A Supplement to Clarke's Dictionary of Practical Materia Medica
by Peter David Fraser
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This is Clarke's original introduction to The Dictionary and in it he outlines the arrangement which I have generally followed in adding remedies to the Supplement
Name of the work
I have named this work a Dictionary of "Materia Medica" because no other name would have been intelligible. But the name, nevertheless, in homopathy, is somewhat of a misnomer. We are dealing with forces which, though derived from materials, are anything but "material" in the common acceptation of the word. Our agents are forces of a higher order than any known to Old Physic, and it is important that homopathists should know them as such. Homopathy is from first to last an art of individualising. We have to individualise patients, and individualise remedies. However convenient it is to think of remedies in connection with the diseases in the treatment of which they are most frequently called for, it must never be forgotten that this is a convenience and nothing more. To allow our conception of our remedies to be limited by any list of nosological terms is to accept again the mental fetters of old-school therapeutics. To understand and utilise our remedies to the fullest extent, we must know them as powers ready to serve us in any case, no matter what the name of the disease may be, when the indications for them come to the front. And we must be prepared to find these powers hidden in common articles food and drinks, which we are constantly taking into our bodies in large quantities with complete impunity; and even in the tissues and secretions, morbid and healthy, of our bodies themselves. My object in the Dictionary has been to so present the picture of each remedy that it may be at once recognised and distinguished from any other by those who consult its pages. In doing this I have considered first those points which seem to me to have a practical bearing; points which have seemed of academic interest only I have left in the main to other works.
The body of every homopathic Materia Medica must consist of a Schematised list of the Symptoms belonging to each remedy. This is known, in brief, as "The Schema". In the Dictionary it comprises all that portion given under the heading, SYMPTOMS.
Abridged Materia Medicas and lists of keynotes, though of very great value, cannot take the place of a full Schema. The prescriber is constantly requiring to know the exact symptoms produced or cured by a drug, and very often these are not to be found among the recognised keynotes. Again, when a prescriber has found his correspondence in some leading symptom, he may wish to test the correspondence in other particuliars. For these purposes nothing short of a detailed list of symptoms in each section of the Schema is of any service. My work in no way lessens the value of the abridged works; on the contrary, it very greatly enhances it, by providing the necessary complement to their usefulness.
The Schema arrangement adopted by Hahnemann was a necessary evolution of his method. Day-to-day records of provings, though of much interest, are of little use in practice, from the impossibility of finding individual symptoms in them. The Schema adopted by me is arranged under 27 numbered headings: I, Mind; 2, Head (including sensorium and scalp); 3, Eyes; 4, Ears; 5, Nose; 6, Face; 7, Teeth; 8, Mouth; 9, Throat; 10, Appetite; 11, Stomach; 12, Abdomen; 13, Stool and Anus; 14, Urinary Organs; 15, Male Sexual Organs; 16, Female Sexual Organs; 17, Respiratory Organs; 18, Chest; 19, Heart; 20, Neck and Back; 21, Limbs (en general); 22, Upper Limbs; 23, Lower Limbs; 24, Generalities; 25, Skin, 26, Sleep; 27, Fever. The sources from which the Schema is compiled are mainly, Timothy, Field Allen's Encyclopaedia of Pure Materia Medica, and Constantine Hering's Guiding Symptoms. Without these two monumental works my work would have been scarcely possible. Allen includes all the symptoms of Hahnemann's Materia Medica Pura and Chronic Diseases, with all the later provings up to the date of his work's completion (1879). Hering's Guiding Symptoms includes in addition to the chief symptoms of the older works, many clinical additions and glosses. Hale's New Remedies, 2nd and 5th editions, have rendered me services scarcely less important.
In my Schema I have sometimes indicated when symptoms are of clinical origin, but not always, as the distinction is more academical than practical. I have also sometimes inserted in the Schema names of diseases. These will be taken as clinical suggestions depending for their value on the appropriateness of the remedy in other respects.
In regard to the inclusion of Clinical Symptoms without always distinguishing them, my reasons are these; I know that symptoms removed by a remedy in a patient who is taking it are an indication of the remedy's power, even though the remedy may not have produced those symptoms in a prover. I know that many of the best indications we possess for different remedies were found out during the provings by the disappearance of symptoms from which the provers themselves were at the time suffering. I know that a remedy when being taken by a patient will often produce some new symptoms of its own whilst removing the others. I know that these new symptoms are available for practice; and what is more than this, I know that the practitioner who cannot recognise drug symptoms in his patients loses the best materia medica teacher he is ever likely to find, and will spoil many of his cases by supposing them worse when they are really doing well on the right medicine and only require to have the medicine suspended or partially antidoted.
Those who have scruples about prescribing on clinically observed symptoms have the Cyclopedia of Drug Pathogenesy at their disposal. It is a work which has rendered me excellent service in compling much of my Dictionary; but it seems to me to need digesting and schematising it is to be of much use in daily practice. Those again, who like to know the authority for every symptom, have Allen's Encyclopaedia to supply their want so far as the vast bulk of the materia medica is concerned. In the case of the less well known remedies. I have named the authorities; in regard to the old-established remedies, I take for granted that the authorities for these are known.
In addition to the works of Allen and Hering and the Cyclopedia of Drug Pathogenesy, Dr. Curie's edition of Jahr's Materia Medica, the Materia Medicas of Lippe and Guernsey, Cowperthwaite's well-known Text-Book, and many others have been consulted. But the account of many of the remedies in the Dictionary has been compiled from sources inaccessible to the general reader, being scattered up and down the periodical literature of Homoeopathy, and throughout the writings of original workers, among whom I may name Dr. Compton Burnett and Dr. Robert T. Cooper as pre-eminent, each in a line of his own. Throughout the Dictionary will be found accredited to these authorities many guiding symptoms of their observation, some already recorded in their published works, very many communicated to me in private conversations, and verified by myself in practice. And I am no less indebted to Dr. Thomas Skinner for generous help in materia medica studies. Years ago when I was making a special investigation into the action of the high attenuations, Dr. Skinner gave me the greatest possible assistance. We went over a large part of the materia medica together, and the notes I then made have been of great service in compiling this work, especially the introductory sections.
The introductory sections
Whilst the Schema is the essential feature of the materia medica, it is of great assistance in the understanding and using of it, to have, in addition, some introductory guide. This I have supplied in each instance, and the combination of the two is one of the main objects of this work. Hitherto narrative accounts of remedies have been provided independently in works like Dr. Hughes's classic Pharmacodynamics; and through no fault of their authors, practitioners have endeavoured to make these works do service for a complete materia medica, dispensing with the use of both schema and repertory. I think my method will obviate this risk.
Names and preparations of the remedies
Under the name of each remedy I have given the synonyms, mentioned its place in nature and the preparations of it that have been used. In regard to the last, I wish it to be understood that I give the actual preparations used in the experiments or in practice. I offer no opinion as to whether these may be the best or not. Some contend that acetic acid is a better solvent of the native alkaloids of plants than is alcohol. When acetic preparations have been used I have mentioned the fact. Dr. Cooper has used fresh plant tinctures, made from young shoots, with other actively growing parts of plants, in the case of remedies of which the usual preparations are made from roots or dried specimens; and he maintains that in such cases the fresh-plant tinctures are superior. The same may be said of animal preparations. I have used a preparation of Sepia made from the fresh ink-bag, given me by Dr. R. Swallow, of Ningpo, and I can confirm his opinion that it is a better preparation than that made from the ordinary dried ink.
Next, under the head CLINICAL, I have given an alphabetical list of the diseases in relation to which the remedy has manifested, or seems likely to manifest, some curative power. This list is of no independent authority, many of the items being merely suggestions of my own. It is not to be regarded either as inclusive or exclusive, but rather as suggestive. But the list serves further purposes; and first, it enables me to save space. If I were to describe the sphere of a remedy in each of the diseases in which it has been used, I should be obliged to repeat the same indications many times, over in slightly varied form. The main indications of a remedy are the same in any disease, and the fine indications will be found on referring to the headings under which they occur in the Schema. Further, the list enables me to relate the Dictionary to the Prescriber. A number of the names of diseases in the list will be found printed italics. This does not mean that the remedies is more indicated in these diseases than in the others; it is merely to indicate that under that and that there its special indications are given and compared with those of other remedies. For example, under ATROPINUM is the following list: "Blepharospasm. Convulsions. Enuresis. Epilepsy. Eyes affections of. Gastric ulcer. Locomotor ataxy. Mania. Neuralgia. Pancreatitis. Spinal irritation. Tetanus. Vision, disorders of." On referring to the Prescriber, under GASTRIC ULCER and PANCREATITIS, Atropinum will be found mentioned along with other remedies. Finally the lists will afford a convenient basis for compiling a clinical index.
Following the heading CLINICAL, comes one which I have named CHARACTERISTICS. Under this I have endeavoured to bring together the leading individual features of each remedy, sketching its outlines with as firm a hand as I can command. It is not a bare list of keynote symptoms, although it includes all of these that are known to me. But it is written in a more or less connected, narrative form so that it will not have the effect of a catalogue on the reader's mind. This part will contain an account of the leading Conditions of aggravation and amelioration which characterise the remedy; an essential portion of a practical knowledge and understanding of homopathic remedies. In indicating these I have made use of the signs "< (aggravation) and ">" (amelioration), for the double reason that they readily catch the eye, and at the same time, save space. These and other signs and abbreviations are explained more fully on p. xi. This section, more especially, I intend to supply a kind of introduction and guide to the Schema.
Following this section is another headed Relations. Under this will be found an account of the chief allies of each remedy. The older homoeopaths appreciated the value of this knowledge much more than do the moderns; and a very great assistance it often is in prescribing. When a remedy (e.g. , Belladonna) has done all that it can in a case, it is of very great use to know of a remedy (e.g. , Mercurius) that is likely to follow out and complete its action, where both are related to the case. When this relationship is very close the two related remedies are said to be complementary to one another, as is the case with Iodine and Lycopodium. On the other hand some remedies have a very injurious effect on each other's action when one is given immediately after the other. I have known a chronic case which was doing well on Calcarea, irretrievably spoiled by a prescription of Bryonia immediately following. Further, it is necessary to know the antidotal relations of remedies in order to be able to control the over-action of any remedy administered. I once experienced very disagreeable symptoms from a dose of Natrum mur. in potency, and suffered for some days before I realised the cause. As soon as I did I looked up Jahr, and found that smelling Sweet Nitre was one of the antidotes. I put it to the test, and the magical way in which the symptoms were wiped out was a revelation to me of the importance of this branch of homoeopathic knowledge. In this section I have also pointed out many of the characteristic differences distinguishing between medicines that have symptoms in common.
Under the further heading CAUSATION I have mentioned (when such relation is know to exist), the conditions to the effects of which the action of a remedy is particularly suited. For it not unfrequently happens that the Cause of any state is the keynote indication. A case of Rheumatism, for example, supervening on a wetting, will probably not be cured by the same remedy which would have cured if exposure to dry cold had been the cause. The effects of over-eating may resemble the effects of over-drinking, but a different remedy will probably need Arnica; if due to fright, Opium will most likely be called for. I have often, in practice, wished for a tabulated list of "causes", and I think this section will be found of value.
It will possibly be remarked that I have seldom indicated the relative importance of symptoms by difference of type. My reason is this: while not denying the utility of emphasising by conspicuous type symptoms of proved characteristic value, this can only be done at the cost of apprently depreciating symptoms not so marked. I have so often found my indications in symptoms not distinguished by special type at all, that I hesitate to put any under this ban. My arrangement, however, meets the difficulty to a great extent. If it is considered that, in a general way, all the symptoms I have mentioned under the heading CHARACTERISTICS are deserving of heavy type, and that the symptoms mentioned only in the Schema are worthy of italics, a very fair estimate of their value will be obtained.
Grades of homopathy
Having had experience of every grade of homopathic practice, and knowing the possibilities that lie in all, I have sought in this work to supply the materials needful for the application of the Law of Similars in any of its modes. It is possible to obtain the needed correspondence in a great variety of ways and degrees, and one practitioner will find it in one way and another in another. Homopathy uses phenomena as guides to reach the unseen activities operating below the surface. Keeping my attention steadily on the plane of phenomena, and disregarding all the hypothetical and ever-changing explanations of pathology and physiology, I have endeavoured to portray every feature of drug-activity that is likely to find its correspondence in the manifestations of disease. It may be in organ-affinity; it may be in coarse tissue changes; it may be in the finest sensations: my object has been to supply the practitioner of every grade with sufficient data for practice.
If time serves, I may in the future provide a special Repertory to this work. In the meantime all the fuller repertories now in use will be available. It is impossible to practice homopathy as it should be practised without the aid of repertories, and the best repertory is the fullest.
The test of a homopath
Complaints are not unfrequently made that the homopathic materia medica is too vast for practical utility; that the schematised lists of symptoms are unprofitable, if not impossible reading. I do not think so. Indeed, I think that the test of a genuine homeopath might not unfairly be said to lie in his capacity to read through a Schema with both profit and enjoyment - because of the possibilities it reveals of dealing with cases occurring every day in practice. Again and again in the course of my work I have come across symptoms in the Schemas of remedies reminding me of cases in the past which I might have cured had I but known the remedies then. And many a time a case has turned up in my practice calling for a particular remedy at the very time I have been working upon it, and a cure has resulted, when, but for my study of the Schema, I might more than likely have failed to find what was wanted. I think that the introductory sections preceding each Schema will make the study of the Schema profitable and enjoyable to some who have hitherto only found it dry. And when we consider that the Materia Medica is the very raison d'être of the homopathist, and that in it he must live and move and have his being, it is not too much to expect of him that he shall at least give as much mind to its cultivation as is required for maintaining high proficiency, say, in billiards, or in golf.
Every homopath his own materia medica maker
And now I have a final word to my readers. Every homopath, in the last resort, must make his own materia medica for himself.
It is not alone what an authors offers to a reader, it is what the reader can get out of his author that tells. I have done my best to put the matter in an orderly and tangible shape, but nothing short of hard work can make a proficient homopath, no matter how handy his tools may be. I have selected paper for the book which will take ink, so that any reader may make annotations, corrections, or additions, as his experience or reading may suggest. If I had chosen to wait a few more years before publishing, I have no doubt I could have improved my work; but if I had waited till doomsday I could not have made it perfect. In the meantime I want it every day for my own use; and if I could have found any one else to do the work for me I should most gladly have spared myself the task.