190 T H E B R I T I S H H O M ( E O P A T H I C J O U R N A L

HOM(EOPATHIC PHILOSOPHY BROUGHT UP TO DATE

By JOH~ PATERSON, M.B., Ch.B., D.P.H.(Camb.), F.F.Hom.

To ANNUAL ASSEMBLY OF FACULTY OF HOM(EOPATHY.

LONDON, JUNE 25TH, 1947.

AT this Annual Asscmbly of the Faculty of Homceopathy, it is not inappropriate that we, the members, should refresh our memories with the objects for which the Faculty was established. Like its predecessor, the British Homceopathic Society, its aim is " to advance and extend the principles and practice of Homceopathy ", but there is a very important addition to the Memorandum of Incorporation--" to grant to registered medical practitioners, diplomas, certificates, or other equivalent recognition of special knowledge in Homceo- pathy, either alone or in co-operation with teaching "

Having taken some par t in the framing of the above Memorandum, I realize the importance of our duty to teach, but when called upon to give a series of lectures on Homceopathic Philosophy to the post-graduate class in Glasgow, I was faced with the problem of bringing this up to date and of using a language which would be understood by the student of modern medicine.

The Homceopathic Philosophy formulated by Samuel Hahnemann some 150 years ago may be quite sound, but its language is out of date, and in any case its logic wants re-testing in the light of the available scientific data.

I t was no doubt the rumour, that I was undertaking this task for my own use, which reached London and prompted my colleagues on the Council of the Faculty t o " press gang " me into giving this paper to you under the above title. The title was not of my choosing, as I realized the tremendous scope which the world " philosophy " could offer and ] was not consoled by con- suiting the Oxford Standard Dictionary, which stated that " Philosophy is love of wisdom or knowledge, especially that which deals with ultimate realities."

Much as I desire Wisdom and Knowledge, I have no t the mental quality to address you under such a definition. I t was, therefore, with some degree of relief that I found a simpler definition in Collins's Clear Type Dictionary, which states that " Philosophy is the general laws or principles of knowlcdge, material, mental, or moral."

This was what I wanted, as b y interpreting the word " principle " as " rule " or " axiom ", I could formulate some working hypothesis by which a physician could apply homceopathic philosophy in the treatment of ~he sick person.

I t was the philosophy of a Kent, not that of a Kant, which I most desired.

Next, I had to fix on a standard work and the only one is The Organon of Rational Healing, published by Hahnemann in 1810.

:It is true that the sixth edition was translated into English 1 language and republished in 1922, but its language is still almost unintelligible to the modern student. How many members of the Faculty have read through, paragraph by paragraph, and understood the standard work of Hahnemann on Homceopathic Philosophy ?

However difficult the reading, and however "ancient the philosophy, I hope to show that it can be modernized and brought up to date, and :I propose to study certain paragraphs with you.

Paragraph 1. This is a simple sentence and its axiom will be acceptable to all. " The physician's high and only mission is to restore the sick to health, to cure, as it is called."

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P a r a g r a p h 3. The next paragraph of importance is, I think, No. 3, as it defines what, in Hahnemann's Philosophy, is required of a true practitioner of the healing art. He must have a knowledge of :

(1) Disease ; (2) Medicinal power; (3) Principles for the application of medicine to disease ; (4) Preparation of remedy, dose, and period for repetition. (5) Obstacles to recovery, to be removed.

Fully equipped with such knowledge the physician " understands how to treat judiciously and rationally, and is a true practitioner of the healing art "

I shall assume that it is the desire of all of us to have this knowledge, to be true practitioners of the healing art.

Also I take it as granted that No. 5, removal of obstacles to recovery, is agreed by all as a necessary requirement

1. KNOWLEDGE OF DISEASE. What is disease, and how is it recognized ? For rational treatment, the

physician must have a clear conception in his mind as to what constitutes disease.

Hippocrates, the founder of Modern Medicine, had a simple philosophy ; disease could be classified, each disease run a prescribed course, and there is an inherent tendency to recovery possessed by the body-- the Vis Medicatrix Natur~e.

Hahnemann, likewise, recogn~cd this inherent power to recovery, but he elaborated his philosophy a bit further by formulating that it was this vital force (Dynamis) which actually created the symptom complex which Hippo- crates recognized as disease.

Paragraph l 1 in the sixth edition of the O r g a n o n , fully explains this conception of disease and I propose to discuss it with you and to attempt a practical application from its philosophy.

The whole paragraph, written as one sentence, is cumbersome and archaic in its language, but it centres round the definition of the term " Dynamis " and in the sixth edition Hahnemann thought this of such importance that he added a footnote which occupies two and a half pages of closely printed type. I am of ()pinion that this is the keynote to the whole of the Hom~eopathic Philosophy, and I shall t ry to analyse and discuss the paragraph with you.

Dynamis is an inherent force or potential possessed by every living cell ; it is the characteristic of life itself, without it there can be no life. Whence this force comes and whither it goes, I do not propose to discuss, I leave that to the true philosopher who desires knowledge of ultimate realities. My purpose is to reduce philosophy to practice and to find a conception of this vital force (Dynamis) which can be translated into working principles.

From this papagraph then, I conceive that this " Dynamis ", which maintains life, is at EASE with its immediate environment and manifests itself by normal function and sensation. Any factor which can affect and disturb this Dynamis must be regarded as the CAUSE of DiS-ease, of unbalance. Disease, can thus be defined as an unbalanced state of the Dynamis, and be it noted as such it cannot be seen. No physician has ever seen Disease--the disturbed vital force--nor indeed has he ever seen " life " the normM vital force.

What then are the subjective and objective symptoms--the symptom complex--which so often are referred to as " disease "

According to homceopathic philosophy, the symptom complex is the RESULT of the DiS-ease, of the unbalanced Dynamis, which manifests itself by abnormal function and abnormal sensation.

The medical student of to-day is taught to recognize the symptom complex as the DmEASE ; the homceopathic medical student must be taught that the symptom complex is ~OT the " disease ", it is the RESULT of disease.

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To be a true practitioner one must rationalize one's treatment to one's philosophy, so let us take a hypothetical case for illustration.

The physician is called to treat a patient who has suddenly complained of feeling ill, of having abnormal sensation expressed by a mental restlessness, a sense of fear ; of abnormal function of organs expressed by vomiting, profuse sweating and profuse urination. The chnical thermometer registers 104 ~ F.

I f one accepts the diagnosis as " fever " and presumes that this is the cause of the abnormal functioning and sensation, then an antipyretic is the indicated remedy. That is the rationale of treatment of the allopathic physician.

On the other hand, if one sees in the symptom complex not disease, but the evidence of Dis-ease, and the ahnormal working of the Dynamis, then treatment must be aimed at restoring balance to assure the return of normal function and sensation and normal temperature.

No doubt my hom0eopathic colleagues have already chosen the remedy Aconite, according to principles about which I shall speak later.

I feel that this paragraph 11 and its philosophy as to the cause of disease must be the foundation stone upon which we must build up our homceopathie philosophy and formulate our rules for the rational treatment of the sick person. The dominant school of medicine still practises the covering up of symptoms by powerful drugs without consideration for this philosophical conception of disease.

Dynamis. I now propose to consider the rather lengthy footnote to paragraph 11

and find out, if possible, what prompted Hahnemann to add this to his 6th and last edition of the Organon.

The reason, I think, is not far to seek, he realized that he had discovered a form of energy for which, in his day, there was no appropriate language with which to define it. Physical science had not yet discovered that form of energy with which we are now familiar--radio-active or atomic. It must have been difficult for Hahnemann to find words with which to express what he considered of fundamental importance, but it is clear from his illustration of the power possessed by a magnet that he had some prevision of this modern conception of energy.

With such a conception--that this vital force (Dynamis) was not material, that it was an ethereal force--he could not accept the view prevalent in his day, that material substances in themselves could disturb the Dynamis and cause disease. Infection from outside was the theory of his day and with the epoch-making discovery of Pasteur, the germ theory of disease became firmly established. Every effort was concentrated upon isolating and identifying specific germs according to the postulates of Koch. Seeming success crowned these efforts, but many common diseases, e.g. Mumps and Measles defied all investigation to identify a specific germ, although as diseases, they were obviously infectious and could be transmitted from individual to individual.

When l set out to write this paper, I had no intention of discussing the germ theory of disease, but I found that there was no other way by which I might illustrate the conception of this footnote.

I shall now speak for a httle as a bacteriologist, who like many another has been faced with many anomalies in the course of routine work.

Host/Parasite, Relationship. The germ--or since I now spcak as a bacteriologist, perhaps I should

say " bacterium " - -has a place in Nature, its function is " to break up into more simple combinations, the complex molecules of the organic substances which form the bodies of plants and animals, or are excreted by them -.2 On this it can be assumed that normal function will be carried out in harmony with environment ; that the germ or bacterium is a healthy organism in its normal habitat.

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Many of the so-called pathogenic germs have their prototypes in natural habitats, and there they do not cause disease. Even on the body surface and on the mucous membranes of the body, a variety of organisms can bc found without any evidence of unbalance, of disease.

The reason may be put forward that they are not pathogenic, hence no disease, but pathogenic organisms capable of satisfying the Koch postulates, can also be found in the " carrier state " and once again there is no dis-ease. I t will be evident from these facts that the germ thcory of disease, as formulated by Pasteur and elaborated by Koch, requirc~ modification. The old idea that there is a continuous war between the germ and the host must give place to the newer conception, that there is a natural harmony between germ and host, a state of balance, of undisturbed vital function in each of these living entities. The question arises, can these germs become pathogenic, capable of producing disease, and if so, by what means ? I f not, then, what is the genetic origin of the pathogenic germ. Does every epidemic infection arise from a pre- existing pathogenetic germ ?

The newer conception of the origin of the disease germ is very ably presented in a monograph recently published by the Harvard University Press. '~ The writer in speaking of the host /parasi te relationship says " i t was once easy to think of the interaction between man and some pathogenic micro-organism as a simple antagonism, success for the pathogen being measured by its own overwhelming multiplication with death of the host ; success for the patient, by recovery with annihilation of the invaders, but once the pathogen began to be thought of as a living organism dependent for its existence on a means o f continuous survival, such a point of view became obviously untenable "

The living organism strives to maintain a peaceful life under a social order where there is security and freedom from want, and in these days we humans can fully appreciate how a shortage of the essential foods can affect normal function and sensation.

Anything which disturbs the factors essential for normal function will cause Dis-ease, an unbalanced state of the Dynamis of the living organism.

In this manner it is possible to conceive how a harmless germ may become affected, become pathogenic and capable of carrying Dis-ease to another host. This it does because it has itself become diseased.

I t is not the material substance of the germ but its potential of energy (dynamis) which is capable of causing disease, and thus the Hahnemannian conception expressed in this footnote seems to be borne out by the modern version; that a normal functioning germ in its natural habitat is non- pathogenic, but circumstances may arise which cause it to function abnormally and to become pathogenic.

A further quotation from this monograph affords an excellent illustration of this conception.

Referring to the meningococcus and its role in causing cerebrospinal meningitis, it says " its real life ( that is the coccus) is carried on as an almost saprophytic inhabitant of the human throat, probably without exception every strain of the mcningococcus isolated from the cerebrospinal fluid of typical cases, is descended from organisms which, never in their whole evolu- t ionary history, have produced meningeal infection. From the viewpoint of the meningococcus, its power to provoke meningitis is a mere biological accident, of no significance for its survival or evolution "

McDonagh, in his Nature of Disease ~ makes a similar s tatement regarding the B. coil of the intestinal tract, that through chemical, physical, psychological or cosmic action, these normal functioning organisms may be mutated to become pathogenic, capable of carrying disease to another host. He believes that typhoid fever epidemics may arise in this manner. Will you note the sequence of events. I t is the disturbed Dynamis (disease) of the host which initiates the disturbance in the germ by which it becomes pathogenic, capable of passing

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on thc disturbance (disease) to other hosts. I t is thus possible to conceive the genetic origin of " disease germs ".

The homceopathic philosophy of this paragraph and footnote gives an up-to-date working hypothesis for the modern bacteriologist and gives a rational explanation for the seeming anomalies encountered by those who still accept the Pasteur-Koch theory of disease. That theory, as we have seen, is based on but a half truth.

Before leaving the bacteriological field, [ feel that I must make onemore quotation from the monograph, as it will have a bearing on the subject of Chronic Disease and Miasm to be discussed later. " An acutely fatal infection is disadvantageous for the survival of the germ, and conversely a low grade infection with no more than TRIVIAL SYMPTOMS, but with the free liberation of the pathogen over a CONSIDERABLE PERIOD OF TIME will usually provide the maximum opportunity for the dissemination of the parasite " 3

Side by side with this, I offer for consideration a quotation from the Organon " that true, natural chronic diseases are those which owe their origin to a chronic parasitic miasm "..~

This dual conception upon the basis of chronic disease is to-day finding practical expression in the work of the intestinal flora and the application of the bowel nosodes to the treatment of chronic disease. 5

I shall not, however, pursue my bacteriological argument any further, but return to philosophy and consideration of the next requirement of the true practitioner of the healing art.

2. MEDICINAL POWER. A knowledge of the nature and the cause of disease would be of little value

to the physician without knowledge of the medicinal power of remedies, and for the student of homceopathy, there is a rich heritage of the " provings " of drug action of a very large number of remedies. Like the philosophy, these provings may be ancient but the accuracy of detail of many of the remedies finds up-to-date verification in the articles appearing in current medical litcrature.

There is no need for me to take time by proving the up-to-dateness of our Materia Medica, since my colleagues of the modern school of medicine seem to be doing that very successfully, but unwittingly.

I would rather make use of the time at my disposal to consider how rcmedics act, and apply the philosophy of paragraph 11.

Here is opportunity to test out this ancient philosophy against modern scientific fact. According to the philosophy of tile Organon, no remedy can have any action on the vital principle of the living cell which does not itself carry a similar vital principle (])ynamis).

Let us examine this claim, and first we note that life is made manifest by a continuous process '--the process of Metabolism--in which complex chemical substances arc formed. These, because they are cssential to, or are the products of, life can rightly be called UIO-CHEMICALS, something which has a vital quality (Dynamis).

Biochemistry is in the forefront of medical science to-day and in the 'Congress which is to follow this Assembly of the Faculty, this subject will no doubt be discussed in some detail. I have no wish to forestall my colleagues in their deliberations, but in my philosophy I must consider the action of the new chemotherapeutic remedies, which have been synthesized in the laboratory. Before the introduction of these newer remedies we were dependent for our remedies upon the animal, vegetable or mineral kingdom. Of these it is not difficult to conceive that the remedies from the animal or vegetable kingdoms might contain some vital quality, a biochemical which was essential to, or the result of, the life process. Vaccine therapy is a good example, whether the lower form of germ life be considered animal or plant. But what about the

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mineral and inorganic chemical substances. According to our homeopa th ic philosophy, they must have a vital quahty (Dynamis) to have any therapeutic effect. Are there any scientific facts to support such a thesis ?

I t is assumed that there is general consent to the fact that, in the hands of the physician, these mineral and inorganic remedies do seem to have thera- peutic action. What are the scientific facts ~.

The chemist, in his search for a chemical substance which would have bactericidal action without affecting the body cell, discovered complex chemical substances which he grouped under the general term of SULPrmN-AMIDES, the simplest form of which is the drug known as SrLPH-ANrL-AMIDE. In subsequent experiment he also isolated and identified another complex substance p-amino- benzoic acid which he proved to be a product of metabolism and essential for the life, growth and motility of certain micro-organisms. These two chemical substances have been proved to have similar affinity for the living bacterial cell, hence they can be rightly called Bin-chemicals, possessing a vital quality (Dynamis) and in virtue of this, according to homceopathic philosophy, they can have power to affect the living cell, to cause or to cure Dis-ease.

The scientific version of their therapeutic action is summed up in two words " E S S E N T I A L ME T A BOLITES ". Philosophy and Science agree on this point. This is true, not only of the general principle, but also of the degree of action. I put side by side two quotations ; first the scientific, " the varying sensitivity to the sulphanilamide of different organisms, is due to differences in their power of synthesizing p-amino-benzoic-acid-7 Anderson's Bacteriological Chemistry (1946) ; second, the philosophic, " Dynamis, the inherent vital factor of the living cell determines the degree of action of any remedy-1 Hahnemann, Orgaaon (1810).

Such a thesis may explain the action of BIo-chemical substances, but what of the simpler mineral and inorganic chemical substances. Do they possess any vital factor (Dynamis), can they have any dynamic action and if so, how ?

Here I hope to show that philosophy may anticipate the discovery of the scientist. I propose to consider the action of the simple element Sulphur as a therapeutic remedy. In a very recent publication Homo~opathy and Chemo- therapy, by Dr. Lecser, s under chapter I V - - " Coccal Infections--Sulphanila- mides ", there is a paragraph which has particular interest for me, and I hope to all who seek to understand the action of remedies. Accepting the e~cntial metabolite theory, Dr. Leeser goes on to say " assuming this theory is con- firmed, no theory will be satisfactory unless it accounts also for the wider issue, that other and simpler incompletely oxidized sulphur compounds are similarly effective. The cardinal point to be kept in mind is that the Sulphur is indispensable in these compounds for the anti-coccal action. We may therefore expect to gain a broader view on the problem by including in our suryey, the old hom<eopathic use of the sulphur preparations in comparable infectious processes "

He then goes on to discuss the " provings " of Sulphur on healthy persons which resulted in purulent inflammation, and the curative effects from the use of the triturations of Sulphur.

Dr. Leeser's method of combining his clinical experience as a homceopathic physician with his skill as a chemist, has particular interest for me.

In presenting the Annual Medical Report (1939) of the Scottish Homceo- pathie Hospital for Children, I made a casual remark about the new remedy for pneumonia. At this hospital we are very proud of our statistics for B.pneu- monia, using homceopathic remedies, in this very fatal illness of children. I expressed my delight that our allopathie colleagues had discovered a new remedy for pneumonia, but I added, to the homo~opath, however, it is not a new remedy for pneumonia, as the actual BASIC FACTOR (Sulphur) had been used by the homceopathists for 150 years.

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My Glasgow colleagues may recall the lengthy discussion which was carried on through the Press with a certain professor of Materia Mcdica of one of our Scottish Universities. He, and many others denied that Sulphur ha~l anything to do with the action of the new remedy, Sulphanilamide.

1 must confess that when I made that casual remark, I had no scientific data in mind, ] was using my clinical experience as a homceopathic physician, and on logical grounds put forward the claim that there must be some similar action between the Sulphur in the potentized form, and that of the synthetic compound, Sulphanilamide.

In the earlier experiments with Prontosil, the prototype of sulphanilamides, it was proved that the prontosil had to he converted in corpore, by the metabolic process of the living cell,into Sulphonamide before it could affect the coccalgerms.

There is thus some scientific basis to support the clinical observations of the homceopathic physician, and the homceopathic philosophy, that the simpler elements and mineral substances are capable of conversion into true Blo-chemicals and thus becoming, in corpore: Dynamic in the sense implied by paragraph 11 of the Organon. The bio-chemist has discovered a laboratory process for the production of " essential mctabolites " a process which is also active in the living cell.

The mode of action of Penicillin is still under investigation, but the fact that this complex substance is an extract from the living Penicillinm Notatum is enough to allow of its admission to the class of BIO-chemicals, of having dynamic quality according to the conception of our philosophy.

The term " anti-biotic " suggests that these complex substances have a part to play in the living process of metabolism, and from the lower plant life, attention is now being given to the highcr plants and already it has been dis- covered that the Ranunculaceae have anti-biotic properties similar to penicillin, m

Anemone, clematis, hellebore, ranunculus, and even the leaves of our Scots Thistle have yielded antibiotic substances.

The record of homceopathic practice over the last 150 years would show that many of the plant remedies of our Materia Mcdica have been accredited with specific action against organisms, e.g. Sulphur and coccal infection; Mercury and B. diphtheriae; Baptisia and B. typhosus; Drosera and B. pertussis ; Phosphorus and T.B. ; to mention but a few. I t may well be that the homceopathic philosophy may again anticipate the scientific discoveries of the bio-chemist.

Virus. From simple chemical substances, I now turn to what is considered

generally to be the most complex of all--the Viruses. Again I do not intend to go into details except in so far as they affect my

philosophy. " I t is not long ago since the gulf between the living and the non-living

was regarded as impassable, but now the increase of knowledge makes it seem that the solution of the problem of making life in the laboratory just eludes us ". That is the comment of the reviewer of " What is Life ?--The Physical Aspect of the Living Cell ,,s

There is much discussion as to whether the virus is a living organism or an inanimate but complex protein molecule derived from the living cell. Whatever view is taken, there is one conclusion acceptable by all, that " they ( the viruses) still show evidence in their chemical structure of conformity with the general pattern of living material, and their behaviour must be interpreted in terms of biological concepts ,,.a

I t is a remarkable fact that " even after several re-crystallizations, minute amounts of virus proteins can induce virus disease when injected into healthy plants, and so affect the metabolism, that comparatively large quantities of the

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particular protein can be recovered ".'~ That is an unique quality for an inanimate chemical substance, and it must be assumed that it possesses some dynamic force (Dynamis) which directs the Dynamis of the host cell to syn- thesize and reproduce the virus molecule. Virus action is thus acceptable to the homceopathic philosophy of the Organon, paragraph 11, footnote.

(3) PRINCIPLES FOR THE APPLICATION OF I)~EMEDY TO DISEASE. In presenting the case for homceopathy in truc historical sequence, the

principle of the law of similars takes first place�9 I t was oifly after a period of twelve years of this therapeutic practice

that Hahnemann published the Organon of Rational Healing which forms our text-book of Homceopathic Philosophy.

In the teaching of homceopathy, I suggest that philosophy MUST be given first place, and the student given opportunity to acquire a knowledge of disease, and the medicinal power of remedies, according to the philosophy of the Organon BEFORE hc is offered the working principle of the law of simflars in treatment.

I t should be pointed out that there are two sets of observable phenomena : (1) Disease action; (2) Drug action; and that Hahnemann established, as the rcsult of experiment, that there is a definite relationship between these two phenomena, and from these experimental observations he formulated a working hypothesis, the law of similars, as a therapeutic measure for the treat- ment of the sick person.

I t would be presumption on my part, if I were to waste time pressing the claim for this therapeutic principle to such an audience as I have the honour to address this afternoon.

By your membership of the Faculty of Homceopathy, or of the International Homeopathic League, you have already declared your faith and proved the principle in your practice as physicians�9

To those upon whom responsibility for teaching homceopathy rests, I would like to present two aspects.

(I) I t is important that the student, at the outset of his study of homceo- pathy, should be made acquaint with the fact that this therapeutic principle is presented as a working hypothesis, as an axiom or rule with which to consider treatment. I t is NOT presented as a " law " - - an immutable fact and as proof of this our latin motto Similia, similibus curentur should be given its literal translation" Let likes be treated by likes ". There are many factors, mentioned in the Organon, which influence the action of the similar remedy, and it is there- fore wrong to change the tense and the sense of the latin, as some authors have done in recent publications, by writing " Similia, similibus curantur " That translates into the definite statement that " Likes ARE cured by likes " ; it is establishing a law in the strictest sense of the word and any student who accepts it as such will find disappointment in practice and may condemn the principle of the law of similars. I t is not in accordance with the philosophy of the Organon, paragraph 275, which says " the suitableness of a medicine for any given disease does ~OT depend on its accurate homceopathic (similar) selection alone "

(2) Another aspect of this therapeutic principle which should t)e impressed on the student is that the action is NOT entirely dependent upon a small or infinitesimal dose. So often homceopathy is associated with the small dose by people who have no knowledge of the philosophy of its principle.

As we shall see later, action may take place from material doses of crude substances, the question of the dose is a refinement, not an essential for the application of the working hypothesis of the law of similars.

Dose�9 And that brings me to the consideration of " the dose " and here I must

confess that philosophy gives way to practice and experience.

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I t would seem that the allopathic prescriber has an advantage over the homceopathic prescriber. The modern medical student must learn the quan- titative doses of many remedies and in practice he has at hand a posological table which will give him the dose and frequency of repetition of a remedy in any particular disease.

For the homceopathic student, this is not possible--unless he is prepared to accept a form of empiricism--and his guide must be paragraph 278 of the Organon, " that pure experiment and accurate observation of the sensitiveness of each patient, and accurate experience alone can determine the dose in each individual case "

Is there no other guide than experience .~ I suggest that no one can accept the philosophy of disease and drug action without finding that it has application to the question of dose. The physician must observe the sensitiveness of each patient, that means assessing the degree of disturbance of the Dynamis, and from this determining the degree of~nedicinal power required to restore normal balance and normal function.

Disease (non-surgical) may be divided into two categories: (a) acute disease ; (b) chronic disease.

Acute disease as was noted by Hippocrates, tends to recovery unaided in virtue of inherent vital force, and according to homccopathic philosophy this would imply that there was a high potential of vital energy. To restore balance to such a disturbed dynamis-- the cause of the disease--a similar high degree of medicinal energy (high potency) would be required.

Chronic disease as observed by Hahnemann, never yields to the sinlple action of a robust constitution, thus it may be assumed that the vital fi~rce (Dynamis) is at low potential and that a similar low degree of medicinal energy would be indicated (low potency).

In speaking of chronic disease two concepts must be kept in mind. (1) Acquired chronic--in the sense that from some acquired disease in

earlier life, a latent action may go on until in later adult life it becomes manifest: as " chronic disease "

(2) Inherited chronic--in the sense that by heredity the cell has an inherent instability which will remain and affect the whole future life of the individual, as a " chronic disease ". Earlier in this l referred to the Hahnemannian conception " that true chronic diseases owe their origin to a chronic miasm "

I t is convenient therefore at this point to interrupt our consideration of the dose, and consider in the light of modern science what is implied by this conception. " Miasm " can be translated into the more modern term " Allergy" and defined as a hypersensitive state of the vital force (Dynamis) of a living cell. That such a condition is inherited, is acceptable to allergic and hom0eopathie philosophy, and the tendency in such cases to manifest skin eruption likewise acceptable.

With this brief reference to Miasm and Allergy, I can return to the con- sideration of dose with added interest, and paragraph 282 footnote 163, of the Organon. Here attention is drawn to a notable exception to the rule to com- mence treatment of chronic diseases with the lower dynamizations. Where chronic disease can be attributed to inherited miasm (which we now speak of as allergy) and where there is evidence of activity, e.g. " while they still effloresce on the skin, these chronic diseases not only tolerate, but indeed require from the very beginning a large number of doses of their specific remedies of ever higher and higher degrees of dynamizations daily--possibly also several times daily " That is philosophy, and to reduce this to practice may I present some hypo- thetical cases.

In ACUTE diseases (not due to any miasm or allergy) the rule is to use the smallest number of doses of the highest potencies, as for example in the zymotic diseases of children. A case of scarlet fever would in all probability respond to a single dose of the similar remedy in the higher potencies, say 50m.

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In CH~tO~IC diseases--in the extreme case, " where there is a low grade of infection with no more than trivial symptoms, but with a free liberation of the pathogen over a considerable period of time "--where pathological change has at last manifested the disease, the rational dose would be a very low potency, with frequent but cautious repetition over a period of time�9 But between these two extreme types, there is the group to which the footnote 163 refers, an intermediate group of diseases where there is a chronic miasm, but this manifests itself, not by trivial symptoms, but by acute disturbances which may be regarded as acute disease. For example an acute broncho-pneumonia may be regarded as an " acute disease ", but in this case it would not respond to the single dose even of high potency, it would require higher and higher dynamizations and in repeated doses during the acute phase, because there is an underlying miasm, possibly tubercular.

For the chronic phase in such a ease, since there is evidence of an active dynamic vital force, a similar degree of dynamization would be required, repeated over a period.

My experience in the use of the bowel nosodes in this type of chronic disease which is liable to acute manifestations, suggests that 30c to I m potencies are likely to be called for, provided that the case has not passed into the category of chronic disease with marked pathological changes.

I make this suggestion from experience because the student invariably asks the question, what is a high and what a low potency, what potency do you recommend ?

There is a working rule, which applies to all cases, to be found in the Organon, " the doses of all homceopathic medicines, WITHOUT EXCEPTION, are to be reduced to such a point, that after ingestation, they will excite a scarcely t~erceptible homceopathic aggravation "

Modern allergic practice is based upon the conception of the Arndt-Schultz law, which formulates that large material doses inhibit, while small doses, infinitesimal doses, stimulate vital function. Once again I suggest that this is not a " law ", but a working hypothesis capable of being qualified in its action by many factors.

However, it can he assumed that between the two extremes of its action, there must be a point at which inhibition ceases and stimulation begins in anygiven set of experiments. This is the point through which a line may be drawn which divides the allopathic from the homceopathic therapeutic application of a remedy.

The posological tables of the ailopath, to which I have already referred, are based upon the action of a remedy within the inhibition zone, but well within the extreme action which would endanger life itself.

The homceopathic physician must find his dose within the stimulation zone, or like the allergist just on the border line with the possibility of a slight "reaction " (allergy) or a " homceopathic aggravation " (homceopathy). I f the homceopathic dose is well below the danger line, so that there is no apparent disturbance of the Dynamis, it is possible to conceive that such a stimulating dose might only manifest itself by stimulation of normal sensation and function, by a " sense ~ of well being " and that is a conception which is borne out by clinical observation and experience.

I t is very important to realize that for any given remedy there can never be a fixed dose which determines the dividing line between inhibition and stimu- lation, it is the Dynamis of the living cell, as conceived by our paragraph I I of the Organon, which determines what action any particular dose will effect. Large material doses of any given remedy may destroy, inhibit, or stinmlate vital activity. Small, even infinitesimal doses, do not always stimulate, they may also destroy or paralyse vital function. The phenomenon of allergy is based upon the hypersensitivity of the living cell to the infinitesimal dose of the specific allergen. The violent reactions which infinitesimal doses may evoke in such cases may endanger life.

200 T H E B R I T I S H H O M ( E O P A T I t I C J O U R N A L

On the other hand, as in acquired or natural immunity, the living cell may withstand, without disturbance, large doses of toxic material.

Is there any method of preparation or working rule by which the physician may find a dose within the safety zone of stimulation. The answer to that can be considered under the next heading.

I)OTENTIZATION. In his at tempt to get within the safety zone of stimulation, Hahnemann

discovered a " process by which the medicinal properties of drugs, which are in a latent state in the crude substance, are excited and enabled to act dynamically upon the vital force ".

The modern physician would do well to consider this process of preparing remcdics a~ it would enable him to solve at least one of the problems of dose which faces him at present. My British colleagues, who take time to read the British Medical Journal, will have noted that attention is once again concen- trating upon the question of tuberculosis, and its treatment by a vaccine of the living virus. (It may be remarked that the killed virus was found not to have much power of developing immunity.)

The tragedy of the first experiments in immunization with the living virus is too fresh in the memory of many physicians to allow acceptance in general practice of such an infinitesimal dose as one millionth of a milligramme. I t is regarded as being too dangerous. Despite this risk, there are many, who bclieving in the specific immune-therapy principle, declare that there must be a safe level of dose at which therapeutic action is possible. Here, I think, the philosophy of the Organon offers definite guidance.

Suppose, as an exercise, we apply our philosophy to the disease tuber- culosis. First of all we must classii~r the disease as acute or chronic, or falling within the intermediate class of chronic with acute manifestations. Tuber- culosis is accepted generally as evidence of an inherited instability, of a miasm, phthisis pulmonalis may be regarded as an acute manifestation of the chronic disease, and according to our working rule, such conditions not only tolerate but require higher and higher dynamizations of their similar remedy.

I t is easy for us, therefore, to understand why the infinitesimal dose of -one millionth of a milligramme of the remedy is liable to cause aggravation which will endanger life. I t is on the wrong side of the Arndt-Schultz line, it is a gross dose, 3c in the homceopathic centesimal scale of potencies, compared to the 1,000c potency recommended in Bocricke's Materia Medica by an experi- enced homceopathic physician. He also says that he has seen terrible aggrava- tion from the 30, 100 and 200c potencies. 11

Appreciation of the real significance of the Arndt-Schultz phenomena and a knowledge of the homceopathic philosophy regarding OY~AMIS which deter- mines the action of any dose would solve the problem for the allopath in his problem of dose in tuberculosis.

I t is interesting to quote from a small monograph published as far back as 1890, entitled New Cure for Consumption by Compt~n-Burnett, whose name we perpetuate in the Compton-Burnett Professorship o f Homceopathic Philosophy. He was the pioneer in the use of a preparation of the living virus in treatment, and had been using this successfully for five years before Koch made his dis- covery of the tubercle bacillus. A year after this first publication, Burnett wrote: " ahnost universally voted useless as a cure and terribly dangerous, Koch and his world-famed remedy have come and gone, but they will return anon and remain, only the dose will get smaller and smaller, until the long contemned homceopathic dilutions will acquire rights of citizenship in the universities and hospitals of the world. What now bars the way to further progress of Kochism is the awful admission that will have to be made, of the therapeutic efficacy of the infinitesimally small; and the LITTLE dose is the GREAT barrier to its onward march " 12

IIOM(EOPATYIIC ]PHILOSOPHY BROUGHT U]P TO DATE 201

The prophesy has come true, Koch i sm has indeed re tu rned and the barr ier to i ts onward march is the problem of the dose.

Here I th ink I might ven ture on a prophesy. Tha t by a combina t ion of the science of .the b iochemis t and the skill of the homceopathic chemist , since each has discovered methods of impar t ing '.' Dynamis " to a remedy , a new sys tem of chemo-therapeut ics m a y soon be es tabl ished which will have va luable ac t ion in the t r e a t m e n t of disease, B[:[T the only barr ier being t h a t the principle of the law of similars and the phi losophy of the Organon of Rat ional Heal ing will have to be recognized.

The biochemist mus t now recognize t ha t i t is the v i ta l pr inciple (Dynamis) which manifes ts normal metabol i sm, by a series of biochemical processes, which allow of normal funct ion and normal s e n s a t i o n - - t h a t is heal th.

A n y d is turbance of this process, d i s tu rbed metabol i sm, will resul t in a changed b iochemis t ry and the mani fes ta t ion of disease.

" I n the chemical field ", says Professor W. E. Gye, d i rector of the Imper i a l Cancer Research Labora tor ies , " s tudies of the re la t ion between carcinogenic ac t ion and sulphur metabo l i sm continue. There is a paral le l be tween the degree of ant i -carcinogenic ac t ion and su lphur inhibi t ing ac t ion ." Tha t [ th ink has g rea t s ign i f i cancefor thefu ture . B iochemica l subs tances are nowava i l ab l ewh ich have cancer producing proper t ies ; according to the homceopathic phi losophy I have endeavoured to present , these can be conver ted into DY.~AMIC remedies with va luable the rapeu t ic power in the t r e a t m e n t of d i seases - -o f CANCER. SUMMARY.

And now, ladies and gent lemen, m a y I crave your indulgence for a few minutes more while I summarize this r a the r l engthy discourse.

To be a t rue prac t i t ioner of the healing a r t requires a knowledge of (1) Disea~se ac t ion ; (2) Medicinal power ; (3) Pr inciples for the app l ica t ion of the remedies to disease ; (4) Method of p repa ra t ion of the remedies and the dose.

I have dea l t a t considerable length with the homceopathic phi losophy as to the na ture of DYNAMIS as a v i ta l factor, and pu t forward the thesis t h a t remedies can have the rapeu t ic power, only if t hey possess dynamic qual i ty . Many of our remedies can r ight ly be said to have this qual i ty , bu t even the s impler elements, and crude mater ia ls , by the ac t ion of the v i ta l process of metabol i sm, can be conver ted into " essential metabol i t es ". I t is possible for the biochemist to an t ic ipa te the metabol ic processes by synthesiz ing in his l abo ra to ry s imilar substances. By the process of po tep t iz ing the homceopathic chemist impar t s dynamic power to the remedies and by the p repa ra t ion of high potencies makes i t possible for the homceopathic phys ic ian to keep wi thin the s t imula t ion zone for the thc rapeu t i c act ion.

The homceopathic phi losophy of the Organon of Rat ional Heal ing of IS l0 , is capable of being b rought up to da te and al igned with modern scientific fact .

Ph i losophy can offer the phys ic ian cer ta in principles, working rules to guide him in his " only mission, to restore the sick to heal th, to cure disease as i t is called "

I t is the d u t y of this F a c u l t y to see t ha t the teaching of homceopathic ph i losophy is presented in an up- to -da te manner .

REFERENCES Ha~memann : The Orga~mn of Rational Healing. (1810.)

2 Muir and rCi~hie : Manual of Bacteriology. {1919.} 3 Burnet, F. M. : Virus as Organism. (IIarvard University Press, 1945.) 4 MeDonagh, J. E. R : Nature of Disease Journal. (Heinemann, Ltd., 1934.) 5 Paterson, Jo|m : British Homo~opathic Journal. (April, 1936.) 6 Leeser, i)r. O. : Homeopathy and Chemotherapy. (Hippocrates Publishing Co., 1945.)

Anderson : Introduction to Bacteriological Chemi~gtry. (1946.) 8 Schrodinger : The Physical Aspect of the Living Cell. (1944.) 9 Thorpe : Biochemistry for the Medical Students. (1941.) lo British Medical Journal. (October 5th, 1946.) n Boericke : Homoeopathie Materia Medica. (Boericke & Runyon, 1922.) 12 Burnett, Compton : New Cure of Con,s'umption. (1890.)

202 T H E B R I T I S H H O M ( E O P A T H I C J O U R N A L

~)ISCUSSION

Dr. F. E. BOI)MAN congratulated Dr. Paterson on his very thoughtful and comprehensive s t u d y of the philosophy of Hahnemann and his very constructive gift restated in terms of modern science. He thought it was quite striking, too, that one of the points on which he laid great stress was that regard should be paid to the laws of Homceopathy--llkes to be treated by likes--as an essential hypothesis. This was the attitude of the scientist who was still regarding each case in the nature of an experiment.

Dr. Paterson by his paper declared himself quite frankly an out ~nd out vitalist. Perhaps the speaker could not follow him quite so far in his vitalism as Dr. Paterson himself was prepared to go. I t would have been noticed that he had attributed the dynamis of Hahnemann not only to the organism, to the patient, but also to the curative agent. There were, of course, trends in modern science which would find such a position very difficult to maintain and he thought it was possible to classify most human beings into people who were out and out vitalists and those who were not prepared to accept such an outstanding and overwhelming statement of position. One could see the question of disease as the struggle of the mechanism of the body to right itself in its environment, one could see health and disease as a question of equilibrium and he was glad to see that Dr. Paterson spoke of this striving to maintain what he called ease or the peaceful equilibrium becauseit was a very active thing, it was not a passive thing. But it was also instructive to see the question of disease as a question of maintaining an equilibrium and that the symptoms expressed by the organism, called disease, were efforts on the part of the organism to restore its previous equilibrium so that this process of whatever it might be, rise in temperature, the quick pulse, the alteration in the constituents of the blood, the alteration of the proportion of the protein in the cells, which manifested themselves, were processes designed, in the long run, to restore the organism to its original equilibrium. Unfortunately for the organism some of these processes in themselves might be exaggerated or abnormal in degree and therefore in themselves threatened the survival of the organism as a unit and so, again, he thought it was perhaps quite useful to envisage disease or the symptoms even as normal rather than abnormal, that they were the normal reactions of a threatened organism to changes in the environment.

He was not quite sure what Dr. Paterson was talking about when he spoke of the dynamis ; at the same time he referred to modern discoveries of radio- active energy. Had the dynamis which Dr. Paterson mentioned any relation to radioactive energy ?

He hesitated to rush into the bacteriological field where Dr. Paterson was an acknowledged expert but it was interesting again to see the trend of modern bacteriology which was no longer conceived as a struggle between the host and the parasite but rather as a problem of symbiosis, as a problem of living together, and there were many examples in the world of infections of various organisms one with the other which were necessary to maintain the life of both. One could think of botanical examples such as the lichens. New work was being carried out on the infestation of the root systems of various plants such as orchids, tree roots were infested with fungi and without that infestation they could not survive. The host provided certain metabo- lites for the maintenance of the fungi and the fungi provided certain metabolites for the host. One had in the botanical world degenerate plants such as the wintergreen which could not exist without the fungus infestation and there were other degenerate plants which became completely parasitic and made no chlorophyl at all.

The same thing had been shown in the recent work on viruses where it was demonstrated that some of the viruses, particularly those responsible for actual disease in human beings and animals, were degenerate, they had no

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longer a useful function with regard to their hosts, but had degenerated and were completely parasitic so that there was no mutualinterconnection and interfunction.

Dr. Paterson had emphasized Hahnemann's contention that as organisms human beings, animals, patients, were imbued and existed by virtue of their dynamis or vital force, when such organisms became out of equilibrium and diseased the only things which would put them right were remedies which themselves contained or carried some dynamic force and that was a question which was worthy of discussion. Was it really true that remedial agents must also have a vital quality ~. Dr. Paterson had argued this question very ingeniously and claimed that he had substantiated Hahnemann's original contention, but he wondered whether there was not an example of Hahne- mann's vitalism, his philosophy of vitalism, in which could be detected from time to time a trace of the old alchemy ? Hahnemann was an extremely well-read man who had read authorities in many languages, and there was no doubt on studying some of his commentaries that there was more than a hint that he was very well read in alchemy, and some of his vitalistic notions were a carry-through of the ancient conceptions about the nature of life. I t was interesting, too, that to prove his point Dr. Paterson had to maintain that the remedial agents became dynamic because the organism incorporated them within itself, so that really it was the organism which conferred the dynamism upon them.

I t had to be remembere(] that amongst the many trends of medicine or the philosophy of medicine there was a general consensus of opinion of treating the organism as a whole, and not only that, one had also to consider the present trend of the multiplicity of factors in the causation of disease and amongst this multiplicity of factors were no doubt those obstacles to be removed which Hahnemann insisted on in the cure of the patient, so that when treating a case of tuberculosis one had not only to find the individual remedy b u t also had to consider the patient's attitude to his disease and the attitude of those arou.nd him and the circumstances of his life. I t might be said that this was social medicine or psychological medicine or psychiatry but he thought these could be included as factors which brought about the disease or helped to maintain it. No doubt these were the obstacles to be removed which formed a rather comprehensive category at the end of Hahnemann's list of the nosodes to promote the restoration to health.

Dr. Paterson had given illustrations of the theory of chronic disease and he again had related it to the question of the strength of the dynamis in the organism, that is to say, the patient, and this was a very useful conception, but it had to be considered also that in any infection there were two factors to be taken into account. There was the energy associated with the patient and there was the energy of the infecting organism, and these were two variables. One could have three or four possible combinations but one also had to consider in chronic disease illnesses which did not appear to be related to infections at all, illnesses such as hyperpiesia, coronary thrombosis, diabetes, and it might be a little too restricting to consider miasm as only allergy. I f one was to talk of miasms other factors besides allergy must be considered. Here would be remembered the ICussian work which showed that the patient's own tissues altered as a result of disease and these became toxic factors.

What he would be interested to hear further in this discussion would be again : What was the nature of the energy conferred by potentization ? Was it known, was there any evidence of its nature ? I t was known that potentizing did something to the remedial agent, but did it impart any special energy into that rcmedial agent or did it release some kind of energy or did it make a remedial agent more acceptable so that it could be absorbed into the organism and so help to restore the organisms.

Finally, ])r. Bodman congratulated Dr. Paterson on successfully dealing with a very difficult task and expressing himself most clearly because these

3 0 4 T H E B R I T I S H H O M ( ~ O P A T H I C J O U R N A L

philosophical discussions could become so abstract. Dr. Paterson had kept to ground level all the time and made it possible to pick up points for further elucidation.

Dr. BOYD also thanked Dr. Paterson for his paper, which was a masterly effort. Almost everything Dr. Paterson had said could be supported from a scientific aspect. There was only one small point to which he would like to have an answer because he could not quite fit it in and that was the point that in order to attain adequate effects from the sulphonamides, a large dose had to be given in order to obtain a high concentration in the system. That was the one paradoxical point about which he felt a difficulty.

On the other hand, Dr. Paterson's putting forward of the dynamis was of extraordinary importance. While Dr. Bodman referred to it as the vitalistic outlook he would take an intermediate position and say that what was called dynamis was a universal energy property present in all substance and that energy property he would like to mention was definitely present in the inorganic substances. I t was apparently possible to detect it in a substance such as gold in its crude form. I t was of a very low order as far as it could be detected but the methods he was trying to use showed that as one potentizcd or ground down the gold and created a greater surface and a more even preparation, its dynamic effect, its energy effect, definitely increased so that it would appear that the energy was inherent in the substance and was in some way released.

In that relationship (he did not want to get too far afield) some of them might have heard of what was called entropy, a tendency to break up, a tendency towards chaos, a tendency towards general break down. During life the body was subject to this entropy, the process was going on all the time and the only place in the universe where there was what was called negative entropy was in living substances in which there was a building-up factor, a creative factor which was absent in entropy, in other words, an attempt to create order out of chaos, I f substances were potentized they were split up into infinitely small particles. In other words, one was getting a very fine and purely dispersed condition (Dr. Leescr had pointed that out in one.of his papers) which created a new condition which was negative entropy. One was preparing out of the drug something which, given to the patient, would supplement the vital factor of negative entropy, opposing breakdown or chaos, so that in the modcrn language by imparting energy to the substance and by splitting it up one was creating in the drug to be given to the patient this factor of negative entropy in the human subject.

The second thing he would like to mention was that in the work he had been trying to carry out the points Dr. Paterson mentioned were very well borne out. The Arndt-Schulz hypothesis could be shown and the point of interest from the point of view of homceopathic prescribing was that at one end there was inhibition and at the other there was stimulation, but when one came to stimulation there was an increasing degree of entropy. At the intermediate stage, round about the threshold between the two the most astonishing thing happened, there were variations of actions on the enzyme with identical doses. In other words, what appeared to be identical doses as calculated by weight and so on had varying effccts when they came to act on a biotic sub- stance. Apparently the same type of dose would have different effects on the different patients and might even at different times have different effects on the same patient.

In the laboratory sphere there was ample evidence in favour of Dr. Paterson's presentation of a homceopathic philosophy.

Dr. NEUBERT said that Dr. Paterson had given a most excellent paper, but he was rather disappointed with it because he expected to hear him explain many of the problems in Homceopathy which had always baffled him. He had no dispute with his Homceopathy but his philosophy did not go far enough, a point o f view which bore on what was meant by philosophy. I f one read

H O M ( E O P A T H I C ] P H I L O S O P H Y B R ( ) U G I I T U P T O D A T E 2 0 5

Aristotle, Plato, Barclay, Kant, and others, one found that the philosopher attempted to discover the actual fundamentals of the subject under con- sideration. In fact the philosopher went so far into the realm of the ultimate that he found himself literally hanging on to a negative or positive charge of electricity in a space devoid of reality. To establish a philosophy of Homceopathy besides investigating health and disease one must consider the response of the body to all noxious agents in large, medium, and infinitesimal doses whether given homceopathically or allopathically, and establish a scientific explanation of what that response was. Allergy must be explained, including natural and acquired sensitivity and desensitization in terms of Homeeopathy, the difference between the action of different potencies of the same agent must be explained, and where conditioned succussion aided that action. I t must be explained why remedies apparently only acted in such potencies as 3x, 12x, 30c, 200c, Im, 50m, and so on, and why 13x or 27c were not used, a method of therapeutics which savoured of magic and was laughed at by the orthodox man who was not blessed with the advantage of the homceopath's simple faith.

I-lomceopathic physicians claimed that the system initiated the natural healing processes which produced cure, the philosophy of Homceopathy must say by what right it was claimed that treatment by similars was preferable to treatment by opposites and why Homoeopathy did not take in nature cure which claimed to cure without the use of drugs. A new theological Hippocrates should start to declare a synthesis of medicine with a careful analysis of those things they knew, and it was on the lines of really establishing their funda- mentals that they must go before they could hope to produce an acceptable homceopathic philosophy.

There was one point he wouht like to ask Dr. Paterson to explain and that was that in stating that the acceptance of tuberculin as a treatment of tuberculosis was in support of Homceopathy : he did not add that the big thing: was that the homceopathic physician claimed that potentizing added something which allopathy had not added, and this had not taken place in the allopathic preparation of tuberculin.

Dr. LEI)ERMAN said that he wanted to go back from Kent to Kant. I-[e did not think Homceopathy would gain by declaring itseff a vitalistic doctrine ; vitalism had been killed by Kant, there was no such thing as a vital force, it was a concept. A concept was used by the allopath when he said that the kidney's function was to excrete body products. I t was true that they could do without that concept, but it was not something which was there and he (lid not think that homceopathic physicians should think of the vital force in this way. Jt was a concept which could be used in interpreting phenomena. There was no reason why this should not be done. Each science had its own form of classification of knowledge. A science was systematized knowledge, Homccopathy used a certain set of concepts in its classification, allopathic medicines used different concepts from that of Homoeopathy and he would claim that the different schools of medicine had tried to elucidate their particular sets of concepts making clear the system which they really represented. This it was impossible to do in a discussion. He would like to bring to the notice of everybody that they were using concepts and when they talked of entropy, energy, allergy, they were talking of concepts which arose from modes of thought. The philosopher was trying to elucidate the most fundamental openings for his thought.

Dr. LEESER paid a tribute to the comprehensive survey of Dr. Paterson but he had left out one of the leaves of his own book, the bowel vaccines. Dr. Paterson should be very gratified that in recent years his bowel vaccines had been in the forefront of biological and medical research, not only the symboids which made vitamins, and it was a pity that he could not exchange notes with such schemes as the Cambridge scheme of Sir Joseph Barcroft and others who had found that certain species of bacteria made vitamin B complex

206 T H E B R I T I S H I ~ O M ( E O P A T H I C J O U R N A L

in the bowels of certain individuals. This was very important in Dr. Paterson's theory of bowel vaccines. Not only was there the healthy action of bacteria but the vitamin B complexes were, generally speaking, alkaloids and the alkaloids and the chlorophyl fungi which were parasites on organic matter were making alkaloids in plants.

He would not go into that but would return to Dr. Paterson's theory that out of nine men, five had proper function and four had not of the bowel flora. Bowel collaborators caused deficiency diseases through their absence, others caused disease through their presence. The pathogenic microbes were known to all, but there was not only the direct effect but the indirect effect through changing bowel contents, for instance, by forming alkaloidal substances in the bowel. I t was a pity that Dr. Paterson, who propounded his theory long before the official bacteriologists discovered these things, could not compare notes with the scientific people at Cambridge. He not only described the relation of certain inhabitants of the bowel to certain constitutional diseases, but also related them to nosodes and homceopathic medicines. The only question he would like to ask was whether he knew which species made the vitamins, especially the vitamin B complex. One of them was B. vulgaris, but perhaps from his studies Dr. Paterson knew more about them.

Dr. GUTMAI~ said that Dr. Paterson's masterful presentation of homceo- pathic philosophy demanded rather thoughtful reading more than a rash discussion and he would make a short remark linking up a few facts. I t was mentioned to him during conversation that morning that the sulpha drugs produced fever which disappeared the moment the drugs were discarded. Those who attended the International Congress in Buda Pesth might recall the delightful swimming pool which did not prove so delightful to himself because after he was there he had fever which was unaccountable until he realized that the water wa~ very rich in sulphur, so that there was the relation- ship which Dr. Paterson had pointed out between sulphur and sulphur drugs.

He thought the time was ripe for a new edition of Hahnemann's Organon, brought up to date. I t would be an enormous job but it would be worth while if it was done by a number of workers and it could be handed to the allopath and to the student for study in the light of modern science.

The CHAIaMAN said that he was glad that the discussion had not degenerated into a futile effort where everyone agreed with the speaker. I t was said that nearly all Scotsmen were philosophers ; there were exceptions, but Dr. Paterson was not one of those. He himseff could only wish that Collins's C~ar Type Dictionary had been as clear as its type.

Hahnemann's philosophy, he felt, had not been brought up to date but it had been shown not to disagree with any of the modern trends, which was a different matter. He did not want Hahncmann brought up to date but the discoveries of to-day shown to agree with Homceopathy. Dr. Paterson said, e.g. that virus action was considered now quite acceptable to homceopathic philosophy ; that, he thought, was a proper spirit. He had somc sympathy with Dr. Lederman and his conception, for was not Hahnemann's conception of miasm as good as this new conception of dynamis ? He would agree with ])r. Bodman that " allergy " covered " miasm ". What was hypersensitivity supposed to be, and how did the modern experimenters describe desensitiza- tion ? Did their ideas fit into the homceopathic conception ? An American homceopath, Mackenzie, always did hold that the homceopathic drug action was desensitization. The dosage in modern desensitization was another point, one started with small doses and gradually increased them, finishing with a very large dose. That was not in accord with homceopathic practice. How did the statement that crude doses caused aggravation fit with our conceptions of potency action ? Dr. Bodman said that the modern trend was not to consider the question of host and parasite and their reaction, but they d/d do that ; they were concerned with killing the organism. He was not criticizing

H O M ( E O P A T H I C P H I L O S O P H Y B R O U G H T U P T O D A T E 207

the point of view but it was the modern view whatever the philosophers might say behind the scenes.

He wanted to say something on the question of dosage. One had in the hospital a case of sub-bacterial endocarditis, and one had been reduced to giving penicillin. The point was that, according to Dr. Paterson's rule, in a ease like that where there was a germ infection and poor reaction of the patient a low potency should be given. In this case Phosphorus covered moat of the symptoms but failed in high potency. Should it have been given in low potency ? This was a point well worth considering. He liked Dr. Paterson's observation that a germ in itself might be diseased ; that was new to him, in other words, it might become pathogenic. He would point out that Macdonagh's views quoted as orthodox were not accepted by the orthodox school. He would also like to ask if mutation of organisms was accepted generally and widely ? Then the claim for a similarity of action between the sulphonamides and potentized sulphur : he could hot accept this ! nor even understand, it might be his ignorance or his stupidity, but he could not follow him. In order to get the action of sulphonamide drugs there must be a high blood level of the drug. ]f there was not a high blood level of the sulphonamides one did not get the reaction and the patient relapsed. I t did not seem to have that dynamic action which they claimed for the homceopathic drug. I t was a massive dosage and a massive action.

With reference to the antibiotic plants, what was the dosage which produced this action and would the plants which were quoted give a similar antibiotic action if used in potency ? If so, it should be put to the proof, but to argue that they were antibiotic in certain doses was not proving it. The dose was all~important. I f energy was supplied to the body he would like to have the proof of that ; he did not quite see the point. The question of the low dosage in chronic disease did not seem to fit in with modern practice. In acute disease he rarely saw one dose of a high potency suffice, one continued the high potency until the patient's condition improved. Where there were marked pathological changes they were advised to keep to a low potency: what if they caused greatly aggravated symptoms ? A high potency was thought to give a greater aggravation than a low. He could not see that a Im was safe when a 30 was not. All this wanted a very full discussion.

He wanted to ask Dr. Boyd about his type of energy. In the past he said he had tested his energy against all other forms of known energy and none of them fitted. Dr. Neubert must write the next paper on bringing homeeopathic philosophy up to date, but he wou/d point out that within recent weeks or months there had been an epidemic of enteritis amongst children and the word " miasm " was offered as an explanation. He was glad they had not all agreed with Dr. Paterson, for in order to reply Dr. Paterson would have to write another paper; when he gave his Presidential Address in October perhaps he would do so and allow discussion on it.

Dr. PATEaSO~ said that there was much to which he would like to reply but time was limited. He thought Dr. Boyd answered Dr. Bodman's references to vitalization in the form of energy and he would not answer him in detail. He would have referred Dr. Bodman to Dr. Boyd in any case. Dr. Boyd's question on why it was necessary in allopathic practice to give mass doses and concentrated doses, he hoped might be left until the Congress discussion on modern therapy. One must distinguish between treating the patient and treat- ing the germ, and the allopath when using sulphonamide was using the massive dose to paralyse the germ, he was doing nothing to establish the equilibrium of the patient and the proof of that was that when one used massive doses there might be a reduction of temperature, but there was no actual restoration of balance, the patient was still ill. In proof of that the patient might relapse, or, he might have time for his own vital force to establish energy to combat the disturbing factor. When using massive doses one used them to paralyse

20~ T H E B R I T I S H H O M ( E O P A T H I C J O U R N A L

the germ and nothing was done to increase the immunity of the patient. Because the germ was paralysed there was a disappearance of symptoms. This was the experience of many practitioners, they obtained an apparent effect but there was still something wrong.

Dr. TEMrLETO~ asked if the germ was not paralysed by the natural force. Dr. PATERSON replied that one was affecting the balance of the germ : one

was not effecting balance in the patient. That was a point which might be more fully discussed at the Congress on modern therapy.

Dr. Neubert was disappo!nted but he would suggest that he forgot the introduction in which he said qu~te specifically--and this answered Dr. Lederman-- that he was restricting his philosophy to a definition which he found in a certain dictionary. He wanted to reduce his philosophy to practice. There was a great deal of philosophy in which he would like to indulge. At the beginning of the paper he gave his definition for this paper on philosophy, as he was going to interpret it to this meeting and throughout the paper he had tried to reduce it to a working rule. To go down to some philosophy of Kant might be very good, but it would not help him as a practitioner if hc was called to see an acute illness when he must have the rules for working Kent 's philosophy. He was a practitioner, not a philosopher.

With regard to Tuberculinum, it depended upon each particular experiment the reaction which was obtained : the reaction was not in the dose itself, but in the vital principle of the living cell at that particular time.

Dr. Leeser mentioned the bowel vaccines. He was not talking of bowel vaccines, he was trying to reduce philosophy for the ordinary student who might wish to take up the practicc of Homccopathy. With regard to the vitamin B complex,it was pretty well accepted that the gram-negative organisms might have some effect on the vitamin B complex. Dr. Gutman mentioned the sulphur fever at Buda Pesth ; he also bathed in that pool and had a temperature that evening so he probably had sulphur fever also.

He could give a whole paper on Dr. Templeton's remarks. Might he point out that he said that the title of the paper was not of his own choosing. The title of the paper was provided by Dr. Templeton and he was instructed to write a paper on " Philosophy brought up to date ". Dr. Templeton said he could not follow what h'aA been said about " miasm " and " allergy "; if he understood the philosophy of miasm it would include allergy but he did not think the allergist knew sufficient about his subject ; he had still to appreciate the homoeopathic philosophy and then he would know more about his allergy.

Dr. TEMPLETON : I t is more than allergy. ])r. PATERSOn': I t is. With regard to immunity, he continued, Dr.

Templeton spoke of the allergist using a small dose which was increased. The cell was able to deal with a small dose, and the dose could be increased so that the cell was not disturbed. ] t was the principle of defensive medicine, which he had referred to. Endocarditis was an acute disease, but there again there must he the definition of what was an acute disease. He tried to make a distinction between an acute disease which came from outside, an endocarditis might be acute disease, but more likely it was associated with a rheumatic miasm and therefore might be regarded as a pathological condition. With endocarditis there was certainly a pathological condition when a very low potency should be used. I t was a question of trying to assist the disturbance of the dynamis or vital factor. On the question of acceptance of views the bacteriologists themselves had published and did accept the fact that it was possible to mutate a germ ; it was possible to change a bacillus into a coccus and a coccus into a bacillus. I f that was not accepted by the orthodox physicians it was accepted by the practising bacteriologists.

With regard to antibiotics from plants, it was only a small reference in the medical journal to the effect that these antibiotic substances being found in the penicillin (which was a very low form of plant), prompted some attempt

H O M ( E O P A T H I C P H I L O S O P H Y B R O U G H T UP TO DATE 209

being made to see whether antibiotics could be extracted and it was found that they could. I t was not a question of dosage use, but it was a fact that these plants gave to the chemists substances which were similar in their chemical powers to that of penicillin.

With regard to the question of enteritis in children, it was rather interesting that when he was a student he was told that there was a common Bacillus coli. Bacillus coli was said to be non-pathogenic ; it was suggested now that the normal Bacillus coli of the child's bowel through certain influences changed and became a pathogenic germ. This was the view which had been put forward to explain the epidemic of children's enteritis and to accept that one had to accept mutation of the germ.

TUBERCULINUM (KOCH): METHOD OF PREPARATION OF A POTENCY

BACTERIOLOGY, by Dr. Linfoot. The tubercle bacillus was grown on Dorsett's Egg medium from a very

highly infected specimen of sputum, After five weeks' incubation a free growth of the bacillus was obtained. A portion of a colony of fair thickness was chosen and, by means of a platinum loop, a portion of the growth picked off with care, so that no medium was touched at all. This was emulsified in sterile glass distilled water.

PHARMACY

To Dr. Linfoot's culture washings was added absolute alcohol, so that they were contained in 75 per cent. alcohol (maximum inhibition effect is obtained with this strength of alcohol).

THREE METHODS OF PREPARATION WERE USED : (a) All fluid potencies from a maceration using the original culture wushinej

liquid. The washings as received in the 75 per cent. alcohol were shaken and

allowed to stand overnight (16 hours). One drop was then decanted into 99 drops of 75 per cent. alcohol, machine succussed and allowed to stand as before, to give what was called the 2nd centesimal potency. This process using 75 per cent. alcohol was repeated three times more, to produce the 5th centesimal potency. Higher potencies were then run up to the 30c by the usual fluid method. All stages were kept.

(b) Potencies from an initial trituration, by macerating the triturate and then potentizing by the fluid method.

Meanwhile, the washings were shaken to ensure that a good proportion of the cells be available, when about three-quarters of the quantity supplied (one-quarter kept) were quickly poured on to about 200 grains of May & Baker's Lactose " AI~ ", in a new glass mortar, and triturated by hand for one hour. From time to time, as the lactose began to lose its grinding power, that which caked on the apparatus was freed by the addition of more 75 per cent. alcohol. Half the +~rituration was then macerated with 20 per cent. alcohol for 24 hours to give what was called 2c. This liquid was then potentizcd by the usual fluid method to the 30th c. The 3c and 4c in 20 per cent. spirit, but the 5c and upwards in absolute alcohol.

(c) Three initial centesimal trituratious, then upwards by the usual fluid procedure.

Two grains of the 1st trituration (of b) were triturated with 198 grains of the M. & B. lactose " AI~ " for an hour, without the use of alcohol to break down the caking of the lactose, to give the 2nd c trituration, and the third trituration made similarly. The 4c potency was made by macerating the required quantity of 3c trituration in 95 per cent. alcohol and potencies carried up to the 30th by the usual fluid method.