The Unity of Medicine by Stuart Close
“As our studies in medicine penetrate deeper into the problems of each individual branch or specialty one fact stands out with ever-increasing emphasis; namely, that medicine is a unit and incapable of real division into specialities. The superior man in medicine of as future will not be the great laboratory worker, or the man who is known for his studies in metabolism, or the expert gastro-enterologist or neurologist or surgeon, or he who stands preeminently above his confreres in his knowledge of disease of the heart and arterial system or of the lungs, *but the man who recognizes the fact that the truths derived from all these sources of study and investigation must be interpreted as belonging to the patient as a whole in other words, *the internist who appreciates the unity of medicine. The distinguished specialist will be one who regards his field of study in its intimate relationships to *the body as a whole.”
With these weighty words, Francis Marion Pottenger, A.M., M.D. LL. D. F.A.C.P, the most distinguished specialist in diseases of the chest in the United States, opens his great book entitled “Symptoms of Visceral Disease”.
Mistaken ideals, wrong theories, wrong practice, materialism, commercialism and selfish competition, as well as the great enlargement of the field of medicine in the advance of science, have led to overspecialization in the medical profession, the disappearance of the general practitioner and the springing up of numerous so-called “non-medical” cults and fads.
The Genius of Homoeopathy. – There are “57 different varieties” of specialists- one for almost every organ of the body, besides those who deal with many other subjects connected with medicine. In addition to the old-time allopathic, homoeopathic and eclectic schools (which are still with us) we now have the pharmico- physio-mechanico-electro-hydro-balneo-sero-vaccino and radio- therapeutic schools, not to mention the osteopaths, the chiropractors, the Christian Scientists and the mental psychic and spiritual healers, all of whom are “practicing medicine” in the broad sense of the term.
There is an old saying: “It takes nine tailors to make a man” Now we might say: “It takes nine specialists to make a physician, if it were not that nine would not be enough to make a good, all- around physician of the old school.
The people realize, in a blind sort of way, that they are getting from the medical profession a good many things they do not want, and are not getting some very important things which they need. The failure of the surgeon and organ specialists to do more than palliate or remove the tangible products of disease; the rise of the seductive serum and vaccine therapy and the reign of the reptilian derived hypodermic needle; the disappearance of the general practitioner with the system of medical education which made him, and the refusal of the profession to accept the beneficent law of therapeutic medication and its corollaries enunciated by Hahnemann, are the main reasons for the increase of quackery and humbug in the practice of medicine and the rise of non-medical cults. There is rebellion and revolution in the medical world as well as in all the other worlds.
Are we really any better off by all the elaborate specialization in medicine? In certain respects, perhaps, yes. In general, no A reasonable amount of specialization in medicine, as in other professions, is necessary and beneficial. Medicine, covers a very broad field. It is too great to be compassed by the activities of any individual, except in a broad way. The exigencies of the situation require that it should be divided into certain departments, any one of which is large enough to fully engage the time, talents and energy of one man.
But no man can successfully do the work of a department without recognizing the essential unity of medicine and the vital relation of his chosen department to every other department. Especially is this true of the internist the individual who devotes himself to curative medicine as distinguished from preventive medicine and surgery; and still more is it true of the pharmaco-therapeutist who relies mainly for his results upon the scientific use of drugs, as in the case of the homoeopathician, who is legitimately a specialist under the same rules as govern any other legitimate specialist.
The vital organic relation between all the departments of medicine must never be overlooked. The science of medicine exists only in order that the art of medicine may be made effectual in the prevention, ameliorated and cure of disease. The specialities in medicine are of little value in the treatment of disease unless they are correlated and directed in their application by the internist the general practitioner who views and treats every case as a whole. All the surgery, all the organ specializing, all the theorizing, laboratory research, classifying, naming and explaining of diseases amount to very little if it does not lead to the cure of the patient.
Now cure relates to the case as a whole, not merely to a part or an organ. A human being is something more than a miscellaneous assortment of eyes, ears, nose, throat, lungs, etc. organs which the ordinary specialists, if left to themselves, usually treat as if they were independent of each other. They are only parts of a very intricate machine the most intricate machine in the world. They are assembled according to a wonderful plan made by the Designer of The Universe for the purpose of utilizing the divine power of life. Life the motive power, flows through them all and unites them into an organic whole. Each part depends upon every other part, and all act together as one, in health or disease. All diseases originate as a disturbance of the life principle. No organ can become diseased without a preceding disturbance of the life principle in which all the other organs participate.
The cure of disease takes place in the same way. The curative remedy, through the media of the nerves and blood vessels, acts first upon the life principle everywhere present in the organism, and then upon the affected parts, in a perfectly natural manner. It is only necessary that the remedy shall be correctly selected, properly prepared and administered by the natural channels in appropriate dosage in order to get its curative effects. No hypodermic needle is required. One who knows how to do these things never makes the mistake of treating a part as if it stood alone. Before his mental eye is always pictured the individual patient-the case as a whole.
It is a characteristic of homoeopathy that all of its practical processes are governed by the principle of individualization. In its drug provings; its study of the materia medica complied from those provings; its examination of a patient and study of a case; its selection of the remedy and its conduct of whatever auxiliary treatment is required, it seeks always to individualize.
*Homoeopathy recognizes the individuality of each drug and substance in nature. Its method of testing or “proving” drugs upon the healthy is designed and used for the express purpose of bringing out the symptomatic individuality of each drug so that its full powers and relations may be established. There are no “sucodanae” in the homoeopathic materia medica. A given drug is symptomatically indicated in a case or it is not. There are no substitutes for the conscientious prescriber. Symptomatic comparison between similar drugs i instituted and carried on until one (the one bearing the closet symptom-similarity to the case) stands clearly out as the indicated remedy.
*Homoeopathy recognizes the individuality of each patient or case. The entire examination of a patient is conducted with a view to discovering not only the general or common features of the case by which it may be classified diagnostically and pathologically, but the special and particular symptoms which differentiate the case from other of the same general class. It recognizes the fact that no two cases or patients, even which the same disease, are exactly alike and maintains that a true science of therapeutics must enable the practitioner to recognize these differences and find the needed remedy for each individual. In actual practice the “differences” are very often the deciding factor in the choice of the remedy. To use a frequently quoted epigram; “Homoeopathy does not treat disease. It treats patient” In one word, it individualizes. It may be added that homeopathy is the only method by which the prescriber is able to thus individualize his medication.
In the auxiliary treatment the same principle is applied as far as possible. In dietetics, for example, instead of laying down rigid rules and making up a diet list composed of articles selected solely for their supposed chemical or physiological relation to the case, the patient’s idiosyncrasies, his likes and dislikes, his aggravations and ameliorations, as revealed by his symptoms are considered and allowed for. Nature as thus revealed in the patient’s temperament, constitution and clinical history is consulted.
This is not to say that theoretical considerations are of no use or value, but simply that theory is to be checked up and modified by facts as revealed in the individual. That a patient ought to take or avoid a certain article of food does not always mean that he can do so. Frequently he can not do so. Knowledge of homoeopathic principles and methods thus enables the practitioner to make these individual adjustments and modifications intelligently and overcome obstacles otherwise insurmountable.
The question of individual susceptibility to medicinal action must be considered. Susceptibility to medicinal influence varies in different individuals according to time and circumstances, as well as to different drugs. In health one may be susceptible to the action of a medicine at one time and under certain circumstances and not at other times and under other circumstances. Moreover, one may be constitutionally susceptible to only a few medicines. In sickness, susceptibility to the symptomatically similar potentiated medicine is greatly increased, but in that case the action is curative, although new symptoms (proving) may arise if the potency be not suitable or too many doses be taken.
Age, sex, temperament and constitution; occupation, habits, climate, season, weather; the nature, type, extent and stage of the disease everything, in fact, which modifies the psychological, physiological, or pathological status of the individual patient modifies, at the same time, the susceptibility to medicine, increasing or decreasing it, in health and disease. All these modifying factors must be observed, considered, weighed and their influence estimated in conducting a proving, or treating a case. One will react only to a high potency, another only to a medium potency or still another only to a low potency or tangible doses of the crude drug.
In practice the whole scale of potencies from the lowest to the highest is open to the homoeopathic physician. He defines his power and sphere of influence over health and disease largely by the number of differing potencies he possesses and the skill with which he uses them.
Success in homoeopathic treatment largely depends, therefore, upon the ability to correctly measure the individual patient’s degree of susceptibility to medication and select the most appropriate potency.
Therapeutic Nihilism. – Although it has spread to all parts of the civilized world, numbering its practitioners by thousands and its patients by millions, homoeopathy has never found open and general acceptance in the medical profession. Occasional conversions of individuals from the ranks of the dominant school have apparently made little impression on the profession as whole, but the influence of Hahnemannian principles is increasingly perceptible as time goes on. By long, tedious, circuitous routes medical science appears to be approaching the goal attained over a century ago by Hahnemann.
It is only another illustration of the fact that poets, prophets and philosophers often perceive great truths and announce them to the world long before slow-moving scientists succeed in proving them to their own satisfaction.
Intuition, the highest faculty of the human mind, wings its aerial way home, while research and investigation laboriously plod their way along upon the ground.
The main subjects of controversy in the past have been:
1. The idea of a general principle of curative medication; 2, the doctrine of potentiation and the minimum dose; 3, proving medicines on the healthy, and 4 the single remedy.
Refusing to submit these questions to the test of competent, systematic investigation and experimentation, and baffled in their own efforts to find a successful way of treating the sick by medication, leaders of the dominant school have practically abandoned drugs, and now rely mainly upon surgery and hygienic methods, supplemented more recently;by the use of sera and vaccines.
In pathology and physiology there has been a gradual breaking away from the tyranny of authority that has so long held the medical profession in its grip. But in pharmaco-therapy this nihilistic tendency has carried them almost to the point of complete negation.
Osler, writing in 1901, said: “He is the best physician who knows the worthlessness of most medicine”.
Barker, his successor at Johns Hopkins, says; “The death-blow came first to polypharmacy. To-day with many, pharmaco-therapy as a whole is almost moribund”.
Billings in his address as president of the American Medical Association, says; “Drugs, with the exception of quinine in malaria, and mercury in syphilis, are valueless as cures”.
Musser, of Philadelphia, two years later, from the same chair said; “One sees less and less of the use of drugs.”
Cabot, of Harvard, in his notable address before the Boston Homoeopathic Medical Society, said “I doubt if you gentlemen realize how large a proportion of our patients are treated without any drugs at all, and how little faith we have to-day in the curative power of drugs”.
These extracts indicate the extremity to which some keen observers, clear thinkers and honest men of the dominant school have been drive, in the absence of a general principle of therapeutic medication. In the meantime the rank and file have gone on stolidly in the same old course of pernicious drugging.
Blinded by professional pride and prejudice, the dominant school as a whole has bitterly antagonized or ignored the principle enunciated by Hahnemann a century ago and demonstrated by him and his successors continuously ever since.
In no profession, perhaps, has there been so little open- mindedness, so little of the impersonal, so little of the true scientific spirit, as in medicine. Few indeed have there been in either school who could rise above the petty personal and professional jealousies which have hampered them into the freedom of the higher, impersonal realm of pure science. The controversial rather than the scientific spirit has ruled to largely on both sides.
In one respect at least the leaders of the old school are in perfect accord with the followers of Hahnemann who have always maintained that the use of drugs in the treatment of disease, except in minimum doses and in accordance with the law of similars, is both useless and injurious.
One of the first and most important truths taught to homoeopathic students is that drugs, in crude from and ordinary so-called physiological doses, have the power to make even well people sick. It is demonstrated by the pathogenetic record of every drug in our materia medica. How much more injurious drugs are to sick persons, with their lower power of resistance and increased irritability, might easily be inferred theoretically if the comparative mortality rates did not continually furnish proof of their deadly influence and make such inferences superfluous.
There have been signs of a beginning change of base in the ranks of the dominants school of medicine within the last few years. Among others, the wide acceptance and practice of serum and vaccine-therapy and the hospitality of many of its advocates to the suggestion that the underlying principle of this form of treatment is analogous to if indeed it be not in fact the homoeopathic principle, tends to show a more tolerant spirit toward the idea of a general therapeutic principle governing the curative action of all drugs in all diseases by medication.
General medicine has made great advances since the days of Hahnemann; notably in the sciences of biology, physiology, pathology and bacteriology. Research and discovery in these fields have revealed facts which not only tend to confirm, but to elucidate the essential principles of homoeopathy. This has not escaped the notice of certain of the leaders in the dominant school of medicine, although for obvious reasons they prefer not to enlarge upon it publicly. Having made and announced an important discovery in medical science, it is not flattering to one’s vanity to be shown that in all essential points the same discovery was made announced and put to use in the better way more than a century ago, by one who has been held up to obloquy and scorn by a large part of the profession ever since.
Modern biological science has confirmed homoeopathists anew in their belief that in homoeopathy they have not only the basic law of therapeutic medication, but also of all tissue reaction. Study of the reactions of protoplasm to stimuli (Chemical, electrical and mechanical) has led to the formulation of the biological law now universally accepted viz; *”The same agent which in relatively large quantities damages or destroys activity, will in relatively small quantities stimulate it”.
This is substantially a statement of the well-known law upon which homoeopathy is based. It establishes a firm foundation for a practical system of a therapeutic medication formulated by the methods of pure experimental science. It leads naturally and logically to systematic experimentation with drugs upon healthy, living subjects to determine their natural tissue relations and organic affinities and the kind of reactions their administration arouses.
Reactions in the living subject manifest themselves in perceptible functional and tissue changes which, in the case of human beings, may be felt and intelligently observed, described, measured and recorded. In medical parlance, reactions are expressed by symptoms, subjectively and objectively. Under this principle and by this method have our homoeopathic provings been conducted, and from these provings our materia medica is constructed.
Tests, of course, are conducted with doses only sufficient to arouse characteristic reactions without endangering or destroying, life since to do otherwise would defeat the end in view.
Knowing experimentally the damaging or pathogenetic effects of relatively large doses of a drug upon the healthy living subject; knowing also that relatively small doses of the same drug exercise a more moderate and stimulating effect, the next logical step is to determine the natural relation between drugs and disease.
Systemic reactions to pathogenetic agents of every kind, tangible or intangible, are observed and studied by the physician in the light of this principle in the same manner as the reactions of protoplasm to drugs and other stimuli are studied by the biologist; for the physician is essentially a biologist, as medicine is fundamentally a biological science.
Systemic reactions to morbific influences, pathogenic organisms and drugs alike are all manifested by perceptible phenomena or symptoms. In fact, the student of the comparative symptomatology of drugs and diseases needs not to progress very far to realize that it is impossible to draw any sharp line of demarcation between them. All diseases are produced by morbific agencies or poisons of some kind, primarily or secondarily generated and the symptoms of disease are precisely similar to the symptoms of drugs. It is not illogical to deduce that the direct. causative agents are similar if not identical, and that the differences in effects are due to differences in the size and quantity of the doses, the morphological peculiarities of the subjects and different conditions.
Modern medicine in its use of the sera and vaccines, in demonstrating the identity, or at least the similarity, of disease-producing and disease-curing agents, and in so doing is demonstrating the homoeopathic principle.
The biological law under discussion brings again to the front, as of fundamental importance, the old, old subject of The Dose, which has received so much discussion in the past. Perhaps from this time on the discussion can be carried on without bigotry, acrimony or prejudice to a point where the two schools of medicine can arrive at some amicable understanding based upon the acceptance of a general principle of therapeutic medication.
Medical Sociolists – The homoeopathic medical profession would have been spared a large part of the tiresome and unprofitable discussions which have wasted time, paper and printer’s ink in the past if would-be critics, before entering the literary field, had at least informed themselves correctly of the derivation and meaning of certain terms used by those whom they attacked. Misunderstanding or misusing a word, they attached an arbitrary or imaginary meaning to it and proceeded to belabor their “man of straw.”
In reviewing the controversial literature of homoeopathy it is surprising to find so large a part of it thus initiated. Much of it could never have been written by men who had even “a speaking acquaintance” with sciences other than the one they professed to represent.
Men who thoroughly understand a subject rarely misunderstand each other. They have been over the same course and learned the same language. They know the groundwork and essentials of their common art or science, and they also know something of its relations with the other branches of art and science.
All true science are interrelated. They touch one another at many points. Each is dependent upon the others in many respects. They often “Exchange works” as well as words.
Entrance upon the profession of medicine has, until recent years, been so easy and unrestricted, that a large proportion of its matriculants had not even the equivalent of a modern grammar school education. With little or none of the cultural and still less of the scientific training which goes into the make-up of a well educated man, they have been permitted to take a course in medicine and enter upon its practice. Innate ability, a studious disposition and hard work have enabled some of these men to make up for their pre-medical shortcomings and earn high honors; but the majority have been medical misfits, without whom the profession and the public would have been better off.
So long as such men confined their attention strictly to the practice of medicine, according to their lights, much could be forgiven. But when they invaded the literary field and began to write of matters of which they knew little or nothing, and even to set themselves up as critics of men who did know patience ceased to be a virtue. In pillorizing the culprits, the editors of magazines and society Transactions who admitted such trash to their pages should not be overlooked. Verily they have much to answer for!
A striking example of the misunderstanding and misuse of words is found in the voluminous and for a long time seemingly endless discussion centered around the word “spiritual” used by Hahnemann in paragraph 9 of the Organon, which reads as follow: “In the healthy condition of man, the *spiritual vital force (autocracy), the dynamis that animates the material body (organism) rules with unbounded sway, and retains all the parts of both sensations and functions, so that our in-dwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purposes of our existence”.
Failing to see that Hahnemann had permissibly used the word “spiritual” as the antithesis of the words “material” or “tangible” the would-be critics swooped down upon it like a hawk upon a chicken, fastened their talons in it and proceeded to make the feathers fly. Unfamiliar also with the word “dynamis” and ignorant of its derivation and meaning, they turned their imagination loose and assumed that Hahnemann was referring to some mystical, “spiritualistic” sort of a thing which to their half-educated and crudely materialistic minds had no existence. Much ridicule and cheap wit, as well as invective, were wasted upon Hahnemann and homoeopathy.
Had they taken pains to refer to any good dictionary they might have learned that dynamis is a Greek noun meaning power or force; the power or principle *objectively considered, applied by Hahnemann to the life principle.
By the use of that word and its adjectives, dynamic and dynamical (of or pertaining to forces not in equilibrium; pertaining to motion as the result of force: opposed to static) Hahnemann introduces us into the realm of Dynamics, the science which treats of the motion of bodies and action of forces in producing or changing their motion. In medicine dynamical commonly refers to functional as opposed to organic disease. Hahnemann thus opened the way for bringing homoeopathy under mathematical laws, creating the Science of Homoeopathics and giving it its rightful place in the “Circle of the Sciences”.