An Engineer Talks on Medicine

I

EVEN a casual survey of the broad field of healing will turn up the most divergent doctrines as to disease, cure, and health. They divide practitioners into schools, mutually exclusive, more or less competitive, about as receptive each of another’s philosophy as rival political parties. In fact, the more powerful of them have their political aspects quite as marked as their scientific. In discussing the subject almost everybody, professional as well as lay, stresses what he or she ‘believes,’ or what his or her ‘view’ happens to be. Medical wisdom has a nebulous fringe. Now is that not a hard pass for the layman? Charged with preserving whatever he may have of health and perhaps improving it, he is faced sooner or later with the practical task of deciding what advice and assistance to select. How is he to choose?

A bashful swain in a bevy of girls has no more difficult or delicate selection to make, nor is he more likely to be booed.

Modesty stands much in the way. Few indeed have been the professors of medicine who have suggested at all audibly that there may be understandable laws at the bottom of the science, as there are laws underlying most fields of exact knowledge. It is not that medicine has lacked a most fascinating publicity. On the contrary, it occupies a generous share of type space; but the conclusion most readily drawn from the public print would be that, rather than any laws of general application, there are separate laws for separate ailments, or at any rate for separate groups of diseases, and that successful practice is too mystical, too involved, too confused and technical for a mere layman to grasp. People thus dazzled find interesting and ingenious ways of avoiding the need of thought and yet making a choice that they can accept. Some gravitate to the most prominent physician in town, gauging therapeutic success by size of practice and invoicingability. Business men of ample spoils, deeming themselves good buyers, want their doctors in Packards. The more doctrinaire take up with one or another of the ‘systems,’ fasten themselves to it offensively and defensively, much as they would join a church, and patronize those physicians who profess the chosen articles of faith. They place the emphasis less on circumstance and more on denomination. A taste for precision inclines some people of means to specialists. If by precedent or by comparing notes with neighbors they persuade themselves to a fair certainty what part of their being is at the time deranged, they may take upon themselves the responsibility of selecting which specialist to consult. On the other hand, if discretion is held above courage they may employ the family physician to make the preliminary survey and to guess more expertly to what address they should be referred, saving in that way unnecessary examinations of parts not rightfully under suspicion.

To choose with thought, however, and even to discover simple principles in medicine, is not unreasonably hard for the layman if he discounts at the outset the uncomfortable feeling that he may be in that respect odd and lonely. Going candidly at it, he will soon make an enlightening discovery. He will find all thought and action in the practice of healing divided into two great parts. One embraces the vast majority of the profession and the laity, and devotes itself to isolated diseases; the other embraces but a very few, and deals with disease-tendencies and constitutional remedy. On one side he has found all the confusion, and on the other a few simple principles he can really understand.

This division occurred about one hundred years ago, as a result of Hahnemann’s work. He had based all of his conclusions on experiment, thorough and systematic, covering an arduous lifetime, working along independent lines and carrying them to their end. He more than anyone else had deduced laws. He was therefore reviled by the established profession. His work was distorted and misunderstood even by well-meaning would-be disciples.

What characterizes this odd philosophy? In what principal ways does it depart from usual traditional or common thought?

In the first place. Homoeopathy has a different objective. It is quite satisfactory to almost any ordinary physician if he succeeds in causing the symptoms of the ailment to disappear. Any means may be justified that has that result. A cancer may be carved off. After that, whatever there may be for the patient to complain of, certainly he no longer suffers from cancer, for there is no cancer. Suppose the cancer occurs at some point — say on an important internal organ — where it cannot be cut off, because that would kill or seriously injure the patient. Two other courses are still open: a delicate operation to remove the organ, eliminate the cancer, and replace the organ with all necessary connections, — perhaps to substitute a fresh part from another individual, — or a cancer-destroying agent applied at the spot. New agents are discovered every few months. X-ray, ultra-violet light, and radium have been numbered among them. And related to these in purpose, but different in technique, are the many attempts to isolate a serum or virus such that, when properly injected into the blood, it will terminate the bacterial action that characterizes cancer. Whole institutions with large endowment, elaborate equipment, and amazing laboratory methods are devoted to the quest for still other and better ways of ‘attacking’ this one disease.

All this is based on the idea that cancer is a local affection and that, aside from the cancer itself, all the remainder of the patient is well. Whatever the disease, the usual examination goes no further than that; it stops at the boundary of the affected parts and includes nothing that went before.

Consider the matter from the other end. People confess that they are sick. If you sit down with one of them and make note of everything he tells you, you will cover page after page with notes and by looking into his face you will see that he is sick. He may drift from one doctor to another, be examined from top to toe, and every examination and every test may turn out negative, and in that case he would be pronounced sound. Allow him to go unaided, even though he recover some of his lost powers for a time, nevertheless he becomes sick so that any doctor would recognize it finally. When in later years such a person shows cancer of some sort, tuberculosis, fatty degeneration of the liver, some form of Bright’s disease, or whatever it may be, can we excuse the physician who said in the first instance that he was not sick? The doctor was blind to everything that was not ponderable, that he could not sense with his own eye, and he passed over the sensations that the patient wanted to tell him about. He considered only a part of his case.

Again, if the case is presented after the disease has run to ultimation in morbid tissue, and the doctor can see by his own independent senses that something is wrong, he then gathers only an unimportant part of the facts if he neglects what went on before — precisely the kind of things, the very manner of suffering, that would have been his surest guide to treatment years before, had he known how to make use of it. That is the error of the doctor who treats cancer merely as cancer.

These elaborate institutions for cancer research are beside the mark. What they ought to be studying is not cancer, but patients who have cancer, together with patients who are going to have cancer if they arc not cured now.

It is characteristic of Homœopathy that disease-tendencies are divined and treated rather than diseases themselves. The significance of ailments is in relation to the tendencies that they betray. If ihe specific maladies are attacked separately the patient is not improved, — he may easily be made seriously worse, — even though the troubles that describe the disease are terminated. It is invariably true that when some deep-seated pathology is presented, such as a case of cancer, the patient’s peculiarities that went before were less serious and easier to treat.

Attacking a specific symptom or special disease separately, aiming to eradicate it without reference to the patient as a whole, results in one of two ways. First and least harmful is palliation. A sore throat is palliated by a hot pack. A headache is palliated by soaking the feet in hot water. Such devices establish no reason why the pain should not return. The patient is eased, but not cured. Now the second is a more dangerous way of getting rid of symptoms — suppression. Surgical removal of the cancer is a case in point. Driving away eczema by external lotions is another. Suppression closes off the avenue of discharge taken by the disorder. If the eruption is regarded as the entity to be treated in eczema, and if it is suppressed from outside, it may never return as eczema, but sooner or later it will return — very likely as Bright’s disease.

Much modern therapy takes this blundering course, driving the patient from a comparatively light malady to a deeper and more difficult one, and we wonder why it is that, along with the increasing power of modern specifics, there is also an increase in the deepest disorders of body and brain, which end in death or public asylum. We wonder at the frequent stories in the paper telling of the sudden ending of a vigorous invaluable career in a shock, a general breakdown, a sudden, complicated dissolution, somewhere between fifty-five and sixty-five years of age; and the answer almost always is local suppression, cumulative through life, and practised by the choice of the profession. This is not altogether to be laid at the physician’s door. We get in doctors’ services, as in other services, about what we demand, and so we pay for our thoughtlessness.

II

Though almost any physician is quite content with any means that will rid the patient of disease symptoms, Homœopathy, as I have suggested, knows three ways in which that can be done: palliation, suppression, — one futile and the other desperately harmful, — and cure. What is cure? Cure rids the patient not only of his disease symptoms but also of his disease-tendencies; renders him less likely to be sick; places him at a higher level of health than he has known before. To cure in this sense is the full mission of the doctor.

How then is cure to be recognized, if not by the disappearance of the symptoms?

Cure follows out a definite law. This law, like Newton’s law of motion, is commonly stated in two parts, though it is one law. First, cure proceeds from within outward. ‘Complaints of the heart and chest and head must in recovery be accompanied by manifestations upon the surface, in the extremities, upon the skin, nails, and hair. Hence you will find that these parts become diseased when patients are getting well. . . . In cases of rheumatism of the heart you find, if the patient is recovering, that his knees become rheumatic; and he may say, “Doctor, I could walk all over this house when you first came to me, but now I cannot walk, my joints are so swollen.”That means recovery.’ Thus the late Doctor Kent of Chicago to his pupils twenty-five years ago. Cure proceeds from more important to less important parts of the economy, and thence permanently away.

Secondly, cure retraces in inverse order the coming of the malady. A woman of middle age was about to go to the operating-table in a famed Eastern hospital, near death from cancer. Surgeons prescribed operation, but said at the same time that she could not survive the shock. It happened that a sister knew of a true Homœopathist and determined to try him. He examined into the history of the case, as well as into the cancer, and found out what had gone before. She had suffered agonies of another sort months earlier, had been treated locally, and supposed she had been cured. This former malady was brought back to her and it in turn cured, and she lived to advanced age in good health and activity.

Homoeopathy stands alone in medicine in results aimed at, in facts taken account of when examining a case, in conception, and in method. It stands alone also in that there are laws — definite, simple, understandable — that always apply and always, when applied, work.

But someone says: ‘You haven’t been describing the Homoeopathy I have heard about. You have n’t mentioned the infinitesimal dose.’

The handling of infinitesimals is pari of Homœopathy. So also is the law of similars, from which it gets its name. But these belong to the therapeutics, while we are talking of the philosophy. When you know the laws you can employ potentized remedies. If you do not know the laws, potentized remedies mean nothing to you and you can accomplish next to nothing with them. Potentizing empowers medicines. That is a matter of experiment. When you have found the basis of a prescription according to the laws, remedies potentized and used in the right potency do the quickest and most permanent work.

Notice, if you will, how much more comprehensive is the study of the case in Homœopathy; and yet there is no such thing as diagnosis. The peculiarities of the patient that guide to the remedy are not those that identify the disease. The patient is considered as a whole, and treated not on the diagnostic manifestations, but on the totality of symptoms. When all the symptoms, those belonging to the patient and those belonging to the specific disease, — if there is a specific disease, — have disappeared from within outward and in the inverse order of their coming, then there has been a cure.

So much for theory. The fact is that this philosophy has penetrated traditional medicine not at all. It could not penetrate. It would have to upset, wreck, demolish. Too many physicians are dogmatists, and too many laymen like that sort of physician. The traditionalists, called regulars, meet in convention, compare notes, relate their experiences, recount their laboratory discoveries, air their differences, and settle by consensus of opinion what shall be the approved practice. The following year, their experience having changed, they vote out the old practice and vote in a new one. Every disease is a separate problem. New diseases have a special fascination. New diseases, like influenza, catch them unprepared. They have little to offer to those armies of people who suffer but who have no disease that can be named. Traditional medicine is no nearer to law now than it was two centuries ago, though its practice has been shifting.

III

When Homœopathy came into the field traditional medicine was in a bad way. It used drugs in big doses. They were ill fitted to the maladies at which they were aimed. They brought on gross overeffects, and drug afflictions became as common and as dangerous as the more natural sicknesses. Public and profession were deserting the faith and casting about for something better. The thought was growing that, as Doctor Holmes later expressed it, the world would have been the gainer if all the drugs that people had consumed had been sunk in the sea.

Homœopathy seemed to offer a way to use drugs in very small doses and thus encourage the old school to abandon their gross drugging. This influence, superficial as it was, was still under way when the work of Pasteur came on the field. Here, it seemed, would be a possible escape from drugs altogether, by substituting preparations containing microörganisms nicely fitted to the diseases because derived from them. In the temper of medicine at that time, this was seized upon and elaborated as no other innovation has ever been seized by the established school. It was confidently expected to furnish a specific for each and every human ailment, and to establish the origin of each at some point outside the human economy, where it could be located, attacked, and routed. Entrenched practice had laughed at infinitesimals, but here was an opportunity to reach infinitesimals by making them seen, by bringing them to light. This was real progress. Besides, were not preparations similar in nature to the infecting agents to be used as cures, and would that not embrace all there could be in the law of similars?

Not all the influence of these two major developments was felt inside the traditionalist camp. Going a bit further than old-school men, but still failing to comprehend the philosophy, a new school grew up, called by the name ‘Homœopathy.’ These men made some study of Hahnemann’s work, used the laws sometimes when cases were light, and got some characteristic successes in that way; but in desperate circumstances they resorted to the same palliatives, stimulants, and suppressives that characterized the older school. They thus took up in a limited way with some of the practices, but did not absorb the reasons. They were superficial, and presented a wavering front.

With the advent of bacteriology as a factor in old-school practice, bearing a ghastly resemblance to Homœopathy, but dealing nevertheless with diseases and not with patients, it is little wonder that these half-breed Homceopathists were disconcerted. They were on no firmer ground scientifically than their elder brothers. They were no less exponents of empiricism. Most of their thunder had been stolen. They flocked to serum therapy with quite as much zest as anybody. They lost their distinction as to method, and had never had any as to principle. Out of the jumble there could be ultimately no other issue than submergence.

So one hears everywhere that Homœopathy is a dead issue. The great schools and hospitals that used to bear the name have closed or have been handed over to the dominant practice. Scarcely a single medical college of first rank that was teaching at the opening of this century what passed generally as Homœopathy has survived. The once powerful flourishing American Institute has fear and confesses it. Once reared as a menace to the entrenched medicine of its day, once the butt of the medical jibe and the victim of professional slight, scorn, persecution, this ill-founded mongrel empiricism is nowpassing out of sight by a process like that which one of our Presidents described as ‘benevolent assimilation.’

Thus draws to a close an important epoch in the history of medicine. If the dominant school swells with pride in a well-earned victory, it is entitled to do it. But the blessing of it is that the air is becoming clearer. One confusion is blending itself with another, naturally enough, and it leaves standing in a less beclouded light the simple truths that, are the law s of medicine. Homœopathy itself is being rid of travesty, sophistry, and plausible misrepresentation. Homœopathy is not going down, but has come to the morning of a new day.