Harris L. Coulter - Homoespathic Medicine
Harris L. Coulter - Homoespathic Medicine
Harris L. Coulter - Homoespathic Medicine
$1.65
HARRIS L. COULTER
HOMOEOPATHIC
MEDICINE
TRX #8252
76 Coulter, Harris L«
^83 Homoeopathic medicine / Harris
1975 Coulter. St Louis : Formur,' elfq
iii, 73 p. ; 1R cm,
Includes bibli ORraphlcal referer
#P252 Gif t:Whitmyer S1.6F.
1« Fotneopathy. I» Title
Copyright 1972 by
Copyright 1975 by
ISBN 0-89378-072-3
AND DISEASE
-We are compelled to use the words, "cure" and "recovery", beeause there
are no convenient substitutes. I he reader will be aware that even in homoeo-
pathie practice the concepts are ambiguous, involving the complexities of
tiering'* I aw and <>! Hahnemann's thcorv ot ehronie disease
In the second place, the symptoms will move from the
more vital organs to the less vital and from the interior
of the body toward the skin.
In the third place, the symptoms will move from the
top of the body —
downward disappearing first from the
head, then from the torso, and then from the extremities,
proceeding from the shoulders to the elbow, wrist, and
hand, or from the thigh to the knee, ankle, and foot.
These rules are known in homoeopathy as Hering's
Law, in honor of Constantine Hering (1800-1880), the
Father of American Homoeopathy, who discerned them
and thus made the only major addition to Hahnemann's
initial system. Hering's Law can be illustrated as follows:
4
Knud Faber. "Nosography In
'
Modern Internal Medicine". Annals of Medi-
cal History IV (1922). p. 63.
^Discussed on pages 20. 25. 30-32. 38.
several of the Hippocratic writings, has at times given
rise to the extreme position that the disease is a meta-
physical entity. As Sir Clifford Allbutt has written: "It
was born to signify that reality of substance which was
once supposed to underlie abstract names, and in these
ontological circles it has moved ever since." 6 Since his
time, about 70 years ago, all prominent spokesmen for
allopathic medicine have rejected this understanding of
the disease entity. But no attempt has since been made
to create a precise theoretical definition of the disease
entity. Furthermore, physicians often seem to adhere to
the idea that the disease is, in fact, an entity in the on-
tological sense denounced by Allbutt. The very word,
"entity", is used in medical writing. This aberration is, of
course, favored by the absence of an accepted theory of
the disease entity.
There is a psychological connection between the dis-
ease-entity concept and the view that the symptom is a
lesion inflicted by a morbific stimulus. The entity is built
up from the prominent or striking symptoms; attention is
directed to these symptoms, and it is thus natural to re-
gard them as harmful manifestations. Fever is a good
example. While the homoeopathic physician will regard
fever as a benign symptom, reflecting the body's effort
to overcome the morbific influence at work on the body,
the orthodox physician will take the contrary view and
administer medicines which lower the fever. (It is fair to
note that the contrary interpretation of fever is also oc-
casionally given in the allopathic medical writings, but
then how is the physician to distinguish the benign fever
from the one which is harmful?) Many of the medicines
used in allopathic practice aim to oppose or counteract
one or several prominent disease symptoms.
6
Quoted in Otto Guttentag, M.D., "On The Clinical Entity", Annals of In-
ternal Medicine XXXI (1949), p. 488.
We may carry the analysis a step further and note that
the allopathic physician's attitude toward the symptom
determines his toward the "vital force." He
attitude
cannot admit the existence of such a force in the body and
at the same time administer medicines which counteract
or suppress the symptoms which are the very manifesta-
tions of this force. Hence he instinctively rejects the
vital-force doctrine.
Thus the homoeopath and the regular physician start
off with divergent interpretations of the symptom. The
concept of the vital force is of considerable moment for
the day-to-day practice of medicine in the homoeopathic
school, and its rejection by medical orthodoxy has a
similarly pronounced effect on the practice of allopathic
medicine.
This concept is significant in yet another way. Its ac-
ceptance by homoeopathy symbolizes the deeply held
conviction of this school that the internal processes of
the organism are (1) extremely complex and not to be
—
wholly comprehended by the physician so that therapy
may not be based upon this assumed knowledge, and
(2) linked to one another in such a way as to make all
parts of the organism interdependent — so that any at-
tempt treatment must be treatment of the whole pa-
at
tient, treatment which is proportioned to all parts and
10
comprehend the significance of individual symptoms as
well as the dynamic interaction among symptoms in
spond that it has served for 150 years as the basis for
the successful homoeopathic treatment of disease and
the preservation of health. And if the homoeopathic phy-
sician can cure his patients consistently and methodically
on the basis of this theory, this set of assumptions, who is
II
II. EPISTEMOLOGICAL ASSUMPTIONS:
13
The homoeopathic and orthodox physicians take op-
posed views of the nature and importance of these two
kinds of knowledge. The former attribute prime impor-
tance to sensory knowledge of the patient's symptoms
and secondary importance to the so-called "objective"
disease parameters. With the latter, this emphasis is re-
versed. Allopathic physicians attribute greater impor-
tance to the "objective" information and less to the "sub-
jective" symptoms.
The from homoeopathy's orientation
difference stems
toward the dynamic and changeable vital force, as op-
posed to allopathic medicine's concentration on the static
disease entity. This initial difference in approach leads
to different views of the relative importance of the symp-
toms and the "objective" pathological or physiological
data.
Homoeopathy holds that the disease process first af-
fects the vital force, where its presence is manifested by
a change in the patient's general well-being — before any
"objective" changes can be noted in the patient's fluids
or tissues. These pathological changes are the result of
the alteration in the vital principle and not its cause. The
initial morbid changes in the state of the vital force are,
therefore, expressed only as symptoms. Symptoms are
chronologically prior to pathology. For this reason they
are also prior in importance. The ongoing pathological
changes are, at all stages, preceded by symptomatic
changes. Attention to these symptomatic changes will
enable the physician to forestall the pathological deteri-
oration.
The homoeopathic physician of today will conduct the
same chemical, microscopic, and other tests of the pa-
tient's tissues and fluids as are done by the allopathic
14
the vital force. Tissue and fluid changes are chrono-
logically posterior to the alterations in the vital force it-
the state of his disposition, his humor, his memory? How about
7
Samuel Hahnemann. Lesser Writings, New York: William Radde, 1852,
p. 443.
15
the thirst? What sort of taste has he in his mouth? What kinds
of food and drink are most relished? What are most repugnant
to him? Has each its full natural taste, or some other unusual
taste? How feel after eating or drinking? Has he any-
does he
thing to about the head, the limbs, or the abdomen?
tell . . .
What did the patient vomit? Is the bad taste in his mouth
putrid or bitter or sour, or what? Before or after eating or during
the repast? At what period of the day was it worst? What is the
taste of what iseructated? Does the urine only become turbid
on standing, or is it turbid when first discharged? . . . Does he
start during sleep? Does he lie only on his back, or on which
side? Does he cover himself well up, or can he not bear the
clothes on him? Does he easily awake, or does he sleep too
soundly? How does he feel immediately after waking from
sleep? How often does this or that symptom occur? What is the
cause that produces it each time it occurs? Does it come on
whilst sitting, lying, standing, or when in motion? Only when
fasting? . . . how the patient behaved during the visit — whether
he was morose, quarrelsome, hasty, lachrymose, anxious, des-
pairing, or sad, or hopeful, calm, etc. Whether he was in a
drowsy state or in any way dull of comprehension; whether he
spoke hoarsely or in a low tone or incoherently, or how other-
wise did he talk? What was the color of his face and eyes, and
of his skin generally? What degree of liveliness and power was
there in his expression and eyes? What was the state of his
tongue, his breathing, the smell from his mouth, and his
hearing? Were his pupils dilated or contracted? How rapidly
and to what extent did they alter in the dark and in the light?
What was the character of the pulse? What the condition of the
abdomen? How moist or hot, how cold or dry to the touch, was
the skin of this or that part, or generally? Whether he lay with
head thrown back with mouth half or fully open, with the arms
placed above the head, on his back, or in what other position?
What effort did he make to raise himself? And anything else in
16
orthodox physician. He must pay special attention to the
"modalities": Is the particular symptom aggravated or
17
After all, there is no a priori reason to assume that
diseases are not capable of being accurately measured in
terms of their symptoms. While only a highly skilled
physician can elicit and complete disease descrip-
a true
tion by this method, the method itself is intrinsically
accurate. To seek a greater degree of precision in the
measurement of vital phenomena would be an error.
Aristotle has noted that the educated man does not seek
greater precision than is inherent in the subject-matter.
The homoeopaths feel that the so-called objective mea-
surement techniques of orthodox medicine all too often
yield a spurious precision —
highly refined data which
have no precise meaning, no precise therapeutic applica-
tion.
The allopathic physician takes the contrary view,
feeling that these parameters are more reliable guides
to treatment precisely because they are "objective",
while the "subjective" symptoms are too ephemeral and
unstable to be reliable. While he does note the symptoms
generally, he does not go into them in the exhaustive way
urged by Hahnemann, and the diagnosis will always rely
more heavily upon the "objective" parameters than upon
the "unstable" or "evanescent" symptoms.
The attempt to balance symptoms and "objective"
findings places this physician in a dilemma. Symptoms
are very numerous, as homoeopathic experience indicates.
But the orthodox physician is not interested in all the
patient's symptoms, only in the "important" ones, the
ones which characterize unambiguously the presence
of some typical disease process. But the "importance" of
a given symptom is, of course, related to the diagnosis
which is ultimately accepted. The physician may simply
discard all the symptoms which do not fit the diagnosis,
ascribing them to the patient's tendency to neurosis or
hypochondria. Or he may retain some of them on the
18
ground that the case is "atypical". What is important is
" 'What do we care,' say the medical teachers and their books,
'what do we care about the presence of many other diverse
symptoms that are observable in the case of disease before us,
or the absence of those that are wanting? The physician should
pay no attention to such empirical trifles; his practical tact, the
penetrating glance of his mental eye into the hidden nature of
the malady, enables him to determine at the very first sight of
the patient what is the matter with him, what pathological form
of the disease he has to do with, and what name he has to give
"9
it .'
. .
19
mcndous proliferation of possible disease states. Any
physician knows that the variety among patients is inex-
haustible. If symptoms alone are to be the guide, where is
20
action will oppose or counteract the fundamental pro-
cesses at work in the disease.
Allopathic medicine aims to develop a theory of drug
action which it combines with a theory of the disease
entity.
It is contemporary allopathic medicine
quite difficult in
to determine which new medicine will be effective in a
given "disease". There is a body of knowledge known as
pharmacological theory, but theory is still too crude
this
to give a priori information about the action of drugs.
"There does not exist any sound theoretical basis on
which to build a rational approach to the search for really
new types of drugs." 11 "There are few drugs, if any, for
which we know the basic mechanism of action." 12 "To
date, the subject of biochemorphology has advanced to
the point where intelligent guesses may be made as to the
influence of alteration in structure on the activity of a
given molecule. However, prediction of usefulness and
safety on this basis is impossible." 13 The dependence of
biological performance on chemical and molecular struc-
ture is, in fact, so erratic that even changes in the manu-
facturing process will sometimes alter therapeutic action
in an unacceptable way and compel withdrawal of the
medicine from the market.
Consequently, pharmacological theory only offers sug-
gested lines of research, and these suggestions must be
tested through trials on animals and ultimately on
humans. Medicines are tested for their toxicological
effect and their gross physiological effect on some organ
"Rene Dubos, in Paul Talalay. ed.. Drugs in our Society, Baltimore: Johns
Hopkins, 1964, p. 37.
i:
Louis S. Goodman, in ibid., p. 54.
21
or organ system in animals. For the actual therapeutic
trial, it is necessary to gather together a group of persons
suffering from the "same disease" and administer the
medicine to them (following the accepted procedures for
ensuring statistical validity of the results, eliminating ob-
server bias, etc.), then subject the results to appropriate
statistical analysis. If the patients in the group receiving
the medicine seem to benefit from it, by comparison with
those under traditional treatment or those receiving a
placebo, and this benefit falls within the area of statistical
significance, the medicine is viewed as possessing some
therapeutic potential.
The methodological defects in this procedure will be
discussed in more detail below. Here let us merely note
that the procedure is subject to two major criticisms from
the homoeopathic standpoint. The first is that the medi-
cines are usually evaluated in terms of some "objectively"
measurable parameter. But these "objective" phenomena
are the effects of the changes which the drug has made in
22
Although vaunted on all sides as thoroughly "empiri-
procedure was an unstable mixture
cal", this drug-testing
of sensory symptomatic data and the measurements of
pathological parameters. Hahnemann thought that this
was imprecise and speculative. He objected, as homoeo-
pathic physicians object today, that the disease descrip-
tions were too imprecise and that the "disease entity"
contains many quite dissimilar diseased states which
should perhaps be treated by a number of different
remedies.
As proof of his argument, he pointed out that the most
acclaimed medicines often have a very short life expec-
tancy, being denounced as regularly — after the profession
has accumulated some years of experience with them
as they were praised upon their introduction.
23
produced by the same substance when administered to
a healthy person.
Hence the name, homoeopathy, from the Greek:
homoion pathos, meaning "similar disease."
If a healthy person takes any drug or medicinal sub-
stance on a regular basis for several days or weeks, he
will come to manifest a set of symptoms which are pecu-
liar to the particular drug or substance. 14 In homoeopathic
philosophy, this procedure is known as "proving" the
medicine (from the German: Pruefung, meaning "test"
or "trial"). Calomel by its physiological action produces
diarrhoea, frequent bloody and mucous stools, increased
secretion of bile, and salivation. When a case of disease
is characterized by these symptoms, very small doses of
calomel {Mercurius dulcis) will be curative. Belladonna
is indicated homoeopathically when the patient presents
dilated pupils, violent congestion of blood to the head
with throbbing headache, high fever with hot red skin,
cerebral excitement, dryness of mouth and throat, muscu-
lar twitchings (the symptoms frequently encountered in
scarlet fever).Any physician will recognize these symp-
toms as the well-known toxic effects of Belladonna.
Thus, when the homoeopathic physician has a complete
and exhaustive listing of the patient's symptoms, he com-
pares this with the listings of symptoms in the homoeo-
pathic books of provings. When there is precise corres-
pondence between the patient's symptoms and the symp-
toms of some particular medicine, as listed in the books
of provings, this medicine will act curatively.
It will be seen that Hahnemann's assumption that the
symptom is a benign manifestation is perfectly adapted
to therapy based upon the Law of Similars. If the symp-
l4
Persons who are particularly sensitive to a given drug will manifest the
drug's symptomatology to amore marked degree. Those who are less sensitive
will yield a less striking symptom picture.
24
torn is recognized as the expression of the organism's
effort to counteract morbific stimuli and to rid itself of
disease, the medicine which stimulates the organism in
precisely this direction is the one which will act cura-
tively. Thus in homoeopathy the symptoms, which are
the sense-perceptible evidence of the disease process,
are at the same time sufficient to characterize the ef-
fects of medicines upon the organism. The disease pro-
cess and the operations of medicines are described by
sensory phenomena.
By the same token it is seen that the Law of Similars
yields the basis for the homoeopathic classification of
diseases. The traditional disease categories are largely
rejected, and these physicians, if pressed, will only say
that the patient has a Sulphur disease, Belladonna dis-
ease, Cantharis disease, or the like. 15
From the thera-
peutic viewpoint, what more useful criterion of disease
classification could be desired than the medicine which
acts curatively?
l5
James Tyler Kent, the foremost American homoeopath of an earlier gen-
an Irishman who came into the clinic one day, gave
eration, tells the story of
his symptoms, and then wanted to know what he had. "The physician answered,
'Why you have Nux Vomica' that being his remedy. Whereupon the old man
said, 'Well, did think
1 had some wonderful disease or other' ..." (Kent,
I
25
III. THE HOMOEOPATHIC THERAPEUTIC
METHOD
27
fest under the same circumstances. As Hahnemann wrote,
"the more common and undefined symptoms: loss of
appetite, headache, debility, restless sleep,
discomfort,
and so forth, demand but little attention when of
that
vague and undefined character, if they cannot
be more
accurately described, as symptoms of such
a common
nature are observed in almost every disease
and from
almost every drug."'" "The most singular, most
uncom-
mon signs furnish the characteristic, distinctive, and
peculiar features."' 7 "The more striking, singular,
uncommon, and peculiar (characteristic) signs and symp-
toms of the case of disease are chiefly and most
solely
to be kept in view." 18
The medicine which resembles the patient's syndrome
in only its more common features will have little
or no
curative effect. The highly similar remedy,
the sim-
ilimurn, derives its curative power from its
close resem-
blance to the fleeting but strongly characteristic
symp-
toms of the patient. Hahnemann, whose father wrote
a
treatise on portrait-painting, used the
artist's language
to express his idea of
how the picture of the disease should
be matched to the picture of the remedy:
28
natural production; such was never the way
in which any zoolo-
29
The reader is referred to the competent discussion of the
M.D. 20
subject by Margaret Tyler,
The homoeopathic analysis of symptoms provides a
sound method for "treating the patient and not the dis-
ease." This is an oft-mentioned desideratum in orthodox
30
cable to these symptoms when manifested in the provings
of remedies. Nearly every proving will yield a group of
these common symptoms, and for that reason they are of
little value for treatment. What is significant are the
"modalities": which conditions relieve the headache or
the nausea, which aggravate them, etc. It is found that
remedies can be distinguished from one another on the
basis of the modalities and that these are often the key
to correct prescribing.
The remedy prescribed according to the Law of Similars
is "specific" to a particular syndrome, a par-
disease
ticular conglomeration of symptoms, and homoeopathy
thus provides an answer to the time-honored dispute in
medical history over the meaning of the "specific medi-
cine." In the orthodox tradition the "specific" has meant
the medicine which was of use in a particular disease even
though no explanation of its action was forthcoming, the
best examples being quinine (Cinchona) in malaria
(intermittent fever) and mercurial compounds in syphilis.
Hahnemann's provings of these two substances revealed
them to be homoeopathic to certain instances of their
respective "diseases," and he rightly observed that their
popularity over the centuries stemmed from the fact that
they were truly curative in these cases because homoeo-
pathic to their symptoms. In the light of the homoeopathic
experience, therefore, "specific" means homoeopathic to
a particular set of symptoms. Every medicine or substance
used as a medicine is the specific remedy for the group
of symptoms which it develops when proved on healthy
persons. Quinine is specific to certain cases of malaria,
and mercury is specific to certain syphilis syndromes.
Neither is specific to all cases of disease lumped by some
physicians under the headings, "malaria", or "syphilis".
The specificity is not to the disease name but to certain
symptom-syndromes which, in the case of malaria and
31
syphilis, happen to be syndromes often encountered in
32
all the symptoms of the remedy, and the indicated remedy
is the one whose symptoms match all the symptoms of
the patient.
Another important difference between the homoeo-
pathic and the allopathic approaches to therapeutics
stems from the homoeopathic awareness of the existence
of "primary" and "secondary" symptoms of drugs. Hahne-
mann discovered in 1796 that any drug administered to a
healthy person gives rise to two consecutive sets of symp-
toms, the second set being in a sense the "opposite" of
the first. Hahnemann
wrote, with respect to the primary
and secondary symptoms of Opium: "A fearless elevation
of spirit, a sensation of strength and high courage, an
imaginative gaity, are part of the direct primary action of
a moderate dose on the system: But after the lapse of eight
or twelve hours an opposite state sets in, the indirect
secondary action; there ensue relaxation, dejection,
diffidence, peevishness, loss of memory, discomfort,
fear ." 2I Initially he felt that both sets of symptoms
. .
21
Hahnemann, Lesser Writings, pp. 266-267.
33
the organism's reaction to the drug (expressed in the form
of the secondary symptoms) will be the "opposite" of
the disease symptoms and will thus neutralize or annihi-
late the "disorder of the vital force" which is the disease.
Hence the frequently observed "aggravation" of the
disease after administration of the indicated remedy.
Since the primary symptoms of the remedy are identical
with the symptoms of the disease, these latter are at first
34
throughout the diluent, and it is then known as the 1 X
The mixture can also be made
dilution. in the proportion 1
35
Several comments may be made on homoeopathic the
been proven
dilutions. In the first place, their value has
by much clinical experience. Thousands of homoeopaths
have used them and are using them today. These dilu-
tions have been found highly effective when used ac-
cording to the correct indications. In the second place,
a series of biological, chemical, and physical experiments
have uniformly demonstrated the existence of some
physico-chemical, or other, force in the ultra-molecular
dilutions. In 1928, H. Junker added various substances,
in dilutions up to 10 -27
to bacterial cultures and found
,
23
See James Stephenson, M.D., "A Review of Investigations into the Action
of Substances in Dilutions Greater than 1 x 10- :4 (Microdilutions)," Journal
oj the American Institute of Homoeopathy XLVIII ( 1955), 327-355.
24
Some on the physical basis of the action of microdilu-
results of research
tions are reported in James Stephenson, M.D. and G. P. Barnard, "Fresh
Evidence for a Biophysical Field," Journal of the American Institute of
Homoeopathy LX1I (1969). 73-85.
36
molecular dose has been strictly a priori — with vague
references to common sense which is a notoriously un-
guide in medical matters.
reliable
Use of the ultra-molecular dose, in any case, is not an
essential principle ofhomoeopathy. Hahnemann insisted
on the "minimum dose", which is an ambiguous concept in
view of the associated doctrine that increased dilution of
the substance actually enhances its power. Homoeopathic
physicians, like Hahnemann himself, make use of the
whole range of dilutions, from the lowest to the highest.
3.) The Single Remedy. Hahnemann's third rule re-
quires the physician to administer one remedy at a time.
Here again his rule contrasts with orthodox practice
which permits the use of several drugs at once or in
combination.
The homoeopathic principle is not arbitrary but stems
logically from the other elements of the homoeopathic
system. The physician may give only one drug at a time
because the provings are only of a single substance. The
physician may not give two remedies at once (i.e., on the
37
distinctive action not found in either of its components.
The characteristic symptoms produced by Ferrum phos-
phoricum mark it as a distinctive single remedy, and it
must be prescribed on the basis of the symptoms from
its own proving, not on the basis of a mixture of Ferrum
38
In 1828 he published a work which hypothesized the
existence of three basic chronic diseases; psora, syphilis,
and sycosis (gonorrhoea). These three chronic diseases,
which assume the most protean forms (Hahnemann wrote
five volumes of their symptoms), were to be cured by
Sulphur, Mercurius, and Thuja (Arbor vitae) respectively.
Hahnemann's theory of chronic diseases is a departure
from his principle of the uniqueness of each individual
case and a step in the direction of reliance on the disease
entity. For this and other reasons it provoked fierce con-
troversy in homoeopathic ranks which lasted for decades.
Today, however, a consensus has been reached on this
point, which can be summarized as follows.
While it is felt that Hahnemann's symptomatic descrip-
tion of these three chronic diseases, and the remedies he
selected for them, are correct, there is less agreement on
the causal relationship between these miasms and their
respective acute forms, that is, the acute forms of psora
(the "itch"), syphilis, and gonorrhoea. 25 Therefore, at
the present time, Hahnemann's chronic-disease theory has
been converted into a principle of homoeopathic practice.
When the indicated remedy fails to cure, or effects a cure
which is not permanent, one of the chronic-disease
remedies is probably indicated, and when this remedy has
run its course, the indicated remedies for the acute disease
are seen to be once again effective. Thus, a contemporary
homoeopathic materia medica states, with respect to
sulphur: "When carefully selected remedies fail to act,
especially in acute diseases, it frequently arouses the
reactionary powers of the organism . . . prescribed for
complaints that relapse." 26
39
In conclusion, it should be stressed that the rationale
for prescribing the remedy in homoeopathic practice is
27
In 1832, Hahnemann suggested that the cause of the Asiatic cholera epi-
demic of that year was probably "an enormous brood of excessively
. . .
40
true or permanent cure, since it in no way strengthens the
organism. In fact, this type of medication may well weaken
the organism and affect adversely its inherent recuperative
powers, leaving the patient prone to a relapse or to infec-
tion with another disease. It is well-known that antibiotics
can at times upset the balance of microorganisms within
the body and thus permit the ingress of pathogenic
varieties.
Similarly, in the homoeopathic view, the other typical
medicines used in orthodox practice — substances which
stimulate or depress some physiological function, deal
only with particular manifestations of the disease process
and fail to reach the root.
Killing the germ inside the body does not eliminate the
disease cause. The "cause" is not the germ but the pre-
existing state of the organism which permits the germ to
exist and multiply there. Enhancing or blocking some
physiological function does not remove the disease cause
but only diverts the vital force into different channels.
The "cause" is the preexisting state of the organism
which in time gives rise to an observable pathological
process. It is non-material and cannot be cognized di-
41
IV. THE PLACE OF PATHOLOGICAL
DIAGNOSIS IN HOMOEOPATHY
43
A careful analysis of this argument, however, reveals
it to be merely a remnant of the disease-entity way of
thinking. It reflects the belief that the "disease itself
issomehow in existence within, and independent of, the
body. The presence of this entity is thought to produce
certain symptoms, and the "mere" removal of these symp-
toms is not viewed as equivalent to curing the "disease."
Homoeopathy, however, regards disease as a distortion,
disharmony, or misdirection of the body's vital force. If
a medicine is administered which covers the totality of
the patient's symptoms and thus removes all of these
—
symptoms so that the patient feels entirely well after-
wards and appears in excellent health, who is to say that
the "disease" has not been removed, that the patient has
not been cured?
Hahnemann answered this criticism in the following
words: "It is not conceivable nor can it be proved by
any experience in the world, that, after removal of all the
symptoms of the disease, and the entire collection of the
perceptible phenomena, there should or could remain
anything else besides health, or that the morbid alteration
in the interior could remain unaltered." 28 "In the cure
effected by the removal of the whole of the perceptible
signs and symptoms of the disease, the internal alteration
of the vital principle to which the disease is due — conse-
quently the whole of the disease — is at the same time
removed." 29 As a later commentator has put it, "Cessat
"
efjectus, cessat causa. 30
Of fundamental importance to Hahnemann's dictum is
the idea that the totality of the symptoms must be re-
2s
Hahnemann, Organon, Section 8.
44
moved by the single remedy. 3I The idea that the symp-
tomatology of the disease must match that of the remedy
to the last detail is a far cry from what is called symp-
tomatic prescribing in orthodox practice, where several
different medicines are administered because of their
presumed action "against" several of the patient's
symptoms.
The next problem is the role of pathology in the total
management of the patient. It must be admitted that this
question has not always been properly understood in the
past by the homoeopaths themselves, as they have often
confused the purely pharmaceutical side of medicine with
the whole of medical practice. A more balanced view
prevails at present, however, and it can be summarized
as follows:
1) Pathological knowledge has the important function
of demarcating the cases which are, in principle, amenable
to drug treatment from those where some other type of
treatment, such as surgery, dietary adjustment, or manipu-
lative therapy, may be indicated. Diseases caused by
defective diet are best treated by improving the diet, and
it may be found that no medicine at all is needed there-
after. Deficiency diseases can often be spotted by symp-
toms alone, but in many cases pathological investigations
are also needed. The same is true for diseases requiring
surgery. While homoeopaths have always held that
surgery is less used in homoeopathic practice than in
orthodox practice, there is no theoretical objection to it.
Often is revealed through pathological in-
its necessity
and it may be employed whenever needed.
vestigations,
Homoeopathy, furthermore, is fully compatible with the
3,
lbid., Section 70. It is understood that the development of the disease will
usually require different remedies— matching the changing symptom-pattern.
But two medicines are never to be given simultaneously.
45
various forms of manipulative therapy, and homoeopaths,
more than other physicians, have recognized the value of
these types of treatment.
2) Just as pathological knowledge helps to demarcate
the diseases curable by drug therapy from those which are
not, it also helps to distinguish the symptoms of the
patient's altered vital force from those symptoms which
may be the secondary consequences of some gross patho-
logical alteration. An authority notes: "frequency of
micturition, with a morbid growth impacted in the pelvis,
would not help you in the choice of a remedy. It would be
asymptom secondary to gross pathological change; not a
symptom expressing the patient herself, but a symptom
merely dependent on mechanical pressure; promptly
relieved by the removal of the tumor." 32
3) Another important use of pathological knowledge is
in demarcating cases with favorable prognosis from those
in which the prognosis is unfavorable. When the patho-
logical changes are far advanced, and the vital organs have
been seriously affected, use of a powerful and deep-
acting homoeopathic remedy may so disturb the economy
as to lead to death. The homoeopathic literature contains
a number of instances of this. Thus, when the prognosis
is unfavorable, the homoeopath is often best advised to
employ superficial and palliative remedies which do not
attempt to provoke a far-reaching restorative process,
since the patient's recuperative powers may not be equal
to the task of cure. This state of the organism is often
to be discovered through use of the common diagnostic
procedures.
4) A final use of pathology, mentioned in one of the
leading contemporary homoeopathic texts, is the follow-
32
J. T. Kent, Repertory of the Homoeopathy Materia Medica, Introduction
by Margaret Tyler, M.D., p. viii.
46
ing: When treating such epidemic diseases as typhoid or
cholera, in which the same group of homoeopathic rem-
edies is may benefit from
usually indicated, the physician
a knowledge of the pathological changes which indicate
the particular epidemic process. Then the correct remedy
can be administered at an early stage when the symp-
tomatology is still diffuse and unclear, i.e., before the
typical symptoms characterizing the particular epidemic
process have had time to develop.
This latter procedure is still, in principle, identical
with prescribing on a symptomatic basis. The pathological
indications enable the physician to resolve which of the
patient's unclear symptoms are of significance for
prescribing.
Practitioners are agreed, however, that this procedure
carries a serious risk of abuse, for its apparent short-
cutting of the laborious stage of symptom analysis. The
general rule remains, as always, that remedies are to be
selected on the basis of the symptoms.
Pathological knowledge is imprecise. It does not permit
of individualization. That is why it is rejected as a
guide to remedy selection. A modern authority has
written:
33
J. T. Kent, Repertory of the Homoeopathic Materia Medica, Introduction
47
pathological indications, this would be extremely labori-
ous, and a thorough pathological picture of the remedy's
effectwould demand an autopsy of the prover! And what
would be the point? The symptoms already provide more
subtle and differentiated pictures of drug effects than
could ever be obtained from pathological investigations.
48
V. THE SEARCH FOR A SCIENTIFIC
THERAPEUTICS
49
fying to the practitioner, always entails a risk to the
patient. While we admit that therapeutics contains an
"artistic" dimension, we also feel that its magnitude
should be diminished to the utmost.
Art should be a supplement to scientific knowledge,
not a substitute for it. It would be odd if engineers were
medicine.
Spokesmen for orthodox medicine will generally claim
that their procedures are scientific to the extent that they
embody measurements. Thus the various diag-
precise
nostic tests employed, which are based upon
and other
recognized chemical and physical principles, are supposed
to be scientific and to make the practice of medicine
scientific. But the unreliability and ambiguity of diag-
50
sides, and these procedures could thus not be "scientific"
in any ordinary sense of the word. At this point the phy-
sician usually falls back upon the concept of the phy-
sician's "tact" or artistic sense: "Judgment is the es-
sence of the clinical method in its fullness," 34 diagnosis
is "the product not of guessing but of a sifted experience
by which the significant is recognized with such rapidity
that the steps of reasoning are not discernible to the
uninitiated." 35
If diagnosis is not a scientific procedure, the next
step — the selection of treatment — can hardly be scien-
tific either. Allopathic diagnosis never points unam-
biguously to a single no necessary
medicine; there is
1950. p. 784.
51
The disease entity plays as pivotal a role in today's
orthodox therapeutics as it did for Galen. This concept
was refined with Pierre Louis' introduction of statistics in-
to medicine in the early nineteenth century and immedi-
ately encountered the most serious methodological and
philosophical objections. The essence of these objections
has always been that finding a statistical mean or average
between unlike things does not make them like. An aver-
age could be found between six oranges and six apples,
but it would have no physical meaning; nothing cor-
responds to it in the physical world, especially in a field
such as medicine where the ultimate reality is always a
single individual person. These ideas have been presented
in their most trenchant form by Claude Bernard:
,6
Claude Bernard, An Introduction to the Study of Experimental Medicine,
New York: Dover, 1957, pp. 134-135.
52
It is odd indeed French physiologist, who
that the great
is usually foremost philosopher of con-
cited as the
temporary orthodox therapeutic method, should in fact
have rejected the fundamental concept upon which this
method is founded. But the nineteenth-century contro-
versy over the use of statistics in medicine is presumed
to have been settled, and Claude Bernard's spiritual
descendants have until recently been content to leave it
so.
53
characteristics, in view of the necessarily small sample sizes,
,7
J. B. Chassan, "Statistical Inference and the Single Case in Clinical De-
sign", Psychiatry, XXI 11 (1960). pp. 173. 184.
W A. Hoffer and H. Osmond. "Double-Blind Clinical Trials", Journal of
Neuropsychiatry,, II (I960 1961). p. 222.
54
to affect prognosis in this disease Coronary artery disease
. . .
unproven.
Consequently, the allopathic physician must attempt
to measure the drug effect empirically and generalize
these results over the whole patient population. But this
gives rise to the same procedural difficulty as in the case
of diagnosis, for patients react very differently to the same
drug. The modern literature emphasizes that drug effects
"are never identical in all patients or even in a given
patient on different occasions." 41 "An occasional in-
dividual responds to a drug in a fashion qualitatively
different from the usual response . . . Such a response is
" 42
called 'idiosyncrasy' . . .
55
The emotional state of the individual is crucial in evaluation of
nitrites. Patients with angina pectoris, not all of them, but many
of them, tend to be somewhat dependent upon their physician as
a bulwark between them and the sudden death that they fear.
The placebo effect is strong in suggestible individuals with
angina pectoris, and relief of angina may be effected by a reduc-
tion in anxiety due to the personality of the physician rather
than to the nitrites administered. 41
56
is drug A better than drug B and vice-versa? If drug A cures 40%
and drug B cures 60%, perhaps the right choice of drug for each
person would result in 100% cures'. 45
the pneumonia season and not find two that sounded exactly
alike. But this is not the same as saying that there are no common
45
Paraphrased in Annual Review of Medicine IX (1958), p. 349.
46
In Paul Talalay, ed.. Drugs in Our Society, pp. 93-94.
57
therapeutics would be as follows: It would be hypothe-
sized, on whatever grounds seem sufficient, that disease
X is cured or alleviated by medicine Y. Whatever scientific
input behind it, the outcome
lies is a proposition in the
above form. The physician's task is to verify the truth of
this proposition.
58
ease entity is a statistical mean or average of a number
of different cases, and its description may not match
the description of a single one of the observed cases. The
outcome is a methodological morass in which one defec-
tive hypothesis is temporarily propped up by others
59
itself. Only in the context of the patient's whole syn-
drome — which is at the same time the symptom-syndrome
of the curative medicine — does the individual symptom
take on meaning. The patients are not shunted into
speculative pathological categories but are classified
in terms of the meaningful symptoms. And the symptoms
which are meaningful are the ones which at the same time
point to the curative medicine. 47
Thus, the homoeopathic method has solved the problem
of establishing an unambiguous definition of the primary
data — the individual cases of disease, the individual
patients. Each is described in the minutest way, and the
proof that these descriptions are valid and accurate is
that they have withstood the test of more than 150 years.
What is often seen as a weakness of homoeopathy — that
it is unchanged in its essentials — is actually an advan-
tage. A well-observed symptom is an unchanging datum.
Careful physicians for generations have found that the
homoeopathic characterizations of disease processes are
as true for them as for their predecessors. The homoeo-
pathic system is a sturdy and stable edifice because it
rests on this firm methodological foundation.
In this way homoeopathy reduces to a minimum the
artistic component in medical practice. To quote James
Tyler Kent:
4
The idea of distinguishing diseased states in terms of the medicines which
cure them has recently been proposed in an allopathic medical journal. Com-
plaining that the emphasis on disease categories has caused the production
of medicines with undesirable side-effects, Drs. A. Hoffer and H. Osmond
have proposed that a search be made for more specific drugs. They call for a
focus on the drug and not on the disease -"the essence of this method is to find
the clinical situation which will respond to a known chemical. This should not
frighten clinicians, for it is one of the standard methods in medicine. ..."
(A. Hoffer and H. Osmond, "Double-Blind Clinical Trials," Journal of Neuro-
psychiatry II (1961), p. 222).
60
The symptoms of the sick man are recorded as so many facts.
The similarity between the two is the only variable quantity,
and this is a matter of art: and art is always a variable
quantity." 41 *
61
The next step follows naturally. Giving the patient the
indicated medicine is equivalent to applying the hypo-
thesis that this particular case is cured by the similar
remedy. It is a scientific test of the Law of Similars,
and if the patient recovers, the truth of this doctrine
can be provisionally accepted. Of course, a single recovery
proves nothing in particular. But when the physician has
treated hundreds and thousands of patients and has found
that: 1)most of them recover, 2) recovery is in accordance
with Hering's Law, and 3) the recovered patients remain
healthy and are comparatively free from chronic physical
and mental disease later in life, he is justified in con-
cluding that the Law of Similars is a scientific guide to
medical practice.
Further support for the scientific status of homoeopathy
is found in the realization that its knowledge is stable and
cumulative, as opposed to allopathic medical knowledge
which is unstable and non-cumulative. Carrol Dunham in
62
Spokesmen for allopathic medicine extol this as the
veriest proof that their doctrines are scientific, but one
may rightly wonder if the continued instability of funda-
mental pathological doctrines does not rather reflect a
methodological weakness. One often overlooked conse-
quence is the impossibility of constructing a medical
doctrine which will remain stable over time. Any sta-
tistical analysis based on disease entities is invalidated
when these entities disappear and are replaced by new
ones.
In medicine, as in so many other areas of life, unceasing
change has long been regarded as evidence of progress,
but in the latter part of the twentieth century people have
come to realize that change in and for itself is not an
unalloyed good. The practice of medicine could only
benefit if, instead of meekly accepting every supposedly
world-shaking discovery destined to revolutionize the
healing art, physicians sought the permanent and un-
changing in the phenomena of health and disease.
63
VI. HOMOEOPATHY AND MODERN
MEDICINE
65
cifically prohibited by the AMA's Code of Ethics. 50 In
the early 20th century this inherent prejudice of orthodox
medicine against homoeopathy seemed to be legitimized
by the findings of science. The homoeopathic approach
—
appeared to be outdated superseded by the new activist
orientation offered by bacteriology. For several decades
the principles embodied in the homoeopathic system have
been under a cloud.
Today, however, the pendulum is swinging back. Not
only has modern medicine failed to provide the promised
cures for all of man's ills but it has itself become a
"Loc. cit.
66
of the abuse of drugs in contemporary orthodox practice.
Some patients react instantaneously to improper medica-
tion, but what of the patient whose reaction takes weeks,
months, or perhaps years to manifest itself? The sta-
tisticswill indicate that he was "cured" of his first
67
ship between prior medication and the onset of chronic
disease.
Another aspect of this problem, to which orthodox
medicine is equally inattentive, is the connection between
68
Most biological, physiological, and biochemical research
has been focused so far on the study of the phenomena which
are common to all living things. From the point of view of sci-
entific philosophy, the largest achievement of modern bio-
chemistry has been the demonstration of the fundamental unity
of the chemical processes associated with life. Bacteria, yeasts,
liver cells, pigeon muscle, squid nerve fibers, etc., have been
selected as objects for biological research not because of their
own specific peculiarities but merely for reasons of convenience.
The investigator uses these materials for the discovery of general
biochemical and physiological laws, not for the identification of
components which are peculiar to the organism or the function.
While this so-called fundamental approach has been im-
mensely fruitful for the discovery of the structures and reac-
tions which are common to all forms of life, it has almost com-
pletely failed to provide information concerning the structures
and reactions which determine the peculiarities of each organ
and function. As a result, the search for metabolic inhibitors
has been limited to attempts at interfering with processes ubi-
quitous in all living beings, for the simple reason that these are
the only ones which are known. Powerful metabolic inhibitors
have been synthesized on the basis of this knowledge, but in
56
ln Paul Talalay, ed., Drugs in Our Society, pp. 38-39.
69
Pathological indications are by their very nature too
crude to be the basis for a specific therapy, and as long
as they continue to be used, the incidence of iatrogenic
disease is bound to rise.
70
sician'seconomic interest. The basic reason for allopathic
rejection of homoeopathic principles is that these prin-
ciples hold the physician to a standard of performance
which is intellectually more demanding, and sometimes
less economically rewarding, than the ordinary mode of
allopathic practice.
Wehave already shown that the homoeopathic phy-
sicianmust have an intimate knowledge of many hundreds
of different drugs, only one of which will suit the par-
ticular patient before him. The precise differentiation
among diseased states and among medicines is arduous
and time-consuming work.
intellectual
Homoeopathy has always been plagued by the funda-
mental requirement that the physician devote substantial
time to diagnosis of his patient and selection of the
remedy. No technique has yet been devised for bypassing
symptom elucidation and repertori-
the difficult stages of
zation.Thus homoeopathy could not use the time-saving
procedures developed by orthodox medicine, the "broad-
spectrum" drugs which in many cases obviate the need for
diagnosis, the farming out of certain procedures to
para-medical personnel. Homoeopathy cannot be prac-
tised on an assembly-line.
On
the other hand, all who have had experience with
homoeopathy view it as far more effective therapeutically
than the method used in orthodox medicine. The time-
saving techniques which enhance the physician's income
only too often have a deleterious effect on the patient's
health.
Today's homoeopathic physician is in a dilemma. He
knows that his system of practice is therapeutically sound.
At the same time, he finds that he may have to take a
reduced income if he is really to be an effective phy-
sician. Thus homoeopathy does not appeal to everyone.
It is simply too difficult for the ordinary practitioner,
71
too demanding for all but those who, for whatever reason,
are willing to make a certain material and personal sacri-
fice to practice a truly scientific medicine. One of today's
foremost homoeopathic physicians has stated the problem
succinctly:
57
Dhawale, Principles and Practice of Homoeopathy, Vol. I, pp. 23-24.
72
At the same time, there are many other positive aspects.
The physician knows that his patients are receiving the
best care possible. They will probably be sick less fre-
quently, will recover more rapidly, and will lead longer
lives. Many will realize that this is due to the efforts
73
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book list
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The doctor provides data on the strange
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\ !^BP I
hand experience with homoeopathic
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HOMEOPATHIC