A paper by E. B. Nash ( 1838-1917) in which he poses questions about the nature of the similimum. Not much is answered, but the ensuing discussion between Nash, Kent, and a few others, shed much light upon the views of Kent upon this subject.
In the January number (1889) of the Homeopathic Physician, we have a report of the Rochester Hahnemannian Society. Dr. Schmitt is there reported as saying:
"I think the sections read (Org. 164 to 169) explain why there are cases where the high potencies do not act, and the low will. I make the point that we can have a remedy, according to Hahnemann, very similar to the case-- not the simillimum-- where a single or repeated dose of a high potency, will not do anything for you, but in a lower potency we get an effect, although transient and not a cure. The case I give will illustrate the point. It is a case of chronic diarrhea, where the indications were for Sulphur. I gave it in the mm. cm. and 200th in single and repeated doses, without any effect whatever; then gave the 30th potency, a dose for two or three mornings, which controlled the diarrhea, but did not cure. I knew I had only the similar, not the simillimum, after a time the patient developed a cough which came on at 4 a.m., with retching, blueness of the face, cold sweat and trembling. Ant. tart. cm., one dose, cured cough and diarrhea. Sulph. was the similar but Ant. tart was the simillimum."
Question. Was this a case of chronic disease? Hahnemann on page 23, vol. 1
of Hempel's translation of his Chronic Diseases, says that most chronic
ailments originate in the three psoric miasms known as syphilis, sycosis and
psora. To which of these did this case belong? Ant. tart. is not in Hahnemann's
Chronic Diseases ranked among the antipsorics, although there seems to
be no doubt it cured this case.
Now, if the simillimum is found as in this case, must it not cure, if a cure
is at all possible, though the disease is chronic, and the remedy has never
been recognized as having any right to be classed with either of the so-called
antisyphilitic, sycotic or psoric remedies? So much for chronic disease cured
with Ant. tart.
In vol. 22, page 317, Medical Advance, Dr. Hawley is reported as saying in reply
to the question of Dr. Stow: "Will Dr. Hawley explain what we are to do with
the analogues?
"You cannot, according to the teachings of the Organon, use anything but the
one most similar. The term analogue applies to the drugs of a class having like
characteristics."
This is as I read the Organon. Then it is true that the simillimum
alone cures while the similar only palliates and never cures? What about intercurrents,
compatibles and complementaries? See Organon, 171, where Hahnemann speaks
of employing several antipsoric remedies in succession.
Since Hahnemann we have added many remedies to our Materia Medica, among which
are Baptisia, Cactus, Cimicifuga, Gelsemium, Lilium tig., etc. If, in
Hahnemann's time, a condition had appeared in his patient that found its simillimum
only in one of the above named remedies, what could he have done to cure them?
Many remedies are still unknown to us. If we get a patient whose simillimum
is as yet undeveloped in our Materia Medica, what can we do? If only one half
the remedial powers extant are at present known and the simillimum alone cures,
then with our best wisdom applied, only one half can be cured, unless more than
one half happen to come under the remedies we do know.
I remember a story of an incident that occurred during old tavern times. It
was customary in some of them, as the loungers and travelers gathered in the
bar room in order to pass away the evening, among other pastimes to each one
ask a question all around, and the rule was that any one that asked a question
which he could not answer himself, should stand treat.
I don't want any such rule made here, for fear I might find myself in the predicament
of the landlord, who, on one of these old time occasions, pressed very hard
a Dutch traveler to ask a question. "V'ell," said the reluctant Dutchman, "
off I musht, I musht. How does a chip-munk dig his hole und leaf no dirt aroundt
the outside?"
"Give it up," said the landlord, "answer it yourself."
Dutchman: "He pegins at the bottom."
Landlord: " How the did he get there? "
Dutchman: "Oh, dat's your question."
It is needless to say that the landlord stood treat that time.
Now, at the risk of failing to even suggest the correct answer to some of
my own questions, I submit the following:
1st. Most cases of acute disease will, with good care, nursing, and diet, get
well (recover) without medicine.
2d. The simillimum will shorten their duration by curing quickly.
3d. The nearest similar will aid and secure a quicker recovery and ameliorate
suffering, then no medicine, etc.
4th. Even those eases which would not have recovered at all without medicine
will be correspondingly cured or aided to recover by the simillimum or similar.
In regard to complementaries. We often see in the reports of cases in our journals,
when some marvelous results with some particular remedy have been accomplished,
that this remedy had to be followed by some other remedy to finish the cure.
One case comes to my mind as reported by that prince of prescribers, Dr. Ad.
Lippe, in the Organon (journal), in which a very bad case of pneumonia
was very remarkably benefited by Kali carb., but the cure had to be finished
by Lycopodium. Two remedies having to be used here, both antipsorics.
Were both only similars, or which was simillimum?
Before Baptisia was discovered, no doubt the cases for which it is the simillimum
were treated with some of its analogues such as Arnica, Rhus, Arsenic,
etc. Were all eases so treated only palliated, or did all such cases die for
want of the simillimum? So much for the similar and simillimum.
Now we are in the business we will raise one more question: In the treatment
of chronic diseases, especially those dependent upon or complicated with psora,
we are taught to administer the antipsoric remedy, and then to wait upon the
action of the remedy, until the cure is accomplished or the action of the dose
already administered is expended. If during the action of this remedy the patient
is attacked with acute disease such as pneumonia, dysentery or typhoid fever,
will the proper treatment for the acute affection interfere with the action
of the antipsoric remedy for the chronic trouble?
It is true that some chronic diseases have their origin in a maltreated acute
affection, like the one reported by Caroll Dunham, in which he was able (or
thought he was) to trace the cause to a suppressed eczema capitis. He gave the
remedy which the child should have had for the acute disease, with the effect
of a re-development of the suppressed eczema and perfect relief of all its consequences.
Many cases of this kind are on record. To interfere with the action of the remedy
in such a case would certainly be hazardous. Such are not the cases under consideration,
but rather those in which the acute affection does not depend upon the psoric
one.
Bonninghausen taught (see Hom. Phys., vol. IX, page 203), to use intercurrent remedies for chronic diseases; also on next page gives us a list of remedies for disturbances of the antipsoric cure (as he terms them) and instances such affections as arise from colds, fright, derangements of the stomach, debility, etc. Now to my question again.
Do these remedies for the acute disturbance, materially affect the action
of the antipsoric treatment? If they do not, then of course all there is to
do after using the remedy for the acute disturbance until that is relieved,
is to still wait upon the antipsoric.
If they do, then must the antipsoric be repeated. These questions may all be
settled in the minds of some, but not all, and I know of no body of men more
capable of settling them than this.
Finally: What about our list of antipsoric remedies? How many and which of
all the remedies developed since the time of Hahnemann's work on Chronic
Diseases, are to be added to his list?
Last year Dr. Wesselhoeft in an article on Aloe gives his conviction
that it is entitled to such a place. This claim as I understood him was based
mainly on the fact, that chronic troubles relieved by this remedy were often
followed by the reappearance of a formerly suppressed skin trouble, upon which
the symptoms for which this remedy was prescribed seemed to depend, and certainly
this would have been considered good evidence if it had occurred under the action
of Sulphur, Causticum or Arsenic. Now notice, Dr. W. says: "Aloe
was selected only on account of its symptoms of the diarrhea, which were very
characteristic."
If Dr. W. had known anything of the psora in this case must he not have prescribed
Aloe just the same, although it was not yet known to be antipsoric?
In the light of this fact allow me to submit for your consideration the following:
If the principle formulated in the words Similia Similibus Curantur be true,
then:
1st. The remedy indicated by the symptoms must be curative without regard to
its antipsoric or non-antipsoric properties.
2nd. That the reason why some seemingly indicated remedy fails and we ascribe
its failure to psora, is simply because we have not yet gotten our whole case;
and a further search into its history will make another picture, and consequently
indicate another remedy, perhaps an antipsoric one.
3rd. The reason why Sulphur given to counteract a suspected psora, so often
acts beneficially, is because Sulphur in its wonderful wide range of action,
covers more symptoms in the subject of psora than any other remedy thus far
known. In other words, is oftener the simillimum.
4th. If Hahnemann had lived until now; aside from the first volume, a new edition of the chronic Diseases would not have appeared.
DISCUSSION:
Dr. Ballard: What is psora?
Dr. Nash: Ask me something easier; ask me what is scrofula.
Dr. H. C. Allen: I would like to know where he draws the line between similar and simillimum?
Dr. Nash: Dr. Schmitt may answer; that is one of the questions for which I wrote this paper. I would like to know whether we are to understand that we only cure when we have the simillimum, or whether not having the simillimum, the best similar is curative and therefore useful. It must be a fact that if Cactus is the simillimum for a group of symptoms, there is no other remedy that can be the simillimum. It is probably a fact that many cases for which Cactus is given now, were formerly covered by other remedies, because we did not then have Cactus.
Dr. Stow: Is the best similar absolutely not the exact simillimum?
Dr. Nash: Not necessarily.
Dr. Stow: I would ask for an explanation why that is the case?
Dr. Nash: I cannot explain that; because, as I said before, nothing can be a remedy for that condition in which Cactus is the simillimum but Cactus; it is the best similar, but if you know nothing about Cactus and Cactus is the simillimum, then the other remedies that supply its place are only the similar, not the simillimum.
Dr. Stow: It helps explain a little point I mentioned yesterday, that Dr. Lippe told me that we do know what remedies follow one another, one remedy acts to a certain point, and another is needed. That is just what Dr. Lippe did before we had other remedies; that is zig-zag.
Dr. Campbell: If the simillimum had not yet been discovered, those patients must die if we had not the remedy sufficiently similar to bring them to a certain stage of improvement. Then it follows that we must still go on developing remedies, for the simillimum still remains undiscovered for some diseases.
Dr. Nash: Dr. Hering said there would be a simillimum for everything. I would like to hear what Dr. Kent says.
Dr. Kent: That paper is so erratic I don't know how to get at it; he has asked a great many questions and not answered any. It would take me about two years to answer that paper, and the Organon tells you all about it.
There is one point worthy of consideration; we are trying to make a distinction between the similar and the simillimum, with which I do not agree. I have not any doubt, from experience, that two medicines may be similar enough to the totality of symptoms, and either may be the simillimum, each would be similar enough to cure it; and how can you say both of these are, or either of them is, the simillimum. If you go into degrees you may consider it in this way: The medicine may be so dissimilar, that in dynamic power it would have little or no effect upon the disease; it then approaches it in a degree of similarity by becoming more and more similar. As it approaches in similarity it sustains an inability to change the symptoms that exist. It may be sufficiently similar to spoil it, to change and not effect a cure, until you have not improved the patient, but only changed the symptoms. I have observed in the management of intermittent fevers more than in any other class of complaints, giving a medicine that has a few characteristics in intermittents, but which does not correspond to the genus of the disease or patient, and immediately follow it with its complementary, and you may change it from time to time for five or six weeks; I have seen it in so Many cases. Medicines may be similar enough to effect curative results in a patient, and improve the health of that patient, improve the general condition whether an acute or chronic disease. When that medicine has done all the curing it is capable of, then its complementary will take up the work and go on with it. This is a matter of experience fully established by the Organon and every man's experience, and it seems to me the paper does not call out anything new, for it is in keeping with every man's experience.
Where there is psora or acute miasm, you can have a medicine similar enough to spoil the case, or similar enough to have a curative action; or the simillimum, which is the medicine that cures the symptoms present, eradicates them completely.
Dr. Nash: The simillimum cures the whole case.
Dr. Kent: Dr. Nash makes one mistake in Dr. Lippe's reference to Kali carb. and Lycopodium in pneumonia, (I have forgotten the quotation) evidently Kali carb. was the simillimum and eradicated all the symptoms present at the time; we don't look upon the simillimum as a medicine that is going to completely cure the disease, but for the time being controls the case and makes way for a second series of symptoms to arise, while the partially curative medicines for a set of symptoms would cause only a few of the symptoms to give way, when another remedy is needed. The simillimum does not eradicate the disease at once, but only a part of the symptoms which corresponds to its totality.
The medicine that changes the totality to the extent that it may cure, thus causing to disappear a few of the symptoms in this present totality, and others come in their place, it has performed no curing action at all without physical symptoms taking the place of mental symptoms; but as a rule the mental symptoms disappear under the similar, although the physical symptoms may be made more alarming, and yet the patient will say‹" I feel better."
Dr. Nash: The Doctor did not mention what we shall do when we have not the best similar; there are remedies that have been discovered since the time of Hahnemann that are the best similars for the conditions existing in the patient, and better than Hahnemann ever knew of, and there are probably a number of remedies unproved that are still better similars or the simillimum for the curing of ailments that may arise in patients. Of course, whether you term it simillimum or similar, we must do something; and the question is, will what we do benefit our patient.
I believe with Dr. Kent, that the best similar is the best we can do, and will benefit the patient in proportion to its similarity. It sometimes occurs to me in difficult cases-- and I presume it does to every one-- now, Homeopathy ought to cure this case. I feel that I have selected the remedy most similar, and yet my patient does not get well; I don't get the improvement that I ought to. It is not possible to claim that we have at present in our Materia Medica either the similar or simillimum that covers all the ills that flesh is heir to. I believe there is no remedy that can cure so perfectly as Cactus its own similar condition; but zig-zagging the symptoms may after a while bring them out. If I were to give a definition I would say that the similar removes the totality for which it was selected, and the simillimum covers it perfectly and cures it completely.
Dr. Campbell: And yet, there is another side to that. We have a larger number of remedies than the " Fathers" had, but who can show a more brilliant record than they? As, for example, four hundred cases of epilepsy cured, as Boenninghausen did.
Dr. Nash: He could show a better record now, with the means we have at our disposal.
Dr. Beigler: This is a difficult paper to answer, because there are so many questions asked, but we rely upon the Organon to answer them all. I would say that the question of obtaining the simillimum in all cases, to me seems doubtful; or shall we ever have a simillimum for all classes and shades of disease.