Pathogenetic practice of medicine: embracing chemicopathology and the symptoms and treatment of chronic diseases by pathogenetic remedies ...

Front matter

.""¥5*

•ibp*

ZJ£> zm>

Preface

In presenting my patients and the public with this first edition of the Pathogenetic Practice of Medicine, a few statements introductory rnay properly be made.

For the last ten years the author has been actively engaged in the local practice of medicine, as has been elsewhere stated. During that time he has directed his reading and practice to the elucidation of a new theory and treatment of Chronic Diseases. The great success of the new practice induced him to devote his time exclusively to the treatment of the particular diseases described in the body of this little work.

Patients reasonably desire to know what effects are expected from the use of the medicines I prescribe, also how they may be advantageously changed or varied to meet the changing symptoms of each case. This I had not time to do, nor would it have been acurrately remembered if I had. Information, too, of this kind, is quite essential to the successful treatment of patients whom we cannot see oftener than once in four or six weeks, and those we treat by correspondence not at all.

Again, many who only read a single copy of the Advocate do not get sufficient knowledge of my theory of practice to overcome their piejudice against any new method, or against the itinerant manner of introducing it.

Therefore, it seemed quite necessary that patients and invalids should have an abridgement, at least, of the general features of my system. This I have given in a very condensed form in the following pages, and in such plain and familiar language, that no one of ordinary intelligence can fail to fully understand its application. I have avoided medical terms and language, using that only with which every one is acquainted. The style is not satisfactory to myself, but I choose to sacrifice taste to usefulness.

In the first part we have traced the relation between diseases of the Liver, Stomach and Lungs, to show one important fact, viz: that Consumption is, in the majority of cases, only a constitutional termination of disease in the fiver and stomach, by which the nutritive function is impaired, and fife destroyed. This fact is equally important for the physician and patient to observe ; and if rightly understood by the former, and well attended to by the latter, eight cases out of ten of Pulmonary disease would be prevented.

In the second part of this work I have endeavored to set forth the effects which my numbers have upon the human system — not the laws governing their action, but the result of that action — the indications they are intended to fill as medical agents — also, their preparation — the doses — time of taking, and such incidental circumstances as are necessary for the patient to understand.

The third part embraces a condensed summary of the symptoms of individual diseases, not in detail, but those which are positive indications of disease of a particular organ, in order that the reader even may decide with a sufficient degree of accuracy to select such a number as is indicated in his case. Some of the symptoms of obscure disease it requires great skill and experience to detect. My object has been more to define the meaning of certain symptoms and signs of disease of a particular organ than to trace mere sympathetic pains, or bad feelings, many of which occur remote from the part affected, and are not material to know in the treatment of the case. I have noticed only those remarkable symptoms which will be readily recognized and understood. In addition to that, I have designated the numbers to be used, and the changes that may become necessary in the treatment.

That the work is free from literary errors I have not the vanity to claim; and should another edition be needed, I will promise the addition of much valuable matter; for in this I did not intend to " write a book," but to afford many useful suggestions, and furnish my patients with information for which I have frequently been asked. How far my efforts may be acceptible to the public, and how far this little volume may control the health and fives of the sick or well, cannot now be determined ; but if it subserves the interest of humanity, and saves any of my fellow creatures from suffering or an untimely grave, the author will feel fully rewarded.

New York, December, 1858.

PAKT I.

PATHOGENY;

OR,

The Cause, Course and Symptoms of Disease Explained and Treated from the Changes in the Elements of the Blood, Saliva, Gastric Juice, and other Secretions and Excretions — Based upon Latest Discoveries in Animal Chemistry, and Chemico- Pathology.

This elementary treatise upon Pathogeny is only an abridgement of MS. papers for a larger volume, and as this is designed only for a guide to patients unacquainted with professional literature, I shall present the pathogenetic theory of disease, disencumbered of much that the medical student might desire or expect.

Pathogeny, properly defined, relates to the generation, production and development of disease ; to the earliest, as also the successive changes in the blood, and other fluids of the human system, which characterize the origin, course and termination of every generic departure from health. Certain elements are known to be essential to life and health, and they must exist in certain definite and uniform proportions ; a greater or less proportion of any one of them constitutes disease, in its origin. The first elemental change in all inflamatory diseases is an increase of fibrin in the blood — the elemental changes in anema, (or thinning of the blood,) is a marked deficiency of the red globules, or carbonate of iron. Therefore the name of my system is not arbitrary, but expresses just what is desired, viz : elemental changes from Nature's divine scale of proportion — and that is disease, by whatever other name called.

There are external and internal causes of disease. The external can only be guarded against, but not altogether avoided or controlled. The internal can be reached only so far as to restore the diminished or enfeebled elements, and reduce that which has accumulated in excess. Nearer the true course of physical disease or pathogenetic changes in the human system we can never arrive. From that point onward the varying conditions of health and disease are to be investigated.

Allopathy claims to treat the cause of disease, but it does not reach it — the effects only are treated. Pathogeny goes beyond, and studies disease in the elemental condition of those fluids — the result of which is the phenomena of life, and the purity ol which maintains the function in the organ producing them. The fountain imbitters the stream, and the stream indicates the condition of the fountain.

Pathogenetic is derived from the Greek word pathos — disease ; and genos — I make ; hence its application and significance in regard to the elemental changes marking disease. One who endorses this theory may be called a pathogenist, and pathogenetic, being the adjective of pathogeny, properly characterizes the system of medical practice based upon it. In like manner other systems of medicine are known, viz : Allopathic — Allopathist and Allopathy; also Homcepathy, Hydropathy, <fec.

This explanation is .sufficient to enable the reader to understand our position, and was necessary, this being the first treatise ever published upon Pathogeny, and the pathogenetic system of Medicine.

THE BASIS OF PATHOGENY.

1st. Before the science of Chemistry attained a reliable degree of certainty, the morbid changes in the fluids of the body were left to mere conjecture, although all external and other manifestations or signs of those changes were as palpable as now. Every step in the improvement and advance in the knowledge of inorganic chemistry, threw additional fight upon the metallic and earthy compounds of which the human body is composed. The blood was found to contain many of them in a fluid state — a most wonderful revelation — a condition that the chemist never has been able to imitate, except by the aid of great heat, and in others not at all. The further application of chemistry to organized matter enabled medical men to analize compounds, and separate their simple elements, thus developing the relative proportion of each substance of which they were composed. In this manner the bones were found to contain certain elemental principles, such as phosphorus, carbonate of lime, amonia, &c, Every tissue of the body has thus by eminent men been subjected to rigid and repeated chemical tests, so that the accuracy of these experiments at the present day does not admit of a doubt. Indeed, the results of the labratory are admitted as conclusivetestimony in every court in the civilized world. So perfect have these results been, that chemically the labratory can furnish the earthy part of man in the different proportions of his body.

At this point chemistry was for a long time instatu quo. Another great field of enquiry was yet unexplored; the other continent of chemical truth was undiscovered ; these were vegetable and animal chemistry. These two latter branches fill the measure of all human knowledge concerning the elemental parts of inorganic, vegetable and animal organic matters, — the first (the earthy) unpossessed of the life principle, but capable of imparting it first to the vegetable, and that in turn to the animal. A sublime and incomprehensible ascension of dead matter, to stationary, inconscious life, up to the firm, delicate, mysterious structures of the human frame ; and at each remove we find the dead earth in combination with living organic , structures, till at last intelligence is superadded !

When Chemistry first revealed the fact that the red globules of the blood were composed of carbonate of iron, and that in certain diseases it was less in quantity than in health ; and that in other diseases the iron carbonate was greatly increased, two important facts were established, and the effort to increase the amount in one instance and to diminish it in the other, was at once decided as the only reasonable and scientific mode and means of cure. That was Pathogeny and the treatment purely Pathogenetic; and no physician can pronounce it unscientific, or " quakery," for the principle was developed and applied longbefore any one now living was born. We throw in this latter remark en passant to those who will try to induce the public to believe that pathogeny is a "humbug," when every dose of the preparations of iron given to a pale, "bloodless" female, or a dose of Soda for sour stomach, is in principle pathogenetic.

Why is it that certain vegetable remedies possess a direct curative influence in certain diseases ? The " learned doctors " cannot tell you the scientific reason of the well known effect of their own remedies. It is an established fact in organic chemistry that animal tissues, in their elemental constitution, are identical with the vegetable, having been metamorphosed under the life principle, and endowed with a new and higher grade of vitality. Certain names are given to the substances and the changes they undergo ; but a greater amount of chemical knowledge is requisite to understand them than the common reader is supposed to possess, therefore I will only state the mere facts, it being sufficient for my purpose.

Medicine does not possess an arbitrary power over chronic disease, however much it may be concluded to have in the accute form. Vegetable remedies then, affect the human system just as the earthy and mineral ones do, by uniting with similar elements in the body to increase that which may be deficient, or by the power of neutralizing another which may be in excess. This theory of the operation of remedies is not only reasonable, but it is chemically and demonstrably true.

The farmer even, unconsciously practices pathogeny every day. He well knows by certain signs when his stock needs salt — he knows that if they are not supplied with this substance that their hair becomes rough, the animal droops, and does not thrive ; experience has taught him that salt and ashes will change the bodily condition of the animal ; yet ask the farmers the philosophy, or rather the reason for all this, and he cannot tell you. The blood of that animal is deficient in the compounds of sodium ; the life principle in the animal converts the chloride of sodium, which is common salt, and the alkali into the required elements, and their health is restored. Is there any "quackery" about the piinciple here? Can an intelligent person, or even one of common observation, deny the evident relation between cause and effect in this case ? Illustrations of this kind sufficient to fill a volume mio-ht be collected, both from animals and the human species, wherein certain abnormal or unhealthy conditions have been removed bv particular substances which admit of no other explanation than the one given above. All of these facts will be fully treated of in a large volume designed for medical readers.

Without the aid of organic chemistry we at best could only grasp at what is known to be established truth, and the pathogenetic practice is founded on acknowledged and well established principles of Chemico- Pathology. Certain facts have long been known, but never before systematized, elucidated, and so arranged as to form a useful consistent whole, and applied to the treatment of disease.

Even an intelligent nurse has advanced far enough in observation to practice pathogeny. If the child under her care becomes weakly, looses its appetite, has " watery stomach," cannot retain its food, vomits frequently, and the skin becomes rough and dry, why, she know r s better what to do than many physicians ; she will give the little urchin salt — freely as you would a calf, till there is sufficient muriatic acid generated in the stomach to digest the food. Wherefore is gelatine given to an emaciated patient convalescent from typhoid fever? Because that is just w T hat he has lost during the fever; our bodies are made for what we eat.

Vegetable albumen, fibrin, gelatine, &c, we have said in their elements are identical with the animal elements of the same name, but are in a lower state of organization, and the stomach must do more work to convert the vegetable into animal tissues than would be required to transpose animal food (which is already organized) into human flesh and bone and blood; for this is all that is done when animal food is used. Muscles or flesh is eaten to make muscles of, but if the iron in the blood be deficient, there will be a ratio of deficiency of fibrin, because the iron is necessary to generate the fibrin, to which condition the muscle must be reduced before it can be assimilated or applied to the purposes of nutrition. Therefore, by reason of this correspondence between the vegetable and animal elements, is it that vegetable remedies derive then* medicinal power. Pathogenetic remedies are as abundant in the vegetable kingdom as in the mineral, and are indicated just in proportion as those of vegetable origin preponderate over those of the earthly. This is the union God ordained ; hence the folly of those who would " put asunder what He has joined together."

The correctness of the pathogenetic principle is supported by every known law in nature, unl.ke homoeopathy, which is directly in opposition to all her known laws.

The intelligent agriculturalist doctors his farm upon the fundamental principles here advocated. Particular elements are known to be fertilizers of a particular soil : now, when by protracted tillage a special element is exhausted, the farmer feeds the debilitated soil with the elements known to be deficient. Agricultural Chemistry has taught him this, and he profits by the instruction.

These familiar examples and illustrations have been adduced to show not only the reasonableness of pathogeny, but that it is daily observed and practiced upon by all classes, though unconsciously, even from the servant girl in the pantry who uses salseratus to remove the excess of acid from her bread, — the farmer in caring for both his stock and the fruitfulness of his farm, up to the intelligent physician who is guided by a full knowledge of the symptoms that point to excesses or deficiencies which exist in the human system, and administers such agents as chemistry tells him will equalize and harmonize those unnatural proportions.

2. Chronic constitutional disease, and all the morbid changes in the fluids, and secretions and excretions, admit of no satisfactory explanation, except upon the principle of pathogeny. Morbific agem* operate both within and without the system. They reived directly into the system with the food

we eat, or fluids we drink : may be inhaled with the air breathed, or absorbed by the skin and mi ogled with the circulation. All the ae&e&s&Fy elements for the support of life must enter the system in the above manner; hence, the liability of noxious agents invading the sanctuary of life through the same channels. Should any unnatural circumstances intervene to prevent the ingress of necessary elements, .disease is inevitable. Nature requires in her scale of supply equal and exact weight and measure in quality, as well as quantity, corresponding with the waste or expenditures of the system in performing the functions of animal life.

The cause of most diseases, with the p: mt high degree of perfection attained in animal chemisry and < J hemico- Pathology, may now be thus explained. Every succeeding medical journal brings news of further and more brilliant discoveries tending to establish the correctness of this means of diagnosis. True it is that a few diseases have thus far eluded the keen and vigilant eye of chemical science, — like an adroit enemy concealed the means of invasion and particular mode of operation. The same obscurity once invested many diseases now fully understood ; therefore it is reasonable to believe from the rapidly accumulating evidence before us that by the aid and guidance of unerring chemical science the hitherto mysterious and inexplicable causes of certain known maladies will be fully discovered, and a more scientific and successful mode of treatment introduced for their cure. The laws of life and health have undergone an intelligent, rigid and patient investigation; every advance in their knowledge s marked by a corresponding enlightenment in the causes of disease, which knowledge is indispensible to the successful appliance of remedial means. Every science is progressive — none, more so than medicine, and no part of that more than pathology which means the cause and nature of any particular disease.

3d. Already has this theory found advocates. Professors Jackson and Churchill, of Philadelphia, Baron Liebig, of Germany, and many distinguished physicians in America and Europe endorse it, as the only truly scientific mode of removing disease.

Lately an effort his been made to prepare in the laboratory a compound consisting of those elements that naturally exist in the blood, and which are found by careful analysis to be deficient in certain chronic diseases. That preparation has received the significant name of "chemical food," and is composed of the phosphates of iron, soda, lime, ifce., in the same proportions found in the blood of a healthy person. The same principle applies to vegetable and animal substances; and has long been the diet of the sick. The instincts of appetite suggest to those in health, the same principle pertaining to diet, and is universally, though unconsciously obeyed.

A cold climate requires an increased production of animal heat, because its consumption or waste is greater than in a warm climate; hence the appetite is quickened, and craves the most highly carbonized food — such as fat meat or even pure oil. Such substances are the most highly carbonized, therefore they produce an increased amount of animal heat. In certain forms of chronic disease deficient animal heat is the first svmptom noticed — an increased susceptibility to cold, and in such cases the stomach has lost in a degree its power to use carbon in that form; then highly carbonated medicines are called for, and are the only substitute.

On this principle alone can the often prompt action of Cod- Liver-Oil be explained; it matters not whether that article be cold food or medicine. Prepared charcoal or other carbonized substances will produce the same effects before the fatty por- . tions of the body are consumed. A given amount of carbon in the blood is requisite to the healthy combustion produced by the oxygen which enters that fluid in the lungs. The amount of oxygen depends much upon the condition of the air breathed. If it be heated or rarified the oxygen is expelled, and is likewise removed by respiration, becoming unfit to be breathed again : in that condition it is insufficient to support life. When, however, the oxygen is in excess of the carbon, a pernicious effect must be produced upon that portion of the lungs where this change or combination takes place. Herein is the key to the elemental causes of pulmonary disease, because deficiency of carbon is only another name for deficient nutrition, as stated elsewhere in this treatise, and advocated in the first issue of the " Pathogenetic Advocate " and since by the " Medical Times " and other journals, and is the true cause of pulmonary consumption.

It will be noticed that constitutional changes or diseases have been particularly the subject of enquiry. Acute diseases are g3nerally the result of excesses and consequent obstruction in the fluids of the system. Certain medical agents, having an arbitrary influence over the functions of particular organs, will be required to remove such accumulations, the suddenness of the attack being such that the organ is overpowered and its functions temporarily suspended. Hereby is explained the usefulness of evacuents of every kind — purges, emetics, diaphoretics, diuretics, and bleeding. These have their application in the varied forms of acute disease, caused by excesses in the fluids, the suddenness of which may be sufficient to cause death without their immediate aid. These being used, if the organs involved have not became too much prostrated they will immediately resume a healthy, normal action, and no further treatment be required. A timely dose of physic, an emetic, a " sweat," or perad venture bleeding, may prevent the advent of a fever,the rise of inflammation or other serious or even fatal maladies. Common observation has long since given authority to such a mode of procedure.

Treatment being delayed, not efficient or appropriate, the constitution becomes involved, and then the subsequent treatment is truly pathogenetic. If my professional brethren take issue upon this, I will ask whether they give ten or twenty grains of calomel when first called to see a patient sick of certain inflammatory diseases, and only half a grain subsequently ? In addition to its evacuating power it can only subdue inflammation by diminishing the red globules in the blood, thereby preventing the increase of fibrin. For the same reason no intelligent physician would give that remedy to a patient where the blood already deficient in red globules, as in dropsy, anema, or consumption. No principles in pathology or practice are better established than this.

4th. The coincidence or harmony between certain signs and symptoms indicative of special pathological conditions, and the evidence of the same afforded by chemical analysis, may be called chemical diagnosis. A difference exists between signs and symptoms of disease. Symptoms are direct manifestations of morbid or altered conditions of the systern, as pain, heat and swelling are symptoms of inflammation. Frequent and bloody discharges from the bowels are symptoms of inflammation, &c. Symptoms constitute the legitimate language of disease; are uniform. Signs are only attending phenomena, but not essential to the disease; varying, may or may not be present; such as a patient sleeping with half closed eye% or one shut, and the other partly open, a tendency to slide down in bed, the impression of being away from home, which is often observed in the delirium attending fevers, some peculiar expression of countenance, &c. But since particular signs usually attend particular symptoms, they may assist some in the diagnosis and also influence the prognosis in a given case.

Symptomatology , then, gives in urinary calculi or gravel the following: — A sandy or gravelly deposit in the urine, presenting in different cases two distinct colors, with the many other symptoms and also the mechanical result of it. It has been ascertained that alkalies for red, and acids for the white gravel, are proper and useful remedies. Chemical diagnosis confirms correctness of the remedy, and faithfully assigns the reasons therefor, viz ; the one is produced by an excess of acid ; the other by an excess of alkali in the system; or that the gravelly deposits respectively present an acid and alkaline an base.

In like manner chemical diagnosis assists symptomatology concerning every disease of the fluids, secretions and excretions, affording the only scientific reasons for the administration of a particular remedy.

Another patient has the following group of symptoms — a dry, rough -skin, acid, or fresh taste in the mouth, high-colored urine, the fauces are light-colored, bowels confined, and some of the earlier symptoms of indigestion; in such cases we give the alkalies, salts in the various proportions of potassium, with such other remedies as concurrent symptoms indicate, until these peculiar conditions disappear from the system. Why did these effect a cure ? Chemical diagnosis explains it. The fluids of the body were deficient in the compounds of sodium of acids or alkalies. This parallel might be continued till every form of chronic or constitutional disease is shown to present a perfect correspondence between the prominent symptoms and chemical diagnosis, but it is not in accordance with the design of this work.

Chemical diagnosis has been diligently and successfully presented by men eminent for their integrity and learning, and the results have been given to the world as authentic scientific truth, as all know who are acquainted with medical science, and if not they can possess the knowledge by studying Liebig.

Since, then, the correspondence or uniform coincidence found to exist between modern symptomatology and chemical diagnosis has been fully established in theory, and further confirmed by practice, the analysis of fluids, &c, in patients applying for treatment is unnecessary. That work has been done, and is being performed under more favorable circumstances than are ordinarily had, nevertheless their results are received and accredited, as are other ascertained facts. It is not necessary for the practitioner to wait for personal autopsies ; or where he is called to a pale, white-lipped patient, or finds a particular sediment in the mine, to delay his prescriptions for the revelations of the laboratory. That has been made, and he should be in possession of it as much as he is supposed to be of physical symptoms and indications of cure. I cannot better illustrate this idea than by referring to the crude narrow-mindedness (ignorance would be appropriate) of some members of the profession. Conversing with one of such, who " held sway" in his little village, while presenting the claims of pathogeny and the new speciality of practice, he gravely enquired: " Can you carry a laboratory sufficient for these purposes V " Oh yes !" said I, " it is very conveniently packed in a brain of ordinary size !"- This ended the conversation.

Medical learning, experience and skill are requisite to prepare a remedy capable of curing a particular disease, yet the most illiterate might recognize the symptoms indicating its use. The patient having acidity of the stomach, constipation of the bowels, a dry, rough skin, yellowness of the eyes, &c, can, by consulting this work, find his remedy all prepared, with directions for using it. The intellectual work has all been done for him. No benefit could otherwise be had by the common reader from this work. Its whole arrangement was planned with reference to the availability and use of patients and invalids, as its title imports.

The amplitude of the above facts thus obtained constitute the foundation of pathogeny, and furnish the necessary instructions for preparing pathcgenetic remedies. This was distinctly stated in the first and subsequent issues of the Pathogenetic Advocate, and 1 claim the authorship of pathogeny on the ground of systematizing and arranging the vast amount of scattering, isolated materials in a practical form.

5th. Of the relation of diseases of the liver and stomach to those affecting the respiratory organs, I shall speak quite frequently in subsequent .pages, therefore much need not be said here.

This relation, or organic sympathy, has been disregarded both by writers and practitioners of medicine. The mere derangement of the liver or deficiency of bile receives perhaps the compliment of a few blue pills, et cetera, and the patient is allowed to linger unconscious of his danger till a dry cough reveals it to him.

Bile is not a mere excrement to be thrown out of the system. It is ascertained to be not only an essential agent in preparing the chyme for absorption, but performs an important part in sustaining respiration and the maintenance of animal heat. Therefore any deficiency in this secretion deprives the animal economy of a fundamental principle of life. That secretion being retarded or obstructed endangers the lungs in the ratio of such deficiency. No fact in disease has been more fully demonstrated in my observation than this : — that diseases of the stomach and liver conjointly produce more than eight- tenths of the cases of consumption. Before dyspepsia was so general consumption was far less frequent. Consumption, by the well-ascertained laws of life, is the legitimate effect of protracted diseases of the liver and stomach. Neither do the lungs become affected through mechanical agencies, as one would suppose — by the enlarged liver pressing against the lungs, thereby compressing them, and inducing irritation and a cough — but from constitutional results, whereby the standard of vitality is reduced. Pathogeny investigates these facts, and points out remedies calculated to thwart that sad result, by supplying the deficient elements till the organ shall have recovered the power of furnishing the same, according to Nature's established laws.