Medical Essays, 1842-1882. Oliver Wendell Holmes

statements been made by the most competent persons of the utter failure of all their trials, and there were the same abundant explanations offered as used to be for the Unguentum Armarium and the Metallic Tractors. I could by no possibility perform any experiments the result of which could not be easily explained away so as to be of no conclusive significance. Besides, as arguments in favor of Homoeopathy are constantly addressed to the public in journals, pamphlets, and even lectures, by inexperienced dilettanti, the same channel must be open to all its opponents.

      It is necessary, for the sake of those to whom the whole subject may be new, to give in the smallest possible compass the substance of the Homoeopathic Doctrine. Samuel Hahnemann, its founder, is a German physician, now living in Paris, [Hahnemann died in 1843 at the age of eighty-seven years. In 1796 he published the first paper containing his peculiar notions; in 1805 his first work on the subject; in 1810 his somewhat famous “Organon of the Healing Art;” the next year what he called the “Pure Materia Medica;” and in 1828 his last work, the “Treatise on Chronic Diseases.” He has therefore been writing at intervals on his favorite subject for nearly half a century.

      The one great doctrine which constitutes the basis of Homoeopathy as a system is expressed by the Latin aphorism, “SIMILIA SIBILIBUS CURANTUR,”

      or like cures like, that is, diseases are cured by agents capable of producing symptoms resembling those found in the disease under treatment. A disease for Hahnemann consists essentially in a group of symptoms. The proper medicine for any disease is the one which is capable of producing a similar group of symptoms when given to a healthy person.

      It is of course necessary to know what are the trains of symptoms excited by different substances, when administered to persons in health, if any such can be shown to exist. Hahnemann and his disciples give catalogues of the symptoms which they affirm were produced upon themselves or others by a large number of drugs which they submitted to experiment.

      The second great fact which Hahnemann professes to have established is the efficacy of medicinal substances reduced to a wonderful degree of minuteness or dilution. The following account of his mode of preparing his medicines is from his work on Chronic Diseases, which has not, I believe, yet been translated into English. A grain of the substance, if it is solid, a drop if it is liquid, is to be added to about a third part of one hundred grains of sugar of milk in an unglazed porcelain capsule which has had the polish removed from the lower part of its cavity by rubbing it with wet sand; they are to be mingled for an instant with a bone or horn spatula, and then rubbed together for six minutes; then the mass is to be scraped together from the mortar and pestle, which is to take four minutes; then to be again rubbed for six minutes. Four minutes are then to be devoted to scraping the powder into a heap, and the second third of the hundred grains of sugar of milk to be added. Then they are to be stirred an instant and rubbed six minutes,—again to be scraped together four minutes and forcibly rubbed six; once more scraped together for four minutes, when the last third of the hundred grains of sugar of milk is to be added and mingled by stirring with the spatula; six minutes of forcible rubbing, four of scraping together, and six more (positively the last six) of rubbing, finish this part of the process.

      Every grain of this powder contains the hundredth of a grain of the medicinal substance mingled with the sugar of milk. If, therefore, a grain of the powder just prepared is mingled with another hundred grains of sugar of milk, and the process just described repeated, we shall have a powder of which every grain contains the hundredth of the hundredth, or the ten thousandth part of a grain of the medicinal substance. Repeat the same process with the same quantity of fresh sugar of milk, and every grain of your powder will contain the millionth of a grain of the medicinal substance. When the powder is of this strength, it is ready to employ in the further solutions and dilutions to be made use of in practice.

      A grain of the powder is to be taken, a hundred drops of alcohol are to be poured on it, the vial is to be slowly turned for a few minutes, until the powder is dissolved, and two shakes are to be given to it. On this point I will quote Hahnemann's own words. “A long experience and multiplied observations upon the sick lead me within the last few years to prefer giving only two shakes to medicinal liquids, whereas I formerly used to give ten.” The process of dilution is carried on in the same way as the attenuation of the powder was done; each successive dilution with alcohol reducing the medicine to a hundredth part of the quantity of that which preceded it. In this way the dilution of the original millionth of a grain of medicine contained in the grain of powder operated on is carried successively to the billionth, trillionth, quadrillionth, quintillionth, and very often much higher fractional divisions. A dose of any of these medicines is a minute fraction of a drop, obtained by moistening with them one or more little globules of sugar, of which Hahnemann says it takes about two hundred to weigh a grain.

      As an instance of the strength of the medicines prescribed by Hahnemann, I will mention carbonate of lime. He does not employ common chalk, but prefers a little portion of the friable part of an oystershell. Of this substance, carried to the sextillionth degree, so much as one or two globules of the size mentioned can convey is a common dose. But for persons of very delicate nerves it is proper that the dilution should be carried to the decillionth degree. That is, an important medicinal effect is to be expected from the two hundredth or hundredth part of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of the millionth of a grain of oyster-shell. This is only the tenth degree of potency, but some of his disciples profess to have obtained palpable effects from “much higher dilutions.”

      The third great doctrine of Hahnemann is the following. Seven eighths at least of all chronic diseases are produced by the existence in the system of that infectious disorder known in the language of science by the appellation of PSORA, but to the less refined portion of the community by the name of ITCH. In the words of Hahnemann's “Organon,” “This Psora is the sole true and fundamental cause that produces all the other countless forms of disease, which, under the names of nervous debility, hysteria, hypochondriasis, insanity, melancholy, idiocy, madness, epilepsy, and spasms of all kinds, softening of the bones, or rickets, scoliosis and cyphosis, caries, cancer, fungua haematodes, gout,—yellow jaundice and cyanosis, dropsy,—”

      [“The degrees of DILUTION must not be confounded with those of POTENCY. Their relations may be seen by this table:

      lst dilution,—One hundredth of a drop or grain.

      2d “ One ten thousandth.

      3d “ One millionth, marked I.

      4th “ One hundred millionth.

      5th “ One ten thousand millionth.

      6th “ One million millionth, or one billionth, marked II.

      7th “ One hundred billionth.

      8th “ One ten thousand billionth.

      9th “ One million billionth, or one trillionth, marked III.

      10th “ One hundred trillionth.

      11th “ One ten thousand trillionth.

      12th “ One million trillionth, or one quadrillionth, marked

       IV.,—and so on indefinitely.

      The large figures denote the degrees of POTENCY.]

      “gastralgia, epistaxis, haemoptysis,—asthma and suppuration of the lungs,—megrim, deafness, cataract and amaurosis,—paralysis, loss of sense, pains of every kind, etc., appear in our pathology as so many peculiar, distinct, and independent diseases.”

      For the last three centuries, if the same authority may be trusted, under the influence of the more refined personal habits which have prevailed, and the application of various external remedies which repel the affection from the skin; Psora has revealed itself in these numerous forms of internal disease, instead of appearing, as in former periods, under the aspect of an external malady.

      These are the three cardinal doctrines of Hahnemann, as laid down in those standard works of Homoeopathy, the “Organon” and the “Treatise on Chronic Diseases.”

      Several other principles may be added, upon