BY DR. C. VON BOENNINGHAUSEN, MUNSTER.

If we attentively read and study the long series of symptoms of the thoroughly proved remedies, we find therein, without giving them any forced significance, the material for a great number of the most various diseases. Almost all remedies exhibit in common this abundance of symptoms and it is repeated alike in the oldest and the newest provings. Only now and then does one come across one or another symptom, which occurs under only one or only a few remedies, but this is rarely sufficient of itself alone to completely characterize a morbid affection, still less a (generic) disease.

From these facts, of which every one may convince himself with his own eyes, it is easily comprehensible that besides the strictly morbid phenomena and sensations, still other items than the Physiological and Pathological indications must be taken into account, if we would be in a condition to make a correct choice of a remedy in any concrete case.

But these items are to be found, directly and especially, in the individual peculiarities as well of the disease as of the remedies; and the important problem is, to investigate and comprehend both with the utmost possible precision and to bring them into relation with each other so as to satisfy with the necessary perfectness the fundamental principle “Similia Similibus.”

With what comprehensiveness the founder of the homoeopathic school and his early immediate pupils, recognized and met this necessity, appears most clearly from their writings. But many younger Homoeopathists appear not to have thoroughly understood the importance and necessity of this part of Therapeutics, but instead thereof, seem to lay a preponderating weight upon general Physiology and Pathology which in recent times have made such wonderful growth, sciences which teach indeed to recognize the disease with certainty but not to cure it. It needs only to compare the more recent records of clinical cases, even those which are published as model cases, with the earlier ones, to show that my assertions are just.

It would require too much space were I to attempt to delineate, even with the greatest possible brevity, all the peculiarities of the Homoeopathic Therapeutics, in which it differs from the Allopathic and to which strict regard must be paid in its practical application. But it may not be superfluous to touch, by way of illustration upon one point, of which for the most part no notice is taken by the Allopaths, for the reason that they do not understand how to make it available, but which is by us brought into constant use, inasmuch as it manifests a great influence upon internal and external symptoms, and hence demands the greatest consideration as a necessary constituent of the Simile. I mean the influence of Motion and Rest upon the aggravation of symptoms.

The occurrence or aggravation of (internal as well as external) symptoms, by motion of the whole body, or only of the part affected, in contradistinction to repose, is without doubt known in a general way to every Homoeopathist. No one would, for example, blindly give Bryonia in a so-called Nervous fever if the patient kept constantly tossing about and could And no rest on account of pains in the limbs which were relieved only by motion; neither would he give Rhus, in a disease going by the same pathological name if every motion, however trivial, aggravated to an intolerable degree the pains in the limbs and if the pains were only relieved by absolute repose.

It would, however, be a great mistake to suppose that with these general designations, Motion and Rest, the subject is exhausted. In this very particular it is most evident, as in like manner with regard to many other influencing circumstances, with what sharpness and precision the examination of the patient must be made, if we would select the remedy with as much certainty as that with which we desire to cure the disease. The following pages are devoted to a closer consideration of Motion and Rest such as has been alluded to. They are the fruit of careful experiment and observation for many years, and as such I venture to commend them to my younger colleagues.

When a patient, in reply to a question put to him, simply replies, “Motion aggravates;” this may be understood in a threefold sense. The aggravation, namely, may take place, first, on beginning to move, second, during continued motion, and third immediately after motion. These are clearly important distinctions which are wont to be predicated of motion and to be specified as legitimate sequences of it, but each o which has special relation to its own peculiar group of remedies.

When, for example, the aggravation takes place only at the beginning of motion, but diminishes gradually as the motion is continued, then Caps., Carbo veg., Caust., Con., Euphorb., Ferrum, Fluor. acid, Lyc., Puls., Rhus tox., Sabad., Samb., and Silicea are most frequently indicated. When, on the other hand, the aggravation occurs during motion and is increased by continuance of the motion, our first choice will fall upon Bell., Bry., Cocc., Colch., Ledum., Nux vom., etc. When however the aggravation occurs immediately after motion, that is, in the period of repose which immediately follows motion, still other remedies are to be preferred, such as Agaricus, Anac., Arsen., Cannabis, Hyoscyam, Kali carb., Puls., Rhus tox., Ruta, Sepia, Spong., Stann., Stram., Valer. and Zinc.

Important as it is to notice the above distinctions yet in many cases even this is not sufficient. There exist in reference to motion and rest still other points which require equally to be observed inasmuch as they correspond, like the foregoing to the individual genius of the different remedies.

First, it makes an important difference whether the motion is violent, involving much bodily exertion, in which case, while observing the distinctions previously defined, preference is to be given to Acon., Arn, Ars., Bry., Calc., Cann., Lyc., Nux vom., Rhus, Ruta, Sil. and Sulph.

If, further, there has been, in conjunction with the motion, considerable overheating, the choice will fall especially among Acon., Ant., crud., Bell., Bry., Camphora, Carbo veg., Dig., Kali, Opium, Phos., Sep., Sil., Thuja and Zinc. What might be said of the same character respecting taking cold (simultaneously with and immediately after motion) either in the entire body or in isolated parts, whether from getting wet through, or from some other causes — circumstances which might sometimes require the selection of still other remedies — this we must omit for lack of space.

It is necessary however to state, briefly, that the kind and manner of the motion likewise furnish their peculiar indications. Thus for aggravation from assuming the erect position, we have Acon., Bell., Bry., Ign., Nux vom., Opium, Rhus., Staph, and Sulph., while to aggravation from stooping, the following more frequently correspond: Alum., Ammon. carb., Arn., Calc., Lach., Mang., Sep., Spig., Thuja and Val.; although the desired favorable result may be wrought by still other remedies especially by such as produce alternate effects, when they correspond homoeopathically in respect of other symptoms.

The same is true of aggravation on rising from a sitting posture which requires especially Aconite, Apis, Caps., Conium., Fluor, acid, Lyc., Phos., Puls., Rhus tox., Spig.; and rising from the recumbent posture (from the bed) which calls for Apis, Bry., Carbo veg., Conium, Lach., Sulph. acid.

As a matter of course, under these heads, the beginning of motion is involved in assuming the upright posture; and in rising (from the bed) is involved also the aggravation of symptoms after sleep and thus still other remedies may come under consideration.

Furthermore it is to be observed whether the aggravation of symptoms takes place during or after the rising from a sitting or a recumbent posture, because in these cases, as has been before remarked of motion in general, different remedies compete for a preference.

The kind of motions must be carefully noticed; aggravation from extending the part affected is a verified indication for Alum., Calc., Coloc, Rhus tox., Sep., Staph., Sulph. and Thuja. And aggravation from flexing or turning it, for Ammon. mur., Cicuta vir., Ign., Kali, Lyc., Nux vom., Puls., Spig. and Spongia. The direction in which the motion of flexion is executed makes an important difference. If outward, Caps, and Caust, are preferable; if inward, Ignatia and Staphysagria; if backward, Calc., Kali, Puls., Sepia, and Sulph.; if sidewise, Bell., Natr. mur.; if forwards, Coffea and Thuja; or finally, if the part be retained in the flexed position, Hyos., Spong. and Valer. Under the head of Extension, belong also stretching and twisting for which likewise certain remedies are especially indicated, viz.: Amm. carb., Ran. bulb. and Rhus tox., as well as drawing-up a limb, which frequently indicates Ant. tart., Rhus tox. and Secale corn.

Under this general head come also aggravations from lifting the limb affected, for which Arn., Baryta, Bell., Fer., Kali, Ledum, Rhus tox. and Sil. are indicated; and in particular from straining, for which Arn., Bor., Bry., Calc., Cocc., Graph., Ign., Lyc., Natr. carb., Nux vom., Phos. acid, Rhus tox., Sep., Sil. and Sulph. stand in the first rank as remedies.

If walking in general is to be included under the head of motion, then the distinctions above specified of motion will apply to walking and aggravations occurring on beginning to walk, by continued walking and on ceasing to walk will have a corresponding therapeutic value. But there are certain additional varieties which furnish special indications by reason of their connection with certain accessory circumstances. For example, walking in the open air gives rise to aggravation of a great number of symptoms and hence serves as indication for a large number of remedies, but especially for the following: Anac., Bell., Carbo veg., Cocc., Colch., Con., Fluor acid, Hepar, Nux vom., Phos. acid, Selen., Spig. and Sulph.

But even this is far from exhausting our therapeutic store. The additional question arises, whether this aggravation on walking in the open air occurs in a damp atmosphere or in rainy weather, in which case Amm. carb., Calc., Colch., Dulc., Fluor. acid, Lach., Lyc., Nux mosch., Rhus t., Sulph., or Verat., are usually indicated; or whether it take place in dry weather, in which event Asar., Bell., Bry., Caust., Hep., Nux vom. and Puls, are especially indicated. Moreover special indications are furnished — by aggravation from exposure to the hot sun — for Ant. crud., Bell., Bry., Lach., Natr. carb., Puls., Selen. and Valer; from exposure to the air just before a thunderstorm, for Agar., Natr. carb., Phos., Rhod., and Sil.; from exposure to snowy air, for Calc., Con., Lyc., Phos., Phos. acid, Puls., Rhus tox., Sep., Sil., Sulph.; and from exposure to fog, for Bry., Cham., China, Mang., Nux mosch., Rhod., Rhus tox., Sep., Sulph. and Verat. Under this head belongs also walking in the wind; and Ars., Asar., Bell., Calc., Cham., China, Euphras., Graph., Lach., Lyc., Nux vom., Phos., Puls., Rhus tox., Spig. and Thuja are especially indicated where aggravation occurs from walking in a strong wind.

Besides the preceding conditions which exert an influence in a therapeutic point of view upon the motion of walking, there are several others which sometimes accompany isolated symptoms and furnish indications that are all the more useful because in such cases leading concomitants are often altogether lacking. Such are, for example, under vertigo, the aggravation by walking over a narrow bridge, which indicates Baryt., Ferr. and Sulph.; or upon or over water, which indicates Ang., Ferr. and Sulph. The same is true of pains in the soles of the feet, aggravated by walking upon a hard floor or upon a cement-walk, a condition which calls for Ant crud., Ars., Con. and Hepar.

But motion upwards or downwards requires also very particular consideration. For motion upwards (ascending, going upstairs) among many other remedies, Arn., Ars., Bry., Cup., Nux vom., Senega, Sep., Spig., and Spong. are most prominent, while for motion downwards (descending, going downstairs) Arg., Con., Ferr., Lyc., Rhod., Ruta, Sabina and Verat. have in many cases proved to be indicated.

Driving and riding must be included among the varieties of motion. Various symptoms are induced or aggravated by driving in a wagon, which generally find their remedy among Ars., Bry., Cocc., Colch., Hepar., Hyos., Ignat., Lach., Nux mosch., Op., Petr., Rhus tox., Selen., Sep., Sil. and Sulph. On the other hand the remedies for sea-sickness, from motion in a ship, are pretty much confined to Ars., Cocc., Colch., Ferr., Hyos., Opium, Petr., Sil. and Tabac, although the motion of rocking which seems to nearly related to the above, corresponds only to Borax and Carbo veg. It may here be mentioned as something remarkable that some symptoms are relieved by driving in a wagon, and in such cases Ars., Graph., Nit. acid or Phos., are most likely to be indicated.

As regards riding (on horseback) the totality of the symptoms in those persons with whom this exercise does not agree, will generally be found to be of such a character that Graph., Nat. carb., Sep., Spig. or Sulph. acid, are among the remedies best indicated. In this connection, as above, we note a singular circumstance, viz.: that cases of exceedingly painful, inflamed and protruding hemorrhoids sometimes present themselves, in which, contrary to all analogy and to all reasonable expectation, riding (on horseback) affords the greatest relief. In such cases as these a single very small dose of a high potency of Kali carb. is generally sufficient to cure the disease rapidly and permanently.

Just as change of position may, through the aggravation of symptoms, furnish a useful indication for several remedies, most strikingly, for Caps., Carbo veg., Con., Euphorb., Lach., Lyc., Phos., Puls, and Samb., so it may also happen that it alleviates the symptoms. This affords a very characteristic indication for Cham., Ign., Phos. acid, Valer. or Zinc.

Turning over in bed is also a motion which produces more or less of aggravation under several remedies, and may therefore serve as an indication. It is most marked under Acon., Ars., Borax, Bry., Cann., Caps., Carbo veg., Con., Ferr., Hepar., Lyc., Nat. mur., Nux vom., Puls., Rhus tox., Sil., Staph. and Sulph. Closely related to this is the motion of looking around, although as regards aggravation it is as yet noted only of Calc., Cicuta vir., Con., Ipec. and Kali.

In addition to the above-named varieties of motion there are many others, which however we may pass by here the rather because they affect often only isolated portions of the body, a fact which constitutes in itself something of an individual characteristic and which therefore gives to the motion associated with it a somewhat subordinate rank. Among the number, are, for example, respiration, inspiration as well as expiration, swallowing, whether only of saliva, or empty swallowing, or also swallowing of food or drink; sneezing, yawning, coughing, speaking, writing, etc. Respecting all of these conditions, in so far as they exercise an influence upon the aggravation or amelioration of symptoms, our Materia Medica Pura contains a large quantity of observations which were first obtained by provings upon the healthy and then verified by administration to the sick. They have therefore sustained a double test, a priori and a posteriori, and they deserve just as much consideration, in the search for the most complete and perfect simile, as any other symptoms that have been discovered and verified in the same way. If at the present day this consideration is not commonly accorded, f, indeed attention is chiefly fixed on the pathological, the general symptoms, while the concomitant symptoms, which for the most part are very characteristic, are correspondingly neglected, assuredly such laxity and incompleteness in the application of our fundamental principle are utterly inexcusable and it is not; to be wondered at that even “experiments on the sick,” to their great injury should be ever on the increase, while pure experiment is growing less and less frequent.

Thus much, for the present, I have felt constrained to say respecting the influence of motion and its varieties upon the phenomena of disease and respecting, consequently, the importance of regarding them and finding their correspondence in the drug symptoms in order to show to what extent and with what critical discrimination we are to avail ourselves of them. At the same time, what has been written will demonstrate, with what industry in a period of fifty years (the first volume of Materia Medica Pura of 243 pages, appeared in 1811, the third edition of the same volume with 504 pages in 1830) our therapeutic edifice has been extended, while every duly verified new observation or discovery finds always therein its appropriate place and must contribute to the further extension and completeness of the whole.

All that needs to be said concerning the influence of rest upon the aggravation of symptoms, may be done with considerable brevity, for essentially it consist in the converse of what has been already said.

One variety of rest, however, demands a brief consideration and all the more, because in the first place it affords for many internal and external diseases a truly indispensable characteristic, and in the second place because it must astonish every experienced Homoeopathist to see, as he reads the more recent descriptions of clinical cases, that many practitioners appear to leave it altogether out of account. I mean rest in the recumbent position.

I pass by simple lying, which is merely rest in contradistinction to motion, and also lying in bed and propose to consider the different recumbent positions, which are the points of greatest interest in this connection.

First under this head comes aggravation from lying outstretched in contradistinction to lying crooked or in a curved position. For aggravation in the former posture, Cham., Colch., Coloc, Platina, Puls., Rheum, Rhus tox. and Staph. are most likely to be appropriate. For aggravation in the latter, most frequently Hyos., Lyc., Spong., Teuc. and Valer.

Aggravation from lying with the head low indicates other remedies again, among which are Ant. tart, Arg., Ars., Caps., Chin., Colch., Hepar., Lach., Nit, Puls, and Spig. If in addition the horizontal position is most tolerable to the patient, then Apis, Arn., Bell. and Spong. may be added to the above.

But still more important than these, are the recumbent positions upon the back and upon the sides.

If lying upon the back aggravates, this indicates especially Amm. mur., Ars., Caust, Cham., Chin., Coloc, Cup., Cycl., Iod., Nit, Nux vom., Phos., Plumb., Rhus tox., Sep., Sil. or Spig. When, on the contrary this position affords relief, the most suitable remedy will generally be found among Acon., Anac., Bry., Calc. carb., Carb. an., Kali carb., Lyc., Merc., Puls., Seneg., Stann. or Thuja.

Aggravation from lying on the side requires in general Acon., Anac., Bry., Calc., Carb. an., Kali carb., Lyc., Phos., Puls., Stann., Sulph. and Thuja. But under this head there are two varieties which are of very great importance, viz.:

1. The aggravation may be produced by lying upon the right or upon the left side; or,

2. It may be produced by lying on the painful side or on the side which is not the seat of pain.

If we disregard these distinctions we grope about in the dark in treating many affections of the head, chest, abdomen and limbs, and we fail to select the correct and successful remedy until we have long sought it and experimented in vain, whereas we might easily have found it at the outset had we paid attention to the distinctions above indicated.

The following remedies correspond to aggravation produced by lying upon the right side; Amm. mur., Borax, Caust, Mag. mur., Merc., Nux vom. and Spong.; by lying on the left side, Acon., Amm. carb., Baryt, Bry., Colch., Ipecac., Nat. carb., Nat. mur., Petr., Phos., Puls., Sep., Sil., Sulph. and Thuja. But when this condition comes into collision with the following one, the preference is always to be given to the latter.

The most important distinction and one of which we may the most frequently avail ourselves in practice is that between aggravation produced by lying on the painful side, and that produced by lying on the painless side.

In the former case the chief remedies are: Acon., Amm. carb., Ars., Baryt., Calad., Cycl., Dros., Graph., Hepar., Iod., Lach., Lyc., Magn., Mag. mur., Mosch., Nit. acid, Nux mosch., Nux vom., Par., Phos., Phos. acid, Rheum, Ruta, Sabad., Selen., Sil., Spong., Staph. and Thuja.

On the other hand, aggravation when lying on the side which is not the painful one occurs uniformly under the following remedies; Ambra, Arn., Bry., Calc., Cann., Caust., Cham., Coloc, Fluor. acid, Ign., Kali carb., Puls., Rhus tox., Secale corn., Sep., Stann. and Viola tr.

All of these indications are so trustworthy and have been verified by such manifold experience that there are hardly any others which can equal them in rank, to say nothing of surpassing them. But the most valuable fact respecting them is this: that this characteristic is not confined to one or another symptom, but like a red thread it runs through all the morbid symptoms of a given remedy which are associated with any kind of pain whatever or even with a sensation of discomfort, and hence it is available for both internal and external symptoms of the most various character.

It is really a matter of surprise and wonder that an element so obvious and so very valuable for the appropriate selection of a remedy should have remained so entirely unheeded in many of the most recent details of cases so carefully drawn up in other respects and that instead of these, the results of auscultation and percussion should be recorded with the utmost exactness, notwithstanding the fact that the symptoms of our old and well-tried pure Materia Medica contain nothing whatever relating to these, then unknown methods of observation and that, consequently, they are almost worthless as items on which to base the choice of the remedy.

If the conscientious homoeopathic physician is more intent on curing his patient as speedily and as safely as possible, than on making a parade before him and astonishing him by a display of scientific accomplishments, he will, at least, first, seek out in the case those, I had almost called them therapeutic-pathological, characteristic symptoms by which he may make sure his choice of the remedy; and not until he has done this, will he seek to make available the general physiologico-pathological phenomena, for these, at least, can then do no mischief. And if he desires, in a laudable manner, to prepare the way for a future useful application of the stethoscope and the pleximeter, let him seek to bring the results of the employment of these new implements into relation with the above-mentioned old and verified symptoms, in such wise that both united may be employed in making the cure even more certain and precise than before.

He, however, who does not go to work in this fashion, but in contradiction of section 153 of the Organon, pursues his way over the barren waste of a pathology without characteristic, should as little expect to be recognized as a true homoeopathic physician as those others who in opposition to section 245, et seq., of the Organon, by their, to say the least, unnecessary administration of massive doses, give our adversaries occasion to declare (as in the Allg. Preuss. Med. Zeit., 1861, and not altogether without reason) that the distinction between allopathic and homoeopathic remedies no longer exists, and to deduce from this the futility of the claim on the part of physicians to the liberty of dispensing their own remedies, since in fact the necessity for this liberty is denied to exist. If anyone, whoever he may be, has the audacity to proclaim to the world, that Hahnemann himself, towards the end of his life, returned to the use of massive doses and only maintained an outside semblance of adherence to his potentization theory from unworthy motives, such a man is nothing but a common slanderer, unworthy of respect and credit at the hands of any honorable man, whether Allopath or Homoeopath, and he will be nailed to the pillory as a malignant liar, by the publication, which we may very soon expect, of original matter from our great master's own journals.

Dunham.