LIBERTY OF Medical Opinion and Actios. by I ADOLPH LIPPE, M.D. Read before the Central New York Homoeopathic Medical Society, September 15th, 1870. REPRINTED FROM THE HAIINEMANNIAN MONTHLY. PHILADELPHIA: SHERMAN & CO., PRINTERS. 1 870. LIBERTY OF MEDICAL OPINION AND ACTION. Liberty of medical opinion and action is, fortunately, an inherent right of all citizens, guaranteed under the Constitution and laws of the United States. Every person is at perfect liberty to choose such medical treat- ment (if in need of any) as he, in his own individual judgment, considers best for himself. Every physician is also at perfect liberty to choose and adopt that system of medicine which, in his own judgment, he thinks best adapted for the cure of the sick ; and all the law exacts of him, before granting him the rights, privileges, and immunities of a practicing physician, is “a diploma;” that is, the certificate of a chartered medical school, to the effect that he has acquired the necessary medical knowledge, and has thereby prepared himself and has become competent to exercise the duties of a practicing physician. The liberty to judge finally of the superiority of one medical system over another, rests, as it should, with those most interested in the question, the people at large; and whatever system of medicine can show the best re- sults, and in its application for the cure of the sick ex- hibit the smallest mortality and the shortest duration of disease, will be adopted by the people; and the physician who obtains the best results in his practice, will most likely meet an approving patronage from the people.' A 4 system of medicine, or a practitioner, failing to support pretensions by superior practical results, will be cast aside as of no worth; their shortcomings settle their fate. Such was the case when the people rejected the Thomp- sonians, and such is the case at present when the Eclec- tics are also discarded by the people. And the people have a right to do all this, because they enjoy liberty of opinion in matters medical. The rejection of homoeopathy by the allopathic school may be a source of grief to us, and we may feel very much inclined to charge them with illiberality, because of their culpable ignorance of our principles and therapeutic law; yet, at the same time, a sense of justice compels us to give them credit for consistency. They, as a school, admit only such persons to membership in their various medical societies as are fully qualified practitioners, and who adhere to what they, as a body, take the liberty to consider legitimate practice; and they will summarily expel any member from their societies who violates their rules or code of ethics. Whatever fault we may find with their rules and code of ethics, they are governed by them, and they claim their right to thus make use of the liberty of medical opinion and action. They are con- sistent ; and this very consistency with which they adhere to their regulations becomes, to some extent, a bar against what the allopathists consider innovations, and what we consider progress, in medicine. We find this well-organ- ized body of consistent men opposing our progressive course, and we look for means to overcome this opposition. Would it not be well, under these circumstances, to adopt the tactics of our opponents? Should we not organize under a common banner, and then consistently enforce our rules and code of ethics ? Is it not the chief concern of the artist, the mechanic, the craftsman, to observe and closely scrutinize his rivals’ methods of procedure, that he may profit by his discoveries and successes ? The superiority of our system of medicine must in the 5 end secure for it the ascendency over our at present nu- merically stronger and better organized opponents; but we must not flatter ourselves with the vain hope that this final victory will be ours without a desperate struggle; and that we may be well prepared for it, it behooves us to be well organized, and, in this respect, learn from our adversaries. We have made a good beginning, and have organized already many medical societies, whose aim is “the advancement of medical science.” When a physician becomes a member of any of these medical societies, it is taken for granted that he is a bona fide homceopathist; the very fact that he applies for membership implicating the belief that he has accepted our formula, “ Similia similibus curanturand adopted our motto, “In certis unitas, in dubiis libertas, in omnibus charitas.” Our motto expresses plainly and unmistakably that we are in the possession of some “ certainties,” and that as far as these certainties are established, we must stand by them as a united body; and as we stand united by these certainties, we declare our full conviction that homoeopathy has advanced the science of medicine so far, that we have been able to emerge in reality from the former uncertainties of medicine, and that we are founded and rely on certain fundamental principles based on the laws of nature. These certainties are also expressed in our formula, and comprise by logical sequences the law of the similars, the single remedy, and the minimum dose. It is, then, to be supposed, that every person seeking and accepting membership in our various societies, has made use of his liberty of medical opinion and action in accept- ing these first and fundamental principles. There are true and good men among us who erroneously believe and endeavor to establish the opinion, that any person profess- ing to be a homceopathist, and who bases his pretensions on the fact that he is a member of a homoeopathic society, must be allowed full freedom of medical opinion and ac- tion, and that therefore he is at liberty to accept, reject, 6 or modify any or all of the principles constituting homoe- opathy ; that, in fact, he may consistently enjoy a multi- plicity of opinions, and do just what he has a mind to do; that he may habitually send his compound prescriptions of crude drugs to the common apothecaries; that he may habitually administer morphia, or order injections of starch and laudanum for diarrhoea, or, in fact, practice a sort of disgraceful mongrel allopathy ; and that no fault should be found with him on these accounts, and, as a member of our societies, we are hound to indorse him and his practice. This unlimited amount of freedom is claimed for all members of our medical societies, because, by contrast, the allopathists have circumscribed medical liberty inju- riously, by the force of opinion, within the limits of the medical profession itself. These true and good men hold these opinions erroneously, because there exists this de- cided and vast difference between the two schools ot medicine: that the allopathists exact from their gradu- ates and members of the profession, and especially from members of their medical societies, an explicit adherence to and an obligation not to swerve from the “ teachings ” of their Alma Mater, on pain of forfeiting their member- ship and even their diploma ; and whatever opinions have been taught are binding on the graduate. On the other hand, homoeopathy does not recognize the opinions of any man. We only recognize fundamental principles as the basis of our therapeutic law. Our school, based on infal- lible principles, on certainties (which are very different from mere opinions), cannot admit the propriety of hold- ing its members and graduates bound to tamely accept, and be bound not to swerve from, the teachings of a mul- tiplicity of opinions; but they are bound to explicitly adhere to and not swerve from certainties, fundamental principles; and the teachings of the schools must be in harmony with or be deductions from these our established principles. The allopathists have no fixed principles. The 7 laws of nature from which we draw our knowledge and principles are to them a sealed book, and they there- fore always did and still do submit to be guided by indi- vidual opinions of this or the other man; and when the opinions taught by one man were found to be fallacious by the practical test, the opinions of some other man were substituted, and in this manner medical authorities were created, and to them the adherents of that school were bound to bow down and pay homage. We have accepted and abide by established principles to guide us in our therapeutic laws and in all our further investigations. The solution of such questions as are comprised under the “ dubiis ” of our motto, can only be satisfactorily deter- mined, and their number diminished, by our always ad- hering to our first fundamental principles; and the accept- ance of the solutions of open questions can only he ratified if found to he in full harmony with already established principles. It is an acknowledged fact that, as the new practice be- came popular, men took the name of homoeopathic physi- cian who did not accept the homoeopathic law as of uni- versal application in therapeutics, or who did not accept the peculiar modes of practice generally known as homoeo- pathic ; the single remedy, for instance, and the minimum dose. The liberty to accept homoeopathy surely does not include the freedom to reject, modify, or alter any or all of its fundamental principles ; this freedom is the pre- rogative of the Eclectics only, who claim that we must be guided by expediencies in our endeavor to cure the sick, and that to be trammelled by certain principles is dogma- tism, and not to be tolerated in any medical school claim- ing freedom of opinion and action ; and in their progress backwards, they show themselves the most unrelenting opponents even of that wing of the allopathic school, which endeavors to elevate medicine to an exact science, and to establish certain principles. There are those who, willing to be with us and of us, 8 and who are seeking to reach the standard of knowledge and practice of those who have had long experience in the strictest methods of Hahnemann, and animated by such a desire to progress, will seek and take advice from those wTho have fully adopted homoeopathy and practice it; and every true man is willing to aid such seekers for truth, in every possible manner, and they will surely ob- tain the knowledge they seek. There are others, calling themselves homceopathists, who positively decline to he advised by those who have had long experience in the strict method of Hahnemann, but who claim the freedom to teach, write, and practice that which is in full contravention of homoeopathy, as taught and practiced by Hahnemann and his followers. They claim the freedom to reject, alter, and modify any or all of the principles and practical rules constituting homoeop- athy ; and, not satisfied with this exercise of freedom, they go much further, and under a perverse idea of liberty, they believe themselves possessed of the privilege to mis- represent, ridicule, and persecute those who, by long ex- perience in the stricter methods of Hahnemann, have accepted the principles and practical rules constituting homoeopathy, and practice accordingly. Such men boldly claim it to be their right as homceopathists, and as mem- bers of homoeopathic societies, to administer habitually cpiinia in massive doses for the cure of intermittent fever, in violation of the very first principles of homoeopathy, or massive doses of morphia for the lulling of all sorts of pains, cathartics for constipation, injections of starch and laudanum for diarrhoea, they habitually send prescriptions of compound crude drugs to the common apothecaries, and whenever they order such medicines as are habitually prescribed by homceopathists, they give them in absurd alternation, as, for instance, belladonna and aconite tinc- tures in alternation for the cure of “ fever.” And they persevere in practicing this caricature of homoeopathy, claim the liberty to set aside the law of the similars and 9 its sequences, and unblushingly boast of superior successes in following their own opinions, untrammelled and un- guided by any tixed principles or therapeutic law. To he so guided and trammelled would, in their opinion, be an infringement on the liberty of medical opinion and action. The fact is, that when these men, pretending to be homoeopathists, are, as such, called upon to prescribe for patients who are in the habit of being waited on by phy- sicians who are consistently following out the teachings of Hahnemann, and when they prescribe in violation of all the principles known to the patient as belonging essen- tially to homoeopathy, when their massive doses, their opiates and quinine administered in poisonous doses, act injuriously on the patient, making him alarmingly ill, then the pretender is disgracefully dismissed, and a sensi- ble allopathist is sent for to undo the harm done under the guise of homoeopathic practice; and he fails not to make capital out of such cases, to be used against the system. In fortunately rarer cases, the pretender falls into the clutches of the law, as did a practicing homoeop- athist who but a short time ago prescribed for a child thirty-six grains of acetate of lead, and killed it of course. In how far these men will ever assist in the promotion of homoeopathy, or of medical science in general, is a question to be decided by every organized homoeopathic medical society which has been unfortunate enough to have allowed such men to become members of it. The community at large look upon our societies as represent- ative bodies, and as a standard by which to estimate the character of homoeopathic physicians in general; and the organized homoeopathic medical societies which have been unfortunate enough to allow such objectionable men to become members, will have to decide what in their wis- dom would be the best course to be pursued, that the character of all homoeopathic physicians may not lose by the composition of our societies. In this connection it must not be forgotten that the 10 recent history of our country offers us an analogous con- dition. But ten years ago, citizens of the United States, professing to adhere to the Constitution of the United States, and by inference to the fundamental principles on which the Constitution is based, contained in the Decla- ration of Independence, who presumed to be entitled to all the rights, privileges, and immunities of citizens of the United States, clamorously demanded the freedom to in- terpret the Constitution as they thought best, for the ad- vancement of their own personal interests. The Declara- tion of Independence proclaims to the world that the first principle, the corner-stone on which is built the whole edifice of self-government, consists in the doctrine, that “ all men are born with certain inalienable rights, such as life, liberty, and the pursuit of happiness.” These mis- guided men claimed “ freedom of opinion,” and for many years good and true men thought that perfect liberty would the sooner bring knowledge of the truth. And truth was distinctly proclaimed before an open forum; it was pro- claimed for the benefit of the people in the halls of Con- gress and by the free press; the perverters of our funda- mental principles were accorded full liberty to defend their false position in Congress and in the press; they were permitted to hold offices of honor, trust, and profit; the true and only possible logical interpretation of the Constitution was persuasively enforced, that error should have no chance; the advocates of truth illustrated and defended the true interpretation of the Constitution with earnest and great ability, and for a long time there was no fear for the result. Tender suasion and the most ex- tended Christian charity were wasted on these perverse men. At last they resorted to the terrible tyranny over word and deed, which was imposed by public opinion in the Southern States before the late civil war, on the subject of slavery. The overthrow of self-government, and the de- struction of this great republic, were threatened by men Avho were only with us in order that they might destroy 11 what they had simulated to support. The fundamental principles on which rests this republic, had to be vindi- cated at last, not “ by perfect liberty, which the sooner brings knowledge of the truth,” but by a long and bloody civil war; and when the enemies of true liberty were dis- armed, it was deemed necessary to give an unmistakable interpretation to the fundamental doctrines contained in our Constitution, and Congress gave us what is known as the “ Equal Rights Bill,” and the people finally made the victory of our great principles doubly sure, by indorsing such amendments to the Constitution as would forever prevent malicious, self-interested, and perverse men from attempting a fallacious interpretation of that great docu- ment. The great questions now before the homoeopathic phy- sicians of this country in general, and before the organized homoeopathic societies in particular, are these: Shall we be governed by principles or by opinions ? And if we are to be governed by principles, wThat are they ? The people look forward to the homoeopathic medical societies for an interpretation of the doctrines and practical rules taught and promulgated by Hahnemann, and accepted by homce- opathists; and such an interpretation once given and in- dorsed by the profession, will forever secure to us that unity of action, without which, we cannot successfully combat error and our present numerous opponents, who in turn would have to surrender to a superior united array on the side of truth. “ The price of liberty is eternal vigilance.”