III.
GENERAL THERAPEUTICS.
[Continued from page 243] I come, now, to speak of the second grand division of the therapeutic field, where an appeal is made to the vital energies by means of pathogenetic forces.
I might, by numerous quotations like those already made from the writings of Hahnemann and Paine show that the advocates of all active treatment, which is not specially governed by chemical, mechanical, antiparasitic or hygienic principles, agree as to the necessary institution of an artificial pathological condition, which shall lead to the extinction of that already existing.
The pathogenetic action has been variously stated and explained by different writers, some calling it dyamic, or spiritual, and others vital, physiological, etc. Some writers1. (William R.Dundham., M.D., Theory of Medical Science, 1876.) have maintained that there is no such thing as medicinal force and medicinal action; that drugs have medicinal properties only; that while they may be the cause of certain symptomatic displays, they are yet devoid of inherent power.
They forget that all forces which we may employ, are but attributes or properties of matter, so far as our discernment goes, and that we can obtain no knowledge of them, whatever, while they are disembodied, or when simply potential. When they become actual by the presence of something to act upon, and when their immediate environment is favorable, we come to a knowledge of their presence and are able to study them qualitatively and quantitatively in the phenomena of their action.
Whatever the theory or philosophy entertained, all alike recognize a disease-producing property in the remedy and look to the signs of symptoms it may develop, in one way or another, for a knowledge of its special character and tendency.
The first step, in special therapeutics, the institution of an artificial disease, brings up a question of the greatest importance, namely:
What relation must the new disease bear to the old, in order that a cure may result?
A relationship, of some kind, there must be. Taking the disease, as presented in its symptoms and history, as the basis or standard, if we know the relation that the artificial affection must bear to it, in order that a cure may result, a faithful comparison between it and the affections produced by various medicines, should bring us to the right remedy. If that relationship is to be same in all cases, calling for medicines, in determining its character we arrive at a general principle in therapeutics paramount to all others.
In trigonometry, the mathematician has the same need of the relationship between the two sides, of his triangle, when he wishes to learn the third side. The two sides given and the angle between them, he has no trouble in finding the third side.
In looking over the means employed in medical practice, and the different theories entertained regarding their action, we find but four possible relationships between the affections they induce and the morbid conditions they are effected to remove, namely:
1. THE ANTIPATHIC – Where the same tissues or organs are affected, but in an opposite manner; the relation being one of direct opposition.
2. THE ALLOPATHIC – where the same tissues or organs are affected in a different manner, or where other tissues or organs are affected in some manner; the relation being one of general difference or indefinite diversity.
3. THE ISOPATHIC – Where the same tissues or organs are affected in the same manner; the relation being that of identicals.
4. THE HOMOEOPATHIC – where the same tissues or organs are affected in a like manner; the relation being that of similars.
Inasmuch as the allopathic relationship includes the antipathic – an opposite affection being also a different one from the original – it is hardly necessary to preserve a distinction between them.
1. ANTIPATHIC.
But it may be proper to say that, while an opposite affection may, in some cases, be induced, as a diarrhoea for constipation, somnolence for insomnia, warmth for coldness, etc., such things as opposites to scarlatina, to yellow fever, to whooping-cough, to pneumonia, and a host of other familiar, yet dreaded affections, are not thinkable; unless, indeed, entire good health be the universal opposite, which it can not be, since good health is the absence and not the opposite of any one of them.
And the constipation, to-day removed by catharsis, becomes all the more, obstinate to-morrow; the sleeplessness relieved by the narcotic to-night is the more troublesome the night following; and the cold feet, made warm by the hot bath, are surely colder thereafter. This return of the original trouble is due to the reactive energies of the organism, making sure resistance to all abnormal forces from without, a fact generally overlooked by the people and the masses of medical men.
The antipathic principle, contraria contrariis curantur, is thus a law of palliation merely, and, as such, available to a limited extent only in special therapeutics.
It cannot be claimed that all cures, affected by pathogenetic means are the result of opposite affections instituted; and hence the principle contraria is not general. Nor can it be maintained that any cures, complete and permanent, follow efforts to forcibly institute opposite affections of the organs or tissues diseased; and hence the principle contraria is not even a limited law of cure.
2. ALLOPATHIC.
The possibility of instituting an artificial affection, different from one existing in a given case, is not to be doubted; but a moments reflection must convince us that the relationship is nothing definite, or useful, as a principle.
Suppose a person were to specify the destination of a friend by simply saying, “he did not go to New York,” what would the information be worth?
The practitioner told to employ an agent, in a given case, known to induce a condition of suffering unlike that existing, would be in a singular quandary. He might render strict obedience by the exhibition of any one of a thousand different drugs, none of which had been known to induce a like condition. Hence, the allopathic relationship fails to be a principle, either general or limited, in therapeutics; nor can it supply a rule in medical art.
The practice usually denominated allopathic is based upon a multitude of limited and ever-changing theories, and upon the individual hints of empiricism.
Before passing on, I should mention that some writers have endeavored to show that, after all, the similar and the dissimilar are one and the same. Quite lately it was said –
“There are varying shades of difference, some of which are so slight as to amount to similarity, and some so great as to antagonism, which is only the greatest degree of difference; while similarity is merely the least or a less degree of difference.”
This speculative view of the subject presents a fallacy very apparent in practice.
Two things may be similar in some respects, and very dissimilar in others; but what is contemplated is that the totality of the symptoms or the characteristic features of the one case are like, or unlike, those of another case. There is no practical difficulty in deciding when there is such a similarity or dissimilarity.
Two men can not be said to be alike because they are of the same height, or same weight, or same color merely; nor unlike because they differ in those particulars only.
The relationship similar is quite definite and practical, while that of dissimilar is exceedingly indefinite and unsatisfactory.
3. ISOPATHIC.
The possibility of instituting an artificial affection, identical with one already existing, we must admit; but only in cases where the causa morbi is distinctly known to us , and where it is such that we can grasp and apply it in practice.
A brief survey of human ailments will convince us that their causes, almost universally, are either too obscure or too intangible for our reach and employment as remedies. In cases of poisoning, where the noxious material is distinctly recognized, we might be able to obtain and employ it-not to cure, not to antidote its own effects, but to increase them.
There can be no such general principle as that all diseases may be cured by the institution of the same disease, because its general application would be simply impossible. It might seem, however, that be simply impossible. It might seem, however, that it could be a principle of limited tenure and application, as some affections appear to be relieved by the agencies causing them.
For example, coldness of feet, from standing in the snow, may be removed by the direct and brief application of snow; and the lameness of muscles, over-exercised, may be relieved by their gentle use. But a proper comparison of the snow long enveloping the feet, clad in shoes, with the same article, directly and briefly applied to the naked feet, will reveal to us so much difference in the forces operating and circumstances attending, as to convince us that the relation between their effects must be more that of similarity than identity.
