Read before the Annual Meeting of The International Hahnemannian Association, on board S.S. Lapland, 1927.
Daniel E.S. Coleman, Ph. B., M.D., F.A.C.P.
We are not concerned with the great benefits derived from animal experimentation as developed by such master as Pasteur, Koch, Behring, Ehrlich, Wassermann, Harvey, etc., but to what extent can the symptoms produce on the lower animals by the action of drugs enable us to select the homoeopathically indicated remedy. Crude would our prescribing be, and scanty our practices, if we depended upon such superficial indications.
It is impossible to accomplish consistent therapeutic results unless we are familiar with the constantly make use of the subject symptoms developed in the provings, or those repeatedly verified at the bedside (co-called symptoms).
Some years ago I was consulted by a hay fever patient, Her symptoms recurred year after year, with very little relief from the treatment. Marked aggravation from sleep was the outstanding characteristic symptom. I prescribed Lachesis 30th in repeated doses. Her symptoms were entirely controlled for the season. The following year they reappeared and Lachesis again acted with the same effectiveness. She was highly pleased and said: “Doctor, that remedy was wonderful.
Will you please write it down so that I can have it in case you should die.” A cheerful thought. I repeat the lines of a once popular song, That isnt all; that isnt all.” When the calendar moved around, all her hay fever symptoms returned. Lachesis this time failed absolutely to relieve her. Why was this so? I reviewed her case. The aggravation from sleep was absent. Arsenicum iod. was indicated. Now, could the symptoms obtained from any possible animal experimentation have aided me in this case? The apparent pathology was the same each year.
A prominent New York business man was spending a vacation in Florida. He telegraphed that he was suffering from asthmatic attacks, and that his usual remedies had failed. The peculiarity of these attacks, and that his usual remedies had failed. The peculiarity of these attacks was their appearance between 2 and 4 A.M. I sent him Kali carb. 6x. It relieved him promptly.
Female, forty years old, consulted me on February 25, 1927. She had been suffering from gastric symptoms for about eight years. Knowing considerable materia medica, she often prescribed for herself. At other times she would be attended by a homoeopathic physician. At present she was not obtaining any relief, not- withstanding a very strict diet. Her symptoms were many. She was a milk disposition, inclined to be somewhat tearful. Menses irregular; flatulence; distress if eats a little too much, etc. The relief from cold food and the aggravation from fats put the selection of remedy beyond doubt. I prescribed Puls. 6 four times daily. She noticed improvement within twenty-four hours and had continued to grow better ever since. She self provoked at her own prescribing and said: “Why did I not think of Pulsatilla?”.
Lady, eight-six years old, remarkable for her mentality up to a very short time ago, at last began to show the inevitable symptoms of senility. Last week she would mutter and pick at the bedclothes. Her mind cleared rapidly under Hyoscyamus 30.
Female, age fifty-five. Depressed, cries, sighs, and broods, Dyspnoea, desires to take a deep breath. These symptoms were caused by loss of sister. Improved quickly under Ignatia 3x.
Female, age thirty. Heavy, constricted feeling about the heart, dyspnoea, anxiety, numbness of the left arm, etc. Pulse 91. Systolic and diastolic murmurs heard over apex. Prompt relief from Cactus grand., gtt. X in half glass of water, three doses repeated frequently.
I could recite many more cases showing the value of subjective symptoms, but I will limit myself to one other which illustrated to me very early in my medical life the superiority of subjective symptoms over purely objective ones. The late Dr. Henry M. Dearborn was a skillful prescriber as well as a great dermatologist. It was his custom during the clinical lecture to assign cases to the students. A diagnosis was to be made and a remedy suggested. A fellow student and myself departed from the lecture room with a patient. It was a typical case of herpes zoster. The vesicular lesions suggested Rhus tox., but the characteristic modality, relief of the burning and itching by the application of heat, pointed to Arsenicum.
We left the choice to Dr. Dearborn. He selected Arsenicum on its modality (subjective symptom), making the statement (which we all know well) that the modalities ranked first in homoeopathic prescribing. Such an assertion coming from a dermatologist, forced to prescribe on purely objective symptoms many times, was most convincing. He also called our attention to the difficulty in curing psoriasis, because of its well-known absence of subjective sensations. If any were present, the selection of a remedy became infinitely more easy and the probability of a cure more likely.
Let me quote our old friend, Dr. Nash again. Under Kali iod. he writes: “I give you Farringtons words for it : Pneumonia, in which disease it is an excellent remedy when hepatization has commenced, when the disease localizes itself, and infiltration begins. In such cases, in the absence of other symptoms calling distinctively for Bryonia, Phosphorus or Sulphur, I would advise you to select Iodine or Iodide of Potassia. It is also called for when the hepatization is so extensive that we have cerebral congestion, or even an effusion into the brain as a result of this congestion. The symptoms are as follows in these cases:.
“First they begin with a very red face, the pupils are more or less dilated, and the patient is drowsy; in fact, showing a picture very much like that of Belladonna. You will probably give that remedy, but it does no good. The patient becomes worse, breathes more heavily, and the pupils more inactive to the light, and you know then that you have serous effusion into the brain, which must be checked or the patient dies. So far so god but now even Farrington dulls – all great men sometimes do.
He says, Why did not Belladonna cure? He who prescribes on the symptoms alone in this case would fail, because he has not taken the totality of the case. What does Farrington mean? Does he mean that in his picture of Belladonna he had the totality of the case without the hepatization, or does he mean that the hepatization was the totality of the case. The hepatization was one, and only one, of the totality of the symptoms. Now, he says, Put you ear to the patients chest, and you will find one or both lungs consolidated. Well, I should call that a very important objective symptom, and one that could not be left out of the totality of the case. Remember that both subjective and objective symptoms must enter into every case in order to make the totality complete”.
The above quotation shows that the objective symptoms (pathology) do play a part, and sometimes an important part, in the selection of a remedy. The careful, thinking mind of Dr. Richard Hughes appreciated this, but he did not fail to comprehend and record the subjective symptomatology in his Pharmaco-dynamics.
The statement is sometimes made that the objective or pathological symptoms are more trustworthy because the imagination can play no part in their production. This statement is based on false reasoning. If we were to accept “out of whole cloth” all the sensations expressed by the provers, our materia medica would be as untrustworthy as it would be unworkable if the objective symptoms were alone admitted. It is only after repeated, careful and independent verification that we should admit subjective symptomatology. It is then indispensable.
Animal experimentation can furnish us with only the most superficial understanding of our remedies from a homoeopathic prescribers standpoint, provings on the healthy human body characterizing the work of our school. We do not claim, however, that animal experimentation is without merit. To observe a consolidated lung produced by Bryonia, or a congested liver caused by chelidonium naturally aids us in our prescription, but its practical adaptability is extremely limited.
The chief value of such experimentation is didactic. To be able to say to the student: “Observe the consolidation of the lung produced by Bryonia resembling that which occurs in pneumonia,” or “Note the action of Chelidonium on the liver, etc.” “Do these not show the truth of the homoeopathic doctrine?” But if that is all a student learns of Bryonia in connection with pneumonia, or of Chelidonium in connection with the liver, we advise that he discontinue any ambition (if he has any) of becoming a first- class homoeopathic prescriber. Failure to hold his practice, if such were held on results obtained, would be the unfortunate (for patient as well as doctor) consequence.
If we examine the heading “Experiments on Animals” under Hyoscyamus, in the Cyclopaedia of Drug Pathogenesis, we see how imperfect such experiments can be from a homoeopathic standpoint. “As the name implies, H. may be eaten by swine with impunity; it is also said to be innocuous to cows and sheep, while deer, barnyard fowls and fish are poisoned by it. According to Orfilas experiments, it acts upon dogs as upon the human species.
1. Although the alkaloids is poisonous to rabbits, twenty times the quantity of strong alcoholic extract does not injure them. (Stille, Op. cit.).
“2. Given to horses in large quantities, it causes dilatation of pupils, spasmodic movement of lips, and frequency of pulse. (Perrira, op cit.)”.
We admit, of course, that much of the animal experimentation of late has been conducted on more elaborate lines, nevertheless it can never take the place of human provings. Great care is necessary in the selection of the animals used because of their varying susceptibility to the action of drugs.
The only advantage, and it is not such a great one as some imagine, that animal experimentation can possibly have, is that the provings can be carried to pathological conclusion. In the human subject, this cannot usually be done. Dr. Nash, who was one of the the kindest hearted old gentlemen, suggested that murderers be used for such purposes, claiming that they would then be of some use to the world, having in most cases failed to be during their lives.
Such a step would be looked upon by certain individuals as inhuman, but the murderer could be given his choice between the electric chair and taking a chance with a drug proving. This is not new. To learn if leprosy could be transmitted, a murder was given the choice of being hanged or receiving an injection of the products of a leprous lesion. He jumped at the latter chance for life. He was injected and in due time a report went out that the disease had not bee transmitted. Scarcely had this news gone forth, that he showed the first symptoms of this dread malady.
We differ with the rhetorical but illogical Mr. Clarence Darrow in his opinion of the criminal. He thinks that they are “poor, sick young men,” whereas we consider the ordinary criminal as a lazy, desperate character who thinks that the world owes him a living. To hold up an armed United States mail car and evade a strong pursuing force requires a nerve, even if it is perverted, absolutely incompatible with this celebrated criminal lawyers notion of a criminal.
Just as a nation has a right to protect itself by any means against opposing violence, so have the law-abiding citizens a right to use such methods as will effectually stamp out or lessen crime. The idea of vengeance plays no part in the punishment of the criminal. Self-protection is the only object. Punishment should be such as to produce this protection. The remarkably efficient handling of the New York Police Department by the most able Mr. McLaughlin diminished to a marked degree crime in that city. The therapeutic measures applied by the former commissioner to these “poor, sick young men” should earn for him the degree of M.D. Equally effective, although somewhat different, were the methods employed by the famous Thomas Burns, superintendent of the New York police, during my youth.
The criminal feared him personally and dreaded to be brought before “The Chief.” He established the “Dead line,” below which no crook dared to go, and kept the city comparatively free from invasion by the criminal element. The old chief stood no fooling and carried a knockout punch in either hand. Captain Williams, of the same period, could wield his night-stick with a grace and efficiency that would have delighted Hercules. He once remarked: “Theres more law in the end of a night-stick than in all the courts in the United States.” These men believed in physical therapeutics and they obtained brilliant results. So, after all, Dr. Nashs suggestion, carried on in a humane manner, is not without merit.
One thing more. Recognizing the value of subjective symptoms is not confined to our school. The great Sir James Mackenzie knew their worth. Let me quote a few of his statements: “The proper appreciation of the patient;s sensations enables us to understand many obscure complaints, as for example in the recognition of abnormal heart action.” “The study of pain, its site, radiation and accompanying phenomena, reveals the mechanism by which it is produced.”
“The knowledge of the progress of disease reveals the meaning of abnormal signs and constitutes the basis for an intelligent prognosis.” “The general practitioner is the only investigator that has the real opportunity.” “The opportunity for investigation in hospitals is too restricted.” “When heart failure sets in, the earliest manifestation is always a subjective sensation of a disagreeable kind”.
Note what Sir James says regarding the general practitioner. the same is true in relation to the homoeopathic materia medica. True knowledge of materia medica and prescribing can only be obtained at the bedside by one actively engaged in private practice. The hospital, using Mackenzies own words, “is too restricted.” The laboratory is still more so.
One of the best pathologists I know remarked to me one day: “Coleman, the young doctor of the present expects me to make all his diagnoses for him. He seems never to have acquired the skill of drawing conclusions from the symptoms presented, or to make a good physical examination. You know that the laboratory is only confirmatory.
We conclude, then, that animal experimentation can aid, but only to a very limited extent, homoeopathic prescribing. The bulk of our knowledge must be obtained from provings on the healthy human body and from repeated verifications of the symptoms.