Physician and patient

by Worthington Hooker

Hahneman thought much of the amount of agitation and trituration, which were employed in preparing medicines. He gives very particular directions as to the exact number of minutes to be consumed by different portions of these processes. In mixing one grain of any substance with a hundred grains of sugar of milk, he directs that the mixture shall be made thus—the grain of substance is to be added first to a third part of the sugar of milk and they are to be rubbed together six minutes—the mass is then to be scraped from the pestle and mortar, which is to take four minutes—now it is to be rubbed again six minutes—then scraped into a heap, which is to take four minutes—the second third of the sugar of milk is now added—rubbing six minutes follows—scraping together four minutes—rubbing six minutes again—another scraping together four minutes is followed by the addition of the last third of the sugar of milk—then there is rubbing six minutes, scraping together four minutes, and six minutes more of rubbing completes the mixture. But this is only the beginning of the preparation which is required. A long course of processes is directed to carry the medicine to its proper state of dilution, up to the billionth, trillionth, quadrillionth, even the decillionth, degree. For a more full statement of Hahneman’s directions, I refer the reader to Dr. Holmes’ Lecture on Homœopathy.

Hahneman is very particular as to the number of shakes to which medicines in solution should be subjected. On this point he says, “A long experience and multiplied observations upon the sick lead me within the last few years to prefer giving only two shakes to medicinal liquids, whereas I formerly used to give ten.” What particular effect this difference in the amount of shaking has upon the ‘dynamic power’ of the medicines, he does not see fit to say. I suppose he means that the more shakes a medicine receives, the greater is its power. If this be true, what a tremendous ‘dynamic power’ must be imparted to some of the liquid medicines in the saddle bags of country doctors, as they jog about from place to place; and yet, poor unobserving mortals, they never discern any of the effects of this power though they might be very apparent to the acute vision of Hahneman and his followers.

The common idea on this subject is, that when any substance, as tartar emetic, for example, is fully dissolved in water, no amount of shaking can effect a more intimate union between the tartar emetic and the water. Nor can it alter the nature of the union, so as to give the solution any new power, or any increase of power. In order to alter the nature of the union, you must introduce a third agent, which shall act chemically upon the tartar emetic and the water.

This is true so far as we know; and it was universally acknowledged to be true till Hahneman came out with an opposite opinion. But to establish what is so opposite to all past experience, and to overthrow what has been considered by all as an established fact, the very best of proof is necessary. Hahneman says, that the proof is to be found in the effects of the solutions, to which agitation has communicated the ‘dynamic power.’ And if the effects, which he asserts that he and other Homœopathists have seen, are really produced, then the proof I allow is competent.

Some loose analogies, which have hardly the shadow of plausibility are much relied upon by Homœopathists in advocating the efficacy of their medicines. In relation to the ridicule which has been cast upon the little doses, Dr. Hering says, “suppose electricity had at its first disclosure been sneeringly called the little tempest, how ridiculous might it have appeared to those persons who were incapable of comprehending its minuteness or its might.” And the minute division of matter, as, for example, in the making of gold leaf and in the diffusion of odors, is often alluded to by Homœopathists, as illustrating the power of the little doses. When they will prove that a little electricity will produce a greater effect than a large amount of it, that a decillionth of a grain of gold will make a stronger leaf than a whole grain with the same extent of surface, or that a decillionth of a grain of musk can be made to give out a more powerful odor than any ‘allopathic’ quantity of it: then I will not only grant that the analogies are good ones, and that they go to show that Homœopathy is probably true; but I will also engage to prove, that a tack-hammer can give a stronger blow than a sledge, that smallness is always the emblem of might, that a man will be better nourished by Homœopathic doses of food than by the usual allopathic ones, and any other ridiculous thing of a kindred character.

Having thus noticed the two great principles of Hahneman’s system, let us now see on what kind of observation or experience these principles rest. If the experience be satisfactory in its amount and character, then, however opposed these principles are to the ideas and doctrines current among physicians, we must admit them to be true. It is to facts that I appeal—numerous, well observed, well attested, comparable facts. Nothing else can settle this question. If the decillionth of a grain of strychnine, or mercury, or charcoal, or salt, or oystershell, does produce palpable and measurable effects upon the human system, lasting twenty, thirty, forty, or fifty days, and does thus cure disease, as Homœopathists assert, let it be proved by facts.

As an example of the character of the observations, which are relied upon by Homœopathists to establish this point, I will take Jahr’s Manual of Homœopathic Medicine published in 1838. It was ‘translated from the German by authority of the North American Academy of the Homœopathic Healing Art.’ This book is high in favor with all the Homœopathists in this country. It is a closely printed octavo volume of six hundred pages. Four hundred pages are occupied with descriptions of the effects of about two hundred remedies, and the remaining two hundred pages contain a Repertory, as it is called, in which the symptoms are arranged alphabetically, with the remedies which produce them opposite. The Repertory is of service in investigating cases, and, if we understand it, it is to be used in this way. A list is to be made of the symptoms presenting in any case, and then the remedies appropriate to the cure of these symptoms can be found opposite to them in the Repertory.

The descriptions of the effects of remedies are exceedingly minute and particular. I will give a few examples, taken almost at random from the descriptions of a few articles. ‘Drawing pain in hollow teeth, extending to the eye-brows—cracked upper lip—stitches in hollow teeth, when biting—pain and pungency in the elbow, which allows one not to stretch or exert the arm—pungency in the knee and bend of the knee—inflammation and swelling of one half of the nose—torpor and stiffness of one half of the tongue (which half?)—blood blisters on the inside of the upper lip—loss of appetite chiefly for bread and tobacco-smoking—phlegm is hawked out, chiefly in the morning—rending and stinging in the corns—red itching spots on the shin-bone—tightening pain in the joint of the elbow—blueish spots on the fore arm—tremor of the hands, when occupied with fine small work—tingling in the points of the toes—tingling in the arms and joints of the fingers—perspiration on the hands, and between the fingers—stitches in the ankle when stepping out (not when stepping in)—a voluptuous tickling on the sole of the foot, after scratching a little, making a man (woman too?) almost mad—ulceration of the big toe, with a pricking pain—after stooping some time, sense of painful weight about the head, upon resuming the erect posture—an itching, tickling sensation at the outer edge of the palm of the left hand, which obliges the person to scratch.’

With such minuteness of observation as this, the Materia Medica of Homœopathy must contain a mass of facts, if they really are facts. They are claimed to be such, established by numerous and careful observations. Let us see how this is done. If an individual take an article, his condition is watched for some length of time, according to the duration of the effect of the article. This is various. The effect of carbonate of lime (common chalk) lasts fifty days; saltpetre, seven weeks; red pepper, twenty days; salt, fifty days; &c. If then common salt, for example, be the article, all bodily conditions, all sensations, all mental states, &c., occurring within fifty days, are to be set down as the effects of that salt. A collection of many such histories of cases is used in making up a complete description of the effects of this article. And so of other articles. The four hundred pages of descriptions of the effects of remedies in Jahr’s Manual are, according to the statement of Hering in his introduction to it, made up precisely in this way.

If all action in the human system were produced only by what is applied to it from without, and if the system could be so insulated that only one thing at a time should be permitted to act upon it, in this case, and in this only, would such kind of observation be available. But how is it? Numerous agents are constantly acting upon the system—food of various kinds—air, through the medium of the skin and the lungs—variations of temperature—varying electrical and other states—mental influences—processes resulting from previous impressions—all these exert a constant influence, modifying the effects of remedies almost infinitely. Some allowance is indeed made or affected to be made, by Homœopathists, for some of these influences; but, after all, the remedy administered is considered as overtopping them all—it has supreme possession of the patient, by virtue, I suppose, of its dynamic power. All symptoms that can be observed in him, whatever they may be, are the effects of the medicine, and Hahneman considers the various influences of which I have spoken as only modifying these effects, and that to a limited degree.