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HSIFILivn^31IS)2 EXPOSITION OF THE DOCTRINE ACCORDING TO THE OPINIONS PUBLISHED BY THE PRINCIPAIi PHYSICIANS OP THE FACULTY OF PARIS. BY DOCTOR LACOMBE, Late of Paris. (.rttent's,y So ^ JAMES E. BETTS—214 BROADWAV, James Ornwnd, Printer. 1835. 1/ W/3K I $** D~> r - PREFACE. I have read and witnessed many controver- sies on Homgeopathia, and yet found but few, that gave a correct idea of the doctrine of Hahnemann. All books and pamphlets writ- ten on this matter, have been published more for the investigation of physicians, than for the general reader. I thought, therefore, that I might render myself useful to the community by writing an explanation of Homceopathia, such as may be understood by every one. I have joined my judgment on the new doctrine (with, I trust, as much impartiality as sound reason could require,) to the opinion published by the principal Physi- cians of the Faculty of Paris, on the same sub- ject, and confidently leave the work to the con- sideration and appreciation of the public. New York, July 90th, 1835. m®S2@E®I?.&,H,IHa& IBSSPIEi&SES'SlIE)* Homosopathia, from Bpoiov, similar, and ™e°s, suffer- ing, or similar disease ; a Therapeutic doctrine, which is pretended to cure diseases, by remedies capable of producing on the system, the same artificial symptoms, as the original morbid ones, or to convert the morbific power, into the medicinal disease, so as to destroy it. Hahnemann, the author of this doctrine, asserts, that all diseases can be determined by medicinal causes, as well as by natural ones; that all substances, which possess the property of producing symptoms in any organ, ought to have also the property of combating those symptoms which are similar. The minutest facts, taken in common practice, and in all ancient and modern doctrines, as well as numerous experiments made on subjects in health, are inductions leading us to find, in the effects of specific medicines, as many similar pathological phenomena, as are equally presented in forming the basis of this doctrine. Fully to comprehend the Homoeopathic doctrine, it is requisite to follow its author, and to examine into the fi nature of those principles, that induced him to gene- ralize the liicts and reasonings which compose it Little satisfied with existing theories, and particularly with the suppositions by which the specific properties of medicinal substances are explained, Hahnemann had, for a long time, decided on the reform of the Therapeutic doctrine, and, after having practised medicine for several years, in a very wavering and uncertain manner, relin- quished it, in order to confine himself to experiments on the effects of Pharmaceutical agents, observable on the healthy subject. After a long time, entirely occupied in discovering some curative etfects, although thereby disturbing methods previously established^ he was stopped in his theory by the Therapeutic law of similars; but the fact which seems principally to have given birth to Homceo- pathia, was the discovery of the Pharmaceutic pro- perties of the Peruvian bark, which took place in the year 1790. He observed that this substance, employed on a subject in health, would bring on an accession of intermittent fever, precisely similar to that which it would cure, almost as a specific. From thence he followed his examinations on the same views, and with a Posolo- gical system, (of which we shall soon speak,) on a great number of medicinal substances, and in particular, those called specifics, such as mercury, sulphur, antimony, lead, gold, tyc. fyc. His results were received with all the prejudices at- tached to innovations, and, consequently, obtained in the first instance, but few adherents. They were disclaimed by the greatest number, as the fruit of a fantastic and 7 dreaming imagination. He was persecuted during several years, and even obliged to leave the country that- had been the theatre of his experiments, (Georgenthal, Brunswick, Kcenigslutter,) and retired to Hamburgh; then to Eclenburgh, and at last toTorgau, where he con- tinued his labours till 1810, at which time he returned to Leipsic. He had already published, in the Journal de Hufeland, a great number of observations on Homceopathia, when, in 1800, an epidemic disease, (the scarlet fever,) broke out, furnishing him an opportunity to apply his method, in the use of the Belladona, both as a pre- ventive and cure. Some time after, in 1805, he compiled in a special work, other results of his practice, under the title of " fragmenta de viribus medicamentorum positivus sive in sano corpore humano observatis ;" but it was only in 1810, he published his " Organon of the Art of Curing Diseases," wherein is found, fully eluci- dated his Therapeutic system, which, soon after, was followed by the publication of his " Materia Medica," (1811-1821,) a work which simply contains all the facts ascertained by the Homoeopathic doctrine, on the Pathognomonic properties of medicinal substances upon the healthy subject. Hahnemann, however, who, till 1816, had limited the applications of his theory, to acute diseases, was, at that period, desirous of extending it to chronic, diseases : he consequently made, for that purpose, anew collection of facts, of which he published the result in 1828, under the title of " Treatise on Chronic Diseases," fyc. Sfc. The singularity of the Homoeopathic doctrme, the s novelty of its principles, the plausible accounts given «»f its success, enthusiastically repeated abroad, and, j.>er- haj)s, still more, the persecutions of which its author had been the object, obtained for it disciples in Russia, <»er many, Italy, England, Switzerland, France, &e. ; while courses established, ad hoc, inonographes, special news papers, translated in all the European languages; spread its tame over Europe and America, and increased, each day, (he number of its adherents. But the time has at length arrived, if not to judge (his doctrine without apjieal, at least to present it to the serious attention and candid investigation of practitioners. It is on this account, that the author lias thought proper to explain to the public its essential principles. In medicine, as in all other sciences, no one has a right to assume false premises, in opposition to tacts, however extraordinary they may appear, nor attempt to refiite them without adequate examination or proof. Up to the present time, all Therapeutic doc- trines, have been based upon a theory, more or less specious. The doctrine of Hahnemami, however, has none, it recognizes simply, that the theory of dis- eases, or pathology, is the secret of nature, and that it is folly to endeavour to explain, or even guess at, them. According to his doctrine, all the labours of the physician, ought to be turned towards find- ing remedies, as being the only real design of the science of medicine—the art of curing. A maxim like this, must necessarily be extremely vague, unfixed, and uncertain; giving rise to idle speculation, vain eurio sity, and wild fancy, or illusion of the mind. 9 Homceopathia, consequently, does not admit of any classification, nor even of any denomination of diseases; the only distinction it allows, is that between acute and chronic diseases. These last, Syphilis and Sycosis excepted, which are only a variety, have all one common cause, a principle or miasma psorical; and it is the pas- sage of this miasma through millions of organisms, in the succession of generations, which explains all the varieties and forms of chronic diseases ; but the cause is one and identical: the symptoms alone differ. The doctrine of Homceopathia consists therefore, en- tirely in the Therapeutic discovery, and application of the Pharmaceutical agents ; it is founded on this great rule—similia similibus curantur, and admits no other theory, but the one which compares and identifies each with the other, while it assimilates between themselves the properties of medicines, and the different causes of diseases. Disdaining the best known, as well as the hazarded, laws of Physiology, giving a speciality and an individuality to all Pathological facts, as so many inde- pendent acts; it admits as many specifics as it acknow- ledges symptoms of diseases; as many hidden properties in medicinal substances, as occult or abstruse in dis- eases ; and employs Therapeutical agents, only after having previously experimented with them upon the healthy subject. Homceopathia does not seek either in the blood, the lymph, the nerves, in irritation or in asthenia, for the proximate causes of disease, it admits of none—while, at the same time, it admits of all of them : but it is of little consequence, according to this theory, in what 2 10 manner their different morbid actions affect the system, individually or collectively. The symptoms of diseases are all that are to be regarded, and even diseases themselves, are to be over- looked, excepting particular species ; and of remedies, none but specifics, are to be employed. Thus, instead of being based upon the laws of Anatomy, Physiology, and Pathology, or the diseases of the viscera; Homceopathia strikes them all from the history and study of medicine, and contents itself simply with a history of symptoms and medicaments. Its great law, which includes the whole doctrine, is to cure all diseases by medicaments, having an action similar to that of the previously exist- ing: morbid state. All medicinal substances must create artificial dis- eases, and have a curative property, only because they produce diseases similar to the natural symptoms. For instance, it pretends to stop vomiting by emetics; to com- bat diarrhoea by cathartics; sweating by sudorifics; the itch by sulphur ; the scarlet fever by the belladona, ecificacy, analogy, similitude and elective suitableness, between the remedy and the disease, the Therapeutic effect depends more on nature than on a large quan- tity of medicaments; and on that account, no compa- 11 rison can be established between Homceopathia, and the other Therapeutic doctrines. The doctrine of the contraries, or of the revul- sives, is intended to operate or accomplish the The- rapeutic fact, whilst Homceopathia tends to no other purpose, than to raise to the smallest degree, and in a similar way, the morbid state existing, and this explains the infinity of its Posology, or minuteness of doses. The mode of preparing the Homoeopathic medicines is still a circumstance on which Hahnemann insists much, so as to justify the inequality of his medicinal doses. His medications, he says, are all specifics. They act, consequently, with all the activity of specific agents, or even of the imponderable powers. They attack, imme- diately, the principle of the disease itself, and require for that purpose, neither masses nor determined quan- tities, by pounds, ounces, &c. Halmemann asserts, that the Homoeopathic medicines loose nothing of their activity, by the minuteness of their doses; so that one ten thousandth part of a grain has a power of action almost equal to y^- of a grain ; that even the tt,o"o"o °f a gram> a l°ng ^me triturated, acts in a more penetrating manner, than the y|q of a grain submitted to a manipulation of less duration. It is the same of the t.oTT.ttto compared to the to.Ito and so forth. The author of this doctrine, in other respects, recom- mends the utmost precaution in the preparation, conser vation and dispensation, of the Homoeopathic remedies. All vessels, utensils, bottles, boxes, and other instru- ments, which are used for preparing or keeping the 15 medicaments, must be exclusively appropriated to this object, and preserved from any sort of alteration; and, that no doubt may exist in regard to the cleanliness, and the prescribed mode of preparing the medicaments, Hahnemann requires that the physician should take upon himself this charge. As for the means by which cures are performed, this, in few words, is Hahnemann's reasoning. 1st. The artificial cause of the medicine acts by means similar to the morbific cause. 2d. The artificial cause displaces the effects of the morbific cause. To operate this double action, it is requisite that the remedy, which possesses in itself the artificial means or similar, of the disease, should operate immediately on the suffering organ, and Hahnemann acknowledges that it does so, when the aggravation of the disease takes place, after the administering of the said remedy. It is then that he assures himself, that there is an affi- nity between the artificial Pathological cause, and iden- tity, as well as similitude, between the effort of the pre- existent or natural disease, and the effect of the secon- dary or artificial disease. There must, then, be a super addition of the morbid causes and effects, in the applica- tion of the Homoeopathic remedies. But as the addi- tional effects and causes of the remedy are of the same nature as the Pathological phenomena; they ought, by reason of their prevalence over those of the disease, to carry off these last, comparatively, less strong ones. For, two sensations of the same kind, cannot simultane- ously be received; nature becoming insensible to the 16 weakest of them, while it receives an impression from the strongest. When the Homoeopathic medication takes effect, an- other disease is found still to exist, but it is no longer the natural one, which is now subdued or displaced by the more active cause possessed by the medicament; it is no more the disagreement which was produced by the natural cause of the disease, it is that of the medica- ment administered, which is under the control or power of the Homoeopathic physician, because he is always the sole master of the dose of his medicine. The organism is, in this case, submitted to another law, in virtue of which each medicinal sensation will soon disappear, after the disappearance of the natural disease, which yields or gives place to the cure ; it being understood that, the artificial disease, by reason of its similitude and preponderance, substitutes itself in the place of the natural disease. The special object, as well as the great difficulty, of the Homoeopathic doctrine, is in the true application of the instruments of medication, and in the accurate ap- preciation of their specific properties, as well as in the rigorous determination of the doses of the medicines it prescribes, according to the nature of the symptoms and the susceptibility of the organism. The Homoeopathic physician can choose to act, either in the direct or sympathetic way ; between the mucous membrane and the skin, or between all the ways of ab- sorption. But, in all cases, it is necessary that the dose of the medicine used, should be calculated very accu- rately, in order that it may increase the existing morbid 17 state only in the smallest degree possible; consequently, the remedies must be in minutest doses, as the aug- mentation of the disease should be slight; in chronic dis- eases, particularly, the extreme smallness, or attenuation, of the doses, must be strictly observed. It must be, at al} events, as simple and as pure, as the curative law of the similars requires it. According to Hahnemann's state- ment, all complex preparations of medicaments for in- ternal or external use, for instance : all ptisans, potions, lavements, frictions, &c, must be left to the prejudices and ignorance of the common practice of medicine. Even the maxims of regimen, in the treatment of dis- eases, are pointedly ridiculed by him ! In the rapid explanation of the fundamental princi- ples of the Homoeopathic doctrine, it was thought proper to abstain from all reflections which might distract the attention of the reader, in perusing the multiplicity of facts related. If I am not mistaken; the principal errors of the Ho- moeopathic doctrine, are those peculiar to all universal and exclusive doctrines, viz: the having generalized facts, essentially distinct—that is to say, dissimilar, or having often but an indirect connexion; having seen in the organism but one law, in its anomalies, but one cause, and in its curative means, but one rule of application; and the having forgotten, whether the principle of life be one, or the organism, multiple, in its elements, and vary- ing necessarily in the organs and apparatus of the organs, in the elements of anatomy which compose them, in the molecule actions which animate them, and in the diversity of composition and vitality of the fluids which penetrate 3 IS them, m such order, that the most simple function, in appearance, is the complex result of actions, which the most attentive mind cannot follow. In the same manner, the most simple morbid state, always pre-supposes the cessation of a combination of actions, more or less diffi- cult. It follows, then, that as long as the laws of physic, chemistry, mechanics, vitality, Ccc. exist in the orga- nism, exclusive systems must necessarily experience the fate of all errors. But let us return to Hahnemann. Attacking the symptoms, without accounting for the numerous and various organic lesions, which may regu- late them: using remedies, under such forms and doses, as render their effects ineffectual, or at most imaginary ; and pretending to give, gratuitously, the faculty of de- stroying the disease, by increasing it—to this is reduced the 1 loinoeopathic doctrine. Now, we would ask of the adepts themselves, is it really possible to recognize a dis- ease, when you have seen only the apparent symptoms ? And is it possible to proclaim as infallible, a therapeutic principle, which addresses itself only to the simple ex- ternal phenomena of the disease—which recoo-nizes no law of anatomy or physiology—which shuts its eyes on all organic alterations, disdaining all diagnostic know- ledge, and all explorating means—to be contented with the simple character of dispensator of remedies ? With such principles, we ask again of the Ger- man reformers, what is to be found in Homoeopathic remedies, to act against those concealed plegmons, which kill without any apparent symptoms? Against those organic alterations, which destroy the existence, secretly, without announcing themselves by positive symptoms * 19 Will an Homoeopathist treat, by the same means, a vo- miting, arising from a gastric or bilious illness, and a sympathetic vomiting, caused by an affection of the brain, loins, &c 7 There is, perhaps, not one single symptom, which would not put in fault the Homoeopathic doctrine, because there is not one that cannot be ascribed to dif- ferent causes, and, therefore, ought to suffer some differ- ence of treatment. A practice of medicine, exclusively of the symptoms, may be conceived, which, unsuccessful against the real sources of the disease, may confine itself to combating and pursuing all the symptoms it meets with. Too often, it must be confessed, necessity makes a law in the common practice; but where is the physician, who, in such a case, would dare to deny the existence of more intimate and deeper causes, and not doubly attack the symptoms, both as effects of organic lesions, or inju- ries ; and also as causes of disease 1 To do otherwise would be to act as an inexperienced practitioner, or an empyric ; but, certainly, not as a practical man, whose practice consists in the observation, and first appreci- ation, of the state of the organs. The new German doctrine, on this account, is but mere empiricism, a mere dispensation of remedies, and those remedies, what are they 1 Substances that become medicaments, only because they aggravate the disease : which cannot be instruments of health, because they are instruments of disease, assuming to acquire real virtues, only in consequence of the chimerical doses in which they are administered, and which, to cure dis- eases, must produce similar ones—when, by the acknow • 20 ledo-ement of the author himself, nature never rcpro- duces any. Is it at all credible, that a grain of any given medica- ment, divided as much as the mind can conceive, and thrown into a pond of water, will produce a liquid of more Therapeutic activity, than if that same grain, less divided, was taken only in a few ounces of liquid ? Be- sides, why should the Homoeopathic art alone give to medicaments this excessive dilution, which constitutes all the virtue of the Homoeopathic remedies? as if the organism was incapable of retaining it in its less di- luted state, and of accomplishing the necessary dilution; or, as if alimentary and medicinal substances were not one thousand times more divided, more triturated, and more dissolved, when their molecules arrive at the or- gans, through the ducts in the animal economy, than when they come out of the mortars of Dr. Hahne- mann ? And, what will appear still more singular, is, that the new reformer, who attaches so much import- ance to the inalterability of the medicaments, has not perceived, that, by triturating some of the substances in the air, during so many hours, so many minutes, or so many seconds, decomposition actually takes place, which necessarily modifies their properties. If the German doctrine had rendered more justice to the dilutive force of nature, if it had better understood the essential laws of physiology, it would have taken less care and trouble in the preparing of its remedies, or at least, what it calls remedies—nor would they have been less sure in their application, or less efficacious in their The- rapeutic action. Let us add, that the simplciity, Ho- 21 mogeneousness, and purity of such of the Homoeopa- thic medicaments, as may have these advantages, would happily have taken the place of all those foolish combi- nations, and dissimilar medicaments, which are found too often among our pharmaceutic preparations. If it be true, that one disease, or one symptom never manifests itself twice in the same way, how can it be expected that the Homoeopathic remedies, even those most tried and confirmed, will effect a cure by trans- ferring a similar disease ? Would it not be, at least, a manifest contradiction ? The reader will, perhaps, still find it difficult to con- ceive how Hahnemann, after having long discussed and experimented upon chronic diseases, could arrive at this curious conclusion—that the itch is the only true, fun- damental, and productive cause of chronic diseases, and that the only remedies to be opposed to them arc the anti-psorics. As the reformer gives to the etiology of that class of diseases, an origin as ancient as the world—it seems difficult to examine into the fact; and even those, who believe him on his word, and take his assertions as well proved facts, must always remain in doubt, whether, after all the metamorphoses that the itch has undergone, through the thousands of generations, which separate us from the time of creation, it will still possess something psorical; and whether there is still identity of nature between hypochondria and the gravel; between megrims and cancer; rickets and piles ; epilepsy and the jaundice, &c. All the diseases that Hahnemann places on the same footing, and at- 22 tributes to the same cause, the itch—be pretends to cure with the same remedies, the anii-psorics. If it be true that certain medicaments will cure, by the result of the perturbation or irritation they cause in another part of the animal economy ; (and this doctrine does not belong to Homceopathia only, but to all who advocate the doctrine of counter irritants) it is not true; to say, as an exclusive and fundamental Therapeutic proposition—that the only curative properties of medi- caments are in their morbific action. It is, on the con- trary, certain, that there are medicaments, which have no active or positive medicinal properties, but which, nevertheless, perform cures, for instance : all anti-phlo- gistics, emollients, &c.; and, whatever the Homoeopathic doctrine may say, diseases can assuredly be cured, without creating more gravity than they intrinsically possess. It is very doubtful if any practitioner, in order to per- form a cure, would ever consider himself obliged to increase, even in the slightest degree, a pneumonia or inflammation of the lungs, an apoplexy, an asphyxy, &c. There is, besides, great difficulty in determining the precise dose of an Homoeopathic medicine, so as to adjust it exactly to the degree of intensity of the dis- ease ; and if an experience, as long as that of the author of the doctrine (about sixty years) be re- quired for that purpose ; it is doubtful whether any physi- cian would consent to such a sacrifice of time and labour, in making the requisite experiments. The diffi- culty is still greater, since diseases, remedies, and all in \ lomoeopathia, are specifics! and never, says Hahne- 23 mann, does a disease or a symptom present itself twice in the same way. By the same mode of reasoning, it will be difficult to conceive how Hahnemann could proceed, from the healthy, to the diseased, subject, in the application of his Homoeopathic remedies, when he himself recognizes that the condition or state of the healthy subject, differs en- tirely from that of the diseased subject. It may be supposed no easy matter, to be able to produce any given disease, with all its complications, and for this reason, the morbific action of remedies, acting exactly in the same way as the existing morbid state, may still more be doubted. However, Hahnemann answers this objection by facts, and it is astonishing to see the im- mense number of specifics that Homceopathia has already acquired, within the short time of its existence ! and, whatever may be the apparent childishness of the manipulations of those medications, we must in justice bear testimony to the admirable patience of its author ! The Homoeopathic doctrine will pass away like all universal and exclusive doctrines, and, like them, too, it will leave something worthy of remembrance, for among its errors will be found some useful truths, which, in time to come, will be justly appreciated. It will be found, that in the generalization of facts, some Therapeutic principles have been corroborated. While we cannot but admire the ingenuity of Hahne- man's work, and his indefatigable perseverance, we must also allow that there are, in some of the particu- lars of the facts, as well as in some of their rules of ap- plication, and particularly in the accurate and precise appreciation of many new medicaments, ample evi- 24 deuces of enlightened and instructing experiments, of which all existing doctrines will one day avail them- selves, in the practice of medicine. With respect to its errors, it is, as a science of Therapeutics, at least un- certain or doubtful, if it is, indeed, anything more than a mere desire to produce results. On this account, it has also its real dangers, which cannot be dissimulated—arising from its harmless- ness or innoxious qualities; because in acute affections, where existence is immediately compromised, it leaves little more to be done by the practitioner, than to receive the last sigh of his expiring patient. FINIS. = V\ I /Vi IOiW JO AHVIBIT IVNOIiVN JNIIIOIW JO AI V II I 11 IVNOIIVN 1NI3I03W iO A I V « • I 1 1VNOI IONAI LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL IIBRARY OF MEDIC lt ^^ I laiW dO AtVllll IVNOIIVN JNIDIOJW iO A»»»9I1 IVNOIIVN INOI03W 40 A IIV * t II 1VN0I /V?'- IONAL IIBRARY OF MEDICINE NATIONAL IIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDI I I 0 1 W iO 11*1111 IVNOIIVN 1NI3I01W IO A 1 V I « I 1 IVNOIIVN 3NI3I03W iO ABVIflll 1VN0 Cjaulord === SPEEDY BINDER 1 Syracuse, N. 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