Stuart Close

Homoeopathy in Terminal Conditions and Apparently Incurable Diseases

Is Homoeopathy sufficient in terminal stages of such diseases as Bright's, diabetes, tuberculosis, cancer or valvular heart disease?

Is Homoeopathy able to cope with such grave emergencies as collapse during severe acute diseases or shock after injuries or surgical operations?

Is it not necessary in such conditions to resort to the stimulants, narcotics, sedatives, diuretics, etc. of "physiological medicine"; to administer drugs in doses sufficient to produce their so-called physiological effects, for palliative purposes?

In other words, is a homoeopathic physician justified in sticking to his colors in such cases, or should he give up, haul down his colors, confess himself beaten, admit the insufficiency of Homoeopathy in such conditions, and fall back on the routine methods of the dominant school?

In one form or another, these questions are often asked. Indeed, they present themselves frequently to every one of us. Some answer them one way, some another. Some stand up, manfully, proclaiming that the similar remedy is the best palliative, and all-sufficient for every medical emergency. They affirm that every emergency requiring the use of medicine is best met by administering the similar medicine, in dose or form suited to the nature of the case. In the matter of the dose they are not disposed to dogmatize, but are content to let individual judgment and experience decide. They insist, however, that the effect sought shall always be the medicinal, and not the so-called physiological effect; for it is agreed that the purpose in giving a homoeopathic remedy is not to produce symptoms, but to remove those already present. It is established that the homoeopathic dose is always a sub-physiological dose; i.e., a dose too small to produce symptoms. The nature of its action is curative. In practice it often turns out that the highest potencies do the best work.

There are others in our school, (and they are in the majority) who assert that Homoeopathy is not sufficient; that it has its limitations, even in purely medical cases, and that there comes a time in many such cases when it is necessary, for them at least, to abandon homoeopathic methods and resort to traditional or conventional routine measures for relief. They would be "physicians first, and homoeopathists afterwards", and they are disposed to criticize those who do not agree with them.

The real question at issue between these two parties is not one of the size or quality of the dose, as it is commonly held to be, but one of principle and policy. One party holds that the true welfare of the patient is best served by adhering to homoeopathic principles and administering remedies for their medicinal, homoeopathic or curative effect irrespective of the stage of the disease. Theirs is the Hahnemannian treatment exclusively by symptom-similarity. The case may have reached the incurable stage and be hopeless so far as ultimate cure is concerned, but the greatest good, they hold, will be accomplished for the patient if similar remedies in medicinal doses only are used, for the action of the homoeopathic remedy is always along the line, or in the direction of cure. It is curative in nature as far as it goes, and it is the highest good we can attain.

On the contrary, drugs administered in physiological doses have a pathogenetic action. They produce symptoms. They create disturbance in organs where, perhaps, there was no disturbance before. They are noxious to the organism, sick or well. They compel a defensive or eliminative reaction which exhausts the already weakened vital energy. The physiological dose is a toxic dose.

To every action there is a corresponding reaction in the opposite direction. The drug which stimulates in its direct or primary action depresses and weakens in its secondary action. If the case be in its terminal stage, life is shortened and the sum total of suffering increased; for the temporary sense of comfort and well-being sometimes experienced after a palliative or stimulant is fleeting and deceptive. It is soon replaced by the weakness and irritability of the secondary action, with increase of suffering and decrease of ability to endure it. The physiological action is never curative but always pathogenetic. Hence, our purists say that we are never justified in giving drugs for their so-called physiological effects, except when it is necessary to make provings in the healthy for the purpose of creating or augmenting the materia medica.

If the physician knows what can really be accomplished with homoeopathic remedies, and if he had the best welfare of the patient at heart, there would seem to be but one answer to the questions under discussion. He will adhere to the use of homoeopathic remedies only, because they are capable of accomplishing more for the comfort and benefit of both curable and incurable medical cases than any other measure whatever - with one possible exception of which I will speak later. The real duty incumbent upon us is to make ourselves proficient in the application of the homoeopathic method.

It may be stated as a general proposition that the Homoeopathician always treats his case as if it were curable. That is to say, he observes and studies its phenomena, and selects his remedy according to the method of symptom-similarity without being influenced by any feeling or opinion as to what the outcome will be. He knows that death comes in time to all men; that some cases are incurable by any means; and that the most that can be done for some cases is to make their condition as tolerable as possible as long as they live. He may know, or think he knows, that a particular case is incurable or about to die; but he also knows that many cases pronounced incurable and hopeless have been saved, or helped, or cured, by one who ignored all such feelings and suppositions and opinions, and settled resolutely down to the task of finding and giving the similar remedy. The sooner our practitioners realize and accept this as a duty to themselves, their patients, and to Homoeopathy the better will it be for all concerned.

There is too much servility to opinion; too much bending the knee to those who parade the authority of place and power; too much easy compliance with the whims or pleadings of patients who, while they suffer, are yet ignorant of what is good or best for them; too much running after the ever-changing medical fads.

The Homoeopathician should know his art, and know the best there is in it; and being thus prepared, should take and hold his true position as a medical director. Upon occasion, he should be a dictator, brooking no opposition, submitting to no influence which would tend to turn him from his plain path of duty. Rather than lower his standards and compromise his principles, he should withdraw from a case. Thus only will he retain his self respect and the respect of all whose consideration is worth having.

If it were true, as it is claimed, that to resort to other than homoeopathic remedies really accomplished anything for either the comfort or welfare of the patient, the case would be different. But it is not true. No one who has ever seen the two methods and their results side by side, and made a fair comparison between them, would hold for one moment that it was true. Who of us has not taken cases from the hands of those who have pursued such methods up to a point where it was admitted that "nothing more could be done", and seen those came cases, under homoeopathic treatment, either recover, or have life prolonged and suffering greatly ameliorated by homoeopathic remedies alone?

I can conceive a situation where for myself, or for a fellow sufferer, I would welcome, might even demand, the merciful surcease of pain which morphine or chloroform can give, even to "the sleep that knows no waking". But I cannot conceive how any one who knows and has seen what homoeopathic remedies can do, even in the hands of indifferent prescribers, could turn aside into the tantalizing and deceptive paths of "regular medicine". "That way madness lies". The primary effect of certain drugs may simulate Heaven, but their secondary effects give a remarkably good imitation of Hell.

It may be that only the master can select the simillimum, but even the tyro can select a similar, if he tries, and accomplish some good. Certainly he will do no harm, as he will if he resorts to other measures. Let him but do the best he can, and strive always to do better, and all will be well. Let him know, also, that to the one who performs his work in this spirit, "inward revelations" are sometimes given, by which he is richly rewarded for his faith and loyalty to principle. The simillimum has sometimes been found by the humblest among us, who make no pretensions to expertness, and marvelous cures have been thereby effected when they were least expected. Such rewards come only to those who are in "The Way", ready and worthy to receive them.

DISCUSSION

W.S. Hatfield: When is it not right to depend upon the homoeopathic remedy?Stuart Close: I did not specify any particular condition, but I can imagine a condition that might demand relief, or release from suffering, by means of a suitable dose of morphine or chloroform. I can say that only on two occasions have I ever met such a condition. One was a case of uremic convulsions in the terminal stage of chronic interstitial nephritis, immediately preceding inevitable death, and the other was a case of severe traumatism from instrumental delivery of an acephalous monstrosity.

P.E. Krichbaum: I have never found anything better to produce comfort in the dying hours than the homoeopathic remedy. If the patient demands on opiate, they must go elsewhere because I do not use anything but the homoeopathic remedy.

W.S. Hatfield: I believe that the homoeopathic remedy is always equal to the occasion; I have found it to be so. Carbo veg. given in extremis either saves the patient or allows them to die easy.

H.L. Houghton: A year ago last winter I treated a little frail woman for pneumonia; she already had progressive arthritis deformans. Phosphorus was her remedy as it turned out after studying her symptoms a while. She told me a very similar story to that related by Dr. Close, as happening twenty years ago. Does he think that the shouting did it or the Arsenicum?

J.F. Roemer: The adjuvant remedies that were used in the case of the sea captain should be emphasized. I do not believe for a moment that the doctor could have cured him unless he had had the co-operation of the patient and his wife.

E.A. Taylor: In regard to the shouting as to whether it did good or not there need be no trouble. At any rate it did not interfere with the action of the homoeopathic remedy. I was impressed with the point the doctor made when he said that we need not all be experts; we need not be experts, if we know the principles of Homoeopathy and do the best we can, we can do better than by any other known method whether we are experts or not. I was displeased with the circular that our officers sent out to us because it spoke of the members of this society as therapeutics specialists. We are physicians and surgeons. Therapeutics is the most important part of medicine; what do we do most in general practice? Is it not to get the indicated remedy? We are called upon to prescribe for symptoms twenty times as often as we are called on to do surgery. Those who practice Homoeopathy should qualify themselves to practice it. The way for us to do is to go at the problem in a plain sensible way, take the case as well as possible, and then follow the plain directions of Hahnemann; we may not always get the simillimum, but we will get a remedy that will be similar enough to help the patient and will never do any damage such as may be done by some of these new fashioned fads.

G.E. Dienst: The point is, will Homoeopathy do as well for the patient in emergency cases as the old school will? Is the indicated remedy as efficacious in severe hemorrhages, post-partum and others as are the expedients of the old school? In traumatisms? Dislocations? Fractures? Violent vomiting of blood? I simply ask these questions without attempting to answer them.

A.P. Bowie: All who ask such questions as those, should get hold of the recent work by Edmund Carleton, a man who was a surgeon of the first class. He will tell you in that book how his homoeopathic treatment helped him in his surgery. Dr. Carleton has gone, but he has left us a legacy that is worth its weight in gold.

Lawrence M. Stanton: A patient in such a state of collapse that death seems imminent may be said to be an emergency case. Such a case, the heart beats not audible, water rolling into his stomach with audible gurgling as into a paper bag, was given Laurocerasus and made a complete recovery. I think that beats any vaccine.

Julia M. Green: A case of nine got into an extreme condition and it seemed would have died until it dawned upon me that it was a complete picture of Opium which produced a favorable reaction and recovery. I was asked to report it at a meeting and did so. After reading it they all crowded around me and said, that is all right but I could not have done it.

C.M. Boger: it is well not to make up one's mind as to what Homoeopathy is capable of doing or not doing and always await an extension of its possibilities. Careful and conscientious prescribing does greater and still greater things with our remedies. Our new hospital superintendent found a lot of old uncured cases had been dumped there. Among them a case of syphilis in a woman who had been infected eighteen years before. Some eight months ago she had had an attack of grippe followed by myelitis and contracture of the hamstrings; the lower limbs were firmly flexed on the thighs, hands clenched and she had the argyll-Robertson pupil. She could not even sit up in bed. She now received a daily massage and a single dose of Pulsatilla 1M. In three weeks she was better; in seven weeks she was dressed and sitting at the window, after which complete recovery gradually followed.

G.E. Dienst: I want to say for myself that I asked the question in order to bring out this very discussion. Personally I have had very little trouble with emergency cases. The indicated remedy will do more than all the thousand that are not indicated. A child was sent to me from Wisconsin; the child was losing rapidly. I tried to find symptoms but could not. The weight had fallen from twelve to five pounds. I prescribed as best I could without result, when the family moved to Lockport. They sent for me and told me to bring a death certificate. I found the child nearly gone. It was so weak that when I pulled the eyelid down it could not raise it up. Finally I asked the mother what she ate while she was carrying the child. I found out that she had an inordinate craving for salt. Only one dose of Natrum muriaticum was needed. He is a big boy now.

Geo. G. Starkey: I am emboldened to add a stone to the pile that has been heaped up here from the experience of many. A little boy of five years was the patient. He was in a tremble, uncertain of movement, could not walk straight, staggering, running into the door-frame when trying to go through; easily crying, eyes rolling; some nystagmus; getting rapidly worse. Legs were giving away, yet he wanted to climb things. It looked like Friedreich's ataxia. Phosphorus caused a slight improvement. Dr. Kent helped me to see that Alumina was indicated and in the 10m after a slight aggravation it helped promptly. In a few weeks, he was a well child.

Stuart Close: I can only endorse Dr. Bowie's suggestion about the excellence of the posthumous work of Dr. Carleton. I hope that every member of this association will send to Boericke and Tafel for a copy and read it as they would their bibles. It will do more to strengthen Homoeopathy than any other book that has been published within the last twenty-five years. As to Dr. Houghton's question I may say that I did not "shout", I merely spoke in an ordinary tone of voice, and it was not at all to sustain my own courage; thought of myself never entered my mind. I never felt more exultant and confident nor have I ever had a keener inward sense of power and efficiency than I had when I entered that room. The course that I pursued was entirely without premeditation although I saw afterward that I had followed physiological lines and dynamical principles in beginning with the smallest muscle in the upper part of the organism, the upper eyelid.While I understand Dr. Taylor's and Dr. Houghton's attitude towards anything that savors of mysticism, I believe that everything I did was necessary to recall that patient and save her from dissolution; it was necessary to relax those rigid muscles, to awaken her attention, and to arouse in some way her desire and will to live. She had died in her mind; the victim of ignorance and error; she had been surrounded by those who thought that she was dying, and said so in her presence. The depressing psychical influence had brought on slowly what is brought on rapidly in those cases of hazing in our colleges, where students are sometimes told that they are being bled to death, and while blindfolded, the arm is scratched and water poured slowly down so that they imagine they feel the blood trickling down. Death from fright has occurred in such cases. My patient was dying because psychical traumatism was an element in her condition as well as physical disease.Psychical treatment was as necessary as medicine. I used a combination of physical manipulation, psychical control and drug action, and I am certain that she would have passed away never to return if I had omitted any of them.