The truth of this is made apparent by a glance at the history of Homoeopathy. Certain of Hahnemann's followers discarded the apparently trivial subjective phenomena from the provings of drugs, retaining only the objective, organic symptoms. They thus lost the means of distinguishing between the individual members of the groups of remedies. It was thenceforward useless for them to discriminate closely between individual cases of any one type of disease.
Hence, inevitably, arose the fashion of prescribing a specific remedy for a disease, as the phrase went, putting the leading members of respective groups of drugs and diseases to represent the whole groups. These were the so-called "specifikers," who had one or two remedies for dysentery, one for whooping-cough, one or two for scarlatina, etc., "of whom the world is weary."
But the characteristic is not always a definite symptom. Sometimes it is so, as in the case of Crocus, and as in the peculiar diplopia of Stramonium. But sometimes it resides in a peculiar condition which attaches to some symptom common to two or more drugs. This condition may be of time, or circumstance, or concomitance.
Thus, if two drugs have the symptom "dry cough from tickling in the suprasternal fossa," but to one is added the condition "occurring only in the evening," this condition of time is the characteristic of that drug in so far as the dry cough is concerned; or if one have this condition of circumstance, that "the cough is aggravated by inspiring cold air," this condition is the characteristic; or if one have the concomitant that the cough is attended by retching, this condition of concomitance is the characteristic.
Sometimes the characteristic resides in the conditions collectively. We borrow examples from Dr. Drysdale's admirable Introduction to The British Repertory:
"Pain in the stomach with nausea occurs under twenty-eight medicines.
"Pain in the stomach in the morning under thirty-seven.
"Pain in the stomach with nausea in the morning under four only."
Or it may reside in a concomitant.
"Dry retching occurs under forty-five drugs.
"Dry retching in the morning under five.
"Dry retching with eructation under one only - Ledum."
Every drug-proving, then, is to be studied in a two-fold way: On the one-hand, so as to enable us to attach it in our memory to certain groups of drugs to which it shows marked general resemblances; and, on the other hand, so as to bring out clearly into view those characteristics which distinguish it from all the other drugs of these groups in particular and of the Materia Medica in general. Our study will be at once synthetic and analytic.
Such a study is of necessity comparative in its nature. Each positive step in the study of a drug involves a question of the correspondence or difference of other drugs in respect of that step. An isolated study of all the remedies would not give us an available knowledge of the Materia Medica.
It is not enough to know that Pulsatilla, Nux vomica and Chamomilla each produce diarrhoea of a certain kind. We must also know and fix in our minds the similarities and differences of each of these diarrhoeas to those of the two others and of all other drugs.
The study of one drug is, in fact, then, the study of the whole Materia Medica. One is never so competent to thoroughly master a proving as when he has already mastered all other provings. The first effort must necessarily be the least satisfactory, the most imperfect.
This is the task to which the student of Materia Medica is invited and at which his predecessors have been laboring for fifty years. Why, he may ask, has not this been wrought out and systematized by those who have gone before? Why is the Materia Medica left in the same state in which Hahnemann placed it fifty years ago?
Our Materia Medica consists of the provings of drugs upon the healthy, made by Hahnemann and his disciples. These provings, as we have them, are, for the most part, a formal arrangement of the symptoms subjective and objective observed by the prover or his friends.
No attempt is made, with but few exceptions, to trace any pathological connection between symptoms, or to give any physiological explanations, or to distinguish between characteristic and generic symptoms. The symptoms alone are given, just as the symptoms of a case of disease would be given by an intelligent but uninstructed patient who unfolds his case to us in as plain untechnical words as he can, leaving to us the task of tracing connections and contriving explanations. There they stand, records of facts made in the plain vernacular, intelligible so long as the language shall endure.
But Hahnemann had a much higher idea of the kind of knowledge of Materia Medica which a physician requires than this statement would imply. In an essay on "The Power of Small Doses," in Hufeland's Journal, he describes this knowledge as follows:
"What organs it (the drug) deranges functionally, what it modifies in other ways, what nerves it principally benumbs or excites, what alterations it effects in the circulation and digestive operations, how it affects the mind, how the disposition, what influence it exerts over some secretions, what modification the muscular fiber receives from it, how long its action lasts, and by what means it is rendered powerless, etc., etc."
Why, then, did he not construct his Materia Medica on this model? Unquestionably because, with a wonderful sagacity which together with his brilliant genius and his prodigious learning made him the "double-headed prodigy," which Jean Paul Richter called him, Hahnemann clearly perceived the following truths:
- That the positive facts with which a physician has to deal in constructing a Materia Medica are the observations of the prover recorded in plain, unfigurative, non-hypothetical language.
- That the construction which he saw to be so desirable must be the result of the application of the sciences of Physiology and Pathology to these facts.
- That the facts of the proving being of the nature of positive observation are enduring and unchangeable.
- But that the sciences of Physiology and Pathology, being incomplete and progressive, are continually undergoing change, and that their terms must therefore be ever varying in significance as the theories on which the sciences are based vary.
- That, consequently, a Materia Medica constructed by him out of these two elements, one constant and the other variable, would of necessity be transient, could not be enduring, would soon grow obsolete and in its decline would carry out of sight the constant element also, and thus the labor of the provers would soon be lost to the world.
Such a structure would have involved an intermingling of the current physiological theories with the facts derived from observation. The precise point and extent of the intermingling would soon become undistinguishable and thus a vitiated record would be transmitted to posterity such as the advance of science would soon render useless.
A comparison of the present state of Physiology with that of 1800, of which the very terms are almost obsolete, makes the great wisdom of this view apparent. On the other hand, the pure records of observed facts, untainted by theoretical speculations, come to us from the Master's hand as pure, as intelligible, as available as when first recorded.
We have the same material for the construction of a physiological theory of the drug-action that Hahnemann had, and we can construct it with the advantage in our favor of the great advances which Physiology and Pathology have made since Hahnemann's day. This is the work which each of us must do for himself. No other can do it for him.
The result of his labor may and will differ somewhat from that of every other student, for with the light of the auxiliary sciences he forms a judgment concerning observed facts, and the significance of a fact is measured by the capacity of the observer.
The student should seek his knowledge of Materia Medica at the fountain head, in the original publications of Hahnemann's Materia Medica Pura and Chronic Diseases in the provings in Stapf's Archiv. and in the Austrian and other journals.