What Is Disease AND How It Can Be Cured ESSAY BY ALCIDES VALDIRI MEDICAE STUDENT PHILADELPHIA George S. Harris & Sons 718-724 Arch Street 1894 What Is Disease AND How It Can Be Cured ESSAY BY ALCIDES VALDIRI MEDICAL STUDENT PHILADELPHIA George S. Harris & Sons 718-724 Arch Street 1894 I have determined upon the publication of the following essay in the hope that those who may consider it of any value, will make use of whatever facts and explanations it may be found to contain, and which may contribute to form a foundation for general rules in the administration of medicines. I. Health is preservea by the will of man, who, in his tendency to be happy, avoids or rejects what he knows to be the cause of pain or of discomfort, and acquires and preserves everything that produces pleasure or makes him feel well. Experience has taught us that by taking a certain amount of food and sleep, keeping the body within certain limits of temperature, taking some exercise avoiding excesses of any kind, respiring, etc., the activity of the functions is kept within limits (variable in different individuals and in different conditions), without causing pain or discomfort and permitting the performance of the functions of relation ; this we call the state of health. When we feel pain or discomfort, or are unable to per- form any particular function or functions, we say we are sick, that is, wTe have lost the state of health. If we have anomalies or lesions in the organs, or alterations of the functions without feeling any trouble we say, or the physician tells us, we are in 3 danger of becoming sick. If we treat those mani- festations it is only for the sake of preventing the discomfort and pain which might otherwise ensue. The disease practically does not exist }ret. 11. So long as we have not an accurate knowledge of the nature of our being we shall find it difficult to comprehend the nature of many diseases. Espe- cially does this apply to inherited diseases. I may say, however, that neither the mind (spirit) nor the becomes sick, it is man who is affected by any disease. It is as incorrect to suppose the body sick as it is untrue that the oxygen of the water is turbid when the latter is so. Disease is practically one or two or all of the following things, viz.: a feeling of discomfort or of pain, or the inability to perform all the functions we are able to accomplish in each individual case. It being primarily due : ist. To the direct effects of a poison or of an influence, as, for instance, cold, hunger, overwork, anger, etc., upon the living organism. 2d. To the reaction (defense) of the latter against the effects of a poison or of an influ- ence, or against the presence of a neutral foreign body, or of a systemic abnormalit}'. The reaction often becomes excessive or is more or less deviated from its useful direction. How could our nature be more intelligent and wiser than ourselves ? 4 Diseases sometimes are aberrations of the physi- cal nature similar to those present in the moral character ; hygiene and force of will directed to the acquirement of good habits and good tenden- cies are more essential in this case than therapeutic treatment. The pathological changes of all kinds, called by some causes of disease, that is of the morbid symp- toms, are effects of the above quoted causes. Mi- crobes are present in our body : ist. When the organism is too weak to destroy them after infec- tion. 2d. When they are the product of a reaction (defense) or of an aberration of the living organ- ism. Diseases in which they are found have then as cause one of the two given above, the microbes, or their products, taking the place of a poison in cause ist. Acute forms of disease which tend to recovery without medical help, and which cannot be stopped in their course are the development of a reaction A common example of disease of this kind is fur- nished by the irritation and fever which follows undue exposure to cold; this is a disease of pure reaction. In zymotic diseases the reaction coexists with the effects of a poison, in traumatism it coexists with the presence of a systemic abnor- mality, etc. 5 The nature of the reaction may be poisonous itself, and its products are always abnormal con- stituents of the organism. As a rule, every disease may be produced in an}' person, provided the dose of poison or the dura- tion of the exposure to the influence is sufficient in each particular case. A short exposure to cold produces a hot reaction and enables to support a severer cold afterwards. A short hot bath gives a better endurance for rude work. In the same manner vaccination prevents small-pox by creating, as after effect, a disease of reaction ; whilst this lasts, the small-pox poison cannot produce its direct effects, unless it is very strong, in relation to the individual; in this case, as it has to overcome the disease of reaction, its direct effects become weaker and so the following reaction or small-pox disease. Persons who take poisons (as cocaine, opium) for feeling their first effects have to increase each following dose, because the next dose has to overcome the reaction caused by the preceding before acting directly. The increase is necessary until a habit is created, that is, until the organism ceases to react. According to the preceding two paragraphs we can prevent disease by creating a reaction opposed in character to the first effects of the poison we wish to make harmless. 6 111. To recover the state of health we must make use of the following facts (besides the mechanical and dietetic requirements) : ist. That any noxious poison may be expelled from or neutralized for the economy, any perni- cious influence may he avoided, any foreign body (bullets, some kind of tumors, etc.) extracted or made inoffensive, and any systemic abnormality corrected if hurtful. 2d. That drugs, and many influences (external and internal, physical and moral), have the power of producing in the living organism (healthy or sick), if accurately applied, the same conditions as are present in any particular disease, or like or opposite to them. 3d. That within variable limits of vitality, no matter how wTe feel, we have the property of react- ing against the direct effect of any drug or influence in a way opposed to it, provided the dose of remedy, or the duration of the exposure to the influence, is sufficient, but not excessive. 4th. That the time for the reaction to appear depends upon the quantity of remedy given. sth. That the direct effects of a remedy may be kept acting constantly for a while by' giving small doses of remedy at short intervals. 7 6th. That out of those variable limits of vitality the direct effects of remedies are not followed by any reactive manifestation in the organism. The economy is then passive, almost like a machine. I shall endeavor to give a classification of dis eases for their treatment Reaction domi- nating : Well di- rected. Aberrant. Ist. Due to poi- son (animal, vegetable, or mineral,) i n the tissues; Without power of reaction (the direct effects of poi- son alone manifesting themselves). Diseases ad. Due to reac- tion (well di- rected or aber- rant) against the presence of: An influence. A foreign body. A systemic abnormality. 3d. Due, after removal of the above inciting causes, to an excess of reaction, the affected sensibility, or a loss of energy. 4th. Due to an aberration of the physical or the moral nature. The general rules for the treatment of an}- dis- ease are as follows : Ist. Remove the inciting cause. 2d. Put the patient in the best available condi- tions (regimen and diet), to enable him to concen- trate all his energy against the morbid condition. 3d. Remove, if present, the condition of no reaction in the economy by using antidotes to the excess of poison, stimulants, and remedies with 8 effects opposed to the conditions to be removed, and drugs or infhiences producing the direct effects we wish to obtain. I shall now take up for consideration the case of a disease due to the presence of poison (animal, vegetable or mineral,) in the economy; When a poison has passed into the tissues its direct effects become mingled with the reaction (defense) of the organism, the morbid symptoms being character- ized by the stronger of the two. It is easy to understand that as long as the poison is there, no cure is possible either of the direct effects or of the cousecjuent reaction. If the direct effects of the poison annihilate the reaction the former must be removed or neutralized for the economy. If the reaction is the strongest it tends to expel or neu- tralize the poison, and the curative measures must help the organism in that direction. If the reac- tion is well directed, by increasing it (by giving a remedy which produces the same or like symptoms as present), and keeping it increased (by repetition of small doses of remedy at short intervals), the defensive power is augmented, and the cause and effects of the disease may be very soon destroyed. If the reaction is aberrant the poison must be expelled from the economy or neutralized for it. After the poison has been removed the task con- sists in curing any excess of reaction, or the results 9 of the loss of energy, or the consequences of the affected sensibility; here we have to deal with a disease of pure reaction. This kind of diseases must be cured by giving a remedy of similar direct effects upon the economy ; the agency first increases the symptoms, then the reaction of the organism tends to diminish them. (See facts ad and 3d). A small dose must be repeated at sufficiently long intervals to allow the organism to react. For the same symptoms the same must be given until the patient feels well steadily. A small dose permits the reaction to manifest itself quickly. A large dose (in rela- tion to the sensibility of the patient) of analogous remedy could create such an aggravation that the reaction would become impossible, or be a weak and slow one. An aggravation produced by an overdose of similar remedy requires for its cure the same, or a like agency, in much smaller dose, provided the patient has not been brought out of the limits of reaction. Here we obtain the expla- nation of the fact that smaller doses of remedy (high potencies of the homoepaths) antedote larger ones. The practice of applying remedies opposed to a reactionary morbid condition is uncertain of its good effects. A large dose (in relation to the indi- vidual) of opposed remedy will first destroy the 10 morbid symptoms, then it may produce seme of its direct effects and inhibit the reaction for a while. When this appears it is characterized by manifestations like to those it was intended to cure, though they may be altered in some way by the reaction against new effects brought on by the remedy. A small dose of the same remedy may, if not capable of overpowering the disease of reac- tion, increase its manifestations. It is very difficult to recommend a dose of remedy which will defeat the morbid symptoms in any case without creating a reaction anew; this is due to the variations in the sensibility of different (typical) individuals, and in the same person in different conditions. When the living organism is out of the limits of reactionary power the application of similar reme- dies in large doses would be harmful, an increase in strength of the symptoms being produced with- out the salutary reaction following. Small doses may have no effect at all. When it is obvious that the power of reaction has ceased, or when indicated, similar remedies have been given without success, we must apply a medicine (drug or influence) known by experience to produce in the living economy effects opposed to those to be removed, or such as we wish to obtain. The best way to procure the direct effects of remedies (drugs or influences) consists in testing each of them in healthy typical persons. Drugs must be given in large doses in order to observe their direct effects without admixture of reactive manifestation. As stated before, small doses allow a quick manifestation of the reaction ; if, to a morbid condition, we apply a remedy known to bring on reactionary effects (after-effects), like to those of the disease, we apply an opposed remedy. It must not be forgotten that effects and after-effects may be different, and even opposed in different (typical) persons. It is not of great importance to know how the effects of remedies are produced in us for the prac- tical treatment of disease. Remedies have not a mysterious curative action. Diseases due to an aberration of the physical or moral nature require, as said before, besides a remedy, good moral training, hygiene, and force of will in the patient directed towards the acquire- ment of good habits and good tendencies. I hope to be able, in due time, to publish some very important facts in connection with the fore- going. Philadelphia, April, 1894 12