The characteristic symptoms of Aconite have already been brought before you, and will enable yon to select and administer to advantage this much abused remedy. I will now proceed to caution you against the administration of Aconite and Belladonna in alternation, and I do so, because you will find this alteration recommended in the ordinary books on practice; yon will also find cases recorded in which Aconite was administered in alternation with Belladonna, and when you see practitioners follow this mode of prescribing, giving as a reason, that it has been done by others, and quoting precedents, you might perhaps also fall into the same error. To enable you then to resist this wide-spread mongrelism, and to give your reasons for disapproval, and also to prepare you rationally and understandingly to combat this violation of our principles as well as of the fundamental rules of practice, we will first consider the error of alternating medicines in general, and then show in what particulars Aconite and Belladonna are similar or differ.
The question of alternating medicine has been brought before the profession from time to time, and but very lately an interesting paper “On the Alternation of Medicines” was read before the British Homoeopathic Society by Dr, Drysdale, and published in the September number of the Annals of that society. As the paper expresses the opinion at present pendant among a large majority of the homoeopathic physicians in England, we will here take occasion while considering this subject, to allude to it. The learned author of that paper, Dr. Drysdale, whilst saying that he does not give a preference to the plan of alternation, yet the bulk of said paper treats of the cases in which it is allowable. Without entering more fully on the fundamental ideas of Homoeopathy upon which he bases his conclusions, and without here showing his misconception of Homoeopathy and his false position, or questioning the admissibility of the authorities he quotes, taking the doubtful assertions of Trinks in preference to the sound and long accepted teachings of Hahnemann, we will deal with the question only as it should present itself to us as Homoeopathicians.
The alternation of medicines can occur in two different ways, first an alternation a priori, as for example the prescribing of Aconite and Belladonna in alternation, each remedy to be administered after a specified lapse of time, whether this time is numbered by minutes, hours or days is immaterial, the principle remains the same. Suppose then, that yon are called upon to prescribe for a given case, and are, of course, believed to understand the homoeopathic law of cure, the fundamental principles and practical rules left us by Hahnemann, and, acknowledged as the unerring guide, by all true Homoeopathicians and also to know the effects of the medicines, how can you ever be induced to violate one and all of the practical rules, and by prescribing two medicines in alternation, give evidence of your want of accurate knowledge of the effects of either of them.
One of the great fundamental practical rules is, never to repeat the same remedy or give another medicine until the first dose administered has fully developed and exhausted its effects. A priori this knowledge is not in your possession. One dose of Aconite, for instance may develop and exhaust its effects in six, twelve, or twenty-four hours, or in one, two, three or more days or weeks, and in chronic cases may even act for a longer period of time; the symptoms then, according to which you have selected Aconite, although much diminished may not have entirely disappeared, but still they are certainly yet aconite symptoms, you must then repeat the same remedy Aconite, and probably with better results should a still smaller dose be given than the previous one. On the contrary, should the symptoms according to which you selected Aconite have disappeared, and others have shown themselves, in that case you have to take up a new, careful record of the symptoms, and select another remedy, again waiting for the effects of this second remedy, and neither repeating nor giving a new medicine until its effects are exhausted. This then is the only correct and reliable practice if we are guided by the practical rules. But, say the advocates of alternating medicines, in order that they may set aside these practical rules and the practice based on them, we can prove the correctness of our position by practical and clinical experience. We have cases reported by Dr. Cate [We quote from the Annals, pages 376, 377 and 381.] who brings forward inflammation of the mucous coat of the colon. When it extends to the peritoneal coat of the gut, he gives Mercurius corr. in alternation with Sulphur, corresponding to their specific action on their different tissues. Also in inflammation of the membranes of the brain threatening effusion, he finds Bryonia alternated with Hellebore, more efficacious than either singly. In the analysis of Tessier's Pneumonia. Cases by Dr. Bayes, we find several cases that improved rapidly under alternation of Phosphorus with Bryonia, though the latter alone was not doing as much good as usual. Dr. Drysdale says of Dr. Cate's reported cases, “But this is already recognized in Homoeopathy, without stepping into the doubtful regions of pathology.” If then in the above cases the doubtful regions of pathology do not help us and can not help us to select any curative remedy, how can Homoeopathy recognize such alternation based on nothing else than these acknowledged doubtful regions of pathology? Without in the least calling in question Dr. Cate's superior pathological knowledge and his ability to determine when the inflammation of the mucous coat of the colon extends to the peritoneal coat of the gut, or when the inflammation of the membranes of the brain threaten effusion, and without either calling in question Dr. Cate's superior knowledge of the specific action of remedies on different tissues irrespective of accompanying subjective symptoms; for argument's sake, considering the cases as he gives them, they do not in the least prove the correctness of the practice of alternating medicines. This practice never has been and never can be recognized by Homoeopathy because medicines cannot be selected solely according to pathological indications, and if they could be so selected, no two distinct pathological conditions could be observed on one patient at the same time. Not only do Homoeopathicians treat only the sick and not diseases, but even the progressive allopathic schools have taught this great principle in practice for some time. But will you ask “how then do patients recover under this treatment by alternation? Dr. Drysdale tells us “Upon the two principles - viz, the meeting of complications, and maintaining the susceptibility, rests the practice of alternation of medicines. And when used with circumspection, it is a practice that has proven useful, anti developed the powers of Homoeopathy.” In every case we have to treat, we meet with complications, and what is generally understood under complications, are the unaccountable, often apparently small and trifling symptoms, not belonging strictly to the pathological condition present to the so-called disease, the class of symptoms that generally guide us in the selection of the truly curative remedy; if we select a remedy according to these symptoms, there will be no need of maintaining the susceptibility. If, furthermore, we must use circumspection should this practice prove useful, we are much afraid that between the doubtful regions of pathology as a guide, and circumspection as a landmark, we shall lose our way; I would advise you once for all, to hold fast to certain fundamental rules laid down by Hahnemann, and guard against unmeaning phrases, which, with all circumspection, will lead you into doubtful regions. If a patient recovers under the treatment by alternate medicines, it is to be supposed that one of the medicines was homoeopathic to the case, that the frequent repetition would have done more harm and protracted the recovery, had not the alternated remedy, being similar and therefore an antidote in that capacity, suspended and modified the action of the oft-repeated medicine.
As no two morbid states can exist in the animal organism, whether they are similar or dissimilar, without either the recent morbid condition silencing, at least for a time, the former morbid state or uniting itself with it, forming a double-headed monster, so can never any two medicines develop their effects separately on the healthy or on the diseased animal organism, without necessarily interfering and interrupting the action of both or at least of one. The knowledge of the effects of medicines is based upon the provings of drugs, and if so, who can ever have thought of proving two drugs on one and the same person, at one and the same time? As for instance, Aconite and Belladonna. Aconite to be given and allowed to act, say for twelve hours, then Belladonna to be given and also allowed to act for twelve hours, and so they are given alternately, and what will be the result of this medication duetto? Will it end in a harmonious solution of the questions we asked of nature, viz,: how do Aconite and Belladonna effect the human organism? If the healthy organism will not give a satisfactory answer to our question, which it could only do if the two medicines did not interfere with each other and the development of the altered sensations of each respectively; how much less can we suppose that the organism when effected by disease, will, under the double action of alternate medicines, respond and be beneficially affected by them? As two medicines cannot be proved at the same time in alternation on the same person, and as two distinct diseases cannot exist in the same person at the same time, so cannot two medicines administered in alternation affect the diseased organism beneficially,
Secondly. An alternation a posterori, may be good practice in some few and rare cases, and in those, you will find that after the effects of the first dose of a well selected remedy have been exhausted, the patient may be quite in a different condition; and then after selecting another remedy and its effects being exhausted, you may find again, all the symptoms for which you prescribed it, have disappeared, and the case presenting precisely the same symptoms for which the first remedy was given, with the difference that they may not be quite so intense, then, of course, you return to the first remedy; if, when its action is exhausted, yon again find the same symptoms, though most likely less severe than yon found them before, when you selected the second remedy; yon will give it again, and so continue as long as recurring circumstances require it and till your patient recovers. To fortify his position, i. e.,” that alternation of medicines a priori is admissible, Dr. Drysdale quotes a case related by Dr. Hering and cured by alternate doses of Ignatia and Ruta because a liver-complaint and a jaundice both were present; the inference from this statement would be, that the two distinct diseases were present and demanded the alternation or the two medicines, one for each disease. The fact is this, Dr. Hering relates in the third part of Archive. vol. xiii, p. 68: “A very short time after I first became acquainted with Homoeopathy in 1822, I cured permanently, in a few weeks, a patient attacked with jaundice and liver diseases, by giving every third or fourth day the tincture of Ruta and Ignatia12. In this case Ignatia was first indicated by the symptoms of jaundice, the patient, a lady, had suffered much from grief, and they disappeared under Ignatia, but other liver symptoms then appearing, Ruta was indicated and removed them, but the jaundice returning Ignatia was again given, and so the two medicines were taken in alternation, not for two distinct diseases, but for two distinctly different complexity of symptoms of one and the same disease of one patient. In 1822, very few remedies were proved, Dr. Hering had just become acquainted with Homoeopathy and he relates this case as one of alternation and success; the practice of alternating medicines was then scarcely spoken of. Dr. Hering could not have given in this case, Lachesis, which he did not prove until 1833 and was therefore unknown to him in 1822. This is a case of alternating a posteriori, and does not sustain Dr. Drysdale in his efforts to uphold that mongrelism. The quotation of this case does not give color to the habitual practice of alternation common to most physicians calling themselves Homoeopathicians in England, and we must be allowed to
draw the inference from this quotation, and their habits of alternating, that the author and those who sustain him are ignorant of progressive Homoeopathy and are unaware of all the developments following the fundamental ideas since the year 1822; in fact the advocates of indiscriminate alternations of medicines, give full evidence of their lack of” knowledge of our Materia Medica and refute the fundamental principles of the school to which they claim to belong. The appeal of this faction, to statements made in 1822, when Homoeopathy was in its infancy, are only applied to suit their faction's retrogressive assertions, and not to accept the fundamental ideas on which the homoeopathic practice was based then and has developed itself progressively and is still developing new truths. To quote what, since 1822, has been unsaid by the same witness, to accept his passing remark while he had but just become acquainted with Homoeopathy, but ignore what he has said during the forty-two subsequent years, is to say the least, a deplorable resort to perversion and misrepresentation of our cause.
If it even admitted that the alternation a posteriori, is at times, but very seldom, admissible, it will also be acknowledged that this only allowable alternation proves that we have not chosen the only curative remedy for the patient; and we have not chosen it because it was not known to us, and it certainly might not have been known to us as our Materia Medica is far from being complete. The alternation of Medicines can never be excused on the plea that two distinct diseases existed which can never take place; it is in contradiction with true homoeopathic practice as we have nothing to do with diseases or forms of diseases or pathological conditions, as indicating the curative medicine, we have but one patient who is sick, and we prescribe for the patient, not for the disease.
The practice of administering medicines in alternation is wrong, but to alternate Aconite and Belladonna is simply ridiculous, and to substantiate this assertion let us now investigate in what particulars these two remedies are similar and in what they differ, and when you know these differences which, in some instances as under fever, become opposites, it will be an easy task to decide which of the two medicines is homoeopathic in a given case; you will not remain in doubt, nor hesitate, and above all you will never alternate.“
Belladonna has further, a wild, staring look, sparkling, red, glassy eyes, and momentary loss of sight, especially when rising up in bed; and also paralysis of the optic nerve, all symptoms which Aconite has not.
Abdomen. - Both have swelling of the abdomen with tympanitis, and sensitiveness of the abdomen to the touch, but Belladonna alone has painful clawing and tearing in the abdomen. Both have colic from flatulency, but under Belladonna the colon transversum is considerably inflated, is palpable to the touch, and the pain is relieved by stooping and external pressure.
|The American Homoeopathic Review Vol. 04 No. 05, 1864, pages 262-269, pages 309-315
|The Alternation of Aconite and Belladonna
|Aconitum napellus, Belladonna
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