Medical Essays, 1842-1882 · Chapter 8Homoeopathy and Its Kindred Delusions (5)
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Dr. Hering, whose name is somewhat familiar to the champions of Homoeopathy, has said that “the new healing art is not to be judged by its success in isolated cases only, but according to its success in general, its innate truth, and the incontrovertible nature of its innate principles.”
We have seen something of “the incontrovertible nature of its innate principles,” and it seems probable, on the whole, that its success in general must be made up of its success in isolated cases. Some attempts have been made, however, to finish the whole matter by sweeping statistical documents, which are intended to prove its triumphant success over the common practice.
It is well known to those who have had the good fortune to see the “Homoeopathic Examiner,” that this journal led off, in its first number, with a grand display of everything the newly imported doctrine had to show for itself. It is well remarked, on the twenty-third page of this article, that “the comparison of bills of mortality among an equal number of sick, treated by divers methods, is a most poor and lame way to get at conclusions touching principles of the healing art.” In confirmation of which, the author proceeds upon the twenty-fifth page to prove the superiority of the Homoeopathic treatment of cholera, by precisely these very bills of mortality. Now, every intelligent physician is aware that the poison of cholera differed so much in its activity at different times and, places, that it was next to impossible to form any opinion as to the results of treatment, unless every precaution was taken to secure the most perfectly corresponding conditions in the patients treated, and hardly even then. Of course, then, a Russian Admiral, by the name of Mordvinov, backed by a number of so-called physicians practising in Russian villages, is singularly competent to the task of settling the whole question of the utility of this or that kind of treatment; to prove that, if not more than eight and a half per cent. of those attacked with the disease perished, the rest owed their immunity to Hahnemann. I can remember when more than a hundred patients in a public institution were attacked with what, I doubt not, many Homoeopathic physicians (to say nothing of Homoeopathic admirals) would have called cholera, and not one of them died, though treated in the common way, and it is my firm belief that, if such a result had followed the administration of the omnipotent globules, it would have been in the mouth of every adept in Europe, from Quin of London to Spohr of Gandersheim. No longer ago than yesterday, in one of the most widely circulated papers of this city, there was published an assertion that the mortality in several Homoeopathic Hospitals was not quite five in a hundred, whereas, in what are called by the writer Allopathic Hospitals, it is said to be eleven in a hundred. An honest man should be ashamed of such an argumentum ad ignorantiam. The mortality of a hospital depends not merely on the treatment of the patients, but on the class of diseases it is in the habit of receiving, on the place where it is, on the season, and many other circumstances. For instance, there are many hospitals in the great cities of Europe that receive few diseases of a nature to endanger life, and, on the other hand, there are others where dangerous diseases are accumulated out of the common proportion. Thus, in the wards of Louis, at the Hospital of La Pitie, a vast number of patients in the last stages of consumption were constantly entering, to swell the mortality of that hospital. It was because he was known to pay particular attention to the diseases of the chest that patients laboring under those fatal affections to an incurable extent were so constantly coming in upon him. It is always a miserable appeal to the thoughtlessness of the vulgar, to allege the naked fact of the less comparative mortality in the practice of one hospital or of one physician than another, as an evidence of the superiority of their treatment. Other things being equal, it must always be expected that those institutions and individuals enjoying to the highest degree the confidence of the community will lose the largest proportion of their patients; for the simple reason that they will naturally be looked to by those suffering from the gravest class of diseases; that many, who know that they are affected with mortal disease, will choose to die under their care or shelter, while the subjects of trifling maladies, and merely troublesome symptoms, amuse themselves to any extent among the fancy practitioners. When, therefore, Dr. Mublenbein, as stated in the “Homoeopathic Examiner,” and quoted in yesterday's “Daily Advertiser,” asserts that the mortality among his patients is only one per cent. since he has practised Homoeopathy, whereas it was six per cent. when he employed the common mode of practice, I am convinced by this, his own statement, that the citizens of Brunswick, whenever they are seriously sick, take good care not to send for Dr. Muhlenbein!
It is evidently impossible that I should attempt, within the compass of a single lecture, any detailed examination of the very numerous cases reported in the Homoeopathic Treatises and Journals. Having been in the habit of receiving the French “Archives of Homoeopathic Medicine” until the premature decease of that Journal, I have had the opportunity of becoming acquainted somewhat with the style of these documents, and experiencing whatever degree of conviction they were calculated to produce. Although of course I do not wish any value to be assumed for my opinion, such as it is, I consider that you are entitled to hear it. So far, then, as I am acquainted with the general character of the cases reported by the Homoeopathic physicians, they would for the most part be considered as wholly undeserving a place in any English, French, or American periodical of high standing, if, instead of favoring the doctrine they were intended to support, they were brought forward to prove the efficacy of any common remedy administered by any common practitioner. There are occasional exceptions to this remark; but the general truth of it is rendered probable by the fact that these cases are always, or almost always, written with the single object of showing the efficacy of the medicine used, or the skill of the practitioner, and it is recognized as a general rule that such cases deserve very little confidence. Yet they may sound well enough, one at a time, to those who are not fully aware of the fallacies of medical evidence. Let me state a case in illustration. Nobody doubts that some patients recover under every form of practice. Probably all are willing to allow that a large majority, for instance, ninety in a hundred, of such cases as a physician is called to in daily practice, would recover, sooner or later, with more or less difficulty, provided nothing were done to interfere seriously with the efforts of nature.
Suppose, then, a physician who has a hundred patients prescribes to each of them pills made of some entirely inert substance, as starch, for instance. Ninety of them get well, or if he chooses to use such language, he cures ninety of them. It is evident, according to the doctrine of chances, that there must be a considerable number of coincidences between the relief of the patient and the administration of the remedy. It is altogether probable that there will happen two or three very striking coincidences out of the whole ninety cases, in which it would seem evident that the medicine produced the relief, though it had, as we assumed, nothing to do with it. Now suppose that the physician publishes these cases, will they not have a plausible appearance of proving that which, as we granted at the outset, was entirely false? Suppose that instead of pills of starch he employs microscopic sugarplums, with the five' million billion trillionth part of a suspicion of aconite or pulsatilla, and then publishes his successful cases, through the leaden lips of the press, or the living ones of his female acquaintances,—does that make the impression a less erroneous one? But so it is that in Homoeopathic works and journals and gossip one can never, or next to never, find anything but successful cases, which might do very well as a proof of superior skill, did it not prove as much for the swindling advertisers whose certificates disgrace so many of our newspapers. How long will it take mankind to learn that while they listen to “the speaking hundreds and units,” who make the world ring with the pretended triumphs they have witnessed, the “dumb millions” of deluded and injured victims are paying the daily forfeit of their misplaced confidence!
I am sorry to see, also, that a degree of ignorance as to the natural course of diseases is often shown in these published cases, which, although it may not be detected by the unprofessional reader, conveys an unpleasant impression to those who are acquainted with the subject. Thus a young woman affected with jaundice is mentioned in the German “Annals of Clinical Homoeopathy” as having been cured in twenty-nine days by pulsatilla and nux vomica. Rummel, a well-known writer of the same school, speaks of curing a case of jaundice in thirty-four days by Homoeopathic doses of pulsatilla, aconite, and cinchona. I happened to have a case in my own household, a few weeks since, which lasted about ten days, and this was longer than I have repeatedly seen it in hospital practice, so that it was nothing to boast of.
Dr. Munneche of Lichtenburg in Saxony is called to a patient with sprained ankle who had been a fortnight under the common treatment. The patient gets well by the use of arnica in a little more than a month longer, and this extraordinary fact is published in the French “Archives of Homoeopathic Medicine.”
In the same Journal is recorded the case of a patient who with nothing more, so far as any proof goes, than influenza, gets down to her shop upon the sixth day.
And again, the cool way in which everything favorable in a case is set down by these people entirely to their treatment, may be seen in a case of croup reported in the “Homoeopathic Gazette” of Leipsic, in which leeches, blistering, inhalation of hot vapor, and powerful internal medicine had been employed, and yet the merit was all attributed to one drop of some Homoeopathic fluid.
I need not multiply these quotations, which illustrate the grounds of an opinion which the time does not allow me to justify more at length; other such cases are lying open before me; there is no end to them if more were wanted; for nothing is necessary but to look into any of the numerous broken-down Journals of Homoeopathy, the volumes of which may be found on the shelves of those curious in such matters.
A number of public trials of Homoeopathy have been made in different parts of the world. Six of these are mentioned in the Manifesto of the “Homoeopathic Examiner.” Now to suppose that any trial can absolutely silence people, would be to forget the whole experience of the past. Dr. Haygarth and Dr. Alderson could not stop the sale of the five-guinea Tractors, although they proved that they could work the same miracles with pieces of wood and tobacco-pipe. It takes time for truth to operate as well as Homoeopathic globules. Many persons thought the results of these trials were decisive enough of the nullity of the treatment; those who wish to see the kind of special pleading and evasion by which it is attempted to cover results which, stated by the “Homoeopathic Examiner” itself, look exceedingly like a miserable failure, may consult the opening flourish of that Journal. I had not the intention to speak of these public trials at all, having abundant other evidence on the point. But I think it best, on the whole, to mention two of them in a few words,—that instituted at Naples and that of Andral.
There have been few names in the medical profession, for the last half century, so widely known throughout the world of science as that of M. Esquirol, whose life was devoted to the treatment of insanity, and who was without a rival in that department of practical medicine. It is from an analysis communicated by him to the “Gazette Medicale de Paris” that I derive my acquaintance with the account of the trial at Naples by Dr. Panvini, physician to the Hospital della Pace. This account seems to be entirely deserving of credit. Ten patients were set apart, and not allowed to take any medicine at all,—much against the wish of the Homoeopathic physician. All of them got well, and of course all of them would have been claimed as triumphs if they had been submitted to the treatment. Six other slight cases (each of which is specified) got well under the Homoeopathic treatment, none of its asserted specific effects being manifested.
All the rest were cases of grave disease; and so far as the trial, which was interrupted about the fortieth day, extended, the patients grew worse, or received no benefit. A case is reported on the page before me of a soldier affected with acute inflammation in the chest, who took successively aconite, bryonia, nux vomica, and pulsatilla, and after thirty-eight days of treatment remained without any important change in his disease. The Homoeopathic physician who treated these patients was M. de Horatiis, who had the previous year been announcing his wonderful cures. And M. Esquirol asserted to the Academy of Medicine in 1835, that this M. de Horatiis, who is one of the prominent personages in the “Examiner's” Manifesto published in 1840, had subsequently renounced Homoeopathy. I may remark, by the way, that this same periodical, which is so very easy in explaining away the results of these trials, makes a mistake of only six years or a little more as to the time when this at Naples was instituted.
M. Andral, the “eminent and very enlightened allopathist” of the “Homoeopathic Examiner,” made the following statement in March, 1835, to the Academy of Medicine: “I have submitted this doctrine to experiment; I can reckon at this time from one hundred and thirty to one hundred and forty cases, recorded with perfect fairness, in a great hospital, under the eye of numerous witnesses; to avoid every objection—I obtained my remedies of M. Guibourt, who keeps a Homoeopathic pharmacy, and whose strict exactness is well known; the regimen has been scrupulously observed, and I obtained from the sisters attached to the hospital a special regimen, such as Hahnemann orders. I was told, however, some months since, that I had not been faithful to all the rules of the doctrine. I therefore took the trouble to begin again; I have studied the practice of the Parisian Homoeopathists, as I had studied their books, and I became convinced that they treated their patients as I had treated mine, and I affirm that I have been as rigorously exact in the treatment as any other person.”
And he expressly asserts the entire nullity of the influence of all the Homoeopathic remedies tried by him in modifying, so far as he could observe, the progress or termination of diseases. It deserves notice that he experimented with the most boasted substances,—cinchona, aconite, mercury, bryonia, belladonna. Aconite, for instance, he says he administered in more than forty cases of that collection of feverish symptoms in which it exerts so much power, according to Hahnemann, and in not one of them did it have the slightest influence, the pulse and heat remaining as before.
These statements look pretty honest, and would seem hard to be explained away, but it is calmly said that he “did not know enough of the method to select the remedies with any tolerable precision.” [“Homoeopathic Examiner, vol. i. p. 22.]
“Nothing is left to the caprice of the physician.” (In a word, instead of being dependent upon blind chance, that there is an infallible law, guided by which; the physician MUST select the proper remedies.') ['Ibid.,' in a notice of Menzel's paper.] Who are they that practice Homoeopathy, and say this of a man with the Materia Medica of Hahnemann lying before him? Who are they that send these same globules, on which he experimented, accompanied by a little book, into families, whose members are thought competent to employ them, when they deny any such capacity to a man whose life has been passed at the bedside of patients, the most prominent teacher in the first Medical Faculty in the world, the consulting physician of the King of France, and one of the most renowned practical writers, not merely of his nation, but of his age? I leave the quibbles by which such persons would try to creep out from under the crushing weight of these conclusions to the unfortunates who suppose that a reply is equivalent to an answer.
Dr. Baillie, one of the physicians in the great Hotel Dieu of Paris, invited two Homoeopathic practitioners to experiment in his wards. One of these was Curie, now of London, whose works are on the counters of some of our bookstores, and probably in the hands of some of my audience. This gentleman, whom Dr. Baillie declares to be an enlightened man, and perfectly sincere in his convictions, brought his own medicines from the pharmacy which furnished Hahnemann himself, and employed them for four or five months upon patients in his ward, and with results equally unsatisfactory, as appears from Dr. Baillie's statement at a meeting of the Academy of Medicine. And a similar experiment was permitted by the Clinical Professor of the Hotel Dieu of Lyons, with the same complete failure.
But these are old and prejudiced practitioners. Very well, then take the statement of Dr. Fleury, a most intelligent young physician, who treated homoeopathically more than fifty patients, suffering from diseases which it was not dangerous to treat in this way, taking every kind of precaution as to regimen, removal of disturbing influences, and the state of the atmosphere, insisted upon by the most vigorous partisans of the doctrine, and found not the slightest effect produced by the medicines. And more than this, read nine of these cases, which he has published, as I have just done, and observe the absolute nullity of aconite, belladonna, and bryonia, against the symptoms over which they are pretended to exert such palpable, such obvious, such astonishing influences. In the view of these statements, it is impossible not to realize the entire futility of attempting to silence this asserted science by the flattest and most peremptory results of experiment. Were all the hospital physicians of Europe and America to devote themselves, for the requisite period, to this sole pursuit, and were their results to be unanimous as to the total worthlessness of the whole system in practice, this slippery delusion would slide through their fingers without the slightest discomposure, when, as they supposed, they had crushed every joint in its tortuous and trailing body.
3. I have said, that to show the truth of the Homoeopathic doctrine, as announced by Hahnemann, it would be necessary to show, in the third place, that remedies never cure diseases when they are not capable of producing similar symptoms! The burden of this somewhat comprehensive demonstration lying entirely upon the advocates of this doctrine, it may be left to their mature reflections.
It entered into my original plan to treat of the doctrine relating to Psora, or itch,—an almost insane conception, which I am glad to get rid of, for this is a subject one does not care to handle without gloves. I am saved this trouble, however, by finding that many of the disciples of Hahnemann, those disciples the very gospel of whose faith stands upon his word, make very light of his authority on this point, although he himself says, “It has cost me twelve years of study and research to trace out the source of this incredible number of chronic affections, to discover this great truth, which remained concealed from all my predecessors and contemporaries, to establish the basis of its demonstration, and find out, at the same time, the curative medicines that were fit to combat this hydra in all its different forms.”
But, in the face of all this, the following remarks are made by Wolff, of Dresden, whose essays, according to the editor of the “Homoeopathic Examiner,” “represent the opinions of a large majority of Homoeopathists in Europe.”
“It cannot be unknown to any one at all familiar with Homoeopathic literature, that Hahnemann's idea of tracing the large majority of chronic diseases to actual itch has met with the greatest opposition from Homoeopathic physicians themselves.” And again, “If the Psoric theory has led to no proper schism, the reason is to be found in the fact that it is almost without any influence in practice.”
We are told by Jahr, that Dr. Griesselich, “Surgeon to the Grand Duke of Baden,” and a “distinguished” Homoeopathist, actually asked Hahnemann for the proof that chronic diseases, such as dropsy, for instance, never arise from any other cause than itch; and that, according to common report, the venerable sage was highly incensed (fort courrouce) with Dr. Hartmann, of Leipsic, another “distinguished” Homoeopathist, for maintaining that they certainly did arise from other causes.
And Dr. Fielitz, in the “Homoeopathic Gazette” of Leipsic, after saying, in a good-natured way, that Psora is the Devil in medicine, and that physicians are divided on this point into diabolists and exorcists, declares that, according to a remark of Hahnemann, the whole civilized world is affected with Psora. I must therefore disappoint any advocate of Hahnemann who may honor me with his presence, by not attacking a doctrine on which some of the disciples of his creed would be very happy to have its adversaries waste their time and strength. I will not meddle with this excrescence, which, though often used in time of peace, would be dropped, like the limb of a shell-fish, the moment it was assailed; time is too precious, and the harvest of living extravagances nods too heavily to my sickle, that I should blunt it upon straw and stubble.
I will close the subject with a brief examination of some of the statements made in Homoeopathic works, and more particularly in the brilliant Manifesto of the “Examiner,” before referred to. And first, it is there stated under the head of “Homoeopathic Literature,” that “SEVEN HUNDRED volumes have been issued from the press developing the peculiarities of the system, and many of them possessed of a scientific character that savans know well how to respect.” If my assertion were proper evidence in the case, I should declare, that, having seen a good many of these publications, from the year 1834, when I bought the work of the Rev. Thomas Everest, [Dr. Curie speaks of this silly pamphlet as having been published in 1835.] to within a few weeks, when I received my last importation of Homaeopathic literature, I have found that all, with a very few exceptions, were stitched pamphlets varying from twenty or thirty pages to somewhat less than a hundred, and generally resembling each other as much as so many spelling-books.
But not being evidence in the case, I will give you the testimony of Dr. Trinks, of Dresden, who flourishes on the fifteenth page of the same Manifesto as one of the most distinguished among the Homoeopathists of Europe. I translate the sentence literally from the “Archives de la Medecine Homoeopathique.”
“The literature of Homoeopathy, if that honorable name must be applied to all kinds of book-making, has been degraded to the condition of the humblest servitude. Productions without talent, without spirit, without discrimination, flat and pitiful eulogies, exaggerations surpassing the limits of the most robust faith, invectives against such as dared to doubt the dogmas which had been proclaimed, or catalogues of remedies; of such materials is it composed! From distance to distance only, have appeared some memoirs useful to science or practice, which appear as so many green oases in the midst of this literary desert.”
It is a very natural as well as a curious question to ask, What has been the success of Homoeopathy in the different countries of Europe, and what is its present condition?
The greatest reliance of the advocates of Homoeopathy is of course on Germany. We know very little of its medical schools, its medical doctrines, or its medical men, compared with those of England and France. And, therefore, when an intelligent traveller gives a direct account from personal inspection of the miserable condition of the Homoeopathic hospital at Leipsic, the first established in Europe, and the first on the list of the ever-memorable Manifesto, it is easy enough answer or elude the fact by citing various hard names of “distinguished” practitioners, which sound just as well to the uninformed public as if they were Meckel, or Tiedemann, or Langenbeck. Dr. Leo-Wolf, who, to be sure, is opposed to Homoeopathy, but who is a scholar, and ought to know something of his own countrymen, assures us that “Dr. Kopp is the only German Homoeopathist, if we can call him so, who has been distinguished as an author and practitioner before he examined this method.” And Dr. Lee, the same gentleman in whose travels the paragraph relating to the Leipsic Hospital is to be found, says the same thing. And I will cheerfully expose myself to any impertinent remark which it might suggest, to assure my audience that I never heard or saw one authentic Homoeopathic name of any country in Europe, which I had ever heard mentioned before as connected with medical science by a single word or deed sufficient to make it in any degree familiar to my ears, unless Arnold of Heidelberg is the anatomist who discovered a little nervous centre, called the otic ganglion. But you need ask no better proof of who and what the German adherents of this doctrine must be, than the testimony of a German Homoeopathist as to the wretched character of the works they manufacture to enforce its claims.
As for the act of this or that government tolerating or encouraging Homoeopathy, every person of common intelligence knows that it is a mere form granted or denied according to the general principles of policy adopted in different states, or the degree of influence which some few persons who have adopted it may happen to have at court. What may be the value of certain pompous titles with which many of the advocates of Homoeopathy are honored, it might be disrespectful to question. But in the mean time the judicious inquirer may ponder over an extract which I translate from a paper relating to a personage well known to the community as Williams the Oculist, with whom I had the honor of crossing the Atlantic some years since, and who himself handed me two copies of the paper in question.
“To say that he was oculist of Louis XVIII. and of Charles X., and that he now enjoys the same title with respect to His Majesty, Louis Philippe, and the King of the Belgians, is unquestionably to say a great deal; and yet it is one of the least of his titles to public confidence. His reputation rests upon a basis more substantial even than the numerous diplomas with which he is provided, than the membership of the different medical societies which have chosen him as their associate,” etc., etc.
And as to one more point, it is time that the public should fully understand that the common method of supporting barefaced imposture at the present day, both in Europe and in this country, consists in trumping up “Dispensaries,” “Colleges of Health,” and other advertising charitable clap-traps, which use the poor as decoy-ducks for the rich, and the proprietors of which have a strong predilection for the title of “Professor.” These names, therefore, have come to be of little or no value as evidence of the good character, still less of the high pretensions of those who invoke their authority. Nor does it follow, even when a chair is founded in connection with a well-known institution, that it has either a salary or an occupant; so that it may be, and probably is, a mere harmless piece of toleration on the part of the government if a Professorship of Homoeopathy is really in existence at Jena or Heidelberg. And finally, in order to correct the error of any who might suppose that the whole Medical Profession of Germany has long since fallen into the delusions of Hahnemann, I will quote two lines which a celebrated anatomist and surgeon (whose name will occur again in this lecture in connection with a very pleasing letter) addressed to the French Academy of Medicine in 1835. “I happened to be in Germany some months since, at a meeting of nearly six hundred physicians; one of them wished to bring up the question of Homoeopathy; they would not even listen to him.” This may have been very impolite and bigoted, but that is not precisely the point in reference to which I mention the circumstance.
But if we cannot easily get at Germany, we can very easily obtain exact information from France and England. I took the trouble to write some months ago to two friends in Paris, in whom I could place confidence, for information upon the subject. One of them answered briefly to the effect that nothing was said about it. When the late Curator of the Lowell Institute, at his request, asked about the works upon the subject, he was told that they had remained a long time on the shelves quite unsalable, and never spoken of.