ON MATERIA MEDICA CONSIDERED AS ONE OF THE NATURAL SCIENCES
A few questions – with the answers
C. HERING, M.D.,
(RESONANCE, Vol. 19, 6/1997)
The first question is: Is it possible to derive a science of Materia Medica from nature?
The best answer to this question undoubtedly would be to develop the fundamental principle of such a science even if it were only empirically done in the first instance. But since the labors preparatory to this step have only been begun in our own times, such an attempt could be easily made to serve as evidence on the other side. The next best answer is the demonstration of the possibility of such a science, and the pointing out of the ways and means to that end. To do this we shall temporarily assume the possibility, following in this course of the mathematicians in the solution of their problems who often take for granted the possibility of the points to be proved, and then either proceed to the demonstration, or show that it is impossible. Let us once and for all represent the whole scattered, present and future resources of knowledge out of which our science is to be constructed by S, and its development into a scientific form by the raising of S to the powers n, m,o, p, q, and out provisional answer resolves itself into this, that Sn is possible, and consequently all the further developments also.
The second question is: What is the proper material for such a science? or, Of what elements is S composed? What facts may be admitted into this great mass of knowledge, and what the most general expression of its speciallity?
The answer to this question is: Effects upon the living. By the living, which we desire once and for all to designate by O, we understand men, animals, and plants, leaving the physiologists to settle their own disputes in the matter, it being enough for us that every one knows what we mean by the term.
Any change in O which can be referred to a special cause, either remote or immediate, we call an effect. As we only know O by its phenomena, we designate any change in these phenomena roduced by an effective cause s, and thus S becomes the infinite sum of s. Effects, however, are so manifold that the science of Materia Medica falls necessarily into divisions. And hence arises the third question:
How, i.e., on what principles shall this division be made? This important question we shall consider subsequently.
From the answer to this question, it will result that the experience and laws of one division find other applications; we shall, therefore, to hasten our progress, confine our remarks to the province of substantial causes.
Substance is everything in the world which in any respect belongs to the domain of Chemistry: we willingly leave the chemists to settle the matter. We designate generally by M, any substance either simple or compound, so far as Chemistry can present them to us or as we find them in Nature.
We convince ourselves, then, provisionally to M and its effects, s. It will be readily perceived that we have nothing to do with any substance which has no effect upon O. We have no concern with the substance itself as such, but solely with its operation upon O. In like manner, we are equally indifferent to the phenomena produced by its action upon dead matter except so far as we find and can demonstrate a parallelism of effect.
There are, however, three sorts of effect which manifest themselves in more or less immediate connection and must be exactly discriminated from first to last.
I. M may be a vital condition of O; that is, the state and character of O may be determined by and dependent upon M, so that without this latter, O can never be developed in perfection. In such a case, S is classed as one of the effects which we call regular, normal or healthy phenomena of existence in O. These phenomena are not easy of determination, but are still accessible to experiment, and therefore susceptible of demonstration, and it is the province of Physiology to ascertain how far one or the other is a condition of this or that symptom, and so, a condition of the entire life. Physiology, therefore, regards it from the point of normal life, but we have to consider every effect of every M as such. This is a wide and essential difference. Since we must distinguish these effects, we will designate them as os.
II. M may be the cause of effects which depart more or less widely from those belonging to healthy existence – symptoms from which we conclude that there is a disturbance of the normal life – s may be morbid phenomena. These are the easiest to seize, the simples to investigate and determine, and are of the greatest importance. We designate them by ps.
III. M may also operate upon O so that the abnormal phenomena ps already present may be caused to disappear, or may be moderated in intensity. These effects we designed by qs. They are far more difficult of ascertainment. They are called curative effects, because if M so operates upon diseased O that the morbid s vanish, health returns. This effect of M upon O is called a cure, although when any M is capable of producing morbid effects, it can only operate in that way, and a cure is altogether a separate matter, and one that can only be arrived at under other influences and laws; as for example, in the cure of a wound. The same influences which operate upon a part from within continue in constant operation when the part is wounded, and it is the same influence and that alone, which cures.
These curative effects qs cannot be omitted in a scientific arrangement, nor should they be excluded, but we must guard ourselves beforehand from the dangerous error that the science of remedies, although called Materia Medica, has anything to do with curing. This is the business of the therapeutists, and with it we have no concern.
Is it childish to ask, what is then the use of all this knowledge? To what practical end does it look?
Every truth has an everlasting use, because it is immortal; science, therefore, is so far as it is truly such, i.e., truths in their natural relations or necessary connections must partake of the same qualities.
It is of no consequence to us what therapeutic use physicians can, may or will make of a science treating of the effects of substances; that is their business. It is evident, however, that it will be used somehow; but physicians have cured and do and will continue to cure without it. Many a thing is done, not scientifically, to be sure, but still effectually.
We must once and for all exclude also all theories, hypotheses, systems, or whatever else they may be called, that belong to the science of Therapeutics.
Our business is simply with effects; it matters nothing whether they are preservative or destructive, morbific or curative. The verification of any result which is to be considered as an effect, is a contribution to our stores, a grain of sand to our heap, although the therapeutist, whose sole object is to cure, may view it in a far different light and arrange it in an entirely different order.
As that part of our material which we have represented by qs is derived from Therapeutics, so ps brings us into connection with Pathology, and os with Physiology, while the determination of our M introduces us to Chemistry and the Natural Sciences. But when we have borrowed all we can use from the Arts and Sciences, there still remains a mass of matter which belongs to us quite independently as a peculiar science.
We may here take notice of a rooted prejudice which has been highly injurious, and may as well be removed once and for all. Every independent science has its own peculiar province within the limits of which it develops ad infinitum. All human knowledge is either finite or infinite; there are no bounds to investigation and discovery – no “thus far and no farther,” but simply self-restricted provinces in the infinite. Every science can make use of every other, but none is dependent on another, or it would resemble a parasite. It is true that the existence of any thing presupposes that of other things, but this does not interfere with independent existence. Thus, every true science must be developed without foreign aid, without any other foundation than that of its own self-proposed, independent experience. Let us make this a little clearer.
M is a substance which Chemistry has either determined or is to determine. If new, and of vegetable origin, Botany points to the plant from which it is derived; if animal, Zoology determines the species; if a morbid product, Pathology informs us of what disease. It is well when the substance is well defined, but if it were not so, if it were unknown and undescribed, it still remains the selfsame M, provided we can be sure of its identity; nay, even if we cannot be sure of this, except that in this latter case our future progress would be hindered. Many animal substances were long unrecognized, many vegetable substances are so to this day, many bodies are as yet insufficiently explored by Chemistry, though, we trust, ere long that this will be remedied. But we are not dependent upon this nor need we wait for it. So long as M="M" and produces the effect S upon O, we have no need of anything further. It is exactly so with os and Physiology, and it would be utter foly to wait. Wherever we recognize and establish the effect of any M as one pertaining to the vital phenomena, that is our province; let the physiologists then see to it in reckoning up the sum of vitality.
Whatever effects have been already recognized by the physiologists, we receive and appropriate as a matter of course; or whatever discoveries have been made by them in our own province, these we also accept; if these be nothing, we march on by ourselves. In short, the dependence of one science upon another is always purely apparent, even in those cases in which we have been accustomed to consider it as necessary, for it is always reciprocal. Every other science may become just as dependent upon ours, the moment we really have one. We shall soon see that the science of Pathogenetics will shed light upon the chemist, still more upon the physiologist, and most of all, upon the pathologist, not to speak of the therapeutist.
We must speak a little more at length, however, about the pathologist. Whenever the influence of any M upon any O is manifested by the phenomena ps, these latter are always morbid, even though they be insignificant in amount; as they become more important, they approach the character of diseases, become more similar to them, and like them may end in death. Here we are upon common ground with the pathologist.
It is the business of the pathologist to arrange in scientific groups the infinite varieties of morbid phenomena, and to collect these groups into a whole according to their causes, conditions, circumstances, and results. Disease is what can be thus represented in a collective picture. The more developed becomes the science of Pathology, the more completely do the old symptomatic titles, such as Headache, Bellyache, Diarrhea and Constipation, disappear, however popular they may have been among the therapeutists, by whom they were considered as “practical.” The great discoveries of modern times have effected a great revolution in the old Pathology, and must result in its entire destruction.
The utter ruin of all the old teachings was easily predictable from an inspection of the momentous point when Pathology begun to struggle for a place among the Natural Sciences. Until then the whole thing had been purely empirical in spite of all their “splendid theories.” Facts of the most diverse significance and value were bundled together in the shape of a Manual of Pathology, or Materia Medica, which were nothing more that the merest heaps of material, destitute of order, where, after all their labor, chaff, wheat, and dirt, are inextricably mixed together.
Science, like men, should ever go hand in hand, but it is to be remembered that to be subordinate is to be poor and dependent; when Pathology ceased to consider herself dependent, she became separate and assumed rank as a science by herself.
We will here notice some points of contact between Pathology and Materia Medica. The older pathologists had their delirium tremens and their lead-colic, then their hydrargyrosis, etc. SCHONLEIN, aiming at consistency, admitted into his general and species, metallic Rheumatism, China-rheumatism, Chamomilla-rheumatism, Valeriean-rheumatism, and so on, introducing necessarily, if carried out, as many different species as there are substances capable of exciting pains, similar to those of rheumatism. Had he chosen to carry this frippery into the department of cutaneous eruptions, he might have established some ten thousand species, for at least as many substances excite an eruption on the skin, and each different from the other. The different species of Rhus, indeed, may be distinguished by the different eruptions they produce; but what of that? We should see springing up on every side in Pathology, great, unsightly fungi, and instead of an infinite development, we should have the endless growth of a monster.
Pathology has, however, already shaken this off to some extent. Whatever does not tend directly to its development is false; whatever leads to an absurdity is itself absurd, and must be rejected with as much rigor, when it can be shown with as much exactitude as in mathematics.
It is nothing to the pathologist that the practical therapeutist finds it convenient to have his lead-colic, Iodine-atrophy, and Phosphorus-necrosis treated in the same manual; each one stands on his own bottom and takes care of his own interest. It is the same between us and the therapeutists; if they can use our materials, they are welcome; if not, they may let them alone; their office is different from ours, their ways are not as our ways.
It may be asked what will become of lead-colic, mercurial, and other cachexies, if Pathology does not treat them. The therapeutist may do what he likes, but the whole of this matter falls within the province of Materia Medica as the effect of M upon O, in a most special and essential manner.
Let us compare the aims of Pathology and Pharmacology, beginning with isolated phenomena and symptoms. At first sight it would seem as if our ps represented the same thing as the symptoms of the pathologist. We will, for the present, admit this, though not unconditionally, and say that the totality of the morbid phenomena is common to both, but the method of treating them is not only different in each, but wholly opposite.
The pathologist arranges them in groups according to their contemporaneity, sequence or casual relationship. Observing groups of symptoms, and arranging them according to their order, he is able to conclude from the visible to the invisible, from the audible to the inaudible, from that which is to that which will be.
This conclusion is the test of his laws; the laws of groups and their sequences is his highest aim. Whenver he can so far master a subject as that, he can with certainty conclude from the known to the unknown, he sets it down as a scientific fact. Let us call this N. since now in every affection of an individual O, many causes and antecedents had a share before a regular N takes place, i.e., a disease having a regular course independent of its cause, except in cases of contagion. Where the vital alteration in one causes a similar or related alteration in another, though even in these cases many causes conduce to this effect, we will call these “Synnosen,” and indicate them by N.
We must remember here that these “Synnosen” of the pathologists are not real existencies; reality presents us only with a patient, Peter or Paul; they are intellectuial pictures, abstract ideas, and consequently not real, though they are true when they occur. This is so often forgotten that it cannot be too often repeated.
Our course in Materia Medica is altogether different when we would attain generalities. Here we have to deal with a single M as the conditional cause of various S, and here we meet with difficulty in distinguishing what are the pure effects of M upon the many, and exceedingly varied O, which are at the same time continually subject to many other contemporaneous influences.
In this case, too, we have to separate one from many, but in a very different way. The unit M is given, and out of the various effects of this unit upon many objects, we have to determine its unity as a cause. We have also to watch this M in its workings on very many O, and when it presents to us a constantly changing panorama of effects, we must in them find the unity and sequence of law. Such pictures we will call “Paranosen,” and designate them by (pi) N.
We have already considered Aetiology as a Science, if it can be so styled, in so far as it has the same range as these effects, but in so far as it presupposes a Pathology, we have nothing to do with it, for we assume nothing but what we mentioned in the beginning.
The problem for us then is to raise S to Sn, so that the s of every M shows the form (pi) N, that is, we have to produce characteristic drug portraits, and show scientifically their relations.
The next question will be: whence shall we derive our S, how arrange it, how view and shape it? In general, what method shall we follow? We reserve a circumstantial and satisfactory answer to all these questions; let us first add a few preliminaries; first principles must be agreed upon or no progress can be made.
Principle A: From our literature, from the writings of ancient and modern authors, cases of poisoning, and of cure, and everything possible, whether communicated on account of its relation to Toxicology or Therapeutics; all together, the good and the bad, the true and the false.
We lay down as a fundamental principle, which opens a new era for science, that nothing should be taken as true unless it is satisfactorily proved so; on the other hand, nothing shall be considered as false, unless satisfactorily shown to be so. What is just on the one side is just on the other. Science has received far more determent from the over zealous rejection of what was accounted fasle, than from the too hasty reception of what was considered true. Falsehood is to be rejected, and doubtless it abounds on every hand, but the question is, how to discern it.
The great majority of observations and relations can only be regarded as having a greater or less degree of probability. Errors are unavoidable; so much is certain; but it is a great weakness to be frightened of them when we know that to err is human, and that it must happen every day.
I have already given the following advice, but repeat it here. In Saxony, in Surinam, and in Pennsylvania, I have at various times cultivated a garden on a spot which had been previously wild. Besides culinary vegetables and medicinal plants, I also studied a little Botany, and sometimes enjoyed the most agreeable surprises when I adhered strictly to the rule never to destroy any weed except I knew what it was; what I did not recognize I suffered to grow, and even cultivated assiduously until it could answer the questions who, how, what are you?
Why should we not pursue the same course in Literature? It will often be found that the greatest folly is in the highest favor, and then all criticism is only thrown away, or even injures the truth; let the thing grow until it can be seen what it is, when it can be rightfully and authoritatively rejected.
Truth has a remarkable and peculiar power when it is protected and cherished; it waxes great even though it be surrounded by errors; it will sooner or later unfailingly vindicate its claims to reception. But falsehood also challenges reception; let us have patience then, and suffer it to develop; it will shape itself into such a caricature that existence will no longer be possible. Every falsehood dies by its own hands. Therefore let us go on, only collecting materials enough, and by-and-by we shall find out how to dispose of them.
If we have principles upon which we can determine the truth or probability of any fact, let us apply them, but we must first have the material collected. By the same principles we may reject the false and improbable. While in some of these judgments the majority will be unanimous, it is not to be expected that such will always be the case in every instance, and on this account, too, must we have a collection of material as complete as possible, and apart from hasty and one-sided criticism. In such a collection, therefore, completeness and comprehensiveness are the greatest desiderata.
FRANK’s Magazine, for example, is an excellent compilation. No one can conceive the intolerable labor of such a task, unless he has himself undertaken a similar one. The exceedingly cautious editor has inserted many things which seem to be destitute of utility; others will be of the same opinion in respect to entirely different articles, but no one need be so silly as to feel hard about it. He has, however, omitted the alleged poisonings by merculius lacrymans in Hufeland’s Journal, Vol. 62, 6, 3, and this omission has pronounced a judgment which cuts off all future investigation. This we have no right to do until authorized to do so by a decisive course of experiments; the cases should, therefore, have been admitted.
I have insisted upon this, because the future construction of a Materia Medica involves these principles. When the miner brings his ores to the surface, he can generally recognize what is of value, but many a ton has found its place among the refuse which subsequent generations have larned to appreciate and which they would have forever lost, had their forefathers known how to destroy it altogether.
We know at any rate but little; we are just beginning to know something; we are but little fit, then, for judges. Our duty is to collect, and after that to endeavor to ascertain what should be rejected. And it cannot be too often repeated, that to reject without cause is far more injurious than to receive.
Principle B: When we have exhausted literature, we shall find another source of information in our daily observation. Every physician and amateur philosopher should note everything that happens, record it while it is still new and fresh, and among the mass may be found that which will become trees wherein the birds of heaven may build their nests.
A painter in Sepia, for instance, was sick, and HAHNEMANN, who was disappointed in the effects of his remedies, conjectured that Sepia was the difficulty in the way; he accordingly proved it, though it had till then been considered as an absolutely inert substance, and with what extraordinary results we well know.
WEINHOLD noticed that the workmen in a glass factory rubbed the scrapings of a lead pencil upon their eruptions. He mentioned the fact, and HAHNEMANN proved Graphites.
A theological student, a friend of HAHNEMANN, was playing with a branch of arbor vitae without knowing what it was; he mentioned afterwards that he had subsequently noticed warts upon the glans penis. HAHNEMANN proved Thuja, which became an inexhaustible remedy, ever bringing forth something new. BRAUNS found that it would cure the grease, and BOENNINGHAUSEN, reasoning apparently from the eruptive power, that it would cure Variola.
ENGELHARDT and NEUMANN’S cases show conclusively that HAHNEMANN, in his account of the pathogenetic effects of common salt, which had been hitherto rejected as destitute of authority, was the same mastermind as elsewhere.
Principle C: A third, and by far the most important field of all for our cultivation, is that of methodical experimentation upon the living.
I. Experiments on plants are not destitute of value, especially as respects general principles, but they teach us nothing especial.
II. Experiments on animals instituted with an acquaintance with the animal, and conducted with patience through numbers of various species, may be of much use, but not otherwise. Most of those which have been hitherto made, have been admirably clumsy. Many of the experimenters did not even know the animals. Most of them seem to have forgotten that as it takes time for plants and animals to grow, so it requires a certain period for morbid changes and manifestations to take place. Most of the experiments seem to have been conducted as if one, anxious to ascertain whether pressure would cause corns, had screwed up an animal’s leg in a vice until it was mashed, and then reported that pressure, instead of producing indurations, made the parts soft! The principles upon which such experiments are to be conducted must yet be laid down and illustrated by examples.
III. Experiments on men are evidently the most important, and those upon the healthy of more value than those upon the sick. It would be worth while to accumulate what has been urged against this mode of experimenting for the last half century, but we have not now the time or opportunity., we can only refer to the most absurd objections:
2. A Dutchman to the honor of the doctors be it recorded, not a doctor, objects that the whole doctrine depends upon experiments made upon the healthy by themselves; the whole thing must fall to the ground then, according to him, for no one will be such a fool as to make himself sick in order that he may know how to cure others! This was said, anno domini 1830!
3. “There can be no experiments on the healthy, for there are none perfectly healthy.” And, therefore, there can be no mathematics, because no one can make a point that shall have no extension, nor draw a line that shall have no breadth. No one can drink water either, because rain water contains Nitric acid and Ammonia, besides Ozone, and nobody knows what else besides.
4. “Experiments upon the healthy are useless, because the sick are entirely different.” Experiments upon men as healthy as possible, upon men who go about their daily avocations without inconvenience, will produce, at any rate, different results from experiments in hospitals. It is plain that the problem is simply to determine whether M will produce any effect upon O, and if so, what; anything further does not concern us. Every s is definitively determined by the constitution of M, and the susceptibility of O. Whether the determination of this problem is of any service, and how to make it so, will then be seen.
Laying these intricacies on one side, let us take it for granted that when M produces effects on O, these phenomena may be noted with more or less probability, may be collected, compared, and examined, and thus the general be deduced from the particular. To express it generally: whenever M produces in the vital phenomena of O, certain changes, S, these may be made to assume the form (pi) N, and thus S be raised to Sn.
A host of new and mighty questions arises here, the most important of which relate to the method of making Provings. How shall the substances submitted to experiment be prepared, how used, in what quantity, how often, under what circumstances, how shall the results be recorded, and how collected? Finally, where are we to begin with such a collection, how arrange it, how make it convenient, etc.?
The most important question of all, however, is the inquiry into the method of constructing a science from such a confused mass of materials. Where, and how, out of this confusion shall we erect order? We have seen that the amount of materials already makes severe demands upon the most exemplary patience. In spite of the prophecies of the Dutch skeptic, the provings of drugs upon the healthy have so accumulated, occupy so much space, and threaten such an increase, that it is not to be wondered at that quiet people are terrified. But notwithstanding, the mass increases day by day, books swell into libraries, and no resistance can prevent the accumulation.
We must have fundamental principles, and if these are founded in truth, the whole mass can be arranged and controlled. Let him who cannot evolve order out of this confusion stand aside; let him who thinks he can do his best to that end; if he fails, and is laughed at, there is no harm done; if he succeeds, he becomes the interpreter of this chaos of voices and the herald of the truth that underlies this mountain of facts and contradictions.
(From The North American Journal of Homœopathy)