Cases Illustrative of Homoeopathic Practice (1833)
by Samuel Hahnemann
Many persons of my acquaintance but half converted to homoeopathy have begged of me from time to time to publish still more exact directions as to how this doctrine may be actually applied in practice, and how we are to proceed. I am astonished that after the very peculiar directions contained in the Organon of medicine more special instruction can be wished for.
I am also asked, “How are we examine the disease in every particular case?” As if special enough directions were not to be found in the book just mentioned.
As on homoeopathy the treatment is not directed towards any supposed or illusory internal causes of disease, nor yet towards any names of diseases invented by man which do not exist in nature, and as every case of non-miasmatic disease in nature from all others, never compounded of a hypothetical arrangement of symptoms, so no particular directions can be laid down for them (no schema, no table), except that the physician, in order to effect a cure, must oppose of every aggregate of morbid symptoms in a case a group of similar medicinal symptoms as exact as it is to be met with any single known medicine, for this doctrine cannot admit of more than a single medicinal substance (whose effects have been accurately tested) to be given at once (see Organon of medicine, § 271, 272).
Now we can neither enumerate all the possible aggregates of symptoms of all concrete cases of disease, nor indicate a priori undefinable) possibilities. For every individual given case (and every case is an individuality, differing from all others) the homoeopathic medical practitioner must himself find then, and for this end he must be acquainted with the medicines that have till now been investigated in respect of their positive action, or consult them for every case of disease; but besides this he must do his endeavour to prove on himself to on other healthy individuals medicines that have not yet been investigated as regards the morbid alterations they are capable of producing, in order thereby to increase our store of known remedial agents, (Before the discovery of Homoeopathy, medicinal substances were known only in respect to their natural history, and besides their names nothing was known, regarding them but their presumed qualities, which were either imaginary or altogether false.) so that the choice of a remedy for every one of the infinite variety of cases of disease (for the combating of which we can never possess enough of suitable tools and weapons) may become all the more easy and accurate.
That man is far from being animated with the true spirit of the homoeopathic system, is not true disciple of this beneficent doctrine, who makes the slightest objections to institute on himself careful experiments for the investigation of the peculiar effects of the medicines which have remained unknown for 2500 years, without which investigation (and unless their pure pathogenetic action on the healthy individual has previously been ascertained) all treatment of disease must continue to be not only a foolish, but even a criminal operation, a dangerous attack upon human life.
It is somewhat too much to expect us to work merely for the benefit of such self-interested individuals as will contribute nothing to the complete and indispensable building up of the indispensable edifice, who only seek to make money by what has been discovered and investigated by the labours of others, and to furnish themselves with the means of squandering the income derived from the capital of science, to the accumulation of which they do not evince the slightest inclination to contribute.
All who feel a true desire to assist in elucidating the peculiar effects of medicines – our sole instruments, the knowledge of which has for so many centuries remained uninvestigated, and which is yet is indispensable for enabling us to cure the sick, will find the directions how these pure experiments with medicines should ne conducted in the Organon of medicine, § 118- 142.
In addition to what has been there stated I shall only add, that as the experimenter cannot, any more than any other human being, be absolutely and perfectly healthy, he must, should slight ailments to which he was liable appear during these provings of the powers of medicines, place these between brackets, thereby indicating that they are not confirmed, or dubious. But this will not often happen, seeing that during the action upon a previously healthy person of a sufficiently strong alone, and it is seldom that any other symptom can shew itself during the first days but what must be the effect of the medicine. Further, that in order to investigate the symptoms of medicines for chronic diseases, for example, in order to develop the cutaneous diseases, abnormal growths and so forth, to be expected from the medicine, we must not be contented with taking one or two doses of it only, but we must continue its use for several days, to the amount of two adequate doses daily, that is to say, of sufficient size to cause us to perceive its action, whilst at the same time we continue to observe the diet and regimen indicated in the work alluded to.
The mode of preparing the medicinal substances for use in homoepathic treatment will be found in the Organon of medicine, § 261 – 271, and also in the chronic diseases. I would only observe here, that for the proving of medicines on healthy individuals, dilutions and dynamizations are to be employed as high as are used for the treatment of disease, namely, globules moistened with the decillionth development of power.
The request of some friends, halting half-way on the road to this method of treatment, to detail some examples of this treatment, is difficult to comply with, and no great advantage can attend a compliance with it. Every cured case of disease shews only how that case has been treated. The internal process of the treatment depends always on those principles which are already known, and they cannot be rendered concrete and definitely fixed for each individual case, now can they become at all more distinct from the history of a single cure than they previously were when these principles were enunciated. Every case of non-miasmatic disease is peculiar and special, and it is the special in it that distinguishes it from every other case, that pertains to it alone, but that cannot sere as a guide to the treatment of other cases. Now if it is wished to describe a complicated case of disease consisting of many symptoms, in such a pragmatical manner that the reasons that influence us in the choice of the remedy shall be clearly revealed shall be clearly revealed, this demands details laborious at once for the recorder and for the reader.
In order, however, to comply with the desires of my friends in this also, I may here detail two of the slightest cases of homoepathic treatment.
Sch - , a washerwoman, somewhat above 40 years old, had been more than three weeks unable to pursue her avocations, when she consulted me on the 1st September, 1815.
1. On any movement, especially at every step, and worst on making a false step, she has a shoot in the scrobiculus cordis, that comes, as she avers, every time from the left side.
2. When she lies she feels quite well, then she has no pain anywhere, neither in the side nor in the scrobiculus.
3. She cannot sleep after thee o’clock in the morning.
4. She relishes her food, but when she has ate a little she feels sick.
5. Then the water collects in her mouth and runs out of it, like the water-brash.
6. She has frequently empty eructations after every meal.
7. Her temper is passionate, disposed to anger, - Whenever the pain is severe she is covered with perspiration. – The catamenia were quite regular a fortnight since.
In other respects her health is good.
Now, s regards Symptom 1, belladonna, china, and rhus toxi codendron cause shootings in the scrobiculus, but none of them only on motion, as is the case here. Pulsatila (See Symp. 387) certainly causes shootings in the scrobiculus on making a false step, but only as a rare alternating action, and has neither the same digestive derangements as occur here at 4 compared with 5 and 6, nor the same state of the disposition.
Bryonia alone has among its chief alternating actions, as the whole list of its symptoms demonstrates, pains from movement and especially shooting pains, as also stitches beneath the sternum (in the scrobiculus) on raising the arm (448), and in making a false step it occasions shooting in other parts (520, 574).
The negative symptom 2 met with here answers especially to bryonia (558?)’ few medicines (with the exception, perhaps, of nux vomica and rhus toxicodendron in their alternating action – neither of which, however, are suitable for the other symptoms) shew a complete relief to pains during rest and when lying; bryonia does, however, in an especial manner (558, and many other bryonia-symptoms).
Symptom 3 is met with in several medicines, and also in bryonia (694).
Symptom 4 is certainly, as far as regards “sickness after eating,” met with in several other medicines (ignatia, nux vomica, mercurius, ferrum, belladonna, pulsatilla, cantharis), but neither so constantly and usually, nor with relish for food, as in bryonia (279).
As regards Symptom 5 several medicines certainly cause a flow of saliva like water-brash, just as well as bryonia (282); the others, however, do not produce the remaining symptoms in a very similar manner. Hence bryonia is to be preferred to them in this point.
Empty eructation (of wind only) after eating (Symptom 6) is found in few medicines, and in none so constantly, so usually, and to such a great degree, as in bryonia (255. 239).
To 7. – One of the chief symptoms in diseases (see Organon of Medicine, § 213) is the “state of the disposition,” and as bryonia (778) causes thus symptom also in an exactly similar manner – bryonia is for all these reasons to be preferred in this case to all other medicines as the homoeopathic remedy.
Now, as this woman was very robust, and the force of the disease must accordingly have been very considerable, to prevent her by its pain from doing any work, and as her vital forces, as has been observed, were not consensually affected, I gave her one of the strongest homoeopathic doses, a full drop of the pure juice of bryonia root, to be taken immediately, and bade her cone to me again in 48 hours, I told my friend E., who was present, that within that time the woman would be quite cured, but he, being but half a convert to homoeopathy, expressed his doubts about it. Two days afterwards he came again to ascertain the result, but the woman did not return then, and, in fact, never came back again. I could only allay the impatience of my friend by telling him her name and that of the village where she lived, about three miles off, and advising him to seek her out and ascertain for himself how she was. This he did, and her answer was: “What was the use of my going back? The very next day I was quite well, and could again commence my washing, and the day following I was as well as I am still. I am extremely obliged to the doctor, but the like of us have no time to leave off our work; and for three weeks previously my illness prevented me earning anything.”
W – e, a weakly, pale man of 42 years, who was constantly kept by his business at is desk, came to me on the 27th December, 1815, having been already ill five days.
1. The first evening he became, without manifest, without manifest cause, sick and giddy, with much eructation.
2. The following night (about 2 a.m.) sour vomiting.
3. The subsequent nights severe eructation.
4. To-day also sick eructation of fetid and sourish taste.
5. he felt as if the food lay crude and undigested in his stomach.
6. In his head he felt vacant, hollow and confused, and as if sensitive therein.
7. The least noise was painful to him.
8. He is of a mild, soft, patient disposition.
Here I may observe: -
To 1. That several medicines cause vertigo with nausea, as well as pulsatilla (3), which produces its vertigo in the evening also (7), a circumstance that has been observed from very few others.
To 2. Stramonium and nux vomica cause vomiting of sour and sour-smelling mucus, but, as far as is known, not at night. Valerian and cocculus cause vomiting at night, but not of sour stuff. Iron alone causes Pulsatilla produces the same state at night (61, 62), and can also cause sour vomiting (66), but not the other symptoms observed here.
Pulsatilla, however, causes not only sour vomiting in the evening (349, 356) and nocturnal vomiting in general, but also the other symptoms of this case not found among those of iron.
To 3. Nocturnal eructations is peculiar to pulsatilla (296, 297).
To 4. Feted, putrid (249) and sour eructations (301, 302) are peculiar to pulsatilla.
To 5. The sensation of indigestion of the food in the stomach is produced by few medicines, and by none in such a perfect and striking manner as by pulsatilla (321, 322, 327).
To 6. With the exception of ignatia (2) which, however, cannot produce the other ailments, the same state is only produced by pulsatilla (39 compared with 40, 81).
To 7. Pulsatilla produces the same state (995), and it also cause over-sensitiveness of other organs of the senses, for example, of the sight (107). And although intolerance of noise is also met with in nux vomica, ignatia, and aconite, yet these medicines are not homoepathic to the other symptoms and still less do they possess 8, the mild character of the disposition , which, as stated in the preface to pulsatilla, is particularly indicative of this plant.
This patient, therefore, could not be cured by anything in a more easy, certain and permanent manner than by pulsatilla, which was accordingly given to him immediately, but on account of his weakly and delicate state only in a very minute dose, i. e., half-a drop of the quadrillionth of a strong drop of pulsatilla. This was done in the evening.
The next day he was free from all ailments, his digestion was restored, and a week thereafter, as I was told by him, he remained free from complaint and quite well.
The investigation in such a slight case of disease, and the choice of the homoeopathic remedy for it, is very speedily effected by the practitioner who has had only a little experience in it, and who either has the symptoms of the medicine in his memory, or who knows where to find them readily; but to give in writing all the reasons pro and con (which would be perceived by the mind in a few seconds) gives rise, as we see, to tedious proxility.
For the convenience of treatment, we require merely to indicate for each symptom all the medicines which can produce the same symptoms by a few letters (e. g., Ferr., Chin., Rheum, Puls.), and also to bear in mind the circumstances under which they occur, that have a determining influence on our choice and in the same way with all the other symptoms, by what medicine each is excited, and from the list so prepared we shall be able to perceive which of the medicines homoeopathically covers the most of the symptoms present, especially the most peculiar and characteristic ones, - and this is the remedy sought for.