Medical Essays, 1842-1882. Oliver Wendell Holmes

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СКАЧАТЬ Hahnemann, I will mention carbonate of lime. He does not employ common chalk, but prefers a little portion of the friable part of an oystershell. Of this substance, carried to the sextillionth degree, so much as one or two globules of the size mentioned can convey is a common dose. But for persons of very delicate nerves it is proper that the dilution should be carried to the decillionth degree. That is, an important medicinal effect is to be expected from the two hundredth or hundredth part of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of a grain of oyster-shell. This is only the tenth degree of potency, but some of his disciples profess to have obtained palpable effects from “much higher dilutions.”

      The third great doctrine of Hahnemann is the following. Seven eighths at least of all chronic diseases are produced by the existence in the system of that infectious disorder known in the language of science by the appellation of PSORA, but to the less refined portion of the community by the name of ITCH. In the words of Hahnemann's “Organon,” “This Psora is the sole true and fundamental cause that produces all the other countless forms of disease, which, under the names of nervous debility, hysteria, hypochondriasis, insanity, melancholy, idiocy, madness, epilepsy, and spasms of all kinds, softening of the bones, or rickets, scoliosis and cyphosis, caries, cancer, fungua haematodes, gout,—yellow jaundice and cyanosis, dropsy,—”

      [“The degrees of DILUTION must not be confounded with those of POTENCY. Their relations may be seen by this table:

      lst dilution,—One hundredth of a drop or grain.

      2d “ One ten thousandth.

      3d “ One millionth, marked I.

      4th “ One hundred millionth.

      5th “ One ten thousand millionth.

      6th “ One million millionth, or one billionth, marked II.

      7th “ One hundred billionth.

      8th “ One ten thousand billionth.

      9th “ One million billionth, or one trillionth, marked III.

      10th “ One hundred trillionth.

      11th “ One ten thousand trillionth.

      12th “ One million trillionth, or one quadrillionth, marked

       IV.,—and so on indefinitely.

      The large figures denote the degrees of POTENCY.]

      “gastralgia, epistaxis, haemoptysis,—asthma and suppuration of the lungs,—megrim, deafness, cataract and amaurosis,—paralysis, loss of sense, pains of every kind, etc., appear in our pathology as so many peculiar, distinct, and independent diseases.”

      For the last three centuries, if the same authority may be trusted, under the influence of the more refined personal habits which have prevailed, and the application of various external remedies which repel the affection from the skin; Psora has revealed itself in these numerous forms of internal disease, instead of appearing, as in former periods, under the aspect of an external malady.

      These are the three cardinal doctrines of Hahnemann, as laid down in those standard works of Homoeopathy, the “Organon” and the “Treatise on Chronic Diseases.”

      Several other principles may be added, upon all of which he insists with 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.

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