Problems confronting one when first attempting to prescribe homoeopathically. by Dr Elizabeth Wright Hubbard

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Problems confronting
one when first attempting to prescribe homœopathically.
by Dr Elizabeth Wright Hubbard
Presented by Sylvain Cazalet

Dr E. Wright
Hubbard

Before discussing the
problems of actual homœopathic practice, let me show you some of the
difficulties in the ordinary practice of medicine which led me to an
interest in Homœopathy. When I was student at Columbia Medical School.
“P. & S.” as we called it in the wartime. I was much
disappointed at the paucity of therapeutic information. There was
pathology and bacteriology galore, and fascinating drill in diagnosis,
but being a woman, and therefore a practical soul (I see some of you
smiling at women you have met) I hankered after means of cure. Most of
what we were taught in therapeutics was hygiene, nursing procedure,
diet, hydrotherapy, etc.

A large proportion of
my class, who had intended to go into general medicine, took up surgery
or the specialties because in those fields there was something definite
to do for the patients. From medical school I went to Bellevue Hospital
for two years’ rotating internship, and there again I met the prevailing
therapeutic nihilism. Our chief of service was a wizard at diagnosis,
but I always felt that an autopsy was fully as acceptable as a cure and
much more frequent. One class of patients in the hospital particularly
distressed me, those who had abundant subjective symptoms and on whom
the diagnostic and laboratory pronouncement was, “There is nothing
wrong with you”. I remember one say, “Well, doctor, I may be
perfectly well, but I know I am sick”. And then there were the
chronic, not only those with marked pathology but life-long sufferers
from “indigestion” or migraine, who had been passed around
from doctor to doctor with nothing but temporary relief.

Two other problems
puzzled me particularly in those days besides the apparently functional
cases and the chronic One of these was the patient with a classically
recognizable disease who did not respond to the usual
“specific” treatment for that disease. For instance, a young
sailor with a severe malaria which no amount of quinine influenced in
the least, to the consternation of all the visiting. The other matter
set me thinking was the wide variety of types of a single disease. I
used to wonder why the pneumonia in the second bed who was such a
strapping specimen, and had come down suddenly at mid-night on the date
of admission, was in such mortal terror of dying by noon the next day,
(which, I may add, he did, to the surprise of all of us), and why the
besotted looking fellow in the next bed, lay on the affected side with
his hand under his chest, motionless, gulping two or three glasses of
water at long intervals, complaining of the light and snapping your head
off when spoken to ; and why the pneumonia on the other side of the
ward thrashed about so incessantly, especially in the evening, calling
for cold milk. Now I know that although these three had the same disease
and received the same treatment, they would have responded to three
different remedies ; Aconite. Bryonia
and Rhus-tox. But that is getting
ahead of our story. My puzzles, then, in my training, were the
apparently functional cases, the chronics, the patients who did not
respond to the classical treatment of a clearly marked disease, and the
varied types classified and treated according to one diagnosis.

Dr E. Underhill

Dr. Underhill has told
you most graphically and humorously how he was led into homœopathy so I
will omit my initiation except to say that after working at the Allgemeine
Krankenhaus in Vienna in the usual way, I was apprenticed for
nine months to a homœopathic physician in Geneva where I studied,
literally, from 12 to 16 hours a day.

Before he was willing
to take me as a pupil, he gave me a stiff examination in ordinary
medicine, including Anatomy, fractures, surgical diagnosis, pathology,
bacteriology, and chemistry, and gave me slides to diagnose under the
microscope, etc. He then asked me certain questions as to what I thought
life was about, why I went into the practice of medicine, what were the
chief duties of a physician and so on. These questions perplexed me, as
I did not then understand their bearing on the philosophy of homœopathy.
It was, “What do homœopaths give for rheumatism ?”
Having read somewhat in homœopathic literature. I answered that
homœopaths do not give a remedy for rheumatism or for any disease name
or diagnosis (although, of course, certain remedies are more frequently
indicated in rheumatic conditions). They give a remedy on the symptoms
of the patient who has the disease, in other words on the reaction of
the individual in question to any given disease entity. This defines one
of the fundamental differences between the homœopathic approach and
regular medicine.

Until the physician’s
mind has compassed the differences between the viewpoints of ordinary
medical training and Homœopathy he cannot even begin to prescribe
homœopathically. Let me enumerate, for clarity, wherein these
differences lie. First, as above mentioned, he must grasp the principle
of individualization. Modem medicine
lays a good foundation for this through its interest in endocrinology
and psychiatry, but except for obvious glandular imbalances it offers,
as yet, no therapy commensurate with the refinements of differentiation.
What does individualization mean to the homœopath and how does he
arrive at it ? It involves a subsidiary new method of case-taking.
After you have your classical history, elicited largely by asking
questions, you can often make a diagnosis but rarely a homœopathic
prescription. For the latter you need to know the mental state of your
patient, and what the homœopaths call his “generals”, which
mean the things which apply to the patient as a whole-his reaction to
heat and cold, wet and dry weather and storms, motion, position, food,
etc.

You need to know how
these same factors affect the specific complaints of your patient, in
other words the modalities of his
particular disease symptoms-whether his headache is better from hot or
cold applications, from motion or rest, from lying or walking, from
pressure, or food, and at what time of day it is worse.
(“Modalities”, in other words, mean aggravations or
ameliorations of specific symptoms, just as “generals” mean
aggravations and ameliorations of the patient as a whole). There is a
fourth type of thing that you must know about your patient in order to
prescribe homœopathically and that is his rare, peculiar, or
characteristic particular symptoms. These often appear trivial
idiosyncrasies to the patient, things that he has always had, or that no
doctor to whom he has told them, has ever been interested in. These
often serve as Keynotes to guide to a remedy. But of what use is all
this additional information about your patient ? How does this
picture of his personality aid you ? You have individualized, but
of what use is such differentiation, if you have only a standard
treatment for the condition that you have diagnosed ?

Dr G. B. Stearns

This brings us to the
second great difference between homœopathy and regular medicine. The
law on which homœopathy is based, or, if you prefer, the hypothesis, is
to be found in the statement of Hippocrates, “similia
similibus curantur.” which Hahnemann revived and
amplified. Dr. Sterns has told you how Hahnemann came to apply this law
and made the first so-called “proving” of quinine. A
“proving”, in the homœopathic sense, is experimenting with a
drug in minute doses on a relatively healthy human being. The record of
symptoms so produced, on a large number of provers of different ages and
sexes, constitutes the basis of our homœopathic materia medica. The
object of proving a drug is to delineate the drug personality.

Each of our remedies is
to us a living individual, they are like friends whom one recognizes
whenever seen, not only by their grand characteristics but also by their
mannerisms and tricks. We now have on the one hand, the drug
personalities, and on the other the picture of our patient in his
present state. It follows, if like cures like that we must match
pictures and fit the personality of a drug to our patient, administer
it, and watch the results. After one has grasped this ingenious theory
and learned to put it into practice, it remains only to see it work. I,
for one, being a natural septic, was slow to believe that evidence of my
senses. Could the astonishing improvements and cures have been
coincidence, or suggestion, or faulty diagnosis ?

There are certain
controls which one can use. Put the patient on the proper regimen
including diet, etc., and see what that alone does for your condition.
Then give Placebo, with your best manner. In my experience, in nine
cases out of ten, the patient will report no progress. When they are
discouraged by this unsuccessful first prescription, give them the
remedy you have chosen, the simillimum.
If you feel reasonably certain that the drug-picture fits your
patient ; and you have the simillimum,
in most cases you will see a swift and beautiful result. But these are
not the only possible methods of control. There are laws of remedy
action which are contrary to anything you could expect in an untreated
case. When you see these, you know that your remedy is taking hold. They
were formulated by Constantine Hering, one of the pioneers of Homœopathy
in this country, and are as follows : The curative remedy acts from
within outward, from above downward, and in the
reverse order of the symptoms.

Dr Constantin
Hering

Take, as an
illustration, a case of rheumatic fever in which, after the customary
salicylate dosing, the joints appear to have cleared up but a heart
condition develops. Give such a patient the similar remedy and he will
complain that his joints are worse again, but he himself feels better
and you find that his heart is clearing up. You explain to him that the
remedy is working from within outward ;
the more vital organ, the heart, is getting well first, and the
peripheral organs, the joints, are again involved. Give him nothing but
Placebo. Shortly he will tell you that his shoulders and wrists are
clearing up but that the pain is now in his knees or ankles. Again you
see the law of cure in action, from above
downward, and you wait. You observe that his symptoms are
disappearing in the reverse order of their
appearance, the heart condition which came last, going first.
If you trust your remedy under these conditions, your patient will make
a real recovery without the annoying recurrences. (If, on the contrary,
you found that the joints in the lower extremities cleared up and those
of the upper extremities became involved, you would know you were on the
wrong track and had not found the simillimum).

One of the knottiest
problems for the beginner is the different concept of pathology and
bacteriology. Homœopaths accept the facts of these branches of
medicine. The difference lies in the interpretation. Pathology is an end
result of some morbid process. The homœopath is not nearly as
interested in the diseased tonsil, the hæmorrhoid, the ovarian cyst,
the cancer, the tapeworm, or the psoriasis, as he is in the
constitutional dyscrasia behind these. He is not eager to remove the
ultimates of disease at once, but rather to cure the underlying cause.
In the course of this cure the ultimate will often disappear, as in the
case of diseased cervical glands or fibroids. If not, it can be removed
when it has become merely a foreign body, and when the constitution is
so changed that it will not ultimate itself in further pathology in a
more deep seated organ. Similarly one is taught to consider that
bacteria cause disease.

The homœopath is more
interested in the individual’s susceptibility, than in the bacteria
themselves. Instead of poisoning the malarial plasmodia with quinine or
the syphilitic spirochætæ with salvarsan, the homœopath prefers to
stimulate the body to make itself uninhabitable for these organisms, and
he does this by means of the similar remedy. To give another instance,
instead of killing off head lice with delphinium and leaving the patient
susceptible to further invasions, the homœopath gives chronic
constitutional remedy which removes the susceptibility and the lice seek
better pasturage.

A fourth
stumbling-block for the medical mind is the question of suppression.
Discharges and eruptions are ordinarily classed with pathology as
something to be gotten rid of by local measures. We are taught to use
argyrol in coryza, to paint cervices with mercurochrome in leucorrhœa,
to stop a gonorrhœal discharge with protargol, to check a diarrhœa
with opium or bismuth, to clear up skin eruptions with ammoniated
mercury or sulphur ointment or other applications. The homœopath holds
that this is suppression, and not cure, that these outward
manifestations ate not primarily local but an expression of deep
disease, the body trying to throw off impurities. They have watched the
incidence of more deep-seated troubles following such
“suppression”. The chronic constitutional homœopathic remedy
given to a case which has been so treated, will offer bring back the
original eruption or discharge with concomitant relief of recent grave
symptoms and ultimate clearing up from within
of the original discharge or eruption. Let me illustrate with a case
from my practice recently.

A women of 45, came to
see me for suicidal depression, for which she could give no emotional
cause. She dated her mental symptoms definitely from the time when she
had had a foul, lumpy, green leucorrhœa “cured” by local
vaginal applications, a few months before. I gave her a dose of Sepia (a
remedy made from cuttlefish ink) on her mental symptoms. A week later
she returned exuberant, all the depression for which she had been
doctoring being gone, and said, “By the way, doctor. I have that
awful discharge back again, just as it was before”. I was
delighted, warned her against suppressing it a second time, and gave
Placebo. The discharge has since lessened and improved in character and
she continues, as her husband says, a changed woman. So much for the
fundamental differences.

Another problem which
confronted me was whether the homœopathic remedy could influence
definite chronic pathology. A girl of 19 came to me for severe
intermenstrual bleeding. On examination I found a nodular fibroid bigger
than my fist. A well-known New York specialist, she told me later, had
diagnosed it and advised merely general health measures, as he did not
want to x-ray so young a girl. Her chronic case worked out on mental and
general symptoms to Phosphorus,
which happens to be one of the main remedies useful in fibroids. Three
months after I gave her this, I sent her to be checked up by the same
specialist. He was amazed at the decrease in size of the fibroid and
asked her what she had been doing. Six months later he pronounced her
normal and sanctioned her marrying.

A further difficulty I
experienced was in believing the current statement that homœopathic
remedies can do no harm. THEY CAN !

Another problem which
one frequently meets in general practice is that of prophylaxis. Strict
homœopaths believe that vaccines and inoculations are harmful. It took
considerable experience for me to be convinced that the chronic
constitutional remedy is the best prophylactic. The whole subject of the
chronic constitutional remedy is a fascinating one, but beyond the scope
of this paper.

As a last problem comes
the practical one which is such a stumbling-block to students, as to
whether one can make a living on homœopathic general practice.
Certainty more than half of my patients were not believing in
Homœopathy, many of them dead against it, but I have found that by
up-to-date examination and laboratory procedures, by the actual
accomplishment of the remedies, and by adroitly “selling” to
the patient the principles of homœopathy without the name, they are
intrigued, send you their friends, and become staunch believers in the
method.

To all of the puzzling
problems outlined above, a satisfactory solution can be found, if one is
willing to do the hard work involved in learning enough to get results.
I am completely “sold” to Homœopathy. When I fail I know that
the failure is mine and not homeopathy’s and when I can see a similar
remedy for a case, I have, even before giving it, a perfect certainty
that good results will be forthcoming.

Source :

Homœopathic Recorder. May
1929.

Copyright ©
Sylvain Cazalet 2001

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