla, the thirstlessness of Apis, the 42 A COMPEND OF THE dullness and drowsiness of Gelsemium, the hysterial contradiction of its symptoms of Ignatia, the melan- choly of Aurum, etc. Modalities and Concomitants. Modalities are con- ditions influencing or modifying drug action. They are the phenomena of time, place, circumstances on which the development and appearance of the symp- toms depend. Every drug has its own mode of action, manifests itself in a way peculiar to itself, distinguish- ing it from every other. It acts best under certain conditions, in certain bodily and mental constitutions, which present, therefore, the most favorable ground and environment for the full and free manifestation of the drug's individuality. Just as a plant thrives best in certain conditions of soil, climate, elevation, etc. — needs, in short, for its perfect development, a suitable environment, — so a drug must be similarly situated to enable it to express itself clearly and fully. It is of the greatest importance in drug proving, as well as in prescribing homoeopathically, to note the peculiar method in which a drug invades the animal economy, its aggravations and ameliorations, the times of the day, and conditions of the weather, when the action is most pronounced. For instance, the marked increase of pain on motion of Bryonia, the relief of headache by wrapping head up warmly of Silica, the marked preference of the left side of the body of Lachesis, the aggravation of all the symptoms from 4 to 8 p. m. of Lycopodium, the relief by heat of Arsenic, the aggrava- tion of damp weather of Dulcamara, are characteristic conditions of great value, clearly expressing the pecu- liar genius of these drugs and are paramount in esti- mating their place in the symptomatology. But, while they hold this important place, they must not be studied independently of the whole of a drug's action. Principles of Homceopathy. 43 for this is needed for their interpretation. It is a fact that the study of characteristics alone leads quickly to practical results, but also to permanent mediocrity in knowledge of drug action. Boeiiiiighaiisen's method of interpreting symp- tomatology consists essentially in the selection from the symptoms of the patient, and from those of the drug, of their elements, rather than try to obtain the complete symptom, which latter consists of a seat or location^ a sensation and a modality; but, in the present incomplete state of our Materia Medica, most of the symptoms are fragmentary, and but few are complete in the above sense. By the use of Boeninghausen's method, these fragmentary symptoms are supple- mented by clinical observation of the curative effects. A remedy is selected for a case that is found to possess in its symptomatology marked action (1) in a certain location; (2) to correspond with sensation, and (3) pos- sess the same modality; without necessarily having in the proving produced the very symptom resulting from the combination. It is to be inferred that a full proving would have it, however. For instance, a patient with a bearing pain in the left hip, relieved by motion, greatly worse in the afternoon, would receive Lycopodium, not because Lycopodium has so far produced in the healthy such a symptom, but because, from the study of its symptoms as recorded in the Materia Medica, we do find that it affects the left hip prominently (locality); that its pains, in various parts of the body, are "tear- ing" (sensation); and that its general symptoms are relieved by motion and aggravated in the afternoon (modality.) The only justification for such analysis and synthesis of symptoms is the imperfection and limitation of our provings and especially the success following the application of the newly constructed 44 A COMPEND OF THE symptom, out of these elements, in removing similar symptoms in the patient, hence in curing, and the reasonableness of the presumption that future, com- plete provings will develop the missing links of the complete symptom of the drug. It is in entire har- mony with the fact that every genuine symptom has these three factors — locality, sensation, and modality — these, when combined, constitute a perfect symptom. It is not usual to get these, in any one symptom, from any one prover, but they may be found scattered through the various provings; hence the legitimacy of Boeninghausen's method. Read in this connection: T, F. Allen's paper before the World's Medical Congress at Chi- cago, 1893, entitled, "The Selection of the Homoeopathic Eemedy, especially in regard to Boeninghausen's Method," published, with discussions, in North American Journal of Hommopathy, August, 1893. For further practical illustration of the use of Boeninghausen's method see an instructive, analytical report of a case of "Progres- sive Muscular Atrophy Cured with Phosphorus," by T. F. Allen, reported in Ilahnemannian Advocate, July 15, 1896. For further study, consult "Organon," §$ 153, 164, 165, 178. Also, the preface to Hering's "Guiding Symptoms," Vol. I. "Hirschel's Rules and Examples for the Study of Pharmacody- namics," Thos, H. Hayle. Principles of Homceopathy. 45 CHAPTER VI. DRUG RELATIONSHIP. The study of drug pathogenesy, and its application to the treatment of disease, is furthered by the recogni- tion of different relationships that drugs occupy to each other. Among these, the most apparent, but of least practical value, therapeutically, is the Family relation, or collateral, side relation (con- geners), such as belong to the same, or allied botanical family, or chemical group; thus similarity in origin is its claim. In a very broad way, drugs may be divided, according as they belong, to one of the three kingdoms of nature, thus drugs from the animal kingdom, vege- table or mineral. It is not difficult to note certain great features, common to drugs, belonging to one kingdom; but similarity of effects is more marked as different members of a botanical family, or chemical group, are examined. Thus the Ranunculacese family, comprising drugs like Aconite, Pulsatilla, Cimicifuga, etc., show certain symptoms of marked similarity — a family likeness not to be mistaken. This is soiiietimes so great as to seem identical. For instance, in the case of Ignatia and Nux vomica. Both come from the same order of plants, both contain Strychnia, to the pres- ence of which, undoubtedly, this similarity in effect can be attributed. Now, when this similarity ap- proaches identity of effects, it has been found that they do not follow each other well. For instance, in a given case of stomach disorder, indicating Nux vomica, it is injudicious practice to follow this by Ignatia, on ac- count of its too close resemblance to the symptoms of the former remedy, the results being unfavorable, dis> 46 , A COMPEND OF THE turbing rather the normal evolution of the curative influence. Antidotal Relation. Certain drugs antidote each other therapeutically, because they produce similar effects locally in certain parts of the organism or on certain tissues and functions or generally throughout their action as a whole. The antidotal relation is based therefore on similarity and is operative according to the law of cure, similia similibus; and again the anti- dotal relationship between drugs may be general or partial, according as the similarity in their action is general or confined to certain parts only. Thus cam- phor antidotes the effects of cantharis only so far as these concern the mucous membrane of the urinary tract, while the same tissue elsewhere is not antidoted by it. Such antidotal relation is of use in practice, by which we can modify or annul an undesirable action of a drug, for instance, Anacardium bears an antidotal re- lation to Rhus, especially in its action on the skin, Hepar to Mercury, Chamomilla to Coffea and Pulsa- tilla, etc. An interesting phase of the antidotal rela- tionship is the mutual antidotal or at least modifying power of the higher and the lower attenuations of the same drug, as well as the antidotal relationship between the chronic effects of the crude drug and the attenuated drug, as is seen in treating chronic tobacco poisoning with Tabacum high. This holds true at times in acute conditions as has been frequently verified in poisoning with Rhus where a high attenuation will prove the quickest antidote. Concordant or Compatible Relationship. Hahne- mann first made the valuable, practical observation that certain remedies act better when they are given in a certain series. There seems to be an afiinity be- Principles of Homceopathy. 47 tween them. They are not of the same natural family, but of wholly dissimilar origin; but they have marked similarities in action. Such remedies may follow each other well; they point to a deeper and closer relation- ship than that of mere family, or similarity in origin. Such relationship exists, for example, between China and Calcarea, Pulsatilla and Sepia, Belladonna and Mercurius, Nitric acid and Thuja, Mercurius and Sul- phur, etc. Complementary Relation exists between drugs that complete a cure that is begun by another and carried to a certain point, where it is taken up by another drug and completed. If a remedy is allowed its full time of action, it will often lead up to a complement- ary remedy — that is, the symptoms remaining un- touched, or brought to the surface, will often suggest a drug known to be complementary to the one given. This useful relationship of certain group of drugs is of great service in the treatment especially of chronic dis- eases. Such relationship exists between Belladonna and Calcarea; Apis and Natrum muriaticum; Aconi- tum and Sulphur; Chamomilla and Magnesia phos- phorica; Thuja and Silica. Inimical relation is the very opposite of the concor- dant and complementary. There seems to be a lack of harmony between certain drugs, as is also seen in cer- tain chemical affinities. This may be so marked that when following each other in the treatment of a case, disturbance shows itself and the cure is interfered with and the whole case mixed up. Such a relation seems to exist between Apis and Rhus, between Causticum and Phosphorus; Mercurius and Silica; Sepia and Lachesis and others. Do not give these remedies after each other. It is well to note these inexplicable condi- tions of drug action, based on friendly or inimical 48 A COMPEND OF THE relationship. If it be remembered that drugs are em- bodied forces, distinct entities with distinct powers to modify human life as manifested in functional activity and organic changes we can readily see that certain forces can work advantageously side by side; their joint result, thus following each other, being greater than either one singly; and again certain others cannot do so, but mere contact or propinquity upsetting the orderly progress of the case. For further study see Boeninghausen, "The Sides of the Body and Drug Afi&nities." Mohr, "The Inimical Relationship of Drugs." Bering's contributions in the Archiv. "Farrington's Clinical Materia Medica." Lecture I. Principles of Homceopathy. 49 CHAPTER VII. THE APPLICATION OF HOMCEOPATHY. Homceopathy consists essentially in the application of the principle of similars. Drug selection alone consti- tutes Homoeopathy. The homoeopathic physician has to deal with two sets of phenomena in treating disease. On the one hand the patient, with a certain train of morbid symptoms; on the other, similar symptoms known to be produced in the healthy by some drug. The closer this correspondence in its essential features, the more certain and speedy the cure, on the principle that two like and similar forces may neutralize each other. This necessitates consideration of — 1. The examination of the patient, and the record of his symptoms. 2. The selection of the remedy corresponding to this totality of symptoms. 3. The administration of the single remedy. 4. The dose and its repetition. The Examination of the Patient. The first duty of the homoeopathic prescriber is clearly to understand the nature of the disturbed functions of the patient, to get at the full facts of the case so far as they are expressed by symptoms. The examination that elicits them must be thorough and complete, and will yield satisfactory results according to the perfection of the physician's general medical knowledge. His knowledge of anatomy will enable him to detect abnormal conditions of organs; physiology will show abnormal performance of func- tion; chemistry, microscopy, etc., will discover morbid secretions and excretions, etc. He makes use of all instruments that modern science places at his disposal, 4 50 A COMPEND OF THE from the clinical thermometer to the stethoscope, and all other instruments of precision of modern diagnostic skill. All the results thereby attained furnish him with the objective phenomena which the patient presents. These go far to establish the diagnosis of the pathologi- cal condition. The totality of symptoms ascertainable, with the help of our numerous diagnostic aids, furnishes a much more complete picture, analytically, than was possible in Hahnemann's time, when the main reliance had to be placed on the subjective symptoms. These latter are still of paramount importance in deciding between drugs that are capable of producing a similar change in the organism; they thus serve to determine the one most nearly indicated remedy from among a group of more or less related remedies. The totality of the symptoms must he the sole indication to determine the choice of a curative remedy. Hahnemann's teaching on this point is expressed in § 18 of the Organon, as follows: " It is then unquestionably true that, besides the totality of symptoms, it is impossible to discover any other manifestation by which diseases could express their need of relief; hence, it undeniably follows that the totality of symptoms observed in each individual case of disease, can be the only indication to guide us in the selection of a remedy." And, again, in § 70, he says: "All that a physician may regard as curable in diseases, consists entirely in the complaints of the patient and the morbid changes of his health perceptible to the senses — that is to say, it consists entirely in the totality of symptoms through which the disease expresses its demand for the appro- priate remedy; while, on the other hand, every ficti- tious or obscure, internal cause and condition, or imag- inary, material, morbific matter are not objects of treatment." Principles of Homceopathy. 51 The totality of the symptoms consists in the sys- tematic ascertaining of all the symptomatic facts nec- essary to determine the curative remedy. The totality of symptoms includes every change of state of body and mind that we can discover or have observed, or that has been reported to the physician; thus, every deviation from health. It includes every subjective symptom that the patient can describe correctly and every objective symptom the physician can discover by his senses, aided by all diagnostic instruments. In examining the patient, a definite, systematic plan should be followed. The regional plan, the Hahne- mannian Schema form, is perhaps the best, as it fol- lows a natural, anatomical arrangement. Special Precautions to be Observed. Be patient in getting at the symptoms, especially in chronic diseases. There is a great difference between patients; some can- not, others will not, give much aid in. analyzing their case; some are morbidly desirous of imparting symp- toms and will perhaps, unconsciously, warp their state- ment by exaggeration. Do not interrupt the patient in his first recital too much; lead him on, if he wanders off. When he has finished, cross-examine him, by careful questioning, to supply any deficiencies. Avoid asking leading questions, as far as possible, and not so that the patient must answer yes or no. Accept no diagnostic suggestions, or pathological theories, or former opinions of other physicians, as these can be no guide for the selection of a curative remedy. Be sure and get the modalities, especially the influ- ence of the times of day, weather, season, position of body, exercise, sleep, etc. Pay special attention to the mental state of the patient and his intellectual functions. 52 A COMPEND OF THE Take the apparent, immediate cause of his sickness into special account; this is often of importance for selecting the remedy, even long afterwards. In chronic diseases, especially, investigation should be extended to the family history of the patient; heredity is a potent factor in determining disease. The history of the patient's previous diseases, par- ticularly eruptions of any kind that may have been treated with strong local remedies and so suppressed; also, as to all forms of local treatment generally, and the patient's medical habits, the use of patent medi- cines, purgatives, mineral waters, etc. Notice any alternation of groups of symptoms, such as gastric and rheumatic symptoms, rheumatic and catarrhal, bronchial and skin affections, etc. Remember that certain bodily conditions have cer- tain mental states — depression and constipation, anx- iety and heart affections, hopefulness and consump- tion, etc. Remember that, when a certain train of symptoms are present in some one organ or apparatus of the body, there are almost sure to be present certain other symptoms, objective and subjective, in other organs often, anatomically, quite remote, and of which the patient probably is hardly aw^are until his attention is called to them by the physician.* For instance, cer- tain pains in the head co-exist with certain uterine affections, or anomalies of vision, etc. Write down the record of the symptoms, beginning a new line with every symptom. This will greatly facilitate study and reference to allied remedies. Subjective symptoms are a description by the pa- tient of his feelings as they appear to him — his sensa- tions. The ability to express and describe sensations * Dunham. Principles of Homceopathy. 53 is not common to all patients; and hence, subjective symptoms must always be interpreted by the physician to a large extent. The patient may deceive his physi- cian in stating them, as is frequently the case with hysterical subjects, or he may not be able to describe •them accurately enough to be utilized, as in the case of young children. Objective symptoms are, as a rule, the most import- ant. They are all such as the physician can ascertain by means of his senses, aided and unaided. In many phases of disease, and with children and frequently in old people, where organic changes can go on to an alarming extent without very marked, sub- jective disturbance, objective symptoms are all we practically have on which to base a prescription. In mental diseases, objective symptoms are most import- ant for purposes of prescribing. Objective symptoms are of special value when they occur during sleep, as then the system is relaxed. Objective symptoms that are not specially diagnostic of the disease, or of some pathological state, when pres- ent, are important for purposes of prescribing. On the other hand, objective symptoms that are diagnostic of certain pathological, states, so-called pathognomonic symptoms^ are of great importance in guiding to a cer- tain class of remedies and excluding other groups, even though such may seem superficially indicated. The Totality in Acute Diseases. In the treatment of acute diseases, much of this investigation is neces- sarily dispensed with, the physician learns to use his eyes and other senses intuitively and thus to get hold of certain characteristic conditions quickly that are known to correspond to certain remedies. Epidemic conditions come to his aid here for rapid and usually successful prescribing. 54 A COMPEND OF THE The Collective Totality of Epidemic Diseases. During the prevalence of epidemic diseases, colds, grippe, eruptive diseases, etc., it is often the case that two or three remedies cover the field. It is needless to go into every detail of the symptomatology, since the epidemic remedies, when found, correspond to the col- lective totality of numerous cases and types of the epi- demic disease; each single case of an epidemic disease presenting only a partial picture of the true totality of the epidemic. Interpretation of the Totality. Having taken a full stock of the case and thereby obtained the totality of symptoms, before prescribing the homoeopathically indicated remedy, correct all hygienic, dietetic and sani- tary errors. Often a change in the mode of life or abstinence from some hurtful article of diet will be all that is necessary. But after these things have been attended to, whatever symptoms remain will call for medical treatment. Having obtained a record of the totality of symp- toms, a winnowing process must be instituted, by eli- minating the general symptoms and interpreting the totality according to the relative value of the symp- toms, and thus individualize the case under treathient. In §83, Hahnemann says: " Individualization in the investigation of a case of disease, demands, on the part of the physician, principally unbiased judgment and sound sense, attentive observation and fidelity in noting down the image of the disease." Hahnemann's first rule here is that the characteristics of the case must be similar to the characteristics of the drug. § 153. The more prominent, uncommon and peculiar features of the case are specially and almost exclusively considered and noted, for these, in particular, should bear the closest similitude to the symptoms of the desired medicine, if that Principles of Homceopathy. 55 is to accomplish the cure. By this individualization, then, we eliminate the general symptoms common to similar pathological conditions, and present to view the individual patient as the pathological process affects him. The morbid forces of the disease unite themselves more or less with the inherent weaknesses and disease tendencies, hereditary or acquired, of the individual and give us his peculiar and therefore characteristic symp- toms. Characteristic or Peculiar Symptoms. Hahnemann calls especial attention to the "more striking, singular and uncommon, peculiar signs and symptoms of a case of disease" which are chiefly to be kept in view. These symptoms of themselves may be of no special value, but become valuable or characteristic by their conditions of aggravation or amelioration, their concom- itants or locality. Transient odd and peculiar symp- toms are however not so important as such as affect the patient's general condition, hence the modalities, con- ditions of aggravation and amelioration effects of heat, cold, weather, position, times of day, etc , are most im- portant. The modalities of a drug are the pathognomo- nic symptoms of the Materia Medica. Mental symptoms of drugs are most important, and are a very pronounced feature in the pathogenesis of certain drugs. Notice the mental state of the patient particularly; does he suffer patiently or otherwise. They are also of great importance prognostically; improvement in the mental condition often precedes bodily and general improvement. First, or Oldest, Symptoms. In the treatment of chronic diseases, the first indications of a departure from health are of the greatest value, particularly those occurring before there was any treatment. After a 56 A COMPEND OF THE remedy has been given, and old symptoms reappear in the inverse order of their development, it is an indica- tion that the cure is progressing favorably, and no other medicine should be given. So, also, in acute diseases, the value of first symptoms is great. In diph- theria for instance, the side upon which it begins may decide the choice of the remedy.* Etiological Factors. As a further aid in arriving at a utilizable totality of symptoms, the immediate cause of the present illness, if determinable, or its exciting factor, will be a great aid in the selection of the remedy. Such causes may be remote in time, and not of any apparent connection with the present state. This Hahnemann also teaches in § 5, Organon, as fol- lows: " The physician, in curing, derives assistance from the knowledge of facts concerning the most proba- ble cause of acute disease, as well as from the most sig- nificant points in the entire history of a case of chronic disease; aided by such knowledge he is enabled to dis- cover the primary cause of the latter, dependent mostly on a chronic miasm." This gives, on the one hand, an important place to the first, or oldest, symptoms and to causes however remote; and, on the other, it elevates to commandhig importance, signs of constitutional defects, the underlying psoric conditions. Unquestionably, such frequently modify and relegate to comparative insignificance symptoms of acute disorder, and favor the selection of a deep-acting, anti-psoric remedy even in acute diseases. Such a selection would be justified by its relationship to a truer similarity than would be expressed by an uninterpreted totality of symptoms. Late Symptoms. The more recent symptoms are valuable as being the latest expression of the diseased * S. Kimball, in Homceopathic Physician, June, 1895. Principles of Homceopathy. 57 condition, and must be covered by the remedy. This is especially true in acute diseases. This is so when another remedy is chosen; the last symptoms that ap- pear must be the guide to it. Again, if a patient has been drugged by palliative medication, we must direct our antidotes principally against the drugs given last — for instance, against Quinine, Pulsatilla, Ipecac, etc.; against Iodine, Hepar; against Chloroform, Hyoscyam, etc. But this rule should not be applied too rigorously; it is best to give no medicine at all for a time. Functional symptoms of an affected organ are of much less value than symptoms which occur in other parts during the exercise, of the function of that organ. Burning pain in the urethra, during or after micturi- tion, is of little value in gonorrhoea, for it is usually present; but pain in the testicles, thighs, or abdomen during or after micturition, or symptoms of some other part not immediately concerned in that function, would be more important. So, also, pain in the stom- ach after eating, in indigestion, is not of as much value as vertigo or headache after eating would be in the same attack. Therefore, symptoms that affect the gen- eral organism are of more value than those that are functionally related to the organ affected.* Need of Pathology. A knowledge of the pathol- ogy of disease (not mere passing, pathological theories, against which Hahnemann so justly protested,) is nec- essary to interpret the symptomatology obtained and prescribe the truly indicated remedy, and not merely one externally homoeopathic. The true meaning of any symptom is reached not by considering it alone, but by viewing it in relation to all the rest, and thus placing it in its proper relative position. We must * S. Kimball. 58 A COMPEND OF THE learn to view symptoms in perspective. The natural history of diseases must be learned, as well as their different stages and characteristic signs accompanying them. The use of pathology in interpreting the symptoms is seen in the treatment of a case of typhoid fever, where the fever, restlessness, etc., might call to mind Aconite as a remedy; but a little closer examination would show this to be but a partial and apparent homoeopathic relationship. Pathology would interpret the fever and restlessness of the typhoid patient and associate them with the coming prostration, the septic condition, the asthenia — conditions wholly foreign to Aconite, which can deal only with sthenic inflamma- tions and healthy blood. Some symptoms are primary, others reflex. After an organic disease has become established, secondary modifications of health take place, which do not offer valuable symptoms for purposes of prescribing the curative remedy. Really valuable guiding symptoms, if found at all, will be in the earlier state of the patient before the organic changes have taken place; thus, in the treatment of an organic kidney disease, a curative remedy would be more likely to be found in the earlier symptoms that preceded the development of the drop- sy, anemia, etc., characteristic of the later stages. Pathology also teaches the important difference be- tween the absolute, pathognomonic symptoms and the contingent or peculiar symptoms of a given case of disease. General or absolute symptoms are those which are common to all patients suffering from the same disease and they are essential for purposes of diagnosis. Thus the fever, sore throat and rash are general or absolute symptoms of Scarlatina, while again, the fever, cough. Principles of Homceopathy. 59 physical signs and bloody sputa are absolute symptoms of Pneumonia. Contingent or peculiar symptoms are those which vary with the individual and are not essentially patho- gnomonic of the disease^ but always of the individual' patient. They are therefore the characteristic symp- toms of the patient's totality of symptoms, and hence most essential in selecting the remedy. Hence the rule: The greater the value of a symptom for purposes of diagnosis, the less its value for the selection of the homoeo- pathic remedy and vice versa. The seemingly unimportant, peculiar, contingent symp- toms of the patient, though valueless for purposes of diag- nosis, are the chief guiding symptoms for the selection of the homoeopathic remedy. Totality of quality rather than of quantity, is the basis for homoeopathic prescribing. In any case of dis- ease it is necessary to discover in what way, that is, by what peculiar, symptoms, does one case of illness differ from every other of the same disease. How does this patient's typhoid or rheumatism differ from the typhoid or rheumatism of every other patient. This special totality of quality, or of characteristics will unerringly lead to the curative homoeopathic remedy. This is the Hahnemannian Similarity. It exists between the char- acteristic symptoms of the patient and the characteristic symptoms of the drug, and we must individualize each case in order to arrive at this desirable goal, for the selection of the hemoeopathic remedy. This differs from the mere Pathological Similarity which consists in matching diseased conditions or pathological processes as determined by pathological anatomy. It adapts the remedy to a disease rather than to the individual patient. Thus, in the treatment of pneumonia, a remedy would be given that actually produces lesions similar 60 A COMPEND OF THE to the pneumonic process. Phosphorus has actually produced hepatization of the lungs in animals poisoned by it; hence, it should be the curative similar, as it is undoubtedly the pathological similar. So Arsenic pro- duces a gastro-enteritis and ultimate lesions just like cholera, and should, therefore, be the curative remedy in this disease, since it is the pathological similar. But experience denies this deduction. To be curative, a remedy must correspond to the characteristic symp- toms, whether these are based upon the ultimate patho- logico-anatomical lesion or not. Unquestionably, the similarity in pathological process or lesion is one of the most important factors in the totality, but not the determining one in every case. Examples of pathological similarities between dis- eases and drugs. The gastro-enteritis and paralysis of Arsenic; epileptiform convulsions of Hydrocyanic acid; broncho-pneumonia of Tartar emetic; anaemia of Ar- gentum; catalepsy of Cannabis indica; tinnitus auri- um of Quinine; Meniere's disease of Salycilic soda; colic of Plumbum; asthma of Ipecac; tabes of Ergot; fatty degeneration of Phosphorus; glycosuria of Uranium; meningitis of Belladonna, etc, etc. Use of Pathological similarity. Often in the course of acute diseases, and in children, where no character- istic symptoms can be obtained, pathological corres- pondence may be the only recourse; but it is otherwise in the treatment of most chronic diseases. Here the method of the Hahnemannian similarity yields best results. Method of Treating Slight Ailments. It is a mis- take to prescribe remedies for every slight ailment. It is best to follow Hahnemann's directions, Organon, § 150: "Whenever a patient complains of only a few insignificant symptoms of recent origin, the physician Principles of Homceopathy. 61 is not to regard them as a disease requiring serious medical aid. A slight change of diet and habits of living generally suffices to remove so slight an indispo- sition. Absence of Characteristic Syinptoms in the To- tality. There are cases where it is almost impossible to obtain any very characteristic symptoms; these are difficult to handle. § 165. Or there may be only one or two prominent symptoms, which may obscure the remaining features of the case, so-called Partial or One-sided Diseases. The best rule is to be most painstaking in eliciting symptoms, and then make the best uses of the few symptoms to serve as guides in the selection of the remedy. Although the remedy may be but imperfectly adapted, it will serve the purpose of bringing to light the symptoms belong- ing to the disease, thus facilitating a choice of the next remedy. Organon, §§ 173-184. Diagnostic symptoms of a disease, although of least importance for selecting the remedy, may be all we have in a given case for guidance. If so, the remedy corresponding to them can be chosen by paying special attention to their modali- ities, i. e.j conditions of aggravation, concomitants, etc. For instance, in dysentery, the tenesmus is an important, diagnostic symptom, but no guiding one to any remedy, since many medicines have this general symptom; but if attended with any modalities or con- comitants, it may become a leading indication; for instance, Nux vom., the tenesmus and pain in the back cease with the stool; in Mercurius, they continue after it. In this way a general symptom may become a characteristic one, leading to the choice of the curative drug. For further study consult: •'Organon, ' ^ 153-173. 62 A COMPEND OF THE '* The Relative Value of Symptoms," by S. A. Kimball, M.D., in Homceopathic Physician, June, 1895. A very valuable essay. ** The Examination of the Patient for a Homceopathic Pre- scription," by P. P. Wells, M.D. Transactions Int. Homceopathic Association, 1888, page 18. "The Genus Epidermicus, " by A. McNeil, M.D. Transactions of Hahnemann Association, 1889. "The Selection of the Homoeopathic Eemedy," by T. F. Allen, M.D. Eead before World's Medical Congress in Chicago, 1893; published in North American Journal of Homoeopathy, August, 1893. "The First Prescription," by O. M. Drake, M.D., in Homeeo- pathic Physician, January, 1895. "Dudgeon's Lectures on Homoeopathy." Lecture XI: On the Selection of the Remedy. This gives an account of the different views held by the representative older disciples of Hahnemann, and is very interesting from an historical point of view. "The Totality of Symptoms." A paper read before the Amer- ican Institute of Homoeopathy, by Wm. Boericke, M.D. Pub- lished in the Hahnemannian Advocate, August, 1896. Principles of Homceopathy. 63 CHAPTER VIII. THE SIMILIMUM. The indicated remedy in any case is the remedy that corresponds to the totality of symptoms, as inter- preted according to the relative rank of symptoms, and not one covering, merely some isolated characteris- tic or key-note symptom, or, on the other hand, one that corresponds merely to the pathological lesion. The objections to the key-note system of selecting the remedy are its disregard for the fall study of the remedy and elevation, instead of some minor often clinical symptom, yielding at best only palliative results, while the objection to the pathological basis is its incompleteness, being only a partial picture of the totality of symptoms and therefore an unreliable basis for curative prescribing. The similimum is the most similar remedy corres- ponding to a case, one covering the true totality of symptoms, and when found, is always curative, and in incurable cases, it is the best possible palliative remedy. Unfortunately, in the present state of our Materia Medica, and other limitations of our art, the Similimum in any case of illness, is not always discoverable. Nevertheless, a cure is possible, albeit, not so prompt as it would be if the chosen remedy were the Simili- mum to the case. While this is the ideal to be sought, the prescriber must more frequently be satisfied with the selection of a mere similar instead. Fortunately, the very conception of similarity is one of relative near- ness and does not express an absolute relation; it is com- parative always, thus a drug is more or less similar according to the nearness of its correspondence to the totality of symptoms. Moreover, the experience and 64 A COMPEND OF THE practice of the homoeopathic school teaches that any- one of several more or less similar remedies may be used with alike good results, that is, it may be suffici- ently similar to bring about nature's reaction. The merely similar remedy, though falling short of the dignity of the Similimum is not thereby removed from capacity of curative service, but the curative res- ponse is not as direct and prompt as results from the administration of the similimum which must ever be, in every homoeopathic prescription, the ideal to be sought. The selection of the Similimum involves its adminis- tration singly and without admixture of any other medicinal substance. The single remedy is the necessary corollary to the similar remedy. It is to be given alone, not alternated or mixed with any other*. Only then can its pure effects be evolved and estimated, and the single remedy must be given in the smallest dose that will bring about nature's reaction. The single remedy does not mean a simple remedy. All chemical salts, which are composite substances, the juice of plants, like Opium, a most marvelously compounded substance, are all single remedies and used as such in homoeopathy. Any single substance that has been proved upon the healthy, as an entity and whose pathogenesis is known, can be administered; but it must be given unmixed with any other medicinal substance, so as to obtain its own peculiar drug force unmodified by any other. It is the similar relationship alone that constitutes the homoeopathicity. The size of the dose has com- * As early as 1797, Hahnemann wrote, in Hufeland's Journal, that for several years he had never administered anything but the single remedy at a time, and never repeated the dose until the action of the first had expired. Principles of Homoeopathy. 65 paratively little to do with it, except so far as experi- ence may indicate it. It may be given in a crude form, wholly unprepared by the pharmacist's skill, or in material dosage, provided it does not produce tem- porary aggravation of the symptoms; or it may be ad- ministered stripped of all its apparent material, vis- ible and tangible particles. Experience alone can teach which will bring about the best results in any given case. Alternation or rotation of remedies is reprehensible practice, since it leads away from accurate and definite knowledge of drug effects, and sooner or later leads to polypharmacy, which is the most slovenly of all prac- tice. Since we have no provings of combination of drugs, it would be impossible to prescribe such combi- nations with scientific accuracy. In regard to alterna- tion, Hahnemann says : '' Some homoeopathists have made the experiment in cases where they deemed one remedy suitable for one portion of symptoms of a case of disease, and a second for another portion, of admin- istering both remedies at once, or almost at once; but I earnestly deprecate such hazardous experiments, that can never be necessary, though they sometimes seem to be of use." Note to § 272, Organon. For further study, read — "Organon," $$272-275. Dunham: "Science of Therapeutics — Alternation of Remedies." Edmund Capper: "The Method of Hahnemann and the Homoe- opathy of To-day," in Journal of British Homoeopathic Society, Jan- uary, 1895. Jones: "The Ground's of a Homoeopath's Faith." Lecture 2: "The Single Remedy." Joslin: "The Principles of Homoeopathy — The Single Rem- edy." Eleanor F. Martin, M.D.: "The Single Remedy vs. Alterna- tion," in Pacific Coast Journal of Homoeopathy, October, 1894. 5 66 A COMPEND OF THE CHAPTER IX. THE SECOND PRESCRIPTION. In the treatment of chronic diseases, Hahnemann's instructions to write out the symptoms and arrange them according to the rules given, is an absolute neces- sity to attain accuracy of knowledge of the possible indicated drugs and the selection of the most similar remedy. This procedure ensures also a ready selection of the second prescription, since the record will answer all of the necessary questions and determine the right course to be pursued. The prescriber's attitude after the first prescription, in the treatment of chronic dis- eases especially, ought to be passive. The first and foremost rule is to wait and watch further developments. The selected homoeopathic remedy simply stimulates the vital forces to reaction, and we must await results. No further interference is called for when any one of the following conditions presents itself: 1. Short aggravation of the Symptoms. This is a curative effect of the remedy. Do not interfere with it unless the aggravation continues and the general state of the patient is worse, in which case an antidote, i. e., a homoeopathic remedy for the latest symptoms is indicated. Usually on^ dose of such an antidote is all that is required to modify the condition, and then the case can progress without further interruption. 2. General Amelioration of the Symptoms. It is self evident that such a condition should not be disturbed by further medication, on the principle of letting well enough alone. If the disease gets better from within outward, from above downward from more vital to less vital parts, the improvement is permanent and radical. Principles of Homceqpathy. 67 So an improved mental state is always a favorable in- dication of a well chosen remedy. 3. Reappearance of old Symptoms. The return of some of the older symptoms, if not too severe, indicates a curative action of the remedy administered, if they appear in the reverse order of their development, i. e., if the latest symptoms disappear first. 4. Appearance of new symptoms. If such come on after the administration of a remedy, they may be clinical symptoms of the remedy, and if there is at the same time general improvement, they need not be con- sidered, as they will disappear. If they persist, the homoeopathic antidote will soon rectify the passing increase of the morbid phenomena. Under all these conditions, no further medication is required. So long as improvement is thus progressing, it is folly to change the remedy, and it is not advisable even to repeat the dose. Other Favorable Symptoms. In acute disease, it is a favorable symptom if the patient falls asleep soon after taking the remedy; also, if he feels generally better, though the local symptoms may not show any improve- ment. The improvement here is probably largely psychical, and will soon be followed by the necessarily slower improvement on the physical plane. The mental condition and general behavior of the patient, if more tranquil and natural, are among the most certain and intelligible signs of incipient improve- ment, especially in acute diseases. Should this progressive evolution of the symptoms towards health cease, A further review of the case is required, and a new remedy is to be chosen when — (1) The mental state shows an embarrassed, help- less state instead of the tranquility of improvement. 68 A COMPEND OF THE (2) When no change of any kind follows the first prescription, after waiting long enough for reaction, which is, however, a variable matter, according to the chronicity of the case and character of the remedy chosen, the shortest period to be allowed in a chronic disease being one week, and preferably a longer time. (3) When new and important symptoms and old mo- dalities, especially aggravations that persist , characterize the case, proving that the remedy was not homoeopathic to the case, and acted only as a pathogenetic agent in producing new symptoms. This is the danger of select- ing a remedy only remotely similar instead of the similimum. The second remedy will often be found a complementary drug of the first. Three Precautionary Rules of Hahnemann. The author of Homoeopathy, in his work on " The Chronic Diseases," has established three precautionary rules, which he has impressed in the most urgent manner upon the minds of his disciples, and which no homoeo- pathic physician can violate without committing the greatest faults in practice. They are the following: 1. To suppose that the doses which he had recom- mended for every anti-psoric remedy, and which expe- rience had taught him to be the proper doses, are too small. 2. The improper selection of a drug. 3. The too great haste in administering a new dose. Precautionary Rule No. 1. — Smallness of dose. The debates relative to the smallness of doses are far from being closed. The more that has been written on that subject for some years past, the more contradiction has been heaped upon contradiction. What is a truly re- markable circumstance in this discussion — a circum- stance which is by no means creditable to the oppo- nents of small doses — is the fact that the manner in Principles of Homceopathy. 69 which Hahnemann gradually arrived at the introduc- tion of the small doses in practice, in consequence of repeated trials, observations, experience, seems either to have been forgotten or entirely ignored. It is experience, and nothing else, which led the carefully-observing author of that immortal text-book to that minuteness of doses which has now become an object of derision. In the second edition of " Chronic Diseases," after having spoken of homoeopathic aggra- vations, Hahnemann continues thus: ^^ If the original symptoms of the disease continue ivith the same intensity in the succeeding days as in the beginning, or if this inten- sity increases, this is a sure sign that, although the remedy may be homoeopathic, yet the magnitude of the dose will make the cure impossible. The remedial agent, by its powerful disproportionate action, not only neutralizes its genuine homoeopathic effects, but established, more- over, in the system, a medicinal disease by the side of the natural disturbance, which is even strengthened by the medicine." That portion of the preceding quotation, which is printed in italics, embodies a great truth which has never been denied, which has been abundantly con- firmed by the numerous results of the allopathic treat- ment of chronic diseases, and is, therefore, well worthy of attentive and serious consideration. Such results are even witnessed in the comparatively easy treatment of syphilis, from the abuse of mercury, which is then secondary syphilis. Hahnemann continues afterwards: ^'This pernicious effect of too large a dose may be observed already in the first sixteen, eighteen or twenty days of its action. In such a case it becomes necessary either to give an anti- dote, or if the antidote should not be known, to admin- ister a very small dose of such antipsoric as corre- sponds most homoeopathically to the symptoms of both 70 A COMPEND OF THE the natural and the artificial disease. If one anti- psoric should not be sufficient, another, of course, ought to be given, after having been selected with the same care." How little an excessive dose is capable of displaying its full curative powers may be seen from the following remarks of the author of homoeopathy: "The excessive action of the otherwise homoeopathic remedial agent having been subdued by the proper antidote or by antipsoric remedies, the same agent may then be ex- hibited again, but of a much higher potency, and in a more minute dose." But this agent would have no effect, if a first powerful dose of it had not accomplished in the beginning all the good that the agent is capable of doing. Finally, Hahnemann observes: " Nothing is lost by giving even smaller doses than those which I have in- dicated. The doses can be scarcely too much reduced, provided the effects of the remedy are not disturbed by improper food. The remedial agent will act even in the smallest quantity, provided it corresponds perfectly to all the symptoms of the disease, and its action is not interfered with improper diet. The advantage of giv- ing the smallest dose is this, that it is an easy matter to neutralize their effects in case the medicine should not have been chosen with the necessary exactitude. This being done, a more suitable antipsoric may be admin- istered." This advice ought to be carefully considered, especi- ally by the beginners, together with the warning which Hahnemann has expressed in the preface to his work on " Chronic Diseases." " What would they have risked, if they had first followed my indications and then employed small doses ? The worst which would have befallen them was, that those doses would have been of no avail. It was impossible that they should Principles of Homceopathy. 71 do any harm. But instead of exhibiting small doses, they employed, from a want of sense and of their own accord, large doses for homoeopathic use, thus exposing the lives of their patients, and arriving at truth by that circuitous route which I had traveled upon before them with trembling hesitation, but the end of which I had just reached with success. Nevertheless, after having done much mischief, and after having squand- ered the best period of their lives, they were obliged, when they were really desirous of curing a disease, to resort to the only true method which I had demonstra- ted to them a long while ago. * Diet and Regimen during Homoeopathic Treat- ment. Hahnemann and the early homoeopathists laid great stress on a strict diet; but this is a field that has been greatly neglected in modern times, largely be- cause it was found that the power and efficacy of the well-chosen remedy were able to manifest themselves, notwithstanding great license in diet and hygiene. Nevertheless, a return to Hahnemann's careful restric- tions may be advisable in many cases. His teachings, in this regard, are as follows: "The minuteness of the dose required in homoeo- pathic practice, makes it necessary that every other kind of medicinal influence that might cause a dis- turbance should be avoided in the diet and regimen of patients, in order that the highly rarified dose may not be counteracted, overpowered, or disturbed by extra- neous, medicinal influences. In chronic cases, there- fore, it is especially necessary to remove all obstacles of this nature with the greatest care, since they exer- cise a deleterious effect. '* Regimen in Acute Diseases. Here the instinct of the patient usually guides him aright, and his cravings * Quoted from Von Boenninghausen. 72 A COMPEND OF THE can be judiciously gratified. " The food and drink most commonly craved by patients suffering from acute diseases is generally of a palliative and soothing kind, and not properly of a medicinal nature, but merely adapted to the gratification of a certain longing." " In acute diseases, the temperature of the room and the quantity of covering should be regulated entirely according to the wishes of the patient, while every kind of mental exertion and emotional disturbance is to be carefully avoided." For further study, read: " brganon," ^ 253-263. "The Second Prescription," by Dr. J. T. Kent, in Proceed- ings of the Hahnemannian Association, 1888, page 71. "Practical Hints on the Management of Chronic Cases." by W. P. Wesselhoeft, M.D., in Transactions of Hahnemannian Asso- ciation, 1889, page 8. "Procedure in the Treatment of Inactive, Progressive Chronic Diseases," by T. J. Kent, in Hahnemannian Advocate, July, 1896. Principles of Homceopathy. 73 CHAPTER X. HAHNEMANN'S NOSOLOGY. The classification of diseases adopted by Hahne- mann includes two types, acute and chronic. §§ 72-82, Organon. Acute diseases originate from defective hygiene, errors in diet, physical agents, cold, heat and other atmospheric changes, mental and moral influences. Again, telluric and meteoric and bacterial influen- ces give rise to acute diseases, attacking a number of individuals, at the same time giving rise to epidemic and contagious diseases. Besides these general causes, there are types of acute disease that are transient acti- vities of the hitherto dormant psoric miasm, rendered so from some cause or other. It is well to bear this possible cause of certain acute diseases in mind, since corresponding antipsoric reme- dies may possibly come into requisition for their cure or temporary subsidence. Chronic diseases are such as are produced by infec- tion from a chronic miasm, and which the vital powers of the organism, aided by hygienic and dietetic and sanitary measures are not able to extinguish. The chronic miasms giving rise to all forms of chronic dis- ease are psora, syphilis and sycosis. Hahnemann does not classify among these chronic diseases such as result from living under unhygienic and unsanitary influen- ces, or trying mental conditions, dietetic errors, excesses of all kinds, etc. These diseases disappear of themselves by mere change of regimen and surround- ings and removing the cause, provided, there is not 74 A COMPEND OF THE present one of the three chronic miasms that are the real causes of all chronic disease. Drug Diseases. On the other hand, prolonged drug use in heroic doses does produce a species of chronic disease that is most difficult to cure, and when such have attained a considerable hold, it would seem as if no remedy could be discovered for their radical cure. * Organon, §§ 74 and 75. " It is a matter of regret that we are still obliged to count among chronic diseases, very common affections which are to be regarded as the result of allopathic treatment, and the continual use of violent, heroic medicines in large and increasing doses. Examples of that kind are: the abuse of Calomel, Corrosive subli- mate, Mercurial Ointment, Nitrate of Silver, Iodine and its ointments. Opium, Valerian, Quinine, Digitalis, etc., the use of purgatives persisted in for years, etc." To which might be added the modern abuse of Coal tar products, patent medicines. Such wanton treatment weakens the organism, abnormally deranged and wholly altered. Irritability and sensibility are in- creased or decreased, hypertrophy and atrophy, soften- ing and indurations in certain organs and organic lesions are produced. Such are some of the results of nature's efforts to protect the organism against com- plete destruction by aggressive treatment with perni- cious drugs. The Evolution of Halinemann's Doctrine of Chronic Diseases. After Hahnemann's discovery of the Law of Cure in 1790, he worked incessantly inves- * The treatment of drug diseases by the use of the highest po- tency of the drug producing them is to be tried in these obstinate chronic affections, it is an entirely consistent homoeopathic proce- dure. Principles of Homceopathy. 75 tigating the action of drugs on the healthy, and prac- ticed according to the newly-discovered law and by the light and aid the new Materia Medica was able to give. The success of this practical application of the Law of Cure was striking in the extreme. Especially true was this in the treatment of acute diseases and epidemics. As to chronic diseases, in which allopathic treatment was so often worse than useless, homoeo- pathy rarely failed to improve or ameliorate the condi- tions in a very short time. But, though the patients were often very much relieved, they were not cured, for their complaints would return more or less by many unfavorable circumstances, such as errors of diet, poor hygienic conditions, unfavorable weather, mental emotions, etc. Their return, under these cir- cumstances, was generally attended with the appear- ance of new symptoms, often more troublesome and more difficult of removal than before. Even when the treatment of these chronic diseases was conducted strictly according to the doctrines of the homoeopathic art, Hahnemann himself owned that " their commence- ment was cheering, their progress less favorable, their issue hopeless." "And yet," he adds, " the homoeo- pathic doctrine itself is built upon the impregnable pillars of truth and must ever remain so." Whence this inferior success, this absolute want of success in the prolonged treatment of chronic diseases? If homoeopathy is based upon a natural law — nature's law for healing — and the conditions for carrying out the law are observed, there ought not to be any failure — only success. Why, then, this failure at times in certain patients and even typical acute diseases; why this almost constant failure in chronic disease? He says that, from the year 1816-17, the solution of this problem occupied him day and night, and at length he succeeded in solving it. Like all of Hahne- 76 A COMPEND OF THE mann's work, it was the fruit of long and patient observation and study and experiment. Ten years later, in 1827, he was ready to communi- cate this new discovery, as he believed this epoch- making theory, to the profession. He summoned to Coethen, where he was then practicing as physician to the reigning prince, two of his most esteemed disciples, Doctors Stapf and Gross, and communicated to them his theory of the origin of chronic diseases and his dis- covery of a completely new series of medicines for their cure, exhorting them to test the truth of his opinions and discoveries in their own practice. He disclosed this to these two disciples in case his death — for he was then in his seventy^third year — should have occurred before the publication of his book on the subject. This remarkable book, entitled " The Chronic Diseases, Their Peculiar Nature and Homoeopathic Treatment," duly appeared the next year, 1828. With the publica- tion of this book, supplementing the Organon, the high- water mark of medical philosophy was reached. A few generations hence this will be generally acknowledged. Cause of Recurrence of Chronic Diseases. His researches and reflections, Hahnemann tells us in his work, led him to the conclusion that the cause of the constant recurrence of chronic diseases after their apparent or partial removal by the homoeopathic rem- edy, and their recurrence with new and grave symp- toms, was that the symptoms manifesting themselves at any one time were only a portion of the deeply-seated fundamental malady, whose great extent was shown by the new symptoms that appeared from time to time. He believed it to be a chronic miasm, which the body could not throw off spontaneously and unaided, not by careful diet or regimen, but that it rather increased in intensity and extent from year to year. Principles of Homceopathy. 77 "The most robust constitution, the best regulated life, and the greatest energy of the vital powers, are insufficient to extinguish them." § 78, Organon. The Skin Phase of Chronic Diseases. His further research showed that the obstacle to the cure seemed to lie in a previous scabious eruption, which the patient frequently acknowledged having had, and from which he often dated all his sufferings. He believed that chronic diseases occurred on the suppres- sion artificially, or disappearance from any cause of a scabious, itching, eruption from the skin in otherwise healthy persons. Itch, in Hahnemann's time, was a term which covered many other affections besides the one now known as scabies or itch. This itch dyscrasia he called Psora, meaning thereby the internal itch dis- ease, with or without any present skin symptoms. It is the source of all varieties of skin diseases, abnormal growths, tumors, deformity, mental diseases, etc. In short, it is the parent of all chronic diseases, with the exception of venereal diseases. It is the oldest, most universal and obstinate of all miasmatic diseases. The leprosy of the Israelites, the epidemic St. Anthony's fire of the middle ages, were but forms of this taint. In these forms the whole malignity seemed to be expended on the skin. Greater cleanliness and generally better modes of living have modified its local manifestations, so that, at the present day, it is more in herpetic and eczematous diseases that we meet with it. The readi- ness with which these are suppressed, the readiness with which ordinary practice dries up discharges of all kinds, the immense development of local treatment, and the increase of all kinds of specialists, whose ten- dency is to suppress local manifestations of disease, has driven this psora within to more vital regions, and thus has lead to the great increase of chronic maladies that afflict mankind. 78 A COMPEND OF THE The appearance of skin symptoms, or discharge from a mucous surface, shows that nature is making an effort to localize on the outskirts of the body the mor- bid process, removed as far as possible from the more vital parts of the organism, where it would be much more mischievous. Therefore, forcing it back into the interior by strong, local treatment must necessarily work detrimentally to a radical and permanent cure. " Every external treatment of a local symptom whose aim is to extinguish it on the surface of the body with- out curing the internal miasmatic disease — such, for example, as that of destroying a psoric eruption on the skin by means of ointments, healing up a chancre by the use of caustic, destroying the granulations of sycosis by ligature, excision or the application of a hot iron — is not only useless, but injurious. This perni- cious method, in such general use at the present day, is the chief source of the innumerable chronic diseases that oppress the human race. This is the most crimi- nal practice physicians can adopt, and it has, notwith- standing, been very generally practiced till the present time, and taught, ex cathedra, as the only one. § 203, Organon. The Underlying Facts of the Psoric Theory. With- out the necessity of accepting the Psoric doctrine as a whole, the homoeopathic school has found in it an excel- lent working hypothesis, and certain facts are undeni- able and go far to establish the essential truth of the doctrine. These are the following: 1. In many patients, the even and regular clinical course of diseases is from some course or other within themselves interfered with. 2. Remedies apparently indicated and chosen ac- cording to the law of similars, fail to accomplish what, as a rule, they ought. Principles of Homceopathy. 3. This is especially true of most chronic diseases. 4. It is a further fact that frequently the suppres- sion or disappearance of a skin disease is followed by serious mischief in more vital organs, as respiratory affections (asthma), after eczema capitis, etc., showing a reciprocal relation between the skin and internal organs. It is the presence of this unseen but nevertheless very active and perturbing factor that accounts for these con- ditions. Now, this fact of recognition is the mark of genius. The theory of its precise nature is of compa- ratively little importance and may or may not be true. That it is nothing but suppressed itch in the narrow sense is not true. That, however, suppressed skin affec- tions in a wider acceptation than what we now-a-days understand by itch are an indubitable factor in the pro- duction of many forms of obstinate and occult chronic suffering far removed from local skin manifestation, is an established truth. The Hahnemannian conception of Psora is a very real thing, the Psora theory an in- tensely practical thing and that is its passport to the general practitioner whose aim is to cure permanently rather than palliate and relieve for the time being. Perhaps it would have been better not to try and define the inner essence of this dyscrasia. The celebrated Botanist Schleiden, used to open his lectures on Botany by frankly confessing that he did not know what a plant was. So we may not know what Psora is, ex- cept that it consists of the sum of all the biological obstacles which resist, deface, complicate and alter the natural course of diseases and interfere with the action of the apparently well selected homoeopathic remedy. In this wider sense, as indicating cachexia or dyscrasia, the Psora theory is founded in nature and truth. Though Hahnemann's theory is not proven, it is a most admirable working theory, a stepping stone by means 80 A COMPEND OF THE of which we attain remarkable results in the treatment of disease. Anti-psoric remedies are such as show in their pathogenesis a tendency to act from within outwards, from above downwards, who thus abound in skin symptoms and are deep and long-acting remedies; hence, they are of special value in the treatment of chronic disease and for the eradication of inherited and constitutional disease tendencies. They show their greatest medicinal power in highly attenuated form and do not bear frequent repetition. Many of them are wholly inert in their crude state and require the pharmaceutical processes of homoeopathy to develop their latent medicinal force. The principal anti-psoric remedies are Sulphur, Cal- carea, Lycopodium, Sepia, Silica, Natrum mur., Gra- phites, Arsenic, Alumina, etc. * Hahnemann's Suggestion in Regard to Adminis- tering Anti-psoric remedies. " The best time for '^ The following is Hahnemann's list of anti-psoric remedies, but there are quite a number of others that ought to be included, which have been proved and introduced since his time: Agaricus, Alumina, Ammon. carb., Ammon. mur., Anacardium, Antimon. crud.. Arsenic, Aurum, Baryta carb., Borax, Calcarea carb., Carbo animalis, Carbo vegetabilis, Causticum, Clematis, Colocynthis, Cuprum, Digitalis, Dulcamara, Euphorbium, Graphites, Guaiacum, lodum. Kali carb., Kali nitricum, Lycopodium, Magnesia carb., Manganum, Mezereum, Muriatic acid, Natrum carb., Natrum mur.. Nitric acid. Petroleum, Phosphorus, Phosphoric acid, Platina, Sarsaparilla, Sepia, Silica, Stannum, Sulphur, Sulphuric acid, Zincum. Principles OF Homceopathy. 81 taking a dose of an anti-psoric medicine is early in the morning while fasting; no food or drink should be taken within half an hour after. After taking the medicine, the patient should keep perfectly quiet at least a full hour, but without going to sleep, avoiding mental exertion of any kind as well. '^ To females, anti-psoric remedies should not be given immediately before or during menstruation, not until four days after the flow has commenced." Pregnancy offers a most favorable time for the ad- ministration of anti-psoric remedies, the organism being then in a specially receptive state for the eradica- tion of chronic and inherited disease tendencies. During treatment of a chronic disease, do not inter- fere too readily with the acute sufferings that may arise during the treatment. Often such acute symptoms are really a part of the curative action and hence it would be unwise to interfere with their development. Other Miasms Recognized by Halinemann. In the Hahnemannian pathology of chronic diseases, besides psora, two other miasms, i. e. syphilis and sycosis figure as etiological factors. The importance and extent of syphilis as a cause of a distinct miasm does not differ as conceived by Hahnemann from that accepted by modern pathology, but sycosis assumes a distinctive importance peculiar to homoeopathy. Sycosis is the suppression of the gonorrhoeal poison in the system. Its main local manifestation is the production of figwarts around the genital region, but its later constitutional symptoms are not confined to any part of the. organism but are a general deviation of health. Hahnemann distinguishes two kinds of gonorrhoea — one comparatively innocent — a urethral, catarrhal in- flammation, and the other the sycotic form. In regard 6 82 A COMPEND OF THE to the more common and comparatively innocent form, he says in his "Chronic Diseases": "The miasm of the other common gonorrhoeas seems not to penetrate the whole organism, but only to locally stimulate the uri- nary organs. They yield either to a dose of one drop of fresh parsley-juice, when this is indicated by a fre- quent urgency to urinate, or a small dose of Cannabis or Cantharis, or of Copaiva, according to their different constitution and the other ailments attending it. These should, however, be always used in the higher and highest dynamizations, unless a psora, slumbering in the body of the patient, has been developed by means of a strongly-affecting, irritating or weakening, old-school treatment. In such a case, frequently, sec- ondary gonorrhoeas remain, which can only be cured by anti-psoric treatment." The sycotic form of gonorrhoea differs in being a much more serious matter. Hahnemann describes it as follows: "The discharge is from the beginning thickish, like pus; micturition is less difficult, but the body of the penis swollen somewhat hard; the penis is also, in some cases, covered on the back with glandu- lar tubercles, and very painful to the touch." The characteristic features of sycosis are the wart- like, cauliflower excresences around the genitals, soft, spongy, bleeding easily, recurring when violently re- moved, frequently emitting a specific, fetid fluid. All heroic, external treatment is forbidden, tending to produce the sycotic diathesis; only the external use of Thuja is permitted. For internal treatment. Thuja is the great anti-sycotic. The violent suppression of a sycotic, urethral dis- charge is often followed by chronic suffering, which is characterized by peculiar symptoms and conditions, among which the following have frequently been observed : Principles of Homceopathy. 83 Symptoms of Suppressed Sycosis. Great muscular debility- is the most characteristic physical sign ; anx- iety; anguish; fear of associating with strangers; going into a crowd; great irritability; dysmenorrhcea, before, during and after flow, with great debility; sterility; in- flammation of the Fallopian tubes, ovaries; neurasthe- nia; asthma; bronchial affections; distorted finger nails, eruption in the palms of the hands; dryness of the hair, etc.; rheumatism setting in shortly after the suppression of the discharge or remova^l of the warts; ankle and knee are specially affected; pains worse be- fore a storm and during the day. Eradicative Possibilities of Anti-psoric Treatment. The greatest evil of these miasms, is that they are made organic and rendered permanent by heredity. It is this fact of heredity and the pollution of the vital fluids * entailed thereby that modifies not only the course of acute diseases, but establishes and makes a permanent field for chronic diseases. This hereditary gift and this organized field give rise to certain bodily constitutions and certain dyscrasic conditions. Acute diseases and possibly the action of remedies run their course in the track marked out by these bodily constitu- tions, which again are largely modified by the latent psoric taint. Every practitioner of experience arrives sooner or later at this fact — namely, that in order to get a true and practical understanding of diseases, the ground, the human organization modified more or less by heredity, upon which ground diseases feed, and which is the battlefield of the malignant forces of disease from * " The vaccinated syphilis of one organism passing into another, ncay not manifest itself by eruption, or chancre or visible syphilitic taint at all, but may fall upon the nervous life and be a raging and unappeasable lust in afterlife." — J. J. Garth Wilkinson. 84 A COMPEND OF THE without combining with the impurities within, the char- acter of this ground must be studied; for, according to its composition, it will certainly modify one way or another the course of diseases that from time to time invade it. The presence of this modifying something — this perturbing and yet determining factor — this psoric taint, was recognized by Hahnemann. His facts are true; his theory, true or not, is, nevertheless, an admir- able working theory, leading to remarkable, successful results. Pre-natal Treatment by Means of Anti-psoric Rem- edies. This is a peculiar field for Homoeopathy. By means of the deeply-acting anti-psoric remedies, the lower strata of perverted life where it first establishes itself in impurities in the finest fibres and cellular structures, can be restored. Medicines chosen wisely and given to the expectant mother, can benefit the coming child. Frequently, with the indicated remedy, anatomical and structural deficiencies — as cleft palate, hare lip, eczema, etc. — can be prevented in families where such have appeared, because the taint that gave rise to them in former pregnancies has been neutral- ized by the timely administration of the homoeopathic anti-psoric remedies. Suggestions for the Treatment of Chronic Diseases. 1. Before beginning the treatment of a chronic dis- ease, it is necessary to inquire carefully if the patient has been infected by venereal disease, and, if so, to in- stitute treatment against such infection; but more fre- quently it will be found that psora complicates the case. 2.' Ascertain, also, the nature of medical treatment that the patient had received, either from drugs or mineral baths, etc., in order to understand the devia- tions which this treatment had produced in the origi- nal disease. Principles of Homceopathy. 85 3. Patient's age, mode of living, diet, occupation, domestic circumstances, and even his social position, should be considered, in order to see how the cure may- be favored or impeded thereby. 4. Patient's mental condition and temperament should not be overlooked, as it may be necessary to direct or modify his mental state by psychical means. 5. Several interviews may be necessary before the physician will find himself enabled to determine the state of the patient's case as perfectly as possible, and to mark the most conspicuous, characteristic or peculiar symptoms, which alone will guide him to the first anti- psoric, anti-syphilitic or anti-sycotic remedy for the beginning of the cure. §§ 206-209, Organon. * Partial Diseases and Local Affections. Diseases presenting an insufficient number of symptoms, usu- ally only one or two prominent ones, though compara- tively rare, are met with. Here, the first selected rem- edy will only be partially adopted and will, therefore, excite accessory symptoms, which, however, are not wholly due to the remedy given, but were latent, and the remedy served to arouse them; therefore, the new totality of symptoms will enable the prescriber to dis- cover the truly indicated remedy. Organon, §§ 172-184. The so-called local affections occupy a prominent place among partial diseases. The term is applied to diseased conditions appearing upon external parts, and are mostly of recent origin and caused by external injury. Affections of external parts, requiring me- chanical skill, properly belong to surgery alone; as, for instance, when external impediments are to be re- moved that prevent the vital force from accomplishing * See, also, Hahnemann's Golden Kule, page 93, and "Chronic Diseases," page 125. 8f) A COMPEND OF THE the cure, as the opening of cavities, either for the re- moval of cumbersome substances, or to form an outlet to effusions, etc. §§ 185-6, Organon. Besides the local affections, requiring surgical and mechanical treatment, there are local affections that proceed from an internal morbid state. Such involve the entire state of health of the whole organism, since all its parts are so intimately connected as to form an indivisible whole in feelings and functions; hence, all curative measures should be planned, with reference to the state of the whole system and by means of in- ternal remedies. This is done most effectually by including the record of the exact state of the local disease to every other change that is perceptible in the state of the patient. All these symptoms ought to be united in one perfect image and a remedy chosen according to this true totality. Organon, §§ 190-193. Objections to Local Application of a Medicine Simultaneously with its Internal Use. It may seem as if such a practice were conducive to more rapid im- provement, but it is objectionable in local affections dependent on some chronic miasm, on account of the more rapid disappearance of the local phase than of the internal disease. This often leads to the decep- tive impression that a perfect cure has been accom- plished. The local application of non-homceopathic rem- edies renders the case even more difficult. Local symptoms should not be obliterated by caustics, es- charotics, or by excision, since thereby the symptoms necessary for a choice of a curative remedy are ob- scured, and, also, the chief evidences of a permanent cure are taken away; for, if the local symptoms disap- pear after the administration of the homoeopathic rem- Principles of Homceopathy. 87 edy, we have established evidence of the achievement of a radical cure and of complete recovery from the general disease. §§ 196-200, Organon. The Local Disease is Nature's Effort to Relieve by Derivation. '' When the system is affected with some chronic disease which threatens to destroy vital organs and life itself, and which does not yield to the sponta- neous efforts of the vital force, this endeavors to quiet the inner disease, and to avert the danger by substi- tuting and maintaining a local disease on some exter- nal part of the body, whither the internal disease is transferred by derivation. In this way, the local affec- tion for a time arrests the internal evil, without, how- ever, being able to cure it, or to lessen it essentially. The fontanels of the old school have a similar effect, in the form of artificial ulcers upon external parts; they soothe internal chronic complaints, but without curing them." Nevertheless, the local malady is never anything more than a part of the general disease, but it is a part which has become excessively developed in one direc- tion by the vital force, and transported to the surface of the body where there is less danger, in order to les- sen the internal morbid process. § 201, Organon. The mental state and temperament of the patient are often of most decisive importance in the homoeo- pathic selection of a remedy, and should never escape the accurate observation of the physician, as the state of mind is always modified in so-called physical diseases. Mental Diseases and their Treatment. Most of them are in reality bodily diseases. Certain mental and emotional symptoms are peculiar to every bodily disease; these symptoms develop more or less rapidly, and become predominant over all other symptoms, and are finally transferred, like a local disease, into the 88 A COMPEND OF THE invisibly fine organs of the mind, where, by their pres- ence, they seem to obscure the bodily symptoms. In regard to the totality of symptoms of a case of this kind, all physical symptoms which prevailed before the disease assumed the mental form are very essential. Comparison between these early symptoms and their present indistinct remnants, which may occasionally appear during lucid intervals or during transient ame- lioration of the mental disease, will show the continu- ance of the physical disease, although obscured. Study §§ 214-220, Organon. Acute insanity, even though due to latent psora, should not be treated with anti-psoric remedies at once, but met with remedies like Aconite, Belladonna, etc., in highly attenuated doses. After such treatment, anti-psoric remedies, with well regulated diet and habits, will do the rest. In the treatment of insanity, the medicines may be given mixed with the patient's usual drink, without his knowledge, thus obviating every kind of compulsion. Study §§ 221-231, Organon, in this connection. Intermittent and alternating diseases are such as return at certain periods, or where certain morbid con- ditions alternate with each other. Such are mostly a product of developed psora. The symptoms which mark the condition of the patient during the period of intermission should chiefly be taken as guides in selecting the most striking homoe- opathic remedy. In intermittents, besides the importance of the apy- rexia as offering most guiding symptoms for the selec- tion of the remedy, the stage which is most prominent and peculiar should next be considered. The best time to administer the remedy is a short time after the ter- mination of the paroxysm, when the patient has par- Principles of Homceopathy.