Homoeopathy the Science of Therapeutics – C Dunham

Review by Dr Pooja

• Dr Carrol Dunham was born in New York on 29^th October 1828.  He graduated from Columbia University with Honour in 1847. He received M.D. at the college of Physicians and Surgeons of New York in the year 1850. While in Dublin, he received a dissecting wound that nearly killed him, but with the aid of homoeopathy he cured himself with Lachesis. He visited various homoeopathic hospitals in Europe and then went to Munster where he stayed with Dr. Boenninghausen and studied the methods of that great master. He was a voluminous writer. For 25 years, he regularly contributed articles. Among his works are – “Lectures on Materia Medica” and “Homoeopathy- science of Therapeutics”.  Under the stress of his large practice he developed rheumatic carditis. The old school specialists gave up but once again homoeopathy saved him. His friend Dr Hering prescribed Lithium carb which cured him. What made him a great teacher was that, like Hering, he truly understood the strict inductive method of Hahnemann. He studied under Hering and Boenninghausen. He said chief duty of Prescriber is to “base the treatment on facts, results of pure observation”. Dunham was one of the most brilliant homoeopaths ever. Later he organized “World Homoeopathic Convention” which had been his dream of many years. The convention was highly successful, but it exhausted him. He took to bed in Dec 1876 and passed away on Feb 18, 1877 in his 49^th year.

HOMOEOPATHY THE SCIENCE OF THERAPEUTICS

Therapeutics of science:

• Homoeopathy claims to be “the science of therapeutics”.
• First to discuss the nature & conditions of the only possible science of therapeutics.
• Second to examine the methods by which this science may be most successfully studied and made subservient to the practical art of medicine.
• Therapeutics being etymologically the science of curing disease. The medical man rely on his knowledge of pathology for representing the nature, cause, and probable termination of the disease.

1. Ex: a man who lies in an epileptiform convulsion, it is known that convulsions may arise from the most various proximate causes. They may result from physical irritation of nervous centers or of the extremities of nerve-filaments, in this case they cease to recur soon as the cause of irritation is removed Or from modifications of vital functions. May be mechanical or hygienic, latter it must be therapeutic.

If convulsion is eccentric in its origin and reflex in its nature, he sees reason for suspecting that it depends on some cause of irritation in a nerve-filament of lower extremity. From thorough history and physical examination physician discovered that patient had a history of gunshot wound in the thigh years ago, no evidence that ball was ever extracted, a close examination confirm the conjecture that it still lies imbedded in the muscle of thigh. An operation performed and ball actually found lying upon a branch of sciatic nerve, it is removed and the patient has no more convulsions.

In this case from beginning to end, Therapeutics was not called into play.

1. Ex: child of two and a half years, subject to epileptiform convulsions, which occur daily, often twice a day. First appeared when child was fourteen months old and soon after it was weaned.  Same question of proximate cause, which last case gave rise to the mind of physician. On careful investigation he came to know that there is a frequent repeated source of irritation in the digestive apparatus.                                                                              

    Question is put at once, “what food does your child take?” “Nothing except molasses cake and milk.” how do you make molasses cake?  “Three cups of flour, one of butter, one of milk, one of molasses, one egg and a tea-spoonful of pearlash!

–“very bad for your child! Give good wheat bread & milk & nothing else, except this powder” (placebo). The diet of child is reformed, but no medicine is administered and the case is carefully watched.  For 1 week spasms steadily decrease in frequency and in violence, at the end they cease and they never recur.

• An abnormal state is rectified by the application of knowledge of physiology, pathology and hygiene; but therapeutics has no part in it.  Error in diet treated successfully without recourse to medicine- without the aid of therapeutics.

3)  Ex: again a patient presents herself with a history of- within 3 months she has rapidly emaciated; her sleep is disturbed, appetite gone, has night sweat, prone to diarrhea, takes frequent deep inspiration which fatigue her, has a dry, hacking cough; complains of extreme weakness and despondency. Careful physical examination fails to discover organic disease or thoracic or abdominal organs.

— He discovers that the patient is nursing an infant of twelve month. She is suffering from anemia, it is ordered that she wean her babe at once, as soon as she does, appetite returns, cough & night sweat disappear, strength and flesh are restored.  So no administration of medicine could be an offset to drain which is exhausting the patient.

— In case of similar exhaustion, facial neuralgia of intermitting character, patient declining rapidly in strength and health, patient induced to wean her infant and thereby enabled to take hearty food, strength and flesh return, and neuralgic pain cease.

           –In this case also, restoration may be accelerated by a judicious recourse to therapeutics, but here too therapeutics must be subordinate to hygiene.

1. Ex: patient has severe darting and aching in shin, especially evening, with coldness of extremity, great sensibility to touch, relieved by warmth and continued motion. This case treated by variety of therapeutic agents in hands of several practitioners, but with no success. It is noticed that patient in course of his business, incurs great exposure to dampness and cold.                                                                                                                  —  a woolen stocking is advised, and he enjoys ever after adopting it almost complete freedom from suffering, and which is rendered absolutely complete by few doses of Rhustox.

• The thorough and extensive knowledge of physiology, pathology and hygiene are indispensable to the physician to enable him to make that preliminary analysis of case by which he will determine under what category the case belongs, and whether or not it calls for treatment by medicines in part or entirely – whether it comes under the domain of therapeutics or not.

The Nature & Limits of the sciences of Hygiene & Therapeutics:

• The living organism possesses a susceptibility to the action of certain general stimuli, such as light, heat, electricity, ailment, atmospheric air etc. The action and reaction of these stimuli and this susceptibility are the conditions of life. The absolute withdrawal of one of the stimuli for any considerable length of time results in death. A disturbance of their due proportion, in respect of intensity or quantity, produces an abnormal performance of function in the organism- deviation from health-disease.
• “Vis medicatrix natura”
• If stimuli remain disturbed for too long, than the functions of organism become permanently deranged, to such an extent that no restoration of balance of stimuli cause a return to their normal function.
• Disease has occurred, now disease has no tendency to revert to health without the intervention of some extraneous influence foreign to the organism.
• General stimuli will not bring back the organism to healthy action, new element must be sought. This new element will be a special stimulus, this constitute an empirical law, which will be the law or fundamental principle of Therapeutics.
• For the application of special stimuli to the diseased organism is the domain of science of Therapeutics, while all that concerns the restoration & maintenance of a proper equilibrium of general stimuli appertains to the science of Hygiene.
• A healthy man is exposed to an unusual degree of cold; there exists for him a deficit of heat. He is chilled and suffers from rigors etc.

After a time he seeks shelter, sits by a fire, takes a warm drinks; in other words, receives from external sources. His functions resume their normal play. He is in perfect health.

• The case was treated upon “general principles” in accordance with the maxim causa sublata tollitur effectus.  And this maxim represents, the great law of Hygiene, (it is ascertained what stimulus has been deficient or excessive in quantity or abnormal in quality, and that equilibrium of stimuli be restored).
• Same man again exposed to cold, perhaps to a greater degree. He seeks shelter and essays to restore the lost heat, but without avail. Despite the fire and warm drinks, the rigors continue and succeeded by fever and quickened respiration, cough etc., rheumatic pains, redness & swelling etc. Why this difference between the case? This case has been treated on “general principles”. The cause removed, why has not the effect ceased?
• The normal proportion of the general stimuli, it is true, has been restored, but during the disturbance a new element has been introduced into the problem. The wonted general stimuli under the laws of Hygiene being insufficient, new stimuli of a special character must be applied according to a new law. This new law is the Therapeutic law, and these new stimuli are Therapeutic agents, and the study of the law and of the agents constitutes the science of Therapeutics.
• The elements of science :

—He has to deal with a subject known by its phenomena- the sick body.

—With an agent known also by its phenomena- the drug.

—With a law which shall tell how to apply the agent to the subject for the accomplishment of a cure, – a law which shall express the general relation between the drug & the morbid organism.

• Therapeutics is in reality the most complex of all the natural sciences.
• Each class of phenomena requires for its study the aid of several auxiliary sciences.
• In order to know thoroughly the phenomena of disease, we must know anatomy, physiology, chemistry, physics and psychology.

The conditions of a Science of Therapeutics:

We consider two conditions to which every natural science must be subject.

• First is a capability of infinite progress in each of its elements without detriment to its integrity as a whole.

The science of Physics is capable of progress in the phenomena with which it deals. Our knowledge of these phenomena is continually growing more comprehensive and minuter, yet their relation to each other through the law of attraction remains the same.

The same is true of Chemistry.

Our means of investigation become more exact & extensive; our knowledge of properties of bodies’ increases; yet the law of chemical affinity remains undisturbed.

• Second condition of natural science, is prediction of future events within its own domain.

Condition is stated by Whewell: “men cannot help believing that the laws laid down by discoverers must be in a great measure identical with the real laws of nature, when discoverers determine same manner in which nature herself determines when occasion occurs. The prediction of results even of the same kind as those which have been observed, in new cases, is a proof of real success in our inductive processes”.

• This condition applies to all natural sciences, and of course to therapeutics.

The problem would be: given the Therapeutic law and a certain series of phenomena of natural or drug disease, to find the corresponding series of phenomena of drug or natural disease.

Does “Rational medicine” fulfill these conditions?

• The nature and these conditions and the tests of the only possible science of Therapeutics, we inquire whether the old school therapeutics are of this nature or will sustain these tests.
• Divide old-school therapeutics into two methods, the one bases the plan of cure upon a theory of nature of the disease, so as to study the pathology of the disease as to form a sound hypothesis of its modus operandi and then essays the cure upon “general principles”. We all see cases which present the pathognomonic symptoms plus certain others peculiar to the individual, but these vary with the individual, and thus make each case different from every other.

This fallacy was perceived and well exposed by Leipsic Professor who recently exclaimed to his class: “Gentlemen, we have to do with patients and not with diseases.”

• The second method of old-school therapeutics is the methodical, which discards theory and founds its rules for treating disease upon numerical data, obtained from observation or by experience upon the sick.
• M. Auguste Comte, one of the mathematicians, would disposed to apply mathematical methods to the natural sciences wherever this were possible.

Has “Rational medicine” accomplished nothing?

• A large number of men of every generation since Hippocrates, and among them some of biggest intellects have engaged in the study and practice of medicine, with no better result. But it is said that Therapeutics must have advanced in as much as the rates of mortality have steadily diminished.
• Simultaneously with the spread of Homoeopathy, old-school physicians began to learn to abstain from mischievous modes of treatment formerly pursued, and which terribly enhanced the natural fatality of disease.
• Professor Bennett, in the introduction to his work on clinical medicine, specifies apoplexy, pneumonia and pleurisy, syphilis, small pox, phthisis, bright’s disease, and favus diseases in treating which, he says, “great improvement have been made.” and he adduces this as a proof of the advancement of medicine.
• Ex: blood-letting in apoplexy, the immoderate use of mercury in syphilis, heroic medication and external warmth in small-pox, and avoidance of all internal medication for favus. This improvement is purely negative.
• The formula for improvement of all kinds is, “cease to do evil; learn to do well.” Old-school learning to obey the former, the negative clause. We invite them to advance and join us in the latter, the positive.
• As increased knowledge in this department of science has enabled us to dispense with therapeutic agents in many cases in which they were formerly resorted to, so we believe that, with the advancement of learning, hygiene will more and more curtail the boundaries of therapeutics.

Does Homoeopathy fulfil the conditions of a science of Therapeutics?

• Homoeopathy conforms to the model , it consist of a law or formula which expresses the relation between two series of phenomena,  case of disease on one hand and those of drug proving on other. It constitutes the Science of Therapeutics.
• The study of phenomena from external manifestations and subjective sensations.
• Expressed by the law Similia, Similibus, and Curantur.

How to study the Science of Therapeutics:

• The method of studying two series of phenomena together with the law of relation constitutes the science of therapeutics.
• The business of the physician is to ascertain what branch of medical science he is called upon to exercise. Is the case requires hygienic management or therapeutic or both or is the patient beyond the reach of art?
• To answer these questions a diagnosis and prognosis must be made. The case is to be individualized as sharply as possible and a complete picture of morbid phenomena obtained in their natural groups & connections. A morbid phenomenon is a deviation from healthy phenomena. We are able to get a complete picture of morbid symptoms only by an orderly & methodical investigations. Such a investigation is possible to those who are familiar with the relations & sequences of morbid phenomena- pathology.
• Physiology & pathology are quite indispensable to the physician, they speak with little thought who affirm that these sciences are of no value to the Homoeopathist. Pathology is for him not a guide in Therapeutics, but an instrument which he uses in studying those phenomena which are to be respectively the subject & the agents of his therapeutic operations.
• Through the Pathology he learns to know disease, but it is through Therapeutics alone that he can cure.
• Pneumonia, cholera, or Rheumatism – their pathology is well understood, yet this gives no clue to their therapeutic treatment.

The study of the Materia Medica:

• In accordance with the homoeopathic law, we select for the cure of each individual case of disease that remedy of which pathogenetic effects are most similar to the symptoms of the case.
• Our materia medica consists of the provings of drugs upon healthy made by Hahnemann and his disciples.

General analysis: Action on vital power, Action on the organic substance, The sphere of action of the remedy, Sensations, Periodicity, Peculiarities and Resume of the characteristics of the remedy.

Special analysis: Head, Eyes, Ears, Nose, Face, Lips, Gums & teeth, Mouth, Taste, Tongue, Throat & fauces, Esophagus, Stomach, Hypochondria, Abdomen, Stool, Anus & rectum, Urinary organs, Genital organs – male, Genital organs – female, Respiratory organs, Heart, Back, Upper extremities, Lower extremities, Sleep, Fever, Skin and Mind.

References:
Dunham C, Homoeopathy The Science of Therapeutics. Homoeopathy the science of therapeutics, 14^th Impression 2019, B Jain Publishers, Noida-201307, U.P.; 1-62.

Dr. Pooja
PG Scholar
Dept of Organon of Medicine & Homoeopathic Philosophy
GHMC&H Bangaluru