Medical Essays, 1842-1882. Oliver Wendell Holmes
great force, and which are very generally received by his disciples.
1. Very little power is allowed to the curative efforts of nature. Hahnemann goes so far as to say that no one has ever seen the simple efforts of nature effect the durable recovery of a patient from a chronic disease. In general, the Homoeopathist calls every recovery which happens under his treatment a cure.
2. Every medicinal substance must be administered in a state of the most perfect purity, and uncombined with any other. The union of several remedies in a single prescription destroys its utility, and, according to the “Organon,” frequently adds a new disease.
3. A large number of substances commonly thought to be inert develop great medicinal powers when prepared in the manner already described; and a great proportion of them are ascertained to have specific antidotes in case their excessive effects require to be neutralized.
4. Diseases should be recognized, as far as possible, not by any of the common names imposed upon them, as fever or epilepsy, but as individual collections of symptoms, each of which differs from every other collection.
5. The symptoms of any complaint must be described with the most minute exactness, and so far as possible in the patient's own words. To illustrate the kind of circumstances the patient is expected to record, I will mention one or two from the 313th page of the “Treatise on Chronic Diseases,”—being the first one at which I opened accidentally.
“After dinner, disposition to sleep; the patient winks.”
“After dinner, prostration and feeling of weakness (nine days after taking the remedy).”
This remedy was that same oyster-shell which is to be prescribed “fractions of the sextillionth or decillionth degree.” According to Hahnemann, the action of a single dose of the size mentioned does not fully display itself in some cases until twenty-four or even thirty days after it is taken, and in such instances has not exhausted its good effects until towards the fortieth or fiftieth day,—before which time it would be absurd and injurious to administer a new remedy.
So much for the doctrines of Hahnemann, which have been stated without comment, or exaggeration of any of their features, very much as any adherent of his opinions might have stated them, if obliged to compress them into so narrow a space.
Does Hahnemann himself represent Homoeopathy as it now exists? He certainly ought to be its best representative, after having created it, and devoted his life to it for half a century. He is spoken of as the great physician of the time, in most, if not all Homoeopathic works. If he is not authority on the subject of his own doctrines, who is? So far as I am aware, not one tangible discovery in the so-called science has ever been ascribed to any other observer; at least, no general principle or law, of consequence enough to claim any prominence in Homoeopathic works, has ever been pretended to have originated with any of his illustrious disciples. He is one of the only two Homoeopathic writers with whom, as I shall mention, the Paris publisher will have anything to do upon his own account. The other is Jahr, whose Manual is little more than a catalogue of symptoms and remedies. If any persons choose to reject Hahnemann as not in the main representing Homoeopathy, if they strike at his authority, if they wink out of sight his deliberate and formally announced results, it is an act of suicidal rashness; for upon his sagacity and powers of observation, and experience, as embodied in his works, and especially in his Materia Medica, repose the foundations of Homoeopathy as a practical system.
So far as I can learn from the conflicting statements made upon the subject, the following is the present condition of belief.
1. All of any note agree that the law Similia similibus is the only fundamental principle in medicine. Of course if any man does not agree to this the name Homoeopathist can no longer be applied to him with propriety.
2. The belief in and employment of the infinitesimal doses is general, and in some places universal, among the advocates of Homoeopathy; but a distinct movement has been made in Germany to get rid of any restriction to the use of these doses, and to employ medicines with the same license as other practitioners.
3. The doctrine of the origin of most chronic diseases in Psora, notwithstanding Hahnemann says it cost him twelve years of study and research to establish the fact and its practical consequences, has met with great neglect and even opposition from very many of his own disciples.
It is true, notwithstanding, that, throughout most of their writings which I have seen, there runs a prevailing tone of great deference to Hahnemann's opinions, a constant reference to his authority, a general agreement with the minor points of his belief, and a pretence of harmonious union in a common faith. [Those who will take the trouble to look over Hull's Translation of Jahr's Manual may observe how little comparative space is given to remedies resting upon any other authority than that of Hahnemann.]
Many persons, and most physicians and scientific men, would be satisfied with the statement of these doctrines, and examine them no further. They would consider it vastly more probable that any observer in so fallacious and difficult a field of inquiry as medicine had been led into error, or walked into it of his own accord, than that such numerous and extraordinary facts had really just come to light. They would feel a right to exercise the same obduracy towards them as the French Institute is in the habit of displaying when memoirs or models are offered to it relating to the squaring of the circle or perpetual motion; which it is the rule to pass over without notice. They would feel as astronomers and natural philosophers must have felt when, some half a dozen years ago, an unknown man came forward, and asked for an opportunity to demonstrate to Arago and his colleagues that the moon and planets were at a distance of a little more than a hundred miles from the earth. And so they would not even look into Homoeopathy, though all its advocates should exclaim in the words of Mr. Benjamin Douglass Perkins, vender of the Metallic Tractors, that “On all discoveries there are persons who, without descending to any inquiry into the truth, pretend to know, as it were by intuition, that newly asserted facts are founded in the grossest errors.” And they would lay their heads upon their pillows with a perfectly clear conscience, although they were assured that they were behaving in the same way that people of old did towards Harvey, Galileo, and Copernicus, the identical great names which were invoked by Mr. Benjamin Douglass Perkins.
But experience has shown that the character of these assertions is not sufficient to deter many, from examining their claims to belief. I therefore lean but very slightly on the extravagance and extreme apparent singularity of their pretensions. I might have omitted them, but on the whole it seemed more just to the claims of my argument to suggest the vast complication of improbabilities involved in the statements enumerated. Every one must of course judge for himself as to the weight of these objections, which are by no means brought forward as a proof of the extravagance of Homoeopathy, but simply as entitled to a brief consideration before the facts of the case are submitted to our scrutiny.
The three great asserted discoveries of Hahnemann are entirely unconnected with and independent of each other. Were there any natural relation between them it would seem probable enough that the discovery of the first would have led to that of the others. But assuming it to be a fact that diseases are cured by remedies capable of producing symptoms like their own, no manifest relation exists between this fact and the next assertion, namely, the power of the infinitesimal doses. And allowing both these to be true, neither has the remotest affinity to the third new doctrine, that which declares seven eighths of all chronic diseases to be owing to Psora.
This want of any obvious relation between Hahnemann's three cardinal doctrines appears to be self-evident upon inspection. But if, as is often true with his disciples, they prefer the authority of one of their own number, I will refer them to Dr. Trinks's paper on the present state of Homoeopathy in Europe, with which, of course, they are familiar, as his name is mentioned as one of the most prominent champions of their faith, in their American official organ. It would be a fact without a parallel in the history, not merely of medicine, but of science, that three such unconnected and astonishing discoveries, each of them a complete revolution of all that ages of the most varied experience had been taught to believe, should spring full formed from the brain of a single individual.
Let us look a moment at the first of his doctrines. Improbable though it may seem to some, there