Part 9

Such was the state of opinion when Hahnemann came forward with the proposition that all the cases of successful treatment found in the works of all preceding medical writers were to be ascribed solely to the operation of the Homoeopathic principle, which had effected the cure, although without the physician's knowledge that this was the real secret. And strange as it may seem, he was enabled to give such a degree of plausibility to this assertion, that any person not acquainted somewhat with medical literature, not quite familiar, I should rather say, with the relative value of medical evidence, according to the sources whence it is derived, would be almost frightened into the belief, at seeing the pages upon pages of Latin names he has summoned as his witnesses.

It has hitherto been customary, when examining the writings of authors of preceding ages, upon subjects as to which they were less enlightened than ourselves, and which they were very liable to misrepresent, to exercise some little discretion; to discriminate, in some measure, between writers deserving confidence and those not entitled to it. But there is not the least appearance of any such delicacy on the part of Hahnemann. A large majority of the names of old authors he cites are wholly unknown to science. With some of them I have been long acquainted, and I know that their accounts of diseases are no more to be trusted than their contemporary Ambroise Pare's stories of mermen, and similar absurdities. But if my judgment is rejected, as being a prejudiced one, I can refer to Cullen, who mentioned three of Hahnemann's authors in one sentence, as being “not necessarily bad authorities; but certainly such when they delivered very improbable events;” and as this was said more than half a century ago, it could not have had any reference to Hahnemann. But although not the slightest sign of discrimination is visible in his quotations,--although for him a handful of chaff from Schenck is all the same thing as a measure of wheat from Morgagni,--there is a formidable display of authorities, and an abundant proof of ingenious researches to be found in each of the great works of Hahnemann with which I am familiar. [Some painful surmises might arise as to the erudition of Hahnemann's English Translator, who makes two individuals of “Zacutus, Lucitanus,” as well as respecting that of the conductors of an American Homoeopathic periodical, who suffer the name of the world-renowned Cardanus to be spelt Cardamus in at least three places, were not this gross ignorance of course attributable only to the printer.]

It is stated by Dr. Leo-Wolf, that Professor Joerg, of Leipsic, has proved many of Hahnemann's quotations from old authors to be adulterate and false. What particular instances he has pointed out I have no means of learning. And it is probably wholly impossible on this side of the Atlantic, and even in most of the public libraries of Europe, to find anything more than a small fraction of the innumerable obscure publications which the neglect of grocers and trunkmakers has spared to be ransacked by the all-devouring genius of Homoeopathy. I have endeavored to verify such passages as my own library afforded me the means of doing. For some I have looked in vain, for want, as I am willing to believe, of more exact references. But this I am able to affirm, that, out of the very small number which I have been able, to trace back to their original authors, I have found two to be wrongly quoted, one of them being a gross misrepresentation.

The first is from the ancient Roman author, Caelius Aurelianus; the second from the venerable folio of Forestus. Hahnemann uses the following expressions,--if he is not misrepresented in the English Translation of the 'Organon': “Asclepiades on one occasion cured an inflammation of the brain by administering a small quantity of wine.” After correcting the erroneous reference of the Translator, I can find no such case alluded to in the chapter. But Caelius Aurelianus mentions two modes of treatment employed by Asclepiades, into both of which the use of wine entered, as being “in the highest degree irrational and dangerous.” [Caelius Aurel. De Morb. Acut. et Chron. lib. I. cap. xv. not xvi. Amsterdam. Wetstein, 1755.]

In speaking of the oil of anise-seed, Hahnemann says that Forestus observed violent colic caused by its administration. But, as the author tells the story, a young man took, by the counsel of a surgeon, an acrid and virulent medicine, the name of which is not given, which brought on a most cruel fit of the gripes and colic. After this another surgeon was called, who gave him oil of anise-seed and wine, “which increased his suffering.” [Observ. et Curat. Med. lib. XXI obs. xiii. Frankfort, 1614.] Now if this was the Homoeopathic remedy, as Hahnemann pretends, it might be a fair question why the young man was not cured by it. But it is a much graver question why a man who has shrewdness and learning enough to go so far after his facts, should think it right to treat them with such astonishing negligence or such artful unfairness.

Even if every word he had pretended to take from his old authorities were to be found in them, even if the authority of every one of these authors were beyond question, the looseness with which they are used to prove whatever Hahnemann chooses is beyond the bounds of credibility. Let me give one instance to illustrate the character of this man's mind. Hahnemann asserts, in a note annexed to the 110th paragraph of the “Organon,” that the smell of the rose will cause certain persons to faint. And he says in the text that substances which produce peculiar effects of this nature on particular constitutions cure the same symptoms in people in general. Then in another note to the same paragraph he quotes the following fact from one of the last sources one would have looked to for medical information, the Byzantine Historians.

“It was by these means (i.e. Homoeopathically) that the Princess Eudosia with rose-water restored a person who had fainted!”

Is it possible that a man who is guilty of such pedantic folly as this,--a man who can see a confirmation of his doctrine in such a recovery as this,--a recovery which is happening every day, from a breath of air, a drop or two of water, untying a bonnet-string, loosening a stay-lace, and which can hardly help happening, whatever is done,--is it possible that a man, of whose pages, not here and there one, but hundreds upon hundreds are loaded with such trivialities, is the Newton, the Columbus, the Harvey of the nineteenth century!

The whole process of demonstration he employs is this. An experiment is instituted with some drug upon one or more healthy persons. Everything that happens for a number of days or weeks is, as we have seen, set down as an effect of the medicine. Old volumes are then ransacked promiscuously, and every morbid sensation or change that anybody ever said was produced by the drug in question is added to the list of symptoms. By one or both of these methods, each of the sixty-four substances enumerated by Hahnemann is shown to produce a very large number of symptoms, the lowest in his scale being ninety-seven, and the highest fourteen hundred and ninety-one. And having made out this list respecting any drug, a catalogue which, as you may observe in any Homoeopathic manual, contains various symptoms belonging to every organ of the body, what can be easier than to find alleged cures in every medical author which can at once be attributed to the Homoeopathic principle; still more if the grave of extinguished credulity is called upon to give up its dead bones as living witnesses; and worst of all, if the monuments of the past are to be mutilated in favor of “the sole law of Nature in therapeutics”?

There are a few familiar facts of which great use has been made as an entering wedge for the Homoeopathic doctrine. They have been suffered to pass current so long that it is time they should be nailed to the counter, a little operation which I undertake, with perfect cheerfulness, to perform for them.

The first is a supposed illustration of the Homoeopathic law found in the precept given for the treatment of parts which have been frozen, by friction with snow or similar means. But we deceive ourselves by names, if we suppose the frozen part to be treated by cold, and not by heat. The snow may even be actually warmer than the part to which it is applied. But even if it were at the same temperature when applied, it never did and never could do the least good to a frozen part, except as a mode of regulating the application of what? of heat. But the heat must be applied gradually, just as food must be given a little at a time to those perishing with hunger. If the patient were brought into a warm room, heat would be applied very rapidly, were not something interposed to prevent this, and allow its gradual admission. Snow or iced water is exactly what is wanted; it is not cold to the part; it is very possibly warm, on the contrary, for these terms are relative, and if it does not melt and let the heat in, or is not taken away, the part will remain frozen up until doomsday. Now the treatment of a frozen limb by heat, in large or small quantities, is not Homoeopathy.

The next supposed illustration of the Homoeopathic law is the alleged successful management of burns, by holding them to the fire. This is a popular mode of treating those burns which are of too little consequence to require any more efficacious remedy, and would inevitably get well of themselves, without any trouble being bestowed upon them. It produces a most acute pain in the part, which is followed by some loss of sensibility, as happens with the eye after exposure to strong light, and the ear after being subjected to very intense sounds. This is all it is capable of doing, and all further notions of its efficacy must be attributed merely to the vulgar love of paradox. If this example affords any comfort to the Homoeopathist, it seems as cruel to deprive him of it as it would be to convince the mistress of the smoke-jack or the flatiron that the fire does not literally “draw the fire out,” which is her hypothesis.

But if it were true that frost-bites were cured by cold and burns by heat, it would be subversive, so far as it went, of the great principle of Homoeopathy.

For you will remember that this principle is that Like cures Like, and not that Same cures Same; that there is resemblance and not identity between the symptoms of the disease and those produced by the drug which cures it, and none have been readier to insist upon this distinction than the Homoeopathists themselves. For if Same cures Same, then every poison must be its own antidote,--which is neither a part of their theory nor their so-called experience. They have been asked often enough, why it was that arsenic could not cure the mischief which arsenic had caused, and why the infectious cause of small-pox did not remedy the disease it had produced, and then they were ready enough to see the distinction I have pointed out. O no! it was not the hair of the same dog, but only of one very much like him!

A third instance in proof of the Homoeopathic law is sought for in the acknowledged efficacy of vaccination. And how does the law apply to this? It is granted by the advocates of Homoeopathy that there is a resemblance between the effects of the vaccine virus on a person in health and the symptoms of small-pox. Therefore, according to the rule, the vaccine virus will cure the small-pox, which, as everybody knows, is entirely untrue. But it prevents small-pox, say the Homoeopathists. Yes, and so does small-pox prevent itself from ever happening again, and we know just as much of the principle involved in the one case as in the other. For this is only one of a series of facts which we are wholly unable to explain. Small-pox, measles, scarlet-fever, hooping-cough, protect those who have them once from future attacks; but nettle-rash and catarrh and lung fever, each of which is just as Homoeopathic to itself as any one of the others, have no such preservative power. We are obliged to accept the fact, unexplained, and we can do no more for vaccination than for the rest.

I come now to the most directly practical point connected with the subject, namely,--

What is the state of the evidence as to the efficacy of the proper Homoeopathic treatment in the cure of diseases.

As the treatment adopted by the Homoeopathists has been almost universally by means of the infinitesimal doses, the question of their efficacy is thrown open, in common with that of the truth of their fundamental axiom, as both are tested in practice.

We must look for facts as to the actual working of Homoeopathy to three sources.

1. The statements of the unprofessional public.

2. The assertions of Homoeopathic practitioners.

3. The results of trials by competent and honest physicians, not pledged to the system.

I think, after what we have seen of medical facts, as they are represented by incompetent persons, we are disposed to attribute little value to all statements of wonderful cures, coming from those who have never been accustomed to watch the caprices of disease, and have not cooled down their young enthusiasm by the habit of tranquil observation. Those who know nothing of the natural progress of a malady, of its ordinary duration, of its various modes of terminating, of its liability to accidental complications, of the signs which mark its insignificance or severity, of what is to be expected of it when left to itself, of how much or how little is to be anticipated from remedies, those who know nothing or next to nothing of all these things, and who are in a great state of excitement from benevolence, sympathy, or zeal for a new medical discovery, can hardly be expected to be sound judges of facts which have misled so many sagacious men, who have spent their lives in the daily study and observation of them. I believe that, after having drawn the portrait of defunct Perkinism, with its five thousand printed cures, and its million and a half computed ones, its miracles blazoned about through America, Denmark, and England; after relating that forty years ago women carried the Tractors about in their pockets, and workmen could not make them fast enough for the public demand; and then showing you, as a curiosity, a single one of these instruments, an odd one of a pair, which I obtained only by a lucky accident, so utterly lost is the memory of all their wonderful achievements; I believe, after all this, I need not waste time in showing that medical accuracy is not to be looked for in the florid reports of benevolent associations, the assertions of illustrious patrons, the lax effusions of daily journals, or the effervescent gossip of the tea-table.

Dr. Hering, whose name is somewhat familiar to the champions of Homoeopathy, has said that “the new healing art is not to be judged by its success in isolated cases only, but according to its success in general, its innate truth, and the incontrovertible nature of its innate principles.”

We have seen something of “the incontrovertible nature of its innate principles,” and it seems probable, on the whole, that its success in general must be made up of its success in isolated cases. Some attempts have been made, however, to finish the whole matter by sweeping statistical documents, which are intended to prove its triumphant success over the common practice.

It is well known to those who have had the good fortune to see the “Homoeopathic Examiner,” that this journal led off, in its first number, with a grand display of everything the newly imported doctrine had to show for itself. It is well remarked, on the twenty-third page of this article, that “the comparison of bills of mortality among an equal number of sick, treated by divers methods, is a most poor and lame way to get at conclusions touching principles of the healing art.” In confirmation of which, the author proceeds upon the twenty-fifth page to prove the superiority of the Homoeopathic treatment of cholera, by precisely these very bills of mortality. Now, every intelligent physician is aware that the poison of cholera differed so much in its activity at different times and, places, that it was next to impossible to form any opinion as to the results of treatment, unless every precaution was taken to secure the most perfectly corresponding conditions in the patients treated, and hardly even then. Of course, then, a Russian Admiral, by the name of Mordvinov, backed by a number of so-called physicians practising in Russian villages, is singularly competent to the task of settling the whole question of the utility of this or that kind of treatment; to prove that, if not more than eight and a half per cent. of those attacked with the disease perished, the rest owed their immunity to Hahnemann. I can remember when more than a hundred patients in a public institution were attacked with what, I doubt not, many Homoeopathic physicians (to say nothing of Homoeopathic admirals) would have called cholera, and not one of them died, though treated in the common way, and it is my firm belief that, if such a result had followed the administration of the omnipotent globules, it would have been in the mouth of every adept in Europe, from Quin of London to Spohr of Gandersheim. No longer ago than yesterday, in one of the most widely circulated papers of this city, there was published an assertion that the mortality in several Homoeopathic Hospitals was not quite five in a hundred, whereas, in what are called by the writer Allopathic Hospitals, it is said to be eleven in a hundred. An honest man should be ashamed of such an argumentum ad ignorantiam. The mortality of a hospital depends not merely on the treatment of the patients, but on the class of diseases it is in the habit of receiving, on the place where it is, on the season, and many other circumstances. For instance, there are many hospitals in the great cities of Europe that receive few diseases of a nature to endanger life, and, on the other hand, there are others where dangerous diseases are accumulated out of the common proportion. Thus, in the wards of Louis, at the Hospital of La Pitie, a vast number of patients in the last stages of consumption were constantly entering, to swell the mortality of that hospital. It was because he was known to pay particular attention to the diseases of the chest that patients laboring under those fatal affections to an incurable extent were so constantly coming in upon him. It is always a miserable appeal to the thoughtlessness of the vulgar, to allege the naked fact of the less comparative mortality in the practice of one hospital or of one physician than another, as an evidence of the superiority of their treatment. Other things being equal, it must always be expected that those institutions and individuals enjoying to the highest degree the confidence of the community will lose the largest proportion of their patients; for the simple reason that they will naturally be looked to by those suffering from the gravest class of diseases; that many, who know that they are affected with mortal disease, will choose to die under their care or shelter, while the subjects of trifling maladies, and merely troublesome symptoms, amuse themselves to any extent among the fancy practitioners. When, therefore, Dr. Mublenbein, as stated in the “Homoeopathic Examiner,” and quoted in yesterday's “Daily Advertiser,” asserts that the mortality among his patients is only one per cent. since he has practised Homoeopathy, whereas it was six per cent. when he employed the common mode of practice, I am convinced by this, his own statement, that the citizens of Brunswick, whenever they are seriously sick, take good care not to send for Dr. Muhlenbein!

It is evidently impossible that I should attempt, within the compass of a single lecture, any detailed examination of the very numerous cases reported in the Homoeopathic Treatises and Journals. Having been in the habit of receiving the French “Archives of Homoeopathic Medicine” until the premature decease of that Journal, I have had the opportunity of becoming acquainted somewhat with the style of these documents, and experiencing whatever degree of conviction they were calculated to produce. Although of course I do not wish any value to be assumed for my opinion, such as it is, I consider that you are entitled to hear it. So far, then, as I am acquainted with the general character of the cases reported by the Homoeopathic physicians, they would for the most part be considered as wholly undeserving a place in any English, French, or American periodical of high standing, if, instead of favoring the doctrine they were intended to support, they were brought forward to prove the efficacy of any common remedy administered by any common practitioner. There are occasional exceptions to this remark; but the general truth of it is rendered probable by the fact that these cases are always, or almost always, written with the single object of showing the efficacy of the medicine used, or the skill of the practitioner, and it is recognized as a general rule that such cases deserve very little confidence. Yet they may sound well enough, one at a time, to those who are not fully aware of the fallacies of medical evidence. Let me state a case in illustration. Nobody doubts that some patients recover under every form of practice. Probably all are willing to allow that a large majority, for instance, ninety in a hundred, of such cases as a physician is called to in daily practice, would recover, sooner or later, with more or less difficulty, provided nothing were done to interfere seriously with the efforts of nature.

Suppose, then, a physician who has a hundred patients prescribes to each of them pills made of some entirely inert substance, as starch, for instance. Ninety of them get well, or if he chooses to use such language, he cures ninety of them. It is evident, according to the doctrine of chances, that there must be a considerable number of coincidences between the relief of the patient and the administration of the remedy. It is altogether probable that there will happen two or three very striking coincidences out of the whole ninety cases, in which it would seem evident that the medicine produced the relief, though it had, as we assumed, nothing to do with it. Now suppose that the physician publishes these cases, will they not have a plausible appearance of proving that which, as we granted at the outset, was entirely false? Suppose that instead of pills of starch he employs microscopic sugarplums, with the five' million billion trillionth part of a suspicion of aconite or pulsatilla, and then publishes his successful cases, through the leaden lips of the press, or the living ones of his female acquaintances,--does that make the impression a less erroneous one? But so it is that in Homoeopathic works and journals and gossip one can never, or next to never, find anything but successful cases, which might do very well as a proof of superior skill, did it not prove as much for the swindling advertisers whose certificates disgrace so many of our newspapers. How long will it take mankind to learn that while they listen to “the speaking hundreds and units,” who make the world ring with the pretended triumphs they have witnessed, the “dumb millions” of deluded and injured victims are paying the daily forfeit of their misplaced confidence!