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Medical Essays, 1842-1882 · Oliver Wendell Holmes — chapter 8 of 44 · ~2,474 words · public domain

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Yet this is given only at the quadrillionth, or fourth degree of potency, and various substances are frequently administered at the decillionth or tenth degree, and occasionally at still higher attenuations with professed medicinal results. Is there not in this as great an exception to all the hitherto received laws of nature as in the miracle of the loaves and fishes? Ask this question of a Homoeopathist, and he will answer by referring to the effects produced by a very minute portion of vaccine matter, or the extraordinary diffusion of odors. But the vaccine matter is one of those substances called morbid poisons, of which it is a peculiar character to multiply themselves, when introduced into the system, as a seed does in the soil. Therefore the hundredth part of a grain of the vaccine matter, if no more than this is employed, soon increases in quantity, until, in the course of about a week, it is a grain or more, and can be removed in considerable drops. And what is a very curious illustration of Homoeopathy, it does not produce its most characteristic effects until it is already in sufficient quantity not merely to be visible, but to be collected for further use. The thoughtlessness which can allow an inference to be extended from a product of disease possessing this susceptibility of multiplication when conveyed into the living body, to substances of inorganic origin, such as silex or sulphur, would be capable of arguing that a pebble may produce a mountain, because an acorn can become a forest.

As to the analogy to be found between the alleged action of the infinitely attenuated doses, and the effects of some odorous substances which possess the extraordinary power of diffusing their imponderable emanations through a very wide space, however it may be abused in argument, and rapidly as it evaporates on examination, it is not like that just mentioned, wholly without meaning. The fact of the vast diffusion of some odors, as that of musk or the rose, for instance, has long been cited as the most remarkable illustration of the divisibility of matter, and the nicety of the senses. And if this were compared with the effects of a very minute dose of morphia on the whole system, or the sudden and fatal impression of a single drop of prussic acid, or, with what comes still nearer, the poisonous influence of an atmosphere impregnated with invisible malaria, we should find in each of these examples an evidence of the degree to which nature, in some few instances, concentrates powerful qualities in minute or subtile forms of matter. But if a man comes to me with a pestle and mortar in his hand, and tells me that he will take a little speck of some substance which nobody ever thought to have any smell at all, as, for instance, a grain of chalk or of charcoal, and that he will, after an hour or two of rubbing and scraping, develop in a portion of it an odor which, if the whole grain were used, would be capable of pervading an apartment, a house, a village, a province, an empire, nay, the entire atmosphere of this broad planet upon which we tread; and that from each of fifty or sixty substances he can in this way develop a distinct and hitherto unknown odor: and if he tries to show that all this is rendered quite reasonable by the analogy of musk and roses, I shall certainly be justified in considering him incapable of reasoning, and beyond the reach of my argument. What if, instead of this, he professes to develop new and wonderful medicinal powers from the same speck of chalk or charcoal, in such proportions as would impregnate every pond, lake, river, sea, and ocean of our globe, and appeals to the same analogy in favor of the probability of his assertion.

All this may be true, notwithstanding these considerations. But so extraordinary would be the fact, that a single atom of substances which a child might swallow without harm by the teaspoonful could, by an easy mechanical process, be made to develop such inconceivable powers, that nothing but the strictest agreement of the most cautious experimenters, secured by every guaranty that they were honest and faithful, appealing to repeated experiments in public, with every precaution to guard against error, and with the most plain and peremptory results, should induce us to lend any credence to such pretensions.

The third doctrine, that Psora, the other name of which you remember, is the cause of the great majority of chronic diseases, is a startling one, to say the least. That an affection always recognized as a very unpleasant personal companion, but generally regarded as a mere temporary incommodity, readily yielding to treatment in those unfortunate enough to suffer from it, and hardly known among the better classes of society, should be all at once found out by a German physician to be the great scourge of mankind, the cause of their severest bodily and mental calamities, cancer and consumption, idiocy and madness, must excite our unqualified surprise. And when the originator of this singular truth ascribes, as in the page now open before me, the declining health of a disgraced courtier, the chronic malady of a bereaved mother, even the melancholy of the love-sick and slighted maiden, to nothing more nor less than the insignificant, unseemly, and almost unmentionable ITCH, does it not seem as if the very soil upon which we stand were dissolving into chaos, over the earthquake-heaving of discovery?

And when one man claims to have established these three independent truths, which are about as remote from each other as the discovery of the law of gravitation, the invention of printing, and that of the mariner's compass, unless the facts in their favor are overwhelming and unanimous, the question naturally arises, Is not this man deceiving himself, or trying to deceive others?

I proceed to examine the proofs of the leading ideas of Hahnemann and his school.

In order to show the axiom, similia similibus curantur (or like is cured by like), to be the basis of the healing art,--“the sole law of nature in therapeutics,”--it is necessary,

1. That the symptoms produced by drugs in healthy persons should be faithfully studied and recorded.

2. That drugs should be shown to be always capable of curing those diseases most like their own symptoms.

3. That remedies should be shown not to cure diseases when they do not produce symptoms resembling those presented in these diseases.

1. The effects of drugs upon healthy persons have been studied by Hahnemann and his associates. Their results were made known in his Materia Medica, a work in three large volumes in the French translation, published about eight years ago. The mode of experimentation appears to have been, to take the substance on trial, either in common or minute doses, and then to set down every little sensation, every little movement of mind or body, which occurred within many succeeding hours or days, as being produced solely by the substance employed. When I have enumerated some of the symptoms attributed to the power of the drugs taken, you will be able to judge how much value is to be ascribed to the assertions of such observers.

The following list was taken literally from the Materia Medica of Hahnemann, by my friend M. Vernois, for whose accuracy I am willing to be responsible. He has given seven pages of these symptoms, not selected, but taken at hazard from the French translation of the work. I shall be very brief in my citations.

“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.” The medicine was acetate of lime, and as the action of the globule taken is said to last twenty-eight days, you may judge how many such symptoms as the last might be supposed to happen.

Among the symptoms attributed to muriatic acid are these: a catarrh, sighing, pimples; “after having written a long time with the back a little bent over, violent pain in the back and shoulder-blades, as if from a strain,”--“dreams which are not remembered,--disposition to mental dejection,--wakefulness before and after midnight.”

I might extend this catalogue almost indefinitely. I have not cited these specimens with any view to exciting a sense of the ridiculous, which many others of those mentioned would not fail to do, but to show that the common accidents of sensation, the little bodily inconveniences to which all of us are subject, are seriously and systematically ascribed to whatever medicine may have been exhibited, even in the minute doses I have mentioned, whole days or weeks previously.

To these are added all the symptoms ever said by anybody, whether deserving confidence or not, as I shall hereafter illustrate, to be produced by the substance in question.

The effects of sixty-four medicinal substances, ascertained by one or both of these methods, are enumerated in the Materia Medica of Hahnemann, which may be considered as the basis of practical Homoeopathy. In the Manual of Jahr, which is the common guide, so far as I know, of those who practise Homoeopathy in these regions, two hundred remedies are enumerated, many of which, however, have never been employed in practice. In at least one edition there were no means of distinguishing those which had been tried upon the sick from the others. It is true that marks have been added in the edition employed here, which serve to distinguish them; but what are we to think of a standard practical author on Materia Medica, who at one time omits to designate the proper doses of his remedies, and at another to let us have any means of knowing whether a remedy has ever been tried or not, while he is recommending its employment in the most critical and threatening diseases?

I think that, from what I have shown of the character of Hahnemann's experiments, it would be a satisfaction to any candid inquirer to know whether other persons, to whose assertions he could look with confidence, confirm these pretended facts. Now there are many individuals, long and well known to the scientific world, who have tried these experiments upon healthy subjects, and utterly deny that their effects have at all corresponded to Hahnemann's assertions.

I will take, for instance, the statements of Andral (and I am not referring to his well-known public experiments in his hospital) as to the result of his own trials. This distinguished physician is Professor of Medicine in the School of Paris, and one of the most widely known and valued authors upon practical and theoretical subjects the profession can claim in any country. He is a man of great kindness of character, a most liberal eclectic by nature and habit, of unquestioned integrity, and is called, in the leading article of the first number of the “Homoepathic Examiner,” “an eminent and very enlightened allopathist.” Assisted by a number of other persons in good health, he experimented on the effects of cinchona, aconite, sulphur, arnica, and the other most highly extolled remedies. His experiments lasted a year, and he stated publicly to the Academy of Medicine that they never produced the slightest appearance of the symptoms attributed to them. The results of a man like this, so extensively known as one of the most philosophical and candid, as well as brilliant of instructors, and whose admirable abilities and signal liberality are generally conceded, ought to be of great weight in deciding the question.

M. Double, a well-known medical writer and a physician of high standing in Paris, had occasion so long ago as 1801, before he had heard of Homoeopathy, to make experiments upon Cinchona, or Peruvian bark. He and several others took the drug in every kind of dose for four months, and the fever it is pretended by Hahnemann to excite never was produced.

M. Bonnet, President of the Royal Society of Medicine of Bordeaux, had occasion to observe many soldiers during the Peninsular War, who made use of Cinchona as a preservative against different diseases, but he never found it to produce the pretended paroxysms.

If any objection were made to evidence of this kind, I would refer to the express experiments on many of the Homoeopathic substances, which were given to healthy persons with every precaution as to diet and regimen, by M. Louis Fleury, without being followed by the slightest of the pretended consequences. And let me mention as a curious fact, that the same quantity of arsenic given to one animal in the common form of the unprepared powder, and to another after having been rubbed up into six hundred globules, offered no particular difference of activity in the two cases.

This is a strange contradiction to the doctrine of the development of what they call dynamic power, by means of friction and subdivision.

In 1835 a public challenge was offered to the best known Homoeopathic physician in Paris to select any ten substances asserted to produce the most striking effects; to prepare them himself; to choose one by lot without knowing which of them he had taken, and try it upon himself or any intelligent and devoted Homoeopathist, and, waiting his own time, to come forward and tell what substance had been employed. The challenge was at first accepted, but the acceptance retracted before the time of trial arrived.

From all this I think it fair to conclude that the catalogues of symptoms attributed in Homoeopathic works to the influence of various drugs upon healthy persons are not entitled to any confidence.

2. It is necessary to show, in the next place, that medicinal substances are always capable of curing diseases most like their own symptoms. For facts relating to this question we must look to two sources; the recorded experience of the medical profession in general, and the results of trials made according to Homoeopathic principles, and capable of testing the truth of the doctrine.

No person, that I am aware of, has ever denied that in some cases there exists a resemblance between the effects of a remedy and the symptoms of diseases in which it is beneficial. This has been recognized, as Hahnemann himself has shown, from the time of Hippocrates. But according to the records of the medical profession, as they have been hitherto interpreted, this is true of only a very small proportion of useful remedies. Nor has it ever been considered as an established truth that the efficacy of even these few remedies was in any definite ratio to their power of producing symptoms more or less like those they cured.

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