“Why doctor you dont think my case is chronic do you?” Casually, perhaps thoughtlessly, we let slip the fatal word and it has struck deep, carrying terror and a feeling of utter hopelessness to the very centers of conscious existence. Doubtless we have all had this experience; we have spoken the word, have seen the look, have heard the question and have tried to comfort as best we could. Can one doubt the power of the spoken word?.
Chronos means time, but chronic means incurability as far as the average patient is concerned, and it must be admitted that the medical fraternity in defining chronic disease includes, as part of the definition, the same idea of incurability and fatal outcome.
What does chronic mean to us as Hahnemannians? Does it mean a long case?–it means that to the “successful” physician of whatever school or system of therapy. Does it mean incurability?–if it does there is something radically wrong and we have been boasting of powers we are either failing to use or do not possess.
Let us pin down this word incurability in the hope that it may no longer, inevitably like a shadow, or a nemesis, dog the footsteps of our chronic patients.
It has been pretty definitely determined that all chronic diseases of whatever nature begin on the functional plane and gradually progress toward altered structure and organic change. Properly handled no case should be considered incurable so long as the disease manifestations are chiefly those of functional disturbance.
Does the death of the patient prove that his case was incurable? Not necessarily by any means. Was the real similimum given in proper potency and repeated, or the potency changed at the proper time? Were all the obstacles to cure removed? Was the diet intelligently managed? Did the patient really co-operate with his physician? Did the environment and routine of life receive due consideration?.
Unless all these questions can be honestly answered in the affirmative we have no right to call the case incurable.
In section four of the Organon Hahnemann says: “He (the physician) is at the same time a preserver of health when he knows the causes that disturb health, that produce and maintain disease and when he knows how to remove them from healthy persons.”.
This lead us to consider in general and very broadly the cause of chronic disease. For this consideration we must not allow ourselves to worry too much about the three chronic miasms of Hahnemann or the transcendental speculations of modern medical science.
The causes of chronic disease are:.
1. The inherent, individual constitutional bias and susceptibility. This may or may not follow the general family trend. It is highly probable that this “constitutional bias”– call it psora if you wish–determines in large measure the type, direction and ultimate localization of chronic disease.
Every human being is born with certain mental tendencies and with corresponding and correlated physical tendencies. There are in everyone some inherent defects in character, mind and body. Balanced, more or less, against these are certain strong points of character, mind and body.
The homoeopathic physician would be the last to call in question the correlation and reciprocity of reaction between the spiritual, mental and physical planes of life.
2. The environment. This is to be considered in its broadest sense–namely, the totality of all the conditions of existence,.
Philosophers have taught that back of will stands desire. Accepting this statement as axiomatic we are forced to conclude that in so far as possible man will harmonize his environment– consciously, but more often unconsciously–with his inherent constitutional bent or tendencies. Almost automatically his environment will, as the years go by, tend to gradually increase and augment the original bias. Chronic disease, therefore, has its roots in the very core or essence of existence. It is a part and parcel of the defects and faults in mans own nature. The environment merely furnishes the conditions and culture necessary to work those defects out to their ultimate manifestations. Intelligent intervention on the part of the physician is absolutely necessary in order to stop or retard the progress of chronic disease.
In order to intelligently intervene the physician must know the essential generals in respect to the patients environment and routine of life. He must comprehend in some measure the loves and hates, the unsatisfied longings, the griefs and disappointments, the shame and remorse, the fears and forebodings, the jealousy, the avarice, the ambition, the lust for name, fame and fortune. Clearly perceive the dominant qualities, perversions of the mind and heart, and the relation existing between the patient and his environment, and his chronic sufferings will be made plain and understandable. Moreover the similimum for the case in hand must, in the provings, have shown essentially similar mental and moral characteristics.
The remedy must fit the mind, the internal man. Recovery must be from within out, from mind to body, from cause to effect and not from effect to cause. “That physician is also the preserver of health and the promoter of happiness” who not only gives the similimum but who also counsels his patients to think less of themselves and more of others, to be less introspective and more altruistic. By careful suggestion and correction of the attitude of mind some of the serious obstacles to recovery can be removed.
Coming now to the more external or physical elements of environment we must consider the matter of intake–food, drink, drugs, anything and everything taken into or consumed by the body, including even the very air the patient breathes.
The intake is apt to be more or less habitual and, therefore, directional. We have only too often to contend with the alcoholic habit, various drug habits, the candy habit, the soft drink habit, the tea, coffee, pastry and tobacco habits– perversions of appetite, wrong food combinations, over-eating, over-seasoning, vitamin deficiencies, radical reducing diets, over-indulgence in canned, bottled and preserved foods, delicatessen products, manipulated, processed, adulterated and medicated foods. Less time in the kitchen and more than time at the club, the card parties and the movies. The modern tempo is a fast one but everything has its price. The relation of diet to chronic disease cannot be ignored.
The physician who fails to correct and simplify the diet in harmony with good, common sense is unintentionally leaving serious obstacles to recovery unremoved and to that extent he is falling short of “the physicians highest and only calling (which) is to restore health to the sick”.
The intake of laxatives, tonics, sedatives, serums, vaccines, antitoxins, external medicaments, antiseptic douches, cold tablets, headaches remedies, nostrums, poisons of all kinds and description must be absolutely and finally discontinued. There can be no temporizing in the handling of the chronic case. Patients exposed by occupation or otherwise to noxious or deleterious gases may require the removal of these obstacles before the remedy can do really curative work.
Next we will briefly consider the question of elimination of waste from the body.
Retention is a word that fits many a chronic case–a damming up process that may have been going on for years. Too much going in, not enough going out. A chronic toxic state is the inevitable result.
Normally the elimination of waste is accomplished through the kidney, the bowel, the skin, the expired air and to a greater or less extent through all the mucous membranes, especially those of the nose and throat. Abnormally or pathologically other means of elimination are devised by nature–eruptions, fistulas, sores and discharges of all kinds. The excretory organs function on a selective basis and only to a partial and limited extent is one able to do the work of another. Stimulation of the excretory mechanism is often but temporary and palliative in effect. Moreover, in many cases artificially increased elimination through certain of these organs is more than offset by reactive suppression through other channels and this to the detriment of the patient.
The relation between intake and output is direct and obvious,, yet many physicians pay scant if any attention to the matter. Others concentrate on laxatives, purgatives, bowel lubricants, enemas, irrigations and whatnot, meanwhile permitting their patients unrestricted license in the management or mismanagement of their diet and habits of eating.
The next factor in environment is the daily routine–the more or less habitual schedule followed and only occasionally interrupted day after day, year in and year out. No matter how large a variety there is in ones daily life, it is more or less the same old grind after all, until finally a rut or groove is formed–in other words it becomes habitual, and therefore, directional in respect to chronic disease.
For how many is breakfast a quiet, restful meal? How many find time for a little repose of mind and body other than perhaps occasionally on Sunday? How many take any worthwhile exercise in the open air or enjoy the priceless benefits of the great outdoors and the free and glorious sunshine? How many retire at a reasonable hour and get really sufficient sleep?.
Eugene passed away at his country home on Spring Hill, Tuscarora Township, Bradford County, PA. He had been in ill health for several months. His wife, the former Caroline Davis, whom he had married in Philadelphia in 1910, had passed away in 1961. They spent most of their marriage lives in Swarthmore, PA.
Dr. Underhill was a member of the United Lodge of Theosophy, a member of the Philadelphia County Medical Society, and the Pennsylvania Medical Society. He was also the editor of the Homœopathic Recorder.