Hand Book of Materia Medica and Homopathic Therapeutics.By T. F. Allen.
Presented by Médi-T.
Main * A * B * C * D * E * F * G * H * I * J * K * L * M * N * O * P * R * S * T * U * V * W * X * Z
Preface * Remedies
The preparation of this Handbook was commenced immediately after the completion of the Encyclopedia, and in accordance with a desire, strongly and unanimously expressed by a number of prominent physicians at a dinner given by the publishers to the Author of that work, to possess a condensed volume for ready reference. The first labor undertaken was to correct the errors and supply the omissions which to some extent marred the Encyclopedia ; this work proved to be gigantic, involving, as it did, a review of nearly every symptom in comparison with the originals ; the whole Encyclopedia could, almost as well, have been re-cast.
To this revised material have been added most of the provings and many cases of poisoning which have accumulated during the past ten years, omitting only such as seemed to rest upon a doubtful basis or which would not be of any practical value. A number of drugs included in the Encyclopedia have been omitted in the Handbook by reason of their inutility or unreliability (for example, the provings of Mure and Houatt.), since scarcely any of them have been found valuable ; all of Houatt's contributions have been thrown aside on account of their inherent improbability : the "Lacs" have been left to Dr. Swan's announced Materia Medica of the Nosodes, to which also Hydrophobinum, Syphilinum, et cetera, have been referred. This procedure has been forced upon the author by the necessity to provide the profession with a working handbook ; but should the work find so much favor that a new edition be called for, the wishes of the profession generally would be considered in adding some of the drugs that have been omitted, especially if these shall have proved themselves reliable. The material thus selected has been condensed in accordance with a system uniformly adhered to, omitting nothing important and avoiding repetition.
The following example will serve to illustrate the method employed.
Under Agaricus, as condensed :
Vertex :- ►Stitches ; itching. ► Tearing ; lancinating, to left ear. ► Aching ; morning ; morning, amel. after rising ; at night ; amel. open air ; pulsating, with despair bordering on rage. ► Deep-seated boring.
Stitches in vertex. Itching stitches in vertex. Tearing in vertex. Lancinating tearing in vertex, extending to left ear. Aching in vertex. Aching in vertex in morning. Aching in vertex in morning, relieved after rising. Aching in vertex at night. Aching in vertex, relieved in open air. Pulsating pain in vertex, with despair bordering on rage.
In the above paragraph all symptoms belong to the Vertex. In the first period only Stitches. In the second period, Tearings. In the third period all are Achings ; but each semicolon closes a symptom ; thus Aching in the vertex at night is not said to be amel. in the open air ; but the Aching in the vertex amel. open air is a separate semicolon and a separate symptom. In the last semicolon the "pulsating" still refers to the aching, which dominates the whole period ; the last period might read as follows :
Vertex, Aching in morning.
Vertex, Aching in morning amel. after rising.
Vertex, Aching at night.
Vertex, Aching amel. open air.
Vertex, Aching-pulsating, with despair, etc.
This plan of making a dominating sensation cover a whole period, and dividing that period into semicolons for each symptom, affords a good method of condensation. It is confidently believed that no confusion will arise from following this plan.
In some places very long paragraphs have been divided even when the whole refer to one locality.
The sensations have been arranged in accordance with the general idea of the Encyclopedia of giving first in a paragraph the objective symptoms, namely, those to be apprehended by the observer alone, including the appearance, the motions or lack of motion, et cetera ; second, the sensations arranged in the order of acuteness ; sharp pains first, followed by dull pains or sensations.
Very few signs or abbreviations have been used :
< [or agg.], means getting worse from, aggravated by, or sometimes simply worse.
"< [or agg.] right side" means "Worse on the right side."
> [ or amel.], means getting better, et Cetera.
r. means right.
l. means left.
The initial letter of dominating word is sometimes repeated to avoid the possibility of confusion.
Comparisons of each drug have been made with a few of its allies, but it has been deemed advisable to limit these to a very few. Comparison is often confounded with contrast, and to attempt both would greatly swell the size of the book, without any increase of its usefulness ; the limited number of comparisons admitted will be found reliable and a real help to those not quite satisfied with the remedy under inspection and looking for one generally similar to it and to the case in hand.
The clinical sections have given the author a great amount of tribulation. To sift the enormous mass of reported cures is no light task ; much has been rejected, some modified and admitted after comparison with the observations of the most careful prescribers. There is no doubt that much fault can be found, with admissions as well as with rejections ; doubtless some reliable clinical indications have escaped notice, but it is believed that what is here gathered fairly represents the therapeutic range of our drugs as at present known.
Much might be said concerning the reliability of our symptomatology ; the errors that have been perpetuated from year to year in old material, and in new material obtained by faulty methods, are well known. There is no doubt that some of even Hahnemann's symptoms were observed in the sick, both as apparent results of drug action and as probable cured ; it is also true that most provers have allowed themselves to record, as effects of drugs taken for experiment, symptoms which would have arisen spontaneously or which were "suggestions" of a mind watching for such effects. There is no doubt that many if not most symptoms have been observed in only one or two persons as the effect of a drug, and that many of these would fail of confirmation by repeated experiment, but after all these allowances have been made there remains a good and true pathogenesis sufficient for a working materia medica and capable of justifying itself by unfailing results when put to the test of homopathic therapeutics. Numerous provings, each consisting of but a single observation, even the result of but a single dose, appeal to our knowledge of the effects of analogous drugs as genuine ; they must be utilized, their symptoms guide us unerringly to the saving of life, and they cannot be discarded. We acknowledge the lack of accuracy in observation, the failure of confirmation required for scientific accuracy ; we are cognizant of the absolute necessity of rebuilding the whole symptomatology from the very foundation, cure the sick as best we may, and use sometimes doubtful material to accomplish our results. During this interim we must endeavor to keep separate the probably pure pathogenesis and the merely clinical history of each drug, for by doing this our pathogenesis will undergo a slow regeneration, good observations will replace the bad and our therapeutics will rest upon an ever-increasingly strong foundation.
The arrangement of a symptomatology for daily work in therapeutics is a matter of the utmost importance. Attempts have been made to construct working materia medicas for homopathists on the plan of grouping the symptoms of each prover by themselves, but they fail of ready usefulness and we find ourselves obliged to work on the lines of our great master, Hahnemann. The actual need is a grouping of symptoms under the regions of the body, and under rubrics so that the symptoms of our patients may readily be compared with those of a drug thought to be a applicable. We are compelled to prescribe for symptoms, and drug-symptoms must constantly be compared with those of the patient. It is rarely possible to find identity of expression between patient and prover ; even the designation of similar pains varies ; frequently the peculiar pain of the sick person has never been experienced by any prover in exactly the same locality, but drug-analogies may be followed and a remedy successfully selected. The necessity of looking through the symptoms referred to any locality constantly forces itself upon us. The "Schema" of Hahnemann must then be followed for all ordinary work. For extraordinary symptoms repertories of various sorts are needed ; usually Bnninghausen's method can be followed, namely, get the drugs affecting the part, get the drugs causing the particular sensation noted, get the conditions ; then turn to the "Schema" and see which of the selected drugs applies best to the patient. Sometimes also we feel the need of some sort of a concordance to hunt up remarkable symptoms.
Systematic study of a drug requires a very different sort of an arrangement ; for this the student needs to consult impartially all provings which have been made in good faith, to note the evolution of drug-effects, to compare the day books of the different provers, and to determine, if possible, the true characters of the drug-disease. A full collection of all provings would be most valuable.
In the study of provings or of the "Schema" it should be kept constantly in mind that just as groups of symptoms vary in individuals sick with any definite "disease," pathologically considered, so the groupings of symptoms in the provings vary, and it is extremely rare, if indeed it has ever happened, to find the total symptoms of any patient paralleled by those of any prover. While it is even infrequent to get the total of any patient out of all the provers, it is constantly necessary to make up the nearest possible to the total from several provers, and it really matters not where the individual symptoms come from, so they be reliable ; even parts of symptoms may be pieced together, a pain here, a locality there, a condition from another or from several (the "condition" should dominate the whole.), to complete the picture and the cure. Hence it follows that in condensing our symptomatology great liberties may be taken, if only the exact meaning be preserved. Liberties have not been taken, after this fashion, in the preparation of this book, but smaller books could readily and safely be made from this by condensing after the above method.
The selection of the remedy.
The first duty of the therapeutist is to note carefully and completely the various complaints of his patient and add thereto his own observations concerning his condition, that is to say, he must get all of the subjective and objective symptoms. This duty is frequently quite apart from that performed in making a diagnosis and requires quite a different line of investigation ; this duty may, indeed, be performed without making a diagnosis, though it is not wise to attempt it. Having "taken the case," one sets about finding the remedy which corresponds most closely to the symptoms. Three things must be done before this Handbook is consulted : (1) get a list of the drugs which affect the localities complained of by the patient ; (2) get a list of the drugs which correspond to the sensations, and (3) get the drugs which have the same aggravations and ameliorations. The importance of these groups is inverse to the order above mentioned ; the last is most important. These lists are to be obtained from the "Pocket-book of Therapeutics," based on Bnninghausen's work.
Select from these lists those drugs which occur most frequently, compare their symptoms in the Handbook with those of the patient, and select the drug which best covers the case. These directions are simple, easily followed by any one, whether educated or not, and will frequently lead to success. It must, however, be remembered that there are great and important differences in the symptoms of the sick, not only as regards their influence over a diagnosis, but also as regards their importance in influencing the choice of a remedy. It must also be recognized that a thorough knowledge of the peculiarities of a drug may lead to its selection, even if it may have but few of the symptoms of the patient. The above sort of knowledge distinguishes the "professional" from the un-professional therapeutist, the leader from the imitator.
In the case of the patient, it may be said that there are comparatively few simple diseases to prescribe for. Most symptom-lists are extremely complicated ; in chronic complaints the observation that one organ after another has become involved finishes series of symptoms from new foci, as it were, the lately developed symptoms often overpower and obscure previous affections ; in acute diseases the immediate symptoms are complicated by a series of old chronic troubles which, likely as not, have so affected the vitality of the individual that the acute disease has become possible. In the latter case (frequently in scarlatina and the other so-called zymotic diseases.), we find our patient unresponsive to the remedy selected for the most numerous and apparently important symptoms, and are compelled to fall back upon a careful analysis of a few chronic troubles.
It seems to be true that an individual, free from inherited and acquired disease, will not be affected by any zymosis whatever, and that a person sick with a zymotic disease will, if freed from the incubus of his chronic complaint, speedily recover. In such a case, then we may safely say that the totality of the symptoms is not to be regarded.
Still we must prescribe very frequently for a few severe and distressing symptoms, and postpone for a time the investigation of the past history and present complications of the malady. This symptom-palliation is usually followed by most practitioners to the exclusion of thorough work in therapeutics, but he who practices it exclusively or even habitually is liable to administer as many different medicines as there are urgent symptoms, and finally to resort to physiological palliation and become almost wholly empirical in his practice.
In these acute diseases a knowledge of the nature of the morbid process enables the expert to separate the symptoms due to the recent malady from those which are contingent and individual and which must be considered most seriously. In the vast majority of cases the most brilliant cures are made and life actually saved by the selection of a remedy which corresponds to the fewer individual rather than to the more numerous generic symptoms. Herein lies the secret of getting at what is characteristic in the patient.
In chronic diseases the conditions are somewhat different, and as a rule the symptoms are less complicated, but it frequently becomes necessary to exercise great partiality toward a few symptoms to the exclusion of the many. In most of the chronic maladies which show no tendency to recover, but rather to involve one organ after another, the original symptoms become obscured. For example, in cancer, the tumor, with its destructive metamorphoses, has developed from the underlying cachexia which has determined its manifestations. This secondary development gives rise to new and obtrusive symptoms which may entirely mask the real disease. Consumption develops from the scrofulous habit. The Lithæmic diathesis gives rise to a host of degenerative changes in various organs and tissues which develop new sets of symptoms. In all of these and other similar diseases it becomes our duty to investigate thoroughly the nature of the morbid processes, to study the evolution of the malady and separate the symptoms into groups. While it may be true that the absolute totality of all the symptoms would include the original, determining and essential symptoms of the case, yet he who fails to grasp the full significance of all the symptoms will fail to appreciate the overpowering value of the few. It is then necessary to get at what is characteristic in the patient in all forms of sickness.
Drugs must be studied in much the same way ; provings are to be followed step by step as they develop in the day books of the provers. Unfortunately the earlier provers have given us no day books, and too many of the later disciples have followed their example ; but when possible study the originals and note the peculiarities of each drug, observe the predominating sensations, study the conditions under which these sensations appear or are modified, note the organs affected ; this study is to be pursued during quiet hours, and need not be associated with the selection of a remedy for a patient.
In the selection of the remedy it must always be remembered that there is no specific for a "disease," that the symptoms only of the sick are to be treated, and that these symptoms vary in each individual. It may also be recognized that these groups of symptoms, varying so constantly in individuals, are to be met by varying groups of drug symptoms, and that these groups must be made up from different provers. The recognition of this fact determines the arrangement of our symptomatology for practical work in therapeutics ; it seems clear that in no other way can homopathy be practiced successfully.
Nothing need be said concerning the size of the dose further than it bears upon the relative value of symptoms. It is contended by some that the order of evolution of symptoms in provers varies with the amount of drug taken, and that this has a bearing upon the size of dose of the drug to be administered to the sick who suffer from symptoms which appear in a similar way.
It may be said in reply that the practical experience of the best prescribers negatives such a hypothesis, and it may further be asserted that there is no fixed order of evolution either in prover or patient. Provers vary greatly in their susceptibility to drugs, and any given amount of a drug may be large relatively to the sensitiveness of one prover and small as regards the sensitiveness of another, so that the order of evolution of effects is constantly changing. The same is true of the sick ; a dose large for one individual is small for another, and the only guide to the size of dose for any patient is his individual susceptibility to drugs in general or to any particular drug at any particular time. It has been fully established by experience that it matters not (for therapeutics.) by what sort of dose an effect has been produced ; only let a symptom be reliable, it will be cured by different doses for different people. The people of drug necessary to produce it varies with the susceptibility of the prover, the amount needed for its removal varies with the susceptibility of the patient.
It is confidently hoped that this Handbook will contribute to the more certain application of homopathic therapeutics to the symptoms of the sick by the critical examination of which the best results are to be attained.
New York, April, 1889.
Copyright © Médi-T 2005.