The Study of the Materia Medica. — The thorough study of this science is second in importance to that of no other in the circle necessary to the complete furnishing of the physician for the duties of his responsible calling. His knowledge of Materia Medica cannot be too perfect — cannot embrace too much of detail. Indeed it is the knowledge of this detail, the gaining of which is such an unparalleled drudgery, the possession of which is just the power that distinguishes the master from the tyro. It is indispensable to practical success. By it all that has been achieved in the sick-room, which has given Homoeopathy a name among the nations, and made it a power, in spite of opposition from prejudice, ignorance and falsehood. Homoeopathy is detail. It is in the likeness of the details of the elements of disease and drug-action that its law of cure has its existence. He who despises or neglects these, despises or neglects the substance which gives vitality to the system of our school. Different methods of obtaining mastery of these hare been resorted to by students, according, to their mental habits, or their perception of the importance of the study and of the elements to be acquired, with success varied by difference of method and diligence. The course suggested below is from a valued correspondent in a neighboring city. It is given to our readers, as it was written, with the intent to urge upon all a more earnest devotion to this study, and also to make it the occasion of some remarks we have intended to make on the proper record of symptoms.
“Ill health and other causes have led me to seek expedients to stimulate study and aid the memory. One of these methods I wish to suggest to the Editors of the American Homoeopathic Review. I desire to interest them in it and wish they would adopt it as one of the features of their journal.
Let the student keep a numbered list of oases with the principal and characteristic symptoms of each. Let this list include cases treated by himself and also cases which he meets with in his reading. Let no case be admitted which does not point clearly to a single remedy. If there would be serious doubt between two medicines, the case should not be admitted until further light renders its relations to a single remedy unmistakable. To the list may be added groups of symptoms and imaginary cases such as occur to the mind in the course of study.
In insisting that each group or case shall apply to but one medicine, it is of course understood that absolute precision is not attainable. All that is expected is, that when the study of a case is completed, the mind shall rest satisfied that no more appropriate remedy can be found than that which has been fixed upon. In this way may speedily be formed a record containing many real and supposed cases.
In another place should be kept a list of the remedies which are supposed to fit these groups with numbers corresponding to those of the oases. Be sure, however, that the recorded cases shall in no way suggest the remedies except through the symptoms, as they would do when presented to the mind in the course of your daily practice.
To use this record in studying, the eye may run over the cases beginning at any point you may choose to start from. On reading a case if it suggests the proper remedy, the next one in order may be taken. But if the recorded symptoms are not recognized as characteristic of a single remedy, the case should be made the subject of careful study with the books. On no account is the key to be resorted to, except in cases of extreme doubt which cannot be resolved by faithful study. The object in view is not to obtain the solution of the problem but to gain strength and skill by working it out.
Such a method of study will repay the labor. A distinguished opponent of our system characterizes our Materia Medica as “an endless farrago of ridiculous trivialities” He blasts his own fame who leaves on record such slurs at what is approaching the place of a science. A pleasure not surpassed by that of the naturalist or mathematician is in store for him who shall faithfully compare the symptoms of natural disease with the pathogenetic effects of medicines. The first steps in the study of any science are painfully laborious. When the first difficulties are overcome the reward begins and every subsequent step rapidly increases it.
I append a few cases copied from such a record as is above described. They are given as they were noted down at the time of prescribing. I use partly the language of the patient and partly such terms as occurred to me at the time. In each case the remedial effect appeared to be prompt and all that could be desired.
If the Editors of the Review will open such a list, taking cases from their own practice and from other sources, I for one shall be most thankful. It will soon be found that among the cases which occur in practice there is much choice in this adaptedness for the purpose in view, a wide variety is of course desirable. The names of the appropriate remedies can be given in subsequent numbers if that is thought best.
Case I. Miss M. N., has usually good health, except that menstruation is profuse and debilitating. Several days since was taken with chills and headache; since then, every second day, she has had a chill with shivering all over her, at the same time or very soon the face is hot and the head aches; her hands are cold; there is no thirst; the pulse is weak; the headache is stupefying. This is the fourth such chill she has had. They are followed by fever, with some thirst, lasting several hours. She continues to have stupid headache; feeling of faintness; dullness; she lies dull; takes no notice; inclines to sleep; perspiration ensues, which smells sour. The face is cold and pale; the lips are dry; the tongue is clean, but except on the edges is parched as if burnt. She complains of some colic pains and the abdomen is sore and tender on pressure; the bowels are torpid; the urinary secretion is slight.
Case II. Mrs. D. C. Dyspepsia of three or four weeks duration. After eating has pain and distress near the cardiac orifice of the stomach. She has nausea; sour risings at times; there is pain in the throat, but no soreness or pain in swallowing; has at times pain in drawing a long breath; a week ago had heavy cold in the head, which is better now; has pain in the back as if overtired; frequently she feels sore all around the waist; “feels so weak;” sleeps well, but don't get rested; wakes tired out; has headache a great deal; attributes her present symptoms to excessively eating fruit; has long suffered slightly from leucorrhea; menstruation is scanty, but regular.
Case III. Mrs. H. S. M. Diarrhea for three days. She has been subject to irregularly recurring attacks of severe illness. She is taken with severe distress in the right hypochondrial region; the aching pain comes and goes like cramps; they usually result in vomiting which brings relief. In this instance diarrhea takes the place of vomiting; the pain is passing off; there is some soreness in the region of the liver; the discharges are watery and dark yellow; odor very bad. There is some tenesmus, but she can't bear to strain because there is so much soreness at the extremity of the rectum. She has had partial prolapsus uteri. The abdominal walls are drawn in; her feet are icy cold.
Case IV. Mr. M. P., is subject to attacks of weakness, like faintness, coming over him of a sudden, without obvious cause. Has much headache, chiefly the back of the head and nape of the neck; painfulness of the scalp when touching the hair; throbbing in the back-side of the head; eyelids turn in, with smarting, soreness and itching. Has much pain and soreness in the left hypochondriac region; frequent hoarseness, almost entire loss of voice at times; has much tightness of the chest and short breathing; tired and weak in the chest; face pale, grayish yellow.”
The proper record of a case presents it to the reader in all its entireness, so that he has before him all the necessary elements for a specific prescription. It gives all the symptoms, and each in its completeness, so that these can be judged of and prescribed for as if the living sufferer were present for examination. This is no easy duty, nor is it always well performed. One difficulty in the case has seemed to be a partial misconception of what a symptom really is. The result is only a partial record, which not only leaves out facts, but omits parts of facts, either because they were not enquired into, or were not deemed of importance. The omission of these often leaves the case where no master can find the curative, however extended the record, and numerous the statements given. Indeed the statement given are often not symptoms, because of these omissions. What is a symptom?
A symptom of either drug action or disease is a fact, and something more. It is a fact with distinct qualities; with attendant circumstances of time, place, position, motion, repose, and whatever else by which it is caused, aggravated or mitigated; it has antecedents and subsequents by which it is characterized; it has definite location, if the fact affects the physical man; all these, and all else belonging to the fact, are to be stated, or it is only a partial statement of a fact and not a symptom. Incompleteness in these particulars makes exact prescribing impossible. Thus in the first case of the above series, the antecedents of the chills, if any, are omitted, and also the time of day of the attack, a most important and often indispensable element to the prescriber. The peat of the pain in the head is not given nor its aggravating or mitigating circumstances. The seat of the colic pains and of the sensibility of the abdomen are not given. In the second case the kind of “pain or distress” which followed eating, the time which elapsed after eating, before the appearance of the pain, the time and circumstances of the appearance of the “nausea and sour risings,” the kind of “pain in the throat,” the kind of “pain in drawing a long breath,” and at what “times” it occurred, are all omitted. Similar defects are found in the third and fourth cases. Now the study of model cases cannot but be useful, and one of the first and most important lessons to be learned from these by the student is to make a perfect record of cases himself. This is not the least difficult of his duties, and till he is master of this he cannot become a perfect prescribe. In many of our so-called drug provings, these imperfections of the record render them of little or no practical value. But neither “reports of cases” of disease, nor of drug action called provings, can be given as models for study, and instruction which are wanting in these elements. Hence from the multitude of cases reported and published there is so little to be gleaned to add to our positive knowledge or power to cure the sick. The elements by which these cases might have been brought into relation with our positive knowledge, and made to increase its sum, are just those which have too often been left out, and with too many of them it is true that the most they teach is, an individual sickened; a few facts (too often not symptoms) of the case are given; he got medicines so and so; and recovered or died as the case may be; and why he did either, the record too often fails to furnish the reasons for a judgment, and no man can tell. Why? Because the writers have failed to perceive the important difference between mere facts and pure and complete symptoms. A fact is simple. A symptom, as we use the term in our school, is complex — is often made up of many facts. Facts are but poor helps to the prescriber till he has combined them into symptoms, by adding to each all its related facts. We propose a further consideration of this subject in a future paper on the subject of “Drug Proving.'” W.
|The American Homoeopathic Review Vol. 03 No. 08, 1863, pages 374-377
|The Study of the Materia Medica; Practice cases.
|errors only; interlinks; formatting