Ribs in the head
All in all there has been quite a lot of eye-rolling in my immediate vicinity down the years, just outside my line of sight, or just within it when people have underestimated my peripheral vision. Most of the useful information I have gathered has reached me out of the tail of my eye.
With Alan I found myself talking about homœopathy. As a medical student, he was biased against therapies not based on the Western tradition, but he wasn’t entirely opposed to new ideas. His mind was neither open nor shut, but ajar. I argued that homœopathy was a Western tradition in itself.
I emphasised that homœopathy individuates, taking each person as a separate unit, while conventional science generalises and expects the same results to hold for everyone. Alan was intrigued by the unimportance in homœopathy of theory without result, its sheer practicality as a set of techniques.
As always when homœopathy was the subject in those years, I was at least partly thinking about something else. Similes similibus amentur, if you like. I had heard of something called the Gay Liberation Front, which sounded angry rather than loving, and in any case hadn’t yet forced itself on my attention in the university or the town.
I asked Alan if he knew the story of the 1854 cholera epidemic in London. ‘Bloody hell, John,’ he said. ‘I am a medical student, you know. I know a little bit about the history of diseases and a few things about the human body. This is my third year of study, so I even know that the ribs aren’t located in the head.’ I rather enjoyed being on the receiving end of some sarcasm. It gingered me up. Normally people get rather mealy-mouthed in my vicinity. ‘So if you’re referring to the discovery of the water-borne transmission of cholera, and how the doughty John Snow saved lives in Soho by taking the handle off the Broad Street pump, then yes, I know the story of the 1854 cholera epidemic.’
He had taken the bait. ‘Then you know about the report on the epidemic prepared for Parliament by the Board of Health.’
‘What about it?’
‘The exclusion from it of the data from the Homœopathic Hospital in Golden Square, which was in the middle of the outbreak.’ After my visit to Great Ormond Street I had discovered that it wasn’t the original London base of homœopathy.
He went rather quiet. ‘I’m a little vague about that. Remind me.’
‘The Homœopathic Hospital gave the information as requested — names and addresses of patients, symptoms, remedies and results. The whole hospital had been given over to victims of the epidemic. Out of 61 cases of cholera, 10 died — a mortality of 16.4 %. At the Middlesex Hospital nearby, 123 died out of 231. A mortality of over 50 %. Under protest the Board of Health released these figures, which had been kept out of the original tally.’
‘Did they say why they had suppressed them in the first place?’
‘Oh yes. First because they were so out of keeping with the other results that they would have distorted the findings. Second because they didn’t want to lend support to “empirical practice”. You weren’t supposed to cure illness without understanding its causes, and in homœopathy you just pay attention to symptoms and deal with those. Hahnemann himself, the chap who invented the system in the first place, came up with a therapy for cholera without seeing a single case, from the symptoms described by colleagues. Treatment without formal diagnosis is intolerable to the medical establishment which you’re so keen on joining. Better to let people die than have cures that don’t obey the formalities. But perhaps John Snow wasn’t the only one saving lives in Soho that year.’
‘Is this all on the record, John? I’d hate you to be pulling my leg.’
‘I can’t reach your leg. And yes, it’s on the record. Will Hansard do? I’m afraid I don’t have the exact references.’
‘I’ll manage.’
I’m sure I would have heard about it if Alan’s researches hadn’t corroborated what I had told him. His attitude towards homœopathy slowly changed. Soon he was saying that if I gave him a prescription he would take it with an open mind. I said that it would only be a fair test if some symptom was troubling him. Perhaps there was?
The mother tongue of the placebo
Apparently so. At least there was a physical condition, too trivial to be taken to the doctor, which could be examined for experimental purposes. The matter was intimate enough for him to deliver me back to A6 Kenny so that he could make his confession. It turned out that Alan was troubled by copious sweating under the arms, even in winter, and by an accompanying animal odour. In short, B.O.
He had an exaggerated idea of his case. I was well placed, after all, while he was labouring up and down steps with me, to detect any offensive aroma. He smelled like an animal, yes, of course, but only because he was one. He smelled clean, he smelled warm and alive. Barry, on the other hand, the botanist who had been a whiffy basidiomycetous saprophytic fungus in a (recent) previous life, would never be able to detect his own aroma, any more than saints can see their own haloes.
I didn’t have to work very hard to select a remedy for Alan. There’s a passage of Magic of the Minimum Dose — from which I had been freely quoting, of course, preaching in borrowed robes — which describes just such a case. I knew I should ask a full set of questions, but on this occasion I went by hunch. Chronic issues require particular attention to the Mind section, and I let myself be guided by my impressions (Nervous and excitable / ‘Brain-fag’ / Abstracted / Fixed Ideas).
I took out an empty notebook and wrote For Overactive Sweat Glands in Young Adult Male — Silicea 200 on the first page. Then I wrote Alan Linton / signetur 1/1 silicea c200 / x3 gutt. sub linguam on a label and attached it to a vial that had come with my starter kit of remedies. I enjoyed the paperwork for once, or more exactly the methodical feeling that comes from separating and labelling, even if there was an element of the rough and ready about my Latin. Nobody really reads the Latin — I could have written lingam for linguam without making any difference to Alan — but it massively reinforces the psychological effect. Slightly bogus Latin is the mother tongue of the placebo.
When I saw him next, Alan told me that from the first moment he held the pillule on his tongue he could feel it taking effect. His sweating moderated and any odour dissipated in a few days. Certainly his self-consciousness about it rapidly became a thing of the past. Of course homœopathy normally brings about improvements over a longer period of time, but rapid cures are not unknown. One of the great virtues of the method, in fact, is that it doesn’t persist with remedies that are proving ineffective. Not for the homœopath the GP’s reflex of the repeat prescription, the increased dosage. If it doesn’t make a difference at the first attempt, you stop and try something else.
‘What did I tell you?’ I crowed. Despite this I was astounded by the success of my first attempt at prescription. What had I told him, after all? Nothing that I really knew about. Could the whole pretty system possibly work?
From that moment on, Alan Linton was a believer, verging on zealotry. He started borrowing what books I had on the subject, but he soon exhausted my modest library and started researching on his own account. To some extent this played into my hands. I was someone, after all, who had special borrowing privileges from the University Library, but found it impossible to consult the catalogue so as to order books. Alan on the other hand could only consult the UL’s holdings, not take them away, but was easily able to do the legwork. So it was agreed. He would use the catalogue for me, and I would borrow books for him.