A Cyclopedia of drug pathogenesy – Book review

Book review by Dr Beenadas

Issued Under The Auspices  Of :- The  British Homoeopathic  Society And The  American  Institute of Homoeopathy.

Edited By : Richard Hughes,  J.P. Dake, M.D.

With The Aid Of Following Consultative Committee

Great Britain.                                                United States.
J.DRESDALE,  M.D.                                 CONRAD WESSELHOEFT, M.D.
R.E. DUDGEON, M.D.                              H.R. ARNDT, M.D.
A.C. POPE, M.D.                                       A.C. COWPERTHWAITE,M.D.

PUBLISHED BY :-   B. Jain Publishers  Pvt. Ltd.    New Delhi, India.

VOLUMES :-

This work has four volumes.

Vol. 1 –    1886 –  Abies  – Cannabis indica

Vol   2-    1888 – Cantharis – Kali. iod

Vol  3 –    1890 – Iodoformum – Sabadilla

Vol  4 –    1891 –  Sabina –  Zincum valerianicum.

TOTAL DRUGS –  304.  3027 pages.

Price  – Rs.500

Richard Hughes 1836-1902

Richard Hughes was born in London, England. He received the title of M.R.C.S. (Eng.), in 1857 and L.R.C.P. (Edin.) in 1860. The title of M.D. was conferred upon him by the American College a few years later.

Richard Hughes was a great writer and a scholar. He actively cooperated with Dr. Timothy Field Allen to compile his ‘Cyclopedia of Drug Pathogenesy‘ and rendered immeasurable aid to Dr. Robert Ellis Dudgeon in translating Samuel Hahnemann’s ‘The Materia Medica Pura‘ into English.

n 1889 he was appointed an Editor of the ‘British Journal of Homeopathy‘ and continued in that capacity until his demise.

Books:

  • A Repertory to the Cyclopaedia of Drug Pathogenesy.
  • Cyclopaedia of Drug Pathogenesy
  • Manual of Pharmacodynamics.
  • Principles & Practice of Homeopathy.
  • The Knowledge of the Physician. 

Richard Hughes co-edited the British Journal of Homeopathy (including this one on Cholera), The Materia Medica Pura of Samuel Hahnemann,

A Course of Lectures Delivered at the Boston… ,  On the Sources of the Homœopathic Materia Medica: Three Lectures Delivered … , A Manual of Therapeutics According to the Method of Hahnemann.

He contributed to the American Institute of Homeopathy Proceedings… and the Transactions of the Homeopathic Medical Society of the State of New York, the Hahnemannian Monthly and many other pamphlets and journals on both sides of the Atlantic.

The Faculty of Homeopathy still conducts annual Richard Hughes Memorial Lectures.

The Cyclopedia of Drug Pathogenesy was a unique attempt to present a truly critical collection of the materia medica and demanded a high degree of dedication from its readers. He wrote, “It seems to be the impression of some that our Cyclopedia of Drug Pathogenesy is a mere luxury of pathogenesy, quite beyond the requirements of the student and the practitioner, and only really valuable to the teacher or writer on the subject.”

But it was the student who was expected to use the Cyclopedia of Drug Pathogenesy. He wrote,“will be found full of life and meaning; and materia medica, hitherto the dullest and most hopeless, will become the most interesting of studies.”

American ‘Hahnemannian Monthly‘ described the Cyclopedia of Drug Pathogenesy as “a work without parallel in all medical literature” (which was undoubtedly true) and went on to say that

In the preface of  The Cyclopedia of Drug Pathogenesy, the editors express acknowledgments to  –

  • Dr.Dudgeon, – for the bulk translations from German.
  • Dr. Galley Blackley – for proovings of Jorg’s   Materialien
  • Dr. Pullar – for the Austrian provings of Bryonia
  • Dr. J.H.Clarke –  for provings of Argentum nitricum
  • Dr. Lloyd Tuckey – for, Aurum, Campher

Introduction
Introduction  gives a full account  about the origin, nature and objects of this work. The object of art of Medcine is the cure of disease. For this, practitioner of art – the physician, presses into his service all agencies which makes for health.  Among these are the  medicines, that are taken from one or other of the kingdoms of Nature, which when administered to sick person, modify some or whole of his morbid state.  They are  discovered either empirically or rationally. Rational mode is by interference from their  physiological effects. It is conceived that, the rational application of drug to disease will be greatly furthered by the presentation in detail of the original experiments and observations from which our knowledge of pathogenesy is derived.

Origin
In 1796, Hahnemann published in Hufeland’s Journel – ‘On a new Principle for Ascertaining the Curative Power of Drugs’.  This “new principle” was their selection according as their effects on the healthy resembled more or less closely the features of the morbid conditions to be treated. It was the rule afterwards formulated as “similia similibus curentur”- let likes be treated by likes. It was obvious that for carrying it out the first requirement was a full knowledge of drug pathogenesy,- much fuller than was afforded by the records of poisoning and over-dosing which were then available. Hahnemann collected these from all sources; but he completed them by carrying out a vast series of experiments of his own. That which Magendie began some ten years later with the lower animals. Fragmenta de Viribus Medicamentorum Positivis (1805), Reine Arzneimittellehre (1811-1833), and Chronischen Krankheiten (1835-1839), contain pathogeneses of nearly one hundred medicines, obtained largely by “proving” on his own person and those of his friends and disciples. The result is an immense accumulation of the pathogenetic material required for working the homoeopathic method. But it lies scattered in books and journals innumerable, and is inaccessible in its entirety to the ordinary student and practitioner. For these, a collection of drug pathogenesy should be made, which shall be available for their needs. The method of Hahnemann requires comparison between the totality of symptoms on the two sides. For homoeopathic practice, therefore, even more than for other therapeutic applications of pharmacology, a presentation in detail of the original records is desirable and necessary.

The need is not now felt for the first time, nor is this the earliest attempt to supply it, The Manual of Jahr, the Handbuch of Noack and Trinks, were just such collections brought down to their day-now forty years ago; and the Encyclopoedia of Dr. Allen (1874-1880) has performed a similar task for our own time.

The  answer to such challenge is twofold.

1. First of all, Dr. Allen’s work is an unrevised edition of the homoeopathic Materia Medica. He has felt it his duty, as editor, to admit all published provings made bona fide, whatever may have been his private opinion of their worth. He has since shown that,  he can discriminate as could be desired. Their publication has brought to an acute crisis the dissatisfaction which has long smouldered over Jahr’s Manual. It has been felt throughout the homoeopathic body that the for revising our pathogenetic material, upon definite principles, and to retain only that which is genuine.

The urgent need of such revision have takenup – Clotar Muller, Langheinz, Roth, Trinks, Arnold, Yeldham.  They wrought according to their light; in ours, which we are fain to think brighter, we must submit their work to a searching scrutiny, which will often lead to its rejection.

2. Other defects in Dr. Allen’s work is,  the editor has himself acknowledged that the translations which form so large an element in it are often incorrect. This is a serious matter and impair the confidence of such a work. Again, in his earlier volumes especially, Dr. Allen has too frequently worked with second-hand material. Earlier volumes do not exclude so-called “clinical symptoms,” -i.e. such as have disappeared during the use of the medicines under which they are placed; and these not always distinguished from their surroundings. Dr. Allen has indeed intended so to distinguish them (by the usual prefix); but has frequently taken matter from compilations where no such sign is used, and thus given as pathogenetic (e.g. under “Calcarea phosphorica”) scores of symptoms which are obviously of clinical origin.

The result is that this great work, Encyclopoedia of Pure Materia Medica is  to a large extent untrustworthy, and the work must be done over again. It has laid the foundation of the Materia Medica of the future.

This was the conclusion arrived at by the British editor, after  examination of the first thirty medicines of Dr. Allen’s first volume. In the presidential address delivered at the British Homoeopathic Congress of 1880, Dr. Yeldham called attention to the unsatisfactory state of out Materia Medica, and urged action being taken for its revision. In March 1882,a series of resolutions passed, by the British Homoeopathic Society, declaring for such reconstruction, and  the two practitioners expressing its readiness to undertake the task. A Committee of seven members was named for the purpose, and instructed to present specimen medicines, which it continued to do during the next two years.

In the meantime, the American editor had been appointed-in 1882- chairman of the Bureau of Materia Medica in the American Institute of Homoeopathy; and he took advantage towards purging our symptomatology. He had advocated a thorough re-proving of the constituents of the Materia Medica; but, finding the profession unwilling to make the necessary efforts for this purpose, he proposed co-operation with what was being done in England to revise and re-present existing material. In 1883,  much correspondence ensued, the issue of which was a vote of the British Society that Dr. Hughes, as a delegate therefrom, should attend the annual meeting of the Institute in June, 1884, and should in conference with the members of the Bureau endeavor to arrive at some conclusion which might be presented to the two national bodies for their acceptance.

The result of such conference was a decision to recommend the formation of ‘Cyclopaedia of Drug Pathogenesy,’ to be carried our under the following instructions:

1  .Give the scientific name and synonyms of each article, and its natural order.

Ii.  Give a narrative of all provings, stating the symptoms in the order of their occurrence, with such condensation as  completeness allows.

Iii.  Give, in describing virulent drugs, such selected cases as  may properly illustrate the various forms of poisoning    by them, condensed as before.

Iv.  Give the results of experiments on the lower animals,  where of value; generally in abstract.

V.  Trace all version and copies to their originals, and verify, correct, or reproduce therefrom.

Vi.  Include, as a rule, no drug that has not shown pathogenetic power in two or more persons.

Vii  Include in the narratives, as a rule, no symptom  reported as occurring from a drug administered to the  sick.

Viii . Include no symptoms reported as occurring in the  persons of provers under the influence of other drugs,   or when in conditions or circumstances not allowing a   clear reflection of the pathogenetic influence of the   article under consideration.

Ix.  Include symptoms reported as coming from attenuations.

X.  Above the 12th decimal only when in accord with symptoms from attenuations below.”

This recommendation was adopted by the American Institute, and subsequently by the British Society, the physicians named on the titlepage being appointed in their respective countries editors and consultees.

A few remarks upon the rules thus formulated may now advantageously be made. 

I. The first rule needs no exposition. The headings are to be sufficient to identify precisely the substance whose effects are to record, and to indicate its natural relations. In the account of each proving,  states the form in which the drug was employed; and anything more than this would be irrelevant to a Cyclopaedia of Pathogenesy.

2. The second rule prescribes the from the  Materia Medica, and is of the utmost importance. Hahnemann kept in manuscript the daily records made by himself and his fellow-provers; publishing them to the world in the form of a schema, in which the individual symptoms elicited by the drugs were distributed according to their anatomical seat. Many provers of his school and Austrians have imitated him in so doing. In this respect the present work makes an entirely new departure. Whenever we have provings in narrative, and arranging them in accordance with the time -indications generally given- to restore them to something like individuality and sequence.

It should scarcely be necessary to learn disease from books, the symptoms of a given malady presented, in the Hahnemannian schema. We have so to learn drug-disease; and for clinical cases illustrating the evolution of each disorder in its various forms. In the series of narratives given under each drug we have as many varieties of its specific sick making power, from which we can learn its general action, its kind and character, and which we can fir-as likes to likes- to the cases of disease which come before us.

The only objection to such presentation of this provings would be the voluminousness of the result, as illustrated in the I04 pages of the Annals of the British Homoeopathic Society required for the pathogeneses of ten of the acids, and the I6 pages of the British Journal occupied by that of aconitinum. But here comes in our rule of condensation, not contemplated when the above-mentioned were compiled, but since illustrated in the instances of carbolic acid and of sulphur. By this potent solvent a considerable reduction of bulk can be effected, and this without any sacrifice of the minutiae of pathogenesis so justly prized in homoeopathy. By its use, moreover, we shall be enabled to present our finer and poorer material in just proportion: the former we can give in all reasonable fullness, while the latter will bear a considerable degree of epitomizing.

3. Drs. Dudgeon and Hayward have included in their articles all the cases of poisoning by aconite and of rattlesnake bites which they could find on record. Poisoning elicits the general rather than the finer actions of a drug, and the latter are fully portrayed in the provings. A few typical cases are therefore sufficient to illustrate the recognised forms of poisoning by each substance, as described in treatises on toxicology; and to these may be added any exceptional but genuine phenomena, such as the acute rheumatism once induced by a toxical dose of colchicum. In this way Dr.Dudgeon’s 75 aconite poisonings have, in our work, been reduced to I3.

4. In addition to provings and poisonings,  should give the results of experiments on the lower animals. Writers of the school, from Hahnemann downwards, made objections to pathogenesy derived from this source. But  Hughes & Dake recognise their justice, when directed against exclusive or even predominant reliance on such experimentation; but  cannot doubt the positive value of it. Eg :- bryonia,  from the information derived from the animals poisoned with it in the Austrain provings as to its power of inflaming the serous membranes.

5. All our bookmakers have been copying one from another, and accumulating faults as they have gone on; so that  symptom-lists are made of shoddy instead of new. In the revised Materia Medica, whenever possible, gone back to the originals; so that in substance, as well as in form, its pathogeneses may be fresh from Nature’s mint.

6. The discretion is allowed here, to prevent the rejection of obviously valuable matter, a security is given in the direction of trustworthiness. It proceeds upon the ancient canon that “at the mouth of two or three witnesses every truth shall be established.” It reduces to a minimum the peril of mistaking coincidences for drug-effects.

7. As a rule, Hahnemann’s caution holds good – “how, even in diseases, amid the symptoms of the original malady the medicinal symptoms may be discovered, is a subject for the exercise of a higher order of inductive minds, and must be left solely to masters in the art of observation.” Our wisdom is to reject from the Materia Medica supposed drug-effects thus derived. They belong rather to clinical guides and therapeutic hints, where their dubious worth need not prevent their tentative employment in practice.

8. Rule VIII. This instruction va sans dire.

9. Lastly,  the employment of provings with infinitesimal doses. The rule is,”Include symptoms reported as coming from attenuations above the I2th decimal only when in accord with symptoms from attenuations below.” Hahnemann proposed the 30th as the limit for the sick & the 6th for the healthy- which, having regard to the difference of susceptibility. It involves no judgment as to the activity of attenuations above the 6th; it does not even exclude effects referred to them if in accord with those obtained from more appreciable quantities. It is possible that some few genuine drug-effects may thus be omitted; but this chance is more than outweighed by the certainty of the greater acceptableness of pathogeneses so limited.

Guided by the foregoing instructions, thus prepared the hundred or more pathogeneses. The Appendix to the fourth part contains reparations of  error, with all corrigenda and addenda that have come to the editors’ knowledge. Each volume will contain a similar supplement, bringing  knowledge down to the date of its publication.

Special features in this work.

I. It will be noticed that the pathogeneses of Hahnemann and his fellow-provers are simply referred to. This work have no means of verifying, correcting, illuminating them, or of re-forming their order – is narrative, and  possessed by every student of drug pathogenesy.

2. Two sizes of type,- the smaller being used for minor medicines, and for matter of inferior importance or quality bearing upon drugs of higher rank. The practitioner will find nothing omitted which has any claim to be regarded as genuine and instructive.

3. The abbreviations employed are few and obvious,- as “m.” “e.” “n.” for morning, evening, night, “d.” “h.” “m.” for day, hour, minute, “r.” “l.” for right and left. Occasionally “m.m.” is used for mucous membrane.

Cyclopaedia is a mere luxury of pathogenesy, quite beyond the  requirements of the student and the practitioner, and only really valuable to the teacher or writer on the subject. It shows how injurious has been the influence of the schemas which have hitherto reigned in the homoeopathic school. It hold the true way of learning the physiological. study of a series of cases illustrating the disorder they cause. Between the two, however, as for the student of disease there is the observation at the bedside, for the student of drug-action there should be the clinical records of pathogenesy, will become the most interesting of studies.

For the student this work is primarily designed. To the practitioner it  does not so obviously appeal, and he must wait till the index is made. He can use it for  reference in actual practice.

Commentary
Published jointly by the British Homoeopathic Society and the American Institute of Homoeopathy. The four volumes contain records of all provings done to date. Hughes believed that Allen’s Encyclopedia had several faults, among them poor translations of the provings and admitting all published provings without checking their veracity. This latter issue was quite touchy since several years earlier a German physician, C.W. Fickel, had published (to enhance his reputation) several provings that were pure inventions. He had published under several pseudonyms as well and his work was often quoted by opponents of the homoeopathic system.

This work was assembled by a committee including Drysdale, Dudgeon, and Pope in the UK, and Conrad Wesselhoeft, E.A. Farrington, and H.R. Arndt in the USA.

As usual, with the work by Hughes, the scholarship is outstanding. If you have questions about symptoms in Allen’s 10 volumes, a check of these four volumes might resolve doubts. But in the process, Hughes, ever the advocate of the physiological dose, eliminated all provings that were done with the higher potencies, thus eliminating much useful information.

This commentary is reprinted from The Heritage of Homoeopathic Literature with permission of the author Julian Winston

Dr.Beenadas
Lecturer, Department of MM
Govt. Homeopathic Medical College. Calicut

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