Phineas Parkhurst Wells (1808-1891) was one of the "guiding lights" of the IHA, and served as its first president in 1881. He was a teacher and colleague of Carroll Dunham, Bernhardt Fincke, and Stuart Close. This paper is a rebuttal, in effect, of the idea that the "germ theory" has anything to do with "disease."

A Revolution in Old Physic!

P. P. Wells, MD, Brooklyn, NY

Transactions of the International Hahnemannian Association 1889, page 32.

Is not the suggestion startling? And if it comes, from whence, and from what and from whom shall it come? If it comes, what shall be the result? That it is to come we have the authority of the New York Daily Times which is not given to trifling with serious matters, and this brave journal gives the forum which voices Dr. Austin Flint in this prophecy, as its assurance that this extraordinary event is near. Who is not tempted (after reading in this much-read journal of its confidence in the near approach of this great over-turning) to say--How can these things be? How can an institution that claims an antiquity of many centuries, and that in it is, and has been, embodied the treasured wisdom, observations and experience of these eenturies, and the gathered "science" which these, formulated, have made its own, be revolutionized, or in any way or degree be susceptible of this? May not the everlasting hills be as easily overturned and cast into the sea? Can there be any need of revolution in the present condition of the institution itself? Dr. Flint says it is to be, and it is believed he holds the position of an official teacher in it, and therefore he ought to know, and the New York Daily Times believes him. Indeed he, Dr. F., says this is now in progress, and this is how he says it: "The science and practice of medicine and surgery are undergoing a revolution of such magnitude and importance that its limit can hardly be conceived." So-- this revolution is not only to be, it has come, and is even now upon us, and yet the world goes on much the same as it did before this great eventwas initiated. If this overturning of old physic is really in progress, this so little commotion as we see at present in the medical world, would seem to be evidence of one of two things, or of both. Either old physic is not made out of the observations and experiences of these centuries, or the results of these are of far less importance than it would have the world suppose. There has been a kind of a suspicion abroad for some time that even old physic itself has had little confidence in this boasted antiquity, observations and experience, and the claimed results, and this has seemed plainly declared in its restless haste to seize on any new thought or supposed discovery of a fact which could be taken and used as its own. And the question would ask itself: why this haste, if it has half the confidence in the old which it would have the world believe it has? If it has not at times some inklings of the utter false pretense of the formulated science, from these alleged observations and experiences; why this haste after the new, and the unseemly readiness to accept and glorify whatever comes before it with claims of novelty or loud assumption of merit? How else can we explain its constant antagonism to truth, so full of hatred and falsehood, but that these spring from a great fear that the alleged truth could reveal the emptiness of its boasts, that of these votaries of old physic, of the possession of the formulated "science" of these centuries? Its . constant failure to grapple successfully with new problems in therapeutics must have impressed on the mind of average stupidity to question the truth of this claim, while average intelligence it could seem must have known its gaseous nature from the beginning. We have asked, what is this revolution to come from?

Dr. Flint has answered the question, and the Times says he "is a physician of prominence," and therefore, presumably, he knows.

He says: "In certain diseases the causative action of bacteria can no longer be doubted." So it is the microbe which is working this so great change! This announcement of the cause of this revolution imposes doubt on us either as to the truth of this causation, or the importance of the proclaimed results. Dr. F. gives this list of important diseases in which he says, "the causative action of bacteria can no longer be doubted": "Tuberculosis, pneumonia, erysipelas, carbuncle, diphtheria, typhoid fever, the malarial fevers, certain catarrhs, tetanus, nearly all contagious diseases, and a great number of skin affections."

It is a just cause of surprise when we fail to see malignant cholera in this list of diseases alleged to be indebted to the microbe for causation, and the more as we cannot but remember that the microbe, in the character of cause of disease, was first introduced to our attention by Koch as the cause of cholera. And we remember how all adherents of old physic shouted paeans to Koch and his microbes, for pure joy, because they believed they had now the cause of this dread disease, discovered for them, "tolle causam," and the difficulty of cure would be ended.

The cause, a microbe-- why, kill the microbe, and the work is done. Then why omit cholera from the list of sicknesses caused by the microbe? Did Dr. F. remember Marseilles and Naples in 1884, where the first attempts were made to kill Koch's microbes, in the fatal epidemic of that year? If so, this sufficiently explains the omission of cholera from his list of diseases caused by the microbes. But then, what becomes of the paeans to the first born of this microbe folly? This epidemic appeared in these two cities soon after Kooch proclaimed, so ostentatiously, his discovery of the cholera microbe, and claimed for it the important function of cause of this hitherto so fatal and uncombatable plague. Now, the doctors thought they had the mastery of the scourge. It was only to kill the microbe, and cholera would cease to trouble them, so they proceeded with confidence, and without less of time to battle with the microbe, secundem artem with the most approved germicides, and talked as loud, and as long, as old physic is accustomed to of matters it is most assured, of "stamping out" the microbes and their resulting cholera; and there was much of this kind of "stamping" attempted. But after all, there was no abatement of the epidemic. The microbes may have been killed, but the cholera was not; nor was the rate of mortality from this great "stamping" in the least abated. So it turned out that in the first attempt to proceed on Koch's assurance of the microbe being the cause of cholera, the result was to demonstrate, that as a cause of epidemic the microbe had had neither part nor lot in the matter. And whatever may have been the result of the much attempted "stamping" on the microbes, on the patients this was left in no doubt. In Naples 54 per cent. Of all so treated were "stamped out." Here was demonstrated conclusively, the utter neutrality of the microbes as the producing cause of the disease. The claim of Dr. F. of the causative agency of these organisms in the diseases of which he has given so long a list, is neither more earnestly put forth, nor its truth more perfectly proved than was that of Koch for his cholera microbe, and this claim of Dr. F. is no doubt as equally empty of all importance as was that of Koch.

The practical test of the value of Koch's discovery, when made an integer of means resorted to for the prevention or cure of cholera, demonstrated this to be nil. The rate of mortality, with the knowledge of the discov ered microbes in the treatment, in 1884, was substantially the same as that which attended the treatment by old physic in the epidemics of 1829 and 1832, into which no knowledge of microbes entered. And we have no reason for honoring the claim now put forth by Dr. F. of the value of these organisms as cause of any of the important sicknesses which he names. No doubt these organisms sustain relations to the sicknesses in which they are found, similar to that of Koch in cholera, whatever that may be. The epidemic of '84 and its treatment demonstrated that causation of the disease makes no part of these.

And yet, we are told by Dr. F. that "the science and practice of medicine and surgery are undergoing a revolution (by reason of this microbe) of such magnitude and importance that its limits can hardly be conceived." We do not believe a word of this, and for several reasons. First, we see no evidence that any such revolution is in progress. Old physic has only acted just like itself, before this microbe hypothesis, with only its traditional haste and want of reason. It took this into its confidence and acted on it, and would have the world give confidence to it and them, though when introduced into its practical duties more than half of the patients, so treated, died! Is such a result as this a sufficient cause for a "revolution" of the "science" of old school therapeutics, as this existed before the discovery of microbes? If so, what are we to think of that "science?" We admit that the "science" of the therapeutics of old physic is an unknown quantity. That ts most ardent votaries have never been able to demonstrate it. And even with the help of the instrument which alone discloses the existence of the microbes, it is still an unknown quantity! But what of the declared "revolution" in the practice of old physic? Did it not, when Koch proclaimed his discovery of the cholera microbe, "go for it" while it knew nothing of it, except Koch's description and his assurance of its causation, with all its habitual haste and unreason? There is no change in this. It was only its accustomed rush after novelty. The change was, and is, not in the "practice" of old physic, but only in the objective of the rush. This time this happened to be the microbe, and the result was, as ever before, in similar rushes after the falsečonly disappointment and defeat.

Then, speaking of the discoveries in bacteriology, the Doctor says: "The higher the plane of actual knowledge, the more extended the horizon." The expression "plane of actual knowledge" is decidedly good. Will some one, now, explain to us just what of "actual knowledge"of the microbe there is in the possession of doctors, besides the one fact that these organisms really exist? Are not their life functions, if they have any, wholly in the territory of the unknown? That of claimed causation for them in two of the most important acute diseases, malignant cholera and yellow fever, in which this claim has been fully tested, has been proved to be without foundation in truth. For this, see the record of the epidemic of the first in Naples 1884, and for the second in that of the last serious epidemic, which prevailed along the banks of the Mississippi. What talk there was here of "disinfection" (by which was meant "germ" or microbe killing) and of "disinfectants" (by which was meant the means employed for this end) and after all the disease was neither less frequent nor less fatal; showing conclusively in the results of these experiments in these epidemics, that as to their cause, the microbes had had nothing to do. Then as to the more "extended horizon"-- if by this they meant a broader view of the field of therapeutic science and endeavor, we are constrained to inquire: What then? What is the use of this to old physic? It has had no vision of the facts in this field before the extension. It can, before this extended plain, be only in the condition of the unfortunate myopic who has lost his spectacles. Dazed, not enlightened, that is all; "extended horizon" does not carry with it necessarily, extended vision, or increased knowledge, and this supposed extension of the horizon of therapeutic knowledge, by reason of the discovery of the microbe, is a mirage in the fancy of old physic, and no addition to its knowledge which has increased its power to prevent or cure sicknesses, and it is very sad to be compelled by its conduct to believe, that this knowledge is no part of the quest of old physic. Not an enlarged horizon of the therapentic field, and of the means which cure in it, but an expanded view of old physic and an expanding idea of its supposed knowledge and importance. This seems to be the uppermost thought in its policy and action. Does any one say this judgment is unjust in its severity, and not called for or justified by facts of history? We submit that it is neither unjust nor uncalled for, and appeal for its truth and justice to the history of the cholera epidemic as this vas wrought out in Naples in 1884, when old physic lost fifty-four patients in every hundred it treated.

While passing through this experience, of its inability to cope with this so great destruction, and the demonstration which it gave of the worthlessness of the microbe as an integer of means in its treatment, how did it receive the intelligence of another method of treatment, by other means in which there was neither microbe or "stamping out," by which of 703 cases treated in Naples 701 were cured? Of these 703 cases, 391 were inmates of the alms house, or members of a regiment of Swiss guards. The facts as to these were sworn to, by the governor of the almshouse and the Colonel of the regiment. The statement of this result so sworn to, was given to every doctor in the city of Naples in a printed circular, which also stated the means by which this unexampled success had been achieved. The circular also gave the statement that a means of prophylaxis had been employed which had perfectfy protected many thousands of those exposed to the cause of cholera, and that of the few who were attacked after these means, not one died. What reception did this circular have from those doctors who were meeting so great losses? Did they run for the means which had thus demonstrated its power to cure and protect from this plague, and cease from their microbe folly? They did nothing of the kind. They only ran after hypothetical novelties, apparently, not at all after truth.

In Marseilles, the doctors banished from their hospital apothecary stores, the medicine which alone had cured these 701 cases. Could prejudice and hate go farther?

Then where is the evidence of the "Revolution in the science and practice of medicines," proclaimed by Dr. Flint ?

Before grave therapeutic problems, old physic only acts just as it always has, rushing upon hypothesis and after the last novelty in theory, or discovered means. The only revolution there is in the hypothesis, is the novelty, not in the least ill any "science" whatever, for with these, the only means of old physic in therapeutic "science" has never had the least connection. So the claim for this "revolution" in the "science" of old physic therapeutics is only ludicrously absurd, because there is no science in this, but only guessing. Where nothing is, there "revolution" is impossible, for there is no objective for the overturning.

But it cannot be denied that in the magnitude of cause and effect in this proclaimed revolution, there is the most conspicuous similarity. Neither is perceptible without the microscope.

Dr. Kent: Mr. President, the paper is open for discussion.

Dr. Bell: It seems to me there are many remarks which may be made. But if the germ theory belongs in this bureau, if that is true we don't need this bureau, therefore, it may be well to listen to this paper. If the germ theory, or the causation of disease by germs, be true, of course our therapeutics are no longer of any use. Are the allopathic men doing anything else than killing germs, and how are they going to do it? The germs are existing in the body when doing their noxious work. We don't care how many they kill of them in the carpets or furniture, but when it comes to the treatment of disease they must attack the germs while the germs are attacking the patient. Sternberg has worked a long while, and he is still on the hunting path for these sort of things; but does not seem to recognize the force of all his facts. He says the ordinary man, weighing 166 pounds, has 20 pounds of blood, and to render that blood sterilized, in order to be no longer fit to create a medium for the development of germs, it must contain 3 1/2 grains of Mercuric chloride (3 grains is a fatal dose); then it will not abide in the blood alone for any length of time, so that we must keep putting in this great germicide; that is, we cannot cure our patient without killing him first. The other great germicide is carbolic acid. How much of that would have to be taken into the blood? One ounce of the solid-- I think the fatal dose is very much less than that. Those two germicides may stand for all, they are all of the same character. A germicide is also a homicide, every time; so we are shown from the simplest standpoint that the germicidal theory is absolutely impossible and incomprehensible, and not for a moment to be thought of.

President: Any further remarks on this paper?

Dr. Kent: It is almost too bad to have the germicides knocked off in that kind of a way.