Discussion on the Classification of remedies. By Adolph Lippe, M.D.

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Discussion on the
Classification of remedies.
By Adolph Lippe, M.D.
Presented by Sylvain Cazalet

Dr David James

Dr. Frost :

The classification of remedies is a matter of far greater interest and
importance in the Allopathic than in the Homœopathic School ;
since classification has especial reference to generalization which
suits well enough with Allopathy, but which is entirely foreign to the
genius of Homœopathy. Perhaps the most useful method of classification
is that adopted in a clinical repertory, in which the remedies are
arrayed under many different heads. This classification of Homœopathic
remedies may be purely pathogenetic ; or the pathogenetic
indications may be confirmed by the results of clinical
experience ; such is the method adopted by Bœnninghausen. A method
which, while greatly facilitating the selection of the remedy in a
particular case, is far from being infallible, or entirely free from
objections.

Dr. J. C. Morgan :

I do not know in what part of Bœnninghausen’s Pocket Book is found the
classification of remedies referred to by Dr. Lippe.

Dr. H. N. Martin :

If I have understood Dr. Lippe correctly there is no arbitrary
classification of remedies possible. Every physician, if he be a
thoughtful man, must necessarily make a classification for himself. We
compare one remedy with another ; one group of symptoms of a drug
with those of another, for the purpose of assisting our memory. Thus
every physician makes his own classification, and there is probably no
two alike.

Dr. David James :

According to my impression about the classification proposed by Dr.
Lippe, it is to arrange remedies by key notes or by confirmed symptoms,
and that by these they are to be classified.

Dr H. N.
Guernsey

Dr.
H. N. Guernsey :

It is impossible to make a useful
classification of remedies except it be done after the method commenced
by Bœnninghausen. We examine a patient thoroughly ; get all the
symptoms of the case that are to be had, and then prescribe. If we have
selected a right remedy, and the patient gets well, it is all right. If,
however, the patient does not improve as we think he should do, or if,
while part of the symptoms improve or disappear, others remain unchanged
or become worse, we then know that we have not selected the exactly
right remedy. Now our first remedy was one of a class according to Bœnninghausen’s
method, and if we turn to the concordance and look under the head of
that remedy we will find what others are its nearest analogues by their
appearing in the largest type, and in all probability we will find among
these, the one that is exactly Homœopathic and that will of course
positively cure the totality of the symptoms. Take for instance, Causticum.
If we think, from the symptoms, Causticum
is indicated, and it fails us, we- look under that remedy for those in
the same class. We take those in the largest type first. Nine times out
of ten we will find the remedy we want to be one or the other of them.
If not, we must look at those in the next largest type and so on. I
reiterate that it is impossible to make any valuable arbitrary
classification.

Dr. J. C. Morgan :

I would again repeat the question I have asked Dr Lippe. I do not know
anything about classification in any of Bœnninghausen’s observations.
Dr. Okie’s translation of the German edition of the Pocket Book, there
is a part in which a remedy is divided under seven heads, and which Dr.
Okie considered of so little value that he has not translated it.

Comte Adolph
von LIPPE
(1812-1888)

Dr. Lippe :

Dr. Okie no doubt left this part out because he did not comprehend it.
If an allopathist examines our Materia Medica, he says the remedies are
all alike ; that each remedy has the same kind of symptoms ;
pains, diarrhœas, constipation, headaches, etc., and that it is
impossible to see any difference between one and another. This is not
the case. It only appears so to the Allopathist because he does not
comprehend it. Bœnninghausen’s book tells us which remedies have
certain symptoms or conditions in common. For instance. Aconite
produces certain mental symptoms and there are certain other remedies
that have mental symptoms similar to those of Aconite.
So with the symptoms which suggest Aconite
to us, but on looking into our Materia Medica we find that remedy has
not quite the whole condition. We then consult the remedies that are the
analogues of Aconite ; that have condition that are similar to
those of that drug. I have used Bœnninghausen’s concordance in this
manner for a number of years, and have found it to be a very great help.

Dr. J. C. Morgan :

I agree with Drs. Lippe and Guernsey as to the value of Bœnninghausen’s
concordance, and am glad of an opportunity to express my regret that Dr.
Okie had left it out. For a man who has some knowledge of our Materia
Medica, it is invaluable, but is however, useful only to this class. It
is valuable to the practitioner, but not to the student. The student
better comprehends a family analogy between drugs ; for instance,
between Belladonna and Stramonium.
In the whole family of the Solanaceæ there is a natural relationship
and analogy of action, and it is an advantage to the student and
beginner to know this. Their relationship being then known, it becomes
easy to learn their points of dissimilarity. There are a great many
symptoms of Belladonna and Hyoscyamus
that are alike, and it takes a very nice sense to discriminate between
them. They have in common the power to irritate the roots of the fifth
and eighth pairs of nerves, etc. They have an anatomical analogy as well
as a pathogenetic. We may locate the primitive action of a drug.

It may be confined to a
certain part or tissue, but its consecutive, secondary, sympathetic
action may be characteristically felt all over the body. Dr. Williamson
has alluded to the specific action of remedies on certain tissues, and
here is one plan for classification. Remedies may be classified upon an
anatomical basis. This would be a natural one therefore must necessarily
be true. We may say here are masses of remedies that are much
alike ; but it will not do to say we may therefore give them
indiscriminately. If we have them classified upon an anatomical basis it
will aid us greatly in choosing between them and finally selecting the
proper remedy by individualization.

Dr. Williamson :

I am happy that Dr. Lippe’s paper pointed in the right direction. A
classification of remedies is something that we all want. Suppose we had
had a good classification 35 years ago. How much valuable time would
have been saved ! The value of classification is not to be lightly
thrown aside. The old school has always attempted to classify. Diseases
are arranged into classes and orders, and it would take as much time to
learn the nosological arrangements of Cullen and Wood, as to learn the
whole Materia Medica. They have attempted to classify drugs according to
their primary action. This was very good for them, but would not do for
us. Homœopathists require something better ;; something that is
based on truth and not likely to change. We are very far from having
reached the ultimatum, and we should always be on the lockout for
something that may direct us to the better plan.

Drugs have also been
classified according to their chemical properties, and again into
natural families. Thirty five years ago, the best classification we
possessed was that which divided remedies into animal, vegetable and
mineral. The classification attempted by Bœnninghausen is far in
advance of that. It is more homœopathic, so to speak ; more
consistent with our method of thought. We have our drug symptoms, and
when we have discovered the symptoms of our patient we believe that if
we find the remedy that produces symptoms similar, and give it, we will
cure. Bœnninghausen classifies remedies according to their curative
actions. For instance, for a certain kind of headache we may note down
all the remedies that produce this same kind of headache. If it is
ameliorated or aggravated by certain conditions, we will note down that
also. The time of its accession will be another link. Thus several
remedies may have the kind of headache, a fewer number of conditions of
aggravation or amelioration, and perhaps only one the time of accession,
aggravation or amelioration. Classification is not to improve the
remedies, but to aid us in selecting the right one.

Dr. Morgan has referred
to classification by tissues. We may expect from a certain tissue a
certain kind of pain. A patient complains of pain in the head. There are
a variety of tissues in the head : nervous, osseous, muscular, etc.
We then ask -what kind of pain ? If we know what kind of pain each
tissue produces, we will know in which tissue the pain is located. The
remedy that will cure that kind of pain in the head, if it has no
symptoms of pain in the suspected tissue in the head, will be found to
have produced that kind of pain in the same tissue in some other part of
the body.

It is impossible to
teach the Materia Medica to students without having some method of
classification. When I taught I conjured up a method to suit myself. I
formed the remedies into groups, often having vegetable, animal and
mineral in the same group. My arrangement was somewhat as follows :
Aconite, for instance, was taken as
the head of a group, and the remedies that produced symptoms most nearly
analogues to those of Aconite, arrayed with it. Thus Pulsatilla
for some reasons, Bryonia for
others, were in the Aconite group.
The one was a type of class, and I dwelt most fully upon it. Then
followed the analogues, of which the points of difference from and
similarity to the type were shown. Often these had nothing in common as
natural families, or according to the pathological arrangements of the
old school, but they had always according to Homœopathic pathogenesis.
Our remedies must be classified, not according to the nosology of
disease, but according to the symptoms they produce in proving.

Dr J. Jeanes

Dr.
Jacob Jeanes :

In the diverse products of nature,
naturalists have found it necessary to resort to classification. We as
naturally seek after it for our Materia Medica ; but we may find it
already existing in every well-prepared repertorium. If we examine the
symptoms, “spots before the eyes” we find that such and such
remedies have it. Here already is a step to classification. Take now
other symptoms of your patient and see which of the remedies that have
spots before the eyes have the second symptoms also. You will find your
list of remedies is reduced -say one-half- already. Take a third symptom
in the same manner, and you are thus marking it down, closer and closer,
until finally, you come to only one that has all the symptoms of your
case. This is the method of classification that every physician may make
from a good Repertory. The division according to natural families would
not do. They differ too greatly. In the animal kingdom, in the natural
family canes we have the wild fierce, naturally untamed wolf, and the
house-dog whose natural condition is one of tameness ; and drugs of
the same natural family differ as widely.

The classification of
the Allopathic school is made on pathogenetic grounds, but when they
seek to bring it into actual practice it fails them. When I was a member
of an Allopathic Medical Society in Philadelphia, a good many years ago,
I once heard read an essay on tonics. A gentleman present -whose remarks
I then thought very foolish, but had since come to regard as very wise,-
said. “There is no such thing as a tonic, and there cannot be. If
it were so, there is nothing to prevent you or I, Mr. President, from
taking enough of it to give us such strength as would enable us to leap
from mountain top to mountain top.” Tonics, so called, act upon the
condition producing debility, and thus build up the exhausted strength,
but when pushed too far, their action secondarily, becomes atonic. So
far as the classification of drugs, of the old school, is based on
pathogenetic action, it is a good one, but when brought into
therapeutics it is a failure.

I am disposed to think
that when Dr. Morgan proposes to classify remedies upon an anatomical
basis, and Dr. Williamson upon the basis of their action upon certain
tissues, that both of these gentlemen are treading upon exceedingly thin
ice. I have examined Bœnninghausen’s method of classification and think
it would be of little use to me, though it might be of great utility to
others. I prefer a good Repertory. If we have a remedy that is capable
of producing certain symptoms, we are able to compare the symptoms of
the patient with it, and find whether it will be the true homœopathic
spent.

Dr. Lippe :

Complaint has frequently been made that all the symptoms are not found
in Bœnninghausen’s work. When in Europe, I had made this complaint to
Bœnninghausen himself. I told Dr. Bœnninghausen that I had had a
number of patients who complained of headache only when their hair had
grown long, and which left them as soon as the hair was cut, and that
this condition was not in his book. Bœnninghausen told me that I should
look under the heading, “amelioration by uncovering the head.”
Common sense and judgement are to be exercised in choosing a remedy.

Dr. H. N. Martin :

Dr. Lippe has hit the nail right on the head. Our idea of classification
should be to enable us to individualize. We take one remedy and we
endeavor to personify it. We have another very much like it ; they
area like and yet very different. We find therein both apparently having
all the symptoms of a patient, but suppose we decide to give one of them
and it should happen to be upside down, so to speak, head to feet and
feet to head. It will not cure. We must find which of them applies to
our patient, head to head and feet to feet, and then we are sure we have
the right one.

The nosology of
disease, according to the old school, may become of use to us, in its
way. If I have a case of rheumatism, that fact calls to mind a certain
series of remedies, none of which, however, would I prescribe without
individualizing.

Dr. Frost :

Bœnninghausen’s
work cannot properly be called a method of classification ; it does
not profess to be. It is simply an agreement of principal (then known)
remedies of the Materia Medica under successive heads. And it must be
regarded as a succession of partial classifications, rather than a
single complete one.

In our school this
business of classification seems to be almost as much a vexed question
as that of the dose. The Allopaths have attempted to classify in various
ways. One for example from the positive or negative condition of the
remedies ; another may be termed the anatomical method. This is
perhaps the most plausible and seductive of all. To a certain extent the
topical anatomical relations are already laid down in the
symptomatology ; and these furnished valuable aids in selecting the
remedies, and have been fully made use of by Bœnninghausen. But when it
comes to discriminate the particular tissues, then the difficulty
arises. In one of the earlier volumes of the North
American Journal of Homeopathy, may be found a very
interesting paper on this subject. And I have attempted to verify and
extend the views there so ably presented. But after six weeks hard study
in this direction, I have found my self plunged into what Bunyan aptly
terms the “slough of despond”.

We find, indeed, that
certain remedies act on particular tissues ; and that similar pains
characterize the natural disorders of these tissues. And we think that
we have made a great discovery -opened a broad way to scientific
truth ; but it narrows down very quickly. For after a very few such
obvious examples as Bryonia and the
serious tissues, but little more can be clearly distinguished in this
direction. And there is yet another consideration in this
connection ; while we think, we may be able to assign to each
particular tissue its own characteristic pain, we forget, on the one
hand that these tissues are very seldom simply and exclusively
affected ; and on the other, that all these pains are but
neuralgias, or affections of the nerves distributed to the tissues. And
while we are still far from being able positively to assign the pains in
all cases to affections of the sympathetic or voluntary system of
nerves, we should seem to be still more incapable of determining with
accuracy and certainly which of the various tissues of the body is
affected. Until we have our remedies proved by persons competent to
locate each sensation in its particular tissue, we can hardly expect to
classify them according to the tissues which they affect ; and here
as in the classification of natural disorders arises the additional
difficulty -which is present in very many instances- of several tissues
being simultaneously affected, either through contiguity, through
sympathy, or through both. While we confine our attempts at
classification to pathogenic grounds, we rest on a substantial
foundation. But when we leave this and attempt to build our
classification on the theories we find the ice very thin, and we are
likely to break through and plunge in to the thick mud beneath.

Dr. J. C. Morgan :

The anatomical basis lies at the foundation of everything in
medicine, and it is a solid basis ; as solid as the earth. The only
thing to be considered is, have we the proper acumen to take the
symptoms as they are and properly arrange them ; to take the
symptoms given to us by ignorant men, women and children ; form a
minute diagnosis of their pathogenetic sphere ; and build up from
this the classification of remedies, according to the anatomical method.
Bœnninghausen’s method requires a vast amount of previous knowledge of
Materia Medica, before it can be used understandingly, Dr Lippe has
illustrated that even he, with his great knowledge of the subject was
obliged to ask the author himself for information, and Dr. James has
said that it would be of no use to him.

There is no sufficient
explanation of the manner in which it is to be used, offered in the
introduction, which is a great fault, and the value of the book was
appropriately expressed by Dr. Hering, who said of it, “It is
grains of gold, in heaps of sand.”

The anatomical
relations of remedies is very simple, if properly expressed, and
something that students can grasp at and comprehend. For instance, Cantharides
inflames the skin when locally applied and produces a like effect, after
absorption, upon the bladder. Nux-vomica
also affects the bladder, but has no local inflammatory action when
applied to the skin. The urinary symptoms of Nux.
though similar, must therefore, be different, in anatomical
significance, from Cantharis. The latter clearly has a direct
muco-cutaneous relation, primitively ; but Nux-vomica
can act on the bladder only indirectly, sympathetically
centres. This is a fair diagnosis inference, generally acknowledged from
its pathogenesis. Per contra. Cantharides must,
in its turn, have a consecutive centric influence. It is by the
primitive effects of a drug that its anatomical classification is to be
made. The “narcotics” and “bitters” thus belong to
the “spinal centric” class. The “acrids” to the
vegetative centric class, etc.

Bœnninghausen’s work
is of great value to those who have previously become familiar with
certain landmarks. It is to a beginner suggestive to the story of the
countryman who, on first visiting the city, said he “could not see
the town for the houses.” But if he had looked the top of a steeple
he would have been more fortunate. The beginner, finding no scientific
classification of our Materia Medica, such as anatomy affords, is
liable, first to run into the crudest generalization, and finally to
abjure the science. Diagnose minutely the medicinal diseases that drugs
may produce ; then having formed classes of similar remedies, you
are able to individualize from them with comparative ease.

Dr W.
Williamson

Dr. Williamson :

I do not like to hear any thing said against the provings of women and
children ; because some of the most reliable proving of drugs he
had ever seen were made by them and other laymen ; while some of
the poorest and most unsatisfactory ones were made by physicians. To be
sure, physicians can better tell in what tissues their sensations are
seated but sometimes they mix opinions with symptoms, which are not
always easily separated ; while laymen can describe their
sensations and give the locality just as well as physicians can, and are
not so apt to express an opinion.

I am surprised to hear
a physiologist say that it is impossible to distinguish between the
symptoms of one tissue and those of another ; and that as the
nervous tissues is the only one endowed with sensation we would really
have but one tissue to treat. I acknowledge that all pains are more
sensations, and that the impressions of them are conveyed from the
affected part through the nervous filaments to the sensorium before they
gain expression, but contend that there are about the pains of each
tissues peculiarities by which they can be distinguished from the pains
of every other tissue. And the physician who is acquainted with the
functions of the organs and tissues of the body can tell the organ and
generally the tissue in which the pains or other sensations of disease
are located. I do not care to know the opinion of a patient about his
disease. I want to learn from him the symptoms or facts of the case, and
from these would form my own opinion.

Source :

H. M. 1867.

Copyright © Sylvain
Cazalet 2000

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